Internal medicine journal
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Internal medicine journal · Jan 2025
Rationale, objectives and design of a national prospective database for idiopathic inflammatory myopathies: the Australian Myositis Registry.
Idiopathic inflammatory myopathies (IIMs) are a group of autoimmune diseases characterised by inflammation of skeletal muscle and other organ systems. They have high morbidity and mortality but, in part because of their rarity and heterogeneity, improving understanding and outcomes remains challenging. To address these problems, numerous IIM registries exist globally, but no national registry yet exists in Australia. ⋯ The AMR is the first nationwide registry in Australia for patients with IIMs and one of the very few national registries for IIMs globally. It aims to provide valuable insight into the epidemiology and clinical experience of IIMs in Australia to help address multiple research agendas.
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Cytomegalovirus (CMV) infections continue to be associated with significant morbidity and mortality following solid organ transplantation and haemopoietic stem cell transplantation. Advances in understanding the biology of CMV in the immunosuppressed host will translate into improved management approaches and better clinical outcomes. Updated definitions of resistant and refractory CMV infections will lead to more consistent reporting of CMV outcomes, better inform appropriate antiviral strategies and influence clinical trial design. ⋯ As the boundaries of transplantation are extended, new patterns of CMV infection are being recognised. Finally, recent studies support the use of novel antiviral therapies in transplant recipients in the appropriate clinical setting. In this review, we provide an update on important new and emerging concepts in the management of CMV in immunosuppressed transplant recipients.
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Internal medicine journal · Jan 2025
Observational StudyA retrospective examination of risk factors for central line-associated bloodstream infections in home parenteral nutrition patients from a Queensland tertiary hospital.
Central line-associated bloodstream infections (CLABSIs) are a potential complication for home parenteral nutrition (HPN) patients. ⋯ In this cohort of patients, regular opioid use was associated with increased risk of developing CLABSI. Based on our findings, an empiric antimicrobial regime of vancomycin, cefepime and caspofungin will provide adequate coverage for most HPN-related CLABSIs in Australian IF units with a similar antimicrobial distribution and resistance pattern.
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Internal medicine journal · Jan 2025
Impact of Karnofsky performance status on outcomes of patients with severe alcohol-associated hepatitis: a propensity-matched analysis.
Severity scores, including the model for end-stage liver disease (MELD) and discriminant function score, guide the treatment of patients with severe alcohol-associated hepatitis (AH). We aimed to investigate the impact of functional status on outcomes of patients with AH. ⋯ KPS is an important determinant of outcomes in patients with AH, including survival, recompensation, response to corticosteroids and complications.