Internal medicine journal
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Internal medicine journal · Jan 2025
Results of an Australian trial of an automated insulin delivery (AID) system and other studies support likely benefit of AID use for many Australian adults with type 1 diabetes.
Less than 20% of Australians with type 1 diabetes (T1D) meet recommended glucose targets. Technology use is associated with better glycaemia, with the most advanced being automated insulin delivery (AID) systems, which are now recommended as gold-standard T1D care. ⋯ Insulin pumps are not subsidised for most Australian adults with T1D. We advocate change.
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Internal medicine journal · Jan 2025
Case ReportsMuscular dystrophy as a cause of unilateral scapular winging.
Shoulder weakness with unilateral scapular winging is a common issue that initially presents to the general physician, sports physician or rheumatologist. Although most of these cases are neurogenic in nature, it is important to consider alternative causes for unilateral scapular winging. Muscular dystrophies can present with marked asymmetry, the most typical being facioscapulohumeral dystrophy (FSHD). We describe a case of FSHD with a summary of the key clinical features to increase the awareness of this condition among physicians.
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Internal medicine journal · Jan 2025
Uptake of gonadotrophin-releasing hormone agonists for prevention of premature ovarian insufficiency in women undergoing chemotherapy: an Australian single-centre study.
Treatment-related premature ovarian insufficiency (POI) can result in early-onset menopause and infertility. ⋯ One-quarter of eligible patients did not have a documented discussion regarding goserelin, despite the negative consequences of POI. Efforts are needed to increase the discussion and use of goserelin in all premenopausal women regardless of their fertility interests and to ensure timely administration in those who choose to receive it.
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Internal medicine journal · Jan 2025
Predictive value of urine microscopy and urine culture in bacteraemic adults without localising urinary features.
Urine microscopy (UM) and urine culture (UC) are used in bacteraemic patients to identify a urinary focus of infection. However, their positive and negative predictive values (PPV and NPV) in patients without localising urinary features are uncertain. ⋯ bUTI without localising urinary features is common. In bacteraemia of unclear focus, UM/UC has a high NPV for excluding bUTI, although PPV is limited and non-urinary foci require consideration despite a positive result. UM/UC is low yield in those with a suspected non-urinary focus of infection.
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Internal medicine journal · Jan 2025
Bacteraemia over 4 years in a Greater Western Sydney Metropolitan Local Health District: a retrospective descriptive study.
Bacteraemia is associated with significant morbidity and mortality. Understanding local patterns of bacteraemia including pathogen distribution, infection source, clinical speciality team burden, susceptibility data and mortality rates can inform empiric antibiotic choices, prevention approaches and education strategies. ⋯ This study provides valuable insight into the local epidemiology of bacteraemia, which will allow for targeted prevention, management and educational strategies to improve outcomes.