Internal medicine journal
-
Internal medicine journal · Dec 2024
ReviewThe heart of the matter: a re-iteration of the role of the social determinants of health in addressing health inequity in Central Australia.
The persisting life-expectancy 'gap' between First Nations and non-First Nations Australians is fundamentally driven by the social determinants of health. These include income and social protection, access to adequate housing and food security, among others. These factors are particularly prominent in Central Australia. ⋯ Food insecurity and inadequate social protection manifesting as energy insecurity result in inadequate nutrition and have resulted in a huge burden of diabetes in Central Australia. These factors, combined with social exclusion, racism and the pervasive effect of colonisation, also drive a high rate of alcohol misuse. Only by prioritising equity in these 'social determinants' and emphasising the importance of First Nations leadership in formulating and implementing solutions will health inequity be addressed.
-
Internal medicine journal · Dec 2024
Comparative StudyTreatment outcomes of mild to moderate Clostridioides difficile infection in inflammatory bowel disease: an Australian experience.
The incidence of Clostridioides difficile infection (CDI) in inflammatory bowel disease (IBD) is rising and associated with adverse outcomes. Optimal treatment for CDI in IBD remains unknown, with various organisations suggesting vancomycin as first-line therapy. ⋯ Metronidazole compared to vancomycin for treatment of mild to moderate CDI in IBD is effective however may be associated with higher rates of treatment failure.
-
Internal medicine journal · Dec 2024
Historical ArticleBlack-and-white pepper: unravelling Cruella De Vil's medical diagnoses.
Cruella De Vil, the iconic character from Dodie Smith's novel The Hundred and One Dalmatians, was traditionally viewed through a psychodynamic lens as a figure embodying narcissistic personality disorder, psychosis and mania. In this article, we propose an alternative hypothesis that her erratic behaviour and distinctive physical appearance may be attributed to a chronic systemic condition.
-
Internal medicine journal · Dec 2024
Randomized Controlled Trial Multicenter StudyVitamin D status and intermediate vascular and bone outcomes in chronic kidney disease: a secondary post hoc analysis of IMPROVE-CKD.
Cardiovascular disease is the leading cause of death in patients with chronic kidney disease (CKD) and has been associated with abnormalities of mineral metabolism and vascular calcification. Vitamin D influences parathyroid hormone values and calcium and phosphate metabolism, and may play a role in vascular function and bone health. We aimed to test our hypothesis that vitamin D deficiency is associated with arterial stiffness, aortic calcification and lower bone mineral density (BMD) in patients with CKD. ⋯ Baseline 25(OH)D levels were not associated with intermediate markers of vascular function and BMD in patients with CKD stages 3b and 4.
-
Internal medicine journal · Dec 2024
ReviewPulmonary arterial hypertension: updates and perspective with newer therapies.
Pulmonary arterial hypertension (PAH) is a rare condition for which a remarkable change has been witnessed in the epidemiology, assessment and treatment landscape over the last three decades. Well-established registries from the Western world have not only highlighted the shift in the epidemiology to an older, more comorbid cohort but have also identified markers of prognosis that have been validated as part of risk stratification scores in multiple cohorts. The emphasis on early identification through a systematic assessment pathway and the option of upfront combination therapy with serial risk stratification assessment has laid the foundation for the standard of care and improved prognosis. This review provides an update on the assessment and newer therapies for PAH.