Internal medicine journal
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Internal medicine journal · Feb 2025
Multicenter StudyPatients with functional gastrointestinal disorders spend less time in tertiary care when managed by a single clinician: results of a multicentre audit in South Australia.
Functional gastrointestinal disorders (FGIDs) impact quality of life and represent a significant burden on healthcare services. Guidelines recommend an early, positive diagnosis to reduce harmful over-investigation in FGID patients. The aim of this multicentre study was to evaluate FGID management against current guidelines. ⋯ Consistent delivery of clinical care reduces healthcare utilisation in the management of FGIDs. Further studies are needed to identify optimal care models for managing outpatients with FGIDs.
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Internal medicine journal · Feb 2025
Multicenter StudyPrevalence of heart failure pharmacotherapy utilisation, frailty and adverse drug events among hospitalised adults older than 75 years: a multicentre cross-sectional study.
Optimal heart failure (HF) pharmacotherapy (guideline-directed medical therapy and diuretics) in older people with frailty is uncertain due to limited evidence. ⋯ Frailty, HF-pharmacotherapy changes in hospital and ADEs were common among older inpatients with HF. The association of adverse outcomes according to frailty needs further investigation. Poor documentation of HF phenotype may be a barrier to medication optimisation in older inpatients.
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Internal medicine journal · Feb 2025
Multicenter StudyCharacteristics and management of eosinophilic esophagitis in Australasian children: a decade of experience.
The frequency of EoE has been increasing in Northern Hemisphere cohorts, yet there is a scarcity of data in our region. Regional climatic factors, and lifestyle habits may influence the presentation of EoE, and appropriate management is crucial to prevent complications. WIth this is mind we undertook the first comprehensive multisite study of EoE in Australasian children. ⋯ The prevalence of EoE in Australasian children is comparable to that observed elsewhere, and the incidence is increasing significantly. Regional differences in disease frequency, management practices and access to endoscopy warrant further study.
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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.
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Internal medicine journal · Nov 2024
Multicenter Study6-Thioguanine nucleotide levels are associated with infliximab but not adalimumab levels in inflammatory bowel disease patients on combination therapy.
Thiopurine co-therapy with anti-tumour necrosis factor-alpha (anti-TNFα) agents is associated with higher anti-TNFα drug levels and reduced immunogenicity in inflammatory bowel disease (IBD). ⋯ 6-TGN levels were weakly associated with infliximab but not adalimumab levels in combination therapy. 6-TGN levels in the lower end of the therapeutic range (230-260 pmol/8 × 108 RBC) may be adequate to maintain higher infliximab levels, particularly with escalated infliximab dosing.