Internal medicine journal
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Internal medicine journal · Jan 2025
Evaluation of preventive medicine amongst people living with human immunodeficiency virus attending a hospital-based care setting.
With improved outcomes in human immunodeficiency virus (HIV) due to the use of anti-retroviral therapy, ensuring adequate preventative healthcare and management of HIV-related comorbidities is essential. ⋯ There is a disparity amongst comorbidity screening and documentation of vaccination status. Further measures are required to target improvements in immunisation, bone health, substance misuse and cognitive impairment screening.
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Internal medicine journal · Jan 2025
Impact of a multidisciplinary diabetes care programme on glycaemic and metabolic outcomes in regional and First Nations communities: a retrospective observational study.
Type 2 diabetes mellitus (T2DM) poses a significant public health challenge in Australia, particularly among underserved populations such as First Nations people and rural communities. In response, the Together Strong Connected Care (TSCC) programme was developed to address these disparities by offering a culturally appropriate, multidisciplinary approach to diabetes management in a regional hospital setting. ⋯ The TSCC programme significantly improved glycaemic control in regional First Nations patients, supporting the effectiveness of culturally appropriate, multidisciplinary care models in managing diabetes in underserved communities. Further research is warranted to evaluate long-term outcomes of similar interventions.
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Internal medicine journal · Jan 2025
Severe sepsis-associated acute kidney injury and outcomes: a longitudinal cohort study.
Sepsis-associated acute kidney injury (SA-AKI) is common among patients admitted to the intensive care unit (ICU) with sepsis. ⋯ These results demonstrate an association between an index episode involving SA-AKI and the composite outcome in a defined population. Identification of this group may allow intensive nephrology follow-up and secondary prevention with the goal of mitigating the risk of progression of disease with significant economic and personal benefits.
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Internal medicine journal · Jan 2025
Are we disadvantaging smokers by excluding them from kidney transplantation? A single-centre experience and survey of kidney transplantation units.
Smoking has been shown to have detrimental effects on KT outcomes and survival. Most units and guidelines advocate for the cessation of smoking prior to a kidney transplant and consider it a general contraindication to listing. Smoking prevalence is higher in disadvantaged groups. Smoking cessation is complex and often takes many years. For those suffering from the burden of chronic kidney disease, a delay in transplantation with a longer dialysis time may result in worse outcomes and accentuate the difficulty of cessation. ⋯ Patients not listed for KT due to smoking are generally younger and less comorbid than those not listed for other reasons. Our survey shows variation in practice between units. As smoking is more prevalent in marginalised communities, not listing these patients for KT may be an equity-of-access-to-treatment issue.
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Internal medicine journal · Jan 2025
Impact of distance from liver transplant centre on outcomes following liver transplantation: an Australian single-centre study.
Access to liver transplantation (LT) is affected by geographic disparities. Higher waitlist mortality is observed in patients residing farther from LT centres, but the impact of distance on post-LT outcomes is unclear. ⋯ In our single-centre Australian study, patients living farther from their LT centre had different demographics. Distance from the LT centre was not associated with long-term inferior graft or patient survival after LT.