Internal medicine journal
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Internal medicine journal · Oct 2024
Black-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.
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Internal medicine journal · Oct 2024
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.
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Internal medicine journal · Oct 2024
The 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.
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Internal medicine journal · Oct 2024
Development and validation of a predictive scoring system for hypoglycaemic agents for optimal control of blood glucose during glucocorticoid therapy.
Glucocorticoid (GC) treatments are often used. There is limited information on the prediction of hyperglycaemia after GC administration. ⋯ This scoring system is a novel, valid and reliable tool for predicting GC-induced hyperglycaemia and the need for hypoglycaemic agents to correct it.
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Internal medicine journal · Oct 2024
Pulmonary 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.