The Medical journal of Australia
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Multicenter Study Comparative Study
Unplanned admissions to two Sydney public hospitals after naltrexone implants.
To describe hospital presentations related to the use of naltrexone implants, an unlicensed product used in Australia for treating heroin dependence. ⋯ These severe adverse events challenge the notion that naltrexone implants are a safe procedure and suggest a need for careful case selection and clinical management, and for closer regulatory monitoring to protect this marginalised and vulnerable population.
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Review Meta Analysis
Models of chronic disease management in primary care for patients with mild-to-moderate asthma or COPD: a narrative review.
To review the literature for any promising strategies for the primary care management of mild-to-moderate asthma and chronic obstructive pulmonary disease (COPD) in adults. ⋯ The role of primary health care in management of mild-to-moderate asthma and COPD requires further investigation using randomised controlled trials.
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Comparative Study
Metformin and lactic acidosis in an Australian community setting: the Fremantle Diabetes Study.
To determine the incidence of lactic acidosis in community-based patients with type 2 diabetes, with special reference to metformin therapy. ⋯ The incidence of lactic acidosis in patients with type 2 diabetes is low but increases with age and duration of diabetes, as cardiovascular and renal causes become more prevalent. Metformin does not increase the risk of lactic acidosis, even when other recognised precipitants are present.
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To identify sustainable governance arrangements for health care organisations undertaking integrated health service delivery based on best available evidence. ⋯ State governments are increasingly attempting to work with non-government organisations and the private sector to maximise scarce resources in the face of increasing health care demand. Ambitious integration agendas must be underpinned by effective governance mechanisms that are appropriate to the undertaking, the stakeholders involved and the scale of delivery.