The Medical journal of Australia
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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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Comparative Study
Current use of Australian snake antivenoms and frequency of immediate-type hypersensitivity reactions and anaphylaxis.
To investigate current use of Australian snake antivenoms and the frequency and severity of immediate-type hypersensitivity reactions. ⋯ Antivenom was used appropriately, and most commonly for coagulopathy. Hypersensitivity reactions were common, but most were not severe. The discretionary use of premedication was not associated with any reduction in reactions.
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Comparative Study
Bystander basic life support: an important link in the chain of survival for children suffering a drowning or near-drowning episode.
Eight children suffered drowning or near-drowning in Sydney pools over an 11-day period in January 2007. Four received basic life support (BLS) within 5 minutes of immersion and survived with good functional neurological outcomes. The other four were not discovered for >or= 5 minutes and all died. This cluster serves as a reminder that timely effective bystander BLS is crucial to survival and good clinical outcomes in near-drowning episodes.
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To review the effectiveness of chronic disease management interventions for physical health problems in the primary care setting, and to identify policy options for implementing successful interventions in Australian primary care. ⋯ The Chronic Care Model provides a useful framework for understanding the impact of chronic disease management interventions and highlights the gaps in evidence. Consultation with stakeholders and policymakers is valuable in shaping policy options to support the implementation of the National Chronic Disease Strategy in primary care.
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Comparative Study
Impact of specialty on attitudes of Australian medical practitioners to end-of-life decisions.
To compare attitudes and practices of Australian medical practitioners, by specialty, to a range of medical decisions at the end of life. ⋯ Perceptions about the causation of death and aspects of medical culture appear to influence physicians' attitudes towards medical decisions at the end of life. Our findings have implications for medical education, interprofessional communication and discussion between the medical profession and the community.