The Medical journal of Australia
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The Australian Government has committed to reducing Indigenous disadvantage, including closing the life-expectancy gap within a generation, and to halving the gap in mortality rates for children under 5 years of age within a decade. Sixty per cent of the health gap between Indigenous and non-Indigenous Australians is attributable to the health of Indigenous people living in non-remote areas of Australia. ⋯ Although Indigenous Australians living in remote areas experience greater health disparity, the government will not achieve its aims without paying due attention to the non-remote-living population. More research is required, and particularly research that actually tests the impact of policies and programs.
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Comparative Study
Haemodialysis outcomes of Aboriginal and Torres Strait Islander patients of remote Kimberley region origin.
To compare the clinical outcomes and mortality rates of Aboriginal and Torres Strait Islander people of Kimberley origin receiving haemodialysis (HD) treatment with other subsets of Aboriginal and Torres Strait Islander HD patients (Northern Territory, Western Australia excluding the Kimberley region, the rest of Australia) and Australian non-Indigenous HD patients. ⋯ This is the first report showing similar mortality rates for Aboriginal and Torres Strait Islander people exclusively from a remote area of Australia and non-Indigenous Australians receiving HD treatment. HD treatment delivered closer to home can be safe and effective in remote areas.
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To describe the contemporary management and outcomes of patients presenting with ST-segment-elevation myocardial infarction (STEMI) in Australia. ⋯ Timely reperfusion, not the modality of reperfusion, was associated with significant outcome benefits. Australian use of timely or any reperfusion remains poor and incomplete.
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To determine whether changes in 24-hour average background ozone (O₃), nitrogen dioxide (NO₂), carbon monoxide (CO) and particulates < 10 μm (PM₁₀) increase the risk of hospital emergency department (ED) presentations for asthma among children. ⋯ The effect sizes observed in this study were higher than those of past studies, and indicated that children aged 0-4 years were the most vulnerable to the effects of air pollution. The period of exposure most clinically relevant is the day before ED presentation.
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Case Reports
Community-acquired Klebsiella pneumoniae liver abscesses - an "emerging disease" in Australia.
Liver abscess due to Klebsiella pneumoniae infection has been widely reported in Asia, but rarely reported in Australia until now. We describe four previously well Asian-born patients who presented across Australia with community-acquired K. pneumoniae liver abscesses. With prompt recognition, appropriate antibiotics and early drainage, outcome is significantly improved, although vigilance for metastatic complications is essential.