Internal medicine journal
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Internal medicine journal · Nov 2010
Comparative StudyReferral patterns to a palliative care service in rural Australia servicing indigenous Australians.
Territory palliative care (TPC) of the Northern Territory covers a population of 150000 over 400000 km² in urban, rural and remote settings. Thirty-two per cent of the population are indigenous Australians. There is little documentation of palliative services to the indigenous Australians. ⋯ These data showed major differences from the largest Australian study published so far, based on a population of predominantly non-indigenous Australians. This study identifies for the first time how TPC needs to have an encompassing service plan and delivery model to cater for indigenous patients and people in remote locations.
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Internal medicine journal · Nov 2010
Multicenter Study Comparative StudyExploratory study of the 'weekend effect' for acute medical admissions to public hospitals in Queensland, Australia.
To determine whether in-hospital deaths of patients admitted through emergency departments with acute exacerbations of chronic obstructive pulmonary disease (COPD), acute myocardial infarction, intracerebral haemorrhage and acute hip fracture are increased by weekend versus weekday admission (the 'weekend effect'). ⋯ This is the first Australian study on the 'weekend effect' (in a cohort other than neonates), and the first study worldwide to assess specifically the weekend effect among COPD patients. Observed patterns were consistent with overseas research. There was a significant weekend effect for myocardial infarction. Further research is needed to determine whether location (e.g. rural), clinical (e.g. disease severity) and service provision factors (e.g. access to invasive procedures) influence the weekend effect for acute medical conditions in Australia.
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Internal medicine journal · Nov 2010
Comparative StudyImpact of troponin 1 on long-term mortality after emergency orthopaedic surgery in older patients.
To determine the association between post-operative troponin rises and longer term (2-year) mortality after emergency orthopaedic surgery in patients over 60 years of age. ⋯ Elevated post-operative troponin levels are predictive of 1-year but not 2-year mortality in older patients undergoing emergency orthopaedic surgery.
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Internal medicine journal · Nov 2010
Comparative StudyScreening for hepatitis B in East Arnhem Land: a high prevalence of chronic infection despite incomplete screening.
Infection with hepatitis B virus (HBV) is common in Aboriginal Australians, but current seroprevalences in Northern Territory communities are unknown. We performed an audit of HBV serology on a convenience sample of 112 adults at an East Arnhem Land Health Service. ⋯ Evidence of HBV exposure (core antibody-positive) was found in 43 of 68 (63%) patients tested, and current HBV infection (surface antigen-positive) was found in nine of 76 (12%). HBV is an incompletely defined, under-resourced and substantial public health problem in Aboriginal Australians.