Internal medicine journal
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Internal medicine journal · Sep 2012
Palliative care for patients with chronic obstructive pulmonary disease: exploring the landscape.
Patients with chronic obstructive pulmonary disease experience a substantial symptom burden, high levels of psychosocial need and significant mortality. This epidemiological study reveals that the majority of patients are cared for in the public hospital system (64%) and generally die in hospital (72%) with a number of identifiable predictors of 6-month mortality. Our results suggest that palliative care services need to be redirected from a community-based admission focus to a model that is responsive to emergency and acute care hospital systems.
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Internal medicine journal · Sep 2012
Rheumatic heart disease in pregnancy: cardiac and obstetric outcomes.
Rheumatic heart disease (RHD) remains an important health issue for indigenous women of child-bearing age in northern Australia. However, the influence of RHD on maternal outcomes with current clinical practice is unclear. ⋯ RHD has a major impact on maternal cardiac outcomes. However, with current management practices, maternal and fetal mortality are low, and the incidence of complications is predictable based on known risk factors.
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Internal medicine journal · Sep 2012
ReviewSystematic review of the prevalence of gout and hyperuricaemia in Australia.
Gout is a growing health problem worldwide especially in affluent countries, such as Australia. Gout and hyperuricaemia are associated with the metabolic syndrome, diabetes mellitus, obesity and hypertension. More importantly, Australia has a growing prevalence of these important health problems. The aim of this study was to systematically review published information regarding the prevalence of gout and hyperuricaemia in Australia. ⋯ The rate of gout and hyperuricaemia in Australia is high in relation to comparable countries and is increasing. The prevalence of gout in elderly male Australians is second only to New Zealand, which has the highest reported rate in the world. Further research on Aboriginal and Torres Strait Islander gout and hyperuricaemia is required as a result of the lack of contemporary data.
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Internal medicine journal · Sep 2012
Retinal vascular caliber and metabolic syndrome in a Chinese population.
Microvascular changes have been associated with the metabolic syndrome. ⋯ Retinal arteriolar narrowing and, to a lesser extent, retinal venular dilatation were associated with metabolic syndrome in this Chinese population. These vascular changes, although small in magnitude, may still be important in the pathophysiological mechanisms involved in the metabolic syndrome.
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Thirty-one umbilical cord blood transplants performed in Western Australia were retrospectively examined in order to document local experience and relevant prognostic factors. Three cord units were from human leucocyte antigen-matched siblings and the remainder were unrelated single (n= 22) or double (n= 6) cord blood transplants. ⋯ Cord blood transplantation for malignant and non-malignant disease is practised in Western Australia and outcomes are satisfactory. Trends and techniques in cord blood transplantation in this state are comparable with those observed nationally and overseas. Although numbers are small, cell dose appears to be predictive of overall survival