Internal medicine journal
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Cannabis has been used as a medicine for millennia. Prohibition in the mid-20th century precluded early scientific investigation. 'Cannabis' describes three separate forms - herbal cannabis, 'hemp' products, pharmaceutical-grade regulated cannabinoid-based medical products (CBMP). In Australia, CBMP became available for prescription in November 2016. ⋯ CBMP are well tolerated with few serious adverse events. Additional clinical benefits are promising in many other resistant chronic conditions. Pharmaceutical grade prescribed CBMP has proven clinical benefits and provides another clinical option in the physician's pharmacopeia.
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Internal medicine journal · Nov 2020
Can a liveable city be a healthy city, now and into the future?
City planning and infrastructure can influence the social determinants of health, the liveability of cities and the physical and mental health of city residents. This article defines these concepts and discusses how city planning can help in mitigating COVID-19 transmission, and support health by accommodating active transport (i.e. walking and cycling) and emerging technologies (i.e. autonomous and electric vehicles).
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Internal medicine journal · Nov 2020
Effectiveness of epoprostenol in the management of pulmonary arterial hypertension: findings of an Australian retrospective chart review.
Pulmonary arterial hypertension (PAH) is a progressively fatal disease. Parenteral prostanoids, including intravenous (IV) epoprostenol, are the most effective therapies for PAH. As epoprostenol requires continuous infusion, therapy is challenging and use is managed by specialist units. ⋯ Epoprostenol therapy was associated with impressive survival rates and durable improvements in functional outcomes. Epoprostenol therapy is challenging; however, it is manageable by the majority of patients with most experiencing positive, sustainable outcomes.
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Internal medicine journal · Nov 2020
Goals of care conversations and documentation in patients triggering medical emergency team calls.
It is widely accepted that early discussions about goals of care (GOC) should occur during a hospital admission. Whilst rapid response systems such as Medical Emergency Team (MET) calls were designed to identify patients at risk of deterioration early enough in their illness to intervene, it is becoming apparent that these teams frequently diagnose the dying patient. ⋯ This audit confirms that documentation surrounding GOC is inadequate, and that at 9% of MET calls, MET doctors are involved in discussions surrounding treatment limitations. This suggests that further education and training is required for doctors working in inpatient care, including those who staff the MET.
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Internal medicine journal · Nov 2020
Testicular cancer: a 13-year retrospective review of ethnic disparities in the Waikato region, New Zealand.
The testicular cancer incidence in New Zealand is rising. We evaluated if testicular cancer outcomes differed by ethnicity in NZ. ⋯ Māori patients were younger at diagnosis of testicular cancer and presented with more advanced non-seminoma testicular tumours compared with non-Māori but survival was comparable.