Internal medicine journal
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Internal medicine journal · Oct 2021
Aspirin and preeclampsia prevention in women with pre-existing diabetes: a retrospective study.
Aspirin is routinely prescribed in high-risk pregnancies to prevent pre-eclampsia; however, there is a paucity of data in women with pre-existing diabetes. ⋯ The aspirin group had a higher baseline risk of pre-eclampsia and placental insufficiency, therefore the absence of difference between the groups favoured the efficacy of aspirin. PPH was highlighted as a potential complication of therapy, and early pregnancy HbA1c as a novel risk stratification tool for pre-eclampsia in women with pre-existing diabetes.
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Internal medicine journal · Oct 2021
ReviewThe health impacts of ambient air pollution in Australia: A systematic literature review.
Ambient (outdoor) air pollution is a key risk factor for health for which effective policy plays an important preventative role. Australian federal and related state air quality standards have historically relied on international evidence for guidance, which may not accurately reflect the Australian context. However, there has been a large increase in Australian epidemiological studies over recent years. ⋯ The remaining three studies found no significant association with asthma, mortality and a range of self-reported diseases, respectively. Ambient air pollution has substantial health impacts in Australia. The body of domestic evidence has increased markedly since national air quality standards were first set in the 1990s, which could be drawn on by policy-makers when revising the existing standards, or considering new standards.
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Internal medicine journal · Oct 2021
Palliative care physicians' preparation and planning for the implementation of the Voluntary Assisted Dying Act in Victoria.
In November 2017, the Victorian Voluntary Assisted Dying (VAD) Act was passed enabling people with a progressive terminal illness to end their life voluntarily. Heated debate abounded including, to some extent within palliative care, which was also challenged with developing processes around the legislation enactment. ⋯ A description of the key elements of these discussions may be useful to others who may yet face similar circumstances with the introduction of VAD legislation.
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Internal medicine journal · Oct 2021
Intentional hastening of death through medication: A case series analysis of Victorian deaths prior to the Voluntary Assisted Dying Act 2017.
Voluntary assisted dying is lawful in Victoria in limited circumstances and commences in Western Australia in mid-2021. There is evidence that in rare cases, unlawful assisted dying practices occur in Australia. ⋯ Unlawful assisted dying practices seem to have occurred in a small number of deaths in Victoria prior to commencement of the VAD Act. These practices typically occurred within the context of palliative or terminal sedation and may be difficult to distinguish from lawful palliative care practice. Some survey responses possibly reflect ambiguity in doctors' intentions when providing medication.