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In 2014, the South Australian coroner recommended that residents of aged care facilities (RACF) who had sustained a head injury should be transported to emergency departments (ED) for assessment and a head CT scan, with the view to preventing mortality. The evidence base for the recommendation is unclear.The aim of this study was to determine the rate of emergent intervention (neurosurgery, transfusion of blood products or reversal of anticoagulation) in residents transferred to ED with minor head trauma wh...
Invasive group A streptococcal (iGAS) infections are increasing worldwide with at risk groups being children, pregnant women and the elderly. In 2017, there was a rise in iGAS cases in Victoria, prompting a Chief Health Officer advisory.
This study aimed to determine the clinical and biochemical variables associated with change in HbA1c in patients with type 2 diabetes who start sodium-glucose linked transporter (SGLT) inhibitor therapy.
Potentially inappropriate polypharmacy is common in residential aged care facilities (RACFs). This is of particular concern among people with cognitive impairment who, compared with cognitively intact residents, are potentially more sensitive to the adverse effects of medications.
Up to 30% of medical spending in developed countries is unnecessary. We conducted a study to determine if the passive intervention of placing signs on clinicians' computers was effective in reducing unnecessary testing.
Kidney biopsy is the gold standard for the diagnosing kidney disease but may result in bleeding, especially in uremia. DDAVP (1-deamino-8-D-arginine vasopressin) may reduce uremic bleeding but guidelines on its use are lacking. We aimed to evaluate whether DDAVP reduced bleeding complications after percutaneous kidney biopsies.
Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease often managed with Nintedanib, a tyrosine kinase inhibitor targeting several profibrotic pathways. Although clotting processes are involved in wound healing and repair in the lung, there is no data on the role of antithrombin III on in IPF patients treated with Nintedanib. A previous proteomic analysis of serum of IPF patients before and after one year of Nintedanib treatment showed differential protein expression of antithrombin III.
Progression of kidney disease is a deceptively simple word for a complex bio-clinical process, evidenced by the number of definitions in the literature. This has led to confusion and differences in interpretation of studies.
Cardiovascular disease is the leading cause of mortality in peritoneal dialysis (PD) patients. Infection is known to increase the risk of cardiovascular events (CVE), however no studies have examined the association between PD peritonitis and CVE.
People with incurable cancer require information about their prognosis to make informed decisions about their future. We sought to determine the frequency, form and documentation of prognostic discussions between oncologists and their patients with incurable cancer.
Smartphones have become novel healthcare tools for patients with diabetes. However, it is uncertain whether the smartphone application support system helps in glycemic control in patients with type 2 diabetes.
In this retrospective study we evaluated the demographic and clinical characteristic of adult Aboriginal Australian patients with a clinical diagnosis of COPD with and without bronchiectasis from the remote communities of the Northern Territory of Australia.
Infective endocarditis results in substantial morbidity and mortality in people who inject drugs (PWID).
Cancer therapy related cardiac dysfunction (CTRCD) is an area of increasing focus, particularly during the survivorship period, for paediatric, adolescent and adult cancer survivors. With the advent of immunotherapy and targeted therapy, there is a new set of mechanisms from which paediatric and young adult patients with cancer may suffer cardiovascular injury. Furthermore, cardiovascular disease is the leading cause of morbidity and mortality in the survivorship period. The recently established Australian ...
Australian hospital data on hyperglycaemia without previously known diabetes are lacking.
Febrile neutropenia is a frequently encountered complication when caring for cancer patients and can lead to intensive care admission, with high mortality rates in those patients who require invasive mechanical ventilation (IMV). Although hospital survival in this population has improved, long term outcomes of critically ill neutropenic cancer patients have not been well defined.
Inequalities in access to renal services and acute care for rural and remote populations in Australia have been described but not quantified.
Evidence supporting dose modifications to reduce serious treatment-related adverse events of antineoplastic therapy is limited and frequently based on clinical trial protocols, which are not always generalisable to community patients. eviQ is an online resource with treatment protocols and recommendations for dose modification formulated by expert opinion and evidence-based review. Original recommended haematological thresholds to delay treatment were: neutrophil count
Rapid response teams (RRTs) were first proposed as a means of reducing inpatient morbidity and mortality. Modifying RRT activation triggers poses a potential risk for delayed recognition of a deteriorating patient. Trigger modifications have not been validated for safety. This study examined the relationship between RRT trigger modifications and patient outcomes including rate of recurrent RRT activation, length of stay (LOS), and in-hospital death for all RRT activations at the Launceston General Hospital ...
The Goals-Of-Care (GOC) form is a resuscitation planning tool used to document informed decisions tailored for individual patients admitted to hospital. Proper and timely completion of the GOC form is essential for its effective utility.
Guillain-Barré syndrome (GBS) causes acute neuromuscular weakness. Severe cases are life-threatening and many are left disabled. Intravenous immunoglobulin (IVIg) or plasma exchange (PE), with supportive care, are the mainstays of treatment. Multiple factors influence treatment choice. Clinico-epidemiological features of GBS in Australia have not been reviewed in 30 years and few studies have assessed contemporary treatment choices.
Due to the rising prevalence of obesity and type II diabetes mellitus, non-alcoholic fatty liver disease (NAFLD) is becoming the leading cause of chronic liver disease in the Western world. In some patients, simple steatosis can result in non-alcoholic steatohepatitis (NASH) which over time can lead to liver cirrhosis and its associated sequalae, including hepatocellular carcinoma (HCC). Early identification and management of patients at risk with intensive dietary and lifestyle modification are essential t...
An electronic prescribing and administration (ePA) system has been progressively rolled out to Canterbury District Health Board (CDHB, Christchurch, New Zealand) public hospitals since 2014, and is currently used for around 1300 tertiary beds. ePA data can be used to monitor user behaviour, and to evaluate and inform the local customisation of clinical decision support (CDS) tools within the ePA system.
Investigate the association of albumin levels on admission and change in levels during hospitalization of patients in general surgery wards with hospitalization outcomes.
The incidence, presentation and outcomes of lupus nephritis (LN) varies with geography, ethnicity, socioeconomic status, and gender. There is relatively few data on LN in the non-Caucasian populations in Australia. This study describes the clinical presentation, histological features, natural history, and outcomes of a historical cohort of Aboriginal and Torres Strait Islanders people in Far North Queensland with biopsy-proven LN.