Allowing ad libitum sleep during overnight polysomnography affects Multiple Sleep Latency Test results in patients being assessed for hypersomnolence.

Study Objectives: The Multiple Sleep Latency Test (MSLT) is a key diagnostic component in the diagnosis of central disorders of hypersomnolence. Due to time constraints, it is common practice to wake patients at a standard time from overnight polysomnography (PSG) prior to the MSLT. This has the potential to influence MSLT results due to sleep deprivation.

A nurse-led Asthma Care Team transitioning patients from hospital to home improves asthma control: A pilot study exploring an alternative model of care.

Introduction: Recurrent asthma admissions are frequent in our patients at a tertiary Australian hospital and are commonly related to poor health literacy and medication adherence. A need exists to improve these asthma self-management skills within our current model of care, especially during the vulnerable postdischarge period.

Aim: To examine if the addition of a nurse-led Asthma Care Transition Team (ACTT) compared with usual care alone (UC) (1) improves asthma control at 12 weeks posthospital discharge; the number of patients using a Written Action Plan (WAP), compliance with inhaler therapy at 12 weeks, and readmission rates at 6 months.

Quality of acute asthma care: an audit of clinical practice in a Victorian health service.

Background: Gaps in the treatment of patients with acute asthma have been repeatedly described in Australia. We conducted a retrospective audit of acute asthma care at a Victorian tertiary institution.

Aims: To describe acute asthma care at a large health network in metropolitan Melbourne, and evaluate the extent to which Emergency Department (ED) care was consistent with National Asthma Council guidelines.

Access to pulmonary rehabilitation for people from culturally and linguistically diverse communities: A cohort study.

Little is known about the extent of cultural and linguistic diversity among people with chronic obstructive pulmonary disease (COPD) in Australia and if ethno-cultural factors influence engagement in pulmonary rehabilitation (PR). We conducted a prospective cohort study to evaluate the extent of cultural and linguistic diversity among people with COPD and identify variables that influence engagement in PR. Patients with COPD attending the respiratory outpatient clinic at a metropolitan health service completed a study-specific questionnaire with results descriptively analysed.

Thunderstorm asthma in seasonal allergic rhinitis: The TAISAR study.

Background: Asthma epidemics associated with thunderstorms have had catastrophic effects on individuals and emergency services. Seasonal allergic rhinitis (SAR) is present in the vast majority of people who develop thunderstorm asthma (TA), but there is little evidence regarding risk factors for TA among the SAR population.

Objective: We sought to identify risk factors for a history of TA and hospital presentation in a cohort of individuals with SAR.

Phase 1 trial of intrapleural LTI-01; single chain urokinase in complicated parapneumonic effusions or empyema.

Background: Current dosing of intrapleural fibrinolytic therapy (IPFT) in adults with complicated parapneumonic effusion (CPE) / empyema is empiric, as dose-escalation trials have not previously been conducted. We hypothesized that LTI-01 (scuPA), which is relatively resistant to PA inhibitor-1 (PAI-1), would be well-tolerated.

Methods: This was an open-label, dose-escalation trial of LTI-01 IPFT at 50,000-800,000 IU daily for up to 3 days in adults with loculated CPE/empyema and failed pleural drainage.

Evaluation of the implementation of a Tracheostomy Review Services (TRS): an observational cohort study.

It has been suggested that interprofessional tracheostomy teams improve safety, enhance outcomes and promote excellence. This study evaluated the effect of a Tracheostomy Review Service (TRS) on patient outcomes and staff attitudes. The TRS reviewed patients with a tracheostomy tube (TT) on our wards.

The 2016 Melbourne thunderstorm asthma epidemic: Risk factors for severe attacks requiring hospital admission.

Background: The world's most catastrophic and deadly thunderstorm asthma epidemic struck Melbourne, Australia, on November 21, 2016.

Objective: Among thunderstorm-affected patients presenting to emergency rooms (ERs), we investigated risk factors predicting severe attacks requiring admission to hospital.

Methods: Thunderstorm-affected patients were identified from ER records at the eight major Melbourne health services and interviewed by telephone.

Treatable traits can be identified in a severe asthma registry and predict future exacerbations.

Background And Objective: A new taxonomic and management approach, termed treatable traits, has been proposed for airway diseases including severe asthma. This study examined whether treatable traits could be identified using registry data and whether particular treatable traits were associated with future exacerbation risk.

Methods: The Australasian Severe Asthma Web-Based Database (SAWD) enrolled 434 participants with severe asthma and a comparison group of 102 participants with non-severe asthma.

The Melbourne epidemic thunderstorm asthma event 2016: an investigation of environmental triggers, effect on health services, and patient risk factors.

Background: A multidisciplinary collaboration investigated the world's largest, most catastrophic epidemic thunderstorm asthma event that took place in Melbourne, Australia, on Nov 21, 2016, to inform mechanisms and preventive strategies.

Methods: Meteorological and airborne pollen data, satellite-derived vegetation index, ambulance callouts, emergency department presentations, and data on hospital admissions for Nov 21, 2016, as well as leading up to and following the event were collected between Nov 21, 2016, and March 31, 2017, and analysed. We contacted patients who presented during the epidemic thunderstorm asthma event at eight metropolitan health services (each including up to three hospitals) via telephone questionnaire to determine patient characteristics, and investigated outcomes of intensive care unit (ICU) admissions.

The evidence of benefits of exercise training in interstitial lung disease: a randomised controlled trial.

Background: Uncertainty exists regarding the clinical relevance of exercise training across the range of interstitial lung diseases (ILDs).

Objective: To establish the impact of exercise training in patients with ILDs of differing aetiology and severity.

Methods: 142 participants with ILD (61 idiopathic pulmonary fibrosis (IPF), 22 asbestosis, 23 connective tissue disease-related ILD (CTD-ILD) and 36 with other aetiologies) were randomised to either 8 weeks of supervised exercise training or usual care.

Achalasia cardia presenting as stridor.

Achalasia cardia is a motility disorder of the oesophagus characterized by aperistalsis of the oesophageal body and incomplete relaxation of the lower oesophageal sphincter. It usually presents with dysphagia, regurgitation and heartburn. It may have various respiratory manifestations.

An analysis of the evidence-practice continuum: is surgery for obstructive sleep apnoea contraindicated?

Rationale, Aims And Objectives: Currently there are multiple surgical interventions utilized in the treatment of adult obstructive sleep apnoea (OSA). The role of these operations remains controversial, with perspectives on treatment efficacy varying considerably. Despite this, their use is proliferating.