Publications by authors named "Daniel Engelman"

Background: Scabies and impetigo cause direct health effects and contribute to severe infectious and immune-mediated complications. Ivermectin-based mass drug administration can reduce scabies and impetigo prevalence in island settings with high prevalence, but the effectiveness in moderate-prevalence settings is not known.

Methods: We conducted a single-arm, before-after community intervention trial.

View Article and Find Full Text PDF

Introduction: Rheumatic heart disease (RHD) is underdiagnosed globally resulting in missed treatment opportunities and adverse clinical outcomes. We describe the protocol for a study which aims to co-design, implement and conduct an evaluation of a task-sharing approach to echocardiographic active case finding for early detection and management of RHD in high-risk settings in Australia and Timor-Leste.

Methods And Analysis: Echocardiograms will be obtained by trained local staff using hand-held echocardiographic devices employing the 'Single Parasternal Long Axis view with a Sweep of the Heart' (SPLASH) technique and interpreted by experts remote from the site of acquisition.

View Article and Find Full Text PDF
Article Synopsis
  • Scabies and related bacterial skin infections are common in tropical and low-income areas, significantly raising healthcare costs and straining health systems.
  • The "Big SHIFT" trial in Fiji analyzed scabies and SSTIs from 2018 to 2019, aiming to estimate the healthcare costs associated with these conditions before a mass drug treatment campaign.
  • The study found that healthcare costs for scabies and SSTIs in Fiji totaled approximately $3 million annually, with an estimated cost of $3.3 per person, highlighting the economic impact and the potential benefits of prevention efforts.
View Article and Find Full Text PDF
Article Synopsis
  • Scabies is a common issue in many tropical areas, especially in places with limited resources, but accurate information on its prevalence in Africa is scarce due to diagnostic challenges.
  • The study aimed to test how well minimally trained field-workers could diagnose scabies compared to standard medical assessments after they received basic training.
  • Results showed that these field-workers had a high diagnostic accuracy (94% sensitivity and 96% specificity), indicating they could effectively identify scabies, which can improve public health initiatives and treatment strategies in affected regions.
View Article and Find Full Text PDF

Background: Excessive perioperative bleeding is associated with major complications in cardiac surgery, resulting in increased morbidity, mortality, and cost.

Methods: An international expert panel was convened to develop consensus statements on the control of bleeding and management of transfusion and to suggest key quality metrics for cardiac surgical bleeding. The panel reviewed relevant literature from the previous 10 years and used a modified RAND Delphi methodology to achieve consensus.

View Article and Find Full Text PDF

Background: In Victoria, Australia, children with Pacific Islander ('Pacific') ethnicities are overrepresented in acute rheumatic fever (ARF) and rheumatic heart disease (RHD). In June 2023, ARF and RHD became notifiable in Victoria. To inform public health and clinical practice, we described young Pacific patients' and their caregivers' understandings and experiences of ARF/RHD, and identified possible ways to improve the delivery of clinical care.

View Article and Find Full Text PDF
Article Synopsis
  • A group of heart surgeons and doctors met to talk about how to improve a special type of heart surgery called minimally invasive cardiac surgery (MICS).
  • They want to make sure the surgery uses smaller cuts to make recovery easier for patients while still achieving good results.
  • They believe that to get the best results from MICS, there should be three key parts: smaller surgical cuts, proper care of the heart during surgery, and a program called Enhanced Recovery After Surgery (ERAS) that helps patients heal better afterward.
View Article and Find Full Text PDF

Aim: The cardiac surgery-related ischemia-reperfusion-related oxidative stress triggers the release of cytotoxic reactive oxygen and nitrogen species, contributing to organ failure and ultimately influencing patients' short- and long-term outcomes. Selenium is an essential co-factor for various antioxidant enzymes, thereby contributing to the patients' endogenous antioxidant and anti-inflammatory defense mechanisms. Given these selenium's pleiotropic functions, we investigated the effect of a high-dose selenium-based anti-inflammatory perioperative strategy on functional recovery after cardiac surgery.

View Article and Find Full Text PDF

There is an evolving role for guideline-directed medical therapy (GDMT) in managing heart failure with reduced ejection fraction after cardiac surgery. GDMT is based on the use of pharmacologic agents from each of 4 distinct drug classes, also known as the 4 pillars of heart failure therapy: β-blockers, renin-angiotensin system inhibitors, often paired with neprilysin inhibitors, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors. Despite the demonstrated benefits of GDMT in reducing mortality and hospitalization rates in the nonsurgical literature, there is conspicuous underuse of GDMT after cardiac surgery.

View Article and Find Full Text PDF

Background: Rheumatic Heart Disease (RHD) persists as a major cardiovascular driver of mortality and morbidity among young people in low-and middle-income countries. Secondary antibiotic prophylaxis (SAP) with penicillin remains the cornerstone of RHD control, however, suboptimal treatment adherence undermines most secondary prevention programs. Many of the barriers to optimal SAP adherence are specific to the intramuscular form of penicillin and may potentially be overcome by use of oral penicillin.

View Article and Find Full Text PDF

Background: Postoperative atrial fibrillation (POAF) is a prevalent complication following cardiac surgery that is associated with increased adverse events. Several guidelines and expert consensus documents have been published addressing the prevention and management of POAF. We aimed to develop an order set to facilitate widespread implementation and adoption of evidence-based practices for POAF following cardiac surgery.

View Article and Find Full Text PDF
Article Synopsis
  • - Valvular heart disease, particularly aortic stenosis (AS), is common among older adults, and treatment has improved significantly with transcatheter aortic valve replacement (TAVR), but many still suffer from poor quality of life due to existing health issues.
  • - Sarcopenia, the loss of muscle strength and function, affects a large percentage of older adults with AS and is linked to worse outcomes after TAVR, necessitating its assessment in treatment planning.
  • - Early detection and management of sarcopenia through exercise and nutrition can enhance recovery and quality of life post-TAVR, although more research is needed to fully understand the benefits of preoperative exercise programs.
View Article and Find Full Text PDF

Objectives: Surgical-site infections (SSIs) after cardiac surgery increase morbidity and mortality, consume health care resources, impair recovery, and diminish patients' quality of life. Numerous guidelines and expert consensus documents have been published to address the prevention and management of SSIs. Our objective is to integrate these documents into an order set that will facilitate the adoption and implementation of evidence-based best practices for preventing and managing SSIs after cardiac surgery.

View Article and Find Full Text PDF
Article Synopsis
  • Previous studies on enhanced recovery after surgery (ERAS) protocols in cardiac surgery showed positive outcomes, but comprehensive data from randomized studies were lacking, prompting this analysis of randomized controlled trials (RCTs) comparing ERAS-like protocols to standard care.* -
  • The meta-analysis included 13 RCTs with 1,704 participants, finding no significant difference in in-hospital mortality between ERAS and standard groups, but ERAS was linked to shorter ICU and hospital stays and lower overall complication rates, particularly stroke.* -
  • The results indicate that while ERAS-like protocols do not affect short-term survival, they facilitate quicker recovery and discharge from the hospital while potentially reducing complications.*
View Article and Find Full Text PDF

Background: Ivermectin mass drug administration (MDA) is effective for controlling onchocerciasis and scabies, with evidence supporting its role in some species of soil-transmitted helminth (STH) infections. In the context of RISE, a cluster-randomised trial for scabies, this study evaluated the effectiveness of ivermectin MDA in reducing STH burden in the Western Province of Solomon Islands.

Methods: Twenty villages were randomised 1:1 to receive ivermectin MDA as one dose (IVM-1) or two doses (IVM-2) for scabies.

View Article and Find Full Text PDF

Enhanced Recovery After Surgery (ERAS) programs have been shown to lessen surgical insult, promote recovery, and improve postoperative clinical outcomes across a number of specialty operations. A core tenet of ERAS involves the provision of protocolized evidence-based perioperative interventions. Given both the growing enthusiasm for applying ERAS principles to cardiac surgery and the broad scope of relevant interventions, an international, multidisciplinary expert panel was assembled to derive a list of potential program elements, review the literature, and provide a statement regarding clinical practice for each topic area.

View Article and Find Full Text PDF

Background: Secondary antibiotic prophylaxis reduces progression of latent rheumatic heart disease (RHD) but not all children benefit. Improved risk stratification could refine recommendations following positive screening. We aimed to evaluate the performance of a previously developed echocardiographic risk score to predict mid-term outcomes among children with latent RHD.

View Article and Find Full Text PDF

Aim: Here, we present results of a survey of scabies prevalence in childcare centres and primary schools in Auckland.

Methods: Children whose parents agreed to take part in participating centres in the Auckland region were examined for scabies by general practitioners and given questionnaires of relevant symptoms. Diagnoses of clinical or suspected scabies were made according to the International Alliance for the Control of Scabies (IACS) criteria.

View Article and Find Full Text PDF

Objectives: There are multiple published guidelines on comprehensive patient blood management (PBM), centered on the 3 pillars of PBM: managing preoperative anemia, minimizing blood loss, and tolerating intraoperative/postoperative anemia. We sought to create an order set to facilitate widespread implementation of evidence-based PBM for cardiac surgery patients.

Methods: Subject matter experts were consulted to translate existing guidelines and literature into a sample turnkey order set (TKO) for PBM.

View Article and Find Full Text PDF

Objectives: Older studies of coronary artery bypass grafting (CABG) institutional case volumes and outcomes reported conflicting results. We explored this association in the rapidly changing contemporary practice of American surgeons using the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database.

Methods: The 2018-2019 isolated primary CABG experience in the STS Adult Cardiac Surgery Database was analysed (241 902 patients; 1014 hospitals; 2718 surgeons).

View Article and Find Full Text PDF

Background: Scabies is a common skin infestation caused by the Sarcoptes scabei mite. Ivermectin, one of three drugs used in mass drug administration (MDA) for lymphatic filariasis, is also effective for treating scabies. Ivermectin-based MDA was first conducted in Samoa in August 2018, with ivermectin being offered to those aged ≥5 years.

View Article and Find Full Text PDF