COVID-19 infection among patients with cancer in Australia from 2020 to 2022: a national multicentre cohort study.

Background: The global COVID-19 pandemic disproportionately affected certain populations and its management differed between countries. This national study describes characteristics and outcomes of COVID-19 in patients with cancer in Australia.

Methods: We performed a multicentre cohort study of patients with cancer and COVID-19 from March 2020 to April 2022.

Intracranial hemorrhage detected through a craniotomy site with point of care ultrasound.

A 60-year-old male presented to the emergency department with acute change in mental status while recovering from a recent hemicraniectomy. During evaluation by the emergency physician, a point-of-care ultrasound (POCUS) was performed using the patient's existing craniectomy site as a sonographic window. Multiple areas of intracranial hemorrhage were visualized on POCUS and head computed tomography scan ultimately requiring urgent neurosurgical intervention.

Treatment of Community-Acquired Pneumonia in Immunocompromised Adults: A Consensus Statement Regarding Initial Strategies.

Background: Community-acquired pneumonia (CAP) guidelines have improved the treatment and outcomes of patients with CAP, primarily by standardization of initial empirical therapy. But current society-published guidelines exclude immunocompromised patients.

Research Question: There is no consensus regarding the initial treatment of immunocompromised patients with suspected CAP.

Cavity Attenuated Phase Shift Faraday Rotation Spectroscopy.

Cavity attenuated phase shift Faraday rotation spectroscopy has been developed and demonstrated by oxygen detection near 762 nm. The system incorporates a high-finesse cavity together with phase-sensitive balanced polarimetric detection for sensitivity enhancement and achieves a minimum detectable polarization rotation angle (1σ) of 5.6 × 10 rad/√Hz, which corresponds to an absorption sensitivity of 4.

Frequency-locked cavity ring-down Faraday rotation spectroscopy.

Cavity ring-down Faraday rotation spectroscopy (CRD-FRS) is a technique for trace gas measurements of paramagnetic species that retrieves the molecular concentration from the polarization rotation measured as the difference between simultaneously recorded ring-down times of two orthogonal polarization states. The differential measurement is inherently insensitive to nonabsorber related losses, which makes off-resonance measurements redundant. We exploit this unique property by actively line-locking to a molecular transition for calibration-free trace gas concentration retrieval.

Massive splenomegaly due to concurrent primary Epstein-Barr virus and cytomegalovirus infection in a patient on adalimumab.

A 32-year-old man who was receiving adalimumab for seronegative rheumatoid arthritis presented with a 4-week history of fever, night sweats, fatigue, myalgias and diarrhoea. On examination, he had obvious splenomegaly but no lymphadenopathy or pharyngitis. Full blood count revealed mild neutropenia and significant lymphocytosis, with a blood film showing atypical lymphocytes.

Controversies in diagnosis and management of community-acquired pneumonia.

Community-acquired pneumonia (CAP) is a common condition; however, it appears to be overdiagnosed. Diagnosing CAP too frequently may be adding to the problems of overuse of antibiotics, such as bacterial resistance in the community and greater costs and complications in individuals. Data support that most patients with non-severe CAP can be treated for 3-5 days; however, most patients with CAP are receiving much longer courses of therapy.

Inadvertent Intrathecal Administration of Local Anesthetics Leading to Spinal Paralysis with Lipid Emulsion Rescue.

Bupivacaine and ropivacaine are local anesthetics frequently used for interscalene nerve blocks, which are generally well tolerated; however, some complications include pneumothorax, Horner syndrome, nerve injury and cardiovascular toxicity from vascular injection. On rare occasions, it may be associated with spinal paralysis. While the treatment is mostly supportive, we report an unusual case of administering intravenous lipid emulsion (ILE) as part of resuscitative efforts to hasten neurological recovery from spinal shock.

Old but not forgotten: Antibiotic allergies in General Medicine (the AGM Study).

Objectives: To determine the nature, prevalence and description accuracy of recorded antibiotic allergy labels (AALs) in a cohort of general medical inpatients, and to assess the feasibility of an oral antibiotic re-challenge study.

Design: Multicentre cross-sectional study.

Setting And Participants: All patients admitted to the general medical units of Austin Health and Alfred Health, 18 May - 5 June 2015.

Endoscopic investigation in non-iron deficiency anemia: a cost to the health system without patient benefit.

Background And Aims: The indication for endoscopy to investigate anemia of causes other than iron deficiency is not clear. Increasing numbers of endoscopic procedures for anemia raises concerns about costs to the health system, waiting times, and patient safety. The primary aim of this study was to determine the diagnostic yield of endoscopy in patients referred to undergo investigation for anemia.

Help Me Tell My Story: Development of an Oral Language Measurement Scale.

Help Me Tell My Story (HMTMS) is an assessment tool that uses a holistic approach and an electronic application to measure the oral language development of pre-kindergarten and kindergarten children. It includes access to an online portal that provides meaningful information to caregivers, educators and administrators. This study examines the psychometric properties of one of the five questionnaires included in the HMTMS assessment, which explores the ability of children to talk to family members, friends and teachers.

The role of anaerobes in diabetic foot infections.

Diabetic foot infections (DFI) are a common cause of morbidity and, on occasion, even mortality. Infection can be either mono- or polymicrobial, with a wide variety of potential pathogens. Anaerobes may be involved, particularly in wounds that are deeper or more chronic, and are more frequently identified when using modern molecular techniques, such as 16s PCR and pyrosequencing.

Estimating the burden of pneumococcal pneumonia among adults: a systematic review and meta-analysis of diagnostic techniques.

Background: Pneumococcal pneumonia causes significant morbidity and mortality among adults. Given limitations of diagnostic tests for non-bacteremic pneumococcal pneumonia, most studies report the incidence of bacteremic or invasive pneumococcal disease (IPD), and thus, grossly underestimate the pneumococcal pneumonia burden. We aimed to develop a conceptual and quantitative strategy to estimate the non-bacteremic disease burden among adults with community-acquired pneumonia (CAP) using systematic study methods and the availability of a urine antigen assay.

Guillain-Barré syndrome following pandemic (H1N1) 2009 influenza A immunisation in Victoria: a self-controlled case series.

Objectives: To determine the relative incidence (RI) of Guillain-Barré syndrome (GBS) in a single Australian state following pandemic (H1N1) 2009 influenza A immunisation (monovalent vaccine or seasonal trivalent influenza vaccine [TIV]) in 2009-2010.

Design, Setting And Participants: Active GBS surveillance (cases assessed by two neurologists according to the Brighton criteria) from 30 September 2009 to 30 September 2010, conducted at 10 hospitals in Victoria, Australia.

Main Outcome Measures: The RI of GBS in the risk window of 0-42 days after vaccination.

Faecal microbiota transplantation for severe Clostridium difficile infection in the intensive care unit.

We describe a case of faecal microbiota transplantation (FMT) used for severe binary toxin-positive Clostridium difficile infection in an intensive care setting. The patient was admitted to the ICU of a tertiary hospital and failed traditional maximal pharmacological management. Adjunctive therapy with FMT given through gastroscopy resulted in resolution of the C.

Buruli ulcer disease in travelers and differentiation of Mycobacterium ulcerans strains from northern Australia.

Buruli ulcer (BU) is a necrotizing infection of skin and soft tissue caused by Mycobacterium ulcerans. In Australia, most cases of BU are linked to temperate, coastal Victoria and tropical, northern Queensland, and strains from these regions are distinguishable by variable-number tandem repeat (VNTR) typing. We present an epidemiological investigation of five patients found to have been infected during interstate travel and describe two nucleotide polymorphisms that differentiate M.

Managing Severe Community-Acquired Pneumonia Due to Community Methicillin-Resistant Staphylococcus aureus (MRSA).

Community-associated methicillin-resistant Staphylococcus aureus (MRSA) is a rare, but significant cause of community-acquired pneumonia (CAP). A number of virulence determinants have been implicated in the development of severe community MRSA pneumonia, characterized by multilobar cavitating necrosis in patients without usual risk-factors for pneumonia. Optimal management is uncertain, and is extrapolated from anecdotal experiences with small case series, randomized studies of hospital-acquired pneumonia, and laboratory investigations using in vitro experiments and animal models of MRSA pneumonia.

Comparison of immunoglobulin G subclass concentrations in severe community-acquired pneumonia and severe pandemic 2009 influenza A (H1N1) infection.

We compared immunoglobulin G (IgG) subclasses in patients with severe noninfluenza community-acquired pneumonia (CAP) to those in patients with severe pandemic 2009 influenza (H1N1) virus infection. Low IgG1 and IgG2 levels occurred often in the CAP group; however, H1N1 patients had lower IgG1 and IgG2 levels (5.4 versus 3.

New aspirations: the debate on aspiration pneumonia treatment guidelines.

Aspiration pneumonia occurs most commonly in patients with a predisposition to aspiration (eg, those with neurological bulbar dysfunction). There is limited evidence regarding the involvement of anaerobes in most cases of aspiration pneumonia. Most patients respond to treatment for aspiration pneumonia without specific anti-anaerobic therapy such as metronidazole.