Intraoperative factors contributory to myocardial injury in high-risk patients undergoing abdominal surgery in a South Indian population.

Background And Aims: Myocardial injury after non-cardiac surgery (MINS) is associated with high postoperative mortality. We sought to examine the intraoperative variables associated with MINS among high-risk patients undergoing abdominal surgery at a South Indian Centre.

Methods: A retrospective analysis of patients who underwent abdominal surgery, aged >45 years with one of five factors: hypertension, diabetes mellitus, previous coronary artery disease (CAD), stroke, or peripheral vascular disease or all patients >65 years of age was undertaken.

Effect of an electronic medical record design modification on laxative co-prescribing among hospitalised patients taking opioids: A before-and-after study.

Context: Constipation occurs in up to 71.7% (33/46) of hospital inpatients taking opioid analgesics. Co-prescribing laxatives with opioid analgesics is recommended to prevent opioid-induced constipation.

Akkermansia muciniphila reduces Porphyromonas gingivalis-induced inflammation and periodontal bone destruction.

Aim: Akkermansia muciniphila is a beneficial gut commensal, whose anti-inflammatory properties have recently been demonstrated. This study aimed to evaluate the effect of A. muciniphila on Porphyromonas gingivalis elicited inflammation.

Myocardial injury after noncardiac surgery-incidence and predictors from a prospective observational cohort study at an Indian tertiary care centre.

Asymptomatic myocardial injury following noncardiac surgery (MINS) is an independent predictor of 30-day mortality and may go unrecognized based on standard diagnostic definition for myocardial infarction (MI). Given lack of published research on MINS in India, our study aims to determine incidence of MINS in patients undergoing noncardiac surgery at our tertiary care hospital, and evaluate the clinical characteristics including 30-day outcome.The prospective observational study included patients >65 years or >45 years with either hypertension (HTN), diabetes mellitus (DM), coronary artery disease (CAD), cerebrovascular accident (CVA), or peripheral arterial disease undergoing noncardiac surgery.

Rapid response systems: a prospective study of response times.

Purpose: The purpose of the study was to evaluate the time taken for delivery of each component of care following patient deterioration and to assess the effect on response times of strategies implemented to improve the system.

Methods: A model identifying the sequence of organizational responses following a patient's unexpected clinical deterioration was developed. The time to key events and interventions from initial deterioration was measured for 3 months in 2005 and again in 2006 at a tertiary care hospital with a rapid response team (RRT) in place.

Estimating the risk of fatal arrhythmia in patients in methadone maintenance treatment for heroin addiction.

Aims: To estimate risk of death due to cardiac arrhythmia during methadone maintenance treatment.

Background: There is evidence that methadone prolongs the QT interval, and has been associated with ventricular tachycardia in some individuals.

Methods: We identified 51 deaths occurring during methadone treatment, occurring in a cohort with a defined exposure to methadone treatment.

Comparing retention in treatment and mortality in people after initial entry to methadone and buprenorphine treatment.

Unlabelled: AIM To compare retention in treatment and mortality among people entering methadone and buprenorphine treatment for opioid dependence.

Data Sources: The Pharmaceutical Drugs of Abuse System (PHDAS) database records start- and end-dates of all episodes of methadone and buprenorphine treatment in New South Wales, and the National Death Index (NDI) records all reported deaths.

Methods: Data linkage study.

Preventive health reform: what does it mean for public health?

A revitalised public health strategy offers the most sustainable way to address current health inequalities and prevent chronic non-communicable diseases. Success in these goals requires a whole-of-government approach and long-term investments. A sizeable proportion of this investment must be outside the health sector, in the social, economic and environmental fabric of our society.

Legislative change is associated with improved health status in people with whiplash.

Study Design: Interrupted time series.

Objective: To assess whether a change in legislation improved health status and quality of life for people with whiplash.

Summary Of Background Data: Whiplash was the most prevalent injury in a compulsory, fault based, third party motor vehicle insurance scheme in New South Wales, Australia.

Challenges in health and health care for Australia.

The next Australian Government will confront major challenges in the funding and delivery of health care. These challenges derive from: Changes in demography and disease patterns as the population ages, and the burden of chronic illness grows; Increasing costs of medical advances and the need to ensure that there are comprehensive, efficient and transparent processes for assessing health technologies; Problems with health workforce supply and distribution; Persistent concerns about the quality and safety of health services; Uncertainty about how best to balance public and private sectors in the provision and funding of health services; Recognition that we must invest more in the health of our children; The role of urban planning in creating healthy and sustainable communities; and Understanding that achieving equity in health, especially for Indigenous Australians, requires more than just providing health care services. The search for effective and lasting solutions will require a consultative approach to deciding the nation's priority health problems and to designing the health system that will best address them; issues of bureaucratic and fiscal responsibility can then follow.

Availability and development of guidelines in a tertiary teaching hospital.

Objective: The purpose of this study was to review existing guidelines in clinical departments and describe their characteristics, development and implementation at a large teaching hospital in Sydney, Australia.

Methods: The study was undertaken in two stages. First, from September to November 2005, we reviewed and classified documents from eight departments as clinical practice guidelines (CPGs), clinical procedural protocols (technology and technique) or administrative guidelines.

Late entry to antenatal care in New South Wales, Australia.

Aims: This study aimed to assess the prevalence of women who entered antenatal care (ANC) late and to identify factors related to the late entry to ANC in New South Wales (NSW) in 2004.

Methods: The NSW Midwives Data Collection contained data of 85,034 women who gave birth in 2004. Data were downloaded using SAS and transferred to STATA 8.

Health care safety: what needs to be done?

Recent MJA editorials assert that Australian hospitals are no safer than they were when the first hospital safety report was published in 1995. Despite many recommendations by several committees and much activity to improve safety over the past decade, we lack concrete evidence that safety and quality of health care have improved. Efforts to promote hospital safety in the United States and the United Kingdom also remain unevaluated.

Cancellation of operations on the day of intended surgery at a major Australian referral hospital.

Objective: To establish the rate of and reasons for cancellations of surgery on the scheduled day in an Australian hospital.

Design: Prospective survey.

Setting: Major metropolitan tertiary hospital, 13 May to 15 November 2002.

Risk factors for tinnitus in a population of older adults: the blue mountains hearing study.

Objective: To identify potential and modifiable risk factors for tinnitus in a population of older adults.

Study Design: Cross-sectional study. Detailed questionnaires were interviewer-administered in a representative sample of 2015 persons aged 55+ yr, living in an area west of Sydney, Australia.

Prevalence and characteristics of tinnitus in older adults: the Blue Mountains Hearing Study.

There have been few recent estimates of the prevalence of tinnitus from large population-based samples of older persons. Our study aimed to assess the prevalence and characteristics of prolonged tinnitus in a representative sample of 2015 adults aged 55-99 years, residing in the Blue Mountains, west of Sydney, Australia, during 1997-99. All participants underwent a detailed hearing examination by an audiologist, including comprehensive questions about hearing.

Appropriateness of platelet, fresh frozen plasma and cryoprecipitate transfusion in New South Wales public hospitals.

Objectives: To estimate the appropriateness of transfusions of platelets, fresh frozen plasma (FFP) and cryoprecipitate using National Health and Medical Research Council and Australasian Society for Blood Transfusion guidelines (NHMRC/ASBT 2002).

Design And Setting: Three separate retrospective surveys of medical records from 1 January to 31 August 2000 (1147 transfused patients) from 14 hospitals selected randomly from all public hospitals that use these blood products in New South Wales: five tertiary referral, five major metropolitan, and four major rural (base) hospitals.

Main Outcome Measures: Proportion of potentially inappropriate transfusions.