The impact of delayed screening colonoscopies during the COVID-19 pandemic on clinical outcomes.

Background: Colorectal cancer (CRC) screening services in Ireland were cancelled or postponed for periods during the COVID-19 pandemic. The aim of this study was to assess the impact of screening colonoscopy delays after a positive FIT on clinical and histopathological outcomes due to these restrictions.

Methods: Participants in the Irish National Bowel Screening Programme with a positive Immunochemical Faecal Test (FIT) during the COVID-19 pandemic (March 2020-December 2021) were included.

Simulation in New Zealand: what have you done for me lately? New Zealand Association for Simulation in Healthcare (NZASH) white paper.

Medical simulation has become an integral aspect of modern healthcare education and practice. It has evolved to become an essential aspect of teaching core concepts and skills, common and rare presentations, algorithms and protocols, communication, interpersonal and teamworking skills and testing new equipment and systems. Simulation-based learning (SBL) is useful for the novice to the senior clinician.

Newly Diagnosed Hypokalemic Periodic Paralysis Triggered by COVID-19.

Hypokalemic periodic paralysis (HypoPP) is a rare genetic disorder characterized by low potassium levels and episodic periods of muscle weakness. HypoPP has previously been attributed to numerous viral infections; however, cases related to coronavirus disease 2019 (COVID-19) are extremely limited. The current case is thus unique and involves a healthy 23-year-old male who presented to the emergency department after several uncharacteristic falls and three days of upper and lower extremity weakness.

Sindbis Virus Replication Reduces Dependence on Mitochondrial Metabolism During Infection.

Alphaviruses are single stranded, positive sense RNA viruses that are often transmitted through mosquito vectors. With the increasing spread of mosquito populations throughout the world, these arboviruses represent a significant global health concern. Viruses such as Sindbis Virus (SINV), Chikungunya Virus (CHIKV) and Equine Encephalitis Viruses (EEV) are all alphaviruses.

Temperature and Season Influence Phagocytosis by B1 Lymphocytes in the Mojave Desert Tortoise.

Lymphocytes are usually interpreted as functioning in adaptive immunity despite evidence that large proportions of these cells (B1 lymphocytes) have innate immune functions, including phagocytosis, in the peripheral blood of ectothermic vertebrates. We used a recently optimized assay to assess environmental influences on phagocytic activity of lymphocytes isolated from the Mojave desert tortoise (Gopherus agassizii). Previous studies suggest that lymphocytes in this species are associated with reduced pathogen loads, especially in cooler climates, and that lymphocyte numbers fluctuate seasonally.

Severe Mucositis Secondary to Pembrolizumab: Reports of Two Cases, Review of the Literature, and an Algorithm for Management.

The indications for use of programed cell death receptor (PD-1) inhibitors to treat cancer continues to expand rapidly. Treatment with PD-1 inhibitors has been associated with numerous immune-mediated mucocutaneous side effects. Here, we report 2 cases of severe mucositis caused by the PD-1 inhibitor pembrolizumab and review the defining features of similar cases.

Impact of prenatal education on maternal utilization of analgesic interventions at future infant vaccinations: a cluster randomized trial.

Analgesic interventions are not routinely used during vaccine injections in infants. Parents report a desire to mitigate injection pain, but lack the knowledge about how to do so. The objective of this cluster-randomized trial was to evaluate the effect of a parent-directed prenatal education teaching module about vaccination pain management on analgesic utilization at future infant vaccinations.

Measuring the forces of middle ear surgery; evaluating a novel force-detection instrument.

Hypothesis: The forces applied to the middle ear structures during surgery are measurable.

Background: Surgical forces applied to the middle ear are often cited as a cause of postoperative sensorineural hearing loss; however, no literature exists on how much total force is applied during common middle ear procedures.

Methods: Using our novel middle ear surgical force sensor, we took measurements from 6 temporal bones of common middle ear manipulations.

Development of a surgical instrument for measuring forces applied to the ossicles of the middle ear.

Surgery of the middle ear is a delicate process that requires the surgeon to manipulate the ossicles, the smallest bones in the body. Excessive force applied to the ossicles can easily be transmitted through to the inner ear which may cause a permanent sensorineural hearing loss. An instrument was required to measure the forces applied to cadaveric temporal bone ossicles with the vision of measuring forces in vivo at a later stage.

Systemic adverse events following botulinum toxin A therapy in children with cerebral palsy.

Aim: We studied the incidence of incontinence and respiratory events in children with cerebral palsy who received injections of botulinum toxin A (BoNT-A).

Method: We used multivariable logistic regression to investigate relationships between (BoNT-A) dose, Gross Motor Function Classification System (GMFCS) level, and the incidence of bladder or bowel incontinence, unplanned hospital admission, emergency department consultation or prescription of antibiotics for respiratory symptoms, and diagnosis of upper respiratory tract infection.

Results: Of 1980 injection episodes in 1147 children (mean age 4y 7mo, SD 1y 10mo, range 9mo-23y), 488 (25%) were in children with unilateral involvement and 1492 (75%) in children with bilateral involvement.

Antenatal and perinatal antecedents of moderate and severe spastic cerebral palsy.

Routinely collected perinatal morbidity data were abstracted for 204 cases of moderate and severe spastic cerebral palsy and 816 matched controls. Separate analyses were conducted for cases with birth-weight > or = 2,500 g and birth-weight < 2,500 g. The presence of a congenital abnormality was an important risk factor for cerebral palsy in both groups and further analyses were conducted after dividing the groups according to presence or absence of a congenital abnormality.

Studies of postnatal diabetes mellitus in women who had gestational diabetes. Part 2. Prevalence and predictors of diabetes mellitus after delivery.

An important part of the management of women with gestational diabetes (GD) is their subsequent follow-up after delivery. At this postnatal visit a glucose tolerance test (GTT) is essential. We have analysed the results of the postnatal GTT's in 2,957 women whose pregnancies were complicated by GD.

Studies of postnatal diabetes mellitus in women who had gestational diabetes. Part 1. Estimation of the prevalence of unrecognized prepregnancy diabetes mellitus.

This study investigated the prevalence of undiagnosed diabetes in women in the reproductive age group in a Victorian population by analysis of the results of glucose tolerance testing in 57,563 pregnancies. Gestational diabetes (GD) was diagnosed in 4,243 pregnancies and in 2,957 (69.7%) of these, postnatal glucose tolerance testing was performed.

A follow-up program for women with previous gestational diabetes mellitus.

Objective: To analyse the patterns of attendance in a gestational diabetes mellitus (GDM) follow-up program for detection of impaired glucose tolerance and diabetes mellitus.

Design: Retrospective cohort study using computerised data from the GDM follow-up program.

Participants And Setting: All women with GDM who delivered at the Mercy Hospital for Women in Victoria between 1 January 1981 and 31 December 1995.

Identification and treatment of women with hyperglycaemia diagnosed during pregnancy can significantly reduce perinatal mortality rates.

We wished to determine whether gestational diabetes was associated with an increased perinatal mortality rate, and to investigate the cause for the observed increase in the incidence of gestational diabetes. We therefore reviewed the results of glucose tolerance tests and pregnancy outcome in 116,303 pregnancies, 1971-1994, at the Mercy Hospital for Women. The main outcome measurements were the presence or absence of gestational diabetes, and perinatal mortality.

Effect of follow-up of women with gestational diabetes on the ratio of IDDM to NIDDM in pregnancy.

Objective: We wished to test the hypothesis that the diagnosis of diabetes in women with previous gestational diabetes in our follow-up program had altered the ratio of IDDM to NIDDM in our pregnant population.

Research Design And Methods: We identified all pregnancies managed at the Mercy Hospital for Women in Melbourne, Australia, from 1971 to 1994 that were complicated by prepregnancy diabetes. In these 374 pregnancies, we identified those women who had previously been diagnosed with gestational diabetes mellitus (GDM).

Maternal serum triglyceride, glucose tolerance, and neonatal birth weight ratio in pregnancy.

Objective: To determine the value of measuring serum triglyceride (TG) levels early in pregnancy for predicting late-gestation glucose tolerance and neonatal birth weight ratio (BWR) (birth weight corrected for gestational age).

Research Design And Methods: The relationships between morning nonfasting TG measured early in pregnancy (gestational age 12 +/- 6 weeks [mean +/- SD]) and glucose tolerance measured by a 3-h 50-g oral glucose tolerance test (OGTT) late in pregnancy (gestational age 30 +/- 3 weeks) and BWR were investigated in 388 women attending routine antenatal care. The data were analyzed for all women in addition to subgroups of Australian/Western European-born (n = 246) and Asian-born (n = 97) women.

Prevalence of antibodies to glutamic acid decarboxylase in women who have had gestational diabetes.

Objectives: Our purpose was to determine the prevalence of autoantibodies to glutamic acid decarboxylase in women who had had gestational diabetes, including those in whom insulin-requiring or non-insulin-requiring diabetes mellitus has since developed.

Study Design: The study group comprised 734 women with previous gestational diabetes who were consecutive attendees to a follow-up clinic. These women were tested for autoantibodies to glutamic acid decarboxylase with a radioimmunoprecipitation assay.

Factors predictive of recurrent gestational diabetes diagnosed before 24 weeks' gestation.

The purpose of this study was to determine which patient and pregnancy characteristics in the first pregnancy complicated by gestational diabetes mellitus (GDM) were associated with the diagnosis of GDM before 24 weeks' gestation in a subsequent pregnancy--early recurrent GDM. The case notes of 180 women who previously had GDM diagnosed and who had glucose tolerance tests performed before 24 weeks' gestation in their next ongoing pregnancy were reviewed. Factors examined included severity of GDM, insulin requirement, racial origin, macrosomia, obesity, age, family history of diabetes, preeclampsia, and parity.

The biochemistry and clinical application of urinary oestriol measurement during late pregnancy in the 1990's.

Part 1. The present disillusionment with oestriol measurement as a test of fetoplacental function could be explained by the use of poor methodology and inappropriate normal ranges rather than that the test has lost its usefulness. We have updated the Lever method for measuring oestriol in urine, and examined the automatic TDX system supplied by Abbott Laboratories.

Maternal glucose tolerance and obstetric complications in pregnancies in which the offspring developed type I diabetes.

Objective: To identify possible in utero risk factors in children who develop type I diabetes and to determine the risk of development of type I diabetes in the children of women with gestational diabetes.

Research Design And Methods: All known children with type I diabetes born at the Mercy Hospital for Women whose mothers had glucose tolerance tests (GTTs) performed during pregnancy were identified. The results of the mothers' GTTs were compared with those of the hospital population, as were their obstetric complications.

Value of cardiotocography in women with antepartum haemorrhage--is it too late for caesarean section when the cardiotocograph shows ominous features?

Caesarean section is thought to be indicated by an ominous antepartum cardiotocograph (CTG). However, the fear remains that infants delivered for this indication in the presence of antepartum haemorrhage, especially when premature, are destined to have severe hypoxic neurological damage. We therefore reviewed our experience of cardiotocography in women with antepartum haemorrhage (APH) from 1989 to 1992.

Update of growth percentiles for infants born in an Australian population.

Growth percentiles require periodic revision because of changes in the ethnic mix of a population and socioeconomic factors. Anthropometric measurements were derived from singleton livebirths, without lethal malformations, from 22 completed weeks' gestation, at the Mercy Hospital for Women, Melbourne, from 1980 to 1989 (49,429 infants). Infants were included if reasonable assessment of gestation was available.

Amniotic fluid insulin values in women with gestational diabetes as a predictor of emerging diabetes mellitus.

Amniotic fluid insulin levels were estimated in 30 women with insulin-dependent diabetes, 216 with gestational diabetes and 27 with normal glucose tolerance. Results were correlated with birth-weight, incidences of fetal macrosomia and neonatal hypoglycaemia, and the risk of the mothers with gestational diabetes developing diabetes mellitus on follow-up. The women with prepregnancy diabetes had significantly higher amniotic fluid insulin values and showed a significant correlation between raised liquor insulin values (> 97th percentile) and hypoglycaemia in the infant (p = 0.