Clinical outcomes and risk factors in patients with COVID-19 and autoimmune rheumatic diseases: insights from a major Australian hospital study.

Background And Aim: Patients with autoimmune inflammatory rheumatic disease (AIIRD) are at higher risk of severe infections because of their underlying diseases and immunosuppression. Our objective was to elucidate the epidemiological and clinical characteristics of patients with AIIRD presenting with COVID-19 and their relation to disease severity. We explored whether variables, including underlying diagnosis, disease-modifying antirheumatic drugs (DMARDs) and COVID-19 vaccine status, were associated with more severe forms of COVID-19 infection.

Characterization of bilateral reaching development using augmented reality games.

Bilateral coordination is commonly impaired in neurodevelopmental conditions including cerebral palsy, developmental coordination disorder, and autism spectrum disorder. However, we lack objective clinical assessments that can quantify bilateral coordination in a clinically feasible manner and determine age-based norms to identify impairments. The objective of this study was to use augmented reality and computer vision to characterize bilateral reaching abilities in typically developing children.

Antiviral therapies for the management of persistent coronavirus disease 2019 in immunocompromised hosts: A narrative review.

Antiviral agents with activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have played a critical role in disease management; however, little is known regarding the efficacy of these medications in the treatment of SARS-CoV-2 infection in immunocompromised patients, particularly in the management of persistent SARS-CoV-2 positivity. This narrative review discusses the management of persistent coronavirus disease 2019 in immunocompromised hosts, with a focus on antiviral therapies. We identified 84 cases from the literature describing a variety of approaches, including prolonged antiviral therapy (n = 11), combination antivirals (n = 13), and mixed therapy with antiviral and antibody treatments (n = 60).

Late parastomal evisceration: A case report of a rare complication following loop ileostomy for an obstructing rectal cancer.

Introduction And Importance: Parastomal evisceration is a very uncommon complication of a stoma, with only a few cases currently published in the literature. It may occur either early or late following either ileostomy or colostomy and has been reported in both the emergency and elective setting. The aetiology is likely multifactorial, but a few risk factors have been identified that predispose to its occurrence.

Survey of treatment practices for immunocompromised patients with COVID-19 in Australasia.

Coronavirus disease 2019 (COVID-19) in immunocompromised patients can lead to severe and prolonged illness. Data are limited with regard to management of COVID-19 in this setting, particularly in persistent or recrudescent infection. The authors conducted an online survey among infectious diseases doctors to determine current approaches to treatment across Australasia.

Negative predictive value of the FebriDx host response point-of-care test in patients presenting to a single Australian emergency department with suspected COVID-19: an observational diagnostic accuracy study.

Objectives: To determine the negative predictive value (NPV) of the FebriDx point-of-care host response device in patients presenting with symptoms suggestive of COVID-19 infection in a mostly immunised Australian emergency department (ED) population during the late 2021 phase of the COVID-19 pandemic.

Design: Observational diagnostic accuracy study comparing FebriDx point-of-care test to SARS-CoV-2 PCR.

Setting: An ED in Melbourne, Australia, with 63 000 annual presentations in 2021.

State-wide genomic epidemiology investigations of COVID-19 in healthcare workers in 2020 Victoria, Australia: Qualitative thematic analysis to provide insights for future pandemic preparedness.

Background: COVID-19 has affected many healthcare workers (HCWs) globally. We performed state-wide SARS-CoV-2 genomic epidemiological investigations to identify HCW transmission dynamics and provide recommendations to optimise healthcare system preparedness for future outbreaks.

Methods: Genome sequencing was attempted on all COVID-19 cases in Victoria, Australia.

Impact of SARS-CoV-2 transmission-based precautions on inpatient management of general medical patients.

This audit reviewed the impact on access to routine medical care and adverse outcomes in patients with suspected SARS-CoV-2 infection managed on a 'COVID-19' (CV) ward compared with a general medicine ward at Box Hill Hospital, Victoria. Data were collected at two time points to capture changes associated with onsite testing. We found no healthcare delays from admission to CV wards and observed faster exits from CV wards with improved testing efficiency.

Worth the risk? Contemporary indications, yield and complications of lumbar punctures in a metropolitan Australian health service.

Background: Performing lumbar punctures carries a risk of harm to the patient, but the information cerebrospinal fluid provides often makes this procedure necessary. Clinicians in the Australian setting would benefit from having more information on these procedures, in order to help them in a risk versus benefit analysis.

Aims: To describe the contemporary indications, cerebrospinal fluid findings and complications of lumbar punctures in a metropolitan Australian health service.

Patients Generally May Return to Driving 4 Weeks After Hip Arthroscopy and 6 Weeks After Knee Arthroscopy: A Systematic Review and Meta-analysis.

Purpose: To consolidate the evidence from the available literature and undertake a meta-analysis to provide a reference for physicians to make evidence-based recommendations to their patients regarding the return to driving after hip or knee arthroscopic procedures.

Methods: A systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The OVID, Embase, and Cochrane databases were searched through June 2020 for articles containing keywords and/or MeSH (Medical Subject Headings) terms "hip arthroscopy" and "knee arthroscopy" in conjunction with "total brake response time" or "reaction time" in the context of automobile driving.

Acute knee clinics are effective in reducing delay to diagnosis following anterior cruciate ligament injury.

Background: Delays to diagnosis of anterior cruciate ligament (ACL) injury and specialist consultation continue to place patients at risk of early onset osteoarthritis. Incorporating acute knee clinics within a streamlined accident and emergency (A&E) pathway have shown potential in reducing delay but specific evaluative research is lacking. The aim of this service evaluation was to investigate the effectiveness of an acute knee clinic at one NHS Trust in the United Kingdom (UK), on reducing the delay to diagnosis of ACL injury and specialist consultation compared to a standard A&E pathway.

Doctor when can I drive? Braking response after knee arthroplasty: A systematic review & meta-analysis of brake reaction time.

Background: There is limited evidence available on return to driving for patients undergoing knee arthroplasty (KA). Primarily, surgeons have used brake reaction time as a surrogate measure of safe return to driving. The purpose of this study was to review existing literature and provide guidance on the recovery of braking performance following knee arthroplasty.

Implementation of an organ space infection prevention bundle reduces the rate of organ space infection after elective colorectal surgery.

Background: Surgical site infections (SSIs) are morbid and costly complications after elective colorectal surgery. SSI prevention bundles have been shown to reduce SSI in colorectal surgery, but their impact on organ space infections (OSI) is variable. Adoption of an evidence-based practice without an implementation strategy is often unsuccessful.

SARS-CoV-2 seroprevalence in healthcare workers in a tertiary healthcare network in Victoria, Australia.

Background: Healthcare workers (HCW) are exposed to an increased risk of COVID-19 through direct contact with patients and patient environments. We calculated the; seroprevalence of SARS-CoV-2 in HCW at Eastern Health, a tertiary healthcare network in Victoria, and assessed associations with demographics, work location and role.

Methods: A cross-sectional cohort study of HCW at Eastern Health was conducted.

Doctor when can I drive? A systematic review and meta-analysis of return to driving after total hip arthroplasty.

Background/objective: Advice given to patients on driving resumption after total hip arthroplasty (THA) is inconsistent. Due to a lack of clear guidelines, surgeons' recommendations range between 4-8 weeks after surgery to resume driving. Delays in driving return can have detrimental social and economic impact.

Effect of Vancomycin or Daptomycin With vs Without an Antistaphylococcal β-Lactam on Mortality, Bacteremia, Relapse, or Treatment Failure in Patients With MRSA Bacteremia: A Randomized Clinical Trial.

Importance: Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is associated with mortality of more than 20%. Combining standard therapy with a β-lactam antibiotic has been associated with reduced mortality, although adequately powered randomized clinical trials of this intervention have not been conducted.

Objective: To determine whether combining an antistaphylococcal β-lactam with standard therapy is more effective than standard therapy alone in patients with MRSA bacteremia.

Stratifying the mechanical performance of a decellularized xenogeneic tendon graft for anterior cruciate ligament reconstruction as a function of graft diameter: An animal study.

Objectives: This study investigated the biomechanical performance of decellularized porcine superflexor tendon (pSFT) grafts of varying diameters when utilized in conjunction with contemporary ACL graft fixation systems. This aimed to produce a range of 'off-the-shelf' products with predictable mechanical performance, depending on the individual requirements of the patient.

Methods: Decellularized pSFTs were prepared to create double-bundle grafts of 7 mm, 8 mm, and 9 mm diameter.

Developing a Sustainable Renal Transplant Program in Low- and Middle-Income Countries: Outcome, Challenges, and Solutions.

Introduction: The initiation of a kidney transplant program, in a low- and middle-income country, while striving to maintain excellent outcomes and adhere to high ethical, legal standards, is a formidable task. Herein, we review the outcomes and challenges of a living donor kidney transplant program from its inception to sustainability, in Guyana, South America.

Methods: This is a retrospective review of a living donor kidney transplant program instituted in Guyana in 2008.

Association Between Weight Loss Before Deceased Donor Kidney Transplantation and Posttransplantation Outcomes.

Rationale & Objective: There is debate on whether weight loss, a hallmark of frailty, signals higher risk for adverse outcomes among recipients of deceased donor kidney transplantation (DDKT).

Study Design: Retrospective cohort study.

Setting & Participants: Using national Organ Procurement and Transplantation Network data, we included all DDKT recipients in the United States between December 4, 2004, and December 3, 2014, who were adults (aged ≥ 18 years) when listed for DDKT.

Predicting Perceived Disfigurement from Facial Function in Patients with Unilateral Paralysis.

Background: Clinical rating tools such as the electronic, clinician-graded facial function (eFACE) scale provide detailed information about aspects of facial functioning relevant to the assessment and treatment of facial paralysis. Past research has established that eFACE scores significantly relate to expert ratings of facial disfigurement. However, no studies have examined the extent to which eFACE scores relate to casual observers' perceptions of disfigurement in facial paralysis.

Actinomyces spp. bloodstream and deep vein thrombus infections in people who inject drugs.

Introduction: Actinomyces spp. cause several well-described syndromes including cervicofacial and pelvic infections. Actinomyces spp.

Association of the kidney allocation system with dialysis exposure before deceased donor kidney transplantation by preemptive wait-listing status.

Background: It is unknown whether the new kidney transplant allocation system (KAS) has attenuated the advantages of preemptive wait-listing as a strategy to minimize pretransplant dialysis exposure.

Methods: We performed a retrospective study of adult US deceased donor kidney transplant (DDKT) recipients between December 4, 2011-December 3, 2014 (pre-KAS) and December 4, 2014-December 3, 2017 (post-KAS). We estimated pretransplant dialysis durations by preemptive listing status in the pre- and post-KAS periods using multivariable gamma regression models.

Association between Medicaid Expansion under the Affordable Care Act and Preemptive Listings for Kidney Transplantation.

Background And Objectives: Before 2014, low-income individuals in the United States with non-dialysis-dependent CKD had fewer options to attain health insurance, limiting their opportunities to be preemptively wait-listed for kidney transplantation. We examined whether expanding Medicaid under the Affordable Care Act was associated with differences in the number of individuals who were pre-emptively wait-listed with Medicaid coverage.

Design, Setting, Participants, & Measurements: Using the United Network of Organ Sharing database, we performed a retrospective observational study of adults (age≥18 years) listed for kidney transplantation before dialysis dependence between January 1, 2011-December 31, 2013 (pre-Medicaid expansion) and January 1, 2014-December 31, 2016 (post-Medicaid expansion).