Insulin pump access issues for visually impaired people with type 1 diabetes.

Background: An electronic literature search was conducted to determine suitability of insulin pumps for people with type 1 diabetes who have visual impairment.

Methods: Ovid MEDLINE and CINAHL databases as well as the Internet were searched. Search terms used were insulin pump therapy, continuous subcutaneous insulin infusion, blindness, vision disorders, visually impaired persons and low vision.

Capturing the data: nutrition risk screening of adults in hospital.

This study aims to explore limitations with the Malnutrition Screening Tool in identifying malnutrition risk, in a cohort of 3,033 adult Australian medical and surgical hospital inpatients. Seventy-two percent of patients were screened; illness and medical care limited access to others. Malnutrition risk (16.

Evidence-based guidelines for perioperative management of diabetes in cardiac and vascular surgery.

Background: Management of patients with hyperglycaemia undergoing vascular and cardiac surgery is important, with mounting evidence that hyperglycaemia in this setting is associated with worse outcomes. Evidence-based guidelines for the management of these patients have been limited.

Methods/results: Our institution was aware of the lack of standardization of care in this growing population group and formed a multidisciplinary guideline development group to develop evidence-based guidelines to standardize the perioperative management of hyperglycaemia.

Use of the visual analog scale to rate and monitor severity of nausea in the emergency department.

Objectives: The objective was to describe the association between verbal descriptors of nausea severity and visual analog scale (VAS) ratings in an undifferentiated emergency department (ED) population and to calculate the minimum clinically significant difference (MCSD) in VAS rating of nausea severity in this population.

Methods: A prospective observational study was conducted at three EDs on a convenience sample of stable, consenting adult patients presenting with nausea as part of their symptom complex. Data included demographics, adjectival description of nausea severity (none, mild, moderate, or severe), and VAS rating (standard 100-mm line) at enrollment, 30 minutes, and 60 minutes.

Management of Chronic Heart Failure in Primary Care: What Evidence do we have for Heart Failure with Preserved Systolic Function?

Chronic Heart Failure (CHF) is a debilitating illness commonly encountered in primary care. Its prevalence in developing countries is rising as a result of an ageing population, and an escalating epidemic of hypertension, type 2 diabetes and coronary heart disease. CHF can be specifically diagnosed as Heart Failure with Reduced Systolic Function (HF-RSF) or Heart Failure with Preserved Systolic Function (HF-PSF).

Factors influencing rural versus metropolitan work choices for emergency physicians.

Objectives: To survey Fellows of the Australasian College for Emergency Medicine (FACEM) on how a range of factors influenced their decision to accept their most recent position. To compare this information between rural and metropolitan FACEM.

Methods: Analytical cross-sectional survey of FACEM.

Thrombolytic therapy for management of complicated catheter-related Candida albicans thrombophlebitis.

In immunocompromised patients, endovascular infection due to Candida albicans is associated with significant morbidity and mortality. Recommended management includes removal of any existing central venous catheter. Rarely, complications of endocarditis or infected mural thrombi may arise, with poorer clinical outcomes.

Traumatic pseudoaneurysm of superficial temporal artery: a case report.

We report a case of a 36-year-old male who presented with a pulsatile mass at the left temporal region after a head injury. Duplex sonographic examination confirmed the diagnosis of traumatic pseudoaneurysm of the superficial temporal artery. Imaging showed the pseudoaneurysm was partially thrombosed.

Long saphenous vein and its anatomical variations.

Vascular ultrasonography has an important role in the diagnosis and management of venous disease. The venous system, however, is more complex and variable compared to the arterial system due to its frequent anatomical variations. This often becomes quite challenging for sonographers.

Career development year in emergency nursing: using specific educational preparation and clinical support to facilitate the transition to specialist practice.

This article outlines the development, implementation and evaluation of the Career Development Year (CDY) in the Emergency Department (ED) at Dandenong Hospital in Victoria, Australia. As a consequence of a shortage of emergency nurses, hospitals have recruited inadequately prepared nurses to staff their EDs. The resultant increase in stress of qualified and experienced emergency nurses has had a major impact on the retention of emergency nurses.

In vivo and in vitro assessment of human saphenous vein wall changes.

Purpose: To investigate if noradrenaline (NA) and 5-hydroxyptamine (5-HT) drugs induce responses of isolated control and varicose veins are altered by removal of the endothelium. SUBJECTS #ENTITYSTARTX00026;

Methods: Specimens of the great saphenous vein (GSV) were obtained from 12 subjects with primary varicose veins and 12 subjects from donor vessels at cardiac surgery. A total of 10 normal healthy volunteers were selected for comparison.

Staphylococcal pyomyositis in a temperate region: epidemiology and modern management.

Objectives: To describe all cases of staphylococcal pyomyositis in the Geelong region of Victoria over 110 months, to estimate the incidence of this disease, and to describe the clinical outcomes and identify any predisposing factors.

Design, Participants And Setting: A prospective case series identified by clinical features (local pain and fever) and magnetic resonance imaging (MRI) findings (hyperintense signal on T2-weighted scan), among patients presenting to Geelong Hospital, Victoria between 1 April 1998 and 1 June 2007.

Main Outcome Measures: Estimation of incidence, clinical course and identification of predisposing factors.

Mechanical and circulating biomarkers in isolated clinic hypertension.

1. This review examines the current evidence for altered mechanical and circulating biomarkers in isolated clinic hypertension and their potential significance. 2.

Is venous reflux a common disease in post-thrombotic patients with unilateral deep vein thrombosis episode?

Objectives: To investigate reflux development and changes in resting venous diameters in the DVT and the non-DVT lower limbs.

Methods: Twenty subjects (40 limbs) with acute unilateral proximal DVT diagnosed by ultrasound, who were treated with low-molecular-weight-heparin (LMWH), followed by at least three months of oral warfarin therapy, were enrolled in the study. The limbs were classified according to CEAP (clinical, aetiologic, anatomic, pathophysiology) clinical classification on a scale of 0-6.

Six year audit of cardiac arrests and medical emergency team calls in an Australian outer metropolitan teaching hospital.

Problem: In-hospital cardiac arrest often represents failure of optimal clinical care. The use of medical emergency teams to prevent such events is controversial. In-hospital cardiac arrests have been reduced in several single centre historical control studies, but the only randomised prospective study showed no such benefit.

Review of mannequin-based high-fidelity simulation in emergency medicine.

The spectrum of uses of high-fidelity simulation in emergency medicine has increased in the past 10 years and ranges from teaching isolated skills to improving complex team behaviours in critical situations. This review will describe these published uses and explore the evidence supporting the use of high-fidelity simulation, as well as the future directions and difficulties of using this technology in our specialty.

Association of carotid intima-medial thickness and indices of arterial stiffness with cardiovascular disease outcomes in CKD.

Background: Indices of arterial structure and stiffness are proposed as surrogate markers of cardiovascular disease in patients with chronic kidney disease (CKD), but no study examined multiple markers in the same population.

Study Design: Prospective observational study.

Setting & Participants: 315 subjects with stages 4 to 5 CKD, aged 24 to 79 years (mean age, 56.

Incomplete excision of basal cell carcinoma: a prospective trial.

Background: As a measure of the standard of surgical care, incomplete excision of skin malignancy is an important clinical indicator, developed by the Royal Australasian College of Surgeons and the Australian Council on Healthcare Standards. Reported rates of incomplete excision of basal cell carcinoma vary widely (5 to 25 percent) among centers worldwide. This prospective study reports on the incidence of incomplete excision at a tertiary referral public hospital and determines the factors that may influence this.

Best practices: the consultation-liaison in primary-care psychiatry program: a structured approach to long-term collaboration.

This column presents the Consultation-Liaison in Primary-Care Psychiatry model, which was developed in Australia. This model is a structured approach to collaborative care of people with mental illnesses between primary care services and specialist mental health services. The first component of the model is a consultation, liaison, and education service provided by psychiatric consultants at participating general practices.

The safety of nurse clearance of the cervical spine using the National Emergency X-radiography Utilization Study low-risk criteria.

Objectives: To determine the level of agreement between trained ED nursing staff and senior ED medical staff in the application and interpretation of the National Emergency X-radiography Utilization Study (NEXUS) low-risk criteria (NLC).

Methods: A NEXUS training and accreditation package was developed. It was successfully undertaken by 22 senior ED nursing staff and 26 senior ED medical staff.

Arterial stiffness and cardiovascular outcome.

1. Studies have reported an association between arterial function indices and cardiovascular risk factors, as well as the risk of incident cardiovascular events, including coronary heart disease and stroke. 2.