5,393 results match your criteria: "Epworth Hospital; and.[Affiliation]"

Background: Estimating prognosis can be a barrier to timely palliative care involvement. The modified Hospitalized-patient One-year Mortality Risk (mHOMR) score uses hospital admission data to calculate the risk of death within 12 months and may be a useful tool to trigger a referral to palliative care.

Methods: The mHOMR tool was retrospectively applied to consecutive acute admissions to a quaternary cancer center in Toronto, Canada from March 1 to May 31, 2018.

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  • The research analyzes data from 605 patients and establishes a correlation between TIAO rates and surgical procedures, indicating that single or multilevel total disc replacements (TDR) have higher TIAO rates compared to anterior lumbar interbody fusions (ALIF).
  • Key findings reveal that the risk for TIAO is significantly elevated at the L4/5 level, with rates reaching as high as 65.2%, although no patients experienced serious postoperative complications related to thrombosis.
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The Swedish sleep apnea registry (SESAR) cohort - "Real world data" on a national level.

Sleep Med

December 2024

Center for Sleep and Wake Disorders, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. Electronic address:

Introduction: The Swedish Sleep Apnea Registry (SESAR) collects clinical data from individual obstructive sleep apnea (OSA) patients since 2010. SESAR has recently been integrated with additional national healthcare data. The current analysis presents the SESAR structure and representative clinical data of a national sleep apnea cohort.

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  • Many patients experience neuropsychiatric symptoms post-SARS-CoV-2 infection, but the prevalence of post-COVID-19 condition (PCC) is inconsistent due to vague diagnostic criteria and nonspecific symptoms.
  • A study followed 175 PCC patients for up to 18 months, revealing common symptoms like fatigue, stress intolerance, and cognitive deficits, with 28% also diagnosed with psychiatric disorders.
  • Over time, most patients showed improvement, with 76.8% reporting reduced symptoms and 51.2% symptom-free, while testing did not support the role of suggested biomarkers in identifying PCC.
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  • Obstructive sleep apnea (OSA) often causes excessive daytime sleepiness (EDS), and pitolisant, a medication that targets histamine receptors, was tested for its efficacy in treating this issue in patients with moderate to severe OSA.
  • In a clinical trial with 361 participants, pitolisant was administered in varying doses up to 40 mg daily for 12 weeks, showing a significant reduction in EDS as measured by the Epworth Sleepiness Scale compared to a placebo.
  • The study found that pitolisant was well tolerated and improved not only daytime sleepiness but also reaction times and overall patient satisfaction, regardless of whether patients used continuous positive airway pressure (CPAP) therapy.
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There is a clinical need for improved intraoperative detection of endometriosis, and the use of Indocyanine Green with Near-Infrared Imaging (NIR-ICG) is a novel technique for this purpose. The aim of this review is to determine whether NIR-ICG is an effective tool for endometriosis detection and establish an evidence-based methodology for its use. This review searches Ovid MEDLINE and Embase through July 2023 and considers primary literature published in English describing the use of NIR-ICG to detect endometriosis intraoperatively.

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Introduction And Hypothesis: Vaginal pessaries are the mainstay of the non-surgical management of pelvic organ prolapse (POP). A flexible silicone irregular hexagonal (SIH) pessary was developed based on the results of a prior vaginal case study. We hypothesised that the SIH pessary would have a higher rate of retention and self-management than the polyvinyl chloride (PVC) pessary.

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Objective: This study compares the efficacy of oral exercise alone to oral exercise with frenectomy in improving obstructive sleep apnea (OSA) symptoms and quality of life (QOL) in patients with ankyloglossia.

Materials And Methods: A prospective, controlled, double-blind clinical study enrolled fifteen adults (20-60 years) newly diagnosed with mild to moderate OSA and ankyloglossia. Participants were randomly assigned to either oral exercise alone (control group; n = 8) or oral exercise with frenectomy (intervention group; n = 7).

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Purpose: The diagnosis of severe OSA still relies on polysomnography, which causes a strong sense of restraint in patients with obesity. However, better prediction tools for severe OSA applicable to patients with obesity have not been developed.

Patients And Methods: Relevant clinical data of 1008 patients with OSA who underwent bariatric surgery in our hospital were collected retrospectively.

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  • A study evaluated a new streamlined approach for hypoglossal nerve stimulator (HGNS) implantation, comparing it to a traditional method.
  • The streamlined pathway reduced hospital costs by an average of $9,258 and decreased time to surgery by about 3.82 months without compromising clinical outcomes.
  • The findings suggest that this new approach could be beneficial for certain patients, but more research is needed to refine patient selection and assess long-term effects.
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  • The study examined whether a standard dose of bilastine (20 mg) is as effective as a double dose of second-generation H1-antihistamines for treating patients with refractory chronic spontaneous urticaria (CSU).
  • Conducted as a phase IV, multicenter trial, it involved 128 patients and measured treatment efficacy through the mean total symptom score (TSS) after 5-7 days of administration.
  • Results showed that bilastine was non-inferior in effectiveness to double-dose H1AH and had a similar safety profile, with no serious adverse effects reported in either treatment group.
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Background: Traumatic injuries, defined as physical injuries with sudden onset, are a major cause of distress and disability, with far-reaching societal consequences. A significant proportion of trauma survivors report persistent symptoms and difficulties after the injury, and studies show unmet health care needs. Self-management programs delivered in the sub-acute phase after traumatic injuries are scarcely evaluated.

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Pathophysiology, blood biomarkers, and functional deficits after intimate partner violence-related brain injury: Insights from emergency department patients and a new rat model.

Brain Behav Immun

January 2025

Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Centre for Trauma & Mental Health Research, Vancouver Island University, Nanaimo, BC, Canada; Neuroscience Program, Division of Medical Sciences, University of Victoria, Victoria, BC, Canada. Electronic address:

Intimate partner violence is a serious, but underappreciated, issue that predominantly affects women and often results in concussion (i.e., mild traumatic brain injury).

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Background And Aims: Since the onset of the Coronavirus disease 2019 (COVID-19) pandemic, there has been a significant opportunity to leverage virtual platforms for communication and dissemination of knowledge. An online survey was conducted to examine the viewpoints of World Gastroenterology Organization (WGO) leaders concerning the necessity, primary priority areas, and implementation strategies for a virtual global gastroenterology educational program.

Methods: We conducted a survey of leaders of WGO member societies to assess their opinions on creating opportunities for global education using virtual platforms, identifying practical implementation steps and priority educational areas.

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Study Objectives: To evaluate efficacy of vibrotactile positional therapy (PT) compared to standard CPAP therapy in mild-to-moderate positional obstructive sleep apnea (pOSA).

Methods: Prospective crossover randomized controlled trial of adult patients with treatment-naïve, symptomatic, mild-to-moderate pOSA - defined as ≥5 total apnea-hypopnea index (AHI) <30 with supine-to-non-supine (s:ns)AHI ratio ≥2. Participants were randomized to in-laboratory treatment initiation polysomnography with either PT or CPAP on sequential nights before an eight-week trial of each therapy.

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Background: Obstructive sleep apnoea (OSA) is a common chronic respiratory disease associated with a high burden of disabilities related to sleepiness and reduced quality of life. Despite first-line treatment with continuous positive airway pressure (CPAP) therapy, many patients experience residual excessive daytime sleepiness (EDS). The aim of this study is to compare the relative efficacy and safety of medications authorised for this indication in Europe and/or the United States (modafinil/armodafinil, solriamfetol, and pitolisant) for OSA.

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Prior Appendicectomy and Gut Microbiota Re-Establishment in Adults after Bowel Preparation and Colonoscopy.

Biomedicines

August 2024

The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, VIC 3220, Australia.

Emerging evidence suggests that the human vermiform appendix is not a vestigial organ but rather an immunological organ of biological relevance. It is hypothesised that the appendix acts as a bacterial 'safe house' for commensal gut bacteria and facilitates re-inoculation of the colon after disruption through the release of biofilms. To date, no studies have attempted to explore this potential mechanistic function of the appendix.

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Background: Sleep disturbances are a prevalent phenomenon in patients with multiple sclerosis (PwMS). The present study employs polysomnography (PSG) to quantify sleep efficiency and architecture in PwMS, aiming to elucidate the relationships between PSG parameters and factors including gender, disability level, brain lesion location, and subjective measures of insomnia, excessive daytime sleepiness (EDS), fatigue, pain, and mood disorders.

Methods: The study cohort comprised 51 adult PwMS, of whom 31 underwent overnight PSG.

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Understanding the risk factors for cognitive impairment in interstitial lung disease (ILD) can help guide disease management tailored to cognitive function. However, no review articles or randomized controlled trial articles have been found for cognitive impairment in ILD. This scoping review aimed to systematically map studies on factor-related cognitive impairment in ILD and organize current knowledge.

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Introduction And Objectives: Full blood examinations, often referred to as FBE, are commonly ordered postoperatively, despite limited utility in many of its markers in the acute phase. It is estimated that in the 2022-2023 financial year, the Australian healthcare system billed over $13 million for full blood examinations (FBEs) to Medicare. This study aims to assess the cost of using FBE following surgery.

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Objectives: Hypoglossal nerve stimulation (HGNS) is a treatment option for patients with CPAP-intolerant (CPAPi) obstructive sleep apnea (OSA). The modified sleep apnea severity index (mSASI) combines patient anatomy, weight, sleep study metrics, and symptoms into a composite index ranging from 1 (least severe) to 3 (most severe). Prior studies have associated mSASI with quality of life, CPAP adherence, and hypertension, but its utility in CPAPi patients is unknown.

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  • Extended-release sodium oxybate (ON-SXB) showed significant improvements in narcolepsy symptoms in the REST-ON trial, which was a phase 3 study comparing it to a placebo.
  • This analysis looked at the effectiveness of ON-SXB in patients both with and without the use of other alerting medications.
  • Results indicated that ON-SXB led to substantial improvements in sleep latency, cataplexy episodes, and overall sleepiness, regardless of whether participants were using alerting agents.
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  • This study investigates the connection between depression and narcolepsy type 1 (NT1) in Chinese patients, employing machine learning (ML) techniques to predict depression risk.
  • A total of 203 drug-free NT1 patients were assessed using various scales for depression, sleepiness, and impulsivity, and three ML models were tested to identify factors contributing to depression.
  • The Support Vector Machine (SVM) model outperformed others, identifying hallucinations and motor impulsivity as significant predictors of depression, suggesting its potential for personalized treatment approaches in NT1 patients.
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Background And Objectives: Coronary artery calcification (CAC) is a frequent additional finding on lung cancer screening (LCS) low-dose computed tomography (LDCT). Cardiovascular disease (CVD) is a major cause of death in LCS participants. We aimed to describe prevalence of incidental CAC detected on LDCT in LCS participants without prior history of coronary artery disease (CAD), evaluate their CVD risk and describe subsequent investigation and management.

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Plasma biomarkers in chronic single moderate-severe traumatic brain injury.

Brain

November 2024

Department of Neuroscience, School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3004, Australia.

Blood biomarkers are an emerging diagnostic and prognostic tool that reflect a range of neuropathological processes following traumatic brain injury (TBI). Their effectiveness in identifying long-term neuropathological processes after TBI is unclear. Studying biomarkers in the chronic phase is vital because elevated levels in TBI might result from distinct neuropathological mechanisms during acute and chronic phases.

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