Outcomes of Del Nido and hyperkalemic blood cardioplegia in adult cardiac surgery with prolonged aortic cross-clamp times★.

Background: The utility and uptake of Del Nido cardioplegia in adult cardiac surgery is rapidly increasing. Cases with prolonged aortic cross-clamp times necessitate multi-dosing however an understanding of safe ischaemic times and definitive guidelines in this domain are lacking. Therefore, this study aimed to assess the safety and efficacy of our DNC strategy by comparing post-operative troponin profiles and clinical outcomes between Del Nido and hyperkalaemic cardioplegia for cases with aortic cross-clamp times of greater than 90 min.

Anakinra in relapsing polychondritis: a case report and review of the literature.

Relapsing polychondritis is rare and affects non-synovial fibrocartilage. Currently, there is a paucity of treatment algorithms, especially for those with refractory disease. A middle-aged man presented with polychondritis affecting the nose, ears, joints, and larynx.

Strategies to improve research participation by older people with cognitive impairment: a systematic review.

Background And Objectives: Older people with cognitive impairment are unrepresented in clinical research. Our objective was to review evidence for strategies to support their research inclusion and participation.

Research Design And Methods: Systematic review of published reports of inclusion and participation strategies for older people with cognitive impairment in clinical research (PROSPERO CRD42020212092).

Management, outcomes and predictors of mortality of Cryptococcus infection in patients without HIV: a multicentre study in 46 hospitals from Australia and New Zealand.

Background: Limited data exist regarding outcomes of cryptococcosis in patients without HIV with few studies having compared outcomes of Cryptococcus gattii, versus C. neoformans, infection.

Methods: We conducted a retrospective study in 46 Australian and New Zealand hospitals to determine the outcomes of cryptococcosis in patients without HIV diagnosed between 2015 and 2019, and compared outcomes of C.

Association between body mass index and clinical outcomes in patients with acute myocardial infarction and reduced systolic function: Analysis of PARADISE-MI trial data.

Aims: The relationship between body mass index (BMI) and clinical outcomes in patients with cardiovascular disease, including acute heart failure (AHF) and acute myocardial infarction (AMI), remains debated. This study investigates the association between BMI and clinical outcomes within the PARADISE-MI cohort, while also evaluating the impact of angiotensin receptor-neprilysin inhibitor (ARNI) versus angiotensin-converting enzyme inhibitor (ACE-I) treatment on this relationship.

Methods And Results: The analysis included 5589 patients from the PARADISE-MI study with available baseline BMI data.

Clinical Application of 3D-Assisted Surgery Techniques in Treatment of Intra-Articular Distal Radius Fractures: A Systematic Review in 718 Patients.

: Three-dimensional (3D) technology is increasingly applied in the surgical treatment of distal radial fractures and may optimize surgical planning, improve fracture reduction, facilitate implant and screw positioning, and thus prevent surgical complications. The main research questions of this review were as follows: (1) "How do 3D-assisted versus 2D-assisted distal radius fracture surgery compare in terms of intraoperative metrics (i.e.

Association Between Multivitamin Use on Admission and Clinical Outcomes in Patients Hospitalised with Community-Acquired Pneumonia: A Case-Cohort Study.

Background/objectives: Community-acquired pneumonia (CAP) is a leading cause of hospitalisations worldwide. Micronutrient deficiencies may influence CAP risk and severity, but their impact on CAP outcomes remains unclear. This study investigated the influence of multivitamin use on hospital length of stay (LOS), intensive care unit (ICU) admission, in-hospital mortality, and 30-day readmissions in hospitalised CAP patients.

The effects of low-dose morphine on sleep and breathlessness in COPD: A randomized trial.

Background: Low-dose morphine may be prescribed to reduce chronic breathlessness in chronic obstructive pulmonary disease (COPD). Recent subjective findings suggest morphine may influence breathlessness through sleep-related mechanisms. However, concerns exist regarding opioid safety in COPD.

Tetrodotoxin toxicity: an increasing threat.

A man aged in his sixties presented to the emergency department with vomiting, dizziness and generalised weakness preceded by perioral and peripheral paraesthesias for several hours. He did not speak English and was visiting from overseas. Examination revealed multidirectional nystagmus, subtle bilateral ptosis, marked bilateral upper limb dysmetria and heel-shin ataxia, with mild proximal limb weakness.

Association of Lupus Low Disease Activity State And Remission With Reduced Organ Damage And Flare in Systemic lupus erythematosus Patients With High Disease Activity.

Objective: High disease activity status (HDAS) in patients with systemic lupus erythematosus (SLE) is associated with adverse long-term outcomes. We examined the frequency of lupus low disease activity state (LLDAS) and remission (REM) attainment in HDAS patients and whether their attainment was associated with improved patient outcomes.

Methods: Demographic, clinical and outcomes data, collected prospectively from a multinational cohort between 2013 and 2020, were analysed.

An international Delphi consensus on patient preparation for metabolic and bariatric surgery.

Global obesity rates have risen dramatically, now exceeding deaths from starvation. Metabolic and bariatric surgery (MBS), initially for severe obesity (BMI ≥35 kg/m), is performed globally over 500 000 times annually, offering significant metabolic benefits beyond weight loss. However, varying eligibility criteria globally impact patient care and healthcare resources.

Statewide neurology inpatient whole body and brain 18F-fluorodeoxyglucose positron emission tomography utilisation patterns demonstrate avenues for optimisation.

18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) can provide unique insights; however, access may be difficult. In this 2-year statewide study of all neurology inpatient admissions, 27.9% (41/147) of PET (any field of view) demonstrated significant abnormalities.

The Role of the Neutrophil-to-Lymphocyte ratio in Predicting Outcomes Among Patients with Community-Acquired Pneumonia.

Objectives: The value of the neutrophil-to-lymphocyte ratio (NLR) in predicting outcomes in patients hospitalised with community-acquired pneumonia (CAP) remains debated. This study evaluated whether NLR independently predicts clinical outcomes and enhances the predictive performance of the CURB-65 score in CAP patients.

Methods: Data from CAP admissions at two Australian hospitals from 2018 to 2023 were analysed.

Dynamic CT features of scapholunate instability during the wrist extension to flexion-An in vivo study.

Purpose: This biomechanical study aimed to assess the change in the radioscaphoid and the radiolunate angles during wrist extension to flexion in scapholunate instability compared to the healthy wrist.

Methods: Dynamic CT scans of 19 participants with no history of wrist pathology and 19 patients with scapholunate instability without degenerative changes were selected. Motion sequence studied was wrist extension to flexion.

Vascular endothelial growth factor as a potential biomarker in systemic sclerosis: a systematic review and meta-analysis.

Introduction: Systemic sclerosis (SSc), a chronic autoimmune condition, is characterized by microvascular dysfunction, ineffective angiogenesis, and fibrosis. The identification of robust biomarkers reflecting these processes may assist in clinical management and lead to the discovery of new therapies. We sought to address this issue by conducting a systematic review and meta-analysis of studies investigating one such biomarker, vascular endothelial growth factor (VEGF), in SSc patients and healthy controls and in SSc patients with localized or diffuse disease, different video capillaroscopy patterns (early, active, or late), and presence or absence of complications.

Characteristics of paracetamol poisoning in a local health network and consistency of hospital management with national guidelines.

The management of paracetamol poisoning in our local health network and consistency with national guidelines is unclear. We conducted a 4-month retrospective study of all paracetamol poisonings identified in two South Australian hospitals. Most presentations were deliberate self-poisoning (90.

Symmetric dimethylguanidino valeric acid, a novel single biomarker of hepatic steatosis.

There is an unmet need for a biomarker of liver fat. We identified dimethylguanidino valeric acid (DMGV) as a circulating biomarker of liver fat. Here, we assess its two isoforms-symmetric (SDGV) and asymmetric (ADGV)-as biomarkers of steatosis.

Comparing post-treatment urinary and colorectal procedures in prostate cancer patients using population-based linked data.

Purpose: To investigate urinary and colorectal procedures among men who underwent radical prostatectomy (RP) and external beam radiotherapy (EBRT).

Methods: We studied 16,271 (RP = 8516 and EBRT = 7755) South Australian men diagnosed with prostate cancer between 2001 and 2021. Colorectal and urinary procedures were extracted from hospital admission procedure codes and Medical Benefits Schedule item codes.

Iatrogenic Erosion of Orbital Walls due to Expanding Hydrogel Explant.

Hydrogel scleral buckles are a hydrophilic explant that may lead to significant delayed complications. They can insidiously enlarge over decades and may mimic an orbital tumor or cyst. The authors report a case of an expansive hydrogel scleral explant in a previously eviscerated socket.

VEGF in psoriatic arthritis: Systematic review and meta-analysis.

Psoriatic arthritis (PsA), a chronic autoimmune disease of unclear aetiology, is associated with dysregulated angiogenesis due to the proliferation, migration, and differentiation of endothelial cells. Vascular endothelial growth factor (VEGF) plays a key role such that PsA patients exhibit skin and joint symptoms, e.g.

Prioritising domains of glucocorticoid therapy to measure in trials: Results from a modified delphi exercise from the OMERACT glucocorticoid impact working group.

Introduction: There is no consensus amongst patients and healthcare professionals about how to measure important adverse effects of glucocorticoids (GCs) that includes the patient's perspective. The OMERACT GC Impact working group sought to identify the domains of greatest importance to both patients and healthcare professionals for use in a proposed core outcome set.

Methods: Patients and healthcare professionals participated in a Delphi consensus exercise to rate the importance of previously identified candidate domains.

Early Patient-Reported Outcome Measures Following Computer Navigated Total Hip Arthroplasty: A Study from the Australian Orthopaedic Association National Joint Replacement Registry.

Background: Total hip arthroplasty (THA) is a well-established treatment for symptomatic hip osteoarthritis (OA). The use of computer navigation in THA aims to achieve the reconstruction of the joint more consistently and precisely. The aim of this study was to contrast patient-reported outcome measures (PROMs) for THA procedures with and without commercially available navigation technologies.

Somatosensory evoked potentials: technique, interpretation and clinical applications.

Somatosensory evoked potentials (SSEPs) are electrical potentials that measure various parts of the ascending somatosensory pathways. They are elicited through stimulating mixed nerves, with subsequent orthodromic stimulation of sensory nerves. Despite advances in imaging, SSEPs complement both the clinical examination and peripheral neurophysiological studies when assessing the functional integrity of the sensory pathways, being especially helpful when imaging is inconclusive.