Exploring the experience of post-stroke fatigue in community dwelling stroke survivors: a prospective qualitative study.

Purpose: To explore the experience of post-stroke fatigue in community-dwelling stroke survivors with and without post-stroke mood disturbance within one year of stroke.

Methods: This was a prospective qualitative cohort study including semistructured interviews undertaken at baseline (stroke onset), 3, 6, 9 and 12 months in 23 stroke survivors; eight single interviews were held with "supplementary" participants. Qualitative data analysis involved an inductive thematic approach using a process of constant comparison.

The role of speech pathology in the management of patients with chronic refractory cough.

Cough remains refractory to medical treatment in approximately 20% of cases. Speech pathology intervention is a useful treatment option for patients with chronic cough that is refractory to treatment based on the anatomic diagnostic protocol. One of the reasons for this is that the larynx can be implicated in the pathogenesis of chronic refractory cough.

Modification of Diamedica drawover anaesthetic equipment to facilitate introduction to an Australian teaching hospital.

We wanted to provide training in the use of drawover techniques and apparatus at an Australian teaching hospital. Equipment based on the Diamedica vaporiser was selected as it is suitable for use with sevoflurane. A lack of standards specific to drawover equipment from either anaesthetic professional bodies or national standards authorities hinders introduction of such equipment to Australian hospitals.

Death and dying in Australia: perceptions of a Sudanese community.

Aims: The aims of this study were to obtain information to support Palliative Care healthcare workers to meet the needs of the Sudanese population in death, dying, and bereavement.

Background: Australia is a multicultural society and healthcare workers are faced with increasing numbers and diversity of immigrants to whom healthcare professionals strive to provide quality health care.

Methods: A qualitative interpretive approach was used with data collected from a sample of 15 participants during focus group discussions.

Features and outcomes of neonatal neuroblastoma.

Purpose: Neonatal neuroblastoma (NNBL) is a rare tumour with few reported cases in the literature. The prognosis of NNBL is unclear with reported survival between 76 and 91%. The growing use of ante-natal ultrasound (USS) in recent years has resulted in an increasing incidence of NNBL.

Prospective study of antenatally diagnosed congenital cystic adenomatoid malformations.

Purpose: Congenital cystic adenomatoid malformations (CCAMs) are increasingly diagnosed in recent years due to the routine usage of antenatal ultrasound. The aim of this study was to present the natural course and outcome of antenatally diagnosed cystic lung diseases, which were prospectively studied.

Methods: Between the period June 2004 and June 2010, 25 fetuses with suspected CCAMs were seen in a single tertiary maternal fetal unit.

Mission to eliminate postinjury abdominal compartment syndrome.

Objectives: To determine the current incidence of postinjury abdominal compartment syndrome (ACS), the effect of intra-abdominal hypertension (IAH) on trauma outcomes, and the independent predictors of postinjury IAH.

Design: Prospective cohort study.

Setting: University-affiliated level 1 trauma center.

Baseline depression predicts malnutrition in head and neck cancer patients undergoing radiotherapy.

Purpose: Poor nutritional status is common and associated with mortality and morbidity in patients with head and neck cancer (HNC). While there are several established clinical risk factors for poor nutritional status during HNC radiotherapy, the complete aetiology is not known. The association of malnutrition with psychological factors has been recognised in other chronic illnesses but has not been studied in HNC patients who have higher levels of malnutrition and psychological disorder than many other patient populations.

A team approach: implementing a model of care for preventing osteoporosis related fractures.

Unlabelled: The implementation of a multidisciplinary team-based model of care has led to significant increases in identification of patients with osteoporosis who are at risk of refracture, together with improved treatment uptake and ongoing management.

Introduction: Osteoporosis-related fractures and consequent hospital admissions are largely preventable; however, little attention has been paid to how to achieve this, in particular, through improved models of care. Presentation to emergency departments (ED) with minimal trauma fracture (MTF) provides opportunity for patients at risk to be identified, referred and managed through a systematic process ensuring prompt intervention and continuing follow-up.

Five unit bolus oxytocin at cesarean delivery in women at risk of atony: a randomized, double-blind, controlled trial.

Background: I.v. bolus oxytocin is used routinely during cesarean delivery to prevent postpartum hemorrhage.

Ward reduction of gastroschisis: risk stratification helps optimise the outcome.

Purpose: Categorization of gastroschisis into low risk (simple) and high risk (complex) has been reported as an important determinant of outcome. The role of risk categorization in choosing the optimal surgical approach is unreported. This study aims to investigate the role of risk categorization in decision making for ward reduction of gastroschisis.

Video-assisted thoracoscopic surgery of childhood empyema: early referral improves outcome.

Background/aim: Video-assisted thoracoscopic surgery (VATS) is considered a safe and effective option in the treatment of childhood empyema. The aim of this study was to assess the efficacy of early referral for primary VATS in childhood empyema.

Method: A cohort of 24 consecutive children (12 boys, 12 girls) from 2004 to 2009 with post-pneumonic empyema, as demonstrated by loculation on ultrasound, undergoing VATS at a single tertiary level institution, was reviewed.

The Audio Recorded Cognitive Screen (ARCS) in patients with multiple sclerosis: a practical tool for multiple sclerosis clinics.

Background: Cognitive impairment is a common complication of multiple sclerosis, even in early stage disease, with significant impacts on life quality and social interaction. However, its detection is highly test-dependent.

Objective: To validate a recently described screening tool, the ARCS, for detecting cognitive impairment in a multiple sclerosis population.

Cardiogenic shock complicating subarachnoid haemorrhage diagnosed as Tako Tsubo cardiomyopathy: a cautionary tale.

Tako Tsubo or "stress" cardiomyopathy and its variants are well recognised as potential causes of acute coronary presentations, with manifestations including chest pain, cardiac failure and arrhythmia. Similarly, subarachnoid haemorrhage may be associated with cardiac abnormalities. Tako Tsubo cardiomyopathy is a diagnosis of exclusion with typical left ventricular dysfunction in the absence of epicardial coronary disease, but importantly also after exclusion of an intracerebral insult.

Adverse outcomes following emergency department discharge of patients with possible acute coronary syndrome.

Objective: To determine the proportion of adverse events in patients discharged after ED assessment for possible acute coronary syndrome.

Methods: Prospective observational cohort study enrolling consecutive patients presenting with symptoms suggestive of coronary syndrome. Main outcome was the proportion of adverse coronary events (defined a priori) within 30 days.

BraveHeart begins: pilot results of group cognitive behaviour therapy for depression and anxiety in cardiac patients.

Objective: In a general medical hospital with limited mental health resources, a clinical need arose for an effective treatment for depression and anxiety symptoms in cardiac rehabilitation patients.

Method: A total of 628 cardiac rehabilitation outpatients at a tertiary care centre were screened with the Hospital Anxiety and Depression Scale at week 4 of their programme, and 182 of 558 responders (33%) scored > or =8 on the Depression and/or Anxiety subscales. A 6 week group cognitive behaviour therapy programme was developed to assist these identified patients.

The influence of hepatitis C infection and interferon-alpha therapy on thyrotropin blocking and stimulating autoantibodies in Graves' ophthalmopathy: a case report.

Background: Hepatitis C virus is a highly immunogenic pathogen often inducing autoimmune activation changes and this can often be further exacerbated by Interferon therapy. As HCV is lymphocytotropic, it can modulate T cell and B cell antibody responses, affecting many endocrine organs, most commonly the thyroid.

Case Presentation: We hereby describe a case of fluctuating and wavering thyrotropin autoantibodies of both stimulating and blocking nature in the setting of Graves's ophthalmopathy, hepatitis C infection and interferon-alpha, causing hypo- and subsequently hyper-thyroidism.

Differential gene expression and cytokine production from neutrophils in asthma phenotypes.

Asthma is characterised into eosinophilic and non-eosinophilic phenotypes based on inflammatory cell patterns in airway secretions. Neutrophils are important in innate immunity, and are increased in the airways in non-eosinophilic asthma. The present study investigated the activity of neutrophils in asthma phenotypes.

The independent predictive utility of computed tomography angiographic collateral status in acute ischaemic stroke.

It is unknown whether collateral vessel status, as seen on computed tomography angiography, can predict the fate of penumbral tissue identified on perfusion computed tomography and thereby influence clinical outcome. We tested this hypothesis in consecutive patients who underwent perfusion computed tomography/computed tomography angiography within 6 h of anterior circulation stroke, who also had repeat perfusion/infarct volume imaging at 24 h, and modified Rankin Scale at 3 months. Collateral status was graded as good or reduced depending on the extent of contrast visualized distal to the occlusion on computed tomography angiography.

Postinjury abdominal compartment syndrome: are we winning the battle?

Postinjury (primary) abdominal compartment syndrome (ACS) was described more than 15 years ago as severe abdominal distension with high peak airway pressures, CO(2) retention, and oliguria, which led to unplanned re-exploration after damage-control laparotomy. Later, a more elusive type of ACS was recognized, which develops without abdominal injuries (secondary ACS). Both syndromes were recently characterized, their independent predictors were identified, and preventive strategies were developed to reduce their incidence.

An energy fluence-convolution model for amorphous silicon EPID dose prediction.

In this work, an amorphous silicon electronic portal imaging device (a-Si EPID) dose prediction model based on the energy fluence model of the Pinnacle treatment planning system Version 7 (Philips Medical Systems, Madison, WI) is developed. An energy fluence matrix at very high resolution (< 1 mm) is used to incorporate multileaf collimator (MLC) leaf effects in the predicted EPID images. The primary dose deposited in the EPID is calculated from the energy fluence using experimentally derived radially dependent EPID interaction coefficients.

Innate immune mechanisms linking non-esterified fatty acids and respiratory disease.

Local airway inflammation in chronic respiratory disease is well described. Recently it has been recognised that chronic obstructive respiratory disease, asthma and obstructive sleep apnoea, all involve a systemic inflammatory component. Overspill of airway inflammation, as well as direct metabolic effects, are potential contributors to systemic inflammation.