Concomitant Paratubal Cyst and Isolated Fallopian Tube Torsion Masquerading as Acute Appendicitis in a Pregnant Female.

Abdominal pain in pregnant individuals presents diagnostic challenges, especially when appendicitis is suspected. We report a rare case of a 26-year-old pregnant female with recurrent right lower quadrant (RLQ) abdominal pain initially misdiagnosed as a urinary tract infection. Diagnostic uncertainty led to a magnetic resonance imaging (MRI) scan, which revealed a right adnexal cystic structure and a thickened tubular structure adjacent to the cecal pole, raising concerns of complicated appendicitis.

Inadvertent inoculation of following tetanus immunisation- a case report.

Mucormycosis is a rare, life-threatening fungal infection. While typically affecting immunosuppressed individuals, cases in the immunocompetent have been reported, particularly secondary to trauma, and the subspecies . These fungi are typically difficult to isolate.

Intranasal Mupirocin to Reduce Surgical Site Infection Post Cardiac Surgery: A Review of the Literature.

Sternal wound infections after cardiac surgery are associated with high rates of morbidity and mortality. One of the known risk factors of sternal wound infection is Staphylococcus aureus colonisation. Intranasal mupirocin decolonisation therapy implemented pre-operatively appears to be an effective preventative measure in reducing sternal wound infections post-cardiac surgery.

Challenges of conducting kidney health checks among patients at risk of chronic kidney disease and attending an urban Aboriginal and Torres Strait Islander primary healthcare service.

Background: The increasing incidence of chronic kidney disease (CKD) globally highlights the importance of early targeted screening of at-risk persons in primary healthcare settings. This study investigated the early detection of CKD among Aboriginal and Torres Strait Islander patients attending an urban primary healthcare service.

Methods: Routine data extracted for all patients with an active electronic medical record on 7 December 2017 were used to identify patients who were eligible to have a kidney health check (KHC), comprising estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR) tests.

Enhancing speech-language pathology head and neck cancer service provision in rural Australia: Using a plan, do, study, act approach.

Purpose: People with head and neck cancer (HNC) require ongoing speech-language pathology (SLP) services into the post-acute recovery phase of care. However, there are recognised service inequities/barriers for people from rural areas who are unable to access SLP services locally, necessitating travel to metropolitan centres. This study implemented strategies to assist rural speech-language pathologists to work to full scope of practice and support post-acute rehabilitation services for people with HNC.

What is the optimal strategy for managing primary care patients with an uncomplicated acute sore throat? Comparing the consequences of nine different strategies using a compilation of previous studies.

Objective: Identifying optimal strategies for managing patients of any age with varying risk of acute rheumatic fever (ARF) attending for an apparently uncomplicated acute sore throat, also clarifying the role of point-of-care testing (POCT) for presence of group A beta-haemolytic (GABHS) in these settings.

Design: We compared outcomes of adhering to nine different strategies for managing these patients in primary healthcare.

Setting And Participants: The nine strategies, similar to guidelines from several countries, were tested against two validation data sets being constructs from seven prior studies.

Clinician and consumer perceptions of head and neck cancer services in rural areas: Implications for speech pathology service delivery.

Objective: Individuals with head and neck cancer residing in rural areas face numerous challenges accessing post-acute rehabilitation services, including speech pathology services. In order to inform future service enhancements, the key issues impacting access to, and the provision of, speech pathology head and neck cancer services in rural areas was explored through the perspectives of patients, carers, speech pathology clinicians and service managers.

Setting: A rural health referral network in Queensland consisting of tertiary, regional and remote hospitals.

Speech pathology service enhancement for people with head and neck cancer living in rural areas: Using a concept mapping approach to inform service change.

Background: Speech pathology (SP) services provide swallowing and communication intervention to people with head and neck cancer (HNC) across the continuum of care. However, difficulties exist with access and delivery of services in rural areas. The study aim was to identify actionable goals for SP change, utilizing a concept mapping approach.

Improving antibiotics targeting using PCR point-of-care testing for group A streptococci in patients with uncomplicated acute sore throat.

Background And Objectives: Evidence supports some beneficial effects of antibiotics prescribed to patients with a sore throat and proven presence of group A streptococci (GAS).

Method: A total of 283 patients were included from North and North-West Queensland, Australia, at their first presentation for uncomplicated acute sore throat. Patterns of antibiotic prescribing were explored before and after testing for GAS using a rapid point-of-care polymerase chain reaction (PCR) test.

Therapeutic relationships: Making space to practice in chaotic institutional environments.

WHAT IS KNOWN ABOUT THE SUBJECT?: While therapeutic relationships remain core to mental health nursing practice and patient recovery, increased managerialism and focus on risk has impacted nurses' therapeutic practice with patients. While there is anecdotal evidence of the impact there has been little research that demonstrates nurses experience of therapeutic engagement within the current context. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The paper reports on qualitative research that highlights nurses' strong attempts to create the space for therapeutic engagement with clients.

Registered nurses' provision of end-of-life care to hospitalised adults: A mixed studies review.

Objectives: To describe, critically appraise and synthesise research regarding nurses' perceptions of their knowledge, skills or experiences in providing end-of-life care to hospitalised adults to help inform both future educational and practice initiatives.

Design: Mixed studies review.

Data Sources: MEDLINE, CINAHL, Cochrane Library, Web of Science and SCOPUS databases were searched for the years 2004-June 2018, along with journal hand-searching and reference list searching.

Point of care testing for group A streptococci in patients presenting with pharyngitis will improve appropriate antibiotic prescription.

Objective: History, clinical examination and throat culture may be inadequate to rule in or out the presence of group A streptococci (GAS) infection in patients with sore throat in a remote location. We correlated the diagnostic accuracy for guiding antibiotic prescription of clinical decision and physiological scoring systems to a rapid diagnostic point of care (POC) test result in paediatric patients presenting with sore throat.

Methods: Prospective diagnostic accuracy study conducted between 30 June 2014 and 27 February 2015 in a remote Australian ED using a convenience sample.

Etiologic predictive value of a rapid immunoassay for the detection of group A Streptococcus antigen from throat swabs in patients presenting with a sore throat.

Background: Clinical reasoning utilizing certain symptoms and scores has not proven to be a reliable decision-making tool to determine whether or not to suspect a group A Streptococcus (GAS) infection in the patient presenting with a sore throat. Culture as the so-called 'gold standard' is impracticable because it takes 1 to 2 days (and even longer in remote locations) for a result, and thus treatment decisions will be made without the result available. Rapid diagnostic antigen tests have demonstrated sufficient sensitivities and specificities in detecting GAS antigens to identify GAS throat infections.

Maternal and personal religious engagement as predictors of early onset and frequent substance use.

Background And Objective: This study examined whether maternal and offspring's religiosity independently predict age of onset and frequency of substance use in offspring, and whether gender differentiates these associations.

Methods: Data were from the Mater Hospital and University of Queensland Study of Pregnancy, a birth cohort study. Participants were a cohort of 3,537 persons who were born during 1981-83 and were followed-up to 21 years.

Investigating complaints to improve practice and develop policy.

Purpose: This paper aims to make use of patient complaints as a valuable source of information to enable improvements to the quality of health service delivery.

Design/methodology/approach: Thematic analysis was used to analyse records of de-identified patient complaints made about medical or nursing staff or medical or nursing services between January 2006 and May 2008 in the Mount Isa Health Service District.

Findings: Three main themes were identified.

Knowledge for practice: challenges in culturally safe nursing practice.

Aboriginal people currently remain the most vulnerable and sickest population within Australian society and therefore are frequent users of the Australian health system. In this paper I will discuss the importance of the role of Aboriginal and non-Aboriginal nurses in diminishing the negative ramifications of perceived racism that can be felt by patients. This exemplar will explore an example of perceived racism through the eyes of an Aboriginal nurse.

Antistreptokinase antibodies: implications for thrombolysis in a region with endemic streptococcal infection.

Aims: To determine antistreptokinase antibody (anti-SK) titres in patients with the acute coronary syndrome from communities with endemic group A streptococcal infection because of the implications for streptokinase (SK) thrombolysis.

Methods: Anti-SK titres were determined using a standard method in 47 consecutive SK naive patients, presenting to the Mt Isa Hospital emergency department, Australia, with an acute coronary syndrome. Both indigenous and non-indigenous subjects were enrolled.