Reconsidering the nursing role in antimicrobial stewardship: a multisite qualitative interview study.

Objectives: This study responds to calls for greater focus on nursing roles, and the need for nursing integration within the antimicrobial optimisation agenda. The objective of this study was to explore Australian hospital nurses' views on antimicrobial resistance and antimicrobial stewardship (AMS) in a hospital setting, in order to better understand the opportunities for and challenges to integration of nursing staff in antimicrobial optimisation within hospital settings.

Design: Qualitative one-on-one, semistructured interviews.

Cepheid Xpert Flu/RSV and Seegene Allplex RP1 show high diagnostic agreement for the detection of influenza A/B and respiratory syncytial viruses in clinical practice.

Background: Molecular assays based on reverse transcription-polymerase chain reaction (RT-PCR) provide reliable results for the detection of respiratory pathogens, although diagnostic agreement varies. This study determined the agreement between the RT-PCR assays (Xpert Flu/RSV vs Allplex RP1) in detecting influenza A, influenza B, and respiratory syncytial viruses (RSVs) in clinical practice.

Methods: We retrospectively identified 914 patient encounters where testing with both Xpert Flu/RSV and Allplex RP1 was undertaken between October 2015 and September 2019 in seven hospitals across New South Wales, Australia.

Diabetes-related outcomes after pancreatic surgery.

Background: The development of pancreatogenic diabetes mellitus (PDM) is a common complication post-pancreatectomy; however, its prevalence has not been described in Australia. We aimed to describe the glycaemic status pre- and post-pancreatectomy, compare patients' clinical characteristics, group according to pre- and post-pancreatectomy diabetes mellitus (DM) status and identify predictors of post-operative PDM.

Methods: We retrospectively reviewed the medical records of patients admitted for pancreatic resection at a single institution from 2011 to 2017.

Management of adult cardiac arrest in the COVID-19 era: consensus statement from the Australasian College for Emergency Medicine.

Introduction: The global pandemic of coronavirus disease 2019 (COVID-19) has caused significant worldwide disruption. Although Australia and New Zealand have not been affected as much as some other countries, resuscitation may still pose a risk to health care workers and necessitates a change to our traditional approach. This consensus statement for adult cardiac arrest in the setting of COVID-19 has been produced by the Australasian College for Emergency Medicine (ACEM) and aligns with national and international recommendations.

Advanced cancer patient preferences for receiving molecular profiling results.

Objective: This study aimed to discern preferences for receiving somatic molecular profiling (MP) results in cancer patients who have given consent to undergo testing.

Methods: We conducted a mixed-methods study to explore patients' views on which MP results they would like to receive and why. Advanced cancer patients (n = 1299) completed questionnaires after giving consent to participate in a parent genomics study and undergoing MP.

Understanding implementation success: protocol for an in-depth, mixed-methods process evaluation of a cluster randomised controlled trial testing methods to improve detection of Lynch syndrome in Australian hospitals.

Introduction: In multisite intervention trials, implementation success often varies widely across settings. Process evaluations are crucial to interpreting trial outcomes and understanding contextual factors and causal chains necessary for successful implementation. Lynch syndrome is a hereditary cancer predisposition conferring an increased risk of colorectal, endometrial and other cancer types.

Potential benefit of combination antifungal therapy in endocarditis.

endocarditis (AE) is a rare condition with a mortality rate greater than 60%. While it is generally accepted that both antifungal therapy and surgery are necessary for survival, the optimal antifungal regimen is unclear. A 62-year-old man was diagnosed with AE of a prosthetic aortic valve, complicated by cerebral emboli.

Acute kidney injury following intravenous acyclovir in children.

Objective: The objective of this study was to describe the incidence of acute kidney injury (AKI) in children receiving intravenous acyclovir and determine risk factors that may be associated with it.

Design: This was a retrospective cohort study, conducted by chart review.

Setting: The study was conducted across two paediatric hospitals.

Evaluating the influence of data collector training for predictive risk of death models: an observational study.

Background: Severity-of-illness scoring systems are widely used for quality assurance and research. Although validated by trained data collectors, there is little data on the accuracy of real-world data collection practices.

Objective: To evaluate the influence of formal data collection training on the accuracy of scoring system data in intensive care units (ICUs).

When to break the news and whose responsibility is it? A cross-sectional qualitative study of health professionals' views regarding disclosure of BRCA genetic cancer risk.

Objectives: Disclosure of a hereditary condition in the family poses notable challenges for patients who often seek the assistance of genetic health professionals (GHPs). This study aimed to investigate GHPs' opinions about the ideal time for disclosure to offspring and their responsibility to at-risk relatives.

Design: Cross-sectional qualitative study.

Impact of respiratory muscle training on respiratory muscle strength, respiratory function and quality of life in individuals with tetraplegia: a randomised clinical trial.

Background: Respiratory complications remain a leading cause of morbidity and mortality in people with acute and chronic tetraplegia. Respiratory muscle weakness following spinal cord injury-induced tetraplegia impairs lung function and the ability to cough. In particular, inspiratory muscle strength has been identified as the best predictor of the likelihood of developing pneumonia in individuals with tetraplegia.

Intravascular Lithotripsy for Stent Underexpansion Despite Utilization of Rotational Atherectomy for Plaque Modification.

Percutaneous coronary intervention (PCI) in the context of heavily calcified coronary arteries can be challenging. Intravascular lithotripsy (IVL) has been suggested as an alternative to rotational atherectomy (RA). We report a case of stent under expansion, despite plaque modification using rotational atherectomy that was successfully managed with intravascular lithotripsy.

Updated guidelines for the management of paracetamol poisoning in Australia and New Zealand.

Introduction: Paracetamol is a common agent taken in deliberate self-poisoning and in accidental overdose in adults and children. Paracetamol poisoning is the commonest cause of severe acute liver injury. Since the publication of the previous guidelines in 2015, several studies have changed practice.

Residual risk of infection with blood-borne viruses in potential organ donors at increased risk of infection: systematic review and meta-analysis.

Objective: To estimate the prevalence and incidence of human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) among people at increased risk of infection in Australia; to estimate the residual risk of infection among potential solid organ donors in these groups when their antibody and nucleic acid test results are negative.

Study Design: Systematic review and meta-analysis of reports of the incidence and prevalence of HIV, HCV, and HBV in groups at increased risk of infection in Australia.

Data Sources: MEDLINE, government and agency reports, Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine conference abstracts, the Australian New Zealand Clinical Trial Registry, and National Health and Medical Research Council grants published 1 January 2000 - 14 February 2019; personal communications.

Edwards SAPIEN 3 Transcatheter Heart Valve Implantation in a Native Bicuspid Aortic Regurgitation.

Transcatheter aortic valve replacement over the last few years has revolutionized the way severe aortic stenosis patients are being managed [1-4]. Randomized clinical trials commonly excluded bicuspid aortic valves and pure native severe aortic regurgitation [2,4]. We present a case with severe acute aortic regurgitation complicated by refractory pulmonary oedema successfully managed by transfemoral transcatheter aortic valve replacement using a Sapien 3 valve.

The influence of Elixhauser comorbidity index on percutaneous coronary intervention outcomes.

Background: Clinical outcomes with respect to the evolution of comorbidity burden in national cohorts of patients undergoing PCI have not been reported.

Objectives: We sought to explore the association between comorbidity burden and periprocedural outcomes in patients treated with PCI in the National Inpatient Sample.

Methods: 6,601,526 PCI procedures were identified between 2004 and 2014 and comorbidities were defined by the Elixhauser classification system (ECS) consisting of 30 comorbidity measures.

Spontaneous splenic rupture due to rivaroxaban.

In conjunction with , will feature occasional drug-related cases that are likely to be of interest to readers. These will include cases that involve recently marketed drugs for which there is limited knowledge of adverse effects and cases that highlight unusual reactions to drugs that have been marketed for several years.