Prevalence and Outcomes of Gastrointestinal Manifestations in an Australian Scleroderma Cohort.

Objective: The gastrointestinal tract (GIT) is the most commonly affected internal organ in systemic sclerosis (SSc). We sought to determine the prevalence and impact of GIT symptoms on survival and patient-reported outcomes.

Methods: A total of 907 consecutive patients from the Australian Scleroderma Cohort Study who had prospectively completed the University of California, Los Angeles, Scleroderma Clinical Trials Consortium Gastrointestinal Tract 2.

Diagnostic yield of an insertable cardiac monitor in a large patient population.

Background: Insertable cardiac monitors (ICMs) are increasingly used for cardiac rhythm diagnosis with expanding indications. Little has been reported about their use and efficacy.

Objective: The study sought to evaluate the clinical utility of a novel ICM (Biotronik BIOMONITOR III) including the time to diagnosis in unselected patients with different ICM indications.

Volar Lunate Facet Fractures of the Distal Radius: Fracture Mapping Using 3D CT Scans.

 Fractures of the distal radius involving the lunate facet at the volar articular surface are unstable injuries and are usually managed operatively. Management of these fractures is challenging as our understanding of the exact fracture characteristics and associated injuries to the carpus is poor.  This study aims to define the anatomy and associated injuries of lunate facet fractures using three-dimensional computed tomography (CT) scans and fracture mapping techniques.

Trends in myocardial infarction and coronary revascularisation procedures in Australia, 1993-2017.

Objective: Prior data have shown rising acute myocardial infarction (MI) trends in Australia; whether these increases have continued in recent years is not known. This study thus sought to characterise contemporary nationwide trends in MI hospitalisations and coronary procedures in Australia and their associated economic burden.

Methods: The primary outcome measure was the incidence and time trends of total MI, ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) hospitalisations from 1993 to 2017.

Predictors of Treatment Success After Periprosthetic Joint Infection: 24-Month Follow up From a Multicenter Prospective Observational Cohort Study of 653 Patients.

Background: Periprosthetic joint infection (PJI) is a devastating condition and there is a lack of evidence to guide its management. We hypothesized that treatment success is independently associated with modifiable variables in surgical and antibiotic management.

Methods: The is a prospective, observational study at 27 hospitals across Australia and New Zealand.

Treatment preferences for primary membranous nephropathy: Results of a multinational survey among nephrologists in the South Asia Pacific region.

Aim: There is no clear consensus on how best to treat primary membranous nephropathy (PMN). This study aimed to ascertain prevailing views among nephrologists on their choice of immunosuppressive agents to treat this disease.

Methods: The Australasian Kidney Trials Network conducted a multinational online survey among nephrologists from the South Asia-Pacific region to identify prescribing practices to treat PMN.

Expert consensus statements for the management of COVID-19-related acute respiratory failure using a Delphi method.

Background: Coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented pressure on healthcare system globally. Lack of high-quality evidence on the respiratory management of COVID-19-related acute respiratory failure (C-ARF) has resulted in wide variation in clinical practice.

Methods: Using a Delphi process, an international panel of 39 experts developed clinical practice statements on the respiratory management of C-ARF in areas where evidence is absent or limited.

Precision Medicine With Leflunomide: Consideration of the DHODH Haplotype and Plasma Teriflunomide Concentration and Modification of Outcomes in Patients With Rheumatoid Arthritis.

Objective: Leflunomide is a commonly used disease-modifying drug in the treatment of rheumatoid arthritis (RA). Its effects are mediated via inhibition of dihydroorotate dehydrogenase (DHODH) by its active metabolite teriflunomide, and the pharmacokinetics of teriflunomide are highly variable. Our objective was to examine the association between the DHODH haplotype and plasma teriflunomide concentration with response to leflunomide in patients with RA where leflunomide was added to an existing disease-modifying drug regimen after failure to achieve an adequate response with conventional triple therapy.

Plasma Exchange and Glucocorticoids in Severe ANCA-Associated Vasculitis.

Background: More effective and safer treatments are needed for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis.

Methods: We conducted a randomized trial with a 2-by-2 factorial design to evaluate the use of plasma exchange and two regimens of oral glucocorticoids in patients with severe ANCA-associated vasculitis (defined by an estimated glomerular filtration rate of <50 ml per minute per 1.73 m of body-surface area or diffuse pulmonary hemorrhage).

Randomized Trial of Systemic Therapy After Involved-Field Radiotherapy in Patients With Early-Stage Follicular Lymphoma: TROG 99.03.

Purpose: Follicular lymphoma (FL) is curable by involved-field radiotherapy (IFRT) in < 50% of patients with stage I to II disease. We hypothesized that adding systemic therapy to IFRT would improve long-term progression-free survival (PFS).

Patients And Methods: A multicenter randomized controlled trial enrolled patients with stage I to II low-grade FL after staging computed tomography scans and bone marrow biopsies.

Pericardial fat is associated with atrial fibrillation severity and ablation outcome.

Objectives: The aim of this study was to characterize the relationship between pericardial fat and atrial fibrillation (AF).

Background: Obesity is an important risk factor for AF. Pericardial fat has been hypothesized to exert local pathogenic effects on nearby cardiac structures above and beyond that of systemic adiposity.

What is the randomised evidence for surgery and stereotactic radiosurgery for patients with solitary (or few) brain metastases?

Patients with solitary (or few) brain metastases are often treated with surgery (S) or stereotactic radiosurgery (SRS) with or without adjuvant whole brain radiotherapy (WBRT). This review examines the randomised evidence supporting this aggressive approach. A search of MEDLINE, EMBASE and Cochrane databases for published papers and Abstracts on relevant randomised trials was undertaken.

The effectiveness of strategies for the management and/or prevention of hypothermia within the adult perioperative environment: systematic review.

Background: Inadvertent hypothermia is common in patient's undergoing surgical procedures. Hypothermia within the perioperative environment may have many undesired physiological effects that are associated with significant postoperative morbidity. Patient's temperature drops to below 35°C during the first hour of anaesthesia because of impaired thermoregulatory mechanism and patient getting cold in the operating theatre.

A systematic review of the management of short-term indwelling urethral catheters to prevent urinary tract infections.

Background: Indwelling urinary catheterisation is a relatively common procedure in hospital settings, associated with potential risk of infection. Around 80% of urinary tract infections (UTIs) are associated with urinary catheters and the risk of infection increases in patients who are acutely ill. The objective of this review was to present the best available critically appraised evidence related to preventing infections associated with the use of short-term indwelling urethral catheters.

A systematic review on the effectiveness of nurse-led cardiac clinics for adult patients with coronary heart disease.

Aim: Nurse-led clinics offer the possibility of patient education, support and continuity of care for patients with Coronary Heart Disease (CHD) to address and reduce risk factors. The objective of this review is to present the best available evidence related to nurse-led cardiac clinics for adults with CHD by updating an existing systematic review.

Methods: Twenty databases for published literature and 11 databases or websites for unpublished literature were searched for the period September 2002 to March 2008.

Policy related to rhinoplasty in publicly funded elective surgery programs: a systematic review.

Objectives  This systematic review set out to establish best practice in relation to policy for the inclusion/exclusion of rhinoplasty within public health systems. Inclusion criteria  The review considered any studies relating to rhinoplasty that addressed issues of inclusion/exclusion from public funded health systems including criteria for clinical need, contraindications, fit/ready for surgery, policy compliance and issues in relation to surgical training. Search strategy  The search strategy sought to find published and unpublished studies and papers limited to English.

Policy related to abdominoplasty in publicly funded elective surgery programs: a systematic review.

Objectives  This systematic review set out to establish best practice in relation to policy for the inclusion/exclusion of abdominoplasty procedures within public health systems. Inclusion criteria  The review considered any studies relating to abdominoplasty that addressed issues of inclusion/exclusion from public funded health systems including criteria for clinical need, contraindications, fit/ready for surgery, policy compliance and issues in relation to surgical training. Search strategy  The search strategy sought to find published and unpublished studies and papers limited to English.

Percutaneous closure of atrial septal defects leads to normalisation of atrial and ventricular volumes.

Background: Percutaneous closure of atrial septal defects (ASDs) should potentially reduce right heart volumes by removing left-to-right shunting. Due to ventricular interdependence, this may be associated with impaired left ventricular filling and potentially function. Furthermore, atrial changes post-ASD closure have been poorly understood and may be important for understanding risk of atrial arrhythmia post-ASD closure.

Hyperbaric oxygen treatment and survival from necrotizing soft tissue infection.

Hypothesis: Necrotizing soft tissue infection (NSTI) refers to a spectrum of infective diseases characterized by necrosis of the deep soft tissues. Features of manifestation and medical management have been analyzed for association with outcome. The use of hyperbaric oxygen (HBO(2)) therapy has been recommended as an adjunctive treatment but remains controversial.

The jigsaw sign. A reliable indicator of congenital aetiology in os odontoideum.

There is evidence in the literature for both a congenital and a post-traumatic aetiology for os odontoideum. In no series published to date has CT been used to aid in the diagnosis. This is a prospective study of the history of trauma and presence of diagnostic features on CT of 18 consecutive cases with os odontoideum.

Measurement of bone defects adjacent to acetabular components of hip replacement.

Computed tomography can assist in the detection of periprosthetic osteolysis, but it has not been used to measure the actual volume of bone defects adjacent to hip replacement components because of the scanning artifact caused by metal. The aim of the current study was to develop a spiral computed tomography technique that provides precise and reliable volumetric measurement of bone defects adjacent to uncemented metal-backed acetabular components. Computed tomography scans were taken of small and large defects of known volume created in the ilium in a bovine hemipelvis and a pelvis from a cadaver.

The skeletal response to matt and polished cemented femoral stems.

We studied the effect of the surface finish of the stem on the transfer of load in the proximal femur in a sheep model of cemented hip arthroplasty. Strain-gauge analysis and corresponding finite-element (FE) analysis were performed to assess the effect of friction and creep at the cement-stem interface. No difference was seen between the matt and polished stems.

Direct measurement of hoop strains in the intact and torn human medial meniscus.

OBJECTIVE: To measure the circumferential or hoop strains generated in the medial meniscus during loading of the knee joint and to examine the effect of longitudinal and radial tears in the meniscus on these strain values. DESIGN: An in vitro investigation measuring the circumferential strains in the medial menisci of cadaveric human knees as they were loaded in a materials testing machine. BACKGROUND: The menisci transmit approximately 50% of the load through the knee, the rest being transmitted by direct contact of the articular cartilage.