1,314 results match your criteria: "Royal Darwin Hospital Northern Territory; Menzies School of Health Research[Affiliation]"

Marginal zone lymphomas (MZLs) are a rare, indolent group of non-Hodgkin lymphomas with different diagnostic, genetic and clinical features and therapeutic implications. The most common is extranodal MZL of mucosa-associated lymphoid tissue, followed by splenic MZL and nodal MZL. Patients with MZL generally have good outcomes with long survival rates but frequently have a relapsing/remitting course requiring several lines of therapy.

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Introduction: There is limited evidence in the literature illustrating chest computed tomography (CT) characteristics among adult Aboriginal Australians with bronchiectasis. This retrospective study evaluates the radiological characteristics of bronchiectasis in Aboriginal Australians residing in the Top End, Northern Territory of Australia.

Methods: Patients aged >18 years with chest CT-confirmed bronchiectasis between 2011 and 2020 were included.

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Background: The period before, during, and after pregnancy presents an opportunity to reduce diabetes-related risks, which in Australia disproportionately impact Aboriginal and Torres Strait Islander women. Collaboration with Aboriginal and Torres Strait Islander women/communities is essential to ensure acceptability and sustainability of lifestyle modifications. Using a novel co-design approach, we aimed to identify shared priorities and potential lifestyle strategies.

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Article Synopsis
  • About 25% of patients with unexplained kidney failure have a genetic cause, specifically related to monogenic disorders.
  • A study explored the effectiveness of whole genome sequencing (WGS) combined with broad gene panel analysis in diagnosing these cases, finding it to be a viable method for identifying genetic mutations.
  • Among 100 participants aged ≤50 with stage 5 chronic kidney disease, a genetic diagnosis was reached in 25%, with a higher likelihood of positive results in those with a family history of chronic kidney disease.
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Background: Hepatitis B is endemic amongst the Australian Aboriginal population in the Northern Territory. A participatory action research project identified the lack of culturally appropriate education tools and led to the development of the "Hep B Story" app in the Aboriginal language Yolŋu Matha. This paper describes a formal evaluation of the app's first version, which informed improvements and translation into a further ten Aboriginal languages.

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NaHCO responsiveness is a novel phenotype where some methicillin-resistant (MRSA) isolates exhibit significantly lower minimal inhibitory concentrations (MIC) to oxacillin and/or cefazolin in the presence of NaHCO. NaHCO responsiveness correlated with treatment response to β-lactams in an endocarditis animal model. We investigated whether treatment of NaHCO-responsive strains with β-lactams was associated with faster clearance of bacteremia.

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Background: Under-identification of Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) people can result in inaccurate estimation of health outcomes. Data linkage has improved identification of Aboriginal people in administrative datasets.

Aim: To compare three methods of ascertainment of Aboriginal status using only pregnancy data from the Western Australian Midwives Notification System (MNS), to the linked Indigenous Status Flag (ISF) derived by the Department of Health.

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Background: Pediatric community-acquired pneumonia (CAP) can lead to long-term respiratory sequelae, including bronchiectasis. We determined if an extended (13-14 days) versus standard (5-6 days) antibiotic course improves long-term outcomes in children hospitalized with CAP from populations at high risk of chronic respiratory disease.

Methods: We undertook a multicenter, double-blind, superiority, randomized controlled trial involving 7 Australian, New Zealand, and Malaysian hospitals.

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Background: In Australian remote communities, First Nations children with otitis media (OM)-related hearing loss are disproportionately at risk of developmental delay and poor school performance, compared to those with normal hearing. Our objective was to compare OM-related hearing loss in children randomised to one of 2 pneumococcal conjugate vaccine (PCV) formulations.

Methods And Findings: In 2 sequential parallel, open-label, randomised controlled trials (the PREVIX trials), eligible infants were first allocated 1:1:1 at age 28 to 38 days to standard or mixed PCV schedules, then at age 12 months to PCV13 (13-valent pneumococcal conjugate vaccine, +P) or PHiD-CV10 (10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine, +S) (1:1).

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Introduction: Limited evidence exists on the distribution of ABO RhD blood groups and prevalence and specificity of red blood cell (RBC) alloantibodies in Aboriginal and Torres Strait Islander peoples of Australia. We investigated RBC alloantibody prevalence and ABO RhD groups in Aboriginal patients undergoing cardiac surgery at a South Australian (SA) tertiary hospital, a major cardiac surgical referral centre for Northern Territory (NT) patients METHODS: Retrospective analysis of all consecutive patients undergoing cardiac surgery at Flinders Medical Centre (FMC) between January 2014 and June 2019. ABO and RhD blood groups, and RBC alloantibody prevalence, specificity, and clinical significance in Aboriginal and non-Aboriginal cardiac patients were determined at time of surgery and on follow up to 2021.

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Background: Australian Aboriginal and Torres Strait Islander women with diabetes in pregnancy (DIP) are more likely to have glycaemic levels above the target range, and their babies are thus at higher risk of excessive fetal growth. Shoulder dystocia, defined by failure of spontaneous birth of fetal shoulder after birth of the head requiring obstetric maneuvers, is an obstetric emergency that is strongly associated with DIP and fetal size. The aim of this study was to investigate the epidemiology of shoulder dystocia in Aboriginal babies born to mothers with DIP.

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Melioidosis and Activation from Latency: The "Time Bomb" Has Not Occurred.

Am J Trop Med Hyg

July 2024

Infectious Diseases Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia.

Burkholderia pseudomallei, the causative agent of melioidosis has long been considered able to exist in a latent form. Seropositivity among U.S.

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Epidemiology and genetic diversity of Burkholderia pseudomallei from Riau Province, Indonesia.

PLoS Negl Trop Dis

May 2024

Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.

Article Synopsis
  • Melioidosis, caused by the Burkholderia pseudomallei bacteria, is prevalent in tropical regions, particularly in Southeast Asia and Northern Australia, with potential endemicity in Riau Province, Indonesia.
  • A retrospective study analyzed 68 cases from hospitals in Riau from 2009 to 2021, revealing a mean patient age of 49.1 years, predominantly male (85%), and a high incidence of diabetes mellitus as a risk factor, with a mortality rate of 41%.
  • Genomic analysis of B. pseudomallei isolates confirmed three distinct sequence types, indicating a genetic link between strains in Indonesia and Southeast Asia, and highlighting the need for improved detection and diagnostics in the region.
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Background: The use of adjunctive antibiotics directed against exotoxin production in Staphylococcus aureus bacteremia (SAB) is widespread, and it is recommended in many guidelines, but this is based on limited evidence. Existing guidelines are based on the theoretical premise of toxin suppression, as many strains of S. aureus produce toxins such as leukocidins (eg, Panton-Valentine leukocidin, toxic shock syndrome toxin 1, exfoliative toxins, and various enterotoxins).

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  • Adult Aboriginal Australians have a higher prevalence of bronchiectasis compared to non-Aboriginal Australians, but there's limited research on what factors influence their survival rates.
  • The study included 459 Aboriginal patients with confirmed bronchiectasis, and findings showed that older age, chronic obstructive pulmonary disease, and certain sputum cultures were linked to higher mortality rates among the deceased cohort.
  • Insights from the study could help identify at-risk patients and create strategies to reduce mortality in this population.
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Aim: This study examined the outcomes of a telehealth model for sleep health assessment among Indigenous and non-Indigenous children residing in remote and regional communities at the Top End Northern Territory (NT) of Australia.

Methods: Video telehealth consultation, that included clinical history and relevant physical findings assessed virtually with an interstate paediatric sleep physician was conducted remotely. Polysomnography (PSG) and therapeutic interventions were carried out locally at Darwin, NT.

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Corrigendum to "Type 2 diabetes after a pregnancy with gestational diabetes among first nations women in Australia: The PANDORA study" [Diabetes Res. Clin. Pract. 181 (2021) 109092].

Diabetes Res Clin Pract

July 2024

Menzies School of Health Research, Charles Darwin University, John Mathews Building, Royal Darwin Hospital Campus, 58 Rocklands Drive, Tiwi, NT 0810, Australia; Department of Endocrinology, Royal Darwin Hospital, 58 Rocklands Drive, Tiwi, NT 0810, Australia.

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  • Bronchiectasis is a chronic lung disease affecting many, especially Indigenous populations in wealthy countries, and currently has no approved treatments.
  • A randomized controlled trial (RCT) aims to test the mucoactive agent erdosteine over 12 months to see if it reduces acute respiratory exacerbations in children and adults aged 2-49 with bronchiectasis.
  • The study will also evaluate the impact of erdosteine on quality of life, exacerbation duration, hospitalizations, lung function, and its overall cost-effectiveness.
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  • Peritoneal dialysis (PD) is a preferred kidney replacement therapy for Aboriginal and Torres Strait Islander people, allowing them more independence from healthcare facilities.
  • An observational study from 2004 to 2020 showed that 14.4% of Aboriginal and Torres Strait Islander individuals starting kidney replacement therapy opted for PD, experiencing varying rates of peritonitis and declining cure rates over time.
  • The study revealed a higher peritonitis rate among this population compared to general benchmarks, indicating a critical need for improved kidney care and support services for Aboriginal and Torres Strait Islander communities.
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  • Desirability of outcome ranking (DOOR) is a new method for measuring clinical trial results that assesses both efficacy and safety using an ordinal scale.
  • A study applied the DOOR endpoint to participants from the CAMERA2 trial, comparing standard therapy to an added antistaphylococcal β-lactam treatment for methicillin-resistant bacteremia.
  • Results showed that those receiving combination therapy had a probability of worse outcomes compared to standard therapy, suggesting that the risks of combination treatment may outweigh its benefits, although a slight advantage cannot be ruled out.
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Aim: To assess the impact of the Early Onset Sepsis (EOS) calculator, implemented as a quality improvement study, to reduce the rate of unnecessary antibiotics in neonates born ≥35 weeks' gestation.

Methods: An audit of routinely collected hospital data from January 2008 to March 2014 (retrospective) and from January 2018 to September 2019 (prospective) determined baseline incidence of EOS intravenous antibiotic use in neonates born ≥35 weeks' gestation in a tertiary level perinatal centre. Plan-do-study-act (PDSA) cycles were applied to implement the EOS calculator.

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Melioidosis is a potentially life-threatening infection. This study aimed to assess the melioidosis knowledge among distinct participant groups in the tropical Top End of the Northern Territory (NT) of Australia. Participants were categorised into three groups: NT medical students and health research staff (Group 1: Hi-Ed), Aboriginal Rangers and Aboriginal Healthcare Workers (Group 2: Rangers/AHWs), and patients with a history of melioidosis infection (Group 3: Patients).

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Background: Mental health conditions prior to or during pregnancy that are not addressed can have adverse consequences for pregnancy and birth outcomes. This study aimed to determine the extent to which women's mental health-related hospitalisation (MHrH) prior to or during pregnancy was associated with a risk of adverse birth outcomes.

Methods: We linked the perinatal data register for all births in the Northern Territory, Australia, from the year 1999 to 2017, to hospital admissions records to create a cohort of births to women aged 15-44 years with and without MHrH prior to or during pregnancy.

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Pediatric anesthesia in Australia and New Zealand and health inequity among First Nations and Māori children.

Paediatr Anaesth

September 2024

Department of Anaesthesia, Children's Health Queensland Clinical Unit, Queensland Children's Hospital, Brisbane, Queensland, Australia.

Australia and New Zealand are two countries in the Southern Pacific region. They share many pediatric anesthesia similarities in terms of medical organizational systems, education, training, and research, however there are important differences between the two nations in relation to geography, the First Nations populations and the history of colonization. While the standards for pediatric anesthesia and the specialty training requirements are set by the Australian and New Zealand College of Anesthetists and the Society for Pediatric Anesthesia in New Zealand and Australia, colonization has created distinct challenges that each nation now faces in order to improve the anesthetic care of its pediatric population.

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