135 results match your criteria: "Starship Hospital[Affiliation]"

We describe a simple and reproducible technique for neonatal peritoneal dialysis catheter insertion following cardiac surgery which prevents the catheter from becoming blocked by the omentum.

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Objective: Asthma is the most common chronic disease among children. Dry-powder inhalers (DPIs) are effective for medication delivery in adults and adolescents, and provide a lower environmental footprint and more portability than a metered dose inhaler (MDI) with a spacer. They require a specific technique, and it is necessary to ascertain whether they can be used in younger age groups.

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Aim: Hospitalisation rates for paediatric bone and joint infection (BJI) in New Zealand (NZ) are among the highest globally. This study aims to quantify hospitalisation costs of BJI in 2018-2019.

Methods: National hospitalisation data from the NZ Ministry of Health was used to describe costs associated with all paediatric hospitalisations coded for osteomyelitis or septic arthritis in those aged <16 years.

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Background: Seasonal trends in hospitalization for childhood bone and joint infection (BJI) are reported inconsistently. True seasonal variation would suggest an element of disease risk from environmental factors. This review evaluates all reported seasonal variations in childhood BJI, with additional analysis of seasonal trends for diseases secondary to Kingella kingae.

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Optimal Timing for Advanced Imaging in Childhood Bone and Joint Infection.

J Pediatr Orthop

February 2025

Department of Paediatric Orthopaedics, Starship Children's Hospital, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

Objective: Advanced imaging in the management of childhood bone and joint infection (BJI) has the potential to improve disease outcomes. Knowledge about the optimal timing for magnetic resonance imaging (MRI) in relation to both surgically and nonsurgically managed BJI is limited. This study examines the impact of MRI timing on number of surgeries, length of stay (LOS), hospitalization cost, and disease recurrence in childhood BJI.

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Purpose: It is unknown whether social distancing impacts frequency of presentation and severity of childhood bone and joint infection (BJI). In New Zealand, the COVID-19 disease elimination strategy involved strict social isolation policies spanning March 2020-September 2022. Examination of this period may provide insight around risk factors for BJI.

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Introduction: Genetic predisposition to autoimmune encephalitis with antibodies against N-methyl-D-aspartate receptor (NMDAR) is poorly understood. Given the diversity of associated environmental factors (tumors, infections), we hypothesized that human leukocyte antigen () and killer-cell immunoglobulin-like receptors (), two extremely polymorphic gene complexes key to the immune system, might be relevant for the genetic predisposition to anti-NMDAR encephalitis. Notably, KIR are chiefly expressed by Natural Killer (NK) cells, recognize distinct HLA class I allotypes and play a major role in anti-tumor and anti-infection responses.

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Background: Childhood bone and joint infection (BJI) is a potentially severe disease with consequences for growth and development. Critically unwell children may require prolonged hospitalization and multiple surgeries. Acknowledging rising healthcare costs and the financial impact of illness on caregivers, increased efforts are required to optimize treatment.

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The Australian New Zealand Consortium in Children, Adolescents, and Young Adults Oncofertility action plan.

Pediatr Blood Cancer

July 2024

Department of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Parkville, Melbourne, Victoria, Australia.

International and national oncofertility networks, including the US-led Oncofertility Consortium, FertiProtekt, and the Danish Network, have played pivotal roles in advancing the discipline of oncofertility over the last decade. Many other countries lack a shared approach to pediatric oncofertility health service delivery. This study aims to describe baseline oncofertility practices at Australian New Zealand Children's Haematology/Oncology Group centers in 2019-2021, describe binational priorities for care, and propose a 5-year action plan for best practice to be implemented by the newly formed Australian New Zealand Consortium in Children, Adolescents, and Young Adults (CAYA) Oncofertility (ANZCO).

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Article Synopsis
  • Ebstein anomaly is a rare heart condition affecting the tricuspid valve, posing challenges for cardiac surgery due to its varying severity and complex repair process, especially in patients of different age groups.* -
  • A study reviewing 125 patients over the age of 15 who underwent surgery between 1985 and 2019 found that 60% had valve repair, with a notable percentage using the Cone repair technique, while early mortality was low at 2% and 10-year survival was high at 91.5%.* -
  • The findings suggest that older children and adults with Ebstein anomaly can achieve good medium-term survival rates post-surgery, with similar outcomes whether they received valve repair or replacement.*
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Introduction: Fortified expressed breast milk (FEBM) is a standard of care for premature and low birth weight neonates, but comes with an elevated risk of a rare but re-emergent pathology called milk curd obstruction (MCO). Little is known about normal sonographic appearances of bowel contents in this feeding setting, making the recognition of abnormalities difficult. Thus, we aimed to describe appearances that may be considered typical pre- and post-fortifier inclusion.

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Objective: To identify the outcomes considered important, and factors influencing the patient experience, for parents and caregivers of children presenting to hospital with a severe acute exacerbation of asthma. This work contributes to the outcome-identification process in developing a core outcome set (COS) for future clinical trials in children with severe acute asthma.

Design: A qualitative study involving semistructured interviews with parents and caregivers of children who presented to hospital with a severe acute exacerbation of asthma.

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Background: Seizures after initiation of rewarming from therapeutic hypothermia for neonatal encephalopathy are well recognised but not easy to predict.

Methods: A secondary analysis was performed of NEOLEV2 trial data, a multicentre randomised trial of levetiracetam versus phenobarbital for neonatal seizures. Enrolled infants underwent continuous video EEG (cEEG) monitoring.

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2023 World Heart Federation guidelines for the echocardiographic diagnosis of rheumatic heart disease.

Nat Rev Cardiol

April 2024

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

Rheumatic heart disease (RHD) is an important and preventable cause of morbidity and mortality among children and young adults in low-income and middle-income countries, as well as among certain at-risk populations living in high-income countries. The 2012 World Heart Federation echocardiographic criteria provided a standardized approach for the identification of RHD and facilitated an improvement in early case detection. The 2012 criteria were used to define disease burden in numerous epidemiological studies, but researchers and clinicians have since highlighted limitations that have prompted a revision.

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Diazoxide is a potential candidate for the treatment of transitional hypoglycaemia in infants. A clinical trial is currently underway to investigate whether low-dose oral diazoxide is beneficial for severe or recurrent transitional neonatal hypoglycaemia (the NeoGluCO Study, registration ANZCTR12620000129987). The present study aimed to develop and validate the parameters for quantifying diazoxide from neonatal plasma samples, and to assess the stability of extemporaneously prepared diazoxide suspensions to support the NeoGluCO Study.

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Background: Heterotaxy syndromes encompass left and right atrial isomerism (LAI and RAI respectively) and are associated with variable cardiac and non-cardiac anomalies which greatly influence outcomes. RAI is usually associated with complex congenital heart disease (CHD), early surgical intervention and increased mortality. LAI is less commonly associated with complex CHD but can be associated with heart block.

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Purpose: 7% of adolescent idiopathic scoliosis (AIS) patients also present with a pars defect. To date, there are no available data on the results of fusion ending proximal to a spondylolysis in the setting of AIS. The aim of this study was to analyze the outcomes of posterior spinal fusion (PSF) in this patient cohort, to investigate if maintaining the lytic segment unfused represents a safe option.

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Purpose: To evaluate risk factors for distal construct failure (DCF) in posterior spinal instrumented fusion (PSIF) in adolescent idiopathic scoliosis (AIS). We hypothesise increased inferior angulation of the pedicle screw in the lowest instrumented vertebra (LIV) predisposes to failure and aim to find the critical angle that predisposes to failure.

Methods: A retrospective cohort study was performed on all patients who underwent PSIF for AIS at our institution from 2010 to 2020.

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CSF neopterin, quinolinic acid and kynurenine/tryptophan ratio are biomarkers of active neuroinflammation.

EBioMedicine

May 2023

Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Clinical School, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia. Electronic address:

Background: Defining the presence of acute and chronic brain inflammation remains a challenge to clinicians due to the heterogeneity of clinical presentations and aetiologies. However, defining the presence of neuroinflammation, and monitoring the effects of therapy is important given its reversible and potentially damaging nature. We investigated the utility of CSF metabolites in the diagnosis of primary neuroinflammatory disorders such as encephalitis and explored the potential pathogenic role of inflammation in epilepsy.

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Incidence of Sinusoidal Obstruction Syndrome/Veno-Occlusive Disease and Treatment with Defibrotide in Allogeneic Transplantation: A Multicenter Australasian Registry Study.

Transplant Cell Ther

June 2023

Haematology Department, St Vincent's Hospital & The Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia; Australasian Bone Marrow Transplant Recipient Registry, Level 6, The Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia; University of New South Wales, Sydney, Australia; University of Notre Dame Australia, Sydney, Australia.

Sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) is an established complication in patients undergoing allogeneic hemopoietic stem cell transplantation (HSCT). Defibrotide is an effective and safe pharmacologic option for treating diagnosed SOS/VOD. By exploring data provided to the Australasian Bone Marrow Transplant Recipient Registry (ABMTRR) by centers in Australia and New Zealand, this study aimed to describe the incidence of SOS/VOD and patterns of defibrotide use from 2016 to 2020.

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Survival Outcomes and Care Equity among Patients with Advanced Breast Cancer in Auckland, New Zealand.

J Cancer Epidemiol

November 2022

Te Pūriri o Te Ora Auckland Regional Cancer and Blood Service, Auckland District Health Board, New Zealand.

Aim: The Auckland Advanced Breast Cancer Review (AABC) was a review of patients diagnosed with advanced inoperable/metastatic breast cancer (ABC) within the Auckland region of New Zealand, commissioned in response to a Breast Cancer Registry report (BCFNZR) that showed poor and inequitable survival outcomes. The review was aimed at assessing equity of care and identifying healthcare delivery gaps for patients with ABC in the Auckland region.

Method: In this retrospective study, patients living within the Auckland region, diagnosed with ABC between the 1st January 2013 to the 31st December 2015 were identified from the Breast Cancer Registry.

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Job satisfaction and symptoms of depression, anxiety, stress, and burnout: A survey of Australian and New Zealand intensive care research coordinators.

Aust Crit Care

January 2023

Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia; Critical Care Program, The George Institute for Global Health and UNSW Sydney, Australia; NHMRC Emerging Leader Fellow and Associate Professor, Faculty of Medicine, UNSW Sydney, Australia.

Introduction: Intensive care unit clinical research is often implemented by specialised research coordinators (RCs). Clinical research activity within Australian and New Zealand intensive care units has escalated, particularly during the COVID-19 pandemic. Growth of the intensive care RC workforce to match research demand is poorly understood.

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Decreased cerebrospinal fluid kynurenic acid in epileptic spasms: A biomarker of response to corticosteroids.

EBioMedicine

October 2022

Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Clinical School, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia. Electronic address:

Background: Epileptic (previously infantile) spasms is the most common epileptic encephalopathy occurring during infancy and is frequently associated with abnormal neurodevelopmental outcomes. Epileptic spasms have a diverse range of known (genetic, structural) and unknown aetiologies. High dose corticosteroid treatment for 4 weeks often induces remission of spasms, although the mechanism of action of corticosteroid is unclear.

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Article Synopsis
  • The study aimed to evaluate clinical outcomes in adults with invasive meningococcal disease (IMD), comparing those with penicillin-susceptible and reduced penicillin-susceptible isolates.
  • A retrospective analysis from 2004 to 2017 included 139 patients, revealing similar cure rates between the two groups, with a short median treatment duration of 3 days for both.
  • The findings suggest short-duration IV beta-lactam treatment is generally effective for IMD, but ceftriaxone is recommended for cases involving reduced penicillin susceptibility.
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