Effect of Proton Pump Inhibitor Treatment in "PPI Non-responsive" Patients with Eosinophilic Esophagitis.

Background And Aims: Some eosinophilic esophagitis (EoE) patients can have a decline in eosinophil count after proton pump inhibitor (PPI) treatment without achieving histologic response, but little is known about this group. We aimed to determine the effect of PPIs on reducing esophageal eosinophilia in patients deemed non-responsive to PPI therapy.

Methods: We analyzed prospectively collected cohort data from newly diagnosed adults with EoE who were histologic non-responders (≥15 eos/hpf) to PPI-only therapy.

Prevalence and Prognostic Implication of Atrial Fibrillation in Heart Failure Subtypes: Systematic Review and Meta-Analysis.

Background: Atrial fibrillation (AF) and heart failure (HF) portends a poor outcome. The HF universal definition has incorporated Heart Failure with mildly reduced Ejection Fraction (HFmrEF). We sought to evaluate the relationship between AF and different HF subtypes, with emphasis on HFmrEF.

Gallbladder Paraganglioma: A Mysterious Histological Finding.

Gallbladder paragangliomas are extremely rare with only a handful of cases reported so far. There are no definitive guidelines for the management of gallbladder paragangliomas due to their rarity. We present a case of a 53-year-old male who was found to have gallbladder paraganglioma post-laparoscopic cholecystectomy, performed for right upper abdominal pain.

A rarer cause of Bouveret syndrome - A case report.

Introduction And Importance: Bouveret syndrome is a rare type of gallstone ileus causing gastric outlet obstruction with high morbidity and mortality risk, and hence important to have a high degree of clinical suspicion on presentation for prompt diagnosis and management.

Case Presentation: We present a case of an elderly woman with abdominal pain, haematemesis, and an unremarkable radiograph whose initial emergent endoscopy showed a gastric obstruction and a duodenal diverticulum with a non-bleeding broad based duodenal ulcer. Subsequent computerised tomographic (CT) scan revealed a cholecystoduodenal fistula and gastric outlet obstruction secondary to a 5 cm stone in the duodenojejunal (DJ) flexure.

Robot-assisted general surgery is safe during the learning curve: a 5-year Australian experience.

Robot-assisted general surgery has become increasingly common in the Australian public sector since 2003. It provides significant technical advantages compared to laparoscopic surgery. Currently, it is estimated that the learning curve for surgeons starting off with robotic surgery is complete after 15 cases.

Is T-Wave Alternans a Repolarization Abnormality Marker in COVID-19? An Investigation on the Potentialities of Portable Electrocardiogram Device.

Background: Cardiac arrhythmias are significantly associated with poor outcomes in coronavirus disease 2019 (COVID-19) patients. Microvolt T-wave alternans (TWA) can be automatically quantified and has been recognized as a representation of repolarization heterogeneity and linked to arrhythmogenesis in various cardiovascular diseases. This study aimed to explore the correlation between microvolt TWA and COVID-19 pathology.

Early non-disabling relapses are important predictors of disability accumulation in people with relapsing-remitting multiple sclerosis.

Background: The prognostic significance of non-disabling relapses in people with relapsing-remitting multiple sclerosis (RRMS) is unclear.

Objective: To determine whether early non-disabling relapses predict disability accumulation in RRMS.

Methods: We redefined mild relapses in MSBase as 'non-disabling', and moderate or severe relapses as 'disabling'.

Measuring the impact of steroid therapy on health-related quality of life in patients with rheumatic diseases: international development of a glucocorticoid treatment-specific patient-reported outcome measure.

Objectives: Glucocorticoids (GCs) ('steroids') are used to treat rheumatic diseases but adverse effects are common. We aimed to explore the impact of GC therapy on health-related quality of life (HRQoL), to inform the development of a treatment-specific patient-reported outcome measure (PROM) for use in clinical trials and practice.

Methods: Semi-structured qualitative interviews were conducted with patients from the UK, USA and Australia, treated for a rheumatic condition with GCs in the last 2 years.

Evaluation of Clinical Assessment in Predicting Complicated Acute Diverticulitis.

Background Acute diverticulitis is a common surgical condition and one of the leading gastrointestinal conditions that require hospital admission. The presence of complications increases the hospital stay and risk of requiring surgical intervention. This study aimed to investigate the clinical features that can be identified during clinical assessment and evaluate their predictive value and sensitivity in differentiating between complicated and uncomplicated diverticulitis.

Creating change with families: Reflections and recommendations for the care of gender diverse and LGBTQIA+ individuals and their families throughout pregnancy and birth.

Objective: To derive a deeper understanding of transgender and non-binary people's experience of pregnancy and birth, and ways to modify practice to provide inclusive care.

Design: Case study reports describe the experiences of two transgender and non-binary people who received pregnancy and birth care through a Midwifery Group Practice program.

Setting: A tertiary hospital in metropolitan South Australia with approximately 3800 births per annum.

An Exercise and Physical Activity Program in Patients With Atrial Fibrillation: The ACTIVE-AF Randomized Controlled Trial.

Background: There are limited data on the effect of exercise interventions on atrial fibrillation (AF) recurrence and symptoms.

Objectives: The aim of this study was to determine the efficacy of an exercise and physical activity intervention on AF burden and symptoms among patients with symptomatic AF.

Methods: This prospective, randomized controlled trial included 120 patients with paroxysmal or persistent, symptomatic AF, randomized 1:1 to receive an exercise intervention, combining home and supervised aerobic exercise over 6 months, or to receive usual care.

Diabetic Ketoacidosis at Onset of Type 1 Diabetes and Long-term HbA1c in 7,961 Children and Young Adults in the Australasian Diabetes Data Network.

Objective: The relationship between diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes and long-term glycemic control varies between studies. We aimed, firstly, to characterize the association of DKA and its severity with long-term HbA1c in a large contemporary cohort, and secondly, to identify other independent determinants of long-term HbA1c.

Research Design And Methods: Participants were 7,961 children and young adults diagnosed with type 1 diabetes by age 30 years from 2000 to 2019 and followed prospectively in the Australasian Diabetes Data Network (ADDN) until 31 December 2020.

Clinical determinants of insulin requirements during treatment of prednisolone-induced hyperglycaemia.

Aims: The optimal treatment of prednisolone-associated hyperglycaemia is unclear, but guidelines recommend using a body weight-based daily insulin dose. This study evaluated how clinical variables were associated with insulin requirements in hospitalised patients with prednisolone-associated hyperglycaemia.

Methods: In this prospective study, fifty adult inpatients who were taking prednisolone ≥20 mg/day and experienced hyperglycaemia were prescribed a 24-h intravenous insulin infusion.

Complicated Diverticulitis: Age Distribution, Management and Burden on Health Care.

Introduction: Acute diverticulitis represents a common surgical condition and one of the leading gastrointestinal causes of hospital admissions in Western societies. The aim of the study is to examine the distribution, management and cost to healthcare of complicated diverticulitis and compare those to uncomplicated diverticulitis.

Methods: The case-control study was performed for patients with acute diverticulitis in Lyell McEwin Hospital in Adelaide, South Australia.

Early pregnancy cardio metabolic risk factors and the prevalence of metabolic syndrome 10 years after the first pregnancy.

Background: We aimed to compare risk factors for CVD 10 years postpartum among women who had ≥ 1 compared to no cardio metabolic risk factor in early first pregnancy.

Methods: Women of the SCOPE (Screening fOr Pregnancy Endpoints) study from Adelaide, South Australia were invited to participate in a cardiovascular risk assessment 10 years after the delivery of the first child. Data from 141 women who completed all the assessments are included in the analyses.

Recurrent nephrolithiasis and loss of kidney function: a cohort study.

Purpose: To evaluate whether symptomatic recurrent nephrolithiasis leads to loss of kidney function.

Methods: Adults who presented to the Emergency Department at least twice with symptomatic and radiologically confirmed nephrolithiasis were retrospectively recruited. Primary endpoint was the change in glomerular filtration rate (GFR) between baseline and at the time of data collection.

Mucosal imaging in colon polyps: New advances and what the future may hold.

An expanding range of advanced mucosal imaging technologies have been developed with the goal of improving the detection and characterization of lesions in the gastrointestinal tract. Many technologies have targeted colorectal neoplasia given the potential for intervention prior to the development of invasive cancer in the setting of widespread surveillance programs. Improvement in adenoma detection reduces miss rates and prevents interval cancer development.

Role of conservative therapy prior to surgery in xanthogranulomatous mastitis: a case report.

Background: Xanthogranulomatous mastitis is an extremely rare condition that is characterised by the infiltration of the breast parenchyma by foamy histiocytes. There have been only 26 reported cases amongst 10 publications. The clinical and radiological presentation of xanthogranulomatous mastitis often causes diagnostic confusion due to its similarity to breast cancer and other forms of chronic inflammatory mastitis.

Characterization of Patients With Metastatic Renal Cell Carcinoma Experiencing Complete Response to First-line Therapies: Results From the International Metastatic Renal Cell Carcinoma Database Consortium.

Purpose: Clinical trials have demonstrated higher complete response rates in the immuno-oncology-based combination arms than in the tyrosine kinase inhibitor arms in patients with metastatic renal cell carcinoma. We aimed to characterize real-world patients who experienced complete response to the contemporary first-line therapies.

Materials And Methods: Using the International Metastatic Renal Cell Carcinoma Database Consortium, response-evaluable patients who received frontline immuno-oncology-based combination therapy or tyrosine kinase inhibitor monotherapy were analyzed.

Establishing a state-wide pelvic exenteration multidisciplinary team meeting in South Australia.

Background: Pelvic exenteration surgery is complex, necessitating co-ordinated multidisciplinary input and improved referral pathways. A state-wide pelvic exenteration multidisciplinary team (MDT) meeting was established in SA and the outcomes of this were audited and compared with historical data.

Methods: All patients referred for discussion between August 2021 and July 2022 to the SA State-wide Pelvic Exenteration MDT were included in this study.