Diagnostic yield of upper gastrointestinal tract endoscopy and colonoscopy in patients with iron deficiency anaemia while on direct oral anticoagulants.

Background: Iron deficiency anaemia (IDA) related to occult gastrointestinal tract (GIT) blood loss is associated with high rates of GIT malignancies. Major society guidelines recommend bidirectional endoscopic evaluation for all men and post-menopausal women with newly diagnosed, unexplained IDA. However, in patients prescribed direct oral anticoagulants (DOACs), the endoscopic yield, specifically the rate of high-risk findings, including colorectal cancers (CRCs) and advanced adenomas (AAs), is unknown.

A national Australian Congenital Heart Disease registry; methods and initial results.

Background: Although several National Data Registries for Congenital Heart Disease (CHD) exist, few are comprehensive and contemporary. A National Australian CHD Registry has been developed that aims to redress this by creating the first comprehensive data collection for CHD children and adults, initially across Australia.

Methods: We defined and collected a minimum dataset of demographics, diagnoses, and procedures from people with CHD presenting at participating quaternary CHD services Australia-wide.

Association between Driving Pressure, Systemic Inflammation and Non-pulmonary Organ Dysfunction in Patients with Acute Respiratory Distress Syndrome, a Prospective Pathophysiological Study.

Background: Driving pressure is thought to determine the effect of low tidal ventilation on survival in patients with acute respiratory distress syndrome. The leading cause of mortality in these patients is non-pulmonary multiorgan dysfunction, which is believed to worsen due to the biological response to mechanical ventilation (biotrauma). Therefore, we aimed to analyze the association between driving pressure, biotrauma, and non-pulmonary multiorgan dysfunction.

Mortality associated with moderate and severe mitral regurgitation in 608 570 men and women undergoing echocardiography.

Background: Although the prognostic implications of severe mitral regurgitation (MR) are well recognised, they are less clear in moderate MR. We therefore explored the prognostic impact of both moderate and severe MR within the large National Echocardiography Database Australia cohort.

Methods: Echocardiography reports from 608 570 individuals were examined using natural language processing to identify MR severity and leaflet pathology.

Adherence to Wearing Therapeutic Footwear Among People at High-Risk of Diabetes-Related Foot Ulcers in Jordan.

This study aimed to investigate the levels of adherence to wearing therapeutic footwear, and the factors associated, among people at high-risk of diabetes-related foot ulcers (DFUs) in Jordan. This was a secondary analysis of data from a multi-centre cross-sectional study of participants at high-risk of DFU in Jordan who had therapeutic footwear. Participants had socio-demographic, health, limb, and psychosocial variables collected, plus self-reported their proportion of adherence time wearing therapeutic footwear on an average day (excluding sleeping time) using a visual analogue scale.

Comparative Analysis of the Therapeutic Potential of Extracellular Vesicles Secreted by Aged and Young Bone Marrow-Derived Mesenchymal Stem Cells in Osteoarthritis Pathogenesis.

Osteoarthritis (OA), a joint disease, burdens global healthcare due to aging and obesity. Recent studies show that extracellular vesicles (EVs) from bone marrow-derived mesenchymal stem cells (BMSCs) contribute to joint homeostasis and OA management. However, the impact of donor age on BMSC-derived EV efficacy remains underexplored.

A Novel Porcine Model of Bilateral Hindlimb Bypass Graft Surgery Integrating Transit Time Flowmetry.

Background: Bypass graft surgery is a key surgical intervention for ischemic heart disease (coronary bypass graft surgery) and critical limb ischemia (peripheral bypass graft surgery). Graft occlusion remains a significant clinical problem for both types. Further research into the pathobiological mechanisms of graft occlusion are needed in order to design targeted therapeutic strategies.

Estimates of the eligible population for Australia's targeted National Lung Cancer Screening Program, 2025-2030.

Australia's National Lung Cancer Screening Program will commence in July 2025, targeted at individuals aged 50-70 years with a 30 pack-year smoking history (equivalent to 20 cigarettes per day for 30 years), who either currently smoke or have quit within the past 10 years. We forecasted the number of screening-eligible individuals over the first 5 years of the program using data from the 2019 National Drug Strategy Household Survey and the 2022 Australian Bureau of Statistics population projections. Multiple imputation integrated with predictive modelling of future or unmeasured smoking characteristics was used to address missing data and, simultaneously, to project individuals' smoking histories to 2030.

Population pharmacokinetics of caspofungin in critically ill patients receiving extracorporeal membrane oxygenation-an ASAP ECMO study.

This study aimed to describe the population pharmacokinetics of caspofungin in critically ill patients receiving extracorporeal membrane oxygenation (ECMO) and to identify dosing regimens with a high likelihood of achieving effective exposures. Serial blood samples were collected over a single-dosing interval during ECMO. Total plasma concentrations were measured by a validated chromatographic assay.

Imipenem pharmacokinetics/pharmacodynamics in preclinical hollow fiber model, dose-finding in virtual patients, and clinical evidence of efficacy for Mycobacterium abscessus lung disease.

Background: Guideline-based therapy (GBT) for Mycobacterium abscessus (Mab) lung disease achieves sputum culture conversion rates (SCC) of 35%. This poor GBT efficacy is mirrored in the hollow fiber system model of Mab (HFS-Mab). While imipenem is part of GBT, biological effect with or without β-lactamase inhibitors, is unproven.

Incidence, timing and variation in unplanned readmissions within 30-days following isolated coronary artery bypass grafting.

Background: Coronary Artery Bypass Grafting (CABG) is the most common cardiac surgery, yet little is known about unplanned readmissions after CABG despite increasing clinical and policy focus on reducing readmissions. We assessed the incidence, timing, and reasons for unplanned readmission within 30 days of CABG and evaluated for variation in readmission rates across hospitals in Australia and New Zealand (ANZ).

Method: We identified isolated CABG procedures from 2013 to 2017 across all public and most private hospitals in ANZ.

Insights into artificial intelligence and our intelligence-on the frontier of lung cancer screening.

This paper explores the potential of artificial intelligence (AI) in lung cancer screening programs, particularly in the interpretation of computed tomography (CT) scans. The authors acknowledge the benefits of AI, including faster and potentially more accurate analysis of scans, but also raise concerns about clinician trust, transparency, and the deskilling of radiologists due to decreased scan exposure. The rise of AI in medicine and the introduction of national lung cancer screening programs are both increasing contemporarily and naturally the overlap and interplay between the two in the future is ensured.

totally implantable venous access device infection in a person with cystic fibrosis: Complex management considerations.

Totally implantable venous access devices (TIVADs) are frequently used in people with cystic fibrosis as a means of securing consistent vascular access, particularly in the context of severe disease and microbial colonization. Infection of TIVADs is not uncommon and typically associated with coagulase negative staphylococci, though infection with other organisms does occur too. We report on the first case of a TIVAD infection caused by in person with cystic fibrosis.

Incorporating Patient and Family Perspectives into ICU Environmental Design: A Systematic Review and Narrative Synthesis of Existing Literature.

Objective: This review aims to assess the incorporation of patient and family input into intensive care unit (ICU) design processes. It aims to highlight the importance of prioritising patient and family perspectives in ICU design to improve patient experiences and clinical outcomes.

Background: Traditionally, ICU design has focused on clinical efficiency at the expense of patient-centered needs, leading to heavily sedated patients and neglected holistic care delivery.

Nurses' Perspectives on the Use of Prophylactic Dressings to Prevent Pressure Injury: A Qualitative Study.

Aim: To understand, from a nursing perspective, factors affecting the use of prophylactic dressings to prevent pressure injuries in acute hospitalised adults.

Background: Pressure injury causes harm to patients and incurs significant costs to health services. Significant emphasis is placed on their prevention.

Nurse-surgeons in the Australian public health system: A descriptive quantitative survey.

Background: With over five billion people worldwide lacking access to surgery, innovative solutions are vital to address the global surgical crisis. Nurse-surgeons present a promising innovation. Considering their contribution worldwide and impact on surgical care in Australia, an exploration of these advanced practice nurses is timely.

Compassionate access to virus-specific T cells for adoptive immunotherapy over 15 years.

Adoptive T-cell immunotherapy holds great promise for the treatment of viral complications in immunocompromised patients resistant to standard anti-viral strategies. We present a retrospective analysis of 78 patients from 19 hospitals across Australia and New Zealand, treated over the last 15 years with "off-the-shelf" allogeneic T cells directed to a combination of Epstein-Barr virus (EBV), cytomegalovirus (CMV), BK polyomavirus (BKV), John Cunningham virus (JCV) and/or adenovirus (AdV) under the Australian Therapeutic Goods Administration's Special Access Scheme. Most patients had severe post-transplant viral complications, including drug-resistant end-organ CMV disease, BKV-associated haemorrhagic cystitis and EBV-driven post-transplant lymphoproliferative disorder.

A novel tape-free sample preparation method for human osteochondral cryosections for high throughput hyperspectral imaging.

Understanding the osteochondral junction, where non-mineralised cartilage and mineralised bone converge, is crucial for joint health. Current sample preparation techniques are insufficient for detailed spatial hyperspectral imaging analysis. Using the enhanced Kawamoto method, we used the super cryo embedding medium's temperature-dependent properties to transfer high-quality tissue samples onto slides for spatial imaging analysis.

Neurological Monitoring and Management for Adult Extracorporeal Membrane Oxygenation Patients: Extracorporeal Life Support Organization Consensus Guidelines.

Background: Critical care of patients on extracorporeal membrane oxygenation (ECMO) with acute brain injury (ABI) is notable for a lack of high-quality clinical evidence. Here, we offer guidelines for neurological care (neurological monitoring and management) of adults during and after ECMO support.

Methods: These guidelines are based on clinical practice consensus recommendations and scientific statements.