Beyond COVID-19: Reported clinical practices in maternity care in Victoria during the COVID-19 pandemic and implications for the future - A statewide review.

Background: In Australia, during the COVID-19 pandemic many routine pregnancy visits were replaced by telehealth, along with changes to routine screening and visitor policies. Many providers plan to continue these changes.

Aims: Describe changes to maternity care provision across the state of Victoria during the COVID-19 pandemic.

Antagonisation of Prokineticin Receptor-2 Attenuates Preeclampsia Symptoms.

Preeclampsia (PE) is the most threatening pathology of human pregnancy. Placenta from PE patients releases harmful factors that contribute to the exacerbation of the disease. Among these factors is the prokineticin1 (PROK1) and its receptor, PROKR2 that we identified as a mediators of PE.

Protocol for a multisite randomised controlled trial assessing the effect of the Telehealth for Early Developmental Intervention in babies born very preterm (TEDI-Prem) programme on neurodevelopmental outcomes and parent well-being.

Introduction: Infants born very preterm (VPT, <32 weeks' gestation) are at increased risk for neurodevelopmental impairments including motor, cognitive and behavioural delay. Parents of infants born VPT also have poorer mental health outcomes compared with parents of infants born at term.We have developed an intervention programme called TEDI-Prem (Telehealth for Early Developmental Intervention in babies born very preterm) based on previous research.

Surgery and minimally invasive treatments for uterine fibroids.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of surgery and minimally invasive treatments for uterine fibroids.

Interleukin-6 Modulation in Ovarian Cancer Necessitates a Targeted Strategy: From the Approved to Emerging Therapies.

Despite significant advances in treatments, ovarian cancer (OC) remains one of the most prevalent and lethal gynecological cancers in women. The frequent detection at the advanced stages has contributed to low survival rates, resistance to various treatments, and disease recurrence. Thus, a more effective approach is warranted to combat OC.

Surgical parathyroidectomy in pregnancy for severe secondary hyperparathyroidism associated with end-stage kidney disease.

Secondary hyperparathyroidism (SHPT) is common in patients with end-stage kidney disease (ESKD) on kidney replacement therapy, which leads to abnormalities of bone and mineral metabolism. Patients conceiving on kidney replacement therapy add a further layer of complexity to the management of their SHPT. Existing literature in cases of primary hyperparathyroidism (PHPT) has linked untreated hyperparathyroidism to increased maternal and fetal morbidity, including hypertensive disorders of pregnancy, fetal growth restriction and neonatal hypocalcaemia.

Can maternal serum soluble fms-like tyrosine kinase-1 to placental growth factor levels at term anticipate adverse pregnancy outcomes?

Aim: To evaluate if maternal serum soluble fms-like tyrosine kinase-1(sFlt-1) to placental growth factor (PlGF) ratio levels at term can anticipate the following adverse pregnancy outcomes: small for gestational age neonates; operative delivery for suspected fetal welfare compromise; and neonatal compromise.

Methods: A retrospective analysis of a single hospital database containing antenatal soluble fms-like tyrosine kinase-1 to placental growth factor (sFlt-1/PlGF) ratio results together with associated demographic, clinical and investigative information. Subjects with antenatal sFlt-1/PlGF measurements taken ≥37 weeks' gestation were analyzed.

Pathology and risk stratification-based evaluation of ovarian masses on MRI.

Characterisation of an indeterminate ovarian mass is important as it guides management and clinical outcomes. Ultrasound is the first-line modality in the assessment of ovarian tumours. When ovarian masses are indeterminate on ultrasound, MRI provides excellent resolution in tissue characterisation and enhancement patterns.

Efficacy of Therapeutic Hypothermia During Transport of Newborns With Perinatal Hypoxic-Ischaemic Encephalopathy: Experience From Newborn and Paediatric Transport Service, New South Wales.

Aim: To examine the efficacy of current non-servo-based cooling methods used by NETS NSW in treating hypoxic ischaemic encephalopathy (HIE) with therapeutic hypothermia (TH) in neonatal retrieval.

Methods: A retrospective observational study of infants treated with TH for HIE retrieved by NETS NSW from January 2017 to June 2020 inclusive. Primary outcomes were the proportion of neonates achieving TH within 6 h of life and maintaining temperature in a therapeutic range.

Breaking down barriers: A qualitative study of the influence of clinical space design on teamwork.

Background: Delivery of safe maternity care requires not only individual competence but collective team work, influenced by knowledge, team culture and physical working spaces. The ideal layout for a birthing unit is not known, but deliberate changes to the built environment can influence patient care.

Aims: To explore the impact of creation of an open 'hub' on maternity team culture in a tertiary birthing unit and how physical changes to the environment shape values and practice.

Persistent urticarial eruption preceding systemic features of adult-onset Still's disease: A case report.

Adult-onset Still's disease (AOSD) is a rare autoinflammatory systemic disorder classically characterised by inflammatory polyarthritis, daily fevers and a transient asymptomatic salmon-pink maculopapular rash that typically arises with the onset of fevers. We report a case of AOSD presenting with a severely pruritic urticarial eruption starting 6 weeks prior to the onset of fever and arthritis and complicated by macrophage activation syndrome. This case highlights the importance of early recognition of diverse cutaneous manifestations of AOSD to facilitate timely diagnosis and treatment to improve disease outcomes.

Rapid genomic testing in critically ill pediatric patients: Genetic counseling lessons from a national program.

Genetic counselors (GCs) face unique challenges in the acute care setting. Acute care environments-such as neonatal and pediatric intensive care units-are characterized by urgency, complexity, and rapid decision making. These settings require GCs to navigate a delicate balance between addressing the immediate clinical needs of patients and providing comprehensive genetic information to families, while demanding adaptation of existing skills for practice.

Reducing unplanned extubation in the neonatal intensive care unit: a quality improvement project.

Background And Aim: Unplanned extubation (UE) is an adverse event that can occur for neonates that are intubated and mechanically ventilated. UE is recognised as an important quality measure in the neonatal intensive care unit (NICU) due to the negative impact these events may have on the neonate. We aimed to use quality improvement (QI) methodology to reduce the rate of UE to the global standard of <1/100 ventilation days.

Adalimumab Use in Severe Recalcitrant Vulval Lichen Sclerosus and Vulval Lichen Planus.

Objectives: This case series aims to evaluate the demographic features, disease characteristics, and treatment outcomes of 8 patients receiving subcutaneous (SC) adalimumab for severe, refractory vulval lichen sclerosus (VLS) and/or vulval lichen planus (VLP). Both conditions are chronic inflammatory dermatoses that significantly impair quality of life, and although first-line treatment typically involves potent to ultrapotent topical corticosteroids, managing severe cases is challenging due to a lack of FDA-approved systemic therapies. Adalimumab, a TNF-α inhibitor, may offer a promising alternative by targeting the inflammatory cytokine implicated in the pathogenesis of both conditions.

Living with Pyoderma Gangrenosum: A Qualitative Study.

Pyoderma gangrenosum is a rare, autoinflammatory disorder characterized by rapidly progressive painful ulcers that are challenging to diagnose and treat. This qualitative study aimed to explore the experiences of patients living with pyoderma gangrenosum. Using an inductive qualitative approach, semi-structured interviews were completed with a purposive sample of 21 patients with pyoderma gangrenosum recruited from a public dermatology outpatient clinic in Melbourne, Australia.

I love my job. But it's physically, mentally, and emotionally draining": a cross-sectional survey exploring midwives' intentions of leaving the profession in Melbourne, Australia.

Background: Prior to the COVID-19 pandemic there were midwifery workforce deficits reported in Australia, but inadequate workforce data to identify retention and attrition in the profession. In the post-pandemic era, workforce deficits continue. This paper reports on midwives' intentions to leave the profession and explores reasons for and factors associated with having high intention to leave, to inform strategies that can address retention and attrition of midwives.

Excisional surgery versus ablative surgery for ovarian endometrioma.

Background: Endometrioma are endometriotic deposits within the ovary. Laparoscopic management of endometriomas is associated with shorter hospital stay, faster recovery, and decreased hospital costs compared with laparotomy. The previous version of this systematic review (2008), including randomised controlled trials (RCTs) of surgical interventions for endometrioma, concluded that laparoscopic cystectomy (excision) was preferable to drainage and ablation of endometrioma.