61 results match your criteria: "The University of Melbourne Faculty of Medicine[Affiliation]"

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.

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Unlabelled: Diagnosing cancer in general practice is complex, given the non-specific nature of many presenting symptoms and the overlap of potential diagnoses. This trial evaluated the effectiveness of a technology, Future Health Today (FHT), which provides clinical decision support, auditing, and quality improvement monitoring, on the appropriate follow-up of patients at risk of undiagnosed cancer.

Methods: Pragmatic, cluster randomised trial in Australian general practice.

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Article Synopsis
  • * A patient was found to have this rare tumor during staging scans after the removal of a malignant rectosigmoid polyp, leading to further imaging that indicated a lobulated lesion with no metastases.
  • * The patient successfully underwent a radical resection of the affected bile ducts, and histological analysis confirmed a well-differentiated NET, with no recurrence two years later, highlighting the need for careful surgical planning for uncommon tumors.
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Objective: People with advanced chronic obstructive pulmonary disease (COPD) have substantial palliative care needs, but uncertainty exists around appropriate identification of patients for palliative care referral.We conducted a Delphi study of international experts to identify consensus referral criteria for specialist outpatient palliative care for people with COPD.

Methods: Clinicians in the fields of respiratory medicine, palliative and primary care from five continents with expertise in respiratory medicine and palliative care rated 81 criteria over three Delphi rounds.

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Objective: To identify the patient population profile and the spectrum of training activities and influencing factors of Australasian College of Sport and Exercise Physician (ACSEP) trainees.

Design: Retrospective cross-sectional design.

Setting: Training settings for ACSEP trainees.

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The use of clinical ethics services (CES) has been increasing over time, but little is known about the role of CES in cancer care. Cancer diagnosis and treatment are emotionally charged and life-changing experiences, raising existential and ethical questions about the quality and meaning of, living and dying. This narrative review seeks to consolidate the available information regarding how CES are accessed and used in cancer care.

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Objectives: The use of cannabis-based medicine (CBM) as a therapeutic has surged in Australia over the past 5 years. Historically, the United Nations Single Convention on Narcotic Drugs (1961) prohibited cannabis use in Europe, the USA, the UK and Australia, leading to legislative resistance and limited preclinical data on CBM. Existing safety monitoring systems for CBM are poorly structured and do not integrate well into the workflows of busy health professionals.

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Introduction: Mental disorders are common in adult patients with traumatic injuries. To limit the burden of poor psychological well-being in this population, recognised authorities have issued recommendations through clinical practice guidelines (CPGs). However, the uptake of evidence-based recommendations to improve the mental health of trauma patients has been low until recently.

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Seamless EMR data access: Integrated governance, digital health and the OMOP-CDM.

BMJ Health Care Inform

February 2024

Health and Biomedical Informatics Centre, Research Information Technology Unit (HaBIC R2), Department of General Practice and Primary Care, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia

Article Synopsis
  • The Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM) standardizes electronic medical record (EMR) data, making it easier for health service providers and researchers to access and analyze the data securely.
  • It uses techniques like pseudonymisation and common data quality assessments to protect patient privacy while allowing for the efficient sharing of de-identified, aggregated data for research.
  • By simplifying governance and promoting interoperability, the OMOP-CDM supports various clinical and epidemiological research initiatives, enabling faster and more accurate analysis across different healthcare systems without direct data exchange.
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Gluteal tendinopathy (GT) is common and can be debilitating and challenging to manage. A lack of condition specific and appropriate outcome measures compromise evidence synthesis for treatment and limits clinical guideline development. Our objective was to develop a core outcome measurement set for GT (COS-GT).

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Objective: To investigate factors that differentiate elderly adults in rural China who accept free vision screening and cataract surgery from those who could benefit from vision care but refuse it when offered.

Design: We conducted a population-based, cross-sectional study between October and December 2016. Logistic regression models were used to examine the predictors of accepting free vision screening and cataract surgery.

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Article Synopsis
  • - Foreign body ingestion is a frequent reason for Emergency Department visits, particularly in vulnerable groups such as the elderly, individuals with psychiatric issues, and prisoners, with a study in Melbourne analyzing data from 2017 to 2021 involving 63 patients.
  • - The study found that a significant portion (65%) of cases involved prisoners, with common ingested items being batteries (23%), drug-containing balloons (17%), and razor blades (16%); most ingestions were categorized as high-risk.
  • - Conservative management was successfully applied in 55% of cases without complications, although 31% of patients returned within 30 days, highlighting the ongoing challenges in managing those with high-risk, intentional ingestions and mental health concerns.
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Objective: This study aimed to estimate the direct effects to recipients and indirect (herd) effects to non-recipients of each of topical antibiotic prophylaxis (TAP) and oral care methods on patient mortality within randomised concurrent controlled trials (RCCT) using Cochrane review data.

Design: Control and intervention groups from 209 RCCTs of TAP (tier 3), oral care (tier 2) each versus non-antimicrobial (tier 1) ventilator-associated pneumonia (VAP) prevention interventions arranged to emulate a three-tiered cluster randomised trial (CRT). Eligible RCCTs were those including ICU patients with >50% of patients receiving >24 hours of mechanical ventilation (MV) with mortality data available as abstracted in 13 Cochrane reviews.

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Barrett's esophagus (BE) with low-grade dysplasia (LGD) is considered usually endoscopically invisible and the endoscopic features are not well described. This study aimed to: 1) evaluate the frequency of visible BE-LGD; 2) compare rates of BE-LGD detection in the community versus a Barrett's referral unit (BRU); and 3) evaluate the endoscopic features of BE-LGD. This was a retrospective analysis of a prospectively observed cohort of 497 patients referred to a BRU with dysplastic BE between 2008 and 2022.

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The clinical presentation of gastrointestinal histoplasmosis (GIH) is often non-specific, mimicking several other gastrointestinal diseases, making diagnosis difficult. We present a case of GIH, causing bowel obstruction in an immunocompetent patient. A woman in her 80s presented with anorexia and a distended abdomen.

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Objectives: To describe the incidence of and patterns of 'escalated care' (care in addition to standard treatment with systemic corticosteroids and inhaled bronchodilators) for children receiving prehospital treatment for asthma.

Design: Retrospective observational study.

Setting: State-wide ambulance service data (Ambulance Victoria in Victoria, Australia, population 6.

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Background: People experiencing cognitive concerns and symptoms of depression or anxiety are at risk for Alzheimer's disease and dementia. We know physical activity can benefit cognition but understanding how to best support engagement is an ongoing challenge. Evidence-based conceptual models of factors underpinning physical activity engagement in target populations can inform intervention tailoring to address this challenge.

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towards a pluralist account of non-sexual reproduction.

J Med Ethics

April 2023

Children's Bioethics Centre, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia

Fertility clinicians participate in non-sexual reproductive projects by providing assisted reproductive technology (ART) to those hoping to reproduce, in support of their reproductive goals. In most countries where ART is available, the state regulates ART as a form of medical treatment. The predominant position in the reproductive rights literature frames the clinician's role as medical technician, and the state as a third party with limited rights to interfere.

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Screening for colorectal cancer (CRC) is effective in reducing CRC related mortality. Current screening methods include endoscopy based and biomarker based approaches. This guideline is a joint official statement of the Asian Pacific Association of Gastroenterology (APAGE) and the Asian Pacific Society of Digestive Endoscopy (APSDE), developed in response to the increasing use of, and accumulating supportive evidence for the role of, non-invasive biomarkers for the diagnosis of CRC and its precursor lesions.

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Introduction: Despite the availability of effective, subsidised hepatitis B treatment, linkage to care and treatment rates remain very low globally. In Australia, specially trained primary care physicians (general practitioner, GPs) can prescribe hepatitis B treatment, however, most hepatitis B care occurs in specialist clinics. Increasing hepatitis B management by GPs in primary care clinics is essential to achieve national hepatitis B linkage to care and treatment targets by 2030.

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Mortality-Risk With "Capacity" Constraints On Community Treatment Order Utilization.

Schizophr Bull Open

January 2023

Mental Health and Social Welfare Research Group, School of Social Welfare, University of California, Berkeley, USA.

Article Synopsis
  • The study examined the impact of reduced community treatment order (CTO) assignments on mortality risk among patients with schizophrenia in Victoria, Australia between 2010 and 2019.
  • Nearly 78% of 777 deaths among three patient groups were premature, with no significant difference in mortality risk between hospitalized patients assigned to CTOs and those not assigned.
  • Outpatients with schizophrenia showed a significantly higher mortality risk, indicating that decreased CTO utilization might contribute to increased mortality in this at-risk population.
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