133 results match your criteria: "The Wollongong Hospital.[Affiliation]"

Objectives: Efforts to monitor and combat antimicrobial resistance (AMR) are typically focused on the hospital-based laboratory setting. The aim of this study was to longitudinally examine and compare trends in AMR among urine Escherichia coli isolates from a private community-based laboratory and a public hospital-based laboratory in an Australian local health district.

Methods: A total of 108 262 urine E.

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A 19-year-old female has multiple presentations to emergency department with recurrent abdominal pain. During her third presentation, the radiological features were suggestive of high-grade small bowel obstruction in a virgin abdomen. A diagnostic laparoscopy has been performed.

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Article Synopsis
  • Nonadherence to antiplatelet therapy is prevalent among patients after percutaneous coronary intervention (PCI), even in clinical trials like the MASTER DAPT study aimed at high bleeding risk individuals.
  • The study involved 4,579 patients randomized to receive either abbreviated or standard dual antiplatelet therapy, examining outcomes such as adverse clinical events and bleeding risks.
  • Results showed that while adherence levels varied, the abbreviated treatment led to similar levels of adverse events but significantly reduced major bleeding compared to standard treatment.
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Molecular typing of enteroviruses: comparing 5'UTR, VP1 and whole genome sequencing methods.

Pathology

October 2022

Serology and Virology Division (SAViD), NSW Health Pathology East, Department of Microbiology, Prince of Wales Hospital, Randwick, NSW, Australia; Department of Infectious Diseases, Prince of Wales Hospital, Randwick, NSW, Australia; Virology Research Laboratory, Serology and Virology Division (SAViD), New South Wales Health Pathology East, Prince of Wales Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia; School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.

Enteroviruses (EV) commonly cause hand, foot and mouth disease (HFMD), and can also cause potentially fatal neurological and systemic complications. In our laboratory, sequencing 5' untranslated region (UTR) of the viral genome has been the routine method of genotyping EVs. During a recent localised outbreak of aseptic meningitis, sequencing the 5'UTR identified the causative virus as EV-A71, which did not fit with the clinical syndrome or illness severity.

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Immune checkpoint inhibitors have been incorporated into the treatment of various malignancies. An increasing body of literature is reporting rare but potentially fatal adverse events associated with these agents. In this case series, the authors report the clinical features and outcomes of seven patients who received immune checkpoint inhibitors for different solid organ malignancies and developed a tetrad of immune-related myocarditis, myositis, myasthenia gravis and transaminitis.

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Head in the sand: Contemporary Australian attitudes towards induction of labour.

Aust N Z J Obstet Gynaecol

August 2022

College of Medicine & Dentistry, James Cook University, Townsville, Queensland, Australia.

Ambivalence in Australian thought on induction of labour, despite recent evidence, stands out in contrast to ever-increasing rates of this intervention. As consent obligations on information provision have crystallised in maternity care, this article examines whether consumer-led expectations and legal obligations may precipitate change to end the cultural stigma around induction of labour.

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Article Synopsis
  • The ISARIC mortality score is a tool designed to predict the risk of in-hospital death among COVID-19 patients, primarily validated on a British population, prompting the need for testing its effectiveness in other regions.
  • This study focused on external validation of the ISARIC score in a large ICU in Saudi Arabia, analyzing data from 1493 adult COVID-19 patients admitted between March 2020 and June 2021.
  • Results indicated that the ISARIC score effectively predicted mortality, with a cutoff value of >9 showing 70.5% sensitivity and 73.97% specificity, establishing its reliability for critically ill COVID-19 patients in the Saudi cohort.
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BRAF mutation testing for patients diagnosed with stage III or stage IV melanoma: practical guidance for the Australian setting.

Pathology

February 2022

Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia; Mater Hospital, North Sydney, NSW, Australia; Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia.

Targeted therapy (BRAF inhibitor plus MEK inhibitor) is now among the possible treatment options for patients with BRAF mutation-positive stage III or stage IV melanoma. This makes prompt BRAF mutation testing an important step in the management of patients diagnosed with stage III or IV melanoma; one that can help better ensure that the optimal choice of systemic treatment is initiated with minimal delay. This article offers guidance about when and how BRAF mutation testing should be conducted when patients are diagnosed with melanoma in Australia.

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Pseudodelirium.

Aust N Z J Psychiatry

July 2022

Department of Psychiatry, The Wollongong Hospital, Wollongong, NSW, Australia.

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Objective: To describe transient and permanent hypocalcaemia following partial and total pharyngolaryngectomy with parathyroid gland preservation or autotransplantation.

Methods: Thirty patients underwent partial or total pharyngolaryngectomy by a single surgeon during the period 2009-2020. Intraoperative parathyroid gland preservation or autotransplantation (where the gland appeared devascularized) was routinely performed.

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Chylous ascites (CA) is the uncommon extravasation of triglyceride-rich fluid into the abdominal cavity as a result of the disruption of the abdominal lymphatic system. A patient who had previously undergone a subtotal colectomy presented with a closed-loop small bowel obstruction (SBO), underwent an emergency laparotomy with adhesiolysis and had intra-operative findings of milky intra-abdominal free fluid confirmed on analysis as CA. His post-operative period was complicated by a prolonged ileus, and following resolution, he was subsequently discharged home.

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Background:  Advanced biliary tract cancer (ABTC) is a highly aggressive malignancy, with a 5-year overall survival of < 10%. Although preliminary evidence suggests a role of targeted treatments or immunotherapy in a subset of patients, chemotherapy remains the standard second-line treatment in the majority. We conducted a pilot study of second-line chemotherapy with capecitabine and nab-paclitaxel after failure of gemcitabine and platinum.

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Behcet's Syndrome resembling complex perianal Crohn's Disease.

SAGE Open Med Case Rep

April 2021

Department of Surgery, The Wollongong Hospital, Wollongong, NSW 2500, Australia.

Behcet's syndrome is a systemic inflammatory disorder that involves several organ systems and is exceptionally rare in the Western world. The diagnosis is frequently difficult as it resembles several other disease processes. A 23-year-old male with a previous presumptive diagnosis of Crohn's disease presented to our unit with genital ulceration.

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Low morbidity high anterior neck approach for removal of a deep intraglossal foreign body: A case report.

Int J Surg Case Rep

April 2021

Department of Otolaryngology-Head and Neck Surgery, The Wollongong Hospital, Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia; University of Wollongong School of Medicine, Wollongong, New South Wales, Australia.

Article Synopsis
  • The text discusses a case of a 73-year-old woman who ingested a sewing needle, highlighting a low morbidity approach using a midline transcervical incision to access and remove the foreign body in the tongue.
  • It contrasts this method with the more commonly discussed transoral methods, suggesting that the anterior neck approach can be safer and less invasive.
  • The authors advocate for otolaryngologists to consider this technique for similar cases where other methods may be insufficient or risk more complications.
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Stent migration is a well-documented complication following biliary stent insertion. The majority of cases demonstrate passage through the bowel without incident; however, migration may also result in complications, including bowel obstruction or perforation requiring urgent intervention. Risk factors for stent migration comprise of disease pathology as well as stent characteristics including dimension, material and number.

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Background: The number of cases of rectal cancer in our older cohort is expected to rise with our ageing population. In this study, we analysed patterns in treatment and the long-term outcomes of patients older than 80 years with rectal cancer across a health district.

Methods: All cases of rectal cancer managed at the Illawarra Cancer Care Centre, Australia between 2006 and 2018 were analysed from a prospectively maintained database.

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Aim: To conduct a prospective, consecutive cohort study to evaluate the incidence of allergen-specific and total immunoglobulin E (IgE) in a paediatric population undergoing adenotonsillectomy for sleep-disordered breathing.

Methods: A total of 64 consecutive patients presenting for adenotonsillectomy at a single centre were recruited over a period of 3 months. All patients underwent adenotonsillectomy and had allergen-specific and total IgE serum testing at the time of anaesthesia induction.

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Collaborative, interprofessional nutritional care within head and neck cancer teams: an international multi-site qualitative study.

J Interprof Care

December 2021

School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia,g School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, NSW,

Evidence-based guidelines (EBGs) for patients with head and neck cancer (HNC) recommend that nutritional care is delivered by an interprofessional team inclusive of dietitians, doctors, nurses, and speech pathologists. Barriers to collaboration exist within interprofessional teams. However, research on this is currently lacking in the HNC setting, particularly with regard to the provision of nutritional care.

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Gestational diabetes - Major problems with post-partum testing.

Aust N Z J Obstet Gynaecol

August 2021

Illawarra Shoalhaven Diabetes Service, Wollongong, New South Wales, Australia.

Background: Post-partum follow up testing of women with gestational diabetes mellitus (GDM) is important. All women, and their family doctors, receive written reminders. There are no recent major Australian reviews of the efficacy and compliance with this advice conducted in an ethnically representative population and using the current diagnostic criteria.

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Chemoimmunotherapy-related enteritis resulting in a mechanical small bowel obstruction - A case report.

Int J Surg Case Rep

February 2021

Department of Surgery, The Wollongong Hospital, Loftus Street, Wollongong, New South Wales, 2500, Australia.

Introduction And Importance: Mechanical small bowel obstruction (SBO) is amongst the commonest diagnoses encountered in surgical departments. Although the aetiology is frequently post-surgical adhesions, the condition can arise in a virgin abdomen and we now know several of these cases do not require acute operative management. Here we report one such case where a small bowel obstruction transpired due to enteritis in the setting of chemoimmunotherapy with no prior abdominal surgery.

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Complex ventral hernias following laparotomy present a unique challenge in that repair is hindered by the lateral tension of the abdominal wall. A novel approach to overcome this is the "chemical component separation" technique. Here, botulinum toxin A (BTA) is instilled into the muscles of the abdominal wall.

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Objective: Early mobilisation and early enteral feeding after burn injury are two of the most important treatment therapies for optimal recovery. These factors form a part of a team approach, but research has historically focused on one discipline at a time and its effects in isolation; integrated inter-disciplinary influences are not typically studied. This observational study combines strategies and outcomes from the disciplines of nutrition and physiotherapy in an attempt to part-way exemplify the team approach.

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