A case of an asymptomatic sacrococcygeal teratoma diagnosed in adulthood.

Sacrococcygeal teratomas are rare congenital tumours that are even more uncommon when present in adulthood. They are derived from residual stem cells in the presacral space that differentiate into clusters of somatic cell. We present the diagnosis, management and post-operative follow-up in a 37-year-old gentleman referred to our department with an incidental finding of a lobulated presacral cystic mass on computed tomography imaging.

Necrotic Excluded Gastric Remnant Post Gastric Bypass: A Rare Fatal Complication.

We report an unusual case of a 76-year-old woman with a necrotic perforated excluded gastric pouch who had stomach partitioning gastrojejunostomy 20 years earlier for morbid obesity. The necrotic mucosa of the excluded gastric pouch was seen on gastroscopy with retrograde cannulation from the pylorus. Laparotomy revealed a distended excluded stomach with full-thickness ischaemia of the posterior wall with perforation into the lesser sac.

Surgical management of obstructive sleep apnoea: A position statement of the Australasian Sleep Association.

Surgery for adult obstructive sleep apnoea (OSA) plays a key role in contemporary management paradigms, most frequently as either a second-line treatment or in a facilitatory capacity. This committee, comprising two sleep surgeons and three sleep physicians, was established to give clarity to that role and expand upon its appropriate use in Australasia. This position statement has been reviewed and approved by the Australasian Sleep Association (ASA) Clinical Committee.

Intestinal T-cell lymphoma presenting as colonic perforation in the setting of ulcerative colitis: a case report.

The intestinal T-cell lymphomas are a rare group of lymphatic malignancies arising from the gastrointestinal tract. They frequently manifest with non-specific clinical and radiographic findings that may mimic several other disease processes. The most common subtype is linked with refractory coeliac disease and commonly affects the small intestine.

Smart polymer implants as an emerging technology for treating airway collapse in obstructive sleep apnea: a pilot (proof of concept) study.

Study Objectives: To assess the use of a novel magnetic polymer implant in reversing airway collapse and identify potential anatomical targets for airway implant surgery in an in vivo porcine model.

Methods: Target sites of airway collapse were genioglossus muscle, hyoid bone, and middle constrictor muscle. Magnetic polymer implants were sutured to these sites, and external magnetic forces, through magnets with pull forces rated at 102 kg and 294 kg, were applied at the skin.

Retrospective study on the epidemiology of antineutrophil cytoplasmic autoantibodies-associated vasculitis in two Australian health districts.

Background: Antineutrophil cytoplasmic autoantibodies (ANCA)-associated vasculitis (AAV) is more prevalent in rural Australia compared with metropolitan areas, suggesting a role of environment in disease pathogenesis. However, the prevalence of environmental risk factors in Australian AAV patients has not been described.

Aims: To compare the incidence of AAV between two health districts (Illawarra Shoalhaven Local Health District (ISLHD), a mixed rural/metropolitan region, and South Eastern Sydney Local Health District (SESLHD), a metropolitan region) in Australia and its relationship to environmental exposures.

Outcomes of Reduced Frequency Dosing of Ibrutinib in Chronic Lymphocytic Leukemia Patients Following Complete or Partial Remission: A Pilot Study.

Background: Ibrutinib is a Bruton's tyrosine kinase inhibitor that has shown to be a superior choice in the treatment of chronic lymphocytic leukemia (CLL) and a simple, oral alternative to other chemoimmunotherapies. The standard dose is 420 mg daily; however, its irreversible binding mechanism allows adequate target blockade at much lower doses due to prolonged effect. Dose reductions or interruptions are often used in clinical practice to limit its distinct side effects, including diarrhea, bleeding and atrial fibrillation and emerging evidence exists that these do not hinder efficacy.

Gestational diabetes mellitus testing in the COVID-19 pandemic: The problems with simplifying the diagnostic process.

Background: Multiple professional bodies have temporarily revised recommendations for gestational diabetes mellitus (GDM) testing during the COVID-19 pandemic to reduce person-to-person contact. The current Australian temporary criteria advise that if the fasting glucose is ≤4.6 mmol/L, then no glucose tolerance test (GTT) is required.

Small Bowel Perforation Secondary to Biliary Stent Migration in an Incarcerated Inguinal Hernia.

We describe the case of a 90-year-old female who presented with signs of a strangulated inguinal hernia. Further history revealed a paired biliary-pancreatic stent insertion three years prior for ascending cholangitis and a long-standing asymptomatic right inguinal hernia. Biochemistry revealed a slightly elevated C-reactive protein level of 65 mmol/L, but was otherwise unremarkable.

Implementing and measuring person-centredness using an APP for knowledge transfer: the iMPAKT app.

Objective: The aim of the study was to evaluate a technological solution in the form of an App to implement and measure person-centredness in nursing. The focus was to enhance the knowledge transfer of a set of person-centred key performance indicators and the corresponding measurement framework used to inform improvements in the experience of care.

Design: The study used an evaluation approach derived from the work of the Medical Research Council to assess the feasibility of the App and establish the degree to which the App was meeting the aims set out in the development phase.

Gallstone Ileus: An Unusual Cause of Intestinal Obstruction.

Gallstone ileus is an uncommon complication of gallstones and a rare cause of intestinal obstruction. Typically as a result of the formation of cholecystoduodenal fistula, surgical removal of the gallstone is the mainstay of treatment in order to relieve the intestinal obstruction. A 34-year-old male with no history of cholelithiasis presented with features of a small bowel obstruction.

Synchronous Acute Appendicitis and Cholecystitis in a Paediatric Patient with Salmonella Enteritis.

We present the case of a 13-year-old male who presented with right upper quadrant pain and diarrhoea after recently travelling from Bali, Indonesia. He had a normal white cell count of 8x10^9/L and elevated c-reactive protein (CRP) of 205 mg/L with normal liver function tests. Originally thought to be appendicitis, given the rarity of cholecystitis in a child, he was commenced on broad-spectrum antibiotics and was taken to the operating theatre based on his clinical presentation.

Increasing the delivery of upper limb constraint-induced movement therapy post-stroke: A feasibility implementation study.

Introduction: Few stroke survivors receive upper limb constraint-induced movement therapy (CIMT). The aims of this study were to evaluate whether a behaviour change program for occupational therapists increased the number of stroke survivors receiving CIMT, describe the time and process involved in delivering the first program, any adverse events, fidelity and dose of CIMT provided, and upper limb outcomes.

Methods: A feasibility pre-post implementation study design was used, with intervention and measures for therapists and stroke survivors.

Primary Small Bowel Volvulus: An Unusual Cause of Small Bowel Obstruction.

We present the case of a 78-year-old female who presented to the emergency department with small bowel obstruction in a virgin abdomen. Although the patient did not have peritonism and biochemical investigations did not reveal alarming features of ischemia, an abdominal computed tomography (CT) scan was suggestive of small bowel volvulus (SBV), and operative exploration was pursued. No obvious cause was identified aside from hard stools throughout the colon and a diagnosis of primary SBV was determined.

The myopic shift associated with hyperbaric oxygen administration is reduced when using a mask delivery system compared to a hood - a randomised controlled trial.

Introduction: A temporary myopic shift is a well-recognized complication of hyperbaric oxygen treatment (HBOT). Oxidation of proteins in the crystalline lens is the likely cause. Direct exposure of the eye to hyperbaric oxygen may exacerbate the effect.

Current practice in the introduction of solid foods for preterm infants.

Objective: The present study compared the age of first solid foods in a cohort of preterm infants with term infants and identified factors influencing timing of solid food introduction.

Design: Structured interviews on infant feeding practices, growth and medical status at term equivalence and at 3, 6, 9 and 12 months corrected postnatal age. The age of solid food introduction was compared between term and preterm infants, and the influence of maternal, infant and milk feeding factors was assessed.

The patient experience of having a feeding tube during treatment for head and neck cancer: A systematic literature review.

Background And Aims: Patients undergoing treatment for head and neck cancer (HNC) can experience severe weight loss, malnutrition and dehydration which can cause treatment delays. Enteral feeding can reduce the risk of these. However, the use of feeding tubes (FT), including FT type and placement timing is debated.