435 results match your criteria: "War Memorial Hospital[Affiliation]"

Vaccinating children with disability in low- and middle-income countries, such as Fiji, is a key priority for equity. This study aimed to understand the social and behavioral drivers of vaccine uptake among children with disability in Fiji, from the perspectives of health, disability, and community stakeholders. Five qualitative focus groups were conducted with 22 stakeholders, including healthcare workers, disability service providers and advocates, and community and faith leaders (female n = 17, 77%).

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Background: Individual surgeons' learning curves are a crucial factor impacting patient outcomes. While many studies investigate procedure-specific learning curves, very few carried out a longitudinal analysis of individual cardiac surgeons over the course of their career. Given the evolving landscape of cardiac surgery with the introduction of transcatheter and robotic procedures, a contemporary evaluation of the cardiac surgical learning curve is justified and a method of personal performance monitoring is proposed in this study.

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Management of adult sepsis in resource-limited settings: global expert consensus statements using a Delphi method.

Intensive Care Med

December 2024

Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.

Purpose: To generate consensus and provide expert clinical practice statements for the management of adult sepsis in resource-limited settings.

Methods: An international multidisciplinary Steering Committee with expertise in sepsis management and including a Delphi methodologist was convened by the Asia Pacific Sepsis Alliance (APSA). The committee selected an international panel of clinicians and researchers with expertise in sepsis management.

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Background: Blood group incompatibility previously represented an obstacle to living related donor (LRD) options; desensitization modalities have expanded LRD options. ABO-incompatible kidney transplants have been successful in adults and pediatric liver transplants, but to date not yet in pediatric kidney transplants in South Africa.

Case Report: Patient X is a 5 year old male with end-stage kidney failure due to Posterior Urethral Valves, requiring peritoneal dialysis pre-transplant.

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Objective: Our study aimed to explore the experience of attaining higher education among women in medicine at the largest national hospital in Fiji, focusing on barriers and enablers to completing training, and to explore women's perception of gender-based discrimination in the world of medicine. Findings subsequently informed evidence-based recommendations on enablers and barriers at the hospital and medical university to improve experiences of women in medicine.

Methods: We conducted a mixed-method study, emphasising the phenomenological qualitative component.

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Background: Fiji is a Pacific Island nation grappling with the increasing threat of antimicrobial resistance (AMR). While genomic technologies are increasingly utilised to understand the emergence and spread of AMR globally, its application to inform outbreak responses in low- and middle-income settings has not been reported.

Methods: Through an established capacity building program, suspected carbapenem-resistant organisms (CRO) identified at Colonial War Memorial Hospital in Fiji (Jan 2022-Oct 2023) underwent whole genome sequencing and analysis.

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Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation.

Intensive Care Med Exp

November 2024

Critical Care Research Group, The Prince Charles Hospital, Level 3, Clinical Sciences Building, Chermside Qld 4032, Brisbane, QLD, Australia.

Article Synopsis
  • - Open-lung ventilation during cardiopulmonary bypass (CPB) may help reduce postoperative lung damage in heart transplant patients, based on a study using sheep models to compare ventilatory strategies during surgery.
  • - The study found that the group receiving open-lung ventilation had significantly less lung damage and inflammatory cell infiltration compared to the group that received no ventilation (measured by histological scores).
  • - Despite showing benefits in lung protection, no significant differences were observed in overall hemodynamic stability between the two groups, indicating the need for more research to confirm these findings in clinical settings.
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Introduction: Interventions to treat speech-language difficulties in primary progressive aphasia (PPA) often use word accuracy as a highly comparable outcome. However, there are more constructs of importance to people with PPA that have received less attention.

Methods: Following Core Outcome Set Standards for Development Recommendations (COSSTAD), this study comprised: Stage 1 - systematic review to identify measures; Stage 2 - consensus groups to identify important outcome constructs for people with PPA (n = 82) and care partners (n = 91); Stage 3 - e-Delphi consensus with 57 researchers.

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Background: Due to the ageing population, the number of symptomatic degenerative rotator cuff tears has increased substantially, and some are challenging to repair due to poor tendon quality with significant retraction. In order to optimize repair integrity and function, rotator cuff repair reinforcement with a superior capsule reconstruction has been proposed. This study presents the results of a technique combining cuff repair and capsular reconstruction (CRACR) using acellular dermal allograft in patients with massive rotator cuff tears and retears.

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Background And Objectives: Screening for elder abuse can improve detection, but many health providers lack the necessary skills and confidence. To address this, training for health providers on elder abuse screening was co-designed as part of a trial aimed at improving elder abuse detection and response.

Research Design And Methods: Between March and April 2023, 7 health providers and 10 older people and family carers participated in two national Australian online codesign workshops.

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An ovine septic shock model of live bacterial infusion.

Intensive Care Med Exp

October 2024

Critical Care Research Group, The Prince Charles Hospital, 627 Rode Road, Level 3 Clinical Sciences Building, Chermside, Brisbane, QLD, 4032, Australia.

Article Synopsis
  • Escherichia coli is a leading cause of bloodstream infections and sepsis, but existing animal models fail to replicate the complexities of these conditions, hindering the development of effective treatments.
  • Researchers aimed to create a more accurate large-animal model of septic shock using sheep, by infusing a specific strain of antibiotic-resistant E. coli and closely monitoring their health over 48 hours.
  • The study successfully induced septic shock in five sheep, showing consistent and reproducible results, including significant drops in blood pressure and increases in lactate levels following the bacterial infusion.
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: Proximal humeral bone deficiency in revision shoulder arthroplasty is an emerging and challenging problem as the use of reverse shoulder arthroplasty (RSA) increases. This paper presents a technical note discussing our detailed preoperative planning steps, surgical techniques, and their rationale in carrying out the use of an allograft prosthetic composite (APC) to address proximal humeral bone deficiency in revision RSA. The outcomes of this technique are also presented.

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Environmental contamination with carbapenem resistant in healthcare settings in Fiji: a potential source of infection.

Front Cell Infect Microbiol

October 2024

Department of Microbiology and Immunology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand.

Introduction: There are multiple ongoing outbreaks of carbapenem resistant (CR) infection in Fiji's hospitals. CR is able to colonize and persist on various hospital surfaces for extended periods. We conducted a study to understand the extent of hospital environmental contamination and phylogenetic links with clinical isolates.

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Aims: To identify the prevalence, trends, and outcomes of same-day discharge following elective percutaneous coronary intervention among six public hospitals in one Australian State.

Methods And Results: A retrospective observational research design was used. A total of 4387 cases were obtained from the State Cardiac Outcomes Registry and National Hospital Cost Data Collection.

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Background: integrated Rehabilitation and EnAblement Program (iREAP) is an innovative redesign of the traditional day rehabilitation model, providing an anticipatory, early assessment and intervention program that manages care of community-dwelling older people with complex needs. It coordinates access to disciplines across medical, allied health and nursing, with a self-management focus, partnering with primary health in an integrated approach.

Objective: This observational study reviews the effectiveness of iREAP on frailty, patient activation, quality of life and physical outcome measures on older people at risk of, or experiencing falls and frailty, or with neurodegenerative conditions, including Parkinson's Disease.

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Sex differences in the outcome of critically Ill patients with COVID-19 - An international multicenter critical care consortium study.

Heart Lung

October 2024

Neuroscience Critical Care Division, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:

Article Synopsis
  • The study analyzes sex differences in ICU outcomes for severe COVID-19 patients, focusing on mortality rates between males and females.
  • It includes data from 10,259 patients admitted to ICUs worldwide between January 2020 and June 2022, revealing that males had a higher hazard of death (HR=1.14) despite adjustment for complications.
  • Additionally, males exhibited more severe health issues, requiring greater interventions and showing higher risks for cardiac arrest and pulmonary embolism compared to females.
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Renal chloride metabolism is currently poorly understood but may serve as both a diagnostic and a treatment approach for acute kidney injury. We investigated whether plasma chloride, ammonia and glutamine as well as urinary chloride, ammonium and glutamine concentrations may serve as markers for acute kidney injury in paediatric patients. We conducted a prospective observational trial in a tertiary care paediatric intensive care unit.

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Background: Gram-negative bacteria resistant to carbapenems are also known as critical antimicrobial resistant organisms. Their emergence at Colonial War Memorial Hospital (CWMH), the largest hospital in Fiji, is a major clinical concern. This study was conducted to determine the knowledge, attitudes, and readiness of healthcare workers (HCW) at CWMH regarding management of patients with infections caused by critical antimicrobial resistant organisms.

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Giant molluscum contagiosum with preseptal cellulitis.

J AAPOS

October 2024

Department of Ophthalmology, The Children's Hospital at Westmead, Sydney Australia; Department of Ophthalmology, Sydney and Sydney Eye Hospital, Sydney, Australia; Department of Ophthalmology, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia; Save Sight Institute, Central Clinical School, Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, Australia.

Article Synopsis
  • Molluscum contagiosum (MC) is a common, non-threatening viral skin infection primarily affecting children and certain adults, including those with weakened immune systems.
  • The article discusses two rare pediatric cases of giant periorbital MC lesions accompanied by preseptal cellulitis.
  • In the first case, a 9-month-old boy underwent surgical excision after a diagnosis of MC, while the second case involved an 18-month-old girl who was treated with antibiotics and surgery.
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Background: Packed red blood cell (pRBC) transfusion is a relatively safe and mainstay treatment commonly used in cardiac surgical patients. However, there is limited evidence on clinical effects of transfusing blood nearing end-of shelf life that has undergone biochemical changes during storage.

Objective: To investigate evidence of associations between morbidity/mortality and transfusion of blood near end of shelf-life (> 35 days) in cardiac surgical patients.

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Comprehensive review of deep learning in orthopaedics: Applications, challenges, trustworthiness, and fusion.

Artif Intell Med

September 2024

School of Mechanical, Medical, and Process Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia.

Deep learning (DL) in orthopaedics has gained significant attention in recent years. Previous studies have shown that DL can be applied to a wide variety of orthopaedic tasks, including fracture detection, bone tumour diagnosis, implant recognition, and evaluation of osteoarthritis severity. The utilisation of DL is expected to increase, owing to its ability to present accurate diagnoses more efficiently than traditional methods in many scenarios.

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Increasing countries' access to data can improve immunisation coverage through evidence-based decision-making. However, data collection and reporting is resource-intensive, so needs to be pragmatic, especially in low-and-middle-income countries. We aimed to identify which indicators are most important for measuring, and improving, national immunisation performance in Pacific Island Countries (PICs).

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Article Synopsis
  • The study examined a new topical gel for treating vulvovaginal skin conditions in women, focusing on its feasibility and effectiveness.
  • Fifty-two women with conditions like lichen sclerosus and genitourinary syndrome applied the gel daily for up to two years, with positive outcomes measured short-term and long-term.
  • Results showed significant symptom improvement, high patient compliance, and no reported adverse effects, suggesting the gel could be a beneficial treatment option.
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