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

Background: As advancements in critical care medicine continue to improve Intensive Care Unit (ICU) survival rates, clinical and research attention is urgently shifting toward improving the quality of survival. Post-Intensive Care Syndrome (PICS) is a complex constellation of physical, cognitive, and mental dysfunctions that severely impact patients' lives after hospital discharge. This review provides a comprehensive and multi-dimensional summary of the current evidence and practice of exercise therapy (ET) during and after an ICU admission to prevent and manage the various domains of PICS.

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Background: Hypoxaemia occurs in approximately 30% of children during anaesthesia for flexible bronchoscopy. High-flow nasal oxygen (HFNO) can prolong safe apnoea time and be used in children with abnormal airways. During flexible bronchoscopy, there is limited evidence if HFNO confers advantages over current standard practice in avoiding hypoxaemia.

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Article Synopsis
  • The study explores the effectiveness of the echocardiographic left ventricular to left atrial volume ratio in estimating filling pressure in patients experiencing dyspnoea with preserved heart function.
  • It analyzes data from 53 patients, comparing those with elevated filling pressure to those with normal levels, using cardiac catheterization and echocardiography for precise measurements.
  • Findings indicate that a lower LV/LA volume ratio significantly correlates with elevated filling pressure, suggesting it could serve as a reliable non-invasive marker for clinicians.
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Background: Clinical practice guidelines (CPGs) improve patient care by standardising medical practice. However, little is known about their applicability in low-resource settings. Since 2010, Fiji has introduced guidelines to increase the application of evidence-based practice.

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  • The global shortage of medical oxygen during COVID-19 has severely impacted low- and middle-income countries, highlighting the need for accurate data on oxygen consumption in healthcare settings.
  • A study analyzed oxygen requirements for over 12,000 COVID-19 patients in intensive care, revealing varying flow rates and durations depending on the method of oxygen delivery (like mechanical ventilation or high-flow nasal cannula).
  • Findings emphasize the importance of continuous monitoring of oxygen use in hospitals to optimize delivery systems and ensure adequate supplies for fluctuating patient needs.
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Background: Social isolation and low levels of physical activity are strong drivers for frailty, which is linked to poor health outcomes and transition to long-term care. Frailty is multifactorial, and thus an integrated approach is needed to maintain older adults' health and well-being. Intergenerational programs represent a novel multifactorial approach to target frailty, social isolation and physical decline but these have not yet been rigorously tested in Australia.

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In situ single-cell profiling sheds light on IFI27 localisation during SARS-CoV-2 infection.

EBioMedicine

March 2024

Division of Bioinformatics, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, 3052, Australia; Department of Medical Biology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia; Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia; South Australian ImmunoGENomics Cancer Institute, The University of Adelaide, SA, Australia; Department of Clinical Pathology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.

The utilization of single-cell resolved spatial transcriptomics to delineate immune responses during SARS-CoV-2 infection was able to identify M1 macrophages to have elevated expression of IFI27 in areas of infection.

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Background: The androgen receptor is a tumour suppressor in oestrogen receptor-positive breast cancer. The activity and safety of enobosarm, an oral selective androgen receptor modulator, was evaluated in women with oestrogen receptor (ER)-positive, HER2-negative, and androgen receptor (AR)-positive disease.

Methods: Women who were postmenopausal (aged ≥18 years) with previously treated ER-positive, HER2-negative, locally advanced or metastatic breast cancer with an Eastern Cooperative Oncology Group performance status of 0-2 were enrolled in a randomised, open-label, multicentre, multinational, parallel design, phase 2 trial done at 35 cancer treatment centres in nine countries.

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Introduction: Lung weight is an important study endpoint to assess lung edema in porcine experiments on acute respiratory distress syndrome and ventilatory induced lung injury. Evidence on the relationship between lung-body weight relationship is lacking in the literature. The aim of this work is to provide a reference equation between normal lung and body weight in female domestic piglets.

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Mortality and morbidity of Acute Respiratory Distress Syndrome (ARDS) are largely unaltered. A possible new approach to treatment of ARDS is offered by the discovery of inflammatory subphenotypes. In an ovine model of ARDS phenotypes, matching key features of the human subphenotypes, we provide an imaging characterization using computer tomography (CT).

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Article Synopsis
  • * It involved 100 trauma patients and assessed the consistency of four measurement methods: ROTEM® Delta, ROTEM® Sigma, TEG® 6s, and the standard Clauss Fibrinogen measure.
  • * Results showed that ROTEM® machines (both Delta and Sigma) performed similarly for fibrinogen levels, indicating these assays could be used interchangeably in clinical settings to support patient resuscitation efforts.
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Deep Brain Stimulation for Obsessive-Compulsive Disorder: Optimal Stimulation Sites.

Biol Psychiatry

July 2024

Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany; Einstein Center for Neurosciences Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany; Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Article Synopsis
  • Deep brain stimulation (DBS) is being explored as an effective treatment for severe obsessive-compulsive disorder (OCD), with various potential targets in the brain, especially around the anterior limb of the internal capsule and ventral striatum.
  • A study involving 82 OCD patients identified two key stimulation sites linked to significant symptom improvements: one near the anterior limb of the internal capsule and another near the inferior thalamic peduncle, while also showing that stimulation at certain locations can lead to better outcomes for depression and anxiety.
  • The findings suggest that refining the targeting of DBS could enhance treatment effectiveness and help optimize DBS programming for patients already receiving therapy.
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Does forearm referencing using a retroversion guide achieve the targeted retroversion of the humeral component in reverse shoulder arthroplasty?

J Shoulder Elbow Surg

July 2024

Queensland Unit for Advanced Shoulder Research (QUASR), Queensland University of Technology, Brisbane, QLD, Australia; Australian Shoulder Research Institute, Brisbane, QLD, Australia; Greenslopes Private Hospital, Brisbane, QLD, Australia; Akunah, Brisbane, QLD, Australia.

Background: Component positioning affects clinical outcomes of reverse shoulder arthroplasty, which necessitates an implantation technique that is reproducible, consistent, and reliable. This study aims to assess the accuracy and precision of positioning the humeral component in planned retroversion using a forearm referencing guide.

Methods: Computed tomography scans of 54 patients (27 males and 27 females) who underwent primary reverse shoulder arthroplasty for osteoarthritis or cuff tear arthropathy were evaluated.

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Molecular and clinical epidemiology of carbapenem resistant ST2 in Oceania: a multicountry cohort study.

Lancet Reg Health West Pac

November 2023

Department of Microbiology and Immunology, School of Biomedical Sciences, University of Otago, Dunedin 9054, New Zealand.

Article Synopsis
  • The study investigates the transmission of carbapenem-resistant pathogens in the Oceania region, particularly focusing on isolates from hospitals in Fiji and Samoa, alongside comparisons with strains from Australia, New Zealand, and India.
  • A total of 64 isolates from Fiji and 32 from Samoa were analyzed through various methods including mass spectrometry and whole-genome sequencing to understand the characteristics and relationships of these resistant strains.
  • The results indicated that a significant majority of the isolates from both Fiji and Samoa belonged to sequence type 2 (ST2), which exhibited resistance mechanisms related to β-lactam antimicrobials, highlighting the need for further research and monitoring in the region.
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  • Enhancing healthcare access for ethnic minorities is crucial, yet there's limited understanding of how to effectively incorporate race and ethnicity data into large-scale global studies, particularly regarding COVID-19.
  • The COVID-19 Critical Care Consortium study analyzed data from 7,394 adults across 32 countries, focusing on race and ethnicity in relation to treatment and in-hospital mortality among patients admitted to intensive care from January 2020 to February 2022.
  • Results revealed significant disparities, with Indigenous ethnic groups in the US and Australia facing higher disease severity and mortality rates, highlighting the persistent healthcare inequalities affecting these populations.
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  • - This review focuses on three main objectives: understanding factors affecting oxygen levels in patients on ECMO, examining how hyperoxia impacts patient outcomes, and offering practical guidance on adjusting oxygen levels during treatment.
  • - Research included observational and interventional studies as well as guidelines from the Extracorporeal Life Support Organization to gather evidence about hyperoxia and clinical results.
  • - Findings indicate that both the ECMO machine and a patient’s natural heart and lung function influence systemic oxygenation, with high risks of hyperoxia emerging during treatment, which can increase the chances of in-hospital mortality.
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Haemorrhage is a major cause of death in severe trauma. Fibrinogen plays a critical role in maintaining haemostasis in traumatic haemorrhage, and early replacement using fibrinogen concentrate (FC) or cryoprecipitate (Cryo) is recommended by several international trauma guidelines. Limited evidence supports one product over the other, with widespread geographic and institutional variation in practice.

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  • Neuropsychological interventions are increasingly recognized as essential for addressing the cognitive, psychological, and behavioral effects of brain conditions in clinical settings.
  • This clinical guidance paper outlines recommendations for selecting and implementing these interventions, focusing on principles like person-centered goals and essential clinical competencies.
  • Developed by an expert group, the guidance includes evidence from key patient cohorts—acquired brain injury, psychiatric disorders, and older adults—and emphasizes the importance of sustainable implementation and the need for action within neuropsychology.
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  • Shock-induced endotheliopathy (SHINE) is a condition characterized by severe endothelial dysfunction due to extreme sympathetic activation during shock states, which can worsen organ perfusion despite aggressive resuscitation efforts.
  • This study systematically reviewed literature from Jan 2011 to July 2023, focusing on how resuscitation can affect endothelial health in critically ill patients, while excluding animal studies and reviews.
  • Out of 32 relevant studies analyzed, many identified biomarkers related to endothelial damage, but only a few comparable studies were suitable for a quantitative meta-analysis on specific markers like syndecan-1 and thrombomodulin, indicating significant variability in the results.
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Hypothermic oxygenated perfusion (HOPE) safely and effectively extends acceptable donor heart preservation times: Results of the Australian and New Zealand trial.

J Heart Lung Transplant

March 2024

Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia; Monash-Alfred-Baker Centre for Cardiovascular Research, Monash University, Melbourne, Australia.

Background: Cold static storage preservation of donor hearts for periods longer than 4 hours increases the risk of primary graft dysfunction (PGD). The aim of the study was to determine if hypothermic oxygenated perfusion (HOPE) could safely prolong the preservation time of donor hearts.

Methods: We conducted a nonrandomized, single arm, multicenter investigation of the effect of HOPE using the XVIVO Heart Preservation System on donor hearts with a projected preservation time of 6 to 8 hours on 30-day recipient survival and allograft function post-transplant.

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  • This study evaluates the effectiveness and safety of dexmedetomidine as a sedative for infants undergoing open heart surgery compared to midazolam.
  • The research involved a double-blinded, randomized trial in a pediatric cardiac unit, focusing on sedation levels and feasibility measures.
  • Results showed that dexmedetomidine led to increased time in light sedation without significant differences in overall safety or long-term health outcomes compared to midazolam.
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  • Reactive arthritis, previously called Reiter's Syndrome, is characterized by asymmetrical acute joint pain, fever, and various symptoms like conjunctivitis and rash.
  • Although named after Hans Reiter, the condition had been documented earlier by French doctors who studied soldiers with similar symptoms during World War I.
  • Due to Reiter's controversial past, including his allegiance to the Nazi regime, the term has been changed to reactive arthritis for ethical and clinical reasons.
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Hemostatic Profiles of Patients Who Underwent Transcatheter Versus Surgical Aortic Valve Replacement Versus Percutaneous Coronary Intervention.

Am J Cardiol

November 2023

Intensive Care Services, St. Andrew's War Memorial Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Queensland, Australia; Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia; School of Medicine, Griffith University, Queensland, Australia.

Guidelines for transcatheter aortic valve replacement (TAVR) antithrombotic prophylaxis are extrapolated predominantly from percutaneous coronary intervention (PCI) data. Here, we examined temporal coagulation changes occurring in the early perioperative period to determine the pathobiologic validity of this supposition. This was a prospective observational study of consecutive patients who underwent transfemoral TAVR (n = 27), PCI (n = 12), or surgical aortic valve replacement (SAVR) requiring cardiopulmonary bypass and cross-clamping (n = 12).

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