Tasman Medical Journal

ISSN:  2652-1881

Category: Research

The role of ultrasound in scleroderma skin disease

The authors have measured skin thickness in patients with scleroderma and compared the results with the current standard clinical measure, the modified Rodnan Skin Score (mRSS). Though US had satisfactory reliability and reproducibility, and detected changes in skin thickness over time, it did not correlate well with the mRSS, for reasons that remain uncertain.

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Assessing the accuracy of discharge coding for gout, using the International Classification of Disease, at two tertiary teaching hospitals in Perth

Clinical and epidemiological research is often conducted using data from hospital discharge coding. The authors have studied the accuracy of a discharge coding diagnosis of gout, compared to clinical diagnoses based on ACR/EULAR 2015 gout classification criteria and case note review. The coding diagnosis was not supported by the former in over half the cases, or by the latter in almost one third.

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Impact of ‘Can’t Intubate Can’t Oxygenate’ (CICO) kit ergonomic design on the timed responses of participants in simulated CICO crises: A randomised, crossover pilot study

IntroductionThe ‘Can’t Intubate Can’t Oxygenate’ (CICO) situation is a life-threatening, time-critical airway emergency.1 Although a rare event, it is associated with significant patient morbidity and mortality.1 The 4th National Audit Project by the Royal College of Anaesthetists (RCOA) and Difficult Airway Society (DAS) highlighted multiple factors influencing CICO outcome.2 A major modifiable factor included the availability and accessibility of essential equipment.2 The purported ergonomic utility of pre-packaged CICO equipment into kits has also been recently described in literature.3 However, there remains a lack of evidence in current literature to support the superiority of any one packaged design or inferences as to its impact on task performance. At Fiona Stanley Hospital, the Vortex approach and Vortex CICO status tool are used for in-theatre emergency airway and CICO crisis management, respectively. As part of the Vortex CICO status tool, there exists a recommendation for the use of a CICO ‘kit’ as part

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Outcomes from the first five years of allogeneic haemopoietic progenitor cell transplantation at Fiona Stanley Hospital

INTRODUCTIONAllogeneic haemopoietic progenitor cell transplantation (alloHPCT) involves the infusion of third party-derived haemopoietic precursor cells into a recipient who has undergone sufficient chemotherapy or radiotherapy conditioning treatment to allow engraftment of these cells and eventually full haemopoietic and immunological reconstitution.  The treatment is effective as replacement of haemopoiesis in bone marrow failure syndromes, and allows high doses of chemotherapy as well as life-long immunological surveillance against relapse to treat malignant conditions.  Donors are preferentially siblings who are human leukocyte antigen (HLA) matched at both class I and II loci, HLA-matched unrelated donors, or alternative donors such as partially matched unrelated adult, related adult or cryopreserved umbilical cord blood products.  In usual circumstances, donor cells are infused ‘fresh’, immediately after collection, into a recipient who has just received conditioning therapy.  Risks to recipients include toxicity of chemotherapy or radiotherapy, infection during aplasia or immunological reconstitution, relapse and graft-versus-host disease.  Western Australia

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An evaluation of research capacity and culture in a sample of Western Australian Allied Health professionals

Introduction Research should be one of the pillars of a resilient flexible health system,1 and building research capacity is crucial for maintaining or improving quality of care and patient outcomes.  Translational research is an important phase of the research process.  Allied Health professionals (AHP) comprise a significant and vital proportion of the Australian healthcare workforce across several professional categories.  Such personnel are uniquely placed to design, generate, and execute clinically meaningful research, and translate it into practice.2,3 However, the literature indicates that the research culture within Allied Health is overshadowed by prioritisation of delivery of clinical services, and is hampered by a number of barriers to engagement (such as lack of time, research skills, and resources) despite an interest in conducting research.4-7 Given evidence that the proportion of edAHP either leading or participating in research is limited, an examination of the factors influencing Allied Health research capacity and culture is

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Trends in acute myeloid leukaemia in Western Australia over time: Improved outcomes with contemporary management

IntroductionReal-world outcomes of acute myeloid leukaemia (AML) are poor compared to the results of clinical trials.  This partially reflects population differences due to patient selection criteria in trials (excluding older and unfit patients who are unsuitable for aggressive treatment), and lack of improvement in the efficacy of intensive chemotherapy over time.  However, there have been successful developments in AML management including improved non-intensive therapies, laboratory diagnostics to stratify patient risk, donor selection for allogeneic stem cell transplantation (allo-SCT) and supportive care.  We have performed a retrospective analysis of all cases of AML in Western Australia from 2009 to 2018 with respect to clinical and laboratory characteristics, treatments and outcomes, compared to a historical cohort. MethodsAML was defined as per the 2016 WHO classification1.  Cases were identified by hospital discharge summary records at 3 tertiary public hospitals in WA and the laboratory cytogenetics records for new diagnoses of AML between 2009

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