Journal articles on the topic 'Headache Australia'
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1
Martin, Paul R. "Behavioural Approaches to Headaches." Behaviour Change 4, no. 2 (June 1987): 3–5. http://dx.doi.org/10.1017/s0813483900008421.
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Headaches are a common problem, and psychological factors are widely acknowledged as playing a critical role in the development and maintenance of a high proportion of cases. This mini series consists of six contributions to the headache literature from researchers working in Australia. The papers focus on cycles in headache activity; behavioural patterns, copying styles and personality characteristics of headache sufferers; psychophysiological pain mechanisms; and potential adverse consequences of simplistic treatment approaches. The emphasis on non-treatment studies is unusual in this field but argued to be appropriate in view of the lack of knowledge concerning basic headache processes.
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Gregson, Robert A. M. "The Time-Series Analysis of Self-reported Headache Sequences." Behaviour Change 4, no. 2 (June 1987): 6–13. http://dx.doi.org/10.1017/s0813483900008433.
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Individual case histories collected variously in Europe and in Australia, recorded over long unbroken sequences, on a daily self-report basis, are potentially analysable as time series. The assessment of spontaneous changes in the dynamics of headache generation and attenuation, and the consequences, if any, of superimposed therapeutic intervention, require that we treat the self-report ratings of headache intensity and duration as a multistate process which is highly autoregressive. Some strong insights into individual differences both in chronic headache patterns, and in response to treatment, are obtained. Of particular interest are individual differences in cyclical and quasi-periodic headaches and in the possible causality of such differences.
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Silva-Néto, Raimundo Pereira, and Adriana Almeida Soares. "Osmophobia and Odour-triggered Headaches – Review of the Literature and Main Research Centres." European Neurological Review 12, no. 01 (2017): 24. http://dx.doi.org/10.17925/enr.2017.12.01.24.
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There is an important relationship between odours and primary headaches. Patients may present osmophobia during headaches and odours may trigger headache attacks. This review aimed to describe the studies on osmophobia, odour-triggered headache, the main researchers and their research centres. Publications on the relationship between odours and primary headaches were searched in 193 sovereign countries and 48 dependent territories in all continents. We consulted the PubMed database and used the descriptors: “osmophobia in [name of the country or territory]”; “odours and headache in [name of the country or territory]” and “smell and headache in [name of the country or territory]”. A total of 254 articles were found, but only 31 articles were considered relevant and composed this review. Of the 31 articles, 90.3% were cross-sectional studies, 6.5% case reports and 3.2% systematic reviews. All studies were performed on three continents: Europe (45.2%), America (32.2%) and Asia (22.6%). For the purpose of this study, North America and South America have been classed as one continent. No research was developed in Africa or Australia. More than 50.0% of the studies were conducted in Italy and Brazil. Only five authors published 38.7% of the studies. Osmophobia during headache attacks was investigated in 67.7% of studies, and odour-triggered headache in 19.3%. Studies on osmophobia and/or odour-triggered headache were carried out in several countries. They were useful in differentiating between migraine and tension-type headache. This could improve the accuracy of diagnosis of migraine compared to the current criteria.
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Cheng, Shuli, Bronwyn Jenkins, and Elspeth Hutton. "074 Early australian experience with erenumab for chronic migraine." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A23.2—A23. http://dx.doi.org/10.1136/jnnp-2019-anzan.62.
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IntroductionErenumab is available in Australia since October 2018. We review the effectiveness and safety in 2 Australian headache centres.MethodsErenumab (70 mg or 140 mg) was prescribed. We monitored headache days, migraine days, analgesic use, adverse reactions, Headache Impact Test-6 (HIT6) score and Migraine Disability Assessment (MiDAS) score, at baseline and at 3 months. Primary outcomes were reduction in headache and migraine days, and adverse effects. Secondary outcomes were improvement in functional scores and analgesic use.Results65 patients (ages 18–73; mean 44 years) commencing Erenumab were assessed before and after 3 monthly treatments. The duration of chronic migraine (CM) ranged from 1 to 40 years, with 3 to 16 previous failed prophylactic treatments.There was a >50% response in overall headache days and migraine days in 29% (19/65) and 46% (27/59), respectively. There was a modest (10–49%) response in overall headache days and migraine days in 29% (19/65) and 27% (18/59), respectively. There was no improvement in headache days and migraines in 42% (27/65) and 27% (14/59), respectively.At onset, the mean HIT-6 and MiDAS scores were 66 and 65, decreasing after 3 treatments to 59 and 32, respectively. The mean monthly days taking triptan and codeine medications reduced from 9 and 6 days, to 5 and 3 days, respectively.There were few reported side effects.ConclusionThis Australian cohort in tertiary referral refractory migraine patients achieved a significant rate of reduced headache and migraine days with good safety and tolerability.
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Burke, David. "James Waldo Lance 1926–2019." Historical Records of Australian Science 32, no. 2 (2021): 190. http://dx.doi.org/10.1071/hr21001.
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James W. Lance was a clinical neurologist who created the first university-based department of neurology in Australia. He championed academic enquiry and the scientific basis of clinical practice, and his research had two major themes, motor control and headache. After his doctoral studies on the pyramidal tract of the cat, he became a pioneer of the new field of motor control studied in human subjects, making seminal contributions on the control of muscle tone, reflexes and movement in healthy subjects and the pathophysiology of movement disorders in patients. At the same time he developed a clinical research program into the mechanisms and management of headache, in particular migraine. These studies evolved into parallel experiments in human subjects, cats and monkeys, probing the control of the cerebral circulation and the mechanisms underlying craniofacial pain, for which he received international acclaim in both fields. He received international and Australian honours and was the first practising clinician to be elected a fellow of the Australian Academy of Science. He is rightfully credited with leading the development of academic neurology in Australia and overseas.
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Zhang, Lin, Bronwyn Jenkins, Richard Stark, and Elspeth Hutton. "061 Training in headache in australia, new zealand and asia." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A20.1—A20. http://dx.doi.org/10.1136/jnnp-2019-anzan.53.
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IntroductionMigraine is the leading cause of age-adjusted neurological disability in Australia, but little is known about headache training in our region. We aimed to assess the quantity of teaching in headache subjects during undergraduate and postgraduate years.MethodThis is a cross-sectional survey study where questionnaires were sent to 137 delegates from Australia, New Zealand and Asia, prior to the Headache Master School in Sydney in August 2018. The Main outcome measured are recalled number of hours of teaching in undergraduate year and postgraduate years in: 1) Migraine; 2) Trigeminal autonomic cephalalgias (TACs); 3) Asthma; 4) Myasthenia gravis (MG).ResultsThe questionnaire response rate was 73% (100 of 137), of which 29 delegates were within 10 years of completing their undergraduate degree and 98 were neurologists. In undergraduate training, there was much greater quantity of teaching in asthma than migraine (Z=5.007, p<0.000) despite both being high-prevalent (asthma 11%, migraine 15–20%) conditions. Similarly, for diseases of medium-to-low prevalence, there was less training in TACs (1/1000), compared to MG (1.2/10,000) (Z=6.196, p<0.000). These major differences in training were also seen in postgraduate years even though overall headache teaching was greater in postgraduate than undergraduate training (p<0.000).ConclusionsDespite the high prevalence and morbidity of headache disorders, they receive less attention in training than conditions with similar prevalence. We propose that headache training opportunities should be improved in our region, particularly in the undergraduate course and preceptorships or fellowships in postgraduate years.
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Wilhelm, Kay, Viola Korczak, Tad Tietze, and Prasuna Reddy. "Clinical pathways for suicidality in emergency settings: a public health priority." Australian Health Review 41, no. 2 (2017): 182. http://dx.doi.org/10.1071/ah16008.
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Rates of self-harm in Australia are increasing and constitute a concerning public health issue. Although there are standard treatment pathways for physical complaints, such as headache, abdominal pain and chest pain, in Emergency Medicine, there is no national pathway for self-harm or other psychiatric conditions that present to the emergency department. Herein we outline the difference between clinical practice guidelines and clinical pathways, discuss pathways we have identified on self-harm in Australia and overseas and discuss their applicability to the Australian context and the next steps forward in addressing this public health issue.
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Grice, I. Darren, Kelly L. Rogers, and Lyn R. Griffiths. "Isolation of Bioactive Compounds That Relate to the Anti-Platelet Activity ofCymbopogon ambiguus." Evidence-Based Complementary and Alternative Medicine 2011 (2011): 1–8. http://dx.doi.org/10.1093/ecam/nep213.
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Infusions and decoctions ofCymbopogon ambiguushave been used traditionally in Australia for the treatment of headache, chest infections and muscle cramps. The aim of the present study was to screen and identify bioactive compounds fromC. ambiguusthat could explain this plant’s anti-headache activity. A dichloromethane extract ofC. ambiguuswas identified as having activity in adenosine-diphosphate-induced human platelet aggregation and serotonin-release inhibition bioassays. Subsequent fractionation of this extract led to the isolation of four phenylpropenoids, eugenol, elemicin, eugenol methylether andtrans-isoelemicin. While both eugenol and elemicin exhibited dose-dependent inhibition of ADP-induced human platelet serotonin release, only eugenol displayed potent inhibitory activity with an IC50value of 46.6 μM, in comparison to aspirin, with an IC50value of 46.1 μM. These findings provide evidence to support the therapeutic efficacy ofC. ambiguusin the non-conventional treatment of headache and inflammatory conditions.
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Benhaddi, Hicham, Sophie McCabe, and Diana T. Lau. "070 Burden of migraine is australia: a systematic literature review." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A22.2—A22. http://dx.doi.org/10.1136/jnnp-2019-anzan.59.
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IntroductionMigraine is a disabling neurological disease characterised by recurrent attacks of moderate to severe headaches. This systematic literature review (SLR) aimed to investigate the clinical, humanistic, and economic burden of chronic migraine (CM), episodic migraine (EM), and of current preventive migraine treatments in Australia.MethodsThe methodology of this SLR was aligned with the National Institute for Health and Care Excellence (NICE) guidelines. An electronic database search was conducted in Embase, MEDLINE and the Cochrane Library, with a time frame of 2008 to 2018.ResultsIn total, 1,122 records were identified and 168 of these were included for data extraction. The prevalence of migraine in Australia is estimated at 18.9%. Of those, 44% of people with EM and 86% of people with CM reported moderate-to-severe disability. Over one-third (36%) of people with EM and nearly two-thirds (64%) of people with CM reported visiting a healthcare provider in the previous three months. No data relating to the economic burden of migraine were returned by the searches. In people with EM and CM, anti-calcitonin gene-related peptide (anti-CGRP) preventive treatments for migraine safely, effectively and significantly reduced the mean number of monthly migraine and/or headache days from baseline compared with placebo.ConclusionsMigraine is associated with a substantial burden, and people living with migraine feel the impact in their day-to-day lives. Anti-CGRPs are a promising class of preventive treatments for all people with migraine. Longer-term studies are needed to determine if the positive effects of anti-CGRPs are sustained over greater time periods.
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Perry, Jeffrey J., Debra Eagles, Catherine M. Clement, Jamie Brehaut, Anne-Maree Kelly, Suzanne Mason, and Ian G. Stiell. "An international study of emergency physicians' practice for acute headache management and the need for a clinical decision rule." CJEM 11, no. 06 (November 2009): 516–22. http://dx.doi.org/10.1017/s1481803500011775.
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ABSTRACTObjective:Patients with acute headache often undergo computed tomography (CT) followed by a lumbar puncture to rule out subarachnoid hemorrhage. Our international study examined current practice, the perceived need for a clinical decision rule for acute headache and the required sensitivity for such a rule.Methods:We approached 2100 emergency physicians from 4 countries (Australia, Canada, the United Kingdom and the United States) to participate in our survey by sampling the membership of their emergency associations. We used a modified Dillman technique with 3–5 notifications and a prenotification letter employing a combination of electronic mail and postal mail. Physicians were questioned about neurologically intact patients who presented with headache. Analysis included both descriptive statistics for the entire sample and stratification by country.Results:The total response rate was 54.7% (1149/2100). Respondents were primarily male (75.5%), with a mean age of 42.5 years and a mean 12.3 years of emergency department (ED) experience. Of the physicians who responded, 49.5% thought all acute headache patients should be investigated with CT and 57.4% felt CT should always be followed by lumbar puncture. Of the respondents, 95.7% reported they would consider using a clinical decision rule for patients with acute headache to rule out subarachnoid hemorrhage. Respondents deemed the median sensitivity required by such a rule to be 99% (interquartile range 98%–99%). Approximately 1 in 5 physicians suggested that 100% sensitivity was required.Conclusion:Emergency physicians report that they would welcome a clinical decision rule for headache that would determine which patients require costly or invasive tests to rule out subarachnoid hemorrhage. The required sensitivity of such a rule was realistic. These results will inform and inspire the development of clinical decision rules for acute headache in the ED.
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Stark, Richard J., Treasure McGuire, and Mieke L. Driel. "Medication overuse headache in Australia: a call for multidisciplinary efforts at prevention and treatment." Medical Journal of Australia 205, no. 6 (September 2016): 283. http://dx.doi.org/10.5694/mja16.00492.
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Kovalchuk, P. V., O. V. Katilov, and S. O. Panenko. "Modern approaches to diagnostics and treatment of migraine in children." Pain medicine 3, no. 4 (February 21, 2019): 41–53. http://dx.doi.org/10.31636/pmjua.v3i4.2.
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This article reviews modern approaches to diagnostics and treatment of a very common and simultaneously underestimated and often maltreated disorder in children. It is fallacious management of migraine masked behind the diagnoses such as autonomic vessel dysfunction and vascular headache here in Ukraine. This is a tremendous problem and it should be solved with appropriate information spread across the medical community.
Up-to-date classification according to the International Headache Society, diagnostic criteria, differential diagnosis, investigation and treatment strategies are presented in the article. All supported data are com-pliant with guidelines of developed countries with evidence-based medicine (US, Canada, Great Britain, Japan, Australia, New Zealand) enhanced with new trials and approved methods. Migraine management is a rapidly evolving concept, where major changes were done during recent years (transcranial Deep Brain Stimulation, vagus stimulation, CGRP-receptor mono-clonal antibodies).
Considering disorder incidence and its impact on life quality and the existence of options for alleviating symptoms, this information is important for physicians who work with children, especially for general practitioners, pediatrics, pediatric and adult neurologists.
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Al Alawi, Abdullah M., Usama Al Amri, and Henrik Falhammar. "Lactation Ketoacidosis: A case series." Sultan Qaboos University Medical Journal [SQUMJ] 19, no. 4 (December 22, 2019): 359. http://dx.doi.org/10.18295/squmj.2019.19.04.012.
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Lactation ketoacidosis is an extremely rare type of high anion gap metabolic acidosis. We report two lactating women who were diagnosed with lactation ketoacidosis. The first patient presented to the Emergency Department at Royal Darwin Hospital, Darwin, Australia, in 2018 with lethargy, nausea and abdominal pain after she commenced a new diet regimen based on three meals of protein per day and free of glucose, gluten and dairy products. The second patient presented to the Emergency Department at Sultan Qaboos University Hospital, Muscat, Oman, in 2018 with headache, severe malaise, epigastric pain and worsening of gastroesophageal symptoms. Blood investigation results showed that both patients had high anion gap metabolic acidosis, ketosis and hypoglycaemia. The patients responded well to intravenous dextrose and resumption of a balanced diet. Both patients were able to continue breastfeeding and remained well on follow-up.Keywords: Breastfeeding; Starvation; Hypoglycemia; Ketosis; Acid-Base Imbalance; Metabolic Diseases; Ketone Bodies; Fasting; Case Series; Australia; Oman.
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Krishnadas, Natasha, and Bruce Taylor. "Incidence of idiopathic intracranial hypertension in Southern Tasmania, Australia." BMJ Neurology Open 3, no. 1 (June 2021): e000145. http://dx.doi.org/10.1136/bmjno-2021-000145.
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IntroductionAnecdotally, the incidence of idiopathic intracranial hypertension (IIH) is increasing, linked to an increase in the obesity rate in Australian society. However, formal incidence and prevalence studies are rare. We therefore sought to determine the incidence and clinical features of IIH in Southern Tasmania, Australia.MethodNeurology discharge summaries and lumbar puncture referrals from the single tertiary referral centre in this region were screened for an IIH diagnosis. All regional neurologists were surveyed to capture patients diagnosed through private neurology clinics. A retrospective review of medical records was conducted to confirm the diagnosis and determine whether patients met the Modified Dandy Criteria (MDC). Patients were included if they were above the age of 18 years and received a new diagnosis of IIH between June 2016 and June 2018. Population statistics were obtained from the Australian Bureau of Statistics.ResultsIIH incidence was 5.4/100 000. All patients were females, aged between 18 and 45 years. Headache was the most commonly reported symptom, with high rates of pre-existing or concurrent migraine diagnoses. Weight loss and commencement of oral acetazolamide were the most common treatment approaches. Four patients were medically refractory and required surgical intervention.ConclusionThe incidence of IIH in Southern Tasmania is comparable with the incidence reported in subgroups of females of childbearing age in recent prior studies. The demographic, diagnostic and therapeutic data presented can inform future local health service provision and serve as a baseline for ongoing assessment of change in incidence and treatment of IIH at a community level.
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Singh, Kasha P., Joe Sasadeusz, Sharon R. Lewin, and Jennifer Audsley. "Therapeutics for COVID-19: established and in development." Microbiology Australia 41, no. 4 (2020): 217. http://dx.doi.org/10.1071/ma20058.
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COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first recognised in late 2019, with over 30000000 cases and over 1000000 deaths reported by the end of September 2020. SARS-CoV-2 infection is usually associated with fever, cough, coryza, dyspnoea, anosmia, headache and fatigue and may cause pneumonia and hypoxemia. An excessive/dysregulated inflammatory response may lead to lung damage including acute respiratory distress syndrome (ARDS), coagulopathy and other complications. Mortality amongst hospitalised patients is higher in those needing intensive care. In Australia over 27000 cases with 882 deaths had been reported by 30 September, most in Victoria. Two therapies have proven beneficial in treatment of hospitalised patients in expedited randomised placebo-controlled trials and are now in widespread use. Dexamethasone improved survival of those requiring respiratory support and the antiviral agent remdesivir decreased time to recovery in mild-moderate disease. Remdesivir was authorised by the Australian Therapeutic Goods Administration in July 2020. Over 200 other therapeutics are being tested for COVID-19 in more than 2000 clinical trials, and many more agents are in preclinical development. We review the evidence for some of the candidates for therapy in COVID-19.
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Singh, Kasha P., Joe Sasadeusz, Sharon R. Lewin, and Jennifer Audsley. "Corrigendum to: Therapeutics for COVID-19: established and in development." Microbiology Australia 42, no. 1 (2021): 46. http://dx.doi.org/10.1071/ma20058_co.
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COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first recognised in late 2019, with over 30 000 000 cases and over 1 000 000 deaths reported by the end of September 2020. SARS-CoV-2 infection is usually associated with fever, cough, coryza, dyspnoea, anosmia, headache and fatigue and may cause pneumonia and hypoxemia. An excessive/dysregulated inflammatory response may lead to lung damage including acute respiratory distress syndrome (ARDS), coagulopathy and other complications. Mortality amongst hospitalised patients is higher in those needing intensive care. In Australia over 27 000 cases with 882 deaths had been reported by 30 September, most in Victoria. Two therapies have proven beneficial in treatment of hospitalised patients in expedited randomised placebo-controlled trials and are now in widespread use. Dexamethasone improved survival of those requiring respiratory support and the antiviral agent remdesivir decreased time to recovery in mild-moderate disease. Remdesivir was authorised by the Australian Therapeutic Goods Administration in July 2020. Over 200 other therapeutics are being tested for COVID-19 in more than 2000 clinical trials, and many more agents are in preclinical development. We review the evidence for some of the candidates for therapy in COVID-19.
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Dineen-Griffin, Sarah, Victoria Garcia-Cardenas, Kris Rogers, Kylie Williams, and Shalom Isaac Benrimoj. "Evaluation of a Collaborative Protocolized Approach by Community Pharmacists and General Medical Practitioners for an Australian Minor Ailments Scheme: Protocol for a Cluster Randomized Controlled Trial." JMIR Research Protocols 8, no. 8 (August 9, 2019): e13973. http://dx.doi.org/10.2196/13973.
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Background Internationally, governments have been investing in supporting pharmacists to take on an expanded role to support self-care for health system efficiency. There is consistent evidence that minor ailment schemes (MASs) promote efficiencies within the health care system. The cost savings and health outcomes demonstrated in the United Kingdom and Canada open up new opportunities for pharmacists to effect sustainable changes through MAS delivery in Australia. Objective This trial aims to evaluate the clinical, economic, and humanistic impact of an Australian Minor Ailments Service (AMAS) compared with usual pharmacy care in a cluster randomized controlled trial (cRCT) in Western Sydney, Australia. Methods The cRCT design has an intervention group and a control group, comparing individuals receiving a structured intervention (AMAS) with those receiving usual care for specific health ailments. Participants will be community pharmacies, general practices, and patients located in Western Sydney Primary Health Network (WSPHN) region. A total of 30 community pharmacies will be randomly assigned to either intervention or control group. Each will recruit 24 patients, aged 18 years or older, presenting to the pharmacy in person with a symptom-based or product-based request for one of the following ailments: reflux, cough, common cold, headache (tension or migraine), primary dysmenorrhea, or low back pain. Intervention pharmacists will deliver protocolized care to patients using clinical treatment pathways with agreed referral points and collaborative systems boosting clinician-pharmacist communication. Patients recruited in control pharmacies will receive usual care. The coprimary outcomes are rates of appropriate recommendation of nonprescription medicines and rates of appropriate medical referral. Secondary outcomes include self-reported symptom resolution, health services resource utilization, and EuroQoL Visual Analogue Scale. Differences in primary outcomes between groups will be analyzed at the individual patient level accounting for correlation within clusters with generalized estimating equations. The economic impact of the model will be evaluated by cost-utility and cost-effectiveness analysis compared with usual care. Results The study began in July 2018. Thirty community pharmacies were recruited. Pharmacists from the 15 intervention pharmacies were trained. A total of 27 general practices consented. Pharmacy patient recruitment began in August 2018 and was completed on March 31, 2019. Conclusions This study may demonstrate the efficacy of a protocolized intervention to manage minor ailments in the community and will assess the clinical, economic, and humanistic impact of this intervention in Australian pharmacy practice. Pharmacists supporting patient self-care and appropriate self-medication may contribute to greater efficiency of health care resources and integration of self-care in the health system. The proposed model and developed educational content may form the basis of a national MAS service in Australia, using a robust framework for management and referral for common ailments. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12618000286246; http://www.anzctr.org.au/ACTRN12618000286246.aspx International Registered Report Identifier (IRRID) DERR1-10.2196/13973
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Zhan, Yuefu, Yehua Wu, Qun Li, and Anle Yu. "Neuromelioidosis: a series of seven cases in Hainan province, China." Journal of International Medical Research 45, no. 2 (March 29, 2017): 856–67. http://dx.doi.org/10.1177/0300060516685967.
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Melioidosis, which is caused by Burkholderia pseudomallei, is predominately a disease of tropical climates and is especially widespread in south-east Asia and northern Australia. Melioidosis affecting the central nervous system has a low incidence but a high mortality. We present seven cases of neuromelioidosis and analyze the disease characteristics and imaging features. Typical clinical features of this disease included high fever and headache. Five patients had an irregular fever with a temperature ≥ 39℃. Peripheral blood leukocytes and the neutrophil ratio were raised in all patients. On computed tomography and magnetic resonance imaging the disease mainly manifested as intracerebral single or multiple nodules, as well as ring and flake-like enhancements with rapid lesion progression. This study demonstrated the importance of imaging examination in the clinical evaluation and diagnosis of neuromelioidosis.
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Wressnigg, Nina, Maikel V. W. van der Velden, Daniel Portsmouth, Wolfgang Draxler, Maria O'Rourke, Peter Richmond, Stephen Hall, et al. "An Inactivated Ross River Virus Vaccine Is Well Tolerated and Immunogenic in an Adult Population in a Randomized Phase 3 Trial." Clinical and Vaccine Immunology 22, no. 3 (December 24, 2014): 267–73. http://dx.doi.org/10.1128/cvi.00546-14.
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ABSTRACTRoss River virus (RRV) is endemic in Australia and several South Pacific Islands. More than 90,000 cases of RRV disease, which is characterized by debilitating polyarthritis, were reported in Australia in the last 20 years. There is no vaccine available to prevent RRV disease. A phase 3 study was undertaken at 17 sites in Australia to investigate the safety and immunogenicity of an inactivated whole-virus Vero cell culture-derived RRV vaccine in 1,755 healthy younger adults aged 16 to 59 years and 209 healthy older adults aged ≥60 years. Participants received a 2.5-μg dose of Al(OH)3-adjuvanted RRV vaccine, with a second and third dose after 3 weeks and 6 months, respectively. Vaccine-induced RRV-specific neutralizing and total IgG antibody titers were measured after each immunization. Vaccine safety was monitored over the entire study period. The vaccine was safe and well-tolerated after each vaccination. No cases of arthritis resembling RRV disease were reported. The most frequently reported systemic reactions were headache, fatigue, and malaise; the most frequently reported injection site reactions were tenderness and pain. After the third immunization, 91.5% of the younger age group and 76.0% of the older age group achieved neutralizing antibody titers of ≥1:10; 89.1% of the younger age group and 70.9% of the older age group achieved enzyme-linked immunosorbent assay (ELISA) titers of ≥11 PanBio units. A whole-virus Vero cell culture-derived RRV vaccine is well tolerated in an adult population and induces antibody titers associated with protection from RRV disease in the majority of individuals. (This study is registered atwww.clinicaltrials.govunder registration no. NCT01242670.)
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HALL, G., L. McDONALD, S. E. MAJOWICZ, E. SCALLAN, M. KIRK, P. SOCKETT, and F. J. ANGULO. "Respiratory symptoms and the case definition of gastroenteritis: an international analysis of the potential impact on burden estimates." Epidemiology and Infection 138, no. 1 (June 4, 2009): 117–24. http://dx.doi.org/10.1017/s0950268809990112.
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SUMMARYEstimates of the burden of foodborne disease rely on attributing a proportion of syndromic gastroenteritis to foodborne transmission. Persons with syndromic diarrhoea/vomiting can also present with concurrent respiratory symptoms that could be due to respiratory infections, gastrointestinal infections, or both. This distinction is important when estimating the foodborne disease burden but has rarely been considered. Using data from population surveys from Australia, Canada and the USA we describe the effect of excluding persons with respiratory and associated symptoms from the case definition of gastroenteritis. Excluding persons first with respiratory symptoms, or second with respiratory symptoms plus fever and headache, resulted in a decrease in the weighted estimates of acute gastroenteritis of about 10–50% depending on the exclusion criteria. This has the potential to have a very significant impact on estimates of the burden of foodborne infections using syndromic case definitions of acute gastroenteritis.
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Subramaniam, Swadhini, and Dhanalakshmi Jaganathan. "A Comprehensive review on Dichrostachys cinerea." Journal of University of Shanghai for Science and Technology 23, no. 09 (September 29, 2021): 1298–312. http://dx.doi.org/10.51201/jusst/21/09686.
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For a very long time, the medical plants have been used worldwide to treat human diseases and it serves as a safe source of drugs to cure several diseases and conditions through complementary medicine system. It is a native plant of Indian subcontinent, Africa and North Australia and is known to have significant pharmacological activities. The wide range of pharmacological activities of D.cinerea are due to the presence of different groups of active biological compounds present in it. Traditionally, D.cinerea has been used for the treatment the treatment of many diseases such as headache, toothache, dysentery, leprosy, coughs, syphilis and also as diuretic, anthelmintic, purgative and laxative. Research on the pharmacological, biological isolation of metabolites and biologically active compounds of this plant have already been done worldwide. However, the study to evaluate the complete therapeutic values of this plant still needed to conduct. This paper briefly reviews the various pharmacological properties of D.cinerea that could be useful for further experimental and clinical investigations.
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Babl, Franz E., Vanessa C. Rausa, Meredith L. Borland, Amit Kochar, Mark D. Lyttle, Natalie Phillips, Yuri Gilhotra, et al. "Characteristics of concussion based on patient age and sex: a multicenter prospective observational study." Journal of Neurosurgery: Pediatrics 28, no. 6 (December 2021): 647–56. http://dx.doi.org/10.3171/2021.6.peds20953.
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OBJECTIVE Children with concussion frequently present to emergency departments (EDs). There is limited understanding of the differences in signs, symptoms, and epidemiology of concussion based on patient age. Here, the authors set out to assess the association between age and acute concussion presentations. METHODS The authors conducted a multicenter prospective observational study of head injuries at 10 EDs in Australia and New Zealand. They identified children aged 5 to < 18 years, presenting with a Glasgow Coma Scale score of 13–15, presenting < 24 hours postinjury, with no abnormalities on CT if performed, and one or more signs or symptoms of concussion. They extracted demographic, injury-related, and signs and symptoms information and stratified it by age group (5–8, 9–12, 13 to < 18 years). RESULTS Of 8857 children aged 5 to < 18 years, 4709 patients met the defined concussion criteria (5–8 years, n = 1546; 9–12 years, n = 1617; 13 to < 18 years, n = 1546). The mean age of the cohort was 10.9 years, and approximately 70% of the patients were male. Sport-related concussion accounted for 43.7% of concussions overall, increasing from 19.1% to 48.9% to 63.0% in the 5–8, 9–12, and 13 to < 18 years age groups. The most common acute symptoms postinjury were headache (64.6%), disorientation (36.2%), amnesia (30.0%), and vomiting (27.2%). Vomiting decreased with increasing age and was observed in 41.7% of the 5–8 years group, 24.7% of the 9–12 years group, and 15.4% of the 13 to < 18 years group, whereas reported loss of consciousness (LOC) increased with increasing age, occurring in 9.6% in the 5–8 years group, 21.0% in the 9–12 years group, 36.7% in the 13 to < 18 years group, and 22.4% in the entire study cohort. Headache, amnesia, and disorientation followed the latter trajectory. Symptom profiles were broadly similar between males and females. CONCLUSIONS Concussions presenting to EDs were more sports-related as age increased. Signs and symptoms differed markedly across age groups, with vomiting decreasing and headache, LOC, amnesia, and disorientation increasing with increasing age.
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Wijeratne, Tissa, Win Sen Kuan, Anne Maree Kelly, Kevin H. Chu, Frances B. Kinnear, Gerben Keijzers, Richard Body, et al. "Migraine in the Emergency Department: A Prospective Multinational Study of Patient Characteristics, Management, and Outcomes." Neuroepidemiology 56, no. 1 (2022): 32–40. http://dx.doi.org/10.1159/000520548.
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Background and Aim: Migraine headache is commonly diagnosed in emergency departments (ED). There is relatively little real-world information about the epidemiology, investigation, management, adherence to therapeutic guidelines and disposition of patients treated in ED with a final diagnosis of migraine. The primary aim of the current study is to get a snapshot of assessment and management patterns of acute migraine presentations to the different settings of EDs with a view to raise awareness. Methods: This is a planned sub-study of a prospective study conducted in 67 health services in 10 countries including Australia, New Zealand, Southeast Asia, Europe, and the UK investigating the epidemiology and outcome of adult patients presenting to ED with nontraumatic headache. Outcomes of interest for this study are demographics, clinical features (including severity), patterns of investigation, treatment, disposition, and outcome of patients diagnosed as having migraine as their final ED diagnosis. Results: The cohort comprises 1,101 patients with a mean age of 39 years (SD ± 13.5; 73.7% [811]) were female. Most patients had had migraine diagnosed previously (77.7%). Neuroimaging was performed in 25.9% with a very low diagnostic yield or significant findings (0.07%). Treatment of mild migraine was in accordance with current guidelines, but few patients with moderate or severe symptoms received recommended treatment. Paracetamol (46.3%) and nonsteroidal anti-inflammatory drugs (42.7%) were the most commonly prescribed agents. Metoclopramide (22.8%), ondansetron (19.2%), chlorpromazine (12.8%), and prochlorperazine (12.8%) were also used. Conclusions: This study suggests that therapeutic practices are not congruent with current guidelines, especially for patients with severe symptoms. Efforts to improve and sustain compliance with existing management best practices are required.
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Krishnadas, Natasha, and Bruce Taylor. "080 The incidence, diagnosis and outcomes of idiopathic intracranial hypertension in the southern tasmanian catchment." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A25.3—A26. http://dx.doi.org/10.1136/jnnp-2019-anzan.68.
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IntroductionThis study aimed to identify the incidence of idiopathic intracranial hypertension (IIH) in Southern Tasmania, Australia. Secondary aims were to elucidate demographics, current approaches to investigation, treatment and outcomes. To our knowledge, similar regional studies have not been performed.MethodsThe study was approved by the University of Tasmania Human Ethics Committee. Patients presented between June 2016-June 2018 to Royal Hobart Hospital, the single tertiary Neurology service in Tasmania. Cases were identified by screening lumbar punctures (LP) performed by Neurology services (inpatient, outpatient, Radiologically-assisted) and by surveying all regional Neurologists. Medical records were used to corroborate LP results and determine whether patients met Modified Dandy Criteria (MDC) (used to define IIH in current literature). Regional population statistics were obtained from the Australian Bureau of Statistics (ABS). Duplicate records were excluded. Exclusion criteria included age <18 at data collection, LP opening pressure <20cm of water or secondary causes for IIH.Results45 cases identified; 30 within the Greater Hobart region, population of 229,088 (June 2016-June 2017). Cumulative incidence was 6.55/100,000 (incidence rate 0.06/1000) with classification based on Neurologist diagnosis and 5.46/100,000 (0.05/1000) with classification according to MDC. 100% of the cohort were female. Mean age was 26.7 (range 17–45) and mean weight was 105.3kg (range 78–170). Headache was the most commonly reported symptom. 8.9% (4/45) of the total cohort were medically refractory (requiring VP/LP shunting). Ophthalmology services initiated 51% (23/45) of the referrals.ConclusionsOur incidence rates are higher than rates in previous studies for population subsets of young women.
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Chowdhury, Nargis Sultana, Farhana Farjana, Sifat Jamaly, Mst Nadira Begum, and Mst Elina Akhter Zenat. "Pharmacological Values and Phytochemical Properties of Devil’s Cotton (Ulatkambal) - A Review." Bangladesh Pharmaceutical Journal 22, no. 1 (January 31, 2019): 109–16. http://dx.doi.org/10.3329/bpj.v22i1.40082.
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Devil’s cotton (Ulatkambal) is a genus in the family Malvaceae, with one or two species from Asia and Australia. Literature review revealed that Abroma augusta (Devil’s cotton) is widely used in Ayurvedic medicine as a popular drug. Devil’s cotton has been claimed to possess major biological activities like anti-diabetic, analgesic, anti-inflamatory, thrombolytic, antioxidant, hypolipidemic etc. They are also utilized by the traditional local healers of different Asian countries to treat various diseases like diabetes mellitus, as uterine tonic in emmerogogue, dysmenorrhea, amenorrhoea, sterility and other menstrual disorders, rheumatic pains of joints and headache with sinusitis. Biochemical profiling of different parts of the plant demonstrated the presence of some important phytochemicals like alkaloids, abromin, sterol, friedelin, abromasterol, taroxerylacetate, taraxeral and β-sitosterol. The aim of this review was to analyze the published report based on the medicinal values of Devil’s cotton species as well to provide the updated information about the ethnomedicinal, pharmacological as well as the phytochemical properties.
Bangladesh Pharmaceutical Journal 22(1): 109-116, 2019
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Grimmer, K., L. Nyland, and S. Milanese. "Repeated Measures of Recent Headache, Neck and Upper Back Pain in Australian Adolescents." Cephalalgia 26, no. 7 (July 2006): 843–51. http://dx.doi.org/10.1111/j.1468-2982.2006.01120.x.
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The epidemiological and clinical literature identifies strong associations between adult headache, cervical and thoracic spine dysfunction and spinal posture. This paper reports on the prevalence and incidence of headache, neck and upper back pain which occurred in the previous week, in urban Australians aged 13–17 years. Commencing in 1999, we followed a cohort of South Australian students through 5 years of secondary schooling. Of our commencing cohort of students, 132 (30±) provided data on bodily pain every year. For both girls and boys, there was a significantly decreasing prevalence of headache over the study period, while neck pain and upper back pain increased. There was a significantly increasing trend over time for boys with upper back pain. Twenty percent of girls and boys consistently reported headache, neck pain or upper back pain over 5 years. The progression of early adolescent headaches to mid-adolescent neck and upper back pain potentially reflects the adolescents’ biomechanical responses to intrinsic and extrinsic imposts. This requires further investigation to understand the causes of adolescent headache, neck and upper thoracic pain.
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Rahman, Shahanur, Nandita Sarkar, Abdul Kader Sheikh, and Sultana Ferdousi. "Effect of slow breathing exercise on heart rate variability in tension-type headache female patients: A time domain analysis." Journal of Bangladesh Society of Physiologist 17, no. 1 (December 27, 2022): 56–63. http://dx.doi.org/10.3329/jbsp.v17i1.63217.
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Background: Tension-type headache (TTH), the most frequently occurring primary headache is associated with autonomic dysfunction. Time domain analysis of heart rate variability (HRV) is a popular tool to detect changes in cardiac autonomic nerve function (CANF) in TTH patients. Slow breathing exercise (SBE) can significantly improve HRV in patients with cardiovascular disorders. Objective: To observe the effect of SBE on HRV by time domain analysis in TTH female patients. Methods: This quasi-experimental study was conducted from March 2021 to February 2022 in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka on 60 female TTH patients aged 20-45 years. Thirty patients performed SBE every morning and evening for 30 minutes in addition to receiving conventional treatment and 30 patients continued only conventional treatment without any exercise for 90 days. Thirty age, sex and BMI matched apparently healthy control were enrolled who did not perform SBE or any other exercise. All subjects were assessed at baseline and also after 90 days. Time domain HRV parameters were recorded by Power Lab 8/35 AD Instruments, Australia. One way ANOVA followed by post-hoc test and Paired sample t-test were performed for statistical analysis and p<0.05 was considered as statistical significance. Results: Mean heart rate (HR) was significantly higher (p<0.001) and SDRR (Standard deviation of all RR interval); CVRR (Coefficient variation of RR interval); SDSD (Standard deviation of successive RR interval differences between adjacent RR intervals); RMSSD (Square root of mean of squared differences of successive RR interval) and pRR50% (Proportion of RR interval with duration > 50ms) were significantly lower (p<0.001) in TTH female patients compared to control at baseline. Significant decrement of mean HR (p<0.001) and increment of all other time domain parameters (p<0.001) was observed after 90 days of SBE. Again, significantly decreased SDRR, CVRR, SDSD, RMSSD and pRR50% (p<0.001, p<0.01) was observed in the patients who did not perform SBE. Conclusion: SBE may effectively improve cardiac autonomic dysfunction in TTH female patients. J Bangladesh Soc Physiol. 2022, June; 17(1): 56-63
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Gunasekera, Lakshini, Christina Sun-Edelstein, John Heywood, and Lauren Sanders. "018 Management of migraine in the australian emergency department." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 6 (May 24, 2018): A8.2—A9. http://dx.doi.org/10.1136/jnnp-2018-anzan.18.
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IntroductionAcute migraine commonly causes significant personal, economic and work-related disability. Australian guidelines recommend treating mild migraine with aspirin and metoclopramide, and moderate-severe migraine with prochlorperazine, chlorpromazine or sumatriptan. Stratified treatment based on severity is preferred to step-wise treatment. Australian data regarding Emergency Department (ED) migraine treatment are scarce. We evaluated prescribing patterns at a Melbourne hospital against national guidelines.MethodsRetrospective cohort study of migraine (G439 ICD-10-AM) between 2012–2016. Exclusion criteria included migraine without headache, other primary headaches and secondary headaches. Demographic and prescribing data were extracted from medical records. Proportions were calculated with 95% confidence intervals using Wilson’s method. Comparisons were made between groups using Mann-Whitney and Chi-square tests.ResultsOf 214,932 ED presentations, 744 with headache presentation received a G439 diagnosis. Most were female (75%; 558/744), young (mean age 34±13 years) and self-reported migraine history (75%; 558/744). There were 55 different medications prescribed. Paracetamol was more frequently prescribed (52%; 385/744) than aspirin (10.6%; 78/744). Opioid prescription occurred in 46% (345/744), single opioid 36% (267/744),>1 opioid 10% (78/744). Median time-to-discharge was 38 min longer with opioid prescription compared with no opioid (222; IQR 164–309 vs 184; 122–258; p<0.01). Just 6.85% (51/744) received triptans. Other treatments were prochlorperazine (14%; 97/744), metoclopramide (38%; 286/744) and chlorpromazine (44%; 3 25/744). Overall, 25.4% (189/744) received no guideline-recommended medication.ConclusionWe observed considerable polypharmacy in ED migraine management with inconsistent prescribing patterns. Recommended medications are infrequently used. Opioid use is common and associated with increased time-to-discharge. Failure of ED staff to follow guidelines is unexplained, and requires further investigation.
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Ifediora, Chris O. "Non-clinical factors associated with headache presentations in patients with psychological co-morbidities: a 7-year retrospective study." European Journal for Person Centered Healthcare 6, no. 4 (December 4, 2018): 649. http://dx.doi.org/10.5750/ejpch.v6i4.1567.
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Background: Multiple factors potentially influence doctors’ decisions regarding neuroimaging for headaches in general practice and psycho-morbidities are one of such. Unfortunately, other non-clinical factors at play among psychological patients with headaches are poorly known and the need to identify these factors has become important in view of recent findings on the impact of psychological issues in managing headaches in primary care. The findings from this study are expected to help improve efficiency and confidence in managing headaches in this subset of patients.Method: This is a 7-year retrospective study exploring headache presentations of patients aged ≥18 in an Australian general practice setting from 1 January 2010 to 1 April 2017.Results: A total of 517 patients were identified, with an average age of 45.5 +/- 16.2 years (range of 18 to 94 years). Psycho-morbidities were reported among 190 (36.8%) patients. The female to male ratio was 72% to 28%. Most cases of headaches were among those aged 40 to 59 years (199 or 38.5%), while the least presentations were among the 18 to 24-year-olds (47 or 9.1%). It was found that 40% fewer males had psycho-morbidities relative to females (OR 0.6; CI 0.39 to 0.91; p -0.02), while those aged between 40 and 59 years were more likely to have associated psycho-morbidities compared to other age groups (OR 1.68; CI 1.17 to 2.42; p -0.01).Conclusion: General Practitioners should properly evaluate the psychosocial issues of all patients presenting with headaches for which neuroimaging is being considered, particularly middle-aged females. This is important given the recent report that neuroimaging for headache presentations among patients with associated psycho-morbidities are ordered more disproportionately and yet were less likely to have findings that can explain the headaches. A larger national or international study may be needed to further explore the identified associations.
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Salter, Sandra, Gurkamal Singh, Lisa Nissen, Kevin Trentino, Kevin Murray, Kenneth Lee, Benjamin Kop, Ian Peters, and Alan Leeb. "Active vaccine safety surveillance of seasonal influenza vaccination via a scalable, integrated system in Western Australian pharmacies: a prospective cohort study." BMJ Open 11, no. 6 (June 2021): e048109. http://dx.doi.org/10.1136/bmjopen-2020-048109.
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ObjectivesWe integrated an established participant-centred active vaccine safety surveillance system with a cloud-based pharmacy immunisation-recording program in order to measure adverse events following immunisation (AEFI) reported via the new surveillance system in pharmacies, compared with AEFI reported via an existing surveillance system in non-pharmacy sites (general practice and other clinics).DesignA prospective cohort study.Participants and settingIndividuals >10 years receiving influenza immunisations from 22 pharmacies and 90 non-pharmacy (general practice and other clinic) sites between March and October 2020 in Western Australia. Active vaccine safety surveillance was conducted using short message service and smartphone technology, via an opt-out system.Outcome measuresMultivariable logistic regression was used to assess the primary outcome: differences in proportions of AEFI between participants immunised in pharmacies compared with non-pharmacy sites, adjusting for confounders of age, sex and influenza vaccine brand. A subgroup analysis of participants over 65 years was also performed.ResultsOf 101 440 participants (6992 from pharmacies; 94 448 from non-pharmacy sites), 77 498 (76.4%) responded; 96.1% (n=74 448) within 24 hours. Overall, 4.8% (n=247) pharmacy participants reported any AEFI, compared with 6% (n=4356) non-pharmacy participants (adjusted OR: 0.87; 95% CI: 0.76 to 0.99; p=0.039). Similar proportions of AEFIs were reported in pharmacy (5.8%; n=31) and non-pharmacy participants (6; n=1617) aged over 65 years (adjusted OR: 0.94; 95% CI: 0.65 to 1.35; p=0.725). The most common AEFIs in pharmacy were: pain (2%; n=104), tiredness (1.9%; n=95) and headache (1.7%; n=88); and in non-pharmacy sites: pain (2.3%; n=1660), tiredness (1.9%; n=1362) and swelling (1.5%; n=1121).ConclusionsHigh and rapid response rates demonstrate good participant engagement with active surveillance in both pharmacy and non-pharmacy participants. Significantly fewer AEFIs reported after pharmacist immunisations compared with non-pharmacy immunisations, with no difference in older adults, may suggest different cohorts attend pharmacy versus non-pharmacy immunisers. The integrated pharmacy system is rapidly scalable across Australia with global potential.
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Che Mohammad Nizam, Ahmad Rasdan Ismail, and Norlini Husshin. "A Review of Heat Stress Impact Towards Construction Workers Productivities and Health Based on Several Heat Stress Model." Journal of Advanced Research in Fluid Mechanics and Thermal Sciences 85, no. 1 (August 1, 2021): 161–68. http://dx.doi.org/10.37934/arfmts.85.1.161168.
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Global average temperature has increase 0.2°C in the past 10 years. Furthermore, several studies have predicted that the temperature will keep increasing due to lack of effort in restricting carbon emission. Therefore, the objective of this review is to examine the impact of heat stress towards construction workers productivities and health and also assess the risk of exposure. Literature review was done through scoping method on major journal database and Google Scholar. Major heat stress models are Heat Index, Wet bulb globe temperature and Thermal Work Limit. On the other hands, there are more complex heat stress model that incorporate complex data measurement, such as Predicted Heat Strain endorsed by ISO 7933:2004. Several studies have been conducted based on these heat stress model. Findings of these studies shown that hot and humid countries, such India, China, Hong Kong, Thailand, Japan, Iran, Saudi Arabia, Egypt, United Arab Emirates, and Australia WBGT level are at least 28°C, which is beyond safe level for medium and heavy construction work. Productivities were estimated to decline up to 2% for every 1°C increase in temperature above safe WBGT level. In extremely high temperature environment, productivities can decrease in the range of 48% - 94%. Heat stress negative side effect on health include minor heat related illness such as thirst, fatigue, headache, dehydration, vertigo, nausea and muscle pain.
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Marmion, B. P., R. A. Ormsbee, M. Kyrkou, J. Wright, D. A. Worswick, A. A. Izzo, A. Esterman, B. Feery, and R. A. Shapiro. "Vaccine prophylaxis of abattoir-associated Q fever: eight years' experience in Australian abattoirs." Epidemiology and Infection 104, no. 2 (April 1990): 275–87. http://dx.doi.org/10.1017/s0950268800059458.
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SUMMARYDuring the period 1981–8 a clinical trial of a Q fever vaccine (Q-vax; Commonwealth Serum Laboratories, Melbourne) has been conducted in abattoir workers and other at-risk groups in South Australia. Volunteers in four abattoirs and visitors to the abattoirs were given one subcutaneous dose of 30 μg of a formalin-inactivated, highly-purifiedCoxiella burnetiicells, Henzerling strain, Phase 1 antigenic state, in a volume of 0·5 ml.During the period, over 4000 subjects have been vaccinated and the programme continues in the abattoirs and related groups. ‘Common’ reactions to the vaccine comprised tenderness and erythema, rarely oedema at the inoculation site and sometimes transient headache. Two more serious ‘uncommon’ reactions, immune abscess at the inoculation site, were observed in two subjects, and two others developed small subcutaneous lumps which gradually dispersed without intervention.Protective efficacy of the vaccine appeared to be absolute and to last for 5 years at least. Eight Q fever cases were observed in vaccinees, but all were in persons vaccinated during the incubation period of a natural attack of Q fever before vaccine-induced immunity had had time (≥ 13 days after vaccination) to develop. On the other hand, 97 Q fever cases were detected in persons working in, or visiting the same abattoir environments.Assays for antibody and cellular immunity showed an 80–82% seroconversion after vaccination, mostly IgM antibody to Phase 2 antigen, in the 3 months after vaccination. This fell to about 60%, mostly IgG antibody to Phase 1 antigen, after 20 months. On the other hand, 85–95% of vaccinees developed markers of cell mediated immunity as judged by lymphoproliferative responses withC. burnetiiantigens; these rates remained elevated for at least 5 years.The Q fever vaccine, unlike other killed rickettsial vaccines, has the property of stimulating long-lasting T lymphocyte memory and this may account for its unusual protective efficacy as a killed vaccine.
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McWhirter, Laura, Nick Miller, Catriona Campbell, Ingrid Hoeritzauer, Andrew Lawton, Alan Carson, and Jon Stone. "Understanding foreign accent syndrome." Journal of Neurology, Neurosurgery & Psychiatry 90, no. 11 (March 2, 2019): 1265–69. http://dx.doi.org/10.1136/jnnp-2018-319842.
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ObjectiveForeign accent syndrome (FAS) is widely understood as an unusual consequence of structural neurological damage, but may sometimes represent a functional neurological disorder. This observational study aimed to assess the prevalence and utility of positive features of functional FAS in a large group of individuals reporting FAS.MethodsParticipants self-reporting FAS recruited from informal unmoderated online support forums and via professional networks completed an online survey. Speech samples were analysed in a subgroup.ResultsForty-nine respondents (24 UK, 23 North America, 2 Australia) reported FAS of mean duration 3 years (range 2 months to 18 years). Common triggers were: migraine/severe headache (15), stroke (12), surgery or injury to mouth or face (6) and seizure (5, including 3 non-epileptic). High levels of comorbidity included migraine (33), irritable bowel syndrome (17), functional neurological disorder (12) and chronic pain (12). Five reported structural lesions on imaging. Author consensus on aetiology divided into, ‘probably functional (n=35.71%), ‘possibly structural’ (n=4.8%) and ‘probably structural’ (n=10.20%), but positive features of functional FAS were present in all groups. Blinded analysis of speech recordings supplied by 13 respondents correctly categorised 11 (85%) on the basis of probable aetiology (functional vs structural) in agreement with case history assignment.ConclusionsThis largest case series to date details the experience of individuals with self-reported FAS. Although conclusions are limited by the recruitment methods, high levels of functional disorder comorbidity, symptom variability and additional linguistic and behavioural features suggest that chronic FAS may in some cases represent a functional neurological disorder, even when a structural lesion is present.
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Chang, Christina C., David E. Leslie, Denis Spelman, Kyra Chua, Christopher K. Fairley, Alan Street, Suzanne M. Crowe, and Jennifer F. Hoy. "Symptomatic and asymptomatic early neurosyphilis in HIV-infected men who have sex with men: a retrospective case series from 2000 to 2007." Sexual Health 8, no. 2 (2011): 207. http://dx.doi.org/10.1071/sh10060.
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Background The rise in serious complications of early syphilis, including neurosyphilis, particularly in those with HIV infection and in men who have sex with men (MSM), is of concern. Objectives: To review the manifestations and management of neurosyphilis in a population of HIV-infected MSM. Methods: Retrospective review of patients with HIV and early neurosyphilis in three centres in Melbourne, Australia, in 2000–07. Results: Eighteen male HIV patients met the criteria for diagnosis of early neurosyphilis. Thirteen patients (72.2%) had neurological symptoms: six with headache (33.3%), four with tinnitus (22.2%) and five with impaired vision (27.8%), and one patient each with ataxia, leg weakness and anal discharge with faecal incontinence. Five patients (27.8%) reported no neurological symptoms. All had serum rapid plasma reagin (RPR) titres ≥1 : 32 and all except one had cerebrospinal fluid positive for syphilis fluorescent treponemal antibodies-absorbed. After treatment with 14–15 days of 1.8 g intravenous benzylpenicillin 4-hourly, 12 of 17 patients (71%) demonstrated a four-fold drop in serum RPR titre over 6–12 months and were considered successfully treated. A rise in RPR was noted in three patients during the 12-month follow-up period, suggesting re-infection or recurrence. Conclusion: HIV-infected patients found to have syphilis either because of symptoms or by routine screening should be carefully assessed for neurological, ophthalmic and otological symptoms and signs. A low threshold for a diagnostic lumbar puncture to exclude the diagnosis of neurosyphilis enables appropriate administration and dose of penicillin for treatment, which appears successful in ~75% of cases.
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McCrory, P. "Prevalence of headache in Australian footballers." British Journal of Sports Medicine 39, no. 2 (February 1, 2005): e10-e10. http://dx.doi.org/10.1136/bjsm.2004.014860.
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Sibil, Allen S., Suresh S. Kumar, and Alex Aiswariya. "A Rare Case of Burkholderia Pseudomallie Presenting as Brain Abscess." European Journal of Medical and Health Sciences 3, no. 1 (January 11, 2021): 24–27. http://dx.doi.org/10.24018/ejmed.2021.3.1.620.
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Rationale: Meiliodosis is an extremely rare condition in Neurosurgery which is caused by the gram negative organism Burkholderia pseudomallie. Burkholderia pseudomallei (also known as Pseudomonas pseudomallei) is a Gram-negative, bipolar, aerobic, motile rod-shaped bacterium. It is a soil-dwelling bacterium endemic in tropical and subtropical regions worldwide, particularly in Thailand and northern Australia. It infects humans and animals and causes the disease melioidosis. It is also capable of infecting plants. If treatment is below par or delayed, this infection can produce diverse clinical symptoms and result in death.
Patient Concerns: A 52 year old female, known case of Type 2 Diabetes mellitus on insulin, presented with complaints of a swelling in the left parieto-occipital region since 2 months & headache since 1 month. She had a past history of a fall from scooter 7 months ago, which then was not radiologically imaged. Patient was, otherwise, conscious, oriented and had no focal neurological deficit.
Diagnosis: left parieto-occipital space occupying lesion confirmed by Ct brain and [mri + mrv] brain and culture and sensitivity of fluid aspirate showed moderate growth of burkholderia pseudomallie.
Interventions: Intravenous Ceftazidime [1 g/12 h] was administered in-hospital for 4 weeks (Intensive Phase) and Oral Cotrimoxazole (Trimethoprim + sulfomethoxazole) {TAB.BACTRIM DS} twice daily was administered out-hospital (Maintenance Phase).
Patient underwent Left parieto-occipital abscess drainage and debridement [Pus sent for Culture and Sensitivity] – Abscess drainage and removal of irregular thinned out bone around the skull defect + Biopsies sent from small extradural collection near the skull defect.Intravenous Ceftazidime was continued and discharged with Oral Cotrimoxazole (Trimethoprim + sulfomethoxazole).
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Jenkins, Bronwyn, Shuli Cheng, and Elspeth Hutton. "027 Will refractory patients respond to erenumab in the real world?" Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A10.1—A10. http://dx.doi.org/10.1136/jnnp-2019-anzan.26.
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IntroductionErenumab has been studied in Randomised Controlled Trials (RCT), with stricter exclusion criteria than real world populations.Methods65 patients from two Australian headache centres on Erenumab had primary outcomes of ≥ 50% response in monthly migraine days (MMD) and monthly headache days (MHD), compared to their demographics, frequency, duration of Chronic Migraine (CM), failed prophylactic medications, severity scores and medication overuse headache (MOH).Results35% (23/65) had daily headaches, with ≥ 50% MHD and MMD reduction in this subgroup of 17% (4/23) and 65% (13/20), respectively. Duration of CM was >10 years in 48% (29/61), with ≥ 50% MHD and MMD reduction in 28% (8/29) and 48% (13/27), respectively. 100% (64/64) had failed > 3 prophylactic medications with ≥50% MHD and MMD reduction in 30% (19/64) and 47% (27/58), respectively, with reducing rates of ≥ 50%MMD reduction if >5 (29%; 17/58) and >10 (22%;2/9). 95% had high severity scores (HIT-6 score >60), with a ≥ 50% MMD reduction in 43% (23/54). MOH occurred in 41% (24/58) for triptan and 29% (17/58) for codeine medications, with a ≥ 50% MMD reduction in 71% (17/24) and 41% (7/17), respectively (all groups p>0.05).ConclusionThis real world cohort treated with Erenumab included patients that would be excluded from RCT analysis- including more chronic, frequent, severe and refractory migraine. Despite this, there were still ≥50% responders in more severe subgroups, particularly daily headache, high severity scores and triptan MOH. Measuring MMD may be more sensitive for assessing improvement than MHD.
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Pardanani, Animesh, Geeta George, Terra Lasho, William J. Hogan, Mark R. Litzow, Kebede Begna, Curtis A. Hanson, et al. "A Phase I/II Study of CYT387, An Oral JAK-1/2 Inhibitor, In Myelofibrosis: Significant Response Rates In Anemia, Splenomegaly, and Constitutional Symptoms." Blood 116, no. 21 (November 19, 2010): 460. http://dx.doi.org/10.1182/blood.v116.21.460.460.
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Abstract Abstract 460 Background: CYT387 is a potent JAK-1/2 inhibitor that suppresses the in vitro growth of cells harboring JAK2V617F (Leukemia 2009;23:1441) and was effective in a murine model of myeloproliferative neoplasms (MPN) (Blood 2010;115:5232). Aims/Methods: To assess the safety, tolerability, and pharmacokinetic behavior of CYT387 in a Phase I dose-escalation study in patients with high- or intermediate-risk primary myelofibrosis (PMF) and post-PV or post-essential thrombocythemia (ET) myelofibrosis. The secondary objective was evaluation of preliminary efficacy. CYT387 was administered orally once daily in 28-day cycles. Once dose-limiting toxicity (DLT) was identified, a dose-confirmation cohort initiated treatment at the maximum tolerated dose (MTD) or lower. Result: Thirty six subjects (median age 64 years) have been enrolled (targeted accrual 120); 18 each in the dose escalation and dose confirmation phases. Twenty-three subjects had PMF, 8 post-PV MF, and 5 post-ET MF; 81% were JAK2V617F-positive. Median palpable spleen size was 18 cm and 20 subjects (56%) were red cell transfusion-dependent at study entry. Prior treatment included JAK inhibitors (9 and 1 subjects with INCB018424 and TG101348, respectively) and pomalidomide in 9 patients. The median treatment duration to date is 15 weeks (range 4–38). Dose-linear plasma exposures were observed up to 300 mg/day, with mean elimination T1/2 at steady state ranging from 3.9 to 5 hours across doses. Toxicity: All 36 subjects were evaluable for toxicity. At 400 mg/day, 2 of 6 subjects experienced DLT (1 each with asymptomatic grade 3 hyperlipasemia and grade 3 headache that were reversible upon holding drug); consequently, the MTD was declared at 300 mg/day. In the dose-confirmation phase, subjects were started at one of 2 dose levels that were deemed clinically effective: 150 mg/day (n=15) and 300 mg/day (n=3). Thirty-five subjects are currently on active therapy: 100 mg/day (n=2), 150 mg/day (n=20), 300 mg/day (n=10), and 400 mg/day (n=3). CYT387 was well tolerated. No grade 4 non-hematological toxicities were observed. Grade 3 non-hematologic adverse events were infrequent and included increased transaminases (n=2), increased alkaline phosphatase (n=2), headache/head pressure (n=2), increased lipase (n=1), and QTc prolongation (n=1). Thirteen (36%) subjects experienced “first-dose effect” characterized by grade 1 lightheadedness and hypotension; this phenomenon was self-limited and generally resolved within 3–4 hours with rare recurrence. Grade 3/4 thrombocytopenia was seen in 8 (22%) subjects, and treatment-emergent grade 3 anemia was seen in 1 subject only (3%). Treatment-emergent grade 3/4 neutropenia was not observed. Efficacy: Thirty two of 36 subjects who completed at least 1 cycle were eligible for response assessment: Anemia: Twenty two subjects were evaluable for anemia response (baseline Hgb <10 g/dL or red cell transfusion-dependent). Of these, 9 subjects (41%) achieved the threshold of response for “Clinical Improvement (CI)” per the International Working Group for MPN Research and Treatment (IWG-MRT) criteria, including 2 of 4 subjects who were previously treated with INCB018424. An additional 5 subjects experienced a >50% reduction in transfusion requirement, thus increasing the total anemia response rate to 63%. Splenomegaly: Thirty of 32 evaluable subjects had splenomegaly at baseline: median 20 cm; range 10–32 cm. Twenty nine subjects (97%) had some degree of spleen size reduction (median 9 cm; range 2–18 cm): 11 (37%) patients have achieved a minimum 50% decrease in palpable spleen size, thus qualifying them for a CI, including 3 of 8 subjects (38%) who were previously treated with INCB018424. Constitutional symptoms: The proportion of patients with the following symptoms at baseline, are: fatigue (97%), pruritus (22%), night sweats (38%), cough (13%), bone pain (28%), and fever (16%). At last follow up, improvement (complete resolution) in these symptoms was reported by 68% (16%), 86% (57%), 83% (75%), 75% (50%), 78% (44%), and 100% (100%), respectively. Conclusion: CYT387 is first-in-class of the JAK inhibitors with a significant response rate in anemia in myelofibrosis patients. The drug also shows substantial activity in reducing spleen size and controlling constitutional symptoms. CYT387 is well tolerated, and treatment responses have been seen both at (300 mg/day) and below (150 mg/day) the MTD. Disclosures: Pardanani: Cytopia Inc.: Research Funding. Off Label Use: Clinical trial data for CYT387 use in Myelofibrosis. Fida:YM Biosciences Australia: Employment, Equity Ownership. Burns:YM Biosciences Australia: Employment, Equity Ownership. Smith: YM Biosciences Australia: Employment, Equity Ownership.
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Lim, Hui Yin, Cheryl Ng, Carole L. Smith, Geoffrey Donnan, Harshal Nandurkar, and Prahlad Ho. "Ten Years of Cerebral Venous Thrombosis (CVT) in Melbourne, Australia: Male Gender and Presence of Myeloproliferative Neoplasm Is Associated with Thrombotic Recurrence in Unprovoked Events." Blood 126, no. 23 (December 3, 2015): 4468. http://dx.doi.org/10.1182/blood.v126.23.4468.4468.
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Abstract Aim Cerebral venous thrombosis (CVT) accounts for 0.5-1.0% of all strokes and is a common cause of stroke in young people. The presentations are often heterogeneous and can be associated with significant morbidity and mortality. This review aims to evaluate our local experience in CVT compared to other venous thromboembolism (VTE) with a focus on risk factors for thrombotic recurrence. Methods Retrospective evaluation of consecutive CVT presentations from January 2005 to June 2015, at two major tertiary hospitals in Melbourne, Australia. Data collected included demographics, risk factors, management, complications, modified Rankin score (mRS) and mortality. Results 52 patients (31 female, 21 male) with median age 9.5 (18-83) years, including 4 with cancer, presented with 53 episodes of CVT. Females were younger (32 vs 41 years, p=0.06). Typical presenting symptoms were headache (87%), nausea/vomiting (43%), visual disturbances (38%), focal neurological deficits (28%) and seizures (17%). All but one case was symptomatic, with 53% reporting symptoms in the preceding week. 18 (34%) failed to be diagnosed on initial presentation while 35% (13/37) of CT brain yielded false negative for thrombosis; all of which were subsequently diagnosed on magnetic resonance imaging (MRI) or CT angiography/venography. Commonly thrombosed sinuses included transverse/sigmoid (40%), superior sagittal (11%) or both (43%), with no location-dependent outcome differences. Nine (17%) had CVT-related haemorrhagic transformation and was associated with CVT-related death (2/9 vs 0/44; p=0.04). 28 episodes were provoked - twice more common in female (p=0.02) with 45% attributed to oral contraceptive pill(OCP). 44 patients (85%) had thrombophilia screen performed with 21% positivity. Median duration of anticoagulation was 6.5 months (8 remained on long-term); 78% treated with warfarin. Eight (15%) required intensive care support, while 2 patients required decompressive surgery. 12 (23%) were not followed up in our institutions. At last follow-up of the remaining 40, 2 (5%) had worsening mRS of ³ 2 compared to premorbid, 2 had CVT-related deaths and 2 succumbed to malignancy. 30% reported ongoing symptoms such as headaches, residual neurological deficits, seizures and memory impairment. There were three clot recurrences (1 CVT, 2 portal vein thrombosis) - all male with initial unprovoked events and were subsequently diagnosed with myeloproliferative neoplasm (MPN). Of the 3, one was positive for JAK2V617F mutation. Men with unprovoked CVT had a 20% risk of recurrence, significantly higher compared to women with unprovoked events (3/15 vs 0/10; p=0.02). Clot progression, defined as increased clot burden on repeat imaging, occurred in 2 patients - one was associated with MPN while another progressed in the setting of subtherapeutic anticoagulation post partum. There was one episode of Grade III bleeding (following a procedure) in addition to the 2 (4%) clot-related deaths discussed prior. Table 1.compares the characteristics of CVT and other VTE previously audited by us. Conclusions CVT is rare and may be missed on initial presentation (34%)_with a high degree of clinical suspicion required to improve detection rate. Given there was 35% of CT brain had false negative, MRI or CT angiography is the preferred modality of investigation. It is more common in young people, particularly females on OCP. The presence of haemorrhagic transformation was associated with higher mortality. All thrombotic recurrences in this audit occurred in men with unprovoked events, who were subsequently diagnosed with MPN. This suggests the need for further evaluation, particularly for MPN in males with unprovoked events. Table 1. Comparison between CVT and VTE patients CVT VTE RR; p-value No of patients 52 743 No of episodes 53 753 Incidence 5 cases/year 502 cases/year Median age (years) 39 63 RR 0.39, p<0.001 Male genderRecurrence in males 21 (40%)3 (14%) 367 (49%)33 (9%) p=0.24 Provoked events 28 (53%) 467 (62%) p=0.23 Past VTE history 3 (6%) 157 (21%) RR 0.27, p=0.02 Positive family history 6 (12%) 56 (8%) p=0.29 Thrombophilia screen done (%)Any positive screen 44 (85%)11 (21%) 304 (40%)69 (23%) RR 2.10, p<0.001 p=0.76 Median duration of anticoagulation 6.5m Below knee VTE 3mMajor VTE 6m RecurrenceProvoked 3 (5%)0 (0%) 55 (7%)27 (6%) p=0.79p=0.39 Grade III/IV bleeding 3 (6%) 42 (6%) p=0.98 Non-cancer mortality 2 (4%) 109 (15%) RR 0.28, p=0.07 Disclosures No relevant conflicts of interest to declare.
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Richards, Karen V., Darren J. Beales, Anne J. Smith, Peter B. O'Sullivan, and Leon M. Straker. "Neck Posture Clusters and Their Association With Biopsychosocial Factors and Neck Pain in Australian Adolescents." Physical Therapy 96, no. 10 (October 1, 2016): 1576–87. http://dx.doi.org/10.2522/ptj.20150660.
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Abstract Background There is conflicting evidence on the association between sagittal neck posture and neck pain. Objective The purposes of this study were: (1) to determine the existence of clusters of neck posture in a cohort of 17-year-olds and (2) to establish whether identified subgroups were associated with biopsychosocial factors and neck pain. Design This was a cross-sectional study. Methods The adolescents (N=1,108) underwent 2-dimensional photographic postural assessment in a sitting position. One distance and 4 angular measurements of the head, neck, and thorax were calculated from photo-reflective markers placed on bony landmarks. Subgroups of sagittal sitting neck posture were determined by cluster analysis. Height and weight were measured, and lifestyle and psychological factors, neck pain, and headache were assessed by questionnaire. The associations among posture subgroups, neck pain, and other factors were evaluated using logistic regression. Results Four distinct clusters of sitting neck posture were identified: upright, intermediate, slumped thorax/forward head, and erect thorax/forward head. Significant associations between cluster and sex, weight, and height were found. Participants classified as having slumped thorax/forward head posture were at higher odds of mild, moderate, or severe depression. Participants classified as having upright posture exercised more frequently. There was no significant difference in the odds of neck pain or headache across the clusters. Limitations The results are specific to 17-year-olds and may not be applicable to adults. Conclusion Meaningful sagittal sitting neck posture clusters were identified in 17-year-olds who demonstrated some differences with biopsychosocial profiling. The finding of no association between cluster membership and neck pain and headaches challenges widely held beliefs about the role of posture in adolescent neck pain.
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Barkhoudarian, Garni, Michael Badruddoja, Nicholas Blondin, Ricky Chen, Sajeel Chowdhary, Charles Cobbs, Anthony Dowling, et al. "ACTR-68. FEASIBILITY STUDY OF THE EMULATE THERAPEUTICS™ VOYAGER SYSTEM IN PATIENTS WITH RECURRENT GLIOBLASTOMA (GBM)." Neuro-Oncology 21, Supplement_6 (November 2019): vi29. http://dx.doi.org/10.1093/neuonc/noz175.109.
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Abstract BACKGROUND The EMulate Therapeutics Voyager system is an investigational non-sterile, non-invasive, non-thermal, non-ionizing, portable, home-use medical device that uses a specific, localized ultra-low radio frequency energy (ulRFE®) cognate for the treatment of brain cancer. METHODS This ongoing, open-label, multi-center study (NAT-101) is being conducted in the US and Australia in patients with recurrent GBM. There are 3 treatment groups: 32 patients treated with Voyager alone, 43 patients treated with Voyager + Investigator’s choice of anti-cancer therapy, and 21 patients treated with Voyager+lomustine+/-bevacizumab. The objective of the study is to assess if the Voyager is a safe and feasible treatment for recurrent GBM. The primary outcome measure is safety, assessed by the incidence and evaluation of adverse events (AEs) associated with the Voyager. The secondary outcome measures are progression-free survival and overall survival. RESULTS Enrollment is closed, and long-term treatment and follow-up is ongoing. 96 patients were enrolled and treated. 82 patients reported at least one AE, and 18 AEs were assessed as device-related (mild-moderate; 12 headache, 2 vomiting, 1 nausea, 1 confusion, 1 insomnia, and 1 skin irritation). 31 patients reported at least one serious AE, and none were assessed as device-related. 33% of patients treated with Voyager alone and 36% of patients treated with Voyager + chemotherapy were progression-free after 6 months. 58% of patients treated with Voyager alone and 60% of patients treated with Voyager + chemotherapy remained alive after 6 months; median overall survival is 7 months (95% CI=4.4±14.3) in patients treated with Voyager alone and 10 months (95% CI=6.7±11.5) in patients treated with Voyager + chemotherapy. CONCLUSIONS The Voyager system appears to be safe and feasible for the treatment of recurrent GBM. Given that therapy is delivered non-invasively and no device-related serious adverse events were reported, further prospective study of the investigational device is planned.
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Marks, Clive A. "Fumigation of rabbit warrens with chloropicrin produces poor welfare outcomes - a review." Wildlife Research 36, no. 4 (2009): 342. http://dx.doi.org/10.1071/wr06128.
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Chloropicrin (CLPN) is used in Australia and New Zealand as a warren fumigant for the control of exotic European rabbits (Oryctolagus cuniculus) but is no longer registered for this purpose in the United States or the European Union. This review summarises the mammalian toxicology and clinical records from 56 accounts where signs, symptoms and pathology have been related to a range of CLPN concentrations. The approach follows a general principle where an assessment of the humaneness of vertebrate pest control techniques should be firstly based upon a thorough synopsis of published behavioural, physiological and pathological impacts. Chloropicrin produces intense irritation by stimulation of trigeminal nerves and brief exposures to concentrations of ≤1 ppm can severely irritate the eyes and cause lacrimation in mammals. Beyond 8 ppm, exposures are reported to be painful and incapacitating in humans. Mammals experience an array of common signs and symptoms including: headache, nausea, diarrhoea, laboured breathing, decrease in spontaneous motor activity, salivation, rhinorrhea, blood stains around the nose and mouth, painful irritation of mucous membranes, profuse lacrimation, audible obstruction of respiration and distress vocalisation. Acute pathological changes from CLPN exposure can cause death in mammals from pulmonary oedema, bronchopneumonia, emphysema or general destructive changes and necrosis of the small and medium bronchi. Overall, the signs, symptoms and pathology arising from CLPN exposure at any airborne concentration beyond 0.3 ppm indicate that it must be assumed to cause suffering in all mammals. Exposure to CLPN that is not acutely lethal may debilitate rabbits and other species and cause a protracted death over hours or days. To produce a humane death a fumigant must be non-irritating, have an initial depressive action on the central nervous system and/or produce a rapid death without protracted distress while having little ability to cause debilitation or chronic injury. Given that CLPN has none of these characteristics, it cannot be considered to be acceptably humane.
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FORD, FRED. "A splitting headache: relationships and generic boundaries among Australian murids." Biological Journal of the Linnean Society 89, no. 1 (August 29, 2006): 117–38. http://dx.doi.org/10.1111/j.1095-8312.2006.00663.x.
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Fernandez, Ephrem, and Jeanie Sheffield. "Descriptive Features and Causal Attributions of Headache in an Australian Community." Headache: The Journal of Head and Face Pain 36, no. 4 (April 1996): 246–50. http://dx.doi.org/10.1046/j.1526-4610.1996.3604246.x.
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Stephens, Dianne, Matt Brearley, and Lisa Vermeulen. "Heat Health Management in a Quarantine and Isolation Facility in the Tropics." Prehospital and Disaster Medicine 37, no. 2 (February 28, 2022): 259–64. http://dx.doi.org/10.1017/s1049023x22000255.
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AbstractIntroduction:The Howard Springs Quarantine Facility (HSQF) is located in tropical Northern Australia and has 875 blocks of four rooms (3,500 rooms in total) spread over 67 hectares. The HSQF requires a large outdoor workforce walking outdoor pathways to provide individual care in the ambient climate. The personal protective equipment (PPE) required for the safety of quarantine workers varies between workgroups and limits body heat dissipation that anecdotally contributes to excessive sweating, which combined with heat stress symptoms of fatigue, headache, and irritability, likely increases the risk of workplace injuries including infection control breaches.Study Objective:The purpose of this study was the description of qualitative and quantitative assessment for HSQF workers exposed to tropical environmental conditions and provision of evidenced-based strategies to mitigate the risk of heat stress in an outdoor quarantine and isolation workforce.Methods:The study comprised two components - a cross-sectional physiological monitoring study of 18 workers (eight males/ten females; means: 41.4 years; 1.69m; 80.6kg) during a single shift in November 2020 and a subjective heat health survey completed by participants on a minimum of four occasions across the wet season/summer period from November 2020 through February 2021. The physiological monitoring included continuous core temperature monitoring and assessment of fluid balance.Results:The mean apparent temperature across first-half and second-half of the shift was 34.7°C (SD = 0.8) and 35.6°C (SD = 1.9), respectively. Across the work shift (mean duration 10.1 hours), the mean core temperature of participants was 37.3°C (SD = 0.2) with a range of 37.0°C - 37.7°C. The mean maximal core temperature of participants was 37.7°C (SD = 0.3). In the survey, for the workforce in full PPE, 57% reported feeling moderately, severely, or unbearably hot compared to 49% of those in non-contact PPE, and the level of fatigue was reported as moderate to severe in just over 25% of the workforce in both groups.Conclusion:Heat stress is a significant risk in outdoor workers in the tropics and is amplified in the coronavirus disease 2019 (COVID-19) frontline workforce required to wear PPE in outdoor settings. A heat health program aimed at mitigating risk, including workplace education, limiting exposure times, encouraging hydration, buddy system, active cooling, and monitoring, is recommended to limit PPE breaches and other workplace injuries in this workforce.
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Nuttall, Linda, and Mary-Ellen Vigden. "Microfilming Exposed." Australian Medical Record Journal 17, no. 4 (December 1987): 11–13. http://dx.doi.org/10.1177/183335838701700406.
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In the June issue of the Australian Medical Record Journal an article describing the advantages of new microfilming equipment appeared. This article describes some of the organisational and management headaches associated with the introduction of this new technology, as experienced in one hospital.
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Makdissi, Michael, Alex Collie, Paul Maruff, Paul McCrory, Peter Brukner, and Kim Bennell. "DIFFERENTIATING CONCUSSION FROM POST-TRAUMATIC HEADACHES IN AUSTRALIAN FOOTBALLERS - A PILOT STUDY." Medicine & Science in Sports & Exercise 35, Supplement 1 (May 2003): S321. http://dx.doi.org/10.1097/00005768-200305001-01778.
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Sugunan, A. P., K. Natarajaseenivasan, P. Vijayachari, and S. C. Sehgal. "Percutaneous exposure resulting in laboratory-acquired leptospirosis – a case report." Journal of Medical Microbiology 53, no. 12 (December 1, 2004): 1259–62. http://dx.doi.org/10.1099/jmm.0.45735-0.
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A screw-capped glass tube containing a Leptospira culture accidentally broke and the laboratory worker who was handling the tube sustained a cut on his hand. The wound was flooded with the culture. The culture was that of strain MG 347 belonging to serovar Australis recovered from a patient, and it had undergone 52 passages in Ellinghausen McCullough Johnson Harris medium. The laboratory worker developed a headache 21 days after the accident and became febrile the next day. He was hospitalized for 5 days and was treated initially with doxycycline and later with ciprofloxacin. A blood sample collected on the second day of illness, after starting doxycycline therapy, yielded leptospires and the isolate, HZ 651, was identified as serovar Australis. Monoclonal antibody patterns and randomly amplified polymorphic DNA fingerprinting patterns of the isolate and strain MG 347 were identical, thus indicating that HZ 651 and MG 347 were clonal.
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Feldman, Robert H., and Ronald Laura. "The Use of Complementary and Alternative Medicine Practices Among Australian University Students." Complementary health practice review 9, no. 3 (October 2004): 173–79. http://dx.doi.org/10.1177/1533210104272356.
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A survey of 518 university students in Australia was conducted to gain a better understanding of complementary and alternative medicine (CAM) use. Results indicated that 81.1% of the students used at least 1 of 24 CAM practices. Top practices were relaxation, massage, herbs, art therapy, and prayer. The most common health reasons for using CAM were stress or psychosomatic issues (i.e., anxiety, allergies, stress, and headaches). Other reasons reflected a positive perspective: lifestyle, availability, and holistic health. Students who did not use CAM cited economic factors as the chief reason. Thus, these results offer further insights into the growing worldwide use of CAM.
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Champion, David, Minh Bui, Aneeka Bott, Theresa Donnelly, Shuxiang Goh, Cindy Chapman, Daniel Lemberg, Tiina Jaaniste, and John Hopper. "Familial and Genetic Influences on the Common Pediatric Primary Pain Disorders: A Twin Family Study." Children 8, no. 2 (January 28, 2021): 89. http://dx.doi.org/10.3390/children8020089.
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The primary pain disorders of childhood are highly prevalent but have infrequently been studied collectively. Genetic influences have been suggested to be causally implicated. Surveys were sent to 3909 Australian twin families, assessing the lifetime prevalence of growing pains, migraine, headache, recurrent abdominal pain, low back pain, and persistent pain (not otherwise specified) in pediatric twins and their immediate family members. Comparisons between monozygous (MZ) and dizygous (DZ) twin pair correlations, concordances and odds ratios were performed to assess the contribution of additive genetic influences. Random-effects logistic regression modelling was used to evaluate relationships between twin individuals and their co-twins, mothers, fathers and oldest siblings with the subject conditions. Twin analyses of responses from 1016 families revealed significant influence of additive genetic effects on the presence of growing pains, migraine, and recurrent abdominal pain. The analyses for headache, low back pain, and persistent pain overall did not conclusively demonstrate that genetic influences were implicated more than shared environmental factors. Regression analyses demonstrated varying levels of significance in relationships between family members and twin individuals for the tested conditions, with strongest support for genetic influences in growing pains and migraine. These data, together with previously published association analyses, suggest common causal influences including genes.