Artigos de revistas: "Children's Hospital at Westmead"

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Efron, Daryl. "THE CHILDREN'S HOSPITAL AT WESTMEAD HANDBOOK". Journal of Paediatrics and Child Health 47, n.º 1-2 (janeiro de 2011): 70. http://dx.doi.org/10.1111/j.1440-1754.2010.01963.x.

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Capon, Joanna. "Art at The Children's Hospital at Westmead". Journal of Paediatrics and Child Health 48, n.º 10 (outubro de 2012): 865–68. http://dx.doi.org/10.1111/j.1440-1754.2012.02573.x.

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Berman, Edwina L., Craig E. Donaldson, Michael Giblin e Frank J. Martin. "Outcomes in retinoblastoma, 1974?2005: The Children's Hospital, Westmead". Clinical & Experimental Ophthalmology 35, n.º 1 (janeiro de 2007): 5–12. http://dx.doi.org/10.1111/j.1442-9071.2006.01386.x.

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Zhou, Li, Namrata Nath, Oksana Markovich, Aysen Yuksel, Aedan Roberts e Daniel Catchpoole. "The Tumour Bank of The Children's Hospital at Westmead". Biopreservation and Biobanking 13, n.º 2 (abril de 2015): 147–48. http://dx.doi.org/10.1089/bio.2015.1324.

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Brewster, DR. "THE CHILDREN'S HOSPITAL AT WESTMEAD HANDBOOK: CLINICAL PRACTICE GUIDELINES FOR PAEDIATRICS". Journal of Paediatrics and Child Health 40, n.º 8 (agosto de 2004): 498–99. http://dx.doi.org/10.1111/j.1440-1754.2004.00445.x.

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John Phamnguyen, Thienan, Mark Dexter, Andrew Bleasel, Deepak Gill, Sachin Gupta, Manori Wijayath, Zebunnessa Rahman, Melissa Bartley e Chong Wong. "O-EG002. 8-Year experience of stereoelectroencephalography at Westmead Hospital and the Children’s Hospital at Westmead". Clinical Neurophysiology 132, n.º 8 (agosto de 2021): e66. http://dx.doi.org/10.1016/j.clinph.2021.02.123.

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Armitage, Kerry. "Trauma at the New Childrens Hospital Westmead NSW". Australian Emergency Nursing Journal 1, n.º 2 (abril de 1997): 21. http://dx.doi.org/10.1016/s1328-2743(97)80027-2.

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Khatami, Ameneh, Alex C. Outhred, Philip N. Britton, Emilie Huguon, David J. E. Lord, Melanie Wong, Amanda Charlton, Alison M. Kesson e David Isaacs. "Mediastinal mass in a healthy adolescent at The Children's Hospital at Westmead, Australia". Thorax 70, n.º 2 (10 de outubro de 2014): 194–97. http://dx.doi.org/10.1136/thoraxjnl-2014-205764.

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Pham, Alan Chuong Q., Christine Fan e Brian K. Owler. "Treating pediatric hydrocephalus in Australia: a 3-year hospital-based cost analysis and comparison with other studies". Journal of Neurosurgery: Pediatrics 11, n.º 4 (abril de 2013): 398–401. http://dx.doi.org/10.3171/2013.1.peds12233.

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Object The aim of this study was to quantify the financial costs of surgical intervention in patients with newly diagnosed hydrocephalus and patients with treatment failure or complications of previously treated hydrocephalus between 2007 and 2009 at the Children's Hospital at Westmead in Sydney, Australia. Methods This was a retrospective study of patients who underwent shunt insertion, shunt revision, treatment of an infected shunt, and endoscopic third ventriculostomy (ETV) between 2007 and 2009. Actual hospital costs associated with each inpatient stay were obtained from the accounting office of Children's Hospital at Westmead. Patients with hydrocephalus secondary to trauma, malignancy, or other complex conditions (except myelomeningocele) were excluded. Results Hydrocephalus-related procedures comprised approximately one-third of neurosurgical procedures performed each year. From 2007 to 2009, there were 192 admissions during which 300 procedures were performed for 162 patients. The total cost was $4.78 million (Australian) with an average cost of $1.59 million per year. The cost per admission for shunt insertion and ETV were similar ($13,905 vs $14,128, respectively). The average cost per admission for shunt revision was $9,753. However, shunt infection was associated with 40% of total costs, averaging $83,649 per admission. Management of patients with myelomeningocele undergoing insertion of shunt procedures in the same admission accounted for an average cost of $50,186. Conclusions Hydrocephalus is a chronic condition that imposes a significant and growing economic burden upon the Australian hospital system. Seventy-five percent of hydrocephalus-related hospital expenditure is used to surgically treat patients for complications or failure of previously treated hydrocephalus. Further research into the economic impact of pediatric hydrocephalus on the Australian health care system and concerted research efforts in the area of effective long-term surgical treatment and complication minimization are essential.

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Wood, Nicholas J. "The role of the Immunisation Adverse Events Clinic at The Children's Hospital at Westmead". New South Wales Public Health Bulletin 21, n.º 10 (2010): 234. http://dx.doi.org/10.1071/nb10041.

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Babalis, K., E. Harnett e K. Steinhoff. "Implementation of the process of ethical review of improvement activities at the Children's Hospital at Westmead". BMJ Quality & Safety 20, n.º 4 (12 de janeiro de 2011): 366–71. http://dx.doi.org/10.1136/bmjqs.2010.043869.

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Mohd Khialdin, Safinaz, Frank J. Martin, Michael Jones e Craig Donaldson. "Outcome of frontalis suspension surgery in pediatric ptosis". Asian Journal of Ophthalmology 16, n.º 4 (23 de novembro de 2019): 242–49. http://dx.doi.org/10.35119/asjoo.v16i4.392.

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Purpose: To describe the outcome of pediatric ptosis surgery using frontalis suspension technique. Design: Retrospective study. Methods: All patients with ptosis who underwent frontalis suspension from April 2009 to April 2014 at the Children’s Hospital at Westmead were included. Medical records of patients were reviewed and analyzed. Results: A total of 55 patients (74 primary procedures) were included in the study. Sixty-eight procedures (91.9%) used silicone as frontalis suspension material, three procedures used Gore-Tex, and three procedures used fascia lata. For procedures using silicone, the recurrence rate was 10.29%; 4.41% had infection and 1.47% had exposure keratopathy. All three procedures using Gore-Tex developed postoperative infection. No postoperative complication was documented in all the three procedures using fascia lata. Conclusion: A change in the practice from using banked fascia lata to silicone as frontalis suspension material is seen at the Children’s Hospital at Westmead. The postoperative complications and recurrence rate in procedures using silicone are relatively low. Autologous fascia lata could be considered as an alternative for older children in view of its long-term success rate and fewer complications.

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Kopel, Heidi, Kenneth Nunn e David Dossetor. "Evaluating satisfaction with a child and adolescent psychological telemedicine outreach service". Journal of Telemedicine and Telecare 7, n.º 2_suppl (dezembro de 2001): 35–40. http://dx.doi.org/10.1258/1357633011937074.

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A child and adolescent telepsychiatry service in rural New South Wales was evaluated. Part of the evaluation was to assess whether rural mental health workers and patients were satisfied with the videoconferencing services provided by child psychiatrists from the Children's Hospital at Westmead. During a 12-month study, information was collected using questionnaires on a total of 136 new patients who had been interviewed via videoconferencing. Satisfaction questionnaires were completed by 100 rural mental health workers, and 82 patients and their families/carers. Questionnaires about satisfaction with the technology were completed by 136 child psychiatrists, 101 rural mental health workers and 79 patients. Patients and their families/carers, as well as rural clinicians, expressed high overall satisfaction with the telepsychiatry service. The evaluation suggested that videoconferencing is a good method of providing child and adolescent psychiatry services to remote and rural communities.

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Wallis, Andrew, Colleen Alford, Aimee Hanson, Joanne Titterton, Sloane Madden e Michael Kohn. "Innovations in Maudsley family-based treatment for anorexia nervosa at the Children's Hospital at Westmead: a family admission programme". Journal of Family Therapy 35 (22 de agosto de 2012): 68–81. http://dx.doi.org/10.1111/j.1467-6427.2012.00604.x.

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Fisher, Rebecca, Peter John Shaw, Ida Twist e Melissa Ann Gabriel. "Body Composition of Five Year Survivors of Paediatric Haematopoietic Cell Transplantation (HCT) at the Children's Hospital at Westmead (CHW)". Biology of Blood and Marrow Transplantation 22, n.º 3 (março de 2016): S185—S186. http://dx.doi.org/10.1016/j.bbmt.2015.11.564.

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Spence, Kaye. "NIDCAP Training Centers Around the World: Australasian NIDCAP Training Centre- Sydney Australia". Developmental Observer 12, n.º 2 (20 de setembro de 2019): 16–17. http://dx.doi.org/10.14434/do.v12i2.27855.

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In October 2017 we achieved our goal of becoming a NIDCAP Training Centre, this was nearly 20 years after Dr. Heidelise Als had come to Australia in 1998 to begin training in the Grace Centre for Newborn Care at the Children’s Hospital at Westmead in Sydney Australia. Over this time we changed trainers to Dr. Joy Browne in 2000 and we saw many nurses, neonatologists and occupational therapists commence training. In 2008 we had our ﬁrst successful NIDCAP Professionals. In 2017 we had our ﬁrst NIDCAP Trainer – Nadine Griﬃths.

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McCormack, Rebecca A., Erik R. La Hei e Hugh C. O. Martin. "First‐aid management of minor burns in children: a prospective study of children presenting to the Children's Hospital at Westmead, Sydney". Medical Journal of Australia 178, n.º 1 (janeiro de 2003): 31–33. http://dx.doi.org/10.5694/j.1326-5377.2003.tb05038.x.

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Iskander, Mary, Alison Kesson, Dominic Dwyer, Laura Rost, Margaret Pym, Han Wang, Mary McCaskill e Robert Booy. "The burden of influenza in children under 5âyears admitted to the Children's Hospital at Westmead in the winter of 2006". Journal of Paediatrics and Child Health 45, n.º 12 (dezembro de 2009): 698–703. http://dx.doi.org/10.1111/j.1440-1754.2009.01597.x.

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Cu, Jonathan, Phuong Phan e Fenton M. O'Leary. "Knowledge and attitude towards paediatric cardiopulmonary resuscitation among the carers of patients attending the Emergency Department of the Children's Hospital at Westmead". Emergency Medicine Australasia 21, n.º 5 (outubro de 2009): 401–6. http://dx.doi.org/10.1111/j.1742-6723.2009.01217.x.

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Mary Starte, Julia, Amir Taher, Madeleine Powys, Craig Donaldson, Luciano Dalla-Pozza, Bhavna Padhye, Robyn Jamieson e Michael Murray Jones. "Management and Outcomes of Retinoblastoma Cases Presenting to Children’s Hospital Westmead, Sydney Between 2008 and 2018". International Journal of Ophthalmology & Visual Science 6, n.º 4 (2021): 273. http://dx.doi.org/10.11648/j.ijovs.20210604.24.

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Rhodes, Paul, e Sloane Madden. "Scientist-practitioner family therapists, postmodern medical practitioners and expert parents: second-order change in the Eating Disorders Program at The Children's Hospital at Westmead". Journal of Family Therapy 27, n.º 2 (maio de 2005): 171–82. http://dx.doi.org/10.1111/j.1467-6427.2005.00309.x.

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Sheikh, Mohamud, e C. Raina MacIntyre. "The impact of intensive health promotion to a targeted refugee population on utilisation of a new refugee paediatric clinic at the children's hospital at Westmead". Ethnicity & Health 14, n.º 4 (agosto de 2009): 393–405. http://dx.doi.org/10.1080/13557850802653780.

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O'Leary, Fenton, Andrew Hayen, Francis Lockie e Jennifer Peat. "Defining normal ranges and centiles for heart and respiratory rates in infants and children: a cross-sectional study of patients attending an Australian tertiary hospital paediatric emergency department". Archives of Disease in Childhood 100, n.º 8 (17 de março de 2015): 733–37. http://dx.doi.org/10.1136/archdischild-2014-307401.

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ObjectiveKey components in the assessment of a child in the emergency department (ED) are their heart and respiratory rates. In order to interpret these signs, practitioners must know what is normal for a particular age. The aim of this paper is to develop age-specific centiles for these parameters and to compare centiles with the previously published work of Fleming and Bonafide, and the Advanced Paediatric Life Support (APLS) reference ranges.DesignA retrospective cross-sectional study.SettingThe ED of the Children's Hospital at Westmead, Australia.PatientsAfebrile, Triage Category 5 (low priority) patients aged 0–15 years attending the ED.InterventionsCentiles were developed using quantile regression analysis, with cubic B-splines to model the centiles.Main outcome measuresCentile charts were compared with previous studies by concurrently plotting the estimates.Results668 616 records were retrieved for ED attendances from 1995 to 2011, and 111 696 heart and respiratory rates were extracted for inclusion in the analysis. Graphical comparison demonstrates that with heart rate, our 50th centile agrees with the results of Bonafide, is considerably higher than the Fleming centiles and fits well between the APLS reference ranges. With respiratory rate, our 50th centile was considerably lower than the comparison centiles in infants, becomes higher with increasing age and crosses the lower APLS range in infants and upper range in teenagers.ConclusionsClinicians should consider adopting these centiles when assessing acutely unwell children. APLS should review their normal values for respiratory rate in infants and teenagers.

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Anaissi, Ali, Madhu Goyal, Daniel R. Catchpoole, Ali Braytee e Paul J. Kennedy. "Case-Based Retrieval Framework for Gene Expression Data". Cancer Informatics 14 (janeiro de 2015): CIN.S22371. http://dx.doi.org/10.4137/cin.s22371.

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Background The process of retrieving similar cases in a case-based reasoning system is considered a big challenge for gene expression data sets. The huge number of gene expression values generated by microarray technology leads to complex data sets and similarity measures for high-dimensional data are problematic. Hence, gene expression similarity measurements require numerous machine-learning and data-mining techniques, such as feature selection and dimensionality reduction, to be incorporated into the retrieval process. Methods This article proposes a case-based retrieval framework that uses a k-nearest-neighbor classifier with a weighted-feature-based similarity to retrieve previously treated patients based on their gene expression profiles. Results The herein-proposed methodology is validated on several data sets: a childhood leukemia data set collected from The Children's Hospital at Westmead, as well as the Colon cancer, the National Cancer Institute (NCI), and the Prostate cancer data sets. Results obtained by the proposed framework in retrieving patients of the data sets who are similar to new patients are as follows: 96% accuracy on the childhood leukemia data set, 95% on the NCI data set, 93% on the Colon cancer data set, and 98% on the Prostate cancer data set. Conclusion The designed case-based retrieval framework is an appropriate choice for retrieving previous patients who are similar to a new patient, on the basis of their gene expression data, for better diagnosis and treatment of childhood leukemia. Moreover, this framework can be applied to other gene expression data sets using some or all of its steps.

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O'Leary, Fenton, Blessy John-Denny, Kathryn McGarvey, Alexandra Hann, Ioannis Pegiazoglou e Jennifer Peat. "Estimating the weight of ethnically diverse children attending an Australian emergency department: a prospective, blinded, comparison of age-based and length-based tools including Mercy, PAWPER and Broselow". Archives of Disease in Childhood 102, n.º 1 (31 de outubro de 2016): 46–52. http://dx.doi.org/10.1136/archdischild-2016-310917.

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ObjectiveTo prospectively compare the actual weights of Australian children in an ethnically diverse metropolitan setting with the predicted weights using the Paediatric Advanced Weight Prediction in the Emergency Room (PAWPER) tape, Broselow tape, Mercy system and calculated weights using the updated Advanced Paediatric Life Support (APLS), Luscombe and Owens and Best Guess formulae.MethodsA prospective, cross-sectional, observational, blinded, convenience study conducted at the Children's Hospital at Westmead Paediatric Emergency Department in Sydney, Australia. Comparisons were made using Bland-Altman plots, mean difference, limits of agreement and estimated weight within 10% and 20% of actual weight.Results199 patients were enrolled in the study with a mean actual weight of 27.2 kg (SD 17.2). Length-based tools, with or without body habitus adjustment, performed better than age-based formulae. When measuring estimated weight within 10% of actual weight, PAWPER performed best with 73%, followed by Mercy (69%), PAWPER with no adjustment (62%), Broselow (60%), Best Guess (47%), Luscombe and Owens (41%) and revised APLS (40%). Mean difference was similar across all methods ranging from 0.4 kg (0.0, 0.9) for Mercy to −2.2 kg (−3.5, −0.9) for revised APLS. Limits of agreement were narrower for the length-based tools (−5.9, 6.8 Mercy; −8.3, 5.6 Broselow; −9.0, 7.1 PAWPER adjusted; −12.1, 9.2 PAWPER unadjusted) than the age-based formulae (−18.6, 17.4 Best Guess; −19.4, 15.1 revised APLS, −21.8, 17.7 Luscombe and Owens).ConclusionIn an ethnically diverse population, length-based methods with or without body habitus modification are superior to age-based methods for predicting actual body weight. Body habitus modifications increase the accuracy and precision slightly.

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Manglick, Maria Patricia, Frank I. Ross, Mary-Clare Waugh, Andrew J. A. Holland, Daniel T. Cass e Soundappan S. V. Soundappan. "Neurocognitive outcomes in children following immersion: a long-term study". Archives of Disease in Childhood 103, n.º 8 (23 de março de 2018): 784–89. http://dx.doi.org/10.1136/archdischild-2017-314051.

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ObjectiveTo investigate long-term neurocognitive outcomes after a near-drowning incident in children who were deemed neurologically intact on discharge from hospital.DesignA prospective cohort study of near-drowning children.Setting95 drowning and near-drowning admissions, 0–16 years of age, from January 2009 to December 2013, to The Children’s Hospital at Westmead, Sydney, NSW, Australia.Participants23 children both met the criteria and had parental consent for the study.Main outcome measuresIdentification of the long-term deficits in behaviour, executive function, motor skills, communicative skills and well-being over a 5-year period. Assessment was undertaken at 3–6 months, 1 year, 3 years and 5 years after near-drowning at clinic visits. Physical developmental screening and executive function screening were done using Behavior Rating Inventory of Executive Function-Preschool version (BRIEF-P) and BRIEF.Result95 drowning and near-drowning episodes occurred during the study period. 10 (11%) children died, 28 were admitted to the paediatric intensive care unit and 64 directly to a ward. 3 children died in emergency department, 7 children had severe neurological deficit on discharge from the hospital. 23 were subsequently recruited into the study; 5 (22%) of these children had abnormalities in behaviour and/or executive function at some during their follow-up.ConclusionChildren admitted to hospital following a near-drowning event warrant long-term follow-up to identify any subtle sequelae which might be amenable to intervention to ensure optimal patient outcome.

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McKean, Elissa B., Nadine A. Kasparian, Shweta Batra, Gary F. Sholler, David S. Winlaw e Jacqueline Dalby-Payne. "Feeding difficulties in neonates following cardiac surgery: determinants of prolonged feeding-tube use". Cardiology in the Young 27, n.º 6 (23 de janeiro de 2017): 1203–11. http://dx.doi.org/10.1017/s1047951116002845.

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AbstractAimThe aims of this study were to examine the prevalence and potential correlates of feeding difficulties in infants who underwent cardiac surgery in the neonatal period and to investigate resource utilisation by infants with feeding difficulties.MethodsAll neonates who underwent their first cardiac surgery at the Heart Centre for Children, The Children’s Hospital at Westmead, between January and December, 2009 were included. Demographic, preoperative, intraoperative, and postoperative data were collected via electronic medical records. For the purpose of this study, feeding difficulty was defined as the requirement for ongoing tube feeding at the time of discharge home or transfer to another hospital.ResultsOut of a total of 79 neonates, 24 (30%) were discharged home or transferred to another hospital with a feeding tube. Feeding difficulties were associated with the presence of a genetic syndrome (p<0.0001), assisted feeding preoperatively (odds ratio (OR)=4.4, p=0.03), and having a palliative procedure before biventricular repair (OR=5.1, p=0.02). Infants with feeding difficulties had significantly more reviews by speech pathologists (M=5.9, SD=7.9), dieticians (M=5.9, SD=5.4), and cardiac clinical nurse consultants (M=1.2, SD=1.4) compared with those without feeding difficulties.ConclusionsThis study identified factors that can be used in the early recognition of infant feeding difficulties, to help guide the direction of limited health resources, as well as being focal points for future research and clinical practice improvement.

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Novakovic, Daniel, Alan T. L. Cheng, Daron H. Cope e Julia M. L. Brotherton. "Estimating the prevalence of and treatment patterns for juvenile onset recurrent respiratory papillomatosis in Australia pre-vaccination: a pilot study". Sexual Health 7, n.º 3 (2010): 253. http://dx.doi.org/10.1071/sh09142.

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Background: Recurrent respiratory papillomatosis (RRP) causes serious morbidity. RRP in Australia may be eliminated in the near future following the implementation of a national vaccination program using a human papillomavirus (HPV) vaccine that protects against infection with HPV types 6 and 11, those responsible for RRP. Baseline data on RRP prevalence and disease burden in Australia are lacking. Methods: Three study methods were used to estimate the burden of juvenile onset RRP in Australia. We conducted a retrospective chart review of RRP cases treated at The Children’s Hospital at Westmead over 10 years, examined the coding of these cases, and then calculated and applied the positive predictive value of the codes to national data to estimate the prevalence of RRP in Australia. We also conducted an online survey of otolaryngologists in Australia who manage RRP. Results: Nineteen patients were treated at the hospital over 10 years, involving 359 admissions. We estimate that between 33 and 56 RRP cases aged <20 are being treated nationally per year (0.6–1.1 per 100 000 persons), with children 5–9 years having a higher estimated rate of 1.2–1.8 per 100 000. Among 39 otolaryngologists treating juvenile onset RRP, the majority (73%) treated RRP in a paediatric tertiary hospital, and used the microdebrider for ablation of lesions. Conclusions: Our estimates of RRP disease burden agree with international estimates. As a small number of clinicians treat RRP nationally, we believe that establishment of a national RRP register is both feasible and necessary to monitor the impact of vaccination.

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Montgomery, Kay Vanessa, Janelle Lee Hewlett e Katherine Stephen. "Past, Present and Future - the Implementation of an Enhanced Education and Training Program for Blood and Marrow Transplant Nursing Staff to Ensure FACT Compliance at the Children's Hospital at Westmead". Biology of Blood and Marrow Transplantation 22, n.º 3 (março de 2016): S466. http://dx.doi.org/10.1016/j.bbmt.2015.11.1067.

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Porter, Melanie, Sindella Sugden-Lingard, Ruth Brunsdon e Suzanne Benson. "Autism Spectrum Disorder in Children with an Early History of Paediatric Acquired Brain Injury". Journal of Clinical Medicine 12, n.º 13 (28 de junho de 2023): 4361. http://dx.doi.org/10.3390/jcm12134361.

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Autism spectrum disorder (ASD) is a neurodevelopmental condition that arises from a combination of both genetic and environmental risk factors. There is a lack of research investigating whether early acquired brain injury (ABI) may be a risk factor for ASD. The current study comprehensively reviewed all hospital records at The Brain Injury Service, Kids Rehab at the Children’s Hospital at Westmead (Australia) from January 2000 to January 2020. Of the approximately 528 cases, 14 children with paediatric ABI were subsequently given an ASD diagnosis (2.7%). For this ASD sample, the mean age at the time of the ABI was 1.55 years, indicating a high prevalence of early ABI in this diagnostic group. The mean age of ASD diagnosis was, on average, 5 years later than the average ASD diagnosis in the general population. Furthermore, 100% of children had at least one medical comorbidity and 73% had three or more co-occurring DSM-5 diagnoses. Although based on a small data set, results highlight early paediatric ABI as a potential risk factor for ASD and the potential for a delayed ASD diagnosis following early ABI, with comorbidities possibly masking symptoms. This study was limited by its exploratory case series design and small sample size. Nonetheless, this study highlights the need for longitudinal investigation into the efficacy of early screening for ASD symptomatology in children who have sustained an early ABI to maximise potential intervention.

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BRITTON, P. N., R. C. DALE, E. ELLIOTT, M. FESTA, K. MACARTNEY, R. BOOY e C. A. JONES. "Pilot surveillance for childhood encephalitis in Australia using the Paediatric Active Enhanced Disease Surveillance (PAEDS) network". Epidemiology and Infection 144, n.º 10 (26 de fevereiro de 2016): 2117–27. http://dx.doi.org/10.1017/s0950268816000340.

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SUMMARYWe aimed to assess the performance of active surveillance for hospitalized childhood encephalitis in New South Wales (NSW) using the Paediatric Active Enhanced Disease Surveillance (PAEDS) network to inform methodology for the nationwide Australian childhood encephalitis (ACE) study. We piloted active surveillance for suspected encephalitis from May to December 2013 at the Children's Hospital at Westmead, Sydney, NSW. Cases were ascertained using four screening methods: weekday nurse screening of admission records (PAEDS), cerebrospinal fluid (CSF) microscopy records, magnetic resonance imaging (MRI) reports, and pharmacy dispensing records. Comprehensive clinical data were prospectively collected on consented participants and subsequently reviewed by an expert panel. Cases were categorized as confirmed encephalitis or ‘not encephalitis’; encephalitis cases were sub-categorized as infectious, immune-mediated or unknown. We performed an ICD-10 diagnostic code audit of hospitalizations for the pilot period. We compared case ascertainment in the four screening methods and with the ICD code audit. Forty-eight cases of suspected encephalitis were identified by one or more methods. PAEDS was the most efficient mechanism (yield 34%), followed by MRI, CSF, and pharmacy audits (yield 14%, 12%, and 7% respectively). Twenty-five cases met the criteria for confirmed encephalitis. PAEDS was the most sensitive of the mechanisms for confirmed encephalitis (92%) with a positive predictive value (PPV) of 72%. The ICD audit was moderately sensitive (64%) but poorly specific (Sp 9%, PPV 14%). Of the 25 confirmed encephalitis cases, 19 (76%) were sub-categorized as infectious, three (12%) were immune-mediated, and three (12%) were ‘unknown’. We identified encephalitis cases associated with two infectious disease outbreaks (enterovirus 71, parechovirus 3). PAEDS is an efficient, sensitive and accurate surveillance mechanism for detecting cases of childhood encephalitis including those associated with emerging infectious diseases. Active surveillance significantly increases the ascertainment of encephalitis cases compared with passive approaches.

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Shaw, Peter J. "Suspected infection in children with cancer". Journal of Antimicrobial Chemotherapy 49, suppl_1 (1 de janeiro de 2002): 63–67. http://dx.doi.org/10.1093/jac/49.suppl_1.63.

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Abstract A common complication of the intensive therapy that children with cancer receive is infection. The Oncology Unit of The Children's Hospital at Westmead maintains a comprehensive database of all admissions for suspected sepsis. From July 1994 to June 1999 broad-spectrum antibiotics were commenced in 2331 episodes. With early and aggressive use of empirical amphotericin B, 545 courses were given. Bacteraemia was documented in 701 episodes and invasive fungal disease in 73. Trends seen during the study included: (i) the proportion of febrile neutropenic patients receiving granulocyte colony stimulating factor increased from 40% to 60%; (ii) the mean neutrophil count at cessation of antibiotics fell from 0.97 to 0.63 × 109 cells/L for patients not receiving growth factors; (iii) the proportion of non-albicans Candida species infections increased. In addition, an outbreak of infection caused by Scedosporium sp. was documented; (iv) first-line empirical antibiotic combinations containing vancomycin fell from 20% to 7%; and (v) the ability to maintain or escalate anti-fungal therapy with reduced nephrotoxicity through use of lipid formulations of amphotericin was increasingly apparent in high-risk patients. During the study, infection was the primary cause of death in 11 non-bone marrow transplant (BMT) patients (five fungal, four viral, one bacterial infection and one sepsis syndrome) and five BMT patients (two bacterial and three viral). A prospective randomized study of toxicity due to amphotericin B given in either lipid emulsion or dextrose showed no significant difference, but both groups showed a lower incidence of amphotericin B intolerance in comparison with the adult series. The inability to reduce toxicity of amphotericin B by simple mixing with lipid emulsion has led to increasing use of commercially available lipid formulations of amphotericin B.

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Lystad, Reidar P., Andrew Fyffe, Rhonda Orr e Gary Browne. "Incidence, Trends, and Seasonality of Paediatric Injury-Related Emergency Department Presentations at a Large Level 1 Paediatric Trauma Centre in Australia". Trauma Care 2, n.º 3 (21 de julho de 2022): 408–17. http://dx.doi.org/10.3390/traumacare2030033.

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This retrospective cohort study aimed to examine the characteristics, incidence, temporal trends, and seasonality of paediatric injury-related Emergency Department (ED) presentations at a large metropolitan paediatric hospital. It included children aged ≤15 years who presented to the ED at The Children’s Hospital at Westmead, Sydney Australia, with a principal diagnosis of injury during the ten-year period from 1 January 2010 to 31 December 2019. Descriptive statistics were used to describe the characteristics of the cohort and the distribution of ED presentations by mode of arrival, triage category, discharge status, injury diagnosis. Negative binomial regression was used to examine percentage change in annual incidence. Seasonality was examined with Seasonal and Trend decomposition using Loess (STL). There were 134,484 (59.7% male children) paediatric injury-related ED presentations during the ten-year period, of which 23,224 (17.3%) were admitted to hospital. Head injury accounted for more than one-quarter (26.8%) of ED presentations. The average annual increase in incidence was more pronounced during the first five years (5.6% [95%CI 4.1% to 7.1%]) than in the last five years (0.8% [95%CI 0.2% to 1.5%]). The monthly incidence of ED presentations had a bimodal distribution with peaks during autumn (March–May) and spring (October–November) seasons. The mean number of ED presentations per day was higher on weekends (40.8 ± 0.3) than weekdays (35.3 ± 0.8). During 2010 to 2019, there was a significant increase in the annual incidence of injury-related ED presentations for children aged ≤15 years, with head injury accounting for more than one-quarter of the ED presentations. The incidence of paediatric injury-related ED presentations was higher during autumn and spring seasons and at weekends. These data will inform health resource planning and priority-setting and advocacy for child injury prevention strategies in Australia.

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Mukerji, Amit, Emily Rempel, Lehana Thabane, Heather Johnson, Georg Schmolzer, Brenda Hiu Yan Law, Pranav Jani et al. "High continuous positive airway pressures versus non-invasive positive pressure ventilation in preterm neonates: protocol for a multicentre pilot randomised controlled trial". BMJ Open 13, n.º 2 (fevereiro de 2023): e069024. http://dx.doi.org/10.1136/bmjopen-2022-069024.

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IntroductionLow pressure nasal continuous positive airway pressure (nCPAP) has long been the mainstay of non-invasive respiratory support for preterm neonates, at a constant distending pressure of 5–8 cmH2O. When traditional nCPAP pressures are insufficient, other modes including nasal intermittent positive pressure ventilation (NIPPV) are used. In recent years, high nCPAP pressures (≥9 cmH2O) have also emerged as an alternative. However, the comparative benefits and risks of these modalities remain unknown.Methods and analysisIn this multicentre pilot randomised controlled trial, infants <29 weeks’ gestational age (GA) who either: (A) fail treatment with traditional nCPAP or (B) being extubated from invasive mechanical ventilation with mean airway pressure ≥10 cmH2O, will be randomised to receive either high nCPAP (positive end-expiratory pressure 9–15 cmH2O) or NIPPV (target mean Paw 9–15 cmH2O). Primary outcome is feasibility of the conduct of a larger, definitive trial as assessed by rates of recruitment and protocol violations. The main secondary outcome is failure of assigned treatment within 7 days postrandomisation. Multiple other clinical outcomes including bronchopulmonary dysplasia will be ascertained. All randomised participants will be analysed using intention to treat. Baseline and demographic variables as well as outcomes will be summarised and compared using univariate analyses, and a p<0.05 will be considered significant.Ethics and disseminationThe trial has been approved by the respective research ethics boards at each institution (McMaster Children’s Hospital: Hamilton integrated REB approval #2113; Royal Alexandra Hospital: Health Research Ethics Board approval ID Pro00090244; Westmead Hospital: Human Research Ethics Committee approval ID 2022/ETH01343). Written, informed consent will be obtained from all parents/guardians prior to study enrolment. The findings of this pilot study will be disseminated via presentations at national and international conferences and via publication in a peer-reviewed journal. Social media platforms including Twitter will also be used to generate awareness.Trial registration numberNCT03512158.

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Lystad, Reidar P., Andrew Fyffe, Rhonda Orr e Gary Browne. "Changes in Paediatric Injury-Related Emergency Department Presentations during the COVID-19 Pandemic". Trauma Care 3, n.º 2 (3 de abril de 2023): 46–54. http://dx.doi.org/10.3390/traumacare3020006.

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This study aimed to quantify changes in paediatric injury-related Emergency Department (ED) presentations at a large metropolitan paediatric hospital during the first two years of the COVID-19 pandemic (i.e., 2020 and 2021). This retrospective cohort study included children aged ≤15 years who presented to the ED at the Children’s Hospital at Westmead, Sydney, New South Wales, Australia, with a principal diagnosis of injury during 1 January 2010 to 31 December 2021. Annual and monthly incidence of paediatric injury-related ED presentations from 2010 to 2019 were used to fit autoregressive integrated moving average models, from which forecast estimates with 95% prediction intervals were derived and compared against corresponding observed values to obtain estimates of absolute and relative forecast errors. The distributions of injuries by injury severity in 2020 and 2021 were compared against the 2010–2019 reference period. The annual incidence of paediatric injury-related ED presentations was 7.6% and 4.7% lower than forecasted in 2020 and 2021, respectively, equating to an estimated total of 1683 fewer paediatric injury-related ED presentations during the two-year period. The largest reductions in monthly incidence of paediatric injury-related ED presentations were observed during the periods of major societal restrictions (i.e., March–May 2020 and July–October 2021). Significant reductions in monthly incidence of injury-related ED presentations were observed for minor injuries only, with no discernable reductions in moderate and serious injuries. These findings highlight the impact of the COVID-19 pandemic on paediatric injury-related ED presentations and the need for future epidemiological studies examining secular trends in paediatric trauma volumes to account for the impact of the COVID-19 pandemic.

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Hanson, Ralph M. "Good health information - an asset not a burden!" Australian Health Review 35, n.º 1 (2011): 9. http://dx.doi.org/10.1071/ah09865.

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Good health information is central to informing the delivery of health care. Health has mostly struggled to promote the effective use of information to manage services on a day to day basis. Based on the experience at the Children’s Hospital at Westmead, a case is made for seeing information as an asset that requires a structured approach to improving data quality, and making a concerted effort to grow a more robust information culture. Transforming Health through better health information will not happen overnight. It needs a long range plan. It should be supported by appropriate business intelligence tools and a structured approach to process improvement, built around data management. What is known about the topic? Good Health Information is central to informing the delivery of health care. Health has mostly struggled to promote the effective use of information to manage services on a day to day basis. What does this paper add? A case is made for seeing information as an asset that requires a structured approach to improving data quality and a concerted effort to grow a more robust information culture. What are the implications for practitioners? Health is at a point where far greater use can be made of available information assets and the development of staff. Good health information needs to be seen as an asset. Health facilities need to recognise the importance of a clear vision for information management and how it can support the overall transformation of Health.

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Vilvarajan, Sandra, Madeleine McDonald, Lyndal Douglas, Jessica Newham, Robyn Kirkland, Gloria Tzannes, Diane Tay, John Christodoulou, Susan Thompson e Carolyn Ellaway. "Multidisciplinary Management of Rett Syndrome: Twenty Years’ Experience". Genes 14, n.º 8 (11 de agosto de 2023): 1607. http://dx.doi.org/10.3390/genes14081607.

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Over the last 20 years, the understanding and natural history of Rett syndrome has advanced, but to date no cure has emerged, with multidisciplinary management being symptomatic and supportive. This study provides a comprehensive review of the clinical features, comorbidities and multidisciplinary management of a well-characterized cohort of females with classical Rett syndrome. We aim to improve awareness and understanding of Rett syndrome amongst pediatricians, pediatric subspecialists and allied health professionals to enable early diagnosis and a streamlined enrolment approach for future clinical trials. Rett syndrome, a complex X-linked condition, affecting mainly females, is due to pathogenic variants of the MECP2 gene in most affected individuals. The Rett syndrome Multidisciplinary Management clinic at The Children’s Hospital at Westmead, Sydney, Australia, was established in 2000. This retrospective analysis of individuals who attended the clinic from 2000 to 2020 was performed to identify the incidence and predicted age of onset of Rett syndrome related comorbidities, disease progression and to review management principles. Data collected included age of Rett syndrome diagnosis, MECP2 genotype, clinical features and medical comorbidities, such as sleep disturbance, seizures, breathing irregularities, scoliosis, mobility, hand stereotypies, hand function, constipation, feeding ability, use of gastrostomy, communication skills, QTc prolongation, anthropometry, and bruxism. Analysis of 103 girls who fulfilled the clinical diagnostic criteria for classical Rett syndrome with a pathogenic variant of the MECP2 gene showed a median age of diagnosis of 3 years. The most frequent MECP2 variant was c.502 C>T.

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Barbaro, Pasquale M., Marion Mateos, Luciano Dalla-Pozza, Anthea Ng, Glenn M. Marshall, Jodie E. Giles, Rosemary Sutton et al. "Age Adjusted Telomere Length Decreases Following Treatment for Pediatric Acute Lymphoblastic Leukemia, but Does Not Predict Toxicity". Blood 126, n.º 23 (3 de dezembro de 2015): 4984. http://dx.doi.org/10.1182/blood.v126.23.4984.4984.

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Abstract Introduction Telomeres are specialized DNA structures found at the end of linear chromosomes, which in humans contains the repetitive DNA sequence, (TTAGGG)n and associated proteins. Telomere length (TL) is important for replicative capacity of cells, and, in somatic cells, telomere length shortens with each cell division. Once a critically short length is reached, cells enter senescence or undergo apoptosis. In the general population, TL varies greatly and declines with age. Chemotherapy can increase the rate of telomere shortening, although these findings have not been consistently demonstrated. There is evidence, mostly in adults, suggesting that patients with shorter TL experience increased toxicity from cancer treatment. Patients with the short telomere syndrome, Dyskeratosis Congenita undergoing hematopoietic stem cell transplantation have increased rates and degree of organ toxicity when given myeloablative conditioning. In the pediatric population there have been no studies assessing the relationship between TL and rates of toxicity after chemotherapy, and few investigating telomere dynamics following chemotherapy. We undertook a retrospective analysis to investigate the relationship between TL and chemotherapy toxicity, and also telomere dynamics in children treated for acute lymphoblastic leukemia (ALL). Methods Patients enrolled on the Australian and New Zealand Children's Hematology and Oncology Group's (ANZCHOG) Study 8 for ALL at the Children's Hospital at Westmead and the Sydney Children's Hospital from October 2002 to November 2011 who had provided consent and who had stored samples suitable for TL analysis were included in the study. Organ toxicity information was collected from the Study 8 database, as well as examination of patient medical records and pathology information systems. Liver and renal toxicities were documented based on abnormalities in transaminases, bilirubin and creatinine respectively. Pulmonary and neurotoxicities were determined through medical record and imaging findings. Standard common terminology criteria for adverse events (CTCAE) criteria were used to systematically grade toxicity. Infectious disease information and intensive care admissions as well as time to complete each cycle of therapy were used as surrogate markers for toxicity and bone marrow recovery. Survival and relapse rates were also analyzed. Relative TL was measured using a quantitative PCR technique on DNA extracted from mononuclear cells taken at Day 79 following commencement of induction and consolidation therapy, and also at the end of treatment, typically 24 months from diagnosis. The relative TL was converted to an age adjusted TL (AATL) by subtracting the expected relative TL (i.e. 50th percentile for age of the patient) from the measured relative TL, so that patients of all ages could be analyzed together. For analysis the cohort was separated into four groups based on AATL quartiles. Results In all, 460 patients with research consent were enrolled on ANZCHOG ALL Study 8 at the 2 hospitals included in this study. Of these 157 patients with AATL measurement and toxicity information were included in our analysis with 149 being standard or medium risk. The median age of diagnosis was 4.79 years (range 1.1 - 17.89) with a median follow up of 53 months (range 9-124 months). The median AATL on Day 79 was 0.035 (range -0.41 to 0.73). The average change in TL from day 79 to end of treatment was -0.126 (range -0.81 to 0.40), which is equivalent to approximately 8-10 years of natural ageing. There was no significant association between survival (Figure 1) or rates of grade 3 or 4 organ toxicity, relapse (Table 2) or bone marrow recovery and AATL. Renal toxicity was significantly increased in the second shortest quartile, however numbers are small (4 patients in second quartile vs 1 in fourth quartile). Conclusion There is an increased rate of telomere attrition during treatment for childhood ALL, however telomere length does not appear to be associated with increased rates of organ toxicity. Support: NHMRC APP1057746 and NHMRC GNT1056667 Disclosures No relevant conflicts of interest to declare.

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Ricciardello, Daniel, Nam Kyu Yang, Kira Chamberlain e Andrew Holland. "Firework and sparkler burns in paediatric patients". Australasian Journal of Plastic Surgery 4, n.º 1 (30 de março de 2021): 30–34. http://dx.doi.org/10.34239/ajops.v4n1.240.

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Background: While the consumer sale of fireworks is illegal in New South Wales, the sale of sparklers is legal—however, both still pose a significant risk of harm in the paediatric population. Anecdotally, burns services are aware that the misuse of sparklers can result in burns but there appears to be a paucity of studies examining this incidence in the paediatric population in Australia.Method: A retrospective review of all burns related to the use of fireworks or sparklers referred to the Children’s Hospital at Westmead (CHW) Burns Unit (BU) from January 2004 to December 2019. Results: 96 patients were referred to the CHW BU with a burn as a result of a firework or sparkler. Sparklers accounted for 69 (72%) of burns, compared with 27 (28%) from fireworks. The mean age of those injured by sparklers was five years compared with eight years in the firework group. Average total body surface area (TBSA) affected for both mechanisms was similar—for sparkler burns (2.0%) firework burns (2.4%), with a range of 0.1–15 per cent. Hands were the most common area burnt in both groups comprising 41 (59%) of sparkler burns and 13 (48%) of firework burns. Twenty patients required a total of 32 visits to the operating theatre for acute management of their burns.Conclusion: This study demonstrates the potential for significant injuries as a result of fireworks and sparklers. These findings can be used to raise awareness regarding their dangers, direct targeted educational campaigns and guide safety advice regarding their use.

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Dwyer, Christopher M., Kristina Prelog e Brian K. Owler. "The role of venous sinus outflow obstruction in pediatric idiopathic intracranial hypertension". Journal of Neurosurgery: Pediatrics 11, n.º 2 (fevereiro de 2013): 144–49. http://dx.doi.org/10.3171/2012.10.peds1299.

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Object The authors examined the role of venous sinus obstruction in the etiology of idiopathic intracranial hypertension (IIH) by reviewing more than 200 MR venograms performed in suspected cases of IIH. Methods Individual MR venograms performed in cases of suspected IIH at the Children's Hospital at Westmead in Sydney, Australia, were reviewed. The authors excluded cases in which an intervention was performed before the scan or a structural cause for venous obstruction was identified. Cases with confirmed hydrocephalus were also excluded. For each of the 145 remaining scans, the authors completed a detailed review on a slice-by-slice basis of the 2D source images used to compile the rendered 3D MR venogram. The anatomical configuration of the dural venous sinuses and any areas of decreased flow in circulation were then noted. Where possible, they correlated their radiological findings with evidence of raised intracranial pressure based on LP opening pressures. They also reviewed a control group of 50 MR venograms. Results Seventy-six (52%) of 145 scans showed evidence of venous obstruction in the dominant-side circulation. Substantial nonphysiological collateral circulation was seen in 68% of cases with dominant-sided obstruction, suggesting a process of recanalization. In contrast, in the absence of dominant-sided obstruction, collateral circulation was uncommon. In 27 cases, CSF opening pressure measurements were available. In 20 cases the opening pressures were in excess of 20 cm H2O. Of those, 17 demonstrated evidence of dominant-sided venous outflow obstruction. Among those cases, the median opening pressure was 34 cm H2O. Dominant-sided venous outflow obstruction was seen in only 2 of 50 MR venograms in the control group. Furthermore, evidence of collateral circulation was also uncommon in the control group. There was a highly statistically significant difference between rates of dominant-sided venous obstruction in the suspected IIH and control groups (p ≤ 0.001). Conclusions A majority of patients presenting for investigation of suspected IIH demonstrated evidence of dominant-sided venous obstruction on MR venogram. In addition there was a high correlation between elevated CSF opening pressures and dominant-sided venous sinus obstruction. This correlation was further supported by evidence of collateral recanalization in patients with elevated CSF pressures and dominant-sided venous obstruction. A control group of 50 MR venograms indicated that dominant-sided venous outflow obstruction is an unlikely incidental finding, and a highly statistically significant difference was found between rates of obstruction in the suspected IIH and control groups.

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Loveday, Thomas, Mark W. Wiggins, Ben J. Searle, Marino Festa e David Schell. "The Capability of Static and Dynamic Features to Distinguish Competent From Genuinely Expert Practitioners in Pediatric Diagnosis". Human Factors: The Journal of the Human Factors and Ergonomics Society 55, n.º 1 (5 de junho de 2012): 125–37. http://dx.doi.org/10.1177/0018720812448475.

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Children’s Hospital at Westmead, Sydney, Australia Objective: The authors describe the development of a new, more objective method of distinguishing experienced competent nonexpert from expert practitioners within pediatric intensive care. Background: Expert performance involves the acquisition and use of refined feature-event associations (cues) in the operational environment. Competent nonexperts, although experienced, possess rudimentary cue associations in memory. Thus, they cannot respond as efficiently or as reliably as their expert counterparts, particularly when key diagnostic information is unavail- able, such as that provided by dynamic cues. Method: This study involved the application of four distinct tasks in which the use of relevant cues could be expected to increase both the accuracy and the efficiency of diagnostic performance. These tasks included both static and dynamic stimuli that were varied systematically. A total of 50 experienced pediatric intensive staff took part in the study. Results: The sample clustered into two levels across the tasks: Participants who performed at a consistently high level throughout the four tasks were labeled experts, and participants who performed at a lower level throughout the tasks were labeled competent nonexperts. The groups differed in their responses to the diagnostic scenarios presented in two of the tasks and their ability to maintain performance in the absence of dynamic features. Conclusion: Experienced pediatricians can be decomposed into two groups on the basis of their capacity to acquire and use cues; these groups differ in their diagnostic accuracy and in their ability to maintain performance in the absence of dynamic features. Application: The tasks may be used to identify practitioners who are failing to acquire expertise at a rate consistent with their experience, position, or training. This information may be used to guide targeted training efforts.

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Govender, Dinisha, e David Chung. "IMG-34. THE UTILITY OF [18F]FET PET IMAGING IN PAEDIATRIC CNS TUMOURS: A SINGLE INSTITUTION EXPERIENCE IN SYDNEY, AUSTRALIA". Neuro-Oncology 26, Supplement_4 (18 de junho de 2024): 0. http://dx.doi.org/10.1093/neuonc/noae064.371.

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Abstract BACKGROUND MRI remains the standard imaging modality in paediatric CNS tumours. Whilst Positron emission tomography (PET) with O-(2-[18F]fluoroethyl)-L-tyrosine ([18F-FET) is a well-established tool in adult central nervous system (CNS) tumours, established data on its diagnostic utility and impact on clinical management in children and adolescents remain limited. METHODS Single centre retrospective review of database of all paediatric and adolescent patients (age 0-19years) who underwent 18F]FET-PET imaging with cross referencing of patient electronic medical records. Conducted at the Children’s Hospital at Westmead in Sydney, Australia. RESULTS 116 patients underwent 18F-FET PET imaging between October 2012 and January 2024. 28 patients had additional comparative fluorodeoxyglucose (FDG) CNS dedicated PET imaging. Primary indications for FET PET imaging included differentiating between a neoplastic versus non-neoplastic process (23.3%), identifying active residual tumour (14.7%), characterising tumour grade in patients including in those with the known tumour predisposition syndromes (6%), distinguishing between progression pseudo-progression (2.5%) and providing additional localisation or biopsy guidance (8.6%). Malignant transformation, gliomatosis and extent of disease was also noted as indications. 15 patients were able to avoid a biopsy or invasive surgery. Nearly 60% of FET PET imaging was considered clinically useful with the management of 52/112 (46%) patients being supported or changed. Management changes included change second look surgery, change of radiation field, change of treatment and access to a clinical trial. Only 3 scans were reported to have technical challenges in resolution or poor spatial correlation with MRI. Further analysis is currently being conducted, reviewing standard uptake values (SUV’s) of histologically proven low/high grade tumours and T2 enhancing/non-enhancing lesions. CONCLUSIONS This small study demonstrated the clinical benefit and utility of 18F-FET PET imaging in paediatric CNS tumours. Our experience has demonstrated significant surgical and diagnostic advantage in tumour localisation as well as avoiding surgery where able.

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Fletcher, J. P., J. M. Little e J. M. Mudie. "HOME PARENTERAL NUTRITION: WESTMEAD HOSPITAL EXPERIENCE". ANZ Journal of Surgery 56, n.º 12 (dezembro de 1986): 897–900. http://dx.doi.org/10.1111/j.1445-2197.1986.tb01851.x.

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Russell, Paul A. "Cardiology at Westmead Hospital 1978–1990". Heart, Lung and Circulation 16, n.º 3 (junho de 2007): 144–48. http://dx.doi.org/10.1016/j.hlc.2007.03.003.

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Watson, C. E., E. A. Clous, M. Jaeger e S. K. D’Amours. "Introduction of the Abbreviated Westmead Post-Traumatic Amnesia Scale and Impact on Length of Stay". Scandinavian Journal of Surgery 106, n.º 4 (7 de abril de 2017): 356–60. http://dx.doi.org/10.1177/1457496917698642.

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Background and Aims: Mild traumatic brain injury is a common presentation to Emergency Departments. Early identification of patients with cognitive deficits and provision of discharge advice are important. The Abbreviated Westmead Post-traumatic Amnesia Scale provides an early and efficient assessment of post-traumatic amnesia for patients with mild traumatic brain injuries, compared with the previously used assessment, the Modified Oxford Post-traumatic Scale. Material and Methods: This retrospective cohort study reviewed 270 patients with mild traumatic brain injury assessed for post-traumatic amnesia over a 2-year period between February 2011 and February 2013. It identified those assessed with Abbreviated Westmead Post-traumatic Amnesia Scale versus Modified Oxford Post-traumatic Scale, the outcomes of these post-traumatic amnesia assessments, the hospital length of stay for patients, and their readmission rates. Results: The Abbreviated Westmead Post-traumatic Amnesia Scale was used in 91% of patient cases (and the Modified Oxford Post-traumatic Scale in 7%), and of those assessed with the Abbreviated Westmead Post-traumatic Amnesia Scale, 94% cleared post-traumatic amnesia testing within 4 h. Of those assessed with the Abbreviated Westmead Post-traumatic Amnesia Scale, 56% had a shorter length of stay than had they been assessed with the Modified Oxford Post-traumatic Scale, resulting in 295 bed-days saved. Verbal and written discharge advice was provided to those assessed for post-traumatic amnesia to assist their recovery. In all, 1% of patients were readmitted for monitoring of mild post-concussion symptoms. Conclusion: The Abbreviated Westmead Post-traumatic Amnesia Scale provides an effective and timely assessment of post-traumatic amnesia for patients presenting to the Emergency Department with mild traumatic brain injury compared with the previously used assessment tool. It helps identify patients with cognitive impairment and the need for admission and further investigation, resulting in appropriate access to care. It also results in a decreased length of stay and decreased hospital admissions, with subsequent cost savings to the hospital.

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Fellas, A., J. Chaitow, D. Singh-Grewal, D. Santos, M. Clapham e A. Coda. "OP0207-HPR EFFECT OF FOOT ORTHOSES IN REDUCING PAIN IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS: A 12-MONTH RANDOMISED CLINICAL TRIAL". Annals of the Rheumatic Diseases 81, Suppl 1 (23 de maio de 2022): 136.3–136. http://dx.doi.org/10.1136/annrheumdis-2022-eular.854.

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BackgroundJuvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and adolescents [1]. The manifestation of JIA may include joint swelling, tenderness, and painful limitation with joint movement. Only few studies have explored the effect of foot orthoses (FOs) alone in children with JIA [2,3]. These studies showed FOs can reduce pain in children with JIA, however, further research with larger sample sizes and longer follow-ups are needed [4]. Prescribing FOs on the same day of the initial assessment may promote early clinical and targeted intervention, which is the gold standard approach in paediatric rheumatology.ObjectivesThis single blinded multicentre randomised clinical trial (RCT) aims to investigate the effect of customised prefabricated FOs in reducing pain amongst children and adolescents with JIA.MethodsOverall, 66 children and adolescents with JIA presenting with foot symptoms were recruited from the Sydney Children’s Hospitals Network (Westmead and Randwick) and John Hunter Children’s Hospital (Newcastle). The primary outcome measure was pain with a minimal clinical significance of 8mm on the visual analogue scale (VAS). Participants were randomly allocated to receive either customised prefabricated or sham FOs. The trial intervention was a low-density Slimflex Simple device that was customised at chair-side. The control (sham) device was made of 2mm flat leather board with no corrective modifications. Standardised tests such as the Foot Posture Index, navicular drift and drop were used to identify biomechanical abnormalities. The FOs were worn for a total of 12 months, with data collected at baseline, 4 weeks, 3, 6 months and 12 months.ResultsReduction in self-reported pain was statistically and clinically significant at 4-weeks (p=0.018, -14.92 [-27.30, -2.55]) and 3 months (p=<0.001, -28.93 [-40.90, -16.96]) post intervention in favour of the trial group. The 6- and 12-month follow-ups were not statistically or clinically significant. Parent reported pain was statistically and clinically significant at the 3-month (p=<0.001, -21.92 [-33.16, -10.67]) in the reduction of pain in favour of the trial group. However, parent reported pain was not statistically significant at the 4-week, 6- and 12- month follow-ups. These results are similar to child reported pain with a p-value of less than 0.001 and average coefficients twice that of the clinical significance cut-off for VAS pain in paediatric rheumatology. The trial intervention was safe and tolerated well by participants with high compliance and adherence rates.ConclusionResults of this clinical trial indicate customised preformed FOs can be effective in reducing pain and in children with JIA experiencing foot and ankle symptoms. Significant clinical effects appear to be within the first 3-months of intervention prescription and reduce beyond 6 months. Overall, this podiatric intervention was safe, inexpensive, well tolerated and it can be easily implemented as part of the multidisciplinary paediatric rheumatology care.References[1]Ravelli A, Martini A. Juvenile idiopathic arthritis. Lancet. 2007;369:767–78.[2]Powell M, Seid M, Szer IS. Efficacy of custom foot orthotics in improving pain and functional status in children with juvenile idiopathic arthritis: a randomized trial. J Rheumatol 2005;32:943–50.[3]Coda A, Fowlie PW, Davidson JE et al. Foot orthoses in children with juvenile idiopathic arthritis: a randomised controlled trial. Arch Dis Child 2014;99:649–51.[4]Fellas A, Coda A, Hawke F. Physical and mechanical therapies for lower-limb problems in juvenile idiopathic arthritis: a systematic review with meta-analysis. Journal of the American Podiatric Medical Association. 2017 Sep;107(5):399-412.AcknowledgementsWe would like to acknowledge all parents and children for their precious time.Disclosure of InterestsNone declared

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Zissiadis, Yvonne, Allan O. Langlands, Bruce Barraclough e John Boyages. "BREAST CONSERVATION: LONG-TERM RESULTS FROM WESTMEAD HOSPITAL". ANZ Journal of Surgery 67, n.º 6 (junho de 1997): 313–19. http://dx.doi.org/10.1111/j.1445-2197.1997.tb01979.x.

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Kovoor, Pramesh. "Cardiology at Westmead Hospital from 1990 to 2007". Heart, Lung and Circulation 16, n.º 3 (junho de 2007): 207–13. http://dx.doi.org/10.1016/j.hlc.2007.02.105.

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Younis, Nageia, Danny Cass e Andrew Holland. "The Long-Term Outcome of Abdominal Wall Defects Exomphalos & Gastroschisis Retrospective Single Centre Study Children Hospital at Westmead, Sydney, Australia". SVOA Paediatrics 2, n.º 5 (21 de setembro de 2023): 128–35. http://dx.doi.org/10.58624/svoapd.2023.02.045.

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Objective: To examine the natural history and detailed outcome of diagnosed cases of abdominal wall defects that admitted to The Children`s Hospital at Westmead. Methods: This was A retrospective single centre study of all cases of abdominal wall defects admitted between the 1st of October 1998 and the 1st of January 2007 to The Children`s Hospital at Westmead. The study had been conducted through a retrospective review of the neonatal, pediatric surgery records and subsequent follow-up information of all cases of Omphalocele and Gastroschisis diagnosed. Results: Ninety cases with anterior abdominal wall defects were admitted. Majority of the cases were born at Westmead Hospital. There were 25 neonates with Gastroschisis (27 females, 28 males), and 35 neonates with Exomphalos (15 females, 20 males). Eighty-one neonates had prenatal ultrasound diagnosis. Some neonates had associated congenital anomalies which results in five deaths (4 Exomphalos, 1 Gastroschisis). Post operative complications were common and the postoperative hospital stay was often lengthy. Twenty-five patients out of the ninety (15 Gastroschisis, 10 exomphalos) required further operations which were related to their primary diagnosis of Gastroschisis or Exomphalos, mostly for abdominal wall hernias. Conclusions: Long-term outcome was favourable in majority of cases with abdominal wall defects and mortality substantially happened in neonates with associated anomalies. Reoperations were necessary in those patients who had postoperative hernias.

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Howell, Susan, e Geoffrey Morel. "Orthodontic treatment needs in Westmead Hospital Dental Clinical School". Australian Dental Journal 38, n.º 5 (outubro de 1993): 367–72. http://dx.doi.org/10.1111/j.1834-7819.1993.tb05518.x.

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