https://swslhd.intersearch.com.au/swslhdjspui/handle/1/6 2026-06-14T11:45:37Z 2026-06-14T11:45:37Z A Harris, I. A. Page, R. S. Buchbinder, R. ��rimaa, V. Adie, S. Brown, G. Cinnadaio, N. Damiani, M. Descallar, J. Ferreira, M. L. Foster, N. E. Gill, S. Hutchison, K. Jarvinen, T. Khoo, O. Lieu, D. Maher, C. G. Naylor, J. M. Smith, G. Spencer, L. Toh, Y. Whan, A. Yeoh, T. https://swslhd.intersearch.com.au/swslhdjspui/handle/1/13789 2025-10-29T03:35:13Z 2025-01-01T00:00:00Z

Title: ARC (Australian Rotator Cuff) trial: study protocol for a randomised placebo-controlled trial comparing rotator cuff repair to no repair during arthroscopic shoulder surgery for people with shoulder pain and non-acute rotator cuff tears Authors: A Harris, I. A.; Page, R. S.; Buchbinder, R.; ��rimaa, V.; Adie, S.; Brown, G.; Cinnadaio, N.; Damiani, M.; Descallar, J.; Ferreira, M. L.; Foster, N. E.; Gill, S.; Hutchison, K.; Jarvinen, T.; Khoo, O.; Lieu, D.; Maher, C. G.; Naylor, J. M.; Smith, G.; Spencer, L.; Toh, Y.; Whan, A.; Yeoh, T. Abstract: Background: Degenerative rotator cuff tears are common and are often treated with surgical repair. Randomised trials have not shown a clear advantage to surgery over non-surgical treatment, but there have been no published placebo-controlled trials investigating rotator cuff repair. This study aims to compare arthroscopic shoulder surgery with rotator cuff repair to surgery without rotator cuff repair (placebo) for improving shoulder pain and function in people with shoulder pain and full-thickness degenerative rotator cuff tears. Methods: The study is a multicentre two-parallel arm, blinded, individually randomised controlled trial (RCT). Participants will be people aged 40?75 years (inclusive) with more than 6 months of shoulder pain, a degenerative (non-traumatic) full thickness rotator cuff tear 1 to 4 cm in length for whom surgery is recommended and repair of the tear is the main reason for surgery. The intervention is arthroscopic surgery (including?as indicated?bursectomy, debridement, acromioclavicular joint resection, acromioplasty and biceps tenodesis or tenotomy) with rotator cuff repair. The control is the same arthroscopic shoulder surgery without rotator cuff repair. Participants will be randomised to cuff repair or no cuff repair in a 1:1 ratio intra-operatively, after all other surgical procedures have been performed. Participants, follow-up surgeons, physiotherapists, study staff and statisticians will be blinded. Post-surgical rehabilitation will be usual care for rotator cuff repair in both groups. The primary outcome will be shoulder pain and function measured using the Western Ontario Rotator Cuff Index at 6 months post-surgery. Discussion: The ARC trial will provide low bias evidence on a common surgical procedure: rotator cuff repair for degenerative tears. Trial registration: The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000789965) on 5 August 2020 and the WHO International Clinical Trials Registry Platform (universal trial number U1111-1251-6599). � 2025 Elsevier B.V., All rights reserved.

2025-01-01T00:00:00Z Kumar, A. Venkatesh, B. Finfer, S. Delaney, A. Thompson, K. Middleton, P. M. Aneman, A. Shetty, K. Bhonagiri, D. Saxena, M. van Haren, F. M. P. Bradford, C. Reece, G. Rodda, S. Mackellar, C. Bass, F. Tsang, L. Li, S. Kwok, R. Buckley, A. Zou, A. Sridharan, S. Hu, D. Iskandar, M. Frost, S. Headington, T. Connor, G. Klironomos, A. Shan, S. Li, Y. Anderson, B. Sidoli, R. Inskip, D. Lam, M. Fuller, G. Yu, C. Sigurdson, B. McNulty, R. Sadeghpour, M. Billot, L. Hammond, N. https://swslhd.intersearch.com.au/swslhdjspui/handle/1/13602 2025-08-21T05:21:31Z 2025-01-01T00:00:00Z

Title: Accuracy of the modified Global Burden of Disease International Classification of Diseases coding methods for identifying sepsis: a prospective multicentre cohort study Authors: Kumar, A.; Venkatesh, B.; Finfer, S.; Delaney, A.; Thompson, K.; Middleton, P. M.; Aneman, A.; Shetty, K.; Bhonagiri, D.; Saxena, M.; van Haren, F. M. P.; Bradford, C.; Reece, G.; Rodda, S.; Mackellar, C.; Bass, F.; Tsang, L.; Li, S.; Kwok, R.; Buckley, A.; Zou, A.; Sridharan, S.; Hu, D.; Iskandar, M.; Frost, S.; Headington, T.; Connor, G.; Klironomos, A.; Shan, S.; Li, Y.; Anderson, B.; Sidoli, R.; Inskip, D.; Lam, M.; Fuller, G.; Yu, C.; Sigurdson, B.; McNulty, R.; Sadeghpour, M.; Billot, L.; Hammond, N. Abstract: Background: This study assessed the accuracy of three International Classification of Diseases (ICD) codes methods derived from Global Burden of Disease (GBD) sepsis study (modified GBD method) in identifying sepsis, compared to the Angus method. Sources of errors in these methods were also reported. Methods: Prospective multicentre, observational, study. Emergency Department patients aged ? 16 years with high sepsis risk from nine hospitals in NSW, Australia were screened for clinical sepsis using Sepsis 3 criteria and coded as having sepsis or not using the modified GBD and Angus methods. The three modified GBD methods were: Explicit?sepsis-specific ICD code recorded; Implicit?sepsis-specific code or infection as primary ICD code plus organ dysfunction code; Implicit plus?as for Implicit but infection as primary or secondary ICD code. Agreement between clinical sepsis and ICD coding methods was assessed using Cronbach alpha (?). For false positive cases (ICD-coded sepsis but not clinically diagnosed), the ICD codes leading to those errors were documented. For false negatives (clinically diagnosed sepsis but ICD-coded), uncoded sources of infection and organ dysfunction were documented. Results: Of 6869 screened patients, 450 (median age 72.4 years, 48.9% females) met inclusion criteria. Clinical sepsis was diagnosed in 215/450 (47.8%). The explicit, implicit, implicit plus and Angus methods identified sepsis in 108/450 (24.0%), 175/450 (38.9%), 222/450 (49.3%) and 170/450 (37.8%), respectively. Sensitivity was 41.4%, 58.1%, 67.4% and 55.8%, and specificity 91.9%, 78.7%, 67.2% and 79.1%, respectively. Agreement between clinical sepsis and all ICD coding methods was low (? = 0.52?0.56). False positives were 19, 50, and 77, while false negatives were 126, 90, and 70 for the explicit, implicit, and implicit plus methods, respectively. For false positive cases, unspecified urinary tract infection, hypotension and acute kidney failure were commonly assigned infection and organ dysfunction codes. About half (44.3%-55.6%) of the false negative cases didn?t have a pathogen documented. Conclusion: The modified GBD method demonstrated low accuracy in identifying sepsis; with the implicit plus method being the most accurate. Errors in identifying sepsis using ICD codes arise mostly from coding for unspecified urinary infections and associated organ dysfunction. Trial registration: The study was registered at the ANZCTR (ACTRN12621000333819) on 24 March 2021. The Author(s) 2025.

2025-01-01T00:00:00Z Boot, M. Archer, J. Ali, I. https://swslhd.intersearch.com.au/swslhdjspui/handle/1/9624 2024-09-27T03:10:21Z 2023-01-01T00:00:00Z

Title: The diagnosis and management of pulmonary actinomycosis Authors: Boot, M.; Archer, J.; Ali, I. Abstract: Pulmonary actinomycosis is a rare infection caused by the bacterial species actinomyces. This paper aims to provide a comprehensive review of pulmonary actinomycosis to improve awareness and knowledge. The literature was analysed using databases including Pubmed, Medline and Embase from 1974 to 2021. After inclusion and exclusion, a total of 142 papers were reviewed. Pulmonary actinomycosis is a rare disease occurring in approximately 1 per 3,000,000 people annually. Historically, pulmonary actinomycosis was a common infection with high mortality; however, the infection has become rarer since the widespread use of penicillins. Actinomycosis is known as the great masquerade"; however, it can be differentiated from other diseases with acid-fast negative ray-like bacilli and sulphur granules being pathognomonic. Complications of the infection include empyema, endocarditis, pericarditis, pericardial effusion, and sepsis. The mainstay of treatment is prolonged antibiotic therapy, with adjuvant surgery in severe cases. Future research should focus on multiple areas, including the potential risk secondary to immunosuppression from newer immunotherapies, the utility of newer diagnostic techniques and ongoing surveillance post-therapy. © 2023"

2023-01-01T00:00:00Z He, S. Rolls, K. Stott, K. Shekhar, R. Vueti, V. Flowers, K. Moseley, M. Shepherd, B. Mayahi-Neysi, M. Chasle, B. Warner, B. Ní Chróinín, D. Frost, S. A. https://swslhd.intersearch.com.au/swslhdjspui/handle/1/888 2026-04-09T00:35:36Z 2022-01-01T00:00:00Z

Title: Does delirium prevention reduce risk of in-patient falls among older adults? A systematic review and trial sequential meta-analysis Authors: He, S.; Rolls, K.; Stott, K.; Shekhar, R.; Vueti, V.; Flowers, K.; Moseley, M.; Shepherd, B.; Mayahi-Neysi, M.; Chasle, B.; Warner, B.; Ní Chróinín, D.; Frost, S. A. Abstract: Objectives: To determine whether delirium prevention interventions reduce the risk of falls among older hospitalised patients. Methods: A systematic search of health-care databases was undertaken. Given the frequency of small sample sized trials, a trial sequential meta-analysis was conducted to present estimate summary effects to date. A Bayesian approach was used to estimate the posterior probability of the delirium prevention interventions reducing falls risk by various clinically relevant levels. Results: Five randomised controlled trials were included in our final meta-analysis. There was a 43% reduction in the risk of falls among participants in the delirium prevention intervention arm, compared to the control; however, confidence intervals were wide (RE RR = 0.57, 95% CI 0.32; 1.00, p = 0.05). This result was found to be statistically significant, according to traditional significance levels (z > 1.96) and the more conservative trial sequential analysis monitoring boundaries. The posterior probabilities of the delirium prevention intervention reducing the risk of falls by 10%, 20% and 30% were 0.86, 0.63 and 0.29 respectively. Conclusions: The results of this systematic review and trial sequential meta-analysis suggest that delirium prevention trials may reduce the risk of in-hospital falls among older patients by 43%. However, despite significant risk reduction found upon meta-analysis, the variation among study populations and intervention components raised questions around its application in clinical practice. Further research is required to investigate what the necessary components of a multifactorial intervention are to reduce both delirium and fall incidence among older adult in-patients. © 2022 AJA Inc.

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