A5075208582- Telemedicine and Telehealth Implementation
- Metabolism and Genetic Disorders
- Mitochondrial Function and Pathology
- COVID-19 and healthcare impacts
- Trauma and Emergency Care Studies
- Diet and metabolism studies
- Healthcare Systems and Technology
- Electronic Health Records Systems
- Clinical Nutrition and Gastroenterology
- Venous Thromboembolism Diagnosis and Management
- Hemodynamic Monitoring and Therapy
- Ultrasound in Clinical Applications
- Sepsis Diagnosis and Treatment
- Emergency and Acute Care Studies
- Renal and Vascular Pathologies
- Palliative Care and End-of-Life Issues
- Dialysis and Renal Disease Management
- Diabetes Management and Research
- Long-Term Effects of COVID-19
- Renal function and acid-base balance
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Atrial Fibrillation Management and Outcomes
- Disaster Response and Management
- Diabetes Treatment and Management
- Cardiac Imaging and Diagnostics
The Royal Melbourne Hospital
2018-2025
The University of Melbourne
2018-2025
Clinical Trials New Zealand
2024
Australia and New Zealand Banking Group
2024
Monash University
2010-2023
Monash Health
2023
Taranaki Base Hospital
2023
Melbourne Health
2013-2021
Austin Health
2019
The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the health-care system both in Australia and internationally, rapidly transformed delivery of health care hospitals community. Implementation social isolation distancing measures to stop spread reduce potential harm patients necessitated use alternate models delivery. Changes that would normally take months or years have occurred within days weeks.We conducted analysis outpatient clinic data during period compared...
Hyperglycemia in hospital inpatients without pre-existing diabetes is associated with increased mortality. However, the independent contribution of hyperglycemia to health care-associated infection (HAI), acute kidney injury (AKI), and stroke unclear.
Royal Melbourne Hospital (RMH) performs over 140 kidney transplant operations annually. Kidney recipients require regular medical review, which results in loss of time and costs from travel, particularly for regional patients, places high demand on the hospital outpatient service. The RMH renal unit initiated a telehealth service 2016 to provide cost effective, patient-centred clinical care patients. To date, 263 reviews have been conducted via telehealth, potentially saving 203,202...
People with severe mental illness (SMI) have a reduced life expectancy. A major cause of mortality is cardiovascular disease.The aims this study were to document the prevalence risk factors in people SMI engaged community psychiatric rehabilitation and compare rates general, Aboriginal Torres Strait Islander (ATSI) populations Australia.A cross-sectional audit was conducted on patients receiving care from Melbourne's Inner-West Area Mental Health Service. Profiles collected on: smoking...
Abstract Background Metabolic acidosis is a major complication of critical illness. However, its current epidemiology and treatment with sodium bicarbonate given to correct metabolic in the ICU are poorly understood. Method This was an international retrospective observational study 18 ICUs Australia, Japan, Taiwan. Adult patients were consecutively screened, those early (pH < 7.3 Base Excess –4 mEq/L, within 24-h admission) included. Screening continued until 10 who received did not...
Hypophosphatemia occurs frequently. Enteral, rather than IV, phosphate replacement may reduce fluid replacement, cost, and waste.
Introduction This protocol outlines a mixed methods study evaluating new Digital Coordination Centre (DCC) at the Royal Melbourne Hospital (RMH), Melbourne, Australia. While coordination centres show potential for impact, evidence on effective implementation in Australian context remains scarce. aims to address this gap. Methods and analysis The evaluation involves two-stage approach: process clarify DCC design identify factors, an initial outcome assess short medium term outcomes. A...
Abstract Background The healthcare disparities of sexual and gender minority (SGM) people are globally recognised. Research from the United States has advocated for orientation identity (SOGI) information capture via electronic medical record (EMR) to support generation knowledge regarding SGM people’s needs appropriate care this population. In November 2022, Royal Melbourne Hospital (RMH) enabled SOGI EMR functionality. purpose study is understand how can inform person-centred by way...
Abstract Hyperammonaemia during stem cell transplant is a distinct biochemical and clinical entity. It has different pathological driver from other common forms of hyperammonaemia. Early recognition this pathology an understanding its biochemical, microbiological aspects inform aggressive management algorithm.
Mitochondrial diseases are rare, heterogeneous conditions affecting organs dependent on high aerobic metabolism. Presenting symptoms and signs vary depending the mutation mutant protein load. Diabetes mellitus is most common endocrinopathy, recognition of these patients important due to its impact management screening family members. In particular, glycemic differs in patients: use metformin avoided because risk lactic acidosis. We describe a patient who presented with gradual weight loss an...
Abstract Background Phenylketonuria (PKU) is an autosomal recessive inherited disorder characterised by a deficiency in phenylalanine hydroxylase. Untreated, PKU associated with wide range of cognitive and psychiatric sequelae. Contemporary management guidelines recommend lifetime dietary control (Phe) levels, however many individuals who discontinue subsequently suffer symptoms anxiety, depression disturbances to cognition. We undertook prospective cohort study patients early-treated...
Hospital acquired infections are common, costly, and potentially preventable adverse events. This study aimed to determine the effect of COVID-19 pandemic-related escalation in infection prevention control measures on incidence hospital surgical patients a low environment Australia.This was retrospective cohort tertiary institution. All undergoing procedure from 1 April 2020 30 June (COVID-19 pandemic period) were compared pre-pandemic (1 2019-30 2019). The primary outcome investigated odds...
Abstract Background The proliferation of electric scooters globally has been associated with an increase in related injuries and consequent economic burden. This study aims to assess the injury patterns impact scooter use Melbourne, Australia. Methods A retrospective cohort was conducted using hospital registry data from January 2022 2023. Data collected included demographic details, alcohol helmet use, type severity, operative treatment provided, direct medical costs. (in AUD) patient's...
Liver abscess due to Klebsiella pneumoniae infection has been widely reported in Asia, but rarely Australia until now. We describe four previously well Asian-born patients who presented across with community-acquired K. liver abscesses. With prompt recognition, appropriate antibiotics and early drainage, outcome is significantly improved, although vigilance for metastatic complications essential.
Abstract Background Point-of-care ultrasound (POCUS) is emerging as a reliable and valid clinical tool that impacts diagnosis decision-making well timely intervention for optimal patient management. This makes its utility in patients admitted to internal medicine wards attractive. However, there still an evidence gap all the medical setting of how use affects variables such length stay, morbidity, mortality. Methods/design A prospective randomized controlled trial assessing effect surface...
<h3>Importance</h3> There are accumulating data about the utility of diagnostic multiorgan focused clinical ultrasonography (FCU) in assessment patients admitted with cardiopulmonary symptoms. <h3>Objective</h3> To determine whether adding FCU to initial evaluation symptoms reduces hospital length stay, readmissions, and in-hospital costs. <h3>Design, Setting, Participants</h3> This is a prospective, parallel-group, superiority, randomized trial 1:1 allocation ratio. The study was conducted...
Background Research exploring perspectives on inpatient portals reports that patients desire the information affordances of portals, and clinicians recognize their value for improving patient experience but also express caution regarding sharing aspects medical record. This study contributed to existing literature by considering psychosocial dimension clinician resistance with inpatients power dynamic associated clinician-patient asymmetry. Along commonly discussed in this area, explored...
The COVID-19 pandemic has had a profound effect on the presentation and management of trauma at Royal Melbourne Hospital, level 1 adult major service designated hospital. This study compares changes in epidemiology patient access to emergency imaging surgery during response.The population interest was all patients captured hospital's registry from 16 March 2016 10 September 2020. Regression modelling assessed mechanism severity injury, mortality two lockdowns compared with proceeding 4...
This article aims to quantify prevalence of patient aggression or threatened/actual violence during critical illness.
Objectives The threat of a pandemic, over and above the disease itself, may have significant broad effects on healthcare system. We aimed to describe impact SARS-CoV-2 pandemic (during relatively low transmission period) associated societal restrictions presentations, admissions outpatient visits. Design compared hospital activity in 2020 with preceding 5 years, 2015–2019, using retrospective cohort study design. Setting Quaternary Melbourne, Australia. Participants Emergency department...
The cornerstone treatment of hyperphenylalaninemia (HPA) and phenylketonuria (PKU) is a lifelong low-protein diet with phenylalanine (Phe) free L-amino acid supplements. However, the PKU has significant shortcomings, there clinically unmet need for new therapeutics to improve patient outcomes. CDX-6114 modified ammonia-lyase (PAL) enzyme obtained by mutation in Anabaena variabilis PAL sequence. CodeEvolver® protein engineering technology been applied degradation resistance enzyme. In our...
To establish the feasibility of embedding an RCT into EMR in ICU, we evaluated route phosphate replacement. The screened 207 patients who met inclusion criteria from 20 April 2022 to 30 June 2022. 162 were randomised and 145 allocated treatment. Our study showed that it was feasible embed screening, randomisation, treatment allocation for within ICU.