Active cycle of breathing technique versus oscillating PEP therapy versus exercise with huffing during an acute exacerbation of bronchiectasis: a randomised controlled trial

开始日期2021-05-11

申办/合作机构

Bond University

[+1]

ACTRN12612001137886 / RecruitingN/AIIT

In men referred to a urologist with a high or concerning prostate specific antigen (PSA), can 3T multi-parametric MRI of the prostate be used as a triage for reducing the need to biopsy patients?

开始日期2012-06-27

申办/合作机构

The Wesley Hospital

[+1]

ACTRN12607000462482 / CompletedN/AIIT

To assess the change in cardiac output from clinical fluid challenge in patients with septic shock.

开始日期2007-09-01

申办/合作机构

The University of Queensland

[+1]

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668

项与 The Wesley Hospital 相关的文献（医药）

2024-10-01·European Journal of Clinical Investigation

Echocardiographic surrogate of left ventricular stroke work in a model of brain stem death donors

Article

作者: Wildi, Karin ; Haymet, Andrew ; Suen, Jacky Y. ; Ainola, Carmen ; Wilson, Emily S. ; Heinsar, Silver ; Platts, David ; Sato, Noriko ; Skeggs, Kris ; Obonyo, Nchafatso G. ; McGiffin, David C. ; Sato, Kei ; Hoe, Louise See ; Jung, Jae‐Seung ; Bouquet, Mahe ; Fraser, John F. ; Bassi, Gianluigi Li ; Palmieri, Chiara ; Hyslop, Kieran ; Chan, Jonathan ; White, Nicole ; Colombo, Sebastiano M. ; Abbate, Gabriella ; Livingstone, Samantha ; Passmore, Margaret R.

AbstractBackgroundThe commonest echocardiographic measurement, left ventricular ejection fraction, can not necessarily predict mortality of recipients following heart transplantation potentially due to afterload dependency. Afterload‐independent left ventricular stroke work index (LVSWI) is alternatively recommended by the current guideline; however, pulmonary artery catheters are rarely inserted in organ donors in most jurisdictions. We propose a novel non‐invasive echocardiographic parameter, Pressure‐Strain Product (PSP), as a potential surrogate of catheter‐based LVSWI. This study aimed to investigate if PSP could correlate with catheter‐based LVSWI in an ovine model of brain stem death (BSD) donors. The association between PSP and myocardial mitochondrial function in the post‐transplant hearts was also evaluated.MethodsThirty‐one female sheep (weight 47 ± 5 kg) were divided into two groups; BSD (n = 15), and sham neurologic injury (n = 16). Echocardiographic parameters including global circumferential strain (GCS) and global radial strain (GRS) and pulmonary artery catheter‐based LVSWI were simultaneously measured at 8‐timepoints during 24‐h observation. PSP was calculated as a product of GCS or GRS, and mean arterial pressure for PSPcirc or PSPrad, respectively. Myocardial mitochondrial function was evaluated following 6‐h observation after heart transplantation.ResultsIn BSD donor hearts, PSPcirc (n = 96, rho = .547, p < .001) showed the best correlation with LVSWI among other echocardiographic parameters. PSPcirc returned AUC of .825 to distinguish higher values of cardiomyocyte mitochondrial function (cut‐off point; mean value of complex 1,2 O2 Flux) in post‐transplant hearts, which was greater than other echocardiographic parameters.ConclusionsPSPcirc could be used as a surrogate of catheter‐based LVSWI reflecting mitochondrial function.

2024-08-02·Physical Therapy

Holistic Care for People Living With Chronic Musculoskeletal Pain: The Relevance and Importance of Sexual Function

Article

作者: Restoux, Laura ; Dobo, Brooke ; Briggs, Andrew M ; Ackerman, Ilana N ; Slater, Helen ; Ross, Megan H

Abstract People living with chronic primary or secondary musculoskeletal pain conditions such as low back pain, fibromyalgia, and inflammatory arthritis typically experience wide-ranging impacts on their physical function, activity participation, and psychosocial wellbeing. These can extend to negative impacts on a person’s sexual function and their intimate relationships. While sexual function is an important component of wellbeing, it is often not considered within musculoskeletal pain care. Without awareness or targeted training, physical therapists may lack the confidence and skills to screen, assess, and manage the impacts that pain may be having on a person’s sexual function and can miss the opportunity to tailor their care and optimize wellbeing. This article seeks to raise awareness among physical therapists of how living with chronic musculoskeletal pain can impact a person’s sexual function and intimate relationships, and provide guidance on how to consider these issues within a person-centered approach to care. It describes why considering sexual function and intimate relationship issues as part of a person’s lived musculoskeletal pain experience may be relevant, outlines the use of validated patient-reported outcome measures to assess sexual dysfunction, and suggests practical strategies for sensitively raising sexual function in consultations. Management approaches and possible referral pathways are also presented, to assist physical therapists in understanding available care options. This article seeks to support holistic care by improving physical therapists’ knowledge and understanding of sexual dysfunction and its management in people living with chronic musculoskeletal pain.ImpactConsidering sexual function as a valued functional activity, together with other activities of daily living, will assist physical therapists to provide more holistic and person-centered care. This article covers the main considerations for raising sexual function and intimate relationship issues with people living with chronic musculoskeletal pain, as well as management options and potential referral pathways. Physical therapists are encouraged to seek targeted training to improve their confidence and skills in this area, and to use inclusive, respectful language for discussions around sexual function and intimate relationships.

2024-08-01·Journal of Urology

Beyond Prostate Imaging Reporting and Data System: Combining Magnetic Resonance Imaging Prostate Imaging Reporting and Data System and Prostate-Specific Membrane Antigen–Positron Emission Tomography/Computed Tomography PRIMARY Score in a Composite (P) Score for More Accurate Diagnosis of Clinically Significant Prostate Cancer

Article

作者: Fendler, Wolfgang ; Calais, Jeremie ; Emmett, Louise ; Ho, Bao ; Burger, Irene ; Rasiah, Kris ; Papa, Nathan ; Roberts, Matthew ; Kasivisvanathan, Veeru ; Murphy, Declan ; Agrawal, Shikha ; Hsiao, Edward ; Buteau, James ; Hofman, Michael S. ; Nguyen, Andrew ; Hope, Thomas A. ; Frydenberg, Mark ; Thompson, James ; Eiber, Matthias ; John, Nikeith ; Yaxley, John ; Moon, Daniel ; Stricker, Phillip ; Liu, Victor ; Barbato, Francesco ; Lee, Jonathan ; Franklin, Anthony ; Perry, Elyse ; Xue, Alan ; Counter, William ; Sutherland, Thomas ; Woo, Henry

PURPOSEThe Prostate Imaging Reporting and Data System (PI-RADS) score is standard of care for clinically significant prostate cancer (csPCa) diagnosis. The PRIMARY score (prostate-specific membrane antigen [PSMA]-positron emission tomography [PET]/CT) also has high diagnostic accuracy for csPCa. This study aimed to develop an easily calculated combined (P) score for csPCa detection (International Society of Urological Pathology [ISUP] ≥2) incorporating separately read PI-RADS and PRIMARY scores, with external validation.MATERIALS AND METHODSTwo datasets of men with suspected PCa, no prior biopsy, recent MRI and ⁶⁸Ga-PSMA-11-PET/CT, and subsequent transperineal biopsy were evaluated. These included the development sample (n = 291, 56% csPCa) a prospective trial and the validation sample (n = 227, 67% csPCa) a multicenter retrospective database. Primary outcome was detection of csPCa (ISUP ≥2), with ISUP ≥ 3 cancer detection a secondary outcome. Score performance was evaluated by area under the curve, sensitivity, specificity, and decision curve analysis.RESULTSThe 5-point combined (P) score was developed in a prospective dataset. In the validation dataset, csPCa was identified in 0%, 20%, 52%, 96%, and 100% for P score 1 to 5. The area under the curve was 0.93 (95% CI: 0.90-0.96), higher than PI-RADS 0.89 (95% CI: 0.85-0.93, P = .039) and PRIMARY score alone 0.84 (95% CI: 0.79-0.89, P < .001). Splitting scores at 1/2 (negative) vs 3/4/5 (positive), P score sensitivity was 94% (95% CI: 89-97) compared to PI-RADS 89% (95% CI: 83-93) and PRIMARY score 86% (95% CI: 79-91). For ISUP ≥ 3, P score sensitivity was 99% (95% CI: 95-100) vs 94% (95% CI: 88-98) and 92% (95% CI: 85-97) for PI-RADS and PRIMARY scores respectively. A maximum standardized uptake value > 12 (P score 5) was ISUP ≥ 2 in all cases with 93% ISUP ≥ 3.CONCLUSIONSThe P score is easily calculated and improves accuracy for csPCa over both PI-RADS and PRIMARY scores. It should be considered when PSMA-PET is undertaken for diagnosis.

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