Medical Education - Research Publications
Permanent URI for this collection
Search Results
1 - 10 of 1687
-
ItemNon-SARS-CoV-2 respiratory viral detection and whole genome sequencing from COVID-19 rapid antigen test devices: a laboratory evaluation study.(Elsevier BV, 2024-02-07)BACKGROUND: There has been high uptake of rapid antigen test device use for point-of-care COVID-19 diagnosis. Individuals who are symptomatic but test negative on COVID-19 rapid antigen test devices might have a different respiratory viral infection. We aimed to detect and sequence non-SARS-CoV-2 respiratory viruses from rapid antigen test devices, which could assist in the characterisation and surveillance of circulating respiratory viruses in the community. METHODS: We applied archival clinical nose and throat swabs collected between Jan 1, 2015, and Dec 31, 2022, that previously tested positive for a common respiratory virus (adenovirus, influenza, metapneumovirus, parainfluenza, rhinovirus, respiratory syncytial virus [RSV], or seasonal coronavirus; 132 swabs and 140 viral targets) on PCR to two commercially available COVID-19 rapid antigen test devices, the Panbio COVID-19 Ag Rapid Test Device and Roche SARS-CoV-2 Antigen Self-Test. In addition, we collected 31 COVID-19 rapid antigen test devices used to test patients who were symptomatic at The Royal Melbourne Hospital emergency department in Melbourne, Australia. We extracted total nucleic acid from the device paper test strips and assessed viral recovery using multiplex real-time PCR (rtPCR) and capture-based whole genome sequencing. Sequence and genome data were analysed through custom computational pipelines, including subtyping. FINDINGS: Of the 140 respiratory viral targets from archival samples, 89 (64%) and 88 (63%) were positive on rtPCR for the relevant taxa following extraction from Panbio or Roche rapid antigen test devices, respectively. Recovery was variable across taxa: we detected influenza A in nine of 18 samples from Panbio and seven of 18 from Roche devices; parainfluenza in 11 of 20 samples from Panbio and 12 of 20 from Roche devices; human metapneumovirus in 11 of 16 from Panbio and 14 of 16 from Roche devices; seasonal coronavirus in eight of 19 from Panbio and two of 19 from Roche devices; rhinovirus in 24 of 28 from Panbio and 27 of 28 from Roche devices; influenza B in four of 15 in both devices; and RSV in 16 of 18 in both devices. Of the 31 COVID-19 devices collected from The Royal Melbourne Hospital emergency department, 11 tested positive for a respiratory virus on rtPCR, including one device positive for influenza A virus, one positive for RSV, four positive for rhinovirus, and five positive for SARS-CoV-2. Sequences of target respiratory viruses from archival samples were detected in 55 (98·2%) of 56 samples from Panbio and 48 (85·7%) of 56 from Roche rapid antigen test devices. 98 (87·5%) of 112 viral genomes were completely assembled from these data, enabling subtyping for RSV and influenza viruses. All 11 samples collected from the emergency department had viral sequences detected, with near-complete genomes assembled for influenza A and RSV. INTERPRETATION: Non-SARS-CoV-2 respiratory viruses can be detected and sequenced from COVID-19 rapid antigen devices. Recovery of near full-length viral sequences from these devices provides a valuable opportunity to expand genomic surveillance programmes for public health monitoring of circulating respiratory viruses. FUNDING: Australian Government Medical Research Future Fund and Australian National Health and Medical Research Council.
-
ItemEfficacy and safety of oral immunotherapy for peanut, cow's milk, and hen's egg allergy: A systematic review of randomized controlled trials(WILEY, 2023-07)BACKGROUND: Oral immunotherapy (OIT) is a promising treatment for food allergies; however, safety is a concern. We synthesized evidence from the best randomized controlled trials (RCTs) on efficacy/safety of OIT for desensitization (DS) and remission (sustained unresponsiveness (SU)) in IgE mediated allergy to peanut, hen's eggs, and cow's milk. BODY: We searched Pubmed, EMBASE, and Cochrane databases (Until Oct 22) identifying 16 eligible RCTs published in English measuring food allergy by food challenge at the beginning and at the end of the study. The Cochrane Risk of Bias tool was used to assess study quality. We found 18 eligible studies. There was evidence of efficacy for DS for all allergens: peanut (RR 11.32; 95% CI 5.93, 21.60, I2 49%, 8 studies); hen's egg (RR 4.67; 2.66, 8.21, I2 0%, 5 studies); cow's milk (RR 13.98; 3.51, 55.65, I2 0%, 4 studies) and evidence for SU for peanut (RR 7.74; 2.90, 20.69, I2 0%, 3 studies) and hen's egg (RR 6.91; 1.67, 28.57, I2 0%, 2 studies). Allergic events were increased with intervention, and risk of adrenaline use increased for peanut RR 2.96; 1.63, 5.35, I2 0%, 8 studies; egg RR 1.71; 0.42, 6.92, I2 0%, 6 studies; and milk RR 8.45; 2.02, 35.27, I2 0%, 4 studies. CONCLUSION: We found strong evidence that peanut, hen's egg, and cow's milk OIT can induce DS and some evidence for remission. There was a high risk of allergic reactions. Generalizability to the entire food allergic population is not known.
-
ItemSystematic reviews of osteopathic care: protocol for an umbrella review(Taylor and Francis Group, 2024)Background: The practice of osteopathy differs around the world. However, the dominant practice is that of manual therapy interventions guided by assessment of the neuromusculoskeletal system. Patient populations treated by osteopaths vary across the lifespan and include groups with more-nuanced care requirements such as those who are pregnant. The volume of evidence for osteopathy care is increasing. Objectives: This umbrella review seeks to identify systematic reviews of osteopathic care with the purpose of highlighting current knowledge about the high-level evidence underpinning the profession. Methods: The umbrella review will be conducted consistent with the Joanna Briggs Institute umbrella review methodology. Articles will be limited to those describing osteopathic care. An initial search did not identify a similar study and nor is one registered. A search of MEDLINE and CINAHL informed the search syntax. A full search will be performed across MEDLINE (PubMed), CINAHL (EBSCO), Scopus, Web of Science, PEDro, Osteopathic Research Web, AMED, Index to Chiropractic Literature, Cochrane Database of Systematic Reviews, and the Osteopathic Medicine Digital Repository (OSTMED.DR). The reference lists of included articles will be reviewed to identify potentially relevant systematic reviews. Data will be extracted from each systematic review and presented in tabular format. Conclusion: The umbrella review will synthesise what is known about osteopathic care as described in systematic reviews. The review will inform stakeholders about the role of osteopathic care in the health system and provide recommendations for future research. The findings will be submitted for peer-review publication.
-
ItemNo Preview AvailableRecommendations from the Medical Education Editor(WILEY, 2023-04)
-
ItemNo Preview AvailableRecommendations from The Medical Education Editor(WILEY, 2023-07)
-
ItemNo Preview AvailableRecommendations from the Medical Education Editor(WILEY, 2023-10)
-
ItemNo Preview AvailableRecommendations from The Medical Education Editor(WILEY, 2024-01)
-
ItemNo Preview AvailableUtility of the stop and stop-bang questionnaires in a pre-screened population presenting for overnight polysomnography(Wiley, 2009)Obstructive Sleep Apnoea (OSA) is a common condition, the diagnosis of which is often delayed by prolonged waiting lists at the point of referral or in the sleep laboratory. Clinical prediction tools may become useful in triaging assessment and management of this condition.Recent publications have proposed and validated two new pre-opera-tive screening tools for Obstructive Sleep Apnoea (OSA) in surgical patients (STOP and STOP-BANG). These screening tools have not been examined in a general sleep population.Methods: All patients attending for in-laboratory polysomnography at Box Hill Hospital during the study period were asked to complete the STOP questionnaire, and sleep scientists recorded the biometric data required for the BANG component. Polysomnography proceeded with sleep staging and event scoring performed according to the Chicago Criteria.Risk stratification by the STOP and STOP-BANG tools was combined with total Respiratory Disturbance Index from polysomnogram reports.Results: 69 patients have been recruited, although data continues to be collected. As expected, there is a predominance of moderate and severe OSA in this cohort (45/69, 65%).The STOP-BANG tool maintains higher sensitivity, negative predic-tive value and odds ratios than the STOP tool at each degree of OSA severity examined. Receiver operating characteristic curves demonstrate superiority of the STOP-BANG tool for RDI > 15, when compared with STOP-BANG for RDI > 30 and STOP at both RDI cut-offs.Conclusions: With ongoing data collection we hope to confirm trends seen in predictive values with these tools. Removal of less discrimina-tory criteria may improve their statistical usefulness, perhaps allowing development into risk stratification tools that will assist in triaging investigation and management of patients with suspected OSA.
-
ItemRecommendations from The Medical Education Editor(Wiley, 2023-01)This quarterly editorial discussing Respirology articles of continuing educational value is the fourth in a series and the final covering publications from 2022.
-
ItemPrevalence of type 2 diabetes risk factors, including overweight and obesity, among youth attending hospital-based paediatric care in Western Melbourne.(Wiley, 2023-02)AIM: To determine the prevalence of risk factors for type 2 diabetes in overweight and obese adolescents attending hospital-based paediatric care in Western Melbourne. METHODS: One hundred overweight and obese adolescents (aged 10-17 years) who attended an outpatient clinic at Sunshine Hospital between May 2019 and May 2020 were randomly selected following a retrospective chart review of 10-17 years old for whom a height and weight had been documented. Additional risk factors for type 2 diabetes were ascertained via structured telephone interview. Data were analysed to determine the overall prevalence of risk factors for type 2 diabetes, and to evaluate for associations between each parameter with body mass index and the number of risk factors. RESULTS: Of the 487 adolescents who had height and weight data recorded, 45% were overweight or obese. 77% of those who were interviewed had an additional risk factor for type 2 diabetes. No association between the number of risk factors and body mass index standard deviation score was found. Additionally, there was no association between the number of risk factors for type 2 diabetes and either family history of type 2 diabetes or ethnicity. CONCLUSIONS: This paediatric subpopulation had a high rate of risk factors for type 2 diabetes in addition to overweight and obesity, and are at risk of premature mortality and chronic morbidity should they develop type 2 diabetes.