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Geelong West, Australia

Gates P.,Geelong Hospital
Practical Neurology | Year: 2011

The brainstem is incredibly complex. It contains nuclei, pathways and structures, many with unusual names such as the olives, medial longitudinal fasciculus and the superior and inferior colliculi. The neurological examination can only assess some of them. This article is designed to help make sense of the signs in the more common brainstem syndromes using 'the rule of 4'. Source

Somers G.T.,Monash University | Spencer R.J.,Geelong Hospital
Australian Journal of Rural Health | Year: 2012

Objective: Do undergraduate rural clinical rotations increase the likelihood of medical students to choose a rural career once pre-existent likelihood is accounted for? Design: A prospective, controlled quasi-experiment using self-paired scores on the SOMERS Index of rural career choice likelihood, before and after 3years of clinical rotations in either mainly rural or mainly urban locations. Setting: Monash University medical school, Australia. Participants: Fifty-eight undergraduate-entry medical students (35% of the 2002 entry class). Main outcome measures: The SOMERS Index of rural career choice likelihood and its component indicators. Results: There was an overall decline in SOMERS Index score (22%) and in each of its components (12-41%). Graduating students who attended rural rotations were more likely to choose a rural career on graduation (difference in SOMERS score: 24.1 (95% CI, 15.0-33.3) P<0.0001); however, at entry, students choosing rural rotations had an even greater SOMERS score (difference: 27.1 (95% CI, 18.2-36.1) P<0.0001). Self-paired pre-post reductions in likelihood were not affected by attending mainly rural or urban rotations, nor were there differences based on rural background alone or sex. Conclusions: While rural rotations are an important component of undergraduate medical training, it is the nature of the students choosing to study in rural locations rather than experiences during the course that is the greater influence on rural career choice. In order to improve the rural medical workforce crisis, medical schools should attract more students with pre-existent likelihood to choose a rural career. The SOMERS Index was found to be a useful tool for this quantitative analysis. © 2012 The Authors. Australian Journal of Rural Health © 2012 National Rural Health Alliance Inc. Source

Chan Z.H.,Geelong Hospital
Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand | Year: 2013

Open carpal tunnel release is commonly performed under local anaesthesia. No study has compared intra-operative short- versus long-acting local anaesthetics as preemptive analgesics in carpal tunnel surgery. In this single-blinded prospective study, 100 consecutive carpal tunnel releases were performed by a single surgeon at one institution with either lignocaine (n = 50) or ropivacaine (n = 50). Allocation was performed via the method of alternation. Subjects were given a questionnaire to answer the following: (1) time to first incidence of pain, (2) quality of first night's sleep, and (3) mean numerical pain scores in the first 24 hours. The time to the first postoperative pain was significantly shorter in the lignocaine group (5.58 vs. 9.17 hours, p < 0.035). There were no significant difference in the incidence of poor first night's sleep (16% vs. 26%, p = 0.28) or mean pain scores in the first day (3.6 vs. 2.9, p = 0.16). Existing evidence advocates for long-acting intraoperative local anaesthetic because it results in a longer duration of postoperative analgesia, however, our study suggests that it may also result in a poorer first night's sleep. Source

Machado C.,Geelong Cardiology Research Unit | Appelbe A.,Geelong Hospital | Wood R.,Geeloong Private Hospital
Heart Lung and Circulation | Year: 2012

Cobaltism related to athroplasty implants has been anecdotally documented in at least six cases presenting with a combination of neurological, endocrine and cardiac symptoms with improvement in most symptoms after revision. Causality however has not been well established.This report documents the case of a 75 year-old male farmer who presents with possible cobalt cardiomyopathy from severe cobalt poisoning in the setting of arthroprosthetic cobaltism with symptomatic improvement upon revision of the hip. © 2012 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Source

Background: To determine if there is a different clinical outcome after TransFix versus endobutton femoral fixation in hamstring anterior cruciate ligament (ACL) reconstruction. Methods: Twenty-nine patients were randomized into either Endobutton (Smith & Nephew, Andover, MA, USA) (n = 13) or TransFix (Arthrex, Naples, FL, USA) (n = 16) femoral fixation in hamstring ACL reconstruction. The distal fixation was with a bioabsorbable interference screw. The evaluation methods were clinical history and examination, KT1000 arthrometry for laxity as well as the International Knee Documentation Committee (IKDC) scores over a 2-year time frame. Results: There were no significant differences between the study groups preoperatively. For the 2-year follow-up, 11 patients in the Endobutton group and 13 patients in the TransFix group were available (greater than 80%). No statistical differences between the two groups were found at the 1- or 2-year follow-up examinations. At the 2-year follow-up, 72.7% of the Endobutton and 84.6% of the TransFix group patients were in the IKDC A or B categories. Additional procedures postoperatively occurred more frequently in the TransFix group. Conclusions: There were no significant differences in the results for either technique of femoral fixation. Level of Evidence: Level I. © 2009 Royal Australasian College of Surgeons. Source

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