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Brisbane, Australia

Bauer J.,University of Queensland | Egan E.,The Wesley Hospital | Clavarino A.,University of Queensland
e-SPEN | Year: 2011

Background & Aims: To evaluate the scored patient-generated subjective global assessment (PG-SGA) as a nutrition assessment tool in subjects with chronic obstructive pulmonary disease. Methods: Seventy-two participants attending a pulmonary rehabilitation program (22M, 50F; mean age 66.6 ± 8.6 y). Nutritional status was assessed using the scored PG-SGA - global categorisation and score; fat free mass index. Results: According to the subjective global assessment, 61 participants were well-nourished and 11 were moderately malnourished. Well-nourished participants had significantly lower PG-SGA scores (5.9 ± 3.0 vs 12.1 ± 5.4), higher % oxygen saturation (94.9 ± 2.8 vs 93.6 ± 2.4) and higher BMI (27.8 ± 6.1 vs 19.5 ± 3.2) than malnourished. There was a significant correlation between PG-SGA score and % oxygen saturation (r = -0.275, p = 0.026) and 6-min walking distance (r = -0.245, p = 0.044). The PG-SGA score had an 82% sensitivity and 79% specificity of predicting the global categorisation of nutritional status. Conclusions: The scored PG-SGA identifies malnutrition in participants with chronic obstructive pulmonary disease. The nutritional status of subjects attending pulmonary rehabilitation programs could be assessed and tracked with the scored PG-SGA. © 2010 European Society for Clinical Nutrition and Metabolism. Source

Cristaudo A.,Princess Alexandra Hospital | Nayak A.,Princess Alexandra Hospital | Martin S.,The Wesley Research Institute | Adib R.,The Wesley Hospital | Martin I.,Princess Alexandra Hospital
International Journal of Surgery | Year: 2015

The totally extraperitoneal (TEP) approach for surgical repair of inguinal hernias has emerged as a popular technique. We conducted a prospective randomised trial to compare patient comfort scores using different mesh types and fixation using this technique.Over a 14 month period, 146 patients underwent 232 TEP inguinal hernia repairs. We compared the comfort scores of patients who underwent these procedures using different types of mesh and fixation. A non-absorbable 15 × 10 cm anatomical mesh fixed with absorbable tacks (Control group) was compared with either a non-absorbable 15 × 10 cm folding slit mesh with absorbable tacks (Group 2), a partially-absorbable 15 × 10 cm mesh with absorbable tacks (Group 3) or a non-absorbable 15 × 10 cm anatomical mesh fixed with 2 ml fibrin sealant (Group 4). Outcomes were compared at 1, 2, 4 and 12 weeks using the Carolina Comfort Scale (CCS) scores.At 1, 2, 4 and 12 weeks, the median global CCS scores were low for all treatment groups. Statistically significant differences were seen only for median CCS scores and subscores with the use of partially-absorbable mesh with absorbable tacks (Group 3) at weeks 2 and 4. However, these were no longer significant at week 12.In this study, the TEP inguinal hernia repair with minimal fixation results in low CCS scores. There were no statistical differences in CCS scores when comparing types of mesh, configuration of the mesh or fixation methods. © 2015 IJS Publishing Group Limited. Source

Hung Y.-C.,University of Queensland | Bauer J.D.,University of Queensland | Bauer J.D.,The Wesley Research Institute | Horsely P.,The Wesley Hospital | And 3 more authors.
Nutrition | Year: 2014

Objective: The aim of this study was to assess the agreement between detected changes in body composition determined by bioimpedance spectroscopy (BIS) and air-displacement plethysmography (ADP) among patients with cancer undergoing peripheral blood stem cell transplantation (PBSCT); and to assess the agreement of absolute values of BIS with ADP and dual energy x-ray (DXA). Methods: Forty-four adult hematologic cancer patients undergoing PBSCT completed both BIS and ADP assessment at preadmission and at 3 mo after transplantation. A subsample (n = 11) was assessed by DXA at 3 mo after transplantation. Results were examined for the BIS instrument's default setting and three alternative predictive equations from the literature. Agreement was assessed by the Bland-Altman limits of agreement analysis while correlation was examined using the Lin's concordance correlation. Results: Changes in body composition parameters assessed by BIS were comparable with those determined by ADP regardless of the predictive equations used. Bias of change in fat-free mass was clinically acceptable (all <1 kg), although limits of agreement were wide (more than ±6 kg). Overall, the BIS predictive equation accounting for body mass index performed the best. Absolute body composition parameters predicted by the alternative predictive equations agreed with DXA and ADP better than the BIS instrument's default setting. Conclusion: Changes predicted by BIS were similar to those determined by ADP on a group level; however, agreement of predicted changes at an individual level should be interpreted with caution due to wide limits of agreement. © 2014 Elsevier Inc. Source

Thompson B.S.,University of Queensland | Coory M.D.,Senior Research Fellow in Clinical Epidemiology | Lumley J.W.,The Wesley Hospital
Medical Journal of Australia | Year: 2011

Objective: To examine the trends in the uptake of laparoscopic resection for colorectal cancer. Design and setting: Retrospective analysis of Australia-wide data on elective resections for colorectal cancer over the 8 financial years 2000-01 to 2007-08, obtained from the National Hospital Morbidity Database. Main outcome measures: National trends in annual percentage of colorectal resections for cancer that were conducted laparoscopically for each year, stratified by hospitals conducting a high volume of elective resections (40 or more/year) versus a low volume, and by public versus private hospitals. Results: For all Australian hospitals combined, the percentage of resections for colon cancer conducted laparoscopically increased from 2.4% in 2000-01 to 27.5% in 2007-08. For rectal cancer, this increase was from 1.1% to 21.5%. The largest increases were seen in high-volume private hospitals (colon cancer, 2.7% to 34.1%; rectal cancer, 1.5% to 26.2%), but increases also occurred in high-volume public hospitals (colon cancer, 2.7% to 32.2%; rectal cancer, 0.5% to 20.3%), low-volume private (colon cancer, 3.8% to 27.1%; rectal cancer, 2.4% to 25.5%) and low-volume public (colon cancer, 1.1% to 17.0%; rectal cancer, 0.5% to 13.8%) hospitals. Conclusions: The use of laparoscopic resection for colorectal cancer has increased throughout Australian hospitals. Our findings provide the data necessary to ensure adequate resource allocation by the appropriate medical bodies to achieve optimal success in the uptake of laparoscopic resection for colorectal cancer in Australia. Source

Hung Y.-C.,University of Queensland | Bauer J.,University of Queensland | Horsley P.,The Wesley Hospital | Isenring E.,University of Queensland
Journal of Human Nutrition and Dietetics | Year: 2014

Background: This study aimed to determine patient satisfaction with clinical nutrition services delivered by an accredited practicing dietitian amongst cancer patients treated with autologous stem cell transplantation that was provided with usual and extended care at 100 days post-transplantation. Methods: Patients were randomised to receive usual nutrition care or extended nutrition care during the course of their stem cell transplantation. After hospital discharge, usual care patients received no further nutrition support, whereas extended care patients received telephone dietary counselling from the same dietitian for up to 100 days post-transplantation. The patient satisfaction with clinical nutrition service questionnaire was completed anonymously at 100 days post-transplantation. Group comparisons were made using independent t-tests. Results: Thirty-seven patients consented to participate in the study (54% male; mean age 58.7 ± 9.5 years; median body mass index 26.8 kg m-2, range 16.4-47.6 kg m-2); 33 patients completed the study and 28 patients returned the questionnaire (response rate = 85%). All components of the questionnaire were rated highly by both groups; there was no significant difference between the groups (P > 0.05). Although not statistically significant, extended care patients who received at least three telephone calls rated a higher overall satisfaction compared to those who received less calls; this difference was clinically important (score difference = 0.56). Conclusions: Cancer patients treated with autologous stem cell transplantation were satisfied with usual and extended nutrition care. Extended care patients who received at least three telephone calls after hospital discharge were more satisfied than those with less frequent intervention. Further exploration regarding the frequency and intensity of nutrition service is required. © 2013 The British Dietetic Association Ltd. Source

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