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With an upcoming publication in the Worldwide Leaders in Healthcare, Nyree L. Parker, RN/Clinical Nurse Specialist, Dip. Health Science, BN, Graduate Certificate of Health Education, Graduate Certificate Health Promotion, Graduate Diploma Critical Care/Emergency, MN, Master Degree in Disaster Health, joins the prestigious ranks of the International Nurses Association. She is a Registered Nurse with twenty-four years of experience in her field and extensive expertise in all facets of nursing, including emergency care and Disaster Health. Nyree is currently serving patients as Clinical Nurse Specialist in the Emergency Department and Emergency Management and BCP Consultant in the Facilities Management Department at Peninsula Health in Victoria, Australia. This involves policy and procedure/plan writings for i.e. mass casualties incidents, CBR decontamination processes, pandemics, heatwaves, bushfires and severe weather impacting on the public hospital organisation. Furthermore, she works as Assistance in Care Emergency Volunteer Coordinator in the Emergency Departments at Peninsula Health Frankston Hospital in Frankston, Victoria, Australia. Nyree acquired her graduate diploma in applied sciences in 1991 at Monash University, where she also received her bachelor degree of nursing in 1992. She also obtained a diploma of critical care nursing majoring in Emergency care (1997), a master degree of nursing (2001), and a Master Degree in emergency Disaster Health (2013) at Monash University. In 1998, Nyree earned a postgraduate certificate in health promotion from Deakin University. She is a Clinical Nurse Specialist and was a Trauma Nursing Core Course Instructor as well as a member of the Australian College of Emergency Nursing, the Victoria Hospital Management Forum, the Royal College of Nursing Australia, the Australian Nurses Federation, and an active member of the Nursing Section of the World Association of Disaster Emergency Medicine. Furthermore, she was honoured with the Dux of Group Award in 2009 and was a volunteers with St. John’s Ambulance. Nyree credits her success to being a third generation nurse in her family. She also has acted as a Clinical Instructor of Emergency Management and Critical Care at Monash University. Nyree is aiming to commence her PhD in Disaster Health looking at topics of climate change implications on emergency nurses and the role of an Emergency Management Consultant in the hospital environment. In her spare time, Nyree enjoys reading the Great Hospital Emergency Disaster Relief Journal and the Emergency Medicine News Journal. She also dedicates to dog walking and antique shopping and driving her 1948 Morris car! Learn more about Nyree here: http://inanurse.org/network/index.php?do=/4125803/info/ and read her upcoming publication in the Worldwide Leaders in Healthcare.


News Article | December 28, 2016
Site: www.cemag.us

The year 2016 has seen the deaths of many celebrities from the world of entertainment … Prince, David Bowie, Gwen Ifill, Florence Henderson, Muhammad Ali, and just this week we lost George Michael and Carrie Fischer. We’ve also had to bid farewell to many scientists and innovators this year. Here are just a few of those we lost in 2016 — we thank them for their significant contributions to science and technology. Marvin Minsky, a pioneer in the field of artificial intelligence, died on Jan. 24. The MIT computer science instructor laid the groundwork for AI when he demonstrated the possibilities of imparting common-sense reasoning to computers. Starting in the 1950s, he studied computational ideas in order to characterize human psychological processes. He then came up with theories on machines could be endowed with intelligence. He co-founded the MIT Artificial Intelligence Project (later the Artificial Intelligence Laboratory) in 1959. Edgar Mitchell, the lunar module pilot on Apollo 14, died on Feb. 4. He was the sixth man to walk on the moon (out of just 12 total). Mitchell and Alan Shephard Jr., the first American in space, touched down on the moon on Feb. 5, 1971, in order to travel on the lunar surface to deploy scientific instruments and perform a communications test. Mitchell spent 33 hours on the surface of the moon. The Apollo 14 mission was his only time in space. Ray Tomlinson, the man who invented email and selected the @ symbol for use in email addresses, died on March 5. Tomlinson invented a program for ARPANET, the Internet’s predecessor, in 1971 — the program enabled people to send personal messages to other computer users on other servers. The @ symbol was chosen for email addresses because Tomlinson deduced that the symbol would not otherwise be part of the address — some say the symbol may have faded out of use entirely had it not been for him. Zaha Hadid, a groundbreaking architect from Britain by way of Iraq, died on March 31. Her designs, experts note, were not pigeonholed by her background or her gender. She became the first woman to win the Pritzker Prize, “architecture’s Nobel,” in 2004, and the first on her own merit to be awarded the RIBA Gold Medal, Britain’s top architectural award, in 2015. Her science-related designs include the Phaeno Science Center in Germany, Maggie's Centres at the Victoria Hospital in Scotland, and Innovation Tower at Hong Kong Polytechnic University. She also designed the London Aquatics Centre for the 2012 Olympics. Dr. Gordon Hamilton, a climate scientist who studied glaciers and their impact on sea levels in a warming climate, died Oct. 22. He perished in a snowmobile accident in Antarctica. Hamilton traveled to the Antarctic each winter and to Greenland each summer, to study the behavior of modern ice sheets and their role in the climate system and modulating global sea levels. “The things I’ve seen in Greenland in the last five years are alarming,” Hamilton said to the The New York Times six years ago. “We see these ice sheets changing literally overnight.” He was a professor at the University of Maine. Dr. Piers Sellers, a climate change scientist and former NASA astronaut, died on Dec. 23. He served as the acting director of the Earth Sciences Division at NASA's Goddard Space Flight Center in Greenbelt, Md. After learning he had terminal pancreatic cancer, Sellers devoted the rest of his life to confronting the challenges of climate change, as he noted during his appearance in Leonardo DiCaprio's climate change documentary Before the Flood. John Glenn, a former NASA astronaut and U.S. Senator, died on Dec. 8. Glenn was one of NASA's original seven Mercury astronauts, and became the first American to orbit the earth when he flew on the Friendship 7 on Feb. 20, 1962. The astronaut faced life-threatening problems when the spacecraft’s automatic control system malfunctioned and its heat shield loosened, but Glenn made it safely back to Earth and was hailed as a national hero. Glenn returned to space at age 77 — he spent 9 days on the space shuttle Discovery in 1998, where he participated in a series of tests on the aging process. Dr. Edwin Goldwasser, a physicist who co-founded the Fermi National Accelerator Laboratory, died Dec. 14. Goldwasser persuaded President Lyndon Johnson to establish a high-flight research facility in Illinois in order to attract more physics students to the Midwest. During the 1960s Goldwasser became the deputy director for what became known as Fermilab in Batavia, Ill., which does particle physics research and has contributed to major discoveries in medicine, energy, and the origins of the universe. During the Cold War he convinced President Richard Nixon to permit scientific exchanges with Soviet physicists. When the Soviets refused to invite the recommended number of Israeli physicists to an international meeting in the present-day country of Georgia, Goldwasser threatened to cancel the meeting — the Soviets gave in. Vera Rubin, who discovered evidence of dark matter, died on Dec. 25. The astrophysicist, who was elected to the National Academy of Sciences and awarded the National Medal of Science, was the first woman allowed to observe at Caltech's Palomar Observatory. Turned away by Princeton University, Rubin instead studied at Cornell and Georgetown — she began her Ph.D. program at the age of 23, while pregnant and also caring for another young child at home. Image Credit: Piers Sellers most recently served as the deputy director of the Sciences and Exploration Directorate and acting director of the Earth Sciences Division at NASA’s Goddard Space Flight Center in Greenbelt, Md. Image: NASA/Rebecca Roth


Javed A.,St Vincent And Mercy Private Hospital | Javed A.,Victoria Hospital | O'Donnell J.M.,St Vincent And Mercy Private Hospital
Journal of Bone and Joint Surgery - Series B | Year: 2011

We reviewed the clinical outcome of arthroscopic femoral osteochondroplasty for cam femoroacetabular impingement performed between August 2005 and March 2009 in a series of 40 patients over 60 years of age. The group comprised 26 men and 14 women with a mean age of 65 years (60 to 82). The mean follow-up was 30 months (12 to 54). The mean modified Harris hip score improved by 19.2 points (95% confidence interval 13.6 to 24.9; p < 0.001) while the mean non-arthritic hip score improved by 15.0 points (95% confidence interval 10.9 to 19.1, p < 0.001). Seven patients underwent total hip replacement after a mean interval of 12 months (6 to 24 months) at a mean age of 63 years (60 to 70). The overall level of satisfaction was high with most patients indicating that they would undergo similar surgery in the future to the contralateral hip, if indicated. No serious complications occurred. Arthroscopic femoral osteochondroplasty performed in selected patients over 60 years of age, who have hip pain and mechanical symptoms resulting from cam femoroacetabular impingement, is beneficial with a minimal risk of complications at a mean follow-up of 30 months. ©2011 British Editorial Society of Bone and Joint Surgery.


Kumar K.,Victoria Hospital | Singh S.I.,Victoria Hospital
Journal of Anaesthesiology Clinical Pharmacology | Year: 2013

Pruritus is a troublesome side-effect of neuraxial (epidural and intrathecal) opioids. Sometimes it may be more unpleasant than pain itself. The prevention and treatment still remains a challenge. A variety of medications with different mechanisms of action have been used for the prevention and treatment of opioid-induced pruritus, with mixed results. The aim of this article is to review the current body of literature and summarize the current understanding of the mechanisms and the pharmacological therapies available to manage opioid-induced pruritus. The literature source of this review was obtained via PubMed, Medline and Cochrane Database of Systematic Reviews until 2012. The search results were limited to the randomized controlled trials, systemic reviews and non-systemic reviews.


Osteomas are benign tumours characterized by proliferation of compact or cancellous bone. The most common site is the mandible, followed by the sinuses. These tumours are slow-growing, usually asymptomatic, and are generally discovered as incidental radiological findings. Osteomas occur commonly in frontal sinus, followed by the ethmoid and maxillary sinus, and very rarely in the sphenoid sinus. Symptoms arise when osteomas obstruct the ostium of the sinus or impinge on adjacent orbital or intracranial structures. Two cases of maxillary sinus osteoma are presented along with a review of the literature.


Cundy T.,University of Auckland | MacKay J.,Victoria Hospital
Current Opinion in Gastroenterology | Year: 2011

Purpose of Review: Hypomagnesaemia has recently been recognized as a rare, but severe, complication of proton pump inhibitor (PPI) use. We reviewed all the cases published to date in peer-reviewed journals to summarize what is known of the epidemiology, risk factors, cause and treatment. Recent Findings: Hypomagnesaemia has been described with all substituted pyridylmethylsulphonyl benzimidazadole derivatives and is a class effect, recurring with substitution of one PPI for another. A long duration of use and high rates of adherence are probably risk factors, but the prevalence is unknown. The diagnosis is often missed, despite the severe symptomatology. Renal magnesium handling is normal, so implicating impairment of net intestinal absorption as the proximate cause. It is not known whether this is the consequence of defective absorption of magnesium through the active or passive transport processes, or increased losses. Summary: PPI-associated hypomagnesaemia is a rare, but potentially life-threatening, side-effect that has emerged only in the era of mass use of these agents. The cause of hypomagnesaemia remains poorly understood, but it responds rapidly to withdrawal of the PPI. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.


O'Neill S.,Victoria Hospital | Yalamarthi S.,Victoria Hospital
Colorectal Disease | Year: 2012

Aim The study reviews the literature related to ischaemic colitis (IC) to establish an evidence base for its management and to identify factors predicting severity and mortality. Method A systematic review of the English language literature was conducted according to recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. MEDLINE, Embase and Cochrane Library databases were searched using the keyword search 'ischaemic colitis OR colon ischaemia OR colonic ischaemia OR management ischaemic colitis'. IC is often misdiagnosed so only studies where the diagnosis was supported by histopathology in every case were included. Critical appraisal was performed of included studies using predefined quality assessment checklists and narrative data synthesis. Results In all, 2610 publications were identified. Of these, eight retrospective case series and three case controlled studies describing 1049 patients were included. Medical management was used in 80.3% patients of whom 6.2% died. Surgery was required in 19.6% of whom 39.3% died. The overall mortality of IC was 12.7%. Lack of rectal bleeding, peritonism and renal dysfunction were commonly quoted predictors of severity; however, right sided IC appeared to be the most significant predictor of outcome. Conclusion Most patients with IC can be managed conservatively. Right sided IC may be the most significant predictor of severity. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.


Mackay J.D.,Victoria Hospital | Bladon P.T.,Victoria Hospital
QJM | Year: 2010

Background: Reports since 2006 have identified proton-pump inhibitor (PPI) therapy as a cause of hypomagnesaemia, in a total of 13 cases. Aims: To summarize the clinical course of 10 patients (one male, nine female) identified with severe hypomagnesaemia, all of whom were on PPI therapy. A case report illustrates the experience of a severely affected patient. Methods: Clinical and biochemical review. Severe hypomagnesaemia was defined as 0.54 mmol/l or less, >4 SD below the mean. Results: Patients were 68.8±8.6 years old when they presented with severe hypomagnesaemia, having been on PPI therapy for a mean of 8.3±3.5 years. Eight patients were on diuretics at initial presentation. There was significant morbidity as eight patients remained on PPI therapy after presentation for a mean of 2.75±1.54 years. There were 18 emergency hospital admissions with severe hypomagnesaemia. Oral and parenteral magnesium supplements were relatively ineffective at correcting the problem, but stopping PPI therapy lead to prompt resolution of the hypomagnesaemia (within 2 weeks in five carefully monitored patients), with symptomatic benefit. Hypomagnesaemia recurred if PPI therapy was re-introduced because of troublesome dyspepsia. However, pantoprazole, the least potent PPI, largely relieved dyspepsia and hypomagnesaemia did not inevitably develop when combined with oral magnesium supplements. Conclusions: These cases confirm that long-term PPI therapy can cause severe, symptomatic hypomagnesaemia, which resolves when PPI therapy is withdrawn. The serum magnesium should be checked annually in patients on long-term PPI therapy, or if they feel unwell. © The Author 2010. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved.


Viswanatha B.,Victoria Hospital
Ear, Nose and Throat Journal | Year: 2012

A comparative clinical study was carried out that included 50 cases of otomycosis in immunocompetent patients and 50 cases of otomycosis in immunocompromised patients. Clinical presentation, predisposing factors, mycologic profile, and treatment outcomes were compared. Aspergillus spp were the most commonly isolated fungi in the immunocompetent group, and Candida albicans in the immunocompromised group. Bilateral involvement was more common in the immunocompromised group. All the patients were treated with topical clotrimazole ear drops. Four patients in the immunocompromised group did not respond to treatment with clotrimazole but were treated successfully with fluconazole ear drops. Three patients had a small tympanic membrane perforation due to otomycosis. © 2012 Vendome Group, LLC.


Pillay Y.,Victoria Hospital
International Journal of Surgery Case Reports | Year: 2015

Introduction Gallbladder duplication is a rare congenital malformation that occurs in about one in 4000 births. Congenital anomalies of the gallbladder and anatomical variations of their positions are associated with an increased risk of complications after laparoscopic cholecystectomy. Presentation of case We report the case of a double gallbladder in a fifty-six year old man. He presented with recurrent episodes of biliary colic. Pre-operative imaging confirmed the diagnosis. He subsequently underwent surgery for biliary colic. Discussion Inspection of the resected gallbladder specimen showed that it consisted of two chambers with a single cystic duct, which communicated through a common ostium. Both chambers had cholelithiasis. There were two cystic arteries as well. Duplication of the gallbladder has an incidence of approximately 1: 4000. However, the exact incidence of this rare anomaly cannot be accurately assessed, since the only cases which have been identified are those that became symptomatic or were encountered as incidental findings during surgery, imaging studies or at autopsy. Conclusion Duplication of the gallbladder is a rare congenital abnormality, which requires special attention to the biliary ductal and arterial anatomy. Laparoscopic cholecystectomy with intraoperative cholangiography is the appropriate treatment in a symptomatic gallbladder. The removal of an asymptomatic double gallbladder remains controversial. © 2015 Published by Elsevier Ltd. on behalf of Surgical Associates Ltd.

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