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Perth Hospital (perth + hospital)

Distribution by Scientific Domains
Medical Sciences100%

Kinds of Perth Hospital

  • royal perth hospital
    		•

    Selected Abstracts

    Pulmonary hypertension in pregnancy: two cases and review of the literature

    INTERNAL MEDICINE JOURNAL, Issue 11 2009
    A. M. Higton
    Abstract Pulmonary arterial hypertension (PAH) in pregnancy carries a mortality of 30,56%. There are few published data to guide clinicians in its management. Two pregnant women with severe PAH have been treated at Royal Perth Hospital with a successful result in both. Their presentation and management are described. We review the physiological changes in pregnancy, pathophysiology in PAH, and review the literature describing treatment of PAH in pregnancy. [source]

    The formulation and introduction of a ,can't intubate, can't ventilate' algorithm into clinical practice

    ANAESTHESIA, Issue 6 2009
    A. M. B. Heard
    Summary Both the American Society of Anesthesiologists and the Difficult Airway Society of the United Kingdom have published guidelines for the management of unanticipated difficult intubation. Both algorithms end with the ,can't intubate, can't ventilate' scenario. This eventuality is rare within elective anaesthetic practice with an estimated incidence of 0.01,2 in 10 000 cases, making the maintenance of skills and knowledge difficult. Over the last four years, the Department of Anaesthetics at the Royal Perth Hospital have developed a didactic airway training programme to ensure staff are appropriately trained to manage difficult and emergency airways. This article discusses our training programme, the evaluation of emergency airway techniques and subsequent development of a ,can't intubate, can't ventilate' algorithm. [source]

    UPDATE: SNIPPITS OF SCIENCE

    ANZ JOURNAL OF SURGERY, Issue 6 2007
    Article first published online: 9 MAY 200
    The following synopses have been prepared in conjunction with members of the Editorial Board. John Hall (Editor-in-Chief) School of Surgery & Pathology (Royal Perth Hospital) University of Western Australia [source]

    OUTCOMES OF A CONTEMPORARY AMPUTATION SERIES

    ANZ JOURNAL OF SURGERY, Issue 5 2006
    Tao S. Lim
    Background: The aim of this study was to determine the outcomes of a contemporary amputation series. Methods: A retrospective audit of 87 cases of major lower limb amputation from January 2000 to December 2002 from the Department of Vascular Surgery, Royal Perth Hospital, was conducted. Results: The mean age of the study population was 70.1 ± 14.3 years; the male : female ratio was 3.35:1. Comorbid problems included diabetes (49.4%), smoking (81.6%), hypertension (77.0%), ischaemic heart disease (58.6%), stroke (25.3%), raised creatinine level (34.5%) and chronic airway limitation (25.3%). Preamputation vascular reconstructive procedures were common, 34.5% in a previous admission and 23.0% in the same admission. The main indication was critical limb ischaemia (75.9%) followed by diabetic infection (17.2%). There were 51 below-knee (58.6%), 5 through-knee (5.7%) and 31 above-knee (35.6%.) amputations. The below-knee amputation to above-knee amputation ratio was 1.65:1. The overall wound infection rate was 26.4%; the infection rates for below-knee (29.4%) and above-knee (22.6%) amputation did not differ significantly (P = 0.58). Revision rates were 17.6% for below-knee, 20% for through-knee and none for above-knee amputations. Twenty patients (23.0%) underwent subsequent contralateral amputation. Thirty-nine patients (44.8%) were selected as suitable for a prosthesis by a rehabilitation physician; 31 (79.5%) used the prosthesis both indoors and outdoors and 6 (15.4%) used it indoors only within 3 months. Cumulative mortality at 30 days, 6 months, 12 months and 24 months was 10.1, 28.7, 43.1 and 51.7%, respectively. Conclusion: This series agrees with the current published work in finding that patients undergoing major lower limb amputation are older, with a high prevalence of comorbid conditions. Successful prosthesis rehabilitation depends on patient selection and a multidisciplinary approach. Despite a low immediate mortality, the overall long-term results of lower limb amputation remain dismal. [source]

    Thromboprophylaxis practice patterns in hip fracture surgery patients: experience in Perth, Western Australia

    ANZ JOURNAL OF SURGERY, Issue 10 2003
    Susan Wan
    Background: International guidelines recommend that all patients undergoing hip fracture surgery receive specific thromboprophylaxis. The purpose of the present study was to examine current thromboprophylaxis practice patterns in patients undergoing hip fracture surgery at Royal Perth Hospital. Methods: A total of 129 consecutive patients admitted to Royal Perth Hospital between 4 February and 21 July 2002 for surgical repair of a fractured neck of femur, was studied. The primary outcome was the frequency, type, and duration of thromboprophylaxis use during hospitalization. Results: Mean patient age was 79.4 ± 13.4 years and 69.8% (90/129) were female. Seventy-four patients (57.8%; 95% confidence interval (CI): 48.8,66.8%) received specific thromboprophylaxis during hospitalization, including 50 patients (39.1%; 95%CI: 30.6,48.1%) who received pharmacological prophylaxis only, three (2.3%; 95%CI: 0.5,6.7%) who received mechanical prophylaxis only, and 21 (16.4%; 95%CI: 10.5,24.0%) who received both mechanical and pharmacological prophylaxis. Of those receiving pharmacological prophylaxis, 35 (49.3%; 95%CI: 37.2,61.4%) received low-molecular-weight heparin, 26 (36.6%; 95%CI: 25.5,48.9%) received low-dose unfractionated heparin, eight (11.3%; 95%CI: 5.0,21.0%) received warfarin, 35 (49.3%; 95%CI: 37.2,61.8%) received aspirin or clopidogrel, and 27 (38.0%; 95% CI: 26.8,50.3%) received combined anticoagulant and antiplatelet prophylaxis. The median duration of mechanical prophylaxis was 8 days (range: 6,12 days) and that of pharmacological prophylaxis was 12 days (range: 6,26 days). When the 32 patients already taking aspirin or warfarin at the time of admission were excluded, only 45 (46.9%; 95%CI: 36.6,57.3%) of the remaining 96 patients received specific thromboprophylaxis. Conclusion: Specific thromboprophylaxis remains under-utilized in patients undergoing surgery for hip fracture at Royal Perth Hospital. These data should prompt the implementation of effective strategies to improve thromboprophylaxis practice patterns in high-risk orthopaedic patients. [source]

    EGFR mutation testing in NSCLC: Patterns of care and outcomes in Western Australia

    ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 1 2009
    Suzanne WEBB
    Abstract Aims: This study evaluated the EGFR mutation status, administration of gefitinib or erlotinib and outcomes of patients assessed for EGFR mutations since the commencement of testing in Western Australia. Methods: A retrospective study identified patients with NSCLC who undergone EGFR mutation testing in the Department of Anatomical Pathology, Royal Perth Hospital, Western Australia from March 2005 until May 2007. Patient characteristics, cancer history, treatment, outcomes and survival were collected from the medical records and pathology reports. Results: Tumor samples from 64 patients were sequenced for mutations in exons 18,21 EGFR and, of these, 53 patients with NSCLC were included in the analysis. The mean age at diagnosis was 61 years (range 19,80) and most of the tumor samples tested were from female patients (76%). Overall 36% of patients tested were mutation-positive with 95% of mutations occurring in exons 19 or 21. A total of 63% of mutation-positive and 18% of mutation-negative patients were treated with gefitinib or erlotinib. Of these, 83% of patients whose tumors had an EGFR mutation had a favorable response following treatment, compared to 17% of mutation-negative patients. The duration of treatment was longer in mutation-positive patients (mean 30 weeks vs 9 weeks). Conclusion: EGFR mutation testing is not routinely performed in NSCLC in Western Australia. Referral for testing is at the discretion of the treating physician, accounting for the high proportion of women and adenocarcinoma histology. Selection of mutation-positive tumors for treatment with gefitinib or erlotinib is associated with good responses to treatment. This study supports the use of gefitinib or erlotinib in routine clinical practice in patients with NSCLC carrying an EGFR mutation. [source]