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2. Adherence with Medical Therapy for Primary Open-Angle Glaucoma in Kenya – A Pilot Study

Author

Murdoch I, Nyakundi D, Baker H, Dulku S, and Kiage D

Subjects
adherence, glaucoma, africa, medical treatment, Medicine (General), R5-920
Abstract

Ian Murdoch, 1 David Nyakundi, 2 Helen Baker, 1 Simon Dulku, 3 Daniel Kiage 2 1Institute of Ophthalmology, London EC1V 9EL, UK; 2Innovation Eye Centre Ltd, Kisii, Kenya; 3University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, UKCorrespondence: Ian MurdochInstitute of Ophthalmology, Bath Street, London EC1V 9EL, UKEmail i.murdoch@ucl.ac.ukBackground/Objectives: Adherence is a major challenge in topical glaucoma therapy, particularly in an African context. We report a pilot study assessing adherence independently for the first time in an African context.Subjects/Methods: Participants with newly diagnosed open-angle glaucoma received a weighed bottle of Lumigan 0.01% with counselling on therapy. The bottles were returned monthly for renewal and weighed on return to estimate drops taken during the period. Data collection was for one year with a short compliance questionnaire.Results: 11 patients participated. 5 (45%) failed to complete one full year of topical therapy. The overall mean number of drops per eye per day was 1.74 (SD 0.69) for the 6 with one year of monthly returned bottles and controlled IOPs at each visit. Self-perception of compliance in these patients was good.Conclusion: The signs of poor adherence based on both self-report (previous literature), and in this small-scale study of an objective measure suggest medication may not be the first-line treatment of choice in this environment. Our report does, however, raise the possibility that those patients who return for repeat prescriptions and review are indeed adhering to their treatment regimens.Keywords: adherence, glaucoma, Africa, medical treatment

Published
2020

11. General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multicentre observational study

Author

Odor, P. M., Bampoe, S., Moonesinghe, S. R., Andrade, J., Pandit, J. J., Lucas, D. N., A’Court, A., Abdel-Gadir, D., Abdu, A., Abisogun, C., Aboud, Z., Abrams, J., Ackerman, A., Adamson, C., Addison, R., Adeyeye, A., Adler, R., Aduse-Poku, M., Adyanthaya, S., Ahmad, N., Ahmed, D., Ahmed, A., Akindele, B., Akindele, O., Akrimi, S., Al-Rawi, S., Ali, Y., Allam, J., Allana, A., Allen, K., Allen, O., Amaradasa, N., Amarasekara, L., Amoakwa-adu, F., Anandageetha, P., Anandakrishnan, S., Anandanadesan, R., Anderson, M., Apps, S., Aquilina, A., Arbane, G., Arch, A., Armstrong, S., Arya, R., Ashiru, G., Ashpole, K., Atkinson, C., Atkinson, F., Auer, E., Avery, B., Babio-Galan, M., Bader, H., Badham, G., Bagchi, S., Bailey, S., Baird, Y., Balaka, C., Baldwin, M., Balfour, P., Bali, S., Banks, S., Barclay, P., Barnes, L., Barnes, T., Barot, N., Barrett, S., Barrett, V., Barrett, K., Bates, L., Batte, K., Baytug, B., Behravesh, M., Bell, S., Benloch, R., Bentley, R., Berg, J., Berwick, C., Berwick, R., Bhadange, R., Bhattacharyya, S., Bielskute, E., Birch, S., Bird, S., Bird, Ruth, Birts, William, Black, Becky, Blagova, Tatyana, Blake, Holly, Blightman, Oliver, Blunden, Susara, Bolton, R., Borkett-Jones, C., Boselli, J., Bowen, M., Bowen, R., Bowyer, J., Boyle, H., Brar, Z., Bray, J., Brayshaw, S., Bressington, C., Brewer, A., Brice, N., Bridge, L., Briscoe, J., Brocklesby, S., Brown, H., Brown, S., Brunnen, D., Burijintichenna, K., Burnard, S., Burtt, A., Buswell, V., Bykar, H., Cairney, M., Calvert, C., Camarasa, L., Campbell, N., Campbell-Jones, F., Cantliffe, J., Carrol, W., Carvalho, J., Cashell, C., Cassie, S., Cassim, K., Chandler, M., Chapman, R., Charles, R., Chen, P., Cheyne, D., Chima, K., Chin, F., Chirvasuta, R., Shao Chong, M., Choudhury, S., Chowdhury, P., Christmas, T., Chughwani, S., Ciechanowicz, S., Clarey, E., Coe, R., Cohen, J., Coker, N., Collins, K., Collis, L., Comar, J., Conroy, M., Constantin, K., Corfe, J., Coulborn, E., Cowie, V., Crone, R., Cronin, J., Crooks, J., Crowther, N., Crowther, E., Cruz, C., Curtis, A., Curtis, S., Dabrowicz, A., Daines, N., Dalal, V., Dannatt, P., Das, D., Dash, J., Davidson, K., Davies, S., Davis, Y., Dawson, J., Dean, J., Dean, C., Denman, J., Desai, N., Dewan, P., Dimont, S., Donovan, C., Doraiswami, M., Doughty, K., Douglass, J., Dower, M., Downing, S., Duberry, W., Duckham, E., Dudgeon, L., Dukes, S., Dunn, L., Duraiswamy, V., Dwyer, A. O., Dyer, K., Eapen, S., Earl, M., Eason, S., Edwards, K., Edwards, Z., Egole, O., Ekpa, J., el-Amin, O., el-Boghdadly, K., Elbasir, O., Eldridge, J., Elgie, L., Ellington, M., Elliott, K., Elliott, J., Elmi, M., Elnoumeir, R., Emeakaraoha, E., Evans, M., Everett, M., Fabb, P., Farooq, H., Farrimond, R., Faulds, F., Fawcett, E., Feneley, A., Fernando, D., Ferns, J., Finlay, C., Fitzgerald, S., O’Flaherty, D., Fleet, M., Fletcher, L., Fludder, V., Follet, T., Forbes, J., Forth, M., Foster, G., Francis, J., Fraser, K., Friedman, L., Fruggeri, L., Fulton, L., Funnell, S., Gadre, A., Gandhi, A., Gardiner, H., Garner, Z., Garvey, G., Gately, T., George, R., Gillespie, S., Glover, S., Goddard, J., Goodman, B., Gopal, T., Graham, G., Green, D., Griffin, D., Griffith, J., Grigsby, S., Grindey, J., Griffiths, H., Groome, J., Grother, C., Grounds, G., Groves, A., Guha, A., Gunawardhana, A., Gupta, A., Gupta, R., Gutsell, J., Haddon, R., Hadi, D., Hadjipavlou, N., Hammerbeck, H., Hammon, L., Hammond, S., Hampanna, H., Hancock, H., Handapangoda, H., Haroon-Mowahed, Y., Harpham, D., Harris, G., Harrison, A., Harshan, D., Hartopp, A., Harty, E., Haslam, N., Hawkins, G., Hawkins, E., Hawksey, S., Hays, C., Hazelton, T., Heavyside, A., Hemeson, C., Henderson, K., Henry, O., Herbert, L., Higgins, N., Hilton, J., Hindmoor, C., Hitchcock, R., Hobbs, L., Homsy, M., Honeywell, C., Hoque, N., House, K., Howle, R., Tiller, A., Huniak, M., Hunte, J., Husain, T., Huson, C., Hussain, C., Hussain, T., Hussein, Z., Hyams, J., Hyde, E., Laverdino, M., Ignacka, A., Innes, E., Ioannidis, S., Iqbal, R., Ismail, F., Jackson, J., Jackson, M., Jackson, G., Jacobs, R., Jadhav, P., Jalaly, A., James, L., James, M., Jani, S., Jeganathan, C., Joannides, C., Johnson, R., Johnson, T., Johnston, C., Jones, R., Jones, T., Kadr, M., Kainth, R., Kane, J., Kanji, R., Kannanparambil, S., Kar, G., Kasianandan, T., Kaskos, H., Kavanagh, L., Kaye, R., Kelliher, L., Kelliot, S., Kelly, J., Kenyon, C., Kessack, L., Kestner, S., Khaku, M., Khaleeq, S., Khan, P., Khan, S., Kidwai, U., King, C., King, H., Kingston, E., Kok, W., Konig, R., Konstantinova, Z., Krishnan, P., Kua, J., Kuntumalla, K., Kursumovic, E., Kurzatkowski, K., Kuttambakam, H., Lane, K., Lane, S., Langton, A., Latif, H., Lau, N., Laxman, S., Laycock, H., Lee, R., Leonardi, S., Light, K., Lightfoot, H., Liu, S., Liyanage, S., Lowe, J., Lucas, N., Lungu, M., Lunn, M., Lynes, H., Machavarapu, K., Mackenzie, M., Magee, D., Major, J., Male, V., Malik, Z., Manso, K., Maquinana, M., Marciniak, K., Maronge, L., Marsh, C., Martella, C., Martin, N., Martins, N., Marway, J., Mason, L., Masood, N., Masters, J., Maton-Howarth, M., Mazzola, F., McAllister, T., McCarthy, R., McCormick, C., McCready, S., McDougall, S., Mcewan, L., McGarry, J., McKevitt, H., Mckinley, S., Mckskeane, A., McMaster, E., McMonagle, M., McNamara, H., McPhee, H., McRae, L., Mead, D., Meadows, E., Mehta, M., Meikle, J., Metodiev, Y., Michael, C., Millar, V., Miller, S., Miller, G., Milne, S., Miltsios, K., Misquita, L., Misquita, S., Mittal, M., Mohamed, M., Powell Monaghan, K., Monk, J., Monkhouse, A., Monks, D., Montague, L., Moon, A., Moran, J., Moreton, A., Morgan, E., Morgan, O., Morland, D., Morosan, M., Morris, K., Morris, A., Moser, C., Mount, M., Muir, C., Mupudzi, M., Murali, M., Murdoch, I., Murray, H., Murray, T., Murrell, K., Narasimha Murthy, G., Neeley, D., Nei, H., Neil, K., Nejim, T., Nel, M., Nicholson, A., Nicklin, A., Nolan, C., Nolan, T., Nurmi, E., O’Neill, B., Oakes, C., Oakes, N., Ochoa-Ferraro, M., Odeleye, N., Oliver, K., Oliver, M., Onslow, J., Onwochei, D., Oommen, T., Orr, T., Osagie, O., Osborn, H., Overend, J., Owston, H., Pack, E., Padhi, P., Palani, P., Pandey, R., Pandya, D., Panesar, N., Papageorgiou, C., Papanastasiou, G., Papoutsos, C., Pararajasingham, S., Parry, J., Patel, H., Patel, J., Patel, K., Patel, M., Patel, R., Patel, N., Pathak, S., Pearson, F., Peciulene, V., Peers, B., Peirce, B., Pepper, S., Perinpanayagam, J., Perry, H., Petrova, N., Phillips, T., Phillips, S., Phylactides, L., Pilkington, F., Plumb, J., Poimenidi, E., Sau Kuk Poon, A., Potter, T., Poultney, U., Powell, L., Prenter, A., Preston, K., Price, A., Pritchard, N., Pullen, J., Purohit, M., Quamina, C., Qureshi, J., Rajput, Z., Ramage, S., Ramanathan, T., Ranasinghe, U., Ranatunga, K., Rand, A., Randive, S., Rangarajan, D., Rao, C., Rao Pelluri, S., Ratnasingham, A., Razzaque, J., Reddy, A., Redington, K., Reel, E., Remeta, P., Ricco, F., Riccoboni, A., Rice, P., Rich, M., Richards, N., Riches, J., Ripoll, S., Roberts, F., Roberts, K., Robins, K., Robinson, S., Roche, S., Rojo, M., Carmela Romano, N., Rosser, H., Roughley, L., Routley, C., Rowley, C., Rudra, P., Russell, R., Ryan, C., Saad, C., Sadeghi, A., Salberg, A., Salota, V., Samuel, M., Samuels, R., Sanapala, S., Sanusi, S., Sarao, S., Sathyabhama, S., Saunders, Z., Sawarzynska-ryszka, B., Sceales, P., Schumacher, N., Schwartz, N., Sellers, C., Sellers, H., Sellick, J., Sen, S., Senaratne, D., Senbeto, S., Seneviratna, D., Setty, T., Shah, R., Shah, S., Shambly, J., Sharafudeen, S., Sharieff, I., Sharifi, L., Sharpe, L., Shaw, M., Sheldrake, I., Shinde, P., Shonfeld, A., Short, J., Siah, J., Sibug, S., Siddique, O., Siew, S., Simpson, M., Singleton, G., Sinha, K., Sinha, A., Sinnott, M., Sivadhas, H., Sivakumar, S., Sivarajan, B., Sivarajan, S., Skeoch, C., Slade, S., Slater, P., Smith, C., Smith, E., Smith, J., Smith, L., Smith, A., Smith, R., Smith, S., Smith, T., Smithers, H., Smolen, S., Smyth, C., Snel, T., Snipe, C., Soltanifar, S., Sonawane, N., Soundararaja, A., Spence, E., Spiliopoulos, M., Srivastava, C., Stacey, K., Stafford, H., Staines, N., Stead, R., Stevens, E., Stilwell, A., Stocks, G., Stokes, A., Stone, C., Straughan, B., Subbarathnam, V., Sudunagunta, S., Sultan, P., Suppiah, P., Surve, P., Sutherland, A., Swanton, R., Swarbrick, C., Swinson, A., Syrrakou, E., Tadbiri, S., Tamhane, P., Tamilselvan, P., Tan, A., Tanna, S., Tarft, H., Tarry, L., Taylor, I., Taylor, S., Tebbot, J., Theron, S., Thomas, M., Todd, S., Tolliday, H., Topham, C., Tovell, N., Traves, M., Trodd, D., Tufchi, A., Turley, K., Turnbull, M., Turnbull, C., Turner, O., Turner, W., Turney, S., Tyagi, E., Uncles, D., Unsworth, V., Vadnere, P., Varadan, R., Vasishta, V., Veal, A., Vedham, L., Venkaya, J., Verghese, M., Veronica, I., Vidanagamage, D., Vincent, R., Vyapury, V., Wain, H., Walbridge, F., Walker, E., Walsh, P., Walshe, E., Walters, M., Wan, Y., Wang, C., Wankhade, K., Waters, G., Watts, C., Webber, A., Wedgwood, T., Wee, M., Wellstead, S., White, A., Whitear, M., Whitefield, L., Wilkinson, S., Williams, L., Williams, R., Wilson, D., Wilson, S., Wimble, K., Winkley, E., Winslow, L., Winwright, P., Wloch, K., Wong, G., Wong, H., Man Wong, J., Wood, T., Wray, S., Wrench, I., Wu, J., Wynn, K., Yap, Y., Kuan Yeow, C., Young, E., Yusaf, A., Uz Zafar, S., Zeinali, D., Zhang, S., Zope, S., Zucco, L., Anwar, S., Blunt, N., Grover, V., Grailey, K., Gray, M., Highton, D., Hopkins, P., Kemp, H., Lo, Q., Martin, D., Morkane, C., O’Carroll, J., Oliver, C., Post, B., Visram, A., Wickham, A., General Paediatrics, Graduate School, Adult Psychiatry, and Pulmonology

Subjects
medicine.medical_specialty, medicine.medical_treatment, Population, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, medicine, Caesarean section, General anaesthesia, general anaesthesia, 030212 general & internal medicine, Rocuronium, General anaesthetic, education, Neuromuscular Blockade, education.field_of_study, airway management, obstetrics, business.industry, Tracheal intubation, Surgery, Anesthesiology and Pain Medicine, caesarean section, Airway management, business, medicine.drug
Abstract

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%).

Published
2020

12. The Australasian Resuscitation In Sepsis Evaluation: Fluids or vasopressors in emergency department sepsis (ARISE FLUIDS), a multi-centre observational study describing current practice in Australia and New Zealand.

Author

Tan E., Burcham J., Coggins A.R., Delaney A., Fatovich D.M., Fraser J.F., Harley A., Jones P., Kinnear F.B., May K., Peake S., Williams P., Nguyen K., Foong L.H., Hullick C., McNulty R., Na A., Trethewy C., Lutze L., Zhang M., Cowan T., Middleton P., Avis S., Vidler S., Salter M., Janes S., Harwood T., Oliver M., Jazayeri F., Jones S., Davoren M., Coggins A., Pradhananga B., Newby L., Beck S., Sandleback B., Rabas S., Harger S., Song R., Gutenstein M., Munro A., Connely M., Goodson J., Mclean A., Brabyn C., Mukerji S., Simmonds H., Young P., Sugeng Y., Bird C., McConnell A., Henderson P., Johnson D., Perez S., Mahani A., Orda U., Thom O., Roberts K., Kinnear F., Hazelwood S., Pham H., Eley R., Livesay G., Devlin M., Murdoch I., Wood E., Williams J., Brown N., King A., Sadewasser J., Jones L., Gangathimmaiah V., Manudhane A., Haustead D., Ascencio-Lane J.-C., Taylor D.M., Buntine P., Walker K., Pouryahya P., Crompton D., Sultana R., Campbell T., Dwyer R., Blecher G., Knott J., Mitra B., Luckhoff C., Young R., Rudling N., Mukherjee A., Dyke K.-L., Parker C., Cooper A., Nagree Y., Koay K., Kruger C., Ghedina N., Smedley B., Macdonald S., Hamersley H., Keijzers G., Macdonald S.P.J., Udy A.A., Arendts G., Bailey M., Bellomo R., Blecher G.E., Tan E., Burcham J., Coggins A.R., Delaney A., Fatovich D.M., Fraser J.F., Harley A., Jones P., Kinnear F.B., May K., Peake S., Williams P., Nguyen K., Foong L.H., Hullick C., McNulty R., Na A., Trethewy C., Lutze L., Zhang M., Cowan T., Middleton P., Avis S., Vidler S., Salter M., Janes S., Harwood T., Oliver M., Jazayeri F., Jones S., Davoren M., Coggins A., Pradhananga B., Newby L., Beck S., Sandleback B., Rabas S., Harger S., Song R., Gutenstein M., Munro A., Connely M., Goodson J., Mclean A., Brabyn C., Mukerji S., Simmonds H., Young P., Sugeng Y., Bird C., McConnell A., Henderson P., Johnson D., Perez S., Mahani A., Orda U., Thom O., Roberts K., Kinnear F., Hazelwood S., Pham H., Eley R., Livesay G., Devlin M., Murdoch I., Wood E., Williams J., Brown N., King A., Sadewasser J., Jones L., Gangathimmaiah V., Manudhane A., Haustead D., Ascencio-Lane J.-C., Taylor D.M., Buntine P., Walker K., Pouryahya P., Crompton D., Sultana R., Campbell T., Dwyer R., Blecher G., Knott J., Mitra B., Luckhoff C., Young R., Rudling N., Mukherjee A., Dyke K.-L., Parker C., Cooper A., Nagree Y., Koay K., Kruger C., Ghedina N., Smedley B., Macdonald S., Hamersley H., Keijzers G., Macdonald S.P.J., Udy A.A., Arendts G., Bailey M., Bellomo R., and Blecher G.E.

Abstract

Objectives: To describe haemodynamic resuscitation practices in ED patients with suspected sepsis and hypotension. Method(s): This was a prospective, multicentre, observational study conducted in 70 hospitals in Australia and New Zealand between September 2018 and January 2019. Consecutive adults presenting to the ED during a 30-day period at each site, with suspected sepsis and hypotension (systolic blood pressure <100 mmHg) despite at least 1000 mL fluid resuscitation, were eligible. Data included baseline demographics, clinical and laboratory variables and intravenous fluid volume administered, vasopressor administration at baseline and 6- and 24-h post-enrolment, time to antimicrobial administration, intensive care admission, organ support and in-hospital mortality. Result(s): A total of 4477 patients were screened and 591 were included with a mean (standard deviation) age of 62 (19) years, Acute Physiology and Chronic Health Evaluation II score 15.2 (6.6) and a median (interquartile range) systolic blood pressure of 94 mmHg (87-100). Median time to first intravenous antimicrobials was 77 min (42-148). A vasopressor infusion was commenced within 24 h in 177 (30.2%) patients, with noradrenaline the most frequently used (n = 138, 78%). A median of 2000 mL (1500-3000) of intravenous fluids was administered prior to commencing vasopressors. The total volume of fluid administered from pre-enrolment to 24 h was 4200 mL (3000-5661), with a range from 1000 to 12 200 mL. Two hundred and eighteen patients (37.1%) were admitted to an intensive care unit. Overall in-hospital mortality was 6.2% (95% confidence interval 4.4-8.5%). Conclusion(s): Current resuscitation practice in patients with sepsis and hypotension varies widely and occupies the spectrum between a restricted volume/earlier vasopressor and liberal fluid/later vasopressor strategy.Copyright © 2020 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian

Published
2020

13. The Australasian Resuscitation In Sepsis Evaluation: Fluids or vasopressors in emergency department sepsis (ARISE FLUIDS), a multi-centre observational study describing current practice in Australia and New Zealand

Author

Keijzers, G, Macdonald, SPJ, Udy, AA, Arendts, G, Bailey, M, Bellomo, R, Blecher, GE, Burcham, J, Coggins, AR, Delaney, A, Fatovich, DM, Fraser, JF, Harley, A, Jones, P, Kinnear, FB, May, K, Peake, S, Taylor, DM, Williams, P, Khanh, N, Foong, LH, Hullick, C, McNulty, R, Na, A, Trethewy, C, Lutze, L, Zhang, M, Cowan, T, Middleton, P, Avis, S, Vidler, S, Salter, M, Janes, S, Harwood, T, Oliver, M, Jazayeri, F, Jones, S, Davoren, M, Coggins, A, Pradhananga, B, Newby, L, Beck, S, Sandleback, B, Rabas, S, Harger, S, Tan, E, Song, R, Gutenstein, M, Munro, A, Connely, M, Goodson, J, Mclean, A, Brabyn, C, Mukerji, S, Simmonds, H, Young, P, Sugeng, Y, Bird, C, McConnell, A, Henderson, P, Johnson, D, Perez, S, Mahani, A, Orda, U, Thom, O, Roberts, K, Kinnear, F, Hazelwood, S, Hanh, P, Eley, R, Livesay, G, Devlin, M, Murdoch, I, Wood, E, Williams, J, Brown, N, King, A, Sadewasser, J, Jones, L, Gangathimmaiah, V, Manudhane, A, Haustead, D, Ascencio-Lane, J-C, Buntine, P, Walker, K, Pouryahya, P, Crompton, D, Sultana, R, Campbell, T, Dwyer, R, Blecher, G, Knott, J, Mitra, B, Luckhoff, C, Young, R, Rudling, N, Mukherjee, A, Dyke, K-L, Parker, C, Cooper, A, Nagree, Y, Koay, K, Kruger, C, Ghedina, N, Smedley, B, Macdonald, S, Hamersley, H, Keijzers, G, Macdonald, SPJ, Udy, AA, Arendts, G, Bailey, M, Bellomo, R, Blecher, GE, Burcham, J, Coggins, AR, Delaney, A, Fatovich, DM, Fraser, JF, Harley, A, Jones, P, Kinnear, FB, May, K, Peake, S, Taylor, DM, Williams, P, Khanh, N, Foong, LH, Hullick, C, McNulty, R, Na, A, Trethewy, C, Lutze, L, Zhang, M, Cowan, T, Middleton, P, Avis, S, Vidler, S, Salter, M, Janes, S, Harwood, T, Oliver, M, Jazayeri, F, Jones, S, Davoren, M, Coggins, A, Pradhananga, B, Newby, L, Beck, S, Sandleback, B, Rabas, S, Harger, S, Tan, E, Song, R, Gutenstein, M, Munro, A, Connely, M, Goodson, J, Mclean, A, Brabyn, C, Mukerji, S, Simmonds, H, Young, P, Sugeng, Y, Bird, C, McConnell, A, Henderson, P, Johnson, D, Perez, S, Mahani, A, Orda, U, Thom, O, Roberts, K, Kinnear, F, Hazelwood, S, Hanh, P, Eley, R, Livesay, G, Devlin, M, Murdoch, I, Wood, E, Williams, J, Brown, N, King, A, Sadewasser, J, Jones, L, Gangathimmaiah, V, Manudhane, A, Haustead, D, Ascencio-Lane, J-C, Buntine, P, Walker, K, Pouryahya, P, Crompton, D, Sultana, R, Campbell, T, Dwyer, R, Blecher, G, Knott, J, Mitra, B, Luckhoff, C, Young, R, Rudling, N, Mukherjee, A, Dyke, K-L, Parker, C, Cooper, A, Nagree, Y, Koay, K, Kruger, C, Ghedina, N, Smedley, B, Macdonald, S, and Hamersley, H

Abstract

OBJECTIVES: To describe haemodynamic resuscitation practices in ED patients with suspected sepsis and hypotension. METHODS: This was a prospective, multicentre, observational study conducted in 70 hospitals in Australia and New Zealand between September 2018 and January 2019. Consecutive adults presenting to the ED during a 30-day period at each site, with suspected sepsis and hypotension (systolic blood pressure <100 mmHg) despite at least 1000 mL fluid resuscitation, were eligible. Data included baseline demographics, clinical and laboratory variables and intravenous fluid volume administered, vasopressor administration at baseline and 6- and 24-h post-enrolment, time to antimicrobial administration, intensive care admission, organ support and in-hospital mortality. RESULTS: A total of 4477 patients were screened and 591 were included with a mean (standard deviation) age of 62 (19) years, Acute Physiology and Chronic Health Evaluation II score 15.2 (6.6) and a median (interquartile range) systolic blood pressure of 94 mmHg (87-100). Median time to first intravenous antimicrobials was 77 min (42-148). A vasopressor infusion was commenced within 24 h in 177 (30.2%) patients, with noradrenaline the most frequently used (n = 138, 78%). A median of 2000 mL (1500-3000) of intravenous fluids was administered prior to commencing vasopressors. The total volume of fluid administered from pre-enrolment to 24 h was 4200 mL (3000-5661), with a range from 1000 to 12 200 mL. Two hundred and eighteen patients (37.1%) were admitted to an intensive care unit. Overall in-hospital mortality was 6.2% (95% confidence interval 4.4-8.5%). CONCLUSION: Current resuscitation practice in patients with sepsis and hypotension varies widely and occupies the spectrum between a restricted volume/earlier vasopressor and liberal fluid/later vasopressor strategy.

Published
2020

14. The future of glaucoma clinics

Author

Morley, A.M.S. and Murdoch, I.

Subjects
Glaucoma -- Care and treatment, Ophthalmology -- Practice, Health
Published
2006

17. Severe and unrecognised: pertussis in UK infants

Author

Crowcroft, NS, Booy, R, Harrison, T, Spicer, L, Britto, J, Mok, Q, Heath, P, Murdoch, I, Zambon, M, George, R, and Miller, E

Subjects
Whooping-cough -- Care and treatment -- Diagnosis, Family and marriage, Health, Diagnosis, Care and treatment
Abstract

Aims: To diagnose pertussis using culture, polymerase chain reaction, and serology, in children admitted to intensive care units (PICUs) and some paediatric wards in London, and in their household contacts [...]

Published
2003

27. Posters

Author

Török, T., Kardos, A., Rudas, L., Paprika, D., McLuckie, A., Beale, R. J., Bihari, D., Keller, H., Seltzer, N., Weimer, A., Menning, H., Ulrich, P., Staedt, U., Kirschstein, W., Kasai, T., Endo, S., Arakawa, N., Sato, N., Suzuki, T., Taniguchi, S., Inada, K., Hiramori, K., Schmidt, W., Meineke, I., Nottrott, M., Frerichs, I., Müller, S., Hellige, G., De Blasio E., De Sio A., Sibilio G., Papa A., Golia D., Grassia V., Bove G., Zehelgruber, M., Mundigler, G., Christ, G., Merhaut, C., Klaar, U., Kratochwill, C., Hofmann, S., Siostrzonek, P., Suarez, F., Corrales, M., Rábago, R., Gonzalez-Arenas, P., Morales, R., Sanchez J., Fraile, J., Rey, M., Martinell, J., Niederst, P. -N., Mellwig, K. -P., Schmidt, H. K., Gleichmann, U., Körfer, R., Di Bartolomeo, S., Bertolissi, M., Nardi, G., De Monte, A., Janssens, U., Ochs, J. -G., Klues, H. G., Hanrath, P., Sajjanhar, T., Tibby, S. M., Hatherill, M., Anderson, D., Murdoch, I. A., Krivec, B., Voga, G., Žuran, I., Skale, R., Parežnik, R., Podbregar, M., Bonnefoy, E., Chevalier, P., Kirkorian, G., Guidolet, J., Marchand, A., Bouchayer, D., Marcaz, P. Bert, Touboul, P., Welte, T., Molling, J., Jepsen, M. S., Claus, G., Klein, H., Cinnella, G., Dambrosio, M., Brienza, N., Conte, M., Maggiore, S. M., Leone, A. M., Brienza, A., DiVenere, N., Vandewoude, K., Poelaert, J., Vogelaers, D., Garcia, R. Blanca, Buylaert, W., Roosens, C., Colardyn, F., Annane, D., Béllissant, E., Pussard, E., Asmar, R., Lacombe, F., Lanata, E., Madonna, O., Safar, M., Giudicelli, J. F., Raphael, J. C., Gajdos, Ph., Mattys, M., Dumont, L., Annaert, J. F., Mardirosoff, C., Goldstein, J., Verbeet, T., Massaut, J., Haas, N. A., Uhlemann, F., Daehnert, I., Berger, F., Stiller, B., Dittrich, S., Schulze-Neick, I., Eweit, P., Lange, P. E., Langenherp, C. J. M., Pietersen, H., Geskes, G., Wagenmakers, A., Soeters, P., Maggiorini, M., Brimioulle, S., Lejeune, P., Delcroix, M., Vermeulen, F., Stephanazzi, J., Naeije, R., Kunert, M., Stolzenburg, H., Scheuble, L., Emmerich, K., Ulbricht, L. J., Krakau, I., Gülker, H., Broch, M. J., Valentín, V., Murcia, B., Bartual, E., Málaga, A., Miralles, L. L., Valls, F., Wallin, C. J., Sidenö, B., Vaage, J., Leksell, L. G., Stuchlinger, H. G., Seidler, D., Hollenstein, U., Janata, K., Muellner, M., Loeffler, W., Gamper, G., Bur, A., Malzer, R., Laggner, A. N., Hirschl, M. M., Binder, M., Herkner, H., Bur, A., Laggner, A. N., Turani, F., Ceraso, C., Lironcurti, A., Senesi, P., Leonardis, C., Sabato, A. F., Pietersen H. G., Langenberg C. J. M., Geskes G., Wagenmakers A. J. M., de Lange S., Soeters P. B., Royira, A., Oussedik, L., Cambray, C., Glmeno, C., Cerda, M., Sanchez, Ma. A., Lesmes, A., Guerrero, M., Vigil, E., Ortega, F., Lucena, F., Righini, E. R., Alvisi, R., Marangoni, E., Gritti, G., Ordóñez, A., Hernández, A., Pérez-Bernal, J., Hinojosa, R., Borrego, J. M., Franco, A., López-Barneo, J., Pérez-Bernal, J., Gutiérrez, E., Hinojosa, R., Hernández, A., Borrego, J. M., Cerro, J., Rincón, D., Ordóñez, A., Martin, R., Saussine, M., Sany, C. L., Calvet, B., Raison, D., Frapier, J. M., Wallin, C. -J., Olsson, Å., Nordländer, R., Leksell, L. G., Vasilkov, V., Safronov, A., Marinchev, V., Rodrigues, A. C., Moraes, A., Galas, F., Angelim, V., Medeiros, C., Auler, J. O., Bellotti, G., Pilleggi, F., Carmona, M. J., Messias, E. R. R., Joseph, D., Baigorri, F., Artigas, A., Blanch, L., Wagner, F., Dandel, M., Günther, G., Schulze-Neick, I., Weng, Y., Loebe, M., Hetzer, R., Colreavy, F., Balea, M., Cahalan, M., Carpintero, JL., de la Fuente, M. C., Estecha, M. A., Molina, J. M., del Fresno, L. R., Daga, D., Toro, R., Poullet, A., de la Torre, M. V., Garcia, A. J., Michalopoulos, A., Rellos, K., Skambas, D., Liakopoulos, O., and Geroulanos, S.

Published
1996
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28. Posters

Author

Frutos, F., Nuñez, C., Garrido, P., Lorenzo, J. M., Aranda, M., Revuelta, P., Chinea, C., Rico, M., Ibáñez-Nolla, J., León-Regidor, M. A., Díaz-Boladeras, R. M., García-Hernández, F., Nolla-Salas, M., Sirvent, J. M., Torres, A., El-Ebiary, M., Castro, P., de Batlle, J., de Velasco, J. G., Alvarez, A., Bonet, A., Thomas, M. L., McLure, H. A., Soni, N., Roberts, A. P., Azadian, B. F., Tibby, S. M., Cheema, I. U., Cox, S., Gransden, W. R., Murdoch, I. A., Tayoro, J., Legras, A., Dequin, P. F., Hazouard, E., Perrotin, D., Anglès, R., de Latorre, F. J., Ferrer, A., Palomar, M., Burgueńo, M. J., Bosque, M. D., Pont, T., Bermejo, B., Melgar, J. L., Chamorro, C., Romera, M. A., Borrallo, J. M., de Luna, R. Ruiz, De la Calle, N., Sousa-Dias, C., Paiva, J. A., Pereira, A. Costa, Ribeiro, T., Gomes, J., Carmo, E., Gaspar, I., Simões, I., Monteiro, E., Neves, J. L., Abecasis, P., Álvarez-Lerma, F., de la Cal, M. A., Insausti J., Olaechea, P., Anđelić, N., Ćosić, O., Risović, M., Todorović, K., Đukić, V., Karamarković, A., Ricart, A., Garrigosa, F., Prieto, A. Diaz, Casanovas, T., Rodriguez, P., Avila, F. J., Pujol, M., Ariza, X., Shunko, E., Polishchuk, O., Kostiuk, O., Poluliakh, O., Nys, M., Damas, P., Ledoux, D., De Mol, P., Melin, P., Lamy, M., Ivanović, D., Radonić, R., Gaŝparović, V., Merkler, M., Gjuraŝin, M., van ’t Veen, A., Gommers, D., Mouton, J. W., Kluytmans, J. A. J. W., Lachmann, B., Adnet, F., Bekka, R., Vicaut, E., Lapostolle, F., Giraudeaux, V., Bismuth, C., Baud, F., Young, S. P., Haj, M. A., Robbie, L. A., Adey, G., Croll, A. M., Booth, N. A., Bennett, B., Santos, J. A., Ormaechea, E., Barcons, M., Quintana, E., Rialp, G., Bak, E., Puzo, C., Coll, P., Net, A., Blazková, M., Ŝteparová, P., Nejdlová, H., Jelínková, L., Winkelhoferová, H., Rokyta, R., Matejovic, M., Ŝrámck, V., Novák, I., Blinzler, L., Franz-Kilian, K., Benda, N., Heuser, D., Lerma, F. Alvarez, Maladorno, D., Hager, H., Richelo, B., Teller, S., Berkowicz, C., O’Brien, D., Leighton, A., Dougnac, A., Hernandez, G., Angus, D., Ojeda, M., Castro, J., Labarca, E., Castillo, L., Andresen, M., Bugedo, G., Diaz, O., Arriagada, D., Dagnino, J., Spanish Study Group of Surveillance of ICU-Acquired Infection, Spanish Study Group of Surveillance of ICU-acquired Infection., and Ro 4S-2081 Study Group

Published
1996
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29. Free Papers

Author

Murdoch, I. A., Sajjanhar, T., Tibby, S. M., Hatherill, M., Schaufeli, W. B., Blance, P. M. Le, Sanders, G. J. E. M., van der Veen, J. R., Antonsen, K., Thiessen, B., Bonde, J., Ridley, S., Rowan, K., Edwards, R. E., Stockwell, M. A., Añón, J. M., Lorenzo, A. García de, Zarazaga, A., Gómez-Tello, V., Sánchez, M., Asensio, M. J., McKenzie, C., Treacher, D. F., Leach, R. M., Dickie, H., Vedio, A., Dundas, R., Bakker, J., Rommes, J. H., Rafkin, H., Hoyt, J., Jakob, S. M., Rothen, H. U., Schmid, H., Ballmer, P. E., Regli, B., Roth, F., Edbrooke, D. L., Wilson, A. J., Stevens, V. G., Hibbert, C. L., Mann, A. J., Kingsley, J., Smith, S., Bur, A., Müllner, M., Sterz, F., Hirschl, M. M., Barrientos, M., Laggner, A. N., Marx, G., Jankowski, M., Ruckoldt, H., Vangerow, B., Piepenbrock, S., Moreno, R., Miranda, D. Reis, and Iapichino, G.

Published
1996
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32. Impact of annual dosing with ivermectin on progression of onchocercal visual field loss

Author

Cousens, S.N., Cassels-Brown, A., Murdoch, I., Babalola, O.E., Jatau, D., Alexander, N.D.E., Evans, J.E., Danboyi, P., Abiose, A., and Jones, B.R.

Subjects
Ivermectin -- Evaluation, Onchocerciasis -- Drug therapy
Abstract

Reported are the results of a randomized, double-masked, placebo-controlled trial of annual ivermectin dosing in 34 rural communities, Kaduna State, northern Nigeria, where guinea savanna onchocerciasis is mesoendemic. A total of 939 individuals underwent Friedmann field analysis at the first examination and saw at least 19 spots in at least one eye. Of these, 636 (68%) completed a subsequent Friedmann field analysis 2-3 years later. The adjusted incidence rate ratio for the ivermectin group versus the placebo group was 0.64 (95% confidence interval (Cl): 0.42-0.98). There was some evidence that the impact of ivermectin was greatest among those who had received one dose of ivermectin. The majority of the deteriorations occurred in eyes that gave evidence of optic atrophy at the first examination. An analysis restricted to individuals with optic atrophy at baseline indicated a reduction of 45% in the incidence of visual field deterioration in the ivermectin group (95% Cl: 8-67%). Previous findings have shown that ivermectin has an impact on the incidence of optic atrophy. Our results indicate, for the first time, that ivermectin has a substantial impact on the progression of visual field loss among those with pre-existing optic atrophy., Introduction Onchocerciasis is one of the major causes of blindness. Two commonly reported ocular sequelae of onchocercal infection are optic nerve disease and chorioretinitis[1], both of which can cause dramatic [...]

Published
1997

35. Red-dot card test of the paracentral field as a screening test for optic nerve disease in onchocerciasis

Author

Murdoch, I., Jones, B.R., Babalola, O.E., Cousens, S.N., Bolarin, I., and Abiose, A.

Subjects
Onchocerciasis -- Diagnosis
Abstract

A new screening test for optic nerve pathology is described, consisting of a series of four red targets presented at an angle of 12 [degrees] in the paracentral field above and below the horizontal meridian. Nonperception and desaturation of the targets are recorded. Inter-observer variability studies found a [Kappa] value = 0.8. A total of 6831 individuals aged [is greater than or equal to] 5 years in communities that were mesoendemic for savanna onchocerciasis in Kaduna State, northern Nigeria, were screened using the test. Of the participants 22% were unable to complete the test; almost two-thirds of these (62%) were aged 5-8 years. After exclusion of those visually impaired or blind according to WHO criteria and those unable to complete the test, the test showed a sensitivity of 40% and a specificity of 98% for optic nerve disease when inability to visualize one or more targets was used as the definition of test failure. The sensitivity increased to 54% with a specificity of 96% when the criterion for failure included desaturation of one or more targets. These values compare favourably with those for other available screening methods. The test took 1-2 minutes to perform and was readily accepted by patients and nurses., Introduction Traquair postulated that all colour isopters were of equal size if hue, saturation and intensity were equated (1), and this has been corroborated by subsequent work by Carlow et [...]

Published
1996

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