Medicine and Health Sciences Commons^™

Inpatient Rehabilitation Did Not Positively Affect 6-Month Patient-Reported Outcomes After Hip Or Knee Arthroplasty, Adam G. Hutchinson, Benjamin Gooden, Matthew C. Lyons, Justin P. Roe, Michael D. O'Sullivan, Lucy J. Salmon, Kaka Martina, Leo Pinczewski

Medical Papers and Journal Articles

Background: The aim of this study was to compare patient-reported outcomes 6 months after hip or knee arthroplasty in subjects who were discharged to home compared to those who attended inpatient rehabilitation.

Methods:

Seven hundred and forty-eight consecutive total hip or knee replacement patients were identified from a prospective database. Preoperative and 6-month post-operative patient-reported outcome measures were recorded. Forty-four patients discharged directly to home were cohort matched by age, gender, procedure and surgeon to 44 patients from the cohort who received inpatient care. Patient outcomes were compared using SPSS version 24 software.

Results: Both cohorts saw significant improvements from …

Antenatal Influenza And Pertussis Vaccination In Western Australia: A Cross-Sectional Survey Of Vaccine Uptake And Influencing Factors, Donna Mak, Annette K. Regan, Dieu T. Vo, Paul V. Effler

Medical Papers and Journal Articles

Background: Influenza and pertussis vaccines have been recommended in Australia for women during each pregnancy since 2010 and 2015, respectively. Estimating vaccination coverage and identifying factors affecting uptake are important for improving antenatal immunisation services.

Methods: A random sample of 800 Western Australian women ≥18 years of age who gave birth between 4th April and 4th October 2015 were selected. Of the 454 (57%) who were contactable by telephone, 424 (93%) completed a survey. Data were weighted by maternal age and area of residence to ensure representativeness. The proportion immunised against influenza and pertussis was the main outcome measure; multivariate …

Accuracy Of Multiparametric Magnetic Resonance Imaging To Detect Significant Prostate Cancer And Index Lesion Location, Hariette Goldman, Neha Singh, Catherine Harding, Joe Mcgirr, Alexa Seal, Ian Duncan, Steven Sowter

Medical Papers and Journal Articles

Background: Multiparametric magnetic resonance imaging (mpMRI) of the prostate appears to improve prostate cancer detection, but studies comparing mpMRI to histopathology at the time of radical prostatectomy (RP) are lacking. This retrospective study determined the accuracy of mpMRI predicting Gleason score and index lesion location at the time of RP, the current gold standard for diagnosis.

Methods: Between April 2013 and April 2016, a database of all men aged more than 40 years who underwent RP after positive transrectal ultrasound biopsy by an experienced urological surgeon was collated at a single regional centre. This was cross‐referenced with a database of …

The Importance Of Left Atrial Volume Assessment In Identifying The Cause Of Ischemic Stroke, David Playford, Sarah Bowler, Max Bulsara, David J. Blacker, Timothy R. Bates, James P. Codde

Medical Papers and Journal Articles

Separating cardioembolic from large artery stroke has important treatment implications. We investigated whether echocardiography could improve Cardioembolic Stroke (CES) prediction compared with traditional measures and cholesterol biomarkers.

Data from 40 consecutive patients presenting with acute ischemic stroke which included brain and carotid imaging, ECG, echo, serum cholesterol and apolipoproteins were independently reviewed. Patients were classified into two groups: a) CES, defined by sustained or paroxysmal atrial fibrillation and <50% stenosis of a perfusing cerebral artery; b) Large artery stroke (LAS) defined as > 50% stenosis of an ipsilateral perfusing cerebral artery, with no evidence of AF on monitoring or evidence of small artery disease on neuroimaging and confirmed by an independent neurologist.

Other than the …

20-Year Outcomes Of Anterior Cruciate Ligament Reconstruction With Hamstring Tendon Autograft: The Catastrophic Effect Of Age And Posterior Tibial Slope, Lucy J. Salmon, Emma Heath, Hawar Akrawi, Justin P. Roe, James Linklater, Leo Pinczewski

Medical Papers and Journal Articles

Background: No well-controlled studies have compared the long-term outcome of anterior cruciate ligament (ACL) reconstruction with hamstring tendon autograft between adolescents and adults. Increased posterior tibial slopes (PTSs) have been reported in the ACL-injured versus controls, but the effect of PTS on the outcome after reconstruction is relatively unexplored.

Purpose: To compare the prospective longitudinal outcome of ‘‘isolated’’ ACL ruptures treated with anatomic endoscopic ACL reconstruction using hamstring tendon autograft over 20 years in adolescent and adult cohorts and to examine factors for repeat ACL injury.

Study Design: Case-control study; Level of evidence, 3.

Methods: A single-surgeon series of 200 …

Evaluation Of Serum Glycoprotein Biomarker Candidates For Detection Of Esophageal Adenocarcinoma And Surveillance Of Barrett’S Esophagus, Alok K. Shah, Gunter Hartel, Ian Brown, Clay Winterford, Renhua Na, Kim-Anh Le Cao, Bradley A. Spicer, Michelle Dunstone, Wayne A. Phillips, Reginald V. Lord, Andrew P. Barbour, David I. Watson, Virendra Joshi, David C. Whiteman, Michelle M. Hill

Medical Papers and Journal Articles

Esophageal adenocarcinoma (EAC) is thought to develop from asymptomatic Barrett’s esophagus (BE) with a low annual rate of conversion. Current endoscopy surveillance for BE patients is probably not cost-effective. Previously, we discovered serum glycoprotein biomarker candidates which could discriminate BE patients from EAC. Here, we aimed to validate candidate serum glycoprotein biomarkers in independent cohorts, and to develop a biomarker candidate panel for BE surveillance. Serum glycoprotein biomarker candidates were measured in 301 serum samples collected from Australia (4 states) and USA (1 clinic) using previously established lectin magnetic bead array (LeMBA) coupled multiple reaction monitoring mass spectrometry (MRM-MS) tier …

Atrial Fibrillation Screen, Management And Guideline Recommended Therapy (Af Smart Ii) In The Rural Primary Care Setting: An Implementation Study Protocol, Jessica J. Orchard, Lis Neubeck, Ben Freedman, Ruth Webster, Anushka Patel, Robyn Gallagher, Jialin Li, Charlotte Hespe, Caleb Ferguson, Nicholas Zwar, Nicole Lowres

Medical Papers and Journal Articles

Introduction: Screening for atrial fibrillation (AF) in people ≥65 years is now recommended by guidelines and expert consensus. While AF is often asymptomatic, it is the most common heart arrhythmia and is associated with increased risk of stroke. Early identification and treatment with oral anticoagulants can substantially reduce stroke risk. The general practice setting is ideal for opportunistic screening and provides a natural pathway for treatment for those identified. This study aims to investigate the feasibility of implementing screening for AF in rural general practice using novel electronic tools. It will assess whether screening will fit within an existing workflow …

Vitamin D Deficiency And Segregation Status In Prisoners, Zelda Doyle, John Dearin, Joe Mcgirr

Medical Papers and Journal Articles

Purpose: The purpose of this paper is to investigate if any exposure to segregation minimal association in a single male prison population had any association with an increased risk of vitamin D deficiency.

Design/methodology/approach: A retrospective case study was undertaken with all inmates who had a 25-hyrdoxy-vitamin D test taken during the study period deemed eligible. Hand searching of the medical records by an independent party identified eligible participants whose data were recorded for analysis.

Findings: In total, 124 prisoners were deemed eligible for inclusion; 67 were vitamin D sufficient and 57 were vitamin D deficient by Australian standards. Time …

Improving Household Surveys And Use Of Data To Address Health Inequities In Three Asian Cities: Protocol For The Surveys For Urban Equity (Sue) Mixed Methods And Feasibility Study, Helen Elsey, Ak Narayan Poudel, Tim Ensor, Tolib Mirzoev, James Nicholas Newell, Joseph Paul Hicks, Christopher Cartwright, David Wong, Caroline Tait, Sushil Baral, Radheshyam Bhattarai, Sudeepa Khanal, Rajeev Dhungel, Subash Gajurel, Shraddha Manandhar, Saidur Mashreky, Junnatul Ferdoush, Rumana Huque, Tarana Ferdous, Shammi Nasreen, Hoang Van Minh, Duong Minh Duc, Bao Ngoc, Dana Thomson, Hilary Wallace

Medical Papers and Journal Articles

Introduction: As rapid urbanisation transforms the sociodemographic structures within cities, standard survey methods, which have remained unchanged for many years, under-represent the urban poorest. This leads to an overly positive picture of urban health, distorting appropriate allocation of resources between rural and urban and within urban areas. Here, we present a protocol for our study which (i) tests novel methods to improve representation of urban populations in household surveys and measure mental health and injuries, (ii) explores urban poverty and compares measures of poverty and ‘slumness’ and (iii) works with city authorities to understand, and potentially improve, utilisation of …

Dermal Nerve Fibre And Mast Cell Density, And Proximity Of Mast Cells To Nerve Fibres In The Skin Of Patients With Complex Regional Pain Syndrome, Natalie Morellini, Philip M. Finch, Andreas Goebel, Peter D. Drummond

Medical Papers and Journal Articles

An interaction between cutaneous nerves and mast cells may contribute to pain in complex regional pain syndrome (CRPS). To explore this, we investigated the density of dermal nerve fibres, and the density and proximity of mast cells to nerve fibres, in skin biopsies obtained from the affected and unaffected limbs of 57 patients with CRPS and 28 site-matched healthy controls. The percentage of the dermis stained by the pan-neuronal marker protein gene-product 9.5 was lower in the affected limb of patients than in controls (0.12 ± 0.01% versus 0.22 ± 0.04%, P < 0.05), indicating a reduction in dermal nerve fibre density. This parameter did not correlate with CRPS duration. However, it was lower in the affected than unaffected limb of patients with warm CRPS. Dermal mast cell numbers were similar in patients and controls, but the percentage of mast cells less than 5 μm from nerve fibres was significantly lower in the affected and unaffected limbs of patients than in controls (16.8 ±1.7%, 16.5 ± 1.7% and 31.4 ± 2.3% respectively, P < 0.05). We confirm previous findings of a mild neuropathy in CRPS. Our findings suggest that this either develops very early after injury or precedes CRPS onset. Loss of dermal nerve fibres in CRPS might result in loss of chemotactic signals, thus halting mast cell migration towards surviving nerve fibres. Failure of normal nerve fibre-mast cell interactions could contribute to the pathophysiology of CRPS.

Decision Makers' Experience Of Participatory Dynamic Simulation Modelling: Methods For Public Health Policy, Louise Freebairn, Jo-An Atkinson, Paul M. Kelly, Geoff Mcdonnell, Lucie Rychetnik

Medical Papers and Journal Articles

Background: Systems science methods such as dynamic simulation modelling are well suited to address questions about public health policy as they consider the complexity, context and dynamic nature of system-wide behaviours. Advances in technology have led to increased accessibility and interest in systems methods to address complex health policy issues. However, the involvement of policy decision makers in health-related simulation model development has been lacking. Where end-users have been included, there has been limited examination of their experience of the participatory modelling process and their views about the utility of the findings. This paper reports the experience of end-user decision …

Patient Attitudes Towards Analgesia And Their Openness To Non-Pharmacological Methods Such As Acupuncture In The Emergency Department, Andrew L. Jan, Emogene S. Aldridge, Ian R. Rogers, Eric J. Visser, Max K. Bulsara, Dana A. Hince

Medical Papers and Journal Articles

Aims: To investigate patient attitudes to analgesia, opioids and non-pharmacological analgesia including acupuncture, in the ED.

Methods: ED patients with pain were surveyed regarding: pain scores, satisfaction, addiction concern, non-pharmacological methods of pain relief, and acupuncture. Data were analysed using logistic regression.

Results: Of 196 adult patients, 52.8% were ‘very satisfied’ with analgesia. Most patients (84.7%) would accept non-pharmacological methods including acupuncture (68.9%) and 78.6% were not concerned about addiction. Satisfaction was associated with male gender, and ‘adequate analgesia’ but not with opioids.

Conclusion: Most patients were generally satisfied with ED analgesia and were open to non-pharmacologic analgesia including …

Buprenorphine Versus Morphine In Paediatric Acute Pain: A Systematic Review And Meta-Analysis, Nathan Murray, Utsav Malla, Ruan Vlok, Alice Scott, Olivia Chua, Thomas Melhuish, Leigh White

Medical Papers and Journal Articles

Introduction: In lab-based studies, buprenorphine appears to have a ceiling effect on respiratory depression but not on analgesia. There is increasing evidence in adult patients that buprenorphine has no ceiling effect on analgesia or side effects. The aim of this study was to investigate the efficacy and adverse effects of buprenorphine versus morphine in paediatric acute pain.

Methods: A systematic review of five databases was performed until May 2018. Only randomised controlled trials were eligible for inclusion. The outcomes of interest included pain, respiratory depression, nausea, sedation, dizziness, and pruritus.

Results: Four randomized controlled trials (n = 195) were …

5-Year Survival Of Pediatric Anterior Cruciate Ligament Reconstruction With Living Donor Hamstring Tendon Grafts, Emma L. Heath, Lucy J. Salmon, Robert Cooper, Evangelos Pappas, Justin P. Roe, Leo Pinczewski

Medical Papers and Journal Articles

Background: It is well accepted that there is a higher incidence of repeat anterior cruciate ligament (ACL) injuries in the pediatric population after ACL reconstruction (ACLR) with autograft tissue compared with adults. Hamstring autograft harvest may contribute to the risk for repeat ACL injuries in this high functional demand group. A novel method is the use of a living donor hamstring tendon (LDHT) graft from a parent; however, there is currently limited research on the outcomes of this technique, particularly beyond the short term.

Purpose/Hypothesis: The purpose was to determine the medium-term survival of the ACL graft and the contralateral …

Depression Across Pregnancy And The Postpartum, Antidepressant Use And The Association With Female Sexual Function, Megan Galbally, Stuart J. Watson, Michael Permezel, Andrew J. Lewis

Medical Papers and Journal Articles

Background: There is an established relationship between depression and sexual functioning in women. However, there is limited research examining the relationship between perinatal depression and sexual functioning.

Methods: This study draws on the Mercy Pregnancy and Emotional Wellbeing Study and reports on 211 women recruited in early pregnancy and followed to 12 months postpartum. Women were assessed for depression using the Structured Clinical Interview for the DSM-IV, repeated measurement of depressive symptoms using the Edinburgh Postnatal Depression Scale and sexual functioning using the Female Sexual Functioning Inventory. Data were also collected on antidepressant use, mode of delivery, history of childhood …

Patient Reported Outcomes Of Pastoral Care In A Hospital Setting, Elizabeth A. Lobb, Susanne Schmidt, Natalia Jerzmanowska, Ashley M. Swing, Safrina Thristiawati

Medical Papers and Journal Articles

This study aimed to establish whether Pastoral Care (PC) visits were an effective component of a hospitalized patient’s overall health experience. Outcomes of PC visits were reported by 369 patients in 7 sites across Australia. The patient reported outcomes of PC visits included: the patients felt they could be honest with themselves, with a sense of peace, a better perspective of their illness, less anxiety, and felt more in control. Five factors of the PC visit significantly related to higher patient’s overall outcomes: (a) having more Pastoral Care visits (p < 0.5 0 R 0.778, CI 0.17–1.38); (b) the patient was able to talk about what was on their mind (p < 0.01, OR1.48, CI 0.58–2.37); (c) they had something to be hopeful about (p < 0.01 OR1.18, CI 0.51–1.85); 4); the visit focused on decisions about the patient’s health care (p < 0.05, OR0.70, CI 0.05–1.35); and (d) a belief in God/Higher Being (p < 0.01, OR 1.01, CI 0.43–1.71).

Who Knows What 'Healthy Weight' Looks Like?, Rowan Flanagan, Daniel Waugh, Xingqiong Meng, Epi Kanjo, Catherine Krejany

Medical Papers and Journal Articles

Background: Obesity is a global epidemic. The World Health Organization (WHO) reports that worldwide obesity has nearly tripled since 1975. In 2016, more than 1.9 billion adults were overweight and had corresponding increases in well-recognised, associated chronic diseases.

Aims: This study aimed to explore whether the general population is able to identify a healthy BMI and accurately perceive their own BMI using a visual scale.

Method: A cross-sectional, population-based survey of 103 participants were shown a visual scale of computer-generated images representing different BMIs and asked to identify: (1) which images represented a healthy body weight; (2) which image best …

Existential Distress In Cancer: Alleviating Suffering From Fundamental Loss And Change, Sigrun Vehling, David Kissane

Medical Papers and Journal Articles

A severe life threatening illness can challenge fundamental expectations about security, interrelatedness with others, justness, controllability, certainty, and hope for a long and fruitful life. That distress and suffering but also growth and mastery may arise from confrontation with an existentially threatening stressor is a long‐standing idea. But only recently have researchers studied existential distress more rigorously and begun to identify its distinct impact on health care outcomes. Operationalizations of existential distress have included fear of cancer recurrence, death anxiety, demoralization, hopelessness, dignity‐related distress, and the desire for hastened death. These focus in varying emphasis on fear of death, concern …

'What’S On Your Mind?' The Only Necessary Question In Spiritual Care, Austyn Snowden, Elizabeth Anne Lobb, Susanne Schmidt, Ashley M. Swing, Pamela Logan, Catherine Macfarlane

Medical Papers and Journal Articles

Around the world, chaplains provide specialist spiritual care for people with complex healthcare needs. If the nature of chaplain interventions was better understood then multidisciplinary colleagues could both improve their own skills in spiritual care and better understand when to refer people to chaplains. A survey was constructed to establish what aspects of the chaplain/patient relationship were most important for patients in Scotland and Australia. Outcomes were measured with the Scottish Patient Reported Outcome Measure (Scottish PROM©). Results from 610 respondents showed the strongest correlation was between ‘being able to talk about what is on my mind’ and the Scottish …

Increasing The Knowledge, Identification And Treatment Of Osteoporosis Through Education And Shared Decision-Making With Residents Living In A Retirement Village Community, Jane Anderson-Wurf, Catherine Harding, Alexa Seal

Medical Papers and Journal Articles

Objective: This pilot study explored whether individual goal setting in a retirement village setting could improve strategies to strengthen bones in an ageing population and help prevent osteoporosis.

Methods: A two-phased osteoporosis prevention program was developed, piloted and evaluated involving a group education session followed by the development of individualised Bone Plans based upon personal understanding of individual fracture risk and lifestyle factors.

Results: A significant improvement in knowledge and understanding of factors to prevent and manage osteoporosis was achieved, and changes in lifestyle behaviours were sustained at six months.

Conclusion: Success was due to education by specialist medical and …

Primary Goals, Information-Giving And Men's Understanding: A Qualitative Study Of Australian And Uk Doctors' Varied Communication About Psa Screening, Kristen Pickles, Stacy M. Carter, Lucie Rychetnik, Kirsten Mccaffery, Vikki A. Entwistle

Medical Papers and Journal Articles

Objectives: (1) To characterise variation in general practitioners’ (GPs’) accounts of communicating with men about prostate cancer screening using the prostate-specific antigen (PSA) test, (2) to characterise GPs’ reasons for communicating as they do and (3) to explain why and under what conditions GP communication approaches vary.

Study design and setting: A grounded theory study. We interviewed 69 GPs consulting in primary care practices in Australia (n=40) and the UK (n=29).

Results: GPs explained their communication practices in relation to their primary goals. In Australia, three different communication goals were reported: to encourage asymptomatic men to either have a PSA …

The Teaching And Learning Of Health Advocacy In An Australian Medical School, Arabelle M. Douglas, Donna B. Mak, Caroline Bulsara, David J. Macey, Indira V.M Samarawickrema

Medical Papers and Journal Articles

Objectives: To determine if medical graduates from an Australian university are educated and skilled in health advocacy for their future practice with patients and the wider community.

Methods: The authors used an exploratory mixed methodology starting with curriculum mapping of the medical curriculum, followed by key informant interviews with the University of Notre Dame, School of Medicine academics (n = 6) and alumni (n = 5) on teaching/learning and practice of health advocacy. The final stage consisted of a cross-sectional survey on teaching/learning health advocacy among third and fourth (final) year medical students (N = 195).

Results: The medical curriculum …

Community Peer-Led Falls Prevention Presentations: What Do The Experts Suggest?, Linda Khong, Richard G. Berlach, Keith D. Hill, Anne-Marie Hill

IHR Papers and Journal Articles

Falls among older adults are a major problem. Despite considerable progress in falls prevention research, older adults often show low motivation to engage in recommended preventive strategies. Peer-led falls prevention education for older adults may have potential for bridging the research evidence-practice gap, thereby promoting the uptake of falls prevention strategies. We evaluated peer educators’ presentations of falls prevention education to community-dwelling older adults in regard to established criteria that were consistent with adult learning principles, the framework of health behaviour change, falls prevention guidelines, and recommendations for providing falls prevention information. We conducted a within-stage mixed model study using …

Cauliflower Ear - A Minimally Invasive Treatment Method In A Wrestling Athlete: A Case Report, Josef Haik, Or Givol, Rachel Kornhaber, Michelle Cleary, Hagit Ofir, Moti Harats

Health Sciences Papers and Journal Articles

Acute auricular hematoma can be caused by direct blunt trauma or other injury to the external ear. It is typically seen in those who practice full contact sports such as boxing, wrestling, and rugby. “Cauliflower ear” deformity, fibrocartilage formation during scarring, is a common complication of auricular hematomas. Therefore, acute drainage of the hematoma and postprocedural techniques for preventing recurrence are necessary for preventing the deformity. There are many techniques although no superior method of treatment has been found. In this case report, we describe a novel method using needle aspiration followed by the application of a magnet and an …

The General Motor Ability Hypothesis: An Old Idea Revisited, Beth Hands, Fleur Mcintyre, Helen Parker

Health Sciences Papers and Journal Articles

While specific motor abilities have become a popular explanation for motor performance, the older, alternate notion of a general motor ability should be revisited. Current theories lack consensus, and most motor assessment tools continue to derive a single composite score to represent motor capacity. In addition, results from elegant statistical procedures such as higher order factor analyses, cluster analyses, and Item Response Theory support a more global motor ability. We propose a contemporary model of general motor ability as a unidimensional construct that is emergent and fluid over an individual’s lifespan, influenced by both biological and environmental factors. In this …

Manipulating Field Dimensions During Small-Sided Games Impacts The Technical And Physical Profiles Of Australian Footballers, Brock Fleay, Christopher Joyce, Harry Banyard, T Carl Woods

Health Sciences Papers and Journal Articles

This study investigated the effect of manipulating field dimensions on the technical and physical profiles of Australian football (AF) players during small-sided games (SSGs). A total of 40 male players (23.9 ± 3.5 y) participated in three, five-a-side SSGs; defined as ‘small’ (20m x 30m; 600m²), ‘medium’ (30m x 40m; 1200m²), and ‘large’ (40m x 50m; 2000m²). Notational analyses enabled the quantification of technical skill indicators, while physical activity profiles were measured using microtechnology, resulting in 18 criterion variables. A multivariate analysis of variance modelled the main effect of field dimension on the criterion …

Monitoring And Managing Fatigue In Basketball, Toby Edwards, Tania Spiteri, Benjamin Piggott, Joshua Bonhotal, G Gregory Haff, Christopher Joyce

Health Sciences Papers and Journal Articles

The sport of basketball exposes athletes to frequent high intensity movements including sprinting, jumping, accelerations, decelerations and changes of direction during training and competition which can lead to acute and accumulated chronic fatigue. Fatigue may affect the ability of the athlete to perform over the course of a lengthy season. The ability of practitioners to quantify the workload and subsequent fatigue in basketball athletes in order to monitor and manage fatigue levels may be beneficial in maintaining high levels of performance and preventing unfavorable physical and physiological training adaptations. There is currently limited research quantifying training or competition workload outside …

Literature Review: Anthropometric, Strength And Physical Capacities Of Senior And Junior Australian Footballers, Ashley Cripps, Ysabel Jacob, James Walker, Benjamin Piggott

Health Sciences Papers and Journal Articles

This study demonstrates that senior Australian Football players are heavier and possess superior strength characteristics without any meaningful difference in aerobic capacities when compared to under 18 players.

The aim of this study was to compare the anthropometric and physical characteristics of state based junior and senior Australian Football (AF) players. Thirty-One League (age 23.7 ± 2.6 years), 19 Development League (DL) (age 20.5 ± 1.9 years), and 34 Under 18 (U18) players (age 17.4 ± 0.7 years) were recruited from a single AF club. Assessments included height and mass, upper body (bench press and weighted pull-up) and lower body …

Is There A Link Between Vitamin B And Multiple Sclerosis?, Natalie Nemazannikova, Kathleen Mikkelsen, Lily Stojanovska, Gregory L. Blatch, Vasso Apostolopoulos

Health Sciences Papers and Journal Articles

Background: Damage to the myelin sheath (demyelination) is one of the main manifestations of multiple sclerosis (MS). Interestingly, both MS and vitamin B deficiencies result in severe myelin degeneration, leading to loss in neuronal signal transmission.

Objective: Deficiency in vitamin B complex vary, although common symptoms include fatigue, increased oxidative stress, inflammation and demyelination. In particular, vitamin B12 (cobalamin) has had increased attention for its role in the methylation process, involvement in myelination and remyelination, and reversal of MS symptoms.

Method: Here, we discuss the role of vitamin B complex (B1, B2, B3, B4, B5, B6, B7, B9, B12) in …

Cosmetic Outcome As Rated By Patients, Doctors, Nurses And Bcct.Core Software Assessed Over 5 Years In A Subset Of Patients In The Targit-A Trial, Tammy Corica, Anna K. Nowak, Christobel M. Saunders, Max K. Bulsara, Mandy Taylor, Norman R. Williams, Mohammed Keshtgar, David J. Joseph, Jayant S. Vaidya

Health Sciences Papers and Journal Articles

Background: The purpose of this research was to assess agreement between four rating systems of cosmetic outcome measured in a subset of patients with early breast cancer participating in the randomised TARGIT-A trial. TARGIT-A compared risk-adapted single-dose intra-operative radiotherapy (TARGIT-IORT) to whole breast external beam radiotherapy (EBRT).

Methods: Patients, their Radiation Oncologist and Research Nurse completed a subjective cosmetic assessment questionnaire before radiotherapy and annually thereafter for five years. Objective data previously calculated by the validated BCCT.core software which utilizes digital photographs to score symmetry, colour and scar was also used. Agreement was assessed by the Kappa statistic and longitudinal …