581 research outputs found
Trough concentrations of vancomycin: adult therapeutic targets are not appropriate for children
No full textDespite the need for effective vancomycin therapy, there are few data guiding vancomycin monitoring in children. We reviewed retrospectively vancomycin use in children 1 month to 12 years of age. Initial and adjusted target trough vancomycin concentrations in serum were infrequently achieved regardless of the dosing schedule. Currently recommended trough concentrations need to be re-examined with a more detailed pharmacokinetic study in children.Claire L. Gordon, Chantelle Thompson, Jonathan R. Carapetis, John Turnidge, Charles Kilburn and Bart J. Curri
Acute rheumatic fever and rheumatic heart disease in the Top End on Australia's Northern Territory. by Jonathan R. Carapetis, Don R. Wolff and Rart J. Currie
No full textTo describe the epidemiological and clinical features of acute rheumatic fever and rheumatic heart disease in the Top End of the Northern Territory
Recreational fishing-related injuries to Australian pelicans (Pelecanus conspicillatus) and other seabirds in a South Australian estuarine and river area
No full text113 seabirds treated over 5.5 years had 132 fishing-related injuries that included entanglement with line only (N=35/132; 26.5%), entanglement with line and an associated hook (N=47/132; 35.6%), embedded hooks only (N=34/132; 25.7%) and foreign body ingestion (N=16/132; 12.1%). The percentage of fishing-related injuries ranged from 0.9% for banded stilts (Cladorhynchus leucocephalus), pacific gulls (Larus pacificus) and masked lapwing plovers (Vanellus miles), to 59.3% for Australian pelicans (Pelecanus conspicillatus). Entanglement and/or embedded hooks were present more often than injuries from ingestion; i.e. 97% (70/72) of pelicans had entanglement and/or embedded hook injuries; of these 35/72 [48.6%] were entangled with line and hooks, 24/72 [33.3%] had embedded hooks alone and 11/72 [15.3%] were entangled with lines only, with only 3% (2/72) having injuries from ingestion. A count of sea and river birds in close proximity to fishers revealed that the majority were pelicans (33.9%), compared to pied cormorants (28.6%), silver gulls (21.4%) and black swans (16.1%). Regular removal of discarded fishing material along local shores resulted in no reduction in the numbers of entangled or hooked seabirds. It appears likely, therefore, that such injuries may result from seabird proximity to active recreational fishing, rather than from entanglement in discarded material.ER Carapetis, A Machado, K Braun, RW Byar
Prospective surveillance of invasive group a streptococcal disease, Fiji, 2005-2007.
No full textWe undertook a prospective active surveillance study of invasive group A streptococcal (GAS) disease in Fiji over a 23-month period, 2005-2007. We identified 64 cases of invasive GAS disease, which represents an average annualized all-ages incidence of 9.9 cases/100,000 population per year (95% confidence interval [CI] 7.6-12.6). Rates were highest in those >65 years of age and in those <5 years, particularly in infants, for whom the incidence was 44.9/100,000 (95% CI 18.1-92.5). The case-fatality rate was 32% and was associated with increasing age and underlying coexisting disease, including diabetes and renal disease. Fifty-five of the GAS isolates underwent emm sequence typing; the types were highly diverse, with 38 different emm subtypes and no particular dominant type. Our data support the view that invasive GAS disease is common in developing countries and deserves increased public health attention
High burden of impetigo and scabies in a tropical country.
No full textBACKGROUND: Impetigo and scabies are endemic diseases in many tropical countries; however the epidemiology of these diseases is poorly understood in many areas, particularly in the Pacific. METHODOLOGY/PRINCIPAL FINDINGS: We conducted three epidemiological studies in 2006 and 2007 to determine the burden of disease due to impetigo and scabies in children in Fiji using simple and easily reproducible methodology. Two studies were performed in primary school children (one study was a cross-sectional study and the other a prospective cohort study over ten months) and one study was performed in infants (cross-sectional). The prevalence of active impetigo was 25.6% (95% CI 24.1-27.1) in primary school children and 12.2% (95% CI 9.3-15.6) in infants. The prevalence of scabies was 18.5% (95% CI 17.2-19.8) in primary school children and 14.0% (95% CI 10.8-17.2) in infants. The incidence density of active impetigo, group A streptococcal (GAS) impetigo, Staphylococcus aureus impetigo and scabies was 122, 80, 64 and 51 cases per 100 child-years respectively. Impetigo was strongly associated with scabies infestation (odds ratio, OR, 2.4, 95% CI 1.6-3.7) and was more common in Indigenous Fijian children when compared with children of other ethnicities (OR 3.6, 95% CI 2.7-4.7). The majority of cases of active impetigo in the children in our study were caused by GAS. S. aureus was also a common cause (57.4% in school aged children and 69% in infants). CONCLUSIONS/SIGNIFICANCE: These data suggest that the impetigo and scabies disease burden in children in Fiji has been underestimated, and possibly other tropical developing countries in the Pacific. These diseases are more than benign nuisance diseases and consideration needs to be given to expanded public health initiatives to improve their control
Privacy legislation and research
No full textTo the Editor: The Victorian Health Records Act 2001 became operational on 1 July 2002. This legislation provides important protection for the individual against misuse of health information through the establishment of Health Privacy Principles. We support the spirit of this legislation, but would like to draw attention to its potential effects on multicentre research and disease surveillance..
Review of acute rheumatic fever and rheumatic heart disease among Indigenous Australians
No full textThis review is intended to provide an authoritative, up-to-date account of acute rheumatic fever and rheumatic heart disease among Indigenous people.PrefaceThis review of acute rheumatic fever and rheumatic heart disease among Indigenous Australians has been prepared by the Australian Indigenous HealthInfoNet as a part of our contributions to ‘closing the gap’ in health between Indigenous people and other Australians by making relevant, high quality knowledge and information easily accessible to policy makers, health service providers, program managers, clinicians, researchers and the general community. The review is an example of the HealthInfoNet’s translational research, defined as ‘comprehensive applied research that strives to translate the available knowledge and render it operational’.The main purpose of the review, which follows the model of narrative reviews/syntheses, is to provide an authoritative, up-to-date review of acute rheumatic fever and rheumatic heart disease among Indigenous people that: (1) is a valuable overview for people working in the area; and (2) assists in the development/refinement of policies, strategies and programs.Research for the review involved the collection, collation, and analysis of a wide range of relevant information, including both published and unpublished material. Sources include the full range of relevant literature, including journal articles and other relevant publications, the vast majority of which are accessible via the HealthInfoNet’s Australian Indigenous HealthBibliography. This bibliography, with more than more 20,000 entries, captures all relevant journal articles, books, book chapters and reports (including the ‘grey’ literature).As well as the relevant journal literature, the HealthInfoNet’s reviews draw on important government reports, particularly those produced by the Australian Bureau of Statistics (ABS), the Australian Institute of Health and Welfare (AIHW) and the Steering Committee for the Review of Government Service Provision (SCRGSP), and reports in the Aboriginal and Torres Strait Islander health performance framework series. These reports, prepared by the Australian Health Ministers’ Advisory Council (AHMAC) in 2006, 2008, 2011 and 2012, are accompanied by substantial detailed analyses, which are accessible on the AIHW website. The HealthInfoNet’s reviews also draw on information from the main administrative data collections (such as the birth and death registration systems and the hospital inpatient collections) and national surveys. Information from these sources has been published mainly in government reports, particularly those produced by the ABS and the AIHW.After providing the context of acute rheumatic fever and rheumatic heart disease, the body of the review outlines the extent of acute rheumatic fever and rheumatic heart disease among Indigenous people, provides an overview of the various contributing factors, considers prevention and management, summarises a number of relevant policies and strategies, and provides some brief concluding comments. Rather than commence with an executive summary, the review is preceded by a section devoted to ‘Key facts’, which presents the summarised information in a more concise form.  
Nitazoxanide for the treatment of infectious diarrhoea in the Northern Territory, Australia 2007-2012
No full textIntroduction: Australian Indigenous children suffer a high burden of diarrhoeal disease. Nitazoxanide is an antimicrobial that has been shown to be effective against a broad range of enteropathogens. To date, its use has not been reported in the tropical Top End (northernmost part) of the Northern Territory, Australia. The objective was to describe the use of nitazoxanide at the Royal Darwin Hospital, Northern Territory, and to assess any association with the time to resolution of diarrhoea. Methods: Eligible children (=13 years) were identified from dispensary records as having been prescribed nitazoxanide during the audit period, 1 July 2007 to 31 March 2012. Patient demographics, symptoms, diarrheal aetiology, treatment details and clinical outcomes were obtained by chart review. Results: Twenty-eight children were treated with nitazoxanide, mostly for Cryptosporidium infection associated with prolonged diarrhoea. Dehydration was evident in 27 (96%) children on admission, and 11 (41%) were underweight. Diarrhoeal duration prior to treatment was 11.5 days (6.5 days pre- and 5 days post-admission). For children =12 months, nitazoxanide was prescribed according to guidelines stipulated by the Centers for Disease Control and Prevention (CDC). Resolution of diarrhoea occurred a median of 2.4 days (IQR: 1.4-7.3) after starting treatment. An increase in weight for length at discharge was found for all children. Conclusions: Prompt resolution of diarrhoea without adverse outcomes suggests nitazoxanide may be an effective treatment for Cryptosporidium infection in this setting. Its role in the treatment of other causes of infectious diarrhoea needs further investigation. Randomised trials will further direct its use and determine optimal dosing regimens. © C McLeod, PS Morris, TL Snelling, JR Carapetis, AC Bowen, 2014
A Report on the Feasibility Study of the Proposed NT Pneumococcal Vaccine Trial
No full text*This report is free to read on the publisher's website
- …
