ORCID Profile
0000-0001-5910-1218
Current Organisations
University of Queensland
,
Queensland Health
,
College of Intensive Care Medicine
,
Royal Australasian College of Physicians
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Terrestrial Ecology | Ecology |
Ecosystem Adaptation to Climate Change | Expanding Knowledge in the Biological Sciences | Flora, Fauna and Biodiversity at Regional or Larger Scales
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.NMD.2018.12.002
Abstract: Myotonic dystrophy type 1 (DM1) is one of the most common muscular dystrophies in adults. This review summarises the current literature regarding the natural history of respiratory dysfunction in DM1, the role of central respiratory drive and peripheral respiratory muscle involvement and its significance in respiratory function, and investigates the relationship between genetics (CTG repeat length) and respiratory dysfunction. The review included all articles that reported spirometry on 10 or more myotonic dystrophy patients. The final review included 55 articles between 1964 and 2017. The major conclusions of this review were (1) confirmation of the current consensus that respiratory dysfunction, predominantly a restrictive ventilatory pattern, is common in myotonic dystrophy and is associated with alveolar hypoventilation, chronic hypercapnia, and sleep disturbance in the form of sleep apnoea and sleep related disordered breathing (2) contrary to commonly held belief, there is no consensus in the literature regarding the relationship between CTG repeat length and severity of respiratory dysfunction and a relationship has not been established (3) the natural history and time-course of respiratory functional decline is very poorly understood in the current literature (4) there is a consensus that there is a significant involvement of central respiratory drive in this alveolar hypoventilation however the current literature does not identify the mechanism for this.
Publisher: Wiley
Date: 03-2022
DOI: 10.1111/RESP.14226
Publisher: European Respiratory Society (ERS)
Date: 2021
Publisher: European Respiratory Society
Date: 05-09-2021
Publisher: Wiley
Date: 2013
DOI: 10.1111/IMJ.12016
Publisher: Wiley
Date: 10-2022
DOI: 10.1111/IMJ.15924
Abstract: Predicting success of a therapy in acute respiratory failure is clinically important. The FOx index (high‐flow rate × FiO 2 )/SpO 2 was retrospectively applied to 70 patients who required high‐flow nasal prongs for hypoxaemic and hypercapnic respiratory failure. The FOx index could predict between success and failure of high‐flow nasal prongs at 6 hours, using non‐invasive markers. This adds to the clinician's toolbox in managing respiratory failure and represents important proof of concept for a prospective study.
Publisher: Elsevier BV
Date: 08-2006
Abstract: Recombinant activated factor VII (rFVIIa) is a powerful hemostatic agent developed for use in hemophilia. It has been used increasingly in life-threatening hemorrhage in a variety of other settings in which conventional medical or surgical therapy is unsuccessful. This report describes the successful use of rFVIIa for pulmonary hemorrhage due to a focal bleeding source in a regional hospital where bronchial artery embolization or surgery were not available. rFVIIa may be a useful temporizing measure in the unstable patient with pulmonary hemorrhage without coagulopathic bleeding when conventional treatment is not immediately available.
Publisher: Springer Science and Business Media LLC
Date: 06-05-2010
DOI: 10.1007/S11325-010-0351-6
Abstract: Lingual thyroid is a rare embryological abnormality that occurs as a result of failed descent of the thyroid gland. We report the case of a 39-year-old male with an incidental finding of a lingual thyroid during intubation for surgery for lower limb fractures. A sleep study indicated an RDI of 38.6, consistent with severe sleep apnoea. The ectopic thyroid was excised via a suprahyoid approach, with resolution of apnoeic symptoms post-operatively. A follow-up sleep study subsequent to his operation confirmed an RDI of 3.7. This is the first time a lingual thyroid causing sleep apnoea has been studied with pre- and post-treatment sleep studies. This is also the first recorded instance of lingual thyroid causing sleep apnoea has been recorded in a male.
Publisher: BMJ
Date: 07-2023
DOI: 10.1136/BMJRESP-2023-001637
Abstract: Data on right ventricular (RV) exercise adaptation following acute intermediate and high-risk pulmonary embolism (PE) remain limited. This study aimed to evaluate the symptom burden, RV functional recovery during exercise and cardiopulmonary exercise parameters in survivors of intermediate and high-risk acute PE. We prospectively recruited patients following acute intermediate and high-risk PE at four sites in Australia and UK. Study assessments included stress echocardiography, cardiopulmonary exercise testing (CPET) and ventilation–perfusion (VQ) scan at 3 months follow-up. Thirty patients were recruited and 24 (median age: 55 years, IQR: 22) completed follow-up. Reduced peak oxygen consumption (VO 2 ) and workload was seen in 75.0% (n=18), with a persistent high symptom burden (mean PEmb-QoL Questionnaire 48.4±21.5 and emPHasis-10 score 22.4±8.8) reported at follow-up. All had improvement in RV-focused resting echocardiographic parameters. RV systolic dysfunction and RV to pulmonary artery (PA) uncoupling assessed by stress echocardiography was seen in 29.2% (n=7) patients and associated with increased ventilatory inefficiency (V̇E/V̇CO 2 slope 47.6 vs 32.4, p=0.03), peak exercise oxygen desaturation (93.2% vs 98.4%, p=0.01) and reduced peak oxygen pulse (p=0.036) compared with controls. Five out of seven patients with RV–PA uncoupling demonstrated persistent bilateral perfusion defects on VQ scintigraphy consistent with chronic thromboembolic pulmonary vascular disease. In our cohort, impaired RV adaptation on exercise was seen in almost one-third of patients. Combined stress echocardiography and CPET may enable more accurate phenotyping of patients with persistent symptoms following acute PE to allow timely detection of long-term complications.
Publisher: Wiley
Date: 07-03-2017
DOI: 10.1002/RCR2.217
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2013
Publisher: European Respiratory Society (ERS)
Date: 07-2021
Publisher: Elsevier BV
Date: 08-2020
Publisher: Springer Science and Business Media LLC
Date: 24-07-2008
DOI: 10.1007/S00134-008-1217-2
Abstract: To report the clinical manifestations of acute hyperammonemic encephalopathy in adult onset ornithine transcarbamylase deficiency (OTCD). Case report. Intensive care unit of a tertiary medical centre. A 48-year-old Caucasian male body builder who developed acute loss of consciousness after a febrile illness. The patient was immediately started on hemodia-filtration, protein elimination and ammonia scavenging medications. Serum ammonium was elevated and plasma and urine amino acids had a pattern indicative of a urea cycle defect. DNA studies revealed a mutation of the urea cycle enzyme, ornithine transcarbamylase. The encephalopathy resolved and the patient slowly recovered though with some cognitive impairment. Adult presentation of OTCD is rare and the mortality and morbidity rates are high. However, survival is possible with rapid correction of hyperammonemia. As the clinical manifestations are non-specific, a high index of suspicion is necessary for the correct diagnosis and management.
Publisher: Wiley
Date: 26-01-2010
DOI: 10.1111/J.1440-1843.2009.01669.X
Abstract: Spinal cord-injured subjects were assessed during the acute admission for sleep-disordered breathing. Polysomnography demonstrated a high incidence of sleep apnoea that persisted during the acute phase. There was no correlation with respiratory function tests or measures of ventilatory control. Screening of this population is worthwhile although the clinical significance is uncertain. Previous studies have demonstrated an increased incidence of sleep apnoea in spinal cord-injured patients. Many of these studies were performed in long-term, stable spinal cord injury (SCI). The aims of this study were: (i) to determine the prevalence of sleep-disordered breathing (SDB) in acute SCI (ii) to document the change in SDB over time during the rehabilitation period and (iii) to correlate the degree of SDB with ventilatory parameters. Sixteen subjects with an acute SCI level T12 and above with complete motor impairment (American Spinal Injury Association impairment scale A or B) were recruited. Assessment, including polysomnography, respiratory function testing, and hypoxic and hypercapnic ventilatory responses, were performed 6-8 weeks post SCI, and repeated 6 months post SCI. Eleven of 16 subjects (73%) had evidence of sleep apnoea, five of whom were moderate to severe. This high incidence persisted during the acute admission, with 9 of 12 subjects (75%) having sleep apnoea on polysomnography 20 weeks following injury. There was no correlation between the severity of SDB and other measures, such as level or completeness of injury, respiratory function tests or measures of ventilatory responses. We have demonstrated a high incidence of sleep apnoea in the acute phase of SCI that persisted during the acute admission. Despite the high incidence of sleep apnoea, patients were relatively asymptomatic. Screening of this population would appear worthwhile given the high prevalence, although the significance of the sleep apnoea and clinical impact is not known.
Publisher: Springer Science and Business Media LLC
Date: 2009
DOI: 10.1186/CC8181
Publisher: Wiley
Date: 04-12-2014
DOI: 10.1002/RCR2.87
Publisher: Springer International Publishing
Date: 2016
Publisher: Wiley
Date: 03-2019
DOI: 10.1111/RESP.13492
Publisher: Springer Science and Business Media LLC
Date: 12-09-2010
Publisher: BMJ
Date: 30-04-2010
Start Date: 04-2012
End Date: 12-2015
Amount: $300,000.00
Funder: Australian Research Council
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