Logan Hospital is the major health centre servicing the Logan region in the state of Queensland and provides a range of speciality services for children and adults. Located at the corner of Armstrong and Loganlea Roads in Meadowbrook, Queensland, Australia.It provides acute medical, surgical, rehabilitation, and maternity services for children and adults. As of 2018, the emergency department is the second busiest in Queensland, seeing more than 88,000 presentations each year.Logan Hospital serves patients who are generally younger, have culturally or linguistically diverse backgrounds, and have an income below the national median.Logan Hospital has grown from a 48-bed community hospital in 1990 to a 448-bed hospital today, mirroring the rapid growth in population in the Logan region.Logan Hospital provides true general medical experience for nursing, medical and allied health trainees and graduates with exposure to a wide spectrum of medical conditions. The new rehabilitation unit, MAPU, orthogeriatric and perioperative services started in 2014 and early 2015. The hospital is affiliated to Griffith University.The hospital's services include mental health, palliative care, and the medical & surgical services of obstetrics, gynaecology, orthopaedics, ear nose & throat, paediatrics, respiratory medicine, neurology, endocrinology, cardiology, renal dialysis, anaesthetics, emergency medicine, specialist outpatient clinics, oral health, pathology, medical imaging, allied health services, and pharmacy.
Nontuberculous mycobacterial (NTM) infections are difficult to treat and are associated with significant morbidity and mortality. Reported success rates with guideline-based therapy vary depending on NTM species and up to 70
To estimate the effect of restrictive fluid management on renal function and mortality in critically ill patients with acute kidney injury (AKI) at high risk of developing positive fluid balance. We conducted a target trial emulation using data from 12 intensive care units in Queensland, Australia (2015–2021). Adults with AKI within 72 h of intensive care unit (ICU) admission and an AKI-Fluid Balance Risk Score ≥ 32 were included. The intervention comprised conservative crystalloid administration, restricted nutritional fluid intake, and diuretic use for 72 h. We estimated per-protocol effects using a sequential doubly robust estimator for longitudinal modified treatment policies. The primary outcome was AKI Rank at day 7; secondary outcomes included 30-day mortality. Among 8,685 patients, the intervention was associated with substantial reduction in fluid balance (− 2,304 mL at 72 h; 95
BACKGROUND:There is a lack of evidence regarding the impact of body weight on the safety of surgical abortion. STUDY DESIGN:We performed a systematic review and meta-analysis of observational studies reporting the effects of obesity on perioperative anaesthetic and surgical outcomes during surgical abortion. Analytical observational studies examining individuals undergoing surgical abortion up to 28 weeks gestation were eligible for inclusion if they reported perioperative anaesthetic or surgical outcomes in participants with body mass index (BMI) in two groups: BMI < 30 kg/m2 and BMI ≥ 30 kg/m2. Sub-analyses were performed comparing outcomes in those with BMI < 30 kg/m2 and ≥ 40 kg/m2. RESULTS:Eight retrospective cohort studies were included, comprising 9912 obese and 31 672 non-obese participants. 1770 participants had BMI ≥ 40 kg/m2 and only 71 had BMI ≥ 50 kg/m2. BMI ≥ 30 kg/m2 was not associated with an increase in major surgical adverse outcomes (RR [95% CIs] 1.16 [0.83-1.62]) compared to BMI < 30 kg/m2. BMI ≥ 40 kg/m2 was associated with increased risk of major complications (RR [95% CIs] 2.60 [1.28-5.28]) based on low-quality evidence from two studies on second-trimester surgical abortion. Anaesthetic adverse outcomes were rare and not increased by BMI ≥ 30 kg/m2 (RR [95% CIs] 1.02 [0.50-2.06]) or BMI ≥ 40 kg/m2 (RR [95% CIs] 2.0 [0.55-7.24]). CONCLUSIONS:Anaesthetic and surgical risks are not increased by BMI ≥ 30 kg/m2. Individuals with BMI ≥ 40 kg/m2 may have increased risk of major surgical complications. The lack of sufficient data on those in the BMI ≥ 40 kg/m2 and BMI ≥ 50 kg/m2 categories underscores the need for further research to ensure high-quality abortion care for this population.
OBJECTIVES:This study examines the symptoms experienced by patients investigated for Acute Coronary Syndrome (ACS). It aims to determine whether symptom clusters exist, whether these predict acute myocardial infarction (AMI), and whether symptom patterns differ between Aboriginal and Torres Strait Islander people and non-Indigenous Australians. METHODS:This analysis of the LEGEND trial included 2185 patients (22.7% of whom identified as Aboriginal and Torres Strait Islander). Data on presenting symptoms and outcomes were collected from patient medical records. Regression analyses examined whether individual symptoms predicted AMI for Aboriginal and Torres Strait Islander and non-Indigenous patients. Factor analysis identified symptom clusters. Regression analyses estimated the associations between each symptom cluster and AMI. RESULTS:Six symptom clusters were identified: pleuritic, numbness, anginal, palpitations, epigastric, and infectious. Anginal was most strongly associated with AMI (Risk ratio [RR] = 1.46; 95% CI: 1.31-1.62), while pleuritic was linked to a reduced risk (RR = 0.47; 95% CI: 0.35-0.62). Numbness (RR = 1.29; 95% CI: 1.11-1.49) and infectious (RR = 1.21; 95% CI: 1.05-1.41) were associated with an increased AMI risk. There were individual symptoms that differed for Aboriginal and Torres Strait Islander patients. However, cluster-level predictive performance was similar across groups. No symptom cluster provided sufficient discriminatory power to rule in or rule out AMI. CONCLUSIONS:Symptom presentation in AMI is heterogeneous, and reliance on "classic" symptoms alone may miss at-risk patients. While some differences in individual symptom associations were observed for Aboriginal and Torres Strait Islander patients, overall cluster patterns were comparable.
