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2.
ANZ J Surg ; 87(4): 277-281, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28219124

ABSTRACT

BACKGROUND: Western Australia accounts for one-third of Australia's total land mass. Princess Margaret Hospital is the only dedicated plastic surgery tertiary referral centre providing services to over 500 000 children across the state. The aim of this study is to share our experience using telehealth for service provision and delivery of care in a geographically challenging setting. METHODS: A retrospective review was conducted, and data were extracted from patients' notes. The time period was from January 2014 to 31 December 2015 and included all patients registered for plastic surgery telehealth service. RESULTS: There were a total of 194 rural patients (66 males and 128 females), 26 of whom were elective cases. A total of 358 telehealth follow-up consultations were conducted for the 194 patients during the study period. A total of 10 patients were managed via telehealth alone without a clinical review in Perth; 24 patients had their first clinical review in Perth and further follow-up via telehealth, and 99 patients were post-operative cases. Case load ranged from skin lacerations to complex soft tissue and bony injuries as well as elective hand and craniofacial post-operative follow-up cases. Telehealth service was utilized mainly for post-operative follow-up. CONCLUSION: It is our experience that telehealth provides access to Specialist Plastic Surgery service across the state. We utilize telehealth for a wide scope of functions. Patients in rural areas are managed in their home environments, reducing financial and psychosocial burden with the option of transfer to Princess Margaret Hospital should an intervention be required.


Subject(s)
Plastic Surgery Procedures/methods , Plastic Surgery Procedures/statistics & numerical data , Telemedicine/methods , Telemedicine/statistics & numerical data , Australia , Child , Female , Humans , Male , Pediatrics/methods , Retrospective Studies , Rural Population/statistics & numerical data , Tertiary Care Centers/statistics & numerical data
3.
Int J Surg ; 6(6): e52-4, 2008 Dec.
Article in English | MEDLINE | ID: mdl-17400528

ABSTRACT

Heterotopic pancreas is usually asymptomatic. Associated complications include ulceration, bleeding and obstruction, especially gastric outlet obstruction. Acute and chronic pancreatitis including malignant change have been reported. These lesions are often difficult to differentiate clinically from other gastrointestinal diseases including primary gastric malignancy. Histological examination is mandatory to make a correct diagnosis. Limited surgical excision has been shown to be safe and adequate for heterotopic pancreas. We present a patient with heterotopic pancreas who presented with a non-healing gastric ulcer.


Subject(s)
Choristoma/surgery , Pancreas , Stomach Ulcer/surgery , Choristoma/pathology , Humans , Male , Middle Aged , Stomach Ulcer/pathology
5.
Emerg Med J ; 24(7): 485-6, 2007 Jul.
Article in English | MEDLINE | ID: mdl-17582040

ABSTRACT

In the UK, about 2% of the population attend the accident and emergency (A&E) department every year after a head injury. A majority of the patients have minor head injury and are discharged. Studies reveal that patients who reattend the A&E after a minor head injury represent a high-risk group. Concussion injuries are common and not all require treatment at the time of presentation. However, some may worsen after initial presentation and develop signs of serious head injury. A case of minor head injury as a result of head butt during a game of rugby, not associated with alteration in conscious state or focal neurological signs, and subsequent development of frontal lobe abscess a month later is reported. It is important that patients fit to be discharged at the time of consultation are discharged in the care of a responsible adult with clear head injury instruction sheets and are advised to return should their symptoms change. A high index of suspicion should be maintained and an early imaging technique, such as CT scan should be considered in patients reattending the A&E with persistent symptoms even after minor head injury.


Subject(s)
Brain Abscess/etiology , Craniocerebral Trauma/complications , Football/injuries , Streptococcal Infections/etiology , Adult , Craniocerebral Trauma/diagnostic imaging , Craniocerebral Trauma/microbiology , Emergencies , Humans , Male , Radiography , Streptococcus milleri Group/isolation & purification
6.
Aust Fam Physician ; 35(9): 697-8, 2006 Sep.
Article in English | MEDLINE | ID: mdl-16969439

ABSTRACT

In underdeveloped countries, where abortion is still illegal and not easily accessible, the number of unsafe abortions is soaring, as are the associated complications. However, in developed countries, where termination of pregnancy is legal and freely accessible, unsafe methods are uncommonly seen and reported. We report one such case of self induced abortion with instrumentation that presented to an accident and emergency department in the United Kingdom.


Subject(s)
Abortion, Induced/instrumentation , Abortion, Induced/methods , Self Care/instrumentation , Self Care/methods , Adult , Female , Health Knowledge, Attitudes, Practice , Humans , Patient Education as Topic , Pregnancy , Self Care/ethics
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