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Petsoglou C, Weinel L. Biomaterials and their impact on corneal transplantation and eye banking. Clin Exp Ophthalmol 2023; 51:7-8. [PMID: 36631989 DOI: 10.1111/ceo.14202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Constantinos Petsoglou
- Speciality of Ophthalmology, Save Sight Institute, University of Sydney, Camperdown, New South Wales, Australia.,NSW Tissue Bank, Cornea Unit, Sydney Eye Hospital, Sydney, New South Wales, Australia
| | - Luke Weinel
- The Eye Bank of South Australia, Department of Surgical and Perioperative Medicine, Ophthalmology, Flinders Medical Centre, Bedford Park, South Australia, Australia
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Machin H, Buckland L, Georges P, Ghabcha M, Golding-Holbrook T, Leighton C, Mackey A, Weinel L, Whiting V, Sutton G, Baird PN. Supply and Demand of Domestic Corneal Tissue and Its Implications on Export Potential-Using Australia as an Example. Cornea 2021; 40:1229-1235. [PMID: 33290321 DOI: 10.1097/ico.0000000000002599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/22/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Corneal tissue importation is only possible if another country is able to export corneas without impacting its own domestic demand. Currently, there is little evidence to indicate whether export nations have such surplus capacity and in a position to export. To explore this concept, we examined our nation, Australia, which is reported to routinely decline donations because of its ability to meet domestic corneal transplant demand. Our research offers insights and opportunities for Australia and other nations to evaluate their domestic and international supply and allocation of corneal tissue in this space. METHOD We collated 12 months of data on collected and noncollected donations, through participating Australian Eye Banks. The explanation of why some known donors were declined or not pursued indicated if demand was met and potential surplus-for-export levels. RESULTS There were 7.5% (n = 11,889) of deaths in Australia that were notified to Australian Eye Banks during our reporting period. Of those, 9.3% (n = 1106/11,889) were recovered and allocated, 15.7% (n = 1863/11,889) were known but declined, and 75% (n = 8920/11,889) were not pursued. Of those that were declined, 64.3% (n = 1197/1863) were declined because of limitations with service/manpower at the eye bank, whereas 35.7% (n = 666/1863) were declined because demand was met. CONCLUSIONS Australia did not meet demand all the time, during our data period. There were adequate quantities of potential donors to support increasing recovery for domestic allocation and provide for exportation without hindrance to Australian demand. Further examination of domestic supply and demand cycles and the export process is required before routine exportation.
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Affiliation(s)
- Heather Machin
- Lions Eye Donation Service, Center for Eye Research Australia, University of Melbourne, East Melbourne, Australia
| | - Lisa Buckland
- Lions Eye Bank of Western Australia, Lions Eye Institute, Perth, Australia
| | - Pierre Georges
- New South Wales Tissue Banks, New South Wales Organ and Tissue Donation Service, Sydney, Australia
| | - Mona Ghabcha
- New South Wales Tissue Banks, New South Wales Organ and Tissue Donation Service, Sydney, Australia
| | - Tamme Golding-Holbrook
- Eye Bank of South Australia, Department of Ophthalmology, Surgical and Perioperative Medicine, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, Australia
| | - Candice Leighton
- Queensland Eye Bank, Queensland Tissue Bank, Organ and Tissue Donation Service, Metro South Health, Brisbane, Australia
| | - Adrienne Mackey
- Lions Eye Donation Service, Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Department of Surgery|Ophthalmology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Luke Weinel
- Eye Bank of South Australia, Department of Ophthalmology, Surgical and Perioperative Medicine, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, Australia
| | - Victoria Whiting
- Queensland Eye Bank, Queensland Tissue Bank, Organ and Tissue Donation Service, Metro South Health, Brisbane, Australia
| | - Gerard Sutton
- New South Wales Tissue Banks, New South Wales Organ and Tissue Donation Service, Sydney, Australia
- Discipline of Ophthalmology, Sydney Medical School, Save Sight Institute, The University of Sydney, Sydney, Australia; and
- Graduate School of Health, The University of Technology Sydney, Sydney, Australia
| | - Paul N Baird
- Department of Surgery|Ophthalmology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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Weinel L, Summers M, Poole A, Chapple L. Are point-of-care urine albumin-creatinine ratio measurements accurate in the critically ill? Aust Crit Care 2021; 34:569-572. [PMID: 33663949 DOI: 10.1016/j.aucc.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/23/2020] [Accepted: 01/01/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND In the critical care environment, elevated albuminuria values show capacity to reflect illness severity and predict mortality and hence assessing albumin/creatinine ratio (ACR) at the bedside has potential clinical benefit Point-of-care (POC) analysers offer rapid results but may be less accurate then laboratory analysis. METHODS Critically ill adult patients with a urinary catheter in situ had albumin, creatinine, and ACR measurements performed via laboratory and POC analysis. Data are presented as mean (standard deviation) or median [interquartile range]. Measurement agreement was assessed by Lin's concordance correlation coefficient, Bland Altman 95% limits of agreement, and classification by Cohen's kappa statistic. RESULTS/FINDINGS Albumin, creatinine, and ACR analysis was performed for 30 patients. Lin's correlation coefficient showed 'substantial' agreement for albumin and ACR and 'almost perfect' agreement for creatinine for POC vs laboratory analysis. POC vs laboratory analysis also showed poor agreement for identification of normal ACR (>1 mg/mmol) and mild urine ACR (1-3 mg/mmol) and 'substantial' agreement for moderately increased urine ACR (3-30 mg/mmol). CONCLUSIONS ACR POC values appear to provide an accurate and rapid method that has potential to provide an early indication of injury severity and mortality risk in the critically ill.
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Affiliation(s)
- L Weinel
- Intensive Care Research, Royal Adelaide Hospital, Adelaide, Australia; Discipline of Acute Care Medicine, School of Medicine, The University of Adelaide, Adelaide, Australia.
| | - M Summers
- Intensive Care Research, Royal Adelaide Hospital, Adelaide, Australia; Discipline of Acute Care Medicine, School of Medicine, The University of Adelaide, Adelaide, Australia
| | - A Poole
- Discipline of Acute Care Medicine, School of Medicine, The University of Adelaide, Adelaide, Australia
| | - L Chapple
- Intensive Care Research, Royal Adelaide Hospital, Adelaide, Australia; Discipline of Acute Care Medicine, School of Medicine, The University of Adelaide, Adelaide, Australia
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Chapple LAS, Weinel L, Ridley EJ, Jones D, Chapman MJ, Peake SL. Clinical Sequelae From Overfeeding in Enterally Fed Critically Ill Adults: Where Is the Evidence? JPEN J Parenter Enteral Nutr 2019; 44:980-991. [PMID: 31736105 DOI: 10.1002/jpen.1740] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 10/11/2019] [Accepted: 10/25/2019] [Indexed: 12/13/2022]
Abstract
Enteral energy delivery above requirements (overfeeding) is believed to cause adverse effects during critical illness, but the literature supporting this is limited. We aimed to quantify the reported frequency and clinical sequelae of energy overfeeding with enterally delivered nutrition in critically ill adult patients. A systematic search of MEDLINE, EMBASE, and CINAHL from conception to November 28, 2018, identified clinical studies of nutrition interventions in enterally fed critically ill adults that reported overfeeding in 1 or more study arms. Overfeeding was defined as energy delivery > 2000 kcal/d, > 25 kcal/kg/d, or ≥ 110% of energy prescription. Data were extracted on methodology, demographics, prescribed and delivered nutrition, clinical variables, and predefined outcomes. Cochrane "Risk of Bias" tool was used to assess the quality of randomized controlled trials (RCTs). Eighteen studies were included, of which 10 were randomized (n = 4386 patients) and 8 were nonrandomized (n = 223). Only 4 studies reported a separation in energy delivery between treatment groups whereby 1 arm met the definition of overfeeding, which reported no between-group differences in mortality, infectious complications, or ventilatory support. Overfeeding was associated with increased insulin administration (median 3 [interquartile range: 0-41.8] vs 0 [0-30.6] units/d) and upper-gastrointestinal intolerance in 1 large RCT and with duration of antimicrobial therapy in a small RCT. There are limited high-quality data to determine the impact of energy overfeeding of critically ill patients by the enteral route; however, based on available evidence, overfeeding does not appear to affect mortality or other important clinical outcomes.
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Affiliation(s)
- Lee-Anne S Chapple
- Intensive Care Research, Royal Adelaide Hospital, Adelaide, Australia.,Discipline of Acute Care Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
| | - Luke Weinel
- Intensive Care Research, Royal Adelaide Hospital, Adelaide, Australia.,Discipline of Acute Care Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
| | - Emma J Ridley
- Australaian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University Melbourne, Melbourne, Australia.,Nutrition Department, Alfred Health, Melbourne, Australia
| | - Daryl Jones
- Intensive Care Unit, Austin Health, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University Melbourne, Melbourne, Australia
| | - Marianne J Chapman
- Intensive Care Research, Royal Adelaide Hospital, Adelaide, Australia.,Discipline of Acute Care Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
| | - Sandra L Peake
- Discipline of Acute Care Medicine, School of Medicine, University of Adelaide, Adelaide, Australia.,Department of Intensive Care Medicine, The Queen Elizabeth Hospital, Adelaide, Australia
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Chapple L, Weinel L, Ali Abdelhamid Y, Summers M, Nguyen T, Kar P, Chapman M, Deane A. MON-P003: Critical Illness Reduces Self-Reported Appetite and Oral Intake but Notactual Intake at a weighed Meal 3- Months Post-Discharge. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)31080-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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