George Tay

Obstructive sleep apnoea (OSA) is common in Australia but underexamined among First Nations peoples. We conducted a retrospective cross‐sectional analysis of 1563 adult sleep studies in South East Queensland (2022–2023). Thirty‐eight participants (2.4%) identified as First Nations, of whom 74% had OSA. Comorbidities were more frequent among the First Nations cohort, though small sample size limited certainty. These findings reveal both under‐identification of First Nations status and a substantial OSA burden, emphasising the need for culturally informed, community‐led approaches to OSA care in Queensland.

Pseudomonas aeruginosa (Pa) is the predominant bacterial pathogen in people with cystic fibrosis (CF) and can be transmitted by airborne droplet nuclei. Little is known about the ability of ultraviolet band C (UV-C) irradiation to inactivate Pa at doses and conditions relevant to implementation in indoor clinical settings. We assessed the effectiveness of UV-C (265 nm) at up to seven doses on the decay of nebulized Pa aerosols (clonal Pa strain) under a range of experimental conditions. Experiments were done in a 400 L rotating sampling drum. A six-stage Andersen cascade impactor was used to collect aerosols inside the drum and the particle size distribution was characterized by an optical particle counter. UV-C effectiveness was characterized relative to control tests (no UV-C) of the natural decay of Pa. We performed 112 tests in total across all experimental conditions. The addition of UV-C significantly increased the inactivation of Pa compared with natural decay alone at all but one of the UV-C doses assessed. UV-C doses from 246–1968 µW s/cm² had an estimated effectiveness of approximately 50–90% for airborne Pa. The effectiveness of doses ≥984 µW s/cm² were not significantly different from each other (p-values: 0.365 to ~1), consistent with a flattening of effectiveness at higher doses. Modelling showed that delivering the highest dose associated with significant improvement in effectiveness (984 µW s/cm²) to the upper air of three clinical rooms would lead to lower room doses from 37–49% of the 8 h occupational limit. Our results suggest that UV-C can expedite the inactivation of nebulized airborne Pa under controlled conditions, at levels that can be delivered safely in occupied settings. These findings need corroboration, but UV-C may have potential applications in locations where people with CF congregate, coupled with other indoor and administrative infection control measures.

There are no published data on Australian adult cystic fibrosis (CF) patient outcomes post bronchial arterial embolisation (BAE). We report 20 years of experience of BAE at a major Australian tertiary adult CF centre, where 46 patients underwent 100 BAE during this period. Mortality rate was comparable to previous studies (4% per year) and most who died had repeat BAE requirements. A higher proportion (9 out of 45) of patients were transplanted compared to previous publications. Repeat BAE was common and significantly higher in patients already on tranexamic acid.

Background A major impediment to provision of obstructive sleep apnoea (OSA) treatment is reliance on labour‐intensive and costly laboratory‐based polysomnography (PSG). This study investigated if measurement of oximetry and nasal flow via the ApneaLink™ device (AL) could identify patients with moderate–severe OSA among those referred for PSG to a tertiary sleep service. Methods New referrals to The Prince Charles Hospital Sleep Disorders Centre were assessed for suitability. Demographics, anthropometrics, Epworth Sleepiness and OSA50 scores were collected. Exclusion criteria included age < 18 years, pregnancy, significant cognitive impairment, poorly controlled psychiatric disorder, domiciliary oxygen and prior OSA treatment. Participants underwent concurrent type 1 PSG and AL assessments. Results One hundred participants had a mean age of 55 years (SD 17) and were 49% male. Forty‐eight (48%) had moderate–severe OSA on PSG. Composite variable AL 3% oxygen desaturation index (ODI) ≥16 and AL apnoea‐hypopnea index ≥15 had receiver operator characteristic area under the curve of 0.87, sensitivity of 80% and specificity of 94% for PSG AHI ≥15. The three false positives seen with this composite variable had PSG AHI 11–14 and ESS 6–17. The various composites of AL, anthropometric and questionnaire variables did not improve the AUC or specificity but did improve sensitivity. Conclusions AL is useful in the diagnosis of moderate–severe OSA in patients referred to a tertiary sleep disorders centre. This could lessen reliance on PSG, expedite OSA care, lead to significant cost savings and make diagnosis of OSA more available in non‐urban areas.

Patients with neuromuscular diseases benefit from coordinated multidisciplinary care to achieve best outcomes. The integration of multi‐specialty healthcare delivered in a single clinic can be challenging for service providers due to cost and resource limitation. Our cross‐sectional survey of 53 adult patients with neuromuscular disease across Queensland revealed only 27% support the introduction of an integrated multidisciplinary clinic. The most cited reason for opposition to a multidisciplinary clinic was a perceived loss of contact with one's usual doctor. Modifying service delivery in neuromuscular disease is a complex undertaking and will need input from numerous stakeholders.

A prospective study of non-invasive ventilation at The Prince Charles Hospital outside of the intensive care unit from March 2015 to March 2016 was performed. Overall 69 patients were included. Acute hypercapnic respiratory failure was the most common indication (n = 59; 85%). 49 (71%) had multifactorial respiratory failure. 15 (22%) patients died. Premorbid inability to perform self-care (P = 0.001) and the combination of mean pH < 7.25 and mean PaCO₂ ≥ 75 mmHg within 2 h of NIV initiation (P = 0.037) were significantly associated with mortality. There was a non-significant association between older age and mortality.