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  1. Article: The Diagnostic Performance of a Clinical Diagnosis of Diabetic Kidney Disease.

    Tan, Ken-Soon / McDonald, Stephen / Hoy, Wendy

    Life (Basel, Switzerland)

    2023  Volume 13, Issue 7

    Abstract: Background: Diabetic kidney disease (DKD), a common cause of CKD and kidney failure, is usually diagnosed clinically. However, there is little evidence comparing the performance of a clinical diagnosis to biopsy-proven diagnosis.: Purpose of the study! ...

    Abstract Background: Diabetic kidney disease (DKD), a common cause of CKD and kidney failure, is usually diagnosed clinically. However, there is little evidence comparing the performance of a clinical diagnosis to biopsy-proven diagnosis.
    Purpose of the study: Diagnostic performance of a clinical diagnosis was determined in a group of patients with diabetes and chronic kidney disease who underwent kidney biopsy after an initial clinical diagnosis.
    Methods: A data analysis of 54 patients who were part of a study cohort for a prospective analysis of cardiovascular and kidney outcomes and who had undergone kidney biopsy after an initial clinical diagnosis of DKD or non-DKD (NDKD) at enrolment was used. We determined the sensitivity, specificity, and positive and negative predictive values of a clinical diagnosis of DKD.
    Results: A total of 37 of 43 patients clinically diagnosed with DKD also had biopsy-proven DKD, whilst only 1 of 11 patients who had clinically diagnosed NDKD had biopsy-proven DKD. Sensitivity was 97.4%, specificity was 62.5%, positive predictive value 86%, and negative predictive value 90.9%. Comparable values were obtained when analysis was restricted to those with primary rather than secondary diagnosis of DKD or when restricted to those with only DKD found at biopsy.
    Conclusion: A clinical diagnosis of DKD has high sensitivity and is unlikely to overlook cases but may lead to overdiagnosis.
    Language English
    Publishing date 2023-06-30
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662250-6
    ISSN 2075-1729
    ISSN 2075-1729
    DOI 10.3390/life13071492
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Sterility of antibiotic-admixed peritoneal dialysis solution over time.

    Tan, Ken-Soon / Rogers, Robyn / Shephard, Deanna / Lewis, Amanda / George, Narelle / Johnson, David W

    Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis

    2023  , Page(s) 8968608231213736

    Abstract: Background: Intraperitoneal antibiotics may be required daily for up to three weeks to treat peritoneal dialysis (PD)-related peritonitis. In some jurisdictions, antibiotic-admixed PD solutions are required to be used within 24 h due to concerns ... ...

    Abstract Background: Intraperitoneal antibiotics may be required daily for up to three weeks to treat peritoneal dialysis (PD)-related peritonitis. In some jurisdictions, antibiotic-admixed PD solutions are required to be used within 24 h due to concerns regarding microbial contamination and growth. This requires patients to attend the PD unit daily or alternatively for staff to perform home delivery with associated transport, staffing and cost implications.
    Objective: The aim of this study was to determine if significant microbial growth occurs in PD solutions following their injection with antibiotic or sterile water.
    Methods: Twelve PD solution bags were admixed with cefazolin sodium 1 g, diluted in 10 mL sterile water, while a further 12 PD solution bags were admixed with 10 mL sterile water using aseptic technique (AT) under supervision. All bags were stored at room temperature. Three bags from each experimental group were sampled for microbiologic culture at 0-, 24-, 48- and 72-h intervals.
    Results: One sterile water admixed bag sampled at 24 h yielded a
    Conclusions: Antibiotic-admixed PD solutions prepared using AT and stored at room temperature remained sterile for up to 72 h. This suggests that patients can be safely issued with a supply of antibiotic-admixed PD bags for up to three days at a time.
    Language English
    Publishing date 2023-12-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645010-6
    ISSN 1718-4304 ; 0896-8608
    ISSN (online) 1718-4304
    ISSN 0896-8608
    DOI 10.1177/08968608231213736
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A spurious decline in kidney function: A reality check.

    Vardesh, Deepak L / Frazier, Jeremy Elton / Tan, Ken-Soon

    Australian journal of general practice

    2020  Volume 49, Issue 10, Page(s) 681–682

    MeSH term(s) Aged ; Creatinine/pharmacology ; Creatinine/therapeutic use ; Humans ; Kidney/abnormalities ; Kidney/physiopathology ; Kidney Function Tests/methods ; Male ; Renal Insufficiency/blood ; Renal Insufficiency/diagnosis ; Renal Insufficiency/physiopathology
    Chemical Substances Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2020-10-01
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2924889-9
    ISSN 2208-7958 ; 2208-794X
    ISSN (online) 2208-7958
    ISSN 2208-794X
    DOI 10.31128/AJGP-01-20-5204
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Should we biopsy?

    Chandler, Shaun / Oliver, Kimberly / Tan, Ken-Soon / Palamuthusingam, Dharmenaan

    Internal medicine journal

    2021  Volume 51, Issue 8, Page(s) 1359–1360

    Language English
    Publishing date 2021-08-23
    Publishing country Australia
    Document type Letter
    ZDB-ID 2045436-3
    ISSN 1445-5994 ; 1444-0903
    ISSN (online) 1445-5994
    ISSN 1444-0903
    DOI 10.1111/imj.15454
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Pharmacist-Managed Therapeutic Drug Monitoring Programs within Australian Hospital and Health Services-A National Survey of Current Practice.

    Firman, Paul / Tan, Ken-Soon / Clavarino, Alexandra / Taing, Meng-Wong / Whitfield, Karen

    Pharmacy (Basel, Switzerland)

    2022  Volume 10, Issue 5

    Abstract: Pharmacist-managed therapeutic drug monitoring (TDM) services have demonstrated positive outcomes in the literature, including reduced duration of therapy and decreased incidence of the adverse effects of drug therapy. Although the evidence has ... ...

    Abstract Pharmacist-managed therapeutic drug monitoring (TDM) services have demonstrated positive outcomes in the literature, including reduced duration of therapy and decreased incidence of the adverse effects of drug therapy. Although the evidence has demonstrated the benefits of these TDM services, this has predominately been within international healthcare systems. The extent to which pharmacist-managed TDM services exist within Australia, and the roles and responsibilities of the pharmacists involved compared to their counterparts in other countries, remains largely unknown. A cross-sectional online survey was conducted evaluating pharmacist-managed TDM programs within Australian hospital and healthcare settings. Pharmacist perceptions were also explored about the strengths, weaknesses, opportunities, and barriers associated with implementing a pharmacist-managed TDM service. A total of 92 surveys were returned, which represents a response rate of 38%. Pharmacist-managed TDM programs were present in 15% of respondents. It is only in the minority of hospitals where there is a pharmacist-managed service, with pharmacists involved in recommending pathology and medication doses. The programs highlighted improved patient outcomes but had difficulty maintaining the educational packages and training. For hospitals without a service, a lack of funding and time were highlighted as barriers. Based on the findings of this survey, there is minimal evidence of pharmacist-managed TDM models within Australian hospital and health services. A standardized national approach to pharmacist-managed TDM services and recognition of this specialist area for pharmacists could be a potential solution to this.
    Language English
    Publishing date 2022-10-18
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2737194-3
    ISSN 2226-4787 ; 2226-4787
    ISSN (online) 2226-4787
    ISSN 2226-4787
    DOI 10.3390/pharmacy10050135
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The impact of an electronic hospital system on therapeutic drug monitoring.

    Firman, Paul / Whitfield, Karen / Tan, Ken-Soon / Clavarino, Alexandra / Hay, Karen

    Journal of clinical pharmacy and therapeutics

    2021  Volume 46, Issue 6, Page(s) 1613–1621

    Abstract: What is known and objective: Australian hospitals have undergone a transformation with both a review and expansion of traditional roles of healthcare professionals and the implementation of an ieMR. The implementation of an ieMR brings large scale ... ...

    Abstract What is known and objective: Australian hospitals have undergone a transformation with both a review and expansion of traditional roles of healthcare professionals and the implementation of an ieMR. The implementation of an ieMR brings large scale organizational change within the health system especially for staff with direct patient contact. This is changing the future of healthcare and the roles of healthcare professionals. There is minimal research on the impact of these electronic systems on the people and processes required to realise the improvements in patient care such as therapeutic drug monitoring (TDM) and the role of the pharmacist within the TDM process. The literature has discussed the use of computerised programs to assist with the interpretation of results and calculating of doses but the impact of an ieMR on the TDM process has not been discussed. This study undertook a retrospective analysis at an Australian tertiary hospital to investigate the impact of a digital hospital system on TDM within the facility.
    Methods: A 2-year retrospective audit was conducted on TDM at an Australian Tertiary Hospital. The periods were 2016 (a paper-based hospital) and 2018 (ieMR). Patients were identified using the pathology database. Patients were excluded if under the age of 18, in an outpatient setting or the emergency department. Progress notes, medication charts, ieMR and other relevant pathology were reviewed. They were assessed for appropriateness of the timing of collection, compliance to recommended TDM guidelines, and pharmacist documentation.
    Results and discussion: A total of 2926 observations were included in the analysis. There was as similar percentage of appropriately collected samples between the paper-based system (2016) and the digital hospital system (2018) with 59% and 58% respectively. Results of logistic regression analysis models show the effect of year was not significant with regards to TDM for either a sample being appropriate or the dose adjustment being appropriate. Samples for TDM were more likely to be appropriate if the pharmacist had documented advice but less likely with regards to appropriate dose adjustment. This study considered the effect of introducing a hospital wide digital system on TDM processes. Overall, the results indicate no difference between the paper-based system and ieMR for appropriate samples and doses adjustments.
    What is new and conclusion: To our knowledge, this is the first study of this kind looking at the impact of a digital hospital system on TDM. The introduction of a digital hospital system does not appear to have made improvement on the effective use of TDM. Inappropriate sampling as seen in this study can lead to ineffective clinical management of patients, inefficient use of time, and waste of financial resources. Further work is required to incorporate specific guidance and recommendations within the digital system to optimize TDM.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Australia ; Body Mass Index ; Documentation/standards ; Drug Monitoring/methods ; Electronic Health Records/organization & administration ; Electronic Health Records/standards ; Female ; Guideline Adherence ; Humans ; Male ; Middle Aged ; Practice Guidelines as Topic/standards ; Retrospective Studies ; Tertiary Care Centers/organization & administration ; Tertiary Care Centers/standards
    Language English
    Publishing date 2021-07-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 639006-7
    ISSN 1365-2710 ; 0269-4727
    ISSN (online) 1365-2710
    ISSN 0269-4727
    DOI 10.1111/jcpt.13497
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: The Development, Implementation, and Evaluation of a Pharmacist-Managed Therapeutic Drug Monitoring (TDM) Service for Vancomycin-A Pilot Study.

    Firman, Paul / Tan, Ken-Soon / Clavarino, Alexandra / Taing, Meng-Wong / Dixon, Sally / Singh, Helender / Whitfield, Karen

    Pharmacy (Basel, Switzerland)

    2022  Volume 10, Issue 6

    Abstract: Background: In recent years, pharmacists in Australia have been able to expand their scope to include the provision of a range of services. Although evidence has demonstrated the benefits of pharmacist-managed TDM services, recent studies have shown ... ...

    Abstract Background: In recent years, pharmacists in Australia have been able to expand their scope to include the provision of a range of services. Although evidence has demonstrated the benefits of pharmacist-managed TDM services, recent studies have shown that these services are not prominent within Australia and that the current TDM workflow may not be optimal.
    Methods: An interventional pilot study was conducted of a pharmacist-managed TDM program for vancomycin at a tertiary hospital in Australia.
    Results: In total, 15 pharmacists participated in the program. They performed 50.5% of the medication-related pathology over the intervention period. Pharmacist involvement in the TDM process was more likely to lead to appropriate TDM sample collection (OR 87.1; 95% CI = 11.5, 661.1) and to an appropriate dose adjustment (OR 19.1; 95% CI = 1.7, 213.5). Pharmacists demonstrated increased confidence after the education and credentialling package was provided.
    Conclusions: This study demonstrated that a credentialling package for pharmacists can improve knowledge, skills, and confidence around the provision of pharmacist-managed TDM services for vancomycin. This may lead to the evolution of different roles and workflows enabling pharmacists to contribute more efficiently to improving medication safety and use.
    Language English
    Publishing date 2022-12-12
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2737194-3
    ISSN 2226-4787 ; 2226-4787
    ISSN (online) 2226-4787
    ISSN 2226-4787
    DOI 10.3390/pharmacy10060173
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  8. Article ; Online: The first case of paracoccus yeeii species infection in Australia causing peritonitis in an APD patient.

    Palamuthusingam, Dharmenaan / Tan, Ken-Soon

    Nephrology (Carlton, Vic.)

    2014  Volume 19, Issue 2, Page(s) 116

    MeSH term(s) Aged ; Australia ; Gram-Negative Bacterial Infections/microbiology ; Humans ; Male ; Paracoccus/isolation & purification ; Peritoneal Dialysis/adverse effects ; Peritonitis/etiology ; Peritonitis/microbiology
    Language English
    Publishing date 2014-02
    Publishing country Australia
    Document type Case Reports ; Letter
    ZDB-ID 1303661-0
    ISSN 1440-1797 ; 1320-5358
    ISSN (online) 1440-1797
    ISSN 1320-5358
    DOI 10.1111/nep.12167
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  9. Article ; Online: Kidney failure, CKD progression and mortality after nephrectomy.

    Ellis, Robert J / Cameron, Anne / Gobe, Glenda C / Diwan, Vishal / Healy, Helen G / Lee, Jeremy / Tan, Ken-Soon / Venuthurupalli, Sree / Zhang, Jianzhen / Hoy, Wendy E

    International urology and nephrology

    2022  Volume 54, Issue 9, Page(s) 2239–2245

    Abstract: Purpose: This study tested the hypothesis that progression of chronic kidney disease (CKD) is less aggressive in patients whose primary cause of CKD was nephrectomy, compared with non-surgical causes.: Methods: A sample of 5983 patients from five ... ...

    Abstract Purpose: This study tested the hypothesis that progression of chronic kidney disease (CKD) is less aggressive in patients whose primary cause of CKD was nephrectomy, compared with non-surgical causes.
    Methods: A sample of 5983 patients from five specialist nephrology practices was ascertained from the Queensland CKD Registry. Rates of kidney failure/death were compared on primary aetiology of CKD using multivariable Cox proportional hazards models. CKD progression was compared using multivariable linear and logistic regression analyses.
    Results: Of 235 patients with an acquired single kidney as their primary cause of CKD, 24 (10%) and 38 (17%) developed kidney failure or died at median [IQR] follow-up times of 12.9 [2.5-31.0] and 33.6 [18.0-57.9] months after recruitment. Among patients with an eGFR < 45 mL/min per 1.73m
    Conclusion: Patients who developed CKD after nephrectomy had similar rates of adverse events to most other causes of CKD, except for diabetic nephropathy which was consistently associated with worse outcomes. While CKD after nephrectomy is not the most aggressive cause of kidney disease, it is by no means benign, and is associated with a tangible risk of kidney failure and death, which is comparable to other major causes of CKD.
    MeSH term(s) Diabetic Nephropathies/complications ; Disease Progression ; Glomerular Filtration Rate ; Glomerulonephritis/complications ; Humans ; Nephrectomy/adverse effects ; Proportional Hazards Models ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/epidemiology ; Solitary Kidney/complications
    Language English
    Publishing date 2022-01-27
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 204048-7
    ISSN 1573-2584 ; 0301-1623 ; 0042-1162
    ISSN (online) 1573-2584
    ISSN 0301-1623 ; 0042-1162
    DOI 10.1007/s11255-022-03114-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Frequency and Consequences of Acute Kidney Injury in Patients With CKD: A Registry Study in Queensland Australia.

    Zhang, Jianzhen / Healy, Helen G / Baboolal, Keshwar / Wang, Zaimin / Venuthurupalli, Sree K / Tan, Ken-Soon / Cameron, Anne / Hoy, Wendy E

    Kidney medicine

    2019  Volume 1, Issue 4, Page(s) 180–190

    Abstract: Background: Acute kidney injury (AKI) contributes to and complicates chronic kidney disease (CKD). We describe AKI documented in hospital encounters in patients with CKD from the CKD Queensland registry.: Study design: A retrospective cohort study ... ...

    Abstract Background: Acute kidney injury (AKI) contributes to and complicates chronic kidney disease (CKD). We describe AKI documented in hospital encounters in patients with CKD from the CKD Queensland registry.
    Study design: A retrospective cohort study during 2011 to 2016.
    Setting & participants: Participants had been admitted to a hospital in Queensland.
    Predictors: AKI was identified from
    Outcomes: All-cause mortality with or without kidney replacement therapy (KRT), start-up KRT and maintenance KRT, costs of care.
    Analytical approach: Time to outcomes for those with versus without AKI was evaluated using Cox regression models. Mann-Whitney test was used to compare number of admissions, hospitalized days and costs by AKI status.
    Results: Among 6,365 patients followed up for up to 5.4 years, 2,199 (35%) had 4,711 hospital encounters with an AKI diagnosis. Those with AKI were older (68 vs 64 years old), were more often men (36.7% vs 32.2%;
    Limitations: These findings may not be generalizable to CKD populations from the general community or in other health care environments.
    Conclusions: AKI is associated with strikingly increased deaths, increased rates of KRT, and higher hospital costs.
    Language English
    Publishing date 2019-07-13
    Publishing country United States
    Document type Journal Article
    ISSN 2590-0595
    ISSN (online) 2590-0595
    DOI 10.1016/j.xkme.2019.06.005
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