Hugh Mitenko - Academia.edu (original) (raw)
Papers by Hugh Mitenko
Emergency Medicine Australasia, Dec 22, 2020
This is the author manuscript accepted for publication and has undergone full peer review but has... more This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as
Acta Paediatrica, Apr 18, 2023
Emergency Medicine Australasia, 2020
ObjectivesTo investigate patient‐level factors predictive for computed tomography of the brain (C... more ObjectivesTo investigate patient‐level factors predictive for computed tomography of the brain (CTB) use and abnormality in head injured children in Australia and New Zealand.MethodsRetrospective data from tertiary, urban/suburban and regional/rural EDs including factors predictive for CTB use and abnormality.ResultsOf 3072 children at 31 EDs, 212 (6.9%) had a CTB scan, of which 66 (31%) were abnormal. Increasing age, serious mechanisms of injury and decreasing Glasgow Coma Score were predictive for ordering CTB. Decreasing age was predictive for CTB abnormalities. Other factors were not.ConclusionPatient‐level drivers of CTB use in children in Australia and New Zealand are consistent with international data.
Background The mechanisms involved in the amplification of the mast cell response during anaphyla... more Background The mechanisms involved in the amplification of the mast cell response during anaphylaxis are unclear. Mouse models of anaphylaxis demonstrate the critical involvement of neutrophils. These innate immune cells are highly abundant in peripheral blood and can be rapidly activated to trigger both local and systemic inflammation. Objective To investigate neutrophil activation in peripheral blood during acute human anaphylaxis. Methods Patients presenting to the Emergency Department with anaphylaxis underwent blood sampling upon enrolment and at up to three subsequent time points. Traditional anaphylaxis biomarkers, histamine and mast cell tryptase, were measured by ELISA and ImmunoCAP respectively. Plasma myeloperoxidase concentrations were measured by ELISA, serum soluble CD62L concentrations by cytometric bead array, and both compared to healthy controls. Results In 72 patients, 37 (51%) had severe anaphylaxis, 33 (60%) were histamine positive, and 47 (70%) were mast cell t...
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 2016
The mechanisms involved in the amplification of the mast cell response during anaphylaxis are unc... more The mechanisms involved in the amplification of the mast cell response during anaphylaxis are unclear. Mouse models of anaphylaxis demonstrate the critical involvement of neutrophils. These innate immune cells are highly abundant in peripheral blood and can be rapidly activated to trigger both local and systemic inflammation. To investigate neutrophil activation in peripheral blood during acute human anaphylaxis. Patients presenting to the Emergency Department with anaphylaxis underwent blood sampling upon enrolment and at up to three subsequent time points. Traditional anaphylaxis biomarkers, histamine and mast cell tryptase, were measured by ELISA and ImmunoCAP respectively. Plasma myeloperoxidase concentrations were measured by ELISA, serum soluble CD62L concentrations by cytometric bead array, and both compared to healthy controls. In 72 patients, 37 (51%) had severe anaphylaxis, 33 (60%) were histamine positive, and 47 (70%) were mast cell tryptase positive. At enrolment, myelo...
Internal Medicine Journal, 2016
Australasian Journal on Ageing, 2021
ObjectiveTo describe the characteristics, assessment and management of older emergency department... more ObjectiveTo describe the characteristics, assessment and management of older emergency department (ED) patients with non‐traumatic headache.MethodsPlanned sub‐study of a prospective, multicentre, international, observational study, which included adult patients presenting to ED with non‐traumatic headache. Patients aged ≥75 years were compared to those aged <75 years. Outcomes of interest were epidemiology, investigations, serious headache diagnosis and outcome.ResultsA total of 298 patients (7%) in the parent study were aged ≥75 years. Older patients were less likely to report severe headache pain or subjective fever (bothP < 0.001). On examination, older patients were more likely to be confused, have lower Glasgow Coma Scores and to have new neurological deficits (allP < 0.001). Serious secondary headache disorder (composite of headache due to subarachnoid haemorrhage (SAH), intracranial haemorrhage, meningitis, encephalitis, cerebral abscess, neoplasm, hydrocephalus, vas...
Headache: The Journal of Head and Face Pain
Emergency medicine Australasia : EMA, Jan 2, 2017
Clinical diagnosis of anaphylaxis is principally based on symptoms and signs. However, particular... more Clinical diagnosis of anaphylaxis is principally based on symptoms and signs. However, particularly for patients with atypical symptoms, laboratory confirmation of anaphylaxis would be useful. This study investigated the utility of mast cell tryptase, an available clinical biomarker, for differentiating anaphylaxis from other causes of critical illness, which can also involve mast cell activation. Tryptase was measured (ImmunoCAP) in serum from patients with anaphylaxis and non-anaphylactic critical illness (controls) at ED arrival, and after 1-2, 3-4 and 12-24 h. Differences in both peak and delta (difference between highest and lowest) tryptase concentrations between groups were investigated using linear regression models, and diagnostic ability was analysed using Receiver Operating Characteristic curve analysis. Peak tryptase was fourfold (95% CI: 2.9, 5.5) higher in anaphylaxis patients (n = 67) than controls (n = 120) (P < 0.001). Delta-tryptase was 5.1-fold (95% CI: 2.9, 8....
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 2016
The mechanisms involved in the amplification of the mast cell response during anaphylaxis are unc... more The mechanisms involved in the amplification of the mast cell response during anaphylaxis are unclear. Mouse models of anaphylaxis demonstrate the critical involvement of neutrophils. These innate immune cells are highly abundant in peripheral blood and can be rapidly activated to trigger both local and systemic inflammation. To investigate neutrophil activation in peripheral blood during acute human anaphylaxis. Patients presenting to the Emergency Department with anaphylaxis underwent blood sampling upon enrolment and at up to three subsequent time points. Traditional anaphylaxis biomarkers, histamine and mast cell tryptase, were measured by ELISA and ImmunoCAP respectively. Plasma myeloperoxidase concentrations were measured by ELISA, serum soluble CD62L concentrations by cytometric bead array, and both compared to healthy controls. In 72 patients, 37 (51%) had severe anaphylaxis, 33 (60%) were histamine positive, and 47 (70%) were mast cell tryptase positive. At enrolment, myelo...
Emergency Medicine Australasia, 2016
This perspective article summarises the experience of conducting a multicentre research project. ... more This perspective article summarises the experience of conducting a multicentre research project. We describe expected and unexpected hurdles we experienced as well as suggesting possible solutions for researchers embarking on multicentre studies.
Emergency medicine Australasia : EMA, Jan 24, 2015
We aimed to provide 'adequate analgesia' (which decreases the pain score by ≥2 and by <... more We aimed to provide 'adequate analgesia' (which decreases the pain score by ≥2 and by <4 [0-10 scale]) and determine the effect on patient satisfaction. We undertook a multicentre, cluster-randomised, controlled, intervention trial in nine EDs. Patients with moderate pain (pain score of ≥4) were eligible for inclusion. The intervention was a range of educational activities to encourage staff to provide 'adequate…
Emergency Medicine Australasia, 2014
Internal Medicine Journal, 2016
Emergency Medicine Australasia, Dec 22, 2020
This is the author manuscript accepted for publication and has undergone full peer review but has... more This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as
Acta Paediatrica, Apr 18, 2023
Emergency Medicine Australasia, 2020
ObjectivesTo investigate patient‐level factors predictive for computed tomography of the brain (C... more ObjectivesTo investigate patient‐level factors predictive for computed tomography of the brain (CTB) use and abnormality in head injured children in Australia and New Zealand.MethodsRetrospective data from tertiary, urban/suburban and regional/rural EDs including factors predictive for CTB use and abnormality.ResultsOf 3072 children at 31 EDs, 212 (6.9%) had a CTB scan, of which 66 (31%) were abnormal. Increasing age, serious mechanisms of injury and decreasing Glasgow Coma Score were predictive for ordering CTB. Decreasing age was predictive for CTB abnormalities. Other factors were not.ConclusionPatient‐level drivers of CTB use in children in Australia and New Zealand are consistent with international data.
Background The mechanisms involved in the amplification of the mast cell response during anaphyla... more Background The mechanisms involved in the amplification of the mast cell response during anaphylaxis are unclear. Mouse models of anaphylaxis demonstrate the critical involvement of neutrophils. These innate immune cells are highly abundant in peripheral blood and can be rapidly activated to trigger both local and systemic inflammation. Objective To investigate neutrophil activation in peripheral blood during acute human anaphylaxis. Methods Patients presenting to the Emergency Department with anaphylaxis underwent blood sampling upon enrolment and at up to three subsequent time points. Traditional anaphylaxis biomarkers, histamine and mast cell tryptase, were measured by ELISA and ImmunoCAP respectively. Plasma myeloperoxidase concentrations were measured by ELISA, serum soluble CD62L concentrations by cytometric bead array, and both compared to healthy controls. Results In 72 patients, 37 (51%) had severe anaphylaxis, 33 (60%) were histamine positive, and 47 (70%) were mast cell t...
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 2016
The mechanisms involved in the amplification of the mast cell response during anaphylaxis are unc... more The mechanisms involved in the amplification of the mast cell response during anaphylaxis are unclear. Mouse models of anaphylaxis demonstrate the critical involvement of neutrophils. These innate immune cells are highly abundant in peripheral blood and can be rapidly activated to trigger both local and systemic inflammation. To investigate neutrophil activation in peripheral blood during acute human anaphylaxis. Patients presenting to the Emergency Department with anaphylaxis underwent blood sampling upon enrolment and at up to three subsequent time points. Traditional anaphylaxis biomarkers, histamine and mast cell tryptase, were measured by ELISA and ImmunoCAP respectively. Plasma myeloperoxidase concentrations were measured by ELISA, serum soluble CD62L concentrations by cytometric bead array, and both compared to healthy controls. In 72 patients, 37 (51%) had severe anaphylaxis, 33 (60%) were histamine positive, and 47 (70%) were mast cell tryptase positive. At enrolment, myelo...
Internal Medicine Journal, 2016
Australasian Journal on Ageing, 2021
ObjectiveTo describe the characteristics, assessment and management of older emergency department... more ObjectiveTo describe the characteristics, assessment and management of older emergency department (ED) patients with non‐traumatic headache.MethodsPlanned sub‐study of a prospective, multicentre, international, observational study, which included adult patients presenting to ED with non‐traumatic headache. Patients aged ≥75 years were compared to those aged <75 years. Outcomes of interest were epidemiology, investigations, serious headache diagnosis and outcome.ResultsA total of 298 patients (7%) in the parent study were aged ≥75 years. Older patients were less likely to report severe headache pain or subjective fever (bothP < 0.001). On examination, older patients were more likely to be confused, have lower Glasgow Coma Scores and to have new neurological deficits (allP < 0.001). Serious secondary headache disorder (composite of headache due to subarachnoid haemorrhage (SAH), intracranial haemorrhage, meningitis, encephalitis, cerebral abscess, neoplasm, hydrocephalus, vas...
Headache: The Journal of Head and Face Pain
Emergency medicine Australasia : EMA, Jan 2, 2017
Clinical diagnosis of anaphylaxis is principally based on symptoms and signs. However, particular... more Clinical diagnosis of anaphylaxis is principally based on symptoms and signs. However, particularly for patients with atypical symptoms, laboratory confirmation of anaphylaxis would be useful. This study investigated the utility of mast cell tryptase, an available clinical biomarker, for differentiating anaphylaxis from other causes of critical illness, which can also involve mast cell activation. Tryptase was measured (ImmunoCAP) in serum from patients with anaphylaxis and non-anaphylactic critical illness (controls) at ED arrival, and after 1-2, 3-4 and 12-24 h. Differences in both peak and delta (difference between highest and lowest) tryptase concentrations between groups were investigated using linear regression models, and diagnostic ability was analysed using Receiver Operating Characteristic curve analysis. Peak tryptase was fourfold (95% CI: 2.9, 5.5) higher in anaphylaxis patients (n = 67) than controls (n = 120) (P < 0.001). Delta-tryptase was 5.1-fold (95% CI: 2.9, 8....
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 2016
The mechanisms involved in the amplification of the mast cell response during anaphylaxis are unc... more The mechanisms involved in the amplification of the mast cell response during anaphylaxis are unclear. Mouse models of anaphylaxis demonstrate the critical involvement of neutrophils. These innate immune cells are highly abundant in peripheral blood and can be rapidly activated to trigger both local and systemic inflammation. To investigate neutrophil activation in peripheral blood during acute human anaphylaxis. Patients presenting to the Emergency Department with anaphylaxis underwent blood sampling upon enrolment and at up to three subsequent time points. Traditional anaphylaxis biomarkers, histamine and mast cell tryptase, were measured by ELISA and ImmunoCAP respectively. Plasma myeloperoxidase concentrations were measured by ELISA, serum soluble CD62L concentrations by cytometric bead array, and both compared to healthy controls. In 72 patients, 37 (51%) had severe anaphylaxis, 33 (60%) were histamine positive, and 47 (70%) were mast cell tryptase positive. At enrolment, myelo...
Emergency Medicine Australasia, 2016
This perspective article summarises the experience of conducting a multicentre research project. ... more This perspective article summarises the experience of conducting a multicentre research project. We describe expected and unexpected hurdles we experienced as well as suggesting possible solutions for researchers embarking on multicentre studies.
Emergency medicine Australasia : EMA, Jan 24, 2015
We aimed to provide 'adequate analgesia' (which decreases the pain score by ≥2 and by <... more We aimed to provide 'adequate analgesia' (which decreases the pain score by ≥2 and by <4 [0-10 scale]) and determine the effect on patient satisfaction. We undertook a multicentre, cluster-randomised, controlled, intervention trial in nine EDs. Patients with moderate pain (pain score of ≥4) were eligible for inclusion. The intervention was a range of educational activities to encourage staff to provide 'adequate…
Emergency Medicine Australasia, 2014
Internal Medicine Journal, 2016