Publications by authors named "Brian Le"

Background: High-flow nasal oxygen (HFNO) therapy delivers humidified, heated air with flow rates of up to 60 L/min with oxygen entrained. HFNO has advantages over conventional oxygen therapy, including precise and reliable fraction of inspired oxygen delivery, therefore is recommended as first-line treatment for people with acute hypoxaemic respiratory failure.

Objectives: This pilot study aimed to determine the feasibility and acceptability of domiciliary nasal high flow (NHF) without entrained oxygen for people with chronic obstructive pulmonary disease (COPD) and severe breathlessness.

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Previous reports indicated many patients with advanced cancer and limited life expectancy have ongoing preventive medication prescription (PMP) of uncertain benefit and increased risk. Our review of palliative care oncology admissions found high rates of PMP (69%) at time of first palliative care admission, despite high rates of inpatient deprescription (88%) and death at a median of 16 days (interquartile range 10-45) following admission. Rates of PMPs did not vary by time from last systemic treatment (P = 0.

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Objective: To compare the magnitude of post-arthroplasty leg length discrepancy (LLD) and incidence of clinically significant LLD measured on CT scanogram using a commonly used measurement method (from the acetabular apex to tibial plafond) to an alternative technique avoiding the use of the acetabular prosthesis as a landmark and to assess inter-observer and intra-rater reliability of the new technique.

Materials And Methods: In this retrospective study, post-arthroplasty LLD measurements were conducted in 100 hips by two interpreters on CT scanogram scout views from the acetabular apex to the tibial plafond (AA-TP) and the inter-teardrop line to the tibial plafond (IT-TP). Aggregate means and proportions of clinically relevant LLD (≥ 10 mm) were compared between methods.

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A collision tumor is a rare neoplastic lesion consisting of two or more coexisting, distinct cell line entities. In this report, we present the case of a 56-year-old male patient with a history of colon cancer who presented to the emergency room with visual deficits that had started about eight months earlier. An ophthalmologic examination reported left homonymous hemianopsia, prompting a brain MRI, which showed a right posterior temporal extra-axial mass concerning intracerebral metastatic colon cancer, in consideration of patient history.

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Aims: To examine the associations between and polymorphisms, plasma oxycodone and metabolite concentrations, and oxycodone response (dose, pain scores, and adverse effects) in people with pain from advanced cancer.

Patients & Methods: This multi-center prospective cohort study included clinical data, questionnaires (pain and adverse effects), and blood (pharmacokinetics, DNA). Negative binomial regression and logistic regression were used.

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Article Synopsis
  • Sleep disturbances are common in advanced cancer patients, affecting 30-78% of them, yet there are few rigorous studies on treatment options.
  • This study tested the effectiveness and safety of temazepam and prolonged-release melatonin against a placebo for treating insomnia in advanced cancer patients, with a total of 21 participants.
  • Both temazepam and melatonin resulted in a significant reduction in insomnia severity compared to placebo, but did not improve overall quality of life; further research with more participants is needed to confirm these results.
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The influence of pharmacogenomics on opioid response, particularly with (rs4680) and (rs1799971) variants, has been studied individually and in combination. However, most studies are in a noncancer context and not all their possible variant combinations have been examined. This study examined (rs4680) and (rs1799971), and their allele combinations, in advanced cancer to examine associations with pain scores, opioid dose, and adverse effects.

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Introduction: Constriction amniotic band syndrome (CABS) is a rare condition associated with the fibrous amniotic bands that restrict and ensnare the fetus in utero resulting in malformations at birth in one per around 15,000 live births. CABS associated with clubfoot, historically required extensive soft-tissue release due to its propensity for relapse.

Case Report: A 2-day-old Caucasian male infant born at 27 weeks gestation through emergency cesarean section due to concern for placental abruption and premature rupture of membranes in the setting of a prenatal history significant for oligohydramnios.

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Introduction: Distal radius fractures account for nearly one-third of all pediatric fractures, making it among the most common of all pediatric fractures. Studies report that distal radius physeal arrest rates following trauma to the distal radius seem to occur in only about 5% of patients. Significant ulnar variance can develop leading to notable pain and limitations in function.

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  • The study looked at when patients with advanced cancer start taking opioid pain medicine after being diagnosed.
  • Most patients got referrals to palliative care (special care for serious illnesses) about 54 days after their diagnosis.
  • People with pancreatic cancer started taking opioids the fastest, but they also had the shortest time to live after diagnosis.
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Microscopes are essential for the biomechanical and hydrodynamical investigation of small aquatic organisms. We report a prototype of a do-it-yourself microscope that enables the visualization of organisms from two orthogonal imaging planes - top and side views. Compared to conventional imaging systems, this approach provides a comprehensive visualization strategy of organisms, which could have complex shapes and morphologies.

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A multidisciplinary approach to the management of tongue cancer is vital for achieving optimal patient outcomes. Nursing and allied health professionals play essential roles within the team. We developed symposia comprising a series of online lectures offering a detailed perspective on the role each discipline and consumer perspective has in the management of patients with tongue cancer.

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Existing medical treatments for endometriosis-related pain are often ineffective, underscoring the need for new therapeutic strategies. In this study, we applied a computational drug repurposing pipeline to stratified and unstratified disease signatures based on endometrial gene expression data to identify potential therapeutics from existing drugs, based on expression reversal. Of 3,131 unique genes differentially expressed by at least one of six endometriosis signatures, only 308 (9.

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Background: Osteoporotic fractures occur in almost half of patients with a spinal cord injury (SCI) and are associated with significant morbidity and excess mortality. Paralyzed Veterans Administration (PVA) guidelines suggest that adequate calcium and vitamin D intake is important for skeletal health, however, the association of these supplements with osteoporotic fracture risk is unclear.

Objectives: To determine the association of filled prescriptions for calcium and vitamin D with fracture risk in Veterans with an SCI.

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Article Synopsis
  • The study investigates how specific gene variants may influence the effectiveness and side effects of opioids in patients with advanced cancer.
  • A total of 35 gene variants were analyzed using clinical data and DNA samples from 54 participants, employing statistical methods like negative binomial and logistic regression.
  • The findings revealed eight significant associations between certain gene variants and opioid-related outcomes, primarily linked to the neuroimmune TLR4 and ARRB2 pathways, suggesting these genes play a role in varied opioid responses among cancer patients.
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Opioid switching is common, however, conversion tables have limitations. Guidelines suggest postswitch dose reduction, yet, observations show opioid doses may increase postswitch. To document the opioid conversion factor postswitch in cancer, and whether pain and adverse effect outcomes differ between switched opioid groups.

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Microscopes are essential for the biomechanical and hydrodynamical investigation of small aquatic organisms. We report a do-it-yourself microscope (GLUBscope) that enables the visualization of organisms from two orthogonal imaging planes - top and side views. Compared to conventional imaging systems, this approach provides a comprehensive visualization strategy of organisms, which could have complex shapes and morphologies.

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In considering the impact of medically hastened death (MHD) on cancer care, a wide range of variables needs to be considered including demographic factors, diagnoses, local cultural factors, and the legislative frameworks in place. Here, we present a synthesis of recently available published literature and empirical data collected following legislative change to enable MHD in Victoria, Australia to explore in detail the potential impact of MHD on cancer care with a focus on patients/families and professional groups. Our findings reveal that for patients and families, both physical and existential distress frequently underlie MHD requests, with the latter less readily recognised by health professionals.

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This study explores and describes the state-wide needs of the first 1000 calls to the newly established Victorian Palliative Care Advice Service (PCAS). A retrospective analysis investigated calls from the Victorian general public (n  = 618 calls) and healthcare professionals (n  = 382 calls) to PCAS between 26 May 2020 and 24 October 2022. Caller demographics, disease type, reason for call, and perceived utility of service were described.

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