Clinical impact of the Z0011 trial on axillary surgical management in Australia and New Zealand from the BreastSurgANZ Quality Audit.

Background: The clinical management of the axilla in early breast cancer has changed since the Z0011 trial, which showed that axillary lymph node dissection (ALND) is not necessary in select patients with a positive sentinel lymph node biopsy (SLNB). Studies have shown a significant decrease in the rates of completion ALND (cALND) since Z0011. The aims of this study were to investigate the effect of the Z0011 trial on the management of positive axillary sentinel nodes and the trends in axillary surgical management since 2005 in Australia and New Zealand.

Clinical outcomes and management following progressive disease with anti-PD-(L)1 therapy in patients with advanced Merkel Cell Carcinoma.

Aim: Merkel Cell Carcinoma (MCC) is a rare skin cancer with a rising incidence worldwide. Anti-programmed death-1/ligand-1 (anti-PD-(L)1) therapies are effective for the treatment of advanced MCC. This study examines patterns of response / progression of advanced MCC to anti-PD-(L)1 therapies and describes subsequent management.

A preliminary hospital-based study of a hybrid placement incorporating traditional and non-traditional placement and supervisory model elements: Perspectives of undergraduate speech-language pathology.

Purpose: This preliminary study sought to explore speech-language pathology students' perspectives of a novel placement experience embedding traditional and non-traditional placement and supervisory model-elements in a hospital setting.

Method: A mixed-method sequential explanatory design was used, incorporating an online survey comprising of 26 questions and a focus group. Descriptive statistics were obtained and a reflexive thematic approach was used to analyse the transcripts.

Vedolizumab serum trough concentrations with and without thiopurines in ulcerative colitis: The prospective VIEWS pharmacokinetics study.

Background: Ulcerative colitis (UC) is a chronic inflammatory condition requiring continuous treatment and monitoring. There is limited pharmacokinetic data on vedolizumab during maintenance therapy and the effect of thiopurines on vedolizumab trough concentrations is unknown.

Aim: To investigate the exposure-response relationship of vedolizumab and the impact of thiopurine withdrawal in UC patients who have achieved sustained clinical and endoscopic remission during maintenance therapy.

The impact of medication regimen complexity on patient-related and clinical outcomes in kidney failure: a systematic review.

Introduction: Kidney failure is a life-limiting condition that profoundly impacts an individual's quality of life. The significant medication burden on patients required to manage the comorbidities and complications of kidney failure can have implications for patient-reported and clinical outcomes.

Methods: This work systematically reviewed methods used to assess medication regimen complexity amongst adults with kidney failure, the associated patient-reported and clinical outcomes, and the effectiveness of interventions to address regimen complexity.

Affinity maturation endows potent activity onto class 6 SARS-CoV-2 broadly neutralizing antibodies.

The emergence of SARS-CoV-2 variants of concern (VOCs) has greatly diminished the neutralizing activity of previously FDA-approved monoclonal antibodies (mAbs), including that of antibody cocktails and of first-generation broadly neutralizing antibodies such as S309 (Sotrovimab). In contrast, antibodies targeting cryptic conformational epitopes of the receptor binding domain (RBD) have demonstrated broad activity against emerging variants, but exert only moderate neutralizing activity, which has so far hindered clinical development. Here, we utilize in vitro display technology to identify and affinity-mature antibodies targeting the cryptic class 6 epitope, accessible only in the "up" conformation of the SARS-CoV-2 spike trimer.

Breast Desmoid Tumours: A Review of the Literature.

Breast desmoid tumour is a rare type of benign breast disease that presents like malignancy. Current guidelines are based on limited evidence derived from case reports and small case series and recommend resection with microscopically-negative margin (R0). There is a high risk of recurrence despite negative surgical margins.

Excipient induced allergies in oral medications: unravelling the covert threat - a systematic review.

Excipients have been identified as 'inert' substances that often enhance the non-pharmacological aspects of a medication. However, recent clinical evidence elucidates their potential in inducing anaphylaxis and indicates that they are often overlooked as potential allergens in routine clinical practice. The aim of the study was to assimilate published evidence on excipient-induced allergies associated with the use of oral medications and to underline their potential as potent allergens.

Open-Access 12-Minute MRI Screening for Acute Appendicitis: A Five-Year Retrospective Observational Study of Diagnostic Accuracy.

: This retrospective observational diagnostic accuracy study aims to demonstrate that open-access rapid-sequence non-contrast magnetic resonance imaging (MRI) is accurate for exclusion or confirmation of acute appendicitis (AA). : In 2017, a locally designed 12 min MRI protocol was made available as a new open-access option (no booking needed) for any emergency department (ED) or acute surgical patient with any clinical presentation at the authors' sites. Uninterrupted single-radiologist reporting availability was provided.

Caregiver Medication Information Needs and Medication Management Challenges in Pediatric Cancer: A Systematic Review.

The objective of this systematic review was to identify the medication information needs and preferences of caregivers of children with cancer and explore the medication management challenges these caregivers experienced. We conducted a systematic search of three databases (Cumulative Index to Nursing and Allied Health Literature, Embase, and Medline) for studies published from database inception to February 27, 2024, and assessed the medication information needs of caregivers of children with cancer. The methodological quality of qualitative studies was assessed using the Critical Appraisal Skills Programme Qualitative Research Checklist.

Consumption of Sugar-Sweetened Beverages in People with Severe Mental Illness: A Community-Based Cohort Study.

Objective: Excess mortality in mentally ill is largely due to high rates of physical illnesses that lead to worse health outcomes. This study examines the intake of added sugar from sugar-sweetened beverages (SSBs) and factors associated with poor mental and physical health in people with severe mental illness.

Methods: Data were collected as part of the standard care of consumers attending the Collaborative Centre for Cardiometabolic Health in Psychosis clinics where a diet history is taken by a dietitian.

Ethnic Differences in Characteristics of Women Diagnosed with Early Gestational Diabetes: Findings from the TOBOGM Study.

Objective: To compare the prevalence and clinical characteristics of early gestational diabetes (eGDM) and associated birth outcomes amongst women of different ethnic groups.

Research Design And Methods: This is a secondary analysis of an international, multicentre randomized controlled trial of treating eGDM among pregnant women with GDM risk factors enrolled <20 weeks' gestation. The diagnosis of GDM was made using WHO-2013 criteria.

Association Between Glycemia, Glycemic Variability, and Pregnancy Complications in Early GDM.

Objective: To investigate the association of timing of commencing glucose management with glycemia, glycemic variability, and pregnancy outcomes among women with early gestational diabetes mellitus (GDM).

Research Design And Methods: In this substudy among participants of a trial of immediate vs. delayed treatment of early GDM diagnosed by 2013 World Health Organization criteria, all women treated immediately and those with delayed diagnosis at 24-28 weeks' gestation (treated as if late GDM) were instructed to monitor capillary blood glucose (BG) four times a day (fasting and 2-h postprandial) until delivery.

Same patient but different worlds: A state-of-the-art review translating best practice psychosocial care from musculoskeletal care to the orthopaedic context.

Background: Individuals with chronic musculoskeletal conditions experience persistent pain and disability that has deleterious impacts on physical function, psychological health, social engagement, relationships, and work participation. This impact is greater in people with psychosocial risk factors, and best practice musculoskeletal care recommends a biopsychosocial approach to management. Orthopaedic surgery is often an effective management approach for chronic musculoskeletal conditions, but research has only recently explored the links between differing patient outcomes after orthopaedic surgery and psychosocial risk factors.

Barriers and facilitators to using feedback from clinical quality registries: a scoping review protocol.

Background: A clinical quality registry (CQR) is a structured database that systematically collects data to monitor clinical quality and improve healthcare outcomes. The aims of CQRs are to improve treatment plans, assist in decision-making, increase healthcare value, enhance care quality, and reduce healthcare costs by providing feedback to healthcare providers. Feedback to clinicians is used as a quality improvement tool.

The quality and safety of using generative AI to produce patient-centred discharge instructions.

Patient-centred instructions on discharge can improve adherence and outcomes. Using GPT-3.5 to generate patient-centred discharge instructions, we evaluated responses for safety, accuracy and language simplification.

MOGAD presenting as fulminant intracranial hypertension.

Objectives: Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) has an expanding phenotype. We describe two cases of MOGAD with associated severe intracranial hypertension. Case 1: A 21-year-old male presented with diffuse cortical encephalitis and intracranial hypertension with both serum and CSF MOG antibody positivity.

Telehealth Use and Legal Considerations in Drug Health Services During Pandemics: Systematic Scoping Review.

Background: The COVID-19 pandemic impacted patients with substance use disorder (SUD) more than the general population and resulted in substantially increased emergency department admissions. Routine care of patients attending drug health services during the pandemic transitioned, with telehealth being important in delivering appropriate care. However, telehealth introduces unique risks such as privacy, confidentiality, and data safety.

Air Purifiers and Acute Respiratory Infections in Residential Aged Care: A Randomized Clinical Trial.

Importance: The effectiveness of in-room air purification for the reduction of acute respiratory infections (ARIs) in residential aged-care facilities (RACFs) is unknown.

Objective: To investigate the effectiveness of in-room air purifiers with high-efficiency particulate air (HEPA)-14 filters in reducing the incidence of ARIs among residents of RACFs.

Design, Setting, And Participants: This randomized clinical trial used a multicenter, double-blind, 2-period, 2-treatment crossover design for 6 months from April 7 to October 26, 2023, in 3 RACFs with a bed capacity of 50 to 100 in New South Wales, Australia.

The Development of Heart Failure Electronic-Message Driven Tips to Support Self-Management: Co-Design Case Study.

Background: Heart failure (HF) is a complex syndrome associated with high morbidity and mortality and increased health care use. Patient education is key to improving health outcomes, achieved by promoting self-management to optimize medical management. Newer digital tools like SMS text messaging and smartphone apps provide novel patient education approaches.

On being on the same page: Predictors of gastroenterologist-patient misalignment in inflammatory bowel disease.

Objectives: This study explored the prevalence and degree of misalignment between gastroenterologists and people with inflammatory bowel disease (IBD) and investigated communication features related to misalignment.

Methods: A mixed-methods approach incorporated qualitative and quantitative analyses of consultations and post-consultation patient and doctor interviews. Gastroenterologists at two Australian teaching hospitals and IBD patients participated in this study.