2,397 results match your criteria: "Concord Hospital.[Affiliation]"

Advances and challenges in modeling inherited peripheral neuropathies using iPSCs.

Exp Mol Med

June 2024

Peripheral Neuropathy Research Group, Department of Biomedical Sciences, University of Antwerp, 2610, Antwerp, Belgium.

Inherited peripheral neuropathies (IPNs) are a group of diseases associated with mutations in various genes with fundamental roles in the development and function of peripheral nerves. Over the past 10 years, significant advances in identifying molecular disease mechanisms underlying axonal and myelin degeneration, acquired from cellular biology studies and transgenic fly and rodent models, have facilitated the development of promising treatment strategies. However, no clinical treatment has emerged to date.

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Opioid Analgesic Use among Patients with Kidney Disease: A Systematic Review.

Kidney Blood Press Res

July 2024

The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Camperdown, New South Wales, Australia.

Article Synopsis
  • Opioid analgesics, often used for managing moderate to severe pain, pose safety and efficacy concerns for patients with kidney disease due to their compromised renal function.
  • A systematic review of 32 studies highlighted the use of various opioids, including morphine and fentanyl, despite the overall limited quality of evidence available on their effects in patients with reduced kidney function.
  • The review suggests morphine as the most studied opioid for safety and effectiveness in renal disease, emphasizing the need for further high-quality research to better understand the risks and benefits of different opioids in this patient population.
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Acute kidney injury (AKI) is a frequent finding in acutely ill and hospitalized patients arising from various etiologies. Anuric AKI, a more pronounced form of AKI in which less than 100 cc of urine is produced per day, is most frequently encountered in hospitalized, septic, and post-surgical patients, often secondary to shock or bilateral urinary tract obstruction. The development of anuric AKI in previously healthy patients after outpatient urological procedures presents a unique challenge to physicians, as many outpatient procedures require the routine perioperative administration of multiple nephrotoxic medications.

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Background: Delayed cerebral ischemia and vasospasm are the most common causes of late morbidity following aneurysmal SAH, but their diagnosis remains challenging.

Purpose: This systematic review and meta-analysis investigated the diagnostic performance of CTP for detection of delayed cerebral ischemia and vasospasm in the setting of aneurysmal SAH.

Data Sources: Studies evaluating the diagnostic performance of CTP in the setting of aneurysmal SAH were searched on the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Clinical Answers, Cochrane Methodology Register, Ovid MEDLINE, EMBASE, American College of Physicians Journal Club, Database of Abstracts of Reviews of Effects, Health Technology Assessment, National Health Service Economic Evaluation Database, PubMed, and Google Scholar from their inception to September 2023.

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MOG antibody-associated optic neuritis.

Eye (Lond)

August 2024

Translational Neuroimmunology Group, Kids Neuroscience Centre and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a demyelinating disorder, distinct from multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). MOGAD most frequently presents with optic neuritis (MOG-ON), often with characteristic clinical and radiological features. Bilateral involvement, disc swelling clinically and radiologically, and longitudinally extensive optic nerve hyperintensity with associated optic perineuritis on MRI are key characteristics that can help distinguish MOG-ON from optic neuritis due to other aetiologies.

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Neuroinflammation in amyotrophic lateral sclerosis: pathogenic insights and therapeutic implications.

Curr Opin Neurol

October 2024

Brain and Nerve Research Centre, Concord Clinical School, The University of Sydney, Concord Hospital, Sydney, New South Wales, Australia.

Article Synopsis
  • - Neuroinflammation plays a significant role in amyotrophic lateral sclerosis (ALS) by involving immune pathway dysfunction, including activation of microglia and astrocytes, which lead to neurodegeneration.
  • - Recent findings highlight that ALS is influenced by genetic, epigenetic, and environmental factors, with noncell autonomous inflammatory mechanisms exacerbating the disease through various immune cells and inflammatory cytokines.
  • - The imbalance in both adaptive and innate immunity contributes to the severity and progression of ALS, suggesting that targeting inflammatory processes may offer potential therapeutic benefits.
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Exploring Definitions and Predictors of Response to Biologics for Severe Asthma.

J Allergy Clin Immunol Pract

September 2024

Observational and Pragmatic Research Institute, Singapore; Optimum Patient Care Global, Cambridge, United Kingdom; Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom. Electronic address:

Background: Biologic effectiveness is often assessed as response, a term that eludes consistent definition. Identifying those most likely to respond in real-life has proven challenging.

Objective: To explore definitions of biologic responders in adults with severe asthma and investigate patient characteristics associated with biologic response.

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The Impact of Deprescribing Interventions on the Drug Burden Index and Other Outcomes: A Systematic Review.

J Am Med Dir Assoc

July 2024

Ageing and Pharmacology Laboratory, Kolling Institute, Faculty of Medicine and Health, The University of Sydney and the Northern Sydney Local Health District, Sydney, Australia; Aged Care Department, Royal North Shore Hospital, Sydney, Australia; Clinical Pharmacology Department, Royal North Shore Hospital, Sydney, Australia.

Objectives: The Drug Burden Index (DBI) calculates a person's exposure to anticholinergic and sedative medications. We aimed to review randomized controlled trials (RCTs) of deprescribing interventions that reported the DBI as an outcome, their characteristics, effectiveness in reducing the DBI, and impact on other outcomes.

Design: Systematic review with meta-analysis.

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Background: Invasive CFT is the gold standard for diagnosing coronary vasomotor dysfunction in patients with ANOCA. Most institutions recommend only testing the left coronary circulation. Therefore, it is unknown whether testing multiple coronary territories would increase diagnostic yield.

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Hypertension is often linked with metabolic risk factors that share common pathophysiological pathways. Despite wide-spread availability of multiple drug classes, optimal blood pressure (BP) control remains challenging. Increased central sympathetic outflow is frequently neglected as a critical regulator of both circulatory and metabolic pathways and often remains unopposed therapeutically.

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Inherited peripheral neuropathies (IPNs) encompass a clinically and genetically heterogeneous group of disorders causing length-dependent degeneration of peripheral autonomic, motor and/or sensory nerves. Despite gold-standard diagnostic testing for pathogenic variants in over 100 known associated genes, many patients with IPN remain genetically unsolved. Providing patients with a diagnosis is critical for reducing their 'diagnostic odyssey', improving clinical care, and for informed genetic counselling.

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Oral corticosteroid dosage and taper duration at onset in myelin oligodendrocyte glycoprotein antibody-associated disease influences time to first relapse.

J Neurol Neurosurg Psychiatry

October 2024

Translational Neuroimmunology Group, Kids Neuroscience Centre and Brain and Mind Centre, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia

Article Synopsis
  • The study aimed to find an effective oral corticosteroid regimen for myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) that extends the time to first relapse and reduces overall steroid exposure.
  • In a retrospective study of 109 patients, higher doses of oral prednisone, particularly 12.5 mg/day or more for at least 3 months, significantly delayed the time to first relapse, with notable reductions in relapse risk.
  • The findings suggest that a daily dose of 12.5 mg of prednisone for adults (or 0.16 mg/kg for children) at disease onset is optimal, showing no serious adverse effects in patients treated at this level.
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Poor nutrition is a risk factor for dental decay in younger people. However, except for sugar, it is unclear if this is true in older age groups. The aim of this study was to analyze the possible associations between overall dietary intake of nutrients and diet quality and the presence of dental decay in community-dwelling older men.

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Background: Microvascular resistance reserve (MRR) has been proposed as a specific metric to quantify coronary microvascular function. The long-term prognostic value of MRR measured in stable patients immediately after percutaneous coronary intervention (PCI) is unknown. This study sought to determine the prognostic value of MRR measured immediately after PCI in patients with stable coronary artery disease.

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Inflammatory bowel disease (IBD) is rapidly emerging in the Asia Pacific region. However, there are many challenges in the diagnosis and management of this condition. The Asian Pacific Association of Gastroenterology (APAGE) Working Group on IBD conducted a round table meeting to identify 10 common mistakes in the management of IBD in Asia.

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Hexanucleotide repeat expansions (HREs) in the chromosome 9 open reading frame 72 (C9orf72) gene are the most frequent genetic cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Both are debilitating neurodegenerative conditions affecting either motor neurons (ALS) in the brain and spinal cord or neurons in the frontal and/or temporal cortical lobes (FTD). HREs undergo repeat-associated non-ATG (RAN) translation on both sense and anti-sense strands, generating five distinct dipeptide repeat proteins (DPRs), poly-GA, -GR, -GP, -PA and -PR.

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Objectives: The aim of the study was to evaluate mortality and morbidity outcomes following open-heart isolated tricuspid valve surgery (TVSx) with medium to long-term follow-up.

Design: Retrospective cohort study.

Setting: New South Wales public and private hospital admissions between 1 January 2002 and 30 June 2018.

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Article Synopsis
  • The study investigates how pre-biologic biomarker levels, specifically immunoglobulin E (IgE), blood eosinophil count (BEC), and fractional exhaled nitric oxide (FeNO), influence asthma treatment outcomes when patients start biologic therapy.
  • Conducted across 23 countries with over 3750 patients, the research focused on changes in exacerbation rates, symptom control, and lung function about a year after starting treatment.
  • Results showed that higher levels of BEC and FeNO were linked to significant improvements in lung function for specific biologic therapies, while IgE was not a strong predictor of treatment effectiveness.
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A tale of two studies: is peripheral eosinophilia associated with Dientamoeba fragilis detection in adult stool samples?

Pathology

August 2024

Department of Microbiology and Infectious Diseases, Concord Hospital, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. Electronic address:

The protozoan parasite Dientamoeba fragilis is a frequently isolated stool organism and postulated cause of gastrointestinal symptoms. Peripheral blood eosinophilia has been described. This is the first study amongst the Australasian adult population to assess the relationship between organism detection and eosinophilia.

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Article Synopsis
  • There is currently no agreed-upon definition for asthma remission in real life, and the factors that help patients achieve it after starting biologics are not well understood.
  • A study analyzed data from 23 countries to see how many adults with severe asthma reached multidomain-defined remission after beginning biologic treatment, using specific criteria for remission.
  • Results showed that less than a quarter of participants achieved full remission, with higher chances for those with fewer exacerbations, lower corticosteroid use, and better control and lung function before treatment, suggesting that early intervention is crucial for better outcomes.
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Safety of vaginal oestrogens for genitourinary symptoms in women with breast cancer.

Aust J Gen Pract

May 2024

BMBS, FRACGP, General Practitioner, General Practice Plus, South Hobart, Tas; Clinical Senior Lecturer, University of Tasmania, Hobart, Tas; President, Australasian Menopause Society, Healesville, Vic.

Background: Oestrogen deprivation is the mainstay of treatment for women with hormone receptor-positive breast cancer, but unfortunately it causes multiple side effects that can significantly impair quality of life. Genitourinary symptoms are very common and although these symptoms can be effectively managed with vaginal oestrogens, concerns about their safety in women with breast cancer limits their use.

Objective: The aim of this review is to provide a summary of the data on the safety of vaginal oestrogens in women with breast cancer to help general practitioners advise their patients in this situation.

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Optimising Transitional Care Following a Heart Failure Hospitalisation in Australia.

Heart Lung Circ

July 2024

Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia; Faculty of Science, Health, Education and Engineering, University of Sunshine Coast, Sunshine Coast, Qld, Australia; Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia.

Hospitalisations for heart failure (HF) are associated with high rates of readmission and death, the most vulnerable period being within the first few weeks post-hospital discharge. Effective transition of care from hospital to community settings for patients with HF can help reduce readmission and mortality over the vulnerable period, and improve long-term outcomes for patients, their family or carers, and the healthcare system. Planning and communication underpin a seamless transition of care, by ensuring that the changes to patients' management initiated in hospital continue to be implemented following discharge and in the long term.

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Next-Generation Sequencing and Emerging Technologies.

Semin Thromb Hemost

October 2024

Translational Genomics Group, Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.

Article Synopsis
  • Genetic sequencing technologies are rapidly advancing, leading to significant changes in both research and clinical practices, particularly through next-generation sequencing (NGS) which is more efficient than traditional methods.
  • The authors detail various short-read sequencing techniques, including sequencing by synthesis and nanoball sequencing, as well as the benefits of third-generation long-read sequencing, which addresses limitations of short-read methods.
  • Emerging technologies like nanopore sequencing and microscopy-based techniques are paving the way for personalized medical care, especially in treating hematological disorders.
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Purpose: To analyse real-world outcomes in Asian eyes of iStent inject, a second-generation trabecular micro-bypass stent, combined with phacoemulsification.

Methods: This is a multi-centre, observational study of glaucomatous Asian eyes that have undergone iStent inject implantation combined with cataract surgery. Patient data were extracted from the Fight Glaucoma Blindness! Registry.

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Secondary fracture prevention in primary care: a narrative review.

Osteoporos Int

August 2024

Bone Research Program, ANZAC Research Institute, The University of Sydney at Concord Campus, Hospital Rd, Gate 3, Concord, NSW, Australia.

The global burden of osteoporosis continues to rise with an ageing population. Untreated osteoporotic fractures not only heighten the risk of subsequent fractures but are associated with excess mortality. Although primary care guidelines consistently stress the importance of secondary fracture prevention, fewer than 20% of patients are appropriately treated for osteoporosis following an initial osteoporotic fracture.

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