3,448 results match your criteria: "General Hospital "Alexandra"[Affiliation]"

Background And Aim: In immunochemical fecal occult blood test (iFOBT) positive subjects, colonoscopy screening can detect colorectal cancers and advanced adenomas, yet most iFOBT-positive subjects find no relevant lower gastrointestinal lesions. Limited data are available on upper gastrointestinal (UGI) cancer risk in iFOBT-positive patients. This study investigated the incidence of UGI malignancies diagnosed within 3 years post-colonoscopy after a positive iFOBT.

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Purpose: Hospital length of stay (LOS) following admission for appendicitis is difficult to predict. Shock index, pediatric age adjusted (SIPA) accurately identifies severely injured trauma patients and predicts mortality among children admitted to the ICU. Our aim was to determine if elevated SIPA at presentation, and time to normalization of SIPA, can identify children with perforated appendicitis and predict hospital LOS.

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Australian community and inpatient general public sector mental health services between 2017-18 and 2021-22: Relative stasis in bed capacity, increasing outpatient demand, and stunted expenditure.

Australas Psychiatry

November 2024

Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia; Department of Psychiatry, The Canberra Hospital, Garran, ACT, Australia; Academic Unit of Psychiatry and Addiction Medicine, School of Medicine and Psychology, Canberra Hospital, The Australian National University, Canberra, ACT, Australia.

Objective: To descriptively analyse Australian public sector General Mental Health Services (GMHS) expenditure, ambulatory, and inpatient services, including key performance indicators (KPIs) in comparison with other subspeciality mental health services (MHS).

Method: We descriptively analysed data published by the Australian Institute of Health and Welfare (AIHW), including inpatient, ambulatory services, expenditure, and KPIs.

Results: From 2017-18 to 2021-22, per capita expenditure for Australian GMHS (18-64) rose by an average annual inflation-adjusted change of 2%.

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We present a 39-centimeter thecoma with ascites and elevated Ca-125 values which is compatible with an atypical/incomplete Meigs' syndrome. Giant ovarian masses with elevated Ca-125 values and ascites are an alarming combination, although Gynecologists should be aware that there are also benign entities that mimic advanced stage ovarian cancer.

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Siltuximab in Idiopathic Multicentric Castleman Disease: Real-World Experience.

J Hematol

October 2024

Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital, Athens, Greece.

Article Synopsis
  • Castleman disease (CD) is a rare non-cancerous condition that can be unicentric or multicentric (MCD), with MCD leading to serious symptoms due to cytokine issues, particularly involving interleukin-6 (IL-6).
  • This study examined the real-world effectiveness of siltuximab, an anti-IL-6 therapy recommended for idiopathic MCD, in treating patients in Greece and Romania from 2017 to 2022.
  • Out of 48 patients treated, 71.1% had a response to the treatment, with a 3-year survival rate of 74%, but some patients experienced adverse effects like elevated liver enzymes and anxiety.
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Recommendations from the French Societies of Rheumatology and Physical Medicine and Rehabilitation on the non-pharmacological management of knee osteoarthritis.

Ann Phys Rehabil Med

October 2024

Department of Rheumatology, Saint-Antoine Hospital, Assistance Publique-Hopitaux de Paris, Sorbonne Université, Inserm UMRS_938, FHU PaCeMM Paris, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France. Electronic address:

Article Synopsis
  • - The French Society of Rheumatology and the French Society of Physical Medicine and Rehabilitation aimed to create recommendations for non-drug treatments for knee osteoarthritis due to their inadequate consideration in care.
  • - A systematic review of literature was conducted, followed by discussions among experts to draft and evaluate a list of recommendations for managing knee OA non-pharmacologically.
  • - Five key principles were established, emphasizing a combination of treatments, personalized management, adherence, appropriate exercise, and education, alongside specific recommendations for 11 modalities like braces, physical therapy, and weight loss.
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Article Synopsis
  • * Overlapping DGBI patients tend to have more severe gastrointestinal symptoms and a higher psychosocial burden, influenced by various factors such as gut motility, brain function, immune response, and genetic markers.
  • * Recent research indicates that alterations in the gut microbiome may play a crucial role in the mechanisms of DGBI, which could help refine diagnostic and treatment approaches for better patient outcomes.
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Introduction: The aim of this study was to pilot test a question prompt list (QPL) about cardiovascular disease (CVD) risk reduction after hypertensive pregnancy (HDP).

Methods: In a prospective cohort study of adult women who had HDP given the QPL before and surveyed after a physician visit, we assessed perceived person-centred care, self-efficacy for self-management, perceived self-management and QPL feasibility.

Results: Twenty-three women participated: 57% of diverse ethno-cultural groups, 65% < 40 years of age and 48% immigrants.

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The evolving role of medical thoracoscopy on therapeutic management of pleural disease.

Curr Opin Pulm Med

January 2025

Division of Respiratory and Critical Care Medicine. Department of Medicine, National University Hospital, Singapore.

Article Synopsis
  • Medical thoracoscopy (MT) is a less invasive procedure widely accepted for diagnosing and managing pleural diseases, offering advantages for patients who cannot undergo general anesthesia.
  • Recent advancements include new techniques for identifying malignant pleural effusions and the potential benefits of combining MT with talc poudrage and pleural catheter insertion to reduce hospital stays.
  • The review discusses MT's role in treating a range of conditions beyond malignant effusions, including pneumothorax and pleural infections, highlighting its benefits and drawbacks compared to traditional methods for better clinical decision-making.
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Multiple myeloma (MM) is the second most common hematological malignancy, characterized by unregulated monoclonal proliferation in the bone marrow. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) are premalignant conditions that can progress to MM. Identifying etiological risk factors for MM and its precursor diseases is crucial for prevention.

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Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease (ILD) relating to specific occupational, environmental or medication exposures. Disease behaviour is influenced by the nature of exposure and the host response, with varying degrees of lung inflammation and fibrosis seen within individuals. The differentiation of HP from other ILDs is important due to distinct causes, pathophysiology, prognosis and management implications.

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This study evaluated patient-reported outcomes (PROs) of Medicine Access Programmes (MAPs) for Australian metastatic breast cancer patients on ribociclib. Limited patient awareness of MAP enrolment was identified, emphasising the need for improved education and consent processes. Most patients expressed gratitude for accessing non-funded medications and perceived enhanced medication adherence as a key benefit.

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Red blood cell alloimmunization in transfused patients with hereditary hemorrhagic telangiectasia: A single centre retrospective study.

Transfus Apher Sci

December 2024

Division of Hematology-Oncology, Department of Medicine, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada; Department of Laboratory Medicine, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON, M5B 1W8 Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 King's College Cir, Toronto, ON, M5S 1A8, Canada. Electronic address:

Background: Hereditary hemorrhagic telangiectasia (HHT) is a genetic blood vessel disorder which may lead to chronic bleeding and red blood cell (RBC) transfusions. Data on transfusion requirements and complications in HHT patients are sparse.

Study Design And Methods: Retrospective chart review was conducted at St.

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Exogenous Opioids and the Human Endocrine System: An Endocrine Society Scientific Statement.

Endocr Rev

November 2024

Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara 44100, Italy.

The use and misuse of opioids are a growing global problem. Although the effects of these drugs on the human endocrine system have been studied for decades, attention on their related clinical consequences, particularly on the hypothalamic-pituitary system and bone health, has intensified over recent years. This Statement appraises research data related to the impact of opioids on the gonadal and adrenal function.

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An Assessment of an Inpatient Robotic Nurse Assistant: A Mixed-Method Study.

J Med Syst

October 2024

Medical Affairs - Research Innovation & Enterprise, Alexandra Hospital, National University Health System, Singapore, Singapore.

The worldwide nursing shortage has led to the exploration of using robotics to support care delivery and reduce nurses' workload. In this observational, mixed-method study, we examined the implementation of a robotic nurse assistant (RNA) in a hospital ward to support vital signs measurements, medication, and item delivery. Human-robot interaction was assessed in four domains: usability, social acceptance, user experience, and its societal impact.

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Background: Programmed cell death 1 receptor (PD-1) inhibition as monotherapy followed by Cytotoxic T-lymphocyte associated protein 4 (CTLA-4) inhibition in case of progression or as upfront double co-inhibition has drastically improved the survival outcomes of metastatic melanoma. Still, many patients develop primary or acquired resistance to both agents, relapse soon, and survive less. For these patients, the therapeutic options are very limited, and for many years, conventional chemotherapy (CC) was the standard of care.

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The occurrence of multiple pregnancies is consistently and significantly linked to the growing use of assisted reproductive technology (ART). Even very young women opt for having multiple embryos implanted by medical professionals in order to increase the chances of a successful outcome. Our aim is to review the research on cesarean section rates and perinatal outcomes, like perinatal morbidity, risk of preterm delivery, and low birth weight (LBW) of neonates in multiple pregnancies that resulted from ART in comparison to those that were naturally conceived.

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Objectives: Children who experience socioeconomic adversity often have worse health; however, less is known about their quality of care. We sought to evaluate the association between parent/caregiver-reported socioeconomic adversity and quality of pediatric primary, acute, and chronic ambulatory care on a national level.

Methods: This was a retrospective cohort study of 5368 representative US children (1-17 years) in the 2021 Medical Expenditure Panel Survey.

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Objective: Despite efforts toward achieving gender-based equality in clinical trial enrollment, females are frequently underrepresented and gender-specific data analysis is lacking. Identifying and addressing gender bias in medical decision-making and outcome reporting may facilitate more equitable healthcare delivery. This study aimed to determine if gender differences exist in the clinical evaluation and surgical management of patients with degenerative lumbar conditions.

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Article Synopsis
  • Mismatch repair-deficient (dMMR) endometrial cancer is associated with poor outcomes and limited treatment options, particularly for high-risk patients after surgery.
  • In a phase III clinical trial, patients with dMMR tumors were treated with pembrolizumab plus chemotherapy, showing improved disease-free survival (DFS) rates compared to those who received placebo.
  • The interim analysis revealed a significant DFS benefit for pembrolizumab, with a two-year DFS rate of 92.4% versus 80.2% for the placebo group, indicating its potential effectiveness in high-risk dMMR endometrial cancer.
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Background Prostate disorders, including benign enlargement and malignancy, are commonly evaluated through imaging techniques. Historically, transrectal ultrasound (TRUS) has been used for prostate imaging and biopsy. However, multiparametric MRI (mpMRI), which integrates structural and functional imaging methods, offers enhanced diagnostic capabilities.

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: Many clinical trials have shown beneficial effects of low-dose dopamine on renal function, diuresis and symptom relief, or cardiac function in hospitalized patients with acute decompensated heart failure (HF). The aim is to assess the neurohormonal effects and the effects on clinical outcomes of the addition of low-dose dopamine in furosemide treatment in patients hospitalized for acute decompensated HF. : A total of 62 patients hospitalized for acute decompensation of HF, were randomly allocated to one of the following three groups: i.

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Altered brain complexity in first-episode antipsychotic-naïve patients with schizophrenia: A whole-brain voxel-wise study.

Neuroimage Clin

November 2024

Department of Psychiatry and Psychotherapy, and Center for Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany. Electronic address:

Background: Measures of cortical topology are believed to characterize large-scale cortical networks. Previous studies used region of interest (ROI)-based approaches with predefined templates that limit analyses to linear pair-wise interactions between regions. As cortical topology is inherently complex, a non-linear dynamic model that measures the brain complexity at the voxel level is suggested to characterize topological complexities of brain regions and cortical folding.

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Objective: To assess changes in key measures of kidney care using data reported in 2019 and 2023.

Design: Cross sectional survey in 148 countries.

Setting: Surveys from International Society of Nephrology Global Kidney Health Atlas between 2019 and 2023 that included participants from countries in Africa (n=36), Eastern and Central Europe (n=16), Latin America (n=18), the Middle East (n=11), Newly Independent States and Russia (n=10), North America and the Caribbean (n=8), North and East Asia (n=6), Oceania and South East Asia (n=15), South Asia (n=7), and Western Europe (n=21).

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Article Synopsis
  • The haemolytic uraemic syndromes (HUS) include various conditions, with some linked to complement activation (CaHUS).
  • The 2023 International Society of Nephrology HUS Forum featured experts discussing the latest knowledge, uncertainties, and proposed solutions in diagnosing and managing HUS.
  • Key areas needing research include naming conventions, complement testing, identifying biomarkers, genetic factors for aHUS, treatment strategies for C5 inhibitors, and improving access to care for patients.
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