5,328 results match your criteria: "Monash medical Centre[Affiliation]"

Background: Sinonasal malignancies, in which squamous cell carcinomas are the most common are rare and difficult to treat given the location and anatomical structures involved. Sinonasal malignancies often present late due to non-specific and benign symptoms. Partial resections are often associated with poorer outcomes [1].

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Background: Adoptive transfer of autologous regulatory T cells (Tregs) is a promising therapeutic strategy aimed at enabling immunosuppression minimization following kidney transplantation. In our phase 1 clinical trial of Treg therapy in living donor renal transplantation, the ONE Study (ClinicalTrials.gov: NCT02129881), we observed focal lymphocytic infiltrates in protocol kidney transplant biopsies that are not regularly seen in biopsies of patients receiving standard immunosuppression.

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Tranexamic acid in hip and spine surgery for children with cerebral palsy - a PRISMA-compliant scoping review.

Syst Rev

December 2024

Department of Paediatrics, The Royal Children's Hospital, University of Melbourne, 50 Flemington Road, Parkville, VIC, 3052, Australia.

Many children with cerebral palsy (CP) are frail and require major hip and/or spine surgeries associated with substantial blood loss. Tranexamic acid (TXA) is commonly used to reduce blood loss, but there is uncertainty around the optimal dose and timing of administration. There have been reviews in sub-populations and specific dosing regimens, but a broad overview of the available literature is lacking.

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Systematic review and meta-analysis of audits measuring antithrombotic therapy within forty-eight hours for ischemic stroke.

J Stroke Cerebrovasc Dis

December 2024

Stroke and Aging Research Group, Department of Medicine, Monash University, Melbourne, Australia. Electronic address:

Article Synopsis
  • A meta-analysis showed that 81.1% of patients received antithrombotic therapy within 48 hours of ischemic stroke, indicating general compliance with treatment guidelines.
  • There was no significant difference in therapy rates between low- to middle-income countries and high-income countries, nor between older and more recent studies.
  • The study concluded that most countries still fall short of the standards set by North America's Get With The Guidelines program for early antiplatelet therapy.
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Background: The ovarian response to gonadotropin stimulation varies widely among women, and could impact the probability of live birth as well as treatment risks. Many studies have evaluated the impact of different gonadotropin starting doses, mainly based on predictive variables like ovarian reserve tests (ORT) including anti-Müllerian hormone (AMH), antral follicle count (AFC), and basal follicle-stimulating hormone (bFSH). A Cochrane systematic review revealed that individualizing the gonadotropin starting dose does not affect efficacy in terms of ongoing pregnancy/live birth rates, but may reduce treatment risks such as the development of ovarian hyperstimulation syndrome (OHSS).

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Management of Osteoporosis in Parkinson's Disease: A Systematic Review of Clinical Practice Guidelines.

Mov Disord Clin Pract

December 2024

Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Monash Medical Centre, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.

Background: Parkinson's disease (PD) is the fastest-growing neurological disorder globally. Defining features include tremor, muscular rigidity, bradykinesia, and postural instability, which in combination with nonmotor symptoms such as cognitive impairment and orthostatic hypotension increase the risk of falls. Along with low bone mineral density, fracture risk is high in PD.

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Effects of statins on kidney function in older adults.

J Am Geriatr Soc

December 2024

School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Background: The effect of statin therapy on kidney function among older adults is unclear.

Objectives: To examine the association between statin use and changes in estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR), positive or negative, in an older adult cohort with versus without chronic kidney disease (CKD) at baseline.

Methods: This analysis included 18,056 participants aged ≥65 years with versus without CKD at baseline in a randomized trial of low-dose aspirin, who had no prior cardiovascular events, major physical disability, or dementia initially.

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Clinical outcomes of cardiogenic shock among critically ill patients admitted to intensive care units in Australia and New Zealand from 2003 to 2022.

J Crit Care

December 2024

Monash University, Victoria, Australia; Department of Critical Care, Melbourne University, Victoria, Australia; Austin Health, Victoria, Australia; The Australian & New Zealand Intensive Care Society (ANZICS) CORE, New Zealand; Hospital Israelita Albert Einstein, São Paulo, Brazil.

Purpose: Patients with Cardiogenic shock (CS) admitted to intensive care units (ICUs) have high mortality rates. We aimed to investigate the changes patient characteristics and outcomes over time among patients admitted to the ICU with CS.

Methods: Retrospective study utilizing a large bi-national ICU database from 2003 to 2022.

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Objectives: To assess the clinical impact on generally healthy older Australians of changing from the 2009 CKD-EPI (CKD-EPI) to the 2021 CKD-EPI (CKD-EPI) equation for calculating the estimated glomerular filtration rate (eGFR).

Study Design: Secondary analysis of data from the prospective ASPirin in Reducing events in the Elderly (ASPREE) cohort study.

Setting, Participants: Australians aged 70 years or older living in the community and without life-limiting medical conditions, recruited 1 March 2010 - 31 December 2014 for the ASPREE trial.

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Introduction/objectives: Patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) experience reduced health-related quality of life (HRQoL). Global assessment tools use visual analogue scales to provide patients' and physicians' views on disease activity or the patient's overall health and well-being. The aim of this study was to examine the relationships between patient and physician global assessments (PtGA and PhGa) as they relate to overall health in people with AAV.

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Eosinophilic granulomatosis with polyangiitis (EGPA) is a chronic inflammatory disease belonging to the spectrum of small-vessel vasculitis associated with the presence of anti-neutrophil cytoplasmic antibodies (ANCAs), also characterized by eosinophilic infiltration of target organs. Peripheral neuropathy (PN) affects about 2/3 of the patients as a presenting symptom and typically represents a vasculitic involvement. A few studies have addressed the role of intravenous immunoglobulin (IVIg) for the treatment of PN in EGPA.

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Purpose: Treatment options for advanced head and neck squamous cell carcinoma (HNSCC) previously treated with platinum-based chemotherapy and a programmed death-1 (PD-1) inhibitor are limited. Trophoblast cell-surface antigen 2 (Trop-2) is highly expressed in HNSCC. Sacituzumab govitecan (SG) is a Trop-2-directed antibody-drug conjugate approved for patients with certain previously treated solid tumors.

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Aims: Individuals with diabetes frequently encounter sleep disturbances, which can detrimentally impact glycaemic management. We reviewed the relationship between sleep outcomes and glycaemic variability in adults with diabetes.

Methods: We systematically searched Medline, EMBASE and Cochrane Library (2002-March 2023) for studies evaluating sleep and glycaemic variability in adults with type 1 and type 2 diabetes.

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This study systematically reviews existing data on the efficacy of Tyrosine Kinase 2 (TYK2) inhibitors in comparison to placebo or standard treatments for therapeutic benefit and improving quality of life in dermatological diseases. Seventeen records representing 13 clinical trials, one matching-adjusted indirect comparison, and one case study were included. Results indicate that Deucravacitinib is superior to placebo, Apremilast and Adalimumab in treating adult patients with moderate-to-severe plaque psoriasis and superior to placebo in the treatment of adults with systemic lupus erythematosus.

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The integration of rare disease medical databases belonging to different countries is an important problem, as a large number of observations are required for reliable statistical inference of patient data in order to facilitate clinical research. Such integration of national registry data, which requires harmonization of the heterogeneous data sets into a unified view, is facilitated in the European FAIRVASC project by developing a domain-specific ontology. The FAIRVASC project is dedicated to the rare disease of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV).

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Article Synopsis
  • The study aimed to create a prioritized list of research themes and essential data points related to mental health issues in children and adolescents presenting to emergency departments (ED).
  • A Delphi survey involving various stakeholders, including clinicians and patients, was conducted to gather and prioritize these research themes and data points.
  • The final results highlighted 71 key items, focusing on safety in the ED, the effectiveness of mental health spaces, follow-up care, and important data like risk factors and behavioral disturbances.
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Background: Use of serum procalcitonin (PCT), an inflammatory biomarker for bacterial infections, has shown promising results for early stopping antibiotic treatment among patients with respiratory infections and sepsis. There is need for additional data regarding effectiveness and safety of this concept among patients with cancer.

Methods: Individual data of patients with a documented diagnosis of cancer and proven or suspected respiratory infection and/or sepsis were extracted from previous trials where adult patients were randomized to receive antibiotic treatment based on a PCT protocol or usual care (control group).

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Tranexamic Acid Within 4.5 Hours of Intracerebral Hemorrhage With the CTA Spot Sign: Systematic Review and Individual Patient Meta-analysis.

Neurology

December 2024

From the Department of Medicine and Neurology (N.Y., V.Y., L.C., B.C.V.C., H.Z., G.A.D., S.M.D.), Melbourne Brain Centre @ The Royal Melbourne Hospital, University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Division of Neurology (V.Y.), Department of Medicine, The Ottawa Hospital and Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada; Melbourne Medical School (L.C.), University of Melbourne, Parkville, Australia; Department of Neurology (A.M., D.S.), Helsinki University Hospital, Finland; Department of Neurology (T.W.), Christchurch Hospital, New Zealand; Stroke Centre and Department of Neurology (J.-S.J.), National Taiwan University Hospital, Taipei; Stroke Trials Unit (L.J.W., Z.K.L., P.M.B., N.S.), Mental Health & Clinical Neuroscience, University of Nottingham, United Kingdom; Department of Neurology (C.O.), Bispebjerg and Frederiksberg Hospital, University Hospital of Copenhagen, Denmark; Department of Medicine (Z.K.L.), Faculty of Medicine, National University of Malaysia, Kuala Lumpur; Department of Neurology (H.-Q.G., X.N., J.L., L.L.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Centre for Neurological Diseases (H.-Q.G., X.N., J.L., L.L.), Beijing; and Department of Neurology (H.H.M.), Monash Medical Centre, School of Clinical Sciences, Monash University, Melbourne, Australia.

Article Synopsis
  • Tranexamic acid, an antifibrinolytic agent, was tested in a study on patients with intracerebral hemorrhage who had ongoing bleeding (spot signs) to assess its effect on hematoma growth when administered within 4.5 hours of onset.
  • A systematic review and meta-analysis were conducted, evaluating randomized trials comparing tranexamic acid to a placebo, specifically including 162 participants with follow-up imaging.
  • Results showed that tranexamic acid treatment did not significantly reduce hematoma growth compared to placebo, with a slightly lower growth rate in the treatment group, but overall outcomes suggested continued monitoring and assessment of safety was needed.
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Unlabelled: The purpose of this study was to determine the real-world incidence and predictors of additional vertebroplasty or balloon kyphoplasty after initial vertebral augmentation, as a proxy for subsequent symptomatic vertebral fracture. Of patients, 15.5% underwent subsequent vertebral augmentation.

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Neutralizing the IL-7Rα limits injury in experimental ANCA-associated glomerulonephritis.

Nephrol Dial Transplant

November 2024

Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Monash University, Clayton, Victoria, Australia.

Background And Hypothesis: Increased T cell IL-7Rα signaling is associated with a poorer prognosis in ANCA-associated vasculitis. These studies examined the functional role of IL-7Rα (CD127) in experimental glomerulonephritis mediated by anti-MPO T cell autoimmunity. We hypothesized that T cells would express IL-7Rα in the kidney and that blocking the function of IL-7Rα, without cellular depletion, would be protective.

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