369 results match your criteria: "National Health and Medical Research Council Clinical Trials Centre[Affiliation]"

Background: Care gaps remain in modern health care despite the availability of robust, evidence-based medications. Although sodium-glucose cotransporter-2 (SGLT2) inhibitors have demonstrated profound benefits in improving both cardiovascular and kidney outcomes in patients, the uptake of these medications remain suboptimal, and the causes have not been systematically explored.

Objective: The purpose of this study was to use the Consolidated Framework for Implementation Research (CFIR) to describe the barriers and facilitators faced by clinicians in British Columbia, Canada, when prescribing an SGLT2 inhibitor.

View Article and Find Full Text PDF

Background: CA-125 alone is widely used to diagnose progressive disease (PD) in platinum-sensitive recurrent ovarian cancer (PSROC) on chemotherapy. However, there are increasing concerns regarding its accuracy. We assessed concordance between progression defined by CA-125 and RECIST using data from the CALYPSO trial.

View Article and Find Full Text PDF

Objectives: The number of colorectal cancer (CRC) survivors is increasing and current models of survivorship care are unsustainable. There is a drive to implement alternative models of care including shared care between general practitioners (GPs) and hospital-based providers. The primary objective of this study was to explore perspectives on facilitators and barriers to shared care.

View Article and Find Full Text PDF
Article Synopsis
  • Extrapulmonary small cell carcinomas (EPSCCs) are rare cancers, making up only 0.1-0.4% of all cancers, and current treatments are largely based on small cell lung cancer (SCLC) due to their similar features.
  • A study analyzed outcomes of extensive-stage SCLC versus EPSCC in a cohort of 384 patients, revealing comparable overall survival (OS) but noting variations in treatment approaches and effectiveness.
  • The findings suggest the need for more research into EPSCC's unique genomics to find better treatment options, particularly since prostate EPSCC patients showed significantly longer median OS compared to others.
View Article and Find Full Text PDF

Risk of Mortality Following Surgery in Patients With a Previous Cardiovascular Event.

JAMA Surg

February 2024

Anaesthesia and Critical Care Section, Academic Unit of Injury, Inflammation and Repair, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom.

Importance: There is a lack of consensus regarding the interval of time-dependent postoperative mortality risk following acute coronary syndrome or stroke.

Objective: To determine the magnitude and duration of risk associated with the time interval between a preoperative cardiovascular event and 30-day postoperative mortality.

Design, Setting, And Participants: This is a longitudinal retrospective population-based cohort study.

View Article and Find Full Text PDF

A Systematic Review of Clinical Practice Guidelines for Neonatal Abstinence Syndrome.

Children (Basel)

October 2023

School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.

Background: The prevalence of neonatal abstinence syndrome is increasing, but the number and quality of clinical practice guidelines available are unknown. This systematic review aimed to identify, appraise and evaluate clinical practice guidelines for neonatal abstinence syndrome.

Methods: A systematic search of databases and the grey literature was conducted between 1 June and 1 July 2022.

View Article and Find Full Text PDF
Article Synopsis
  • Reducing standard modifiable cardiovascular risk factors (SMuRFs) is essential for addressing coronary artery disease (CAD), but some patients develop CAD without any SMuRFs.
  • Patients without SMuRFs who have a heart attack tend to have higher early mortality rates compared to those with at least one SMuRF.
  • An international team has created a clinical pathway for managing SMuRFless CAD patients, focusing on confirming their condition, ensuring proper secondary prevention, and identifying other risk factors to improve their healthcare outcomes.
View Article and Find Full Text PDF

Background: The growing number of melanoma patients who need long-term surveillance increasingly exceeds the capacity of the dermatology workforce, particularly outside of metropolitan areas. Digital technologies that enable patients to perform skin self-examination and send dermoscopic images of lesions of concern to a dermatologist (mobile teledermoscopy) are a potential solution. If these technologies and the remote delivery of melanoma surveillance are to be incorporated into routine clinical practice, they need to be accepted by clinicians providing melanoma care, such as dermatologists and general practitioners (GPs).

View Article and Find Full Text PDF

The ACCELERATE Plus (assessment and communication excellence for safe patient outcomes) Trial Protocol: a stepped-wedge cluster randomised trial, cost-benefit analysis, and process evaluation.

BMC Nurs

August 2023

Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.

Background: Nurses play an essential role in patient safety. Inadequate nursing physical assessment and communication in handover practices are associated with increased patient deterioration, falls and pressure injuries. Despite internationally implemented rapid response systems, falls and pressure injury reduction strategies, and recommendations to conduct clinical handovers at patients' bedside, adverse events persist.

View Article and Find Full Text PDF

Introduction: Globally, acute respiratory infections (ARIs) are a leading cause of childhood morbidity and mortality. While ARI-related mortality is low in Australia, First Nations infants are hospitalised with ARIs up to nine times more often than their non-First Nations counterparts. The gap is widest in the Northern Territory (NT) where rates of both acute and chronic respiratory infection are among the highest reported in the world.

View Article and Find Full Text PDF

Background: The impact of survivorship care plans (SCPs) on the proximal and distal outcomes of adult and childhood cancer survivors, and parent proxies, is unclear. This study aimed to determine the relationship between SCP receipt and these outcomes.

Methods: A cross-sectional survey of adult and childhood cancer survivors (and parent proxies for survivors aged younger than 16 years) across Australia and New Zealand was conducted.

View Article and Find Full Text PDF

Impact of female sex on anaesthetic awareness, depth, and emergence: a systematic review and meta-analysis.

Br J Anaesth

September 2023

Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, NSW, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, NSW, Australia; National Health and Medical Research Council Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

Background: Suggested anaesthetic dose ranges do not differ by sex, likely because of limited studies comparing sexes. Our objective was to systematically synthesise studies with outcomes of unintended anaesthesia awareness under anaesthesia, intraoperative connected consciousness, time to emergence from anaesthesia, and dosing to achieve adequate depth of anaesthesia, and to compare between females and males.

Methods: Studies were identified from MEDLINE, Embase, and the Cochrane library databases until August 2, 2022.

View Article and Find Full Text PDF

PROMPT: Prospective Meta-analysis for Pessary Trials Study Protocol.

Am J Perinatol

May 2024

Department of Obstetrics and Gynecology, My Duc Hospital, Ho Chi Minh City, Vietnam.

Objective: Preterm birth, defined as birth before 37 weeks of gestation, is a leading cause of perinatal and infant mortality throughout the world. Preterm birth is also associated with long-term neurological disabilities and other significant health issues in children. A short cervix in the second trimester has been noted to be one of the strongest predictors of subsequent spontaneous preterm birth in both singleton and multiple pregnancies.

View Article and Find Full Text PDF

The Eating Disorders In weight-related Therapy (EDIT) Collaboration brings together data from randomised controlled trials of behavioural weight management interventions to identify individual participant risk factors and intervention strategies that contribute to eating disorder risk. We present a protocol for a systematic review and individual participant data (IPD) meta-analysis which aims to identify participants at risk of developing eating disorders, or related symptoms, during or after weight management interventions conducted in adolescents or adults with overweight or obesity. We systematically searched four databases up to March 2022 and clinical trials registries to May 2022 to identify randomised controlled trials of weight management interventions conducted in adolescents or adults with overweight or obesity that measured eating disorder risk at pre- and post-intervention or follow-up.

View Article and Find Full Text PDF
Article Synopsis
  • The Australian Placental Transfusion Study looked at how long to wait before cutting the umbilical cord in babies, comparing waiting at least 60 seconds to waiting 10 seconds or less.
  • The study found that waiting longer might help reduce the chances of babies dying or having disabilities by 17%.
  • However, the results aren't super strong because a few missing data points could change things, so future studies should try to collect all important information to make the results more reliable.
View Article and Find Full Text PDF

Dedifferentiated umbilical metastases from low grade endometrioid endometrial adenocarcinoma complicated by super-obesity: A case report.

Int J Surg Case Rep

July 2023

Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; Chris O'Brien Lifehouse, Department of Gynaecological Oncology, Sydney, New South Wales, Australia.

Introduction: Umbilical metastases are uncommon and rarely associated with endometrial cancer. In this report we describe a unique case of a patient with low-grade endometrioid adenocarcinoma (EAC) who developed an umbilical metastasis containing dedifferentiated endometrial carcinoma, in the context of super-morbid obesity with a body mass index (BMI) of 80 kg/m.

Presentation Of Case: A 55-year-old female with atypical endometrial hyperplasia was treated with progestogens whilst attempting weight loss prior to definitive surgery, given the impact of her obesity on surgical risk.

View Article and Find Full Text PDF

Background: Sentinel node-based management (SNBM) is the international standard of care for early breast cancer that is clinically node-negative based on randomised trials comparing it with axillary lymph node dissection (ALND) and reporting similar rates of axillary recurrence (AR) without distant disease. We report all ARs, overall survival, and breast cancer-specific survival at 10-years in SNAC1.

Methods: 1.

View Article and Find Full Text PDF

Background: Peripheral arterial tonometry (PAT) provides non-invasive measures of vascular health. Beneficial effects of metformin on vascular function have been reported in youth with type 1 diabetes (T1D). In the REducing with MetfOrmin Vascular Adverse Lesions (REMOVAL) trial in adults with T1D and high cardiovascular risk, we examined: (i) the extent to which routinely-measured cardiometabolic risk factors explain variance in baseline PAT; and (ii) the effects of metformin on PAT measures.

View Article and Find Full Text PDF

Patient navigation is a strategy for overcoming barriers to reduce disparities and to improve access and outcomes. The aim of this umbrella review was to identify, critically appraise, synthesize, and present the best available evidence to inform policy and planning regarding patient navigation across the cancer continuum. Systematic reviews examining navigation in cancer care were identified in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), Epistemonikos, and Prospective Register of Systematic Reviews (PROSPERO) databases and in the gray literature from January 1, 2012, to April 19, 2022.

View Article and Find Full Text PDF

Background: infection (CDI) is associated with significant morbidity and mortality in both healthcare and community settings. We aimed to define the predisposing factors, risks for severe disease, and mortality determinants of CDI in eastern Australia over a 1-year period.

Methods: This is an observational retrospective study of CDI in hospitalized patients aged ≥18 years in 6 tertiary institutions from 1 January 2016 to 31 December 2016.

View Article and Find Full Text PDF

Cost-effectiveness of Interventions to Increase Utilization of Kidneys From Deceased Donors With Primary Brain Malignancy in an Australian Setting.

Transplant Direct

May 2023

Collaborative Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.

Unlabelled: Kidneys from potential deceased donors with brain cancer are often foregone due to concerns of cancer transmission risk to recipients. There may be uncertainty around donors' medical history and their absolute transmission risk or risk-averse decision-making among clinicians. However, brain cancer transmissions are rare, and prolonging waiting time for recipients is harmful.

View Article and Find Full Text PDF

Background: Standard treatment for locally advanced cervical cancer is chemoradiotherapy, but many patients relapse and die of metastatic disease. We aimed to determine the effects on survival of adjuvant chemotherapy after chemoradiotherapy.

Methods: The OUTBACK trial was a multicentre, open-label, randomised, phase 3 trial done in 157 hospitals in Australia, China, Canada, New Zealand, Saudi Arabia, Singapore, and the USA.

View Article and Find Full Text PDF