Experiences of Oral Corticosteroid Use and Adverse Effects: A National Cross-Sectional Survey of People with Asthma.

Purpose: Oral corticosteroids (OCS) are an effective treatment for severe uncontrolled asthma or asthma exacerbations, but frequent bursts or long-term use carry serious and sometimes irreversible adverse effects, or complications such as adrenal insufficiency upon discontinuation. Our aim was to survey people with asthma on their experiences of, and attitudes towards, using OCS.

Patients And Methods: This study was a national descriptive cross-sectional survey of people with asthma in Australia.

Repeat expansions in gene in refractory chronic cough.

Introduction: Refractory chronic cough (RCC), persisting despite addressing contributory diagnoses, is likely underpinned by neurally mediated cough hypersensitivity. disorders are genetic neurodegenerative conditions caused by biallelic repeat expansion sequences, commonly presenting with cough, followed by neurological features including cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS). The prevalence and identifying clinical characteristics of repeat-expansion disorders in patients with RCC are unknown.

Baseline Characteristics of Frailty and Disease Stage in Older People Living With CKD.

Introduction: The GOAL trial, a cluster randomized controlled trial, investigated the effect of comprehensive geriatric assessment (CGA) on frail older people with chronic kidney disease (CKD). This paper describes the following: (i) participant baseline characteristics, and (ii) their relationship with CKD stage and frailty severity.

Methods: Sixteen kidney outpatient clinics (clusters) were randomly allocated 1:1 to CGA or usual care.

EMPOWER PKD: Patient, Caregiver, and Researcher Priorities for Research in Polycystic Kidney Disease.

Background: Patient involvement in research can help to ensure that the evidence generated aligns with their needs and priorities. In the Establishing Meaningful Patient-Centered Outcomes With Relevance for Patients with Polycystic Kidney Disease (EMPOWER PKD) project we aimed to identify patient-important outcomes and discuss the impact of PKD on patients.

Methods: Nine focus groups were held with adult patients with PKD, caregivers, and clinical or research experts in PKD.

Beta-Blockers and Cutaneous Melanoma Outcomes: A Systematic Review and Random-Effects Meta-Analysis.

Beta-blockers have generated an exciting discourse for their potential as a cheap, safe, and effective adjunctive therapy for cutaneous melanoma patients, but the field remains murky. This systematic review investigates the association between beta-blocker use and survival outcomes in cutaneous melanoma patients. We reviewed 12 studies with 21,582 patients in a network meta-analysis and found a benefit between beta-blocker use and disease-free survival but no other significant association for melanoma-specific or overall survival.

Factors Influencing the Use of Shave Biopsy for Lesions Suspicious of Melanoma in Australia: An Exploratory Mixed-Methods Study.

Background: Recent Australian trends indicate that shave biopsies for diagnosing lesions suspicious of melanoma are increasing, yet reasons for this remain relatively unknown. We sought to understand which factors influence Australian clinicians' use of shave biopsy for managing thin lesions suspicious of melanoma in sites of low cosmetic sensitivity.

Methods: We used a convergent, exploratory mixed-methods design, with a cross-sectional online survey (n = 59) and semi-structured qualitative interviews (n = 15).

Phase 3, Randomized, Comparison Study of Intracameral Bimatoprost Implant 10 µg and Selective Laser Trabeculoplasty.

Purpose: To evaluate the intraocular pressure (IOP)-lowering effect and safety of up to two bimatoprost implant administrations versus selective laser trabeculoplasty (SLT).

Design: Phase 3 (Stage 2), randomized, 24-month, multicenter, patient- and efficacy evaluator-masked, paired-eye clinical trial (NCT02507687).

Participants: Patients (n=183) with open-angle glaucoma or ocular hypertension inadequately managed with topical IOP-lowering medication for reasons other than efficacy.

Parallel randomised trial testing community fibrosis assessment for suspected non-alcoholic fatty liver disease: outcomes from LOCATE-NAFLD.

Objective: Non-alcoholic fatty liver disease (NAFLD) is estimated to affect a third of Australian adults, and its prevalence is predicted to rise, increasing the burden on the healthcare system. The LOCal Assessment and Triage Evaluation of Non-Alcoholic Fatty Liver Disease (LOCATE-NAFLD) trialled a community-based fibrosis assessment service using FibroScan to reduce the time to diagnosis of high-risk NAFLD and improve patient outcomes.

Methods: We conducted a 1:1 parallel randomised trial to compare two alternative models of care for NAFLD diagnosis and assessment.

Lentivirus-mediated gene therapy for Fabry disease: 5-year End-of-Study results from the Canadian FACTs trial.

Background: Fabry disease is an X-linked lysosomal storage disorder due to a deficiency of α-galactosidase A (α-gal A) activity. Our goal was to correct the enzyme deficiency in Fabry patients by transferring the cDNA for α-gal A into their CD34+ hematopoietic stem/progenitor cells (HSPCs). Overexpression of α-gal A leads to secretion of the hydrolase; which can be taken up and used by uncorrected bystander cells.

Examining Whole Blood, Total and Free Plasma Tacrolimus in Elderly Kidney Transplant Recipients.

Background: Therapeutic monitoring is routinely performed to ensure tacrolimus whole-blood concentrations fall within a predefined target. Despite this, patients still experience inefficacy and toxicity that could be related to variability in free (unbound) tacrolimus exposure. Therefore, the aim of this study was to compare tacrolimus-free plasma (C u ), total plasma (C p ), and whole-blood (C wb ) concentrations in adult kidney transplant recipients and to characterize tacrolimus disposition across different matrices.

Analytical Techniques for Supporting Hospital Case Mix Planning Encompassing Forced Adjustments, Comparisons, and Scoring.

: This article presents analytical techniques and a decision support tool to aid in hospital capacity assessment and case mix planning (CMP). To date, no similar techniques have been provided in the literature. : Initially, an optimization model is proposed to analyze the impact of making a specific change to an existing case mix, identifying how patient types should be adjusted proportionately to varying levels of hospital resource availability.

Comparing the Efficacy and Safety of the Transperineal Versus Transrectal Prostate Biopsy Approach in the Diagnosis of Prostate Cancer: A Systematic Review and Meta-Analysis.

Prostate cancer (PCa) has high prevalence rates in men and is a leading cause of cancer-related death. Transrectal (TR) biopsy has traditionally been the gold standard for diagnosis, but transperineal (TP) biopsy is increasingly favoured due to its lower infection risk. However, debate remains regarding which method has superior cancer detection rates.

Comparative study of management strategies for immune checkpoint inhibitor-induced inflammatory arthritis: rheumatologists versus oncologists.

Background: Immune checkpoint inhibitors (ICIs) have significantly improved cancer treatment outcomes but are associated with immune-related adverse events (irAEs), such as inflammatory arthritis (ir-IA). Management of ir-IA is evolving, with corticosteroids as the primary treatment, though some cases require steroid-sparing agents.

Aims: This study aimed to compare initial mean prednisolone doses and disease persistence over 12 months in patients with rheumatoid arthritis (RA)-like ir-IA managed by rheumatologists or oncologists.

Severe intensive care unit-acquired hypernatraemia: Prevalence, risk factors, trajectory, management, and outcome.

Background: Severe intensive care unit-acquired hypernatraemia (ICU-AH) is a serious complication of critical illness. However, there is no detailed information on how this condition develops.

Objectives: The objective of this study was to study the prevalence, risk factors, trajectory, management, and outcome of severe ICU-AH (≥155 mmol·L).

Timing of adjunctive vasopressin initiation for septic shock patients and hospital mortality: A multicentre observational study.

Objective: The optimal timing of vasopressin initiation as an adjunctive vasopressor remains unclear. We aimed to study the association between the timing of vasopressin commencement, pre-specified physiological parameters, and hospital mortality.

Design: We conducted a multicentre, retrospective, observational study.

ICU-acquired hypernatremia: Prevalence, patient characteristics, trajectory, risk factors, and outcomes.

Objective: Knowledge of intensive care unit (ICU) acquired hypernatremia (ICU-AH) has been hampered by the absence of granular data and confounded by variable definitions and inclusion criteria.

Design: Multicentre retrospective cohort study.

Setting: Twelve ICUs in Queensland (QLD), Australia.

AGITG MONARCC: A Randomized Phase 2 Study of Panitumumab Monotherapy and Panitumumab Plus 5-Fluorouracil as First-Line Therapy for Older Patients With RAS and BRAF Wild Type Metastatic Colorectal Cancer. A Study by the Australasian Gastro-Intestinal Trials Group (AGITG).

Background: Panitumumab (pan) plus chemotherapy is a preferred first-line therapy for unresectable RAS and BRAF wild type metastatic colorectal cancer (mCRC). Older patients may not be suitable for combination regimens. We investigated 2 lower intensity pan-containing regimens.

A Comparison of Peripherally Inserted Central Catheter Materials.

Background: New catheter materials for peripherally inserted central catheters (PICCs) may reduce the risk of device failure due to infectious, thrombotic, and catheter occlusion events. However, data from randomized trials comparing these catheters are lacking.

Methods: We conducted a randomized, controlled, superiority trial in three Australian tertiary hospitals.

The British Geriatrics Society's position on assisted dying.

In response to increased focus on the issue of Assisted Dying (AD) in the UK due to the presentation of The Terminally Ill Adults (End of Life) Bill 2024-25 [1] and bills before parliaments in the Isle of Man, Guernsey and Scotland, the British Geriatric Society (BGS) recently developed a position statement opposing legalisation of AD in the UK [2]. We set out our key reasoning behind this position, namely the current adverse health and social care context and significant concern about whether effective safeguards can be created to protect older people with complex needs from undue harms. The BGS asks for improved, personalised, multidisciplinary care for older people at the end of their lives, including high-quality palliative and end-of-life care.

Colonic tuberculosis mimicking malignancy: a multidisciplinary medical and surgical approach.

Colonic tuberculosis (TB) is a rare form of extrapulmonary TB with nonspecific clinical presentations such as weight loss, abdominal pain and fever. It is often misdiagnosed, as the presentations mimic other more common diseases such as colon cancer and inflammatory bowel diseases, especially in those countries with low TB incidence. Although a combination of CT imaging, colonoscopy and histopathology forms the essential part of the diagnostic assessment, the high variability and low specificity of each investigation may delay or overlook the diagnosis.

Could have carcinogenic potential? A critical review of current evidence.

There is growing evidence that microbial dysbiosis is intimately related to carcinogenesis across several types of human cancer. is best known for causing acute exudative genitourinary infection in males. can also cause chronic, asymptomatic infection of the female genitourinary tract along with the oropharynx and rectum of both sexes.

Systematic review and meta-analysis of the treatment of hypernatremia in adult hospitalized patients: impact on mortality, morbidity, and treatment-related side effects.

Background: Hypernatremia is relatively common in acutely ill patients and associated with mortality. Guidelines recommend a slow rate of correction (≤ 0.5 mmol/L per hour).

Optimizing inpatient diabetes management with the diabetes dashboard.

Abstract: Inpatient diabetes management presents a complex challenge that is distinct from outpatient management. This is due to acute changes in physiology, medication regimens, and eating patterns associated with hospitalization, alongside the condition's prevalent and variable nature. The conventional systems for managing glycemic control in hospital have been found lacking, with gaps in data integration, decision support, and timely intervention.