Baseline Nodal Status on Ga-PSMA-11 Positron Emission Tomography/Computed Tomography in Men with Intermediate- to High-risk Prostate Cancer Is Prognostic for Treatment Failure: Follow-up of the proPSMA Trial.

Background And Objective: There is uncertainty regarding the clinical significance of Ga-PSMA-11 positron emission tomography (PET) computed tomography (CT) findings in men with prostate cancer. In this prespecified objective of the proPSMA study, we report the prognostic value of PET-defined nodal involvement.

Methods: Men with intermediate- to high-risk prostate cancer (grade group 3-5, prostate-specific antigen [PSA] ≥20 ng/ml, or clinical stage ≥T3) underwent Ga-PSMA-11 PET-CT or CT and bone scanning as first- or second-line imaging.

Baseline Characteristics of the DISCOVER CKD Prospective Cohort.

Introduction: Real-world data from patients with chronic kidney disease (CKD) are limited, particularly regarding clinical management, treatment patterns and health-related quality of life (HRQoL) in the context of new therapies and updated standard of care guidelines.

Methods: DISCOVER CKD is an observational cohort study enrolling adult patients with CKD, defined by an International Classification of Diseases, 10th Revision code, or with two estimated glomerular filtration rate measures < 75 ml/min/1.73 m recorded 91-730 days apart.

Better Oncological Outcomes After Prostate-specific Membrane Antigen Positron Emission Tomography-guided Salvage Radiotherapy Following Prostatectomy.

Background And Objective: Up to 50% of patients with prostate cancer experience prostate-specific antigen (PSA) relapse following primary radical prostatectomy (RP). Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is increasingly being used for staging after RP owing to its high detection rate. Our aim was to compare outcomes for patients who received salvage radiotherapy (sRT) with versus without PSMA PET guidance.

Rate of decline in kidney function with age: a systematic review.

Objective: To determine the distribution of kidney function values as measured by glomerular filtration rate (GFR), and the rate of decline with age in male and female healthy subjects without pre-existing medical conditions.

Design: Systematic review and structured synthesis.

Search Sources: PubMed, Embase, Cochrane Central Register of Controlled Trials and Web of Science, from database inception to 25 October 2023.

Mitochondria-targeting therapeutic strategies for chronic kidney disease.

Chronic kidney disease (CKD) is a multifactorial health issue characterised by kidney impairment that has significant morbidity and mortality in the global population. Current treatments for CKD fail to prevent progression to end-stage kidney disease, where management is limited to renal replacement therapy or kidney transplantation. Mitochondrial dysfunction has been implicated in the pathogenesis of CKD and can be broadly categorised into abnormalities related to excessive oxidative stress, reduced mitochondrial biogenesis, excess mitochondrial fission and dysregulated mitophagy.

Emotional Intelligence as a Component of Surgical Coaching: A Scoping Review.

Objective: Surgical coaching has become more widespread and involves both technical and nontechnical skills. Emotional Intelligence (EI) is an important nontechnical skill and is associated with leadership skills, increased job satisfaction and superior nontechnical skills. This scoping review aimed to explore the use of EI as a component of surgical coaching.

Characteristics of Inherited Metabolic Disorders Following Kidney Transplantation: A 13-Year Observational Study.

Inherited metabolic disorders (IMDs), primarily cystinosis, Fabry disease, and methylmalonic acidemia (MMA), are genetic conditions that typically result in multi-organ disease manifestations. Kidney function progressively deteriorates in many cases, with patients eventually reaching end-stage kidney disease (ESKD) and requiring renal replacement therapy. Kidney transplantation has been deemed the optimal renal replacement therapy option to achieve long-term survival in patients with IMD.

Understanding and Managing Vulvar Psoriasis in Girls: Findings From a Cohort Study.

Background/objectives: Pediatric vulvar psoriasis in girls is under-recognized and under-treated due to its nonspecific clinical appearance. This paper aims to describe the signs and symptoms of pediatric vulvar psoriasis and treatment strategies used by our group.

Methods: A retrospective cohort study was undertaken at a private pediatric dermatology referral practice from January 2016 to December 2022.

Randomized Controlled Trial of a Virtually Delivered Exercise and Stress Management Program to Improve Physical Performance of Hematopoietic Cell Transplant Survivors.

Purpose: Because of advances in hematopoietic cell transplant (HCT), meeting the long-term health needs of increasing numbers of HCT survivors remains challenging. This multicenter trial aimed to assess the short- and long-term effects of an exercise and mindfulness intervention delivered by telehealth.

Methods: One hundred thirty-nine participants >6 months post-HCT were randomly assigned 1:1 to a 6-week personalized exercise and mindfulness training with three motivation sessions at 3-6 months via an online meeting platform or usual care.

Reproductive decision-making experiences of Australian adults with neurofibromatosis type 1 and schwannomatosis.

Individuals with neurofibromatosis type 1 and schwannomatosis (NF) often face difficult reproductive choices when family planning; however, their experiences and the barriers and enablers to reproductive decision-making are poorly understood. The purpose of this study was to explore the opinions and experiences of individuals with NF in Australia and inform the development of practice recommendations and resources. Focus groups with adults with NF were conducted using a semi-structured interview schedule developed by the research team.

The effect of expiratory flow limitation on supine persistent hyperinflation in COPD: a prospective observational study.

Introduction: COPD is characterised by airflow obstruction, expiratory airway collapse and closure causing expiratory flow limitation (EFL) and hyperinflation. Supine posture may worsen ventilatory function in COPD, which may cause hyperinflation to persist and contribute to symptoms of orthopnoea and sleep disturbance. Our aim was to determine the impact of supine posture on hyperinflation, dynamic elastance and EFL in COPD and healthy subjects.

Utilization and associated factors of TPMT testing among Australian adults receiving thiopurines: A national retrospective data-linkage study.

Introduction: Thiopurine drugs are metabolized by thiopurine methyltransferase (TPMT) and low TPMT activity can result in severe adverse drug reactions. Therefore, TPMT testing is recommended for individuals receiving thiopurines to reduce the risk of toxicity.

Objectives: The objectives of this study were to assess the rate of TPMT testing among individuals receiving thiopurines and explore factors associated with undergoing TPMT testing in Australia.

A Self-Administered Gamified Mobile Application for Secondary Prevention of Heart Disease in Patients Following a Cardiac Event (MyHeartMate): Process Evaluation from a Randomized Controlled Trial.

This study reports the process evaluation of a randomized controlled trial of the MyHeartMate app for patients with coronary heart disease (CHD). Data were collected on engagement in the intervention group from the app platform logs and self-reported usage and via interviews for perspectives of usefulness and acceptability. Participants' ( = 194) data logs showed 80.

Cross-Generational Impact of Maternal Exposure to Low Level of PM2.5 on Kidney Health.

Introduction: Inhaled fine and ultrafine particulate matter may affect organs other than the lung, including the kidney. Recent studies have consistently shown the possibility of air pollution in highly polluted countries to be nephrotoxic. However, in countries like Australia, where air quality generally adheres to or remains below the WHO standards, the subtle yet consequential impacts of chronic exposure to seemingly safe levels of traffic PM2.

Impact of prior CAR-T cell therapy on mosunetuzumab efficacy in patients with relapsed or refractory B-cell lymphomas.

Mosunetuzumab and other CD20/CD3 bispecific antibodies (BsAbs) have efficacy in B-cell lymphomas relapsing after or refractory to CD19-directed chimeric antigen receptor-modified T cells (CAR-T). The optimal timing of BsAbs and biomarkers of BsAb response after CAR-T are unknown. We addressed these questions using clinical data and blood samples from patients previously treated with CAR-T treated on a phase I/II study of mosunetuzumab (clinicaltrials.

Angiotensin Receptor Neprilysin Inhibition and Cardiovascular Outcomes Across the Kidney Function Spectrum: The PARAGON-HF Trial.

Background: Lower estimated glomerular filtration rate (eGFR) may be one of the major reasons for hesitation or failure to initiate potentially beneficial therapies in patients with heart failure (HF).

Objectives: This study sought to assess if the effects of sacubitril/valsartan (vs valsartan) on cardiovascular outcomes differ according to baseline kidney function in patients with HF with preserved ejection fraction.

Methods: The PARAGON-HF (Prospective Comparison of ARNI with ARB Global Outcomes in HF with Preserved Ejection Fraction) trial was global clinical trial of 4,796 patients with chronic HF and left ventricular ejection fraction (LVEF) ≥45% randomly assigned to sacubitril/valsartan or valsartan.

Nationwide, Couple-Based Genetic Carrier Screening.

Background: Genomic sequencing technology allows for identification of reproductive couples with an increased chance, as compared with that in the general population, of having a child with an autosomal recessive or X-linked genetic condition.

Methods: We investigated the feasibility, acceptability, and outcomes of a nationwide, couple-based genetic carrier screening program in Australia as part of the Mackenzie's Mission project. Health care providers offered screening to persons before pregnancy or early in pregnancy.

Consumer and multidisciplinary clinician experiences after implementation of the Drug Burden Index intervention bundle to facilitate deprescribing in older inpatients: A mixed method study.

Rationale: The Drug Burden Index (DBI) measures exposure to anticholinergic and sedative drugs, which are associated with harm in older adults. To facilitate deprescribing in older Australian inpatients, we piloted an intervention bundle integrating the DBI in Electronic Medical Records, clinician deprescribing guides, consumer information leaflets and a stewardship pharmacist.

Objectives: To understand (i) hospital clinician experiences of using the bundle and (ii) consumer (patient and carer) and General Practitioner (GP) experiences of in-hospital deprescribing, following bundle implementation.

Relapse-free survival with adjuvant dabrafenib/trametinib therapy after relapse on a prior adjuvant CPI in BRAF V600-mutated stage III/IV melanoma.

Background: In BRAF-mutated high-risk melanoma, targeted therapy (BRAF/MEK inhibitors) and checkpoint inhibitor (CPI) immunotherapy have durable benefits as first-line (1L) adjuvant therapy. Based on differing action mechanisms of BRAF/MEK inhibitors and CPI immunotherapies, there is interest in evaluating the activity of 2L adjuvant targeted therapy in decreasing the risk of subsequent recurrence after repeat resection following relapse on/after 1L adjuvant CPI.

Patients And Methods: This was a retrospective review of BRAF V600-mutated resected stage III/IV melanoma patients in the United States, Australia, and The Netherlands who received 1L adjuvant CPI immunotherapy, relapsed locoregionally/distantly, were again resected to no evidence of disease, and received dabrafenib/trametinib (dab/tram) as 2L adjuvant therapy.