218 results match your criteria: "St. John of God Subiaco Hospital[Affiliation]"

Pelvic congestion syndrome: Not all pelvic pain is gynaecological.

Aust J Gen Pract

December 2024

MBBS (Hons), FRACS (Vasc), Vascular Surgeon, Department of Vascular Surgery, Hollywood Private Hospital, Perth, WA; Vascular Surgeon, Ponosh Vascular, Perth, WA.

Background: Chronic pelvic pain is a debilitating but common syndrome that is a burden both for patients and health systems. Pelvic congestion syndrome (PCS) contributes to 30-40% of patients presenting with chronic pelvic pain where no other cause is identified. However, PCS is poorly understood, underdiagnosed and undertreated, with the average time to diagnosis being reported as up to four years after initial presentation.

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This narrative review provides a comprehensive overview of complications in interventional radiology (IR), focusing on their aetiology, recognition, and management. As IR procedures continue to evolve and expand, understanding potential adverse events is crucial for improving patient safety and outcomes. The review will summarise various common complications associated with IR-based procedures, including their presentation, aetiology, and management.

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Purpose: Breast cancer treatments often lead to unfavourable changes in body composition, physical fitness, and quality of life (QoL). We compared the effects of resistance training (RT) and high-intensity interval training (HIIT) on these outcomes in survivors of breast cancer.

Methods: Twenty-eight survivors of breast cancer, post-treatment (Stage I-III), aged 55.

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Introduction: Acute upper gastrointestinal bleeding (UGIB) secondary to gastric cancer presents a significant clinical challenge due to its high morbidity and mortality rates. Transcatheter arterial embolisation (TAE) has emerged as a potential therapeutic option for managing this condition, especially in the context of failed endoscopic management. This systematic review aims to evaluate the efficacy and safety of TAE in treating acute upper gastrointestinal (GI) bleeding caused by gastric cancer.

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Article Synopsis
  • Eftilagimod alpha (efti) is a protein that activates immune cells, potentially overcoming resistance to PD-(L)1 inhibitors, and was tested with pembrolizumab on NSCLC patients who had previously failed anti-PD-(L)1 therapy.
  • In a study of 36 patients, efti was administered alongside pembrolizumab, with primary focus on the objective response rate and secondary measures including overall survival and disease control.
  • Results showed modest activity with an 8.3% objective response rate and a median overall survival of 9.9 months, particularly benefiting patients with higher PD-(L)1 expression, while the treatment was well-tolerated without severe adverse events.
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Pericyte phenotype switching alleviates immunosuppression and sensitizes vascularized tumors to immunotherapy in preclinical models.

J Clin Invest

September 2024

Cancer Microenvironment Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre and Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.

T cell-based immunotherapies are a promising therapeutic approach for multiple malignancies, but their efficacy is limited by tumor hypoxia arising from dysfunctional blood vessels. Here, we report that cell-intrinsic properties of a single vascular component, namely the pericyte, contribute to the control of tumor oxygenation, macrophage polarization, vessel inflammation, and T cell infiltration. Switching pericyte phenotype from a synthetic to a differentiated state reverses immune suppression and sensitizes tumors to adoptive T cell therapy, leading to regression of melanoma in mice.

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Endocervical adenocarcinomas (EACs) are a group of malignant neoplasms associated with diverse pathogenesis, morphology, and clinical behavior. As a component of the International Society of Gynecological Pathologists International Endocervical Adenocarcinoma Project, a large international retrospective cohort of EACs was generated in an effort to study potential clinicopathological features with prognostic significance that may guide treatment in these patients. In this study, we endeavored to develop a robust human papillomavirus (HPV)-associated EAC prognostic model for surgically treated International Federation of Gynecology and Obstetrics (FIGO) stage IA2 to IB3 adenocarcinomas incorporating patient age, lymphovascular space invasion (LVSI) status, FIGO stage, and pattern of invasion according to the Silva system (traditionally a 3-tier system).

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As medical treatment increasingly focuses on improving health-related quality of life, patient-reported outcome measures (PROMs) are an essential component of clinical research. The National Gynae-Oncology Registry (NGOR) is an Australian clinical quality registry. A suitable PROM was required for the NGOR ovarian cancer module to complement clinical outcomes and provide insights into outcomes important to patients.

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Introduction: Physical activity is associated with improved disease progression and cancer-specific survival in patients with prostate cancer (PCa). However, the mechanisms underlying these associations remain unclear, while the relative impact of exercise modes is unknown. This study aims to examine the differential impact of exercise mode on tumour-suppressive skeletal muscle-associated systemic molecules as well as their delivery mechanism.

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Background: Peripheral Intravenous Cannulas (PIVCs) are frequently utilised in the Emergency Department (ED) for delivery of medication and phlebotomy. They are associated with complications and have an associated cost to departmental resources. A growing body of international research suggests many of the PIVCs inserted in the ED are unnecessary.

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Spatial transcriptomics reveals discrete tumour microenvironments and autocrine loops within ovarian cancer subclones.

Nat Commun

April 2024

Harry Perkins Institute of Medical Research, QEII Medical Centre and Centre for Medical Research, The University of Western Australia, Nedlands, Perth, WA, 6009, Australia.

High-grade serous ovarian carcinoma (HGSOC) is genetically unstable and characterised by the presence of subclones with distinct genotypes. Intratumoural heterogeneity is linked to recurrence, chemotherapy resistance, and poor prognosis. Here, we use spatial transcriptomics to identify HGSOC subclones and study their association with infiltrating cell populations.

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Purpose/aim: Perianal wound healing and/or complications are common following abdominoperineal resection (APR). Although primary closure is commonly undertaken, myocutaneous flap closure such as vertical rectus abdominis myocutaneous flap (VRAM) is thought to improve wound healing process and outcome. A comprehensive meta-analysis was performed to compare outcomes of primary closure versus VRAM flap closure of perineal wound following APR.

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Vedolizumab and Ustekinumab Levels in Pregnant Women With Inflammatory Bowel Disease and Infants Exposed In Utero.

Clin Gastroenterol Hepatol

January 2025

Department of Gastroenterology, Monash Health, Clayton, Victoria, Australia; Centre of Inflammatory Disease, Department of Medicine, Monash University, Clayton, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia.

Background & Aims: Vedolizumab and ustekinumab pharmacokinetics in pregnancy and the infant after in utero exposure remain incompletely defined. We aim to define the antenatal stability of ustekinumab and vedolizumab levels and the time at which infant drug levels become undetectable.

Methods: This multicenter prospective observational cohort study recruited pregnant or preconception women with inflammatory bowel disease receiving vedolizumab or ustekinumab.

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Background/aim: This study reviews the literature to examine the proportion of patients requiring surgical management in ischemic colitis (IC) and identify surgical outcomes.

Method: A systematic review of PubMed, EMBASE, and Cochrane Central Register of Controlled Trials was conducted in accordance with the latest Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. English language studies and adult patients were included.

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Low grade appendiceal mucinous neoplasm (LAMN) is a rare tumor presenting typically with symptoms of acute appendicitis. A 33-year-old gentleman presented with abdominal fullness and discomfort secondary to abdominal trauma obtained during boxing training. Investigations with magnetic resonance imaging (MRI), ultrasound, and colonoscopy revealed a large cystic lesion in the ascending colon mesentery with unclear continuation with the appendix.

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Introduction: The study examined whether increased physical activity (PA) in nonmetropolitan cancer survivors was maintained 12 weeks following the PPARCS intervention.

Methods: PA outcomes were assessed using an accelerometer at baseline, end of the intervention, and at 24 weeks. Linear mixed models were used to examine between-group changes in PA outcomes.

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Sternal sparing aortic valve replacement via right anterior minithoracotomy: An early experience.

Indian J Thorac Cardiovasc Surg

March 2024

Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, WA 6009 Australia.

Purpose: This study aims to evaluate the perioperative outcomes of aortic valve replacement (AVR) via right anterior minithoracotomy (RAT) during the learning curve.

Methods: It was a retrospective, observational, cohort study of patients who underwent RAT AVR from June 2015 to April 2022. Primary outcomes measured were 30-day morbidity and mortality.

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Thymic carcinoma is rare, with resulting treatment of patients with extrathoracic metastasis being on a case-by-case basis. We describe the management of a woman in her 70s with an incidentally discovered cystic hepatic lesion with confirmation of a solitary extrathoracic metastasis from a synchronous primary thymic carcinoma. Following chemotherapy and staged resection of the metastasis and the primary tumour, the patient remained free of disease on radiological surveillance 6 months postoperatively.

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To describe the protocol and statistical analysis plan for the Treatment of Invasively Ventilated Adults with Early Activity and Mobilisation (TEAM III) trial. An international, multicentre, parallel-group, randomised controlled phase 3 trial. Intensive care units (ICUs) in Australia, New Zealand, Germany, Ireland, the United Kingdom and Brazil.

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Heterotaxy syndrome is a disease of embryo development resulting in abnormal distribution of thoracic and abdominal organs across the left-right axis. In this case, A 77-year-old gentleman was admitted with gastric outlet obstruction secondary to cholangiocarcinoma. This is on a background of heterotaxy syndrome, specifically .

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Brief Report: Real-World Toxicity and Survival of Combination Immunotherapy in Pleural Mesothelioma-RIOMeso.

J Thorac Oncol

April 2024

Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia; University of Sydney, Sydney, Australia; Blacktown Hospital, Sydney, Australia.

Background: Australia has one of the highest rates of asbestos-associated diseases. Mesothelioma remains an area of unmet need with a 5-year overall survival of 10%. First-line immunotherapy with ipilimumab and nivolumab is now a standard of care for unresectable pleural mesothelioma following the CheckMate 743 trial, with supportive data from the later line single-arm MAPS2 trial.

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Aim: To evaluate the impact of a co-designed intervention to reduce time spent on clinical documentation and increase time for direct patient care.

Design: A pre- and post-test interventional study with multi-method evaluation, reported according to the Transparent Reporting of Evaluations with Nonrandomised Evaluations Designs guidelines.

Methods: An intervention to decrease the burden of documentation was co-designed and implemented.

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Objectives: To compare the needs and issues faced by breast cancer survivors (BCSs) who received chemotherapy as part of their treatment with those who did not and assess satisfaction with a specialist breast care nurse-led survivorship clinic.

Sample & Setting: BCSs who attended a specialist breast care nurse-led survivorship clinic at a Western Australian private, not-for-profit hospital.

Methods & Variables: A multimethod evaluation included surveys, quality-of-life assessments, and reviews of wellness plans.

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Background: The Australian population is ageing, with an increasing number of patients diagnosed with colorectal cancer in their eighth decade. This group represents a challenging cohort to deliver multidisciplinary care, with increased morbidity and mortality related to surgical and oncological therapies. This project aimed to compare surgical and oncological outcomes in octogenarian and non-octogenarian patients with colorectal cancer.

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