2,663 results match your criteria: "St. Vincents Hospital Melbourne[Affiliation]"

AI in radiology: From promise to practice - A guide to effective integration.

Eur J Radiol

December 2024

Department of Radiology, Los Angeles General Medical Center, 1200 N State Street, Los Angeles, CA 90033, USA.

While Artificial Intelligence (AI) has the potential to transform the field of diagnostic radiology, important obstacles still inhibit its integration into clinical environments. Foremost among them is the inability to integrate clinical information and prior and concurrent imaging examinations, which can lead to diagnostic errors that could irreversibly alter patient care. For AI to succeed in modern clinical practice, model training and algorithm development need to account for relevant background information that may influence the presentation of the patient in question.

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Clinical findings of long-term ambulatory video EEG following routine EEG.

Epilepsy Behav

December 2024

Seer, Melbourne, Australia; Department of Medicine, St. Vincent's Hospital Melbourne, University of Melbourne, Fitzroy, Australia; Graeme Clark Institute for Biomedical Engineering, University of Melbourne, Parkville, Australia.

Article Synopsis
  • This study evaluates the effectiveness of routine EEG (rEEG) followed by long-term ambulatory EEG (aEEG) in diagnosing abnormalities and capturing events in a cohort of 95 patients.
  • Findings showed that abnormal EEG results increased from 18% with rEEG to 33% with aEEG, and non-epileptic events were detected in 35% of aEEG cases, while no non-epileptic events appeared in rEEG.
  • The results suggest that aEEG significantly enhances diagnostic outcomes, especially in adults, and advocates for further research to maximize its clinical application.
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  • * A thorough literature search was conducted, analyzing 29 studies involving 767 patients, focusing on various gastrointestinal problems associated with SLE and their treatments.
  • * The findings indicate that while treatments like intravenous methylprednisolone and oral prednisolone may benefit patients, the overall quality of evidence is low, emphasizing the necessity for better-defined disease standards and more robust clinical trials.
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: Grade-2 gliomas (G2-glioma) are uncommon. In 2016, RTOG9802 established the addition of chemotherapy after radiation (CRT) as a new standard of care for patients with high-risk G2-glioma, defined as subtotal resection or age ≥40 yrs. Here, we report current practices using real-world data.

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Letter Response to: Hernandez-Rocha C et al, Clin Gastroenterol Hepatol 2024.

Clin Gastroenterol Hepatol

October 2024

Department of Gastroenterology, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Australia.

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Recently, several bispecific antibodies (BsAbs) have been approved for the treatment of relapsed multiple myeloma (MM) after early phase trials in heavily pre-treated patients demonstrated high response rates and impressive progression-free survival with monotherapy. These BsAbs provide crucial treatment options for relapsed patients and challenging decisions for clinicians. Evidence on the optimal patient population, treatment sequence, and duration of these therapeutics is unknown and subject to active investigation.

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Xenon gas has significant advantages over conventional general anesthetic agents but its use has been limited by the cost associated with its production. Xenon also has significant potential for medical use in the treatment of acquired brain injuries and for mental health disorders. As the demand for xenon gas from other industries increases, the costs associated with its medical use are only likely to increase.

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Background: To evaluate, in a cohort study, whether coronary microvasculature and myocardial structure differ between people with and without coronary artery disease (CAD).

Methods And Results: We performed histological analysis of left ventricle free wall obtained at autopsy from 25 men and 23 women with ≥1 coronary artery with ≥75% area stenosis, and 25 men and 25 women without (no or minimal) CAD, matched for sex and age, who died suddenly from noncardiac causes. Decedents with myocardial infarction or other cardiac abnormality were excluded.

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  • - The study investigated how season, temperature, and humidity affect the severity of Raynaud phenomenon (RP) in patients with systemic sclerosis, utilizing data from the Australian Scleroderma Cohort Study.
  • - Among 1,972 participants, 26.7% experienced worsened RP related to environmental factors such as low temperatures and high humidity, which were linked to poorer health-related quality of life.
  • - The findings suggest that managing RP may benefit from maintaining warmer and drier conditions, highlighting the importance of environmental factors in treating this condition.
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  • - The study evaluated the impact of nurse-led implementation of protocols to manage fever, hyperglycemia, and swallowing in German stroke units, showing significant improvements in adherence to these protocols after training and support from an Australian team.
  • - Results indicated a notable increase in overall adherence from 20% to 28%, with specific improvements in managing hyperglycemia (from 43% to 55%) and swallowing (from 52% to 61%), though fever protocol adherence showed little change.
  • - Additional findings revealed increased timely administration of anti-pyretics and insulin, as well as improved screening for swallowing within 24 hours of admission, highlighting the effectiveness of the implemented support strategies.
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Articular cartilage injuries in the knee can lead to post-traumatic osteoarthritis if untreated, causing debilitating problems later in life. Standard surgical treatments fail to ensure long lasting repair of damaged cartilage, often resulting in fibrotic tissue. While there is a vast amount of research into cartilage regeneration, integrating engineered implants with cartilage remains a challenge.

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  • The study investigates the safety of accessing the L4-5 disc level in the lumbar spine using two different patient positions: lateral decubitus (LAT) and supine (SUP).
  • It involves a retrospective analysis of 140 patients, where LAT patients had significantly more additional lateral lumbar interbody fusion procedures and surgeries for spinal deformity compared to SUP patients.
  • Results show that while intraoperative complications were similar, LAT patients experienced significantly fewer postoperative complications, including a notable reduction in postoperative ileus.
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  • Generalized pustular psoriasis (GPP) is a rare and serious skin condition characterized by pustules and systemic symptoms, with differences in genetic mutations affecting its presentation and treatment among various ethnic groups.
  • A modified Delphi panel study involving dermatology experts from the Asia-Pacific region aimed to establish a consensus on GPP management due to limited existing evidence and information.
  • The panel reached agreement on 106 key statements addressing GPP’s definition, diagnosis, treatment strategies, and flare severity, creating treatment algorithms to assist clinicians in making informed decisions.
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Background: In the absence of direct evidence supporting how to use nasal endoscopy findings to judge chronic rhinosinusitis (CRS) disease control, experts' practice patterns could provide guidance.

Methodology: Participants consisted of a diverse group of twenty-nine rhinologists. Participants were presented with every possible combination of bilateral nasal endoscopy findings represented by the modified Lund-Kennedy (MLK; range: 0-12) endoscopic scoring system and Nasal Polyp Score (NPS; range: 0-8).

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The Use of the Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Predicting Transcatheter Aortic Valve Implantation Mortality.

Heart Lung Circ

December 2024

Department of Cardiology, St Vincent's Hospital Melbourne, Fitzroy, Vic, Australia; Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; Department of Medicine, The University of Melbourne, Parkville, Vic, Australia.

Aim: Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are simple biomarkers that reflect systemic inflammation and are associated with adverse cardiovascular disease outcomes. The utility of NLR and PLR for risk prediction following transcatheter aortic valve implantation (TAVI) is not clear.

Method: We retrospectively analysed a prospectively maintained database of patients who underwent TAVI at a tertiary hospital from 2009 to 2022.

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  • Pulmonary arterial hypertension and left ventricular diastolic dysfunction are serious complications in patients with systemic sclerosis, which can lead to high morbidity and mortality rates.
  • A study involving 61 systemic sclerosis patients in Australia assessed the prevalence of these conditions along with their correlation to N-terminal pro-brain natriuretic peptide levels.
  • The findings revealed that 8% of patients had a high likelihood of pulmonary hypertension, and those with either pulmonary hypertension or diastolic dysfunction showed significantly elevated levels of N-terminal pro-brain natriuretic peptide compared to those without these conditions.
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Article Synopsis
  • ACL injuries often lead to damage not just to the ligament itself but also to other knee structures, and this can result in ongoing cartilage deterioration after surgical reconstruction.
  • Researchers aimed to systematically review existing literature to find biomarkers in urine, serum, or synovial fluid that correlate with recovery outcomes following ACL surgery.
  • Out of 9360 studies reviewed, 16 were included that analyzed 45 different biomarkers, revealing that 17 of them were significantly linked to various outcome measures related to knee function and healing post-surgery.
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Purpose: Our aim was to determine whether the administration of a micro-enema immediately prior to prostate MRI is associated with a reduction in rectal gas, gas related artifacts and an improvement in image quality and PI-QUAL score.

Method: This retrospective analysis enrolled 171 patients who underwent multiparametric 3T prostate MRI at our institution between January 2021 and September 2022. 86 patients received a micro-enema, and a further 85 patients did not.

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Article Synopsis
  • - The study investigates chair, bed, and toilet heights in rehabilitation hospitals and at home to help clinicians better prepare stroke survivors for returning home post-recovery.
  • - Data was gathered from six rehabilitation hospitals and homes of 200 first-time stroke survivors, revealing that home furniture is generally lower than in hospital settings (e.g., chairs are 2-5 cm shorter).
  • - The findings highlight a significant height disparity that clinicians need to address by lowering chair and bed heights in hospitals to facilitate a smoother transition for stroke survivors to their home environment.
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Hierarchically vascularized and suturable tissue constructs created through angiogenesis from tissue-engineered vascular grafts.

Acta Biomater

November 2024

Department of Biomedical Engineering, Graeme Clark Institute, University of Melbourne, Victoria 3010, Australia; Aikenhead Centre for Medical Discovery (ACMD), Fitzroy, Victoria 3065, Australia. Electronic address:

A major roadblock in implementing engineered tissues clinically lies in their limited vascularization. After implantation, such tissues do not integrate with the host's circulation as quickly as needed, commonly resulting in loss of viability and functionality. This study presents a solution to the vascularization problem that could enable the survival and function of large, transplantable, and vascularized engineered tissues.

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Atrial Fibrillation Surgery in Australia: Are We Doing Enough?

Heart Lung Circ

December 2024

Department of Cardiothoracic Surgery, Gold Coast University Hospital, Gold Coast, Qld, Australia.

Aim: This study aimed to examine contemporary burden and treatment trends of atrial fibrillation (AF) in patients undergoing cardiac surgery in Australia and New Zealand. This allows comparison of contemporary practice with the Society of Thoracic Surgeons guideline recommendations for the surgical treatment of AF in patients undergoing cardiac surgery.

Method: A 10-year retrospective review of the Australian & New Zealand Society of Cardiac & Thoracic Surgeons National Cardiac Surgery Database was performed, examining all adult cardiac surgery patients from 2011 to 2021.

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Cardiorespiratory Fitness in Childhood Cancer Survivors: A Systematic Review and Meta-Analysis.

Eur J Prev Cardiol

October 2024

Integrated Cardiovascular Exercise Physiology and Rehabilitation Lab, Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.

Aims: Cardiovascular disease (CVD) is a leading cause of mortality in childhood cancer survivors (CCS) that may be related to the cardiotoxic effects of radiation or chemotherapy and concomitant reductions in cardiorespiratory fitness. Therefore, we sought to compare cardiorespiratory fitness (peak oxygen uptake, V̇O2peak) between CCS and age-matched non-cancer controls (CON). Secondary outcomes included hemodynamics and resting cardiac function.

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