673 results match your criteria: "Sydney Medical School-Nepean[Affiliation]"

Background: Chronic, low-intensity air pollution exposure has been consistently associated with increased atherosclerosis in adults. However, there was limited research regarding the implications of acute, high-intensity air pollution exposure during childhood. We aimed to determine whether there were any associations between early-life exposure to such an episode and early-life vascular function changes.

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A survey of Australian public opinion on using comorbidity to triage intensive care patients in a pandemic.

Aust Health Rev

August 2024

Intensive Care Unit, Concord Repatriation General Hospital, Hospital Road, Concord, NSW 2139, Australia; and Sydney Medical School - Concord, University of Sydney, Sydney, NSW, Australia.

Article Synopsis
  • The study aimed to assess public perceptions of fairness in intensive care triage methods during a pandemic, focusing on chronic comorbidity factors.
  • A survey conducted with 2000 registered voters evaluated the fairness of triaging based on medical conditions, long-term survival, function, and frailty, alongside preferences for vulnerable individuals and frontline workers.
  • Results revealed that while most respondents found comorbidity-based triage methods fair, a notable minority viewed it as unfair, particularly regarding preferential treatment for vulnerable groups; however, triage for healthcare workers was generally seen as fair.
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Removal of endothelial surface-associated von villebrand factor suppresses accelerate datherosclerosis after myocardial infarction.

J Transl Med

May 2024

Cardiovascular Division and Robert M. Berne Cardiovascular Research Center, University of Virginia, Box 801394, 415 Lane Rd, Charlottesville, VA, 22908, USA.

Background: Thromboinflammation involving platelet adhesion to endothelial surface-associated von Willebrand factor (VWF) has been implicated in the accelerated progression of non-culprit plaques after MI. The aim of this study was to use arterial endothelial molecular imaging to mechanistically evaluate endothelial-associated VWF as a therapeutic target for reducing remote plaque activation after myocardial infarction (MI).

Methods: Hyperlipidemic mice deficient for the low-density lipoprotein receptor and Apobec-1 underwent closed-chest MI and were treated chronically with either: (i) recombinant ADAMTS13 which is responsible for proteolytic removal of VWF from the endothelial surface, (ii) N-acetylcysteine (NAC) which removes VWF by disulfide bond reduction, (iii) function-blocking anti-factor XI (FXI) antibody, or (iv) no therapy.

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Tracking of serum lipid levels from childhood to adulthood: Systematic review and meta-analysis.

Atherosclerosis

April 2024

Baker Heart and Diabetes Institute, Melbourne, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland. Electronic address:

Background And Aims: The utility of lipid screening in pediatric settings for preventing adult atherosclerotic cardiovascular diseases partly depends on the lifelong tracking of lipid levels. This systematic review aimed to quantify the tracking of lipid levels from childhood and adolescence to adulthood.

Methods: We systematically searched MEDLINE, Embase, Web of Science, and Google Scholar in March 2022.

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Background: Cuff blood pressure (BP) is recommended for guiding hypertension management. However, central BP has been proposed as a superior clinical measurement. This study aimed to determine whether controlling hypertension as measured by central BP was beneficial in reducing left ventricular mass index beyond control of standard cuff hypertension.

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Background: Breastfeeding (BF) confers metabolic benefits to infants, including reducing risks of metabolic syndrome such as obesity and diabetes later in life. However, the underlying mechanism is not yet fully understood. Hence, we aim to investigate the impacts of BF on the metabolic organs of infants.

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Integrating Cardio-Oncology Across the Research Pipeline, Policy, and Practice in Australia-An Australian Cardiovascular Alliance Perspective.

Heart Lung Circ

May 2024

Newcastle Centre of Excellence in Cardio-Oncology, The University of Newcastle, Hunter Medical Research Institute, Calvary Mater Newcastle, Newcastle, NSW, Australia; College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia; Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia. Electronic address:

Over 18 million people worldwide were diagnosed with cancer in 2020, including over 150,000 people in Australia. Although improved early detection and treatment have increased the survival rates, cardiotoxic treatment and inadequate management of cardiovascular risk factors have resulted in cardiovascular disease (CVD) being one of the leading causes of non-cancer-related death and disability among cancer survivors. International guidelines outline the standards of care for CVD risk surveillance and management.

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Objectives: To evaluate the safety of current guidelines on methotrexate (MTX) administration in women with pregnancy of unknown location (PUL) who are considered to have a high risk of underlying ectopic pregnancy (EP), and to investigate whether implementation of these guidelines would result in inadvertent exposure to MTX of viable intrauterine pregnancies (IUPs).

Methods: This was a retrospective observational study of consecutive clinically stable women who were classified with PUL at the early pregnancy unit of Nepean Hospital, Sydney, Australia, between 2007 and 2021. PUL was defined as a positive pregnancy test in the absence of signs of IUP or EP on transvaginal ultrasound.

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Social media platforms are used for support and as resources by people from the endometriosis community who are seeking advice about diagnosis, education, and disease management. However, little is known about the scientific accuracy of information circulated on Instagram about the disease. To fill this gap, this study analysed the evidence-based nature of content on Instagram about endometriosis.

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Prophylaxis to Prevent Cardiotoxicity in Patients Receiving Anthracycline for Breast Cancer: A Combined Bayesian and Frequentist Network Meta-Analysis of Randomised Controlled Trials.

Heart Lung Circ

May 2024

Department of Cardiology, Nepean Hospital, Sydney, NSW, Australia; Department of Academic Medicine, Sydney Medical School Nepean, Faculty of Medicine and Health, Charles Perkins Centre Nepean, The University of Sydney, Sydney, NSW, Australia. Electronic address:

Background: The benefits in survivorship gained with anthracycline (ANT)-based chemotherapies for breast cancer are unfortunately mitigated for some patients by irreversible cardiotoxicity. Randomised controlled trials (RCTs) have explored multiple cardioprotection options, however, it remains unclear which drug is most effective in preserving left ventricular ejection fraction (LVEF). This study aimed to perform a systematic review and network meta-analysis, using Bayesian and frequentist approaches, of RCTs evaluating cardioprotective agents.

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Background: Microvascular obstruction (MVO) is an independent predictor of adverse cardiac events after ST-elevation myocardial infarction (STEMI). The Index of Microcirculatory Resistance (IMR) may be a useful marker of MVO, which could simplify the care pathway without the need for Cardiac Magnetic Resonance (CMR). We assessed whether the IMR can predict MVO in STEMI patients.

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Purpose: The progression of deep endometriosis (DE) in women of reproductive age is highly variable. This study aimed to analyze the sonomorphological changes of rectal endometriosis over long periods of time and the influence of hormonal treatment.

Methods: This retrospective study included premenopausal women with rectal DE treated conservatively between 2002 and 2021.

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Addendum to consensus opinion from International Deep Endometriosis Analysis (IDEA) group: sonographic evaluation of the parametrium.

Ultrasound Obstet Gynecol

August 2024

Department of Obstetrics and Gynaecology, Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium.

Preoperative sonographic staging in patients with suspected parametrial endometriosis is essential to plan surgical intervention and anticipate the need for a multidisciplinary approach, and thus optimize surgical outcome. The results of a recent meta-analysis suggest that there is a need to define more accurately the ultrasonographic criteria for parametrial involvement in endometriosis. This addendum to the International Deep Endometriosis Analysis (IDEA) consensus highlights the sonographic characteristics of the parametrium and identifies ultrasound techniques to diagnose deep endometriosis in this area.

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General practitioners' attitudes and knowledge about attention-deficit hyperactivity disorder (ADHD): Insights from a survey.

Australas Psychiatry

February 2024

Department of Paediatrics, Nepean Hospital, Penrith, NSW, Australia; Sydney Medical School Nepean, Discipline of Paediatrics, The University of Sydney, Sydney, NSW, Australia; and Brain Mind Centre Nepean, The University of Sydney, Penrith, NSW, Australia.

Objective: The Review of health services for children, young people and families within the NSW Health system identified that novel models of care were needed to improve access to clinical management for people with ADHD. The present study aimed to evaluate GPs' knowledge of and attitudes towards ADHD and the challenges and opportunities for a more substantial role for GPs in ADHD management.

Method: An online survey of Australian GPs was conducted, with recruitment via email invitation.

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Introduction: The relationship of acute right heart dysfunction (RHD) with long-term cardiopulmonary dysfunction and its' associated morbidity has not been clearly elucidated. We propose a prospective, observational study to assess the natural history of acute RHD using a combination of imaging, functional and qualitative assessment methods, including the recently described combination of simultaneous maximal effort cardiopulmonary exercise testing and stress echocardiography.

Methods And Analysis: We propose a single-centre study of patients ≥18 years admitted to either the intensive care or respiratory close observation units with RHD on transthoracic echocardiography (TTE).

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Simulation has been shown to improve clinical learning outcomes, speed up the learning process, and improve trainee confidence, while taking the pressure off initial face-to-face patient clinical areas. The second part of The World Federation for Ultrasound in Medicine and Biology state-of-the-art paper on the use of simulators provides a general approach on the practical implementation. The importance of needs assessment before developing a simulation-based training program is outlined.

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Health Economic Analysis of CMR: A Systematic Review.

Heart Lung Circ

August 2023

Charles Perkins Centre, Sydney Medical School Nepean, The University of Sydney, Sydney, NSW, Australia; Department of Cardiology Nepean Hospital, Sydney, NSW, Australia. Electronic address:

Introduction: Uptake of cardiac magnetic resonance (CMR) in Australia has been limited by issues of cost and access. There is a need to inform future application of CMR by evaluating pertinent health economic literature. We sought to perform a systematic review on the health economic data as it pertains to CMR.

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Left ventricular longitudinal systolic dysfunction in children with type 1 diabetes mellitus: A systematic review and meta-analysis.

J Diabetes Complications

August 2023

Sydney Medical School Nepean, Faculty of Medicine and Health, Charles Perkins Centre Nepean, The University of Sydney, NSW, Australia; Department of Cardiology, Nepean Hospital, NSW, Australia. Electronic address:

Article Synopsis
  • This study investigates the presence of subclinical myocardial dysfunction in children with type 1 diabetes mellitus (T1DM) by comparing their left ventricle (LV) strain values to those of healthy controls.
  • It utilizes a meta-analysis of ten studies that involved echocardiography to measure LV global longitudinal strain (GLS) and circumferential strain (GCS) in both groups.
  • The findings show that children with T1DM have significantly lower GLS compared to healthy peers, indicating early signs of cardiac dysfunction, while GCS did not show statistically significant differences.
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Background: Cardiovascular risk prediction models incorporate myriad CVD risk factors. Current prediction models are developed from non-Asian populations, and their utility in other parts of the world is unknown. We validated and compared the performance of CVD risk prediction models in an Asian population.

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Introduction: COVID-19 vaccine acceptance research has mostly originated from high-income countries and reasons why youth may not get vaccinated may differ in low-income settings. Understanding vaccination coverage across different population groups and the sociocultural influences in healthcare delivery is important to inform targeted vaccination campaigns.

Methods: A population-based survey was conducted in 24 communities across three provinces (Harare, Bulawayo and Mashonaland East) in Zimbabwe between October 2021 and June 2022.

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Although a more efficient adaptive humoral immune response has been proposed to underlie the usually favorable outcome of pediatric COVID-19, the breadth of viral and vaccine cross-reactivity toward the ever-mutating Spike protein among variants of concern (VOCs) has not yet been compared between children and adults. We assessed antibodies to conformational Spike in COVID-19-naïve children and adults vaccinated by BNT162b2 and ChAdOx1, and naturally infected with SARS-CoV-2 Early Clade, Delta, and Omicron. Sera were analyzed against Spike including naturally occurring VOCs Alpha, Beta, Gamma, Delta, and Omicron BA.

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