203 results match your criteria: "and Royal Prince Alfred Hospital[Affiliation]"

Background: Patients with systemic right ventricle (SRV), either d-transposition of the great arteries following an atrial switch procedure or congenitally corrected transposition of the great arteries, develop severe right ventricular dysfunction, prompting appropriate medical therapy. However, the efficacy of beta-blockers and angiotensin receptor blockers or angiotensin-converting enzyme inhibitors (ACEI) in SRV patients is unproven.

Objectives: The objective of this study was to determine the effects of ACEI/ARB and beta-blockers on outcomes in SRV patients after accounting for likely cofounders affecting their use.

View Article and Find Full Text PDF

A unique collaboration of multi-disciplinary experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF), and the European Organization of Research and Treatment of Cancer (EORTC) was formed to make recommendations on cutaneous melanoma diagnosis and treatment, based on systematic literature reviews and the experts' experience. Cutaneous melanomas are excised with one to two-centimeter safety margins. For a correct stage classification and treatment decision, a sentinel lymph node biopsy shall be offered in patients with tumor thickness ≥ 1.

View Article and Find Full Text PDF

This guideline was developed in close collaboration with multidisciplinary experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF) and the European Organization for Research and Treatment of Cancer (EORTC). Recommendations for the diagnosis and treatment of melanoma were developed on the basis of systematic literature research and consensus conferences. Cutaneous melanoma (CM) is the most dangerous form of skin tumor and accounts for 90 % of skin cancer mortality.

View Article and Find Full Text PDF

Levofloxacin for the Prevention of Multidrug-Resistant Tuberculosis in Vietnam.

N Engl J Med

December 2024

From the Faculty of Medicine and Health (G.J.F., P.N.Y., E.L.M., H.M.Y., E.G.-R., P.D.C., B.J.M., N.T.A.), the Sydney Infectious Diseases Institute (B.J.M.), and Sydney Medical School (H.M.Y.), University of Sydney, and Royal Prince Alfred Hospital, Sydney Local Health District (G.J.F.), Camperdown, NSW, the Woolcock Institute of Medical Research, Macquarie Park, NSW (G.J.F., N.C.B., P.N.Y., P.D.C., N.T.A., G.B.M.), the School of Clinical Medicine, University of New South Wales, Liverpool (F.L.G.), and the Department of Paediatrics, University of Melbourne (S.M.G.), and the Division of Global Health, Burnet Institute (G.B.M.), Melbourne, VIC - all in Australia; the University of Medicine and Pharmacy, Vietnam National University (N.V.N.), and the National Lung Hospital, Ba Dinh District (N.B.H., N.K.C.), Hanoi, and Pham Ngoc Thach Hospital, Ho Chi Minh City (N.H.L.) - all in Vietnam; the Departments of Medicine (A.B., O.S., M.A.B., D.M.), Epidemiology, Biostatistics, and Occupational Health (A.B., M.A.B., D.M.), and Microbiology and Immunology (O.S., M.A.B.), McGill University, Montreal; and Johns Hopkins University, Baltimore (D.W.D.).

Background: Prevention of drug-resistant tuberculosis is a global health priority. However, trials evaluating the effectiveness of treating infection among contacts of persons with drug-resistant tuberculosis are lacking.

Methods: We conducted a double-blind, randomized, controlled trial comparing 6 months of daily levofloxacin (weight-based doses) with placebo to treat infection.

View Article and Find Full Text PDF
Article Synopsis
  • - 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.
View Article and Find Full Text PDF
Article Synopsis
  • A phase 3 trial found that 12 months of adjuvant pembrolizumab significantly improved recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) in patients with high-risk stage III melanoma compared to placebo, with longer follow-up data available.
  • With a median follow-up of 6.9 years, the pembrolizumab group showed a 50% RFS at 7 years versus 36% for the placebo group, and a 54% DMFS compared to 42% in the placebo group.
  • The results indicated consistent positive outcomes across various melanoma subtypes, confirming the long-term benefits of pembrolizumab in improving survival metrics in these patients.
View Article and Find Full Text PDF

Prevalence and Outcomes of Gastrointestinal Manifestations in an Australian Scleroderma Cohort.

Arthritis Care Res (Hoboken)

December 2024

St. Vincent's Hospital Melbourne, Fitzroy, The University of Melbourne, Melbourne, Victoria, and the University of Sydney and Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.

Objective: The gastrointestinal tract (GIT) is the most commonly affected internal organ in systemic sclerosis (SSc). We sought to determine the prevalence and impact of GIT symptoms on survival and patient-reported outcomes.

Methods: A total of 907 consecutive patients from the Australian Scleroderma Cohort Study who had prospectively completed the University of California, Los Angeles, Scleroderma Clinical Trials Consortium Gastrointestinal Tract 2.

View Article and Find Full Text PDF

Comparison of Three Physician Global Assessment Instruments in Systemic Sclerosis.

Arthritis Care Res (Hoboken)

September 2024

The University of Melbourne, Melbourne, Victoria, and the University of Sydney, Sydney Musculoskeletal Health Research Flagship Centre, and Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.

Article Synopsis
  • * Analysis of 1,965 participants revealed that while PhyGA scores were strongly correlated at visits, changes were discordant 50% of the time, highlighting variations in patient experiences.
  • * Findings indicate that PhyGAs for overall health, activity, and damage relate to distinct SSc features, suggesting a need for a standardized assessment to improve consistency in clinical evaluations.
View Article and Find Full Text PDF
Article Synopsis
  • Patients with transposition of the great arteries (TGA) and systemic right ventricle face serious heart-related risks, and researchers sought to determine if specific invasive hemodynamic measures can predict outcomes.
  • The study included 242 adults who underwent cardiac catheterization from 1994 to 2020, analyzing various hemodynamic parameters over an average follow-up period of 11.4 years.
  • Results indicated that a low aortic pulsatility index (<1.5) strongly predicts negative outcomes such as death or the need for heart transplantation, with the cold/wet hemodynamic profile presenting the highest associated risk.
View Article and Find Full Text PDF

Objectives: To identify the trajectories and clinical associations of functional disability in systemic sclerosis (SSc).

Methods: Australian Scleroderma Cohort Study (ASCS) participants meeting ACR/EULAR criteria for SSc recruited within 5 years of disease onset, with ≥2 Health Assessment Questionnaire-Disability Index (HAQ-DI) scores were included. Group based trajectory modelling (GBTM) was used to identify the number and shape of HAQ-DI trajectories.

View Article and Find Full Text PDF

Background: Localization of non-palpable melanoma, Merkel cell carcinoma (MCC) and soft tissue sarcoma (STS) lesions can be difficult due to size, location, and obesity of patients or fibrosis due to previous treatments. Magnetic seed localization (MSL) is a common method to localize non-palpable breast lesions, but the feasibility of MSL for non-palpable melanoma, MCC and STS lesions has not yet been described.

Methods: In this retrospective single center cohort study, all consecutive patients between January 2021 and October 2023 who had a resection of a non-palpable melanoma, MCC or STS lesion guided by Sirius Pintuition, a MSL technique, were included.

View Article and Find Full Text PDF

Development and Initial Validation of the Novel Scleroderma Clinical Trials Consortium Activity Index.

Arthritis Rheumatol

November 2024

University of Melbourne and St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Sydney Musculoskeletal Research Flagship Centre (University of Sydney), University of Sydney School of Public Health, Sydney, New South Wales, and Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.

Objective: Accurate measurement of disease activity in systemic sclerosis (SSc) remains a significant clinical challenge. The Scleroderma Clinical Trials Consortium (SCTC) convened an Activity Index (AI) Working Group (WG) to develop a novel measure of disease activity (SCTC-AI).

Methods: Using consensus methodology, we developed a conceptual definition of disease activity.

View Article and Find Full Text PDF

Background: Hepatitis C virus (HCV) infection can now be cured with well-tolerated direct-acting antiviral (DAA) therapy. However, a potential barrier to HCV elimination is the emergence of resistance-associated substitutions (RASs) that reduce the efficacy of antiviral drugs, but real-world studies assessing the clinical impact of RASs are limited. Here, an analysis of the impact of RASs on retreatment outcomes for different salvage regimens in patients nationally who failed first-line DAA therapy is reported.

View Article and Find Full Text PDF

Background: Weight reduction is a standard recommendation for obstructive sleep apnea (OSA) treatment in people with obesity or overweight; however, weight loss can be challenging to achieve and maintain without bariatric surgery. Currently, no approved anti-obesity medication has demonstrated effectiveness in OSA management. This study is evaluating the efficacy and safety of tirzepatide for treatment of moderate to severe OSA in people with obesity.

View Article and Find Full Text PDF
Article Synopsis
  • - The CLASS project aims to develop data-driven classification criteria for anti-synthetase syndrome (ASSD) by assessing the effectiveness of local immunoassays for detecting anti-aminoacyl tRNA synthetase antibodies (anti-ARS) in real-world settings.
  • - Researchers collected 787 serum samples from various centers and compared local testing results with a central standard using immunoprecipitation and other methods to evaluate tests' sensitivity, specificity, and predictive values.
  • - While local detection of anti-Jo1 antibodies showed high reliability, the agreement for anti-non-Jo1 antibodies varied, indicating some local tests may not align well with central definitions.
View Article and Find Full Text PDF

Quantifying the Need for Specialist Palliative Care Management in Patients With Systemic Sclerosis.

Arthritis Care Res (Hoboken)

July 2024

University of Melbourne, Parkville, Victoria, Australia, University of Sydney School of Public Health, Sydney, NSW, Australia and Royal Prince Alfred Hospital, Camperdown, NSW, Australia.

Objective: The importance of early integration of palliative care in the management of complex multisystem diseases has been recognized. In this study, we aimed to quantify the need for specialist palliative care in patients with systemic sclerosis (SSc).

Methods: Using data from 875 patients enrolled in the Australian Scleroderma Cohort Study, we defined the need for palliative care as a high symptom burden at two or more consecutive study visits, at ≥50% of overall study visits, or at the study visit immediately before death.

View Article and Find Full Text PDF

Background And Aims: For patients with congenitally corrected transposition of the great arteries (ccTGA), factors associated with progression to end-stage congestive heart failure (CHF) remain largely unclear.

Methods: This multicentre, retrospective cohort study included adults with ccTGA seen at a congenital heart disease centre. Clinical data from initial and most recent visits were obtained.

View Article and Find Full Text PDF
Article Synopsis
  • The article provides updated guidelines for clinicians on systemic therapy options for melanoma, based on a systematic review by the American Society of Clinical Oncology Expert Panel.
  • New recommendations include using neoadjuvant pembrolizumab for resectable stage IIIB to IV melanoma, and adjuvant nivolumab or pembrolizumab for stage IIB-C disease.
  • Additionally, certain older treatments are no longer recommended for specific melanoma types, and new options are suggested for unresectable or metastatic cases.
View Article and Find Full Text PDF

Implementing structured pathology reporting protocol for non-melanocytic skin cancers: practical considerations.

Pathology

October 2023

Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, NSW, Australia; Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.

Non-melanocytic skin cancers (NMSCs) account for five times the incidence of all other cancers combined and cost US $6 billion annually. These are the most frequent specimens encountered in community pathology practice in many Western countries. Lack of standardised structured pathology reporting protocols (SPRPs) can result in omission of critical information or miscommunication leading to suboptimal patient management.

View Article and Find Full Text PDF

Orexin Agonists - Two Steps Forward, One Step Back.

N Engl J Med

July 2023

From the Centre for Integrated Research and Understanding of Sleep, Woolcock Institute for Medical Research (N.S.M., R.R.G.), the Department of Health Sciences, Macquarie University (N.S.M.), and Royal Prince Alfred Hospital, Sydney Health Partners (R.R.G.) - all in Sydney.

View Article and Find Full Text PDF

Dimethyl fumarate (DMF) is a widely used oral disease-modifying therapy for multiple sclerosis (MS). Its efficacy and safety profiles are supported by over a decade of experience. Differences exist between Asia and Europe/United States in the prevalence and characteristics of MS; most data for DMF are derived from populations outside Asia.

View Article and Find Full Text PDF

Cilta-cel or Standard Care in Lenalidomide-Refractory Multiple Myeloma.

N Engl J Med

July 2023

From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.).

Background: Ciltacabtagene autoleucel (cilta-cel), a B-cell maturation antigen (BCMA)-directed CAR T-cell therapy, is effective in heavily pretreated patients with relapsed or refractory multiple myeloma. We investigated cilta-cel in earlier treatment lines in patients with lenalidomide-refractory disease.

Methods: In this phase 3, randomized, open-label trial, we assigned patients with lenalidomide-refractory multiple myeloma to receive cilta-cel or the physician's choice of effective standard care.

View Article and Find Full Text PDF