4,336 results match your criteria: "the Alfred Hospital[Affiliation]"

Introduction: Infants born very preterm (VPT, <32 weeks' gestation) are at increased risk for neurodevelopmental impairments including motor, cognitive and behavioural delay. Parents of infants born VPT also have poorer mental health outcomes compared with parents of infants born at term.We have developed an intervention programme called TEDI-Prem (Telehealth for Early Developmental Intervention in babies born very preterm) based on previous research.

View Article and Find Full Text PDF

Challenges of symptom management in interstitial lung disease: dyspnea, cough and fatigue.

Expert Rev Respir Med

January 2025

Respiratory Research @ Alfred, School of Translational Medicine, Monash University, Melbourne, Australia.

Introduction: Interstitial lung disease (ILD) is a broad group of conditions characterized by fibrosis of the lung parenchyma. Idiopathic pulmonary fibrosis (IPF) is the most common subvariant. IPF is marked by considerable symptom burden of dyspnea, cough and fatigue that is often refractory to optimal disease-directed treatment.

View Article and Find Full Text PDF

We investigated the accuracy of predicting preload responsiveness by means of a passive leg raising test (PLR) using the perfusion index (PI) in critically ill patients showing signs of hypoperfusion in a resource-limited setting. We carried out a prospective observational single center study in patients admitted for sepsis or severe malaria with signs of hypoperfusion in Chattogram, Bangladesh. A PLR was performed at baseline, and at 6, 24, 48, and 72 h.

View Article and Find Full Text PDF

Adjunctive Fresh Frozen Plasma Versus Adjunctive Cryoprecipitate in Cardiac Surgery Patients Receiving Platelets for Perioperative Bleeding.

J Cardiothorac Vasc Anesth

December 2024

Department of Critical Care, University of Melbourne, Parkville, Australia; Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia; Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia; Data Analytics Research and Evaluation Centre, Austin Hospital, Melbourne, Australia.

Objective(s): This study was designed to assess the relative association between adjunctive fresh frozen plasma (FFP) or adjunctive cryoprecipitate and morbidity and mortality in cardiac surgery patients receiving platelets for perioperative bleeding.

Design: Retrospective cohort study using inverse probability of treatment weighting with entropy balancing.

Setting: Multi-institutional study of 58 centers using the Australian and New Zealand Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database from January 1, 2005, to December 31, 2021.

View Article and Find Full Text PDF

Purpose: Intracerebral haemorrhage (ICH) is an absolute contraindication for therapeutic oral anticoagulation therapy (OAT). Re-bleeding carries significant risk of morbidity and mortality. Patients with prosthetic heart valves are at higher risk of thromboembolic complications when OAT is withheld.

View Article and Find Full Text PDF

The collective experience of moral distress: a qualitative analysis of perspectives of frontline health workers during COVID-19.

Philos Ethics Humanit Med

January 2025

Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Australia.

Background: Moral distress is reported to be a critical force contributing to intensifying rates of anxiety, depression and burnout experienced by healthcare workers. In this paper, we examine the moral dilemmas and ensuing distress personally and collectively experienced by healthcare workers while caring for patients during the pandemic.

Methods: Data are drawn from free-text responses from a cross-sectional national online survey of Australian healthcare workers about the patient care challenges they faced.

View Article and Find Full Text PDF

Background: Patients in the intensive care unit (ICU) frequently develop hyperactive delirium, which may be accompanied by behaviour that increases clinical risks to themselves as well as other patients and staff. There is a paucity of evidence to inform the urgent enteral administration of antipsychotic drugs to treat such hyperactive delirium and behavioural disturbances.

Objective: The aim of this study is to test the efficacy and safety of administering enteral olanzapine when compared to quetiapine in critically ill patients with hyperactive delirium.

View Article and Find Full Text PDF

Objective: The optimal timing of vasopressin initiation as an adjunctive vasopressor remains unclear. We aimed to study the association between the timing of vasopressin commencement, pre-specified physiological parameters, and hospital mortality.

Design: We conducted a multicentre, retrospective, observational study.

View Article and Find Full Text PDF

Prone positioning of nonintubated patients with COVID-19 in Australian intensive care units.

Crit Care Resusc

December 2024

Australian and New Zealand Intensive Care - Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne Australia.

Objective: To describe the use of and outcomes from awake prone positioning (APP) in nonintubated patients with COVID-19 in Australian intensive care units (ICUs) in comparison to those who did not receive APP, and to explore the temporal relationship between publication of APP research and changes in clinical practice.

Design: Multicentre, observational cohort study.

Setting: Seventy-eight Australian ICUs participating in SPRINT-SARI Australia.

View Article and Find Full Text PDF

Prognostic assessment in chronic lymphocytic leukemia (CLL) is essential for delivery of timely, personalized therapy. status, karyotype, IGHV mutational status, minimal residual disease (MRD), gene mutations and markers of cell proliferation were important prognostic tools in the era of chemo-immunotherapy (CIT). With BCL2 inhibitors (BCL2i), outcome is still impacted by IGHV status, status, complex karyotype, and achievement of undetectable MRD.

View Article and Find Full Text PDF

The impact of a tailored nutrition intervention delivered for the duration of hospitalisation on daily energy delivery for patients with critical illness (INTENT): a phase II randomised controlled trial.

Crit Care

January 2025

Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Department of Epidemiology and Preventative Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, Australia.

Background: Nutrition interventions commenced in ICU and continued through to hospital discharge have not been definitively tested in critical care to date. To commence a program of research, we aimed to determine if a tailored nutrition intervention delivered for the duration of hospitalisation delivers more energy than usual care to patients initially admitted to the Intensive Care Unit (ICU).

Methods: A multicentre, unblinded, parallel-group, phase II trial was conducted in twenty-two hospitals in Australia and New Zealand.

View Article and Find Full Text PDF

Background: The penile suspensory ligament (PSL) plays a significant role in penile support and erection and its injury or congenital absence may result in functional impairment of erectile function.

Aim: To describe the diagnosis and surgical repair technique for PSL abnormalities and overall outcomes.

Methods: A comprehensive review of the literature was performed to understand the anatomic relevance of the PSL and historical management of PSL defects.

View Article and Find Full Text PDF

Background: This study aimed to evaluate the current status of dental sleep medicine education across dental schools in Australia and New Zealand and gain further insights into the educational background of dentists who have sat the Australasian Sleep Association Fellow of Dental Sleep Medicine examination in 2023.

Methods: Online surveys were carried out, and descriptive statistics were used to analyse data.

Results: All dental schools responded to the survey.

View Article and Find Full Text PDF

Background And Objectives: The pharmacokinetics (PK) of piperacillin/tazobactam (PIP/TAZ) is highly variable across different patient populations and there are controversies regarding non-linear elimination as well as the fraction unbound of PIP (f). This has led to a plethora of subgroup-specific models, increasing the risk of misusing published models when optimising dosing regimens. In this study, we aimed to develop a single model to simultaneously describe the PK of PIP/TAZ in diverse patient populations and evaluate the current dosing recommendations by predicting the PK/pharmacodynamics (PD) target attainment throughout life.

View Article and Find Full Text PDF

Clinical profile and recovery pattern of dysphonia following inhalation injury: A 10-year review.

Burns

November 2024

Burns Unit, Concord Repatriation General Hospital, Sydney, NSW, Australia; Faculty of Medicine & Health, The University of Sydney, Sydney, NSW, Australia.

Introduction: Inhalation injury may be associated with increased risk of dysphonia and laryngotracheal pathology; however, presentation and recovery patterns are not well documented.

Objectives: To examine the prevalence, clinical characteristics, and recovery patterns of dysphonia and laryngeal pathology following inhalation injury.

Methods: A retrospective audit was conducted of all burn patients with diagnosed inhalation injury admitted to two Australian burn units over ten years.

View Article and Find Full Text PDF

Aims: Clustering algorithms have been widely applied to tumor DNA methylation datasets to define methylation-based cancer subtypes. This study aimed to evaluate the agreement between subtypes obtained from common clustering strategies.

Materials & Methods: We used tumor DNA methylation data from 409 women with breast cancer from the Melbourne Collaborative Cohort Study (MCCS) and 781 breast tumors from The Cancer Genome Atlas (TCGA).

View Article and Find Full Text PDF

Objective: Randomized controlled trials (RCTs) are necessary to evaluate the efficacy of novel treatments for epilepsy. However, there have been concerning increases in the placebo responder rate over time. To understand these trends, we evaluated features associated with increased placebo responder rate.

View Article and Find Full Text PDF

A Novel Porcine Model of Bilateral Hindlimb Bypass Graft Surgery Integrating Transit Time Flowmetry.

J Cardiothorac Surg

December 2024

Critical Care Research Group, The Prince Charles Hospital, L1 Clinical Sciences Building, Chermside, QLD, 4032, Australia.

Background: Bypass graft surgery is a key surgical intervention for ischemic heart disease (coronary bypass graft surgery) and critical limb ischemia (peripheral bypass graft surgery). Graft occlusion remains a significant clinical problem for both types. Further research into the pathobiological mechanisms of graft occlusion are needed in order to design targeted therapeutic strategies.

View Article and Find Full Text PDF

Background: Hepatitis B infection is a major public health concern in Vanuatu, with approximately 9% of the general population estimated to be living with chronic hepatitis B. Most new infections are due to mother-to-child transmission (MTCT). Hepatitis B vaccination is available in Vanuatu, but coverage rates for first dose within 24 h of birth and third dose are suboptimal.

View Article and Find Full Text PDF

Ligand-receptor interactions: A key to understanding microglia and astrocyte roles in epilepsy.

Epilepsy Behav

December 2024

Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, Victoria, 3004, Australia; Department of Neurology, The Alfred Hospital, Melbourne, Victoria, 3004, Australia; Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Victoria, 3000, Australia.

Epilepsy continues to pose significant social and economic challenges on a global scale. Existing therapeutic approaches predominantly revolve around neurocentric mechanisms, and fail to control seizures in approximately one-third of patients. This underscores the pressing need for novel and complementary treatment approaches to address this gap.

View Article and Find Full Text PDF

Once bitten, twice shy: Antimicrobial stewardship in the setting of arthropod-associated superficial lymphangitis.

Aust J Gen Pract

January 2024

MBBS, PhD, Neurology Registrar, Department of Neurology, Royal Adelaide Hospital, Adelaide, SA; Neurology Registrar, Department of Neurology, Flinders University, Bedford Park, SA.

View Article and Find Full Text PDF

Background: Orthopaedic surgeon engagement with patient-reported outcome measures (PROMs) data has not been comprehensively evaluated, despite increasing uptake of orthopaedic PROMs programmes globally. The aim of this review was to systematically identify, appraise and synthesise qualitative evidence on barriers and facilitators to orthopaedic surgeons' engagement with PROMs data and their use of these data to support clinical practice.

Methods: Six databases (MEDLINE, EMBASE, COCHRANE CENTRAL, PSYCINFO, CINAHL and EMCARE) were searched from January 2000-March 2024 to identify potentially eligible qualitative studies.

View Article and Find Full Text PDF

Population pharmacokinetics of caspofungin in critically ill patients receiving extracorporeal membrane oxygenation-an ASAP ECMO study.

Antimicrob Agents Chemother

December 2024

University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.

This study aimed to describe the population pharmacokinetics of caspofungin in critically ill patients receiving extracorporeal membrane oxygenation (ECMO) and to identify dosing regimens with a high likelihood of achieving effective exposures. Serial blood samples were collected over a single-dosing interval during ECMO. Total plasma concentrations were measured by a validated chromatographic assay.

View Article and Find Full Text PDF

Objective: The Broset Violence Checklist (BVC) can stratify the risk of violence and aggression in EDs. The aim of the present study was to report the initial uptake of introducing this checklist and associations with unplanned alerts to potential or actual violence in two EDs.

Methods: The BVC was recommended in all patient care episodes.

View Article and Find Full Text PDF