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

Objective: We investigated diagnostic utility of phosphorylated tau 217 and 181 (ptau217, ptau181), glial fibrillary acidic protein (GFAP), amyloid beta 42 and 40 (Aβ42, Aβ40), and neurofilament light (NfL) to distinguish biomarker-defined Alzheimer disease (AD) from non-AD conditions, in a heterogenous clinical cohort of younger people.

Methods: Plasma biomarkers were analysed using ultrasensitive technology, and compared in patients with CSF Alzheimer disease profiles (A+T+) to other CSF profiles (Other).

Results: Seventy-nine patients were included, median age 60.

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Objective: Radiological evaluation of cervical spine injury with computed tomography (CT) scanning is a fundamental component of the assessment of major trauma. Accurate interpretation of scans is essential for safe clearance or diagnosis of injuries. However, delays in radiologist reporting often result in prolonged spinal immobilisation.

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Introduction: Effective linkage to prevention and care is a crucial step following HIV testing services. This systematic review aimed to determine the proportion of individuals linked to prevention and care after HIV self-testing (HIVST) and describe factors associated with linkage.

Methods: Following PRISMA guidelines, a comprehensive search across eight databases (2010-October 2023) identified studies on linkage to care after HIVST, defined as receiving a confirmatory test or initiating antiretroviral therapy (ART) if the self-test was reactive, and/or pre-exposure prophylaxis (PrEP) if the self-test was non-reactive.

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Ceftolozane/tazobactam disrupts Pseudomonas aeruginosa biofilms under static and dynamic conditions.

J Antimicrob Chemother

December 2024

Infection Program, Department of Microbiology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia.

Background: Pseudomonas aeruginosa biofilms limit the efficacy of currently available antibacterial therapies and pose significant clinical challenges. Pseudomonal biofilms are complicated further when other markers of persistence such as mucoid and hypermutable phenotypes are present. There is currently a paucity of data regarding the activity of the newer β-lactam/β-lactamase inhibitor combination ceftolozane/tazobactam against P.

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Cricothyroidotomy in out-of-hospital cardiac arrest: An observational study.

Resusc Plus

December 2024

Ambulance Victoria, 375 Manningham Rd, Doncaster, Melbourne, Victoria 3108, Australia.

Aim: To describe the incidence, characteristics, success rates, and outcomes of out-of-hospital cardiac arrest (OHCA) patients receiving cricothyroidotomy.

Methods: Over an 18-year period, we retrospectively analysed patient care records and cardiac arrest registry data for cricothyroidotomy cases. Multivariable logistic regression analysis was used to examine associations between study characteristics and cricothyroidotomy success.

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Assessing the response to systemic therapy in neuroendocrine tumors (NET) is challenging since morphological imaging response is often delayed and not necessarily reflective of clinical benefit. Peptide receptor radionuclide therapy (PRRT) has a complex mechanism of action, further complicating response assessment. In response to these challenges, the European Neuroendocrine Tumor Society (ENETS) Theranostics Task Force conducted a statement-based survey among experts to identify the current landscape and unmet needs in PRRT response assessment.

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Scoring Systems in Rib Fracture Care.

Curr Probl Surg

December 2024

Department of Cardiothoracic Surgery and Transplantation, The Alfred Hospital, Melbourne, VIC, Australia.

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Fatigue in Severe Uncontrolled Asthma.

J Allergy Clin Immunol Pract

December 2024

Allergy, Asthma & Clinical Immunology, The Alfred Hospital, Melbourne, Victoria, Australia; Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Electronic address:

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Background: Effectiveness of disease-modifying treatment (DMT) in people affected by primary progressive multiple sclerosis (PPMS) is limited. Whether specific subgroups may benefit more from DMT in a real-world setting remains unclear. Our aim was to investigate the potential effect of DMT on disability worsening among patients with PPMS stratified by different disability trajectories.

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Introduction: Evidence-based clinical practice guidelines drive optimal patient care and facilitate access to high-quality treatment. Creating guidelines for rare diseases such as haemophilia, where evidence does not often come from randomized controlled trials but from non-randomized and well-designed observational studies and real-world data, is challenging. The methodology used for assessing available evidence should consider this critical fact.

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Article Synopsis
  • - In the last decade, significant advancements have been made in treating adults with newly diagnosed B-cell acute lymphoblastic leukaemia, driven by better understanding of the disease and innovative treatment strategies like incorporating immunotherapy and tyrosine kinase inhibitors.
  • - Despite these advancements, adults still have worse outcomes compared to children, facing higher rates of treatment failure and complications, leading to ongoing use of transplant consolidation for high-risk cases.
  • - The article emphasizes the need for new trial designs to further improve treatment strategies and personalize care for adults with acute lymphoblastic leukaemia, sharing insights from practices across Europe and other continents.
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Compassionate access to virus-specific T cells for adoptive immunotherapy over 15 years.

Nat Commun

December 2024

Queensland Immunology Research Centre, Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.

Adoptive T-cell immunotherapy holds great promise for the treatment of viral complications in immunocompromised patients resistant to standard anti-viral strategies. We present a retrospective analysis of 78 patients from 19 hospitals across Australia and New Zealand, treated over the last 15 years with "off-the-shelf" allogeneic T cells directed to a combination of Epstein-Barr virus (EBV), cytomegalovirus (CMV), BK polyomavirus (BKV), John Cunningham virus (JCV) and/or adenovirus (AdV) under the Australian Therapeutic Goods Administration's Special Access Scheme. Most patients had severe post-transplant viral complications, including drug-resistant end-organ CMV disease, BKV-associated haemorrhagic cystitis and EBV-driven post-transplant lymphoproliferative disorder.

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Background: The adoption of electronic referral systems has transformed healthcare delivery, particularly in neurosurgery, where timely referrals are crucial. Despite increasing interest, limited research exists on the demographic characteristics and referral patterns in neurosurgery. This study aims to fill this gap by analysing data from the Hospital Emergency Neurosurgical Referral Interface (HENRI) at the Royal Brisbane and Women's Hospital (RBWH).

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Article Synopsis
  • The thalamus's structural vulnerabilities in mild traumatic brain injury (mTBI) are not well-explored, prompting this study to investigate thalamic subnuclei volume shortly after mTBI.
  • Participants, including mTBI patients and trauma control individuals, underwent MRI scans to analyze thalamic subregion volumes and neurite orientation parameters in the early recovery phase.
  • Results indicated increased gray matter volume in specific thalamic subregions in mTBI patients compared to controls, suggesting potential issues with myelin repair processes post-injury.
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Dysglycemia among drivers with type 1 diabetes (T1D) is associated with impaired driving performance, and glucose levels "above 5 to drive" are often recommended for insulin-treated drivers. Evidence for diabetes treatments that support euglycemia while driving is minimal, particularly for older drivers. In this randomized, crossover trial involving adults aged ≥60 years with T1D, we used continuous glucose monitoring (CGM) during driving to compare the first-generation closed-loop automated insulin delivery (AID) versus a sensor-augmented pump therapy.

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Objectives: In clinical chimeric antigen receptor (CAR) T cell therapy, one of the strongest correlates of favorable patient responses is lower levels of differentiation in T cells from the peripheral blood mononuclear cell (PBMC) starting material or the CAR T cell product. T cells from older patients are inherently more differentiated, but we hypothesised that specific activation protocols could be used to limit CAR T cell differentiation during manufacturing, particularly in older patients.

Methods: We used PBMCs from young (20-30 years old) and older (60+ years old) healthy donors to generate CAR T cells using two activation protocols: soluble anti-(α) CD3 monoclonal antibody (mAb) immune complexes of αCD3 and αCD28 mAbs.

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Article Synopsis
  • - The text emphasizes that new antiretroviral drugs and formulations are continuously being developed for HIV prevention and treatment, highlighting the importance of updated strategies to manage the virus effectively.
  • - A panel of expert physician scientists has compiled updated recommendations for 2024 based on extensive literature reviews and data from scientific conferences, focusing on treatment protocols tailored to specific patient needs.
  • - Current recommendations advocate for antiretroviral therapy for all individuals with HIV, primarily using integrase strand transfer inhibitors, while also offering alternatives for those with unique circumstances, and suggesting both oral and injectable options for HIV prevention.
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Article Synopsis
  • The "Hospital Emergency Neurosurgical Referral Interface" (HENRI) is a web-based referral system developed at the Royal Brisbane and Women's Hospital to streamline communications between referrers and neurosurgeons, enhancing efficiency and documentation.
  • In its first year, HENRI managed nearly 4,000 referrals, reduced phone calls to registrars by 35%, and improved user satisfaction despite some concerns about communication nuances and response times.
  • Overall, HENRI has proven effective in improving neurosurgical referral processes, relieving on-call staff pressure, and enhancing patient care, with suggestions for future enhancements to its functionality.
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The impact of metabolic dysfunction-associated steatotic liver disease (MASLD), the preferred nomenclature for NAFLD, on cardiovascular health and mortality among older adults is uncertain. As such, we aimed to identify whether MASLD increases the risk of Major Adverse Cardiovascular Events (MACE) (a composite of fatal coronary heart disease [excluding heart failure], nonfatal myocardial infarction, or fatal or nonfatal ischemic stroke), Atrial Fibrillation (AF), or all-cause mortality in older adults, and whether aspirin attenuates these risks in individuals with MASLD. This is a non-prespecified post-hoc analysis of the ASPREE (ASPirin in Reducing Events in the Elderly) randomized trial.

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Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation.

Intensive Care Med Exp

November 2024

Critical Care Research Group, The Prince Charles Hospital, Level 3, Clinical Sciences Building, Chermside Qld 4032, Brisbane, QLD, Australia.

Article Synopsis
  • - Open-lung ventilation during cardiopulmonary bypass (CPB) may help reduce postoperative lung damage in heart transplant patients, based on a study using sheep models to compare ventilatory strategies during surgery.
  • - The study found that the group receiving open-lung ventilation had significantly less lung damage and inflammatory cell infiltration compared to the group that received no ventilation (measured by histological scores).
  • - Despite showing benefits in lung protection, no significant differences were observed in overall hemodynamic stability between the two groups, indicating the need for more research to confirm these findings in clinical settings.
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Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is widely used in prostate cancer. Recent studies indicate hepatocellular carcinoma (HCC) demonstrates PSMA PET uptake. The diagnostic accuracy of PSMA PET for HCC is not known.

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Objective: This paper presents a preclinical feasibility study to investigate the efficacy of a game-based virtual reality (VR) intervention in the functional training of upper-limb prosthesis use.

Methods: The study compared the skill of 2 able-bodied groups (intervention and control, 5 participants in each group) using a surface electromyography controlled self-experience prosthetic hand and wrist through the Box and Blocks Test (BBT). The Intervention Group followed the game-based VR intervention for 4 weeks and underwent real-life (RL) BBT assessments before and after the intervention using the self-experience prosthesis.

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Pedaling Through Uncertainty - Evaluating the Impact of Cycle Ergometry in Critical Care.

NEJM Evid

December 2024

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

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