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

Injecting drug use is a risk factor for methicillin resistance in patients with Staphylococcus aureus bloodstream infections.

Intern Med J

November 2024

Department of Infectious Diseases, The Alfred Hospital and School of Translational Medicine, Monash University, Melbourne, Victoria, Australia.

Article Synopsis
  • * Out of 273 patients, 46 (16.9%) had methicillin-resistant S. aureus (MRSA), with higher prevalence in those who injected drugs in the past 6 months (20.6% compared to 15.7% of other patients).
  • * Injecting drug use was found to significantly increase the odds of having MRSA by 4.82 times, even after controlling for other factors.
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Bedside Neuromodulation of Persistent Pain and Allodynia with Caloric Vestibular Stimulation.

Biomedicines

October 2024

Monash Biomedicine Discovery Institute, Department of Physiology, Monash University, Melbourne, VIC 3800, Australia.

Background: Caloric vestibular stimulation (CVS) is a well-established neurological diagnostic technique that also induces many phenomenological modulations, including reductions in phantom limb pain (PLP), spinal cord injury pain (SCIP), and central post-stroke pain.

Objective: We aimed to assess in a variety of persistent pain (PP) conditions (i) short-term pain modulation by CVS relative to a forehead ice pack cold-arousal control procedure and (ii) the duration and repeatability of CVS modulations. The tolerability of CVS was also assessed and has been reported separately.

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Background: Limited data exists about treatment outcomes in nationwide hepatitis C virus (HCV) elimination programs where injection drug use (IDU) is the main mode of transmission. In 2016 Iceland initiated the HCV elimination program known as Treatment as Prevention for Hepatitis C (TraP HepC). Factors associated with HCV cure in this population are examined.

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Persistent Atrial Fibrillation Phenotypes and Ablation Outcomes: Persistent From Outset vs Progression From Paroxysmal AF.

JACC Clin Electrophysiol

September 2024

The Baker Heart and Diabetes Research Institute, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia; Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia. Electronic address:

Background: Many patients with persistent atrial fibrillation (PsAF) have progressed from an initial paroxysmal phenotype; however, there are patients in whom atrial fibrillation (AF) is persistent at diagnosis. Relatively little is known about this subgroup, but prior observational studies have suggested these patients have worse outcomes with ablation.

Objectives: This study sought to: 1) assess demographic and electrophysiologic characteristics of patients with PsAF at first diagnosis compared with those with who have progressed from paroxysmal atrial fibrillation (PAF); and 2) assess the impact of pattern of AF at diagnosis on recurrence post ablation.

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The use of extracorporeal life support (ECLS) throughout the perioperative phase of lung transplantation requires nuanced planning and execution by an integrated team of multidisciplinary experts. To date, no multidisciplinary consensus document has examined the perioperative considerations of how to best manage these patients. To address this challenge, this perioperative utilization of ECLS in lung transplantation consensus statement was approved for development by the International Society for Heart and Lung Transplantation Standards and Guidelines Committee.

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Background: Treatment strategies for BK polyomavirus (BKPyV) infection in kidney transplant recipients are heterogeneous among clinicians. We aimed to identify the treatment preferences of key stakeholders for BKPyV infection and measure the trade-offs between treatment outcomes.

Methods: Adult kidney transplant recipients, caregivers, and clinicians were eligible to participate in a discrete choice experiment between February 2021 and June 2022.

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Purpose: Understanding the long-term safety of disease-modifying therapies for multiple sclerosis (MS) in routine clinical practice can be undertaken through registry-based studies. However, variability of data quality across such sources poses the challenge of data fit for regulatory decision-making. CLARION, a non-interventional cohort safety study of cladribine tablets, combines aggregated data from MS registries/data sources, except in Germany (which utilizes primary data collection).

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Article Synopsis
  • The study aimed to evaluate the impact of a Disability Liaison Officer (DLO) service in the Emergency Department (ED) on adults with various disabilities, focusing on their length of stay (LOS).
  • Conducted in a major referral ED in Melbourne, the research compared standard care patients with those supported by the DLO, analyzing their outcomes over a one-year period.
  • Results suggested that the DLO service significantly reduced LOS for patients with disabilities, particularly those discharged directly from the ED, indicating the need for further studies on the service’s effectiveness and cost-efficiency.
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A simplified axisymmetric model of a transfemoral osseointegration implant was used to investigate the influence of the contact condition at the bone-implant interface on the vibrational response. The experimental setup allowed the degree of implant tightness to be controlled using a circumferential compression device affixed to the bone. Diametrically placed sensors allowed torsional modes to be distinguished from flexural modes.

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Article Synopsis
  • - MEDI2228 is an antibody drug conjugate designed to target B-cell maturation antigen (BCMA) and was tested in a phase 1 trial for patients with relapsed/refractory multiple myeloma after prior treatments with standard medications.
  • - The trial involved 107 patients, identifying a maximum tolerated dose of 0.14 mg/kg every three weeks, with common side effects including photophobia, rash, and thrombocytopenia; two patients experienced serious dose-limiting toxicities.
  • - Although MEDI2228 showed promising efficacy with a 56.1% objective response rate in one treatment group, ocular toxicity issues led to the decision not to pursue further development of the drug.
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Remote cutaneous confocal microscopy: A multicentric prospective study evaluating diagnostic accuracy for melanoma and keratinocyte carcinoma in tertiary settings.

J Am Acad Dermatol

October 2024

Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, Australia.

Article Synopsis
  • Cutaneous confocal microscopy (CCCM) is a technique that allows for detailed imaging of the skin at a cellular level, and this study tested a remote version (Remote-CCM) to enhance access to skin cancer diagnoses.
  • In the study, 201 lesions were assessed, with Remote-CCM showing a sensitivity of 89% for detecting skin malignancies and a specificity of 64%, effectively reducing unnecessary biopsies in 90% of benign cases.
  • The findings suggest that while Remote-CCM is accurate and can lower biopsy rates, it may not be suitable for potential cases of squamous cell carcinoma (SCC), indicating a need for follow-up on uncertain melanoc
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Multidrug-resistant organism bloodstream infections in solid organ transplant recipients and impact on mortality: a systematic review.

JAC Antimicrob Resist

October 2024

Department of Infectious Diseases, The Alfred Hospital and School of Translational Medicine, Monash University, Melbourne, Australia.

Article Synopsis
  • Bloodstream infections (BSIs) in solid organ transplant (SOT) recipients show high levels of multidrug-resistant organisms (MDROs), significantly impacting morbidity and mortality rates.
  • A systematic review analyzed 52 studies, revealing that resistance percentages for MDROs like carbapenem-resistant Enterobacterales and MRSA varied geographically, with the highest rates found in Asia and North America.
  • The crude mortality associated with MDRO BSIs ranged from 15.4% to 82.4%, indicating a critical need for more comprehensive research in this vulnerable patient population.
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Opioids for the palliation of symptoms in people with serious respiratory illness: a systematic review and meta-analysis.

Eur Respir Rev

October 2024

Respiratory Medicine, Allergology and Palliative Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.

Article Synopsis
  • People with serious respiratory illnesses often face distressing symptoms, and while opioids are commonly prescribed for relief, their effectiveness and potential side effects are in question.
  • A review of 17 trials showed that opioids did reduce breathlessness during exercise in controlled lab settings, but they had little impact on daily breathlessness, cough, or overall quality of life.
  • The use of opioids was associated with increased occurrences of adverse effects like nausea, constipation, and drowsiness, along with serious risks such as hospitalization and death.
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Article Synopsis
  • Scientists studied how different types of epilepsy in rats show specific electrical patterns called spike-wave complexes (SWCs) during seizures.
  • They used special software to analyze the frequency of these SWCs in various models of epilepsy, including brain injuries and genetic conditions.
  • The research found that while the spike part of these complexes was similar across different models, the wave part varied a lot, which could help understand seizures better and develop treatments.
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Article Synopsis
  • This study looked at a surgery called parotidectomy, which is done to remove benign (non-cancerous) tumors from the parotid gland, a gland near your jaw.
  • It found that a less aggressive way of doing the surgery can reduce the risk of having problems with facial nerves, which control how your face moves.
  • Most tumors were found near the outside of the gland and did not come back after surgery, especially when doctors used special tools to monitor the facial nerve during the operation.
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The epithelial barrier theory and its associated diseases.

Allergy

December 2024

Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.

The prevalence of many chronic noncommunicable diseases has been steadily rising over the past six decades. During this time, over 350,000 new chemical substances have been introduced to the lives of humans. In recent years, the epithelial barrier theory came to light explaining the growing prevalence and exacerbations of these diseases worldwide.

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Nature and management of melanoma recurrences following adjuvant anti-PD-1 based therapy.

Eur J Cancer

November 2024

Melanoma Institute Australia, University of Sydney, 45 Rocklands Road, Wollstonecraft, Sydney, NSW, Australia; Department of Medical Oncology, Royal North Shore Hospital, North Sydney, Sydney, NSW, Australia. Electronic address:

Introduction: Approximately 50 % of resected stage II-IV melanoma patients develop recurrent disease by 5 years despite adjuvant anti-PD-1 therapy. Data to define best management of recurrences is lacking.

Methods: This was a multicentre, international, retrospective cohort study.

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Engineering Hyperechogenic Colloids with Clot-Targeting Capabilities from Platelet-Derived Membranes.

ACS Appl Mater Interfaces

October 2024

Molecular Imaging and Theranostics Laboratory, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia.

Thrombosis-related cardiovascular diseases remain the leading global cause of mortality and morbidity. In this study, we present a pioneering approach in the field of nanobiotechnology, with a focus on clinical translation, aimed at advancing early diagnosis and enhancing treatment options for thrombotic disorders. We introduce the fabrication of Platelet Membrane-Derived Bubbles (PMBs), which exhibit distinctive characteristics compared to conventional nanoparticles.

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Objectives: As thyroid disorders are common amongst the elderly, this study aims to evaluate the reference interval (RI) for thyroid stimulating hormone (TSH) in healthy adults aged 70 years and over.

Methods: A proposed RI was determined from the Australian participants of the ASPirin in Reducing Events in the Elderly (ASPREE) randomised trial. Participants had no history of cardiovascular disease, thyroid cancer, dementia, or life-threatening illnesses.

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Modern intensive care for moderate-to-severe traumatic brain injury (msTBI) focuses on managing intracranial pressure (ICP) and cerebral perfusion pressure (CPP). This approach lacks robust clinical evidence and often overlooks the impact of hypoxic injuries. Emerging monitoring modalities, particularly those capable of measuring brain tissue oxygen, represent a promising avenue for advanced neuromonitoring.

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Article Synopsis
  • Bladder inflation can help stop pelvic bleeding in certain trauma cases, giving doctors time to perform more serious treatments.
  • Doctors use an ultrasound to check if the bladder is okay and if there's bleeding around it in injured people.
  • The text gives an example of how blowing up the bladder with a special liquid can help control bleeding until doctors can do more advanced procedures.
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Background: Patients with shock treated by emergency medical services (EMS) have high morbidity and mortality. Knowledge of prehospital factors predicting outcomes in patients with shock remains limited. We aimed to describe the prehospital predictors of mortality in patients with non-traumatic shock transported to hospital by EMS.

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