The Alfred Hospital

Effects of testosterone on exercise capacity in postmenopausal women with stage B heart failure

Objective Asymptomatic individuals with stage B heart failure (HF) often have reduced exercise capacity. As exogenous testosterone may have favorable skeletal muscle and vasculature effects, this study investigated whether transdermal testosterone improves exercise capacity in wo...

Taking a clinical history in adolescents and adults presenting with seizures or epilepsy

Abstract Despite advances in EEG, neuroimaging, and other diagnostic technologies, a carefully obtained clinical history remains the cornerstone of diagnosis, classification, and treatment planning. However, structured guidance on history‐taking that integrates state‐of‐the‐art e...

The Gap Between Perceived and Objective Diet Quality in Patients with Lynch Syndrome

Background and Aims: Lynch syndrome (LS) confers a substantially elevated lifetime risk of colorectal cancer (CRC). While enhanced endoscopic surveillance and aspirin chemoprevention are the cornerstones of management, evidence suggests modifiable lifestyle factors like diet may...

Assessing and Addressing Frailty in Candidates for Lung Transplantation: An ISHLT Consensus Statement.

The ISHLT Consensus document for the selection of lung transplant candidates recommends frailty assessment as part of a comprehensive candidacy evaluation. Missing from this and other recent consensus documents were practical recommendations on which frailty measures to consider...

Incidence and Predictors of Complications After Transcatheter Aortic Valve Implantation According to VARC‐3 Criteria: A Systematic Review and Meta‐Analysis

BACKGROUND: Despite continuous advancements in devices and techniques, transcatheter aortic valve implantation remains associated with complications impacting outcomes. In 2021, the Valve Academic Research Consortium (VARC) introduced the VARC-3 criteria to better classify proced...

Werner helicase inhibitor for advanced microsatellite instability solid tumors: a phase 1 trial

Abstract Werner syndrome helicase (WRN) is a synthetic lethal target for microsatellite instability (MSI) cancers. In part 1 of this ongoing first-in-human, phase 1 trial, escalating doses of RO7589831 (VVD-133214), a first-in-class, WRN covalent inhibitor, were evaluated in 88 p...

Seizure control and foetal malformation in primiparous women with Epilepsy: statistical analysis of data from a prospective observational study

Purpose To evaluate seizure control and foetal malformation in the first pregnancy of women with epilepsy through the analysis of the Australian Pregnancy Register database focusing of women with epilepsy intending or beginning their first pregnancy. This was achieved through a s...

Multimodal Magnetic Resonance Imaging and Machine Learning Uncovers Distinct Progression Patterns in Friedreich Ataxia

Abstract Background Friedreich ataxia (FRDA) is a rare neurodegenerative disorder with heterogenous clinical progression, complicating prognosis and trial design. Neuroimaging offers objective biomarkers of disease progression, yet variability in progression patterns remains poor...

Strategies for integrating artificial intelligence and cognitive assessment to predict disability progression in relapsing-remitting multiple sclerosis: A model development study

Serial cognitive assessment in multiple sclerosis can help identify patients at higher risk of disability progression, but high dimensionality of reaction-time data makes analysis challenging. We developed a method to convert longitudinal reaction-time data into images and applie...

Ethnography of Singing for Breathing in COPD and ILD: Understanding Group Dynamics and Experiences

Background/Aim A growing body of evidence exists detailing the benefits of singing for lung health programs in improving participants’ breathlessness and quality of life. However, the pandemic prompted a shift to online delivery, and there is limited understanding of how this mod...

Early life trauma and endometriosis: A case-control study on type and timing of adverse experiences

PURPOSE: Endometriosis is a common chronic inflammatory gynaecological condition characterised by the abnormal presence of endometrial tissue outside the uterus. Different risk factors for endometriosis have been proposed, with some research finding a significant relationship bet...

Dynamic risk stratification using early CAR ‐T expansion in R/R LBCL treated with axicabtagene ciloleucel

The clinical utility of routine monitoring of chimeric antigen receptor (CAR) T-cell expansion post-infusion remains controversial. We conducted a retrospective analysis of a prospectively collected cohort of 176 patients with relapsed/refractory large B-cell lymphoma (LBCL) trea...

A Modified Delphi Study on the Ethics and Governance of Live Injecting at Aesthetic Conferences. Is There a Better and Safer Alternative?

BACKGROUND: Live clinical demonstrations at aesthetic medicine conferences is common, yet concerns regarding patient safety, commercial influence, and ethical governance. This study established a consensus-based governance framework for live injecting and compared expert and atte...

Artificial intelligence tools in sepsis prediction: a systematic review and meta-analysis

Abstract Background Machine learning (ML) models have been used to improve diagnosis of sepsis, but their effectiveness is uncertain. We aimed to systematically evaluate the diagnostic accuracy of ML models for sepsis prediction through a systematic review and network meta-analys...

The Impact of Intrathecal Hydrophilic Opioids on Postoperative Pain, Opioid Consumption and Adverse Events for Abdominal Surgery: A Systematic Review and Meta-analysis

Abstract Purpose of Review Intrathecal morphine (ITM) is a promising analgesic option for major abdominal surgery, but its clinical efficacy, potential adverse events and optimal dosing require further investigation. Methods We searched MEDLINE, Embase, and Cochrane Central Regis...

Stable tissue oxygen cerebral perfusion pressure (stoCPP): Proof of concept for a novel method for the assessment of optimum cerebral perfusion pressure in severe traumatic brain injury

Abstract To demonstrate a method for the identification of safe cerebral perfusion pressure (CPP) in patients with severe traumatic brain injury using brain tissue oxygen (PbtO₂) readings as a surrogate marker of cerebral blood flow. Retrospective analysis of prospectively collec...

HITH4HIPs: a feasibility trial of hospital in the home after hip fracture

In Australia, as in many other jurisdictions, people with low-trauma hip fractures often stay in hospital for extended periods, even when medically stable, increasing risk of hospital-related complications and increasing healthcare costs. In this context, we sought to determine t...

The effect of augmented protein intake on nitrogen balance: A nested cohort study of the TARGET protein trial

Purpose The impact of augmenting enteral protein delivery on nitrogen balance, urea generation, and kidney function in critically ill patients remains poorly defined. This study aimed to investigate these effects in a nested cohort within the TARGET Protein trial. Methods We cond...

Association between prior ICU admission for drug overdose and ICU readmission: A retrospective registry-based study

Objective We aimed to investigate patients discharged alive from hospital following an ICU admission for drug overdose and whether exposure of prior overdose-related ICU admission was associated with a future ICU readmission. Design, setting, participants This multicentre registr...

Inaccuracy of self-reported migraine: insights from 601 paired assessments from a single-centre study in Australia

Both clinical and research settings may rely on accurate self-diagnosis of migraine for medical triage, population-based surveys or epidemiological studies. Unfortunately, accessing neurologists for diagnosis may be cost-prohibitive, delayed due to workforce shortages or impracti...