The Royal Melbourne Hospital

A community-validated tool for clinical outcome calculation in multiple sclerosis: Consensus development and scenario-specific recommendations

Background: Reproducibility and comparability of disability outcomes remain major challenges in multiple sclerosis (MS) research. Definitions of disability progression vary widely across studies, and calculation criteria are often insufficiently documented to enable replication....

The Association of Umbilical Cord Blood Neurofilament Light With Nonreassuring Fetal Status: A Prospective Observational Study

( Int J Gynaecol Obstet . 2026 Mar;172(3):1491–1500. doi:10.1002/ijgo.70421) A prospective observational study explored whether neurofilament light (NfL), a marker of neuronal injury, can be reliably measured in umbilical cord blood and whether it is associated with nonreassuring...

Aorto‐Ostial Lesion Percutaneous Coronary Intervention: Clinical Characteristics, Predictors and Clinical Outcomes

ABSTRACT Background Aorto‐ostial coronary lesions represent a high‐risk subset of coronary disease because of fibrocalcific disease, elastic recoil, and difficulty achieving precise stent positioning. Percutaneous coronary intervention (PCI) of these lesions may therefore be asso...

Intraarterial Thrombolysis: Past, Present, Future

Suboptimal clinical outcomes are common after ischemic stroke with large vessel occlusion despite current reperfusion treatment with intravenous thrombolysis and mechanical thrombectomy. Targeting residual distal arterial and microvascular occlusions with intraarterial thrombolys...

Scaling up Genomics

Introduction: Genomic testing has substantial diagnostic and clinical value in nephrology, yet integrating testing into routine care requires service-level changes to ensure timely and equitable access. Methods: We conducted an observational cohort study at four tertiary centres,...

Histological aging signatures for monitoring tissue-specific aging and disease

Aging is the primary risk factor for chronic disease and is characterized by profound structural and architectural remodeling of human tissues. Here, we present a comprehensive assessment of these changes using 25,712 whole-slide histopathological images from 40 tissue types acro...

Effect of the November 2023 Medicare Benefits Schedule PSA Testing Reform on National Utilisation, Diagnostic Activity, and Health-System Expenditure in Australia

Background/Objectives: On 1 November 2023, the Medicare Benefits Schedule (MBS) introduced major reforms to prostate-specific antigen (PSA) testing in Australia, extending the minimum re-test interval for average-risk men (item 66655) from 12 to 23 months and introducing a new an...

Fibrinogen Early In Severe Trauma studY II (FEISTY II): study protocol for a randomised clinical trial of fibrinogen concentrate vs cryoprecipitate in traumatic haemorrhage in Australia and New Zealand

Haemorrhage is a leading cause of preventable death amongst severe trauma patients and is often complicated by hypofibrinogenaemia. Fibrinogen replacement can be achieved using fibrinogen concentrate (FC) or Cryoprecipitate (Cryo), but comparative evidence in traumatic haemorrhag...

Acute kidney injury and renal replacement therapy: a critical synthesis of metabolic derangements and nutritional implications

Acute kidney injury (AKI) affects up to 50% of critically ill patients and is frequently complicated by severe metabolic derangements, requiring the initiation of replacement therapy (RRT) in 10–15% of cases. Despite substantial progress in the diagnosis of AKI and optimisation o...

Hypothermia in the intensive care unit after surgery: a registry based retrospective cohort study

Background Hypothermia is common in patients admitted to the ICU after surgery; however, its relationship with postoperative outcomes has not been fully explored. This study investigates the association between postoperative hypothermia in the ICU and patient mortality. Methods R...

Tumour Volume Independently Predicts Metastasis in ISUP 2 Prostate Cancer

Background and Objectives: The outcomes for patients with localised prostate cancer are variable, even within defined tumour grades or clinical risk groups. Identifying features associated with disease aggression is imperative in contemporary PCa research. ISUP 2 PCa is particula...

Rethinking Muscle Wasting in Critical Illness: A Systematic Review and Meta-Analysis of Myofiber Size and Protein Turnover

OBJECTIVES: To identify biological findings underlying skeletal muscle dysfunction in adults with critical illness and meta-analyze myofiber cross-sectional area and protein turnover variables. DATA SOURCES: Six databases were electronically searched from inception to January 202...

Lemborexant Versus Sedative-Hypnotics in the Treatment of Insomnia: A Systematic Narrative Review

Abstract Purpose Sedative-hypnotics for insomnia carry risks of adverse effects and dependence. We reviewed how lemborexant, a dual orexin receptor antagonist (DORA), compares with sedative-hypnotics (benzodiazepines and z-drugs) in adults with insomnia across sleep, adverse even...

Progress, challenges, and future directions of pancreatic cancer surveillance in high-risk populations

Pancreatic cancer remains one of the most lethal malignancies because most patients are diagnosed with advanced disease, when curative treatment is rarely possible. Population-wide screening is not currently recommended because pancreatic cancer remains relatively uncommon. Early...