The Royal Melbourne Hospital

Neutrophil to Lymphocyte Ratio and Neurological Outcome in Ischemic Stroke at 4.5 to 24 Hours: A Post Hoc Analysis of TRACE-III Trial

Whether neutrophil to lymphocyte ratio (NLR), as a marker of increased inflammatory response, modifies the efficacy and safety of tenecteplase is uncertain in patients 4.5–24 h after stroke onset. We investigated this in the Tenecteplase Reperfusion Therapy in Acute Ischemic Cere...

Prospective phase I study of nivolumab to promote graft‐versus‐tumour in relapsed or refractory haematological malignancy post allogeneic haematopoietic stem cell transplantation

Summary Allogeneic haematopoietic stem cell transplantation (alloHSCT) relies on donor‐derived T cells to mediate the graft‐versus‐tumour (GVT) effect, but relapse may result from impaired immune reconstitution, tumour antigen downregulation or T‐cell exhaustion. This prospective...

Cerebral No‐Reflow after Thrombectomy: International Delphi Consensus on Definition and Imaging Assessment

BACKGROUND: The operational definition and imaging assessment of the no-reflow phenomenon, a potential contributor to poor clinical outcome despite successful thrombectomy, remains debated. We aimed to develop expert-based international consensus on the definition, assessment, an...

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...

Evidence-hierarchy audit of public DGA benchmarks for trustworthy AI-assisted transformer assessment

Dissolved gas analysis (DGA) is widely used for condition assessment of oil-immersed power transformers, but public-data artificial intelligence (AI) studies can overstate evidential reliability when labels are heterogeneous, samples overlap across benchmarks, or random splits ig...

Introduction of a digital care companion to facilitate patient reported outcome measures and breast care nurse-led survivorship

As part of the Breast Cancer Survivorship program in the Royal Melbourne Hospital (RMH), a new electronic platform, Care Companion was designed to facilitate resource access, appointments and monitoring of breast cancer patients using patient-reported outcome measures (PROMs). Th...

Astrocytic activity in treatment-resistant and ultra-treatment-resistant schizophrenia

Astrocytic dysfunction has been implicated in schizophrenia, but biomarkers of astrocytic activity have shown inconsistent patterns. Studies on disease heterogeneity, specifically treatment-resistant schizophrenia (TRS) and ultra-treatment-resistant schizophrenia (UTRS) are lacki...

Establishing Stakeholder Priorities for Development of a Multi‐Arm Multi‐Stage Platform Trial in Crohn's Disease

ABSTRACT Background and Aims The expanding range of advanced therapies for Crohn's disease (CD) has increased complexity in treatment selection, particularly in refractory disease. Conventional randomised controlled trials are limited in evaluating multiple treatment strategies e...

Management of De Novo miN1 Prostate Cancer in the PSMA-PET Era.

BACKGROUND: Prostate-specific membrane antigen positron emission tomography (PSMA-PET) is reshaping nodal staging in prostate cancer by detecting regional lymph node metastases with greater accuracy than conventional imaging. This has created a new cohort of patients with N1M0 di...

Mind the Gap: Disparities in Education on Organ Donation and Transplantation-Results of a Global Survey.

Background: Widely accessible education on organ donation and transplantation (ODT) is a tool to reduce waiting lists, as <10% of transplant needs are met (Global Observatory on Donation and Transplantation). We aimed to assess the current state of access to education on ODT worl...

Acceptance of Organs From Deceased Donors: Results of a Global Survey.

Background: With <10% of transplantation needs being met, one contributing factor may be the potential subjectivity in transplant specialists' acceptance of organs. Such decisions, if influenced by knowledge and/or comfort gaps, warrant intervention. We assessed knowledge and com...

Body Weight in Relation to the Effectiveness of Intravenous Alteplase in Acute Ischemic Stroke: The ENCHANTED Trial

BACKGROUND: The prognostic significance of body weight in patients receiving thrombolysis for acute ischemic stroke remains uncertain. This study aimed to determine whether body weight modifies the comparative effects of low- versus standard-dose intravenous alteplase and to eval...

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...

Cardiovascular risk factors at 24-months after risk reducing oophorectomy- a prospective controlled study from WHAM

Structured Abstract Background Women at risk of ovarian cancer due to BRCA1/2 pathogenic variants are advised to undergo bilateral risk-reducing salpingo-oophorectomy (RRSO) prior to natural menopause. Epidemiologic evidence suggests that surgical menopause increases cardiovascul...

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...

Clinical Improvement, No Improvement, and Worsening at 24 Hours Following Reperfusion in Patients With Stroke due to Large-Vessel Occlusion

BACKGROUND: Restoring blood flow to ischemic tissue is the cornerstone of acute stroke therapy and is usually beneficial. However, when reperfusion is achieved for severely injured tissue, it is often futile and may occasionally cause harm. We aim to determine the prevalence and...

Gene Expression Biomarkers for Breast Ductal Carcinoma in Situ Recurrence Prediction

ABSTRACT Breast ductal carcinoma in situ (DCIS) is often overtreated due to a lack of robust prognostic and predictive tools. This study aimed to evaluate gene expression in a well‐characterised DCIS cohort to determine their clinical utility as biomarkers for ipsilateral recurre...

Adenovirus infection after cellular therapy: diagnostic and therapeutic challenges

Purpose of review To review recent advances in the epidemiology, diagnosis, and management of human adenovirus (HAdV) infection following haematopoietic cell transplantation (HCT) and other cellular therapies, with emphasis on risk stratification, molecular surveillance, and emer...

The Development of Non‐Tuberculosis Mycobacterial Infections in Sézary Syndrome: A Case Report of Two Patients

ABSTRACT Sézary syndrome (SS) is a rare cutaneous T‐cell lymphoma associated with increased risks of opportunistic and atypical infections. This report presents two patients with SS and concurrent non‐tuberculosis mycobacterial cutaneous infections. Although rare, difficult to di...

International consensus guidance for general population screening for islet autoantibodies to diagnose early-stage type 1 diabetes: a nominal group technique process

Type 1 diabetes is an autoimmune disease that targets and destroys insulin-producing beta cells in the pancreatic islets. The incidence of type 1 diabetes is rising globally. At the clinical diagnosis of type 1 diabetes, between 20% and 67% of children and adolescents present wit...