Implementing CYP2C19-guided clopidogrel therapy: a scoping review of pharmacogenomic testing services.

Pharmacogenomic testing for CYP2C19 helps personalise clopidogrel therapy and reduces the risk of experiencing a secondary myocardial infarction in individuals with impaired CYP2C19 function. Routine testing, however, is uncommon and it is proposed that the key requirements and processes of testing services are poorly understood. This scoping review aimed to explore the literature for CYP2C19 testing services for clopidogrel and identify their commonalities to inform the design and delivery of future services.

Treatment With a Nonaromatizable Androgen for Transgender Man With a Hormone-sensitive Ovarian Cancer.

Gender-affirming hormone therapy (GAHT) is increasingly prescribed to transgender men and gender diverse individuals to better align their affirmed gender identity and somatic phenotype, aiming to improve psychosocial well-being. However, the long-term outcomes of GAHT, especially risk of hormone-related malignancy, remains unclear. We report a case of transgender man on long-term GAHT with testosterone who developed recurrent hormone-sensitive endometrioid ovarian cancer.

Long-Read Sequencing: The Third Generation of Diagnostic Testing for Dystonia.

Long-read sequencing methodologies provide powerful capacity to identify all types of genomic variations in a single test. Long-read platforms such as Oxford Nanopore and PacBio have the potential to revolutionize molecular diagnostics by reaching unparalleled accuracies in genetic discovery and long-range phasing. In the field of dystonia, promising results have come from recent pilot studies showing improved detection of disease-causing structural variants and repeat expansions.

Non-home discharge in the octogenarian and nonagenarian colorectal cancer population: a retrospective cohort study.

Purpose: This study aims to determine the rate of non-home discharge (NHD) and identify factors associated with non-home discharge in a colorectal cancer (CRC) population of adults aged 80 years and older. This is the first study looking specifically at NHD as an outcome in the ≥ 80 years colorectal cancer cohort.

Methods: This is a single-centre retrospective exploratory observational study from a high-volume colorectal cancer unit.

Robot-assisted ileocystoplasty for the treatment of adult neurogenic bladder: A video demonstration and outcomes.

Ileocystoplasty is one of the treatment options in the armamentarium for the management of adults with neurogenic bladder dysfunction, after failure of less invasive treatment alternatives, such as intravesical onabotulinum toxin A injection therapy and sacral neuromodulation. It has traditionally been performed as open surgery and can be associated with significant morbidity, especially in the early postoperative period. Complications associated with open ileocystoplasty include prolonged postoperative ileus, wound infections, and pain.

Geographic remoteness-based differences in in-hospital mortality among people admitted to NSW public hospitals with heart failure, 2002-21: a retrospective observational cohort study.

Objective: To examine associations between remoteness of region of residence and in-hospital mortality for people admitted to hospital with heart failure in New South Wales during 2002-21.

Study Design: Retrospective observational cohort study; analysis of New South Wales Admitted Patient Data Collection data.

Setting, Participants: Adult (16 years or older) NSW residents admitted with heart failure to NSW public hospitals, 1 January 2002 - 30 September 2021.

Diagnostic utility of threshold tracking TMS paradigms in early amyotrophic lateral sclerosis.

Objective: Threshold tracking transcranial magnetic stimulation (TMS) has exhibited utility as a diagnostic technique in Amyotrophic Lateral Sclerosis (ALS). Different threshold tracking paradigms have recently been proposed. The present study assessed the diagnostic utility of serial ascending and parallel threshold tracking TMS in ALS.

ChatGPT-4 for addressing patient-centred frequently asked questions in age-related macular degeneration clinical practice.

Purpose: Large language models have shown promise in answering questions related to medical conditions. This study evaluated the responses of ChatGPT-4 in answering patient-centred frequently asked questions (FAQs) relevant in age-related macular degeneration (AMD).

Methods: Ten experts across a range of clinical, education and research practices in optometry and ophthalmology.

Standardized Definition of Progression Independent of Relapse Activity (PIRA) in Relapsing-Remitting Multiple Sclerosis.

Importance: Progression independent of relapse activity (PIRA) is a significant contributor to long-term disability accumulation in relapsing-remitting multiple sclerosis (MS). Prior studies have used varying PIRA definitions, hampering the comparability of study results.

Objective: To compare various definitions of PIRA.

The Frontloading Approach to Meet Guideline-Recommended Visual Field Testing for Glaucoma: Time and Cost.

Purpose: To measure the time and clinical resources taken to obtain 6 reliable visual field (VF) tests for glaucoma in a glaucoma clinic.

Design: Longitudinal, prospective study in a glaucoma clinic.

Subjects: Ten thousand and ten SITA-Faster VF tests of 535 clinical subjects.

Is computed tomography assessment of residual arterial pedicle length following colorectal cancer surgery a useful marker of surgical quality?

Background: In vivo residual arterial pedicle length (RAPL) has been proposed as a quality indicator for central vascular ligation (CVL [i.e., RAPL ≤ 10 mm]) in colorectal cancer (CRC) surgery.

Machine learning to optimize use of natriuretic peptides in the diagnosis of acute heart failure.

Aims: B-type natriuretic peptide (BNP) and mid-regional pro-atrial natriuretic peptide (MR-proANP) testing are guideline-recommended to aid in the diagnosis of acute heart failure. Nevertheless, the diagnostic performance of these biomarkers is uncertain.

Methods And Results: We performed a systematic review and individual patient-level data meta-analysis to evaluate the diagnostic performance of BNP and MR-proANP.

Statin effects on the lipidome: Predicting statin usage and implications for cardiovascular risk prediction.

Statin therapy is a highly successful and cost-effective strategy for the prevention and treatment of cardiovascular diseases (CVD). Adjusting for statin usage is crucial when exploring the association of the lipidome with CVD to avoid erroneous conclusions. However, practical challenges arise in real-world scenarios due to the frequent absence of statin usage information.

Glomerular disease registry and biobank: design and baseline results.

Background: The diverse and rare causes of glomerular disease, coupled with the absence of Australian registries and biobanks, pose significant research and treatment challenges.

Aim: To establish a longitudinal glomerular disease data registry, a biorepository, and to enhance patient participation in clinical trials.

Methods: This prospective, observational study includes incident and prevalent patients with biopsy-proven glomerular disease.

Excess subsequent fracture and mortality risk after ankle fractures: a relative survival analysis of the 45 and Up Study.

Unlabelled: Ankle fractures are one of the common fractures that account for hospitalization. Ankle fractures were often thought of inconsequential as limited data on their long-term consequences. After accounting for age, sex, and time, ankle fractures were associated with increased risk of subsequent fracture and mortality.

Safety and Effectiveness of Apixaban versus Warfarin by Kidney Function in Atrial Fibrillation: A Binational Population-Based Study.

Background: Evidence to guide use of apixaban in people with atrial fibrillation (AF) and chronic kidney disease (CKD) in routine clinical practice has been limited. We assessed comparative safety (major bleeding) and effectiveness (ischemic stroke and death) of apixaban versus warfarin in patients with AF across the spectrum of non-dialysis-dependent CKD using large, routinely collected data.

Methods: We combined findings from 5 retrospective cohorts (2013-2018) across Australia and Canada.

A review of the safety of sodium-glucose co-transporter-2 inhibitors.

The development of sodium-glucose co-transporter-2 (SGLT2) inhibitors represents a major turning point in the effort to preserve kidney function and prevent cardiovascular events and heart failure hospitalisations in those at high risk. These agents have now transcended their original glucose-lowering indication and provide a range of clinical benefits in people both with and without diabetes, and at varying levels of kidney function. Despite this, SGLT2 inhibitors remain underutilized by the medical community.

Natural history of lower urinary tract symptoms and voiding parameters in ageing men with 5-year follow-up-the concord health and ageing in men project (CHAMP).

Background: Natural history of voiding parameters with age is poorly understood. We aim to understand both subjective and objective lower urinary tract parameters in older men over 5 years.

Methods: The Concord Health and Ageing in Men Project is a prospective cohort study of older men, involving 1705 men aged 70 years and over living in Sydney, Australia.

Co-designing solutions to the challenges speech pathologists and interpreters encounter when they collaborate to deliver aphasia therapy.

Purpose: Aphasia caseloads worldwide are becoming increasingly diverse. Both speech pathologists and professional interpreters have identified challenges when working together in the delivery of aphasia rehabilitation to culturally and linguistically diverse people with aphasia. In this study we aimed to co-design solutions to the challenges that speech pathologists and interpreters encounter when they collaborate to adapt and deliver aphasia rehabilitation.

Climate change and neurology: A survey of neurologists in Australia and New Zealand.

Objective: This study aimed to assess the perceptions of neurologists in Australia and New Zealand regarding climate change and its impact on neurological practice.

Methods: Members of the Australian and New Zealand Association of Neurologists were surveyed gathering demographic information and views on climate change and its impact on clinical practice. A composite score was generated based on five key climate change-related questions.

A Systematic Review and Meta-Analysis of The Efficacy of Endoscopic Ultrasound Guided Celiac Plexus Blocks for Chronic Pancreatitis Pain.

Chronic pancreatitis is a globally prevalent progressive disease, with pain affecting up to 90% of patients, significantly impairing quality of life and leading to high rates of disability, hospitalizations, and opioid dependence. Pain management is crucial in treating chronic pancreatitis, with endoscopic ultrasound-guided celiac plexus block (EUS-CPB) recognized as an interventional option. This systematic review and meta-analysis, following PRISMA guidelines, synthesized data from 12 studies (5 randomized control trials and 7 observational) on the efficacy of EUS-CPB in managing chronic pancreatitis pain.

Move to improve - Prescribing physical activity and deprescribing paracetamol for people with low back pain: Findings from a hybrid type III feasibility study.

Objective: To evaluate the feasibility of implementing a culturally adapted multimedia intervention in the waiting room of a public hospital physiotherapy outpatient service to guide the implementation of a large multicentre trial investigating the effects of a multimedia intervention to promote physical activity and reduce paracetamol use in people reporting low back pain (LBP).

Methods: A six-month (March to September 2024) hybrid type III feasibility study was conducted in an outpatient physiotherapy department of a public hospital in Sydney, Australia. The intervention included a brief video and booklet designed to engage patients and encourage informed management of LBP.