https://nova.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:42269 Wed 20 Sep 2023 12:13:03 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:52436 Wed 11 Oct 2023 14:54:40 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:27247 Wed 11 Apr 2018 14:43:09 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:14869 Wed 11 Apr 2018 09:36:06 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:49072 Wed 03 May 2023 16:08:08 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:55239 Wed 01 May 2024 15:42:09 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:36663 Tue 23 Jun 2020 11:12:42 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:43109 Tue 13 Sep 2022 13:22:36 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:30493 2; odds ratio, 2.710; P=0.040). No difference was found in reperfusion rate after treatment between patients with and without SMCV-(P > 0.05). In patients achieving major reperfusion (=80%), there was no difference in 24-hour infarct volume, or rate of poor outcome between patients with and without SMCV-(P > 0.05). However, in those without major reperfusion, patients with SMCV-had larger 24-hour infarct volume (P=0.011), higher rate of poor outcome (P=0.012), and death (P=0.032) compared with those with SMCV filling. SMCV-was significantly associated with brain edema at 24 hours (P=0.037), which, in turn, was associated with poor 3-month outcome (P=0.002). Conclusions: Lack of SMCV filling contributed to poor outcome after thrombolysis, especially when reperfusion was not achieved. The main deleterious effect of poor venous filling appears related to the development of brain edema.]]> Thu 28 Oct 2021 13:03:14 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:654 Thu 25 Jul 2013 09:10:27 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:33600 Thu 22 Nov 2018 16:43:21 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:37497 Thu 21 Jan 2021 17:11:20 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:36545 post hoc analysis after excluding subjects that were recruited at centers reporting a decline in the balance of randomization between sonothrombolysis and concurrent endovascular trials. Results: From a total of 676 participants randomized in the CLOTBUST-ER trial we identified 52 patients from 7 centers with perceived equipoise shift in favor of endovascular treatment. Post hoc sensitivity analysis in the intention-to-treat population adjusted for age, National Institutes of Health Scale score at baseline, time from stroke onset to tPA bolus and baseline serum glucose showed a significant (p < 0.01) interaction of perceived endovascular equipoise shift on the association between sonothrombolysis and 3 month functional outcome [adjusted common odds ratio (cOR) in centers with perceived endovascular equipoise shift: 0.22, 95% CI 0.06–0.75; p = 0.02; adjusted cOR for centers without endovascular equipoise shift: 1.20, 95% CI 0.89–1.62; p = 0.24)]. After excluding centers with perceived endovascular equipoise shift, patients randomized to sonothrombolysis had higher odds of 3 month functional independence (mRS scores 0–2) compared with patients treated with tPA only (adjusted OR: 1.53; 95% CI 1.01–2.31; p = 0.04). Conclusion: Our experience in CLOTBUST-ER indicates that increasing implementation of endovascular therapies across major academic stroke centers raises significant challenges for clinical trials aiming to test noninterventional or adjuvant reperfusion strategies.]]> Thu 09 Dec 2021 11:02:10 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:36740 hypo-i), non-hypoperfused region of ischaemic hemisphere (rPS_nonhypo-i) and their contralateral mirror regions (rPS_hypo-c and rPS_nonhypo-c). The changes of rPS were analysed using analysis of variance (ANOVA) with repeated measures. Logistic regression was used to identify independent predictors of unfavourable outcome. Results: Fifty-six patients were included in the analysis, median age was 76 (IQR 62-81) years and 28 (50%) were female. From baseline to 24 h after treatment, rPS_hypo-i, rPS_nonhypo-i and rPS_hypo-c all decreased significantly. The decreases in rPS_hypo-i and rPS_hypo-c were larger in the reperfusion group than non-reperfusion group. The rPS_hypo-i at follow-up was a predictor for unfavourable outcome (OR 1.131; 95% CI 1.018-1.256; P = 0.022). Conclusion: Early disruption of BBB in AIS is reversible, particularly when greater reperfusion is achieved. Elevated BBBP at 24 h after treatment, not the pretreatment BBBP, predicts unfavourable outcome. Key points: Early disruption of blood-brain barrier (BBB) in stroke is reversible after treatment; The reversibility of BBB permeability is associated with reperfusion; Unfavourable outcome is associated with BBB permeability at 24 h after treatment; Contralateral non-ischaemic hemisphere is not 'normal' during an acute stroke.]]> Thu 02 Jul 2020 16:31:45 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:10753 24 hours). Demographics, Injury Severity Score, pelvic Abbreviated Injury Score, first 24-hour transfusions, physiologic parameters, time to operating room (OR), angiography requirement, length of stay (LOS), and mortality were recorded. Data are presented as mean ± SD or percentages. Statistical significance was determined at p < 0.05 based on univariate analysis. Results: Forty-five patients met inclusion criteria, 18 patients had acute definitive ORIF (5.5 hours to OR) and 27 had late definitive ORIF (5 days to OR). Acute and late ORIF patients had comparable demographics (age: 48 ± 22 years vs. 40 ± 14 years, gender: 82% vs. 79% men) and injury severity (Injury Severity Score: 30 ± 18 vs. 24.5 ± 13, pelvic Abbreviated Injury Score: 3.7 ± 1 vs. 3.4 ± 1.1). Initial shock parameters were significantly worse in the acute ORIF group (systolic blood pressure, 69.7 ± 17 mm Hg vs. 108 ± 21 mm Hg; BD, −7.4 ± 4 vs. −4.9 ± 2 mEq/L, lactate 6.67 ± 7 mmol/L vs. 2.51 ± 1.3 mmol/L). Angiography was used in 18% (3/18) vs. 21% (6 of 27) of the cases. All early ORIF patients survived and one (3%) of the late ORIF patients died. There was a trend to shorter hospital LOS (25 ± 24 days vs. 37 ± 32 days) and a decreased 24-hour red cell transfusion rate (4.7 ± 5 U vs. 6.6 ± 4 U) in the early ORIF group. The intensive care unit admission rate (12 of 18 vs. 15 of 27) and LOS was comparable (2.9 ± 2.5 days vs. 3.7 ± 3.6 days). Conclusion: Acute ORIF of unstable pelvic ring fractures within 6 hours could be safely performed even in severely shocked patients with multiple injuries. The procedure did not lead to increased rates of transfusion, mortality, intensive care unit LOS, or overall LOS. Furthermore, all these parameters showed a trend toward benefit compared with a staged approach.]]> Sat 24 Mar 2018 08:08:21 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:19523 Sat 24 Mar 2018 08:02:06 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:19727 Sat 24 Mar 2018 07:53:44 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:5013 Sat 24 Mar 2018 07:44:12 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:28601 IGF1 locus could also associate with both IS and s-IGF1. We investigated whether genetic variation at the IGF1 locus is associated with i) s-IGF1, ii) IS occurrence, iii) IS severity, and iv) post-stroke outcome. Design/methods: Patients (n=844; 66% males, mean age 56 years) and community controls (n=668) were included from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). Post-stroke outcome was evaluated with the modified Rankin Scale at 3 and 24 months after index stroke, and baseline stroke severity with the Scandinavian Stroke Scale. s-IGF1 was determined in patients and after random selection in 40 of the controls. Results: Eleven single nucleotide polymorphisms (SNPs) were selected in the IGF1 gene. In healthy controls the major allele of rs7136446 was associated with higher s-IGF1, whereas in patients no such association was found. No SNP was associated with IS, nor with stroke severity. After multivariate correction for presence of diabetes, smoking, and hypertension, the major allele of rs7136446 was associated with favorable functional outcome 24-months post-stroke (odds ratio 1.46; 95% CI 1.09–1.96). Conclusion: Variation in rs7136446 of the IGF1 gene associates with post-stroke outcome in relatively young IS patients. Also, rs7136446 associates with s-IGF1 in controls but not in IS, which indicates that IS perturbs a normal genetic impact on s-IGF1 levels.]]> Sat 24 Mar 2018 07:37:28 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:28647 P<0.0001, r=−0.7, r²=0.53; SIS recovery n=2970, P<0.0001, r=−0.71, r²=0.52). Proxy responses had a stronger association with BI (EQ-5D weighted score n=837, P<0.0001, r=0.78, r²=0.63; SIS recovery n=867, P<0.0001, r=0.68, r²=0.48). mRS explained more of the variation in QoL (EQ-5D weighted score=53%, recovery by SIS v3.0=52%) than NIHSS or BI and resulted in fewer mismatches between good primary outcome and poor QoL (P<0.0001, EQ-5D weighted score=8.5%; SIS recovery=10%; SIS-16=4.4%). Conclusions: The mRS seemed to align closely with stroke survivors’ interests, capturing more information on QoL than either NIHSS or BI. This further supports its recommendation as a primary outcome measure in acute stroke randomized controlled trials.]]> Sat 24 Mar 2018 07:37:14 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:22253 Sat 24 Mar 2018 07:17:35 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:25077 Sat 24 Mar 2018 07:15:02 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:38955 Mon 29 Jan 2024 17:47:53 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:38395 146.7 ng/ml). The s-IGF-I level was not associated with recurrent stroke (N=79) or death (N=44), although it correlated with recovery (r=0.12, P=0.035). In the regression analysis, s-IGF-I associated with recovery between 3 months and 7 years (but not between 2 and 7 years). The associations did not withstand adjustment for age and sex. For comparison, the corresponding associations between 3 months and 2 years withstood all adjustments. Conclusion: The association for s-IGF-I with long-term post-stroke recovery persists after 7 years, which is also reflected in the mRS score distributions at all time-points. The effects are however modest, and not driven by mortality or recurrent stroke.]]> Mon 29 Jan 2024 17:47:17 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:35890 Mon 13 Jan 2020 17:14:28 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:43023 2 = 83%) with considerable heterogeneity. Conclusion: Intracorporeal anastomosis can be considered a safe alternative technique in laparoscopic colectomies, with potential benefits in patient outcomes. A lack of randomised studies and heterogeneity need to be addressed by additional high-quality trials.]]> Mon 12 Sep 2022 10:25:20 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:46873 7. Overall positive surgical margins (PSM) occurred in 15.9% with pT2 PSM 9.8%, pT3a PSM 30.8% and pT3b PSM 39.2%. Mean urinary continence at 12 months was 91.4% (data available from five surgeons). Mean 12 months potency after bilateral nerve spare was 47.2% (data available from four surgeons). Biochemical recurrence occurred in 10.6% (mean follow up 17 months). Conclusion: The Australian experience of Fellowship trained surgeons performing LRP demonstrates favourable peri-operative, oncological and functional outcomes in comparison to published data for open, laparoscopic and robotic assisted radical prostatectomy. In our Australian centres, LRP remains an acceptable minimally invasive surgical treatment for prostate cancer despite the increasing use of robotic assisted surgery.]]> Mon 05 Dec 2022 09:22:03 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:42211 P =.78). Patients managed in SUs more often received recommended management (e.g. swallowing screening). Conclusion: The benefits of SU care may extend to patients experiencing in-hospital stroke. Validation, including accounting for potential residual confounding factors, is required.]]> Fri 26 Aug 2022 09:25:59 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:51943 Fri 22 Sep 2023 16:57:08 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:40581 Fri 15 Jul 2022 10:39:13 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:49366 Fri 12 May 2023 12:42:14 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:46103 185/105 mmHg) during the first 24 h following tPA-bolus. The majority of BP excursions (46%) occurred within the first 75 min from tPA-bolus. Patients with at least one BP excursion in the first 24 h following tPA bolus had significantly lower rates of independent functional outcome at 90 days (31 vs. 40.1%, P = 0.028). The total number of BP excursions was associated with decreased odds of 24-h clinical recovery (OR = 0.88, 95% CI:0.80–0.96), 24-h neurological improvement (OR = 0.87, 95% CI: 0.81–0.94), 7-day functional improvement (common OR = 0.92, 95% CI: 0.87–0.97), 90-day functional improvement (common OR = 0.94, 95% CI: 0.88–0.98) and 90-day independent functional outcome (OR = 0.90, 95% CI: 0.82–0.98) in analyses adjusted for potential confounders. DBP excursions were independently associated with increased odds of any intracranial hemorrhage (OR = 1.26, 95% CI: 1.04–1.53). Conclusion: BP excursions above guideline thresholds during the first 24 h following tPA administration for AIS are common and are independently associated with adverse clinical outcomes.]]> Fri 11 Nov 2022 15:33:52 AEDT ]]>