Royal Prince Alfred Hospital

About: Royal Prince Alfred Hospital is a healthcare organization based out in Sydney, New South Wales, Australia. It is known for research contribution in the topics: Population & Transplantation. The organization has 7424 authors who have published 14798 publications receiving 550338 citations. The organization is also known as: RPAH & RPA.

Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer

Abstract: Background: The safety and efficacy of laparoscopic resection (LR) for colorectal cancer remains to be established. Methods: A meta-analysis of randomized clinical trials comparing the short-term outcomes of laparoscopic with those of open resection for colorectal cancer was undertaken. A literature search was performed for relevant articles published by the end of 2002. Two reviewers independently appraised the trials using a predetermined protocol. Results were analysed using Comprehensive Meta-analysis®. Results: The outcomes of 2512 procedures from 12 trials were analysed. LR took on average 32·9 per cent longer to perform than open resection but was associated with lower morbidity rates. Specifically, wound infection rates were significantly lower (odds ratio 0·47 (95 per cent confidence interval 0·28 to 0·80); P = 0·005). In patients undergoing LR, the average time to passage of first flatus was reduced by 33·5 per cent, that to tolerance of a solid diet by 23·9 per cent and that to 80 per cent recovery of peak expiratory flow by 44·3 per cent. Early narcotic analgesia requirements were also reduced by 36·9 per cent, pain at rest by 34·8 per cent and during coughing by 33·9 per cent, and hospital stay by 20·6 per cent. There were no significant differences in perioperative mortality or oncological clearance. Conclusion: LR for colorectal cancer is associated with lower morbidity, less pain, a faster recovery and a shorter hospital stay than open resection, without compromising oncological clearance. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Selective BRAF Inhibitors Induce Marked T-cell Infiltration into Human Metastatic Melanoma

Abstract: Purpose: To evaluate the effects of treatment with the potent mutant BRAF inhibitors GSK2118436 or vemurafenib (PLX4720) on immune responses to metastatic melanoma in tissues taken before and after treatment. Experimental Design: Thirty-seven tumor biopsies were collected from 15 patients with unresectable American Joint Committee on Cancer stage III or IV melanoma immediately before and approximately 7 days after the commencement of BRAF inhibitor treatment and at the time of tumor progression. Immunohistochemical staining was carried out on the biopsies using specific antibodies for CD8, CD4, CD20, CD1a, and Granzyme B. Results: Tumor infiltration by CD4 + and CD8 + lymphocytes increased markedly following BRAF inhibitor treatment (both ρ = 0.015). There was a correlation between the degree of tumor infiltration by CD8 + and Granzyme B–expressing lymphocytes in post–BRAF inhibitor–treated biopsies ( r = 0.690 and ρ = 0.013). Increased intratumoral CD8 + lymphocyte expression was correlated with a reduction in tumor size and an increase in necrosis in posttreatment biopsies ( r = −0.793, ρ = 0.011; and r = 0.761, ρ = 0.004, respectively). Conclusions: The increase in tumor-infiltrating lymphocytes induced by treatment with BRAF inhibitors provides strong support for conducting trials that combine BRAF inhibitors with immunotherapy in the hope of prolonging clinical responses. Clin Cancer Res; 18(5); 1386–94. ©2011 AACR .

A Prospective Study of Sudden Cardiac Death among Children and Young Adults

Abstract: BackgroundSudden cardiac death among children and young adults is a devastating event. We performed a prospective, population-based, clinical and genetic study of sudden cardiac death among children and young adults. MethodsWe prospectively collected clinical, demographic, and autopsy information on all cases of sudden cardiac death among children and young adults 1 to 35 years of age in Australia and New Zealand from 2010 through 2012. In cases that had no cause identified after a comprehensive autopsy that included toxicologic and histologic studies (unexplained sudden cardiac death), at least 59 cardiac genes were analyzed for a clinically relevant cardiac gene mutation. ResultsA total of 490 cases of sudden cardiac death were identified. The annual incidence was 1.3 cases per 100,000 persons 1 to 35 years of age; 72% of the cases involved boys or young men. Persons 31 to 35 years of age had the highest incidence of sudden cardiac death (3.2 cases per 100,000 persons per year), and persons 16 to 20 yea...