Institution
John Hunter Hospital
Healthcare•Newcastle, New South Wales, Australia•
About: John Hunter Hospital is a healthcare organization based out in Newcastle, New South Wales, Australia. It is known for research contribution in the topics: Population & Asthma. The organization has 2162 authors who have published 3727 publications receiving 121992 citations. The organization is also known as: The John Hunter.
Topics: Population, Asthma, Stroke, Randomized controlled trial, Medicine
Papers published on a yearly basis
Papers
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TL;DR: In patients with ischemic stroke with a proximal cerebral arterial occlusion and salvageable tissue on CT perfusion imaging, early thrombectomy with the Solitaire FR stent retriever, as compared with alteplase alone, improved reperfusion, early neurologic recovery, and functional outcome.
Abstract: Background Trials of endovascular therapy for ischemic stroke have produced variable results. We conducted this study to test whether more advanced imaging selection, recently developed devices, and earlier intervention improve outcomes. Methods We randomly assigned patients with ischemic stroke who were receiving 0.9 mg of alteplase per kilogram of body weight less than 4.5 hours after the onset of ischemic stroke either to undergo endovascular thrombectomy with the Solitaire FR (Flow Restoration) stent retriever or to continue receiving alteplase alone. All the patients had occlusion of the internal carotid or middle cerebral artery and evidence of salvageable brain tissue and ischemic core of less than 70 ml on computed tomographic (CT) perfusion imaging. The coprimary outcomes were reperfusion at 24 hours and early neurologic improvement (≥8-point reduction on the National Institutes of Health Stroke Scale or a score of 0 or 1 at day 3). Secondary outcomes included the functional score on the modified Rankin scale at 90 days. Results The trial was stopped early because of efficacy after 70 patients had undergone randomization (35 patients in each group). The percentage of ischemic territory that had undergone reperfusion at 24 hours was greater in the endovascular-therapy group than in the alteplase-only group (median, 100% vs. 37%; P<0.001). Endovascular therapy, initiated at a median of 210 minutes after the onset of stroke, increased early neurologic improvement at 3 days (80% vs. 37%, P = 0.002) and improved the functional outcome at 90 days, with more patients achieving functional independence (score of 0 to 2 on the modified Rankin scale, 71% vs. 40%; P = 0.01). There were no significant differences in rates of death or symptomatic intracerebral hemorrhage. Conclusions In patients with ischemic stroke with a proximal cerebral arterial occlusion and salvageable tissue on CT perfusion imaging, early thrombectomy with the Solitaire FR stent retriever, as compared with alteplase alone, improved reperfusion, early neurologic recovery, and functional outcome. (Funded by the Australian National Health and Medical Research Council and others; EXTEND-IA ClinicalTrials.gov number, NCT01492725, and Australian New Zealand Clinical Trials Registry number, ACTRN12611000969965.)
4,562 citations
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National Institutes of Health1, University of Pittsburgh2, McMaster University3, University of Washington4, University of Cape Town5, Wake Forest University6, University of Leicester7, Karolinska Institutet8, University of Southampton9, Boston Children's Hospital10, John Hunter Hospital11, McGill University12, University of Wisconsin-Madison13, University of Virginia14
TL;DR: Recommendations and guidelines on the evaluation and treatment of severe asthma in children and adults and coordinated research efforts for improved phenotyping will provide safe and effective biomarker-driven approaches to severe asthma therapy are provided.
Abstract: Severe or therapy-resistant asthma is increasingly recognised as a major unmet need. A Task Force, supported by the European Respiratory Society and American Thoracic Society, reviewed the definition and provided recommendations and guidelines on the evaluation and treatment of severe asthma in children and adults. A literature review was performed, followed by discussion by an expert committee according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach for development of specific clinical recommendations. When the diagnosis of asthma is confirmed and comorbidities addressed, severe asthma is defined as asthma that requires treatment with high dose inhaled corticosteroids plus a second controller and/or systemic corticosteroids to prevent it from becoming “uncontrolled” or that remains “uncontrolled” despite this therapy. Severe asthma is a heterogeneous condition consisting of phenotypes such as eosinophilic asthma. Specific recommendations on the use of sputum eosinophil count and exhaled nitric oxide to guide therapy, as well as treatment with anti-IgE antibody, methotrexate, macrolide antibiotics, antifungal agents and bronchial thermoplasty are provided. Coordinated research efforts for improved phenotyping will provide safe and effective biomarker-driven approaches to severe asthma therapy.
2,795 citations
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The Heart Research Institute1, University of Erlangen-Nuremberg2, Saarland University3, Barts Health NHS Trust4, John Hunter Hospital5, Université catholique de Louvain6, University of Kiel7, University of Cologne8, Leipzig University9, Medical University of Vienna10, Complutense University of Madrid11, St. Vincent's Health System12, University of Duisburg-Essen13, Canterbury Hospital14, University of Zurich15, University of Glasgow16, Auckland City Hospital17, University of Freiburg18, Jagiellonian University19, Stanford University20, Harvard University21
TL;DR: Catheter-based renal denervation can safely be used to substantially reduce blood pressure in treatment-resistant hypertensive patients and should be continued, according to the authors.
2,200 citations
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TL;DR: In this article, a proof-of-principle trial of therapeutic renal sympathetic denervation in patients with resistant hypertension (i.e., systolic blood pressure ≥160 mm/hg on three or more antihypertensive medications, including a diuretic) was conducted to assess safety and blood-pressure reduction effectiveness.
1,985 citations
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TL;DR: Education in asthma self-management which involves self-monitoring by either peak expiratory flow or symptoms, coupled with regular medical review and a written action plan improves health outcomes for adults with asthma.
Abstract: Background
A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been conducted to measure the effectiveness of asthma education programmes. These programmes improve patient knowledge, but their impact on health outcomes is less well established. This review was conducted to examine the strength of evidence supporting Step 6 of the Australian Asthma Management Plan: "Educate and Review Regularly"; to test whether health outcomes are influenced by education and self-management programmes.
Objectives
The objective of this review was to assess the effects of asthma self-management programmes, when coupled with regular health practitioner review, on health outcomes in adults with asthma.
Search methods
We searched the Cochrane Airways Group trials register and reference lists of articles.
Selection criteria
Randomised trials of self-management education in adults over 16 years of age with asthma.
Data collection and analysis
Two reviewers assessed trial quality and extracted data independently. We contacted study authors for confirmation.
Main results
We included thirty six trials, which compared self-management education with usual care. Self-management education reduced hospitalisations (relative risk (RR) 0.64, 95% confidence interval (CI) 0.50 to 0.82); emergency room visits (RR 0.82, 95% CI 0.73 to 0.94); unscheduled visits to the doctor (RR 0.68, 95% CI 0.56 to 0.81); days off work or school (RR 0.79, 95% CI 0.67 to 0.93); nocturnal asthma (RR 0.67, 95% CI 0.0.56 to 0.79); and quality of life (standard mean difference 0.29,CI 0.11 to 0.47). Measures of lung function were little changed.
Authors' conclusions
Education in asthma self-management which involves self-monitoring by either peak expiratory flow or symptoms, coupled with regular medical review and a written action plan improves health outcomes for adults with asthma. Training programmes that enable people to adjust their medication using a written action plan appear to be more effective than other forms of asthma self-management.
1,279 citations
Authors
Showing all 2180 results
Name | H-index | Papers | Citations |
---|---|---|---|
Nicholas J. Talley | 158 | 1571 | 90197 |
Peter A. Jones | 130 | 513 | 81683 |
Thomas J. Ryan | 116 | 675 | 67462 |
Peter G. Gibson | 103 | 711 | 45722 |
Jeffrey S. Ginsberg | 101 | 343 | 37014 |
Nikolai Bogduk | 101 | 363 | 31503 |
Rodney J. Scott | 94 | 669 | 51860 |
John Attia | 91 | 727 | 32950 |
Peter Hersey | 90 | 399 | 37026 |
Annika Lindblom | 86 | 344 | 36494 |
Stephen J. Nicholls | 78 | 595 | 31109 |
Boris C. Bastian | 75 | 274 | 27029 |
Annette J. Dobson | 74 | 525 | 35061 |
Lisa Wood | 73 | 475 | 17825 |
R. John Aitken | 72 | 208 | 16807 |