Latest news with #RoyalMelbourneHospital
News.com.au
15 hours ago
- News.com.au
Four teenagers arrested after knife attack left man's arm amputated
Police have arrested four teenagers after a knife attack in Melbourne's southwest, which left a man's arm needing to be amputated. Officers were called to the Altona Meadows Central Square Shopping Centre about 8pm on Saturday. It is alleged the victim was approached by a group of males and pushed to the ground, with one of the teens allegedly producing an edged weapon and striking the victim's forearm. The Herald Sun reports the 33-year-old male victim had the lower part of an arm amputated at Royal Melbourne Hospital on Sunday. He is in a serious but non-life-threatening condition. Police allege the teenager then fled the scene with the victim's phone. A 14-year-old boy from the Wyndham area has been charged with intentionally causing serious injury, recklessly causing injury, robbery and unlawful assault. He has been remanded to appear before a children's court. Two 15-year-old boys from the Hobsons Bay area face the same charges and have been released on bail to appear in a children's court at a later date. A 14-year-old boy, also from the Hobsons Bay area, is expected to be charged on summons. Police are continuing to search for a fifth individual believed to be involved in the alleged incident. These latest attacks come amid a spate of knife crimes at Melbourne shopping centres. A major brawl between rival gangs at a northern suburbs shopping centre in May sparked a statewide machete ban, which has already stopped stores selling them but criminalises possessing one as of September 1. Just last Monday, a 44-year-old man was stabbed in the chest and neck outside the Moonee Ponds Central shopping centre. Police said the alleged offender had a history of mental health issues. Barely an hour earlier, a 37-year-old man allegedly pulled a knife at a nearby cafe. After these two Moonee Ponds incidents, Police Minister Anthony Carbines stressed that officers were recently given more power to stop and search people for weapons without a warrant. 'We've seen a record number of edged weapons seized in the past year and that's a demonstration of the work police are doing to disrupt and dismantle crime in the community,' Mr Carbines told reporters last week. In February, two men were stabbed outside a Bunnings in Broadmeadows, allegedly over a pair of stolen headphones.
Sydney Morning Herald
6 days ago
- Health
- Sydney Morning Herald
Hospital toilet spying investigation expanded to further sites
The investigation into a young doctor accused of filming hospital colleagues in a toilet in Melbourne's north-eastern suburbs has expanded to additional hospitals in Melbourne and regional Victoria. A Victoria Police spokesperson told The Age that several hospitals had been identified as 'workplaces of interest' after Ryan Cho, who most recently worked at the Austin Hospital, was last week arrested and charged with stalking and use of an optical surveillance device. 'The 27-year-old worked at these hospitals located in Melbourne's CBD and regional Victoria between 2020 and 2025,' the police spokesperson said. 'Police are in the process of contacting the additional hospitals and those potentially impacted during the time of the man's employment.' Staff at the Austin uncovered a mobile phone allegedly recording them on Thursday, July 3. The Age revealed this week that staff at the Royal Melbourne Hospital had since been informed that Cho was employed at the CBD-adjacent Parkville site between February 2024 and February 2025. The Age has seen signage at the Royal Melbourne Hospital, placed on entrances and exits to these facilities this year that says: 'Please do not leave your belongings in here. Please use your staff lockers.' A Royal Melbourne spokesperson said the hospital had been in contact with Victoria Police and would support their investigation as required. 'The RMH takes the wellbeing and safety of our staff very seriously. As this is now a police matter, it would be inappropriate to make any further comment.'
Medscape
09-07-2025
- Health
- Medscape
CLL: Hematologists Face Off on Best Long-Term Strategy
In the age of targeted therapy, what's the best long-term strategy to treat chronic lymphocytic leukemia (CLL), the most common leukemia in Western countries? Should treatment be continuous to achieve deep remissions or time-limited to allow patients to take breaks? At the 18th International Conference on Malignant Lymphoma (ICML) 2025 in Lugano, Switzerland, a pair of hematologists set aside their friendship for a few moments and took opposite sides in a debate over off-and-on BCL2 targeting vs continuous treatment with Bruton's tyrosine kinaseinhibitors (BTKis). Here's a summary of their discussion — and insight from another specialist who provided perspective to Medscape Medical News. Team Venetoclax: It's the 'Most Potent' Therapy Hematologist John F. Seymour, MBBS, PhD, of the Royal Melbourne Hospital, Parkville, and the Peter MacCallum Cancer Center, Melbourne, both in Australia, supported on-and-off BLC2 targeting via therapy with venetoclax, which he called 'the most potent known anti-CLL therapy.' He highlighted its early record of rapid improvement in patients and asked, 'Why would we not want to use a drug that potent?' He cited data from the 2023 CLL13 study, which he said showed that venetoclax combinations have 'an astonishing and unprecedented ability to achieve incredibly deep remissions, as measured by undetectable MRD [measurable or minimal residual disease] rates in the peripheral blood above 90% with short term time-limited treatment.' The study authors reported that 'venetoclax-obinutuzumab [VO] with or without ibrutinib was superior to chemoimmunotherapy as first-line treatment in fit patients with CLL.' Seymour also noted phase 3 data from several studies demonstrating that time-limited therapy of 12-14 months achieved 4-year progression-free survival (PFS) rates between 75% and 85%, similar to continuous BTKi therapy outcomes. 'So in terms of PFS, both are equivalent,' he said. Team BTKi: The Evidence Is in Hematologist Stephan Stilgenbauer, MD, of Ulm University, Ulm, Germany, countered by emphasizing the extensive evidence base supporting continuous BTKi therapy, noting data from 'almost 2000 patients on nine clinical trials' with nearly 5 years of aggregate follow-up. He added that 'we have a median follow-up time that is close to 50 years in aggregate, and even more importantly, seven of these nine trial arms involved the relevant CLL patient population — namely, patients of a median age of about 70 years.' He contrasted this with more limited data for venetoclax combinations, stating that VO had evidence from only two trials, the CLL13 and CLL14 trials, with 'only a single arm' addressing the relevant older patient population. And the aggregated median follow-up time, he said, is just over 10 years. Regarding efficacy, Stilgenbauer presented cross-trial comparisons showing 48-month PFS rates in older patients, with aggregate data showing 72% for BCL-2 inhibitors and 79% for '79% BTKis.' 'It is quite clear efficacy is better with [BTKis],' he said. Team Venetoclax: Listen to Guidelines and Patients Seymour highlighted European Society For Medical Oncology (ESMO) recommendations regarding therapy. ESMO's 2024 interim guideline update says that in front-line therapy, 'first-line treatment in patients with CLL regardless of IGHV [immunoglobulin heavy chain variable region status] but without a TP53 mutation or del(17p), preference should be given to time-limited therapies and to therapies and/or combinations with longer follow-up data, if efficacy is similar.' However, the 2021 ESMO guidelines offer these cautions about time-limited therapies: 'side-effect profile (renal impairment and risk of TLS [tumor lysis syndrome] vs atrial fibrillation and bleeding risk), application mode (intravenous [IV] application with combination therapy due to the antibody infusion vs oral medication only), intensity of controls (5-week ramp-up period with the combination), and shorter follow-up have to be taken into consideration.' Seymour also noted patient preference data showing that 'the most dominant factor for patients' preference with given equivalent efficacy was shorter duration of treatment.' As for adverse effects, Seymour argued that current protocols have minimized this risk for TLS. 'Interventions are very uncommonly needed. When analyzing aggregate data, TLS is in less than 1 in 200 patients,' he said. He contrasted this with the risks of continuous therapy, noting that 'continuous accumulation of risk of adverse events is seen, and some of those, and the most troublesome among those are cardiovascular. That can be atrial fibrillation or flutter. While second-generation drugs have a lower rate, they still occur, and they still increase with time.' Most devastatingly, 'the risk of sudden cardiac death is increased with ibrutinib across a number of these studies. And that risk continues to accumulate with time.' Team BTKi: Safety Matters Stilgenbauer challenged safety perceptions about BTKis, highlighting the CLL12 placebo-controlled trial. 'When you look at the adverse event table from this trial, you see that all of these so-called treatment-emergent adverse events that occurred with ibrutinib also occurred with placebo,' he said. 'These adverse events occur due to the disease and not due to the treatment.' He also noted safety data showing higher rates of severe neutropenia in venetoclax combinations. 'You have a high-grade neutropenia in more than 55% of patients. You have thrombocytopenia, anemia, you have febrile neutropenia and pneumonia,' Stilgenbauer said, comparing this to single-digit percentages with BTKis. The Outside Expert: Focus on Patient Characteristics Medscape Medical News contacted Hematologist Seema Ali Bhat, MD, of The Ohio State University in Columbus, Ohio, and asked her for her perspective. Here are excerpts from our conversation: What do you think regarding time-limited venetoclax-based therapy vs continuous BTKi therapy? Both regimens are highly effective options for CLL, and the choice between them should be individualized. Time-limited venetoclax combinations (with obinutuzumab or acalabrutinib +/- obinutuzumab) offer the advantage of finite therapy, with potential for deep remissions, MRD negativity, and treatment-free intervals. On the other hand, BTKis have shown sustained efficacy with long-term data, even in high-risk groups. In fact, a pooled analysis of three trials showed that first-line treatment with ibrutinib provides long-term overall survival benefits, with estimates similar to those of an age-matched adult population. What should hematologists be thinking about when they make decisions regarding treatment in these patients? Several factors should guide treatment selection: •Patient-specific factors: age, fitness, cardiovascular comorbidities (atrial fibrillation, hypertension, congestive heart failure, etc.), renal function, medication adherence, and treatment goals. BTKis are known to have cardiac adverse effects, so patients with underlying uncontrolled cardiac condition like atrial fibrillation or hypertension may not be suitable for this kind of therapy. On the other hand, patients with renal dysfunction may be prone to worsening renal function due to risk for TLS with venetoclax. •Patient preferences: If a patient does not want to come in for frequent laboratory monitoring during venetoclax ramp-up, a BTKi is preferred. Similarly, if coming for IV infusions for 6 months is burdensome, it is better to avoid a VO regimen. If there is a patient who wants fixed duration therapy but prefers not to have IV treatments, the acalabrutinib plus venetoclax (AV) regimen will be ideal in this case. The consideration of patient preferences is important. Some patients value time off treatment and the concept of deep remissions while others may prioritize fewer visits or simpler oral treatments. •Disease characteristics: We take disease biology into consideration, especially IGHV mutation status and TP53 disruption. In the CLL14 study, it was very clear that in patients with TP53 disruptions, the responses were not as durable as in patients without these abnormalities. Studies with BTKis have consistently shown similar outcomes in patients with or without TP53 disruption. •Drug interactions: Due to an increased risk for bleeding, it is advised to be cautious when combining BTKis with blood thinners. In a patient who is at an increased risk for bleeding, venetoclax-based therapy may be preferred. •Access and cost: Time-limited therapy may be more cost-effective, but access to obinutuzumab and logistical complexity of venetoclax ramp-up can be barriers. Shared decision-making is essential, especially as both options — time-limited or continuous offer excellent outcomes in many patients. Is there anything else you'd like to add about this topic? Head-to-head comparisons between these different types of treatments are ongoing — for example, trials like FLAIR and CLL17— so we are eagerly awaiting those results which may help further refine this field. Also, the oral doublets have so far been compared with chemoimmunotherapy, it will be important to see how AV compares to VO in the MAJIC trial or how zanubrutinib plus sonrotoclax, a new BCL2 inhibitor, compares to VO in the CELESTIAL trial. Until we have definitive long-term comparative data, clinicians should avoid rigid treatment algorithms.
The Age
26-05-2025
- The Age
Victoria's machete ban fast-tracked after shoppers terrified by Northland brawl
A blanket ban on machete sales in Victoria has been fast-tracked after a violent gang brawl at a Melbourne shopping centre sent shoppers running, screaming and hiding in stores. The ban, an Australian-first, was to begin on September 1, but was brought forward after Sunday's brawl at Northland Shopping Centre in Preston. Premier Jacinta Allan announced on Monday the ban would take effect at midday on Wednesday. 'We're doing this today as quickly as possible because we must never let the places where we gather, the places where families come together to shop, to enjoy the peace of their weekend, become places we fear,' she said. Retailers must not supply machetes, broadly described as knives with a blade longer than 20 centimetres, for sale or possess them with an intent to sell with no exemptions. The ban follows the violent brawl breaking out at the shopping centre on Sunday afternoon in front of horrified onlookers. A 15-year-old boy and a 16-year-old boy have since been charged, and are due to front a children's court on Monday. Loading The fight, which spilled into outdoor and indoor areas of the shopping centre, left a 20-year-old man with serious injuries. He was taken to Royal Melbourne Hospital, where he remained in a stable condition on Monday. Two other males involved have since sought hospital treatment, police said. Police are working to identify others involved in the affray, which they believe was an act of 'retaliation' after another incident on Saturday.
Sydney Morning Herald
26-05-2025
- Sydney Morning Herald
Victoria's machete ban fast-tracked after shoppers terrified by Northland brawl
A blanket ban on machete sales in Victoria has been fast-tracked after a violent gang brawl at a Melbourne shopping centre sent shoppers running, screaming and hiding in stores. The ban, an Australian-first, was to begin on September 1, but was brought forward after Sunday's brawl at Northland Shopping Centre in Preston. Premier Jacinta Allan announced on Monday the ban would take effect at midday on Wednesday. 'We're doing this today as quickly as possible because we must never let the places where we gather, the places where families come together to shop, to enjoy the peace of their weekend, become places we fear,' she said. Retailers must not supply machetes, broadly described as knives with a blade longer than 20 centimetres, for sale or possess them with an intent to sell with no exemptions. The ban follows the violent brawl breaking out at the shopping centre on Sunday afternoon in front of horrified onlookers. A 15-year-old boy and a 16-year-old boy have since been charged, and are due to front a children's court on Monday. Loading The fight, which spilled into outdoor and indoor areas of the shopping centre, left a 20-year-old man with serious injuries. He was taken to Royal Melbourne Hospital, where he remained in a stable condition on Monday. Two other males involved have since sought hospital treatment, police said. Police are working to identify others involved in the affray, which they believe was an act of 'retaliation' after another incident on Saturday.
