Annual Report 2008-09 - Austin Health

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Nevada in March on behalf of Dr Tanya Newnham, Dr Sarah Wilson and Prof Ingrid Scheffer. This was the first study to show the serious consequences on the family of the adolescent with CFS in terms of family activities, parental employment and financial burden. CLINICAL PHARMACOLOGY The Department of Clinical Pharmacology and Therapeutics, together with Nucleus Network, established the Austin Centre for Clinical Studies, a 16-bed, phase one, clinical trials unit in February 2008. Since opening, 15 new drugs have been tested. In its drug discovery activities, Clinical Pharmacology also focussed on the identification of novel markers for the diagnosis and treatment of prostate cancer and neural regulation of the circulation, pancreatic function and blood glucose. With The University of Melbourne, the department continued to provide evaluation of drugs submitted for registration with the Australian Therapeutic Goods Administration (TGA) and the New Zealand equivalent, Medsafe. After independently evaluating clinical trial results, the department made recommendations to the TGA on the safety and efficacy of 20 drugs, as it does each year. AGED CARE SERVICES The department participated in a number of Alzheimer’s disease treatment trials. Major projects included: the single blind, placebocontrolled, randomised study in mild to moderate Group Alzheimer’s Disease patients to assess the safety, tolerability, pharmacokinetics and pharmacodynamics of GSK239512, a selective histamine H3 receptor antagonist; ENA713D Exelon® (rivastigmine) a 24-week, multi-centre, open-label evaluation of compliance and tolerability of the once-daily 10cm 2 patch formulation in patients with probable Alzheimer’s disease; and a fixed-dose study of SB-742457 versus placebo when added to existing donepezil treatment in subjects with mild to moderate Alzheimer’s disease; CTN Phase IV Prospective Research in Memory clinics; and an open-label, non-randomised, multi-centre study to optimise image assessment and evaluate the efficiency and safety of BAY94-9172 (ZK 6013443) positron emission tomograph for detection/exclusion of cerebral amyloid beta in patients with probable Alzheimer’s disease compared to healthy volunteers. DEPARTMENT OF MEDICINE The University of Melbourne at Austin Health In a NHMRC-funded grant, Dr Rachel Davey led a team who questioned the mechanism by which male hormones, androgens, contribute to skeletal growth and bone accrual in puberty and in bone maintenance post-puberty. In a paper published in the November edition of the prestigious American Journal of Bone and Mineral Research (JBMR), the team demonstrated that androgens act through androgen receptors in mineralising osteoblasts to maintain bone by regulating both bone breakdown and the coordination of bone matrix synthesis and mineralisation. The team found that this action is most important during times of bone accrual and high rates of bone remodelling. These findings make a valuable contribution to the body of research into male osteoporosis. Likewise funded by NHMRC, Dr Davey led a project that provided fuel to the debate on the physiological role of calcitonin, a thyroid hormone that inhibits bone breakdown and is used in some countries to treat this condition in patients with osteoporsis. Research findings published in the JBMR provided strong evidence for a biological role of the calcitonin reception in the regulation of homeostasis in states of calcium stress. Again funded by the NHMRC and published in the international biology journal, The FASEB Journal in August, Dr Helen MacLean led a project that identified the mechanisms of anabolic androgen action in muscle strength. The team bred a mutant strain of mice in which males had extra fat and reduced muscle development and strength, but females were normal. The team demonstrated that in males, androgens act through the androgen receptor to regulate multiple pathways that control muscle mass, strength and fatigue resistance, but that androgens are not required for peak muscle mass in females. The work has implications for drug therapies used for older people at risk of falls and those with chronic disease. ENDOCRINE CENTRE FOR EXCELLENCE A team led by Prof George Jerums and Assoc Prof Richard MacIsaac investigated the usefulness for indigenous Australians of a common kidney function test, as this group’s rate of kidney failure is over five times that of the general population. Assoc Prof MacIsaac led a study of 3,900 type 2 diabetes patients and found that earlier, more proactive intervention in the treatment of the disease could reduce the risk of serious complications such as visual impairment, nerve function and kidney disease. Prof Jerums, Assoc Prof MacIsaac and Dr Elif Ekinci showed that a diet high in salt reduced the effectiveness of the two most commonly used drugs to protect kidney function in patients with type 2 diabetes. Prof Ego Seeman led a team including Dr Sandy Iuliano that showed that nutrition supplementation made of whey protein concentrate and vitamin D reduced the rate of falls among elderly people. Dr Cherie Chiang and Prof Jeffrey Zajac reported that over 90 per cent of patients admitted with a hip fracture were vitamin D deficient. EMERGENCY DEPARTMENT The Emergency Department (ED) researchers were involved in over a dozen publications, many more conference presentations and posters, and increases in intra and inter-institution collaboration. Emphasis was placed on the evaluation of drugs in the ED setting with considerable work being undertaken by both under and post-graduate research students. One highlight was a randomised controlled trial (RCT) demonstrating that a vapocoolant spray, compared with 24 Austin Health : 2008-09 ANNUAL REPORT
Pictured below: Dr Sofianos Andrikopoulos reviewing research into the cause of diabetes. a placebo (water) spray, significantly reduced the pain of intravenous cannulation. This research won the ‘Best Paper by a Fellow’ at the Australasian College for Emergency Medicine Annual Scientific Meeting and was published in the prestigious British Medical Journal. ED also completed a second RCT demonstrating that vapocoolant spray has significant advantages over the more traditional subcutaneous lignocaine. INTENSIVE CARE UNIT As the foremost intensive care research unit in Australia, the ICU participated in 18 major international and national trials, multiple in-house investigatordriven trials, and national and international collaborations. Published in the prestigious New England Journal of Medicine, the NICE-SUGAR Study Investigators (2009) Intensive versus conventional glucose control in critically ill patients showed that the practice of lowering an ICU patient’s blood sugar levels to normal levels carries significant risk of death. Another significant investigation was whether the hormone erythropoietin could reduce the severity of disability from traumatic brain injury. Prof Rinaldo Bellomo and Prof Ian Baldwin led research activities which produced in excess of 50 journal publications and multiple book chapters for the year. By this measure, Austin Health’s ICU is one of the top five research focussed ICUs in the world. LIVER TRANSPLANT UNIT The Liver Transplant Unit (LTU) is actively involved in clinical research both nationally and internationally. The LTU’s national network includes the NSW Virology Research Lab, studying antiviral therapy and the prevention of cytomegalovirus (CMV) disease in liver transplant patients. With the Anti-Cancer Council of Australia and the University of New South Wales, the LTU looked at the incidence of cancer post-transplantation and identified risk factors for this group of patients. With the Royal Victorian Eye and Ear Hospital, the LTU investigated the prevalence of age-related macular degeneration post-transplant. With the Liver Transplant Unit at Flinders Medical Centre, SA, the researchers retrospectively collected data from patients with cirrhosis and hepatocellular carcinomas who underwent liver resection, determining the long-term survival, the rate of tumor recurrence and identifying prognostic factors associated with liver resection. The Liver Transplant Unit undertook research with other transplant units around the globe. Research currently being undertaken internationally involves studying the safety and efficacy of anti-viral medication to enable patients diagnosed with hepatitis B and C to safely receive organ transplants and studying the safety and efficacy of new anti-rejection medication to improve long term transplant survival. Austin Health : 2008-09 ANNUAL REPORT 25
Page 1 and 2: Annual Report 2008-09 TURNING SCIEN
Page 3 and 4: To provide our patients with the be
Page 5 and 6: PERCENTAGE OF TIME AMBULANCES WERE
Page 7 and 8: The team’s genetic research contr
Page 9 and 10: The ongoing development and upgrade
Page 11 and 12: on disability access improvement is
Page 13 and 14: Mr Stephen Kerr Ms Joe Manton Ms Jo
Page 15 and 16: this will defend them against the r
Page 17 and 18: Pictured left: Mr Philip Hayward an
Page 19 and 20: Tower opened in 2005. ED staff cont
Page 21 and 22: Prof Seeman’s boundless enthusias
Page 23 and 24: Pictured left: Emergency Department
Page 25: Research Austin Health’s culture
Page 29 and 30: LUDWIG INSTITUTE FOR CANCER RESEARC
Page 31 and 32: the provision of new simulation equ
Page 33 and 34: Pictured opposite: Dr Michael Geluk
Page 35 and 36: Prof Proietto also says that there
Page 37 and 38: Pictured left: the Food Services De
Page 39 and 40: Pictured below: division 1 nurse Je
Page 41 and 42: Fundraising Austin Health’s world
Page 43 and 44: Mr Keith Bailey Mr and Mrs Carl and
Page 45 and 46: Dr F Kerr Director Emergency Medici
Page 47 and 48: SCHOLARSHIPS Dr Ali Al-Fiadh Nation
Page 49 and 50: Our Clinical Services STATEWIDE SER
Page 51 and 52: “Hand hygiene is the single most
Page 53 and 54: Mandatory Reporting AVAILABILITY OF
Page 55 and 56: Statement of Priorities A ‘statem
Page 57 and 58: Statement of Priorities Part B: Per
Page 59 and 60: Disclosure Index The annual report

Annual Report 2008-09 - Austin Health

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