MeDeFacts September 2010 - The University of Western Australia

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the word is out - faculty in the news the West australian Associate Professor Peter Richmond, of the School of Paediatrics and Child Health, is QAS some infants with respiratory syncytial virus and parainfluenza virus 3 end up in hospital for weeks but there is no vaccine against them. He will head a study to test a nasal vaccine that could prevent the two viruses, which are common causes of bronchiolitis and are responsible for most hospital admissions of young children in winter. The Telethon Institute for Child Health Research’s Vaccine Trials Group, Princess Margaret Hospital and the University of WA will conduct the study as part of a broader international study of more than 700 babies and toddlers. Winthrop Professor Billie Giles-Corti, of the School of Population Health, is QAS it was alarming that there was a decrease in the number of people walking for recreation and transport, not just for health reasons but because it means more cars are on the road. Figures from the Physical Activity Taskforce released this month show a nine per cent drop in the past decade in the number of people walking for recreation, and 10 per cent fewer people walking as a means of transport compared with 2006. Professor Giles-Corti said walking was one of the easiest, cheapest and most convenient ways to be active. Walking for 30 minutes a day was like the magic bullet to protect health. Even people who exercised in other ways such as at a gym should try to walk as well because it was cheap and more sustainable, she said. Clinical Professor Trevor Parry, of the School of Paediatrics and Child Health, is QAS he was concerned that troubled children were falling through the cracks because WA lacked a co-ordinated approach to early intervention. Together with Winthrop Professor Fiona Stanley, Director of the Telethon Institute for Child Health Research, and Children’s Commissioner Michelle Scott, he has written to State MPs calling for an office for early childhood to be set up to address a critical lack of resources and worsening waiting lists for therapy. Clinical Professor Parry said it was unethical that parents who were told their troubled child needed to see a clinical psychologist had to wait up to a year for an appointment. “All the evidence is there that we need to help children as early as possible and we have seen all these reports raising concerns yet we have seen no clear action by successive governments,” he said. Respiratory physician Dr Barry Clements, clinical lecturer in the School of Paediatrics and Child Health, is QAS pseudomonas aeruginosa infection is harmless in most people but could be dangerous in people with cystic fibrosis who could not clear it from their lungs. Researchers hope to be able to use natural proteins to develop a class of “super antibiotics” to treat infections, particularly in people with chronic illnesses such as pseudomonas, which is notoriously difficult to treat with traditional drugs. Perth biotechnology company Phylogica, a spin-off company from the Telethon Institute for Child Health Research, has signed a deal with pharmaceutical company AstraZeneca to use compounds known as Phylomer peptides to find new drugs to treat multiresistant bacteria. 14 Adjunct Associate Professor Wendy Oddy, of the Telethon Institute for Child Health Research, is QAS caffeine tablets and energy drinks should be more tightly controlled, particularly as their use in elite sport sends the wrong message to children. About one third of 12 to 17-year-olds consumed caffeine products regularly, and pills posed a special danger because it was easy to consume large amounts at a time. “They can get heart palpitations and there have been cases where they end up in hospital because they’ve had too much,” she said. Caffeine stimulated the nervous system and when taken in big doses could cause anxiety, sleeplessness, stomach problems and heart arrhythmia. Clinical Professor Stephen Stick, of the School of Paediatrics and Child Health, is QAS it appears the linings of the airways in people with asthma are defective in the way they repair. WA research has shown that cell abnormalities in airways may be the cause of asthma rather than allergies, as has been long believed. Researchers found that the epithelial cells that lined the airways of the lungs were different in children with asthma, particularly the way they responded to injury. mJa insight Professor Richard Prince, of the School of Medicine and Pharmacology, is QAS doctors should be wary of prescribing oral bisphosphonates to patients in the absence of dual energy x-ray absorptiometry (DXA) evidence of osteoporosis or spinal fracture. “Then the risk is unacceptable and may place the prescribing practitioner at risk of a law suit for malpractice,” he said. He was commenting on a UK study published in the British Medical Journal which found that oesophageal cancer was a risk associated with the long term use of bisphosphonates. The study by Green and colleagues, which included nearly 3000 oesophageal cancer patients, found the risk of oesophageal cancer increased with 10 or more prescriptions for oral bisphosphonates, and with prescriptions over about a 5-year period. Other risks associated with long-term bisphosphonate use that have gained public attention in recent years include osteonecrosis of the jaw, atrial fibrillation, and atypical femur fractures. However the study’s authors stressed the cancer risks remained low. Associate Professor David Mountain, of Emergency Medicine in the School of Primary, Aboriginal and Rural Health Care, is QAS a new emergency department (ED) approach to managing cases of suspected myocardial infarction is cost-effective because it involves fewer medical staff. He was co-author of a report published in the Medical Journal of Australia of an Australian trial of the strategy that cut 20 minutes off door-to-balloon (DTB) time. The strategy involves ED doctors activating the cardiac catheterisation laboratory (CCL) and Quoted As Saying immediately transferring patients with suspected ST-elevation myocardial infarction (STEMI), bypassing time-consuming consultation with the cardiology team. The 2-year trial included 234 patients who underwent emergency coronary angiography for suspected STEMI at Sir Charles Gairdner Hospital. The median DTB time for patients who subsequently required percutaneous coronary intervention (PCI) was cut from 97 to 77 minutes. The proportion of patients treated within the recommended DTB time of less than 90 minutes almost doubled, from 41% to 77%, and there was no change in false-positive CCL activation rates. Associate Professor Mountain said that since the trial ended in 2009, DTB time had been cut by a further 10-15 minutes. Clinical Professor Graeme Hankey, of the School of Medicine and Pharmacology, is QAS when assessing patients with migraine with aura for cardiovascular risk, the assessment should be based on their age, sex, blood pressure, cholesterol, blood sugar, smoking status, family history and history of migraine with aura. If their risk was more than 15% in the next 5 years, or 3% per year, they should aim to lower their risk by stopping smoking and reducing blood pressure and cholesterol, and antiplatelet therapy should be considered, he said. He was commenting on two articles published in the BMJ linking migraine with aura to an increase in the risk of cardiovascular and all-cause mortality. In a 26-year follow-up study of over 18 000 middle-aged men and women, Icelandic researchers found that, for people who had migraine with aura (compared with people with no headache), the relative risk of dying from all causes increased by 21%, and from cardiovascular disease by 27%. But the 10-year absolute risk was considered low. The risk was not increased for those with migraine without aura. A second migraine study, involving 27 860 women older than 45 years, found the risk of haemorrhagic stroke more than doubled among women who had migraine with aura compared with women with no history of migraine. However, the authors cautioned against definitive conclusions about the association in view of the low number of haemorrhagic strokes (85 overall, with only nine among women with migraine with aura) and the relatively low attributable risk. Winthrop Professor John Olynyk, of the School of Medicine and Pharmacology, is QAS the increasing evidence of an association between liver cancer and non-alcoholic fatty liver disease (NAFLD) is another reason to not get fat and focus on preventing obesity in children. He was commenting on an article in Gut, which said that the rapidly increasing prevalence of obesity and diabetes in affluent societies, and their significance in the pathophysiology of NAFLD, would result in a rising incidence of NAFLD and its complications — including hepatocellular cancer— in the mid-term future. Professor Olynyk said modifiable risk factors where present should be addressed, including weight reduction and exercise for NAFLD and NASH, treatment of viral hepatitis, reduction of alcohol, improvement in nutrition and treatment of hereditary haemochromatosis. MeDeFacts September 2010 The University of Western Australia
From gestetner to webcam – 30 years with the Faculty Denis Brown started his liaison with the School of Psychiatry and Clinical Neurosciences three decades ago when the sturdy Gestetner copying machines were still in vogue. He is now their IT and electronics expert, improviser and troubleshooter, using the latest in technology. He began at the Biomedical Engineering Department of Sir Charles Gairdner Hospital in 1978. Two years later, he was seconded to the Department of Psychiatry, where he has remained for the past 30 years. “It was originally supposed to be a one year secondment,” he says with a laugh. “Our greatest technology, apart from the Gestetner machine, would have been the Devices M19 physiological rack, a polygraph machine.” Mr Brown helped devise sensors for studies in areas such as sleep and male impotence and equipment for other electrophysiological studies. “My task was to create the equipment because in those days you couldn’t buy it or if you could buy some of it, it was cripplingly expensive,” he explains. His invaluable training, straight from school in 1968, was as an apprentice in a small local radio and electrical hardware store. He then was then head-hunted by Albert Berkavicius of Alberts HiFi to work in the electronics area. The young apprentice was exposed to colour TV before it even hit the streets. “Albert designed, built and ran the colour closed circuit television at the Ascot and Belmont racecourses,” Mr Brown says. “He was definitely ahead of his time.” Later Mr Brown was sent overseas to help set up and maintain an airborne geophysics system. “It was basically flying aircraft at embarrassingly low levels above the ground looking for magnetic and radioactive anomalies,” he explains. “Basically, it was X marks the spot, dig here folks.” On his return, he was offered the job at Sir Charles Gairdner Hospital and has been involved with the hospital ever since although he also provides relief service for various other Schools. Winthrop Professor Sasha Janca, who is Head of the School of Psychiatry and Clinical Neurosciences, says Mr Brown is the only person whose face has appeared on almost all Departmental and School staff photographs. “Over the years, the IT technology has changed a lot and so has the staff of the School and their research interest and projects,” Professor Denis Brown Janca says. “Somehow, it is only Denis who remained the same, albeit a bit older and greyer, always willing to help and support us in all our professional endeavours.” Mr Brown’s work as senior technician spans the metropolitan area because the School has a big presence at Sir Charles Gairdner, Royal Perth and Fremantle Hospitals and, to a lesser extent at the outer urban clinical schools at Osborne Park, Bentley and Joondalup hospitals. He is the trouble-shooter if staff have problems with anything concerned with computers, IT, electronics and data from imaging, including magnetic resonance imaging, CT scans or Positron Emission Tomography scans. “The trickiest problems are those posed not by the hardware or even the human interaction but those caused by our physical outreach,… finding out with whom to liaise and establishing a rapport,” he says. “We work with the Health Department, Department of Justice, Australian Bureau of Statistics, you name it.” Mr Brown also takes part in software testing. “Many years ago, for example, I helped test a new brand of anti-viral software,” he said. One of his current projects that excites him is developing a system to link students undertaking tutorials on various campuses via webcam and laptops, creating one “virtual tutorial room” so that clever questions and answers can be shared. He also writes software in a variety of areas, including imaging and specialised software to convert data from one form to another. The graphing of survey results using various programs is another forte. “While I don’t pretend that this is unique, I think the likelihood is that these tasks are not accepted as the norm by IT people generally these days,” he said. “However without that capability, my colleagues in Psychiatry may be less able to effectively express their results or work as efficiently.” assessing respiratory risk before childhood surgery A WA paediatric anaesthetist has achieved two major career milestones within weeks of one another. Winthrop Professor Britta Regli-von Ungern-Sternberg was appointed the inaugural Woolworths Chair in Paediatric Anaesthesiology in the Faculty. Shortly after, a study in Winthrop Professor Britta Regli-von Ungern-Sternberg which she was lead author appeared in the prestigious medical journal, The Lancet. The researchers found that a risk assessment questionnaire could be used in everyday clinical practice to identify the likelihood of anaesthetic complications in children before they underwent surgery. Respiratory adverse events are one of the main causes of complications and death during anaesthesia in children. The researchers identified risk factors for perioperative respiratory adverse events in 9,297 children given general anaesthesia for surgical or medical interventions at the Princess Margaret Hospital for Children between February 2007 and January 2008. They also assessed the anaesthetic management to identify prevention strategies for respiratory complications. A positive respiratory history (recent cold, wheezing during exercise, wheezing more than three times in the past 12 months, nocturnal dry cough, and eczema), present or recent upper respiratory tract infection, a history of asthma, atopy, smoking, rhinitis, or eczema in at least two family members, were associated with increased risk of respiratory adverse events, including the potentially life threatening complications bronchospasm and laryngospasm. The risk was higher when children were exposed to maternal smoking or both parents smoking than when only the father smoked. Professor Regli-von Ungern-Sternberg, who works in the School of Medicine and Pharmacology and at PMH, said the questionnaire could be used at the preanaesthetic assessment to identify children at high risk of respiratory complications who would then benefit from specifically targeted anaesthesia management. The University of Western Australia MeDeFacts September 2010 15
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Page 3 and 4: the dean’s desk Whither our inter
Page 5 and 6: linked by a love of research Winthr
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Page 9 and 10: Fellowship winner chooses public he
Page 11 and 12: taking research a degree further St
Page 13: Claremont worse,” Dr Martyr says.

MeDeFacts September 2010 - The University of Western Australia

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