2006 Annual Report - Department of Medicine
Transcription
2006 Annual Report - Department of Medicine
2006 Annual Report Department of Medicine (Royal Melbourne Hospital / Western Hospital) > Striving for Excellence in Medical Education and Research... ...from the interface of basic science and clinical medicine, through novel approaches to research, through the training of high-quality undergraduate, Honours and postgraduate students, and through leadership in the provision of outstanding evidence-based teaching and clinical practice. >> Welcome Heading The Department of Medicine (RMH/WH) aims to: Contact • provide a unique mix of research and clinical capabilities in a clinical department of a research-led university. 4th Floor, Clinical Sciences Building Parkville, Vic. 3050 AUSTRALIA • conduct innovative disease-oriented and patient-oriented research, and to test the relevance of findings for improved care of patients. T: +61 3 8344 6252 F: +61 3 9347 1863 • provide leadership and role models for high-quality clinical teaching in the Bachelor of Medicine, Bachelor of Surgery program. • train Honours and postgraduate students to think critically and to equip them with excellent organisational and problem-solving skills. • interpret and disseminate research findings to the scientific and general communities. • provide leadership in collaboration and cooperation between the Department of Medicine (RMH/WH) and its host hospitals and their staff, other research institutions both nationally and internationally, and partners in industry. • ensure a well-equipped, safe and supportive working environment for staff and students that stimulates creativity and novel approaches to problem solving. • facilitate timely and relevant professional development opportunities for all staff. Cover photographs (clockwise from left): Dr Philippe Boeuf and Alex Umbers, Dr Nigel Jones and Dr Stefanie Dedeurwaerdere (background), Dr Damian Myers. The Royal Melbourne Hospital: E: [email protected] W: http://www.medrmhwh.unimelb.edu.au Western Hospital: Cnr Eleanor and Marion Streets Footscray, Vic. 3011 AUSTRALIA T: +61 3 8345 6252 F: +61 3 9318 1157 E: [email protected] W: http://www.medrmhwh.unimelb.edu.au © Department of Medicine (RMH/WH) 2007 Head of Department's Report Awards Visitors Education Postgraduate Program AMS Projects 2006-07 Honours Projects 2006 The Richard Larkins Prize RMH/WH Clinical School Report Research and Knowledge Transfer Arthritis and Inflammation Research Area Cooperative Research Centre fo Chronic Inflammatory Disease Lung Disease Research Malaria Research International and Immigrant Health Research Genetics Research Hepatitis Molecular Virology Research and Travel Medicine Service > Contents 4 6 8 9 9 11 11 12 12 13 13 15 18 20 23 25 26 01 Centre for Clinical Research Excellence in Infectious Diseases Bone and Mineral Research Epilepsy and Neuropharmacology Research Centre for Rheumatic Diseases Rheumatology Research Endocrinology Research, Western Hospital Gastrointestinal Cancer Research, Western Hospital Gastric Cancer Research 28 35 39 41 47 48 50 52 Research: Honorary Fellows 54 Department Activities 59 59 60 61 63 Environment, Health and Safety DoMSA Report Department Seminar Series Celebrating 50 Years Staff and Students Research Staff Administrative Staff CRC-CID Administrative Staff Honorary Appointments Students 64 64 64 65 65 65 Publications 2006 66 http://www.medrmhwh.unimelb.edu.au/ Department of Medicine (RMH/WH) Annual Report 2006 Research Cont'd < Professor Graham Brown James Stewart Professor of Medicine Head, Department of Medicine (RMH/WH)) Head of Department's Report It is a great pleasure to be able to report on the numerous activities undertaken during 2006 in the Department of Medicine (RMH/WH). This report describes some of the efforts of the large number of individuals and the groups who contribute to research and teaching of clinical medicine and biomedical research in our Department, and the wide range of collaborations we have with colleagues outside the Department. We are very fortunate to have excellent relationships with the Royal Melbourne Hospital and Western Hospital where our work is based. Hospitals also provide the environment for academic activities of many Fellows of the Department who play such a critical role in all aspects of our work. Fellows of the Department offer excellent programs in neurosciences, oncology, gastroenterology, cardiology and most of the clinical disciplines represented in our Hospital. The Melbourne Model of Education At the University of Melbourne, 2006 will be remembered as the year of planning for implementation of the first stage of the Melbourne Model of education that is part of a new strategy that sets three priorities for the University - a continuing focus on research, learning and teaching and an expanded commitment to knowledge transfer. The change is symbolised by a "triple helix" in which the three strands of research, learning and teaching and knowledge transfer are closely bound, each reinforcing the other. Under the leadership of the Vice Chancellor, Professor Glyn Davis, the Melbourne Model will mean a radical departure from the University's current model of curriculum delivery. A large number of undergraduate specialist degrees will be removed and replaced by seven general undergraduate degrees that will lead to graduate programs in a range of disciplines. Many students of the Faculty of Medicine, Dentistry and Health Sciences will first complete a Bachelor of Biomedicine degree over three years, to be followed by professional courses in graduate schools leading to postgraduate qualifications, in such disciplines as Medicine, Dentistry or Physiotherapy. Students can also opt instead to > follow their undergraduate degree with a Masters, Honours or PhD program. The change to the postgraduate programs of education will alter the mix of students undertaking our courses and with the drive to privatisation of Australian higher education, we need to ensure equity of access to our programs. Many Faculty members have been involved in the Curriculum Commission to design the new undergraduate courses that will begin in 2008. The new courses have breadth and depth, and we are delighted that the department’s suggestion for a core subject bringing together the spectrum of biomedicine. From Molecule to Malady has been accepted as a capstone core subject for the Program. Campus clusters for greater collaboration The Faculty is also seeking greater collaboration and synergy with other University Departments on campuses such as the Royal Melbourne and Western Hospitals through the formation of clusters of academic activity. As the activities in research, education and knowledge transfer associated with Western Health grow, they will be better served by independence from the Royal Melbourne Hospital. The Victorian State Government is committed to re-development of Sunshine Hospital and a new biomedical cluster will develop in a purpose designed building for teaching, training and research on the Sunshine campus to replace facilities at Western Hospital. Research Quality Framework Another critical area for the University is the proposed change to the way in which funding is allocated for research infrastructure. Under a new framework proposed by the Federal Government, support will be allocated in different ways, but we are yet to understand the fine details of these proposals. In other countries, these changes have lead to increased focus on selected areas of excellence, a consequence that creates challenges for clinical Our role in medical education The Royal Melbourne Hospital/Western Hospital Clinical School for undergraduate medical students is organisationally separate from the Department but we are key partners in the shared goal of ensuring the best education experience for our medical students. The head of the Clinical School, Associate Professor Geoff McColl plays an extremely important role in managing this program and the results have been outstanding. We acknowledge the enormous contribution of Departmental Fellows and others who assisted in the design of the current curriculum and can now see the successful outcomes for the graduates of this program. We recognise that there may be considerable call on the time of all our colleagues as the University changes to the Melbourne Model with the requirement to develop a new four year postgraduate course to begin in 2011. The Department continues to host interactive sessions for undergraduates and postgraduates in the context of a learning organisation for continuing education and the practice of medicine. New Professors We are absolutely delighted that Professor Edward Janus has joined the Department at Western Hospital and Professor Ingrid Winship has been appointed as the first Professor of Adult Genetics at the University of Melbourne with her placement at the Royal Melbourne Hospital. In her other role as Director of Research at Melbourne Health, she makes an enormous contribution to the intellectual life on the Royal Melbourne Hospital Campus. We are also delighted that long-serving academic staff Andy Giraud, Gary Anderson and Stephen Jane have been promoted to full Professors within the University of Melbourne. Research successes Our research retains the same major themes with groups devoted to arthritis, inflammation, infectious diseases, gastroenterology, bone disease, epilepsy and neuropharmacology. Our scientists have had continued success in attracting competitive research grants and this will be recognised as one component of assessment of our research output described above. It is a testament to our research strengths that we are associated with 12 new NH&MRC Project or Program Grants. Continuity of funding is a critical factor in team building and increased research output. In particular, I would like to congratulate Dr Louise Judd who was appointed a CR Roper Fellow in the Faculty of Medicine, Dentistry and Health Sciences. I would also like to congratulate Mark Rosenthal and Jeff Szer who have been appointed to positions as Professor/Directors in their roles as Head of Oncology and Clinical Haematology respectively following a redesign of cancer services at Melbourne Health. Readers should note that publications by staff and fellows listed in this report may have arisen from research performed as part of their roles as members of other organisations. Partnerships with our host Hospitals, Royal Melbourne Hospital and Western Hospital are extremely important to us. I wish to thank Michael McCambridge, Sue Ralph and their infrastructure support teams as well as Professor Ingrid Winship, Dr Gad Trevaks, Dr Angela Watt, Ms Michelle Clemson, and teams in the RMH Research Directorate for their support. Members of the Department contribute to the Committee work of the Research Directorate and I acknowledge the excellent work of the Human Ethics Research Committee, headed by Professor Peter Colman, a departmental Fellow, and the leadership of the Animal Ethics Committee by the Chair, Professor Colin Chapman. In particular we thank the Animal Ethics Committee for their work over a number of years as the Research Directorate has made a decision to bring this Committee to an end. The Department will now submit projects to an Animal Ethics Committee within the University of Melbourne. At Western Hospital, I would particularly like to thank the Chief Medical Officer, Dr Arlene Wake, the Chief Executive Officer, Mr Jon Evans and Ms Denner from Infrastructure for their help in achieving the renovations that have been so important in the past year. We are very pleased to continue our interaction with Western Health to assist in the development of the new medical facility at Sunshine Campus. This will be an excellent opportunity to plan a superb new centre for the cluster of activities that will become a University biomedical precinct in association with the University of Melbourne at that campus. Professor's Report Once again, our research and teaching have been of the highest quality and our staff members have made great contributions to knowledge transfer, the third strand of the University's triple helix. These are represented in many of the projects described in this report. Continuing Partnerships 2006, a successful year for the Department of Medicine (RMH/WH) The success of the Department in 2006 has been the result of hard work from many people, but in particular I wish to thank the administrative and technical support staff under the leadership of Mr Nick Christopher who as Departmental Manager is responsible for the smooth running of education and research activities. Ms Lorraine Parker and Ms Lynette Kalms once again performed wonderfully well in ensuring that we met the requirements for SafetyMAP and continue to do so. We have been well supported by Mr Tim Byrne and Mr Paul Masendycz during absence of some of these individuals. We congratulate Ms Jenny Davis and her team for the smooth move to a new facility in the Dental Hospital. The Department at both campuses has been greatly improved with infrastructure. Renovations have taken place at the Western and Royal Melbourne Hospital for better facilities for our research and teaching including the installation of airconditioning. All staff deserve congratulations for meeting our responsibilities under SafetyMAP and the Environmental Health Programs and I am grateful for the work of so many people in achieving these aims. Our IT Managers, Ms Gina Barri-Rewell and Ms Ann McIntyre have once again provided superb support for the increasing number of staff and students within our Department and we also wish to thank Mr Bruce Elmer and Ms Lana Makarov from Human Resources who have assisted in our staff employment and development activities. We thank Mr Dominic DeNardo for his work as President of the Students’ Association and encourage them in their activities to welcome newcomers to the Department. I acknowledge Professor Peter Ebeling for his work as Research Higher Degrees Coordinator while Dr Sharon van Doornum was on leave, and thank Dr Alex Boussioutas for taking on this role for next year. Department of Medicine Annual Report 2006 departments that aim to provide breadth in research-led teaching across the majority of disciplines. http://www.medrmhwh.unimelb.edu.au/ Dr Megan Brooks should be congratulated for the role she plays for the Department in managing the activities of the Centre for Clinical Research in Infectious Diseases, including an excellent Annual Symposium and report to our Scientific Advisory Committee. A straightforward list of events and outputs does not do justice to all those who contributed to our success or our sense of community. Special thanks go to those who recognised meetings, morning teas, Cup Day fun, bake-offs and charity fundraising events. Awards and Achievements Staff and Honorary Fellows Dr Ilana Ackerman Postdoctoral Travel Grant, CASS Foundation Professor Gary Anderson In concluding, I would like to pay special tribute to my colleagues in the department executive who set the standards and create momentum for a learning organisation, my executive assistant, Heather Saunders for her contribution to the department over so many years, and Kate Hannah for preparing the Annual Report and upgrading our website: www.medrmhwh.unimellb.edu.au Research Medal, Thoracic Society of Australia and New Zealand Dr Alex Boussioutas Grant-in Aid (Astrazeneca) for travel to Cambridge, UK, Gastroenterology Society of Australia Dr Felix Clanchy Australasian Post Doctoral Fellowship in Translational Research, Kennedy Institute of Rheumatology, London Dr Sharon van Doornum Australian Rheumatology Association/Barbara Cameron Fellowship Associate Professor Andrew Grigg Robert Pitney Travelling Fellowship, Haematology Society of ANZ Dr Louise Judd C.R. Roper Fellow, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne Professor Yean Lim Gary Roubin Life Achievement Award, 2nd APIA Conference Associate Professor Terence O’Brien Dreifuss-Penry Epilepsy Award, American Academy of Neurology Dr Richard Osborne Solander Fellowship, Lund University’s Department of Orthopaedics, Sweden BJD Scholarship, Bone and Joint Scientific Committee for Awards Allied Health prize, Melbourne Health Medical Research Week. Melbourne Health Population Health Career Development Award Fellowship, National Health and Medical Research Council Dr Caroline Marshall Siew Min Gan National Health and Medical Research Council Medical PostGraduate Scholarship Anastasia Hutchinson Victor Hurley Award, Royal Melbourne Hospital Dr Chris Lemoh Victor Hurley Award, Royal Melbourne Hospital Rink-Jan Lohman Best Poster Award, Epilepsy Society of Australia Meeting Awards Sandra Nolte Victor Hurley Award, Royal Melbourne Hospital Sylvia and Charles Viertel Clinical Investigatorship Professor Ingrid Winship David Danks Oration Dr Raju Yerra Warren Holmes Fellowship, The Royal Melbourne Hospital Neuroscience Foundation Adrian Achuthan Endeavour Fellowship, Department of Education, Science and Training Best Abstract, Australian Disease Management Association (ADMA), 2nd Annual National Disease Management Conference, Melbourne Sophie Adams Epilepsy Society of Australia Annual Scientific Meeting, Scientific Achievement Award New Investigator Award, Best Oral Presentation, International Society for Quality of Life Research (ISOQOL), Lisbon, Portugal Gaurav Kumar Regional Award (Onshore), RMIT Research Awards Sandra Petty James Lance Young Investigator Award (Best Poster), Australian and New Zealand Association of Neurology Louise Rose Victor Hurley Award, Royal Melbourne Hospital Evelyn Tsantikos Richard Larkins Prize, Department of Medicine (RMH/WH) Thao Nguyen Dora Lush Postgraduate Scholarship, National Health and Medical Research Council Thomas Zheng Scientific Merit Award, Epilepsy Society of Australia Meeting Young Investigator Award, American Epilepsy Society Meegan Howlett Early Investigators Forum Award, Best Oral Presentation, Western Health Research Expo, Western Hospital, Footscray Department of Medicine Annual Report 2006 Students http://www.medrmhwh.unimelb.edu.au/ Visitors Ashild Bjornerem, has been a visiting specialist in gaenacology and obstetrics from Tromsø, Norway with the Genes and Environment in Common Diseases laboratory. Ashlid researched the potential hormonal mechanisms in the effects of smoking on bone health. Associate Professor R. Edward Hogan, from the University of St. Louis, USA visited the Epilepsy and Neuropharmacology group for two weeks to facilitate collaborative studies using high resolution structural mapping of hippocampal structure on MRI in patients and animal models of epilepsy. Professor Hogan is an international expert in neuroimaging and epilepsy. Jeanine Brok, a masters student from Radboud University Nijmegen, The Netherlands visited the Gastric Cancer Research laboratory at Western Hospital for six months. She completed a project looking at the expression of candidate markers of gastric cancer progression and has now successfully completed her Masters of Biomedical Science at Radboud University. Professor Paul Dieppe, Director of MRC Health Services Research Collaboration at the University of Bristol, UK visited the Centre for Rheumatic Diseases in April 2006. The visit was sponsored by the Victorian Department of Human Services and the Commonwealth Department of Health and Ageing. Professor Peter Fayers, Professor of Medical Statistics in the Department of Public Health at the University of Aberdeen Medical School in Scotland, visited the Centre for Rheumatic Diseases in August 2006. Sten Libregts from the Netherlands spent four months towards his Masters studies working with Dr Cook in the Arthritis and Inflammation Research Centre. Ms Kanuengnuch (Nuch) Muenphon was a visiting PhD student from Royal Golden Jubilee Program in Thailand. Nuch was supervised by Professor Andy Giraud and began her six month visit in September 2006. Based at the Western Hospital, she studied molecular mechanisms of cancer biology and the development of new cancer therapeutic strategies, particularly as it relates to cholangiocarcinoma. Dr Rintis Noviyanti, a scientist from the Eijkman Institute for Molecular Biology in Jakarta was supported by Aus Aid to spend five weeks with Dr Michael Duffy and Associate Professor Stephen Rogerson. She continues her studies investigating pregnancy associated malaria and examining diagnosis and prevention strategies. She will return in 2007 for six months to undertake further post doctoral studies. Dr Tim Von Oertzen, St. Georges Hospital, London, UK visited the Epilepsy and Neuropharmacology group for two weeks to facilitate collaborative studies of SPECT imaging in patients with medically refractory epilepsy. Dr Oertzen is an international expert in epilepsy and functional imaging. Dr Tran Quang Phuc was a visiting scientist from the Vietnam National Institute of Malariology, Parasitology and Entomology in Hanoi. Dr. Phuc spent one week with Associate Professor Bev Biggs and Mr Gerard Casey working on statistical analysis of data and in discussions with project staff and consultants as part of the ongoing collaboration with NIMPE for strengthening research capacity and control of parasitic diseases in Vietnam. Dr Cleo (Cleofé) Romagosa is a clinical pathologist and PhD student from the Centre for International Health at the University of Barcelona. She spent six months in the Malaria Laboratory, learning laboratory techniques including molecular analysis of parasite gene expression and assays of immune response to malaria-infected cells. She also contributed her pathology expertise to Dr Boeuf’s studies on the role of hypoxia in placental malaria. Marie Strandlund was a visiting student for four months from the University of Gothenburg in Sweden. She completed a Masters Thesis on lung lesions in a mouse model of gastric cancer at Western Hospital. Her work here will contribute to a Master of Science In Pharmacy. Ms Anna Tostevin and Ms Lucy Vivash, Masters of Neuroscience Students, Nottingham, UK. Each visted for a year to work on projects related to 'Benzodiazepine receptor mapping in-vitro and in-vivo serially during epileptogenesis in animal models of epilepsy.' Doctor of Philosophy The Department of Medicine at Royal Melbourne and Western Hospitals offers PhD programs to suitably qualified Science (with Honours) and medical graduates. We offer a wide variety of biomedical research ranging from molecular biology to clinical epidemiological research. PhD projects are also undertaken in affiliated research units working on such diverse areas as critical care and rehabilitation medicine. Grant Peck ‘Molecular interactions with insulin regulated aminopeptidase’ In 2006 there were 49 PhD students actively enrolled with the Department. Our students are supported by 13 senior academic staff members and 20 post-doctoral fellows, as well as a large number of academic associates. Our location close to on-campus departments and neighboring institutes allows us to offer collaborative projects and students have the opportunity of attending seminar programs. Postgraduate Coordinators (MD and PhD): Dr Sharon Van Doornum ([email protected])/ Professor Peter Ebeling Doctor of Medicine (MD) The Department offers the degree of Doctor of Medicine to medical graduates as either a supervised research program or via non-attending candidature. The research program is a two-year full-time or four to five year part-time course undertaken in a relevant field of research and a thesis is submitted at the end of the supervised period of research. Non-attending candidature of six months is available to University of Melbourne medical graduates who have already completed their research and wish to prepare a compilation of published work to be used as a basis for the award of the degree. Approval to enrol as a non-attending student is only for the purpose of preparing the compilation of published work with the assistance of an approved advisor. Master of Medicine (MMed) The Department offers a Master of Medicine (Internal Medicine) course for overseas students. This is a two-year course, the first year consisting of a lecture or tutorial program combined with clinical attachments and with a written examination at the end of the year. The second year consists of a further clinical attachment in the area of subspecialty interest chosen by the student, combined with a research dissertation. Clinical attachments can be arranged in the following areas: Dermatology; Endocrinology and Diabetes; Gastroenterology; Haematology; Immunology / Allergy; Infectious Diseases; Intensive Care; Nephrology; Neurology; Oncology; Respiratory Medicine; Rheumatology. Completed Programs Masters of Medicine (MMed) Anna Braue, ‘Molluscum contagiosum virus: swimming pool flotation aids as a mode of transmission’ Doctor of Philosophy (PhD) Louise Allport, ‘Disordered physiological parameters in acute ischaemic stroke: a study of hyperglycaemia and haematological variables’ Felix Clanchy, ‘Properties of macrophage-lineage precursors’ Christopher MacIsaac, ‘Superantigens and the innate immune response in human sepsis’ Rosemary Masterson, ‘Endogenous and pharmacological antagonists of renal fibroblast function’ Gabriela Minigo, ‘Modulation of immunity by malaria parasites - implications for vaccine development’ Paul Wraight ‘Improving clinical outcomes for patients with diabetes-related foot complications’ Doctor of Medicine (MD) Monica Slavin, 'Prevention of infection in patients undergoing treatment of haematological malignancies' Education Postgraduate Program Rajna Ogrin/Rimac, ‘The use of low frequency transcutaneous electrical nerve stimulation to improve wound healing and sensory nerve function’ (MMed): A/Professor Geoff McColl ([email protected]) The 2007 Coordinator is Dr Alex Boussioutas ([email protected]). Current Programs PhD Students, Topics and Supervisors Adrian Achuthan, 'Molecular regulation of macrophage proliferation and activation', (Supervisors: Glen Scholz and Matthew Sweet) Christen Barras, 'Imaging based prediction in the evolution and prognosis of stroke', (Supervisors: Stephen Davis and Brian Tress) Lucy Busija, 'The avoidable burden due to arthritis in Australia', (Supervisors: Richard Osborne and Rachelle Buchbinder) Dr Sabina Ciciriello, 'Multi-media education provision to people recently diagnosed with rheumatoid arthritis', (Supervisiors: Ian Wicks, Rachelle Buchbinder [Monash], Richard Osborne) Margaret Chang, 'Monocyte/macrophage gene regulation in atherosclerosis', (Supervisors: John Hamilton and Caryn Elsegood) Ben Cowie, 'The seroprevalence, molecular characterisation and mathematical modelling of hepatitis B virus infection in Australia', (Supervisors: Heath Kelly and Graham Brown) Dominic De Nardo, 'Molecular dissection of the regulation of macrophage activation by Toll-like receptors' (Supervisors: Glen Scholz and John Hamilton) Hang Dinh, 'Analysis of gene expression in macrophage differentiation', (Supervisors: John Hamilton and Glen Scholz) Natalie El Haber, 'Genetic and environmental determinants of gait/balance in adult female twins' (Supervisors: John Wark and Keith Hill) Karen Fang, 'Mechanisms of sex dimorphism in heart disease', (Supervisor: Yean Leng Lim) GaoQian Feng, 'Effects of antibodies to pregnancy associated variant surface antigens of P.falciparum and HIV infection in intrauterine growth retardation' (Supervisor: Stephen Rogerson) Andrew Fleetwood, 'Macrophage subpopulations in inflammation', (Supervisors: Andrew Cook and John Hamilton) Theo Gouskos, 'Mutations in the overlapping reading frames of hepatitis B virus producing altered virus antigenicity and replication', (Supervisors: Graham Brown and Joe Torresi) Department of Medicine Annual Report 2006 Education http://www.medrmhwh.unimelb.edu.au/ Haris Haqqani, 'Mechanisms of ventricular arrhythmias in cardiomyopathy', (Supervisors: Jonathan Kalman and Joseph Morton) Kurt Roberts-Thomson, 'Electrical and structural remodelling of the atrium in atrial arrhythmias', (Supervisors: Jonathan Kalman and Prash Sanders) Meegan Howlett, 'Regulation of gastric cancer development and metastasis by cytokines that signal through GP130', (Supervisors: Andrew Giraud and Louise Judd) Rebecca Rose, 'Warning Readiness Assessment in the Australian Intensive Care Setting', (Supervisors: Jack Cade and Jeff Presneil) Anastasia Hutchinson, 'Self-management strategy, microbial infection patterns and biomarkers in patients with exacerbations of COPD', (Supervisors: Jim Black, Gary Anderson and Lou Irving) Jessica Salmon, 'Functional significance of the interaction between the T-cell oncoproteins SCL and LMO-2 in T cell leukaemia', (Supervisors: Stephen Jane and David Curtis) Cameron Jackson, 'Implications for gastric cancer initiation and development of dysregulation of IL-6 family cytokine signaling pathways', (Supervisors: Andrew Giraud and Louise Judd) Bianca Jupp, 'PET hypometablism and MRI perfusion changes in a rat kindling model of mesial temporal epilepsy', (Supervisors: Terry O'Brien, Simon Foote and Sandra Rees) Gaurav Kumar, 'Stress, Limbic Epileptogenesis, Affective and Cognitive Disturbances', (Supervisors: Terry O'Brien and Margaret Morris) Roya Lari, 'The development of the macrophage lineage', (Supervisor: John Hamilton) 10 Murray Leikis, 'Effects of anaemia and erythro on kidney and muscle function in acute and chronic renal failure', (Supervisors: Lawrence McMahon and Michael McKenna) Christopher Lemoh, 'HIV/AIDS in Victoria's African communities: reducing risk and improving care', (Supervisor: Beverley Ann Biggs) Michael Lian, 'Vascular pathology in chronic kidney disease', (Supervisors: Gavin Becker and Tim Hewitson) Rink-Jan Lohman, 'Role of PAR2 in brain of rats and epileptogenesis', (Supervisors: Tom Cocks and Terry O'Brien) Emily Mann, 'Assessment of the immune response to malaria during pregnancy' (Supervisors: Stephen Rogerson, Graham Brown and Anthony Hodder) Christine Massa, 'The role of the plasminogen activators (PA)-urokinase PA and tissue type PA in inflammatory arthritis', (Supervisors: Andrew Cook and John Hamilton) Caroline Ng, 'Hyperpolarisation-activated Cyclic NucleotideGated channels in models of temporal lobe epilepsy', (Supervisors: Terry O'Brien and Christopher Reid) Sandra Nolte, 'Outcomes evaluation of chronic disease education programs' (Supervisiors: Gerald Elsworth [RMIT], Richard Osborne, Andrew Sinclair [Deakin University] Anja Scholzen, 'Direct and indirect effects of the malaria parasite on the human immune system', (Supervisors: Magda Plebanski and Stephen Rogerson) Susan Senn, 'Pharmacogenomics: mechanisms underlying valproate associated weight changes', (Supervisors: Terry O'Brien and Sof Andrikopoulos) Sue Skull, 'A case-cohort study: Impact of influenza and pneumococcal vaccination on hospital admissions due to community acquired pneumonia among persons aged 65 years or older', (Supervisors: Terry Nolan, Graham Byrnes and Graham Brown) Kean Soon, 'Role of 16-slice computerized tomography in the evaluation of coronary disease and revascularization procedures', (Supervisors: Yean Leng Lim and Anne Maree Kelly) Irene Stevenson, 'Mechanisms of atrial fibrillation', (Supervisors: Jonathan Kalman and Harry Teichtahl) Rosemary Sutton, 'Identification and characterisation of novel factors that regulate erythroipoiesis and fetal globin gene expression', (Supervisor: Stephen Jane) Tawan Thammanichanond, 'TARC and MDC expression in chronic allograft rejection’ (Supervisors: Jim McCluskey and Joe Torresi) Anita Vinton, 'The relationship of the focal EEG changes seen on PET imaging in temporal lobe epilepsy to the underlying EEG activity and post surgical outcome', (Supervisors: Terry O'Brien, Rodney Hicks and Patricia Desmond) Paul Vinton, 'An evaluation of the potential for new technology to contribute to improving tuberculosis control', (Supervisors: Bev Biggs and Paul Johnson) David Wang, 'Pathogenesis of sleep disordered breathing in stable methadone program patients' (Supervisors: Neville Yeomans and Dr H Teichtahl) Nhu-Y Nguyen, 'The role of WNT signalling in hematopoetic development', (Supervisors: Stephen Jane and David Curtin) Leon Worth, 'Clinical surveillance and risk factors predictive of catheter-related bloodstream infection in patients with haematological malignancy', (Supervisors: Jim Black, Graham Brown and Monica Slavin) Tony Peterson, 'Molecular markers defining precursor phenotypes in gastric cancer' (Supervisors: Andrew Giraud and Louise Judd) Laura Zamurs, 'Molecular regulaton of migration in normal and neoplastic colonic cells' (Supervisors: Edouard Nice and Peter Gibson) Sandra Petty, 'The effect of anti-epileptic medications on bone dentisy, body composition and fracture risk' (Supervisors: John Wark, Terry O'Brien and Keith Hill) Thomas Zheng, 'The neuropharmacological and neurophysiological mechanisms underlying the aggravation of seizures by anti-epileptic drugs', (Supervisors: Terry O'Brien and Margaret Morris) Jane Prosser, 'The brain-heart interface in acute stroke', (Supervisor: Stephen Davis) Irani Ratnam, 'Infection control and post-discharge surveillance of surgical site infections', (Supervisors: Joe Torresi, Jim Black and Michael Richards) Jack Richards, 'The role of antibodies to Plasmodium falciparum erythrocyte invasion ligands in protection against malaria', (Supervisors: James Beeson and Graham Brown) Yeliz Rifat, 'Analysis of a novel family of genes critical for the development of the central nervous system', (Supervisor: Stephen Jane) MD Students, Topics and Supervisors Andrew Grigg, ‘Optimising the outcome of haemopoietic stem cell transplantation’, MD (Supervisors: Geoff McColl and Jeff Szer) Sophie Treleaven, ‘Prospective surveillance of pneumonia and meningitis attributable to haemophilus influenzae type B (Hib) in Thailand’, MD (Co-Supervisors: Beverley-Anne Biggs, Terry Nolan and Mark Steinhoff) Ian Woolley, ‘Determination of Fy numbers on erthyrocytes, reticulocytes and its relevance to malaria susceptibility’, MD (Supervisor: Beverley-Anne Biggs) Lit Kim Chin, 'Evaluation of bone ultrasound in AEDassociated bone disease' (Supervisors: John Wark and Terry O’Brien) AMS Administrator: Ms Heather Saunders ([email protected]) Honours Projects 2006 Marc-James Friso, 'Immunity to malaria in pregnancy' (Supervisors: Stephen Rogerson and Graham Brown) Elizabeth Aitken, ‘Immunity to malaria in pregnancy’ (Supervisor: Stephen Rogerson) Mohd Ibrahim, 'Pushing the boundaries of Capsule Endoscopy: comparative studies with Push Endoscopy and Barium Follow Through in Patients with Peutz-Jeghers Syndrome, Juvenile Polyposis and Orofacial Granulomatosis' (Supervisor: Finlay Macrae) Nicola Ball, ‘Relative influence of uncertainty and harm components of anxiety on experimental pain perception’ (Supervisor: Stephen Gibson) Saman Kazemi Manshady, 'NPY and absence epilepsy' (Supervisors: Margaret Morris, Terry O’Brien and Nigel Jones) Julien Schulberg, 'The Use of Long-acting Inhaled beta2 Agonists in the Management of Exercise-induced Bronchoconstriction' (Supervisors: Lou Irving, Karen Holzer, Peter Brukner.) Yu-Tang Shen, 'Manganese-enhanced magnetic resonance imaging (MEMRI) in a rat model of epilepsy' (Supervisors: Stefanie Dedeurwaerdere, Gary Egan and Terry O’Brien) Shreerang Sirdesai, 'Correlation of genotpye for the 3.2 subtype of the Alpha-1 subunit of the Ca++ channel with the epileptic and anxiety phenotype in genetic absence epilepsy model' (Supervisors: Kim Powell and Terry O’Brien) Paul Tescher, 'Capsule endoscopy: expanding the indications and quality control' (Supervisor: Finlay Macrae) AMS Co-Coordinators: Associate Professor Beverley-Anne Biggs ([email protected]) James Becker, ‘Relaxin in experimental diabetic nephropathy’ (Supervisors: Tim Hewitson and Chrishan Samuel) Geraldine Cheng, ‘Lyn-deficient mice express a novel Gr-1+CD8+ T cell population that is implicated in antiviral immunity’ (Supervisors: Margaret Hibbs and Gary Anderson) Joelle Dodin, ‘Dendritic cells in malaria’ (Supervisor: Salenna Elliott) Education Daniel Bennett, 'Resistance to aspirin in stroke study' (Supervisor: Bernard Yan) Associate Professor Terry O’Brien ([email protected]) Nelly Kua, ‘Regulation of macrophage migration by cytokines’ (Supervisor: Caryn Elsegood) Nigel Kwok, ‘Is regular table tennis activity associated with 11 increased bone and muscle strength and improved balance in older Asian men and women?’ (Supervisor: John Wark) Helen Lescesen, ‘The influence of the cytokine, IL-11 on gastric pathologies’ (Supervisor: Louise Judd) Vivian Leung, ‘Mechanisms of bone loss in systemic mastocytosis’ (Supervisor: Peter Ebeling) Lainie Sutton, ‘Mossy fibre sprouting in an in vivo model of epilepsy’ (Supervisors: Terry O'Brien and Damian Myers) 2006 Honours Students L-R Evelyn Tsantikos, Geraldine Cheng, Lainie Sutton, Vivian Leung, Elizabeth Aitken, James Becker, Nelly Kua, Nigel Kwok, Joelle Dodin, Nicola Ball Absent: Helen Lescesen Department of Medicine Annual Report 2006 AMS Projects 2006-07 http://www.medrmhwh.unimelb.edu.au/ Evelyn Tsantikos, ‘The role of Tregs in the development of immune system disorders in mutant mice’ (Supervisors: Margaret Hibbs and Gary Anderson) RMH/WH Clinical School Honours Coordinators Honours Co-Coordinator: Associate Professor Gary Anderson ([email protected]) Honours Administrator: Ms Heather Saunders ([email protected]) The Richard Larkins Prize 12 Professor Richard Larkins with 2006 Larkins Prize recipient Evelyn Tsantikos The recipient of the Richard Larkins Prize for the Best BSc Honours Student in the Department of Medicine (RMH/WH) for 2006 was Evelyn Tsantikos. Professor Richard Larkins, now Vice-Chancellor of Monash University and after whom the prize is named, personally handed the award to the winner at a ceremony held in March 2007. Tsantikos' project ‘The role of Tregs in the development of immune system disorders in mutant mice’ was supervised by Professor Gary Anderson and Dr Margaret Hibbs (Ludwig Institute for Cancer Research). Professor Richard Larkins held the positions of Head of the Department of Medicine (RMH/WH) and the James Stewart Professor from 1984 to 1998, and was Dean of the Faculty of Medicine, Dentistry and Health Sciences from 1998 to 2003. The inaugural Larkins Prize was presented in 2000 for students completing the course in 1999. Previous winners of the award are listed below. 1999 Amanda Notini 2000 Sonia Caruana and Sakeneh Zraika 2001 Elizabeth Bond 2002 Margaret Shaw 2003 Amy Brennan and Anthea Pappas 2004 Michael Braude and Andrew Lilja 2005 Nhu-Y Nguyen Associate Professor Geoff McColl Clinical School Dean The 2006 clinical school year began with the retirement of Dr Christine Penfold as Subdean after 23 years. Christine has been the glue that has bound the clinical school together over all of this time. She has contributed in every aspect of clinical school life and will be missed by the academic and professional staff, hospital staff and most of all the students. Christine’s contribution was celebrated at a variety of functions during the year with many accolades for her work presented at each of them. We thank her for her tireless work and wish her well for her retirement. This year was also notable for the formal opening of the new clinical school space at the RMH and the inauguration of the Richard Lovell lecture theatre. This event was attended by the Vice Chancellor of the University of Melbourne, Professor Glyn Davis and the CEO of Melbourne Health, Dr Peter Brennan among other friends of the clinical school. These new teaching spaces are already enhancing our ability to provide quality teaching. The teaching program at the RMH/WH clinical school continues to be enthusiastically received by the students and their results are a testimony to the quality of the program. Assessment results at our clinical school remain excellent with outstanding results in the Semester 12 cohort in 2006. Ongoing evaluation and revision of the current teaching program is always required but its governance is now relatively stable. There are plans for development of a separate clinical school at Western Hospital that will become part of a new cluster of academic activities with future developments at Sunshine Hospital. Research The clinical school views one of its key goals as medical education research. Work in this area includes an examination of the methods used by experienced teachers to teach clinical reasoning and the use of new technologies in teaching. In association with the Medical Education Unit and the Biomedical Multimedia Unit in the Faculty we also have collaborated on a variety of projects and in the supervision of students. This is an area targeted for expansion in 2007. Arthritis and Inflammation Research Centre Research The University of Melbourne is embarking on an ambitious plan to revise and reinvigorate tertiary training under the Growing Esteem strategic plan, beginning in 2008 with the new generation undergraduate degrees. The clinical school will be intimately involved in the development of the new graduate medical degree which will commence in 2011 as a part of these changes. As always the teaching and research outcomes of the clinical school would not be achieved without the enormous input of all our teachers, collaborators and students – we thank them all Geoff McColl Clinical Dean 13 Research Highlights The overall goal of the laboratory is to understand the functions of macrophage lineage cells in chronic inflammatory diseases, in particular rheumatoid arthritis. More specifically, macrophage lineage cells are isolated from diseased human and murine tissue and blood to assess how different they are from controls. Studies on the molecular mechanisms governing macrophage lineage survival, proliferation, differentiation and activation are being explored. Techniques utilised include cell sorting, microarray analysis and proteomics. More specific findings include: • A potential role for a Src-like adapter protein downstream of the CSF-1 (Colony Stimulating Factor -1) receptor • Identification of biochemical pathways linking macrophage cell survival and glycolysis in response to a range of pro-survival stimuli • Modulation of expression of certain "SNARE" proteins by CSFs most likely involved in controlling vesicle trafficking in macrophages • Control of osteolcastogenesis by GM-CSF and TGF • Detection and properties of an immature human peripheral blood monocyte population Department of Medicine Annual Report 2006 Head: Professor John Hamilton http://www.medrmhwh.unimelb.edu.au/ 14 • Switching of macrophage lineages from a proinflammatory to a ‘homeostatic’ phenotype Collaborations • Understanding how molecular chaperones regulate Tolllike receptor mediated macrophage activation • Defining the role of IRAKs in regulating Toll-like receptor mediated macrophage activation R. Anderson, Peter MacCallum Institute; S. Breit, University of NSW; E. Brown, UCSF; R. Buchanan, Austin Hospital; I. Cassady, University of Queensland and IMB; H.C. Cheng, Department of Biochemistry and Molecular Biology, The University of Melbourne; L. Cleland, University of Adelaide; D. Haynes, University of Adelaide; P. Hertzog, Monash; W. Hong, Institute of Molecular and Cell Biology, Singapore, D. Hume, University of Queensland and IMB; P. Gleeson, The University of Melbourne; D. James, Garvan Institute, Sydney; W. Jessup, University of NSW; T Lawrence and R. Williams, University College, London; L. Macaulay, CSIRO; A. Mansell, Monash Institute of Medical Research, Monash Medical Centre; A. Möeller and D. Bowtell, Peter MacCallum Institute; E. Reynolds, The University of Melbourne; S. van Doornum, The University of Melbourne; P. Simmons, Peter MacCallum Institute; J. Stow, University of Queensland, R. Strugnell, The University of Melbourne,; M. Sweet, University of Queensland; K. Visvanathan, Monash University; W. van den Berg, The Netherlands; A. Whetton, University of Manchester; I. Wicks, WEHI and Royal Melbourne Hospital. Publications Clanchy FI, Holloway AC, Lari R, Cameron PU, Hamilton JA. Detection and properties of the human proliferative monocyte subpopulation Journal of Leukocyte Biology 79: 757-766, 2006. Cook AD, Vlahos R, Massa CM, Braine EL, Lenzo JC, Turner AL, Way KJ, Hamilton JA. The effect of tissue typeplasminogen activator deletion and associated fibrin(ogen) deposition on macrophage localization in peritoneal inflammation. Thrombosis and Haemostasis 95:659-667, 2006. Elsegood CL, Zhuo Y, Wesolowski GA, Hamilton JA, Rodan GA, Duong LT. M-CSF induces the stable interaction of cFms with V3 integrin in osteoclasts. International Journal of Biochemistry and Cell Biology 38:1518-1529, 2006. Manes GA, Masendycz P, Nguyen T, Achuthan A, Dinh H, Hamilton JA, Scholz GM A potential role for the Src-like adapter protein SLAP-2 in signaling by the colony stimulating factor-1 receptor. FEBS Journal 273:1791-1804, 2006. Vlahos R, Bozinovski S, Hamilton JA, Anderson GP. Therapeutic potential of treating COPD by neutralising GMCSF. Pharmacology and Therapeutics (commissioned review) 112(1):106-115, 2006. Achuthan A, Elsegood C, Masendycz P, Hamilton JA, Scholz G. CpG DNA enhances macrophage cell spreading by promoting the Src-family kinase-mediated phosphorylation of paxillin. Cellular Signalling 18(12):2252-61, 2006. Chong Y, Chan A, Chan K, Williamson N, Lerner E, Smithgall T, Bjorge J, Fujita D, Purcell A, Scholz G, Mulhern T, and Cheng H C-terminal Src kinase-homologous kinase (CHK) – A unique inhibitor inactivating multiple active conformations of Src-family tyrosine kinases. Journal of Biological Chemistry. 281: 32988-99, 2006. New Grants NH&MRC Fellowship – SPRF JA Hamilton. 2006-2010, $796,250 Ongoing Grants NH&MRC Program Grant: RE O’Hehir, GP Anderson, J A Hamilton and JM Rolland, 2005–09, ‘The interface between innate and adaptive immunity in allergy and asthma’: $4,300,000 NH&MRC Development Grant: JA Hamilton, JW Schrader and GP Anderson, 2005–06, ‘Development of a highly potent, fully human anti-GM-CSF monoclonal antibody’: $398,000 NH&MRC Grant: A Cook, R Vlahos and JA Hamilton, 2004– 06, ‘The role of the plasminogen activators (PAs), urokinasePA and tissue-type PA in arthritis’: $473,250 CRC Program Grant: The University of Melbourne, University of Queensland and Monash, 2001–07, ‘CRC for Chronic Inflammatory Diseases’: $24,600,000 CRC Program Grant: The University of Melbourne, University of Queensland and Monash, 2003–08, ‘CRC for Chronic Inflammatory Diseases—Supplementary Funding’: $9,500,000 CRC Program Grant: The University of Melbourne, 2005–07, ‘CRC for Oral Health Science’, $300,000 Collaborations with: Conference and Seminar Presentations John Hamilton Invited Speaker. Inflammation Research Association, New Jersey. GM-CSF as a proinflammatory cytokine, March 2006 Department of Medicine, Monash Medical Centre, Macrophage lineage cells and chronic inflammatory diseases, June 2006 CSL Laboratories. Control of macrophage lineage numbers and phenotypes – implications for inflammation, adjuvant action and tumourigenesis, June 2006. University of Melbourne Department of Medicine (RMH/ WH) Osteoarthritis and Inflammation, August 2006. Yale-Boehringer-Ingelheim Joint Retreat, Connecticut. Control of macrophage numbers and phenotypes by colony stimulating factors. October, 2006 Glen Scholz Presentation: ‘Keeping the inflammatory response of macrophages to pathogens under control’, Department of Medicine, The University of Melbourne, March Presentation: ‘IRAKs and Toll-like receptor signalling’, Toll-like Receptor Research Network Meeting, Melbourne, May Supervision John Hamilton Hang Dinh, ‘Analysis of gene expression in macrophage differentiation’, PhD Roya Lari, ‘The development of the macrophage lineage’, PhD Alan Rembach, ‘The role of microglia in motor neuron disease’, PhD Omar Kaddour, ‘The role of inflammation in lumbar disc herniation with radiculopathy’, PhD Glen Scholz Adrian Achuthan, ‘Molecular regulation of SNARE proteins in macrophages by CSF-1’, PhD Dominic DeNardo, ‘Molecular dissection of the regulation of macrophage activation by Toll-like receptors’, PhD Thao Nguyen, ‘Irak-1 and the regulation of macrophage activation’, PhD Caryn Elsegood Margaret Chang, ‘Regulation of glucose metabolism by survival factors in macrophages’. PhD Cooperative Research Centre for Chronic Inflammatory Diseases Andrew Cook Andrew Fleetwood, ‘Macrophage subpopulations in inflammation’, PhD Christine Massa, ‘Tissue-type plasminogen activator and fibrin deposition in inflammation and arthritis’, PhD Student Completions Nelly Kua, ‘Regulation of macrophage migration by colony stimulating factor-1’, BSc(Hons) (Supervisor: Dr Caryn Elsegood) Research Professional Activities John A Hamilton Member: NH&MRC Final Report Review Group Member: Editorial Board, Inflammation Research Member: Editorial Board, Encylopedia of Inflammatory Diseases Member: Scientific Advisory Committee, Victorian Centre for Oral Health Science 15 Member: Scientific Advisory Board, Microsurgery Research Centre, St Vincent’s Hospital Board Member: International Association of Inflammation Societies Member: NH&MRC Program Grant Review Panel (co-opted) Program Leader: CRC for Chronic Inflammatory Diseases Member: IAIS Lifetime Achievement Award Panel Glen Scholz Member: Program Committee, 2006 Australian Health and Medical Research Congress Member: Royal Melbourne Hospital Institutional Biosafety Committee Deputy Chair: Program Management Committee, CRC for Chronic Inflammatory Diseases Seminar Coordinator: Department of Medicine, The University of Melbourne Ms Robyn McLachlan Chief Operations Officer Core Participants Industry: AstraZeneca Universities: The University of Melbourne Contact Details The University of Queensland Professor John A Hamilton Director, Arthritis and Inflammation Research Centre Department of Medicine (RMH/WH) The University of Melbourne 4th Floor, Clinical Sciences Building The Royal Melbourne Hospital Victoria 3050 AUSTRALIA Monash University Tel: +61 3 8344 5480; Fax: +61 3 9347 1863 Email: [email protected] Email: [email protected] Dr Glen Scholz Department of Medicine (RMH/WH) The University of Melbourne 3rd Floor, Clinical Sciences Building The Royal Melbourne Hospital Victoria 3050 AUSTRALIA Tel: +61 3 8344 3298 Fax: +61 3 9347 1863 Email: [email protected] Supporting Participants Industry: Zimmer Inc Research Focus The Cooperative Research Centre for Chronic Inflammatory Diseases (CRC–CID) is a joint venture between three universities and two major commercial organisations. Its scientists are endeavouring to understand the processes underlying serious chronic inflammatory diseases and to discover better treatments to reduce the burden of these diseases for development and marketing by its commercial partners. The objectives of the CRC–CID are to: • Discover new molecular targets involved in the pathogenesis of chronic inflammatory lung and joint disease and use this information to develop novel treatments for these disorders. • Reduce the burden of chronic inflammatory diseases. • Strengthen the Australian pharmaceutical/biotechnology sector. Department of Medicine Annual Report 2006 Chair: Education and Training Committee, CRC for Chronic Inflammatory Diseases http://www.medrmhwh.unimelb.edu.au/ • 16 Apply our established macrophage biology discovery platform to develop new methods to: • treat debilitating joint diseases by targeting the molecular processes that cause joint replacement failure, particularly in osteoarthritis (OA); and • generate synthetic tissues to repair injured joints. Chronic inflammatory diseases are a substantial burden in social and economic terms for the Australian community. Arthritis alone afflicts 3.4 million Australians and the financial costs for 2004 were in excess of $19.25 billion (Access Economics 2005). Areas of Research Expertise The CRC–CID is focused on understanding the macrophage biology of these core diseases. Macrophages (literally ‘big eaters’) are named after their important physiological role in host defence, which is to clear away cellular debris and foreign materials including infectious bacteria, fungi and viruses. Macrophages are further armed with a formidable biochemical arsenal to destroy invading pathogens with destructive proteases that break down the molecular framework of cells, and potent antioxidants that chemically burn invaders. To complement this direct attacking ability, macrophages secrete a diverse range of danger signal molecules that prime host tissue for defence and recruit waves of other defensive cells to broaden the assault. When the normal defensive role of macrophages is turned against host tissue, devastating disease states develop. Why this happens in rheumatoid arthritis (RA) and chronic obstructive pulmonary disease (COPD) is obscure. There are good reasons to believe that the same process is implicated in osteoarthritis and aseptic failure of joint implants. The CRC–CID research program has been designed to address several discrete areas of macrophage biology in Programs 1–4. Program 5 focuses on new technology platforms, for example, bioinformatics, the set of information technologies that allow complex biological data sets to be analysed, integrated and compared with the vast biological, genomic, protein and clinical databases worldwide. CRC–CID Established: 1 July 2001 Supplementary Program Established: 1 July 2003 Round No: (Supplementary Funding Round 8) Grant Period: (Supplementary Funding 5 years) 7 years Incorporated: No Personnel involved in CRC–CID: 304 Postgraduate students: 24.5 Full-time equivalent research staff: 64.3 Chair and Chief Executive Officer: Dr John Flack Research Highlights The CRC has implemented a dual research strategy for the generation of intellectual property that can be offered to its partners as targets for drug development in return for commercial rewards. The strategy is to validate targets reported in the scientific literature and to discover new targets by investigating tissue from affected individuals, our animal disease models, and our expert knowledge of macrophage biology. The CRC-CID conducted two independent Science Reviews in 2006 which helped focus and implement its strategy over its final two years until wind-up on 30th June 2008. The CRC-CID is on track to deliver at least one validated target by June 2007 and one novel piece of the CRC-CID's intellectual property. Two target validation programs were completed during the year, but neither met criteria for further assessment as anti-inflammatory drug targets. Successful elements of the validation program included the genomics and bioinformatics analyses and the demonstration of expression of RNA and protein in diseased tissue. These validation programs have shown that truly cooperative research could be achieved across the CRC, with more than a dozen scientists involved in each validation team from all three universities and AstraZeneca. New intellectual property was generated for a potential new target and four potential anti-inflammatory drug candidates derived from the literature are undergoing validation. Team leaders, members and validation programs have been established for target selection and validation. Sixteen entirely novel genes as potential new candidate targets have been prioritised. Two are surface glycoproteins, three are receptors, two are peptidases, four have other enzymatic functions and five have unknown activity. They will be expressed to confirm that the proteins are secreted in mammalian cells, and then cloned into bacterial expression plasmids for protein production. Publication Highlights (by CRC–CID Department of Medicine (RMH/WH) members) Publications in Refereed Journals Achuthan A, Elsegood C, Masendycz P, Hamilton JA, Scholz GM. CpG DNA enhances macrophage cell spreading by promoting the Src-family kinase-mediated phosphorylation of paxillin. Cell. Signal 2006; 18(12):2252-61. Chen H, Hansen MJ, Jones JE, Vlahos R, Bozinovski S, Anderson GP, Morris MJ. Cigarette smoke exposure reprograms the hypothalamic neuropeptide Y axis to promote weight loss. American Journal of Respiratory and Critical Care Medicine 173: 1248-1254, 2006. Clanchy FIL, Holloway A, Lari R, Cameron PU, Hamilton JA, Detection and properties of the human proliferative monocyte subpopulation. Journal of Leukocyte Biology 79:757-66, 2006. Cook AD, Vlahos R, Massa CM, Braine EL, Lenzo JC, Turner AL, Way KJ, Hamilton JA. The effect of tissue typeplasminogen activator deletion and associated fibrin(ogen) deposition on macrophage localization in peritoneal inflammation. Thrombosis and Haemostasis, 95:659-667, 2006. Elsegood CL, Zhuo Y, Wesolowski GA, Hamilton JA, Rodan GA, Duong LT. M-CSF induces the stable interaction of cFms with Alpha Vbeta3 integrin in osteoclasts. International Journal of Biochemistry and Cell Biology 38:1518-1529, 2006. Gualano R, Vlahos R, Anderson GP. What is the contribution of respiratory viruses and lung proteases to airway remodelling in asthma and chronic obstructive pulmonary disease? Pulmonary Pharmacology and Therapeutics 19(1):18-23, 2006. Hansen MJ, Gualano RC, Bozinovski S, Vlahos R, Anderson GP. Therapeutic prospects to treat skeletal muscle wasting in COPD (chronic obstructive lung disease). Pharmacology and Therapeutics 109(1-2):162-72, 2006. Manes GA, Masendycz P, Nguyen T, Achuthan A, Dinh H, Hamilton JA, Scholz, GM. A potential role for the Src-like adapter protein SLAP-2 in signaling by the colony stimulating factor-1 receptor. FEBS. J.273:1791-1804, 2006. Vlahos R, Bozinovski S, Hamilton JA, Anderson GP. Therapeutic potential of treating COPD by neutralising GM- CSF. Pharmacology and Therapeutics (commissioned review) 112(1):106-115, 2006. Email: [email protected] Website: www.crccid.com.au Vlahos R, Bozinovski S, Jones JE, Powell J, Gras J, Lilja A, Hansen MJ, Gualano RC, Irving L, Anderson GP. Differential protease, innate immunity and NF{kappa}B induction profiles during lung inflammation induced by sub-chronic cigarette smoke exposure in mice. American Journal of Physiology - Lung Cellular and Molecular Physiology. 290(5):L931-45, 2006. Awards and Prizes Felix Clanchy: Fellowship, Kennedy Institute for Rheumatology, London Research Adrian Achuthan: Endeavour Fellowship, Department of Education, Science and Training Gary Anderson: Research Medal of the Thoracic Society of Australia and New Zealand Conference and Seminar Presentations Gary Anderson Presentation: ‘GM-CSF and CSF-1 co-regulate LPSinduced lung inflammation: role of macrophage progenitor recruitment’ Annual Meeting Thoracic Society of Australia and New Zealand (March 26-29), Canberra, Australia. 17 Presentation: ‘Respiratory viruses cause exacerbations of COPD: A timematched case-control study. Melbourne Longitudinal COPD Cohort Study (MLCC)’ Annual Meeting Thoracic. Society of Australia and New Zealand (March 2629), Canberra, Australia. Presentation: ‘Predicting outcome of COPD exacerbations using clinical measures and C-reactive protein in the Melbourne Longitudinal COPD Cohort (MLCC). Annual Meeting Thoracic. Society. of Australia and New Zealand. (March 26-29, 2006), Canberra, Australia. Presentation: ‘Interleukin (IL)-23 accumulates macrophages and neutrophils in the bronchoalveolar in vivo space via IL-17. Annual Meeting Thorac. Soc. of Aust. and NZ. (March 26-29), Canberra, Australia. Presentation: ‘A comparison of nutrition assessment tolls in the Melbourne Longitudinal COPD Cohort (MLCC). Annual Meeting Thoracic. Society of Australia and New Zealand. (March 26-29, 2006), Canberra, Australia John Hamilton Presentation: Strategies to identify the CSF-1 receptor signalosome. Department of Biochemistry and Molecular Biology, University of Melbourne. July. Others Ms Christine Massa and Mr Dominic de Nardo, Young Australia Achievement Biotechnology Entrepreneur Awards oral presentation, DIIRD Melbourne, 9 October 2005 Contact Details Ms Robyn McLachlan Chief Operations Officer CRC for Chronic Inflammatory Diseases Suite 9, 87–89 Flemington Road North Melbourne, Vic. 3051 AUSTRALIA Tel: 61 3 9321 3330 Fax: 61 3 9328 8676 Department of Medicine Annual Report 2006 Presentation: Endotoxin-induced IL-17 production in the airways in vivo – dosing of a systemic glucocorticoid’ Annual Meeting Thoracic. Society of Australia and New Zealand (March 26-29), Canberra, Australia. http://www.medrmhwh.unimelb.edu.au/ Lung Disease Research determinants of macrophage subpopulations, differentiation and survival. The role of a variety of macrophage growth factors in the pathogenesis of COPD is also being explored. Lyn kinase in asthma: Lyn is a src family kinase that regulates the integration and amplitude of numerous signalling pathways thought to be important in allergy and asthma. Molecular basis of viral exacerbations of lung disease: Exacerbations of asthma and COPD are common and associated with much of the illness and costs of these diseases. Virus infection is often assumed to be the cause but it is not understood. Wasting as a COPD co-morbidity: Skeletal muscle wasting is a major COPD co-morbidity that increases suffering and reduces life expectancy but its molecular basis is not understood. Immune subversion by cigarette smoke: although smoke causes inflammatory lung disease it also has the property of suppressing immune defences in the lung. This increases the chance of bacterial colonisation and viral infections. Research in this area is directed towards repairing the molecular defects in the lung that weaken lung defences. Gp130 in lung fibrosis. Gp130 is a co-receptor used by a family of growth factors implicated in the development of lung inflammation and fibrosis. 18 The role of IL-17A in neutrophilic lung inflammation: IL-17 is a factor released from neutrophils that may have a central role in sustaining neutrophilic lung inflammation. Proteomics of COPD: proteomic profiling methods are increasingly used to identify patterns of disease associated molecules. Work in this area includes understanding the pathways of disease exacerbations and the identification of predictive biomarkers. Prizes and Awards Head: Professor Gary P. Anderson Research in our laboratory is aimed at understanding the molecular processes that underlie induction, progression, severity and exacerbation (sudden, potentially serious worsening) of chronic inflammatory lung conditions, especially asthma and chronic obstructive lung disease (COPD). GP Anderson, Research Medal, Thoracic Society of Australia and New Zealand E Tsantikos, Larkins Prize, University of Melbourne Collaborations Australia • A/Prof Margaret Hibbs, Dr Matthias Ernst, Ludwig Institute • Prof Peter Sly, Dr Debra Turner, Telethon Institute of Child Heath Research, Perth • A/Prof Lou Irving, Dr David Smallwood, Ms Anastasia Hutchinson, Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne • Prof Robyn O’Hehir, A/Prof Jennifer Rolland, Alfred Hospital, Melbourne • Prof John Hamilton, Prof Paul Hertzog, Dr Trevor Wilson, Dr Bernadette Scott, Prof David Hume, Dr Matt Sweet, CRC for Chronic Inflammatory Diseases Research Focus • Prof Judith Black, University of Sydney Acquired somatic mutations in COPD: Not all long term smokers develop COPD. We propose that mutagens in cigarette smoke cause genetic mutations in lung epithelial progenitors that lead to tissue changes which may be a key determinant of COPD severity, exacerbation and progression. • Dr Steve Muesters, University of Perth • Prof Ivan Bartoncello, National Stem Cell Centre/ Peter Macallum Cancer Centre • Prof Margaret Morris, University of New South Wales • Prof Dick Ruffin, Dr Carol Lang, University of Adelaide Our group is a core laboratory of the Cooperative Research Centre for Chronic Inflammatory Diseases (CRC-CID) (see above), and also supported by an NH&MRC program grant on the role of innate immunity in severe persistent asthma. Three new project grants support research on mouse models of lung disease and its systemic comorbidities. Our current research is centred on the macrophage biology of lung inflammation, innate immunity signalling in vivo, and mouse models of asthma and COPD including viral exacerbations of these conditions. Macrophage biology of COPD: Macrophages are the main effector cells in chronic lung inflammation but little is understood about how to limit their role in pathology without losing their essential defence capacity. Research in this area includes work on the src family kinases Hck, molecular International • Prof Anders Linden, Göteborg University, Sweden • Dr Karen Duca and Dr Vy Lam: Virginia Bioinformatics Institute, USA • Prof Bruce Levy, Harvard USA • Dr Darryl Knight, Hogg Institute, UBC Canada Funding National Health and Medical Research Council (NH&MRC; Project Grants (4) , Development Grant (1) , Program Grant (1)) CRC-CID (Commonwealth Department of Industry) Grants Role of GM-CSF in COPD (R Vlahos and S Bozinovski), Melbourne University Research Grant Scheme Role of GM-CSF in the pathogenesis of COPD, (R Vlahos, S Bozinovski and I Bertoncello), NH&MRC project grant 20072009, Vlahos R, Bozinovski S, Hamilton JA and Anderson GP. Therapeutic potential of treating chronic obstructive pulmonary disease (COPD) by neutralizing granulocyte macrophage-colony stimulating factor (GM-CSF). Pharmacology Therapeutics 112(1): 106-115, 2006. Hardy CL, O’Connor AE, Yao J, Sebire K, de Kretser DM, Rolland JM, Anderson GP, Phillips DJ and O’Hehir R. Follistatin is a candidate endogenous negative regulator of activin-A in experimental allergic asthma. Clinical and Experimental Allergy, 36: 941-950, 2006. Anderson GP. Current issues with beta 2 adrenoceptor agonists: pharmacology and molecular and cellular mechanisms. Clinical Reviews in Allergy and Immunology, 31: 119-130, 2006. Research Molecular mechanisms of wasting in experimental COPD. NH&MRC project grant (2007-2009) to Dr Michelle Hansen (Chief Investigator A) and A/Prof Louis Irving (CIB) Use of mouse models to study mechanisms of pathology in viral exacerbations of chronic obstructive pulmonary disease. NH&MRC project grant (2007-2009) to Dr Rosa Gualano. Publications Vlahos R, Bozinovski S, Gualano RC, Ernst M. and Anderson GP Modelling COPD in mice. Pulmonary Pharmacology and Therapeutics, 19 (1), 12-17 2006. 19 Gualano RC, Vlahos R and Anderson GP, What is the contribution of respiratory viruses and lung proteases to airway remodelling in asthma and chronic obstructive pulmonary disease? Pulmonary Pharmacology and Therapeutics, 19 (1), 18-23 2006. Vlahos R, Bozinovski S, Jones JE, Powell J, Gras J, Lilja A, Hansen MJ, Gualano RC, Irving L, and Anderson GP, Differential protease, innate immunity and NFκB induction profiles during lung inflammation induced by sub-chronic cigarette smoke exposure in mice. American Journal of Physiology – Lung Cellular and Molecular Physiology, 290(5), L931-L945 2006. Bozinovski S, Vlahos R, Hansen MJ, Liu K and Anderson GP, Akt in the pathogenesis of COPD. International Journal of COPD, 1, 31-38 2006. *Cook AD, *Vlahos R, Massa CM, Braine EL, Lenzo JC, Turner AL, Way KJ and Hamilton JA ,The effect of tissue type-plasminogen activator deletion and associated fibrin(ogen) deposition on macrophage localization in peritoneal inflammation. Thrombosis and Haemostasis, 95(4), 659-667 2006. *These authors contributed equally. Chen H, Hansen MJ, Jones JE, Vlahos R, Bozinovski S, Anderson GP and Morris MJ, Cigarette smoke exposure reprograms the hypothalamic neuropeptide Y axis to promote weight loss. American Journal of Respiratory and Critical Care Medicine, 173, 1248-1254 2006. Kingwell BA, Anderson GP, Duckett SJ, Hoole EA, JacksonPulver LR, Khachigian LM, Morris ME, Roder DM, RothwellShort J and Wilson AJ. National Health and Medical Research Council Evaluations and Outcomes Working Committee. Evaluation of NH&MRC funded research completed in 1992, 1997 and 2003: gains in knowledge, health and wealth. Medical Journal Australia 184 (6): 282286, 2006. Anderson GP, COPD, asthma and C-reactive protein. European Respiratory Journal, 27: 874-876, 2006. Department of Medicine Annual Report 2006 Hansen MJ, Gualano RC, Bozinovski, S, Vlahos R and Anderson GP, Therapeutic prospects to treat skeletal muscle wasting in COPD. Pharmacology and Therapeutics, 109 (1-2), 162-172 2006. http://www.medrmhwh.unimelb.edu.au/ Malaria Research • Dr Philippe Boeuf adapted the technique of laser capture dissection to study gene expression in P falciparum-infected placental cells and presented this work at ICOPA XI in Glasgow. • Associate Professor Stephen Rogerson has been part of a Malaria in Pregnancy Start Up Group, which has led to a Malaria in Pregnancy Consortium, funded by the Bill and Melinda Gates Foundation, to develop a comprehensive strategy to improve treatment and prevention of malaria in pregnant women. An application for funding consortium activities has now been lodged. • Dr Nicolas Senn commenced recruitment of children into a study of intermittent preventive therapy with antimalarial medication in Papua New Guinea. Approximately 1800 children will be randomised to two antimalarial combinations or to placebo over the next two years. This will determine whether these drugs decrease malaria and anaemia Research Staff 20 Heads: Associate Professor Stephen Rogerson (pictured) and Professor Graham V. Brown Research Highlights • • • Associate Professor Stephen Rogerson, in collaboration with Professor Steven Meshnick (University of North Carolina), Dr Victor Mwapasa (University of Malawi College of Medicine) and others found that untreated syphilis infection was particularly common in women with HIV infection, and that it increased the risk that these women will pass HIV infection to their babies— as well as being an important cause of infant deaths in its own right. Dr Wai-Hong Tham has begun to unravel the mechanisms by which expression of members of the Plasmodium falciparum rif family of 150 genes is controlled. Dr Michael Duffy, Ms Aphrodite Caragounis and others have shown that malaria-infected erythrocytes from women with placental malaria almost always transcribe one specific var gene, out of many in each parasite. This gene is called var2csa. • Dr Michael Duffy collaborated with researchers at The Walter and Eliza Hall Institute of Medical Research to study the mechanisms underlying the control of antigenic variation in P falciparum. • Dr Salenna Elliott has investigated how P. falciparum infected erythrocytes interact with dendritic cells, important in regulating the immune response to malaria. • Professor Graham V. Brown • Associate Professor Stephen Rogerson: Wellcome Trust Senior Research Fellow • Dr Nicolas Senn, Clinical Trial Physician (seconded to Papua New Guinea Institute of Medical Research) • Dr Wai-Hong Tham: ARC Research Fellow • Dr Philippe Boeuf: Postdoctoral Fellow • Dr Michael Duffy: Postdoctoral Fellow • Dr Salenna Elliott: Postdoctoral Fellow • Mr Tim Byrne: Research Assistant • Mr Paul Payne: Research Assistant • Ms Francisca Yosaatmadja: Research Assistant • Ms Emily Mann: PhD Student • Ms Katya Boysen: MSc Student • Ms Lucille Pantel: Visiting Student • Ms Aimee Tan: UROP Student Publication Highlights Kwiek J, Mwapasa V, Milner D, Alker A, Miller W, Tadesse, Molyneux, Rogerson S, Meshnick S. Maternal-fetal microtransfusions and HIV-1 mother-to-child transmission in Malawi. PLoS Medicine. 3(1):e10, 2006. Beeson J, Mann E, Byrne T, Caragounis A, Elliott S, Brown G, Rogerson S. Antigenic differences and conservation among placental type Plasmodium falciparum-infected erythrocytes and acquisition of variant-specific and cross-reactive antibodies. Journal of Infectious Diseases. 193(5):721-30, 2006. Frankland S, Adisa A, Horrocks P, Taraschi T, Schneider T, Elliott S, Rogerson S, Knuepfer E, Cowman A, Newbold C, Tilley L. Delivery of the Malaria Virulence Protein PfEMP1 to the Erythrocyte Surface Requires Cholesterol-Rich Domains. Eukaryotic Cell 5(5):849-60, 2006. Dembo E, Phiri H, Montgomery J, Molyneux M, Rogerson S. Are Plasmodium falciparum parasites presented in peripheral blood genetically the same as those sequestered in the tissues? American Journal of Tropical Medical Hygiene, 74(5):730-732, 2006. Montgomery J, Milner, D, Tse M, Njobvu A, Kayira K, Dzamalala C, Taylor T, Rogerson S, Craig AG, Molyneux M. Genetic analysis of circulating and sequestered populations of Plasmodium falciparum in fatal paediatric malaria. Journal of Infectious Diseases. 194(1):115-22,2006. Duffy M, Caragounis A, Noviyanti R, Kyriacou H, Choong E, Boysen K, Healer J, Rowe J, Molyneux M, Brown G, Rogerson S. (2006). Transcribed var genes associated with placental malaria in Malawian women. Infection and Immununity 74(8):4875-83, 2006. Mwapasa V, Rogerson S, Kwiek J, Wilson P, Milner D, Molyneux M, Kamwendo D, Tadesse E, Chaluluka E, Ou C, Meshnick S. Maternal syphilis infection is associated with increased risk of mother-to-child transmission of HIV in Malawi. AIDS. 11;20(14):1869-1877, 2006. Benet A, Khong T, Ura A, Samen R, Lorry K, Mellombo M, Tavul L, Baea K, Rogerson S, Cortes A. Placental malaria in women with South-east Asian ovalocytosis. American Journal of Tropical Medical Hygiene. 75(4):597-604, 2006. Voss T, Healer J, Marty A, Duffy M, Thompson J, Beeson J, Reeder J, Crabb B, Cowman A. A var gene promoter controls allelic exclusion of virulence genes in Plasmodium falciparum malaria. Nature. Feb 23;439(7079):1004-8, 2006. Marty A, Thompson J, Duffy M, Voss T, Cowman A, Crabb B. Evidence that Plasmodium falciparum chromosome end clusters are cross-linked by protein and are the sites of both virulence gene silencing and activation. Molecular Microbiology, Oct;62(1):72-83, 2006. New Grants National Health and Medical Research Council Project Grant 400090:SJ Rogerson and A Jaworowski. HIV and immunity to malaria. 2006: $138,500, 2007: $143,500, 2008 $81,750. National Health and Medical Research Council Project Grant 406647. JG Beeson and SJ Rogerson: Identifying the targets of protective immunity to malaria in pregnancy. 2006: $149,250, 2007: $149,250, 2008: $149,250. Melbourne Research Grants: M F Duffy. $30,000 National Health and Medical Research Council Program Grant 406601. AF Cowman, GV Brown BS Crabb, E Handman, MJ McConville, GI McFadden, L Schofield, TP Speed. Host parasite interactions: Disease, pathogenesis and control. 2006-2010 $13,500,000 NH&MRC equipment grant: Confocal microscope: live cell imaging. CU's: GV Brown, J Hamilton, A Giraud, S J Rogerson, S Jane, T O'Brien, D Myers, G Anderson. $125,000 Ongoing Grants National Health and Medical Research Council Program Grant 215201: AF Cowman, H Billman-Jacobe, GV Brown, BS Crabb, E Handman, MJ McConville, GI McFadden, L Schofield and TP Speed, 2002–05, ‘The molecular basis of host-pathogen interactions’: $11,540,000 National Health and Medical Research Council: GV Brown, S Lewin, J Sasadeusz, M Richards, M Slavin, D Campbell, SJ Rogerson, J Torresi and BA Biggs, ‘Centre for Clinical Research Excellence in Infectious Diseases’ 2003–07: $2,000,000 Wellcome Trust: Stephen J. Rogerson, 2001–06, Senior Overseas Research Fellowship: $1.4m National Health and Medical Research Council Capacity Building Grant: CR Macintyre, NG Becker, M Law, A Plant, TM Nolan and GV Brown, 2005–09, ‘Mathematical modelling for improved planning of infectious disease control policy’: $3,000,000 Bill and Melinda Gates Foundation: SJ Rogerson with J Reeder, Papua New Guinea Institute of Medical Research (PI), 2005–09, ‘Intermittent preventive treatment during EPI for the prevention of malaria and anemia in Papua New Guinean infants’: US$2,858,276, Bill and Melinda Gates Foundation: SJ Rogerson with Feiko ter Kuile, University of Liverpool (PI), 2005–06, ‘Start up activities of malaria in pregnancy working group’: US$358,735 Research Meshnick S, Mwapasa V, Rogerson S. Protecting Pregnant Women from Malaria in Areas of High HIV Infection Prevalence. Journal of Infectious Diseases.194(3): 273-5, 2006. National Institutes of Health: S Meshnick, SJ Rogerson and M Molyneux, 2001–06, ‘Malaria and HIV in pregnant Malawian women’: USD$250,000 p.a. Collaborations Graham V Brown Project: ‘The molecular basis of host-pathogen infections’ (NH&MRC Program Grant). Collaborators: AF Cowman, H Billman-Jacobe, E Handman, M McConville, G McFadden, L Schofield and T Speed (collaboration among ten Chief Investigators). 21 Graham V Brown and Michael Duffy Project: ‘Studies of P. falciparum var gene transcription’ (funded by AusAID). Collaborator: Dr Rintis Noviyanti, Eijkman, Institute for Molecular Biology, Jakarta Indonesia. Graham V Brown and Stephen Rogerson Project: Centre for Clinical Research Excellence in Infectious Diseases (funded by NH&MRC). Collaborators: S Lewin, J Sasadeusz, M Richards, M Slavin, D Campbell, J Torresi and BA Biggs. Stephen Rogerson Project: ‘Malaria and HIV in pregnancy’ (field studies in Malawi funded by NIH). Collaborators: Professor Steven Meshnick and Dr Victor Mwapasa. Project: ‘Pathogenesis of malaria in pregnancy’ (field studies in Malawi). Collaborator: Professor Malcolm, Molyneux. Project: ‘Effect of HIV on opsonic phagocytosis of malaria infected erythrocytes’. Collaborator: Dr Anthony Jaworowski, Burnet Institute. Project: ‘Identifying the targets of protective immunity to malaria in pregnancy’. Collaborator: Dr James Beeson, The Walter and Eliza Hall Institute of Medical Research. Project: ‘Malaria and pregnancy in Papua New Guinea’. Collaborators: Dr James Beeson and Dr Danielle Stanisic, The Walter and Eliza Hall Institute of Medical Research; Dr Pascal Michon, Dr Ivo Mueller and Professor John Reeder, Papua New Guinea Institute of Medical Research; Dr Chris King, Case Western Reserve University Cleveland USA. Project: ‘Var genes associated with severe malaria in Malawi’. Collaborators: Dr Jacqui Montgomery and Professor Malcolm Molyneux, Malawi–Liverpool–Wellcome Trust Clinical Research Program, College of Medicine, Blantyre Malawi; and Dr Alister Craig, School of Tropical Medicine, University of Liverpool. Salenna Elliott Project: ‘Role of CD8 T cells in human cerebral malaria’. Collaborators: Professor Nick Hunt, University of Sydney; Dr Steve Kamiza, University of Malawi College of Medicine; and Professor Terrie Taylor, Michigan State University. Department of Medicine Annual Report 2006 Duffy M, Maier A, Byrne T, Marty A, Elliott S, O’Neill M, Payne P, Rogerson S, Cowman A, Crabb B, Brown G. VAR2CSA is the principal ligand for chondroitin sulfate A in two allogeneic isolates of Plasmodium falciparum. Molecular and Biochemical Parasitology.148(2):117-24, 2006. http://www.medrmhwh.unimelb.edu.au/ Conference and Seminar Presentations Graham V Brown Participant, 37th PHAA Annual Conference, Sydney, Tackling the determinants of health from the bush to Bondi. Session Chair, 23rd NRL Workshop on Serology, Melbourne Invited speaker, Specialist Medical Aid Symposium, Royal Australasian College of Surgeons, Melbourne Invited speaker, Pandemic Preparedness and Response Forum, Sydney Invited speaker, Thinking Games: exercise your mindCreating our own future. City of Melbourne Invited lecture, Avian Influenza: Impact, solution and readiness. Asialink, University of Melbourne. Invited lecture, International Centre for Genetic Engineering and Biotechnology, New Delhi, India Stephen Rogerson Invited Speaker: International Congress of Parasitology, Glasgow, August Invited Speaker: American Society of Tropical Medicine and Hygiene Annual Meeting, Atlanta GA, November 22 Teaching and Training Graham V Brown Professorial morning report for postgraduate trainees Professorial student report; lectures and tutorials to undergraduate medical students in Semesters 3,5, 8/9 Undergraduate and postgraduate examination (for fellowship of Royal Australasian College of Physicians) Stephen Rogerson Coordination of, and lectures for ‘Oral Health Sciences 3–Medicine’ (Medicine for dental students) Supervision Elizabeth Aitken BSc(Hons) Supervisor Stephen Rogerson Joelle Dodin BSc(Hons) Supervisor Dr Salenna Elliott Emily Mann PhD Supervisors: Stephen Rogerson, Graham Brown and Anthony Hodder Professional Activities Graham V Brown Director, Nossal Institute for Global Health, University of Melbourne Head: Victorian Infectious Diseases Service (Royal Melbourne Hospital) (resigned 2006) Governor: Royal Melbourne Hospital Foundation Director: Australian International Health Institute, The University of Melbourne Site Director: Geo Sentinel Surveillance Network, a collaboration with the Centres for Disease Control USA (with Dr J Torresi) Chair: Strategy and Development Committee, Australian International Health Institute Chair: Expert Advisory Group on Antimicrobial Resistance (EAGAR), NH&MRC Chair: Scientific Advisory Board, The Queensland Institute of Medical Research, Brisbane Chair: Infection Prevention and Surveillance Committee, RMH Chair: Centres of Clinical Research Excellence Grants Review Committee, NH&MRC Chair: Murdoch Children’s Research Institute Career Grants Committee Convenor: Dean's Lecture Series—Ethics Symposium, MDHS, The University of Melbourne Member: Commonwealth Panel of Experts for Crisis Management (CAPE) Member: Malaria Vaccine Advisory Committee (MALVAC), World Health Organization Member: Scientific Consultants Group, USAID Malaria Vaccine Development Program, Maryland, USA Member: Advisory Board, National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Westmead, NSW Member: Scientific Advisory Committee, Bio21 Australia Ltd Member: Clinical Advisory Group, The Walter and Eliza Hall Institute of Medical Research/RMH Member: Medical Advisory Committee, (Past Chair), RMH Member: Medical Course Committee, MDHS, The University of Melbourne Member: MDHS Faculty Executive, The University of Melbourne Member: MDHS Faculty Planning, Budget and Research Committee, The University of Melbourne Member: Advisory Committee, Student Ambassador Leadership Program, The University of Melbourne Member: Senior Appointments Committee, The University of Melbourne Member: National Clinical Research Steering Committee to oversee the development of a National Clinical Research Framework, Office for Science and Medical Research (OSMR), NH&MRC Member: Study Committee, Institute of Medicine (IOM) of the National Academies. Review of the U.S. Army Medical Research and Material Command Malaria Vaccine Research Program. Member: Genetic Services Development Committee, Department of Human Services, Victoria Contact Details Department of Medicine (RMH/WH) The University of Melbourne 4th Floor, Clinical Sciences Building The Royal Melbourne Hospital Victoria 3050 AUSTRALIA Tel: +61 3 8344 6252 Fax: +61 3 9347 1863 Professor Graham V. Brown: [email protected] A/Professor Stephen Rogerson: [email protected] Dr Salenna Elliott: [email protected] Dr Michael Duffy: [email protected] Dr Philippe Boeuf: [email protected] International and Immigrant Health Research Australians with HIV in gaining access to social support; and to explore potential means of providing Australia’s African communities with accurate, relevant, culturally appropriate information about HIV. The community study has been completed and the patient case series is underway. Middle Eastern and Afghan immigrant and refugee health study. This project has highlighted the inadequate health assessments in refugees from Iraq, Iran and Afghanistan, and has led to the development of a comprehensive refugee health assessment package. Most newly arrived refugees, particularly those from war zones and refugee camps, will have had minimal pre-arrival health screening, hence the need for a careful and empathetic history, thorough examination, and consideration of the recommended investigations. An assessment guide was developed by the physicians at the Victorian Infectious Diseases Service, Refugee/Travel Clinic: www.mh.org.au/VIDS; 23 Royal Children’s Hospital Immigrant Child Health Clinic, Tel: +61 3 9345 5522; Victorian Foundation for Survivors of Torture, www.survivorsvic.org.au, and general practitioners in the Northern and Western Divisions of General Practice, Melbourne. The findings of the study have been submitted for publication. Research Cambodian immigrant and refugee health study. This project has identified that as many as a third of Cambodian immigrants are infected with Strongyloides stercoralis, a parasite that can cause chronic illness and death. The project is now complete and being prepared for publication. Principal: Associate Professor Beverley-Ann Biggs Research Highlights International Health Strengthening the capacity for research and control of malaria and parasitic diseases in Vietnam. This project has fully equipped a malaria laboratory at the National Institute of Malariology, Parasitology and Entomology (NIMPE) in Hanoi, and is now monitoring malaria drug resistance in sentinel sites. Further funding by Atlantic Philanthropies Inc. until 2008 has enabled a new initiative in hookworm control to be undertaken in collaboration with the World Health Organization (WHO). The introduction of a provincial demonstration project for improved control and prevention of hookworm infection and anaemia in Vietnamese people is the major initiative planned for the next three years. A pilot project that has provided iron supplements and treatment for worm infection to all women of reproductive age in 2 districts (50,000) in Yen Bai province commenced in 2006. The project is being implemented by NIMPE and provincial staff in conjunction with the project manager Mr Gerard Casey from the Department of Medicine. In 2007 the project will expand to the entire province in collaboration with the World Health Organisation. Immigrant and Refugee Health HIV in Victoria’s African communities: reducing risks and improving care. This project aims to identify the factors that expose African Australians to risk of infection with HIV, and impede timely diagnosis; to describe the barriers faced by African A clinical audit of African immigrants attending the Royal Melbourne Hospital. The aim of this study is to document the risks for, and prevalence of, medical conditions diagnosed in African immigrants attending the Victorian Infectious Diseases Service. For further details visit: http://www.internationalhealth.unimelb.edu.au Publication Highlights Articles Hipgrave D, Maynard J, Biggs B. (2006) Improving birth dose coverage of hepatitis B vaccine. Bulletin of the World Health Organization. Jan;84(1):65-71 Karunajeewa H, Kelly H, Leslie D, Leydon J, Saykao P, Biggs BA. (2006) Parasite specific IgG response and peripheral blood eosinophil count following albendazole treatment for presumed chronic strongyloidiasis. Journal of Travel of Medicine Mar-Apr;13(2):84-91 Hipgrave D, Huong V, Tran T, Long H, Van N, Dat D, Nga N, Jolley D, Maynard J, Biggs B. (2006) Immunogenicity of a locally produced hepatitis B vaccine with the birth dose stored outside the cold chain in rural Vietnam. American Journal of Tropical Medicine and Hygiene Feb 1;74(2):255-60. Soeung S, Grundy J, Ly C, Samnang C, Boreland M, Brooks A, Maynard J, Biggs B. (2006) Improving immunization coverage through budgeted microplans and sub-national performance agreements: Early experience from Cambodia. Asia Pacific Journal of Public Health Jun; 18(1):29-38. Department of Medicine Annual Report 2006 An evaluation of a new test for the detection of latent tuberculosis infection in Victoria. The aim of this study is to evaluate a new diagnostic test (2nd Generation Quantiferon Assay) as a potential alternative to the skin test for the detection of latent tuberculosis (TB). Three studies comparing the new test to the skin test were undertaken—in contacts of patients with active TB, immigrants and health care workers—the results of which are currently being analysed and prepared for publication. http://www.medrmhwh.unimelb.edu.au/ 24 Caruana S, Kelly, H, Ngeow J, Ryan N, Chea, L, Nuon, S, Bak, N, Skull S, Biggs B. (2006) Undiagnosed and potentially lethal parasitic infections among immigrants to Australia. Journal of Travel Medicine;13(4):233–239. Soeung S, Grundy J, Maynard J, Brooks A, Boreland M, Sarak D, Jenkinson K, Biggs B. (2006) Financial sustainability planning for immunization services in Cambodia: experience to date and future directions. Health Policy Plan;21(4):302-9. Jeanette Fyffe and Heath Kelly, The University of Melbourne, 2004–07) Dr Chris Lemoh, ‘HIV in Victoria’s African communities’, PhD (Co-Supervisors: Alan Street and Margaret Hellard, The University of Melbourne, 2004–07) Dr Sophie Treleaven, MD (In progress) Dr Ian Woolley, MD (In progress) Grundy J, Soeung S, Samnang C, Boreland M, Biggs B, Brookes A, Maynard J. (2006) Improving immunization coverage through budgeted microplans and sub-national performance agreements: Early experience from Cambodia. Asia-Pacific Journal Public Health 18 (1):29-28. Dr Albert Tiong, MAE Tiong A, Patel M, Gardiner J, Ryan R, Linton K, Walker K, Scopel J, Biggs B. (2006) Health issues in newly arrived African refugees attending general practice clinics in Melbourne. Medical Journal Australia 185, 602-606 Andrea Neale, Public Health Trainee Ongoing Grants Beverley-Ann Biggs Member: AMS Taskforce, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne Atlantic Philanthropies Inc. Grant: Le Khanh Thuan, Alan Cowman, Beverley-Ann Biggs, 2003–08, ‘Strengthening program and research capacity in parasitic disease surveillance and control in Vietnam’: $1,600,000 Department of Human Services Grant: BA Biggs, P Vinton, P Johnson and J Black, 2003–05, ‘An evaluation of a new test for the detection of latent TB infection in Victoria’: $69,020 TB Foundation Grant: P Vinton, BA Biggs, P Johnson, H Kelly and J Fyfe, 2003–05, ‘Epidemiology of TB in Victoria’: $40,000 Department of Human Services Grant: Beverley-Ann Biggs, Margaret Hellard and Alan Street, 2004–05, ‘Reducing the risk of transmission of HIV/AIDS in African and Arabicspeaking communities in Victoria’: $75,627 Australia-India Council Grant: Beverley-Ann Biggs. Improving the diagnosis and treatment of tuberculosis, and multi-drug resistant tuberculosis, in Nagpur, Central India. 2006-7. $11,000. Collaborations Alfred and Austin Hospitals; Australian Research Centre in Sex, Health and Society; Darebin Community Health Centre; Key Centre for Women`s Health; local GP medical clinics; Monash Institute of Health Services Research; Multicultural Health and Support Service; Nossal Institute for Global Health; Victorian Department of Human Services; Victorian Infectious Diseases Reference Laboratory (VIDRL); Victorian Infectious Diseases Service (VIDS) at the Royal Melbourne Hospital; Western Region Health Centre; World Health Organization (WHO);. Affiliations and/or joint projects with: VIDS; VIDRL; Australian International Health Institute; Walter and Eliza Hall Institute (WEHI); Nossal Institute for Global Health; NIMPE (Hanoi, Vietnam); RTCCD (Hanoi, Vietnam). Teaching and Training Beverley-Ann Biggs Lecturing ‘Infectious Diseases’ to undergraduate Medical students Workshops with GP Divisions on Refugee Health issues Workshops with NIMPE staff, Hanoi Supervision Beverley-Ann Biggs Dr Paul Vinton, ‘An evaluation of a new test for the detection of latent TB infection’, PhD (Co-Supervisors: Paul Johnson, Ms Jane Goller, Public Health Trainee Ms Michelle Sweidan, Public Health Trainee Rachel Tham, Public Health Trainee Professional and Community Affiliations and Service Co-Coordinator: AMS program, Department of Medicine (RMH/WH) Contact Details Associate Professor Beverley-Ann Biggs Department of Medicine (RMH/WH) The University of Melbourne 4th Floor, Clinical Sciences Building The Royal Melbourne Hospital Victoria 3050 AUSTRALIA Tel: +61 3 8344 3256 Fax: +61 3 9347 1863 Email: [email protected] Web: www.internationalhealth.unimelb.edu.au Genetics Research Cox B, Humar B,More H, Guilford P. Hereditary Diffuse Gastric Cancer: diagnosis and management. Clinical Gastroenterology and Hepatology 2006. 4(3): 262-275 Chow E, Lipton L, Lynch E , D’Souza R, Aragona C, Hodgkin L,Brown G, Winship I, Barker M, Buchanan D, Nasioulas S, du Sart D, Young J, Leggett B, Jass J, Macrae F. Hyperplastic Polyposis Syndrome: Phenotypic presentations and the role of MBD4 and MYH Gastroenterology 2006 131(1) 30-9 Watkins W, Umbers A, Woad K, Harris S, Winship I, Gersak K and Shelling A. Mutational screening of FOX03A and FOX01A in Preamature Ovarian Failure Fertility and Sterility 2006 86(5) 1518-21 Research Chand A, Ponnampalam A, Harris S, Winship I, Shelling A. Mutational analysis of BMP15 and GDF9 as candidate genes for Premature Ovarian Failure Fertility and Sterility 2006 86(4) 1009-12 Abbott W, Winship I, Gane E, Finau S, Munn S, Tukuitonga C. Genetic diversity and linkage disequilibrium in the Polynesian population of Niue Island. Human Biology 2006 78(2) 131-45 James PA, Parry S, Arnold J, Winship I. Confirming a diagnosis of hereditary colorectal cancer :the impact of a Familial Bowel Cancer Registry NZ Medical Journal 2006 119 (1242) u2168 25 New Grants NH&MRC, 2006-2008, Mismatch repair carriers, who are they, what is their risk of cancer and how can the risk be decreased Jenkins M, Baglietto L, Bishop T, Barker M, Winship I, AU$213,000 NH&MRC, 2006-2008, Predicting the individual risk of developing prostate cancer in Australian men, Severi G, Giles G, English D , Hopper J, Winship I, Neerhut G Baglietto L, AU$ 341,028 Research Highlights Recognising the importance of the growing discipline of Adult Genetics, the Royal Melbourne Hospital provided funding for the University to create a position of Professor of Adult Genetics in the Faculty of Medicine, Dentistry and Health Sciences based at the Royal Melbourne Hospital. The outstanding clinician and researcher Professor Ingrid Winship was selected to take on this important role that now impacts on all disciplines in clinical medicine. Research in adult onset genetic disorders has covered areas recognised in listed publications and a major commitment to familial cancer and multi disciplinary, multi centre collaborations. New collaborative research funding has been obtained as listed below and NIH funding continues to support studies in colorectal cancer. Publication Highlights Longo I, Scala E, Caselli R, Pescucci C, Antonietta Mencarelli M, Speciale C, Giani M, Angela Caringella D, Borochowitz Z, Siriwardena K, Winship I, Renieri A, Meloni I. Autosomal recessive Alport syndrome: an in-depth clinical and molecular analysis of five families. Nephrology Dial Transplant 2006 21(3) 665-671 Watkins W, Harris S, Craven M, Vincent AL, Winship I, Gersak, K and Shelling A. An investigation into FOXE1 polyalanine tract length in Premature Ovarian Failure and BPES. Mol Hum Reprod 2006 12(3) 145-9 Blair V, Martin I, Shaw D, Winship I, Kerr D, Arnold J, Harawira P, McLeod M, Parry S, Charlton A, Findlay M, Tenders Awarded Family Cancer Education Program – Workshop Curriculum review and update, S.Metcalfe, M Aitken, I. Winship, $8480.00 Cancer Council of Victoria Collaborations • School of Population Health, University of Melbourne • Professor John Hopper (University of Melbourne) • Cancer Council of Victoria • Research Council Advisor to the Human Genome Research Project with Justice Michael Kirby, and a panel of New Zealand Experts, New Zealand Other Activities Inaugural David Danks Orator at the University of Melbourne. Contact Details Professor Ingrid Winship Department of Medicine (RMH/WH) The University of Melbourne 4th Floor, Clinical Sciences Building The Royal Melbourne Hospital Victoria 3050 AUSTRALIA Tel: +61 3 9349 1846 Email: [email protected] Department of Medicine Annual Report 2006 Head: Professor Ingrid Winship DHS Victoria, Disclosure of genetic information to those at risk of familial cancer, a RCT and evaluation of 2 methods of assisting families. Winship I,Harris M, Lindeman G, Mitchell G, Macrae F, Young MA, Mann B, Warner B, Howell D, White V, Fitzpatrick S, AU$85,856 http://www.medrmhwh.unimelb.edu.au/ Hepatitis Molecular Virology Research and Travel Medicine Service this project will contribute significantly to our understanding of how hepatitis B infection predisposes to HCC development and identify targets for novel antineoplastic agents. Neutralising antibody and cellular immune responses to self-adjuvanting recombinant HCV virus like particles. HCV infects 3% of the world’s population or170 million individuals and causes an estimated 476,000 deaths per year as a result of HCV-associated end-stage liver disease and its complications. The correlates of protective immunity for HCV are not completely known although it is apparent that an immune response capable of preventing reinfection in humans is possible. An effective preventative vaccine against HCV will need to induce both neutralizing antibody (NAb) and cellular immune responses. A vaccine based on HCV virus-like particles (VLP) has the potential to achieve all of these requirements. HCV coreE1E2 VLPs (HCV-VLPs) resemble mature HCV virions and are able to elicit humoral immune responses and NAb including cross-reactive NAb to HCV. To improve the authenticity and immunogenicity of HCV VLPs we have produced HCV VLPs in a human liver-derived cell line using a recombinant adenovirus system encoding the HCV structural proteins (core, E1 and E2) of HCV 77H, genotype 1a. These HCV VLPs therefore contain HCV envelope glycoproteins and the internal core protein that resemble those found on mature virions. In addition, the purified HCV VLPs can be modified by the addition of lipid to produce an effective selfadjuvanting vaccine candidate. 26 This project aims to study the immunogenicity of lipidated HCV VLPs in mice, including HLA class II transgenic mice and determine the neutralising activity of antibody to the HCV VLPs. In addition, the ability of the lipidated HCV VLPs to stimulate dendritic cell maturation and produce HCV specific CD8+ and CD4+ T cell responses will be investigated. Head: Dr Joseph Torresi Hepatitis Research • Identification and characterisation of cellular and humoral epitopes of hepatitis C virus (HCV) • Identification and characterisation of neutralising epitopes of HCV Modulation of cell signaling pathways by hepatitis B virus and association with Hepatocarcinogenesis. Hepatocellular carcinoma (HCC) is the fifth most frequent cancer and the third leading cause of cancer death worldwide after lung and stomach cancer. The overwhelming characteristic of HCC is that over 90% of cases have chronic Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV). Although HBV is a known hepatocarcinogen the precise mechanism by which it causes HCC is unknown. Furthermore, the effectiveness of nucleoside analogues such as lamivudine in eliminating the risk of HCC is unclear as is the hepatocarcinogenic potential of antiviral-resistant HBV. • Development of recombinant HCV coreE1-GFP-E2 VLPs to study neutralising antibody responses to HCV • Development of recombinant HCV VLPs as vaccine candidates for HCV • Identification of cross reactive CD8 epitopes of HCV • Identification of CD4 epitopes of HCV • Characterisation of dendritic cell activation in hepatitis C infected patients • Modulation of MAPK and JAK/STAT/SOCS cell signalling by HBV and HCV: mechanisms of viral persistence and hepatocarcinogenesis Replication of wild type HBV and antiviral drug resistant HBV cause dysregulation of ras-ERK and PI(3)/Akt signal transduction and cell cycle progression leading to viral persistence and creating an intracellular environment that is conducive to the development of hepatocellular carcinoma (HCC). Up-regulation of p21cip1 provides a central component of the mechanism by which HBV alters cell cycle and thereby promotes HCC development. The aim of this work is to study the mechanisms of HBV persistence and hepatocarcinogenesis in the context of HBV replication in hepatocyte cultures and correlate this with changes in human liver. In addition, the role of interferon alpha in reversing the HBV induced dysregulation of both signal transduction and cell cycle will be investigated. In so doing, • Development of recombinant adeno-HBV and adenoHCV systems to study cell signalling events in liver derived cell lines • Analyses of HBV and HCV modulation of ERK, p38 and JNK signalling. • Analyses of HBV and HCV modulation of cell cycle regulatory proteins p53, p21, p27 and cyclins D1, B1, A1. • Analyses of cell cycle modulation by HBV and HCV. • Analyses of SOCS3 expression in HBV and HCV associated liver disease. Research Focus Analysis of malaria in travellers • Analysis of gastrointestinal infections in travellers • Analysis of P.vivax malaria in travellers • Analysis of dengue fever in travellers Publication Highlights Dr David C. Jackson, Department of Microbiology and Immunology, The University of Melbourne: Identification of immunodominant epitopes of hepatitis C virus and generation of a polymerised peptide HCV prophylactic and therapeutic vaccine. Dr Thomas Bock, Department of Molecular Pathology, University Hospital, Tuebingen, Germany and Professor Hanswalter Zentgraf, German Cancer Research Center, Heidelberg, Germany: Modulation of hepatitis B virus and hepatitis C virus interactions and persistence in coinfected cells through cell signalling pathways. Hepatitis B virus genotype mixtures: Clinical relevance and molecular characteristics. Professor Eric Gowans, Hepatitis Research, Burnet Institute Melbourne: GB virus-B/HCV chimeras to evaluate potential self-adjuvanting HCV vaccines that generate neutralising antibody in vivo. Six Month Sabbatical: Germany, 2006 • Collaborated with A/Prof Thomas Bock (Department of Molecular Pathology, University of Tuebingen) and Prof Hanswalter Zentgraf (German Cancer Centre, Heidelberg University, Germany) working on projects 27 investigating how hepatitis B virus modulates JAK/ STAT/SOCS pathways; viral-viral interactions in hepatitis B and C coinfection; the design and production of hepatitis C virus like particles (HCV VLPs) as vaccine candidate for HCV; and mechanisms of pathogenesis of parvovirus B19 infection in inflammatory cardiomyopathy. The vaccine project commenced in Australia and work is now continuing as a central component of the HCV vaccine initiatives in the Hepatitis laboratory. Results obtained on sabbatical form the basis for an NHMRC project application and provided a project for a new PhD student, Dr Doug Johnson. • Attended the 12th International Symposium on Viral Hepatitis and Liver Disease in Paris, and presented two talks on current research programs. • Visited the head office of Sanofi-Pastuer in Lyon to discuss a number of research projects in travel medicine. A substantial grant for a investigator-initiated project will form on the seroprevalence of influenza, dengue and Japanese encephalitis in Australia and Canadian travellers. The three-year project has now commenced and forms the basis of a PhD project for Dr Irani Ratnam, infectious diseases physician, Royal Melbourne Hospital. O’Brien DP, Leder K, Matchett E, Brown GV, Torresi J. Illness in returned travellers and immigrants/refugees: the 6-year experience of two Australian infectious diseases units. 2006. Journal Travel Medicine. 13(3): 145-152. Song L, Toan L, Duy D, Binh V, Koeberlein B, Kaiser S, Kremsner P, Kandolf R, Torresi J, C-T Bock. Impact of the hepatitis B virus genotype and genotype-mixtures on the course of liver disease in Vietnam. 2006. Hepatology. 43:1375-1384. Toan N, Song L, Kremsner P, Duy D, Binh V, Duechting A, Kaiser H, Torresi J, Kandolf R, and Bock C. Co-infection of human parvovirus B19 in Vietnamese patients with hepatitis B virus infection. 2006. Journal of Hepatology 45 361–369. Leder K, Tong S, Weld L, Kain K, Wilder-Smith A, Black J, Brown B, Torresi J. Illness in Travelers Visiting Friends and Relatives: A Review of the GeoSentinel Network. 2006. Clinical Infectious Diseases. 43:1185-1193. Nguyen, Toan L, Duechting A, Kremsner P, Song L, Ebinger M, Aberle S, Binh V, Duy D, Torresi J, Kandolf R and Bock C. Phylogenetic analysis of human Parvovirus B19 indicating two sub-groups of genotype 1. 2006. Journal General Virology. 87:2941-2949. Grollo L, Torresi J, Drummer H, Zeng W, Williamson N, and Jackson D. Cross reactive epitopes identified in hepatitis C virus E1E2 proteins induce antibodies that capture virions from infected patients’ sera and also inhibit pseudo virus entry into susceptible cells. 2006. Antiviral Therapy.11(8):1005-14. Research Grants NH&MRC Grant: G. V. Brown, S. Lewin, J. Sasadeusz, M. Richards, M. Slavin, D. Campbell, S. J. Rogerson, J. Torresi, and B. A. Biggs, 2003–07, ‘Centre for Clinical Research Excellence in Infectious Diseases’ $2,000,000 NH&MRC Project Grant (454640) DJackson, W Zeng, L Brown, J Torresi. Using the Information inherent in Immune Responses to Design Vaccines. 2007-2009 $430,000 Australian Centre for Hepatitis and HIV Virology, Population Health Division of the Commonwealth Department of Health and Ageing: Preclinical testing of replication-defective adenovirus-based vaccines to boost Hepatitis C Virusspecific cellular immunity. M Bharadwaj, J Torresi. 2007 $110,000. Seroprevalence of respiratory tract and arboviral infections in Australian and Canadian travellers. Joseph Torresi (CIA), Kevin Kain, Karin Leder, James Black, Michael Catton, Beverley-Ann Biggs. Sanofi-Pasteur. 2007-2009. $500,000. International Conference and Seminar Presentations Joseph Torresi Presentation: with Ruth Chin, Bernd Koeberlein, Nguyen Linh Toan, Stefanie Illmann, Hanswalter Zentgraf and C.-Thomas Bock, ‘Mechanism of HBV-associated hepatocarcinogenesis by modulation of MAPK pathways and cell-cycle regulation’, Seminar, Department of Molecular Pathology, University of Tübingen, Germany 2006 Oral Presentation: Mechanism of HBV-associated hepatocarcinogenesis by modulation of MAPK pathways and cell cycle regulation. R Chin, B Koeberlein, H Zentgraf, T Bock, J Torresi. 12th International Symposium on Viral Hepatitis and Liver Disease, Paris, 2006 Oral Presentation: Cross-reactive epitopes identified in hepatitis C virus E1E2 proteins induce antibodies that capture virions from infected patients’ sera and inhibit HCV/HIV pseudo virus entry into susceptible cells. L Grollo, J Torresi, O Stock , A Fischer, H Drummer,W Zeng, DC. Research • Major Collaborations Department of Medicine Annual Report 2006 Travel Medicine Service, Victorian Infectious Diseases Service, Royal Melbourne Hospital Geosentinel is an international surveillance network that monitors the global spread of exotic infectious diseases amongst travellers, immigrants and expatriates. The program was established jointly by the International Society for Travel Medicine and CDC in Atlanta. The Victorian Infectious Diseases service at the Royal Melbourne Hospital is the only site in Australia involved with this international program and has played a lead role in conducting and publishing several research projects arising from within the network. Through this ongoing collaboration, the Travel Medicine unit will continue to develop a strong evidence base for clinical practice in this medical discipline including: http://www.medrmhwh.unimelb.edu.au/ 28 Jackson. 12th International Symposium on Viral Hepatitis and Liver Disease, Paris, 2006 Invited Seminar: HCV Vaccine Strategies, Department of Gastroenterology and Hepatology, School of Medicine, Hannover University, Germany, October 2006 Centre for Clinical Research Excellence in Infectious Diseases Teaching and Training Joseph Torresi Semesters 5, 8 and 9 lectures to undergraduate Medicine students Assessor for undergraduate Medicine students Examiner for undergraduate Medicine students Supervision Joseph Torresi Duangtawan Thammanichanond, ‘Identification and characterisation of HLA associations, NKT and dendritic cell responses with disease outcome in patients with acute and chronic hepatitis C infection’, PhD (Co-supervisor: Professor J. McCluskey, Department of Microbiology and Immunology, The University of Melbourne) Emily Ericsson, ‘Cytotoxic and NKT cells responses in the prevention of hepatitis C infection’, PhD (Principal Supervisor: Dr David Jackson, Department of Microbiology and Immunology, The University of Melbourne). Completed. Lara Grollo, ‘Mass spectroscopic identification of neutralising epitopes of hepatitis C virus’, PhD (Principal Supervisor: Dr David Jackson, Department of Microbiology and Immunology, The University of Melbourne). Completed Professional Activities Joseph Torresi Organiser and Presenter: Fairfield Travel Health Symposium for general practitioners and travel health specialists (from 1996—conducted jointly with the Victorian Medical Postgraduate Foundation and the Royal Australasian College of General Practitioners Member: Melbourne Hepatitis Molecular Research Group (from 2001) Associate Chair Scientific Committee of the 10th Conference of the International Society of Travel Medicine, Vancouver, 2007 Chair, Scientific Committee, Asia Pacific International Conference in Travel Medicine, Melbourne, 2008 Site Director: GeoSentinel, Melbourne (since 1998) Member: GeoSentinel Scientific Review Committee Member: International Society for Travel Medicine (since 1999) Member: Australian Centre for Hepatitis Research (since 1999) Contact Details Joseph Torresi Infectious Diseases Physician and Senior Lecturer Hepatitis Molecular Virology Laboratory Department of Medicine (RMH/WH) The University of Melbourne 4th Floor, Clinical Sciences Building The Royal Melbourne Hospital Victoria 3050 AUSTRALIA Tel: +61 3 8344 3262 Fax: +61 3 9347 1863 Email: [email protected] Head: Professor Graham V. Brown (Pictured) Clinical Trials Director: Dr Joe Sasadeusz Clinical Trials Manager: Dr Megan Brooks 2006 has been a very successful year for the Centre for Clinical Research Excellence in Infectious Diseases in fulfilling its goals of increasing capacity through career development of clinician scientists. Many young investigators are well advanced in their doctoral studies and several new grants have been obtained by postdoctoral fellows supported by the program. Dr Chris MacIsaac completed his PhD. Dr Caroline Marshall, Dr Allen Cheng and Dr Emma McBryde all received substantial new research funding. Particularly pleasing is the breadth of the program that includes doctoral scholars from Pharmacy and Nursing. Several members of the CCREID are now actively involved in our new work relating to the Capacity Building Grant from NHMRC which has the goal of developing Australia's expertise in modelling the spread and control of infectious diseases. The Guidance Decision Support team won the 'Innovation in Information Technology' section of the Victorian Public Healthcare awards. Demonstration that introduction of this technology leads to improved prescribing (and reduced cost) has created great interest among hospitals in Victoria, and interstate, with prospects for improved prescribing well beyond the hospital of origin. Special recognition should go to Kaz Thursky, Jim Black, Kirsty Buising and Marion Robertson for many years of Research Highlights Computer Based Decision Support Systems for Antibiotic Prescribing This research activity continues to provide important information regarding antibiotic usage and advice for prescribers. Results demonstrate that this approach reduces use and inappropriate prescribing in the Intensive Care Unit. Assessment in severity of pneumonia Dr Kirsty Buising has studied a variety of methods for assessing severity of pneumonia and criteria for admission to high dependency care. She has focused on the needs of clinicians requiring rapid assessment in the early period of hospitalisation. Low mannose-binding lectin function is associated with predisposition to Legionnaires’ disease. Innate immune system deficiency may predispose to severe infections such as Legionnaires’ disease. We have investigated the role of mannose-binding lectin (MBL) deficiency in the Melbourne Aquarium Legionnaires’ disease outbreak. MBL function, as shown by C4 deposition, was lower in Legionnaires’ disease patients than in age and sex matched uninfected, exposed controls. Hospitalised patients had a higher frequency of MBL deficiency than those who did not require hospitalisation. There was no difference in MBL levels between Legionnaires’ disease patients and controls. MBL functional deficiency may predispose to Legionnaires’ disease. Prevalence of Staphylococcus aureus, MRSA and Acinetobacter species at discharge from the Royal Melbourne Hospital Intensive Care Unit. Methicillin-resistant Staphylococcus aureus (MRSA) has been a long standing problem world-wide and Acinetobacter has become an increasing problem because of escalating antibiotic resistance. The exact prevalence of these organisms however, is unknown, and the utility of Evaluating the efficacy and safety of Pegasys RBV (peginterferon alfa-2a plus ribavirin) in patients with chronic hepatitis C (CHC) attending a drug dependency treatment programs. Most infections with chronic hepatitis C in Australia are related to injecting drug use (IDU) and an estimated 37,000 people receive drug dependency treatment. Despite treatment, there has been an overall increase in these patients in Australia since 2001 and uptake has been limited. This pilot study will determine the safety, efficacy, and tolerability of peginterferon alfa 2a (40KD) and ribavirin among people with CHC receiving drug dependency treatment (methadone, buprenorphine or naltrexone). Interim results suggest that efficacy and safety of Pegasys RBV when used in a patient population receiving drug dependency treatment are similar to non-IDU populations. Further, although data on the psychological impact of therapy is limited, it suggests treatment does not have a negative psychological impact on this group of patients. Please Note: Specific details relating to Publications, Seminars, Teaching and Training, Conference and Seminar Presentations, and Professional Activities of CCREID Investigators Professor Graham Brown, A/Professor Beverly-Ann Biggs, Dr Joe Torresi and A/Professor Stephen Rogerson, are described in this report under: Malaria Group, International and Immigrant Health Group, and Hepatitis Molecular Virology Research and Travel Medicine Service. Research For the purposes of this Annual Report, duplication was avoided by listing some outputs of academic staff in other sections of the report, such as the leadership role taken by Joe Torresi and Graham Brown in developing an evidence base for the international travel medicine with colleagues of the GEOSENTINEL network. active screening for detection of these organisms is still debated, particularly for Acinetobacter. Active screening in the Intensive Care Unit provided important additional data on MRSA and MSSA but may not be as important for Acinetobacter. 29 Publication Highlights Alonso-Echanove J, Sippy BD, Chin AE, Cairns L, Haley R, Epstein JS, Richards MJ, Edelhauser H, Hedberg K, Kuehnert MJ, Jarvis WR, Pearson ML. Nationwide outbreak of red eye syndrome associated with transfusion of leukocyte-reduced red blood cell units. Infection Control and Hospital Epidemiology. 2006; 27:1146-1152. Bennett NJ, Bull AL, Dunt DR, Russo PL, Spelman DW, Richards MJ. Surgical antibiotic prophylaxis in smaller hospitals. Australia and New Zealand Journal of Surgery. 2006;76:676-678. Bennett NJ, Bull AL, Dunt DR, Gurrin LC, Richards MJ, Russo PL, Spelman DW. A profile of smaller hospitals: planning for a novel, statewide surveillance program, The Centre for Clinical Research Excellence in Infectious Diseases (CCREID) Annual Colloquium, held on October 19, 2006, provided an opportunity for those involved in infectious diseases clinical research to present findings of research projects being conducted through the CCREID. L-R Front Row: Ms Marion Robertson, Dr Emma McBryde, Dr Jennifer Marriott, Prof Tania Sorrell (SAC), Dr Caroline Marshall, Prof Sharon Lewin, Prof Peter Ebeling, Ms Mary Ljubanovic L-R Middle Row: Dr Tabish Zaidi, Dr Joe Sasadeusz, Dr Jim Black, Prof Joe McCormack (SAC), Prof Steve Wesselingh (SAC), Dr Allen Cheng, Ms Jennifer Audsley, Dr Orla Morrissey, Ms Emily Mann, Dr Monica Slavin L-R Back Row: Ms Ana Hutchinson, Dr Chris Lemoh, A/Prof Eugene Athan, Dr Alan Street, Prof Graham Brown. Department of Medicine Annual Report 2006 contribution to the program and Professor Rana MacIntyre and Dr Hugo Stevenson who were intimately involved in obtaining funding to initiate the program. http://www.medrmhwh.unimelb.edu.au/ 30 Victoria, Australia. American Journal of Infection Control 2006;34:170-175. Buising KL, Thursky KA, Black JF, MacGregor L, Street AC, Kennedy MP, Brown GV. A prospective comparison of severity scores for identifying patients with severe community acquired pneumonia: reconsidering what is meant by severe pneumonia. Thorax 2006;61:419-424. Bull AL, Russo PL, Friedman ND, Bennett NJ, Boardman CJ, Richards MJ. Compliance with surgical antibiotic prophylaxis-reporting from a statewide surveillance Program in Victoria, Australia. Journal of Hospital Infection 2006; 63:140-147. Chen S, Slavin M, Nguyen Q, Marriott D, Playford EG, Ellis D, Sorrell T. Active surveillance for candidemia, Australia. Emergency Infectious Diseases 2006;12:1508-1516. Cowie BC. Is there an optimal genetic target for molecular analysis of hepatitis B virus transmission? Journal of Clinical Microbiology 2006;44:3051. Deb S, Walterfang M, Varghese D, Eisen DP, Tomlinson B, Velakoulis D. Cryptococcal dementia in a patient with sarcoidosis. Medical Journal of Australia 2006;184:86-87. Eisen DP, Dean MM, Thomas P, Marshall P, Gerns N, Heatley S, Quinn J, Minchinton RM, Lipman J. Low mannosebinding lectin function is associated with sepsis in adult patients. FEMS Immunology and Medical Microbiology 2006;48:274-282. Giles ML, Hellard ME, Lewin SR, Mijch AM. The evidence for a change in antenatal HIV screening policy in Australia. Medical Journal of Australia. 2006;185:217-220. Giles ML, Garland SM, Grover SR, Lewin SM, Hellard ME. Impact of an education campaign on management in pregnancy of women infected with a blood-borne virus. Medical Journal of Australia 2006;184:389-392. Hocking JS, Lim MS, Vidanapathirana J, Read TR, Hellard M. Chlamydia testing in general practice - a survey of Victorian general practitioners. Sex Health 2006;3:241-244. Leder K, Tong S, Weld L, Kain KC, Wilder-Smith A, von Sonnenburg F, Black J, Brown GV, Torresi J. Illness in travelers visiting friends and relatives: a review of the GeoSentinel Surveillance Network. Clinical Infectious Diseases 2006;43:1185-1193. Lemoh C, Biggs BA. Reducing the risk of transmission of HIV/AIDS in African and Arabic speaking communities in Victoria. June 2006 report to the Victorian Department of Human Services, prepared by the Department of Medicine (RMH/WH) in collaboration with the Burnet Institute, the Victorian Infectious Diseases Service and the Australian Research Centre in Sex, Health and Society. Leong CL, Buising K, Richards M, Robertson M, Street A. Providing guidelines and education is not enough: an audit of gentamicin use at The Royal Melbourne Hospital. Internal Medical Journal 2006;36:37-42. Lim MS, Marshall CL, Spelman D. Carriage of multiple subtypes of methicillin-resistant Staphylococcus aureus by intensive care unit patients. Infection Control and Hospital Epidemiology 2006;27:1063-1067. Matthews GV, Bartholomeusz A, Locarnini S, Ayres A, Sasaduesz J, Seaberg E, Cooper DA, Lewin S, Dore GJ, Thio CL. Characteristics of drug resistant HBV in an international collaborative study of HIV-HBV-infected individuals on extended lamivudine therapy. Aids. 2006; 20:863-870. McBryde ES, McElwain DL. A mathematical model investigating the impact of an environmental reservoir on the prevalence and control of vancomycin-resistant enterococci. Journal of Infectious Diseases 2006;193:14731474. Mijch A, Burgess P, Judd F, Grech P, Komiti A, Hoy J, Lloyd JH, Gibbie T, Street A. Increased health care utilization and increased antiretroviral use in HIV-infected individuals with mental health disorders. HIV Medicine 2006;7:205-212. Morrissey CO, Slavin MA. Antifungal strategies for managing invasive aspergillosis: The prospects for a preemptive treatment strategy. Medical Mycology 2006;44 Suppl:333-348. O'Brien DP, Leder K, Matchett E, Brown GV, Torresi J. Illness in returned travelers and immigrants/refugees: the 6-year experience of two Australian infectious diseases units. Journal Travel of Medicine 2006;13:145-152. Richards JS, MacDonald NJ, Eisen DP. Limited polymorphism in Plasmodium falciparum ookinete surface antigen, von Willebrand factor A domain-related protein from clinical isolates. Malaria Journal 2006;5:55. Russo PL, Bull A, Bennett N, Boardman C, Burrell S, Motley J, Berry K, Friedman ND, Richards M. The establishment of a statewide surveillance program for hospital-acquired infections in large Victorian public hospitals: a report from the VICNISS Coordinating Centre. American Journal of Infection Control. 2006;34:430-436. Thursky KA, Buising KL, Bak N, Macgregor L, Street AC, Macintyre CR, Presneill JJ, Cade JF, Brown GV. Reduction of broad-spectrum antibiotic use with computerized decision support in an intensive care unit. International Journal of Quality Health Care 2006;18:224-231. Thursky KA, Worth LJ, Seymour JF, Miles Prince H, Slavin MA. Spectrum of infection, risk and recommendations for prophylaxis and screening among patients with lymphoproliferative disorders treated with alemtuzumab*. British Journal of Haematology 2006;132:3-12. Thursky KA, Mahemoff M. User-centered design techniques for a computerised antibiotic decision support system in an intensive care unit. International Journal of Medical Information 2006 Sep 1; (Epub ahead of print) Thursky K. Use of computerized decision support systems to improve antibiotic prescribing. Expert Review of AntiInfective Therapy 2006;4:491-507. Tong SY, Haqqani H, Street AC. A pox on the heart: five cases of cardiovascular syphilis. Medical Journal of Australia 2006;184:241-243. Worth LJ, Thursky KA. Cytomegalovirus reactivation in patients with chronic lymphocytic leukemia treated with alemtuzumab: prophylaxis vs. pre-emptive strategies for prevention. Leukemia and Lymphoma. 2006;47:2435-2436. Ongoing Grants NH&MRC Capacity Building Grant: C R Macintyre, N G Becker, M Law, A Plant, T M Nolan and G V Brown, 2005–09, ‘Mathematical modelling for improved planning of infectious disease control policy’: $3,000,000 NH&MRC: G V Brown, B-A Biggs, D Campbell, S Lewin, M Slavin, M Richards, J Sasadeusz, J Torresi and S Rogerson, 2003–07, Centre for Clinical Research Excellence in Infectious Diseases: $2,000,000 National Institutes of Health (USA) RO1 Project Grant: J Sasadeusz, S Locarnini, S Lewin, J Hoy, G Dore and G Mathews, 2004–09, “Liver Disease and HIV/HBV coinfection in the era of HAART.” US$998,552 Sylvia and Charles Viertel Charitable Foundation: C Marshall, “Do rapid detection and isolation of colonised patients reduce MRSA spread? An epidemiological, economic and modelling study.” A$60,000 Victor Hurley Foundation: A Hutchinson, “Role of newlydiscovered respiratory viruses in exacerbations of COPD.” Victor Hurley Foundation: C Lemoh, “HIV in Victoria’s African communities.” A$5,000 Collaborations Non-Industry: Department of Human Services, Victoria; MedSeed; The GeoSentinel Network, Centres for Disease Control and Prevention (CDC); Mycosis Interest Group (MIG) of the Australasian Society for Infectious Diseases (ASID); National Centre for HIV Epidemiology and Clinical Research; The Alfred Hospital; Burnet Institute; Walter Eliza Hall Institute; International Collaboration on Endocarditis; Clinical Haematology and Bone Marrow Transplant Unit, Royal Melbourne Hospital; Royal Adelaide Hospital Conference And Seminar Presentations Ms Jennifer Audsley • Presentation: “Surveillance of hepatitis B virus mutations during tenofovir treatment in HIV/HBV co-infected individuals.” Australian Society for HIV Medicine, 11-14 October 2006. Dr Damon Eisen • Plenary Presentation: “Fungal infections and the innate immune system.” Australasian Society for Infectious Diseases. Invited Plenary, Annual Scientific Meeting 2006. • Plenary Presentation: with M Dean, P Thomas, P Marshall, N Gerns, S Heatley, J Quinn, R Minchinton and J Lipman. “Low mannose-biding lectin function is associated with sepsis in immunocompetent adults.” 31 Australasian Society for Infectious Diseases. Annual Scientific Meeting 2006. • Poster Presentation: with M O’Sullivan. “The primaquine tolerant phenotype of Plasmodium vivax isolates from the south west pacific region is shared between genotypically diverse organisms.” Australasian Society for Infectious Diseases. Annual Scientific Meeting, 2006. • Presentation: with C Cabell, C Mestres, N Chipigna, V Fowler. “The Use of Early Surgery in Definite Infective Endocarditis (IE): A Propensity Matched Analysis from 1622 Patients.” American Heart Association. Scientific Sessions 2006. • Invited Lecture: “Mannose binding lectin; Biology and therapeutic potential of an innate immune system – pattern recognition molecule.” Australian and New Zealand Society of Blood Transfusion. Annual Scientific Meeting 2006. Industry: Gilead Sciences, Inc.; GlaxoSmithKline; Novartis; Roche Products Pty Ltd; Ribapharm Inc; Bristol Myers Squibb; Human Genome Sciences; Intercell AG; Theravance, Inc, Schering-Plough Inc Awards And Prizes The Victorian Infectious Diseases Service (VIDS) Guidance DS team won the Innovation in Information Technology category at the Victorian Public Healthcare Awards. L-R: Dr Jim Black, Dr Kirsty Buising, Dr Karin Thursky, Ms Marion Robertson and Ms Renukadevi Shanmuga Sundaram Back row: Prof Graham Brown. Dr Benjamin Cowie Awarded life membership to the John Snow Society, Introduction to Infectious Disease Modelling and its Applications, London School of Medicine and Tropical Hygiene, August 2006. Dr Kirsty Buising, Dr Karin Thursky, Dr Jim Black, Ms Marian Robertson, Ms Renu Shanmugasundaram GUIDANCE decision support system. DHS Victorian Public Health Care Award for Innovation in Information Technology. October, 2006. Dr Sharon Lewin Identification of hepatitis B virus adaptation to host HLArestrcted immune responses in vivo. SR Lewin, S Mallal, G Lau, S Locarnini, C desmond, S Roberts. Roche PILLAR awards. 2006-2007. Role: PI. $40,000 total. The role of CCR7 ligands in HIV latency. American Foundation for AIDS Research. 2006-2007. Role: PI. $120,000 USD. Dr Emma McBryde PhD awarded December 2006 - Dean's prize for outstanding thesis, the Faculty of Science, QUT Dr Allen Cheng • Poster Presentation: with AJ Wade, E Athan, JL Molloy, OC Harris, J Stenos, AJ Hughes. “Q fever outbreak in a cosmetics supply industry.” The Australasian Society for Infectious Diseases Annual Scientific Meeting, Auckland, New Zealand. May, 2006. Dr Benjamin Cowie (PhD student) • Presentation: “Natural history and disease progression of HCV infection. Australasian Society for HIV Medicine Short Course in Viral Hepatitis Medicine.” Melbourne, October. • Presentation: “Epidemiology, natural history and public health issues in HBV infection.” Australasian Society for HIV Medicine Short Course in Viral Hepatitis Medicine, Melbourne, October. • Presentation: “The unwell returned traveller.” Australian Doctor / Coppleson Committee for Continuing Medical Education seminar, Melbourne, March A/Professor Jenny Hoy • Invited Speaker: “Overview of Treatment Interruption Studies.” 18th Annual Conference of the Australasian Society for HIV Medicine, Melbourne, 11-14 October 2006. • Presentation: with K Singh, J van Herpen, S Jones, SR Lewin. “Human Cytomegalovirus (HCMV)-specific CD8+ T-cell responses are reduced in HIV-infected Research NH&MRC: E McBryde “Mathematical modelling of influenza epidemics”. Dr Monica Slavin Doctor of Medicine Thesis 2006 (Department of Medicine, University of Melbourne). “Prevention of Infection in patients undergoing treatment for Haematological Malignancies.” Supervisors: A/Prof Beverley Ann Biggs, Professor Richard Fox. Department of Medicine Annual Report 2006 Victor Hurley Foundation: C Marshall, “Do rapid detection and isolation of colonised patients reduce MRSA spread? An epidemiological, economic and modelling study.” A$10,000 http://www.medrmhwh.unimelb.edu.au/ individuals with a history of HCMV Disease despite CD4+ cell Recovery.” 18th Annual Conference of the Australasian Society for HIV Medicine, Melbourne, 1114 October 2006. • • • • 32 • Presentation: with AB Pierce, S Herber, EJ Wright. “Re-attenders for Non-occupational Post-exposure Prophylaxis – Experience from a Tertiary Referral Centre, Australia.” 18th Annual Conference of the Australasian Society for HIV Medicine, Melbourne, 1114 October 2006. Poster Presentation: with JF Chen. “Mycobacterial Immune Restoration Disease after Highly Active Antiretroviral Therapy – A Retrospective Case Series.” 18th Annual Conference of the Australasian Society for HIV Medicine, Melbourne, 11-14 October 2006. Poster Presentation: on behalf of the SMART Study Group. “Severity of Clinical Events by Proximal CD4 cell counts in the SMART study.” 18th Annual Conference of the Australasian Society for HIV Medicine, Melbourne, 11-14 October 2006. Poster Presentation: on behalf of the SMART Study Group. “Predictors for the Initial CD4 cell Decline after Antiretroviral Treatment Interruption in the SMART Study.”18th Annual Conference of the Australasian Society for HIV Medicine, Melbourne, 11-14 October 2006. Poster Presentation: with G Beatty, T Vangeneugden, E Lefebvre. “Body mass change and anthropometricrelated adverse events at week 24 in treatment experienced HIV-infected patients receiving TMC114/r or control PIs in POWER 1,2 and 3.” 8th International Workshop on Adverse Drug Reactions and Lipodystrophy, San Francisco, USA, 24-26 September 2006. Anastasia Hutchinson (PhD Student) • Thoracic Society of Australia and New Zealand, Canberra 2006 and American Thoracic Society, San Diego, 2006. -Presentation: Respiratory viruses cause exacerbations of COPD: a time-matched case-control study. Melbourne Longitudinal COPD Cohort Study (MLCC). -Presentation: Predicting outcome of COPD exacerbations using clinical measures and C-reactive protein in the Melbourne Longitudinal COPD Cohort (MLCC). -Presentation: Patient self-management training and a nurse-led rapid assessment service in the community decreases severity of exacerbations and readmission rates in the Melbourne Longitudinal COPD Cohort (MLCC). Professor Sharon Lewin • Plenary Speaker: Determinants of HIV-related immune reconstitution. 9th Bangkok HIV symposium, Bangkok, Thailand • Invited Speaker: Establishment of a National QA program for PBMC collection in Australia. Laboratory Workshop, 9th Bangkok HIV symposium, Bngkok, Thailand • Third Shanghai-Hong Kong International Liver Congress. Shanghai, March 2006 - Keynote Speaker: “The adaptive immune response to hepatitis B virus infection” - Invited Speaker: “Immunopathogenesis of HIV-HBV co-infection” • Keynote Speaker: “The adaptive immune response to hepatitis B virus infection.” Pohang University • Speaker: The adaptive immune response to hepatitis B virus infection. Autumn conference for the Korean Society for immunology. Dr Caroline Marshall • Presentation: “Acinetobacter in three Melbourne hospitals: an emerging nosocomial pathogen.” Australasian Society for Infectious Diseases Annual Scientific Meeting, Wellington, New Zealand. • Presentation: “Clinical and Laboratory investigation of Undiagnosed Encephalitis (The CLUE Study).” Australasian Society for Infectious Diseases Annual Scientific Meeting, Wellington, New Zealand. Dr Orla Morrissey (PhD student) • Invited Speaker: “Antifungal Strategies in High Risk Patients.” New Zealand Branch of the Haematology Society of Australia and New Zealand Annual Scientific Meeting. 6 April 2006. Palmerston North. • Presentation: “Antifungal Stragegies for Invasive Aspergillosis in High-Risk Haematology Patients.” Department of Medicine, Central and Eastern Clinical School, Monash University. 4 May 2006. • Presentation: “A Randomised Controlled Trial Comparing Two Stragegies for the Diagnosis of Invasive Aspergillosis in High-Risk Haematology Patients.” Australasian Leukaemia Lymphoma Group Meeting, 710 Nov 2006. Brisbane. Associate Professor Michael Richards • Presentation: “Clinical performance indicators: The VICNISS Program: Surveillance of hospital-acquired infections in acute-care Victorian public hospitals.” Better State of Hospitals Conference April 2006, Melbourne. • Presentation: “VICNISS: A state-wide surveillance program for hospital-acquired infections in acute-care Victorian public hospitals.” Monitoring the Quality of Care in Hospitals seminar, Melbourne, April 2006. • Poster Presentation: with N Bennett, K Berry, C Boardman, A Bull, S Burrell, N Friedman, P Russo. “Educating smaller rural hospital infection control (IC) nurses, Victoria, Australia.” Association for Professionals in Infection Control and Epidemiology (APIC) 33rd Annual Educational conference and International Meeting. Tampa, Florida. June 2006. • Poster Presentation: with N Bennett, K Berry, C Boardman, A Bull, S Burrell, N Friedman, P Russo. “Piloting a novel State-wide smaller hospital nosocomial infection surveillance program.” Association for Professionals in Infection Control and Epidemiology (APIC) 33rd Annual Educational Conference and International Meeting. Tampa, Florida. June 2006. • Poster Presentation: with N Bennett, K Berry, C Boardman, A Bull, S Burrell, N Friedman, P Russo. “Surgical antibiotic prophylaxis in smaller hospitals, Victoria, Australia.” Society for Healthcare Epidemiology of America 16th Annual Scientific Meeting. Chicago, March 2006. • Invited Plenary Speaker: “Hospital Infection Surveillance in Australia – one nation or many states?” Hospital Infection Society Biannual meeting, Amsterdam, October 2006. Associate Professor Monica Slavin • Presentation: “Antifungal Strategies for Invasive Aspergillosis: Prophylaxis, Empiric or Pre-emptive therapy?” Advances in Aspergillosis, Athens, February 2006. • Presentation: “Fungal infection: newer approaches for diagnosis and treatment: experience in the haematology department.” 10th Western Pacific Congress on Chemotherapy and Infectious Diseases, Fukuoka, Japan, December 2006. • Co-opted examiner, FRACP Clinical examination. • Dr Alan Street • Invited speaker: “Update on tuberculosis.” Society of Hospital Pharmacists of Australia (Vic). June 2006 Tutorials on Infectious Diseases to Basic Physician Trainees. • Lectures on Infectious Diseases to undergraduate Medicine Students (semester 8/9). • Chair: Consensus conference: Australasian Society for HIV Medicine Annual Conference, Melbourne, Vic, October. Dr Leon Worth (PhD student) • Poster Presentation: with MA Slavin, JF Seymour, KA Thursky. “Enterococcus faecium bacteremia in patients with haematological malignancy: a case control study to identify risk factors.” Infectious Diseases Society of America meeting, Toronto, 2006. Associate Professor Jenny Hoy • Lectures on Infectious Diseases to undergraduate Medicine students (semester 8/9) Professor Sharon Lewin • Overall supervision of the infectious diseases module of the Bachelor of Biomedical Science, Monash University • Post graduate teaching for physician trainees and advanced trainees in Infectious Diseases. Dr Emma McBryde • Series of three seminars on mathematical modelling of infectious diseases at the University of Melbourne Presentation: “Achieving quality outcomes: an infection control needlestick prevention initiative two years on.” Australian Infection Control Association meeting. Sydney, 2006. • Centre for Clinical Research Excellence in Infectious Diseases Annual Colloquium, 19 October, 2006. • FRACP candidate tutorials. • Intern training (antibiotic usage). • Lectures: Nosocomial infection surveillance and hospital epidemiology for post graduate students, School of Population Health, University of Melbourne. • Dr Caroline Marshall: Staphylococcus aureus, MRSA and Acinetobacter in the RMH intensive care unit: prevalence at discharge Dr Chris MacIsaac: Superantigens in sepsis Dr Chris Lemoh: HIV in Victoria’s African communities Ms Jennifer Audsley: Surveillance of Hepatitis B Virus (HBV) mutations during Tenofovir (TDF) treatment in HIV and HBV co-infected individuals Lecture at the infectious diseases research course Associate Professor Michael Richards • Lectures on Infectious Diseases to undergraduate Medicine students, undergraduate examiner. Program Dr Joe Sasadeusz: Chair Professor Graham V Brown: Welcome • Lectures and group learning for General Practitioners Associate Professor Monica Slavin • Lecture “Infection in the immunocompromised host.” RACP Lecture Series, Melbourne Peter MacCallum Cancer Centre resident medical officer lecture series. “Infections in cancer patients.” 2000-2006. • Postgraduate nursing courses in Bone Marrow Transplantation, Unviersity of Melbourne and Monash University. “Infections in marrow transplant recipients.” 2000-2006. Dr Emma McBryde: Using mathematical models of MRSA transmission to inform isolation strategy • Master of Pharmacy course, Monash University. “Update on antifungals.” 2002-2006. Dr Tabish Zaidi: Translating research into action-formative evaluation of an antibiotic decision support system. Dr Alan Street • Lectures on Infectious Diseases to undergraduate Medicine students (semester 8/9 and semester 12) Dr Allen Cheng: Simple mathematical models in melioidosis Teaching And Training Dr James Black • Lecture: Ethics of research (‘Context and Practices’ unit for the Master of Clinical Research). • Lecture: International surveillance (Infectious Disease Epidemiology unit). • Lecture: Surveillance in complex emergencies (Refugee health course. Burnet Institute for Medical Research). • Lecture: Surveillance in complex emergencies (Refugee health course. Burnet Institute for Medical Research). • Lecture: Water and sanitation, control of enteric diseases and ORS (Field Methods course Burnet Institute for Medical Research). Dr Damon Eisen • Director of Physician Training, RMH. 33 Dr Joe Sasadeusz • Lectures on Infectious Diseases to undergraduate Medicine students (semester 8/9) • Professor Steve Wesselingh: Clinical research at The Macfarlane Burnet Centre for Medical Research Research Presentation: “Clinical dilemmas in HIV management — TB.” Australasian Society for HIV Medicine Annual Conference, Melbourne, Vic, October. • Preparation of candidates for part 1 examination, RACP • General practitioner continuing education Supervision • Dr Ben Cowie: Epidemiology of hepatitis B virus in Victoria. PhD. University of Melbourne, 2005-2008. Co-Supervisors: Professor Sharon Lewin, Professor Graham V Brown, Heath Kelly, Margaret Hellard. • Ms Judy Chang: HBV-specific T cell immunity. PhD. Department of Microbiology and Immunology, University of Melbourne, 2004-2007. Supervisor: Sharon Lewin. • Dr Christopher Desmond. Pathogenesis of Hepatitis B virus infection. PhD. Department of Medicine, Monash University. 2006-2009. Supervisor: Sharon Lewin Department of Medicine Annual Report 2006 • http://www.medrmhwh.unimelb.edu.au/ • Ms Maria Downey: Pharmacoeconomic analysis of antifungal prophylaxis in haematology patients. Master of pharmacy, 2006-2007. Supervisor: Monica Slavin. • Ms Vanessa Evans: Thymic dendritic cells and HIV infection. PhD. Department of Medicine, Monash University. 2006-2009. Supervisor: Sharon Lewin. • Dr Michelle Giles: HIV and pregnancy in Australia. PhD. Department of Medicine, Monash University, 20052008. Co-Supervisors: Sharon Lewin, Suzanne Garland, Margaret Hellard. • • Ms Ana Hutchinson: Viral exacerbation of COPD. PhD. University of Melbourne, 2004–07. Co-Supervisors: James Black, Gary Anderson, Louis Irving. Dr David Iser: Interactions between HIV and Hepatitis B Virus. PhD. Department of Medicine, St Vincent’s Hospital. The University of Melbourne, 2005-2008. Supervisor: Sharon Lewin. • Mr Nick Jones: Bedside monitoring for aminoglycoside induced vestibular toxicity. Master of Clinical Pharmacy, 2005-06. Co-Supervisors: Mike Richards, Jim Black, David Kong, Owen White. • Ms Emily Karahalios: The effect of the Commonwealth games on frequency of ICD-10 codes in syndromic surveillance data from hospital emergency departments. Master’s degree.Supervisor: Jim Black 34 • Ms Natalie Lane: BSc (Hons). Monash University, Supervisor: Sharon Lewin. • Dr Chris Lemoh: HIV in Victoria’s African Communities. PhD. University of Melbourne, 2004–07. CoSupervisors: Bev Biggs, Alan Street, Margaret Hellard. • Dr Orla Morrissey: Early diagnosis and management of invasive aspergillosis in patients with haematological malignancy. PhD. Monash University, 2002-06. CoSupervisors: Monica Slavin, Steve Wesselingh, Tania Sorrell. • Dr Mark Newell: ICD-10 codes corresponding to influenza-like illness in syndromic surveillance data from hospital emergency departments. Public Health Trainee, Victorian Public Health Training Scheme. Supervisor: James Black. • Dr Irani Ratnam: Acquisition of respiratory and arbovirus infections by Australian travellers. PhD. University of Melbourne, 2006-2009/10. Co-Supervisors: A/Prof Mike Richards, Joe Torresi, James Black. • Dr Jack Richards: The role of antibodies to Plasmodium falciparum erythrocyte invasion ligands in protection against malaria. PhD. University of Melbourne, 200608. Co-Supervisors: Graham Brown, James Beeson. • Ms Emma Tippet: Macrophages and HIV infection. PhD. Department of Medicine, Monash University. 2005-2008. Co-Supervisor: Sharon Lewin • Dr Paul Vinton: An evaluation of a new test for the detection of latent TB infection. PhD. University of Melbourne, 2004–07. Co-Supervisors: Bev. Biggs, Paul Johnson, Janet Fyfe, Heath Kelly. • • Dr Leon Worth: Risk factors and surveillance for catheter-related bloodstream infections in patients with haematological malignancy. PhD. University of Melbourne, 2004–07. Co-Supervisors: Monica Slavin, James Black, Graham Brown. Dr Tabish Zaidi: Evaluating the impact of computerised antibiotic decision support system at RMH. PhD. Monash University, 2004-2007. Co-Supervisors: Jennifer Marriott, Roger Nation. Professional Activities Dr James Black • Australasian Faculty of Public Health Medicine (AFPHM) - Examiner - Mentor: Four advanced trainees for the Fellowship of the AFPHM: Drs Mark Newell, Danny Csutoros, Julie Wang and Ben Coghlan. Dr Damon Eisen • Consortium Management Committee, Greater Western Basic Physician Training Consortium. • Department of Human Services, Pandemic Influenza Steering Committee. • Infection Control Committee, Melbourne Private Hospital. • Medical Advisory Committee, Melbourne Private Hospital. Dr Jenny Hoy • National Centre in HIV Epidemiology and Clinical Research Working Groups - Protocol Working Group, Chair. - Toxicology and Pharmacology Working Group, Chair. • Australasian Society in HIV Medicine (ASHM) - Education Program Steering Committee. - National Clinical Sub-Committee - Australasian Antiretroviral Guidelines Panel. • Alfred Hospital - Deputy Chair, Research Committee - Member, Quality and Audit Committee Professor Sharon Lewin • Chair: Australian Antiretroviral Guidelines Consensus Conference, Melbourne, 2006. • Member: Ministerial Advisory Committee on HIV and Sexual Health and Hepatitis. Dr Emma McBryde • Assisting in organisation and teaching at one day workshop on infectious diseases modelling satellite workshop of CDNA conference run by NIDMA • Drafting guidelines, validation studies and methodology to compare risk across hospital groups for VICNISS, the Victorian hospital acquired infection surveillance service. A/Professor Michael Richards • Member: Victorian Advisory Committee for Infection Control. Dr Joe Sasadeusz • Treasurer, Australasian Society for HIV Medicine. • Member Ministerial Advisory Committee on Blood Borne Viruses and Sexually Transmitted Infections. • Human Research and Ethics Committee, Melbourne Health. Dr Monica Slavin • Research Associate: Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne. Dr Alan Street • Member: Ministerial Advisory Committee on Tuberculosis, Department of Human Services. • Chair: Australian Antiretroviral Guidelines Panel, Australasian Society of HIV Medicine. • Member: Expert Writing Group, Therapeutic Guidelines: Antibiotic Version 13. • Member: Organising Committee, Australasian Society for HIV Medicine (ASHM) Annual Meeting, Melbourne, Vic, 2006. Bone and Mineral Research Other Prominent Activities A/Professor Michael Richards • Session Chair: Sir Edward Dunlop Medical Research Foundation Annual Symposium. A/Professor Monica Slavin • Symposium Co-Chair: “What the ID specialist should know about opportunistic fungal pneumonia.” 46th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), San Francisco, 2006. Research Dr James Black • Lectures: 2nd Annual Nossal Global Health Forum - Information Technology Tools for Epidemiologists in Developing Countries. - Information technology in global disease surveillance and outbreak response. Contact Details Centre for Clinical Research Excellence in Infectious Diseases (CCREID) 35 Victorian Infectious Diseases Service Dr Megan Brooks, Clinical Trials Manager 9 North, City Campus, Main Block Royal Melbourne Hospital, Grattan Street Parkville, Vic. 3050 Tel: +61 3 9342 8896 Fax: +61 3 9342 2107 Email: [email protected] Head: Professor John Wark Activities of the Bone Research Group are underpinned by an integrated approach to research, teaching and patient care. High-profile publications have been produced by members of the group on the prevention of falls by vitamin D supplementation in residential care, the association of maternal vitamin D status with foetal long bone growth, genetic determinants of mammographic density and bone density, the association between antiepileptic drug therapy and bone mineral density, and the utility of sub-regional vertebral bone mineral density measurements. Current and Completed Research Projects • Efficacy and safety of vertebroplasty for the treatment of painful osteoporotic spinal compression fractures • Is bisphosphonate therapy in benign bone disease associated with impaired dental healing? A casecontrolled study • A naturalistic 'real life' comparison of osteoporosis therapies: the comprehensive cohort study (CCS) design including a nested randomised trial (RCT): A pilot program extension • Patient preferences in osteoporosis therapy (Time Trade Off) • A collaborative research program with the RMH Department of Neurology in studying the effects of anti-epileptic drugs on bone health • Effects of smoking on bone health Department of Medicine Annual Report 2006 Research Highlights http://www.medrmhwh.unimelb.edu.au/ 36 • Optimizing the bone response to dietary calcium: a physiological approach • The effect of anti-epileptic medications on bone mineral density, bone turnover and fracture risk • Heritability of gait and balance function • Is regular table tennis activity associated with increased bone and muscle strength and improved balance in elderly Asian men and women • Intrauterine growth restriction programs reduce bone development and bone mass • The evaluation of quantitative ultrasound in AED – induced bone desease, comparing AED users and non users • Smoking cessation and bone health: observational and intervention studies in twins and a Quitline population • Predictors of glucocorticoid induced bone loss • Keppra versus older anti-epileptic medications and neuropsychiatric, neurocognitive and quality of life outcomes in treatment of epilepsy as first substitution monotherapy. Bone health and body composition substudy. Publication Highlights Dite GS, Wark JD, Giles GG, English DR, McCredie MRE, Hopper JL. Is there a positive association between breast density and bone mineral density? Breast Cancer Research 8: 401, 2006 Reid DM, Hosking D, Kendler D, Brandi ML, Wark JD, Weryha G, Marques-Neto JF, Gaines KA, Verbruggen N, Melton ME. Alendronic acid produces greater effects than risedronic acid on bone density and turnover in postmenopausal women with osteoporosis: Results of FACTS-International. Clinical Drug Investigation 26, 63-74, 2006 Briggs AM, Wark JD, Kantor S, Fazzalari NL, Greig AM, Bennell KL Bone mineral density distribution in thoracic and lumbar vertebrae: an ex vivo study using dual energy x-ray Absorptiometry. Bone 38 (2) 286-288, 2006. Morley R, Carlin JB, Pasco JA, Wark JD. Maternal 25hydroxyvitamin D and parathyroid hormone concentrations, and offspring birth size. Journal of Clinical Endocrinology and Metabolism. 91(3): 906-12, 2006 Scherer SC, Farrell MJ, Flicker L, Davis I, Wark JD. Promoting evidence-based best practices for hip fracture prevention in residential aged care. Australasian Journal of Ageing. 25 (4); 185-190, 2006 Matthews BL, Bennell KM, McKay HA, Khan KM, BaxterJones ADG, Mirwald RL, Wark JD. The influence of dance training on growth and maturation of young females: a longitudinal study. Annals of Human Biology. 33(3): 342-56, 2006 Matthews B, Wark JD, Bennell K, Bell M. Dancing for bone health: A 3-year longitudinal study of bone mineral accrual across puberty in female non-elite dancers and controls. Osteoporosis International 17(7): 1043-54, 2006 El Haber N, Hill KD, Cassano AT, Paton AL, MacInnis RJ, Cui JS, Hopper JL, Wark JD. Genetic and environmental influences in variation on balance performance. American Journal of Epidemiology 2006, 164(3); 236-256. Flicker L, MacInnes RJ, Stein MS, Scherer SC, Mead KE, Nowson CA, Thomas J, Lowndes C, Wark JD, Hopper JL Response Letter to Dr Gau Barcikowski RS JAGS 2006 Choo, CS, Maylor Z, Wark JD. D2, D3 – what’s the difference. Pharmacy Practice and Research, 2006: 36(3); 246-248 Clinical and Biochemical Disorders of the Skeleton - authors – Roger Smith and Paul Wordsworth. Oxford University Press. 2005. Wark. JD. Review published in the British Journal of Sports Medicine. 2006. Chapters RG Larkins, JD Wark. (Chapt. 4)35-43 Abnormal laboratory results: Chapter – Calcium: 2nd Edition. The McGraw-Hill Companies 2006. Selected Abstracts Greater gains in BMD with Alendronate than Risedronate after 24 months: Results of Fosamax comparison trials (FACTS) – International. Marques-Neto JF, Reid DM, Hosking D, Kendler D, Brandi ML, Ward JD, Weryha G, Vertbrugge N, Hustad CM, Mahlis EM, Melton ME. Panlar Meeting, August 2006. A comparison of the effect of Alendronate and Risedronate on bone mineral density in postmenopausal women with osteoporosis over 24 months (Fosamax Actonel Comparison Trials – International). Reid DM, Hosking D, Kendler D, Brandi ML, Wark JD, Weryha G, MarquesNeto JF, Verbrugger N, Hustad CM, Melton ME. ECCEO International Conference 2006. Vienna. Maternal vitamin D deficiency predicts decreased fetal growth. Wark JD, Morley R, Carlin J, Pacso J. 6th International Symposium on Nutritional Aspects of Osteoporosis 2006. Switzerland The relationship of nutrient intake to bone density in females: a twin study. Nowson C, Conn J, Lucas M, Wark JD. 6th International Symposium on Nutritional Aspects of Osteoporosis 2006. Switzerland. Maternal vitamin D deficiency is associated with reduced fetal growth. Wark JD, Morley R, Carlin J, Pasco. 33rd European Symposium on Calcified Tissues 2006. Prague, Czech Republic. Greater gains in BMD with Alendronate than Risedronate after 24 months: Results of FOSAMAX, ACTONEL comparison trials (FACTS)-International. Marques-Neto JF, Reid DM, Hosking D, Kendler D, Brandi ML, Wark JD, Weryha G, Verbrugger N, Hustad CM, Mahlis EM, Melton ME. 14th Pan-American Rheumatology Conference 2006, Peru. The relationship of nutrient intake to bone density in females: A twin study. Nowson C, Conn J, Lucas M, Wark JD. 3rd IOF Asia-Pacific Regional Conference on Osteoporosis and 16th Annual Meeting of the Australian and New Zealand Bone and Mineral Society. October 2006. Being born small following placental insufficiency programs reduced bone size independent of the quality of the postnatal lactational environment. Romano T, Wark JD, Owens JA, Wlodek ME. AHMRC Bone 2006. Subregional BMD is a better predictor of vertebral morphology than standard DXA-derived BMD measures. Briggs AM, Kantor S, Fazzalari N, Wark JD. 3rd IOF AsiaPacific Regional Conference on Osteoporosis and 16th Annual Meeting of the Australian and New Zealand Bone and Mineral Society. October 2006. Port Douglas Static balance is affected by vertebral fracture but not thoracic kyphosis in individuals with osteoporosis. Greigg, AM, Bennell KL, Briggs AM, Wark JD, Hodges PW. 3rd IOF Asia-Pacific Regional Conference on Osteoporosis and 16th Annual Meeting of the Australian and New Zealand Bone and Mineral Society. October 2006. Port Douglas. Why is smoking a risk factor for fractures? A new twin study. Bradbeer M, Day L, Kantor S, Segan C, Osborne R, Nowson C, Gill S, Sambrook, Federova T, Wark JD. 3rd IOF Asia-Pacific Regional Conference on Osteoporosis and 16th Peripheral quantitative computed tomography in patients receiving long term glucocorticoid therapy. Kantor S, Gong FF, Wong P, McColl G, Wark JD. 3rd IOF Asia-Pacific Regional Conference on Osteoporosis and 16th Annual Meeting of the Australian and New Zealand Bone and Mineral Society. October 2006. Port Douglas. Chronic anti-epileptic drug treatment is associated with impairment in balance function: A twin and matched sibling pair pilot study. Petty SJ, Paton LM, El Haber N, O’Brien TJ, Bennell K, Berkovic SF, Wark JD. 3rd IOF Asia-Pacific Regional Conference on Osteoporosis and 16th Annual Meeting of the Australian and New Zealand Bone and Mineral Society. October 2006. Port Douglas. More patients gain BMD with Alendronate than Risedronate after 24 months: Results of FOSAMAX/ACTONEL comparison Trials (FACTs) – International. Kendler D, Reid DM, Hosking D, Brandi ML, Wark JD, Marques-Neto JF, Weryha G, Verbruggen N. Hustad CM, Mahlia EM, Melton ME. ASBMR 28th Annual Meeting 2006. Philadelphia USA Vitamin D status, parathyroid hormone levels and predictors of falls risk in well women aged 47-80 years. El Haber N, Hill K, Wark JD. 3rd IOF Asia-Pacific Regional Conference on Osteoporosis and 16th Annual Meeting of the Australian and New Zealand Bone and Mineral Society. October 2006. Port Douglas. The relationship between age and measures of balance, strength and gait - analysis using non-linear modeling. El Haber N, Erbas B, Hill KD, Wark JD. 3rd IOF Asia-Pacific Regional Conference on Osteoporosis and 16th Annual Meeting of the Australian and New Zealand Bone and Mineral Society. October 2006. Port Douglas. An update on Fracture Prevention Strategies (Exercise for preventing falls and fractures: A review of 50 randomised controlled trials). Wark JD. Australian Falls Prevention Conference, 5-7th November 2006, Brisbane, Australia. Conference and Seminar Presentations ‘Hypercalcaemia – tips for diagnosis and management.’ Board of Postgraduate Medical Education (MURMA). March 2006. Roundtable on the Women’s Health Initiative. 6th International Symposium on Nutritional Aspects of Osteoporosis. May 2006 2004-2007 Efficacy and safety of vertebroplasty for the treatment of painful osteoporotic spinal compression fractures. NH&MRC Project Grant. Investigators: R Buchbinder, D Connell, R Osborne, J Wark, P Ebeling, S Graves, ($568,000) 2006 Intrauterine growth restriction programs reduced bone growth and development in rats. Eli Lilly 2006 Endocrinology Research Grant. M Wlodek. J Wark, J Owens, D Myers. ($25,000). 2006-08. The effect of anti-epileptic medication on indices of bone health and risk factors for falls and fractures. NH&MRC Project Grant. Investigators: J Wark, T O’Brien, P Sambrook, K Hill, M Seibel, G Herkes ($440,000). 2006-7 Study Extension - A naturalistic (‘ real life’) comparison of osteoporosis therapies: the comprehensive cohort study (CCS) design including a nested randomized trial (RCT): A pilot program. Novartis Pharmaceuticals Aust P/L Grant-in-aid. J Wark, R Osborne, A Dalton, E Hristov. ($62,617) 2006 - 08 Keppra versus older AEDS and neuropsychiatric, neurocognitive and quality of life outcomes in treatment of epilepsy as first substitution monotherapy. Bone health and body composition substudy. KONQUEST: R Yerra, T O’Brien, 37 S Petty, J Wark, M Seibel. UCB Pharma $469,800 2006 - 08 Is bisphosphonate therapy in benign bone disease associated with impaired dental healing? A case-control study. M Borromeo, J Wark, J Clement, M McCullough, C Brand, L MacGregor, D Weisenfeld, Grant-in-Aid, Novartis ($ 255,000). Collaborations The University of Melbourne School of Physiotherapy, Centre for Genetic Epidemiology, Department of Physiology, Department of Medicine (St Vincent’s Hospital), Centre for Gender Health, Dental Science; World Health Organization (Ageing and Health/Life Course and Health Program); Deakin University; Department of Gerontology, University of Western Australia; School of Human Kinetics, University of British Columbia, Canada; Edith Cowan University, Western Australia; Royal Freemasons Homes of Victoria; Institut Recherche Medical, Geneva, Switzerland; Johns Hopkins University, Baltimore, USA; Institute of Medical and Veterinary Science, Adelaide; Department of Anatomy, University of Queensland. Supervision PhD ‘Genetic and environmental determinants of gait/balance in adult female twins‘. N. El Haber (in progress). Vitamin D Brochure Launch. Moonee Valley City Council, 6th October, 2006. ‘ The effect of anti-epileptic medications on bone mineral density, bone turnover and fracture risk’ SJ Petty ‘ An update on fracture prevention strategies.’ Australian Falls Prevention Conference. 5-7th November 2006. Brisbane, Australia MPhysio (Research) ‘ The effect of exercise and physiotherapy on bone density in osteoporotic post menopausal women’. K. Bolton (in progress). ‘ AEDs and fracture risk.’ Epilepsy Society of Australia. 5th – 7th October 2006. Melbourne Australia. ‘ Therapeutic approaches in fracture prevention.’ AMGEN Australia, National Training Program. November 2006. Melbourne Australia. ‘ Vitamin D effects at the extremes of life.’ Australian Health and Medical Research Conference, November 2006. Melbourne, Australia. Research DXA and PQCT techniques identify mouse strains with bone deficits due to sodium Valproate treatment. Senn S, Kantor S, Andrikopoulos S, O’Brient TJ, Morris MJ, Wark JD. 3rd IOF Asia-Pacific Regional Conference on Osteoporosis and 16th Annual Meeting of the Australian and New Zealand Bone and Mineral Society. October 2006. Port Douglas. Grants BSc(Hons) 'Cross-sectional study of table tennis activity and indices of bone health and fall risks in older Asians'. N Kwok AMS ‘Predicting of glucocorticoid-induced osteoporosis'. FF Gong. 2005-2006 ‘Evaluation of bone ultrasound in AED-associated bone disease’. Lit Kim Chin. 2006-2007 Department of Medicine Annual Report 2006 Annual Meeting of the Australian and New Zealand Bone and Mineral Society. October 2006. Port Douglas. http://www.medrmhwh.unimelb.edu.au/ 38 Student Completions ‘Effects of a physiotherapy intervention Program on individuals with a history of osteoporotic vertebral fracture’. A Greig. PhD Granting Bodies - Expert Assessor • National Health and Medical Research Council • Victorian Health Promotion Foundation • Cancer Council of Victoria • Health Research Council (New Zealand) • Wellcome Trust (United Kingdom) • New Zealand Dairy Board Membership of Medical and Scientific Societies • The Endocrine Society of Australia • Australian Kidney Foundation • Arthritis Foundation of Australia • The Australian Society for Medical Research • Merck Sharp and Dohme Research Foundation • The Endocrine Society (U.S.) • Western Australian Health Promotion Foundation. • The University of Melbourne Medical Society • Various institutional research funds/foundations. • The Australia and New Zealand Society for Cell Biology • Dairy Research and Development Corporation • The American Society for Bone and Mineral Research • LactoPharma. • The Australian Diabetes Society • Arthritis Research Campaign (UK) • The Bone and Tooth Society • Australian and New Zealand Bone and Mineral Society (foundation member of Council) External Consultancies (Non-Government) • New Zealand Dairy Board ‘Strength and endurance of trunk extensor muscles, thoracic range of motion and the role of transversus abdominis in patients with vertebral fractures’. A Briggs. PhD Professional Activities: • Roche Products • Medical and Scientific Advisory Committee • Merck Sharp and Dohme (Australia) Pty Ltd • International Bone and Mineral Society • Lilly Research Laboratories • The Medicolegal Society • Australian Medicine Handbook • Member, Medical Research Society • Therapeutic Guidelines Ltd • Asia Pacific Menopause Federation • Novartis Pharmaceuticals • International Society of Musculoskeletal and Neuronal Interactions. • AstraZeneca Pharmaceuticals • VacTX • Medical Practitioners Board of Victoria • LactoPharma • Centre for Menstrual Cycle and Ovulation Research, Scientific Advisory Council Editorial Boards • Clinical Science, Specialist Editor (1999 – current) • Osteoporosis International (2005 – current) • Virtual Bone Centre Medical and Scientific Journals - Referee • Australian and New Zealand Journal of Medicine • Australian and New Zealand Journal of Surgery • Bone/ Bone and Mineral • Cancer Forum • Clinical Endocrinology • Endocrinology • International Journal of Oral and Maxillofacial Surgery • Journal of Bone and Mineral Research • Journal of Clinical Endocrinology and Metabolism • Journal of Endocrinology • Maturitas • Medical Journal of Australia • Osteoporosis International • European Journal of Epidemiology • The Lancet • Journal of Applied Physiology • British Journal of Sports Medicine • Asia Pacific Journal of Clinical Nutrition • American Journal of Epidemiology • Internal Medicine Journal Contact Details Professor John Wark Department of Medicine (RMH/WH) The University of Melbourne 4th Floor, Clinical Sciences Building, Royal Melbourne Hospital Victoria 3050 AUSTRALIA Tel: +61 3 8344 5201 Fax: +61 3 9347 1863 Email: [email protected] • Investigations using a mouse model to better understand the mechanisms underlying the adverse bone effects of treatment with anti-epileptic drugs • The effect of stress, hypercortisolaemia and early life exposures on epileptogenesis in a rat model of temporal lobe epilepsy • Serial functional (PET) and structural (MRI) neuroimaging of changes occurring during epileptogenesis in a rat model of temporal lobe epilepsy • Saturation ENU mutagenesis screen for novel antiepileptic and anti-epileptogenic genes • Role of proteases in the mechanisms of acquired limbic epileptogenesis • Functional genomics of rodent models of epilepsy • The effects of neuroleptic medications on NMDAmediated high frequency (gamma) thalamocortical oscillations in epileptic and non-epileptic rats Human Function Neuroimaging Studies • Pathological and clinical significance of the region of hypometabolism on FDG-PET in medical refractory temporal lobe epilepsy (TLE) • Diffusion sensor MRI, contrast-enhanced perfusion MRI and MRI spectroscopy in TLE • Patterns of hyperperperfusion on ictal SPECT in subtypes of partial epilepsy and relationship to outcome Research Epilepsy and Neuropharmacology Research 39 Head: Associate Professor Terence O'Brien Research Highlights The Epilepsy and Neuropharmacology Research Group is focused on clinical research with current projects covering a wide range of basic science, translational and clinical research related to epilepsy and neuropharmacology. The basic research involves innovative animal epilepsy models of focal and generalised seizure disorders, particularly directed to understanding the processes that result in epilepsy, and identifying new targets and approaches to improving treatment options for patients. The clinical research program covers a wide variety of patient focused research areas, including imaging, pharmacogenetics, electrophysiology, neuropsychiatry, neurocognitive, bone health and fracture risk and epilepsy surgery. A particular focus of the research is to better characterise the predictors of long-term outcome of both newly treated and chronic epilepsy, and to identify new therapeutic targets and treatments • Long-term outcomes (seizure, psychosocial and quality of life) of the ‘First Seizure’ population • Long-term neuropsychiatric outcomes of medically refractory partial epilepsy, and relationship to markers of neurobiological progression of the disease • Long-term outcome of non-epileptic seizures (seizure, psychosocial and quality of life) • Long-term discordant twin–sister cohort study of effects of anti-epileptic drug use on bone health and fracture risk Research Staff Associate Professor Terence O’Brien: Neurologist and Head of Group Dr. Damian Myers – Senior Scientist Dr. Michelle Porritt – Peter Doherty Postdoctoral Fellow. Dr. Kim Powell – Postdoctoral Scientist Dr. Stefanie Dedeurwaerdere – Postdoctoral Scientist Dr. Nigel Jones – Postdoctoral Scientist Dr. Chris French – Neurologist and Research Fellow Ms. Valentina Jovanovska – Research Assistant Some of the key research projects being undertaken by the group are listed below: Ms. Leena van Raay – Research Assistant Basic Models of Epilepsy • Investigation into the effect of neuropeptide Y-related mechanisms in a genetic model of absence epilepsy Ms. Abbie Couper – Research Assistant • The neuropharmacological and neurophysiological mechanisms underlying the aggravation of absence seizures by carbamazepine utilising a genetic rat model Ms. Lisa Cardamone – Research Assistant Ms. Bianca Jupp – Research Assistant Mr. Gaurav Kumar – Research Fellow Associate Professor Christine Kilpatrick – Neurologist Dr. Raju Yerra – Neurologist Dr. Cassandra Szoeke – Epilepsy Research Fellow Department of Medicine Annual Report 2006 Clinical Outcome Studies • Pharmacogenetic study of the outcome of newly treated epilepsy http://www.medrmhwh.unimelb.edu.au/ Dr. Zelko Matkovic – Neurologist 40 Ms. Annie Rote – Clinical Research Coordinator Mr. Darren Germaine – Research Nurse Mr. Dennis Cassidy – Research Assistant Mr. Slave Petrovski – Research Assistant Publication Highlights Jupp B, Williams JP, Tesiram YA, Vosmansky M, O’Brien TJ. Hippocampal T2 signal change during amygdala kindling epileptogenesis. Epilepsia 2006;47:41-46. Szoeke CIE, Newton M, Wood JM, Goldstein D, Berkovic SF, OBrien TJ, Sheffield LJ. Pharmacogenetics in epilepsy – A review. Lancet Neurology 2006;5:189-196. Wetjen NM, Cascino GD, Fessler AJ, So EL, Buchhalter JR, Mullan BP, O’Brien TJ, Meyer FB, and Marsh WR. Subtraction Ictal SPECT coregistered to MRI in the evaluation for repeat epilepsy surgery. Journal of Neurosurgery 2006;105:71-6. Vajda FJE, Hitchcock A, Graham J, Solinas C, O’Brien TJ, Lander CM, Eadie MJ. Foetal malformations and seizure control; 52 months data of the Australian Pregnancy Registry. European Journal of Neurology 2006;13:645-54. Jupp B, Williams JP, Tesiram YA, Vosmansky M, O’Brien TJ. MRI compatible electrodes for the induction of amygdala kindling in rats. Journal of Neuroscience Methods 2006;155:72-6. Liu L, Zheng T, Wallengren C, Morris MJ, Clarke A, Reid C, Petrou S, O’Brien TJ. The mechanism of carbamazepine aggravation of absence seizures. Journal of Pharmacology and Experimental Therapeutics 2006 319: 790-798. Salzberg M, Taher T, Davie M, Carne R, Hicks R, Cook MJ, Murphy MA, Vinton A, O’Brien TJ. Depression in temporal lobe epilepsy surgery patients: a FDG-PET Study. Epilepsia 2006;47:2125-2130. New Grants Peer-Reviewed Research Grants Phamacogenetics of Anti-Epileptic Drugs, Principal Investigators: C Szoeke, O’Brien TJ, Newton M, Funding Source:Pfizer Neuroscience Grant, $55,000 Longitudinal in vivo study of hippocampal structure and function, and relationship to neurocognitive, neurobehavioral and epileptic outcomes, in a model of human traumatic brain injury. Principal Investigator: O’Brien TJ, Funding Source: Victoria Neurotrauma Initiative, $1,061,808 Anxiolytic and anti-epileptogenic roles of brain proteaseactivated receptor (PAR2), Principal Investigators: Cocks T, O’Brien TJ, van den Buuse M, Funding Source: National Health and Medical Research Council Project Grant 454489, $251,750 Is TLE a progressive disorder? A follow-up study of neuroimaging, neurological and neuropsychiatric outcomes, Principal Investigators: Adams S, Velakoulis D, O’Brien TJ, Funding Source: Pfizer Neuroscience Grant, $55,000 NH&MRC equipment grant: Confocal microscope: live cell imaging. Brown, Hamilton, Giraud, Rogerson, Jane, O'Brien, Myers, Anderson. $125,000 Pharmaceutical Industry Investigator Initiated Grants Neuropsychiatric, neurocognitive and quality of life outcomes in patients with epilepsy treated with levetiracetam verses older AEDs as first substitution monotherapy. Principal Investigators: SR Yerra, TJ O’Brien, N Moore. Funding Source: UCB Pharma, $328,000 KONQUEST: Keppra versus older AEDS and neuropsychiatric, neurocognitive and quality of life outcomes in treatment of epilepsy as first substitution monotherapy. Bone health and body composition substudy Principal Investigators: R Yerra, TJ O’Brien, S Petty, JD Wark, M Seibel. Funding Source:UCB Pharma, $469,800 Comparison of anti-seizure efficacy and CSF concentrations during conventional versus controlled release valproate administration in two rodent models of epilepsy, Principal Investigators: TJ O’Brien, Dedeurwaerdere S, Morris MJ, Hogan RE, Funding Source: Abbott Neuroscience Research, $111,954 USD Ongoing Grants Molecular Medicine Informatics Model (MMIM): A Multiinstitutional, Multi-disciplinary Research and Training Platform for Clinical Research, Principal Investigator: TJ O’Brien. Associate Investigators: Appelbe B, Hibbert M, Georgeff M, Gibbs P, Burgess T, Macrae F, Colman P, Foote S, Lowenthal R, Jerums G, Panagiotopoulos S, Donnan G, Freezer N, Robinson P, Wilson J, Kay T, Dwyer T, Polglass A, McMurrick P, Shapiro J, Strickland A, Kilpatrick T, Davis S, Hand, P. D’Souze W, Hicks R, Hart W, Funding Source: Department of Education, Science and Training, Funding Amount:$4,370,669 AUD – Awarded: Sept 2005 NARSAD 2005 Independent Investigator Award, Principal Investigator: TJ O’Brien, Funding Source: National Alliance for Research on Schizophrenia and Depression, Funding Amount: $100,000 USD – Awarded September 2005 Stress, temporal lobe epilepsy and affective disorder, Principal Investigators: TJ O’Brien, Morris M, Salzberg M, Rees S, Velakoulis D. Funding Source: National Health and Medical Research Council Project Grant 400088, $372,625 AED’s and fracture risk, Principal Investigators: JD Wark, O’Brien TJ, Sambrook P, Hill K, Seibel M, Herkes G. Funding Source: National Health and Medical Research Council Project Grant 400089 $459,750, Neuropeptide Y and absence seizures, Principal Investigators: M Morris, O’Brien TJ, Reid C Funding Source: National Health and Medical Research Council Project Grant 400106, $377,625 Finding better targets for new epilepsy treatment, Principal Investigators: SJ Foote, O’Brien TJ, McKinnon R, Funding Source: National Health and Medical Research Council Project Grant 406640, $457,500 Awards and Prizes Terence O’Brien: Dreifuss-Penry Epilepsy Award, American Academy of Neurology Siew Min Gan: NH&MRC Medical Post-Graduate Scholarship Rink-Jan Lohman: Epilepsy Society of Australia Annual Scientific Meeting, Best Poster Award Thomas Zheng: Epilepsy Society of Australia Annual Scientific Meeting, Scientific Achievement Award Sophie Adams: Epilepsy Society of Australia Annual Scientific Meeting, Scientific Achievement Award Gaurav Kumar: American Epilepsy Society Young Investigator Award Sandra Petty: James Lance Young Investigator Award. Australian Association of Neurologists Raju Yerra: Warren Holmes Fellowship Supervision Rosemary Panelli, ‘Effect of an epilepsy support program in a first seizure clinic’, PhD Bianca Jupp, ‘PET hypometabolism and MRI perfusion and diffusion changes during acquired epileptogenesis in a rat kindling model of mesial temporal lobe Epilepsy’, PhD Centre for Rheumatic Diseases Dr Anita Vinton, ‘The mechanisms underlying hypometabolism on FDG-PET and the relationship with EEG activity’, PhD Brendan Adams, ‘Thalamocortical network activity in a model of childhood absence epilepsy’, PhD Susan Senn, ‘Pharmacogenomics: Valproate-associated weight changes in nine inbred strains of mice’, PhD Sophie Adams, ‘Long-term follow-up study of neuropsychiatric co-morbidity in focal epilepsy’, PhD Research Rink-Jan Lohman, ‘The role of proteases and their receptors in epilepsy’, PhD Dr Sandra Petty, ‘The effect of anti-epileptic medications on bone mineral density, bone turnover and fracture risk’, PhD Dr Raju Yerra, ‘Psychosocial and seizure outcome following new onset epilepsy’, MD Thomas Zheng. ‘The mechanisms underlying the aggravation of seizures by anti-epileptic medication.’ PhD Caroline Ng Li Min. Changes in HCN mRNA expression in the hippocampus during epileptogenesis in rat models of temporal lobe epilepsy. PhD 41 Student Completions Cassandra Szoeke, ‘Epilepsy, genetics and anti-epileptic drugs’, PhD Willy Hando, ‘New MRI imaging techniques in TLE with and without HS’, AMS Lainie Sutton, ‘Mossy fibre sprouting in an in vitro model of epilepsy’. BSc (Hons) Contact Details Tel: +61 3 8344 3260 Fax: +61 3 9347 2254 Email: [email protected] Senior Lecturer: Dr Richard Osborne (Pictured) Director: Professor Ian Wicks Overview The Centre aims to improve the well-being of people with arthritis and other musculoskeletal disorders. The AFV Centre for Rheumatic Diseases was founded in 1995 as a joint venture between the Arthritis Foundation of Victoria (AFV), the Royal Melbourne Hospital and The University of Melbourne. The partners agreed from the outset that the Centre would have a broad agenda of promoting patient care, education, and research in the rheumatic diseases in Victoria recognizing the importance of rheumatic diseases and the need to improve the academic profile of Rheumatology in Victoria. The AFV supports research by funding Dr Richard Osborne and a part-time administrative assistant. The output and impact of the CRD research effort has grown steadily with the Centre comprising ten research staff, four Doctoral scholars, and four Master of Science scholars in 2006. The impact of the Centre’s work was evident in its influence on national and state health policy and practice, and career development of research staff who can expand future contributions in arthritis research. In 2006 the Centre attracted primary research grants of more than $1 million in population health, self-management of arthritis and other chronic diseases, and ways of improving functions of healthcare professionals and the Department of Medicine Annual Report 2006 Associate Professor Terence O’Brien Department of Medicine (RMH/WH) The University of Melbourne 4th Floor, Clinical Sciences Building The Royal Melbourne Hospital Victoria 3050 AUSTRALIA http://www.medrmhwh.unimelb.edu.au/ 42 healthcare system in managing and supporting people with arthritis. Each research project has a direct link to improving the wellbeing of people with arthritis and other musculoskeletal conditions. This may be through evaluating new treatments, procedures or education programs, or by designing tools or systems that health professionals or healthcare organisations can use to improve care. The CRD also undertakes extensive data analysis and reporting on the burden of musculoskeletal disorders and reports social disparities in health if they are identified. Findings are regularly presented to policymakers, clinicians, other researchers and to members of the public to facilitate knowledge transfer for improvements in patient care and management. An important part of the CRD’s success has been the generous contribution of numerous colleagues including Professor Rachelle Buchbinder (Monash), Dr Caroline Brand (RMH), Professor Kim Bennell (Physiotherapy), Professor Stephen Graves (RMH), Associate/Professor Gerry Elsworth (RMIT), Mr Richard de Steiger (RMH), Dr Peter Greenberg (RMH), Mr Andrew Dalton (ADHealth), Professor Tony Scott (UoM Institute for Applied Economic and Social Research), Prof Paul Dieppe (University of Bristol), Professor Peter Fayers (University of Aberdeen), the Rheumatologists at the Royal Melbourne Hospital, and the numerous people with arthritis and other musculoskeletal disorders who have generously given their time to inform our research through participating in our committees, workshops, interviews and by answering questionnaires. Centre Highlights • Buchbinder R, Osborne RH. The safety, effectiveness and cost-effectiveness is unproven. Australian Family Physician 2006;35(9):665 Buchbinder R, Osborne RH. Vertebroplasty: a promising but as yet unproven intervention for painful osteoporotic spinal fractures Editorial. Medical Journal of Australia 2006;185(7): 351-352 Haines TP, Bennell KL, Osborne RH, Hill KD. A new instrument for targeting falls prevention interventions was accurate and clinically applicable in a hospital setting. Journal of Clinical Epidemiology 2006;59:168-175 Haines TP, Hill KD, Bennell KL, Osborne RH. Recurrent events counted in evaluations of predictive accuracy. Journal of Clinical Epidemiology 2006;59: 115-1161 Haines TP, Hill KD, Bennell KL, Osborne RH. Patient education to prevent falls in subacute care. Clinical Rehabilitation 2006;20: 970-979 Haines TP, Bennell KL, Osborne RH, Hill KD. Hip protector use amongst older hospital inpatients: Compliance and functional consequences. Age and Aging 2006;35(5):520523. Osborne RH, Hawkins M, Sprangers MAG. A change of perspective: a measurable and desired outcome of chronic disease self-management intervention programs that violates pre-post assessment. Arthritis Care and Research 2006;55(3): 458-465 Osborne RH, Buchbinder R, Ackerman IN. Can a diseasespecific education program augment self-management skills and improve Health-Related Quality of Life in people with hip or knee osteoarthritis? [ACTRN012606000174583] BMC Musculoskeletal Disorders 2006;7:90 The Orthopaedic Waiting List (OWL) Project, funded by the Victorian Department of Human Services (DHS), aimed to develop a way to make waiting lists for hip and knee replacement surgery fairer and informed by clinical and individual need for surgery. After two years of challenging and innovative work, this was achieved in 2006 and the CRD was then commissioned to develop the State-wide rollout of this new system. Importantly, the key tool, the Hip and Knee Questionnaire, was translated into 12 languages to assist with the improvement of access to the service across culturally and linguistically diverse groups. This research has generated real changes to the Victorian public health care system and better care is now being delivered to many people with severe arthritis who enter this system. Whitfield K, Buchbinder R, Segal L, Osborne RH. Parsimonious and efficient assessment of health-related quality of life in osteoarthritis research: validation of the Assessment of Quality of Life (AQoL) instrument. Health and Quality of Life Outcomes 2006; 4 (19): 1-10 • The Centre had a very successful year in obtaining peer-reviewed grants from NH&MRC and impact research from Government • Dr Osborne was appointed to the peak Government committees; the Arthritis and Osteoporosis Expert Advisory Committee (AOEAC) and the AIHW National Centre for Monitoring Arthritis and Musculoskeletal Conditions Steering Committee. He was awarded one of two International Bone and Joint Decade Fellowships. ‘Implementation and evaluation of heiQ pilot and testing the heiQ with a range of self-management interventions and with six culturally and linguistically diverse groups (CALD).’ Dr Richard H Osborne, Ms Joanne Jordan. Commonwealth Department of Health and Ageing, Chronic Disease Management Section, Primary Care Programs Branch, Primary Care Division, $399,544 Publication Highlights Ackerman IN, Graves SE, Wicks IP, Bennell KL, Osborne RH. Assessment of quality of life in people undergoing total joint replacement surgery: Validation of the WHOQOL-BREF instrument. Arthritis and Rheumatism 2006;55:583-590 Ackerman IN. Invited commentary on Barker et al: Patient satisfaction with accelerated discharge following unilateral knee replacement. International Journal of Therapy and Rehabilitation 2006;13:253. New Grants Advancing arthritis public health research and evidenceinformed policy in Australia.’ Dr Richard Osborne. NH&MRC Population Health Career Development Award. $436,250 ‘Can patient self-management education programs improve outcomes of people with osteoarthritis?’ Dr Richard Osborne, A/Prof Rachelle Buchbinder, Prof Stephen Graves. NH&MRC Project grant, $340,500 ‘Development and implementation of a model for comprehensive prioritisation and management of orthopaedic waiting lists (OWL).’ Prof Stephen Graves, Dr Richard H Osborne, Prof Ian Wicks and Dr Caroline Brand. Victorian Department of Human Services, $698,519 ‘Chronic disease self-management and education programs: Where should Victoria go?’ Dr Richard Osborne, Dr Caroline Brand. Victorian Government Department of Human Services, $72,000 ‘Efficacy and safety of vertebroplasty for treatment of painful osteoporotic spinal compression fractures: a randomised trial.’ A/Prof Rachelle Buchbinder, Dr David Connell, B, Prof John Wark, A/Prof Peter Ebeling and Prof Stephen Graves. NH&MRC Project Grant, $612,360 ‘Is post-operative physiotherapy management associated with Health-Related Quality of Life after primary total hip or knee replacement surgery?’ Dr Ilana Ackerman, Dr Richard Osborne. Thermoskin Research Grant. Australian Physiotherapy Association. $4,842. 2006–07 Ongoing Grants ‘Systematic application of a program evaluation tool; Health Education Impact Questionnaire nationally across various self-management health education programs.’ Dr Richard Osborne, Joanne Jordan. 2005/06. $336,522 ‘Effects of laterally wedged insoles on symptoms and disease progression in knee osteoarthritis.’ 2005-2008. A/Prof Kim Bennell, Dr Rana Hinman, A/Prof Flavia Cicuttini, Dr Chris Payne, A/Prof Anthony Harris, Dr Richard Osborne, Dr A Smith. NH&MRC. $476,575 Completed Grants ‘Systematic application of the Stanford model of Chronic Conditions Self-Management (CCSM) in Australia.’ 20052006.Dr Richard H Osborne. Commonwealth Department of Health and Ageing, Sharing Health Care Initiative. $350,118. Completed September 2006 ‘Development of guidelines for referral to Joint Replacement Surgery.’ Dr Richard H Osborne, Dr Caroline Brand, Kerry Haynes. 2006. RACGP/DHA. $55,000. Completed July 2006 ‘Evaluation of chronic disease self-management courses for veterans’ Dr Richard H. Osborne. 2004/5–2005/6,: Health Promotion and Aged Care Branch, Department of Veterans’ Affairs: $110,000 Collaborations Extensive collaborations exist between staff at the Centre for Rheumatic Diseases and musculoskeletal health researchers within the Royal Melbourne Hospital and other hospitals and universities. These include the following studies: • The RMH OWL (orthopaedic waiting list) Project: A/ Professor Kim Bennell, School of Physiotherapy, The University of Melbourne • The OWL Prioritisation and Management Project—a major DHS-funded elective surgery healthcare reform initiative. Collaborators: Dr Caroline Brand and Mr Richard de Steiger (RMH), Department of Orthopaedic, RMH • Professor Paul Dieppe, Director of the Medical Research Council Health Services Research Collaboration, University of Bristol, UK. • A multi-centre randomised controlled trial of vertebroplasty for painful osteoporotic lumbar spine fractures. Collaborators: Professor Rachelle Buchbinder (Chief Investigator: Monash University); Dr David Connell (Cabrini Hospital); Dr Richard Osborne. • Health status prior to hip and knee joint replacement surgery: An international comparison. Collaborators: Mr Graham Brown, Department of Surgery, Barwon Health; Ms Karen Sloan, Royal Perth Hospital; Ilana Ackerman. CASS Early Career Researcher Travel Grant to attend the American College of Rheumatology Annual Scientific Meeting in Washington DC. Contributing to Australian Scholarship and Science (CASS) Foundation. Lucy Busija. Solander Travel Scholarship. Population health studies of the personal and societal impact of arthritis. The Solander Program Sandra Nolte. Elsworth GR, Springer AL, Sinclair AJ, Osborne RH. Best Oral Presentation. Who benefits most from participating in chronic disease self-management programs? The Australian Disease Management Association 2nd Annual National Conference, Melbourne, Australia. Sandra Nolte. New Investigator Award - Best Oral Presentation. Is a one-off post intervention assessment a valid method to assess outcomes from chronic disease selfmanagement programs? 13th Annual ISOQOL Conference. International Society for Quality of Life Research. Lisbon, 43 Portugal, 11th to 14th October 2006 Research ‘Referral for joint replacement—a management guide for health providers.’ Dr Richard H Osborne, Dr Caroline Brand and Kerry Haynes. RACGP/DHA. $59,400 Awards and Prizes Sandra Nolte. ISOQOL (International Society of Quality of Life Research) travel grant Sandra Nolte. RMIT University Regional Award (onshore) 2006 in recognition of important research for the Australian community Richard Osborne. International Bone and Joint Decade Scholar (only 2 awarded annually). The Bone and Joint Scientific Committee for Awards Richard Osborne. Allied Health prize. Melbourne Health Medical Research Week. June 2006. Richard Osborne. Solander Fellow. Advancing arthritis public health research and evidence-informed policy – an Australia– Sweden collaborative. The Solander Program. Richard Osborne. Population Health Career Development Award Fellowship. Expanding capacity for public health and health service delivery research and for evidencebased policy development in Australian health systems; and encouraging the translation of research outcomes into practice (NH&MRC) Conference and Seminar Presentations Invited Presentations • Osborne RH, Graves SE, Brand C, Haynes K, Chubb P, Robbins D, de Steiger R, Scott A, Wicks I. The Orthopaedic Waiting List (OWL) Project: Redesigning processes for elective waiting lists in Victoria to get the right person to the right care at the right time. Better State of Hospitals Conference, April, Melbourne • Osborne RH. Chronic disease self-management models: what has to happen to take policy into practice? Victoria Healthcare Association Community Health Conference, May, Melbourne • Osborne RH. Self-management education evaluation and quality. Danish Committee for Health Education, National Board of Health. Copenhagen, Denmark. • Osborne RH. Evaluation, quality and monitoring in chronic disease self-management programs: an Australian—German Collaborative. Department for Physical Medicine and Rehabilitation, Hanover Medical University, Germany. Department of Medicine Annual Report 2006 ‘Smoking cessation and bone health: observational and intervention studies in twins and a Quitline population.’ Prof John Wark, Ms Cathy Segan, Dr Richard H Osborne, Dr Carly Nowson and A/Prof Peter Ebling. NH&MRC Project Grant, $568,000 A/Professor Lyn March, University of Sydney; Professor Paul Dieppe; A/Professor Ewa Roos, Lund University, Sweden; Dr Anna Nilsdotter, Department of Orthopedics, Halmstad County Hospital, Halmstad, Sweden; and Dr Beth Pollard. http://www.medrmhwh.unimelb.edu.au/ 44 • Osborne RH. Advances in Chronic Disease Selfmanagement. Department of Health Sciences, Lund University, Sweden. • Osborne RH. Disparities in Modifiable and NonModifiable Risk Factors for Onset of Arthritis: Population Survey Approaches. American College of Rheumatology (ACR) Clinical Research Conference: The Evidence for Disparities in Onset of Rheumatic Conditions. Washington DC, USA, November 2006. • Survey. Australia Rheumatology Association Annual Scientific Meeting, 20th to 24th May, Perth, Australia. • Poster Presentation: Barber M, Buchbinder R, Osborne R, Elder, C, Clerehan R, Busija L. Pronunciation of words is not a good measure of health literacy: determination of The Validity of the Rapid Estimate of Adult Literacy in Medicine (REALM). Australia Rheumatology Association Annual Scientific Meeting, 20th to 24th May, Perth, Australia. Osborne RH. Patient centred outcomes by design – the identification and incorporation of patient values into outcomes assessment. American College of Rheumatology Study Group: Patient Perspective in Outcomes Research. 2006 Program on Patient centred outcomes for health care delivery. Washington DC, USA, November 2006. • Oral Presentation: Hill C, Buchbinder R, Osborne RH. Quality of reporting of randomized clinical trials (RCTs) in abstracts of the 2005 Annual Scientific Meeting of American College of Rheumatology. American College of Rheumatology and Association of Rheumatology Health Professionals Combined Annual Scientific Meeting, 10th – 15th November, Washington DC, USA. Conference presentations • Oral Presentation: Ackerman IN, Graves SE, March LM, Brown G, Sloan K, Dieppe PA, Osborne RH. Health status prior to hip and knee replacement surgery varies considerably between Australian and international centres. Health Outcomes Conference: Managing Health and Disease in Today’s Society (12th Annual National Conference), 9th to 10th August, Canberra, Australia. • Oral Presentation: Jordan J, Nankervis J, Brand C, Osborne R. To integrate or not to integrate? Future considerations for chronic disease self-management programs in the health care system. The Australian Disease Management Association 2nd Annual National Conference - Evidence-based Disease Management in the 21st Century, 7th to 8th September, Melbourne, Australia. • Oral Presentation: Jordan J with Nankervis J, Brand C, Osborne RH. Chronic disease self-management programs: perspectives on enablers and barriers to GP and patient engagement. GP and PHC Research Conference, 5th to 7th July, Perth, Australia. • Oral Presentation: Jordan J, Osborne RH. Does the transition question reflect the pre-post assessment? Qualitative assessment of outcomes from participant perceptions of chronic disease self-management programs. Health Outcomes Conference: Managing Health and Disease in Today’s Society (12th Annual National Conference), 9th to 10th August, Canberra, Australia. • Oral Presentation: Jordan J, Osborne RH. The pursuit of ‘true’ patient outcomes from chronic disease selfmanagement programs (CDSMP). The flaws of the prepost assessment. 13th Annual ISOQOL Conference, 11th to 14th October, Lisbon, Portugal. • Oral Presentation: Jordan J, Nankervis J, Brand C, Osborne RH. Development of the Victorian chronic disease self-management service improvement framework: Perspective from policy makers, health practitioners and consumers. Health Outcomes Conference: Managing Health and Disease in Today’s Society (12th Annual National Conference), 9th to 10th August, Canberra, Australia. • Oral Presentation: Nankervis J, Laidlaw C, Osborne RH. Structure, function and value of a quality assurance program for Stanford Self Management Programs: Impact and sustainability of a national pilot program. Health Outcomes Conference: Managing Health and Disease in Today’s Society (12th Annual National Conference), 9th to 10th August, Canberra, Australia. • Oral Presentation: Nankervis J, Laidlaw C, Osborne RH. Structure, function and value of a quality assurance program for Stanford Self Management Programs: Impact and sustainability of a national pilot program. The Australian Disease Management Association 2nd Annual National Conference - Evidence-based Disease Management in the 21st Century, 7th to 8th September, Melbourne, Australia. • Poster Presentation: Nolte S, Elsworth GR, Springer AL, Sinclair AJ, Osborne RH. The value of self-management programs: Outcomes from 842 Australians. Melbourne • • • Oral Presentation: Ackerman IN, Graves SE, Bennell KL, Osborne RH. The WHOQOL-BREF instrument: A useful adjunct to disease-specific measures in people undergoing joint replacement surgery. Health Outcomes Conference: Managing Health and Disease in Today’s Society (12th Annual National Conference), 9th to 10th August, Canberra, Australia. Oral Presentation: Ackerman IN, Graves SE, Dieppe PA, Roos EM, Nilsdotter A, Brown G, Sloan K, Osborne RH. Timing of joint replacement surgery varies according to centre: An international comparison. The annual American College of Rheumatology and Association of Rheumatology Health Professionals Scientific Meeting, 10th to 15th November, Washington DC, USA. Poster Presentation: Ackerman IN, Graves SE, March L, Brown G, Sloan K, Dieppe PA, Osborne RH. Marked national and international variation in disease severity before hip and knee replacement surgery. Australia Rheumatology Association Annual Scientific Meeting, 20th to 24th May, Perth, Australia. • Poster Presentation: Ackerman IN, Bennell KL Graves SE, Osborne RH. Health-Related Quality of Life and psychological distress do not return to population norms 12 months after joint replacement surgery. Australian Rheumatology Association Annual Scientific Meeting, 20th to 24th May, Perth, Australia. • Poster Presentation: Ackerman IN, Graves SE, Bennell KL and Osborne RH. Persistent psychosocial morbidity after joint replacement surgery: Health-Related Quality of Life and psychological distress do not approach population norms by 12 months. The annual American College of Rheumatology and Association of Rheumatology Health Professionals Scientific Meeting, 10th to 15th November, Washington DC, USA. • Oral Presentation: Busija L, Taylor A, Osborne RH. How do we estimate population prevalence of arthritis? Health Outcomes Conference: Managing Health and Disease in Today’s Society (12th Annual National Conference), 9th to 10th August, Canberra, Australia. • Oral Presentation: Busija L, Hollingsworth B, Buchbinder R, Osborne RH. Demographic, socioeconomic, and lifestyle factors in arthritis in Australia: Results from the Victorian Population Health • • • Oral Presentation: Nolte S, Elsworth G, Sinclair A, Osborne RH. The role of age, gender and education as determinants of benefits from chronic disease self-management programs: Outcomes from 842 Australians. Health Outcomes Conference: Managing Health and Disease in Today’s Society (12th Annual National Conference), 9th to 10th August, Canberra, Australia. Oral Presentation: Nolte S, Elsworth GR, Springer AL, Sinclair AJ, Osborne RH. Who benefits most from participating in chronic disease self-management programs? The Australian Disease Management Association 2nd Annual National Conference Evidence-based Disease Management in the 21st Century, 7th to 8th September, Melbourne, Australia. Oral Presentation: Nolte S, Elsworth G, Sinclair A, Osborne RH. Are Age, Gender and Education Determinates of Benefits from Chronic Disease Self-management Programs? Outcomes from 842 Australians. 15th Annual Meeting of the Australasian Epidemiological Association, 18th to 19th September, Melbourne, Australia. Oral Presentation: Nolte S, Hawkins M, Elsworth GR, Sinclair AJ, Osborne RH. Is a one-off post intervention assessment a valid method to assess outcomes from chronic disease self-management programs? 15 Annual Meeting of the Australasian Epidemiological Association, Melbourne, Australia. 18 to 19 September, 2006. • Oral Presentation: Nolte S, Hawkins M, Elsworth GR, Sinclair AJ, Osborne RH. Is a one-off post intervention assessment a valid method to assess outcomes from chronic disease self-management programs? 13th Annual ISOQOL Conference, 11th to 14th October, Lisbon, Portugal. • Poster Presentation: Nolte S, Elsworth GR, Springer AL, Sinclair AJ, Osborne RH. The extent and breadth of benefits from participating in Chronic Disease SelfManagement courses: A national patient-reported outcomes survey. 13th Annual ISOQOL Conference, 11th to 14th October, Lisbon, Portugal. • Oral Presentation: by Osborne RH: Nolte S, Springer A, Elsworth G, Sinclair A, Osborne RH. The value of self-management programs: Outcomes from 842 Australians. Australia Rheumatology Association Annual Scientific Meeting, 20th to 24th May, Perth, Australia. • Oral Presentation: Osborne R, Brand C, Haynes K, Chubb P, Robbins D, de Steiger R, Scott A, Dieppe P, Wicks I, Graves S. The OWL Project: Development and implementation of a model for comprehensive prioritisation and management of orthopaedic waiting lists (OWL). Melbourne Health Research Week, 1st to 8th June, Melbourne Australia. • • Oral Presentation: Osborne RH, Haynes K, Chubb P, Robbins D, de Steiger R, Scott A, Dieppe P, Fayers P, Wicks I, Brand C, Graves SE. Clinically relevant priority ranking for hip and knee joint replacement surgery (JRS): The validation and scaling of the Multidimensional Arthritis Priority Tool (MAPT) against WOMAC, Oxford hip/knee, SF36, AQoL, EQ-5D and HADS. Health Outcomes Conference: Managing Health and Disease in Today’s Society (12th Annual National Conference), 9th to 10th August, Canberra, Australia. Oral Presentation: Osborne RH, Morgan M, Haynes K, Lew S, Rawlin M, Brand C. Improving the health outcomes of individuals who may require joint • Oral Presentation: Osborne R, Roberts M, Graves S, Brand C, de Steiger R, Wicks I. The Victorian Orthopaedic Waiting List (OWL) Project: Re-designing elective joint replacement surgery (JRS) waiting lists to get the right person to the right care at the right time. ARCHI Improving Patient Flows: Elective Surgery, 17th to 18th August, Brisbane, Australia. • Oral Presentation: Osborne RH, Roberts M, Graves SE, Jones C, Chubb P, Brand C, de Steiger R, Wicks I, for the OWL Project team. Evidence based care and prioritisation of people waiting for elective hip and knee replacement surgery: the new Victorian management and prioritisation system. The Australian Disease Management Association 2nd Annual National Conference - Evidence-based Disease Management in the 21st Century, 7th to 8th September, Melbourne, Australia. • Oral Presentation: Osborne RH, Haynes K, Fayers P, Graves SE, Chubb P, Robbins D. The Development of an 45 Orthopaedic Waiting List Prioritisation Questionnaire: Meeting the Challenges of Clinical Priority, Gaming and Equitable Access. 13th Annual ISOQOL Conference, 11th to 14th October, Lisbon, Portugal. • Poster Presentation: Osborne RH, Haynes K, Chubb P, Robbins D, de Steiger R, Dieppe PA, Fayers P, Wicks I, Brand C, Graves SE. Developing clinically relevant priority ranking for hip and knee joint replacement surgery (JRS): The validation of the management and priority tool (MAPT) against WOMAC, Oxford hip/knee, SF36, AQoL, EQ-5D and HADS. Australia Rheumatology Association Annual Scientific Meeting, 20th to 24th May, Perth, Australia. • Presentation: Osborne R, Morgan M, Haynes K, Lew S, Rawlin M, Brand C. Improving the communication between care providers of individuals who may require joint replacement surgery (JRS) – a framework for referral. GP and PHC Research Conference, 5th to 7th July, Perth, Australia. • Poster Presentation: Osborne RH, Haynes K, Brand C, Dieppe P, Wicks I, Graves SE. Prioritization for Hip and Knee Joint Replacement Surgery (JRS): A New System that Assigns Queue Position To Get The Right Person To The Right Care At The Right Time. The annual American College of Rheumatology and Association of Rheumatology Health Professionals Scientific Meeting, 10th to 15th November, Washington DC, USA. • Symposia: Osborne RH (Symposia organiser), Dieppe PA, Hawker G, Katz J (Chair). Variation and Outcomes in Joint Replacement Surgery: Toward Optimizing Care. Talk Title: Optimizing the System to Maximize Outcomes: The Role of Referral, Prioritization and Preparation for Joint Replacement. American College of Rheumatology / American College of Rheumatology Health Professionals Annual Scientific Meeting. Washington DC, USA, November 2006. Workshops 1. Osborne RH. Evaluation of Chronic Disease Selfmanagement Programs. Australian Health Outcomes Conference. 8th August 2006, Canberra. 2. Osborne RH. Specifying patient-reported outcome measures for complex interventions: A framework to ensure the right outcomes are assessed at the right time. International Society for Quality of Life Research Research • replacement surgery (JRS) – a framework for referral and communication between care providers. Health Outcomes Conference: Managing Health and Disease in Today’s Society (12th Annual National Conference), 9th to 10th August, Canberra, Australia. Department of Medicine Annual Report 2006 Health Research Week. 1st to 8th June, Melbourne Australia. http://www.medrmhwh.unimelb.edu.au/ 46 Annual Scientific Meeting, 11th October 2006, Lisbon, Portugal. Supervision Lucy Busija. PhD. ‘Population avoidable burden due to arthritis in Australia’, Supervisors: Richard Osborne and Rachelle Buchbinder. Sandra Nolte. PhD. ‘Outcomes evaluation of chronic disease education programs’. Supervisors: Richard Osborne, Gerald Elsworth and Andrew Sinclair Dr Sabina Ciciriello. PhD. ‘Development and Evaluation of a multimedia education intervention about methotrexate for patients with rheumatoid arthritis.’Supervisors: Ian Wicks, Rachelle Buchbinder, Richard Osborne. Kate Francis, MSc ‘Evaluation of the osteoporosis prevention and self-management course’, Supervisors: Kim Bennell and Richard Osborne. Joanne Jordan. MPH ‘The concordance between interview-derived and questionnaire-derived outcomes in chronic disease education programs’, (minor thesis). Supervisors: Richard Osborne, Kerry Haynes and Jenni Livingston. Tracey Kane, M.Epi,Biostats. ‘Quality of life and disability of people waiting for hip and knee joint replacement across 6 Victorian Hospitals’, Supervisors: Richard Osborne and Mark Jenkins Bella Laidlaw, M.Epi,Biostats. ‘Does type of course leader affect patient reported outcomes of chronic disease self management programs?’ MPH. Supervisor: Richard Osborne. Student Completions Ilana Ackerman, B Physio (Honors) PhD. March 2006. ‘The pre-operative status of people undergoing primary total hip and knee replacement surgery.’ Supervisors: Kim Bennell, Stephen Graves, Richard Osborne. Professional and Community Affiliations and Service Dr Richard H. Osborne • Member: Data Working Group Committee, National Arthritis and Musculoskeletal Conditions Advisory Group • Member: Working Group, National Service Improvement Framework for Arthritis and Musculoskeletal Conditions • Member: Better Arthritis and Osteoporosis Care (BAOC) initiative • Member: Arthritis and Osteoporosis Expert Advisory Committee (AOEAC), • Member: Steering committee for the AIHW National Centre for Monitoring Arthritis and Musculoskeletal Conditions International Visiting Professors • Professor Paul Dieppe, Director, MRC Health Services Research Collaboration, University of Bristol, UK. Sponsors: Victorian Department of Human Services, Commonwealth Department of Health and Ageing, 10–24 April • Professor Peter Fayers, Professor of Medical Statistics, Department of Public Health, University of Aberdeen Medical School, Foresterhill, Aberdeen, Scotland, UK. Co-sponsor: Australian Health Outcomes Collaboration, 8–20 August Contact Details Dr Richard H.Osborne AFV Centre for Rheumatic Diseases Department of Medicine (RMH/WH) The University of Melbourne 7 East, City Campus The Royal Melbourne Hospital Victoria 3050 AUSTRALIA Tel: +61 3 8344 3144 Fax: +61 3 9342 7632 Email: [email protected] Rheumatology Research risk factors, details about the index event, prognostic factors, interventions and medical treatment will be recorded and compared between the rheumatoid arthritis patients and controls. In this way we can determine what factors contribute to the increased case fatality in rheumatoid arthritis. Effect of atorvastatin on arterial stiffness and disease activity in rheumatoid arthritis – a randomised placebo-controlled trial. We have previously demonstrated, in an open-label pilot study, that atorvastatin improved arterial stiffness in 30 rheumatoid arthritis patients. The present study aims to confirm this with a randomised, placebo-controlled trial design, evaluating the effect of atorvastatin on arterial stiffness and disease activity in 120 rheumatoid arthritis 47 patients. Research Increased case fatality in rheumatoid arthritis following myocardial infarction – a study of the role of prescription medications. This project is utilising a large population –based database to investigate the role of anti-inflammatory and immunosuppressant medication use in the increased case fatality rate seen in rheumatoid arthritis patients following myocardial infarction and will compare the cardioprotective treatment provided, following a myocardial infarction, to rheumatoid arthritis patients versus the general population. The Arthritis Tissue Bank. This is a non-profit service that supports approved research using human tissue. The Arthritis Tissue Bank, located at the Department of Medicine (RMH/WH), collects and stores blood and tissue samples and information from patients who may have arthritis, for use in various research projects. Publication Highlights Van Doornum S, Brand C, King B, Sundararajan V. Increased case fatality rates following a first acute cardiovascular event in patients with rheumatoid arthritis. Arthritis and Rheumatism 2006;54(7):2061-8 Research Assistant: Ms Angela Wood Research Highlights Screening and management of cardiovascular risk factors in rheumatoid arthritis patients. This project is evaluating the attitudes towards, and behaviour directed at, screening and management of cardiovascular risk factors in patients with rheumatoid arthritis by Australian and New Zealand rheumatologists. It includes a baseline audit, development of clinical guidelines and assessment of improvements in quality of care. Mortality rates following a first acute cardiovascular event—A comparison between patients with inflammatory arthritis and the general population. We have previously demonstrated that in the 30 days following a myocardial infarction, patients with rheumatoid arthritis have twice the mortality of the general population. This project has now been extended to evaluate 30-day mortality rates following a first acute cardiovascular event (stroke or myocardial infarction) in patients with other forms of inflammatory arthritis (lupus, seronegative spondylitis, vasculitis etc) compared with the general population. Mortality following myocardial infarction in rheumatoid arthritis – a retrospective case control study. The aim of this study is to investigate the factors which contribute towards increased mortality in rheumatoid arthritis following myocardial infarction. This will be achieved using a structured medical record review of rheumatoid arthritis cases and matched controls who have experienced myocardial infarction. Demographic details, cardiovascular Van Doornum S, Jennings G, Wicks I. Reducing the cardiovascular burden in rheumatoid arthritis. Medical Journal of Australia 2006;184:287-90 New Grants Arthritis Foundation of Australia Win Dunne Grant-in-Aid: Sharon Van Doornum, ‘Mortality following cardiovascular events in rheumatoid arthritis’ RACP Barbara Cameron/ARA Fellowship: Sharon Van Doornum, ‘ Increased Case Fatality in Rheumatoid Arthritis Following Myocardial Infarction – A Study of the Role of Prescription Medications’ Pfizer Australia Pty Ltd: Sharon Van Doornum, ‘ Effect of Atorvastatin on Arterial Stiffness and Disease Activity in RA – a Randomised Placebo-Controlled Trial’ Collaborations Professor Ian Wicks, Department of Rheumatology, Royal Melbourne Hospital; Dr Caroline Brand, Clinical Epidemiology and Health Service Evaluation Unit, Royal Melbourne Hospital; Dr Vijaya Sundararajan, Victorian Department of Human Services; Dr Lynden Roberts, Department of Rheumatology, Royal Melbourne Hospital Conference and Seminar Presentations Sharon Van Doornum Oral Presentation: Australian Rheumatology Association Meeting, Perth 2006. ‘ Cardiovascular Risk Assessment in the Patient with RA’. Department of Medicine Annual Report 2006 Principal: Dr Sharon Van Doornum http://www.medrmhwh.unimelb.edu.au/ Teaching and Training 48 • Postgraduate Coordinator, Department of Medicine (RMH/WH) • Medical student teaching—Professional Development Tutor • Rheumatology student teaching Professional and Community Affiliations and Service Member: Australian Rheumatology Association (ARA) ARA Education and Training Subcommittee (2000–05) ARA Quality and Safety Subcommittee (from 2005) Chairperson: Victorian Branch, ARA Advisor: Medical Workforce, Royal Melbourne Hospital Member: Royal Australasian College of Physicians Contact Details Department of Medicine Western Hospital Overview Western Health has been boosted by the Victorian State Government’s promise to commit $184 million to the first-stage of the redevelopment of Sunshine Hospital. This will include support of approximately $18 million towards a Teaching, Training and Research Building, which will be occupied and funded in a partnership between the University of Melbourne and Victorian University, who will each also contribute approximately $9 million. Planning documents and functional briefs have been prepared and will be revised in 2007, with the entry of Victoria University into the mix. In the future, there are plans for a separate Clinical School. Dr Jacinta Tobin has recently been appointed Clinical Sub-Dean and has made a very positive impact on the Department. Endocrinology Research, Western Hospital Dr Sharon Van Doornum Department of Medicine (RMH/WH) The University of Melbourne 4th Floor, Clinical Sciences Building The Royal Melbourne Hospital Victoria 3050 AUSTRALIA Tel: +61 3 8344 3279 Fax: +61 3 9347 1863 Email: [email protected] Head: Professor Peter Ebeling Endocrinology Research focuses on the effects of calcium, vitamin D and exercise on promoting positive skeletal outcomes. During the year 2006, the department obtained funding through an NH&MRC RAGS Equipment Grant and a small amount of funds from the Faculty and School of Medicine to purchase a state of the art Hologic Discovery W Bone Densitometer, which is now functional. This will be used predominantly for research projects within the department and with collaborating institutions. Achievements and Appointments Honorary Medical Director of Osteoporosis Australia • Chair, Victorian State Committee, Royal Australasian College of Physicians • Member, Postgraduate Medical Council of Victoria • Councillor, Endocrine Society of Australia • Co-Chair, Australian Musculoskeletal Quality Improvement Program • Member, Arthritis and Musculoskeletal Steering Committee, AIHW • Member, NH&MRC and RACGP Osteoporosis Guidelines Working Group • Chairman, Inaugural Clinical Research Professionals Conference (CCRE / ACRP) – August 17-19, 2007 • Member, Osteonecrosis of the Jaw Taskforce, American Society of Bone and Mineral Research Current Research and Collaborations • A study of vitamin D levels and obesity in University of Melbourne Teaching hospitals. This study of body composition and correlations with vitamin D levels will be led by a Canadian Endocrinologist, Dr Claudia Gagnon, who will be studying with me in our Department for two years on a Canadian Research Fellowship. • Collaborative research with RMH and RCH on ‘ Health literacy and effective health promotion with is planned vulnerable communities - health literacy in newly arrived African communities’. • Collaborative research with Professor Anne-Maree Kelly, Emergency Department, Western Health. ‘ Identification and treatment of osteoporosis in elderly patients treated in an emergency department for a wrist fracture’. Awarded Windermere Foundation Grant. Research • Richard Wettenhall and Dr David Stapleton from Bio21 will examine collagen-derived small molecules and correlate profiles in urine with conventionally used bone turnover markers in controls and patients with various metabolic bone diseases, including Paget’s disease of bone and osteoporosis. 49 Peter Ebeling with journalist Maxine McKew at an Osteoporosis Australia Press Conference • A collaboration with Professor Dallas English and the Health 2020 Cohort Study through an NH&MRC Enabling Grant. The Melbourne Collaborative Cohort Study (MCCS) holds blood samples, physical measurement and lifestyle questionnaire data from more than 40,000 people, ages 40-69 years recruited in Melbourne in the early 1990’s. The lifestyle data include dietary calcium intakes and various sex hormone concentrations.Spine and proximal femur BMD will be measured in the sub-cohorts with hormonal data, and the highest and lowest dietary calcium intakes. The comparison will be corrected for baseline serum 25(OH) Vitamin D levels. • Collaborative research project with the Ortho-geriatric Unit at Western Health. This involves a 3-month study of low vs. high-dose vitamin D replacement in hospital inpatients with mild vitamin D deficiency. This project is underway with partial support from Key pharmaceuticals. • Osteonecrosis of the jaw. This will be a project led by Mina Borromeo at the Dental Hospital, which will examine pathophysiological mechanisms in the disease. • Proteomic profiling using NMR in metabolic bone disease – establishing a strategy for reclassifying new bone biomarkers. This collaboration with Professor Department of Medicine Annual Report 2006 A number of collaborations have been formed: http://www.medrmhwh.unimelb.edu.au/ Gastrointestinal Cancer Research, Western Hospital • Houli N, Loh SW, Giraud AS, Baldwin GS, Shulkes A. Mitogenic effects of both amidated and glycineextended gastrin-releasing peptide in de-functioned and azoxymethane treated rat colon. Regulatory Peptides 134: 9-16, 2006. • Shulkes A, Baldwin, Giraud AS. Regulation of acid secretion (Ch.49). In: L.R. Johnson, K.E Barrett, FK Gishen, JL Merchant, HM Said, JD Wood. Eds, Physiology of the Gastrointestinal Tract 4th Edition, Elsevier, 2006. • Judd LM, Bredin K, Kalantzis A, Jenkins Bj, Ernst M, Giraud AS. STAT3 activation regulates gastric tumour growth, inflammation and vascularization in a mouse model of gastric tumorigenesis. Gastroenterology 131(4): 1073-1085, 2006. New Grants ARC Discovery grant. (2006-2008) ‘ Reg growth factors in gastric regeneration and disease’, I van Driel, A Giraud, L Judd. $274,000 Melbourne Research Grants Scheme 2006 ‘ Molecular markers of the progression of intestinal metaplasia to gastric cancer’. A Boussioutas, A Giraud, Bowtell. $30,000 50 NH&MRC equipment grant Confocal microscope: live cell imaging. G Brown, J Hamilton, A Giraud, S Rogerson, S Jane, T O’Brien, D Myers, G Anderson. $125,000. Ongoing Grants NH&MRC Project Grant: A Giraud, L Judd, N Yeomans and M Ernst, 2004–06, ‘Factors that regulate the initiation, progression and submucosal invasion in gastric cancer’: $442,500 Collaborations Head: Professor Andy Giraud Research Highlights The Gastrointestinal Cancer Laboratory, led by Professor Andy Giraud, focuses on understanding the molecular mechanisms underlying the initiation, development and metastasis of gastric cancer. There is also a subsidiary programme centred on inflammatory bowel disease, particularly the discovery of IBD susceptibility genes derived from forward genetic screens in mice. Project: ‘Cytokine signalling via gp130 regulates trefoil peptide gene expression’ (2000–). Collaborator: Dr Mathias Ernst, Colon Biology group, Ludwig Institute, Melbourne. Outcomes: 5 papers; 2 successful NH&MRC applications 2003–05, 2004-2006. Project: ‘The role of Helicobacter pylori Cag pathogenicity island proteins in imbalancing IL-6/IL-11 signalling pathways and promoting gastric neoplasi’ (2003–). Collaborators: Professor Rick Peek, Vanderbilt University, USA; Professor Takeshi Azuma, Kobe University, Japan; Professor M. Hatakeyama, Hokkaido University, Japan; Dr Richard Ferrero, Monash University; Professors Richard Strugnell and Roy Robins-Browne, The University of Melbourne. • The role of STAT3 in driving gastric inflammation . Project: ‘The role of Reg gene members in gastric cancer initiation and progression’, and ‘The role of trefoil factor peptides in gastric pathology’ (2004–). Collaborator: A/Professor Ian van Driel, The University of Melbourne. Outcomes: ARC Discovery grant 2006–08; 2 papers published. • gp130 ligands differentially regulate gastric cancer invasion and growth. Awards and Prizes • Dysregulation of IL-6 family cytokine signaling in precancerous lesions of the human stomach. • Mechanisms of anti-tumour actions of NSAID’s in the gut. • Discovery of a novel mouse model of Crohn's disease. Research highlights include: • The role of the transcription factor STAT3 in mouse and human gastric neoplasia. Publication Highlights • Dumesny C, Patel O, Lachal S, Giraud AS, Baldwin GS, Shulkes A. Synthesis, expression and biological activity of the pro-hormone for gastrin releasing peptide (ProGRP). Endocrinology 147:502-9, 2006. L Judd: The University of Melbourne’s C. R. Roper Fellowship for ‘The role of the IL-6 and IL-11 family of cytokines in the development of gastrointestinal disease and cancer’ Conference and Seminar Presentations A S Giraud Invited speaker: Khon Kaen University, Thailand, ‘ Trefoil peptides and carcinogenesis’. Invited speaker: Changi General Hospital, Singapore, ‘ Basic and translational research in gastric cancer’. Teaching and Training A S Giraud BSc (Hons) lecture series PhD student supervision Visiting student supervision L M Judd PhD student supervision Visiting student supervision T R Menheniott PhD student supervision Visiting student supervision Supervision Anthony Peterson, ‘Tumour suppressor genes in gastric cancer’, PhD Cameron Jackson, ‘Implications for gastric cancer initiation and development of disregulation of IL-6 family cytokine signalling pathways’, PhD Western Hospital Footscray, Vic. 3011 AUSTRALIA Tel: +61 3 8345 6210/6252 Fax: +61 3 9318 1157 Email: [email protected] Dr Louise Judd Department of Medicine (RMH/WH) The University of Melbourne Western Hospital Footscray, Vic. 3011 AUSTRALIA Tel: +61 3 8345 6829/6252 Fax: +61 3 9318 1157 Email: [email protected] Dr Treve Menheniott Department of Medicine (RMH/WH) The University of Melbourne Western Hospital Footscray, Vic. 3011 AUSTRALIA Research Meet the Investigator: Western Hospital Medical Research Week, ‘ Inflammation and gastric cancer: basic mechanisms and translational research’. Tel: +61 3 8345 6252 Fax: +61 3 9318 1157 Email: [email protected] 51 Meegan Howlett, ‘Differential signaling through gp130 by cytokines to regulate submucosal invasion and growth in gastric cancer’, PhD. Helen Lesencen, B.Sc (Hons; H1) ‘ Hormone and cytokine growth factors in fundic hyperplasia of the stomach’. David Ong, ‘The role of GDDR/TFIZ1 in tumour suppression in gastric cancer’, Visiting Fellow ( 12 months; Singapore) Maha Chaer, ‘ Growth factor genes in gastric cancer’ M.Med.Lab.Sci, Goteborgs University, Sweden (5 months). Anna-Karin Orbjorn, ‘ Preliminary characterisation of lung pathology in mice with gastric cancer’ M.Med.Lab.Sci, Goteborgs University, Sweden (5 months). Kanuengnuch Muenphon, Ph.D student (7 months), ’The role of the trefoil peptides in progression of cholangiocarcinoma’ Khon Kaen University, Thailand. Professional Activities Professor Andy Giraud • Member: NH&MRC Project grants review committee • Member and Acting Chair: Melbourne Health Animal Ethics Committee • Member: American Gastroenterological Association • Member: Gastroenterological Society of Australia • Member: OHS Committee, Department of Medicine (RMH/WH) • Editor: Journal of Gastroenterology and Hepatology • Editorial Board: Journal of Gastroenterology Dr Louise Judd • Member: American Gastroenterological Association • Grant Reviewer: NH&MRC (Australia) Contact Details Professor Andy Giraud Department of Medicine (RMH/WH) The University of Melbourne Department of Medicine Annual Report 2006 Marie Strandlund, ‘ Evaluation of secondary lung pathology in gastric cancer’ M.Pharm, Goteborgs University, Sweden (6 months) http://www.medrmhwh.unimelb.edu.au/ Gastric Cancer Research, Western Hospital Publication Highlights Tinker AV, Boussioutas A, Bowtell DD. The challenges of gene expression microarrays for the study of human cancer. Cancer Cell 2006;9:333-9, 2006.* Aggarwal A, Li Guo D, Hoshida Y, Tsan Yuen S, Chu KM, So S, Boussioutas A, Chen X, Bowtell D, Aburatani H, Leung SY, Tan P. Topological and functional discovery in a gene coexpression meta-network of gastric cancer. Cancer Res 2006;66:232-41, 2006.* Jenkins, B. J., Grail, D., Nheu, T., Najdovska, M., Wang, B., Waring, P., Inglese, M., McLoughlin, R. M., Jone,s S. A., Topley, N., Baumann, H., Judd, L. M., Giraud, A. S., Boussioutas, A., Zhu, H. J. and Ernst, M. Hyperactivation of Stat3 in gp130 mutant mice promotes gastric hyperproliferation and desensitizes TGF-beta signaling. Nat Med., 11:845–52, 2006. Gorringe, K. L., Boussioutas, A. and Bowtell, D. D. Novel regions of chromosomal amplification at 6p21, 5p13, and 12q14 in gastric cancer identified by array comparative genomic hybridisation. Genes, Chromosomes and Cancer 42:247–59, 2006. Grants 52 NH&MRC Project Grant (454584): Dr Alex Boussioutas, Prof. A. Giraud and Prof D. Bowtell, 2007–09, ‘Molecular markers of the progression of intestinal metaplasia to gastric cancer: $535,000 NH&MRC Project Grant (288714): Professor David Bowtell and Dr Alex Boussioutas, 2004–06, ‘Gastric cancer: Early detection of disease, relapse and prediction of extent of disease: $420,000 Collaborations Head: Dr Alex Boussioutas Research Highlights The Gastric Cancer Group is divided between Western Hospital and the Peter MacCallum Cancer Centre Research Division. At Western Hospital we focus on the pathogenesis of gastric cancer through the investigation of premalignant stages of gastric cancer that involve chronic inflammation, intestinal metaplasia and dysplasia. The model for this study is to use human material collected at endoscopy to determine gene candidates involved specifically with the premalignant progression of gastric cancer, and study those genes in an available animal model to investigate potential mechanisms. This is occurring in collaboration with Professor Giraud using his animal model of gastric malignancy that was created at the Ludwig Institute of Cancer Research (Mathias Ernst). The Peter MacCallum projects deal with genomic studies into the sub-classification of gastric cancer and the use of microarray technology as a potential prognostic tool. Another project is the evaluation of biomarkers for early disease using proteomics and correlating the results with microarray data. More recently the project is starting to investigate tumour-stroma interactions in the setting of gastric cancer and how this impacts invasion and metastasis. Dr Boussioutas has collaborations with Professor David Bowtell at the Peter MacCallum Cancer Centre, and has been involved in the creation of an Asia–Pacific Consortium investigating gastric cancer with collaborators: Dr Patrick Tan, National Cancer Center, Singapore; Dr SY Leung, Queen Mary Hospital, Hong Kong; Professor Hiroyuki Aburatani, University of Tokyo, Japan; Professor Hyun Cheol Chung, Yonsei Cancer Centre, Korea. Dr Boussioutas recently spent time in Cambridge University, UK where he established an exciting collaboration with Dr Rebecca Fitzgerald (Hutchison MRC) to investigate Barrett’s Oesophagus. Other collaborators include: Professor Hong Li, Dalian Medical Center, PR China; Professor Stephen Meltzer, University of Maryland, USA; Professor Eleftherios Diamandis, Mount Sinai Hospital, Toronto, Canada; Professor Ben Cravatt, Scripps, La Jolla, USA. Awards and Prizes AstraZeneca Emerging Leaders in Medicine Award Peter MacCallum Research Medal for research excellence during PhD GESA Grant-in-Aid Conference and Seminar Presentations Speaker: Peter MacCallum Cancer Centre Grand Rounds Convener and Presenter: Inaugural Asia–Pacific Gastric Cancer Conference, Couran Cove, Queensland. Teaching and Training • Lectures to undergraduate Medicine students (including clinical examination), Western Hospital • AMS assessment • FRACP clinical tutorials • RACP lecture series in Gastroenterology Professional Activities Member, Melbourne Health Human Research Ethics Committee Member, Hereditary Bowel Cancer Committee, Cancer Council of Victoria Member, Medical Advisory Committee, Western Hospital Deputy Chair, NH&MRC Grants Review Panel Examiner, Australian Medical Council Member, Gastroenterological society of Australasia Research Member, American Gastroenterological Association Founding Member, Asia–Pacific Gastric Cancer Consortium Grant Reviewer, NH&MRC Grants Review Panel Reviewer, NH&MRC Australia and Singapore Editor, Journal of Gastroenterology and Hepatology Reviewer, Genes, Chromosomes and Cancer (journal) Contact Details 53 Dr Alex Boussioutas Department of Medicine (RMH/WH) The University of Melbourne Western Hospital Footscray, Vic. 3011 AUSTRALIA Department of Medicine Annual Report 2006 Tel: +61 3 8345 6252 Fax: +61 3 9318 1157 Email: [email protected] http://www.medrmhwh.unimelb.edu.au/ Associate Professor Peter David Danne Research Highlights Member of Advisory Board: The National Trauma Registry Consortium Publication Highlights Ireland S., Gray T., Farrow N., Danne P., Flannagan B. “Rural Mobile Simulation – Based Trauma Tram Training – An innovative Educational Platform.” International Trauma Care (ITACCS) Volume 16, Number 1, 2006, pp 6-12. Davey T., Pollard C, Aitken L, Fitzgerald M., Bellamy N., Cass C., Danne P. Et.al. “Tackling the burden of injury in Australasia: developing a binational trauma registry.” M.J.A. Volume 189, Number 9, November 2006, pp 512-514. Zalstein S., Cameron P., Danne P., Taylor D.“ The Victorian Major Trauma Transfer Study”. Final report to the Victorian Trauma Foundation September 2006 – (private publishing). Awards and Prizes Certificate of Outstanding Service awarded by R.A.C.S Council. 54 Prominent Activities • Senior Teaching Faculty – Definitive Surgical Trauma Care (D.S.T.C.) Courses Porto (Portugal) and Madrid (Spain). • Director D.S.T.C. Course Melbourne Novemebr 2006. • Director (Council Member) Melbourne Grammar School Council. Peter B Greenberg Research Highlights • Optimising communication between consumers and clinicians, Greenberg PB, Walker C, Buchbinder R. Medical Journal Aust 2006;185:246-247 • Cautionary tales in the interpretation of systematic reviews of therapy trials, Scott I, Greenberg P, Poole P, Campbell D. Intern Medical Journal 2006:36:587-599. • Translating health research into clinical advice and health recommendations: the NH&MRC experience 2000-2006, Green AC, Greenberg P, Fitzgerald G, Clutton C. Intern Medical Journal 2006;36:335-337 • International perspectives on general internal medicine and the case for ‘globalization’ of a discipline, Ghali WA, Greenberg PB, Mejia R, Otaki J, Cornuz J. Journal of Gen Intern Medicine 2006;21:197-200. Prominent Activities Chair, Health Advisory Committee, NH&MRC until June 30 2006 • Member of Board of Directors and Chair of Quality and Research and Education Committees, Western Health Melbourne, until June 30 2006 • Tutor, 12th UK workshop in Teaching and Practising Evidence Based Medicine, St Hilda’s College, Oxford, Sept 2006 Contact Details Deptartment of General Medicine 4 West, The Royal Melbourne Hospital, Grattan Street, Parkville, Vic, Australia 3050 Phone: (613) 9342-7459 Fax: (613) 9342-8082 Email: [email protected] Melbourne Health internet site http://www.mh.org.au/Royal_Melbourne_Hospital/ www/353/1001127/displayarticle/1001645.html Professor Yean Lim Centre for Cardiovascular Therapeutics – Western Hospital Research Highlights Prof Y L Lim: Research on MSCT Coronary Angiography and CT guided PCI Prof Y L Lim and Dr R Newman: Participation in International Clinic Trials, GRACE registry, ACUITY A/Prof A Royse: Use of echocardiography during cardiac surgery Publication Highlights Soon KH, Cox N, Kelly AM, Chaitowitz I, Bell KW, Lim YL. Non-invasive multi-slice CT coronary angiography for imaging coronary arteries, stents and bypass grafts. Internal Medicine Journal. 2006;36;(1): 43-50. Soon KH, Farouque HMO, Chaitowitz I, Cox N, Selvanayagam J, Bell KW, Lim YL. Discrepancy between computed tomography coronary angiography and selective coronary angiography in the pre-stenting assessment of coronary lesion length. Australasian Radiology (In Press: Accepted 23-10-06). New Grants NH&MRC Post Graduate Scholarship 2006 – Dr Kean H Soon, ‘ Role of multi-slice computer tomography in the evaluation of coronary artery disease and revascularisation procedures’ Awards and Prizes Prof Y L Lim: Inaugural ‘ Gary Roubin Award’ for contribution to interventional cardiology in Australasia and the Asia Pacific Region, 1 December 2006, Sydney. Prominent Activities Co-course Director, 3rd China Interventional Therapeutics, Beijing, China International Faculty, 2006 EuroPCR, Paris Keynote Speaker, National Health Management Conference, Wuxi, China International Faculty, TCT, Washington Contact Details Prof Y L Lim Western Hospital Gordon Street Footscray Victoria 3011 Tel: + 61 3 8345 6302 Fax: + 61 3 8345 6882 Genome wide association studies using SNP platforms in familial bowel cancer: this work, seeking evidence of new loci to explain clusters of bowel cancer not accounted for by the known cancer predisposition genes, continues in association with the CSIRO. There are early indications of a new locus from the first cohort of families studied. Research : Honorary Fellows Professor Finlay Macrae Diagnostics in Polyposis Capsule endoscopy involves swallowing a capsule sized device which includes a CCD camera and transmitter. Images are registered in a computer storage device worn by the patient. Two projects evaluating its role in familial adenomatous polyposis, and Peutz Jeghers Syndrome and Juvenile Polyposis have been completed. In the former, the approach is not of general utility, but in PJS and JP there is now an essential role identified through our studies and others overseas. This work will be presented to regulatory authorities (MSAC) in Australia to secure funding for surveillance of these patients. MR colonography in HNPCC gene carriers We are testing the role of this technology which produces virtual images of the colon, as if viewed through a colonoscope, via manipulation of imaging data from MR scanning. Its appeal includes the lack of radiation, an important factor in carriers of cancer predisposing genes. We are approaching our target of 50 studies in association with Dept of Radiology at RMH and St Vincent's Hospital.. 55 Colorectal Medicine and Genetics is an academic department at The Royal Melbourne Hospital, which focuses on large bowel diseases, notably colorectal cancer, and inflammatory bowel disease. Research Activities Genetics and Colorectal Neoplasia (Bowel Cancer) Hyperplastic polyposis is the last known hereditary polyposis condition for which no gene predisposition has been identified. The work of MD scholar Dr Elizabeth Chow collated the world's largest series of these patients, described their phenotype and explored the role of two candidate genes (MDB4 and MYH) through sequencing and hot spot analysis respectively. This identifed a minor role for MYH mutations in the syndrome, leaving the question of a predosposing gene still open. This work was published in the world's leading gastroenterology journal 'Gastroenterology'. Mutational Analysis in Peutz Jegher's Syndrome This rare polyposis condition is also associated with high cancer risk. The gene predisposing to the condition (STK11) had been previously thought to account for only about half the families affected. Our work using extended mutational analytic techniques, beyond sequencing, identified a further 30% of families with mutations in the same gene, but detected only through Multiplex Ligand Probe Amplification which detects large deletions and reaarangements missed on sequencing. Juvenile Polyposis A family has been studied providing evidence for a mutation associated with BMPR1A on haplotyping, but no mutation has yet been identified. Celecoxib The pivotal international randomized controlled trial testing the preventative effects of celecoxib against colorectal neoplasia was also nationally lead by our team and published in the New England Journal of Medicine. Celecoxib significantly reduces the incidence of adenomas - both small and advanced. This was also the trial that identified the cardiovascular risk associated with high dose celecoxib which has substantially altered prescribing patterns for this and other COX2 inhibitors universally. Our patients were part of the risk profile that developed, although there were no fatalities. Follow up continues. The US National Institutes of Health Colon Family Register As one of the main recruitment centres worldwide for ascertainment of familial colon cancer families, we have been strong contributors to this US/Canadian and Australasian project. It provides a valuable clinical and biospecimen resource for investigators to access. We have recently approached the entire resource for studies of gene modifiers in hereditary non polyposis colon cancer, and to enhance the genome wide SNP association study. Professor Macrae is on the international steering committee. Surveillance in Familial Bowel Cancer Our 25 year experience in surveillance for members of families with bowel cancer has been subject to intense analysis in association with the CSIRO eHealth team. Presented at Australian Gastroenterology Week, it is the first time we have explored this data. Inflammatory Bowel Disease Multi-centre Inflammatory Bowel Disease Adalimumab and certolizumab in Crohn's Disease: Recruitment is now complete in the placebo controlled randomized trials, and open label therapy is continuing in Department of Medicine Annual Report 2006 Chemoprevention of Colorectal Cancer Aspirin and Resistant Starch: As major contributors and national management centre of the worldwide CAPP2 trial, we have been key investigators in this randomized controlled trial of aspirin and resistant starch in mismatch repair gene carriers (HNPCC). This 6 year trial will be complete by mid 2007 with initial results available mid year. It will provide pivotal level 2 evidence for the benefits of these two agents in preventing colorectal cancer. http://www.medrmhwh.unimelb.edu.au/ 56 these two trials of new, humanised anti-TNF agents. Both are effective. OPC 6535 in ulcerative colitis This randomized controlled trial is complete and further development of this phosphodiesterase 4 inhibitor has recently been abandoned because of inadequate efficacy. GM CSF in Crohn's Disease This randomized controlled trial has also been abandoned because of lack of efficacy. Given GM CSF's discovery at WEHI, we were particularly pleased to participate in this trial and disappointed in its outcome. Investigator initiated trials in IBD AMS student Maneesha Bhullar completed a correlation of NOD2/CARD15 genotyping in patients with at least one resection for small bowel Crohn's Disease against the natural history of the disease. Initial analysis, presented at the Australian Gastroenterology Week in Adelaide 2006, revealed a strong correlation between a frame shift mutation in the gene and rapid and aggressive onset of the disease requiring early surgery. Further work continues evaluating other mutations; mono-allelic and bi-allelic mutations carriage status and disease aggression, and response to infliximab. MR enterography prediction of response to infliximab Infliximab is very expensive and although powerful, is only 67% capable of inducing response in Crohn's Disease. This trial, half recruited, is evaluating whether MR criteria of activity and extent of disease will predict responsiveness and allow the therapy to be targeted to likely responders. Capsule Endoscopy in Suspected Small Bowel Crohn's Disease This national project is fully recruited and under analysis. Strong recruitment was achieved through our department. Mucosal biomarkers of cancer risk This project testing wheat bran and resistant starch in volunteers, and which first evaluated proliferative biomarkers with crypt location specificity, has now completed markers of apoptosis, all using a dedicated software Program 'Hemicrypt' developed in association with US collaborator Roberd Bostick. It is planned to use this platform to explore other preventative approaches. P2X7 expression in the colon Our preliminary studies have identified this marker in 100% of cancers and in a majority of adenomas, but not in normal mucosa. Control samples are now being evaluated, and the performance of the marker in dysplasia patients with ulcerative colitis and Barrett's oesophagus is being tested. Publication Highlights Jenkins MA, Baglietto L, Dowty JG, Van Vliet CM, Smith L, Mead LJ, Macrae FA, St John DJ, Jass JR, Giles GG, Hopper JL, Southey MC. Cancer risks for mismatch repair gene mutation carriers: a population-based early onset casefamily study. Clinical Gastroenterology and Hepatology 2006 4: 489-498 Park JG, Kim DW, Hong CW, Nam BH, Shin YK, Hong SH, Kim IJ, Lim SB, Aronsno M, Bisgaard ML, Brown GJ, Burn J, Chow E, Conrad P, Douglas F, Dunlop M, Ford J, Greenblatt MS, Heikki J, Heinimann K, Lynch EL, Macrae F, McKinnon WC, Moeslein G, Rossi BM, Rozen P, Schofield L, Vaccaro C, Vasen H Velthuizen M, Viel A, Wijnen J; International Society for Gastrointestinal Hereditary Tumours. Germ line mutations of mismatch repair genes in hereditary nonpolyposis colorectal cancer patients with small bowel cancer: International Society for Gastrointestinal Hereditary Tumours Collaborative Study. Clinical Cancer Research 2006; 12; 3389-93 Chow E, Lipton L, Lynch E, D’Souza R, Aragna C, Hodgkin L, Brown G, Winship I, Barker M, Buchanan D, Cowie S, Nasioulas S, du Sart D, Young J, Leggett B, Jass J, Macrae F, Hyperplastic polyposis syndrome: phenotypic presentations and the role of MBD4 and MYH. Gastroenterology 2006; 131; 30-9. Chow E, Meldrum CJ, Crooks R, Macrae F, Spigelman AD, Scott RJ. An updated mutation spectrum in an Australian series of PJS patients provides further evidence for only one gene locus. Clinical Genetics 2006; 70: 409-14 Bertagnolli MM, Eagle CJ, Zauber AG, Redston M, Solomon SD, Kim K, Tang J, Rosenstein RB, Wittes J, Corle D, Hess TM, WoloJ GM, Boisserie F, Anderson WF, Viner JL, Bagheri D, Burn J, Chung DC, Dewar T, Foley TR, Hoffman N, Macrae F, Pruitt RE, Saltzman JR, Salzberg B, Sylwestrowicz T, Gordon GB, Hawk ET; APC Study Investigators Celecoxib for the prevention of sporadic colorectal adenomas. New England Journal of Medicine 2006; 355:873-84 Rozen P, Macrae F, Familial adenomatous polyposis: The practical applications of clinical and molecular screening. Familial Cancer 2006; 5:227-35 Ollila S, Sarantaus L, Kariola R, Chan P, Hampel H, HolinskiFeder E, Macrae F, Kohonen-Corish M, Gerdes AM, Peltomaki P, Mangold E, de la Chapelle A, Greenblatt M, Nystrom M Pathogenicity of MSH2 missense mutations is typically associated with impaired repair capability of the mutated protein. Gastroenterology 2006:131:1408-17 Andrews L, Mireskandari S, Jessen J, Thewes B, Solomon M, Macrae F, Meiser B, Impact of familial adenomatous polyposis on young adults: attitudes towards genetic testing, support, and information needs. Genetic Medicine 2006; 8: 697-803 Smith L, Tesoriero A, Mead L, Royce S, Grubb G, Young J, Giles G, Jenkins M, Macrae F, Hopper JL, Southey MC. Large genomic alterations in hMSH2 and hMLH1 in early onset colorectal cancer: identification of a large complex de novo alteration. Clinical Genetics 2006; 70:250-52. Grants Project Grant, Genome wide SNP association study in Familial Bowel Cancer, CSIRO Project Grant , NIH CFR study, US NIH Grant, Studies on Genetics of Bowel Cancer, Hicks Foundation Contractual Research Grants, Clinical trials in IBD, Abbott, UCB, Otsuka, Others Grant, Genotyping and MR colonography in IBD, Schering Plough Contact Details Professor Finlay Macrae Colorectal Medicine and Genetics Level 3 Centre, City Campus The Royal Melbourne Hospital Victoria 3050 Tel: +61 3 9347 0788 Fax: +61 3 9348 2004 Email: [email protected] Associate Professor James St. John, AM Research Highlights • After 30 years of research on strategies and methods for prevention and early detection of colorectal cancer, the major highlight was commencement of the Continued collaboration with the Centre for Reviews and Dissemination, University of York, UK, to produce a report for the National Health Service (UK) on diagnostic accuracy and cost-effectiveness of faecal occult blood tests used in screening for colorectal cancer. [email protected] [email protected] Continued collaboration with the Murdoch Children’s Research Institute on the study of psychological outcomes and screening behaviours related to predictive genetic testing in HNPCC. Associate Professor James St John The Cancer Council Victoria 1 Rathdowne St., Carlton, VIC 3053 Associate Professor Brian D Tait Victorian Transplantation and Immunogenetics Service Research Highlights • The continuing collaboration with Drs Nicole Mifsud and Tom Kotsimbos in the Lung Transplant Unit at the Alfred Hospital . We are examining the HLA alloresponsive hierarchy in vitro with a view to identifying ‘ acceptable and ‘ non acceptable’ mismatches. The in vitro approach we have taken has provided some very interesting results which will be tested in a clinical setting. • Examining the role of the CDKN1A gene which codes for p21 involved in control of cell division. This gene is located at the centromeric end of the short arm of Chromosome 6 near the MHC complex. We 57 hypothesise that polymorphisms in this gene alter function and that that these polymorphisms are present on the A1,B8,DR3 (8.1) haplotype and account for the auto-immune nature of this haplotype. We have demonstrated a new polymorphism in this gene which is in linkage disequilibrium with the 8.1 haplotype. We are currently looking at this polymorphism in type 1 diabetes and plan functional studies involving this polymorphism. • Continuation of our collaboration with the Centre for Integrated Genomic Medical Research. at the University of Manchester on the immunogenetics of polymyositis. This collaboration has led to several publications. • VTIS is the co-ordinating centre for the Asia-Pacific region of the International Type 1 Diabetes Consortium. We have genotyped and created cell lines from diabetic probands and family members from hundreds of families in the Asia Pacific region including the Phillipines, India, Hong Kong and we expect China to be a collaborating nation during 2007. All this material is available for future research projects. Publication Highlights Jenkins MA, Baglietto L, Dowty JG, van Vliet CM, Smith L, Mead LJ, Macrae FA, St. John DJB, Jass JR, Giles GG, Hopper JL, Southey MC. Cancer risks for mismatch repair gene mutation carriers: a population-based early onset casefamily study. Clinical Gastroenterology and Hepatology 2006; 4:489-498 St. John J. Colonoscopic screening in individuals with a family history of colorectal cancer. Nature Clinical Practice Oncology 2006; 3:362-363 Awards and Prizes Appointment as Honorary Senior Associate, The Cancer Council Victoria Prominent Activities Appointment as Councillor, Specialist Medical Review Council, Department of Veterans Affairs Advisor to the Department of Health and Ageing (DoHA) on bowel cancer screening Appointment as Member, Program Advisory Group, National Bowel Cancer Screening Program, DoHA Appointment as Chair of the Quality Working Group (QWG), National Bowel Cancer Screening Program, DoHA. The QWG has been established by the Australian Health Ministers Advisory Council to provide advice to DoHA on strategies to improve the quality, consistency and availability of colonoscopy services in Australia Consultant to the Cancer Institute New South Wales Member of the Principal Committee and Working Party Executive and contributor for the Second edition of the NH&MRC “Clinical Practice Guidelines for Prevention, Early Detection and Management of Colorectal Cancer” Contributor to the revision of The Cancer Council Australia’s National Cancer Prevention Policy document Invited speaker, Annual Scientific Meeting, Royal Australian and New Zealand College of Obstetricians and Gynaecologists, held in Perth, 18 October 2006. Title of presentation: “Keeping women well: screening for bowel cancer” Hawke’s Bay Cancer Society Public Lecture on “Tackling bowel cancer: New Zealand is still in the front row”, given in Hastings, New Zealand on 17 August 2006 Hawke’s Bay Cancer Society Lecture for Health Professionals on “Bowel cancer: challenges and opportunities”, given at Napier, New Zealand on 17 August 2006 Publication Highlights Murphy N, Diviney M, Szer J, Bardy P, Grigg A, Hoyt R, King B, MacGregor L, Holdsworth R, McCluskey J, Tait BD. Donor methylene tetrahydrofolate reductase genotype is associated with graft versus host disease in haematopoietic stem cell transplant patients treated with methotrexate. Bone Marrow Transplantation 37(8): 773-779,2006. Stockman A, Tait BD, Wolfe R, Brand CA, Rowley MJ, Varney MD, Buchbinder R, Muirden KD. Clinical laboratory and genetic markers associated with erosions and remission in patients with early inflammatory arthritis: a prospective cohort study. Rheumatoid International 26:500-509,2006. Chinoy H, Salway F, Fertig N, Shepard N, Tait BD, Thomson W, Isenberg DA, Oddis CV, Silman AJ, Ollier WE, Cooper RG. In adult onset myositis the presence of interstitial lung disease and myositis specific /associated antibodies are governed by HLA class 2 haplotypes rather than by myositis subtype. Athritis Research and Therapy 8:R13 (E pub. ahead of print). Chinoy H, Salway F, Fertig N, Tait BD, Oddis CV, Ollier WE, Cooper RG. Monocyte chemotactic protein-1 single nucleotide polymorphisms do not confer susceptibility Research : Honorary Fellows • Contact Details Department of Medicine Annual Report 2006 • Australian National Bowel Cancer Screening Program in August 2006. In the initial phase (August 2006 to June 2008), close to one million Australians are being invited to undergo screening. http://www.medrmhwh.unimelb.edu.au/ 58 for the development of adult onset polymyositis/ dermatomyositis in UK caucasians. Rheumatology 2006 (E pub ahead of print). Professor Ian Wicks Yap C-H, Skillington PD, Matalanis G, Davis BB, Tait BD, Hudson F, Ireland L, Nixon I, Yii M. Anti-HLA antibodies after cryopreserved allograft valve implantation do not predict valve dysfunction at three year follow up. Journal of Heart and Valve Disease 15:540-544,2006. New Grants Recipient with Dr Nicole Mifsud of an ARCBS Research Project Grant for ‘ Dissecting the immunogenicity of HLA class 1 molecules for improved transplant outcomes using a novel cellular based assay’ Tait BD and Mifsud N. Amount $60,000. Prominent Activities Guest lecturer at the International Transplant Congress in Boston, July 2006. Guest lecturer Japanese Society of Histocompatibility and Immunogenetics ,Tokyo, September 2006. Contact Details Associate Professor Brian Tait 2nd Floor Rotary Bone Marrow Research Building c/o Royal Melbourne Hospital Ph: +61 3 9341 6305 Fax: +61 3 9348 1278Email: [email protected] Reid Rheumatology Laboratory, Division of Autoimmune Diseases and Transplantation, Walter and Eliza Hall Institute of Medical Research (WEHI) Centre for Rheumatic Diseases (CRD) Research Highlights As Head of the Reid Rheumatology Laboratory, Division of Autoimmune Diseases and Transplantation, at WEHI. a laboratory role focuses on the immunopathogenesis of inflammatory diseases such as rheumatoid arthritis (RA), using a variety of murine models. Major interests include G- and GM-CSF and related cytokines, and the SOCS proteins, which negatively regulate cytokine signal transduction. This work has led to involvement in pre-clinical development of novel G-CSF and GM-CSF receptor antagonists, in association with Zenyth and CSL. It has also emphasized the importance of clinical translation and to that end, a WEHI translational research fellowship in RA has been established for a clinician to work in this capacity at RMH. The Rheumatology Unit at RMH headed by Professor Wicks has also embarked on a Phase 1 trial of a chimeric anti-GMCSF antibody in Rheumatoid Arthritis (RA). This trial builds on work from Professor John Hamilton’s Laboratory, using an antibody derived initially through the Melbourne Ludwig Iinstitute for Cancer Research. Professor Wicks is also Head of the Centre for Rheumatic Diseases (CRD), co-located with the Rheumatology Unit at RMH. The CRD, especially through the work of Senior Lecturer, Dr Richard Osborne, and his team, pursues a broad clinical research program including evidence-based re-design Department Activities Environment Health and Safety Research : Honorary Fellows of the orthopaedic waiting list and evaluation of patient education and self-management strategies described in detail elsewhere in this report. These important areas for translational research provide academic opportunities and increased community relevance and are described in detail elsewhere in this report. Dr Sabina Ciciriello co-supervised with Dr Osborne and A/Prof Buchbiner studies patient drug education in RA, including design of a novel, audiovisual program for patients with RA commencing Methotrexate, which will now be evaluated in a randomised controlled trial. Another interest is the accelerated atherosclerosis which accompanies RA, a problem of increasing concern in many chronic inflammatory diseases.The research program on atherosclerosis is a collaboration headed by Dr Sharon van Doornum. Publication Highlights Granulocyte colony stimulating factor and neutrophils – forgotten mediators of inflammatory disease. Nature Clinical Practice Rheumatology 2006 Sep 2(9):500-10 SOCS-3 negatively regulates innate and adaptive immune mechanisms in acute, IL-1 dependent inflammatory arthritis. Journal Clin Invest 2006 Jun 116(6):1571-81 59 Interleukin-6 modulates production of T lymphocytederived cytokines in antigen induced arthritis and drives inflammation-induced osteoclastogenesis. Arth Rheum 2006 Jan 54(1):158-68 Reducing the cardiovascular burden in rheumatoid arthritis. Medical Journal Aust 2006 Mar 20;184(6):287-90 New Grants How does endogenous G-CSF drive joint inflammation? NH&MRC Project Grant (CIA Wicks –WEHI) Awards and Prizes NH&MRC Clinical Practitioner Fellowship – re-appointed and promoted to PF2. Patient drug education in RA (Wicks – philanthropic trust, University of Melbourne). Contact Details Professor Ian Wicks Reid Rheumatology Laboratory Walter and Eliza Hall Institute of Medical Research and Rheumatology Unit, Royal Melbourne Hospital Lorraine Parker, Laboratory Manager. Supported by Tim Byrne and Paul Masendycz, Lorraine ensures the Department meets the requirements of SafetyMAP. The Department of Medicine is committed to providing a safe working environment for the students, members of staff, and contractors who work within the Department, and is compliant to SafetyMAP Version 4. The Department is also aware of the responsibilities it has to protect the environment, and is compliant to the international standard ISO 14001. More information on our EHS initiatives can be found on our website at: http://www.medrmhwh.unimelb. edu.au/resources/ehs.html SafetyMAP As a self-insurer for workers compensation, the University of Melbourne is required by the Victorian WorkCover Authority (VWA) to have in place a safety management system to at least SafetyMAP (Safety Management Achievement Program) Initial Level. The university chose the VWA audit standard SafetyMAP as the tool to ensure it would provide safe systems of work to reduce risk, to measure its occupational health and safety performance, and to implement a cycle of continuous improvement. This has been achieved by having good safe work procedures, by providing appropriate induction and training for staff and students, and by regularly inspecting the workplace for hazards. The Department of Medicine at both the Royal Melbourne and Western Hospitals, as part of the Faculty of Medicine, Department of Medicine Annual Report 2006 WEHI Translational Research Program in RA (Wicks – philanthropic trust, WEHI), which provides for a translational research fellowship in RA at RMH. Inaugural recipient is Dr Simon Chatfield. http://www.medrmhwh.unimelb.edu.au/ 60 Dentistry and Health Sciences, has undergone regular annual internal audits to ensure compliance with the SafetyMAP criteria. DoMSA President's Report Environment Emma Braine and Amanda Turner, campaigners for a greener department The University of Melbourne is committed to care of the environment through the implementation of an Environment Management System compliant to the international standard ISO 14001. This system enables the University to formulate a policy regarding environment objectives, taking into account legislative requirements and information about significant environmental impacts. The Environment Management System is integrated into the University's Safety Management System, and annual audits are held concurrently with the SafetyMAP audit. The Department is committed to supporting the 'green laboratory' and 'green office' programs offered by the university, for the management of substances hazardous to the environment, waste reduction and recycling, reducing the amount of water and energy used, and where possible purchasing environment-friendly products. More on the Department's environmental initiatives can be found on our website at: http://www.medrmhwh.unimelb.edu.au/ resources/ehs.html#environment Dominic De Nardo, Student Association President 2006 The Department of Medicine Student Association (DoMSA) was established in 2003 with four broad aims: • to enhance the academic and professional life of Department of Medicine (RMH/WH) postgraduate students; • to encourage social interaction of students within the department; • to provide academic support to fellow postgraduates and thus foster communication of research ideas and collaborations; and • to represent the Department of Medicine (RMH/WH) postgraduate students to the department, faculty and university. The 2006 DoMSA committee of strong friendships (and possible collaborations) were made with our honorary Dutch DoMSA member. Fundraising has been an ongoing initiative since DoMSA’s inception. In previous years DoMSA has raised money not only to help hold DoMSA events but also for the Juvenile Diabetes Research Foundation and to help individuals in famine and Malaria-stricken Malawi (Plan Australia). In 2007 DoMSA aims to use funds raised in 2006 to sponsor an impoverished child for one year through World Vision. DoMSA would like to thank the Department of Medicine (RMH/WH) for their ongoing support, and for making student life much more enjoyable. Getting sporty. L-R Thao Nguyen, Christine Massa, Dominic DeNardo, Philippe Boeuf and Sten Libregts In April 2006, a new DoMSA committee was elected, with Dominic De Nardo as president, Thao Nguyen taking the role of secretary, Christine Massa continuing her excellent work as treasurer, and Hang Dinh and Nelly Kua as our social representatives. Salenna Elliot was asked to continue her role as the staff representative. Our honours representative role for 2006 was filled by Nicki Ball. Dominic De Nardo, DoMSA President 2006 (d.denardo@ pgrad.unimelb.edu.au) Department Seminar Series Department Activities Fundraising 61 Students of the department also play important roles on the EHS committee and the DoMSA president represents the students on the Department of Medicine (RMH/WH) executive committee. An important part of this role was communicating student related issues at the executive meetings. This led to review of student support in 2006 and resulted in a number of staff being appointed honours mentors, providing honours students with additional support. Early in the year the honours students organized a well attended ‘get-to-know-each-other’ dinner, which ignited new friendships. A post-exam chocolate session for the honours students at ‘KoKo Black’ on Lygon Street, was a huge success, with students drowning their sorrows with gallons of hot chocolate and handfuls of rich chocolaty delights. The theme of food was again the focal point when we set out for a mid-year dinner at ‘Papa Gino’s’ followed by a sugar binge at a local lolly shop. Prior to the honours students’ final presentation, DoMSA held an afternoon tea and practice session that attendees found very helpful. Then, as has become customary, following their final presentation, the honours students, with postgrad students in check, headed out for a much deserved celebratory lunch and drinks. Students Get Fit in 2006 After eating too much pizza and chocolate at previous events the committee decided that it was time for DoMSA to get healthy. In the second half of the year we ditched the traditional pizza and movie nights for numerous sport sessions at the Melbourne University Sports Centre. Sessions were attended by both students and staff inciting great rival matches of basketball, badminton and soccer. In December, DoMSA hosted the annual Staff Vs Students Cricket Match and BBQ at Princes’ Park in Carlton. The well attended and highly competitive match ended a draw for the second year running, with the skill and class of each team being matched by the other. Honorary Dutch DoMSA member As part of his Masters studies Sten Libregts, spent 4 months working in the Hamilton group with Dr Cook within the Department of Medicine. His enthusiasm and participation in DoMSA events was valued by all. A number Glen Scholz, Senior Research Fellow and Seminar Series Coordinator March Dr Edward Hogan, Mapping Structural Hippocampal Changes in Epilepsy, University of St. Louis Michael Lian (PhD confirmation), Mesenchymal cell pathology in progressive renal disease, RMH Dr Glen Scholz, Keeping the inflammatory response of macrophages to pathogens under control Department of Medicine, University of Melbourne Department of Medicine Annual Report 2006 Social Events http://www.medrmhwh.unimelb.edu.au/ 62 Dr Elizabeth Chow, (Final MD Thesis Presentation), Defining genetic mechanisms of colorectal cancer: From bedside to bench and back again, Department of Colorectal Medicine and Genetics (RMH) April Prof Ron du Bois, Genetic predisposition to ILD-any translational value?, Royal Brompton Hospital, London Dr Benjamin Cowie (PhD confirmation) Host: SVD The seroprevalence, molecular characterisation and mathematical modelling of hepatitis B virus infection in Victoria, VIDRL Dr Louise Allport, (Final PhD Thesis Presentation), Disordered physiological parameters in acute ischaemic stroke: A study of hyperglycaemia and haematological variables, Department of Neurology, RMH May September Dr Andrew Cook, Differing roles for the plasminogen activators in arthritis, University of Melbourne October Dr Michael Hickey, Mechanisms of leukocyte trafficking in the kidney, Monash University Dr Philippe Boeuf, Placental functional impairment during malaria in pregnancy, University of Melbourne Dr Alex Andrianopoulos, Understanding the molecular mechanisms controlling morphogenesis in the human fungal pathogen Penicillium marneffei, University of Melbourne November Mr Adrian Achuthan (PhD Oration), Regulation of SNARE proteins and vesicle trafficking by macrophage-colony stimulating factor, University of Melbourne Dr Stefanie Dedeurwaerdere, Neuromodulation in animal models of epilepsy, Department of Medicine, University of Melbourne Ms Nhu-Y Nguyen, (PhD confirmation) Signalling pathways that regulate B cell development, Bone Marrow Research Laboratory, WEHI Dr Sandra Petty (PhD confirmation, Epilepsy and bone health, Department of Medicine, University of Melbourne Dr Christen Barras (PhD confirmation) Imaging predictors of hematoma growth in primary intracerebral hemorrhage, Deptartment of Radiology, RMH June Ms Hang Dinh (PhD Oration) Gene expression analysis of macrophage differentiation, University of Melbourne Dr Cleo Romagosa, Maternal mortality in Mozambique Hospital Clinic, Barcelona University Dr Kim Powell, Histamine receptors in the nervous system and ion channel expression in animal models of temporal lobe epilepsy, Department of Medicine, University of Melbourne Dr Anthony Jaworowski, How HIV-1 infection inhibits macrophage function, Burnet Institute Dr Graham Lieschke, Unravelling myeloid development using zebrafish genetics, Cancer and Haematology Division, WEHI July Dr Nigel Jones, The many applications of animal behaviour in neuroscience research, Department of Medicine, University of Melbourne Ms Thao Nguyen (PhD confirmation) and Regulation of the inflammatory responses of macrophages by Toll-like receptors, Department of Medicine, University of Melbourne Ms Lucy Busija (PhD confirmation) Personal and societal burden of osteoarthritis, Department of Medicine, University of Melbourne Dr Margaret Hibbs, Signaling networks in myelo- and lympho-proliferative disease Ludwig Institute for Cancer Research August Dr Richard Osborne, The stick and/or the carrot? Integration of innovation into the healthcare system within the Victorian Orthopaedic Waiting List (OWL) University of Melbourne Prof Peter Barnes, HDACs, Steroids and Chronic Obstructive Lung Disease, Imperial College School of Medicine, National Heart and Lung Institute, London Prof John Furness, The intrinsic sensory neurons of the intestine, and the control of their excitability and roles in disorders following inflammation in humans and in animal models, University of Melbourne Dr Stephen Rogerson, Pathogenesis of low birth weight due to malaria, University of Melbourne December Dr Sabina Ciciriello (PhD confirmation)Development and validation of a multimedia education program about methotrexate for patients with rheumatoid arthritis Department of Rheumatology, RMH Dr Kean Soon (PhD Oration), Role of multi-slice computed tomography in the evaluation of coronary artery disease and revascularization proceduresUniversity of Melbourne 2006 marks the 50th Anniversary for the Department of Medicine and its partnership with the Royal Melbourne Hospital. Over the years, joint research projects and ventures have provided a nexus between hospital and university from teaching and research to clinical applications of discoveries that benefit the wider community. A collection of archived photographs has been compiled to celebrate years of achievement. 1. Test on patients’ lung capacity in the Department of Medicine in 1958. 2. The electron microscope in the University Department of Medicine in 1964. It provided magnification of up to one million times and cost £17,000 following a grant from the Wellcome Foundation. 3. The Department of Medicine’s Dr Richard Larkins and Laboratory Technician, Lilly Simenova, in 1972 conducting research into diabetes using a strain of mice that develop obesity, leading to the observation that increasing weight gain can affect the nature of the pancreas’ response to different stimuli. 4. Long-time Department of Medicine staff member, Associate Professor J.R.E. Fraser, in the laboratory, c.1989. 5. The Department of Medicine’s ‘Brown’s Corner’ in 1984, where technical assistants Kerry Brown and Tracey Brown assisted with research on viruses and arthritis, in particular the culture of the lining cells of joints and hyaluronic acid. 6. Quantitating enzyme activity in patients with rheumatoid arthritic in the Department of Medicine in 1983. 7. Dr Ken Muirden, of the Department of Medicine, treating a patient in 1981 8. The Department of Medicine’s Dr Len Harrison in 1980. 9. Dr Ross Bury measuring drug levels in patients within the Department of Medicine’s laboratories in 1983. 10. Professor Richard Larkins, Dr Marjorie Dunlop and Dr Michael Hill in 1987. The researchers from the Department of Medicine were studying the early changes in diabetic kidney disease and diabetic disease of the small blood vessels. 11. Professor Young and research assistants examining microscopic changes in the development of large bowel cancer in 1992. 12. Collaboration between the Department of Medicine and the RMH Department of Diabetes and Endocrinology with Associate Professor Joe Proietto and Dr Anne Thornburn in 1997. 13. Professor Lovell demonstrating an examination technique to fourth year medical students, c.1970s. Department Activities Celebrating 50 Years 63 4 9 12 2 3 5 6 7 10 8 11 13 Department of Medicine Annual Report 2006 1 http://www.medrmhwh.unimelb.edu.au/ Staff and Students 64 Staff and Students at the Department of Medicine (Royal Melbourne Hospital/Western Hospital), July 2006 Research Staff Head of Department and James Stewart Professor Graham Vallancey Brown Head of Unit at Western Hospital and Professor Peter Robert Ebeling Professors Gary Peter Anderson Steven Graves John Dennis Wark Ingrid Winship Chair of Adult Clinical Genetics Ingrid Winship National Health and Medical Research Council Senior Principal Research Fellow and Professorial Fellow John Allan Hamilton National Health and Medical Research Council Principal Research Fellow and Professor Stephen Marsden Jane Western Hospital Principal Research Fellow and Professor Andrew Simon Giraud Associate Professors Beverley-Ann Biggs Geoff John McColl Terence John O'Brien Associate Professor and Wellcome Trust Fellow Stephen John Rogerson Senior Lecturers Alex Boussioutas Richard H. Osborne Sharon van Doornum Joseph Torresi Senior Research Fellows Allen Cheng Damian E. Myers Glen Matthew Scholz CR Roper Fellow for the Faculty of MDHS Louise Monique Judd Western Hospital Clinical School Sub Dean Jacinta Tobin National Health and Medical Research Council Industry Fellow Grade 2 Nicholas John Wilson Postdoctoral Research Fellow Grade 2 Ruth Chin Caroline Marshall Research Fellows Grade 2 Gerard Casey Andrew David Cook Yi Mo Deng Nigel Jones Joanne Jordan Melissa Morgan Joan Nankervis Kerrie Way Research Fellows Grade 1 Ilana Ackerman Mark Bailey Philippe Boeuf Bianca Chan Natasha Davidson Stephanie Dedeurwaerdere Selenna Elliott Caryn Leonie Elsegood Anjali Haikerwal Melanie Hawkins Jakob Jackson Catherine Jones Derek Lacey Christina Laidlaw Jason C. Lenzo Emma McBryde Erin Ng Kim Powell John Roiniotis Nicholas Senn Kathy Speed Rebecca Temple Alisa Turbic Jill Moveley Barbara Newell Erin Ng Bree Norton Paul Payne Jarrad Pobjoy Debra Robbins Amanda Springer Alisa Turbic Amanda Turner Leena Van Raay Angela Wood Francisca Yosaatmadja Clinical Trials Manager Megan Brooks Assistant Clinical Trials Manager Emily Mann Senior Bone Densitometry Technologist Susan Kantor Genetics Nurse Masha Slattery Administrative Staff Department Manager Nick Christopher Unit Manager, Western Hospital Lyn Kalms Laboratory Manager Lorraine Parker IT Managers Gina Barri-Rewell Anne MacIntyre Communications Manager Jane Yule to July 2006 Kate Hannah from September 2006 Finance Officer Angela Luu Personal Assistants Mirella Ozols Rifa Sallay Heather Saunders Wendy Cadd Administrative Officer Julie Holland National Health and Medical Research Council Senior Research Officer Michael Frank Duffy Trevelyan Menheniott NH&MRC Peter Doherty Postdoctoral Fellowship Michelle Porritt Australian Research Council Postdoctoral Research Fellow Wai Hong Tham Research Assistants Kaye Beckman Emma Braine Tim Byrne Lisa Cardamone Peta Chubb Soren Christensen Jemma Christie Felix Clanchy Lucy Crouch Lauren Day Bernard De Kok Linda Earnest-Silveira Anthony Favaloro Dean Hewish Biba Horvatic Meegan Howlett Jacob Jackson Valentina Jovanovska Bianca Marie Jupp Anastasia Kalantzis Martin Keene Rink-Jan Lohman Paul Masendycz Department Manager, Nick Christopher BRF Manager Jenny Davis Senior Fellows Paul Andrews James Beeson Robert Chen Nikola Chosich John Dowling Joseph Epstein Shing Fan David Freilich Maurice Frenkel Peter Hand Timothy Hewitson Marienne Hibbert Robert Hjorth Malcolm Holmes Karen Holzer Anne Howard Elizabeth Hristov Debra Kerr Ian Kronborg Garry Lane Lara Lipton Stuart Macaulay Lawrence Mcmahon Joseph Morton Alison Nankervis Robert Newman Kathleen Nicholls David Packham John Reeder Andrew Roberts Lynden Roberts Abe Rubinfeld Joseph Sasadeusz Jennifer Schwarz David Smallwood Paul Sparks Antony Speer Alan Street Vijaya Sundararajan Brian Tait Richard Travers George Varigos Kumar Visvanathan James Wong Peter Wong BRF Technician Rebecca Bowyer Preparation Services Margaret Muir Cooperative Research Centre for Chronic Inflammatory Diseases Staff Chairman and CEO Dr John Flack Business Manager Robyn McLachlan Office Manager Melissa Coyle Education Officer Susan Cumming Communications Manager Astrid Sweres Finance and Administration Officer Graham Burns Honorary Appointments Professorial Fellows with the title Professor Gavin Becker Stephen Davis Peter Disler Robert Helme Jonathan Kalman Anne-Maree Kelly Yean Lim Finlay Macrae Allan Mclean Mark Rosenthal Jeff Szer Ian Wicks Principal Fellows with the title Associate Professor John Balla Peter Colman Peter Danne Marjorie Dunlop Damon Eisen Joseph Epstein Leon Flicker Michael Green Keith Hill David Hunt Louis Irving Christine Kilpatrick Geoffrey Lindeman Lawrence McMahon Geoffrey Metz Harry Mond Fellows Narin Bak Andrea Bendrups Mark Bradbeer Roger Brown Michael Bryant Michael Chou Anastasia Chrysostomou Xavier Csar David Cunnington Philip Davies Theo Gouskos Thomas Hale Karen Holzer Ian Jennens Jacques Joubert Farees Khan Zeff Koutsogiannis Lan Li David Lightfoot Vesna Markovska Jacqui Montgomery Eugenia Pedagogos Sandra Petty Jeffrey Presneill Jack Richards Cleofe Romagosa Sagal Serar Narelle Skinner Gregory Taggart Niall Tubridy Paul Wraight Bernard Yan Honorary Clinical Appointments Clinical Fellows with the title Associate Professor Peter Hamblin Samuel Scherer Clinical Fellows Paul Champion de Crespigny Monica Slavin Students National Health and Medical Research Council Medical Postgraduate Research Scholar Christopher Mark MacIsaac Sandra Petty Susan Anne Skull Rosemary Sutton National Health and Medical Research Council Public Health Scholar Paul Charles Vinton National Health and Medical Research Council Dora Lush Biomedical Scholar Anastasia Hutchinson Australia Postgraduate Award Louise Evelyn Allport Laura Kate Zamurs Melbourne Research Scholarship Christine Massa Melbourne International Research Scholarship Gabriela Minigo University of Melbourne Special Postgraduate Studentship Adrian Achuthan Margaret Chang Benjamin Cowie Hang Thi Cam Dinh Felix Clanchy Dominic DeNardo Natalie El Haiser Andrew Fleetwood Cameron Jackson Bianca Jupp Roya Lari Rink-Jan Lohman Christopher Lemoh Emily Mann Caroline Ng Rajna Ogrin Jane Prosser Susan Senn Anita Vinton Thomas Zheng University of Melbourne Viola Edith Reid Scholarship Elizabeth Chow Postgraduate PhD and MD Scholars Ilana Naomi Ackerman Christian Barras Lucy Busija Anna Brave Sabina Cicirello David Nicholas Edis Jennifer Elliott Alexandra Fischer Theo Gouskos 65 Andrew Grigg Haris Haqqani Julian Hunt-Smith Meegan Howlett Gaurav Kumar Michael Lian Poh-Sien Loh Murray Letkis Sina Malki Rosemary Masterson Katherine Murray Nhu-Y Nguyen Thao Nguyen Paul Older Anthony Peterson Grantley Peck Irani Ratnam Yeliz Rifat Leo Rando Jonathan Richards Kurt Roberts-Thomson Rebecca L. Rose Anna Scholzen Jessica Salmon Ken Hoo Soon Irene Stevenson Cassandra Szoeke Sophie Treleaven David Wang Lindy Washington Ian Woolley Leon Worth Paul Wraight Srinivasa Raju Yarra Staff and Students Michael Richards David Russell Monica Slavin Donald St John Neil Strathmore Harry Teichtahl Jitendra Vohra Department of Medicine Annual Report 2006 Administrative Assistants Virginia Champion de Crespigny, Julie Ciccone Bernadette Crankshaw Dianne Ferguson Stella Vo http://www.medrmhwh.unimelb.edu.au/ 2006 Publications 66 Achuthan AA, Elsegood C, Masendycz P, Hamilton J & Scholz G. 2006. CpG DNA enhances macrophage cell spreading by promoting the Src-family kinase-mediated phosphorylation of paxillin. Cellular Signaling. 18 (12): 2252-2261. Ackerman I, Graves S, Bennell K & Osborne R. 2006. Evaluating quality of life in hip and knee replacement: Psychometric properties of the World Health Organization Quality of Life short version instrument. Arthritis and Rheumatism. 55 (4): 583-590. Aggarwal A, Wong J & Campbell D. 2006. Carvedilol reduces aldosterone release in systolic heart failure. Heart Lung and Circulation. 15 (5): 306-9. Aggarwal A, Guo DL, Hoshida Y, Yuen ST, Chu KM, So S, Boussioutas A, Chen X, Bowtell D, Aburatani H, Leung SY & Tan P. 2006. Topological and functional discovery in a gene coexpression meta-network of gastric cancer. Cancer Research. 66 (1): 232-241. Aghmesheh M, Suo Z, Friedlander M, Nesland JM, Kaern J, Stewart M, Kconfab , Dorum A, Tucker KM & Buckley MF. 2006. Chromosome 2q24.2 is lost in sporadic but not in BRCA1-associated ovarian carcinomas. Pathology. 38 (2): 145-151. Alibrahim EY, Gibson R, Vincent J, Speer A, Collier N & Jardine. 2006. Spiral computed tomography-intravenous cholangiography with three-dimensional reconstructions for imaging the biliary tree. Australasian Radiology. 50 (2): 136-142. Allport L, Baird T, Butcher K, Macgregor, Prosser J, Colman P & Davis S. 2006. Frequency and temporal profile of poststroke hyperglycemia using continuous glucose monitoring. Diabetes Care. 29 (8): 1839-1844. Anderson G. 2006. COPD, asthma and C-reactive protein. European Respiratory Journal. 27 (5): 874-876. Anderson G. 2006. Current Issues With beta2Adrenoceptor Agonists: Pharmacology and Molecular and Cellular Mechanisms. Clinical Reviews in Allergy and Immunology. 31 (2-3): 119-130. Bosè F, Fugazza C, Casalgrandi M, Capelli A, Cunningham JM, Zhao Q, Jane SM, Ottolenghi S & Ronchi A. 2006. Functional interaction of CP2 with GATA-1 in the regulation of erythroid promoters. Molecular and Cellular Biology. 26 (10): 3942-3954. Bozinovski S, Vlahos R, Hansen M, Liu KW & Anderson G. 2006. Akt in the pathogenesis of COPD. The International Journal of Chronic Obstructive Pulmonary Disease. 1 (1): 31-38. Brettig TW, Clooney, Kelly A & Kerr D. 2006. Head computed tomography guidelines are being followed. Emergency Medicine Australasia. 18: 238-244. 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Department of Medicine Annual Report 2006 73 Department of Medicine (RMH/WH) 2006 Department of Medicine (RMH/WH) Annual Report Authorised by: Professor Graham Brown Copyright: The University of Melbourne Photography: Photosmith CRICOS Provider Code: 00116K The information in this publication was correct at the time of printing. The University reserves the right to make changes as appropriate. As details may change students are encouraged to visit the University's web site or contact the International Centre to obtain the latest information. >