Monday, 12 March 2018

High-dose steroids don’t prevent asthma flare-ups

Professor Phil Bardin

High-doses of glucocorticoids are not effective in preventing life-threatening asthma exacerbations, according to a landmark study published in The New England Journal of Medicine last week.

Monash University’s Professor Phil Bardin was specially invited by the NEJM to assess the evidence for this therapy based on two recent asthma clinical trials.

“Inhaled glucocorticoids are pivotal to achieve asthma control in both children and adults but despite their use, many patients with asthma have flare-ups,” said Professor Bardin, Director Monash Lung & Sleep.

“Acute flares of asthma are detrimental because they adversely affect quality of life, lung function, and health care costs and have the potential to end in death.”

“Everyone agrees that preventing exacerbations is a priority in asthma care,” Professor Bardin said.

Professor Bardin said asthma specialists have long thought that more aggressive use of inhaled glucocorticoids can prevent exacerbations if initiated at the first signs of deterioration.

Professor Bardin found good evidence that children, in particular, receive no significant benefit from high-dose inhaled glucocorticoids in terms of their likelihood of having an asthma attack.

“The evidence indicates that substantial escalation of regularly used inhaled glucocorticoids, even by a factor of 4 or 5, fails to prevent most asthma exacerbations,” Professor Bardin said.

The editorial invitation by the prestigious journal is due to Professor Bardin and his team’s significant research into asthma at the Monash Health Translation Precinct (MHTP).

“The invitation to contribute to the NEJM on this topic is a testament to our global reputation built upon the outstanding clinical research done at Monash over many years,” Professor Bardin said.

“In particular, the Clinical Trials Unit in Monash Lung and Sleep, Monash Health under the leadership of Ms Joanne McKenzie has recently conducted ground-breaking research on monoclonal antibodies in asthma.”

This new treatment has had dramatic benefits for many patients with crippling severe asthma.

Monash emergency physician and researcher inducted onto Victorian Honour Roll of Women

Mr Andrew Stripp,
Assoc Prof Diana Egerton-Warburton,
Ms Barbara Yeoh

Monash University’s Associate Professor Diana Egerton-Warburton was inducted onto the Victorian Honour Roll of Women for 2018 last week, in recognition of her remarkable achievements and commitment to the field of emergency medicine.

Associate Professor Egerton-Warburton is Director Emergency Medicine Research, Monash Medical Centre ED and an Emergency Physician with a passion for patient and community advocacy.   She is an Associate Professor at the School of Clinical Sciences at Monash health (SCS) and the National Drug Research Institute, Curtin University.

Associate Professor Egerton-Warburton has led and participated in a number of multi-site clinical trials and clinical research projects, with an emphasis on focused on pragmatic, patient-centered research, to influence practice and policy. She has received numerous research grants including NHMRC, AMA and VicHealth.

Minister for Women, the Hon Ms Natalie Hutchins,
Assoc Prof Egerton-Warburton
“Throughout my career I’ve endeavoured to ‘make a difference’ for patients and the healthcare system with which they interact,” Associate Professor Egerton-Warburton said.

“I use an investigate, innovate, evaluate and propagate model to produce effective, sustainable, cost-effective transformational change and knowledge translation to improve patient care at Monash Health and Victoria.”

“Using this model alongside public health advocacy and my college role I have broadened the impact of my work nationally and internationally,” she said.

Associate Professor Egerton-Warburton was the president of the Australasian Society for Emergency Medicine from 1997 to 2000. She was chair of the Australasian College for Emergency Medicine Public Health Committee for almost a decade and has led an international project to highlight and reduce the harmful effects of alcohol.

She has been awarded numerous prizes including VicHealth and Australian Medical Associations (AMA), Women in Medicine Award 2016 for an “outstanding contribution to emergency medicine with a strong passion for public health”. She is a member of the Australian National Advisory Council on Alcohol and other Drugs (ANACAD) providing policy advice to the Commonwealth Government. She has provided policy advice to the Victorian minister for Health. As a supporter of #foamED (Free Open Access Medical Education) she believes in the use of social media as an education, research and advocacy tool.
Twitter: #First_do_noharm

Renowned nephrologist receives Monash University promotion

Professor John Kanellis
Head of Transplantation and Deputy Director of Nephrology at Monash Medical Centre John Kanellis has been recognised for his outstanding clinical work and research, receiving an academic promotion at Monash University.

Adjunct Clinical Professor Kanellis’ early research focused on the role of Vascular Endothelial Growth Factor (VEGF) in renal disease as well as various other inflammatory pathways and their role in renal and cardiovascular disease and in hypertension.

In more recent years, Professor Kanellis’ basic and clinical research has focussed on transplantation.

“PhD students under our supervision in the renal laboratory (headed by Professor David Nikolic-Paterson) have studied antibody mediated rejection of kidney transplants, and we’ve developed a unique animal model to better study this clinical problem which has very limited therapeutic options,” Professor Kanellis said.

“Given the large size of the transplant unit at Monash Medical Centre—more than 900 patients with current transplants—clinical research has been very collaborative.”

“Over the last decade, our unit has been heavily involved in studies of new immunosuppressive agents and new immunosuppressive regimens.”

“In collaboration with colleagues at the University of Sydney, we’ve undertaken qualitative research involving quality of life improvements from transplantation as well as psychological aspects of living donation,” Professor Kanellis said.

Under Professor Kanellis’ leadership, Monash Transplant has grown immensely in the last decade, seeing more than 100 patients every week with functioning transplants in their clinics.

“We perform approximately 100 new transplants every year, including kidney-only transplants as well as double kidney and pancreas transplants—for type 1 diabetics,” Professor Kanellis said.

Monash Medical Centre is a Nationally Funded Centre (1 of only 2 in Australia) for pancreas transplantation.

“We service Victoria, Tasmania and South Australia with this unique activity, performing 20-25 new double transplants per year, and we also have a very active living kidney donor programme.”

Beyond his clinical and research activities, Professor Kanellis has lectured medical students and supervised several BMedSc(Hons) and PhD students.

He is the current Chair of the National Renal Transplant Advisory Committee, the peak national advisory body for kidney transplantation in Australia.

Professor Kanellis said he feels honoured be recognised for his work through this promotion.

“I owe much credit to my clinical and basic science colleagues, our transplant team (clinicians, surgeons and nurses) and the renal fellows, PhD students and to my wonderful family for their endless support,” Professor Kanellis said.

“I would also like to acknowledge all the patients. Collectively we are all striving to help them through our activities and I am very lucky to have such an interesting and rewarding job.”

Cutting edge bone imaging at Monash University - an Australian first

Ms Barbara Yeoh, Chair Monash Health,
Professor Peter Ebeling and
Dr Ayse Zengin in front of the XtremeCT-II scanner at MHTP
In an Australian-first, Monash University’s Bone and Muscle Health Research Group has acquired a new generation scanner that measures bone density and quantifies three dimensional microarchitecture of bones to assess musculoskeletal diseases.  There are only two such scanners in the world—the other in China.

The XtremeCT-II high resolution peripheral quantitative computed tomography was purchased with funds from the National Health and Medical Research Council, Monash University and the Ian Potter Foundation.

Research fellow Dr Ayse Zengin said the XtremeCT-II measures 3D bone microstructure, tendons, cartilage, joints, muscle, fat and vascular calcification at the highest resolution and precision currently available.

“The XtremeCT-II is the only one of its kind in Australia and will allow cutting edge musculoskeletal research both domestically and internationally,” Dr Zengin said.

The XtremeCT-II will be available as a research platform for researchers, clinicians and surgeons—ensuring collaboration amongst health care professionals.

Professor Peter Ebeling, AO who heads the research group at Monash University anticipates that utilising a low-radiation method for high-resolution imaging of bone, muscle and joints will enhance understanding of musculoskeletal conditions, enabling effective preventative and treatment strategies. 

SCS travel award benefits precision medicine research

Dr Tu Nguyen-Dumont

Congratulations Dr Tu Nguyen-Dumont, recipient of the SCS Research Fund Travel Scheme in recognition of her research in personalised medicine.

Dr Nguyen-Dumont, a senior research fellow in the Precision Medicine group will use the $1000 grant to travel to the 7th International Symposium on Hereditary Breast and Ovarian Cancer (HBOC Symposium) in Montreal, Canada where she will present a poster, ‘BRA-STRAP: Personalized medicine to precision public health’.

BRA-STRAP is the largest, nation-wide, clinically set study of breast cancer susceptibility.

“We are performing targeted-sequencing of 24 genes commonly included on panel tests for breast cancer predisposition in 30,000 Australian women of all ages across the cancer risk spectrum, affected and unaffected with breast cancer, and their families,” Dr Nguyen-Dumont said.  

Data on this scale exemplifies the opportunities and challenges for realising precision medicine and precision public health for breast cancer.”

Dr Nguyen-Dumont said the Symposium’s program this year provides wide clinical and population health relevance and is delivered by leaders in these fields.

“The Symposium covers topics including breast cancer biology, gene variant classification, global perspectives on clinical practice in genetics and oncology, and is an opportunity to meeting with international collaborators to advance our work,” Dr Nguyen-Dumont said.

“Our successful collaborations will contribute greatly to the University’s research quality and performance, provide considerable opportunity for multi- and interdisciplinary research at the international front line, thus enhancing the visibility and reputation of the Faculty and Monash University”.

“My participation to this conference is an excellent strategic fit with the Faculty’s identified research strengths and priorities that include cancer and precision medicine.”

MHTP research grant enables collaborative research into the prevention of gestational diabetes

Ms Aya Mousa and Dr Stacey Ellery

Early career researchers Ms Aya Mousa and Dr Stacey Ellery have won the MHTP Research Week ECR speed networking event, receiving a $10,000 grant to progress their collaborative research idea.

Co-organised by the Hudson Institute and School of Clinical Sciences ECR Committees, the event invited early career researchers from across the precinct to submit a collaborative grant idea.

Aya Mousa (a PhD student/early post-doctoral researcher at MCHRI, SPHPM) and Stacey Ellery (a postdoctoral researcher in The Ritchie Centre) emerged from the event with a novel idea that combines their expertise in pregnancy and metabolic disorders to help women with gestational diabetes.

“Gestational diabetes (GDM) is a common disease developed by 20,000 Australian women during pregnancy each year,” Ms Mousa and Dr Ellery said.

“Not only are women with GDM at higher risk of adverse pregnancy outcomes including pre-eclampsia, and preterm birth, the disease also predisposes both the mother and infant to developing diabetes and cardiovascular diseases later in life.”

Using plasma samples from over 500 pregnant women, stored in clinical biobanks at MCHRI and The Ritchie Centre, the researchers will explore the influence of diet and lifestyle intervention on the development of gestational diabetes and will conduct the first studies to comprehensively assess lipid biomarkers in GDM.

By combining samples from both low- and high-risk pregnancies, they will potentially identify novel metabolic markers (lipids) that could be used to improve risk prediction, prevention, and management of GDM in the future.

Ms Mousa and Dr Ellery said the ECR event was instrumental in forming this new collaboration, as their respective research teams were not previously aware of their joint interests. They said the support of funds pledged by Hudson and SCS also ensured the idea could be made a reality, an opportunity not often afforded to young researchers. 

During Research Week, ECRs met for casual one-on-one conversations to find common interests and unearth potential novel research ideas. The committee reviewed EOIs and then, after an initial round of selection, full applications.

Event co-organiser Dr Aimee Dordevic said ECRs at MHTP are spread across many different centres and departments, and the event provided important opportunities for face-to-face meetings.

“It was fantastic to see how well the event was able to facilitate collaborations between researchers that may not have otherwise come to life. We look forward to seeing the outcomes of the projects, from Aya and Stacey, and all of the other grant applicants,” Dr Aimee Dordevic said.

“Importantly, we would like to thank Hudson and SCS for supporting this event. We plan to run the event again in 2018 so that we can continue to nurture collaborations between ECRs and foster world-class research outcomes.”

About the winners:
Ms Aya Mousa recently completed her PhD at the Monash Centre for Health Research and Implementation (MCHRI). She has published extensively in diabetes, nutrition and metabolism, developing expertise across the research continuum (mechanistic, epidemiological, clinical, and translational research).

Dr Stacey Ellery is based at The Ritchie Centre, Hudson Institute. She has published extensively in the field of metabolic regulation during pregnancy and the use of dietary interventions to improve pregnancy outcomes.

SCS Early Career Research Practitioner Fellowship scheme - applications due 29 March

Applications are now open for the SCS Early-Career Clinical Practitioner Fellowship scheme.   The successful candidate will be appointed up to 0.5 FTE, Academic Level B.  

Recognising the difficult transition from PhD student to independent clinician scientist, in 2015 the School established the Early-Career Clinical Practitioner Fellowship scheme to further the aims of the School in training tomorrow’s clinical academic workforce and of consolidating Monash Health as leading academic health service. 

The Fellowships are offered on a competitive basis, to clinician scientists who have recently been awarded a PhD or MD to provide protected research time to allow them to further develop their clinical or basic science research portfolio while also undertaking clinical duties at Monash Health. 

It is envisaged that successful applicants will apply for external funding, such as through NHMRC schemes (e.g. Project Grants, Early-Career Fellowships, Career Development Fellowships, or Translational Research Fellowships) during the period of the Fellowship, such that the Fellowship acts as a bridge to independent, sustainable research funding.

The Position Description (HERE) and Application form (HERE) can also be found on the SCS intranet:
Applications are due by 5:00 pm on Thursday 29th March 2018