Monday, 16 October 2017

Simple blood test reduces antibiotic use in patients with acute respiratory infections

Professor Yahya Shehabi
Patients with acute respiratory infections should be tested for a blood marker for bacterial infection to determine antibiotic treatment, according to a large international study including researchers at Monash University.

Published yesterday in The Lancet ID, an individual patient data analysis from 26 randomised controlled trials across 12 countries was used to investigate the use of procalcitonin—a biomarker for bacterial infections—as a tool to improve decisions about antibiotic therapy.

Acute respiratory infections (ARIs) comprise a large group of infections including bacterial, viral and from other causes, accounting for over 10% of global disease burden. 

In these patients, “despite their mainly viral cause, unnecessary antibiotics significantly contribute to bacterial resistance, medical costs and the risk of drug-related side effects”, said co-author Professor Yahya Shehabi from Monash University who is also a critical care physician at Monash Health.  

“Blood levels of Procalcitonin (PCT) is negligible in normal people but rises substantially within hours of bacterial infection and decreases as patients recovers with appropriate antibiotic therapy.”

Randomised trials evaluated the use of procalcitonin based algorithms, to guide decision making for antibiotics prescription in acute respiratory infection. 

“Our individual patient meta-analysis, combining high quality trials using data from 6708 patients showed that the use of procalcitonin guided algorithms significantly reduced the risk of death by 17% and treatment failure by 12%.

“It also reduced antibiotic consumption and antibiotic-related side effects (16.3% versus 22.1%).”
“Our analysis also demonstrated that the benefits for sicker patients, like those needing intensive care treatment, is more pronounced.”  

 “Procalcitonin can be measured in the blood of patients at point of care providing clinicians with on the spot decision making for individual patients,” said Professor Shehabi, the only Australian author on the study.



Are Australian women being ‘left out in the cold’ over policies governing egg freezing?

SCS graduate research student Molly Johnston 
Australia is experiencing the growing global trend of women freezing their eggs for fertility preservation providing the option for thawing and IVF treatment in future to have children.

However, a major medical conference in Adelaide today heard there was no consistent cross border regulation about who should be able to access egg freezing with a call to review policies that encompass “changing societal opinions and community needs.”

Speaking at the annual scientific meeting of the Fertility Society of Australia, Monash University researcher Molly Johnston said: “While across border differences in health care are to be expected, they raise questions about whether the principles that underpin various policies on egg freezing are ethically justified and transparent.

“The variety of egg freezing policies seen worldwide suggest they lack evidence, are outdated and require serious review.  The distinction between medical and non-medical infertility underpins Australian policies, and it is open to challenge.”

Ms Johnston said another driving factor for a review was the advent of commercial or employer funding of elective egg freezing to keep young women in the workforce while delaying motherhood.

Australian women seeking elective or social egg freezing to preserve their fertility face a costly disadvantage compared to those seeking the treatment for medical reasons, including the prospect of being left infertile from cancer treatments or conditions such as severe endometriosis.

Women choosing elective egg freezing must pay for the treatment at around $10,000 per cycle, while those seeking it for medical reasons are eligible for Medicare rebates of around $5,000 per cycle.

“All women in Australia can seek egg freezing treatment regardless of their reasons,” Ms Johnston said.  “However, in the absence of common regulation, individual clinics govern access to the treatment and can impose their own restrictions such as an age limit. 

“What is contentious is whether reasons for seeking fertility preservation should matter.

“In medical or elective circumstances, women are seeking to prevent infertility and they are not infertile at the time they seek egg freezing.

“Similarly, it can be argued that there is no difference between medical and non-medical egg freezing as in both cases women are freezing their eggs with the same motive  – the hope of securing their reproductive future and protecting the chance of having their own biological offspring.”

Ms Johnston said company sponsored egg freezing began in the United States about three years ago with major companies including Microsoft, Google, Facebook and Apple now offering to cover the costs of egg freezing for their female employees as part of their medical benefits package.

“This trend is now emerging in Australia, but I am not aware of any employees who have yet taken up this option,” she said.

“While some hail company sponsored egg freezing as promoting a woman’s reproductive rights and choices, other argue that it is disempowering to women as they may feel pressured to take up the option or risk not being competitive in the workforce.”

National and world leaders in assisted reproductive technology are attending the Fertility Society meeting at the Adelaide Convention Centre providing compelling insights into new ways of assisting couples struggling to conceive naturally.

Story courtesy of Trevor Gill, Fertility Society of Australia.


MHTP Research Week poster competition - call for abstracts NOW. Submissions close 20 October.

MHTP Research Week is an exciting opportunity to acknowledge the achievements and showcase the ground-breaking research being conducted at the Monash Health Translation Precinct.

Poster competition and Early Career Researchers Awards.

A key element of Research Week is the poster competition and display.  The poster competition includes awards for Best Posters and Early Career Researchers. 

There will be a $500 prize for the Best Poster in each research category.  

The best Early Career Researcher will be chosen from the abstracts and the top four will be invited to present their research at an oral presentation. The first prize winner will receive $1,000.  

Please submit your entries online by clicking on the link below and following the instructions.  You will need to create a Currinda account (instructions on the link below).

https://mhtp.currinda.com/register/event/7 

Please note that the closing date for poster submissions is Friday 20 October.

For further information, please contact Annette.McClellan@monashhealth.org  or jinleng.graham@monash.edu



MHTP Research Week draft program available






















Draft program now available HERE.

SCS trivia quiz



Save the Date: Centre for Cancer Research Childhood Cancer Research Symposium, 7 February 2018

Objective: Improving outcomes in children diagnosed with cancer through innovative research into the development and progression of these diseases and identification of new and more effective therapeutic strategies.

Description: On 7 February 2018, the Centre for Cancer Research at the Hudson Institute of Medical Research will be hosting a Childhood Cancer Research Symposium.  This is a scientific event, targeted at paediatric cancer researchers and clinicians.  The Symposium will include prestigious guest speakers from local and international organisations, such as the Children's Hospital of Philadelphia (USA), the SickKids Hospital (Canada), KK Women's and Children's Hospital (Singapore), the Queensland Brain Institute, the Royal Children's Hospital, Monash University, Monash Children's Hospital and the Hudson Institute of Medical Research.


Symposium attendees will learn first-hand about the latest developments and advancements in paediatric cancer research.  They will hear about cutting-edge strategies, technologies and solutions for basic and translational research, including clinical implications.  Specific themes include: latest developments and discoveries in paediatric brain tumours; translational research highlights and paediatric precision medicine.

CID special seminar: "The HMGB1-RAGE axis in chronic inflammatory airways disease", 17 October

17 October, 12-1pm, seminar room 1, TRF

Presented by Dr Maria Sukkar, Graduate School of Health, University of Technology Sydney

Dr Sukkar’s work focusses on the role of the protein high-mobility group box-1 and its receptor RAGE in chronic inflammatory airways disease. Dr Sukkar was the first to show that soluble RAGE, an endogenous inhibitor of RAGE signaling, is deficient in sub-phenotypes of asthma/COPD in which neutrophilic inflammation plays a key role. Subsequent mechanistic investigations in mouse models identified a crucial role for HMGB1 and RAGE in driving distinct endotypes of asthma. Studies in mouse models of cigarette smoke exposure also revealed the important role of this inflammatory axis in COPD pathogenesis. In this seminar, Dr Sukkar will discuss current understanding of the HMGB1-RAGE axis in chronic inflammatory airways disease, and its potential as a therapeutic target.

Having completed her PhD at the University of Sydney in 2002, Dr Sukkar undertook postdoctoral research on a Wellcome Trust programme grant at the National Heart and Lung Institute, Imperial College London; one of the top-ranked universities in the world. There, she worked with Prof Kian Fan Chung, a world leader in respiratory medicine. She returned to Australia in 2008 to take up a Lectureship at the Faculty of Pharmacy, University of Sydney. In 2012, she moved to the Graduate School of Health, University of Technology Sydney, where she is currently Senior Lecturer in the Discipline of Pharmacy. Upon returning to Australia, Dr Sukkar established her own laboratory for respiratory research. She has maintained her international links, and has built an extensive network of national and international collaborations. Her current research is focused on innate immune mechanisms that drive the abnormal airway inflammatory response to environmental allergens, pollutants and pathogens in people with asthma and COPD.