Grossmann M.,University of Melbourne |
Grossmann M.,Austin Health
Journal of Endocrinology | Year: 2014
A wealth of observational studies show that low testosterone is associated with insulin resistance and with an increased risk of diabetes and the metabolic syndrome. Experimental studies have identified potential mechanisms by which low testosterone may lead to insulin resistance. Visceral adipose tissue is an important intermediate in this relationship. Actions of testosterone or its metabolite oestradiol on other tissues such as muscle, liver, bone or the brain, and body composition-independent effects may also play a role. However, definitive evidence from randomised controlled trials (RCTs) to clarify whether the association of low testosterone with disordered glucose metabolism is causative is currently lacking. It therefore remains possible that this association is due to reverse causation, or simply originates by association with common health and lifestyle factors. RCTs of testosterone therapy in men with or without diabetes consistently show modest metabolically favourable changes in body composition. Despite this, testosterone effects on glucose metabolism have been inconsistent. Recent evidence suggests that the hypothalamic-pituitary-testicular axis suppression in the majority of obese men with metabolic disorders is functional, and may be, at least in part, reversible with weight loss. Until further evidence is available, lifestyle measures with emphasis on weight reduction, treatment of comorbidities and optimisation of diabetic control should remain the first-line treatment in these men. Such measures, if successful, may be sufficient to normalise testosterone levels in men with metabolic disorders, who typically have only modest reductions in circulating testosterone levels. © 2014 Society for Endocrinology Printed in Great Britain.
Villemagne V.L.,Austin Health
International psychogeriatrics / IPA | Year: 2011
Molecular neuroimaging techniques such as PET are proving valuable in the early and differential diagnosis of Alzheimer's disease (AD).With the advent of new therapeutic strategies aimed at reducing β-amyloid (Aβ) burden in the brain to potentially prevent or delay functional and irreversible cognitive loss, there is increased interest in developing agents that allow assessment of Aβ burden in vivo. Amyloid imaging with PET has proven useful in the discrimination of dementias, showing significantly higher Aβ burden in the gray matter of AD patients when compared with healthy controls or patients with frontotemporal dementia. ApoE ε4 carriers, independent of diagnosis or disease severity, present with higher Aβ burden than non-ε4 carriers. Amyloid imaging matches histopathological reports in aging and dementia, reflecting the true regional density of Aβ plaques in cortical areas. It also appears to be more sensitive than FDG-PET for the diagnosis of AD. In healthy older people there is an increasing prevalence of amyloid positive scans with age, rising from 20% in the seventh decade to 60% in the ninth decade. Of people with mild cognitive impairment (MCI), 40-60% present with detectable cortical Aβ deposition. In both groups, Aβ deposition is associated with a higher risk for cognitive decline and dementia due to AD. These observations suggest that Aβ deposition is not part of normal aging, supporting the hypothesis that it occurs well before the onset of symptoms and is likely to represent preclinical AD in asymptomatic persons and prodromal AD in MCI. Further longitudinal observations, coupled with different disease-specific tracers and biomarkers, are required to confirm this hypothesis and further elucidate the precise role of Aβ deposition in the course of AD.
Bladin P.F.,Austin Health
Journal of Clinical Neuroscience | Year: 2014
The well-established medical involvement of derivatives of the azo dye industry lent credibility to the 1935 announcement by Stanley Cobb of the use of vital brilliant red dye as an anticonvulsant. Although in the fullness of time clinical experience would discard this concept, nevertheless it was to give rise to Robert Aird who posited that the mechanism of action of this dye was due to its ability to decrease the permeability of the blood-brain barrier. In a very prolonged exploration of this concept, Aird concluded that blood-brain barrier permeability underlay the causation of a long list of chronic neurological conditions - a concept that was eventually abandoned. This article examines the details and the effects of this concept and its impact upon neurology. © 2013 Elsevier Ltd. All rights reserved.
Manley K.J.,Austin Health
Journal of Renal Care | Year: 2014
Objective: To investigate self-reported upper gastric symptoms experienced by patients with chronic kidney disease (CKD) and compare associations between uraemic symptoms and saliva composition. Methods: In a cross-sectional observational study, 30 patients with Stages 4 and 5 CKD were selected from a tertiary hospital renal outpatient clinic. Subjects answered a questionnaire to assess upper gastrointestinal (GI) symptoms. A saliva sample was collected to determine biochemical composition. Possible associations between saliva composition and uraemic upper GI symptoms were assessed. Results: Only 3 (10%) patients reported no upper GI symptoms whilst 19 (63%) complained of a dry mouth, 16 (56%) had a change in taste, 9 (30%) had nausea, 7 (23%) vomited and 7 (23%) dry retched. Lower saliva bicarbonate concentration related to both dry mouth (p<0.003) and dry retching (p<0.01). An elevated level of saliva calcium was also implicated in a dry mouth sensation (p<0.01). Nausea was associated with higher saliva sodium levels (p<0.03) and a higher saliva sodium/potassium ratio (p<0.02). Conclusion: Altered saliva composition in patients with Stages 4 and 5 CKD may be associated with uraemic upper GI symptoms. In particular, lower saliva concentrations of bicarbonate are associated with dry mouth and retching. Higher saliva calcium levels are also related to a dry mouth whilst higher saliva sodium levels and a greater sodium/potassium ratio are associated with nausea. Further studies investigating strategies to improve uraemic symptoms via changes in saliva are required. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.
Melbourne Health, Austin Health and Southern Health | Date: 2011-05-11
The present invention relates generally to viral variants exhibiting reduced sensitivity to particular agents and/or reduced interactivity with immunological reagents. More particularly, the present invention is directed to hepatitis B virus (HBV) variants exhibiting complete or partial resistance to nucleoside analogs and/or reduced interactivity with antibodies to viral surface components including reduced sensitivity to these antibodies. The present invention further contemplates assays for detecting such viral variants, which assays are useful in monitoring anti-viral therapeutic regimens and in developing new or modified vaccines directed against viral agents an in particular HBV variants. The present invention also contemplates the use of the viral variants to screen for agents capable of inhibiting infection, replication and/or release of the virus.
Austin Health | Date: 2014-01-30
A computerized method for monitoring cardiac output of a subject by a processor executing the method, the method comprising the steps of:
Melbourne Health, Austin Health and Southern Health | Date: 2012-05-23
The present invention relates to methods for determining the potential of hepatitis B virus, HBV, variants to exhibit reduced sensitivity to Adefovir dipivoxil, ADV, and/or Tenofovir, TFV. The present invention is also directed to isolated HBV variants exhibiting decreased sensitivity to ADV and/or TFV. The present invention further contemplates methods for detecting agents having inhibitory activity to such viral variants, as well as the uses of such viral variants in the rational design of anti-HBV agents and in the manufacture of medicaments for the treatment and/or prophylaxis of HBV infection.
Melbourne Health, Austin Health, Southern Health, St. Vincents Hospital Melbourne Ltd. trading as St. Vincents Hospital Melbourne and Alfred Health | Date: 2012-01-11
The present invention relates generally to viral variants exhibiting reduced sensitivity to particular agents and/or reduced interactivity with immunological reagents. More particularly, the present invention is directed to hepatitis B virus (HBV) variants exhibiting complete or partial resistance to nucleoside or nucleotide analogs and/or reduced interactivity with antibodies to viral surface components including reduced sensitivity to these antibodies. The present invention further contemplates assays for detecting such viral variants, which assays are useful in monitoring anti-viral therapeutic regimens and in developing new or modified vaccines directed against viral agents and in particular HBV variants. The present invention also contemplates the use of the viral variants to screen for and/or develop or design agents capable of inhibiting infection, replication and/or release of the virus.
News Article | February 22, 2017
FILE PHOTO - An exam room at the Planned Parenthood South Austin Health Center is shown in Austin, Texas, U.S. on June 27, 2016. REUTERS/Ilana Panich-Linsman/File Photo AUSTIN, Texas (AP) — A federal judge ruled Tuesday that Texas can't cut off Medicaid dollars to Planned Parenthood over secretly recorded videos taken by anti-abortion activists in 2015 that launched Republican efforts across the U.S. to defund the nation's largest abortion provider. An injunction issued by U.S. District Sam Sparks of Austin comes after he delayed making decision in January and essentially bought Planned Parenthood an extra month in the state's Medicaid program. Texas is now at least the sixth state where federal courts have kept Planned Parenthood eligible for Medicaid reimbursements for non-abortion services, although a bigger question remains over whether President Donald Trump will federally defund the organization. Sparks' decision preserves what Planned Parenthood says are cancer screenings, birth control access and other health services for nearly 11,000 low-income women at 30 clinics. Texas originally intended to boot Planned Parenthood in January but Sparks told the state to wait pending his ruling. Arkansas, Alabama, Kansas, Mississippi and Louisiana have also had similar efforts blocked. Sparks' unsparing opinion excoriated Texas for not providing "any evidence" of Planned Parenthood wrongdoing and stalling on the ouster for nearly a year. "A secretly recorded video, fake names, a grand jury indictment, congressional investigations — these are the building blocks of a best-selling novel rather than a case concerning the interplay of federal and state authority through the Medicaid program," Sparks wrote. "Yet, rather than a villain plotting to take over the world, the subject of this case is the State of Texas's efforts to expel a group of health care providers from a social health care program for families and individuals with limited resources." Like in other states, Texas health officials accused Planned Parenthood officials of making misrepresentation to investigators following the release of secretly recorded and heavily edited videos by an anti-abortion group last year. Investigations by 13 states into those videos have concluded without criminal charges, and Planned Parenthood officials have denied any wrongdoing. For more news videos visit Yahoo View, available now on iOS and Android. Republican Texas Attorney General Ken Paxton said the state intends to appeal in a statement that repeated accusations that Planned Parenthood manipulated the timing of abortions to benefit researchers. Planned Parenthood has denied those claims, and Sparks said there was no evidence the organization violated ethical or medical standards. "No taxpayer in Texas should have to subsidize this repugnant and illegal conduct. We should never lose sight of the fact that, as long as abortion is legal in the United States, the potential for these types of horrors will continue," Paxton said in a statement. A Houston grand jury indicted two activists behind the videos over how they covertly gained access inside a Planned Parenthood clinic, but a judge later dismissed the charges. Planned Parenthood serves only a fraction of the 4.3 million people enrolled in Medicaid in Texas, but Sparks said he was not convinced that its clients would quickly and easily be able to find new providers. Anti-abortion activists emboldened by a new Trump administration are looking for the federal government to cut off all federal funding to Planned Parenthood. That would cut nearly $400 million in Medicaid money to the group and result in roughly 400,000 women losing access to care, according to the nonpartisan Congressional Budget Office. In one of his first acts as president, Trump last month banned U.S. funding to international groups that perform abortions or even provide information about abortions. Vice President Mike Pence strongly opposes abortion, citing his Catholic beliefs, and the newly confirmed health secretary, Tom Price, has supported cutting off taxpayer money to Planned Parenthood.
News Article | February 22, 2017
FILE PHOTO - Planned Parenthood South Austin Health Center is seen in Austin, Texas, U.S. on June 27, 2016. REUTERS/Ilana Panich-Linsman/File Photo AUSTIN, Texas (Reuters) - A U.S. judge in Austin issued a preliminary injunction on Tuesday halting Texas' plan to cut Medicaid funding for Planned Parenthood, saying the state did not present evidence of a program violation that would warrant termination. U.S. District Judge Sam Sparks said state health officials "likely acted to disenroll qualified health care providers from Medicaid without cause." He said the preliminary injunction will preserve the court's ability to render a meaningful decision on the case's merits. "Such action would deprive Medicaid patients of their statutory right to obtain health care from their chosen qualified provider," wrote the judge who was appointed by Republican former President George H.W. Bush. The reproductive healthcare group has said the threatened funding cut, by terminating Planned Parenthood's enrollment in the state-funded healthcare system for the poor, could affect nearly 11,000 patients across Texas as they try to access services such as HIV and cancer screenings. Texas and several other Republican-controlled states have pushed to cut the organization's funding since an anti-abortion group released videos it said showed Planned Parenthood officials negotiating prices for fetal tissue collected from abortions. Texas investigated Planned Parenthood over the videos and a grand jury last January cleared it of any wrongdoing. The grand jury indicted two anti-abortion activists who made the videos for document fraud but the charges were dismissed. The state took no further criminal action against Planned Parenthood after that but has repeated its accusations that the abortion provider may have violated state law. Planned Parenthood has denied any wrongdoing and sued the anti-abortion activists who made the videos. Texas Republican Attorney General Ken Paxton said his office would appeal. "Today’s decision is disappointing and flies in the face of basic human decency," he said in a statement. In fiscal 2015, Planned Parenthood affiliates across Texas received about $4.2 million in Medicaid funding, the state's Health and Human Services Commission said. Planned Parenthood said the amount for 2016 was estimated at around $3 million. None of the money that the group received went for abortions, plaintiffs in a lawsuit against Texas and the Medicaid defunding plan have said. Planned Parenthood has 34 health centers in Texas, serving more than 120,000 patients, 11,000 of whom are Medicaid patients, it said.