Simpson J.L.,University of New South Wales |
Simpson J.L.,Hunter Medical Research Institute |
Gibson P.G.,University of New South Wales |
Gibson P.G.,Hunter Medical Research Institute |
And 9 more authors.
Respirology | Year: 2014
Background and objective The non-eosinophilic phenotype of asthma (NEA) is associated with chronic airway inflammation and airway neutrophilia. An accumulation of apoptotic airway epithelial cells, if not efficiently cleared by efferocytosis, can undergo secondary necrosis, with the potential for inflammation of surrounding tissues. Apoptosis may occur via the T cell granzyme B pathway. The role of granzyme B in NEA is not known. The aim of this study was to investigate production of granzyme B and its inhibitor proteinase inhibitor (PI)-9 by T cells from induced sputum and compare expression between eosinophilic, NEA and healthy controls. Methods We investigated T cell intracellular granzyme B and its inhibitor, PI-9, in sputum from healthy control subjects (n = 10), and patients with NEA (n = 22) or eosinophilic asthma (EA) (n = 15) using flow cytometry. Results Granzyme B expression and the ratio of granzyme B to PI-9 positive cells were highest in those with NEA for both CD3+ and CD4+ T cells. The expression of granzyme B was not statistically different between patients with NEA and EA; however, the ratio of granzyme B to PI-9 positive cells for CD3+ T cells was significantly higher in those with NEA compared with EA. Conclusions Induced sputum provides a non-invasive tool for investigating T cell cytotoxic mediators in the various asthma subtypes. Granzyme B expression is increased in NEA and the contribution of granzyme B to chronic inflammation requires further study. The non-eosinophilic phenotype of asthma is associated with chronic airway inflammation and airway neutrophilia. The role of granzyme B in NEA is not known. Increased granzyme B expression in NEA may contribute to increased epithelial cell apoptosis, lung injury and chronic inflammation. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.
Gettens S.,Prince Charles Hospital Queensland |
Fulbrook P.,Australian Catholic University |
Fulbrook P.,Prince Charles Hospital
Journal of Evaluation in Clinical Practice | Year: 2014
Rationale, aims and objectives Falls in hospital are costly and may impact psychologically on fallers causing them to avoid mobilization, thereby affecting recovery rate and hospital length of stay. The study aim was to investigate the relationships between fear of falling, falls risk, in-hospital falls and hospital length of stay. Method A convenience sample (n = 141) of patients from a large tertiary hospital was recruited. Data were collected over 6 months using the Modified Falls Efficacy Scale (MFES) on ward admission, prior to discharge, and in the event of a fall. Results A third of the sample (n = 44) was admitted to hospital following a fall. The majority (65%) was categorized as medium falls risk. Twenty-five participants sustained a total of 30 falls during their hospital admission of which 13 sustained a total of 15 falls on the study wards. The mean admission MFES score was 5.5, which increased to 6.1 on hospital discharge. Fallers scored significantly lower admission MFES scores than non-fallers (P = 0.003). Receiver-operating curve analysis indicated that admission MFES score was a 'fair' predictor of sustaining a fall (area under curve = 0.71, P = 0.013). With a cut-off score of 5, admission MFES sensitivity was 77% and specificity was 55%. Study ward fallers had significantly longer hospital length of stay (49 days) than non-fallers (27 days; P = 0.037). Furthermore, regardless of whether the participant was a faller or not, significantly longer hospital stay was associated with an admission MFES score of less than 5. Conclusions An admission MFES score of less than 5 is an effective predictor of patient falls and is associated with a significantly longer hospital length of stay. © 2014 John Wiley & Sons, Ltd.
Varzeshi N.,Prince Charles Hospital Queensland |
Hansen M.,Prince Charles Hospital Queensland |
Rezaee A.,Prince Charles Hospital Queensland |
Dixon N.,Prince Charles Hospital Queensland |
And 2 more authors.
Journal of Medical Imaging and Radiation Oncology | Year: 2012
Infiltrative cardiomyopathies generally pose a diagnostic dilemma as current diagnostic tools are imprecise. Invasive endomyocardial biopsy is considered as the gold standard however it has some limitations. Recently cardiovascular magnetic resonance (CMR) is emerging as an excellent technique in diagnosing infiltrative cardiomyopathies and is increasingly being used. Characteristic pathologic and radiologic findings in most common infiltrative cardiomyopathies (amyloid, sarcoid and Fabry's) are discussed and correlated with relative CMR and histologic examples. There is fairly good correlation between the non-invasive radiologic and the invasive histologic findings in common infiltrative cardiomyopathies. Non-invasive CMR with its high sensitivity and specificity has an excellent role in establishing the diagnosis and improving the prognosis of common infiltrative cardiomyopathies. © 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.