Royal Brisbane and Womens Hospital Brisbane

Brisbane and, Australia

Royal Brisbane and Womens Hospital Brisbane

Brisbane and, Australia
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PubMed | University of Queensland, Royal Brisbane and Womens Hospital Brisbane, University of New South Wales, CSIRO and Queensland Institute of Medical Research Brisbane
Type: Journal Article | Journal: Journal of medical radiation sciences | Year: 2015

Accurate knowledge of O(6)-methylguanine methyltransferase (MGMT) gene promoter subtype in patients with glioblastoma (GBM) is important for treatment. However, this test is not always available. Pre-operative diffusion MRI (dMRI) can be used to probe tumour biology using the apparent diffusion coefficient (ADC); however, its ability to act as a surrogate to predict MGMT status has shown mixed results. We investigated whether this was due to variations in the method used to analyse ADC.We undertook a retrospective study of 32 patients with GBM who had MGMT status measured. Matching pre-operative MRI data were used to calculate the ADC within contrast enhancing regions of tumour. The relationship between ADC and MGMT was examined using two published ADC methods.A strong trend between a measure of minimum ADC and methylation status was seen. An elevated minimum ADC was more likely in the methylated compared to the unmethylated MGMT group (U=56, P=0.0561). In contrast, utilising a two-mixture model histogram approach, a significant reduction in mean measure of the low ADC component within the histogram was associated with an MGMT promoter methylation subtype (P<0.0246).This study shows that within the same patient cohort, the method selected to analyse ADC measures has a significant bearing on the use of that metric as a surrogate marker of MGMT status. Thus for dMRI data to be clinically useful, consistent methods of data analysis need to be established prior to establishing any relationship with genetic or epigenetic profiling.

Singh B.,Queensland University of Technology | Buchan J.,Queensland University of Technology | Box R.,Queensland Lymphoedema and Breast Oncology Physiotherapy Grange Australia | Janda M.,Queensland University of Technology | And 4 more authors.
Asia-Pacific Journal of Clinical Oncology | Year: 2016

Aim: This study assessed the association between compression use and changes in lymphedema observed in women with breast cancer-related lymphedema who completed a 12-week exercise intervention. Methods: This work uses data collected from a 12 week exercise trial, whereby women were randomly allocated into either aerobic-based only (n = 21) or resistance-based only (n = 20) exercise. Compression use during the trial was at the participants discretion. Differences in lymphedema (measured by lymphedema index [L-Dex] score and interlimb circumference difference [%]) and associated symptoms between those who wore, and did not wear compression during the 12-week intervention were assessed. We also explored participants' reasons surrounding compression during exercise. Results: No significant interaction effect between time and compression use for lymphedema was observed. There was no difference between groups over time in the number or severity of lymphedema symptoms. Irrespective of compression use, there were trends for reductions in the proportion of women reporting severe symptoms, but lymphedema status did not change. Individual reasons for the use of compression, or lack thereof, varied markedly. Conclusion: Our findings demonstrated an absence of a positive or negative effect from compression use during exercise on lymphedema. Current and previous findings suggest the clinical recommendation that garments must be worn during exercise is questionable, and its application requires an individualized approach. © 2016 John Wiley & Sons Australia, Ltd.

Yaxley J.W.,Royal Brisbane and Womens Hospital Brisbane | Lah K.,University of Queensland | Yaxley J.P.,Townsville Hospital Brisbane | Gardiner R.A.,Royal Brisbane and Womens Hospital Brisbane | And 2 more authors.
BJU International | Year: 2016

Objective: To evaluate the long-term outcomes of high-dose-rate (HDR) brachytherapy for patients with intermediate- and high-risk prostate cancer. Subjects and Methods: We retrospectively analysed a prospective longitudinal cohort database including a single-surgeon series of 507 consecutive men treated with external beam radiotherapy and an HDR prostate brachytherapy boost between August 2000 and December 2009. The risk factors used were based on the D'Amico classification. We measured the incidence of no biochemical evidence of disease (bNED) based on the Phoenix definition of failure (nadir PSA + 2 ng/mL). We also reviewed the incidence of urethral stricture in this cohort. Results: With minimum and median follow-ups of 6 and 10.3 years, respectively, the bNED rates for men with intermediate- and high risk disease were 93.3% and 74.2%, respectively, at 5 years and 86.9% and 56.1%, respectively, at 10 years. The 10-year bNED rate for men with only one intermediate-risk factor was 94%, whereas for patients with all three high-risk factors it was 39.5%. The overall urethral stricture rate was 13.6%. Before 2005, the urethral stricture rate was 28.9% and after January 2005 it was 4.2%. For the 271 men with a minimum follow-up of 10 years the actuarial 10-year prostate cancer-specific survival rate was 90.8% and the actuarial overall survival rate was 86.7%. Conclusions: For men with intermediate- or high-risk prostate cancer features, who are considered not suitable for, or wish to avoid a radical prostatectomy, HDR prostate brachytherapy remains an appropriate treatment option. From December 2004, prevention strategies decreased the risk of post-brachytherapy urethral strictures. © 2016 BJU International.

Shing C.M.,University of Tasmania | Adams M.J.,University of Tasmania | Fassett R.G.,Royal Brisbane and Womens Hospital Brisbane | Coombes J.S.,University of Queensland
Nutrition | Year: 2011

Objective: Nutritional compounds that potentially limit inflammation and tissue factor expression may decrease the progression of chronic kidney disease (CKD) and associated cardiovascular disease. This project aimed to determine the effect of curcumin, bovine colostrum, and fish oil on inflammatory cytokine and tissue factor procoagulant activity of peripheral blood mononuclear cells (PBMCs) from patients with CKD before dialysis. Methods: Peripheral blood mononuclear cells from patients with CKD before dialysis (n = 13) and age- and sex-matched healthy controls (n = 12) were cultured alone and with low and high doses of the nutritional compounds for 24 h. Cells were cultured with and without lipopolysaccharide. Supernatants were analyzed for tumor necrosis factor-α, interleukin (IL)-6, IL-8, monocyte chemoattractant protein-1, IL-1β, C-reactive protein, and tissue factor procoagulant activity. Results: The production of C-reactive protein, monocyte chemoattractant protein-1, IL-6, and IL-1β by PBMCs was inhibited by low- and high-dose fish oil in the CKD group (P < 0.05). Curcumin decreased secretion of IL-6 (P = 0.015) and IL-1 β (P = 0.016). Curcumin was more effective than colostrum at decreasing the procoagulant activity of PBMCs in the CKD and control groups (P < 0.019). Conclusion: Fish oil decreased inflammatory cytokine secretion from CKD PBMCs. In addition, the beneficial effects of curcumin were demonstrated in decreasing inflammation in vitro, often to a similar magnitude as fish oil. © 2011 Elsevier Inc.

Greenland K.B.,Royal Brisbane and Womens Hospital Brisbane | Greenland K.B.,University of Queensland | Greenland K.B.,University of Hong Kong | Edwards M.J.,Royal Brisbane and Womens Hospital Brisbane | And 4 more authors.
British Journal of Anaesthesia | Year: 2010

Background. The sniffing position is often considered optimal for direct laryngoscopy. Another concept of airway configuration involving a laryngeal vestibule axis and two curves has also been suggested. We investigated whether this theory can be supported mathematically and if it supports the sniffing position as being optimal for direct laryngoscopy.MethodsMagnetic resonance imaging scans were performed in 42 normal adult volunteers. The airway passage was divided into two curves - primary (oro-pharyngeal curve) and secondary (pharyngo-glotto-tracheal curve). Airway configuration was evaluated in the neutral, extension, head lift, and sniffing positions. The airway passage, point of inflection (where the two curves meet), its tangent, and the line of sight were plotted on each scan. The point of inflection lay within the laryngeal vestibule in all positions. The head lift and sniffing positions caused the tangent to the point of inflection to approximate the horizontal plane. The sniffing, extension, and head lift positions caused a reduction in the area between the line of sight and the airway curve compared with the neutral position.ConclusionsA two-curve theory is proposed as a basis for explaining airway configuration. The changes in these curves with head and neck positioning support the sniffing position as optimal for direct laryngoscopy. Application of this new concept to other forms of laryngoscopy should be investigated. © 2010 The Author. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved.

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