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Media Release: The 'eHarmony approach' to improving liver transplant outcomes

Research Fellow Dr Lawrence Lau chats to recent liver transplant recipient Paul McDonald
Research Fellow Dr Lawrence Lau chats to recent liver transplant recipient Paul McDonald

12th January, 2017


The concept used by global matchmaking giant eHarmony to pair lonely hearts may hold the key to improving liver transplant outcomes and reducing the number of viable livers which are unused.

In an Australian-first, an Austin Health led study recently published in Transplantation journal found using artificial intelligence to predict the outcome of future transplants can greatly improve the accuracy in matching donors and recipients - leading to less graft failures and deaths post-transplant. The Chief Investigator, Austin Health's research fellow Dr Lawrence Lau said the study used machine-learning - a type of artificial intelligence that provides computers with the ability to learn without being explicitly programmed.

"Machine-learning algorithms can be trained to predict the outcome of a new event, based on multiple interactive factors observed in previous events where the outcome is known," Dr Lau said.

"This approach not only considers the influence of each variable, but also looks at how the variables interact with each other in complex, interdependent ways.

"This is the same concept eHarmony uses to match those looking for love with potential partners. eHarmony considers hundreds of variables in deciding the ideal match for prospective partners. Similarly, long-term organ/recipient compatibility is our ultimate aim and this is dependent on many different interactive donor and recipient factors."

The study, which was in collaboration with University of Melbourne Department of Computing and Information Systems PhD candidate, Yamuna Kankinage, used Austin Health liver transplant data from 2010-2013. The top 15 donor, recipient and transplant factors influencing the outcome of graft failure within 30 days were selected using a machine-learning methodology and an algorithm predicting the outcome of graft failure or primary non-function was developed based on those factors.

Dr Lawrence Lau said the study found the method had an accuracy rating of 84% at predicting graft failure 30 days post-transplant compared to 68% with current methods.

"At the moment there's really no method to determine the safest and most effective way to use the scarce donor livers. It largely comes down to a surgeon's judgement call of who we should give a particular organ to," Dr Lau said.

"This study is a proof-of-concept that machine-learning algorithms can be an invaluable tool, supporting the decision-making process for liver transplant organ allocation.

"The benefits of being able to assess the suitability of organs in a quantitative way, and to assess how well they match a particular recipient, are huge.

"Currently about 10% of Australian patients in need of a liver transplant die on the waiting list. Because our current donor liver assessment method is subjective, sometimes probably viable organs are discarded. This technique would minimise this.

"It could also reduce patient mortality post transplant and the need to re-transplant, both of which continue to be big problems in liver transplantation.

"The idea to use machine-learning algorithms came from a desire to replicate the experience of some of our most senior clinicians, like Austin Health's Professor Bob Jones, who has over 30 years liver transplantation experience and performed Victoria's first liver transplant in 1988, in a quantifiable way. This tool can then be used by transplant surgeons to make better calculated decisions in the future."

Dr Lau said the concept could be successfully applied to many other areas of medicine such as in cancer detection, prognostication and treatment planning to enhance clinical decision-making.

"Machine-learning algorithms are already used across a wide range of fields including search engines, agriculture, financial markets and match-making. There is so much untapped potential to apply this in medicine," Dr Lau said.

The next step is to perform a randomised prospective trial, pitting liver transplant decisions aided by specially designed machine-learning algorithms against unaided clinician-made decisions.

Chronic viral hepatitis is the leading reason for liver transplantation. Each year, approximately 2500 Australians die from Hepatitis C while over 7000 die from chronic liver disease overall.

For interviews with Dr Lau please contact Julie McNamara, Austin Health Corporate Communications on: 0419 595 688

Fellowship to support research into transgender health

Dr Ada Cheung

Austin Health endocrinologist Dr Ada Cheung is set to begin 2017 as the new Bernie Sweet Clinical Research Fellow. Dr Cheung will use the $25,000 grant to investigate the bone effects of hormone therapy in people who are transgender - the first time that the fellowship has ever been used to support transgender health research.

Dr Cheung, from the new Transgender Research Group, is seeing an increasing number of transgender patients. She says that people who are transgender or gender diverse can experience distress because their physical appearance does not match their inner identity, contributing to alarming rates of depression and suicide.

"Cross-sex hormone therapy can relieve that distress," Dr Cheung says. "But there is much we don't understand about hormone therapy. Which hormonal treatments work best? One drug or two? How fast? What are the side effects? And is this safe? Our research seeks to answer these questions," she says.

"We know that sex hormones are critical for bone health and when we treat transgender individuals, we usually reduce their natural levels to nearly zero. This must have some sort of effect on their bones and we want to study this. It will help inform transgender individuals and their treating doctors about potential risks and allow us to monitor for or prevent any possible side effects on their bone."

"There is a profound lack of good quality medical research in the trans and gender diverse area and as such clinical care is not evidence based. Traditionally there has been a lack of awareness and sensitivity in health care that has perhaps led to inadequate access to health care and disparities in the health system for this population, and lack of medical research in this area. I want to change this," Dr Cheung says.

To undertake the research, Dr Cheung will collaborate with the Bone Research Group, which is also based at Austin Health's Endocrine Centre of Excellence. Researchers will use the group's state-of-the-art high resolution 3D bone scanner to compare the 3D structure of bone in people starting cross-sex hormone therapy with people the same age who are not undertaking the therapy.

Dr Cheung will begin looking for participants once approval from the Austin Health Human Research Ethics Committee has been finalised.

She has also founded a not-for-profit organisation called the True Colours Medical Research Fund, to crowdfund medical research to advance healthcare for trans and gender diverse people. It will have a presence at Midsumma Festival on January 15 and is supported by Austin Health, The University of Melbourne and TransGender Victoria.

The Bernie Sweet Clinical Research Fellowship is the flagship grant awarded each year by the Austin Medical Research Foundation (AMRF). The AMRF supports research undertaken at Austin Health, and recently allocated over $320,000 in grants, for 20 new research projects to begin in 2017.

If you'd like to support the great research done here at Austin Health, visit http://austinmrf.org.au/support-amrf

Austin Health receives $4.8 million NHMRC grant for study into chronic pain post surgery.

Ketamine infusion

Austin Health will lead a $4.8 million study which may be a game-changer in preventing chronic pain after major surgery.

Chief Investigator, Austin Health’s Professor Philip Peyton has received the largest Australian National Health and Medical Research Council Project grant for 2017 to carry out the ROCKET (Reduction of Chronic Post-Surgical Pain with Ketamine) trial.

Assoc Prof Peyton said a recent large study showed 12% of patients who have major surgery – particularly abdominal, thoracic or orthopaedic surgery – developed long-term pain as a result of their surgical wound.

 “This funding is an affirmation that this condition is a major health problem,” Assoc Prof Peyton said.

“The trial will answer one of the most important clinical questions in our field,’’ Assoc Prof Peyton said.

“Chronic pain not only has a major detrimental impact on patients’ quality of life but it also is likely to cost the Australian economy billions of dollars annually in lost productivity and additional medical costs.”

Data from a number of small studies indicates ketamine might make a difference to chronic pain post surgery but a large trial is needed to provide a reliable answer.

The international study will involve almost 5000 patients who will be followed for 12 months post their surgery.

All patients on the trial will receive standard anaesthesia and post-operative pain relief while half of the patients will also receive ketamine as part of their anaesthesia and then for post-operative pain relief for up to three days post-surgery.

“Ketamine is a powerful analgesic that targets specific pain receptors in the nervous system that we think might be involved in the development of chronic pain,” Assoc Prof Peyton said.

“Ketamine might influence the development of processes in the central nervous system that lead to this.’’

The study will also focus on patients’ well being and quality-of-life post surgery.

The trial will begin in mid-2017.

Over $12 million in research funding will flow to Austin Health from the December round of NHMRC funding.

Perinatal mental illness continuing to go unrecognised, undiagnosed and untreated, say Austin Health-based research team

mum and baby

Mental illness during pregnancy is going unrecognised, undiagnosed and untreated, according to researchers from the Parent-Infant Research Institute (PIRI) at Austin Health.

And as Perinatal Depression and Anxiety Awareness Week draws to a close, there is still much to do to increase awareness of perinatal mental health conditions other than depression. These include anxiety - which is nearly as common as depression, as well as postnatal psychosis, obsessive-compulsive disorder and post-traumatic stress disorder, says PIRI director, Professor Jeannette Milgrom.

"Under recognition is a serious problem that reduces women's likelihood of seeking help."

"Even with post-natal depression, which is better recognised, few women are treated at all and even fewer are treated adequately," Professor Milgrom says.

This is despite research showing that treatment can be effective: in fact, recent research from PIRI into an Internet-based CBT program for postnatal depression found that 79% of women who received the treatment no longer had depression.

A similar trial is now investigating whether the program is effective for pregnant women too.

The need to improve understanding and treatment of perinatal mental health is an epic one, and to undertake this task, a new Global Alliance for Maternal Mental Health (GAMMH) was recently launched in Melbourne, with PIRI as one of the founding members..

"The Alliance is based on a successful model from the UK, which saw over 60 organisations from different sectors form an alliance, which significantly improved understanding of perinatal mental health and accelerated the availability of care," Professor Milgrom says.

When left untreated, perinatal depression and anxiety may lead to complications for unborn babies, including preterm birth and low birth weight. For conditions that continue into the postnatal period, children are at increased risk of worse emotional, behavioural and cognitive outcomes. There is also increased risk of infanticide in the most severe cases.

"At PIRI and in the Mother-Baby Unit at Austin Health, we've observed the impact on children and have actually pioneered treatment that focuses on the mother-baby relationship and on dads, rather than just the mother herself."

"There's a need to transfer what we know from research into identification and treatment programs that provide help to all women and children affected by perinatal mental health conditions," Professor Milgrom said.

Some facts:
  • For approximately 20% of women, depression and anxiety can begin during pregnancy.
  • Many women are concerned about seeking treatment while pregnant or breastfeeding. However, timely access to treatment is likely to benefit your unborn and new baby.
  • Online treatments can be effective and are easy to access - visit MumMoodBooster.com to find out more.
  • Perinatal mental illness comes in many forms - if you don't feel depressed but still feel like you're not okay, speak to your GP.

To support great research done right here at Austin Health, make a donation to the Austin Medical Research Foundation.

Austin Health leads a revolutionary approach to reduce coronary heart disease

We all have one. The annoying friend who spends five minutes getting the perfect shot of their café breakfast before the rest of the table is allowed to take a bite. Down-to-earth Gary McQuiggan doesn't strike you as the type of bloke who would fit this category but since April he's whipped out his smartphone to take shots of almost every meal that's passed his lips.

Gary isn't taking photos to gain ‘likes' on social media though, he's taking them to save his life.

Taking food ‘selfies' is an integral part of an Austin Health led smartphone based rehabilitation trial Gary joined after suffering a heart attack in April.

Austin Health Interventional Fellow, Dr Matias Yudi is the brains behind the CardiacMate trial which aims to reduce the recurrence of cardiac problems for people who have suffered heart attacks by providing them with ongoing support and guidance when they return home from hospital.

Funded by the Heart Foundation and the Victorian Government, the innovative trial has just finished recruiting patients across six Melbourne hospitals. Dr Yudi was recently named the Heart Foundation's Victorian top-ranked Health Professional Scholar for his work. With the rising popularity of smartphones, Dr Yudi says it makes sense to harness the latest technology to try and reduce coronary heart disease - the world's leading cause of death.

"We know heart attacks are preventable through simple lifestyle modifications and better medical therapy," Dr Yudi explains.

"In an era where prevention is better than cure I think we need to take responsibility and start looking after the patients more holistically and for longer periods of time.''

Dr Yudi says most patients start off with good intentions but, unfortunately, for many, life gets in the way and they slip back to their old unhealthy habits.

"The trial means we can follow patients wherever they are. It makes them more accountable and we can provide them with targeted support and advice''.

Patients are encouraged to upload photographs of every meal they eat so medical staff can provide dietary feedback. The program also tracks physical activity levels through the smartphone's accelerometer and provides interactive feedback and goal setting while a dynamic dashboard is used to review and optimise cardiovascular risk factors.Medical staff send regular health education messages, provide pharmacotherapy review and offer words of encouragement via the app while patients can send staff questions through a built-in messaging service.

Gary lost 11kgs on the program, returning to a healthy weight and also dramatically lowered his cholesterol and improved other risk factors in the process.

"It has absolutely changed my life,'' the father-of-two enthuses. "I knew that I had to change my habits but it was a matter of doing something about it. I never ate a lot of junk food but I ate too much - one of the things the program really helped me do was reduce my portion sizes.Knowing that someone is going to be analysing the food you put on your plate definitely influences what you choose to eat."

The app also spurred the Lower Plenty man to adopt an active lifestyle.

"I used to play a lot of sport when I was younger but as I got older I became less active. Now I'm walking 75kms a week and I feel guilty if I don't get out there.''

Gary lives alone and says another benefit of the app is it helped him feel less isolated post the emotional trauma of his heart attack.

Preliminary results of the trial will be available in February 2017.

Arthritis drug Celebrex creates no greater heart attack risk than similar drugs, discovers game-changing international trial

medication

The widely-prescribed arthritis drug celecoxib (marketed as Celebrex) presents no greater risk of heart attack or stroke than comparable NSAIDs naproxen or ibuprofen, according to a 10-year, Cleveland Clinic-led trial published today in the New England Journal of Medicine.

The result "is a real game-changer" for patients, according to the only Australian author on the study, Austin Health's Professor Emeritus Neville Yeomans, because celecoxib is also around 50 per cent less likely to create dangerous stomach ulcers than more traditional NSAIDs (non-steroidal anti-inflammatory drugs). It has also been found to be protective against the recurrence of pre-cancerous polyps in the bowel.

Other NSAIDs in the same class as Celecoxib/Celebrex - known as COX-2-selective NSAIDs - were taken off the market after two large clinical trials into these drugs were abandoned in 2004 due to concerns about the heart attack risk that they presented.

Since then, Celebrex has come with warnings about its potential cardiovascular risk, and arthritis patients who are thought to be at risk of developing heart disease are usually advised to take one of the more traditional NSAIDs, despite the higher risk of stomach ulcers and gastrointestinal bleeding.

"Most of the consensus guidelines given to doctors ask them to weigh up their patients' potential gastrointestinal and cardiovascular risks and choose an NSAID accordingly, but these are based on evidence that's scanty and fragmentary at best. These results are striking and clear cut, and have bucked what the consensus guidelines have been advising for the last 10 years at least," Prof Yeomans says.

"What was a real surprise was that, in some of the analyses, Celebrex actually caused significantly less cardiovascular events than the traditional NSAIDs. I think this will see the guidelines being rewritten," he says.

NSAIDs work by inhibiting the release of pain and inflammation-causing prostaglandins, but in doing so, also inhibit the useful prostaglandins in the stomach that protect the lining of the stomach from being damaged from the strong acids in the stomach.

NSAIDs prevent the release of these prostaglandins by inhibiting an enzyme called cyclooxygenase (COX).

The discovery that there are in fact two types of COX; COX-1, which is responsible for producing stomach-protective prostaglandins, and COX-2, responsible for the pain-producing ones, sparked a pharmacological treasure hunt for NSAIDs that that only inhibit COX-2.

Following the abandonment of the 2004 trials, Celecoxib/Celebrex is now the only COX-2-selective NSAID available in Australia.

"It's possible these results will reignite the hunt for effective COX-2-selective NSAIDs that have fewer of those side effects like stomach ulcers, bleeding and nausea," Prof Yeomans says.

The research was published in the New England Journal of Medicine today, at http://www.nejm.org/doi/pdf/10.1056/NEJMoa1611593

The original Cleveland Clinic media release is available at http://cle.clinic/2fPuVPH

Professor Yeomans is Director of Research at Austin Health.

To support great research at Austin Health, donate to the Austin Medical Research Foundation.

Austin Health farewells a great leader

Brendan Murphy farewell
Dr Brendan Murphy gives his farewell speech to staff

The Austin Health that young CEO Dr Brendan Murphy commenced at in 2004 would be unrecognisable to many today. At the Austin Hospital in particular, the Austin Tower was yet to be completed, Heidelberg House stood where the ONJ Centre is today and in place of the Melbourne Brain Centre stood an ageing eyesore known as the 3KZ building.

As Dr Murphy left on September 16 after 12 years as CEO to become Australia's chief medical officer, he was most proud of "finally getting the Cancer Centre built, introducing electronic medical records and introducing significant new workforce roles, nursing assistants and nurse endoscopists amongst them".

Austin Health Board Chair Judith Troeth AM says that when Dr Murphy came on board, Austin Health was facing a problem of how to accommodate the growing number of cancer patients and programs.

"A $50 million public appeal had been initiated with the help of Olivia Newton-John but only $1 million had been raised. Brendan's tenacity and skill in securing the final amount of $189 million for what we now know as the Olivia Newton-John Cancer Wellness & Research Centre will be one of his enduring legacies," Ms Troeth said.

"It was Brendan's ability to negotiate relationships that sustained this project. He maintained the momentum and energised stakeholders including successive state and federal governments, the Department of Health, politicians and of course, Olivia Newton-John. Brendan is super relaxed around celebrities, although he would have to be the only person in Australia who hadn't seen Grease when he met Olivia!"

The list of capital projects that Dr Murphy delivered during his time as CEO is astounding: The Surgery Centre (TSC) was the first of many projects that have helped to revitalise and reshape the Heidelberg Repatriation Hospital (HRH) into a centre of innovation. Opening in 2008, TSC soon completed more surgery cases than the main Austin Hospital operating theatres. And then there was the Health and Rehabilitation Centre, a suite of new purpose-built mental health facilities and recommissioned wards all at the HRH, and due to endless passion for promoting research opportunities, the Melbourne Brain Centre and Bio Resources Facility at Austin Hospital.

And yet, he is possibly more proud of the workforce reforms he championed - particularly those that created innovative new nursing and nursing assistant roles that allowed highly educated nurses to work to their full potential while giving basic care tasks like feeding patients to health assistants with more basic qualifications.

The only thing he says he won't miss is the annual budget cycle! But even that is probably because he set himself such a high standard: achieving budget surpluses every year and the strongest financial performance of any major health service in the state over the last decade.

Austin Health's chief finance officer Ian Broadway is one of the few on executive team to have worked with Dr Murphy for most of his tenure.

"He is a passionate and true believer in public health. For Brendan it is all about the patient and ensuring that the taxpayer gets maximum value from the system. I am sure that this passion has driven many of the reforms he has achieved at Austin," says Mr Broadway.

"It is Brendan's deep compassion for patients and staff that has made him such a remarkable CEO. He has been the only CEO in Australia who still does clinical shifts and his Christmas visits to the night staff to distribute gifts demonstrate how much he personally values all clinical staff ," said Ms Troeth.

"I'll miss the people more than anything," Dr Murphy said.

"The most important thing I've learnt is the importance of organisational culture. It's all about people and how they feel about working here. The culture's so strong at Austin Health - that's what makes us a great health service."

Goodbye and thank-you from all the staff at Austin Health!

 

A message of thanks from Olivia Newton-John

The 2016 Wellness Walk and Research Run begins

"Yesterday was a very special day. I walked with over a thousand people around the grounds of the beautiful La Trobe University to raise money for my ONJ Cancer Wellness & Research Centre in Melbourne, Australia. We raised over $200,000 and I am so grateful to everyone who took their Sunday to join us to run towards the cure and walk to wellness!

A special thanks to four-time Olympian Steve Moneghetti who led over 300 runners for the first ever Research Run, and to Bindi Irwin from Australia Zoo, for giving their time to help my Centre.

The people who shared their stories with me on the walk touched my heart forever. Thank you. I believe we will see an end to cancer in my lifetime!

With love and gratitude,
Olivia"

- a message of thanks from Olivia Newton-John to all those who walked, ran and volunteered for us at the Wellness Walk and Research Run on September 11. What a fantastic day!

Immunotherapy trial successes provide new hope in the battle against cancer

Professor Jonathan Cebon
Professor Jonathan Cebon

"It may sound a bit rough, but this is a really good time to have cancer. I'm really lucky to have got cancer at this time when these treatments are available" says Andrew Howard, 29.

While part of a six-month immunotherapy trial at the Olivia Newton-John Cancer Wellness & Research Centre, Andrew's tumours shrank at a "great rate" and nearly 3 years later, he is cancer free. For all the hope that immunotherapy provides, however, the fact remains that not everyone benefits from the treatments.

"There's a real task to try to identify the patients who are going to benefit from treatment, and to understand why others don't," his oncologist and medical director of the ONJ Centre, Professor Jonathan Cebon says.

Support us to do more research like this. Join Olivia Newton-John and Steve Moneghetti at the Wellness Walk and Research Run this Sunday! Register now at http://fundraisingoliviaappeal.com/event/WWRR16

Read more of Andrew Howard and Professor Jonathan Cebon's story in the South China Morning Post.

 

Buruli ulcer in the media

Professor Paul Johnson is the country's leading expert on Buruli ulcer (Mycobacterium ulcerans), and has been in the media recently due to an increase in cases in Victoria, and the discover of cases in suburban Melbourne for the first time. The number of cases in Victoria has increased from 32 in 2010 to 106 in 2015.

If you are concerned that you may have an ulcer, please visit your GP. Buruli ulcers are treatable. If diagnosed accurately early, they often remain no larger than a pimple.

GPs can find the latest clinical guidelines in the Medical Journal of Australia

Professor Johnson, who is deputy director of the Infectious Diseases Department at Austin Health and director of the World Health Organization Collaborating Centre for Mycobacterium ulcerans, also maintains a website on Buruli ulcer in Australia.

Recent media coverage has included the Age and ABC Online.

Farewell to A/Prof Larry McNicol

Larry McNicol
A/Prof Larry McNicol

Throwback to: June 1988, when a young and ambitious surgical team at Austin Hospital performed Victoria's first ever liver transplant - a surgery fraught with complications and a major allergic reaction to one of the drugs. The anaesthetist overseeing that operation was the young Director of Anaesthesia, the then Dr Larry McNicol.

"We started at 3pm and did not finish the operation until 7am, still very unsure as to whether [the patient] would survive. He defied all the odds to not only pull through...he went on to live for 13 years," A/Professor McNicol said in an interview in 2008, still able to vividly recall the events of that day.

This week Austin Health said a sad farewell to the extraordinary A/Prof McNicol, who still counts that first liver transplant as one of the highlights of his career. The well-loved anaesthetist leaves after an extraordinary 37 years, including 25 as Director of Anaesthesia. In 2014, he was recognised with a Victorian Health Lifetime Achievement award at the Victorian Public Healthcare Awards.

A story on A/Prof McNicol's contribution to public healthcare was published in this week's Heidelberg Leader.

Prof McNicol was also the Medical Director of the Anaesthesia, Perioperative and Intensive Care Clinical Service Unit.

Olivia urges other young people to register for organ donation

Robert Clark, his wife Sue and daughter Olivia speak about the anguish of waiting for a donor liver.

Robert Clark has been chronically ill for longer than his daughter, Olivia, has been alive.

The Geelong man has been on the waiting list for a liver transplant for 31 months. He gets sicker with every week that passes and it is heartbreaking for his wife Sue and Olivia to watch.

Robert's illness, primary sclerosing cholangitis (PSC), meant he was forced to give up his career as a medical microbiologist in 2003 and Sue juggles work in healthcare project management between caring for him.

Life is on hold for the family as they wait in hope for a phone call to say that a new liver is available for Robert.

The family shared their story at the official launch of DonateLife week at Austin Health to encourage others to register for organ donation.

Olivia urged other young people to take ten minutes out of their day to register. The university student said while it might not feel like a nice thing to talk about, it was so important to share your wishes to become an organ and tissue donor as there are so many people like her Dad, waiting for a life-saving transplant.

Speaking at the official launch at Austin Health, Assistant Minister for Health, Ken Wyatt said just eight per cent of 18-24 year olds have registered their donation decision.

"In most cases, people say they just haven't got around to it,'' Mr Wyatt said. "Registering is very simple and has no down side - and it just might mean the world to someone who needs help to stay alive or live a normal life.

"It's understandable that when you're young you don't think too much about mortality, but it's something we all need to think about and discuss,'' he said.

Mr Wyatt said nine in ten families agreed to organ donation when their loved one was a registered donor. This drops to just five in ten where the deceased was not registered and the family had no prior knowledge.

"DonateLife Week, which begins on 31 July, is a great opportunity to focus on this issue, discuss it with your friends and family and register your decision at donatelife.gov.au. Make it official and share your decision online and then take a leadership role and encourage your family and friends to do the same." Mr Wyatt said.

 

 

The Surgery Centre treats 10,000 this year

John Conner
John Connor was the 10,000th patient to pass through The Surgery Centre this year

"I've only waited a month and a half for surgery - I'm very pleased! My hip's been giving me a bit of pain at night when I lie horizontal, and I've had to take painkillers morning and night. It's just a blessing to get it done so quickly," says 73 year-old John Connor, who last week became The Surgery Centre's 10,000th patient for the financial year.

It's the first time that The Surgery Centre (TSC) has ever clocked such a high number of patients, and TSC has now doubled the number of patients it treats per year since its first year of operation, 2008/09, when it treated 5008 patients.

Its work has had particular impact for orthopaedic surgery patients like John, who waited just 48 days for his hip replacement.

Since four new operating theatres were opened at TSC in late 2013, which allowed it to increase its capacity and perform a greater variety of surgeries, Austin Health's elective orthopaedic surgery waiting list has nearly halved from 1030 people, to 590.

TSC is about to expand again due to new funding for additional beds in the inpatient ward (which is going to expand from 28 to 32 beds Monday to Friday), and additional chairs in the satellite ward (which will rise from 14 to 21 chairs, Monday to Friday).

Surgery at TSC is completely separated from the emergency surgery that occurs at the Austin Hospital, meaning that elective procedures that are planned there never need to be cancelled because of emergency surgery that needs to take priority.

We're aiming to raise $42,350 by 30 June to buy new equipment for the operating theatres at TSC. With new equipment available to staff, we can perform more elective surgeries and shorten waiting times even more. If you're interested in helping, visit Support Us

 

Cutting-edge project aims to improve detection of cardiac disease

14072016_Jay Ramchand_newsroom.jpg
Jay Ramchand

Identifying life-threatening cardiac conditions earlier is the key aim of an innovative project being led by Austin Health.

Dilated cardiomyopathy (DCM) enlarges the heart and reduces the organ's pumping function - in severe cases it results in heart failure and death.

Austin Health consultant cardiologist and project lead, Jay Ramchand says although the cause of DCM often isn't known, as many as one-third of those who have the disease inherit it from their parents.

"The project will test patients who we know already have DCM,'' Dr Ramchand said.

There are different genetic abnormalities that can cause DCM. The project is aimed at finding a specific genetic abnormality in an affected individual. If the testing comes back positive, doctors will then go on to test the same gene in this person's immediate family members.

"We will use a blood test to test the section of the person's genetic information that is relevant to the disease.''

"Usually, if there's a family history of the disease, family members need to undergo cardiac testing every five years. Being able to undergo a single genetic test would remove that stress and burden of life-long assessments and, importantly, may allow earlier intervention.

"We can start medications that may prevent progression of heart disease while the person is still healthy and fit,'' Dr Ramchand said.

"This may reduce the severity and delay the onset and hopefully, may even prevent it all together''.

The project is part of a suite of projects being delivered by the Melbourne Genomics Health Alliance, a partnership of ten leading hospitals and research organisations devoted to finding the best way to bring the benefits of genomics - testing of a person's entire genetic sequence - to everyday healthcare.

The disease areas were selected by experts as those where genomic sequencing is most likely to benefit patients and their care, in comparison with current approaches.

The DCM project is looking to recruit people under the age of 40 who has already been diagnosed with DCM or anyone who has a family member with DCM.

Patients will be recruited through Austin Health, Monash Medical Centre, The Royal Melbourne Hospital and The Royal Children's Hospital.

For further information contact Dr Ramchand on: 0421 047 607.

For more information about the Melbourne Genomics Health Alliance visit: http://www.melbournegenomics.org.au/

To learn more about the DCM project read this Q and A with Dr Ramchand: http://www.melbournegenomics.org.au/news/take-heart

Prof Proietto honoured for lifetime of service

Prof Joe Proeitto_Newsroom.jpg

World-renowned investigator into obesity management, Professor Joseph Proietto has been appointed a Member in the General Division of the Order of Australia for his ground-breaking research and work as a clinician, teacher and mentor.

Prof Proietto heads Austin Health's Weight Control Clinic and was recently appointed to the executive of the World Obesity Federation which is tasked with educating health care professionals from across the globe on how to treat obesity.

The Sicilian-born Professor is delighted his work has been acknowledged.

"It's a great honour for me especially given my origins. I came to Australia aged 8 and not speaking a word of English. I was from a non-academic family and I guess this shows that society appreciates the work we have done in diabetes and obesity,'' Prof Proietto says.

In 2011 Prof Proietto and his team discovered the reason most people regain weight after weight loss. They showed that following weight-loss, the 10 circulating blood hormones that regulate hunger change their levels in a direction to make the person more hungry and that these changes persist for at least one year. Prof Proietto says this explains why most people struggle to maintain weight loss and justifies the use of appetite suppressants for weight maintenance.

In 2014 he spearheaded research which disproved the myth that the quicker you lose weight, the quicker you will regain it. In this study he and his team also found that rapid weight loss is easier and more successful than gradual weight loss and that the hormone changes that occur during weight loss are still evident three years later.

He loves putting his research into practice at Austin Health's Weight Control Clinic.

"It's very satisfying helping people to lose weight and improving their diabetes control. It's incredibly satisfying because they can see the changes in themselves and feel so much better after some weight loss,'' Prof Proietto says.

 

Victorian-first radiotherapy machine to treat more cancer patients, sooner

Rebecca Davies, a 33-year-old mother of three who is one of the first patients in the state to benefit from the targeted imaging.

A Victorian-first radiotherapy machine which will be able to more accurately target tumours in cancer patients has been unveiled at the Olivia Newton-John Cancer Wellness & Research Centre (ONJ Centre).

Victorian Health Minister Jill Hennessy officially launched the $3 million linear accelerator which enables more precise imaging and radiotherapy treatment to tumours, therefore minimising damage to surrounding tissue and reducing possible side-effects.

The ElektaTM linear accelerator provides a unique 4D imaging technique on the treatment machine, a first for Victoria. The technique allows for real time video to show precisely where the tumour lies, and how it may be affected by a patient's breathing. By providing a precise location, doctors are able to target radiotherapy treatment to the tumour area and avoid surrounding normal organs or tissue and reduce possible side effects.

This is great news for patients like Rebecca Davies, a 33-year-old mother of three who is one of the first patients in the state to benefit from the targeted imaging.

Mrs Davies will attend the ONJ Centre for six weeks to receive treatment including radiotherapy, chemotherapy and possible surgery in order to tackle her stage 3 lung cancer diagnosis.
Her recent diagnosis has given Mrs Davies an insight into the way the ONJ Centre offers support to patients and their families.

"It's a comfort to know that I'm able to access the newest technology in a world-class facility. The machine's targeting will help not only treating the cancer but also look after my long term health by being so targeted," Mrs Davies said.

"I'm feeling really positive; the team is looking after me and it's great to see them working together not just on my cancer but on looking after me and my family, being really clear and allowing me to participate in my treatment by making sure we are as informed as we want to be."

The ONJ Centre's director of Radiation Oncology, Associate Professor Farshad Foroudi, says treatments can be adapted daily to allow for even slight changes in patient and organ movements, improving precision and giving patients a better treatment experience.

"For some patients the new technology will also mean that they will need far less treatments than previously to see significant results,'' Assoc Prof Foroudi said. "This means fewer visits to the hospital, a reduction in side effects and - because fewer treatments are required - we will have more availability to treat more patients."

State Government funding boost

20160517_AH_Minister_TransitLounge_newsroom.jpg
Health Minister Jill Hennessy, CEO Dr Brendan Murphy and Mr Agnostopoulo

Austin Health will be able to treat emergency and surgical patients more quickly thanks to a State Government funding boost.

Our ambulatory care centre is set to undergo a $500,000 upgrade meaning that more acute beds will be available for the sickest patients and there will be a better flow of patients through surgery and emergency.

The expansion is also good news for the day patients who use the Ambulatory Care Centre regularly - like John Agnostopoulo, 81, - as it means they will be treated more quickly and will be able to return home sooner.

Health Minister Jill Hennessy met Mr Agnostopoulo and his wife Kolliopi while touring the current centre.

A great-grandfather and retired small business owner, Mr Agnostopoulo attends the centre every three weeks for treatment to drain fluid that accumulates in his stomach as a result of a liver condition.

The funding will create an additional ambulatory care treatment spaces and will also mean the centre's transit lounge will be able to treat 50% more patients each day.

The transit lounge is used by inpatients who are medically ready for discharge but need to wait for something like discharge medications, a final consultation from physiotherapy or dietetics, or because the person coming to collect them is unable to make it until later in the day. Moving well patients to the transit lounge frees up ward beds for seriously ill patients who need to be admitted to a ward from the Emergency Department and also frees up surgical ward beds so the hospital can increase surgical activity.

 

From carer to patient and back – how the patient experience helped Lisa Power to be a better carer

Lisa Power and staff from 7 North
Lisa Power (centre) with staff who cared for her from Ward 7 North

"You never really understand a person until...you climb inside of his skin and walk around in it," Atticus Finch said famously in To Kill a Mockingbird. It's advice that Lisa Power understands well.

The health assistant, who usually works on Austin Hospital's Ward 8 East, was herself admitted to Austin Hospital after a recent kidney and pancreas transplant.

"Being in hospital, it changes you," she says. "You have a greater understanding of what people are experiencing. Some people...are scared and don't know what is happening."

"If you say, ‘I've been in hospital a few times and I know how scary it is and how you're out of your comfort zone', they know that someone knows exactly how they feel and they don't feel so alone."

"Sometimes I duck down and buy them a smiley-face balloon to cheer them up. If you can make someone happy at their weakest and most vulnerable time, that's amazing," she said.

Frequent appointments at Austin since the age of 16 mean Ms Power has "always loved the Austin; it feels like home." But even she was blown away by the care she received recently on Ward 7 North.

"They make me feel safe - that's what I love about them. They make everyone feel like they're a high priority," she said.

After a worrying blood test result, Ms Power said that Renal Transplant Unit deputy director, Assoc Prof Frank Ierino and his team had her admitted to hospital and receiving treatment before she'd even had time to take in that she was experiencing a problem.

On another occasion, after bursting into tears, one of the nurses "gave me a massive hug and said: ‘It's alright; that's what we're here for', and I thought, ‘Yeah, I'm in good hands'."

"They're are all so amazing, so reassuring. I know they've got my back," she says. "No words can describe that kind of feeling. That's not someone doing their job; that's someone who really cares."

Lisa Power was interviewed in the Heidelberg Leader - read her story at: http://bit.ly/1NUAHeO

 

New Austin Health research finds many antibiotic allergy labels are incorrect

Dr Jason Trubiano
Dr Jason Trubiano

Do you think you have an allergy to a ‘first-line' antibiotic, such as penicillin? You could be wrong, new research from Austin Health doctor Dr Jason Trubiano indicates - and may be being treated with more restricted antibiotics that are less effective and more likely to drive antibiotic resistance.

"We need to remove those unnecessary antibiotic allergies from people's drug charts," Dr Trubiano said.

"Not all allergies are the same, and some people who had a reaction a long time ago might not find that their allergy label is relevant anymore. They should talk it over with their GP and if needed, get a referral to the Antibiotic Allergy Clinic at the Austin Hospital."

Hear more about Dr Trubiano's research from his interview with Norman Swan on ABC Radio National's ‘Health Report' on Monday 18 April 2016.

You can also read the original research published in last Monday's Medical Journal of Australia (MJA), or:

New funding to mean patients get surgery sooner

Minister Charles Woods and Shakala
Health Minister Jill Hennessy meets knee replacement surgery patient Charles Woods and his granddaughter, Shakala

Charles Woods had been counting down the days until his knee replacement surgery at Austin Health last week. Each day took him one day closer to getting back to activities he loves, like going for a walk.

He and 9 year-old granddaughter Shakala - who used the experience to practice her nursing skills on her granddad - were amongst those thrilled to hear Health Minister Jill Hennessy announce a $335 million funding package to reduce elective surgery waiting lists in Victoria.

The $335 million includes funding over four years for nearly 200,000 additional elective procedures and a $20 million capital works injection.

"We want Victorians happy and healthy. The sooner they can get their surgeries, the sooner they can recover and get back to their normal lives and families," Minister Hennessy said. She said the additional funding this year would provide the equivalent of 3100 coronary artery bypass grafts, or 6700 hip replacements.

Austin Health will receive money to expand the Austin Hospital's Transit Lounge and Ambulatory Care Centre. At the Heidelberg Repatriation Hospital, this funding will provide four new surgery beds, an expansion of the specialist clinical capacity and a new allied health treatment space.

Launch of Genetics in the North East

Tracey Hamilton and her daughters Chelsea, 17 and Destiny, 15 have all had their thyroids removed after genetic testing revealed a mutation that increases their risk of thyroid cancer.

Identical scars on their necks will forever remind the Hamiltons of the life-saving care their family has received.

Genetic testing revealed Tracey Hamilton, 39, and her four children all have genetic mutations that increase their risk of thyroid cancer.

Unfortunately Tracey has already developed thyroid cancer but the testing has meant that her two eldest children Chelsea, 17 and Destiny, 15 were able to have their thyroids removed before cancer developed while their siblings London, 3 and Riley, 2 will have the same operations as soon as they are old enough.

The Sunbury family was one of the first to benefit from the launch of Genetics in the North East (GENE) - Victoria's clinical genetic service hub encompassing Austin Health and Mercy Health in Heidelberg and Mercy Health in Epping.

Parliamentary Secretary for Medical Research, Frank McGuire launched the service and said it will mean more families in the north-east can access genetic testing so they can get the diagnosis and treatment they need sooner.


"Our genes play an important role in the health of Victorians and their families - that's why we're investing to grow our public genetic services," Mr McGuire said.


Austin Health director of Clinical Genetics and co-director of GENE, Professor Martin Delatycki said the hub provides public clinical genetic services such as medical diagnosis of genetic conditions and genetic counselling, as well as genetic testing for patients and their families in north-east Victoria. This includes regular clinics in Ballarat, Shepparton and Wodonga meaning rural patients no longer need to travel to the city for public genetics services.

Prof Delatycki said genetics underpins many adult medical conditions including breast cancer, cardiac issues and diseases of the nervous system as well as rare childhood disorders.

Testing is vital for the prevention, diagnosis and management of inherited conditions as people with specific genetic mutations are more at risk of that disease than the general population. This knowledge enables people to make informed decisions about how best to manage the higher risk.


Tracey said the service had been ‘life-saving' for her family.


"Without a doubt it has changed our lives. Without these guys we would be in a world of trouble and every day I thank my lucky stars for the genetic counselling team," Tracey said.


‘We are so very lucky because now my girls won't pass it onto their kids. The genetics clinic will be involved if they want to have children, they will have IVF and be safe.

Prof Delatycki said the launch of GENE meant a big expansion of services.

"Not many years ago there was no genetic service in the area and we now have a complete service at two sites - Epping and Heidelberg.

"We have gone from five staff to 21 staff across the sites," Prof Delatycki said.

 

 

New beds boost for elective surgery

Victorian Health Minister Jill Hennessy meets knee replacement patient Franceska Buljanovic

Austin Health's elective surgery centre will treat an additional 750 patients annually thanks to a State Government funding boost.

Minister for Health, Jill Hennessy has officially opened six new beds in the centre which were funded as part of the $200 million Beds Rescue Fund.

The fund paid for a total of 101 new beds across the state and means a total of 19,800 patients will be able to be treated annually.

Minister Hennessy also toured our new satellite ward where 14 chair bays have been installed, meaning there is more room to treat day patients and freeing up the new beds for more surgeries.

Minister Hennessy met patient Franceska Buljanovic who is recovering from a total knee replacement.
Franceksa said she is delighted her surgery is complete and is looking forward to improved mobility going forward.

Austin Health CEO Brendan Murphy said the additional beds are a great boost to our surgery centre, meaning patients like Franceska will spend less time waiting for treatment.

Minister Hennessy, was also joined by former AMA President, Dr Douglas Travis, to launch a new independent body, Better Care Victoria, to drive innovation across the Victorian health care system.

"We know we need to do things differently to ensure our health system is able to cope with increasing demand as a result of our ageing and growing population - and Better Care Victoria will help us do just that,'' Minister Hennessy said.

Better Care Victoria was a key recommendation from the Travis review, the most comprehensive audit ever undertaken in the capacity of Victoria's hospitals, and will help drive improvements by identifying and funding innovative projects that can be scaled up across our health care system.

The independent Better Care Victoria Board is chaired by surgeon and former AMA President Dr Douglas Travis and will advise the Minister on the most effective ways to invest the Better Care Victoria Innovation Fund.

50 years of incredible commitment and service for Rob

"It's my job and it's my hobby'', Rob Winther reflects on 50 years of service.

A tragic accident when he was 13 sparked an extraordinary lifetime of commitment for Rob Winther.

Having survived World War 2, Rob's Dad Paul, a member of the 39th battalion, died in a motor vehicle accident. As well as dealing with their grief, things were tight financially for the family. Legacy stepped into help and their enduring support over the years left a lasting impression on Rob, steering him to a career in Veterans Affairs.

The Veteran Liaison Officer has just notched up 50 years of service at the Heidelberg Repatriation Hospital and his contribution to Austin Health continues to be extraordinary.

As well as helping countless patients and families through difficult times, Austin Health CEO Brendan Murphy describes Rob as the "custodian'' of our heritage who keeps alive memories for so many in our community.

"Rob's unique and hugely valuable to Austin Health. He is tireless in his work for the whole organisation but particularly for the Repat campus and the welfare of Veterans.

"He is loved and respected by all of us and we can't begin to contemplate that one day he might retire,'' Dr Murphy says.

Rob, 68, can't contemplate retirement either.

"I love my job, it's my job and my hobby,'' Rob says.

"I have a great group of people I work with and we want to be here until we drop.

"This hospital has such a feel about it, it rubs off on you. You only need to look around to know why we're here supporting patients,'' he says.

The influence of Rob's passion for the Repat is on display right across the campus - from the Remembrance Garden and the Anzac memorial chapel which he played a pivotal role in establishing, to the iconic signage and, of course, the groups of Veterans sharing coffee and chats at the café.

Diabetes experts warns Paleo diet is dangerous and increases weight gain

Austin Health and University of Melbourne diabetes expert Sof Andrikopoulos. pic courtesy of University of Melbourne

Following a low carbohydrate, high-fat diet for just two months can lead to rapid weight gain and health complications, research led by Austin Health and University of Melbourne diabetes expert Sof Andrikopolous has revealed.

The surprise finding, detailed in a paper in Nature journal Nutrition and diabetes, has prompted Assoc Prof Andrikopolous to warn people about putting faith in fad diets which have little or no scientific evidence.

Assoc Prof Andrikopolous says this type of diet, exemplified in many forms of the popular Paleo diet, is not recommended - particularly for people who are already overweight and lead sedentary lifestyles.

"The low-carb, high-fat diet is particularly risky for people with diabetes or pre-diabetes.

"These diets are becoming more popular but there is no scientific evidence that these diets work. In fact, if you put an inactive individual on this type of diet, the chances are that person will gain weight,'' Assoc Prof Andrikopolous said.

In a study carried out at Austin Health's University of Melbourne, Department of Medicine, researchers took two groups of overweight mice with pre-diabetes symptoms and put one group on the LCHF diet. The mice were switched from a three per cent fat diet to a 60 per cent fat diet. Their carbohydrates were reduced to only 20 per cent. The other group ate their normal diet.

After eight weeks, the group on the LCHF diet gained more weight, their glucose intolerance worsened and their insulin levels rose. The paleo diet gained 15 per cent of their body weight and their fat mass doubled from 2 per cent to almost 4 per cent.

"To put this in perspective, for a 100 kilogram person, that's the equivalent of 15 kilograms in two months. That's extreme weight gain,'' Assoc Prof Andrikopoulos said.

"This level of weight gain will increase blood pressure and increase your risk of anxiety and depressions and may cause bone issues and arthritis.

"For someone who is already overweight, this diet would only further increase blood sugar and insulin levels and could actually pre-dispose them to diabetes.

"We are told to eat zero carbs and lots of fat on the Paleo diet. Our model tried to mimic that, but we did not see any improvements in weight or symptoms. In fact, they got worse. The bottom line is it's not good to eat too much fat."

Prof Andrikopoulos says the Mediterranean diet is the best for people with pre-diabetes or diabetes.

"It's backed by evidence and is a low-refined sugar diet with healthy oils and fats from fish and extra virgin olive oil, legumes and protein.''

 

 

Meet Nicholas Johnson.

Nicholas Johnson
He's 14, and struggles every day with the seizures caused by his epilepsy. He's also set to be the first patient in Australia to participate in a medicinal cannabis trial, thanks to a change in legislation and funding from the Victorian Government.

The trial will investigate whether a synthetic cannabidiol will be effective at treating certain types of childhood epilepsy.

For the Johnson family, the Austin Health trial provides a new treatment option that they hope will help to control Nicholas' seizures, after exhausting seven or eight other medicines that have failed.

Nicholas - who often experiences seizures during the night - hopes for something unsurprising for a teenage boy: to "sleep more!"

Mum D'Lene says that Nicolas is "attending school so tired that his potential probably isn't being reached. We want him to achieve the best he can. We're really hopeful that [this trial] means that we can have a seizure-free life."

The trial in Australia will be led by Austin Health's director of Paediatrics and world-leading epilepsy researcher, Professor Ingrid Scheffer. Professor Scheffer and her team "are very excited about this trial as it will establish if cannabidiol is an effective treatment for severe childhood epilepsy."

The trial has been made possible by research funding from the State Government, as well as new laws introduced into the Victorian Parliament in December that provide a legal framework for the cultivation, manufacturing, supply, patient eligibility and support ongoing research into medicinal cannabis.

Anyone interested in the trial can contact the Medicinal Cannabis Taskforce on 03 9096 7768 or medicinal.cannabis@dhhs.vic.gov.au 

You can support our epilepsy research by donating to the Austin Medical Research Foundation.

Ego Seeman recognised in Australia-day honours

Professor Ego Seeman
Prof Ego Seeman appointed a Member of the Order of Australia

 

Professor Ego Seeman has been appointed a Member of the Order of Australia for his ground-breaking contributions to research into osteoporosis and endocrinology.

Prof Seeman has twice shifted the direction of thinking in osteoporosis research worldwide but it is mentoring up-and-coming talent that gives him the greatest career satisfaction now.

 

In 1989 he was the first to demonstrate a childhood link to osteoporosis, by showing that daughters of women with osteoporosis have reduced bone mass. This led researchers to change their focus from studying ageing bones towards bone growth and development in young people.

 

Two decades later Prof Seeman, along with his then student, Roger Zebaze, shook things up again. The pair had been trying to understand why bones become brittle and break. Contrary to prevailing beliefs, they discovered that 70% of bone loss occurs in the cortical shell of the bone - a momentous discovery because up until then it was thought that most bone loss occurred within the honeycomb-like trabecular bone which dissolves more rapidly with ageing. Their finding led to a method of analysis of bones scans that remains unique to Austin Health and the University of Melbourne.

 

Prof Seeman said his Australia Day honour reflected the work of many past and present staff members.

 

"It's a very satisfying award to get at this late stage of my career and I'm very humbled by it. I don't believe the award belongs just to me a lot of people have helped me,'' Prof Seeman said.

 

One of those people is former Austin Health staff member and Head of Endocrinology, George Jerums, the person who taught him it is okay to ask questions.

 

Prof Seeman thinks the ability to ask questions is pivotal to success in both patient care and research and it is something he goes to pains to emphasise to the many young endocrinologist he mentors.

 

It is nurturing emerging talent that he derives the greatest career satisfaction from now.

 

"Jeff Zajac has built a wonderful endocrinology department which gives people like me a wonderful opportunity to mentor our young people and help young people find their own voice," Prof Seeman said

 Austin Health CEO Brendan Murphy said Prof Seeman's award was recognition of a fantastic contribution.

"Ego epitomises the great academic tradition of Austin Health, with his enormously productive research career and the training and mentoring of many clinicians and researchers. Ego is one of Australia's most internationally recognised bone researchers and has made seminal contributions to bone research," Dr Murphy said.

Michael Woodward receives Australia Day honour

Professor Michael Woodward
Assoc Prof Michael Woodward has been appointed a Member of the Order of Australia.

Michael Woodward has been appointed a Member of the Order of Australia.

Associate Professor Woodward's has worked at Austin Health for 28 years and is current director of our Memory Clinic, Director of Austin Health's Aged Care Research and director of our Wound Management Clinic.

Associate Professor Woodward established Austin Health's Medical and Cognitive Research Unit which is the largest dementia clinical trials site in the Southern Hemisphere and currently has 27 trials underway with patients at various stages of Alzheimer's Disease.

He also oversaw a large expansion of aged care in the hospital and played a key role in helping set up a range of clinics/services to better serve older people in the hospital.

Assoc Prof Woodward described the award as "a privilege'' and said he was delighted to be honoured.

Assoc Prof Woodward has produced over 100 peer-reviewed publications and delivered almost 400 scholarly addresses throughout his career. He said his greatest research achievement was defining the frontal variant of Alzheimer's Disease.

"This variant of Alzheimer's Disease is characterised by rapid spread of pathology to the frontal regions of the brain, and causes early frontal clinical features such as behavioural and personality changes,'' Assoc Prof Woodward said.

Austin Health CEO Brendan Murphy said Assoc Prof Woodward was a tremendous asset to Austin Health and a deserving recipient of the award.

"Austin Health is delighted that Prof Woodward's long and distinguished contribution, especially to dementia research, has been recognised by this award."

A record-breaking year for our renal transplant unit

Austin Health's involvement in an Australian-first seven-way paired kidney swap capped off a record-breaking year for our renal transplant unit.

As well as taking part in the exchange, our unit carried out a record 50 kidney transplants in 2015 - an almost five-fold increase from a decade ago.

Hundreds of staff across Austin Health, Monash Medical Centre, the Royal Melbourne and NSW's Westmead, Prince of Wales and John Hunter hospitals was involved in the exchange which has given seven transplant recipients a new lease of life.

On November 19 simultaneous operations were carried out across the seven hospitals to remove the kidneys from their donors before the precious organs were either couriered across town or flown interstate to be transplanted into recipients.

Austin Health had one transplant-donor pair. Forest Hill mother Veronica Reid received a kidney while her sister Eleanor Canning donated one of her kidneys.

Veronica was suffering from end-stage renal disease.

"I am so grateful. If the transplant didn't happen I would probably be on dialysis by now," Veronica said.
"I used to feel like there was cement in my body. I always felt heavy and tired. All of the symptoms have totally gone now which is great,'' she said.

Austin Health Renal Transplant Unit deputy director, Assoc Prof Frank Ierino said he felt fortunate and proud to be part of the exchange.

"To see the health system working in such a collaborative way is just fantastic,'' Assoc Prof Ierino said.
"It's a great thing to see patients having the opportunity to have a renal transplant where they would otherwise be on a transplant list for long periods of time."

The Australian Paired Kidney Exchange organises organ transplants when a person in urgent need of a kidney has a loved one willing to donate but their organ has an incompatible blood or tissue type. The recipient-donor pair's details are placed into a pool and are matched with other donor-recipient pairs until each is matched with a suitable swap.

A special computer system is used to scan all those needing a kidney, as well as a donor they can offer, to find any potential donor-recipient chains.

The seven-way exchange was kick-started by an altruistic donor, Paul Bannen. Paul had originally offered his matching kidney to a friend with renal failure but when a deceased donor organ became available for his mate, Paul decided to donate his organ anyway to help a stranger.

Assoc Prof Ierino said thanks to initiatives such as the Australian Paired Kidney Exchange and the work of the Organ and Tissue Authority he was confident that Austin Health's renal transplant program would only continue to grow.

Gifts from the community help us to purchase new equipment helping us to better support people in need of our care. If you wish to donate to Austin Health's renal transplant program please click here.

Austin Health performs Australian-first combined transplant

Tim and Robyn surrounded by many of the Austin Health team involved in Tim's lifesaving care and operation.

Austin Health has performed Australia's first combined small bowel and kidney transplant, giving Melbourne businessman Tim Boyle a second chance at life.

 Our Victorian Liver Transplantation Unit team is the only unit in Australia which carries out intestinal transplants and Tim is just the fourth person to receive a small bowel.

Tim, 47, had been gravely ill with intestinal failure for 12 years after a twisted bowel meant 90% of his small intestine had to be removed in emergency surgery. While the average length of a small intestine is between 3-8 metres, Tim was left with a small intestine of just 25 centimetres.

The father-of-two had to spend more than 40 hours a week hooked up to intravenous nutrition to survive because his body could only absorb a small amount of nutrients from the food he ate. When the condition caused his kidneys to also fail 18 months ago, hope seemed to be running out for Tim.

"He had deteriorated so badly that I would be sitting there in church planning his funeral,'' Tim's wife, Robyn Laurie, said.

Austin Health gastroenterologist Adam Testro said just a handful of combined small bowel and kidney transplants are completed around the world each year.

"I've looked after him for five years and there has been a very obvious deterioration in his health in that time. It's so satisfying for us to be able to give him the opportunity to return to the normal life of a young father," Dr Testro said.

A surgical team of 13 took 15 hours to carry out the delicate operation on Tim.

"We knew it was very risky for Tim and we were very anxious about the outcome,'' Liver Transplant Unit director Professor Bob Jones said.

Tim, 47, spent 36 days in hospital recovering from the operation and was released just in time to celebrate his youngest daughter's 7th birthday at home.

"To say it is life changing is an understatement - it is a new life, not life changing," Tim said.

"I've got a whole new opportunity to redesign life which is so exciting,'' he said.

"To be there as a dad and a husband, and to be able to support the loved ones around me is a big thing. In the past few years as my health has continued to deteriorate, and being able to move from a burden to a contributor is great."

Tim and Robyn said they were incredibly grateful to the donor and their family and that they were "constantly in their thoughts and prayers".

Visit donatelife.gov.au to register for organ and tissue donation.

 

Discovering the power of creative therapy

Music therapy patient Annette Lade performed on the harmonica at the Garden Affair event. Photo courtesy of Progress Leader

Annette Lade always loved her music but she never guessed it would help in her recovery from a horrific road accident.

Mrs Lade was left a quadriplegic after a car accident in Traralgon last year.

She has spent the past few months living at the Royal Talbot Rehabilitation Centre in Kew.

"I broke my neck in the accident, which left me a quadriplegic," Mrs Lade said.

"It's been a lengthy road to this point and I'm slowly getting some movement back in my arms, but I doubt I'll ever walk again." Mrs Lade said the work of the Royal Talbot therapists with their range of techniques and programs had made given her a new outlook on life.

"I've been doing music therapy since October," she said. "I love music, I play music and obviously I don't have the method I once did, but I play the harmonica and I'm playing some basic chords now.

"It's all about pushing the boundaries and doing what you can do.

"You should never take life for granted, because anything can happen." At the weekend, Austin Health said thank-you to all supporters of its creative therapies with a garden affair.

The event was hosted by Austin Health's employee Steve Wells, who was ABC Gardening Australia's Gardener of the Year in 2012.

Liver disease expert recognised with lifetime achievement award

Prof Peter Angus has been recognised with a lifetime achievement award from the Gastroenterological Society of Australia.

An Austin Health professor's decades of influential research into liver disease have been celebrated with a lifetime achievement award.

Professor Peter Angus received the 2015 Distinguished Research Prize from the Gastroenterological Society of Australia.

The medical director of Austin Health's liver transplant unit and director of gastroenterology and hepatology, Prof Angus played a key role in establishing highly successful adult and paediatric liver transplantation programs which have resulted in over 1000 life-saving operations since 1988.

Prof Angus has been principal investigator for many clinical trials, including local and international studies in viral hepatitis, transplantation medicine and chronic liver disease.

Prof Angus' laboratory research program is carrying out world-leading work in its study of possible new treatments for preventing liver scarring in patients with chronic liver disease and ways of controlling the complications of severe liver damage.

"If we could stop the scarring it is highly likely that you would stop people going onto develop end-stage liver disease,'' Prof Angus said.

"We are the pioneers in this area and now we are collaborating with international groups to advance these possible new treatments. It's very exciting.

He is delighted to receive the award.

"It's recognition for research achieved by my wonderful team of clinicians and researchers here at Austin Health. We have been at the forefront of so many new therapies for our patients. I'm really very proud of the work that they and the many phD students I've supervised over the decades have done,'' Prof Angus said.

 

 

 

 

 

Austin Health's Physiotherapy team wins Premier's Prize!

Austin Health's Physiotherapy Department has won the Premier's Award for excellence in supporting the health workforce at the 2015 Victorian Public Healthcare Awards.

The Physiotherapy Department designed and implemented an innovative new workforce model of care this year to ensure patients get the right care at the right time by the right physiotherapist. New streams of physiotherapy care were developed to better match patient need across the acute health service. This unique workforce model was so successfully implemented that it has attracted widespread interest from other health services. The leadership demonstrated by the local management team in leading this change was outsanding. 

Austin Health also picked up a silver award (second place) in the 'Innovative models of care' category in partnership with the Royal District Nursing Service for the assisted home peritoneal dialysis program. Congratulations to Allyson Manley and the team behind this project!

Austin Health reaches finals of the Premier's Sustainability awards

Sustainability unit's Lauren Poulton, Karen Hames and Madeline Dorman pictured with gardens officer Steven Wells

Austin Health is a finalist in the Health category for this year's Premier's Sustainability awards.

Sustainability Victoria CEO Stan Krpan congratulated Austin Health staff for their creative and influential work towards building a more sustainable environment for Victorians.

"These awards represent Victoria's highest recognition for sustainability, and acknowledge leadership, innovation and achievement,'' Mr Krpan said.

Mr Krpan said Austin Health has a long-standing dedication to sustainability, showing whole-of-business commitment over seven years which has resulted in remarkable achievements.

Austin Health Sustainability Unit manager (acting) Karen Hames said these achievements include becoming the first Melbourne healthcare facility to recruit a dedicated sustainability officer in 2008 and establishing a sustainability network with metropolitan healthcare facilities, the Victorian Green Health Round Table group, in 2009. The group of 15 private and public healthcare organisations continues to meet bimonthly sharing and discussing sustainability ideas and benchmarking waste data.

Ms Hames said Austin Health is also the only Australian health organisation which recruits a gardens officer, Steven Wells, to develop green spaces for the therapeutic benefit of patients and staff.

"We are proud and excited to celebrate our achievements. Not only for 2014 but since our achievements began in 2008 and we are excited to celebrate with all of the people who have been part of the journey - from nurses and PSAs all the way through to board members,'' Ms Hames said.

Winners will be announced at an awards ceremony on Thursday 29 October at Melbourne's Plaza Ballroom.

 

 

 

 

World-first trial could be the game-changer in the fight against Alzheimer's disease

Laura Sides undergoes a PET scan as part of her participation in the world's first prevention trial for families of Autosomal Dominant Alzheimer's Disease.

 

He was the “most doting and loving Dad” a daughter could ask for which is why Laura Sides knew something was awry when her father Jeremy failed to show up on a date to celebrate her 21st birthday.

Laura would soon discover that her 52-year-old father had just been diagnosed with Autosomal Dominant Alzheimer’s Disease (ADAD). He had first started displaying subtle symptoms of the disease when he was 47 and passed away as a result of ADAD aged 60.

It was devastating for Laura to watch her father, once a successful and well-loved doctor, succumb to the disease. It was terrifying to learn she had a one-in-two chance of suffering the same fate.

Approximately 200 Australians suffer from ADAD. Families with the disease have a dominantly-inherited gene mutation meaning that if one parent has ADAD there’s a 50% chance offspring will get Alzheimer’s at the same age their parent did. Genetic testing can identify if the person is afflicted with the mutation.

Laura, 32, spoke to genetic counsellors at Austin Health about having the testing in 2014 but subsequently decided it wasn’t something she was ready to find out.

“It’s not something I feel I want to do at the moment. I think it’s a really big decision to make and you could potentially, I guess, find out your own fate and I’m just not sure how I feel about that as yet,’’ Laura said.

“I think maybe I was waiting for a right time to do it and I think I’m understanding now that maybe there’s not a right time and it’s something I think a lot more about doing that I have done in the past.’’

It was a result of the meeting with the genetic counselling team that Laura discovered Austin Health, in conjunction with the Florey, is one of three Australian sites taking part in a world-first prevention trial for ADAD families.

The Dominantly Inherited Alzheimer’s Network Trial (DIAN-TU) focuses on drugs it is thought could prevent, delay, or possibly even reverse, Alzheimer’s changes in the brain.The medication is an antibody that works by targeting the build-up of a damaging protein, amyloid, in the brain. Amyloid build-ups form plaques which are thought to cause the damage that ultimately leads to Alzheimer’s.  It is hoped the drugs will bind to the amyloid and flush it from the brain.

Like all of the trial participants, Laura does not know if she is receiving the medication or a placebo. She does know that she felt a moral responsibility to take part in the trial. In researching her family history she discovered her Great-great grandfather had 8 children and 5 died of ADAD. She is worried not only for herself but future generations.

“It’s given me a sense of involvement within something that I’m obviously very interested in and is very important to me. I also wanted to try and find a positive out of what potentially is a negative situation and to help in any way I could,’’ Laura said.“Being involved has made me feel better for a lot of reasons. It has put me in contact with experts in the field and to have as much knowledge as you can gives you a sense of power’’.

Positron Emission Tomography (PET) scanning is integral to the DIAN-TU study and into the research and treatment of Alzheimer’s disease as a whole. The technique uses small amounts of radioactive material to highlight any amyloid plaque build-up in the brain, enabling detection of Alzheimer’s disease 15-20 years before people experience symptoms.

Austin Health’s Prof Chris Rowe is one of the world’s pioneers in PET scanning and has dedicated much of his career to dementia research. He says the DIAN-TU study provides a unique insight because it is one of the first trials to attempt treatment in people who don’t have dementia to prevent them from progressing to the disease.

“It will tell us more about whether amyloid is the true cause of Alzheimer’s disease because if the treatments show that we are clearing the amyloid but the disease is progressing then obviously something else critical is being missed and we will have to look again to find out what’s really driving the development of Alzheimer’s dementia,” Prof Rowe said.

“It will hopefully prove what has been hypotheses - that amyloid causes Alzheimer’s disease – but also, that amyloid is potentially a way to diagnose dementia early so we can stop people from getting it.

“If this works, we’ll have an effective treatment for Alzheimer’s disease, not only for these people with this rare young-onset form, but for Alzheimer’s disease in general, and that will have an enormous benefit to society, reducing suffering of patients and their care givers and also economically, reducing health care expenditure.

Trial results should be known in two years.

Austin Health is home to the biggest dementia clinical trials site in the Southern Hemisphere. Led by Assoc Prof Michael Woodward, our Medical and Cognitive Research Unit currently has 27 trials underway for patients at various stages of Alzheimer’s disease. To find out more about these trials visit: http://www.austin.org.au/cognitiveresearch.

Check out ABC's coverage of the trial here:

New procedure puts a spring back into Peter's step.

Austin Health Cardiology Director Assoc Prof Omar Farouque shows patient Peter Kingsley how his TAVI was inserted. Picture courtesy of Heidelberg Leader

Peter Kingsley used to be a marathon runner. In a typical training week he would clock up 100 kilometres and not even torrential rain would stop him lacing his shoes.

Sadly, a series of cardiac problems ended Peter's athletics career and this time last year he couldn't even walk 200 metres without becoming breathless. Thanks to a new procedure at Austin Health, the 79-year-old is back enjoying an active life.

Peter was one of the first patients at Austin Health to undergo a Transcatheter Aortic Valve Implantation or TAVI. The TAVI is for patients who suffer from aortic stenosis. Aortic stenosis is the narrowing of the left ventricle of the heart. This narrowing results in high blood pressure, prevents the heart from pumping blood efficiently and can lead to heart failure. It's a problem which becomes increasingly common as people age.

Traditionally patients who had this problem would have had to have undergone open heart surgery to fix it. However, open heart surgery is not a viable option for some patients, including Peter who has had multiple heart attacks.

Austin Health Cardiology Director Associate Professor Omar Farouque said the TAVI was a wonderful alternative for people like Peter as it is far less invasive and has a far quicker recovery time.

Rather than opening the patient's chest, an insertion is made through their leg and a fully collapsible replacement valve is delivered to the heart through a catheter. The old, damaged valve remains and the replacement aortic valve is wedged into its place.

Mr Kingsley said the procedure has given him a second chance at life.

"It's brilliant. I had the procedure on the Wednesday and was home on the Sunday," Mr Kingsley enthused. "Within three weeks I was back walking two kilometres without any problem.''

 

 

Olivia's lifesaving procedure marks 1000 for Liver Transplantation Unit

Olivia and her husband Matthew surrounded by some of the Liver Transplant Unit's key staff. From L-R: Michael Fink, Greg Przbylowski, Julie Lokan, Bob Jones, Caroline Miller, Paul Gow, Graeme Hart, Larry McNicol, Angela Vago, Graham Starkey, Cath Devine.

Every liver transplant that is carried out is incredible, but Olivia Sanders' transplant will forever carry extra significance for her and Austin Health.

Olivia's successful surgery marked the 1000th transplant that Austin Health's Victorian Liver Transplantation Unit has carried out.

The transplant is a second chance and a new beginning for Olivia, 40, and her husband, Matthew.
An elated Olivia explained she will now celebrate her transplant date as her new birthday as the transplant has provided a new beginning for her.

The Melbourne woman was given a year to live in April. Primary biliary cirrhosis - an autoimmune disease of the liver - had resulted in advanced organ failure and her only hope of survival was a liver transplant.
"It feels like a dream...It's an absolute miracle, it's a chance for a new beginning. It's like having a new birthday,'' Olivia said.

Olivia had spent every day in hospital or housebound since marrying her husband Matthew in October 2014. The pair will now plan a long-awaited honeymoon to Olivia's homeland of El Salvador.

Matthew said they will feel forever grateful to the liver transplantion team and the donor's family.
"It means the absolute world to us. It's just been incredible seeing my wife look so healthy,'' Matthew said.
Unit director Professor Bob Jones said the safety of the procedure had greatly improved since he performed the state's first in 1988.

"We now know when to do it and who we're likely to get better results with," Prof Jones said.

If you would like to make a donation to help purchase vital equipment for the liver transplantation unit please visit: https://secure.donman.net.au/client/austin/austindonate.asp.

For details on becoming an organ donor go to donatelife.gov.au.

 

 

Naz stands tall

Naz taking his first steps with the aid of the REX exoskeleton.

 

Paralympics gold medal winner Naz Erdem recently took his first steps in more than twenty years.
Naz was the first Australian patient to trial a pair of robotic legs at Austin Health.

The experience left Naz elated and Austin Health Victorian Spinal Cord Services Director, Andrew Nunn excited about future opportunities for patients with high-level quadriplegia.

Naz said it was an amazing experience to be able to stand straight without worrying about falling backwards and to be at his full height again.

"I've been 4 foot 2 for the past few years and now I'm 6 foot again. It feels great,'' he enthused.

The trial provided a break from a busy schedule for Naz - he currently juggles a demanding schedule of training for the 2016 Rio Paralympics wheelchair rugby competition with fulltime work for Aspire, formerly known as Australian Quadriplegic Association, Victoria. His role at Aspire is to help support and motivate people rehabilitating from spinal cord injury.

Dr Nunn said Austin Health plans to conduct Australia's first clinical trial of the REX robotic exoskeleton. The trial will form part of a research project being undertaken by the robot's creator Rexbionics.

Dr Nunn said although a number of mobility robots have been developed over the past decade or so, this is the first that allows people with high-level quadriplegia to walk. Previous technology has required too much upper body strength meaning they are only suitable for people with paraplegia.

"The robot like Rex can provide our spinal patients with the opportunity to stand, to be mobile and exercise," Dr Nunn said.

"This has physiological benefits with the bladder, the bowel, sexual function, reduction in pain, reduction in spasticity, improvement in posture and quite interestingly, body awareness.

Dr Nunn said the huge benefit the robot provided was allowing people to spend part of their day standing, enabling them to carry out everyday tasks - both at home and in the workplace - much more easily.

Rex Bionics spokesman Malcolm Hebblewhite said the company was started by two Scottish immigrants to New Zealand, one of whom had been diagnosed with multiple sclerosis and both of whom had mothers in wheelchairs.

"They decided to do something about this by inventing a robot. They started in their garage and developed a number of prototypes. They faced enormous challenges to be able to put together something so technically sophisticated from an early prototype that literally looked like Wallace and Gromit's wrong trousers."

Victorian-first clinic delivers benefits to some of our most vulnerable patients

Patients at high risk of infection could soon be able to use more powerful and effective drugs, following the opening of Victoria's first antibiotic allergy testing centre at Austin Health.

Clinic coordinator Dr Jason Trubiano said of the 20 per cent of people who came to hospital believing they had an allergy to antibiotics; up to 90 per cent of them did not.

Dr Trubiano said people would sometimes have had a strange reaction in childhood that was mislabelled as an allergy.

"This can be very limiting if, for example, they think they are allergic to penicillin and they have cancer or need a liver transplant, if you're allergic to penicillin it potentially excludes many drugs," Dr Trubiano said.
"When people are labelled as allergic we often have to use second-line drugs.

"Any infection in a patient that has a lowered immune system is a risk and in that situation we want to give them the best antibiotics, so if we can remove a penicillin allergy label and give them the penicillin antibiotic to a bug that's going to work against it, then we want to do that at all opportunities."

Austin Health's clinic is only the second of its kind in Australia. Patients with recurrent infections or a high risk of developing one - such as cancer and organ transplant patients - undergo a detailed consultation of their medical history, then a skin-prick test using a few drops of the antibiotic.

If there is no allergic response, patients are given a small amount of the drug under the skin and if the results are still negative, they are carefully monitored after being given an antibiotic tablet.

If all the tests are completed with no reaction, the patient is given the all-clear. Of the 60 patients tested to date, only one has had a positive response.

Chrissie Hopper, 63, was "over the moon'' when she was told she could use penicillin again, more than five decades after being told she was allergic because of a childhood reaction.

She has suffered from recurring pneumonia and recently was hospitalised for eight days after having to be treated with second-line drugs because of her penicillin "allergy".

"To suddenly be able to know that I could have penicillin was almost life-changing," she said.
"I think it's absolutely brilliant and I was just so fortunate that I got referred here."

Austin Health's head of infectious diseases, Professor Lindsay Grayson said removing incorrect allergy labels, and therefore the need to administer second-line drugs, was also important in the fight against the growing problem of bacteria resistance to antibiotics.

Prof Grayson said first-line drugs were quicker, safer and more effective than second-line drugs. He said the higher rates of side effects and toxicities associated with second-line drugs meant patients were less likely to take them effectively and therefore antibiotic resistance could emerge.

Dr Trubiano said it was just as critical to determine if a person's allergy label was correct as 50 per cent of very severe and rare adverse drug reactions that needed hospitalisation were caused by antibiotics. Of those, he said one in five patients would die from their reaction.

He is also in the early stages of developing a simpler test for antibiotic allergies.

"We'd like to make it as easy as possible in the future and one way would be able to diagnose this in a test tube and we're looking at trying to measure a patient's white blood cell response or immune response to antibiotics in a test tube," he said.

Marathon liver surgery and a mother's love save Charlie

 Six weeks post his life-saving surgery and Charlie Joannidis’ cheeky grin says it all.

The energetic 18-month-old will soon learn to walk and talk – milestones his parents would have found difficult to comprehend a couple of months earlier when they were told his survival was a minute-by-minute proposition.

Charlie was born with biliary atresia, a condition of the bile ducts that causes toxins and waste to accumulate and damage the liver. For months Vanja and Andrew Joannidis hoped for a new liver from a deceased donor to save their son but by May it was obvious time was running out – Charlie had end-stage liver disease.

Vanja asked if she could donate part of her liver to her son - a request that Austin Health’s Liver Transplant Unit director Prof Bob Jones receives regularly.

"It’s a natural instinct for a parent to want to help their child,’’ Prof Jones said. ‘’But as a doctor it’s a very difficult ethical decision, we are operating on a totally well person who doesn’t need surgery, there are significant risks, including death, and the only advantage we can offer them is to their child,’’ Prof Jones said.

Prof Jones said there is also no greater chance that a parent will be an immunological match or that organ rejection is any less likely, even though the child has half of their genes but luckily for the Joannidis family, Vanja’s was a perfect match for Charlie.

Vanja become only the second person in Victoria to have her liver split and given to a child in a marathon exercise that spanned 14 hours and directly involved more than 20 medical staff across two hospitals.

A surgical team led by Michael Fink operated on Vanja at the Austin Hospital and removed part of her liver. The liver was then packed into an esky and driven to the Royal Children’s Hospital where a surgical team led by Austin Health’s Graham Starkey and BZ Wang removed his old liver and connected his tiny arteries and vessels to the adult-sized connections on Vanja’s graft.

Vanja and Michael describe the day as the most difficult of their lives.

"That was the hardest thing, you are faced with a sick child, his mortality and your own," Vanja said.

"I could picture his funeral and I don't know how I will ever ease that image from my mind."

 Andrew was torn between his wife and child, in separate hospitals on opposite sides of the city.

After many hours of tense phone calls, he was told a small section of his wife's liver was in an esky on its way to Parkville.

The first thing Vanja asked when she woke up from surgery was whether the liver was good enough to use.

"There were so many risks, complications or death, but the one that I was the most scared of was that they would open me up, look at my liver and decide that it couldn't be used," she said.

"Then they would close me up and I would have gone through all that, but Charlie would still be sick." It turned out to be such a perfect match that, she said, it was almost as if she had grown the liver for him.

Six weeks on from the operation the family returned to the Austin Hospital to say thankyou to all of the staff involved. Some of the staff shed a tear when they saw the smiling little boy and listened to how he had transformed into a happy, active toddler since the operation.

 The operation is one staff would prefer not to have to repeat which is why they urge people to consider registering to become organ donors. For more information visit:

www.donatelife.gov.au

 

 

 

 

 

Australian-first invention will buy liver surgeons vital time

 

Austin Health researchers have built Australia’s first machine to keep a donor liver functioning after being removed from the body.

The machine acts like an artificial heart and lungs to keep donor livers working after being retrieved from the donor’s body – allowing surgeons vital extra time to assess whether the organ is transplantable.

Austin Health liver transplant surgeon Graham Starkey said the machine had successfully kept livers functioning for up to two days after being removed from the body.

The machine works by storing the liver in a container where it is provided with medication and nutrients, and connected to tubes that keep blood pumping through it.

Austin Health intensive care research director Rinaldo Bellomo said this gave surgeons much greater scope to assess how healthy the liver is. For example, when a donor dies of cardiac arrest there is a risk of their liver being damaged to the point where it would be unsafe to do a transplant but testing it first in the machine will allow much greater assessment of its suitability.

"The liver doesn't know it is outside the body," Prof Bellomo said. "It is just sitting there for us to assess - to look at how it appears, its softness, the way it is functioning. You can do blood tests on it, you can see it making bile the way it normally would, and you can take bits of it and send it to a pathologist (for testing)."

Currently surgeons have about eight hours to complete the transplant operation from when the donor liver has been retrieved.

Prof Bellomo said he hoped the machine could one day be developed into a temporary life support system for ill patients while they wait for a transplantable liver to become available, much like a dialysis machine keeps people's kidneys functioning until they receive a kidney transplant.

A human donor trial is expected to take place later this year.

 

 

 

 

Neill's lucky escape

Neill Ryan and his wife Lorraine

 

 Neill Ryan and his wife Lorraine can continue enjoying their retirement thanks to a fortunate chain of events that saved Neill's life.
The 68-year-old grandfather suffered a cardiac arrest and collapsed metres from the Austin Hospital and in front of Northern Health medical student Noor Lammoza who had just left a meeting at the hospital.
Noor performed CPR on Neill and as he was doing so, an empty ambulance which had just left the Austin Hospital arrived.
The paramedics used a defibrillator to give an electric shock to Neill's heart which enabled it to beat normally again. They then drove Neill the short distance to hospital where Austin Health Cardiology Department Head Associate Professor Omar Farouque and his team performed an angiogram which showed Neill had severe blockages in two of his three main arteries.
Stents were inserted to fix the blockages and a week later Neill is back home and able to reflect on his good fortune.
"It was just one of those lucky days where I've missed a bullet,'' Neill said.
Neill and his wife Lorraine expressed their gratitude to Noor, the paramedics and Austin Health staff who saved his life.
A/Prof Farouque said the blockage in Neill's left anterior descending coronary artery caused his heart to go into a dangerous rhythm meaning blood and vital oxygen couldn't be circulated. He said the CPR performed by Noor "undoubtedly'' saved Neill's life.
"Giving CPR provided support to his circulation system enabling blood to get to the brain,'' A/Prof Farouque explained.
A/Prof Farouque said sadly many patients weren't so lucky.
"Blocked arteries are one of the leading causes of death in Australia.
He said many people suffered brain death because although their hearts were able to be restarted by paramedics, they weren't given CPR in time so their brains became starved of oxygen.
"If the patient is alone or if they are with people who don't know what to do, then sadly the patient will die. Basic CPR should be learned by all,'' A/Prof Farouque said.
A/Prof Farouque said chest pain was a common symptom of blocked arteries and urged people to get checked out immediately.
Austin Health treats around 120 patients for blocked arteries annually.

 

 

 

 

 

 

 

World-first study aims to improve road safety

Dr Mark Howard

 

A world-first Austin Health study is measuring the eye movements of motorists to identify those who are nodding off behind the wheel and require treatment for obstructive sleep apnoea.

Obstructive sleep apnoea is a major catalyst for road accidents. The condition causes the muscles of the throat to relax during sleep and block the airways between five and 50 times an hour resulting in a poor night’s rest and subsequent daytime drowsiness for some sufferers. However, Director of Austin Health’s Victorian Respiratory Support Service, Dr Mark Howard said not everyone with obstructive sleep apnoea is affected by drowsiness, while impaired driving persists in others despite treatment.

"There’s a critical need to develop objective methods to determine which people with obstructive sleep apnoea require treatment in order to drive safely, particularly due to the high prevalence of obstructive sleep apnoea in safety critical transport industries,’’ Dr Howard said.

This is the world’s first on-road study of alertness. Traditionally the only way daytime sleepiness has been measured is by taking brain scans of patients sitting in laboratories.

Dr Howard said earlier research has shown that measuring people’s eye movements can be a useful way to measure drowsiness in real time and thanks to recent advancements in technology, it is now possible to test this while people were driving.

Patients are given glasses to wear while driving which have infra-red sensors that reflect light off the eyelid, allowing speed, duration and size of eyelid movements. The slower the eye movements, the more tired the driver.

"We have lab studies with people on the driving simulator who have their eyes closed for up to 14 seconds, without actually going off the road," Dr Howard said.

"Some people might have the same number of events at night. One person will say they are fine and another might be falling asleep all over the place.

"People are worried about losing their licence, especially when it's their occupation, so they're not going to report if they're having problems.

"This is a simple method to objectively measure eye movements to better identify what people with sleep apnoea have driving problems and clearly need treatment."

The study, funded by the Austin Research Foundation, involves 20 sleep apnoea patients and a control group, with the results expected later this year.

 

 

 

 

New director beams exciting ideas into Radiation Oncology

Dr Farshad Foroudi

 

An innovative treatment program for cancer that has spread to the brain is one of the many projects that Austin Health’s new director of Radiation Oncology is excited about.

Farshad Foroudi says the program will target brain metastases cancer - cancers where the cancer begins in another part of the body and cancer deposits spread to the brain - using a treatment called stereotactic radiotherapy.  Stereotactic radiotherapy is highly accurate and highly focused radiation that targets radiotherapy precisely at the tumour, minimising dose to surrounding normal tissues.

Dr Foroudi says the program is expected to begin in the next month and is hopeful that a full stereotactic radiotherapy program targeting a wide range of cancers will begin in the next 12 months.

Dr Foroudi has 15 years of experience as a radiation oncologist and has come from a leadership role at the Peter MacCallum Cancer Centre. He is also Chair of the Trans Tasman Radiation Oncology Group Scientific Committee.  The Trans Tasman Radiation Oncology Group is the main radiation oncology trials group in Australasia and currently the highest recruiting cancer collaborative trials group in Australasia.

He’s delighted to be part of Austin Health.

“There are beautiful facilities and lots of opportunities. We have doubled the space in our department since the move to the Oliva Newton John Cancer and Wellness Centre, and it’s great to be co-located with medical oncology, haematology and close to the rest of the acute medical services in the same campus,’’ Dr Foroudi said.

In addition to the brain metastases cancer program, he hopes to build on some of the projects in radiation oncology including closer collaborations with other services at Austin.

 

 

Unique study aims to improve health outcomes for mothers and babies

Anjulie Palipane knows that losing weight will increase her chances of a healthy pregnancy which is why she decided to take part in a unique trial being led by Austin Health.

The Pregnancy Outcomes after Preconception Weight Loss (POP) study aims to determine optimal weight loss for obese women planning pregnancy.

Half of the women in the study are put on a diet designed to achieve significant weight loss while a control group adopts a moderate weight loss program.

Anjulie has been on the diet designed to achieve significant weight loss for six weeks and she is delighted to have already lost 8.5 kilograms.

The Fawkner woman said that while the diet takes determination, she is spurred by her big picture goal.

"These days there are so many complications which can occur during pregnancy and if I can reduce the chance of those occurring prior to falling pregnant then I have a greater chance of a healthy pregnancy,'' Anjulie said.

The 28-year-old is aiming to lose 20kgs on the trial and says she has benefitted from the support of her husband Don and her family.

Trial Coordinator, Austin Health and University of Melbourne Endocrinologist Sarah Price said obesity during pregnancy causes a range of significant problems for both mother and baby and has emerged as a major health concern both in Australia and across the Western world.

"Around 20% of women of child bearing age in Australia are obese and we know that excess weight has significant ramifications for mother and child,'' Dr Price said.

"Obese pregnant women are at much greater risk of developing gestational diabetes, gestational hypertension, pre-eclampsia and requiring c-section deliveries, '' Dr Price explained.

"Their babies are much more likely to have a high weight at birth which increases the risk of a traumatic delivery. It also puts them at a greater risk of metabolic syndrome-- diabetes, high blood pressure and obesity - later in life.''

"Babies born to obese mothers are also at greater risk of pre-term delivery, jaundice requiring treatment and admission to the special care unit.

Dr Price said the aim of the study is to see if substantial weight loss for obese women pre-conception has a greater impact on reducing health concerns in mother and baby than moderate weight loss.

"Currently we don't know if significant weight loss is a good thing or not.''

The study will recruit at least 176 women and Dr Price said it is the first large study of its kind.

Dr Price said women would be randomly assigned to either a significant weight loss program for 12 weeks or a moderate weight loss program. Both programs will be nutritionally complete but will contain different calorie contents.

If you are interested in signing up for the POP study or simply want some more information visit: www.popstudy.com.au

 

Austin Health pharmacists deliver safety message

Austin Health pharmacists are urging health professionals and dieters to be aware of the potential dangers of mixing fasting regimes with some medications.

Pharmacists Gina McLachlan and The-Phung To say some fasting diets, such as the popular 5:2 diet, where calorie intake is unrestricted five days a week and limited to 500 calories for women and 600 for men two days a week, could result in adverse effects or therapeutic failure.
In a letter to the Medical Journal of Australia the pair explained intermittent fasting could significantly affect the absorption of some drugs as some drugs require the patient to have food in their stomach to be absorbed while some other drugs could cause gastro-intestinal issues when taken on an empty stomach.

Gina delivered the cautionary message on National Nine News advising viewers who take medications to speak to either their doctor or pharmacist before embarking on a fasting diet.

"We are not warning people off the diet, we are advising them to be aware there could be adverse reactions if undertaken with some medications,'' Gina said

She explained that the diet could also be problematic for diabetics as combining fasting with some diabetes medication could result in hypoglycaemia.

The 5:2 diet could also have negative repercussions for people on the blood-thinning drug warfarin because while the absorption of the drug is not adversely affected by fasting, it is possible that a diet high in Vitamin K could result in it being less effective. Vitamin K is found in leafy green vegetables - a popular choice for dieters on their restricted calorie days.

Bob reaps the benefits of diabetes study

T4DM study participant Bob Beggs undergoing a test with nurse Jenny Healy. Photo courtesy of Leader Newspapers

 

Cobram man Bob Beggs hasn’t looked back since enrolling in diabetes prevention study T4DM.

Bob has shed 10 kilograms since starting the nation-wide trial through Austin Health’s Men’s Health Clinic 12 months ago.

The $4 million National Health and Medical Research council funded study investigates whether testosterone treatment combined with lifestyle changes can prevent type 2 diabetes in men who have ‘prediabetes’ and also have low testosterone. Before people develop Type 2 diabetes they almost always have ‘prediabetes’ which means blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes.

Bob’s motivation to become involved was sparked when he discovered he needed to lose weight before he could have a hip replacement.

"It was suggested I should take part in this trial as everyone who takes part gets two years free membership with Weight Watchers. It seemed like a pretty good deal to me and it’s working – I’m losing weight,’’ Mr Beggs said.

Head of Austin Health’s Men’s Health Clinic, Dr Mathis Grossmann said the trial tests if increasing testosterone levels in men aged 50-74 results in fat loss, muscle gain and prevents type 2 diabetes.

Participants are given either testosterone or a placebo throughout the study with neither the participant nor the medical staff administering the treatment aware of what treatment the patient is receiving.

Dr Grossmann said many people wrongly believe that males only need testosterone to grow from boys into men but in fact, testosterone is essential for a whole lifetime.

"Just as women go through menopause which affects their oestrogen levels, men lose testosterone as they age,’’ Dr Grossmann explained.

"It’s more of a gradual drop for men. So as you get older, as a man, you tend to gain fat and drop muscle and sexual desire drops,’’ Dr Grossmann said.

More than 300 men have enrolled in the study but researchers need a total of 2500 participants.

Dr Grossmann said even if men are part of the placebo group they will still benefit from the free Weight Watchers memberships which aim to create a healthier lifestyle for participants.

To be eligible men must be overweight, aged between 50-74, have a waist line of 95 centimetres or more and not have diabetes.

To find out more visit http://www.t4dm.org.au

 

Austin Health researchers win scholarships

Neil Glassford

 

Two promising Austin Health researchers have been awarded Avant scholarships to fund innovative studies.

Dr Neil Glassford and Dr Lawrence Lau were among four researchers to be awarded $50,000 Doctor In Training Research scholarships by medical defence organisation Avant.

Dr Glassford’s scholarship will enable him to conduct the most detailed study to date on the effects of fluid therapy in critically ill patients while Dr Lau will perform pioneering research on a new test to assess the quality of liver donors.

Dr Glassford’s interest in fluid management and its effect on patient survival was piqued while working as a Registrar in Acute and Intensive Care Medicine in Glasgow.

"I had given four patients over the course of a morning multiple fluid boluses. One of the patients stabilised, two patients had to be admitted to intensive care for ongoing care, and the fourth died in the emergency department," he says.

First reported in 1832, and now a fundamental part of acute care, Neil says intravenous fluid therapy has been "woefully understudied."

"Fluid bolus therapy is probably the most common intervention in acute care prescribed by doctors across the world. It struck me that, despite it being almost ubiquitous, there is very little evidence that it improves patient outcomes over the course of their admission to hospital, and emerging evidence shows that patients who accumulate fluid during an ICU admission do worse than those who do not."

"In 180 years we haven't really developed an evidence-based approach to the administration of intravenous fluid in critically ill patients, despite it being the first-line therapy for anyone who is hemodynamically unstable."

"My research is a very granular examination of the associations between intravenous fluid therapy and outcomes in patients in intensive care, in a way that hasn’t really been done before," Neil says.

Dr Glassford moved to Melbourne from Scotland in 2010 to pursue world-class training opportunities under Austin Health Intensive Care Unit Research Director Rinaldo Bellomo.

Dr Lau is using his scholarship to assess whether an Indocyanine Green (ICG) clearance test – commonly used internationally to assess liver function in cirrhotic patients and in patients before major liver resection - can better predict liver donor quality.

One of the most important factors in determining the success of transplantation and preventing organ dysfunction, which occurs in up to 15% of liver recipients - is the quality of the donor liver.

"We have to decide whether we are going to go ahead with the transplant or not, based on a relatively unscientific assessment of donor liver quality. We have a bit of a look at the donor liver, check out the colour, give it a bit of a squeeze, and feel its suppleness," he says.

"In the balance based on this very subjective assessment are serious consequences. If we use a bad liver the recipient can get very sick and even die if the liver doesn’t work. On the other hand, if we don’t use a good liver then that's someone on the transplant waiting list who could miss out on this life-saving operation."

"ICG is a dye that possesses three very special properties – it's non-toxic and only excreted from the liver which means its rate of clearance correlates directly with liver function. It's also fluorescent so that I can use a non-invasive finger probe to measure the concentration of the dye in the donor," he says.

"Based on those three factors it is an ideal test and what's more, we can do it in five minutes."

Preliminary results show that the ICG test is significantly better in comparison with conventional liver donor assessment and Dr Lau hopes that based on the promising early results, the ICG test will become a routine test performed before organ procurement for liver transplantation, worldwide.

 

Innovative self-check in system wins award

Self check-in system wins award

 

 

Austin Health has won an Australian Council of Healthcare Standards award for a project to introduce a self check -in system which has reduced patient wait times.

The first of its kind in Victoria, the innovative electronic queue management system allows patients attending specialist outpatient clinics to check themselves in. It was introduced in response to consumer feedback that wait times were too long.

The efforts of Austin Health's Specialist Clinics Projects Team consisting of staff members Monica Finnigan, Sophie Karamazalis and Melinda Cosgriff were recognised with a Highly Commended award in the Non-Clinical Service Delivery section of the 2014 Australian Council on Healthcare Standards Quality Improvement awards.

Wait times in some clinics have reduced by up to 50% while other benefits include reduced overcrowding and improved patient privacy. The system also means that patients are in control of their own details which are updated at every visit.

Check-in kiosks were initially installed in 10 crowded clinics with the longest wait times and data about patient flow was collected. In consultation with clinicians, clinic schedules were then changed and patient flow was monitored. As a result, wait times in some clinics reduced between 30-50%.

The system will be progressively rolled out across all three Austin Health campuses and the long-term aim is for every clinic to have an average wait time of 20 minutes.

 

Austin Health anaesthesia expert takes out highest honour

Larry McNicol receives award
Assoc Prof Larry McNicol receiving his Health Lifetime Achievement award

Austin Health’s Larry McNicol has been awarded the highest individual honour at the 2014 Victorian Public Healthcare Awards.

 

Associate Professor McNicol received the Health Lifetime Achievement award in recognition of his extraordinary contribution to anaesthesia, clinical governance and patient safety.

Assoc Prof McNicol said he was humbled by the award.

"It’s as much a celebration for the Austin as it is for me,’’ Assoc Prof McNicol said.

"I’ve been here for 35 years and I just think it’s such a wonderful place and the culture for getting the best possible outcome for patients is what makes most people tick here.

Assoc Prof McNicol has been the Director of Anaesthesia at Austin Health for the past 25 years. He is also the Medical Director of the Anaesthesia, Perioperative and Intensive Care Clinical Service Unit.

He said his award is a wonderful recognition for the specialty of anaesthesia.

"Anaesthesia is increasingly involved in many aspects of healthcare and patient safety and I think the anaesthesia department is in a really strong position to make a difference here at the Austin and in the wider community."

Assoc Prof McNicol said helping develop Austin Health’s liver transplant unit and being involved in the first transplant was a career highlight. His involvement in helping establish the first paediatric liver transplant unit at the Royal Children’s Hospital and the first liver transplant for a child also hold special memories.

Assoc Prof McNicol’s award was the highlight of a successful evening for Austin Health at the awards ceremony.

Austin Health’s entry ‘Peripheral intravenous line safety initiative’ won a silver award in the Excellence in quality healthcare category of the awards.

Neurosurgery nurse practitioner Dr Andrew Scanlon received a high commendation in the Achieving a highly capable and engaged workforce award while Austin Health also received a high commendation for its submission ‘Deteriorating patient program group’ in the Outstanding achievement by an individual or team in healthcare category.

Austin Health was also part of a multi-hospital entry ‘Coordination of Australia’s largest paired kidney exchange’ which was highly commended in the Premier’s Award for advancing healthcare –putting patients first category.

 

 

 

D-Day for Cancer: At What Cost?

 

The potential effectiveness of new strategies to engage the immune system in attacking cancer, as well as the immense cost of these treatments will be the topic of an upcoming lecture at Austin Health.

Director of the Westmead Institute for Cancer Research, Prof Richard Kefford AM will deliver the oration on October 28.

Prod Kefford has been a clinical investigator in melanoma and breast cancer for 30 years. He has recently been deeply involved with the development of new effective treatments for melanoma in Australia and says he has become both astonished at the potential effectiveness of new strategies to engage the immune system in attacking cancer, but also by the immense cost of treatment, with the latest treatments costing $12,000 per month. Through this oration he hopes to spark community debate in Australia about how best to prepare ourselves for cancer's D-Day.

The Smallwood Oration is an annual public lecture honouring the immense contributions made to Australian Medicine and Austin Health by Professor Richard Smallwood AO.

RSVP to: rsvp@austin.org.au

Olivia Newton-John Cancer Research Institute is officially opened

The Olivia Newton-John Cancer Research Institute (ONJCRI) was officially opened by Premier of Victoria, The Hon. Dr. Denis Napthine MP at Austin Health.

ONJCRI is Australia's newest cancer research institute, established to help find the cure for cancer by translating our scientific discoveries to clinical application.

"It's fantastic to see Victoria becoming a hub for collaborative medical innovation; the Institute is an example of Victoria leading the world in the cancer research and treatment," said Dr Napthine in his commemorative speech.

Olivia Newton-John said, "What many of you don't know is that I have science in my genes. My grandfather, Max Born won the nobel prize for quantum physics in 1954. It's incredibly exciting for me to be the champion of this Institute. After all, the best way to wellness is to find a cure and the best path to a cure is by supporting research."

Professor Jonathan Cebon, Medical Director, ONJCRI said, "The Institute is embedded within a facility
that is strategically placed to bring together fundamental research from our laboratories with patient
care. This ensures that emerging discoveries are available for the benefit of cancer patients, and that
observations from the clinic can be investigated by our research teams, thereby contributing to the
continuum for research and care."

As part of today's launch Professor Matthias Ernst was announced as the Scientific Director of ONJCRI
bringing with him more than two decades of experience in leading a group of world‐class cancer
researchers that work on bowel cancer to find new treatments for this deadly disease.

Additionally, ONJCRI has signed an affiliation agreement with La Trobe University leading to the
establishment of the La Trobe School of Cancer Medicine at the Institute.

ONJCRI is the successor to the Melbourne Branch of the Ludwig Institute for Cancer Research. It will
build on the investment and scientific contributions from Ludwig, which has committed $250 million in
cancer research funding to Australia over the last 35 years.

Immunotherapy’s future promise to cancer patients

Cancer immunotherapy clinic
Austin Health is opening a Cancer Immunotherapy Clinic

"Daniel... the tumour on the left lung, we can't find it. It's completely disappeared. The tumour on the right lung has decreased by 80%." They were the words from Professor Jonathan Cebon that changed Daniel Morrissey's life.

Daniel had a Stage 4 melanoma that doctors described as inoperable. Fortunately, Australia is one of the best places in the world to be treated for melanoma, and Prof Cebon and his colleagues at Austin Health and the Ludwig Institute for Cancer Research had been working on a new experimental cancer treatment approach for some 20 years: immunotherapy.

 

Cancer immunotherapy is a largely experimental therapy which boosts the body's own immune system to fight cancer. Still in its infancy and only available within clinical trials, immunotherapy has been shown to be effective in about five per cent of patients with inoperable, advanced cancers that have spread throughout the body.

"It's been a niche area within cancer research, but it's shown huge promise," Professor Cebon says. "It's effective for five percent of patients now, but in five years' time, it could be much higher."

Cancer immunotherapy's future potential is so great that last year the journal Science declared it to be the scientific breakthrough of the year - something that may one day become the fourth pillar of cancer treatment, beside the three that oncologists have relied upon for decades: surgery, radiotherapy and chemotherapy.

Here at the Austin, a new Cancer Immunotherapy Clinic is opening out of the Olivia Newton-John Cancer & Wellness Centre. Building on nearly two decades of promising research here, the clinic will evaluate patients for their suitability to have their cancer treated with immunotherapy in one of a growing number of clinical trials.

For Daniel Morrissey, timing was everything. After all but exhausting other treatment options, a clinical trial became available at the Austin Hospital.

The trial was for the immunotherapy drug ipilimumab (or Yervoy). And even though Daniel was unable to finish the treatments, one of his tumours was eliminated entirely, and his other reduced to 20 per cent of its original size, found to no longer contain live cancer cells.

One day, it's hoped that chance and good timing won't be such important factors, as research advances enable a greater number of patients to access and benefit from cancer immunotherapy.

***


Please note that there is no guarantee of any benefit from participating in clinical trials. If you are interested, find out more about the Immunotherapy Clinic.

Daniel Morrissey's full story has been published by the Cancer Research Institute as part of its ‘30 days, 30 stories' series, at http://www.theanswertocancer.org/online-community-for-cancer-immunotherapy/stories-from-patients-and-caregivers/daniel-morrissey-patient-story

 

Austin celebrates as 250th patient steps into AVERT trial

AVERT trial recruits 250th patient
Austin Health has recruited its 250th patient for the AVERT trial

 

Joan Harris loves being active – she performs the mandolin in a number of bands and enjoys walking her beloved dog Vera.

When Joan found out she had suffered a stroke she was eager to do anything to hasten the return to the lifestyle she loves which is how she came to be the 250th patient to be recruited in Austin Health’s AVERT trial this week.

AVERT (A Very Early Rehabilitation Trial) aims to reduce both the personal and community burden of stroke by getting patients to begin exercising and rehabilitation as early as possible.

Just two days after she had a stroke while walking her dog, Joan is up and moving about the ward.

"I regained my strength pretty quickly and I’ve been moving around,’’ Joan says.

"My (late) husband was an inpatient here for four months and the physios were fantastic so I agreed to take part in the trial straight away."

Clinical Nurse Specialist Cassie Nunn has been involved with the AVERT trial for four years.

"I’ve found it interesting. It’s good to get people up and active as soon as possible hopefully enabling them to get home quicker,’’ Cassie explains.

Austin Health AVERT Trial coordinator and intervention physiotherapist, Hannah Williamson said recruiting the 250th patient was an exciting milestone for the many staff who have been part of the project for the past eight years.

AVERT is the largest international randomised controlled trial of very early rehabilitation ever conducted in stroke and has involved over 2000 patients since it began in 2006. The Austin was one of the first hospitals to get involved in the trial which now involves 50 hospitals from Australia, New Zealand, Singapore, Malaysia, Northern Ireland, Scotland, Wales and England. It is being coordinated by the National Stroke Research Institute which is a part of the Florey Institute of Neuroscience and Mental Health.

Patients in the intervention group receive very early rehabilitation while those in the control group receive standard care. It is thought that early mobilisation of patients in addition to standard care alone, will reduce death and disability in the three months after a stroke has occurred, reduce the number and severity of complications experienced by patients and improve quality of life.

The first of a series of results for the trial will be released at the European Stroke Organisation conference in April 2015.

 

Mary Bawden celebrates the gift of life

Mary Bawden - games participant

Mary Bawden may not be "particularly sporty" but she has a hectic schedule planned for the upcoming Australian Transplant Games.

The Frankston grandmother will take part in a range of events including swimming, petanque, shot put, the 3km walk and ball throw at the Games being held in Melbourne from September 28-October 4.

Her involvement in the Games is an example of how her liver transplant at Austin Health not only saved her life, but enriched it in many ways.

In the decade since her transplant at she has represented Australia at the World Transplant Games in Sweden while this will be her fifth Australian Transplant Games.

"I've met the most wonderful and inspiring people. I used to be an ordinary person and I still am I suppose but having a transplant has opened up a new world to me,'' Mary said.

Mary had a liver transplant after tests revealed she had primary sclerosing cholangitis (PSC) disease.

Prior to her diagnosis she led a busy life as a teacher but she became so sick she was unable to work.

Three weeks after her transplant she was able to attend her daughter's wedding and six months later she returned to work part-time.

She is incredibly grateful to her donor and their family.

"I've had 10 extra years and probably have many more to come,'' Mary said.

Mary said the spirit of the games was very much about celebrating the gift of life.

"It's a way to honour and say thank you to the donors that saved our lives,'' she said.

The Games are taking place at Albert Park and will be launched with a public awareness fun run and Opening Ceremony on 28 September.

About 1500 people touched by organ and tissue donation are expected to take part in the Games which incorporate 21 different sports, cultural activities and a junior program.

Organisers are encouraging people to volunteer at the Games. To find out how to register to volunteer or compete, visit www.australiantransplantgames.com 

To learn more about organ and tissue donation visit: http://www.donatelife.gov.au

Rinaldo Bellomo wins prestigious award

Professor Rinaldo Bellomo

Austin Health's Rinaldo Bellomo's contribution to intensive care medicine has been recognised with a prestigious award.

Professor Bellomo received a Victorian Royal Australasian College of Physicians 75th anniversary award in recognition of his exceptional contributions to clinical, teaching and research roles in intensive care medicine.

Award nominator, Dr Stephen Warrillow, said Rinaldo had made a "truly remarkable'' contribution to healthcare, research, governance and education over several decades.

"His efforts spring from the local level in Melbourne to influence patient care at a national and global level,'' Dr Warrillow said.

He said the Intensive Care Unit (ICU) Research Director provided an inspiring example to colleagues and trainees.

"His balance of science and humanity ensures that the application of knowledge is always encompassed in a respect for the dignity and humanity of the individual," Dr Warrillow said.

"As a physician researcher, he has a truly prodigious output, which has impacted the fundamentals of clinical care at a global level. He has published well over 800 peer reviewed scientific papers and has one of the highest impact factors in medical research in the country.''

Prof Bellomo was delighted and honoured to receive the award but admitted reflecting on his achievements isn't in his nature.

"I'm not really focused on the past that much - I always think about what else there is to do,'' Rinaldo explained.

One of his major achievements was his key role in the introduction of Medical Emergency Teams (METs) in hospitals across the world.

"This has made a very major contribution and has dramatically improved patient care in Australia, New Zealand, the USA and is now spreading through the Western world and developing nations," Rinaldo said.

"I think it is fair to say we have saved thousands of lives.''

The first MET team was introduced to the Austin Hospital by Prof Rinaldo and his team a decade ago. The MET team provides a structured way to deal with people who are unwell across the hospital - providing a rapid response to deteriorating patients who are heading towards a likely cardiac arrest. This shift from the traditional model of providing care to people in the wards has reduced the rate of cardiac arrests in the Austin Hospital by 66 per cent.

Prof Rinaldo's work in the development of better acute dialysis care for ICU patients with kidney failure has also saved thousands of lives worldwide. Key to this was proving through research, demonstrations and trials that intermittent dialysis was wrong and that continuous renal therapy was a better way to care for people.

"Progressively it has been taken up and has become standard care across the western world. It has been a long journey but it has been very gratifying," Prof Rinaldo said.

It is difficult to put an exact measure on the enormous impact of Prof Rinaldo's work, one thing that is certain though is that he will continue to make a huge impact for some time yet.
For Prof Rinaldo, retirement is "unthinkable''.

He quotes a verse from one of his favourite poems, Robert Frost's ‘Stopping by woods on a snowy evening'.

"But I have promises to keep and miles to go before I sleep. Miles to go before I sleep".
"I first read the poem when I was 17 and an exchange student in the US," Rinaldo said.

"It has stuck with me as an inspiration for the way I feel about life - I've got promises to myself, to the craft of medicine and there's so much to do, there's miles to go before I die,'' he said.

 

Epilepsy pioneer recognised

Professor Ingrid Scheffer is presented the BGRF medal

Austin's director of Paediatrics, child epilepsy expert Professor Ingrid Scheffer has been awarded the prestigious Bethlehem Griffiths Research Foundation (BGRF) Medal in recognition of the profound difference her research has made to the understanding, diagnosis and treatment of epilepsy.

Professor Scheffer's work has resulted in major paradigm shifts in the genetics of epilepsy, especially in severe childhood cases known as epileptic encephalopathies.

Professor Scheffer and her group have demonstrated that these disorders, which result in progressive deterioration in areas such as learning, behaviour and motor control, are frequently genetic and typically arise from a new mutation, rather than inherited from their parents.

Her discoveries have enabled a diagnosis in many cases, enabling the development of more effective treatments.

Accepting the BGRF Medal and $5,000 cheque, Professor Scheffer said it was humbling to receive a medal previously awarded to scientists who are unequivocally the crème de la crème of neuroscience researchers in Australia.

Presenting the BGRF Medal on behalf of the Foundation, fellow Austin researcher Professor Sam Berkovic emphasised the remarkable quality of Professor Scheffer's clinical research.

"Her rare skills were evident even at the beginning of her career in her PhD studies in the early 1990s when her work led to the discovery of the first epilepsy gene", Professor Berkovic said. "This PhD won the Chancellor's Prize at Melbourne University and Professor Scheffer has been a world leader in epilepsy gene identification ever since. Her body of work has also produced valuable insights into the biology of seizures and substantially changed practice and patient care within the field."

Professor Scheffer stressed the collaborative nature of her research, saying "My achievements would not have been possible in isolation. They are the result of the effort of our dedicated team working closely together with our collaborators around the world."

Professor Scheffer and her colleagues have described a range of novel epilepsy syndromes beginning in infancy, childhood and adult life, meaning that those with rarer epilepsies can be diagnosed earlier. She has also expanded our understanding of the spectrum of epilepsies associated with glucose transporter deficiency, opening opportunities for treatment through diet.

Professor Berkovic, himself a past winner of the BGRF Medal, said that Professor Scheffer has actually changed our concepts of the underlying neurobiology of genetic epilepsies. "I cannot over emphasise how important this work has been for many thousands of families affected by epilepsy and related conditions."

 

MumMoodBooster trial brings help into the home to new mums

mum and baby

Becoming a mum can be much harder than you expected. If you're feeling sad or depressed, struggling to cope with your baby, or find that you no longer get enjoyment from things, you could be experiencing postnatal depression. The good news is that depression is treatable. Our Parent Infant Research Institute is trialling the effectiveness of an Internet-based treatment.

The MumMoodBooster website uses cognitive-behavioural therapy in online sessions, supported by a weekly call from a psychologist phone coach, with the aim of helping new mums learn coping strategies to help manage their moods.

You need to be over 18, have a baby between 6 weeks and a year of age, and have the Internet and email at home to participate. You also can't be receiving any other treatment for depression.

All mums will have access to the online program either immediately or after 12 weeks, depending on which group you are put into. You will also be reimbursed $35 after completing the follow-up questionnaire.

If you're interested, contact Dr Jessica Ross at PIRI to find out if you're eligible, on (03) 9496 4496 or Jessica.Ross@austin.org.au - or read more about the study in the brochure.

 

The specialist team working with George

George and the team that got him home

George was 34 years old with two young sons when he was admitted to the Austin Hospital Intensive Care Unit (ICU) with swelling on his brain, following a brain operation.

George was well known to Austin staff from his previous hospital visits but this time was different.

George required a tracheostomy tube in his neck-an artificial airway that can be connected to a ventilator to help a patient breath. George was so unwell that he remained in the ICU for over a month.

This is the story of George and all the people who worked together to get him home. It is a story that involves family, carers and staff from many different parts of Austin Health all working with a specialist team of doctors, nurses, speech pathologists and physiotherapists who make up the Tracheostomy Review and Management Service (TRAMS), a team of staff who care for patients who have tracheostomy tubes. The team is recognised as a global leader in tracheostomy care.

Twenty other centres both nationally and internationally have implemented a service based on the Austin Health TRAMS program. The TRAMS team supported George every step of the journey through the Austin Hospital and the Royal Talbot Rehabilitation Centre. With the team by his side, George became stronger; he began eating and his speech was easier to understand. He began to set his sights on returning home but managing a tracheostomy tube at home would be challenging and everyone needed to be confident that he, his wife and other family members and carers could look after him safely.

Fourteen months after his initial admission to Austin Hospital, with his tracheostomy still in place, George returned home to his young family. He has not been readmitted since. This is a superb accomplishment and one which could not have been possible without the TRAMS team, the many staff involved in George's care across different wards at the Austin Hospital and the Royal
Talbot Rehabilitation Centre, and of course, his supportive family and loving wife, Felicia who has been the driving force behind getting him home.

Against all odds, and with the help of his strong team of specialists, George continues to make improvements. One day, everyone hopes George will be well enough to have his tube removed but for now, just being home with his family is a wonderful testimony to the collaborative effort of so many people who have been, and will continue to be, involved in his care.

George's journey shows how the people from different departments all work together to deliver the best possible care for patients:
  • TRAMS nurse: Our staff had the right skills and equipment to look after George and to help him transition back into the community. We continually monitored George's progress, assessed his tracheostomy to ensure it was working properly and educated him and his family about how to care for the tracheostomy.
  • TRAMS doctor: The unique aspect of the TRAMS service is that the same team follows the patient from acute care, through rehabilitation and back into the home. George's journey back into the community was made safe and possible with this support. The team worked closely with George, his numerous medical teams and his family.
  • Intensive Care Unit: George's needs were complex and his progress gradual. His ICU team worked with TRAMS to reduce the level of support George required so that he could move to the ward and start rehabilitation. Staff had constant communication with his wife, Felicia, whose support was important to his recovery.
  • Ward 6 West - Austin Hospital: Caring for patients like George, who have complex medical needs, is a team effort that requires excellent communication. As George improved, the plan for his treatment changed. These changes needed to be well communicated not only between staff but also to George and his family. Staff also did all they could to help George communicate as effectively as possible with his family.
  • Speech pathologists: We assessed and managed George's communication and swallowing issues throughout his journey allowing him to eventually eat, drink and speak again. For George to be able to speak with a tracheostomy, we provided him with a speaking valve which allowed him to communicate more easily.
  • Mellor Ward - Royal Talbot Rehabilitation Centre: Our major goal was to provide George with rehabilitation in order to maximise his independence so that he could return home. George's wife, Felicia was an enormous advocate for him during his stay and supported the staff to provide George with every opportunity to become independent.

Take care of yourself - and others - during the heatwave

glass of icy water

There is extreme weather forecast in Melbourne and other parts of Victoria over the next 4 days (January 14-17), with daytime highs averaging 40 degrees.

Take care of yourself, and look out for others. The most important thing is to keep cool and drink lots of water.

Take special care of the very young, the elderly and anyone you know of with a disease or who may be taking medication that affects their ability to regulate their temperature or look after themselves. For more detailed information about heat stress in the elderly, visit the Better Health Channel.

The Department of Health has issued a
‘heat health' alert for the entire week. Follow their advice to help prevent heat-related illnesses:

  • Drink plenty of water, even if you do not feel thirsty (if your doctor normally limits your fluids, check how much to drink during hot weather);
  • Keep yourself cool by using wet towels on your arms or neck, putting your feet in cool water and taking cool (not cold) showers;
  • Spend as much time as possible in cool or air-conditioned buildings (for example, shopping centres, libraries, cinemas or community centres);
  • Block out the sun during the day by closing curtains and blinds. Open windows when there is a cool breeze;
  • Do not leave children, adults or animals in parked vehicles;
  • Stay out of the sun during the hottest part of the day. If you must go out, stay in the shade and take plenty of water with you. Wear a hat and light-coloured, loose-fitting clothing;
  • Eat smaller meals more often and eat cold meals such as salads. Make sure food that needs refrigeration is properly stored;
  • Avoid strenuous activity like sport, home improvements and gardening; and,
  • Listen and watch out for news reports that provide more information during a heatwave.

If you have concerns, seek medical advice from your usual doctor or phone NURSE ON CALL - 1300 60 60 24.

Getting blood fast

blood

When patients need blood urgently, there is not a moment to waste. Staff at the Austin Health Blood Bank move quickly to deliver blood and save lives.

A red phone in the Pathology Department rings - a dedicated hotline set up to quickly communicate to Blood Bank staff that there is an immediate need for blood. It is all hands on deck.

It might be a patient with a critical bleed in the Intensive Care Unit or in the Emergency Department or it might be a minor operation that has gone wrong. The need for a massive blood transfusion could happen at any time.

Sometimes staff might receive warning; at other times they don't.

Kerry Skinner, nurse unit manager of Anaesthesia says improving the process involved in getting large quantities of blood to these patients as quickly as possible is crucial. "Timing is everything. The communication between Blood Bank and theatre can't miss a beat," she says.

Aiming to inject a greater sense of urgency and clarity into the system, a dedicated phone line was established and a red phone in Pathology was also set up. New protocols were also developed by Austin Health staff to ensure the most efficient and targeted response to a patient needing blood urgently and to clarify individual and team roles and responsibilities.

Now, when the red phone rings in Pathology once or twice per month, this desired sense of urgency is achieved. A senior staff member answers the phone and knows before even asking, that the new Massive Transfusion Protocol (MTP) is being activated.

Laboratory haematologist, Frank Hong says once the MTP is activated, a series of communication channels open up at once and there is a clear line of command.

Different areas of the laboratory immediately respond. "In the Blood Bank, the scientists get the blood ready. Other areas of the laboratory are notified such as the Central Specimen Reception, Haematology and Coagulation. All the samples from this particular patient with the urgent need for blood will be prioritised," he says.

The scientists immediately check to ensure sufficient blood stock is on hand. If it is not, the Australian Red Cross Blood Service is immediately contacted to obtain more.

Frank says the new process puts everyone on the same page. "A key difference in this process is that it involves a formal announcement that a massive blood transfusion is taking place. In the past, Blood Bank scientists would only realise they had such a scenario on their hands because they would be issuing out four or five units of blood in a very short amount of time. We would eventually realise what was going on. Now, there is no doubt about it. We are formally advised, we know what is going on and we can prioritise samples in our laboratory accordingly," he says.

What can you do to help? Visit the Australian Red Cross Blood Service to donate blood.

 

We can't do it without consumers and volunteers!

Consumers know what they want in a health service and that is why Austin
Health listens to them.

Ania Sieracka, consumer participation support officer, says consumers are engaged right across the organisation from the strategic board level to the community or local level.

"We don't know how our service is experienced without feedback. Listening to consumers tells us this. We learn how to improve our service. We learn what is important to consumers and what they want from a health service," she says.

Patients and their families provide personal feedback; friends and carers suggest ways the organisation can do things differently; and members of the community, who may take a local interest in Austin Health, can provide useful guidance, advice and input into decision-making.

Many people even join Austin Health as volunteers and become a part of the everyday workings of the hospital.

Consumers are invited to participate in forums for special projects such as the redesign of a particular service or the redevelopment of certain areas such as Specialist Clinics at the Heidelberg Repatriation Hospital.

Ania says bringing a consumer into the decision-making room ensures a fresh perspective.

"Input from consumers ensures that we stop and reflect on issues that we might not have thought of otherwise," she says.

Austin Health makes every effort to report back to consumers on what can or cannot be implemented and what is being worked towards.

‘My Say' feedback forms have also been implanted right across the organisation after having been successfully utilized at the Heidelberg Repatriation Hospital and the Royal Talbot Rehabilitation Centre for many years.

These forms offer an informal way for all consumers to provide Austin Health with their perspectives on the service.

Volunteering is an alternative way for consumers to become involved. Cherished by staff at Austin Health, volunteers offer conversation to patients; emotional support to families; direction to visitors; and extra assistance to staff, to name just a few of their many contributions.

Leonie Mutimer, manager of Volunteer Services, says a typical volunteer is kind and caring.

"Volunteers come from all walks of life, with men and women up to 90 years of age all offering their unique contribution," she says.

Some volunteers even recently celebrated 50 years of service!

Volunteer roles include guiding visitors and patients; helping nursing staff deliver food and drinks to patients; delivering newspapers; providing emotional support for patients (or their family and friends); and overseeing group activities.

Austin Health is looking for members of the community to help us maintain our high quality of patient care. For information about how to get involved, contact Ania Sieracka on 9496 5186.

To find out more about volunteering at Austin Health, visit http://www.austin.org.au/volunteering 

"Don't risk falling when nature is calling!"

The rate of falls on Ward 8 North has been reduced by 60 per cent in three years after focused efforts by staff and the development of an imaginative communications campaign.

Staff created three catchy slogans to engage patients and visitors on a ward where patients have a particularly high risk of falling. Printed on laminated posters, the slogans have been accompanied by significant efforts in staff training and education to reduce falls.

Nurse unit manager, Rebecca Monger, says her patients have a high risk of falling.

"We are an orthopaedic and plastics ward. Many of our patients are elderly and have broken bones. A fall might be the very reason they are with us. Patients might have osteoporosis or delirium. The patient might not realise that he or she cannot walk," she says.

Aiming to be ‘champions' in falls reduction, staff on Ward 8 North have shown what can be achieved with effort and imagination.

Their slogans, ‘Have you heard the news? Wear your shoes' and ‘Just call-avoid a fall!' are engaging and memorable.

Rebecca says staff on Ward 8 North will continue to look for ways to help patients avoid falling. "Beds that can be lowered to the floor were introduced so we can nurse a patient almost at floor level. We have mats next to some beds. Staff have been trained in delirium and falls management and so have our health assistants who can also keep closer supervision on patients who have had a fall or are at very high risk," she says.

Additionally, patient rounding has also helped, says Rebecca, because it ensures nurses visit patients proactively at least every hour. "Patient rounding works really well on this ward. The nurse talks to the patient at least every hour. Falls risks can be identified and steps can be taken to reduce the risk," she says.

This is just one of the initiatives featured in our 2013 Quality of Care Report - download the full report to read more!

Nearly $450,000 in grants to Austin LifeSciences researchers

Associate Professor David Edvardsson

What impact does oncology massage have on the experience of patients being treated for cancer?

Director of nursing research Associate Professor David Edvardsson studies how better patient experiences can improve health. He will investigate this latest question thanks to a $15,000 Austin Medical Research Foundation (AMRF) grant - one of 32 given to Austin LifeSciences researchers, that will fund nearly $450,000 of research projects in 2014.

The largest single grant, of $25,000, was awarded to Dr Theodora Fifis, who will study how immune cells contribute to tumour chemoresistance and recurrence.

Significant grants of $20,000 also went to Associate Professor James Olver, who will investigate a possible test for Bipolar Disorder based on the sleep hormone melatonin, and to Physiotherapy manager Associate Professor Sue Berney, who will study neuromuscular ultrasound and muscle weakness in intensive care.

See the full list of recipients.

The AMRF provides grants to allow researchers at Austin LifeSciences to explore innovative ideas. Many AMRF-funded projects have gone on to receive sought after NHMRC grants.

The research funded by the AMRF is translational: that is, research that is relevant to patients, and that quickly translates into new treatments and advances in patient care.

Unfortunately, the AMRF is unable to support all projects submitted. Your donation could help to finance the next major medical discovery: see their website to find out how to help.

 

Olivia Newton-­John opens the final stage of her Cancer & Wellness Centre at Austin Hospital!

Olivia Newton-John and Premier at the ONJCWC Stage 2 opening

Olivia Newton-­John formally opened the final stage of her Cancer & Wellness Centre at Austin Hospital on Friday 20 September.

Two levels of acute inpatient wards, the palliative care ward and a further two floors of research facilities will finally complete the Centre, which opened for outpatients last year.

The wards use cutting edge technology - the first of its kind in Australia - to improve patients' experiences on the ward. The sophisticated system (using Wi-­Fi electronic location tags, workflow terminals and a technologically advanced nurse call system) enhances communication between staff, to optimise staff time and attention to patients.

The philosophy of ‘wellness' is incorporated throughout the new wards. Patients can leave their hospital rooms and use gymnasiums, TV rooms and lounges, dining rooms, relaxation and reflection spaces, balcony gardens and even a multi-­sensory room using a selection of lighting, film sound and colour.

Ms Newton-­John says her vision has at last been realised. "I am so delighted that patients and their carers are finding such strength, support and peace from the Cancer & Wellness Centre. It's truly my dream come true."

With the building now complete, Ms Newton-­John's fundraising efforts will continue for the wellness programs which offer a full rangeof evidence-­based complementary therapies to help ease the stress, anxiety and side effects of cancer treatment.

The first stage of the Olivia Newton-­John Cancer & Wellness Centre opened in June 2012. Three of the seven levels in the Centre were opened including radiation oncology, day oncology, specialist cancer clinics, an Info Lounge specialising in providing patient information, the Ludwig Research laboratories, a staff collaboration space and the distinct Wellness Centre.

Austin Health wins big at the Victorian Public Healthcare Awards

The Nurse Endoscopy Initiation Service receiving their award

The excellence of Austin Health's staff was recognised with two awards at this year's Victorian Public Healthcare Awards.

The Nurse Endoscopy Service Initiation Team (pictured) won the Minister for Health's Award for achieving a highly capable and engaged workforce. It was a well-deserved win by the team of innovators, who are behind Australia's first nurse-led endoscopy training service.

Jomon Joseph, who is pictured centre, became Australia's only trainee nurse endoscopist in 2011 and this year began running his own patient lists and performing independent colonoscopies.

Austin Health is now helping other hospitals to implement training for nurse endoscopists, after receiving $2 million in funding to launch the State Endoscopy Training Centre.

Presenting the award, Minister for Health David Davis said that "the team has produced excellent health outcomes for patients, gained strong support from clinicians and led the way for other programs around Australia."

"For patients in the nurse-led endoscopy service, time spent on waiting lists for colonoscopies has halved from around 16-20 weeks to eight weeks."

The Wellness and Supportive Care Team from the Olivia Newton-John Cancer & Wellness Centre also took out the Minister's Award for Outstanding achievement by an individual or team in healthcare.

Mr Davis said the team have seized the opportunity provided by the development of the Olivia Newton-John Cancer & Wellness Centre to pioneer an innovative wellness program.

"The team has launched a unique program to promote the physical, psychological, informational, social and spiritual wellbeing of people affected by cancer," Mr Davis said.

"Core services include oncology massage and acupuncture, group support and exercise programs, music and art therapy, a cancer information and community engagement service and drop-in support.

"Since the Wellness Centre's opening in July 2012, the team has supported over 10,000 visits. The number of professionally facilitated groups available for patients has more than doubled, with 60 group support programs."

Congratulations also go to the team from Specialist Clinics behind the E-queuing project, which came a close runner-up in the Healthcare Innovation Award for Optimising healthcare through e-health & communications technology.