Publications by authors named "Michael Farrell"

Aims: This study tested the efficacy and safety of a 12-week course of lisdexamfetamine in reducing methamphetamine use, an outcome which is associated with improvements in health and wellbeing, in people dependent on methamphetamine.

Design, Setting And Participants: This study was a randomised double-blind placebo-controlled trial conducted in six specialist outpatient clinics in Adelaide, Melbourne, Newcastle and Sydney, Australia (2018-2021). Participants were164 adults with methamphetamine dependence, reporting at least 14 use days out of the previous 28 days (62% male, 38% female, < 1% other; mean age 39 years).

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Many forms of autoimmune encephalitis are mediated by neuronal cell-surface directed autoantibodies. The co-occurrence of four neuronal cell-surface antibodies in a single patient is exceptionally rare. We report a patient who had a severe encephalitis associated with antibodies to NMDA, Glycine, GABA and GABA receptors.

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Biosolids can provide a nutrient rich soil amendment, particularly for poor soils and semi-arid or drought-prone areas. However, there are concerns that sludge and biosolids could be a source of propagation and exposure to AMR determinants such as antibiotic resistant bacteria (ARB), and antibiotic resistance genes (ARGs). To inform risk assessment efforts, a systematic literature review was performed to build a comprehensive spreadsheet database of ARB and ARG concentrations in biosolids (and some sludges specified as intended for land application), along with 69 other quantitative and qualitative meta-data fields from 68 published studies describing sampling information and processing methods that can be used for modeling purposes.

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Background: Very few studies have examined the criminal careers of drug traffickers. Our aim in this study was to determine (a) the percentage of drug traffickers who cease involvement in crime following their first conviction for drug trafficking, (b) the factors that affect the likelihood and speed of re-offending among drug traffickers, (c) the factors that affect the rate of reoffending among drug traffickers and (d) the scale of drug trafficker involvement in crimes other than drug trafficking.

Methods: We characterize the criminal careers of a sample of 30,020 cases of offenders convicted of drug trafficking in New South Wales (NSW), Australia over the 29-year period between 2000 and 2023, focussing on how drug charge, trafficker type, and drug and alcohol use affect the risk and frequency of offending.

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Introduction: Hepatic angioembolization is highly effective for hemorrhage control in hemodynamically stable patients with traumatic liver injuries and contrast extravasation. However, there is a paucity of data regarding the specific location of angioembolization within the hepatic arterial vasculature and its implications on patient outcomes.

Methods: A post-hoc analysis of a multicenter prospective observational study across 23 centers was performed.

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Article Synopsis
  • Baclofen, prescribed for muscle spasms in Australia, has been linked to 102 deaths from 2000-2022, with a majority involving intentional toxicity and a significant presence of mental health and substance use issues among victims.
  • The average age of those who died was about 45.6 years, with 51% being male, and 73.5% had documented mental health problems.
  • The study highlights the importance of caution in prescribing baclofen due to its potential for misuse, dependency, and overdose.
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Background: Prior studies evaluating observation versus angioembolization (AE) for blunt liver injuries (BLT) with contrast extravasation (CE) on computed tomography imaging have yielded inconsistent conclusions, primarily due to limitations in single-center and/or retrospective study design. Therefore, this multicenter study aims to compare an observation versus AE-first approach for BLT, hypothesizing decreased liver-related complications (LRCs) with observation.

Methods: We conducted a post hoc analysis of a multicenter, prospective observational study (2019-2021) across 23 centers.

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  • Routine outcome monitoring (ROM) and feedback are important strategies for evaluating alcohol and drug treatment, but implementing them effectively poses challenges, requiring more research on client perspectives.
  • A study involving 26 Australian clients in AOD treatment revealed four key themes: the value of ROM in treatment, the necessity for clear outcome measures, a preference for visual feedback on progress, and the emotional difficulties that can arise from receiving feedback.
  • Participants emphasized that ROM is most effective when integrated into treatment with clear communication and visual aids, suggesting improvements like concise surveys and relevant feedback to enhance client engagement and treatment outcomes.
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  • The study focuses on the costs associated with providing medication-assisted treatment for opioid dependence using extended-release buprenorphine (BUP-XR) through a detailed bottom-up cost analysis.
  • Conducted in Australia, the research involved 100 participants receiving monthly BUP-XR injections, revealing an average annual treatment cost of $6,656 per client, with medication costs accounting for 95% of the monthly expense.
  • The findings suggest that investing in BUP-XR treatment could optimize health system resources, making this cost data valuable for evaluating its effectiveness compared to other opioid treatments.
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At the beginning of the COVID-19 pandemic, the Georgia Institute of Technology made the decision to keep the university doors open for on-campus attendance. To manage COVID-19 infection rates, internal resources were applied to develop and implement a mass asymptomatic surveillance program. The objective was to identify infections early for proper follow-on verification testing, contact tracing, and quarantine/isolation as needed.

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  • One third of organ donors experience catastrophic brain injury (CBI), but there’s no standardized management for traumatic CBI among trauma centers, leading to variability in practices.
  • A multicenter trial involving 33 trauma centers analyzed 790 CBI patients to investigate whether institutions with CBI guidelines had higher organ donation rates.
  • While centers with CBI guidelines showed greater use of certain treatments, the presence of guidelines did not significantly increase organ donation rates; however, hormone therapies were linked to a higher likelihood of donation.
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  • A study analyzed drug-related fatalities in the UK where individuals were found submerged in baths or hot tubs between 1997 and 2023, identifying case characteristics and drugs involved.* -
  • Of 162 deaths, the majority of victims were middle-aged white males, with an average of three drugs detected in each case; heroin, alcohol, and cocaine were the most common substances.* -
  • The results indicate a consistent annual occurrence of these fatalities, suggesting the need for public health campaigns advising against bathing while under the influence of drugs or alcohol.*
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  • GHB-related death rates in Australia remained stable from 2001 to 2015, but significantly increased from 2016 to 2021, with an annual percent change of 44.4% during the latter period.
  • Most deaths were due to unintentional toxicity (81.6%), and victims tended to be older, less employed, and more likely to have substance use and mental health issues compared to earlier years.
  • Despite the increased rates, the median blood GHB concentration remained relatively stable, while the occurrence of aspiration pneumonia in these cases decreased.
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Background: A major alcohol-related harm is structural pathology affecting the brain. The study aimed to: 1. Determine the frequency and nature of neuropathology amongst cases of death due to acute alcohol toxicity; 2.

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Epilepsy is a neurological disease characterised by recurrent seizures with complex aetiology. Temporal lobe epilepsy, the most common form in adults, can be acquired following brain insults including trauma, stroke, infection or sustained status epilepticus. The mechanisms that give rise to the formation and maintenance of hyperexcitable networks following acquired insults remain unknown, yet an extensive body of literature points towards persistent gene and epigenomic dysregulation as a potential mediator of this dysfunction.

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Background: Gambling behaviours have become of increased public health interest, but data on prevalence remain scarce. In this study, we aimed to estimate for adults and adolescents the prevalence of any gambling activity, the prevalence of engaging in specific gambling activities, the prevalence of any risk gambling and problematic gambling, and the prevalence of any risk and problematic gambling by gambling activity.

Methods: We performed a systematic review and meta-analysis.

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Background: Chronic pain involves communication between neural and immune systems. Recent data suggest localization of glial (brain immune cells) activation to the sensorimotor regions of the brain cortex (S1/M1) in chronic low back pain (LBP). As glia perform diverse functions that impact neural function, activation might contribute to sensorimotor changes, particularly in LBP maintained by increased nervous system sensitivity (i.

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Background: There are no approved pharmacotherapies for methamphetamine use disorder. Two preliminary phase 2 randomised controlled trials have found mirtazapine, a tetracyclic antidepressant, to be effective in reducing methamphetamine use. The proposed Tina Trial is the first phase 3 placebo-controlled randomised trial to examine the effectiveness and safety of mirtazapine as an outpatient pharmacotherapy for methamphetamine use disorder.

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The evaluation and workup of fever and the use of antibiotics to treat infections is part of daily practice in the surgical intensive care unit (ICU). Fever can be infectious or non-infectious; it is important to distinguish between the two entities wherever possible. The evidence is growing for shortening the duration of antibiotic treatment of common infections.

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