Advancing the management of obstructive airways diseases through translational research.

Obstructive airways diseases (OAD) represent a huge burden of illness world-wide, and in spite of the development of effective therapies, significant morbidity and mortality related to asthma and COPD still remains. Over the past decade, our understanding of OAD has improved vastly, and novel treatments have evolved. This evolution is the result of successful translational research, which has connected clinical presentations of OAD and underlying disease mechanisms, thereby enabling the development of targeted treatments.

Clonal wound re-epithelialisation after radiotherapy for skin cancer.

Simple clinical observations can give useful insights into biological processes in humans. Here we present a temporal series of pictures addressing the tissue response of a basal cell carcinoma to radiotherapy, where re-epithelialisation (RE) after radiotherapy appeared to occur by clonal regrowth, rather than the usually described sheet-like RE.

Molecular characterization of a novel Ljungan virus (Parechovirus; Picornaviridae) reveals a fourth genotype and indicates ancestral recombination.

Ljungan virus (LV) was discovered 20 years ago in Swedish bank voles (Myodes glareolus, previously referred to as Clethrionomys glareolus) during the search for an infectious agent causing lethal myocarditis in young athletes. To date, the genomes of four LV isolates, including the prototype 87-012 strain, have been characterized. Three of these LV strains were isolated from bank voles trapped in Sweden.

Prevalence of self-reported risk factors for medication misadventure among older people in general practice.

Objective: To describe the prevalence of risk factors for medication misadventures among older people in general practice.

Design: Descriptive cross-sectional analysis.

Setting: General practices, New South Wales, Australia.

Activation of Jun N-terminal kinase is a mediator of vincristine-induced apoptosis of melanoma cells.

The molecular changes involved in the induction of apoptosis by vincristine in melanoma have not yet been well defined. Two human melanoma cell lines showing moderate (Mel-RM) and high (IgR3) sensitivity to vincristine were selected from a panel of eight melanoma lines for analysis. Induction of apoptosis was caspase dependent, and was associated with increases in mitochondrial membrane permeability.

Fit and well at eighty: defying the stereotypes of age and illness.

While aging is associated with physical decline and increased risk of illness, older age is not inevitably a time of ill-being. Data from the Australian Longitudinal Study on Women's Health challenge negative stereotypes of aging and illness. While an accelerating decline in average physical health was observed over the first 6 years of the study, an important and large proportion of the women experienced minimal change in their physical health during this period.

Influence of hyperglycemia on stroke mortality.

Background: The influence of hyperglycemia on stroke mortality is controversial. The aim of this study was to investigate the prognostic role of hyperglycemia and diabetes on short-term and long-term mortality in patients with acute ischemic stroke.

Methods: This retrospective cohort study included 416 acute ischemic stroke patients admitted to a tertiary hospital between July 1, 1995 and June 30, 1997.

Limitations of the randomized controlled trial in evaluating population-based health interventions.

Population- and systems-based interventions need evaluation, but the randomized controlled trial (RCT) research design has significant limitations when applied to their complexity. After some years of being largely dismissed in the ranking of evidence in medicine, alternatives to the RCT have been debated recently in public health and related population and social service fields to identify the trade-offs in their use when randomization is impractical or unethical. This review summarizes recent debates and considers the pragmatic and economic issues associated with evaluating whole-population interventions while maintaining scientific validity and credibility.

Addressing sexually transmissible infection in HIV-positive patients. A clinical audit.

Australian guidelines for sexual history taking and sexually transmissible infection (STI) screening of HIV-positive patients do not exist. An audit was conducted to assess current practices of sexual history taking and STI testing of HIV-positive patients attending Hunter New England Sexual Health Unit.

An examination of the prescription and dispensing of medicines by Western herbal therapists: a national survey in Australia.

Objective: To describe the patterns of prescription and dispensing of herbal medicines employed by Western herbal practitioners in Australia.

Design: A national postal survey sent to all full members of the National Herbalist Association of Australia (NHAA).

Setting: Nationwide clinics of professional herbal practitioners in Australia.

Docetaxel-induced apoptosis of human melanoma is mediated by activation of c-Jun NH2-terminal kinase and inhibited by the mitogen-activated protein kinase extracellular signal-regulated kinase 1/2 pathway.

Purpose: Our studies have shown variable sensitivity of cultured melanoma cells to docetaxel. To better understand this response, we studied the role of signal transduction pathways in modulating docetaxel-induced melanoma killing.

Experimental Design: Involvement of c-Jun NH(2)-terminal kinase (JNK), extracellular signal-regulated kinase 1/2 (ERK1/2), p38 mitogen-activated protein kinase, and Akt signaling was studied by evaluating their extent of activation in melanoma cells after treatment with docetaxel.

Docetaxel-induced apoptosis in melanoma cells is dependent on activation of caspase-2.

Taxanes have a broad spectrum of activity against various human cancers, including melanoma. In this study, we have examined the molecular mechanism of docetaxel-induced apoptosis of human melanoma. We report that docetaxel induced varying degrees of apoptosis in a panel of melanoma cell lines but not in normal fibroblasts.

The validity of manual examination in assessing patients with neck pain.

Background Context: Although manual therapists believe that they can diagnose symptomatic joints in the neck by manual examination, that conviction is based on only one study. That study claimed that manual examination of the neck had 100% sensitivity and 100% specificity for diagnosing painful zygapophyseal joints. However, the study indicated that its results should be reproduced before they could be generalized.

Lectin and other histochemical studies of the articular cartilage and the chondro-osseous junction of the normal human knee joint.

There are few studies on normal, adult diarthrodial joints which look in detail at the histochemical properties of the chondro-osseous junctional region. This study of the normal human knee joint was performed using lectin and other histochemical techniques. There were differences in the reactions of mineralised cartilage compared to those of hyaline cartilage with the former demonstrating more collagen and less glycosaminoglycans.

Water consumption patterns in rural Bangladesh: are we underestimating total arsenic load?

Risk related to the ingestion of any water contaminants depends on many factors, including the daily per capita amount of consumed water relative to body weight. This study explored the water consumption pattern of a rural arsenic-affected population in Bangladesh. The study findings are likely to contribute to the risk estimation attributable to ingestion of arsenic and other drinking water contaminants.

Evidence-based care for low back pain in workers eligible for compensation.

Background: Although guidelines for the management of low back pain have been promoted, few studies have assessed their effectiveness. One previous study did not include patients with workers' compensation claims.

Aim: To assess the efficacy of evidence-based care for acute low back pain in patients eligible for workers' compensation.

Complex regional pain syndrome.

Despite its recommendation by the International Association for the Study of Pain, the term 'complex regional pain syndrome' has not been widely adopted. Most authors still prefer the term 'reflex sympathetic dystrophy'. The diagnostic criteria recommended by the International Association for the Study of Pain have been criticized as lacking specificity, and refined criteria have been proposed.

The normal human chondro-osseous junctional region: evidence for contact of uncalcified cartilage with subchondral bone and marrow spaces.

Background: The chondro-osseous junctional region of diarthrodial joints is peculiarly complex and may be considered to consist of the deepest layer of non-calcified cartilage, the tidemark, the layer of calcified cartilage, a thin cement line (between the calcified cartilage and the subchondral bone) and the subchondral bone. A detailed knowledge of the structure, function and pathophysiology of the normal chondro-osseous junction is essential for an understanding of the pathogenesis of osteoarthrosis.

Methods: Full thickness samples from human knee joints were processed and embedded in paraffin wax.

Human melanoma cells selected for resistance to apoptosis by prolonged exposure to tumor necrosis factor-related apoptosis-inducing ligand are more vulnerable to necrotic cell death induced by cisplatin.

Purpose: Heterogeneous sensitivity of melanoma cells to tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-induced apoptosis may lead to outgrowth of TRAIL-resistant cells and limit successful treatment by TRAIL. The present study aims to better understand the biological characteristics of melanoma cells resistant to TRAIL-induced apoptosis.

Experimental Design: We generated TRAIL-resistant melanoma cells by prolonged exposure to TRAIL and characterized the cells in terms of their sensitivity to killing induced by a panel of cytotoxic agents using biological and biochemical methods.

An exploratory study of complementary and alternative medicine in hospital midwifery: models of care and professional struggle.

Complementary and alternative medicine (CAM) is increasingly popular amongst midwives in Australia. A growing number of hospital midwives are personally integrating one or a range of CAM within their midwifery practice. Despite this trend we still know little about CAM in midwifery, particularly at a grass-roots level.

Identification of the insulin-like growth factor II receptor as a novel receptor for binding and invasion by Listeria monocytogenes.

The gram-positive bacterium Listeria monocytogenes causes a life-threatening disease known as listeriosis. The mechanism by which L. monocytogenes invades mammalian cells is not fully understood, but the processes involved may provide targets to prevent and treat listeriosis.

Genital injuries in women reporting sexual assault.

Background: The likelihood of genital injury following sexual assault remains unclear. Genital injury related to sexual assault is often an issue in court proceedings, with the expectation that injuries will be found in 'genuine' cases. Conviction rates are higher when the complainant has genital injuries.

The experience of insomnia among older women.

Study Objectives: To measure sleeping difficulty and sleep quality among older women, explore experience and attitudes towards sleep, and test for negative association between difficulty sleeping and health-related quality of life.

Design: Four-year longitudinal study.

Setting: Women were participants in the Australian Longitudinal Study on Women's Health.