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36 results on '"Marshall Plit"'

1. The prevalence and pattern of post tuberculosis lung disease including pulmonary hypertension from an Australian TB service; a single-centre, retrospective cohort study

Author: Anthony Byrne, Yasmeen Al-Hindawi, Marshall Plit, Louis Yeung, Standish Rigava, Meredith King, Kenneth Ng, and Sean F. Mungovan
Subjects: Post TB lung disease, Tuberculosis, Pulmonary hypertension, Bronchiectasis., Diseases of the respiratory system, RC705-779
Abstract: Abstract Introduction Post Tuberculosis Lung Disease (PTLD) is increasingly recognised as a significant cause of morbidity internationally, but has not been described in an Australian setting. We aimed to determine the prevalence of PTLD among adult TB survivors from an Australian TB service and describe the pattens of lung function abnormalities and pulmonary disease, including pulmonary hypertension. Methods We conducted a single-centre retrospective cohort study in Sydney, Australia, including all adults who successfully completed TB treatment between January 2013 and December 2022. Baseline characteristics, post treatment pulmonary function, and thoracic computed tomography (CT) data were analysed to determine the prevalence and patterns of PTLD, defined as any lung function and/or radiological abnormality attributable to TB. Results Among 119 confirmed TB patients (mean age 46 ± 21 years, 61% males) PTLD was identified in 81/119 (68%). Pulmonary function testing was available for 51/119 (43%), of whom 38/51(75%) exhibited abnormalities. Obstructive deficits were found in 25/51 (49%), restrictive deficits in 11/51 (22%), and impaired gas transfer capacity in 26/51 (51%). Chest CT scans were completed in 76/119 (64%), with 70/76 (92%) demonstrating significant abnormalities, including pulmonary fibrosis 43/76 (57%), bronchiectasis 22/76 (29%), and emphysema 11/76 (15%). Pulmonary hypertension was suspected in 52/76 (68%) patients based on radiological findings. Conclusion Despite successful treatment, PTLD was frequently observed among our cohort of Australian TB survivors. Further research into optimal screening practices to diagnose chronic pulmonary diseases and pulmonary hypertension could provide opportunities for earlier intervention and management.
Published: 2025
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2. Proteomic Analysis of Transbronchial Biopsy Tissue Reveals a Distinct Proteome and Mechanistic Pathways in High-Grade Eosinophilic Inflammation After Lung Transplantation

Author: Eisa Tahmasbpour, Ashleigh Philp, Tabitha Cree, Vanathi Sivasubramaniam, Claire Thomson, Marshall Plit, Anjaneyaswamy Ravipati, Mark Raftery, and David R. Darley
Subjects: lung transplantation, eosinophilia, acute cellular rejection, chronic lung allograft dysfunction, proteomics, Specialties of internal medicine, RC581-951
Published: 2025
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3. Bacille Calmette-Guérin vaccination to prevent febrile and respiratory illness in adults (BRACE): secondary outcomes of a randomised controlled phase 3 trialResearch in context

Author: Laure F. Pittet, Nicole L. Messina, Ellie McDonald, Francesca Orsini, Simone Barry, Marc Bonten, John Campbell, Julio Croda, Mariana G. Croda, Margareth Dalcolmo, Kaya Gardiner, Amanda Gwee, Bruno Jardim, Marcus V.G. Lacerda, Michaela Lucas, David J. Lynn, Laurens Manning, Kirsten P. Perrett, Jeffrey J. Post, Cristina Prat-Aymerich, Peter C. Richmond, Jorge L. Rocha, Jesus Rodriguez-Baño, Adilia Warris, Nicholas J. Wood, Andrew Davidson, Nigel Curtis, Tenaya Jamieson, Nicole Messina, Thilanka Morawakage, Susan Perlen, Kirsten Perrett, Laure Pittet, Amber Sastry, Jia Wei Teo, Katherine Lee, Cecilia Moore, Suzanna Vidmar, Rashida Ali, Ross Dunn, Peta Edler, Grace Gell, Casey Goodall, Richard Hall, Ann Krastev, Nathan La, Nick McPhate, Thao Nguyen, Jack Ren, Luke Stevens, Ahmed Alamrousi, Rhian Bonnici, Thanh Dang, Susie Germano, Jenny Hua, Rebecca McElroy, Monica Razmovska, Scott Reddiex, Xiaofang Wang, Jeremy Anderson, Kristy Azzopardi, Vicki Bennett-Wood, Anna Czajko, Nadia Mazarakis, Conor McCafferty, Frances Oppedisano, Belinda Ortika, Casey Pell, Leena Spry, Ryan Toh, Sunitha Velagapudi, Amanda Vlahos, Ashleigh Wee-Hee, Pedro Ramos, Karina De La Cruz, Dinusha Gamage, Anushka Karunanayake, Isabella Mezzetti, Benjamin Ong, Ronita Singh, Enoshini Sooriyarachchi, Suellen Nicholson, Natalie Cain, Rianne Brizuela, Han Huang, Veronica Abruzzo, Morgan Bealing, Patricia Bimboese, Kirsty Bowes, Emma Burrell, Joyce Chan, Jac Cushnahan, Hannah Elborough, Olivia Elkington, Kieran Fahey, Monique Fernandez, Catherine Flynn, Sarah Fowler, Marie Gentile Andrit, Bojana Gladanac, Catherine Hammond, Norine Ma, Sam Macalister, Emmah Milojevic, Jesutofunmi Mojeed, Jill Nguyen, Liz O'Donnell, Nadia Olivier, Isabelle Ooi, Stephanie Reynolds, Lisa Shen, Barb Sherry, Judith Spotswood, Jamie Wedderburn, Angela Younes, Donna Legge, Jason Bell, Jo Cheah, Annie Cobbledick, Kee Lim, Sonja Elia, Lynne Addlem, Anna Bourke, Clare Brophy, Nadine Henare, Narelle Jenkins, Francesca Machingaifa, Skye Miller, Kirsten Mitchell, Sigrid Pitkin, Kate Wall, Paola Villanueva, Nigel Crawford, Wendy Norton, Niki Tan, Thilakavathi Chengodu, Diane Dawson, Victoria Gordon, Tony Korman, Jess O'Bryan, Sophie Agius, Samantha Bannister, Jess Bucholc, Alison Burns, Beatriz Camesella, John Carlin, Marianna Ciaverella, Maxwell Curtis, Stephanie Firth, Christina Guo, Matthew Hannan, Erin Hill, Sri Joshi, Katherine Lieschke, Megan Mathers, Sasha Odoi, Ashleigh Rak, Chris Richards, Leah Steve, Carolyn Stewart, Eva Sudbury, Helen Thomson, Emma Watts, Fiona Williams, Angela Young, Penny Glenn, Andrew Kaynes, Amandine Philippart De Floy, Sandy Buchanan, Thijs Sondag, Ivy Xie, Harriet Edmund, Bridie Byrne, Tom Keeble, Belle Ngien, Fran Noonan, Michelle Wearing-Smith, Alison Clarke, Pemma Davies, Oliver Eastwood, Alric Ellinghaus, Rachid Ghieh, Zahra Hilton, Emma Jennings, Athina Kakkos, Iris Liang, Katie Nicol, Sally O'Callaghan, Helen Osman, Gowri Rajaram, Sophia Ratcliffe, Victoria Rayner, Ashleigh Salmon, Angela Scheppokat, Aimee Stevens, Rebekah Street, Nicholas Toogood, Nicholas Wood, Twinkle Bahaduri, Therese Baulman, Jennifer Byrne, Candace Carter, Mary Corbett, Aiken Dao, Maria Desylva, Andrew Dunn, Evangeline Gardiner, Rosemary Joyce, Rama Kandasamy, Craig Munns, Lisa Pelayo, Ketaki Sharma, Katrina Sterling, Caitlin Uren, Clinton Colaco, Mark Douglas, Kate Hamilton, Adam Bartlett, Brendan McMullan, Pamela Palasanthiran, Phoebe Williams, Justin Beardsley, Nikki Bergant, Renier Lagunday, Kristen Overton, Jeffrey Post, Yasmeen Al-Hindawi, Sarah Barney, Anthony Byrne, Lee Mead, Marshall Plit, David Lynn, Saoirse Benson, Stephen Blake, Rochelle Botten, Tee Yee Chern, Georgina Eden, Liddy Griffith, Jane James, Miriam Lynn, Angela Markow, Domenic Sacca, Natalie Stevens, Steve Wesselingh, Catriona Doran, Alice Sawka, Sue Evans, Louise Goodchild, Christine Heath, Meredith Krieg, Helen Marshall, Mark McMillan, Mary Walker, Peter Richmond, Nelly Amenyogbe, Christina Anthony, Annabelle Arnold, Beth Arrowsmith, Rym Ben-Othman, Sharon Clark, Jemma Dunnill, Nat Eiffler, Krist Ewe, Carolyn Finucane, Lorraine Flynn, Camille Gibson, Lucy Hartnell, Elysia Hollams, Heidi Hutton, Lance Jarvis, Jane Jones, Jan Jones, Karen Jones, Jennifer Kent, Tobias Kollmann, Debbie Lalich, Wenna Lee, Rachel Lim, Sonia McAlister, Fiona McDonald, Andrea Meehan, Asma Minhaj, Lisa Montgomery, Melissa O'Donnell, Jaslyn Ong, Joanne Ong, Kimberley Parkin, Glady Perez, Catherine Power, Shadie Rezazadeh, Holly Richmond, Sally Rogers, Nikki Schultz, Margaret Shave, Patrycja Skut, Lisa Stiglmayer, Alexandra Truelove, Ushma Wadia, Rachael Wallace, Justin Waring, Michelle England, Erin Latkovic, Susan Herrmann, Marcus Lacerda, Paulo Henrique Andrade, Fabiane Bianca Barbosa, Dayanne Barros, Larissa Brasil, Ana Greyce Capella, Ramon Castro, Erlane Costa, Dilcimar de Souza, Maianne Dias, José Dias, Klenilson Ferreira, Paula Figueiredo, Thamires Freitas, Ana Carolina Furtado, Larissa Gama, Vanessa Godinho, Cintia Gouy, Daniele Hinojosa, Tyane Jardim, Joel Junior, Augustto Lima, Bernardo Maia, Adriana Marins, Kelry Mazurega, Tercilene Medeiros, Rosangela Melo, Marinete Moraes, Elizandra Nascimento, Juliana Neves, Maria Gabriela Oliveira, Thais Oliveira, Ingrid Oliveira, Arthur Otsuka, Rayssa Paes, Handerson Pereira, Gabrielle Pereira, Christiane Prado, Evelyn Queiroz, Laleyska Rodrigues, Bebeto Rodrigues, Vanderson Sampaio, Anna Gabriela Santos, Daniel Santos, Tilza Santos, Evelyn Santos, Ariandra Sartim, Ana Beatriz Silva, Juliana Silva, Emanuelle Silva, Mariana Simão, Caroline Soares, Antonny Sousa, Alexandre Trindade, Fernando Val, Adria Vasconcelos, Heline Vasconcelos, Carolinne Abreu, Katya Martinez Almeida, Camila Bitencourt de Andrade, Jhenyfer Thalyta Campos Angelo, Ghislaine Gonçalvez de Araújo Arcanjo, Bianca Maria Silva Menezes Arruda, Wellyngthon Espindola Ayala, Adelita Agripina Refosco Barbosa, Felipe Zampieri Vieira Batista, Fabiani de Morais Batista, Miriam de Jesus Costa, Mariana Garcia Croda, Lais Alves da Cruz, Roberta Carolina Pereira Diogo, Rodrigo Cezar Dutra Escobar, Iara Rodrigues Fernandes, Leticia Ramires Figueiredo, Leandro Galdino Cavalcanti Gonçalves, Sarita Lahdo, Joyce dos Santos Lencina, Guilherme Teodoro de Lima, Bruna Tayara LEOPOLDINA MEIRELES, Debora Quadros Moreira, Lilian Batista Silva Muranaka, Adriely de Oliveira, Karla Regina Warszawski de Oliveira, Matheus Vieira de Oliveira, Roberto Dias de Oliveira, Andrea Antonia Souza de Almeida dos Reis Pereira, Marco Puga, Caroliny Veron Ramos, Thaynara Haynara Souza da Rosa, Karla Lopes dos Santos, Claudinalva Ribeiro dos Santos, Dyenyffer Stéffany Leopoldina dos Santos, Karina Marques Santos, Paulo César Pereira da Silva, Paulo Victor Rocha da Silva, Débora dos Santos Silva, Patricia Vieira da Silva, Bruno Freitas da Rosa Soares, Mariana Gazzoni Sperotto, Mariana Mayumi Tadokoro, Daniel Tsuha, Hugo Miguel Ramos Vieira, Margareth Maria Pretti Dalcolmo, Cíntia Maria Lopes Alves da Paixão, Gabriela Corrêa E Castro, Simone Silva Collopy, Renato da Costa Silva, Samyra Almeida da Silveira, Alda Maria Da-Cruz, Alessandra Maria da Silva Passos de Carvalho, Rita de Cássia Batista, Maria Luciana Silva De Freitas, Aline Gerhardt de Oliveira Ferreira, Ana Paula Conceição de Souza, Paola Cerbino Doblas, Ayla Alcoforado da Silva dos Santos, Vanessa Cristine de Moraes dos Santos, Dayane Alves dos Santos Gomes, Anderson Lage Fortunato, Adriano Gomes-Silva, Monique Pinto Gonçalves, Paulo Leandro Garcia Meireless Junior, Estela Martins da Costa Carvalho, Fernando do Couto Motta, Ligia Maria Olivo de Mendonça, Girlene dos Santos Pandine, Rosa Maria Plácido Pereira, Ivan Ramos Maia, Jorge Luiz da Rocha, João Victor Paiva Romano, Glauce dos Santos, Erica Fernandes da Silva, Marilda Agudo Mendonça Teixeira de Siqueira, Ágatha Cristinne Prudêncio Soares, Sandra Franch Arroyo, Henny Ophorst-den Besten, Anna Boon, Karin M. Brakke, Axel Janssen, Marijke A.H. Koopmans, Toos Lemmens, Titia Leurink, Engelien Septer-Bijleveld, Kimberly Stadhouders, Darren Troeman, Marije van der Waal, Marjoleine van Opdorp, Nicolette van Sluis, Beatrijs Wolters, Jan Kluytmans, Jannie Romme, Wouter van den Bijllaardt, Linda van Mook, M.M.L (Miranda) van Rijen, P.M.G. Filius, Jet Gisolf, Frances Greven, Danique Huijbens, Robert Jan Hassing, R.C. Pon, Lieke Preijers, J.H. van Leusen, Harald Verheij, Wim Boersma, Evelien Brans, Paul Kloeg, Kitty Molenaar-Groot, Nhat Khanh Nguyen, Nienke Paternotte, Anke Rol, Lida Stooper, Helga Dijkstra, Esther Eggenhuizen, Lucas Huijs, Simone Moorlag, Mihai Netea, Eva Pranger, Esther Taks, Jaap ten Oever, Rob ter Heine, Kitty Blauwendraat, Bob Meek, Isil Erkaya, Houda Harbech, Nienke Roescher, Rifka Peeters, Menno te Riele, Carmen Zhou, Esther Calbo, Cristina Badia Marti, Emma Triviño Palomares, Tomás Perez Porcuna, Anabel Barriocanal, Ana Maria Barriocanal, Irma Casas, Jose Dominguez, Maria Esteve, Alicia Lacoma, Irene Latorre, Gemma Molina, Barbara Molina, Antoni Rosell, Sandra Vidal, Lydia Barrera, Natalia Bustos, Ines Portillo Calderón, David Gutierrez Campos, Jose Manuel Carretero, Angel Dominguez Castellano, Renato Compagnone, Encarnacion Ramirez de Arellano, Almudena de la Serna, Maria Dolores del Toro Lopez, Marie-Alix Clement Espindola, Ana Belen Martin Gutierrez, Alvaro Pascual Hernandez, Virginia Palomo Jiménez, Elisa Moreno, Nicolas Navarrete, Teresa Rodriguez Paño, Jesús Rodríguez-Baño, Enriqueta Tristán, Maria Jose Rios Villegas, Atsegiñe Canga Garces, Erika Castro Amo, Raquel Coya Guerrero, Josune Goikoetxea, Leticia Jorge, Cristina Perez, María Carmen Fariñas Álvarez, Manuel Gutierrez Cuadra, Francisco Arnaiz de las Revillas Almajano, Pilar Bohedo Garcia, Teresa Giménez Poderos, Claudia González Rico, Blanca Sanchez, Olga Valero, Noelia Vega, Anna Barnes, Helen Catterick, Tim Cranston, Phoebe Dawe, Emily Fletcher, Liam Fouracre, Alison Gifford, Neil Gow, John Kirkwood, Christopher Martin, Amy McAnew, Marcus Mitchell, Georgina Newman, Abby O'Connell, Jakob Onysk, Lynne Quinn, Shelley Rhodes, Samuel Stone, Lorrie Symons, Harry Tripp, Darcy Watkins, Bethany Whale, Alex Harding, Gemma Lockhart, Kate Sidaway-Lee, Sam Hilton, Sarah Manton, Daniel Webber-Rookes, Rachel Winder, James Moore, Freya Bateman, Michael Gibbons, Bridget Knight, Julie Moss, Sarah Statton, Josephine Studham, Lydia Hall, Will Moyle, and Tamsin Venton
Subjects: Bacille Calmette-Guérin (BCG) vaccine, Immunity, Heterologous, Health personnel, Randomised controlled trial, Primary prevention, Medicine (General), R5-920
Abstract: Summary: Background: Bacille Calmette-Guérin (BCG) vaccination has off-target (non-specific) effects that are associated with protection against unrelated infections and decreased all-cause mortality in infants. We aimed to determine whether BCG vaccination prevents febrile and respiratory infections in adults. Methods: This randomised controlled phase 3 trial was done in 36 healthcare centres in Australia, Brazil, the Netherlands, Spain, and the United Kingdom. Healthcare workers were randomised to receive BCG-Denmark (single 0.1 ml intradermal injection) or no BCG in a 1:1 ratio using a web-based procedure, stratified by stage, site, age, and presence of co-morbidity. The difference in occurrence of febrile or respiratory illness were measured over 12 months (prespecified secondary outcome) using the intention-to-treat (ITT) population. This trial is registered with ClinicalTrials.gov, NCT04327206. Findings: Between March 30, 2020, and April 1, 2021, 6828 healthcare workers were randomised to BCG-Denmark (n = 3417) or control (n = 3411; no intervention or placebo) groups. The 12-month adjusted estimated risk of ≥1 episode of febrile or respiratory illness was 66.8% in the BCG group (95% CI 65.3%–68.2%), compared with 63.4% in the control group (95% CI 61.8%–65.0%), a difference of +3.4 percentage points (95% CI +1.3% to +5.5%; p 0.002). The adjusted estimated risk of a severe episode (defined as being incapacitated for ≥3 consecutive days or hospitalised) was 19.4% in the BCG group (95% CI 18.0%–20.7%), compared with 18.8% in the control group (95% CI 17.4%–20.2%) a difference of +0.6 percentage points (95% CI −1.3% to +2.5%; p 0.6). Both groups had a similar number of episodes of illness, pneumonia, and hospitalisation. There were three deaths, all in the control group. There were no safety concerns following BCG vaccination. Interpretation: In contrast to the beneficial off-target effects reported following neonatal BCG in infants, a small increased risk of symptomatic febrile or respiratory illness was observed in the 12 months following BCG vaccination in adults. There was no evidence of a difference in the risk of severe disease. Funding: Bill & Melinda Gates Foundation, Minderoo Foundation, Sarah and Lachlan Murdoch, the Royal Children's Hospital Foundation, Health Services Union NSW, the Peter Sowerby Foundation, SA Health, the Insurance Advisernet Foundation, the NAB Foundation, the Calvert-Jones Foundation, the Modara Pines Charitable Foundation, the UHG Foundation Pty Ltd, Epworth Healthcare, the National Health and Medical Research Council, the Swiss National Science Foundation and individual donors.
Published: 2024
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4. Specific and off-target immune responses following COVID-19 vaccination with ChAdOx1-S and BNT162b2 vaccines—an exploratory sub-study of the BRACE trialResearch in context

Author: Nicole L. Messina, Susie Germano, Rebecca McElroy, Rhian Bonnici, Branka Grubor-Bauk, David J. Lynn, Ellie McDonald, Suellen Nicholson, Kirsten P. Perrett, Laure F. Pittet, Rajeev Rudraraju, Natalie E. Stevens, Kanta Subbarao, Nigel Curtis, Andrew Davidson, Kaya Gardiner, Amanda Gwee, Tenaya Jamieson, Nicole Messina, Thilanka Morawakage, Susan Perlen, Kirsten Perrett, Laure Pittet, Amber Sastry, Jia Wei Teo, Francesca Orsini, Katherine Lee, Cecilia Moore, Suzanna Vidmar, Rashida Ali, Ross Dunn, Peta Edler, Grace Gell, Casey Goodall, Richard Hall, Ann Krastev, Nathan La, Nick McPhate, Thao Nguyen, Jack Ren, Luke Stevens, Ahmed Alamrousi, Thanh Dang, Jenny Hua, Monica Razmovska, Scott Reddiex, Xiaofang Wang, Jeremy Anderson, Kristy Azzopardi, Vicki Bennett-Wood, Anna Czajko, Nadia Mazarakis, Conor McCafferty, Frances Oppedisano, Belinda Ortika, Casey Pell, Leena Spry, Ryan Toh, Sunitha Velagapudi, Amanda Vlahos, Ashleigh Wee-Hee, Pedro Ramos, Karina De La Cruz, Dinusha Gamage, Anushka Karunanayake, Isabella Mezzetti, Benjamin Ong, Ronita Singh, Enoshini Sooriyarachchi, Natalie Cain, Rianne Brizuela, Han Huang, Veronica Abruzzo, Morgan Bealing, Patricia Bimboese, Kirsty Bowes, Emma Burrell, Joyce Chan, Jac Cushnahan, Hannah Elborough, Olivia Elkington, Kieran Fahey, Monique Fernandez, Catherine Flynn, Sarah Fowler, Marie Gentile Andrit, Bojana Gladanac, Catherine Hammond, Norine Ma, Sam Macalister, Emmah Milojevic, Jesutofunmi Mojeed, Jill Nguyen, Liz O’Donnell, Nadia Olivier, Isabelle Ooi, Stephanie Reynolds, Lisa Shen, Barb Sherry, Judith Spotswood, Jamie Wedderburn, Angela Younes, Donna Legge, Jason Bell, Jo Cheah, Annie Cobbledick, Kee Lim, Sonja Elia, Lynne Addlem, Anna Bourke, Clare Brophy, Nadine Henare, Narelle Jenkins, Francesca Machingaifa, Skye Miller, Kirsten Mitchell, Sigrid Pitkin, Kate Wall, Paola Villanueva, Nigel Crawford, Wendy Norton, Niki Tan, Thilakavathi Chengodu, Diane Dawson, Victoria Gordon, Tony Korman, Jess O’Bryan, Sophie Agius, Samantha Bannister, Jess Bucholc, Alison Burns, Beatriz Camesella, John Carlin, Marianna Ciaverella, Maxwell Curtis, Stephanie Firth, Christina Guo, Matthew Hannan, Erin Hill, Sri Joshi, Katherine Lieschke, Megan Mathers, Sasha Odoi, Ashleigh Rak, Chris Richards, Leah Steve, Carolyn Stewart, Eva Sudbury, Helen Thomson, Emma Watts, Fiona Williams, Angela Young, Penny Glenn, Andrew Kaynes, Amandine Philippart De Floy, Sandy Buchanan, Thijs Sondag, Ivy Xie, Harriet Edmund, Bridie Byrne, Tom Keeble, Belle Ngien, Fran Noonan, Michelle Wearing-Smith, Alison Clarke, Pemma Davies, Oliver Eastwood, Alric Ellinghaus, Rachid Ghieh, Zahra Hilton, Emma Jennings, Athina Kakkos, Iris Liang, Katie Nicol, Sally O’Callaghan, Helen Osman, Gowri Rajaram, Sophia Ratcliffe, Victoria Rayner, Ashleigh Salmon, Angela Scheppokat, Aimee Stevens, Rebekah Street, Nicholas Toogood, Nicholas Wood, Twinkle Bahaduri, Therese Baulman, Jennifer Byrne, Candace Carter, Mary Corbett, Aiken Dao, Maria Desylva, Andrew Dunn, Evangeline Gardiner, Rosemary Joyce, Rama Kandasamy, Craig Munns, Lisa Pelayo, Ketaki Sharma, Katrina Sterling, Caitlin Uren, Clinton Colaco, Mark Douglas, Kate Hamilton, Adam Bartlett, Brendan McMullan, Pamela Palasanthiran, Phoebe Williams, Justin Beardsley, Nikki Bergant, Renier Lagunday, Kristen Overton, Jeffrey Post, Yasmeen Al-Hindawi, Sarah Barney, Anthony Byrne, Lee Mead, Marshall Plit, David Lynn, Saoirse Benson, Stephen Blake, Rochelle Botten, Tee Yee Chern, Georgina Eden, Liddy Griffith, Jane James, Miriam Lynn, Angela Markow, Domenic Sacca, Natalie Stevens, Steve Wesselingh, Catriona Doran, Simone Barry, Alice Sawka, Sue Evans, Louise Goodchild, Christine Heath, Meredith Krieg, Helen Marshall, Mark McMillan, Mary Walker, Peter Richmond, Nelly Amenyogbe, Christina Anthony, Annabelle Arnold, Beth Arrowsmith, Rym Ben-Othman, Sharon Clark, Jemma Dunnill, Nat Eiffler, Krist Ewe, Carolyn Finucane, Lorraine Flynn, Camille Gibson, Lucy Hartnell, Elysia Hollams, Heidi Hutton, Lance Jarvis, Jane Jones, Jan Jones, Karen Jones, Jennifer Kent, Tobias Kollmann, Debbie Lalich, Wenna Lee, Rachel Lim, Sonia McAlister, Fiona McDonald, Andrea Meehan, Asma Minhaj, Lisa Montgomery, Melissa O’Donnell, Jaslyn Ong, Joanne Ong, Kimberley Parkin, Glady Perez, Catherine Power, Shadie Rezazadeh, Holly Richmond, Sally Rogers, Nikki Schultz, Margaret Shave, Patrycja Skut, Lisa Stiglmayer, Alexandra Truelove, Ushma Wadia, Rachael Wallace, Justin Waring, Michelle England, Erin Latkovic, Laurens Manning, Susan Herrmann, Michaela Lucas, Marcus Lacerda, Paulo Henrique Andrade, Fabiane Bianca Barbosa, Dayanne Barros, Larissa Brasil, Ana Greyce Capella, Ramon Castro, Erlane Costa, Dilcimar de Souza, Maianne Dias, José Dias, Klenilson Ferreira, Paula Figueiredo, Thamires Freitas, Ana Carolina Furtado, Larissa Gama, Vanessa Godinho, Cintia Gouy, Daniele Hinojosa, Bruno Jardim, Tyane Jardim, Joel Junior, Augustto Lima, Bernardo Maia, Adriana Marins, Kelry Mazurega, Tercilene Medeiros, Rosangela Melo, Marinete Moraes, Elizandra Nascimento, Juliana Neves, Maria Gabriela Oliveira, Thais Oliveira, Ingrid Oliveira, Arthur Otsuka, Rayssa Paes, Handerson Pereira, Gabrielle Pereira, Christiane Prado, Evelyn Queiroz, Laleyska Rodrigues, Bebeto Rodrigues, Vanderson Sampaio, Anna Gabriela Santos, Daniel Santos, Tilza Santos, Evelyn Santos, Ariandra Sartim, Ana Beatriz Silva, Juliana Silva, Emanuelle Silva, Mariana Simão, Caroline Soares, Antonny Sousa, Alexandre Trindade, Fernando Val, Adria Vasconcelos, Heline Vasconcelos, Julio Croda, Carolinne Abreu, Katya Martinez Almeida, Camila Bitencourt de Andrade, Jhenyfer Thalyta Campos Angelo, Ghislaine Gonçalvez de Araújo Arcanjo, Bianca Maria Silva Menezes Arruda, Wellyngthon Espindola Ayala, Adelita Agripina Refosco Barbosa, Felipe Zampieri Vieira Batista, Fabiani de Morais Batista, Miriam de Jesus Costa, Mariana Garcia Croda, Lais Alves da Cruz, Roberta Carolina Pereira Diogo, Rodrigo Cezar Dutra Escobar, Iara Rodrigues Fernandes, Leticia Ramires Figueiredo, Leandro Galdino Cavalcanti Gonçalves, Sarita Lahdo, Joyce dos Santos Lencina, Guilherme Teodoro de Lima, Larissa Santos Matos, Bruna Tayara Leopoldina Meireles, Debora Quadros Moreira, Lilian Batista Silva Muranaka, Adriely de Oliveira, Karla Regina Warszawski de Oliveira, Matheus Vieira de Oliveira, Roberto Dias de Oliveira, Andrea Antonia Souza de Almeida dos Reis Pereira, Marco Puga, Caroliny Veron Ramos, Thaynara Haynara Souza da Rosa, Karla Lopes dos Santos, Claudinalva Ribeiro dos Santos, Dyenyffer Stéffany Leopoldina dos Santos, Karina Marques Santos, Paulo César Pereira da Silva, Paulo Victor Rocha da Silva, Débora dos Santos Silva, Patricia Vieira da Silva, Bruno Freitas da Rosa Soares, Mariana Gazzoni Sperotto, Mariana Mayumi Tadokoro, Daniel Tsuha, Hugo Miguel Ramos Vieira, Margareth Maria Pretti Dalcolmo, Cíntia Maria Lopes Alves da Paixão, Gabriela Corrêa E Castro, Simone Silva Collopy, Renato da Costa Silva, Samyra Almeida da Silveira, Alda Maria Da-Cruz, Alessandra Maria da Silva Passos de Carvalho, Rita de Cássia Batista, Maria Luciana Silva De Freitas, Aline Gerhardt de Oliveira Ferreira, Ana Paula Conceição de Souza, Paola Cerbino Doblas, Ayla Alcoforado da Silva dos Santos, Vanessa Cristine de Moraes dos Santos, Dayane Alves dos Santos Gomes, Anderson Lage Fortunato, Adriano Gomes-Silva, Monique Pinto Gonçalves, Paulo Leandro Garcia Meireless Junior, Estela Martins da Costa Carvalho, Fernando do Couto Motta, Ligia Maria Olivo de Mendonça, Girlene dos Santos Pandine, Rosa Maria Plácido Pereira, Ivan Ramos Maia, Jorge Luiz da Rocha, João Victor Paiva Romano, Glauce dos Santos, Erica Fernandes da Silva, Marilda Agudo Mendonça Teixeira de Siqueira, Ágatha Cristinne Prudêncio Soares, Marc Bonten, Sandra Franch Arroyo, Henny Ophorst-den Besten, Anna Boon, Karin M. Brakke, Axel Janssen, Marijke A.H. Koopmans, Toos Lemmens, Titia Leurink, Cristina Prat-Aymerich, Engelien Septer-Bijleveld, Kimberly Stadhouders, Darren Troeman, Marije van der Waal, Marjoleine van Opdorp, Nicolette van Sluis, Beatrijs Wolters, Jan Kluytmans, Jannie Romme, Wouter van den Bijllaardt, Linda van Mook, M.M.L (Miranda) van Rijen, Margreet Filius, Jet Gisolf, Frances Greven, Danique Huijbens, Robert Jan Hassing, Roos Pon, Lieke Preijers, Joke van Leusen, Harald Verheij, Wim Boersma, Evelien Brans, Paul Kloeg, Kitty Molenaar-Groot, Nhat Khanh Nguyen, Nienke Paternotte, Anke Rol, Lida Stooper, Helga Dijkstra, Esther Eggenhuizen, Lucas Huijs, Simone Moorlag, Mihai Netea, Eva Pranger, Esther Taks, Jaap ten Oever, Rob ter Heine, Kitty Blauwendraat, Bob Meek, Isil Erkaya, Houda Harbech, Nienke Roescher, Rifka Peeters, Menno te Riele, Carmen Zhou, Esther Calbo, Cristina Badia Marti, Emma Triviño Palomares, Tomás Perez Porcuna, Anabel Barriocanal, Ana Maria Barriocanal, Irma Casas, Jose Dominguez, Maria Esteve, Alicia Lacoma, Irene Latorre, Gemma Molina, Barbara Molina, Antoni Rosell, Sandra Vidal, Lydia Barrera, Natalia Bustos, Ines Portillo Calderón, David Gutierrez Campos, Jose Manuel Carretero, Angel Dominguez Castellano, Renato Compagnone, Encarnacion Ramirez de Arellano, Almudena de la Serna, Maria Dolores del Toro Lopez, Marie-Alix Clement Espindola, Ana Belen Martin Gutierrez, Alvaro Pascual Hernandez, Virginia Palomo Jiménez, Elisa Moreno, Nicolas Navarrete, Teresa Rodriguez Paño, Jesús Rodríguez-Baño, Enriqueta Tristán, Maria Jose Rios Villegas, Atsegiñe Canga Garces, Erika Castro Amo, Raquel Coya Guerrero, Josune Goikoetxea, Leticia Jorge, Cristina Perez, María Carmen Fariñas Álvarez, Manuel Gutierrez Cuadra, Francisco Arnaiz de las Revillas Almajano, Pilar Bohedo Garcia, Teresa Giménez Poderos, Claudia González Rico, Blanca Sanchez, Olga Valero, Noelia Vega, John Campbell, Anna Barnes, Helen Catterick, Tim Cranston, Phoebe Dawe, Emily Fletcher, Liam Fouracre, Alison Gifford, John Kirkwood, Christopher Martin, Amy McAnew, Marcus Mitchell, Georgina Newman, Abby O’Connell, Jakob Onysk, Lynne Quinn, Shelley Rhodes, Samuel Stone, Lorrie Symons, Harry Tripp, Adilia Warris, Darcy Watkins, Bethany Whale, Alex Harding, Gemma Lockhart, Kate Sidaway-Lee, Sam Hilton, Sarah Manton, Daniel Webber-Rookes, Rachel Winder, James Moore, Freya Bateman, Michael Gibbons, Bridget Knight, Julie Moss, Sarah Statton, Josephine Studham, Lydia Hall, Will Moyle, and Tamsin Venton
Subjects: Vaccine, Off-target, Immunoregulation, Cytokine, SARS-CoV-2, Heterologous immunity, Medicine, Medicine (General), R5-920
Abstract: Summary: Background: The COVID-19 pandemic led to the rapid development and deployment of several highly effective vaccines against SARS-CoV-2. Recent studies suggest that these vaccines may also have off-target effects on the immune system. We sought to determine and compare the off-target effects of the adenovirus vector ChAdOx1-S (Oxford-AstraZeneca) and modified mRNA BNT162b2 (Pfizer-BioNTech) vaccines on immune responses to unrelated pathogens. Methods: Prospective sub-study within the BRACE trial. Blood samples were collected from 284 healthcare workers before and 28 days after ChAdOx1-S or BNT162b2 vaccination. SARS-CoV-2-specific antibodies were measured using ELISA, and whole blood cytokine responses to specific (SARS-CoV-2) and unrelated pathogen stimulation were measured by multiplex bead array. Findings: Both vaccines induced robust SARS-CoV-2 specific antibody and cytokine responses. ChAdOx1-S vaccination increased cytokine responses to heat-killed (HK) Candida albicans and HK Staphylococcus aureus and decreased cytokine responses to HK Escherichia coli and BCG. BNT162b2 vaccination decreased cytokine response to HK E. coli and had variable effects on cytokine responses to BCG and resiquimod (R848). After the second vaccine dose, BNT162b2 recipients had greater specific and off-target cytokine responses than ChAdOx1-S recipients. Interpretation: ChAdOx1-S and BNT162b2 vaccines alter cytokine responses to unrelated pathogens, indicative of potential off-target effects. The specific and off-target effects of these vaccines differ in their magnitude and breadth. The clinical relevance of these findings is uncertain and needs further study. Funding: Bill & Melinda Gates Foundation, National Health and Medical Research Council, Swiss National Science Foundation and the Melbourne Children’s. BRACE trial funding is detailed in acknowledgements.
Published: 2024
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5. Oscillometry in Stable Single and Double Lung Allograft Recipients Transplanted for Interstitial Lung Disease: Results of a Multi-Center Australian Study

Author: Joan P. Y. Sim, Kristopher Nilsen, Brigitte M. Borg, Bronwyn Levvey, Jaideep Vazirani, Samantha Ennis, Marshall Plit, Gregory I. Snell, David R. Darley, and Katrina O. Tonga
Subjects: interstitial lung disease, resistance, oscillometry, single and double lung transplantation, reactance, Specialties of internal medicine, RC581-951
Abstract: Peak spirometry after single lung transplantation (SLTx) for interstitial lung disease (ILD) is lower than after double lung transplantation (DLTx), however the pathophysiologic mechanisms are unclear. We aim to assess respiratory mechanics in SLTx and DLTx for ILD using oscillometry. Spirometry and oscillometry (tremoflo® C-100) were performed in stable SLTx and DLTx recipients in a multi-center study. Resistance (R5, R5–19) and reactance (X5) were compared between LTx recipient groups, matched by age and gender. A model of respiratory impedance using ILD and DLTx data was performed. In total, 45 stable LTx recipients were recruited (SLTx n = 23, DLTx n = 22; males: 87.0% vs. 77.3%; median age 63.0 vs. 63.0 years). Spirometry was significantly lower after SLTx compared with DLTx: %-predicted mean (SD) FEV1 [70.0 (14.5) vs. 93.5 (26.0)%]; FVC [70.5 (16.8) vs. 90.7 (12.8)%], p < 0.01. R5 and R5–19 were similar between groups (p = 0.94 and p = 0.11, respectively) yet X5 was significantly worse after SLTx: median (IQR) X5 [−1.88 (−2.89 to −1.39) vs. −1.22 (−1.87 to −0.86)] cmH2O.s/L], p < 0.01. R5 and X5 measurements from the model were congruent with measurements in SLTx recipients. The similarities in resistance, yet differences in spirometry and reactance between both transplant groups suggest the important contribution of elastic properties to the pathophysiology. Oscillometry may provide further insight into the physiological changes occurring post-LTx.
Published: 2023
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6. Bacillus Calmette-Guérin vaccination for protection against recurrent herpes labialis: a nested randomised controlled trialResearch in context

Author: Laure F. Pittet, Cecilia L. Moore, Ellie McDonald, Simone Barry, Marc Bonten, John Campbell, Julio Croda, Margareth Dalcolmo, Andrew Davidson, Mark W. Douglas, Kaya Gardiner, Amanda Gwee, Bruno Jardim, Marcus V.G. Lacerda, Michaela Lucas, David J. Lynn, Laurens Manning, Roberto D. de Oliveira, Kirsten P. Perrett, Cristina Prat-Aymerich, Peter C. Richmond, Jorge L. Rocha, Jesus Rodriguez-Baño, Adilia Warris, Nicholas J. Wood, Nicole L. Messina, Nigel Curtis, Tenaya Jamieson, Nicole Messina, Thilanka Morawakage, Susan Perlen, Kirsten Perrett, Laure Pittet, Amber Sastry, Jia Wei Teo, Francesca Orsini, Katherine Lee, Cecilia Moore, Suzanna Vidmar, Rashida Ali, Ross Dunn, Peta Edler, Grace Gell, Casey Goodall, Richard Hall, Ann Krastev, Nathan La, Nick McPhate, Thao Nguyen, Jack Ren, Luke Stevens, Ahmed Alamrousi, Rhian Bonnici, Thanh Dang, Susie Germano, Jenny Hua, Rebecca McElroy, Monica Razmovska, Scott Reddiex, Xiaofang Wang, Jeremy Anderson, Kristy Azzopardi, Vicki Bennett-Wood, Anna Czajko, Nadia Mazarakis, Conor McCafferty, Frances Oppedisano, Belinda Ortika, Casey Pell, Leena Spry, Ryan Toh, Sunitha Velagapudi, Amanda Vlahos, Ashleigh Wee-Hee, Pedro Ramos, Karina De La Cruz, Dinusha Gamage, Anushka Karunanayake, Isabella Mezzetti, Benjamin Ong, Ronita Singh, Enoshini Sooriyarachchi, Suellen Nicholson, Natalie Cain, Rianne Brizuela, Han Huang, Veronica Abruzzo, Morgan Bealing, Patricia Bimboese, Kirsty Bowes, Emma Burrell, Joyce Chan, Jac Cushnahan, Hannah Elborough, Olivia Elkington, Kieran Fahey, Monique Fernandez, Catherine Flynn, Sarah Fowler, Marie Gentile Andrit, Bojana Gladanac, Catherine Hammond, Norine Ma, Sam Macalister, Emmah Milojevic, Jesutofunmi Mojeed, Jill Nguyen, Liz O'Donnell, Nadia Olivier, Isabelle Ooi, Stephanie Reynolds, Lisa Shen, Barb Sherry, Judith Spotswood, Jamie Wedderburn, Angela Younes, Donna Legge, Jason Bell, Jo Cheah, Annie Cobbledick, Kee Lim, Sonja Elia, Lynne Addlem, Anna Bourke, Clare Brophy, Nadine Henare, Narelle Jenkins, Francesca Machingaifa, Skye Miller, Kirsten Mitchell, Sigrid Pitkin, Kate Wall, Paola Villanueva, Nigel Crawford, Wendy Norton, Niki Tan, Thilakavathi Chengodu, Diane Dawson, Victoria Gordon, Tony Korman, Jess O'Bryan, Sophie Agius, Samantha Bannister, Jess Bucholc, Alison Burns, Beatriz Camesella, John Carlin, Marianna Ciaverella, Maxwell Curtis, Stephanie Firth, Christina Guo, Matthew Hannan, Erin Hill, Sri Joshi, Katherine Lieschke, Megan Mathers, Sasha Odoi, Ashleigh Rak, Chris Richards, Leah Steve, Carolyn Stewart, Eva Sudbury, Helen Thomson, Emma Watts, Fiona Williams, Angela Young, Penny Glenn, Andrew Kaynes, Amandine Philippart De Floy, Sandy Buchanan, Thijs Sondag, Ivy Xie, Harriet Edmund, Bridie Byrne, Tom Keeble, Belle Ngien, Fran Noonan, Michelle Wearing-Smith, Alison Clarke, Pemma Davies, Oliver Eastwood, Alric Ellinghaus, Rachid Ghieh, Zahra Hilton, Emma Jennings, Athina Kakkos, Iris Liang, Katie Nicol, Sally O'Callaghan, Helen Osman, Gowri Rajaram, Sophia Ratcliffe, Victoria Rayner, Ashleigh Salmon, Angela Scheppokat, Aimee Stevens, Rebekah Street, Nicholas Toogood, Nicholas Wood, Twinkle Bahaduri, Therese Baulman, Jennifer Byrne, Candace Carter, Mary Corbett, Aiken Dao, Maria Desylva, Andrew Dunn, Evangeline Gardiner, Rosemary Joyce, Rama Kandasamy, Craig Munns, Lisa Pelayo, Ketaki Sharma, Katrina Sterling, Caitlin Uren, Clinton Colaco, Mark Douglas, Kate Hamilton, Adam Bartlett, Brendan McMullan, Pamela Palasanthiran, Phoebe Williams, Justin Beardsley, Nikki Bergant, Renier Lagunday, Kristen Overton, Jeffrey Post, Yasmeen Al-Hindawi, Sarah Barney, Anthony Byrne, Lee Mead, Marshall Plit, David Lynn, Saoirse Benson, Stephen Blake, Rochelle Botten, Tee Yee Chern, Georgina Eden, Liddy Griffith, Jane James, Miriam Lynn, Angela Markow, Domenic Sacca, Natalie Stevens, Steve Wesselingh, Catriona Doran, Alice Sawka, Sue Evans, Louise Goodchild, Christine Heath, Meredith Krieg, Helen Marshall, Mark McMillan, Mary Walker, Peter Richmond, Nelly Amenyogbe, Christina Anthony, Annabelle Arnold, Beth Arrowsmith, Rym Ben-Othman, Sharon Clark, Jemma Dunnill, Nat Eiffler, Krist Ewe, Carolyn Finucane, Lorraine Flynn, Camille Gibson, Lucy Hartnell, Elysia Hollams, Heidi Hutton, Lance Jarvis, Jane Jones, Jan Jones, Karen Jones, Jennifer Kent, Tobias Kollmann, Debbie Lalich, Wenna Lee, Rachel Lim, Sonia McAlister, Fiona McDonald, Andrea Meehan, Asma Minhaj, Lisa Montgomery, Melissa O'Donnell, Jaslyn Ong, Joanne Ong, Kimberley Parkin, Glady Perez, Catherine Power, Shadie Rezazadeh, Holly Richmond, Sally Rogers, Nikki Schultz, Margaret Shave, Patrycja Skut, Lisa Stiglmayer, Alexandra Truelove, Ushma Wadia, Rachael Wallace, Justin Waring, Michelle England, Erin Latkovic, Susan Herrmann, Marcus Lacerda, Paulo Henrique Andrade, Fabiane Bianca Barbosa, Dayanne Barros, Larissa Brasil, Ana Greyce Capella, Ramon Castro, Erlane Costa, Dilcimar de Souza, Maianne Dias, José Dias, Klenilson Ferreira, Paula Figueiredo, Thamires Freitas, Ana Carolina Furtado, Larissa Gama, Vanessa Godinho, Cintia Gouy, Daniele Hinojosa, Tyane Jardim, Joel Junior, Augustto Lima, Bernardo Maia, Adriana Marins, Kelry Mazurega, Tercilene Medeiros, Rosangela Melo, Marinete Moraes, Elizandra Nascimento, Juliana Neves, Maria Gabriela Oliveira, Thais Oliveira, Ingrid Oliveira, Arthur Otsuka, Rayssa Paes, Handerson Pereira, Gabrielle Pereira, Christiane Prado, Evelyn Queiroz, Laleyska Rodrigues, Bebeto Rodrigues, Vanderson Sampaio, Anna Gabriela Santos, Daniel Santos, Tilza Santos, Evelyn Santos, Ariandra Sartim, Ana Beatriz Silva, Juliana Silva, Emanuelle Silva, Mariana Simão, Caroline Soares, Antonny Sousa, Alexandre Trindade, Fernando Val, Adria Vasconcelos, Heline Vasconcelos, Carolinne Abreu, Katya Martinez Almeida, Camila Bitencourt de Andrade, Jhenyfer Thalyta Campos Angelo, Ghislaine Gonçalvez de Araújo Arcanjo, Bianca Maria Silva Menezes Arruda, Wellyngthon Espindola Ayala, Adelita Agripina Refosco Barbosa, Felipe Zampieri Vieira Batista, Fabiani de Morais Batista, Miriam de Jesus Costa, Mariana Garcia Croda, Lais Alves da Cruz, Roberta Carolina Pereira Diogo, Rodrigo Cezar Dutra Escobar, Iara Rodrigues Fernandes, Leticia Ramires Figueiredo, Leandro Galdino Cavalcanti Gonçalves, Sarita Lahdo, Joyce dos Santos Lencina, Guilherme Teodoro de Lima, Larissa Santos Matos, Bruna Tayara Leopoldina Meireles, Debora Quadros Moreira, Lilian Batista Silva Muranaka, Adriely de Oliveira, Karla Regina Warszawski de Oliveira, Matheus Vieira de Oliveira, Roberto Dias de Oliveira, Andrea Antonia Souza de Almeida dos Reis Pereira, Marco Puga, Caroliny Veron Ramos, Thaynara Haynara Souza da Rosa, Karla Lopes dos Santos, Claudinalva Ribeiro dos Santos, Dyenyffer Stéffany Leopoldina dos Santos, Karina Marques Santos, Paulo César Pereira da Silva, Paulo Victor Rocha da Silva, Débora dos Santos Silva, Patricia Vieira da Silva, Bruno Freitas da Rosa Soares, Mariana Gazzoni Sperotto, Mariana Mayumi Tadokoro, Daniel Tsuha, Hugo Miguel Ramos Vieira, Margareth Maria Pretti Dalcolmo, Cíntia Maria Lopes Alves da Paixão, Gabriela Corrêa E Castro, Simone Silva Collopy, Renato da Costa Silva, Samyra Almeida da Silveira, Alda Maria Da-Cruz, Alessandra Maria da Silva Passos de Carvalho, Rita de Cássia Batista, Maria Luciana Silva De Freitas, Aline Gerhardt de Oliveira Ferreira, Ana Paula Conceição de Souza, Paola Cerbino Doblas, Ayla Alcoforado da Silva dos Santos, Vanessa Cristine de Moraes dos Santos, Dayane Alves dos Santos Gomes, Anderson Lage Fortunato, Adriano Gomes-Silva, Monique Pinto Gonçalves, Paulo Leandro Garcia Meireless Junior, Estela Martins da Costa Carvalho, Fernando do Couto Motta, Ligia Maria Olivo de Mendonça, Girlene dos Santos Pandine, Rosa Maria Plácido Pereira, Ivan Ramos Maia, Jorge Luiz da Rocha, João Victor Paiva Romano, Glauce dos Santos, Erica Fernandes da Silva, Marilda Agudo Mendonça Teixeira de Siqueira, Ágatha Cristinne Prudêncio Soares, Sandra Franch Arroyo, Henny Ophorst-den Besten, Anna Boon, Karin M. Brakke, Axel Janssen, Marijke A.H. Koopmans, Toos Lemmens, Titia Leurink, Engelien Septer-Bijleveld, Kimberly Stadhouders, Darren Troeman, Marije van der Waal, Marjoleine van Opdorp, Nicolette van Sluis, Beatrijs Wolters, Jan Kluytmans, Jannie Romme, Wouter van den Bijllaardt, Linda van Mook, M.M.L (Miranda) van Rijen, P.M.G. Filius, Jet Gisolf, Frances Greven, Danique Huijbens, Robert Jan Hassing, R.C. Pon, Lieke Preijers, J.H. van Leusen, Harald Verheij, Wim Boersma, Evelien Brans, Paul Kloeg, Kitty Molenaar-Groot, Nhat Khanh Nguyen, Nienke Paternotte, Anke Rol, Lida Stooper, Helga Dijkstra, Esther Eggenhuizen, Lucas Huijs, Simone Moorlag, Mihai Netea, Eva Pranger, Esther Taks, Jaap ten Oever, Rob ter Heine, Kitty Blauwendraat, Bob Meek, Isil Erkaya, Houda Harbech, Nienke Roescher, Rifka Peeters, Menno te Riele, Carmen Zhou, Esther Calbo, Cristina Badia Marti, Emma Triviño Palomares, Tomás Perez Porcuna, Anabel Barriocanal, Ana Maria Barriocanal, Irma Casas, Jose Dominguez, Maria Esteve, Alicia Lacoma, Irene Latorre, Gemma Molina, Barbara Molina, Antoni Rosell, Sandra Vidal, Lydia Barrera, Natalia Bustos, Ines Portillo Calderón, David Gutierrez Campos, Jose Manuel Carretero, Angel Dominguez Castellano, Renato Compagnone, Encarnacion Ramirez de Arellano, Almudena de la Serna, Maria Dolores del Toro Lopez, Marie-Alix Clement Espindola, Ana Belen Martin Gutierrez, Alvaro Pascual Hernandez, Virginia Palomo Jiménez, Elisa Moreno, Nicolas Navarrete, Teresa Rodriguez Paño, Jesús Rodríguez-Baño, Enriqueta Tristán, Maria Jose Rios Villegas, Atsegiñe Canga Garces, Erika Castro Amo, Raquel Coya Guerrero, Josune Goikoetxea, Leticia Jorge, Cristina Perez, María Carmen Fariñas Álvarez, Manuel Gutierrez Cuadra, Francisco Arnaiz de las Revillas Almajano, Pilar Bohedo Garcia, Teresa Giménez Poderos, Claudia González Rico, Blanca Sanchez, Olga Valero, Noelia Vega, Anna Barnes, Helen Catterick, Tim Cranston, Phoebe Dawe, Emily Fletcher, Liam Fouracre, Alison Gifford, John Kirkwood, Christopher Martin, Amy McAnew, Marcus Mitchell, Georgina Newman, Abby O'Connell, Jakob Onysk, Lynne Quinn, Shelley Rhodes, Samuel Stone, Lorrie Symons, Harry Tripp, Darcy Watkins, Bethany Whale, Alex Harding, Gemma Lockhart, Kate Sidaway-Lee, Sam Hilton, Sarah Manton, Daniel Webber-Rookes, Rachel Winder, James Moore, Freya Bateman, Michael Gibbons, Bridget Knight, Julie Moss, Sarah Statton, Josephine Studham, Lydia Hall, Will Moyle, and Tamsin Venton
Subjects: Herpes simplex virus, Cold sore, Herpes labialis, Bacille Calmette-Guérin, Mycobacterium bovis, Prevention, Medicine (General), R5-920
Abstract: Summary: Background: Recurrences of herpes simplex virus (HSV) in the orofacial region (herpes labialis or cold sores) impact quality-of-life. We aimed to study whether the bacille Calmette-Guérin (BCG) vaccine can attenuate cold sore recurrences through off-target immunomodulatory effects. Methods: In this nested randomised controlled trial within the multicentre, phase 3 BRACE trial, 6828 healthcare workers were randomised in 36 sites in Australia, the Netherlands, Spain, the United Kingdom and Brazil, to receive BCG-Denmark or no BCG (1:1 ratio using a web-based procedure) and followed for 12 months with 3-monthly questionnaires. Exclusion criteria included contraindication to BCG vaccine or previous vaccination with BCG within the past year, any other live-attenuated vaccine within the last month, or any COVID-specific vaccine. The intervention group received one intradermal dose of 0.1 mL of BCG-Denmark corresponding to 2−8 x 105 colony forming units of Mycobacterium bovis, Danish strain 1331. The primary outcome was the difference in restricted mean survival time (i.e., time to first cold-sore recurrence), in participants with frequent recurrent herpes labialis (≥4 recurrences/year), analysed by intention-to-treat. Secondary outcomes addressed additional questions, including analyses in other sub-populations. Adverse events were monitored closely during the first 3 months and were reported in all participants who received one dose of study drug according to intervention received. The BRACE trial is registered with ClinicalTrials.gov, NCT04327206. Findings: Between March 30, 2020 and February 18, 2021, 84 individuals with frequent recurrent cold sores were randomly assigned to BCG (n = 38) or control (n = 46). The average time to first cold-sore recurrence was 1.55 months longer in the BCG group (95% CI 0.27–2.82, p = 0.02) than the control group (hazard ratio 0.54, 95% CI 0.32–0.91; intention-to-treat). The beneficial effect of BCG was greater in the as-treated population (difference 1.91 months, 95% CI 0.69–3.12, p = 0.003; hazard ratio 0.45, 95% CI 0.26–0.76). In prespecified subgroup analyses, only sex modified the treatment effect (interaction p = 0.007), with benefit restricted to males. Over 12 months, a greater proportion of participants in the BCG group compared with the control group reported a decrease in duration (61% vs 21%), severity (74% vs 21%), frequency (55% vs 21%), and impact on quality of life (42% vs 15%) of cold sore recurrences. In participants who had ever had a cold sore, there was also a decrease in self-reported burden of recurrences in the BCG group. In participants who had never had a cold sore, there was an increased risk of a first episode in the BCG group (risk difference 1.4%; 95% CI 0.3–2.6%, p = 0.02). There were no safety concerns. Interpretation: BCG-Denmark vaccination had a beneficial effect on herpes labialis, particularly in males with frequent recurrences, but may increase the risk of a first cold sore. Funding: Bill & Melinda Gates Foundation, the Minderoo Foundation, Sarah and Lachlan Murdoch, the Royal Children's Hospital Foundation, Health Services Union NSW, the Peter Sowerby Foundation, SA Health, the Insurance Advisernet Foundation, the NAB Foundation, the Calvert-Jones Foundation, the Modara Pines Charitable Foundation, the UHG Foundation Pty Ltd, Epworth Healthcare, and individual donors.
Published: 2023
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7. A hole lot of trouble: Severe bilateral anastomotic dehiscence following bilateral single sequential lung transplant

Author: Cameron White, Alice Stuart, Marshall Plit, Monique Malouf, and Paul Lilburn
Subjects: airway complications, dehiscence, lung transplant, Diseases of the respiratory system, RC705-779
Abstract: Abstract Airway complications post lung transplant including ischaemia and dehiscence have a significant associated mortality (2%–4%) and morbidity. We describe a case of a 22‐year‐old female who developed significant bilateral anastomotic dehiscence with severe ischaemia following a bilateral single sequential lung transplant (BSSLTx). Following an intensive antimicrobial regimen, judicious bronchoscopic surveillance, and a prolonged inpatient stay, the dehiscence resolved without requiring further surgical intervention. Our case highlights a space in the literature for further research with regard to airway complications post‐lung transplant and their management.
Published: 2023
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8. Inescapable Fibrosis: The Development of Desquamative Interstitial Pneumonia Post-Lung Transplantation Performed for a Patient with Idiopathic Pulmonary Fibrosis

Author: Paul Lilburn, Divya Pillutla, Vanathi Sivasubramaniam, and Marshall Plit
Subjects: Surgery, RD1-811
Abstract: Interstitial lung disease is characterised by a combination of cellular proliferation, inflammation of the interstitium and fibrosis within the alveolar wall. A 58-year-old man was referred for lung transplantation after developing worsening dyspnoea and progressive hypoxaemic respiratory failure from idiopathic pulmonary fibrosis. Three years later, he developed desquamative interstitial pneumonia in his transplanted lungs, and despite augmentation of immune suppression, he had a progressive decline in his lung function and exercise capacity. Interestingly, in our case, the histopathology obtained post transplant strongly goes against the recurrence of usual interstitial pneumonia/idiopathic pulmonary fibrosis; rather, two separate interstitial disease processes have been identified.
Published: 2023
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9. Sexually dimorphic production of interleukin‐6 in respiratory disease

Author: Karosham D. Reddy, Sandra Rutting, Katrina Tonga, Dikaia Xenaki, Jodie L. Simpson, Vanessa M. McDonald, Marshall Plit, Monique Malouf, Razia Zakarya, and Brian G. Oliver
Subjects: fibroblasts, inflammation, respiratory disease, sex‐specific response, Physiology, QP1-981
Abstract: Abstract Diverging susceptibility and severity in respiratory diseases is prevalent between males and females. Sex hormones have inconclusively been attributed as the cause of these differences, however, strong evidence exists promoting genetic factors leading to sexual dimorphism. As such, we investigate differential proinflammatory cytokine (interleukin (IL)‐6 and CXCL8) release from TNF‐α stimulated primary human lung fibroblasts in vitro. We present, for the first time, in vitro evidence supporting clinical findings of differential production of IL‐6 between males and females across various respiratory diseases. IL‐6 was found to be produced approximately two times more from fibroblasts derived from females compared to males. As such we demonstrate sexual dimorphism in cytokine production of IL‐6 outside the context of biological factors in the human body. As such, our data highlight that differences exist between males and females in the absence of sex hormones. We, for the first time, demonstrate inherent in vitro differences exist between males and females in pulmonary fibroblasts.
Published: 2020
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10. New Detection of Locally Acquired Japanese Encephalitis Virus Using Clinical Metagenomics, New South Wales, Australia

Author: Joel Maamary, Susan Maddocks, Yael Barnett, Stephen Wong, Michael Rodriguez, Linda Hueston, Neisha Jeoffreys, John-Sebastian Eden, Dominic E. Dwyer, Tony Floyd, Marshall Plit, Jen Kok, and Bruce Brew
Subjects: Microbiology (medical), Infectious Diseases, Epidemiology
Published: 2023
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11. Assessing the role for nailfold videocapillaroscopy in interstitial lung disease classfication: a systematic review and meta-analysis

Author: Marshall Plit, Eshwar Umashankar, Laila Girgis, and Christina Abdel-Shaheed
Subjects: medicine.medical_specialty, Lung, business.industry, Interstitial lung disease, respiratory system, medicine.disease, Connective tissue disease, Idiopathic Pulmonary Fibrosis, Scleroderma, Microscopic Angioscopy, respiratory tract diseases, Idiopathic pulmonary fibrosis, Systematic review, medicine.anatomical_structure, Rheumatology, Internal medicine, Meta-analysis, Cohort, Humans, Medicine, Pharmacology (medical), Connective Tissue Diseases, Lung Diseases, Interstitial, Tomography, X-Ray Computed, business
Abstract: Objectives The nailfold videocapillaroscopy (NVC) has been known to assist with interstitial lung disease (ILD) classification. However, evidence on its diagnostic efficacy is limited, particularly in some connective tissue disease-related interstitial lung diseases (CTD-ILD), and in interstitial pneumonia with autoimmune features (IPAF). This study aimed to address this limitation by conducting a meta-analysis on the efficacy of the NVC in ILD subgroups of CTD-ILD, IPAF and idiopathic pulmonary fibrosis (IPF). Methods MEDLINE, EMBASE, CENTRAL were screened from inception to December 2020 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies that report prevalence of nailfold abnormalities (NVC+) in CTD-ILD, IPAF and IPF cohorts were included. Data were presented as prevalence ratio (PR) with 95% CI using a random-effects model. Quality of evidence was assessed using GRADE criteria. Results Twenty-one studies were eligible. Prevalence of NVC+ was highest in CTD-ILD; PR (95 CI%) 80.4% (74.3%, 85.3%), followed by IPAF; 27.4% (10.9%, 53.7%), and IPF; 13.8% (5.7%, 29.9%). Late scleroderma pattern was the most prevalent nailfold pattern; 40.4% (28.1%, 54.1%) in our CTD-ILD cohort. Quality of evidence was low for CTD-ILD, IPAF and IPF cohorts, moderate for the late scleroderma pattern cohort. Conclusion NVC can increase the diagnostic accuracy of ILD when used in a multi-disciplinary setting, and appears to have greatest utility in CTD-ILD, followed by IPAF and IPF. The Late Scleroderma Pattern was the most frequent nailfold capillary pattern in SSc-ILD. Future research will allow for greater understanding of the prognostic value of the NVC in ILD.
Published: 2021
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12. Feasibility of a Group-Based Telerehabilitation Intervention for Long COVID Management

Author: Meredith King, Anthony Byrne, Linda Denehy, Petra Graham, Ben Douglas, Priscilla de Toni, Angelo Santos, Emily Kitson, Alison Pang, Elena Bartos, Marshall Plit, and Sean Mungovan
Abstract: Background and objective: The increasing awareness of the prevalence and chronic nature of the COVID-19 disease burden requires a better understanding of effective interventions in large scale clinical trials. Telerehabilitation is effective in other chronic disease groups and the aim of this study was to assess the feasibility of a specific, group-based telerehabilitation exercise intervention for Long-COVID. Methods People with Long-COVID symptoms, defined as persistent dyspnoea, fatigue or chest pain, at least 110 days post COVID-19 diagnosis and who had not undertaken exercise training three months prior to randomisation into the trial were included. Participants were randomised to receive a twice-weekly supervised group telerehabilitation program for ten weeks or continue with usual care. Feasibility outcomes included recruitment rate, adherence, completion rate, adverse events and technological issues. Exploratory clinical outcomes including exercise capacity, fatigue and health-related quality of life were also assessed. Results 21 participants with mean age 53 ± 14 yrs, 17 of whom were not hospitalised, were recruited 365 ± 67 days after diagnosis of COVID-19. The recruitment rate was 39% of possible participants. Nine (82%) of the intervention group completed the follow-up assessments. The telerehabilitation participants completed 18 ± 2 sessions, with 100% completing 16 sessions or more. There were no adverse events and two technological problems reported for the intervention group. Conclusion Supervised group telerehabilitation appears to be feasible and safe for people with Long-COVID. A future study is required to examine the efficacy and generalizability of the supervised group-based telerehabilitation exercise intervention. Trial registration: Australian New Zealand Clinical Trials Registry (Trial ID: ACTRN12621000031864)
Published: 2022
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13. Limited recovery from post-acute sequelae of SARS-CoV-2 (PASC) at eight months in a prospective cohort

Author: Anthony Byrne, D.R. Darley, Bruce J. Brew, Gregory J. Dore, Marshall Plit, Gail V. Matthews, and Anthony D. Kelleher
Subjects: Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Quality of life, medicine, Research Letter, Medicine, Longitudinal cohort, Prospective cohort study, business, Bit (key)
Abstract: Global attention is gradually turning to focus on the problem of prolonged illness following acute coronavirus disease 2019 (COVID-19), commonly termed ‘Long COVID’ or Post-Acute Sequelae of SARS-CoV-2 infection (PASC). Whilst an increasing number of reports now recognise this condition, accurate characterisation of its prevalence, clinical features and natural history is complicated by choice of denominator population, lack of case definition and marked self-selection bias. Nevertheless, a picture is emerging of a syndrome characterised predominantly by fatigue, dyspnoea, chest tightness, and ‘brain fog’ present in around 10–30% of individuals at 2–3 months post-acute infection and affecting both those with initial severe illness and those in whom acute infection was mild [1–3].
Published: 2021

14. Swallowing and laryngeal complications in lung and heart transplantation: Etiologies and diagnosis

Author: Marshall Plit, Rebecca J. Black, Peter MacDonald, Catherine Madill, Anna Miles, and Daniel Novakovic
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, Laryngeal Diseases, Postoperative Complications, Quality of life, Swallowing, medicine, otorhinolaryngologic diseases, Humans, Intensive care medicine, 1102 Cardiorespiratory Medicine and Haematology, Heart transplantation, Transplantation, business.industry, Swallowing Disorders, Dysphagia, Etiology, Heart Transplantation, Surgery, medicine.symptom, Deglutition Disorders, Cardiology and Cardiovascular Medicine, business, Lung Transplantation, Oropharyngeal dysphagia
Abstract: Despite continued surgical advancements in the field of cardiothoracic transplantation, post-operative complications remain a burden for the patient and the multidisciplinary team. Lesser known complications including swallowing disorders (dysphagia) and voice disorders (dysphonia) are now being reported. Such disorders are known to be associated with increased morbidity and mortality in other medical populations, however their etiology amongst the heart and lung transplant populations has received little attention in the literature. This paper explores the potential mechanisms of oropharyngeal dysphagia and dysphonia following transplantation and discusses optimal modalities of diagnostic evaluation and management. A greater understanding of the implications of swallowing and laryngeal dysfunction in the heart and lung transplant populations is important to expedite early diagnosis and management in order to optimise patient outcomes, minimise allograft injury and improve quality of life.
Published: 2021

15. Atypical presentations and course of JC virus infection

Author: Sophie Chatterton, Liam Dwyer, Claire Thomson, Marshall Plit, Henrietta Longmuir, Joga Chaganti, Yael Barnett, and Bruce Brew
Subjects: Male, Cellular and Molecular Neuroscience, Neurology, Immune Reconstitution Inflammatory Syndrome, Virology, Antiretroviral Therapy, Highly Active, DNA, Viral, Leukoencephalopathy, Progressive Multifocal, Humans, Neurology (clinical), Middle Aged, JC Virus, Aged
Abstract: There is increasing evidence that the spectrum of human polyomavirus 2 (JCV) CNS disease includes novel syndromes other than progressive multifocal leukoencephalopathy (PML), the appreciation of which is increasingly important in the context of MS therapies and immunodeficiency states. Our objective is to describe unusual presentations of JCV infection to heighten clinician awareness. We describe three case reports of various PML presentations. Firstly a 56-year-old HIV positive male with decades of viral suppression and normal immune function presented with 1 month of non-specific headache that spontaneously resolved despite an MRI showing a new area of PML and CSF being JC DNA + . He had had two similar episodes in 2013 and 2014 with MRI scans consistent with PML, CSF, JCV, and PCR positivity once and brain biopsy-positive twice. Another 61-year-old male presented with subacute binocular vision loss and was found to have newly diagnosed HIV and JCV DNA detected in CSF. MRI brain only demonstrated symmetrical chiasmo-hypothalamic enhancement. There has been some improvement with combination antiretroviral therapy and corticosteroids for immune reconstitution inflammatory syndrome (IRIS). Thirdly, a 65-year-old male presented with subacute progressive confusion and behavioural disturbance, one year post-bilateral lung transplantation. MRI brain demonstrated no evidence of PML but CSF on three occasions demonstrated a progressively increasing JCV DNA load. Despite reduction in his immunosuppression, the patient developed profound encephalopathy without localising features leading to death two months later. These cases emphasise the atypical presentations of JCV: chronic relapsing, unusual symmetrical visual pathway disease, and non-localising encephalopathy without MRI evidence of PML.
Published: 2021

16. Deep multi-region whole-genome sequencing reveals heterogeneity and gene-by-environment interactions in treatment-naive, metastatic lung cancer

Author: W. Samantha N. Jayasekara, Beena Kumar, Emily Stone, Venessa T. Chin, Mark J. Cowley, Rachael A. McCloy, Alvaro Gonzalez-Rajal, Prudence A. Russell, Jason E. Cain, Tracy L. Leong, Anthony T. Papenfuss, Daniel P Steinfort, Muhammad Alamgeer, Louis Irving, Velimir Gayevskiy, Fernando J. Rossello, Marshall Plit, Daniel J. Gough, Vishal Boolell, Andrew S. Field, D. Neil Watkins, Marie Liesse Asselin-Labat, Adrian Havryk, Kieren D. Marini, Vinod Ganju, Marc R. De Massy, Anette Szczepny, and Barton R Jennings
Subjects: Male, 0301 basic medicine, Cancer Research, Lung Neoplasms, DNA Copy Number Variations, DNA repair, Adenocarcinoma of Lung, Biology, medicine.disease_cause, Malignancy, Article, Small-cell lung cancer, Metastasis, Genetic Heterogeneity, 03 medical and health sciences, 0302 clinical medicine, Cancer genomics, Tumor Microenvironment, Genetics, medicine, Humans, Lung cancer, Molecular Biology, Aged, Aged, 80 and over, Mutation, Whole Genome Sequencing, Genetic heterogeneity, High-Throughput Nucleotide Sequencing, Cancer, Middle Aged, Thoracic Neoplasms, medicine.disease, Small Cell Lung Carcinoma, Founder Effect, 3. Good health, 030104 developmental biology, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Cancer research, Female, Gene-Environment Interaction, Non-small-cell lung cancer
Abstract: Our understanding of genomic heterogeneity in lung cancer is largely based on the analysis of early-stage surgical specimens. Here we used endoscopic sampling of paired primary and intrathoracic metastatic tumors from 11 lung cancer patients to map genomic heterogeneity inoperable lung cancer with deep whole-genome sequencing. Intra-patient heterogeneity in driver or targetable mutations was predominantly in the form of copy number gain. Private mutation signatures, including patterns consistent with defects in homologous recombination, were highly variable both within and between patients. Irrespective of histotype, we observed a smaller than expected number of private mutations, suggesting that ancestral clones accumulated large mutation burdens immediately prior to metastasis. Single-region whole-genome sequencing of from 20 patients showed that tumors in ever-smokers with the strongest tobacco signatures were associated with germline variants in genes implicated in the repair of cigarette-induced DNA damage. Our results suggest that lung cancer precursors in ever-smokers accumulate large numbers of mutations prior to the formation of frank malignancy followed by rapid metastatic spread. In advanced lung cancer, germline variants in DNA repair genes may interact with the airway environment to influence the pattern of founder mutations, whereas similar interactions with the tumor microenvironment may play a role in the acquisition of mutations following metastasis.
Published: 2018
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17. Characterisation of Baseline and Chronic Lung Allograft Dysfunction by Airway Oscillometry: Results of a Multi-Centre Cross-Sectional Study

Author: D.R. Darley, J.P. Sim, Gregory I Snell, Brigitte M. Borg, R. Shirol, K. Tonga, Bronwyn Levvey, Jaideep Vazirani, Marshall Plit, and K. Nilsen
Subjects: Pulmonary and Respiratory Medicine, Spirometry, Transplantation, medicine.medical_specialty, Lung, medicine.diagnostic_test, business.industry, Cross-sectional study, Logistic regression, FEV1/FVC ratio, medicine.anatomical_structure, Internal medicine, medicine, Oscillometry, Cardiology, Surgery, Multi centre, Cardiology and Cardiovascular Medicine, Airway, business
Abstract: Purpose Baseline and chronic lung allograft dysfunction (BLAD & CLAD) are leading causes of reduced patient survival. Airway oscillometry characterises the lung's mechanical properties with greater sensitivity than spirometry. This study aims to characterise BLAD and CLAD with airway oscillometry. Methods Oscillometry was performed on all bilateral lung transplant (LTx) recipients at 2 Australian centres between Jan-Oct 2020 with the TremoFlo C-100 device to obtain resistance (R5, R19-5), reactance (X5), and reactance area (Ax). Patients with acute lung allograft dysfunction were excluded. CLAD was diagnosed/staged using spirometry as per ISHLT 2019 Consensus Criteria. BLAD was defined as failure to ever achieve >80%-pred FEV1 and FVC. Multivariate logistic regression measured the association between oscillometry risk of CLAD. Results A total of 179 LTx recipients [47% males; median age 54 (IQR 25); duration post-LTx 5 years (IQR 7)] were recruited. 112/179 (63%) patients had no CLAD and of these 27 (24%) patients had BLAD. There was a significant difference in median X5 (-1.64 vs -1.20, p Conclusion BLAD is characterised by abnormal reactance (X5 & Ax), yet resistive airway properties (R5 & R5-19) are similar to patients without BLAD. The association between oscillometry parameters and CLAD demonstrates that oscillometry provides complimentary information about lung dysfunction after transplant. Longitudinal studies are required to determine whether oscillometry has a role in earlier detection of CLAD.
Published: 2021
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18. Persistent symptoms up to four months after community and hospital‐managed SARS‐CoV‐2 infection

Author: Jeffrey Masters, Bruce J. Brew, Lucette A. Cysique, D.R. Darley, David Andresen, Katrina O. Tonga, Helen Tang, Marshall Plit, Philip Cunningham, Gregory J. Dore, Anthony Byrne, Emily Stone, Kay Wilhelm, Gail V. Matthews, and Anthony D. Kelleher
Subjects: Male, 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Respiratory Tract Diseases, Signs and symptoms, medicine.disease_cause, Neurocognitive disorders, Quality of life, COVID‐19, Virology, Internal medicine, Research Letter, Humans, Medicine, Prospective Studies, Prospective cohort study, Lung, Diagnostic Techniques and Procedures, Lung diseases, Coronavirus, SARS-CoV-2, business.industry, Mental Disorders, Australia, Follow up studies, COVID-19, General Medicine, Middle Aged, Prognosis, Research Letters, Hospitalization, Infectious Diseases, Quality of Life, Female, Symptom Assessment, business, Follow-Up Studies
Published: 2021
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19. P60.01 Single-Cell Transcriptomics to Assess Response to Immunotherapy in Advanced Lung Cancer ex-vivo: Developing a Functional Predictive Assay

Author: Rachael A. McCloy, Alexander D Murphy, Marshall Plit, Andrew S. Field, Venessa T. Chin, N. Watkins, Joseph E. Powell, Emily Stone, and Adrian Havryk
Subjects: Pulmonary and Respiratory Medicine, Oncology, business.industry, Single cell transcriptomics, medicine.medical_treatment, Cancer research, Medicine, Immunotherapy, business, Lung cancer, medicine.disease, Ex vivo
Published: 2021
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20. Development of a Donor-Recipient Matching Algorithm for Lung Transplantation in Australia

Author: Adrian Havryk, Emily Granger, Mark Connellan, A. Watson, Marshall Plit, Monique A. Malouf, Paul Jansz, Arjun Iyer, and B. Hwang
Subjects: Pulmonary and Respiratory Medicine, Transplantation, medicine.medical_specialty, Matching (statistics), Prognostic variable, business.industry, medicine.medical_treatment, Microsoft excel, medicine, Lung transplantation, Surgery, Medical physics, Cardiology and Cardiovascular Medicine, business, Blossom algorithm, Selection (genetic algorithm), Lung allocation score
Abstract: Purpose Whilst the United States, Germany and the Netherlands use the Lung Allocation Score for donor-recipient matching, there currently exists no similar scoring system in Australia. Our objective was to develop a lung allocation algorithm to be used at a thoracic transplantation centre in Sydney, Australia. Methods A review of the current literature and survival analyses of data from lung transplant activity at this centre from 1 January 2015 to 31 December 2019 was performed to determine the prognostic variables to be included in our algorithm. The algorithm was developed using Microsoft Excel, then prospectively validated over a 10-week period in which the transplant clinicians were surveyed on the algorithm's choice of recipient. It was further validated retrospectively by comparing the patients put forward for crossmatch by the algorithm with the clinician's selection for all lung transplants performed between 1 January and 22 June 2020. Results Patient parameters were stratified into suitability, urgency and risk categories (Table 1). Each of these parameters are scored from -100 to a maximum of 500 points, then weighted from 0 to 1. The resultant priority list ranks patients based on total score.The algorithm was trialled a total of 39 times. Almost twice as many patients were put forward for crossmatch by the algorithm than selected by the clinician. However, 3.3% of patients put forward by the clinician fell outside of the algorithm's selection criteria. In all trials, the final recipient chosen by the clinician was within the algorithm's top 5 candidates. Conclusion A working lung allocation algorithm that is able to streamline the allocation process and assist transplant clinicians in allocating lungs to recipients in an equitable, transparent and reproducible manner was developed. Further adjustments and validation may be required before implementation at this centre.
Published: 2021
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21. Novel Measurements of Respiratory System Mechanics Demonstrate Important Features of Donor-Recipient Lung Volume Matching That May Link to Subsequent Chronic Lung Allograft Dysfunction

Author: Marshall Plit, Jaideep Vazirani, Bronwyn Levvey, Gregory I Snell, Brigitte M. Borg, R. Shirol, J.P. Sim, D.R. Darley, and K. Nilsen
Subjects: Pulmonary and Respiratory Medicine, Spirometry, Transplantation, medicine.medical_specialty, Lung, medicine.diagnostic_test, business.industry, Respiratory physiology, Pulmonary function testing, medicine.anatomical_structure, Internal medicine, medicine, Cardiology, Plethysmograph, Surgery, Lung volumes, Respiratory system, Cardiology and Cardiovascular Medicine, Prospective cohort study, business
Abstract: Purpose The effect of matching donor and lung transplant (LTx) recipient lung volumes on LTx outcomes is unknown. The Forced Oscillation Technique (FOT) is a simple measure of the mechanical properties of the respiratory system. We have recently developed novel measures of airway closure using FOT. This study aims to assess the effect of matching donor and recipient lung volumes on respiratory system mechanics using FOT. Methods A multi-centre (Alfred Hospital, Melbourne and St Vincent's Hospital, Sydney) prospective study of (n=19) subjects (63% male, age 56 ±13yrs) at one time point 3-6 months post bilateral LTx were divided into two groups: G1 - Recipient measured pre-LTx total lung capacity (rTLC) predicted dTLC, n=10. All subjects underwent pulmonary function testing including, spirometry, plethysmography and FOT (Tremoflo 2000, Thorasys, Canada). Results In G1, respiratory system elastance (stiffness=AX5) positively correlated with difference between dTLC and rTLC (p Conclusion Novel measurements of respiratory mechanics from FOT demonstrate both oversizing and under-sizing donor TLC can alter recipient respiratory mechanics post-LTx. Longitudinal studies are underway to correlate these effects with the incidence and extent of baseline or chronic lung allograft dysfunction (BLAD & CLAD).
Published: 2021
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22. Baseline Gas Transfer (KCO) and Accessible Alveolar Volume (VA) after Lung Transplant: Determinants and Relative Contributions on Graft Survival

Author: Marshall Plit, Monique A. Malouf, D.R. Darley, and Peter S. Macdonald
Subjects: Pulmonary and Respiratory Medicine, Transplantation, medicine.medical_specialty, Lung, business.industry, Retrospective cohort study, respiratory system, Logistic regression, medicine.anatomical_structure, Gas transfer, DLCO, Internal medicine, Diffusing capacity, Cardiology, Medicine, Surgery, Graft survival, Alveolar volume, Cardiology and Cardiovascular Medicine, business, 1102 Cardiorespiratory Medicine and Haematology
Abstract: Purpose Low baseline diffusing capacity (DLCO), at 1-year after lung transplant, is associated with an increased risk of graft loss. DLCO is the product of 2 measurements; the gas transfer factor (KCO) and the accessible alveolar volume (VA). Our aim was to understand the relative contributions of baseline KCO and VA on survival after lung transplant. Methods A retrospective cohort analysis was conducted of all bilateral lung transplant recipients between 1998 and 2018, with DLCO measured at 1 year after transplant. Low baseline VA was defined as 80%-pred. Patients were divided into 4 groups: Normal VA-Normal KCO, Normal VA-Low KCO, Low VA-Normal KCO, Low VA-Low KCO. Multivariate logistic regression and Cox proportional hazard models were used for statistical analysis. Results 708 patients underwent double lung transplant during the study period. 258 patients had DLCO measured at 1-year post transplant. The mean recipient age was 44.0 (SD 15.5) with 50% males. The median time to measurement of DLCO was 378 days. The median (IQR) VA %-pred was 82 (21), %-Pred KCO 74 (19) and %-Pred FEV1 84 (29). Donor age was significantly associated with low KCO OR 1.06 (95%CI 1.03-1.08), p Conclusion Donor age, ILD and transplant era were associated with baseline KCO and VA. Low baseline VA was a greater risk for future graft loss than low KCO. There may be benefit in the incorporation of baseline VA and KCO at 1-year post transplant to identify patients with an increased risk of graft loss.
Published: 2021
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23. Post-transplant lymphoproliferative disease in heart and lung transplantation: Defining risk and prognostic factors

Author: Joanne Joseph, Ian Nivison-Smith, Orly Lavee, Peter S. Macdonald, Allan R. Glanville, Andrew Jabbour, Adrian Havryk, Marshall Plit, Ann M. Keogh, David D.F. Ma, Christopher S. Hayward, Monique A. Malouf, Andrew Parker, G. Kumarasinghe, Anthony J. Dodds, Keith Fay, Sam Milliken, John Moore, and Eugene Kotlyar
Subjects: Adult, Graft Rejection, Lung Diseases, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, Biopsy, medicine.medical_treatment, Lymphoproliferative disorders, Disease, Risk Assessment, Young Adult, Risk Factors, Internal medicine, medicine, Humans, Transplantation, Homologous, Lung transplantation, Child, Survival rate, Aged, Retrospective Studies, Heart Failure, Immunosuppression Therapy, Heart transplantation, Transplantation, business.industry, Incidence, Immunosuppression, Retrospective cohort study, Middle Aged, Prognosis, medicine.disease, Lymphoproliferative Disorders, Surgery, Survival Rate, surgical procedures, operative, Heart failure, Heart Transplantation, Female, New South Wales, Cardiology and Cardiovascular Medicine, business, Lung Transplantation
Abstract: Heart and lung transplant recipients have among of the highest incidence rates of post-transplant lymphoproliferative disease (PTLD). Despite this, there is a paucity of data specific to this group. We collated data on heart, lung and heart-lung transplant recipients with PTLD to identify disease features and prognostic factors unique to this group of patients.Seventy cases of PTLD were identified from a single institution (41 heart, 22 lung, 6 heart-lung and 1 heart-kidney transplant) from 1984 to 2013. Demographics, immunosuppression, treatment, response, complications and survival data were analyzed. Uni- and multivariate Cox regression analyses were performed to identify prognostic factors.The incidence of PTLD was 7.59% in heart-lung, 5.37% in heart and 3.1% in lung transplant recipients. Extranodal disease (82%) with diffuse large B-cell lymphoma (72%) was the most common presentation. Bone marrow involvement (13%) and central nervous system disease (3%) were uncommon. Heart transplant recipients had later onset of PTLD (1 year post-transplant), with less allograft involvement, compared with lung and heart-lung recipients. Poor prognostic markers were bone marrow involvement (HR 6.75, p0.001) and serum albumin30 g/liter (HR 3.18, p = 0.006). Improved survival was seen with a complete response within 3 months of treatment (HR 0.08, p0.001). Five-year overall survival was 29%.This analysis is the largest to date on PTLD in heart and lung transplant recipients. It provides a detailed analysis of the disease in this group of patients and identifies unique prognostic features to aid risk stratification and guide treatment allocation.
Published: 2015
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24. Identification of miR-93 as a suitable miR for normalizing miRNA in plasma of tuberculosis patients

Author: Magda K. Ellis, Warwick J. Britton, Marshall Plit, Xiaolin Wang, Yu Rong Yang, Guangyu Guan, Brian Chan, Bernadette M. Saunders, and Simone E. Barry
Subjects: Adult, Male, Biochemistry & Molecular Biology, Tuberculosis, Adolescent, Biology, Bioinformatics, normalisation, Mycobacterium tuberculosis, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, microRNA, medicine, Humans, Young adult, plasma, Genetic Association Studies, 030304 developmental biology, Aged, Regulation of gene expression, 0303 health sciences, Case-control study, Australia, Cell Biology, Original Articles, Middle Aged, Reference Standards, medicine.disease, biology.organism_classification, respiratory disease, 3. Good health, MicroRNAs, tuberculosis, Gene Expression Regulation, 030220 oncology & carcinogenesis, Case-Control Studies, Molecular Medicine, Population study, Female, Software, Cohort study
Abstract: © 2015 The Authors. Tuberculosis (TB) remains a major public health issue. New tests to aid diagnoses and monitor the response to therapy are urgently required. There is growing interest in the use of microRNA (miRNA) profiles as diagnostic, prognostic or predictive markers in a range of clinical and infectious diseases, including Mycobacterium tuberculosis infection, however, challenges exist to accurately normalise miRNA levels in cohorts. This study examined the appropriateness of 12 miRs and RNU6B to normalise circulating plasma miRNA levels in individuals with active TB from 2 different geographical and ethnic regions. Twelve miRs (let-7, miR-16, miR-22, miR-26, miR-93, miR-103, miR-191, miR-192, miR-221, miR-423, miR-425 and miR-451) and RNU6B were selected based on their reported production by lung cells, expression in blood and previous use as a reference miRNA. Expression levels were analysed in the plasma of newly diagnosed TB patients from Australia and China compared with individuals with latent TB infection and healthy volunteers. Analysis with both geNorm and NormFinder software identified miR-93 as the most suitable reference miR in both cohorts, either when analysed separately or collectively. Interestingly, there were large variations in the expression levels of some miRs, in particular miR-192 and let-7, between the two cohorts, independent of disease status. These data identify miR-93 is a suitable reference miR for normalizing miRNA levels in TB patients, and highlight how environmental, and possibly ethnic, factors influence miRNA expression levels, demonstrating the necessity of assessing the suitability of reference miRs within the study population.
Published: 2015

25. Rapid cytological analysis of endobronchial ultrasound-guided aspirates in sarcoidosis

Author: Andrew S. Field, Alan Hodgson, Marshall Plit, Allan R. Glanville, Sonia Carbone, R. Pearson, Farzad Bashirzadeh, Anna Chay, Adrian Havryk, Daniel James, Justin Hundloe, and David Fielding
Subjects: Adult, Male, Pulmonary and Respiratory Medicine, Bronchoscopist, medicine.medical_specialty, Biopsy, Biopsy, Fine-Needle, Bronchi, Sensitivity and Specificity, Sarcoidosis, Pulmonary, Bronchoscopy, Predictive Value of Tests, medicine, Humans, Prospective Studies, Endobronchial ultrasound, Pulmonary pathology, Prospective cohort study, Ultrasonography, medicine.diagnostic_test, business.industry, Reproducibility of Results, Middle Aged, medicine.disease, Surgery, Predictive value of tests, Female, Sarcoidosis, Radiology, business
Abstract: Rapid on-site evaluation (ROSE) of endobronchial ultrasound-guided transbronchial needle aspirates (EBUS-TBNA) has not been compared to final detailed cytological analysis in patients with suspected sarcoidosis. To assess the diagnostic accuracy of EBUS-TBNA with ROSE in patients with suspected sarcoidosis, a prospective two-centre study performed EBUS-TBNA with ROSE of cellular material followed by transbronchial lung biopsy (TBLB) and endobronchial biopsy (EBB). The diagnostic accuracy of EBUSTBNA with ROSE was compared to the final cytological assessment and to TBLB and EBB. Analysis confirmed 49 out of 60 cases of sarcoidosis. ROSE sensitivity was 87.8% (specificity 91%, positive predictive value 97.7%). ROSE slide interpretation in combination with the final fixed slide and cell block preparations had a sensitivity of 91.8% (specificity 100%, positive predictive value 100%). 67% of patients were confirmed as having sarcoidosis on TBLB and 29% on EBB. Interobserver agreement between cytotechnologists and pathologists was very good (κ=0.91, 95% CI 0.80-1.0 and κ=0.91, 95% CI 0.79-1.0, respectively). EBUS-TBNA with ROSE has high diagnostic accuracy and interobserver agreement and informs the bronchoscopist in theatre whether additional diagnostic procedures need to be undertaken. EBUS-TBNA with ROSE should therefore be considered as the first-line investigation of sarcoidosis. Copyright
Published: 2012
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26. Laryngeal aspergilloma: a complication of inhaled fluticasone therapy for asthma

Author: Marshall Plit, David Lowinger, and D.R. Darley
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Pediatrics, business.industry, vocal cords, fluticasone, Case Reports, asthma, medicine.disease, Aspergillosis, laryngeal, Corticosteroid therapy, medicine, business, Intensive care medicine, Complication, Aspergilloma, Asthma, Fluticasone, medicine.drug
Abstract: Primary laryngeal aspergillosis in immunocompetent patients is rare. We describe a case of a 59-year-old woman with laryngeal aspergillosis thought to be secondary to long-term inhaled fluticasone therapy. Laryngeal aspergillosis may be an underrecognized complication of inhaled corticosteroid therapy.
Published: 2014
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27. Reversibility of Frailty After Lung Transplantation

Author: M. Harkess, E. Montgomery, Marshall Plit, Peter S. Macdonald, R. Pearson, N. De Tullio, C. Thomson, M. Benzimra, A. Smith, Sunita R Jha, Adrian Havryk, M. Hannu, Monique A. Malouf, Rodrigo Fritis-Lamora, Allan R. Glanville, and Phillip J. Newton
Subjects: Pulmonary and Respiratory Medicine, Oncology, Transplantation, medicine.medical_specialty, business.industry, Internal medicine, medicine.medical_treatment, medicine, Lung transplantation, Surgery, Cardiology and Cardiovascular Medicine, business
Published: 2018
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28. Tacrolimus rescue therapy for severe respiratory failure in the anti‐synthetase syndrome

Author: Marshall Plit, Allan R. Glanville, and Amy L. Rigby
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, Salvage therapy, Case Reports, behavioral disciplines and activities, Rescue therapy, Internal medicine, Pulmonary fibrosis, medicine, Lung transplantation, tacrolimus, pulmonary fibrosis, business.industry, Interstitial lung disease, respiratory system, medicine.disease, Tacrolimus, respiratory tract diseases, body regions, Calcineurin, surgical procedures, operative, Respiratory failure, Immunology, Anti-synthetase syndrome, business
Abstract: Interstitial lung disease (ILD) is the major determinant of morbidity and mortality in the anti-synthetase syndrome (ASS). The therapeutic efficacy of corticosteroids for the ILD component is limited; hence, additional immunosuppressive and immunomodulatory therapies have been tried with a modicum of success in recent years. Tacrolimus, a calcineurin inhibitor, is one potential therapy. We describe four consecutive patients with ASS whom we treated with tacrolimus at a quaternary referral hospital in 2009–2013. All four patients had significant ILD, three had severe and progressive ILD, and two had been referred for consideration of lung transplantation. Tacrolimus use was associated with improvement in ILD in all four patients with a mean follow-up of 3 years. Our case series adds further evidence to support the use of tacrolimus as salvage therapy for severe respiratory failure due to ILD in ASS, which may be associated with a dramatic and enduring response.
Published: 2014
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29. Association of Minimal Rejection in Lung Transplant Recipients with Obliterative Bronchiolitis

Author: S. Rainer, Prashant N. Chhajed, Monique A. Malouf, Peter Hopkins, Allan R. Glanville, Marshall Plit, and C.L Aboyoun
Subjects: Adult, Graft Rejection, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Time Factors, Adolescent, Bronchiolitis obliterans, Critical Care and Intensive Care Medicine, Risk Assessment, Severity of Illness Index, Asymptomatic, Cohort Studies, Age Distribution, Postoperative Complications, Intensive care, Prevalence, medicine, Humans, Clinical significance, Prospective Studies, Sex Distribution, Child, Prospective cohort study, Bronchiolitis Obliterans, Probability, Chi-Square Distribution, business.industry, Graft Survival, Respiratory disease, Middle Aged, Prognosis, medicine.disease, Survival Analysis, Surgery, Transplantation, Bronchiolitis, Female, medicine.symptom, business, Lung Transplantation
Abstract: The clinical significance of minimal acute rejection (grade A1) in lung transplant recipients is unknown. We prospectively analyzed 1,159 transbronchial lung biopsies in 184 patients. Two hundred seventy-nine biopsies in 128 participants confirmed A1 histology at a mean postoperative day of 229 +/- 340. Sixty four of 255 surveillance A1 lesions progressed to high-grade acute rejection by 3 months of follow-up, whereas 40 developed new lymphocytic bronchiolitis. Twenty-four A1 biopsies were symptomatic, with only two cases progressing to high-grade rejection after steroid therapy. Seventy-eight of 184 patients experienced multiple (> or = 2) A1 biopsies in the first 12 months after transplant. Bronchiolitis obliterans syndrome developed in 68% of patients with multiple A1 lesions at a mean of 599 +/- 435 days, compared with 43% of patients with one or less A1 lesions at a mean of 819 +/- 526 (p = 0.022). Eighteen patients experienced multiple A1 biopsies after transplant in the absence of high-grade rejection episodes yet also developed earlier obliterative bronchiolitis (456 +/- 245 days, p = 0.020). We conclude that for A1 transbronchial lung biopsies, the conventional treatment of observation only is now challenged even in patients who are asymptomatic. Patients who experience multiple A1 lesions develop an earlier onset of obliterative bronchiolitis and may warrant alternative immunosuppressive strategies.
Published: 2004
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30. Indirect fluorescent antibody testing of nasopharyngeal swabs for influenza diagnosis in lung transplant recipients

Author: Prashant N. Chhajed, Ian Carter, Marshall Plit, Allan R. Glanville, Peter Hopkins, and Monique A. Malouf
Subjects: Pulmonary and Respiratory Medicine, Adult, Male, Adolescent, medicine.medical_treatment, Bronchiolitis obliterans, Sensitivity and Specificity, Article, Serology, Nasopharynx, Influenza, Human, Medicine, Lung transplantation, Humans, Prospective Studies, Fluorescent Antibody Technique, Indirect, Bronchiolitis Obliterans, Transplantation, business.industry, Viral culture, Respiratory disease, Middle Aged, medicine.disease, Pneumonia, Influenza A virus, Case-Control Studies, Immunology, Pharynx, Surgery, Female, Viral disease, Cardiology and Cardiovascular Medicine, business, Lung Transplantation
Abstract: Background: Rapid and reliable diagnosis of respiratory viral infections (RVI) in lung transplant recipients is essential to direct therapy of acute graft dysfunction and identify epidemic trends. Traditional techniques of serology and viral culture are limited by the lack of antibody response and delay in diagnosis. Methods: We examined the clinical utility of indirect fluorescent antibody (IFA) testing in adult lung transplant patients with suspected RVI, compared with serology and culture. Nasopharyngeal and throat swabs (NT) were obtained to sample epithelial cells, followed by application of monoclonal antibody to respiratory syncytial virus, adenovirus, parainfluenza 1–3 and influenza A and B. The Bartels Respiratory Viral Detection kit was used with IFA results available within 24 hours. Results: Nine of 18 patients tested positive for RVI with influenza A ( n = 8) and influenza B ( n = 1) detected. The sensitivity of IFA (67%) was higher than that of cell culture (45%). With intensive supportive therapy, infection was self-limiting in bronchiolitis obliterans syndrome (BOS) Grade 0–2 patients. However, patients with BOS Grade 3 manifested an acute exacerbation of airflow obstruction, which proved to be irreversible. Conclusions: Lung transplant patients with “flu-like” symptoms should proceed to IFA testing of NT swab specimens for early diagnosis. Samples collected within 7 days of symptom onset have high sensitivity as compared with serology and viral culture techniques.
Published: 2003

31. HIV testing rates and co-infection among patients with tuberculosis in south-eastern Sydney, 2008-2013

Author: Gregory Kaufman, Marshall Plit, Jeffrey J. Post, Kelly-Anne Ressler, H. Goldberg, and Mark J Ferson
Subjects: medicine.medical_specialty, Tuberculosis, Population, Human immunodeficiency virus (HIV), HIV Infections, Hiv testing, Immunologic Tests, medicine.disease_cause, Hiv test, Internal medicine, medicine, Humans, Mass Screening, education, Disease Notification, Retrospective Studies, education.field_of_study, business.industry, Coinfection, virus diseases, General Medicine, medicine.disease, Hiv status, New South Wales, business, South eastern, Co infection
Abstract: OBJECTIVE To evaluate the rate of HIV and tuberculosis co-infection and changes in HIV testing practices for patients with tuberculosis managed in South Eastern Sydney Local Health District (SESLHD), New South Wales, Australia. DESIGN, PARTICIPANTS AND SETTING A retrospective review of tuberculosis notification data from four public tuberculosis treatment clinics in SESLHD (population, >800,000), 2008-2013. Data were extracted from the NSW Notifiable Conditions Information Management System. INTERVENTION Published evidence regarding clinical management of HIV and tuberculosis co-infection and feedback of HIV testing rates was provided to senior clinicians managing tuberculosis in SESLHD between 2008 and 2012. MAIN OUTCOME MEASURES Proportion of patients with tuberculosis with HIV infection status ascertained and proportion with HIV co-infection. RESULTS Of 506 people with notified tuberculosis treated in SESLHD during the study period, 369 had their HIV status ascertained (72.9%), of whom 20 were HIV co-infected (5.4%). Eleven of these cases were new HIV diagnoses. Seven people offered an HIV test declined the offer. The rates of HIV co-infection varied between clinics (1.5%-9.7%; P=0.02) as did the rate of HIV status ascertainment (61.5%-85.4%; P
Published: 2014

32. The Prevalence and Prognostic Significance of Frailty in Patients with Advanced Lung Disease Referred for Lung Transplantation

Author: E. Montgomery, Peter S. Macdonald, M. Harkess, Adrian Havryk, Amy L. Rigby, M. Benzimra, Monique A. Malouf, Marshall Plit, Allan R. Glanville, A. Smith, P. Tunnicliff, A. Hogan, N. DeTullio, and Sunita R Jha
Subjects: Pulmonary and Respiratory Medicine, Transplantation, medicine.medical_specialty, business.industry, Lung disease, medicine.medical_treatment, medicine, Lung transplantation, Surgery, In patient, Cardiology and Cardiovascular Medicine, Intensive care medicine, business
Published: 2016
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33. Achilles tendon disease in lung transplant recipients: association with ciprofloxacin

Author: Prashant N. Chhajed, Marshall Plit, Peter Hopkins, Monique A. Malouf, and Allan R. Glanville
Subjects: Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, Population, Tendonitis, Achilles Tendon, Statistics, Nonparametric, Tendinitis, Ciprofloxacin, Risk Factors, Surveys and Questionnaires, Humans, Medicine, Lung transplantation, Achilles tendonitis, Risk factor, education, Probability, Achilles tendon, education.field_of_study, Dose-Response Relationship, Drug, Rupture, Spontaneous, business.industry, Incidence, Middle Aged, Prognosis, medicine.disease, Surgery, Transplantation, Logistic Models, medicine.anatomical_structure, Tendinopathy, Female, Disease Susceptibility, business, Lung Transplantation
Abstract: Achilles tendonitis or rupture are uncommon complications following the use of fluoroquinolones, with a reported incidence in the general population of 0.4%. The aims of the current study were to determine the incidence of Achilles tendon disease (ATD) in lung transplant recipients (LTR) and to identify risk factors. Questionnaires were sent to 150 LTR of whom 101 responded (67%). Twenty-two LTR (21.8%) experienced ATD (tendonitis 16, rupture six). The mean age of LTR who developed ATD was 52.9+/-6.1 yrs (range: 19-63.5 yrs). Only the use of ciprofloxacin was significantly associated with ATD (p0.05). Age, sex, underlying disease necessitating transplantation, serum creatinine and cyclosporine levels were not associated with ATD. The association between ciprofloxacin and ATD was not dose related. Of the 72 LTR who had received ciprofloxacin, 20 (28%) developed ATD (tendonitis 15, rupture five). In patients receiving ciprofloxacin, there was no association between the mean cumulative dose of prednisolone and ATD. Tendon rupture occurred with a lower ciprofloxacin dosage than tendonitis and the mean recovery duration was significantly longer. To conclude, lung transplant recipients receiving ciprofloxacin are at significant risk of developing Achilles tendon disease. The association between ciprofloxacin and Achilles tendon disease appears to be idiosyncratic rather than dose-related.
Published: 2002
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34. Severity of lymphocytic bronchiolitis predicts long-term outcome after lung transplantation

Author: Monique A. Malouf, Marshall Plit, Adrian Havryk, Steven Rainer, Allan R. Glanville, and C.L Aboyoun
Subjects: Pulmonary and Respiratory Medicine, Adult, Graft Rejection, Male, medicine.medical_specialty, Pathology, Time Factors, medicine.medical_treatment, Biopsy, Bronchiolitis obliterans, Critical Care and Intensive Care Medicine, Gastroenterology, Severity of Illness Index, Risk Factors, Internal medicine, Intensive care, medicine, Confidence Intervals, Odds Ratio, Lung transplantation, Humans, Cumulative incidence, Lymphocytes, Risk factor, Bronchiolitis Obliterans, Retrospective Studies, Lung, business.industry, Incidence, Respiratory disease, Middle Aged, medicine.disease, Prognosis, Survival Rate, medicine.anatomical_structure, Bronchiolitis, Female, business, Respiratory Insufficiency, Follow-Up Studies, Lung Transplantation
Abstract: Severe and recurrent acute vascular rejection of the pulmonary allograft is an accepted major risk factor for obliterative bronchiolitis.We assessed the role of lymphocytic bronchiolitis as a risk factor for bronchiolitis obliterans syndrome (BOS) and death after lung transplantation.Retrospective analysis of 341 90-day survivors of lung transplant performed in 1995-2005 who underwent 1,770 transbronchial lung biopsy procedures.Transbronchial biopsies showed grade B0 (normal) (n = 501), B1 (minimal) (n = 762), B2 (mild) (n = 176), B3 (moderate) (n = 70), B4 (severe) (n = 4) lymphocytic bronchiolitis, and Bx (no bronchiolar tissue) (n = 75). A total of 182 transbronchial biopsies were ungraded (8 inadequate, 142 cytomegalovirus, 32 other diagnoses). Lung transplant recipients were grouped by highest B grade before diagnosis of BOS: B0 (n = 12), B1 (n = 166), B2 (n = 89), and B3-B4 (n = 51). Twenty-three were unclassifiable. Cumulative incidence of BOS and death were dependent on highest B grade (Kaplan-Meier, P0.001, log-rank). Multivariable Cox proportional hazards analysis showed significant risks for BOS were highest B grade (relative risk [RR], 1.62; 95% confidence interval [CI], 1.31-2.00) (P0.001), longer ischemic time (RR, 1.00; CI, 1.00-1.00) (P0.05), and recent year of transplant (RR, 0.93; CI, 0.87-1.00) (P0.05), whereas risks for death were BOS as a time-dependent covariable (RR, 19.10; CI, 11.07-32.96) (P0.001) and highest B grade (RR, 1.36; CI, 1.07-1.72) (P0.05). Acute vascular rejection was not a significant risk factor in either model.Severity of lymphocytic bronchiolitis is associated with increased risk of BOS and death after lung transplantation independent of acute vascular rejection.
Published: 2008

35. Bilateral vocal cord palsy following interscalene brachial plexus nerve block

Author: G. A. Harrison, Marshall Plit, I E Cole, Peter S. Macdonald, and Prashant N. Chhajed
Subjects: medicine.medical_specialty, Cord, medicine.medical_treatment, Stridor, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, otorhinolaryngologic diseases, medicine, Recurrent laryngeal nerve, Paralysis, Humans, Brachial Plexus, 030212 general & internal medicine, Phrenic nerve, Aged, Palsy, business.industry, Shoulder Joint, 030208 emergency & critical care medicine, Nerve Block, Surgery, Anesthesiology and Pain Medicine, Anesthesia, Nerve block, Female, medicine.symptom, business, Brachial plexus, Vocal Cord Paralysis
Abstract: Acute respiratory complications of an interscalene brachial plexus block include ipsilateral phrenic nerve and recurrent laryngeal nerve palsies. A 71-year-old woman who had undergone a total thyroidectomy for papillary carcinoma 35 years ago was administered a right interscalene brachial plexus block for a shoulder hemi-arthroplasty. Subsequently she developed acute respiratory distress associated with marked stridor secondary to an acute right vocal cord palsy, which was superimposed on what was assumed to be a preexisting left-sided vocal cord palsy. On extubation the patient was noted to develop stridor again necessitating reintubation and tracheostomy was performed two weeks later. The vocal cord palsies failed to resolve over the subsequent 18-month follow-up. We describe this case to highlight the significant risk of this procedure in patients with preexisting or suspected contralateral vocal cord palsy.
Published: 2002

36. Influence of antimicrobial chemotherapy on spirometric parameters and pro-inflammatory indices in severe pulmonary tuberculosis

Author: Charles Feldman, C. J. Van Rensburg, L. Page-Shipp, Marshall Plit, J. A. Blott, J. L. Fresen, and Ronald Anderson
Subjects: Pulmonary and Respiratory Medicine, Spirometry, Adult, Male, medicine.medical_specialty, Tuberculosis, Antitubercular Agents, Gastroenterology, Internal medicine, Forced Expiratory Volume, Antimicrobial chemotherapy, medicine, Humans, Lung volumes, Prospective Studies, Prospective cohort study, Lung, Tuberculosis, Pulmonary, medicine.diagnostic_test, business.industry, Respiratory disease, Smoking, respiratory system, medicine.disease, respiratory tract diseases, Surgery, Radiography, medicine.anatomical_structure, C-Reactive Protein, Treatment Outcome, VEMS, alpha 1-Antitrypsin, Regression Analysis, Drug Therapy, Combination, Female, business
Abstract: Patients who have completed a treatment for severe pulmonary tuberculosis (TB) are often left with severe respiratory disability. There have been few prospective studies assessing the effect of treatment on lung function in such patients. The influence of antimicrobial chemotherapy on lung function was investigated over a six month period in patients with newly diagnosed pulmonary TB to test the hypothesis that treatment improves lung function, as well as to identify factors that may influence lung function outcome. Seventy-six patients were recruited into the study, of whom 74 completed the treatment programme. Forty-two were current smokers and 13 seropositive for the human immunodeficiency virus. Improvement in lung function occurred in 54% of patients, but residual airflow limitation or a restrictive pattern was evident in 28% and 24% of patients, respectively. The extent of lung infiltration (radiographic score) both at the outset and after chemotherapy was significantly and negatively related to forced expiratory volume in one second (FEV1) (% pred) (r=-0.41, and r=-0.46, respectively). The post-treatment serum C-reactive protein and alpha1-protease inhibitor levels were negatively associated with FEV1 (% pred) (r=-0.30 and r=-0.35, respectively). These findings demonstrate that, while antimicrobial chemotherapy may lead to improved lung function in patients with pulmonary tuberculosis, a large proportion of patients has residual impairment. The most significant factor influencing post-treatment lung function status, as measured by forced expiratory volume in one second (% predicted), is the pretreatment and post-treatment radiographic score, which acts as a marker of the extent of pulmonary parenchymal involvement in tuberculosis.

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