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Article ; Online: Exploring the role of a recently licensed dengue vaccine in Australian travellers.

Thevarajan, Irani / Torresi, Joseph / Simmons, Cameron

2020 Volume 212, Issue 3, Page(s) 102–103.e1

MeSH term(s)	Antibodies, Viral/immunology ; Australia ; Clinical Trials as Topic ; Dengue/prevention & control ; Dengue Vaccines/immunology ; Dengue Vaccines/therapeutic use ; Dengue Virus/immunology ; Humans ; Licensure ; Public Health ; Travel ; Vaccines, Attenuated/immunology
Chemical Substances	Antibodies, Viral ; Dengue Vaccines ; Vaccines, Attenuated
Language	English
Publishing date	2020-01-07
Publishing country	Australia
Document type	Journal Article
ZDB-ID	186082-3
ISSN	1326-5377 ; 0025-729X
ISSN (online)	1326-5377
ISSN	0025-729X
DOI	10.5694/mja2.50471
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Article ; Online: Clinical presentation and management of COVID-19.

Thevarajan, Irani / Buising, Kirsty L / Cowie, Benjamin C

The Medical journal of Australia

2020 Volume 213, Issue 3, Page(s) 134–139

Abstract: The rapid spread of severe acute respiratory syndrome coronavirus 2 led to the declaration of a global pandemic within 3 months of its emergence. The majority of patients presenting with coronavirus disease 2019 (COVID-19) experience a mild illness that ... ...

Abstract	The rapid spread of severe acute respiratory syndrome coronavirus 2 led to the declaration of a global pandemic within 3 months of its emergence. The majority of patients presenting with coronavirus disease 2019 (COVID-19) experience a mild illness that can usually be managed in the community. Patients require careful monitoring and early referral to hospital if any signs of clinical deterioration occur. Increased age and the presence of comorbidities are associated with more severe disease and poorer outcomes. Treatment for COVID-19 is currently predominantly supportive care, focused on appropriate management of respiratory dysfunction. Clinical evidence is emerging for some specific therapies (including antiviral and immune-modulating agents). Investigational therapies for COVID-19 should be used in the context of approved randomised controlled trials. Australian clinicians need to be able to recognise, diagnose, manage and appropriately refer patients affected by COVID-19, with thousands of cases likely to present over the coming years.
MeSH term(s)	Age Factors ; Antiviral Agents/therapeutic use ; Australia/epidemiology ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Humans ; Immunologic Factors/therapeutic use ; Oxygen Inhalation Therapy ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index
Chemical Substances	Antiviral Agents ; Immunologic Factors
Keywords	covid19
Language	English
Publishing date	2020-07-17
Publishing country	Australia
Document type	Journal Article ; Review
ZDB-ID	186082-3
ISSN	1326-5377 ; 0025-729X
ISSN (online)	1326-5377
ISSN	0025-729X
DOI	10.5694/mja2.50698
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Article ; Online: Reply to a comment on Tuberculosis and the traveller: evaluating and reducing risk through travel consultation.

Denholm, Justin / Thevarajan, Irani

Journal of travel medicine

2016 Volume 23, Issue 4

MeSH term(s)	Humans ; Referral and Consultation ; Travel ; Tuberculosis
Language	English
Publishing date	2016-04
Publishing country	England
Document type	Comment ; Letter
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/taw031
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Article ; Online: Clinical presentation and management of COVID ‐19

Thevarajan, Irani / Buising, Kirsty L / Cowie, Benjamin C

Medical Journal of Australia

2020 Volume 213, Issue 3, Page(s) 134–139

Keywords	General Medicine ; covid19
Language	English
Publisher	AMPCo
Publishing country	au
Document type	Article ; Online
ZDB-ID	186082-3
ISSN	1326-5377 ; 0025-729X
ISSN (online)	1326-5377
ISSN	0025-729X
DOI	10.5694/mja2.50698
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Tuberculosis and the traveller: evaluating and reducing risk through travel consultation.

Denholm, Justin T / Thevarajan, Irani

Journal of travel medicine

2016 Volume 23, Issue 3

Abstract: Background: Although the last 10 years have seen a slow decline in global tuberculosis (TB) incidence, it remains one of the most significant infectious diseases worldwide, with an estimated 9.6 million new cases and 1.5 million deaths in 2014. The ... ...

Abstract	Background: Although the last 10 years have seen a slow decline in global tuberculosis (TB) incidence, it remains one of the most significant infectious diseases worldwide, with an estimated 9.6 million new cases and 1.5 million deaths in 2014. The consequences of contracting TB can be significant for the individual, with extended treatment requirements, risk of long-term health consequences and the possibility of transmitting infection to others among the complications of disease. Methods: This review article discusses the risk of TB infection as a result of international travel including evaluation of risk, risk reduction and a proposed testing strategy for travel-related TB infection. A review of the relevant literature combined with expert opinion was used to formulate this article. Results: The global TB epidemic is varied and dynamic, including changing patterns of both drug sensitive and drug resistant disease. The annual incidence of TB in individual countries such as South Africa may be greater than 800/100,000, while multidrug resistance is found in up to 19% of new cases in the Russian Federation. Recent surveys of traveller risk are presented for short and long-term travellers to various countries and settings. Overall, risk to travelers is low, with rates of acquiring latent TB less than 1% per travel year for most settings. However, detailed travel evaluation is necessary to evaluate individual risk. Travellers with immunosuppressive conditions are at high risk for progression to active disease if infected, and should have special consideration in travel consultation. Discussion: It is important for practitioners giving advice regarding tuberculosis risk and travel to access up-to-date information regarding local conditions. This article provides an approach to assessment and management of TB in travellers, including a guide to pre- and post-travel evaluation, testing and vaccination.
MeSH term(s)	BCG Vaccine ; Humans ; Referral and Consultation ; Risk Reduction Behavior ; Russia ; Skin Tests ; South Africa ; Travel ; Tuberculosis/epidemiology ; Tuberculosis/prevention & control
Chemical Substances	BCG Vaccine
Language	English
Publishing date	2016-03
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/taw008
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Article: Deconstructing the Dogma: Systematic Literature Review and Meta-analysis of Adjunctive Gentamicin and Rifampin in Staphylococcal Prosthetic Valve Endocarditis.

Ryder, Jonathan H / Tong, Steven Y C / Gallagher, Jason C / McDonald, Emily G / Thevarajan, Irani / Lee, Todd C / Cortés-Penfield, Nicolás W

Open forum infectious diseases

2022 Volume 9, Issue 11, Page(s) ofac583

Abstract: Background: Based primarily on in vitro and animal models, with little data directly addressing patient outcomes, current guidelines recommend treating staphylococcal prosthetic valve endocarditis (PVE) with antibiotic combinations including gentamicin ... ...

Abstract	Background: Based primarily on in vitro and animal models, with little data directly addressing patient outcomes, current guidelines recommend treating staphylococcal prosthetic valve endocarditis (PVE) with antibiotic combinations including gentamicin and rifampin. Here, we synthesize the clinical data on adjunctive rifampin and gentamicin in staphylococcal PVE. Methods: We conducted a systematic review and meta-analysis of PubMed- and Cochrane-indexed studies reporting outcomes of staphylococcal PVE treated with adjunctive rifampin, gentamicin, both agents, or neither (ie, glycopeptide or β-lactam monotherapy). We recorded outcomes including mortality, relapsed infection, length of stay, nephrotoxicity, hepatotoxicity, and important drug-drug interactions (DDIs). Results: Four relevant studies were identified. Two studies (n = 117) suggested that adding gentamicin to rifampin-containing regimens did not reduce clinical failure (odds ratio [OR], 0.98 [95% confidence interval {CI}, .39-2.46]), and 2 studies (n = 201) suggested that adding rifampin to gentamicin-containing regimens did not reduce clinical failure (OR, 1.29 [95% CI, .71-2.33]). Neither gentamicin nor rifampin was associated with reduced infection relapse; 1 study found that rifampin treatment was associated with longer hospitalizations (mean, 31.3 vs 42.3 days; Conclusions: The existing clinical data do not suggest a benefit of either adjunctive gentamicin or rifampin in staphylococcal PVE. Given that other studies also suggest these agents add nephrotoxicity, hepatoxicity, and risk of DDIs without benefit in staphylococcal endovascular infections, we suggest that recommendations for gentamicin and rifampin in PVE be downgraded and primarily be used within the context of clinical trials.
Language	English
Publishing date	2022-10-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofac583
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Article ; Online: The APPRISE Virtual Biobank for Infectious Diseases.

Smith, Miranda Z / Turner, Maureen / Haurat, Javier / Thevarajan, Irani / Denholm, Justin / Tong, Steven YC / Matthews, Gail V / Bull, Rowena A / Martinello, Marianne / McMahon, James / Imrie, Allison / Pillai, Priyanka E

Communicable diseases intelligence (2018)

2023 Volume 47

Abstract: The Australian Partnership for Preparedness Research on InfectiouS disease Emergencies (APPRISE) has developed a virtual biobank to support infectious disease research in Australia. The virtual biobank (https://apprise.biogrid.org.au) integrates access ... ...

Abstract	The Australian Partnership for Preparedness Research on InfectiouS disease Emergencies (APPRISE) has developed a virtual biobank to support infectious disease research in Australia. The virtual biobank (https://apprise.biogrid.org.au) integrates access to existing distributed infectious disease biospecimen collections comprising multiple specimen types, including plasma, serum, and peripheral blood mononuclear cells. Through the development of a common data model, multiple collections can be searched simultaneously via a secure web portal. The portal enhances the visibility and searchability of existing collections within their current governance and custodianship arrangements. The portal is easily scalable for integration of additional collections.
MeSH term(s)	Humans ; Australia/epidemiology ; Biological Specimen Banks ; Leukocytes, Mononuclear ; Specimen Handling ; Communicable Diseases
Language	English
Publishing date	2023-11-16
Publishing country	Australia
Document type	Journal Article
ISSN	2209-6051
ISSN (online)	2209-6051
DOI	10.33321/cdi.2023.47.66
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Clinical presentation and management of COVID-19

Thevarajan, Irani / Buising, Kirsty L / Cowie, Benjamin C

Med J Aust

Abstract	The rapid spread of severe acute respiratory syndrome coronavirus 2 led to the declaration of a global pandemic within 3 months of its emergence. The majority of patients presenting with coronavirus disease 2019 (COVID-19) experience a mild illness that can usually be managed in the community. Patients require careful monitoring and early referral to hospital if any signs of clinical deterioration occur. Increased age and the presence of comorbidities are associated with more severe disease and poorer outcomes. Treatment for COVID-19 is currently predominantly supportive care, focused on appropriate management of respiratory dysfunction. Clinical evidence is emerging for some specific therapies (including antiviral and immune-modulating agents). Investigational therapies for COVID-19 should be used in the context of approved randomised controlled trials. Australian clinicians need to be able to recognise, diagnose, manage and appropriately refer patients affected by COVID-19, with thousands of cases likely to present over the coming years.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #650903
Database	COVID19

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Article ; Online: Pathway and Network Analyses Identify Growth Factor Signaling and MMP9 as Potential Mediators of Mitochondrial Dysfunction in Severe COVID-19.

Wang, Ya / Schughart, Klaus / Pelaia, Tiana Maria / Chew, Tracy / Kim, Karan / Karvunidis, Thomas / Knippenberg, Ben / Teoh, Sally / Phu, Amy L / Short, Kirsty R / Iredell, Jonathan / Thevarajan, Irani / Audsley, Jennifer / Macdonald, Stephen / Burcham, Jonathon / Predict-Consortium / Tang, Benjamin / McLean, Anthony / Shojaei, Maryam

International journal of molecular sciences

2023 Volume 24, Issue 3

Abstract: Patients with preexisting metabolic disorders such as diabetes are at a higher risk of developing severe coronavirus disease 2019 (COVID-19). Mitochondrion, the very organelle that controls cellular metabolism, holds the key to understanding disease ... ...

Abstract	Patients with preexisting metabolic disorders such as diabetes are at a higher risk of developing severe coronavirus disease 2019 (COVID-19). Mitochondrion, the very organelle that controls cellular metabolism, holds the key to understanding disease progression at the cellular level. Our current study aimed to understand how cellular metabolism contributes to COVID-19 outcomes. Metacore pathway enrichment analyses on differentially expressed genes (encoded by both mitochondrial and nuclear deoxyribonucleic acid (DNA)) involved in cellular metabolism, regulation of mitochondrial respiration and organization, and apoptosis, was performed on RNA sequencing (RNASeq) data from blood samples collected from healthy controls and patients with mild/moderate or severe COVID-19. Genes from the enriched pathways were analyzed by network analysis to uncover interactions among them and up- or downstream genes within each pathway. Compared to the mild/moderate COVID-19, the upregulation of a myriad of growth factor and cell cycle signaling pathways, with concomitant downregulation of interferon signaling pathways, were observed in the severe group. Matrix metallopeptidase 9 (
MeSH term(s)	Humans ; COVID-19 ; Matrix Metalloproteinase 9/genetics ; Matrix Metalloproteinase 9/metabolism ; Signal Transduction ; Intercellular Signaling Peptides and Proteins ; Mitochondria/metabolism
Chemical Substances	Matrix Metalloproteinase 9 (EC 3.4.24.35) ; Intercellular Signaling Peptides and Proteins ; MMP9 protein, human (EC 3.4.24.35)
Language	English
Publishing date	2023-01-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms24032524
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Blood transcriptome responses in patients correlate with severity of COVID-19 disease.

Frontiers in immunology

2023 Volume 13, Page(s) 1043219

Abstract: Background: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Infected individuals display a wide spectrum of disease severity, as defined by the World Health ... ...

Abstract	Background: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Infected individuals display a wide spectrum of disease severity, as defined by the World Health Organization (WHO). One of the main factors underlying this heterogeneity is the host immune response, with severe COVID-19 often associated with a hyperinflammatory state. Aim: Our current study aimed to pinpoint the specific genes and pathways underlying differences in the disease spectrum and outcomes observed, through in-depth analyses of whole blood transcriptomics in a large cohort of COVID-19 participants. Results: All WHO severity levels were well represented and mild and severe disease displaying distinct gene expression profiles. WHO severity levels 1-4 were grouped as mild disease, and signatures from these participants were different from those with WHO severity levels 6-9 classified as severe disease. Severity level 5 (moderate cases) presented a unique transitional gene signature between severity levels 2-4 (mild/moderate) and 6-9 (severe) and hence might represent the turning point for better or worse disease outcome. Gene expression changes are very distinct when comparing mild/moderate or severe cases to healthy controls. In particular, we demonstrated the hallmark down-regulation of adaptive immune response pathways and activation of neutrophil pathways in severe compared to mild/moderate cases, as well as activation of blood coagulation pathways. Conclusions: Our data revealed discrete gene signatures associated with mild, moderate, and severe COVID-19 identifying valuable candidates for future biomarker discovery.
MeSH term(s)	Humans ; COVID-19/genetics ; Transcriptome ; SARS-CoV-2 ; Gene Expression Profiling ; Neutrophils
Language	English
Publishing date	2023-01-20
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.1043219
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