Clinical School (Austin Health) - Research Publications

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Author: Bolton, Damien × End date: 2017 × Start date: 2014 ×

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    Advances in ureteroscopy
    Wetherell, DR ; Ling, D ; Ow, D ; Koonjbeharry, B ; Sliwinski, A ; Weerakoon, M ; Papa, N ; Lawrentschuk, N ; Bolton, DM (AME PUBLISHING COMPANY, 2014-09)
    Ureteroscopy (URS) is a procedure which has been constantly evolving since the development of first generation devices 40 years ago. Progress towards smaller and more sophisticated equipment has been particularly rapid in the last decade. We review the significant steps that have been made toward improving outcomes and limiting morbidity with this procedure which is central to the management of urolithiasis and other upper urinary tract pathology.
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    A multilingual evaluation of current health information on the Internet for the treatments of benign prostatic hyperplasia
    Chen, EC ; Manecksha, RP ; Abouassaly, R ; Bolton, DM ; Reich, O ; Lawrentschuk, N (ELSEVIER INC, 2014-12)
    PURPOSE: To compare the quality of current Internet information on benign prostatic hyperplasia (BPH) and its surgical and medical managements across four Western languages and a comparative analysis of website sponsors. BPH Internet information quality is particularly relevant in an era of expanding, minimally invasive and surgical therapies. However, no comprehensive analysis exists. METHODS: World Health Organization Health on the Net (HON) principles may be applied to websites using an automated toolbar function. Using a search engine (www.google.com), 9,000 websites were assessed using keywords related to BPH and its medical and surgical treatment in English, French, German, and Spanish. The first 150 websites in each language had HON principles measured whilst a further analysis of site sponsorship was undertaken. RESULTS: Very few BPH websites had greater than ten per cent HON accredited with significant differences (P<0.001) based on terms used for BPH, its medical and surgical management. Tertiles (thirds) of the first 150 websites returned differences in accredited websites (P<0.0001). English language had most accredited websites. Odds ratios for different terms returning accredited websites also were significantly different across terms (P<0.001). Websites were largely commercially sponsored. CONCLUSIONS: A lack of validation of most BPH sites should be appreciated with discrepancies in quality and number of websites across diseases, languages and also between medical and alternate terms. Physicians should participate in and encourage the development of informative, ethical and reliable health websites on the Internet and direct patients to them.
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    Germline BRCA2 mutations drive prostate cancers with distinct evolutionary trajectories
    Taylor, RA ; Fraser, M ; Livingstone, J ; Espiritu, SMG ; Thorne, H ; Huang, V ; Lo, W ; Shiah, Y-J ; Yamaguchi, TN ; Sliwinski, A ; Horsburgh, S ; Meng, A ; Heisler, LE ; Yu, N ; Yousif, F ; Papargiris, M ; Lawrence, MG ; Timms, L ; Murphy, DG ; Frydenberg, M ; Hopkins, JF ; Bolton, D ; Clouston, D ; McPherson, JD ; van der Kwast, T ; Boutros, PC ; Risbridger, GP ; Bristow, RG (NATURE PUBLISHING GROUP, 2017-01-09)
    Germline mutations in the BRCA2 tumour suppressor are associated with both an increased lifetime risk of developing prostate cancer (PCa) and increased risk of aggressive disease. To understand this aggression, here we profile the genomes and methylomes of localized PCa from 14 carriers of deleterious germline BRCA2 mutations (BRCA2-mutant PCa). We show that BRCA2-mutant PCa harbour increased genomic instability and a mutational profile that more closely resembles metastastic than localized disease. BRCA2-mutant PCa shows genomic and epigenomic dysregulation of the MED12L/MED12 axis, which is frequently dysregulated in metastatic castration-resistant prostate cancer (mCRPC). This dysregulation is enriched in BRCA2-mutant PCa harbouring intraductal carcinoma (IDC). Microdissection and sequencing of IDC and juxtaposed adjacent non-IDC invasive carcinoma in 10 patients demonstrates a common ancestor to both histopathologies. Overall we show that localized castration-sensitive BRCA2-mutant tumours are uniquely aggressive, due to de novo aberration in genes usually associated with metastatic disease, justifying aggressive initial treatment.