General Internal Medicine

• 
  Group Leader
  Professor Edward Janus

  edwarddj@unimelb.edu.au

  View researcher's webpage

Research Overview

The General Medicine Research Group, headed by Professor Edward Janus (Head of General Medicine and Western Health’s Director of Office for Research) and Associate Professor Harin Karunajeewa (Divisional Director, Research) aims to develop clinical and health services research that is closely aligned to the areas of greatest burden to hospital services at Western Health. This therefore emphasizes particular issues relating to migrant groups and elderly patients with high rates of multi-morbidity.

We aim to incorporate training and mentorship of our physician trainees into our research program with our overarching objective of being clearly acknowledged as the leading academic General Internal Medicine Unit in Australia within the next 3 years.

We leverage Professor Janus’ existing track record and collaborative links in diabetes, atherosclerotic disease, cardiology and other chronic diseases. We also leverage A Prof Karunajeewa’s interest in infectious diseases, particularly through his co-appointment at the Walter and Eliza Hall Institute of Medical Research (Division of Population and Immunity) and international collaborative links. These create opportunities we hope to exploit to link state of the art biomedical research at WEHI with our clinical research activities. These have included or will include new diagnostics techniques for therapeutic monitoring in tuberculosis and applying microbiomics, transcriptomics and genomics to evaluations of acute respiratory infections.

A new area of research for our group is health services research and health economics. This reflects Western Health’s broader organizational strategy of building capacity in this field and we hope this will see us well placed to capitalize future opportunities that will arise as the Australian research funding environment comes to place increasing emphasis on translational research that generates efficiency dividends for government. Given our existing emphasis on high hospitalization burden conditions and in infectious diseases, these preliminary studies and associated publications have concentrated on areas such as acute respiratory infection (community acquired pneumonia), diabetes and cellulitis (infection of skin). This work has seen us develop expertise in data linkage using existing hospital data sources, utilization of clinical costing data for health economic analyses and a successful funding application from the HCF research foundation to evaluate a new service delivery model for treating community acquired pneumonia.

Staff

• Professor Edward Janus
  A/Prof Harin Karunajeewa  
• Ms Melanie Lloyd (Physiotherapist/ research manager Optimize-CAP trial)
• Ms Stephanie Lowe (Research physiotherapist Optimize-CAP trial)
• Dr Clarice Tang (Research physiotherapist Optimize-CAP trial)
• Dr Rob James (WEHI clinical research fellow/ honorary WH researcher: TB studies)
• Dr Parul Bali (Chief Medical Registrar)
• Dr Soe Ko (Senior Medical Registrar)

Collaborators

• Tuberculosis and acute respiratory infections
  Walter and Eliza Hall Institute of Medical Research (Division of Population Health and Immunity: A/Prof Aaron Jex)
  University of Western Australia (A.Prof Laurens Manning)
  Australian Institute of Tropical Medicine and Health (James Cook University: Professor Emma McBryde)
• Cardiovascular disease and pharmacy
  Monash School of Pharmacy (Dr Kevin McNamara)
• Health services research, physiotherapy and clinical trial design
  Monash University (Professor Terry Haines)
• Diabetes
  Deakin University (Professor James Dunbar)

Funding

• Tuberculosis
  Australian Respiratory Council Harry Windsor Foundation Grant ($50,000)
  John Burge Foundation, State Trustees ($59,000)
  Australian Institute of Tropical Health and Medicine/ James Cook University internal grant ($100,000)
• Community acquired pneumonia/ Acute Respiratory Infections
  HCF research foundation ($300,000)
• Professor Janus and A/Prof Karunajeewa also hold research funding for work done outside Western Health (eg A Prof Karunajeewa holds grants for malaria research as part of his work at WEHI including a grant for $US1 million from the Bill and Melinda Gates Foundation).

Research Publications

Publications of highest relevance to our research agenda and predominantly within the scope of our research group at Western Health are listed here. These include significant co-authorship by Western Health Registrars. (Western Health staff are underlined in authorship lists)

1. Michalczyk AA, Dunbar JA, Janus ED, Best JD, Ebeling PR, Ackland MJ, Asproloupos D, Ackland ML. Epigenetic markers to predict conversion fromgestational diabetes to type 2 diabetes. J Clin Endocrinol Metab. 2016 Apr 5:jc20154206. [Epub ahead of print] PubMed PMID: 27045797.
2. Kameshwar K, Karahalios A, Janus E, Karunajeewa H. False economies in home-based parenteral antibiotic treatment: a health-economic case study of management of lower-limb cellulitis in Australia. J Antimicrob Chemother. 2016 Mar;71(3):830-5. doi: 10.1093/jac/dkv413. Epub 2015 Dec 24. PubMed PMID: 26702920.
3. Dunbar JA, Hernan AL, Janus ED, Vartiainen E, Laatikainen T, Versace VL, Reynolds J, Best JD, Skinner TC, O'Reilly SL, Mc Namara KP, Stewart E, Coates M,  Bennett CM, Carter R. Challenges of diabetes prevention in the real world: results and lessons from the Melbourne Diabetes Prevention Study. BMJ OpenDiabetes Res Care. 2015 Oct 1;3(1):e000131. doi: 10.1136/bmjdrc-2015-000131. eCollection 2015. PubMed PMID: 26464804; PubMed Central PMCID: PMC4597415.
4. Otome O, Guy S, Tramontana A, Lane G, Karunajeewa H. A Retrospective Review: Significance of Vegetation Size in Injection Drug Users with Right-SidedInfective Endocarditis. Heart Lung Circ. 2016 May;25(5):466-70. doi: 10.1016/j.hlc.2015.10.013. Epub 2015 Nov 18. PubMed PMID: 26700022.
5. Somarajah G, Karunajeewa H, Hamblin PS, Karahalios E, Janus E. The true prevalence of diabetes in hospital patients and its implications. Intern Med J. 2015 May;45(5):594. doi: 10.1111/imj.12746. PubMed PMID: 25955475.
6. Malo JA, Versace VL, Janus ED, Laatikainen T, Peltonen M, Vartiainen E, Coates MJ, Dunbar JA. Evaluation of AUSDRISK as a screening tool for lifestyle modification programs: international implications for policy and cost-effectiveness. BMJ Open Diabetes Res Care. 2015 Oct 5;3(1):e000125. doi: 10.1136/bmjdrc-2015-000125. eCollection 2015. PubMed PMID: 26468399; PubMedCentral PMCID: PMC4600182.
7. Karunajeewa H, Waltmann A, Wini L, Mueller I. Missing malaria? Potential obstacles to diagnosis and hypnozoite eradication. Med J Aust. 2015 Apr 20;202(7):360. PubMed PMID: 25877110.
8. Williams E, Girdwood J, Janus E, Karunajeewa H. CORB is the best pneumonia severity score for elderly hospitalised patients with suspected pneumonia. Intern Med J. 2014 Jun;44(6):613-5. doi: 10.1111/imj.12445. PubMed PMID: 24946819.
9. Jex AR, Koehler AV, Ansell BR, Baker L, Karunajeewa H, Gasser RB. Getting to the guts of the matter: the status and potential of 'omics' research of parasitic protists of the human gastrointestinal system. Int J Parasitol. 2013 Nov;43(12-13):971-82. doi: 10.1016/j.ijpara.2013.06.005. Epub 2013 Jul 18. Review. PubMed PMID: 23871821.
10. Abouzeid M, Bhopal RS, Dunbar JA, Janus ED. The potential for measuring ethnicity and health in a multicultural milieu--the case of type 2 diabetes in Australia. Ethn Health. 2014 Aug;19(4):424-39. doi: 10.1080/13557858.2013.828828. Epub 2013 Aug 20. PubMed PMID: 23961834.
11. Knox J, Lane G, Wong JS, Trevan PG, Karunajeewa H. Diagnosis of tuberculous lymphadenitis using fine needle aspiration biopsy. Intern Med J. 2012 Sep;42(9):1029-36. PubMed PMID: 22372860.