Duncan J Topliss - Academia.edu (original) (raw)

Papers by Duncan J Topliss

Poster Presentation Abstract (PP 046), 130th Anniversary International Medical Congress, Sri Lank... more Poster Presentation Abstract (PP 046), 130th Anniversary International Medical Congress, Sri Lanka Medical Association, 13th-16th July 2017 Colombo, Sri Lanka

Medical Journal of Australia, 1995

The fundamental defect in NIDDM has not been established. Insulin resistance, an impairment of B-... more The fundamental defect in NIDDM has not been established. Insulin resistance, an impairment of B-cell function, and overproduction of glucose by the liver have all been implicated. Genetic analysis of the strongly inherited form of NIDDM maturity-onset diabetes of the young has recently identified glucokinase deficiency as a cause,' with a variety of mutations that impair enzyme function resulting in glucose-blindness of the pancreatic B cell, and hepatic insulin resistance.

Medical Journal of Australia, 2004

Endocrinology, Diabetes & Metabolism Case Reports, 2020

Summary Despite improvements in localisation techniques and surgical advances, some patients with... more Summary Despite improvements in localisation techniques and surgical advances, some patients with insulinoma will not be cured by surgery or may not be suitable for surgery. Medical management with diazoxide is an option for such cases. This case report details 27 years of successful management of insulinoma using diazoxide. It has been effective and safe, with only minor adverse effects. Learning points: Long term diazoxide use can be a safe, effective option for insulinoma when it cannot be localised or removed surgically. Common adverse effects include peripheral oedema, hyperuricaemia, and hirsutism. 68Ga-NOTA-exendin-4 PET/CT scan should be considered for insulinoma localisation when other modalities have been unhelpful.

Internal Medicine Journal, 2020

Canadian Medical Association Journal, 2020

Internal Medicine Journal, 2018

The Journal of Clinical Endocrinology & Metabolism, 1998

Australian Family Physician, 2016

Hyperthyroidism and atrial fibrillation (AF) are both common in the Australian community, and oft... more Hyperthyroidism and atrial fibrillation (AF) are both common in the Australian community, and often encountered in general practice. This article discusses the risk of AF and thromboembolism in hyperthyroidism, the role of antithrombotic therapy in this setting, and appropriateness and safety of various antithrombotic agents in thyroid disease. Prevention of thromboembolism is an important consideration in the care of patients with AF and hyperthyroidism. However, the evaluation of thromboembolic risk and management in this setting is challenging. Thyroid disease results in a pro-coagulant state via disruption of coagulation pathways and alters the pharmacodynamics of anticoagulants. Currently, guidelines regarding anticoagulation in AF do not incorporate hyperthyroidism as an additional risk factor. Until further evidence becomes available, we recommend warfarin as the oral anticoagulant of choice in thyroid disease because of ease of monitoring and reversibility.

Alimentary Pharmacology & Therapeutics

1Department of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern Univers... more 1Department of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA 2Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland 3Clinical Trials Unit, University of Bern, Bern, Switzerland 4Adare Pharmaceuticals, Lawrenceville, NJ, USA 5Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland 6Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Email: i-hirano@northwestern.edu

Endocrinology, Diabetes & Metabolism Case Reports

Summary Insulinomas are rare neuroendocrine tumours that classically present with fasting hypogly... more Summary Insulinomas are rare neuroendocrine tumours that classically present with fasting hypoglycaemia. This case report discusses an uncommon and challenging case of insulinoma soon after upper gastrointestinal surgery. A 63-year-old man presented with 6 months of post-prandial hypoglycaemia beginning after a laparoscopic revision of Toupet fundoplication. Hyperinsulinaemic hypoglycaemia was confirmed during a spontaneous episode and in a mixed-meal test. Localisation studies including magnetic resonance imaging (MRI), endoscopic ultrasound (EUS) and gallium dotatate positron emission tomography (68Ga Dotatate PET) were consistent with a small insulinoma in the mid-body of the pancreas. The lesion was excised and histopathology was confirmed a localised well-differentiated neuroendocrine pancreatic neoplasm. There have been no significant episodes of hypoglycaemia since. This case highlights several key points. Insulinoma should be sought in proven post-prandial hyperinsulinaemic ...

Medical Journal of Australia, Feb 16, 2004

The most common cause of hyperthyroidism in Australia is Graves disease, caused by a defect in im... more The most common cause of hyperthyroidism in Australia is Graves disease, caused by a defect in immunoregulation in genetically predisposed individuals, leading to production of thyroid-stimulating antibodies. Each of the three modalities of therapy for Graves disease--thionamide drugs, subtotal or total thyroidectomy, and radioactive iodine ablation--can render the patient euthyroid, but all have potential adverse effects and may not eliminate recurrences. Hypothyroidism occurs in about 5% of the adult population; most present with "subclinical" hypothyroidism (mild thyroid failure), characterised by raised levels of serum thyroid stimulating hormone (TSH) but normal free thyroxine (T(4)). The most common cause of hypothyroidism in Australia is autoimmune chronic lymphocytic thyroiditis, characterised by raised circulating levels of thyroid peroxidase antibody. Symptoms and signs of hypothyroidism are often mild or subtle and, when there is clinical suspicion, thyroid func...

Endocrinology, Diabetes & Metabolism Case Reports

SummaryA 58-year-old man with metastatic radioiodine-refractory differentiated thyroid cancer (DT... more SummaryA 58-year-old man with metastatic radioiodine-refractory differentiated thyroid cancer (DTC) presented with left thigh and right flank numbness. He had known progressive and widespread bony metastases, for which he received palliative radiotherapy, and multiple bilateral asymptomatic pulmonary metastases. CT scan and MRI of the spine revealed metastases at right T10–L1 vertebrae with extension into the central canal and epidural disease at T10 and T11 causing cord displacement and canal stenosis but retention of spinal cord signal. Spinal surgery was followed by palliative radiotherapy resulting in symptom resolution. Two months later, sorafenib received approval for use in Australia and was commenced and up-titrated with symptomatic management of mild adverse effects. Follow-up CT scan three months after commencement of sorafenib revealed regression of pulmonary metastases but no evident change in most bone metastases except for an advancing lesion eroding into the right ace...

Medical Journal of Australia

The Medical journal …, 1995

OBJECTIVE: To examine patterns of use and clinical outcomes of total parenteral nutrition (TPN). ... more OBJECTIVE: To examine patterns of use and clinical outcomes of total parenteral nutrition (TPN). DESIGN: A prospective six-month audit (December 1992-June 1993). PATIENTS AND SETTING: All inpatients administered TPN at a metropolitan teaching hospital during ...

Journal of Clinical Oncology

5518 Background: Lenvatinib is an oral tyrosine kinase inhibitor targeting VEGFR1-3, FGFR1-4, RET... more 5518 Background: Lenvatinib is an oral tyrosine kinase inhibitor targeting VEGFR1-3, FGFR1-4, RET, KIT and PDGFRβ. In a phase II study of lenvatinib, 58 patients (pts) with DTC were enrolled and a response rate of 50% was observed (Sherman, ASCO 2011). Methods: Pts received lenvatinib at a starting dose of 24 mg oral once daily in 28-day cycles. Serum was collected at baseline (BL), on day 8 and on day 36 and concentrations of 47 CAFs were measured using multiplex bead arrays and enzyme-linked immunosorbent assay (ELISA). 33 genes (443 mutations) were examined in archival tumor tissues (n=25). Association of baseline CAF, changes in CAF levels upon treatment and gene mutation status with treatment outcomes was investigated. Results: Combination of low baseline VEGF and ANG-2 (p=0.02 and HR=0.386) correlated with longer PFS. Both baseline and changes in CAF levels demonstrated an association with gene mutation status. High baseline levels of VEGF were observed in pts with wild type R...

Poster Presentation Abstract (PP 046), 130th Anniversary International Medical Congress, Sri Lank... more Poster Presentation Abstract (PP 046), 130th Anniversary International Medical Congress, Sri Lanka Medical Association, 13th-16th July 2017 Colombo, Sri Lanka

Medical Journal of Australia, 1995

The fundamental defect in NIDDM has not been established. Insulin resistance, an impairment of B-... more The fundamental defect in NIDDM has not been established. Insulin resistance, an impairment of B-cell function, and overproduction of glucose by the liver have all been implicated. Genetic analysis of the strongly inherited form of NIDDM maturity-onset diabetes of the young has recently identified glucokinase deficiency as a cause,' with a variety of mutations that impair enzyme function resulting in glucose-blindness of the pancreatic B cell, and hepatic insulin resistance.

Medical Journal of Australia, 2004

Endocrinology, Diabetes & Metabolism Case Reports, 2020

Summary Despite improvements in localisation techniques and surgical advances, some patients with... more Summary Despite improvements in localisation techniques and surgical advances, some patients with insulinoma will not be cured by surgery or may not be suitable for surgery. Medical management with diazoxide is an option for such cases. This case report details 27 years of successful management of insulinoma using diazoxide. It has been effective and safe, with only minor adverse effects. Learning points: Long term diazoxide use can be a safe, effective option for insulinoma when it cannot be localised or removed surgically. Common adverse effects include peripheral oedema, hyperuricaemia, and hirsutism. 68Ga-NOTA-exendin-4 PET/CT scan should be considered for insulinoma localisation when other modalities have been unhelpful.

Internal Medicine Journal, 2020

Canadian Medical Association Journal, 2020

Internal Medicine Journal, 2018

The Journal of Clinical Endocrinology & Metabolism, 1998

Australian Family Physician, 2016

Hyperthyroidism and atrial fibrillation (AF) are both common in the Australian community, and oft... more Hyperthyroidism and atrial fibrillation (AF) are both common in the Australian community, and often encountered in general practice. This article discusses the risk of AF and thromboembolism in hyperthyroidism, the role of antithrombotic therapy in this setting, and appropriateness and safety of various antithrombotic agents in thyroid disease. Prevention of thromboembolism is an important consideration in the care of patients with AF and hyperthyroidism. However, the evaluation of thromboembolic risk and management in this setting is challenging. Thyroid disease results in a pro-coagulant state via disruption of coagulation pathways and alters the pharmacodynamics of anticoagulants. Currently, guidelines regarding anticoagulation in AF do not incorporate hyperthyroidism as an additional risk factor. Until further evidence becomes available, we recommend warfarin as the oral anticoagulant of choice in thyroid disease because of ease of monitoring and reversibility.

Alimentary Pharmacology & Therapeutics

1Department of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern Univers... more 1Department of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA 2Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland 3Clinical Trials Unit, University of Bern, Bern, Switzerland 4Adare Pharmaceuticals, Lawrenceville, NJ, USA 5Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland 6Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Email: i-hirano@northwestern.edu

Endocrinology, Diabetes & Metabolism Case Reports

Summary Insulinomas are rare neuroendocrine tumours that classically present with fasting hypogly... more Summary Insulinomas are rare neuroendocrine tumours that classically present with fasting hypoglycaemia. This case report discusses an uncommon and challenging case of insulinoma soon after upper gastrointestinal surgery. A 63-year-old man presented with 6 months of post-prandial hypoglycaemia beginning after a laparoscopic revision of Toupet fundoplication. Hyperinsulinaemic hypoglycaemia was confirmed during a spontaneous episode and in a mixed-meal test. Localisation studies including magnetic resonance imaging (MRI), endoscopic ultrasound (EUS) and gallium dotatate positron emission tomography (68Ga Dotatate PET) were consistent with a small insulinoma in the mid-body of the pancreas. The lesion was excised and histopathology was confirmed a localised well-differentiated neuroendocrine pancreatic neoplasm. There have been no significant episodes of hypoglycaemia since. This case highlights several key points. Insulinoma should be sought in proven post-prandial hyperinsulinaemic ...

Medical Journal of Australia, Feb 16, 2004

The most common cause of hyperthyroidism in Australia is Graves disease, caused by a defect in im... more The most common cause of hyperthyroidism in Australia is Graves disease, caused by a defect in immunoregulation in genetically predisposed individuals, leading to production of thyroid-stimulating antibodies. Each of the three modalities of therapy for Graves disease--thionamide drugs, subtotal or total thyroidectomy, and radioactive iodine ablation--can render the patient euthyroid, but all have potential adverse effects and may not eliminate recurrences. Hypothyroidism occurs in about 5% of the adult population; most present with "subclinical" hypothyroidism (mild thyroid failure), characterised by raised levels of serum thyroid stimulating hormone (TSH) but normal free thyroxine (T(4)). The most common cause of hypothyroidism in Australia is autoimmune chronic lymphocytic thyroiditis, characterised by raised circulating levels of thyroid peroxidase antibody. Symptoms and signs of hypothyroidism are often mild or subtle and, when there is clinical suspicion, thyroid func...

Endocrinology, Diabetes & Metabolism Case Reports

SummaryA 58-year-old man with metastatic radioiodine-refractory differentiated thyroid cancer (DT... more SummaryA 58-year-old man with metastatic radioiodine-refractory differentiated thyroid cancer (DTC) presented with left thigh and right flank numbness. He had known progressive and widespread bony metastases, for which he received palliative radiotherapy, and multiple bilateral asymptomatic pulmonary metastases. CT scan and MRI of the spine revealed metastases at right T10–L1 vertebrae with extension into the central canal and epidural disease at T10 and T11 causing cord displacement and canal stenosis but retention of spinal cord signal. Spinal surgery was followed by palliative radiotherapy resulting in symptom resolution. Two months later, sorafenib received approval for use in Australia and was commenced and up-titrated with symptomatic management of mild adverse effects. Follow-up CT scan three months after commencement of sorafenib revealed regression of pulmonary metastases but no evident change in most bone metastases except for an advancing lesion eroding into the right ace...

Medical Journal of Australia

The Medical journal …, 1995

OBJECTIVE: To examine patterns of use and clinical outcomes of total parenteral nutrition (TPN). ... more OBJECTIVE: To examine patterns of use and clinical outcomes of total parenteral nutrition (TPN). DESIGN: A prospective six-month audit (December 1992-June 1993). PATIENTS AND SETTING: All inpatients administered TPN at a metropolitan teaching hospital during ...

Journal of Clinical Oncology

5518 Background: Lenvatinib is an oral tyrosine kinase inhibitor targeting VEGFR1-3, FGFR1-4, RET... more 5518 Background: Lenvatinib is an oral tyrosine kinase inhibitor targeting VEGFR1-3, FGFR1-4, RET, KIT and PDGFRβ. In a phase II study of lenvatinib, 58 patients (pts) with DTC were enrolled and a response rate of 50% was observed (Sherman, ASCO 2011). Methods: Pts received lenvatinib at a starting dose of 24 mg oral once daily in 28-day cycles. Serum was collected at baseline (BL), on day 8 and on day 36 and concentrations of 47 CAFs were measured using multiplex bead arrays and enzyme-linked immunosorbent assay (ELISA). 33 genes (443 mutations) were examined in archival tumor tissues (n=25). Association of baseline CAF, changes in CAF levels upon treatment and gene mutation status with treatment outcomes was investigated. Results: Combination of low baseline VEGF and ANG-2 (p=0.02 and HR=0.386) correlated with longer PFS. Both baseline and changes in CAF levels demonstrated an association with gene mutation status. High baseline levels of VEGF were observed in pts with wild type R...