Peter Wark
Newcastle
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Articles by Peter Wark
A 20‐year case‐series of distal intestinal obstruction syndrome at a state‐wide cystic fibrosis service
Introduction Distal Intestinal Obstruction Syndrome (DIOS) is a serious complication of cystic fibrosis (CF), affecting up to 15% of adult CF patients.1 It is caused by the accumulation of viscous mucous in the small intestine, considered to be the result of cystic fibrosis transmembrane conductance regulator (CFTR) dysfunction leading to dehydration of the mucosal surface liquid of and the progressive accumulation of inspissated mucus combined with desiccated faecal material, commonly in the...
Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA). Summary of an updated position statement on chronic cough in Australia
Med J Aust 2024; 220 (9): 492-492. || doi: 10.5694/mja2.52277 Published online: 20 May 2024 In reply: We thank Prentice1 for his comments on the CICADA position statement on chronic cough in Australia.2 He highlights some rare causes of chronic cough that we agree have not received much attention regarding cough pathogenesis.
Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA). Summary of an updated position statement on chronic cough in Australia
Med J Aust 2024; 220 (8): 435-436. || doi: 10.5694/mja2.52269 Published online: 6 May 2024 In reply: We thank Turner and Birring1 for their interest in our updated position statement on cough in children and adults,2 particularly for identifying its strength in separating evidence‐based strategies for children and adults. We also appreciate their comments on our efforts to highlight the importance of identifying and treating chronic cough in Australian First Nations people.
Long-term therapy with elexacaftor/tezacaftor/ivacaftor (ETI) in cystic fibrosis: improved clinical outcomes but infection and inflammation persist
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全球近 6500 萬人受長新冠影響 五件應關注的事
2020 年底，當我們躲在「澳洲的堡壘」中，試圖避開新冠時，我們開始聽到有人在感染新冠後，症狀維持數月。他們被稱為長期新冠患者。 與我們的預期相反，這些症狀不僅是影響人們的肺部或呼吸。長期新冠患者出現其它症狀，包括：活動後更嚴重的疲勞、肌肉酸痛、頭痛、認知功能障礙或腦霧等。 一項議會調查項目正在調查澳洲對長期新冠患者的應對措施、公共衛生系統的反應以及最新研究結果等。 很明顯，在新冠大流行初期，我們對長期新冠的一些看法是錯誤的。三年來，全球估計有6500萬人受到長期新冠的影響，以下是我們已知或正在探索的關於這種情況的五件事。 SBS Chinese 15/09/202204:57 肺功能可能需要數月才能恢復 有些人可能永遠無法恢復 我們現在了解，並不能夠保證長新冠患者的肺功能能完全恢復，五分之一的人仍然抱怨有嚴重的呼吸困難，一成人有嚴重的肺功能障礙。 研究報告顯示，在出院數月後，一些新冠患者可能還會有肺功能受損、胸部掃描異常、運動能力受損和持續呼吸困難等症狀，尤其是那些曾需要在重症監護室接受呼吸支持的患者。...
全球估计有6500万人受长期新冠影响 这五件事情应引起关注
2020 年底，当我们躲在“澳大利亚堡垒”中躲避新冠时，我们开始听到有些人的新冠症状持续数月。他们被称为长期新冠患者。 与我们的预期相反，这些症状不仅是影响人们的肺部或呼吸。长期新冠患者出现一些其它症状：活动后更严重的疲劳、肌肉酸痛、头痛、认知功能障碍或脑雾等。 一项议会调查项目正在调查澳大利亚对长期新冠患者的应对措施、公共卫生系统的反应以及最新研究结果等。 很明显，在新冠大流行早期，我们对长期新冠的一些看法是错误的。三年来，估计有6500万人受到长期新冠的影响，以下是我们已知或正在探索的关于这种情况的五件事。 肺功能可能需要数月才能恢复 有些人可能永远无法恢复 我们现在了解到，并不能够保证长期新冠患者的肺功能完全恢复，五分之一的人仍然抱怨有严重的呼吸困难，10%的人有严重的肺功能障碍。 研究报告显示，在出院数月后，一些新冠患者可能还会有肺功能受损、胸部扫描异常、运动能力受损和持续呼吸困难等症状，尤其是那些曾需要在重症监护室接受呼吸支持的患者。...
Australia got some key things wrong about long COVID. Here are 5 things they've learned
In late 2020 as we hid from COVID behind the moat of "fortress Australia," we started to hear that in some people, COVID symptoms persisted for months. They were called "long haulers" or had "long COVID." Contrary to what we'd expected, it wasn't just affecting people's lungs or breathing. Long haulers were experiencing an enormous range of other symptoms: fatigue that was worse after activity, muscle aches and pains, headache, and cognitive dysfunction or brain fog.
5 phát hiện mới về chứng COVID kéo dài
Từ cuối năm 2020, một số báo cáo cho thấy một số người vẫn bị mắc các triệu chứng của COVID trong nhiều tháng sau khi khỏi bệnh, gọi là “COVID kéo dài”. COVID kéo dài không chỉ ảnh hưởng đến phổi hoặc việc hít thở của người bệnh, mà còn dẫn đến một loạt các triệu chứng khác như mệt mỏi sau khi vận động, đau nhức cơ bắp, đau đầu và rối loạn chức năng nhận thức.
We got some key things wrong about long COVID. Here are 5 things we’ve learnt
In late 2020 as we hid from COVID behind the moat of 'fortress Australia', we started to hear that in some people, COVID symptoms persisted for months. They were called 'long haulers' or had 'long COVID'. Contrary to what we’d expected, it wasn’t just affecting people’s lungs or breathing. Long haulers were experiencing an enormous range of other symptoms: fatigue that was worse after activity, muscle aches and pains, headache, and cognitive dysfunction or brain fog.
We got some key things wrong about long COVID. Here are 5 things we've learnt
In late 2020 as we hid from COVID behind the moat of “fortress Australia”, we started to hear that in some people, COVID symptoms persisted for months. They were called “long haulers” or had “long COVID”. Contrary to what we’d expected, it wasn’t just affecting people’s lungs or breathing. Long haulers were experiencing an enormous range of other symptoms: fatigue that was worse after activity, muscle aches and pains, headache, and cognitive dysfunction or brain fog.
We got some key things wrong about long COVID. Here are 5 things we've learnt
In late 2020 as we hid from COVID behind the moat of “fortress Australia”, we started to hear that in some people, COVID symptoms persisted for months. They were called “long haulers” or had “long COVID”. Contrary to what we’d expected, it wasn’t just affecting people’s lungs or breathing. Long haulers were experiencing an enormous range of other symptoms: fatigue that was worse after activity, muscle aches and pains, headache, and cognitive dysfunction or brain fog.
Asthma-COPD overlap: implications for patient management
Figures © sdominik/istockphoto.com model used for illustrative purposes only Abstract Asthma-COPD overlap (ACO) is characterised by persistent airflow limitation with features typically associated with both asthma and chronic obstructive pulmonary disease (COPD). Because there is no universally accepted definition of ACO, reliable data on managing patients exhibiting ACO is lacking.
“A systematic review of the colorectal microbiome in adult cystic fibrosis patients.”
We need to understand why viral infections lead to acute asthma
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Thousands rally across Australia after Roe v Wade abortion ruling
Thousands have taken to the streets across Australia, protesting the landmark decision by the US Supreme Court to limit access to safe abortions. Crowds rallied in solidarity in Brisbane and Adelaide throughout the week. Big numbers are turning out in Melbourne, Perth, Hobart, Wollongong and Rockhampton on Saturday, with Launceston to follow suit on Sunday. Watch the latest News on Channel 7 or stream for free on 7plus >> In Sydney, thousands braved the rain to March through the CBD on Saturday.
Watchdog wants NSW police powers reined in
Anti-terrorism powers available to NSW Police should be wound back because they aren't able to use them correctly, the law enforcement watchdog says. The Law Enforcement Conduct Commission's (LECC) latest tri-annual report on NSW Police's use of anti-terror powers has given a bruising assessment of the force's use of legislation. In a report released Friday, it found an "unregulated" collection of DNA samples by police and a "concerning" lack of guidance around the use of tough detention measures.
Xi Jinping crushed Hong Kong’s opposition. Now he claims handover to China marked ‘beginning of true democracy’
Chinese leader Xi Jinping on Friday claimed “true democracy” began in Hong Kong 25 years ago when China assumed control, as he marked a symbolic anniversary for the city transformed by his political crackdown.
Drink-driving court date for Qld mayor
A Queensland mayor and campaigner against drink-driving has a court date looming after allegedly returning a blood alcohol test of more than three times the legal limit. Redlands Mayor Karen Williams admitted crashing her vehicle into a tree east of Brisbane after a work function on June 23. Police have been investigating the incident and the 55-year-old was issued with a notice to appear for drink-driving after allegedly returning a blood alcohol test of 0.177 per cent.
Redlands Mayor Karen Williams to face court over alleged drink-driving crash
Redlands Mayor Karen Williams will face court for allegedly drink driving after crashing her car following a work function in Brisbane’s south east last month. Queensland Police said they were called to the scene at Cleveland, on the night of June 23, where a Lexus station wagon had left the road, smashed through a fence and hit a tree. Williams - a campaigner against drink driving - conceded she had “several glasses of wine” before the crash.
A ‘very big wave’ of long COVID is coming - and we aren’t prepared, expert warns Original
Australia’s Omicron wave earlier this year was much larger than we thought, recent research has confirmed. We also heard Health Minister Mark Butler acknowledge Australia can expect a “very big wave” of people with long COVID over the next few years. Doctors and researchers have been warning about the threat of long COVID, as restrictions ease and case numbers climb. Watch the latest News on Channel 7 or stream for free on 7plus >> So we need to take an urgent look at how we manage and treat it.
A Tsunami of Long Covid Awaits Us, And We're Not Quite Sure How To Brace For It
UK advice for treating long COVID involves looking for and managing COVID complications that may affect the lungs, lead to heart disease and managing other existing conditions, such as obesity and diabetes. It also recommends assessing and managing anxiety and depression, which not surprisingly is common in people with long COVID. UK guidelines advise supporting people to manage their own symptoms, including getting support from their GP, then referral to specialist services when needed.
We need to brace for a tsunami of long COVID. But we're not quite sure the best way to treat it
Australia’s Omicron wave earlier this year was much larger than we thought, recent research has confirmed. We also heard Health Minister Mark Butler acknowledge Australia can expect a “very big wave” of people with long COVID over the next few years. Doctors and researchers have been warning about the growing threat of long COVID, as restrictions ease and case numbers climb. So we need to take an urgent look at how we manage and treat it.
Taking COVID pills at home sounds great. But we need to use them wisely or risk drug resistance and new variants
Credit: Shutterstock GPs can now prescribe antiviral pills for some of their vulnerable COVID-19 patients to take at home. More patients are expected to have access in coming weeks and months. These drugs are given to people at greater risk of severe disease at the start of their infection, to stop them getting so sick they need to go to hospital. So they are an important next step in our fight against the pandemic.
Taking COVID pills at home sounds great. But we need to use them wisely or risk drug resistance and new variants
GPs can now prescribe antiviral pills for some of their vulnerable COVID-19 patients to take at home. More patients are expected to have access in coming weeks and months. These drugs are given to people at greater risk of severe disease at the start of their infection, to stop them getting so sick they need to go to hospital. So they are an important next step in our fight against the pandemic. But we should look at these antivirals as another option to manage COVID-19, not a silver bullet.
We’re two frontline COVID doctors. Here’s what we see as case numbers rise
The latest figures available show there are 1,189 people admitted with COVID-19 to hospitals in New South Wales, with 222 of them in intensive care units (ICU), 94 needing ventilation. This week there were over 9,700 people with new COVID infections. That means about one in every 10 people with COVID are sick enough to need admission to hospital. Recently released modelling predicts COVID admissions in NSW will rise steeply over the coming weeks and will peak in mid-October.
We're two frontline COVID doctors. Here's what we see as case numbers rise Original
The latest figures available show there are 1,189 people admitted with COVID-19 to hospitals in New South Wales, with 222 of them in intensive care units (ICU), 94 needing ventilation. This week there were over 9,700 people with new COVID infections. That means about one in every 10 people with COVID are sick enough to need admission to hospital. Recently released modelling predicts COVID admissions in NSW will rise steeply over the coming weeks and will peak in mid-October.
Can ‘viral shedding’ after the COVID vaccine infect others? That’s a big ‘no’
Fears of “viral shedding” and other concerns after the COVID vaccine has led some businesses to ban vaccinated customers from the premises, believing vaccination poses a health risk to others. We’ve seen this in Australia, in the northern New South Wales town of Mullumbimby and on the Gold Coast in Queensland. We’ve also seen this internationally. In the United States, a teacher warned her students not to hug their vaccinated parents for the same reason.
We are not doing enough to prevent the spread of COVID‐19 and other respiratory viruses in Australian hospitals
Article types Advertisement Peter AB Wark, C Raina MacIntyre, Scott Bell, Brian Oliver and Guy B Marks Med J Aust 2021; 215 (4): 152-153.e1. || doi: 10.5694/mja2.51183 Published online: 16 August 2021 Our current approaches to limiting transmission of respiratory viruses, including SARS‐CoV‐2, are inadequate The health care community has been accused of not taking the nosocomial spread of respiratory virus infection to health care workers and patients seriously enough.
Younger adults can get very sick and die from Covid too - Here’s what the data tell us
By Peter Wark for The Conversation We learned this week of the tragic death of a 27-year-old man from Sydney who had Covid-19. This follows a 38-year-old woman who died from the virus last month. Throughout the current Delta outbreak in New South Wales, we’ve heard young people are making up a greater proportion of people in hospital compared with earlier in the pandemic. We’re seeing similar patterns overseas.
Younger adults can get very sick and die from COVID too. Here's what the data tell us
We learned this week of the tragic death of a 27-year-old man from Sydney who had COVID-19. This follows a 38-year-old woman who died from the virus last month. Throughout the current Delta outbreak in New South Wales, we’ve heard young people are making up a greater proportion of people in hospital compared with earlier in the pandemic. We’re seeing similar patterns overseas.
Can 'viral shedding' after the COVID vaccine infect others? The answer is...
A healthcare worker administers a dose of the Moderna COVID-19 vaccine at a vaccination center in San Juan Sacatepequez, Guatemala (Photo | AP) Fears of “viral shedding” and other concerns after the COVID vaccine has led some businesses to ban vaccinated customers from the premises, believing vaccination poses a health risk to others. We’ve seen this in Australia, in the northern New South Wales town of Mullumbimby and on the Gold Coast in Queensland. We’ve also seen this internationally.
Can ‘viral shedding’ after the COVID vaccine infect others? That’s a big ‘no’
Fears of “viral shedding” and other concerns after the COVID vaccine has led some businesses to ban vaccinated customers from the premises, believing vaccination poses a health risk to others. We’ve seen this in Australia, in the northern New South Wales town of Mullumbimby and on the Gold Coast in Queensland. We’ve also seen this internationally. In the United States, a teacher warned her students not to hug their vaccinated parents for the same reason.
Asthma, COPD and SARS-CoV-2 infection (COVID-19): potential mechanistic insights
Peter AB Wark, Prabuddha S. Pathinayake, Mathew Suji Eapen, Sukhwinder Singh Sohal European Respiratory Journal 2021; DOI: 10.1183/13993003.00920-2021 Abstract Patients with asthma are somewhat protected from COVID-19 complications compared to COPD. This may be due to variability in viral attachment protein, ICS use, smoking/vaping status, a skewed inflammatory pattern, and dysregulated endocytic machinery.
We are not doing enough to prevent the spread of COVID-19 and other respiratory viruses in Australian hospitals
Advertisement Peter AB Wark, C Raina MacIntyre, Scott Bell, Brian Oliver and Guy B Marks Med J Aust Published online: 10 June 2021 Related Articles This is a preprint version of an article submitted for publication in the Medical Journal of Australia. Changes may be made before final publication. Click here for the PDF version. Suggested citation: Wark PAB, MacIntyre CR, Bell S, Oliver B, Marks GB.
Could a simple pill beat Covid-19? Pfizer is giving it a go
Representational image | Buddhika Weerasinghe | Bloomberg Text Size: While the focus has been largely on vaccines, you might have also heard Pfizer is trialling a pill to treat COVID-19. It almost sounds too good to be true. Indeed, the results are very preliminary — but it’s a promising approach. Where most antiviral agents we’ve tried to treat COVID-19 target the inflammatory and immune response resulting from infection, Pfizer’s pill directly targets SARS-CoV-2 — the virus itself.
Could a simple pill beat COVID-19? Pfizer is giving it a go
While the focus has been largely on vaccines, you might have also heard Pfizer is trialling a pill to treat COVID-19. It almost sounds too good to be true. Indeed, the results are very preliminary — but it’s a promising approach. Where most antiviral agents we’ve tried to treat COVID-19 target the inflammatory and immune response resulting from infection, Pfizer’s pill directly targets SARS-CoV-2 — the virus itself.
A simple pill to beat Covid-19? It sounds too good to be true, but Pfizer is giving it a go
While the focus has been largely on vaccines, you might have also heard Pfizer is trialling a pill to treat Covid-19. He even described it as a "game-changer." https://t.co/n7UnLxHtZ6 — Health (@healthmagazine) May 23, 2021 It almost sounds too good to be true. Indeed, the results are very preliminary – but it is a promising approach.
Could a simple pill beat COVID-19? Pfizer is giving it a go
While the focus has been largely on vaccines, you might have also heard Pfizer is trialling a pill to treat COVID-19. It almost sounds too good to be true. Indeed, the results are very preliminary — but it’s a promising approach. Where most antiviral agents we’ve tried to treat COVID-19 target the inflammatory and immune response resulting from infection, Pfizer’s pill directly targets SARS-CoV-2 — the virus itself.
Asthma-COPD overlap: current understanding and the utility of experimental models
Xiaofan Tu, Chantal Donovan, Richard Y. Kim, Peter A.B. Wark, Jay C. Horvat, Philip M. Hansbro European Respiratory Review 2021 30: 190185; DOI: 10.1183/16000617.0185-2019 Abstract Pathological features of both asthma and COPD coexist in some patients and this is termed asthma-COPD overlap (ACO). ACO is heterogeneous and patients exhibit various combinations of asthma and COPD features, making it difficult to characterise the underlying pathogenic mechanisms.
What are the long-term effects of having Covid-19? This story is a must-read.
We’re now all too familiar with the common symptoms of Covid-19: a fever, dry cough, and fatigue. Some people also experience aches and pains, a sore throat, and loss of taste or smell. Sufferers with mild illness might expect to get better after a few weeks. But there’s mounting evidence this isn’t the case, and Covid-19 may leave a long-lasting impression on its victims – not just the most severely affected or the elderly and frail.
Here's what we know so far about the long-term symptoms of COVID-19
We’re now all too familiar with the common symptoms of COVID-19: a fever, dry cough and fatigue. Some people also experience aches and pains, a sore throat, and loss of taste or smell. Sufferers with mild illness might expect to get better after a few weeks. But there’s mounting evidence this isn’t the case, and COVID-19 may leave a long-lasting impression on its victims – not just the most severely affected or the elderly and frail.
Management of acute COPD exacerbations in Australia: do we follow the guidelines?
Joyce L. Cousins, Richard Wood-Baker, Peter A.B. Wark, Ian A. Yang, Peter G. Gibson, Anastasia Hutchinson, Dimitar Sajkov, Sarah A. Hiles, Sameh Samuel, Vanessa M.
How Are The Most Serious COVID-19 Cases Treated, And Does The Coronavirus Cause Lasting Damage?
Image: National Institutes of Health As the number of COVID-19 cases around the world continues to climb, hospitals are under increased pressure to provide emergency care for the most severely ill patients. What does this involve, and how does the coronavirus damage the respiratory system? The virus first invades our bodies by attaching to a protein called ACE2 on cells in the mouth, nose and airways. For the first week of infection, symptoms are relatively mild, with sore throat, cough and fever.
How Are the Most Serious COVID-19 Cases Treated? Is There Lasting Damage?
As the number of COVID-19 cases around the world continues to climb, hospitals are under increased pressure to provide emergency care for the most severely ill patients. What does this involve, and how does the coronavirus damage the respiratory system? The virus first invades our bodies by attaching to a protein called ACE2 on cells in the mouth, nose and airways. For the first week of infection, symptoms are relatively mild, with sore throat, cough and fever.
How are the most serious COVID-19 cases treated, and does the coronavirus cause lasting damage?
By Peter Wark, Conjoint Professor, School of Medicine and Public Health, University of Newcastle As the number of COVID-19 cases around the world continues to climb, hospitals are under increased pressure to provide emergency care for the most severely ill patients. What does this involve, and how does the coronavirus damage the respiratory system? The virus first invades our bodies by attaching to a protein called ACE2 on cells in the mouth, nose and airways.
How are the most serious COVID-19 cases treated, and does the coronavirus cause lasting damage?
As the number of COVID-19 cases around the world continues to climb, hospitals are under increased pressure to provide emergency care for the most severely ill patients. What does this involve, and how does the coronavirus damage the respiratory system? The virus first invades our bodies by attaching to a protein called ACE2 on cells in the mouth, nose and airways. For the first week of infection, symptoms are relatively mild, with sore throat, cough and fever.
Targeting treatable traits in severe asthma: a randomised controlled trial
Vanessa M. McDonald, Vanessa L. Clark, Laura Cordova-Rivera, Peter A.B. Wark, Katherine J. Baines, Peter G. Gibson European Respiratory Journal 2020 55: 1901509; DOI: 10.1183/13993003.01509-2019 Abstract Rationale Treatable traits have been proposed as a new paradigm for airway disease management. Objectives To characterise treatable traits in a severe asthma population and to determine the efficacy of targeting treatments to these treatable traits in severe asthma.
Why are people with asthma more susceptible to influenza?
Peter A.B. Wark European Respiratory Journal 2019 54: 1901748; DOI: 10.1183/13993003.01748-2019 Abstract The effect of viruses such as influenza on asthma exacerbations is not the result of either exaggerated type 1 or 2 immune responses in those with asthma. http://bit.ly/2maJHVV In 1860, Henry Hyde Salter characterised the important association between virus infection and acute asthma.
A treatment algorithm adjusting oral corticosteroid using blood eosinophils reduces exacerbations and improves asthma control, in difficult asthmatics | European Respiratory Society
AbstractTreatment options for patients with dificult asthma are limited.
Acute myocardial infarction in disseminated mucormycosis infection
A 26 year old female with a history of cystic fibrosis (homozygous delta F508) and bilateral lung transplant presented with a bi-frontal headache one month post bilateral sinus surgery for chronic sinusitis. The provisional diagnosis was bacterial sinusitis. Although nasal swabs had grown Candida and Staphylococcus aureus, ...
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