Investigating The Utility Of Primary Care Skin Cancer Clinics In Queensland
Funder
National Health and Medical Research Council
Funding Amount
$187,000.00
Summary
Skin cancer is the most common cancer in Australia, with an estimated 375,000 people being treated for some skin cancer in Australia in 2002, and 1462 dying from the disease (mainly from melanoma) in 2001. Australia has the highest rate of skin cancer, both melanoma and non-melanoma is the world. However, if detected early, skin cancer is curable, and the focus of current treatment programs internationally is to detect the disease before it progresses to an advanced stage. A large proportion of ....Skin cancer is the most common cancer in Australia, with an estimated 375,000 people being treated for some skin cancer in Australia in 2002, and 1462 dying from the disease (mainly from melanoma) in 2001. Australia has the highest rate of skin cancer, both melanoma and non-melanoma is the world. However, if detected early, skin cancer is curable, and the focus of current treatment programs internationally is to detect the disease before it progresses to an advanced stage. A large proportion of skin cancers are first detected by the non-medical community. However, due to the two-tiered medical system in Australia, a person first seeks medical opinion from a general practitioner (GP), who acts as a gatekeeper for further treatment from a specialist. Therefore the ability of GPs to be able to discern which lesions require further treatment is crucial, both for the patient, and the financial burden on the health system. A recent development has been the establishment of dedicated primary skin care clinics, which offer open access consultations to the community for the diagnosis and treatment of skin cancers and pigmented lesions. The emergence of these clinics has created much debate in the medical media. Concern has been expressed about the skills of practitioners in these clinics, whilst others argue that sub-specialisation in primary care will lead to improvements in the management of patients. As there is currently no data on the volume, casemix and diagnostic accuracy of these clinics it is difficult to assess the diagnostic ability of skin cancer clinics. This will be the first project to quantify the role of skin clinics in the diagnosis of skin cancer in the community, and in particular their case volume, casemix and diagnostic accuracy, and assess these measures in relation to a comparable sample of general practitioners. Queensland is an ideal location for a study of this type due to its high incidence of both types of skin cancer.Read moreRead less
SNAC2: A Randomised Trial Of Extending Sentinel Node Based Management To Women With Larger Or Multifocal Breast Cancers
Funder
National Health and Medical Research Council
Funding Amount
$1,266,430.00
Summary
SNAC2 extends the work begun in SNAC1, which recruited 1,088 women over 4 years. SNAC1 will determine if sentinel node biopsy causes less arm problems than axillary clearance. The goal of SNAC2 is to establish the risk of local recurrence and long term safety of sentinel node biopsy, especially for women with larger or multiple tumours. SNAC2 is needed to determine whether the smaller operation gives cure rates as good as axillary clearance. If it does, then it will become standard practice.
The Diagnosis Of Obstructive Sleep Apnea In Primary Care
Funder
National Health and Medical Research Council
Funding Amount
$295,075.00
Summary
The gold standard method for diagnosis of sleep apnea is the overnight sleep study. These tests are expensive, have long waiting lists and are hard to access outside larger cities. We aim to determine if general practitioners can combine information from questionnaires and a simple home diagnostic test, to confirm or rule out sleep apnea. The results of this study will eventually lead to more accessible and efficient diagnosis and treatment of this common condition.
Genetic Approaches To Understand How Imbalanced Cytokine Signalling Drives The Pathogenesis Of Emphysema
Funder
National Health and Medical Research Council
Funding Amount
$519,715.00
Summary
Emphysema is a major component of Chronic Obstructive Pulmonary Disease (COPD), the fifth leading cause of death in Australia for which there is no effective treatment. We have discovered a specific mutation in a gene called gp130 that results in the formation of emphysema in mice. This finding allows us to understand the exact mechanisms by which this mutation causes emphysema, and therefore has the potential to uncover new strategies to design novel therapies against emphysema in humans.
Early Detection Of Infants And Young Children With Autism
Funder
National Health and Medical Research Council
Funding Amount
$268,250.00
Summary
Autism is a severely handicapping condition adversely affecting social interaction, communication, behaviour, interests, and activities. Autism requires treatment at an early age (before 4 years). Despite finding that parents notice problems with their child's development within the first 2 years, on average diagnoses are made around 6 years of age. Treatment for autism should begin as early as possible to improve outcome. Diagnosis requires specialist assessment and these services are limited. ....Autism is a severely handicapping condition adversely affecting social interaction, communication, behaviour, interests, and activities. Autism requires treatment at an early age (before 4 years). Despite finding that parents notice problems with their child's development within the first 2 years, on average diagnoses are made around 6 years of age. Treatment for autism should begin as early as possible to improve outcome. Diagnosis requires specialist assessment and these services are limited. Therefore it is not possible to undertake such assessments with all children who have developmental problems. This project therefore proposes to evaluate a method for screening large populations of children for autism, thus enabling timely and more appropriate referral to assessment services. Previous work by the investigators has developed a potential screening tool (DBC Early Screen) for autism in young children under 4 years with developmental delay that has high levels of accuracy in identifying those infants and children who are at risk of autism and require specialist assessment. This project proposes to undertake a community field trial to assess the accuracy and reliability of this early screen and to establish its suitability for wide use as a population screening tool. The preliminary testing of DBC Early Screen demonstrated that a community field trial was feasible. The results of this study will facilitate the referral of infants and young children to specialist autism assessment services, thus enabling the commencement of appropriate early intervention for children and their families from an early age.Read moreRead less
The Opposing Roles Of STAT1 And STAT3 Signalling By IL-6 Family Cytokines In Inflammation And Tumourigenesis
Funder
National Health and Medical Research Council
Funding Amount
$472,770.00
Summary
Stomach cancer is the second most common cause of cancer-related deaths worldwide, and results in the yearly death of several thousand people in Australia alone. We have discovered a specific mutation in a gene for a receptor molecule called gp130 that results in the formation of stomach cancer in mice. Strikingly, mice with this mutation are also highly susceptible to clinically-relevant experimental models of septic shock and peritonitis, two chronic inflammatory disorders induced by bacterial ....Stomach cancer is the second most common cause of cancer-related deaths worldwide, and results in the yearly death of several thousand people in Australia alone. We have discovered a specific mutation in a gene for a receptor molecule called gp130 that results in the formation of stomach cancer in mice. Strikingly, mice with this mutation are also highly susceptible to clinically-relevant experimental models of septic shock and peritonitis, two chronic inflammatory disorders induced by bacterial infection. We are now aiming to understand the exact molecular events by which this mutation results in the uncontrolled growth of epithelial cells that line the stomach wall, as well as uncontrolled regulation of the immune system leading to local and systemic inflammation. At the molecular level, the mutation in gp130 leads to over-activation of two signalling molecules, Stat1 and Stat3, which are also used by a range of other receptors to transmit specific cellular responses. In the context of cancer and inflammation, Stat1 and Stat3 have opposing roles (ie Stat3 promotes cancer and can be both anti-pro-inflammatory, while Stat1 suppresses cancer and is pro-inflammatory), although as yet, the contribution of the gp130 receptor in directing Stat1 and Stat3 activation in these disorders is not known. Our proposal employs established strategies and unique mouse models to specifically address how the mutation in gp130 can orchestrate the opposing biological functions of these two molecules to drive stomach cancer and inflammation. The identification of mechanisms by which gp130-dependent activation of these two molecules causally relate to inflammation and stomach cancer will ultimately provide novel and rational approaches to target these molecules for the screening and treatment of various inflammatory disorders and cancers, including those of the stomach.Read moreRead less
Cross-talk Between Cytokine And Pathogen Recognition Receptor Networks In The Pathogenesis Of Gastric Cancer
Funder
National Health and Medical Research Council
Funding Amount
$174,800.00
Summary
Stomach cancer is the second most common cause of cancer-related deaths worldwide, and results in the yearly death of several thousand people in Australia alone. We have discovered a specific mutation in a gene called gp130 that results in the formation of gastritis and stomach cancer in mice. We are now aiming to understand the exact molecular events by which this mutation results in chronic inflammation and the subsequent uncontrolled growth of epithelial cells that line the stomach wall.
Developing A Skin Test For Early Diagnosis Of Alzheimer's Disease And For Monitoring Effectiveness Of Treatment
Funder
National Health and Medical Research Council
Funding Amount
$285,000.00
Summary
Approximately 140,000 Australians suffer from Alzheimer's disease (AD). As the ageing population continues to grow, this number will double by the middle of the next century unless a cure or prevention is found. Scientists are continuously seeking new, more effective diagnostic tests in an effort to make it easier to diagnose AD in its early stages. Being able to recognize symptoms early and obtain an accurate diagnosis would give affected individuals a greater chance of benefiting from putative ....Approximately 140,000 Australians suffer from Alzheimer's disease (AD). As the ageing population continues to grow, this number will double by the middle of the next century unless a cure or prevention is found. Scientists are continuously seeking new, more effective diagnostic tests in an effort to make it easier to diagnose AD in its early stages. Being able to recognize symptoms early and obtain an accurate diagnosis would give affected individuals a greater chance of benefiting from putative treatments. However, there is no single, comprehensive diagnostic test for AD. Diagnostic tests (including peripheral markers) that can help to reliably diagnose AD at an early stage are needed as are tests that can help in monitoring the progression of AD, including response to therapy. The accuracy and clinical utility of previously proposed peripheral markers (platelets and pupil dilation test) is questionable. The only way to confirm a diagnosis of AD is through autopsy. We have obtained a provisional patent application for the use of a skin test for early diagnosis of AD (Patent No: PQ2881-99). This test is based on our extensive research over the past decade to understand the biochemical mechanisms underlying the txic vascular actions of beta amyloid protein. This protein has been implicated in the pathology of AD and it accumulates in the brain, peripheral tissues and is present in circulating blood of AD patients. The test is based on our discovery that vascular effects of Ab could be detected in the peripheral microcirculation .We now wish to further examine the utility of this novel skin test. If the test is sensitive, it could be used for screening; if it is specific it would be useful for confirmation of suspected AD. If the test is sensitive to change in clinical status it would help select treatments that might cure or improve the symptoms of AD.Read moreRead less
Hydatid disease is caused by a parasitic infection that is transmitted to people by animals. The disease causes substantial human morbidity and mortality worldwide, and is endemic in Australia. Currently available drugs are poorly effective against the parasite and treatment of the disease relies mainly on surgical removal of often large parasitic cysts, where this is possible. Blood tests to identify people who are infected rely on the use of parasite samples obtained from animals, which leads ....Hydatid disease is caused by a parasitic infection that is transmitted to people by animals. The disease causes substantial human morbidity and mortality worldwide, and is endemic in Australia. Currently available drugs are poorly effective against the parasite and treatment of the disease relies mainly on surgical removal of often large parasitic cysts, where this is possible. Blood tests to identify people who are infected rely on the use of parasite samples obtained from animals, which leads to difficulties with adequate supply of material and quality control. Research in this laboratory discovered that the hydatid parasite produces a protein that binds the drug cyclosporin A and that specific antibodies are made to this protein in hydatid patients. Preliminary research by others found that cyclosporin A had anti-parasitic effects on hydatid disease in an animal model system. This research project will examine in detail the characteristics of the cyclophilin protein and related proteins, in the hydatid parasite, their interaction with cyclosporin A, the effects of cyclosporin A on the parasite in defined culture conditions, the mechanism by which cyclosporin A exerts anti-parasitic effects and the prospects for use of cyclophilin in tests for the diagnosis of human hydatid disease. The research will contribute to a better understanding of the basic biology of this pathogen and may identify improved methods for the chemotherapy and diagnosis of infection.Read moreRead less
Melanoma Diagnosis, And The Effect Of Screening On Depth Of Invasion Of Melanoma.
Funder
National Health and Medical Research Council
Funding Amount
$399,961.00
Summary
AIMS This study will assess how melanoma is diagnosed in Queensland, and if improvements can be made. It will assess if skin screening gives earlier diagnosis of some melanomas, and also if it leads to the diagnosis of some thin melanomas which would not progress if left alone. SIGNIFICANCE Melanoma is the most common invasive cancer in Queensland, with some 1,963 people diagnosed annually with the disease. The outlook for these patients varies dramatically with the depth of invasion of melanoma ....AIMS This study will assess how melanoma is diagnosed in Queensland, and if improvements can be made. It will assess if skin screening gives earlier diagnosis of some melanomas, and also if it leads to the diagnosis of some thin melanomas which would not progress if left alone. SIGNIFICANCE Melanoma is the most common invasive cancer in Queensland, with some 1,963 people diagnosed annually with the disease. The outlook for these patients varies dramatically with the depth of invasion of melanoma. Melanoma diagnosed and treated when very thin has an excellent long-term outcome, whereas the outcome for deeply invasive melanoma is much less favourable. Improvements to diagnosis are currently our best hope of reducing deaths and serious distress from this disease. This will be the largest study in the world of the process of diagnosis of melanoma: information on how melanoma presents, and the time between presentation and diagnosis will be compared between thin and deeply invasive melanoma. Results may indicate areas for improvement in education or health services. The use of screening, either by individuals themselves or by health professionals, has the potential to achieve early diagnosis. However, there is currently no good information on whether screening is actually effective. This study will assess the impact of self-screening and doctor screening on the depth of invasion of melanoma at presentation, and ultimately on the likelihood of dying from melanoma. The study will also assess the potential impact of screening on the over-diagnosis of lesions which while labeled as melanoma, may in fact be biologically non-progressive. This is an important issue of current concern internationally. This study will be one of only two studies in the world currently addressing this issue. This project is directly relevant to the early detection and optimum management of the most common invasive cancer in Queensland, and will have relevance internationally.Read moreRead less