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Improving Ubiquitous Interventions To Optimise Outcomes From Critical Illness
Funder
National Health and Medical Research Council
Funding Amount
$333,710.00
Summary
A/Prof Deane is a specialist intensive care physician who combines clinical work at The Royal Melbourne Hospital with a large research program. The research supported by this Fellowship will translate to fundamental changes in the administration of ubiquitous interventions and will optimise management of conditions that occur frequently in the critically ill and represent a major source of mortality, morbidity and healthcare utilisation/costs.
Causes And Management Of Abnormally Elevated Blood Glucose Concentrations In The Critically Ill
Funder
National Health and Medical Research Council
Funding Amount
$430,770.00
Summary
Increased glucose concentrations occur commonly in ICU patients and are associated with increased mortality and morbidity. There is a need to improve the understanding of the causes underlying so-called 'critical illness induced hyperglycaemia' as well as new therapies to reduce blood glucose in this group. The proposed studies will focus on the potential role of incretin hormones, which have the capacity to stimulate insulin without increasing the risk of abnormally low blood glucose levels.
Centre Of Clinical Research Excellence In Nutritional Physiology, Interventions, And Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$2,007,200.00
Summary
Over 20% of Australian adults either have diabetes, or are at imminent risk, while 60% are overweight or obese. Conversely, some 40% of the elderly receiving domiciliary support are at risk of malnutrition. Poor nutrition underpins numerous chronic diseases. We seek to capitalise on the expertise and multidisciplinary collaborations of several groups, all leaders in their fields, and whose collective track record in clinical nutrition research cannot be matched in Australia, to form a Centre of ....Over 20% of Australian adults either have diabetes, or are at imminent risk, while 60% are overweight or obese. Conversely, some 40% of the elderly receiving domiciliary support are at risk of malnutrition. Poor nutrition underpins numerous chronic diseases. We seek to capitalise on the expertise and multidisciplinary collaborations of several groups, all leaders in their fields, and whose collective track record in clinical nutrition research cannot be matched in Australia, to form a Centre of Excellence that encompasses the physiology of nutrition, dietary intervention strategies, and evaluation of outcomes, in diabetic, overweight, elderly, and critically unwell populations.Read moreRead less
Upper Gastrointestinal Motor And Absorptive Function In Critically Ill Patients
Funder
National Health and Medical Research Council
Funding Amount
$260,760.00
Summary
A major concern in critically ill patients is the provision of adequate nutrition to facilitate recovery from devastating metabolic insults. Abnormal contractions of the oesophagus, stomach and small intestine appear to be common in critically ill patients. These may prevent effective feeding of patients at a time when they are especially vulnerable to malnutrition and also result in major complications such as pneumonia, septicaemia and gastrointestinal haemorrhage. However little is known abou ....A major concern in critically ill patients is the provision of adequate nutrition to facilitate recovery from devastating metabolic insults. Abnormal contractions of the oesophagus, stomach and small intestine appear to be common in critically ill patients. These may prevent effective feeding of patients at a time when they are especially vulnerable to malnutrition and also result in major complications such as pneumonia, septicaemia and gastrointestinal haemorrhage. However little is known about the reasons underlying these dysfunctions. The applicants, with ongoing support from the NH and MRC have had a longstanding interest in motility disorders of the gut and have made important contributions to knowledge about both the causes and treatments of these conditions. These contributions have been underpinned by pioneering the development of new methodologies to examine gut function. In collaboration with the intensive care specialists in Adelaide, we now seek to apply this knowledge to evaluate gut function in patients in the Intensive Care Unit. The proposed studies will provide the most comprehensive studies to date of the gut function in critically ill patients and have important implications for treatment.Read moreRead less
Determining The Affect And Cost Effectiveness Of Nutrition In Critically Ill Patients From Intensive Care Unit Admission To Hospital Discharge.
Funder
National Health and Medical Research Council
Funding Amount
$138,964.00
Summary
Nutrition when you are severely unwell is very important to support recovery. Research is required to determine exactly how much nutrition is needed in severely ill patients to ensure their best recovery. This project aims to determine what effect nutrition has on clinical and functional outcomes of patients who are severely ill during their whole hospital stay. It will also aim to determine the cost effectiveness of nutrition for these patients.
Perturbation of the extracellular architecture to promote the absorption and lymphatic transport of biological macromolecules. Macromolecules therapeutics such as proteins, antibodies or polymer conjugates pose a number of pharmaceutical challenges. Where the dose is high, drainage of that dose from a subcutaneous injection site into the circulation, poses a particular problem. Here the project aims to explore how recombinant hyaluronidase, an enzyme that breaks down a structural component (hya ....Perturbation of the extracellular architecture to promote the absorption and lymphatic transport of biological macromolecules. Macromolecules therapeutics such as proteins, antibodies or polymer conjugates pose a number of pharmaceutical challenges. Where the dose is high, drainage of that dose from a subcutaneous injection site into the circulation, poses a particular problem. Here the project aims to explore how recombinant hyaluronidase, an enzyme that breaks down a structural component (hyaluronan) of the interstitum, can be used promote absorption into the draining blood and lymph capillaries. The project aims to also explore the downstream effects of hyaluronidase on lymph nodes and evaluate whether the enzyme is able to temporarily disrupt the lymph node structure and promote drug penetration into the lymph node mass. This has significant potential for improved drug targeting.Read moreRead less
Understanding the Cellular Pathways of Nuclear Receptor Activation. The success of drug treatment depends critically on specificity, i.e., stimulation of a therapeutic response at a target site, and avoidance of activity at other (potentially toxic) locations. This project aims to explore how drug interactions with binding proteins in the cytosol can induce nuclear transport and tissue specific activation of nuclear receptors - a major drug target. The project intends to employ molecular, struct ....Understanding the Cellular Pathways of Nuclear Receptor Activation. The success of drug treatment depends critically on specificity, i.e., stimulation of a therapeutic response at a target site, and avoidance of activity at other (potentially toxic) locations. This project aims to explore how drug interactions with binding proteins in the cytosol can induce nuclear transport and tissue specific activation of nuclear receptors - a major drug target. The project intends to employ molecular, structural and cell biology approaches to map drug-binding protein-receptor interactions and to determine how the structure of these complexes dictates receptor activation. The data could provide a roadmap to design drugs that interact with the right protein in the right tissue and in doing so dramatically enhance drug specificity.Read moreRead less
Synergising nanoemulsion and lipid biomimetic design for advanced delivery. This project aims to identify the critical design characteristics of lipid formulations of lipid-modified probes or drugs (lipid biomimetics) that together promote integration into lipid absorption pathways and target the lymphatic system that drains the small intestine. This has significant potential since the intestinal lymphatic system is a key immune tissue, the site of immune response to autoantigens and antigens de ....Synergising nanoemulsion and lipid biomimetic design for advanced delivery. This project aims to identify the critical design characteristics of lipid formulations of lipid-modified probes or drugs (lipid biomimetics) that together promote integration into lipid absorption pathways and target the lymphatic system that drains the small intestine. This has significant potential since the intestinal lymphatic system is a key immune tissue, the site of immune response to autoantigens and antigens derived from food and the microbiome. The project will deliver a design roadmap of the required characteristics for lymphatic targeting, and in particular, will identify novel lipid nanoemulsions that work synergistically with lipid biomimetics to enhance lymphatic imaging and delivery applications.Read moreRead less