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
As a researcher in evidence-based medicine Prof Glasziou is principally concerned with developing a greater understanding among clinicians and researchers of the causes of, and solutions to, gaps between research evidence and the application of this research to practice. Specific research interests include:understanding the applicability of treatments;the effectiveness of diagnostic and disease monitoring processes; and the cognitive processes underpinning clinicians decisions to use or not use ....As a researcher in evidence-based medicine Prof Glasziou is principally concerned with developing a greater understanding among clinicians and researchers of the causes of, and solutions to, gaps between research evidence and the application of this research to practice. Specific research interests include:understanding the applicability of treatments;the effectiveness of diagnostic and disease monitoring processes; and the cognitive processes underpinning clinicians decisions to use or not use specific treatmentsRead moreRead less
A Trial Of Therapeutic Drug Monitoring In Methadone Maintenance Treatment
Funder
National Health and Medical Research Council
Funding Amount
$542,025.00
Summary
Heroin addiction is an established and increasing problem in developed countries and in many developing nations. Although there have been several new treatments for heroin addiction, methadone maintenance remains the most effective way to minimize the harms associated with heroin addiction. The current research proposal seeks to test a new approach to setting of methadone dose, using monitoring of methadone blood levels, effects and side-effects in determining when to increase doses, and when to ....Heroin addiction is an established and increasing problem in developed countries and in many developing nations. Although there have been several new treatments for heroin addiction, methadone maintenance remains the most effective way to minimize the harms associated with heroin addiction. The current research proposal seeks to test a new approach to setting of methadone dose, using monitoring of methadone blood levels, effects and side-effects in determining when to increase doses, and when to switch to alternative therapies. This provides an objective method of planning treatment that focuses on suppressing heroin use. The potential subjects of the study are the 50% of patients who continue to use heroin regularly during treatment. All will undergo assessment involving measurement of blood levels of methadone, testing of effects and side-effects of methadone, and monitoring of safety. Half will be randomly allocated to usual care, and half to therapeutic drug monitoring, with dose adjustments according to the results of testing. At 3 and 6 months all subjects will undergo repeat test sessions. It is hypothesized that those in the experimental group will be using less heroin (confirmed by hair testing). It is expected that the study will also identify a small group of subjects with genetically different opioid receptors, who will require very high doses of methadone to be stabilized. The study will allow a detailed analysis of how best to monitor dose adequacy; the relationship between withdrawal symptoms, methadone blood levels, and heroin use, and will provide the first clear investigation of the relationship between changes in methadone blood concentration and certain potentially dangerous changes in the electrical activity of the heart. The intended outcome of this research project is a model for a higher standard methadone program that is more effective in reducing the problems of heroin use in our community.Read moreRead less
A Randomised Double Blind Placebo Controlled Clinical Trial Of Naltrexone Implants For The Treatment Of Heroin Addiction
Funder
National Health and Medical Research Council
Funding Amount
$558,675.00
Summary
GoMedical Industries has developed a formulation of sustained release naltrexone, suitable for subcutaneous depot administration (International Patent Application Number: PCT-AU01-01107, GoMedical Industries Pty Ltd, Australia). Currently, implants are inserted by minor surgery under local anaesthetic in high risk patients under the Therapeutic Goods Administration (TGA) Special Access Category A scheme (SAS) through the Australian Medical Procedures Research Foundation (AMPRF), Western Australi ....GoMedical Industries has developed a formulation of sustained release naltrexone, suitable for subcutaneous depot administration (International Patent Application Number: PCT-AU01-01107, GoMedical Industries Pty Ltd, Australia). Currently, implants are inserted by minor surgery under local anaesthetic in high risk patients under the Therapeutic Goods Administration (TGA) Special Access Category A scheme (SAS) through the Australian Medical Procedures Research Foundation (AMPRF), Western Australia. Although there is a preliminary basis for believing that this naltrexone implant treatment may offer significant benefits over oral and other naltrexone depot preparations thus far reported for managing the heroin dependent patient, this needs to be verified through an empirically designed study such a clinical trial. Lack of complete Commonwealth TGA approval to date has been a major impediment to widespread adoption of this naltrexone preparation as an alternative treatment. Hence, the main objective of this study is to provide rigorous clinical data on the efficacy of this naltrexone implant compared to oral naltrexone in the management of heroin dependent persons by primarily monitoring: Maintenance of blood naltrexone and 6-b-naltrexol concentrations above therapeutic levels Retention in treatment assessed by detection of blood naltrexone or 6-b-naltrexol Reduced frequency and quantity of opiate use Prevention of accidental opiate overdose Reduced opiate related morbidity and mortality Reduced craving for heroin and secondarily monitoring: Frequency and quantity of other drug use Other drug related accidental overdose, other morbidity or mortality Level of social functioning . General health Monitoring of implant insertion site healingRead moreRead less
Understanding Australia by analysing wastewater during the Census 2021 . This project aims to utilise the Australian Census 2021, a unique opportunity to link exposure to chemical and biological hazards with catchment socio-demographic data via systematic wastewater analysis. The project is expected to advance our capabilities to identify emerging hazards and understand factors that affect spatiotemporal trends in hazards across Australia. Moreover, in a world first, the project aims to assess c ....Understanding Australia by analysing wastewater during the Census 2021 . This project aims to utilise the Australian Census 2021, a unique opportunity to link exposure to chemical and biological hazards with catchment socio-demographic data via systematic wastewater analysis. The project is expected to advance our capabilities to identify emerging hazards and understand factors that affect spatiotemporal trends in hazards across Australia. Moreover, in a world first, the project aims to assess chemical fate on a national level by linking sales/use with fate and release from wastewater treatment plants and assess treatment efficiency at >100 plants around Australia. The project expects to provide insight for government, wastewater managers and industry into hazards that may affect environmental and human health.Read moreRead less
Can Sawfish Bycatch Within The NPF Be Mitigated Using An Electric Field?
Funder
Fisheries Research and Development Corporation
Funding Amount
$113,468.11
Summary
The Northern Prawn Fishery (NPF) is the largest Australian prawn fishery and the most valuable Commonwealth managed fishery. Annual gross value of production of the fishery was valued at $115.2 million in 2014. In recent decades, the incidental take of bycatch species has become an important issue in trawl fisheries worldwide. Impacts of fishing activities on the marine environment, including bycatch interactions are heavily scrutinised by organisations assessing the sustainability of fisheries ....The Northern Prawn Fishery (NPF) is the largest Australian prawn fishery and the most valuable Commonwealth managed fishery. Annual gross value of production of the fishery was valued at $115.2 million in 2014. In recent decades, the incidental take of bycatch species has become an important issue in trawl fisheries worldwide. Impacts of fishing activities on the marine environment, including bycatch interactions are heavily scrutinised by organisations assessing the sustainability of fisheries such as the MSC. Various Threatened, Endangered and Protected (TEP) species are still regularly caught by the fishery, including sawfishes. All four sawfish species caught within the NPF are listed on the Convention on International Trade in Endangered Species (CITES) Appendix I and the Convention of Migratory Species (CMS) Appendices I & II. Within Australia, three species are listed as Vulnerable, and all four species are listed as Migratory on the EPBC Act 1999.
Sawfishes are among the most threatened family of marine fishes and the most threatened family of cartilaginous fishes (Dulvy et al 2014). Incidental capture, particularly in trawls and gillnets, is the primary threat to sawfishes (Harrison and Duly 2014). Based on a risk assessment of the bycatch species in the NPF, all sawfishes have been identified as ‘at risk’ to trawling and least likely to be sustainable from prawn trawl fishing. A bycatch sustainability assessment also showed little change in catches of sawfishes as a result of the introduction of TEDs into the commercial fleet. The threatened status of sawfishes, vulnerability to fisheries, ongoing catches, and the inefficiency of current bycatch reduction devices to reduce sawfish bycatch suggest an urgent need for the development of new bycatch reduction devices to minimise interactions with fishing gear. This will also have the benefit of improving crew safety on the vessels as the removal of sawfish entangled in the nets is quite dangerous.
Objectives: 1. Assess whether sawfish behaviourally respond to electric fields as measured by reaction from a stationary position 2. Compare sawfish behavioural response across three fields of different characteristics Read moreRead less
Microwave And Laser Energies For Percutaneous Cardiac Ablation For The Cure Of Arhythmias
Funder
National Health and Medical Research Council
Funding Amount
$331,527.00
Summary
The commonest beating disorder of the heart is atrial fibrillation (AF). Whilst it can occur at any age it is more common in the elderly with 12% Australians over 70 y.o having it. AF is the cause of a third of all strokes and increases the risk of dying from any heart disease. Ventricular tachycardia (VT) is the commonest cause of death in the year after a heart attack. Currently these beating disorders are in most cases incurable and respond poorly to medications. We have developed an operatio ....The commonest beating disorder of the heart is atrial fibrillation (AF). Whilst it can occur at any age it is more common in the elderly with 12% Australians over 70 y.o having it. AF is the cause of a third of all strokes and increases the risk of dying from any heart disease. Ventricular tachycardia (VT) is the commonest cause of death in the year after a heart attack. Currently these beating disorders are in most cases incurable and respond poorly to medications. We have developed an operation for AF which is done by open heart surgery. It has been successful at curing some patients who suffer from AF and uses radiofrequency energy. The difficulty of radiofrequency energy is that it is not suitable in a large number of cases for this operation. We are developing Laser and Microwave catheters as alternatives to RF so that the success of the operation can be improved. These new microwave and laser catheters are being designed and tested to be used primarily in a minimally invasive procedure. They would be inserted via the veins with the patient under sedation. This would allow patients to go home sooner and have a recovery period of only a few days. As well as their application in the top chamber of the heart (atrium) for AF, these new energies will be adapted for minimally invasive operations in the ventricle (lower chamber) of the heart for the treatment of ventricular tachycardia. By developing a technique such as this, cure of AFand VT will be available to many more people, helping reduce the strokes, heart failure and premature deaths from these two heart conditions.Read moreRead less
PROTEIN PROFILING FOR THE IDENTIFICATION AND MONITORING OF LYSOSOMAL STORAGE DISORDERS AND OTHER NEUROLOGICAL DISEASES
Funder
National Health and Medical Research Council
Funding Amount
$469,500.00
Summary
Lysosomal storage disorders (LSD) are a group of more than 45 progressive genetic diseases, that result from the absence or impaired function of a specific enzyme in each of the body's cells. Lysosomes rid the cell of excess waste. Impaired enzyme function halts this process and waste begins to accumulate (or 'store') in the cell. Disease severity and patient longevity is variable, but severely affected patients often die by their mid-teens. LSD can affect the skeleton and joints, respiratory an ....Lysosomal storage disorders (LSD) are a group of more than 45 progressive genetic diseases, that result from the absence or impaired function of a specific enzyme in each of the body's cells. Lysosomes rid the cell of excess waste. Impaired enzyme function halts this process and waste begins to accumulate (or 'store') in the cell. Disease severity and patient longevity is variable, but severely affected patients often die by their mid-teens. LSD can affect the skeleton and joints, respiratory and cardiovascular systems, the brain, the eyes, the ears and the airways. As affected children become older, symptoms worsen. Patients often require frequent hospitalisation, and medical and surgical intervention. Approximately 10 to 15% of the general population are affected or carriers of an LSD. In Australia, one LSD child is born in every 5,000 live births. Diagnosis often takes several years, and families often have other children before their affected child is diagnosed. LSD are, therefore, a considerable burden to not only the families but also to the health care system. The goal of the Lysosomal Diseases Research Unit is Diagnosis at birth and effective therapy for lysosomal storage disorders. To this end we have been working toward the development of a newborn screening program for LSD and improved methods for the diagnosis and monitoring of therapy in this group of diseases. In this project we propose to develop and evaluate the use of protein profiling (looking at many diagnostic markers at the same time) to achieve these goals. The technology developed in this project will have potential application beyond LSD. Lysosomal dysfunction has been implicated in Alzheimer's disease and Parkinson's disease; in addition lysosomal proteins are reported to be involved in the spread of some cancers and may be useful markers for early detection. We will collaborate with other research groups to further develop protein profiling in these areas.Read moreRead less
A Trial Of Surgery Versus Surgery Plus Adjuvant Radiotherapy In Patients With Resected Nodal Metastatic Melanoma.
Funder
National Health and Medical Research Council
Funding Amount
$305,000.00
Summary
Skin cancer is extremely common in Australia but usually presents early and is highly curable. Malignant melanoma is the third commonest skin cancer, however is the most lethal. When melanoma spreads away from its primary site on the skin it most frequently presents as a lump in the regional node basin (lymph node metastases). The region containing malignant lymph nodes (or glands) is dependent on where the primary melanoma occurred on the skin. Thus a primary melanoma on the arm or chest would ....Skin cancer is extremely common in Australia but usually presents early and is highly curable. Malignant melanoma is the third commonest skin cancer, however is the most lethal. When melanoma spreads away from its primary site on the skin it most frequently presents as a lump in the regional node basin (lymph node metastases). The region containing malignant lymph nodes (or glands) is dependent on where the primary melanoma occurred on the skin. Thus a primary melanoma on the arm or chest would be expected to spread to nodes in the axilla (armpit) or on the leg to the groin, or on the face to the neck. The standard treatment is surgery (lymphadenectomy, therapeutic lymph node dissection) to remove the malignant nodes, and is usually very effective treatment. However some patients suffer recurrence of the melanoma in the region of the lymph node surgery which can become difficult to control. Early radiotherapy has been variably used soon after the lymph node surgery (called adjuvant radiotherapy as all the known cancer has been removed by surgery) to try and reduce the risk of the melanoma regrowing in the region of the surgically removed (completely resected) nodes. This trial is designed to answer the question as to whether the addition of radiotherapy to the region of lymph node surgery does improve outcomes for patients with this diagnosis. These outcomes include potentially reducing the rate of recurrence of melanoma in the region of the lymph node surgery, finding out the difference in the frequency and severity of side effects for each of the treatments (surgery versus surgery plus radiotherapy) and as a result whether patients on the whole have any difference in their quality of life. The trial will also study what signs in the pathology specimen taken at the time of the operation might indicate when radiotherapy would be best employed. The trial aims to accrue 270 patients over 4 years from multiple centres around Australia and New Zealand.Read moreRead less
A SYSTEMS BIOLOGY APPROACH TO SCREENING, DIAGNOSIS AND PROGNOSIS FOR LYSOSOMAL STORAGE DISORDERS
Funder
National Health and Medical Research Council
Funding Amount
$900,781.00
Summary
Lysosomal storage disorders (LSD) are inherited and, at present, can only be detected in children after symptoms are obvious. We are developing newborn screening for LSD to detect affected babies before the onset of irreversible symptoms. As most LSD babies appear normal at birth it is important to be able to predict disease severity or rate of disease progression; this will help doctors know when to give therapy, which therapy is best and provide families with appropriate genetic counseling.