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Gastrointestinal Sensory Function In Normal And Diseased States
Funder
National Health and Medical Research Council
Funding Amount
$691,026.00
Summary
Chronic pain and discomfort from the digestive system is a major health care issue world-wide. There is currently no effective treatment for these problems, which often have no apparent organic cause. Lack of treatment is due to a lack of understanding about how sensations are transmitted from the digestive system to the brain. Our research group has unique and powerful techniques that allow us to probe the basic mechanisms of sensory function, and make rapid progress towards finding drugs that ....Chronic pain and discomfort from the digestive system is a major health care issue world-wide. There is currently no effective treatment for these problems, which often have no apparent organic cause. Lack of treatment is due to a lack of understanding about how sensations are transmitted from the digestive system to the brain. Our research group has unique and powerful techniques that allow us to probe the basic mechanisms of sensory function, and make rapid progress towards finding drugs that reduce specific types of sensory signals from the gut. We shall investigate sensory mechanisms in the upper and lower regions of the gut, where symptoms are most prevalent in diseases such as non-cardiac chest pain, functional dyspepsia and irritable bowel syndrome. Six aspects of sensory nerve endings in the gut are to be investigated: 1. The grouping of endings into functional classes (similar to touch or pressure receptors in skin) 2. How endings respond to chemicals and hormones found in the gut 3. How currently available drugs may be useful in reducing sensitivity 4. The mechanisms by which inflammation affects sensitivity 5. How nerve growth factors may trigger changes in sensitivity 6. How pores or channels in nerve endings determine their functionRead moreRead less
Coronary artery disease usually presents with chest pain resulting from cardiac muscle being starved of blood and oxygen due to narrowings in the coronary arteries supplying the heart muscle (myocardial ischaemia). The common test to detect this state is the electrocardiogram or ECG which often shows changes known as ST segment shifts. This project follows earlier work and will explain why the ST changes occur and also will determine how to maximize the information from the ECG so that clinician ....Coronary artery disease usually presents with chest pain resulting from cardiac muscle being starved of blood and oxygen due to narrowings in the coronary arteries supplying the heart muscle (myocardial ischaemia). The common test to detect this state is the electrocardiogram or ECG which often shows changes known as ST segment shifts. This project follows earlier work and will explain why the ST changes occur and also will determine how to maximize the information from the ECG so that clinicians are better able to predict the site, size and timing of the ischaemia from the ECG. The proposal will use detailed measurement of the electric field around the ischaemic region to build up the three dimensional electric field from which the explanation as to why the body surface patterns occur will be gleaned by computer modelling. This project will extend the field measurement back into the myocardium using intramyocardial electrodes with a spacing of 2 mm. This project will result in better analysis of the ECG in patients with chest pain, better practice in selecting patients for admission or early treatment and could result in substantial savings to the health system from reduced admissions, more appropriate investigation and treatment. A better diagnosis on one patient daily in Austarlia alone would be expected to save one million dollars in the year.Read moreRead less
Low back pain (LBP) is highly prevalent and enormously expensive to society: total payments made by Workcover for injuries to the low back were in excess of $530 million in NSW in 1996. Chronic LBP (pain lasting more than 3 months) accounts for up to 90% of these costs. Prevention of a large part of this costly problem could be achieved by effective treatment at the earlier sub-acute phase of LBP (6 weeks to 3 months duration). Exercise and advice are two widely-used treatments for sub-acute LBP ....Low back pain (LBP) is highly prevalent and enormously expensive to society: total payments made by Workcover for injuries to the low back were in excess of $530 million in NSW in 1996. Chronic LBP (pain lasting more than 3 months) accounts for up to 90% of these costs. Prevention of a large part of this costly problem could be achieved by effective treatment at the earlier sub-acute phase of LBP (6 weeks to 3 months duration). Exercise and advice are two widely-used treatments for sub-acute LBP, yet remarkably, their efficacy is unknown. For the first time, this study will rigorously evaluate the effectiveness of both a supervised exercise program and advice to return to normal activity for sub-acute LBP. When this study is completed, Australian practitioners will be able to adopt evidence based practice when managing sub-acute LBP. In addition, the study's results will enable practitioners to select the most effective treatment for each individual patient. The results of this study should lead to a large reduction in the incidence of chronic LBP, therefore the results should lead to significant savings in terms of social and economic costs.Read moreRead less
New Methods Of Pain Assessment In Demented Older Persons
Funder
National Health and Medical Research Council
Funding Amount
$306,000.00
Summary
There are substantial risks of inadequate pain assessment and management in persons with cognitive impairment and particularly in those with communication problems. Undetected or under-treated pain can have serious adverse effects on frail older adults including poorer cognitive performance, increased levels of depression, anxiety and disruptive behaviours, a reduced quality of life and higher levels of functional disability. These adverse effects contribute to greater demands for daily nursing ....There are substantial risks of inadequate pain assessment and management in persons with cognitive impairment and particularly in those with communication problems. Undetected or under-treated pain can have serious adverse effects on frail older adults including poorer cognitive performance, increased levels of depression, anxiety and disruptive behaviours, a reduced quality of life and higher levels of functional disability. These adverse effects contribute to greater demands for daily nursing care and a corresponding increase in health care costs. The present proposal aims to develop more sensitive, reliable and valid questionnaire and non-verbal measures of pain in older adults with cognitive impairment and particularly in those with verbal communication problems. By completion, the present studies should provide much needed information on the reliability and validity of several different types of verbal and non-verbal indicators of possible pain. This research should lead to improved pain assessment and management for the growing segment of the population who suffer from pain and impaired cognitive function.Read moreRead less
Synergism Between Opioids And Other Agents At Central Primary Afferent Synapses
Funder
National Health and Medical Research Council
Funding Amount
$202,771.00
Summary
Opioids, such as codeine, pethidine and morphine, are the most effective pain relieving drugs known but their clinical utility is limited by hazardous and potentially lethal side effects, as well as the development of tolerance and physical dependence with associated addiction liability. Recent research in our laboratory has identified for the first time a mechanism in the mammalian brain by which the pain relieving actions of opioids can be greatly enhanced by drugs that independently modulate ....Opioids, such as codeine, pethidine and morphine, are the most effective pain relieving drugs known but their clinical utility is limited by hazardous and potentially lethal side effects, as well as the development of tolerance and physical dependence with associated addiction liability. Recent research in our laboratory has identified for the first time a mechanism in the mammalian brain by which the pain relieving actions of opioids can be greatly enhanced by drugs that independently modulate biochemical processes distinct from those altered by opioids. Exploitation of these mechanisms has great potential for the development of new pharmacotherapies for effective pain relief with minimised side effects. These synergistic mechanisms appear to be at least as important for pain relief in the spinal cord as in brain, so the proposed studies will first examine the basis for synergism with opioid mediated pain relief in spinal cord. There is also strong evidence that the mechanisms to be studied in the proposed work are pivotal in the development of debilitating, chronic pain conditions that involve heightened sensitivity to painful stimuli and-or painful responses to normally innocuous stimuli such as light touch. Such aberrant responses can persist long after initial tissue damage has recovered. It is known that opioids can limit somewhat the initial steps in the induction of these abnormal responses but the mechanisms involved are unknown. The proposed studies will contribute to resolution of these mechanisms. Better understanding of the basis of these pathological processes will lead to better strategies for retarding or preventing the development of chronic pain conditions.Read moreRead less
I am a clinical scientist translating basic science findings into clinical science questions and answers that impart better understanding and management of pain and painful disease.