Improving First Trimester Screening By Combining Rapid MF-PCR Of PAP Smears With Nuchal Ultrasound Scanning
Funder
National Health and Medical Research Council
Funding Amount
$206,809.00
Summary
Genetic defects are the major cause of embryonic and foetal death as well as being responsible for a large proportion of childhood disabilities. Although many are detected by the ~50,000 prenatal tests currently performed annually in Australia, these methods are only offered to high risk mothers because they are invasive (~1% risk of miscarriage), and-or expensive. A rapid, low cost, less invasive and safer alternative prenatal diagnostic method such as PAP smears that could be offered to all mo ....Genetic defects are the major cause of embryonic and foetal death as well as being responsible for a large proportion of childhood disabilities. Although many are detected by the ~50,000 prenatal tests currently performed annually in Australia, these methods are only offered to high risk mothers because they are invasive (~1% risk of miscarriage), and-or expensive. A rapid, low cost, less invasive and safer alternative prenatal diagnostic method such as PAP smears that could be offered to all mothers regardless of risk is therefore of immense value both to mothers and to the health care system. This proposal enhances first trimester screening by improving prenatal diagnosis from PAP smears. Although normally taken to detect cancer, these smears contain significant numbers of foetal cells. We will investigate: the best way and time to obtain these cells, the best way to remove the cells from any contamination, improvements in genetic diagnosis of these cells using a technique known as MF-PCR which is rapidly revolutionising conventional prenatal diagnosis. By automating these procedures, they will become less expensive and more accessible to all mothers regardless of risk. We will also compare these procedures with alternative first trimester screening techniques such as nuchal translucency to determine the value of both tests singly and in combination. This research should provide a safe, reliable and accurate method allowing inexpensive prenatal screening to be available for all pregnancies. General screening programmes using this new test, particularly if combined with nuchal translucency programmes, would result in a dramatic reduction in affected babies with major implications to families and the health care system.Read moreRead less
An Evaluation Of The Validity Of Measureing Salivary Oxycodone Concentrations For Pharmacokinetic Studies In Patients
Funder
National Health and Medical Research Council
Funding Amount
$49,135.00
Summary
In many countries, oxycodone is replacing morphine as the opioid of first choice for the treatment of moderate to severe pain. Despite this, very little is known about how the drug is processed in the body or how its ability to control pain is affected by such factors as other drugs, age or organ function. Studies to determine this usually require multiple blood tests from individual patients over set time periods. Our team is able to measure drug levels in saliva and has shown this to be a vali ....In many countries, oxycodone is replacing morphine as the opioid of first choice for the treatment of moderate to severe pain. Despite this, very little is known about how the drug is processed in the body or how its ability to control pain is affected by such factors as other drugs, age or organ function. Studies to determine this usually require multiple blood tests from individual patients over set time periods. Our team is able to measure drug levels in saliva and has shown this to be a valid substitute for the measurement of drug levels in blood. Furthermore, one of us has developed a computer modelling system that shows how drugs are handled in the body using only a few samples from each patient. Palliative care patients are generally frail and unwell. We are reluctant to expose them to invasive tests such as repeated blood sampling. If we can prove that saliva sampling is as good as blood sampling, we will have identified a simple non-invasive means of greatly increasing our knowledge of oxycodone and how it behaves in individual patients. This in turn may allow us to tailor drug doses according to the unique characteristics of each patient and to optimise their pain control.Read moreRead less
Understanding Relapse In Posttraumatic Stress Disorder: An Investigation Of Return Of Fear.
Funder
National Health and Medical Research Council
Funding Amount
$255,014.00
Summary
Posttraumatic Stress Disorder (PTSD) is common and results in significant impairment. There are effective psychological treatments for PTSD, yet relapse following treatment remains high. The proposed research will involve a series of experiments and observational studies to better understand the process that lead to relapse in patients receiving treatment for PTSD. The findings of these studies will assist in modifying treatment to ensure that symptom gains are maintained following treatment.
Exploration Of Exposures Associated With Bedding That Are Risks For Childhood Allergy And Asthma Symptoms
Funder
National Health and Medical Research Council
Funding Amount
$263,500.00
Summary
Asthma prevalence in Australia has doubled in the last 20 years, with 1 in 4 children now affected. House dust mites are probably the single most important allergen associated with asthma. The prevalence of mite allergy is linked to exposure, and such allergy when combined with high exposure, is a potent risk factor for asthma exacerbations. The current international advice for managing mite-allergic asthma, strongly advocates the use of bedding encasings as the best way to reduce exposure. Howe ....Asthma prevalence in Australia has doubled in the last 20 years, with 1 in 4 children now affected. House dust mites are probably the single most important allergen associated with asthma. The prevalence of mite allergy is linked to exposure, and such allergy when combined with high exposure, is a potent risk factor for asthma exacerbations. The current international advice for managing mite-allergic asthma, strongly advocates the use of bedding encasings as the best way to reduce exposure. However, three recent major trials using encasings and a meta-analysis of earlier trials all fail to show a clinical benefit. One of the applicants (ET) recently showed, using expertise in measuring personal exposure, that these encasings, as used, fail to significantly reduce aeroallergen exposure. By contrast, 3 recent Australian studies, involving the applicants, AK, ALP and NG showed that feather bedding compared to synthetic bedding, was strongly protective for asthma - the opposite of public advice. The suggested mechanisms involve reduced exposure to mite allergens, or altered exposure to bacterial endotoxin, but persuasive experimental support is lacking. We also propose a novel hypothesis that feather exposure may induce allergic 'tolerance'. Currently there is a lack of certainty about valid approaches to prevent asthma, and the Global Initiative for Asthma has described the need to understand mechanisms and improve interventions as urgent. This project is an ideal opportunity to combine the expertise of the CIA (ET) in measuring airborne exposures (mite, endotoxin, proteins) with that of the others who have expertise in children's asthma, and who are already involved in two large clinical trails involving different bedding and allergen avoidance. Our measurements of these bedding exposures and their clinical outcomes will provide, for the first time, a quantitative basis to refine public health allergen-based interventions to prevent and manage asthma.Read moreRead less