Clinical Feasibility Study Of Omega-3 PUFA Therapy For The Reduction Of Post-cardiac Surgery Atrial Arrhythmias
Funder
National Health and Medical Research Council
Funding Amount
$442,092.00
Summary
The aim of this study is to determine the molecular and clinical impact of omega-3 polyunsaturated fatty acids (PUFA) pre-treatment 2 weeks before cardiac surgery in 150 patients. The outcome of this proposal will indicate proof of molecular concepts, clinical feasibility and specific design elements of a future, large scale, placebo controlled, prospective randomised trial of oral therapy with omega-3 polyunsaturated fatty acids (PUFA). Recently, omega-3 PUFA via fish diet was reported to be li ....The aim of this study is to determine the molecular and clinical impact of omega-3 polyunsaturated fatty acids (PUFA) pre-treatment 2 weeks before cardiac surgery in 150 patients. The outcome of this proposal will indicate proof of molecular concepts, clinical feasibility and specific design elements of a future, large scale, placebo controlled, prospective randomised trial of oral therapy with omega-3 polyunsaturated fatty acids (PUFA). Recently, omega-3 PUFA via fish diet was reported to be linked to low incidence of AF. The main aim is to provide a cheap and safe preventative therapy against post-operative atrial fibrillation (AF), a key heart rhythm disorder that occurs in at least 1 in 4 patients after heart surgery and increases post-operative complications, limits recovery and increases hospital stay and cost. Biochemical study elements are important to gain valuable insight into the molecular mechanisms (directly in human heart) that underlie post-operative heart rhythm disorder and may delineate new more precise molecular targets for therapy. No previous clinical study has ever examined whether omega-3 PUFA therapy prevents post-operative heart rhythm disorder. Use of 3g-day omega-3 PUFA pre-treatment in the surgical setting has been shown to be safe in a number of small studies, including our own. Our preliminary data indicates that therapy increases heart and blood content of omega-3 PUFA ~2-fold, and reduces the incidence of AF. Post-operative AF is an expensive resource burden in all cardiothoracic surgery units of Australian hospitals and targets key health priorities. Due to the non-patentable nature of omega-3 PUFA, significant industry based support for clinical research is limited. A positive outcome would rapidly pave the way for widespread use in elective surgery. Reduced length of hospital stay, cost-savings, and the increase in productivity as healthy individuals return to their communities would nationally repay the investment many fold.Read moreRead less
ANALYSIS OF KNEE KINEMATICS- An MRI Study Of The Normal, Anterior Cruciate Injured, And Reconstructed Knee.
Funder
National Health and Medical Research Council
Funding Amount
$161,320.00
Summary
People with anterior cruciate ligament damage to the knee tend to develop osteoarthritis in this knee, perhaps because the instability produced by the ligament tear changes the patterns of wear on the joint surfaces. There are several studies using cadaver knees which examine the impact on the joint surfaces of cutting the anterior cruciate ligament, but very little of people moving voluntarily. This study plans to use MRI images of people with a torn cruciate ligament in one knee, and one norma ....People with anterior cruciate ligament damage to the knee tend to develop osteoarthritis in this knee, perhaps because the instability produced by the ligament tear changes the patterns of wear on the joint surfaces. There are several studies using cadaver knees which examine the impact on the joint surfaces of cutting the anterior cruciate ligament, but very little of people moving voluntarily. This study plans to use MRI images of people with a torn cruciate ligament in one knee, and one normal knee. The subjects will simulate a squat inside the MRI magnet against a weighted footplate. The images will be taken at fifteen degree intervals of knee movement. The contact points between the joint surfaces will be measured and compared to the normal knee. This imaging will be repeated after surgical repair, and then again two years later, to assess whether the normal movement pattern has been restored.Read moreRead less
Alternative Insufflation Gases For Laparoscopic Surgery
Funder
National Health and Medical Research Council
Funding Amount
$227,036.00
Summary
It is now recognised that laparoscopic (keyhole) surgery for cancer can be associated with the spread of tumour to surgical wounds, i.e. port sites. However, whether this is more likely following laparoscopy than conventional open surgery is controversial. Isolated case reports and the recent results of experimental studies suggest that the problem is important. Previous studies suggest that carbon dioxide gas used to inflate the abdomen during laparoscopy may be the specific cause of this probl ....It is now recognised that laparoscopic (keyhole) surgery for cancer can be associated with the spread of tumour to surgical wounds, i.e. port sites. However, whether this is more likely following laparoscopy than conventional open surgery is controversial. Isolated case reports and the recent results of experimental studies suggest that the problem is important. Previous studies suggest that carbon dioxide gas used to inflate the abdomen during laparoscopy may be the specific cause of this problem. A four to fivefold increase in the rate of cancer spread has been shown in previous experiments, and this can be reduced by using an inert gas such as helium. We propose to further investigate this issue using a combination of small and large animal models, and will also commence clinical trials of helium during clinical surgery. These studies aim will determine the gas of choice during laparoscopic surgery. They will also clarify advantages demonstrated for the use of helium in previous animal studies, and better investigate the safety of helium use. If our preliminary findings are supported by these studies, helium (or other inert gases) should be considered for routine use during clinical laparoscopy.Read moreRead less
Nurses' Pain Management Decisions In The Post Surgery Context: A Naturalistic Study
Funder
National Health and Medical Research Council
Funding Amount
$56,368.00
Summary
In the hospital environment, doctors often prescribe medications for pain using an as required format on the drug order chart. Very often, this form of prescription occurs in the surgical wards of a hospital, where a patient may need a lot of pain relieving medication in the early period following the operation, and very little medication a few days following the operation. In the as required form of prescribing, the nurse caring for the patient has enormous flexibility in determining when and h ....In the hospital environment, doctors often prescribe medications for pain using an as required format on the drug order chart. Very often, this form of prescription occurs in the surgical wards of a hospital, where a patient may need a lot of pain relieving medication in the early period following the operation, and very little medication a few days following the operation. In the as required form of prescribing, the nurse caring for the patient has enormous flexibility in determining when and how much medication should be administered. Previous work has consistently shown that nurses do not administer adequate medication, which often results in poor pain control. Several nurse-related reasons have been proposed for poor pain management, including the fear of addiction, the fear of producing difficulties in breathing, and inadequate education about the medications administered. The focus of previous work has relied on examining small areas in isolation. Primarily, researchers have examined information on the drug order charts following patient discharge from hospital. They have also relied on analysing nurses' views on pain management relating to hypothetical patient situations. Overall, the research fails to address the multiple and interconnected factors faced by the nurse which could impact on pain management. Sources of these factors may be the patient, nurse, medication or environment. Examples of these factors include the presence or absence of the doctor, nurses' communication with doctors and other nurses about patient care, layout of the hospital ward, ward management structure, and methods used by the nurse to assess patient pain. By identifying the complex factors that impinge on decisions for managing pain, this study will provide opportunities to address the barriers that prevent adequate pain management. Nurses will then be in a position to change their practice in order to improve the management of patients' pain.Read moreRead less
Optimizing Implanted Cell Survival Using A Tissue Engineering Model
Funder
National Health and Medical Research Council
Funding Amount
$589,175.00
Summary
Cell therapy and tissue engineering involve the insertion of specific cells into damaged tissues or into a bioraector in a patient's body to generate new replacement tissues. This project seeks to improve two factors associated with inserting cells : 1. The innate survival characteristics of the cells being inserted, and 2. The blood vessel supply at the site of insertion. These techniques will greatly improve the survival of inserted cells.
Rock Lobster Post Harvest Subprogram: Quantification Of Shell Hardness In Southern Rock Lobster
Funder
Fisheries Research and Development Corporation
Funding Amount
$86,403.70
Summary
A new, simple and quick solution to the ambiguity of current measures of shell wear is to quantify shell hardness with a durometer, which is a small, hand-held device originally designed to measure the flexibility of plastic sheeting (Hicks and Johnson, 1999). This system of standardisation has recently been introduced in Alaskan crab fisheries. Before these devices can be used for Australian rock lobster stock-assessment, a series of short experiments are needed to calibrate hardness reading ....A new, simple and quick solution to the ambiguity of current measures of shell wear is to quantify shell hardness with a durometer, which is a small, hand-held device originally designed to measure the flexibility of plastic sheeting (Hicks and Johnson, 1999). This system of standardisation has recently been introduced in Alaskan crab fisheries. Before these devices can be used for Australian rock lobster stock-assessment, a series of short experiments are needed to calibrate hardness reading to the moult cycle. These experiments will allow future research sampling to record more useful measures of moult stage and thus provide more effective stock assessment.
This calibration will have immediate application in Tasmanian research for assessing the effect of September and November harvests on mortality of discarded lobsters. Processors in both South Australia and Tasmania anticipate that this project will provide a valuable tool for industry to use in setting acceptable levels of shell hardness for the landing of export-grade lobsters. That is, fishers will be able to establish a quantitative shell hardness grade that a processor will accept prior to landing the catch. This eliminates the current problem of the landing of lobsters that are ambiguously classed as “hard” by a fisher but “soft” by a processor – with resultant negative impacts on economic yield and markets.
Hicks, D. and Johnson, B.A., 1999. A device to measure shell hardness of Dungeness crabs and trial application in the Kodiak Island, Alaska, commercial fishery. Nor. Amer. J. Fish. Man. 19: 581-590.
Objectives: 1. To calibrate the rate of change in shell hardness before and after the moult of southern rock lobsters relative to lobster size, sex, region and temperature. 2. To identify the region of the exoskeleton that is most suited for measuring hardness. 3. To develop a prototype gauge for industry use that can be used to measure shell hardness of lobster with precision in industry conditions. Read moreRead less
Outcomes Of The Arterial Switch Operation: A Multi-centre Study
Funder
National Health and Medical Research Council
Funding Amount
$86,733.00
Summary
The arterial switch operation is the surgery of choice for children born with transposition of the great arteries, a congenital heart defect where the main two vessels of the heart arise from wrong pumping chambers of the heart. There are very few studies looking at adults after this operation. We aim to study all patients who have had an arterial switch. The results of this study will further increase our knowledge of the long term consequences of having the arterial switch operation.