Application Of Novel Sutureless Technology For Eye Surgery
Funder
National Health and Medical Research Council
Funding Amount
$342,623.00
Summary
Corneal disease and trauma are major causes of blindness. Corneal trauma requires surgical repair and vision lost from disease may be restored with corneal transplantation. In both cases sutures are used and can have significant complications. Application of a new surgical adhesive for cost-effective, quick and easy corneal surgery with enhanced wound healing is an innovative solution to a major problem in public health with manifold implications in the field of eye surgery
Evaluating And Disseminating The Implementation Success Of A Surgical Training Program
Funder
National Health and Medical Research Council
Funding Amount
$181,065.00
Summary
Removal of the uterus (hysterectomy) is the most commonly performed major surgical procedure in women (30,000/yr in Australia). Internationally, only about 25% of hysterectomies are still performed through an open abdominal approach, compared to 40% in Australia. This means that too many women in Australia will suffer unnecessary side-effects, pain and long recovery, keeping them away from their family and usual tasks longer than necessary.
THE CONTROL OF TYPE 2 DIABETES THROUGH WEIGHT LOSS IN INDIGENOUS AUSTRALIANS: THE FEASIBILITY AND ACCEPTABILITY OF LAGB
Funder
National Health and Medical Research Council
Funding Amount
$600,854.00
Summary
Our recent clinical trial showed that 3 out of every 4 obese people with type 2 diabetes who undergo substantial weight loss have their diabetes go into remission. In this project we recognise in the Indigenous people specific cultural and socio-economic factors and family and community approach to health care and seek to test if the Lap-Band procedure is acceptable to them and if it is feasible to achieve substantial weight loss and control of diabetes as was seen in a European population.
Role Of Neutrophil Proteases In The Mobilisation Of Haemopoietic Progenitor Cells
Funder
National Health and Medical Research Council
Funding Amount
$318,279.00
Summary
Mobilisation is a procedure consisting in inducing the egress of blood forming cells (haemopoietic stem cells) from the bone marrow, where they normally reside, into the blood. The most common agent to induce mobilisation of haemopoietic stem cell is a cytokine called granulocyte - colony stimulating factor (G-CSF). In recent years, the number of transplantations performed with mobilised blood stem cells has exceeded those performed with bone marrow. Elements contributing to this success have be ....Mobilisation is a procedure consisting in inducing the egress of blood forming cells (haemopoietic stem cells) from the bone marrow, where they normally reside, into the blood. The most common agent to induce mobilisation of haemopoietic stem cell is a cytokine called granulocyte - colony stimulating factor (G-CSF). In recent years, the number of transplantations performed with mobilised blood stem cells has exceeded those performed with bone marrow. Elements contributing to this success have been the simplicity of the procedure (daily injections of a mobilising cytokines such as G-CSF), a more rapid recovery following high dose chemotherapy and transplantation, and lower costs. Despite its common use in clinics, the molecular mechanisms responsible for haemopoietic stem mobilisation following injection of cytokines are still unknown. A large body of experimental data demonstrate the critical role of adhesive interactions between blood forming cells and the bone marrow microenvironment These interactions control the lodgement of blood forming cells in the bone marrow, where they normally reside, and their egress into the blood during mobilisation. Experiments from this laboratory have shown that the mobilisation of blood forming cells that follows the administration of G-CSF, may be the consequence of the accumulation in the bone marrow of a class of leukocytes called neutrophils. These neutrophils subsequently release within the bone marrow a set of enzymes that specifically cleave a cell adhesion molecule expressed in the bone marrow, and therefore disrupt the adhesive interactions between the bone marrow and the blood forming cells resulting in their egress in the blood. This proposal aims to demonstrate this hypothesis and to provide tools to predict and improve the levels of mobilisation that can be achieved with healthy donors and cancer patients.Read moreRead less
Inhaled Mannitol For The Treatment Of Mucociliary Dysfunction- Its Effect And Mechanisms On The Clearance Of Mucus
Funder
National Health and Medical Research Council
Funding Amount
$324,100.00
Summary
Excessive secretion of mucus is a problem in asthma and bronchiectasis. Mucus is secreted from submucosal glands and goblet cells as a result of inflammation present in the airways. Excessive mucus is not easily transported by the cilia (hair like structures) in the airways and accumulation leads to productive cough and to recurrent infections. Cough is a secondary mechanism to clear mucus when the mucociliary system fails. Cough generates high airflow rates that can move mucus. However, patient ....Excessive secretion of mucus is a problem in asthma and bronchiectasis. Mucus is secreted from submucosal glands and goblet cells as a result of inflammation present in the airways. Excessive mucus is not easily transported by the cilia (hair like structures) in the airways and accumulation leads to productive cough and to recurrent infections. Cough is a secondary mechanism to clear mucus when the mucociliary system fails. Cough generates high airflow rates that can move mucus. However, patients with moderately to severely obstructed airways cannot generate high airflow rates. In addition, cough becomes very inefficient in moving mucus if it is sticky and viscous. As the cilia cannot transport large quantities of mucus the best approach is to alter the properties of mucus that would facilitate cough clearance. Increased hydration of mucus could change its surface and rheological properties. Increased hydration can be achieved by the osmotic movement of water into the airway lumen in response to inhaling an aerosol of salt or sugar. We have evidence using radioactive aerosols, that mannitol, a sugar, increases clearance of mucus acutely in patients with excessive secretions. We also have new evidence that mannitol taken daily over two weeks increases the health status in patients with bronchiectasis. Further we now have preliminary data demonstrating that mannitol changes the surface properties of mucus. We aim to study the properties of mucus in relation to its clearance in vivo in humans. This has not been done before. If we can demonstrate that changes in clearance in response to mannitol relate to the changes in mucus then we will be able to easily evaluate current treatments and doses for patients with excessive secretions and to identify new treatments. Mannitol is a potential treatment for diseases with excessive secretions and understanding of how it works will hopefully lead to better outcomes for patients.Read moreRead less
CROSSFIRE: Combined Randomised And Observational Study Of Surgery For Fractures In The Distal Radius In The Elderly
Funder
National Health and Medical Research Council
Funding Amount
$551,077.00
Summary
Fractures (breaks) near the wrist are the most common fractures treated. Treatment previously consisted of straightening and plaster casting in the emergency department, but standard treatment now includes admission to hospital and surgery to apply a plate and screws to the bone. The best evidence we have (which is limited) is that surgical plating does not provide important benefits over plastering. We aim to perform a multicentre trial comparing plating to plaster for these common fractures.
The WA Safety And Quality Of Surgical Care Project: Improving The Safety, Quality And Provision Of Surgical Care.
Funder
National Health and Medical Research Council
Funding Amount
$583,500.00
Summary
The basis of this application is a three-year project which aims to improve the safety, quality and the provision of surgical care. This application constitutes the core of the WA Safety and Quality of Surgical Care Project (SQSCP), which was established in 1996 to evaluate the clinical epidemiology, health care utilisation, patient safety and health outcomes following admission to hospital for specific surgical and medical procedures in Western Australia (WA). The study will use data from the W ....The basis of this application is a three-year project which aims to improve the safety, quality and the provision of surgical care. This application constitutes the core of the WA Safety and Quality of Surgical Care Project (SQSCP), which was established in 1996 to evaluate the clinical epidemiology, health care utilisation, patient safety and health outcomes following admission to hospital for specific surgical and medical procedures in Western Australia (WA). The study will use data from the WA Data Linkage System, which brings together 15 million records from hospital morbidity, death, cancer, midwives notification and mental health databases. Surgical procedures have been selected for review based on national priorities and after consultation with the WA Branch of the Royal Australasian College of Surgeons (RACS) and other clinical Colleges. This application proposes to continue the core research activities of the SQSCP. A special focus will be on the use of minimally invasive surgical techniques including laparoscopic, endoscopic and endoluminal procedures, which have increased dramatically during the last decade. The study will also evaluate differences in the outcomes of surgical care in rural and metropolitan settings. The findings of the SQSCP will be comprehensively disseminated to surgeons, the RACS, hospital managers, health policy makers and consumers. The rationale of this project is that by providing high quality data on the epidemiology, utilisation and outcomes of surgical care, we will be able to increase the knowledge-base that will contribute to improvements in the safety, quality and provision of surgical care in Australia and internationally. The aims of the SQSCP are consistent with national health priorities and the recommendations of the Taskforce on Quality of Australian Health Care Study, the Australian Council for Safety and Quality in Health Care and the National Institute of Clinical Studies.Read moreRead less
A Randomised Controlled Trial Of The Effect Of Substantial Weight Loss On Obstructive Sleep Apnoea.
Funder
National Health and Medical Research Council
Funding Amount
$404,061.00
Summary
Obstructive sleep apnea is now commonly recognized as a major health problem and frequently ocurrs in overweight or obese individuals. Several studies have now demonstrated that weight loss can be an effective treatment for sleep apnea in those with a weight problem. But, it is extremely difficult to achieve and sustain the major weight loss required to adequately treat this condition. Modern obesity surgery is the only reliable method of achieving and sustaining major weight loss in very obese ....Obstructive sleep apnea is now commonly recognized as a major health problem and frequently ocurrs in overweight or obese individuals. Several studies have now demonstrated that weight loss can be an effective treatment for sleep apnea in those with a weight problem. But, it is extremely difficult to achieve and sustain the major weight loss required to adequately treat this condition. Modern obesity surgery is the only reliable method of achieving and sustaining major weight loss in very obese individuals, and several studies have found that along with weight loss there are major improvements in sleep symptoms, and sleep apnea following weight loss surgery. Despite these findings surgery is rarely advised and has never been formally tested as a therapy for sleep apnea. We propose to formally test, for the first time, the effectiveness of weight loss surgery, as an addition to best conventional therapy, in those individuals with the combination of problems; obesity and significant sleep apnea. We propose that significant weight loss, following surgery, may indeed be the best therapy for those with these combined problems, and that weight loss may have additional benefits for other common problems related to obesity, including high blood pressure, poor body image and impaired quality of life. Forty appropriate patients who suffer these combined problems will be randomly allocated to either conventional therapy for their sleep apnea and weight problems or to a similar program that includes placement of a Lap-Band, a minimially invasive form of obesity surgery. We will follow the patients for 2-years and serially measure a broad range of health and quality of life outcomes and compare the effects of each program. This study will help us assess the role of obesity surgery in this group of patients with major health problems.Read moreRead less