Foetal Determinants Of Sleep Disordered Breathing In Infants
Funder
National Health and Medical Research Council
Funding Amount
$174,691.00
Summary
Obstructive sleep apnea (OSA) has been identified and recorded in infants, however the factors that lead to the development of OSA and its prevalence in infants is unknown. We have recorded OSA in some infants and we demonstrated that the severity of apnea was at its peak at approximately 2 months of age and then resolved by 1 year. We hypothesised that these infants possibly had a maturational delay of breathing control during sleep. This project is designed to examine the development and preva ....Obstructive sleep apnea (OSA) has been identified and recorded in infants, however the factors that lead to the development of OSA and its prevalence in infants is unknown. We have recorded OSA in some infants and we demonstrated that the severity of apnea was at its peak at approximately 2 months of age and then resolved by 1 year. We hypothesised that these infants possibly had a maturational delay of breathing control during sleep. This project is designed to examine the development and prevalence of sleep and breathing disorders in infants. The prenatal factors that possibly influence development of sleep and breathing disorders in infants, in particular, the effects of maternal smoking will be determined. Pregnant women will be recruited for the study during their third trimester. The foetal movements, foetal breathing movements, heart rate and sleep state will be monitored continuously overnight in the patients home between 32 and 36 weeks gestation using a newly developed foetal movement monitor. The infants will be subsequently studied using overnight polysomnography at 2 months of age to assess their breathing, sleep patterns, arousal behaviour, and the presence and severity of central and obstructive apnea. A group from these infants will be selected and studied longitudinally to examine the development of sleep and breathing disorders more closely. These infants will undergo overnight sleep studies during the first week of life, then at 2 and 6 months of age. A detailed medical history will also be collected regarding the pregnancy, the perinatal history of the infant, exposure to cigarette smoke during pregnancy and postnatally, and the medical history of other family members. We will examine the quality and quantity of foetal movements and its association with the development of OSA. The occurrence of sleep and breathing disorders in the infants will be correlated with the foetal behaviour and, the prenatal and postnatal factors.Read moreRead less
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
Promoting Activity For Frail Aged In Post-acute Hospital Settings: A Randomised Controlled Trial Of Accelerometry
Funder
National Health and Medical Research Council
Funding Amount
$542,119.00
Summary
Keeping older people in hospital actively mobile is a vital objective of high quality aged care. Using accelerometers, the Centre for Research in Geriatric Medicine at the University of Queensland, and its partner, the CSIRO e-health Research Centre, are trialing a method of promoting activity in older rehabilitation patients. Potentially, a system of _activity management� could solve an age old problem in hospital care of older people.
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
DEVELOPMENT OF CLINICALLY APPLICABLE STRATEGIES TO INDUCE AND MONITOR LONG TERM ACCEPTANCE OF LIVER ALLOGRAFTS
Funder
National Health and Medical Research Council
Funding Amount
$287,036.00
Summary
Liver transplantation is the only therapy for end-stage liver disease and thousands of Australian lives have been saved with this treatment. The major complication of liver transplantation is rejection which leads to loss of about half of the transplanted livers by ten years. Liver transplants in many animal models are not rejected and function normally for the life of the animal. Using one such animal model we have shown that white cells from the donor are responsible for the absence of rejecti ....Liver transplantation is the only therapy for end-stage liver disease and thousands of Australian lives have been saved with this treatment. The major complication of liver transplantation is rejection which leads to loss of about half of the transplanted livers by ten years. Liver transplants in many animal models are not rejected and function normally for the life of the animal. Using one such animal model we have shown that white cells from the donor are responsible for the absence of rejection. Of interest, these cells appear to stimulate a rapid and extreme immune response, which closely resembles rejection. The main difference is that it is quicker and more marked than rejection and then exhausts itself. This observation is unexpected and suggests possibilities for new treatments. Furthermore it questions the effectiveness of our present treatment for rejection of transplanted livers. We have already shown that some kinds of drugs given to prevent rejection in humans actually have the opposite effect in the animal model and prevent long-term acceptance of liver transplants. The aim of this work is to develop in our animal model a better way of treating human liver transplant patients. This will incorporate injection of donor white cells and treatment with drugs which promote the beneficial effects of these cells. We will also develop ways of testing the blood or the liver of the human liver transplant patients early after transplantation to find out whether the patient is accepting the liver or not. This means that we should be able to try this new treatment method in liver transplant patients once it has been optimised in the animal model.Read moreRead less
Clinical Impact Of Clonal Pseudomonas Aeruginosa In Cystic Fibrosis
Funder
National Health and Medical Research Council
Funding Amount
$547,238.00
Summary
In patients with cystic fibrosis (CF), the normal defence mechanisms are compromised by an inherent genetic fault which results in an extremely sticky and dehydrated mucus. The respiratory system is unable to eradicate microbes (infection) from the lungs of patients with CF which begin to multiply and cause infection and inflammation. Recurring infections are treated with multiple courses of antibiotics and frequent hospitalisation and eventually result in premature death. This study focuses on ....In patients with cystic fibrosis (CF), the normal defence mechanisms are compromised by an inherent genetic fault which results in an extremely sticky and dehydrated mucus. The respiratory system is unable to eradicate microbes (infection) from the lungs of patients with CF which begin to multiply and cause infection and inflammation. Recurring infections are treated with multiple courses of antibiotics and frequent hospitalisation and eventually result in premature death. This study focuses on the major bacterial problem, Pseudomonas aeruginosa. Several studies from Australia and the UK, including our own have shown that about 30% to 45% of patients share the same strain of Pseudomonas aeruginosa within a centre. We know that two dominant strains of Pseudomonas aeruginosa are found in CF centres on the eastern board of Australia. This is unexpected as this bacterium is usually acquired from the environment. The emergence of these clonal strains is causing increasing anxiety in the CF community. This study is designed to provide vitally needed information on the clinical implications of being infected by an clonal strain of Pseudomonas aeruginosa and the risk factors for the acquisition of an clonal strain. This new information will provide a rationale basis for the need for changes to infection control policies (including patient segregation), better outcome predictors for patients infected with clonal strain of Pseudomonas aeruginosa.Read moreRead less
MINIMAL RESIDUAL DISEASE IN ACUTE LYMPHOBLASTIC LEUKAEMIA
Funder
National Health and Medical Research Council
Funding Amount
$455,204.00
Summary
This project will study the extremely small numbers of leukaemic cells which are found in patients who are apparently healthy, but which sometimes lead to relapse. Very sensitive methods for measuring and studying low levels of leukaemic cells will be developed and used. To develop new better treatments in the long term, we will study why current treatment sometimes fails to eradicate the leukaemia, leading to patients relapsing. Clinicians currently need to obtain samples of bone marrow to asse ....This project will study the extremely small numbers of leukaemic cells which are found in patients who are apparently healthy, but which sometimes lead to relapse. Very sensitive methods for measuring and studying low levels of leukaemic cells will be developed and used. To develop new better treatments in the long term, we will study why current treatment sometimes fails to eradicate the leukaemia, leading to patients relapsing. Clinicians currently need to obtain samples of bone marrow to assess leukaemia, and the research will show whether this needs to be continued, or whether, with sensitive tests, samples of blood can be used instead. The study will involve collaboration with clinicians throughout Australia and overseas.Read moreRead less