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
Cluster Randomised Trial Comparing One Versus Two Doses Of Ivermectin For Mass Drug Administration To Control Scabies
Funder
National Health and Medical Research Council
Funding Amount
$540,512.00
Summary
Scabies is a common skin disease in developing countries, in particular in the Pacific region. In the Western Province of Solomon Islands, one in two children suffer from the infestation, and 20% of the population. We know that mass drug administration with two doses of oral ivermectin is effective to reduce the burden of scabies in the community. We now propose a study to determine whether one single dose is as effective. This would have major public health benefits.
Does Mass Drug Administration For Scabies Result In Control Of Serious Bacterial Complications? A Proof Of Concept Towards Global Elimination.
Funder
National Health and Medical Research Council
Funding Amount
$883,760.00
Summary
Scabies is common skin disease in developing countries, in particular in the Pacific region. In Fiji, one in two children suffer from the infestation, which affects over 20% of the population. A recent study conducted in Fiji on 2000 people showed that mass drug administration (MDA) with oral ivermectin is a safe and effective way to reduce the burden of scabies in the community. We will expand the MDA program to 100,000 people, the largest study of MDA ivermectin for scabies ever undertaken.
Studies On The Effects Of Endogenous And Exogenous Opioids In Modulating Exercise-induced Dyspnoea In People With Moderate / Severe Chronic Obstructive Pulmonary Disease (COPD). Two Double-blind Randomised, Placebo Controlled Trials.
Funder
National Health and Medical Research Council
Funding Amount
$197,086.00
Summary
There is evidence that morphine-like chemicals made by the body itself help reduce breathlessness. It is not clear whether this response is because of the effects of these morphine-like chemicals on the brain, in the lung or both. This study will help understand where these chemicals act to reduce breathlessness in people with emphysema during exercise. Subsequently, it will also help to understand whether small, regular doses of morphine safely further reduce breathlessness during exercise.
Anti-sporulation Strategies For Clostridium Difficile Infections
Funder
National Health and Medical Research Council
Funding Amount
$651,559.00
Summary
Hospital-acquired infections with the bacterium Clostridium difficile are a major global public health concern with highly virulent isolates emerging overseas in 2002 and in Australia in 2010. These strains have spread through our hospitals and are also found in the community. This project will increase our understanding of how these strains spread and will provide knowledge that is critical for developing improved strategies for preventing these infections.
An Integrated Health-sector Strategy To Combat COPD And Asthma In Vietnam: A Pragmatic Stepped Intervention Cluster Randomized Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,894,349.00
Summary
Chronic lung diseases are a major challenge for resource limited settings. In Vietnam, where smoking rates in males are around 50%, there is an urgent need for better strategies to prevent and treat chronic obstructive pulmonary disease (COPD) and asthma. We will perform a study of a low-cost integrated intervention including a health-system based smoking cessation program and the targeted use of proven therapy for COPD and asthma - inhaled corticosteroids - to reduce the burden of lung disease.
Translating Respiratory And Environmental Epidemiology Into Improved Lung Health
Funder
National Health and Medical Research Council
Funding Amount
$319,714.00
Summary
Chronic respiratory disease, tuberculosis and the effects of air pollution are important health problems globally. Evaluating current approaches to dealing with these problems and developing new approaches requires good data. Over the next five years I will lead a number of studies addressing these issues, in Australia and internationally, in order to provided the strongest possible evidence to underpin policy.
FUNCTIONAL IMAGING OF THE BRAINSTEM AND CORTICAL SITES OF BLOOD PRESSURE CONTROL IN HUMAN SUBJECTS IN HEALTH AND DISEASE
Funder
National Health and Medical Research Council
Funding Amount
$398,498.00
Summary
Disturbances in cardiovascular control underpin many diseases yet little is known about how the brain controls the heart and blood vessels. This project uses brain imaging (fMRI) and concurrent nerve recording in awake human subjects to increase our understanding of how normal blood pressure is maintained and how different disease states influence this control.
A Randomised Placebo-controlled Trial Of Antibiotics To Prevent Urinary Tract Infection In Children
Funder
National Health and Medical Research Council
Funding Amount
$735,000.00
Summary
This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this ....This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this means the identification of children thought to be most at risk of recurrent UTI by renal tract imaging. Those found to have reflux of urine from the bladder to the kidney (present in about 30% of those with UTI) are then placed on antibiotics fro 2-5 years. Unfortunately there has never been a properly designed trial to test whether antibiotics do really prevent UTI and if so, whether children with reflux are the appropriate and only group requiring treatment. Long term antibiotics may in fact do more harm than good because of side effects like skin, bowel and blood problems and because resistant bacteria may develop. The design of this study involves the random allocation of placebo or antibiotic (cotrimoxazole, the usual antibiotic given in this case) to about 800 children after their first symptomatic UTI. These children are treated and followed for one year to determine the rate of futher UTI in both groups. Any difference in outcome between the two groups of children will be because of the antibiotic treatment. This study may prove long-term antibiotics are ineffective and therefore should not be routinely used. In this case investigation of children to detect vesicoureteric reflux would serve little purpose and should be abandoned. Alternatively antibiotic treatment may be shown as effective treatment for preventing further UTI and in this case the study will clearly identify those children who will benefit.Read moreRead less
Population-level Epidemiological Trends In Hepatocellular Carcinoma In Queensland 1996 - 2010.
Funder
National Health and Medical Research Council
Funding Amount
$251,695.00
Summary
Incidence and mortality of hepatocellular carcinoma (HCC, the most common form of liver cancer) is increasing in Australia, driven by viral hepatitis infections. Disease burden is not defined in Queensland, particularly for Indigenous, migrant and regional and remote communities. Such factors may influence risk of viral hepatitis, access to treatment, and incidence and survival of HCC. Defining disease burdens will enable clinical programs targeted at groups most at risk in order to impact HCC t ....Incidence and mortality of hepatocellular carcinoma (HCC, the most common form of liver cancer) is increasing in Australia, driven by viral hepatitis infections. Disease burden is not defined in Queensland, particularly for Indigenous, migrant and regional and remote communities. Such factors may influence risk of viral hepatitis, access to treatment, and incidence and survival of HCC. Defining disease burdens will enable clinical programs targeted at groups most at risk in order to impact HCC trends.Read moreRead less