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
A Trial Of Position Control Therapy For Treatment Of Infantile Gastro-oesophageal Reflux
Funder
National Health and Medical Research Council
Funding Amount
$533,290.00
Summary
Reflux of stomach contents into the gullet and mouth is a very common condition which interrupts feeding and sleep routine in infants. If reflux is not treated, more severe problems may manifest and patients may require anti-reflux surgery. Left-side positioning after feeding is the only non-drug approach proven to reduce the frequency of reflux in infants. This project will determine, by clinical trial, the role for left side positioning for reducing reflux related symptoms in infants.
Impact Of Oesophageal Afferent Processing On Regulatory And Protective Reflexes, And Perception Of Symptoms
Funder
National Health and Medical Research Council
Funding Amount
$247,500.00
Summary
Symptoms of acid reflux, heartburn and regurgitation, are extremely common, occurring weekly in 20% of the population. Curiously, about 1-4 of people with heartburn don't have any more acid exposing their oesophagus than do normal people. We do not understand this apparent increased sensitivity. Many patients with reflux present with cough, asthma, hoarseness, sore throat or even lung fibrosis. Regurgitation of acid causes some of these conditions. It is estimated that 60% of adult asthmatics ha ....Symptoms of acid reflux, heartburn and regurgitation, are extremely common, occurring weekly in 20% of the population. Curiously, about 1-4 of people with heartburn don't have any more acid exposing their oesophagus than do normal people. We do not understand this apparent increased sensitivity. Many patients with reflux present with cough, asthma, hoarseness, sore throat or even lung fibrosis. Regurgitation of acid causes some of these conditions. It is estimated that 60% of adult asthmatics have reflux for example. The purpose of this research is to examine the notion that the sensory nerves coming from the oesophagus are somehow tuned up to fire off too readily. If true this phenomenon may well underlie the inappropriate relaxation of the oesophageal valve mechanisms that normally prevent acid flowing up into the throat and into the airways. Additionally it may explain why so many sufferers seem to be hypersensitive to even small amounts of acid. These studies will better define the nerve pathways involved in heartburn and regurgitation and help us target these diseases with specific drugs in the future.Read moreRead less
Risk Factors For Gastro-oesophageal Reflux Disease And Barretts Oesophagus In A Prospective Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$960,867.00
Summary
Heartburn caused by acid reflux is a common problem in Australia. In 2003, drugs used to treat disorders caused by acid problems, such as heartburn, cost the PBS more than $500 million. Heartburn probably causes a disease of the oesophagus called Barrett's oesophagus, which in turn is a cause of cancer of the oesophagus. The aim of this study is to identify risk factors for heartburn and Barrett's oesophagus, so that we can find ways to prevent them occurring.
Targeting Epigenetic Pathways That Lead To Diabetic Complications
Funder
National Health and Medical Research Council
Funding Amount
$989,948.00
Summary
Glucose remains the major cause of complications in diabetes with prior episodes of high glucose having long lasting effects on blood vessels leading to heart attacks, kidney disease and blindness. We have identified an enzyme Set7 which plays a key role in promoting glucose induced injury. By validating this target using drug and molecular approaches we will strengthen the rationale to develop potent inhibitors of this enzyme in order to reduce the major burden of diabetes, its complications.
Neuromodulation Of Triggering Of Transient Lower Oesophageal Sphincter Relaxation And Gastro-oesophageal Reflux
Funder
National Health and Medical Research Council
Funding Amount
$369,779.00
Summary
Reflux of stomach contents into the gullet is a very common condition. If reflux is not treated, more severe problems may manifest. In patients with reflux disease the anatomy of the junction between the gullet and the stomach is altered. This research program will undertake novel studies to explore how this alteration exacerbates the triggering reflux after a meal and potentially identify new targets for pharmacological therapy for this common problem.
Role Of The Podocyte In Diabetic Nephropathy: Structural, Functional, Molecular And Interventional Studies
Funder
National Health and Medical Research Council
Funding Amount
$227,036.00
Summary
Kidney disease is a major cause of disability and premature death in the Australian population. In disease the kidney's ability to filter out impurities and toxins in blood is impaired as a consequence of excessive cell growth and scar tissue formation. Studies from our group indicate that a highly specialised cell within the kidney's filtering apparatus becomes altered early in the course of diabetes. In the setting of diabetes, this cell, called the podocyte, stretches and begins forming scar ....Kidney disease is a major cause of disability and premature death in the Australian population. In disease the kidney's ability to filter out impurities and toxins in blood is impaired as a consequence of excessive cell growth and scar tissue formation. Studies from our group indicate that a highly specialised cell within the kidney's filtering apparatus becomes altered early in the course of diabetes. In the setting of diabetes, this cell, called the podocyte, stretches and begins forming scar tissue. In addition, it no longer maintains its barrier function and starts to leak protein. The proposed studies will explore the mechanisms that lead to these diabetes-induced changes in the podocyte. In addition, strategies for reversing these changes will also be explored in detail with the aim of providing new treatments for diabetic kidney disease.Read moreRead less