Non-invasive Electrical Nerve Stimulation To Improve Healing Of Chronic Venous Leg Ulcers
Funder
National Health and Medical Research Council
Funding Amount
$206,210.00
Summary
Chronic venous leg ulcers are common in the elderly. They often last for many months or years, causing much suffering and expense (currently around $600,000,000 per year in Australia). As more and more Australians live into advanced age, more and more people will be troubled by leg ulcers, particularly as the likelihood of having a leg ulcer increases markedly in the very old. We have developed a painless, cheap treatment that improves wound healing. The treatment consists of electrical stimulat ....Chronic venous leg ulcers are common in the elderly. They often last for many months or years, causing much suffering and expense (currently around $600,000,000 per year in Australia). As more and more Australians live into advanced age, more and more people will be troubled by leg ulcers, particularly as the likelihood of having a leg ulcer increases markedly in the very old. We have developed a painless, cheap treatment that improves wound healing. The treatment consists of electrical stimulation of nerves that supply the wound. Low frequency current is passed through the skin from small battery powered stimulators. We have tested this technique in laboratory animals and in just a few older people with diabetes and have shown it is remarkably effective. We now plan to test this technique properly in a large study in older adults. If successful, the electrical stimulation could result in healing of wounds in relatively few weeks that otherwise would not heal for many months. Much suffering and expense would be avoided. As people age, nerve function deteriotes. Another part of the project will explore whether electrical nerve stimulation can improve damaged nerves themselves. This will provide interesting scientific insight about nerve repair and could lead to treatments for peripheral neuropathy that occurs in diabetes and other medical conditions. Australia needs to act on this now because the number of people aged over 65 will increase from around 2.3 million at present to over 6 million in the next half century. The increase in those over 85 will be even more marked with numbers increasing four fold to over one million people. Many of these people will experience severe impairment of their quality of life from leg ulcers that could be avoided, or at least minimized if a successful treatment is developed and made available to them. Similarly, much unnecessary expense could be avoided.Read moreRead less
Identifying The Relationship Between Biochemical Markers And Healing In Chronic Leg Ulcers Treated With Compression
Funder
National Health and Medical Research Council
Funding Amount
$374,159.00
Summary
Chronic leg ulcers are a significant cause of pain, immobility and decreased quality of life for 1 - 3% of the over 60 years age group. The condition is difficult to heal and commonly becomes a long term problem, costing the Australian health care system over $500 million - year. Additional costs to the community include loss of productivity and social support systems necessary for people with limited mobility. As the number of people aged over 65 years is expected to double in the next few deca ....Chronic leg ulcers are a significant cause of pain, immobility and decreased quality of life for 1 - 3% of the over 60 years age group. The condition is difficult to heal and commonly becomes a long term problem, costing the Australian health care system over $500 million - year. Additional costs to the community include loss of productivity and social support systems necessary for people with limited mobility. As the number of people aged over 65 years is expected to double in the next few decades, this problem will become increasingly significant. Most chronic leg ulcers are caused by venous disease, and compression bandage therapy is the accepted standard treatment. However, there is little information available on the cellular responses associated with compression treatment and how they promote wound healing. The project proposed here will examine the cellular responses to compression and investigate the relationships between these cellular responses and wound healing. Knowledge gained from the study will provide valuable information for improved techniques to promote wound healing, improved ulcer healing rates, informed decisions on wound care treatment, improved qualtiy of life and reduced health care costs.Read moreRead less
Evaluation A Novel Vitronectin:growth Factor Complex For Treatment Of Chronic Venous Leg Ulcers
Funder
National Health and Medical Research Council
Funding Amount
$854,975.00
Summary
Chronic leg ulcers in the elderly are an important problem, diminshing quality of life and costing at least A$1 billion per year. New treatments are urgently required. This study will test a new topical growth factor therapy designed to have greatly improved activity in wounds.The project is a collaboration between scientists and doctors at the Queensland Univeristy of Technology and the University of Western Australia. Many wound types may ultimately benefit from this treatment.
Improving Efficacy Of Vaccination Against The Gut Pathogen Helicobacter Pylori
Funder
National Health and Medical Research Council
Funding Amount
$504,000.00
Summary
Helicobacter pylori are bacteria which live in the stomachs of half the World's population, where they are the main cause of two types of stomach cancers, as well as stomach and duodenal ulcers. The development of a vaccine against this organism would have a major impact on these diseases. Unfortunately, while there has been some success in animal models, the results from clinical trials have so far been disappointing. A key issue with vaccines against H. pylori is their poor efficacy, i.e. alth ....Helicobacter pylori are bacteria which live in the stomachs of half the World's population, where they are the main cause of two types of stomach cancers, as well as stomach and duodenal ulcers. The development of a vaccine against this organism would have a major impact on these diseases. Unfortunately, while there has been some success in animal models, the results from clinical trials have so far been disappointing. A key issue with vaccines against H. pylori is their poor efficacy, i.e. although they produce a significant reduction in bacteria numbers in animal models, they do not clear all of the bacteria. The remaining bacteria are sufficient to continue to cause disease. It is currently not understood how these vaccines work in mice, which makes it very difficult to improve their design. An additional problem common to all human vaccines, is the lack of a suitable adjuvant. An adjuvant is a non-specific vaccine component which is required to activate the immune system. Thus, for an effective vaccine it is essential to identify suitable adjuvants which will work against H. pylori and can be used in people. The chief investigator on this project has been working in the H. pylori vaccine field, in both academia and industry, for 8 years. He very recently identified an immunisation regime which greatly increases the effectiveness of vaccination against H. pylori in an animal model. The main aim of this project is to further develop this novel discovery to identify key immune factors that are critical to making an improved vaccine. In addition, the two associate investigators are experts in the area of adjuvants for human vaccines, and will help to test new vaccine systems in the H. pylori model. If successful, this project will generate highly significant data that will strongly contribute towards the design of an improved vaccine strategy against H. pylori in people.Read moreRead less
PREVENTION OF HOSPITAL ACQUIRED PRESSURE ULCERS: A RANDOMISED CONTROLLED TRIAL.
Funder
National Health and Medical Research Council
Funding Amount
$195,652.00
Summary
Pressure ulcers are frequently encountered in hospitalised patients. Several factors such as immobility, poor circulation, malnutrition and aging skin and tissue, along with pressure, moisture and friction (shear) from hospital bedding, contribute to their development. Pressure ulcers usually occur over bony prominences. Here, internal tissue pressures are most intense where the skin contacts the supporting surface. The principles for efficient prevention of pressure ulcers are to reduce pressur ....Pressure ulcers are frequently encountered in hospitalised patients. Several factors such as immobility, poor circulation, malnutrition and aging skin and tissue, along with pressure, moisture and friction (shear) from hospital bedding, contribute to their development. Pressure ulcers usually occur over bony prominences. Here, internal tissue pressures are most intense where the skin contacts the supporting surface. The principles for efficient prevention of pressure ulcers are to reduce pressure on the classic ulcer sites, interrupt the pressure frequently, keep the stressed area dry, and provide a low friction cushioning interface between the patient and bed. Sheepskins have been claimed to be of value in the prevention of pressure ulcers. The therapeutic value is believed to be due to the pressure relieving properties of the dense woolpile, the moisture absorbing properties of the wool and the low friction at the wool-tip surface. The CSIRO Leather Research Centre has facilitated the development of an Australian Standard for Medical Sheepskins. In his address at the launch of this Standard (July 1997), Dr Michael Wooldridge, Federal Minister for Health, stated that pressure ulcers would cost the Australian health system over $350M in that year. To unequivocally establish the efficacy of sheepskins in preventing the onset of pressure ulcers, and to meet the present requirements for evidence based medicine, a rigorous Randomised Controlled Trial is essential. CSIRO, in conjunction with the Royal Melbourne Hospital, The University of Melbourne School of Postgraduate Nursing, Deakin University and Fremantle Hospital, plan to undertake a study into the prevention of hospital acquired pressure ulcers comparing the efficacy of two mattress covers: sheepskin overlays and the standard hospital sheet and mattress with or without other low technological constant pressure supports.Read moreRead less
Susceptibility To Venous Leg Ulceration: Investigation Of The First Genetic Risk Factor
Funder
National Health and Medical Research Council
Funding Amount
$291,000.00
Summary
This application aims to confirm our preliminary identification of the first candidate gene as a risk factor for developing venous leg ulceration. Since patients with venous leg ulcers experience pain and psychological consequences including anger and depression, all of which impact negatively on quality of life, active prevention of ulceration will have significant lifestyle and financial benefits. Venous leg ulcers occur in patients who have venous disease, in particular in patients with previ ....This application aims to confirm our preliminary identification of the first candidate gene as a risk factor for developing venous leg ulceration. Since patients with venous leg ulcers experience pain and psychological consequences including anger and depression, all of which impact negatively on quality of life, active prevention of ulceration will have significant lifestyle and financial benefits. Venous leg ulcers occur in patients who have venous disease, in particular in patients with previous deep vein thrombosis. However, not all patients with a deep vein thrombosis or other forms of venous disease will go on to develop a venous ulcer. Our preliminary results show that patients with a venous ulcer have a greater frequency of this gene than healthy controls without venous ulcers, and suggest that patients with the candidate gene have a greater risk of developing venous ulceration. In this study we aim to determine whether the gene itself contributes to ulcer susceptibility or whether it is just a marker of that susceptibility. We can do this by assessing related genes and the levels of the protein produced by this gene. In this study we also aim to assess whether patients with a proven deep vein thrombosis are more likely to develop venous ulceration if they have the candidate gene. These studies have the potential to lead to the development of a diagnostic screening test for use in patients with venous disease, to assess the likelihood of developing leg ulceration. This will enable more active treatment to prevent leg ulceration. If this gene contributes to ulcer susceptibility new specific treatments may be developed for ulcer management and prevention.Read moreRead less
Structural And Functional Studies On The Interaction Between Alpha2-Antiplasmin And Plasmin
Funder
National Health and Medical Research Council
Funding Amount
$280,400.00
Summary
Fibrinolysis is the process by which the body dissolves clots. In this proposal we aim to investigate how the fibrinolysis inhibitor alpha2-antiplasmin interacts with the clot dissolving protease enzyme plasmin. These data will be useful for developing new approaches to accelerate plasmin-mediated clot breakdown.