The Chairman of the Clifford Craig Medical Research Trust, Associate Professor Don McTaggart, today announced the successful recipients of medical research grants for 2012.
Nine new projects will be funded by the Trust in 2012 with the grants totaling $250,000. Associate Professor McTaggart said the combination of the newly announced grants with the existing research program will see the Trust provide in excess of $350,000 for medical research in Northern Tasmania next year.
“This announcement today sees the Clifford Craig Medical Research Trust building upon our reputation for facilitating an important clinical medical research program across Northern Tasmania which supports our local hospital, clinical school and university researchers”, he said.
Associate Professor McTaggart acknowledged and thanked the Trust’s supporters and donors for their contribution towards funding the latest round of research.
The projects to receive funding in 2012 are:
• A pilot study to determine the prevalence of thyroid disease, and its association with iron deficiency among Tasmanian pregnant women
Associate Professor Alhossein Khalafallah – $80,000
The aim of study is to determine the actual incidence of thyroid disease within the northern Tasmanian obstetric population and its possible association with iron deficiency. This may help clinicians to early screen and diagnose thyroid disease in pregnancy and hence offer the appropriate treatment. Furthermore, it is very important to diagnose early cases with thyroid deficiency in order to avoid any complications for the mother or the baby. There is currently no data regarding the incidence of thyroid disease among the northern Tasmanian antenatal population. The current targeted screening based on clinical examination and history is insufficient to identify the real incidence of thyroid disease in pregnancy. Predictors for thyroid deficiency are usually iodine deficiency and autoimmune disease as well as iron deficiency anaemia, which is prevalent in up to 25% of Tasmanian pregnant women. This project, which will target 500 pregnant women, is a conjoint study between the Launceston General Hospital and the School of Human Life Sciences, University of Tasmania.
• Melanoma early detection in a population at high risk of melanoma – The Mole Patrol Study
Dr Philip Clarke – $6,350
A huge number of skin cancers are removed from Australians each year. Well over 300,000 skin cancers are removed and this is far in excess of the total number of all other cancers combined (about 100,000). In comparison, the next most common cancers are prostate (16,000 each year) and breast (12,000 each year). A relatively small proportion of the population is responsible for the vast bulk of skin cancers. This study will enable very accurate identification and quantification of risk factors for melanoma. High risk people in the general Tasmanian population may then be identified and offered screening so that a potentially deadly cancer can be diagnosed at an early and curable stage. The aim of the study will also help to determine the feasibility of whole of population screening for melanoma, which would be a world first.
• Lung Infection Post Surgery (Major Abdominal): Pre-Operative Physiotherapy
Ms Ianthe Boden – Cardio respiratory Specialist Physiotherapist – $61,201
Chest infections can occur in as many as 1 out of every 2 patients after they have had major bowel, stomach, liver or kidney surgery. This is serious and costly. Chest infections dramatically increase the risk of death following surgery, and the average length of time spent in hospital is doubled. Studies have shown that getting up, and out of bed, and walking as early as possible after surgery with a Physiotherapist reduces this chance of getting a chest infection down to as low as 1 in 20. Unfortunately, these studies have also included time spent with a Physiotherapist before the operation on learning how to do breathing exercises and how to get going again soon after the operation. So, it is really hard to say for certain if this significant reduction in chest infections is down, not just to the amount of walking a patient does after the operation, but also to the level of education they received before the operation. No clinical trial to this point has specifically looked at how effective this type of pre-operative education is, in its own right, in reducing the risk of a chest infection after an operation.
The LIPSMAck trial will provide education and training from a Physiotherapist to half of the patients about to undergo major abdominal surgery. The other half will get just get a pamphlet covering the same sort of information. All patients will get a thorough and standardised early walking program following their surgery. The trial will compare these two groups and see if there is any difference in rates of chest infections and how long they stay in hospital. The result of this trial will assist in determining the wisest and most cost effective way to allocate Physiotherapy services to people having a major abdominal operation and assist them in recovering from their operation as quickly as possible.
• Knowledge and Perceptions of Genetic Cardiac Diseases
Dr Kathryn Ogden and Ms Jessica Kawa BMedSc(Hons) – $2,735
Genetic heart conditions are common in our community; however, not all patients fully understand what their condition means and what impact it can have on their family. This project is designed to investigate the knowledge possessed by final year medical students and medical professionals about genetic cardiac conditions and how these conditions are perceived, plus the perception by patients and their knowledge about the condition. The study will survey Tasmanian medical students, medical professionals (both GPs and cardiologists), and patients with genetic heart conditions who are enrolled on the Tasmanian Branch of the National Genetic Heart Disease Registry to ascertain their knowledge about genetic heart conditions and where they would turn to further information, and what services are available for support. In addition, it is proposed to also personally interview patients with genetic heart conditions to further understand what importance they place on being educated about their condition, whether they have shared this knowledge with their families. We hope that the project may give an indication if and where patient education and quality of care may need to be improved, and to provide evidence of what other skills we may need to equip our future doctors with to maintain high quality of care standards when dealing with these patients.
• Resistance to macrolide and fluoroquinolone antibiotics in Haemophilus influenzae.
Dr Stephen Tristram – $8,000
Antibiotic resistance is increasing worldwide and the issue has recently received significant attention by the global and national healthcare establishment. In February, Australia’s peak microbiology and infectious disease bodies held a national antibiotic resistance summit in Sydney, with a goal of establishing recommendations on combating antibiotic resistance, to present to the Government. One of the recommendations was for continual surveillance studies to monitor the emergence of new types of antibiotic resistance. Furthermore, in April, for World Health Day 2011, the World Health Organization (WHO) launched a worldwide campaign on antimicrobial resistance and its global spread, in an effort to safeguard antibiotics for future generations. The most common presenting illnesses for which doctors prescribe antibiotics in Australia are respiratory tract infections, and significant resistance to antibiotics traditionally used in these situations has led to increasing use of newer alternative antibiotics. It is important to establish the current levels of resistance to these new antibiotics so that surveillance studies can be undertaken to monitor for increasing resistance that might compromise treatment and negatively impact on patients.
• Etiologic role of Human papilloma virus (HPV) infection in Barrett’s oesophagus and its implication in oesophageal adenocarcinoma
Professor Shan Rajendra – $23,000
Human papilloma virus (HPV) infections contribute to nearly 50% of virus-induced/associated cancers. Our preliminary landmark study to be published later this year has provided the first evidence of the presence of HPV infection in the squamo-columnar junction of the oesophagus. This transformation zone is known to be particularly susceptible to carcinogenic progression. In the proposed study, critical factors in the understanding of HPV oncogenesis including viral distribution and integration, local viral load, mechanisms of HPV oncogene transcription will be analysed in detail. This study, by genotyping the viruses involved and visualizing the viral DNA using in situ hybridization, and most importantly by using the state of the art techniques of laser capture microdissection and whole genome microarray analysis, will provide better understanding of the etiologic role of HPV infection in Barrett’s oesophagus and dissect the mechanisms involved in oesophageal malignancies. It will have a great impact on public health as identification of high-risk individuals and development of effective preventive strategies become possible.
• Significance of Small Bowel Lipid Deposits Seen On Capsule Endoscopy
Dr John Wettenhall – $2,866
The proposed project aims to determine whether there is an association between the incidental finding of fatty deposits (xanthoma) in the small bowel on capsule endoscopy and abnormal lipid levels or diabetes. Capsule endoscopy is a procedure performed to investigate patients with bowel complaints with suspected disease of the small bowel. This procedure involves the patient swallowing a small camera encased in a capsule only a little larger than a large capsular medication. Films are taken as the capsule passes through the small bowel and the films are then read by a gastroenterologist who is able to determine relevant pathology. This is a relatively new diagnostic procedure. It has been noted by the principle investigator, Dr Wettenhall, that a significant proportion of patients undergoing this procedure have fatty deposits in their small bowel, almost always irrelevant to the clinical indication for having the procedure, i.e. they are an incidental finding. Similar fatty deposits, or xanthoma, can be seen in and under the skin and in tendons, and have long been recognised to be associated with increased lipid (cholesterol or triglyceride) levels and diabetes. As a new procedure, there is currently no evidence for whether small bowel xanthomas are also associated with these conditions. This project aims to determine whether such an association exists and will assist those doctors reading and interpreting capsule endoscopies to provide the referring doctor/GP with appropriate recommendations in patients for whom this incidental finding is made.
• Effect of sodium versus potassium salt in meals on central blood pressure and vascular function
Dr Kiran Ahuja – $21,417
Tasmania is the national capital for hypertension (high blood pressure) and related cardiovascular diseases (CVD). Research suggests a reduction of just 2.5% in blood pressure would reduce cardiac events and stroke events by more than 4 and 9%, respectively. One strategy known to reduce blood pressure is the adoption of a low sodium-salt diet. However, public health messages promoting the benefits of a low salt diet have had limited success and the salt intake for most Australians is still much higher than recommended. One barrier to the acceptance of a low salt diet is that many people are accustomed to the flavour of salty foods. Recently, it has been suggested that using a potassium-based “salt substitute” could result in reductions in blood pressure and still provide a salty flavour. Blood pressure has traditionally been measured on the upper arm using a blood pressure cuff; however blood pressure near the heart known as “central blood pressure” is a better predictor of cardiac and stroke events. Recent technological advances have seen the development of a non-invasive technique, known as pulse wave analysis, to measure central blood pressure and vascular function. The aim of this proposed study is to use this non-invasive technique to compare the effects of sodium and potassium salt intake on central blood pressure and blood vessel function. If improvements in blood pressure and possibly also in blood vessel function are observed, as anticipated, as a result of the substitution of potassium for sodium salt, it may lead to a new strategy for helping to lower salt intakes while maintaining the familiar salt flavour in foods, thereby aiding the fight to control hypertension and prevent the onset of CVD.
• The Tasmanian Gynaecological and Anal Neoplasia Study – Northern Tasmania
Professor Richard Turner and A/Prof Amanda Dennis – $37,038
Cancer of the anus is a relatively rare cancer occurring more commonly in women than in men. Whilst the patterns of occurrence have been studied extensively in men who have sex with men and HIV populations, there have been few studies in women who are HIV negative. It is known however that women who have been treated for high grade pre-cancerous lesions of the cervix and vulva have a higher chance of anal cancer and pre-cancerous changes in the anal canal. Primarily, this study seeks to establish the prevalence of precancer of the anal canal in Tasmanian women who have recently been treated for high grade precancer or invasive cancers of the cervix or vulva that may have been caused by Human papilloma wart virus (HPV). Secondarily, the study will investigate other factors (demography, family history, medical history, environmental exposures, sexual history etc.) influencing the development of anal precancerous changes.
Tasmania's Clifford Craig Medical Research Trust was established in 1991.