Research highlight: The Australia-India Trauma Systems Collaboration

Professor Mark Fitzgerald (2nd from left) speaking at a recent AITSC forum hosted
by the National Trauma Research Institute. Prof Fitzgerald will be giving
Central Clinical School's public lecture on 12 Oct 2016, on trauma systems.

Commencing in 2013, the Australian and Indian governments invested over $2.6 million through their Australia-India Strategic Research Fund Grand Challenge Scheme, to find the best ways of delivering needed care to injured people.

The Australia-India Trauma Systems Collaboration (AITSC) brings together governments, industry, clinicians and researchers to improve information and resources, and to pilot new systems of care.

Iron deficiency in coronary artery surgery patients - the HERROES substudy

Dr Joel Symons with a patient

Dr Joel Symons was awarded the Robin Smallwood bequest from the Australian and New Zealand College of Anaesthetists for $98,000 to complete a substudy HEpcidin, Reticulocyte haemoglobin and soluble transferrin Receptors in Reported OutcomEs in cardiac Surgery (HERROES) sub study, nested within ITACS commencing in 2016.

Iron deficiency is very common in patients having coronary artery surgery. It is the commonest cause of anaemia worldwide, and independently worsens outcomes after surgery. The ITACS trial will determine whether a single dose of IV iron, given to anaemic patients before elective cardiac surgery improves outcome after surgery. The primary endpoint is days alive and out of hospital from surgery to 30 days following operation.  Secondary endpoints include blood transfusions, perioperative complications, hospital stay, survival, quality of life and disability-free survival.

Breakthrough opens door to safer lupus drugs

Prof Fabienne Mackay's group. Lead research Dr Will Figgett
seated far left, Fabienne Mackay next to him. Pin Shie Quah,
another author on the paper, standing immediately behind
Fabienne.

A ground-breaking discovery by Monash University researchers could revolutionise treatments given to lupus sufferers, saving thousands of people each year from serious illness or death caused by secondary infections.

Lupus is a debilitating and widespread autoimmune disease that can attack any part of the body. It affects one in 1,000 Australians and 5 million people worldwide, and its victims are typically young women. Indigenous and Asian people suffer higher rates than other groups.

Centre of Excellence in Traumatic Brain Injury (CETBIR)

Dr Sarah Hellewell, CETBIR Fellow

Traumatic brain injuries in Australia, indeed around the world, create an enormous burden on individuals, families, communities and the economy.  Fortunately, there is a concerted effort being made by researchers around the world to decipher the derangements that occur at a cellular and molecular level in these injuries and in developing new therapies to improve the outcome from these injuries.  

Using TMS as a diagnostic tool for parkinsonian syndromes

Dr Kelly Bertram, a consulting neurologist
at the Alfred's Movement Disorders clinic,
demonstrates the use of the TMS device.

Transcranial magnetic stimulation (TMS) is being employed in a research study for early detection and measurement of neurodegenerative disorders including Progressive Supranuclear Palsy (PSP), Parkinson's Disease (PD) and multiple system atrophy (MSA).

Dr Kelly Bertram (pictured) and Dr Sarah Hewer have designed this study in collaboration with the Movement Disorder team at University of Rome. There is evidence neuronal dysfunction in PSP can be measured utilizing TMS. Given different parkinsonian syndromes are associated with different patterns of brain region involvement, diagnostic accuracy may be improved by the use of TMS. 

The study aims to measure responses to TMS paradigms in patients with PSP and compare these responses to patients with two other forms of parkinsonism, Multiple system atrophy and Parkinson’s disease, and with healthy controls. This will determine if TMS can distinguish between these diagnostic entities. Secondly, they hope to see if these responses correlate with clinical features of disease and change over time with disease progression. Dr Bertram said, "This will allow us to determine if TMS will be useful in future treatment trials."

See more about the Van Cleef/Roet Centre for Nervous Diseases research programs.

Tissue engineering for treatment of burn wounds: Phase 1 clinical trial running

L-R: In the Skin Tissue Culture Laboratory, Mr Dion Martinus
(Quality Officer), Ms Heather Cleland (Director, Burns Unit)
and Dr Shiva Akbarzadeh (Senior Research Fellow)

The Alfred Skin Tissue Culture Laboratory pursues a translational research program directed towards the investigation and development of tissue engineered products for wound healing.

A phase 1 clinical trial evaluating the use of cultured keratinocytes as an adjunctive therapy for patients with severe burns commenced recruitment in 2014. To date, five patients have been recruited.

Optimising paediatric traumatic brain injury (TBI) outcomes

Dr Phil Lewis's research interest is how
the brain regulates blood flow

Dr Philip Lewis completed his PhD during 2014, in which he studied the regulation of blood flow in the brain. Often after traumatic brain injury (TBI), this regulation mechanism is disrupted. As a result, during episodes of low blood pressure the brain cannot prevent a drop in flow. Conversely, during high blood pressure episodes the brain swells as the non-reactive blood vessels stretch. His thesis examined how this mechanism works, and the development of techniques for measuring its deterioration.

Molecular pathways for skin formation

Michael Cangkrama, who has recently
completed his PhD on skin formation

The skin is the body’s largest organ. It forms in utero and is maintained throughout adult life. However, the womb is a more stable and regulated place than the more complex terrestrial environment, and skin function in an embryo and an adult is very different.

What are the molecular mechanisms contributing to the development, regulation and maintenance of the skin structure in utero and post-natally? Why are they different? It comes down to highly conserved genes, largely unchanged from fruit fly to human. These three genes (in mammals) are members of a family of transcription factors known as the Grainy head-like (Grhl) transcription factors that play a role in organ (including skin) development and barrier repair after tissue damage. Grhl1 and 3 are both highly expressed in skin.

Mechanisms of retinopathy in premature babies teased out: Immunology research

ARS cover image is by
Dr Devy Deliyanti, one
of the paper's authors

Effective preventive therapies for retinopathy of prematurity (ROP) don't exist, yet globally, there are at least 50,000 children blind from ROP. Professor Jennifer Wilkinson-Berka in the Department of Immunology leads research efforts into understanding the problem. A recently published paper shows that one form of a particular enzyme complex called NADPH oxidase (NOX) is involved in the development of retinopathy. The research indicates that blocking the action of NOX1 prevents the damage from occurring. Reference: NADPH Oxidase, NOX1, Mediates Vascular Injury in Ischemic Retinopathy. Antioxidants & Redox Signaling. V 20, No 17, 2014 DOI: 10.1089/ars.2013.5357