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A Picture of Health 2007

SOME SELECTED RESEARCH SUMMARIES

 

Autism in the spotlight

Up to 40 per cent of children with autism also suffer from bowel problems and the significance of this has been hotly debated in recent years. Professor John O'Leary of Coombe Women's Hospital now reports that these gastrointestinal disturbances amount to a new form of inflammatory bowel disease (IBD), with a distinctive pathology. Detailed molecular analysis of gut tissue from patients with autism reveals an abnormality of the local immune system, leading to inflammation and symptoms, with younger children being more severely affected. These new findings highlight the importance of the 'gut brain axis' in autism, and suggest that if gastrointestinal symptoms are treated, behaviour may improve too.

 New hope in rheumatoid arthritis

The advent of the anti-tumour necrosis factor-α (TNF-α) therapies marked a major advance for patients with rheumatoid arthritis, an autoimmune disease causing much pain and disability. In a new clinical study, Dr Ceara Walsh of the Department of Rheumatology, St Vincent's University Hospital, has been looking at whether anti-TNF-α therapy can safely be withdrawn among patients in remission and has identified a 'biomarker' in blood cells that may predict a flare-up, allowing doctors to monitor patients' treatment more closely. Meanwhile, also in the Department, Dr Ronan Mullan has identified a central role for a protein called serum amyloid A in driving inflammation in RA, opening up the possibility of using this as a target for new therapies.

Perfecting the art of prescribing

Prescription medicines account for around €1 billion a year in Ireland so its important doctors get their prescribing right. Professor John Feely and his team at St James's Hospital have devised a new set of best practice guidelines called 'quality indicators' that provide the knowledge base that GPs need to make sure their patients get the right medicine at the right time. The scheme should ensure that those at risk of heart disease or stroke do not miss out on preventative medications such as statins and, equally, that prescription of drugs whose long-term use is not recommended, like tranquillisers and antibiotics, is reduced.

Towards better angioplasty

Angioplasty is standard treatment for people with coronary heart disease. The procedure introduces a balloon-tipped catheter to the site of blockages within the coronary artery. The balloon is inflated pushing the walls of the blocked artery apart and a wire device called a stent is left behind to prop the walls open. The procedure can be life-saving, but the artery may re-block because the balloon and stent injure its wall. Dr Alan Keenan of the Department of Pharmacology, University College, Dublin, is developing a drug-coated stent which can improve the performance of the device. A special polymer coats the stent, allowing the incorporation and controlled release of statins, and other drugs, to the

Building an epilepsy Electronic Patient Record

People with chronic diseases like epilepsy interact with many different parts of our healthcare system. Researchers at Beaumont Hospital, Ireland's leading epilepsy centre, are developing an Electronic Patient Record (EPR), a project that promises many benefits to patients. With current paper-based records, patients have to wait a long time for specialist referral. Transferring to an e-system allows instant communication between GP and consultant. Other improvements from the epilepsy EPR include improved quality of data, reduction in the number of tests and queries, and easier development of shared care. The main components of the web-based epilepsy EPR have already been built and the challenge now is to work with users to get it implemented as widely as possible.

New colorectal cancer screen

Colorectal cancer is highly curable if caught early and population screening with colonoscopy is known to save lives. However, colonoscopy is invasive and its cost is far from trivial. Professor Colm O'Morain of the Department of Gastroenterology at Adelaide and Meath Hospital has been working on a non-invasive, but sensitive, test involving the detection of an enzyme, Tumour M2-PK, in stool samples. In a trial involving 162 patients with colorectal cancer or pre-cancer and healthy controls, the test detected 97 per cent of cancers and 76 per cent of pre-cancers. Following further development, the test could be introduced to identify those high risk patients who have most to gain from colonoscopy.

Towards better angioplasty

Angioplasty is standard treatment for people with coronary heart disease. The procedure introduces a balloon-tipped catheter to the site of blockages within the coronary artery. The balloon is inflated pushing the walls of the blocked artery apart and a wire device called a stent is left behind to prop the walls open. The procedure can be life-saving, but the artery may re-block because the balloon and stent injure its wall. Dr Alan Keenan of the Department of Pharmacology, University College, Dublin, is developing a drug-coated stent which can improve the performance of the device. A special polymer coats the stent, allowing the incorporation and controlled release of statins, and other drugs, to the site of the injury.

 

 

For a hard copy of the report contact: Claire Vaughan by emailing cvaughan(at)hrb.ie or phoning +353 1 2345187.

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