ReSeaRchgRantS Translational research grantsProfessor Martin thornhill, University of Sheffield / 98,802 12 months from money donated by Simplyhealth Do patients need antibiotic cover when visiting the dentist?
Infective endocarditis is a serious infection of the inner lining of the heart. It affects around one in 10,000 people every year in the UK and can be life-threatening. Dental procedures are thought to be one of the main causes with up to one half of all cases being caused by bacteria found in the mouth.
For the past 50 years it has been standard practice across the world for dentists to give a dose of antibiotics to patients at risk of infective endocarditis before providing any dental treatment. However, the evidence that antibiotics are effective in preventing the condition has never been properly studied and is unproven. In March 2008, the National Institute for Health and Clinical Excellence (NICE) introduced a new guideline that this cover for at-risk patients should stop after finding that studies did not support the use of antibiotics during dental treatment. It was also noted that it has the risk of side-effects and allergic reactions in patients and may lead to antibiotic resistant bacteria or so-called superbugs.
Following a pilot study, the researchers will now use a full five years data on the prescribing of antibiotic cover by dentists and its effect on the number of cases of infective endocarditis which will give much better and more detailed evidence about the effectiveness, or not, of antibiotic cover. A rise in the number of cases will provide strong evidence that the NICE guidelines should be reconsidered.
The results of this study will be of great importance to all dentists and cardiologists in the UK as well as the many at-risk patients. It will also be of interest in other countries such as the United States and the rest of Europe where guidelines still recommend that dentists give antibiotic cover to at-risk patients.
Dr carrie Ferguson University of Leeds / 60,140 12 months Is Interval training the new exercise panacea?
Cardiovascular disease is the leading cause of death in the UK and being physically active is one of the most effective and inexpensive ways of reducing the risk of developing it. However, fewer than five per cent of the population actually achieve the Government-recommended 150 minutes of continuous, moderate-intensity physical activity per week with many saying it is because they do not have enough time or find exercise boring.
In this project, short-duration Interval Training and long-duration Interval Training, both involving fast walking, will be compared with standard continuous moderate-intensity exercise. The main aim is to find out whether people actually prefer to exercise in short bursts rather than continuously and whether they are more likely to continue with Interval Training at home.
Volunteers taking part in the study, who have an increased risk of developing cardiovascular disease, will exercise in the laboratory on separate days following the three exercise regimes. After each session they will be interviewed about their preferences and will then be randomly allocated to a training group and asked to follow one of the three exercise regimes unsupervised at home for 12 weeks and to keep an exercise diary.
The research will show whether Interval Training is a preferable way of exercising compared with current government guidelines and whether or not participants continue with this training unsupervised at home. It will also show whether it was effective and if it was better than standard training at reducing risk markers for cardiovascular disease. Positive results may result in changes to Government recommendations, with the aim of getting more people participating in meaningful exercise and helping to reduce the number of people affected by cardiovascular disease.
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Prof Manuel Mayr Kings College London / 98,808 2 years a better test to assess cardiovascular disease risk
the Problem Assessment of traditional risk factors like obesity, smoking, lack of exercise, diabetes and high blood pressure and cholesterol levels fails to predict cardiovascular disease in between 25 and 50 per cent of patients. At the moment, there are no reliable biomarkers that can be measured in the blood to identify people before they suffer a heart attack or a stroke something we urgently need to find.
the Project Using advanced technologies, this research team has developed a new lipidomics test that can measure more than 100 different fats in the blood. They have found particular types of fats, not measured in current tests, that may help to identify people at high risk of heart disease and stroke. This project will characterise a unique fingerprint profile of blood fats to identify people who may be at risk of heart attacks or strokes in the future and also in patients already receiving treatment for cardiovascular disease.
the Benefits An accurate test to predict who may develop cardiovascular disease would mean that lifestyle changes could be made or appropriate medical treatment given to help prevent these conditions and save lives.
Dr alberto Figueroa Kings College London and St Thomas Hospital / 93,032 - 12 months Improving care for patients with aortic dissection
the Problem The aorta is the largest blood vessel in the body, taking blood from the heart to all organs. Aortic dissection is a tear in the wall of the aorta which creates a false passage or lumen which is a life-threatening condition if left untreated and affects 3 - 4 people per 100,000 every year. Aortic dissection is more common in people with a history of high blood pressure and those who survive have ongoing problems with expansion of the false lumen leading to death from aortic rupture.
the Project The research team will use magnetic resonance imaging (MRI) and a simulation method to produce a computer model of the aorta which is unique to each patient. This will help them to understand the blood flow in the false lumen, what effect it has on the aorta and the likely outcome for the patients. It is hoped that this will allow them to decide which patients are at high risk of aortic expansion and, therefore, need earlier, closer follow-up or surgery.
the Benefits The aim of this project is to answer fundamental questions about this poorly understood but serious disease. The findings could help clinicians to predict which patients are at increased risk of developing complications and to make an accurate plan about how and when best to treat each patient, improving the outcome for patients with aortic dissection.
Dr Julia gorelik National Heart and Lung Institute, Imperial College London / 125,188 2 years a new target for drugs to improve heart rhythm
the Problem The heart is not just composed of muscle cells but is made up of many different cell types. During development of the foetus and in some disorders including the aftermath of a heart attack - new cells called myofibroblasts appear. If too many myofibroblasts are present in the heart it can cause disturbances to its electrical rhythm - called arrhythmias which can spoil the normal contraction of the heart muscle. This project will study how myofibroblasts interact with heart muscle cells and how they affect normal contractions.
the Project The team has found that bile acids in the blood can disturb contractions of heart muscle cells, but only if they are together with myofibroblasts. Using heart muscle cells alone, mixed with myofibroblasts grown in culture, the team will study in detail how bile acids interact with myofibroblasts. They will also investigate UDCA, a drug used to treat a range of liver disorders and which has been shown to prevent the adverse effects of bile acids on the heart.
the Benefits It is expected that this project will help to show that myofibroblasts represent an important new target for anti-arrhythmia drugs. The findings will help explain how myofibroblasts affect heart rhythm, helping to pave the way for the development of new and better drugs to restore a normal heart rhythm. The work will also focus on whether the drug UCDA can protect the heart against abnormal heart rhythms.
Professor angela clerk University of Reading / 114,583 2 years Protein kinases as targets for new heart failure drugs
the Problem Heart muscle cells can die if deprived of oxygen, for example, during a heart attack, and because they cannot regenerate, some of the function of the heart is lost and heart failure may develop. Despite recent progress, current treatments for heart failure have limited benefit and the outlook for patients is poor. It would be a great step forward if we could find ways to replace dead cells by helping surviving cells to multiply or by giving extra cells such as stem cells.
the Project Protein kinases are a group of proteins that regulate every aspect of cell f