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SCOTTISH HOSPITAL NEWS


ABERDEEN-LED STUDY INTO FRESH APPROACH TO COMMON CONDITION


A new study into the treatment of gallbladder stones is being directed by Professor Irfan Ahmed of NHS Grampian and Professor Craig Ramsay of the University of Aberdeen.


The Joint Chief Investigators have been awarded £1.4 million from the National Institute for Health Research Health Technology Assessment Programme funds to investigate whether pain relief may be as effective for patients with symptomatic gallstones, rather than surgery to remove them.


Between ten and fifteen per cent of the adult UK population have gallstones, with one in three people developing symptoms, including a severe pain called ‘biliary colic’, in the upper right side of the stomach. The standard treatment for gallbladder symptoms due to gallstones is surgery to remove the gallbladder, and this is one of the most common procedures in the UK and costs between £2,500 and £5,000


per procedure. Around 70,000 procedures are carried out in the UK per year.


‘In people with symptomatic gallstone disease,’ said Professor Ahmed, ‘the rates of developing minor/major surgical complications can be as high as ten-fifteen per cent. Even though removal of the gallbladder is considered the standard treatment for symptomatic gallstones, it does not guarantee eradication of symptoms, as one third of the patients may continue to experience pain and abdominal symptoms after surgery. So we want to investigate, through a robustly conducted randomised controlled trial, whether a non-surgical approach would be better for some patients. Reducing the number of non-essential operations would be good news for patients and could make a significant impact on the demands on our hospitals and staff, as there are costs related to surgery and to treatment of post-surgery complications.’


GLASGOW PROFESSOR FUNDED TO DESIGN NEW ALZHEIMER’S MEDICINES


Professor Andrew Tobin, an expert in protein receptors in the brain whose research is focused on the treatment of neurodegenerative diseases, has joined the University of Glasgow’s College of Medical, Veterinary and Life Sciences (MVLS).


Professor Tobin has recently been awarded a £4.2M Wellcome Collaborative Award – funding, which will allow for research into the design of the next generation of drugs for the treatment of neurodegenerative diseases such as Alzheimer’s Disease (AD).


The Wellcome award has been given in collaboration with researchers at


Monash University in Melbourne Australia (Professors Arthur Christopoulos and Patrick Sexton) and Eli Lilly & Company. The £4.2M will fund the team’s research for more than five years, beginning in November, to use state-of-the-art technologies and approaches to discover new ways to make better drugs for the treatment of AD.


Professor Tobin and his collaborators will focus their research on proteins in the brain called receptors, which are involved in receiving the messages that result in us ‘laying down’ and retrieving memories. In AD this process is destroyed, leading to memory loss. By designing drugs that target specific receptor proteins called muscarinic receptors, the team believe that they can restore memory loss in diseases such as AD.


ANEMIC ADULTS MAY HAVE A HIGHER RISK OF DEATH AFTER STROKE


New research from the University of Aberdeen has revealed that anemia may be linked to a higher risk of death in older adults after suffering a stroke.


Anemia is common in patients with acute stroke. Both anemia and low hemoglobin levels, which are proteins in red blood cells that carry oxygen throughout the body, are also common in older people, said Phyo Myint, senior study author and Professor of Medicine of Old Age at the University of Aberdeen in Scotland.


In the study, which was published in the Journal of the American Heart Association, researchers examined data from 8,013 hospital patients at an average age of 77 years old admitted with acute stroke between 2003 and 2015. They assessed the impact of anemia and hemoglobin levels on death at different time points up to one year following stroke.


The researchers found that anemia


was present in about a quarter of patients with stroke upon admission and was associated with a higher risk of death for up to one year following either ischemic (clotted blood vessel) or hemorrhagic (ruptured blood vessel) stroke.


Additionally, elevated hemoglobin levels were associated with poorer outcomes and a higher risk of death, mainly within the first month following stroke, meaning both low and high levels of hemoglobin could be associated with a higher risk of death after stroke7.


‘We found that the likelihood of dying is about two times higher for ischemic stroke in people with anemia compared to those without it, and it’s about 1.5 times higher for a hemorrhagic stroke,’ said Professor Phyo Myint, senior study author and Professor of Medicine of Old Age at the University of Aberdeen in Scotland. ‘So there’s the potential for a much poorer outcome if somebody comes in with stroke and they’re also anemic.’


NEW TREATMENT FOR BREAST CANCER


The European Medicines Agency (EMA) has recommended granting a marketing authorisation in the European Union (EU) for Ibrance for the treatment of women with locally advanced or metastatic breast cancer. It is to be used for cancer that is hormone receptor (HR) positive and human epidermal growth factor receptor 2 (HER2) negative.


Breast cancer is the most common cancer in women worldwide, with nearly 1.7 million new cases diagnosed in 2012. In Europe, there were an estimated 464,000 new cases of breast cancer in 2012 and an estimated 131,000 deaths from the disease. Hormone receptor positive breast cancer accounts for 65 per cent of tumours in women aged 35 to 65 years and 82 per cent of tumours in women older than 65 years.


Ibrance (palbociclib) works by blocking the activity of proteins known as cyclin-dependent kinases (CDK) 4 and 6. This inhibits the division of cancer cells and helps to stop growth of the tumour.


In postmenopausal women, Ibrance is to be used in combination with an aromatase inhibitor or with fulvestrant in cases where the patient has undergone prior hormone therapy. For women in stages preceding menopause, the hormone therapy should be combined with a luteinizing hormone releasing hormone (LHRH).


The most frequently reported side effects are associated with myelosuppression, a condition in which the patient’s bone marrow produces fewer blood cells than normal.


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