Kolling Institute News

Kolling Institute News

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Obesity link to complications for women and their babies

Research identifies a concerning lack of knowledge around heart risks

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Exciting new research to help treat those with a deadly blood cancer

Discovery into reality

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MESSAGE FROM THE EXECUTIVE DIRECTOR

all their efforts. This is one success story from our new Kolling research enabler committees, with the Research Infrastructure and Support Services Enabler closely involved in the funding application. It has been pleasing to see the progress with the Kolling Research Plan, and the comprehensive work that has been undertaken to define the key goals and next steps for the strategic framework. Some of the initiatives will involve broader research collaborations, stronger consumer engagement and an increase in research funding, and I’m sure that all of these measures will help to propel the Kolling as a centre for world-leading translational research, focused on improving the health of our community.

This month’s newsletter provides an insight into the scope of research taking place across the Kolling, and it demonstrates the depth of expertise and experience throughout our institute. Our research is continuing to attract the recognition it deserves through the latest funding announcements, high profile national awards and influential publications. You can read about some of those in this edition, along with details of some exciting clinical and pre-clinical trials. Encouragingly, we will be seeing a boost to our infrastructure following significant funding for a new Digital Spatial Profiling System. This means the Kolling will be one of the first institutes in New South Wales to introduce this world-leading technology, and we expect it will significantly extend our neuroscience and other research capabilities. Many people were involved in applying for the funds, including Professor Mark Molloy and the University of Sydney’s Core Research Facility, and I’d like to acknowledge

The importance of medical research has never been more evident. As we continue to address the challenges presented by the COVID pandemic, the Kolling is stepping up its research activity and increasing its influence nationally and internationally. It’s great to see that the institute is going from strength to strength, with a wealth of valuable research underway right across the organisation. One example of this is research just published by Professor Geoffrey Tofler and Associate Professor Tom Buckley around the early warning signs and risk factors of heart disease, especially for those playing masters soccer. This research is particularly timely given the tragic deaths of cricket hero Shane Warne and federal politician Kimberley Kitching. Importantly, the research is helping to direct the community’s focus to risk factors and how to respond to these risks, and I’m sure it will play a part in saving lives.

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KOLLINGNEWS | APRIL 2022

Research prompts calls for a better understanding of heart attack signs, especially during exercise

Other key findings include:

A new study has directed the spotlight to the risk of a cardiac event for those over 35 playing football, while also highlighting a concerning lack of knowledge around recognising the early signs of a heart attack. Conducted by researchers from Royal North Shore Hospital, the University of Sydney and the Kolling Institute, the study surveyed more than 150 masters age amateur soccer players involved in competitive and social games. The research is believed to be the first of its kind to assess cardiac knowledge and beliefs in this higher- risk amateur football group. Senior author Professor Geoffrey Tofler, RNSH cardiologist and University of Sydney academic said the study identified that one in five participants had one or more possible cardiac symptoms during a game in the prior year, but only a quarter of them sought medical attention. “Our research indicates a concerning trend and we hope that by raising awareness of heart health, we will be able to reduce the risk of a cardiac event such as a heart attack and sudden death,” he said. “We know that strenuous exercise can cause a temporary increase in cardiac risk, but being able to recognise the warning signs of an impending cardiac event will help lower those risks. “It’s important to act quickly on symptoms and if a cardiac arrest occurs, promptly begin CPR and have a readily accessible defibrillator.”

• Almost half of those surveyed had little or no confidence that they would recognise the signs of a heart attack. • In response to a hypothetical episode of chest pain while playing, less than half would leave the field immediately, while 49 per cent would stay on the field for 5-10 minutes to see if the pain eased, and others would play on. • Three quarters of participants said they would use the internet

Professor Geoffrey Tofler

for information about their symptoms before seeing a doctor.

• Less than 40 per cent were aware of the less typical signs of a heart attack. • One high-risk attitude was that nearly half of the participants indicated that if they thought they were having a heart attack, they would prefer someone to drive them to the hospital rather than have an ambulance come to their home. Co-author Associate Professor Tom Buckley said encouragingly, the participants agreed that CPR training was important and that defibrillators should be staples at football fields during all games. “These steps could make the difference between life and death for someone experiencing sudden cardiac arrest, as the survival rate decreases by seven to ten per cent for every minute without the use of CPR or defibrillation” he said.

Associate Professor Tom Buckley

“While the benefits of exercise still far outweigh cardiac risk overall, these measures may further increase the benefit to risk.” The study was conducted as a supervised student MD project by lead author, Dr Matthew Francis. To find out more about heart-attack causes, warning signs and what to do, visit the Heart Foundation resource page https://www. heartfoundation.org.au/conditions/ heart-attack

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Researchers identify link between obesity severity and adverse outcomes for pregnant women and their babies

There are calls for a greater focus on weight management following new research defining the relationship between obesity and pregnancy- related complications for mother and baby. The study follows an increase in obesity levels globally as well as a rise in prevalence during pregnancy. Today, more than 20 per cent of Australian women have obesity at the time of conception. Kolling Institute and University of Sydney researcher and Royal North Shore Hospital Endocrinologist Associate Professor Sarah Glastras said researchers know that obesity in pregnancy increases the risk of the mother developing gestational diabetes, gestational hypertension or high blood pressure, and pre- eclampsia. There’s also a higher risk of stillbirth as well as a caesarean section delivery. “Women with obesity are more likely to deliver a baby with congenital abnormalities, respiratory distress syndrome and have a large baby,” she said. “Our research has now given us a much clearer picture of the direct link between the severity of obesity and the risk of adverse impacts for both the mother and her baby.” Three classes of obesity were identified based on Body Mass Index with class one assessing women with the lowest severity of obesity. • The research found 21 per cent of women with class I obesity developed gestational diabetes, compared with 28 per cent with class III.

• Women with class I obesity had half the risk of developing pre- eclampsia compared class III. (2.8% versus 6.2%). • There was an increased risk of caesarean delivery, with a 40 per cent risk in class I, a 45 per cent risk in class II and 54 per cent in class III. This compared with the national average of 33 per cent. • 26 per cent of women with class I obesity had a large baby compared with 33 per cent in class III. • Stillbirth and birth defects were more common in women with more severe obesity. “Our study highlights the importance of weight management in women of child-bearing age, not just during pregnancy, but also at time of conception,” said Associate Professor Glastras.

Associate Professor Sarah Glastras

“Encouragingly, we also demonstrated that with good

obstetric care, we can mitigate some of the risks associated with obesity in pregnancy. “Our research not only provides individuals with an incentive to manage their own weight, but also offers health providers and policy- makers more evidence to support pre-conception weight management initiatives.”

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KOLLINGNEWS | APRIL 2022

Researchers identify the best ways to ease chronic pain With large numbers of people across the community looking for effective and lasting ways to treat pain, our researchers at the Kolling Institute

are driving nationally significant projects to reduce a reliance on opioid medication and promote proven alternative options. The research by our team from the Pain Management Research Centre follows the latest figures which indicate around 20 per cent of the population experience chronic pain and a large share of those are still relying on opioid treatment to reduce the impact of their pain. Centre Director and Royal North Shore Hospital specialist Professor Paul Glare said despite the wide use of opioids, we now know they are not an effective, long-term option for most people, and cause a wealth of adverse side effects including addiction issues. “Opioid use is directly linked to an increase in mortality, and now accounts for more deaths than car accidents,” he said. “Our research is focusing on the best ways to reduce opioid use considering the complex challenges with medication withdrawal and patient fears that their pain will become unmanageable. “Our research indicates that cognitive behavioural therapy is the most effective option to reduce pain, and patients are three times more likely to be able to stop their opioid use if they adopt the self-management strategies promoted through the cognitive based therapies. “With the number of people experiencing chronic pain continuing to escalate, it’s crucial that we’re able to provide the very latest evidenced- based >Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12

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