The Spring Research Newsletter 2012 is now available for download. This issue covers the results of some of our research projects that have been widely reported in the media.  

We have seen some very important outcomes from our funded research announced during this year.  In addition we have been able to award further grants to young doctors and midwives in partnership with The Wellcome Trust, Royal College of Midwives, British Maternal and Fetal Medicine Society. Here are the latest updates.

Uterine Rupture in the UK

The study found that, overall, uterine rupture is rare. However the risk of occurrence increases for women who have previously had a caesarean section; furthermore this risk increases with the number of previous caesarean sections. The time since the previous caesarean section and the induction of labour were also factors.

Dr Knight expects the study to impact on NICE guidelines. Our Research Advisory Committee rated the project an ‘A’ and noted “This will be a study of major impact”. 

Wellbeing of Women study means Botox could soon be widely described for overactive bladder syndrome

The condition affects one in five women aged 40 and over and can cause urinary incontinence.

Dr Douglas Tincello, Senior Lecturer at the University of Leicester, found that just a single treatment of Botox - typically used as a cosmetic treatment to smooth out facial wrinkles – can reduce the symptoms of urinary incontinence by half in the majority of patients.

Find Out More  Project Grant

Our elective student Reshma Shah from King’s College London, who visited Teule Hospital , Muheza, Tanzania, has had the research findings from her visit accepted for presentation at the British Maternal and Fetal Medicine Society conference in Glasgow on 19-20th April 2012.

Miss Roxanne Keynejad, a Wellbeing of Women elective student from King’s College London, presented her elective poster at the RCOG Medical Students and Young Doctors' Evening on Thursday 26th January and was awarded the prize for Best Poster Presentation. This follows from her commendation for the Elizabeth Garrett Anderson at the Medical Women's Federation Global Health Meeting in London.

A groundbreaking new study funded by Wellbeing of Women means countless women going through the menopause could soon benefit from a range of new treatments that provide relief from the horrors of hot flushes - without having to resort to HRT.

The new research, by Professor Mary Ann Lumsden and her team at the University of Glasgow, specifically looked at the mechanism of hot flushes to fully understand why they happen in the hope that new and innovative drugs could be developed.

Until recently, hot flushes have commonly been best treated with HRT with many established studies showing it works in 75-80% women. But many women are worried about using this treatment due to perceived health risks, such as a slightly increased risk of breast cancer.

Under normal circumstances, if the body temperature rises, the blood vessels under the skin dilate in order to lose heat, thus leading to reddening of the skin and sweating.　In women with hot flushes, this can occur at the smallest provocation or seemingly for no reason at all. Professor Lumsden believes patients who experience severe hot flushes may actually have an abnormality in the function of the blood vessels.

To explore this theory, Professor Lumsden spent some time comparing women who experience hot flushes with those who don't. Crucially, she looked at how the blood vessels function by studying the peripheral blood vessels in patients’ arms Until now, doctors have worked on the assumption that the brain is responsible for hot flushes. When over-heating occurs it sends signals to the body to ‘lose heat’ by dilating blood vessels and producing sweat. Professor Lumsden's new findings suggest abnormalities in the blood vessels themselves may also contribute to the overactive response seen in many menopausal women.

Says Professor Lumsden: 'My team and I have found that the blood vessels of women who get hot flushes dilate much more easily than those don't, and that they became less 'reactive' when a drug such as serotonin is prescribed. What's fascinating is that it appears to be the blood vessels themselves rather than what goes on in the brain that actually causes hot flushes.'

She adds: ‘We've recently done some brain scanning but don't yet have the results and this should clarify the situation further. If we can decrease the reactivity of blood vessels with newer treatments that have fewer side effects than HRT then we can make substantial leaps forward.'

In addition, Professor Lumsden found that patients who are prone to hot flushes have more risk factors for heart disease – a highly unexpected finding.

As part of her research into the mechanism of hot flushes, Professor Lumsden and her team also treated patients with drugs known to decrease the number of hot flushes.  There are chemicals within the brain known as neurotransmitters that translate what is happening in nerve cells to other cells. One of these is serotonin (the so-called ‘happiness hormone’).  Serotonin is active within the brain and also within the blood vessels elsewhere in the body and has been implicated in the mechanism of hot flushing.

The study conclusively showed that the antidepressant venlafaxine, which is designed to boost serotonin levels, dramatically reduces the dilation of blood vessels seen in flushing women. It also decreases the frequency and intensity of flushes. Professor Lumsden concludes that serotonin has a key impact on blood vessel function - an area that requires further investigation.

Professor Lumsden and her team intend to continue with their menopausal studies in order to help find new treatments which inspire confidence in patients.

You can see the original project HERE

The second newsletter from the Baby Bio Bank team is now available, providing an update on their recruitment and progress with a Baby Bio Bank Database. You can download the newsletter by clicking HERE. You can read about the Baby Bio Bank project HERE

 

This Autumn 2011 Research Newsletter focuses on the different partnerships Wellbeing of Women is involved in and looks in detail at some of the researchers we fund as a result of these. You can download it here:

Dr. Katie Morris of Birmingham University was awarded the best oral presentation prize at the British Maternal Fetal Medicine Society Meeting in Harrogate in June 2011 for her work on the PLUTO study. This study is a multi-centre trial looking at lower urinary tract obstruction, the term given to a blockage from the unborn baby’s bladder to the amniotic fluid that surrounds the baby until birth. The build-up of urine within the baby can cause restricted growth and kidney damage. In half these cases, the babies will die in the period shortly before or after birth. The trial was funded by Wellbeing of Women between 2005 and 2007 and is ongoing.   

Miss Roxanne Keynejad commended for the Elizabeth Garrett Anderson Prize
Miss Roxanne Keynejad of King’s College London was awarded one of our 2011 Student Elective Bursaries for her visit to Mulago Hospital in Uganda. Roxanne returned at the end of August and an abstract based on the elective was accepted for presentation at the Medical Women's Federation Global Health Meeting in London. On Friday 11th November Roxanne presented this abstract and it was commended for the Elizabeth Garrett Anderson prize (awarded to the best abstract presentation). You can find further details about the meeting HERE

Dr Evangelia Bakali wins Conference Prize 
Wellbeing of Women has a close relationship with Dr Evangelia Bakali of the University of Leicester. We previously funded her with an Entry-Level Scholarship and this year she was successful in obtaining a Research Training Fellowship. This will enable Dr Bakali to continue her research entitled “Cannabis and the bladder: a study of the effects of cannabis on overactive bladders”, which will improve our understanding of how cannabis affects the bladder and be the first step towards identifying a new drug for bladder control.

We are thrilled to report that Dr Bakali was invited to give a podium presentation at the International Scientific Conference RCOG in Athens, Greece held on the 28-30th of September. This presentation won a prize for Best Oral Presentation in the stream of benign and office gynaecology. Dr Bakali describes her presentation below:“My presentation was on my results from my pilot work funded by the Entry-Level Scholarship from Wellbeing of Women.  Overactive bladder symptoms affect 5 million people in the UK and the current available medication is not curative. A recent study randomized patients who had Multiple sclerosis and overactive bladder in a placebo group or a group taking a tablet form of cannabis and found that the patients in the cannabis group had a marked improvement in incontinence episodes. This led us to explore this further and we were able to localized the receptors in the rat bladder and also found that these receptors have a function in the bladder. We looked at some of the signalling pathways that these receptors may work through and found that both the cannabinoid receptors are coupled to Gi/o protein. In order for cannabis to have a therapeutic role in patients with overactive bladder, the mechanism by which it works in the bladder must be understood and we are due to start further studies to explore this."

Congratulations to Dr Bakali and we look forward to more exciting results from the Research Training Fellowship.

Red's Hot Women Awards 2011

We are excited to share the news that one of our researchers has been nominated for a Pioneer Award by Red magazine. Dr Sarah Blagden is at the Gary Weston Cancer Centre, Imperial College and in 2011 we awarded her £183,855 over 3 years to study The role of Larp1 protein in the development of ovarian cancer chemotherapy resistance.

Details of the Project can be found HERE

We wish Dr. Blagden the best of luck! The full shortlist can be seen HERE 

Premature Infants and brain size

Back in 1999 Wellbeing of Women funded Dr David Edwards at Imperial College for a project called “Fetoplacental infection and brain injury in extremely preterm infants”.  The results of this work led to further research and a paper has just been published in the prestigious Neurology journal. The research suggests that growth rate of the brain's cerebral cortex (the outer layer of the brain, responsible for cognitive functions) in premature babies may predict how well they are able to think, speak, plan and pay attention later in childhood.

“In babies born preterm, the more the cerebral cortex grows early in life the better children perform complex tasks when they reach six years old,” said Dr Edwards, “The period before a full-term birth is critical for brain development. Problems occurring at this time have long-term consequences, and it appears that preterm birth affects brain growth.”

These findings have important  implications for diagnosing potential problems in babies.

Andrew Horne and ectopic pregnancy
A Wellbeing of Women-funded project hit the headlines recently after a major discovery linking smoking and Chlamydia to an increased risk of developing ectopic pregnancies. The project was able to attribute this increased risk in both instances to raised levels of a specific protein in the Fallopian tubes, greatly enhancing our understanding of the link.
The project was based at the University of Edinburgh and led by Dr Andrew Horne, who hopes that this groundbreaking research will lead to a simple test which can diagnose ectopic pregnancy and an effective tablet-based treatment. This would have a dramatic impact as ectopic pregnancy is the leading cause of maternal mortality in the first three months of pregnancy.

Elective Bursary Prizes
Our Elective Bursaries continue to provide valuable support and encouragement for students taking their first steps into research in obstetrics and gynaecology.
Two 2010 recipients of these bursaries, Rowena Mills and Olivia Kenney (both from the University of Birmingham), undertook an elective study examining awareness of cervical cancer and the human papilloma virus (HPV), and acceptance of the HPV Vaccine amongst Guatemalan women. This study was so outstanding that they were invited to present a poster of their findings at the prestigious annual conference of BASHH (British Association of Sexual Health and HIV). Wellbeing of Women provided further support to enable Rowena and Olivia to attend this conference and we are thrilled to report that they won the Best Poster Prize for their work.
Another 2010 bursary recipient, Leena Pandit, undertook an elective in Auckland exploring maternal screening for sexually transmitted infections. This project won the University of Aberdeen prize for Best Medical Elective and has led to Leena being the co-author of a paper which is due to be published soon.

Dr Maranga’s ELS
One of our Entry-Level Scholarship awardees is already making waves despite his scholarship not being due to complete until the end of the year.
Dr Innocent Maranga is studying the effects of viruses and antiviral therapy on the development of cervical cancer (caused by the HPV virus) in HIV positive women. It is hoped that this study will shed light on the complex interaction between the HPV and HIV viruses and enable better prediction, prevention and treatment of cervical cancer.
As a result of his work to date, Dr Maranga has been invited to give two very prestigious oral presentations at the International Papillomavirus Conference (IPC) in Berlin. Furthermore, he has won an IPC Travel Bursary after being highly-graded by the IPC Scientific Committee.
We are thrilled for Dr Maranga and pleased that Wellbeing of Women are funding such exciting work that is, as is already clear, of a very high standard.

Dr Glazener International Study
A twelve-year study which Wellbeing of Women co-funded has cast strong doubt on the commonly-held belief that having caesarean sections protects women from the distressing after-effect of urinary or faecal incontinence.
It has found that 40% of those who had their babies delivered exclusively by caesarean section still reported urinary incontinence, while there was no difference in the occurrence of faecal incontinence between women who had only natural deliveries and those who had only caesareans.
The results were published in the prestigious BJOG Journal of Obstetrics and Gynaecology and were picked up worldwide by Reuters, leading to widespread coverage.
The researchers intend to follow-up with the women in 2014, twenty years after they gave birth. This will hopefully lead to further findings and is a perfect example of how research funded by Wellbeing of Women can continue to provide valuable outcomes long after our financial commitment has ended.

Wellcome Trust/Wellbeing of Women RTF
Each year Wellbeing of Women awards Research Training Fellowships to outstanding candidates eager to pursue a career in academic obstetrics and gynaecology. This year we are very pleased to be able to announce our first ever joint-fellowship with the prestigious Wellcome Trust.
Wellbeing of Women entered into discussions with the Wellcome Trust in recognition of the fact that academic obstetrics and gynaecology is a frequently-neglected field. Under the terms of the agreement, candidates that met the standards of funding in our Peer Review and interview process can be nominated for interview by Wellcome.
In an outstanding outcome for Wellbeing of Women, both of the candidates we put forward to Wellcome were chosen for funding. This is a strong validation of our standards and achievements in attracting world-class candidates. Indeed, one of these candidates was subsequently awarded a Fellowship by the Medical Research Council.
This means that we have the first ever Wellbeing of Women/Wellcome Trust Research Fellow. Dr Catherine James of UCL is an outstanding candidate who will be examining the role of the immune system of the cervix in preventing preterm birth. 

Other Research Training Fellowships Awarded in 2011
Wellbeing of Women also awarded two Research Training Fellowships of its own.
Dr Evangelia Bakali, University of Leicester will be embarking on a study called Cannabis and the bladder: a study to explore the action of cannabis on calcium action and differences between normal and overactive bladders, This is a continuation of an Entry-Level Scholarship funded by Wellbeing of Women.
Dr David Carr, UCL Institute for Women’s Health, will be looking at Understanding how gene therapy can help small babies grow in the womb.

Wellbeing of Women awarded five Entry-Level Scholarships, targeted at medical graduates and midwives in order to enable them to develop their research interests in Obstetrics and Gynaecology
Dr Leo Gurney, University of Newcastle, with the project Developing New Drug tools for Pregnancy Research.
Dr Tom Morewood, Royal Free Hospital, London with the project Freezing the ovaries of women undergoing cancer treatment to preserve fertility. This scholarship was made possible by a generous legacy left by a Wellbeing of Women volunteer and is named after her: The Betty Austin Memorial Scholarship.
Dr Gareth Waring, University of Newcastle, will conduct An investigation into the role of infection in causing premature birth.
Dr Natalie Suff, UCL Institute for Women’s Health, studying Prevention of premature labour by reducing infection within the womb. This ELS is awarded in conjunction with the British Maternal and Fetal Medicine Society.
Mrs Josephine Mary Holleran, University of Central Lancashire, will study Does the use of computers in birthing rooms affect the care that women receive during childbirth? This ELS is awarded in conjunction with the Royal College of Midwives and the British Maternal and Fetal Medicine Society and is our first ever Entry-Level Scholarship to be awarded to a midwife. 

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