ANZCTR search results

The aim of this study is determine the effect of sodium to potassium ratio on postprandial endothelial function in healthy subjects. We speculate that a low sodium to potassium ratio improves postprandial endothelial function compared to high sodium to potassium ratio.

STUDY DESIGN: This study will use a single group design to examine the effects of an exercise intervention on patient outcomes with pre and post assessment. The aim of the study is to improve the hepatic and cardio-metabolic profile of these patients. OUTCOME MEASURES: After referral and screening by the treating specialist participants will undergo baseline assessment. Outcomes will include: - Hepatic steatosis - Plasma lipid profile, insulin, glucose, HOMA2, markers of liver damage (ALT, CK18) and liver enzymes - Arterial stiffness (measured non-invasively via PWA/PWV) - Body composition (DEXA / MRI) - Cardiorespiratory fitness - Muscular strength and physical function EXERCISE INTERVENTION: Participants will undertake supervised training 3 days per week consisting of a combination of aerobic and resistance training. training load and volumes will be individualized based on pre assessment results and progressed throughout the study. SIGNIFICANCE: This study will establish the feasibility and efficacy of an exercise intervention on this patient population and will help inform the design of future larger multi-centre studies of exercise as an adjuvant therapy in advanced liver disease.

This is key research (with the participation of MyHealthTest) to determine if certain human pathology tests using alternative sampling methods can be proven to be as effective as those done with traditional pathology methods. MyHealthTest is a new online business which will offer human pathology tests and support services direct to the individuals. Customers will order a limited set of targeted tests online and access their test results through a secure online portal. They will also be able to share these results with others including their GP. This will allow individuals to monitor and track aspects of their health and wellness from the convenience of their home. GPs and pharmacists will also be able to order tests for their patients/customers. The types of tests proposed to be offered in the future by MyHealthTest include: 1. HbA1c the key period test required by diabetics which provides evidence of how well they are managing their health. 2. Lipid Panel a series of cholesterol tests including Total Cholesterol and Triglycerides. 3. hs-CRP (high-sensitivity C-reactive protein) - used to determine if you are suffering from a significant infection/inflammation and a good indicator of risk of cardiovascular disease. One of the test sample collection methods to be used by MyHealthTest is dried blood spots where capillary blood will be placed onto a dried blood spot card via a finger prick. The dried blood spot sample will be done by the customer or their carer. This is different to the mainstream blood collection method, where venipuncture blood collection is the current process usually performed at a pathology collection centre by a phlebotomist or trained nurse. Although dried blood spot samples have been used as a new born screening tool for many decades, to date there has been limited use of dried blood spot for diagnostic tests as part of disease management. A number of research projects undertaken by universities and medical schools show comparative results can be obtained between tests done with capillary blood on dried blood spot collection medium and venous blood samples. This evidence has focussed on comparison between the two blood sample types. In addition, MyHealthTest want to test the validity of self urine and saliva collection for testing of hormones. A precondition for MyHealthTest to offer alternative sample collection processes is to ensure the processes will deliver comparative and acceptably precise results to that of the standard samples for various tests. The criteria for the proposed dried blood spot, urine and saliva sample collection processes are the sample must: 1. be able to be collected by a lay-person; 2. be able to be legally transported through standard post; 3. not deteriorate during transport 4. deliver comparative and acceptably precise results This research project will compare dried capillary blood, urine and saliva samples against mainstream pathology samples for different pathology tests

The purpose of this study is to examine the effect of gluten on gastrointestinal symptoms and mental health in those with NCGS. It is hypothesised that a major effect of gluten in those with NCGS is on mental health and not necessarily on GI symptoms.

Primary purpose of the study is to examine if a low volume bowel preparation in conjunction with a white diet will have the same cleansing effect as current bowel preparations.

Stroke is a leading cause of disability amongst Australians. After stroke, activity levels are low, with few people able to exercise at an intensity which will reduce the risk of future cardiovascular events. This project examines the feasibility and effectiveness of usual physiotherapy staff in rehabilitation implementing a combined high intensity treadmill training program with a self management approach to improve activity levels, mobility, cardiovascular risk profile in stroke survivors, increasing their independence and reducing the burden of care. In addition, this project will investigate the barriers and facilitators to physiotherapists implementing this approach to stroke management as part of their clinical practice.

There is a rising medical cost base in emergency medicine. There is a rising seniority of medical staff required to safely perform the role of physician in an emergency department. The currently accepted productivity of a FACEM is one patient per hour. Much of this time is spent writing and printing notes, faxing documents and contacting physicians. None of this work requires the skill set of an emergency physician and could be performed by a well-trained medical scribe or secretary. To date scribes have not been used in Australian Emergency Departments and offer a novel way of addressing emergency physician productivity without compromising the quality of emergency physician work. The degree that a medical scribe increases emergency physician productivity in emergency medicine in Australia has not been determined. This is a pilot trial to investigate whether a medical scribe would increase emergency physician efficiency

The proposed study is a national, retrospective cohort study, which aims to determine if the introduction of non calcium-based phosphate binders sevelamer hydrochloride and lanthanum carbonate, since their PBS listing in 2007/2008, has been associated with a change in all-cause or cardiovascular disease mortality. We hypothesize that for patients on dialysis, most of whom require the use of phosphate binding medication, the progressive displacement of traditional calcium-based phosphate binders by the non calcium-based drugs sevelamer hydrochloride (Renagel) and lanthanum carbonate (Fosrenal) will have reduced cardiovascular and/or all-cause mortality after adjustment for covariates.

Current practice in the management of CBD stones varies widely with most patients receiving either pre­ or post­ operative ERCP. This is a two-­step approach to the management of CBD stones. A one-­step approach to CBD stones exists in the form of open or laparoscopic CBD exploration (either laparoscopic trans­cystic exploration (TCE) or laparoscopic choledochotomy). We aim to assess the practice of performing a single-­step approach to CBD stones by performing either intra-­operative ERCP or LCBDE once a CBD stone is identified.

Many older patients admitted to hospital for acute medical illnesses are undernourished, which increases the number and length of hospital admissions. Unfortunately, treating malnutrition during a short hospital admission only produces modest improvements, so we are interested in redesigning the delivery of hospital nutrition care to continue into the post-discharge period to see if this can increase the benefits to patients. With the “Hospital to Home Outreach for Malnourished Elders” (HHOME) program, patients will receive individualised planning of nutrition needs after hospital discharge by their inpatient multidisciplinary team, supported by phone follow-up from their hospital dietitian to reinforce nutritional advice, co-ordinate community-based nutrition services and re-intervene after care would traditionally cease. The program also includes greater education of health care staff involved in the care of older patients, as well as patients and carers. By comparing patients cared for with usual hospital-only dietetics care, and those under the new HHOME program, we hope to measure an improvement in patient outcomes including nutritional and functional status. We will also measure hospital use, quality of life and costs of the new model of care, to inform whether these improvements might benefit the health system by saving future use of health services.