ANZCTR search results

An association between increased dyspnoea scores, mood disorders and anxiety levels in patients with COPD has been well established. On a neurochemical level, this association has been further explained in rat models showing that prolonged hypoxia affects the areas of the brain involved in mood control. The understanding of mechanisms of mood control by antidepressants has evolved over time. The strong antidepressant activity of Tricyclic Antidepressants (TCAs) has supported the role of both norepinephrine and serotonin (5-HT) in mood disorders. The next generation of antidepressants included the Selective Serotonin Reuptake Inhibitos (SSRIs), further supporting the role of serotonin. Furthermore, antidepressants have been hypothesised to work in COPD patients by decreasing autonomic over-activity, or detaching excessive distress associated with COPD, thus enabling patients to better endure increased physical activity and physiological changes. Hence, our hypothesis is that subjects recruited from public hospitals with COPD and clinically significant depression and/or anxiety that are given paroxetine 20 mgs daily for 4 months will: (Hypothesis 1: principle hypothesis): have a significant reduction in their anxiety symptoms as compared with the placebo at 4 months follow-up, and; (Hypothesis 2): these improved levels of anxiety will be associated with: improved quality of life and exercise capacity, and (Hypothesis 3): these improved levels of anxiety will be associated with: a.) a reduction in hospital bed utilisation, and; b.) a reduction in health care costs in relation to existing practice in long term (12 months)

People with type 2 diabetes are at increased risk of developing arterial disease. Arteries stiffen with advancing age and this process is exacerbated in type 2 diabetes and other risk factors for heart disease. Increasing stiffness of arteries in the brain may impede regional blood flow, thus impairing brain function; those with poor mental abilities appear to have stiffer blood vessels in the brain compared to healthy individuals. This may account for the increased prevalence of cognitive decline associated with type 2 diabetes. However, no studies have yet investigated whether arterial function in the brain is related to the mental abilities of adults with type 2 diabetes. This project will be the first of its kind to evaluate whether artery stiffness in the brain and biomarkers of insulin resistance and type 2 diabetes are indicators of impaired mental abilities, such as attention, concentration and memory. The introduction transcranial Doppler ultrasound (TCD) enables us to readily assess the pulsatility of blood flow in the middle cerebral artery, a measure of arterial stiffness in the brain. Moreover, we will also measure cerebrovascular responsiveness (CVR), i.e. the ability of blood vessels in brain regions to dilate in response to psychological stimuli. Thus, at the same time as evaluating the cognitive abilities of people with type 2 diabetes, we can assess the ability of their arteries to supply more blood to the brain during the mental tests. We will compare these capabilities in type 2 diabetes with age and gender matched healthy controls. We will also examine their relationship to indicators of the severity of diabetes, viz. insulin resistance and glycated haemoglobin. We hypothesise that a) cerebral blood flow pulsatility will be higher and CVR to cognitive stimuli will be lower in type 2 diabetes patients than in healthy controls; b) both measures will correlate with the severity of insulin resistance/diabetes and the extent of cognitive decline. The results will indicate the extent to which impaired artery function in the brain is a potential risk factor for decline in mental abilities in type 2 diabetes and will help us to devise early intervention strategies to prevent future loss of mental abilities in this at-risk population.

The aim of the project is to trial the use of a computerized psychological treatment for problematic cannabis use in Early Psychosis. Cannabis use is associated with an increased risk of psychosis and cannabis use is high in people presenting for treatment of first episode psychosis (FEP). Cannabis use is also associated with high relapse rates in FEP. Therefore, it is vital that Early Psychosis Treatment Centers (EPTC) address cannabis use. This project aims to trial the SHADE computerized treatment package among an FEP sample presenting to an EPTC at Bondi Junction Community Mental Health Centre and Campbelltown Community Mental Health Centre, to determine whether the addition of this resource is effective in reducing cannabis use over the treatment period.

The study aims to provide proof-of-concept support for the use of botulinum toxin in difficult-to-treat asthma with vocal cord dysfunction.

The purpose of this study is to determine if a telephone call 2 weeks prior to colonoscopy procedure improves patient understanding of the risks of colonscopy.

This study will investigate the effects of a workplace exercise intervention on cardiovascular disease risk, physical fitness and psychological health in adults aged 18-65 years working within an academic institution. It is hypothesised that adherence to a regular exercise program will result in decreased cardiovascular disease risk and increase physical fitness and psychological health.

This project aims to increase the accessibility of an innovative, evidence-based psychological treatment (Healthy Lifestyles Treatment) for reducing tobacco use, improving cardiovascular and mental health among tobacco smokers with depression, psychosis, or neither of these conditions, by translating it to internet-based delivery (iHeLP) and running a small-scale pilot study of the efficacy of this mode of delivery of treatment.

The National Health and Medical Research council’s Guideline for non-surgical management of Hip and Knee Osteoarthritis includes recommendations for the use of quadriceps strengthening specifically, and resistance training more generally. However, further research is needed to best identify what exercise prescription has maximal benefit. Individuals with late stage osteoarthritis have been shown the preferentially activate the muscles more laterally when compared with healthy individuals. The aim of this study is to identify which clinical exercises cause a more balanced activation between the medial and lateral muscles of the lower limb. The results of this study may help give better understanding into roles of specific muscles in knee osteoarthritis patients, in ways to better distribution load, thereby, assisting practitioners in prescribing efficient exercises in treating symptoms and preventing knee osteoarthritis. It is expected that modified clinical exercises will result in a more balanced, or more medial activation of the muscles crossing the knee

The aim of this study is to investigate the effects of three commonly used treatments for managing heel pain. It is anticipated that more customized interventions will be more effective in reducing pain.

Catheter ablation of atrial fibrillation (AF) has evolved as an effective therapy for drug-refractory AF, and the indications have broadened in recent years. Despite decreased procedural times, reduced complication rates, post-ablation freedom from AF has not improved proportionately in recent years. Metabolic syndrome (MS) and its components, including obesity, hypertension, diabetes, and dyslipidemia in conjunction with obstructive sleep apnoea, excessive alcohol intake and smoking has been associated with increased incidence of AF. However, the impact of modifications of these risk factors on recurrence of AF after catheter ablation is unclear and has not been tested prospectively. Also, these patients are typically not included in risk-factor reduction programs. The purpose of the study is to evaluate the impact of a structured weight managment program as part of the management of atrial fibrillation. It is also intended to assess the effect of weight reduction on the efficacy of atrial fibrillation following catheter ablation and the effect of weight and risk factor management on autonomic tone/pro-arrhythmic substrate.