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Stretching exercises are commonly prescribed by healthcare professionals in treating musculoskeletal conditions of the foot. This comparison study aims to find out how dry needling can affect the effectiveness of stretching exercises in treating heel pain. The treatment of dry needling plus a stretching exercise program will be compared against a stretching exercise program only in this study. Participant satisfaction and the degree of calf muscle relaxation will be compared between the two treatment groups.

This study aims to assess whether the use of a 'retroflexion' technique improves adenoma (tumour) detection in the right colon. Who is it for? You may be eligible to join this study if you are aged 18 years or above and are scheduled to undergo a complete colonoscopy. Trial details All participants in this trial will undergo a single colonoscopy which includes a technique known as 'retroflexion' in the right colon. This is standard practice for many endoscopists. The procedure duration is approximately 20 minutes with retroflexion only adding an extra 1-2mins to the total procedure time. Adenoma detection rate from the standard forward view assessment will be compared to that from retroflexion. It is thought that retroflexion may improve the detection of polyps behind folds that may not be seen on standard forward view.

This study will evaluate the safety and tolerability of combining the 3 drugs, vinorelbine, cyclophosphamide, and Rapamycin, in children with recurrent/refractory malignant disease. Who is it for? You (or your child) may be eligible to join this study if you/they are aged less than 22 years of age and have been diagnosed with any of the following solid tumours/malignancies: all brain tumours, Rhabdomyosarcoma, Soft tissue sarcomas, Osteogenic sarcoma, Ewing sarcoma, Neuroblastoma, Wilms’ tumour. The disease must have either relapsed or not responded to initial therapy. Trial details All participants in this trial will undergo treatment with a combination of the three drugs vinorelbine, cyclophosphamide, and rapamycin. Cyclophosphamide is administered one per day orally, rapamycin is administered twice per day orally, and vinorelbine will be administered on days 1, 8 and 15 of each 28 day cycle intravenously (i.e. into the vein). This cycle will be repeated every 28 days. If the initial dose level is tolerated by patients, then it will be increased for the next patient group in order to determine the optimum dose combination for both heavily pre-treated and less heavily pre-treated participants. In addition to evaluating the toxicity of this drug regimen and determining a dosage range, the potential efficacy of the regimen will be assessed. All participants will be regularly monitored and assessed for a period of up to 5 years in order to evaluate the safety and tolerability of this treatment.

The aim of this study is to investigate the different impact of slow versus fast injection of the anti-VEGF agent, ranibizumab, which is the treatment participants are receiving for the treatment of age-related macular degeneration (AMD). The study will run for 4 months and involve 2 study visits. Participants will receive the intravitreal injection that they are already receiving for AMD. The IOP will be measured before the injection, 2 minutes after the injection and 15 minutes after the injection. Study participants will be randomly assigned to two groups (group A and group B). Participants assigned to group A will receive their intravitreal injection as a quick push in the first visit and slowly (over 3-4 seconds) in the second visit. Participants assigned to group B will receive the opposite allocation. The two injections will be given 4-12 weeks apart according to the scheduled treatment for the participants AMD.

This study is a single-center, prospective, open-label, safety/efficacy study enrolling up to 10 patients. Safety and efficacy are the primary objectives based on analysis of reported and observed adverse events and the WOMAC validated OA questionnaire (pain component). A series of validated subject-completed questionnaires, a visual analogue scale for pain and formal orthopaedic examination, will be performed over the course of the 60 months at the following intervals: baseline, 6 weeks, 3 months, 6, 12, 18, 24, 36, 48 and 60 months. X-ray data will be collected pre-operatively and the following post operative intervals 3, 6, 12, and 24 months.

This project is designed to improve the skills of aged care staff in responding to mental health concerns, and to develop sustainable mental health management protocols within aged care facilities. The research project will assist us to assess the impact of a staff training program that aims to help staff to better detect and manage depression and the challenging behaviours associated with dementia. Hypothesis: Targeting core organisational barriers and staff screening skills to the provision of mental health care will improve implementation of strategies to better manage both depression and BPSD among older adults in aged care.

This is a prospective, single-centre study of adalimumab in participants with severe chronic plaque psoriasis and eligible for biologic treatment as per Australian Pharmaceutical benefits Scheme (PBS) criteria. We hope this study confirms our hypothesis that patients treated with adalimumab for a 12 weeks period will have improved endothelial function compared to pre-treatment score.

Diabetic patients are at a particularly high risk for poor wound healing in general and foot ulcer in particular. The lifetime risk for developing chronic foot ulcer has been estimated to reach about 15-20% (1). Despite considerable advances in diabetic care, foot ulcers continue to be responsible for a high number of lower limb amputations that are associated with decrease in quality of life and increased risk of mortality (2). The major risk factors for diabetic foot ulcer (DFU) are polyneuropathy and peripheral vascular disease. Diabetes induces complex vascular changes, promoting accelerated atherosclerosis and hypercoagulability complicating foot ulcer which can be assessed indirectly by a number of inflammatory markers. Animal studies have suggested numerous beneficial anti-inflammatory effects of dipeptidyl peptidase-4 inhibitors (DPP4i), well beyond the effects on blood glucose alone (3). Interestingly, investigation on anti-inflammatory property of DPP4i-vildagliptin in human setting is scanty (4). Treatment with a DPP4i may offer an attractive blood glucose reduction with synergistic mechanism of action while exerting additional wound healing properties. Reduction of inflammatory marker levels is of great clinical importance and may correlate with improvement of diabetic wound healing. Therefore, in the present study we plan to focus on possible anti inflammatory properties of DPP4i in subjects with DFU. Primary objective: To demonstrate that Vildagliptin therapy is associated with clinically significant reduction in biological markers of inflammation compared to placebo in patients with DFU. Our Primary aim is demonstration of a significant (= 20%) reduction in the serum levels of interleukin 6 (IL-6). Secondary objectives: Partial or complete closure of foot ulcer or improvement in other biological markers of inflammation including: hs-CRP, platelet reactivity testing, TNF-alpha, interleukin 1 beta (IL-1 beta), adiponectin and tissue TGF- beta-1 levels. References 1. Lavery LA, et al. Diabetes Care. 2006:1288. 2. Singh N, et al. JAMA 2005: 293:217. 3. Shah Z, et al. Circulation. 2011: 124:2338. 4. Rizzo MR, et al. Diabetes Care. 2012: 35:2076.

There is now consistent and convincing evidence that dietary inorganic nitrate plays an important role in the physiological control of blood pressure. Clinical trials have established that an increase in nitrate intake, either from supplements or vegetables, results in a dose-related decrease in blood pressure in healthy normotensive individuals. This trial will address the importance of nitrate reduction by bacteria in the mouth for the control of level of blood pressure in treated hypertensive individuals.

Post-operative nausea and vomiting (PONV) are unwanted complications following anaesthesia and surgery. The occurrence of PONV ranges from 20% to 80%, despite optimal pharmacologic interventions. The burden of caring for patients post cardiac surgery in healthcare system world-wide is immense. In 2009-2010, In Australia alone, over 230,000 cardiac procedures were performed, and the number and rate of cardiac procedures are increasing. Similar to many countries world-wide, cardiovascular disease (CVD) remains the most expensive disease group in Australia, costing about $5.9 billion in 2004–05 with just over half of this money spent on patients admitted to hospital. As part of their illness treatment and recovery, cardiac surgery patients experience varying rates of PONV; studies across various populations have reported rates ranging from 22% to 50%.