ANZCTR search results

The purpose of this project is to improve our understanding of the mechanism by which patients with advanced Liver disease (or cirrhosis) develop common complications related to abnormalities in blood flow. These complications include bleeding from the gut (variceal bleeding), behavioural changes (hepatic encephalopathy) and fluid build-up in the abdomen (ascites). Events such as these have a significant impact on patients affected by cirrhosis leading to a deterioration in their quality of life, frequent hospital admissions and in some cases, death. The mechanism behind this abnormal blood flow that occurs in cirrhosis is so far not fully understood. Recently studies performed by our group on animal blood vessels strongly indicate that these problems arise in cirrhosis due to abnormal responses to a hormone, Angiotensin 1-7 (Ang 1-7). As of yet, studies of human blood vessel reactivity to Ang 1-7 in cirrhosis have not been carried out. We propose to perform detailed analysis of blood vessel reactivity to Ang 1-7 on approximately 16 Austin and Alfred Health patients using a technique called Forearm Plethysmography (FP). The FP study will involve insertion of a small tube (cannula) into an artery of the forearm through which Ang 1-7 and other agents will be delivered. After drugs to be studied have been administered changes in blood vessel reactivity will be assessed using a specially designed band around the forearm which records and measures changes in it’s size. Half of the patients involved in the study will have cirrhosis and will be listed for Liver transplantation. The other half will be patients not affected by Liver disease (‘the control group’). Patients with cirrhosis will be asked to return for a repeat study after they have undergone liver transplantation. This study will help us to establish the role of Ang 1-7 in human cirrhosis and may lead the way to further research and the development of available therapies. Also in this study we will evaluate a novel medical device called EndoPAT. EndoPAT is a non-invasive device used to assess the reactivity of blood vessels by applying sensor pads to the tips of the fingers. It's use has not yet been studied in a cirrhotic population where it has the potential to be used as a screening tool to predict complications of cirrhosis.

The overall goal of this project is to develop an online CBT based self-help program for children and adolescents with OCD which incorporates families and carers in the treatment plan. This will fill the current gap between psychoeducation only and high intensity face-to-face assessment and therapy. Consistent with the proposed actions of the research plan, this program will improve the support given to and build the resilience of families and carers of young people with OCD, expand community based youth mental health services, and provide an accessible and targeted treatment to those young people who do not require immediate high intensity intervention.

To compare two different treatment methods of reducing pain and recurrent episodes in individuals with recurrent corneal erosion syndrome, a syndrome characterised by pain, watering and light sensitivity due to episisodic loosening of the surface cells of the eye. The two methods are laser treatment and alcohol treatment to the surface of the eye. It is hypothesised that the two methods are comparable in their effect.

This proposed pilot study's purpose is to explore the viability of a mindfulness meditation intervention in a sample of older-adults residing in a residential aged-care home who have chronic pain. It is hypothesised that for those older adults in the intervention group, mindfulness meditation will have a beneficial effect and decrease these older-adults scores on measures of pain and depression, while also demonstrating a tendency for increased post-study scores of acceptance and awareness.

This study aims to determine whether primigravida women who are experiencing post-date pregnancy (41 weeks gestation) are more likely to experience spontaneous onset of labour using specific acupressure points than women receiving usual antenatal care only. The secondary aim is to explore the women’s experience on the care received and being randomised. For women allocated to the acupressure group,information will be collected on their compliance with intervention protocol and satisfaction with the use of acupressure. This study will add to the body of knowledge and has the potential to address the strategies and targets set by NSW Health Policy Directive Towards Normal Birth, by increasing the number of women commencing labour spontanously and reducing the rate of medical interventions (labour induction).

The technique of collagen cross-linking for keratoconus (a condition leading to thinning and protrusion of the cornea, the front clear window of the eye, leading to a reduction in vision) was introduced in Europe. It involves the use of riboflavin (vitamin B2) and ultraviolet light A, and has been shown in animal studies to strengthen the cornea. This trial was initiated to assess the effectiveness and safety of this treatment in comparison to a second group of participants who have the disease but are not given the cross-linking treatment. It runs over 5 years.

Diabetes is a multi-factorial disease, with a multi-disciplinary approach being advocated for diabetes treatment and the prevention of its complications. In Australia, diabetes is the most common cause of lower limb amputation after trauma. Diabetic foot ulcers are responsible for a substantial medical and financial burden on the Australian healthcare system with costs conservatively estimated to be as high as $45,000 per patient. Improved nutritional status and nutrition supplementation accelerate wound healing while inadequate nutrition prolongs wound healing. During wound healing non-essential amino acids, such as L-Arginine, becomes essential as it enhances a number of pathways involved in wound healing, protein metabolism, such as structural protein synthesis and collagen. Aim: To determine whether supplementation with L-Arginine will improve the healing of diabetic foot ulcers in a routine community based client education and management program conducted by medical and allied health professionals. Methods: This study is being designed as a double blinded RCT (treatment group: n=37+7, 4.5g L-arginine; control group n=19+7 placebo) for 12 weeks. Power calculations indicate 70 patients are required to provide adequate statistical power including anticipated attrition rate. The study will be conducted in a routine community based client education and management setting which includes health professionals (medical, podiatry, dietetic, diabetes educators) as part of a multi-disciplinary approach and holistic care for the client

Reviews of the literature show limited evidence for the efficacy of conservative management of patients with carpal tunnel syndrome and a lack of studies investigating the long term effects of the non-surgical management of patients with carpal tunnel syndrome. The aim of our study is to investigate the long-term efficacy of a multimodal approach comprising of manual mobilisation techniques, education and nerve and tendon gliding exercises (MEX) versus therapeutic ultrasound treatment in managing carpal tunnel syndrome. Hand splinting is included as an adjunct intervention to evaluate its influence on the 2 treatment approaches. We hypothesise that the MEX treatment approach would be superior to therapeutic ultrasound treatment in the long-term and the addition of hand splint in either treatment would improve its overall outcome.

This RCT will evaluate the acceptability and efficacy of a combined CBM + internet-based CBT program for depression by comparing an active CBM intervention with a control comparator.

The Myeloproliferative neoplasms (MPNs) have until recently been under-represented in malignant haematology research. Recent major developments in understanding MPN biology and emerging new pharmaceutical agents have resulted in MPNs being a major growth area for both basic/translational research and clinical trials. Currently there is no systematic approach to collecting data on numbers of MPN patients and the current standards of care of these patients in Australia and New Zealand. This information is vital for planning and feasibility assessments for future clinical trials. A well-constructed database will generate essential data and be a major resource for translational research, particularly if patients in the registry also consent to ALLG tissue banking. Investigators with an interest in a specific subset of MPN patients will be able to query the database for a list of such patients and their characteristics. Patients will be entered into the database either retrospectively (for certain diagnoses and some sites) or prospectively, at diagnosis, with annual follow up.