ANZCTR search results

In the last 5-10 years there have been major advances in the technology and knowledge of assisited reproductive technology treatments. These include improved media and control of the environment for culturing human embryos. As a result there have been significant improvements in pregnancy rates and a significant increase in the transfer of a single embryo, to prevent the complications associated with multiple pregnancy. Historically, pregnancy rates have increased with greater numbers of eggs collected. Therefore superovulation procedures designed to enable the collection of 10-15 eggs per IVF cycle were a required part of the treatment strategy. However, with the recent advances of improved embryology techniques and pregnancy rates the requirement for a large number of eggs to be collected from young women has reduced. Modelling from our own laboratory has shown that pregnancy rates in young women plateau at 3-4 eggs. Therefore in this group of women production of more than four eggs in a stimulated cycle does not increase pregnancy rates but are associated with the risk of complications such as ovarian hyperstimulation syndrome (OHSS) (Reviewed in Verberg et al., 2009). Futhermore, there is increasing evidence in both animal models and also in the human that there are increased benefits of low dose stimulation. High doses of stimulation are associated with increased rates of poor quality oocytes and embryos (Valbuena et al., 2001) and have been reported to affect endometrial competence as well as reportedly increasing the incidence of aneuploidy (Baart et al. 2007). As a result of this new information, there has been the development of a more physiological style of ovarian stimulation in IVF for good prognosis patients, involving very low dose stimulation coupled with high quality embryology. These protocols are designed to produce a small number of eggs (aim 3-4 eggs) which can be fertilised, cultured and the best embryo transferred. As the literature presents such diverse findings we are initiating a pilot case-matched study to establish the efficacy of and patient feedback of tolerance to minimal stimulation regimes in an IVF cycle. Therefore, this pilot study is designed to assess the outcome of a low dose minimal stimulation treatment regime in a selected group of women undergoing IVF treatment.An interim analysis will be conducted after 10 cycles and if significant problems are identified, or average oocyte retrieval rates are below 2 eggs, the study will be abandoned at that point.

The key hole gall bladder surgery is one of the commonest surgery performed. there are various methods used for pain relief after the surgery.Traditionally local anaesthetics is injected into the wounds.Recently by ultrsound guidance local anaesthetics were injected into the abdonminal planes (transverses abdominis plane).The nerves supply the the entire abdominal wall. Recent trials did show they benefit in abdominal surgery. So far only one trial compared these two methods.The purpose of this trial is to find out which one of them did better in regards to pain releief. Also patient satisfaction score may reveal which of these methods were acceptable

It is believed that physiotherapists in Australia use the Bottle/Bubble PEP device to treat patients that have secretion clearance problems. It is unknown though to what extent it is used or the rationale behind its use. This questionnaire will assist in answering these questions at it will be sent to a representative sample of physiotherapists working in hospitals within Australia.

To compare the effects of adding rosuvastatin to switching of ritonavir-boosted protease inhibitor on total cholesterol levels in HIV-infected adults with increased cardiovascular risk profiles over a 12-week period.

The overall purpose of the final study is to undertake a randomised control trial to test the efficacy of an internet delivered physical activity intervention for individuals with Type II diabetes. The randomised control trial will consist of two groups, an intervention and control group. As previously described the intervention group will receive access to all aspects of the internet intervention, whereas, the control group will only be able to access a static web page containing links to external diabetes websites. Specifically, the following hypothesis will be tested: Hypothesis One: It is hypothesised that participants in both groups will report increases in physical activity behaviour, quality of life, physical activity intentions, subjective norms, attitudes and perceived behavioural control at 12 weeks; a) It is hypothesised that participants in the intervention group will report significantly greater improvements in physical activity behaviour than the control group; b) It is hypothesised that participants in the intervention group will report significantly greater improvements in their perception of quality of life than the control group; c) It is hypothesised that participants in the intervention group will report significantly greater improvements in physical activity intentions, subjective norms, attitudes and perceived behavioural control than the control group; Hypothesis Two: It is hypothesised that individuals in the intervention group will record significantly greater logins in comparison to the control group at the completion of the intervention period. The combined outcome will provide a better understanding of the effectiveness of internet delivered physical activity behaviour change programs for secondary prevention of chronic diseases. Secondary aims are to explore factors within internet delivered programs which influence website usage in terms of engagement.

Age-related macular degeneration (AMD) is a common cause of visual loss in older people, and currently treatment options for dry AMD are limited. This study will investigate whether saffron supplements are an effective treatment for dry AMD.

There are no standard approaches to treat haematological malignancies that relapse after allogeneic HPCT. This trial aims to evaluate the safety and efficacy of treatment with the anti-viral drug, Peg-Interferon, in patients with relapsed haematological malignancy after allogeneic haematopoietic progenitor cell transplantation (HPCT). Who is it for? You may be eligible to join this study if you are aged between 18 and 65 years old. Trial details Patients will initially have their immunosuppression withdrawn, and in the presence of frank haematological relapse, also undertake FLAG induction chemotherapy as a platform to provide both short-term disease control as well as lymphodepletion. In the absence of development of subsequent GVHD, Peg-Interferon will commence at a dose of 45mcg subcutaneouly once per week, with weekly escalation of dose to 90mcg, then 135mcg then 180mcg if tolerated. Patients will then continue peg-IFN as “maintenance” at 180mcg weekly for a total of 6 months (calculated from first dose of peg-IFN) if able. If after achieving maximal doses of pegylated-IFN (180mcg/week) significant GVHD has not developed, depending on donor availability, patients will also be eligible to commence donor lymphocyte infusions (DLI) whilst continuing pegylated-IFN. This approach will (i) permit the use of chemotherapy without the induction of severe GVHD that is seen in the majority of patients that receive a second stem cell graft (ii) whilst permitting peg-IFN to be delivered to the majority of recipients and (iii) allowing DLI to be administered thereafter to poor responders. Participants will be assessed at 2 years following enrolment to determine how they responded to this treatment.

The purpose of this study is to investigate the efficacy of lithium as an adjunctive therapy to combined antiretroviral therapy in alleviating HIV associated neurocognitive impairment. We are also investigating whether lithium protects against brain changes that have also been observed in HIV associated neurocognitive impairment.

This study aims to determine whether adding the drug, Tocilizumab, to standard transplant immunosuppression is safe and effective at preventing acute graft versus host disease (GVHD). Who is it for? You may be eligible to join this study if you are aged between 18 and 65 years of age and are undertaking an HLA-matched allogeneic haematopoietic cell transplantation (HPCT). Trial details All participants in this trial will receive a single dose of 8mg/kg Tocilizumab by a 60 minute intravenous infusion (administered via the vein). This will occur one day before your HPCT. Participants will be assessed for up to 2 years to determine the incidence of GVHD.

In recent years there has been a national decline in smoking rates however, this reduction is least evident among the most disadvantaged sector of the Australian population. This is mainly attributable to lower levels of quit success among disadvantaged groups rather than differences in quit intentions or attempts. Recent research has shown that financial stress is a major barrier to sustained smoking cessation among socioeconomically disadvantaged smokers, even after controlling for nicotine addiction, psychological stress, and use of cessation counselling and pharmacotherapies. The aim of this project is to test an innovative approach to improving smoking cessation outcomes among low socioeconomic status (SES) smokers by providing financial counselling to reduce the financial stress experienced by disadvantaged smokers making quit attempts. This will be achieved by conducting a randomised controlled trial comparing cessation rates between low SES smokers who receive subsidised nicotine replacement therapy (NRT) with a Quitline call-back with those who receive subsidised NRT and Quitline call-back plus financial counselling. Smoking outcomes will be assessed at 2 and 6 months post-intervention. The results from this project will provide valuable information on the efficacy of targeted interventions for socioeconomically disadvantaged smokers.