ANZCTR search results

Stroke is currently the second highest cause of death in Australia and a leading source of disability (National Stroke Foundation, 2010). Some strokes are caused by a blockage in a blood vessel within the brain. Evidence suggests that thrombolysis (i.e., administering a drug to dissolve the blockage) shortly after a stroke may reduce some of the neurological damage (Wardlaw, Murray, Berge, & del Zoppo, 2009; Williams et al., 2009). One such drug is called recombinant tissue plasminogen activator (rt-PA). Very little is known about the effects of rt-PA on the recovery of communication or swallowing function. This has significant implications for patient rehabilitation, as it is unknown whether patients who receive rt-PA will respond differently to traditional behavioural rehabilitation methods post-stroke or improve at different rates. It is also unknown whether the effects of rt-PA on post-stroke recovery differ according to stroke location. As a result, the proposed study will investigate the effects of thrombolysis on the recovery of communication and swallowing function after stroke. Increasing our knowledge in this area will assist in the development of effective patient rehabilitation programs to maximise quality of life post-stroke. Aims The overall aim of the project is to investigate the effects of thrombolysis on the recovery of communication and swallowing function after ischaemic stroke. Specifically, the project will investigate whether patients who receive rt-PA following an ischaemic stroke differ from patients who do not receive the drug with respect to language, speech and swallowing function. The project will also investigate whether these communication and swallowing recovery patterns differ following rt-PA over the first 6 months post-stroke. Finally, given the difference in communication disorders resulting from stroke location, the study will investigate whether there is a difference in the effects of rt-PA on communication and swallowing outcomes according to whether patients experienced a left or right sided stroke.

Heart failure is a condition cause by heart muscle weakness. As a result the circulation to the body becomes inefficient and blood flow tends to fall. We are studying whether a simple medicine which is used in other settings can improve blood flow and thus outcomes for patients admitted to hospital with heart failure.

The specific aim of this study is to determine whether methylphenidate significantly reduces deficits in attention and/or executive function in children with NF1. This study also aims to establish whether MPH reduces ADHD related behaviours in neurofibromatosis. It is hypothesised that methylphenidate will improve attention and executive function deficits in children with NF1 and reduce the ADHD like behavioural characteristics in children with NF1.

Although most patients with different blood cancers and solid tumours present with clotting, there is little known about how many patients develop these complications and what risk factors are involved. This study will investigate all patients with cancer and develop blood clots at adult age group who are treated at the Launceston General Hospital for their cancer. The data of the trial will help us enormously to understand and know the risk factors for developing clots among this high-risk group of patients. This trial has the potential to change the treatment approach and the preventive strategies for cancer patients at all ages to improve outcome and benefit all patients avoiding serious complications of treatment of cancer. This trial may able to change the current protocols for prevention of clots during the treatment of oncology patients by applying the best preventive strategy against blood clotting. We are aiming to publish these data and the trial results in adequate international peer reviewed medical journal.

The aim of this randomised controlled trial is to investigate the efficacy of ear-acupressure for smoking cessation, and the effect of ear-acupressure on nicotine withdrawal symptoms. Ear-acupressure is like acupuncture but no needles are used, instead, small round pellets are taped to points on one ear. The study consists of a two week run-in, followed by eight weeks of weekly visits and 12 weeks of follow-up.

The data in this study offer evidence for the value of the referral writer, a computerised, interactive pro forma in improving the utility of referral letters when patients are referred for a specialist opinionby general practitioners. Comprehensive referral letters, based on the evidence for the predictive value of various elements of the history and examination have a significant value in ensuring that the patient is seen by the right specialist at the right time.

A well functioning short-term dialysis catheter (STDC) is of paramount importance in establishing a sufficient, reliable blood flow necessary for the delivery of adequate dialysis during continuous renal replacement therapy (CRRT). The optimal position for the proximal opening of a STDC in critically ill patients with acute kidney injury (AKI) is not well studied and remains controversial. Placing the proximal tip of a STDC in right atrium (RA) may improve blood flow through the STDC and CRRT circuit by reducing the impedance caused by collapsing great thoracic vein (GTV) vessel walls against the STDC when placing the tip of the catheter in the superior vena cava (SVC). Improving blood flow through the CRRT circuit may, in turn, improve dialyser lifespan, dialysis dose delivery, reduced blood loss and thus reduce the costs and nursing workload from setting up of new CRRT circuits. At the centre of this debate is the safety of positioning the proximal tip of a STDC in the RA. When utilizing the GTV, either internal jugular or subclavian vein, for central vascular access, traditional teaching is to avoid placing the tip of the central venous catheter (CVC) in the RA to reduce the risk of atrial arrhythmia, RA wall perforation and cardiac tamponade. Recent evidence, however, suggests that it is the techniques of CVC insertion that are more important than the position of the tip of the CVC in determining the subsequent risk of atrial perforation and cardiac tamponade. Furthermore, it is common practice for long-term tunnelled dialysis catheters to be placed in the RA for improved flow with reports of atrial perforation and cardiac tamponade from such practices being exceeding rare. We hypothesized that placing a soft silicone STDC in the RA is safe, may prolong dialyser circuit lifespan, and improve dialysis intensity delivery of CRRT when compared to placing the proximal tip of the STDC within the SVC in critically ill patients with AKI requiring CRRT.

High levels of Vitamin B12 deficiency were recently found in some refugee groups in studies in Australia and USA (Benson, 2010; CDC, 2011). The cause of the deficiency is unknown but is thought to be due to dietary deficiency in animal source foods or because of infection with helicobacter pylori. There is a well-known relationship of Vitamin B12 deficiency with depression and other problems such as fatigue, irritability, memory problems and unusual sensations in legs and feet (Oh, 2003). These symptoms are often used as indicators of Vitamin B12 deficiency however there have been no studies to date to determine if these are reliable indictors, or whether they are present in all refugees with Vitamin B12 deficiency. Many refugees have psychological problems, (Steel, 2009) as well as fatigue, irritability, dizziness and memory difficulties, but it is unknown whether these symptoms may also be linked to Vitamin B12 deficiency in this population. As refugees settle into a new country their diet and psychological health is likely to change. A control group will assist in adjusting for confounding factors. This pilot study aims to identify: 1. whether symptoms such as fatigue, irritability, memory difficulties, unusual sensations in legs and feet and psychological distress are reliable indictors of Vitamin B12 deficiency in newly arrived refugees 2. whether these symptoms change as Vitamin B12 deficiency normalises 3. whether there is a difference in symptomatology and perceptions of general health in newly arrived refugees with and without Vitamin B12 deficiency.

This study is designed to investigate whether the addition of an extra treatment improves low back pain, compared to standard physiotherapy treatment. The extra treatment consists of gentle manipulation of the organs of the chest, abdomen and pelvis.

The 16-week observational study aims to explore the efficacy and safety outcomes of naturalistic Naturopathic treatment of people with depression or anxiety. The observational study aims to collect data from over 200 people clients of Naturopaths in Australia within 18 months. The primary aims of the study are to evaluate the efficacy and safety of Australian Naturopathy and Medical Herbalism on the outcome of depressed mood and anxiety, assess which interventions are being prescribed, and to explore client’s experiences of being treated by a Naturopath.