ANZCTR search results

The current process for diagnosing heart attack (acute myocardial infarction; AMI) is to take multiple blood tests to measure cardiac troponin. The current definition for AMI requires troponin levels to be elevated (greater than the 99th percentile of a reference population) and to display a rising or falling pattern. However, this definition remains controversial as there is no clearly defined, evidence based data for how much the troponin level should change. We aim to identify what change in troponin value (percentage increase in troponin) has the greatest diagnostic accuracy for diagnosis of AMI. We will focus on the change in combination with the 99th percentile decision limit, at 0-2 hours and 0-6 hours after presentation using the Beckman Coulter Access AccuTnI assay.

The purpose of this study is to prospectively evaluate the benefits of frequent AV/PV and V-V delay optimisation using QuickOpt in patients iwth CRT-D devices

The rates of overweight and obesity are increasing in large numbers in many countries over the past 2 decades. Along with that, we are seeing increasing numbers of people with related health problems including high blood pressure, problems with cholesterol, and elevated blood sugar levels. These factors are a constellation which together are called the metabolic syndrome, and which give people a higher risk of developing diabetes and cardiovascular disease in the future. We wish to study people with metabolic syndrome to discover how these problems resolve with different degrees of weight loss. We also seek to understand better the relationship between gut hormones, obesity, inflammation within fatty tissue and the hormones and proteins fat cells secrete, and their effect on the factors of the metabolic syndrome.

Recent evidence shows an ethnic variability in tolerance of anticancer drugs between Asian and Caucasian breast cancer patients. Pharmacogenetic differences in drug metabolising enzymes have been proposed as the cause of these differences, however they have not been associated with altered cytotoxic drug pharmacokinetics (PK). Other possible explanations include differences in dietary/concomitant medicine intake and inflammatory status. The aim of this study was to investigate inter-ethnic differences in cytotoxic drug metabolism, inflammatory/nutritional status, genotype and outcomes between Asian and Caucasian breast cancer patients.

To determine if low level laser stimulation of acupunctrure points in a course of 8 weekly trearments is effective in relieving pain and disability in patients with chronic low back pain .

The purpose of the study is to 1/ Identify the population of patients selected by physicians to be implanted with a SJM ICD featuring the ST segment monitoring feature. 2/ Document the incidence of ST segment shifts, symptomatic or not, in that population and their possible relationships with clinical events. 3/ Document the change in patient management related to availability of device diagnostics.

Healthy reproductive function is essential for conception and pregnancy. We have discovered that male seminal fluid can influence the female reproductive system after coitus. This project will define the actions of seminal fluid in the cervix and uterus, and the impact on fertility and defence against sexually transmitted infection. The findings will provide new insight on how men contribute to reproductive health in women, and lead to improved treatments for infertility and miscarriage. On the basis of our extensive studies on the female response to seminal fluid in animal models, and observations to date in human tissues, we hypothesise that in women, male seminal fluid interacts with epithelial cells lining the cervix and endometrium to activate a similar but distinct inflammatory cytokine response in both tissues.

The aim of the study is to evaluate the ability of various physiological and inflammatory markers to predict changes in asthma control following changes in the dose of combination therapy. The direction and magnitude of the dose changes are determined for each patient by their baseline level of asthma control. If the baseline variables, either alone or in combination, can predict future benefit or risk from change in treatment then the study will provide new insights into the clinical management of asthma.

Chest pain is one of the most common reasons for presentation to Australian emergency departments. Despite this little is known about the safety of our current practice, which often involves patients spending many hours in an Emergency department awaiting repeated blood tests and electrocardiograms. Recent introduction of a latest generation super-sensistive troponin to our laboratory combined with an interest in an accelerated 'multimarker stratgey' already in widespread use throughout the UK and the USA (that back in 2006 was ranked as having the same level of evidence as our current practice by the American college of Emergency Physicians) and a desire to increase efficiency we have redesigned the way our department manages patients presenting with non-traumatic chest pain that allows us to confidently discharge patients as soon as 4 hours after the onset of their symptoms. This trial is intended to compare the efficacy and safety of this new process, when compared to the old process.