ANZCTR search results

More than 50% of patients requiring surgery for enlargement (aneurysm) of the aorta or narrowing of the carotid or limb arteries have coexistent coronary disease. Indeed, cardiac problems account for the majority of operative complications in patients undergoing vascular surgery. Individuals who have a low cardiac risk from these operations can be identified by clinical evaluation, especially if a stress test is negative. However, if a test is positive, the risk of having a cardiac complication is <20-30%. The optimal response to this finding is still unclear. In this situation, patients are often referred for bypass surgery or coronary balloon angioplasty in order to treat their coronary disease. However, this approach may be inappropriately aggressive, as 70% or more of the patients will undergo their vascular surgery uneventfully. Moreover, patients with vascular disease are often elderly, and have other diseases that make heart operations more difficult and risky than usual. An alternative is the use of medical therapy to protect the heart, but the efficacy of this approach in reducing peri-operative complications is debated. This multicentre study, based at hospitals in the mainland capital cities of Australia, will examine patients with a positive stress test, and then use the results of the test to identify high and intermediate risk levels. Patients will be excluded from the study if the stress test is strongly positive, and a heart operation is definitely in the patient's best interests. In other situations, where the best approach to therapy is unproven, patients will be randomized to a regimen involving intensive medical therapy to protect the heart, or coronary angiography with the intent of myocardial revascularization if possible. Patients will be followed up for events of the time of surgery, and outcome (including quality of life) will be assessed six months after the operation.

This is a 5-year randomised, double blind, placebo controlled study to evaluate the relative benefits of vitamin D and calcium supplementation and calcium alone compared to placebo on hip bone mineral density and bone related biochemistry in ambulant elderly Western Australian women aged 70-80 years at baseline.

This study will explore the clinical significane of interactions between commonly used herbal medicines with the anti-coagulant warfarin. In total 5 independent three- treatment cross over randomnised clinical trials will be conducted with similar study design. In each trial 2 herbs will be studied.

This research study will investigate how speech pathology treatments may work for chronic cough. Chronic cough is a common problem that can be caused by conditions such as asthma, rhinitis and reflux. In approximately 20% of people, chronic cough remains unexplained. Recently we have identified that 50% of chronic cough sufferers have Paradoxical Vocal Cord Movement or Vocal Cord Dysfunction coexisting with chronic cough. Paradoxical vocal movement or vocal cord dysfunction is a condition that results in the vocal cords closing rather than opening when you breathe in. This can cause cough or breathing problems. Paradoxical vocal cord movement can be effectively treated with speech pathology. This study will assess how speech pathology benefits chronic cough. The purpose of this study is to:- (i) To investigate the effects of various aspects of the speech pathology treatment program on cough reflex sensitivity. (ii) To compare changes in cough reflex sensitivity following single components of the speech pathology intervention e.g. voluntary control versus specific strategies. It is hypothesised that specific speech pathology treatments will decrease cough reflex hypersensitivity.

Injecting dye into the heart is a common investigation that helps diagnose coronary artery disease. Although it is known that small bubbles of air are often injected during this procedure and may enter the brain, they have been generally thought to be harmless. We plan to measure cognitive function before and after the heart is studied to see if these small bubbles alter brain function.

The CISCO (Cardiac Interventions, Surgery and Cognitive Outcome) Study is a prospective observational cohort study of the preoperative neuropsychological status of patients presenting for CA (Coronary Angiography) and the relationship of this state with cognitive outcomes following medical, PCI (Percutaneous Coronary Intervention) or CABG (Coronary Artery Bypass Graft) surgery management of their disease.

Strategies for reducing infection are vital in caring for the premature neonate, and include, the use of a topical antiseptic for skin cleansing prior to any invasive procedure that compromises the skin barrier. There is currently little research addressing the issue of what antiseptic solution is best and safest for use in this vulnerable neonatal population. Consequently a wide range of solutions are utilised within the NICU setting

The ACE (Anaesthesia Cognitive Evaluation) Study is a prospective descriptive comparison of the prevalence of MCI (Mild Cognitive Impairment) and the incidence of POCD (Post Operative Cognitive Dysfunction) in patients undergoing THR (Total Hip Replacement) for OA (Osteoarthritis) and a control group of patients who have OA (Osteoarthritis) that is managed medically.

Disability in older adults is multi-factorial, and in part related to age-related changes in exercise capacity, including muscle strength, power, and endurance. To address these multiple areas, more than one kind of exercise may be needed to optimize function. Therefore, we are testing the efficacy of a combined program of strength, power and cardiovascular fitness training on functional independence, health status, psycholgocial health and physical performance over one year.

This is a prospective, randomised study to ascertain if plaster slab immobilisation of the arm is equally acceptable to parents and patients as collar and cuff immobilisation for undisplaced supracondylar fractures (breaks) of the upper arm near the elbow. All children aged 18 months to less than 11 years, presenting to the Emergency Department who sustain this type of break of the upper arm, will be enrolled into the study and randomised to receive one of two methods of immobilisation. Parents will be asked to keep a daily diary of analgesia use, child complaints or perceived problems with the mode of immobilisation. Followup will be 2 weeks post ED presentation, at which time the slab/collar will be removed and the supracondylar fracture xrayed and reassessed. At this time a parent/patient satisfaction questionnaire will be completed. If significant tenderness and discomfort remain the arm will be immobilised again and reviewed again in 2 weeks in ED.