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The study will address two important questions. We anticipate that the results of this study will assist us with the clinical management of Victorian Respiratory Support Service patients with Obesity Hypoventilation Syndrome. In addition, we are leading the planning of a multi-centre RCT of non-invasive ventilation treatment in Obesity Hypoventilation Syndrome. Data from the current project will assist with the design of that application (for submission next year to the NHMRC) in terms of sample size estimations, feasibility and the provision of pilot data.

Abnormal tracking of the patella during knee joint movement, associated with imbalance of the pull of the inner quadriceps muscle (VM) and the outer quadriceps muscles (VL), has been proposed as a primary factor in anterior knee pain. Botulinum toxin (BTXA) can be used to reduce the relative overactivity in the VL muscle in addition to an exercise programme to strengthen the VM muscle in subjects with chronic anterior knee pain who had failed conservative management. We hypothesise that the combination of these therapies (BTXA and specific exercise for VM muscle control) has the potential to facilitate restoration of normal patello-femoral joint mechanics, particularly by restoring timing of onset of the VM muscle compared with VL, and consequently to reduce anterior knee pain and associated disability.

Lateral epicondylitis is a disabling condition that is associated with pain over the outside of the elbow joint and weakness during gripping activities. It is due to and abnormal repair response to repetitive microtrauma, most commonly involving the attachment of the Extensor Carpi Radialis Brevis (ECRB) tendon to the lateral epicondyle of the elbow.This pilot study is investigating the use of botulinum toxin injection to induce selective weakness of the ECRB muscle in order to provide an environment where normal healing of microscopic tears can take place, resulting in relief of pain and decreased disability.

The bacteria pneumococcus (also known as Streptococcus pneumoniae) is the most common cause of pneumonia in the community, and a major cause of illness and death in people with low immunity; it can particularly be a problem after allogeneic bone marrow transplantation, which results in impaired immunity. Patients who receive grafts from an unrelated donor are particularly at risk. This infection can be prevented by vaccination. In fact, the National Health and Medical Research Council (NHMRC) of Australia recommend that all people with impaired immunity, including those who have had an allogeneic bone marrow transplant, should be vaccinated. The vaccine that has been used for many years is called the polysaccharide pneumococcal vaccine or PPV for short. This vaccine has been available for a long time in Australia, but unfortunately it is known to be less effective in people with impaired immune systems. The PPV vaccine had the same problem in young children, and so a new vaccine was developed for children. This new pneumococcal vaccine is called conjugate pneumococcal vaccine, or PCV-7, and has been available since the end of 2000 but only used in children, as it was developed for children and has not been extensively tested in adults. This vaccine uses different technology, and is much more effective in young children than the old vaccine. Clinical trials of PCV-7 have largely been limited to children under 5 years of age and have shown it protects 93.9% of children under 2 years of age against serious pneumococcal infections. This new vaccine is routinely used in Australian children now, and is quite safe. Our study aims to compare two versus three doses of this new vaccine (PCV-7), followed by the old vaccine (PPV) to further boost immunity, in people who are going to have an allogeneic bone marrow transplant. Patients who have not previously received pneumococcal vaccine will be randomly allocated to receive either two or three doses of PCV-7, followed by PPV. PATIENT INFORMATION SHEET. STUDY TITLE: The immunogenicity of 7-valent pneumococcal conjugate vaccine (PCV-7) in allogeneic bone marrow transplant recipients We will also ask a group of patients who had a allogeneic bone marrow transplant over 12 months ago, who return for PPV vaccination as part of their routine care, if we can test their blood, as well as take a nose and throat swab, before and after vaccination. The immune response in this group will be tested as a comparison to the two schedules of the new vaccine. In this study, we will compare their immune response (as measured by antibodies in the blood) to two and three doses of the new vaccines, and to PPV alone. We will also look at whether immunity is improved by boosting with the old vaccine at the end. If the new vaccine offers better protection, this has implications for the development and use of the new pneumococcal vaccines for patients who have had allogeneic bone marrow transplants.

This study plans to measure mild difficulties in thinking (also known as cognitive impairment) in patients undergoing a coronary angiogram (which is an investigation using x-rays to look at the blood vessels in the heart). It will take measurements of thinking ability before and after the test to see if having the test leads to any changes in thinking ability. We will also ask about health problems related to heart disease such as high blood pressure and smoking.Patients who have heart disease are more likely to have problems with thinking compared with other people of similar age. Studies have also shown that having an angiogram may result in the release into the bloodstream of small particles which may be carried to the brain, potentially worsening thinking ability.We plan to ask 50 patients to participate. We will ask patients who are aged 65 years or older whose doctor has recommended that they have an angiogram,. We will use a computer test called Cogstate to test patients before and after the procedure. The computer tests have been shown to be easy and quick - just like playing a computer game. The testing will take 15 min or so and is done while the patients are waiting for the angiogram to be done. The tests will also be done a week after the angiogram to see if there is any change in thinking ability that may have been caused by the angiogram.

Anaesthesia for Caesarean Section is most often performed by an injection of intra-thecal (spinal) or epidural local anaesthetic. This wears after 2-4 hours after which pain needs to be controlled with other agents. The principal class of drugs used for this analgesia are the opioid drugs (eg. oxycodone, codeine or morphine), all of which cause side effects such as nausea, vomiting, itch and sedation. Bilateral ilio-inguinal blocks (superficial injections on each side of the abdominal wall) have been shown to be effective after general anaesthetic in reducing opioid requirements after Caesarean Section. They are also used routinely for procedures such as inguinal hernia repair. We propose to recruit 120 patients undergoing elective Caesarean Section and randomise them to receive ilio-inguinal blocks with either ropivacaine (a long acting local anaesthetic) or saline (placebo). Those who receive placebo blocks will be given subcutaneous morphine at the end of the procedure (the current standard care). We will review patients at 6 and 24 hours seeking a decrease in pain scores, opioid requirements and opioid side effects.

This study is for patients who have newly diagnosed myeloma to check how effective and safe is velcade.