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Patients who are receiving invasive mechanical ventilation treatment are often prescribed a combination of medications to help keep them calm (sedated), and also to remove pain and discomfort. Two commonly used drugs to relieve discomfort are morphine and fentanyl. These are part of the narcotic group of drugs. Currently, either of these agents is prescribed to many thousands of patients in intensive care units in Australia and New Zealand every year. This study will aim to establish which of these two medications that are commonly used for pain relief and sedation in patients receiving treatment with a breathing machine is better with regards to being able to remove the breathing machine earlier, in addition to decreasing the amount of other medications that may be required for sedation and relief of pain or discomfort.

This study aims to identify the most appropriate cooling strategy for older adults with and without hypertension during a simulated hot and dry heatwave (45°C and 15% relative humidity) Research questions: The primary research question guiding this project is: 1. Are fans and/or skin-wetting effective in decreasing the physiological strain experienced by elderly during a simulated hot, dry heatwave (45°C and 15% relative humidity) The research hypotheses going into this study are: 1. All interventions will result in reductions in thermal and cardiovascular strain compared to no intervention (control) With fan and skin-wetting (FSW) being the most effective, then no fan and skin-wetting (NFSW), then fan (F), and finally, the control, no-fan (NF).

Hip fractures result in poor outcomes for older adults. Rehabilitation emphasises physical capacity and does not address lack of confidence. Motivational interviewing has a specific focus on increasing confidence for behaviour change. The primary aim is to determine if motivational interviewing increases walking at 12 months in community-dwelling people after hip fracture compared with an attention placebo control group. The secondary aims are to determine if motivational interviewing is a cost effective intervention that improves mobility-related function, physical activity, participation, and psychological outcomes, and reduces falls and hospital readmissions. In addition to receiving usual care, 270 people aged at least 65 years who have returned home after hip fracture will be randomly allocated to receive 10 telephone-based sessions of motivational interviewing to encourage walking or a control group receiving 10 telephone-based sessions of nutritional advice. Outcomes will be measured at 0, 9, 26, and 52 weeks. It is hypothesised that the motivational interviewing will be a cost effective intervention to help people return to living in the community after hip fracture.

Our study aims to use MRI to assess the effects of empagliflozin on kidney filtration compared to another glucose-lowering medication, sitagliptin. Sitagliptin is another approved drug used to treat high glucose levels; however it is not known to affect the kidneys in the same way as empagliflozin.

The purpose of this trial is to assess whether a high CBD/low THC medicinal cannabis oil product [CannEpil. 20:1 cannabidiol (CBD) to (-) -trans-9-tetrahydrocannabinol (THC)] causes driving impairment using a high fidelity driving simulator. In particular the study will assess whether this medicinal cannabis product causes changes in the standard deviation of the lateral position (SDLP) variable obtained from the driving simulator compared to placebo. Additionally, the project aims will explore the subjective mood and sedative effects of this medicinal cannabis product compared to placebo. 31 participants will undergo a screening and practice visit followed by two testing visits spaced at least one week apart. At each testing visit they will receive either CBD/THC treatment or placebo in a crossover design. Participants will be instructed to consume a standardised breakfast prior to each testing session. During each testing visit participants will complete a driving simulation, cognitive tasks and questionnaires as well as having blood and saliva samples taken.

Obese people comprise 33% of Western Sydney and are 6x and 10x more likely to develop diabetes and non-alcoholic fatty liver disease (NAFLD), respectively, compared to normal weight individuals. This trend will lead to alarming rates of cardiovascular death, liver cirrhosis (scarring) and liver cancer. Weight loss can lead to diabetes remission and can be achieved successfully using very low calorie diets (VLCD), with rates close to 86% in adults. Additionally, a widely available and effective diabetes therapy – glucagon-like peptide-1 receptor analogues (GLP1-RA) – also assist with weight loss. Both treatments lead to significant weight loss, improve diabetes, and can reverse liver damage caused by NAFLD, yet the combination of these treatments has never been studied. This is a pragmatic pilot study of patients attending the Metabolic and Weight Loss Program at Blacktown hospital to investigate the efficacy of VLCD +/- GLP1-RA in achieving diabetes control and reversal of liver injury. This will lead directly to practice change by senior clinicians involved in the study and improve patient care in the clinics at Blacktown hospital, and potentially further afield.

Consuming fruits and vegetables, which naturally contain antioxidants, reduces the risk of developing chronic diseases potentially through reducing oxidative stress and low-grade inflammation in the body. Oxidative stress and inflammation (OSI) are common and are associated with meal digestion, however this only lasts for a short period of time in healthy bodies. We hypothesise that by matching the time when antioxidants are taken and are present in the blood with the onset of post-meal OSI we can optimise the benefits of the antioxidants. This study will provide data on the time course and appearance of markers of oxidative stress and inflammation following a meal.

Background Management of dyspepsia in Australian Emergency Departments (ED) typically includes lidocaine viscous and an antacid (pink lady or pink mix). We will investigate whether the addition of either lidocaine viscous or lidocaine solution improves analgesic efficacy, compared to an antacid monotherapy. Methods A double-blind randomised controlled trial will be undertaken in the ED of the Royal Melbourne Hospital, 7 days a week from 0800 to 2300. Patients prescribed a pink lady by the treating clinician and meeting inclusion criteria will be invited to participate. Patients will be randomly allocated one of three solutions. Option 1: 10mL oral lidocaine 2% viscous plus 10mL Gastrogel, option 2: 10mL lidocaine solution 2% plus 10mL Gastrogel, option 3: 20mL Gastrogel. Patient and investigator will be blinded to the medication given, and a pain score taken at t = 0, 30 and 60 minutes. The primary outcome will be the change in pain on a visual analogue scale at 60 minutes. Secondary outcomes include the change in pain scores at 30 minutes and an evaluation of taste, bitterness, texture and overall acceptability score using visual analogue scores. Proportions will be tested for significance using the chi-square test. Continuous variables are assumed to be non-parametric and will be tested using the Kruskal-Wallis test for difference in populations.

The overall aim of this research is to compare the effects of using special contoured insoles compared to flat insoles in people who suffer painful osteoarthritis (OA) in their big toe joint. To test this, participants who have big toe OA and are eligible to take part in the study, will be allocated into two different insole groups via a random process. All participants will see a podiatrist who will provide one pair of insoles (either flat or contoured depending on which group they are in), which they will be instructed to wear at all times when wearing shoes for the following 12 weeks.

Recent studies have described the change in blood magnesium levels following its administration to children, pregnant women and patients who have had cardiac surgery. We wish to study the effects of IV magnesium supplementation in the general adult ICU population, specifically those who are receiving both ventilatory and blood pressure support. We also wish to study the effect of kidney function on IV magnesium supplementation in these patients. We aim to assess the blood and urine levels of magnesium immediately prior to and during magnesium replacement, administered as a 1-hour bolus followed by a 24-hour infusion, in 30 critically ill patients admitted to the Austin Hospital ICU. Blood and urine samples are already routinely collected in ICU patients for monitoring purposes; it is not anticipated that the additional tests would cause any harm. Retrospectively, we will also record basic demographic and admission details about the patients so that we can appropriately describe the study cohort. It is hoped that the information gathered from this study would fill a fundamental gap in our knowledge of IV magnesium supplementation in the critically unwell patient, helping clinicians to standardise their practice regarding the usage of magnesium.