ANZCTR search results

Post-operative pulmonary complications occur in approximately 10–25% of patients following cardiac surgery, contributing to delayed mobilisation, prolonged ICU and hospital length of stay, and poorer recovery outcomes. Early identification of patients at higher risk of complications and objective monitoring of deconditioning during recovery remain unmet clinical needs. Skeletal muscle status reflects physiological reserve and vulnerability to critical illness. Emerging evidence suggests that rectus femoris muscle cross-sectional area and echogenicity, measured using real-time ultrasound, may predict adverse outcomes in hospitalised populations. Ultrasound is non-invasive, low-cost, portable, and increasingly feasible for use by allied health clinicians in acute and ICU settings. This study evaluates whether cross sectional area of the rectus femoris muscle can be reliably implemented in cardiac surgery pathways and whether these measures predict clinically meaningful outcomes.

This pilot RCT study aims to assess the preliminary effectiveness, feasibility and acceptability of a telehealth Medical Nutrition Therapy (MNT) model of care (Diabeating Nutrition) delivered by dietitians for adults with type 2 diabetes (T2D) using GLP-1 RAs medication over 6-months, within the Hunter, NSW. Adults with T2D that are about to commence, currently using or previously used GLP-1 RA medication of primary care practices participating in the Diabetes Alliance Program Plus or registered in the NDSS will be invited to participate. Adults will be randomised to either: 1) Diabeating Nutrition: personalised MNT plus usual care (intervention), 2) Usual care without MNT (wait-list control). Preliminary effectiveness will be evaluated using the primary outcome measure HbA1c. Feasibility and acceptability will be assessed by MNT appointment attendance rates and process evaluation survey responses respectively. Study findings will be used for the development of fully powered RCT.

Cardiac catheter ablation using radiofrequency (heating energy) is a common treatment for heart rhythm disorders. Catheters are long flexible tubes with electrodes at the tip placed in the heart and deliver heating or cooling thermal injury to disrupt abnormal electrical circuits in the heart (ablation). Radiofrequency ablation can be performed using catheters which are flushed continuously with water (irrigated) or with non-irrigated catheters which are dry. The benefits of irrigated catheters are that they can create larger and deeper injury to the abnormal circuits which may be more effective as the water prevents overheating. Importantly, irrigated catheters also have technology which determines if the catheter has adequate contact or pressure with the cardiac tissue it is ablating, known as contact force. This is vital in achieving a stable position to facilitate effective ablation. Failure to apply enough pressure or energy to the heart tissue consistently can result in poor quality ablation lesions and recurrence of the abnormal heart rhythm. Non-irrigated catheters do not have contact-force sensing capabilities. Catheter ablation is an effective treatment for a fast heart rhythm condition called atrioventricular nodal reentrant tachycardia (AVNRT). Traditionally, ablation has been performed with non-irrigated non-contact force-sensing catheters but more recently due to the benefits of irrigated and contact force-sensing catheters, more operators have been using them. Whilst initially there was concern larger lesions could potentially lead to higher risk of damaging the atrioventricular node, a vital electrical structure in the heart, multiple studies have shown irrigated contact force-sensing catheters are safe to use for this condition and may be even safer than non-irrigated non-contact force-sensing catheters. However, the benefits of contact force-sensing catheter ablation for AVNRT have not been evaluated in high-level evidence studies. A randomised control study is the gold-standard in comparing 2 treatments in research. We will be conducting a randomised trial comparing the effect contact force-sensing catheter ablation has during AVNRT ablation to non-contact force-sensing ablation. There will be 2 treatment groups of equal size with 51 in each for total of 102 patients. All patients will undergo AVNRT ablation using an irrigated contact force-sensing catheter. In half the group, the operator will not know the contact force and perform the procedure as per conventional standard practice. In the other half, the operator will know the contact force during ablation. This is to assess if contact force can make procedures faster, safer and more effective in treating AVNRT which will benefit future patients. Another goal is also to see if junctional rhythm (a finding suggestive of successful ablation) correlates with adequate pressure or contact force during ablation.

This study is testing a new, more convenient way to administer rabies pre-exposure vaccination in adults at risk. Instead of needing two visits to complete the vaccine course, three of the study schedules give the vaccine doses in a single visit: (1) one dose into the skin (intradermal), (2) two doses into the skin (in two injections sites), and (3) one dose into the muscle (intramuscular) in a single-visit, and this is compared with the current standard two-visit schedule: (4) two dosis into the muscle (one dose in each visit). The main aim is to determine whether this single-visit schedule “primes” the immune system sufficiently so that, when people later receive a booster dose, they quickly develop high levels of protective antibodies (“boostability”). To assess the "boostability" of the pre-exposure schedules, all participants will undergo a standard simulated post-exposure prophylaxis regimen with two doses administered intramuscularly (one dose per visit), approximately 56 days after receiving their initial pre-exposure vaccination. The study will also closely monitor and compare any side effects between the different schedules. The researchers hypothesise that the single-visit intradermal schedule will be as effective as the standard schedule in preparing the immune system, while being easier to complete and potentially reducing costs and barriers to protection.

This observational clinical study investigates changes in salivary host-derived extracellular vesicles (EVs) following tooth extraction with or without alveolar ridge preservation (ARP) using Bio-Oss Collagen and Bio-Gide. Saliva samples will be collected longitudinally at baseline and multiple post-operative time points, including during early healing, pre-implantation, and post-implantation phases, and analyzed saliva extracellular vesicles using proteomic, lipidomic, and metabolomic approaches. For all participants, a socket biopsy samples with both soft and bone tissues obtained during routine implant placement will be assessed histomorphometrically and correlated with salivary EV profiles. Post-implantation patients will be followed up for 6-months to monitor periodontal status and saliva extracellular vesicles profiles.

This is an observational study looking at the rate of human leukocyte antigen (HLA) antibodies developing in patients who receive a specific blood product, HLA compatible red cells. The aim is to confirm that this product can be transfused without HLA antibodies to the blood donor developing. Blood will be taken before and 4-8 weeks after the transfusion.

This pilot study aims to explore whether a brief online training program, called Cognitive Bias Modification for Interpretation (CBM-I), is acceptable and feasible and can help reduce fear of cancer recurrence (FCR) in people who have been treated for head and neck cancer. Who is it for? You may be eligible if: You are 18 years or older You have previously been treated for head and neck cancer You are currently experiencing worry or fear about your cancer returning You are not receiving palliative care You can use a smartphone, tablet, or computer with internet access Study details All participants will receive CBMI training. CBM is an intervention that is administered online and trains people not to interpret ambiguous situations in a threatening way. Participants will receive four cognitive bias modification sessions over the duration of 14 days and will be required to answer questionnaires before the trial, and 14, 28 and 84 days after the trial has commenced. It is hoped that this study will help determine if CBMI training is a possible option for treatment of fear of cancer recurrence for those who have previously been treated for head an neck cancer.

Heart failure is a serious long-term illness, and many people living with it need extra support as they approach the end of life. This study looks back at patients who died in one hospital to see how often specialized palliative care services were involved in their care. It also examines whether being linked with community palliative care made patients more likely to get admitted into Palliative Care Unit. The study compares different types of heart failure, and the medications people were taking near the end of life. By understanding current care patterns, the research aims to identify gaps and help improve support for heart failure patients.

Up to 38% of individuals who have a stroke will develop an often-lifelong language impairment called aphasia. There is evidence that repeated sessions of repetitive transcranial magnetic stimulation (rTMS) may improve symptoms of aphasia, however it is not yet understood how this neuromodulation intervention works. The purpose of this novel study is to investigate both physiological and behavioural outcomes of rTMS to gain better neurophysiological insight into this treatment.

This study is a parallel-group, online randomised controlled trial (RCT) designed to evaluate the effect of intervention videos that provide evidence-based information on people’s beliefs and pain self-efficacy regarding the management of low back pain (LBP), compared to an attention control video. Participants will be randomised to watch either an intervention or attention control video before completing a simple 5- to 8-minute survey in a single sitting. Target sample size: 440 participants