ANZCTR search results

This study will determine the effect of respiratory muscle training on the inspiratory muscles after pleurodesis in cancer patients with malignant pleural effusion. It will assess whether this is a promising therapy to improve clinical outcomes in cancer patients with malignant pleural effusion. Who is it for? You may be eligible to join this study if you are aged 18 years or above, have had a diagnosis of malignant pleural effusion and have had pleurodesis with no significant fluid re-accumulation on clinical assessment 3 weeks after. Study details Participants in this study are randomly allocated (by chance) to one of two groups. Participants in one group will receive inspiratory muscle strength training twice daily for 6 weeks using a Powerbreathe Medic device. While participants in the other group will perform deep breaths to improve lung capacity using the same device. Participants will perform tests of the strength of the breathing muscles, lung capacity and the oxygen fuel economy of the breathing muscles. An ultrasound test will be performed to check the thickness of the main breathing muscle. Participants will answer questionnaires to compare the effectiveness of the two interventions. If the respiratory muscles can be trained, this may reduce the need for further invasive drainage procedures and/or improve dyspnea.

General practitioners enrolled in the trial will be randomised to either the "intervention" or the "control" group. The intervention group general practitioners will then be sent reports of their chlamydia screening and test positivity data, that compare their performance to the relevant guidelines and to their peers. The sub-project will then monitor and compare testing rates and patterns between the intervention and control groups over the next six months

We hypothesize that the underlying pathogenesis of Diabetic Macular Oedema (DMO) may be related to a combination of inflammatory and angiogenic cytokines. Although anti-VEGF agents are commonly used for the treatment of DMO, either as a primary measure or more usually in refractory cases, the response to treatment is unpredictable. We propose that measurement of known diabetes association cytokines may allow accurate prediction of response to anti-VEGF treatment and allow a more individualised treatment strategy for patients.

The THRIVE Pilot project will examine whether smokers living with HIV find nicotine replacement products acceptable to use as a quit aid or replacement for smoking. This project aims to measure how acceptable and tolerable the participants find the products to use, and which products are preferred. It will also measure whether participants reduce their smoking while using their products. It will also explore whether providing the participants with information about the use of long-term nicotine substitution as an option to reduce health risk increases or decreases their interest in abstaining from cigarettes and nicotine. We will also monitor adverse events while using the products. Tobacco smoking is a major cause of serious disease. Those who quit smoking reduce their risk of developing a tobacco related disease. The project will help us to better understand whether vaporised nicotine products are a more attractive option than existing NRT products for people living with HIV who smoke. We will also measure their interest in and reactions to harm reduction messages about using nicotine products as a long-term substitute for cigarettes if they cannot or are unwilling to quit smoking. People living with HIV who smoke are a population group that are likely to benefit from harm reduction approaches as smoking is particularly harmful for this population group and previous trials have found low long-term success rates with standard abstinence-based approaches. We hypothesise that more participants will find the VNPs acceptable and preferable to use compared to NRTs and that advice on harm reduction options will not decrease interest in quitting smoking, but may decrease interest in stopping nicotine use.

This study will compare the use of a mechanical hysteroscopic morcellator to monopolar electrosurgical hysteroscopic resection to remove submucosal fibroid in symptomatic women. We hypothesize the hysteroscopic morcellator may reduce intraoperative time and allow additional procedures to be performed in a single operating list. The primary outcome of this study is to determine the difference if there is a difference in cost between two devices used to to resect the leiomyomas. As the operating time will is the most likely to have an impact on this, the time to resect intrauterine pathology between these two different instruments, from insertion of the hysteroscope to removal of instrumentation will form part of this primary outcome. Secondary outcomes include: Fluid deficit, Completeness of resection, and adverse events This is a prospective, randomised, single blinded study, with a minimum of 162 patients to be enrolled over a 1year recruitment period. All cases must satisfy the inclusion/exclusion criteria and will be followed for 6 months after surgery. Following decision to list a woman for a hysteroscopy and resection of fibroid, women will be considered for the study and offered participation. Women who qualify will be randomised to one of two groups: Hysteroscopic morcellator (Myosure, Registered trademark) with normal saline distension medium or monopolar electrosurgical hysteroscopic resector with a glycine distension medium. To ensure concealment, randomisation of women into treatment groups will occur via phone to an automated randomisation service. At the time of surgery, a diagnostic hysteroscopy will first be performed to confirm requirement for resection of a fibroid. Those that do not require resection will continue to have outcome data collected during the operation and followup but will not be included in analysis. Data collection will occur at: recruitment, on the day of admission for surgery and intraoperatively, postoperative review at 6 weeks after index surgery, and postoperative review at 6 months after index surgery. An economic evaluation will be conducted to determine the relative costs and benefits of hysteroscopic morcellation versus electrosurgical resection.

This study is to compare the rates of extravasation injury and phlebitis between newborn infants who have an elective re-site of their peripheral intravenous cannula (PIVC) at 72 hours compared to those in whom the PIVC is changed due to clinical concerns only. We hypothesise that the incidence rates of extravasation injury and phlebitis will reduce by half in our study group with the intervention.

This primary aim of this study is to determine if preoperative hypercoagulability, identified by ROTEM analysis, can predict postoperative thrombotic complications in overweight and obese patients undergoing elective lower limb joint replacements. Secondary aims: 1. To develop clinical threshold with ROTEM parameters to identify high risk patients with increased body mass index and/or waist circumference. 2. To monitor coagulation changes with ROTEM assays and platelet function with Multiplate analyser, preoperatively and postoperatively, in this cohort of patients. 3. To assess the sensitivity of the ROTEM assay to predict high-risk patients stratified according to body mass index and waist circumference.

Total hip replacement (THR) is the gold standard for management of severe hip osteoarthritis. A rising trend has seen an increase of approximately 40% over the last decade with almost 40,000 THRs being performed in Australia in 2013. Systematic reviews have demonstrated the benefits of physiotherapy delivered physical rehabilitation programs following THR which are effective in increasing quadriceps, hip abductor, extensor and flexor strength, walking speed and cadence and function. Although rehabilitation has clear benefits, many people who have had a THR find it difficult to access health care. The elderly demographic coupled with the risk of THR dislocation post-operatively can make travel difficult. Few patients can afford to self fund domiciliary rehabilitation and the public health system has limited scope to provide services outside of it’s centres. For patients living outside metropolitan areas access issues become magnified. This study will aim to determine if a telerehabilitation program delivered remotely is as effective as face to face rehabilitation in the THR population. The effectiveness of the telerehabilitation program will be determined via a randomised controlled trial comparing a traditional face to face rehabilitation program to a telerehabilitation program delivered directly in to patient’s homes.

Skin-to-skin contact (SSC) between a parent and their baby is a commonly used intervention in Neonatal Intensive Special Care Units (NISC). It can help parents to feel more connected to their baby, and feel attached and bonded, as well as help them to feel like they are interacting with their newborn baby, and helping them to feel a little more like a "normal" parent. It also offers multiple benefits to the baby and is the closest for them to being back inside their mother's stomach, as they were before being born. They can hear their mother's heart beat and know their smell, so it can offer the baby comfort and warmth and feel love from their parent. Over recent years, there has been an increased focus on the use of family centred-care interventions, such as SSC, being utilised in NISCs. However, there is an overall lack of studies conducted in Australia on the effect that the duration of the SSC between a parent and baby in a NISC setting has on physiological benefits to the baby, as well as physiological benefits to the parents (both mothers and fathers). The physiological measurements examined in the current study are the baby's heart rate, respiratory rate, temperature and oxygen saturation. The parent's physiological measurements examined in the current study are the parent's heart rate and blood pressure. For the current study, it is hypothesized that the effects from the SSC for the baby will be increased when they have longer SSC with their parent. For the parents, it is hypothesized that there will be physiological benefits from the SSC with their baby, reflected as lower heart rate and blood pressure, and that these benefits will increase with a longer duration of SSC.

This project is a pilot study of an intervention program called Body Brain Life-Fit (BBL-Fit). BBL-Fit aims to determine the effect of a multi-domain dementia risk reduction intervention on cognitive function in community dwelling middle-aged adults with multiple risk factors for dementia. The sample will be healthy but have several risk factors for dementia. The intervention is tailored to individuals based on their level of risk in particular domains. There will be two groups; a control group who receives a pre and post assessment without interventions, and an intervention group who receive online intervention as well as physical activity and dietary (where indicated) interventions.