ANZCTR search results

Activation, Entrainment and Pace mapping techniques has been the mainstay of the catheter based mapping and ablation of all atrial arrhythmias. The original studies describing these mapping techniques were performed almost two decades ago. These studies were performed using fluoroscopy alone without the aid of a 3D electroanatomical mapping system. Indeed all published mapping and entrainment studies have been performed using catheters with a large (4mm or 8mm) distal tip of the roving mapping catheter. These studies are yet to be repeated using the newly available catheter technology. Indeed there is no data on the accuracy of activation, entrainment and pace mapping using these ‘new generation’ of mapping catheters with small micro electrodes and narrow bipolar spacing. Hence the aim of this study is to perform detailed activation, entrainment and pace mapping in a variety of atrial arrhythmias in order to validate the classical mapping criteria and techniques using these new catheters.

This is a study of patients presenting to the Emergency Department (ED) with concussion. Clinical data, imaging, neuropsychological testing and blood samples of patients with concussion will be correlated with outcomes. This may lead to the development of improved tools for diagnosis and prognosis, which could be used in future trials of treatment for concussion.

The aim is to compare the effectiveness of two widely used diets: (1) the RPAH low chemical elimination diet, and (2) the low FODMAP diet. Patients will be randomly allocated to a 3-week period on one of these diets, after which they will cross-over for a further 3 weeks on the other diet. The main outcome measure will be symptom response. In addition to keeping a standard daily food & symptom diary, participants will be asked to complete questionnaires before, during and after the intervention period to assess impact on quality of life. Their dietary intake will also be analysed by a dietitian to ensure ongoing nutritional adequacy.

The study is a prospective randomized controlled study. The study is designed as a paper-based intervention of senior medical and nursing staff working in the resuscitation room environment in the Emergency Department of The Royal Childrens Hospital. The study is single centred. The study is designed to assess the utility of paper-based interventions (checklist or template) in standardizing airway trolley set-up compared to no intervention. As a randomized controlled study, the primary study objective should be free of bias. Data collected will include the participant role (medical or nursing) and level of seniority. Additionally, study information will include the rate of omitted items from airway trolley set-up, the error rate in airway trolley set-up, the time taken to set up the airway trolley, and staff confidence and satisfaction with airway trolley set-up. A photo of the airway trolley set up will be recorded for blinded assessment of variability in equipment location. No identifiable information will be recorded at any stage of the investigation. Data will be collected during the participant encounter for omission rate, error rate, and satisfaction / confidence survey. This data will be recorded on a standardized Clinician Report Form (CRF). This will be stored in a locked study cabinet accessible only to the primary investigator. A photograph of the airway trolley set-up will be taken with a dedicated digital camera at the time of participant encounter for later analysis. This will be stored on a password protected external hard drive. Study preparation and planning will take approximately 2 months. Participant recruitment, based on a total number of participants of 63 with 7 study investigators recruiting 3-5 participants per week, will take approximately 1 month. Data collection and analysis will take approximately 2-3 months.

The purpose of this study is to determine if steroids used at the time of surgery reduce pain, nausea and vomiting, and reduce length of stay in patients undergoing total hip or knee arthroplasty procedures.

The proportion of older Australians is increasing, in parallel to increasing multimorbidity, polypharmacy and an increased risk of Adverse Drug Events (ADEs). The Drug Burden Index (DBI) is a pharmacologic risk assessment tool that measures an individual’s total exposure to anticholinergic and sedative medications. A high DBI score is associated with poor clinical outcomes in older adults. Home Medicines Review (HMR) is a comprehensive medication review service involving a pharmacist, general practitioner (GP) and the patient with the aim of enhancing quality use of medicines and reducing ADEs. To date, the DBI has not been tested in the HMR setting. AIMS: (1) To assess if the DBI report is feasible as a risk assessment tool in this setting; (2) To establish whether the DBI together with HMR service can reduce use of anticholinergic and sedative medications in older adults; (3) To assess changes in clinical outcomes in older adults following reduction of anticholinergic and sedative medications. Methods: An interventional feasibility study with two arms will be conducted: 10-20 pharmacists, who regularly conduct HMRs in the community, will be recruited to participate in the study. Each pharmacist will undergo an education program and be provided access to the Drug Burden Index Calculator 'Copyright'. Each pharmacist will also provide anonymous data on HMRs conducted for 10 patients to serve as historical controls. The intervention will involve pharmacists providing a DBI report to GPs with the HMR service for 10 patients. Patients will be asked to fill in a questionnaire, and be contacted by telephone for an interview at 0 and 3 months (post-HMR) by lead investigator to assess cognition and physical function. Discussion: Results from this study will provide an evaluation of the utility of the DBI as a risk assessment tool for reducing inappropriate prescribing in older adults during a HMR; and set the groundwork for a larger randomised control study.

This is a multi-centre trial to investigate the effects of the pneumococcal vaccination in the primary prevention of heart attacks and strokes. People aged 55 to 60 from 6 sites around Australia will be invited to participate in the study. The selected participants will attend a clinic in their area and will be randomly given the pneumococcal vaccine or a placebo vaccine. Outcomes on the expected 6000 participants will be ascertained by health record linkage with government databases after 6 years.

The purpose of this study is to examine the effects of the medication prazosin on: 1) the quantity and quality of Rapid Eye Movement (REM) sleep; and 2) emotional memory. This is so we can learn more about the basic effects of the medication in healthy adults as a step towards better understanding how the medication might help those with Posttraumatic Stress Disorder. The hypotheses are: 1. Increasing doses of prazosin will lead to greater quantity of REM sleep and fewer disruptions of REM sleep (e.g., fewer awakenings during REM sleep) 2. Increasing quality of REM sleep, resulting from increasing doses of prazosin, will lead to improved overnight memory for emotional pictures.

Intravenous paracetamol is ubiquitously used in hospitals as an antipyretic and analgesic worldwide. It is administered to a wide array of patients including those undergoing major surgeries and the critically ill due to its minimal side effect profile. However, recent studies have provided compelling evidence for a re-evaluation of paracetamol use in this setting as it has been found to cause hypotension in intensive care patients. Importantly, there is a paucity of guidance regarding its haemodynamic safety in surgical and critically ill patients. This may be due to a lack of double-blinded, randomised controlled trials in these settings as well as in healthy patient cohorts for comparative studies. In addition, a previous study found that oral effervescent paracetamol tablets produced hypertension in patients which study investigators linked to the high sodium content in the effervescent formulation. It is therefore important to acknowledge that excipients (pharmacologically inactive compounds that act as vehicles for the active compound in the drug) may affect blood pressure. There is no existing literature that has addressed the potential for the high mannitol content of intravenous paracetamol to produce haemodynamic effects. Hypothesis: Paracetamol (1g IV) and mannitol (3.91g mannitol IV) will have adverse effects on blood pressure in healthy volunteers compared to 0.9% normal saline. No of participants: 24 No of recruiting hospitals: 1 Randomization: In this triple-cross over study, participants will be randomized in a 1:1:1 fashion via a computer generated randomization program to receive 1 treatment from each of the treatment arms. The treatment arms include: 1) Control (100mL 0.9% normal saline) 2) IV paracetamol (100mL paracetamol and mannitol 3.91g) 3) IV Mannitol treatment (100ml mannitol 3.91g) Blinding: This is a double-blinded clinical trial. This study requires the use of 100mL blinded fluid vials. These vials will look identical in all treatment groups. Depending on randomization, IV paracetamol, 0.9% normal saline or mannitol will be transferred into the blinded vials just prior to IV infusion. Preparation of the blinded vials will be conducted by an anaesthesia nurse who will not be involved in the data collection. The participants, sampling anaesthetist and data analyst will be blinded to the assignment of treatment. Primary endpoint: Changes in haemodynamics: Mean, systolic and diastolic blood pressure Secondary endpoints: Cardiac output and cardiac index, stroke volume, systemic vascular resistance, plasma osmolality Other data collected: Patient characteristics and adverse events

This study is looking at the impact of light therapy on pain levels in an older population. There will be two participant groups, group 1 will receive bright light therapy using light therapy glasses, and group 2 will receive natural light therapy. Both groups will receive their specified light therapy for 10 days (2 weeks, Monday to Friday), and will also have two weeks with care as usual before and after receiving light therapy. Group 1 will receive care as usual for the first 2 weeks, then bright light therapy first for 2 weeks, followed by another 2 weeks of care as usual. Group 2 will also receive 2 weeks of care as usual for the first 2 weeks, and will then receive 2 weeks of natural light therapy. This will be followed by another 2 weeks of care as usual. It is hypothesised that light therapy will reduce reported pain levels in an older population. The Brief Pain Inventory will be administered at baseline, 2 weeks, 4 weeks and 6 weeks of the study. A daily Sleep Diary will be kept by all participants, and an Actiwatch2 will be worn for the duration of the study.