ANZCTR search results

Obstructive sleep apnoea (OSA) is characterised by a partial or complete collapse of the upper airway during sleep. Continuous Positive Airway Pressure (CPAP) therapy acts as a positive airway splint, delivering a fixed positive airway pressure to the upper airway via a tube and mask. CPAP compliance is strongly influenced by the patient’s mask system. As masks are worn every night the comfort, seal, stability and ease of use of a CPAP mask is highly important. ResMed teams are constantly designing potential new products. At times it is desirable for internal staff members to volunteer to trial prototypes of masks, frames, headgears and accessories because: employees may wish to assess a design to experience how it works and feels, and determine ways to improve it; there may be a need to gain initial feedback on whether an idea is worth pursuing; design team wishes to narrow down options before proceeding to a user trial on OSA patients.

Obstructive sleep apnoea (OSA) is characterised by a partial or complete collapse of the upper airway during sleep. Continuous Positive Airway Pressure (CPAP) therapy acts as a positive airway splint, delivering a fixed positive airway pressure to the upper airway via a tube and mask. CPAP compliance is strongly influenced by the patient’s mask system. As masks are worn every night the comfort, seal, stability and ease of use of a CPAP mask is highly important. The product development of mask systems is an iterative process. Evaluation of the comfort, seal, stability and ease of use of the mask system by patients in their home environment provides the required information for these iterative design changes. This project will allow the iterative testing of mask systems by patients by comparing them to already released masks or acceptable subjective levels.

Background Whilst pregnancy is a risk factor for urinary incontinence (UI), this condition may precede pregnancy. The prevalence of UI in nulligravid women has not been reported. Objective To investigate the prevalence of UI in young nulligravid women, potential risk factors and the impact on quality of life. Design Single centre, cross-sectional, self-administered questionnaire-based study. Setting University clinical research department Participants Nulligravid Australian women aged 16 to 30 years. Measurements The Questionnaire for Urinary Incontinence Diagnosis, the Psychological General Wellbeing Index (PGWB), the King’s Health Questionnaire and the International Physical Activity Questionnaire. Demographic variables and potential risk factors were also documented. Results 1002 women, mean age 22.4 (SD 3.2) years, provided data. The rate of any UI was 12.6% (95% confidence interval (CI), 10.5-14.7%). The rate of stress-only UI was 6.2% (95% CI, 4.7-7.7%), urge-only UI 4.5% (95% CI, 3.2-5.8%) and mixed UI 1.9% (95% CI, 1.1-2.7%). In logistic regression analyses, ever being sexually active (OR 2.33, 95%CI 1.40 to 3.88) was associated with an increased likelihood of UI, whereas current use of the combined oral contraceptive (COC) was associated with a reduced likelihood of UI (OR 0.38 95% CI 0.24 to 0.61). Women with UI had significantly lower wellbeing than women without UI (mean difference in total PGWB score 5.3 (95% CI 2.3-8.3). Statistically significant lower scores were seen for the PGWB domains of for anxiety (P<0.001), depression (P<0.001), positive well-being (P=0.02) and self-control (P=0.001). Limitations The findings relate to a relatively healthy and active cohort. Conclusions UI was common in this sample of healthy, nulligravid young women and was significantly associated with lower general psychological wellbeing. Further study is required to understand the pathophysiology of UI in young women and management options.

The rationale of this project is to study hypogonadism in the background of regional north Queensland. In the setting of a small population with a relatively variable socioeconomic status attributed to the mining and farming industry, it is interesting to evaluate the different causes of hypogonadism ranging from pathological causes to lifestyle choices with respect to exogenous steroid intake and a widespread use of complementary and alternative medicines. This study will also be stratifying how the level of testosterone may provide an insight to the primary general practitioner as to the possible causes of hypogonadism and if there is any correlation between the two parameters. Furthermore, a study on males with hypogonadism in regional Australia has not been previously undertaken. With the knowledge that a low serum testosterone is known to provide various clinical complications such as increased microvascular disease, hyperlipidaemia, osteopenia, fatigue, weakness and psychological distress from impaired libido it is important to conquer these patients early and attempt to find any underlying cause behind these patients’ hypogonadism.

The overall aim of the current study is to examine the brain correlates of emotion recognition in patients with Body Dysmorphic Disorder using a double-blind placebo controlled intranasal oxytocin design and two MRI techniques involving fMRI and diffusion tensor imaging (DTI).

Chronic pelvic pain (CPP) is one of the most common medical problems among women, though it also affects men with a lower incidence . It is defined as pain in the pelvis that lasts more than six months and affects the patient’s quality of life. There are many potential sources of pelvic pain. Pelvic pain may involve the urinary, reproductive, gastrointestinal, neurological, psychological and musculoskeletal systems. Patients with chronic pelvic pain typically receive multidisciplinary care, including medication (antimicrobials, anti-inflammatories, opioids, muscle relaxants, etc), psychotherapy, physical therapy, and interventional treatments (surgery for distension and ablative procedures). A significant proportion of these patients fail however to derive adequate benefits from these therapies and these CPP patients are often left with few options. Traditional spinal cord stimulation (SCS) is a widely accepted cost-effective therapy for patients with chronic pain, especially in patients with post- surgery back and leg pain. SCS has been used successfully to treat intractable CPP patients. A newer treatment, High-Frequency Spinal Cord Stimulation at 10 kHz (HF10TM SCS) using the Senza system (Nevro Corp, USA) has established itself as a key treatment in treating patients with chronic back pain: data from European and Australian pain centers has shown that HF10 SCS is safe and effective at reducing pain, improving function and sleep, and reducing opioid in patients with predominant back pain. The purpose of this study is to investigate the feasibility of using HF10-SCS to provide pain relief and quality of life improvements to CPP patients.

Iron deficiency - the world’s commonest nutritional disorder affects over 2 billion people (WHO 2008), with women and children at greatest risk. This study aims to evaluate, in a randomised controlled trial (RCT), oral bovine lactoferrin (bLF) vs iron sulphate (FeSO4) in iron deficiency anaemia in pregnancy (IDAP). This study will comparerandomised groups on the following co-primary endpoints: 1) Fetal growth (birth weight for gestational age) 2) Whether oral bLF therapy reduces the proportion of women with IDAP who receive intravenous iron infusion according to standard protocol OR who do not respond to treatment and remain anaemic at any time between 34 weeks gestation and delivery.

Diabetes is a disorder of blood sugar and requires treatment for high blood sugar levels using drugs such as insulin. However, treatments like insulin can cause excessively low blood sugar levels (hypoglycaemia). If unrecognised and untreated hypoglycaemia can induce a coma. To protect against hypoglycaemia certain physiological responses occur. These include release of hormones that break down stores of sugar within the body and emptying the stomach quicker so that nutrient can be absorbed more rapidly. Both physiological responses will increase blood sugar levels. Recent evidence suggests that episodes of low blood sugar levels impair the hormonal response to subsequent episodes of hypoglycaemia, but the effect of these antecedent episodes of hypoglycaemia on gastric emptying rate during subsequent hypoglycaemia is unknown. This study aims to investigate whether there are changes in gastric emptying following repeated hypoglycaemic episodes. In addition this study will assess changes in glucose absorption, autonomic nerve function, secretion of catecholamine, glucagon and pancreatic polypeptide and cardiac function. Null hypothesis: Recurrent hypoglycaemia does not effect hypoglycaemia-induced acceleration of gastric emptying.

The four major pregnancy complications, preeclampsia, preterm birth, intrauterine growth restriction and gestational diabetes mellitus, afflict 25% of first pregnancies and are life-threatening to the mother and/or her baby in more than 6% of pregnancies. Although many aetiological risk factors have been identified, at present we cannot effectively predict which women will develop pregnancy complications. Our previous research has identified a combination of potential clinical and lifestyle factors and genetic and biochemical biomarkers that predict the risk of these pregnancy complications at 15 weeks of gestation. We aim to validate our algorithms in a new cohort of participants and expect to be able to predict the risk of development of pregnancy complications as early as at the 12th week of gestation. Those found to be at increased risk can be managed with a combination of preventive strategies and early targeted interventions that would reduce the risk of developing these complications.

Patients who have knee joint replacement operations can be in a lot of pain afterwards. The doctor will often use a special local anaesthetic injection called a nerve block to try to reduce this pain. These injections use an ultrasound machine to find the nerves. By injecting local anaesthetic right next to these nerves, patients can have less pain after the operation compared to patients who only have local anaesthetic injected into the surgical wound. The main side effect of some of the nerve blocks is leg weakness. It is important that a patient can get up and walk as soon as possible after a knee operation. Too much leg weakness can stop this from happening or lead to a patient falling over and injuring themselves. A nerve block called an “adductor canal block” is currently being used in patients having knee operations. This nerve block can result in a similar amount of pain relief as other nerve blocks but causes much less leg weakness. It can be given either as a one-off injection or by placing a very fine tube, a catheter, next to the nerve and giving a continuous drip of local anaesthetic. Although one-off injections are easier and quicker to perform, the pain relief effects do not last as long as the catheter method. When performing a nerve block, a steroid medication called dexamethasone can be mixed with the local anaesthetic solution to make the pain relief effects last longer. Studies have shown that dexamethasone makes the nerve blocks used in shoulder and arm surgery last longer. Whether dexamethasone would have the same effect on an adductor canal block is not known as it has not been studied before. If dexamethasone was shown to make an adductor canal block last longer, it could be used in knee surgery patients to keep them comfortable for a longer time after their operation. Intravenous dexamethasone (given via a drip in a vein) is widely used for the management of nausea and vomiting associated with general anaesthesia, although it is officially off-license for use via a drip. We intend to do a small pilot study to find out whether dexamethasone has an effect on how long an adductor canal block lasts. This will involve doing an adductor canal block, with or without dexamethasone, on patients already having knee joint replacement surgery. If we can show that using dexamethasone in adductor canal blocks can make the block last longer, we will then plan to do a larger study comparing the one-off adductor canal block with dexamethasone against the adductor canal block catheter.