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The administration of intravenous (IV) crystalloid fluids (also known as fluid therapy) is a ubiquitous intervention in patients undergoing surgery. Worldwide, the most commonly used crystalloid fluids available for patients undergoing major surgery include Saline (0.9%), Hartmann’s and Plasmalyte solutions. All three solutions are available for IV use at Austin Hospital and considered standard of care for all patients undergoing major surgery. Choice of these fluids amongst anaesthetists at Austin Hospital is similar to worldwide practices. In this study we will be collecting information about intravenous fluid intervention (type of fluid and amount) for adult patients undergoing major surgery (duration greater or equal to 2 hours and at least one overnight stay). Data will be collected over a 12-week period. Specifically, the effects of these fluids on kidney function will be investigated. Perioperative care and fluid intervention therefore will remain completely at the discretion of the treating clinicians.

Patients with persistent back pain and suspected mechanical instability are referred to spine surgeons for spine stability assessment and, if need be, stabilization surgery. A significant proportion of these patients fail however to derive adequate benefits from the surgery and these chronic pain 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. High-Frequency Spinal Cord Stimulation at 10 kHz (HF10 SCS) has established itself as a key treatment in treating patients with chronic back pain: data from European 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. HF10 SCS has been used in Australia to treat chronic pain ever since its TGA approval, especially back and leg pain patients. The purpose of this non-interventional data collection study is to collect data on the improvement in pain relief and quality of life associated with HF10 SCS, as used in the clinic routine practice in patients with chronic back pain following back surgery.

The project will assess the utility of a single session behavioral activation intervention to improve wellbeing in a non depressed sample. To assess the possible preventative benefits of the treatment, the study will employ a sample of carers, who are hypothesised to be at increased risk of developing depressive symptomatology due to lifestlye factors such as high stress. It is predicted that a single session of behavioral activation will significantly improve wellbeing outcomes, as indicated on self report measures, compared to a waitlist control and that this pre/post improvement will be significantly maintained at follow up.

This was a prospective study of 369 consecutive patients referred to a single surgeon for treatment of pelvic and acetabular fractures over a 20 year period. All patients were treated with chemoprophylaxis using unfractionated heparin, according to a sliding scale, at an ‘antithrombotic’ dose. Treatment was withheld for 48 hours post-injury and 48 hours post-operatively, due to the risk of bleeding. Patients were fully anticoagulated with warfarin 7 days post-operatively when the risk of secondary bleeding was over. Patients with clinical evidence of pulmonary embolus (PE) were investigated with ventilation-perfusion lung scans early in the study and CT angiography or MRI angiography when those investigations became available. Seven patients developed PE (1.9%). There was 1 fatal PE (0.3%) CONCLUSION: Variable dose unfractionated heparin followed by warfarin offers excellent protection against PE compared to published results of fixed dose regimens using fractionated heparin or unfractionated heparin in patients with pelvic and acetabular fractures.

The aim of this project is to demonstrate that contrast enhanced ultrasound is an equally effective method for detecting synovitis in patients with haemophilia in whom the diagnosis of synovitis (joint capsule inflammation) from physical examination is unclear. Currently, MRI is the screening tool for synovitis in this population; however it is time consuming, claustrophobic for some patients and has long waiting times. Contrast-enhanced ultrasound is the application of ultrasound contrast medium to traditional medical sonography. Ultrasound contrast agents may be used during an ultrasound examination to improve the clarity and accuracy of a conventional ultrasound image.

We believe that exposure to the taste and smell of milk before and during tube-feeding in very preterm infants may lead to better milk tolerance, and subsequent better growth.

The study is an initial evaluation of Cool Little Kids Online, an online parenting program that aims to help inhibited (shy) young children be more confident and prevent them developing anxiety problems.

Obesity is a major health problem which is becoming increasingly costly to individuals and society. It is a major risk factor for diabetes, cardiovascular and liver disease, sleep apnoea, some cancers and osteoarthritis. Despite obesity research being a priority area, current prevention is having little impact at a population level as obesity rates are increasing and treatment programs are generally seen as ineffective because there is little weight lost, or there is weight regain. Pharmacotherapy to reduce hunger improves weight loss, particularly when combined with lifestyle intervention. This study involves using dexamphetamine (DEX), an old drug that is cheap and has been shown to be effective for losing weight. The dose will be titrated in a way that is highly innovative in terms of the treatment of obesity but is supported by decades of experience in the treatment of attention deficit hyperactivity disorder (ADHD). Its complications are already known and are almost exclusively dose dependent. DEX has the potential to provide a cheap and effective alternative to the currently available expensive anorexigenic medications and surgical treatment. The project is designed to test a) whether DEX is safe and more effective than placebo for treating obesity complicated by obstructive sleep apnoea over a six month period and b) whether weight loss can be sustained for 2 years after ceasing the study drug.

There is growing scientific evidence of the clinical efficacy of transcranial direct current stimulation (tDCS) in treating a number of neurological and psychiatric conditions. Although the exact mechanism of action underlying tDCS remains to be fully elucidated, its ability to promote lasting neuroplastic changes within the brain appears central to its therapeutic effects. tDCS involves the application of a very weak electrical current to the scalp, which acts to modulate the excitability of underlying cortical neurons, thereby altering their function. Importantly, tDCS is both safe and painless, and can induce changes in brain function which are measurable up to an hour after the cessation of stimulation. In order for tDCS to be optimally utilised, however, research which directly compares the different stimulation methods available is greatly needed. This project specifically aims to compare two methods of administering tDCS to a region of the brain known as the dorsolateral prefrontal cortex, an important area for cognitive processing. The first is a conventional method, which applies the stimulus to the head using two large sponge electrodes, while the second method, which has been more recently developed, is referred to as high definition tDCS (HD-tDCS) and uses several smaller electrodes to deliver the stimulation to a more confined region of the brain. It is currently unclear which of these two methods of stimulation is the most efficacious. Therefore, the aim of this study is to directly compare, using both behavioural and neurophysiological outcome measures, the effect that each of these stimulation methods has on brain neuroplasticity.

The study was a universal prevention program targeting the onset of symptoms of depression and anxiety in adolescent school students. It target unhelpful perfectionism as a risk factor, was conducted across 4 sites, with more 750 Year 8-10 students participating. Our hypothesis was that the intervention group would exhibit a lower rate of onset of symptoms of depression and anxiety. A prevention effect over the 6-month follow-up period was confirmed.