ANZCTR search results

This study will investigate if Acu-TENS is able to reduce symptoms of breathlessness in people with COPD presenting to the Emergency Department (ED) of the Gold Coast University Hospital (GCUH) and if it is enough to reduce the need for hospital admission. We will also try to clarify the brain and nerve system (neurochemical) pathways whereby Acu-TENS relieves breathlessness - this will be assessed by blood samples.

Children admitted to an acute care facility frequently require the insertion of a CVAD for the administration of medication and fluids. When treatment is required for an extended duration, clinicians often elect to insert a tunnelled, cuffed CVAD. These CVADs are associated with a high rate of failure, including CVAD-related bloodstream infection (BSI). In order to prevent failure, dressings, such as bordered polyurethane (BPU), are used to protect the CVAD insertion site from contamination. Additional securement devices, such as sutures, are used to reduce movement of the catheter. New products, including tissue adhesive (TA), sutureless securement devices (SSD), and combined securement and dressing products (CSD), are available to clinicians to provide securement and dressings for CVAD. It is not known whether these new products are effective at reducing CVAD failure, in comparison to standard care (BPU and suture). The primary aim of this research is to evaluate the feasibility of launching a full-scale efficacy trial, using pre-defined feasibility criteria for recruitment, retention and protocol fidelity. The secondary aim is to compare the effectiveness of dressings and securement products on CVAD failure due to infection, occlusion, dislodgement, thrombosis, or breakage, for children with tunnelled, cuffed CVAD in acute care.

Already known about fibre and ulcerative colitis is that a) Fibre intake goals not achieved by patients with ulcerative colitis b) Gut microbiota differ in patients with ulcerative colitis from healthy people c) Dietary management of ulcerative colitis is not well established New Findings are that a) Patients with inactive ulcerative colitis often have reduced ability to ferment fibre b) Supplementation with fibre as a combination of resistant starch and wheat bran-associated non-starch polysaccharide is well tolerated in patients with ulcerative colitis in remission c) Supplementation with this fibre combination tends to normalise gut transit, but does not increase the proportion of dietary fibre fermented d) Diminished fermentation is not related to rapid gut transit, but more likely resides in the abnormal microbiota Impact on future clinical practice a) The effects of dietary manipulation directed at changing colonic physiology and/or gut microbiota in healthy subjects cannot be extrapolated to patients with ulcerative colitis b) Supplementation with a combination of resistant starch and wheat bran in patients with ulcerative colitis may have some benefits to colonic physiology and health

The individual and community cost of chronic low back pain (CLBP) is staggering. Guidelines recommend physical activity (PA) as a management for CLBP. Adults with CLBP report unique barriers to PA which need to be overcome to facilitate long term PA behaviour change. Walking, regulated by an internal sense of emotion (affect-regulated), may provide an effective approach to increase PA in people with CLBP. The primary hypothesis is that affect-regulated walking (ARW) will lead to improved disability status and increased PA levels compared with usual advice walking (UAW).

This study aims to establish the safety and best tolerated dose of a new investigational drug called APG-1387 in participants with advanced cancer. Who is it for? You may be eligible to join this study if you are aged 18 years or more and have been diagnosed with an advanced solid tumour or lymphoma. Study details All participants in this study will be treated with a new investigational drug called APG-1387. This drug blocks tumour growth by promoting cell death (a process called apoptosis) in cancer cells and attempts to stop the cancer cells from spreading further throughout the body. This drug has not previously been tested in humans. APG-1387 has undergone extensive testing in various animal models (including rats and monkeys) and human cancer cell models in the laboratory. APG-1387 will be administered via intravenous (IV) infusion (i.e. directly into the vein) on Days 1, 8 and 15 of study participation. The first group of participants will receive a dose of 0.3 mg of APG-1387, and if tolerated the dose will be increased for subsequent patient groups. Participants will be regularly monitored until they reach their endpoint (disease progression, intolerable toxicity or withdrawal of consent) in order to determine safety, tolerability and preliminary efficacy of treatment. The results from this study will be analysed to see if it is worthwhile for this new drug to be tested in future studies involving larger numbers of cancer participants.

This study aims to determine whether adding the drug, Tocilizumab, to standard transplant immunosuppression is safe and effective at preventing acute graft versus host disease (GVHD). Who is it for? You may be eligible to join this study if you are aged between 18 and 70 years of age and are undertaking HLA-matched allogeneic haematopoietic cell transplantation (HPCT). Trial details: Participants in this study will be randomly (by chance) divided into one of two groups. Participants in one group will receive a single dose of 8mg/kg Tocilizumab by a 60 minute intravenous infusion (administered via the vein). This will occur one day before your HPCT. Participants in the second study group will receive a placebo treatment. Participants will be assessed for up to 2 years to determine the incidence of GVHD.

Peanut allergy is increasingly common, especially in countries such as Australia and to date no safe and effective therapy exists to cure peanut allergy. Recently studies have looked at desensitising people with peanut allergy by giving them small daily doses of roasted or raw peanut. Although this therapy works for some people, its effects are not generally long lasting and it is associated with many side effects. It is possible that boiled peanut is less immunogenic than roasted peanut and it may provide a safer way to desensitise patients who are allergic to roasted peanut by desensitising them first to boiled peanut.

Distal radius fractures are one of the most common orthopaedic injuries encountered in Australia. Vitamin C has been identified to potentially decrease the incidence of complex regional pain syndrome post distal radius fractures, however the evidence is still inconclusive regarding pain. It is our intention to identify if implementing daily vitamin C post distal radius fixation reduces pain at 6 weeks.

This trial will compare two commonly used treatments for patellofemoral pain, foot orthoses and hip strengthening exercises. There is evidence to support both approaches, and often debate revolves around counter-posing perspectives as to which may be more effective to use, yet the two treatment approaches have not directly compared before. Previous foot orthoses trials have reported benefits on patient rated outcomes from use of foot orthoses over a flat shoe insert or adopting a wait-and-see approach in the treatment of patellofemoral pain. Recent trials implementing hip strengthening exercises have demonstrated reduced pain and improved ability to climb stairs after strength exercises for the hip, in people with patellofemoral pain. In the FOHX trial, participants will be randomly allocated into either wearing foot orthoses or performing hip muscle strengthening exercises. The clinical trial will compare the outcome of the two treatments, and also identify the baseline profile (physical measures and patient perceptions) that are associated with the greatest response to foot orthoses or hip strengthening exercises.

Bloodstream infections (BSI) are an important cause of morbidity and mortality. Several studies have demonstrated that early, appropriate antimicrobial therapy reduces BSI associated mortality and reduces hospital length of stay. Conversely, antimicrobial therapy should be minimised in patients that do not have infection to reduce the impact of antimicrobial agents on resistance, including in patients where blood culture isolates represent contamination. The aim of this project is to assess the implementation of Antimicrobial Stewardship Team review on time to appropriate antimicrobial therapy in patients with a positive blood culture at The Alfred Hospital.