ANZCTR search results

Injuries to the neck following whiplash trauma (whiplash injury) are one of the most common causes of neck pain and disability in the developed world. The purpose of this study is to investigate the use of magnetic resonance (MR) imaging in combination with physical and psychological measures, to identify structural lesions of the neck following whiplash injury. The ability to identify and differentiate the relationship between structural lesions and physical and psychosocial measures in whiplash patients will potentially enable more specific and timely management thereby potentially reducing the number of patients who develop chronic symptoms.

This study will evaluate whether the addition of a survivorship care plan to standard follow-up care is feasible and whether it will have an impact on quality of life and unmet needs in survivors of early breast cancer. Who is it for? Participants in this study are women aged 18 years and above who have completed hospital-based treatment for early invasive breast cancer (surgery, radiotherapy and/or chemotherapy). Study details All participants in this study receive a survivorship care plan in addition to standard follow-up care. The survivorship care plan is a written summary of cancer treatment with a follow-up plan for future care. The care plan will be developed by one of the patient's regular cancer specialists, in consultation with the woman herself. A schedule for follow-up consultations and tests will be developed. The woman will also be advised about what to expect (health and emotions) in the months and years to follow, and who to contact if there are problems between visits. Participants will complete baseline questionnaires evaluating their unmet needs and quality of life. They will then receive routine cancer follow-up, supplemented by the survivorship care plan for a period of 18 months. Questionnaires will be repeated at 6 and 18 months from enrolment in the study. The 6 and 18 months questionnaires will also include an evaluation of the care plan.

Iron deficiency is commonly seen in congestive heart failure (CHF) in both anaemic and nonanaemic patients. Recent studies have shown that intravenous iron treatment for iron deficiency, with or without anaemia, in congestive heart failure patient improves symptoms, functional capacity and quality of life. This study expand the investigation on the effect of intravenous iron to exercise capacity, echocardiogram changes as well as physical functioning and quality of life in patients with iron deficiency and congestive heart failure.

This is a multi-center, prospective, study to collect data on the commercially available Nevro Senza SCS System. Outcomes will be assessed via standardized assessments (trial and IPG implant procedures are part of routine practice). The purpose of this study is to document and assess safety and effectiveness of HF10 electrical stimulation delivered to the spinal cord in subjects with chronic, intractable pain of the upper limb and neck, as part of the centers’ routine practice (on-label use of TGA approved/CE marked device). Data at follow-up visits will be compared to Baseline data collected at the beginning of the study. This study includes extensive data collection (Trial and IPG implant procedures are part of routine practice). Subjects will participate in this investigational plan that includes entry criteria evaluation, baseline assessments, trial stimulation phase, and post-trial assessment. Subjects with a successful Trial Phase will be implanted a permanent system (i.e. IPG) and leads as per center’s routine practice, and undergo 12 months of stimulation delivery with assessments at 1, 3, 6, 9, and 12 months Post-Permanent Device Activation. Assessments of pain and adverse events will be made at 1 month and 9 months following Post-Permanent Device Activation. At 3, 6, and 12 months Post-Permanent Device Activation, subjects will be assessed for pain and adverse events as well as disability, functioning, neurological assessment, medication use, quality of life, depression and sleep. Patient Global Impression of Change, Clinician Global Impression of Change and subject satisfaction will be recorded at 3 and 12 months Post-Permanent Device Activation.

BACKGROUND A significant proportion of caregivers of palliative care patients experience severe psychological distress and complicated grief. Little is known on the psychological impact of a patient’s death and dying among significant others who may not be recognised as the primary caregiver but nonetheless share a close relationship. However, research has shown that caregivers and significant others indicate a similar need for support. In this project, we will evaluate an Acceptance and Commitment Therapy based intervention for caregivers and significant others. Acceptance and Commitment Therapy (ACT) is a mindfulness-based behavioural therapy that encourages individuals to accept unwanted private experiences (e.g. thoughts, feelings) that are out of their personal control and engage in values-guided action that gives meaning to their lives. The intervention is a guided self-help program consisting of an ACT booklet and telephone support by a counsellor. AIMS To measure the efficacy of the ACT self-help program at postintervention in improving: 1. acceptance and valued-living 2. depression and grief METHODS This project is a two-arm randomised controlled trial: participants are randomly allocated to the intervention or control group. The control group will receive treatment as usual from the palliative care service in the form of psychosocial support from social workers. The intervention group will receive the ACT booklet and telephone support. The booklet will guide caregivers and significant others to manage difficult thoughts and feelings and engage in valued activities (i.e. things they care about that give them meaning and fulfilment). The telephone support comprises a phone call after 1 week of receiving the booklet to address questions about the self-help booklet. Participants complete three questionnaires: preintervention, 1-month postintervention, and 6 months postbereavement. The questionnaires ask about feelings; values in life; attitudes towards life, death and dying; and communication with the patient.

Back pain is very common, and the leading cause of disability in Australia. The relationship between MRI findings and symptoms in people with LBP remains unclear. There are very few high quality research papers investigating the relationship between MRI findings and low back pain. Very few studies have performed repeated MRIs and in these studies scans have been separated by long periods of time. Almost nothing is known about the changes in MRI findings in the first 6 weeks after an episode of low back pain despite this being the critical time period when most changes in clinical symptoms occur. To investigate the potential importance of MRI findings as a source of low back pain, it is essential to track these findings closely during an episode of low back pain and investigate the relationship between changes in MRI and changes in patient’s symptoms.

This project builds on an earlier projects and seeks to examine the efficacy and acceptability of the Pain Course when provided in a tertiary pain service. We expect that participants will report improvements in symptoms of anxiety, depression and disability levels.

A prospective randomized clinical trial to compare the urinary sodium excretion in ICU patients with fluid overload treated with frusemide alone when compared with frusemide and Indapamide

Intravenous adenosine is used to minimize the coronary micro-resistance to achieve maximal hyperemia along with nitrates for optimal fractional flow reserve (FFR) measurements. We hypothesize that caffeine, being a competitive inhibitor of adenosine, would influence adenosine mediated FFR readings. Consecutive patients undergoing angiogram and FFR measurements were enrolled after abstaining from caffeine for 24 hours. Patients with any contraindications to intravenous adenosine or caffeine were excluded. FFR measurements were taken using nitrates and adenosine pre and post 4mg/kg intravenous caffeine administration and results were compared.

There is evidence that public health measures aimed at reducing the burden of obesity have not been effective. Whilst there are several possible reasons for this, including a multitude of competing messages, the overabundance of energy dense food and the near absence of obligatory physical activity, it is likely that the more important reason is the fact that weight appears to be physiologically regulated and defended. This means that using public health measures to combat obesity is not likely to work for obese subjects. What is not yet known is if subjects who are overweight (as opposed to obese), defend weight loss, nor is it known if modest (~5%) weight loss is defended. If overweight or modest weight losses are not defended, it would allow the targeting of public health messages towards the overweight and to focus on modest weight loss in the obese. This study aims to investigate if overweight people defend weight loss as vigorously as obese people, and to determine at what degree of weight loss these physiological changes begin. Overweight and obese people will be recruited and placed on a VLED (very low energy diet) for a period of 12 weeks, aiming to decrease body weight by 15%. Measurements in body weight and a number of biomarkers will be taken at proscribed intervals. All participants will be followed up for a period of two years, to observe weight regain (if any). Gut hormone and other biomarker changes over the trial will be compared between the overweight cohort and the obese cohort, to determine any differences. For both cohorts, changes in gut hormones and other biomarkers will be compared at 5%, 10% and 15% baseline body weight lost, to determine when physiological defences increase.