ANZCTR search results

Obstructive sleep apnoea (OSA) is a disorder characterised by repetitive obstruction of the throat during sleep. People who suffer from OSA have increased risk of heart disease and are often very tired during the daytime. Currently, continuous positive airway pressure (CPAP) is the most common treatment for OSA because it treats the disorder in almost all patients. Many patients, however, do not like using CPAP for several reasons (for example it is bulky, or is uncomfortable), and therefore choose not to use it. For this reason, we wish to find an alternative treatment that is effective and well tolerated by patients. A recent research paper has suggested that acupuncture can lower the severity of OSA. However, the authors did not investigate how acupuncture caused the change in OSA severity. Our study aims to 1) see whether acupuncture treats OSA, and 2) try and work out how acupuncture is improving the severity of OSA. It is hypothesized that patients will experience fewer respiratory events and experience less daytime sleepiness after twelve treatments of acupuncture, but that placebo acupuncture will have no effect on the severity of OSA or sleepiness. It is also hypothesized that for those patients who experience reductions in the severity of their OSA symptoms will show changes in the activity of the airway muscles, changes in the resistance to airflow in their throat and changes in the amount of effort required to wake them from sleep while they are having a respiratory event.

The pituitary gland is an important gland that assists in control and release of hormones in the body. Abnormal growths in the gland, called “pituitary tumours or adenomas” can occur. The most frequent type requiring surgery is the non-functioning pituitary macroadenoma (NFPMA), which are tumours that don’t produce any excessive hormones but can be associated with hormone deficiences. At St Vincent’s Hospital, we have reviewed our own historical series of NFPMA. Between 1995 and 2010, 141 cases of NFPMA were operated on. It was observed that males were more likely than females to be to have 2 or more hormonal deficiencies at presentation. Post-operatively, 2 or more hormone deficiencies occurred more frequently in males and postmenopausal females but rarely in premenopausal females. So it appears that premenopausal females to have better hormonal outcomes. We have hypothesed that it may be related to lower pressure within tumours of premenopausal females. High pressure in the tumour is postulated to reduce blood flow to the pituitary gland and leads to death of normal hormone producing cells, thus less ability for hormonal recovery. This current project has been designed to confirm if gender differences in hormone deficiencies do occur after surgery. Also to demonstrate that pressure within tumours of premenopausal females in lower than males and postmenopausal females. These findings are important as they contribute to the understanding of hormonal differences in genders, which has not been fully examined before.

The assessment of patients presenting to Ed with chest pain aims to identify acute coronary artery syndrome (ACS) promptly and rule out ACS efficiently. This project aims to validate a 2 hour rapid rule out process and the GRACE Freedom for events score.

ATL1103 is being developed as a potential treatment for acromegaly, a disease of excessive growth hormone and insulin-like growth hormone (IGF-I) action. Twenty four acromegaly patients will receive 200mg ATL1103 three times in week one and then either once or twice a week for a further 12 weeks. All treatments will be administered by subcutaneous injection. The primary objectives of the study are to evaluate the safety and tolerability of the two dosing regimens of 1103, and to investigate the pharmacokinetic profiles of ATL1103. The effect of ATL1103 on serum IGF-I levels and on other pharmacodynamic markers will also be measured.

This project will examine a new treatment that is based on recent scientific findings about how children direct their attention to different stimuli that triggers anxiety. This treatment, called attention-focused treatment is delivered on a computer and takes about 30 min to complete. Children will complete the treatment 12 times over 3 weeks during sessions they can undertake at home. The treatment is thought to “work” because it helps children learn to control the focus of their attention on certain stimuli in the environment which in turn helps to prevent anxiety.

Approximately 40 % of elderly persons in South Australia are 'at risk' or are malnourished, and health service providers such as 'Meals On Wheels' offer elderly persons in the community a service which delivers nutritional meals to to assist them to live at home in their community for as long as possible. The broad aim of this pilot study is to compare the average amount of nutrients that elderly persons get from their 'Meals on Wheels' three course lunchtime meal to the amount of nutrients health professionals estimate you need for good health. Specifically, we would like to find out: 1) whether or not you are able to eat all of the food that is delivered each day 2) what things influence how much of the meal you eat 3) what helps or hinders you from eating the full meal and, 4) whether meals fortified with enough energy and protein to meet two-thirds of the an elderly persons estimated daily energy requirements and 100 % of their protein requirements are better than the current 'standard' MOW meal that aim to provide one-third of their energy and 50% of their protein needs, and if both meal types are indeed better than receiving no meal.

This study investigates the efficacy of an internet-based insomnia treatment program (SHUTi), compared to an internet delivered control program, as an adjunctive treatment to beyondblue guideline based treatment for reducing depressive symptom severity amongst men aged 50 and over with co-morbid depression and insomnia symptoms. Secondary aims are to determine whether adjunctive SHUTi improves insomnia and anxiety symptoms.

SCI results in severe impairment and is managed by a multidisciplinary rehabilitation approach. Unless sensitive and timely psychosocial assessment occurs, serious complications may not be identified or appropriately managed. This project will investigate the following within the Statewide SCI Units in Sydney: * develop and pilot a standardised psychosocial assessment schedule that can be used to monitor progress, set goals and detect psychosocial risks in people with SCI; * assess the efficacy of a multi-layered psychosocial cognitive behavioural therapy self-management rehabilitation package to be run as a service programme during inpatient rehabilitation in the SCI Units in Sydney

This study is trialling a new model of care for children and adolescents newly diagnosed with type 1 diabetes. Currently children remain in hospital for an average of 5-6 days while they receive initial stabilisation, commencement of insulin therapy and intensive education. Under the model being trialled, children will be discharged on day 2 after admission and will receive nursing support and education at home over a period of two weeks. They will continue to be under the care of an endocrinologist during this time and phone support will be available at all times. We will be assessing a range of clinical measures, patient satisfaction, knowledge, adjustment and quality of life in order to detemine whether this model of care is the same, better or worse than the existing one in terms of patient outcomes.

This study will investigate the quality of post surgical pain relief in patients who have undergone major gynaecological cancer surgery. Who is it for? You may be eligible to join this study if you are a woman aged 18 years or above, who is undergoing a laparotomy for gynaecological cancer procedures. Trial details Participants in this trial will be randomly (by chance) allocated to have their catheter inserted into one of three positions on the abdomen (i.e. abdominis plane, rectus sheath plane, or subcutaneous plane) at the end of their surgery whilst under general anaesthesia. The catheter is used to deliver pain-reducing medication and will remain in place for 48-72 hours post surgery. The total morphine consumption, pain, nausea and patient satisfaction will be compared amongst the three groups at 24 and 48 hours post surgery. It is hoped that the study will show that the patients who receive the rectus sheath block and transversus abdominis block will have more effective pain relief and require less morphine compared with the subcutaneous catheter group. Less morphine should reduce side effects and improve patient satisfaction.