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Lung INterdisciplinary Clinic (LINC): reducing biopsychosocial distress in patients with lung cancer and mesothelioma
Expand descriptionThis study will attempt to determine what causes distress in lung cancer and mesothelioma patients and whether having access to an interdisciplinary team reduces this distress. Who is it for? You may be eligible to join this study if you are 18 years or over with lung cancer or mesothelioma, and currently under the care of any/all medical oncologist, respiratory physician, radiation therapist, palliative care specialist at Sir Charles Gairdner Hospital. Trial details: Participants in this trial will receive access to allied health staff (including Social worker, Physiotherapist, Occupational Therapist, Dietitian and Clinical Nurse) who can assist them with strategies for reducing or managing their concerns. The overall duration of this study will be 6 months in which we will aim to assess all patients with a new diagnosis of lung cancer or mesothelioma and existing patients as required. Study aims: To compare distress in lung cancer and mesothelioma patients before and after having access to a team of allied health staff to address their concerns.
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A Single Centre Phase II Study Of Haematopoietic Stem Cell Transplantation (HSCT) for Severe Auto-Immune Diseases.
Expand descriptionDiseases such as Scleroderma, Multiple Sclerosis (MS), Systemic Lupus Erythematosus (SLE), vasculitis, Chrohn’s disease, Behcet’s disease refractory to all available therapies and in the opinion of the referring physician, HSCT is a valid therapeutic option for that patient. These patients will require an independent physician to assess the patient’s suitability for HSCT. Patients will undergo GSCF stimulated stem cell collection following chemotherapy. Patients are readmitted for autlogous transplant and will have specific high dose immunosuppresssive therapy depending on their disorder followed by stem cell re infusion
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Haploidentical donor stem cell transplantation for haematological malignancies - a Phase 1/2 pilot study in an Australian population
Expand descriptionThis study aims to evaluate the effect of haploidentical donor stem cell transplantation in patients with haematological malignancies. Who is it for? You may be eligible to join this study if you are aged between 16-50 years and have ongoing complete remission of underlying haematological malignancy. You should have available a haploidentical family donor. This is a donor who is a 50% match, and can be a parent, sibling or child. Trial details All participants in this trial will undergo ten days of chemotherapy treatment, followed by infusion of peripheral blood stem cells (PBSCs) from the donor into the vein (i.e. intravenously). Participants will also be administered a number of medications to prevent graft versus host disease (GVHD), which is a common complication following stem cell transplantation. Patients will be regularly assessed for up to 12 months in order to evaluate clinical efficacy and safety of treatment.
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Pilot Study of partially Human Leucocyte Antigen (HLA)-mismatched stem cell infusions after chemotherapy for acute myeloid leukaemia in patients over the age of 60.
Expand descriptionThis study aims to determine the effect of partially HLA-mismatched stem cell infusions after chemotherapy for acute myeloid leukaemia in older patients. Who is it for? You may be eligible to join this study if you are aged between 60-85 years and have been diagnosed with acute myeloid leukaemia (AML) which has been previously untreated. You should be undergoing induction chemotherapy and have an available partially HLA-mismatched donor. Trial details: All participants in this trial will undergo standard induction chemotherapy. Peripheral blood stem cells (PBSCs) will be collected from the available donor, then harvested and administered to the patient on day 9 of induction chemotherapy by intravenous infusion (i.e. directly into the vein). On day 28 a bone marrow biopsy will be performed, and if complete remission is confirmed then patients will proceed with two cycles of consolidation chemotherapy. If the patient is not in complete remission then a further cycle of induction chemotherapy followed by PBSC infusion is offered. Participants will be regularly assessed for up to 24 months in order to determine clinical efficacy and safety of the treatment.
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Randomised controlled trial of cemented and uncemented fixation of primary total hip replacement
Expand descriptionUncemented porous coated prostheses were introduced in the early 1980s as a possible answer to the complications of loosening of cemented prostheses and osteolysis. At that time, there was a lack of comparative studies, there being only one published randomised controlled trial of cemented and uncemented THR. In that trial, worse early pain scores were reported for uncemented THR. Therefore a randomised controlled trial was undertaken to examine the hypothesis that there are no important differences in hip pain and function following cemented and uncemented primary total hip replacement for osteoarthritis in middle-aged patients.
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A randomized controlled trial of fish-oil supplementation for children with autism spectrum disorder.
Expand descriptionBackground: Autism Spectrum Disorder (ASD) is the broad term for neurodevelopmental disorders resulting in impairments in social interaction and communication, and a restricted range of activities and interests. Many countries, including Australia, have reported a dramatic increase in the number of diagnoses over the past three decades, and recent estimates put the prevalence of ASD at 1 in every 110 individuals (~1%). The use of specific supplements, nutrients and dietary plans have become widespread, including the use of supplements such as fish oil (currently up to 40%). However, use of these supplements is typically based on parental report and supported by little actual evidence, and therefore fish oil represents an additional invalidated cost to families already spending a considerable sum for their child’s therapy. Aim: The aim of this study is to find out more about the effect of fish oil for children with ASD, by examining the effects on behaviour, cognition and language. Significance: While there have been a small number of studies investigating the effects of fish oil for children with ASD, these studies had a small number of participants, a large age range of participants, a lower dosage and a less varied range of assessments. Approach: We will recruit children with ASD between the ages of 2 to 6 years to receive either 2ml of fish oil liquid daily consisting of a total of 1.08 grams of omega-3 long-chain polyunsaturated fatty acids per day or 2ml of control liquid per day, containing 1 gram of sunflower oil per day. All group supplements will be provided daily for six months, and will consist of a 2ml flavoured liquid, identical in taste and colour. Before and after supplementation children with be assessed using a number of tests assessing behaviour, neurocognition and language, to see if supplementation improved any of these skills.
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Reducing cost and enhancing access to disease management programs after an acute coronary event
Expand descriptionACS patients discharged from RPH from 1st April 2011- 31st March 2012 will be compared to those discharged 1st April 2013- 31st March 2014 . The study will compare 2 models of cardiac rehabilitation: traditional cardiac rehabilitation vs a new alternative model implemented in April 2013. The proportion that access cardiac rehabilitation and secondary prevention programs plus cost effectiveness will be compared. Cardiac rehabilitation is defined as having an initial assessment and individualised plan within 2 weeks , education, and follow up at 3 months. Between April 2012 - March 2013 changes to referral processes and RPH cardiac rehabilitation program delivery were implemented using information sought from staff and patient surveys and focus groups. The study will compare readmssion rates and mortality of both ACS cohorts at 12 months after discharge.
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A placebo-controlled, randomized, double-blind trial of the effects of modified release 4-aminopyridine on upper limb impairment in Multiple Sclerosis
Expand descriptionThis study involves a new drug, Fampyra (modified release 4-aminopyridine) which has recently become available for the treatment of walking disability in MS. It is not yet known whether the drug could also be helpful in treating other symptoms of MS such as upper limb dysfunction or visual problems. In addition, it is not known how Fampyra works and why it seems to work better in some people than others. This study seeks to answer some of these questions by testing the effects of the drug on upper limb impairment and using a selection of clinical and electrical tests of nerve function.
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The use of ultraviolet light photochemotherapy Polarised Ultra Violet A [PUVA] in the oral cavity in conjunction with a oral photo-sensitiser [5-methoxypsolaren or 8-methoxypsoralen] for oral graft-versus- host disease [GVHD] in allogeneic bone marrow transplant patients [ABMT].
Expand descriptionPatient will recieve a controlled exposure of UVA using a Spectraline wand with a an oral photosensitiser such as 8 MOP or 5 MOP. Exposure to the UVA starts at 15 sec and increments by 15 secs once a week to a maximium exposure of 60 secs. All patients will be offered a total of 40 treatments of the combined therpay. Patients will be evaluated by their specialist at treatments 1, 10, 20 and at treatment 40 or termination/withdrawal. Early conclusion or treatment or temporary interuptions are permitted if remission is attained.
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Impact of pharmacogenomics and metabolism on the effectiveness and toxicity of racemic ketamine in palliative care and chronic pain patients
Expand descriptionThe primary purpose is to determine whether the effectiveness of ketamine and its toxicity are related to the circulating plasma concentrations of ketamine and/or its active metabolite norketamine. The study hypothesis is that there is a plasma concentration window for ketamine, below which it is ineffective to control pain and above which it produces adverse effects, and that the concentration is dependent on the patient's genotype for CYP2B6