ANZCTR search results

This study will evaluate whether maneuvres to re-inflate collapsed areas of lung during surgery for lung cancer help to improve post-operative oxygen levels. Who is it for? You may be eligible to join this study if you are 18 years or above and are scheduled to undergo surgical resection of your lung cancer with one lung ventilation. Trial details Participants in this trial will be randomly (by chance) allocated to one of two groups. Participants in one group will undergo what is called an alveolar recruitment manoeuvre once during and once following surgery. This involves a brief period of increased airway pressures with the aim of re-inflating collapsed lung units. Participants in the other group will undergo standard treatment with a protective one-lung ventilation strategy. Participants will not know to which group they have been assigned. Participants will be assessed peri-operatively to compare respiratory outcomes between these two manoeuvres.

Ventilator Associated Tracheobronchitis (VAT) and Ventilator Associated Pneumonia (VAP) are common complications of mechanical ventilation, that may result in prolonging ICU stays and can also be fatal for critically ill patients. The standard treatment is currently intravenous antibiotics. The emergence of multidrug resistant bacteria and Gram negative pathogens makes this approach increasingly less effective. In order to improve treatment options, aerosol antibiotics have been investigated. They generally result in a higher sputum concentration compared to intravenous delivery, with reduced systemic exposure. Studies of aerosolized antibiotics to treat or to prevent VAP indicate benefits such as lower rates of VAP at the end of treatment, reduced usage of systemic antibiotics, and earlier weaning of patients from the ventilator, leading to shorter stays in the ICU. Since VAP may be caused by Gram negative and/or positive bacteria, an adequate antibiotic regimen needs to cover both, and also have coverage for MRSA. This study therefore plan to investigate the combination of amikacin and fosfomycin.

Background There is debate about the effectiveness of written COPD action plans. A recent study by Bischoff et al (Thorax 2011) showed that adherence to a COPD action plan was associated with reduced time for exacerbation recovery. There are several barriers to adherence with a COPD action plan, such as: *The practicalities of the patient obtaining the relevant prescribed medications from the pharmacy at a time when the patient is unwell. *The indiscriminate us of relevant prescribed medication This study will test the effect of removing one of these barriers. For this pragmatic pilot study the COPD action plan, from the Australian Lung Foundation (ALF) will be utilised The Respiratory Chronic Care Program provides, regular planned home visits, offering continuing health support through education and assistance to patients, carers and their families. The program augments existing respiratory services by enhancing communicating and coordination of care between hospital, community and general partitioners. Primary Aim Is to provide a written action plan to COPD patients to assess whether dispensing antibiotic and prednisone leads to: *Better adherence with a written action plan *Better health outcomes Over 9 months compared with prescription “only” without dispensing these medications Secondary Aims *For the RCC team to gain an appreciation and understanding for research *Providing pragmatic data for future research and funding Reference: Effects of written action plan adherence on COPD exacerbation recovery. Bischoff E, Hamd D, Sedeno M et al. Thorax 2011;66:26-31

The American College of Sports Medicine has highlighted that there is insufficient evidence to recommend the utility of perceptually-regulated exercise as a primary method of exercise prescription. We have provided evidence that sedentary participant can use percpetually regulated exercise to increase fitness. This trial will: 1) test the efficacy of an 8 week perceptually-regulated program on aerobic fitness; 2) test the efficacy of an 8 week percpetually-regulated program on motivational processes. It is hypothesised that perceptually-reguated exercise at RPE 15 will lead to greater increases in aerobic fitness, compared to theRPE 13 and control, but that these will not be sustained over the 6 month follow-up period.

The aim of this investigation is to investigate three modes of supporting our outpatients to undertake the physical activity prescribed by their treating health professional (e.g. physiotherapist). This four group randomised study will investigate the merit of three modes of offering personalised support to patients (via the telephone, letters in the mail or email) in comparison to usual care. Potential participants will be identified by their clinical team who will also provide the research team with a list suitable activities they have prescribed for their patients based on their level of fitness and any health conditions they may have. These participants will then be randomised into one of four groups. The first group will only receive their routine care and no additional support (usual care control). The second group will receive support via the telephone. The third group will receive support via letters sent in the mail. The fourth group will receive letters sent via email. The interventions will last for a period of 12 weeks. They start off with intensive support, gradually reducing to less frequent support over the 12-week period. The support is provided by a suitably qualified health professional (e.g. Physiotherapist) as prescribed by the patients usual treating team. Data from this investigation will provide important information about the feasibility, costs and effectiveness of these interventions. This information will be used to inform future service delivery improvements and future research investigations.

Aims: Determine how, in people with neck pain, segmental spinal mobility changes following manual therapy. Background: Little is known about the specific mechanisms underlying neck pain, the subsequent limitation of movement, or the mechanisms of manual therapy interventions. There has been an international focus on improving the understanding of the underlying pathophysiology of spinal pain and on the pathophysiological effects of treatment to improve patient outcomes and reduce the cost and disability associated with spinal pain. One way of accessing this problem is to investigate what aspects of the person's condition changes when they improve following an intervention. Recently, methods involving MRI have become available that will allow such investigations to occur. Experimental procedure: Participants will be required to: (i) Undergo a standard physiotherapy assessment which includes taking a patient history and conducting a physical examination to ensure the patient is suitable for manual therapy treatment and that they have a limitation of rotation of at least 10 degrees. (ii) Attend Allamanda Private Hospital or a local radiology facility for assessment and treatment. Here one MRI of the cervical spine examination will be performed. (iii) Following the MRI, pain and range of rotation will be measured. One therapist will perform a palpation assessment. One segment considered to be contributing to the patient’s symptoms will be marked by taping a 0.8mm diameter sphere that will be visible on the fluoroscopic images. A second therapist will apply a manual therapy treatment for up to 4 mins to the segment selected. The treatment will be repeated until there is an increase of greater than 10 degrees in rotation or up to a maximum of 8 mins, whichever comes first. A second fluoroscopic examination will then be conducted.

The purpose of the study is to determine the best shock wave therapy protocol for a widely used treatment for calcific soft tissue conditions in musculoskeletal medicine. We would like to see whether the addition of ultrasound to shock wave therapy in treatment of calcific soft tissue pathologies improves patient outcome as determined by decrease in pain, improvement of function and decrease in size of the calcification. We believe that treatment outcome may be similar between groups. However it is possible that for superficial conditions patient guided protocols may be slightly superior. In deep structures such as the shoulder tendon the addition of ultrasound to target the exact area of calcification may be slightly superior . This study will hopefully help answer these questions.

The primary aims of this study are to determine whether the electroretinogram (ERG), particularly the Phototopic negative response (PhNR) can be improved in patients with glaucoma who take oral supplementation with Resveratrol (RSV) of different doses. Participants undertake full-field ERG testing and their recordings of responses are examined to determine whether there is a difference in ERG parameters between glaucoma patients taking different doses of RSV and after a wash-out period after stopping RSV.

A prospective randomised controlled study is to be conducted over 3 separate clinics to determine efficacy of PDT eze (a topically applied, naturally occurring pain receptor blocker) in managing sensory components, such as pain and discomfort, in relation to photodynamic therapy (PDT) and other causes of inflammation. The study will examine patients receiving treatment for solar dermopathy with photodynamic therapy (PDT) utilizing standardized protocols with 5 amino-levulinic acid (5ALA). Differences in both acute and late phase pain and inflammation will be measured. PDT eze and a placebo spray will be used on split body treatment, either arm or face, and therefore the participants are their own control. There will be 10 patients for each treatment area in each individual clinic, with a total of 60 participants included. PDT eze and the placebo will be applied via a spray prior to treatment with PDT. Both will be applied to each participant in a split body application. Application of active and placebo treatments will be randomized and only known to clinician administering. Participants will be asked to give pain scores for both treatment areas on a scale of 1-10 following illumination. These will be recorded and compared to other participants ratings to determine whether PDT eze has an effect on the pain and discomfort experienced during inflammation caused by PDT.

This study aims to evaluate the effect of telephone-administered CBT on outcomes for clients with diagnosed COPD who are assessed as having at least mild to moderate levels of depression and/or anxiety. It is expected that COPD patients completing telephone CBT in addition to usual pulmonary rehabilitation will have greater reductions in depression and/or anxiety scores than patients receiving usual pulmonary rehabilitation care and placebo phone contact.