ANZCTR search results

A study to find out if it is medically appropriate, and acceptable to the woman to use a balloon catheter as an outpatient improve the chances of a successful induction of labour.

The main goal of the study is to grow cells in the laboratory from tumours of patients with diffuse brainstem glioma and similar brainstem tumours. The aim of the results of the study is to help develop new and better treatments for patients with these types of tumours and help in choosing the right treatment for each patient and be able to predict which patients are more likely or not to respond to a certain type of treatment

The trial is a randomised controlled study into the effect of applying non-invasive brain stimulation to the cerebellum on the symptoms of cervical dystonia.

Atopic dermatitis, or eczema, is a chronic, inflammatory, itchy skin disease that affects 15-30% of children and 2-10% of adults. This condition is highly distressing and affects the quality-of-life of its sufferers and their families. Unfortunately, there is currently no adequate treatment for atopic dermatitis. Traditional Chinese medicine has had a long history of treating various conditions, including skin conditions such as atopic dermatitis. However, evidence is lacking. In attempt to find a better form of management for atopic dermatitis, we have formulated a new Chinese herbal formula, RCM-106, using Western and Chinese medicine theories. It is anticipated that RCM 106 would be able to reduce the severity of atopic dermatitis and possibly improve the quality-of-life of sufferers. The efficacy and safety of RCM-106 will be evaluated in a randomised, double-blind, placebo-controlled clinical trial. Participants of the trial have a 50-50 chance of being allocated to receive RCM-106 capsules or the inactive placebo capsules for 8 weeks. The progression of participants’ atopic dermatitis will then be observed and recorded to see how well RCM-106 works. Positive results from the trial may result in a better form of treatment for atopic dermatitis.

Eighty percent of adults will suffer back pain at some time during their life. More than one in three will develop chronic back pain and cost Australia about $9 billion per year. We can now identify those who will develop chronic back pain early. This project will test a new method of treating these people who are risk of chronic back pain. We predict that our short and targeted intervention will stop these people from developing of chronic back pain and this will lead to massive savings to the Australian community

We will collect placenta samples from both normal pregnancies and those complicated by preeclampsia (PE) or intrauterine growth restriction (IUGR). RNA will be extracted from these samples and will be used for whole transcriptome gene expression profiling including both coding and non-coding RNA. This will provide insight into differences between normal and PE and IUGR pregnancies in which the placenta is key to maternal and neonatal outcomes.

Type 2 diabetes mellitus (T2DM) is the fastest growing chronic disease in Australia today with an estimated 275 new cases every day. Currently 1.7 million Australians have diabetes and it is thought that up to half of these individuals are as yet undiagnosed. The annual cost of diabetes to the Australian healthcare system is estimated at least $3 billion. Diabetes was the underlying cause for 3.0% deaths registered in Australia in 2009 and additionally contributed to 10.1% deaths as either an underlying or associated cause of death. Worldwide it is anticipated that by the year 2025 there will be 300 million people with the disease especially given the epidemic of obesity and impact of sedentary lifestyles. It is known that individuals with diabetes have a significantly increased risk of cardiovascular disease. Recent data showed that this condition is underappreciated with 48% of all diabetic individuals, who had no previous history of structural heart disease, having evidence of Diabetic Cardiomyopathy echocardiographically. In diabetics, a complex series of metabolic disturbances results in heart fibrosis and enlargement. which ultimately leads to clinical heart failure. Despite 4 decades of research there are currently no specific treatments for diabetic cardiomyopathy. Prevention of this condition requires its early identification and treatment. Early treatment with medications known to improve heart failure outcome such as angiotensin-converting enzyme inhibitors (ACEI) and beta-blockers has been suggested from meta-analysis data specifically looking at diabetic subjects in the major heart failure trials to be beneficial . There is yet to be a long term follow-up study to definitively confirm this. Much of the previous work focusing on the early identification of this condition has been carried out by the Cardiovascular Imaging Research group through involvement in an NHMRC Centre of Clinical Research Excellence Award (455832). Work initiated in 2003 studied a large cohort of T2DM patients in a randomized controlled trial of lifestyle intervention. The results of this research were groundbreaking, proving that diabetic cardiomyopathy was able to be identified using novel echocardiographic imaging techniques. The proposed project aims to provide long term (10 year) follow up data on these original participants. To our knowledge this will be unique data within the literature allowing identification of markers of long term adverse prognosis and information about the factors affecting the progression of diabetic cardiomyopathy over time. Hypotheses The following hypotheses will be tested: 1. Diabetic cardiomyopathy is prevalent and progressive over time. Clinical and widely available testing including echocardiography and cardiopulmonary exercise testing is able to identify long term risk markers for diabetic cardiomyopathy which result in adverse cardiovascular morbidity and mortality. 2. Novel echocardiographic techniques, are superior to current echocardiographic techniques for the detection of diabetic cardiomyopathy and are better able to assess cardiac risk as evidenced by subclinical left ventricular dysfunction. 3. ACE inhibitor/Angiotensin Receptor Blocker (ARB) therapy and/or beta-blocker therapy will prevent the progression of DCM over long term follow-up.

Adolescent depression is both common and harmful, with an estimated 15-20% of adolescents experiencing clinical depression. Depression is strongly associated with disturbed sleep, a relationship that is particularly marked in adolescence. There is accumulating evidence that disturbed sleep can play a precipitating role in the onset of depression, which suggests that treatment of disturbed sleep might improve resilience against the development of depression. However, efforts to clinically target disturbed sleep as a critical mechanism in treatment or prevention are still in their infancy. Improved sleep can also be expected to benefit cardiovascular health. There is a complex relationship between depression, sleep and cardiovascular disease (CVD) across the lifespan, suggesting that early intervention for sleep may impact on a mechanism jointly associated with risk for CVD and depression. Aim: 1. To deliver a brief sleep intervention to adolescents who are experiencing both anxiety symptoms and sleep disturbance with the aim of preventing the onset of depression and improving cardiovascular health. Research Questions: 1. Can a brief sleep intervention: a. Improve both subjective and objective indices of sleep quality in at-risk adolescents, and will this improvement persist at two-year follow-up? b. Decrease reports of anxiety and mood symptoms, and prevent the onset of case level depression over a two year follow-up period in at-risk adolescents? c. Improve indices of adolescent cardiovascular health at two-year follow-up? 2. Are benefits to both mental and cardiovascular health mediated by measured improvements in sleep that result from the sleep intervention?

The primary purpose of this study is to investigate whether early intervention can improve outcomes following acute lower motor neurone facial nerve paralysis. The hypothesis is that by commencing mental imagery training during the time of complete facial nerve paralysis facial movements and quality of life will be improved following movement return.

Catatonia is a neuropsychiatric syndrome that can occur due to medical or psychiatric disorder. It is a behavioral syndrome that can be associated with schizophrenia, shizoaffective disorder, or atypical psychosis. ECT was found to be effective for both catatonic stupor and excitement, where benzodiazepine or neuroleptics may not prove successful, and has proven to increase intracortical inhibition (ICI) which is reduced in patients with schizophrenia. Since TMS has been shown to alter cortical excitability, this provides a rationale for moving from ECT to TMS based treatment. Essentially arguing by analogy with ECT, and its effect in depression, three case reports appear to show an ECT-like effect of rTMS in catatonic schizophrenia. All studies used facilitatory fast rTMS (10Hz and 20Hz) although on opposite sides of the prefrontal cortex. In this study we will replicate the best practice application of rTMS in the treatment of catatonia. Since this paradigm is similar to an existing treatment for depression at our unit, no additional preparation is required. As suitable participants are expected to be uncommon, a case series approach will allow us to recruit opportunistically, over an extended period, as clinically warranted. Findings will be reported as a series of case studies, or accumulated as a case series report, depending on the number of cases. This is a fairly novel application of rTMS, but builds on our unit’s experience with rTMS, and Dr Lee’s previous experience in catatonia research, to contribute to this emerging field. The objective is to answer two questions. Whether rTMS will affect catatonia, and what are the clinical circumstances that indicate rTMS treatment. A series of case findings will give an indication of an answer, and inform local treatment consideration.