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Working memory is essential for key cognitive processes including reasoning, language comprehension and learning. Many neurological and psychiatric disorders result in working memory impairments and any technique that may enhance working memory would be very useful. For example cognitive dysfunction is a core feature of schizophrenia. The main areas affected include attention, memory and executive functioning; with working memory in particular frequently affected. These difficulties have been shown to negatively influence patients’ psychosocial functioning. Traditional treatment approaches have resulted in small gains at best. It is therefore essential that novel treatment approaches are explored. Recent research has suggested that brain stimulation, and in particular transcranial Direct Current Stimulation (tDCS), may have a role to play in improving cognition. While tDCS has been shown to improve working memory in a number of conditions, to date there have been no tDCS studies looking at the enhancement of working memory in schizophrenia. tDCS has been shown to be safe, with very few side effects. It involves the application of a very weak electrical current (1-2mA) using two surface electrodes (anode and cathode) to the head. The use of tDCS on the cortex has been shown to alter the how likely nerve cells are to fire and the effect generally has been shown to last up to 1 hour after stimulation. To date, a number of studies have examined the effect of tDCS on working memory, with some mixed results. While some studies have shown improvements in working memory during a session of tDCS (Boggio et al., 2006), other recent research has found no significant improvement (Marshall et al., 2005). A recent study has shown significantly better performance in a working memory task completed during an application of tDCS to the dorsolateral prefrontal cortex (DLPFC), a part of the brain associated with this type of thinking activity (Fregni et al., 2005). However, despite the breadth of tDCS research being undertaken, many questions remain regarding the most effective stimulation parameters, particularly with respect to optimal current strength (i.e. 1 or 2 mA). The current study aims investigate this in healthy participants and patients with schizophrenia.

The purpose of this study is to describe in better detail the airway inflammation and remodelling that we know occurs in COPD and to see what effect inhaled steroid medication has on the inflammation/structural changes and symptoms of the disease over a 6 month period.

Approximately 40,000 Australian women annually experience postnatal depression. Postnatal depression interferes with mother-infant relationships, which can influence brain development and long-term cognitive and behavioural outcomes for the child. Current best practice treatment for postnatal depression generally involves treating only maternal mood. However, treatment focusing on maternal mood alone does not improve the mother-infant relationship. Therefore, it is important to directly target mother-infant difficulties as part of the routine care of postnatally depressed women. Existing mother-infant interventions targeted at women with postnatal depression are scarce, poorly-evaluated, of long duration, and have not been adapted for Australian use. This study aims to evaluate the effectiveness of a brief, cost-effective 4-week early intervention program that we developed to improve the mother-infant relationship (Happiness, Understanding, Giving & Sharing "HUGS"). This intervention is added to a 9-week evaluated program we previously developed for treatment of maternal postnatal depression. Treating existing depression first increases the emotional availability needed for optimal mother-infant interaction. The HUGS intervention has shown promising results in two pilot studies. In a randomised controlled trial comparing HUGS to an attention placebo playgroup (control group), the quality of the mother-infant relationship and developmental milestones will be assessed in 100 mother-infant dyads. It is hypothesised that women undergoing the combined postnatal depression treatment and HUGS program will show greater improvement compared to the control group who receive postnatal depression treatment followed by the attention placebo playgroup in: 1. The observed quality of the mother-infant interaction; and 2. Maternal reports of parenting stress, including feelings of attachment to their infant. It is also hypothesised that infants undergoing the HUGS program will show greater improvement compared to infants in the attention placebo playgroup, in terms of: 1. Difficult infant behaviour; and 2. Early developmental milestones.

1. BACKGROUND Febuxostat is a novel xanthine oxidase inhibitor licensed in USA, Europe and Japan for treatment of gout and other hyperuricemic disorders. There has been no attempt to license it in Australia because the market is considered too small. In Australia, the only xanthine oxidase inhibitor on the market is allopurinol. Allopurinol is an analogue of xanthine, which competitively binds xanthine oxidase. Febuxostat is not a xanthine analogue and so works by a different mechanism to competitively inhibit xanthine oxidase. The cornerstone of treatment of patients with moderately severe IBD is thiopurine therapy. Thiopurines are cytotoxic and immunosuppressive therapies originally designed for treatment of acute childhood leukemias and for organ transplantation. Patients have regular monitoring of treatment response as well as blood tests (FBC = full blood count) to ensure that there is no over-immunosuppression and that there is no excessive build-up of methylated metabolites which are hepatotoxic (therapeutic drug monitoring of thiopurine metabolites). Prof Florin and others have pioneered the combination of allopurinol – thiopurine co-therapy in IBD. The advantages of this therapy are that there the thiopurine requires a considerably lower dose (about 1/3 normal dose) to achieve a beneficial treatment outcome and there are less of its toxic methylated metabolites. Currently, there is debate about why allopurinol can result in less methylated metabolites because allopurinol has no known action on methylating enzymes. Some people think that a metabolite of allopurinol inhibits the methylation enzyme but this has not been proven. Allopurinol is generally well tolerated but there are known severe adverse drug reactions including hepatitis, fever, severe skin rash, eosinophilia and renal failure which occurs especially in Asian populations. Febuxostat is a good alternative therapy to allopurinol, but its therapeutic action when combined with thiopurines is unknown. We wish to investigate whether febuxostat – thiopurine co-therapy also works for IBD patients. 2. AIM(S) OF STUDY A pilot experiment with highly motivated patients who accumulate increased methylated metabolites on thiopurine monotreatment. 3 HYPOTHESES 3.1 The combination of thiopurine – febuxostat will allow us to use less thiopurine to effect immunosuppressive and therapeutic success. 3.2 Febuxostat will cause a reduction in methylated metabolites of thiopurines.

This is a placebo-controlled, double-blind, randomized, crossover trial. Conditions will follow a 2 (placebo/glucose) X 2 (+/- secondary task) design. Participants will be required to come for 5 visits. The first visit is a practice day where participants complete screening questionnaires and familiarise themselves with the study procedures and tests. The following 4 days are scheduled at least 48 hours apart and participants are randomised to receive one of two treatment drinks (25g glucose/placebo) and +/- the secondary tracking task. They then undergo 8 blocks of testing. In each block they will be presented with 20 words in the auditory modality, via headphones connected to a computer. If they are in the secondary tracking task condition, they complete the tracking task on the computer while listening to the words. Following the word presentation, there is a word recognition task where participants are presented with the 20 original words mixed with 20 new words. Participants indicate whether or not the word was in the original list by clicking ‘yes’ or ‘no’. If they indicate yes, they are prompted to indicate whether they (1) remembered it was in the original list, (2) know it was in the original list, or (3) guessed it was in the original list. 64 channels of EEG will be recorded during whilst participants perform this recognition memory task. Levels of blood glucose, insulin and cortisol will be taken throughout the study days

Aim is to assess whether a novel cardiac magnetic resonance imaging (CMR) technique, T2 mapping, can identify myocardial edema as a marker of myocardial injury and be used as a predictor of cardiac dysfunction in patients undergoing anthracycline chemotherapy.

This study tests the short and medium term efficacy of the online Mood Mechanic Course with adults aged 18-24 with symptoms of anxiety or low mood.

The trial is a trial comparing two modes of mechanical weaning in patients in ICU who are eligible for weaning from mechanical ventilation

This is a pilot study of safety and infectivity in 2 healthy volunteers of a new Plasmodium vivax Malaria bank obtained from a malaria infected patient under HREC approval from both Royal Brisbane and Women’s Hospital and Queensland Institute of Medical Research. The Malaria bank was prepared under highly controlled conditions using protocols developed in conjunction with the Red Cross the US FDA and QGen. The clinical protocol is based on prior studies using the 3D7 Plasmodium falciparum isolate. The malaria bank has had full serological and PCR evaluations over 6 months meeting the criteria of ARCBS blood donation requirements. The antimalarial agent used to treat the malaria is the TGA approved Riamet, which was also used to eradicated the malaria infection in the patient donor.

Pregnancy is associated with major physiological changes that affect coagulation and fibrinolytic system. An imbalance to this system leads to a hypercoaguable state and pregnant women are therefore at an increased risk of venous thromboembolic disease (VTE), especially if they are affected by an associated acquired or inherited thrombophilia. There are two factors that may exaggerate this risk; the high-risk nature of the thrombophilia and a history of a previous unprovoked VTE. High-risk hereditary thrombophilia include antithrombin deficiency, prothrombin gene mutation (PGM), and factor V leiden (FVL), while the presence of lupus anticoagulant or anticardiolipin antibodies are considered as acquired risk factors. Furthermore, homozygosity or presence of a combination of thrombophilia factors will aggravate the VTE-risk by certain fold increase. Apart from the occurrence of VTE, maternal thrombophilia has also been variably associated with an increased risk of early miscarriages, intrauterine growth restriction (IUGR), and pregnancy loss. Although it may seem intuitive to treat pregnant women with high-risk thrombophilia with anticoagulant prophylactically, there is a paucity of randomised trials in this area, and the balance of intervention versus conservative management should be carefully evaluated from both fetal and maternal point of view. Evidence-based guidelines have been published in an attempt to provide a more uniform clinical approach; however there appears to be a lack of consistency among different guidelines. The decision to recommend anticoagulant prophylaxis to women with thrombophilia is based on the risk-assessment or balance of bleeding versus VTE-risk as well as the potential effects of VTE and anticoagulant can have on pregnancy. However, the use of anticoagulant in pregnancy is challenging because of the potential for maternal and fetal complications. Despite this and the lack of controlled trials, there has been increased use of anticoagulants to prevent VTE and adverse pregnancy outcomes. In this retrospective/prospective study, the management strategies of women with high risk for thrombophilia who received antenatal care at a single institution during the period between Jan 2007 and December 2010 were reviewed and analysed.