ANZCTR search results

Ten participants will be recruited from Austin health into this pilot randomised controlled trial to investigate if negative pressure wound therapy increases healing rates in people with post operative foot wounds in the home care setting.

Following fetal death in the second trimester of pregnancy, labour is usually induced to deliver the fetus. This induction process is usually conducted with the synthetic prostaglandin E1 analogue misoprostol. This prostaglandin, although not licensed for use in pregnancy, is now in common prescribed for labour induction in the second trimester with a large accumulated experience both within Australia and internationally. Since 1996, misoprostol has been used at King Edward Memorial Hospital (KEMH) as the principal agent for second trimester pregnancy induction with a non-viable fetus. The sequential combination of the antiprogesterone agent mifepristone and the prostaglanding misoprostol is an established and effective method for second trimester pregnancy termination. Prior studies have demonstrated a significant reduction in the duration of abortion with misoprostol when mifepristone priming is used. Three senior clinicians at KEMH, including the co-investigator Professor Jan Dickinson, have Authorised Prescriber status for use of mifepristone for pregnancy termination and following fetal death. Since January 2008 the combination of mifepristone and misoprostol has been used at KEMH in approximately 500 cases of first and second trimester pregnancy termination of pregnancy, predominantly for circumstances of severe fetal abnormality. Interestingly, there is very limited published data on the use of mifepristone in combination with misoprostol for induction of mid trimester fetal demise, Currently at KEMH misoprostol alone is the most frequent method used for delivery in the presence of a deceased fetus. This is most likely due to the restricted access to mifepristone and the absence of high quality comparative data of its efficacy. In this study we plan to compare the administration of mifepristone prior to misoprostol for induction after fetal death at 14-28 weeks gestation with the use of misoprostol alone (the current KEMH standard protocol). The primary aim of this research protocol will be to compare the induction commencement to delivery interval between these two regimes. Secondary aims of this study will be to assess the incidence of maternal side-effects for each of the two regimens, post partum blood loss, placental retention rates and the need for subsequent curettage for retained placental tissue. We will also review the women’s satisfaction with the two treatment regimens. The amount of progesterone and estrogen circulating in the blood of the women prior to induction will also be assayed, given that mifepristone works by blocking the effect of progesterone. It may be that the efficacy of mifepristone is related to the concentration of progesterone in the setting of fetal loss.

Charles Sturt University is carrying out a research project on foot circulation in 2012-13. This is to determine if angina patch medication can help people with poor circulation to their feet. There is evidence to suggest that this patch treatment may be useful for many people by improving circulation to their feet and possibly also reducing pain and nerve damage associated with ischemia and diabetes. Reduced circulation to feet can be associated with problems such as foot ulcers, infection and amputations. The study involves about 100 volunteers who use a small dose patch on one foot and are monitored for the effects of this over 6 months of use. The effects on the circulation, the nerve function, wound healing and on foot pain in both feet will be checked. This study has the approval of the Charles Sturt University Human Research Ethics Committee. The study subjects are participating with the knowledge and approval of their general medical practitioners. This study should provide answers to the questions of who can benefit from this treatment and the ideal ways to use this patch medication to improve circulation to feet. The study will be helping the growth of understanding in this important area. This is likely to lead to improved prevention and treatment options.

This study will investigate the effect of prolonged dietary fat intake on fatty acid taste receptor expression (GPR120, GPR40 and CD36), fatty acid taste sensitivity and corresponding satiety responses.

We are studying the drug candidate, PF329, as a potential new medicine to treat pain, that is less easily abused than other pain medications. In early research studies, combinations of PF329 and the compound nafamostat showed the potential to provide protection from people taking too many pills at once. This study is intended to test the effects of various doses of nafamostat mesilate on the way the human body uses the drug PF329.

Falls are the most frequent adverse event reported in hospitals with over 30% of adverse events due to slips trips and falls. Recently we tested a falls prevention patient education program in a large randomised trial and found it was effective in reducing falls for patients with no cognitive problems. We now plan to test this education in 8 wards within the realtime clinical setting. The aims of the study are to evaluate the effect of providing patient education for cognitively intact older patients on the number of falls and also healthcare costs in aged care rehabilitation wards.

Etanercept, when given by injection overlying the spine, has been reported to be very beneficial for treatment of patients with moderate Alzheimer’s disease and is a beneficial treatment for other related forms of dementia in multiple published, peer-reviewed scientific studies. The primary aim of the study is to determine the safety and tolerability of perispinal injection of Etanercept in subjects with progressive dementia with a focus on Australian Alzheimer's sufferers.

The aims of this project are to determine: 1) If adults born small (Birth weight=1500-2500g) show normal aerobic capacity and skeletal muscle mitochondrial function in response to exercise training. 2) If the insulin sensitivity in adults born small is normal in response to exercise training. Method: Young (18-40 yrs) healthy male subjects (n=12/group) and those born small (Birth weight=1500-2500g) will be recruited and the peak pulmonary oxygen uptake (VO2 peak), a well-accepted measure of cardiorespiratory fitness, will be assessed. Seven days later, they will report to the laboratory after an overnight fast and provide a muscle biopsy sample for biochemical and molecular analysis. Insulin sensitivity will then be measured by infusing glucose into the arm via a catheter (a euglycemic, hyperinsulinemic clamp). At the end of the clamp, a second muscle biopsy sample will be obtained for assessment of insulin signalling activation. Subjects will then complete 4 weeks of exercise training that involves 60 min of exercise on a cycle ergometer per day for repeated blocks of 5 consecutive days, separated by a two days of rest. During the training the subjects will be performing cycling exercise for 1 hour for 4 days at 65% of their VO2 max. The subjects will be provided with an exercise bike to take home and they will perform the above mentioned exercise for 4 days at their home. The subjects will also be provided with a heart monitor to record their heart rate during exercise and monitor their activity levels.On the 5th day subjects will report to the laboratory, submit their heart monitors to the researchers and perform an interval training for 1 hour. At the end of the training the subjects will provide a post training VO2 peak test, leg muscle biopsies and another glucose infusion clamp will be performed to assess their response to training. Significance: Exercise can help normalise blood glucose levels in diabetics. However, it is not known if adults born small respond to exercise normally compared with control subjects. Further understanding of this response mechanism could lead to development of life style intervention/exercise training strategies to maximise the benefits of exercise in adults who were born small.

Lately, a new method for intraarticular hip injection has been increasingly considered, and is believed to be very accurate, eliminating the need for imaging assistance (which enables the surgeon to apply the treatment in an outpatient environment). This blind method of injection will be assessed by: 1. Injecting small amount of air into the hip prior to hip arthroscopy surgery in the operating theatre, in the same technique as it is performed on a regular basis, but via a different approach (anterior versus lateral) and initially with no image assistance. The location of the needle will then be assessed using fluoroscopy. 2. Injecting small amount of Methylene Blue into the hip prior to total hip replacement surgery, verifying its location and injection accuracy later during the same operation. Our hypothesis is that anterior hip injection technique, without imaging guidance, would yield high accuracy rates. Hip injections able to be performed without imaging will also lead to less expense for the patient and community with a reduction in burden on imaging services.

This trial will be looking at patients who have osteoarthritis of the knee. Such patients will be referred by their doctor for knee arthroscopy. These patients usually have mild-moderate osteoarthritis of the knee and will undergo arthroscopy to reduce their pain and improve function. At the moment, when the arthroscopy is performed, a certain fluid pressure is used. This trial will try using a lower pressure and compare it with the current standard. It is hypothesised that patients who get the lower pressure will have less pain, less bone marrow swelling and increased degree of function. These are the three areas the trial will be assessing and will be comparing this with patients who get the current standard pressure, 6 weeks after the arthroscopy.