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Cardiac arrest is a common and catastrophic event. Among survivors of cardiac arrest, many have ongoing problems in thinking and performing normal activities of daily living. Such difficulties may arise from lack of oxygen to the brain causing injury that occurs as a result of the cardiac arrest. Therapeutic interventions that can be applied to lessen the degree of brain injury after cardiac arrest are warranted and desperately needed. Insulin-like growth factor-1 (IGF-1) is a major growth factor and has been shown to play a role in recovery from ischemic damage due to its anti-cell death signaling activity. Scp776 is a first-in-class targeted growth factor therapeutic that selectively activates and prolongs insulin-like growth factor-1 receptor (IGF-1R)-driven pro-survival signaling in damaged tissues containing large numbers of apoptotic cells. As such, by conducting a multi-centre randomsied trial, we aim to determine whether treatment with scp776, compared to placebo, decreases the extent of brain injury as calculated by automated assessment of brain magnetic resonance (MR) imaging (RAPID Software) at 72 – 96 hours following randomisation in comatose adults resuscitated after out-of-hospital cardiac arrest. This study will enrol a total of 40 evaluable participants from 5 - 10 hospitals in Victoria, Australia. The primary outcome will be ascertained between 72 - 96 hours after randomisation. Study participants will be followed-up for 180-days post-randomisation, or death, whichever is earlier.

Myocardial infarction (MI) affects -57,000 Australians every year and almost half a million Australians have had a heart attack at some point in their lives. While mortality after MI has been declining over the last few decades, it is in the group of young patients that it has lagged. Data on the biological and pathophysiological factors related to MI in the young is scarce. In addition, there are gaps in quality of care due to the perceived risk for MI being low. The study aims to characterise the clinical presentation, risk factors, angiography findings, underlying aetiology, quality of care and sex differences, of young patients with MI (age <50 years). This is an investigator-initiated, observational, single-centre clinical registry study. Approximately 500 patients under the age of 50 years with MI will be either recruited Prospectively from Westmead Hospital.

Prosthetic joint infection (PJI) is a catastrophic complication of orthopaedic joint replacement surgery that is increasing in incidence despite current best-practice. The success rate of treating Prosthetic Joint Infections (PJI) ranges from 0 to 89%, and the median cost per patient in Australia is $34,800, with a 156% increase in treatment cost when the treatment fails. Emerging evidence suggests that Gut dysbiosis i.e altered gut microflora is associated with absence or reduced abundance of beneficial microorganisms, increased abundance of pathogens and could predispose patients to a higher risk of PJI post orthopaedic procedures. Supplementaion with suitable prebiotics (non-digestable carbohydrates) results in production of short chain fatty acids that alters gut microbiome favourable. Hence, in this study, we will be investigating the effect of modifying gut microbiome with an in-market prebiotic supplement on surgical outcomes and recovery in PJI patients.

Currently, specialised early interventions are not accessible for a majority of youth with Bipolar Disorder (BD) who seek care. To address this gap, we have developed a bipolar-specific model of care for those with early-stage BD (BLEND) integrating: (i) evidence-based psychological strategies delivered through digital and face-to-face sessions; (ii) psychopharmacological interventions; (iii) relapse prevention strategies, and (iv) online peer support networking. We will conduct a randomised trial to evaluate the effectiviness of BLEND, compared with an enhanced form of standard care (ESC). We will include young people aged between 15 and 25 years, seeking specialised help for Bipolar Disorder types I or II. After informed consent, we will randomise 125 such young people (1:1) to BLEND or ESC. Interventions will be delivered over 4 months and assessments will be conducted at Baseline, 2, 4, 6 and 8 months from Baseline.

People with severe asthma experience high symptom burden and frequent severe asthma attacks (termed exacerbations). In the last decade new biologic (antibody) treatments, including mepolizumab, have become available for severe asthma. Clinicians now recognise that mepolizumab treatment results in almost complete suppression of symptoms and exacerbations, termed remission, in around a quarter of patients. Remission of severe asthma is a relatively new concept, and further understanding of numerous aspects of remission is now required to promote remission as a clinical target and to further raise remission rates on treatment. To address this, in this study we aim to understand the clinical, immunological, economic and health literacy characteristics of long-term remission of severe asthma treated with mepolizumab.

This study aims to continue the pursuit of therapy approaches that view the client holistically, and do not just focus on their overt stuttering. Swift Group Improv Therapy uses group improv to support clients to positively participate and continuously engage in the activities and social situations that are important to them. Focusing on increasing the awareness of one’s own communication abilities in a risk-free supported environment guided by experts in the field of stuttering has the potential to improve long term outcomes for participants. Currently, relapse following treatment is estimated to occur in 30% to 60% of stuttering clients. This research will contribute to identifying specific factors that lead to favourable and less favourable outcomes among this group.

This is a multisite, pragmatic cluster randomised trial. We will compare the (1) Ageing Well Tool that incorporates a personalised report (provided to GPs and patients) that outlines the presence/absence of personalised risk factors coupled with clinical treatment recommendations and management plans, to (2) a treatment-as-usual with a self-help control condition. N = 384 patients (n = 192 for each condition) will be enrolled in the study. We expect the The Ageing Well Tool will result in significantly greater reductions in the number of risk factors present from baseline to 12-month screening compared to the control condition. The Ageing Well Tool will also result in increased healthcare costs and improved health outcomes based on activities undertaken by participants to change dementia risk factors, significantly reduced cognitive decline on neuropsychological measures, and older adult and GP satisfaction with the Ageing Well Tool treatment condition will be high with few significant barriers, at 12-month measurement.

Patients who are admitted to the Intensive Care Unit (ICU) are at high risk of developing delirium, a form of acute brain failure which can manifest with agitation and confusion, and/or withdrawal from interaction. When delirium occurs, the overall prognosis for the hospital stay is adversely affected, and there is a risk of future cognitive decline and dementia. There is no gold standard treatment for delirium. Its presentation in people admitted to the Intensive Care Unit (ICU) is complex and it complicates treatment of other conditions requiring ICU admission. ICU patients with acute delirium can be a danger to themselves and others. Presence of delirium confers an adverse prognosis for ICU patients, and management of delirium when it occurs is largely supportive. There is an urgent need for the exploration of new treatment modalities to manage acute delirium in critically ill patients. This exploratory study assesses the application of a helmet (twice daily from Monday to Friday, for up to 4 weeks) that delivers pulses of near-infrared light to the brain in patients admitted to the Mater Adult Intensive Care Service who are diagnosed with acute delirium. Four slightly different protocols (with variations of application parameters) will be used. Patients enrolled in the study will have assessment of brainwaves using Quantitative Electroencephalography (QEEG) before and after treatment. Other behavioural and physiological observations that are routinely collected and recorded in the medical record in ICU patients will also be assessed.

The Longitudinal Head Injury Outcome Project is a long-standing research project investigating the functional, cognitive, behavioural and physical and emotional outcomes of patients who have sustained a TBI from the time of injury up to 30 years after their injury. This study aims to provide comprehensive information regarding the difficulties experienced by these individuals and their families over long periods of time after injury. This information can be used to establish the needs of individuals with TBI, identify predictors of outcome, develop rehabilitation programs to improve outcome, inform TAC policy and provide ongoing service to TBI patients.

This project aims to gain insight into the effect of a digital physical activity intervention (tailored walking program and physical activity coaching) and an online psychological program (Pain Course) in people 50 years and over living with chronic low back pain (CLBP). Does a tailored walking intervention combined with an online psychological program improve physical activity levels measured by daily walk time in people 50 years and older with chronic low back pain (CLBP)? We hypothesise that our intervention will lead to an increase in physical activity levels (daily walk time) over 6-months. This project is a two-arm, single-blinded, interventional, randomised control trial with a 14-week intervention period and a 6-month follow up.