ANZCTR search results

The primary purpose of this study is to determine the efficacy of intranasal remifentanil for improving intubating conditions in neonates requiring the INSURE procedure as part of their medical care. Usual pain management (comfort/environmental measures and age/weight-appropriate sucrose) will be provided to all neonates.

The primary purpose of this study is to determine the efficacy of remifentanil infusion for alleviating pain in neonates requiring insertion of central venous lines for their medical care.

This study will identify whether promotiong the NHMRC safe drinking guidelines for children - not drinking before the age of 18 - has an impact on the uptake an overall alcohol consumption levels of children. Relative to the 14 control communities the adolescent children (age 11 to 17) in the 14 communities that have been randomly assigned to participate in the intervention process will demonstrate an average 15% greater decrease (relative to controls) in the prevalence of alcohol use.

Tendons and Tendinopathy Tendons are the tough fibrous bands of tissue that connect our muscles to bony prominences on the human skeleton. They are extremely strong and allow muscles to work to allow movement and stability of the human body. Tendinopathy is degeneration of healthy tendons and is sometimes called tendonitis or tendinosis. It is usually caused by microtears within the tendon and a decrease in tendon repair cells. GTPS and Gluteal tendinopathy Greater trochanteric pain syndrome (GTPS) is a common condition that typically affects females in the 40-60 year age bracket. Patients complain of pain felt over the outer aspect of the hip. The condition was previously labelled trochanteric bursitis however modern imaging techniques and better understanding has revealed that a common cause of GTPS is tendinopathy or tears of the gluteal tendons around the hip. The reported incidence is 1.8 patients per 1000 per year. Current treatments Currently, initial treatments centre around non-steroidal anti-inflamatory drugs, physical therapy and weight loss. The next stage of treatment is often corticosteroid injections into the gluteal bursa. These may be targeted under xray control, or blind. Steroid injections often give short term relief of symptoms, for 6 to 12 weeks but relapse of symptoms is common. At present, common treatment methods have proven relatively ineffective. Tendinopathy Tendinopathy is also common in other areas of the body such as the achilles tendon, patella tendon, rotator cuff and tendons around the elbow that give rise to tennis elbow. Studies have shown that the process in these diseased tendons is similar. There are micro-tears in and around the tendon that lead to a decrease in tendon repair cells. Given that examination of tendinopathic tendons has revealed cell death there has been recent interest in developing cell technology to potentially aid repair and regeneration. The precursors to tendon cells can be harvested from normal tendons and grown in a laboratory. They can then be injected into diseased tendons. Preliminary animal studies have shown that this treatment can improve tendon remodelling, collagen content and tensile strength. Clinical pilot trials in human tendons for lateral epicondylitis (tennis elbow) have demonstrated safety and efficacy of the techninque, as well improved clinical and radiological outcomes. At present, there is a clinical trial being conducted into the injection of autologous tenocytes for achilles tendinopathy. (http://clinicaltrials.gov/ct2/show/NCT01343836) ATI therapy Autologous tenocyte implantation (ATI) is a new tissue engineering technique that involves an initial biopsy of healthy tendon cells. This is usually taken from the patella tendon. A very small piece of tendon is taken with a needle and then the cells within are cultured and grown over a period of 5-6 weeks in the Orthocell laboratory. The cells are then injected back into the injured tendon under ultrasound guidance. This delivers around 2 million tenocyte cells directly to the area of degenerate tendon. Given the promising work in animal studies and clinical studies in human tendons, we propose a pilot study to investigate the use of ATI in gluteal tendinopathy.

Physical Activity 4 Every1 (PA4E1) is a multi-component physical activity intervention implemented in secondary schools in low-income communities over two years, which aims to prevent the decline in moderate-to-vigorous (MVPA) physical activity among students. The study will be the first Australian study in disadvantaged schools with objectively measured outcome data over an extended follow up period.

Diabetes is a chronic disease where the primary care physician has a central role to play. Historically, evidence has supported the role of diabetes teams in hospital settings being able to provide better care compared with primary care but it has been argued whether this relates to improved systematic and organised care, compared to increased expert knowledge. With appropriate support and recall systems, delivery of diabetes care in general practice can be as good as hospital outpatient care. Recognising this, the United Kingdom has seen the introduction of diabetes clinics conducted by general practitioners with special interests (GPSIs) with demonstrated favourable improvements in HbA1c, cholesterol and blood pressure. To date, Australia has not adopted GPSIs into clinical practice. However, the Australian health care system is facing significant reform aimed at shifting the focus from tertiary and secondary hospital health care to primary health care, including the move towards GP superclinics. This research project focusses on the care of patients with complex T2DM who have been referred by their GPs for specialist diabetes care. This research is based on a novel concept which incorporates the principle of GPs with special interests around a multidisciplinary and coordinated approach to diabetes care in the community. Important to this model is the role of the specialist Endocrinologist in a consulting capacity to review and endorse the advanced skill GPs (GP Clinical Fellows) management plan. Few studies have investigated the staged devolution of diabetes services from secondary/tertiary care to primary care through increasing the capacity of primary care to meet the needs of patients who would otherwise use hospital outpatient services.

Brief summary: Between 10-30% of older community-living population report dizziness often leading to functional disability and psychological distress. The multifactorial aetiology of dizziness combined with a lack of validated diagnostic tests, and a tendency of clinicians to rely on poorly described symptoms and familiar assessments, are significant barriers to objectively establishing a successful diagnosis and implementing effective interventions. Thus, despite effective treatments being available, up to 40% of older people with reported dizziness remain undiagnosed and untreated. A multidisciplinary assessment battery, with new validated assessments of vestibular impairments is required for diagnosing and treating older people with dizziness. This project will aim to conduct a randomized control trial of a multifaceted dizziness intervention based on a multidisciplinary assessment. We hypothesize that a multidisciplinary assessment (tests of balance, inner ear function, blood pressure, mental health etc) followed by a tailored intervention (exercise program, vestibular rehabilitation, comprehensive geriatric assessment and medication review) will improve diagnosis, reduce self-reported dizziness, enhance postural stability and improve quality of life in older people suffering from dizziness.

Rates of heart failure hospitalisations and deaths in Brisbane increase greatly in winter and in cold weather. Many events could be avoided if people took better measures to protect themselves against the outdoor temperature. A simple and cheap protective measure is thermal clothing. We will randomise patients who have a heart failure event at the start of winter to either a control group, or a treatment group who will receive two pairs of thermal tops and hats. At the end of winter we will retrospectively examine their hospital records to compare the length of time spent in hospital. We will contact all participants by phone at the end of winter to ask them about their self-rated health and their compliance with the thermals. This is a pilot study of 100 patients that will lead to a larger study if the results are promising.

Mechanical bowel preparation causes a marked imbalance in the colonic microflora. This altered microflora may play a significant role in post-preparation symptoms and delay in return of the normal bowel function for that patient. AIM Evaluate the benefit of probiotic use, and associated restoration of the balance of intestinal microflora, for patients undergoing colonoscopy after mechanical bowel preparation. METHODS Prospective double-blinded randomised control trial. Use of probiotics vs placebo in the setting of patients who have undergone full mechanical bowel preparation and colonoscopy A commercially available probiotic or placebo at recommended daily dose for 7 days after the procedure END POINTS Evaluation of post-colonoscopy symptoms - Abdominal pain - Time taken for patient bowel function to return to normal (the usual bowel habit for them)

When nutrients, including fat, empty from the stomach after a meal, they pass into the small intestine where they stimulate signals that initiate contractions in the stomach, and alter sensations like fullness. These responses to fat appear to differ between lean and obese individuals. We do not fully understand how the small intestine senses or “tastes” the presence of fat, but studies have recently identified a number of molecules, or “sensors”, that are present in the small intestine and interact with fat. We want to determine the number and location of these fat sensors in the intestine, and to evaluate whether there are any differences in their levels between lean and obese individuals. We also want to determine whether there are any relationships between the occurrence of these fat sensors in the small intestine with the way in which the stomach and small intestine respond to fat. Therefore, we will determine how fat, infused directly into the small intestine, changes the number of these sensors, contractions in the stomach and small intestine, and the secretion of hormones in the gut.