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This study will evaluate the effectiveness of a Clinical Network led organisation intervention to improve evidence based care for locally advanced prostate cancer. The subjects of the research are the clinicians whose practice is being monitored. You may be involved in this study if you are a male of any age who has been diagnosed with locally advanced prostate cancer following radical prostatectomy. You must also be a patient at one of the 9 NSW based hospitals included in this study that have entered the active implementation phase of the intervention. Clinicians involved in this study will be involved in an educational session at their hospital. Clinical champions will be enlisted to persuade peers to attend the education sessions and to educate their peers and multidisciplinary teams. The objective is to use the Urology Clinical Network to increase referrals of patients to a radiotherapist for discussion about the appropriate use of adjuvant radiotherapy for high risk patients with locally advanced prostate cancer after radical prostatectomy. If you are a patient treated by one of the clinicians involved in the study you may be eligible for inclusion. This would involve medical record audit to determine whether you were referred to radiotherapy treatment, whether you completed radiotherapy, and if so, the time between surgery and radiotherapy.

Patients who suffer from Obstructive Sleep Apnoea, a disorder where the airway closes during sleep, are often prescribed treatment with CPAP (Continuous Positive Airways Pressure). This is a device that blows air down the airway via a face mask. Some patients experience stomach bloating as a result of this therapy. This research aims to try an alternative treatment, APAP (Automatic Positive Airways Pressure), to assess if this is better tolerated in these patients. APAP delivers the pressure by sensing when the airway closes and only increasing if necessary. Patients will use CPAP for two weeks and APAP for two weeks (in random order) to see which treatment is best tolerated. We propose that treatment with APAP will result in more effective and comfortable therapy. Patients who currently discontinue or struggle with CPAP due to these side-effects will have a reasonable alternative.

Vaginal dryness and dyspareunia (pain occurring during sexual intercourse) is a common consequence of treatment for breast cancer and has been identified as one of the most common and troublesome consequences for survivors. Vaginal dryness and pain during sexual intercourse significantly negatively impacts on quality of life. With improved survival from breast cancer the absolute number of breast cancer patients affected by symptomatic vaginal dryness and dyspareunia is likely to increase. Systemic or topical (vaginal) estrogens are an effective treatment for symptoms of vaginal dryness. However, the safety of vaginal oestrogens after breast cancer is not established. Water-based lubricants are widely used and silicone based lubricants are also available for vaginal lubrication. However, the relative effectiveness and acceptability of these products is not known. No previous studies have evaluated silicone-based vaginal lubricants for the treatment of vaginal dryness and dyspareunia after breast cancer or compared these with water-based lubricants. Aims: The primary aim of this study is to compare the efficacy and acceptability of a silicone-based vaginal lubricant vs. a water-based lubricant in breast cancer patients with symptomatic vaginal dryness using a randomised cross over design. The Secondary Objective is to clinically assess the symptoms and signs of vaginal dryness, evaluate quality of life and sexual function using established questionnaires. Study Population: 40 subjects with a history of breast cancer complaining of vaginal dryness will be recruited from the Menopause After Cancer Clinic (MSAC) at The Royal Women’s Hospital Melbourne (RWH), the RWH Breast Clinic, oncologist practices in Victoria and community based breast cancer organisations such as the Breast Cancer Network Australia and by media advertising. Methods: To participate in this study subjects must have a history of breast cancer, be sexually active and be complaining of vaginal dryness for at least 4 weeks. Subjects will be asked to attend 3 clinic visits. Ethical Issues: Subjects will be asked to complete questionnaires including details of sexual problems and function and to complete a sexual activity diary. Subjects will be fully informed of the requirements before enrolling in the study and able to withdraw at any time without compromising their care. These vaginal lubricants are not systemically absorbed and are extremely unlikely to impact on breast cancer management or prognosis.

The Cardiva VASCADE VCS consists of a sterile disposable catheter containing a deployable extravascular collagen path and a clip. The objective of the trial is to demonstrate the safety and effectiveness of the Cardiva VASCADE Vascular Closure System (VCS) in sealing femoral access sites and providing reduced times to hemostasis, time to ambulation, and time to discharge eligibility compared with manual compression at the completion of diagnostic or interventional endovascular procedures performed through 6 Fr or 7 Fr introducer sheaths.

The Cardiva VASCADE VCS consists of a sterile disposable catheter containing a deployable extravascular collagen path and a clip. The VASCADE VCS is intended to seal or close the femoral arterial access site while reducing time to hemostasis (stop the bleeding process), time to ambulation (when a person can walk), and time to hospital discharge in subjects who have undergone diagnostic or interventional endovascular procedures.

Early Supported Discharge (ESD) rehabilitation is considered internationally as best practice in rehabilitation of mild and moderate strokes when transferring from hospital to home. At RPH there are approximately 500 admissions for stroke. This research study will undertake a randomised controlled trial comparing an early discharge strategy to that of normal care in 90 individuals with mild and moderate stroke admitted to Royal Perth Hospital. This research study is designed to optimise the rehabilitation processes and pathway of people who have recently had a stroke. This study is a cost utility analysis of processes associated with the pathway of individuals admitted to RPH with mild or moderate stroke. The proposed change in model of care (ESD process) may have an impact on acute LOS and we would like to test the hypothesis that if there is a change that it will not detract from the long term functional outcomes nor satisfaction of the clients Hypothesis: H1: That the ESD strategy decreases LOS when compared to a matched cohort with no difference in functional outcomes at 6 and 12 months.

Traditional approaches for preventing proximal lesions such as flossing and rinsing with fluoride usually have limited success as they rely heavily on patients’ compliance (Alm et al. 2007). More recently, treatment of proximal caries has been focussed on arresting initial caries by sealing these lesions with low viscosity resins (Ekstrand et al. 2010). Although early success has been reported using this technique, there is a need to gain access to the proximal lesions which requires physical separation of the teeth. As this technique usually involves two appointments, it is not practical for young children. A more conservative alternative would be to seal the teeth while it is possible to gain access to the proximal smooth surfaces before the contacts with adjacent teeth are established. There are a few stages in the development of the primary and permanent dentitions which provide windows of opportunity to gain such access to specific proximal surfaces of the posterior teeth. HYPOTHESIS We hypothesize that smooth surface sealants (SSS) placed prior to establishment of the proximal contacts can prevent proximal caries in teeth. AIMS Therefore the aims of the study are to: (1) Determine the caries incidence in sealed surfaces of primary and secondary teeth compared to unsealed surfaces in the same teeth in other quadrants of the mouth. (2) Evaluate the cost effectiveness of smooth surface sealants in preventing caries

This study will randomly allocate participants to either (a) Healing Program, or (b) Healing Program + Cognitive Behaviour Therapy.

The use of the combination of lamivudine (LAM) and low dose hepatitis B immune globulin (HBIg) prophylaxis has had a major impact on the rate of recurrence of hepatitis B following liver transplantation. However, the long-term use of HBIg is extremely costly and very inconvenient for patients. There is a clear need to develop an alternative more convenient and less costly long-term prophylactic regimen for use in this patient group. The aim of the proposed study is to assess the safety and efficacy of switching to tenofovir and lamivudine therapy in patients who have been receiving long-term HBIg and lamivudine prophylaxis post-liver transplant.

This research is designed to specifically compare the performance of the bronchoscopes in the clinical setting using a validated rating scale for bronchoscopic performance – the Global Rating Scale