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The diagnosis of chronic kidney disease (CKD) is on the increase due to the rising incidence of diabetes, high blood pressure and obesity, leading to an increased demand on the healthcare system. Currently, the management of a patient with chronic kidney disease involves 3 - 4monthly review with a kidney specialist. However, we are aware that nurses play a vital role in the management of patients with chronic kidney disease and studies in Canada and South Australia have demonstrated that the regular monitoring of these patients can be safely managed by a nurse who specialises in this area. The nurse discusses the investigation results and patients’ ongoing management with a kidney specialist and liaises with the family doctor. Patients allocated to the CKD nurse group will be seen at the renal clinic by a CKD nurse every 3-4months for a period of 2 years.

The trial looks to establish if the use of a videolaryngoscope in patients with a known difficult airway makes intubation easier, faster and safer.

People who have had a severe stroke generally remain very disabled. An EMG triggered electrical stimulation machine measures electrical activity in muscles and provides electrical stimulation when a threshold level of muscle activity is reached, hence it provides feedback to people with weak muscles and strengthens muscles. Seventy very weak, acute stroke patients will be allocated to receive EMG triggered electrical stimulation to muscles of their arm in addition to conventional therapy or conventional therapy only. Measures of muscle strength and activity will be taken before and after the intervention. This intervention has the potential to increase the likelihood of returning to independence after a severe stroke.

This study is looking at the combination of the drugs Paclitaxel and Epirubicin used as neoadjuvant systemic treatment for women with locally advanced breast cancer in order to assess response rates Who is it for? You may take part in this study if you are a female aged 18 years or over and have a confirmed diagnosis of locally advanced breast cancer (cancer that is considered inoperable by your treating surgeon). Trial Details Participants in this study will receive Neoadjuvant (before surgery) chemotherapy with Paclitaxel and Epirubicin. The schedule of treatment will involve the drug Paclitaxel given at a dose of 175mg per m2 intravenously, and Epirubicin 90mg per m2 given intravenously given once every 3 weeks for a total of 4 doses before surgery (and an overall total of 12 weeks of treatment) The aim of this study is to see how a combination of 2 chemotherapeutic drugs - Paclitaxel and Epirubicin, is tolerated in women with locally advanced breast cancer. We also expect to see how effective this combination is in the treatment of this condition.

This study is designed to study the efficacy of flu vaccine in patients with cancer undergoing chemotherapy, by assessing the antibody response to flu vaccination to see if they reach 'protective' levels Who is it for? You may join this study if you are over 18 years of age, have a histologically or cytologically confirmed neoplasm, and are about to start chemotherapy or currently already on chemotherapy. Trial Details Patients receiving chemotherapy will be given 0.5 ml of the trivalent seasonal flu vaccine for 2011, intramuscular or deep subcutaneous, approximately 7 days before the next dose of chemotherapy. This will be a once off intervention. Blood will be drawn at baseline, 3-4 weeks, 6-7 weeks and 6 months after the vaccine dose and will be analysed for Influenza antibody levels. The aim of this study is to investigate the efficacy of flu vaccine in cancer patient undergoing chemotherapy.

During mechanical ventilation, increased upper airway resistance may be due to a partial obstruction of the artificial airway or a large airway abnormality. Increased lower airway resistance is usually due to acute or chronic airways disease. Either of these problems can lead to increased work of breathing, uncoordinated ventilator support, respiratory distress and difficulty weaning. Recognition of these problems can lead to important interventions such as bronchoscopy, artificial airway change or reposition, bronchodilator therapy and change of ventilation strategy that can improve patient distress and safety. Quantification of these variables can allow assessment of severity and the response to intervention. Our hypotheses are that 1. the most valuable variable for quantifying reduced expiratory airflow will be the passive expiratory volume expired during the first second of expiration PEV1 expressed as a percentage of the Vt (PEV1/Vt ratio). This is similar to the well recognised standard of FEV1/VC ratio from spirometric quantification of (lower) airflow obstruction. 2. the most valuable variable for quantifying increased inspiratory resistance during VCV with decelerating inspiratory flow or during PCV will be the difference between the Paw and calculated Palv during early inspiration divided by the inspiratory flow at that time. 3. Upper airway obstruction will be distinguished from and lower airway obstruction by a higher inspiratory resistance relative expiratory resistance We propose to examine these hypotheses in patients with normal lungs with added inspiratory resistances and in patients with lower airway obstruction (COAD or asthma) to show whether measurements of flow and volume are independent of or can account for ventilator pattern (flow rate, flow pattern, tidal volume) and can recognise and quantify both increasing resistances in large (upper) airways and lower airway obstruction to distinguish between them. Methods Two patient groups will be selected based on the following lung pathology 1. Normal Lungs: 20 mechanically ventilated patients with no significant underlying lung disease and no significant lung injury will be selected. Each will be studied to provide a normal values of the resistance measurements. Then each will be given a series of 3 upper airway resistances for a period of less than a minute to mimic large airway obstruction (similar to a partially blocked endo-tracheal or tracheostomy tube). This will be achieved by placing a 10 cm sterilized flexible tube in the endo-tracheal or tracheostomy tube to simulate a residual diameter equivalent to an ETT size (internal diameter) 6, 4.5 and 3 mm. This is little different to and carries no more risk than routine patient suctioning where the artificial airway is partly occluded to a similar degree for a short time 2. Lower airway obstruction (COPD, Asthma): 20 mechanically ventilated patients with known obstructive airways disease (lower airway obstruction) Each patient group will be placed in controlled mechanical ventilation and given the same series of ventilatory patterns to determine the reliability of the measurements of inspiratory and expiratory resistance measurements under different ventilatory conditions

This study is being run to determine if eating a high fat breakfast will change the way that the body absorbs brivanib. Brivanib is a drug being developed for use in patients with cancer. Based on previous studies performed with this drug, a high fat meal is not expected to change the way that the body absorbs brivanib. The study will involve each participant in the study being given a single dose of brivanib whilst fasted and 7 days later being given a single dose of brivanib following consumption of a high fat breakfast. Following each dose, participants will have numerous blood samples collected to determine the levels of brivanib present in the blood and to perform standard laboratory testing to ensure the safety of the participants. Participants will also have their blood pressure, heart rate and temperature monitored; along with ECG monitoring, physical examinations and general observation throughout the in-patient stay to ensure participant safety. Participants will be required to be inpatients for 3 nights for each treatment and there must be at least 7 days between each dose of brivanib.

The primary objective of this randomised controlled trial is to evaluate the efficacy of intravitreal Bevacizumab in the treatment of macular oedema following branch retinal vein occlusion (BRVO) and compare it with present day standard treatment, macular laser.

The primary objective of this randomized controlled trial is to evaluate the efficacy of intravitreal Bevacizumab in the treatment of macular oedema following central retinal vein occlusion.