ANZCTR search results

The TARGET Study is a prospective, randomised controlled trial, evaluating two standard techniques of tracheal puncture during insertion of percutaneous tracheostomies: the traditional landmark method versus the ultrasound guided method. Percutaneous Dilatational Tracheostomy (PTD) is a frequently performed invasive procedure in the Intensive Care setting, where complications both immediate and short term can contribute to significant morbidity and mortality. It is increasingly recognised that lateral (off midline) and cranio­caudal (too high up or too low down) malposition of PDTs may result in greater incidence of both short and long term complications. The use of ultrasonography in placing tracheostomies is well described in the literature. We aim to evaluate the use of real­time ultrasound guidance for the tracheal puncture, which is the most important determining element in positioning the tracheostomy, to determine which method results in better midline and cranio­caudal placement. Better midline and cranio-caudal placement in turn may decrease complications and improve clinically significant surrogate markers of outcome.

ENCHANTED is an independent, investigator initiated, international collaborative, quasi-factorial randomised controlled trial involving a package of 2 linked comparative randomised treatment arms, which aims to address 4 key questions in patients eligible for thrombolysis in the acute phase of ischaemic stroke. (1) Does low-dose (0.6 mg/kg) intravenous (i.v.) recombinant tissue plasminogen activator (rtPA) provide equivalent benefits compared to standard-dose (0.9 mg/kg) rtPA? (2) Does intensive blood pressure (BP) lowering (130-140 mmHg systolic target) improve outcomes compared to the current guideline recommended level of BP control (180 mmHg systolic target)? (3) Does low-dose (0.6 mg/kg) intravenous (i.v.) recombinant tissue plasminogen activator (rtPA) reduce the risk of symptomatic intracerebral haemorrhage (sICH)? (4) Does the addition of intensive BP lowering to thrombolysis with rtPA reduce the risk of any intracerebral haemorrhage (ICH)?

Research regarding weight loss in people with asthma is limited. Although preliminary research suggests weight loss improves clinical outcomes in asthmatic subjects, it is mostly of poor quality and better studies are justified. In addition, there is no research examining the mechanism by which weight loss results in these improvements. Our previous cross-sectional data suggests that neutrophilic airway inflammation is increased by obesity, which may worsen asthma. It is therefore important to conduct intervention trials to determine whether this airway inflammation is reversible through weight loss and/or fat loss. This will enable a better understanding of the association between obesity and asthma and would play an important role in asthma management and prevention. AIM: To examine the effect of weight loss, via body fat reduction, on systemic and airway inflammation and clinical outcomes in obese asthmatics. HYPOPTHESIS: Weight loss, specifically body fat reduction, will reduce inflammation and improve clinical outcomes in obese asthmatics.

Each year about 15,000 newborn Australian infants are admitted to hospital with respiratory distress and 2,500-3,000 are transferred to a larger tertiary hospital. The use and popularity of high-flow nasal cannulae to treat newborn infants is increasing. Anecdotally, HFNC is an easy to use therapy that has been used in a variety of clinical setting with success. Due to its simplicity and potential benefits, HFNC may be an ideal therapy for non-tertiary special care nurseries, and may reduce the need to transfer babies to tertiary centres. It is imperative to undertake a high-quality trial to assess the safety and efficacy of HFNC in the non-tertiary setting. This trial will be undertaken in 6-8 non-tertiary SCNs in NSW and Victoria.

Of significant concern for healthcare treatment costs around the world are those individuals with chronic low back pain (LBP). While exercise is a first-choice treatment for LBP there is no consensus on the best type of exercise to use, with all modes of exercise equally effective. Core stability exercises are movements for the trunk with bodyweight resistance. Core stability training is thought to be the most effective exercise mode to improve neuromuscular control of the trunk, however research evidence to support this is lacking. Improving neuromuscular control of the trunk is one of the primary physiological mechanisms by which improvement in low back pain patients is observed. There is a lack of research comparing core stability training to other modes of exercise for low back pain. If the literature reviews are indeed correct that no one mode of exercise is superior to any other, it may be likely that an exclusively aerobic training modality may be just as effective as a core stability program for improving pain, disabilty, fear avoidance, and neuromuscular control of the trunk. The aim of this study is to randomly assign participants with chronic low back pain to an 8 week exercise trial of either core stability or general aerobic exercise. Both groups will be directly supervised, and measurements of pain, disability, fear avoidance beliefs, and trunk neuromuscular control will be made before and after the 8 week program.

Cerebrovascular disease is a disease of the blood vessels supplying the brain. Cerebrovascular disease poses a serious threat and is one of the three leading causes of death in humans. Cerebral stroke (a blockage, or bleed in the brain) leads to a lack of oxygen to the brain. Although there are many drugs used to treat this lack of oxygen resulting from cerebral stroke, these drugs do not work well enough. There is a need for a drug that can treat the injury, which is a result of a lack of oxygen, from cerebrovacsular disease. Edaravone is a drug that can be used to improve the neurological symptoms and dysfunction in daily life caused by a lack of oxygen to the brain tissue from a cerebral stroke. Although Edaravone is currently known to help people who have had a cerebral stroke, the development of a better drug is still needed. Compound Edaravone Injection (study drug) is a combination of Edaravone and a second medication, (+)-borneol. It is believed the combination of these two drugs in specific amounts can further improve the recovery of patients who experience a cerebral stroke. Both Edaravone and (+)-borneol have been used in humans, but not in combination with each other as a single compound. The main purpose of this study is to evaluate the safety and tolerability of single doses of Compound Edaravone Injection (study drug) administered to healthy male and female adults. A second objective is to look at the pharmacokinetics (the study of how much study drug is in your blood at different time periods) of each dose of Compound Edaravone Injection (study drug) in healthy male and female adults.

This study aims to investigate the impact of anaesthetist-performed transthoracic echocardiography (TTE) on the quality of recovery of patients undergoing fractured neck of femur surgery. It also aims to collect data to determine if a future trail investigating whether or not TTE reduces patient mortality after surgery.

Recent research has suggested that acupuncture may help to increase pregnancy and live birth rates for women undergoing an embryo transfer during assisted reproductive technology. However, there are still many questions to be answered, and there remains a need for a larger well designed study to see whether acupuncture really does help with increasing pregnancy and live birth rates when used with IVF treatment. Acupuncture is a part of traditional Chinese Medicine, and involves the insertion of very fine needles into specific acupuncture points. This study examines the use acupuncture in improving the proportion of women undergoing in vitro fertilization (IVF). Women undergoing IVF treatment who are less than 43 years of age and undergoing a fresh IVF or ICSI cycle will be invited to participate in the study. Women who agree to be part of this study will receive acupuncture or sham acupuncture (the placement of needles into points that are not true acupuncture points) in addition to their usual IVF care. Those women wishing to be part of the study but not receive the acupuncture or sham acupuncture can also participate though completing questionnaires.

This project aims to identify the relationship between biochemical markers in wound fluid and wound healing in chronic venous leg ulcers being treated with compression therapy. A randomised controlled trial will determine the effect of high level compression on wound fluid composition and wound healing in comparison to low level compression therapy. Identification of biochemical markers directly associated with improved healing will provide important new information for health care professionals on the biological processes underlying wound healing during compression. The overall aim is to gain a better understanding of the wound healing process and to utilise this knowledge to develop improved techniques to increase healing rates of leg ulcers, a significant cause of chronic ill-health for older people.

This study aims to compare the cosmetic outcomes of skin incisions made by diathermy and scalpel blade. Patients undergoing open hernia repair or elective midline laparotomy surgery will be recruited for this study. Each half of the incision (medial/lateral or superior/inferior) will be randomised into scalpel(control) or diathermy(intervention). Patients are blinded to this randomisation process. Primary outcome is the patient’s and independent observer’s assessment of which half of the wound has the better cosmetic outcome.