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Presently, there is no information to guide clinicians on how to dose a new antibiotic, doripenem, in critically ill patients receiving a form of dialysis called continuous venovenous haemodiafiltration. The aim of this study is to describe the how concentrations of Doripenem (a carbapenem antibiotic) in critically ill patients are affected by Continuous Venovenous Haemodiafiltration (CVVHDF). We will then analyse the changing concentrations and use this information to provide strong evidence on what dose of doripenem to use in these patients. We hypothesise that a dose of 500mg every eight hours by intravenous infusion will provide therapeutic doripenem concentrations. Our process will be to enroll 12 patients who clinically need both doripenem and CVVHDF. We will collect various blood samples and analyse the changing concentrations with computer software to enable description of what doses future patients will need.

Patients undergoing haematopietic blood stem cell transplant (HSCT) are primarily treated for haematological cancer. After treatment, these patients can experience a number of side effects affecting their quality of life for up to several years. Common problems observed amongst transplant survivors include weight loss, gastrointestinal symptoms (e.g. nausea, poor appetite, sore mouth and excessive diarrhoea), and fatigue. These symptoms can increase the risks of developing other issues such as poor nutritional status, poorer health status and reduced physical functioning. As a result of the combined factors, some people are unable to return to work or they are unable to perform their usual activities. One of the reasons for physical impairment may be the loss of muscle; and the cause of muscle loss may be the result of reduced physical activity and poor nutritional status. Despite report of these research findings, patients are not routinely followed up by allied health professionals to receive ongoing support. This study looks at the effects of a combined nutrition advice and individualised exercise program compared to standard care on quality of life, nutritional status and body composition in cancer patients after undergoing haematopoietic stem cell transplant. Who is it for – Eligible participants are adult cancer patient over the age of 18 and scheduled for autologous haematopoietic stem cell transplant at The Wesley Hospital. Trial details – Participants will be randomised to one of two groups, either (i) an individualised nutrition program from the hospital dietitian combined with an individualised exercise program from the hospital exercise physiologist, or (ii) usual care as provided as standard by the hospital attended. Participants in the combined group will be followed up by a hospital dietitian fortnightly for a 20-30 minute dietary counselling session to address specific nutritional need (i.e. food choices), and the exercise component will be variable but, in general, patients will undertake a home-based exercise program involving a minimum of 5x30 minutes exercise a week for 12 weeks, and the type and intensity of exercise will be dependent on what is manageable by each patient. There will be a 1 hour consultation with the exercise physiologist conducted face-to-face in the hospital prior to discharge, and subsequent follow up will be done fortnightly (20-30 minutes/session) over the phone after patients are discharged. Participants in the usual care group will receive treatment as usual, according to the recruiting hospital’s standards, and there will be no follow up by a hospital dietitian or exercise physiologist after discharge for this group. The aim of this study is to determine whether a combined nutrition advice and individualised exercise program may help in the quality of life, nutritional status, and body composition of cancer patients post-haematopoietic stem cell transplant compared to standard care.

This was a non-blinded, 2 phase, randomised dietary intervention trial investigating if the rate of weight loss is important in long-term weight maintenance; if physiological adaptations encouraging weight regain are different with different rates of weight loss; if these adaptations reverse with time and if psychological profile can help us choose if slow or rapid weight loss is best suited to a particular psychological profile. Participants were obese (BMI 30.0 - 45.0 kg/m2) and aged between 18 and 70 years. Following telephone and onsite screening 200 subjects commenced phase 1 of the trial (weight loss phase) and were randomised by strata to either a rapid or gradual weight loss program. During this phase appointments were at the same interval with similar quality of dietary education materials for all subjects. Projected weight-loss graphs were personalised to each participant and utilised at each visit to compare expected and actual weight-loss achieved at each time point. Both the rapid and gradual weight loss group had prescriptions for the same overall energy deficit (105,000 kcal or 430,500 kJ). The rapid weight loss group were asked to accumulate the deficit over 3 months while the gradual weight loss group had to accumulate the same deficit over 9 months. In both treatment groups, participants were instructed to undertake at least 30 minutes a day of mild to moderate intensity exercise (e.g. brisk walk). Participants attended fortnightly for individual consultations with the same qualified dietitian. During these visits, they had anthropometry measurements taken and were given dietary counselling based on their individual needs in order to remain on their projected curve and achieve their target weight of 15% weight loss. All participants who successfully achieved 15% weight loss in phase 1 were eligible to enter into phase 2 (weight maintenence phase) of the trial. During phase 2 participants followed a weight maintenance diet which was individualised for each participant and similar to the Australian Guidelines for Healthy Eating(Smith A 1998). Individual sessions were conducted with the study dietitian quarterly for the three years following phase I.

Microbial keratitis is a significant cause of ocular morbidity and visual loss, as well as a significant health cost to the community. Ultraviolet light is known to be microbicidal. We think it is likely that the proposed treatment will lead to quicker recovery from this serious eye infection and better visual outcomes.

ACE inhibitors are a widely prescribed class of medications in Australia with established benefits in reducing mortality in a range of cardiovascular, endocrine and renal conditions. They are generally well tolerated in many patients, although they are assoicated with a range of adverse effects. One of these adverse effects is angioedema, which usually presents as non-pitting oedema of the subcutaneous tissues, usually around the head and neck. Occassionally airway obstruction may occur. While there are some recognised risk factors for ACE inhibitor associated angioedema, it is not possible to prospectively identify patients at particular risk. Improved methods to identify patients at risk may be useful to improve drug safety. One small study has identified a genetic marker, the single-nucleotide polymorphism, C-2399A of the XPNPEP2 gene which encodes plasma aminopeptidase P, for increased risk of ACE inhibitor associated angioedema. This study attempts to confirm the previous study and investigate the frequency of this genetic variant in the Australian population. We aim to enroll 40 patients who have had an episode of ACE inhibitor associated angioedema, and compare the frequency of the genetic variant in these patients with 120 control patients who have been exposed to ACE inhibitor, but have not had angioedema. We will also compare the frequency in a population sample, from healthy people.

People with cancer are required to monitor and to initiate self care activities to manage side effects at home. In haematological cancer patients these side effects are often severe and life threatening. Safe home care requires close communication with the health team. We will test if a mobile phone based system can support patietns to monitor their side effects, promote the delviery of evidence based self care advice in a timely manner, and mediate the role of nurses to effectively provide real-time patient support.

The aim of this pilot study is to assess whether or not objective health criteria (inclusion criteria), coupled with a portable home monitor (ApneaLink) could be a more reliable and valid method of screening for obstructive sleep apnoea in Rail Safety Workers, when compared with the current self reported Epworth Sleepiness Scale.

Primary spontaneous pneumothorax occurs when a lung collapses due to air escaping from a small hole in the surface lining. It occurs predominantly in young people who have no other lung disease. The symptoms are variable but may include chest pain and breathlessness. Currently the treatment recommended by international guidelines is to try to remove the air from the chest and re-expand the lung by inserting a plastic tube through the chest wall. This is done using local anaesthetic but can be uncomfortable and may be associated with complications. It may take up to a week for the lung to re-inflate, during which time the patient must remain in hospital. In some cases air continues to leak out of the lung and surgery is required. However, there are historical reports suggesting that simply observing a pneumothorax and allowing it to re-expand slowly may be as effective as inserting a tube in hospital, although it may take 4-6 weeks to fully resolve. This study will compare the current standard treatment using a tube, to simple observation, in a group of 342 patients with pneumothorax. The proportion in each group who have resolved on an X-ray at 8 weeks will be compared.

The objective of the proposed research is to evaluate a brief motivational interviewing discussion (Ecstasy Check-Up) for regular ecstasy users (1 session) compared with an extended series of discussions (Ecstasy Check-Up Plus), which involves 1 session of motivational interviewing based discussions plus two session of cognitive behavioural based discussions. Our long-term goal is to decrease ecstasy use in Australia by motivating ecstasy users to reduce their use through providing research based information and discussion. The primary hypothesis of the proposed study is that the Ecstasy Check-Up Plus will be associated with lower levels of ecstasy use and problems than will the Ecstasy Check-Up. E Check Up sessions in which the specialist more strongly adheres to motivational interviewing principles are expected to have better outcomes. Additionally, our secondary hypothesis is that participants in the study will like and gain some positive aspects from both conditions, regardless if they have been assigned one or three sessions of discussions on their Ecstasy use. The research is of benefit to participants as it offers an opportunity for them to manage their ecstasy use. This lifestyle change has many benefits including improvements in physical and mental health. This benefit, however, cannot be guaranteed; it is dependent on participants’ engagement with the discussion. At the baseline session, all participants will be assured that any information they provide will remain strictly confidential (within the limits of legal confidentiality and duty of care). After written informed consent is provided and all questions and concerns have been answered, the baseline assessment will occur. At one-, four-, and six-month follow-ups the research assistant will conduct follow-ups with all participants using the measures collected at the baseline assessment. The outcome measures will be modified to assess the relevant durations at each visit. For example, the measures will assess the last 90 days during the baseline assessment, and the past 30-days at the one-month follow-up.

This study is been carried out to investigate if transplanting the nerve from the opposite side to replace the damaged one will help restore sensation to your numb cornea. If procedure is successful, it will restore sensation to your cornea and help prevent the cornea from developing ulcers. This procedure has previously been shown to be successful in restoring sensation to numb corneas.