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This study will compare the short term bioavailability of 3 delivery systems containing Omega-3 oils (gel capsules versus two different MicroMAX powders - one formulated with milk protein-sugar and other with milk protein-sugar-resistant starch) together with a flavoured milk in individuals. Bioavailablilty will be assessed by measurement of EPA and DHA in blood/plasma. To investigate the bioavailability of EPS and DHA delivered in 3 formats after a 4 week intervention.

CRP may be useful in the newborn period as an infection screen. Universal hepatitis B immunisation may limit the usefulness of CRP if an inflammatory response is induced. This study looks at CRP response after birth in a group of babies where infection can definitely be excluded. Babies are randomised to recieve vaccination at either 24 hours of age or after 96 hours. A CRP level is taken each day and the levels in the 2 groups are compared.

Endogenous DHEA is banned for use in elite competitive sports, however its covert use in combination with other non banned steroid precursors (eg pregnenolone, letrozole) to increase testosterone levels is suspected. This pilot study aims to identify the serum and urine changes in the androgen profile of healthy men (n=4) following the administration of DHEA with and without pregnenolone and in healthy women (n=4) following the administration of DHEA with and without letrozole. We aim to test the hypotheses that these drug combinations will result in increased androgenic effects in both men and women; thus requiring improved detection methods to detect this DHEA augmentation doping in both serum and urine.

Background: There is growing interest in the potential role of anti-inflammatory n-3 polyunsaturated fatty acids (n-3 PUFAs) in the prevention of allergic disease. Objective:We sought to determine whether maternal dietary supplementation with n-3 PUFAs during pregnancy could modify immune responses in infants. Methods: In a randomized, controlled trial 98 atopic, pregnant women received fish oil (3.7 g n-3 PUFAs per day) or placebo from 20 weeks’ gestation until delivery. Neonatal PUFA levels and immunologic response to allergens were measured at birth. Results: Eighty-three women completed the study. Fish oil supplementation (n = 40) achieved significantly higher proportions of n-3 PUFAs in neonatal erythrocyte membranes (mean ± SD, 17.75% ± 1.85% as a percentage of total fatty acids) compared with the control group (n = 43, 13.69% ± 1.22%, P < .001). All neonatal cytokine (IL-5, IL-13, IL-10, and IFN-g) responses (to all allergens) tended to be lower in the fish oil group (statistically significant only for IL-10 in response to cat). Although this study was not designed to examine clinical effects, we noted that infants in the fish oil group were 3 times less likely to have a positive skin prick test to egg at 1 year of age (odds ratio, 0.34; 95% confidence interval, 0.11 to 1.02; P = .055). Although there was no difference in the frequency of atopic dermatitis at 1 year of age, infants in the fish oil group also had significantly less severe disease (odds ratio, 0.09; 95% confidence interval, 0.01 to 0.94; P = .045). Conclusions: These data suggest a potential reduction in subsequent infant allergy after maternal PUFA supplementation. More detailed follow-up studies are required in larger cohorts to establish the robustness of these findings and to ascertain their significance in relation to longer-term modification of allergic disease in children.

To ensure the safe delivery of oxygen and anaesthesia gases to a child, the anaesthetist will insert a tube into the child’s mouth. There are two tubes which can be used for this purpose. Both look very similar and do the same thing. One type of tube, the laryngeal mask, has an inflatable soft silicone cuff at the end while the other, called an Igel, has a non-inflatable cuff made of soft gel. Both devices have been independently shown to be safe in children’s anaesthesia. However, a direct comparison between the two devices is lacking in the paediatric population, which we are doing.

The proposed project is a crossover prospective design study which aims to: 1.) compare hydrotherapy versus land based exercise for patients with CHF with respect to functional capacity and quality of life. 2.) measure cardiac function during immersion and exercise in water in this patient group. Patients will be recruited through the Heart Failure Services at Royal Brisbane and Women's Hosptal (RBWH) and Princess Alexandra Hospital (PAH). Patients will only be eligible if they have stable CHF and have successfully completed a hospital based, disease specific rehabilitation programme. Patients will be enrolled over a 6 month period and will be randomly selected into one of 2 intervention groups. All individuals will attend an exercise session once per week for 12 weeks which will include 6 weeks of land based exercise and 6 weeks of water based exercise. Whilst some will commence in the land based programme to be followed by the water based programme, the second intervention group will commence in the water based programme followed by the land based programme. Participants will undertake an assessment on 3 occasions: before starting, after the first 6 weeks and at completion of the 12 weeks. During each assessment a number of measures will be collected. These include exercise capacity using a submaximal walking test, grip strength using a hand held dynamometer and 4 balance tests. Participants will also be asked to complete a survey regarding their perception of water based exercise. In a small subgroup of 10 patients, cardiac function will be measured on 1 occasion. This will be done using a portable echo machine and measures will be completed in 3 positions which include: standing outside of the pool, and standing waist deep in the pool prior to and at the completion of the exercise session. To date, no studies have compared aquatic therapy versus land based maintenance exercise in patients with CHF. If shown to be at least equally effective as traditional maintenance exercise, this may provide patients with a valid alternative that is more accomodating for those with musculoskeletal or balance issues that normally hinder land based exercise. This study will inform clinical practice and will provide valuable pilot data that will enable our research team to participate in more comprehensive trials in the future.

BACKGROUND A goal in rehabilitation for older people is promotion of mobility to reverse functional decline and deconditioning. Recent developments in accelerometry for quantifying ambulatory activity can assist clinical practice in rehabilitation settings. AIM The study tests the hypothesis that use of accelerometry to provide accurate activity data to patients and clinicians, in the context of explicit goal setting, substantially increases patient walking activity. The study will also explore the effects of increased activity on patient outcomes and undertake a cost utility analysis. RESEARCH PLAN A randomised controlled trial will be conducted in Geriatric Rehabilitation Units at 3 sites (QLD, NSW, SA). Eligible patients are aged greater than or equal to 60 and able to ambulate. Based on pilot data, a sample size of 270 patients (135 per group) is required to demonstrate a mean significant differencein daily walking time of 33% between intervention and control groups.Accelerometers will be fitted to eligible subjects to monitor daily activity. Intervention subjects will be offered a formal activity-related rehabilitation goal, and receive daily feedback, sourced from the accelerometer, of their activity levels. Neither staff nor subjects in the control arm of the trial will receive data on walking times. The primary outcome measure will be walking times measured by accelerometry. Secondary outcome measures will include lower extremity function, quality of life, length of stay, post discharge hospital readmissions and level of care at one month follow-up. The time frame for the study is two years six months. SIGNIFICANCE If patient activity can be increased through the use of accelerometer data, it will revolutionise the management of activity in hospital. There will be enormous impetus to further develop accelerometer technology for clinical application so that activity prescription will be a routine component of a rehabilitation care plan.

This study looks at the tolerability and effectiveness of an 11 week program of integrated radiotherapy and chemotherapy with oxaliplatin, 5-flurouracil (5-FU), folinic acid and the agent bevacizumab in patients with simultaneous primary and metastatic adenocarcinoma of the rectum (back passage)

The purpose of the proposed project is to report the clinical presentation, the subsequent surgical management and the outcome of a series of 20 patients with recurrent pelvic organ prolapse (POP) following implantation of synthetic mesh in the vagina for the treatment of POP (mesh-failure). This study is conducted to obtain a better understanding of the surgical management after vaginal mesh-failure that should be proposed. The hypothesis of this study is to evaluate and to assess the surgical treatment in women who underwent surgical correction for recurrent POP after initial treatment with synthetic mesh in the vagina for POP. For gynaecologist clear surigcal strategies are required to propose the surgical intervention that is most effection in this situation.

The recent randomised controlled trial of Droperidol versus Midazolam for acute behaviour disturbance (ACTRN 12607000527460) resulted in the drug type being droperidol as effective at sedation as Midazolam but with significantly less adverse effects. There was no significant QT abnormalities. With ethics approval an extension to this trial followed and we have introduced a protocol of sedation with inclusion criteria and guidelines with the recommendation to give droperidol in a set dose and route as an observational study in the emergency department. This extension of the original trial has resulted in positive outcome for both patients and staff. The patient cohort is over 250 patients to date with no serious adverse effects. We now wish to extend this observational study to include rural regional and metropolitan hospitals to increase the sample size of the safety study.