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A randomised controlled trial of oral antibiotics compared with intravenous antibiotics for the treatment of cellulitis.
Expand descriptionCellulitis is an acute spreading infection of the skin. It develops as a result of entry of bacteria, especially beta-haemolytic Streptococci spp. and Staphylococcus aureus, through the skin barrier. It is a common condition that is often thought by health professionals to require treatment with intravenous antibiotics initially, resulting a high rate of presentation and admission to acute medical services. To reduce the burden on hospital inpatient beds, intravenous antibiotics have increasingly been administered at home by visiting nursing services or Hospital In The Home (HITH) programs to treat cellulitis. Intravenous antibiotics have the associated problems of local intravenous line site complications including phlebitis and infection as well as the costs of nursing and medical staff required to administer the antibiotics. With these problems in mind, clinicians at the The Northern Hospital (TNH) have developed clinical experience successfully using oral antibiotics for many patients with cellulitis referred for treatment with intravenous antibiotics. Limited evidence exists supporting this approach in patients with cellulitis. Oral penicillin has been shown to be equivalent to initial intravenous then oral penicillin in inpatients admitted with the diagnosis of cellulitis. Similarly oral pristinomycin has been shown to be non-inferior to an intravenous then oral penicillin regimen for inpatients with cellulitis. Neither of these studies investigated patients treated by HITH programs nor did they use antibiotics regimens that would commonly be prescribed in Australia for this indication. There is more recent and substantial evidence showing success in favouring early oral antibiotics in patients with community-acquired pneumonia another common infection that was previously thought to require intravenous antibiotics in many cases presenting to hospital. Justification for project Any research that demonstrated that treatment of cellulitis with oral antibiotics was as effective as treatment with intravenous antibiotics would have important implications in that patients may be able to be treated more safely and with less expense. Comparison with patients treated in HITH settings and in Australia with antibiotics commonly used here would have particular relevance. If information gained from this trial is useful then this may be used to justify a larger multi-centre trial to more definitively inform guidelines in the area.
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INSPIRE (International trials of aspirin to prevent recurrent venous thromboembolism)
Expand descriptionThe INSPIRE study is a prospective combined analysis of 2 previously registered studies (ASPIRE and WARFASA). This study is registered before the unblinding of either dataset
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Serum Brain Derived Neurotrophic Factor (BDNF) and cytokines in quetiapine treated psychosis
Expand descriptionPsychosis in general and schizophrenia in particular are currently best understood as a group of illnesses whose symptoms are related to brain abnormalities that are the final common pathway from a multitude of aetiologies, due to the assorted interaction of specific genetic and environmental factors. The concept probably encompasses several primary disease processes (for example with a phospholipid, neurotrophin or autoimmune aetiology) that display a common endpoint in dopamine and other neurochemical abnormalities, and structural changes. While there has been a lot of research concerning the phospholipid hypothesis, there has been little around the neurotrophin and autoimmune aetiologies. We seek to determine BDNF and cytokine levels in the serum of 19 drug-naive subjects with psychosis, before and after treatment with quetiapine (an antipsychotic), as markers of neurotrophin activity and autoimmunity respectively, and compare with 19 age and sex matched healthy controls.
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Chiropractic manipulation for osteoarthritis of the hip.
Expand descriptionThe primary purpose of this study was to investigate if chiropractic treatment for the entire lower limb kinetic chain (lumbar spine, hip, knee, ankle and foot joints) has better outcomes than treatment of the symptomatic hip alone. Our hypothesis is that full lower limb kinetic chain treatment is better for changes in pain, range of motion, quality of life and risk for falls in subjects with hip osteoarthritis. The intervention tested was chiropractic manipulation performed at one area (symptomatic osteoarthritic hip) versus chiropractic manipulation at various areas (ipsilateral lower limb kinetic chain).
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The rehabilitation of glenohumeral Range of Motion in Patients with Frozen Shoulder: A Comparison Between Conventional Therapy, Placebo and 'SCENAR' Electrical Stimulation Therapy.
Expand descriptionWhat is the effect of 12 weeks of SCENAR electrical stimulation therapy on glenohumeral range of motion in subjects with frozen shoulder? As no literature exists relating specifically to SCENAR therapy, the null hypothesis is supported. This is that the device does not cause any changes to glenohumeral ROM.
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The effect of diet and portion size on oral fatty acid sensitivity
Expand descriptionThe primary purpose of this study is to investigate the effect of diet on people's ability to detect fatty acids in the oral cavity.
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NSW Cancer Lifestyle and Evaluation of Risk Study (CLEAR Study)
Expand descriptionThe NSW Cancer, Lifestyle, and the Evaluation of Risk (CLEAR) Study is a multi-centre case-control surveillance study in the NSW population. The objectives of the study are: 1. To provide ongoing data on the relative importance of known or emerging exposures and their relationships to leading or emerging cancer types. 2. To investigate in the short term once sample sizes permit, the effects of migration, ethnicity, physical activity, alcohol consumption, smoking, reproductive history, occupation, screening behaviour and certain dietary patterns on the risk of developing cancer of the colon and rectum, prostate, breast and lung, cutaneous melanoma and non-Hodgkin lymphoma. 3. To investigate in the longer term, once sample sizes permit, the effects of these factors on rarer cancer types, such as hepatoma, thyroid, ovarian and pancreatic cancers. 4. To develop a recruitment infrastructure and biological repository of sufficient size to enable the testing of new hypotheses on gene and environment factors, and in some situations, gene-environment interactions, on the risk of cancers affecting the Australian population.
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An Australian Study assessing the effects of Avene Thermal Water Spray in patients with recessive dystrophic epidermolysis bullosa
Expand descriptionTo determine the efficacy and safety of the Avene Thermal Spring Water (ATSW) in wound healing in patients with recessive dystrophic epidermolysis bullosa. The hypothesis is that the ATSW, instead of bathing, will result in reduced number of infections and improved wound healing.
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Piloting osteopathic manipulative treatment for depression in peri-menopausal women
Expand descriptionThe aim of this research is to determine if osteopathic manipulative treatment (OMT) along with cognitive behavioural therapy (CBT) provides a better management of depressive symptoms in peri-menopausal women when compared to CBT alone. Peri-menopause is the three years, or more, prior to menopause, which is the final menstrual period a women experiences. It is hypothesised peri-menopausal women who receive OMT as part of their managment of mild depression or depressed mood will demonstrate a greater improvement in their depressive symptoms than those peri-menopausal women who receive only counselling.
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A randomised, cross-over trial of upright sitting versus alternate side lying during nebulised delivery of medication to improve the pattern of aerosol deposition in healthy participants
Expand descriptionParticipants will inhale a 4mL radioaerosol in two positions in random order throughout the nebulisation period of 20 minutes: 1. Upright sitting: or 2. Alternate Side Lying: (alternated between left and right at each minute) After each nebulisation a gamma camera will perform a 20-minute deposition scan incorporating a 2-minute transmission scan to outline the three-dimensional margin of the lung fields. This data will be reconstructed to determine the distribution of the deposited radioaerosol in the lungs. A 15% improvement in uniformity of deposition is the proposed minimum difference that would make further investigation of the alternate side lying strategy worthwhile in patient populations. Significance of project: In many patient populations (eg, cystic fibrosis, HIV and bronchiectasis), the pattern of deposition of inhaled medication is poor and non-uniform. Typically the upper lobes receive a reduced dose compared to the rest of the lung. The ability to deliver a drug more uniformly to the lung using a strategy of side lying may have a significant impact on treatment efficacy for people with lung disease. Data from healthy participants will aid interpretation of subsequent studies in patients.