ANZCTR search results

Ultrasound assessment of the lumbar region prior to neuraxial blockade is becoming more popular. Trials have demonstrated a smalll benefit in thin patients. It is hypothesised that a bigger benefit will be found in obese patients in whom it is difficult to determine lumbar anatomy by traditional palpatio techniques.

Acute ureteric colic is the pain caused by the passage of kidney stones. Standard treatment is the administration of pain-relieving medications. Intravenous (IV) fluids may also help relieve pain, may cause further pain or have no effect on pain at all. There is a lack of evidence regarding the impact of IV fluids on pain relief in acute ureteric colic. This study hopes to delineate this role by randomising participants with acute ureteric colic into two groups, both of which reflect current practice. The first group will receive IV fluids at a preset rate; the second group will receive IV fluids only with medications. Pain scores via a visual-analogue scale will be taken hourly for up to four hours; these will then be compared to see if there is any clinically significant difference in the pain scores between the two groups.

There is an association between obesity and asthma. Obesity is thought to increase the risk of developing asthma and also the severity of asthma. The mechanisms behind this association are unclear. The aim of this study is to determine the of obesity on the pattern of ventilation (termed heterogeneity) and of airway closure. We propose that obesity increases closure of airways but improves ventilation patterns, thereby paradoxically protecting against asthmatic airway narrowing (airway hyperresponsiveness).

Elderly asthmatics have poorer clinical outcomes compared with younger asthmatics. The reasons for this are unclear but may involve age-related changes in the disease itself. In this project we aim to show that asthma in the elderly is dominated by abnormalities of very small peripheral airways, in contrast to younger patients where the abnormalities occur in larger airways. The results will provide the basis for new and better targeted treatment strategies for asthma in the elderly.

The aims of this intervention are: 1. To conduct environmental audits of obesogenic factors in the community and monitor any changes that might occur over the period of the study. 2. To demonstrate that central obesity (as measured by waist circumference) and associated diabetes risk among Indigenous women can be reduced and this reduction can be maintained with a locally planned and managed group-based physical fitness intervention. 3. To understand how individual and micro/macro environmental factors contribute to waist circumference trajectories from post-program to 3 and 12-months post-program.

Background: In patients with chronic heart failure (CHF) depression is common, chronic and more severe than in other groups of cardiac patients. Unfortunately, at the present time in this group of patients, depressed mood is rarely screened for, let alone treated. Many patients have a mild form of depression “minor depression” that is debilitating with consequences that are anything but “minor”. We have data that demonstrate that depression (both major and minor) is a marker of a worse future health, including death, in CHF patients. However, these data do not conclusively answer two questions: 1. Does providing antidepressant medication for people with heart failure and depression improve their mood? 2. Does improving mood with antidepressant medication also improve physical functions related to heart health? Aims: This study, therefore, aims to test the hypothesis that treatment with an antidepressant medication (escitalopram) can improve minor and major depression in depressed patients with CHF. The study will also examine whether by reducing depression, other known medical risk factors that are related to both depression and CHF are changed at the same time. A third part of the study will examine whether there are longer term benefits to hospitalizations and longevity, and finally, genetic testing will done to assess the role of certain genes in the response to treatment.

This study will use carotid intima-media thickness, a marker of atherosclerosis, to address the unresolved issue about how to most efficiently manage intermediate risk subjects with a family history of premature atherosclerosis by combining better selection of such individuals for active treatment and recommended lifestyle changes with a disease management program strategy to optimise their successful application in the longer-term. Therefore, the study hypothesis is that in intermediate risk, first-degree relatives (mother, father, brother or sister) of individuals with premature atherosclerosis, a carotid intima-media thickness-targeted disease management program for primary prevention incorporating more intensive non-pharmacological and pharmacological management, provides better reduction of atherosclerotic burden than usual health care management during 36 months follow-up.

The purpose of this trial is to understand the differences between a disease management program incorporating better risk identification and management, and atrial fibrillation-specific components of treatment designed to specifically improve health outcomes in patients with chronic, non-valvular forms of atrial fibrillation. Given that this represents an increasing patient population subject to complex treatment, it has the potential to deliver significant clinical benefits from an individual to a health care system perspective. Therefore, SAFETY will test the hypothesis that in patients with chronic, non-valvular forms of atrial fibrillation, a specific program of enhanced risk identification and management (above conventional risk profiling) combined with an atrial fibrillation-specific form of chronic disease management will significantly reduce all-cause death and/or unplanned hospital readmission relative to standard medical care during a follow-up of 24 months.

The primary purpose of the study is to develop an alternative to the conventional facemask protraction therapy in the treatment of skeletal class III malocclusion. The hypothesis is that the treatment of skeletal class III malocclusions with miniscrews and intraoral elastics will produce a more profound skeletal change in less time than the conventional therapy.

This study will investigate the effect of metformin on breast tissue in well women intending to undergo reduction mammoplasty. There is an interest in the possibility that metformin could decrease breast cancer incidence or cancer related deaths. Our proposed research is to examine the effects of metformin treatment on LKB1 expression and activity, AMPK phosphorylation and CRTC2 phosphorylation and translocation, as tissue in vivo and to explore relationships between identified cellular effects with serum indicators of insulin resistance.