ANZCTR search results

Acid-base disorders are frequently associated with liver dysfunction and may occur in patients undergoing partial liver resection. Liver resection decreases the working liver mass and causes a variable degree of liver insufficiency that in turn, may cause or aggravate metabolic acidosis. The quantitative acid-base effects of fluid therapy during liver resection are unclear with few reported studies. For patients undergoing liver resection, the most frequently administered intravenous crystalloid (clear) fluids are Hartmann’s solution, Normal Saline, and to a lesser extent, Plasmalyte. Normal Saline is not considered an acceptable fluid for prolonged perioperative administration due to its high chloride content that results in hyperchloremic metabolic acidosis. Therefore, both Hartmann’s Solution and Plasmalyte, being more “balanced” solutions compared to Normal Saline, remain the fluids of choice for patients undergoing hepatic resection. However there are no studies to determine which of these fluid has a more favourable acid-base profile. We propose to conduct a prospective, multicentre-centre, blinded, randomized non-inferiority trial to test whether Plasmalyte solution is associated with similar or improved metabolic status (non-inferiority) than Hartmann’s solution. Adult patients undergoing elective hepatic resection will be randomized to receive either Plasmalyte or Hartmann’s solution for all crystalloid fluid therapy during elective liver resection surgery. Primary aim: to examine the effect of Plasmalyte or Hartmann’s solution on acid-base status (measured by base excess). Secondary aims: to compare changes in plasma lactate concentration, effect on NGAL (a novel marker for acute kidney injury), need for blood and blood products, need for mechanical ventilation and its duration, length of hospital stay and survival to hospital discharge. Another factor that may affect acid-base status after liver resection is perioperative kidney injury. In research conducted in the Intensive Care Unit at Austin Hospital, it was found that a new marker for early postoperative kidney injury called NGAL (neutrophil gelatinase associated lipocalin) can be used to predict acute kidney injury in patients undergoing major cardiac surgery. From the published data, the incidence of acute kidney injury after elective hepatic resection is between 10-15%. The value of NGAL after liver resection has not been examined, therefore we also propose to examine if the acid-base status effects of the study fluids have any influence on the incidence of postoperative acute kidney injury. Number of recruiting hospitals: 3 (Austin Hospital, Monash Medical Centre, Peter MaCallum Cancer Centre) Number of patients planned for involvement at each hospital: 15- 20

This study is to investigate the efficacy of vardenafil and CPAP on erectile dysfunction and obstructive sleep apnoea

Post Therpetic Neuralgia is the pain that persist after the shingles rash has gone. The purpose of this sutdy is to research the use of Lignocaine in treating this pain. There will be no long term benifits from particpating in this trial as the patients will only recieve one dose of study drug.

The aim of this study is to assess the impact of nephrectomy on cardiovascular risk factors and vascular function, with emphasis on early markers of vasuclar disease including endothelial dysfunction, oxidative stress and inflammation. The follow-up studies of donor safety are flawed by being retrospective and with significant loss to follow-up. The numbers of patients who have died or have significant cardiovascular disease have not been adequately assessed. In the general population any degree of renal impairment, eGFR < 60mls/min (Glomerular filtration rate) is independently associated with an increase in cardiovascular risk, death and hospitalization. Retrospective analysis or our cohort of live donors over the last 15 years (up till 2005) revealed that 39% of respondents had stage 2 (eGFR 15 -30mls/min) chronic kidney disease. We hypothesize that donors, post nephrectomy with the associated decrement in GFR may be at increased risk of future vascular disease. Specifically, we will scrutinize the following features of early vascular disease: Inflammation: hsC-reactive protein, IL-6 Endothelial dysfunction: Brachial Artery Reactivity ) Smooth muscle dysfunction: Pulse Wave Velocity Oxidative stress:Plasma, urinary 8-iso-prostaglandin 2 and oxidized LDL Vascular structure: Carotid intima-media thickness We will also collect data relevant to features of metabolic syndrome including triglyceride, High Density Lipoprotein, waist-hip ratio and fasting glucose, to determine the association between renal and cardiac function and traditional cardiovascular risk factors. This is a 5 year longituidinal study of live donors. All patients will be reviewed in outpatient clinic every 12 months. Data on vascular imaging studies will be collected at baseline and annually. Glomerular filtration rate will be estimated at baseline and annually using 24 hour urine collection, MDRD and 51Cr-EDTA nuclear scan. 24 hour urine collection will be used to measure urinary protein and albumin excretion. All cardiovascular events, admissions, biochemical and clinical data will be recorded at specific annually at time of follow up. A control group (already established within the CCRE), matched for age and gender will be approached for comparative purposes.

This PhD project investigates a phonics based treatment program for Australian children who have severe problems learning to read (developmental dyslexia). In particular these children have difficulty learning to 'sound-out' word and thus have poor phonics skills (phonological dyslexia). The treatment will focus on improving phonics skills (i.e., parsing, letter-sound correspondences, and blending) in these children (50 children). The results of this reading treatment trial will aid Australia's efforts to developing effective treatments of dyslexia.

Evidence exists that surgery conducted with the use of a tourniquet results in blood being more prone to clotting. This phenomena starts whilst the tourniquet is inflated and increases when the tourniquet is deflated. Platelets are thought to be central to this process. Activation of the platelets may in part be due to products produced by the oxygen deprived tissue secondary to the use of the tourniquet. Some evidence exists that these products can be modified by altering the concentration of inspired oxygen at the time of reperfusion. However, whether altering the inspired concentration of oxygen influences platelet function remains unexplored. We plan to investigate whether changes in the inspired oxygen concentration alter platelet function in a model of ischaemic reperfusion injury. This is of clinical interest because ischaemic reperfusion injuries are encountered commonly in surgical practice. Examples include revascularisation of limbs in vascular surgery, organ transplantation, crush injuries etc. Maintenance of normal blood clotting is vital to clinical outcome.

Bariatric surgery is increasingly used as a treatment for morbid obesity. This is a retrospective audit of existing data in which we wish to analyse the efficacy and safety of the Swedish Adjustable Gastric Band (SAGB) VC in the treatment of morbid obesity. It is our intention to analyse follow-up data from those patients who have an SAGB-VC.

In this study we are seeking to evaluate the implementation of an education program addressing exercise prescription for falls prevention designed for health professionals in regional Victoria. In particular, a face-to-face mode of facilitation will be compared with online based facilitation.

A study to evaluate the reduction in incidence of, and mortality from, breast cancer associated with taking tamoxifen daily for five years

The primary objective of the ABSORB EXTEND trial is to continue the assessment of the safety and performance of the Bioresorbable Vascular Solutions Everolimus Eluting Coronary Scaffold System.