ANZCTR search results

Electro convulsive therapy (ECT) remains the only established treatment for the large percentage of patients with depression who fail to respond to standard therapies. It is commonly used (with 10 to 15% of inpatients with depression receiving ECT) but has substantial problems including the occurrence of cognitive side effects that are often highly distressing for patients. ECT is associated with both short term and long term cognitive side effects. The short term effects include anterograde and retrograde memory loss and post treatment disorientation which can be distressing, dangerous and significantly slow treatment progress. In the longer term, ECT can affect autobiographical memory which can be very distressing to patients. The development of a new treatment with similar efficacy but which minimises these side effects would have great clinical value. A highly promising possibility is magnetic seizure therapy (MST). MST involves replacing the electrical stimulation used in ECT with a magnetic stimulus. This appears to be able to produce similar clinical effects but without the disabling cognitive side effects related to ECT. However, substantive trials using the newest MST equipment are required. Due to the rarity of the equipment available so far, these studies are only being undertaken in a handful of places internationally and no research with MST has occurred. Building on a pilot study conducted by the applicants, we propose to undertake a substantive head-to-head trial of MST versus ECT. There will be a total of 60 patients in the study undertaking a treatment course of between 9 and 15 treatments. Baseline and endpoint assessments will be undertaking to investigate efficacy, these will include clinical assessments, cognitive assessments and neurophysiological assessment If MST proves to be as efficacious as ECT, but with fewer side effects, we anticipate that it could be rapidly adopted in clinical practice. All of the facilities are available for the provision of MST in every substantive mental health service in the country (in current ECT suites / facilities); all that would be required would be the replacement of the ECT machine with MST equipment for seizure induction. Fewer cognitive side effects will enhance patient outcomes and improve treatment acceptability and hence access. In addition, a reduced duration of post treatment disorientation will shorten the period of post treatment observation required enhancing capacity for convulsive therapy to be provided on an outpatient basis, lessening demand on inpatient psychiatric services.

The aim of this project is to undertake an evaluation of a consumer-oriented pamphlet for the self management of low back pain within a primary care context. The project will determine whether providing the pamphlet to individuals who visit a community pharmacy to purchase pain-relieving medications for low back pain is effective (with and without additional education from the pharmacist) compared to not providing the pamphlet. Effectiveness is defined as improving consumer beliefs about low back pain and minimising fear avoidance behaviours related to low back pain. when appropriate, messages are targeted towards best-practice self management of spinal pain. Where additional support is required, a recommendation to seek evidence-based guidance from a health professional is encouraged. Primary hypothesis: Providing this low back pain educational pamphlet to consumers who visit a community pharmacy to purchase pain-relieving medications for LBP improves beliefs about LBP and minimises fear avoidance behaviours compared to usual care.

This project aims to assess the usefulness of telehealth technology for speech and language assessment. The specific aims are: a) to compare the quality of visual and auditory information during an in-person assessment versus assessment via two telehealth methods (custom-built telehealth equipment, and internet-based videoconferencing). b) To compare the cost and feasibility of these three methods. c) To compare the patient, caregiver and therapist's preference for these three methods. Two groups of children will be recruited from the existing speech pathology caseload at the Royal Children's Hospital: 20 pre-school aged children (3 - 5 years) with a history of cancer, and 20 primary school-aged children (6 - 12 years) with a history of cancer. Both groups of children will complete a speech and language screening assessment under 3 conditions (in-person, and via custom-built telehealth and internet-based videoconferencing). All conditions will be simulated at the Royal Children's Hospital. Data collected will include the number of requests for repetition, number of breaks in visual and auditory signal, and total time to complete the assessment. At the end of each assessment the patient, caregiver and therapist will rate the assessment against a standard checklist. After all 3 assessments the patient, caregiver and therapist will rate their preference. A cost and feasibility analysis will be performed based on the participant accessing the different options while living at their residential address.

Thiamin or benfotiamine supplementation has been shown to have positive effects on CVD risk factors in animals with experimental diabetes and a few studies of humans with diabetes. This study is designed to see if thiamin has benefts in those with glucose intolerance.

A study of proteins involved in the inflammation and pain associated with arthritis of the knee The study involves inviting people with a diagnosis of arthritis of the knee to participate in the study. The treatment for their arthritis will not be altered in any way. Participants will be asked to attend a single appointment, which will take about 2 hours and the following will occur: Questions about their health and specifically their arthritis and about any medications they are taking. This will be followed by a physical examination by the doctor (including weight, height, abdominal and waist circumference, BP) Questionnaires about pain, and difficulties/disability caused by the arthritis and associated pain. The knee joint will be examined by a doctor and undergo an ultrasound examination of the knee. The fluid in the knee will be withdrawn through a needle.

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.