ANZCTR search results

Patients with low back pain who fulfil the diagnostic criteria for deficient load transfer through the sacro-iliac joint (SIJ) (Hungerford et al, 2004; Mens et al, 2001) (sacro-iliac joint dysfunction) and who do not respond to exercise therapy have deficient ligamentous function. 1. The primary hypothesis of this study is that the injection of 20% Glucose solution into the posterior ligaments of the SIJ will stimulate the formation of new collagen and increase ligament strength. Tis will be measured by improvement in the following tests: a) Stork test (Hungerford et al Spine 2004), b) Active straight leg raise (ASLR) (Mens et al, 2001 and 2002) , c) Posterior pelvic pain provocation test (PPPP) (Ostgaard et al, 1994, Vleeming et al, 2002) d) Palpation of the long dorsal sacro-iliac ligament (Vleeming at al, 1996) 2. The secondary hypothesis is that the improvement in the ligament function will lead to a decrease in symptoms and an improvement in quality of life measured by a) Quebec Back Pain Disability Scale (Kopek et al, 1995) and b) Patient Generated Index Questionnaire (PGI) Ruta at al, 1994 Both have been used previously in back pain studies. The aim of the study is to compare by randomised trial wether CT guided injection of 20% glucose solution into the ligaments of the sacroiliac joint as compared to a sham injection control results in a) A negative Stork test b) A negative ASLR test c) A negative PPPP test d) A lower Quebec score e) Improvement in the PGI, as measured three months after the intervention

One of the most visible signs of ageing is the loss of muscle mass. This loss of muscle mass has subtle, yet significant, impacts on the health of an individual. Muscle provides the necessary tissue for physical activity, therefore a loss of muscle reduces physical capacity. With time, the loss of muscle mass, strength and coordination increases the risks of falls. NatraGuard consists of proteins isolated from cow’s milk. Studies have been performed on muscle cells in the laboratory and in mouse models that demonstrate NatraGuard stimulates muscle cell growth and therefore may contribute to muscle strength. The aim of this project is to determine, in participants undertaking aerobic and resistance training, the dose(s) of a dairy protein extract (NatraGuard) that produce improvement in muscle strength. This new knowledge will be used to design future research studies.

Malnutrition, especially unintentional weight loss, is a known issue in Parkinson's disease. Malnutrition is associated with a number of adverse outcomes including decreased physical function, higher mortality, impaired immunity, longer hospital stays and decreased quality of life. People with Parkinson's disease are at a higher risk of malnutrition due to the motor and non-motor symptoms associated with the disease as well as the side effects of anti-parkinsonian medication. To date, an intervention to address malnutrition in this population has not been conducted.

The relationship between periodontal disease and cardiovascular surrogate endpoints, both of which are high among the Indigenous Australian population, is established. This study seeks to explore the prevalence of cardiovascular surrogate endpoints among this population with periodontal disease, and to determine if implementation of a periodontal intervention leads to improved cardiovascular risk outcomes. There may be benefit in applying this model to other areas of Indigenous health research.

Chronic kidney disease (CKD) affects approximately 10-15% of the population in developed countries. Cardiovascular disease (CVD) is the greatest risk faced by CKD patients compared to the general population, with an increased mortality that parallels the decline in renal function. Traditional strategies to reduce the risk of CVD, such as lipid lowering and blood pressure control, have had limited impact in the CKD population. This is likely because much of the excess risk of CVD has been attributed to non-traditional risk factors such as anaemia, inflammation and accelerated vascular calcification (VC) and arterial stiffness, related to abnormal phosphate and calcium metabolism in this population. Vitamin D deficiency has been linked to vascular calcification in epidemiological studies. Our aim is to assess as to whether vitamin D supplementation can delay or decrease the progression and incidence of vascular calcification in this population. At this stage there have been no clinical trials assessing the impact of vitamin D therapy on improving CV outcomes or altering the natural progression of surrogate CV markers such as VC and arterial stiffness in the CKD population.

We are conducting a trial to systematically evaluate if 14-24 year old young people are more likely to complete a telephone interview if they receive a guaranteed movie ticket upon completion compared with a 1/500 chance of winning a bigger prize ie an iPod. This trial is nested within a larger randomised controlled trial (RCT) ("Health risk screening and counselling of adolescents and youth friendly practice: a cluster randomised controlled trial in primary care" - ISRCTN16059206) which is exploring the effects of a systems level intervention encouraging youth friendly practice in primary care.

The life expectancy gap for Indigenous people in Australia is 13 years and most of this gap is due to preventable chronic disease (diabetes, heart, lung and renal problems) in adults. Once people have these conditions, many complications can be prevented with good primary-level chronic care. This project aims to introduce and evaluate a new strategy for integrated community-based, intensive chronic condition management in rural and remote Indigenous primary care services: Diabetes, hypertension, coronary heart disease (CHD), renal disease and chronic obstructive pulmonary disease (COPD). Proposed strategy: An intervention in 3 phases over 5 years: 1. A trial of intensive locally delivered chronic care in 6 out of 12 participating sites in FNQ with clear clinical and quality-of-life outcomes; 2. Review of lessons learned in the first phase trial, modified as necessary to reflect findings, a discussion about generalisability to the “control” sites in the trial, with an implementation plan and the development of a curriculum package for the program and; 3. In collaboration with the trial partners(QH, Apunipima CYHC and local AMS where relevant), a more general system rollout of lessons learned, with potential regional implications of a patient-centred service delivery model, including workforce and funding applications.

The aim of this clinical study is to determine the safety and effectiveness of the Cementless Total Hip System (CL2 stem/C2 cup). This will be done by collecting information and data on measured outcomes on the Total Hip System, using the Radiostereometric Analysis (RSA) method to provide early results on the implant. The intended use of this implant is for patients with degenerative joint disease who require a primary total hip replacement.

This study aims to determine if some women with early breast cancer can avoid radiotherapy treatment after breast surgery. If radiotherapy treatment can be omitted without there being any more than a very small risk of the cancer coming back in the same breast, more women may be able to avoid radiotherapy in the future. This means that these women would avoid 5 weeks of daily radiotherapy and the possible short term side effects; including, fatigue, skin redness, discomfort. Radiotherapy is associated with long term side effects which also may be avoided: discomfort in the breast, thickening of breast tissue, and very occasionally possible lung problems (pneumonitis and lung scarring), heart problems and a very small risk of radiation-induced cancer. Who is it for? This study is for women with early breast cancer that must be positive for the oestrogen receptor and/or progesterone receptor and/or human epidermal growth factor receptor. Prior to entering the main study, patients must have a magnetic resonance imaging (MRI) scan. All treatment is standard treatment except that radiotherapy after surgery to remove the breast cancer will not be given. Trial Details The study will use magnetic resonance imaging (MRI) to select women with early breast cancer for whom radiotherapy is not needed because the risk of a local recurrence (cancer coming back in the same area) is low. We are investigating whether the abnormalities found by MRI are in fact the reason that local recurrence sometimes occurs, so if nothing is found on MRI, radiotherapy may not be required.

Procalcitonin (PCT) is a marker of bacterial infection, severity of infection and response to therapy. This study aims to examine the use of this biomarker to guide antibiotic therapy in intensive care patients. We assume that a 25% reduction in exposure to antibiotic days can be produced by using a PCT guided algorithm.