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This study aims to determine the optimal bladder filling instructions for prostate cancer patients undergoing radical radiation therapy using Image Guided Radiation Therapy (IGRT) Who is it for? You can join this study if you are undergoing radical radiation therapy using Image Guided Radiation Therapy (IGRT) as treatment for prostate cancer. Trial details Participants will be divided into two groups. One group will be asked to empty their bladder 1 hour prior to their treatment appointment time, and then consume 300mL of water at least 30 minutes prior to their treatment appointment time. The second group will be asked to empty their bladder 1 hour prior to their treatment appointment time, and then consume 750mL of water at least 30 minutes prior to their treatment appointment time. The amount of daily bladder volume variation over the course of treatment will be measured daily in week 1 of treatment, and then every 2nd day until treatment is completed. Participants will also be asked to complete some questions measuring quality of life and distress, in weeks 1, 4 an 7 of treatment. Further monitoring will occur 6months and 12 months after treatment has completed.

The aim of this project is to assess the effect of a clinical Pilates intervention in community dwelling older adults on balance, strength, range of movement and blood glucose. A variety of exercise programs have been found to be beneficial in addressing physiological parameters (blood glucose control, lipid profile control, cardiovascular health) and biomechanical parameters (balance, range of movement and strength) but this form form of exercise had been little studied. Pilates is a popular form of exercise that proposes a range of health benefits, although the research into physiological and psychological benefits is limited.

This study was undertaken to determine whether the two different aquatic exercise programs undertaken between Day 4 and Day 6 after joint replacement surgery were equivalent to usual ward exercise in terms of physiological demand and self-rated pain and effort. These three programs were then to be used in a larger Randomised Controlled Trial to investigate the efficacy of inpatient aquatic physiotherapy after arthroplasty. All participants undertook the programs in the same order so that all were naive to the water programs on their first day in the pool after surgery and could rate the easy water exercise program without having a comparison to the intensive program.

This study firstly aims to determine if there are differences in the post-operative recovery in terms of muscle activation, lower limb strength and balance between people who have had additional aquatic physiotherapy and those who have had standard ward treatment. The second aim is to determine if there is a relationship between the laboratory measures of muscle activation, with clinical measures of strength and function. The third is to compare the muscle activation patterns and timing at various stages of recovery of those who have had surgery with those of healthy older people. We hypothesise that, people undergoing total hip or knee replacement will demonstrate a delay in timing of muscle activation in a step task and greater variation in gait parameters in comparison to healthy elders; those who have not had additional inpatient aquatic physiotherapy after THR or TKR will demonstrate a delay in timing of muscle activation in a step task and greater variation in gait parameters than those who had aquatic physiotherapy; and there will be a positive correlation between a delay in muscle timing and reduced clinical measures of strength and function.

Biobrane is our gold standard for superficial partial thickness burns. AWBAT is very similar but adheres more rapidly to the wound. This is the rate limiting step in healing and allowing theses patients to be treated as outpatients. The study aims to compare the two in rate of epithelialisation and pain perception (the other issue which keeps burn patients in hospital).

Traumatic brain injury (TBI) is a leading cause of death and long term disability, particularly in young adults. Studies from Australia have shown that approximately half of those with severe traumatic brain injury will be severely disabled or dead 6 months post injury. Given the young age of many patients with severe TBI and the long term prevalence of major disability, the economic and more importantly the social cost to the community is very high. Pre-hospital and hospital management of patients with severe brain injury focuses on prevention of additional injury due primarily to lack of oxygen and insufficient blood pressure. This includes optimising sedation & ventilation, maintaining the fluid balance and draining Cerebrospinal Fluid (CSF) & performing surgery where appropriate. In recent years there has been a research focus on specific pharmacologic interventions however to date there has been no treatment that has been associated with improvement of neurological outcomes. One treatment that shows promise is the application of hypothermia (cooling). This treatment is commonly used in Australia to decrease brain injury in patients with brain injury following out-of-hospital cardiac arrest. Cooling is thought to protect the brain using a number of mechanisms. There have been a number of animal studies that have looked at how cooling is protective and also some clinical research that suggests some benefit. However at the current time there is insufficient evidence to provide enough proof that cooling should be used routinely for patients with brain injury and like all treatments there can be some risks and side effects. The POLAR trial has been developed to investigate whether early cooling of patients with severe traumatic brain injury is associated with better outcomes. It is a randomised controlled trial, which is a type of trial that provides the highest quality of evidence.

Randomised controlled trial to test if short periods of lack of blood flow to the leg can improve the function of new lungs in lung transplantation.

Anticoagulants are recommended for prevention and treatment of venous thromboembolism (VTE); comprising deep vein thrombosis (DVT) and pulmonary embolism (PE). Without prophylaxis, DVT occurs in 10–40% of general surgical or medical patients. Patients undergoing major orthopaedic surgery are at a higher risk; without prophylaxis, 40–60% of these patients may develop VTE. Guidelines for VTE prevention recommend the routine use of thromboprophylaxis with low molecular weight heparins (LMWHs) or vitamin K antagonists (VKAs) for patients undergoing major orthopaedic surgery; however, the oral VKAs are rarely used for this indication. The American College of Chest Physicians (ACCP) guidelines currently recommend that thromboprophylaxis be continued for at least 14 days after total knee replacement (TKR), and up to 35 days after total hip replacement (THR). LMWHs are effective; however, their long-term use is limited by their parenteral route of administration. VKAs are the only licensed oral anticoagulants and, although they are effective, they have unpredictable pharmacokinetics (PK) and pharmacodynamics (PD), which are affected by drug and food interactions. As a result, VKAs require frequent monitoring and dose adjustment to ensure that their anticoagulant effects remain within the therapeutic range. Advances in the understanding of the coagulation pathway have enabled the development of novel anticoagulants targeting specific enzymes within the coagulation cascade, including Factor Xa (FXa) and Factor IIa. FXa has been identified as a particularly attractive target for effective anticoagulation: by catalysing the conversion of prothrombin to thrombin through the prothrombinase complex, one molecule of FXa results in the generation of more than 1000 thrombin molecules. Therefore, inhibition of FXa activity may block the amplification of thrombin generation, limiting thrombinmediated activation of coagulation and platelets, without affecting existing thrombin levels. Several FXa inhibitors, such as rivaroxaban, apixaban, betrixaban and edoxaban, are currently at advanced stages of development. Rivaroxaban (Bayer Healthcare AG, Wuppertal, Germany) is a novel, oral, direct FXa inhibitor in advanced development for the prevention and treatment of thromboembolic disorders. Rivaroxaban 10 mg orally once-daily (od) has recently received approval by the Therapeutic Goods Administration (TGA). Australia for the prevention of VTE in patients undergoing elective total hip or knee replacement (THR or TKR) surgery. Recent reports showed high efficacy of rivaroxaban compared to different regimen of LMWH in the prevention of VTE in patients undergoing elective total hip or knee replacement (THR or TKR) surgery. A once-daily, 10-mg oral dose of rivaroxaban was significantly more effective for extended thromboprophylaxis than a once-daily, 40-mg subcutaneous dose of enoxaparin in patients undergoing elective total hip arthroplasty. The two drugs had similar safety profiles. However further studies are warranted to establish the safety profile and to assess the effect of different anticoagulants on the post operative microvascular bleeding.

Multiple myeloma is a common blood cancer that affects mainly elderly people with a current trend to affect younger patients from both sexes as well. This disease mainly affects the bones and causes in late stages a permanent bone damage and fractures. This bone damage becomes worse and irreversible if there is a delay in diagnosis or treatment of myeloma occurs. To date, in Australia and worldwide convential x-rays are used to diagnose bone disease commonly associated with myeloma (about 80% of cases). However this technique is insensitive in prediction or detection of bone damage. It can be replaced by more sensitive techniques like whole body MRI, which we know little about it in conjunction with diagnosing bone disease in myeloma patients. Fortunately enough the MRI scan is now available at the Launceston General Hospital (LGH). More recently another nuclear scan technique called Sestamibi bone scan, also available at the LGH, developed to detect bone disease in cancer and may have a promising role in myeloma disease. Currently, there is no data available to compare both above techniques in early detection and diagnosis of bone disease associated with myeloma blood cancer. This trial offers a comparison between these methods in addition to other myeloma markers for early detection of bone disease. Furthermore establishing a reliable sensitive method compared to current standards for early detection of bone disease will enable clinicians to commence the appropriate treatment to prevent a devastating consequence of myeloma with bone fractures that disable many patients, who are suffering from this dreadful cancer.

Luminal restoration of the prostatic urethra involves implanting the NeoTract Anchor System, which is designed to hold back the lobes of the prostate, and open the urethra (the tube that carries urine from your bladder to the outside of your body) to relieve symptoms associated with urinary obstruction. This study is a prospective, open-label feasibility study enrolling up to 70 participants. Safety and feasibility are the primary endpoints while patient questionnaires and therapeutic effectiveness is assessed as a secondary endpoint. Follow-up visits are at 24 hours, 2 weeks, 4 weeks, 6 weeks, 3 months, 6 months, 1 year, and annually thereafter for the 7 year duration