ANZCTR search results

Currently knee replacement surgery is performed using external jigs or a computer navigation system to guide bone cuts necessary to implant the metal and plastic prosthesis. The computer navigation system is considered the "gold standard" for guiding and evaluating the cuts. However, new technology as been developed that allows patient-specific instruments to be manufactured based on a pre-operative MRI scan and x-rays of the affected knee. These instruments should allow bone cuts and thus implants to be positioned more accurately. The current study will include 10 patients that have met the criteria for total knee replacement. The patients will require a pre-operative MRI and full-leg x-rays. Their surgery will be performed with the custom instrumentation. All bone cuts will be evaluated intra-operatively, using the computer navigation system. Any cut that is inappropriate will be revised using the standard, computer navigated instruments. The surgery will require approximately 2 hours. The patients will require a post-operative computer tomography [CT] scan and full-leg x-rays to evaluate the limb and implant alignment. These studies will be performed 6 weeks post-operatively. Otherwise, the recovery and post-operative follow-up will be unchanged from that expected for routine knee replacement surgery. Our hypothesis is that the patient-matched instrumentation will align the bone cuts, implants, and the mechanical axis of the limb at least as well as would be expected using external jigs or computer assisted surgery.

The purpose of this study is to determine how three different medications influence brain activity whilst healthy participants are performing cognitive tasks. The three medications are methylphenidate, atomoxetine and citalopram. The first two medications are commonly used to treat attention deficit hyperactivity disorder (ADHD) in both children and adults, whereas citalopram is used to treat depression in adults. Importantly, we know that these medications act on different chemical systems in the brain. What we do not know, however, is whether these medications can influence underlying brain activity when people are performing cognitive tasks. This project will help us to understand which chemicals in the brain modulate our ability as humans to inhibit and control our behaviour. Studying these effects in healthy people will provide important clues to the underlying biology of a range of mental disorders where problems of inhibition and control of behaviour are common.

The primary purpose of this study is to find out if high salt intake contributes to the severity of obstructive sleep apnoea. Our hypothesis is that reduction of salt intake in people with moderate to severe sleep apnoea will reduce the symptoms of the sleep apnoea.

Knee osteoarthritis (OA) is a common musculoskeletal condition that affects many adults and is likely to become more common as the population ages. Much of the research to-date has focussed on identifying treatment strategies to reduce physical problems such as knee pain and dysfunction. However, we also know that many individuals with knee OA report psychological issues such as anxiety and depression. Therefore, treatment of knee OA should focus not only on the physical impairments, but psychological and emotional ones as well. By addressing both of these, we hope to improve the overall burden of the disease on affected individuals. The purpose of this study is to examine the effectiveness of physiotherapy treatment that combines physical components through strengthening and walking exercises with psychological components through discussion of symptoms and their effects.

Actinic keratosis are scaly patches on sun-exposed skin, especially the face, scalp and backs of hands. They are usually grey to dark pink in colour and if left unattended, may develop into skin cancer. 5-Fluorouracil is a man-made drug that is currently in widespread use in the non-transplant population as a topical therapy for actinic keratoses. The purpose of this study is to look at how effective 5-Fluorouracil is at reducing the number of actinic keratoses in renal transplant patients. 5-Fluorouracil has been widely tested in the non-transplant population. It is recognised as being a successful therapeutic agent with two randomised controlled trials finding that patients had a 70-78% reduction in lesions following treatment. It is applied topically over a three week period to the area affected by actinic keratoses. This study will help to provide more information on 5-Fluorouracil. This information will be used to determine the safety and efficacy (the ability of the drug to produce an effect) of this drug in renal transplant patients that suffer from pre-cancerous skin lesions. This study drug is approved by the Therapeutic Goods Act for use in the general population and has been used for many years in renal transplant patients. The side effects are well known.

Shoulder pain is a common and debilitating symptom for a large number of people following a stroke. The cause of shoulder pain is usually related to several factors, including trauma, inflammation and positioning. In cases when shoulder pain is unable to be prevented, current treatment options include arm supports, physiotherapy techniques, and simple analgesic medication. It is commonly observed that shoulder pain persists or is inadequately controlled by these interventions. This research aims to study the effect of an injection that numbs the nerve (Suprascapular Nerve) that supplies pain fibres to the shoulder. The technique has previously been proven safe and effective in the treatment of shoulder pain associated with rheumatoid arthritis and degenerative shoulder conditions.

The aim of this study is to examine the independent and combined effects of Pioglitazone and Omacor (fish oil) on VLDL transport in metabolic syndrome subjects with non-alcoholic fatty liver disease (NAFLD). NAFLD, which afflicts 20-30% of our population, increases the risk of cardiovascular disease (CVD) and is related to a higher prevalence of insulin resistance, obesity and dyslipidaemia, key characteristics of the metabolic syndrome. Eligible participants will be randomised to one of 4 groups: Pioglitazone alone, Omacor alone, combined Pioglitazone and Omacor, or usual care, that is, no additional treatment or placebo.

In this study, we aim to show whether hyperbaric oxygen therapy (HBOT) is beneficial for patients with sudden onset of hearing loss (with or without a ringing in the ears) where no cause can be found for the hearing loss.

Thus study aims to investigate new methods of treating a specific cause of hip pain, where the top of the thigh bone hits against the pelvic bone. Existing keyhole surgery techniques will be combined with a new computer-assisted method to determine if the surgery can be improved. Patients will be assessed before and after their operation to measure activity, pain and quality of life.

The aims of the study are to determine the effect of various systemic antibiotic prophylaxis regimes on patient-centred outcomes and perceptions, postsurgical complications in patients undergoing standard oral implant therapy. The hypothesis is that the use of both peri-operative and/or post-operative systemic antibiotics does not provide additional benefits, in terms of decreasing postsurgical complications. 336 medically healthy adults who are consecutively admitted to 7 study centres for standard oral implant therapy will be randomly assigned to one of the 4 groups (3 test and 1 control groups). Pre-operative antibiotics of 2 g amoxicillin 1 hour prior to standard implant placement will be prescribed to test group 1 (positive control), post-operative antibiotics of 2 g amoxicillin following implant placement for test group 2, and pre-operative antibiotics of 2 g amoxicillin 1 hour prior to standard implant placement and 500 mg thrice daily on days 2 through 3 after standard implant placement for test group 3. The control group will be given a placebo tablet of 2g 1 hour prior to standard implant placement without any antibiotics. Subjects will be examined clinically by blinded examiners at 1 week, 2 weeks, 4 weeks and 8 weeks from implant installation for post-operative complications. In addition, Visual analogue scores (VAS) on pain, swelling, bruising and bleeding will be obtained from the patients from day 1 through day 7 and 14. The present study will answer an important clinical question with regards to the recommendation of antibiotic usage to prevent post-operative complications (suppuration) with oral implant placement and to recommend a protocol of pre-, peri- or post-operative administration of antibiotics, if required.