ANZCTR search results

This study looks at two types of surgical wound dressing used after fixing fractures of the hand with a pin called a K-wire and whether there is a difference in infection rates and the ease of , and pain associated with, application and removal. When a person fractures a bone they may have a closed fracture or an open or compound fracture. A closed fracture is when the broken bone does not penetrate the skin. In this study, we are only looking at patients with closed fractures. In addition, for inclusion in this study, the fracture must be of the hand higher (distal) than the wrist crease. The Kirscher Wire Pin (commonly known as a K-wire) is a sharpened, sterilised metal pin that is used to hold the fractured bone fragments together. After insertion of the K-wire, the wound is dressed and then assessed on a weekly basis for infection. Infection is common (about 10% of cases) because the insertion of the wire through the skin into the bone creates a passage for bacteria. The area around the wire may become red and swollen and there may be a discharge. Antibiotics may have to be prescribed and sometimes the pin needs to be removed prematurely. Current practice involves dressing the wound in Melolin – a dry non-adherent sterile dressing and Mefix – a surgical tape. In this study we would like to compare this dressing with a new anti-microbial barrier dressing which contain nanocrystalline silver. This type of silver has long been known for its antimicrobial properties. The patients would be consented prior to surgery and then randomly allocated one of the two wound dressings. For both arms of the study, the patients will be followed up and assessed in exactly the same manner. If a patient does not wish to participate in the trial the wound will be dressed in the dry dressing as is current practice.

Little is known about ways to promote informed and effective treatment by providers other than medical practitioners. Expanding evidence demonstrates that interventions to change practice should be targeted at specific clinical behaviours and underpinned by appropriate behavioural theory. Existing research into behavioural change in medical practitioners may not be generalisable to other professionals. Acute low back pain (LBP) is common and chiropractors and physiotherapists provide most care for the condition in Australia. The NHMRC clinical practice guidelines (CPGs) for acute LBP provides recommendations with potential to improve quality of care and safety for people with LBP. Relevant CPG recommendations are that x-rays are rarely needed and that patients should be advised to remain active. We are currently investigating the effectiveness of a targeted, theory-based implementation strategy to implement CPGs in general practice (NHMRC project grant 334060). Whether implementation strategies are transferable between professional groups is not known. This project allows us to build on our completed work to date, incorporating qualitative interviews and surveys of physiotherapists and chiropractors to explore barriers and enablers to CPG uptake (NHMRC project grant 436767) in order to develop a targeted implementation strategy for use in physiotherapy and chiropractic clinics. A cluster randomised controlled trial will then be conducted to determine the effects of the strategy. Practices (n=136) will be randomised to receive either the developed implementation strategy, including strategies targeted at clinicians and patients, or to a control group receiving access to the CPG alone. We plan to recruit 2720 patients from the 136 practices. The outcomes of the implementation strategy will be assessed at the level of the practitioner (did the strategy result in a change of practice?) and the patient (did the practice change result in improved patient outcomes?). Subgroup analyses will investigate effects specific to chiropractors and physiotherapists.

to determine appropriate patients that can be managed by ohysiotherapists in the emergency department and assess the effect on patient waiting times to be treated and have treatment completed when presenting to the emergency department with musculoskeletal or mobility related issue.

Acetylcholine levels are decreased in delirium, a condition of a sudden change in mental capacity occurring due to a illness, medication or similar insult. Rivastigmine is a medication for Alzhiemer's Disease, another condition where there is a change in mental capacity and low levels of acetylcholine. It increases levels of acetylcholine in the brain. THis trial aims to determine if a rivastigmine patch given to elderly patients in hospital after their illness has resolved but who still have delirium will have a less severe delirium.

This research project sought to assess the migration patterns and rotational stability of two modular cementless femoral stems (K2 and Apex, Global Orthopaedic technology) used routinely for hip replacement surgery.

This study is primarily designed to assess the safety of two different doses of allogeneic Mesenchymal Precursor Cells (MPCs) combined with Hyaluronan when injected into the knee joint following Anterior Cruciate Ligament reconstruction. Long term safety, tolerability and efficacy of a single injection of two different doses of allogeneic MPCs + Hyaluronan compared to Hyaluronan alone will be assessed at 6, 12 and 24 months following MPC injection. This study aims to provide prelimanary data to support dose selection for future studies.

Fat emulsions are an essential part of parenteral nutrition (PN) combining a high energy load with an essential fatty acid (EFA) intake.The primary purpose of this study is to test the safety and efficacy of new fish oil based intravenous fat emulsion (SMOFlipid) as compared to traditional olive oil based intravenous fat emulsion (Clinoleic). This study will specifically look at plasma and red cell fatty acid levels particularly Docosahexaenoic acid (DHA) which plays an important role in development and vision of newborn babies and also oxidative strss levels (F2-isoprostanes) before and after the intervention in a randomised controlled trial.

This is a before and after evaluation of the impact of group exercise and diet therapy for people with type 2 diabetes. Participants will be assessed at the start of eight one-hour sessions, after the final session, and again three months later. At each time point they will report their exercise and diet activity, and their health status. Their weight, waist circumference and knowledge will also be assessed

This study draws on the observation that there are genetic, clinical and neuropsychological similarities between Borderline Personality Disorder (BPD) and Attention-Deficit/Hyperactivity Disorder (ADHD). Since psychostimulants such as methylphenidate are the mainstay of treatment of ADHD, it is proposed that psychostimulants be trialed in a population of female adolescents with BPD, with the intention of enhancing our understanding of BPD and providing a novel treatment option for this difficult-to-treat condition. Hypothesis: That selected patients with BPD will respond positively to a trial of methylphenidate.