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Upper Abdominal Surgery (UAS) is a common surgical procedure, with average hospitalisation of 11.4 days. Breathing problems are a major contributor to longer periods of hospitalisation following UAS, and account for nearly 25% of deaths within 6 days of surgery. The incidence of such breathing problems following UAS is as high as 53%. There is a need for evidence-based approaches to reduce these rates, with potential benefits including reduced hospitalisation and healthcare costs, improved quality of care, and improved patient outcomes and quality of life. Research suggests that postoperative physiotherapy should be targeted towards high-risk patients, and is effective in reducing the incidence of breathing complications compared to no postoperative physiotherapy. However, potential benefits of additional preoperative physiotherapy for patients undergoing elective UAS have not been established. A randomised trial will be undertaken comparing current practice (postoperative physiotherapy only) to a program incorporating a preoperative physiotherapy session combined with postoperative physiotherapy. It is proposed that a single, preoperative physiotherapy session in the Pre Admission Clinic (PAC) setting would improve the quality of physiotherapy care for these patients. The aims of this preoperative session would be to: (a) Reduce the incidence of breathing problems; (b) Reduce patient anxiety during the first postoperative physiotherapy session; (c) Decrease the physiotherapist’s overall patient contact time, thus improving efficiency of the physiotherapy service. The study will investigate 4 questions: (a) Does preoperative physiotherapy reduce the incidence of breathing problems compared with standard management? (b) Does the timing of physiotherapy intervention (preoperative and postoperative vs. postoperative only) affect patient anxiety during the first postoperative physiotherapy session? (c) Does preoperative physiotherapy reduce overall physiotherapy contact time compared with standard management? (d) Should preoperative physiotherapy only be provided to patients at high risk of postoperative breathing problems?

BRIEF SUMMARY: Laparoscopy and hysteroscopy is a common day case gynaecological procedure. This operation involves keyhole surgery, inserting a small telescope-like device or fibreoptic lens into the abdomen via a 10mm port. This enables direct visualisation of inside the abdomen. There is also one other cut on the abdomen of 5mm, where a thin metal probe is inserted. Finally, a second fibreoptic device, is inserted inside the womb via the vagina and cervix, and the inside of the womb is visualised. A scraping of the womb tissue is taken and sent to the pathology laboratory to be analysed under a microscope. Patients usually go home the same day, unless there have been complications. Pain relief for this procedure has not been studied in any recent large trials. Current pain management involves use of pain relief tablets after the operation, and intravenous analgesics during the operation, including ropivacaine, depending on the anaesthetist. We aim to evaluate the use of intraperitoneal Ropivacaine. This is a local anaesthetic medication that can be squirted inside the abdomen at the areas that have been manipulated including the womb and fallopian tubes and injected at port sites, which are the two small incisions on the abdomen. HYPOTHESIS: We hypothesise that the use of ropivacaine at the end of the procedure will reduce post operative pain and hasten recovery after a diagnostic laparoscopy and hysteroscopy.

The aim of this study is to determine how clonidine affects the absorption of levobupivacaine in children having caudal anaesthesia for sub-umbilical surgery. Our study hypothesis is that the absorption of levobupivacaine will be affected when administered in conjunction with clonidine via the caudal route.

The aim of the study is to demonstrate a protective role of omega 3 fatty acids during time of intense psychological stress (exam stress in university students) compared with a placebo.

As our lives get busier, it is increasingly common for people to work longer hours and get less sleep during the week. People often rely on weekends to catch-up on the sleep they have missed during the week. There has been some evidence that restricting the amount of sleep we have may predispose to developing glucose resistance and subsequent diabetes. We will also test how sleep deprivation impacts on daytime concentration and brain and memory function. This study will involve 3 study visits, with 2 being conducted over 2 weekends, at least 3 weeks apart.

The primary purpose of this study is to determine whether the perception of pain is affected by the way women are questioned after their caesarean birth

Purpose and Background of this research During your last appointment in Dr Maher’s clinic you have decided to undergo an operation to correct genital prolapse with or without stress incontinence. We currently conduct the above study to compare two different approaches of prolapse repairs, the laparoscopic = “key-hole surgery” and the vaginal route. Both routes have been shown to be safe and efficient with similar success rates but they have never been compared in a randomised controlled trial. Success, complications and risks of the operations are individually different depending on previous operations for example. These issues will be discussed with you prior to the operation. You are invited to participate in this research project because we think that your prolapse can be repaired by both routes the key-hole surgery or the vaginal repair. The results of this repair will help future patients and doctors to decide on the best management of prolapse. 3. Procedures If you decide to take part in this study, the computer will allocate you by chance to undergo key-hole or vaginal surgery. There will be no extra tests than those required for any of the surgery. We will ask you to complete three different questionnaires regarding your symptoms and effect on your quality of life before and six months after the surgery. After surgery, we will review the outcome at a routine six-weeks, six-months and one-year appointment or more often as required. 4. Possible benefits Participation in the study is voluntary. There are no direct benefits for you from participating. Future patients with similar problems might benefit from the study results when deciding on the most appropriate route of prolapse and stress incontinence repair. You will not be paid for your participation in this project. 5. Possible risks Your decision to take part or not does not in any way affect your future treatment. Participating in this study does not involve any additional risk than the surgery you had already decided to undergo for the treatment of your problems. The benefits, risks and complications of the different procedures are explained in specific surgical information sheets that will be provided to you before you decide to take part in this project. All procedures, risks and complications will be discussed with you prior to the surgery. 6. Alternative to participation The alternative to surgery is conservative management of your prolapse with or without stress incontinence which we will have offered to you before considering surgery. If you do not feel comfortable with one or another part of the surgery, you may withdraw from the study at any time before the surgery starts without any explanation. 7. Privacy and Confidentiality Your confidentiality is ensured by using your hospital number only. The results of this study will be published in a way that prevents any identification. The research data will be kept in a safe way for at least seven years. Only the above named researchers and a research nurse will have access to the collected data. Any information obtained in connection with this project and that can identify you will remain confidential. It will only be disclosed with your permission, except as required by law. In any publication, information will be provided in such a way that you cannot be identified.

A potential treatment for some blood cancer types is high dose therapy with stem cell transplantation. Stem cells are normally found in the bone marrow. Stem cells are collected from your bone marrow by ‘mobilising’ them into the blood stream. An apheresis machine removes blood from a vein in your arm or chest, collects off the stem cells and then returns the rest of your blood back to your vein. The collected stem cells are frozen and stored for later use. At the time of transplantation, a high dose of chemotherapy with or without radiotherapy would be given, and your frozen stem cells thawed and injected into your body (similar to a blood transfusion). These stem cells can help your bone marrow recover from the high dose therapy. Stem cells are usually mobilised from the bone marrow into the bloodstream using daily or twice-daily injections of a drug called Granulocyte-Colony Stimulating Factor (G-CSF), or filgrastim (Neupogen). This usually requires 6-10 days of injections. This project aims to test the combination of Mozobil® (a new agent for stem cell collection) with Neulasta® (a single dose, long-acting version of filgrastim) in the hope that it will produce better yields of stem cells in a shorter time with fewer injections.

The purpose of the study is to compare the outcomes of the surgical treatment for pelvic organ prolapse using two different mesh grafts, namely the anterior Prolift(TM) and the Perigee(TM) systems. Women with genital prolapse who underwent surgery using one of these mesh systems were recruited in the study and the anatomical outcomes as well as subjective success, patients' satisfaction and complication rates were prospectively evaluated.

This study aimed to evaluated the efficacy and safety of anterior vaginal mesh repair, sacrospinous hysteropexy and posterior fascial plication in the management of anterior compartment dominated uterovaginal prolapse. Patient’s demographics, medical and obstetric history, previous surgeries, pre-operative POP-Q and peri-operative information were collected. Post-operative patient evaluation occurred at six weeks and six-monthly thereafter and included pelvic examination (POP-Q), patients’ satisfaction and 2 additional questions: ‘would you have chosen again to undergo this surgery?’ and ‘would you recommend this surgery to a friend with a similar condition?’ The primary outcome measure of this study was the objective success rate, defined as less than stage 2 prolapse at all compartments. Secondary outcome measures included subjective success rate (defined as no prolapse sensation), patients’ satisfaction, functional (bladder, bowel and sexual) outcomes and complication rates.