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Pain, particularly neuropathic pain, is a common and debilitating consequence of spinal cord injury. Despite the high prevalence and severity of pain, there are currently no available treatments that provide consistent or satisfactory relief. Transcranial direct current stimulation (tDCS) is a safe non-invasive brain stimulation technique that may be helpful in reducing pain following spinal cord injury. This study is aimed at evaluating the effectiveness of tDCS as a treatment for spinal cord injury neuropathic pain. Subjects will undergo 10 tDCS treatment sessions over a period of 5 weeks as well as magnetic resonance imaging (MRI) scans prior to and immediately following each treatment week, and at 10 weeks and 6 months after study commencement. The technique is not painful and no serious side effects have been reported. Our hypothesis is that tDCS will provide relief of neuropathic pain following spinal cord injury. If proven effective, tDCS may provide a much needed non-invasive alternative treatment for patients with persistent spinal cord injury neuropathic pain.

Bedwetting affects 10% school aged children and 2% adults. It impacts on sleep, concentration, learning and self esteem. First line treatment is with a bedwetting alarm. The Children’s Hospital at Westmead has designed a bedwetting alarm which is more effective, including in those who had previously failed alarm therapy. This alarm incorporates the latest technology with a new concept in treating bedwetting. The predicted success rate is 80-95% (compared with 65-75% for standard alarms).We aim to further refine the proof of concept alarm and compare it to standard alarms.

Cefepime is a broad spectrum antibiotic used as part of the Alfred Intensive Care Unit (ICU) antibiotic guidelines at a dose of 1g every 12 hours in combination with other agents, higher doses are used (eg 2g every 12 hours) in many international centres. Conventional administration is via short infusion over a few minutes. However the antibacterial effect is dependent on adequate drug concentrations being maintained over most of the period between doses. Extended infusions have been shown in computer modelling to achieve this for cefepime. Clinically, extended infusions have been shown in intensive care patients to be more effective for other antibiotics of similar class to cefepime. This study will be a randomised controlled trial in intensive care patients which aims to compare the pharmacokinetic profile (blood concentrations of the drug over time) of conventional administration of cefepime over a few minutes at the dose of 1g every 12 hours (the dose routinely used in The Alfred ICU) and the higher dose of 2g every 12 hours against an extended infusion of 1g given over 6 hours every 12 hours. Cefepime blood concentration will be obtained from analysis of blood samples taken at predetermined time points over two 12 hour periods on Day 1 and Day 3 (steady state) of therapy. This will allow determination of the pharmacokinetic profile of cefepime in intensive care patients for each of the three dosing regimens. Comparison of these profiles will provide evidence of any advantage of extended infusions in intensive care patients leading to larger scale clinical investigations of this administration method.

This study aims to determine the lens parameters in orthokeratology lenses that allow manipulation of peripheral refraction in adult myopes. Additionally, relationships between corneal topography and peripheral refraction changes induced by orthokeratology lenses will be investigated.

To assess bacterial contamination of regular lens cases when used in conjunction with investigational or marketed contact lenses on a daily wear schedule.

This proposed study is intended to investigate if the antifungal drug, caspofungin, when applied as an eye drop is able to penetrate into the human eyes. The use of caspofungin as an eye drops in human has never been reported. Caspofungin eye drops are anticipated to safely penetrate into the human eyes when applied as eye drops and to achieve adequate concentrations to treat fungal eye infections.

The aim of this study is to assess if a self-help manual for primary caregivers of family members with first episode psychosis is effective in improving the caregivers' general wellbeing and lowering their distress. The study involves two groups: an 'intervention' group who will study the manual, and a 'control' group who will not study the manual.

Redback spider bites are common in Australia and red back spider envenoming (latrodectism) is the commonest significant envenoming in Australia. Redback spider antivenom (RBS AV) is the most frequently used antivenom in Australia. An estimated 5000 redback spider bites are treated with antivenom each year requiring a median of 2 vials of redback spider antivenom and an emergency department or hospital admission. We estimate this costs between $200,000 and $500,000 annually for antivenom and an equivalent amount in hospital costs. Early adverse reactions occur in approximately 4% of cases (40 to 120 patients annually) causing additional risk to the patient and costs to the health care system. Redback antivenom treatment therefore carries a considerable cost and measureable risk. However, despite the wide use of RBS AV and the clinical impression that it is effective, it has never been tested in a placebo randomized controlled trial. The results from our recent randomised controlled trial of intravenous versus intramuscular administration of redback spider antivenom (RAVE I) raise questions about the effectiveness of the antivenom. It is therefore essential to determine whether RBS AV is effective and justifies the costs and risks associated with its use. We propose to determine the effectiveness of RBS AV in a multicentre randomised placebo-controlled trial.

Recent advances in diagnostic technologies and subsequent physiological research has lead to a number of techniques being widely available for use in the pre-school age group and resulted in the transition of these techniques into clinical practice. The use of these newer respiratory function techniques to assess airway function in pre-school children with recurrent wheeze may have major implications for our understanding of the pathophysiology of asthma.

SEISMIC is a population based incidence study of epilepsy to be conducted in the Sydney South West Area Health Service (Eastern Zone). It is a 3 year cohort study of people newly diagnosed with epilepsy and the associated psychosocial, educational and economic sequelae. Participants are enrolled over 24 months and they, or their carer/proxy/guardian, will be interviewed at three time points: 28 days (Baseline), 4 and 12 months following first diagnosis of epilepsy. The aim is to identify modifiable factor that enhance resilience and reduce vulnerability to the socioeconomic impact of epilepsy in an Australian population.