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Double Blind Randomised Crossover Trial of Temazepam in Mild to Moderate Obstructive Sleep Apnea
The efficacy of Temazepam on sleep disordered breathing in untreated patients with mild to moderate OSA as measured by the Apnea Hypopnea Index (AHI) via standard overnight polysomnography (PSG). The effect of temazepam on OSA will be correlated with awake HVR and HCVR. The hypothesis is that Temazepam reduction of OSA will be correlated with the baseline HVR and HCVR.
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Is triage an effective way of initiating early intervention for patients with a chronic musuloskeletal condition on a hospital waiting list?
This study aims to determine if early intervention for chronic pain problems, provided in the form of physiotherapy triage, improves patient outcomes while they wait for their physiotherapy treatment. Triage involves a brief assessment, with advice about pain management, basic exercises and resource information.
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A placebo controlled multiple dose study of flupirtine in the treatment of painful Human Immunodeficiency Virus (HIV) -associated neuropathy.
HIV associated painful sensory neuropathy (HIV-SN) is a common and disabling neurological complication of HIV infection, that may result from damage to sensory nerves from either HIV disease itself and/or as a side effect some of the medications used to treat the HIV infection. The damaged sensory nerves develop increased activity and transmit excessive pain signals, even when no pain stimuli are present. Pain in the feet is the most frequent symptom, as well as burning and painful soles and/or numbness usually occurring bilaterally in the extremities. There has been considerable research into the treatment of painful HIV-SN, but current therapies typically afford inadequate relief of symptoms and may have unpleasant side effects. Flupirtine is an orally available, centrally acting non-opioid analgesic that has been used in Germany for the treatment of acute pain, back pain and muscle stiffness since 1984. The purpose of this study is to investigate if the pain relieving drug flupirtine is a safe and effective treatment for painful HIV-SN when used together with opioid medication.
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The analgesic efficacy of ultrasound guided transversus abdominis plane (TAP) block after laparascopic appendicectomy in children: a prospective randomised trial
Safe and effective regional anaesthesia requires local anaesthetics to be placed in close proximity to nerves without injury to the target nerves or adjacent structures. A promising approach to the provision of postoperative analgesia after abdominal surgery is to block the sensory nerve supply to the anterior abdominal wall. Ultrasound guidance allows accurate identification of target tissue planes whilst avoiding adjacent structures. Ultrasound guidance also allows spread of local anaesthetic to be monitored in real time during the injection. We therefore anticipate improved safety and efficacy when utilising ultrasound guided TAP block when compared to standard care. Standard care for laparascopic appendicectomy involves general anaesthesia and endotracheal intubation, intravenous opiate and local anaesthetic infiltration of laparascopic port sites by the surgeon. In this study we will add to standard care bilateral ultrasound guided TAP block.
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Medication self-management in consumers with diabetes and kidney disease from culturally and linguistically diverse backgrounds
This project aims to assist culturally and linguistically diverse consumers safely manage their complex medication regimens for the co-existing comorbidities of cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD). Taking medicines as prescribed is critical for well-managed chronic diseases. Approximately 40% of Victorians with CVD, diabetes and CKD speak a language other than English at home, most commonly Greek, Italian, and Vietnamese, which increases the likelihood of medicine-related problems. A language-specific medication intervention to enhance medication self-efficacy will be developed and tested. Better medicine self-efficacy results in improved general wellbeing, medication safety and reduced healthcare costs. Null hypothesis: 1. Compared to patients receiving standard care, patients who receive the intervention will show no change in medication self-efficacy
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Improving outcome after stroke
AIMS: The primary aim of this project is to determine if a simple intervention (a personalised postcard, sent monthly) improves psychosocial outcomes in patients with a recent stroke. The secondary aim is to determine appropriate outcome measures and potential mechanisms of action for a large, multi-centre, randomized controlled trial in patients surviving stroke. RESEARCH PLAN: This is a single-centre (Gosford Hospital Stroke Service), randomized, double-blind pilot/proof of concept trial of a simple intervention to improve psychosocial outcomes in patients with a recent (within 8 weeks) stroke.
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Evaluation of dye spraying with magnification colonoscopy for detecting colorectal polyp.
The aim was to study whether indigo carmine dye spray colonoscopy increases a detection rate of colorectal polyp including flat adenoma in an Australian population.
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Do dynamic splints reduce wrist stiffness following fracture?
The primary purpose of the study is to determine the effectiveness of dynamic splints applied for two months on wrist stiffness and patient restrictions following wrist fractures.
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Effects of Peri-procedural Iron Chelation on Myocardial Infarct Size and Oxidative Stress in ST-elevation Myocardial Infarction
The aim of the project is to test whether giving a medication called desferrioxamine (commonly used in patients with iron-overload conditions such as beta-thalassaemia) in the setting of a heart attack can reduce the amount of heart muscle injury. We hypothesise that that this medication may therefore improve the outlook for people following heart attacks. This medication has been used safely in adults and children with beta thalassaemia at even higher doses. This drug has been shown in experimental, animal and a few human studies to reduce the “oxidative stress” (that is, acts as an “antioxidant”) of tissues which have had their blood supply compromised (as in the case of a heart attack). Some of the animal studies have also shown that it reduces the size of heart attacks.
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A randomised, controlled comparison of uridine, pravastatin or uridine plus pravastatin to accelerate recovery of lipoatrophy in Human immunodeficiency virus (HIV)-infected adults
Prospective, randomised, 28-week trial in 40 patients. The first step: forty (40) eligible, consented participants will switch from existing PI or NNRTI and commence ritonavir-boosted lopinavir at week 0 (2 tablets twice-daily). The second step: patients on lopinavir/r will be randomised to initiate study therapy at week 4 (4 weeks after initiation of lopinavir/r) for 24 weeks. Eligible subjects will be randomised equally (10 patients per group) to: 1. uridine (36g tid for 10 days per month) 2. pravastatin (40 mg nocte) 3. uridine (36g tid for 10 days per month) + pravastatin (40 mg nocte) 4. delayed treatment arm (DTA) All patients will be offered the combination of pravastatin and uridine for 24 weeks from week 28.