ANZCTR search results

Cerebral Palsy (CP) is a disorder affecting around 2 in 1000 live births. Commonly, children with CP have spasticity in their muscles causing stiffness. When Botox (Botulinum Toxin A) is injected into a spastic muscle, it helps it to relax for around 3 months, after which the effect begins to wear off. During this relaxed time, the muscle is able to exercise through a greater range, helping to prevent contractures from forming. Botox is therefore used to both reduce spasticity in the short term, and to slow or prevent the development of contractures in the long term. This in turn, assists to delay corrective orthopaedic surgery until the later childhood years when surgical outcomes are more predictable and longer lasting. Currently, the most important clinical question is how often Botox should be used. More regular injections may provide additional time that the effects of Botox are working, and muscle contractures could be delayed more effectively. The aim of this study is to compare over a two-year period, the effects of Botox injections once a year compared to 3 times a year (every four months). The main measure will be the rate of development of contractures over the two years. Measurements (such as calf strength, questionnaires and blood tests) will also be made to determine whether either program negatively affects the muscle, whether the children in either group have a different level of function or quality of life and whether either program leads to the Botox having a reduced effect over time.

This trial tests the hypothesis that molecular response can be maximised by a combined approach of higher dose imatinib for all de-novo CML patients plus a rapid switch to nilotinib in patients who are intolerant or have suboptimal response to imatinib.

MRSA is a significant problem for hospital patients, causing increased length of stay and risk of complications. It is spread mainly on the contaminated hands of healthcare workers. Control of MRSA within hospitals still remains controversial, with some insisting that swabbing of all patients and use of special isolation precautions is mandatory for prevention of its spread. We plan to test whether swabbing all patients admitted to the intensive care unit and then putting patients who are found to be positive in single rooms and using gloves and gowns for all contact with these patients is more effective at preventing spread of MRSA from patient to patient than what we currently do ie looking after patients in the general ward, wearing plastic aprons at all times and only using gowns and gloves if we are likely to come into contact with bodily fluids (and not swabbing any patients). We plan to use the most rapid tests available to determine whether someone is carrying MRSA on their body which will give us a result within hours compared with the 2-3 days it currently takes to get a result. We also plan to do an economic evaluation to see if the intervention is worth the extra cost.

The primary aim of this 18-month randomised, double-blind, placebo-controlled clinical trial is to establish whether vitamin D supplementation can delay progression of cognitive decline amongst older adults with Mild Cognitive Impairment (MCI) who have low vitamin D concentrations (between 12.5 and 50 nmol/L). The main hypothesis of this study is that older adults with MCI randomised to a 18-month treatment with vitamin D will experience significantly less cognitive decline (as measured with the CAMCOG) at the end of the 18-months follow-up than subjects with MCI randomised to placebo. Secondary outcomes of interest for this study include quality of life, gait, balance and muscle strength.

Main purpose of this study is to identify whether a single injection of Avastin, in addition to the current antiscarring treatment 5 FU, improves the outcome from trabeculectomy surgery.

The purpose of the study is to find out whether the addition of an attention re-training component to our best-practice treatment program can provide a significantly greater treatment effect, and enhance the maintenance of effects. This will inform the development of future programs to help people suffering from social phobia.

This study looks at the disclosure of information indicating a genetic risk of cancer. Who is it for? You can join this study if you attend a Victorian Familial Cancer Centre and you are the first person in your family to have a genetic (mutation) test for breast, ovarian or colorectal cancer and your test is positive (that is, you have a gene that predisposes you to cancer). Trial details Participants will be randomly divided into two groups. Participants in one group (the treatment group) will be encouraged to tell their relatives about the result of their genetic test, and a Risk Notification Letter will also be sent to their relatives from the Familial Cancer Centre. This process is called ‘active disclosure’. Participants in the other group (the control group) will be encouraged to tell their relatives the result of their genetic test, but a letter will not be sent from the Familial Cancer Centre. This process is called ‘passive disclosure’. The number of relatives from both groups who contact the Familial Cancer Centre during the next year will be recorded. The number of relatives who have genetic tests and the acceptability of the process to participants and their relatives will also be measured. The aim of the study is to test whether active disclosure may be a more effective and acceptable way of providing information to people who may have a genetic predisposition to cancer.

Macular oedema, or swelling around the macula, results in decreased vision. It is termed "refractory" when it does not adequately respond to the usual treatment methods. It can occur with conditions like diabetic retinopathy or uveitis. Without effective treatment, vision loss can progress and become permanent. Early studies have suggested that a new treatment called Avastin (Bevacizumab) may be effective in treating this type of macular oedema, however further research is required to confirm this. Choroidal neovascularisation (CNV) is a condition where abnormal blood vessels grow in the back of the eye and causes blurred or distorted vision. Without treatment, vision loss may be quick and severe. There are many causes of CNV, the most common being Age Related Macular Degeneration. Uveitis can also cause this condition. As Avastin (Bevacizumab) has been found to be useful in the treatment of CNV due to AMD, it is expected that it will be useful in cases of CNV from uveitis. The purpose of this project is to assess whether Avastin (Bevacizumab) is both safe and effective in the treatment of the above conditions, namely: 1. Macular oedema due to diabetic retinopathy 2. Macular oedema due to uveitis 3. Choroidal neovascularisation due to uveitis

This RCT is designed to test weather the CLIMATE Schools Alcohol and Cannabis program is more successful in preventing Alcohol and cannabis use and related harms, compared to the current programs

Intubation is the insertion of an endotracheal tube into the trachea of an anaesthetized patient for airway management during surgery. Intubation is traditionally achieved by inserting a laryngoscope into the anaesthetized patient’s mouth, moving the tongue out of the way and inserting the endotracheal tube through the vocal cords if they can be seen. In the last decade there has been growing interest in a new type of intubating device called optical stylet. Optical stylets incorporate fiberoptic imaging elements in an intubation stylet design. Their appearance is of a thin semi-rigid telescope which an endotracheal tube is threaded over. While any patient may be intubated using a stylet, they have been particularly reccomended for difficult intubations, which occur with an incidence of between 1:300 and 1:3000 (rising with conditions such as obesity and sleep apnoea). The proposed study compares the ease of use and intubation success of the 2 optical stylets, the Bonfils (Storz, Germany) and the Levitan (Clarus, USA) (pictures) amongst specialist anaesthetists whose only experience with them was basic training with the device on airway mannikins. Both devices will be used according to their approved application for device entry at the Therapeutic Goods Administration.