ANZCTR search results

The degree of movement in the Cervical and Thoracic Spines contribute to the effectiveness of breathing. In cases of respiratory disease, the degree to which this movement may limit breathing potential is well understood. However, strategies that address correcting such limitations are not as well documented. Furthermore, the inclusion of such strategies within respiratory rehabilitation programs is yet to be investigated. This study aims to test the effectiveness of Spinal Manipulation as a co-management strategy for use within a respiratory rehabilitation setting. The overall aim is to test a new respiratory rehabilitation program that includes Spinal Manipulation as a standard component in the management of certain chronic respiratory conditions.

Younger subjects with type 1 diabetes are being encouraged to undertake exercise, with no limitation on type/intensity of exercise (providing that there are no complications of diabetes present, e.g. cardiovascular disease), however, there is very little scientific information on the response of those with type 1 diabetes to intense exercise, and almost no studies on the response of these patients to high intensity exercise training. This study aimed to compare the metabolic (e.g. blood and muscle lactate, blood glucose) and ionic responses (e.g. muscle sodium potassium adenosine triphosphatase, blood potassium, blood acidosis) during high intensity exercise, as reflected in samples of blood, muscle, and expired gas analysis, in younger people with and without type 1 diabetes; and secondly to evaluate the responses of both groups to high intensity exercise training. We hypothesised that acute exercise responses would be similar in the subjects with and without type 1 diabetes; and that high intensity exercise training would improve metabolic and ionic responses during high intensity exercise in subjects with type 1 diabetes; and would not result in deterioration of overall metabolic control (reflected by glycosylated haemoglobin).

Early enteral feeding is recognised as an important contributor to patient outcome in critically ill patients. This goal can be hard to achieve as patient often have difficulty tolerating nasogastric feeds. This is due to the tendency for seriously ill patients to develop a gastric ileus. One option is to begin intravenous feeding. However, parentral feeding is expensive and associated with a number of complications including sepsis. The insertion of post-pyloric tubes has been advocated for a number of years to overcome the problems with gastric feeding. Unfortunately, these tubes are difficult to place blindly, often requiring the assistance of gastroenterologists or radiologists. This often leads to delays instituting feeds, negating the benefits of early feeding. A number of centres have described protocols for placing small bowel tubes but with limited success. Recently, a simple technique with a relatively high success rate was described by a group of researchers. Our ICU has adopted their protocol and over the past few months have noted a success rate of nearly 100%. The implications are that by using this method, we are able to entrally feed virtually all our patients from day one. The aim of our study is to compare gastric and post-pyloric feeding in ventilated, critically ill patients. Our primary end-points include: time to insertion of feeding tube, time to reaching goal feeds and total nutrition received over ICU stay as proportion of calculated ideal. As part of the analysis we intend to compare complication rates between groups.

To compare changes in blood sugar levels (glycemic index) after consumption of bread made with the new wheat flour with the response obtained following consumption of bread manufactured from conventional wheat flour.

All hospitals in NSW are working towards becoming “Smoke Free Environments”. Patients are no longer be able to smoke in hospital. The study aims to analyse: - The effectiveness of opportunistic intervention in smokers about to undergo surgery; Perioperative effects (physiological and physical) of short notice cessation of smoking up to six weeks prior to surgery.

This study tests whether Temgesic improves the effectiveness of exposure therapy for decreasing social anxiety symptoms. We predict that individuals from the community diagnosed with social phobia who receive four exposure therapy sessions in combination with Temgesic will experience a greater reduction in social anxiety symptoms in comparison to individuals who received the placebo in combination with four exposure therapy sessions. Participants receive, in total, five weekly group therapy sessions, the first is educational and the next four consist of public speaking exposure therapy. One month post intervention participants are assessed for social anxiety symptoms as well as other general health indicators. All subjects, therapists, assessors, and data entry staff are blind to condition.

This study tests whether oxytocin facilitates the processing of human faces by enhancing memory and attractiveness towards exposed faces. Participants are assigned to Oxytocin or Placebo and then given a presentation of facial expressions. Participants must rate the attractiveness of each face. The next day, participants return to be assessed for their memory of faces and their attractiveness toward each face. THe hypothesis is that participants who were exposed to facial expressions with oxytocin will demonstrate better memory and greater attractiveness rating for these faces the next day than participants assigned to placebo. All participants, assessors, and research staff handling data are blind to condition.

This study looks at the effects of the drug capecitabine with or without bevacizumab in the treatment of patients with stage III colorectal cancer. You can join this study if you have cancer of the back passage (rectum) or large bowel (colon). Trial details: Participants will be divided into two groups. One group will receive oral capecitabine (from day 1 to day 14, rest for 7 days then repeat every 3 weekly for a total of 8 cycles), plus intravenous(IV) bevacizumab (one dose on day 1, repeated every 3 weekly for 16 cycles). The other group will receive capecitabine alone (from day 1 to day 14, rest for 7 days then repeat every 3 weekly for a total of 8 cycles), which is standard treatment. New preventative chemotherapies have been developed to reduce the risk of relapse of colorectal cancer. QUASAR2 uses a new combination of an oral chemotherapy drug (capecitabine) and a molecularly targeted therapy (bevacizumab), to determine whether this is more effective and less toxic than capecitabine alone. Colorectal cancer is the most commonly occurring cancer in Australia (excluding non-melanomic skin cancer), and the second most common cancer-related cause of death, responsible for 4,447 deaths in 2003 (1) As many as 40% of patients who undergo potentially curative treatment will ultimately relapse and die of metastatic disease. This observation has led to the development of adjuvant chemotherapies which reduce the risk of relapse. QUASAR2 uses a new combination for adjuvant therapy: an oral chemotherapy drug (capecitabine) and a molecularly targeted therapy (bevacizumab), to define whether this is superior in efficacy and less in toxicity than capecitabine alone, which is a standard of care in this disease.

To test whether six months' oral treatment with unregistered drug MKTVIF75HV improves magnetic resonance imaging brain scans in people with relapsing remitting multiple sclerosis.

Aims: Certain patients have a narrowing in the blood vessel that supplies blood to the brain. If this blood vessel gets blocked these patients can suffer a stroke because there is no blood flow to that part of the brain. One method of keeping this blood vessel open is a procedure where a special line is inserted into the blood vessel and a balloon is inflated. Inflating the balloon will cause the blood vessel to get bigger. To make sure that the blood vessel stays open a device called a stent (like a rigid internal pipe) is placed as well. This procedure is called carotid angioplasty and stenting. However, making the blood vessel bigger in this way can activate a nerve which can act on the heart, which can cause the heart rate and blood pressure to change significantly. Glycopyrrolate is a drug which is commonly used to increase a patient’s heart rate. In this study, glycopyrrolate, is given before the balloon is inflated to try to prevent the changes in heart rate and blood pressure. The aims of the study are to see if giving glycopyrrolate can prevent the changes in heart rate and blood pressure as well as improving the outcome of the patient after the procedure. Methodology: Information will be collected on the patient’s medical problems before the procedure. Patients will then be randomised to receive either an injection of glycopyrrolate or water before balloon inflation. Complications during the procedure will be noted such as changes in heart rate, blood pressure and electrocardiograph changes. If the patient does develop changes in heart rate or blood pressure, rescue medications will be available. After the procedure, cardiovascular and neurological complications will be noted. Blinding: Double blind: Non-participating anaesthetist will open a sealed opaque envelope and draw up either glycopyrrolate or water (to an equal volume) and give it to the participating anaesthetist to administer. Neither the patient or the participating anaesthetist will know if the drug is glycopyrrolate or placebo.