ANZCTR search results

Clinical experience has shown continued use of antiviral medication to treat hepatitis B can lead to changes or ‘mutations’ in the hepatitis B virus (or HBV). The virus, once it has ‘mutated’, might then be resistant to the particular medication previously taken, and a new hepatitis B medication is needed to mange the infection. If the infection is not managed with effective medication liver damage can occur. Early detection of hepatitis B mutations can enable doctors to manage hepatitis B treatment before further liver damage can occur. The purpose of this project is to describe the mutations in the hepatitis B virus in Australian patients with hepatitis B. Further, it aims to investigate the relationships between demographic and clinical factors to the appearance of these viral mutations.

The specific aims are to compare Gen II and Journey TKA regarding : •Patient satisfaction and functional outcome •The degree of postoperative knee flexion. •3D kinematics of the knee joints •Gait pattern •The rate of complications and difficulties •The migration pattern of the tibia trays

Chronic neck pain sufferers have been found to often suffer from trigger points in neck musculature. Trigger points are bands of hyper-irritable spots in taut muscle, which can cause tenderness, a jump sign, and radiculations of pain. Chronic pain, that greater than 3 months duration, is understood to have significant psychosocial overlay. Very few primary health care therapists have the means to treat this psychosocial overlay and hence reduce associated physical symptoms. Neuro Emotional Technique is a well-established chiropractic intervention which attempts to treat this psychosocial overlay. This study took chronic neck pain sufferers, and measured their presentations of pain on a visual analog scale, and also via a quantified pressure applied to the trigger points with a pressure gauge algometer. The treatment group then received one NET treatment, whilst the control received a SHAM treatment. They both presented 3 days later to see if their symptoms had changed in severity. The primary purpose was to see if NET consultation had a short term effect of the severity of trigger points in neck musculature. The null hypothesis was that NET would not cause a reduction in pain sensitivity in trigger points as measured by pressure algometry.

Angina is a medical term used to describe pain (usually felt in the chest) due to coronary artery disease causing reduced blood flow to the heart. We are investigating the use of G-CSF to treat chronic angina in patients who have failed standard treatment with medications and or coronary stenting/coronary artery bypass surgery. G-CSF is a man made version of a naturally occuring hormone. There is experimental evidence that G-CSF can stimulate the formation of new blood vessels in the heart and protect heart muscle cells. Through these effects, we hypothesise that patients will derive improvements in blood flow to the heart and hence angina symptoms. We will be measuring the effects of G-CSF on blood flow to the heart with cardiac magnetic resonance imaging (MRI scan).

The aim of the study is the in vivo investigation of the plasma concentration and the renal excretion rates following Naltrexone implantation. This will allow us to determine the pharmacokinetic properties of the implants. In other words, the study assesses how quickly naltrexone is released following an implant and how quickly it is processed by the body. Blood and urine samples will be collected frequently over the 1st 72 hour and then at extended intervals to 6 months.

To determine if the addition of either topical clindamycin or a topical probiotic/oestrogen combination, reduces recurrent rates of bacterial vaginosis (BV), when added to the current recommended therapy of seven days of the oral antibiotic metronidazole. Hypotheses 1. Combination antibiotic therapy of oral metronidazole with vaginal clindamycin will be more effective than oral metronidazole alone in the treatment of bacterial vaginosis. 2. Restoring normal vaginal acidity and healthy bacteria through replacement of Lactobacillus bacteria and topical oestrogen (in addition to oral metronidazole), will achieve higher rates of cure than current recommended therapy oral metronidazole alone.

In patients with cystic fibrosis (CF), recurring infection causes inflammation and airway damage. This study focuses on the major bacterial problem, Pseudomonas aeruginosa. Several studies from Australia and the UK including our own have shown that about 30-45% of patients share the same strain of P. aeruginosa within a Centre. We know that two dominant strains of P. aeruginosa are found in CF Centres on the eastern board of Australia. The emergence of these clonal strains is causing increasing anxiety in the CF community. A cross sectional study will be initially conducted among patients who attend 19 CF centres in Australia. These patients will be able to spontaneously produce sputum and are chronically infected with P. aeruginosa (approximately 1500 patients). Sputum samples will be screened for the presence of related (clonal) P. aeruginosa strains. The aim of this cross sectional study is to establish the prevalence and extent of current spread of these strains amongst adult and paediatric CF centres in Australia. Following the prevalence study, a second longitudinal (observational) study will be performed on any patients who are identified as free of infection from clonal strains. In this study each patient’s clinical course and clonal P.aeruginosa status will be monitored over a period of 4 years. The aims of this study are: i) to determine the incidence of infection with clonal strains and any associated epidemiological risk factors for their acquisition; and ii) to determine if infection with a clonal strain is associated with an adverse clinical course and whether clinical or microbiological features predispose to or potentiate this effect. This study is designed to provide vitally needed information on the clinical implications of being infected by a clonal strain of P. aeruginosa and the risk factors for the acquisition of a clonal strain. This new information will provide a rational basis for the need for changes to infection control policies and better outcome predictors for patients infected with clonal strains of P. aeruginosa.

Stem cell transplantation has the potential to cure many patients with blood cancers. These cures occur when immune cells from the donor attack blood cancer cells left in the patient. This is called the graft versus leukaemia (GVL) effect. These immune cells also cause a reaction against the patient called graft versus host disease (GVHD), which can be serious and life threatening. Thus, one of the major goals of transplantation today is is to reduce GVHD and increase GVL. The drugs cyclosporine and prednisone are used to reduce graft versus host disease in over 90% of transplants performed in Australia and New Zealand. The aim of this study is to reduce the dose of cyclosporine which may increase the GVL effect and add a higher dose of prednisone which may inhibit GVHD – this is the intervention. This new combination of these two drugs will be compared to the standard dose of cyclosporine which has been used for many years – this will be the control group. Patients will be followed for 2 years to assess whether this change in drugs will result in more patients being cured of their blood cancers.

We aim to demonstrate no difference (equivalence) in performance of the LMA® Classic™ compared to the Meditech Systems Limited (MSL) and ProAct (PA) silicone disposable laryngeal masks. The Laryngeal Mask Airway ClassicTM (LMAC) manufactured by The Laryngeal Mask Company Ltd in the United Kingdom is the current ‘gold standard’ for silicone LMAs when inserted for airway management during general anaesthesia. The laryngeal mask airway is a reusable supraglottic airway device that has been available since 1998 and is widely used during elective general anaesthesia where endotracheal intubation is not thought necessary. Newer single-use disposable supraglottic airway devices are now available, which potentially reduce the risk of infection transfer. The laryngeal mask is the most commonly used supraglottic device; its silicone construction ensures that it is easy to insert and minimises airway trauma. The Therapeutics Goods Administration in Australia has recently assessed a number of silicone disposable LMAs, and they are now available for use in Australia. The LMAC is easy to insert, creates an effective airway seal but provides only limited protection against aspiration. The LMAC is predominantly silicone construction with a PVC cuff. The major differences between the LMAC and the disposable devices are that the MSL and PA LMA have no aperture bars on the inferior surface of the laryngeal cuff.

It is proposed to evaluate a selenised dairy product with regard to its safety and influence on selenium status, using plasma and rectal biomarkers. It will be compared for its efficacy & bioavailability with a selenium yeast product.