ANZCTR search results

The study compares the psychosocial outcomes of different management strategies for women with minor atypia (incl 'HPV effect') detected on Pap smears: conventional management (a repeat Pap smear at 6 months) versus Human Papillomavirus (HPV) DNA testing, a new method proposed for the management of minor atypia and the informed choice of either management supported by a decision aid. The study examines women's informed preferences for each of these options and compares the psychosocial outcomes in women who are not given the choice of management.

Acute whiplash is a heterogeneous disorder that becomes persistent in 40-60% of cases. Estimates of recovery have not changed in recent decades. This randomized, single blind, controlled trial tested whether multidisciplinary individualized treatments for patients with acute whiplash (<4 weeks post-injury) could reduce the incidence of chronicity at 6-months by 50% compared to usual care. Participants (n=101) were recruited from accident and emergency centres and the community. It was hypothesized that better recovery rates were achievable if the heterogeneity was recognised and patients received individualised interventions. Patients randomized to pragmatic intervention (n=49) could receive pharmaceutical management (ranging from simple to opioid analgesia), multimodal physiotherapy and psychology for post-traumatic stress based on their presentations. The treatment period was 10-weeks with follow-up at 11-weeks, 6 and 12-months. The primary outcome was neck pain and disability (Neck Disability Index (NDI)). Analysis revealed no significant differences in frequency of recovery (NDI=8%) between the pragmatic and usual care groups at 6 and 12 month follow-up (LR chi-sq=1.94, p=0.16 and LR chi-sq=1.09, p=0.30 respectively). There was no improvement in current non-recovery rates at 6 months (63.6% - pragmatic care; 48.8% - usual care), indicating no advantage of the early multi-professional intervention. Baseline levels of pain and disability had a significant bearing on recovery both at 6 and 12 months in both groups, suggesting that future research focus on finding early effective pain management particularly for the sub-group of patients with initial high levels of pain and disability towards improving recovery rates.

Overweight people are at risk of developing heart disease due to their predisposition of also having high blood pressure, high blood fats and high blood sugar levels. This project examines the role of certain fatty acid metabolites called cytochrome P450 metabolites of arachidonic acid (CYP-450AA) in conditions associated with being overweight. These fatty acid metabolites act on blood vessels causing them to constrict or dilate. In doing this they affect blood pressure regulation. Being overweight or obese makes people vulnerable to developing diabetes and cardiovascular disease. This study will examine CYP-450AA in overweight men and women before and after weight reduction compared with overweight volunteers who maintain their weight over the same time period. This will enable us to see if the levels of fatty acid metabolites that constrict blood vessels are altered and related to a fall in blood pressure after weight reduction. This project will help scientists decide how important these metabolites are for blood pressure regulation in overweight people.