ANZCTR search results

The OVERALL AIM of this project is to build on our recent demonstration that the reduction in airway inflammation following introduction of systemic corticosteroids (CS) during acute exacerbations of COPD (AECOPD) is rapid and significant at 48 hours. We will now compare two CS treatment regimens: short course (72 hours only) of high dose versus more conventional, moderate dose therapy over 14 days in terms of efficacy and adverse events (AE). At the same time, we will continue our work to delineate the aetiological factors and inflammatory processes underlying AECOPD. This project will test the following hypotheses: 1 Systemic CS are effective during AECOPD because of a rapid reduction in neutrophil chemotactic cytokines and down-regulation of neutrophil-related vascular adhesion molecules; this occurs over the first 2-3 days of therapy. 2. Thus, short-course, high-dose CS therapy is as efficacious in the treatment of AECOPD as a more conventional 14-day course of moderate dose CS, but with significantly less risk of AE and without rebound of inflammation after cessation. Hospital length of stay can be reduced. 3.Exacerbations over the subsequent one month (treatment failure) are no more frequent with short versus conventional course CS therapy. 4. Viral and bacterial organisms isolated from sputum during an AECOPD are associated with a greater inflammatory response within the airway than non-infective exacerbations, but both are responsive to CS therapy. Specific aims are: 1.To build on our preliminary findings of a rapid reduction in sputum neutrophilia and improvement in symptoms by systemic CS during AECOPD and to examine whether this relates to inhibition of neutrophil-related chemotactic factors and vascular adhesion molecules. 2.To compare short-course (3 day), high dose CS treatment and more conventional 14-day moderate dose CS therapy with focus on clinical outcomes, reductions in airway inflammation, rebound exacerbation and adverse events. 3.To identify bacterial and viral organisms as well as determine bacterial load at admission and to then relate these to airway inflammation, response to treatment and rate of rebound.

In this study the antibody response (immunity) to pertussis vaccination will be compared in 3 groups, those who have routine pertussis vaccination commmencing at 2 months old with those who have received pertussis vaccines at birth and 1 month old or only birth.

In adults with severe diffuse traumatic brain injury and refractory intracranial hypertension, early bifrontotemporoparietal decompressive craniectomy decreased intracranial pressure and the length of stay in the ICU but was associated with more unfavorable outcomes.

The study was completed about 7 years ago but due to a lack of funding and two investigators not being on site it has not been analysed. The study now has been analysed and will be presented in November 2016.

We investigated the effect of a programme to increase self-management behaviours delivered by community health nurses, compared to usual care, on health-related quality of life and healthcare utilisation in people with COPD following hospitalisation. Participants were recruited during an admission to hospital and allocated according to domicile. The mentor role was to collaboratively develop self-management strategies over the 12-month study duration. Outcomes included quality of life and healthcare utilisation. Linear mixed models analyses found a significant benefit in the Physical Functioning and General Health components of the SF-36 questionnaire for the mentored arm, the average difference between interventions being 5.60 and 4.14 respectively over 12 months. Survival analysis using a combined end-point of time to next acute exacerbation requiring rehospitalisation or death found a significant benefit favouring the mentored group (p = 0.037).