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This project is part of a research program funded by the NHMRC (No. 630560) to develop and evaluate Internet based transdiagnostic education and treatment programs for people with anxiety and depression. This project examines the relative efficacy of a disorder-specific internet-delivered treatment for depression vs. trans-diagnostic internet-delivered treatment for both anxiety and depression. Both interventions will be tested in guided and self-guided formats. We expect that the guided interventions will results in superior outcomes to the unguided interventions. We do not expect differences between the two guided interventions at post-treatment, but expect that the trans-diagnostic treatment will result in superior outcomes at follow-ups.

This study uses a newly­ developed spinal cord stimulator and measurement system. The aims of the study are: 1. To determine if the nerve response to stimulation recorded from the spinal cord can be used to maintain the stimulation at a constant and comfortable level for the patient. 2. To make measurements from the spinal cord to optimise the stimulator settings automatically. 3. To determine different stimulation patterns to provide pain relief without the patient feeling the stimulation. 4. To determine if a patient’s pain can be detected from the nerve signals measured in the spinal cord.

Patients referred to the community rehabilitation programs (CRPs) at the Peter James Centre (PJC) and Wantirna Health (WH) have traditionally been placed on a waiting list and given a triage category, which guides clinicians as to who should be seen first when demand exceeds supply. This study is trialling an alternative model of triage within the orthopaedic team at the PJC CRP in which all patients are seen for a face to face assessment soon after referral, with a subsequent decision on priority and patient management made by the treating clinician. The aim of the trial is to compare the outcomes with the traditional model at WH, and determine whether the new model improves waiting times without negatively impacting on the quality of service received, patient outcomes or staff and patient satisfaction

The purpose of this project is to explore whether a clinician-guided treatment program can help to reduce anxiety symptoms in a population of mature adults (aged 60-75), when administered over the internet. A secondary purpose is to determine how acceptable people find this form of treatment. The study will inform how services can best improve future treatment programs for mature adults with anxiety.

Patients who have been diagnosed with non-small cell lung cancer may receive, or already be receiving treatment with a drug called Erlotinib or Gefitinib. Erlotinib and Gefitinib are similar drugs that belong to a class of drugs that inhibit a specific biological receptor, called the Epidermal Growth Factor Receptor (EGFR), which is over expressed in a number of different cancers. One of the potential side effects of Erlotinib and Gefitinib is skin rash, which occurs in up to 75% of patients. In this study, we will investigate whether treatment with a new drug, BN83495, can reduce the severity and/or frequency with which this rash occurs. BN83495 is an experimental drug, which is taken as a tablet, and is being tested as a possible anti-cancer treatment. The drug inhibits steroid production and is being developed by Ipsen Pty Ltd. Excess steroid production in the skin has also been linked to the development of acne and skin rashes. Therefore, it is our hypothesis that BN83495 pre-treatment may complement the use of erlotinib or gefitinib and reduce the severity of rash. This project will be performed at the Peter MacCallum Cancer Centre and will involve approximately 10 to 20 patients. The aim of this project is to measure the frequency and severity of skin rash, and other side-effects, for patients treated with Erlotinib or Gefitinib and BN83495. Changes in the drugs and hormones bllod levels will also be measured. Patients will be assessed at Peter MacCallum Cancer Centre weekly for a period of 12 weeks from the first day of treatment with BN83495.

Patients with spinal cord injury (SCI) have improved outcomes with a specialized and systematic approach to their care. The management of nontraumatic SCI (NTSCI) is more fragmented compared with traumatic SCI (TSCI). Whereas patients with TSCI are often managed within specialised SCI units Patients with NTSCI can be admitted to a wide range of hospitals, receive care from many different hospital departments, and wait prolonged periods for a rehabilitation bed after they have been accepted as ready for transfer to rehabilitation. There is generally a lack of specialist SCI knowledge and related practical skill among acute hospital staff about the principles of caring for patients with a SCI. This places these patients at higher risk of preventable complications and adverse outcomes. This project is a study of the possible benefits of involving a specialized multidisciplinary consultation team of health care professionals in the management of patients with a recent onset of SCI who are in acute hospitals. The team will function as a mobile unit, assessing and providing therapy recommendations, simple equipment and limited treatment for SCI patients accepted by the Spinal Rehabilitation Unit (SRU) at Caulfield Hospital for admission to the unit and who are waiting for transfer. The median time for transfer is currently over 2 weeks. These patients tend to have a NTSCI. Patients accepted for admission to the SRU at Caulfield Hospital, Alfred Health, will be approached to participate in the study. Those who agree will be randomly allocated to receive either the multidisciplinary consultation team or usual care. It is our hypothesis that the team would significantly improve patient outcomes and prevent SCI complications.

Acid-base disorders are frequently associated with liver dysfunction and may occur in patients undergoing partial liver resection. Liver resection decreases the working liver mass and causes a variable degree of liver insufficiency that in turn, may cause or aggravate metabolic acidosis. The quantitative acid-base effects of fluid therapy during liver resection are unclear with few reported studies. For patients undergoing liver resection, the most frequently administered intravenous crystalloid (clear) fluids are Hartmann’s solution, Normal Saline, and to a lesser extent, Plasmalyte. Normal Saline is not considered an acceptable fluid for prolonged perioperative administration due to its high chloride content that results in hyperchloremic metabolic acidosis. Therefore, both Hartmann’s Solution and Plasmalyte, being more “balanced” solutions compared to Normal Saline, remain the fluids of choice for patients undergoing hepatic resection. However there are no studies to determine which of these fluid has a more favourable acid-base profile. We propose to conduct a prospective, multicentre-centre, blinded, randomized non-inferiority trial to test whether Plasmalyte solution is associated with similar or improved metabolic status (non-inferiority) than Hartmann’s solution. Adult patients undergoing elective hepatic resection will be randomized to receive either Plasmalyte or Hartmann’s solution for all crystalloid fluid therapy during elective liver resection surgery. Primary aim: to examine the effect of Plasmalyte or Hartmann’s solution on acid-base status (measured by base excess). Secondary aims: to compare changes in plasma lactate concentration, effect on NGAL (a novel marker for acute kidney injury), need for blood and blood products, need for mechanical ventilation and its duration, length of hospital stay and survival to hospital discharge. Another factor that may affect acid-base status after liver resection is perioperative kidney injury. In research conducted in the Intensive Care Unit at Austin Hospital, it was found that a new marker for early postoperative kidney injury called NGAL (neutrophil gelatinase associated lipocalin) can be used to predict acute kidney injury in patients undergoing major cardiac surgery. From the published data, the incidence of acute kidney injury after elective hepatic resection is between 10-15%. The value of NGAL after liver resection has not been examined, therefore we also propose to examine if the acid-base status effects of the study fluids have any influence on the incidence of postoperative acute kidney injury. Number of recruiting hospitals: 3 (Austin Hospital, Monash Medical Centre, Peter MaCallum Cancer Centre) Number of patients planned for involvement at each hospital: 15- 20

Avena sativa (oats), in its various forms and extracts, has been traditionally known for its physical and psychological fortifying properties. Proposed beneficial effects include: reduced risk of heart disease, raised energy levels, increased ability to cope with stress, reduced anxiety and depression, and increased physical and cognitive performance. The mechanism of effect is currently unknown. However, it has been suggested that some ingredient(s) found in green oats have clinically significant inhibitory effects on monoamine oxidase B (MAO-B) and phosphodiesterase 4 (PDE4), effects which may improve cerebral vasodilatation. As enhancement of cerebral blood flow by vasoactive nutrients has been hypothesised to improve cognitive function, this may be the mechanism by which oat extract could improve cognitive performance and stress response. The aim of this study is to examine the effect of daily consumption of Neuravena for 12 weeks on the ability to cope with stressful cognitive tasks, cognitive performance and on psychological well-being (mood) and whether these effects are mediated by changes in cerebral blood flow.

Phase 1 and 2 This study looks at the effectiveness and side effects of different dose strengths of the drug sunitinib used in combination with standard pre-operative radiotherapy for soft-tissue sarcoma. Who is it for? You can join this study if you have soft-tissue sarcoma that has been confirmed by microscopic analysis, and is suitable for preventative radiotherapy and surgery and you are aged 16 years or older. Trial details Location: Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, Victoria, Australia. Participants will receive treatment over seven and a half weeks’ treatment. This involves 14 days of orally administered sunitinib followed by 5 weeks of combination treatment comprising standard pre-operative radiotherapy and oral administered sunitinib, at varying dosage levels. This research is being carried out with the aim of developing a more effective treatment than standard radiotherapy and surgery alone. Although standard treatment is frequently successful, some patients do not respond well to this treatment. Low oxygen levels in tumours, which may be a particular problem with sarcomas, are thought to be one factor that contributes to failure of radiotherapy. Sunitinib is a new drug that is active against cells with low oxygen levels. The combination of sunitinib and radiotherapy has shown promising results in other cancers. The purpose of this study is to find out whether treatment with a new drug, sunitinib, can increase the effectiveness of radiotherapy at killing cancer cells, and to test the safety of the combination of sunitinib and radiotherapy.

This research study will investigate how speech pathology treatments may work for chronic cough. Chronic cough is a common problem that can be caused by conditions such as asthma, rhinitis and reflux. In approximately 20% of people, chronic cough remains unexplained. Recently we have identified that 50% of chronic cough sufferers have Paradoxical Vocal Cord Movement or Vocal Cord Dysfunction coexisting with chronic cough. Paradoxical vocal movement or vocal cord dysfunction is a condition that results in the vocal cords closing rather than opening when you breathe in. This can cause cough or breathing problems. Paradoxical vocal cord movement can be effectively treated with speech pathology. This study will assess how speech pathology benefits chronic cough. The purpose of this study is to:- (i) To investigate the effects of various aspects of the speech pathology treatment program on cough reflex sensitivity. (ii) To compare changes in cough reflex sensitivity following single components of the speech pathology intervention e.g. voluntary control versus specific strategies. It is hypothesised that specific speech pathology treatments will decrease cough reflex hypersensitivity.