ANZCTR search results

Pre-clinical studies indicate that insufflation using dry-cold carbon dioxide (DC-CO2) leads to peritoneal cellular damage, inflammation and hypothermia compared humidified warm-CO2 (HW-CO2). These parameters were explored in patients undergoing surgery for colorectal cancer.

Haemorrhoids are enlarged veins in the anus or lower rectum, which can cause bleeding, itching, pain and prolapse outside of the anal canal. The disease is commonly managed using rubber band ligation (RBL), where a band is placed around the base of the haemorrhoid, preventing blood flow to the haemorrhoid and causing it to fall off and pass through the anal canal. The most common complication of RBL is pain. Currently, surgeons vary widely in their approach to preventing pain in these patients, owing to a lack of quality evidence supporting one strategy over another. Surgeons may inject local anaesthetic at the site where the band is placed, or use it to block the nerve supplying the anus and lower rectum. Some patients receive no local anaesthetic, and rely on standard postoperative medications such as paracetamol, anti-inflammatories, and opioids. There is a need for quality research to determine the best strategy for pain management in patients undergoing this common procedure. In our study, participants undergoing RBL will be randomly assigned to receive either local anaesthetic at the banding site, a nerve block, or standard postoperative medications only. These pain management strategies are all routinely used in practice and are safe procedures common in many operations. At several timepoints following the procedure, participants will be asked to report their pain on a scale (up until 2 weeks post procedure). Participants’ use of pain medications in recovery; the time taken for participants to be discharged after their procedure; participant satisfaction with their procedure; the time it takes for participants to return to work after their procedure; and procedure associated complications, will also be recorded. These outcomes will then be used to determine which strategy is best for managing pain in patients undergoing RBL. We hypothesise that both pudendal nerve block and submucosal infiltration of local anaesthetic will be superior to no local anaesthetic for post-procedural pain management.

Whether the use of Point-Of-Care Ultrasound (POCUS) bladder scan reduced the time taken to collect a clean catch urine sample in non-toilet trained children

The Care Navigation intervention is a 6-month program of support for adult patients with depression and/or anxiety referred by a GP to the Black Dog Institute (BDI) Psychiatry Services. It aims to assist participants in navigating the mental health system and implementing the treatment plan written by their BDI psychiatrist, and to subsequently improve their mental health outcomes. The primary aim of this pilot trial is to determine the feasibility and acceptability of the Care Navigation intervention for adults with depression and/or anxiety and to identify necessary improvements. Acceptability will be assessed by participants’ ratings of satisfaction and by interviews with participants, Patient Care Navigators and BDI clinical staff. A further aim of this pilot trial is to conduct a preliminary examination of the efficacy of the Care Navigation intervention in improving clinical outcomes, including symptoms of depression (PHQ-9) and anxiety (GAD-7), functional impairment, mental health self-efficacy and health care utilisation. Changes in these outcomes from pre-intervention will be examined within the Care Navigation group at both mid-intervention (3 months) and post-intervention (6 months).

This is a Post-market, multi-centre, non-comparative, open label study . The study aims to measure the performance and the safety of Trinity™ Dual Mobility System in patients who will receive Trinity™ Dual Mobility System during Total Hip Arthroplasty (THA). A subset of these patients will also provide blood sample for measuring whole blood metal ions (Co, Cr and Ti) levels in patients receiving the TrinityTM Dual Mobility System. In the prospective component, patients who are eligible for the THA that will receive the TrinityTM Dual Mobility System in combination with a Corin Femoral Stem. These patients will complete follow up visits over a span of 5 years where the safety and performance of the Trinity DM cup will be measured by quality of life questionnaires. Those patients that are deemed suitable will be invited to provide a blood sample for the measurement of Cobalt, Chromium and Titanium levels. The metal ion levels in the blood of the participants will be monitored over time to determine any presence of metal ions (Co, Cr and Ti) above the local laboratory normal range in whole blood.

Study Aim is to identify the mean quantities and ranges of fat, protein and carbohydrate consumed in meals and snacks times in a small sample of children aged 6-18 years with type 1 diabetes attending John Hunter Children's Hospital and to then explore any possible associations between macro nutrient variability and HbA1c or BMI.

In Australia, one in 6 couples will have difficulty conceiving a baby. Diminished ovarian reserve (DOR) lowers the chance of pregnancy even more. The best way to assist women with DOR is unclear as there are few helpful treatments available. Many women in Australia use naturopathy to improve their chances of getting pregnant and having a healthy baby. However, there is no rigorous evidence that can tell us if naturopathy is effective or safe for women with DOR. We are also interested in the possible role of naturopathy as an additional treatment to increase pregnancy rates in women with DOR. To answer this question, we will need to first check that rigorous clinical trial methodology is acceptable to women with DOR and, if it is, to follow up with a larger clinical trial. Prior to embarking on such a large and expensive study, we propose to do a small, preliminary study to see if women with DOR are interested in participating in clinical research of naturopathy, and gather preliminary safety data. We have completed a survey with women with DOR which has informed the design of this study; and a survey and focus group to ensure the naturopathic management being evaluated is close to that which is provided by naturopaths when they support women with DOR.

This research will investigate the effects of exercise for people with rotator cuff tendinopathy. Rotator cuff tendinopathy is the most common reason for pain among people experiencing shoulder pain. It is characterised by pain at the front or side of the shoulder and may radiate into the upper arm. Pain is typically worse when lifting the arm, completing overhead activities or generally with increased shoulder activity. Current guidelines recommend exercise, activity modification and anti-inflammatory medication as first line treatment for rotator cuff tendinopathy. However, we do not yet know which exercise is most effective. The proposed study is a two arm parallel group randomised control trial. The primary aim of this research is to compare the feasibility of two different exercise interventions for rotator cuff tendinopathy.

Cognition is required so that individuals can make decisions, communicate, think, analyse and move on a daily basis. Patients with chronic obstructive pulmonary disease (COPD) have impaired cognition compared to age matched healthy controls and this is associated with increased mortality and disability (Wen et al. 2018). However, the mechanisms for this cognitive dysfunction remain poorly understood. Several studies have also reported that a reduced brain (cerebral) blood flow can lead to cognitive dysfunction and patients with COPD also have a reduced brain blood flow compared to age matched healthy controls (Beaudin et al. 2017). This finding suggests that the impaired cognition observed in patients with COPD may be due to a reduction in brain blood flow. However, this hypothesis has not been tested. Patients with COPD experience airway obstruction which loads the respiratory muscles and increases the work of breathing. Inspiratory loaded breathing required healthy individuals to breathe through a narrow tube and increases the work of breathing and replicates an exacerbation of COPD. This model of airway obstruction can be used to replicate COPD in healthy young individuals and investigate the effects of loaded breathing on cognition and brain blood flow. The aim of the study is to investigate the effects of inspiratory loaded breathing on cerebrovascular blood flow and cognition in healthy young adults. We will test the hypothesis that inspiratory loaded breathing reduces cerebrovascular blood flow and cognition.

Aphasia is a communication disorder often caused by stroke and may affect a person's ability to talk, read, write and understand language. Aphasia does not affect a person's intelligence. Speech Pathologists provide intervention and therapy for people with aphasia to support their language recovery. Research has shown that people with aphasia benefit when more therapy is provided over a longer period, however the amount of therapy that people with aphasia receive in Australia is typically less than what is recommended. The University of Queensland has developed the Comprehensive, High-dose Aphasia Treatment (CHAT) program to address this issue. The overall aim of this research project is to evaluate the real-world implementation of the CHAT program. Specifically, this research aims to: 1) Evaluate the process of implementing the CHAT program within rehabilitation settings 2) Determine how effective the CHAT program is compared to current therapy options (usual care) 3) Examine the potential cost-effectiveness of CHAT compared to current therapy options (usual care) 4) Investigate whether speech pathologists report and demonstrate increased knowledge and skills in providing high-quality aphasia treatment We hypothesise that compared to current therapy options (usual care), the CHAT program will result in: 1) A greater proportion of high-quality aphasia therapy being delivered to people with aphasia 2) Improved recovery for language, communication and quality of life of people with aphasia 3) Increased speech pathologist knowledge and skills in providing high-quality aphasia treatment