ANZCTR search results

Net ultrafiltration (NUF) (i.e., fluid removal) during continuous renal replacement therapy (CRRT) enables management of volume status and is supported by international clinical guidelines. Emerging evidence from epidemiologic studies of critically ill patients with acute kidney injury suggests that higher intensities of NUF (i.e., higher NUF rates) impair renal recovery and are associated with increased mortality. However, no randomised studies have compared patient outcomes achieved by targeting a moderate NUF rate to usual care. The primary aim of this study is to determine whether targeting a moderate NUF rate in critically ill patients receiving CRRT affects renal recovery and patient survival compared to usual care. The primary outcome is the time to renal recovery, defined as the number of hours between the initiation and discontinuation of renal replacement therapy (CRRT or intermittent RRT). Death will be considered as a semi-competing risk. Secondary outcomes relate to the feasibility, efficacy, and safety of the intervention.

The Australian Arthritis and Autoimmune Biobank Collaborative (A3BC) was established in 2016 by Australian rheumatologists and researchers to address the urgent need for better prediction of prognosis and treatment outcomes among Australians living with arthritis and autoimmune conditions. The group identified that building a state-of-the-art national resource would not only improve outcomes but also strengthen research capacity in a significantly underfunded National Health Priority Area, given the disproportionate burden and cost of musculoskeletal (MSK) conditions. The A3BC’s vision is to identify the causes and cures of MSK and autoimmune diseases through biobank-enabled, data-linked, collaborative, and multidisciplinary research. Now merged with the Australian Rheumatology Association Database (ARAD), integrated with the Australian Juvenile Arthritis Registry (AJAR), and partnered with the Australian and New Zealand ChiLdhood Arthritis Risk factor Identification sTudY (ANZ CLARITY), the A3BC provides a powerful platform. It combines biological and environmental data with patient and population datasets to reveal new associations that will lead to safer, more effective prevention, diagnosis, treatment, and prognosis strategies. Beyond high-quality biospecimen collection, the most innovative feature of the A3BC is the unprecedented level of integrated data analysis. The A3BC will link biospecimen-derived ‘omic’ data with patient-reported outcomes, cross-jurisdictional electronic medical records (EMR), imaging and pathology data, national datasets (MBS, PBS, AIR), cancer and death registries, and longitudinal studies. This integration offers a comprehensive platform for transformative research. Initially focusing on Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA), Juvenile Idiopathic Arthritis (JIA), Ankylosing Spondylitis (AS), gout, and vasculitides (including Polymyalgia Rheumatica and Giant Cell Arteritis), the A3BC infrastructure will enable expansion to other significant or rare MSK conditions. These include Sjögren's Syndrome, Low Back Pain, Scleroderma, Systemic Lupus Erythematosus, Myositis, and Osteoarthritis. A broad range of childhood and adolescent MSK conditions, in addition to JIA will gradually be added, including but not limited to, juvenile systemic lupus erythematosus, juvenile scleroderma, juvenile dermatomyositis, juvenile vasculitis (e.g. Kawasaki’s, Henoch-Schonlein), and congenital skeletal dysplasias. Built on a national network of integrated registry, biobank, and research infrastructure, supported by leading clinical and scientific expertise, the A3BC promises a new era of evidence generation. It will deliver a cost-effective, future-focused research platform to drive smarter health policy, better clinical decision-making, and ultimately, new paths to diagnosis, treatment, and prevention.

Adequate analgesia is vital to functional recovery after rib fractures and prevention of respiratory morbidity. Erector spinae catheters provide an alternative regional technique for analgesia by infusion of local anaesthesia to sensory nerves of the posterior rami of the affected spinal level(s). Currently, there is a lack of uniformity and consensus on the best regimen for local anaesthesia infusion: whether using a programmed intermittent bolus, or a continuous infusion, regimen. Theoretical and anatomical considerations, with initial confirmation by in vitro cadaveric and low-quality evidence clinical studies, suggest that PIB provides better local anaesthesia spread. This study will evaluate if the Programmed intermittent bolus is superior to Continous infusion using clinically relevant outcomes of pain scores, opioid consumption, and improved respiratory function.

The Virtual Model of Antenatal Asthma Care (VMAC) study evaluates the suitability of 2 types of asthma care in pregnancy. 1) virtual (tele/video conferencing) and 2) face-to-face (in person). Uncontrolled asthma in pregnancy may harm the mother and the baby. Self-management education and clinical care may help to control asthma throughout pregnancy. Traditionally, it is provided as a face-to-face service which largely depends on the availability of both the mother and the healthcare team. To address this, we have developed a virtual model of care to provide the same service remotely (i.e., via tele or video conferencing). Women can access care at a convenient place and time. In this study, we are testing the suitability of this new approach.

The purpose of this study is to determine whether feeding into the small bowel after combined CRS and HIPEC is feasible and can promote post-operative return to bowel function Who is it for? You may be eligible for this study if you are an adult who is going to have cytoreductive surgery and hyperthermic intraperitoneal chemotherapy to treat your cancer. Study details Participants in this study will undergo their surgery as normal. During the surgery, study participants will receive a nasojejunal gastric decompression tube and receive enteral feeds (formula) into the small bowel within 24 hours from the end of the surgery up until the participant commences a solid oral diet. Tolerance and delivery of nutrition will be monitored. It is hoped that this research will help determine if it is possible to commence feeding patients after their CRS and HIPEC and therefore reduce gut-related side effects

The human digestive tract, especially the gut, is populated by millions of microorganisms including bacteria, and fungi, the so-called microbiome. Many studies have shown that the microbiome is linked to health from digestive disorders, to heart health, or mental health. The microbiome can be modified by your diet, and probiotics are frequently advertised to alter the gut microbiome. One such product is kefir, a probiotic dairy beverage that has been consumed for over 2,000 years. Traditional kefir is produced by taking for example cow’s milk, and adding Kefir ‘grains’ which contain a diverse range of symbiotic bacteria and yeast species. Anecdotal statements in the media continue to link the consumption of Kefir to gut health, despite a lack of scientific evidence to support this. In order to advance the scientific understanding of Kefir, this study aims to examine whether kefir consumption leads to changes in the oral and gut microbiome, i.e. the bacteria living in the digestive tract. It is hypothesised, that kefir will increase the number of beneficial bacteria in the mouth and gut.

This study aims to explore the impact of home-based exercise sessions supervised via telehealth on the health and fitness of people with breast cancer. Who is it for? You may be eligible for this study if you are an adult aged 18 or over who has been diagnosed with breast cancer, have recently completed anti-cancer therapy, and have a risk of heart damage. Study details All participants will undertake remotely-monitored aerobic exercise sessions at home (e.g., walking, cycling), 3 times per week over 8 weeks. The session length and exercise intensity will be individualised for each participant. Participants will also be provided with general exercise education, and learn about behaviour change through the study mobile application. Participants will be asked to attend three study appointments to complete a questionnaire and undertake a cardiopulmonary exercise test. Each visit with take approximately 75 minutes (15 minutes for the questionnaire and 60 minutes for the exercise test). The visits occur before the study, after 2 months, and after 5 months. It is hoped that this research will help determine if home-based exercise supervised via telehealth in real time is safe and effective in improving the health and fitness of breast cancer patients.

Bronchiolitis is a common viral infection of the small airways of infants and some affected infants will require hospital admission. Severe bronchiolitis is a marker for greatly increased risk of developing both preschool wheeze and subsequent school age asthma. Since epidemiological studies suggest that exposure to microbial products protects against preschool wheeze, lysates of bacteria may prevent the development of wheeze after bronchiolitis, with long-term beneficial consequences. BLIPA is a phase IIb, randomised, double blind, placebo-controlled study, investigating the efficacy superiority of bacterial lysate (Broncho Vaxom) capsules over placebo, in reducing wheeze in infants after severe bronchiolitis. The primary end point of the study is rate of parent-reported wheeze episodes. The study aims to test bacterial lysate capsules (3.5mg over 12-24 months) for safety, efficacy, and to advance mechanistic understanding of its action.

This study examines whether a virtual reality experience can be used to prepare children aged 4- 10 years age for magnetic resonance imaging scans. Magnetic resonance imaging (MRI) is an important type of medical imaging frequently used in paediatric care. Successful image acquisition needs children to enter and lay still in a narrow tunnel for 30-60 minutes. This environment can be anxiety provoking for children, and some children will refuse to lie on the magnetic resonance imaging table. This study examines whether a virtual reality (VR) experience can be used to prepare children aged 4- 10 years age for magnetic resonance imaging scans.

This study seeks to explore the health-related beliefs, motivations, skills and support needs of people who access online psychological treatment for depression and/or anxiety, and how these influence whether and how people engage with and respond to treatment. There is already a lot of research to support the safety, acceptability, and effectiveness of online psychological treatments for adults with depression and/or anxiety. Now, we wish to build our understanding about how different people may engage with and respond to treatment differently, so that we can develop practical strategies and supports to help people engage in way that best suits their needs and priorities. To do this, we will recruit adults both in Australia and overseas with depression and/or anxiety and if eligible, randomly allocate them to receive treatment either straightaway or after an 8-week delay (waitlist control). We will ask participants to complete questionnaires when they apply for treatment, before starting treatment, mid-way through treatment, and after finishing treatment. Australian participants who enrol in treatment will also be asked to participate in an optional interview asking about their views and experience of deciding to take-up online psychological treatment. It is expected that participants reporting lower health literacy levels in their application will have higher levels of depression and anxiety at all time-points (before, during, and after treatment), and will be less likely to take-up and complete treatment.