ANZCTR search results

To perform a prospective non-inferiority study of a rapid cardiac MRI acquisition protocol using 4D-flow compared to the current gold standard cardiac MRI examination to measure cardiac function and detect pathology

The purpose of this study is to test whether metformin treatment is associated with greater improvement of cognitive function and brain growth compared to placebo group for children/adolescents with a brain tumour. Who is it for? You may be eligible to participate in this study if you are between 7 years and 21 years and 11 months old and have been treated for a brain tumour. Study Details Participants will be required to take oral medication in tablet form daily for 16 weeks. 'Participants will be randomly allocated to receive either metformin as an oral tablet taken daily or a placebo tablet. Participation in this trial will require an overall time commitment of 40 weeks as participants must undergo screening and pre-treatment assessments and as well as a 6 month post-treatment follow-up. Assessments will include MRI scans and cognitive testing to measure memory, attention and processing speed. It is hoped that this research will help to determine if metformin has a positive effect on cognitive and brain recovery from brain cancer in this population

Paediatric Hand and Feet burns are a challenging injury for burns clinicians. They have a high prevalence and rate of ongoing morbidity. This is due to a combination of factors including children being curious about their environment and exploring with their hands, having slow withdrawal reflexes and hands and feet having multiple joints within a small body surface area. We believe the management of these burns could be further improved to try and reduce the ongoing morbidity. Currently, standard dressings (mepitel, acticoat and hypafix) are used to dress these burns but there is evidence to suggest that including Negative Pressure Wound Therapy as well may reduce the time to healing and therefore the ongoing morbidity. To include negative pressure as a standard practice of treatment, it must first be shown that it is both feasible and safe. Hypothesis: That the use of NPWT is both feasible and safe in paediatric hand and feet burns.

A transradial arterial approach is being used more frequently for coronary angiography due to the lower vascular complications and lower bleeding rates reported in recent large trials. Radial artery spasm, subclavian tortuosity and the increased technical difficulty of puncturing a smaller and more mobile artery are causes for access failure. This prospective randomised placebo controlled trial aims to look at the role of subcutaneous glyceryl trinitrate, as a vasodilatory agent, injected prior to arterial puncture to improve the technique. Radial artery diameter change will be assessed using ultrasound at the site of injection as well as the contralateral side to review for a systemic effect. Time to successful arterial access will be recorded and patient satisfaction in the form of pain scores will also be recorded.

This study aims to evaluate a 12-week Tai Chi training program as an intervention to add evidence on the therapeutic effect of a non-pharmacological approach in chronic disease management. We hypothesize that QoL, physical function, and mental wellbeing in Tai Chi group is better than the waiting list control group. We hope that the results of our research can be used to inform our knowledge about how to better manage chronic diseases. There are no foreseeable risks associated with this research project.

Dry mouth and the sensation of thirst are common and significant symptoms experienced by people with advanced illness. Dry mouth can be a distressing symptom, and it can interfere with talking and eating. The cause of dry mouth is often multi-factorial and includes the administration of medications which dry out oral secretions. The current management strategies for alleviating the symptom of dry mouth are limited and lack a strong evidence base, particularly in the palliative care setting. The use of mini mint ice cubes for the relief of thirst was established as effective in significantly reducing thirst intensity and distress in critical care patients in two French intensive care units (Lemyze, Lavoisier, Temime, Granier, & Mallat, 2020). However, the mint ice cubes were not evaluated against a control group and the authors noted that further trials may be needed to confirm their findings. This intervention was identified as appropriate for the inpatient palliative care population as the ice cubes are cost-effective and easy to produce. It is also similar to the usual care already provided at the Laurel hospice (plain ice), so is likely to be acceptable to the staff implementing the care. Therefore, there is the potential for significant clinical benefit with little cost and minimal impact to current practice patterns. Demonstrating the efficacy of this intervention for palliative care patients and comparing against a control intervention will comprise a meaningful and novel contribution to the evidence base. Lemyze, Lavoisier, Temime, Granier, & Mallat. (2020). To relieve the patient’s thirst, refresh the mouth first: a pilot study using mini mint ice cubes in severely dehydrated patients. Journal of Pain and Symptom Management, 60(1), e82-e88

Improvements in skeletal muscle mass (SMM) have been linked to numerous health outcomes including lower risk of cardiovascular disease, better cancer survival, improved glucose control, and enhanced bone mineral content and density. Methods of increasing SMM are therefore of interest. Resistance training (RT) and creatine supplementation are respectively the established exercise and supplement methods for increasing SMM. However, the processes that underly these gains are unclear. The gut microbiome has been identified as a potential influencer of SMM. However, no original research has investigated links between the gut microbiota and SMM. The primary purpose of this study is therefore to determine if the gut microbiome affects RT-based gains in SMM. The secondary purpose is to investigate the effects of creatine supplementation on the gut microbiome. We hypothesise that the make up and function of the gut microbiome before the exercise intervention will effect the SMM growth response to RT, and that creatine supplementation will change the make-up of the gut microbiome.

The spectrum of illness in secondary PPH is vast. While some patients experience severe bleeding with haemodynamic instability, or even maternal death, more commonly the vaginal bleeding is less than with a primary PPH. However, the morbidity is still considerable, with many women requiring blood transfusion and surgical interventions such as hysterectomy (Hoveyda & MacKenzie, 2003). Breastfeeding, newborn bonding, and peripartum mental health are also impacted when prolonged inpatient care or repeated outpatient reviews are required. There are no randomised controlled trials or other high-quality research data to guide best management for women who present with a secondary PPH (Mavrides et al, 2016). With the exception of certain antibiotic regimes for postnatal endometritis, current management options for secondary PPH are, at best, based on Level 3 and Level 4 evidence. As such, most institutions and professional bodies do not have a specific policy or guideline to assist clinicians managing this relatively common complication, nor are there audit systems in place to assess safety and success of management. This prospective project aims to recruit women attending a single institution for the management of secondary PPH. This women will have baseline antenatal, intrapartum and postnatal data entered and then be invited to participate in a longitudinal study collecting survey-based data every 6months for 36months. A nested cohort study will arise from the patients managed surgically (group managed with traditional suction curette, compared to those managed hysteroscopically).

For most endovascular stenting procedures dual antiplatelet therapy is necessary with a combination of antiplatelet medications. The standard medication regime is a trial of the antiplatelet clopidogrel in combination with aspirin, this study pioneers a tailored medication approach to the genetic profile of each patient.

This study is aimed at establishing tolerable and potentially effective doses of two medicinal cannabis products in paediatric palliative care. Who is it for? Participants may be eligible for this study if they are aged 6 months to 21 years, have advanced cancer (metastatic or locally advanced solid tumours, brain tumours or advanced hematological malignancies) and have been referred to or are known by the paediatric palliative service. Study details Participants will undergo baseline measurements, before being randomly allocated to either of two cannabis oil treatments which will be delivered daily for a total of 6 weeks. Participants will visit the clinic weekly to have their symptom burden assessed. Results from this study will help determine clinical dosing of medicinal cannabis for relief of symptom burden in children with advanced cancer.