ANZCTR search results

The aim of this study is to examine whether subgroup classification of chronic low back pain patients results in differing effects from a device based isolated, targeted and progressive resistance strength rehabilitation programme (24 Sessions) on respective measures of spinal strength, range of motion and pain and disability. The sustainability of the results will be examined in a 12 month followup. It is hypothesized that all groups will respond positively to the device based rehabilitation as the specific nature of the exercise addresses the underlying weak spinal musculature as a major factor in all patients with chronic low back pain.

Most children receiving inpatient care at the Queensland Children's Hospital will require the insertion of a PIVC. Two thirds of healthcare consumers describe peripheral intravenous catheter (PIVC) insertion, as the ‘worst’ thing to happen during hospital admission, describing it as painful, frustrating and stressful. Despite their importance, PIVCs can be hard to insert with unacceptably high rates of first attempt insertion failure reported. This study aims to determine the efficacy of ultrasound guided PIVC insertion compared to landmark technique to increase first time insertion success in children aged <18 years.

Over the last few years, there has been a significant increase in the use of robotic-assisted surgery (RAS) in total knee arthroplasty (TKA), as well as increasing adoption of kinematic alignment (KA) strategies. Given the significant expenditure required for robotic-assisted surgery, along with increasing use of kinematic alignment, rigorous clinical evidence is required to guide practice in these areas. The RASKAL study will be assessing patient outcomes by comparing 2 different assistance (Robotic- RAS/Computer-CAS) and alignment (Kinetic -KA/Mechanical-MA) techniques currently used in Total Knee Arthroplasty in Australia. The study will be assessing patient outcomes by comparing 2 different assistance (Robotic- RAS/Computer-CAS) and alignment (Kinetic -KA/Mechanical-MA) techniques currently used in Total Knee Arthroplasty in Australia. The primary aim of the study is to determine if there is a difference between the groups measured by Patient Reported Outcome Measures (PROMs) over 2 years. The study will be nested within the AOANJRR utilising the RAPID (Real time Automated Platform for Integrated Data capture) system and will be conducted in around 10 sites (across NSW and WA) with 15 surgeons.

This trial will observe the physiological gastrointestinal responses to a single dose (20 drops, 1.1 ml) of STW5-II, vs placebo, to investigate the mechanisms by which this herbal preparation may exert its gastrointestinal symptom relieving effects. Participants will attend two visits at which they will receive either STW5-II or placebo, and gastric emptying will be measured for the following three hours. The hypothesis is that STW5-II will increase meal retention in the proximal stomach and decrease content in the antrum, without affecting overall gastric emptying.

We propose treating hypertensive moderate heart failure by directly treating aortic stiffness (increasing aortic distensibility; increasing expansion and contraction). Our passive recoil extra aortic balloon counterpulsation device, the BioQ Cardiac Assist device (BioQ CA), reduces aortic stiffness leading to a reduction in afterload, achieving reduced pulse and mean aortic pressures in pilot animal testing by 27% and 10% respectively, and improved left coronary artery (LCA) blood flow by 39%. The device is minimally invasive, non-blood contacting, failure mode safe, and requires no pump, leads, or ECG timing, and is a cost effective approach. Additionally, the device offers the ability to adjust its performance post implantation (for future chronic studies) by changing balloon pressure via a subcutaneous inflation port. Device proof-of-principle has been established where the BioQ CA device has shown to operate as a counterpulsation device by decreasing heart load, reducing pulse and mean pressures, and improving left coronary artery blood flow. These changes are within the range of improvement achieved with pump powered Intra-Aortic Balloon Pump (IABP) and extra-aortic balloon (EAB) systems, and the blood pressure reduction achieved with renal denervation and barostim modulation, demonstrating our passive recoil counterpulsation device is competitive on performance yet with the advantages of being a simple self-powered, stand alone device, offering superior cost savings compared to other technology approaches. More recently the device was implanted in two patients in India prior to scheduled coronary artery bypass grafting (CABG). Devices were attached around the ascending aorta for approx. 30 minutes with increases in left coronary artery (LCA) blood flow of 30% to 100% measured, cardiac output improvements of up to 18%, and heart rate decreased by 8%. Patients recovered normally and were released from hospital with no adverse events. This data is very competitive and justifies further acute studies before considering a chronic human study. In this pilot study, we propose to test up to 40 patients with the device for 30 minutes on consenting patients who are scheduled for CABG. Testing will be done during vessel harvesting to minimise procedure time. We aim to measure LCA blood flow, arterial blood pressures, and cardiac output.

Chronic subdural haematoma (cSDH) is one of the most common neurosurgical conditions and its frequency continues to rise as a result of the aging population and the increasing use of anticoagulation and antiplatelet medications. While there are no established guidelines for its management, symptomatic cSDHs are usually treated with surgical evacuation. The reported recurrence rates following surgical evacuation in the literature vary widely from 2% to 37%, with most estimates ranging between 20% and 30%. Recent studies have suggested middle meningeal artery (MMA) embolisation to be a potential alternative treatment for cSDH. Numerous case reports and series have demonstrated MMA embolisation as a safe primary treatment for cSDHs or as an adjunct treatment following surgical evacuation. We aim to conduct the first randomised controlled trial to further confirm the efficacy of MMA embolisation. -Stable cSDH patients who do not require urgent surgical evacuation will be randomly allocated to observation or to receive MMA embolisation. -We aim to demonstrate that MMA embolisation can reduce the need for surgical evacuation in stable patients

The overall objective of this study is to assess the effectiveness of a simple, scalable intervention (an ‘activity supporting’ school uniform) in reducing cardiovascular risks in children attending primary school. The primary aim is to compare the difference between the intervention and control group in their mean cardio-respiratory fitness at 9 months (primary end-point) and 18 months follow up, as measured by a multistage fitness test. It is hypothesised that the intervention group will report a higher mean cardiovascular fitness compared to the control group.

Background Artificial intelligence (AI) has become increasingly capable over the last decade. AI technologies are approaching or surpassing human abilities at complex tasks. Specifically, in healthcare, AI is approaching or surpassing human clinician ability in multiple narrow domains. Research on AI in medicine has been increasing worldwide and across almost all specialties. General public opinion has seen to be positive in a number of surveys, with the public expressing high hopes that AI could be used to improve healthcare. Interaction with AI technologies is likely to become an increasingly common aspect of healthcare for both patients and physicians. Despite these trends, there is no data regarding Australian and New Zealand emergency doctors’ knowledge, attitudes, and opinions towards AI in general and the use of AI in emergency medicine. Aim Assess Australian and New Zealand emergency doctors’ attitudes and knowledge towards AI in general and the use of AI in emergency medicine. Plan We will conduct voluntary semi-structured interviews with a representative sample of Australian and New Zealand emergency medicine doctors until thematic saturation is achieved. Participants will be recruited through the research teams’ personal networks, and through recruitment advertising through ACEM. We will continue interviews as required until we achieve appropriate representation of the emergency medicine workforce. We will undertake qualitative analysis on transcribed interviews to uncover attitudes and themes.

The EMT study is investigating a molecular process (epithelial-mesenchymal transition) which can occur in the breast cancer cells of some patients, which can make the cancer more aggressive and might reflect how well the cancer cells will respond to treatment. Who is it for? Eligible patients in this study are aged 18 years or older, have been diagnosed with hormone receptor positive, HER2 negative breast cancer and have received a cyclin D kinase inhibitor in the adjuvant setting and have experienced a breast cancer recurrent event, or have received a cyclin D kinase inhibitor for treatment of metastatic cancer. Any metastatic breast cancer patient who has received at least one dose of eribulin in the course of their treatment may also be eligible. Study details All participants enrolled in this study will be asked to provide 1-2 tumour biopsies (tissue samples) that will be used to perform the molecular tests to determine EMT activity. Samples from previous surgeries and/or biopsies may be used to perform the molecular tests. Some eligible participants may be asked to undergo a maximum of two new biopsies if tissue from prior procedures is not available. No other patient procedures will be performed. It is hoped this research will provide more information regarding the EMT process which may allow doctors to better select treatment for their patients whose breast cancer has this feature, and potentially allow the development of new drugs which can target the EMT process to increase cancer cell kill.

Procedural sedation to facilitate painful and non-painful procedures is a core skill of specialist emergency physicians (EPs) in Australasia. Our goal is to establish a national procedural sedation dataset to monitor practice for trends in techniques and safety on a large scale over time. This will collect data on current practices around procedural sedation, including patient selection and optimisation, staffing, medication use, monitoring modalities and rates of procedural success and sedation complications. We hope that this database will form fertile ground for the exploration of future research hypotheses.