ANZCTR search results

Patients referred to orthopaedics (ortho) commonly face long wait times for outpatient appointments and surgery. After study participants are offered assessments by hospital funded advanced physios -to referred chronic musculoskeletal patients – they will be offered community-based allied health services at different subsidy rates. This study aims to determine the most acceptable cost of community-based allied health services to meet consumer needs.

Thoracic surgery induces severe postoperative pain and has depended on thoracic epidural and opioids in the management of pain in the perioperative period. The increasing availability of ultrasonography to identify fascial layers has led to development of several techniques for analgesia of chest wall with promising results(1). Also, recent studies have hypothesized that opioids may result in an increase in cancer metastases(2) resulting in a trend towards avoiding opioids while utilising more regional techniques. However, it is not clear to what extent the results of these studies have changed daily clinical practice. Literature search shows that studies looking at perioperative practice in thoracic patients were conducted by Cook et al 1997(3) [post-thoracotomy patients, 24 anaesthetists in Australian Hospitals] and Kotemane (4) 2010 (major thoracic surgery, 240 anaesthetists, United Kingdom). The only recent survey available by Shanthanna (5) 2018 looked only at video -assisted thoracoscopic surgery (VATS) procedures among anaesthetists in Canada (response rate only 19%). We have limited information on the current trends in analgesia management for the patients undergoing thoracic surgery in Australia and New Zealand (ANZ) We hypothesize that despite the emergence of other regional blocks, thoracic epidural would still be the choice of the majority (> 50%) of the anaesthetists for open thoracotomy. The purpose of this cross-sectional survey across thoracic anaesthetists across ANZ is to understand the current practice and preferred mode of analgesia as well as the perception of anaesthetists towards various modalities of pain management of the patients undergoing thoracic surgery. In addition, it would also act as a benchmark for future studies especially with regards to prevalence of opioid-sparing anaesthetic techniques that might become a standard of practice in the future. References (1) Chin KJ. Thoracic wall blocks: from paravertebral to retrolaminar to serratus to erector spinae and back again–a review of the evidence. Best Practice & Research Clinical Anaesthesiology. 2019 Apr 5. (2) Maher DP, Wong W, White PF, McKenna Jr R, Rosner H, Shamloo B, Louy C, Wender R, Yumul R, Zhang V. Association of increased postoperative opioid administration with non-small-cell lung cancer recurrence: a retrospective analysis. British journal of anaesthesia. 2014 Jul 1;113(suppl_1):i88-94 (3) Cook TM, Riley RH. Analgesia following thoracotomy: a survey of Australian practice. Anaesthesia and intensive care. 1996 Oct;24(5):520-4. (4) Kotemane NC, Gopinath N, Vaja R. Analgesic techniques following thoracic surgery: a survey of United Kingdom practice. European Journal of Anaesthesiology (EJA). 2010 Oct 1;27(10):897-9. (5) Shanthanna H, Moisuik P, O’Hare T, Srinathan S, Finley C, Paul J, Slinger P. Survey of postoperative regional analgesia for thoracoscopic surgeries in Canada. Journal of cardiothoracic and vascular anesthes

This is a randomised, double-blind, placebo-controlled study to evaluate the efficacy and determine the optimal dose of a potential new treatment called GaRP in adults with irritable bowel syndrome. The aim of this study is to determine the efficacy of two different doses of GaRP in IBS patients after 8 weeks of intervention.

There has been recent interest in fluid balance during surgery and the impact on patient recovery. However, it is currently unknown whether any anaesthetic drugs substantially impact upon fluid balance during surgery. The aim of this study is to provide a thorough analysis of the medications and infusions provided to patients during a pancreaticoduodenectomy (also known as a Whipple procedure). Who is it for? You may be eligible for this study if you are an adult who underwent a pancreaticoduodenectomy (Whipple procedure) at the Austin Hospital between January 2011 and June 2020. Study details This study will be conducted using a review of medical records, and no patient contact is required. The study will review the medical records of adult patients who underwent a pancreaticoduodenectomy at the Austin Hospital between 1st January 2011 and 1st June 2020. It is hoped that this research will help to provide a better understanding of fluid balance during surgery and the impact of fluid balance on complications and outcomes after surgery.

Postoperative infections are the most common cause of complications in surgical patients and result in an average increase of four days in the hospital. Foot and ankle surgery may have a higher infection rate than other surgical areas since surgical preparation cannot fully reduce the bacterial load prior to incision. Due to the increased rate of infection and wound breakdown surgeons routinely reinforce absorbable subcuticular wound closures with non-absorbable skin sutures. Removal of these sutures can be painful and leave unsightly scars. 2- Octyl-cyanoacrylate tissue adhesive is available in Australia as an alternative to skin suturing for wound closure. There have been mixed results with this product with some studies showing good wound closure and low infection rates and others showing high rates of wound dehiscence and infection. The high rates of wound dehiscence with tissue adhesive has been postulated to be due to high wound tension. We believe that tissue adhesive may be successful an occlusive reinforcement after proper skin closure with appropriate methods to reduce tension such as subcuticular stitching. There have been no studies looking at using tissue adhesive in this fashion in foot and ankle surgery. The hypothesis of this study is that using tissue adhesive rather than non absorbable sutures to reinforce forefoot wounds will reduce patient pain and anxiety at dressing change whilst not affecting the quality of wound healing. The study will be powered to assess these two parameters.

Physical activity is vital for children’s health, well-being and development. It is important to establish healthy physical activity and sedentary behaviour habits early in life. Only one third of young children meet the recommended 3 hours of daily physical activity. ECEC services play an important role in encouraging young children to be physically active, healthy and developing well. Only 16% of ECEC services in Perth, WA have a formal written physical activity policy. This study aims to evaluate the effectiveness of the Play Active program tailored to ECEC services on ECEC educators physical activity practices. We hypothesise that educators from ECEC services implementing the Play Active physical activity policy will increase the amount of time and opportunities provided for children in their care to be physically active.

Apnoea, a pause in respiration, reflects the immaturity of a preterm infant’s respiratory control and is the major contributor to requiring protracted respiratory support, mostly spent on non-invasive forms of support which is reliant on an adequate respiratory drive and airway patency, at a time when both are prone to failure. Despite current administration of therapies to reduce apnoea burden, including non-invasive respiratory support and caffeine, bedside staff are still often required to react urgently to apnoeic events by providing tactile stimuli to re-establish respiratory efforts. Such an approach to management of apnoeic events makes adverse consequences of apnoea (hypoxia and/or bradycardia) in preterm infants inevitable. The ARIA study uses a crossover study design to investigate whether targeted auditory stimulus applied opportunistically soon after the onset of a respiratory pause in preterm infants born at <30 weeks gestation has an effect on shortening apnoea duration and mitigating the adverse apnoea-associated physiological consequences, when compared to standard care. The auditory stimuli examined in the ARIA study includes the mother's voice (attenuated), and a non-vocal sound. The primary outcome measure of the ARIA study is the frequency of apnoeic events lasting >= 5 seconds (per hour).

The study will investigate a new PET radiotracer PI-2620 to see if it can visual the tau protein which is observed in the brains of patients with progressive supranuclear palsy (PSP). The tau protein builds up in certain brain areas in patients with PSP, such as the basal ganglia. We hypothesise that PI-2620 will show high levels of uptake in the basal ganglia, indicating the presence of tau. Patients will undergo a single PET scan, whereby we inject a small amount of the radiotracer. The patient will then be scanned for 60 minutes. The resulting image will then show whether or not the radiotracer binds in the basal ganglia (indicating tau accumulation). The amount of tau in the basal ganglia can be measured from these images and we will then establish whether the levels of tau increase with increasing severity of PSP symptoms. If successful this radiotracer could be used in the future to help diagnose PSP.

This is a prospective, single-arm study of adults who react at blinded challenge to less than 300mg of peanut protein (approx. one peanut kernel) that will evaluate the utility of omalizumab as an adjunctive therapy to improve safety, as indicated by severity and frequency of reactions due to immunotherapy, and patient acceptability, as indicated by improved completion of the full course of oral immunotherapy, when compared to existing literature. Treatment in the study will consist of three phases. For the first phase, all participants will receive omalizumab injections every 4 weeks for 12 weeks. In the second 12 weeks, all participants will commence peanut oral immunotherapy and will continue omalizumab injections every 4 weeks. In the third phase, from week 24, omalizumab will cease and a maintenance dose of peanut will continue until the final study visit at 48 weeks. DBPCFC will be performed at screening, Week 24 and Week 48. Peanut protein doses of up to 100mg will be in the form of roast peanut fines or flour. Doses of 150mg and above will be taken in the form of whole roast peanut or smooth peanut butter according to patient preference. At Baseline, Week 12, Week 24 and Week 48 blood will be collected and tested for specific IgE, IgG4 and basophil activation tests to total peanut protein and protein components to assess for changes in peanut-specific immunity in response to trial interventions, and to evaluate the utility of such tests in predicting outcomes to therapy in adults

The main purpose of this study is to investigate whether passive movements prevent or reduce joint stiffness in intensive care unit (ICU) patients. It is believed that ICU patients, particularly longer-term patients, are at risk of developing joint stiffness because of their critical illness, and the management thereof, and immobility which prevents them from moving their limbs in a normal way. The development of joint stiffness has the potential to adversely affect functional ability and health-related quality of life. For this reason, physiotherapists often carry out passive movements on ICU patients, particularly longer-term ICU patients, with the aim of preventing or reducing joint stiffness. However, to date, there is little evidence to support or refute this practice. The primary aim of this within-participant study is to measure the effect of passive movements on joint range of motion (ROM) for longer-term ICU patients. The within-participant design of the study means that each participant will act as their own control, with one side of their body randomly allocated to receive the intervention (i.e. passive movements) and the other side to receive no intervention (i.e. control).