ANZCTR search results

The hypothesis (based of the previous literature) of the study that obese patients should receive higher prophylactic anticoagulant doses. Therfore, the purpose of the study was to evaluate drug dosing practice of prophylactic anticoagulants in obese patients who underwent gastric band surgery and to look at the clinical outcomes (venous thromboembolism and major bleed). .

It is unknown whether knowing a diagnosis of PCOS encourages women to engage in recommended preventative activities for associated long-term implications, such as a healthy diet and exercise, and if this is more effective than giving advice regarding weight gain on its own. If genetic explanations for PCOS reduce personal agency/self-control and induce doubt about the effectiveness of non-biomedical treatments (lifestyle), this could have significant negative consequences. It is vital the potential impact of a PCOS diagnosis on lifestyle behaviours is explored. The aim of this study are threefold: - What is the effect of the PCOS label on intention to eat healthier compared to a weight label? - How does the PCOS label influence perceived personal control of weight compared to a weight label? - Does this differ depending on whether an environmental or genetic explanation is given?

Current cardiac arrest algorithms require assessment of the return of spontaneous circulation (ROSC) following rhythm checks by observation for patient movement or spontaneous respirations, both of which may be absent in sedated and paralysed patients. Healthcare professionals may also check for a pulse in the presence of an organized rhythm, however manual pulse checks have been demonstrated to be unreliable, even when performed by health professionals. There have been two papers published from St George Hospital (Sydney) related to the use of ultrasound (US) of central pulses and whether they may be an alternative to manual pulse checks. The first was a case report where US of the femoral artery demonstrated ROSC and guided subsequent resuscitation, following cardiac arrest in a patient where manual pulses were absent. The second was an investigation into the inter-rater reliability of carotid US in detecting the return of a pulse, using cardiac surgery patients coming off bypass (where they go from no-pulse to a pulse). This showed a high intraclass correlation (0.86) for two-dimension (2D) ultrasound when detecting the return of a pulse. This current study seeks to extend on these previous efforts by assessing the validity of carotid US in detecting the presence/absence of a pulse. We hope to use cardiac surgery patients as a human model for the presence and absence of a pulse by obtaining 2D US of the carotid arteries when not on bypass (when there is a pulse), and on bypass (when a pulse is not present). We will then present these videos to critical care physicians who are familiar with US and would be likely to perform an US in a cardiac arrest. We will assess the validity using diagnostic test criteria for subgroups of MAP, and the cohort as a whole. Our gold standard will be presence or absence of a pulsatile waveform on the participants radial artery pressure monitoring.

The aim of PATRIC Clinical Registry is to develop improved evidence-based treatment of Acute Respiratory Infections (ARI), the most common reason that children attend the emergency department (ED) for care. The data collected by the PATRIC Clinical Registry will evaluate current treatments for ARI in a variety of patient groups and provide a platform the PATRIC Clinical Trial that will test various interventions in ARI treatment and management. The PATRIC Clinical Registry will recruit parents and children from the Emergency Department at Perth Children's Hospital (PCH) utilising an informative video and e-consent form. The informative video and e-consent are accessed via a study iPad. A baseline survey immediately follows completion of e-consent with a link sent to the parent's smartphone that can be completed later, if necessary. Following this, engagement with parents will continue with weekly follow-up e-surveys until Day 28, unless they report their child is no longer sick or choose to withdraw from the study.

This project aims to see whether hyperbaric oxygen therapy (HBOT) after debridement and skin grafting of a diabetic lower limb burn improves healing. Diabetic lower limb burns are very common - a recent audit performed in our service revealed 35 such injuries over the past 18 months, 75% of which required debridement and skin grafting. It also identified that these patient stay on average 2.5 times longer in hospital than our normal average length of stay. In addition a third require a second operation and due to poor healing 23% proceeded to some form of amputation. Hyperbaric oxygen therapy has been used increasingly to assist with healing of complex and chronic wounds, however robust evidence for its use, particularly in burns, is still lacking. At Fiona Stanley Hospital we have a HBOT unit and are the adult tertiary referral service for burn injuries. We therefore propose to perform a double blind randomised controlled trial looking at diabetic lower limb burns which required debridement and skin grafting. All diabetic patients with deep lower limb burns would be considered for the trial and would have debridement, skin grafting and VAC therapy within 72 hours of presentation to our service. Immediately post-operatively they would be randomised to receive either HBOT post-operatively OR sham HBOT. These treatments would be delivered daily for 2-4 weeks. After the treatment or sham treatment, the patient would receive standard care for all wounds. At 4 weeks the wounds would be assessed by a clinician blinded to treatment to assess the percentage healing of the wound, using a camera to map the area of the healed/unhealed area of wound to form a ratio. At 3, 6 and 12 months the wounds would be assessed for healing, time in dressings, episodes of breakdown, requirements for secondary surgery and QoL

This study is testing a new cancer treatment, atezolizumab, given in combination with standard chemotherapy (paclitaxel and carboplatin) for endometrial cancer. Who is it for? You may be eligible to join this study if you are a woman aged 18 years or above, with advanced endometrial cancer or endometrial cancer recurrence. Study details Patients will be randomly allocated to one of two groups, Group 1 or Group 2. Group 1 One third of participants will receive paclitaxel and carboplatin administered intravenously (through a fine needle directly into a vein in your arm or through an infusion port if you have one) every 3 weeks for 6-8 cycles or until treatment no longer seems to be controlling your cancer, whichever comes first. In addition, a placebo will be given via a vein every 3 weeks, until the treatment no longer controls the participants cancer. A placebo is a medication with no active ingredients that is identical in appearance to the real medication. Group 2 Two thirds of participants will receive of paclitaxel and carboplatin administered intravenously (through a fine needle directly into a vein in your arm or through an infusion port if you have one) every 3 weeks for 6-8 cycles or until treatment no longer seems to be controlling your cancer, whichever comes first. In addition, atezolizumab will be given via a vein every 3 weeks, until the treatment no longer controls the participants cancer. The purpose of this study is to measure the effect of atezolizumab given in combination with paclitaxel and carboplatin and placebo given in combination with paclitaxel and carboplatin. This study will also investigate the activity of this treatment on the control of cancer growth.

The monitoring of blood volume status in patients requiring advanced monitoring in the operating theatres or the intensive care unit is fundamental to patient protection and treatment. However, it is currently difficult and only partly addressed by the use invasive monitoring devices. The development of new technique called peripheral intravenous volume analysis (PIVA) has recently been shown in animal experiments and dialysis patients to provide a continuous, reliable, reproducible, safe, and non-invasive assessment of blood volume state. The monitor then does mathematical modifications of the pressure waves to calculate a blood volume signal. Then it displays such information about the pressure generated by the volume of blood in the veins to the treating doctor. Finally, the monitor allows the collection of such pressure information every minute, which can then be used for detailed analysis. In this study, we simply want to connect this device to the existing drip line in a group of patients having major surgery or admitted to ICU for advanced haemodynamic monitoring. The aim of this study is to see if the PIVA monitoring delivers similar information to that which we currently obtain with more invasive, more expensive, and more complex technology. Moreover, we aim to ask clinicians whether easy to use; and achieves the reliable delivery of good quality data. Finally, we wish to see if all these aspects of PIVA prove correct, as we will then seek approval to conduct further and more advances studies of PIVA.

The aims of the PPOIT-003 randomised trial was to evaluate if Probiotic and Peanut Oral Immunotherapy (PPOIT) is more effective than placebo in inducing sustained unresponsiveness (SU) in children with peanut allergy, and more effective than peanut OIT alone, in inducing SU in children with peanut allergy. This is a follow-on study for all participants who complete the PPOIT-003 randomised trial in order to evaluate whether the beneficial effects of PPOIT (at inducing sustained unresponsiveness or desensitization) are maintained out to 72 months post treatment.

Early and regular ingestion of the common allergens, peanut and egg has been shown to be an effective allergy prevention strategy. Little is known about tree nut allergy. Current allergy testing methods are indicative of IgE sensitisation only and are not diagnostic of food allergy. Current practice at RCH allergy clinic in children who are egg and/or peanut allergic is to advise families to introduce each individual tree nut into their child’s diet via a cautious home introduction protocol without prior allergy testing (screening). The safety and effectiveness of this strategy has not been formally evaluated. This pilot study is a 2-armed, open-label, randomised, controlled trial (RCT) to assess the safety and feasibility of a supervised hospital based multi-tree nut oral food challenge (OFC) versus standard care (home introduction of individual tree nuts) in infants with egg and/or peanut allergy to reduce the risk of developing tree nut allergy.

This study will investigate the effects of regular and premium grade beef mince consumption on indicators of metabolic and gut health in healthy human participants. The specific aims of this study will determine the effects of two, 1-week intervention periods on either regular or premium grade beef mince consumed at in low (65g /day) and high (130g/day) amounts. The specific aims of the study will seek to determine the metabolic and gut response to red meat as part of the habitual diet in free living healthy adults; and how the quantity (serving size) and quality (fat content) of red meat mediates these responses. By answering these questions the study will aim to generate clinically relevant results and knowledge.