ANZCTR search results

The study hypothesizes it's feasible and effective to use intensive BP-lowering to reduce AF burden. In this pilot study of 60 patients with non-permanent AF who have a baseline BP >130/80, we aim to examine whether patients randomized to intensive BP-lowering in addition to usual care will have reduced AF burden as measured by continuous cardiac monitoring using an implanted device. Intensive BP-lowering will be achieved by randomizing patients to the quadpill (single pill with irbesartan 37.5 mg, amlodipine 1.25 mg, indapamide 0.625 mg, and bisoprolol 2.5 mg) or to placebo on top of usual care.

The purpose of this study is to assess whether early unclamping during robot assisted partial nephrectomy surgery for kidney cancer is superior to regular clamping in maintaining renal function 6 months after surgery Who is it for? You may be eligible for this study if you are aged at least 18 years and are undergoing a partial nephrectomy for kidney cancer with one of the participating surgeons involved in this study. Study details Participants in this study will be randomised (by chance) into two groups. Both groups will have urine and blood tests, a CT-scan and a DTPA renal scan before surgery. Both groups will then undergo their planed partial nephrectomy procedure. One group will have their renal blood vessels unclamped at the regular (standard) time during the procedure, and the other group will have their renal blood vessels unclamped slightly earlier during the procedure. All participants will have repeat blood and urine tests at 6 timepoints over the 2 years following their surgery, and a repeat CT-scan and DTPA-scan at 6 months after their surgery. It is intended that this study will help to find out which clamping technique (regular or early unclamping) is better for maintaining kidney function after partial nephrectomy surgery.

We are investigating how Atrial Fibrillation (AF), a common heart rhythm disorder, disrupts normal cardiovascular reflexes by affecting nerves from the heart. Whilst it is known that nerves leading to the heart can cause AF, we aim to study whether nerves arising from the heart are equally implicated, in order to provide information that can be used to offer targeted treatment using these nerves. Hypotheses: 1. Patients with Atrial Fibrillation (AF) have abnormal cardiovascular reflexes; likely arising from dysfunction of sensory nerves arising from the heart (cardiopulmonary receptors). 2. These abnormal reflexes are more severe in patients with Permanent AF compared to paroxysmal AF and treatment of AF results in improvement of cardiac reflexes. 3. Autonomic dysfunction parallels disease progression; therefore the nerves of the heart may represent a therapeutic target in the management of AF. We aim to characterise cardiovascular reflex function in detail of patients with AF with a minimally- invasive protocol designed to evaluate the normal function of the heart to maintain blood pressure in response to changes in blood volume (simulated by gently creating a vacuum seal around the legs; negative pressure and raising the legs passively; returning blood to the heart). We shall measure blood pressure, heart rate and do a blood test to measure hormones involved in blood pressure control. We shall also use a painless stimulator of the nerve leading from the heart (using a clip that attaches to the tragus of the ear), thereby bypassing the heart nerves on the way to the brain in order to confirm that any abnormality seen is due to the nerves within the heart rather than elsewhere). In a subset of patients, we shall insert a small needle (similar to acupuncture) to directly measure nerve activity in the forearm during reflex testing.

We will recruit 120 women with singleton pregnancies without cardiac abnormalities from 28 weeks gestation to term. Each participant will undergo a NI-FECG recording session with concurrently recorded CTG and tocodynamometer to ascertain a gold standard for the fetal heart activity and uterine activity.

D-mannose is a carbohydrate and important in the metabolism of some proteins within the human body. It has been shown to prevent the adherence of E-coli bacteria to the uroepithelial lining found in the bladder. This is important because E coli is the most common pathogen responsible for urinary tract infections. D-mannose has also been shown to be useful in reducing the bacteriuria (bacteria in the urine) in animal studies and is used in equine veterinarian practices for this purpose. Previous studies using D-mannose as a preventative measure against UTI have been promising. However, none have examined the effect in patients with diabetes mellitus or the elderly patient, who frequently have recurrent and resistant strains of E-coli in their urine. Therefore the aim of this study is to measure the effectiveness of D-Mannose in reducing the development of full urinary tract infection in those high risk patients who experience recurrent urinary tract infection. The study will be a double blind randomised trial with the primary outcome examining the percentage of patients developing a UTI during the study period. It will be conducted over a 24 week period.

There are many factors which are thought to contribute to the ability to maintain good brain health, including genetics, psychosocial and environmental factors. In addition, recent research has indicated that it may be possible to induce, or promote, brain health using non-invasive brain stimulation - namely transcranial Alternating Current Stimulation (tACS). Therefore, the purpose of this project is to investigate brain activity that is related to cognitive performance (i.e. thinking skills) in people with mild cognitive impairment. We will conduct these investigations a number of times over a three-year period to allow us to look at any changes that may occur in brain activity and cognitive performance. We will also be looking at any psychosocial and environmental factors that might contribute to changes in brain activity and cognitive performance. Finally, we will also investigate the effects of tACS on brain activity and cognition over the same period of time. Overall, this project aims to help provide a better understanding of the reasons why some people with MCI go on to develop Alzheimer’s, whilst others do not, and ultimately help in the development of early intervention treatments for Alzheimer’s disease. It is hypothesised that participants receiving active treatment will improve cognitive function, enhance brain activity, and strengthen functional brain connectivity after each yearly treatment course compared to those who undergo sham treatment. It is also hypothesised that there will be a lower conversion from MCI to Alzheimer’s disease in individuals receiving the active treatment over the three-year period, compared to those receiving the sham treatment. Finally, it is hypothesised that biopsychosocial factors will influence pathophysiological changes in people with MCI over time.

Disturbances of sleep occur frequently in the critically ill. Much less is known as to whether sleep disturbance is acute and resolves as patients recover, or is an issue that persists after hospital discharge and continues to adversely affect patients. Studies using patient subjective assessment suggest that sleep disturbances persist. However, only 28 patients in total (3 studies) have used objective measures (e.g. polysomnography) in ICU survivors to measure sleep, and in none of these three studies were measurements taken in ICU or hospital. This study will provide novel data as it will be the first comprehensive and objective longitudinal assessment of sleep disturbances in patients admitted to ICU. This inception cohort study will determine feasibility of objectively and subjectively measuring sleep, provide estimates of the proportion of long-stay ICU patients who have a new sleep disorder and evaluate whether sleep changes over time during critical illness and recovery.

This project is designed to determine if specific genetic sub-groups associated with metabolic disease risk benefit from a Mediterranean diet. This research may lead to personalised nutrition recommendations using genomic information to promote health. The aims of the proposed project are to: (i) Determine the influence of an 8-week Mediterranean dietary intervention on gut bacteria, levels of metabolites (involved in glucose, fat and protein metabolism) present in blood, and gene modifiers (whether genes are turned on or off) in blood. This will be compared to a person’s habitual diet (baseline results) and a general healthy eating diet following The Australian Guide to Healthy Eating (control diet). (ii) Determine the potential of key genetic variants related to metabolic disease (including the Fat Mass and Obesity-Associated (FTO) gene, Transcription Factor 7-Like 2 (TCF7L2) gene, and Apolipoprotein E (APOE) gene) to influence gut bacteria, blood metabolite and gene modifying outcomes in response to the dietary interventions. (iii) Determine whether differences between genetic variants exist for body composition, key hormones (ghrelin and insulin), glucose tolerance, and dietary intake (food frequency and nutrient composition) in response to the dietary interventions. It is hypothesized that variations in key genes associated with metabolic disease impacts on gut bacteria, blood metabolites and gene modifiers following an 8-week Mediterranean dietary intervention.

Acute adenoviral conjunctivitis is a highly contagious, widespread endemic disease associated with frequent outbreaks, significant patient discomfort, lost productivity, and in some cases permanent visual compromise from long-term immune mediated sequelae. OKG-0301 is a novel ophthalmic solution with a potent ribonuclease that has broad-spectrum antiviral properties relevant for the treatment of acute adenoviral conjunctivitis. This randomized, double masked, multi-center Phase 2 study is being conducted entirely within Australia and is designed to support the safety and efficacy of OKG-0301 for the treatment of acute adenoviral conjunctivitis. The study intends to show superiority of OKG-0301 Ophthalmic Solution compared to vehicle for the primary efficacy endpoint of mean change from baseline in viral titre in patients with acute adenoviral conjunctivitis. Secondary efficacy endpoints including adenoviral eradication, clinical cure of acute adenoviral conjunctivitis, subepithelial infiltrates, other clinical signs and symptoms, and rate of cross-over infection to the other eye will also be assessed. Safety will also be evaluated.

Although impaired cardiac function initiates the syndrome, subsequent skeletal muscle and vascular abnormalities are major determinant of functional capacity and quality of life in the heart failure (HF) syndrome. Exercise based rehabilitation is a cornerstone of HF therapy. Improvements in functional capacity resulting from exercise training predict prognosis, enhance quality of life, and reduces frailty and hospitalizations. An impediment to exercise rehabilitation for heart failure patients is the early physical deconditioning which is a trademark characteristic of this patient group which can limit classical aerobic and concentric strengthening exercise prescription. The current project aims to trial a new form of exercise, utilising eccentric muscular contractions, which have unique characteristics that allows for peripheral (muscular) gains at lower oxygen consumption and promisingly suggests enhanced functional benefits at lower cardiovascular risk.