ANZCTR search results

Liver transplant recipients are at high risk of antibiotic-resistant bacterial and fungal infections after transplant. In patients who are colonised with antibiotic-resistant superbugs, this study will test whether it is safe, feasible, and effective to adjust the antibiotics given at the time of liver transplant surgery to cover these superbugs, instead of following a “one-size-fits-all” approach where all patients receive the same antibiotics, regardless of whether they carry superbugs. In patients who are not colonised with antibiotic-resistant superbugs and are started on antifungal medications, this study will also test whether it is safe, feasible, and effective to give a fixed duration (five days) of antifungals compared to a clinician-guided duration after a minimum of five days. This is a small, early-stage study. The primary aim is to assess whether this type of study is feasible, including whether enough patients can be recruited, whether the study procedures can be carried out as planned, and whether sufficient high-quality data can be collected. In addition, two optional substudies will be undertaken at Austin Health and will be available only to participants enrolled at this site. The first will investigate the pharmacokinetic-pharmacodynamic properties of perioperative antimicrobial prophylaxis during liver transplantation. The second will evaluate longitudinal changes in the microbiome during the first 90 days following liver transplantation. The outcomes for the substudies will not be described as these are exploratory and specific to one site.

There is evidence that the deepest form of sleep, slow wave sleep, may be a critical target for maintaining cognitive function and reducing the risk of developing Alzheimer’s disease. One way deep sleep may affect the risk of Alzheimer’s disease risk is by helping the brain and body clear out chemicals. We aim to test whether improving deep sleep using an at home EEG device helps with this clearance, and explore what health and lifestyles factors might influence the results, including brain toxin and volume level as measured using MR-PET scans..

This is an observational study, where we will use a catheter pre- and post-coronary procedures to look for damage to the radial artery caused by trans-radial access. The primary hypothesis is that the radial artery sheath protect the radial artery from spasm and radial artery injuries, and looking at the distribution of injuries along the artery before and after the procedure will allow us to investigate this and guide strategies to protect patients (potential surgical candidates) at higher risk of radial artery injury. We will also study demographic data to help identify these patients that are more susceptible to injury.

To create scalable solutions for the growing number of people living with dementia, we developed MATCH. MATCH is an eHealth solution – Music Attuned Technology for Care via eHealth – developed to support care staff to use music intentionally to support care with people with dementia. The MATCH App has been developed for home and professional care (RAC/hospital) settings, and preliminary trials have been conducted in Victoria, South Australia, and Western Australia. MATCHplus integrates the MATCH App with a bespoke agitation detection system via wearable sensors and an AI-based music recommender system. In this study we will recruit across different professional care settings to: a) Assess the feasibility of implementing MATCH in dementia care in different professional aged care settings; b) Understand the impact of using MATCH Strategies during care on their job satisfaction and care outcomes using self-reported data from care staff; c) Collect data via clinical assessment tools to understand the impact of using MATCH Strategies during personal care and in moments of agitation on neuropsychiatric symptoms of dementia; d) Explore the feasibility, acceptability and utility of the MATCH agitation detection and prediction system; e) Explore the feasibility, acceptability and utility of the MATCH music recommender system for suggesting appropriate individualised music; f) Understand care staff experiences of using MATCH Strategies during care using post-trial interviews; and g) Understand nursing (registered nurse/nurse-in-charge) and management perspectives on the acceptability and utility of implementing MATCH in their professional care setting using post-trial interviews.

The administration of furosemide (a diuretic drug designed to increase production of urine) has been shown to predict a critically ill patient's requirement for dialysis (CRRT). This has been termed the frusemide stress test (FST). Critically ill patients often require dialysis in ICU for severe injury to the kidneys. There is a large amount of evidence around when to start, however there is little to guide clinicians on when the optimal time to stop dialysis is. This is important as whilst dialysis may be life saving, once the kidneys have started to recover it can result in harm. We aim to seek the proportion of patients who respond to the FST and identify whether a future randomised trial to aid clinicians in stopping dialysis at an appropriate time is feasible.

Acute kidney injury (AKI) is a frequent and serious complication after cardiac surgery. Current diagnostic methods rely on blood tests and urine output, which often detect AKI only after significant kidney damage has occurred. This prospective cohort study will assess whether the urine albumin-to-creatinine ratio (uACR), a simple and inexpensive urine test, can predict AKI earlier. We will enroll 200 adult patients undergoing cardiac surgery at Austin Hospital. Urine samples will be collected at three time points: before surgery, at admission to the intensive care unit, and the following morning. Our hypothesis is that patients with rising uACR after surgery will have a higher risk of developing acute kidney injury. Early identification could allow timely preventive strategies and improve patient outcomes.

The AQUA Pilot Trial is testing whether giving hypotonic fluids (such as 5% glucose or enteral free water) helps critically ill patients with ICU-acquired hypernatraemia (high sodium levels) recover faster compared to usual care. Patients will be randomly assigned to receive either a structured hypotonic fluid protocol or standard treatment to determine which approach leads to quicker sodium normalisation. The study hypothesis is that the protocolised administration of hypotonic fluid will result in a shorter time to normal serum sodium levels (equal or less than 145 mmol/L) compared to usual care. This research aims to help doctors develop better treatment strategies for managing hypernatraemia in intensive care patients, potentially improving outcomes and reducing complications. The trial will also assess safety by monitoring glucose levels, electrolyte balance, and other important clinical measures.

This study aims to test a new way to deliver radiation therapy to people with cancer that has spread to their bones to enhance local control of metastatic lesions while maintaining acceptable toxicity profiles. Who is it for? You may be eligible to join this study if you are aged 18 years and older, are with Pathological diagnosis of a solid tumour, no planned change to main medication on the first day of protocol radiotherapy. You must have a imaging confirmed bone metastases, estimated life expectancy greater than 3 months. Study details All participants who meet the eligibility criteria in this study will be given either: once a day for 5 days over 1 week, or once a day for 10 days over 2 weeks (Monday to Friday, with weekends off unless needed). The treatment includes a standard radiation dose to the affected bone area, along with a more focused, higher-dose boost to the main tumour area using advanced imaging. This boost is designed to better target the cancer while protecting healthy tissue. During and after completion of the treatment participants will be assessed for pain response and patient outcomes using questionnaires, fractures using imaging, and need for reirradiation and salvage surgery to treatment sites through clinical follow-up and medical record review. It is hoped that this research project will help determine if this combined approach is safe, effective, and practical to deliver in routine care to improve pain relief and tumour control while keeping side effects low

Non-invasive ventilation (NIV) uses a breathing machine and a mask to help people with sleeping and/or breathing problems. Using NIV at night can reduce tiredness, hospital visits, and improve quality of life. In this research study, people with sleep and breathing problems who are having difficulties with using their non-invasive ventilation (NIV) will be randomly allocated to one of three groups: 1) night time hospital stay to monitor sleep patterns while using NIV; 2) detailed virtual monitoring of sleep patterns while sleeping at home using NIV; 3) basic virtual monitoring of sleep patterns while sleeping at home using NIV. The aim of this research study is to determine if there is a difference between these three ways of monitoring sleep patterns and whether they improve the amount of time people use NIV while sleeping.

People with pulmonary fibrosis (PF) are 70% less active than healthy individuals. Low levels of physical activity increases fatigue and worsens breathlessness and quality of life. Pulmonary rehabilitation is a recommended intervention to improve physical function, breathlessness, and quality of life in people with PF. Finding strategies that prolong the benefits of pulmonary rehabilitation such as improving physical activity are needed. This study will explore whether a physical activity counselling session, combined with using a physical activity tracker can increase physical activity levels and make pulmonary rehabilitation benefits last longer in people with PF.