Fluid resuscitation is widely used in the management of critically ill patients. There are a variety of different fluids available to doctors but there is little evidence regarding how effective they are. One of the most commonly used fluids, a hydroxyethyl starch was recently approved by the TGA for use in Australia. This project aims to compare how effective and safe this fluid is compared to another widely used fluid, saline, for resuscitation of critically ill patients in intensive care.
Multi-centre Randomised Trial Of Early Decompressive Craniectomy In Patients With Severe Traumatic Brain Injury
Funder
National Health and Medical Research Council
Funding Amount
$490,500.00
Summary
Despite optimal neurosurgical and intensive care therapy, many trauma patients with severe brain injury (typically young males) have very poor long term neurological outcomes. Current knowledge suggests that a key contributor to secondary brain damage which occurs after injury and to poor neurological outcomes is brain swelling and subsequent increase in brain pressure. Present intensive care therapies to control brain pressure are often not effective, and favourable neurological outcomes occur ....Despite optimal neurosurgical and intensive care therapy, many trauma patients with severe brain injury (typically young males) have very poor long term neurological outcomes. Current knowledge suggests that a key contributor to secondary brain damage which occurs after injury and to poor neurological outcomes is brain swelling and subsequent increase in brain pressure. Present intensive care therapies to control brain pressure are often not effective, and favourable neurological outcomes occur in only 20-30% of these patients. Small studies suggest that a surgical operation called decompressive craniectomy (DC) may decrease brain pressure and improve neurological outcomes in these patients. DC involves temporarily surgically removing a piece of skull bone (during the swelling period) and replacing it when the swelling has subsided. DC is done under general anaesthetic in unconscious patients and is used occasionally at present, although due to insufficient research the benefits are controversial. The proposed study is a multi-centre randomised controlled study of best current therapies plus early decompressive craniectomy vs best current therapies alone in selected unconscious patients with severe head injury. The study outcome is patient neurological function measured 6 months after the injury. A study of this type is required before early DC could become a routine therapy in Australia. Next of kin will sign informed consent for the study and then also for the surgery if patients are randomised to surgery. The study will be managed at the Alfred Hospital-Monash University in Melbourne and includes fifteen collaborating ANZ neurotrauma centres over 3.0 years. There are >200 patients in Australia annually in this category with potential for DC to increase favourable outcomes in >40 patients annually. Lifetime costs for these patients with severe disability are > $2.4 million, so there may be substantial economic and social impact.Read moreRead less
Evaluation Of Aspirin And Tranexamic Acid In Coronary Artery Surgery: The ATACAS Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,185,000.00
Summary
This large study will compare two types of drug treatment in 4600 patients undergoing heart surgery, to see whether either can reduce the risk of death or major complications. The complications after surgery we are measuring include heart attack, stroke, lung embolism, bleeding around the heart, breathing failure, kidney failure, major haemorrhage, serious wound infection, and death. The first drug being tested is low-dose aspirin. It is believed that aspirin can reduce the risk of a further hea ....This large study will compare two types of drug treatment in 4600 patients undergoing heart surgery, to see whether either can reduce the risk of death or major complications. The complications after surgery we are measuring include heart attack, stroke, lung embolism, bleeding around the heart, breathing failure, kidney failure, major haemorrhage, serious wound infection, and death. The first drug being tested is low-dose aspirin. It is believed that aspirin can reduce the risk of a further heart attack or stroke in patients with pre-existing heart disease. There is some evidence that aspirin may have similar effects in people undergoing heart surgery, but such use is constrained by a concern that there may be an increased risk of bleeding after surgery. For this reason, most patients having heart surgery are advised to stop their aspirin about one week before surgery. But patients could be missing out on aspirin's beneficial effects. At present, we do not know whether the benefits of aspirin could outweigh the risk of excesive bleeding. The second drug being tested is tranexamic acid. This drug prevents blood clot being broken down at the stitching sites of surgery, and probably reduces the amount of blood loss during and after heart surgery. It is known that use of this drug reduces the need for a blood transfusion. It is possible that this could avoid other more serious complications after surgery. Both of these drugs are being tested individually, but in addition we are testing whether they may have an extra beneficial effect when used together. The study is being done by a partnership of anaesthetitsts and surgeons at more than 20 hospitals around Australia.Read moreRead less
Is Physiotherapy Beneficial For People With Hip Osteoarthritis?
Funder
National Health and Medical Research Council
Funding Amount
$629,508.00
Summary
Hip osteoarthritis (OA) is a chronic joint disease that causes pain and reduced function. There is currently no cure so safe, effective treatments are needed. Physiotherapy plays a role in the management of hip OA but there is little evidence of its effectiveness. This project will determine the effects of a 12 week physiotherapy program on pain and function in 148 people with hip OA. The results will help with recommendations as to the best ways to treat this chronic condition.
Ankylosing spondylitis (AS) is a chronic arthritis which causes severe back and joint pain in young men and women. It can be difficult to diagnose as it takes years to show up on x-ray, and by then the joints are already damaged. This study looks at new ways to diagnose people with AS much earlier, which will allow earlier treatment and better outcomes. The study will also look at the role of lifestyle factors such as diet and physical activity which might impact on AS.
A Novel Approach To The Training Of Functional Standing Following Spinal Cord Injury
Funder
National Health and Medical Research Council
Funding Amount
$412,706.00
Summary
The study will employ a new type of functional electrical stimulation (FES), strength-endurance muscle conditioning and standing training to improve stance in SCI victims with incomplete paralysis. We will evaluate an innovative combination of muscle training and novel FES protocols which allow paralysed people to stand and perform upper limb functional tasks. The primary outcomes will be duration of standing, number of repetitions of standing and sitting and upper limb function while standing.
Molecular Epidemiology Of Ovarian Cancer: The Australian Ovarian Cancer Study National Clinical Follow-Up Core
Funder
National Health and Medical Research Council
Funding Amount
$883,244.00
Summary
Ovarian cancer is the seventh most common cancer in Australian women and fifth most common cause of cancer death, with approximately 1200 new cases diagnosed and 750 deaths each year. There is an urgent need to better understand the molecular, epidemiological and genetic characteristics of epithelial ovarian cancer and how these influence response to treatment and clinical outcome. Ovarian cancer is a histologically and clinically diverse disease and the variability in clinical outcome in ovaria ....Ovarian cancer is the seventh most common cancer in Australian women and fifth most common cause of cancer death, with approximately 1200 new cases diagnosed and 750 deaths each year. There is an urgent need to better understand the molecular, epidemiological and genetic characteristics of epithelial ovarian cancer and how these influence response to treatment and clinical outcome. Ovarian cancer is a histologically and clinically diverse disease and the variability in clinical outcome in ovarian cancer patients suggests that reliable predictive factors would be of clinical value. However, it is clear that the collection of hundreds of annotated biospecimens is essential if the interaction of genes and environment in the genesis of this disease is to be understood or the molecular features of this disease dissected. Recognizing that this can only be achieved through large-scale collaboration, the Australian Ovarian Cancer Study (AOCS) was established in 2000 by scientists from the Peter MacCallum Cancer Centre, the Queensland Institute for Medical Research, Melbourne University and Westmead Institute for Cancer Research in collaboration with clinicians across Australia. AOCS has recruited 1105 patients to date and this Research Proposal aims to complete the collection of clinical data on all AOCS patients nationally, to validate the use of microarray gene expression profiles to predict clinical outcome and to find genetic variants that may determine clinical outcome in individual patients. The creation of AOCS has provided a unique oportunity to collect one of the finest ovarian cancer biological sample sets in the world. We believe that this internationally significant study will shed light on the basis of response of ovarian cancer to treatment and provide an ongoing resource for research into the causes of ovarian cancer, and studies on the response to treatment.Read moreRead less