Randomised Controlled Trials Of Laparoscopic Techniques For Antireflux Surgery
Funder
National Health and Medical Research Council
Funding Amount
$275,923.00
Summary
Gastro-oesophageal reflux is common, and over the last decade there has been an exponential rise in the usage of acid suppressing medication. Current trends suggest that the national cost of medical treatment of reflux will become unaffordable unless new management or preventative strategies can be developed. Presently, surgery is the only treatment which can cure reflux. Laparoscopic fundoplication has recently become an acceptable, low morbidity keyhole surgical treatment for this problem. How ....Gastro-oesophageal reflux is common, and over the last decade there has been an exponential rise in the usage of acid suppressing medication. Current trends suggest that the national cost of medical treatment of reflux will become unaffordable unless new management or preventative strategies can be developed. Presently, surgery is the only treatment which can cure reflux. Laparoscopic fundoplication has recently become an acceptable, low morbidity keyhole surgical treatment for this problem. However, research is essential to develop a procedure which optimizes the outcome for patients undergoing surgical management of reflux, and minimizes the risk of complications. This may provide a better alternative to long term management with acid suppressing medication, and could eventually achieve long term savings to the nation's health budget. Since 1994 research conducted at the Royal Adelaide Hospital has evaluated a range of different key hole operations aimed at improving the outcome for patients undergoing surgery for gastro-oesophageal reflux. Over 100 patients have been entered into each of the following clinical trials: total fundoplication with or without division of the short gastric vessels, total versus anterior partial fundoplication and posterior or anterior hiatal repair. Further trials will compare a lesser degree of anterior partial fundoplication with total fundoplication. A common research protocol has been developed and applied to all of these trials. This involves the use of double blind randomised methodology, with independent follow-up obtained by an independent investigator. These trials will determine the best surgical technique for the surgical correction of reflux, and this should lead to a more widely accepted surgical alternative to existing non-operative strategies for pathological reflux.Read moreRead less
About 1 in 10 Australians have persisting or chronic low back pain. Most are managed in primary care and the most frequently prescribed treatment is exercise. Chronic low back pain remains a major health problem because not all patients respond to each treatment so on average treatment effects are small. At present there are no guidelines to help clinicians select the best treatment for a patient. As a result a lot of time and money is wasted on treatments which ultimately fail to help the patie ....About 1 in 10 Australians have persisting or chronic low back pain. Most are managed in primary care and the most frequently prescribed treatment is exercise. Chronic low back pain remains a major health problem because not all patients respond to each treatment so on average treatment effects are small. At present there are no guidelines to help clinicians select the best treatment for a patient. As a result a lot of time and money is wasted on treatments which ultimately fail to help the patient. We have begun a research program to solve this primary health care problem. We have focussed on exercise because the treatment is widely available in primary care and of modest cost. The program includes basic research to understand the mechanism of action of exercise and clinical trials testing the effectiveness of different types of exercise. The proposed study falls into the latter category, and is a direct comparison of the two most promising types of exercise used in Australia. The study will also identify clinical features that modify treatment effects, a finding that will allow clinicians to identify which type of exercise is more likely to be effective for an individual patient. This study offers a potential solution to a major health problem with enormous economic and social costs.Read moreRead less
The Effect Of High-dose Vitamin-D Supplementation On Mental Health In A Randomised, Controlled Trial Of 1500 Older Women
Funder
National Health and Medical Research Council
Funding Amount
$81,965.00
Summary
Vitamin D is commonly deficient in Western populations, more so in the winter months and in the elderly. A link between depression and vitamin D insufficiency may exist. This study aims to see if vitamin-D supplementation is a practical health intervention for depressive symptoms and may define a public health strategy. In this study participants receive a dose of vitamin D3 or placebo annually for three years. Self-rated psychiatric assessments are administered.