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Clinical trialls

Martin J Gillies, Paul C Lyon, Feng Wu, Tom Leslie, Daniel Y Chung, Fergus Gleeson, David Cranston, Stana Bojanic
High-intensity focused ultrasound describes the use of high-intensity focused ultrasound (HIFU) to ablate tumours without requiring an incision or other invasive procedure. This technique has been trialled on a range of tumours including uterine fibroids, prostate, liver and renal cancer. We describe our experience of using HIFU to ablate sacral chordoma in four patients with advanced tumours. Patients were treated under general anaesthetic or sedation using an ultrasound-guided HIFU device. HIFU therapy was associated with a reduction in tumour volume over time in three patients for whom follow up scans were available...
December 12, 2016: British Journal of Neurosurgery
Weijia Chen, Piers D L Howe
Breast screening is an important tool for the early detection of breast cancers. However, tumours are typically present in less than 1% of mammograms. This low prevalence could cause radiologists to detect fewer tumours than they otherwise would, an issue known as the prevalence effect. The aim of our study was to investigate a novel breast screening protocol, designed to decrease the number of tumours missed by radiologists, without increasing their workload. We ran two laboratory-based experiments to assess the degree to which the novel protocol, called the catch trial (CT) protocol, resulted in greater sensitivity (d') than the double screener protocol (DS), currently utilised in Australia...
2016: PloS One
Elizabeth Craig, Neal Kerr, Gabrielle McDonald
AIM: In New Zealand, there is a paucity of information on children with chronic conditions and disabilities (CCD). One reason is that many are managed in hospital outpatients where diagnostic coding of health-care events does not occur. This study explores the feasibility of coding paediatric outpatient data to provide health planners with information on children with CCD. METHODS: Thirty-seven clinicians from six District Health Boards (DHBs) trialled coding over 12 weeks...
October 7, 2016: Journal of Paediatrics and Child Health
Ravi Gondhalekar, Eyal Dassau, Francis J Doyle
A novel Model Predictive Control (MPC) law for an Artificial Pancreas (AP) to automatically deliver insulin to people with type 1 diabetes is proposed. The MPC law is an enhancement of the authors' zone-MPC approach that has successfully been trialled in-clinic, and targets the safe outpatient deployment of an AP. The MPC law controls blood-glucose levels to a diurnally time-dependent zone, and enforces diurnal, hard input constraints. The main algorithmic novelty is the use of asymmetric input costs in the MPC problem's objective function...
September 2016: Automatica: the Journal of IFAC, the International Federation of Automatic Control
Katharine Reid, David Smallwood, Margo Collins, Ruth Sutherland, Agnes Dodds
BACKGROUND: To ensure the rigour of objective structured clinical examinations (OSCEs) in assessing medical students, medical school educators must educate examiners with a view to standardising examiner assessment behaviour. Delivering OSCE examiner training is a necessary yet challenging part of the OSCE process. A novel approach to implementing training for current and potential OSCE examiners was trialled by delivering large-group education sessions at major teaching hospitals. METHODS: The 'OSCE Roadshow' comprised a short training session delivered in the context of teaching hospital 'Grand Rounds' to current and potential OSCE examiners...
2016: Medical Education Online
Roy Ventura, Chris O'Loughlin, Boris Vavrik
Since the introduction of sutureless securement products for vascular access devices (VADs), there has been a great deal of discussion of their advantages and disadvantages in comparison with sutures. This includes questions related to VAD securement, patients' comfort, infection control, user-friendliness and potential complications of using the device. The literature review of the available evidence indicates the superiority of the novel sutureless devices in the aforementioned aspects. The authors collected data to further contribute in the analysis of the attributes of these products, namely Statlock™ and Grip-Lok™ (current devices)...
July 28, 2016: British Journal of Nursing: BJN
Bernhard T Baune
The aetiology and pathophysiology of depression have long been associated with inflammation, at least in a proportion of patients. Altered cytokine activity in the periphery and in the brain has brought support to a concept of depression-associated inflammation. However, these immunological changes - and inflammation in particular - in depression have only been recently targeted for treatment. Non-steroidal anti-inflammatory drugs (NSAIDs) have been proposed to be of clinical use in the treatment of depression either as monotherapy or as adjuncts in combination with antidepressants...
2017: Current Topics in Behavioral Neurosciences
Lynette Mackenzie
PURPOSE: The HOME FAST was developed and trialled in Australia as a screening tool designed to be used by any health professional to identify older people at increased risk of falls and to facilitate referral for more detailed assessment and intervention. This study aimed to evaluate the clinical utility of the HOME FAST from the perspective of users. METHOD: A mixed-methods approach using survey data (n = 32), focus group data (n = 46) and interview data (n = 5) from occupational therapists, physiotherapists, community nurses and other health professionals working in hospitals, community services and private practice, located in the UK, Canada and Australia...
July 6, 2016: Disability and Rehabilitation
Jason G Kettle, David M Wilson
Sir James Black famously said: 'The most fruitful basis of the discovery of a new drug is to start with an old drug', and this idea has featured in a significant number of kinase drug discovery programmes at AstraZeneca over the past two decades. Of the marketed kinase inhibitors and various clinically trialled agents, candidate drugs and multiple lead optimisation programmes delivered over this timeframe at AstraZeneca the overwhelming majority trace their origins back to a small handful of pioneering drug discovery programmes...
June 15, 2016: Drug Discovery Today
Yu-Ichi Noto, Kazumoto Shibuya, Steve Vucic, Matthew C Kiernan
INTRODUCTION: Motor neuron hyperexcitability appears linked to the process of neurodegeneration in amyotrophic lateral sclerosis (ALS). As such, therapies that inhibit neuronal hyperexcitability may prove effective in arresting the progression of ALS. AREA COVERED: We searched MEDLINE and and selected randomised controlled trials that covered neuroprotective therapy. Riluzole has been established to reduce neuronal hyperexcitability. More recently, initial studies of Na(+) channel blockers (mexiletine and flecainide) have been trialled...
October 2016: Expert Review of Neurotherapeutics
Weiliang Chong, Ronny Ban Wei Tan
Peyronie's disease is a disfiguring and psychologically devastating disease, which continues to pose a significant clinical conundrum to the attending doctor. Many forms of therapy have been trialled but results have been inconsistent at best. Non-surgical therapy revolves around oral, intralesional and shockwave therapies. The focus of this paper is on intralesional agents, their evolution and efficacy of treatments. The mere fact that so many agents have been tried is a testament to the incomplete knowledge that we have with regards to the underlying pathophysiology of the disease...
June 2016: Translational Andrology and Urology
Melad Farraha, James J H Chong, Eddy Kizana
Atrial Fibrillation (AF) is one of the most common types of cardiac arrhythmias experienced in clinical practice, increasing the risk of stroke, dementia, myocardial infarction and death. Currently available options for the treatment of AF use either pharmacological agents or catheter-based ablation therapies to restore sinus rhythm or control the ventricular response rate. These current treatment options are suboptimal at best, motivating research into discovering more effective and innovative ways to treat AF...
August 2016: Heart, Lung & Circulation
Stephen Parker, Frances Dark, Ellie Newman, Nicole Korman, Carla Meurk, Dan Siskind, Meredith Harris
BACKGROUND: A novel staffing model integrating peer support workers and clinical staff within a unified team is being trialled at community based residential rehabilitation units in Australia. A mixed-methods protocol for the longitudinal evaluation of the outcomes, expectations and experiences of care by consumers and staff under this staffing model in two units will be compared to one unit operating a traditional clinical staffing. The study is unique with regards to the context, the longitudinal approach and consideration of multiple stakeholder perspectives...
2016: BMC Psychiatry
Ahmed Sivardeen, Deborah Laughton, James S Wolffsohn
PURPOSE: To determine the utility of a range of clinical and non-clinical indicators to aid the initial selection of the optimum presbyopic contact lens. In addition, to assess whether lens preference was influenced by the visual performance compared to the other designs trialled (intra-subject) or compared to participants who preferred other designs (inter-subject). METHODS: A double-masked randomised crossover trial of Air Optix Aqua multifocal, PureVision 2 for Presbyopia, Acuvue OASYS for Presbyopia, Biofinity multifocal and monovision was conducted on 35 presbyopes (54...
October 2016: Contact Lens & Anterior Eye: the Journal of the British Contact Lens Association
Alasdair N Warwick, Fatima Shawkat, Andrew J Lotery
BACKGROUND: Autosomal dominant cone-rod dystrophy 7 (CORD7) has been previously associated with the RIM1 c.2459G>A (Arg820His) mutation. Cystoid macular oedema (CMO) is a rare feature of CORD and has not been described in CORD7. We report a patient who was heterozygous for the RIM1 mutation with bilateral CMO and who manifested a retinitis pigmentosa phenotype. MATERIALS AND METHODS: The patient's medical notes were retrospectively reviewed over an 18-month period...
May 13, 2016: Ophthalmic Genetics
Caroline E Gargett, Shanti Gurung
No abstract text is available yet for this article.
June 2016: Biology of Reproduction
Apostolos Papandreou, Paul Gissen
Niemann-Pick type C (NP-C) disease is a neurovisceral disorder caused by mutations in the NPC1 and NPC2 genes. It is characterized by lysosomal storage of a broad range of lipids as a result of abnormal intracellular lipid trafficking. Typically patients develop neurodegeneration; however, the speed of disease progression is variable. The exact functions of NPC1 and NPC2 proteins have not been determined and therefore the molecular pathophysiology of NP-C is still not clearly understood. Due to the disease's rarity and clinical heterogeneity, delays from symptom onset to diagnosis and treatment initiation are common...
May 2016: Therapeutic Advances in Neurological Disorders
Doug Elliott, Emily Allen, Sharon McKinley, Lin Perry, Christine Duffield, Margaret Fry, Robyn Gallagher, Rick Iedema, Michael Roche
AIMS AND OBJECTIVES: To examine user acceptance with a new format of charts for recording observations and as a prompt for responding to episodes of clinical deterioration in adult medical-surgical patients. BACKGROUND: Improving recognition and response to clinical deterioration remains a challenge for acute healthcare institutions globally. Five chart templates were developed in Australia, combining human factors design principles with a track and trigger system for escalation of care...
August 2016: Journal of Clinical Nursing
Eva O Melin, Ralph Svensson, Sven-Åke Gustavsson, Agneta Winberg, Ewa Denward-Olah, Mona Landin-Olsson, Hans O Thulesius
BACKGROUND: Depression is linked with alexithymia, anxiety, high HbA1c concentrations, disturbances of cortisol secretion, increased prevalence of diabetes complications and all-cause mortality. The psycho-educational method 'affect school with script analysis' and the mind-body therapy 'basic body awareness treatment' will be trialled in patients with diabetes, high HbA1c concentrations and psychological symptoms. The primary outcome measure is change in symptoms of depression. Secondary outcome measures are changes in HbA1c concentrations, midnight salivary cortisol concentration, symptoms of alexithymia, anxiety, self-image measures, use of antidepressants, incidence of diabetes complications and mortality...
April 27, 2016: Trials
Mark Wainwright, Ciara O'Kane, Sophie Rawthore
The phenothiazinium derivative toluidine blue O (TBO) is widely employed as a photoantimicrobial agent in clinical trialling, particularly in dentistry. However, its activity against a range of pathogenic microbial species is not significantly different to that of the standard photoantimicrobial methylene blue. In the current study, derivatives of TBO with varying hydrocarbon substitution in chromophore position 2 were synthesised via the established anilinethiosulphonic route, using the mild oxidant silver(II) carbonate to allow substituent preservation...
July 2016: Journal of Photochemistry and Photobiology. B, Biology
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