ANZCTR search results

A difference in leg length is an important concern for some patients following total hip replacement, but measurements on medical imaging do not always reflect what patients actually feel. This prospective study will follow adults undergoing primary total hip replacement and compare measurements of leg length, pelvic alignment and hip reconstruction on medical imaging with whether patients perceive a difference in their leg lengths after surgery. Participants will complete questionnaires before surgery and during follow-up, and imaging measurements will be collected before and after surgery. We hypothesise that greater radiographic leg-length imbalance will be associated with a greater likelihood of patients perceiving a leg-length difference at 12 months. The study aims to identify which measurements best reflect patients' perception of leg length and may help improve assessment and management of leg-length discrepancy after total hip replacement.

This study will offer patients that had open heart surgery and their family members a genetic test to investigate their high cholesterol and improve their treatment. We are hoping to evaluate how effective this strategy is for identifying patients with a genetic condition so that they can be offered treatment and enrolment in a registry.

Cardiovascular disease (CVD) remains a leading cause of death and there is a need to better understand modifiable risk factors, such as a dysfunctional autonomic nervous system (ANS). Preliminary data suggest there may be a difference in the size of the coeliac ganglia (CG) in people with prevalent hypertension and CVD, suggesting that CG size may be an indicator of a dysfunctional ANS. We propose that measuring the CG size by MRI imaging may be a non-invasive technique for understanding a person’s chronic exposure to a dysfunctional ANS. Furthermore, we propose that a molecular imaging technique, using Gallium-68 prostate-specific membrane antigen positron emission tomography (Ga-68 PSMA PET) imaging, can identify glutamate metabolism in the coeliac ganglia and may represent a real-time measure of ANS dysfunction. In this prospective case-control study, we are inviting three groups of people with differing levels of expected ANS dysfunction, to undergo MRI of the abdomen and Ga-68 PSMA PET/CT imaging. Group 1 participants will have resistant hypertension and cardiovascular disease (n=15), group 2 participants essential hypertension (n=15) and group 3 are a control group with no hypertension and no cardiovascular disease (n=15). All participants will also undergo muscle sympathetic nerve activity (MSNA) testing as a gold standard of ANS dysfunction. The study will compare the size of the coeliac ganglia, and glutamate metabolism of the coeliac ganglia, across the three groups and with MSNA measures.

Title: AMLM28-A4. Achieving Durable remissions via Adaptive Pro-survival Targeting in Acute Myeloid Leukaemia (AML)-VEN/AZA/Lasmotinib: A therapeutic arm of the ALLG AMLM28 ADAPT study. Purpose of this trial: This treatment arm is part of the AMLM28 ADAPT “platform” trial, where many treatment options are being explored for participants who are being treated with the standard of care (SOC) drugs Venetoclax (VEN) and Azacitidine (AZA). These participants are being treated with VEN-AZA because intensive chemotherapy is not considered an appropriate treatment option for them. The goal is to find out if adding a new drug, lasmotinib, can help participants live longer without the disease returning or worsening. About 20% of newly diagnosed AML patients will have a gene mutation called FLT3-ITD. FLT3 is a gene that tells blood cells when to grow. FLT3-ITD is a mutation where the FLT3 gene has been duplicated, causing the gene to be permanently switched on and leukaemia cells to grow out of control. Lasmotinib works by blocking this signal, helping to slow the growth of the leukaemia cells and improve disease control. Who is this trial for? You may be eligible for this trial if you are: • A newly diagnosed AML patient enrolled on the AML28 ADAPT trial. • Eligible to receive SOC VEN-AZA treatment • Have an abnormality on a specific gene, FLT3-ITD. • Have been tested for another gene called NPM1. Trial details: A4 treatment arm: There will be 12 cycles of treatment, with each cycle lasting for 28 days. Azacitidine is given either as an injection under the skin or through a vein for 7 days. Venetoclax is taken orally once a day for 21-28 days. This study will begin with a small group of participants (n=12) to find the safest dose of lasmotinib that can be added to SOC VEN-AZA treatment. Lasmotinib is taken orally once a day from day 8-day 28. The study is then expanded to recruit an additional 60 patients for a total of 72 patients in Australia only. Participants will be randomised to either receive SOC VEN-AZA or VEN-AZA with lasmotinib. If a participant is benefiting from treatment and wants to continue treatment past 12 cycles, this can be requested. Participants will be followed up for a year, every 3 months, after they have completed 12 cycles of treatment. Long term follow up data will be captured through the ALLG National Blood Cancer Registry (NBCR). This new approach could lead to better, more personalised treatment for people with AML who can’t have intensive chemotherapy. It aims to improve long-term outcomes and change how AML is treated in Australia.

Semaglutide use in adults with obesity and previous cardiovascular disease has been shown to reduce further cardiovascular events, however the exact mechanism is uncertain. Whether semaglutide exerts effects on the heart quickly after medication commencement is unknown. One parameter which may be rapidly affected is the energy state of the heart, which can be measured using an advanced cardiac MRI scan. This is a randomised trial to assess this occurs and to what degree.

Many people receiving dialysis feel lonely or cut off from others, and social prescribing connects people with activities, groups and services in their local community. This pilot study will test whether a social prescribing program is feasible for adults receiving dialysis at four units in Western Sydney, Australia. Fifty participants will be randomly assigned to one of two groups: the social prescribing program, or their usual care. In the program, a link worker with lived experience of kidney failure makes a plan with each person to join one or two community activities and calls them regularly over 3 months. We expect that at least half of eligible patients will agree to take part and at least 8 in 10 will stay in the study to 3 months; we will also measure loneliness, social isolation, life participation, fatigue, hospital admissions, changes in dialysis type, survival and costs.

This project focuses on improving the way non-surgical multidisciplinary team (MDT) management is matched to the needs of patients with chronic musculoskeletal pain, such as low back, shoulder or knee pain, in the Queensland Musculoskeletal Physiotherapy Screening Clinic and Multidisciplinary Service (MPSC&MDS). A service improvement initiative (MATCH), has been developed to better align MDT referrals with patient needs and to enhance patient engagement with care. This pilot and feasibility trial will evaluate the impact of implementing MATCH at four MPSC&MDS sites (approximately 458 patients). Outcomes will include the appropriateness of MDT referrals, patient engagement, patient-reported health outcomes, health service utilisation and costs, and the feasibility and fidelity of implementing MATCH within routine service delivery. Findings from this trial will inform the feasibility and design of a future, larger-scale evaluation of MATCH across the state-wide MPSC&MDS.

Endometriosis is a common condition that can cause ongoing pelvic pain, tiredness and reduced quality of life. This study aims to find out whether an 8-week group dance program called “Dance for Me” is a safe, enjoyable and practical exercise option for people with endometriosis. Twenty people with endometriosis will take part in one 45-minute group dance class each week for eight weeks, with movements adapted to how participants feel and what they are able to do. We expect that most participants will be able to attend and complete the program and will find it acceptable and safe. The study will also explore whether participants report changes in pain, tiredness, wellbeing and quality of life after completing the program. The results will help us decide whether the program should be tested in a larger study in the future.

This pilot study is evaluating a rapid multidisciplinary assessment pathway (RADAR) with molecular profiling-guided targeted therapy and/or immunotherapy to assess progression-free survival in patients with anaplastic thyroid cancer Who is it for? You may be eligible to join this study if you are aged 18 years or above, have a histopathologically confirmed diagnosis of anaplastic thyroid cancer diagnosed within New South Wales, have been referred to the Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, and are able to provide informed consent. You will not be eligible if you are pregnant or within six weeks of giving birth, or if your diagnosis is advanced differentiated or poorly differentiated thyroid cancer that does not meet the criteria for anaplastic thyroid cancer. Study details All participants will receive the Rapid Access for Diagnosis, Assessment, and Response (RADAR) pathway on diagnosis or clinical suspicion of anaplastic thyroid cancer. A multidisciplinary team of endocrinologists, medical oncologists, endocrine surgeons, anatomical pathologists, radiation oncologists and palliative care physicians is convened within 24 hours on weekdays or 48 hours on weekends, coordinated by a designated surgical registrar. A tumour biopsy is taken quickly and tested for genetic changes, with the first results available within 24 hours and full results within a week. These genetic results tell the team which treatments are most likely to work for that person. Depending on what is found, the team recommends particular targeted drugs, immunotherapy, surgery or radiotherapy. The drugs themselves are not provided by the study; they are prescribed as part of normal clinical care, and access is arranged individually for each person. Overall survival, side effects, quality of life, the cost-effectiveness of treatment, and how quickly each step of the pathway happens will also be assessed at regular intervals. It is hoped that assessing and treating people this quickly, and choosing treatment based on the tumour’s genetic profile, will mean more people are alive and free of cancer growth six months after diagnosis than has been the case for patients treated at our hospital in the past.

The primary aim of this prospective cohort study is to audit compliance with perioperative diabetes guidelines for patients undergoing elective surgery in Australia and Aotearoa New Zealand. Secondary aims include exploring associations between concordance with guideline recommendations and incidence of postoperative complications.