There are about 25435 clinical studies being (or have been) conducted in United Kingdom. The country of the clinical trial is determined by the location of where the clinical research is being studied. Most studies are often held in multiple locations & countries.
The purpose of this study is to determine the effects of combination treatment of Nivolumab with Ipilimumab followed by Nivolumab monotherapy in patients with previously untreated advanced Melanoma.
Obesity has become one of the most common risk factors in obstetric practice with serious anaesthetic implications. Obese pregnants have limited physiological reserves and cardiovascular co- morbidities when compared to non-obese pregnant women. Spinal anaesthesia is the anaesthetic technique of choice for caesarean section. The haemodynamic changes associated with spinal anaesthesia pose the greatest hazard to the mother and the foetus and are exaggerated in obese pregnant women. However differences in the changes in haemodynamic variables such as cardiac output (CO), stroke volume (SV) and systemic vascular resistance (SVR) between obese and non-obese pregnant women having caesarean section (CS) under spinal anaesthesia have not been studied before. This study compares the haemodynamic changes after spinal anaesthesia for CS in non-obese and obese parturients in a single centre, prospective case control study, using LiDCOrapidV2. This LiDCOrapidV2 device is a noninvasive method of measuring haemodynamic variables. It is a single centre, prospective, case control study. The primary outcome compares the differences and variability in CO, SV and SVR between obese and non-obese parturients. The secondary outcomes include comparison of the correlation between changes in blood pressure (BP) and CO in each patient and the difference in BP between conventional intermittent oscillometric device and continuous LiDCORapidV2in each patient with a view to assess the need for measurement of cardiac output in obstetric anaesthesia
In an attempt to standardise the degree of impairment of gas exchange in the lungs of ICU patients a number of indices of oxygen exchange have been developed. These include: the arterial−alveolar oxygen tension ratio (a/APO2), the arterial oxygen tension−inspired oxygen concentration ratio (PaO2/FIO2), the respiratory index (RI), [A−a)DO2/PaO2) and the alveolar−arterial oxygen tension difference [A−a)DO2). These are used clinically despite the fact that they do not accurately predict gas exchange particularly with changing the amount of inspired oxygen or when there is mixing of oxygenated blood with unoxygenated blood in the patient (called shunt). None of the indices reliably reflect the behaviour of the physiological shunt. In a pilot study as inspired oxygen (FIO2) was increased incrementally from 0.30 to 1.00, up to 55 per cent of the measured changes in these indices were opposite in direction to the corresponding changes in the physiological shunt. The investigators have developed a computer algorithm and a slide rule to try and improve on these clinical measures. The investigators wish to test their slide rule on ventilated patients by altering the inspired oxygen to see if it will predict what the actual change in oxygen will be.
The purpose of this study is to evaluate the safety, tolerability, and efficacy of single agent ibrutinib or the combination treatments of ibrutinib with everolimus, paclitaxel, docetaxel, pembrolizumab or cetuximab in selected advance gastrointestinal and genitourinary tumors.
Patients having radiotherapy to their head and neck wear an immobilisation shell to prevent patient movement and improve treatment accuracy. These shells tend to cover the face and have the potential to cause anxiety and distress in patients, particularly if they suffer with claustrophobia or a similar fear. The study will use an 'open-face' shell that does not cover the face and compare this with the investigators' current 'closed-face' shell. The investigators will obtain treatment verification x-ray images to assess the daily set-up errors and compare these between the two shell type, and ask both patients and radiographers of their experiences from using the shells. Hypothesis: Open-face immobilisation shells offer equivalent accuracy and efficiency of radiotherapy delivery and are better accepted by patients and radiographers as compared to closed-face immobilisation shells for cranial radiotherapy.
Shoulder impingement syndrome is a very common cause of shoulder pain and normally treated with physiotherapy or surgery. Research has shown that physiotherapy is as effective as surgery, however, the incidence of surgery for this condition is on the rise internationally, nationally and locally. The most effective form of physiotherapy, however, is not known. Laboratory studies have suggested that posterior shoulder tightness may contribute to irritation of the soft tissue around the shoulder joint and perpetuate pain from shoulder impingement syndrome. There is a lack of good quality evidence to support this perspective. The aim of this study is to assess the feasibility of conducting a randomized controlled trial to evaluate the effectiveness of treatment for posterior shoulder tightness in combination with 'best care' compared with 'best care' alone in individuals with shoulder impingement syndrome. The study will be a randomised, controlled, double blind (patient and assessor), parallel group, feasibility study with 1:1 allocation ratio. Patients awaiting surgery will be assessed for inclusion/exclusion criteria and then randomly allocated into one of two groups. 60 patients will be assigned to receive 'best care' physiotherapy, with or without treatment for posterior shoulder tightness. Physiotherapy treatment will be delivered over 13-15 weeks and outcomes will be assessed at 0, 6-8, 13-15, 26 and 52 weeks. The results will help us to understand if this is an important part of physiotherapy treatment, which might help reduce patient's pain and disability as well as reduce the cost of treatment for the National Health Service.
The purpose of this study is to directly compare traditional plaster treatment with early weightbearing in a walking boot for the non operative treatment of acute achilles tendon rupture.
Measurements of Structured Light Plethysmography (SLP) using a chest wall movement based method will be compared to those obtained by spirometry using a flow based pneumotachograph method. This study will enable validation of SLP in children and adults by allowing direct comparison of simultaneous measurements of breathing sequences using the two measurement techniques. The investigators will also examine, in a group of normal adults, repeatability of the agreement between the two devices, and whether the agreement is affected by a change in tidal breathing parameters.
The aim of this study is to assess the mass balance recovery from excreta of carbon 14 labelled BI409306 ([14C] BI 409306) in healthy, CYP2C19 genotyped subjects and to provide plasma, urine and faecal samples for metabolite profiling and structural identification.
Systemic Sclerosis (SSc) is a devastating disease of unknown etiology. Patients suffer from multiple organ fibrosis whereas lung fibrosis (interstitial lung disease, ILD) is one of the main driver for mortality. There is preclinical evidence for efficacy of nintedanib in SSc and associated ILD (SSc-ILD) and the anti-fibrotic efficacy of nintedanib was proven in idiopathic pulmonary fibrosis patients, who are presenting a similar pattern regarding lung fibrosis. Hence it is the purpose of the trial to confirm the efficacy and safety of nintedanib 150 mg bid in treating patients with SSc-ILD, compared with placebo. The trial will be conducted as a double blind, randomised, placebo-controlled trial with primary efficacy evaluation at week 52 and placebo-controlled treatment until last patient out (up to a maximum of 100 weeks). Respiratory function is globally accepted for assessment of treatment effects in patients with lung fibrosis. The chosen endpoint (Forced Vital Capacity (FVC) decline) is easy to obtain and is part of the usual examinations done in patients with SSc-ILD.