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NCT ID: NCT04284553 Completed - Aging Clinical Trials

Optimizing Electronic Health Record Prompts With Behavioral Economics to Improve Prescribing for Older Adults

NUDGE-EHR
Start date: October 13, 2020
Phase: N/A
Study type: Interventional

Prescribing of potentially unsafe medications for older adults is extremely common; benzodiazepines and sedative hypnotics are, for example, key drug classes frequently implicated in adverse health consequences for vulnerable older adults, such as confusion or sedation, leading to hospitalizations, falls, and fractures. Fortunately, most of these consequences are preventable. Physicians' lack of awareness of alternatives, ambiguous practice guidelines, and perceived pressure from patients or caregivers are among the reasons why these drugs are used more than might be optimal. Reducing inappropriate use of these drugs may be achieved through decision support tools for providers that are embedded in electronic health record (EHR) systems. While EHR strategies are widely used to support the informational needs of providers, these tools have demonstrated only modest effectiveness at improving prescribing. The effectiveness of these tools could be enhanced by leveraging principles of behavioral economics and related sciences.

NCT ID: NCT04284046 Completed - Clinical trials for CT Scores Predict Mortality in 2019-nCoV Pneumonia

CT Scores Predict Mortality in 2019-nCoV Pneumonia

Start date: January 31, 2020
Phase:
Study type: Observational

While 2019-nCoV nucleic acid swab tests has high false positives rate, How to diagnose 2019-nCoV pneumonia and predict prognosis by CT is very important.In this retrospective single-center study, we consecutively included suspected 2019-nCoV pneumonia critical cases in the intensive care unit of Wuhan third hospital from January 31, 2020 to February 16, 2020. The cases were confirmed by real-time RT-PCR, and all patients were evaluated with CT, cutoff values were obtained according to the Yoden index, and were divided into high CT score group and low CT score group. Epidemiological, demographic, clinical, and laboratory data were collected.

NCT ID: NCT04282889 Completed - Clinical trials for Coagulation in Liver Transplantation

Rotational Thromboelastometry (ROTEM) TRUE-NATEM Reference Value Validation in Liver Transplantation

Start date: October 6, 2020
Phase:
Study type: Observational

Background: Rotational thromboelastometry (ROTEM) has been used widely in liver transplantation for coagulation management. However, a TRUE-NATEM (TRUE-Non-Activated Rotational Thromboelastometry) reference value has never been established. A TRUE-NATEM value is of clinical significance since no coagulation activators or reagents will be added to the blood sample for analysis. Therefore, the result will reflect the true coagulation profile of the patient. Methods: Non-citrated whole blood will be used for analysis. Blood will be drawn from the patient and transferred into a plastic reagent cup that has no reagent. Test will be performed within 4 minutes of blood draw to avoid activation of coagulation. Primary outcome measure will be clotting time (CT), clot formation time (CFT) and maximum clot firmness (MCF). The specific aims of the study are to establish a TRUE-NATEM reference value using Rotational Thromboelastometry (ROTEM®) in patients undergoing liver transplantation. Our hypothesis is that clotting time (CT), clot formation time (CFT) is prolonged and maximum clot firmness (MCF) decreased compared to healthy volunteers in patient undergoing liver transplantation due to synthetic coagulation factor deficiency.

NCT ID: NCT04282772 Completed - Clinical trials for Failure of Tooth Eruption Associated With Tooth Impaction

Ectopic Eruption of Permanent First Molars

Start date: January 1, 2019
Phase:
Study type: Observational

Ectopic eruption may be defined as the eruption of a permanent tooth that takes place in such a manner that a partial or a total resorption of the root(s) of an adjacent primary tooth occurs and can be noted during routine dental radiographic evaluation. It is a common case in mixed dentition and is usually diagnosed by a pediatric dentist. This retrospective study aimed to determine the prevalence and related factors of the ectopic eruption of permanent first molars(PFM). This retrospective study was performed using the panoramic radiographs of 11,924 child patients aged 6-10 years with at least one ectopically erupted PFM were included. The total prevalence of ectopic eruption, type, age, gender, jaw distribution, and bilateral versus unilateral occurrence were determined. The angulation of PFM, mesialization ratio of PFM, and degree of adjacent primary second molar(PSM) tooth root resorption were also assessed. The chi-square test, ANOVA was used for statistical analysis. A total of 76 ectopic eruptions were detected in the maxilla, 6 in the mandible, and 2 in both the maxilla and the mandible. In terms of the eruption status of cases with ectopic eruption, 27 were self-corrected, 51 remained impacted, and 6 were both. The impaction rate of the right upper PFMs was higher than that of others. No significant relationship was found between eruption status and degree of resorption. As a conclusion, small impaction of the PFM does not mean that the PSM lesion is also small. With substantial displacements, a proportionally diminutive lesion can exist, and vice versa.

NCT ID: NCT04282525 Completed - Clinical trials for Extracorporeal Membrane Oxygenation Complication

Monitoring of Cerebral Autoregulation in Pediatric ECMO (ECMOX 1)

ECMOX1
Start date: June 1, 2018
Phase:
Study type: Observational

Children supported by Extra-Corporeal Membrane Oxygenation (ECMO) present a high risk of neurological complications and cerebral autoregulation (CA) impairment may be a risk factor. Our first objective is to investigate the feasibility of CA continuous monitoring during ECMO treatment. The second objective is to analyze the relationship between CA impairment and neurological outcome.

NCT ID: NCT04282460 Completed - Clinical trials for Attention Deficit Hyperactivity Disorder

Ba Duan Jin in Treatment of Attention Deficit Hyperactivity Disorder

Start date: October 24, 2020
Phase: N/A
Study type: Interventional

This study is designed to test if Baduanjin training can reduce the hyperactive-impulsive symptoms of children with Attention deficit hyperactivity disorder (ADHD) compared to routine excise. Investigators will also evaluate if the Baduanjin training will positively affect Chinese Traditional Medicine (TCM) symptoms compared to controls and if these impacts are related to the change of the executive function.

NCT ID: NCT04281849 Completed - Heart Failure Clinical Trials

Balance, Aerobic Capacity, Mobility and Strength in Patients Hospitalized for Heart Failure (BAMS-HF) Program

BAMS-HF
Start date: June 15, 2020
Phase: N/A
Study type: Interventional

This is a pilot randomized trial of the BAMS-HF (Balance, Aerobic capacity, Mobility and Strength in patients hospitalized for Heart Failure) Program versus usual care. The BAMS-HF Program pilot study is an initial step in eventually creating a comprehensive, patient-centered, primarily home-based rehabilitation intervention aimed at preventing worsening disability and dependence among older adults hospitalized for HF. The BAMS-HF Program will enroll patients hospitalized for HF (or with HF as an active problem during hospitalization) within the past 4 weeks and will engage patients during the vulnerable post-discharged period. The objective of this pilot study is to test the feasibility, acceptability and preliminary effect of the BAMS-HF Program in older (>/= 65 years) adults hospitalized for HF. The BAMS-HF Program will begin within 4 week of hospital discharge and be administered 3 times weekly for 12 weeks in the patient's home upon discharge. Patients who are able to safely complete the program without in-person assistance will transition to telehealth (aka telerehabilitation) visits. The BAMS-HF Program is innovative because it is home-based, and will utilize rigorous, progressive exercises across multiple domains of physical function. The estimated preliminary effect size will be measured with the Short Physical Performance Battery (SPPB), a well-validated measure that predicts incident mobility/disability and falls in the geriatric population. Aim #1: To assess the feasibility of the BAMS-HF Program by measuring 1) study enrollment rate, 2) proportion of prescribed sessions that were actually performed, 3) proportion of patients completing full baseline assessment and outcome measures Aim #2: To assess the acceptability of the BAMS-HF Program with qualitative interviews of participants in the intervention arm that will ask about their experience in the program, any aspects of the intervention they recommend changing and whether patients would recommend the program to others. Reason for declining or stopping participation in the study will also be recorded and considered in adjusting the study protocol. Aim #3: To estimate the preliminary intervention effect by investigating the difference in change in SPPB between the BAMS-HF Program arm and the usual care arm.

NCT ID: NCT04281784 Completed - Dementia Clinical Trials

Project to Improve Communication About Serious Illness--Hospital Study: Pragmatic Trial (Trial 1)

PICSI-H
Start date: April 23, 2020
Phase: N/A
Study type: Interventional

The objective of this protocol is to test the effectiveness of a Jumpstart intervention on patient-centered outcomes for patients with chronic illness by ensuring that they receive care that is concordant with their goals over time, and across settings and providers. This study will examine the effect of the EHR-based intervention to improve quality of palliative care for patients 55 years or older with chronic, life-limiting illness with a particular emphasis on Alzheimer's disease and related dementias (ADRD). The specific aims are: 1. To evaluate the effectiveness of a novel EHR-based (electronic health record) clinician Jumpstart guide, compared with usual care, for improving the quality of care; the primary outcome is documentation of a goals-of-care discussion in the period between randomization and 30 days following randomization. Secondary outcomes focus on intensity of care: ICU use, ICU and hospital length of stay, costs of care during the hospitalization, and 7 and 30-day hospital readmissions. 2. To conduct a mixed-methods evaluation of the implementation of the intervention, guided by the RE-AIM framework for implementation science, incorporating quantitative evaluation of the intervention's reach and adoption, as well as qualitative analyses of interviews with participants, to explore barriers and facilitators to future implementation and dissemination.

NCT ID: NCT04281498 Completed - IDH2 Mutation Clinical Trials

Combined Ruxolitinib and Enasidenib in Patients With Accelerated/Blast-phase Myeloproliferative Neoplasm or Chronic-phase Myelofibrosis With an IDH2 Mutation

Start date: January 14, 2021
Phase: Phase 2
Study type: Interventional

The presence of IDH mutation is associated with worse survival in patients with myelofibrosis. Moreover IDH mutations are among the most frequently encountered events in MPNs that have progressed to acute myeloid leukemia. Ruxolitinib, a JAK1/2 inhibitor, and enasidenib an IDH2 inhibitor are effective and tolerable treatments for patients with myelofibrosis (MF) and acute myeloid leukemia (AML), respectively. The study team hypothesize that the combination of these agents in patients with MPN with an IDH2 mutation will improve the overall clinical response to therapy.

NCT ID: NCT04281472 Completed - Clinical trials for Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

A Study to Assess the Safety and Efficacy of a Subcutaneous Formulation of Efgartigimod in Adults With Chronic Inflammatory Demyelinating Polyneuropathy (CIDP, an Autoimmune Disorder That Affects the Peripheral Nerves)

ADHERE
Start date: April 15, 2020
Phase: Phase 2
Study type: Interventional

This is a Phase 2 study to evaluate the safety and efficacy of the subcutaneous formulation of efgartigimod in adults with CIDP.