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NCT ID: NCT04229511 Not yet recruiting - Clinical trials for Urinary Tract Infections

Development of Risk Score Model and Decision Tree Algorithm for Predicting Infections With CRKp in Colonized Patients

DETERMINE
Start date: April 2020
Phase:
Study type: Observational

DETERMINE trial is a prospective multicenter multinational cohort study. This study will be carried out to predict the risk of bloodstream infections (BSIs) or other types of invasive infection with carbapenem resistant K.pneumoniae in patients being colonized by CRKp. The results of DETERMINE trial would be quite important to prevent unnecessary coverage of carbapenem resistant Klebsiella pneumoniae in empirical treatment of colonized patients. In this study, both risk score model and decision tree algorithm will be constructed and compared with each other in terms of sensitivity, specificity, positive predictive value and negative predictive value.

NCT ID: NCT04237051 Not yet recruiting - Clinical trials for Knowledge, Attitudes, Practice

Knowledge, Attitude and Practice Among Undergraduate Dental Students, Cairo University Towards Ergonomics

Start date: April 2020
Phase:
Study type: Observational

this study will evaluate knowledge, attitude, and practice of fifth-year dental students Cairo university toward ergonomics

NCT ID: NCT04244994 Not yet recruiting - Clinical trials for Sexually Transmitted Diseases, Bacterial

Self-taken Penile Meatal Swabs for Chlamydia, Gonorrhoea and Mycoplasma Genitalium Detection

Me-swab
Start date: April 2020
Phase: N/A
Study type: Interventional

Objectives: To compare self-taken penile meatal swabs versus first-catch urine samples for the detection of chlamydia, gonorrhoea and Mycoplasma genitalium from the penile urethra using nucleic acid amplification tests. To assess the acceptability of self-taken penile meatal swabs compared with first-catch urine samples. To assess the prevalence of Mycoplasma genitalium in those with urethritis. To assess the prevalence of Mycoplasma genitalium antimicrobial resistance. To evaluate the utility of using Mycoplasma genitalium resistance-guided therapy. To compare the cost of using self-taken penile meatal swabs versus FCU samples for the correct detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium. Methods: Men and transwomen presenting for a sexual health screen will perform a self-taken penile meatal swab followed by a first-catch urine (FCU) sample. Both will be analysed using the Aptima Combo 2 test (Hologic, San Diego, California [CA], USA) for chlamydia and gonorrhoea. In those with urethritis they will also be analysed using Aptima MGen test for Mycoplasma genitalium. Details of demographics, past history, sexual history, clinical symptoms and signs will be collected. The acceptability of each sample will be assessed using a patient questionnaire. The samples of those infected with Mycoplasma genitalium will be tested for Mycoplasma genitalium macrolide and fluoroquinolone resistance mutations by in-house polymerase chain reaction (PCR) using Sanger sequencing to characterise mutants in the 23s gene for macrolide resistance and DNA gyrase subunit A (gyrA) and DNA topoisomerase IV subunit C (parC) genes for fluoroquinolone resistance. The result of this will be used to guide the therapy prescribed to treat the infection. Primary outcome: Sensitivity, specificity, positive and negative predictive values of self-taken penile meatal swabs compared with FCU samples for the detection of chlamydia, gonorrhoea and Mycoplasma genitalium in the penile urethra. Secondary outcomes: Acceptability of self-taken penile meatal swabs compared with FCU samples for the detection of chlamydia, gonorrhoea and Mycoplasma genitalium. Prevalence of Mycoplasma genitalium in those with urethritis. Prevalence of Mycoplasma genitalium antimicrobial resistance. Utility of using Mycoplasma genitalium resistance-guided therapy. Cost of using self-taken penile meatal swabs versus FCU samples for the correct detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium.

NCT ID: NCT04259957 Not yet recruiting - Chronic Pain Clinical Trials

Staff Experiences of Using Virtual Reality in a Pain Management Group

Start date: April 2020
Phase:
Study type: Observational

Immersive Virtual Reality is a fast developing technology that allows a number of opportunities to engage people in activities that they otherwise might find difficult. For instance exercising in a fun way when they have difficulty exercising in the way they previously enjoyed. Alternatively the immersive nature of the experience might make it easier to engage in tasks in an otherwise distracting world. The investigators are interested in exploring how Virtual Reality games and programs can help people with Chronic Pain. Working with Researchers at Sheffield Hallam University the research team introduced Virtual Reality headsets and games to people engaging in a Pain Management Program Group lasting 6 weeks for 3 hours a week. This involved NHS patients in the UK, delivered by a physiotherapist and an occupational therapist. This group involved 8 individuals with a variety of chronic pain conditions. Patients used Virtual Reality headsets and games throughout the program to aid exercise and mindfulness activities. This is a relatively new approach and the investigators are not aware of any other organisations making use of this technology in this way. It would be useful developing its use to explore the issues those leading the Pain Management Group and supporting patients found. Speaking to these individuals in interviews will explore their experiences and feelings deeply and allow us to learn about what worked well and what challenges they faced. These interviews would be conducted in a format of qualitative research that would explore the experiences staff had, and compare it to other experiences of introducing patient-used technology in healthcare.

NCT ID: NCT04269187 Not yet recruiting - Clinical trials for Diaphragmatic Dysfunction in Critically Ill Patients

Diaphragmatic Ultrasound With Theophylline Therapeutic Trials

Start date: April 2020
Phase: Early Phase 1
Study type: Interventional

Critically ill patients are a group of patients with special needs during hospitalization. The vast majority of them is mechanically ventilated and requires continuous assessment of vital parameters. It is quite impressive that assessment of respiratory muscles, and specifically of the diaphragm, is lacking in the daily practice of ICU. The diaphragm-the main inspiratory muscle-is considered so important in ICU. A lot of time in ICUs is spent on weaning patients from mechanical ventilation. Although weaning from mechanical ventilation can be a rapid and uneventful process for the majority of the patients, it can be difficult in as many as 20-30% of them (1)(2). It is during weaning that the diaphragm becomes the major pathophysiological determinant of weaning failure or success. Weaning failure is defined as failing a spontaneous breathing trial or developing a post-extubation respiratory distress that requires re-intubation or non-invasive ventilation within 48 h following extubation (3). So, identification of reliable predictors of weaning failure may represent potential avenues of treatment that could reduce the incidence of weaning failure and its associated morbidity. Known predictors of weaning failure include chronic obstructive airway disease (3), cardiac failure(4-6), lung de-recruitment (7), pneumonia (8) and diaphragmatic dysfunction (9). Rapid shallow breathing index (RSBI) is a clinical predictor of failure of weaning from mechanical ventilation and it is widely used in clinical research and in practice (10). However, diaphragmatic ultrasonography could be a promising tool for predicting reintubation within 48 hours of extubation. As it permits direct assessment of diaphragm function. It should be mentioned that diaphragmatic dysfunction among patients hospitalized in the intensive care unit (ICU) is commonly attributed to critical illness polyneuropathy and myopathy. Mechanical ventilation, even after a short period of time, can also induce diaphragmatic dysfunction. Recent researches have shown that theophylline improves diaphragmatic contractility in isolated muscle preparations in animals and in normal human subjects. The question now does the theophylline have a significant role in critical ill patients with diaphragmatic dysfunction whether they are diabetic or not ?

NCT ID: NCT04270851 Not yet recruiting - Cancer Clinical Trials

Colorectal Liver Metastases: Novel Assessment Tools for Technical Resectability

CoNoR
Start date: April 2020
Phase:
Study type: Observational

The CoNoR study aims to assess whether the use of the LiMAx test and the HepaT1ca pre-operative planning magnetic resonance scan impact upon technical resectability decision-making in colorectal liver metastases (CLM).

NCT ID: NCT04275050 Not yet recruiting - Clinical trials for Advanced Malignant Solid Tumor

A Study to Evaluate the Tolerance and Pharmacokinetics of TQB3303 Tablets

Start date: April 2020
Phase: Phase 1
Study type: Interventional

TQB3303 tablet is a small molecule oral drug inhibiting cyclin-dependent kinases 4 and 6 (CDK4 / 6). Based on current research, overexpression of positive regulatory proteins in the cell cycle is one of the important reasons for resistance to endocrine therapy. CDK4 / 6 is the key regulators of the cell cycle inhibiting tumor cell proliferation.

NCT ID: NCT04277949 Not yet recruiting - p53 Expression Clinical Trials

To Evaluate and Compare p53 Epidermal Expression in Healthy Volunteers 3 Months After Treatment With a 2,940-nm Fractional Ablative Erbium Laser and Topical DNA Repair Enzymes

Start date: April 2020
Phase: N/A
Study type: Interventional

The p53 gene is located on the short arm of chromosome 17 and serves as a tumor suppressor gene. Alteration in p53 is an early event in skin cancer development. Further, p53 is the most commonly mutated gene in non-melanocytic skin cancers. The presence of p53 within epidermal skin cells is believed to reflect the malignant potential of photo-damaged skin. Studies have demonstrated that increasing sun exposure and age are directly associated with higher levels of p53 in facial skin. Consequently, the physiologic overexpression of p53 present in epidermal skin may be indicative of both past photodamage and future risk for developing skin cancer. Advancements in dermatologic research have allowed clinicians to treat photo-damaged skin with with novel modalities. For example, epidermal ablation with the 2,940nm fractional erbium laser has been shown to reduce the risk of carcinogenesis by promoting apoptosis, working similarly to p53. Laser resurfacing results in the replacement of epidermal cells once the necrotic debris is cleared away. This therapeutic effect of laser resurfacing may be gauged by cutaneous p53 expression before and after such interventions. Investigators have noted the reliability of cutaneous p53 expression to gauge therapeutic effects in patients receiving erbium doped yttrium aluminum garnet laser (Er:YAG), dermabrasion, and CO2 laser. Similarly to laser resurfacing, topical DNA repair enzymes have been shown to be protective against skin cancer development and, therefore, may also reduce epidermal p53 expression. UV endonuclease, a DNA repair enzyme derived from the UV-resistant microbe Micrococcus luteus, enhances DNA repair by removing cyclobutane pyrimidine dimers (CPDs) induced by ultraviolet radiation (UVR). To efficiently penetrate the stratum corneum, this enzyme is encapsulated within liposomes, which facilitate entry into keratinocyte nuclei. Once exposed to CPDs, UV endonuclease repairs DNA by catalyzing two reactions: the first uses glycosylase, which releases thymine and causes an apurinic site; the second involves lyase, which incises the phosphodiester backbone, causing a single stranded break. An exonuclease then removes bases around this site, and a polymerase fills the gap, thereby repairing the photodamaged DNA. In addition to repairing damaged DNA on the molecular level, UV endonuclease has also demonstrated the ability to clinically decrease non-melanocytic skin cancer and pre-cancer development. The capability of topical DNA repair enzymes to reverse DNA damage leads us to believe that it will also lead to a reduction in p53 expression within epidermal cells. For these reasons, we wish to investigate the role of 2,940 fractional erbium laser and topical DNA repair enzymes on reducing cutaneous p53 expression.

NCT ID: NCT04297085 Not yet recruiting - Clinical trials for Thromboembolic Venous Disease

Prospective Cohort Study on the Determinants of Venous THromboembolic Recurrence

BREIZH-Cohorte
Start date: April 2020
Phase: N/A
Study type: Interventional

The main objective of the BREIZH-Cohorte study is to determine the incidence of recurrent short, medium and long-term thromboembolic venous disease as well as risk factors for recurrence in two specific populations: patients under 50 years of age, men and women (5 year recurrence), as well as cancer patients (all ages) (1 year recurrence).

NCT ID: NCT04297540 Not yet recruiting - Ataxia, Cerebellar Clinical Trials

Neuromodulation of Social Skills in Childhood Ataxia

Start date: April 2020
Phase: N/A
Study type: Interventional

The present study aims to define a protocol of electrical stimulation of the cerebellum via transcranial direct current stimulation (tDCS) combined with a virtual reality protocol to assist the rehabilitation of social skills in adolescents and young adults with childhood ataxia. Taking into account the high neuronal density of the cerebellum, its strong connection with the cerebral cortex, and its involvement in motor, cognitive and affective processes, as well its involvement in social prediction abilities, the investigators hypothesized that excitatory stimulation of the cerebellum might improve social prediction abilities in adolescents and young adults with childhood ataxia. Moreover, as suggested by previous studies investigating the effect of tDCS in paediatric population, the investigators expected that tDCS will be safe and well tolerated. Such a result would encourage the use of non-invasive brain stimulation in the rehabilitation of social skills in childhood ataxia.