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NCT ID: NCT05314400 Recruiting - Clinical trials for Liver Metastasis Colon Cancer

Gadoxetate Abbreviated MRI in Metastatic Colorectal Cancer

Start date: July 1, 2022
Phase: N/A
Study type: Interventional

After a patient is diagnosed with colon cancer, they receive a CT of the chest, abdomen, and pelvis to see if the cancer has spread (metastasized) to other parts of the body. A common site for the cancer to spread to is the liver. If an abnormality is seen in the liver on CT, sometimes an MRI of the liver is required to determine a) whether it is cancer or not and b) whether there are small tumours in the liver that were not visible on CT. During the MRI, the patient is injected with intravenous (IV) contrast. This makes liver lesions more conspicuous and also helps determine if they are cancerous or not. The most commonly used IV contrast agent is called Gadovist. However, there is another IV contrast agent called Primovist that is better at detecting liver metastases from colon cancer than Gadovist. This is very important information for surgeons, because if they considering cutting out (resecting) the liver tumours, they want to make sure they get them all. Unfortunately, Primovist is used sparingly in Canadian hospitals because it is more expensive than Gadovist and the MRI takes longer. Some early small studies have suggested that it may be possible to shorten the Primovist MRI significantly (e.g. from 60 minutes to 15 minutes), making it economically feasible to offer Primovist to more patients. However, there have not been any large studies performed to confirm these findings. The purpose of this study is to compare the accuracy of colon cancer liver metastasis detection between a regular, full-length Primovist MRI versus a shortened Primovist MRI protocol. The economic impact will also be assessed.

NCT ID: NCT05313815 Recruiting - Prostate Cancer Clinical Trials

Moderate Hypofractionated Boost to the Prostate With Pelvic RT in High Risk Prostate Cancer

MOB-RT
Start date: July 18, 2022
Phase: N/A
Study type: Interventional

This is a single-arm phase II prospective trials that is recruiting 100 participants. The study population that is being investigated are patients with localized high-risk or node-positive prostate cancer. Participants will receive external beam radiotherapy as a moderately hypofractionated boost to the prostate with pelvic radiation therapy. Androgen deprivation therapy will be prescribed at the discretion of the treating physician as per standard of care.

NCT ID: NCT05312879 Recruiting - Clinical trials for Proteinuric Kidney Disease

Phase 2/3 Adaptive Study of VX-147 in Adult and Pediatric Participants With APOL1- Mediated Proteinuric Kidney Disease

AMPLITUDE
Start date: March 30, 2022
Phase: Phase 2/Phase 3
Study type: Interventional

The purpose of this study is to evaluate the efficacy, safety, tolerability, and pharmacokinetics (PK) of VX-147 in adult and pediatric participants with apolipoprotein L1 (APOL1)-mediated proteinuric kidney disease.

NCT ID: NCT05312827 Recruiting - Telerehabilitation Clinical Trials

Training Intervention and Program of Support (TIPS): Fostering Family-centred Telehealth in Pediatric Rehabilitation

TIPS
Start date: October 17, 2022
Phase: N/A
Study type: Interventional

Timely access to family-centred services for children with disability and their families is important to support their development and well-being. Currently, many children face long wait times and barriers to services. Lack of access can lead to negative impacts for children and stress for their families. With the COVID-19 pandemic, these issues have been made more challenging with the loss of rehabilitation support for children, increasing stress on families. During this time, therapists moved to telehealth service delivery to support children and families. We know that telehealth can improve access to services, children's outcomes, and family satisfaction, and that telehealth a key element of Family Centred Services (FCS) in pediatric rehabilitation. FCC include practices that promote flexibility, respect and dignity for families' views, knowledge and strengths, effective information sharing, partnership and collaboration in decision making, and coordinated and comprehensive care. FCC focuses on developing collaborative family-provider relationships, where parents are active participants in collaborative goal-setting, therapy planning, implementation, and evaluation, and where activities are integrated within daily routines and contexts (e.g., home and community). Compared to traditional service delivery methods, telehealth offers opportunities to enhance FCC practices. FCC provides alternate, convenient, and flexible ways to partner with families, respecting their characteristics and barriers, allows knowledge and information sharing about the child within their contexts, supports family decision making and parents' well-being, and has been recognized as an important addition to comprehensive care coordination and service delivery. Telehealth is an important and effective alternative for families living in both urban and remote or underserved areas and can be more convenient than in-person visits (e.g., less travel time, schedule flexibility). However, the use of telehealth prior to the pandemic was low in pediatric rehabilitation. In addition, many therapists report delivering telehealth without prior experience, and lack confidence, knowledge, and training in effective intervention strategies. Although therapists' knowledge, skills and attitudes toward telehealth can improve with time and experience, training and support are required for behavioural changes to occur. Following the pandemic, there has been continued support for the use of FCT and for its ongoing use to support families of children with disability. Pediatric rehabilitation therapists, service managers, professional associations, policy makers, and families are all making the case for not "returning to normal", and are asking for help to keep telehealth as part of FCS care. The goal of the current study is to evaluate the use and effectiveness of a Training Intervention and Program of Support (TIPS) to increase the uptake of FCT in pediatric rehabilitation centres across Canada. The main research question is: Can TIPS be adapted to increase the use of FCT interventions by therapists working in different contexts? The primary objectives are to: 1. Evaluate the use of FCT regarding: 1. Therapists' desire to use vs actual use of FCT practices 2. Use of FCT practices as they were intended to be used Secondary objectives are to: 2. Describe the variations required to adapt the TIPS to meet each site's needs 3. Identify factors that influence FCT use and adherence 4. Evaluate the effectiveness with regards to: 1. Service wait-times 2. Family-centredness of services 3. Changes in service delivery 5. Evaluate the costs (and possible cost savings) related to increased use of FCT The primary hypotheses are that therapists' desire to adopt FCT and deliver FCT practices as intended will (i) improve slightly in the short term (i.e., one-month post-TIPS), yet (ii) will improve significantly post-TIPS, (iii) while actual use will vary over time, across sites and therapists, and will depend on therapist-, client-, organizational- and system-factors. For the secondary hypotheses, the investigators expect that, for sites with the largest changes in desire to use and use of FCT practices as intended, (iv) wait times will significantly decrease and (v) families' perceptions of service quality will significantly improve post-TIPS.

NCT ID: NCT05312736 Recruiting - Gyrate Atrophy Clinical Trials

Gyrate Atrophy Ocular and Systemic Study

GYROS
Start date: November 21, 2023
Phase:
Study type: Observational

The Gyrate Atrophy Ocular and Systemic Study characterizes the natural history of ornithine levels and retinal degeneration (RD) associated with disease-causing OAT variants in the presence of standard care dietary treatment regimens over 4 years. The research goal is to understand the impact of OAT mutations on plasma ornithine levels and retinal degeneration.

NCT ID: NCT05311696 Recruiting - PTSD Clinical Trials

Residential Retreat for Veterans and First-responders

Start date: March 27, 2022
Phase:
Study type: Observational

The purpose of this study is to determine the potential efficacy and feasibility of a residential retreat program to address PTSD symptoms in Veterans and First-responders

NCT ID: NCT05310799 Recruiting - Clinical trials for Juvenile Idiopathic Arthritis

Personalized Estimates of Response and Severity Outcomes in Newly-diagnosed JIA

PERSON-JIA
Start date: May 23, 2023
Phase: N/A
Study type: Interventional

The PERSON-JIA Trial is a cluster-randomized trial testing the use of Shared Decision Making (SDM) with families for treatment of children with arthritis. The intervention is a discussion between physicians and families at the time of diagnosis that uses computer-generated personalized outcome reports generated by previously developed prediction algorithms. By using information provided by thousands of families, the investigators have developed a way of providing answers to common questions asked by patients and their families at diagnosis. We will test whether a structured discussion and shared decision between families and doctors (guided by the patient's personal report) will improve the tailoring of treatment to the child and control of their disease. The personal report is called the PERSON-JIA report and presents the child's expected disease severity, the likelihood the child will be arthritis free by age 18 and the chance treatments will be effective and/or have side effects. This way, answers to these questions can be shared by physicians and families to weigh potential benefits and harms according to family values and preferences. The investigators expect that using the personalized report in a frank and thoughtful discussion will help physicians and families make better decisions about managing the child's disease. This in turn will result in better disease control, greater family engagement and satisfaction with care and better-tailored treatment. If so, this will be a ground-breaking way of using information provided by families and doctors to improve the care provided to and the outcomes of children with arthritis in Canada.

NCT ID: NCT05309785 Recruiting - ESRD Clinical Trials

Safety and Efficacy of Canagliflozin in Advanced CKD

SIP-AKiD
Start date: November 24, 2022
Phase: Phase 4
Study type: Interventional

The study objective is to characterize the pharmacokinetics (PK), pharmacodynamics, and surrogate measures of efficacy for canagliflozin in patients with advanced CKD, including those receiving HD. As the CV and renoprotective effects of SGLT-2 inhibitors appear to be independent of glycemic control, the investigators hypothesize that canagliflozin will reduce albuminuria in patients with advanced CKD in the same manner as observed in patients with higher eGFR. The investigators also hypothesize that the 300 mg dose will be equally safe as the 100 mg dose but will have greater efficacy, given data which suggests efficacy correlates with drug exposure in patients without CKD. Given its negligible renal elimination, the investigators hypothesize that exposure to canagliflozin 100 mg at steady state will not exceed the standard bioequivalence boundary of 80-125% in patients receiving HD, compared with published estimates with the 300 mg dose at steady state in individuals with preserved kidney function.

NCT ID: NCT05309733 Recruiting - Clinical trials for Leukemia, Myeloid, Acute

A Long-term Follow-up Study of Patients Who Received VOR33

Start date: April 15, 2022
Phase:
Study type: Observational

VOR33 long-term follow-up (LTFU) study

NCT ID: NCT05309356 Recruiting - Clinical trials for Chronic Obstructive Pulmonary Disease

Using Clinical Prediction Models to Improve Treatment for Patients With Chronic Obstructive Pulmonary Disease (COPD)

Start date: March 21, 2023
Phase: N/A
Study type: Interventional

Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease of the lungs that affects more than 2.5 million Canadians. Patients with COPD experience episodes of lung attacks (or exacerbations). During these attacks, patients experience an intense increase in symptoms, such as breathlessness and cough. It is challenging to decide which patients should be put on treatments that would reduce the risk of such lung attacks. The digitization of health records in many clinics and hospitals means complex risk prediction algorithms can be used to predict the risk of lung attacks to enable personalized care. In this study, our team will implement a risk prediction tool (called ACCEPT) into the electronic health records in two teaching hospitals in Vancouver, British Columbia (BC), Canada. A clinical study will be conducted to evaluate if the use of this tool results in patients with COPD receiving better care with better outcomes, and if they are more satisfied with the care they are receiving.