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NCT ID: NCT06095128 Recruiting - Ulcerative Colitis Clinical Trials

A Study of Vedolizumab With Tofacitinib in Adults With Ulcerative Colitis (UC)

Start date: June 12, 2024
Phase: Phase 4
Study type: Interventional

The main aim of this study is to learn about the effect of treatment with vedolizumab IV (vedolizumab) together with tofacitinib in adults with moderate and severe ulcerative colitis (UC). Another aim is to learn about treatment with Vedolizumab alone after the double treatment. All participants will receive vedolizumab together with tofacitinib for 8 weeks and will be checked for response. Participants who show a response to the treatment after 8 weeks will be treated with vedolizumab alone for an additional 44 weeks. Each participant will be followed up for at least 26 weeks after the last dose of vedolizumab.

NCT ID: NCT06095063 Recruiting - Alzheimer Disease Clinical Trials

dTMS for Subjective Cognitive Decline

Start date: November 15, 2023
Phase: N/A
Study type: Interventional

Deep transcranial magnetic stimulation (dTMS) is a brain stimulation technique that involves generating a brief magnetic field in a coil that is placed on the scalp. The magnetic field passes through the skull and induces a weak electrical current in the brain that briefly activates neural circuits at the stimulation site. The Brainsway dTMS H7-Coil is able to target an area of the brain that has been shown in studies to be linked to greater resilience to cognitive decline. In this study, the investigators will combine dTMS with cognitive training in older adults with subjective cognitive decline (SCD) and examine the effect of this treatment on memory, other cognitive abilities, and mood. In addition, the investigators will examine the combined effects of dTMS and cognitive training on brain activity as measured using electroencephalography (EEG). Approximately 30 older adults from ages 55 to 70 with SCD and a positive family history of Alzheimer's disease will be enrolled in this study.

NCT ID: NCT06093386 Recruiting - Clinical trials for Children and Youth With Medical Complexity

Promoting Intensive Transitions for Children and Youth With Medical Complexity From Pediatric to Adult Care

PITCare
Start date: November 24, 2023
Phase: N/A
Study type: Interventional

Medical advances have allowed many more children and youth with medical complexity (CMC) to survive well into adulthood. However, this has not been matched with increases in knowledge of complex conditions or the availability of supports as they transition into the adult care system. The goal of this randomized control trial is to compare intensive transition support from a transition team, led by an advance practice nurse, during transition to adult care for 2 years, with usual care in CMC. Participants assigned to the intervention group will be offered support in care planning, receiving funding, and connecting with a primary care provider and adult subspecialists. The main questions it aims to answer are: 1. Does intensive transition support improve the patient's continuity of care over 2 years compared with usual care? 2. Will there be differences between intervention and control groups with respect to other outcomes related to the youth/family's satisfaction with care, care coordination, self-care, health service utilization, cost-effectiveness, and quality of life? 3. What are the experiences of youth, parents, the transition team, and other clinicians involved in the intensive transition support process?

NCT ID: NCT06093126 Recruiting - Dementia Clinical Trials

Lemborexant for Insomnia in a Patient With Dementia: An N-of-1 Trial

Start date: December 11, 2023
Phase: Phase 4
Study type: Interventional

Insomnia is a highly common, chronic disorder that is distressful for the patient but also for caregivers and can give rise to a heavy burden on the healthcare team. Sleeping aids like benzodiazepines and other sedatives (e.g., zolpidem, zopiclone) have been widely used to help treat insomnia. However, sleeping aids are also known to cause adverse drug reactions such as drowsiness and dizziness, that increases the risk of falls, driving impairment, visual impairment, cognitive impairment, and upon discontinuation may cause paradoxical rebound insomnia, delirium, and nightmares all of which exacerbate the initial insomnia. All of the negative aspects of sleeping aid use are exaggerated for older, frail adults. Some patients experience an early (young-age) onset dementia with a substantial component of insomnia. Due to the many risks associated with traditional sleeping aids they are often inappropriate in adults living with cognitive impairment and/or frailty. Lemborexant comes from a new class of medications for insomnia. Lemborexant is a dual orexin receptor antagonist that blocks the binding of wake-promoting neuropeptides orexin A and orexin B to their receptors orexin 1 receptor (OX1R) and orexin 2 receptor (OX2R), which is thought to suppress wake drive. Unlike other traditional sleeping aids, lemborexant has not shown to be significantly associated with driving impairment, rebound insomnia, or dependence/withdrawal symptoms. Also, in clinical trials it only rarely causes the types of adverse events associated with benzodiazepines and other traditional sedatives and is less often associated with discontinuations due to adverse events. While lemborexant is available on the Canadian market it is unclear how this medication will be tolerated by patients living with an early onset dementia. Understanding the effectiveness and tolerability of lemborexant will be helpful in an N of 1 trial to understand the details of effect and effectiveness in individual patients.

NCT ID: NCT06092970 Recruiting - Clinical trials for Post-Operative Complications in Cardiac Surgery

An Evaluation of Patient Reported Outcomes and Clinical Outcomes

Start date: October 16, 2023
Phase:
Study type: Observational

This extension study is being conducted to assess the following objectives through 12 months post-cardiac surgery: - Patient reported outcomes (PRO), using the EQ-5D questionnaire - Clinical outcomes

NCT ID: NCT06092320 Recruiting - Medical Education Clinical Trials

Does Teaching Before or After Simulation Improve Learning?

Start date: September 20, 2023
Phase: N/A
Study type: Interventional

The goal of the randomized educational intervention study is to test whether simulation preceding didactic teaching leads to improved knowledge and performance retention compared to a didactic lecture proceeding simulation for medical students Participants will be randomized to one of two different groups with reverse orders for simulation and lectures. Researchers will compare each group to see which way is better for learning.

NCT ID: NCT06091319 Recruiting - Stroke Clinical Trials

Florbetaben for Imaging of Vascular Amyloid

FERMATA
Start date: October 9, 2023
Phase:
Study type: Observational

The Primary Objective is to determine if a new nuclear tracer (named 18F-Florbetaben) used with nuclear imaging (PET imaging) can detect inflamed plaque in patients with recent ACS or stroke/TIA.

NCT ID: NCT06090292 Recruiting - Parkinson Disease Clinical Trials

Effects of Peripheral Electrical Stimulation With Focused Ultrasound on Motor Symptoms in Parkinson's Patients

tbFUS-FES_PD
Start date: June 13, 2023
Phase: N/A
Study type: Interventional

Transcranial Ultrasound Stimulation (TUS) is an emerging non-invasive brain stimulation(NIBS) technique that can be used on both superficial and deep brain targets with a high spatial resolution as small as a few cubic millimeters. Functional Electrical stimulation is a peripheral stimulation technique researched and clinically used to restore motor function following conditions like stroke and Spinal cord injury. To date, there are no studies that have looked at the neuro modulatory effects of combining TUS and FES on motor symptoms in patients with Parkinson's disease. The current study aims to understand the neuromodulatory effects of combining tbFUS to bilateral primary motor cortex (M1) in Parkinsons's disease patients immediately followed by bilateral upper extremity FES of the hand muscles for improving motor symptoms.

NCT ID: NCT06089486 Recruiting - Clinical trials for Cardiac Allograft Vasculopathy

MARINER Trial: Multiparametric Cardiac PET for CAV Surveillance After Heart Transplantation

Start date: January 8, 2024
Phase: N/A
Study type: Interventional

Cardiac allograft vasculopathy (CAV) is a common complication affecting heart transplant patients. This condition causes narrowing of the heart arteries leading to graft dysfunction. Surveillance for CAV is vital; however an ideal approach has not been established. The goal of this study is to assess whether noninvasive positron emission tomography (PET) based surveillance is non-inferior to invasive coronary angiography (ICA) surveillance.

NCT ID: NCT06088160 Recruiting - Osteoarthritis, Hip Clinical Trials

Changes in Postural Stability Following THA for OA

CPS
Start date: December 27, 2023
Phase:
Study type: Observational

Total hip arthroplasty (THA) is a common surgery that eases pain, restores functional movement, and improves the overall quality of life in people with severe hip osteoarthritis (OA). Unfortunately, problems with postural stability, commonly known as balance, are still noticed in people even years after the surgery. These postural stability problems typically result in falls. The aim of the proposed study is to investigate how THA surgery affects a person's overall quality of life, both physically and psychologically, in terms of postural stability and balance confidence (self-efficacy) within the first three months after THA for osteoarthritis. This prospective cohort study will focus on people over 60 years old.