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NCT ID: NCT05801549 Completed - Clinical trials for Arterio-venous Fistula

Arterio-Venous Fistula Audit. Successful Utilisation Rates of Arterio-Venous Fistulae for Haemodialysis at University Hospital Limerick

Start date: September 13, 2022
Phase:
Study type: Observational

We wish to examine Arterio-Venous Fistula (AVF) and Arterio-Venous Graft (AVG) utilisation rates for Haemodialysis at University Hospital Limerick. We want to determine out of the AVF's that are surgically created, how many go on to be used as anticipated for haemodialysis treatments successfully.

NCT ID: NCT05800860 Recruiting - Clinical trials for Treatment-resistant Depression

A Trial of GH001 in Patients With Treatment-resistant Depression

Start date: May 24, 2023
Phase: Phase 2
Study type: Interventional

The aim of this randomized, double-blind, placebo-controlled, phase 2b clinical trial is to investigate the safety and efficacy of GH001 (containing mebufotenin [5-methoxy-N,N-dimethyltryptamine; 5-MeO-DMT]) in patients with treatment-resistant depression (TRD). The study is comprised of a 7-day double-blind (DB) part (Part 1) and a 6-month open-label extension (OLE) part (Part 2). Patients will be randomized to receive GH001 or placebo in a 1:1 ratio. The primary endpoint is the mean change in the Montgomery-Åsberg Depression Rating Scale (MADRS) from baseline to Day 7.

NCT ID: NCT05793554 Not yet recruiting - Rectal Cancer Clinical Trials

CLASSICA: Validating AI in Classifying Cancer in Real-Time Surgery Study 1

Start date: March 2023
Phase:
Study type: Observational

Cancer of the lowermost part of the intestine (the rectum) is a common disease and both this disease and its treatment can have major impact on patients. Unless treated early, the disease can progress, spread to other parts of the body and ultimately cause death. Treatment often involves radical surgery, but this too has consequences and risks major complications. Best outcomes regarding cure with least impact depend on the disease being detected at an early stage as rectal cancer tends to start first as a non-cancerous polyp. The smallest of these precursor polyps can be easily removed during a routine colonoscopy but once the polyp grows over 2cm in size it is much harder to categorise correctly as the risk of it containing cancer somewhere in it increases markedly. If there is definitely cancer present in such a polyp it is best treated from the outset as a cancer with major surgery, but if there is definitely not a cancer in it then it can be removed from inside the bowel with minimally invasive techniques. Unfortunately, despite our current very best methods, up to 20% of tumours initially thought to be benign are found to be malignant only after they are excised We have previously shown that cancerous and non-cancerous tissues can be visually differentiated by analysis of their perfusion during the examination. For this we use a specific approved fluorescent dye, indocyanine green (ICG). ICG is commonly used in bowel surgery anyway to assess the blood supply to the bowel and has a very good safety profile. ICG is injected into the bloodstream during surgery and the rate at which it is taken up by various tissue types is detected by specific and approved cameras which can reveal fluorescence in tissue. We have previously found that the rate of uptake of this dye is different in cancer tissue compared to non-cancer tissue and have used artificial intelligence algorithms to measure this difference. However, we now need to ensure that this method can work also in other patients, in other centres and indeed in other countries to ensure it is indeed a valid and useful way of assessing rectal polyps. The goal of this observational study is to validate the use of fluorescence pattern analysis in the classification of rectal tumours. Patients enrolled in the study will attend for a visual examination of the rectal tumour in theatre as is standard practice. During this examination a video recording of the fluorescence perfusion will be taken following ICG administration. Patients will then have the tumour excised or treated as is standard of care by their surgeon. The video will later be analysed to determine the pattern of fluorescence perfusion within the tumour, and a classification will be assigned based on the pattern seen. All tumours that are excised are examined under the microscope by a pathologist to determine the final diagnosis. The fluorescence based classification will be compared to this pathological diagnosis to determine the accuracy of the method. So, patients will still have the exact same standard of care as currently happens, the hope is that in future this method can be developed to the point where it could be useful by means of a useable, accurate automated software process. If so, that will form the basis of another study in the future to look to see if it can guide or even replace biopsies and help with ensuring complete removal ('clear margins') after excision.

NCT ID: NCT05783427 Completed - Clinical trials for Aspiration; Gastric Contents, Anesthesia

An Evaluation of a Liberal Hydration Regimen Before Elective Caesarean Section Using Beside Gastric Ultrasound

Start date: March 13, 2023
Phase:
Study type: Observational

The aim of this study is to compare the residual gastric volumes in non-labouring parturients prior to elective Caesarean delivery when fully fasted as per European Society of Anaesthesia pre-operative fasting guidelines against the 'Sip Til Send' fasting guideline via a paired cohort study. The primary hypothesis is that 'Sip Til Send' would be non-inferior to standard fasting at minimising the residual gastric volume prior to surgery.

NCT ID: NCT05773183 Not yet recruiting - Obesity Clinical Trials

Exploring the Relationship Between Androgen Metabolism, Metabolic Disease and Skeletal Muscle Energy Balance in Men

MMetdMH
Start date: March 12, 2023
Phase:
Study type: Observational

This study relates to men with hypogonadism, a condition describing a deficiency of androgens such as testosterone. Deficiency of these hormones occurs in men due to testicular (primary) or hypothalamic-pituitary (secondary) problems or may be observed in men undergoing androgen deprivation therapy for prostate cancer. Testosterone plays an important role in male sexual development and health, but also plays a key role in metabolism and energy balance. Men with testosterone deficiency have higher rates of metabolic dysfunction. This results in conditions such as obesity, nonalcoholic fatty liver disease, diabetes, and cardiovascular disease. Studies have confirmed that treating testosterone deficiency with testosterone can reduce the risk of some of these adverse metabolic outcomes, however cardiovascular mortality remains higher than the general population. We know that testosterone deficiency therefore causes metabolic dysfunction. However, research to date has not established the precise mechanisms behind this. In men with hypogonadism there is a loss of skeletal muscle bulk and function. Skeletal muscle is the site of many critical metabolic pathways; therefore it is likely that testosterone deficiency particularly impacts metabolic function at this site. Men with testosterone deficiency also have excess fat tissue, this can result in increased conversion of circulating hormones to a type of hormone which further suppresses production of testosterone. The mechanism of metabolic dysfunction in men with hypogonadism is therefore multifactorial. The purpose of this study is to dissect the complex mechanisms linking obesity, androgens and metabolic function in men. Firstly, we will carry out a series of detailed metabolic studies in men with testosterone deficiency, compared to healthy age- and BMI-matched men. Secondly, we will perform repeat metabolic assessment of hypogonadal men 6 months after replacement of testosterone in order to understand the impact of androgen replacement on metabolism. Lastly, we will perform the same detailed metabolic assessment in men with prostate cancer before and after introduction of a drug which causes testosterone deficiency for therapeutic purposes.

NCT ID: NCT05759299 Not yet recruiting - Clinical trials for Airway Complication of Anesthesia

International obServational sTudy on AiRway manaGement in operAting Room and Non-operaTing Room anaEsthesia

STARGATE
Start date: December 2023
Phase:
Study type: Observational

According to WHO, more than 230 million major surgical procedures are carried out under general anaesthesia each year worldwide. Despite important technological advances, airway management remains a major challenge in anaesthesiology. Data from large perspective studies on current incidence of major peri-intubation adverse events are lacking in the anaesthesia setting, especially on outcomes such as peri-intubation cardiovascular collapse, severe hypoxemia, and cardiac arrest. These events are more common in case of difficulties with airway management so that first pass intubation failure significantly increase the risks. Moreover, it has been documented that even transient hypotension during general anaesthesia, may have long-term consequences and may be associated with a worse outcome in patients undergoing non-cardiac surgery. The primary aim of the study is to assess the current incidence of major peri-intubation adverse events during anaesthesia in patients undergoing elective or emergency surgery and in the setting of nonoperating room anesthesia. The secondary aim is to assess the current practice of airway management during anesthesia worldwide. STARGATE Study will be a large international observational study recruiting all consecutive adult (≥ 18 years old) patients undergoing general anesthesia in operating room and outside operating room. Primary outcome will be a composite of cardiovascular collapse, cardiac arrest and severe hypoxemia.

NCT ID: NCT05757427 Recruiting - Breast Cancer Clinical Trials

Pilot Clinical Evaluation of a Microwave Imaging System for Breast Cancer Detection

Start date: March 9, 2023
Phase: N/A
Study type: Interventional

The trialed investigational medical imaging device is a low-power microwave breast imaging system for cancer screening purposes. It is an active device which uses non-ionizing radiation. Microwave imaging is an emerging imaging modality for the early detection of breast cancer. The physical basis of microwave imaging is the dielectric contrast between healthy and cancerous breast tissues at the microwave frequency spectrum. This study is a pilot Clinical Evaluation of a microwave imaging system (Wavelia #2) for Breast Cancer Detection. The clinical data that will be collected in the context of this study is intended for the assessment of the imaging diagnostic capability and the safety of the investigational device.

NCT ID: NCT05753852 Recruiting - Clinical trials for Amyotrophic Lateral Sclerosis

Open Label Extension of TUDCA-ALS Study

TUDCA-ALS OLE
Start date: October 25, 2021
Phase: Phase 3
Study type: Interventional

This study will provide extended access to patients and assess longer-term outcomes on patients who have completed the TUDCA-ALS study.

NCT ID: NCT05749731 Completed - COVID-19 Clinical Trials

Pan-European Study on Geriatric Rehabilitation After COVID-19 Disease

EU-COGER
Start date: October 1, 2020
Phase:
Study type: Observational

Older and more vulnerable persons are more likely to get very ill when infected with the coronavirus, and have the highest COVID-19 morbidity and mortality rate. The majority of patients that are admitted to the hospital are older (>70 years), and some of them have been admitted to Intensive Care Units (ICU). In the case of rehabilitation of older patients post-COVID-19, we do not know what the course of recovery for these patients will be, and what treatment/approaches will deliver the best outcomes. Persons that are recovering from a COVID-19 infection, and admitted on a geriatric ward for early rehabilitation, or geriatric rehabilitation ward or facility, can be included in the study. They will receive routine, usual care; participation in this study will not affect their rehabilitation care. Routine care data will be collected from their electronic patient files at admission to geriatric rehabilitation, and at discharge. This also includes some data about their premorbid status. In addition, study participants will be called six weeks and six months after discharge from rehabilitation and asked some questions about their recovery. There is no risk association with participation in this study. Data will be anonymously collected in an online database. The primary aim of this study is to get insight into the course of recovery in (geriatric) rehabilitation patients affected by COVID-19 in Europe. Mainly, we are interested in functioning in activities of daily living (ADL-functioning) such as toileting, bathing, dressing, etc., and in quality of life. The second aim of this study is to get insight into the treatment modalities employed and the organization of geriatric rehabilitation that post-COVID patients in Europe receive. Therefore, we collect data on the types of care provided and the professionals involved. Moreover, we collect some patient characteristics such as year of birth, gender, date of admission and date of discharge; and data about complications such as delirium, pain, post-traumatic stress syndrome, hospital readmissions, and mortality. Our hypothesis is that most patients will show recovery during geriatric rehabilitation and in the six months after. However, we expect that the amount and/or speed of recovery will vary between patients.

NCT ID: NCT05741710 Recruiting - Clinical trials for Post Traumatic Stress Disorder

A Study to Assess the Use of Methylone in the Treatment of PTSD

IMPACT-1
Start date: March 1, 2023
Phase: Phase 1/Phase 2
Study type: Interventional

This study is evaluating the safety, tolerability, and efficacy of methylone in adults with PTSD. The study will be conducted in two parts. - Part A is open-label and will enroll up to 15 participants with PTSD - Part B is randomized (1:1), double-blind, placebo-controlled and will enroll up to 64 participants with PTSD Eligible participants will enter a 4-week Treatment Period where they will receive methylone once weekly for 4 weeks (4 treatment sessions). Following the Treatment Period, participants will enter a 6-week Follow-up Period which includes 3 reflection visits (Week 4, 5, and 6) and a final study visit at Week 10.