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Emergencies clinical trials

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NCT ID: NCT05605093 Recruiting - COVID-19 Clinical Trials

Strategies and Treatments for Respiratory Infections & Viral Emergencies (STRIVE): Shionogi Protease Inhibitor (Ensitrelvir)

Start date: December 23, 2022
Phase: Phase 3
Study type: Interventional

Treatments are needed to improve outcomes among patients hospitalized for COVID-19, including direct-acting antiviral (DAA) agents to mitigate the pathology driven by ongoing viral replication. This trial will evaluate S-217622 (ensitrelvir), an anti-SARS-CoV2 3C-like protease inhibitor (PI) developed by Shionogi &; Co. Ltd. The study design is a randomized, placebo-controlled, multi-center international clinical trial that will evaluate the clinical efficacy of ensitrelvir when given in addition to standard of care (SOC) for inpatients with COVID-19. The SOC will be determined by local established guidelines and may include additional DAA (e.g., remdesivir) and immunomodulatory treatment strategies. Certain SOC treatments will be pre-specified prior to randomization.

NCT ID: NCT05596929 Recruiting - Internal Disease Clinical Trials

Build-up Computed Assisted History Taking, Physical Examination and Diagnosis System of Emergency Patient Through Machine Learning (II)

MLD
Start date: December 12, 2022
Phase: N/A
Study type: Interventional

In emergency department(ED), physicians need to complete patient evaluation and management in a short time, which required different history taking, and physical examination skill in healthcare system. Natural language processing(NLP) became easily accessible after the development of machine learning(ML). Besides, electronic medical record(EMR) had been widely applied in healthcare systems. There are more and more tools try to capture certain information from the EMR help clinical workers handle increasing patient data and improving patient care. However, to err is human. Physicians might omit some important signs or symptoms, or forget to write it down in the record especially in a busy emergency room. It will lead to an unfavorable outcome when there were medical legal issue or national health insurance review. The condition could be limited by a EMR supporting system. The quality of care will also improve. The investigators are planning to analyze EMR of emergency room by NLP and machine learning. To establish the linkage between triage data, chief complaint, past history, present illness and physical examination. The investigators will try to predict the tentative diagnosis and patient disposition after the relationship being found. Thereafter, the investigators could try to predict the key element of history taking and physical examination of the patient and inform the physician when the miss happened. The investigators hope the system may improve the quality of medical recording and patient care.

NCT ID: NCT05593692 Recruiting - Emergencies Clinical Trials

Gender Differences and Age Related Differences in Emergency Department Admission

SADE
Start date: October 18, 2022
Phase:
Study type: Observational

The goal of this observational study is to learn about difference related to age and gender in patients admitted to emergency department.

NCT ID: NCT05589181 Recruiting - Opioid Use Disorder Clinical Trials

High Dose Buprenorphine (BUP) Induction in the Emergency Department (ED)

Start date: April 10, 2023
Phase: Phase 3
Study type: Interventional

This project, involving two distinct clinical trials, tests whether induction to a higher than currently recommended buprenorphine (BUP) induction dose is safe and can improve the proportion of patients who engage in comprehensive addiction services within 7-day of induction. Trial 1 is a head-to-head comparison of the safety, tolerability and feasibility of high dose BUP induction (32 mg). The study involves two cohorts, (1) a 12mg cohort (standard) to determine baseline data and (2) a 32 mg (high dose) cohort. If the 32mg is intolerable, a 24 mg dose may be evaluated. Trial 2 is a small pilot multicenter randomized, double blinded, clinical trial in 80 participants (randomized 1:1) that will provide preliminary information on efficacy with the primary outcome being engagement in comprehensive addiction treatment 7-days post BUP induction. In collaboration with National Institute on Drug Abuse (NIDA), the research team have determined that there must be a minimum increase in engagement in comprehensive addiction treatment of 15% at 7-days in the high dose induction group to justify a larger future clinical trial.

NCT ID: NCT05589103 Recruiting - Head Trauma Injury Clinical Trials

Mild Head Trauma in the Emergency Room: Assessment of the Risk of Intracranial Hemorrhage in Patients Receving Platelet Inhibitors.

Trauma-Head
Start date: January 1, 2020
Phase:
Study type: Observational

The clinical signs presented by a patient with a mild head injury are highly variable but remain strongly predictive of brain damage. The reference examination for the diagnosis of post-traumatic intracranial hemorrhage is currently the cerebral scanner without injection of contrast medium. Magnetic resonance imaging (MRI) tends to surpass CT in equipped centers, except for suspected bone lesions. The time required to perform brain imaging depends on the patient's clinical condition, comorbidities and treatments. The responsibility of antiplatelet agents in post-traumatic intracranial hemorrhage is currently discussed, particularly with aspirin. The hypothesis is that there is no significant difference in the proportion of intracranial hemorrhage in patients on antiplatelet agents after mild head trauma, in the absence of other factors favoring the occurrence of intracranial hemorrhage.

NCT ID: NCT05588193 Recruiting - HIV Clinical Trials

ED2PrEP - Patient Focused, Low-burden Strategies for PrEP Uptake Among Emergency Departments

ED2PrEP
Start date: July 2024
Phase: N/A
Study type: Interventional

Severe inequities in HIV pre-exposure prophylaxis (PrEP) access and use in communities hardest hit by the HIV epidemic persist, further exacerbating ongoing racial/ethnic and socioeconomic disparities in HIV incidence. In these same communities, many patients at risk for HIV seek care for sexually transmitted infections (STIs) in Emergency Departments (EDs), but the structure of traditional ED care is poorly suited to address HIV prevention or provide PrEP. To advance the Prevent objective of the Ending the HIV Epidemic (EHE) initiative, ED2PrEP will leverage an implementation science approach to rigorously test two innovative strategies for increasing PrEP uptake among patients seeking STI care in EDs in one of the 48 EHE-identified geographic hotspots.

NCT ID: NCT05575934 Recruiting - Syncope Clinical Trials

Management of Transitory Loss of Consciousness and Syncopes in the Emergency Department

Start date: October 3, 2022
Phase:
Study type: Observational

The goal of this observational study is to examine the clinical presentations, the diagnostic tests performed and the management of patients presenting with transient loss of consciousness (TLOC) The main questions it aims to answer are: - prevalence of TLOC - prevalence of different diagnoses leading to TLOC Demographic, clinical, paraclinical and biological data will be collected from the emergency medical file

NCT ID: NCT05561101 Recruiting - Clinical trials for Patient Without Cognitive Disorders

Evolution of the Health Status of Caregivers After the Admission of Their Elderly Relative to the Emergency Department

ETAP-U
Start date: September 20, 2022
Phase:
Study type: Observational

The main objective of this non-interventional, propective and multipercentric study is to Assess the evolution of caregiver burden 1 month after their elderly relative's Emergency Department (ED) admission

NCT ID: NCT05555771 Recruiting - Clinical trials for Postural Orthostatic Tachycardia Syndrome

Paediatric Syncope in the Emergency Department

DETECT-ED
Start date: September 3, 2022
Phase: N/A
Study type: Interventional

The investigators will assess the efficacy of clinically recommended counterpressure maneuvers (CPM) in preventing syncope for paediatric patients. Participants presenting to the emergency department (ED) will first provide written informed consent. In stage I, they will be asked to complete a brief survey documenting the presentation of their syncopal episode, and any prodromal symptoms they experienced. Participants that consent to the second stage of the study will either receive usual care (control arm) or training in counter pressure maneuvers alongside usual care (intervention arm; leg crossing, bending, arm tensing). These patients will be followed for one years time, and will be asked to complete monthly surveys detailing their syncopal and presyncopal recurrence. Medical records will be accessed over the duration of the study to identify any changes in medical diagnosis.

NCT ID: NCT05555576 Recruiting - Pain, Acute Clinical Trials

Impact of Vitamin C on opioïd Consumption After an Emergency Department Visit for Acute Musculoskeletal Pain

Start date: November 1, 2023
Phase: N/A
Study type: Interventional

Recent evidence has shown that vitamin C has some analgesic properties and can therefore reduce opioids used during healing. Vitamin C analgesic effect has been explored mostly during the short-term postoperative context or in disease specific chronic pain prevention but not after acute musculoskeletal injuries, which are often seen in the emergency department (ED). The study's primary aim is to compare the total morphine 5 mg equivalent pills consumed during a two-week follow-up between patients receiving vitamin C or a placebo after ED discharge for an acute musculoskeletal pain complaint. The investigators will conduct a double-blind randomized placebo-controlled trial with 464 participants distributed in two arms, one group receiving 1 000 mg of vitamin C twice a day for 14 days and another one receiving a placebo. Participants will be ≥18 years of age, treated in ED for acute musculoskeletal pain present for less than 2 weeks, and discharged with an opioid prescription for home pain management. Total morphine 5 mg equivalent pills consumed during the two-week follow-up will be assessed via an electronic (or paper) diary. In addition, patients will report their daily pain intensity, pain relief, side effects, and other types of pain medication or other non-pharmacological approach (ice, heat, immobilization, etc.) used. Three months after the injury, participants will also be contacted to evaluate chronic pain development. The investigators hypothesized that vitamin C, compared to a placebo, will reduce opioid consumption during a 14-day follow-up for ED discharged patients treated for acute pain.