Clinical research

Intermittent Theta-Burst Stimulation with D-Cycloserine: A New Hope for Suicidal Ideation Background Depressive disorders are common among people who die by suicide. Intermittent theta-burst stimulation (iTBS) is a noninvasive treatment for those struggling with hard-to-treat depression and at risk for suicide. Combining iTBS with D-cycloserine, a medication that enhances antidepressant effects, may offer better outcomes. However, its effects on suicide risk were previously unknown. What We Did We investigated the impact of iTBS combined with D-cycloserine on suicidal thoughts and implicit suicide risk in two clinical trials: An open-label trial with 12 participants. A randomized placebo-controlled trial with 50 participants.… ➡️➡️➡️

Upadacitinib for Active Non-Radiographic Axial Spondyloarthritis: 2-Year Study Results Study Overview The SELECT-AXIS 2 study showed that upadacitinib significantly improved symptoms of active non-radiographic axial spondyloarthritis (nr-axSpA) over 52 weeks compared to a placebo. This report evaluates its effectiveness and safety over 2 years. Study Details Eligible adult patients with nr-axSpA were enrolled based on specific criteria. They were randomly assigned to receive either upadacitinib (15 mg daily) or a placebo for the first year. After 52 weeks, all patients switched to upadacitinib. The study tracked results for 104 weeks, focusing on various health measures and any side effects. Key… ➡️➡️➡️

Youth Experiencing Homelessness at Risk for Suicide Study Overview This study looks at young adults who are homeless and at risk of suicide. It aims to understand their mental health challenges and how they use available services to help prevent suicide. Key Findings Out of 193 young adults studied, 126 (65.3%) were at low risk, 32 (16.6%) at moderate risk, and 35 (18.1%) at high risk for suicide. Many reported having a psychiatric disorder (57.5%) and cannabis was the most commonly used substance. Only a small number received medical care (40%) or mental health services (34%) in the last three… ➡️➡️➡️

Phase II Trial Overview Study Title: PADDLE This trial investigates the combination of nab-paclitaxel, ramucirumab, and nivolumab for patients with advanced gastric cancer (AGC) who have not responded to previous treatments. Background Patients with AGC often have limited survival after initial treatments. New research suggests that continuing immunotherapy after disease progression can be beneficial. The combination of nab-paclitaxel, ramucirumab, and nivolumab may improve treatment outcomes for these patients. Trial Details The PADDLE trial is sponsored by Ono Pharmaceutical and involves multiple centers in Japan. Key points include: Participants must have advanced gastric or esophagogastric junction cancer. They should have a… ➡️➡️➡️

Tissue Doppler Echocardiography and Long-Term Cardiovascular Mortality Study Overview This study examines how tissue Doppler echocardiography can predict long-term cardiovascular mortality in hypertensive patients based on data from the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). Key Findings Background: Left ventricular diastolic function, evaluated through tissue Doppler echocardiography, has shown to predict cardiovascular events within 4 years in hypertensive patients. Long-Term Prediction: The study aimed to see if these findings also apply to predicting cardiovascular deaths over 20 years. Methodology The study involved 506 hypertensive patients, with follow-up data linked to national statistics. Various echocardiography measurements were taken and analyzed against cardiovascular… ➡️➡️➡️

Effect of Selective Caries Removal and Photobiomodulation on Postoperative Sensitivity Study Overview This clinical trial studied how selective removal of decay in deep cavities affects sensitivity after dental procedures. It involved 33 molars and compared three different treatment methods. Methods The teeth were divided into three groups: Control Group: Selective removal of infected dentine only. IR Group: Selective removal followed by infrared laser treatment. R Group: Selective removal followed by red laser treatment. All teeth were restored with a special adhesive and composite material. Sensitivity was measured at 12 hours, 7 days, and 14 days after treatment. Results The findings… ➡️➡️➡️

Intracameral Enoxaparin for Descemet Membrane Endothelial Keratoplasty: A Pilot Safety Study Study Overview The goal of this study was to assess the safety and results of using intracameral enoxaparin during Descemet membrane endothelial keratoplasty (DMEK). Methods The study included two parts: a clinical multicenter retrospective cohort arm (CA) and an ex vivo basic science arm (BSA). In the CA, DMEK procedures were performed by 6 skilled corneal surgeons across various locations. Intracameral enoxaparin (40 mg/500 mL) was added to the irrigation fluid for all surgeries. Outcomes were evaluated at 6 and 12 months. In the BSA, graft pairs were randomly… ➡️➡️➡️

Prediction and Prevention of Fascial Dehiscence After Laparotomy Objective The goal of this study was to assess how effective a special suture technique is in preventing fascial dehiscence (a complication where the surgical wound reopens) in patients who have certain risk factors during and after abdominal surgery. Methods This study looked at 112 patients who had abdominal surgery from 2013 to 2023. They were divided into three groups: Group 1: 57 patients who experienced fascial dehiscence shortly after surgery. Group 2: 41 patients who did not have fascial dehiscence, reviewed retrospectively. Group 3: 22 patients who received a new preventive… ➡️➡️➡️

Phenomapping Patient Responses to CABG in Ischemic Cardiomyopathy Study Overview Coronary artery bypass grafting (CABG) can improve long-term survival for patients with heart failure and blocked arteries. This study explores how different patient characteristics affect the benefits of CABG. Research Methods We analyzed data from the STICHES trial, which compared CABG plus medical treatment to medical treatment alone. Participants were divided into two groups for analysis. We identified different patient types (phenogroups) and assessed their long-term health risks and responses to CABG. Key Findings Four distinct phenogroups were identified. The highest-risk group had: Twice the risk of death Twice the… ➡️➡️➡️

Study on Visceral Adipose Tissue and Weight Loss Background Visceral adipose tissue (VAT) is a harmful type of body fat that can negatively affect health, while superficial subcutaneous adipose tissue (SAT) has little to no negative impact. This study looks at how VAT area and its proportion of total abdominal fat during weight loss can predict health outcomes. Methods We used MRI scans to measure VAT and different types of SAT from two 18-month weight loss trials, CENTRAL and DIRECT PLUS, involving 572 participants. Results At the start, participants had an average VAT area of 144.8 cm² and a VAT… ➡️➡️➡️

Implementation of a Rapid Diagnostic Test for Infections Study Overview This study evaluated a new blood test, MeMed BV® (MMBV), which can tell if an infection is bacterial or viral. The test was used in ten urgent care centers (UCCs) from April 2022 to March 2023. The main goal was to see how the test affected antibiotic use, and the secondary goal was to see how it helped doctors manage patients. Study Methods We conducted a pragmatic study with real-time reports from 144 physicians who ordered the MMBV test. They noted if they planned to prescribe antibiotics before the test… ➡️➡️➡️

Visual, Clinical, and Quality of Life Outcomes of a New Multifocal IOL Study Overview This study focuses on the BIOS Trifocal intraocular lens (IOL), designed to help patients see clearly at various distances without needing glasses. The lens aims to minimize issues like halos and glare, which can occur with other multifocal lenses. Key Features of BIOS Trifocal IOL Single-piece acrylic design: Enhances stability and centration. Aspheric surface: Reduces visual distortions. Optimized diffraction grating: Distributes light effectively for clear vision at all distances. Study Methods Participants received the BIOS Trifocal IOL and were evaluated at 30 and 90 days after… ➡️➡️➡️

Shift from Chronic to Episodic Migraine Frequency in a Long-Term Phase 3 Study of Galcanezumab Background Chronic migraine (CM) is a severe condition where patients experience 15 or more headache days per month, with at least 8 being migraine-type headaches. Galcanezumab is a medication designed to prevent migraines. A key goal in treating CM is to help patients transition to episodic migraine (EM), which involves fewer headache days. Methods Patients aged 18-65 with CM were randomly assigned to receive either a placebo or galcanezumab (120 mg or 240 mg) over a 3-month period. Following this, they could continue treatment in… ➡️➡️➡️

Effectiveness of Online Cognitive Behavioral Therapy for Mild Depression, Insomnia, and Panic: A Clinical Trial Study Background Many people experience symptoms of depression, insomnia, or panic that are not severe enough to be diagnosed as a mental health disorder. However, these symptoms can still make daily life challenging and lower quality of life. There is a lack of specific treatments for these mild symptoms, despite their importance in preventing more serious mental health issues. Objective This study aimed to test how effective an online cognitive behavioral therapy (ICBT) program is for individuals with mild depression, insomnia, and panic. It also… ➡️➡️➡️

Unified Protocol vs Mentalization-Based Therapy for Adolescents With Borderline Personality Disorder Study Overview This study compares two treatments for adolescents with borderline personality disorder (BPD): Mentalization-Based Therapy for Adolescents (MBT-A) and Unified Protocol for Adolescents (UP-A). It involved 91 Iranian adolescents, mostly female, to see which treatment better reduces BPD symptoms. Methodology Participants were randomly assigned to either MBT-A (45 participants) or UP-A (46 participants). They were monitored for 36 months after treatment. The effectiveness of both therapies was assessed using a statistical method called MIXED ANCOVA, focusing on the severity of borderline symptoms and other related issues like impulsivity… ➡️➡️➡️

Post-Acute Care Interventions for COPD Patients Study Overview This study focused on improving care for patients hospitalized due to COPD exacerbations in Switzerland. While inpatient care is good, there was a need for better post-acute care. An integrated care program was started at University Hospital Zurich to address this issue. Research Goals The goal was to compare how well post-acute care interventions were implemented before and after the new program started. Methods Used Researchers looked at medical records of patients hospitalized for COPD from July 2019 to March 2023. They compared two groups: one received standard care (Control Group) and… ➡️➡️➡️

Overview of the CINTS-R Trial Background Neoadjuvant chemoradiotherapy (nCRT) is the standard treatment for locally advanced rectal cancer (LARC). New methods like total neoadjuvant therapy (TNT) and immunotherapy are promising. We need better ways to select patients for these treatments. Our previous research shows that circulating tumour DNA (ctDNA) can help predict treatment outcomes and guide therapy choices. Trial Design The CINTS-R trial is a large study to compare ctDNA-guided treatment with standard therapy for LARC patients. We will include 470 patients with specific cancer stages from seven centers in China. Patients will be randomly assigned to either the experimental… ➡️➡️➡️

Topical Intranasal Anesthesia and Its Effects Background Topical intranasal anesthesia may affect how we perceive airflow in our noses. This could explain chronic nasal obstruction (CNO) in patients who do not have visible issues like deformities or inflammation. Our goal is to understand how this anesthesia impacts sensitivity in the nose and the feeling of nasal blockage. Methodology We conducted a study with 16 healthy participants. They were randomly assigned to receive either topical intranasal anesthesia (10% Xylocaine) or a placebo (saline solution). We assessed trigeminal sensitivity using the Trigeminal Lateralization Task (TLT) with eucalyptol. We measured nasal airflow using:… ➡️➡️➡️

A Study on Biosimilar Denosumab for Postmenopausal Osteoporosis Objective This study aimed to compare the safety and effectiveness of a biosimilar version of denosumab with the original product, Prolia, in Indian women with postmenopausal osteoporosis. Denosumab helps regulate bone turnover by decreasing bone loss. Methods This was a phase III, double-blind study involving postmenopausal women with osteoporosis. Participants were randomly divided into two groups: one received the biosimilar denosumab (Treatment A) and the other received Prolia (Treatment B). All participants also took daily vitamin D3 and calcium supplements. The main outcomes measured were changes in bone mineral density (BMD) at… ➡️➡️➡️

Comparative Efficacy of Lumbar and Pelvic Support for Postpartum Pain Study Overview This study examined how lumbar and pelvic supports help women with postpartum pelvic girdle pain (PPGP), a common issue after pregnancy. The goal was to see how these supports affect pain, disability, and movement control. Methodology 84 women diagnosed with pregnancy-related PPGP took part in this randomized controlled trial. They were divided into three groups: Pelvic Support Group Lumbar Support Group Control Group (received a patient education leaflet) We measured pain, disability, and muscle control at different times: Before the intervention Immediately after the intervention 4 weeks later… ➡️➡️➡️