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The purpose of this study is to determine the optimal radiation dose fractionation regimen for low grade follicular lymphoma. It is hypothesized that the complete response rate with the use of 12 Gy in 6 daily fractions is 80% (10% total width of the confidence interval) at 3 months. This phase II study will evaluate whether an intermediate dose for follicular lymphoma is associated with excellent response rates while minimizing acute and late toxicity.
Conditions:
Follicular LymphomaLocation:
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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ALLAges:
Over 18Frontotemporal dementia (FTD), the most common dementia in individuals younger than 60 years of age, has no disease-modifying treatment. Neuroimaging studies have revealed salience and default mode network dysfunction, frontotemporal atrophy and hypometabolism as pathophysiological hallmarks of behavioral variant FTD (bvFTD). A key brain structure affected by bvFTD is the subgenual cingulate (SGC), which serves as a hub for multi-axonal projections to and from the ventromedial prefrontal, dorsal anterior cingulate, orbitofrontal, and dorsolateral frontal cortices, and limbic structures. The disruption of these SGC projections in bvFTD result in the core clinical features of apathy, disinhibition, loss of empathy, compulsivity, hyperorality and loss of executive function. The central goal of this proposal is to use deep brain stimulation (DBS) for modulation of the SGC downstream projections to treat bvFTD. Investigators hypothesize that SGC DBS will drive activity in the dysfunctional networks, reverse hypometabolism, and potentially improve symptoms. To determine the physiologic effects and mechanisms of SGC DBS, investigators will assess cerebral metabolism by FDG-PET, connectivity by rsfMRI and MEG, atrophy by volumetric MRI, and neurodegenerative and neuroinflammatory biomarkers. The safety and preliminary efficacy data obtained in these patients will inform the possible future role of DBS in apathetic bvFTD.
Conditions:
Frontotemporal Dementia | Deep Brain StimulationLocation:
- Toronto Western Hospital, Toronto, Ontario, Canada
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ALLAges:
40 - 85Every year, the pain, disability, addiction, and expense associated with LBP increase in Alberta. This escalation is largely because most people with LBP seek care from family physicians who are unable to provide effective, guideline-based interventions due to three recognized barriers: 1) a lack of training, 2) a lack of no (or low) cost access to these interventions and 3) a lack of physician time and reimbursement to deliver these interventions. As a result, most LBP care provided in Alberta is "low-value". With input from Alberta patients, healthcare providers, administrators and international scientists, the Alberta Back Carepathway (ABCp) was designed to overcome these barriers by giving family physicians a common, guideline-based approach to coordinate, assess and manage LBP patients in day-to-day practice. The ABCp trains family physicians to quickly and easily place patients into 5 categories each having evidence-based interventions that can be provided by physicians at no or low cost to patients and no net cost to the healthcare system. By designing the ABCp to resolve barriers related to training, access and delivery, the ABCp will "pull" rather than "prod" patients and clinicians toward sustained, long-term implementation of this cost-effective solution. This study is based on a multi-clinic, controlled, non-randomized stepped-wedge study designed for urban and rural primary care networks (PCNs). The primary outcome will be decreased healthcare resource utilization with secondary improvements in quality of life and opioid consumption. Overall, the savings realized through ABCp will create a self-sustaining, scalable solution for LBP care in Alberta.
Conditions:
Low Back PainLocation:
- University of Alberta, Edmonton, Alberta, Canada
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ALLAges:
Over 18Exploration to optimize mixed quantitative and qualitative methodology using multiple outcome measures in a randomized, cross-over trial structure comparing the effect of robotic gait training (RGT) group, and functional clinical therapy (FCT) using each subject as their own control.
Conditions:
Cerebral PalsyLocation:
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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ALLAges:
2 - 12The main purpose of this study is to assess the efficacy and safety of volrustomig compared to observation in participants with unresected locally advanced head and neck squamous cell carcinoma (LA-HNSCC) who have not progressed after receiving definitive concurrent chemoradiotherapy (cCRT).
Conditions:
Locally Advanced Head and Neck Squamous Cell CarcinomaLocation:
- Research Site, Kingston, Ontario, Canada
- Research Site, Montreal, Quebec, Canada
- Research Site, Kelowna, British Columbia, Canada
- Research Site, Montreal, Quebec, Canada
- Research Site, Calgary, Alberta, Canada
- Research Site, London, Ontario, Canada
- Research Site, Montreal, Quebec, Canada
- Research Site, Edmonton, Alberta, Canada
- Research Site, Toronto, Ontario, Canada
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ALLAges:
18 - 130Specialized equipment is required to put pacemakers in the heart. This requires use of radiation to see the wires or leads being implanted in the heart. Repeated radiation use can result in permanent injury to the patient and to the doctor. The investigators aim to investigate if they can use ultrasound to guide and help in the implantation of leads into the heart. Ultrasound is a safe method and requires only a small handheld probe and a small screen to see different structures in the heart. If ultrasounds proves successful as a tool to reduce radiation then this would be very useful technical breakthrough. It would help develop smaller centres where pacemakers can be implanted without purchasing xray equipment and expensive setups.
Conditions:
Bradycardia | Brady-tachy SyndromeLocation:
- London Health Sciences Centre Res. Inc. (Ont.), London, Ontario, Canada
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ALLAges:
Over 18This study is being done to answer the following questions: * Is the new drug, RP-6306, safe to use, and what effects does it have on cancer when given with standard treatment? * If there are specific biomarkers, do patients have an improved response to treatment compared to those without the biomarker? This study is being done to find out if this approach is better or worse than the usual approach for this type of cancer. The usual approach is defined as care most people get for this type of cancer.
Conditions:
Advanced CancerLocation:
- Verspeeten Family Cancer Centre, London, Ontario, Canada
- BCCA - Kelowna, Kelowna, British Columbia, Canada
- Kingston Health Sciences Centre, Kingston, Ontario, Canada
- BCCA - Vancouver, Vancouver, British Columbia, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Juravinski Cancer Centre at Hamilton Health Sciences, Hamilton, Ontario, Canada
- University Health Network, Toronto, Ontario, Canada
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Over 18Does an educational intervention for untreated COPD and cardiovascular disease which is integrated in an existing lung cancer screening program improve guideline concordant medication adherence at 12 months
Conditions:
COPD | Coronary Artery CalcificationLocation:
- McGill University Health Center, Montreal, Quebec, Canada
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ALLAges:
55 - 74Chest injuries are common in patients with polytrauma and are responsible for approximate 25% of all trauma-related mortalities. Traumatic injuries to the thorax often result in the accumulation of blood within the chest (i.e. a hemothorax (HTX)). The management of HTX remains a clinical dilemma when the volume of blood is small to moderate and the patient is hemodynamically stable. The East American Association of Trauma guidelines suggest that all HTXs should be considered for chest tube drainage. However, a prospective observational study suggested small to moderate HTXs could be absorbed without intervention. Although HTXs are effectively managed with chest tube drainage of the blood (i.e. tube thoracostomy), this intervention is associated with numerous potential major complications, including injury and infection in up to 22% of patients. The purpose of this study is therefore to conduct a randomized controlled study to compare patients with traumatic HTX managed by chest tube drain or expectant management (close monitoring), to determine when a chest tube is needed and when it is not to treat hemothoraces. The results from this study will inform the care of future trauma patients who present with this common injury throughout the globe.
Conditions:
Hemothorax | Thoracic InjuriesLocation:
- Foothills Medical Centre, Calgary, Alberta, Canada
- Foothills Medical Centre, Faculty of Medicine, Calgary, Alberta, Canada
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ALLAges:
18 - 100Evaluation of Mother's Empowerment Program and Kid's Club Program adapted specifically for Indigenous mothers and children affected by intimate partner violence in Canada
Conditions:
Violence, DomesticLocation:
- Discovery House, Calgary, Alberta, Canada