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Spasticity, or greater muscle resistance, is a major disabling condition following stroke. Recovery of lost motor function in patients with stroke may be affected by spasticity, which most commonly develops in elbow and ankle muscles. However, despite its clinical relevance, the natural development of spasticity over the first 3 months after stroke is not clearly understood. Indeed, common clinical measures of spasticity such as the Modified Ashworth Scale (MAS) do not take into account the neurophysiological origin of spasticity and lack reliability and objectivity. The objective of this study is to examine the natural history of the development of spasticity among patients with stroke over the first 3 months using a new neurophysiological measure (TSRT, the tonic stretch reflex threshold angle) and its velocity sensitivity (mu) in comparison to MAS and other common clinical tests. In addition, detailed brain imaging will be used to understand the relationship between damage to brain regions relevant to the development of spasticity and TSRT/mu values. It is hypothesized that 1) TSRT/mu will indicate the presence of spasticity earlier than MAS/clinical tests; 2) TSRT/mu measures will be more closely related to motor impairments and activity limitations than MAS; 3) the lesion severity (identified by imaging) will be related to the change in TSRT/mu values. Outcomes will be measured in a pilot cohort of 12 patients hospitalized for first-ever stroke. Measurements will be taken at the bedside within the 1st week of the patient's admission and will be done once per week for 12 weeks with a follow-up at week 16. Brain Imaging will be done around the 6th week post-stroke.
Conditions:
Stroke, Acute | Stroke, Ischemic | Stroke Hemorrhagic | Spasticity as Sequela of StrokeEmplacement:
- Jewish General Hospital, Montreal, Quebec, Canada
Sexe:
ALLÂges:
18 - 85The CREDE pilot randomized study will compare the intraoperative Crede manoeuver (M1) to preoperative prolapse (POP) reduction cough stress test (M2) for the prediction and prevention of PONSUI. The rates of PONSUI and its effect on patient reported outcomes and quality of life will be determined among women with positive or negative tests, and those with and without concomitant anti-incontinence procedure performed. This information will help inform larger studies on the topic.
Conditions:
Pelvic Organ Prolapse | Stress Urinary Incontinence | de Novo Stress Urinary IncontinenceEmplacement:
- McGill University Health Centre, Montréal, Quebec, Canada
- St. Mary's Hospital, Montreal, Quebec, Canada
- McGill University Health Centre, Montreal, Quebec, Canada
Sexe:
FEMALEÂges:
Over 18This clinical trial is studying the safety and potential anti-tumor activity of an investigational drug called ARV-393 in patients diagnosed with advanced Relapsed/Refractory non-Hodgkin's lymphoma to determine if ARV-393 may be a possible treatment option. ARV-393 is thought to work by breaking down a protein present in many types of non-Hodgkins lymphomas, which may prevent, slow or stop tumor growth. This is the first time ARV-393 will be used by people. The investigational drug will be given as an oral tablet.
Conditions:
Relapsed/Refractory (R/R) Angioimmunoblastic T-cell Lymphoma...Emplacement:
- Clinical Trial Site, Toronto, Ontario, Canada
- Clinical Trial Site, Montreal, Quebec, Canada
Sexe:
ALLÂges:
Over 18Lung cancer is the chief cause of cancer death. The new standard-of-care (SOC) in operable lung cancer combines chemotherapy and an immune-stimulating drug before the surgery (neoadjuvant approach). This results in a large increase in complete cancer clearance rates compared to chemotherapy alone (±30% with combination vs ±4% with chemotherapy alone), leading to much better long-term survival and probably many more cures. However, most still don't achieve complete clearance, and a few have increases in, or spread of, their tumors while on treatment. Therefore, we need to understand why some patients benefit (responders) and others don't benefit (non-responders) on an immunotherapy-based treatment. Also, some patients unpredictably develop severe immune-type side effects related to the immunotherapy drug, although such side effects may be associated with improved anti-cancer effects. In short, the same treatment can result in complete cancer clearance in one patient, and in a worst-case scenario may result in severe toxicity or fail to control spread/growth thus precluding surgery. The immune system obviously plays a key role in both benefit and harm, yet most of the research in this field has focused only on the cancer. We plan an in-depth study in 60 patients, focusing on the cancer as well as the patient's immune system, pre-surgery. This will enable us to identify factors predicting complete cancer clearance, and the occurrence of immune-type side effects. Using highly sophisticated resources available to us here in London, we will develop predictive models enabling better patient management (including possible avoidance of surgery), and identification of key biological differences between major responders and non-responders, to highlight important new targets for the development of even newer and better therapies.
Conditions:
Non-small Cell Lung Cancer Stage II (Resectable) | Non-small Cell Lung Cancer Stage IB...Emplacement:
- London Regional Cancer Program, London, Ontario, Canada
Sexe:
ALLÂges:
Over 18This is the first pilot phase II trial assessing the response of SBRT layered on Darolutamide (BAY1841788) on RPFS and deferring palliative second line systemic therapy in M0CRPC with oligoprogression.
Conditions:
Metastatic Prostate Cancer | Castration-resistant Prostate CancerEmplacement:
- Prostate Cancer Centre, Calgary, Alberta, Canada
- Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada
- Hôpital Fleurimont (CHUS), Sherbrooke, Quebec, Canada
- Centre of Applied Urology Research, Halifax, Nova Scotia, Canada
- Hôpital Maisonneuve-Rosemont, Montréal, Quebec, Canada
- Centre hospitalier affilié universitaire régional (CHAUR), Trois-Rivières, Quebec, Canada
- Service d'urologie et Centre de la prostate, Longueuil, Quebec, Canada
- L'Hôtel-Dieu de Québec (CHUQ), Québec city, Quebec, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Sir Mortimer JGH, Montréal, Quebec, Canada
- L'Hôtel-Dieu de Québec (CHUQ), Québec, Quebec, Canada
- Sir Mortimer JGH, Montreal, Quebec, Canada
- Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
Sexe:
MALEÂges:
Over 18In clinical practice, women living with type 1 diabetes frequently report that insulin requirements change across the menstrual cycle. Consequently, glycemic fluctuations are observed. This phenomenon could be explained by a decrease in insulin sensitivity during the second half of the menstrual cycle (luteal phase). Overall, despite an important proportion of women reporting glycemic and/or insulin variations across the menstrual cycle, studies to date have involved small sample sizes, and have had inconsistent results. The objective of this study will be to study glycemic fluctuations across the menstrual cycle using CGM data, alongside insulin data, in a large sample of women.
Conditions:
Type1diabetesEmplacement:
- Institut de recherches cliniques de Montréal, Montreal, Quebec, Canada
Sexe:
FEMALEÂges:
18 - 50The goal of this clinical trial is to test the investigational product, Montbretin A (MbA) in either individuals with type 2 diabetes (T2D) or healthy participants. The main questions it aims to answer are: * Safety of MbA * Whether MbA has less side effects in comparison to other medications used to treat T2D Participants will: * Be given MbA at increasing amounts (10 mg to 300 mg) over a two-week treatment period, along with standardized meal; * Undergo testing, including blood draws, blood sugar checks, electrocardiogram (ECG) and questionnaires.
Conditions:
Type 2 DiabetesEmplacement:
- VCHRI Clinical Research Unit, Vancouver, British Columbia, Canada
Sexe:
ALLÂges:
19 - 65Prostate cancer is the most common cancer diagnosed in men in Canada. Magnetic resonance imaging (MRI) may become a valuable tool to non-invasively identify prostate cancer and assess its biological aggressiveness, which in turn will help doctors make better decisions about how to treat an individual patient's prostate cancer. Despite the promise of MRI for detecting and characterizing prostate cancer, there are several recognized limitations and challenges. These include lack of standardized interpretation and reporting of prostate MRI exams. The investigators propose to validate and improve a computer program computerized prediction tool that will use information from MR images to inform us how aggressive a prostate cancer is. The hypothesis is that this computer-aided approach will increase the reproducibility and accuracy of MRI in predicting the tumor biology information about the imaged prostate cancer.
Conditions:
Prostate CancerEmplacement:
- Victoria General Hospital, Halifax, Nova Scotia, Canada
Sexe:
MALEÂges:
AnyThere is no consensus in the literature on the best way to treat cystic lesions of the pituitary area. Patients who are symptomatic from these tumours are rare. The cystic form of tumours present special challenges since traditional treatment modalities (surgery and/or external radiation) are often not able to completely remove or treat the cyst wall without major morbidity or even mortality. There is no 'best practice' for the treatment of cystic tumours per se. Treatments available to patients with cystic sellar/parasellar tumours include conservative management using a 'wait and scan' approach, cyst drainage, and cyst removal via transsphenoidal and/or craniotomy approach (i.e. open surgery). Over the last 10 years we have treated approximately 8 patients with intracystic radiotherapy. All of these patients continue to be monitored clinically and radiologically and all have done well with stable regression of the cysts and no new neurological deficits. Over the past 2 years, 90yttrium colloid has been provided to CDHA through Health Canada's Special Access Program (SAP). It has only been of recent that Health Canada has requested a clinical trial to assess the benefit of intracystic radiotherapy over other available treatment options. The experimental treatment being proposed is the stereotactic intracavitary instillation of 90yttrium colloid for treatment of cystic lesions of the pituitary (sellar) and surrounding areas (parasellar).
Conditions:
Cystic Tumors of the Sellar/Parasellar RegionEmplacement:
- Halifax Infirmary, Halifax, Nova Scotia, Canada
Sexe:
ALLÂges:
Over 17The specimen collection is designed for the purpose of the development of a noninvasive prenatal test for T21.
Conditions:
Down Syndrome | Fetal AneuploidyEmplacement:
- North York General Hospital, Toronto, Ontario, Canada
- IWK Health Centre, Halifax, Nova Scotia, Canada