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CONVERGE-HF is a 4-center pilot phase IIb randomized control trial in ambulatory patients with chronic heart failure (≥ 6 months) and mild-to-moderate cognitive impairment.
Conditions:
Cognitive Impairment | Heart FailureEmplacement:
- McGill University Health Center, Montreal, Quebec, Canada
- University of Ottawa, Ottawa, Ontario, Canada
- University of Alberta, Edmonton, Alberta, Canada
- University of Calgary, Calgary, Alberta, Canada
Sexe:
ALLÂges:
Over 18Critically ill patients who (1) are not able to maintain their airway, (2) cannot breathe on their own, or (3) both, are ones who often require tracheal intubation and support from a breathing machine (mechanical ventilator). When the patient is ready to be liberated from the mechanical ventilator because the initial insult for intubation has been resolved, the patient is screened using the readiness to wean test in preparation for extubation. As the patient passes this screening, a spontaneous breathing test (SBT) is initiated. Currently, there are many debates surrounding which SBT technique is most favorable. At Toronto General Hospital, the clinical team uses a zero-end expiratory pressure (ZEEP) trial. Once the patient successfully passes their SBT they are then extubated. The patient will undergo a spontaneous breathing trial of continuous positive airway pressure (CPAP) of 5 cmH2O and ZEEP, in which time the investigators will be using a new technology called electrical impedance tomography (EIT), to study and compare the end expiratory lung volume (EELV); investigators will use an esophageal catheter to measure and monitor pressures in the lung, and also assess the patient's work of breathing. This will be repeated once the patient has been extubated safely.
Conditions:
Ventilator Associated Pneumonia | Lung Transplant; Complications | Ventilator-Induced Lung InjuryEmplacement:
- Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
Sexe:
ALLÂges:
Over 18The radial forearm free flap (RFFF) is widely used in head and neck reconstruction. Its thinness, pliability, pedicle length, and vessel size are particularly suited for oropharyngeal and oral cavity reconstruction. Concerns about aesthetic and functional morbidity at the donor site have given rise to various techniques of closing the donor site, two of which are the split-thickness skin graft (STSG), taken from the thigh, and the hatchet flap, which uses a local flap within the radial forearm. This RCT will determine whether retrospectively reported improvements to aesthetic and functional outcomes for STSG patients are greater compared to hatchet flap patients.
Conditions:
Oral Cancer | Donor Site Complication | Oral Cavity CancerEmplacement:
- Vancouver General Hospital, Vancouver, British Columbia, Canada
Sexe:
ALLÂges:
Over 18Ultrasound-guided regional anesthesia/analgesia techniques (or simply, 'regional blocks') have gained popularity as they can reduce, and sometimes even eliminate, the need for opiate analgesics (and, consequently, their side effects), thereby improving patient safety, reducing length of hospital stay and medical costs, and improving patient satisfaction. However, a major barrier to mainstream uptake of such techniques relates to training. These techniques require the acquisition of new skills under expert guidance, which is often not possible given the daily demands placed upon anesthesiologists. As a result, many opportunities for providing regional blocks may be missed. The purpose of this study is to implement a new real-time 'near remote' guidance method in which trainees who are to perform regional blocks can do so via tele-mentoring under expert guidance. This will be done using a novel technology whereby the ultrasound image is concurrently displayed on an iPad screen (for the block operator/trainee) as well as on the (near remotely supervising) expert mentor's smartphone. Trainees and mentors will use this method to perform various standard of care regional blocks, either in the perioperative or emergency department settings. Participants' opinions of the novel teaching and learning method will be assessed.
Conditions:
Analgesia | Nerve Block | Anesthesia | Delivery of Healthcare | Hospitals, TeachingEmplacement:
- Hotel Dieu Hospital site (primary) and Kingston General Hospital site (secondary), Kingston Health Sciences Centre, Kingston, Ontario, Canada
Sexe:
ALLÂges:
Over 18This proposed study is a single-center, double blind, parallel group RCT comparing the use of low (10 mm Hg) versus standard pressure (15 mm Hg) pneumoperitoneum at the time of benign gynecologic laparoscopic surgery. Patients will be randomized to the control group (standard pressure) or the intervention group (low pressure) and surgeons will be blinded to the study pressure. Data on post-operative recovery and pain scores will be recorded for each patient.
Conditions:
Surgery | Laparoscopy | Post-operative Pain | Laparoscopic | Post-operative Recovery | PenumoperitoneumEmplacement:
- Women's College Hospital, Toronto, Ontario, Canada
Sexe:
FEMALEÂges:
Over 18The INCOGNITO Pilot Trial is a single centre pilot prospective randomized open-label blinded endpoint (PROBE) trial to assess the feasibility of a full-scale randomized trial to determine whether an occult cancer screening strategy of FDG PET/CT (F-fluorodeoxyglucose positron emission/computed tomography) in addition to usual care increases the number of occult cancers diagnosed after screening compared to usual care cancer screening alone in patients with cryptogenic stroke.
Conditions:
Occult CancerEmplacement:
- The Ottawa Hospital, Ottawa, Ontario, Canada
Sexe:
ALLÂges:
Over 18This study is a prospective open-label randomized clinical trial. Following informed consent eligible LASCCHN patients (n=100) planned for CRT will be stratified by tumor p16 status and then randomized in a 1:1 fashion to either concurrent HD cisplatin or concurrent weekly LD cisplatin.
Conditions:
Locally Advanced Head and Neck Squamous Cell CarcinomaEmplacement:
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- London Regional Cancer Program, London, Ontario, Canada
- Juravinski Cancer Centre, Hamilton, Ontario, Canada
Sexe:
ALLÂges:
Over 18The Sunnybrook Type 2 Diabetes Study (S2DS) is a prospective observational study of people with prediabetes or Type 2 Diabetes Mellitus (T2DM), that aims to understand the aetiologies, manifestations, and clinical consequences of mood and cognitive complications. The study recruits from the services at Sunnybrook Health Sciences Centre and from the neighbouring University Health Network Toronto Rehabilitation Institute Cardiac Rehabilitation Program.
Conditions:
Type 2 Diabetes | PreDiabetesEmplacement:
- Sunnybrook Research Institute, Toronto, Ontario, Canada
Sexe:
ALLÂges:
Over 18A novel temporary peripheral nerve stimulation system that delivers a single dose of electrical stimulation therapy for 1 hour will be evaluated for safety and effectiveness.
Conditions:
Nerve InjuryEmplacement:
- Hamilton General Hospital, Hamilton, Ontario, Canada
- Trillium Health Partners, Toronto, Ontario, Canada
- University of Alberta Hospital, Edmonton, Alberta, Canada
- North York General Hospital, Toronto, Ontario, Canada
- Roth | McFarlane Hand & Upper Limb Centre, London, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Saint John Regional Hospital, Saint John, New Brunswick, Canada
Sexe:
ALLÂges:
18 - 65This is a placebo-controlled, randomized, double-blind, parallel group, phase 3 multicenter study in subjects recently hospitalized for ACS and with the appropriate genetic profile. Subjects will provide informed consent before any study-specific procedures are performed. A separate informed consent will be allowed for an initial pre-screening genetic testing. Subjects meeting the AA genotype will then consent to the full study and confirmatory genetic testing as required. Subject enrollment may begin in the hospital and will continue following release from the hospital or may begin following release from hospital. Screening procedures may be performed at the time of the index ACS event or anytime thereafter, with the condition that randomization must occur within the mandated window (up to12 weeks after the index event). Subjects will be assessed based on their medical history. Those who are likely to qualify will undergo Genotype Assay testing to evaluate genetic determination for the presence of AA genotype.
Conditions:
Acute Coronary SyndromeEmplacement:
- Research Site, Edmonton, Alberta, Canada
- Research Site, Abbotsford, British Columbia, Canada
- Research Site, North Vancouver, British Columbia, Canada
- Research Site, Moncton, New Brunswick, Canada
- Research Site, Cambridge, Ontario, Canada
- Research Site, Moncton, New Brunswick, Canada
- Research Site, Vancouver, British Columbia, Canada
- Research Site, Kingston, Ontario, Canada
- Research Site, Ottawa, Ontario, Canada
- Research Site, Scarborough, Ontario, Canada
- Research Site, Toronto, Ontario, Canada
- Research Site, Toronto, Ontario, Canada
- Research Site, Granby, Quebec, Canada
- Research Site, Montréal, Quebec, Canada
- Research Site, Greenfield Park, Quebec, Canada
- Research Site, Montréal, Quebec, Canada
- Research Site, Québec, Quebec, Canada
- Research Site, Québec, Quebec, Canada
- Research Site, Saint-Jérôme, Quebec, Canada
- Research Site, St-Hubert, Quebec, Canada
- Research Site, Saskatoon, Saskatchewan, Canada
- Research Site, Calgary, Alberta, Canada
- Research Site, Kamloops, British Columbia, Canada
- Research Site, Winnipeg, Manitoba, Canada
- Research Site, Brampton, Ontario, Canada
- Research Site, Newmarket, Ontario, Canada
- Research Site, Toronto, Ontario, Canada
- Research Site, Chicoutimi, Quebec, Canada
- Research Site, Lévis, Quebec, Canada
- Research Site, Montréal, Quebec, Canada
- Research Site, Saint Charles Borromee, Quebec, Canada
- Research Site, Trois-Rivières, Quebec, Canada
- Research Site, Burnaby, British Columbia, Canada
- Research Site, Victoria, British Columbia, Canada
- Research Site, St. John's, Newfoundland and Labrador, Canada
- Research Site, Scarborough Village, Ontario, Canada
- Research Site, Laval, Quebec, Canada
- Research Site, Montreal, Quebec, Canada
- Research Site, Rimouski, Quebec, Canada
- Research Site, Terrebonne, Quebec, Canada
- Research Site, Montreal, Quebec, Canada
- Research Site, Saint-Hubert, Quebec, Canada
- Research Site, Sherbrooke, Quebec City, Canada
- Research Site, Montreal, Quebec, Canada
- Research Site, Halifax, Nova Scotia, Canada
- Research Site, London, Ontario, Canada
- Research Site, Scarborough Village, Ontario, Canada
- Research Site, Montreal, Quebec, Canada
- Research Site, Saint-Charles-Borromée, Quebec, Canada