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CaNAL is a longitudinal observational cohort study of patients diagnosed with Primary Biliary Cholangitis (PBC), Autoimmune Hepatitis (AIH), or overlap syndrome. This study creates a nationwide registry and network focusing on high quality long-term follow-up of individual patient data from major Canadian centers. Primary Biliary Cholangitis (PBC) and Autoimmune Hepatitis (AIH) are rare and slowly progressive liver diseases associated with development of cirrhosis, liver cancer (HCC) and liver failure requiring liver transplantation or leading to premature death. The rarity and slowly progressive nature of these autoimmune liver diseases make them difficult to study and only a large scale approach combining patient data from multiple centers across Canada will allow new insights. The primary aim of the Canadian Network for Autoimmune Liver Disease is to build a Canadian registry of patients with PBC, AIH, and overlap syndrome. We capture patient characteristics, laboratory assessments and natural history, patient-reported outcomes including quality of life measures and environmental exposures, response to treatment, and pre- and post-transplant outcomes. We will then identify risk factors associated with critical outcomes for the patient, including response to treatment, progression to transplant, risk of liver cancer, and recurrent disease after transplant. We can identify biomarkers (biochemical indicators of progression of disease) to help diagnose autoimmune liver disease at its earliest stages, ensuring timely treatment and preventing disease progression. CaNAL will provide a better understanding of autoimmune liver diseases, biomarkers predictive of disease progression or non-response to therapy as well as better knowledge of the etiology and pathogenesis. CaNAL will also help to serve as a platform for conducting clinical trials or targeted lab-studies to answer important questions that are unlikely to be evaluated by the pharmaceutical industry.
Conditions:
Autoimmune Hepatitis | Overlap Syndrome | Primary Bilary Cirrhosis (PBC)Emplacement:
- Vancouver General Hospital, Vancouver, British Columbia, Canada
- McMaster University Medical Centre, Hamilton, Ontario, Canada
- Toronto General Hospital, Toronto, Ontario, Canada
- Royal University Hospital, Saskatoon, Saskatchewan, Canada
- University of Alberta Hospital, Edmonton, Alberta, Canada
- Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Université de Sherbrooke, Sherbrooke, Quebec, Canada
- St. Paul's Hospital, Vancouver, British Columbia, Canada
- Kingston Health Sciences Centre (HDH Site), Kingston, Ontario, Canada
- McMaster University Medical Centre, Montreal, Quebec, Canada
- Foothills Medical Centre, Calgary, Alberta, Canada
- Health Sciences Centre, Winnipeg, Manitoba, Canada
- London Health Sciences Centre - University Hospital, London, Ontario, Canada
- Centre hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
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ALLÂges:
Over 18Our objective in this pilot study will be to identify PA parameters that can distinguish benign vs. malignant lesions, and also, if PA parameters change with within breast tumors during chemotherapy treatment over time.
Conditions:
Breast CancerEmplacement:
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Sexe:
ALLÂges:
AnyRecent 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.
Conditions:
Pain, AcuteEmplacement:
- Hôpital du Sacré-Coeur de Montréal, Montréal, Quebec, Canada
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ALLÂges:
Over 18The goal of this pilot randomized cross-over study is to compare the effect of a full-face mask with expiratory washout to a conventional full face mask on non-invasive ventilation (NIV) in patients with acute hypercapnic, and acute hypoxemic, respiratory failure. The main questions it aims to answer are: * Does a mask with expiratory washout improve minute ventilation in patients using non-invasive ventilation compared with a conventional single-limb NIV mask * How does a mask with expiratory washout affect respiratory variables compared with a dual-limb NIV mask. Participants already prescribed NIV will undergo 3 arms of the investigation in a randomized order: * Single-limb NIV with investigation mask (with expiratory washout) * Single-limb NIV with conventional mask * Dual-limb NIV with conventional mask
Conditions:
Acute Hypoxemic Respiratory Failure | Acute Hypercapnic Respiratory FailureEmplacement:
- Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada
- Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ), Quebec City, Quebec, Canada
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ALLÂges:
Over 18The standard treatment for Type 2 diabetes involves management of the disease based on average of blood glucose control over the past few months. In this study, the investigators test for the participants' ability to produce insulin, which is the hormone that the body makes to control blood sugar levels. The body produces insulin in response to eating. The participants will drink a meal replacement shake, and then test the blood for levels of insulin produced over 2 hours. With blood tests taken five times over two hours, the investigators will measure the blood glucose (sugar), and insulin levels. This study will assess the differences in insulin produced in the participants and try to understand the reasons for these differences.
Conditions:
Type 2 DiabetesEmplacement:
- The Ottawa Hospital, Ottawa, Ontario, Canada
Sexe:
ALLÂges:
Over 18Multi-center, prospective, concurrently controlled, non-randomized, double-blind (patient and assessor). Treatment of large chondral lesions in the knee with microfracture plus the Chondro-Gide® ACC is non-inferior to treatment of small chondral lesions treated with microfracture alone.
Conditions:
Knee Injuries | Knee Discomfort | Cartilage Injury | Cartilage DiseaseEmplacement:
- Fraser Orthopaedic Institute, New Westminster, British Columbia, Canada
- Sunnybrook Research Institute (SRI), Toronto, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- University of Calgary, Calgary, CGY, Canada
- University of Toronto Orthopaedics, Toronto, TOR, Canada
- Hamilton Health Sciences, Hamilton, Ontario, Canada
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ALLÂges:
18 - 55New challenges, stressors, and a loss of support often accompany the transition from adolescence to adulthood. Not surprisingly, transitional-aged youth (TAY) between the ages of 18-25 experience some of the highest rates of mental distress. However, access to mental health services diminish for TAY due to gaps in care when transitioning from pediatric to adult services. These challenges are exacerbated in rural communities, such as in Northwestern Ontario, where youth already access mental health services less frequently and face longer wait times than those in more urban areas. Limited access and extended waits can exacerbate symptoms, prolong distress, and increase the risk for adverse outcomes. Novel, innovative approaches are urgently needed to support TAY in Northwestern Ontario. In partnership with St. Joseph Care Group and Thunder Bay Counselling Centre, the investigators are evaluating the impact of a mental health app (JoyPop) as a tool for TAY waiting for mental health services. The JoyPop app was developed to support improved emotion regulation - a fundamental difficulty for youth presenting with mental health challenges. A two-arm randomized controlled trial (RCT) will be used to evaluate the effectiveness of the app compared to usual practice while TAY are waiting for mental health services.
Conditions:
Anxiety | Depression | Stress | Emotion RegulationEmplacement:
- Lakehead University, Thunder Bay, Ontario, Canada
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ALLÂges:
18 - 25Hospitalizations are harmful to patients. Without a proper intervention, it will lead to a permanent decline in physical function, especially among frail individuals. Ultimately, this will worsen quality of life, as well as the cognitive and functional status of affected elderly people, which will arguably reduce functional independence, increase post-discharge institutionalization and death among frail older adults. It is known that patients receiving early physical evaluation and rehabilitation (in the 24 hours following admission) improves post-discharge orientation, decreases delirium and the need of acute care. The rehabilitation often involves ergocycles, but commercially available devices are expensive and often hard to move, to set up in hospital bed and lack connectivity. In this context, a connected ergocycle prototype which has a number of desired characteristics, including low production cost, relatively light and easy to move and with internet connectivity. The goal of this study is thereby to assess the usefulness and acceptability of the prototype with health professionals involved in physical rehabilitation and patients receiving said rehabilitation.
Conditions:
End-stage Renal DiseaseEmplacement:
- CIUSSS de l'Estrie - CHUS, Sherbrooke, Quebec, Canada
Sexe:
ALLÂges:
AnyThis is a phase II randomized trial, where patients with histologically proven squamous cell carcinoma of oropharynx that have primary tumor (T3 - T4) in place, treated with curative intent chemoradiation, will be randomized to systematic mid-treatment MRI-based radiotherapy adaptation vs. standard of care. The primary objective is to compare patient-rated dysphagia (as assessed by the MD Anderson Dysphagia Inventory composite score at 6 months post-treatment in patients undergoing routine mid-treatment MR-guided radiotherapy adaptation vs. in patients receiving the current standard of care.
Conditions:
Dysphagia | Radiotherapy; Complications | Oropharynx Cancer | MRI | Radiotherapy Side EffectEmplacement:
- Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
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ALLÂges:
Over 18Abdominal aortic aneurysm (AAA) is an abnormal dilatation of the aorta in the abdomen due to a wall weakening caused by atherosclerosis. While indications for a rupture intervention are based on AAA maximal diameter (MaxD) (5 cm), 23% of ruptured AAAs are less than 5 cm and in large AAAs, rupture rate could be lower than expected. We propose to expand and validate our vascular ultrasound elastography software to 3D. Strain maps generated from radiofrequency (RF) data acquired from 30 AAA patients with a matrix-array 3D probe will be registered to conventional CT (phase 1) and validated to a biomechanical for characterization of AAA wall, assessing vulnerability and influence of surrounding tissues (phase 2). At the end of the project, we will have analyzed 3D strain maps to improve patient selection before surgery.
Conditions:
Abdominal Aortic Aneurysm Without RuptureEmplacement:
- Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada