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One third of individuals aged \>60 years will be diagnosed with at least one renal cyst following abdominal imaging. These cystic lesions are categorized according to the Bosniak classification which categorizes cysts according to their degree of complexity and risk of malignancy. Growing evidence suggests that a significant proportion of Bosniak III and IV cysts are benign and that the malignant ones present low metastatic potential. Since renal surgery carries substantial morbidity (20%) and potential mortality (0.5%), active surveillance has gained attention as a potential tradeoff to surgery to overcome overtreatment. Therefore, prospective studies of long-term follow-up are needed to confirm the oncologic safety of this strategy for patients with Bosniak III/IV cysts. This is an multicenter prospective observational longitudinal study. The main objective is to compare the 5-year follow-up cancer-specific survival between the active surveillance and the surgical groups.
Conditions:
Complex Renal CystEmplacement:
- Vancouver Prostate Centre, Vancouver, British Columbia, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches - Hôtel-Dieu de Lévis, Lévis, Quebec, Canada
- CHU de Québec - Université Laval, Québec, Quebec, Canada
- Northern Alberta Urology Center, Edmonton, Alberta, Canada
- St-Joseph's Hospital, Hamilton, Ontario, Canada
- Woodstock hospital, Woodstock, Ontario, Canada
- McGill University Health Centre, Montreal, Quebec, Canada
- Mens Health Clinic, Winnipeg, Manitoba, Canada
- Thunder Bay Health Sciences Center, Thunder Bay, Ontario, Canada
- CHUM, Montreal, Quebec, Canada
- Centre de recherche du Centre hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Prostate Cancer Center, Calgary, Alberta, Canada
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
- Princess Margaret Hospital, Toronto, Ontario, Canada
- Hôpital Maisonneuve-Rosemont (CISSS-EIMtl), Montreal, Quebec, Canada
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ALLÂges:
Over 18This is a phase 2 open-label study to test the safety and effectiveness of combining pembrolizumab and bendamustine in patients with relapsed (cancer that has come back or started getting worse) or refractory (cancer that is not responding or has stopped responding to treatment) Hodgkin lymphoma.
Conditions:
Classical Hodgkin Lymphoma | Refractory Cancer | Relapsed CancerEmplacement:
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
Sexe:
ALLÂges:
Over 18Elranatamab is a bispecific antibody: binding of elranatamab to CD3-expressing T-cells and BCMA-expressing multiple myeloma cells causes targeted T-cell-mediated cytotoxicity. The main purpose of the study is to evaluate if the combination of Elranatamab, Daratumumab and Lenalidomide or Elranatamab and Lenalidomide offers superior clinical benefit compared with the combination of Daratumumab, Lenalidomide and Dexamethasone in people with multiple myeloma. There are 2 parts to this study. Part 1 will characterize the safety and tolerability of elranatamab in combination with daratumumab and lenalidomide or in combination with lenalidomide and will identify the optimal dose(s) of the combination regimen. Part 2 of the study will evaluate the minimal residual disease (MRD) negativity rate and the progression free survival (PFS) of the combination of elranatamab, daratumumab, and lenalidomide or elranatamab and lenalidomide compared with the combination of daratumumab, lenalidomide, and dexamethasone in participants with newly diagnosed transplant-ineligible multiple myeloma.
Conditions:
Multiple MyelomaEmplacement:
- QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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ALLÂges:
Over 18The ABT-TCSCS study investigates how feasible and beneficial are activity-based therapy and transcutaneous spinal cord stimulation on improving of arm and hand recovery after cervical spinal cord injury.
Conditions:
Spinal Cord Injuries | Spinal Cord Injury CervicalEmplacement:
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
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ALLÂges:
Over 18This study is aiming to look into patients' treatment preferences and their socio economic background as well as the exploration of thought processes leading to these preferences. It will integrate, in two exploratory questionnaires, the three most common treatment schema (standard of care, non-operative management, surgery alone) all of which have been demonstrated efficacious.
Conditions:
Patient PreferenceEmplacement:
- Jewish General Hospital, Montreal, Quebec, Canada
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ALLÂges:
Over 18Transcranial Ultrasound Stimulation (TUS) is an emerging non-invasive brain stimulation(NIBS) technique that can be used on both superficial and deep brain targets with a high spatial resolution as small as a few cubic millimeters. Functional Electrical stimulation is a peripheral stimulation technique researched and clinically used to restore motor function following conditions like stroke and Spinal cord injury. To date, there are no studies that have looked at the neuro modulatory effects of combining TUS and FES on motor symptoms in patients with Parkinson's disease. The current study aims to understand the neuromodulatory effects of combining tbFUS to bilateral primary motor cortex (M1) in Parkinsons's disease patients immediately followed by bilateral upper extremity FES of the hand muscles for improving motor symptoms.
Conditions:
Parkinson DiseaseEmplacement:
- Toronto Western Hospital, Toronto, Ontario, Canada
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ALLÂges:
18 - 90A flexible energy metabolism matched with the contractile needs of the muscle is essential to a normal heart. Loss of metabolic flexibility and cardiac systolic efficiency coexist in Sepsis-induced Myocardial Dysfunction (SIMD), a phenomenon attributed to mitochondrial dysfunction and mishandling of energy substrates. Cardiac positron emission tomography (PET) could allow to quantify non invasively the selection of energy substrates by the hearts in sepsis and will be associated in parallel with functional status (ultrasound cardiography), injury biomarkers, apelinergic and metabolomic blood profiles. Comparisons will be performed between septic and acute on chronic heart failures, with or without systolic dysfunction.
Conditions:
Septic Shock | Chronic Heart FailureEmplacement:
- CHUS, Sherbrooke, Quebec, Canada
Sexe:
ALLÂges:
Over 18This study involves the one-time collection of whole blood or saliva samples for the extraction and storage of DNA for use in ongoing and future ChiLDReN studies.
Conditions:
Liver DiseasesEmplacement:
- The Hospital for Sick Children, Toronto, Ontario, Canada
Sexe:
ALLÂges:
24 - 25The iPeer2Peer (iP2P) program is an online peer support mentorship program that provides modelling and reinforcement by trained young adult peer mentors to adolescent mentees with the same condition. A waitlist hybrid implementation-effectiveness type 3 pilot randomized controlled trial design will be employed across four sites. We will recruit 40 mentees (12-17 years of age) and 12-15 mentors (18-25 years of age) who will undergo training in mentoring and the use of eHealth technology. Mentor-mentee pairings will connect over 15 weeks through video calls and text messaging to provide peer support and encourage disease self-management skills. Data will be collected using standardized instruments and interviews across three time points.
Conditions:
Heart FailureEmplacement:
- The Hospital for Sick Children, Toronto, Ontario, Canada
Sexe:
ALLÂges:
12 - 30Antipsychotic (AP) medications are considered to be the gold standard treatment for psychotic disorders including schizophrenia. However, APs have also been commonly associated with serious metabolic adverse effects including weight gain and Type 2 Diabetes, with younger populations disproportionately affected. In addition, young individuals treated with these agents have also been found to be at high risk for glucose dysregulation, including higher rates of prediabetes, with significant associations found between AP use and insulin resistance. Due to the concerning prevalence of these AP metabolic effects, it becomes important to further elucidate the mechanisms underlying AP effects on glucose metabolism, which are still poorly understood. One potential underlying mechanism is insulin which has been found to regulate hepatic (liver) glucose production through insulin receptors in the brain. These insulin receptors also play a role in neuronal growth and memory, or more broadly, cognition. Preliminary data in rat models has demonstrated that the AP olanzapine (OLA) inhibits the ability of a central insulin stimulus (acting at the level of the brain) to decrease endogenous glucose production (EGP), making this mechanism a prime target to translate from rodent models to human research. Furthermore, intranasal insulin (INI) administration (an analogous central insulin stimulus) has been repeatedly associated with improved cognitive performance for verbal memory and visuospatial functions in humans. Given these findings and with the goal of translational research, the present study will investigate OLA's effects in healthy human volunteers including: (a) the ability of INI to reduce EGP during a pancreatic euglycemic clamp (PEC; a glucose metabolism and insulin procedure); and (b) the ability of INI to improve cognitive performance. More specifically, the present study hypothesizes that: 1. INI will be associated with a decrease in EGP relative to intranasal placebo (INP) as measured by the PEC. This effect will be inhibited if OLA is co-administered. 2. OLA administration will be associated with decrements in cognitive measures (i.e., visuospatial, and verbal memory) as compared to placebo (PL). Additionally, OLA co-administration will block the beneficial effects of INI on cognition previously supported by other studies. 3. INI will result in adaptive changes in neurochemical and neurohemodynamic measures as studied using MRI imaging techniques.
Conditions:
Healthy ControlsEmplacement:
- Center for Addiction and Mental Health, Toronto, Ontario, Canada
- University Health Network - Toronto General Hospital, Toronto, Ontario, Canada