Conversion Disorder

Trigger finger is a common pathology in the hand. Patients suffer from pain and depending on which tasks, patients have difficulty to perform them. Its treatment in initial and less serious phases includes conservative measures, but failure of these may require releasing the trigger finger with surgery. The surgical technique performed for trigger finger is the opening of the A1 pulley, the skin incisions used for this surgery are various (transverse, longitudinal, oblique). Trigger finger surgery presents good results in terms of resolution, but complications may also occur. The reason for this study is to assess whether there are functional differences using the Dash scale when we perform a transverse or longitudinal incision in trigger finger surgery.

Suicide is the second leading cause of death among youth, and rates in the US are rising despite prevention efforts. Researchers are evaluating a digital platform called Vira to improve how care is delivered to adolescents at high risk for suicide. This platform aims to use smartphone data and secure communication tools to better understand and manage risk factors like psychological distress, anhedonia, behavioral withdrawal, and sleep problems in young people receiving intensive outpatient treatment. The study compares two groups of adolescent patients aged 13 to 18 years old who are in an intensive outpatient Dialectical Behavior Therapy (DBT) program. One group uses the Vira platform, which collects data passively from smartphone sensors about activity, sleep, mobility, and mood-related language. Vira also prompts daily check-ins and supports practitioners with reminders to encourage behavior changes. The other group receives the usual treatment with the addition of a passive monitoring app called EARS. Participants will use their assigned app during their intensive outpatient treatment. Researchers will assess outcomes using tools like the Columbia Suicide Severity Rating Scale and Scale for Suicidal Ideation over six months. Other measures include anxiety, risky behaviors, sleep quality, mood, and pleasure scales at three and six months. The study monitors clinical outcomes to determine if the digital platform enhances care for youth at risk of suicide.

Researchers are evaluating the feasibility of conducting a larger multi-site randomized controlled trial comparing two treatments for children and teenagers aged 11 to 18 who have functional seizures (FS). This study focuses on testing how well recruitment, retention, acceptability, treatment adherence, and therapy fidelity work across three sites: University of Alabama at Birmingham, Yale School of Medicine/Yale New Haven Children's Hospital, and Baylor College of Medicine/Texas Children's Hospital. Participants will be randomly assigned to receive either Retraining and Control Therapy (ReACT) or Competent Adulthood Transition with Cognitive Behavioral, Humanistic, and Interpersonal Training (CATCH-IT). Both treatments include 12 therapy sessions, with the first session held in person lasting about 2 hours and the following 11 sessions delivered via video telehealth lasting about 1 hour each. ReACT involves working with a therapist to develop a plan to manage seizures, while CATCH-IT uses online CBT modules for the parent and child, supported by 12 coaching sessions. Participants and their caregivers will complete baseline and follow-up visits via secure video calls, including questionnaires about mood, relationships, and seizure symptoms. They will keep a seizure diary throughout the study. Follow-ups occur one week and two months after therapy ends, with additional long-term follow-ups at six and twelve months. Researchers will measure recruitment success, acceptability, retention rates, treatment adherence, seizure frequency, quality of life, and other psychological and functional outcomes to guide future larger trials.

Researchers are evaluating the use of an accelerated, intermittent theta burst stimulation (a-iTBS-rTMS) protocol targeting the left dorsolateral prefrontal cortex for people with Psychogenic Non-Epileptic Seizures (PNES) or Seizure-Type Functional Neurologic Disorder (FND-seiz). This early-phase study aims to assess the feasibility, tolerability, and preliminary effects of this brain-network based treatment, which may help address the challenges and poor outcomes seen with current treatments. The study is open-label and focuses on improving seizure frequency and quality of life measures in this population. Participants will receive 6 to 10 sessions of theta burst TMS per day, each session consisting of 600 pulses, over 3 to 5 days, targeting a total of 30 sessions (18,000 pulses). Treatment is delivered using a MagVenture MagPro TMS System aimed at a specific brain region called Beam F3 to align with previous research and clinical practice. The sessions are spaced with 15-minute intervals, and the study includes a safety protocol developed with experts to monitor risks, including seizure induction. During the study, participants will be assessed through self-report measures before treatment and again four weeks after completing sessions. Researchers will track seizure frequency, stigma, quality of life, depression, PTSD, somatic symptoms, psychosocial functioning, and overall improvement. Safety is monitored daily during treatment and at follow-up. The total participation duration covers screening, treatment days, and a 4-week follow-up to evaluate the intervention's effects and tolerability.

Researchers are studying autonomic dysfunction in patients with functional dysphonia (FD), a voice disorder without clear organic cause, to better understand its underlying psychophysiology and improve therapy options. The study includes both a case-control comparison with vocally healthy individuals matched by age and gender, and a randomized controlled trial to evaluate a novel autonomic nervous system (ANS) regulation therapy alongside conventional voice therapy (CVT). The goal is to assess the frequency of symptoms related to autonomic dysfunction and compare treatment effects on voice and autonomic function. The trial involves three treatment groups for patients with FD: ANS regulation therapy using heart rate variability biofeedback, conventional voice therapy (CVT), and a combination of both therapies. Each participant practices daily for 20 minutes over one month, including one weekly clinic session supervised by a therapist and home sessions tracked by specialized apps and heart rate monitors. The ANS therapy focuses on personalized slow-paced breathing exercises, while the CVT includes voice education, hygiene, posture, breathing, and vocal exercises. Participants will be assessed before treatment, immediately after one month of therapy, and at three months follow-up. Evaluations include physiological measures like heart rate variability, respiration rate, skin conductance, and psychological questionnaires related to stress and anxiety. Voice assessments include the Dysphonia Severity Index, acoustic voice quality, and patient-reported voice outcomes. The study aims to monitor changes in autonomic and voice function over time to inform future treatment approaches for FD.

Researchers are investigating how the intestinal microbiota develops in healthy infants during their first two years of life and beyond. This study focuses on understanding the composition, diversity, and metabolic activity of gut bacteria in infants, as well as how factors like maternal microbiota and the environment affect this development. The goal is to learn how the maturation of the microbiota influences infant growth, immune system development, and potential health issues such as abdominal pain. The study will follow 250 pregnant women and their babies from the 20th week of pregnancy until the children reach 10 years old. Researchers will collect and analyze various biological samples, including infant stool, maternal milk, vaginal and skin swabs, to study bacterial species and their metabolic functions using advanced sequencing and mass spectrometry techniques. The study will also assess infant nutrition, hygiene, socioeconomic factors, and clinical outcomes at regular visits. Participants will be monitored through clinical evaluations, questionnaires, and biological sample collection at multiple time points from birth up to 10 years. The primary outcomes focus on changes in the complexity and activity of the infant gut microbiota at specific intervals after birth. Secondary outcomes include assessing environmental impacts, maternal bacterial transfer, and effects on child development. Any important health findings will be shared with participants and their doctors, and participants can opt out of human DNA analysis without affecting their involvement.

Researchers are evaluating the feasibility of a brief psychotherapy called Clinician-Assisted Videofeedback Exposure Approach Therapy (CAVEAT) for mothers experiencing interpersonal violence-related posttraumatic stress disorder (PTSD) and their very young children aged 1 to 3 years. This open clinical trial aims to pilot the intervention along with pre- and post-intervention measures over a 2-year period with up to 10 mother-child pairs referred to an academic medical center ambulatory care setting. The therapy is based on research showing psychobiological dysregulation in traumatized mothers and its impact on early mother-child relationships. The CAVEAT intervention is a manualized brief psychotherapy divided into four modules, including evaluation and diagnosis, differentiation between past and present relationships, and further therapeutic components. The treatment is delivered to mothers and their young children to help improve maternal perceptions, sensitivity, and reflective functioning. This study involves one experimental group receiving the CAVEAT therapy. Participants will be assessed before and after the intervention using tools such as the Parenting Stress Index-Short Form, Maternal Attributions Rating Scale, and the Brief Infant-Toddler Social Emotional Assessment within six weeks of the last session. Additional measures include intervention satisfaction questionnaires. Mothers and children will be monitored for changes in stress, maternal perceptions, and child social-emotional symptoms during the trial, which runs until July 2026.

Researchers are evaluating the effects of Heart Rate Variability Biofeedback (HRV-BFB) training in adults with Functional Neurological Disorders (FND). FND is a common neurological condition with unclear causes, possibly involving disrupted emotional processes and autonomic nervous system dysfunction. This study aims to understand these mechanisms and assess how HRV-BFB compares to a placebo treatment using a single-blind crossover design. Participants will be randomly assigned to either the HRV-BFB group or a placebo group. Both groups will use the Inner Balance Coherence Plus® software with a Bluetooth ear sensor and smartphone app. Training sessions last 8 minutes, twice daily for 30 days, with different breathing instructions depending on the group. The HRV-BFB group will work to increase their heart rate variability, while the placebo group will receive similar sessions without specific HRV effects. Throughout the study, participants will undergo comprehensive evaluations including symptoms, functional capacity, quality of life, and psychological assessments. These will be measured multiple times up to 360 days after starting. Emotional tasks and autonomic measures will also be repeated. Researchers will track heart rate variability and other physical and psychological outcomes to understand the effects of the training and identify patient subgroups based on autonomic profiles.

Researchers are studying intermittent catheterization in patients who have undergone radical cervical cancer surgery. The study aims to summarize the best existing evidence, develop a nursing protocol for intermittent catheterization based on this evidence combined with clinical practice, and evaluate how well this protocol works in real clinical settings. This research will help improve standardized care and guidelines for patients after this surgery in China. The study compares two approaches: a best evidence-based intermittent catheterization protocol and routine intermittent catheterization care. Participants will be randomly assigned to one of these groups. The trial uses a triple-blind design to ensure unbiased results. The main treatment phase focuses on applying these catheterization protocols after surgery. Participants will be monitored for urinary complications within two months after discharge. Researchers will also assess catheterization compliance, quality of life using a 12-item survey, anxiety levels, and confidence with catheterization before the intervention, immediately after, and one month post-discharge. Health service use will also be tracked during the two months following discharge. This allows a thorough evaluation of the nursing protocol's clinical effects and patient outcomes.

Functional Neurological Disorder (FND) involves symptoms such as tremors, limb weakness, functional seizures, and sensory issues, with many patients experiencing feelings of detachment or disconnection from their body. Researchers are exploring the feasibility of a structured dance/movement therapy (DMT) compared to physical exercise to assess its acceptability and potential to improve trust in the body, overall wellbeing, and reduce FND and dissociative symptoms. Participants will be randomly assigned to either a five-week structured dance/movement therapy program involving light stretching, aerobic dance movements, and body awareness activities, or a five-week physical exercise/body coordination program focusing on functional stretches and limb coordination without emphasis on bodily sensations. Both interventions last about 30 minutes per session and aim to be accessible to various ability levels. Throughout the study, participants will be assessed at multiple points using questionnaires and scales measuring symptom improvement, bodily awareness, mindfulness, dissociation, and physical states. Researchers will monitor recruitment, adherence, withdrawal, adverse events, and acceptability of the intervention up to 20 weeks. Participants will also complete daily diaries during the intervention period to track experiences and feelings related to the tasks.