Croup

Researchers are evaluating the combination of Adebrelimab with carboplatin or cisplatin plus etoposide chemotherapy and concurrent radiotherapy as a first treatment for patients with extensive-stage oligometastatic small cell lung cancer. This Phase II open-label study aims to assess the safety and effectiveness of this regimen in this patient group. The trial is led by Nanfang Hospital, Southern Medical University and focuses on patients with limited metastatic lesions and organs affected. Participants will first receive Adebrelimab intravenously along with carboplatin or cisplatin and etoposide for two cycles during the induction phase. Next, participants undergo concurrent chemoradiotherapy, including thoracic radiation and stereotactic body radiation therapy SBRT to metastases, combined with one to two cycles of chemotherapy. Following this, they will receive one to two additional cycles of Adebrelimab combined with chemotherapy, and then continue on Adebrelimab alone as maintenance therapy until disease progression, unacceptable side effects, or withdrawal from the study. During the study, participants will be closely monitored through clinical assessments, imaging, and laboratory tests to track progression-free survival and other measures such as overall survival and response rates, with follow-up lasting up to approximately 30 months. Safety will be monitored by recording adverse events throughout the treatment and maintenance phases. The total participation time includes induction, concurrent chemoradiotherapy, maintenance, and follow-up periods to fully evaluate treatment outcomes and tolerability.

Researchers are evaluating the effects of a self-administered acupressure intervention on cough and related symptoms in lung cancer survivors. The study aims to see if acupressure can reduce cough, lessen a symptom group involving dyspnea, cough, and fatigue, and improve overall symptom burden, functional capacity, and quality of life for these patients. This is a randomized controlled trial focusing on supportive care for lung cancer survivors. Participants are randomly assigned to either an 8-week acupressure program or an education group. Those in the acupressure group attend two training sessions at the hospital during the first week to learn proper techniques. They then perform acupressure daily on 15 specific points at least twice a day and during coughing episodes. The education group receives a booklet about lung cancer, cough causes, and management strategies. Trainers follow up with acupressure participants twice weekly to support and assess their practice. Participants will keep diaries recording their acupressure practice and symptoms. They are assessed at four times before treatment, after 1 week, after 8 weeks, and 8 weeks post-intervention. Researchers evaluate cough severity, cough-related quality of life, the dyspnea-cough-fatigue symptom cluster, fatigue, symptom burden, functional capacity, and health-related quality of life. The study runs from baseline through an 8-week intervention and an 8-week follow-up period, with ongoing monitoring via diaries and trainer contacts.

Researchers are evaluating the ability of the AeviceMD, a wearable medical device, to detect wheezing in both children and adults. Wheezing, cough, and breathlessness are common respiratory symptoms usually identified manually by healthcare professionals through listening to lung sounds. The study aims to find out if AeviceMD can detect wheezes as accurately as a physician and to explore its potential for remote lung sound monitoring. During the study, participants will have the AeviceMD device placed on them to record lung sounds and detect wheezes. The devices findings will be compared with assessments made by physicians through traditional auscultation. The study includes two groups patients diagnosed with acute asthma exacerbations and patients with other non-cardiac and non-pulmonary complaints. Participants will undergo lung sound recordings both onsite with a physician and remotely, with the results compared between the AeviceMD device and medical professionals. The primary outcome is the detection of wheeze within 60 seconds, while the secondary outcome involves identifying respiratory sounds within 150 seconds. The study is observational and will continue until December 2026, involving children aged 3 years and older.

Researchers are investigating whether adding a diagnostic test that can distinguish whether an acute respiratory illness is caused by bacteria or viruses early in the evaluation can improve patient management and reduce healthcare resource use. The study focuses on adults presenting to the Emergency Department ED with undiagnosed respiratory infections who meet SIRS criteria and require immediate blood tests and treatment. The goal is to see if this test affects decisions about further diagnostic work, antimicrobial use, hospital stay length, and related costs. Participants are randomly assigned to one of two groups. The experimental group receives the usual care plus results from the MeMed BVae biomarker test, which analyzes a blood sample to provide a score that may help guide treatment. The control group receives standard care without the test results. Both groups are managed by clinicians following standard practice protocols. The study aims to compare outcomes such as additional testing, use of antibiotics, hospital admissions, and length of stay between these groups. During the study, participants will be monitored from admission to the ED through about 28 days of follow-up. Researchers will track costs related to diagnostic tests, consultations, antimicrobial treatments, hospital stays, and emergency department visits. They will also assess hospital length of stay up to six months post-admission, the number of patients returning to the ED within 72 hours, and appropriate antibiotic use based on infection type. Safety and patient management quality will be evaluated by reviewing these clinical and resource measures.

Researchers are evaluating the safety and effectiveness of stopping antibiotic treatment early in adults hospitalized with respiratory viral infections. This study focuses on patients with moderately severe disease who test positive for respiratory viruses such as influenza, respiratory syncytial virus, parainfluenza virus, or human metapneumovirus. The goal is to determine if early discontinuation of antibiotics leads to similar clinical outcomes compared to continuing antibiotic therapy, aiming to reduce unnecessary antibiotic use and combat antimicrobial resistance. Participants are randomly assigned to either stop antibiotic therapy as started by their admitting physician or to continue antibiotic therapy without changes. The study monitors early clinical response at 120 hours after randomization, defined by survival with symptom improvement and no need for rescue antibiotics. Secondary assessments include mortality rates, hospital stay duration, antibiotic use, and readmission rates, all measured during hospital admission and up to 30 days after discharge. During the trial, participants undergo nasopharyngeal swab testing to confirm viral infection and are monitored closely for symptoms, survival, and antibiotic use. Researchers evaluate clinical response at 120 hours and track outcomes such as mortality, hospital stay length, and antibiotic doses until discharge and 30 days later. The study aims to gather detailed safety and efficacy data over the hospital stay and follow-up period, supporting more targeted antibiotic use in viral respiratory infections.

Laryngomalacia is the most common congenital laryngeal anomaly in infants and is often linked to feeding difficulties and aspiration. This randomized controlled trial evaluates whether proton pump inhibitor PPI therapy can reduce the incidence of aspiration in children aged 6 months to 5 years with laryngomalacia. The study aims to provide evidence to improve management and reduce aspiration-related complications. Participants will be randomly assigned to one of two groups one receiving PPI therapy along with vitamin D supplementation and feeding instructions, and the other receiving vitamin D supplementation and feeding instructions only as standard care. Clinical and swallowing evaluations will be conducted at the start and during follow-up to compare aspiration rates and swallowing outcomes between the groups. During the study, children will undergo clinical assessments and swallowing tests at baseline and follow-up visits. Researchers will measure the incidence of aspiration over two months to determine the effect of adding PPI therapy. The study includes safety monitoring and lasts until the completion date, with participant involvement spanning the treatment and follow-up periods to assess outcomes.

Researchers are evaluating whether stopping oral antibiotics when symptoms stop is as effective as completing the full prescribed course in children who have been treated with intravenous antibiotics for infections such as cellulitis, urinary tract infection UTI, lower respiratory tract infection LRTI, and lymphadenitis. This study is a phase 4, single-center, basket randomized controlled trial conducted at the Royal Childrens Hospital. It aims to determine if oral antibiotics can safely be stopped early in children with cellulitis and assess the feasibility of a larger study involving other infections. Participants will be randomly assigned to one of two groups those who stop oral antibiotics when symptoms resolve after completing at least 3 days of intravenous plus oral antibiotics, and those who finish the full course as per clinical guidelines. The study includes four groups based on infection type and begins with patients in the Hospital in the Home HITH program, expanding to inpatient wards. Daily symptom tracking is done by parents or guardians, and telehealth appointments are conducted once symptoms resolve. During the study, parents will complete a daily symptom diary while their child takes oral antibiotics and attend telehealth follow-ups after symptom resolution. Additional surveys occur on days 14, 28, and 180 to monitor clinical outcomes, reoccurrence, antibiotic use duration, antimicrobial resistance, and adverse events. The main outcome is the proportion of children who experience clinical failure within 28 days, defined as needing to restart antibiotics due to symptom return. The total study duration spans up to six months for follow-up assessments.

Researchers are conducting a nationwide, multicenter observational study to establish and improve a hospital-based clinical surveillance and early warning system for respiratory syndrome pathogens. The study will include patients with respiratory syndrome from various hospital settings across seven regions in China. It aims to monitor pathogen trends, support risk assessment, and provide evidence for prevention and control strategies over several years. Participants diagnosed with respiratory syndrome will have clinical data collected every two weeks, including demographics, symptoms, diagnoses, lab tests, medications, oxygen therapy, hospital stays, ICU admissions, and outcomes. For those meeting specific diagnostic criteria, respiratory and other biospecimens will undergo a range of tests including routine pathogen tests, multiplex PCR, targeted and metagenomic sequencing, antibody and cytokine testing, and exploratory multi-omics analyses. During the study, data and specimens will be collected routinely from participants receiving clinical care. Researchers will generate national and regional surveillance reports to support early warnings and prevention efforts. The main outcomes measured include detection rates and types of respiratory pathogens and immune responses after infection or vaccination, tracked over three years. Participation involves regular data reporting through secure channels without additional treatment interventions.

Researchers are investigating the best approach to treat low-risk patients with isolated subsegmental pulmonary embolism SSPE, a type of blood clot in small lung arteries. The study aims to determine whether monitoring patients without anticoagulation is as safe and effective as giving anticoagulant medication. This is important because many patients currently receive anticoagulants that carry a risk of bleeding, but it is unclear if all patients with isolated SSPE need this treatment. Patients in the trial are randomly assigned to one of two groups. One group receives the anticoagulant drug rivaroxaban, starting with 15 mg twice daily for 21 days, then 20 mg once daily for a total of 90 days. The other group receives a placebo matching the same schedule. The trial compares clinical surveillance without anticoagulation to anticoagulation treatment to assess safety and effectiveness. Participants will be followed for 90 days after randomization to monitor for recurrent venous thromboembolism, significant bleeding events, and overall survival. Researchers will track these outcomes through clinical assessments and safety monitoring. This study is designed to evaluate if careful monitoring alone is a safe alternative to anticoagulation in selected patients with isolated SSPE, potentially reducing bleeding risks from treatment.

Researchers are evaluating the use of portable dynamic digital radiography DDR, a new advanced chest X-ray technology, in intensive care unit ICU patients. DDR captures dynamic images of lung motion, ventilation, and perfusion at a high frame rate, potentially providing more detailed and quantitative lung function information compared to traditional chest X-rays. This trial aims to test the feasibility and safety of portable DDR in the ICU and to compare its diagnostic value with current standard imaging methods. Participants will receive one to three sets of DDR scans, including 7-second breathing and breath-holding scans. These images will be compared to gold standard clinical exams such as chest X-rays, CT scans, or ventilation-perfusion VQ scans. The study will observe how DDR performs in diagnosing lung conditions like diaphragmatic dysfunction, pulmonary embolism, and pulmonary edema, alongside routine clinical imaging. Throughout the study, participants will undergo DDR imaging alongside their routine clinical imaging. Researchers will analyze these images to measure lung motion, diaphragmatic movement, and perfusion. The primary outcomes include assessing the precision of DDR in evaluating cardiopulmonary functions related to the diaphragm and lung motion as well as pulmonary blood flow, over a period of up to two months. The study will monitor safety and diagnostic accuracy while patients receive standard care.