Diabetes Insipidus

Researchers are evaluating a phase II trial to study the effects of lower dose radiotherapy after chemotherapy in children and young adults with central nervous system (CNS) germinomas. The study aims to see if reducing radiation doses following treatment with carboplatin and etoposide can effectively treat CNS germinomas while potentially reducing long-term side effects. This study also investigates the impact of tumor characteristics and treatments on survival, cognitive function, and neuroendocrine outcomes. Participants first receive chemotherapy with carboplatin given intravenously on day 1 and etoposide intravenously on days 1 to 3, repeated every 21 days for up to four cycles if no disease progression occurs. After chemotherapy, patients are assigned to one of seven groups based on their tumor response and characteristics. Each group receives different doses and types of radiation therapy such as 3-dimensional conformal radiation therapy or intensity-modulated radiation therapy, with treatment lasting from 16 to 24 days. Some patients may undergo second-look surgery depending on their response. Blood, cerebrospinal fluid, and tumor tissue samples may be collected for research. Throughout the study, participants undergo magnetic resonance imaging (MRI) and may have lumbar punctures for cerebrospinal fluid sampling during screening and follow-up. Follow-up visits occur every 3 months for the first year, then less frequently up to 10 years after treatment. Researchers assess event-free survival, overall survival, tumor response, neuroendocrine function, and processing speed. Safety and long-term outcomes including cognitive and behavioral function are monitored over time to better understand treatment effects.

Researchers are studying pituitary tumors, which are a varied group of tumors affecting the pituitary gland. This observational study focuses on collecting detailed clinical, biochemical, morphological, and pathological data from over 1600 patients who have undergone neurosurgical removal of pituitary tumors in the past 20 years. The goal is to develop a prognostic classification to better predict tumor behavior and outcomes, as current data on epidemiology and prognosis are inconclusive. The study involves patients who have had surgery for pituitary tumors, with data collected retrospectively and prospectively. The main focus is on monitoring the frequency of disease recurrence. Participants have been followed for at least two years after their tumor removal, allowing researchers to track tumor recurrence over time. Participants will be observed from enrollment through 24 months of follow-up to assess tumor recurrence. Researchers will gather information from medical records and follow-up visits to evaluate outcomes. This study does not involve any experimental treatment, but rather monitors surgical outcomes and tumor behavior to improve future understanding of pituitary tumors.

This research aims to validate the B-COMPASS, a computational model developed by the BEAMER project to improve patient adherence to treatment across various diseases. Adherence to treatment is a widespread issue leading to increased healthcare use and premature death, with about half of medications not taken as prescribed. The study evaluates the model's ability to predict adherence, identify patient support needs, and enhance healthcare engagement in six therapeutic areas, including cardiovascular, endocrinology, immunology, neurology, oncology, and rare diseases. Participants complete the BEAMER questionnaire, which the B-COMPASS uses to group patients based on their adherence needs and predict their adherence. Patients are randomized into a control group receiving standard care or an intervention group receiving enhanced engagement through educational materials for healthcare providers tailored to the patient's B-COMPASS profile. Engagement occurs in person or by phone, depending on patient schedules, and healthcare providers may also be randomized to limit knowledge of the B-COMPASS in control groups. Participants are involved in two main data collections spaced from 2 weeks to 6 months apart, during which adherence measures, patient support needs, and perceptions of engagement are assessed. The study measures the accuracy, validity, and reliability of B-COMPASS predictions, its impact on adherence, patient and provider perceptions, and cost-effectiveness. The total participation timeline varies by site and disease area, with continuous monitoring of healthcare utilization and patient experience.

Researchers are studying patients with pituitary complex and rare diseases to better understand their clinical features and outcomes. This observational study at Peking Union Medical College Hospital aims to identify factors influencing remission rates, associated comorbidities, perioperative events, radiological findings, and pathological characteristics. By comparing different patient groups, the study seeks to improve knowledge about managing and predicting the course of these conditions. Participants include patients diagnosed with various pituitary disorders such as pituitary adenomas, craniopharyngiomas, Rathke's cleft cysts, sellar region germ cell tumors, and cavernous sinus syndrome. Those needing surgical removal or biopsy of pituitary pathologies will undergo transsphenoidal surgery or craniotomy. Treatments studied involve surgical removal and biopsy procedures to collect tissue for examination and diagnosis. During the study, participants will have detailed clinical evaluations, provide comprehensive medical histories including symptoms, treatments, and outcomes, and take part in follow-up assessments to monitor disease progression. Researchers will track remission starting one week after surgery and continuing up to three years, along with comorbidities and postoperative complications over the same period. The study collects imaging and pathological data to enhance understanding of these rare diseases.

Researchers are collecting data to better understand thyroid, parathyroid, and adrenal diseases. This observational study involves patients with diagnosed or suspected endocrine diseases and aims to gather information from medical records and follow-ups. The data will help learn more about the participant's or their child's illness, treatment, recovery, and medical history over a long period. Participants' medical information will be recorded into a research database. Starting about 2 to 3 years after testing, diagnosis, or treatment, and continuing for up to 15 years after surgery, the research team will follow up by phone to ask about their current health and medical history. If participants have routine clinic visits near their follow-up time, the research team may meet them in person or send questionnaires by mail if needed. Participants or their children will be contacted every 2 to 3 years for phone interviews lasting about 20 to 30 minutes. The study will track their health status and medical history during these calls. The study aims to compile a comprehensive database over 15 years. Up to 15,000 patients will be enrolled, and participation involves data collection and periodic follow-up without altering usual care.

Researchers are studying pheochromocytomas and paragangliomas, rare tumors that often develop in the adrenal glands and release chemicals called catecholamines. These tumors can cause high blood pressure and serious health risks such as stroke, heart attack, and sudden death, especially during surgery or childbirth. The study aims to improve diagnosis, localization, and treatment of these tumors using advanced molecular, genetic, and imaging techniques. The study evaluates various diagnostic methods including blood and urine tests measuring catecholamines and their metabolites, standard imaging like CT, MRI, and specialized PET/CT scans with radioactive compounds such as 18F-DOPA and 18F-6F-DA. Participants with detected tumors may undergo surgery if feasible. If surgery is not an option, ongoing evaluations and medical treatments will be provided. Genetic testing is also performed to analyze DNA and explore tumor predispositions. Participants undergo comprehensive assessments including medical history, physical exams, electrocardiograms, and multiple imaging scans lasting up to two hours. Blood and urine samples are collected for biochemical and genetic analyses. Researchers monitor tumor characteristics, biochemical profiles, and treatment responses over time. The study also includes follow-up visits for ongoing evaluation, education of healthcare providers and patients, and may continue for many years.

The trial investigates the effects of intranasal oxytocin compared to placebo on emotion recognition and acute psychosocial stress in patients with arginine vasopressin deficiency (central diabetes insipidus) compared to healthy controls. This condition involves a deficiency in a neuropeptide that affects water balance and is treated with desmopressin, but patients often experience psychological symptoms such as anxiety, impaired emotion recognition, and increased stress. Oxytocin, a related neuropeptide, may influence social-emotional functions and reduce stress, and this study explores whether oxytocin treatment can improve these psychological symptoms. Participants will self-administer a single dose of 24 IU intranasal oxytocin or placebo under supervision in a randomized, placebo-controlled, double-blind, crossover design. The study is divided into two parts: Part A assessing recognition of facial and body emotions with a two-week washout between visits, and Part B measuring cortisol response to acute psychosocial stress with an eight-week washout. The order of receiving oxytocin or placebo varies among four group assignments. Throughout the study, participants undergo tests measuring facial emotion and body expression recognition, cortisol response to stress, empathy, subjective emotional responses, heart rate, and blood pressure. The study lasts up to 10 weeks for stress response assessments and up to 4 weeks for emotion recognition. The research team monitors participants closely to evaluate the impact of oxytocin versus placebo on psychological and physiological responses.

Researchers are evaluating the effects of intranasal oxytocin on anxiety, depression, and social-emotional functioning in adults aged 18 years and older who have arginine-vasopressin deficiency. This is a randomized, double-blind, placebo-controlled pilot study designed to explore how different doses of oxytocin impact these psychological and behavioral outcomes. The study is led by Elizabeth Austen Lawson and aims to better understand oxytocin's role in people with this condition. Participants first complete a screening visit to confirm eligibility. In Part A, they attend three main visits where they receive single doses of intranasal oxytocin at 6 IU, 24 IU, or placebo in varying orders across six groups. After Part A, participants may opt to join Part B, a two-week substudy where they receive either 6 IU of intranasal oxytocin or placebo three times daily, also in a randomized, double-blind design. During the visits, participants undergo assessments measuring anxious behavior using a dot-probe task, depressive behavior with a probabilistic reward task, and socioemotional functioning through an emotion recognition task at specific times after dosing. The study monitors effects shortly after each intervention, with primary outcomes measured 20 minutes post-dose. The total study duration varies depending on participation in Part B, with careful monitoring of emotional and behavioral changes throughout.

Researchers are investigating whether intranasal oxytocin (OXT) can improve sexual well-being in patients with Arginine Vasopressin Deficiency (AVP-D), a condition caused by disruption in the hypothalamic-pituitary axis leading to fluid balance issues and psychological symptoms such as anxiety, reduced empathy, and decreased sexual desire. This Phase 2 trial aims to address the psychosocial challenges faced by patients despite standard treatment with desmopressin, exploring the potential role of OXT, a hormone linked to social bonding and emotional regulation. The trial uses a randomized, double-blind, placebo-controlled, crossover design with two parts. Part A involves a 7-day treatment with either intranasal OXT (24 IU) or placebo in patients with AVP-D and their partners, followed by self-assessments of sexual well-being and intimacy, with a 3-week washout between treatments. Part B evaluates the effects of a single OXT dose or placebo on sexual arousal, empathy, fear perception, and hormonal responses in both single and partnered patients and healthy controls during one clinical visit. Participants will complete various assessments including sexual satisfaction scales, psychological questionnaires, and hormonal and autonomic measures related to sexual arousal and stress responses. The study monitors changes before and after treatments in Part A and during a single assessment in Part B. The total participation duration varies by part, with Part A involving repeated measures over weeks and Part B involving a one-day clinical evaluation. The goal is to provide insight into how OXT may influence sexual and emotional well-being in AVP-D patients.

Researchers are investigating and comparing the levels of serum endocan and serum copeptin in preterm newborns diagnosed with respiratory distress syndrome (RDS). This study aims to understand how these levels on the first day of life relate to the severity of respiratory distress. Respiratory distress in preterm infants is a significant challenge due to its high risks and impact on families and healthcare. The study involves measuring serum endocan and serum copeptin using enzyme-linked immunosorbent assay (ELISA) tests on the first day of life. Participants include preterm neonates grouped by gestational age: between 28 and 34 weeks and between 34 and 36 weeks. These measurements will help compare the two biomarkers' levels and their association with RDS severity. During the study, blood samples will be taken from the neonates on the first day of life to assess serum endocan and copeptin levels. The researchers will also monitor copeptin levels again on the fifth day of life. The main focus is to predict the severity of respiratory distress syndrome and possible mortality outcomes. The participation period covers the first few days after birth with specific biomarker assessments to support clinical understanding.