Fever

Researchers are evaluating a new strategy to improve the rapid and accurate identification of febrile children aged 2 to under 5 years at risk of life-threatening infections in sub-Saharan Africa. The study compares the current standard of care using IMCI-based guidelines to a new method that adds a rapid point-of-care test measuring suPAR biomarker levels. The goal is to see if this combined approach leads to better decisions about hospital admission, referral, or discharge, and ultimately improves health outcomes. The trial involves two groups one receiving standard IMCI-based care and the other receiving IMCI-based care enhanced by suPAR testing. Blood samples will be taken from all children, but only those in the suPAR group will have their suPAR levels measured on-site using a special device. Decisions about admitting or discharging children during the first clinical assessment will be guided by these results, especially for those with higher suPAR levels indicating greater risk. A second clinical assessment by an independent physician will help ensure safety and confirm decisions. Participants will be monitored with follow-up visits on days 3 and 7 after enrollment, plus additional check-ins if their condition worsens. A 28-day follow-up interview will track serious events, hospitalizations, or deaths, with an optional 3-month follow-up for further health status updates. Throughout the study, children will receive routine treatments as needed. Researchers will measure the appropriateness of discharge decisions, hospital referrals, survival, symptom duration, and other health outcomes to assess the new triage method.

Researchers are studying preterm infants born between 25 and 32 weeks of gestation to compare two methods of incubator temperature control and their effects on infant weight growth and health. The study is based on earlier findings that lower body temperature on admission relates to higher illness and death rates in preterm infants. It aims to see if using a new software to calculate personalized air temperature in incubators can improve growth and reduce side effects compared to the traditional skin temperature control method. The study compares two incubator control methods air temperature control ATC, which uses software to set air temperature to reduce body heat loss to zero, and skin servocontrol SSC, which adjusts incubator temperature based on the infants skin temperature. Both methods are evaluated in closed incubators for preterm infants. The trial randomly assigns infants to one of these two methods to study their effects during the first 10 days of life. Participants will be monitored for changes in body weight until day 10, along with comfort, thermal stress, and humidity challenges. The study also tracks neonatal illness occurrences up to 40 weeks of amenorrhea and length of hospital stay until discharge or 40 weeks of amenorrhea. Parents provide written consent, and infants are included within the first day of life. The study continues through hospitalization, assessing health outcomes and safety related to the incubator settings.

Researchers are evaluating the need for antibiotic prevention in patients with chronic liver disease who have gastric varices and are treated with elective endoscopic injection of cyanoacrylate GVO. Gastric varices can cause serious bleeding with a high chance of rebleeding and mortality. While endoscopic injection of tissue glue is effective in stopping acute bleeding, it still carries risks of rebleeding and infection, which are important concerns for patients with weakened immune systems due to liver conditions. The study compares two groups one receiving an antibiotic called ertapenem injected intravenously before the endoscopic cyanoacrylate injection, and the other not receiving this antibiotic before the procedure. The trial is randomized and aims to clarify whether giving this antibiotic can help prevent infections and complications after GVO treatment. The treatment is delivered during an elective endoscopic procedure to manage gastric varices. Participants will be monitored for three years to evaluate key outcomes such as the prevention of sepsis, rebleeding rates, refractory bacterial infections, and mortality. Assessments will include tracking infections and bleeding events over time. The study is designed to provide long-term data on the benefits and risks of using antibiotic prophylaxis in this patient group, with ongoing safety monitoring throughout the follow-up period.

Researchers are investigating autoinflammatory diseases AID, which involve recurring inflammatory episodes without infection, cancer, or adaptive immune system problems. This study focuses on both monogenic hereditary periodic syndromes and polygenic or multifactorial AID, including rare conditions like Behets disease, Still disease, Schnitzlers disease, PFAPA syndrome, chronic recurrent multifocal osteomyelitis, non-infectious uveitis and scleritis, among others. The goal is to gather detailed data to improve understanding and management of these rare diseases through an international collaboration. The study uses the AIDA registry, a secure online platform for collecting demographic, genetic, clinical, laboratory, radiologic, and therapeutic information. Data are gathered retrospectively and prospectively during routine clinical visits scheduled every 3-6 months. Eleven registries focus on different AID conditions, enabling comprehensive data collection to identify clinical patterns, treatment impacts, and long-term outcomes over a period of at least 10 years. Participants provide information during their usual care visits, allowing researchers to track changes in disease activity, organ involvement, inflammatory markers, visual function, pain levels, fatigue, fertility, and socioeconomic factors. The study monitors these outcomes over multiple timepoints up to 120 months. Data privacy is ensured by pseudonymizing patient information. This registry supports multiple clinical studies and aims to enhance knowledge, awareness, and future research on autoinflammatory diseases worldwide.

This research evaluates the accuracy and consistency of an AI platform called OpenGenome that analyzes free-text symptom descriptions submitted voluntarily by adults. The study collects anonymous symptom data and matches it with real biomedical literature from PubMed and ClinicalTrials.gov to generate structured biological signal reports. It aims to assess how well the extracted signals align with sources, how confidence scores correlate with dataset size and symptom specificity, and the distribution of biological signals across a large population. Adults aged 18 or older can submit free-text symptom descriptions via the OpenGenome platform, which then uses an AI-assisted method to extract primary and secondary biological signals grounded in biomedical evidence. For each submission, the system retrieves up to 16 relevant sources and provides a confidence score and signal strength. No treatment or intervention is given, and no participant contact occurs during the observational registry. Participants are involved by voluntarily submitting symptom descriptions online through the platform, with all data anonymized at collection. The study continuously monitors the internal signal-source concordance rate over 12 months. There are no in-person visits or direct assessments, ensuring privacy and minimal burden. This ongoing data collection helps researchers understand the platforms accuracy and signal calibration in a broad anonymous population.

Researchers are studying acute febrile illness in patients older than 28 days who live in rural areas of Laos, Myanmar, Thailand including the Thai-Myanmar border region, and Bangladesh. This observational study aims to describe the causes, clinical outcomes, and host biomarkers associated with these illnesses, which last 14 days or less. The study is part of a larger community-based network seeking to improve understanding and future interventions for febrile illness in low- and middle-income countries in South and Southeast Asia. The study involves two main parts Work Package A collects data from village health workers and local health facilities to understand the incidence and outcomes of febrile illness at the community level. Work Package B recruits patients seeking care at higher-level health facilities who may be more severely ill. In Work Package B, researchers collect various samples including venous blood and respiratory specimens for detailed diagnostic testing such as blood cultures, serological assays, molecular diagnostics, and host biomarker assays. Participants will be monitored for about one month to measure the prevalence of pathogens and recovery status. The study will analyze the association between host biomarkers and clinical outcomes to help create electronic decision-support tools for village health workers. These tools and other interventions will be tested later to improve assessment, triage, and treatment of patients with febrile illness. The total duration of participation and follow-up is approximately one month.

Researchers are evaluating the effectiveness and tolerability of Ceftolozanetazobactam compared to the standard treatment, Meropenem, in patients with febrile neutropenia who are colonized with or at risk for infections caused by extended-spectrum beta-lactamase ESBL-producing pathogens. This is a planned, double-blind, randomized, non-inferiority clinical trial aiming to assess clinical response, toxicity, and microbiological changes in this patient population. Participants will be randomly assigned to receive either 3g of Ceftolozanetazobactam or 2g of Meropenem intravenously every 8 hours. The treatment duration will follow local guidelines, allowing adjustment after identifying the causative pathogens. The study includes stool sample collections before, during, and after treatment to analyze intestinal microbiota and microbiome effects, particularly regarding graft versus host disease GVHD. During the trial, researchers will monitor clinical cure rates at the end of therapy and test-of-cure visits, microbiologically documented infections, mortality, incidence of GVHD, and multidrug-resistant infections for up to 100 days post-treatment. Safety is tracked through adverse events and serious adverse events up to 35 days after the last dose. The trials total participation timeline includes therapy duration and follow-up assessments, ensuring thorough evaluation of treatment impact and safety.

This research aims to compare the use of ciprofloxacin and ceftazidime in treating high-risk fever caused by low neutrophil count in children with hematological malignancies. It focuses on children aged 0 to 18 years diagnosed with blood cancers such as acute lymphoblastic leukemia, acute myeloblastic leukemia, and non-Hodgkin lymphoma. The study evaluates which antibiotic works better as a first-choice treatment and investigates factors influencing response to these drugs. Participants will be randomly assigned to receive either intravenous ciprofloxacin at 10 mgkg every 12 hours or intravenous ceftazidime at 150 mgkg per day divided into three doses. The treatments are given during hospitalization between June and December 2025. Both groups will be monitored for outcomes like the length of fever, duration of low white blood cell count, hospital stay length, antibiotic use duration, any changes in antibiotic treatment, and death rates. Throughout the trial, participants will undergo medical history collection, physical exams, and supportive tests. Researchers will track key measures including duration of fever and neutropenia from the start of antibiotic treatment, hospitalization duration, and antibiotic escalation decisions. Safety and mortality will also be assessed up to 30 days after enrollment. This comprehensive monitoring aims to understand the effectiveness and clinical impact of these antibiotics in managing high-risk neutropenic fever in children with blood cancers.

Researchers are evaluating the effectiveness of two intravenous drugs, hydrocortisone and dexmedetomidine, in preventing and treating shivering after general anesthesia in patients undergoing abdominal surgeries. This is a randomized controlled clinical trial conducted at Ain Shams University hospitals, focused on adult patients aged 18 to 65 years who are undergoing abdominal open surgeries lasting up to 120 minutes. The study aims to compare these drugs ability to reduce postoperative shivering and monitor hemodynamic changes. Participants are randomly assigned to one of two groups Group A receives hydrocortisone at a dose of 2 mgkg, and Group B receives dexmedetomidine at 1 microgramkg. Both drugs are administered intravenously about 30 minutes before the anticipated end of surgery. Standard anesthesia protocols, including induction and maintenance, are followed, with monitoring of vital signs and core temperature throughout the procedure. After surgery, patients are extubated and transferred to the post-anesthesia care unit for observation. During the study, participants undergo regular monitoring of core temperature and vital signs at specific intervals. Shivering is assessed using a validated scale from 0 no shivering to 3 severe whole-body shivering during the 30 minutes after surgery while in the recovery area. The primary outcome is the number of patients who experience shivering in response to decreased body temperature. Secondary outcomes include observing any changes in heart rate and blood pressure. The total participation includes preoperative assessment, intraoperative treatment, and 30 minutes of postoperative monitoring.

This research aims to compare the effectiveness and safety of QL0605 injections given at two different times after chemotherapy in patients with invasive breast cancer. The study focuses on patients scheduled for at least two cycles of specific chemotherapy regimens TACTCTCbH and evaluates the prevention of febrile neutropenia and other related side effects. It is a multicenter, open-label, randomized phase 4 trial sponsored by Qilu Pharmaceutical Co., Ltd. Patients are randomly assigned in a 21 ratio to receive QL0605 injections subcutaneously either 24 hours or 48 hours after each chemotherapy cycle. Each participant is planned to receive two chemotherapy cycles spaced three weeks apart. The primary comparison is the rate of febrile neutropenia during the first chemotherapy cycle, with secondary assessments including severe neutropenia, chemotherapy dose changes, delays caused by neutropenia, antibiotic use, and pain related to bones, muscles, or joints. Participants will be closely monitored throughout each chemotherapy cycle with assessments of their blood counts and clinical status to detect febrile neutropenia and other adverse events. The main outcome measured is the incidence of febrile neutropenia during the first 21-day chemotherapy cycle. The study includes safety monitoring and follow-up during and after treatment, with total involvement lasting through the two chemotherapy cycles and associated assessments.