Eeklo

Researchers are studying the treatment of foot drop caused by peroneal nerve entrapment to find out if decompressive surgery leads to better recovery than maximal conservative treatment. This trial is the first prospective, randomized controlled study comparing these approaches, as previous research mostly included biased case series. The study focuses on patients whose foot drop persists 10 plus or minus 4 weeks after symptom onset and aims to measure improvement nine months after treatment. Participants will be randomly assigned to either decompressive surgery performed within one week after randomization or to maximal conservative treatment, which includes physiotherapy and gait rehabilitation. The surgery involves releasing the peroneal nerve from surrounding tissue around the fibular head. Conservative treatment focuses on exercises to mobilize the ankle and foot, stretch calf muscles, strengthen dorsiflexion and eversion muscles, and rehabilitate walking. Participants will be evaluated at multiple visits up to 18 months after randomization. Assessments include questionnaires, muscle strength tests, various walking tests such as the six-minute walk test (the primary outcome), and quality of life measures. Electrodiagnostic tests will be done at 3 and 9 months. Researchers will also monitor work productivity and cost-effectiveness. The main measurement is the change in distance walked during the six-minute walk test from baseline to 9 months after treatment.

This research focuses on patients with borderline resectable (BR) and locally advanced pancreatic ductal adenocarcinoma (LAPDA) undergoing neoadjuvant chemotherapy with FOLFIRINOX. The study aims to assess whether combining diffusion-weighted magnetic resonance imaging (DW-MRI), radiomics, and multi-omics profiling from liquid biopsies can better predict successful surgical removal of the tumor. It addresses the challenge that standard CT imaging and tumor marker CA 19-9 lack accuracy in predicting if surgery will be successful, potentially leading to unnecessary operations or missed treatment opportunities. Participants will receive standard care, including chemotherapy and routine CT imaging, along with additional DW-MRI scans and blood samples for advanced genetic and molecular analysis before and after chemotherapy. The study includes one treatment arm and uses specialized imaging and genetic tests to analyze tumor response and progression. If no tumor progression is detected and tumor markers decrease, patients will be considered for surgery, during which further blood samples will be collected to study circulating tumor cells. Throughout the study, participants will undergo imaging, blood tests, and complete questionnaires about their health and quality of life. Researchers will measure outcomes such as surgical resectability, cancer recurrence, and survival over two years. The study aims to refine surgical decision-making, reducing unnecessary surgeries and improving patient outcomes while monitoring safety and treatment responses for up to five years.

Researchers are evaluating the use of therapeutic drug monitoring (TDM) to optimize dosing of biologic drugs for moderate to severe psoriasis. The study compares standard fixed dosing with dosing adjusted based on drug concentrations in the patient's blood. The goal is to maintain effective disease control while avoiding under- or overdosing, which can cause inadequate response, side effects, or increased healthcare costs. This pragmatic, multicenter, randomized Phase 4 trial is conducted in 14 Belgian hospitals with patients already receiving biologics for at least six months. Participants are randomized into two groups: one group receives dosing advice based on measured drug levels (proactive TDM), and the other continues usual care with fixed dosing. The biologics studied include secukinumab, ixekizumab, and guselkumab. Dose adjustments involve lengthening or shortening injection intervals stepwise by weeks depending on drug concentration to reach the target level. Dose reductions and escalations occur in predefined steps specific to each biologic, and adjustments continue at each study visit if targets are not met. During the 76-week study, patients have regular visits every three months to assess disease control using PASI scores and quality of life measures. Researchers track sustained disease control, treatment satisfaction, safety, and cost-effectiveness. Blood drug levels guide dose changes in the intervention group, while usual care patients maintain standard dosing schedules. The study aims to show TDM-based dosing is not inferior to standard care in maintaining disease control over 18 months, potentially improving safety and reducing costs.

Researchers are collecting data in Flanders on how often suicide attempts and suicidal thoughts occur across various healthcare settings like hospitals, psychiatric centers, crisis teams, and general practitioners. The study aims to understand the methods used in suicidal behavior and see how many people receive proper aftercare following a suicide attempt. It uses a detailed tool called the Guideline for Suicide Care and Evaluation (LOES) to gather comprehensive information about individuals with suicidal thoughts or behaviors. The study includes a two-part semi-structured interview conducted by trained healthcare professionals such as nurses, psychologists, and psychiatrists. The first part happens shortly after admission to a healthcare facility following a suicide attempt or suicidal thoughts and collects demographic data, history, social support, hopelessness levels, and current suicidal ideation. The second part explores psychological factors more deeply, including motives, personal and interpersonal problems, and current thoughts of self-harm or suicide. Participants undergo detailed assessments on the first day covering demographics, clinical details, suicidal behavior methods, emotional state, suicidal intent and planning, past self-harm, social support, mental health history, substance use, coping strategies, and care needs. The study tracks participants’ openness to help and care pathways to formulate well-supported risk assessments. This comprehensive evaluation helps understand suicidal processes and needs in the Flanders region.