Aparecida De Goiania

Researchers are evaluating the safety and effectiveness of finerenone compared to a placebo in patients hospitalized with acute decompensated heart failure who have mildly reduced or preserved left ventricular ejection fraction. This international, randomized, double-blind, placebo-controlled Phase 3 trial aims to understand how finerenone affects morbidity and mortality in this patient group. Participants will receive either oral finerenone or a matching oral placebo. The study focuses on patients currently hospitalized or recently discharged with heart failure symptoms and specific heart function measures. The trial is event-driven and will continue for up to approximately 30 months to collect sufficient data on outcomes. During the study, researchers will monitor the total number of heart failure events and cardiovascular deaths, as well as track serious adverse events and any adverse events that lead participants to stop the study drug. These ongoing assessments will help evaluate the overall safety and impact of the treatment over the duration of the trial.

Healthcare-associated infections (HAIs) are a major issue in intensive care units (ICUs), often caused by contamination with multidrug-resistant organisms that remain despite routine cleaning. This trial evaluates different surface disinfection methods to reduce such contamination and improve patient outcomes. It is a cluster-randomized, crossover study conducted in 12 Brazilian ICUs, comparing usual cleaning methods with additional disinfection technologies. The trial involves three sequential strategies in each ICU: usual surface disinfection alone; usual disinfection followed by aerosolized hydrogen peroxide sprayed at 7.9% concentration inside a protective tent during terminal cleaning of patient beds; and usual disinfection followed by automated ultraviolet-C light irradiation applied under the same protective tent to disinfect beds and nearby surfaces. These methods are compared to assess their impact on infection control. Participants admitted to the ICUs will be monitored for antimicrobial use, which is the primary outcome measured as daily defined doses per 100 patient-days over three months. Secondary outcomes include rates of HAIs, environmental contamination by resistant organisms, specific infection types like ventilator-associated pneumonia, bloodstream infections, urinary tract infections, and ICU length of stay and costs. The study includes assessments of contamination and infection rates during each intervention period to evaluate effectiveness and safety.

Researchers are conducting a prospective, observational, multicenter cohort study to evaluate patients with severe and very severe Chronic Obstructive Pulmonary Disease (COPD) in Brazil. The study focuses on patients classified by the GOLD 2024 guidelines, aiming to understand the relationship between COPD severity, exacerbation rates, disease progression, complications, and mortality. This research addresses the lack of national data on this specific subgroup of COPD patients in Brazil, considering regional differences in risk factors, population, and genetics. The study will include multiple medical centers across all five regions of Brazil, representing diverse environments with varying exposure to tobacco smoke, biomass burning, and pollution. Patients will be enrolled consecutively and followed over 12 months. Visits will occur on-site at the start, 6 months, and 12 months, with additional tele-consults at 3 and 9 months to collect clinical data, especially regarding exacerbations. Data collection will be managed locally at each site and reviewed by the ARO Team. Participants will undergo clinical assessments during on-site and remote visits, including spirometry and symptom evaluations with tests like the COPD Assessment Test (CAT) or Chronic Airway Assessment Test (CAAT). The study will monitor the incidence of hospitalizations, exacerbations, and mortality throughout the follow-up period. This comprehensive monitoring will help characterize the disease course and outcomes among severe COPD patients in different Brazilian regions over approximately one year.