Boa Vista

This research aims to evaluate how active health education methods can increase the number of schoolchildren getting the HPV vaccine. The study addresses a recent drop in HPV vaccine adherence among young people in Brazil. It involves 80 schools and 5,000 students, using a stepped-wedge design where clusters of schools are randomized every two months to one of four different interventions. The study compares four approaches active training for both students and teachers, active training for students only, a nurse-led vaccination orientation session in schools, and usual care without specific interventions. Teacher training includes 30 hours of online self-instruction focused on vaccination, while students receive education and active vaccination efforts over two months. Each intervention is applied to clusters of schools in a randomized sequence. Participants are schoolchildren aged 9 to 14 years. Researchers will measure vaccination rates, including the proportion receiving at least one dose and those completing the full HPV vaccine series, along with tracking vaccination refusals among students and teachers over 12 months. The study monitors these outcomes following the interventions to understand their impact on vaccine coverage and refusal rates.

Researchers are investigating whether patients with locally advanced cervical cancer who still have detectable cell-free human papillomavirus DNA cfHPV-DNA in their plasma after standard treatment may benefit from additional chemotherapy. This trial is a prospective, randomized, multicenter clinical study designed to evaluate adjuvant chemotherapy based on this biomarker. The study focuses on patients who have undergone chemoradiotherapy and have persistent cfHPV-DNA, as this may indicate ongoing disease activity. Participants first receive standard treatment with concomitant chemoradiotherapy, including doses of radiation and weekly cisplatin. Four weeks after completing this treatment, a blood test is conducted to detect cfHPV-DNA in plasma. Patients with positive cfHPV-DNA results are randomly assigned to either receive two additional cycles of adjuvant chemotherapy with cisplatin and gemcitabine or to be monitored without further chemotherapy. Patients in both groups undergo regular follow-up every four months, including plasma cfHPV-DNA testing, CT scans of the chest, MRI scans of the abdomen and pelvis, and clinical and gynecological exams. During the study, participants are closely monitored for progression-free survival, overall survival, treatment response, quality of life, and any toxic effects of treatment. Follow-up assessments occur at regular intervals from 7 to 120 days after treatment. The total duration of participant involvement varies based on follow-up schedules. The study uses a single-blind design and randomized allocation to ensure scientific rigor while maintaining patient safety throughout the trial period.

This trial is evaluating the safety and effectiveness of a single high dose of liposomal amphotericin B compared to the standard two-week treatment for disseminated histoplasmosis in patients with AIDS. Disseminated histoplasmosis is a serious fungal infection common in immunocompromised individuals, especially those with advanced HIV. The study aims to determine if the single high dose is at least as effective as the standard treatment in reducing mortality and improving outcomes. Participants will be randomly assigned to receive either a single high dose 10 mgkg of liposomal amphotericin B or the standard daily dose 3 mgkg for two weeks. After induction therapy, all patients will receive oral itraconazole for one year. The study includes safety monitoring by a Data Safety Monitoring Board and oversight by steering and medical committees with scheduled meetings to review progress and maintain quality. During the study, participants will be assessed for overall survival at 14 days, clinical response, fungal load, and treatment-related side effects. Additional evaluations include a Desirability of Outcome Ranking score at 10 weeks and monitoring for adverse events. Data will be analyzed using statistical methods to compare outcomes between the treatment groups. The total duration includes initial treatment and follow-up assessments up to 10 weeks, with ongoing oral therapy for one year.

Researchers are evaluating treatments for women with locally advanced cervical cancer, specifically adenocarcinoma or squamous cell carcinoma at certain stages FIGO Stage IB2-IB3 node positive or Stage IIB-IVA. The study compares standard cisplatin-based chemoradiation with a combination of immunotherapy drugs nivolumab and ipilimumab followed by chemoradiation. This Phase II trial aims to assess 3-year progression-free survival among participants. Participants are randomly assigned to one of two groups. One group receives standard radiation therapy targeting 45 Gy in 25 fractions with concurrent weekly cisplatin or carboplatin chemotherapy. The other group receives 4 cycles of induction immunotherapy with nivolumab and ipilimumab every 3 weeks, followed by the same radiation and chemotherapy regimen combined with nivolumab every 2 weeks. The study includes detailed treatment schedules and dosing for all therapies. During the study, participants will undergo regular evaluations including imaging to assess lesions, health-related quality of life assessments, and monitoring for treatment-related toxicities. Researchers will measure outcomes such as 3-year progression-free survival, overall survival, response rates, and quality of life changes. The total follow-up period includes assessments up to three years after treatment to monitor effectiveness and safety.