Passos

Researchers are evaluating ziltivekimab, a new medicine not yet approved anywhere, to see if it can help people who were hospitalized due to a heart attack. The study aims to find out if ziltivekimab can reduce the development of heart disease and prevent future heart attacks or strokes. This is a Phase 3 clinical trial comparing ziltivekimab to a placebo in patients with acute myocardial infarction. Participants will receive an initial loading dose of ziltivekimab or matching placebo by injection under the skin as soon as possible after an invasive heart procedure, within 36 hours for STEMI or 48 hours for NSTEMI patients. After the loading dose, they will get monthly injections of the same study medicine for up to two years, in addition to their standard care. During the study, participants will be monitored for major cardiovascular events such as heart attack, stroke, and cardiovascular death. Researchers will also track other heart-related outcomes and safety measures over a period of up to 25 months. The study involves regular visits for injections, assessments, and laboratory tests to evaluate the medicines effects and patient health throughout the trial.

Healthcare-associated infections HAIs are a significant issue in intensive care units ICUs, often caused by environmental contamination with multidrug-resistant organisms that remain despite regular cleaning. Researchers are evaluating two advanced disinfection methodshydrogen peroxide aerosolization and ultraviolet-C lightto reduce this contamination. This cluster-randomized, crossover trial will be conducted in 12 Brazilian ICUs to compare these methods with usual surface disinfection practices. The trial includes three sequential cleaning strategies for each ICU usual surface disinfection alone usual disinfection followed by hydrogen peroxide aerosolization at 7.9% concentration applied inside a protective tent during terminal cleaning of beds and usual disinfection followed by automated ultraviolet-C irradiation applied under the same tent. The protective tent is used to prevent exposure of adjacent beds and ICU areas to the disinfecting agents. Participants will be all patients aged 18 years and older admitted to these ICUs. Researchers will measure antimicrobial use at the ICU level over three months, daily defined doses per 100 patient-days, and secondary outcomes such as rates of HAIs, contamination by multidrug-resistant organisms, specific infections like ventilator-associated pneumonia, bloodstream infections, urinary tract infections, and ICU length of stay costs. Safety and effectiveness of surface disinfection methods will be monitored throughout the study.

This research aims to evaluate whether an educational quality improvement intervention focused on antimicrobial stewardship can reduce antimicrobial use in adult patients admitted to intensive care units ICUs in Brazil. The study compares current ICU practices with those after implementing the intervention, which is based on up-to-date guidelines and aims to promote rational antimicrobial use without increasing ICU mortality or length of stay. The trial uses a stepped-wedge cluster randomized design across 10 ICUs participating in the IMPACTO-MR registry platform. The intervention includes educational sessions, cognitive aids for ICU physicians and healthcare professionals to improve decisions on antimicrobial initiation and duration, and monthly audits with feedback to the ICU teams. Each ICU starts with a control phase of usual care, then transitions to the intervention phase approximately monthly starting July 2025. The study also includes a baseline data collection period before the intervention and a phase-out period to assess lasting effects after stopping feedback. Participants are all adult patients admitted to the participating ICUs during the study. Researchers will collect monthly one-day point-prevalence surveys on antimicrobial use and monitor ICU mortality rates and length of stay over 14 months to evaluate outcomes. The study will assess the impact of the educational intervention on antimicrobial use while ensuring patient safety, with no individual informed consent required due to cluster-level data collection and minimal risk.