Gatineau

Atrial Fibrillation AF affects around 200,000 Canadians and increases the risk of stroke, illness, and death. A stroke can severely impact a persons ability to speak, eat, walk, work, care for themselves, and socialize, and it can be fatal. In AF, blood flow slows in the hearts upper chambers, causing blood clots that can travel to the brain and cause a stroke. Blood thinners, or anticoagulants, reduce clot formation and stroke risk. This research compares two newer blood thinners, apixaban and rivaroxaban, to assess their safety in preventing bleeding in patients with non-valvular AF. The study randomly assigns participants to take either apixaban twice daily or rivaroxaban once daily for 12 months. Dose adjustments are made based on age, weight, kidney function, and creatinine clearance. Both treatments are taken by mouth, and kidney function is checked at the start and at least annually during treatment. The trial focuses on comparing bleeding rates between these two approved anticoagulants. Participants will be monitored over 12 months for bleeding events classified as major or clinically relevant non-major bleeding. Researchers will also track strokes, deaths from any cause, medication adherence, and cost-effectiveness. The primary measure is the rate of clinically relevant bleeding during the study, helping to guide first-line therapy choices for stroke prevention in AF.

This research evaluates efgartigimod as a replacement for intravenous immunoglobulin IVIG therapy in adults with stable, acetylcholine receptor antibody positive myasthenia gravis who depend on IVIG. The study aims to compare the effectiveness of efgartigimod with IVIG, assess patient treatment preferences, and monitor safety and tolerability over six months. It is an open-label, single-center prospective study lasting 26 weeks. Participants will stop IVIG one week before starting efgartigimod. Efgartigimod is administered as a one-hour intravenous infusion at a dose of 10 mgkg up to 1200 mg once weekly for four weeks, followed by a four-week break. This cycle repeats four times until week 24, with a final observation visit at week 26. Other myasthenia gravis medications remain unchanged during the study. Throughout the 26 weeks, weekly assessments using the Myasthenia Gravis Activities of Daily Living MG-ADL and Myasthenia Gravis Quality of Life MGQOL questionnaires will be conducted. Researchers will look for sustained improvements in MG-ADL scores lasting at least four consecutive weeks. Safety and continuation of efgartigimod treatment will also be monitored. Participants are involved in regular evaluations to track their symptoms and quality of life during and shortly after treatment.

Researchers are studying whether a wearable robotic exoskeleton can improve mobility, balance, and walking in healthy older adults and people living with Parkinsons disease. These groups face a high risk of falls and mobility challenges due to age-related or disease-related movement impairments. The study aims to understand the immediate effects of the exoskeleton on walking and balance, identify who benefits most, and explore how users feel about using this technology in daily life. The study involves two laboratory sessions held 2 to 4 days apart. In the first session, participants undergo clinical assessments, are fitted with the exoskeleton, and take part in interviews about their expectations and perceptions. In the second session, they perform mobility tasks such as walking and standing with and without the exoskeleton under six different conditions, including various levels of assistance and no assistance. The order of assistance levels is randomized. Movement is measured using wearable sensors to gather detailed walking data. Participants will be involved in clinical tests of balance, gait, physical activity, mood, fatigue, and cognition, along with interviews before and after exoskeleton use. Mobility performance will be evaluated through timed walking and standing tests, and walking variability will be monitored using sensors. For those with Parkinsons, assessments occur during their optimal medication effect. The study measures immediate changes in walking speed, balance, and sit-to-stand times, as well as user acceptability of the device. Participation spans two sessions over about a week, with all data collected in a controlled lab setting.

This research compares two different post-operative salvage radiotherapy schedules for men with recurrent prostate cancer after surgery who have detectable PSA levels. The goal is to determine if a shorter treatment plan is as safe and effective as the standard longer schedule. This study is important because cancer can return in many high-risk patients after prostate surgery, and the best radiotherapy approach, including treatment length and pelvic area coverage, remains under study. Participants will receive either the standard radiotherapy with 25 sessions over about 5 weeks delivering 62.5 Gy to the prostate bed and 45 Gy to the pelvis, or a shorter schedule with 20 sessions over about 4 weeks delivering 52.5 Gy to the prostate bed and 43 Gy to the pelvis. Both groups may also receive hormone therapy Androgen Deprivation Therapy for 6 to 24 months, depending on the doctors discretion. Some patients with pelvic nodal disease may receive additional medications for 24 months following a specific protocol. During the study, participants will be monitored for side effects related to urinary and bowel health for up to 24 months after radiotherapy. Researchers will also assess cancer control through PSA levels and disease spread, survival rates, and quality of life using urinary, bowel, and sexual health questionnaires. Follow-up evaluations will continue for up to 10 years, with assessments at regular intervals to understand long-term outcomes and safety. The entire study is expected to last about 12 years, including 2 years for enrollment and 10 years of follow-up.

Researchers are studying the effects of repetitive Transcranial Magnetic Stimulation rTMS on walking ability in people with Multiple Sclerosis MS who have spastic paraparesis and moderate walking difficulties. The study aims to measure changes in overall disability, walking endurance, quality of life, and brain activity patterns using EEG. This trial is designed to better understand how rTMS might influence these factors in MS patients. Participants will receive either active rTMS or sham rTMS using a machine that delivers magnetic pulses to specific brain areas. Treatment will occur daily, five days a week, for six consecutive weeks. After a six-week break, all participants will undergo an additional six-week session of active rTMS. The sham treatment uses a lower intensity of magnetic pulses to mimic the procedure without full stimulation. During the study, participants will be assessed on walking speed using the Timed 25-Foot Walk Test over 18 weeks, as well as walking endurance with the Six Minute Walk Test and quality of life measures over 12 weeks. Researchers will monitor neurological stability, medication use, and overall health to ensure safety. The total study period covers these evaluations and treatment phases, with ongoing monitoring for changes in walking ability and quality of life.

Researchers are evaluating how an online training and peer support platform called Support-t may help adolescents aged 14 to 16 years with Type 1 Diabetes T1D as they prepare to transition from pediatric to adult diabetes care. This study aims to compare Support-t integrated with usual care against usual care alone, focusing on blood sugar control measured by Hemoglobin A1c HbA1c, adverse health outcomes, and psychosocial effects during this important transition period. The trial is a multi-site, randomized controlled study with blinded outcome assessors and data analysts, conducted at pediatric diabetes clinics in Quebec. Participants will be randomly assigned to one of two groups. The intervention group will receive access to Support-t, a mobile-based platform featuring educational materials, a news blog, and a patient discussion forum, alongside their usual diabetes care for 18 months. Healthcare providers trained in Support-t will encourage its use during routine visits. The control group will receive their usual diabetes care, which includes regular visits and ad-hoc education by nurses and dietitians, without access to Support-t during the study period. After 18 months, control participants may opt to use Support-t. During the 18-month study, participants will be assessed at the start and at 6, 12, and 18 months for changes in HbA1c and other outcomes such as self-efficacy, diabetes distress, quality of life, readiness for adult care, glucose management, severe low blood sugar episodes, diabetic ketoacidosis, emergency visits, and hospitalizations. Researchers will also analyze the cost-effectiveness of Support-t and gather feedback on user engagement and satisfaction. The total participation time is 18 months from enrollment, with ongoing monitoring of health and psychosocial measures.