La Sa Shi

Researchers are studying high altitude pulmonary edema (HAPE), a severe lung condition that occurs at high altitudes. HAPE causes symptoms like shortness of breath, cough, frothy sputum, and blue-tinged skin, and can be fatal if not treated quickly. The condition involves high blood pressure in the lungs leading to fluid buildup, and this trial focuses on inhaled nitric oxide (iNO) as a treatment. The study uses a new portable device, the INOwill N300, which produces nitric oxide gas on-site without needing gas cylinders and monitors gas levels in real-time to ensure safety. The trial compares inhaled nitric oxide therapy delivered through the Nitric Oxide Generation and Delivery System to a control group in patients with mild to moderate HAPE. This device supplies a steady concentration of nitric oxide during breathing. The study evaluates how quickly oxygen levels improve, symptom resolution times, imaging improvements, and treatment effectiveness over days 3 to 7. Hospital stay lengths for patients receiving iNO are also recorded to assess treatment impact. Participants will undergo assessments including oxygen level measurements and symptom scoring using the Lake Louise Acute Mountain Sickness Scale. Chest X-rays and imaging studies are conducted to track lung changes. The study monitors safety by measuring nitric oxide, nitrogen dioxide, and oxygen concentrations continuously. The main outcome measured is the change in oxygen index over an average of 5 days. This trial lasts through the treatment period to assess how inhaled nitric oxide affects lung function and patient recovery in high-altitude pulmonary edema.

Researchers are evaluating treatments for adults with acute spontaneous supratentorial intracerebral hemorrhage (ICH) of 20 mL or more. The study compares early minimally invasive surgery combined with thrombolysis (eMIST) against the best medical management. This multicenter trial is designed to adaptively assess outcomes using a randomized, open-label approach with blinded evaluation of results. The main goal is to improve functional recovery measured by a utility-weighted modified Rankin Scale at 180 days after treatment. Participants are randomly assigned to one of two groups: one receiving early minimally invasive catheter evacuation surgery along with up to ten doses of urokinase administered through the catheter placed in the hemorrhage area, and the other receiving the best available medical care without surgery. The intervention must start within 4 hours after randomization, which itself must occur within 8 hours of stroke symptom onset or the last known well time. The study includes an adaptive design to reassess sample size after 250 patients complete 180-day follow-up. Throughout the study, patients undergo assessments including head CT scans before randomization to confirm eligibility. Functional improvement is tracked using the utility-weighted modified Rankin Scale at 180 days. Safety and effectiveness of treatments are monitored during the trial, which includes long-term follow-up to evaluate outcomes. Participants or their legal representatives provide informed consent prior to enrollment.