Guayaquil

The registry focuses on patients with venous thromboembolism VTE, including those often excluded from typical clinical trials such as pregnant women, elderly patients, and those with serious health conditions. It aims to improve medical knowledge and patient care by collecting detailed data on these patients clinical status and treatment outcomes. The project also seeks to develop predictive scores to identify patients at higher risk of complications from thromboembolic disease. This observational registry collects extensive information on patients diagnosed with VTE, including details on coexisting conditions, antithrombotic treatment type, dose, and duration, as well as outcomes during the first three months of therapy. It captures data on VTE recurrences, bleeding complications, and deaths, providing insights into real-world treatment and patient management. Participants provide informed consent and are followed for at least three months to monitor clinical outcomes. The registry supports physicians by giving access to data on patients with similar profiles to help manage complex cases. The main outcomes measured include VTE events and complications over a three-year period, supporting ongoing improvements in patient care and risk assessment.

This research investigates the role of endoscopic ultrasound-guided shear wave elastography EUS-SWE in assessing liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease MASLD who have absent-to-mild liver fibrosis. MASLD includes a range of liver conditions from simple fat accumulation to inflammation and cirrhosis. Existing methods like vibration-controlled transient elastography VCTE are commonly used due to lower cost and less invasiveness but have limitations in evaluating certain liver areas, especially in overweight patients. The study compares three non-invasive techniques VCTE, transparietal ultrasound-based shear wave elastography US-SWE, and EUS-SWE. EUS-SWE allows a more reliable evaluation of the right hepatic lobe independently of patient body anatomy but is more invasive and costly. Participants will undergo these imaging procedures to measure liver steatosis and fibrosis grades. The trial includes two groups patients meeting MASLD screening criteria and controls without these criteria. Participants will be assessed over six months using these imaging methods to measure liver stiffness and steatosis grades. Procedures will include fasting and avoiding alcohol before imaging. EUS-SWE involves an endoscopic procedure to obtain measurements from both liver lobes. The main outcomes are liver steatosis and fibrosis grades determined by each method. Safety and accuracy of each technique will be monitored throughout the study duration.

Researchers are evaluating whether shortening the healing time between extraction socket preservation and implant placement improves clinical and radiographic outcomes compared to the usual longer waiting period. This randomized controlled clinical trial involves adults needing single-tooth extraction and implant therapy using the Vega Plus implant system. The study aims to optimize treatment timing and improve efficiency while maintaining positive clinical results. Participants will be randomly assigned to receive implant placement either 4 months reduced interval or 6 months standard interval after ridge preservation. Both groups undergo treatment with the Vega Plus implants. Clinical examinations and imaging will be conducted at baseline and follow-up visits to assess differences between the two timing protocols. Throughout the trial, participants will have clinical and radiographic assessments including cone-beam computed tomography CBCT to measure changes in alveolar ridge width and bone height. Implant stability, marginal bone levels, and postoperative pain will also be monitored. Follow-up extends to two years post-prosthetic loading, providing detailed data on treatment outcomes and safety.

This research collects extensive clinical data to evaluate the Willem AI platforms performance in interpreting electrocardiograms ECGs from high-risk cardiac patients in real-world healthcare settings. Cardiovascular diseases pose significant public health challenges, and while ECGs are valuable for early detection, their interpretation can be complex, costly, and time-consuming for cardiology experts. Previous trials have assessed Willems AI-based interpretation, but this study aims to gather additional evidence to support its integration into routine care. Participants include high-risk cardiac patients undergoing routine ECGs for arrhythmia or cardiac disease assessment. Enrollment is both retrospective and prospective, with Willem analyzing ECGs automatically without influencing clinical decisions or altering standard care. The platform processes various ECG types and formats, including 12-lead ECGs and recordings from Holters, wearables, and other devices, with specific technical requirements for data quality and length. Participants contribute clinical data and ECG recordings which Willem evaluates for cardiac abnormalities over a period that may extend up to 10 years for prospective cases. The study tracks Willems diagnostic performance compared to standard care ECG evaluations. No interventions alter patient care, and the study focuses on collecting comprehensive data to assess AI interpretation accuracy and utility in clinical practice.

Achalasia is a disorder where the esophagus has trouble moving food down because the lower esophageal sphincter LES does not relax properly. Patients often experience worsening swallowing difficulties, along with symptoms like nighttime cough, heartburn, weight loss, and food regurgitation. Diagnosis usually involves tests like esophageal imaging, endoscopy, and manometry, with the Eckardt Symptom Score ESS used to judge the severity and treatment effect. This trial aims to assess a new device designed to improve a minimally invasive treatment called per-oral endoscopic myotomy POEM in patients with achalasia. The study evaluates the safety and effectiveness of a novel SpydrBlade Flex device, which uses radiofrequency and microwave ablation technology for the POEM procedure. This device may be used with either the anterior or posterior POEM approach, depending on the patients condition and the doctors preference. The treatment involves creating a tunnel in the esophagus lining and cutting muscle to reduce LES pressure, helping food pass into the stomach more easily. Participants will undergo the POEM procedure using this new device. Researchers will monitor several outcomes, including the technical success of the procedure within one day and clinical symptom improvement after 30 days. Safety will be tracked by noting any complications during and after the operation. Additional assessments of reflux symptoms, esophageal function, and quality of life will be done up to six months post-procedure. The total study duration allows for follow-up to ensure safety and measure longer-term effects.