Guayaquil

Researchers are collecting detailed information about patients with venous thromboembolism (VTE), which includes blood clots in veins such as deep-vein thrombosis and pulmonary embolism. The project aims to improve doctors' understanding of VTE, especially in patients often excluded from clinical trials, like pregnant women, elderly individuals, cancer patients, and those with other complex health issues. The goal is to reduce deaths, clot recurrence, bleeding problems, and artery-related events by sharing this knowledge widely. The study involves gathering extensive data on each patient's health status, treatments, and outcomes during the first three months of therapy. This registry is available online to help doctors quickly find information on patients with similar medical profiles and make informed decisions about managing high-risk individuals. There are no specific interventions being tested; instead, the focus is on collecting real-world patient data. Participants provide informed consent and are followed for at least three years to monitor for new clot events and complications. Researchers track recurrences of VTE, bleeding episodes, and deaths, aiming to create tools that predict which patients are most at risk for problems. This ongoing data collection supports improving care and guiding treatment decisions for diverse patient groups over time.

Researchers are evaluating the role of endoscopic ultrasound (EUS)-guided shear wave elastography (SWE) compared to vibration-controlled transient elastography (VCTE) and ultrasound-based shear wave elastography (US-SWE) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) who have absent-to-mild liver fibrosis. MASLD includes simple liver steatosis, metabolic-associated steatohepatitis, and related cirrhosis. Liver biopsy is the gold standard for diagnosis but is invasive, so non-invasive imaging methods are studied for screening and monitoring. This trial aims to clarify the diagnostic accuracy of these imaging techniques in early-stage liver fibrosis in MASLD patients, addressing gaps in current knowledge. The study involves three main diagnostic methods: VCTE, US-SWE, and EUS-SWE. VCTE and US-SWE use transabdominal ultrasound devices, requiring patients to fast for at least four hours and avoid alcohol for seven days before testing. Both techniques obtain multiple measurements of liver stiffness and steatosis through the right hepatic lobe. EUS-SWE is performed by an experienced endoscopist using a specialized EUS device to assess liver stiffness in both lobes, focusing on right and left liver segments. EUS-SWE is more invasive and costly but offers reliable evaluation independent of patient body proportions. Participants undergo these imaging procedures while blinded operators perform measurements. The study measures liver steatosis and fibrosis grades using various elastography methods and liver biopsy at six months. Researchers collect multiple readings per method to assess liver stiffness quantitatively. The trial monitors patients for safety and accuracy of these techniques over six months, aiming to improve early detection and grading of liver fibrosis in MASLD through less invasive means.

The optimal interval between treatment phases remains uncertain in several clinical settings. Traditional protocols often include a waiting period between phases to allow tissue healing or stabilization; however, prolonged intervals may extend overall treatment time and potentially affect patient adherence and outcomes. Emerging evidence suggests that reducing the interval between phases could maintain clinical effectiveness while improving efficiency and patient satisfaction. This randomized controlled trial will compare a reduced-interval protocol with a conventional-interval protocol. Eligible participants who require multi-phase treatment will be randomized into two groups: (1) reduced-interval treatment and (2) standard-interval treatment. Clinical examinations will be conducted at baseline and at scheduled follow-up visits according to the study protocol. Primary outcomes will assess clinically relevant parameters associated with the treated condition. Secondary outcomes will evaluate treatment duration, patient-reported symptoms, and quality-of-life measures. Statistical analyses will compare outcomes between groups to determine whether the reduced-interval approach provides equivalent or improved results compared with the conventional schedule.

Achalasia is a disorder affecting the movement of the esophagus and its ability to relax properly, leading to symptoms like difficulty swallowing, cough at night, heartburn, weight loss, and regurgitation. It is often mistaken for gastroesophageal reflux disease but is diagnosed using tests such as barium studies, endoscopy, manometry, and specialized imaging of the esophageal sphincter. Treatments focus on lowering the pressure of the lower esophageal sphincter, with per-oral endoscopic myotomy (POEM) being a minimally invasive and commonly used option. This study evaluates the safety and effectiveness of a new device called the SpydrBlade Flex, which uses radiofrequency and microwave energy for POEM procedures. The procedure can be performed from different positions based on clinical needs and the doctor's choice. This novel device aims to improve the efficiency and safety of the POEM treatment for achalasia patients. Participants will undergo the POEM procedure using the SpydrBlade Flex device. Researchers will monitor technical and clinical success rates within the first day and 30 days after treatment, along with any complications during and after the procedure. The study will collect detailed information about the procedure's outcomes and safety to better understand the device's performance in treating achalasia over the short term.