Quito

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 clinical trial investigates the best way to use prone position placing patients on their stomachs for adults with moderate to severe Acute Respiratory Distress Syndrome ARDS who need mechanical ventilation. Researchers want to find out if longer prone sessions lasting more than 48 hours improve survival compared to daily sessions lasting 16 to 24 hours. The study also evaluates the safety of prolonged prone positioning and its impact on medical problems related to this intervention. Participants are randomly assigned to one of two groups one receiving prolonged prone position sessions lasting at least 48 hours and up to 120 hours until their oxygenation improves, and the other receiving intermittent daily prone sessions lasting between 16 and 24 hours. Both groups may have repeated prone sessions during the first 7 days if their oxygen levels fall below a certain threshold after returning to the supine position. This design allows comparison of continuous versus intermittent prone positioning in managing ARDS. During the study, participants will be followed for up to 90 days to monitor their clinical progress. Researchers will assess outcomes including mortality at 28 and 90 days, ventilator-free days, and hospital-free days at 28 days. Safety and adverse events related to prone positioning will also be recorded. The total participation involves receiving the assigned prone sessions during the first week and ongoing clinical follow-up to evaluate the effectiveness and safety of each approach.

Obesity, caused by excess body fat, is linked to chronic diseases and puts stress on the respiratory system, leading to breathing problems and reduced exercise ability. This research aims to find out how respiratory muscle training affects heart, lung, metabolic health, and physical fitness in patients who have undergone bariatric surgery. The study is a randomized clinical trial lasting 12 weeks and includes adults aged 18 to 60 who recently had bariatric surgery. Participants are divided into four groups combining two approaches institutionalized therapeutic exercise and inspiratory muscle training using a pressure threshold device, or their respective controls using a sham simulated device. Exercise includes aerobic and neuromuscular training with increasing intensities over 12 weeks. Inspiratory muscle training starts at 30% of maximum inspiratory pressure and increases to 60%, performed 5 times a week. Control groups receive sham training or usual care. Before and after the 12-week program, researchers will assess maximum inspiratory pressure, sleep apnea, walking distance, and sit-to-stand ability. Additional measures include sleep quality, heart rate, blood pressure, blood sugar control, lipid profile, body composition, quality of life, anxiety, depression, and risk of sleep apnea. The study tracks these outcomes to understand how respiratory muscle training influences health and exercise capacity after bariatric surgery.

Researchers are conducting an international, multicenter observational study to understand acute kidney injury requiring renal replacement therapy AKI-RRT in Latin American countries. The study focuses on the epidemiology, outcomes, and care processes for patients with AKI-RRT, comparing variations across different countries and examining factors such as demographics, clinical profiles, and socioeconomic status that may influence patient outcomes. The aim is to establish a comprehensive database to support clinical research and improve understanding of AKI-RRT in this region. The study observes critically ill adult patients admitted to intensive care units ICUs who are undergoing any form of renal replacement therapy. It collects detailed clinical, laboratory, treatment, and outcome data without assigning treatments, as it is observational. Patients are followed from enrollment through hospital discharge or up to 90 days, including ICU stay and 90-day post-ICU follow-up to track mortality, renal recovery, and complications related to renal replacement therapy. Participants involvement includes monitoring during ICU and hospital stays with data collected on mortality rates, length of stay, renal function recovery, dependence on renal replacement therapy, and complications such as infections or anticoagulation issues. The primary outcome measured is in-hospital mortality, with secondary outcomes covering ICU mortality, 90-day mortality, length of stay, recovery, and procedural complications. This study spans from enrollment until 90 days after ICU admission, providing extensive observational data on AKI-RRT in Latin America.

This research aims to evaluate a telemedicine service for providing legal medication abortion in Ecuador, focusing on women who are less than 12 weeks pregnant. The study is observational and seeks to determine if this remote model is safe, feasible, and acceptable to users. It involves women contacting private providers for a medication abortion and explores how well telemedicine can support sexual and reproductive rights. Participants receive medication abortion using a regimen of misoprostol alone, with three doses of 800 mcg taken sublingually every three hours, plus an optional extra dose if needed. The study involves remote consultations for screening and counseling, shipment of the medication package, and follow-up contacts. Women receive detailed instructions and support via telemedicine, and medications are sent to their address once eligibility is confirmed. During the study, participants are screened and consent remotely, take medications at home, and have follow-up interviews 10 to 15 days after treatment to assess abortion completeness. The researchers collect data on safety, feasibility, and user satisfaction through interviews and medical assessments. The total follow-up includes monitoring adverse events and service acceptability over six weeks, ensuring participants have access to care and support throughout the process.

Researchers are evaluating the mental health and emotional well-being of adolescents aged 14 to 19 in Quito, Ecuador, focusing on how social factors and lifestyle habits affect their psychological state. This study aims to identify risks for mental health disorders like depression and anxiety and develop comprehensive interventions to support adolescent emotional health. It uses a holistic approach that considers various aspects of life and mental well-being beyond just mental disorders. The study involves collecting data through self-reported validated questionnaires that assess mental health and the six pillars of Lifestyle Medicine. Participants will undergo physical measurements like height and weight, have their physical activity levels evaluated, and provide biological samples such as blood and hair for analysis. This observational study will gather extensive information without administering any treatments. Participants will be involved by completing surveys and undergoing health measurements and sample collections. Researchers will evaluate their mental health comprehensively using these assessments and social and lifestyle factors. The study plans to include about 1000 adolescents for increased accuracy and will inform public health strategies. Participation is voluntary, and the study will continue through 2030, monitoring and assessing adolescent mental health over time.

Researchers are evaluating whether low dose colchicine can reduce vascular events in patients with symptomatic peripheral artery disease PAD. This phase 3 randomized, double-blind, multicenter trial aims to prevent major adverse cardiovascular and limb events MACE and MALE such as heart attack, stroke, cardiovascular death, severe limb ischemia requiring intervention, or major vascular amputation. The study includes 6,150 participants and is sponsored by the Population Health Research Institute. Participants will be randomly assigned to receive either colchicine 0.5 mg daily or a placebo tablet that looks identical. Treatment lasts for the duration of the trial, which spans 3 to 5 years, including an active run-in period. The trial is designed to compare the effects of the colchicine drug against placebo in preventing serious vascular complications in PAD patients. During the study, participants will have regular assessments to monitor cardiovascular and limb health, including evaluations of major adverse events, hospitalizations, revascularizations, and quality of life. Researchers will collect data on outcomes like cardiovascular death, stroke, acute or chronic limb-threatening ischemia, and overall mortality over 3 to 5 years. Safety and adherence to the study medication will be monitored throughout the trial period, with follow-up visits to track health status and event occurrences.

Researchers are evaluating an organ dysfunction score adapted specifically for pregnant and early postpartum patients up to 3 days after birth admitted to intensive care units ICU. This observational study aims to determine if this adjusted score, called SOFA-OBS, better predicts ICU mortality compared to the general SOFA score. The study also assesses whether a non-invasive pulse oximeter can effectively evaluate respiratory function instead of the standard arterial blood gas test, which is more painful and invasive. The study involves following pregnant and postpartum patients admitted to the ICU for at least 24 hours. Researchers will collect routine clinical data and laboratory results already used in ICU care, without requiring extra interventions. The SOFA-OBS score adjusts kidney function and blood pressure measurements to reflect the physiological changes during pregnancy and postpartum. It also replaces arterial blood gas oxygen measurements with pulse oximetry when blood gas analysis is unavailable. Data will be recorded daily during the ICU stay. Participants will be monitored for organ dysfunction and mortality outcomes during their ICU stay or up to 28 days after enrollment. Researchers will evaluate and compare the predictive ability of the SOFA-OBS and general SOFA scores for ICU mortality and sepsis-related death. Data quality will be carefully checked, and privacy will be protected by anonymizing patient information. The study is approved by ethical boards and requires informed consent from participants, with a planned enrollment of 130 patients.

Researchers are studying clients in Ecuador who are receiving psychotherapy for common mental health problems to understand how their psychological distress changes during treatment and what factors affect their outcomes. This observational study is conducted in real-world mental health clinics and aims to track therapy progress and results using routine outcome monitoring. The study includes adolescents and adults starting psychotherapy at participating centers. Participants continue their usual psychotherapy sessions while completing questionnaires before each session to report on their well-being. Data is collected at three levels client distress and satisfaction, therapist intake and style, and service operational context. The study is naturalistic, reflecting typical clinical practice, and aims to support broader adoption of outcome measurement systems in Ecuador and Latin America. During the study, participants provide information through questionnaires at the start, throughout, and at the end of therapy, usually spanning about 10 weeks. Researchers measure changes in psychological distress using tools like CORE-OM, CORE-10, and YP-CORE, along with emotional outcomes and treatment satisfaction. This approach helps monitor progress and informs improvements in mental health services over time.

Preeclampsia PE affects about 5% of pregnancies and remains a major cause of illness and death for mothers worldwide. Term PE, which occurs at or after 37 weeks, accounts for 70% of all PE cases and leads to significant health risks for mothers and babies. Researchers are studying whether a simple blood test screening using the sFlt1PlGF ratio at 35 to 37 weeks, followed by planned induction of labor IOL from 37 weeks in high-risk women, can reduce the occurrence of term PE without increasing cesarean deliveries or harming newborns. The study compares two groups of first-time pregnant women one group will have their sFlt1PlGF ratio results revealed to doctors and receive an offer of induction from 37 weeks if their risk is high above the 90th percentile, while the other group will have their results concealed and receive routine care. The screening test is a single-step blood test done between 35.0 and 36.6 weeks. Induction of labor is planned only for those with a high-risk test result in the revealed group. The other group will continue with standard pregnancy follow-up and spontaneous delivery. Participants will be monitored for the development of term PE and other maternal and newborn health outcomes for up to 6 months after delivery. Researchers will assess rates of term PE within 4 weeks, cesarean section rates, maternal and neonatal hospital stays, maternal complications, perinatal complications, maternal experience, and cardiovascular risk post-delivery. The study involves regular follow-up visits and data collection to evaluate the effectiveness and safety of the screening and intervention strategy.