Quito

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.

Obesity results from the excessive buildup of body fat and is linked to chronic diseases, increased stress on the respiratory system, worsened respiratory conditions, and reduced physical fitness and exercise ability. Researchers are studying how respiratory muscle training affects cardiovascular, respiratory, metabolic, and physical exercise-related factors in patients who have undergone bariatric surgery. This trial aims to clarify the benefits of this training on various health aspects related to obesity after surgery. Participants are divided into two main groups for 12 weeks. One group receives both a structured physical exercise program and inspiratory muscle training using a pressure threshold device, while the control group does the same exercise program with a sham device. Another comparison evaluates inspiratory muscle training alone versus a sham device to assess its effects both combined with exercise and in isolation. The exercise program gradually increases intensity and duration, while the inspiratory muscle training starts at 30% of maximum inspiratory pressure and progresses to 60% over the study period. Throughout the 12 weeks, participants undergo assessments before and after the intervention, including maximum inspiratory pressure, sleep apnea index, sleep quality, resting heart rate, blood pressure, exercise capacity, blood sugar control, lipid levels, body composition, and quality of life. These measures help researchers understand the impacts of respiratory muscle training on multiple health outcomes related to obesity and post-bariatric surgery recovery.

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, patient outcomes, and care processes for those with AKI-RRT. It also aims to identify how these factors vary across different Latin American countries and what demographic, clinical, and socioeconomic elements affect patient outcomes. The study collects a wide range of data including clinical details, laboratory results, treatments, care processes, and patient outcomes to create a comprehensive database. It includes adult patients admitted to intensive care units diagnosed with stage 3 acute kidney injury who begin renal replacement therapy within a specific timeframe relative to ICU admission. The study does not involve experimental treatments but observes current care practices across multiple sites. Participants are monitored from enrollment through hospital discharge or up to 90 days to track in-hospital mortality and other outcomes. The research helps compare care approaches and results between countries and supports further clinical research in AKI-RRT. The total participation duration depends on the patient's hospital stay or 90 days, whichever comes first.

Researchers are evaluating a telemedicine model for providing medication abortion services to women in Ecuador who are less than 12 weeks pregnant. The study aims to demonstrate that this remote approach is safe, feasible, and acceptable to users seeking abortion care. It focuses on supporting the sexual and reproductive rights of Ecuadorian women by offering a service comparable in quality to in-person medical abortion procedures. The study involves enrolling 100 women who contact private providers to obtain a medication abortion. Eligible participants receive a study package shipped to their address containing misoprostol tablets, ibuprofen, and instructions for use. The medication regimen includes at least three doses of misoprostol taken sublingually every three hours, with additional tablets available if needed. Providers offer counseling and informed consent remotely via telephone or video calls and may prescribe other medications as necessary. Participants are followed up 10 to 15 days after taking misoprostol through telephone interviews to assess abortion completion using methods like symptom checklists, pregnancy tests, or ultrasound. If needed, participants receive guidance on taking additional doses or obtaining further care. An exit interview gathers feedback on satisfaction and any challenges encountered. Safety is monitored by documenting adverse events within six weeks.

Adolescence is a critical time when mental health disorders often begin, as young people learn to manage strong emotions. Around 15% of adolescents worldwide experience disorders like depression or anxiety. This research focuses on understanding mental health in Ecuadorian adolescents aged 14 to 19, looking beyond disorders to overall mental well-being. It aims to assess mental health by considering social factors and lifestyle medicine, and to develop ways to reduce risks and improve emotional well-being. The study involves collecting information through self-reported questionnaires that measure mental health and lifestyle medicine components. It will also include physical measurements like body size and vital signs, assessments of physical activity, and collection of biological samples such as blood and hair for further testing. The research includes both cross-sectional and ongoing observations, with a planned sample size of about 1000 adolescents from Quito, Ecuador. Participants will be evaluated using validated tools to understand their mental health and lifestyle habits. Researchers will analyze these alongside social determinants of health to identify needs and design strategies to support adolescent mental wellness. The study's findings aim to guide public health policies and interventions to better address adolescent mental health. The study is expected to complete its comprehensive evaluation by 2025.

Researchers are investigating the effect of low dose colchicine, an anti-inflammatory drug, on reducing vascular events in patients with symptomatic peripheral artery disease (PAD). This Phase 3 randomized, double-blind, multicenter trial involves 6,150 participants and aims to prevent major cardiovascular and limb complications such as heart attacks, strokes, cardiovascular deaths, acute limb ischemia, and vascular amputations. The study focuses on patients who have PAD with various levels of severity and associated vascular risks. Participants are randomly assigned to receive either a daily 0.5 mg colchicine tablet or a matching placebo. Both the active drug and placebo look the same to ensure that patients, investigators, and study staff remain unaware of the treatment assignments. The trial includes an active run-in period before randomization. The colchicine is administered orally each day, and the trial medication is securely stored according to specific guidelines. During the study, patients will be monitored for major adverse cardiovascular and limb events over 3 to 5 years. These events include cardiovascular death, heart attacks, strokes, severe limb ischemia requiring vascular intervention, or major amputation. Researchers will assess cardiovascular health and limb status regularly, tracking serious events to evaluate the drug's impact. Safety and adherence to treatment will be closely followed throughout the study period.

Researchers are evaluating an organ dysfunction scoring system adapted specifically for pregnant and early postpartum patients admitted to intensive care units (ICUs). The study aims to develop and validate this obstetric SOFA score (SOFA-OBS) to better predict ICU mortality and sepsis-related mortality in this group. The current general SOFA score does not account for physiological changes during pregnancy and early postpartum, such as reduced creatinine levels and lower blood pressure, which may affect its accuracy in these patients. This study will include about 130 female participants who are either pregnant at any stage or within three days after giving birth and require ICU care. The study will use the new SOFA-OBS score that adjusts kidney and cardiovascular measures to reflect pregnancy changes and simplifies respiratory function evaluation by using a non-invasive pulse oximeter when arterial blood gases are unavailable. The original neurologic, liver, and platelet assessments remain unchanged. Researchers will collect data routinely gathered during ICU care without additional interventions. They will track SOFA and SOFA-OBS scores daily during ICU stays, up to discharge or death, focusing on the first 24 and 48 hours, and assess various organ functions and sepsis definitions adapted to pregnancy stages. Participants will be monitored throughout their ICU stay with data recorded on organ function, infection status, interventions, and outcomes. The study will compare SOFA-OBS with the general SOFA score for predicting mortality and sepsis outcomes. Data collection will include laboratory tests, vital signs, and clinical assessments using standardized forms and electronic systems. Safety and privacy will be maintained, and consent obtained before participation. The total duration depends on ICU stay, with daily evaluations until discharge or death, or up to 28 days post-enrollment for mortality outcomes.

Researchers are investigating the progress and outcomes of clients receiving psychotherapy for common mental health problems in Ecuador. This observational and naturalistic study aims to understand how clients' psychological distress changes during therapy and identify factors linked to treatment outcomes in real-world mental health services. The study includes adolescent and adult populations and is conducted across multiple psychological care centers to reflect actual therapeutic practices. Participants will continue their regular psychotherapy sessions led by licensed practitioners tailored to their individual needs. Throughout their therapy, clients will complete questionnaires about their general well-being before each session as part of a Routine Outcome Monitoring system. Data will be gathered at the client, therapist, and service levels, including psychological distress, sociodemographic information, treatment satisfaction, therapist intake forms, personal style questionnaires, and service operational data. Participants will be assessed at the start, during, and immediately after treatment, with measures including the Clinical Outcomes in Routine Evaluation (CORE-OM, CORE-10) and Young Person's CORE (YP-CORE). Researchers will monitor client progress, treatment satisfaction, and contextual changes throughout therapy. The study aims to promote the adoption of routine outcome monitoring to improve mental health care quality in Ecuador and Latin America, with a total participation duration based on the course of psychotherapy, averaging about 10 weeks.

Preeclampsia (PE) affects about 5% of pregnancies and remains a leading cause of maternal illness and death worldwide, especially term PE, which accounts for 70% of cases. Prediction and prevention of term PE have not been fully solved. Recent findings show that measuring the sFlt1/PlGF ratio at 35 to 37 weeks of pregnancy can predict term PE with an 80% detection rate. Induction of labor (IOL) from 37 weeks has been found to be safe and may help reduce the risks associated with term PE. This trial aims to test whether a simple universal screening using the sFlt1/PlGF ratio followed by planned delivery can lower the rate of term PE without increasing cesarean sections or harming newborns. Participants will be nulliparous women with a singleton pregnancy between 35.0 and 36.6 weeks gestation. They will be randomly assigned to groups where the sFlt1/PlGF screening results are either known to clinicians or concealed. A cutoff above the 90th percentile of the ratio will identify women at high risk for PE, who will then be offered induction of labor from 37 weeks. This approach is designed to be simple and feasible for use in many healthcare settings worldwide. During the study, participants will have their sFlt1/PlGF ratio tested once between 35 and 36.6 weeks. Researchers will monitor and compare the rate at which term PE develops over four weeks. They will also track cesarean section rates and neonatal outcomes to ensure safety. The study focuses on finding an effective, easy-to-apply strategy to reduce term PE and improve both maternal and newborn health outcomes.