Hyvinkaa

Researchers are evaluating the use of mobile-device assisted management of hypertension combined with screening for hidden atrial fibrillation in patients who recently experienced an ischemic stroke or transient ischemic attack TIA. The trial aims to compare this approach to standard care in reducing cardiovascular risks. The study focuses on detecting atrial fibrillation, a key treatable risk factor, and improving blood pressure control, both important for preventing recurrent strokes. Participants are randomly assigned in a 21 ratio to either the standard diagnostic work-up and treatment group or an intervention group. The intervention involves 3 weeks of continuous ECG monitoring to detect hidden atrial fibrillation and monthly self-monitoring of blood pressure for one week with self-adjustment of blood pressure medications guided by a mobile device application. The control group receives usual follow-up and hypertension management without these additional technologies. During the 12-month study period, researchers will measure the incidence of new atrial fibrillation cases and changes in average blood pressure. Secondary outcomes include new cardiovascular events and healthcare costs up to 36 months. Participants will undergo regular assessments and follow-up to monitor these outcomes, with safety and adherence tracked throughout the study.

Researchers are evaluating the use of intravenous IV contrast-enhanced computed tomography CT compared to native CT without contrast in adults with acute abdominal pain who have impaired kidney function. This study addresses concerns about the risk of post-contrast acute kidney injury PC-AKI in patients with reduced renal function, aiming to provide clearer evidence through a randomized controlled trial. The trial focuses on patients with an estimated glomerular filtration rate eGFR between 15 and 45 mlmin1.73 m2 who require emergency abdominal or body CT scans. Participants are randomly assigned to one of two groups one receiving abdominal or body CT with IV contrast, and the other receiving abdominal or body CT without IV contrast native CT. This open-label trial is conducted at multiple centers, comparing the effects and outcomes of these two imaging methods in patients with impaired kidney function. The study is designed to determine if the use of IV contrast affects mortality or the need for renal replacement therapy. During the study, researchers will monitor participants for outcomes including all-cause mortality and renal replacement therapy within 90 days after the CT scan. Additional evaluations include measuring acute kidney injury within 72 hours, any organ failure within 48 hours, hospital-free days within 90 days, and the time from CT to definitive treatment during the hospital stay. Participants will be followed closely after their CT scan to assess these outcomes and ensure safety throughout the study period.

This research aims to identify factors linked to no improvement in gastrointestinal quality of life after elective laparoscopic cholecystectomy for gallstones. The study focuses on patients who have symptomatic gallstones and undergo this surgery, with the goal of understanding outcomes related to abdominal symptoms and quality of life. Participants are observed without any additional intervention. The study monitors patients following their scheduled laparoscopic cholecystectomy, tracking their recovery and quality of life over time to gather data on gastrointestinal health. During the study, participants will complete questionnaires to assess their gastrointestinal quality of life using the GIQLI score at one year after surgery. Researchers will analyze these results to understand the impact of the surgery on abdominal symptoms and overall well-being. The study is observational and involves regular follow-up assessments over the course of the study period.

Researchers are evaluating different imaging approaches for adults suspected of having appendicitis to see how they affect clinical outcomes. The study compares protocol-based selective imaging using clinical scoring to routine imaging with ultrasound andor CT scans. The main questions are whether selective imaging and selective observation combined with scoring affect outcomes like negative appendectomies or complicated appendicitis cases. Participants will be randomly assigned to one of three groups routine imaging with ultrasound and CT as needed selective imaging based on the Adult Appendicitis Score AAS or selective observation using the Appendicitis Severity Score ASS combined with AAS-based selective imaging. In the routine group, patients undergo ultrasound first, followed by CT if results are inconclusive, and urgent surgery if appendicitis is found. In the selective imaging group, patients with high AAS scores have surgery, those with moderate scores get imaging, and low scores are discharged. In the observation group, patients with low AAS are discharged, moderate scores are managed by ASS and observation protocols with re-evaluation, and high scores lead to surgery. During the study, participants will have imaging tests, scoring assessments, and possible observation periods. Researchers will monitor outcomes such as negative appendectomies and complicated appendicitis within 30 days of randomization, along with quality of life, costs, and adverse events up to one year. The studys total follow-up includes tracking appendicitis occurrences for up to two years. This allows evaluation of the safety and effectiveness of selective imaging protocols compared to routine imaging in suspected appendicitis cases.