Hyvinkaa

Researchers are evaluating a new approach to managing cardiovascular risk factors in patients who have recently experienced an ischemic stroke or transient ischemic attack (TIA). This trial focuses on detecting hidden atrial fibrillation (AF), a common cause of stroke, and improving blood pressure control. AF detection is important because anticoagulation treatment can reduce the risk of additional strokes, while hypertension remains a major challenge despite available treatments. The study aims to compare standard care with a mobile-device assisted intervention in this patient group. Participants will be randomly assigned to one of two groups: the control group receiving standard diagnostic work-up, follow-up, and treatment; and the intervention group receiving continuous ECG monitoring for 3 weeks to detect hidden AF, along with monthly one-week periods of self-monitoring blood pressure and adjusting antihypertensive medication using a mobile app. The randomization ratio is 2:1 favoring the control group. This design will help evaluate the benefits of mobile technology and self-management in controlling these cardiovascular risks. During the study, participants will be monitored for the development of new atrial fibrillation and changes in blood pressure over 12 months. Researchers will collect data on the number of patients diagnosed with new AF and measure the difference in average blood pressure between groups at one year. The study includes regular assessments and follow-ups to ensure safety and adherence to the intervention, providing insights into the effectiveness of mobile technology in stroke risk management.

Researchers are evaluating the safety and effects of intravenous contrast enhanced computed tomography (CT) versus native CT (without contrast) in adults with acute abdominal pain and impaired kidney function. This Phase 4, multicenter, open-label randomized controlled trial aims to address concerns about post-contrast acute kidney injury, which is a significant worry in patients with reduced renal function. The study focuses on patients with an estimated glomerular filtration rate (eGFR) between 15 and 45 ml/min/1.73 m2 who require emergency abdominal or body CT scans. Participants will be randomly assigned to receive either an abdominal or body CT scan with intravenous contrast or a native CT scan without contrast. The study compares these two diagnostic methods to see if intravenous contrast worsens kidney function or affects mortality. The trial is designed to follow patients for 90 days after their CT scan to assess outcomes. During the study, participants will be closely monitored for the combined outcome of death or the need for renal replacement therapy within 90 days following the CT scan. Researchers will collect data on kidney function and any adverse events, ensuring safety and effectiveness are carefully evaluated. The total duration of participation includes emergency imaging and a follow-up period to track these critical health outcomes.

This research aims to identify factors linked to no improvement in gastrointestinal quality of life after elective gallbladder removal surgery (cholecystectomy) for gallstones. It focuses on patients undergoing this surgery due to symptoms caused by gallstones. The study evaluates health-related quality of life and abdominal symptoms following the procedure. Participants in this observational study will undergo laparoscopic cholecystectomy for symptomatic gallstones. There is no intervention beyond the surgery itself, as the study mainly observes outcomes post-operation. During the study, researchers will assess participants' gastrointestinal quality of life using the Gastrointestinal Quality of Life Index (GIQLI) score one year after surgery. Participants will be asked to complete questionnaires about their health and symptoms, which will help measure the impact of the surgery on their quality of life.

Researchers are evaluating different imaging strategies for adults suspected of having appendicitis. The trial compares protocol-based selective imaging to routine imaging methods such as ultrasound and computed tomography (CT). The study aims to find out if using clinical scoring to guide imaging decisions affects clinical outcomes, including the rate of unnecessary appendectomies and complicated appendicitis. Participants will be randomly assigned to one of three groups: selective imaging based on the Adult Appendicitis Score; selective observation guided by the Appendicitis Severity Score combined with score-based selective imaging; or routine imaging using ultrasound and/or CT scans. Each approach is studied to see whether it impacts the number of negative appendectomies or complicated cases within 30 days after randomization. During the study, adults with suspected appendicitis will be monitored for clinical outcomes including negative appendectomy and complicated appendicitis within 30 days. Imaging will be done according to the group assignment, with follow-up to assess results. Researchers will compare the outcomes across the groups to evaluate the safety and effectiveness of the selective imaging protocols.