Tullamore

Researchers are evaluating the effects of negative pressure wound therapy NPWT compared to standard open wound care after surgical excision in patients with chronic pilonidal sinus disease PSD. PSD is a chronic inflammatory skin condition in the natal cleft area, often causing infection, abscess, discharge, and pain. The condition affects many, especially young adult males, and has a significant impact on quality of life and healthcare due to frequent recurrence and readmission after surgery. This multicenter randomized controlled trial aims to find the best wound care method to improve healing and patient outcomes. Participants will undergo surgical excision of chronic PSD and be randomly assigned to one of two groups. One group will receive negative pressure wound therapy dressings applied to the wound post-surgery, while the other group will have their wound dressed with standard sterile gauze after the skin is closed. The study will compare these two approaches for up to six months post-surgery, monitoring healing times and other related outcomes. During the study, participants will be followed for six months after surgery. Researchers will assess time to complete wound healing, postoperative pain, complications, quality of life using questionnaires like the EQ-5D-5L, scar appearance using the Patient and Observer Scar Assessment Scale POSAS, costs to patients, and wound recurrence rates. These assessments will occur at various points including the day of surgery, and one, three, and six months afterward, helping to understand the impact of each wound care method on recovery and patient experience.

Researchers are investigating whether using a genetic test called Prosigna4 can help decide if chemotherapy is necessary for premenopausal women with hormone receptor-positive HR and HER2-negative breast cancer. This study aims to determine if treatment guided by this test produces similar outcomes to the standard approach of systematic chemotherapy. The trial focuses on younger women who often experience more side effects from chemotherapy, affecting their quality of life and work capacity. Participants will be randomly assigned to one of two groups. In the experimental group, treatment depends on the Prosigna4 score women with a high score above 60 will receive chemotherapy plus hormone therapy, while those with a lower score will receive only hormone therapy with ovarian suppression. The control group will receive the standard treatment of chemotherapy followed by hormone therapy. The study includes a pre-inclusion period for eligibility testing and randomization. Throughout the study, participants will complete questionnaires about quality of life, treatment side effects, emotional well-being, and other health measures for up to five years after randomization. Researchers will monitor cancer recurrence, survival, fertility, osteoporosis, cardiovascular disease, and other outcomes. Regular assessments include physical activity levels, adherence to therapy, and patient perceptions of treatment and participation, aiming to evaluate the safety and impact of treatment guided by the genetic test.