Aosta

Researchers are conducting a study to continuously evaluate the quality of healthcare provided in semi-intensive care units. The goal is to develop indicators that measure healthcare quality based on data collected from patients in these units and the structural characteristics of the hospitals. This evaluation aims to identify areas of care that need improvement for different types of patients. The study will collect and analyze data over a period of five years. Each year, a report will be produced to show the results and quality levels of care in each semi-intensive care unit. This ongoing monitoring will help assess the care provided and guide improvements. Participants in the study are patients hospitalized in semi-intensive care units. Data related to patient care and hospital structures will be gathered and used to create quality indicators. The outcomes measured include healthcare quality for various patient risk groups, with continuous evaluation from January 2021 through December 2025. Annual reports will track the progress and effectiveness of care in these units.

Researchers are investigating the treatment of coronary in-stent restenosis (ISR), a condition where the artery narrows again after stent placement, despite advances in drug-eluting stents. This trial compares two methods of guiding percutaneous coronary intervention (PCI) for ISR: one using intracoronary optical coherence tomography (OCT) along with angiography, and the other using angiography alone. The goal is to understand whether OCT guidance improves acute PCI performance for ISR patients. Participants with ISR showing 70% to 99% narrowing in a vessel between 2.25 and 5.75 mm will be randomly assigned to two groups. The first group will have PCI guided by OCT and angiography, with OCT runs before and after PCI, and additional OCT imaging allowed during the procedure. The second group will have PCI guided only by angiography, but OCT imaging will still be performed before and after PCI without the operator seeing the OCT results to maintain blinding. Operators in both groups may use various approved tools and techniques during PCI as needed. During the study, patients will undergo imaging and PCI procedures with detailed documentation of the treatment plans and any changes after OCT review. Researchers will measure changes in artery cross-sectional area after PCI as the primary outcome. Safety and procedural details will be closely monitored. The total participation includes the PCI procedure and follow-up imaging to assess treatment effectiveness.

Researchers are studying how best to treat trauma patients with low blood pressure (hypotension) before they reach the hospital, focusing on how different prehospital care methods affect recovery and survival in the hospital. The study addresses gaps in evidence about treatments like prehospital blood transfusions and resuscitative endovascular balloon occlusion of the aorta (REBOA). It also examines the variability in emergency medical services across Italy, especially in helicopter emergency medical services (HEMS), and how these differences might impact patient outcomes. Participants will receive various treatments during prehospital care, including drugs such as antifibrinolytics, analgesics, sedatives, and neuromuscular blockers; devices like REBOA and extended focused assessment sonography for trauma (eFAST); blood transfusions; and different management strategies like "stay and play" versus "scoop and run." Each patient’s demographic information, trauma type, injury severity, and therapies used will be recorded for analysis. Throughout the study, researchers will collect data on hospital outcomes such as the need for blood transfusions, blood gas parameters, length of hospital and ICU stays, use of invasive ventilation and kidney support therapies, recovery progress, and mortality within 30 days. This comprehensive monitoring aims to identify factors during prehospital care that relate to survival and recovery after trauma, with participant involvement lasting through hospitalization and follow-up for 30-day mortality.