Brunico

Researchers are conducting a prospective observational study to monitor core body temperature in patients who experience out-of-hospital cardiac arrest. The study evaluates temperature differences from the time of the cardiac arrest on site through transport and arrival at the hospital, considering environmental factors and hypothermia prevention methods. This study follows resuscitation guidelines from the European Resuscitation Council from 2015 or newer. During ongoing resuscitation at the location of the cardiac arrest, an esophageal temperature probe will be inserted to measure the patient's core body temperature. Environmental temperature, weather conditions, altitude, patient activity, and any protective measures against hypothermia such as clothing will also be recorded. Upon arrival at the hospital, the body temperature will be measured again using the same esophageal probe. Participants will be monitored from the time of probe insertion through hospital arrival, and core temperature will be tracked for about one year on average. Data collected includes body temperature readings, environmental conditions, and interventions to prevent hypothermia. The study aims to understand temperature changes during emergency care and transport in this patient group, ensuring continuous safety monitoring throughout the process.

Researchers are evaluating treatment strategies for patients with Rheumatoid Arthritis (RA) who have moderate to high disease activity despite ongoing therapy with conventional synthetic or biologic/targeted synthetic DMARDs for at least 3 months. The study compares a clinical decision strategy alone to a clinical plus ultrasound-based decision strategy to see which approach better helps patients achieve low disease activity or remission by week 24. This randomized, multicenter clinical study aims to determine if adding ultrasound guidance is not worse than clinical decision-making alone in managing RA. Participants will be randomly assigned to one of two groups. The clinical decision group receives a new biologic or targeted synthetic DMARD treatment, adjusted based on clinical assessments at 12 weeks. The ultrasound group undergoes ultrasound examination of 44 joints at baseline and during follow-up visits; treatment decisions are based on both clinical and ultrasound findings. If inflammation is seen on ultrasound and clinically, patients receive or switch DMARD therapy accordingly. If no inflammation is found by ultrasound, pain management is adjusted while continuing existing background treatment. Ultrasound assessments occur at baseline and weeks 12, 24, and 48. During the study, patients will have clinical assessments and ultrasound scans to monitor joint inflammation and disease activity. The primary outcome is evaluated at 24 weeks to compare how many patients reach low disease activity or remission. Follow-up continues up to 48 weeks to observe treatment effects and safety. The study lasts a total of 72 months with recruitment over 60 months, and each patient participates actively for 48 weeks, including 24 weeks of treatment and 24 weeks of follow-up.