Crotone

This research focuses on patients with Severe Acquired Brain Injuries and aims to identify medium-term factors that can predict their rehabilitation outcomes. The study also seeks to develop a continuous system to assess the quality of care provided by rehabilitation units treating these patients. Identifying these prognostic factors helps understand which patients are likely to experience key rehabilitation milestones. Data will be collected from rehabilitation units and will include information about the units themselves and detailed patient data at admission and again four months after the acute brain injury event. The study will use statistical models to analyze the likelihood of achieving important rehabilitation goals such as removal of tracheostomy tubes, trunk control, and feeding entirely by mouth, all evaluated four months after the injury. Participants will be assessed at the start of rehabilitation and then re-evaluated four months later. The study measures include monitoring tracheostomy tube status, trunk control ability, and feeding methods. This allows researchers to track patient progress and evaluate care quality over time. The total participation duration includes the initial admission and follow-up assessments up to four months post-injury.

This research aims to evaluate the effectiveness of two combinations of regional anesthesia techniques used for pain relief and recovery after unilateral total knee arthroplasty (TKA) in adults over 18 years old with ASA physical status I-III. The study compares the adductor canal block (ACB) combined with the sacral erector spinae plane (ESP) block against ACB combined with the iPACK block. The main goal is to determine whether the ACB plus sacral ESP block combination provides effective postoperative recovery and pain control while potentially reducing risks associated with other techniques. Participants receive spinal anesthesia and multimodal postoperative pain management including paracetamol and rescue tramadol. The regional blocks are performed under ultrasound guidance in sterile conditions. The sacral ESP block is administered at the S2 level using 20 mL of ropivacaine 0.375%. The study observes patients who are already receiving either ACB plus sacral ESP or ACB plus iPACK as part of their regular care. Each participant is expected to have a hospital stay longer than 24 hours after surgery. During the study, researchers monitor pain relief and recovery quality through measures such as the Quality of Recovery (QoR-15) score at 24 hours post-surgery, pain scores at rest and movement up to 48 hours, time to first mobilization, patient satisfaction, analgesic use, and any side effects or complications related to the blocks. Data will be collected for up to 30 months at a single center in Italy, with privacy and ethical standards maintained throughout the study.

Researchers are investigating Disorders of Consciousness (DOC), which can occur after serious brain injuries and range from Unresponsive Wakefulness Syndrome to emerging from a Minimally Conscious State. Diagnosing DOC is challenging due to variability in behavioral assessments and difficulty detecting consciousness levels in patients without clear behavioral signs. This study explores using ultrasound techniques as a low-cost, accessible alternative to expensive and complex tools like neuroimaging, aiming to better understand the brain function and structure related to DOC and its progression. The study evaluates both chronic and post-acute DOC patients using ultrasound to examine brain mechanisms after injuries such as stroke or trauma. Post-acute patients will be followed for one year to assess predictive markers of DOC becoming chronic. Additionally, a subgroup of 10 selected patients will receive low-intensity focused ultrasound stimulation targeting brain areas involved in consciousness recovery, exploring a novel therapeutic approach. Participants undergo brain ultrasound examinations at enrollment and follow-ups at 6 months for chronic patients or 1 year for post-acute patients. Researchers will monitor brain structure and function through real-time ultrasound data, assessing changes over time. The study aims to improve diagnosis, prognosis, and treatment options for DOC, benefiting patients and healthcare systems by offering affordable and less invasive assessment and stimulation methods.