Tortosa

Researchers are collecting detailed information about patients with venous thromboembolism (VTE), which includes blood clots in veins such as deep-vein thrombosis and pulmonary embolism. The project aims to improve doctors' understanding of VTE, especially in patients often excluded from clinical trials, like pregnant women, elderly individuals, cancer patients, and those with other complex health issues. The goal is to reduce deaths, clot recurrence, bleeding problems, and artery-related events by sharing this knowledge widely. The study involves gathering extensive data on each patient's health status, treatments, and outcomes during the first three months of therapy. This registry is available online to help doctors quickly find information on patients with similar medical profiles and make informed decisions about managing high-risk individuals. There are no specific interventions being tested; instead, the focus is on collecting real-world patient data. Participants provide informed consent and are followed for at least three years to monitor for new clot events and complications. Researchers track recurrences of VTE, bleeding episodes, and deaths, aiming to create tools that predict which patients are most at risk for problems. This ongoing data collection supports improving care and guiding treatment decisions for diverse patient groups over time.

Researchers are evaluating a continuity of care intervention to improve metabolic control in adults with type 2 diabetes mellitus (T2DM) in the Terres de l'Ebre health region of Catalonia. This randomized, parallel-group clinical trial is led by the Endocrinology Service at Hospital de Tortosa Verge de la Cinta (HTVC) and aims to assess whether structured, multidisciplinary training and feedback provided to primary care professionals can enhance diabetes management. The study recognizes the complexity of managing T2DM, which requires addressing glycemic control, cardiovascular risk, and multimorbidity, with HbA1c as the main measure of glycemic control. The intervention involves four endocrinologists and four nurses delivering onsite training to primary care physicians and nurses at intervention centers. The training includes six biweekly modules combining theoretical and practical content on T2DM management, cardiovascular risk reduction, and diabetic foot care. This program runs from July 2025 to July 2026, with each participating center receiving 15 sessions per year. Regular feedback on clinical performance and patient outcomes will be provided, and a qualitative component with focus groups will gather professional insights before and after the intervention. Participants are adult patients with T2DM for at least 12 months, registered in the eCAP primary care system. Data collection occurs at enrollment and at 6, 12, and 24 months after enrollment, focusing mainly on HbA1c levels. Secondary outcomes include other health indicators, professional knowledge and engagement, and organizational aspects. All data are anonymized to maintain confidentiality. The study aims to offer evidence on how a multidisciplinary continuity of care program can improve metabolic control for adults with T2DM in real-world primary care settings.

Researchers are studying survivors of acute respiratory distress syndrome (ARDS), including those who had ARDS due to COVID-19 and other causes. The study aims to understand long-term lung problems and recovery patterns in these patients. It focuses on identifying risk factors for lung damage, symptoms, quality of life, cognitive issues, and exercise capacity after ARDS. The goal is to better understand the biological reasons behind severe lung injury and to improve clinical care and personalized treatments for ARDS survivors. This study will include adult ARDS survivors of any cause except COVID-19 from multiple hospitals. Participants will be followed up at 3, 6, and 12 months after hospital discharge. At each visit, researchers will assess symptoms, cognitive function, quality of life, lung function tests including lung volumes and diffusing capacity, exercise tests, chest CT scans, and molecular analyses. The study will compare recovery trajectories between COVID-19 and non-COVID-19 ARDS survivors using advanced data modeling and artificial intelligence. Participants will undergo comprehensive evaluations at each follow-up visit, including lung function tests, chest imaging, exercise assessments, and questionnaires on symptoms and quality of life. Researchers will track changes in lung diffusing capacity, lung volumes, and chest CT findings over time. The study aims to develop a clinical scoring tool to predict lung problems and create cost-effective follow-up plans. Total participation spans one year after hospital discharge, with continuous monitoring of lung and overall health recovery.

Researchers are evaluating a range of treatments to improve outcomes for adults admitted to intensive care units (ICUs) with severe community-acquired pneumonia (CAP), including cases caused by influenza and COVID-19. This Phase 3 adaptive platform trial, REMAP-CAP, is designed to test multiple treatment strategies simultaneously and adapt over time, allowing new treatments to be added as questions are answered. The trial also serves as a platform to quickly evaluate treatments during respiratory pandemics, such as COVID-19, through a sub-study called REMAP-COVID in the United States. Participants receive various interventions including antibiotics like ceftriaxone, moxifloxacin, or piperacillin-tazobactam, as well as macrolide therapies given for different durations. Other treatments assessed include corticosteroids such as hydrocortisone and dexamethasone, antiviral agents like oseltamivir and remdesivir, immune modulators including tocilizumab and baricitinib, and supportive care strategies such as mechanical ventilation methods. Dosing and duration vary for each treatment, with some interventions now closed. Treatments are administered according to local guidelines and clinical decisions, with some requiring intravenous or enteral routes. Participants are closely monitored with assessments focusing on survival and organ support status in the ICU up to 90 days after enrollment. The main outcomes measured include all-cause mortality by day 90 and the number of days alive without needing organ support in the ICU by day 21. The study collects data continuously to adapt treatment assignments for new participants, aiming to identify the most effective therapies. Follow-up and safety monitoring continue throughout hospitalization and up to 90 days after admission.

This observational, multicenter study focuses on patients diagnosed with lung cancer and other thoracic tumors. It aims to improve treatment and prognosis by exploring patient data related to the expression of markers that predict responses to chemotherapy and molecular inhibitors. The study reflects a commitment to individualized treatment and understanding the epidemiology of thoracic tumors in Spain, addressing the high mortality and variability in diagnosis and treatment. The study collects information both retrospectively and prospectively from clinical histories of patients treated by thoracic surgeons and medical oncologists. It investigates epidemiological and therapeutic factors associated with thoracic tumors, including lung cancer, to support strategies like multidisciplinary care and early diagnosis. There are no interventions or treatments assigned, as this is an observational registry gathering comprehensive real-world data. Participants will have their clinical data reviewed to describe characteristics of lung cancer and other thoracic tumors over up to 10 years. The study aims to explore the epidemiology and treatment approaches, supporting future improvements in care. There is no age or gender restriction, and data collection includes both patients receiving active treatment and those under palliative care. The study duration, follow-up, and specific assessments are based on patient records and available medical information.

This trial focuses on adult patients aged 18 to 60 years with Philadelphia chromosome-negative acute lymphoblastic leukemia (Ph-negative ALL). The study evaluates treatment approaches based on measurable residual disease (MRD) and genetic analysis done at the start. The goal is to determine the best continuation therapy after initial consolidation treatment to improve overall survival over three years. Participants first receive a uniform four-drug induction chemotherapy including vincristine, prednisone, pegylated asparaginase, and daunorubicin. Patients who do not respond adequately receive a second induction with fludarabine, Ara-C, G-CSF, and idarubicin (FLAG-IDA). Those with good MRD clearance proceed through early consolidation, delayed intensification, reinduction, and maintenance phases with pediatric-type chemotherapy drugs. Patients with less favorable MRD or genetic profiles may receive early or delayed allogeneic hematopoietic stem cell transplantation (alloHSCT). Throughout the study, participants undergo regular monitoring of disease status and response to therapy. Researchers assess overall survival at three years as the primary outcome. Patients' health status, treatment adherence, and side effects are closely followed. The study aims to personalize treatment plans based on MRD and genetics to optimize outcomes for adults with Ph-negative ALL.