Skelleftea

Researchers are studying patients with abdominal rectus diastasis who are eligible for surgical correction to evaluate the effects of a postoperative rehabilitation program. The trial aims to determine if structured abdominal exercises after surgery improve abdominal wall function at three and twelve months. Additionally, the study examines whether connective tissue components differ in patients with abdominal rectus diastasis compared to healthy individuals. All participants undergo surgery involving plication of the linea alba. Blood samples are taken before surgery and on the first postoperative day. During surgery, biopsies of the skin, connective tissue, and rectus muscle are collected. After surgery, participants are randomly assigned to receive a postoperative rehabilitation program designed by a physical therapist. Follow-up assessments occur at three and twelve months after surgery. These include physical tests such as the time to complete five sit-to-stand repetitions and the number of deadlift repetitions with 20 kilograms. The study monitors abdominal wall function and connective tissue characteristics to understand the treatment effects and recovery.

Researchers are evaluating whether using the World Health Organization's Labour Care Guide (LCG) instead of standard care for monitoring labor progress can improve outcomes for newborns and mothers. This study compares these two guidelines to see if the LCG can reduce adverse neonatal outcomes, such as perinatal mortality, neonatal complications, and the need for cesarean sections during labor. The research also looks at other perinatal interventions, complications, and economic factors, using a multicenter, stepped-wedge cluster randomized trial design conducted from 2023 to 2025 in Sweden. Participants will receive care based on either the WHO's LCG or standard labor monitoring guidelines. The LCG is a next-generation partograph designed to follow the latest intrapartum care recommendations. The study involves multiple delivery units where women in active labor receive monitoring according to the assigned guideline. Researchers will compare outcomes such as neonatal morbidity, cesarean section rates, use of oxytocin, postpartum hemorrhage, labor duration, and experiences of women, their partners, and healthcare providers. Throughout the study, participants will be monitored for neonatal complications including low Apgar scores, hypoxic ischemic encephalopathy, intracranial hemorrhage, seizures, meconium aspiration syndrome, and neonatal unit admissions. The study will also assess maternal outcomes and collect feedback via questionnaires and interviews about childbirth experiences and guideline compliance. The primary outcomes are adverse neonatal events and intrapartum cesarean rates, with follow-up from 12 weeks up to 18 months after birth to gather comprehensive data on health and safety.

Researchers are evaluating treatments for elderly patients aged 75 and older who have an undisplaced femoral neck fracture (uFNF), classified as Garden I-II. The study compares whether replacing the hip (arthroplasty) reduces the need for further surgeries compared to preserving the hip with internal fixation. The goal is to lower the combined risk of needing reoperation or death within 1 to 2 years after surgery. Participants are randomly assigned to one of two treatment groups using the Swedish Fracture Register. One group receives arthroplasty, which may be either a hemi or total hip replacement depending on hospital routine based on patient age and mobility. The other group undergoes internal fixation, where the fracture is repaired using 2-3 screws, pins, or a sliding hip screw device, again according to hospital routine. Both treatments are devices applied to stabilize or replace the hip after fracture. During the study, participants are monitored for outcomes including the rate of additional surgeries and mortality up to 2 years after their initial operation. The main measure combines these two outcomes into a single variable to evaluate overall treatment success. The entire process is registered and randomized within the Swedish Fracture Register system, ensuring consistent follow-up and data collection.

This research aims to explore complications following the closure of a temporary loop ileostomy in patients who have undergone rectal cancer surgery. The study focuses on two main questions: whether the choice of anastomotic method affects the postoperative recovery, and whether using a prophylactic mesh during stoma site closure reduces the occurrence of hernias. The study is a prospective randomized multicenter trial involving patients with rectal neoplasm. Participants will be randomly assigned to receive either a stapled or hand-sewn anastomosis after ileostomy closure. Additionally, they may be randomized to have the stoma site closed using either a lightweight mesh placed under the muscle (retromuscular) or a long-lasting suture. The anterior fascia and skin are closed with running monofilament sutures, with the skin closure performed using a pursestring technique. During the study, researchers will monitor participants for postoperative complications including small bowel obstruction within 30 days and stoma site hernia formation over two years. The assessments will gather data on healing and complications to evaluate the impact of the different surgical techniques. Participant involvement includes follow-up for safety and effectiveness outcomes over the specified periods.

Researchers are conducting a multicenter, single-blinded, randomized controlled trial to study patients with ventral hernias that have an aperture width between four and eight centimeters. The study aims to compare the effects of a multimodal preoptimization program with surgery alone, focusing on the rate of complications three months after surgery. During the surgical procedure, biopsies of skin, muscle, and fascia will be collected, along with blood samples taken before and after surgery, to examine the molecular impact of preoptimization on collagen metabolism.

Heart failure with preserved ejection fraction (HFPEF) is a common and serious condition without effective treatment options. Researchers are evaluating whether adding spironolactone, a medication, to standard care can reduce the combined risk of cardiovascular death and hospitalizations for heart failure in patients with HFPEF. This study is a Phase 3 trial including patients from the Swedish Heart Failure Registry and the US, all having symptoms of heart failure, elevated heart-related blood markers, and an ejection fraction of 40% or higher. Participants are randomly assigned to one of two groups: one receiving spironolactone along with usual care, and the other receiving usual care alone without spironolactone. The study is designed as a registry-randomized clinical trial and will continue until 721 cardiovascular death or heart failure hospitalization events occur, with an enrollment period of 7 years and a total study duration of 9 years. Data collection in Sweden uses registry linkages, while data in the US comes from site reports and supplemented call center follow-up. During the study, researchers will monitor participants for hospitalizations due to heart failure or cardiovascular death as the primary outcome. Secondary outcomes include other hospitalizations, side effects, and how well patients follow their treatment plans. Outcomes are tracked through national registries and direct reporting, with the main data locked and analyzed five years after the study begins. Approximately 2000 patients aged 50 to 99 years will be included to achieve the event target needed for study conclusions.

Researchers are evaluating the safety and effectiveness of apixaban to prevent strokes in adults with stage 5 chronic kidney disease (CKD) who also have atrial fibrillation (AF), a heart rhythm disorder. This phase 3b clinical trial compares apixaban treatment to no anticoagulation to see if apixaban lowers the risk of ischemic stroke without causing unacceptable increases in fatal or brain bleeding. The study also looks at the risk of death from any cause, cardiovascular events, and major bleeding in this patient group. Participants are randomly assigned to receive either apixaban 2.5 mg tablets twice daily along with standard care or standard care without anticoagulation. The study is open-label, meaning both patients and doctors know the treatment given. Apixaban will be prescribed and renewed by the local investigator. The study lasts between 12 and 72 months and includes about 1000 to 1400 patients from multiple sites in Sweden, Finland, Norway, Iceland, Poland, and possibly other European countries. During the study, participants will have routine blood tests including kidney function and coagulation checks. Researchers will monitor the time to first ischemic stroke, fatal or intracranial bleeding, overall mortality, cardiovascular events, and major bleeding events. A safety board will oversee the trial, and outcomes will be reviewed independently. The study may also explore outcomes related to kidney transplant complications and thrombosis. Participation ends after 72 months or when enough primary events have occurred.