Burgdorf

This research investigates the best approach for treating low-risk patients with isolated subsegmental pulmonary embolism (SSPE), a condition where small blood clots block tiny arteries in the lungs. The study aims to clarify whether SSPE truly requires anticoagulant treatment or if careful monitoring without medication is a safe option. Currently, many patients receive anticoagulants, which can increase bleeding risk, but some evidence suggests that avoiding these drugs might be safe in selected patients without other complications. Participants are randomly assigned to receive either the anticoagulant drug rivaroxaban or a placebo, allowing comparison between clinical surveillance without anticoagulation and standard anticoagulation treatment. This phase 4, multicenter trial evaluates outcomes over a 90-day period following randomization. During the study, researchers monitor participants for recurrent venous thromboembolism and assess safety outcomes related to bleeding. Participants provide informed consent and are followed closely to observe any clots returning or adverse events. The total follow-up is at least 90 days to determine the efficacy and safety of withholding anticoagulation in this specific patient group.

Researchers are studying the effects of continued nutritional support after hospital discharge for adult medical patients who are at nutritional risk due to malnutrition. This research aims to compare ongoing post-discharge nutritional support to usual care home nutrition and assess its impact on mortality, frailty, functional outcomes, and recovery. The study builds on earlier findings that nutritional support during hospital stays reduces complications and mortality, but long-term benefits after discharge remain unclear. Participants receive individualized nutritional plans supervised by experienced dietitians, including the daily use of specific oral nutritional supplements with high energy and protein content such as Resource Ultra and Resource 2.0 (Fibre). The plan may be adjusted based on patient preferences, including options like between meal snacking and food enrichment. General nutritional information about healthy food behavior is also provided upon hospital discharge. Follow-up phone calls occur every 2 to 4 weeks to monitor and support adherence to the nutritional intervention. During the study, participants are closely monitored for outcomes including time to death from any cause over a three-year period. Researchers will evaluate frailty, functional recovery, and overall health status. The study involves ongoing assessments and follow-ups to understand how long-term nutritional support influences disease progression and recovery. Participants' adherence to the nutritional plans is supported and tracked through regular dietitian contact and supplement use.

Gastroentero-pancreatic neuroendocrine tumors (GEP-NETs) are rare tumors that arise from the neuroendocrine system in the gastrointestinal tract and pancreas. This registry study aims to better understand these tumors by collecting detailed clinical information from patients diagnosed with GEP-NETs in Switzerland. Since limited knowledge exists about the biology and treatment of these tumors, the study focuses on gathering data to improve understanding and management strategies. Patients with a confirmed diagnosis of neuroendocrine tumors from any location who agree to participate will have their information entered prospectively into a secure, anonymized database. Data collection involves visits from study nurses to healthcare centers, where patient files are reviewed and information is recorded. There are no specific treatments assigned by this registry; instead, it tracks various treatment approaches used in Switzerland. Participants contribute data that includes tumor types, treatments received, and outcomes such as mortality and hospitalization rates. The study reviews and evaluates this information regularly to identify patterns and assess patient outcomes over time. The main outcome measured is tumor-related mortality every five years, helping to monitor long-term effects. This registry allows for improved knowledge sharing across hospitals and practitioners in Switzerland to enhance care for patients with neuroendocrine tumors.

Researchers are conducting an international multicenter prospective observational study to evaluate treatment decisions for patients with symptomatic thoracolumbar fractures caused by primary osteoporosis. The study focuses on postmenopausal women aged 50 and older and men over 60 with radiologically confirmed, single or multilevel contiguous fractures from T1 to L5. These fractures include insufficiency fractures confirmed by MRI and low-energy traumatic fractures confirmed by CT or MRI. The Osteoporotic Fracture (OF) classification system is used to categorize fracture severity from OF 1 to OF 5 to help guide treatment decisions. Patients will be grouped based on whether their initial treatment matches the OF score recommendations: the Accordance group if treatment aligns with the score and the Discordance group if it does not. Treatment options include nonsurgical care or various surgical procedures such as posterior stabilization using pedicle screws, sometimes combined with kyphoplasty, vertebroplasty, screw augmentation, vertebral osteotomy, or anterior stabilization. The initial treatment decision is marked as Day 0, and follow-up treatments may be adjusted based on ongoing OF score assessments. Participants will be followed clinically at hospital discharge, 6 weeks, 3 months, 6 months, and 12 months after treatment begins. The primary outcome is the time it takes for patients to return to their mobility level before the fracture or symptom onset, measured up to 3 months. Secondary outcomes focus on longer-term recovery up to 12 months. Data collected includes clinical evaluations and imaging studies to monitor fracture healing and treatment effects over time.