Burgdorf

Researchers are investigating the best approach to treat low-risk patients with isolated subsegmental pulmonary embolism SSPE, a type of blood clot in small lung arteries. The study aims to determine whether monitoring patients without anticoagulation is as safe and effective as giving anticoagulant medication. This is important because many patients currently receive anticoagulants that carry a risk of bleeding, but it is unclear if all patients with isolated SSPE need this treatment. Patients in the trial are randomly assigned to one of two groups. One group receives the anticoagulant drug rivaroxaban, starting with 15 mg twice daily for 21 days, then 20 mg once daily for a total of 90 days. The other group receives a placebo matching the same schedule. The trial compares clinical surveillance without anticoagulation to anticoagulation treatment to assess safety and effectiveness. Participants will be followed for 90 days after randomization to monitor for recurrent venous thromboembolism, significant bleeding events, and overall survival. Researchers will track these outcomes through clinical assessments and safety monitoring. This study is designed to evaluate if careful monitoring alone is a safe alternative to anticoagulation in selected patients with isolated SSPE, potentially reducing bleeding risks from treatment.

Researchers are evaluating the effect of continued nutritional support after hospital discharge compared to usual care in medical patients at nutritional risk. This trial focuses on adults who have experienced malnutrition, a condition linked to higher risks of death, rehospitalization, and loss of function, especially among elderly and multi-ill patients. Previous studies showed that in-hospital nutritional support helps reduce complications and mortality, but the long-term benefits after discharge remain unclear. Participants are randomly assigned to one of two groups. The intervention group receives customized nutritional support from an experienced dietician to meet their individual energy and protein needs, including oral nutritional supplements as needed. The control group receives general advice on healthy eating habits at discharge without ongoing nutritional support. Follow-up includes regular phone calls every 2 to 4 weeks to monitor adherence and adjust dietary plans as necessary. During the study, participants are monitored for up to three years. Researchers assess key outcomes such as time to death from any cause, hospital readmissions, major complications, and changes in functional status using the Barthel index. Quality of life is measured with the European Quality of Life 5 Dimensions index and a visual-analogue scale at regular intervals by phone. This comprehensive follow-up helps determine whether sustained nutritional support after discharge improves long-term health and recovery.

Gastroentero-pancreatic neuroendocrine tumours GEP-NETs are rare cancers arising from the neuroendocrine cells in the gastrointestinal tract and pancreas. These tumours share common clinical features but their cell biology and mechanisms are not well understood, limiting targeted treatments. The SwissNET registry is designed to collect detailed information to better understand GEP-NETs and improve management strategies in Switzerland. This study collects data prospectively from patients diagnosed with neuroendocrine tumours confirmed by tissue analysis, regardless of the tumours original location. Data entry is anonymized and gathered from hospitals and general practitioners across Switzerland. A study nurse visits contributing centers to review patient files, and a review board addresses conflicting information. The registry monitors treatment approaches including surgery, medical therapy, and peptide-receptor radionuclide therapy. Participants provide informed consent for their data to be included. Researchers regularly evaluate patient outcomes such as tumour-related mortality and hospitalisation rates every five years. The registry also tracks the incidence of GEP-NETs in Switzerland and the effects of different treatments over time. This ongoing data collection aims to improve understanding and guide future care for patients with neuroendocrine tumours.

Researchers are conducting an international multicenter prospective observational study focused on patients with symptomatic, radiologically confirmed single- or multilevel contiguous thoracolumbar T1 to L5 fractures caused by primary osteoporosis. The study includes both insufficiency fractures confirmed by MRI and low-energy traumatic fractures confirmed by CT or MRI. It aims to evaluate how well the Osteoporotic Fracture OF classification-based scoring system guides treatment decisions for these fractures, comparing outcomes when treatment aligns or does not align with the OF score recommendations. Participants will be classified using the OF system from OF 1 to OF 5 based on the severity of their fractures. Treatment decisions are categorized as either nonsurgical or surgical, with patients grouped according to whether their treatment matches the OF score guidance Accordance group or differs from it Discordance group. The initial treatment decision day is designated as Day 0, and patients will be followed clinically at discharge, 6 weeks, 3 months, 6 months, and 12 months. Surgical interventions may include various types of posterior stabilization procedures with or without augmentation or osteotomy. During the study, participants will undergo assessments to measure their return to mobility, which is the primary outcome within the first 3 months after treatment. Secondary outcomes include evaluations of clinical status, pain levels, daily activities, quality of life, and complications related to surgery or fracture subtype over a 12-month period. Researchers will collect data through clinical follow-ups at specified intervals, tracking treatment type, functional recovery, and patient satisfaction. The total follow-up duration extends up to one year to monitor long-term results and health economic impacts.