Goms

Hyponatremia is a common electrolyte imbalance in hospitalized patients, classified as hypovolemic, euvolemic, or hypervolemic. Euvolemic hyponatremia is often caused by the syndrome of inappropriate antidiuresis (SIAD), while hypervolemic hyponatremia frequently occurs in patients with congestive heart failure or liver cirrhosis. Current treatments like fluid restriction have limited success. Researchers are studying the Sodium-Glucose-Co-Transporter 2 (SGLT2) inhibitor empagliflozin (Jardiance) to see if it can improve serum sodium levels without the need for fluid restriction in patients with euvolemic or hypervolemic hyponatremia. Participants will receive either empagliflozin 25 mg or a placebo orally once daily for 30 days. This randomized, double-blind, placebo-controlled trial will compare the effects of empagliflozin on serum sodium concentration in these patients. The study builds on earlier findings showing empagliflozin combined with fluid restriction helped increase sodium levels, but this trial tests the drug alone without fluid restriction. During the study, researchers will measure changes in the average daily serum sodium concentration over 4 days and assess longer-term sodium changes before and after treatment at 30 days. Participants will undergo monitoring and evaluations to track sodium levels and safety. The trial aims to understand if empagliflozin can safely and effectively improve hyponatremia in this patient group over the one-month treatment period.

This research evaluates the effects of a nutritional intervention using ketogenic medium-chain triglycerides (kMCT) and B-vitamins on cognitive functioning in older adults who have mild cognitive impairment (MCI). The trial is designed as a prospective, randomized, double-blind, placebo-controlled, multi-center, and multi-country pivotal study. It aims to study cognitive changes in this population, particularly focusing on those with memory complaints lasting more than three months and clinical diagnoses consistent with MCI. Participants receive either BrainXpert, a dietary supplement sachet containing 25 g of ketogenic medium-chain triglycerides without preservatives or additives, or a placebo consisting of a calorie-equivalent non-ketogenic vegetable oil powder in a similar sachet form. The study includes multiple clinic visits over an 18-month period, with key assessments at randomization, 12 months, and 18 months. The placebo is high-oleic acid sunflower oil without added vitamins, ensuring blinding between groups. During the study, participants and their informants attend scheduled visits where cognitive performance is assessed, including the Preclinical Alzheimer's Cognitive Composite (PACC) score measured at 12 months. Researchers monitor participants' daily living autonomy, cognitive complaints, and compliance with the intervention. Safety and eligibility are closely observed, with attention to medication use and other health factors. The total involvement spans at least 18 months with multiple assessments to evaluate the nutritional intervention's impact on cognition.

Prostate cancer is a common cancer in men and a leading cause of cancer deaths in Europe. For men with localized prostate cancer who have a life expectancy over 10 years, radical prostatectomy is the standard treatment to improve survival. This research evaluates whether removing more lymph nodes in the pelvis, called extended pelvic lymph node dissection (ePLND), during surgery offers additional benefit by better staging the cancer and possibly removing hidden cancer cells, compared to not removing these lymph nodes. The study focuses on men with high-risk prostate cancer and negative PSMA-PET scans for metastasis. The study compares two groups of men undergoing radical prostatectomy: one group will receive extended pelvic lymph node dissection along with surgery, and the other group will have surgery without lymph node removal. Extended lymph node removal involves taking out more nodes to improve detection of cancer spread, but it may increase surgery time and complications slightly. The study is a multicenter, randomized Phase III trial. Participants will be monitored through prostate-specific antigen (PSA) tests three months after surgery to check for cancer persistence and followed for up to 24 months to observe biochemical recurrence-free survival. Researchers will assess cancer staging, treatment outcomes, and safety. The study includes regular evaluations and close follow-up to understand if extended lymph node removal improves long-term outcomes for men with high-risk prostate cancer.

Researchers are evaluating a new way to guide treatment for patients with intermediate risk non-muscle invasive bladder cancer. Fresh tumor samples are collected during surgery and grown as patient derived organoids (PDOs). These PDOs are tested with several drugs commonly used as bladder instillations to see which drug is most effective against the tumor cells in the lab. This approach aims to personalize treatment by identifying the best drug for each patient. Patients' organoids are exposed to drugs including epirubicin, mitomycin, gemcitabine, and docetaxel. After about 10 days of culturing, the PDOs are treated with these drugs for two days to measure how well each drug kills the tumor cells. The drug showing the highest effect is then given to the patient as a weekly bladder instillation for six weeks. If the lab test does not identify a best drug, epirubicin is used by default. This treatment phase is followed by standard care monitoring. During the study, patients will be monitored according to standard practices after treatment. The main outcome being measured is the proportion of patients for whom a successful drug is selected based on the organoid testing over a period of 24 months. Participants will undergo tumor specimen collection, lab testing of their tumor cells, and regular clinical follow-up to assess treatment results and safety.

Researchers are evaluating the treatment of degenerative lumbar spine diseases using different rod stiffness levels in the SpineShape System IV. This study aims to determine whether using high-flex or mid-flex rods is not worse than using low-flex rods regarding clinical outcomes and safety. The focus is on comparing the reduction in back pain and improvement in functionality after surgery in patients with degenerative symptoms in one to two lumbar spine segments. Participants will be randomly assigned in equal groups to receive implantation of one of three rod types: elastic (high-flex), medium (mid-flex), or stiff (low-flex) rods from the SpineShape System IV. The study includes surgical implantation of these devices, and patients will be followed over time to assess clinical results. Questionnaires will be completed before surgery and then at 3 months, 12 months, 24 months, and 60 months post-surgery to monitor progress. During the study, participants will undergo assessments including questionnaires on pain and function at specified intervals up to five years. The primary outcome measured is the level of lower back pain using the Visual Analogue Scale 24 months after implantation. Safety and clinical performance will be monitored throughout, ensuring long-term follow-up of patient outcomes after receiving the implanted rods.

Researchers are evaluating how different types of peripheral nerve stimulation methods affect nerve activation sensitivity. The study focuses on electric, electromagnetic, and temporal interference stimulations, aiming to understand how nerve activation relates to coil placement and coil type. This research is intended for basic science purposes to explore nerve excitation sensitivity. Participants will receive momentary, non-therapeutic stimulation using coils of various designs and electrodes applied to the upper arm. The stimulation involves electric and electromagnetic methods to test peripheral nerve responses. The study is performed as a single-day procedure without therapeutic intervention. During the study, researchers will measure the maximum nerve activation response to electromagnetic stimulation with different coils on day 1. Participants will undergo assessments to ensure safety and adherence to procedures, including monitoring for any reactions to stimulation. The study involves only one visit, and participants will be evaluated for nerve sensitivity and safety throughout the process.

Researchers are collecting detailed clinical data from patients with various urological diseases treated at multiple study sites. This project aims to gather comprehensive information to train advanced neuronal networks that can help define important clinical outcomes. The study includes patients with uro-oncological conditions as well as other urological disorders. Participants will receive the standard care appropriate for their specific urological condition, as determined by their treating physicians. There is no experimental treatment being tested; instead, the study focuses on monitoring and analyzing existing treatment outcomes in real-world settings. During the study, participant data will be stored in multilayered databases for analysis. Researchers will track disease-specific endpoints over a period of 4 to 5 years to assess outcomes. All patients must provide informed consent, and their medical histories will be recorded and analyzed as part of the study process.

Researchers are gathering comprehensive information on cerebral palsy (CP), a chronic disorder affecting movement and posture caused by early brain injury or malformation. This national Swiss registry collects data on diagnosis, symptoms, treatments, and follow-up of children, adolescents, and adults with CP. The goal is to better understand CP's prevalence, risk factors, clinical profiles, and patient needs to improve care and quality of life. The registry was launched in 2017 in major Swiss pediatric clinics and is expanding to include all Swiss clinics and adults in the future. The Swiss Cerebral Palsy Registry collects detailed medical data at diagnosis (ages 0 to 5 years) and during follow-ups at ages 5, 10, 15, and at transition to adult care around age 18. Data include birth history, neonatal care, CP classification, motor functions, comorbidities, neuroimaging, treatments, therapies, surgeries, and socio-economic factors. Questionnaires gather information on quality of life, participation, medical care, and family needs. The registry also links to routine statistics and medical registries for broader health insights. Participants and their families provide consent and receive information about the registry during clinical visits. The study tracks changes over time in motor skills, cognition, behavior, health status, and treatments. Data collection continues throughout childhood and into adulthood, supporting national and international research collaborations. The registry aims to enhance knowledge exchange between clinicians, researchers, therapists, and health authorities to optimize CP treatment and outcomes in Switzerland.

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.