Goms

Hyponatremia, a common electrolyte imbalance in hospitalized patients, is classified into hypovolemic, euvolemic, or hypervolemic types. The syndrome of inappropriate antidiuresis SIAD often causes euvolemic hyponatremia, while congestive heart failure and liver cirrhosis are common causes of hypervolemic hyponatremia. Current treatments, including fluid restriction, have limited effectiveness. Researchers are evaluating the SGLT2 inhibitor empagliflozin Jardiance for its potential to increase serum sodium levels in these conditions through a randomized, placebo-controlled trial. Participants will receive either empagliflozin 25 mg or a placebo once daily by mouth for 30 days. The study is double-blind and randomized, comparing empagliflozins effects without additional fluid restriction. The trial aims to assess the impact of the drug on serum sodium concentration and other related measures over both short-term 4 days and longer-term 30 days periods. During the study, participants will undergo regular assessments including measurements of serum sodium, body weight, blood pressure, plasma and urinary markers, and various health and well-being indicators such as cognitive function, quality of life, and occurrence of symptoms like thirst or headache. Safety and clinical outcomes like hospital stay length will also be monitored. The total participation duration is 30 days, with detailed monitoring throughout this period.

Researchers are studying the effects of a nutritional intervention combining ketogenic medium-chain triglycerides kMCT and B-vitamins on cognitive function in older adults diagnosed with mild cognitive impairment MCI. This randomized, double-blind, placebo-controlled trial aims to evaluate how this nutritional approach impacts cognitive performance over a 12-month period. The study is sponsored by Socit des Produits Nestl and involves multiple centers and countries. Participants will be randomly assigned to receive either BrainXpert, a dietary supplement containing 15 g of kMCT and B-vitamins in powder form, or a placebo consisting of a calorie-equivalent, non-ketogenic high-oleic acid sunflower oil powder. Both are provided in sachetstickpack format without preservatives, flavors, sweeteners, or colorants. The intervention is administered daily during the study period. During the trial, participants and their informants will attend clinic visits at baseline, 12 months, and 18 months. Cognitive function will be assessed using tools such as the Preclinical Alzheimers Cognitive Composite PACC, Montreal Cognitive Assessment MoCA, Wechsler Memory Scale, and Mini-Mental State Examination MMSE. Safety and tolerability will also be monitored throughout the 12 months. The study includes adherence assessments and requires participants to comply with study procedures and medication restrictions.

This research aims to determine whether performing an extended pelvic lymph node dissection ePLND during radical prostatectomy benefits men with high-risk prostate cancer. The study investigates if ePLND improves cancer staging and removes undetectable cancer cells that standard imaging techniques like PSMA-PET might miss, potentially leading to better treatment outcomes. The trial is a multicenter, randomized phase III study sponsored by University Hospital, Basel, Switzerland. Participants will be randomly assigned to one of two groups radical prostatectomy with extended pelvic lymph node dissection or radical prostatectomy without the extended lymph node dissection. Extended PLND involves removing more lymph nodes than the standard procedure, aiming for better detection of cancer spread. The study compares outcomes between these two approaches, while considering surgery time and complication risks, which may be slightly higher with ePLND. During the study, participants will be monitored over a long-term period of up to 10 to 15 years. Researchers will measure prostate-specific antigen PSA persistence about 3 months after surgery and track biochemical recurrence-free survival within 24 months. Secondary measures include time to recurrence, metastasis, survival rates, complications, adverse events related to ePLND, and patient-reported outcomes. This comprehensive follow-up includes assessments during surgery, postoperatively, and over many years to evaluate the overall impact of the surgical approaches.

This research aims to compare different types of rods used in the surgical treatment of degenerative lumbar spine diseases. The study focuses on patients with degenerative symptoms in one or two segments of the lumbar spine from L1 to S1. It seeks to determine whether the use of high-flex elastic or mid-flex medium rods provides clinical and safety outcomes that are not inferior to those achieved with low-flex stiff rods, with a special focus on reducing back pain and improving functionality after surgery. Participants will be randomly assigned to receive one of three types of SpineShape System IV rods elastic high-flex, medium mid-flex, or stiff low-flex. Each group will undergo dynamic stabilization surgery using the assigned rod type. The study will follow patients over five years, with evaluations occurring before surgery and at 3, 12, 24, and 60 months after implantation to assess pain levels, mobility, medication use, and other health indicators. During the study, participants will complete questionnaires and undergo clinical assessments to measure back and leg pain using the Visual Analogue Scale VAS, walking duration, medication consumption, and segmental mobility. Researchers will also monitor adverse events and participants ability to work or perform activities. The total participation spans at least five years, with regular follow-up visits to collect data on safety and treatment outcomes.

Researchers are studying nerve excitation sensitivity in healthy volunteers to understand how different methods of peripheral nerve stimulation affect nerve activation. This study evaluates electric, electromagnetic, and temporal interference stimulations in the upper arm, focusing on the relationship between nerve activation and coil placement as well as how various coil types influence maximal nerve response. Participants will receive momentary, non-therapeutic electric and electromagnetic stimulations using different coil designs and electrodes. These stimulations are applied to assess peripheral nerve sensitivity during a single study day. The study measures maximum nerve activation response with different coils and evaluates the spatial range of nerve activation and amplitude ratios associated with nerve stimulation. During the study, volunteers will undergo various stimulations of the upper arm nerves. Researchers will monitor nerve activation using different coils and electrodes, and collect data on responses to these stimulations. The primary outcome is the maximal activation response to electromagnetic stimulation, with secondary outcomes including spatial activation ranges and amplitude ratios. Participants need to be healthy and able to follow study procedures, with total involvement lasting one day.

Researchers are studying primary and acquired resistance mechanisms to standard treatments targeting BRAF V600E mutations in metastatic colorectal cancer. This observational study focuses on patients receiving combined therapy with BRAF inhibitor encorafenib, anti-EGFR antibody cetuximab, and chemotherapy. Resistance to this combination often develops, limiting treatment options, so the study aims to uncover genetic and non-genetic reasons behind this resistance to help develop better future therapies. Participants will receive standard-of-care treatment with encorafenib, cetuximab, and possibly chemotherapy. Before starting treatment and at the time of disease progression, researchers will collect tumor tissue, blood, and stool samples. These samples will be used to study molecular changes and the microbiome, and to create patient-derived organoids for laboratory testing. Blood samples will be collected regularly during treatment to analyze circulating tumor DNA over time. Throughout the study, participants will be followed longitudinally with sample collections before treatment and at progression, continuing for up to around 24 months. Researchers will measure molecular alterations linked to resistance, compare tissue and liquid biopsy findings, characterize gut microbiome changes, and track tumor DNA dynamics. The studys findings aim to improve understanding of resistance and support personalized treatment approaches for metastatic colorectal cancer.

This research aims to collect and analyze a wide range of information from patients with urologic diseases, including uro-oncological and other urological conditions, who receive care at the study sites. The goal is to use advanced neural networks to identify important clinical outcomes by studying a large sample of these patients over time. This observational study is sponsored by Insel Gruppe AG, University Hospital Bern. Participants will receive standard care tailored to their specific urological conditions without any experimental treatments. The study will gather and store detailed patient data in layered databases for analysis. This approach allows researchers to observe real-world treatment effects and patient outcomes without interfering with usual medical care. During the study, participants medical histories and clinical information will be recorded and monitored over 4 to 5 years to evaluate disease-specific primary outcomes. As an observational study, there are no additional interventions or treatments beyond regular care. The study mainly focuses on collecting data to improve understanding and measurement of quality and outcomes in urological patient care.

Researchers are evaluating the safety and efficacy of intravenous thrombolysis IVT in adults who have experienced an acute ischemic stroke AIS and have taken direct oral anticoagulants DOAC within the last 48 hours. This international, multicenter, randomized trial compares IVT plus standard care to standard care alone in 906 participants to determine if IVT leads to better outcomes 90 days after treatment. Participants are randomly assigned to one of two groups one receives intravenous Tenecteplase or Alteplase along with the best medical treatment following local guidelines, while the other receives only the best medical treatment. The treatment is administered according to current recommendations from leading stroke organizations. The study aims to test whether IVT is superior in improving recovery in AIS patients with recent DOAC intake. During the study, participants are monitored and evaluated at multiple time points, including assessments of stroke severity, functional outcomes using the Modified Rankin Scale at 90 days, and quality of life questionnaires. Safety and efficacy are carefully tracked through these measures. Participants progress is followed up to about 90 days after randomization to assess the main outcomes and overall health status.

Researchers are collecting detailed information about people with cerebral palsy CP in Switzerland through the Swiss-CP-Reg, a national patient registry started in 2017. This registry gathers data on diagnosis, symptoms, treatments, and follow-up care for children, adolescents, and adults with CP. The goal is to better understand CPs prevalence, risk factors, clinical profiles, and needs, ultimately aiming to improve treatment and quality of life. The registry involves multiple Swiss clinics and medical practices and invites all people diagnosed with CP who were born, treated, or live in Switzerland to participate. Data collected include medical records, questionnaires for patients and families, and links to routine statistics and medical registries. Follow-up data are gathered regularly at diagnosis, ages 5, 10, 15, and at the transition to adult care around age 18. The registry also supports clinical research and international collaboration to enhance knowledge exchange and therapeutic approaches. Participants provide informed consent and are followed over time with regular updates on their medical status, motor function, comorbidities, treatments, and quality of life. The registry collects comprehensive information such as birth history, diagnosis details, therapies, surgeries, and socio-economic factors. Data collection includes questionnaires on health, education, and social participation. The study continually analyzes and publishes findings to support better care for people with CP in Switzerland.

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.