Nyon

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 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 evaluating whether nutritional support guided by indirect calorimetry improves recovery and quality of life in critically ill adult patients compared to standard formula-based nutrition. This multicenter randomized controlled trial focuses on mechanically ventilated patients expected to stay in the ICU for more than 72 hours. The study aims to assess patient-centered outcomes, including quality of life measured three months after ICU admission, functional recovery, muscle preservation, infection rates, and rehospitalization. Participants are randomly assigned to one of two groups. The intervention group receives nutrition targets based on resting energy expenditure measured by the QNRG device starting on Day 4, with repeated measurements twice weekly and gradual escalation to 80%-100% caloric coverage by Day 4 according to ESPEN guidelines. The control group receives nutrition based on predictive equations and local protocols for escalation. The study spans the ICU stay and follows patients for three months post-admission. During the study, researchers will assess quality of life at three months using the EQ-5D-5L tool and track secondary outcomes such as mortality, infection, pressure sores, energy and protein deficits, ventilator and ICU-free days, functional recovery, symptom assessment, rehospitalization, discharge location, return to work, and various disability and functioning scales. Data collection includes regular calorimetry measurements and clinical evaluations throughout the ICU stay and follow-up period, lasting up to three months after ICU admission.