Abercynon

Researchers are evaluating the optimal duration of antibiotic treatment for adults with complicated intra-abdominal infections (cIAI). This Phase 3 trial aims to compare a fixed extended duration of 28 days of antibiotics to the current standard care durations, which typically range from 7 to 18 days. The study will assess clinical outcomes, quality of life, and cost effectiveness over a 180-day follow-up period to determine which approach may better reduce treatment failure and improve patient care while considering antimicrobial resistance concerns. Participants will be randomly assigned to one of two groups: the standard care group, where antibiotic type and duration are determined by their clinician, or the fixed extended-duration group, which receives antibiotics for a set 28-day period. The study includes a total of 1166 adult patients recruited from intensive care units and hospital wards across approximately 30 NHS trust hospitals. The treatment period is followed by monitoring up to 180 days after randomization. During the study, patients or their personal consultees will complete quality of life questionnaires at baseline and at 30, 60, and 180 days post-randomization. They will also provide information about antibiotic use and healthcare resource utilization. Researchers will collect hospital records on admissions, relapses, and further infections. The main outcome measured is treatment failure within 180 days of randomization, with safety and effectiveness assessed throughout the follow-up period.

Heart failure occurs when the heart cannot pump blood properly, causing symptoms like breathlessness, swelling, and tiredness. About half of heart failure patients have a normal ejection fraction, known as heart failure with preserved ejection fraction (HFpEF). HFpEF is complex and varies between patients, with unclear causes, severity factors, and limited treatment options. This research aims to better understand HFpEF by studying many patients over time to discover why it develops, improve diagnosis, and find new treatments. The study will create a UK-wide registry collecting detailed information from patients diagnosed with HFpEF by heart failure experts. This registry will include clinical data and outcomes from many centers, enabling advanced analysis to identify different HFpEF subgroups. The platform will support the development of personalized diagnostics and targeted treatment trials, improving how HFpEF is managed. It also facilitates collaboration with industry and enhances patient recruitment for future studies. Participants will provide consent and be diagnosed with HFpEF confirmed by a specialist. Their health data will be collected and linked to long-term outcomes, including measurement of natriuretic peptides. Researchers will monitor and analyze patient information over many years to identify distinct HFpEF groups, understand causes, and improve risk prediction. The study excludes patients with certain heart conditions or very reduced heart function. This long-term approach aims to improve personalized care for people living with HFpEF.

Oesophageal cancer affects over 9,000 patients annually in the United Kingdom, with a poor overall 5-year survival rate of 15%. Most patients present with advanced disease, limiting treatment options. This study investigates how endoscopic ultrasound (EUS) impacts treatment decisions for patients with potentially curable oesophageal cancer who have already undergone staging with CT and PET-CT scans. It also explores clinician and patient attitudes toward EUS use in modern cancer staging. EUS combines upper gastrointestinal endoscopy with ultrasonography, allowing detailed assessment of the oesophageal wall and nearby lymph nodes to determine tumour invasion depth and nodal involvement. Patients receive sedation for this invasive procedure, which carries some risks and requires specialized training to perform. The study includes patients with a range of tumour stages (T1-T4, N0-N3) who are fit for radical treatment and receive EUS as part of their standard care. A qualitative component will involve interviews with both patients and clinicians about their views on EUS. Participants will be monitored to see if EUS changes their treatment management decisions made at baseline. The study collects clinical data and gathers opinions through interviews. This research aims to better understand how often EUS influences treatment plans amid newer imaging techniques and to assess the variation in its use across clinical practice.