Epsom

This research aims to compare the safety and effectiveness of a staged hybrid ablation procedure versus standard catheter ablation in adults with persistent atrial fibrillation and heart failure. The study focuses on patients who have a dilated left atrium and reduced heart function, specifically a left ventricular ejection fraction below 50%. Participants will be randomly assigned to one of two treatment groups to evaluate which approach better prevents ongoing abnormal heart rhythms. Participants will receive either the Convergent hybrid ablation, which combines minimally invasive epicardial ablation with endocardial radiofrequency catheter ablation and may include left atrial appendage exclusion using a clip, or the standard percutaneous endocardial catheter ablation alone. The treatments aim to restore normal heart rhythm through different methods of ablation. During the study, participants will be monitored for freedom from persistent atrial arrhythmia starting after a 3-month healing period and continuing through 12 and 24 months. Researchers will assess heart rhythm stability without the need for specific anti-arrhythmic medications. Safety and efficacy will be measured throughout the follow-up period, with detailed evaluations of heart function and rhythm.

Researchers are evaluating the effects of two different default dialysate sodium concentrations, 137 mmol/l and 140 mmol/l, on major cardiovascular events and death in adults receiving maintenance haemodialysis. This pragmatic, cluster-randomised, open-label study takes place in real-world dialysis sites and aims to compare the outcomes associated with these sodium levels over an extended period. The study focuses on patients with end-stage kidney disease undergoing regular haemodialysis treatment. Dialysis sites are randomly assigned to use either a default dialysate sodium concentration of 137 mmol/l or 140 mmol/l for at least 90% of dialysis sessions at that site. All other care practices continue as usual based on local standards. The study plans to recruit sites over 5 to 7 years, with individual follow-up lasting roughly 2 to 5 years. Site participation requires consent, while individual patient consent may be waived or offered an opt-out option. Participants will be monitored for major cardiovascular events and death, with the primary outcome measuring the time until the first such event occurs. Data collection methods are implemented across participating dialysis units, focusing only on in-center or satellite dialysis patients where applicable. The study's duration depends on the occurrence of endpoints, with an average follow-up of about 5 years anticipated per participant.

Researchers are evaluating the real-world effectiveness of nemolizumab for treating moderate-to-severe atopic dermatitis (AD) in adolescents and adults. This study is a prospective, multicenter, non-interventional trial that aims to measure treatment outcomes through physician assessments and patient-reported outcomes over approximately 12 months. The goal is to understand how nemolizumab works in routine clinical practice, focusing on physician evaluations and patient experiences at Month 6. Treatment with nemolizumab is determined solely by the participant's physician before joining the study, with no extra visits, procedures, or lab tests beyond standard care. The study does not define a specific visit schedule; instead, visits follow routine medical practice to collect data systematically. A sub-study in Germany and the UK will have participants complete daily questionnaires on itch severity, sleep disturbance, and pain from Day -1 to Day 14 remotely, without requiring clinic visits. Participants will be involved in routine clinical visits where physician assessments and patient-reported outcome measures will be gathered. Key outcomes measured include the Investigator Global Assessment (IGA) and the Peak Pruritus Numerical Rating Scale (PP NRS) at Month 6. The study observes participant responses and safety under normal care conditions, with data collection lasting about a year to evaluate nemolizumab's effectiveness in everyday treatment settings.

Researchers are investigating the Avantect test, a new blood test designed to detect pancreatic cancer early in patients recently diagnosed with type 2 diabetes. Pancreatic cancer is highly lethal, often detected too late for curative treatment. The study focuses on adults aged 50 to 84 years who were diagnosed with type 2 diabetes within the past six months, as this group has a significantly higher risk of undiagnosed pancreatic cancer. The trial aims to evaluate if the Avantect test can identify pancreatic cancer at a treatable stage, potentially improving survival rates. Participants will be randomly assigned to either an intervention group or a control group. Those in the intervention arm will have their blood samples tested with the Avantect device soon after collection. If the test detects biomarkers suggesting pancreatic cancer, participants will be informed and offered imaging scans such as MRI or CT to confirm diagnosis. Control group samples will be stored for future testing or research. The study will enroll up to 15,000 participants over three years. Each participant will attend three study visits over a 12-month period, providing blood samples and completing anxiety questionnaires at every visit. Researchers will follow all participants remotely via cancer and mortality registries for three years after enrollment to track any cancer diagnoses. The main outcomes measured include the sensitivity and specificity of the Avantect test and the rate at which pancreatic cancer can be surgically removed, with analyses planned at six months and at three years.

This research evaluates the Medacta SMS femoral stem prosthesis in patients with severely painful or disabling hip joints caused by conditions such as osteoarthritis, traumatic arthritis, developmental dysplasia of the hip, or avascular necrosis of the femoral head. The study focuses on monitoring the device after it has been marketed to understand its long-term performance. It includes adults aged 18 to 75 who are scheduled for primary total hip replacement surgery. Participants receive the SMS femoral stem device as part of their hip replacement procedure. The study is conducted across multiple centers and countries to observe the use of this specific femoral stem component. There are no additional drug treatments or comparison groups specified; the focus is on the prosthesis itself. During the study, participants will be followed for an extended period, with the primary measurement being the survivorship of the femoral stem over 10 years. Researchers will monitor the device's performance and collect data through follow-ups and reviews to assess long-term outcomes and safety. The study aims to gather detailed information on how well the implant functions over time in real-world clinical practice.