Scarborough

This research aims to understand the genetic factors that contribute to the risk of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR). GCA is a serious inflammatory disease affecting blood vessels, mainly in people over 50, which can cause severe complications like vision loss or stroke if untreated. PMR causes pain and stiffness in the limbs with signs of inflammation. The study involves both patients recently suspected of having GCA and those with confirmed diagnoses from the past. It seeks to provide new insights into disease causes and improve diagnosis and treatment approaches. Participants are observed in a multi-center study collecting clinical and genetic data. The study includes both prospective patients with suspected GCA and retrospective patients with confirmed GCA or PMR diagnoses. Some retrospective participants receiving tocilizumab for recurring or difficult-to-treat GCA are also included in a safety monitoring registry. Data collected include clinical features, imaging, tissue and blood samples, and advanced genetic testing. The study also follows patients over time to assess disease impact, quality of life, and long-term outcomes. During the study, participants provide medical information, biological samples, and complete questionnaires about their symptoms and quality of life. Researchers monitor disease activity and treatment effects, especially among those starting certain immune-modifying drugs. The main measurements focus on genetic susceptibility at the study start, with ongoing evaluation of diagnosis, prognosis, and disease progression. The study is designed to improve understanding and management of GCA and PMR over time.

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 investigating heart failure patients with Non-Ischemic Cardiomyopathy (NICM), a condition where heart failure is not caused by blocked arteries. The study aims to compare survival rates between those who receive an Implantable Cardioverter-Defibrillator (ICD) and those who do not over a period of 36 months, with follow-up extending up to 10 years. This research could influence future international guidelines for managing this type of heart failure. Participants will be randomly assigned to one of two groups: one group will receive an ICD or a Cardiac Resynchronisation Therapy Defibrillator (CRTD), devices implanted under the skin that monitor and correct dangerous heart rhythms. The other group will not receive these devices. The device implantation is done under local anesthesia and includes leads fixed inside the heart chambers. Both groups will be monitored to see if the ICD reduces the risk of death. During the study, participants will undergo assessments including cardiovascular magnetic resonance imaging to evaluate heart scarring. Researchers will monitor survival rates and complications related to device implantation, such as bleeding, infections, or inappropriate shocks. The main outcome measured is the percentage of patients alive at 3 years. Safety and long-term effects will be followed to understand the balance of benefits and risks over time.