El Centro

Researchers are evaluating a combination therapy of finerenone plus empagliflozin compared to usual care in patients hospitalized with heart failure. This international, randomized, controlled, open-label trial aims to assess the effectiveness and safety of this early, intensive treatment approach in managing heart failure during and after hospitalization. Participants will either receive the combination of oral finerenone and empagliflozin or continue with usual care management. The study is designed to compare these two approaches to determine their impact on clinical outcomes. The trial includes a treatment period with these medications given alongside usual management during hospitalization and follow-up. During the study, participants will be monitored over six months for clinical benefits and safety outcomes such as serious adverse events and adverse events leading to discontinuation. Researchers will assess heart failure events, symptom changes using the Kansas City Cardiomyopathy Questionnaire, and time to death or heart failure events. Study visits and evaluations will track participant health and response to treatment over this period.

Researchers are evaluating how well the 20-valent pneumococcal conjugate vaccine 20vPnC works against pneumonia caused by seven new types of the Streptococcus pneumoniae bacteria. This study focuses on adults aged 65 years and older who are hospitalized with pneumonia confirmed by chest imaging. The study aims to compare the presence of pneumonia caused by these specific bacteria types in people vaccinated with 20vPnC versus those with pneumonia caused by other bacteria or strains. This observational study involves adults 65 years and older hospitalized with radiologically-confirmed community-acquired pneumonia RADCAP. Participants will provide a urine sample for testing pneumococcal bacteria using BinaxNOW and specific urinary antigen detection assays UAD-1 and UAD-2. Cases are identified by detection of the seven additional bacteria types in 20vPnC beyond the previous 13-valent vaccine, while controls include other pneumonia cases without these serotypes. No treatment is given as part of the study. Participants will be involved for about 1 to 2 days for urine sample collection and providing medical history. Researchers will collect detailed information on illness and hospital stay up to 30 days through medical record review. The main outcome measured is the effectiveness of 20vPnC against pneumonia caused by the seven additional bacterial types over approximately 55 months. Other clinical features and pneumonia types will also be reviewed during this period.

This research aims to assess the impact of a bundle of strategies designed to improve coordination between emergency departments EDs and outpatient clinics for adults starting buprenorphine treatment for opioid use disorder. The study will focus on how these strategies influence long-term retention in buprenorphine treatment after patients leave the ED, measuring outcomes such as days with active buprenorphine prescriptions and timely prescription fills. The study involves multiple hospital EDs and outpatient clinics and addresses the challenge of maintaining effective treatment following initial ED care. Participants will experience a stepped implementation across 12 sites, where each site adopts the care coordination strategies at different times over a 12-month period. Before implementation, standard referral and coordination procedures are used after implementation, ED and outpatient teams incorporate the new strategies, which include standardized notes, improved information sharing, enhanced patient contact methods, clearer team roles, procedures for same-day refills, and external facilitation. These strategies are tailored to each sites needs. During the study, participant data will be collected from electronic health records and linked prescription monitoring programs to track buprenorphine treatment continuity and retention at 3, 6, and 12 months after the initial ED visit. Clinician surveys will evaluate changes in care coordination quality. The studys primary outcome focuses on continuous buprenorphine treatment at 6 months, with secondary outcomes at other time points. Results aim to guide broader implementation to improve opioid use disorder treatment outcomes nationwide.

Researchers are evaluating a multi-component telehealth intervention designed to improve engagement in goal-aligned oncofertility care among adolescent and young adult cancer patients. The study focuses on young cancer survivors and aims to observe how the intervention is implemented while assessing its impact on their participation in fertility preservation care. This is a phase 3 randomized controlled trial sponsored by the University of California, San Diego. The intervention group receives a multi-component telehealth oncofertility care program that includes an adaptive electronic health record-based screening and referral system, telehealth counseling, and financial navigation when needed. The control group receives usual oncology care without the added oncofertility intervention. Eligible cancer patients are assigned randomly to either group as they present to oncology visits. Participants aged from newborns up to 50 years old will be followed, with key outcomes measured 12 weeks after their oncology visit. Researchers will assess how many patients engage in goal-concordant oncofertility care and measure decisional conflict related to fertility choices. The study monitors both male and female patients, with assessments including engagement rates and decision-making clarity regarding fertility preservation options.

This research aims to test a multi-part approach to help young female cancer survivors in rural areas better engage with reproductive health care that matches their personal goals. The study focuses on females aged 15 to 50 who have been diagnosed with cancer and are receiving oncology care. The goal is to see if this supportive intervention can improve their involvement in reproductive health decisions and services. The intervention includes a reproductive health needs screening done during oncology visits to understand each patients desire for children and contraception needs. Patients then have a session with a social worker for personalized education about infertility risks related to cancer and treatment, along with support to pursue care that fits their reproductive goals. Finally, a telehealth consultation with a reproductive specialist lasting about an hour is provided. All eligible patients at participating rural oncology clinics receive this multi-component intervention. Participants will be monitored for their engagement in goal-aligned reproductive health care 12 weeks after the oncology visit. The study will track how well patients follow through with recommended care and support their reproductive health choices. This trial is sponsored by the University of California, San Diego, and participation involves regular oncology visits where the intervention is delivered and assessed over the course of several weeks.

This research aims to compare long-term outcomes of buprenorphine treatment for patients with opioid use disorder OUD who start buprenorphine in hospital emergency departments. It evaluates whether referring patients to outpatient buprenorphine treatment via telehealth or in-person clinics leads to better treatment engagement, longer retention, and improved patient experience. The study addresses challenges faced by patients transitioning from emergency care to ongoing OUD treatment, including barriers like transportation and stigma. Participants will be randomized to receive referrals for outpatient OUD treatment either through telehealth phone or video visits or in-person clinics. The study takes place at three emergency departments participating in Californias CA Bridge program, which supports ED-based OUD care including counseling, naloxone provision, and buprenorphine initiation. Those in the telehealth arm receive outpatient treatment remotely, while the in-person arm involves local clinic visits. Both groups receive support from CA Bridge counselors for up to 30 days to help establish outpatient care. During the study, participants answer questionnaires at baseline and at 1, 3, 6, and 9 months after their emergency department visit. Researchers will monitor prescription records to assess buprenorphine retention over six months, track drug-related overdose deaths, hospital visits, and patient experiences using validated surveys. The study also examines how patients feelings of stigma relate to treatment outcomes. Overall, the study seeks to inform better referral practices to improve long-term OUD treatment and reduce overdose risks.