Active clinical trials for "Wounds and Injuries"

This is an open-label, non-randomized, prospective, multi-site, parallel group (segment), hypothesis-generating study designed to collect data that will aid in future scientific and engineering exploration of correlations between clinical neuropsychological assessments and GE Research Pack II advanced MR imaging in mTBI patients. The results are primarily intended for scientific inquiry and engineering development purposes, and may be used in future regulatory submissions.

Acute kidney injury (AKI) is an infrequent but major and well - recognized complication of cardiac surgery. Recent studies demonstrated that even minimal increases in serum creatinine are associated with a rising risk of mortality, hospital length of stay, and cost. Furthermore a cut-off for baseline serum creatinine and its influence on mortality after cardiac surgery has been shown. In this study the investigators want to test if increased bSCr is influenced by body composition. Further the investigators want to determine if the incidence of AKI is different in patients below or above the estimated cut-off. Therefore the investigators want to perform a prospective cohort analysis and will take several other body composition and nutrition parameters to test their influence on the predictive power of bSCr. Furthermore the investigators want to evaluate several novel biomarkers for AKI on their predictive effect in cardiac surgical patients.

A prospective validation study of the "Scandinavian guidelines for initial management of minimal, mild and moderate head injuries in adults". Enrolling a consecutive sample of 1000 adult head injury patients from the emergency department of the Tampere University Hospital (Tampere, Finland). A venous blood sample with S100 analytics (+storage blood) is drawn from every patient. The patients are head CT-scanned according to the SNC guidelines. Outcome assessment (GOSE, MRS, Rivermead PCS Questionnaire) is completed as follows: 1 week, 6 months, 1 year, and 2 years.

Acute kidney injury requiring dialysis (AKI-D) has increased considerably over last 15 years. The national rise in incidence of acute kidney injury has several ramifications in terms of cost to the health services resulting not only from cost of therapy but also from the later consequences of AKI from development of chronic kidney disease and cardiovascular disease. Mortality in patients with AKI-D is very high and remains unchanged in the last decade in England. In recent years it is becoming clearer that even the national incidence and case-fatality of AKI is influenced by regional variation. In last three decades, many studies have reported unwarranted variation in a wide range of procedures, from the performance of cesarean section and coronary angiography to the treatment of early prostate cancer, stroke, and the ailments of the chronically ill. In surgical care there is evidence that the variation may be driven by forces other than patient illness and medical appropriateness such as access to care and other socioeconomic factors, provider capacity of the local system, medical malpractice pressure, and distinctly different local practices. Despite the public health burden of AKI-D in England, it is unclear if regional variation exists in AKI-D. Variation in incidence of AKI-D in different region of a country may be influenced by patient and physician demographics of the regions, physician preferences or the nature of the hospital serving the population. To reduce the incidence and case fatality of AKI-D, it is imperative to understand if variations in incidence and case-fatality in AKI-D exists in different regions of the country. To address this gap in knowledge, the investigators combined national database of hospital admissions and discharge with census data from office of national statistic over a period of fifteen years to determine the trend in change in the regional incidence and case fatality of AKI requiring dialysis in England. The investigators also explored various determinants of the regional variation in the dialysis requiring AKI. Methods Data source The investigators extracted 2000-2015 data from the Hospital Episode Statistics (HES), a data warehouse containing details of all admissions, outpatient appointments, and A&E attendances at National Health Service (NHS) hospitals in England. Definitions The investigators identified all cases of AKI by using validated International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes in any diagnoses codes, in keeping with the objective of the study. Patients with any of the following codes were included: N17.0 for acute renal failure (ARF) with tubular necrosis, N17.1 for ARF with acute cortical necrosis, N17.2 for ARF with medullary necrosis, N17.8 for other ARF and N17.9 for ARF, unspecified. ARF has been replaced by new terminology, AKI, but due to lack of ICD10 codes for AKI, the investigators used the ICD10 codes for ARF and henceforth, will be referred to as AKI in this study. The investigators also extracted all available secondary diagnosis and up to 24 Office of Population Censuses and Surveys Classification of Interventions and Procedures, 4th revision (OPCS-4) codes. To identify patients with AKI-D, the investigators included OPCS code of X40.3 for hemodialysis or X40.4 for hemofiltration in any of the 25 procedures. Patients with chronic kidney disease stage 5 (CKD-5) starting chronic dialysis and end stage renal disease (ESRD) with ICD-10 code of N18.5 and N18.6 respectively were excluded. The investigators also excluded OPCS-4 codes for Arteriovenous fistula (L74.2) or Arteriovenous graft (L74.3) during the inpatient admission. HES data stratifies patient location into 16 different regions. The geographic regions in England were stratified as per the Office of National Statistic (ONS) into nine regions: North East, North West, Yorkshire and Humber, East Midlands, West Midlands, East of England, London, South East and South West. Patients' in geographical locations outside these nine regions were excluded. Patients who were admitted, but were not discharged during the study period will not be included in the study. The investigators also obtained completed hospital discharges from each region to estimate the effect of hospitalization on AKI-D incidence rates, along with number of nephrology consultants in each region from 2000 to 2015 from Health and Social Care Information Centre (HSCIC) in the annual census of medical and dental staff in the NHS. The investigators will also obtain linkage with ONS and UK Renal Registry (UKRR) for long-term patient and renal outcomes. To obtain population incidence of AKI-D for each region, mid-year population of the region in each year from 2000 to 2015 was obtained from the ONS.

By studying individual biomarkers in body fluids such as saliva, there is a potential for detecting injury to the brain resulting from an acute traumatic even that may not be detectable by conventional neuroimaging like CT scans.

Abdominoplasty is one of the most commonly performed procedures in plastic surgery. The appearance of the scar is a major factor contributing to the aesthetic outcome of the procedure and depends largely on the technique of wound closure. The investigators routinely used resorbable subcutaneous sutures and resorbable intracutaneous sutures for this closure. To overcome the potential detrimental effects of sutures in skin closure, surgical adhesives were introduced as a new technology. The new PrineoTM wound closure system was created to combine the effectiveness of 2-octyl-cyanoacrylate (Dermabond TM) together with a self-adhering mesh to make closure of long skin incisions even more safe and reliable. PrineoTM has the potential to offer a patient several benefits over traditional wound closure with sutures.A patient treated with Prineo™ can shower immediately following a procedure because the product forms a watertight barrier over the incision. PrineoTM can be easily removed, often with less pain than is sometimes associated with suture removal, after the natural wound healing process is complete (approximately 12 to 25 days). Other benefits are that it forms a microbial barrier and provides even distribution of tension across the length of the incision to ensure wound edge approximation throughout the wound healing process. Furthermore, it reduces subcuticular closure time as compared to subcuticular suturing. However, these potential advantages have not been proven until now, as the methods used to assess the aesthetic outcome were not reproducible in most assessments, and none of these studies assessed patient satisfaction.1-3 Moreover, none was performed in a plastic surgical patient population. For these reasons, the investigators prospectively studied the results of wound closure after abdominoplasty with randomized use of PrineoTM and conventional suturing to assess the possible difference in outcome between these two methods.

The primary objective is to assess the long-term impact of hormonal deficiency on Quality of Life (QoL) in a large group of moderate and severe Traumatic Brain Injury (TBI) patients.

The investigators are assessing the platelet function analysis of those who sustained significant head trauma while on aspirin or plavix and to assess if any qualitative difference is obtained if platelets are administered.

Assessment of the safety and performance of the VistaCare® medical device in current medical practice in the treatment of acute and chronic lower limb wounds.

Food security is one's ability to get food. Individuals with a Spinal Cord Injury (SCI) have many risk factors for low rates of food security. Some of these risk factors include lower levels of income and employment. Our long-term goal is to identify if food security is more prevalent in the SCI population, and to develop ways to improve food security in the SCI population. The purpose of this study is to determine the rates of food insecurity in a sample of people living with a SCI and to identify some perceptions of barriers to healthy eating in the SCI population.