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Holman Page McAdams, M.D MAJ Il y a 7 mois

Longitudinal MR Imaging of Pulmonary Function in Patients Receiving Thoracic Radiation Treatment The purpose of this study is to determine whether magnetic resonance imaging (MRI) using inhaled hyper polarized xenon-129 (129Xe) gas, and conventional contrast can help visualize impaired lung function and detect changes over time in patients receiving treatment as well as those who don't. 129Xe is a special type of xenon gas and when inhaled during MRI may be able to show areas of abnormal thickening of parts of the lungs. These images combined with images taken with injected contrast agents or other special types of MRI such as conventional proton (1H) MRI may provide a better way to look at lung structure and function. The ultimate goal is to predict the degree of radiation-induced lung injury that will develop in a given patient for a given treatment plan. The investigators anticipate that these images will provide more specific information about lung disease than standard lung function tests. The use of 129Xe MRI is investigational. Investigational means that these tests have not yet been approved by the US Food and Drug Administration and are only available in research studies like this one. In addition, standard MRI with contrast is not typically done as standard of care for monitoring changes due to thoracic radiation therapy, therefore, its use in this study is also considered investigational. Healthy volunteers are being asked to participate in this study because to develop a database of functional images that are representative of healthy lungs.

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Continuous monitoring of body electric signals in Paediatric Intensive Care Background and study aims In the UK, more than 1.5 million children are admitted to hospital every year, 4,500 of which will require treatment in intensive care. Serious illness can have a big impact on the digestive system and the workload of the muscles involved in breathing (respiratory muscles). Scanning techniques designed to detect electrical activity in the muscles below the skin, such as surface electrogastrography (sEGG) and surface electromyography (sEMG), can help to provide healthcare professionals with more useful information about how these bodily functions are performing than routine testing, which can improve patient care. These techniques have only been used for short periods of time in the past, however recent improvements in technology mean that they could potentially be used for longer. This study aims to find out whether these techniques can be used for continuous monitoring of children in paediatric intensive care to provide ongoing information about the digestive system and respiratory muscles. Who can participate? Children in intensive care who are able to breathe unaided What does the study involve? Eight surface electrode sensors are applied to the bodies of participants. These electrodes are then attached to a special amplifier which in turn is connected to a laptop, which will convert the raw signals into data which can be analyzed. What are the possible benefits and risks of participating? There will be no direct benefits or risks to patients participating in this study. Where is the study run from? Brimingham Children’s Hospital (UK) When is the study starting and how long is it expected to run for? February 2014 to December 2015 Who is funding the study? 1. Birmingham Children's Hospital (UK) 2. Inbiolab BV (UK) Who is the main contact? Dr Balazs Fule balazs.fule@bch.nhs.uk

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A feasibility study of prescribing chair based pedal exercises for older people admitted to hospital on function and mobility compared to standard care Background and study aims The British Heart Foundation recommends physical activity in frail older people. Unfortunately, older patients in hospital spend the majority of their time in a sedentary state. Physical inactivity in hospital leads to poorer health outcomes. Encouraging physical activity in hospital is challenging due to a number of reasons ranging from a limited number of therapists (who usually deliver the exercise sessions), limited therapy time, older patients unable to recall exercises prescribed, lack of patient engagement and motivation; and concern of causing falls. Therefore, chair based pedal exercises offer a simple method of improving physical activity. Its repetitive nature is much easier to follow and this helps those with memory concerns. Resistance training as part of pedal exercise may improve muscle strength. All this should result in improved lower limb function. An activity that involves sitting down is more likely to reassure both patients and staff regarding the risk of falls and resulting injury. Chair based pedal exercise in addition to usual ward care may improve healthcare outcomes. We propose a study to evaluate how feasible it is to deliver regular chair based pedal exercises (the intervention) on older people (≥65 years old) admitted to an acute medical ward. Who can participate? People aged at least 65 admitted to an acute geriatric ward that are able to co-operate and sit in a chair on their own for at least 10 minutes What does the study involve? Participants are randomly allocated into one of two groups. Those in group 1 receive standard care, that is the care currently given on the ward. Those in group 2 receive the intervention. This includes regular chair based pedal exercises for 5 minutes 3 times a day until they leave hospital or after 7 days, whichever comes. This is in addition to the standard care delivered. Participants are asked to pedal continuously with no pre-specified targets set, e.g. rpm or level of resistance. This exercise is initially supervised by a member of the research team and then supervised by members of the ward team. This is to replicate ‘real life’ hospital setting where exercises in hospital are initiated and observed by a therapist and the patients encouraged to continue with the exercises with support by the ward team. Participants in both groups have access to the ward physiotherapist and an inpatient therapy plan as part of their standard care. The participants also have similar access to medical, nursing and other allied healthcare staff. What are the possible benefits and risks of participating? Participants offered pedal exercises will be able to maintain their fitness whilst in hospital. Participating in the study will help to provide the research team with information to improve physical activity and mobility in hospital. There are no known side effects. Tiredness due to the pedal exercise is possible. Hence, if a participant suffers with any heart or lung problems, the research team would urge the participant to pace him or herself, to stop if any discomfort arises and inform the healthcare and research team. Participants may also experience mild discomfort from wearing the activity monitor with its associated dressing. If this was the case the monitor could be repositioned. Where is the study run from? Queens Medical Centre, Nottingham University Hospitals NHS Trust. When is study starting and how long is it expected to run for? August 2015 to April 2016 Who is the main contact? Dr Terence Ong

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