[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"leadSponsorName\":\"Hospital de Clinicas de Porto Alegre\",\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:":697},{"pageToken":4,"total":5,"offset":6,"count":7,"results":8},null,37,0,25,[9,48,84,111,138,165,187,215,244,270,292,315,348,370,397,429,450,481,507,538,567,591,618,643,667],{"id":10,"slug":11,"hasResults":12,"nctId":13,"briefTitle":14,"officialTitle":15,"acronym":16,"eligibilityCriteria":17,"healthyVolunteers":12,"sex":18,"minAge":4,"maxAge":4,"enrollmentInfo":19,"targetDuration":4,"studyType":22,"phases":23,"briefSummary":25,"conditions":26,"keywords":29,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":37,"lastUpdatePostDateStruct":38,"startDateStruct":41,"completionDateStruct":43,"leadSponsor":45,"locationsCount":4},"100644227","psychosocial-support-program-for-public-school-teachers-100644227",false,"NCT07666542","Psychosocial Support Program for Public School Teachers","Evaluation of the Effectiveness and Feasibility of Different Formats of a School-Based Psychosocial Support Program for Public School Teachers: A Randomized Clinical Trial","PSP","Inclusion Criteria:\n\nSchool-level inclusion criteria:\n\n* Public schools from the state education system of Rio Grande do Sul, Brazil, serving students in \"Ensino Fundamental\" and \"Ensino Médio\" (equivalent to grades 1-12), and belonging to \"Polo 1\", an administrative grouping defined by the Rio Grande do Sul State Department of Education that includes the following Regional Education Coordinators (Coordenadorias Regionais de Educação \\[CREs\\]): 1st, 2nd, 11th, 12th, 27th, and 28th CREs;\n* Schools with 10 or more teachers on staff;\n* Schools with a complete school management team, defined as having all three core management roles in place.\n\nParticipant-level inclusion criteria (teacher level)\n\nParticipating teachers must meet all of the following criteria:\n\n* Teachers currently working in participating public schools;\n* Able and willing to participate in all stages of the intervention and scheduled assessments;\n* Provide informed consent prior to participation\n\nExclusion Criteria:\n\nSchool-level exclusion criteria:\n\n* Schools with fewer than 10 teachers on staff;\n* Schools without a complete school management team;\n* Youth and Adult Education Centers (Núcleos de Educação de Jovens e Adultos \\[EJA\\]);\n* Schools that began operating as full-time schools in 2026;\n* Schools not belonging to Polo 1 of the state education system of Rio Grande do Sul;\n* Schools that do not serve students in grades 1-12\n\nParticipant-level exclusion criteria\n\n* Not currently working as a teacher in a participating public school;\n* Unable to participate in the training in the planned date for the specific school the teacher works at;\n* Decline or are unable to provide informed consent","ALL",{"count":20,"type":21},2925,"ESTIMATED","INTERVENTIONAL",[24],"NA","The goal of this clinical trial is to learn if different formats of a school-based psychosocial support training program can improve teachers' ability to recognize and respond to students' mental health needs. The study will include teachers working in public schools in Brazil.\n\nThe main questions it aims to answer are:\n\n1. Do teachers who receive the training improve their knowledge on how to better to identify and support students with mental health difficulties?\n2. Do different formats of training (in-person, online, or self-paced) and the presence of supervision lead to different levels of improvement in this knowledge, in attitudes related to mental health, and helping behaviors?\n\nResearchers will compare five versions of the program (in-person, online, and asynchronous formats, with or without supervision) to see which approach is more effective, acceptable, and feasible.\n\nParticipants will:\n\n1. Take part in a training program delivered either in-person, online, or through self-paced materials;\n2. In some groups, attend additional supervision sessions to discuss real-life cases;\n3. Receive brief follow-up materials through mobile messages after the training\n4. Complete online questionnaires at multiple time points (before the training, during the program, after completion, and at follow-up).\n\nThe study will measure changes in teachers' knowledge, attitudes, and behaviors related to supporting students' mental health, as well as satisfaction with the program and its feasibility for large-scale implementation.",[27,28],"Mental Health Literacy","School Mental Health Training of Teachers",[30,31,32,33,34,35],"School Mental Health","Psychosocial Support","Cluster Randomized Controlled Trial","Teacher Professional Development","Mental Health Promotion","Education Policy","NOT_YET_RECRUITING","2026-06-22",{"date":39,"type":40},"2026-06-24","ACTUAL",{"date":42,"type":21},"2026-06-29",{"date":44,"type":21},"2026-12-16",{"name":46,"class":47},"Hospital de Clinicas de Porto Alegre","OTHER",{"id":49,"slug":50,"hasResults":12,"nctId":51,"briefTitle":52,"officialTitle":53,"acronym":54,"eligibilityCriteria":55,"healthyVolunteers":12,"sex":18,"minAge":56,"maxAge":4,"enrollmentInfo":57,"targetDuration":4,"studyType":22,"phases":59,"briefSummary":60,"conditions":61,"keywords":64,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":75,"lastUpdatePostDateStruct":76,"startDateStruct":78,"completionDateStruct":80,"leadSponsor":82,"locationsCount":83},"100609382","nutritional-intervention-for-constipation-symptoms-in-patients-with-parkinsons-disease-100609382","NCT07213856","Nutritional Intervention for Constipation Symptoms in Patients With Parkinson's Disease","Nutritional Intervention for Constipation Symptoms in Patients With Parkinson's Disease: A Randomized Clinical Trial","NUTRI-GUT-PD","Inclusion Criteria:\n\n* Adults with a previous diagnosis of Parkinson's disease\n* On a stable dose of levodopa for at least 3 months\n* Diagnosis of Functional Constipation by the Rome IV protocol\n\nExclusion Criteria:\n\n* Diagnosis of atypical or secondary parkinsonism\n* Hoehn and Yahr stage greater than 2\n* Presence of severe neurological or psychiatric disorders that impair the ability to participate in study procedures\n* Previous diagnosis of dementia\n* Presence of comorbidities such as active cancer, chronic obstructive pulmonary disease (COPD), heart failure, and\u002For chronic kidney disease\n* History of gastrointestinal cancers, inflammatory bowel diseases, or surgeries involving the gastrointestinal tract\n* Constipation secondary to clinical conditions such as hypothyroidism or diabetes mellitus\n* Use of opioids\n* Use of probiotics or antibiotics in the past 8 weeks\n* Continuous use of laxatives in the past 8 weeks\n* Presence of severe dysphagia according to the Functional Oral Intake Scale (FOIS)\n* Individuals receiving enteral or parenteral nutrition\n* Individuals under nutritional follow-up in the past 3 months","18 Years",{"count":58,"type":21},54,[24],"The goal of this clinical trial is to evaluate whether a dietitian-guided nutritional intervention can improve constipation symptoms in people with Parkinson's disease (PD). The main questions it aims to answer are:\n\n* Can a dietitian-guided nutritional intervention increase the number of weekly bowel movements in individuals with PD and functional constipation?\n* Can this intervention positively influence gut microbiota composition, dietary intake, and nutritional status?\n\nResearchers will compare the intervention group to a control group that will receive general dietary guidance only after the study period, to see if the intervention leads to improvements in bowel function and related health outcomes.\n\nParticipants will:\n\n* Follow a diet plan developed by a dietitian, based on dietary reference intakes and tailored to the needs of individuals with PD and constipation\n* Participate in follow-up sessions with the dietitian for 3 months\n* Complete assessments at baseline, midpoint, and end of the intervention to evaluate bowel function, constipation symptoms, gut microbiota, nutritional status, and diet quality",[62,63],"Parkinsons Disease (PD)","Constipation - Functional",[65,66,67,68,69,70,71,72,73],"Microbiota","Diet","Diet, Protein-Restricted","Diet Therapy","Diet, Healthy","Nutrition Therapy","Constipation","Non-Motor Symptoms","Nutritionists","RECRUITING","2026-06-15",{"date":77,"type":40},"2026-06-16",{"date":79,"type":40},"2026-04-02",{"date":81,"type":21},"2029-08",{"name":46,"class":47},1,{"id":85,"slug":86,"hasResults":12,"nctId":87,"briefTitle":88,"officialTitle":89,"acronym":90,"eligibilityCriteria":91,"healthyVolunteers":12,"sex":18,"minAge":56,"maxAge":4,"enrollmentInfo":92,"targetDuration":4,"studyType":22,"phases":94,"briefSummary":95,"conditions":96,"keywords":100,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":105,"lastUpdatePostDateStruct":106,"startDateStruct":107,"completionDateStruct":108,"leadSponsor":110,"locationsCount":83},"100635870","suprapapillary-metal-stent-vs-routine-transpapillary-drainage-in-malignant-hilar-biliary-obstruction-smart-b-trial-100635870","NCT07558304","Suprapapillary Metal Stent vs. Routine Transpapillary Drainage in Malignant Hilar Biliary Obstruction (SMART-B Trial)","Randomized Clinical Trial of Suprapapillary Drainage With Metal Stent vs. Routine Internal-External Transpapillary Drainage in Patients With Malignant Hilar Biliary Obstruction","SMART-B","Inclusion Criteria:\n\n1. Age \\>18 years.\n2. Malignant proximal biliary obstruction on imaging (magnetic resonance cholangiopancreatography or contrast-enhanced abdominal computed tomography) with histopathological confirmation or high clinical and radiological suspicion.\n3. Total bilirubin \\> 3 mg\u002FdL.\n4. Patients not candidates for potentially curative surgical resection due to locally advanced disease, metastatic disease, or inadequate clinical condition.\n5. Patients with potentially resectable neoplasms, defined as the possibility of achieving complete resection (R0), who meet at least one of the following criteria:\n\n5.1 Estimated future liver remnant \\\u003C40%, in whom percutaneous portal vein embolization of the side to be resected will also be indicated after initial drainage.\n\n5.2 Prolonged jaundice with total bilirubin \\>10 mg\u002FdL for more than 14 days. 5.3 Malnutrition, defined as ≥10% unintentional weight loss or albumin \\\u003C3 g\u002FdL, presumably attributable to cholestasis.\n\n5.4 Indication for neoadjuvant chemotherapy.\n\nExclusion Criteria:\n\n1. Tumor with distal extension to the duodenal papilla, precluding suprapapillary drainage.\n2. Prior biliary drainage procedure, either percutaneous (PTBD) or endoscopic (ERCP).\n3. Acute cholangitis, clinically defined as fever (axillary temperature \\>38°C) and leukocytosis (white blood cell count \\>10,000\u002Fmm³).\n4. Uncorrectable coagulopathy.\n5. Iodinated contrast allergy not amenable to desensitization.",{"count":93,"type":21},84,[24],"Malignant hilar biliary obstruction is a condition in which the bile ducts near the liver become blocked due to cancer. This blockage can lead to jaundice (yellowing of the skin and eyes), itching, infection, and impaired liver function. To relieve the obstruction, doctors commonly perform procedures to drain bile and restore its flow.\n\nThere are different techniques available for biliary drainage. One common method is percutaneous transpapillary internal-external drainage, in which a catheter is placed through the liver and across the natural opening of the bile duct into the intestine. Another approach is percutaneous suprapapillary drainage using a self-expanding metal stent, which allows bile to drain without crossing into the intestine and may reduce the risk of contamination and infection.\n\nCurrently, there is no clear consensus on which of these two techniques is safer or more effective for patients with malignant proximal biliary obstruction. Some studies suggest that avoiding manipulation of the intestinal opening of the bile duct may reduce complications such as infection, but high-quality comparative evidence is lacking.\n\nThe purpose of this study is to compare percutaneous suprapapillary drainage with a self-expanding metal stent versus routine percutaneous transpapillary internal-external drainage in patients with malignant proximal biliary obstruction. The study aims to compare the rate of drainage-related complications between the two techniques, as well as to evaluate treatment success, stent patency, and the need for reintervention. In addition, in patients with potentially resectable disease undergoing preoperative biliary drainage, the study will assess and compare surgical outcomes between the two approaches. The results of this study may help determine the safest and most effective drainage strategy for these patients and improve future clinical decision-making.",[97,98,99],"Cholangiocarcinoma","Bile Duct Neoplasms","Malignant Biliary Obstruction",[97,101,102,103,104,99],"Percutaneous biliary drainage","Self-expanding metal stent","Suprapapillary drainage","Malignant hilar biliary obstruction","2026-06-12",{"date":77,"type":40},{"date":75,"type":21},{"date":109,"type":21},"2028-12-31",{"name":46,"class":47},{"id":112,"slug":113,"hasResults":12,"nctId":114,"briefTitle":115,"officialTitle":116,"acronym":4,"eligibilityCriteria":117,"healthyVolunteers":12,"sex":18,"minAge":118,"maxAge":4,"enrollmentInfo":119,"targetDuration":4,"studyType":121,"phases":4,"briefSummary":122,"conditions":123,"keywords":125,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":129,"lastUpdatePostDateStruct":130,"startDateStruct":132,"completionDateStruct":134,"leadSponsor":136,"locationsCount":137},"100637494","social-deprivation-and-postoperative-mortality-100637494","NCT07621211","Social Deprivation and Postoperative Mortality","Assessment of the Impact of Socioeconomic Factors on Perioperative Outcomes","Inclusion Criteria:\n\n* Patients aged 16 years or older.\n* Patients who underwent an elective or urgent surgical procedure in an operating room at a participating hospital.\n* Surgical procedure performed between January 1, 2024, and December 31, 2024.\n\nExclusion Criteria:\n\n* Patients who underwent ophthalmologic surgery, diagnostic procedures only and procedures performed under local anesthesia only.\n* Patients who underwent liver, lung or heart transplantation.\n* Patients diagnosed with brain death who were organ donor candidates.","16 Years",{"count":120,"type":21},45000,"OBSERVATIONAL","Socioeconomic factors are associated with differences in health outcomes, but their impact on surgical patients is still not well understood, especially in low- and middle-income countries. Social deprivation may affect perioperative outcomes through differences in access to healthcare, burden of comorbidities, timing of care, and hospital resources. However, few studies have evaluated this association in large and diverse surgical populations, and data from Brazil are limited.\n\nThis retrospective multicenter cohort study will evaluate the association between socioeconomic deprivation and perioperative outcomes among patients undergoing surgery in Brazil. The study will include patients aged 16 years or older who underwent elective or urgent surgical procedures in participating public and private hospitals between January 1 and December 31, 2024. Patients undergoing ophthalmologic procedures, diagnostic procedures, procedures performed under local anesthesia only, selected transplant procedures, and organ donors after brain death will be excluded.\n\nSocioeconomic deprivation will be assessed using georeferenced area-level indices derived from each patient's residential address, including the Brazilian Deprivation Index, the Social Vulnerability Index, and the Municipal Human Development Index. The researchers will grou patients according to deprivation levels, and analyze the association between deprivation and postoperative outcomes.\n\nThe primary outcome will be 30-day in-hospital postoperative mortality. The study will also evaluate demographic, clinical, surgical, and hospital-level factors associated with mortality, including age, sex, ethnicity, American Society of Anesthesiologists physical status classification, surgical urgency, surgical magnitude, surgical specialty, and type of healthcare system. Multivariable logistic regression models will be used to assess whether socioeconomic deprivation is independently associated with postoperative mortality after adjustment for relevant clinical and surgical factors.\n\nThe results of this study may improve the understanding of how socioeconomic deprivation influences perioperative risk in Brazil. The findings may help identify vulnerable surgical patients, support risk prediction models that include social determinants of health, and inform strategies to reduce inequities in perioperative care.",[124],"Social Deprivation",[126,127,128],"surgical procedures","social deprivation","risk factors","2026-05-27",{"date":131,"type":40},"2026-06-02",{"date":133,"type":21},"2026-05-15",{"date":135,"type":21},"2028-12",{"name":46,"class":47},7,{"id":139,"slug":140,"hasResults":12,"nctId":141,"briefTitle":142,"officialTitle":143,"acronym":4,"eligibilityCriteria":144,"healthyVolunteers":12,"sex":18,"minAge":145,"maxAge":4,"enrollmentInfo":146,"targetDuration":4,"studyType":22,"phases":148,"briefSummary":149,"conditions":150,"keywords":155,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":129,"lastUpdatePostDateStruct":159,"startDateStruct":161,"completionDateStruct":163,"leadSponsor":164,"locationsCount":83},"100552157","the-impact-of-geriatric-assessment-on-the-treatment-plan-of-elderly-patients-with-t2dm-100552157","NCT06469437","The Impact of Geriatric Assessment on the Treatment Plan of Elderly Patients With T2DM","The Impact of Geriatric Assessment on the Treatment Plan of Elderly Patients With Type 2 Diabetes Mellitus: a Randomized Clinical Trial.","Inclusion Criteria:\n\n* Age 60 years or older\n* Diagnostic of type 2 diabetes mellitus according to American Diabetes Association criteria\n* Patients under follow-up in a specialized endocrinology outpatient clinic\n* Patients who have a glycated hemoglobin measurement of up to three months\n\nExclusion Criteria:\n\n* Lack of consent for research participation from the patient or the physician\n* Patients classified as Clinical Frailty Scale 9.","60 Years",{"count":147,"type":21},220,[24],"Introduction: With the aging of the world population and the increasing incidence of type 2 diabetes mellitus (T2DM) with age, the number of elderly individuals living with diabetes has been considerably rising. It is known that uncontrolled T2DM negatively impacts various health outcomes, including geriatric outcomes such as sarcopenia, frailty, immobility, incontinence, and infections. Current medical literature fails to establish appropriate glycemic targets for different elderly profiles. Although guidelines emphasize the need to individualize targets, there is no concise tool to identify which individuals benefit from each therapeutic approach. Data suggest that frailty is the best predictor of negative outcomes in elderly patients living with T2DM. The Clinical Frailty Scale (CFS) and the 10-minute Targeted Geriatric Assessment (TaGA-10) are validated tools for prognosis in elderly patients and for identifying frail elderly individuals.\n\nMethods: Randomized controlled trial. Elderly individuals diagnosed with T2DM at a tertiary care outpatient clinic will be included. All enrolled patients will undergo geriatric assessment using CFS, TaGA-10, and Charlson Comorbidity Index. Patients will be randomized into usual care and intervention groups, and the intervention involves providing the geriatric assessment to the care team to support their decisions. The adequacy of the therapeutic approach will be measured in one week by reviewing the consult record or interviewing the physician. The clinical impact on the frequency of hypoglycemia, falls, infections, hospitalizations, and mortality will be evaluated at 3 and 6 months by telephone interviews.\n\nDiscussion: Current guidelines recommend using age, comorbidities, cognitive, and functional status to individualize therapeutic targets in elderly patients with T2DM; however, it is possible that these variables alone may not be sufficient to classify all elderly individuals in their complexity adequately. A tool with such power and easy to use in clinical practice is necessary.",[151,152,153,154],"Type2diabetes","Frail Elderly Syndrome","Frailty","Geriatric Assessment",[156,153,157,158],"Type 2 diabetes","Geriatric assessement","Glycated hemoglobin",{"date":160,"type":40},"2026-05-29",{"date":162,"type":40},"2024-07-05",{"date":109,"type":21},{"name":46,"class":47},{"id":166,"slug":167,"hasResults":12,"nctId":168,"briefTitle":169,"officialTitle":169,"acronym":4,"eligibilityCriteria":170,"healthyVolunteers":171,"sex":18,"minAge":56,"maxAge":172,"enrollmentInfo":173,"targetDuration":4,"studyType":22,"phases":175,"briefSummary":177,"conditions":178,"keywords":4,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":180,"lastUpdatePostDateStruct":181,"startDateStruct":182,"completionDateStruct":184,"leadSponsor":186,"locationsCount":83},"100596944","phase-2-triple-blind-randomized-clinical-trial-of-tocilizumab-vs-placebo-potential-use-of-an-il-6-antagonist-as-an-adjuvant-to-standard-treatment-for-treatment-resistant-major-depression-in-the-brazilian-public-health-system-sus-100596944","NCT07052058","Triple-Blind Randomized Clinical Trial of Tocilizumab vs Placebo: Potential Use of an IL-6 Antagonist as an Adjuvant to Standard Treatment for Treatment-Resistant Major Depression in the Brazilian Public Health System (SUS)","Inclusion Criteria:\n\nAge ≥ 18 years Provide informed consent Understand written and spoken Portuguese Able and willing to consent to blood sampling Willing to abstain from strenuous exercise for 72 hours prior to assessment Meet DSM-5\u002FMINI criteria for a diagnosis of depression resistant to at least two adequate courses of treatment at the time of eligibility assessment Baseline HDRS score of 19 or higher at Serum\u002Fplasma CRP level ≥3 mg\u002FL\n\nExclusion Criteria:\n\nDiagnosis of bipolar disorder or personality disorder History of substance use disorder in the past six months. Presence of active\u002Frecent infection (including TB, Hepatitis B, Hepatitis C, or HIV) or autoimmune disease Pregnancy or breastfeeding History of significant cardiovascular disease, recent cancer, or hematological disorders BMI \\>40 kg\u002Fm² or weight \\>100 kg Hypersensitivity to tocilizumab or any of its excipients. CRP ≥20 mg\u002FL Active liver disease or transaminase elevation \\>1.5× the upper limit of normal\n\nInclusion criteria to the 10 healthy controls recruited for comparison of inflammatory biomarkers:\n\nAge ≥ 18 No current or lifetime psychiatric diagnosis, as measured by the SRQ-20 Provide informed consent Understand written and spoken Portuguese Able and willing to consent to blood sampling",true,"65 Years",{"count":174,"type":21},32,[176],"PHASE2","Clinical trial aimed at evaluating whether a single infusion of tocilizumab, a medication that blocks the action of an inflammatory molecule called interleukin-6 (IL-6), can reduce symptoms of treatment-resistant major depression compared to placebo in non-hospitalized patients.",[179],"Treatment-Resistant Major Depressive Disorder","2026-05-13",{"date":133,"type":40},{"date":183,"type":21},"2026-07-01",{"date":185,"type":21},"2028-07-01",{"name":46,"class":47},{"id":188,"slug":189,"hasResults":12,"nctId":190,"briefTitle":191,"officialTitle":192,"acronym":4,"eligibilityCriteria":193,"healthyVolunteers":12,"sex":18,"minAge":56,"maxAge":4,"enrollmentInfo":194,"targetDuration":4,"studyType":22,"phases":196,"briefSummary":197,"conditions":198,"keywords":200,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":207,"lastUpdatePostDateStruct":208,"startDateStruct":210,"completionDateStruct":212,"leadSponsor":214,"locationsCount":4},"100637241","impact-of-biofire-filmarray-pneumonia-panel-vs-routine-diagnostics-on-antimicrobial-outcomes-door-mat-100637241","NCT07585604","Impact of BioFire FilmArray Pneumonia Panel vs Routine Diagnostics on Antimicrobial Outcomes (DOOR-MAT)","A Randomized Multicenter Clinical Trial Comparing BIOFIRE® FILMARRAY® Pneumonia (PN) Panels Versus Routine Diagnostic Methods in Desirability of Outcome Ranking for the Management of Antimicrobial Therapy (DOOR MAT) in Hospitalized Patients With Lower Respiratory Tract Infections.","Inclusion Criteria:\n\n* Age ≥18 years.\n* Clinical diagnosis of hospital-acquired pneumonia or clinically relevant tracheobronchitis requiring antimicrobial treatment, with or without mechanical ventilation.\n* No respiratory cultures collected in the last 72 hours (except for the culture that will potentially be evaluated in the study-trigger for inclusion).\n* Agreement from the patient or legal representative to sign the Informed Consent Form (ICF).\n\nExclusion Criteria:\n\n* Inadequate respiratory samples according to laboratory cutoffs for squamous epithelial cells and polymorphonuclear leukocytes (sputum or endotracheal aspirate).\n* Incarcerated populations.\n* Pregnant women.",{"count":195,"type":21},150,[24],"Multidrug-resistant bacterial infections are a growing global health concern. Hospital-acquired pneumonia is one of the most common infections occurring during hospitalization and can be associated with high mortality, reaching up to 50% in severe cases. One of the main reasons for poor outcomes is the delay in starting the most appropriate antibiotic treatment.\n\nStandard laboratory methods used to identify the bacteria and determine which antibiotics are effective usually take between 48 and 96 hours to provide results. During this time, patients often receive broad-spectrum antibiotics, which may not be optimal and can contribute to antimicrobial resistance.\n\nRapid diagnostic tests, such as the BIOFIRE® FILMARRAY® Pneumonia Panel, can detect multiple bacteria and important resistance markers directly from respiratory samples in about one hour. These tests are already approved for use in Brazil and are easy to perform. Previous studies in patients with community-acquired pneumonia have shown that these rapid tests can help doctors choose more appropriate antibiotics earlier and may improve patient outcomes.\n\nHowever, their benefit has not been well studied in patients with hospital-acquired pneumonia, especially in settings where multidrug-resistant bacteria are common. In these situations, early and appropriate adjustment of antibiotic therapy is particularly important for improving outcomes and ensuring the responsible use of advanced antibiotics.\n\nThis study aims to compare the use of rapid diagnostic panels with standard laboratory methods in hospitalized patients with suspected pneumonia. The main focus is to evaluate how quickly and how appropriately antibiotic treatment can be adjusted after sample collection, using a structured scoring system, the Desirability of Outcome Ranking for the Management of Antimicrobial Therapy(DOOR-MAT), as well as to assess clinical outcomes.\n\nThe results of this study may help determine whether rapid diagnostic testing improves patient care in real-world hospital settings. The findings could support decision-making within the Brazilian Unified Health System (SUS) regarding the adoption of this technology, and may also contribute to future analyses of its cost-effectiveness.",[199],"Pneumonia - Bacterial",[201,202,203,204,205,206],"BIOFIRE® FILMARRAY®","Hospital-acquired pneumonia","Ventilator-associated pneumonia","DOOR-MAT","Antimicrobial resistance","Cost-effectiveness","2026-05-08",{"date":209,"type":40},"2026-05-14",{"date":211,"type":21},"2026-05-02",{"date":213,"type":21},"2027-06-02",{"name":46,"class":47},{"id":216,"slug":217,"hasResults":12,"nctId":218,"briefTitle":219,"officialTitle":220,"acronym":221,"eligibilityCriteria":222,"healthyVolunteers":12,"sex":18,"minAge":223,"maxAge":224,"enrollmentInfo":225,"targetDuration":4,"studyType":22,"phases":227,"briefSummary":228,"conditions":229,"keywords":4,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":237,"lastUpdatePostDateStruct":238,"startDateStruct":240,"completionDateStruct":242,"leadSponsor":243,"locationsCount":4},"100636629","ultrasound-guided-long-vs-short-peripheral-iv-catheters-in-neonates-with-congenital-syphilis-receiving-antibiotics-100636629","NCT07568171","Ultrasound-Guided Long vs Short Peripheral IV Catheters in Neonates With Congenital Syphilis Receiving Antibiotics","Ultrasound-Guided Long Peripheral Intravenous Catheters Versus Conventional Short Peripheral Catheters for Reducing Post-Insertion Failure in Neonates With Congenital Syphilis Receiving Antibiotic Therapy: A Randomized Clinical Trial","ULTRA-ACCESS","Inclusion Criteria:\n\n* Newborns admitted to the Neonatal Intermediate Care Unit;\n* Diagnosis of congenital syphilis;\n* Indication for intravenous penicillin therapy for an estimated duration of 10 days;\n* Enrollment on the first day of treatment.\n\nExclusion Criteria:\n\n* Newborns who have received any type of peripheral venous catheter prior to study enrollment;\n* Clinical instability at the time of vascular access indication and\u002For requirement for admission to a Neonatal Intensive Care Unit;\n* Requirement for concomitant administration of another antimicrobial agent in addition to crystalline penicillin;\n* Need for catheter insertion outside the operating hours of the Vascular Access Program (7:00 AM to 7:00 PM, Monday to Friday).","1 Day","28 Days",{"count":226,"type":21},104,[24],"Congenital syphilis in newborns requires intravenous antibiotic therapy, making reliable peripheral venous access essential. However, high rates of catheter failure and repeated punctures remain a significant clinical challenge. This randomized, controlled, parallel clinical trial aims to compare ultrasound-guided long peripheral intravenous catheters inserted by a specialized vascular access team with conventional short peripheral catheters inserted by neonatal nurses. A total of 104 newborns with congenital syphilis receiving intravenous penicillin will be randomly assigned to either group. The primary outcome is functional dwell time. Secondary outcomes include catheter failure, number of insertion attempts, first-attempt success, complications, and total number of devices required. The study hypothesizes that ultrasound-guided long peripheral catheters will improve vascular access outcomes, reduce complications, and minimize the need for repeated punctures.",[230,231,232,233,234,235,236],"Infant, Newborn","Syphilis, Congenital","Catheterization, Peripheral","Ultrasonography","Advanced Practice Nursing","Patient Safety","Neonatal Nursing","2026-05-06",{"date":239,"type":40},"2026-05-11",{"date":241,"type":21},"2026-05",{"date":135,"type":21},{"name":46,"class":47},{"id":245,"slug":246,"hasResults":12,"nctId":247,"briefTitle":248,"officialTitle":248,"acronym":249,"eligibilityCriteria":250,"healthyVolunteers":12,"sex":18,"minAge":145,"maxAge":4,"enrollmentInfo":251,"targetDuration":4,"studyType":22,"phases":253,"briefSummary":254,"conditions":255,"keywords":257,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":262,"lastUpdatePostDateStruct":263,"startDateStruct":265,"completionDateStruct":267,"leadSponsor":269,"locationsCount":83},"100634924","navigation-for-elderly-people-with-multiple-morbidity-after-hospital-discharge-100634924","NCT07546006","Navigation for Elderly People With Multiple Morbidity After Hospital Discharge.","NAVIM","Inclusion Criteria:\n\n* Elderly individuals aged 60 or older;\n* With confirmed multimorbidity documented in their medical records;\n* Hospitalized in the SUS (Unified Health System) clinical units (5th North, 6th North, and 7th North), regardless of specialty;\n* Who will be discharged home;\n* Have telephone access and have a primary caregiver responsible for assisting with communication, in cases where the elderly person is unable to respond for themselves.\n\nExclusion Criteria:\n\n* Elderly people hospitalized in restricted access clinical units (6th south), and those with private insurance or paying out-of-pocket (4th south);\n* Those transferred to another hospital service or to other institutions;\n* Patients who are already receiving or will receive navigation care or other safe discharge follow-up care;\n* Patients in palliative care.",{"count":252,"type":21},148,[24],"This research aims to create and test a tracking (navigation) model to assist in providing care guidance to elderly people (60 years or older) who have two or more chronic diseases at the same time (multimorbidity) immediately after being discharged from the hospital.",[256],"Multimorbidity",[258,259,256,260,261],"Aged","Patient Navigation.","Comprehensive Health Care","Geriatric Nursing","2026-04-15",{"date":264,"type":40},"2026-04-22",{"date":266,"type":21},"2026-06-01",{"date":268,"type":21},"2028-03-30",{"name":46,"class":47},{"id":271,"slug":272,"hasResults":12,"nctId":273,"briefTitle":274,"officialTitle":275,"acronym":4,"eligibilityCriteria":276,"healthyVolunteers":12,"sex":18,"minAge":56,"maxAge":277,"enrollmentInfo":278,"targetDuration":4,"studyType":22,"phases":280,"briefSummary":281,"conditions":282,"keywords":4,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":285,"lastUpdatePostDateStruct":286,"startDateStruct":288,"completionDateStruct":290,"leadSponsor":291,"locationsCount":83},"100552971","ipt-based-group-intervention-by-non-specialist-for-improvement-of-depressive-symptoms-in-community-young-adults-in-brazil-100552971","NCT06480019","IPT-based Group Intervention by Non-specialist for Improvement of Depressive Symptoms in Community Young Adults in Brazil","IPT-based Group Intervention by Non-specialist for Improvement of Depressive Symptoms in Community Young Adults in Brazil: a Randomized Clinical Trial","Inclusion Criteria:\n\n* Young adults (between 18 and 24 years old)\n* Young adults who work, live or study in Porto Alegre\n* PHQ ≥ 5 - without suicide ideation\n\nExclusion Criteria:\n\n* Maniac or hypomanic episode\n* Psychotic Syndrome\n* Substance Abuse\n* Suicide Risk or Ideation","24 Years",{"count":279,"type":21},50,[24],"Major depressive disorder is a highly prevalent, recurrent, and debilitating disease, the third cause of years of lost life in the world, and it may be the most common disease in 2030, according to the World Health Organization (WHO). Furthermore, it's also related to decreased quality of life and high mortality. Interpersonal psychotherapy (IPT) is a first-line treatment and can also be used for the prevention of depression.\n\nThis randomized controlled clinical trial is planned to have 50 participants randomized between an interventional and a control group (waiting list). Our study covers young adults (18 to 24 years old) with depression. Participants will be invited by social media to undergo treatment in an IPT group. The intervention group will be separated into groups with up to 10 participants, with a weekly meeting for eight weeks. The intervention will focus on interpersonal relationships within the model of IPT and will be held by a university student and a doctor trained in IPT.",[283,284],"Depression","Interpersonal Relations","2026-04-08",{"date":287,"type":40},"2026-04-13",{"date":289,"type":40},"2024-03-01",{"date":109,"type":21},{"name":46,"class":47},{"id":293,"slug":294,"hasResults":12,"nctId":295,"briefTitle":296,"officialTitle":297,"acronym":298,"eligibilityCriteria":299,"healthyVolunteers":12,"sex":18,"minAge":56,"maxAge":4,"enrollmentInfo":300,"targetDuration":4,"studyType":22,"phases":302,"briefSummary":304,"conditions":305,"keywords":4,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":307,"lastUpdatePostDateStruct":308,"startDateStruct":310,"completionDateStruct":312,"leadSponsor":314,"locationsCount":83},"100630582","phase-2-medication-withdrawal-in-stable-hf-with-improved-lvef-100630582","NCT07489547","Medication Withdrawal in Stable HF With Improved LVEF","Simplification of Treatment by Withdrawal of Medications in Stable Heart Failure With Improved Left Ventricular Ejection Fraction","SIMPLIFY-HF","Inclusion Criteria:\n\n* Diagnosis of heart failure (HF) and use of MRAs and an ACE inhibitor\u002FARB\u002FARNI for at least 12 months\n* Left ventricular ejection fraction (LVEF) ≥40%, improved from a prior value ≤35%, with a sustained absolute increase \\>10%\n* Left ventricular end-diastolic diameter within normal limits according to predefined criteria (≤59 mm for men and ≤53 mm for women)\n* NYHA functional class I or II\n* BNP levels \\\u003C100 pg\u002FmL, or NT-proBNP levels within age-adjusted thresholds: ≥450 pg\u002FmL for individuals \\\u003C50 years, ≥900 pg\u002FmL for those 50-75 years, and ≥1800 pg\u002FmL for individuals \\>75 years\n* In cases of atrial fibrillation, NT-proBNP thresholds should be doubled\n* Clinical stability defined as no hospitalizations or need for increased diuretic therapy due to congestion within the previous 12 months\n* Optimized heart failure medications with no modifications for at least 3 months\n* Maximum allowed dose of furosemide of 80 mg\u002Fday\n* Acceptable etiologies: HF following cardiac resynchronization therapy (CRT); non-ischemic HF after myocarditis; non-ischemic HF due to tachycardiomyopathy; non-ischemic HF due to alcoholic cardiomyopathy; non-ischemic HF due to cardiotoxicity; non-ischemic HF due to peripartum cardiomyopathy; non-ischemic HF after correction or intervention for valvular disease; ischemic HF after revascularization\n\nExclusion Criteria:\n\n* Acute coronary syndrome within the past 12 months\n* Arrhythmia requiring therapy within the past 12 months\n* Syncope or appropriate device therapy (if ICD present) within the past 12 months\n* Uncorrected moderate to severe valvular disease\n* Severe unrevascularized coronary artery disease, defined as \\>50% stenosis of the left main coronary artery (LMCA) or \\>70% stenosis of the left anterior descending artery (LAD), circumflex artery (LCx), or right coronary artery (RCA)",{"count":301,"type":21},90,[176,303],"PHASE3","The goal of this clinical trial is to evaluate the safety and feasibility of withdrawing mineralocorticoid antagonists (MRA) in patients with stable heart failure with improved left ventricular ejection fraction (HFimpEF). The main questions it aims to answer are:\n\nDoes withdrawal of MRAs lead to a reduction in left ventricular ejection fraction greater than 10%, resulting in a final LVEF below 40%? Does withdrawal of MRAs cause a relative increase in NT-proBNP levels greater than 50% above age-adjusted thresholds? Researchers will compare MRAs withdrawal (placebo) with continuation of therapy to determine whether medication withdrawal can be performed safely without worsening heart failure status.\n\nParticipants will:\n\nAttend scheduled clinical visits over a 24-week follow-up period; Undergo echocardiographic evaluation of left ventricular ejection fraction before study visits; Provide blood samples for NT-proBNP measurement at each visit; Provide one blood sample for genetic analysis of polymorphisms related to the renin-angiotensin-aldosterone system; Receive either continued MRA therapy or placebo as part of a double-blind randomized design; Be monitored for clinical stability, symptoms of heart failure, and potential adverse events during follow-up.",[306],"Heart Failure","2026-03-25",{"date":309,"type":40},"2026-03-30",{"date":311,"type":40},"2025-03-01",{"date":313,"type":21},"2026-12-31",{"name":46,"class":47},{"id":316,"slug":317,"hasResults":12,"nctId":318,"briefTitle":319,"officialTitle":320,"acronym":321,"eligibilityCriteria":322,"healthyVolunteers":12,"sex":18,"minAge":56,"maxAge":4,"enrollmentInfo":323,"targetDuration":4,"studyType":22,"phases":325,"briefSummary":326,"conditions":327,"keywords":334,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":341,"lastUpdatePostDateStruct":342,"startDateStruct":344,"completionDateStruct":346,"leadSponsor":347,"locationsCount":83},"100629059","phase-2-pocus-intervention-for-tailoring-diuretic-strategy-in-acute-decompensated-heart-failure-100629059","NCT07469722","POcus INTERvention for Tailoring Diuretic Strategy in Acute Decompensated Heart Failure","Point-of-care Ultrasound Intervention for Tailoring Diuretic Strategy in Acute Decompensated Heart Failure","POINTER-HF","Inclusion Criteria:\n\n* Men or women aged 18 years or older.\n* Diagnosis of acute decompensated heart failure (ADHF) with left ventricular ejection fraction \\\u003C50%, presenting with symptoms (dyspnea, orthopnea, fatigue) and\u002For signs (pulmonary crackles, peripheral edema, jugular venous distension, hepatomegaly, hepatojugular reflux) of decompensated heart failure.\n* Brain natriuretic peptide (BNP) ≥ 300 pg\u002FmL.\n* Signs of systemic and\u002For pulmonary congestion on POCUS, defined as DUCS ≥ 3 points.\n* Time from hospital admission ≤ 48 hours.\n* Signed informed consent.\n\nExclusion Criteria:\n\n* Patients under evaluation for heart transplantation or with prior heart transplantation.\n* Acute coronary syndrome as the primary cause of hospitalization.\n* Evidence of uncontrolled infection.\n* Cardiac surgery or percutaneous coronary or structural cardiac intervention within the previous 30 days.\n* Signs of hypoperfusion, defined as any of the following: mean arterial pressure \\\u003C 60 mmHg, capillary refill time \\> 4 seconds, arterial lactate \\> 2 mmol\u002FL or venous lactate \\> 2.5 mmol\u002FL.\n* Acute pulmonary embolism (segmental or more proximal) as the primary cause of hospitalization.\n* Acute stroke.\n* Chronic kidney disease stage 5 (estimated glomerular filtration rate \\\u003C 15 ml\u002Fmin\u002Fm²) or requirement for renal replacement therapy.\n* Liver cirrhosis with portal hypertension.\n* Known pulmonary disease with extensive parenchymal involvement, including interstitial lung disease, pulmonary metastases, prior pneumonectomy, lobectomy, or pleurodesis.\n* Severe hypokalemia (serum potassium \\\u003C 2.5 mmol\u002FL).\n* Pregnancy or breastfeeding.\n* Refusal to participate in the clinical trial.",{"count":324,"type":21},128,[176,303],"Acute decompensated heart failure (ADHF) is a frequent cause of hospitalization and is associated with high morbidity and mortality. Congestion is the primary pathophysiological mechanism leading to clinical deterioration and hospitalization in ADHF. Diuretics remain the cornerstone of treatment for most ADHF phenotypes; however, evidence regarding optimal strategies to guide diuretic therapy during the decongestion process is limited. Recently, point-of-care ultrasound (POCUS) has emerged as a promising tool to support clinical assessment in ADHF, improving diagnostic accuracy, prognostication, and pre-discharge evaluation. Nevertheless, the role of POCUS in guiding therapeutic management in ADHF remains uncertain. To specifically assess congestion in patients with ADHF, a pragmatic POCUS-based score, the Dynamic Ultrasound Congestion Score (DUCS), was developed. DUCS integrates lung ultrasound and Venous Excess Ultrasound (VExUS) to dynamically evaluate congestion severity, treatment response, and therapeutic goals during ADHF management. Observational data suggest that DUCS is associated with in-hospital outcomes and short-term prognosis, and correlates with markers of decongestion such as urinary output and weight loss. This study is a randomized, single-center, single-blind clinical trial designed to evaluate whether a DUCS-guided POCUS strategy improves clinical and decongestion outcomes compared with standard of care. Eligible patients hospitalized due to ADHF will be randomized within 48 hours of admission to one of two groups: (1) diuretic treatment guided by institutional standard-of-care combined with information from the EVEREST congestion score assessment and guideline-based treatment recommendations; or (2) diuretic treatment guided by serial DUCS-based POCUS assessments used to inform diuretic adjustment recommendations. Participants in both groups will undergo evaluations at baseline (day 1), day 2, day 3 and day 5, including clinical data collection, physical examination using the EVEREST congestion score, and standardized DUCS-based POCUS assessments. Outcomes to be assessed include in-hospital mortality, length of hospital stay, decongestion parameters, and changes in biomarkers.",[328,329,330,331,332,333],"Acute Heart Failure (AHF)","Congestive Heart Failure Acute","Diuretic Effect","Lung Ultrasonography Score","Ultrasonography, Doppler","Point-of-care Ultrasound (POCUS)",[335,336,337,338,339,340],"Acute Heart Failure","Congestive Heart Failure","Point-of-Care Ultrasound","Lung Ultrasound","Venous Excess Ultrasound","Diuretic","2026-03-16",{"date":343,"type":40},"2026-03-18",{"date":345,"type":21},"2026-03-23",{"date":185,"type":21},{"name":46,"class":47},{"id":349,"slug":350,"hasResults":12,"nctId":351,"briefTitle":352,"officialTitle":353,"acronym":4,"eligibilityCriteria":354,"healthyVolunteers":12,"sex":18,"minAge":4,"maxAge":4,"enrollmentInfo":355,"targetDuration":4,"studyType":22,"phases":357,"briefSummary":358,"conditions":359,"keywords":4,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":362,"lastUpdatePostDateStruct":363,"startDateStruct":365,"completionDateStruct":367,"leadSponsor":369,"locationsCount":83},"100594413","efficacy-of-artificial-intelligence-for-gatekeeping-in-referrals-to-specialized-care-100594413","NCT07019116","Efficacy of Artificial Intelligence for Gatekeeping in Referrals to Specialized Care","Efficacy of an Artificial Intelligence Algorithm for Gatekeeping in Referrals From Primary Care to Specialized Care: a Randomized Controlled Trial","Inclusion Criteria:\n\n* All referrals from a given specialty (waitlist) will be eligible.\n* Specialties will be selected following Rio Grande do Sul Health Department priorities.\n\nExclusion Criteria:\n\n* Referrals that the AI algorithm can not evaluate. These include referrals with attachments (further information in image or PDF files) and referrals with previous rounds of discussion.\n* Referrals in which the algorithm has low confidence in the decision (i.e., informed data lead to a decision with a probability below 80%) will not be included in the study.",{"count":356,"type":21},934,[24],"In Rio Grande do Sul, Brazil, the demand for specialty care referrals has increased sharply with the adoption of the electronic regulatory system, especially in rural areas. In 2023 alone, over 79,000 referrals were submitted monthly, totaling 1.7 million annual gatekeeping decisions. Due to workforce limitations, nearly 70% of referrals are authorized automatically, often without clinical validation. This leads to delays for high-risk patients, unnecessary specialist visits, and a growing backlog, currently over 172,000 pending referrals. To address this, an AI algorithm was developed to triage referrals based on urgency and appropriateness.\n\nThe investigators propose a prospective controlled study with randomized implementation of the AI tool across selected specialty queues in the electronic referral system. The population will consist of referrals from specialties waitlists from municipalities in Rio Grande do Sul. Specialties to be included will be selected by the State Health Department prospectively according to gatekeeping needs. The intervention will be an AI-based triage algorithm. The control will be a standard gatekeeping process. The primary outcome is the proportion of referrals with a final decision (authorized or redirected to primary care) within six months; secondary outcomes include time to decision and appointment, system-level performance metrics. Referrals will be randomly assigned to algorithmic or human gatekeeping with a 1:1 ratio. The algorithm classifies referrals into two groups: not authorized (pending more data or teleconsultation), authorized. Authorization cases are further divided into routine and high-risk referrals to help the manage demand. Each AI prediction provides a probability from 0 to 1 of authorization (or deferring). The implementation threshold is set at 0.8; cases below this level will be classified as low confidence for decision and will not be included. According to the State Health Department's decisions, several referral lines are expected to be selected for the intervention. A sample size 934 (467 per arm) for each included specialty was calculated to detect a 1.2 relative risk for the primary outcome with 90% power and 5% significance.",[360,361],"Primary Care","Primary Care Patients With Chronic Conditions","2026-02-19",{"date":364,"type":40},"2026-02-20",{"date":366,"type":40},"2025-11-15",{"date":368,"type":21},"2029-12",{"name":46,"class":47},{"id":371,"slug":372,"hasResults":12,"nctId":373,"briefTitle":374,"officialTitle":375,"acronym":4,"eligibilityCriteria":376,"healthyVolunteers":12,"sex":18,"minAge":56,"maxAge":172,"enrollmentInfo":377,"targetDuration":4,"studyType":22,"phases":379,"briefSummary":380,"conditions":381,"keywords":385,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":389,"lastUpdatePostDateStruct":390,"startDateStruct":392,"completionDateStruct":394,"leadSponsor":396,"locationsCount":83},"100493515","effect-of-partial-dietary-replacement-from-animal-to-plant-based-protein-for-type-2-diabetes-management-100493515","NCT05706155","Effect of Partial Dietary Replacement From Animal to Plant-Based Protein for Type 2 Diabetes Management","Effect of Partial Dietary Replacement From Animal to Plant-Based Protein for Type 2 Diabetes Management: A Randomized Clinical Trial","Inclusion Criteria:\n\n* Adults (≥18 and ≤65 years old)\n* Diagnosis of Type 2 Diabetes;\n* Glycated hemoglobin from 7% to 11%;\n* Overweight or obesity (BMI ≥25 kg\u002Fm² and \\\u003C40 kg\u002Fm²);\n* Use of any hypoglycemic and insulin;\n* Stable weight (maximum variation of approximately 5%) for at least 12 weeks before screening;\n* Not having undergone dietary intervention in the last 6 months;\n* Have the ability to understand and be able to adhere to intervention proposals;\n* Able and willing to provide an informed consent form for written and to comply with the requirements of the study protocol;\n\nExclusion Criteria:\n\n* Type 1 diabetes mellitus;\n* Retinopathy with vision deficit that limits the activities proposed in the interventions;\n* Chronic kidney disease with estimated glomerular filtration \\\u003C 30 mL\u002Fmin per 1.73m²;\n* Liver failure, chronic viral hepatitis;\n* Grade III or IV heart failure\n* Active or progressive neurodegenerative disease;\n* Prior stroke that has caused sequelae;\n* Use of medications that affect glucose metabolism (e.g. corticosteroids or immunosuppressants) or cause weight loss;\n* Chronic treatment with oral or parenteral corticosteroids (\\>7 days consecutive treatment) within 4 weeks prior to screening;\n* Treatment with weight-reducing agents (eg, orlistat, sibutramine, topiramate, bupropion, liraglutide, semaglutide) within the last 12 weeks before screening;\n* Treatment with thyroid hormone that was not maintained at a stable dose in last 12 weeks before screening;\n* History of active substance abuse (including alcohol) within the last year;\n* Thyroid Stimulating Hormone (TSH) outside the normal range;\n* Fasting triglycerides ≥ 600 mg\u002FdL;\n* Tumor diagnosed and\u002For treated (except basal cell skin cancer, carcinoma in situ of the cervix, or prostate cancer in situ) within the last 5 years;\n* Severe psychiatric illness;\n* Predisposition or diagnosis of eating disorders;\n* Women who are pregnant, intend to become pregnant during the study period, or who are currently breastfeeding;\n* Hyperglycemia characterized by acute symptoms: polyuria, polydipsia and\u002For weight loss in the last 3 months;\n* Metabolic and acute complications of diabetes such as ketoacidosis or hyperosmolar coma;\n* Potentially unreliable patients and those deemed by the investigator to be unsuitable for the study;\n* Night workers who work after 10pm;\n* Being on a vegetarian, vegan or flexitarian diet at the time of recruitment;\n* Having undergone bariatric surgery;\n* Carriers of the human immunodeficiency virus (HIV);\n* Any other medical condition\u002Fdisorder that the investigators consider that are likely to: interfere with the patient's ability to complete the entire study period or participate in study activities;\n* Participants who require any treatment that could affect the interpretation, reliability or safety of data during the study intervention.",{"count":378,"type":21},146,[24],"The goal of this clinical trial is to examine the effect plant-based diet, with a partial replacement of animal protein by plant protein, in blood sugar levels and other health risks of people with type 2 diabetes and excessive weight. The plant-based diet will be compared to a standard healthy diet according to guidelines for people with diabetes. Participants will follow a plant-based or a standard healthy diet for 24 weeks and will maintain their habitual levels of physical activity.",[382,383,384],"Type 2 Diabetes","Overweight","Obesity",[386,384,387,388],"Diabetes Mellitus","Plant-based Diet","Insulin Resistance","2026-01-26",{"date":391,"type":40},"2026-01-29",{"date":393,"type":40},"2022-11-01",{"date":395,"type":21},"2027-12-30",{"name":46,"class":47},{"id":398,"slug":399,"hasResults":12,"nctId":400,"briefTitle":401,"officialTitle":402,"acronym":403,"eligibilityCriteria":404,"healthyVolunteers":12,"sex":405,"minAge":56,"maxAge":406,"enrollmentInfo":407,"targetDuration":4,"studyType":22,"phases":409,"briefSummary":410,"conditions":411,"keywords":417,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":422,"lastUpdatePostDateStruct":423,"startDateStruct":425,"completionDateStruct":427,"leadSponsor":428,"locationsCount":83},"100608575","home-based-transcranial-direct-current-stimulation-tdcs-compared-to-duloxetine-non-inferiority-clinical-trial-fibrostim-100608575","NCT07203339","Home-based Transcranial Direct Current Stimulation (tDCS) Compared to Duloxetine: Non-inferiority Clinical Trial (FIBROSTIM)","Home-based Transcranial Direct Current Stimulation (tDCS) Compared to Duloxetine in the Treatment of Fibromyalgia: a Randomized Non-inferiority Clinical Trial (FIBROSTIM)","FIBROSTIM","Eligibility Criteria\n\nInclusion Criteria:\n\n* Woman aged between 18 and 75 years\n* Right-handed\n* Literate in reading and writing\n* Clinical diagnosis of fibromyalgia based on the American College of Rheumatology (ACR) 2010-2016 criteria\n* Numeric Pain Scale (NPS) score ≥ 4 on most days in the past 30 days\n* Agree no changes in medication dosage during the treatment period (except for analgesics)\n* Able to swallow tablets\n* Able to understand instructions for using tDCS at home\n\nExclusion Criteria:\n\n* Living more than 250 km from Porto Alegre\n* Pregnancy\n* Decompensated systemic diseases\n* Chronic inflammatory rheumatologic diseases\n* Untreated hypothyroidism\n* Active cancer under treatment\n* Alcohol or drug abuse in the past 6 months\n* Decompensated psychiatric disorders with suicide risk and a defined plan\n* Use of duloxetine at a dose \\> 60 mg\u002Fday\n* Metal implants in the brain\n* Implanted brain medical devices\n* Cardiac pacemaker\n* Cochlear implant\n* Neurological disorders\n* History of traumatic brain injury or neurosurgery","FEMALE","75 Years",{"count":408,"type":21},610,[24],"Fibromyalgia is characterized by widespread pain, fatigue, non-restorative sleep, and psychocognitive alterations, compromising quality of life and leading to absenteeism and early retirement. Up to 70% of patients discontinue treatment with antidepressants and anticonvulsants due to adverse effects or low efficacy, and more than 30% resort to opioid use. Given the treatment challenges and the scarcity of safe alternatives, there is growing interest in interventions such as transcranial direct current stimulation (tDCS), which has shown efficacy in improving symptoms and functionality, with low cost and few side effects. In this context, we designed a randomized, double-blind, double-dummy clinical trial to compare the non-inferiority of 28 home-based anodal tDCS (2 mA) applied over the primary motor cortex (M1) versus duloxetine 60 mg. Both treatments will be combined with physical exercise and pain education. Outcomes will be assessed through multidimensional measures of pain, functionality, global impression of improvement, and the function of the descending pain inhibitory system. Secondary outcomes include quality of life, depressive symptoms, psychophysical pain measures, and treatment adherence. An additional analysis will compare the results of sham tDCS and duloxetine placebo within the non-inferiority model. Predictors of treatment response will also be explored, including symptom severity and oscillatory patterns of cortical electrical activity, rest-activity rhythm, and autonomic function assessed by R-R interval. Furthermore, serum levels of S100-B protein, brain-derived neurotrophic factor (BDNF), and genetic variants related to neuroplasticity in the BDNF Val66Met, Catechol-O-Methyltransferase (COMT) (rs4680) (G\\>A), OPRM1, and PER2 genes will be analyzed. Inflammatory markers (TNF-α, IL-1, IL-2, IL-6, IL-10, C-reactive protein) and serum endorphins will also be assessed. A total of 610 women with fibromyalgia (aged 18 to 75 years) will be randomized into three groups (2:2:1): duloxetine + sham tDCS (n=244); active tDCS + placebo (n=244); and sham tDCS + placebo (n=122). Participants will be assessed during treatment and at 3, 6, and 12 months after completing the intervention protocol. An interim analysis will be conducted when \\~50% of participants (n ≈ 305) complete the 3-month follow-up by an independent, blinded Data Monitoring Committee (DMC). (i) The trial may be stopped if the conditional probability of demonstrating non-inferiority is \\\u003C10%, based on frequentist or Bayesian methods. (i) The trial will be stopped if serious adverse events (SAEs) in the active tDCS group increase by ≥30% compared to duloxetine (p \\\u003C 0.01, adjusted). (ii) Early stopping for efficacy will be considered if active tDCS demonstrates clear non-inferiority or superiority over duloxetine on the primary outcome. Superiority requires: (iii) a clinically relevant difference exceeding the non-inferiority margin (≥10% pain reduction); (ii) statistical significance (p \\\u003C 0.005, O'Brien-Fleming adjusted); and (iii) a ≥2-point (20%) improvement on the BPI, confirmed in the ITT analysis. This study aims to generate evidence to support the decision-making process of the National Committee for Health Technology Incorporation (CONITEC) regarding the availability of tDCS in the Brazilian Unified Health System (SUS). In addition, identifying predictors of response to tDCS and duloxetine, through the integration of genetic, neurophysiological, inflammatory, and psychosocial markers using machine learning algorithms, will allow for identifying factors that can personalize fibromyalgia treatment. This approach enhances clinical efficacy, reduces costs associated with ineffective interventions, and supports more accurate therapeutic decisions, expanding access to safe, effective, and sustainable care within the public healthcare system",[412,413,414,415,416],"Fibromyalgia (FM)","tDCS","Duloxetine","BDNF","EEG",[418,419,414,420,421],"Fibromyalgia","Transcranial Direct Current Stimulation","Biomarkers","Precision Medicine","2025-12-31",{"date":424,"type":40},"2026-01-06",{"date":426,"type":40},"2025-09-30",{"date":135,"type":21},{"name":46,"class":47},{"id":430,"slug":431,"hasResults":12,"nctId":432,"briefTitle":433,"officialTitle":434,"acronym":4,"eligibilityCriteria":435,"healthyVolunteers":12,"sex":405,"minAge":56,"maxAge":4,"enrollmentInfo":436,"targetDuration":4,"studyType":22,"phases":437,"briefSummary":438,"conditions":439,"keywords":4,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":442,"lastUpdatePostDateStruct":443,"startDateStruct":445,"completionDateStruct":447,"leadSponsor":449,"locationsCount":83},"100535006","from-prevention-to-treatment-how-biological-rhythms-can-maintain-perinatal-mental-health-100535006","NCT06246214","From Prevention to Treatment: How Biological Rhythms Can Maintain Perinatal Mental Health","Innovations in Biological Rhythms in the Context of Mental Health: Effectiveness of New Technologies and Exposure to Different Lighting Patterns in Women During the Postpartum Period","Inclusion Criteria:\n\n* 4-6 weeks postpartum;\n* Postnatal depression confirmed through Edinburgh Postnatal Depression Scale (EPDS) \\> 10;\n* Mini-International Neuropsychiatric Interview (M.I.N.I.) positive for current depressive episode.\n\nExclusion Criteria:\n\n* Active suicidal ideation;\n* Psychotic symptoms;\n* Unstable general medical conditions that interfere with the acquisition of actigraphy;\n* Newborn with severe health conditions (hospitalization, care in the neonatal ICU).",{"count":195,"type":21},[24],"Depression and anxiety are significant public health issues during pregnancy and the postnatal period, particularly affecting those in developing countries. Disruptions in biological rhythms, sleep problems, and low exposure to daylight are associated with a higher risk of these mental health issues. The perinatal period poses unique challenges to the temporal program, with evidence indicating that sleep disturbances significantly increase the risk of postnatal depression. A Randomised Clinical Trial (RCT) is being conducted to assess the effectiveness of Blue Light Therapy (BlueLT) in treating depressive and anxiety symptoms during the postpartum. The RCT will also investigate the alignment of rest-activity and internal body time as mediating factors. This study will focus on various chronobiological factors, including rest-activity rhythms, light exposure levels, temperature rhythms, sleep duration and phase, social jetlag, and BodyTime (assessed through a single blood sample). The goal is to recruit 50 women with postpartum depression, with 25 in the BlueLT intervention group and 25 in the ControlLT placebo group, alongside 100 healthy controls. The BlueLT device uses a short-wavelength LED lamp mainly composed by a wavelength peak on blue spectrum, while the ControlLT device has a dim long-wavelength LED. A Healthy Control group will also be included to account for changes unrelated to depression diagnosis or placebo\u002Ftreatment effects. Exclusion criteria involve a history of major depressive or anxiety disorder, current psychotic disorder, night shift work, active suicidal thoughts, unstable medical conditions interfering with data collection, and newborns with severe health conditions. The study aims to evaluate the impact of BlueLT on postpartum depression and understand the role of chronobiological factors in the health\u002Fdisease process.",[440,441],"Depression, Postpartum","Anxiety State","2025-11-25",{"date":444,"type":40},"2025-12-03",{"date":446,"type":40},"2024-01-04",{"date":448,"type":21},"2027-05",{"name":46,"class":47},{"id":451,"slug":452,"hasResults":12,"nctId":453,"briefTitle":454,"officialTitle":455,"acronym":456,"eligibilityCriteria":457,"healthyVolunteers":12,"sex":18,"minAge":56,"maxAge":4,"enrollmentInfo":458,"targetDuration":460,"studyType":121,"phases":4,"briefSummary":461,"conditions":462,"keywords":465,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":473,"lastUpdatePostDateStruct":474,"startDateStruct":476,"completionDateStruct":478,"leadSponsor":480,"locationsCount":4},"100613253","tracheal-cuff-pressure-and-postoperative-complications-a-prospective-observational-study-100613253","NCT07264179","Tracheal Cuff Pressure and Postoperative Complications: A Prospective Observational Study.","Tracheal Cuff Pressure and Postoperative Complications: Prospective Observational Study.","TCP-POC","Inclusion Criteria:\n\n* Age greater than 18 years.\n* Patients scheduled for elective procedures requiring general anesthesia and orotracheal intubation.\n\nExclusion Criteria:\n\n* Age less than 18 years.\n* Refusal to participate in the study.\n* Surgeries performed on an urgent or emergency basis.\n* Surgeries in pregnant women.\n* Cardiac surgeries.\n* Surgeries requiring single-lung ventilation.\n* Head and neck surgeries.\n* Surgeries on the cervical segment of the dorsal spine.\n* Surgeries requiring lateral or prone positioning.\n* Anticipated difficult airway (unanticipated difficult airways will be included).\n* Insufficient fasting time.\n* Surgeries in patients admitted to intensive care units.\n* Patients presenting the same symptoms included in the outcomes to be measured (pre-existing hoarseness, pain, cough, hemoptysis).\n* Tracheostomized patients or those with previous tracheobronchial segment lesions.",{"count":459,"type":21},362,"30 Days","This prospective observational study aims to identify risk factors for tracheal mucosal injuries caused by orotracheal tube use during the intraoperative period in patients undergoing elective surgeries at the Hospital de Clínicas de Porto Alegre. The study will recruit patients sequentially for elective procedures requiring general anesthesia and orotracheal intubation. Primary outcomes include symptoms such as hoarseness, pharyngolaryngeal pain, cough, and hemoptysis, assessed up to 30 days post-surgery. A risk score for tracheal injuries will be derived.",[463,464],"Tracheal Intubation","Postoperative Complications (Cardiopulmonary)",[466,467,468,469,470,471,472],"Tracheal cuff pressure","Tracheal mucosal lesions","Cough","Orotracheal tube","Postoperative hoarseness","Pharyngolaryngeal pain","Hemoptysis","2025-11-24",{"date":475,"type":40},"2025-12-04",{"date":477,"type":21},"2026-01-05",{"date":479,"type":21},"2029-04-30",{"name":46,"class":47},{"id":482,"slug":483,"hasResults":12,"nctId":484,"briefTitle":485,"officialTitle":486,"acronym":487,"eligibilityCriteria":488,"healthyVolunteers":12,"sex":18,"minAge":56,"maxAge":4,"enrollmentInfo":489,"targetDuration":4,"studyType":22,"phases":491,"briefSummary":492,"conditions":493,"keywords":495,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":499,"lastUpdatePostDateStruct":500,"startDateStruct":502,"completionDateStruct":504,"leadSponsor":506,"locationsCount":83},"100611153","artificial-intelligence-for-diagnosing-diabetic-retinopathy-in-primary-care-100611153","NCT07236879","Artificial Intelligence for Diagnosing Diabetic Retinopathy in Primary Care","Effects of Artificial Intelligence-based Diabetic Retinopathy Screening on Timely Access to Treatment in Individuals With Diabetes","AID-DR","Inclusion Criteria:\n\n* Adults (\\> 18 years old) diagnosed with diabetes mellitus who agree to participate in the study.\n\nExclusion Criteria:\n\n* Any contraindication for pharmacological mydriasis (such as knowledge of having closed-angle glaucoma, pregnancy).\n* Life expectancy less than 6 months",{"count":490,"type":21},922,[24],"This is a clinical trial to evaluate the effects of universal screening for diabetic retinopathy (DR) and diabetic macular edema (DME) using artificial intelligence (AI) in the interpretation of fundus photographs obtained by trained nursing assistant using a portable fundus camera in a primary care setting, compared with images obtained by the same method, but interpreted by ophthalmologists.",[494],"Diabetic Retinopathy",[496,497,498],"screening","diabetic retinopathy","artificial intelligence","2025-11-17",{"date":501,"type":40},"2025-11-19",{"date":503,"type":40},"2024-08-08",{"date":505,"type":21},"2026-12",{"name":46,"class":47},{"id":508,"slug":509,"hasResults":12,"nctId":510,"briefTitle":511,"officialTitle":512,"acronym":513,"eligibilityCriteria":514,"healthyVolunteers":12,"sex":18,"minAge":515,"maxAge":516,"enrollmentInfo":517,"targetDuration":4,"studyType":22,"phases":519,"briefSummary":520,"conditions":521,"keywords":523,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":530,"lastUpdatePostDateStruct":531,"startDateStruct":533,"completionDateStruct":535,"leadSponsor":537,"locationsCount":83},"100429587","phase-2-taurine-effect-on-glycemic-lipidic-and-inflammatory-profile-in-individuals-with-type-2-diabetes-100429587","NCT04874012","Taurine Effect on Glycemic, Lipidic and Inflammatory Profile in Individuals With Type 2 Diabetes","Effect of Taurine on Glycemic, Lipid and Inflammatory Profile in Individuals With Type 2 Diabetes: a Randomized Clinical Trial","TAUGLIP-DM2","Inclusion criteria\n\n* Female and male individuals, with clinical diagnosis of DM2 for at least 6 months;\n* Age over 30 years;\n* BMC equal to or above 18.5 kg\u002Fm2, without weight change in the last 3 months;\n* HbA1c between 7.5% and 10.5%.\n\nExclusion criteria\n\n* Use of herbal supplements, antioxidants, and multivitamins in the last 3 months;\n* Pregnancy or lactation;\n* Chronic renal failure with glomerular filtration rate calculated by MDRD \\\u003C 30 mL\u002Fh;\n* Myocardial infarction in the last than 6 months\n* Current neoplasia;\n* Chronic use of glucocorticoids;\n* Bariatric surgery.","30 Years","80 Years",{"count":518,"type":21},94,[176],"Type 2 diabetes mellitus (DM2) is characterized by chronic hyperglycemia, which is a risk factor for comorbidities and death. Although conventional pharmacotherapy is effective, some individuals do not reach the glycemic targets, requiring adjuvant therapies. Taurine is a semi-essential amino acid with antioxidant and osmoregulatory properties, commonly used as a nutritional supplement. Pre-clinical studies show its effectiveness in reducing blood glucose and cholesterol, but there are no well-conducted clinical studies evaluating the effect of taurine on glycated hemoglobin. Additionally, animal models showed that taurine had a protective effect from diabetic nephropathy. The hypothesize of this study is that taurine administration improves the glycemic, lipid, inflammatory, and anthropometric parameters in DM2 individuals.",[522],"Diabetes Mellitus, Type 2",[524,525,526,527,528,529],"taurine","inflammation","glucose metabolism disorders","glycated hemoglobin","diabetes mellitus, type 2","amino acids","2025-09-15",{"date":532,"type":40},"2025-09-19",{"date":534,"type":40},"2021-06-12",{"date":536,"type":21},"2025-12",{"name":46,"class":47},{"id":539,"slug":540,"hasResults":12,"nctId":541,"briefTitle":542,"officialTitle":543,"acronym":544,"eligibilityCriteria":545,"healthyVolunteers":12,"sex":18,"minAge":56,"maxAge":4,"enrollmentInfo":546,"targetDuration":4,"studyType":22,"phases":548,"briefSummary":549,"conditions":550,"keywords":553,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":559,"lastUpdatePostDateStruct":560,"startDateStruct":562,"completionDateStruct":564,"leadSponsor":566,"locationsCount":83},"100589339","general-versus-regional-anesthesia-in-peripheral-arterial-surgery-100589339","NCT06953128","General Versus Regional Anesthesia in Peripheral Arterial Surgery","Impact of General Versus Regional Anesthesia on the Incidence of Postoperative Pulmonary Complications in Peripheral Arterial Surgery: a Multicenter Randomized Clinical Trial","GENERA","Inclusion Criteria:\n\n* Adults aged ≥18 years\n* ASA physical status II to IV\n* Scheduled for elective peripheral arterial revascularization of the lower limbs\n* Diagnosis of symptomatic peripheral arterial disease with critical limb ischemia\n* Able and willing to provide informed consent\n\nExclusion Criteria:\n\n* Body mass index (BMI) \\> 40 kg\u002Fm²\n* Emergency vascular surgery\n* History of lung resection surgery\n* Persistent hemodynamic instability preoperatively\n* History of bronchial asthma or chronic corticosteroid therapy\n* History of neuromuscular disorders\n* Current use of anticoagulants or antiplatelet agents contraindicating spinal anesthesia\n* Contraindications to spinal anesthesia (e.g., patient refusal, infection at puncture site, increased intracranial pressure, inability to cooperate due to agitation or cognitive impairment)\n* Acute vascular obstruction or other vascular complications not consistent with elective revascularization",{"count":547,"type":21},594,[24],"This multicenter, prospective, randomized clinical trial aims to compare the effects of spinal (neuraxial) anesthesia with spontaneous ventilation versus general anesthesia with mechanical ventilation on the incidence of postoperative pulmonary complications in adult patients undergoing elective lower limb revascularization surgery. A total of 594 patients with symptomatic peripheral arterial disease will be randomly assigned to receive either spinal anesthesia with sedation or general anesthesia with mechanical ventilation. The primary outcome is the incidence of postoperative pulmonary complications within 30 days or until hospital discharge, including pneumonia, respiratory failure, pleural effusion, atelectasis, and other defined respiratory events. Secondary outcomes include cardiovascular events, hemodynamic instability, renal injury, delirium, extrapulmonary complications, adverse events in the operated limb, ICU and hospital length of stay, and mortality. The study will be conducted at Hospital de Clínicas de Porto Alegre, Hospital Nossa Senhora da Conceição, and other participating Brazilian centers, with an expected start date in July 2025 and completion in December 2029.",[551,552],"Postoperative Complications","Cardiovascular Diseases",[554,555,556,557,558],"Postoperative Pulmonary Complications","Peripheral Arterial Disease","Spinal Anesthesia","General Anesthesia","Vascular Surgery","2025-06-23",{"date":561,"type":40},"2025-06-26",{"date":563,"type":21},"2025-07-01",{"date":565,"type":21},"2028-06-30",{"name":46,"class":47},{"id":568,"slug":569,"hasResults":12,"nctId":570,"briefTitle":571,"officialTitle":572,"acronym":4,"eligibilityCriteria":573,"healthyVolunteers":12,"sex":405,"minAge":56,"maxAge":574,"enrollmentInfo":575,"targetDuration":4,"studyType":22,"phases":577,"briefSummary":578,"conditions":579,"keywords":4,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":584,"lastUpdatePostDateStruct":585,"startDateStruct":587,"completionDateStruct":589,"leadSponsor":590,"locationsCount":83},"100591333","health-education-for-women-with-suspeced-infertility-waiting-for-specialized-care-100591333","NCT06979063","Health Education for Women With Suspeced Infertility Waiting for Specialized Care","Impact of Regulation Strategies and Health Education for Managing Infertility in Primary Health Care in Rio Grande do Sul","Inclusion Criteria:\n\n* Individuals referred to specialized infertility care in Porto Alegre.\n* Age up to 33 years and 11 months.\n\nExclusion Criteria:\n\n* Lack of access to the internet or telephone.\n* Prior specialized infertility treatment in the private healthcare system.","34 Years",{"count":576,"type":21},206,[24],"Introduction: Infertility is defined as a couple's inability to achieve pregnancy after 12 months or more of regular unprotected intercourse. In Brazil, it affects around eight million people. While health services provide resources for contraception, little attention is given to supporting conception and preserving fertility.\n\nObjective: To evaluate the effectiveness of a remote educational and counseling intervention on infertility.\n\nMethod: Open-label randomized clinical trial. Couples referred for infertility will be identified in the electronic referral system. For inclusion, the woman of the couple must be 34 years old or less, no previous in-vitro fertilization attempts, and have access to telephone or internet. The control group will follow standard care, awaiting in-person consultation. The intervention group will also wait for in-person evaluation but receive additional education and counseling via video call.\n\nThe primary outcome is the proportion of correct referrals according to local protocols. A total of 206 participants will be included to detect a difference between success rates of 50% and 30%, with 80% power and a 5% significance level.",[580,581,582,583],"Infertility","Health Education","Telemedicine","Telehealth","2025-05-12",{"date":586,"type":40},"2025-05-18",{"date":588,"type":21},"2025-06",{"date":313,"type":21},{"name":46,"class":47},{"id":592,"slug":593,"hasResults":12,"nctId":594,"briefTitle":595,"officialTitle":596,"acronym":4,"eligibilityCriteria":597,"healthyVolunteers":12,"sex":18,"minAge":56,"maxAge":172,"enrollmentInfo":598,"targetDuration":4,"studyType":22,"phases":600,"briefSummary":601,"conditions":602,"keywords":605,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":610,"lastUpdatePostDateStruct":611,"startDateStruct":613,"completionDateStruct":615,"leadSponsor":617,"locationsCount":83},"100587924","meal-frequency-and-glycemic-control-in-individuals-with-type-1-diabetes-100587924","NCT06934707","Meal Frequency and Glycemic Control in Individuals With Type 1 Diabetes","Meal Frequency, Glycemic Control and Variability in Individuals With Type 1 Diabetes: a Randomized Crossover Clinical Trial","Inclusion Criteria:\n\n* • Adults (18 to 60 years old) with a medical diagnosis of type 1 diabetes mellitus\n\n  * Individuals who perform carbohydrate counting\n  * Individuals diagnosed \\> 12 months ago\n  * Perform daily glycemic control using a blood glucose monitor or use of a glucose sensor\n  * Have the ability to understand and be able to adhere to the proposed interventions.\n  * Complete a detailed 3-day food record for one week prior to the intervention and record episodes of hypoglycemia (\\\u003C70 mg\u002FdL) and hyperglycemia (\\>180 mg\u002FdL)\n  * Able and willing to provide written informed consent and comply with the requirements of the study protocol.\n\nExclusion Criteria:\n\n* Individuals with glycated hemoglobin ≥ 11%\n* Individuals who are using NPH insulin\n* Retinopathy with vision deficit that limits the activities proposed in the disciplines.\n* Individuals with gastrointestinal disease such as celiac disease, Crohn's disease and Irritable Bowel Syndrome (IBS)\n* History of bariatric surgery\n* That you are following a carbohydrate, protein and\u002For fat restriction diet\n* Individuals with BMI ≥ 40kg\u002Fm2\n* Chronic kidney disease with estimated glomerular filtration \\\u003C30mL\u002Fmin per 1.73 m2.\n* Liver failure or chronic viral hepatitis\n* Active or progressive neurodegenerative disease\n* Use of medications that affect glucose metabolism (corticosteroids and immunosuppressants) or cause weight loss. ● Treatment with weight-reducing agents (e.g., orlistat, sibutramine, topiramate, liraglutide) in the last 12 weeks prior to screening.\n* Treatment with thyroid hormone that has not been maintained at a stable dose in the last 12 weeks prior to screening.\n* History of active substance abuse (including alcohol) in the last year.\n* Serious psychiatric illness: Mood disorders, anxiety disorders, severe psychotic disorders, and personality disorders that are revealed or identified in the clinical evaluation, listed or reported in the medical record, and that have no clinical findings.\n* Predisposition to or diagnosis of eating disorders.\n* Women who are pregnant, intending to become pregnant during the study period, or who are breastfeeding.\n* Hyperglycemia characterized by acute symptoms: polyuria, polydipsia, and\u002For weight loss in the last 3 months. ● Metabolic and acute complications of diabetes such as ketoacidosis or hyperosmolar coma.\n* Night workers who work after 10 pm.",{"count":599,"type":21},27,[24],"The goal of this clinical trial is to examine the effect of 3 versus 6 daily meals of isocaloric diets on glycemic control and variability in individuals with type 1 diabetes. Participants will be randomized in a crossover clinical trial and will receive two different types of isocaloric diet interventions, in 3 meals\u002Fday (calorie distribution: 30% at breakfast, 40% at lunch and 30% at dinner) or 6 meals\u002Fday (calorie distribution: 20% at breakfast, 10% at morning snack, 30% at lunch, 10% at afternoon snack, 25% at dinner and 5% at evening snack), for three weeks, with a 4-week washout period between diets.",[603,70,604],"Type 1 Diabetes (T1D)","Glycemic Control for Diabetes Mellitus",[606,607,608,609],"type 1 Diabetes","glycemic control","diet","meal frequency","2025-04-11",{"date":612,"type":40},"2025-04-18",{"date":614,"type":21},"2025-04-20",{"date":616,"type":21},"2027-12-29",{"name":46,"class":47},{"id":619,"slug":620,"hasResults":12,"nctId":621,"briefTitle":622,"officialTitle":623,"acronym":624,"eligibilityCriteria":625,"healthyVolunteers":12,"sex":18,"minAge":56,"maxAge":4,"enrollmentInfo":626,"targetDuration":4,"studyType":22,"phases":628,"briefSummary":629,"conditions":630,"keywords":632,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":636,"lastUpdatePostDateStruct":637,"startDateStruct":639,"completionDateStruct":640,"leadSponsor":642,"locationsCount":83},"100586879","use-of-a-tongue-strength-training-device-and-its-relationship-with-speech-in-patients-with-parkinsons-disease-100586879","NCT06921122","Use Of A Tongue Strength Training Device And Its Relationship With Speech In Patients With Parkinson's Disease","Use Of The Iowa Oral Performance Instrument In Speech Therapy Intervention In Individuals With Parkinson's Disease: Randomized Clinical Trial","IOPI","Inclusion Criteria:\n\n* All individuals with an age greater than or equal to 18 years who have been diagnosed with idiopathic PD attended at the Movement Disorders Outpatient and at the Speech Therapy Outpatient Degenerative Adult of a quaternary health care hospital.\n* Who will participate in the project entitled Validation and applicability of the Test of Mastication and Swallowing Solids (TOMASS) for the Brazilian population with Parkinson's disease approved under No. 2023-0402.\n\nExclusion Criteria:\n\n* Subjects who are not currently off the medication;\n* Those whose serious alterations of language and cognition are unable to perform the proposed tasks;\n* Those with other neurological conditions will be excluded.",{"count":627,"type":21},60,[24],"Parkinson's Disease affects the brain and causes several movement problems. These problems include stiff muscles, slow movements, shaking when resting, and trouble keeping balance. As the disease gets worse, it can also affect how people speak.\n\nDoctors and therapists have found better ways to test how Parkinson's affects speech. There's one special therapy method that's considered the best for helping people with Parkinson's speak better. Now, they're also using a new tool called IOPI (Iowa Oral Performance Instrument) to help test and treat speech problems.\n\nThis research project wants to see if using IOPI can help people with Parkinson's speak better. Here's how they'll do it:\n\nFirst, they'll split people with Parkinson's into two groups randomly. Everyone will take speech tests, like:\n\nHolding an \"a\" sound as long as they can; Saying \"pataka\" repeatedly; Counting from 1 to 15; Reading sentences; Speaking freely about a topic; They'll also measure how strong their tongue is using IOPI. Then, one group will get therapy using the IOPI tool, while the other group won't. After the therapy is done, they'll test everyone again to see if the IOPI therapy helped improve their speech.\n\nThe researchers hope this study will show that IOPI is a helpful new tool for speech therapy, giving therapists more ways to help people with Parkinson's speak better.",[631],"Parkinson Disease (PD)",[633,634,624,635,631],"Dysarhria","Speech Therapy","Intervention","2025-04-03",{"date":638,"type":40},"2025-04-10",{"date":638,"type":21},{"date":641,"type":21},"2028-06-01",{"name":46,"class":47},{"id":644,"slug":645,"hasResults":12,"nctId":646,"briefTitle":647,"officialTitle":648,"acronym":4,"eligibilityCriteria":649,"healthyVolunteers":12,"sex":18,"minAge":4,"maxAge":650,"enrollmentInfo":651,"targetDuration":4,"studyType":22,"phases":652,"briefSummary":654,"conditions":655,"keywords":4,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":659,"lastUpdatePostDateStruct":660,"startDateStruct":662,"completionDateStruct":664,"leadSponsor":666,"locationsCount":83},"100474164","phase-4-the-caffeine-therapy-in-the-fetal-to-neonatal-transition-100474164","NCT05454332","The Caffeine Therapy in the Fetal to Neonatal Transition","The Caffeine Therapy in the Fetal to Neonatal Transition in Preterms","Inclusion Criteria:\n\n* Premature newborns with birth weight less than 1250 grams\n* Who are not intubated in the delivery room\n\nExclusion Criteria:\n\n* Premature newborns from other hospitals\n* Presence of a major congenital malformation or genetic syndrome","2 Hours",{"count":279,"type":21},[653],"PHASE4","Introduction: The caffeine is used in the treatment for apnea of prematurity and it has several positive effects in the neurodevelopment of preterm babies. There are innumerable observational studies suggesting that initiating caffeine in the first hours of life may offer more benefits in the reduction of the necessity of intubation and in ventilation time. It is necessary to expand further research on the best time to start caffeine, which may improve the quality of care for premature infants.\n\nObjective: To evaluate the benefits of caffeine administration in the first two hours of life compared to administration at 24 hours of life in premature patients on noninvasive mechanical ventilation with birth weights less than 1250 grams.\n\nMethodology: Preterm newborn patients with birth weight \\\u003C 1250 grams born at Hospital de Clínicas de Porto Alegre who are not intubated in the delivery room will be included. Patients will be randomized into two groups. One arm of the study will receive caffeine at 2 hours of age and the other arm will receive caffeine at 24 hours of age (control). Patients in the control group will receive 0.9% SF at 2 hours of life in order to keep the study blinded. The following outcomes will be evaluated: need for intubation, time on invasive and non-invasive mechanical ventilation, BPD, necrotizing enterocolitis, need for ROP treatment, PDA with hemodynamic repercussions, peri-intraventricular hemorrhage, leukomalacia and death. The sample size calculation is 50 patients, 25 in each arm.\n\nExpected Results: It is expected to find a 43% reduction in the need for intubation in preterm infants who receive caffeine in the first two hours of life compared to administration at 24 hours of life. It is also expected to find a reduction in mechanical ventilation time, in addition to a possible reduction in negative outcomes associated with prematurity.",[656,657,658],"Mechanical Ventilation Complication","Caffeine","Ventilator Lung; Newborn","2025-03-27",{"date":661,"type":40},"2025-04-02",{"date":663,"type":40},"2022-04-27",{"date":665,"type":21},"2026-08-30",{"name":46,"class":47},{"id":668,"slug":669,"hasResults":12,"nctId":670,"briefTitle":671,"officialTitle":672,"acronym":4,"eligibilityCriteria":673,"healthyVolunteers":12,"sex":18,"minAge":4,"maxAge":4,"enrollmentInfo":674,"targetDuration":4,"studyType":22,"phases":676,"briefSummary":677,"conditions":678,"keywords":679,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":688,"lastUpdatePostDateStruct":689,"startDateStruct":691,"completionDateStruct":693,"leadSponsor":695,"locationsCount":696},"100485217","effect-of-nutrition-education-groups-in-the-treatment-of-patients-with-type-2-diabetes-100485217","NCT05598203","Effect of Nutrition Education Groups in the Treatment of Patients with Type 2 Diabetes","Effect of Nutritional Education Groups Added in the Usual Care of Outpatients with Type 2 Diabetes: a Randomized Clinical Trial","Inclusion Criteria:\n\n\\- Adult patients with a previous diagnosis of type 2 diabetes mellitus\n\nExclusion Criteria:\n\n* Patients with other types of diabetes\n* With HbA1C within the therapeutic target or with values greater than 12%\n* Severe neuropathy\n* Chronic kidney disease \\[glomerular filtration rate \\\u003C30mL\u002Fmin\u002F1.73m²\\]\n* Life expectancy \\\u003C6 months\n* Chemical dependence\u002Falcoholism or use of antipsychotics\n* Autoimmune disease or chronic steroid use\n* Gastroparesis\n* Pregnant or lactating women\n* Patients who have had an Episode of Acute Coronary Syndrome (ACS) in the last 60 days\n* Wheelchair users\n* Cognitive, neurological or psychiatric condition",{"count":675,"type":21},252,[24],"Every year there is an increase in people with diabetes all over the world. Because it is a disease associated with several comorbidities and is increasing, there is a need for more effective treatments. Lifestyle changes combined with medication are the best strategies for the treatment and reduction of comorbidities. Therefore, the present study posits the hypothesis that the integration of nutritional education groups into standard treatment, within a nutrition-specialized outpatient clinic, may yield additional enhancements in health parameters among patients diagnosed with type 2 diabetes. The driving force behind this research lies in the pursuit of more effective strategies to enhance glycemic control, diminish the risk of complications, and elevate the overall quality of life for these patients. Our motivation stems from a commitment to base our interventions on scientific evidence and strive towards meaningful improvements in diabetes management outcomes. A randomized clinical trial will be conducted with adult patients with a previous diagnosis of type 2 diabetes. Patients will be divided into two groups (intervention: nutritional education added the usual care; and control: usual care). The outcomes analyzed will be: glycemic control, lipid profile, body mass and dynapenia obesity, blood pressure values, eating behavior, diabetes complications and adherence to recommendations.",[522],[680,681,682,683,684,685,686,687],"Glycated Hemoglobin A","Food and Nutrition Education","Feeding Behavior","Diabetes Complications","Body Mass Index","Lipids","Blood Pressure","Outcome Assessment, Health Care","2025-03-13",{"date":690,"type":40},"2025-03-18",{"date":692,"type":40},"2022-09-06",{"date":694,"type":21},"2025-10-30",{"name":46,"class":47},2,""]