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Epidemiology of Silent and Overt Strokes in Sickle Cell Disease
Anemia, Sickle Cell
Sickle Cell Disease
Stroke
Sickle Cell Thalassemia
Sickle Cell-Beta0-Thalassemia
Sickle Cell Disease (SCD) is a rare disease occurring in an estimated 100,000
individuals, often poor and underserved, in the US. Silent and overt strokes contribute
significantly to morbidity in adults with SCD, resulting in functional impairment,
challenges with school and job performance, and pr1 expand
Sickle Cell Disease (SCD) is a rare disease occurring in an estimated 100,000 individuals, often poor and underserved, in the US. Silent and overt strokes contribute significantly to morbidity in adults with SCD, resulting in functional impairment, challenges with school and job performance, and premature death. Five NIH-funded randomized controlled trials have identified therapies to prevent silent and overt strokes in children with SCD, including monthly blood transfusion therapy (for preventing initial and recurrent strokes) and hydroxyurea (for preventing initial strokes). Despite the observation that at least 99% of children with SCD in high-income countries reach adulthood, and approximately 60% of adults will experience one or more strokes (~50% with silent strokes and ~10% with overt strokes), no stroke trials have established therapeutic approaches for adults with SCD. For adults with SCD, inadequate evidence-based guidelines exist for secondary stroke prevention strategies. Applying stroke prevention strategies in children may not be effective for stroke prevention in adults with SCD, particularly given the high rate of co-morbidities. Identifying subgroups of adults with SCD and higher incidence coupled with the contribution of established stroke risk factors in the general population (smoking, diabetes, obesity, renal disease) will provide the requisite data required for the first-ever phase III clinical trials focused on secondary stroke prevention in adults. Type: Observational Start Date: Jun 2017 |
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Neuroblastoma Maintenance Therapy Trial
Neuroblastoma
Difluoromethylornithine (DFMO) will be used in an open label, single agent, multicenter,
study for patients with neuroblastoma in remission. In this study subjects will receive
730 Days of oral difluoromethylornithine (DFMO) at a dose of 750 mg/m2 ± 250 mg/m2 BID
(strata 1, 2, 3, and 4) OR 2500 mg/1 expand
Difluoromethylornithine (DFMO) will be used in an open label, single agent, multicenter, study for patients with neuroblastoma in remission. In this study subjects will receive 730 Days of oral difluoromethylornithine (DFMO) at a dose of 750 mg/m2 ± 250 mg/m2 BID (strata 1, 2, 3, and 4) OR 2500 mg/m2 BID (stratum 1B) on each day of study. This study will focus on the use of DFMO in high risk neuroblastoma patients that are in remission as a strategy to prevent recurrence. Type: Interventional Start Date: Feb 2016 |
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A Phase II/III Trial of Nivolumab, Ipilimumab, and GM-CSF in Patients With Advanced Melanoma
Stage III Cutaneous Melanoma AJCC v7
Stage IV Cutaneous Melanoma AJCC v6 and v7
This phase II/III trial studies the side effects of nivolumab and ipilimumab when given
together with or without sargramostim and to see how well they work in treating patients
with stage III-IV melanoma that cannot be removed by surgery (unresectable) and that may
have spread from where it first s1 expand
This phase II/III trial studies the side effects of nivolumab and ipilimumab when given together with or without sargramostim and to see how well they work in treating patients with stage III-IV melanoma that cannot be removed by surgery (unresectable) and that may have spread from where it first started to nearby tissue, lymph nodes, or distant parts of the body (advanced). Immunotherapy with monoclonal antibodies, such as ipilimumab and nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Colony-stimulating factors, such as sargramostim, may increase the production of white blood cells. It is not yet known whether nivolumab and ipilimumab are more effective with or without sargramostim in treating patients with melanoma. Type: Interventional Start Date: Nov 2015 |
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Hormonal, Metabolic, and Signaling Interactions in PAH
Idiopathic Pulmonary Arterial Hypertension
Heritable Pulmonary Arterial Hypertension
Scleroderma Associated Pulmonary Arterial Hypertension
Appetite Suppressant Associate PAH
Our hypothesis is that optimal treatment of the dysfunctional metabolic pathways which
underlie PAH will improve pulmonary vascular function and consequences of the disease. expand
Our hypothesis is that optimal treatment of the dysfunctional metabolic pathways which underlie PAH will improve pulmonary vascular function and consequences of the disease. Type: Observational Start Date: Sep 2012 |
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Effect of Rose Odor Exposure on Ictal Apnea
Epilepsy
Sudden Unexpected Death in Epilepsy
This study will investigate the potential benefits of rose scent in reducing the risk of
Sudden Unexpected Death in Epilepsy (SUDEP) in patients with epilepsy. Participants will
engage in their routine inpatient observational EEG monitoring for 24 hours followed by
an additional 24 hours of observa1 expand
This study will investigate the potential benefits of rose scent in reducing the risk of Sudden Unexpected Death in Epilepsy (SUDEP) in patients with epilepsy. Participants will engage in their routine inpatient observational EEG monitoring for 24 hours followed by an additional 24 hours of observational EEG monitoring with continuous exposure to rose scent, during which an essential oil diffusor with rose scent will be placed in their hospital room. During these 48 total hours of the study, participants will wear a respiratory monitoring belt across their upper chest to measure their breathing. Potential risks include distress or discomfort when smelling the rose scent used in the study, a physical reaction to the rose scent, and discomfort or feelings of restrictiveness when wearing the respiratory monitoring belt. The total time commitment of the study is 48 consecutive hours over the course of the participants' inpatient EMU stay, during which there will be no restrictions on daily activities during the standard inpatient EMU admission except that participants must wear their respiratory belt for a majority of this 2-day period. Type: Interventional Start Date: Jul 2025 |
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VoiceLove: An App-Based COMMunication Tool Designed to Address DeliriUm and Improve Family ENgageme1
Critical Illness
Intensive Care Medicine
VoiceLove is a phone application allowing family and patients to share information in a
secure platform. This project will compare the VoiceLove app to usual care to learn about
whether VoiceLove improves patient-family communication, family engagement, and ICU
delirium. expand
VoiceLove is a phone application allowing family and patients to share information in a secure platform. This project will compare the VoiceLove app to usual care to learn about whether VoiceLove improves patient-family communication, family engagement, and ICU delirium. Type: Interventional Start Date: Aug 2025 |
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A Combined Biomarker Model for Risk Stratification of Indeterminate Pulmonary Nodules
Pulmonary Nodule
This is a prospective, multicenter observational study aim at estimating the potential
clinical utility of the CBM and at establishing the SOPs and protocols for a future
randomized control trial. expand
This is a prospective, multicenter observational study aim at estimating the potential clinical utility of the CBM and at establishing the SOPs and protocols for a future randomized control trial. Type: Observational Start Date: Mar 2024 |
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Observational Study for Patients at Risk for Chronic Graft-Versus-Host Disease
cGVHD
The purpose of this prospective observational study is to collect data from participants
who have recently had an allogenic Stem Cell Transplant(alloSCT) and are at risk of
Chronic Graft Versus Host Disease(cGVHD) expand
The purpose of this prospective observational study is to collect data from participants who have recently had an allogenic Stem Cell Transplant(alloSCT) and are at risk of Chronic Graft Versus Host Disease(cGVHD) Type: Observational Start Date: Aug 2023 |
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Study of SGR-3515 In Participants With Advanced Solid Tumors.
Advanced Solid Tumor
The purpose of this study is to learn about the effects of a new study drug, called
SGR-3515 that may be a treatment for advanced solid tumors. expand
The purpose of this study is to learn about the effects of a new study drug, called SGR-3515 that may be a treatment for advanced solid tumors. Type: Interventional Start Date: Jun 2024 |
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Telehealth-enhanced Patient-oriented Recovery Trajectory After Intensive Care
Post-intensive Care Syndrome
Intact cognitive skills are necessary for independent living, going to work, and managing
finances, and any loss of cognitive skills places a burden on society akin to what is
seen with Alzheimer's Disease and Related Dementias. The TelePORT Study
(Telehealth-Enhanced Patient-Oriented Recovery Traj1 expand
Intact cognitive skills are necessary for independent living, going to work, and managing finances, and any loss of cognitive skills places a burden on society akin to what is seen with Alzheimer's Disease and Related Dementias. The TelePORT Study (Telehealth-Enhanced Patient-Oriented Recovery Trajectories after Intensive Care) is the first post-intensive care syndrome longitudinal long-term cognitive impairment intervention study. The societal effect from long-term cognitive impairment after critical illness is great as many of these patients are employable adults or functional retirees. Type: Interventional Start Date: Mar 2024 |
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Paclitaxel Coated Balloon for the Treatment of Chronic bEnigN sTricture- Bowel
Bowel; Stricture
To determine the safety and efficacy of GIE Medical's ProTractX3™ TTS DCB for the
treatment of recurrent benign bowel strictures. expand
To determine the safety and efficacy of GIE Medical's ProTractX3™ TTS DCB for the treatment of recurrent benign bowel strictures. Type: Interventional Start Date: Nov 2023 |
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Use of Accelerometer for Quantification of Neurogenic Orthostatic Hypotension Symptoms
Orthostatic; Hypotension, Neurogenic
Autonomic Failure
Pure Autonomic Failure
Multiple System Atrophy
Orthostatic; Hypotension, Parkinsonism
The objective of this study is to find a more objective and accurate way to assess the
efficacy of the treatment for neurogenic orthostatic hypotension. For this purpose, the
investigators will use an activity monitor to determine the amount of time patients spend
in the upright position (standing1 expand
The objective of this study is to find a more objective and accurate way to assess the efficacy of the treatment for neurogenic orthostatic hypotension. For this purpose, the investigators will use an activity monitor to determine the amount of time patients spend in the upright position (standing and walking; upright time) during 1 week of placebo (a pill with no active ingredients) and 1 week of their regular medication for orthostatic hypotension (midodrine or atomoxetine at their usual doses). Total upright time (i.e. tolerance to standing and walking) will be compared between placebo and active treatment to test the hypothesis that it can be used to assess the efficacy of the treatment for orthostatic hypotension and whether this outcome is superior to the assessment of symptoms using validated questionnaires. Type: Interventional Start Date: Feb 2021 |
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The ExTINGUISH Trial of Inebilizumab in NMDAR Encephalitis
Autoimmune Encephalitis
Encephalitis
Determine the difference in the modified Rankin score at 16 weeks in participants with
anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis treated with "first-line"
immunomodulatory therapies provided as standard-of-care, and either inebilizumab
(investigational agent) or placebo. expand
Determine the difference in the modified Rankin score at 16 weeks in participants with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis treated with "first-line" immunomodulatory therapies provided as standard-of-care, and either inebilizumab (investigational agent) or placebo. Type: Interventional Start Date: Mar 2022 |
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Utility of PCD Diagnostics to Improve Clinical Care
Primary Ciliary Dyskinesia
This is a study evaluating the utility of current Primary Ciliary Dyskinesia (PCD)
diagnostic tests, including nasal nitric oxide testing. expand
This is a study evaluating the utility of current Primary Ciliary Dyskinesia (PCD) diagnostic tests, including nasal nitric oxide testing. Type: Interventional Start Date: Jun 2017 |
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Natural History Study of Synucleinopathies
Patients With Synucleinopathies
Neurogenic Orthostatic Hypotension
Pure Autonomic Failure
REM Sleep Behavior Disorder
Parkinson Disease
Synucleinopathies are a group of rare diseases associated with worsening neurological
deficits and the abnormal accumulation of the protein α-synuclein in the nervous system.
Onset is usually in late adulthood at age 50 or older. Usually, synucleinopathies present
clinically with slowness of moveme1 expand
Synucleinopathies are a group of rare diseases associated with worsening neurological deficits and the abnormal accumulation of the protein α-synuclein in the nervous system. Onset is usually in late adulthood at age 50 or older. Usually, synucleinopathies present clinically with slowness of movement, coordination difficulties or mild cognitive impairment. Development of these features indicates that abnormal alpha-synuclein deposits have destroyed key areas of the brain involved in the control of movement or cognition. Patients with synucleinopathies and signs of CNS-deficits are frequently diagnosed with Parkinson disease (PD), dementia with Lewy bodies (DLB) or multiple system atrophy (MSA). However, accumulation of alpha-synuclein and death of nerve cells can also begin outside the brain in the autonomic nerves. In such cases, syncucleinopathies present first with symptoms of autonomic impairment (unexplained constipation, urinary difficulties, and sexual dysfunction). In rare cases, hypotension on standing (a disorder known as orthostatic hypotension) may be the only clinical finding. This "pre-motor" autonomic stage suggests that the disease process may not yet have spread to the brain. After a variable period of time, but usually within 5-years, most patients with abnormally low blood pressure on standing develop cognitive or motor abnormalities. This stepwise evolution indicates that the disease spreads from the body to the brain. Another indication of this spread is that acting out dreams (i.e., REM sleep behavior disorder, RBD) a problem that occurs when the lower part of the brain is affected, may also be the first noticeable sign of Parkinson disease. The purpose of this study is to document the clinical features and biological markers of patients with synucleinopathies and better understand how these disorders evolve over time. The study will involve following patients diagnosed with a synucleinopathy (PD/DLB and MSA) and those believed to be in the "pre-motor" stage (with isolated autonomic impairment and/or RBD). Through a careful series of follow-up visits to participating Centers, we will focus on finding biological clues that predict which patients will develop motor/cognitive problems and which ones have the resilience to keep the disease at bay preventing spread to the brain. We will also define the natural history of MSA - the most aggressive of the synucleinopathies. Type: Observational Start Date: Jun 2011 |
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A Study to Evaluate the Effect of Aficamten in Pediatric Patients With Symptomatic Obstructive Hype1
Pediatric
Symptomatic Obstructive Hypertrophic Cardiomyopathy
The purpose of this study is to evaluate the efficacy, safety and PK of aficamten in a
pediatric population with symptomatic obstructive hypertrophic cardiomyopathy (oHCM). expand
The purpose of this study is to evaluate the efficacy, safety and PK of aficamten in a pediatric population with symptomatic obstructive hypertrophic cardiomyopathy (oHCM). Type: Interventional Start Date: May 2024 |
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Evexomostat Plus PI3K or AKT Inhibitor and Fulvestrant in Patients With a PI3K Alteration and HR+/H1
HR+/HER2-negative Breast Cancer
Metastatic Breast Cancer
This is a Phase 1b/2, open-label, parallel-arms pilot study in men and post-menopausal
women with hormone receptor positive (HR+), HER2- advanced or metastatic breast cancer
with an alteration in the PI3K pathway, including a mutation of the PIK3CA gene, PTEN
loss, or AKT1 mutation, designed to det1 expand
This is a Phase 1b/2, open-label, parallel-arms pilot study in men and post-menopausal women with hormone receptor positive (HR+), HER2- advanced or metastatic breast cancer with an alteration in the PI3K pathway, including a mutation of the PIK3CA gene, PTEN loss, or AKT1 mutation, designed to determine the safety of evexomostat (SDX-7320) plus standard of care treatment alpelisib (BYL-719) or capivasertib and fulvestrant (each combined, the 'triplet therapy'), to measure the severity and number of hyperglycemic events, and to assess clinical, anti-tumor benefit of the triplet therapy. The purpose of this study is: - to characterize the safety of the triplet drug combination consisting of either alpelisib or capivasertib (per the treating oncologist's choice) and fulvestrant plus evexomostat, - to test whether evexomostat, when given in combination with either alpelisib or capivasertib and fulvestrant will reduce the number and severity of hyperglycemic events and/or reduce the number or dose of anti-diabetic medications needed to control the hyperglycemia for metabolically normal patients and those deemed at risk for capivasertib and alpelisib-induced hyperglycemia (insulin resistance, as measured by HOMA-IR, baseline elevated HbA1c or well-controlled type 2 diabetes), and - to assess preliminary anti-tumor efficacy for each combination and changes in key biomarkers and quality of life in this patient population. Type: Interventional Start Date: Aug 2022 |
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Augmented Pacing for Shock in the Cardiac Intensive Care Unit
Cardiogenic Shock
Bradycardia
Shock
The goal of this clinical trial is to learn if backup pacing at an increased rate
improves hemodynamics in adults with relative bradycardia, a permanent pacemaker, and
cardiogenic shock. The main question it aims to answer is:
Does increasing the backup pacing rate to 100 beats per minute lead to1 expand
The goal of this clinical trial is to learn if backup pacing at an increased rate improves hemodynamics in adults with relative bradycardia, a permanent pacemaker, and cardiogenic shock. The main question it aims to answer is: Does increasing the backup pacing rate to 100 beats per minute lead to improved cardiac index compared to a backup pacing rate of 75 beats per minute Participants who are already hospitalized in the Cardiovascular Intensive Care Unit with a permanent pacemaker and pulmonary artery catheter in place will be enrolled in this study. Participants will be exposed to each pacemaker rate in a randomized order with hemodynamics assessed after 10 minutes at each rate. Type: Interventional Start Date: Apr 2025 |
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Comparing Healthcare Visit Recording and Open Notes to Improve Chronic iLlness Care Experience in O1
Diabetes Mellitus
Hypertension
CHRONICLE is a randomized trial assessing the comparative effectiveness of providing
written visit information via the patient portal (NOTES) versus NOTES plus visit audio
recording (AUDIO) to older adult patients with chronic diseases on quality of life and
other outcomes. During the trial, the te1 expand
CHRONICLE is a randomized trial assessing the comparative effectiveness of providing written visit information via the patient portal (NOTES) versus NOTES plus visit audio recording (AUDIO) to older adult patients with chronic diseases on quality of life and other outcomes. During the trial, the team will also invite caregivers identified by patients to join the project. Type: Interventional Start Date: Jan 2024 |
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Reciprocal Imitation Training and Musical Rhythm Sensitivity in Autistic Toddlers
Autism
Autism Spectrum Disorder
The primary goal of this study is to examine rhythm sensitivity as a predictor of
response to naturalistic developmental behavioral intervention (NDBIs) in autistic
toddlers. Toddlers receive either Reciprocal Imitation Training (RIT), an evidence-based
NDBI that supports children's imitation and s1 expand
The primary goal of this study is to examine rhythm sensitivity as a predictor of response to naturalistic developmental behavioral intervention (NDBIs) in autistic toddlers. Toddlers receive either Reciprocal Imitation Training (RIT), an evidence-based NDBI that supports children's imitation and social communication skills, or a music-enhanced version of RIT. Throughout their participation in the intervention, toddlers will complete study procedures of viewing naturalistic videos of infant-directed singing and other social scenes while eye gaze data is collected. Type: Interventional Start Date: Jul 2023 |
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Tranexamic Acid in Rhinoplasty: Perioperative Bleeding, Edema and Ecchymosis
Surgery
Postoperative Blood Loss
This study will be a prospective randomized study to evaluate the effect of tranexamic
acid (TXA) use on intraoperative and postoperative outcomes among patients undergoing
rhinoplasty by two Facial Plastic surgeons at Vanderbilt. Outcomes will include intra-
and post-operative bleeding and postope1 expand
This study will be a prospective randomized study to evaluate the effect of tranexamic acid (TXA) use on intraoperative and postoperative outcomes among patients undergoing rhinoplasty by two Facial Plastic surgeons at Vanderbilt. Outcomes will include intra- and post-operative bleeding and postoperative bruising and swelling. Type: Interventional Start Date: Apr 2023 |
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3D Specimen Maps for RT Planning
Head and Neck Cancer
Head and Neck Squamous Cell Carcinoma
Radiation Therapy
The primary objective of this study is to measure the impact of patient-specific 3D
specimen maps on adjuvant radiation treatment volumes and doses to critical organs. All
patients will receive standard-of-care post-operative radiotherapy not impacted by the
experimental 3D specimen maps. The secon1 expand
The primary objective of this study is to measure the impact of patient-specific 3D specimen maps on adjuvant radiation treatment volumes and doses to critical organs. All patients will receive standard-of-care post-operative radiotherapy not impacted by the experimental 3D specimen maps. The secondary objective is to demonstrate the feasibility of incorporating 3D specimen mapping tools into post-operative communication, and to determine if utilization of the 3D specimen map improves post-operative communication between surgeons, pathologists, and radiation oncologists. Type: Observational Start Date: Jan 2023 |
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Longitudinal Impact of Stressors in Adults With Tourette Syndrome
Tourette Syndrome
The Investigators propose a two-year, longitudinal pilot study of TS adults (>18) to
determine impact of lifetime environmental stress exposure on tic severity, psychiatric
comorbidity severity, and health-related quality of life (HRQOL). expand
The Investigators propose a two-year, longitudinal pilot study of TS adults (>18) to determine impact of lifetime environmental stress exposure on tic severity, psychiatric comorbidity severity, and health-related quality of life (HRQOL). Type: Observational Start Date: Sep 2021 |
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Bio-Integrative, Fiber-Reinforced Kneebar for Treating Subchondral Insufficiency of the Knee
Subchondral Insufficiency Fracture
The OSSIOfiber® Trimmable Fixation Nails are indicated for maintenance of alignment and
fixation of bone fractures, osteotomies, arthrodesis and bone grafts in the presence of
appropriate additional immobilization (e.g., rigid fixation implants, cast, brace). Our
hypothesis is that the use of OSSIO1 expand
The OSSIOfiber® Trimmable Fixation Nails are indicated for maintenance of alignment and fixation of bone fractures, osteotomies, arthrodesis and bone grafts in the presence of appropriate additional immobilization (e.g., rigid fixation implants, cast, brace). Our hypothesis is that the use of OSSIOfiber® Trimmable Fixation Nails for treating subchondral insufficiency of the knee will result in improvement of patient-reported outcomes and imaging findings. The primary objective of this study is to evaluate the effectiveness of implanting bio-integrative OSSIOfiber® Trimmable Fixation Nails, organized in a bi-cortical rafter formation within the tibia or femur for the management of subchondral insufficiency. The OSSIOfiber® Trimmable Fixation Nails used in this study will be considered on-label. Type: Interventional Start Date: Mar 2025 |
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Low-Dose Total Skin Electron Therapy in Treating Patients With Refractory or Relapsed Stage IB-IIIA1
Recurrent Mycosis Fungoides
Refractory Mycosis Fungoides
Stage I Mycosis Fungoides
Stage II Mycosis Fungoides
Stage III Mycosis Fungoides
This clinical trial studies low- dose total skin electron therapy in treating patients
with stage IB-IIIA mycosis fungoides that has not responded to previous treatment
(refractory) or has returned after a period of improvement (relapsed). Radiation therapy
uses high energy electrons to kill tumor1 expand
This clinical trial studies low- dose total skin electron therapy in treating patients with stage IB-IIIA mycosis fungoides that has not responded to previous treatment (refractory) or has returned after a period of improvement (relapsed). Radiation therapy uses high energy electrons to kill tumor cells and shrink tumors. Rotisserie technique is a method in which the patient receives total skin electron therapy while standing on a rotating platform. Giving low dose total skin electron therapy using rotisserie technique may kill tumor cells, while having fewer side effects, and may allow therapy to be repeated in future if clinically indicated. Type: Observational Start Date: May 2016 |