The purpose of this research is to treat disseminated actinic porokeratosis (DSAP) with cholesterol/lovastatin or lovastatin alone. The goal of treatment is to decrease (DSAP) lesions after 12 weeks of treatment and compare which treatment is best.
The study is single-blinded and randomized, meaning the patients will not be told of which treatment they will receive, and the decision of which treatment they will receive will be completely random. The patient will also agree to close up photographs and clinical photographs taken of their disseminated actinic porokeratosis at the initial visit. At weeks 4, 8, and 12, the patients will complete a virtual visit. The subject will take a picture (phone camera/digital camera) of their lesions/skin markings with a measuring instrument. These photos will be shared with the investigators. Physical exam, photographs, and a review of of the subjects medical records will occur in the study. Changes in size, appearance, and pain will be monitored throughout the study.
The possible benefit of joining this study is that the treatment received may be more effective than the other study treatment or than other available treatments for DSAP, although this cannot be guaranteed.
ATHN 9 is a natural history study to assess the safety of various Von Willebrand Factor (VWF) regimens for different indications (on-demand, surgery and prophylaxis) in adult and pediatric participants with clinically severe congenital VWD.
Spinal cord stimulation (SCS) therapy is currently used to treat the symptoms of chronic pain. Studying the effect of SCS during muscle testing, proprioception testing and multiple gait analysis, we expect to gain understanding of exactly how SCS influences motor and sensory pathways of the spinal cord. We expect this approach to broaden our understanding in the application of SCS in the chronic pain conditions, and may lead to therapeutic advances in other populations, for example, patients with spinal cord injury.
The purpose of this study is to determine whether a new medical technology can help reduce post-operative total knee or hip pain when combined with a Cognitive-Behavioral intervention (CBI).
This new medical technology, is called transcranial direct current stimulation (tDCS), it uses a very small amount of electricity to temporarily stimulate specific areas of the brain thought to be involved in pain reduction. The electrical current passes through the skin, scalp, hair, and skull and requires no additional medication, sedation, or needles.
This study will investigate the effects of tDCS, the Cognitive-Behavioral (CB) intervention and their combination on pain among veterans following total knee arthroplasty (TKA) or total hip arthroplasty (THA). You may benefit in the form of decreased pain and opioid requirements following your knee or hip replacement surgery. However, benefit is only likely if you are randomized to one of the 3 (out of 4) groups.
This study hopes to determine the effects of these interventions and their combined effect on post-operative pain, opioid use and functioning during the 48-hour post-operative period following a total knee or hip replacement.
Sickle Cell Disease (SCD) is an inherited disease that can cause sudden and severe pain. Pain management involves the use of analgesic medications. Often, providers are reluctant to follow evidence-based guidelines fo analgesic treatment for various reasons and some patients with SCD perceive they are treated differently from other patients. To understand the causes and solutions for this potential discordance, the first step is establishing a way to measure concordance of perceptions within the fast paced Emergency Department (ED) environment. The purpose of this study is to determine the feasibility of developing a process to measure concordance of perceptions between the patient with SCD and their ED provider after an interaction in the ED.
Youth with one or more chronic diseases are at increased risk of further complications, disease, or even early death as they enter their adult years. Recent increases in both asthma and obesity among youth have led to high health care utilization, increased health-related complications, and expanded risks of subsequent cardiovascular disease burden. The research team will develop educational content in core areas (e.g., fatigue, physical activity) for Managing AsThma AnD Obesity Related Symptoms (MATADORS), an mHealth technology-enhanced nurse-guided intervention. Youth with asthma and obesity and their primary caregivers will participate in interviews to explore their perspectives on barriers, facilitators, needs, and preferences toward adopting health behaviors, medication adherence, disease awareness, symptom self-management behaviors, and utilization of a mobile smartphone platform. Additional details on content availability, delivery approaches, system needs, and functionality will be explored through semi-structured interview questions. Health care providers (physicians, nurses, nurse practitioners, dietitians, and respiratory and exercise therapists) will be invited to participate in interviews to seek their input on patient-caregiver needs, priority clinical focal areas, recommendations for symptom self-management, and preferences for intervention delivery. Interview findings will be used to inform intervention and app design. Providing youth with strategies to enhance symptom self-management may result in decreased symptom prevalence, improved quality of life, and long-term reduction of cardiovascular morbidity and mortality as they move into adulthood.
Chronic pancreatitis is a scarring condition of the pancreas that often results in debilitating pain. When pancreatic duct drainage appears to be impaired by the presence of a blocking stone or scar tissue, pancreatic endotherapy (procedures performed through the mouth using a lighted tube with special instruments to enter the pancreatic duct) is often offered in clinical practice. The rationale for this study is that while pancreatic endotherapy is logical, there are limited studies to suggest it helps patients with their pain. Furthermore, these procedures are costly and have potential risks. This is a preliminary study to perform the first sham (like a placebo) study of pancreatic endotherapy in patients with chronic pancreatitis and evidence of impaired pancreatic duct drainage by radiology scans.
The objectives of this study are to: 1) determine the feasibility of a sham-controlled pancreatic endotherapy trial, and 2) optimize enrollment criteria and outcome measures for a subsequent, definitive study.
Under this study, we would like to collect specimens from CP patients who will undergo pancreatic resection at the VA Hospital for in vitro experiments. In these experiments, we will determine whether immune cells from CP patients are different from cells from healthy donors purchased from ATCC or other commercial sources. We will then assess whether pre-culture of immune cells from CP patients with MSCs can shift them to less pro-inflammatory phenotypes that won't induce inflammation in neuronal cells. All studies will be done in vitro in the cell culture system. Exploring mechanisms that contribute to chronic pain is vital for veterans' health and VA healthcare.