We will determine if aerobic exercise (AEx) and/or repetitive transcranial magnetic stimulation (rTMS) are effective in treating symptoms of depression following stroke. This project is based on the idea that depression negatively affects the brain so that it doesn't change in the same way following treatment, the result being less effective recovery. We believe that effective treatment for depression will help improve how the brain in people with depression responds to other types of treatment. That is, effectively treating depression will enable individuals to better recover other forms of function following their stroke.
This study will enroll two groups of participants. The first group are those who participated in the RADIANCE CAP study, so have already undergone the renal denervation procedure. Those participants can enroll in this post approval study which will entail yearly follow up visits or telephone calls, blood pressure monitoring and questionnaires. The second group of participants are those scheduled to undergo a procedure called renal denervation for the treatment of high blood pressure that has not responded adequately to medications and lifestyle changes. Renal denervation is a procedure which uses a catheter (thin hollow tube) placed in the renal arteries (blood vessels that go to the kidneys) to deliver ultrasound energy. This energy will heat up a small area of tissue around the renal arteries to disable nerves that are surrounding the blood vessels as a way to help reduce blood pressure. Study visits include screening, procedure, discharge, months 1, 3, 6 and 12 then yearly for up to 5 years. Study procedures for this group includes blood work and urine studies, blood pressure monitoring, questionnaires, a follow up ultrasound of your kidneys and the blood vessels around the kidneys. Study related risks include loss of confidentiality, blood draw risks and unknown risks.
This study is looking at people who have recently had a heart transplant to see if a simple blood test can help doctors better understand how the immune system is doing. By checking tiny molecules called microRNAs in the blood, researchers hope to find a way to tell if a patient might have problems like infection or rejection of their new heart. The goal is to help adjust medications so patients stay healthier after their transplant. The study involves taking blood samples during regular doctor visits over three years, but it doesn't change any of the usual care the patients would already get.
This study is enrolling participants with symptomatic ATTR-CM (transthyretin amyloidosis cardiomyopathy). ATTR-CM is a rare and serious disease that occurs when a protein in the blood called transthyretin (TTR) builds up throughout the body, including in the heart and nerves. When the abnormal protein, known as amyloid, deposits in the heart, the heart muscle thickens and stiffens, causing the heart to fail. This research study is designed to test whether the medication nucresiran is safe and helps people with ATTR-CM, in comparison to the effects of placebo.
Nucresiran is considered investigational, meaning it is not currently approved by the U.S. Food and Drug Administration (FDA) for the treatment of ATTR-CM. Nucresiran is a TTR silencer. It is like a "quiet button" that turns down the amount of the disease-causing protein that is made. Because there is less TTR, there may be less buildup in the heart and other organs over time.
This is a randomized study meaning once eligibility is confirmed, participants will be assigned by chance, like drawing straws, to either receive nucresiran or placebo. You will have a 2 out of 3 chance of being assigned to nucresiran and a 1 out of 3 chance of being assigned placebo. Placebo is a substance that looks like the actual medication and is given the same way but contains no active substance. The study drug, which can be either nucresiran or placebo, will be given as an injection under the skin in the abdomen (avoiding the area around the navel), thigh, or the side or back of the upper arms. Neither the participants nor the study doctor will know who is assigned to nucresiran or placebo but this information can be made available if need be.
Participation in this study is expected to last for 5-8 years, Study related procedures include physical exams, vital signs, echocardiograms (ultrasound test of the heart), electrocardiograms, (ECG, a tracing of the heart's electrical activity), blood work, urine samples and questionnaires. Participants will also take Vitamin A daily. Study related risks include risks related to the study drug including injection site reactions, abnormal liver function or an allergic reaction. There may be risks related to study procedures including loss of confidentiality. There may not be any direct benefit, but the information learned may benefit others with ATTR-CM in the future.
Deep brain stimulation (DBS) is a surgical treatment that can help improve the symptoms of Parkinson's disease (PD). However, the effectiveness of this treatment varies among patients, and physicians currently have no way to predict who will benefit the most. This study will investigate whether the types of bacteria in a person's gut can help predict their response to DBS. By analyzing patient samples, we aim to identify biomarkers that could help doctors better select candidates for this procedure, ultimately leading to more successful treatment outcomes for individuals with Parkinson's disease.
Written Exposure Therapy (WET) is a five-session mental health therapy for post-traumatic stress disorder (PTSD). Research shows that it works as well as longer treatments for PTSD among people over 18, even though it requires fewer sessions than other PTSD therapies. However, WET has not been adapted and tested via telehealth with people aged 12 to 18. Our study aims to see how WET can be adapted to meet the needs of people aged 12 to 18 who have experienced trauma and currently have PTSD symptoms. To adapt WET for this age group, first we will talk with PTSD experts and people aged 12 to 18 to learn what changes might make WET more suitable for young people. We'll also deliver WET via telehealth to five people aged 12 to 18 following the manual as it is written for people over age 18 to see what needs adjusting. In the next part of the study, we will offer the adapted version of WET via telehealth to 20 people aged 12 to 18 in our MUSC integrated pediatric primary care clinic. People aged 12 to 18 will take part in five to seven weekly online therapy sessions and three virtual study visits (before therapy, after therapy, and one month later) to better understand who they are as a person and their current mental health symptoms and diagnoses. Individuals who are 18 can participate without caregiver permission; individuals aged 12 to 17 can only participate with caregiver permission. Our goal is to find the best way to provide effective PTSD treatment for young people that can be delivered in real-world pediatric primary care settings, so that ultimately more people can get the help they need after traumatic experiences.
This research explores how ultrasound, a common medical imaging tool, can be used to look at the ligaments that support the base of the thumb. These ligaments are important because they help the thumb stay stable during everyday tasks like opening jars, writing, or buttoning clothes. When these ligaments become weak or damaged, it can cause pain and lead to joint problems like arthritis. Right now, it's not easy for doctors to check the condition of these ligaments without advanced scans or surgery. By using ultrasound, which is safe and non-invasive, we hope to find a quicker and easier way to examine ligament health.
Written Exposure Therapy (WET) is a five-session mental health therapy for post-traumatic stress disorder (PTSD). Research shows that it works as well as longer treatments for PTSD among people over 18, even though it requires fewer sessions than other PTSD therapies. However, WET has not been adapted and formally tested in individual therapy with people aged 12 to 18. Our study aims to see how WET can be adapted to meet the needs of people aged 12 to 18 who have experienced trauma and currently have PTSD symptoms. To adapt WET for this age group, first we will talk with PTSD experts and people aged 12 to 18 to learn what changes might make WET more suitable for young people. We'll also deliver WET to five people aged 12 to 18 following the manual as it is written for people over age 18 to see what needs adjusting.
In the next part of the study, we will recruit 48 adolescents aged 12 to 18 in a pediatric primary clinic who have symptoms of PTSD and randomize them to either receive the adapted version of WET or to receive gold-standard PTSD treatment: Trauma-Focused Cognitive Behavior Therapy. If assigned to receive adapted WET, participants will take part in five to seven weekly therapy sessions and five study visits (before therapy, and 6-week, 10-week, 20-weeks, and 30 weeks after starting the therapy). If assigned to receive TF-CBT, participants will take part in 12 to 16 weekly therapy sessions and five study visits (before therapy, and 6-week, 10-week, 20-weeks, and 30-weeks after starting the therapy). The purpose of the study visits for a 30-week time period is to better understand who they are as a person and their current mental health symptoms and diagnoses. All therapy and study visits can be completed remotely or in person, per your preference. Individuals who are 18 can participate without caregiver permission; individuals aged 12 to 17 can only participate with caregiver permission. Our goal is to find the best way to provide effective PTSD treatment for young people that can be delivered in real-world pediatric primary care settings, so that ultimately more people can get the help they need after traumatic experiences.