622 results match your criteria: "Medical Research Council Clinical Trials Unit[Affiliation]"
Reprod Health
December 2024
Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Plot 51-59, Nakiwogo Road, Entebbe, Uganda.
Background: HIV prevention trials usually require that women of childbearing potential use an effective method of contraception. This is because the effect of most investigational products on unborn babies is unknown. We assessed contraceptive use, prevalence and incidence of pregnancy and associated factors among women in a HIV vaccine preparedness study in Masaka, Uganda.
View Article and Find Full Text PDFNEJM Evid
January 2025
Sydney Infectious Diseases Institute and the WHO Collaborating Centre in Tuberculosis, Faculty of Medicine and Health, The University of Sydney.
Background: Data from randomized trials evaluating the effectiveness of tuberculosis (TB) preventive treatment for contacts of multidrug-resistant (MDR)-TB are lacking. Two recently published randomized trials that did not achieve statistical significance provide the opportunity for a meta-analysis.
Methods: We conducted combined analyses of two phase 3 trials of levofloxacin MDR-TB preventive treatment - Levofloxacin for the Prevention of Multidrug-Resistant Tuberculosis (VQUIN) trial and the Levofloxacin preventive treatment in children exposed to MDR-TB (TB-CHAMP) trial.
N Engl J Med
December 2024
From the Department of Pediatrics and Child Health, Desmond Tutu TB Centre, Stellenbosch University, Stellenbosch (A.C.H., S.E.P., H.S.S., A.G.-P., E.B., A.-M.D., S.N., J.A.S., L. Frigati), the Perinatal HIV Research Unit (N.A.M.) and the Faculty of Health Sciences, Wits Research Health Institute (L. Fairlie), University of the Witwatersrand, and Isango Lethemba TB Research Unit, Port Elizabeth, Wits Health Consortium (F.C.), Johannesburg, and the Tuberculosis and HIV Investigative Network, Durban (S.S.) - all in South Africa; the Johns Hopkins Center for TB Research, Baltimore (N.A.M.); the Medical Research Council Clinical Trials Unit at University College London (J.B., D.M.G., C.M., C.L., R.T., T.D.) and the Department of Infectious Disease, Imperial College London (J.A.S.) - both in London; the Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison (A.G.P.); and the Division of Microbiology, Department of Laboratory Medicine, Centre Hospitalier Universitaire Sainte-Justine, and the Department of Microbiology, Immunology, and Infectious Diseases, Faculty of Medicine, University of Montreal - both in Montreal (A.-M.D.).
Background: Worldwide, approximately 2 million children younger than 15 years of age are infected with multidrug-resistant (MDR) , with MDR tuberculosis developing in approximately 30,000 annually. Evidence from randomized, controlled trials on tuberculosis preventive treatment in persons exposed to MDR tuberculosis is lacking.
Methods: In this community-based, multisite, double-blind, cluster-randomized, placebo-controlled trial in South Africa, we assessed the efficacy and safety of levofloxacin as preventive treatment in children with household exposure to an adult with bacteriologically confirmed MDR pulmonary tuberculosis.
Cochrane Database Syst Rev
December 2024
Medical Research Council Clinical Trials Unit, Institute for Clinical Trials and Methodology, University College London, London, UK.
Rationale: Intravenous iron is increasingly used to treat iron-deficient anaemia (IDA) in pregnancy. A previous network meta-analysis suggested that intravenous irons have a greater effect on haematological parameters than oral irons; however, the impact on serious pregnancy complications such as postpartum haemorrhage (PPH) or the need for blood transfusion was unclear. Since then, several new randomised controlled trials (RCTs) have been conducted.
View Article and Find Full Text PDFInt J Infect Dis
November 2024
The Medical Research Council Clinical Trials Unit at University College London, 90, High Holborn, London, WC1V 6LJ, UK. Electronic address:
Objectives: To provide globally representative data on hospitalisation and death in recently SARS-CoV-2-positive ambulatory populations.
Methods: We enrolled SARS-CoV-2-positive ambulatory adults in the cohort studies, ICOS (47 sites, 5 continents), and PCOS (Liberia) and followed for 28-days. Kaplan-Meier estimates of percentage of those hospitalised or died were derived.
Mult Scler Relat Disord
December 2024
Centre for Preventive Neurology, Wolfson Institute of Population Health and Barts Health NHS Trust.
Therapeutics of neuroinflammatory disorders including multiple sclerosis is one of the fastest growing areas in neurology. However, pressures on higher specialty training in neurology together with an expanding curriculum have led to challenges in adequately preparing trainees for a subspecialist career. In this study we set out to understand current perceptions and barriers to training in neuroinflammatory disorders among neurology trainees in the UK.
View Article and Find Full Text PDFJ Clin Transl Sci
October 2024
Foundation for the National Institutes of Health, North Bethesda, MD, USA.
Accelerating COVID-19 Treatment Interventions and Vaccines (ACTIV) was initiated by the US government to rapidly develop and test vaccines and therapeutics against COVID-19 in 2020. The ACTIV Therapeutics-Clinical Working Group selected ACTIV trial teams and clinical networks to expeditiously develop and launch master protocols based on therapeutic targets and patient populations. The suite of clinical trials was designed to collectively inform therapeutic care for COVID-19 outpatient, inpatient, and intensive care populations globally.
View Article and Find Full Text PDFPLoS One
October 2024
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Background: HIV self-testing (HIVST) may facilitate marginalised populations' uptake of HIV testing, but whether the extent of marginalisation challenges individual uptake of HIVST remains under-researched. We aim to explore the perspectives of multiply marginalised cis-gender gay, bisexual and other men who have sex with men (GBMSM) and trans women on whether HIVST might increase their uptake of HIV testing.
Methods: We reanalysed qualitative interview data from SELPHI (the UK's largest HIVST randomised trial) collected between 2017 and 2020 from marginalised populations, defined as people self-identifying as non-heterosexual, transgender, non-White ethnicity and/or with low educational attainment.
Int J Tuberc Lung Dis
November 2024
Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
Treatment options for children living with HIV have historically been less effective, less practical and more difficult to implement compared with those for adults, as the research and development of new drugs for children has lagged behind. Significant progress has been achieved in response to the paediatric HIV epidemic over the last decade. Several optimised paediatric antiretroviral formulations are currently available or in development, including fixed-dose combination tablets containing a complete World Health Organization-recommended regimen.
View Article and Find Full Text PDFBMC Med Res Methodol
October 2024
Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Background: Epidemiological and clinical studies often have missing data, frequently analysed using multiple imputation (MI). In general, MI estimates will be biased if data are missing not at random (MNAR). Bias due to data MNAR can be reduced by including other variables ("auxiliary variables") in imputation models, in addition to those required for the substantive analysis.
View Article and Find Full Text PDFLancet Infect Dis
September 2024
Institute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town, Cape Town, South Africa; The Francis Crick Institute, London, UK; Department of Infectious Diseases, Imperial College London, London, UK. Electronic address:
Neuroimage Rep
September 2024
NMR Research Unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom.
Background: Deep grey matter pathology is a key driver of disability worsening in people with multiple sclerosis. Quantitative susceptibility mapping (QSM) is an advanced magnetic resonance imaging (MRI) technique which quantifies local magnetic susceptibility from variations in phase produced by changes in the local magnetic field. In the deep grey matter, susceptibility has previously been validated against tissue iron concentration.
View Article and Find Full Text PDFJ Antimicrob Chemother
November 2024
Department of Pharmacy, Radboudumc Research Institute for Medical Innovation (RIMI), Radboud University Medical Center, Nijmegen, The Netherlands.
Background: Darunavir is a potent HIV protease inhibitor with a high barrier to resistance. We conducted a nested pharmacokinetic sub-study within CHAPAS-4 to evaluate darunavir exposure in African children with HIV, taking once-daily darunavir/ritonavir for second-line treatment.
Methods: We used data from the CHAPAS-4 pharmacokinetic sub-study treating children with once-daily darunavir/ritonavir (600/100 mg if 14-24.
Clin Infect Dis
December 2024
Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, Minnesota, USA.
Background: Extrapulmonary complications (EPCs) are common in patients hospitalized for coronavirus disease 2019 (COVID-19), but data on their clinical consequences and association with viral replication and systemic viral dissemination are lacking.
Methods: Patients hospitalized for COVID-19 and enrolled in the Therapeutics for Inpatients with COVID-19 (TICO) platform trial at 114 international sites between August 2020 and November 2021 were included in a prospective cohort study. We categorized EPCs into 39 event types within 9 categories and estimated their frequency through day 28 and their association with clinical outcomes through day 90.
Br J Clin Pharmacol
November 2024
Department of Pharmacy, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.
Bull World Health Organ
September 2024
Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, England.
Most phase III trials in drug-resistant tuberculosis have either been underpowered to quantify differences in microbiological endpoints or have taken up to a decade to complete. Composite primary endpoints, dominated by differences in treatment discontinuation and regimen changes, may mask important differences in treatment failure and relapse. Although new regimens for drug-resistant tuberculosis appear very effective, resistance to new drugs is emerging rapidly.
View Article and Find Full Text PDFWellcome Open Res
May 2024
Institute of Clinical Trials & Methodology, Medical Research Council Clinical Trials Unit at University College London, London, England, WC1V 6J, UK.
Background: African children with cerebral malaria and seizures caused are at greater risk of poor outcomes including death and neurological sequelae. The agonal events are severe hypoventilation and respiratory arrest often triggered by seizures. We hypothesised that prophylactic anti-seizure medication (ASM) could avert 'spikes' of intracranial pressure during or following seizures and that adequate ventilation could be supported by biphasic Cuirass Ventilation (BCV) which requires no intubation.
View Article and Find Full Text PDFN Engl J Med
August 2024
From the Department of Infectious Disease and Institute of Global Health and Innovation, Division of Medicine, Imperial College (K.M.), and the Medical Research Council Clinical Trials Unit, University College London (A.S.W.) - both in London.
JAMA Netw Open
August 2024
Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany.
Importance: The prognosis of patients with adenocarcinoma of the esophagus and esophagogastric junction (AEG) is poor. From current evidence, it remains unclear to what extent preoperative chemoradiotherapy (CRT) or preoperative and/or perioperative chemotherapy achieve better outcomes than surgery alone.
Objective: To assess the association of preoperative CRT and preoperative and/or perioperative chemotherapy in patients with AEG with overall survival and other outcomes.
J Pediatric Infect Dis Soc
September 2024
Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
We characterized population pharmacokinetics in 42 African children receiving once-daily 25 mg (14 to <20 kg) or 50 mg (>20 kg) dolutegravir. Coadministration with emtricitabine and tenofovir alafenamide reduced dolutegravir bioavailability by 19.6% (95% confidence interval: 8.
View Article and Find Full Text PDFBMC Public Health
July 2024
Institute for Global Health, University College London, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK.
J Infect
September 2024
University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
Introduction: Despite antifungal advancements, candidaemia still has a high mortality rate of up to 40%. The ECMM Candida III study in Europe investigated the changing epidemiology and outcomes of candidaemia for better understanding and management of these infections.
Methods: In this observational cohort study, participating hospitals enrolled the first ten consecutive adults with blood culture-proven candidemia.
Open Forum Infect Dis
July 2024
Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Background: Children who are HIV-exposed and uninfected (HEU) are at risk for early neurodevelopmental impairment. Smaller basal ganglia nuclei have been reported in neonates who are HEU compared to HIV-unexposed (HU); however, neuroimaging studies outside infancy are scarce. We examined subcortical brain structures and associations with neurocognition in children who are HEU.
View Article and Find Full Text PDFJ Virus Erad
June 2024
Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom.