The Therapeutic Interventions in Malignant Pleural Effusions Trial (the TIME trial)

此应用程序是为了让我进行临床试验，以改善对肺部和胸壁之间异常胸腔积液患者的护理，并为我提供临床试验培训。在英国和美国，每年有超过250，000名患者在肺和胸壁之间发生液体积聚，这导致了呼吸困难。这种液体的最常见原因之一是肺和胸壁之间的膜中的癌细胞改变了液体调节。为了控制这种液体，将刺激性药物应用于胸腔，液体聚集在胸腔中引起炎症，将肺粘附在胸壁上。这种治疗是非常痛苦的，这种疼痛可以通过使用非甾体类止痛药而不是阿片类止痛药（标准护理）和使用小胸管进行药物输送来减轻。然而，这种非甾体类镇痛药在理论上可能会损害这种治疗的效率。这项试验将确定非甾体类镇痛药和小口径胸管是否可以减轻疼痛，以及非甾体类镇痛药是否确实改变了治疗效果。无论结果如何，这项研究将产生关于治疗这些患者的新信息，并将为我提供临床试验方法的全面培训。

This application is for me to perform a clinical trial to improve care for patients with abnormal chest fluid collections between the lung and the chest wall, and to provide me with training in clinical trials. Over 250,000 patients in the UK and US each year develop fluid collections between the lung and the chest wall, which causes disabling breathlessness. One of the commonest causes of such fluid is cancer cells in the membranes between the lung and the chest wall that alter fluid regulation. To control this fluid, an irritant drug is applied to the chest cavity where the fluid collects to cause inflammation, adhering the lung to the chest wall. This treatment is very painful and this pain may be reduced by using non-steroidal painkillers rather than opiate painkillers (standard care), and by using small chest tubes for drug delivery. However, such non-steroidal analgesics may, theoretically, impair the efficiency of this treatment. This trial will establish if non-steroidal analgesics and small bore chest tubes can decrease pain, and whether non-steroidal analgesics do actually change treatment effectiveness. Whatever its result, this study will produce new information about treating these patients and will provide me with a thorough training in clinical trial method.