cyrilzakka/clinical-trials huggingface dataset:
The Effect Of Ultrasound-guided Modified Pectoral Nerves Block Versus Ketamine Plus Magnesium Infusion On Analgesic Profile In Breast Cancer Surgeries

Background: Postoperative pain is one of the greatest patient concerns following surgery. However, general anesthesia cannot provide adequate postoperative pain control and the routine use of parenteral opioids aggravates postoperative sedation, nausea, emesis, impaired oxygenation and depressed ventilation.

Hypothesis:

The investigators assume that both ultrasound guided Modified Pecs Block and combination of Ketamine and Magnesium sulphate infusion can achieve better analgesia in major breast cancer surgery in the form of reducing total amount of intraoperative fentanyl requirement and reducing postoperative morphine requirement and improvement of postoperative VAS scores both at rest and during shoulder movement so we plan this study to evaluate this assumption

Surgery on the chest wall is relatively common and can be associated with significant postoperative discomfort and pain; and one of the most common surgical sites on the chest wall is the breast, with the main indication for breast surgery being breast cancer. Breast cancer has continued to be the most common cancer in females, accounting for approximately 31% of all newly detected cancer cases in the female population, worldwide. (1, 2) Thousands of patients undergo surgery in the mammary and axillary regions every year, and these procedures tend to cause significant acute pain and may develop in to cases of chronic pain in 25-60% of cases. (3) Pain can be controlled using systemic opioids which have a respiratory depressant effect and causing nausea and vomiting.

Also can be controlled using epidural catheter that can cause haemodynamic instability, so we are searching about how to devrease pain with less complications.

Eligibility Criteria:
Inclusion Criteria:

* female patients with American society of Anesthesia classification(ASA) II physical status undergoing major breast cancer surgery with axillary evacuation under general anesthesia.
* Patients' age from18 to 65 Years.
* Body mass index (BMI) are from 20 to 40 kg/m2.

Exclusion Criteria:

* Pregnant patients
* Patients having sensitivity or contraindication to test drugs or regional anesthesia.
* severe respiratory or cardiac disorders.
* history of psychological disorder.
* chronic pain .
* significant liver or renal insufficiency. .
Effectiveness of Port Site Bupivacaine Injection in Postoperative Pain Reduction After Lap. Chole

To determine the effectiveness of port site bupivacaine infiltration in postoperative pain reduction after laparoscopic cholecystectomy.

The study is being done to determine the effectiveness of port site bupivacaine infiltration in postoperative pain reduction after laparoscopic cholecystectomy.

Eligibility Criteria:
Inclusion Criteria:

1. Patients of both the gender of age \>18 years and \<45years
2. Patients undergoing elective laparoscopic cholecystectomy under general anesthesia.
3. Patients with A.S.A grade I and II.

Exclusion Criteria:

1. Patients with known allergic reactions to local anesthetics.
2. Patients converted to open procedure.
3. Patients developing intra-operative complications.
4. Patients undergoing for laparoscopic cholecystectomy for acute cholecystitis.
5. Patients with obesity and chronic illness.
6. Patients with history of opioids, steroids, NSAIDs and alcohol use.
Reducing Sugar-sweetened Beverage Consumption Among Young Adults

This study aims to test sugar-sweetened beverage (SSB) health labeling elements in an online experiment to determine which elements are the most salient among young adults.


Eligibility Criteria:
Inclusion criteria:

* ≥18 years of age
* current/recent (\<1 year of graduation) undergraduate student at 3 specific universities
* English-speaking
* consumes at least 2 SSBs per week
Variability Analysis During Weaning and Extubation in Critically Ill Patients

For critically ill patients, it is important to know when to liberate them from mechanical ventilation (the removal of breathing or endotracheal tube or extubation) and weaning (the progressive decrease of the amount of support that a patient receives from the mechanical ventilation). It is well recognized that prolonged ventilation and weaning harms patients and introduces significant increased costs to the health care system. The investigators objective is to improve the safety of removal of life support in critically ill patients by harnessing information from two new technologies; NM3 and Nexus device. In particular, the investigators are interested in the patterns of variation of respiratory and cardiac signals from the NM3 device, as well as monitor skin conductance with the Nexus device. The combination of these measures has not yet been investigated to date, and could represent a novel set of measures that can be used to help physicians better manage critically ill patients. The current standard of care dictates that once a patient is considered as a candidate for withdrawal from ventilation, a spontaneous breathing trial (SBTs) is performed, where the degree of ventilator support is decreased, and their response is observed to help predict if they will tolerate extubation.

Health is associated with a high degree of variation of physiologic parameters such as heart rate and respiratory rate, and illness \& stress are associated with a loss of variability. The analysis of variability of biological signals measures the degree of fluctuations present over time. Previous studies have demonstrated that changes in variability (generally decreases) are observed in illness states, and the degree of this change correlates with illness severity. Several studies have reported that reduced heart or respiratory rate variability (HRV or RRV) during SBTs is associated with extubation failure. Until recently, variability analysis has traditionally been done only on heart rate (HRV), derived from analyzing beat-to-beat intervals from the ubiquitous electrocardiogram (ECG). The investigators aim to apply variability analysis to the respiratory and cardiac signals which represent a rich novel set of muti-organ variability measures whose utility in managing extubation and ventilator weaning has not been investigated to date.


Eligibility Criteria:
Inclusion Criteria:

* Respiratory failure
* Cardiac failure
* Consent within 48 hours of admission to the ICU

Exclusion Criteria:

* Allergy to skin adhesives
* On study less than 72 hours
Value of Radionuclide Cisternography

Radionuclide cisternography (RC) is a nuclear medicine examination based on intrathecal injection of \[111In\]diethylenetriaminepentaacetic acid (\[111In\]DTPA). It is prescribed for two recommendations: detection of cerebrospinal fluid (CSF) leak/fistula and diagnosis of normal pressure hydrocephalus.

In the search part of CSF leak/fistula, RC offers the benefit of a 24-hour study of CSF unlike other reference tests.

In addition to SPECT/CT imaging, the radiopharmacist performs sampling in nasal cavities and throat of the patient to collect a possible flow of CSF.

These samples are analysed by radioactivity measurements and bring an added value to the exam.

The interest of this examination for management of CSF leak/fistula remains unclear.

The aim of this study is to identify and analyse results of all RC examinations performed since 2005 in the Nuclear Medicine department of the Neurological Hospital.

The full analysis of patients will allow discussing the role of RC in management of CSF leak/fistulae in clinical practice.


Eligibility Criteria:
Inclusion Criteria:

* patients who received a convocation for realization of RC (extraction with GERA, software of Nuclear Medicine)

Exclusion Criteria:

* patients who received a convocation for realization of RC with "valve" protocol
Neurogenic Lower Urinary Tract Symptoms in Patients With Multiple Sclerosis

There is no consensus in the literature upon the neurourological diagnostic algorithm of the patients with multiple sclerosis (MS). The primary aim of the study is phenotyping the patients with MS. These phenotypes might guide Neurology and Urology specialists during diagnosis and treatment. Secondary aim of this study is to define the presence and severity of urological symptoms' and disorders', involving the patients with diagnosis of MS less than 5 years into a urological follow-up and treatment process. Our study might include 4 visits (the first visit, 3rd month, 6th month and 12th month visit). Questionnaires, uroflowmetry and bladder diary might be repeated on each visit. Filling cystometry and pressure-flow study will be performed only on the first visit. All patients will receive 6 different questionnaires which aim to define the severity and presence of lower urinary tract symptoms. Bladder diary is an online application which will represent at least 3 days of frequency, urgency, incontinence episodes and the amount of fluid intake, and urination. The phenotypes would be defined after performing the first visit diagnostic tools (all of the tools are necessary during the diagnostic algorithm of neurogenic lower urinary tract symptoms). The phenotypes will be defined as: a. no symptoms with normal urodynamics, b. Lower urinary tract symptoms with normal urodynamics, c. no symptoms with abnormal urodynamics, d.lower urinary tract symptoms with abnormal urodynamics. During a follow-up period of 1 year, changes in the bladder diaries and scores in questionnaires of these groups will be compared on each visit.


Eligibility Criteria:
Inclusion Criteria:

The patients who are followed up by Department of Neurology with MS diagnosis less than 5 years

Exclusion Criteria:

1. Patients who are not eligible for completing questionnaires, bladder diaries.
2. Patients who have anatomical disorders preventing lithotomy position during urodynamic study.
3. Patients in relapsing period of MS
4. Patients who have symptoms of urinary tract infection
Internal Iliac Artery Occlusion in Placenta Accreta

This is a randomized study to assess the efficacy of prophylactic bilateral internal iliac artery occlusion performed prior to planned surgical management for placenta accreta spectrum (PAS). The intervention group would receive balloon occlusion, ureteric stenting and caesaeran hysterectomy while the control group would undergo the same procedure, excluding balloon occlusion. The primary outcome is to demonstrate a three pint or greater reduction in pack cell transfusion requirement.

Interventional radiology, including internal iliac artery occlusion, has been used as an adjunct in the management of placenta accreta spectrum (PAS). Retrospective studies have shown benefit in terms of reduction of blood loss. However, studies reported in literature vary widely in terms of the exact surgical procedure undertaken, in conjunction with the radiological intervention. The radiological intervention itself lacks standardization, occurring at different anatomical levels, ranging from infrarenal aortic occlusion to internal iliac or uterine artery. Furthermore, there have been reported cases of arterial thrombosis associated with arterial occlusion.

We sought to clarify the effectiveness of a standardized approach , where perioperative bilateral internal iliac artery occlusion is performed followed by bilateral ureteric stenting and caesarean hysterectomy. The control group would undergo the exact procedure, excluding internal iliac artery occlusion. Patients would be randomized but neither the patient nor surgeon could be blinded.

The primary outcome would be to demonstrate a three pint or greater reduction in packed cell transfusion. Secondary outcomes include a difference in estimated blood loss, additional blood product transfusion, unplanned additional surgical procedure, serious complications arising from internal iliac artery occlusion, total procedural time and early neonatal outcome.

Eligibility Criteria:
Inclusion Criteria:

* All pregnant women with prenatally diagnosed placenta accreta spectrum

Exclusion Criteria:

* Women who declined to participate
* Women with bleeding diathesis or severe thrombocytopenia \<100k x 1,000,000/L
* Surgery performed prior to 28 weeks of gestation
Selective Unilateral Spinal Anesthesia Versus Selective Sensory Spinal Anesthesia for Knee Arthroscopy Surgery

Background: Selective unilateral spinal anesthesia is the gold standard spinal anesthesia technique for knee arthroscopy. Selective sensory spinal anesthesia has recently been validated for this surgery. Both selective techniques are specially indicated for ambulatory surgery because of PACU fast track, low discharge home time and high patient satisfaction. This study compares both spinal techniques for knee arthroscopy surgery.


Eligibility Criteria:
Inclusion Criteria:

* adults scheduled to undergo knee arthroscopy

Exclusion Criteria:

* a previous history of neurological impairment
* insulin-dependent diabetes mellitus
* intolerance to the study drug or related compounds and additives
* BMI \> 38 kg/m2
* height \<155 cm or \>180 cm
* any existing contraindications for spinal anaesthesia
* surgery in which a complete block of the lower limb
Cardiovascular Fitness and Venous Function in Trained and Untrained Subjects

The primary aim is to study the relationship between vascular function, cardiovascular fitness and age in healthy subjects. Individuals with the highest cardiovascular fitness will have the greatest arterial inflow independent of age.


Eligibility Criteria:
Inclusion Criteria:

* Healthy subjects, 18-75 years of age

Exclusion Criteria:

* Inability to exercise due to musculoskeletal conditions
* Known ischemic cardiovascular disease
* Smoking or tobacco use
* Acute medical conditions
* Active infections
* Pharmacotherapy with known vascular effects
Effect of 4 Liver Fibrosis Tests (PIIINP, CIV, LN, and HA) on the Prognosis of Liver Cirrhosis

Liver biopsy is the reference method for the measurement of liver fibrosis. But it has many limitations, such as sampling error and individual variation in interpreting the results. Currently, serum liver fibrosis markers have been employed as non-invasive diagnosis of liver fibrosis and evaluation of the severity of liver fibrosis. They include laminin (LN), hyaluronic acid (HA), collagen type IV (CIV), and N-terminal propeptide of collagen III (PIIINP). However, few study was conducted to explore the role of these liver fibrosis markers in evaluating the prognosis of liver cirrhosis. Our hypothesis is that LN, HA, CIV, and PIIINP in combination or alone can predict the prognosis of liver cirrhosis.


Eligibility Criteria:
Inclusion Criteria:

1. Patients were admitted to our department.
2. Patients were diagnosed with liver cirrhosis.
3. Patients signed the informed consent and agreed to test serum liver fibrosis markers (PIIINP, CIV, LN, and HA).

Exclusion Criteria:

1. Non-cirrhotic patients.
2. Malignancy.
3. Severe cardiopulmonary diseases.
4. Severe infectious diseases.
5. Other diseases with a shortened lifespan.
6. Pregnant and breastfeeding.
7. Poor adherence.
Healing of Ischemic Leg Ulcers in Patients Treated With iSONIAzid

The main objective of this trial is to study the healing effect of an oral drug (isoniazid) in patients with ischemic (arterial) leg ulcers defined by a systolic toe pressure \<40 mm Hg.

Treatment of arterial ulcers is problematic. Previous pharmaceutical interventions with for example prostaglandins have produced only limited beneficial effects but have been associated with frequent adverse effects. Positive effects of isoniazid have been observed in a preclinical model of ischemic wound healing (Weinreich et al. Surgery 2010).

Eligibility Criteria:
Inclusion Criteria:

* Patients with ischemic leg ulcers unsuitable for vascular surgical intervention
* Systolic toe pressure \< 40 mm Hg
* Ulcer duration \> 3 months
* Ulcer area: 1-20 cm2
* Written informed consent

Exclusion Criteria:

* B-Hb \< 6 mmol/l
* Aspartate transaminase \> 50 U/l
* Diabetes mellitus \> 10%HbA1c
* Usage of more than 10 mg prednisolone daily within the last 30 days
* Usage of cytotoxic agents with the last 3 months
* Usage of rifampicin, phenytoin, carbamazepin, theophylline, benzodiazepines (diazepam, triazolam), stavudine and/or valproat
* Alcohol abuse
* Hereditary galactose intolerance
* Hypersensitive to isoniazid or for one or more of the filling substances (magnesium stearate, povidone, talcum, lactose and starch)
* Cellulitis or deep infection (osteomyelitis and/or tendonitis) related to the ulcer
* Gangrene
* Participation in clinical trials within the last 7 days
* Pregnancy or breastfeeding
* Women of child bearing potential who decline to use contraception
Optical Trocar to Create the Pneumoperitoneum in Bariatric Patients

Laparoscopic bariatric surgery are becoming the most used procedure to treat the obesity. To facilitate safe initial access to the abdominal cavity, we insert an optical viewing trocar at the left hypocondrium. The aim of this study is to systematically evaluate all published data existing in the literature to analyze the safety of optical trocars in patients undergoing bariatric surgery and to compare these data with our experiences.

In this study we analyze data existing in the literature about the use of the optical trocars in patients undergoing bariatric surgery and we compare these data with our experiences.

Establishing pneumoperitoneum is classically performed using a Veress needle or the open Hasson technique, but obesity presents its own challenges when using these techniques, including thickened abdominal wall, variable anatomical landmarks, difficult and time-consuming dissection, air leak, inadequate pneumoperitoneum, subcutaneous emphysema, and difficulty with fascial closure

Eligibility Criteria:
Inclusion Criteria:

BMI\>40 kg/m2 BMI\>35 kg/m2with at least one associated major comorbidity

Exclusion Criteria:

secondary obesity due to endocrine and psychological disorders
A Study of 1592U89 in Combination With Protease Inhibitors in HIV-Infected Patients Who Have Never Taken Anti-HIV Drugs

The purpose of this study is to see if it is safe and effective to give 1592U89 plus certain protease inhibitors (PIs) to HIV-infected patients who never have been treated with anti-HIV drugs. This study also examines how the body processes these drugs when they are given together.

In this Phase II, open-label study patients (16 per treatment group) are randomized to receive 1592U89 in combination with one of five protease inhibitors: indinavir, saquinavir, ritonavir, nelfinavir, or 141W94 for up to 48 weeks.

Eligibility Criteria:
Inclusion Criteria

Concurrent Medication:

Allowed:

* Local treatment for Kaposi's sarcoma.
* GM-CSF, G-CSF or erythropoietin.

Patients must have:

* HIV-1 infection documented by a licensed HIV-1 antibody ELISA and confirmed by Western blot detection of HIV-1 antibody or a positive HIV-1 blood culture.
* CD4+ cell count \>= 100 cells/mm3 within 14 days of study drug administration.
* HIV-1 RNA \>= 5,000 copies/ml within 14 days of study drug administration.
* No active or ongoing AIDS-defining opportunistic infection or disease.
* Signed, informed consent from parent or legal guardian for patients less than 18 years of age.

Prior Medication:

Allowed:

Local treatment for Kaposi's sarcoma.

Exclusion Criteria

Co-existing Condition:

Patients with the following conditions or symptoms are excluded:

* Malabsorption syndrome, or other gastrointestinal dysfunction, that might interfere with drug absorption or render the patient unable to take oral medication.
* Life-threatening infection or other serious medical condition that may compromise a patient's safety.

Concurrent Medication:

Excluded:

* Other investigational agents. NOTE:
* Those available through Treatment IND or expanded access programs are evaluated individually.
* Chemotherapeutic agents for the initial 24 weeks of study (except local treatment for Kaposi's sarcoma).
* Agents with documented anti-HIV activity in vitro.
* Foscarnet.
* Immunomodulating agents such as systemic corticosteroids, interleukins, thalidomide, anti-cytokine agents or interferons.
* Antioxidants.

Concurrent Treatment:

Excluded:

Radiation therapy within the first 24 weeks of study.

Patients with the following prior conditions are excluded:

* History of clinically relevant pancreatitis or hepatitis within the last 6 months.
* Participation in an investigational HIV-1 vaccine trial.

Prior Medication:

Excluded:

* Antiretroviral therapy, including reverse transcriptase inhibitor and protease inhibitor therapy.
* Cytotoxic chemotherapeutic agents within 30 days of study drug administration.
* HIV-1 vaccine dose within the 3 months prior to study drug administration.
* Immunomodulating agents, such as systemic corticosteroids, interleukins or interferons within 30 days of study drug administration.

Prior Treatment:

Excluded:

Radiation therapy within 30 days of study drug administration. Alcohol or illicit drug use that may interfere with patient compliance.
RELAXaHEAD for Headache Patients (Phase II)

The goal of this research is to assess the utility of smartphone-based progressive muscle relaxation (PMR) for the treatment of migraine and sleep. While there are many commercially available electronic diary and mind-body intervention apps for headache, there is little data showing their efficacy. RELAXaHEAD app incorporates the electronic PMR that was successfully used in an earlier epilepsy study and beta tested with headache specialist and migraine patient input. It also is an electric headache diary. The app has been studied and findings have been reported in multiple peer reviewed publications. Also, the app has been updated based on prior feedback from the studies. Now, this 2-arm randomized controlled study will evaluate the feasibility and acceptability of RELAXaHEAD for use with patients with migraine and comorbid insomnia. . One arm will be the RELAX group (the RELAXaHEAD app) and the other arm will be a monitored usual care (MUC) group (this group receives standard of care and uses the electronic daily symptom reporting diary). The goals are to assess the feasibility and adherence of the RELAX intervention in persons with migraine and insomnia (Aim 1) and to gather exploratory data on the effects of the RELAX intervention on headache and sleep related outcome measures (Aim 2).


Eligibility Criteria:
Inclusion Criteria:

* Age 18-80 years (age 18-65 in urgent care);
* Meets migraine criteria based on the International Classification of Headache Disorders (ICHD) criteria;
* Migraine Disability Assessment (MIDAS) score \>5. 4+ headache days a month OR; meets chronic post- traumatic headache (PTH) criteria based on International Classification of Headache Disorders (ICHD) criteria, is 3-12 months post-injury, and there are 4+ headache days a month.
* Scoring \> or = 15 on the ISI.

Exclusion Criteria:

* Patients who have had Cognitive Behavioral Therapy, Biofeedback, or other Relaxation Therapy in the past year;
* Cognitive deficit or other physical problem with the potential to interfere with behavioral therapy;
* Alcohol or other substance abuse as determined by self-report or prior documentation in the medical record;
* Opioid or barbiturate use 10+ days a month;
* Unable or unwilling to follow a treatment program that relies on written and audio file materials;
* Not having a smartphone.