cyrilzakka/clinical-trials huggingface dataset:
To Compare the Ability of DiscoVisc® OVD to Protect the Corneal Endothelium and Maintain Anterior Chamber Space With Healon® and Amvisc® PLUS During Cataract Surgery.

The objective of the study is to assess how DisCoVisc Ophthalmic Viscosurgical Device (OVD) compares with Healon and Amvisc Plus in the protection of corneal endothelial cells, and the ability to maintain anterior chamber space, in routine cataract surgery.


Eligibility Criteria:
Inclusion Criteria:

* Patients able to understand and sign a document of informed consent;
* Patients aged ≥49 years with age-related cataract formation;
* Patients planning to undergo surgical removal of cataract by phacoemulsification with implantation of a posterior chamber intraocular lens;
* Patients that have healthy eyes excluding the formation of cataract.

Exclusion Criteria:

* pseudoexfoliation syndrome with glaucoma or zonular compromise in the operative eye;
* A congenital ocular anomaly (e.g., aniridia, congenital cataract) in the operative eye;
* Iris atrophy in the operative eye;
* Glaucoma (including pseudoexfoliation or pigmentary) or any causes of compromised outflow in the operative eye;
* Any abnormality which prevents reliable Goldmann applanation tonometry in the operative eye;
* Ocular hypertension (lntraocular Pressure (IOP) \> 21 mmHg) in the operative eye at the baseline exam;
* Corneal abnormality that results in a poor endothelial cell photograph and prevents reliable endothelial cell density measurement;
* Baseline endothelial cell density \< 1500 cells/mm2, in the operative eye;
* Planned multiple procedures during cataract/Intraocular Lens (IOL) implantation surgery (e.g., trabeculoplasty, corneal transplant). NOTE: A minor relaxing keratotomy
* Patients 48 years of age or younger;
* Proliferative diabetic retinopathy in the operative eye;
* Uncontrolled diabetes mellitus;
* Marfan's Syndrome;
* An ocular disease and/or condition that may compromise results;
* A history of chronic or recurrent inflammatory eye disease (e.g. iritis, scleritis, uveitis, iridocyclitis, rubeosis iritis) in the operative eye;
* Lens for the correction of astigmatism may be performed;
* Previous ocular trauma to the operative eye (this includes previous intraocular surgery and traumatic cataract). NOTE: history of non-invasive laser surgery (with the exception of laser treatment for PDR) is acceptable for inclusion;
* A non-functional fellow eye;
* Participation in any other clinical study within the 30 days before surgery
Diaphragmatic Reinnervation of Tetraplegic Patients With Respiratory Insufficiency

This study evaluates the diaphragmatic reinnervation by inferior laryngeal nerve in tetraplegic patients with ventilatory insufficiency.


Eligibility Criteria:
Inclusion Criteria:

* tetraplegia c3-c4
* respiratory insufficiency

Exclusion Criteria:

* PM
Effect of Anthocyanins on Metabolic Profiles in Subjects With Pre-diabetes

Metabolic problems represent one of the major health concerns which are attractive for being addressed by nutritional interventions, as these are directly connected to dietary habits.Anthocyans possess cardiovascular disease prevention, obesity control, and diabetes alleviation properties, but association between anthocyans and prediabetes need to be more firmly understood and established from robust clinical data. However, there is little human research that has reported on the efficacy of increased anthocyans bioactive consumption on insulin sensitivity in pre-diabetes.

The investigators plan to conduct a randomized double-blind, placebo-controlled trial to characterize the potential effects of anthocyans, purified from bilberries and blackcurrants, on metabolic abnormalities commonly associated with type 2 pre-diabetes.

Eligibility Criteria:
Inclusion Criteria:

* FPG 100 mg/dL (5.6 mmol/L) to 125 mg/dL (6.9 mmol/L) (IFG) OR 2-h plasma glucose in the 75gOGTT 140 mg/dL (7.8 mmol/L) to 199 mg/dL (11.0 mmol/L)(IGT) OR HbA1C 5.7-6.4%.
* Newly diagnosed T2DM who exceed the upper limit of the range but has not yet accepted hypoglycemic therapy.

Exclusion Criteria:

Patients with cardiac, renal, or hepatic diseases or with hyperthyroidism or who had concomitant infections, or who use of anti-diabetic drug or potential affect plasma glucose drugs, pregnant and breast-feeding women, and with polycystic ovarian syndrome.
Efficacy and Mortality of a Loading Dose of Colistin in Critical Ill Patients

The study hypothesis is that the loading dose of intravenous colistin (6 million of international units) is associated with greater clinical and microbiological efficacy, and reduced mortality of critically ill patients infected by multidrug resistant Gram- negative bacilli, compared to a scheme without loading dose.

It is a prospective, multicenter, randomized, controlled study to evaluate a scheme with and without a loading dose of 6 million international units of colistin, followed by a maintenance dose of 3 million international units every 8 hours intravenous. The study should be conducted in 3 hospitals in Chile, in critically patients presenting infection by multidrug Gram-negative bacteria and requiring be treated with colistin for at least 48 hours. The objectives of the study are: to evaluate the clinical and microbiological response, and mortality.

Eligibility Criteria:
Inclusion Criteria:

* patient hospitalized in critical care units
* patient infected by multi drug resistant Gram negative bacteria susceptibly only to colistin
* source of infection: blood, respiratory, intra abdominal or urinary

Exclusion Criteria:

* pregnant or breastfeeding patients
* patient with a history of hypersensitivity to colistin
"eyeMax Insight" Cholangioscopy for Unexplained Bile Duct Stenosis

When clinical doctors cannot diagnose the cause of biliary stricture after comprehensive laboratory and imaging examinations, it is collectively referred to as unexplained bile duct stenosis. This study intends to analyze the diagnostic value of the biliary endoscopy system for unknown cause biliary strictures , and compare the diagnostic efficacy of biopsy under biliary endoscopy guidance with brushing cytology under ERCP.

When clinical doctors cannot diagnose the cause of biliary stricture after comprehensive laboratory and imaging examinations, it is collectively referred to as unexplained bile duct stenosis. This study intends to analyze the diagnostic value of the biliary endoscopy system for unknown cause biliary strictures , and compare the diagnostic efficacy of biopsy under biliary endoscopy guidance with brushing cytology under ERCP.

The etiology of biliary strictures is complex, including not only malignant tumors , but also factors such as stones, inflammatory strictures, congenital variations and so on. Currently, the main methods for diagnosing malignant biliary obstruction in clinical practice include clinical examinations, biochemical testing (such as serum CA19-9), imaging, and endoscopic retrograde cholangiopancreatography (ERCP). However, these methods have limitations, such as the limited specificity and sensitivity of CA19-9 and the indirect imaging of ERCP after contrast agent filling. Therefore, these methods are relatively difficult to distinguish the benign and malignant nature of biliary lesions. This study intends to analyze the diagnostic value of the biliary endoscopy system for these unexplained bile duct stenosis.

Eligibility Criteria:
Inclusion Criteria:

Unexplained bile duct strictures (cannot be clearly diagnosed by CT, MRI or other imaging methods);

Exclusion Criteria:

* Patients with cardiac dysfunction, acute pancreatitis, active viral hepatitis;

  * Patients with mental illness; ③ Previously underwent choledochoscopy examination; ④ Malignant biliary obstruction;
Prognostic Role of Platelet _lymphocyte and Neutrophil _monocyte in CLL

The biological rationale in calculating PLR stems from the increase in the lymphocyte count and reduction in the platelet count often encountered in the advances stages of CLL .NMR median value was significantly higher in untreated patients than in patients who received treatment strengthening the hypothesis that this ratio is associated with a more indolent form of disease

Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in the western world. In Egypt, CLL is the most common subtype of leukemias

* the National Cancer Registry reported over 80% of lymphoid leukemias are CLL . It is the most common types of leukemia diagnosed in adult. ChroniclymphocyticleukemialymphocytesareclonalCD19-positiveBcells characterized by the accumulation of CD5 positive monoclonal B cells in peripheral blood. Bone marrow aspiration shows lymphocytic replacement of normal marrow elements, lymphocytes comprise 25-95% .Trephine biopsy reveals nodular, diffuse or interstitial involvement by lymphocytes
* Both the International Workshop on Chronic Lymphocytic Leukemia (IWCLL) and European Society of Medical Oncology guidelines also require persistence of lymphocytosis for longer than 3 months

The most important prognostic factors in CLL are clinical staging systems developed by Rai and Binet

. These systems based on clinical examination e.g. lymphadenopathy and organomegaly, peripheral blood findings (platelet andhaemoglobinvalues),markersoftumorload(thymidinekinaseand B2-microglobulin), expression of specific proteins in CLL cells; CD38, CD49d \& ZAP-70, genetic abnormalities quantified by FISH which include del(13q), tri12, del(11q), \& del(17p) and genetic parameters.including immunoglobulin heavy chain variable gene segment (IGHV) mutational status. Finally, prognostication in patients with CLL should not only address disease progression and overall survival, but also response to therapy. The biological rationale in calculating PLR stems from the increase in the lymphocyte count and reduction in the platelet count often encountered in the advanced stages of CLL. Therefore, we hypothesized that the ratio using both the platelet and lymphocyte counts may have a prognostic role in patients with CLL. Neutrophil-monocyte ratio(NMR) was found to be higher in untreated patients than in patients who received treatment . and therefore it will be used to prove its relation with disease severity and itsprognosticvalues. It is important to highlight that using these indices, is simple, cheap, easily measured and reproducible and can be integrated into our daily clinical practice as prognostic marker of CLL

Eligibility Criteria:
Inclusion Criteria:

- All CLL patients

Exclusion Criteria:

* CLL patients on treatment
A Study of Aripiprazole in Patients With Major Depressive Disorder

The purpose of this 14 week, randomized, double-blind, placebo controlled study is to assess the safety and efficacy of aripiprazole to placebo as adjunctive treatment to an assigned open-label marketed antidepressant therapy (ADT) in patients with Major Depressive Disorder who demonstrate an incomplete response to a prospective eight week trial of the same assigned open-label marketed antidepressant therapy.


Eligibility Criteria:
Inclusion Criteria:

* Men and women, 18-65 years old who have experienced single or recurrent, non-psychotic episodes of Major Depressive Disorder, with the current episode of minimally 8 weeks in duration.
* Treatment history of an inadequate response to at least one and no more than three adequate antidepressant trials.
Intranasal Dexmedetomidine Premedication

Most patients with preoperative varying degrees of stress, anxiety, which makes the stress response in patients and affect the normal conduct of anesthesia and surgery.The sympathetic system hyperexcitability prone to cause adverse cardiovascular events and affect postoperative recovery. However, phenobarbital, as the traditional premedication, has less sedative, weak anxiolytic and other shortcomings. Midazolam accompanied by inhibition of respiration,excessive sedation, easily induced delirium,prolonged recovery time and so on. Dexmedetomidine is a highly selective α2-adrenergic receptor agonist, it has sedative, anxiolytic, no inhibition of respiration, and also colorless, odorless, non-mucosal stimulation, nasal drip ease of administration, patient acceptance, comfortable. Therefore, dexmedetomidine as premedication has certain advantages. The purpose of this research is to study sedative effect, safety and the impact of anesthesia recovery period of intranasal dexmedetomidine premedication for suspension laryngoscopy.

All patients received intranasal dexmedetomidine (1μg.kg-1) or placebo at approximately 45 min before induction of anesthesia.The study drug was prepared in a 1-ml syringe.An equal volume of dexmedetomidine or placebo was dropped into each nostril by a blinded research assistant in the supine position.Automatic sphygmomanometer measure blood pressure.Oxygen saturation and heart rate were measured by a pulse oximeter. Respiratory rate, sedation score and anxiety levels regularly assessed. Patients with general anesthesia, suspension laryngoscopy surgery and postoperative care, standard monitoring are unified.

Eligibility Criteria:
Inclusion Criteria:

* Surgery:The laryngoscope vocal polyp excision
* Aged 18 to 60 years old
* Body mass index (BMI) \< 30 kg/m2
* American society of Anesthesiologist (ASA) I -II

Exclusion Criteria:

* The investigator refused to participate
* Known allergy or hypersensitive reaction to dexmedetomidine or anesthetic
* With previous history of heart disease
* Pregnant women; no reliable contraceptive measures in postmenopausal women
* Preoperative heart rate less than 45bpm; Ⅱ or Ⅲ degree atrioventricular block; ischemic heart disease
* Taking antihypertensive drugs such as methyldopa, clonidine and other α2 receptor agonist
* Asthma
* Sleep apnea syndrome
* Liver and kidney dysfunction
* Known to suffer from mental illness
* Long-term use of sedatives and analgesics in patients
Neurophysiological Monitoring and Videolaryngoscopy

Myopathic patients undergoing cervical spine surgery are at risk for postoperative neurological deficits and sequelae.

Awake fiberoptic intubation is considered the technique of choice for tracheal intubation in patient with cervical spine instability. However, awake fiberoptic intubation frequently causes significant patient discomfort, requires patient cooperation, anesthesiologist expertise and the availability of costly equipment .

Videolaryngoscopy guided intubation is considered to be an effective alternative to awake fiberoptic intubation for cervical spine surgeries.

Intraoperative neurophysiological monitoring (IONM) is a method that provides real time evaluation of the functional integrity of neural structures. The goal of IONM is to make surgery safer by detecting incipient neurological insults at a time when it can be avoided or minimized and by aiding in the identification of neural structure Rayia, et al. have described a case of monitoring intubation and neck extension for the indication of thyroidectomy in a Down syndrome boy with atlantoaxial instability under anesthesia with propofol and remifentanil without neuromuscular blockade. The authors conclude that this approach can be used to protect against spinal cord compression.

While research has thoroughly evaluated the effect of laryngoscopy and intubation on cervical spine movement, to date, little is known about the impact of intubation process on neurophysiological responses, and on the feasibility of utilizing IONM for establishing a safe airway intubation.

This prospective, interventional, cohort study is the first, to our knowledge, to examine the feasibility and added benefits of IONM throughout anesthetic intubation in patients undergoing cervical spine surgeries with the use of videolarynscope guided intubation.


Eligibility Criteria:
Inclusion Criteria:

All patients above 18y old, presenting for cervical spine surgeries , suffering from cervical spine instability, whom are able to comply with the study requirements and gave a written informed consent will be eligible for study enrollment.

Exclusion Criteria:

* Patients presenting with heart disease will not be eligible to participate.
* Patients with anticipated difficult airway.
* Patients with a language barrier.
* Patients with known allergy to any of the drugs used.
* Pregnant women
* Patients with a history of seizures or CVA.
Ultrasound Diagnostic for Diaphragmatic Dysfunction in Reanimation

Extubation is a crucial step when patients are being weaned from mechanical ventilator support. Indeed, the patient has to face an increasing burden imposed to the ventilation system. The ability to overcome this event will determine the patient survival. A warning signal could be very useful is this situation. 2 recent studies have shown that measuring diaphragmatic cupolas and muscular fibers thickening fraction could help to spot a population with a high risk of "diaphragmatic weakness", characterized by a high failure extubation rate. This study aims to verify that this kind of group of patients does exist.


Eligibility Criteria:
Inclusion Criteria:

* Successful spontaneous breathing trial and extubation expected on the same day and 1 of the following criteria :
* Age \> 65
* Mechanical ventilation during \> 7 days
* Cardiac history (ischemic, rhythmic or valve cardiopathy)
* Respiratory history (documented or likely chronic respiratory failure)

Exclusion Criteria:

* Patient who is tracheotomized
* Peripheric neuromuscular disease (myasthenia, myopathy)
* Surgery circumstances that could affect the quality of the ultrasound exam (drains or bandages)
* Pregnant woman
* Age \< 18
Virtual Reality Training Simulator for Cesarean Section

The goal of this is to determine the effectiveness of virtual reality training simulator for cesarean section.

Evaluate the effect of using VR surgery on the self-confidence and knowledge of cesarean section procedures.

A single center randomized controlled trial (RCT) was performed. The participants were obstetrics residents, fellows and residents in other majors with limited experience in performing cesarean section. The primary outcome measures were the self-assessment scores of trainee confidence using a virtual reality training and an objective assessment of the cognitive skills. The participants were randomly divided into a study group of VR training group and a control group. Participants in the study group used the VR application. The control group participants used similar content in a standard PowerPoint presentation on a laptop.

Eligibility Criteria:
Inclusion Criteria:

* Residents and fellows receiving training at Seoul National University Bundang Hospital and who wish to participate in this study

Exclusion Criteria:

* If trainee refuse to participate in this study
A New Blood Score for Myelofibrosis Staging

BCR:ABL1 negative myeloproliferative neoplasms (MPN) include three entities: polycythemia vera, essential thrombocythemia and primitive myelofibrosis. Myelofibrosis is a life-threatening complication in MPN with several therapeutic options including hematopoietic stem cell transplantation (HSCT) which remains the only curative treatment. Bone marrow biopsy with histological analysis allows myelofibrosis identification and staging. However, it is an invasive procedure that remains painful and provides potential haemorrhagic complications. Development of non-invasive biomarkers for myelofibrosis staging could help to better stratify this disease, better define patients' prognosis and lead to optimal cares.

The main aim of this work is to develop a non-invasive blood score including several biomarkers for myelofibrosis staging in MPN using bone marrow biopsy as a gold standard.


Eligibility Criteria:
Inclusion Criteria:

* Age \> 18 years
* Diagnosis of BCR::ABL1 negative MPN according to WHO criteria classification
* Indication for bone marrow biopsy
* Non opposition
* Social security affiliation

Exclusion Criteria:

* Non-contributory biopsy
* AML transformation
* Organ fibrosis (liver, lung, kidney...)
* HSCT
* Chronic inflammatory disease
SWEtick - a Prospective Multicenter Study of Tick-borne Diseases in Sweden

The purpose of the SWEtick project is to increase the knowledge of the various clinical presentations of emerging tick-borne diseases (eTBD), to assess their importance for human health, to develop and validate laboratory methods for diagnosis of eTBD, and to develop recommendations for knowledge-driven management of patients with suspected eTBD within the Swedish healthcare system.


Eligibility Criteria:
Inclusion Criteria in TBD and Non-TBD groups:

* Clinical suspicion of tick-borne disease (physician's assessment based on medical history, symptoms, clinical findings and sometimes laboratory results)

Exclusion Criteria:

* Incapacitated to understand the study information and make decisions (adults and adolescents \>15 years)
Effect of Reduction of Inflammatory Status on Glucose Metabolism in Overweight Men

Overweight increases the risk to develop chronic diseases including type-2 diabetes and cardiovascular disease. The low-grade inflammatory status often seen in overweight subjects is thought to play an important role in disease development.

The purpose of this study is to determine the role of inflammation on glucose metabolism and insulin resistance. In this study the effect of the anti-inflammatory treatment diclofenac on markers of inflammation and on parameters of glucose metabolism will be studied.


Eligibility Criteria:
Inclusion Criteria:

* Body Mass Index (BMI): 25.1 - 32.0 kg/m2
* Normal Dutch eating habits

Exclusion Criteria:

* diabetes, cardiovascular disease or hypertension
* Not suitable to receive diclofenac treatment
* Smoking
* Extreme physical activity (more than 6 hours/week)
* Reported slimming or medically prescribed diet