cyrilzakka/clinical-trials huggingface dataset:
Comparison of Methods to Improve Abdominal Aortic Aneurysm (AAA) Screening Rates in the Primary Care Setting.

Standard of care dictates that eligible patients should receive an abdominal aortic aneurysm (AAA) screening ultrasound. At present, different military primary care physicians utilize different methods at their discretion to ensure their patients get screened-telephone contact; mail-out reminders; referring patients for ultrasound directly from an office visit; as well as other methods-which we will refer to as "usual care". The purpose of this study is to improve screening rates for AAA and determine what notification methods are best at improving screening rates.

Approximately 1700 male patients (DoD beneficiaries) between the ages of 65-75 will be selected from their medical records. The information on the attached abstracted data sheet will be collected. As part of standard patient care operations, the Family Medicine and Internal Medicine Departments will inform patients on the need to receive a AAA screening ultrasound, based on their primary care manager's (PCM) preference for clinical notification:

1. Nurse initiated Telephone Consult (T-Con) (see attached)
2. Mail-0ut Letter to the patient (see attached)
3. Provider, Nurse and Technician Education with point-of-care patient referrals , Exam Room Flyer
4. Control group (i.e. usual care)

The Provider, Nurse and Technician Education will consist of a presentation given by the Principal Investigator (see attached PowerPoint) to the Family Medicine and Internal Medicine clinic staff and the posting of Exam Room Flyers in each Family Medicine and Internal Medicine exam room to prompt and encourage patient referrals for a AAA screening ultrasound.

Information requested on the attached abstracted data sheet will be used for initial identification of patients that should have a AAA screening ultrasound and again 3-4 months later to see if these same individuals received the procedure. All informational data sets will be totally de-identified by the Research Coordinator, Nellis Air Force Base, prior to releasing to the Principle Investigator.

The data will then be analyzed by Dr. Anneke Bush (WHMC statistician) and the results will be provided to the Principal Investigator for analysis.

Eligibility Criteria:
Inclusion:

* Tricare Insurance Beneficiary (military insurance) receiving care at Nellis AFB
* Male patients (DoD beneficiaries) between the ages of 65-75 years old.

Exclusion:

* Female patients.
* Non-English speaking.
* Patients who have already had abdominal CT scan, abdominal MRI, aortography or aortic ultrasound.
* Patients already diagnosed with AAA
Food-based Approach Development to Fulfil Amino Acid Gap by Considering the Intestinal Permeability of Children

This study will be comprised of 2 phases. Phase 1 study is a comparative cross-sectional study which will be conducted among children aged 12-24 months living in agricultural area. A total of 172 healthy children consisted of 86 stunted children (Length for age z-score \<-2 Standard deviation) and 86 non-stunted children (Length for age z-score ≥0.5 Standard Deviation) will be recruited. Dietary intake, urine and dried blood spot from finger prick will be collected to assess amino acid intake, intestinal permeability and essential blood amino acid respectively. Qualitative study i.e. focus group discussion (FGD) and market survey will also be implemented. According to the result of phase 1 study, 2 types of food-based approaches will be developed, namely Complementary food recommendations (CFR) and Food multi-mix formula

Phase 1 study will recruit a total of 172 healthy children who are matched by sex and age. Aside of being stunted, children must have normal weight for length z-score (not wasted or overweight). Data collection will be performed as follows:

1. Dietary intake of the children will be collected by 9 days Estimated Food Record by visiting the respondents house
2. Urine will be collected once to measure intestinal permeability profile using Lactulose Mannitol ratio indicator.
3. Dried blood spot from finger prick will be collected to essential blood amino acid.

To collect information on locally available and culturally accepted protein rich food sources, series of focus group discussion (FGD) and market survey will also be implemented.

Food-based approaches will be developed according to the information attained from phase 1 study. Problem nutrients that are identified from dietary assessment will be fulfilled through optimization of locally available food by using linear programming approach. Problem nutrients that are not able to be fulfilled by CFR will be use as a basis to develop a Food multi-mix (FMM) formula. Data of intestinal permeability profile will be used to add other locally available food in FMM that are potential to improve intestinal permeability.

Eligibility Criteria:
Inclusion Criteria:

1. Stunting group is defined as length for age Z-score (LAZ) \<-2.0 SD and non-stunting group as LAZ ≥-0.5 SD
2. Normal weight for length Z-score (WLZ ≥-2 SD to ≤+1 SD)
3. Group matching by age, gender
4. Singleton
5. Full term gestation
6. Normal birth weight
7. Living with mother
8. Not suffered from diarrhea at least in the last 1 month (as reported by the mothers)
9. Not suffering from fever during assessment (as measured by the health staff)
10. Not born from diabetic mothers (as reported by the mothers)

Exclusion Criteria:

1. Drink Ultra High Temperature (UHT) milk at least 15 days before urine collection
2. Taking any medication.
3. Had taken non-steroidal anti-inflammatory drugs within two weeks of the study,
4. Taken antibiotics within 4 weeks of the study,
5. Unable to drink the sugar solution
6. Refuse to participate until completion of the study
Daylight PDT for Actinic Keratoses: a Multicentre Study Comparing Two Photosensitizers (BF-200 ALA Versus MAL)

This study compares two photosensitizing creams' BF-200 ALA's (aminolevulinic acid, Ameluz®) and MAL's (methyl 5-aminolevulinate, Metvix®) efficacy on actinic keratoses in natural daylight photodynamic therapy (NDL-PDT). The participants' facial skin or scalp will be randomized in two sides and one side is treated with BF-200 ALA and the other side with MAL. Result of the treatment is assessed with clinical examination 12 months after treatment. The investigators will also compare delayed skin reactions after treatment and cost-effectiveness of both photosensitizer creams.

Photodynamic therapy (PDT) is a widely used method in dermatology clinics for treatment of superficial skin cancers and premalignant lesions. Actinic keratoses (AKs) are premalignant skin lesions which develop due to long-lasting sun exposure and in time can progress into squamocellular skin cancer if left untreated. The incidence of AKs and skin cancers is rapidly booming as the elderly population increases in western countries. It is crucial to treat AKs early and effectively considering their tendency to progress into malign cancer. The current general consensus for treating AKs is to treat large sun-damaged skin areas simultaneously instead of separate AK lesions. Term "skin field cancerization" refers to presence of different degrees of visible and invisible dysplastic changes in widely sun-damaged skin. Natural daylight mediated photodynamic therapy (NDL-PDT) is a well-suited method for treating large field-cancerized skin areas.

In PDT a photosensitizing cream is applied on the skin and let to absorb. After absorption to the skin cells the photosensitizer changes into protoporphyrin IX (PpIX). PpIX reacts with visible light causing a phototoxic reaction which destroys cancer cells targetedly. After absorption the skin can be illuminated using a red lamp (conventional PDT) or natural daylight (NDL-PDT) as the absorption spectrum peaks of PpIX are within the visual spectrum of light.

In Finland the approved photosensitizers for PDT are methyl 5-aminolevulinate cream (MAL, Metvix®, Galderma) and aminolevulinic acid gel (BF-200 ALA, Ameluz®, Biofrontera AG). They both have been clinically studied and proved effective in conventional PDT but in NDL-PDT mainly MAL has been in focus of studies. To our knowledge there is only research report concerning the use of BF-200 ALA in NDL-PDT (Neittaanmaki-Perttu et al 2014) which is a study of our own research group. In this study BF-200 ALA appeared to be more effective than MAL.

Eligibility Criteria:
Inclusion Criteria:

* Patients with widespread AK lesions symmetrically on face or scalp (at least 3 actinic keratoses symmetrically on face or scalp)
* AKs of grade I-II

Exclusion Criteria:

* Thick grade III AKs
* Previous treatment for actinic keratosis on the same skin area during preceding 6 months
* Porfyria or solar dermatitis
* Allergy for photosensitizers used in the study
* Pregnant or breastfeeding patients
* Impaired general condition (patient can't manage required 2 hours in sunlight outdoors)
COMPARATIVE EFFECTS OF PERIOPERATIVE AND ADJUVANT CHEMOTHERAPY ON OUTCOMES OF OPERABLE GASTRIC CANCER: EXPERIENCE FROM A CANCER CARE CENTER

* Patients with gastric adenocarcinoma
* Comparison: perioperative chemotherapy vs. adjuvant therapy.
* Sample size differences between the two groups.
* Kaplan meier survival analysis, overall survival and disease free survival


Eligibility Criteria:
Inclusion Criteria:

* We included histologically proven gastric adenocarcinoma patient with operable disease and the patients who completed their prescribed perioperative or adjuvant chemotherapy cycles

Exclusion Criteria:

* Patients were excluded if they had Tis or T1, N0 disease, inoperable disease, metastatic. In addition, all those who did not undergo adequate lymphadenectomy (\< D2) or had R1 margins following surgery were excluded
Calcium Reduction by Orbital Atherectomy in Western Europe

In calcified lesions, optimal stent placement and expansion may prove to be challenging. Lesion preparation is necessary to facilitate optimal stenting in calcified lesions, for which orbital atherectomy can used. Therefore the aim of this study is to:

1. Show that orbital atherectomy effectuates optimal stent expansion
2. Investigate the mechanics of lesion preparation when using orbital atherectomy

Patients presenting with a significant and severely calcified lesion in need of orbital atherectomy will undergo optical coherence tomography guided orbital atherectomy and stent placement.

The Diamondback 360° Coronary Orbital Atherectomy System (OAS) (Cardiovascular Systems Inc., St. Paul,MN,USA) is a percutaneous device indicated to modify calcified lesion in order to facilitate stent delivery in patients with severely calcified coronary artery disease (CAD). As of to date, detailed sequential intravascular imaging data unraveling the exact calcium modifying effect of orbital atherectomy (OA) prior to stent placement in vivo, are lacking.

The aim of this, international, multicenter, prospective and observational single arm study is to understand the mechanism of action of OA for the treatment of de novo, severely calcified coronary lesions priot to stent placement using optical coherence tomography (OCT) and to assess stent expansion, based on OCT derived minimal stent area. The study population consists of patients undergoing percutaneous coronary intervention of a severely calcified coronary lesion in need of OA to enable proper stent placement and expansion.

A total of 100 patients will be enrolled. All patients will undergo peri-procedural imaging using OCT and the aim is to obtain data for at least 50 patients with OCT before and after OA and after stenting.

Eligibility Criteria:
Inclusion Criteria:

* De novo significant native coronary artery lesion
* The target lesion must have evidence of severe calcification: 1) presence of radiopacities noted without cardiac motion prior to contrast injection involving both sides of the arterial wall with calcification length of at least 15 mm and extend partially into the target lesion. 2) OR presence of ≥ 270° of calcium or lumen protruding calcified nodules at \>1 cross section by intravascular imaging (OCT)
* The target vessel reference diameter ≥ 2.5 mm and ≤ 4.0 mm and lesion must not exceed 40 mm in length

Exclusion Criteria:

* Left main disease
* Prior stenting of the target vessel
* Target lesion has thrombus or dissection
* Known left ventricular ejection fraction LVEF ≤ 25%
* Diagnosed with chronic renal failure (GFR \< 30 ml/min)
* Confirmed pregnancy
* Life expectancy \< 12 months
* Coronary anatomy that prevents delivery of OCT catheter
* Known allergy to soybean oil, egg yolk phospholipids, glycerin or sodium hydroxide
Assessment of the Effectiveness of Virtual Reality as a Learning Tool for Relaxation Techniques in Reducing Pediatric Migraines and Tension Type Headache

The goal of this interventional study is to assess the efficacy of a therapeutic intervention aimed at diminishing pediatric chronic headache. This intervention is based on the development of relaxation skills, particularly the practice of deep breathing, using virtual reality in conjunction with a biofeedback device. Specifically, it aims to assess the relevance of this tool both in learning relaxation techniques and in changing cognitions involved in pain adjustment, such as self-efficacy and pain catastrophizing.

The main hypothesis is that the intervention using virtual reality will lead to greater daily use of the relaxation techniques learned, as well as an increase in the associated self-efficacy, resulting in a reduction in headaches (in terms of frequency and intensity) both immediately after the intervention and two months later.

A secondary hypothesis is that this intervention will contribute to a decrease in negative pain perceptions, pain catastrophizing, and functional disability.

A tertiary hypothesis is that the intervention will lead to an improvement in the child's quality of life.

The effects of this intervention will be compared to those of a similar intervention without the use of virtual reality, as well as to a control condition in which only psychoeducation is provided.


Eligibility Criteria:
Inclusion Criteria:

* Having a history of headaches for at least 6 months, or having been diagnosed with migraines and/or chronic tension-type headaches according to the criteria of the International Headache Society (IHS) by a pediatric neurologist.

Exclusion Criteria:

* having an epilepsy disorder
Sleep Quality and Sleep-disordered Breathing in Bypass Surgery Patients

Patients undergoing non-emergency coronary artery bypass surgery (CABG) are included. All patients will be examined for transthoracic echo, blood samples will be collected, and an overnight sleep polygraph will be performed in a qualified sleep laboratory twice: once before CABG and again after surgery

Detailed Description:

Our hypothesis is that sleep-related apneas are increasing following coronary artery bypass surgery, and sleep quality may deteriorate. We are attempting to determine the causes of these difficulties, which are caused by microemboli in the brain from the use of a heart-lung machine, brain infarction induced by major surgery, thoracic tissue trauma following surgery, or complications during perioperative care. The hypothesis is that postoperative outcomes and recovery are related if a patient is identified with sleep apnea before CABG surgery. A sleep polygraph is performed before surgery and again around six months after, as well as a transthoracic echo and laboratory tests. If a link between sleep quality and coronary bypass surgery can be established, the results can be employed in clinical practice.

The total amount of patients operated on heart-lung machine is anticipated to be 70. The off-pump patient sample size is remarkably smaller, so data is collected and compared with the main sample population. The operation technique is decided when the patient is scheduled for operation. Emergency patients are excluded because pre-operative examinations cannot be performed. Other exclusion criteria are nighttime CPAP- treatment and other heart operations (for example valve surgery) during CABG.

Basic information including age, weight, height, diseases, medications, and medical history are collected from all patients. ECG is registered before and after surgery and sinus or other heart rhythms are recorded. Sleep polygraph is done preoperatively and postoperatively when the patient is fully recovered from surgery (at 6 months or more).

Eligibility Criteria:
Inclusion Criteria:

Elective coronary artery bypass surgery

Exclusion Criteria:

* Emergency cabg
* Night time cpap- treatment
* other heart operations (for example valve surgery)
The Effect of Different Virtual Reality Trainings on Gait, Balance and Posture of Individuals With Dementia

Dementia, a part of geriatric syndrome, is characterized by the deterioration of multiple cognitive domains such as memory, language, orientation, learning and personality as a result of damage to the central nervous system and in terms prognosis persistent and often progressive clinical condition. In the epidemiological studies it is stated that the number of the dementia affected people approximately 2 times in every 20 years. In several studies, it has been mentioned that cognitive disorders affect individuals' motor function such as gait and postural responses. These effects lead to a vicious circle by causing immobilization of individuals due to a decrease in cognitive functions in addition to immobilization due to aging. The lack of pharmacological therapies to change the prognosis of dementia, emphasizes physical activity methods due to its neurological contributions. However, due to the fact that conventional exercise programs are seen as boring in terms of elderly individuals and the exercise attendance rates are low, the virtual reality (VR) training have been preferred recently. To the best of the investigator's knowledge, there is no study examining the effect of different virtual reality trainings on the spatio-temporal characteristics of the gait, posture and balance. Therefore, the aim of this study is to evaluate the effect of different virtual reality trainings on these parameters.


Eligibility Criteria:
Inclusion Criteria:

* Diagnosed with dementia
* Mini-Mental State Examination (MMSE) score between 18-23 points
* Able to walk independently with/without a walking aid (a single point cane)
* Able to speak and understand Turkish
* Understand simple commands
* At least primary education

Exclusion Criteria:

* Severly vision and hearing problems
* Undergo acute retinal hemorrhage or ophthalmic surgery
* Acute or chronic neurological problems
* Musculoskeletal and/or neurological problems affecting movement and balance
* Vestibular problem and/or use medicine
* Uncontrolled cardiovascular disease, congestive heart failure, acute myocarditis, pulmonary hypertension, or using a pacemaker
* Malignancy
* Orthopedic or neurological surgery in the past 6 months
Management and Outcome of Fever in Children in Europe

This is an observational study assessing the management and outcome of children presenting to Emergency Departments (ED) with fever across Europe.

This is an observational study assessing the management and outcome of children presenting to Emergency Departments (ED) with fever across Europe. This study will use large departmental datasets to collect information on at least 50,000 febrile episodes . This study will use large-scale, pseudo-anonymized departmental data, and will not involve consented patient recruitment; nor will it use patient samples. Data included in MOFICHE will be based on that collected as part of routine clinical care. Antibiotic prescription, hospitalisation and number/type of investigations, re-attendance at ED within 5 days of the first hospital presentation will be recorded.

Eligibility Criteria:
Inclusion Criteria:

* aged 0- 18 years visiting the emergency care.
* fever measured at ED or history of (measured) fever less than 3 consecutive days prior to presentation at emergency department

Exclusion Criteria:

-
Simplified vs Conventional Drilling Protocol for Implant Placment

Despite the growing interest in these alternative drilling protocols, there is a lack of robust clinical evidence evaluating their long-term effects on MBL. The aim of the present study was therefore, to evaluate the effect of implant site preparation technique (conventional drilling versus simplfied) on change in the marginal bone level and insertion torque.


Eligibility Criteria:
Inclusion Criteria:

* Patients without any systemic pathologies that could be considered grounds for absolute contraindication.
* Adult patients who agreed to participate in the study and signed the informed consent form.
* Patients who smoked fewer than ten cigarettes per day.
* Patients who were not completely edentulous.
* Patients who were partially edentulous in the posterior maxillary or mandibular area and did not require the use of regenerative techniques.
* Patients with an area of healed, mature bone at least three months post-extraction.

Exclusion Criteria:

* Patients missing teeth in the esthetic zones 13-23 and 33-43 (second and fifth sextants).
* Patients who smoked more than ten cigarettes per day.
* Patients with a bleeding index greater than 30%.
* Patients with dental caries or periodontal disease.
* Pregnant or lactating women.
Myo vs. Myofascial Injection for Myofascial Trigger Points

In this study, the effectiveness of two different application methods that can be used in myofascial trigger point injection treatment will be compared.

This study aims to compare the intramuscular trigger point injection, which is traditionally used in the treatment of myofascial trigger points with the method in which facial layers are also included in the application.

Eligibility Criteria:
Inclusion Criteria:

Pain in the upper back area

Detection of active trigger point in upper back muscles (trapezius, levator scapula, rhomboids, supraspinatus and infraspinatus)

Presence of at least two of the three criteria recommended for the diagnosis of trigger point:

1. Taut band
2. Hypersensitive point
3. Referred pain

Pain VAS score ≥ 4

Between the ages of 18-65 -

Exclusion Criteria:

Using analgesics or anti-inflammatory medicines.

Having received physical therapy for the same symptoms in the past 3 months

Serious psychiatric illness

Presence of malignancy or infection

Coagulation disorder

Pregnancy

History of operation in the relevant region

Presence of fibromyalgia syndrome

History of allergy to local anesthetics

-
Paclitaxel-eluting Balloon Angioplasty With Provisional Use of Nitinol Stent Versus Systematic Implantation of Paclitaxel-eluting Stent for the Treatment of Femoropopliteal de Novo Lesions

To determine in patients with symptomatic femoropopliteal lesions whether percutaneous revascularization with paclitaxel-eluting balloon angioplasty (PEB) and provisional nitinol stent is superior with respect to the 12-month incidence of restenosis compared to treatment with systematic paclitaxel-eluting stent (PES) angioplasty


Eligibility Criteria:
Inclusion Criteria:

* intermittent claudication or critical limb ischemia
* de novo stenosis ≥ 50% or occlusion of at least 40 mm in length located in femoropopliteal arteries
* presence of a clear healthy segment between the lesion in superficial femoral and common femoral artery and between popliteal and tibioperoneal trunk
* presence of at least 1 patent tibial vessel with distal run-off (below-the-knee artery was considered patent if free from obstructive lesions determining angiographic stenosis \>70%)

Exclusion Criteria:

* life expectancy \<1 year
* contraindication for combined antiplatelet therapy or known allergy to nickel or paclitaxel
* need for major amputation (MA) at the time of enrolment
* Failure to recanalize intended below-the-knee arteries in CLI patients at risk of major amputation