cyrilzakka/clinical-trials huggingface dataset:
Effect of Stellate Ganglion Block on Pharyngeal Dysphagia After Cerebralvascular Accident

This was a multicenter randomized controlled study. 66 post-stroke patients with pharyngeal dysphagia were randomly allocated to the observation group (n=33) or the control group (n=33). Both groups were provided with comprehensive rehabilitation including routine rehabilitation and swallowing function training. Besides, the observation group additionally underwent the stellate ganglion block (SGB). At admission and after 20-day treatment, Kubota water swallowing test, video fluoroscopic swallowing study (VFSS), and Rosenbek penetration-aspiration scale (PAS) were used to assess swallowing function.

Dysphagia is a frequent and potentially serious complication of stroke. However, there is no effective measure for the treatment of pharyngeal dysphagia in stroke patients. This study aims to explore the efficacy of stellate ganglion block in post-stroke pharyngeal dysphagic patients who received comprehensive rehabilitation. This was a multicenter randomized controlled study. 66 post-stroke patients with pharyngeal dysphagia were randomly allocated to the observation group (n=33) or the control group (n=33). Both groups were provided with comprehensive rehabilitation including routine rehabilitation and swallowing function training. Besides, the observation group additionally underwent the stellate ganglion block (SGB). At admission and after 20-day treatment, Kubota water swallowing test, video fluoroscopic swallowing study (VFSS), and Rosenbek penetration-aspiration scale (PAS) were used to assess swallowing function.

Eligibility Criteria:
Inclusion Criteria:

* Age between 30 and 80 years;
* New-onset stroke;
* The course of disease between 1 to 6 months;
* With pharyngeal dysphagia;
* Stable vital signs;
* Voluntary participation in the study.

Exclusion Criteria:

* Allergy to Lidocaine injection or vitamin B12 injection;
* Severe cognitive impairment;
* Coagulation disorders;
* Severe dysfunction of organs including heart, lungs, kidney, liver, etc.;
* Complicated with other neurological diseases;
* Dysphagia caused by other diseases or reasons.
Enhanced Kidney Follow-up for AKI Survivors in Care Transitions

The purpose of this study is to assess the ability of education and outpatient kidney care follow-up in order to improve patient knowledge about acute kidney injury (AKI).


Eligibility Criteria:
Inclusion Criteria:

* KDIGO Stage 3 AKI
* Primary care provider at Mayo Rochester.

Exclusion Criteria:

* Patient with need for dialysis at discharge from hospital or hospice.
* Enrolled in the Primary Care Transition Program.
* Non-English speaking.
* Cognitive impairment.
* Dementia.
* Mini-Cog score of less than 3.
A Study of Ganciclovir in the Treatment of Cytomegalovirus of the Large Intestine in Patients With AIDS

To attempt to demonstrate the efficacy of ganciclovir (DHPG) treatment of cytomegalovirus (CMV) colitis in AIDS patients by evaluating both clinical and virologic parameters. To determine acceptability and the safety profile of a 2-week course of intravenous (IV) DHPG therapy.


Eligibility Criteria:
Inclusion Criteria

Patients must have:

* An underlying diagnosis of AIDS by CDC surveillance definition (group IV, category c-1 or subgroup D only).
* Colitis manifested clinically by diarrhea.
* Colon biopsy demonstrating a typical histologic picture of cytomegalovirus (CMV) disease.
* Cultures for CMV from blood and urine should be obtained within 1 week of study entry but need not be positive prior to entry. (A positive culture is needed for final inclusion in AN.)

Prior Medication:

Allowed:

* Topical acyclovir.

Exclusion Criteria

Co-existing Condition:

Patients with the following are excluded:

* History of chronic or acute liver disease.
* History of significant mental illness.
* Life expectancy \< 1 month.
* Presence of any cause of colitis other than cytomegalovirus (CMV). (The following tests must be negative:
* Stool culture for enteric bacterial pathogens, stool exam for ova and parasites, stool exam for cryptosporidia, stool exam for AFB.) Colitis that is so severe that it would be against the patient's best interest to be treated with placebo for 2 weeks prior to being eligible to receive ganciclovir (DHPG) on a "compassionate" use basis. Patients with a colitis of this severity should be treated with DHPG on "compassionate" use basis.
* Presence of clinically significant extra-colonic active CMV disease of retina or visceral organs (which could progress during the no-treatment period).
* Presence of significant renal disease resulting in any decrement of creatinine clearance from normal.

Concurrent Medication:

Excluded:

* Any other investigational drug, whether or not as part of a formal clinical study.

Patients with the following are excluded:

* History of chronic or acute liver disease.
* History of significant mental illness.
* Life expectancy \< 1 month.
* Presence of any cause of colitis other than cytomegalovirus (CMV). (The following tests must be negative:
* Stool culture for enteric bacterial pathogens, stool exam for ova and parasites, stool exam for cryptosporidia, stool exam for AFB.) Colitis that is so severe that it would be against the patient's best interest to be treated with placebo for 2 weeks prior to being eligible to receive ganciclovir (DHPG) on a "compassionate" use basis. Patients with a colitis of this severity should be treated with DHPG on "compassionate" use basis.
* Presence of clinically significant extra-colonic active CMV disease of retina or visceral organs (which could progress during the no-treatment period).
* Presence of significant renal disease resulting in any decrement of creatinine clearance from normal.

Prior Medication:

Excluded within 2 days of study entry:

* Nucleoside analogs.
* Excluded within 1 week of study entry:
* Antimetabolites or interferon.
LEFT ATRIAL MONITORING IN PATIENTS BEFORE AND AFTER MITRAL SURGERY - LAMBDA STUDY

Mitral valve leakage, or mitral regurgitation (MR), is associated with heart failure symptoms including shortness of breath, fatigue, irregular heart rate. When left untreated, it may cause death. Patients with MR can be divided in two broad groups: those with primary MR, caused by disease of the mitral valve structures, and those with secondary MR, due to dilation of the heart chambers. Our study focuses on patients with primary MR.

The standard treatment for severe symptomatic primary MR is mitral valve surgery, a type of open-heart surgery. The outcomes following this procedure are excellent, however, a subset of patients continue to experience heart failure symptoms after surgery due to very high pressures in the heart, more specifically in the left atrium, which is one of the four heart chambers. This is called functional mitral stenosis (FMS).

Previous studies have shown that creating a small opening between the left and right atria can help relieve the pressure inside the left atrium. We would like to determine whether creating this opening between the two atria at the time of mitral valve surgery can help prevent FMS. To answer this question, we will study two groups of patients who need mitral valve surgery for primary MR. The first group will undergo mitral valve surgery, along with the creation of the opening between the two atria. The second group will undergo mitral valve surgery alone. We will then compare the outcomes between both groups, namely with regards to their heart failure symptoms after open-heart surgery.


Eligibility Criteria:
Inclusion Criteria:

* Patients ≥18 years of age
* Severe (4+) symptomatic Carpentier Type II MR due to degenerative disease
* Planned surgical mitral valve repair
* Right-to-left atrial pressure gradient ≥ 5 mmHg at baseline
* Pulmonary vascular resistance ≤ 4 Wood units

Exclusion Criteria:

* Secondary causes of MR and mixed mitral valve disease
* Infective endocarditis within 30-days
* Any prior mitral valve intervention
* Need for emergency intervention or surgery
* Left ventricular ejection fraction 2+
Corrected Measurement of the Retinal Nerve Fiber Layer Thickness by Optic Disc Configuration With the Cirrus HD OCT

Because the measurement of the retinal nerve fiber layer thickness is very sensitive to the position of measurement, it may be incorrect in patients with the tilted disc. In the present study, the corrected RNFL thickness by the optic nerve head configuration using the Cirrus HD OCT will be evaluated. If the corrected RNFL thickness is more sensitive to detect the localized RNFL defect, the present software should be upgrade to reflect the optic nerve head configuration.

Finding the localized retinal nerve fiber layer (RNFL) defect and measuring the RNFL thickness are two main issues for early glaucoma detection. A recently developed imaging device, the Cirrus HD OCT, offers more detailed informations about retina architecture including optic nerve head. To calculate the RNFL thickness, the software of the Cirrus HD OCT supposes an ideal optic nerve head. However, in the cases with not ideal optic disc configuration, the measurement of the RNFL thickness is not correct. Because the measurement of the RNFL thickness is extremely sensitive to the position of measurement, patients with the tilted disc are in danger of misdiagnosis. In the present study, we want to correct the RNFL thickness measurement according to the optic nerve head configuration using the Cirrus HD OCT. If the corrected RNFL thickness is more sensitive to detect the localized RNFL defect, the present software should be upgrade to reflect the optic nerve head configuration.

Eligibility Criteria:
Inclusion Criteria:

* normal controls or glaucoma patients
* signal intensity of the OCT image \> 8
* cooperative subjects

Exclusion Criteria:

* spherical equivalent refractive errors \> +4 diopters or \< -4 diopters
* significant media opacity
* previous intraocular surgery
Antibiotic Use in Distal Hypospadias Repair

Hypospadias is a common condition where the opening of the penis is not located at the tip, but along the underside of the penis. It is estimated to occur in 1/300 live male births, making it one of the most common birth defects. Degrees of hypospadias ranged from minor to severe depending on the location of the opening. Surgical repair is often required and involves placement of a catheter for the urine to drain with known urinary colonization found on prior retrospective studies. The current practice of using preventative antibiotics as long as the catheter is in place is conflicting with resent studies that show antibiotics may not be necessary to prevent urinary tract infections (UTIs).

The purpose of this study was to see how common symptomatic UTIs were after hypospadias repair surgery; and to see whether routine antibiotic use after surgery affected the rate of UTIs. Subjects were randomized to either receive antibiotics or no antibiotics after distal hypospadias repair. The research coordinator made follow-up phone calls with the family and the primary care provider (PCP) after stent removal, 30 days post surgery and after the 3 month post surgical visit.

Males undergoing distal hypospadias repair involving stent placement were randomized to either receive or not to receive antibiotics post-operative. All subjects did not receive intra-operative antibiotics. Routine follow-up included having the stent removed one week post-op and a return visit at 3 months. The research nurse made follow-up phone calls to the family or the (PCP) one week after the stent was removed and at one month post-op to see how things were going with the child and again after teh 3 month post surgical visit, if the subject did not return after multiple rescheduling attempts.

Eligibility Criteria:
Inclusion Criteria:

* Males undergoing primary distal hypospadias repair with open urethral stent drainage.

Exclusion Criteria:

* Males undergoing fistula repair or glandular hypospadias repair without incontinent urethral stent drainage and hypospadias repair of mid or more proximal degrees of hypospadias were excluded from this study.
Electrocardiographic Mapping and Imaging

The purpose of this study is to evaluate a novel non-invasive cardiac electric imaging methodology for localizing and imaging cardiac electrical activity from body surface electrocardiographic recordings in patients with ventricular tachycardia (VT). Using non-invasive means will increase our ability to correctly diagnose cardiac abnormalities, and aid ablation of cardiac arrhythmias, offering enhanced performance to what currently exists.

Specific Aims

1. Use non-invasive cardiac electric imaging to provide information as to the sites of origin of arrhythmias and sequence of cardiac activation and repolarization.

Methods and Procedures Approximately 8 patients with recorded Premature Ventricular Contractions (PVC), Wolff-Parkinson-White (WPW) or other ventricular tachycardia cases which need Ensite/Carto endocardial mapping and radiofrequency ablation treatment will be enrolled.

One day before catheterization and ablation, patients will undergo approximately 30 minutes of Body Surface Potential Mapping (BSPM) recordings with about 200 surface electrodes arranged in 20 strips, attached on his/her front and back. BSPMs will be recorded in the baseline resting rhythm.

On the day of ablation, before catheterization in the surgical room, the BSPM recording procedure will be carried out with the patient using the same technique used during the first BSPM study.

Clinical endocardial mapping data may also be obtained concurrently with BSPM recordings before the ablation procedure.

Another BSPM recording will be made 30-60 minutes after successful ablation with the patient still in normal sinus rhythm if possible. Patients will be followed up 1 month after ablation with the same method of BSPM recorded at the baseline resting rhythm.

Eligibility Criteria:
Any patient undergoing ablation.
Research on the Risk Warning Model and Prevention Strategies for Acute Kidney Injury Associated With Cyclosporine Based on Explainable Deep Neural Networks and Therapeutic Drug Monitoring

In this study, the investigators will focus on hospitalized patients using cyclosporine and develop an acute kidney injury risk prediction model through in-depth analysis of electronic medical record data, employing interpretable deep learning methods. This model aims to provide timely decision-making support for clinicians regarding prevention and treatment. Compared to traditional machine learning models, deep neural network models can extract deeper features from complex medical data and perform more precise pattern recognition, thereby improving the accuracy and reliability of predictions. By developing a prediction tool based on interpretable deep learning models, the investigators will be able to better assess the association between the use of CNI-class immunosuppressants and acute kidney injury, explore targeted prevention strategies, and offer more accurate prediction and intervention guidance for clinicians. Additionally, this study has significant socioeconomic benefits and promising prospects for application and promotion.


Eligibility Criteria:
Inclusion Criteria:

1. During hospitalization, tacrolimus or cyclosporine was used, and therapeutic drug monitoring was conducted according to standard procedures.
2. Aged 18 years or older at the time of admission.
3. Length of hospital stay \&gt; 48 hours.
4. At least 2 serum creatinine tests were conducted during hospitalization.

Exclusion Criteria:

1. Chronic kidney disease stage 5 was achieved before admission.
2. Incomplete clinical data.
3. Serum creatinine levels were consistently below 40 mmol/L during hospitalization.
Understanding GMK Sphere Implant Tibiofemoral Kinematics by Means of Dynamic Videofluoroscopy

The objective of this research project is to perform a comparative study on the in vivo kinematics of the GMK Sphere prosthesis in comparison to the conventional GMK PS Fixed Bearing TKA and the GMK UC Fixed Bearing TKA.


Eligibility Criteria:
Inclusion Criteria:

* subjects bearing a TKA with one of the studied prosthesis
* male and female older than 18 years old
* patients who are willing and able to sign an informed consent form

Exclusion Criteria:

* any case not described in the inclusion criteria
Activity Trackers for Improving BP

The study aims to determine if use of physical activity trackers coupled with provider feedback will increase awareness of young adults of their physical fitness and improve blood pressure levels. The goal of this pilot study is feasibility, with a secondary goal of examining potential effect sizes for planning purposes for a larger randomized controlled trial.

Increasing physical activity levels may improve cardiovascular health and BP levels in young individuals, especially if such strategies promote healthy lifestyles. Physical activity is currently recommended for adults CV health, but physical activity levels are known to be low in populations with diabetes or chronic kidney disease. One prior study of the use of pedometers (not associated with wireless technology or provider feedback) in children with CKD did not significantly improve physical activity levels. Supervised walking appeared to provide some benefit in individuals with type II diabetes, but overall compliance was poor. Interview of adolescents and young adults with chronic illnesses has shown preference for the use of electronic devices and online tools for disease management.Thus, use of sophisticated electronic devices such as FitBits© (wireless pedometers worn on the wrist that sync with cell phones) may improve disease control by engaging young patients in self-monitoring of their own health and lifestyle behaviors. This pilot study aims to determine if use of FitBits© coupled with provider feedback will increase awareness of young adults of their physical fitness and improve blood pressure levels.

Eligibility Criteria:
Inclusion Criteria:

* ages 8-30 receiving anti-hypertensive therapy at the time of recruitment.
* diabetes, non-dialysis requiring chronic kidney disease, kidney transplant, or other etiologies of hypertension
* have phones compatible for wireless device (FitBits©) data transmission

Exclusion Criteria:

* history of decompensated congestive heart failure
* pregnant
* cognitive impairment
* unable to perform physical activity
* BP \>180/110 mm Hg
* prisoners
* contraindication to use or wear of home activity tracker (such as allergy to activity tracker band)
* presence of any co-morbidity that would preclude physical activity
* actively using physical activity tracking devices prior to the study will be excluded.
Study of Provider Computer Alerts Designed to Improve Delivery of HIV Care

The purpose of this study is to determine whether alerts independent of the ambulatory health record are more effective in eliciting physician responses and therefore have greater impact on HIV disease outcomes than traditional static alerts.

This study will compare the effectiveness of standard and enhanced care alerts in HIV infected participants at Massachusetts General Hospital in Boston, Massachusetts.

Participants will be a part of this study for 4 years or until they are no longer followed at Massachusetts General Hospital. Participants will be assigned randomly to one of two arms. Participants assigned to Arm 1 will receive standard care, involving standard provider alerts which will be posted on the participant's health record. Participants assigned to Arm 2 will receive enhanced care, involving improved functionality. Experimental informatics-based provider alerts and support systems will be used to develop a pilot system designed to optimize delivery of HIV clinical care.

All participants will be monitored for new laboratory toxicities, suboptimal follow up, and virologic failure at their normally scheduled appointments.

Eligibility Criteria:
Inclusion Criteria:

* HIV infected
* Followed in the Massachusetts General Hospital HIV clinic.

Exclusion Criteria:
HIgh Flow Versus NIV for Acute Cardiogenic PuLmonary Oedema With Acute Respiratory Failure in an ED

The purpose of this study is to compare non invasive ventilation to high flow nasal cannula oxygen for the management of patients admitted with an acute respiratory failure due to an acute cardiogenic pulmonary edema.

Acute cardiogenic pulmonary oedema is a leading cause of acute respiratory distress in patients admitted in an Emergency Department. With diuretics and nitrite derivative, noninvasive ventilation is the first-line treatment of acute pulmonary oedema recommended by the European Society of Cardiology. Noninvasive ventilation is able to reduce the respiratory rate faster than standard oxygen therapy, to improve oxygenation, and some data suggest it could reduce the mortality rate. NIV may be poorly tolerated in certain patients, in whom it is associated with failure of treatment and poor outcomes. High-flow nasal cannula heated and humidified oxygen (HFNO) is a ventilatory support used in ICU and recently introduced in Emergency Departments. As compared NIV and standard oxygen therapy, HFNO reduces the mortality rate in patients with acute hypoxemic respiratory failure hospitalized in an ICU. In addition, in these patients, HFNO is also better tolerated than noninvasive ventilation. Some data suggested HFNO is superior to standard oxygen therapy in acute pulmonary oedema and could have a similar clinical effect to NIV. However, there is no research that has compared tolerance of patients admitted in an ED with acute pulmonary oedema and treated by HFNO or NIV.

Included patients will be treated with NIV or HFNO. NIV will be provided with an emergency and transport ventilator (Monnal T60, Airliquide, Antony, France) and HFNO will be provided with an AirVO2 device (Fisher and Paykel, New Zealand). Patients will be treated in an Emergency Department immediately after their admission and their consent. Treatment will be provided for a minimum of one hour. Tolerance of patients will be measured under treatment using a comfort numerical scale from 0 - well comfortable to 10 extremely uncomfortable. Clinical and biological patterns will be also recorded. Patients will be followed from their inclusion to 28 days after their inclusion.

Eligibility Criteria:
Inclusion Criteria:

* age over or equal 18 years old
* admitted in an Emergency Department
* acute respiratory failure defined by a respiratory rate over or equal 25 breathes/min or signs of increased work of breathing
* clinical suspicion of acute heart failure defined bu the European Cardiologic Society.

Exclusion Criteria:

* patient requiring immediate invasive mechanical ventilation
* neurologic distress defined by a Glasgow Coma Scale under 13
* haemodynamic failure defined by a Mean Blood Pressure under 65 mmHg or patient requiring catecholamines
Determinants of Compliance With Glaucoma Therapy

The purpose of this study is to determine which medical, demographic, and health belief factors are associated with glaucoma therapy compliance.


Eligibility Criteria:
Inclusion Criteria:

* open angle glaucoma
* be well controlled on current medical therapy
* be using a prostaglandin analogue