cyrilzakka/clinical-trials huggingface dataset:
Chemical and Mechanical Angioplasty for Vasospasm (SAVEBRAIN)

This is a monocentric randomized prospective trial comparing 2 different endovascular strategies of intracranial arterial angioplasty in case of refractory intracranial arterial vasospastic stenosis :

* chemical angioplasty
* chemical and mechanical angioplasty

Compare in a randomized prospective trial 2 approved treatments of refractory intracranial arterial vasospastic stenosis, chemical angioplasty versus chemical and mechanical angioplasty, using devices already used in clinical practice and CE marked: chemical angioplasty using Nimotop versus chemical and mechanical angioplasty with balloon or adjustable remodeling mesh on brain perfusion evaluated by brain computed tomography (CT) Perfusion

Nowadays, the choice between chemical or chemical and mechanical angioplasty depends on the neurointerventionist for each procedure, no difference in efficiency or safety has been proved and no solid scientific data helps the physician in choosing the correct treatment for each patient.

Eligibility Criteria:
Inclusion Criteria:

1. Age ≥ 18 years.
2. Non-traumatic intracranial hemorrhage (ruptured aneurysm, AVM, or per-procedural complication etc)
3. Ruptured aneurysm, AVM, intracranial arterial perforation or any bleeding lesion secured with surgical clipping or endovascular intervention.
4. No contra-indication to both CTP and MRI imaging
5. Subject or legal representative is able and willing to give informed consent.
6. Refractory of intracranial arterial vasospastic stenosis requiring an endovascular angioplasty with a severe stenosis defined on CTA or DSA; and/or a significant hypoperfusion defined according to the mismatch profile in stroke or a MTT\>6 seconds. The volume of critically hypoperfused tissue will be based on a time to maximum of the tissue residue function (Tmax) threshold of \>6 sec using the Rapid (or equivalent) software.

Exclusion Criteria:

1. Angioplasty by one of the two methods considered as impossible or too risky by the neurointerventionist
2. Inability to obtain consent from patient or patients relatives
3. Pregnant women
4. Less than 18 years of age
5. Need to use any other device
6. Vertebro-basilar arteries will not be randomized because of the difficulty to assess the perfusion volume in this territory, but will be treated if necessary according to our local protocol.
Role of Neuraminidase Activity on Endothelial Dysfunction in Type 2 Diabetes

The objective is to determine if neuraminidase inhibition with zanamivir is efficacious as a therapeutic strategy to restore endothelial function in T2D patients.

Twenty subjects will complete five days of treatment with zanamivir. Baseline measurements will be taken before the initiation of treatment, as well as after the conclusion of the treatment period (i.e., a total of two assessment visits per subject). Assessment visits will include: vitals (such as blood pressure, heart rate), fasting blood work for plasma neuraminidase activity, plasma sialic acid, plasma glucose and plasma insulin, brachial artery FMD, and glycocalyx integrity assessment via Glycocheck.

Eligibility Criteria:
Inclusion Criteria:

1. Men and women with a BMI of 25-39 kg/m2
2. Ages 45-64 years at randomization.
3. Diagnosis of T2D classified based on physician diagnosis.
4. No vulnerable populations (e.g., prisoners, pregnant, children) will be enrolled.

Exclusion Criteria:

1. Cardiovascular disease including myocardial infraction, heart failure, coronary artery disease, stroke
2. History of chronic renal or hepatic disease
3. Active cancer
4. Autoimmune diseases
5. Immunosuppressant therapy
6. Hormone replacement therapy
7. Excessive alcohol consumption (\>14 drinks/week for men, \>7 drinks/week for women)
8. Current tobacco use
9. Pregnancy (Premenopausal women will be required to complete a urine pregnancy test before participation)
10. History of asthma or chronic obstructive pulmonary disease.
11. History of allergic reaction to lactose or milk proteins
12. Intranasal live attenuated influenza vaccine (LAIV) given within 2 weeks before zanamivir administration or a planned dose within 48 hours after zanamivir administration. Product insert states to avoid zanamivir administration with intranasal live attenuated influenza vaccine (LAIV).
Self-confidence Study in Patients With Argus II Artificial Retina

To evaluate whether the use of the Argus II retinal prosthesis improves the confidence and self-esteem of patients with advanced retinopathy pigmentosa


Eligibility Criteria:
Inclusion Criteria:

* Major patient (≥18 years old)
* Patient already operated in France with artificial retina and having 1 year of follow-up
* Patient who has agreed to use his medical data for research purposes

Exclusion Criteria:

- Refusal to participate in the study
Urinary Antigen Test for Stretococcus Pneumoniae Serotype Prevalence in Community Acquired Pneumonia

This is an epidemiology study for the prevalence and serotypes of pneumococcus pneumoniae in hospitalized patients with community acquired pneumonia (CAP). The serotypes of the pneumococcus pneumoniae will be determined by a urinary antigen assay


Eligibility Criteria:
Inclusion Criteria:

Admitted with signs and symptoms suggestive of pneumonia which include one or more of the followings:

1. fever
2. CXR changes with consolidation, increased alveolar shadowing or hazziness
3. respiratory symptoms like increase shortness of breath, cough with sputum Raised inflammatory markers suggesting of bacterial infection with either increased white cell count or C-reactive protein, or both

Exclusion Criteria:

* Nosocomial pneumonia which is acquired \>= 48 hours after hospital admission. Pneumonia which are already known to be caused by pathogens other than pneumococcus pneumoniae.
A Study to Evaluate Symlin in Adolescent Subjects With Type 1 Diabetes Mellitus

This study will be the first evaluation of Symlin in adolescent subjects with type 1 diabetes mellitus and is designed to evaluate the blood levels (pharmacokinetics), biochemical and physiological effects (pharmacodynamics), and safety and tolerability of Symlin in these subjects.


Eligibility Criteria:
Inclusion Criteria:

* Diagnosed with type 1 diabetes mellitus for at least 1 year prior to screening
* Be on a stable regimen requiring multiple daily injections of basal and mealtime insulin or continuous subcutaneous insulin infusion for at least 2 weeks prior to screening
* HbA1c between 6.0% and 10.0%, inclusive, at screening
* Body weight \>=50 kg at screening

Exclusion Criteria:

* Currently being treated with the following medications: \*Any oral antihyperglycemic agent; \*Drugs that directly affect gastrointestinal motility
* Has been previously treated with Symlin/pramlintide (or has participated in a Symlin/pramlintide clinical study)
* Has received any investigational drug within 1 month of screening
A Comparative Study Between Amlodipine 10mg And 5mg With Hypertension For Whom 5mg Is Insufficient

The changes in the trough systolic blood pressure from the baseline were assessed after 8 weeks of double-blind treatment with amlodipine 10 mg or amlodipine 5 mg


Eligibility Criteria:
Inclusion Criteria:

* Untreated Hypertensive Patients: An systolic blood pressure of \>=160 mmHg or diastolic blood pressure \>=100mmHg.
* Treated Hypertensive Patients: An systolic blood pressure of \>=140 mmHg or diastolic blood pressure of \>= 90 mmHg.
* Patients with insufficient response to 5 mg of amlodipine in the screening period:Two successive systolic blood pressure measurements at Visit 4 (Week -2) and Visit 5 (Week 0 = baseline) \>=140 mmHg
* Patients with a screening treatment compliance rate \>= 80%

Exclusion Criteria:

* Subjects with secondary hypertension (renal disease, pheochromocytoma, and Cushing's syndrome, etc.), severe hypertension (systolic blood pressure of 180 mmHg or higher, or diastolic blood pressure of 110 mmHg or higher), and malignant hypertension
Effects of Humidified Ventilation on Arterial Oxygenation and Respiratory Mechanics During One Lung Ventilation

A continuous loss of moisture and heat occurs during mechanical ventilation and prediposes patients to airway damage. Vaporizing humidifier has known to be advantages of improvement of oxygenation and protection of airway damage. However, there is a lack of study about the effect of humidified ventilation on oxygenation and respiratory mechanics during one-lung ventilation. We therefore invesgate that the effect of humidified ventilation on oxygenation and respiratory mechanics during one-lung ventilation .


Eligibility Criteria:
Inclusion Criteria:

* ASA physical status class I,II
* Unilateral lung lobectomy
* Use of one-lung ventilation

Exclusion Criteria:

* COPD
* CAOD
* Unstable cardiovascular status
* Peak inspiratory pressure \> 30 mmHg
Impact on Mental, Physical, And Cognitive Functioning of a Critical Care sTay During the COVID-19 Pandemic

Intensive care unit (ICU) survivors and their families frequently present mental, cognitive and physical impairments lasting years. The ongoing pandemic could affect the duration, variety, and severity of these impairments. Our aim is to determine the impact of the COVID-19 pandemic on the physical, mental, and cognitive health of survivors, the experience of their families and their treating healthcare professionals in the long-term.

This is a prospective, multicentre, mixed-methods cohort study in seven Chilean ICUs. The perceptions of family members regarding the ICU stay and the later recovery will be explored 3 months after discharge. Health care professionals will be invited to discuss the challenges faced during the pandemic using semi-structured interviews.


Eligibility Criteria:
Inclusion Criteria:

* Adult patients (≥18 years old)
* Mechanically ventilated for at least 48 hours

Exclusion Criteria:

* Unable to walk independently 2 weeks prior to ICU admission (with or without a gait aid)
* S5q \< 5 or CAM-ICU positive within 72 hours after ICU discharge
* Patient who do not understand or speak Spanish
* Patient unable to communicate verbally
* Burn or severe trauma as admission diagnosis
* Any neurological disorder (i.e. spinal cord injury, stroke and brain tumours) as admission diagnosis
* Transferred to a non-participating study centre before ICU discharge assessment
* Recent prolonged hospital stay (extended by more than 3 months)
Efficacy of Oral Apremilast in the Treatment of Alopecia Areata at the Tertiary Care Hospital, Karachi.

Alopecia areata (AA) is a disease characterized by hair cycle dysfunction and the presence of peribulbar and perifollicular mononuclear cell infiltrate.1 The majority of patients report the rapid onset of one or several well-defined, usually round, 1 to 4 cm areas of scalp hair loss. A common feature is the presence of "exclamation-mark" hairs that are broken and short hairs that taper proximally.

Commonly used treatment modalities are steroids (intra-lesional, topical or systemic), contact immunotherapy, anthraline, minoxidil, calcineurine inhibitors, topical retinoids, systemic immune modulating agents, photo-chemotherapy, dermatography wigs and hypnotherapy etc Apremilast is a newer drug. It is an oral small-molecule inhibitor of phosphodiesterase 4 (PDE4), this may be effective treatment for a variety of inflammatory skin disorders such as alopecia areata.

Due to its increasing prevalence and lack of local data on its long term management, the investigators designed current study On Efficacy of Oral Apremilast in Alopecia areata in-order to evaluate its effectiveness.

Eligibility Criteria:
Inclusion Criteria:

* Either gender.
* Age 20-70 years.

Exclusion Criteria:

* Patients with history of connective tissue disorder, vasculitis, seropositive and seronegative arthritis
* Patients with history of psoriasis.
* Patients excluded from the study will be patients having history of previous treatments with some systemic agents
Study to Assess the Efficacy, Safety and Tolerability of (iTind)

Subjects with AUR secondary to BPO that comply with Inclusion/Exclusion Criteria.

A total of 50 eligible subjects will be recruited into the study to receive treatment with iTind system.

Study duration will be 12 months post implantation, with follow-up extension of up to 3 years. Extension of follow up period will not require an additional ICF.

Spontaneous acute urinary retention (AUR) is one of the most significant complications of long-term benign prostatic hyperplasia (BPH). In the past it has represented an immediate indication for surgery. Between 25% and 30% of men who underwent transurethral prostatectomy (TURP) had AUR as their main indication in older series and today most subjects failing to void after attempted catheter removal still undergo surgery. For this reason alone, AUR is an important and feared event from the viewpoint of the subject. The subject originally has inability to urinate, with increasing pain, and eventually a visit to the emergency room, catheterization, follow-up visits to the physicians, an attempt at catheter removal, and eventual recovery or surgery, which is both painful and time consuming.

After the acute period most men with AUR will be offered a 'trial without catheter' (TWOC) and about half will resume spontaneous voiding. Most men who fail a TWOC, experience a recurrent episode of AUR, or have moderate or severe lower urinary tract symptoms (LUTS) that are refractory to medical management will be considered for surgery.

In the older literature, the risk of recurrent AUR was cited as 56% to 64% within 1 week of the first episode and 76% to 83% in men with diagnosed BPH.

(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476058/). Additional researches show that ten percent of men in their seventies and 30% in their eighties will have AUR within the next five years.

Benign prostatic hyperplasia is the cause for the AUR in at least 65% of men presenting with AUR.

In the below study of the natural history of BPH, the risk of AUR was 1.6% at five years for men aged 40-49 years and 10% at 70-79 years.

Eligibility Criteria:
Inclusion Criteria:

* Male with AUR secondary to BPO
* Age ≥40 years
* Acute urinary retention with at least one failed trial without catheter (TWOC) while on alpha blocker
* Ability to sign an informed consent form
* Prostate volume \<80 ml
* Life expectancy \>1 year.

Exclusion Criteria:

* Suspected malignant disease of the lower urinary tract including prostate or bladder cancer
* Chronic retention of urine with history of either retention volume greater than one liter or upper tract obstruction
* Known neurogenic bladder
* Immunosuppression
* Suspected urethral strictures, bladder neck contracture, Urinary bladder stones
* An obstructive or protruding median lobe of the prostate
* An active symptomatic urinary tract infection
* Enrolled in another treatment trial for any disease
* Previous pelvic irradiation or radical pelvic surgery
* Any previous prostate surgery.
Evaluation of the 1999 and 2018 Periodontal Disease Classifications: a Retrospective Study

The aim of present study was to evaluate how the 2018 classification reflects the severity, extent and progression of the disease, taking into account the risk factors for periodontal disease, smoking and diabetes, when compared with the 1999 classification.


Eligibility Criteria:
Inclusion Criteria:

* Patients with a complete periodontal chart and full mouth radiographic series at baseline
* Diabetes Mellitus:Patients who consulted by an internist/endocrinologist and underwent HbA1c measurements in the last three months.
* Smoking status:All current smokers who had smoked more than 100 cigarettes in their lifetimes and used cigarettes for more than five years
* Patients meeting the case definition of periodontitis
* Relative radiographic bone loss(in %) was assessed on peri-apical radiograph films

Exclusion Criteria:

* individuals with a systemic disease other than diabetes
* Smokers not reporting the number of cigarette/days or patient(s) with diabetes that do not report Hemoglobin A1c (HbA1c) test results for diabetes.
* individuals who do not suffer from periodontitis
* Patients with inaccessible files because of bad debt, destroyed record, or deceased.
Clinical Pharmacists Role in the Management of Hypertension in Jordan

Background: studies have demonstrated the crucial role of clinical pharmacists as integrated part of heath care team. Not only in Jordan but also in the Middle East region, clinical pharmacy practice is not well established. This current study is the first to evaluate physicians - pharmacists' collaborative approach to uncontrolled blood pressure in Jordan and the Middle East.

Objective: this study aimed to evaluate clinical pharmacists' role in the management of uncontrolled hypertensive patients in Jordan. Design: single blinded randomized controlled clinical trial. Patients: 253 patients with uncontrolled hypertension specified as higher blood pressure readings than the recommended goals by the seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure (JNC VII) at the time of enrollment.

Interventions: patients were randomly allocated to an intervention or control group: 130 and 123 patients, respectively. Patients in both arms were followed up for 6 months. In the intervention group, patients were managed by physician-clinical pharmacist team. In the control group, patients were managed by physician(s) only and were not provided pharmaceutical care services.

Eligibility Criteria:
Inclusion Criteria:

* Patients with uncontrolled BP, receiving 0-3 antihypertensive drugs with no change in the regimen or dose within the past 3 month.

Exclusion Criteria:

* Patients with hypertensive urgency or emergency with BP more than (180/110).
* Patients with recent stroke or myocardial infraction (within past 6 months).
* Patients with Class III or IV Chronic heart Failure (CHF).
* Patients with Unstable angina.
* Patients with Serious renal or hepatic disease.
* Pregnant patients.
* Patients with Dementia or cognitive impairment.
* If the patient is unable to provide informed written consent.
Transforming Primary Care Payment in Hawaii

To design an innovative payment system that improves upon fee-for-service (FFS), incorporates behavioral economic principles, and improves work satisfaction among primary care physicians (PCPs) while improving quality and reducing health spending at the state level. Second, to test the incremental effectiveness of two additional interventions: (1) shared financial incentives between physicians and poorly controlled diabetes and (2) social comparisons ranking physicians on quality metric performance and total cost of care.

The goal of this project is to transform the Hawaii Medical Service Association (HMSA) primary care provider payment model to better incentive population health while bending the increasing trend of health spending in the state. Primary care and overall spending patterns will be studied to lay the foundation for a more rationally designed model. This model deliberately shifts away from FFS and includes three components: 1) a risk-adjusted per-member, per-month (PMPM) base payment, 2) an enhanced quality incentive program with larger bonus amounts and 3) a total cost of care incentive at the PO level. The aim is to build on the success of the Alternative Quality Contract (AQC) program implemented by Blue Cross Blue Shield (BCBS) of Massachusetts. While the AQC is used as a starting point, the study introduces and tests a number of innovations using concepts from behavioral economics. First, the move away from the FFS chassis to a PMPM-based capitated payment. Second, 20% of the PMPM payment is at-risk based on metrics designed to increase engagement between HMSA and physicians and engagement with performance feedback. Third, the number of metrics in the quality incentive program is drastically reduced from over 60 metrics to 10-12 per specialty. Fourth, the scoring of quality incentives incorporates rewards for improvement, rather than exclusively attainment of thresholds, to activate physicians along the entire performance distribution. In addition to implementing the new payment model, the initial experiment will include a test of two additional behavioral concepts: social comparisons for physicians and a shared incentive for physicians and poorly controlled diabetics tied to improve glycemic control.

Eligibility Criteria:
Inclusion Criteria:

* HMSA physicians who are part of a Provider Organization that is participating in the payment transformation pilot.

Exclusion Criteria:

* Any physician who is not part of a participating Provider Organization.
The Effect of Acupressure Application on Menopausal Symptoms

The study was conducted randomly controlled to determine the effect of acupressure application on menopausal complaints among women who applied to Cancer Early Diagnosis and Screening Center.

Research, between September 2019 and February 2020 of cancer in the body healthy life center in the east of the provincial center of Turkey was held by early diagnosis and screening center that refer to women.

The Universe and Sample of the Research The universe of the study consisted of women who applied to cancer early diagnosis and screening center for examination for any reason.

The calculation of the sample size of the study was determined according to the studies in which non-pharmacological methods were used to cope with menopausal symptoms. The calculation was determined according to the effect size of 0.5 in a moderate level, considering the effect size ranging between (0.25-0.83) reported by the studies on the subject.

Eligibility Criteria:
Inclusion Criteria:

* in the 45-65 age range.

Exclusion Criteria:

* receiving pharmacological treatment related to menopause,
* having a communication problem,
* have a hearing problem
* It is the presence of tissue deformity in its extremities.
Microcirculation of the Thenar Eminence

Microcirculatory disturbances following cardiac surgery with cardiopulmonary bypass (CPB) have been thought to be at the origin of organ dysfunction. Though, few studies correlated microvascular alterations with outcome. Investigators aimed at firstly describing microcirculation with near infra red spectroscopy (NIRS) and secondly correlating NIRS parameters with intensive care length of stay and organ dysfunction.

40 patients at high risk of post operative systemic inflammatory response syndrome after an elective cardiac surgery with CPB were included in this prospective observational study. Patients were studied during the first 48 postoperative hours. Microcirculation of the thenar eminence was analyzed by NIRS technology, through the StO2 and the resaturation slope after an ischemic challenge. Organ dysfunction was assessed with the SOFA score.

Eligibility Criteria:
Inclusion Criteria:

* Age \> 18 years
* scheduled for an elective cardiac surgery at high risk of post operative systemic inflammatory response syndrome

Exclusion Criteria:

* BMI\>35