cyrilzakka/clinical-trials huggingface dataset:
Pharmacologic Treatment of Myocardial Ischemia Detected by Intracoronary ECG

After PCI searching for target lesion ischemia with intracoronary ECG will be performed and if found it will be treated pharmacologically

The study will include patients with coronary lesions and PCI. It will include patients with stable or unstable angina, without elevated hs-TnT. PCI will be performed and monitoring of intracoronary ST elevation. Any dissection or acute vessel closure will be promptly treated with balloon or stenting.

Although there could be good angiographic result sometimes ischemia could be detected in the treated region by means of intracoronary ECG ST elevation above 1mm.

This study aims to tackle this issue with randomization of the patients into three possible treatments - intracoronary adenosine, IIb/IIIa inhibitors or nitroglycerine alone - intracoronary ST segment will be searched for reverse or residual ischemia after the pharmacologic bolus.

The intracoronary electrocardiography (i.c. ECG) is a very sensitive method for ischemia detection. The i.c. ECG reacts earlier on ischemia; the changes are much more prominent and easy to register. The wire tip could be positioned directly in different regions and thus to "map" regional ischemia. In most of the studies and from our own observations became evident that when surface ECG do not react the i.c. ECG demonstrates significant changes in ST-segment and QRS complex. Moreover, the registration of i.c. ECG is very cheap and needs only an adapter connecting coronary wire end and ECG. An i.c. ECG also can differentiate residual ischemic changes in distal main vessel and side branch as sources of prolonged ischemia, respectively - source of periprocedural myonecrosis.

Once good angiographic result is obtained after stenting there could be different reasons for ischemia in the treated region - microembolic debris or coronary microvascular spasm.

Eligibility Criteria:
Inclusion Criteria:

* Subject at least 18 years of age.
* Target lesion(s) located in a native coronary artery with diameter of ≥ 2.5 mm and ≤ 4.5 mm. If there is side branch lesion(s) located in a native coronary artery with diameter of ≥ 2.0 mm.
* Target lesion(s) amenable for PCI with balloon angioplasty of the side branch.

Exclusion Criteria:

* Subjects with significant ST-T change (≥ 1mm).
* Non-cardiac co-morbid conditions are present with life expectancy \<1 year or that may result in protocol non-compliance (per site investigator's medical judgment).
* Subjects who refuse to give informed consent.
* Subjects with the following angiographic characteristics: left main coronary artery stenosis, total occlusion target lesion, lesion of interest located at infarct-related artery.
* Subjects with LVEF \< 30%.
* Subjects with moderate or severe degree valvular heart disease or primary cardiomyopathy.
* LBBB, RBBB, atrial fibrillation/flutter with no identifiable isoelectric line.
Effect of Adding Sildenafil to Protocol of Endometrial Preparation in Outcome of Frozen-thawed Embryo Transfer Cycles

The target of this study was an estimate the result of sildenafil on ultrasonographic endometrial thickness, endometrial pattern investigation estrogen level on the day of progesterone administration, Implantation rate and chemical pregnancy rate in frozen embryo transfer cycles .


Eligibility Criteria:
Inclusion Criteria:

* women \> 40 years old,
* history of endocrine disease
* Hysteroscopic surgery
* cardiovascular, renal and liver disease
* hypotension( blood pressure \< 90/50)
* history of stroke or myocardial infarction
* use of alcohol or substance

Exclusion Criteria:

A total of 80 patients with antecedent of poor endometrial response and had frozen embryo included in this study all women must to be \< 40 years old,

* no history of endocrine disease,
* no Hysteroscopic surgery, had a high quality embryos no cardiovascular,
* renal and liver disease and
* no hypotension (blood pressure \< 90/50) or
* history of stroke or myocardial infarction and
* don't use of alcohol or substance Patients with these conditions enter this study and based on randomized tables are divided in two groups.
Efficacy Study of Dysport® in the Treatment of Anal Fissure.

To evaluate the effect on healing rates of two different prognostic factors in patients treated with Dysport® for anal fissure: duration of fissure and dose of study drug


Eligibility Criteria:
Inclusion Criteria:

* Patients having idiopathic anal fissure in the posterior anal midline
* Patients having anal fissure present for less than 6 months
* Patients having symptoms (pain) present for a minimum of 2 weeks and not responding after 2 weeks of standard therapy (diet, laxatives, sitz-bathes)

Exclusion Criteria:

* Patients having anal fistulas or anal fissure of various causes such as Crohn disease, Behcet infectious ulceration, anal suppuration, subfissural infiltration, abscesses, acute haemorrhoidal attacks or inflammatory bowel disease
* Patients having idiopathic anal fissure in the anterior anal midline
* Patients having lateral or multiple fissures
* Patients having anal or perianal cancer
* Patients who underwent previous anal surgery or have cicatricial alterations or post-surgical cicatricial lesions
* Patients receiving drugs affecting neuromuscular transmission
* Patients who have received topical anaesthetic within 3 days of injection
* Patients receiving local treatment by myorelaxing agent
* Patients receiving prohibited analgesics
* Patients having bleeding disturbances or currently using coumarin derivates
* Patients having myasthenia or any genetic muscle disease
MANAGE Automated Glucose Monitoring

The objective of this study is to demonstrate that the OptiScanner® is safe and can provide accurate blood glucose levels in critically ill subjects.

Accuracy Hypothesis:

The assessment of blood glucose level that results from the OptiScanner is comparable to the YSI 2300 STAT Plus™ Glucose and Lactate Analyzer ("YSI Analyzer"; YSI Life Sciences, Yellow Springs, OH).

Safety Hypothesis:

The OptiScanner has an acceptable risk/benefit profile for a system that can provide repeated automated blood glucose levels for critically ill subjects.


Eligibility Criteria:
Inclusion Criteria:

* Signed informed consent by participant or his/her legally authorized representative
* At least 18 years old
* Admitted to the ICU or CCU
* Expected ICU or CCU stay of at least 18 hours at the time of enrollment (as judged by Investigator)
* Requires blood glucose monitoring; and
* A vascular access device that can be dedicated for connection to the OptiScanner is either already in-place, is planned to be placed for another purpose or can, in the opinion of the Investigator be safely placed exclusively for use in this study, and another access device is in place or can be placed for manually drawing samples to be evaluated using the YSI Analyzer. Note that CVCs should not be placed solely for the purposes of conducting this study. Refer to section 1.2.7 for details regarding vascular access devices and guidelines for selection and placement.

Exclusion Criteria:

* Pregnant or nursing
* In the Investigator's opinion the subject cannot safely tolerate the amount of saline required to be given to the subject (up to 360 mL per day)
* Hematocrit less than 15% or greater than 60%
* Subjects that require placement of an additional vascular access line will be excluded if they do not have a suitable access site free from any of the following conditions:

  * Peripheral vascular disease
  * History of placement site neuropathy or chronic pain
  * History of placement extremity coagulopathy or clot formation
  * History of vascular surgery on the same extremity as catheter placement
* Any medical condition that, in the Investigator's opinion, would warrant exclusion from the study or prevent the subject from completing the study, including but not limited to a high risk of complications associated with vascular access; or
* Participation in any other investigational drug or device study in the last 30 days and/or while enrolled in this study.
Traditional Versus Virtual Reality for Surgical Skills for ObGyn Residents

This study will verify if a comprehensive laparoscopic curriculum using virtual reality demonstrates skills transfer to the operating room, compared to the traditional teaching method.

Second-year residents from different programs of residency in obstetrics and gynecology in Porto Alegre, RS, Brazil, will be invited to participate in this study. they will be randomized to receive a comprehensive training in laparoscopy using modern virtual reality program or the traditional method of training according to their residency program. After 12 weeks of training, they will finish their training and they will perform advanced laparoscopic surgery in the simulator according to their specific needs, for example, salpingectomy, oophorectomy advanced laparoscopic suture or hysterectomy. Data generated from the simulator program will be compared between groups.

Eligibility Criteria:
Inclusion Criteria:

* residents in obstetrics and gynecology that are about to finish their second-year program

Exclusion Criteria:

* refuse to participate
Artificial Oocyte Activation

Studies reported that calcium signal deficiency or insufficiency during oocyte activation are related with embryo arrest and blastocyst quality. The utilization of Artificial Oocyte Activation (AOA) is safe and does not increase birth defects, cognition, language and motor skills. AOA is the first line of treatment in patients with globozoospermia (round headed spermatozoa). Poor responders in in-vitro fertilization (IVF) cycles represent a major challenge for fertility specialists and comprises about 10-15% of patients undergoing controlled ovarian hyperstimulation. The absence of synergy between the oocyte and sperm leads to a negative impact on oocyte activation. The European Society of Human and REproduction (ESHRE) recommends AOA in cases with failed fertilization/ low fertilization.


Eligibility Criteria:
Inclusion Criteria:

* Patients with poor or no blastocyst development in their primary cycle
* Group 1 - second cycle using AOA following the poor blastocyst development cycle
* Group 2 - second cycle without AOA following the poor development cycle

Exclusion Criteria:

* All cycles who do not have repeat cycles following the poor blastocyst development cycle
Intraoperative Goal-directed Blood Pressure and Dexmedetomidine on Outcomes

Perioperative organ injuriy remain an important threat to patients undergoing major surgeries. Intraoperative hypotension is associated with an increase in postoperative morbidity and mortality. Whereas individualized intraoperative blood pressure management is likely to decrease the incidence of postoperative organ injury when compared with standard blood pressure management strategy. Dexmedetomidine, a highly selective alpha2 adrenergic agonist, has been shown to provide organ protective effects. This study aims to investigate the impact of intraoperative goal-directed blood pressure management and dexmedetomidine infusion on incidence of postoperative organ injury in high-risk patients undergoing major surgery.

The number of patients undergoing surgeries is increasing worldwide. However, some patients develop complications or even die after surgery. Perioperative organ injury is the leading cause of the unfavorable outcomes.

Hypotension is not uncommon during major surgery and is highly responsible for the inadequate perfusion and organ injury. A recent study showed that individualized blood pressure management decreases the incidence of postoperative organ injury when compared with standard blood pressure management strategy.

Dexmedetomidine is a highly selective alpha2 adrenergic agonist. Previous studies showed that dexmedetomidine provides organ protection in various conditions. In a recent meta-analysis, perioperative dexmedetomidine reduceds the occurrence of postoperative delirium. However, whether it can reduce postoperative complications remains inconclusive.

This study aims to investigate the impact of intraoperative goal-directed blood pressure management and dexmedetomidine infusion on the incidence of postoperative organ injury in high-risk patients undergoing major abdominal surgery.

Eligibility Criteria:
Inclusion Criteria:

* Age 50 years or older;
* Scheduled to undergo abdominal surgery under general anesthesia with an expected duration of 2 hours or longer;
* With a preoperative acute kidney injury risk index of class III or higher (meet 4 or more of the following factors: age ≥56 years, male sex, active congestive heart failure, ascites, hypertension, emergency surgery, intraperitoneal surgery, mild or moderate renal insuffificiency, diabetes mellitus requiring oral or insulin therapy).

Exclusion Criteria:

* Severe uncontrolled hypertension (SBP\>180 mmHg or diastolic blood pressure \>110 mmHg);
* Acute or decompensated heart failure, acute coronary syndrome, or stroke within 1 month;
* Severe bradycardia (heart rate \< 50 bpm), sick sinus syndrome, second-degree or higher atrioventricular block without pacemaker, atrial fibrillation, or frequent premature beats;
* Severe hepatic dysfunction (Child-Pugh C) or chronic kidney disease (glomerular filtration rate \<30 ml/min/1.73 m2 or dependent on renal replacement therapy) ;
* Pregnant;
* Receiving dexmedetomidine or norepinephrine infusion before surgery;
* Do not provide written informed consent.
Effectiveness of Routine Physical Therapy With Intensive Bimanual Training in Cerebral Palsy Children

Effectiveness of Routine Physical Therapy With or Without Home Based Intensive Bimanual Training on Clinical Outcomes in Cerebral Palsy Children

Cerebral Palsy is one of the most common issue seen in pediatric rehabilitation .Home based intensive Bimanual training has proven to be one of the most effective rehabilitation training for improving motor. The study determines the effectiveness of routine physical therapy with or without home-based intensive bimanual training on coordination of hands and daily activities of daily living. A nine months randomized control trial was comprised of thirty children with unilateral spastic cerebral palsy aged between 4 to 7 years. One group received routine physical therapy and the other group received a goal specific bimanual training from their parents in their home setting for 3.5 hours per week for 6 weeks according to a modified set up. Follow up sessions were done at 6th week. Activities of daily living and coordination were measured using Pediatric motor log activity scale and ABILHAND respectively.

Eligibility Criteria:
Inclusion Criteria:

* Spastic CP children

  * Both male and female
  * Age 4-7 years
  * Actively grasp of objects from table i.e., stuff toys, making blocks
  * One to one attention

Exclusion Criteria:

* Cognitive delays preventing the child from following two-step instructions

  * Health diagnoses unassociated with USCP.
  * Parents unable to commit to entire duration of intervention.
  * Visual difficulties preventing performance of intervention tasks.
Long-term Outcomes of Post-intubation Tracheal Stenosis; 7-year Follow-up

This retrospective, observational, cohort study evaluates the treatment management, long-term outcomes and survival analyses in patients hospitalized in the Intensive Care Unit with a diagnosis of Post-Intubation Tracheal Stenosis (PITS) between 1st June 2016 and 1st June 2022. The study emphasizes the role of bronchoscopic interventions in treatment management and the effective and efficient use of health services.

This retrospective study will analyze data from adult patients aged 18 years and above who were admitted with a diagnosis of Post-Intubation Tracheal Stenosis to the intensive care units of Health Sciences University Ankara Atatürk Sanatorium Training and Research Hospital and Yenimahalle Training and Research Hospital between 2016 and 2022. The analysis will examine data from both the hospital registration system and the patients' intensive care files. Patients who have a history of malignancy contributing to tracheal stenosis, patients who have a history of congenital tracheal anomalies or tracheal stenosis, those with incomplete intensive care follow-up information, patient follow-up files or hospital information system data, and patients who have been repeatedly hospitalized (with only the first hospitalisation data taken into account) shall be eliminated from the study. If patients who were discharged from the intensive care unit have one-year post-discharge data, the investigators will obtain the information from the hospital's follow-up system. Otherwise, investigators will collect information by calling patients or patients first-degree relatives by phone.The post-discharge data is from a past period, and the one-year follow-up period for the last patient included in the study ends on 1st June 2023.

The aim of the study is to determine whether early diagnosis and interventional bronchoscopic treatment have an impact on the length of intensive care unit stay and prognosis for patients with Post-Intubation Tracheal Stenosis whilst in the intensive care unit. This will be achieved through an investigation of patient outcomes following appropriate interventions.

Eligibility Criteria:
Inclusion Criteria:

* Age \> 18,
* Intensive care patients diagnosed with post-intubation tracheal stenosis (PITS)

Exclusion Criteria:

* Patients with a history of malignancy in the etiology of tracheal stenosis
* Patients with a history of congenital tracheal anomaly or tracheal stenosis
* Patients with missing intensive care follow-up form, patient follow-up file or hospital information system data
* Repeated hospitalizations
Effect of Recombinant Human Growth Hormone (rhGH) on Abdominal Fat and Cardiovascular Risk in Obese Girls

Teenagers and adults who are overweight or obese have an increase in fat in the abdomen, which increases their risk for diabetes and heart disease. Reducing abdominal fat is important to reduce risk for diabetes and for heart disease. Overweight teenagers also have low levels of growth hormone compared to normal weight teenagers, and teenagers with the lowest growth hormone levels also have the greatest abdominal fat. In children who are unable to make growth hormone for other reasons, giving back growth hormone leads to a decrease in abdominal fat. We are studying whether giving growth hormone in small doses to overweight teenagers can change body composition. We hypothesize that growth hormone will cause abdominal fat to decrease and reduce the risk markers for diabetes and heart disease.


Eligibility Criteria:
Inclusion Criteria:

* Adolescent girls 13-21 years old with bone age ≥ 14 years
* Overweight girls: Body Mass Index (BMI) greater than the 95th percentile for age
* Waist/Hip ratio ≥ 0.85
* Insulin Like Growth Factor -1 (IGF-1) below -0.5 standard deviations (SD) for pubertal stage or age

Exclusion Criteria:

* Pregnancy (positive pregnancy test) prior to enrollment in the study
* Significant weight gain or loss within 3 months of study (more than 5 kg)
* Use of medications that affect GH or cortisol levels (such as estrogen including oral contraceptive pills, oral glucocorticoids)
* Use of medications such as Meridian and Orlistat
* Presence of diabetes mellitus
* Uncontrolled Thyroid disorders
* Chronic renal insufficiency
* Participation in another simultaneous medical investigation or trial
* Active neoplasm or history of cancer
* Prader-Willi syndrome
* History of scoliosis if bone age is \<15 years
* Hypersensitivity to rhGH or constituents of the injections
Childhood Cancer Survivors' Affective Response to Exercise

The primary objective of this study is to assess the feasibility of administering the Personalized Single-Category Implicit Association Test (PSC-IAT) to young adult survivors of childhood cancer.

Participants will perform a total of three trials of a cognitive task before and after their scheduled SJLIFE cardiovascular stress testing. Participants will then be asked to participate in a qualitative interview about the cognitive task tool and body sensations and emotions experienced during exercise.

Researchers at St. Jude Children's Research Hospital want to learn about the measurement of implicit association bias towards or against exercise in childhood cancer survivors. Additionally, researchers want to learn more about the physical and emotional experience of exercise from our survivors.

The plan for this study is to administer single category implicit association tests (PSC-IAT's) to participants during on campus SJLIFE testing and use this data to determine the feasibility of this tool's use in survivors of childhood cancer without cognitive impairment. This study will also administer the Behavioral Regulations in Exercise Questionnaire (BREQ-2)37 to participants as a construct validity check to the PSC-IAT.

The procedures include PSC-IAT and BREQ-2 tests (before and after strenuous exercise as part of the SJLIFE protocol) and a qualitative interview. These will be in addition to standard components of the SJLIFE on-campus visit.

Eligibility Criteria:
Inclusion Criteria:

* Participants enrolled in St. Jude Lifetime Cohort (SJLIFE) aged 18-39 years at completion of on campus visit
* Primary diagnosis of acute lymphoblastic leukemia (ALL)
* No cranial radiation therapy (CRT) as part of treatment for ALL
* Identify as physically inactive (do not meet Centers for Disease Control and Prevention (CDC) guidelines of 150 minutes of moderate physical activity per week or 75 minutes of vigorous physical activity per week)
* Women who are not currently pregnant

Exclusion Criteria:

* Individuals who cannot speak, read, and/or understand English.
* Individuals with an estimated IQ of \<70 and/or per PI discretion
* Individuals with any contraindication to stress testing (i.e. cardiovascular complications)
* Women who are currently pregnant