cyrilzakka/clinical-trials huggingface dataset:
Optimizing Care for Children Hospitalized With Community-acquired Pneumonia: Novel Diagnostics

Children are commonly hospitalized because of community-acquired pneumonia. Despite the fact that many of these children have viral disease, a majority is treated with antibiotics. These antibiotics will not accelerate recovery in those with viral pneumonia and can cause harm. We are interested in exploring whether the MeMed BV - a composite biomarker assay - could be used to improve antibiotic prescribing in these children by identifying those who likely have viral disease. This proposal describes a feasibility randomized trial of this diagnostic intervention.


Eligibility Criteria:
Inclusion Criteria:

* children with a history of fever who are hospitalized with CAP (ie. 'severe CAP') as per the clinical team and who have abnormal chest imaging (eg. radiograph, ultrasound) will be eligible. They must also have at least one of the following:

  1. documented tachypnoea (\>60 bpm for age \<1 y, \>50 bpm for 1-2 y, \>40 bpm for 2-4 y, and \>30 bpm for \>4 y);
  2. cough on exam or by history;
  3. increased work of breathing on exam; or
  4. auscultatory findings (eg. focal crackles, bronchial breathing) consistent with CAP.

Exclusion Criteria:

* Children will be excluded from if they have received \>48h of intravenous antibiotics (eg. if transferred from another healthcare facility) or if they have a lobar consolidation that occupies the majority of a lobe on imaging, a pleural effusion that occupies more than ¼ of a lung field, or a positive blood culture for a bacterial pathogen (not a contaminant). Examples of CAP pathogens include S. pneumoniae, S. pyogenes (group A streptococcus), S. aureus, S. anginosus. Examples of contaminants that would be ignored include the coagulase-negative staphylococci and Bacillus spp. Children will also be excluded if they have any of the following: chronic lung disease, congenital heart disease (requiring treatment or with exercise restrictions), malignancy, immunodeficiency (primary, acquired, or iatrogenic), a separate episode of pneumonia previously diagnosed within the past 2 weeks, or lung abscess diagnosed within the past six months. Children will not be eligible to participate more than once.
Evaluation of the Health Digital Territories Program in the Five Pilot Territories (EvaTSN Project )

The aim is to evaluate a national health information technology-based program to improve healthcare coordination and access to information.

Improvement of coordination of all health and social care actors in the patient pathways is an important issue in many countries; Health Information (HI) technology has been considered as a potentially effective answer to this issue. The French Health Ministry first funded the development of five TSN ("Territoire de Soins Numérique" / Digital health territories) programs, aiming at improving healthcare coordination and access to information for healthcare providers, patients or the population, and at improving healthcare professionals work organization; The French Health Ministry then launched a call for grant to fund one Eva TSN project consisting in evaluating the TSN programs implementation and impact and to develop a model for HI technology evaluation.

Eligibility Criteria:
* Patients(people living in the five pilot territories of the Health Digital Territories program and the five control territories
* 'Users' who used the devices implemented, including platforms computerized,
* "Health professionals" : which includes both the health professions, medical and social professionals and groups representing them (URPS, etc.) and health facilities
* "Governance bodies" such as Regional Hospitalization Agency, the local authorities, etc.
* Manufacturers responsable for implementation of considered digital solutions.
Evaluate the Continued Safety and Performance of the Foot and Ankle Products

The objective of the registry is to evaluate the continued safety and performance of the Arthrex foot and ankle products including the ProStop implant for hyperpronated foot, Bio-Compression Screw for reconstruction surgeries of the foot, TRIM-IT Drill Pin, TRIM-IT Spin Pin for fixation of fractures and fusion (bunionectomy osteotomies) of the foot/ankle, Headless Compression Screws and Compression FT Screws for fixation of small bone fragments of the foot/ankle and DynaNite® Nitinol Staple to be used for fixation such as Lisfranc arthrodesis, mono or bi-cortical osteotomies in the forefoot, first metatarsophalangeal arthrodesis, Akin osteotomy, midfoot and hindfoot arthrodeses or osteotomies, fixation of osteotomies for hallux valgus treatment (Scarf and Chevron), and arthrodesis of the metatarsocuneiform joint to reposition and stabilize metatarsus primus varus and Beveled Headed FT Screws for osteotomy fixation of Hallux valgus repair (such as Scarf and Chevron etc.)

To assess safety, related adverse events will be evaluated at six months postoperative and at one-year postoperative time points. To evaluate performance, physical exam and imaging of the target area of the body will be evaluated at three months postoperative. Additionally, patient reported outcomes will be evaluated at three months postoperative, six months postoperative and one year postoperative using the Visual Analogue Scale (VAS), Veterans Rand 12-Item Health Survey (VR-12) and Foot and Ankle Ability Measures (FAAM).

Eligibility Criteria:
Inclusion Criteria:

1. Subject requires surgery for treatment of hyperpronated foot using the Arthrex ProStop® implant
2. Subject is 18 years of age or over (all products except ProStop)
3. Subject age \>two to 17 years (ProStop product only)
4. Subject is not pregnant, nursing, prisoner, or ward of the state
5. Subject or subject's representative signed informed consent and assent when, applicable, and is willing and able to comply with all study requirements

Exclusion Criteria:

1. Insufficient quantity or quality of bone
2. Blood supply limitations and previous infections, which may retard healing
3. Foreign-body sensitivity
4. Any active infection or blood supply limitations
5. Conditions that tend to limit the patient's ability or willingness to restrict activities or follow directions during the healing period
6. Subjects that are skeletally immature (except for ProStop)

   (DynaNite Nitinol Staple Subjects ONLY)
7. Subjects who have a comminuted bone surface that would not allow for staple placement as required by the DynaNite Nitinol Staples directions for use
8. Subjects who have pathologic bone conditions such as osteopenia that would impair the ability to securely fix the implant as required by the DynaNite Nitinol Staples directions for use
Research Study for Patients With Metastatic Renal Cell Carcinoma

This study has been designed to study patients diagnosed with advanced renal cell cancer with the primary tumor in place.


Eligibility Criteria:
Inclusion Criteria:

* Life expectancy of at least 12 weeks
* Clinical, radiographic, or pathologic diagnosis of metastatic renal cell carcinoma (RCC). All renal cell histologies are allowed- Acceptable surgical risk in the judgment of the study investigator and consulting urological surgeon
* At least one uni-dimensional measurable lesion outside the planned nephrectomy specimen
* Patients who have an ECOG performance status of 0 or 1 Exclusion Criteria:
* History of bleeding diathesis or unexpected surgical bleeding- Patients currently receiving treatment with or having a requirement for therapeutic anticoagulation
* Prior therapy for RCC. Palliative radiation therapy for painful or unstable bone metastases is permitted provided that there is measurable metastatic disease outside the radiation field
* Known history of HIV infection- Symptomatic metastatic brain or meningeal tumors, unless the patient is \> 6 months from definitive therapy, has a CT or MRI scan within 6 weeks of study entry negative for brain metastases and is clinically stable with respect to the tumor at the time of study entry
Positron Emission Tomography in Patients With Breast Cancer

This is a prospective study evaluating the role of Positron Emission Tomography (PET scan) in breast cancer. The radiopharmaceutical \[18F\] 2-deoxyglucose will be used as both an imaging modality and to evaluate tumor metabolism in patients with breast cancer. Patients with stage II, stage IIIA or IIIB, or stage IV breast cancer and evaluable disease in the breast and/or at metastatic sites will be studied. Patients will be injected intravenously with \[18F\]2-deoxyglucose and a PET scan conducted over 90 minutes. Examination of the role of PET scan in assessing the response of breast cancer to chemotherapy, especially in stage II and stage III patients, will be done. Up to three PET scans within one year may be performed. Findings by PET scan will be correlated both with those of concurrent imaging techniques (x-ray, CT scan, MRI, bone scan or mammogram), and with histologic, biochemical, and flow cytometric information on the tumor, and with findings in subsequent surgical specimens. Changes in tumor glucose metabolism with treatment will be assessed by PET imaging studies and by biochemical methods when possible.

This is a prospective study evaluating the role of Positron Emission Tomography (PET scan) in breast cancer. The radiopharmaceutical \[18F\] 2-deoxyglucose will be used as both an imaging modality and to evaluate tumor metabolism in patients with breast cancer. Patients with stage II, stage IIIA or IIIB, or stage IV breast cancer and evaluable disease in the breast and/or at metastatic sites will be studied. Patients will be injected intravenously with \[18F\]2-deoxyglucose and a PET scan conducted over 90 minutes. Examination of the role of PET scan in assessing the response of breast cancer to chemotherapy, especially in stage II and stage III patients, will be done. Up to three PET scans within one year may be performed. Findings by PET scan will be correlated both with those of concurrent imaging techniques (x-ray, CT scan, MRI, bone scan or mammogram), and with histologic, biochemical, and flow cytometric information on the tumor, and with findings in subsequent surgical specimens. Changes in tumor glucose metabolism with treatment will be assessed by PET imaging studies and by biochemical methods when possible.

Eligibility Criteria:
Histologically proven invasive carcinoma of the breast.

Patients with stage II, stage IIIA or IIIB, or stage IV breast cancer who have not received local therapy to the breast or axillary lymph nodes.

Evaluable tumor, either gross or microscopic, at locoregional and/or distant sites.

No current pregnancy.

No second invasive malignancy in addition to breast cancer.

No significant concurrent medical disorders (cardiac, renal, hepatic).
Comparative Study of Ropivacaine and Ropivacaine With Dexmeditomedine in TAP Blocks

Comparative study of Ropivacaine and Ropivacaine with dexmedetomidine in transversus abdominis plane (TAP) block for post-operative analgesia in patients undergoing Caesarean Section.

Patients satisfying inclusion criteria will receive Subarachnoid Block with Bupivacaine Heavy 0.5% (11 mg/2.2 ml) with 25 micrograms of fentanyl. Routine NPO protocols will be followed. At the end of the procedure, bilateral TAP block will be performed using Landmark Technique in Triangle of Petit with 2 inches 24 G needle.

Patients would receive 75 mg of intramuscular diclofenac sodium immediately on shifting to the postoperative care unit (PACU) and a second dose 12 hours later. The time after the TAP block when rescue analgesia was first sought, total dose of required morphine in 24 hours postoperatively, its adverse effects like pruritus, nausea and vomiting will be recorded. VAS will be used to assess post-operative pain (VAS; where 0 = no pain and 10 = worst imaginable pain) during rest and on coughing.

Rescue analgesia would be provided with 6 mg of intravenous morphine and additional doses of 3 mg at 10 minutes interval till VAS was less than 3 or in case of development of adverse effects such as nausea and/or vomiting, respiratory depression (SpO2 \<92%, ventilatory frequency rate \<10), or occurrence of deep sedation (eyes closed \>3 min, Ramsay Score RS \>2). An RS on a 6-point scale was used (1=anxious and agitated patient; 2=cooperative patient; 3=asleep patient, brisk response to loud voice; 4=asleep patient, sluggish response to loud voice; 5=no response to loud voice; score of 6=no response to pain). In PACU and in first 24 h post-operatively, MAP, HR, VAS (at rest and on coughing), nausea and vomiting, sedation score (RS) will be recorded on admission to PACU and at 1,4, 8, 12, 18 and 24 hours post-operatively by an observer who will be unaware of the study protocol.

Patients will we assessed on a 5 point scale at the end of 24 hours on the quality of postoperative analgesia. Nausea and vomiting will be recorded using a categorical scoring system (0 = none, 1 = nausea, 2 = retching, 3 = vomiting). IV Metoclopramide 10 mg bolus will be offered for any patient with a score \>/=1.

Eligibility Criteria:
Inclusion Criteria:

* ASA 1 or 2
* Age above 18 years
* Patients for Lower Section Cesarean Section surgery

Exclusion Criteria:

* Patient refusal
* Allergy to study medications
* Localized infection over injection point
* Patients with significant coagulopathies and with contraindications to regional anesthesia
* Patients with a history of cardiac, respiratory, renal or hepatic failure
* Psychological disorders
* Chronic use of pain medications or adrenoreceptors agonists or antagonists.
* BMI \>35 or weight \< 50 kilograms
Transversus Abdominis Plane Catheter Following Kidney Transplantation

Continuous Infusion of Local Anesthetic After Kidney Transplantation

This is a phase III, randomized, double-blinded, sham-controlled trial comparing the use of a continuous infusion of local anesthetic via transversus abdominis plane (TAP) catheter to a saline infusion (sham) via TAP catheter along with standard postoperative analgesia in patients undergoing kidney transplantation. Patients will have a TAP catheter placed at the time of kidney transplantation by the surgical team under direct vision. They are then randomized to a continuous infusion of local anesthetic or saline for 48 hours postoperatively. Both groups will receive a standard postoperative analgesic regimen including a Patient Controlled Analgesic (PCA) pump and multimodal analgesics including acetaminophen and gabapentin.


Eligibility Criteria:
Inclusion Criteria:

1. Provision of signed and dated informed consent form
2. Stated willingness to comply with all study procedures and availability for the duration of the study
3. Male, female, non-binary gender, aged \>18 years.
4. Undergoing a kidney transplant (deceased or living donor) as treatment for stage 5 chronic kidney disease (Glomerular filtration rate \< 15ml/min) either on dialysis, or approaching dialysis
5. No history of allergy to any local anesthetic.
6. Agreement to adhere to Lifestyle Considerations (see section 5.3) throughout study duration

Exclusion Criteria:

1. Current use of opioid pain medications prior to kidney transplantation.
2. Known allergic reactions to components of any local anesthetic medication.
3. Prior local anesthetic systemic toxicity.
4. History of chronic pain undergoing current active treatment for the same.
5. Age \<18 years (this analgesic approach has not been established in this population).
6. Unable or unwilling to use IV PCA pump for any reason (manual dexterity, cognitive impairment, patient choice etc.).
7. Multi-visceral transplantation.
8. Incision other than standard Gibson incision.
9. Unilateral or bilateral nephrectomy at time of kidney transplant.
10. Advanced liver disease.
Fetal Death in Utero in the Internship Experience of Midwifery Students : an Unavoidable Experience?

Fetal death in utero and the psychological and professional impact it could have on the midwifery student in training. Fetal death in utero corresponds to the spontaneous cessation of cardiac activity, from 14 weeks of amenorrhea.

For a large proportion of midwifery students, fetal death in utero is a situation encountered in the field. Despite the theoretical courses, a student does not expect to encounter this type of situation during the internship: it is delicate for both the supervising caregivers and the student. The purpose of this study is to demonstrate the impact that this situation could have on the midwifery student, both psychologically and in terms of their professional project.

The aim of the research is to highlight the psychological and professional impact of in utero fetal death among midwifery students in Strasbourg.

Eligibility Criteria:
Inclusion criteria:

* Age ≥18 years
* Midwifery student of the Strasbourg school of medicine of 3rd year or more
* having experienced the discovery of a fetal death in utero in a birth room internship
* having participated in the follow-up of an in utero fetal death in the birth room
* Agreed to participate in the interview and did not express opposition to the reuse of their data for the purpose of this research

Exclusion Criteria:

- Subject who expressed opposition to participating in the study
Effect of Probiotics on Blood Pressure Management

Dysbiosis of gut microbiota has been reported to be involved in the development and progression of hypertension in both humans and animal models. Probiotics have been reported to have ameliorative effects in murine models. However, whether probiotics could help alleviate hypertension in adults remain obscure.

Probiotics are live microorganisms that have been associated with multiple health benefits. However, its protective role in adults has long been controversial. This study aims to examine the effect of 12-week probiotics supplementation on the prevention of hypertension in Chinese adults. By understanding the mechanisms by which probiotics exert this beneficial effects, we can better control the rising prevalence of hypertension, which is a major risk factor for cardiovascular diseases.

Eligibility Criteria:
Inclusion Criteria:

* Eligible subjects include men and women 18 to 75 years of age with pre-hypertension who has a systemic blood between 120 and 139 mmHg and/ or a diastolic blood pressure between 80 and 80 mmHg;
* Absence of any diet, dietary supplement and medications that might interfere with blood pressure and gut microbiota, especially antibiotics and probiotics.

Exclusion Criteria:

* Any other systemic, metabolic and cardiovascular or cerebrovascular diseases;
* Type 1 diabetes, type 2 diabetes treated with insulin or other medications;
* Acute illness or current evidence of acute or chronic inflammatory or infective diseases;
* Participation in any diet or lifestyle program more than 2 times per week in the latest 3 months prior to recruitment;
* Mental illness rendering them unable to understand the nature, scope, and possible consequences of the study.
Transepithelial Customized Cross-linking

Customized remodeled vision (CuRV) is a new corneal cross-linking protocol for keratoconus, combining a transepithelial approach with customized energy application. Our aim is to follow-up our patients and establish the short-and long-term results of CuRV.

Customized remodeled vision is a protocol for oxygen-boosted, tranespithelial cross-linking, customized to apply higher energy at the apex of the cone, relatively lower to the cone area and none to healthy cornea. Thus CuRV promises to halt keratoconus progression, simultaneously offering potential for relatively good visual rehabilitation.Our primary outcomes involve spectacle-corrected distance visual acuity and changes in corneal topography/tomography and OCT parameters. These parameters include Kmax, thinnest corneal pachymetry, maximal anterior and posterior elevation, the Fourier analysis-derived irregularity index, and demarcation line depth.

Eligibility Criteria:
Inclusion Criteria:

* Topographic evidence of keratoconus:
* maximum corneal curvature (Kmax) ≥47.00 D,
* localized steepening on topographic maps,
* localized elevation in the anterior and posterior corneal surfaces.

Exclusion Criteria:

* Hypersensitivity to riboflavin
* Thinnest corneal pachymetry \< 380 μm
* History of corneal surgery, including previous cross-linking
* Corneal scarring
* Aphakia
* Pseudophakia
* Any visually significant ocular condition
Efficacy of Epidural Analgesia in Lower Extremity Osteosarcoma

In this study, the investigators aim to reduce complications in orthopedic malignancy surgeries and to increase the quality of life of patients who will be operated on.

In the preoperative period, the participants will be taken to the block room. The participants will be monitored, standard sedation will be applied.

Patients in the first group will be provided with preoperative and peroperative analgesia with an epidural catheter. The second group patient will be get no block. Afterwards, both groups will be operated under similar general anesthesia conditions. A patient-controlled analgesia device will be attached to each group of participants and their postoperative follow-up will be made.

Eligibility Criteria:
Inclusion Criteria:

* accepting the study protocol,
* age older than 18 years and younger than 80 years,
* undergoing lower extremity osteosarcoma surgery
* the American Society of Anesthesiologist (ASA) physical status of I-II-III

Exclusion Criteria:

* infection at the injection site
* coagulation disorder
* patients with central nervous system related disease
* septic patients
Sonoguided-microwave Uterine Myoma

This study mainly evaluates the resolution of uterine fibroids by microwave ablation. The medical equipment used is Ke Hui. "The Ampening ablation system is a percutaneous surgery. During laparoscopic surgery, it is directly ablated and soft, including problems that cannot be solved by partial or complete tissue ablation. "Hydrogen is used. If the expected range of ablation can be found, there is no need to wait for 3 to 6 months for ablation slowly like Haifu surgery. A fast, small, high-quality treatment that provides reference for medical treatment and helps doctors choose the most suitable treatment.

A collection of 20 women suffering from uterine fibroids were treated with microwave fibroids ablation for symptoms of uterine fibroids, and they could be discharged the next day or two days after surgery. Schedule return visits and routine blood tests according to clinical needs, and follow up with ultrasound and questionnaires during routine return visits (1, 3, and 6 months) after surgery. In the third month after surgery, there will be another imaging report. Magnetic resonance imaging and blood tests are used to compare the changes of patients' fibroids, their physiological recovery status, and the degree of improvement in their quality of life.

Eligibility Criteria:
Inclusion Criteria:

1. Women who have reached the age of 20 and have not yet menopause.
2. Myoma size≧4cm.
3. Patients with submucosal fmyoma or intramural myoma of the uterus.

Exclusion Criteria:

1. Patients with subserosal myoma.
2. Pregnant, breastfeeding or have menopause.
3. Pelvic infections, vaginitis, cervicitis or endometritis and have not been cured.
4. Malignant diseases of the cervix and uterus.
5. Abnormal reports of clinical significance in Pap smear or thin-layer cell test.
6. Abnormal blood coagulation function or liver and kidney function, with bleeding tendency.
7. There is no safe puncture treatment route.
8. Those who have installed intrauterine contraceptive device or Pacemaker.
9. Those who cannot perform vaginal ultrasound, such as those who have no sexual experience and do not accept hymen repair.