cyrilzakka/clinical-trials huggingface dataset:
Optimizing Medication Therapy for Patients Recently Discharged From Hospital

Patients who are discharged from hospital can be overwhelmed when they suddenly have to manage new conditions or medications. These changes can be particularly difficult for people on many medications or with multiple health conditions. There is a real risk that this will lead to emergency room visits, hospital readmission, and even death. In addition to endangering patients, these adverse events are very costly to the healthcare system. The good news is that these events can be preventable if patients receive care that is better coordinated.

Patient-oriented research will be conducted to determine if a pharmacist-led medication therapy management service can improve health outcomes of 'medically complex' patients transitioning from acute to primary care in Newfoundland and Labrador (NL). This a more comprehensive service than their community pharmacist would normally provide. The program will use a new Pharmacist Clinic service to provide care and support which does not currently exist for patients in NL after they leave hospital. After discharge, patients will be randomly divided into two groups: one group will receive care as usual from their doctor; the other group will have their medications assessed by a clinic pharmacist within one week of hospital discharge along with their usual care from their doctor. The two groups will be compared to determine whether specialized pharmacist services after hospital discharge is satisfactory to patients/providers, improves patient health, and reduces emergency room visits, hospital readmissions, and repeat trips to the doctor. If successful, this project will help ensure that patients are taking the right medications in the right way, improving individual health and making better use of healthcare system resources.


Eligibility Criteria:
Inclusion Criteria:

1. 50 years of age or older
2. Admitted to a General Medicine ward
3. Take 5 or more chronic medications

Exclusion Criteria:

1. Discharge to a long term care facility
2. Life expectancy less than 3 months
3. Have entered palliative care
4. Cognitive impairment (unless a responsible caregiver can provide consent and assist in participation)
5. Non-English speaking
6. Unable to provide informed consent
A Cardiac Ultrasound Evaluation of Two Types of Weaning Trials of Mechanical Ventilation for a First Weaning Trial

Comparing the hemodynamic and cardiac effects of two types of weaning trials of mechanical ventilation in ICU patients of two French ICU.

Prospective clinical study in ICU with ventilated patients eligible to weaning trials of mechanical ventilation (ZEEP and tubing-spontaneous ventilation) comparing hemodynamic and cardiac effects evaluated by trans-thoracic echocardiography.

Eligibility Criteria:
Inclusion Criteria:

* Adult patients ventilated requiring first weaning trial of mechanical ventilation

  * Stable respiratory and hemodynamic conditions
  * Consent of patients or family
  * Arterial line
  * Ventilated patients

Exclusion Criteria:

-
The Water-Blueberry Study

We will study the effect of supplementation of 1 L blueberry juice to participants with at least one elevated cardiovasculat risk factor.

Participants with at leat one elevated cardiovacsular risk factor, as defined as systolic blood pressure between 140 and 165 mmHg, diastolic blood pressure between 90 and 105 mmHg, low density lipoprotein (LDL) cholesterol ≥3.4 mmol/L, total/high density lipoprotein (HDL) cholesterol ratio \>4 or smoking a minimum of 3 cigarettes daily.

Subjects were randomized to two groups, where the blueberry group were supplemented with 1 L blueberry juice per day for four weeks. The control group consumed an equal amount of water.

Clinical markers, as well as biomarkers of antioxidant status, oxidative stress status and inflammation were measured in blood samples before amd after the intervention period.

Eligibility Criteria:
Inclusion Criteria:

* 30-70 years for men and 45-70 years or at least 12 months postmenopausal for women
* at least one elevated cardiovascular risk factor, defined as systolic blood pressure between 140 and 165 mmHg, diastolic blood pressure between 90 and 105 mmHg, low density lipoprotein (LDL) cholesterol ≥3.4 mmol/L, total/high density lipoprotein (HDL) cholesterol ratio \>4 or smoking a minimum of 3 cigarettes daily.

Exclusion Criteria:

* clinically recognized chronic diseases as impaired renal function, diabetes mellitus, cardiovascular disease, liver or gastrointestinal disease or cancer within the last 5 years
* use of lipid-lowering drugs, diuretics or hormone replacement therapy for women
* Subjects with a body-mass index ≥31
* with a alcohol consumption above 3 units/day for men and 1 unit/day for women
* blood donation within the last six months
The Opal - COVID-19 Study

In collaboration with involved healthcare professionals and a patient advisory committee, this study tests the feasibility of using the Opal smartphone app to daily capture self-reported physical and psychological symptoms and vital signs among 50 people who are self-isolating at home with COVID-19. A healthcare team at Montreal's MUHC will remotely monitor their condition and offer advice and teleconsultations, as needed.

In the context of the current pandemic, guidelines were issued by public health authorities to follow the progression of COVID-19 in the community, identify and treat affected people, and limit transmissions. About 90% of people with COVID-19 only exhibit mild symptoms and recover. However, a small percentage of people experience serious symptoms and require hospitalization for severe shortness of breath or low oxygen levels. The current public health protocol is to identify people with COVID-19 and isolate them from others at home to prevent the virus from spreading. Currently, there is no consensus on how to effectively follow-up and treat individuals with COVID-19 who are self-isolating at home. Research is urgently needed. This pilot study will assess the feasibility of one strategy for home-based COVID-19 follow-up . The Opal app for COVID is a mobile application that will allow the completion of a daily symptom and vital sign follow-up questionnaire that will be monitored by a healthcare team. Educational material will also be provided through the app. The study will especially assess the acceptability and usability of the smartphone app.

Eligibility Criteria:
Inclusion Criteria:

* 18 years or older
* Fluent in English and/or French
* Confirmed positive for PCR+ SARS-CoV-2
* Willing and able to understand the requirements of study participation and provide oral informed consent
* Access to a smartphone, tablet or computer at home
* Access to an internet connection at home or data plan on their smartphone
* Comfortable with the idea of using a new smartphone application to complete daily questionnaires, access educational material, and communicate with the healthcare team, or having someone to assist them with technology
* Prescribed self-isolation at home
* Proof of identity (passport, RAMQ, driver's license)

Exclusion Criteria:

* Have received a negative laboratory test result for the infection with COVID-19
* Confirmed negative for PCR+ SARS-CoV-2 and hospitalized
* Has any reason, in the opinion of the investigator, which would make the candidate inappropriate for participation in an investigative study involving a smartphone application
* Enrollment in any study involving an investigational drug for COVID-19 disease during the study period
Fusing Ultrasound and Magnetic Resonance Imaging to Intelligently Plan Highly Conformal Ablation Thermal Field for Hepatocellular Carcinoma

Thermal ablation is an important minimally invasive treatment for hepatocellular carcinoma (HCC), but local tumor progression (LTP) after ablation restricts the efficacy and status of ablation technology and seriously threatens patient survival. Insufficient coverage of thermal field is an important factor on the occurrence of LTP. Current thermal field planning relies on tumor contours and doctor experience, and the safety margin is uniform. Therefore, it cannot cope with the problem of insufficient coverage of thermal field caused by the different invasion capabilities of different tumors and different parts of the same tumor. This project intends to integratively analyze gray-scale ultrasound, contrast-enhanced ultrasound, magnetic resonance imaging and clinical information of HCC through deep canonical correlation analysis; summarize the prior knowledge of LTP risk factors in previous studies and perform conjoint analysis individual case data and common conclusions through knowledge graph; interpretatively predict the LTP risk and the high-risk LTP locations through link prediction; accurately predict the ablation safety margin required for different tumor parts through graph neural network, and achieve highly conformal thermal field planning based on different invasion capabilities to minimize the LTP risk of HCC. The project leverages tumor multi-modal imaging and prior knowledge as the entry point, performs highly conformal planning of the ablation thermal field through artificial intelligence technology, and provides a new method for precise ablation.


Eligibility Criteria:
Inclusion Criteria:

1. Pathologically confirmed primary hepatocellular carcinoma
2. Undergo curative ablation
3. With complete clinical information and pre- and post-operative imaging information

Exclusion Criteria:

1. Undergo palliative ablation
2. Lack of clinical or imaging information
3. Age less than 18 years
IGFD Registry: A Patient Registry for Monitoring Long-term Safety and Efficacy of Increlex

This project is a retrospective (beginning January 2006) and prospective patient registry program sponsored by Ipsen (formerly Tercica, Inc.). In collaboration with participating health care practitioners, the patient registry program is an observational study monitoring the long-term safety of patients treated with Increlex® (mecasermin \[rDNA origin\] injection). The IGFD (Increlex® Growth Forum Database) Registry is intended primarily to monitor the safety and efficacy of Increlex replacement therapy in children with growth failure.

The data collected for a patient will be those that exist in the patient's medical record as part of standard medical care. No additional patient procedures or activities are mandated by this study. The specific data to be collected at each visit and the schedule of data collection are listed in a schedule of assessments.

The collection of safety events is considered essential to the Registry. The website will provide the opportunity to report the occurrence of targeted adverse events (AEs), other important events considered to be related to Increlex administration and serious adverse events (SAEs).

Eligibility Criteria:
Inclusion Criteria:

* Parents or legally authorized representatives must give signed informed consent before any Registry-related activities are conducted. Assent from the subject should also be obtained where appropriate.
* Patients receiving Increlex® by a qualified practitioner may be enrolled

Exclusion Criteria:
Fixed Dose Efficacy and Safety Study of Asenapine for the Treatment of Schizophrenia in Adolescents (P05896)

This study is designed to evaluate whether asenapine, which is approved by the United States Food and Drug Administration (US FDA) for acute treatment of schizophrenia in adults, is also effective in adolescents with schizophrenia. Participants who qualify for the study will be randomly assigned to receive a fixed dose of asenapine (either 2.5 mg or 5 mg twice daily \[BID\]) or placebo for 8 weeks. Throughout the study, observations will be made on each participant at various times to assess the efficacy and safety of the study treatment. The primary objective of the trial is to demonstrate significant superiority of at least one asenapine dose to placebo, as measured by the change from baseline of the Positive and Negative Syndrome Scale (PANSS) total score at Day 56.


Eligibility Criteria:
Inclusion Criteria:

* Each participant must have schizophrenia, diagnosed and confirmed by board-eligible or board certified psychiatrists with at least two years of specialization in pediatric/adolescent psychiatric medicine.
* Each participant must be ≥12 years of age and \<18 years of age.
* Each participant must have a minimum PANSS total score of 80 at Screening and Baseline.
* Each participant must have a score of at least 4 (moderate) on two or more of the five items in the positive subscale of the PANSS (delusions, conceptual disorganization, hallucinatory behavior, grandiosity, suspiciousness/ persecution) at Screening and Baseline.
* Each participant must have a CGI-S scale score of ≥4 at Screening and Baseline.
* Each participant must taper off all prohibited psychotropic medications (including antipsychotics, antidepressants, and mood stabilizers) prior to Baseline.
* Each participant must agree not to begin formal, structured psychotherapy during the trial.

Exclusion Criteria:

* A participant must not have a diagnosis of schizoaffective disorder; schizophrenia of residual subtype; schizophrenia of catatonic subtype, or schizophrenia with "continuous," "single episode in partial remission," or "single episode in full remission" course specifiers.
* A participant must not have a primary Axis I diagnosis other than schizophrenia and must not have a comorbid Axis I diagnosis that is primarily responsible for current symptoms and functional impairment.
* A participant must not have a known or suspected diagnosis of mental retardation or organic brain disorder.
* A participant must not currently (within the past 6 months) meet the Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (DSM-IV-TR\^TM) criteria for substance abuse or dependence (excluding nicotine).
* A participant must not have a diagnosis of psychotic disorder or a behavioral disturbance thought to be substance induced or due to substance abuse.
* A participant must not be at imminent risk of self-harm or harm to others, in the investigator's opinion based on clinical interview and responses provided on the Columbia Suicide Severity Rating Scale (C-SSRS).
Epidural Steroid Injections in Post-lumbar Surgery Syndrome After Single-level Discectomy

62 patients with postlumbar surgery syndrome were randomized and divided into two groups. Transforaminal epidural steroid injection (TFESI) was applied to the TFESI group (n=31), and caudal epidural steroid injection (CESI) was applied to the CESI group (n=31). The age of the patients involved in this study ranged from 18 years old to 65 years old

Patients with low back and radicular pain related to epidural fibrosis following single-level lumbar discectomy were included. The patients were randomly divided into two groups as the CESI group and TFESI group. Transforaminal epidural steroid injection was applied to the TFESI group (n=31), and caudal epidural steroid injection was applied to the CESI group (n=31). All patients were assessed before the procedure (baseline) and at 1 hour, three weeks, and three months after the procedure using the Numerical Rating Scale (NRS) and at baseline and three weeks and three months using the modified Oswestry Disability Index (mODI). Treatment success was defined as ≥50% decrease in the NRS scores compared to baseline

Eligibility Criteria:
Inclusion Criteria:

* Age between 18 and 65 years
* Previous single-level, open, non-fusion discectomy for L4-5 or L5-S1 lumbar disc herniation within the past six months
* Having epidural fibrosis involving the L4, L5 or S1 nerve root on magnetic resonance imaging
* Having low back and leg pain for at least six months and unresponsive to conservative therapies
* A Numerical Rating Scale score of ≥4
* Having a single-level epidural fibrosis in the operated level and side as assessed by contrast-enhanced spinal magnetic resonance imaging

Exclusion Criteria:

* Having a multi-level epidural fibrosis
* Previous surgery for multi-level disc herniation
* Previous lumbar fusion surgery
* Having recurrent disc hernia
* Having sacroiliac/facet joint pain
* Having lumbar spinal stenosis, spondylolysis, spondylolisthesis, or scoliosis
* History of epidural steroid injection within the past six months
* Having bleeding diathesis
* Presence of systemic or local infections
* Pregnancy
* Known hypersensitivity to the injectates to be applied
TRT for ES-SCLC After First Line Treatment With Immune Checkpoint Inhibitors

To Evaluate the Safety and Efficacy of Thoracic Radiotherapy for?ES-SCLC After First Line Treatment with Immune Checkpoint Inhibitors.


Eligibility Criteria:
Inclusion Criteria:

* Age at least 18 years.
* ECOG PS 0-1.
* Histological or cytological syndrome of small cell lung cancer, imaging evaluation staging is extensive
* Life expectancy \>= 3 months.
* Patients are non-progressed after 4 dosed of immunotherapy plus platinum based chemotherapy, with residual thoracic lesions
* Palliative radiotherapy were allowed except for TRT, the interval \> 4 weeks
* Adequate organ function prior to enrollment:
* Adequate bone marrow function: white blood cell (WBC) count ≥ 3.0 \* 10 \^ 9/L or neutrophil count ≥ 1.5 \* 10 \^ 9/L, platelet count ≥ 100 \* 10 \^ 9/L and hemoglobin ≥90g/L,;
* Adequate hepatic function: total bilirubin, urea nitrogen and serum creatinine≤ 1.5 x upper limit of normal (ULN). Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ≤2.0 ULN;
* Sufficient heart and lung function, EF\>55%FEV1\>50%
* Ability to understand and willingness to provide the informed consent.
* Women of childbearing age and men must agree to use effective contraception during the trial.

Exclusion Criteria:

* History of another malignancy or concurrent malignancy;
* Mixed small cell with non-small cell lung cancer histology;
* History of thoracic radiotherapy;
* Malignant pleural or ascites;
* Patients with leptomeningeal metastasis or uncontrolled brain;
* Severe autoimmune disease: inflammatory bowel disease (including Crohn's disease and ulcerative colitis), rheumatoid arthritis, scleroderma, systemic lupus erythematosus, Wegener's granulomatosis and related vasculitides.
* Symptomatic interstitial lung disease or clinically active infectious/non-infectious pneumonitis.
* Active infection, congestive heart failure, or any evidence of myocardial infarction, unstable angina pectoris or cardiac arrhythmia within 6 months prior to enrollment.
* The patient is pregnant (confirmed by serum b-HCG if applicable) or is breastfeeding.
* Mental disorders, drug abuse, and social condition that may negatively impact compliance in the investigator's opinion.
Effect of Broccoli Sprout on Blood Levels of Sulforaphane to Reduce Responsiveness of Immune System

The investigators suggest that inducing anti-oxidant enzymes indirectly may be an effective means of providing vascular protection.

Sulforaphane, a naturally occurring compound found in green vegetables (including broccoli, brussel sprouts and cauliflower) is able to protect against cell inflammatory stress by inducing a number of anti-oxidant molecules. Targeted studies on the consumption of broccoli and related vegetables have been shown to be associated with reduced risk of coronary artery disease.

In the present study the investigators want to test whether the consumption of a "broccoli smoothie" containing sulforaphane can protect white blood cells from becoming activated in the presence of an experimental stress and how long this protective effect lasts for. To do this, the investigators will be analysing inflammatory changes in blood samples taken at different times during the study.

Atherosclerosis is the disease process that leads to hardening of the arteries which causes them to become narrowed. This occurs because fat is first deposited on the inside walls of the arteries, then becomes hardened by fibrous tissue and calcium deposition forming a semi-hardened accumulation of material known as plaque. As this plaque grows, it narrows the channel within the artery and causes a reduction in blood and oxygen supply to the affected organ - such as the heart and brain. The investigators now understand that this process is caused by inflammation and activation of the immune cells over a period of time. It has been proposed that targeting these immune cells and reducing the levels of immune activation can protect against cardiovascular diseases.

Previously it has been observed that consumption of fruit and vegetables rich in anti-oxidants can confer a protective effect against cardiovascular diseases. The use of anti-oxidants experimentally has shown protective benefits against activation.

Eligibility Criteria:
Inclusion Criteria:

* Age 18+ years
* Able to commit for the two week duration of the trial

Exclusion Criteria:

* Age \<18 years
* Pregnancy
* Vegetarian
* History of allergy
* Current smoker or smoking cessation within the last 3 months
* Current use of inhaled, topical or systemic corticosteroids or within the last 2 weeks
* Current use of non-steroidal anti-inflammatory use or within the last 1 week
* Current use of nutritional or multivitamin supplements
* Current participation in any other Randomised controlled trial
Stereotactic Body Radiation Therapy in Treating Patients With Prostate Cancer After Undergoing Surgery

This phase I trial studies the side effects and best dose of stereotactic body radiation therapy in treating patients with prostate cancer after undergoing surgery. Stereotactic body radiation therapy may be able to send x-rays directly to the tumor and cause less damage to normal tissue.

PRIMARY OBJECTIVES:

I. To determine the maximum tolerated dose (MTD) with an upper limit of 45 Gray (Gy) in 5 fractions, in the delivery of stereotactic body radiation therapy (SBRT) to the prostate fossa.

SECONDARY OBJECTIVES:

I. To assess acute and late toxicities from treatment.

II. To assess biochemical progression-free survival.

III. To collect prospective quality-of-life data related to bowel, urinary, and sexual health.

OUTLINE: This is a dose-escalation study.

Patients receive 5 fractions of SBRT over 1.5 weeks.

After completion of study treatment, patients are followed up at 90 days and then periodically for 3 years.

Eligibility Criteria:
Inclusion Criteria:

* History of diagnosis of prostate cancer after undergoing prostatectomy
* No evidence of regional nodal or distant metastases based on computed tomography (CT) abdomen and pelvis and whole body bone scan within 120 days prior to study entry; nodes less than 1.5 cm will be considered reactive and biopsy is not required; nodes 1.5 cm or larger are required to undergo biopsy and be negative prior to study registration; bone scan findings in the absence of blastic or lytic lesion correlates on CT imaging will also be deemed non-neoplastic
* Eastern Cooperative Oncology Group (ECOG) performance scale 0-2
* Child bearing potential: In this patient population, this pertains to the ability to conceive a child; eligible patients already have received prostatectomy, and therefore this risk is not applicable
* Prostate specific antigen (PSA) value can be undetectable up to a value of 2.0 within 30 days prior to study entry
* PSA value that is undetectable can be enrolled if pathology from prostatectomy demonstrates one or more of the following: positive margin, extracapsular extension, or seminal vesicle invasion
* All subjects must have the ability to understand and the willingness to sign a written informed consent

Exclusion Criteria:

* Patients should not have any uncontrolled illness including ongoing or active infection
* Patients may not be receiving any other investigational agents, or concurrent biological chemotherapy
* Patients with history of prior malignancies (with exception to non-melanoma skin cancer) are ineligible for this study, unless they are documented to be disease-free for at least 5 years
* Study-specific exclusions:

  * History of prior radiation to the pelvis
  * History of uncontrolled inflammatory bowel disease
  * Unable to comply with radiation therapy procedures
* Subjects, who in the opinion of the investigator, may not be able to comply with the safety monitoring requirements of the study