cyrilzakka/clinical-trials huggingface dataset:
IPD Meta-analysis of De-escalation Treatment Strategy After PCI in ACS

We will perform a systemic review of previously published data and an updated patient-level meta-analysis of studies, including the most recent publications. PubMed, EMBASE, Cochrane Central Register of Controlled Trials, the United States National Institutes of Health registry of clinical trials, and relevant websites were searched for pertinent published studies.

This is an individual patient-level data meta-analysis (IPD Meta-analysis). This study population was incorporated from studies that were previoiusly published.

We will perform a systemic review of previously published data and an updated patient-level meta-analysis of studies, including the most recent publications. PubMed, EMBASE, Cochrane Central Register of Controlled Trials, the United States National Institutes of Health registry of clinical trials, and relevant websites were searched for pertinent published studies. The electronic search strategy was complemented by manual examination of references cited by included articles, recent reviews, editorials, and meta-analyses. No restrictions were imposed on language, study period, or sample size. The search keywords include "acute coronary syndrome", "ACS", "primary", "percutaneous coronary intervention", "PCI", "de-escalation", "guided", "guide", "antiplatelet", "P2Y12 inhibitor", "P2Y12", "dual antiplatelet therapy", "DAPT".

Articles were included when they met the following prespecified criteria: (1) included the ACS patients who underwent PCI with drug-eluting stent (DES); (2) maintained DAPT for 1 year; (3) de-escalation strategy of DAPT was clearly defined; (4) clinical outcomes, including ischemic and bleeding events, were clearly reported; (5) randomized controlled trials were considered for inclusion. Two independent investigators screened titles and abstracts, identified duplicated studies, performed full-article reviews, and determined the study inclusion. The third investigator supervised the searching process and adjudicated all the disagreements.

After selecting eligible RCTs, we will incorporate all known randomized controlled trials requesting individual patient data from the principal investigator of each trial.

Eligibility Criteria:
This study is a meta-analysis of previously published studies. Therefore, the eligibility criteria may be diverse according to the individual studies.

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Inclusion Criteria:

* Subject must have clinical diagnosis of acute coronary syndrome

Exclusion Criteria:

* The patient has a known hypersensitivity or contraindication to any of the following medications: Heparin, Aspirin, Clopidogrel, Prasugrel, Ticagrelor
Comparison of Hernia Sac Ligation Versus Invagination

Management of indirect hernial sac in inguinal hernia repairs has long been a subject of debate among general surgeons. Although hernial sac high ligation (HL) is a time-honored concept in groin hernia surgery, non-ligation/invagination is gaining more popularity. The aim of this study is to compare the effects of hernia sac ligation and invagination in patients with Lichtenstein mesh hernioplasty (LMH). Also, investigators aimed to investigate the possible association between the hernial defect size and postoperative early pain in both groups.


Eligibility Criteria:
Inclusion Criteria:

* unilateral uncomplicated indirect hernia
* elective operations
* spinal anesthesia

Exclusion Criteria:

* Bilateral hernias
* recurrent cases
* femoral-scrotal hernias
* those who refused to give consent
* those who were given general anesthesia besides spinal anesthesia
* those who were repaired with a method other than Lichtenstein mesh hernioplasty
Population Pharmacokinetics of Benznidazole in Children With Chagas Disease

Background: Chagas disease is a parasitic infection caused by the Trypanosome cruzi. The initial phase of the infection happens mainly in children. Up to 10% of infected children die. Survivors often develop chronic infection leading to heart disease and other complications in 30% of patients. These complications often result in death or severe handicaps in early adulthood, depriving societies of individuals in their most productive years.

There are 20 million people infected in Latin America. Complications lead to 20,000 deaths every year.

Treatment during the acute phase with benznidazole leads to a high cure rate. However, there are very few studies of this drug and virtually none in children, even though benznidazole was developed over 30 years ago.

Hypotheses and Specific Aims: We hypothesize that the pharmacokinetics of benznidazole in children is different from adults, and that obtaining information on how it is absorbed, distributed and eliminated in children will allow optimization of treatment of Chagas disease in this population. This will in turn improve the outlook for children by reducing mortality and long term complications. We aim to study the pharmacokinetics of benznidazole in children receiving the drug for treatment of Chagas disease, and to correlate it with treatment effectiveness and incidence of adverse effects.

Potential Impact: This novel knowledge will allow better and more rational approaches to the treatment of Chagas disease. It will also set the foundation for further studies that will be able to test improved therapies that may increase treatment response in vulnerable children.


Eligibility Criteria:
Inclusion Criteria:

* Children 2 - 12 years old of both sexes, with a diagnosis of Chagas' disease and eligible for treatment with benznidazole, as per current treatment protocols.
* Chagas disease diagnostic criteria: At least 2 positive serological tests for Trypanosoma cruzi infection (ELISA, hemoagglutination, particle agglutination tests).
* Informed consent signed by the parents, and consent or assent of the patients (according to age and consenting capacity).

Exclusion Criteria:

* Patients with a history of hypersensitivity to benznidazole or any of the drug excipients
* Immunocompromised patients
* Altered hepatic function (increase in AST/ALT x3 or bilirubin x3) or altered renal function (increase in creatinine x3)
* Pregnancy
Bronchial Hyperreactivity During Histamine Passive Exposure

Bronchial hyperresponsiveness consists in excessive response to bronchial stimuli.Bronchial challenge test is used to confirm/exclude asthma (metacholine or histamine).Protection are used to avoid passive exposure of the technicians performing the test, despite the absence of evidence that they could develop a bronchoconstriction even if they suffer from BHR.The purpose of the study is to determine if patients with a high level of bronchial hyperreactivity and exposed passively to histamine during a bronchial challenge, are developing a bronchoconstriction, when placed in the same conditions that the technicians performing these tests.

Bronchial hyperresponsiveness (BHR) consists in excessive response to bronchial stimuli.Bronchial challenge test is used to confirm/exclude asthma.BHR is also present in other diseases such as allergic rhinitis, Chronic Obstructive pulmonary disease,heart failure..

Thes test is performed with metacholine or histamine with spirometric documented response to incremental doses.Protection are used to avoid passive exposure of the technicians performing the test, despite the absence of evidence that they could develop a bronchoconstriction if they suffer from BHR.

The purpose of the study is to determine if patients, newly diagnosed with a high level of bronchial hyperreactivity and exposed passively to histamine during a bronchial challenge, are reacting to histamine when placed in the same conditions that the technicians performing these tests.

Eligibility Criteria:
Inclusion Criteria:

* adult patients with positive histamine challenge test (first dose)

Exclusion Criteria:

* other active respiratory disease
Interest of Functional MRI (Magnetic Resonance Imagery) (in Patients Suffering From Hepatocellular Carcinoma and Treated With Yttrium

For patients who are suffering from hepatocellular carcinoma and are treated with radioembolization, the purpose of this study is to analyse parameters of functional MRIs that are modified early and to detect parameters that vary significantly after treatment.


Eligibility Criteria:
Inclusion Criteria:

* Early, intermediate, advanced, non metastatic Hepatocellular Carcinoma. Indication for radioembolization validated after pluridisciplinary committee meeting.
* Isolated target on initial imagery (invasive hepatocellular carcinoma excluded)
* WHO (World Health organization) Performance status: 0, 1 or 2
* If cirrhosis, Child A score with total bilirubin less than 30 micromoles per liter
* Creatinine clearance more or equal to 30 mL/min
* Patient informed and consent signature obtained

Exclusion Criteria:

* Invasive hepatocellular carcinoma without any isolated tumor
* Disease needing 2 injections of Therasphere
* Thrombosis extending into the porta(thrombosis of one of left or right branch authorized), extra hepatic metastasis
* Previous treatment by chemoembolization, radiofrequency less than 3 months before radioembolization
* No antiangiogenic concomitant treatment, 15 days before and 15 days after radioembolization, including Sorafenib
* Associated disease which could prevent patient from receiving treatment
* RMI contre-indication(particle or metal prosthesis, pacemaker, claustrophobia) or contrast product contre-indication (allergy)
* Patient already participating in an other therapeutic trial with an experimental drug
* Pregnant or childbearing potential women or breastfeeding women
* minors, persons deprived of liberty or protected adults (maintenance of justice, guardianship or supervision) Unable to comply with trial medical follow-up for geographical, social or psychological reasons
* Unable to sign an informed consent
Uses of Titanium Nail in Pediatric Fractures

The aim of this study is to investigate the short term functional and radiological outcomes of using double short titanium elastic nails as treatment of pediatric distal radius fractures.

Severely displaced distal radial fractures in children are generally considered unstable; especially when associated with total rupture of the periosteum. Although the remodeling potential of distal radial fractures is very good in childhood, a subgroup of severely displaced and unstable distal pediatric forearm fractures are candidates for operative fixation because acceptable reduction cannot be maintained in a conservative way. These injuries are usually candidates for closed reduction and minimal invasive fixation.

Operative osteosynthesis technique of pediatric wrist fractures are optimally minimally invasive, physeal sparing, and with acceptable reduction.

Most operative methods need complementary 4 to 6 weeks of postoperative immobilization by casting. Many of these techniques do not respect physeal plates. Both current available fixation techniques; modifications of Kirschner wiring or conventional elastic stable intramedullary nailing \[ESIN\]) have the same rate of mild complications. Growth disturbance is a rare, but represents a very rare severe complication of transepiphyseal wire placement.

Varga et al. Medicine (2017) 96:14\[8\] used modified ESIN method for operative treatment of severely displaced pediatric distal metaphyseal or metadiaphyseal radial fractures. With 2 short, prebent, retrograde elastic titanium nails inserted proximal to the distal radial physis, a very stable stabilization achieved without the need for a prolonged period of cast immobilization. The nails do not cross the physeal plates, so the possibility of postoperative physeal arrest is reduced.

their results:(the study shows a new technique in fixation of severely displaced pediatric distal radial fractures é more stable fixation,less pin track irritations and infections,early return to full range of motion within the sixth postoperative week, short removable splint was sufﬁcient for early pain-free mobilization.

All the x-rays made 6 months postoperatively showed anatomic reduction, and there has been no sign of omic reduction, and there has been no sign of growth disturbance at the area of thece at the area of the distal radius) We conduct this study to evaluate the Short term functional and radiological outcomes of using double short titanium elastic nails in treatment of pediatric distal radius fractures.

Eligibility Criteria:
Inclusion Criteria:

* Patient Age ( 4 - 16 ) Years old.
* Both sex included .
* Simple or compound fractures (Grade I).
* Isolated fracture in the limb.
* Severely displaced fracture (Angulated).
* Recent and old distal radius fractures

Exclusion Criteria:

* Ages below 4 years or above 16 years.
* Associated with other fractures in the same limb.
* Compound fractures ( Grade II,III).
* Comminuted or Pathological fractures.
Effect of Weight Reduction on Inflammatory Markers and Genes Expression in Obese Individuals

To investigate whether weight reduction by life style modification for 12 weeks will improve circulating inflammatory markers, adipocytokines as well as gene expression of proinflammatory protein obtained from circulating monocytes from obese individuals.


Eligibility Criteria:
Inclusion Criteria:

* Nondiabetes obese individuals with BMI greater than 27 kgs/m2

Exclusion Criteria:

* Diabetes
* Abnormal hepatic, renal and cardiac function
CAR-T Therapy in Relapsed or Refractory Haematopoietic and Lymphoid Malignancies

This is an open, single-arm, phase I clinical study to evaluate efficacy and safety of chimeric antigen receptor T cell immunotherapy (CAR-T) in the treatment of hematopoietic and lymphoid malignancies. A total of 30 patients are planned to be enrolled over a period of 2 years.

Chimeric antigen receptor (CAR)-modified T cells targeted against CD19 have demonstrated unprecedented successes in treating patients with hematopoietic and lymphoid malignancies. Besides CD19, many other molecules such as CD22, CD30, CD7, BCMA, CD123, etc. may be potential in developing the corresponding CAR-T cells to treat patients whose tumors expressing those markers. Investigators have developed a high efficient platform for constructing different CARs and preclinical studies have demonstrated effective killing of corresponding target cells. In this study, investigators will evaluate their safety and efficacy in patients with different types of hematopoietic and lymphoid malignancies. The primary goal is safety assessment including cytokine storm response and any other adverse effects. In addition, tumor targeting and disease status after treatment will also be evaluated.

Eligibility Criteria:
Inclusion Criteria:

1.The treat history meeting the following criteria:

1. Recurrence of lymphoma patients with imaging (CT/MRI/PET-CT) detection and pathological diagnosis, or recurrence including bone marrow morphology relapse and the MRD recurrence of myeloma patients or leukemia patients, after chemotherapy or stem cell transplantation;
2. Can't get complete remission (including MRD positive) after more than twice repeated chemotherapy of incipient lymphoma, myeloma or leukemia patients;
3. One or twice chemotherapy cannot get remission again (including MRD positive), but not suitable for chemotherapy of incipient lymphoma, myeloma or leukemia patients.

2. There is a measurable lesions before treatment at least; 3. ECOG score≤2; 4. To be aged 1 to 70 years; 5. More than a month lifetime from the consent signing date

Exclusion Criteria:

1. Serious cardiac insufficiency, left ventricular ejection fraction\<50;
2. Has a history of severe pulmonary function damaging;
3. Merging other malignant tumor;
4. Merging uncontrolled infection;
5. Merging the metabolic diseases (except diabetes);
6. Merging severe autoimmune diseases or immunodeficiency disease;
7. patients with active hepatitis B or hepatitis C;
8. patients with HIV infection;
9. Has a history of serious allergies on Biological products (including antibiotics);
10. Happened in 3 \~ 4 acute GvHD after allogeneic hematopoietic stem cell transplantation on recurring patients
11. Pregnancy or lactation women;
12. Any situation that would increase dangerousness of subjects or disturb the outcome of the clinical study according to the researcher's evaluation.
ThoRAciC Trauma IntubatiON Risk Score for Blunt Trauma

The primary objective of this study is the evaluation of risk factors associated with orotracheal intubation in blunt chest trauma patients not intubated on the field and not fulfilling the criteria for intubation based on the Glasgow Coma scale score with the building of a predictive score based on those findings taking into account the clinical, laboratory and radiologic tests performed within 6 hours from hospital admission.

Multicentre, prospective, observational study. All the consecutive blunt thoracic trauma patients consecutively admitted at the participating institutions' Emergency Department (ED) will be considered for enrolment. The primary outcome measure will be the need for orotracheal intubation for primary respiratory failure lasting at least 48 hours within 7 days after trauma. The secondary outcome measures related to analgesia are: the basal analgesia protocol received during the first 7 days from ED admission and the median cumulative dose of morphine-equivalents received as rescue therapy during the first 7 days after trauma. The secondary outcome measure related to the sonographic evolution of thoracic lesions is the global and regional LUS.

Eligibility Criteria:
Inclusion Criteria:

* Blunt thoracic trauma with a documentable lesion (T-AIS ≥ 2)
* Age ≥ 18 years
* GCS \> 8 at ED admission
* Total body CT scan available performed within 6 hours from ED admission

Exclusion Criteria:

* - Penetrating thoracic trauma
* Age \< 18 years
* GCS \<= 8 at ED admission
* Patients already intubated at ED arrival
* Do not intubate order, for any reason
* Intubation for Urgent/Emergent surgery within 24 hours from hospital arrival
Postural Drainage With and Without Aerobic Training on Chronic Suppurative Lung Disease

This will be a randomized controlled trial Patients will be divided into two groups randomly. Both groups will receive postural drainage as baseline treatment thrice a week for two weeks. The intervention group will undergo additional Aerobic Training thrice a week for two weeks as well along with postural drainage. Aerobic training will include a 5-step stair-climbing and a 10-step walk during each session. Data will be collected before and at the end of two weeks. Respiratory Rate, Pulse Oximeter, 10-meter Endurance walk test, and Pediatric Cough Questionnaire will be used to collect data pre and post-treatment. Data will be analyzed by use of SPSS Version 2010. Data will be presented in the form of mean and standard deviation.

Chronic suppurative lung disease (csld) is a clinical syndrome in children with respiratory symptoms and signs. Children who have bronchiectasis symptoms but non-diagnostic scans are described as having chronic suppurative lung disease (csld). Postural drainage improves secretion clearance techniques, it is equally as effective as other airway clearance techniques. This study will focus on the implementation of postural drainage and aerobic training in this disease to find their effect on respiratory rate, oxygen saturation, and endurance.

Eligibility Criteria:
Inclusion Criteria:

* Age of 5-13 years
* Medically stable,
* Patients must have 2 episodes of productive cough, each episode lasting for 4 weeks per year.

Exclusion Criteria:

* Non-Chronic Suppurative Lung Disease related chronic disease
* Chronic Suppurative Lung Disease-related conditions posing an increased risk to the patient when exercising.

children with any MSK-disorder or gait abnormalities
Accessory Pathway Antegrade Effective Refractory Period Among WPW Patients: the Risk in Relation to the Location

To correlate the antegrade effective refractory period of the accessory pathway with its anatomical location in the heart.

To investigate whether the accessory pathway location can predict the high risk nature of the accessory pathway

The Wolf-Parkinson-White (WPW) syndrome is a clinical entity characterized by the presence of ≥1 accessory pathways between the atria and the ventricles pre-disposing patients to arrhythmias. Anterograde conduction through the accessory pathway leads to preexcitation of the ventricles and a delta wave in the ECG. The prevalence of preexcitation in the general population has been estimated to be 1 to 3 in 1000 individuals. Although most asymptomatic patients with pre-excitation have a good prognosis, there is also a lifetime risk of malignant arrhythmias and SCD, estimated to be 0.1 % per patient year.

* More worrisome is the fact that this event can be the first manifestation of the disease in up to 53 % of patients.
* Atrial fibrillation (AF) can be a life-threatening arrhythmia in the WPW syndrome if the AV AP has a short anterograde refractory period (RP), allowing too many atrial impulses to be conducted to the ventricle.
* This will result in very high ventricular rates with possible deterioration into ventricular fibrillation (VF) and sudden death.
* Parameters proved to indicate high risk AP include AP effective refractory period \<240 ms, shortest preexcited RR interval \<250 ms
* Certain Locations were thought to be associated with higher risk of the accessory pathway like Septal localization which was significantly more frequent in patients with VF when compared with individuals with no VF but the overall number of patients is limited . .

These debatable relations between AP location and its risk stratification was not extensively studied in larger scale studies....

Eligibility Criteria:
1. Inclusion criteria:

   all patients with WPW admitted to Assuit university hospital and subjected to invasive EPS
2. Exclusion criteria:

   1. heart failure
   2. cardiomyopathy