cyrilzakka/clinical-trials huggingface dataset:
When Asking the Indication of a Skin Biopsy From a Patient With a Leg Ulcer in Primary Care?

Leg ulcers are frequent. There are no epidemiological studies available in France, but international studies estimate the prevalence between 0.045 and 0.63% of the total population, prevalence increases with age, reaching 5% of patients over 80 years. Extrapolating these prevalences in the French population between 28 000 and 395 000 people are affected in France a leg ulcer.

It is a costly disease. In 2001, a French study conducted among 800 physicians, including 85.7% of general practitioners, involving more than 1000 patients with venous ulcers, it was estimated that the total cost of treatment per patient average was 888 32 euros. This is truly a public health problem.

Leg ulcers are in 80% of cases of vascular causes (venous, arterial or arteriovenous mixed). However, there are rare causes of ulcers: skin carcinoma, infectious ulcers and vasculitis. These ulcers rare causes require specific treatments that can often heal. To diagnose, to perform a skin biopsy. Thus, the general practitioner must know when to put the indication for biopsy of a leg ulcer.

Goal :

Analyzing the last 100 consecutive skin biopsies performed in patients carriers of chronic leg ulcers, followed in the vascular medicine department of the Hospital Saint Joseph Paris, to determine:

* The reasons which motivated the doctor make the indication of biopsy:
* Disease duration of ulcer
* Unusual clinical features
* Other signs associated with ulcer
* Absence of a satisfactory explanation vascular
* The pathological results Purpose: To clear a typical profile ulcers biopsy

Methodology :

* Retrospective, single-center,
* Acquisition of data: via the pathology laboratory of the hospital will be collected the last 100 consecutive biopsies performed with leg ulcers in vascular medicine department of the hospital Saint Joseph Paris, between 1 January 2013 and the October 1, 2013. Then be analyzed all paper and electronic records of these patients.
* Grid and Analysis:

  * Patient histories,
  * vascular profile of patients,
  * clinical and chronological criteria of the ulcer,
  * Other signs associated with ulcer
  * Results of histological biopsies.
* The data will be made anonymous on the grid for collection by a numbering system 1 100.

Eligibility Criteria:
Inclusion Criteria:

* The last 100 consecutive skin biopsies performed in patients carriers of chronic leg ulcers, hospitalized in the vascular medicine department of the Hospital Saint Joseph Paris

Exclusion Criteria:

* No exclusion criteria
Clinical Performance of Withings Move ECG Software for Atrial Fibrillation Detection

Withings Move ECG watch is designed to record ECG and detect automatically atrial fibrillation. The aim of this study is to validate the performance of Move ECG watch to detect atrial fibrillation compared to a reference 12-lead ECG.

Patients with atrial fibrillation are included in hospitals. On each patient, ECG with Move ECG and the reference 12-lead ECG are recorded simultaneously. Both records are then reviewed by independent cardiologists to assess

1. The presence or absence of atrial fibrillation
2. if waveforms of ECG recorded with Move ECG compared with the reference.

Eligibility Criteria:
Inclusion Criteria:

* male or female who are 18 years or older
* Subject who signed the written informed consent form

Exclusion Criteria:

* Vulnerable subject with regard to regulations
* Pregnant, parturient or breastfeeding woman,
* Subject who is deprived of liberty by judicial, medical or administrative decision,
* Underage subject,
* Legally protected subject, or subject who is unable to sign the written informed consent form,
* Subject who is not beneficiary or not affiliated to a social security scheme,
* Subject within several of the above categories,
* Subject who refused to participate in the study,
* Subject in physical incapacity to wear a wrist-worn watch
* Subject with electrical stimulation by pacemaker
Evaluation of a Toolkit to Improve Cardiovascular Disease Screening and Treatment for People With Type 2 Diabetes

Diabetes is a common and serious chronic disease. However, there is a large gap between the level of care that people should receive (based on research and guidelines) and the level of care they actually receive. With the release of their 2008 Clinical Practice Guidelines, the Canadian Diabetes Association has a strategy to improve heart disease screening and treatment for people with diabetes. This study will evaluate whether the strategy works. The focus of the strategy was to give all family physicians in Canada a Toolkit in June 2009 to help them delivery better care for their diabetic patients. In Ontario, only half of doctors received this Toolkit. We will compare the quality of care received by diabetic patients whose doctors received this Toolkit versus those who doctors did not.

A cardiovascular disease Toolkit was developed by the Canadian Diabetes Association and mailed to family physician with the Spring/Summer 2009 edition of the newsletter, Canadian Diabetes. The Toolkit was packaged in a brightly-coloured box with Canadian Diabetes Association branding, and contained: 1) an introductory letter from the Chair of the practice guidelines' Dissemination and Implementation Committee; 2) an eight page summary of selected sections of the practice guidelines targeted towards primary care physicians; 3) a four page synopsis of the key guideline elements pertaining to cardiovascular disease risk; 4) a small double-sided laminated card with a simplified algorithm for cardiovascular risk assessment, vascular protection strategies and screening for cardiovascular disease; and 5) a pad of tear-off sheets for patients with a cardiovascular risk self-assessment tool and a list of recommended risk reduction strategies.

Eligibility Criteria:
Inclusion Criteria:

* Patient with diagnosed diabetes
* Seen in the office of a participating family physician at least once between July 2009 and April 2010
* At high risk for cardiovascular events:

  * Previous cardiovascular disease (including AMI, angina, stroke, TIA, claudication); or
  * Men aged \>= 45 years, women aged \>= 50 years; or
  * Men aged \< 45 years, women aged \< 50 years with at least one of the following:

    1. Macrovascular disease (silent myocardial infarction, or evidence of peripheral arterial, carotid or cerebrovascular disease)
    2. Microvascular disease (nephropathy or retinopathy)
    3. Family history of premature coronary or cerebrovascular disease in a first-degree relative
    4. Duration of diabetes \> 15 years with age \> 30 years
Clinical Diagnostic Approach for Cases of Thyroid Nodules

Thyroid nodules are a common presentation in the clinic, with an increasing incidence, especially in women. Their clinical significance is mainly related to excluding malignancy (4.0 to 6.5% of all thyroid nodules).

Thyroid nodule is a discrete lesion in the thyroid gland that is radiologically distinct from the surrounding thyroid parenchyma.

Thyroid nodules are a common presentation in the clinic, with an increasing incidence, especially in women. The detection rate among healthy individuals is as high as 50%-60%, but the reported incidence of malignant nodules in all thyroid nodules has ranged from only 1.6%-12%.

They are discovered either clinically on self-palpation by a patient, or during a physical examination by the clinician or incidentally during a radiologic procedure such as ultrasonography (US) imaging, computed tomography (CT) or magnetic resonance imaging (MRI) of the neck; with the increased use of sensitive imaging techniques, thyroid nodules are being diagnosed incidentally with increasing frequency in the recent years.

Though thyroid nodules are common, their clinical significance is mainly related to excluding malignancy (4.0 to 6.5% of all thyroid nodules), evaluating their functional status and if they cause pressure symptoms.

Thyroid nodules can be caused by many disorders:

Benign (colloid nodule, Hashimoto's thyroiditis, simple or hemorrhagic cyst, follicular adenoma and subacute thyroiditis) and malignant (Papillary Cancer, Follicular Cancer, Hurthle Cell Cancer, Anaplastic Cancer, Medullary Cancer, Thyroid Lymphoma and metastases).

Initial assessment of a patient found to have a thyroid nodule either clinically or incidentally should include a detailed and relevant history plus physical examination. Laboratory tests should begin with measurement of serum thyroid-stimulating hormone (TSH). Thyroid scintigraphy/radionuclide thyroid scan should be performed in patients presenting with a low serum TSH.

Thyroid ultrasound should be performed in all those suspected or known to have a nodule to confirm the presence of a nodule, evaluate for additional nodules and cervical lymph nodes and assess for suspicious sonographic features.

The next step in the evaluation of a thyroid nodule is a fine needle aspiration (FNA) biopsy, which is the gold standard diagnostic test.

Eligibility Criteria:
Inclusion Criteria:

* all patient presented by thyroid nodules either discovered clinically or incidentally.

Exclusion Criteria:

* no
Health and Migration Trajectories of Housekeepers in Bamako

In Mali, migration from rural zones is a cultural phenomenon existing since 1970. During the dry season (9 months), an important number of young women leave their villages and migrate towards urban zones to seek for a job. In Bamako, the estimated number of housekeepers is 100 000 coming from rural regions and aged between 11 and 19 years. The current healthcare offer seems to be non-adapted to their particularities.

This is a community-based research constructed on the basis of the activities of two NGOs in Mali: ADDAD (association for the defense of the rights of Housekeepers and domestic helpers ) and ARCAD Santé PLUS (the main NGO for healthcare access for HIV, hepatitis, and sexual health services). The research is conducted by the SanteRCom team in the UMR1252 SESSTIM research unit.

The main objective of this observational study is to study the knowledge, beliefs, behaviors and practices in terms of health in general, and sexual health in particular; and to assess the acceptability of an offer of community-based prevention and health services provided by ARCAD Santé PLUS integrated in the activities of ADDAD. The integrating of community-based healthcare offer in a familiar and reassuring framework, such as that of ADDAD, should promote access to health services among housekeepers.

The research is organized in 3 stages:

1. Preliminary qualitative survey based on focus group discussions. Allowing the identification of the housekeepers' needs in terms of prevention and healthcare services; and the behavioral particularities of the housekeepers community. It is planned to conduct 7 focus groups including between 42 and 56 housekeepers.
2. Communication and awareness campaigns in the regions of origin of housekeepers. Campaigns will be constructed on the basis of the results obtained from the preliminary qualitative survey.
3. Communication and awareness campaigns in Bamako; community-based activities for housekeepers will be organized 3 times per week during 5 months by the NGO ADDAD. Activities will include the community-based offer of prevention and healthcare services provided by the NGO ARCAD Santé PLUS, i.e. the novelty in the ADDAD's activities. A quantitative and qualitative surveys will be conducted over 5 months with participants recruited during the community-based activities. It is expected to enroll at least 1134 housekeepers, and to conduct a maximum of 25 individual interviews with selected housekeepers.


Eligibility Criteria:
Inclusion Criteria:

* Being a young girl and working in Bamako as housekeeper
* Speak one of the most current languages : Bambara, Dogon, French
* Being aged at least 12 years,
* To provide written consent. For minors (12 to 17 years old) the consent of a member of the ADDAD NGO as the legal responsible.

Exclusion Criteria:

* Minor housekeepers refusing the presence and signature of the ADDAD's member
* Housekeepers whose mental health would be judged (by the doctor) not appropriate to participate
* Housekeepers not able to understand and/or to sign the written consent
Comparison of Tele-Critical Care Versus Usual Care On ICU Performance (TELESCOPE)

TELESCOPE will be a cluster randomized clinical trial to ascertain whether the use of an intervention including multidisciplinary round with a board certified physician through tele-critical care and periodic meetings to discuss strategies to improve quality indicators can reduce ICU length of stay of patients admitted to intensive care units (ICUs).

Cluster randomized trial involving ICUs in Brazil. ICU is the unit of randomization.

The trial will have two stages:

Stage I - Baseline data:

* Characterize participant ICUs and quality indicators
* Characterize patients from each participant ICU to describe baseline outcomes

Stage II - Intervention:

This is the main stage for data analysis. ICUs will be randomly assigned to an experimental or control group. The experimental group should use a multidisciplinary rounds with a board certified physician through tele-critical care and take part in meetings to discuss how to improve local quality indicators, and the control group will follow the local standard of care.

Eligibility Criteria:
Inclusion Criteria for Clusters:

* Intensive care units from public hospitals and with at least eight beds
* Intensive care units with physician and nurses available 24 hours a day

Exclusion Criteria for Clusters:

* Intensive care units with structured multidisciplinary round more than three times a week based in a formal instrument
* Intensive care units already doing audit \& feedback
* Dedicated coronary care units/cardiac intensive care units or other specialized units
* Step-down units

Inclusion Criteria for Patients:

* Adult patients (\> 18 years old)
* Admitted after the beginning of the study

Exclusion Criteria for Patients:

* Admission for other reasons than medical (e.g., judicial cause)
* Previously included in TELESCOPE (for the primary outcome analysis)
Vein vs Arterial Grafts for Coronary Artery Bypass Grafting Surgery

The investigators have developed a novel technique for saphenous vein graft harvesting for coronary artery bypass grafting (CABG) where the graft is harvested with a pedicle of surrounding tissue. A randomized trial has shown a significantly higher patency rate for vein grafts harvested with this new methode compared to conventional harvesting technique 8.5 years after surgery (90 vs 76 %). In 2004 the investigators started a prospective randomized trial comparing patency between vein grafts harvested with surrounding tissue and radial artery grafts. The result showed that vein grafts harvested with surrounding tissue had a significantly higher patency rate compared to radial artery grafts 3 years after surgery (98 vs 84 %). The present study is a long-term follow-up (8 years) of the patients included in the second randomized trial. The hypothesis is that vein grafts harvested with surrounding tissue have a significantly higher patency rate compared to radial artery grafts 8 years after surgery.


Eligibility Criteria:
Inclusion Criteria:

* Three vessel coronary artery disease

Exclusion Criteria:

* 65 years or older
* Elevated creatinine
* Raynauds disease
* Vein stripping
Evaluate the Incidence of Junctional Rhythms Occurring During Post-procedure TAVI Hospitalization.

Transcatheter Aortic Valve Implantation (TAVI) aims to treat patients with symptomatic narrowing of the aorta by implanting an aortic bioprosthesis. This technique, which is currently highly developed, can lead to the appearance of cardiac conduction disorders following implantation, and in particular the presence of a junctional rhythm. Junctional rhythms are tachycardias involving a circuit between the atria and the ventricles (junction between the two compartments atrium and ventricle).

The goal of this observational study is to describe the incidence and pronostic of this rhythm disorder (junctional rhythm) following the TAVI procedure.

Monocentric observational study including all patients implanted with aortic bioprosthesis \[undergoing Transcatheter Aortic Valve Implantation (TAVI)\] at Clermont-Ferrand University Hospital, between December 1st, 2023 and March 1st, 2025. Telemetric monitoring and daily electrocardiograms were used to identify junctional rhythms. The primary endpoint was pacemaker (PM) implantation between day 0 and day 30 after TAVI. Patients with a junctional rhythm at the time of hospitalization were recalled to find out whether they had benefited from PM implantation within 30 days after the TAVI procedure.

Eligibility Criteria:
Inclusion Criteria:

* Major patients who have undergone or are undergoing a TAVI procedure (since 01/12/2023) and who present a junctional rhythm.

Exclusion Criteria:

* Minor patients
* Patients already implanted with a pacemaker
* Atrial fibrillation
* Pregnant women.
* Patients under guardianship or legal protection
* Patients deprived of liberty
* Patients refusing to participate in the study
Assessing Accuracy of Kavo Diagnodent

This study aims to evaluate the accuracy of kavodiagondent and compare with digital radiograph (vista scan).the gold standard is light microscope

Extracted teeth with intial caries (no cavitation)will be used to detect caries. The teeth will be numbered and each of the occlusal surfaces will be measured by DIAGNOdent with a conical probe in accordance with the manufacturer's instructions. The standard value for each individual tooth will be calibrated before each measurement by measuring in a region of sound tissue. The occlusal surfaces will be carefully scanned and measured 3 times when wet, and 3 times after they had been wiped with paper tissues and exposed to air for about 2 min in room temperature. The maximum value from each measurement will be registered and the mean values of the three data under wet and dry conditions, respectively, will be calculated. After an interval of 2 weeks, the procedure will be repeated under identical conditions. All occlusal surfaces will be photographed. The sites with the highest values will be indicated in the photographs in order to identify the location for the second measurement and for subsequent sectioning for light microscope examination.

The teeth will be arranged in pairs and mounted in plaster blocks. Reproducible radiographs will be obtained. This will be done by digital radiography (vista scan sensor). The radiographs will be examined by 4 radiologists. The observers will be instructed to select one of five ratings to represent his or her level of confidence that a carious lesion was present or not in the occlusal surfaces of the teeth. The following scale was used: 1 = definitely not caries, 2 = probably not Caries, 3 = questionable, 4 = probably caries, and 5 = definitely caries.

After the laser fluorescence measurements had been completed and the digital radiographs had been exposed, the teeth will be removed from the blocks and embedded in plastic. At the sites indicated in the photographs, buccolingual sections approximately 300 µm thick will be taken perpendicular to the occlusal surfaces using a water-cooled saw. The slices will then examined under light microscope. The lesion depth will be scored on a scale from 0 to 4, where 0 = sound, 1 = enamel caries limited to the outer half of the enamel, 2 = enamel caries in the inner half of the enamel, 3 = dentinal caries in the outer half of the dentine, and 4 =dentinal caries in the inner half of the dentine

Eligibility Criteria:
Inclusion Criteria:

* Extracted posterior teeth Visually intact occlusal surfaces or a variety of occlusal carious lesions, but no obvious cavities
* Removal of organic material and stains from the surfaces, the teeth will be immersed in 10% sodium hypochlorite solution for 20 min, followed by rinsing in distilled water for 20 min. The teeth will then stored in saturated thymol solution or formalin.
* The teeth will be arranged in pairs and mounted in plaster blocks.

Exclusion Criteria:

Teeth with deep cavity

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Periodization of Exercise Training in Patients With Coronary Heart Disease.

The research project includes two components that assess exercise physiology parameters, cerebrovascular reserve, cognitive functions and cardiac function in coronary heart disease patients at rest, during an acute exercise, and after two different periodized training programs.


Eligibility Criteria:
Inclusion Criteria for patients with coronary heart disease:

* Major
* Adequate physical and mental capacities
* Autonomy in daily activities
* Documented coronary artery disease
* Stable or recent coronary artery disease

Exclusion Criteria for patients with coronary heart disease:

* Inability to complete the consent form
* Acute coronary syndrome \< 3 months
* Heart failure
* Ejection fraction of the left ventricle \<40%
* Coronary artery disease non revascularisable including left main coronary stenosis
* Waiting for a bridging of the coronary artery
* Chronic atrial fibrillation
* Malignant arrhythmias during exercise
* Restriction to non cardiopulmonary exercise
* Severe intolerance to exercise
Metformin Versus Orlistat in Obese Polycystic Ovary Syndrome (PCOS) Patients

The purpose of this study is to compare the influence of Orlistat and Metformin on obesity treatment in obese PCOS women.

In a randomized clinical trial study, 80 obese women with BMI≥30, oligomenorrhae, hirsutism and presence of \> 12 ovarian follicles (2-10mm diameter), were evaluated. In metformin group , metformin was administered for patients 1500 mg daily for three months. In orlistate group, patients used orlistat tablets (120 mg, 3 times a day) for three months. BMI, serum LH and FSH levels, serum triglyceride and cholesterol levels and also patients' ovulation was compared before and after treatment.

Eligibility Criteria:
Inclusion Criteria:

* BMI\>= 30
* PCOS

Exclusion Criteria:

* Drug use during last three months
Development of a Patient-Reported Outcome Measure to Assess Symptoms in Patients With Primary Sclerosing Cholangitis (PSC)

The objectives of this qualitative study are to elicit concepts about symptoms that are important to patients with primary sclerosing cholangitis (PSC), as well as the key impacts of symptoms on patients' day-to-day functioning.

In Step I, concept elicitation one-on-one interviews (via telephone or in person) will be conducted. The aims of the concept elicitation interviews are to:

1. Identify the most common symptoms, as well as the most important symptoms, for patients with PSC, and
2. Assess whether these symptoms impact day-to-day functioning

An instrument will be developed based on the symptoms reported and in Step II of the study, the performance of the instrument will be assessed with further interviews.

Eligibility Criteria:
Inclusion Criteria:

* Confirmed diagnosis of PSC based on liver biopsy or diagnostic imaging, with diagnosis made at least three months prior to screening
* Patient report of PSC symptoms associated with PSC diagnosis
* Able to speak, read, and understand English
* Willing and able to provide written informed consent to participate in the research study

Exclusion Criteria:

* Patients with other causes of liver or biliary disease, including viral hepatitis, alcoholic liver disease, primary biliary cirrhosis, and secondary sclerosing cholangitis
* Patient with history of liver cirrhosis
* Patients with history of cholangiocarcinoma
* Patients who have received a liver transplant
* Patients currently enrolled in PSC clinical trials; and
* STEP II ONLY: Enrolled in or participated in Step I of this study (concept elicitation)