cyrilzakka/clinical-trials huggingface dataset:
A Dose Finding Study of Remifentanil and Propofol for Lumbar Punctures in Children

This study will examine whether the combination of two anaesthetic medications, propofol and remifentanil, is suitable for short duration surgical procedures, providing a shorter recovery time and fewer side effects than either drug used alone.

Propofol is the primary medication used by anesthesiologists at HSC to provide sedation for lumbar puncture. Propofol provides amnesia, anxiolysis, and hypnosis, but because propofol has no analgestic properties patients often respond to the pain of LP needle insertion. To ensure patient immobility, the dose of propofol is often increased, resulting in a duration of action that is excessive for lumbar puncture. Remifentanil is an ultra-short acting opioid which can be used to provide analgesia and sedation for short painful procedures with minimal residual pain. However, when used as the sole agent, remifentanil is associated with a high incidence of respiratory depression and/or arterial oxygen desaturation and does not provide amnesia or anxiolysis. The combination of propofol and remifentanil may be particularly suitable for short duration procedures, providing a shorter recovery time and fewer side effects than either drug used alone.

The objective is to determine the minimum effective dose of remifentanil required to prevent movement for insertion of a lumbar puncture needle when co-administered with propofol. The results obtained from this study will be used in a future study of the recovery characteristics of propofol and remifentanil in children undergoing lumbar puncture.

Eligibility Criteria:
Inclusion Criteria:

* Clinical diagnosis of a hemato-oncological disorder
* Scheduled to undergo a lumbar puncture
* Aged 4-11 years
* Male or female
* Unpremedicated
* Willing and able to provide informed consent (or informed consent by parents)

Exclusion Criteria:

* Children who are known or suspected to be difficult to ventilate by face mask
* Children who are deemed medically unfit to receive either of the two study medications
* Children who are obese (weight for height \> 95th percentile,
* Children who do not have an indwelling intravenous line
The Utility of Oxygen Insufflation During Flexible Fiberoptic Bronchoscope-guided Intubation

This study investigate the utility of continuous oxygen insufflation during fiberoptic bronchoscope-guided intubation.

One group receives oxygen via suction channel of fiberoptic bronchoscope during intubation.

The other group does not receive oxygen during fiberoptic bronchoscope-guided intubation.

Then, the velocity of deoxygenation difference of PaO2(baseline

Fiberoptic bronchoscope-guided intubation is a gold standard for intubation of a patient with anticipating difficult airway. This technique takes several minutes without oxygen supply, which results in hypoxia when it prolonged. If continuous supply of oxygen during procedure improve the oxygenation, we can reduce the risk of hypoxemia and increase the safety margin during procedure.

Eligibility Criteria:
Inclusion Criteria:

* patients who have surgery under general oral endotracheal anesthesia with invasive arterial blood pressure monitoring

Exclusion Criteria:

* history of lung disease
* abnormality in chest x-ray
* anticipating difficult intubation
* pregnant women
* who is unable to understand and agree the consent form
Pharmacogenetics of Antifolate Disease Modifying Anti-Rheumatic Drugs in Rheumatoid Arthritis in Taiwan

Polymorphisms occur in several genes encoding key enzymes in the folate pathway may affect drug metabolism in patients with rheumatoid arthritis. Whether these genetic variations contribute to differential responses to antifolate drug in patients with rheumatoid arthritis (RA) remains to be investigated in the Taiwanese population.

Objective. The goal of the present study is to investigate the interactions between genetic variations in folate genes and the efficacy/side effects of anti-folate disease-modifying antirheumatic drug in Taiwan.

DESIGN. A cross-sectional study involving 100 patients with RA were enrolled from TCVGH. Genotypes in methylenetetrahydrofolate reductase (MTHFR677C\>T), tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) and folylpoly-gamma-glutamate synthetase (FPGS1901T\>C) were determined by RFLP or pyrosequencing.


Eligibility Criteria:
Inclusion Criteria:

* Male/female age \>18
* Clinical diagnosis of Rheumatoid Arthritis

Exclusion Criteria:

* Must not be pregnant/breastfeeding
* Other conditions may lead to exclusion from the trial (e.g. Diabetes mellitis, malignant melanoma, cardiac conduction disorders, hepatic/renal insufficiency.
Osteopathic Manual Treatment for Hemiplegic Shoulder Pain and Upper Extremity Function in Stroke Patients

This study assesses the feasibility and safety of performing osteopathic manual treatment (OMT) for hemiplegic shoulder pain in stroke patients. This study's participants will be adults with a first-time stroke diagnosis in the past 5 years and shoulder pain on the same side affected by stroke. Eligible participants will be placed on study for approximately 6 weeks and given either OMT or a sham treatment each week.


Eligibility Criteria:
Inclusion Criteria:

* Patients must be at least 18 years or older to participate in the study
* Presence of shoulder pain on the side of the body affected by stroke
* Patients must have a diagnosis of a first-time stroke within the past 5 years
* Stroke type must be subcortical, brainstem, and/or right-MCA stroke. Participants with multiple stroke types within the first-time diagnosis may be included

Exclusion Criteria:

* Presence of an active systemic or localized infection requiring antibiotic therapy
* Presence of fracture in the area being treated
* Presence of open wound in the area being treated
* Presence of rheumatoid arthritis
* Presence of known active malignancy
* Presence of shoulder pain on the affected side within 3 months prior to stroke
* Patients with left-MCA stroke diagnosis who demonstrate the presence of aphasia based on the Mississippi Aphasia Screening Test (MAST)
* Patients who demonstrate hemispatial visual neglect based on screening motor-free visual perception test (MFVPT)
* Patients already receiving any type of manual therapy by a certified therapist through their standard-of-care treatment
* Patients who do not wish to participate
* Patients who are not fit as judged by the study team
* Patients who lack the capacity to consent for enrollment in the study based on the University of California San Diego Brief Assessment of Capacity to Consent
Pulse Pressure Variation in Spontaneously Breathing Patients

The investigators hypothesized that pulse pressure variation (PPV) could predict fluid responsiveness in spontaneously breathing patients undergoing anesthesia induction.

Pulse pressure variation (PPV) is known to be a dynamic indicator to predict fluid responsiveness in mechanically ventilating patients. PPV is generated by cardiopulmonary interaction with respiratory cycles. In spontaneous breathing, the cardiopulmonary interaction may lead to PPV by inverted manner. In this study, the investigators will evaluate the ability of PPV to predict fluid responsiveness in spontaneously breathing patients. Before induction of anesthesia, radial artery cannulation is performed, and FloTrac/Vigileo (Edwards Lifesciences Corp., Irvine, USA) system is connected. And then, the investigators will measure baseline data including invasive blood pressure, pulse pressure, cardiac index, stroke volume variation in two different conditions: during tidal spontaneous breathing and during forced spontaneous breathing. All hemodynamic measurement will be repeated after infusion of fluid using 6mL/kg of hydroxyethyl starch solution (Voluven), and will be averaged over 3 minutes. Patients whose cardiac index increased by \>15% to fluid infusion is defined as responders. The investigators will compare the hemodynamic parameters between responders and non-responders. To evaluate the ability to predict volume responsiveness, receiver operating characteristics curves of the PPV will be calculated.

Eligibility Criteria:
Inclusion Criteria:

* patients undergoing thoracic surgery

Exclusion Criteria:

* preoperative arrhythmia
* left ventricular ejection fraction \<40%
* intra-cardiac valve disease
* intra-cardiac shunt
* pulmonary artery hypertension
* severe peripheral vascular obstructive disease
* decreased pulmonary function
Belotecan and Cisplatin in Treating Patients With Previously Untreated, Extensive-Stage Small Cell Lung Cancer

RATIONALE: Drugs used in chemotherapy, such as cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Belotecan may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving belotecan together with cisplatin may kill more tumor cells.

PURPOSE: This phase II trial is studying how well belotecan works when given together with cisplatin in treating patients with previously untreated extensive stage small cell lung cancer.

OBJECTIVES:

Primary

* To assess the antitumor efficacy, in terms of objective response rate, of belotecan hydrochloride and cisplatin in patients with previously untreated extensive-stage small cell lung cancer.

Secondary

* To assess additional evidence of antitumor activity as measured by overall and progression-free survival of these patients.
* To determine the safety and tolerability of this drug combination in these patients.

OUTLINE: Patients receive cisplatin IV on day 1 and belotecan hydrochloride IV on days 2-4.Treatment continues in the absence of disease progression or unacceptable toxicity.

Eligibility Criteria:
DISEASE CHARACTERISTICS:

* Histologically confirmed small cell lung cancer meeting the following criteria:

  * Extensive-stage disease
  * Previously untreated disease
* At least one measurable disease
* No brain or leptomeningeal metastasis

PATIENT CHARACTERISTICS:

* ECOG performance status 0-2
* Life expectancy ≥ 12 weeks
* ANC ≥ 1,500/mm\^3
* Platelet count ≥ 100,000/mm\^3
* Hemoglobin ≥ 9.0 g/dL
* Total bilirubin ≤ 1.5 mg/dL
* ALT and AST ≤ 2.0 times upper normal limit (ULN) (≤ 5.0 times ULN in the presence of liver metastasis)
* Alkaline phosphatase ≤ 2.0 times ULN
* Creatinine ≤ 1.5 mg/dL OR creatinine clearance ≥ 60 mL/min
* No active infection requiring intravenous antibiotics
* No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or in situ cancer
* No other severe acute or chronic medical condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration, interfere with the interpretation of study results, or make the patient ineligible for study entry, in the judgment of the investigator

PRIOR CONCURRENT THERAPY:

* No prior chemotherapy or radiotherapy
* No other concurrent chemotherapy, radiotherapy, or immunotherapy
Research for Associated Genes for Gastric Cancer in Family Member With Affected First-Degree Relatives

Familial gastric cancer accounts for 10% of all cases, but predisposing genetic variations is unknown except for CDH1 mutation.

Because Germline mutation is believed to be a key aspect of cancer predisposition, we plan to recruit persons with 2 or more affected family members in three-generation pedigree. The investigators will perform a whole-exome sequencing using DNA from blood samples of families including gastric cancer patients and non-gastric cancer patients

1\> Patient selection

Enroll criteria:

1) Gastric cancer patients and their first-degree relatives and 2) family with two or more gastric cancer patients within three-generation pedigree.

A three-generation pedigree will be used for diagnostic consideration or risk assessment of rare variation.

Personal history will be acquired by questionnaire which asks smoking, alcohol intake, dietary preference, socioeconomic information and history of previous eradication of HP. For any family member with gastric cancer, age at diagnosis, histology type, methods of treatment or pathological reports will be evaluated.

2\> Whole exome sequencing, variant annotation, filtering and prioritization After whole exome sequencing, functional annotation of genetic variants will be conducted using ANNOVAR.

3\> Linkage analyses To perform variant and gene-based linkage analysis in pedigrees, data will be analyzed using pedigree-VAAST.

4\> Validation using a genechip

Eligibility Criteria:
Inclusion Criteria :

* Gastric cancer patients and their first-degree relatives
* Members in family with two or more gastric cancer patients within three- generation pedigree

Exclusion Criteria :

* Those who reject the enrollment
Thalidomide Enhances Clinical Efficacy of Cetuximab Combined With Standard Chemotherapy for Left Colorectal Cancer

1. To verify that thalidomide can increase the efficacy of cetuximab plus chemotherapy in the treatment of stage IV RAS and BRAF wild-type unresectable left colorectal cancer, which has important clinical significance and provides a basis for subsequent large-scale research and clinical application.
2. To evaluate the changes of cytokines and verify the effect of some cytokines on the efficacy of cetuximab +FOLFIRI, so as to provide a scientific basis for the subsequent precise therapy using cytokines antibodies.


Eligibility Criteria:
Inclusion Criteria:

1. Patients with RAS and BRAF wild-type IV unresectable left colorectal cancer confirmed by pathology and tissue/cytology and genetic testing;
2. Physical state is good: PS 0-2;
3. Expected survival of more than 3 months;
4. Aged 18-75 years old;
5. Have not received systematic chemotherapy before;
6. Did not receive cetuximab treatment;
7. Liver, kidney and bone marrow functions are basically normal;
8. The clearance period of chemotherapy and molecular targeted therapy is more than 4 weeks;
9. Voluntary participation in the group, good compliance, can cooperate with the experiment observation, and sign the written informed consent.

Exclusion Criteria:

1. Patients with severe dysfunction of vital organs (heart, liver, kidney);
2. Patients with other malignant tumors;
3. Patients who are pregnant or breastfeeding (women of childbearing age need to check pregnancy test);
4. In the active phase of acute or chronic infectious diseases;
5. People with a clear history of drug allergy or allergic constitution;
6. Patients participating in other clinical trials;
7. Other conditions in which the patient was considered inappropriate to participate in the study.
Foot Reflexology to Reduce Pain and Anxiety Before Chest Tube Removal

In open heart surgeries, patients experience severe pain due to tissue trauma, damage to intercostal nerves, and muscle spasm due to pulling tubes from the mediastinal space and between the pleural leaves pull during chet tube removal (CTR). When acute pain is not relieved, the patient develops emotional, psychological (eg post-traumatic stress disorder) and physical problems (eg chronic pain) after surgery. Since this situation negatively affects the healing process, it increases the anxiety level of the patients and decreases the comfort level. Reflexology is one of the non-pharmacological methods used in the management of pain and anxiety after open heart surgery The aim of this randomized controlled study was to identify the effect of foot reflexology applied before chest tube removal process on pain and anxiety level. This study will be done a randomized-controlled trial to test the intervention.

Background: Patients undergoing cardiovascular surgery suffer from anxiety and pain due to the chest tube removal (CTR).

Objective/Hypothesis: The aim of this randomized controlled study was to identify the effect of foot reflexology applied before chest tube removal process on pain and anxiety level.The following hypotheses (H) were tested in this study:

H1a : There was a difference between the reflexology group and the control group in terms of pain level during CTR.

H1b : There was a difference between the reflexology group and the control group in terms of anxiety level during CTR.

H1c : There was a difference between the reflexology group and the control group in terms of the difference between the pain level before CTR and during CTR.

H1d : There was a difference between the reflexology group and the control group in terms of the difference between the anxiety level before CTR and during CTR.

Study design: A randomized controlled trial. Method: The study sample who has gone through coronary artery bypass graft surgery was randomly assigned to reflexology or the control group (twenty- eight each in). The primary outcomes were pain, evaluated using a numeric pain-rating scale, and anxiety evaluated by the profile of mood states scale tension-anxiety subscale, both measured first (before and after reflexology) and second postoperative days (before the reflexology and immediately after chest tube removal, 15th minutes and 1 h).

Eligibility Criteria:
Inclusion Criteria:

* Adult patients over 18 years who have CABG surgery
* Having at least two chest tube catheters
* Having chest tubes removed together
* Volunteering to participate in the research

Exclusion Criteria:

* Patients with diagnosed with psychiatric illness
* Having orientation or confusion problems, complete vision or hearing loss, mental problems due to problems such as dementia, mental retardation, and language problems
* Having pacemaker, varicose veins in the ankles
* Having chronic pain
* Having femoral fracture and open wound on the sole of the foot
* Having acute infection and hyperthermia, thromboembolism, suspected deep vein thrombosis at the postoperatively
Strategy to Prevent Transmission of Multidrug-resistant Gram-negative Organisms in ICU

1. Objective of study The purpose of this study was to investigate whether the active surveillance and preemptive isolation of multidrug-resistant Gram-negative bacteria in the intensive care unit affected the reduction of the rate of acquisition of multidrug- resistant Gram-negative bacteria (MDRGNB).
2. Background Treatment option for MDRGNB (Carbapenem-resistant P. aeruginosa, Carbapenem-resistant A. baumannii, Carbapenem-resistant Enterobacteriaceae) is limited. Development of infection due to MDRGNB is common in ICU. Strategy to prevent transmission of MDRGNB is needed, and there is two approaches; First, antimicrobial stewardship program, and second, infection control strategy.The investigators aimed to figure out the role of active surveillance test and preemptive isolation of MDRGNB in reduction of acquisition rate of MDRGNB.
3. Methods Pragmatic cluster randomized, crossover, controlled trial During first period (6 months), intervention group (randomized 3 ICUs) perform daily chlorhexidine bathing, active surveillance test and preemptive isolation and contact precaution. Control group (randomized 3 ICUs) perform standard precaution with daily chlorhexidine bathing, and start contact precaution when clinical isolates reveals MDRGNB.

After 1 month washout period, intervention group and control group cross over for next 6 months.


Eligibility Criteria:
Inclusion Criteria:

* Enroll all patients who admit to the ICUs during the study period

Exclusion Criteria:

* Patients who discharge within 2 days after admission to ICUs
Efficacy of an Exercise Intervention to Decrease Depressive Symptoms in Veterans With Hepatitis C

In this study, depressed veterans with hepatitis C will be randomly assigned to the control group or to the exercise intervention group. The exercise intervention is designed to begin slowly for most participants and to progress within each participant's target heart rate range for moderate intensity exercise. The exercise intervention is a 12 week home based walking program. Ideally individuals will walk for 30 minutes, at a moderate intensity, a minimum of three times per week. However, the duration and relative intensity will be tailored for each individual.

Central Hypothesis Veterans who receive the exercise intervention will be significantly less symptomatic for depression than veterans in the control group.


Eligibility Criteria:
Inclusion Criteria:

* Male or female, age 18 or older
* Documentation of positive hepatitis C status as indicated by a detectable HCV viral load by polymerase chain reaction
* Mild to moderate depressive symptoms as evidenced by a BDI II score of ≥ 14
* Able to read and understand English
* Written/signed informed consent specific to this protocol
* Being sedentary that is , less than 30 minutes of planned low to moderate intensity exercise 2 days per week

Exclusion Criteria:

* Suicidal ideations
* Current interferon therapy or planning to begin interferon therapy during the next three months
* Diagnosis of Bipolar disorder, Schizophrenia, or Post Traumatic Stress Disorder
* Any medical condition, disorder, or medication that contraindicates participation in a mild to moderate intensity walking program
Study on Abnormal Dopamine Synthesis and Connectivity According to the Antipsychotic Treatment Response in Schizophrenia

The purpose of this study is to evaluate abnormal dopamine synthesis and connectivity according to the antipsychotic treatment response in schizophrenia.


Eligibility Criteria:
Inclusion Criteria:

* diagnosis of schizophrenia
* clinically stable state

Exclusion Criteria:

* history of previous head injury, epileptic disorder, other medical comorbidity
* substance abuse/dependence