cyrilzakka/clinical-trials huggingface dataset:
Postoperative Pain in Shoulder Surgery

After the approval of the ethics committee, the files of the patients who underwent arthroscopic shoulder surgery between 01.01.2019 and 01.03.2020 were evaluated retrospectively.

Data were recorded including age, gender, duration of anesthesia, duration of surgery, postoperative analgesia consumption, complications such as respiratory distress due to hemidiaphragmatic paralysis and complications such as hematoma and nerve damage due to block intervention.

Patients who underwent arthroscopic shoulder surgery and underwent USG-guided interscalene block and concomitant suprascapular block were included in the study. We tried to determine whether there is a difference between different dose regimens in order to determine the effective analgesic dose and minimize the side effects of dose-dependent interscalene block applications.

Eligibility Criteria:
Inclusion Criteria:

arthroscopic shoulder surgery full data form

Exclusion Criteria:

chronic obstructive lung disease chronic opoid consumption missing data from the postoperative pain form
A Long Term Study of Clozapine in Patients With Treatment-resistant Schizophrenia

Clozapine is an antipsychotic. This open study will evaluate the safety and efficacy of long term treatment of clozapine in patients with treatment-resistant schizophrenia.

Clozapine is an antipsychotic. This open study will evaluate the safety and efficacy of long term treatment of clozapine in patients with treatment-resistant schizophrenia.

Eligibility Criteria:
Inclusion Criteria:

* Attended the previous Phase IIb (core) study
* Improved during the core study
* No safety issues during the core study

Exclusion Criteria:

* Discontinued the core study
* Pregnant or nursing (lactating) women

Other protocol-defined exclusion criteria may apply.
Tobacco Intervention in Primary Care Treatment Opportunities for Providers

The purpose of this study is to evaluate the use of "sampling" of smoking cessation medications (nicotine patches and lozenges) among smokers seen in primary care settings. Half of study participants will be provided with samples of medication, to use however they wish; the other half will not be provided with these samples. All smokers will be advised to quit through routine contact with their physician. After the primary care contact, all participants will be contacted by phone for three brief follow-up interviews, which will involve answering questionnaires about their smoking habits.


Eligibility Criteria:
Inclusion Criteria:

* age \>=18
* daily (25+ days within past 30) cigarette smoker of \>5 cigs/day
* English speaking
* recruited through primary care sites aligned with study

Exclusion Criteria:

- no FDA contraindications for use of NRT:

1. not pregnant, breastfeeding, or planning to become pregnant
2. no recent (past 3 months) cardiovascular trauma: MI, stroke
Treatments for Psychogenic Nonepileptic Seizures (NES)

The investigators propose that treatment of the comorbid disorders (depression, anxiety, and impulsivity) with sertraline in patients with lone psychogenic nonepileptic seizures (NES), will result in a decreased number of NES. The purpose of this study is to provide pilot testing and data to inform the future randomized controlled trial based on the hypothesis.

This is a pilot, prospective, single center, randomized, placebo-controlled, double-blind trial, that assesses the number of NES in patients treated with flexible dose sertraline (Zoloft). This study will provide outcomes data and the effect size necessary for a future R01, multi-center randomized control trial. Secondary objective variables include reduction in depression, anxiety, impulsivity scores, and improvement in psychosocial functioning.

After being diagnosed with NES by video electroencephalogram monitoring (vEEG), up to 50 participants will be enrolled and monitored during a two week lead in period for their baseline NES and psychosocial symptoms and functioning. At week 2, they will be blindly randomized to the treatment arm with flexible dose sertraline (25 to 200mg) or to the placebo control arm. The dose will be titrated over 4 weeks up to 200mg or to dose limited by side effects. The subjects will stay on their maximum fixed dose for the next 4 weeks. At week 10, the subjects may elect to remain on the sertraline or they can taper off the medication over the final two weeks of the treatment trial.

After the treatment trial, the subjects will have follow up phone calls at month 4, 8, and 12 after enrollment to assess seizure status, medication usage, and global functioning.

Upon enrollment, subjects will be evaluated with a structured psychiatric and neurological exam, and with bi-weekly, 30 to 60 minute appointments where they will complete symptom and function scales. They will keep a seizure diary prospectively, to evaluate their daily seizure activity. They will be given two weeks of the medication at each visit.

In the first phase of the study 12 patients were screened and 8 enrolled in an open label trial of flexible dose sertraline. In the second phase of the study, 38 patients enrolled in the pilot, randomized, placebo-controlled trial.

Eligibility Criteria:
Inclusion Criteria:

* Video electroencephalogram (vEEG) confirmed diagnosis of NES
* Have at least one nonepileptic seizure per month
* Comorbid diagnosis of either depression, anxiety, or post traumatic stress disorder (PTSD)
* Able to complete self report symptom scales
* Not receiving optimized antidepressant medication

Exclusion Criteria:

* Equivocal electroencephalogram (EEG) findings
* Current suicidality, litigation, or self-mutilation
* Using monoamine oxidase inhibitors (MAOIs), pimozide, or sumatriptan
* Allergy/sensitivity to sertraline
* Current alcohol/drug dependence
* Serious medical illness requiring current hospitalization
Effects of Particulate Matter on the Pulmonary Function and Acute Exacerbation of COPD and Asthma

Particulate matter(PM) exposure has been shown to increase the morbidity and mobility of a variety of respiratory diseases, including COPD and asthma. This study focus on the effects of PM on the pulmonary function and acute exacerbation of COPD and asthma patients in China, where PM exposure is much heavier than the United States and European countries.

Particulate matter(PM) exposure has been shown to increase the morbidity and mobility of a variety of respiratory diseases, including COPD and asthma. This study focus on the effects of PM on the pulmonary function and acute exacerbation of COPD and asthma patients in China, where PM exposure is much heavier than the United States and European countries. This study is an observational study which lasts 3 years. Primary outcome measures:Change in spirometry (FEV1) of COPD, asthma patients and healthy volunteers in response to different exposure doses of PM.

Eligibility Criteria:
Inclusion Criteria:

1. COPD patients: clinical manifestation of COPD; post bronchodilator FEV1/FVC\<0.70.
2. Asthma patients: clinical manifestation of asthma; recurrent dyspnea; with or without wheezing; relief spontaneously or after using bronchodilators; FEV1/FVC\<0.70,with positive bronchial reversible test.
3. Asthma combined with COPD (ACOS) patients: patients with ACOS are included in asthma group.
4. Healthy volunteers: No smoking history, or have quit smoking at least 5 years. Chest X-ray show no abnormality.
5. Information consent form should be signed before entering the study.

Exclusion Criteria:

1. The latest severe acute attack occurred within 4 weeks:

   1. Severe acute attack: status asthmaticus or acute exacerbation of COPD leading to consultation, emergency treatment，hospitalization, or glucocorticoid treatment（oral/i.v).
   2. Controllable non-hospitalized acute attack without glucocorticoid treatment(oral/i.v). COPD attack lasting less than 48h or asthma attack lasting less than 24h are not excluded.
2. Any history of acute/chronic respiratory diseases other than asthma and COPD, including lung cancer and pulmonary infection.
3. Plasma ALT or AST greater than 2 times of the upper normal limit; plasma Creatinine greater than 1.5 times of the upper normal limit.
4. Left heart insufficiency, or malignant arrhythmia.
5. HIV positive.
6. Acute cerebrovascular events within 3 months, including apoplexy, transient cerebral ischemia and acute coronary syndrome.
7. Uncured malignant tumors.
8. Addicted to drug or alcohol, or any history of psychiatric disorders.
9. Breastfeeding, pregnancy or planning to be pregnant.
10. Estimated lifetime less than 2 years due to underlying diseases.
Citrate Pharmacokinetics in Critically Ill Liver Failure Patients Receiving CRRT

Citrate has been proposed as anticoagulation of choice in continuous renal replacement therapy (CRRT). However, little is known about the pharmacokinetics (PKs) and metabolism of citrate in liver failure patients who require CRRT with regional citrate anticoagulation (RCA).

This study aimed to evaluate citrate PKs, metabolic complications, and clinical outcomes among critically ill acute liver failure (ALF) and acute on top chronic liver failure (ACLF) patients receiving CRRT.

Eligibility Criteria:
Inclusion Criteria:

* Critically ill ALF or ACLF adult patients with AKI
* aged ≥ 18 y old
* Currently receiving CRRT.

Exclusion Criteria:

* severe acidosis (pH \< 7.1) or severe alkalosis (pH \> 7.55)
* blood transfusion within 24 h prior to the study
* use of citrate-containing medications
* severe hypocalcemia (serum ionized calcium \< 0.8 mmol/L)
* use of heparin as anticoagulation
THUNDER: Acute Ischemic Stroke Study with the Penumbra System® Including Thunderbolt™ Aspiration Tubing

The objective of this study is to demonstrate the safety and efficacy of the Penumbra System including Thunderbolt Aspiration Tubing (Thunderbolt) in a population presenting with acute ischemic stroke (AIS) secondary to intracranial large vessel occlusion (LVO) who are eligible for mechanical thrombectomy.


Eligibility Criteria:
Inclusion Criteria:

1. Patient age 18 - 80 years
2. Treatment within 8 hours of symptom onset
3. Pre-stroke mRS 0-2
4. Patient experiencing acute ischemic stroke secondary to intracranial large vessel occlusion in the internal carotid, middle cerebral (M1 or M2), basilar, or vertebral artery
5. If patient is eligible for thrombolytic therapy, it was administered as soon as possible, and no later than 3 hours from stroke symptom onset
6. Planned frontline treatment with Penumbra System including Thunderbolt modulated aspiration
7. Informed consent obtained per Institution Review Board/Ethics Committee requirements

Exclusion Criteria:

1. Stenosis, excessive tortuosity, or any occlusion in a proximal vessel requiring treatment or preventing access to the thrombus
2. Alberta Stroke Program Early CT Score (ASPECTS) ≤6 or core infarct volume \>50 mL on MRI or CT-based imaging (for anterior circulation strokes)
3. Pregnant patient
4. Life expectancy \< 90 days due to comorbidities
5. Current participation in an interventional drug or device study that may confound the results of this study. Studies requiring extended follow-up for products that were investigational but have since become commercially available are not considered investigational studies
6. Other medical, behavioral, or psychological conditions that in the opinion of the Investigator could limit the patient's ability to participate in the study, including compliance with follow-up requirements, or that could impact the scientific integrity of the study
NaF/FDG PET/MRI in Measuring Response to Radium Ra 223 Dichloride in Patients With Metastatic Hormone-Resistant Prostate Cancer

This pilot clinical trial studies combined fluorine F 18 sodium fluoride (NaF)/ fludeoxyglucose F 18 (FDG) positron emission tomography (PET) and magnetic resonance imaging (MRI) in measuring response to a drug, radium Ra 223 dichloride (Ra-223), in treating patients with prostate cancer that has not responded to hormone therapy and has spread to other parts of the body. Combining NaF/FDG in a simultaneous PET/MRI scan may help doctors accurately measure how well patients respond to treatment with radium Ra 223 dichloride.

PRIMARY OBJECTIVES:

I. Estimate the performance of simultaneous NaF/FDG PET/MRI for the prediction of treatment response in patients with metastatic castrate resistant prostate cancer (mCRPC).

II. Estimate the performance of simultaneous NaF/FDG PET/MRI for detection of extra-skeletal disease progression during treatment in mCRPC patients.

OUTLINE:

Patients receive 18F NaF and 18F FDG intravenously (IV) over 30 seconds-1 minute and then undergo PET/MRI and contrast-enhanced MRI after 45-60 minutes. Patients undergo imaging at baseline, after course 3 (12 weeks), and after course 6 (24 weeks) of treatment with Ra-223.

After completion of study, patients are followed up for up to 12 months.

Eligibility Criteria:
Inclusion Criteria:

* Provides written informed consent
* Diagnosed with mCRPC and painful bone metastases, referred for Xofigo (radium Ra 223 dichloride)
* Able to remain still for duration of the imaging procedure (about one hour)

Exclusion Criteria:

* Metallic implants
Cumulative Fluids Balance and Ventilator Associated Events

Fluid therapy is widely used to improve organ perfusion and survival in critically patients. Fluid therapy is an important component of intensive care management; however, optimal fluid management is unknown. Inadequate or excessive fluid resuscitation, on the other hand, is linked with a poor prognosis; the former can cause tissue hypo-perfusion and exacerbate organ dysfunction, while the latter can raise the risk of heart failure, pulmonary edema, and pleural effusions. Ventilator-associated lung injury (VALI) is a devastating complication of assisted mechanical ventilation (MV) and is one of the root causes of prolonged MV.

This study is designed to test the association between cumulative fluids balance and ventilator associated events among critically ill patients.

Setting: This research will be carried out in four General Intensive Care Units at two hospitals in El Beheira Governorate, Egypt.

* For three months, from October 1, 2022 to January, 2023, all newly admitted mechanically ventilated patients who will fulfill the inclusion criteria and agree to participate will be screened on a daily basis.
* The investigators will calculate cumulative fluid balance as daily fluid balance within four days of the event of interest. Cumulative fluid balance will be computed as the sum of daily fluid balances over the previous 24 hours, calculated by total fluid input minus total fluid output on a specific day of ICU admission over the first four calendar days of mechanical ventilation. Insensible fluid loss, such as perspiration or evaporative water loss related to respiration will not be routinely assessed and will not be included in the calculation of cumulative fluid balance. The cumulative fluid balance from day 0 to day 1 will be labelled as day 1, and the following days as day 2 and day 3. Cumulative fluid balance at day 3 refers to the cumulative fluid balance during the first four calendar days.
* Variables associated with VAEs will be assessed for each patient including: age, gender, admission diagnosis, comorbidities; and ICU length of stay, APACH II score, Sofa score and duration of tracheal intubation.

Eligibility Criteria:
Inclusion Criteria:

* aged ≥18 years,
* mechanically ventilated for ≥48 h and remain in the intensive care ≥4 days.

Exclusion Criteria:

* Patients with acute renal failure and needs dialysis,
* increasing daily minimum positive end-expiratory pressure (PEEP) or Fio2 during MV treatment
* hemodynamic instability
Dorzolamide-timolol Drops With Injections to Treat AMD, RVO or DME.

This study seeks to evaluate the effect of topical aqueous suppression on the anatomic and functional response to intravitreal anti-vascular endothelial growth factor (VEGF) injections in non-responders with wet age-related macular degeneration.

Intravitreal anti-vascular endothelial growth factor (VEGF) agents, including bevacizumab, ranibizumab, and aflibercept, have become the gold standard treatment for neovascular age-related macular degeneration (AMD). Various treatment modalities using these agents have been proposed, including monthly, pro re nata, and treat-and-extend philosophies. Despite frequent and consistent treatment with anti-VEGF therapy, there is a subset of patients who are incomplete or non-responders and have persistent evidence of exudation on spectral-domain optical coherence tomography (SD-OCT), including subretinal fluid (SRF) and/or intraretinal edema.

While clearance of intravitreal anti-VEGF drugs is not completely understood, some studies have suggested that outflow through the anterior chamber may contribute. We hypothesized that by decreasing aqueous production, outflow may also be reduced which could delay the clearance of intravitreal drugs. As a result, we chose topical dorzolamide-timolol since it is a potent aqueous suppressant and is readily available due to its common use in the treatment of glaucoma. The current study aimed to evaluate the efficacy of topical dorzolamide-timolol on anatomic and visual outcomes in anti-VEGF non-responders with neovascular AMD.

Significance: The results of this study will help delineate whether topical aqueous suppression may be useful as adjuvant therapy in patients receiving chronic intravitreal anti-VEGF injections.

Eligibility Criteria:
Inclusion Criteria:

1. Patient of Wills Eye Hospital Retina Service and/or Mid Atlantic Retina.
2. Volunteer patients age 18 years and older.
3. Healthy enough to participate in the study.
4. Willing and able to consent to participation in the study.
5. Diagnosis of wet age-related macular degeneration
6. Prior treatment with at least 4 injections of anti-VEGF agents in the past 6 months and persistent intraretinal and/or subretinal fluid on SD-OCT at each visit during this period
7. Injection of the same anti-VEGF agent for at least two visits prior to study enrollment
8. Fixed interval between at least two visits prior to study enrollment

Exclusion Criteria:

1. History of uveitis
2. Any ophthalmic surgery within previous 6 months, including cataract extraction.
3. Any history of vitrectomy
4. History of any glaucoma drop usage or prior glaucoma surgery
5. Systemic diuretic or corticosteroid usage
6. Any contraindication (bradycardia, decompensated heart failure, or reactive
7. airway disease) for topical use of a beta-blocker
8. Any history of sulfonamide allergy

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Comparison of Anesthesia Type in Patients Undergoing Transabdominal Cervico Isthmic Cerclage (TCIC)

The investigator aimed to compare the effect of anesthesia on overall postoperative outcomes including post-operative pain score and the fetal well-being (heart rate) in patients undergoing transabdominal cervico isthmic cerclage(TCIC). The investigator divided the patients into two groups. The first group was the patients who undergo general anesthesia with postoperative wound patient-controlled analgesia device(PCA) and the second group was the patients who undergo combined spinal-epidural anesthesia(CSE) with postoperative epidural catheter PCA device for pain control.

Transabdominal cervico isthmic cerclage(TCIC) is performed for the pregnants with Incompetent Internal Os of the Cervix(IIOC) to maintain pregnancy. It is the operation that incise the lower abdomen and ligate the cervix in pelvic cavity. In our center, the surgery was conventionally performed under general anesthesia. Also, for pain control, operator has been inserting a catheter into the incision site and connected the wound PCA. In this way, there were some limitations that the wound PCA could only control the somatic pain and there were significant rates of post-operative nausea and vomiting as common complication of general anesthesia. Thus, the investigator planned to conduct combined spinal-epidural anesthesia(CSE) with postoperative pain control with epidural catheter and compare overall postoperative outcomes with conventional general anesthesia.

Eligibility Criteria:
Inclusion Criteria:

* Patients who undergo TCIC for IIOC and agree to participate in this study.

Exclusion Criteria:

* Hepatic failure
* Chronic kidney disease(\>stage III)
* Hypersensitivity, allergic response and/or resistance to drugs used in this study(ex. pethidine, ropivacaine)
* Spinal anesthesia is not possible
* Refuse to participate in the study
* Cannot understand the agreement
* Body weight is under 50 kg or over 100 kg
Retrospective Evaluation of Risk Factors for Lower Outcomes After Vitrectomy With ILM Flap Technique

A retrospective review of medical charts of patients having undergone vitrectomy with ILM Peeling and ILM flap technique for macular hole repair.

A retrospective review of medical charts of patients having undergone vitrectomy with ILM Peeling and ILM flap technique for macular hole repair. Pre- and postoperative OCT and visual acuity in the time period up to 6 months after surgery are reviewed and possible risk factors for failed macular hole closure or lower visual acuity outcome after surgery are assessed.

Eligibility Criteria:
Inclusion Criteria:

* Vitrectomy with ILM peeling and ILM flap technique in the time period form 1.1.2015 to 31.4.2020
* Age 18 or older

Exclusion Criteria:

* Age \<18
Basic Mechanisms of Meditation and Cardiovascular Disease in Older Blacks

The purpose of this study is to evaluate the effects of meditation on older African Americans with documented cardiovascular disease (CVD).

Cardiovascular disease (CVD) is the leading cause of death and disability in older African Americans, and accounts for 40% of the disproportionate risk for mortality observed in African Americans compared to white Americans. The majority of CVD patients experience acute cardiac events, many sudden and unexpected, despite conventional treatment of their disease and associated traditional risk factors. The pathophysiologic basis of these cardiac events is not fully established, but substantial evidence indicates that psychosocial stress and the sympathetic nervous system have adverse effects on both vasomotor function and long-term autonomic balance. Recent advances in the understanding of the pathophysiology of acute cardiac events-specifically, the roles that arterial vasomotor dysfunction and sympathetic nervous system imbalance play in the pathophysiology of such acute events-provide a platform for a new mechanistic investigation of the interplay of psychosocial and environmental stress and CVD. Preliminary evidence demonstrating elevated peripheral vasoconstriction due to stress-mediated sympathetic nervous system response in African Americans further suggests that these mechanisms are particularly relevant in this group.

Eligibility Criteria:
Inclusion Criteria:

* African-American (self-identified)
* Local residence
* Able to participate
* Coronary artery disease by MI, CABG, PTCA (\>3 months prior), or angiography
* Consent and referring MD approval
Post-operative Mobilization for Carpal Tunnel Syndrome

This study will investigate the effect of one week of immobilization following carpal tunnel release surgery versus no immobilization.


Eligibility Criteria:
Inclusion Criteria:

* Patients undergoing open carpal tunnel release will be included in this study.
* Patients must have clinical evidence of carpal tunnel syndrome.
* Patients must have positive EMG results.
* English speaking patients only.

Patient selection factors include:

* Ability and willingness to follow instructions.
* Patients who are able and willing to return for follow-up evaluations.
* Patients of all races and genders.
* Patients who are able to follow care instructions.

Exclusion Criteria:

* Patients less than 18 years old.
* Patients who are pregnant.
* Patients unwilling or unable to comply with a rehabilitation program for carpal tunnel release who indicate difficulty or inability to return for follow-up visits prescribed by the study protocol.
* Patients who qualify for inclusion in the study, but refuse consent to participate in the study.