cyrilzakka/clinical-trials huggingface dataset:
Brain Connectivity and Mindfulness Training in Youth With Bipolar Disorder Not Otherwise Specified (NOS)

The investigators propose to study 30 adolescents with bipolar disorder, not otherwise specified (BD NOS) and a family history of Bipolar I Disorder (BD) at baseline with rs-fMRI (functional magnetic resonance imaging) and functional connectivity (FC) analyses and compare data with previously acquired rs-fMRI and FC data from 20 age- and gender-matched healthy controls (HC). Subjects will then undergo a 12-week Mindfulness based stress reduction- teen (MBSR-T) intervention and be reassessed and rescanned. The intervention and scanning will take place in groups of 6-8 subjects/group/year over the 4 years. This proposal will be a natural progression of past research, while extending the investigators' expertise to include advanced FC analyses and mindfulness based interventions in youth with mood dysregulation. The investigators will also integrate trainees into the imaging and therapy components of this study, furthering our mission of mentoring the next generation of innovative researchers who will push the field forward.


Eligibility Criteria:
Inclusion Criteria:

* Ages 13-17
* Diagnosed with BD-NOS
* First or second degree relative diagnosed with bipolar I or II

Exclusion Criteria:

* Not English speaking
* For those who are to participate in the MRI scan, having any metal in the body or movement disorders will be an exclusionary factor
Exercise as an Adjunctive Therapy for Patients on Maintenance Hemodiafiltration

Patients with chronic kidney disease suffer from uremic toxin accumulation. Treatments with hemodiafiltration demonstrate the highest capacity for removing solutes, as well as improving mortality. While exercise has been proven as an adjunct therapy in patients on maintenance hemodialysis, little is known about the exercise influence in maintenance hemodiafiltration programs.

Methods: A retrospective observational study of chronic kidney disease patients at Fenix Nephrology group from 2021 until 2023. Patients were assessed at the start of the exercise program and after six months of rehabilitation. Physical tests included a step-test for endurance, handgrip and one-repetition maximum for muscle strength. The Kidney Disease Quality of Life Short Form evaluated patient-reported outcomes. Kt/V urea and urea reduction ratio were surrogates for hemodiafiltration adequacy. Patients carried out twice weekly aerobic exercises at 70% of the maximum heart rate during the step test, and resistance exercises at 60% of one-repetition maximum.

The objectives of this study were twofold: first, to understand if hemodiafiltration (HDF) combined with exercise is a safe and effective treatment for patients with end-stage renal disease (ESRD/CKD 5D); and second, to explore the efficacy of exercise performed during dialysis sessions (intradialytic) versus between sessions (interdialytic).

The study employed a retrospective observational design, analyzing data from CKD 5D patients undergoing maintenance HDF at the Fenix Nephrology group between 2021 and 2023. Inclusion criteria stipulated that participants were aged 18 years or older, on HDF with optimized medication, and agreed to participate in the exercise program with at least 80% adherence. Assessments were conducted at baseline and after six months of rehabilitation, including a step-test for endurance, handgrip strength measurement, one-repetition maximum (1RM) test for muscle strength, and the Kidney Disease Quality of Life Short Form (KDQOL-SF) questionnaire. Kt/V and urea reduction ratio (URR) were used as surrogates for HDF adequacy.

The exercise protocol involved twice-weekly sessions, with aerobic exercises performed at 70% of the maximum heart rate achieved during the step test, and resistance exercises at 60% of 1RM. Participants self-selected their exercise timing, either intradialytic (during HDF sessions) or interdialytic (on non-dialysis days). For the intradialytic group, exercise was seamlessly integrated into the HDF session, excluding the initial and final two hours of dialysis.

Eligibility Criteria:
Inclusion Criteria:

* 18 years or older
* Undergoing maintenance hemodiafiltration (HDF)
* Optimized medication regimen
* Agreed to participate in the exercise program with at least 80% adherence

Exclusion Criteria:

* Patients who underwent kidney transplantation during the study period
* Patients with missing data
* Patients with exercise participation below 80% adherence
* Presence of comorbidities such as COPD, stroke, muscle weakness, or recent orthopedic surgery.
The Influence of Talocrural Manipulation on Proprioception in Stroke

The aim of the study is to investigate the effect of talocrural joint manipulation on the ankle proprioception of patients with stroke.

The study, utilizing a randomized crossover design, is planned to be conducted on a minimum of 26 patients with stroke who meet the inclusion and exclusion criteria. Patients included in the study will be randomly assigned to receive both placebo talocrural joint manipulation and talocrural joint manipulation interventions.

Eligibility Criteria:
Inclusion Criteria:

1. Two months or longer elapsed since the stroke,
2. A Mini-Mental State Examination score of 24 or higher,
3. Being between 45 and 75 years of age,
4. Having a Brunnstrom stage of 4 or above

Exclusion Criteria:

1. The presence of severe osteoarthritis in the lower extremity,
2. The presence of cancer or diabetic neuropathy,
3. The presence of vestibular disorder,
4. The presence of lower extremity ulceration or amputation,
5. Hemodynamic instability,
6. The presence of other neurological disorders (such as multiple sclerosis, Parkinson's disease),
7. Having experienced an acute lower extremity injury in the last six weeks,
8. History of lower extremity surgery
9. Lack of available range of motion values required for the ankle proprioception test
Assessment of the Reliability and Validity of the Leg Lateral Reach Test in Adolescent Tennis Players

The aim of this study is to evaluate the reliability and validity of the Leg Lateral Reach Test to measure thoraco-lumbo-pelvic segment mobility in adolescent tennis players. The fact that the test is valid and reliable for tennis players will contribute to monitoring trunk rotation flexibility in athletes, comparing them bilaterally, and revealing the exercise training necessary to improve performance.

Tennis is a sport characterized by coordinated, repetitive, and rotational movements along the kinetic chain. Ineffective use of the trunk segment to generate rotational momentum is thought to increase the load on the upper extremity. Limited trunk rotation flexibility can cause abnormal trunk motion patterns, resulting in lower back injuries and pain as well as upper extremity injuries in throwing athletes. Therefore, assessment of trunk flexibility in athletes who perform repetitive trunk rotations, such as tennis players, is critical for effective rehabilitation and prevention of sports injuries.

The Leg Lateral Reach Test was developed to measure the rotation of the thoraco-lumbo-pelvic segment and was found to be valid and reliable in physically active, healthy individuals. Therefore, the aim of this study is to evaluate the reliability and validity of the Leg Lateral Reach Test to measure thoraco-lumbo-pelvic segment mobility in adolescent tennis players. The fact that the test is valid and reliable for tennis players will contribute to monitoring trunk rotation flexibility in athletes, comparing them bilaterally, and revealing the exercise training necessary to improve performance.

Eligibility Criteria:
Inclusion Criteria:

* Adolescent tennis players

Exclusion Criteria:

* Athletes with a history of musculoskeletal injury or surgery in the last year that would prevent the tests from being performed
* Athletes who feel pain in the trunk and lower extremities during the tests
Iron Deficiency as an Ignored Cause of Infertility

Iron deficiency may play a critical role in human infertility, oocyte quality and may even play a role in endometrial receptivity. By correcting iron deficiency, low ferritin values, in infertile women with intravenous iron supplementation, embryo quality and pregnancy rates may improve.

The main objective is to evaluate the effect of intravenous iron supplementation on embryo quality (number of good quality blastocysts).

Randomized, double blind, parallel group, cross-over study of ferric carboxymaltose compared to placebo (NaCl infusion).


Eligibility Criteria:
Inclusion Criteria:

* Patient's 18 to 42 years and in full consent
* Ferritin ≤ 30 ug/l
* Anti-mullerian hormone (AMH) \> 1ug/l
* Planned for IVF/ ICSI treatment
* Diagnosis for treatment: tubal factor, male factor or unexplained infertility (NUD)

Exclusion Criteria:

* Endometriosis
* Poor responder
* Inflammatory bowel disease (IBD), colitis ulcerosa
* Rheumatoid arthritis
* Renal insufficiency
* Cardiac insufficiency
* Body Mass Index (BMI) over 35
* Known hypersensitivity to the active substance, to ferric carboxymaltose or any of its excipients, or to other parental iron products
* Clinical evidence of iron overload or disturbances in the utilization of iron
* use of atosiban or filgrastim during stimulation or embryo transfer
Mind Body Syndrome (MBS) Therapy for the Treatment of Chronic Pain

To determine if Mind Body Syndrome (MBS) therapy will reduce or eliminate pain in patients suffering from chronic pain syndromes without organic etiology.


Eligibility Criteria:
Inclusion Criteria:

* Adult patient 18 \> years old
* Chronic pain without clear organic etiology after full evaluation by primary care physician or subspecialist
* Pain persistent for a minimum of 3 days a week for the past three months prior to enrollment

Exclusion Criteria:

* Patients \< 18 years of age
* Diagnosed organic disease as cause of pain, such as but not limited to malignancy, neurologic disorder (i.e., amyotrophic lateral sclerosis)
* Patients with a diagnosis of significant psychiatric co-morbidities such as schizophrenia and bi-polar disorder. Mild to moderate depression and anxiety will not be considered as exclusions
* Pregnancy
* Severe depression or recent suicide attempt
Septic cArdiac Deficiency and MenIngococcal seveRe Sepsis

Use of brain natriuretic peptide to evaluate the cardiac function in the course of meningococcal septic shock or severe sepsis.

OBJECTIVES: determining sensibility and specificity of BNP blood level to detect myocardial dysfunction in septic shock or severe sepsis due to Neisseria meningitidis in children.

METHODS: Prospective multicentric clinical trial including 7 French pediatric intensive care units. Serial cardiac ultra sounds and blood sampling will be done for patients hospitalized for purpura fulminans beginning at the time of admission in pediatric intensive care. Any child from 6 months to 18 years without preexisting cardiac disease and presenting with purpura fulminans will be enrolled after obtaining consent of both parents. From adult's studies on septic shock and BNP, a total number of 30 patients was calculated to be necessary to prove the interest of BNP in this indication.

Eligibility Criteria:
Inclusion Criteria:

* Children
* 6 months to 18 years aged
* without previous cardiac pathology
* hospitalized in the participating pediatric intensive care units for serious sepsis with extensive purpura

Exclusion Criteria:

* Heart malformative disorder with right-left shunt
* Pre-existent known cardiac insufficiency whatever is the origin
* Concomitant participation in another trial
* Patient in period of exclusion from another trial
* Not membership in a national insurance scheme
International Registry for Primary Hyperoxaluria

The purpose of this study is to collect medical information from a large number of patients in many areas of the world with primary hyperoxaluria. This medical information will be entered into a registry to help the investigators compare similarities and differences in patients and their symptoms. The more patients that the investigators are able to enter into the registry, the more the investigators will be able to understand primary hyperoxaluria and learn better ways of treating patients with this disease. It is the investigators hope that by entering as many patients with PH as possible, the information that the investigators collect may help physicians diagnose patients sooner and determine what treatments may work best on patients with similar medical or genetic backgrounds.

This study involves the collection of medical information to create a computer database (registry) for patients with PH. The information will be entered into the registry by your physician, healthcare provider or a staff member of the Mayo Clinic Hyperoxaluria Center. The computer web site for the registry is secure and protected by a required password. Some information which will be entered may include your age at first symptoms of PH,kidney stone history, lab values, kidney function, and your health over time. Information for a patient can only be viewed by the appropriate physician and staff. Once the information is entered into the registry, you will only be identified by a code number.

Eligibility Criteria:
Inclusion Criteria:

* Liver biopsy or genetic analysis that confirms a diagnosis of hyperoxaluria
* In the absence of a liver biopsy:
* Urine oxalate excretion of \>0.8 mmol/1.73 m² /day without other causes such as enteric hyperoxaluria
* Family history of PH in a sibling will be supportive
* A history or current finding of kidney stones or nephrocalcinosis will be supportive
* An increase in urine glycolate may suggest PHI or an increase in urine L-glycerate may suggest PHII, though not required for diagnosis.
* Patients presenting in renal failure with an elevate pre-dialysis plasma oxalate of 60 umol/l and a kidney biopsy that confirms extensive oxalate deposition, or evidence of systemic oxalosis

Exclusion Criteria:

* Patients without any of the above or a confirmed diagnosis of PH
Sural Flap and Anterolateral Thigh Flap in Tissue Reconstruction Around the Ankle

The aim of the study is to evaluate the outcomes of coverage of soft tissue defects of leg and foot by modified sural flap versus anterolateral thigh flap

The leg and foot contain a thin subcutaneous layer and few muscles, thus the tibia and tendons can easily become exposed due to trauma. Therefore leg and foot injuries are often associated with a loss of soft tissues and exposed fractures.

one of the following reconstructive options are chosen:

1. The defect is allowed to heal by secondary intention.
2. The wound is closed primarily.
3. A split or full thickness skin graft and or neodermis is applied.
4. A local random flap or propeller flap is transposed or advanced.
5. A pedicled or island flap is transferred.
6. A microvascular free flap is transferred. The method of soft tissue reconstruction chosen hinges on the patient's medical condition, the surgeon's experience, the size of the wound, the vascular status of the foot and the exposed structures the skin in this region has low flexibility and the subcutaneous circulation does not allow the use of long randomized flaps, the task of finding flaps to cover bones or tendons in wounds with cutaneous loss in the legs and feet is difficult.

The sural flap acts as an axial flap and has 3 sources of nutrition,the vascular plexus of the deep fascia, the medial superficial sural artery which follows the medial sural nerve and the arteries that follow the minor saphenous vein. Venous return is ensured by the minor saphenous vein which may be used as a distal pedicle to provide reverse flow.

sural flap has the advantages of easy and quick harvesting without sacrificing major arteries and can be done in one stage operation.

In the other hand,Since introduction of the anterolateral thigh flap in 1984 by Song et al it has gained widespread popularity, especially in Asian countries, where it has replaced the radial forearm flap as being the workhorse in head and neck surgery.

Anterolateral thigh flaps have been introduced also in lower extremity reconstruction.

Eligibility Criteria:
Inclusion Criteria:

* • patients aging 5 to 70 years.

  * Defect at the lower leg ,ankle or foot
  * Palpable distal pulse

Exclusion Criteria:

* • Peripheral vascular disease

  * Underling bone osteomyelitis
  * Unhealthy skin of posterior or lateral aspect of leg.
  * Vascular injury.
  * Patients with chronic diseases
  * Patients associated with vital organ injuries
  * Patients unfit to surgery
Evaluation and Management of Cardiovascular Risk Factors in Inflammatory and Acquired Dysimmune Diseases (CARMIN)

The hypothesis is that chronic inflammatory dysimmune state promotes the development of cardiovascular complications. The biological assumption is based on the fact that chronic inflammation promotes lesions of the vessel wall (endothelial alterations, calcification, atherosclerosis). The clinical aim is to allow to identify high-risk patients and to act in prevention.

The project CARMIN involves the assessment of cardiovascular risk factors, their management, and their influence on cardiovascular prognosis in patients with autoimmune diseases and immunodeficiencies acquired. It is based on the creation and monitoring of a cohort of patients with different types of dysimmune disorders: systemic lupus erythematosus, rheumatoid arthritis, psoriasis, scleroderma, systemic vasculitis ANCA, kidney transplants, and hematopoietic stem cells transplants.


Eligibility Criteria:
Inclusion Criteria:

* Patients followed in the various services of medical specialties pole of the Edouard Herriot hospital
* The diagnosis of the pathology selected for this study based on a clear clinical and biological evaluation supported by criteria specific to each pathology and compatible with international standards.
* Date of diagnosis should not be less than 5 years (+/- 1 year), except for scleroderma patients where it has been extended to 10 years.
* For kidney transplant patients the investigators take into account only patients with a maximum of 2 years of dialysis before graft.

Exclusion Criteria:

* Diabetic patients
* HIV seropositive
* Patients with multiple pathologies
Neuromuscular Ultrasound in Correlation to Neurophysiological Findings

1. Study the neuromuscular ultrasound findings in different types of neuropathies
2. correlation between ultrasound and neurophysiological findings in peripheral nerve diseases
3. correlation between clinical pain scale and severity of neuropathy

Ultrasonography is a diagnostic tool that is increasingly used in the work-up of peripheral nerve disease.

As many peripheral nerves run a superficial course, especially in the arms. This is a big advantage over Magnetic Resonance Imaging that is relatively expensive, time consuming and not readily available everywhere.

Nerve cross-sectional area (CSA) can be determined at multiple sites along the nerve.

CSA can be measured at entrapment sites but also at nonentrapment sites. vascularization, echogenicity, fascicular pattern and endoneurial thickness can be investigated as well. All those modalities can give critical insight in the origin and development of various peripheral neuropathies1,2,3

Major peripheral nerves in the extremities, such as the median,ulnar thick enough to reflect the sound beam, resulting in hyperechoic on the US scan 4.

The correlation between nerve conduction study parameters and CSA in ultrasound Ultrasound of the peripheral nervous system is an additional useful diagnostic tool in neuromuscular disorders..5,6,7,8,9 In the longitudinal plane, nerves present as long, slim structures with a mixture of parallel hypoechoic and hyperechoic lines.

Nerves must be distinguished from other nearby structures to ensure correct identification Muscles are hypoechoic and interspersed with small hyperechoic foci which easily distinguishes muscles from nerves. Tendons, which are sometimes adjacent to nerves, move proportionately with joint movement.

US has higher specificity than sensitivity in differentiating myopathic and neuropathic changes The most sensitive diagnostic marker for symptomatic carpal tunnel syndrome patients is an enlarged crosssectional area of the median nerve 10,11,12

Eligibility Criteria:
Inclusion Criteria:

* above 18 years old
* males or females
* diabetic complaining of neuropathy or not
* carpal tunnel syndrome
* Guillain-Barré syndrome

Exclusion Criteria:

* Patient refuse to participate
* The anatomy is altered due to sever trauma,tumor,or surgery
* Severe spasticity preventing examination
Effect of Intraoperative IV Ketamine on Postoperative Morphine Consumption During Intestinal Surgery

.The aim of this study is to identify the analgesic effect of intraoperative ketamine intravenous infusion on patients undergoing intestinal surgery and its effect on salivary cortisol and alpha amylase levels as indicator of its effect.

I- Group K (ketamine): 30 patients will receive intraoperative intravenous ketamine infusion.

II- Group C (control): 30 patients will receive intraoperative intravenous normal saline infusion.

Eligibility Criteria:
Inclusion Criteria:

* - Patient's status ASA status-I and II.
* Patients age above 18 years old.
* Patients scheduled for intestinal surgery.

Exclusion Criteria:

* Patient refusal.
* Patients with known allergy to ketamine or morphine.
* Patients with significant hepatic dysfunction.
* Patients with severe renal disease.
* Significant Heart disease.
* Patients with chronic pain.
* Regular use analgesics, antidepressants or opioids in last 2 months.
* Any known convulsive disorder.
* Morbid obesity (BMI\>35).
* Patients with autoimmune disease
* Patients on corticosteroid therapy
* Pregnancy.
* Breast feeding.
* Woman under hormonal treatment.
* Oral disease.
Tissue Oxygen Deprivation as Detected With Raman in Association With Umbilical Artery Catheters

Umbilical artery catheters (UACs) are associated with significant morbidity in preterm neonates however are necessary for the management of this high risk population. UACs have been linked to serious adverse events (SAEs) including arterial thrombosis, necrotizing enterocolitis, limb ischemia, and renal failure. Resonance Raman Spectroscopy (RRS), raman for short, is a technology that utilizes vibrational spectroscopy, rather than absorbance spectroscopy, to determine the oxyhemoglobin concentration in tissues.

In this prospective, observational study, daily measurements of StO2 of low birth weight neonates using raman spectroscopy will be correlated with UACs.The study team hypothesizes that raman can detect changes in peripheral tissue oxygenation in the ipsilateral extremity to the UAC and that raman is more sensitive at detecting changes in peripheral tissue oxygenation then common metrics used to monitor neonatal hemodynamics. If successful, this study would demonstrate that raman can be used as an early marker of tissue oxygen deprivation in neonates with UACs and maybe used to guide management in other clinical scenarios where StO2 is affected.


Eligibility Criteria:
Inclusion Criteria:

* Neonate Inclusion Criteria:

  1. Birth weight less than 1500 grams.
  2. Admitted to the NICU.
  3. UAC placed on admission.
* Mother Inclusion Criteria:

  1. Admitted to the labor and delivery or antenatal floors with reasonable chance of delivery of a neonate weighing less than 1500 grams as determined by the obstetrics team.

Exclusion Criteria:

* Neonate Exclusion Criteria:

  1. Neonates with congenital heart defects or major congenital anomalies such as known or suspected inborn errors of metabolism, ambiguous genitalia, neural tube defects, malignancy, abdominal wall defects, airway defects and chromosomal anomalies.
* Mother Exclusion Criteria:

  1. Mother is pregnant with fetus with congenital heart defect or major congenital anomaly as described above.