cyrilzakka/clinical-trials huggingface dataset:
Analysis of Tumor Deposit At the Fusion Site of the Right Gastric Mesentery and Left Gastric Mesentery in the Patients with Gastric Cancer Who Received Proximal Gastrectomy

This study aims to evaluate the tumor deposit at the fusion site of the right gastric mesentery and left gastric mesentery in the patients with gastric cancer who received proximal gastrectomy.

In the 6th edition of the Japanese Gastric Cancer Treatment Guidelines; during proximal gastrectomy, D2 lymphadenectomy includes nodes No. 1, No. 2, No. 3a, No. 4sa, No. 4sb, No. 7, No. 8a, No. 9, No. 11p, and No. 11d. When performing D2 surgery for proximal gastric cancer, the dissection typically includes No. 3a (Lymph nodes along the branches of the left gastric artery, including those below the cardia branch) and No. 7 (distributed along the left gastric artery from its root to the bifurcation of the ascending branch), while not including the No. 5 group nodes (located in the upper region of the pylorus between the root of the right gastric artery and the first branch of the gastric wall). In D2 lymphadenectomy plus complete mesogastric excision (CME) for proximal gastric cancer, a complete resection of the left gastric mesentery is performed without removing the right gastric mesentery. However, clinical observations have shown that there may be a fusion between the left and right gastric mesenteries. Merely excising the left gastric mesentery could potentially lead to tumor residue or recurrence in the right mesentery. This study aims to investigate tumor deposit at the fusion site of the right gastric mesentery and left gastric mesentery following D2+CME surgery for proximal gastric cancer, intending to provide evidence-based medical insights for standardizing lymph node clearance in gastric cancer.

Eligibility Criteria:
Inclusion Criteria:

1. Aged older than 18 years and younger than 85 years
2. Primary gastric adenocarcinoma confirmed by preoperative pathology result
3. cT2-4aN0-3M0 at preoperative evaluation according to the American Joint 8 Committee on Cancer (AJCC) Cancer Staging Manual 8th Edition
4. Patients undergoing proximal gastrectomy with D2 lymphadenectomy plus complete mesogastric excision
5. American Society of Anesthesiologists (ASA) class I, II, or III
6. Written informed consent

Exclusion Criteria:

1. Negative preoperative biopsy
2. Too late tumour stage or metastasis (cT4b/M1)
3. BMI\>30 kg/m2
4. previous neoadjuvant chemotherapy or radiotherapy
5. Previous upper abdominal surgery
6. Combined with other malignant diseases
7. Reject operation
A Multi-omics Study of Adenomyosis

This study aims to analyze the multi-omics results between eutopic endometrium, adenomyosis and endometriosis of patients diagnosed of adenomyosis with and without endometriosis. The multi-omics profiles include whole exome sequencing, analysis of transcriptomics and metabolomics. A comprehensive multi-omics will reveal the pathogenesis of adenomyosis.


Eligibility Criteria:
Inclusion Criteria:

* Confirmed adenomyosis and/or endometriosis
* Signed an approved informed consents
* Feasible for biopsy

Exclusion Criteria:

* Not meeting all of the inclusion criteria
Reflex Responses to Intermittent Hypoxia in Humans: Mechanisms and Consequences

The overall goal of this project is to better understand the effect of intermittent hypoxia (IH) on sympathetic neuronal discharge patterns in humans, as well as mechanisms that mediate persistent sympathoexcitation with IH.

Sleep apnea is the most common form of sleep disordered breathing and patients with sleep apnea exhibit persistent activation of the sympathetic nervous system. Sympathoexcitation is also the final common pathway for a host of complications in conditions like obesity, hypertension, sleep apnea, and heart failure and plays a significant role in predicting negative clinical outcomes and deteriorating cardiovascular health. However, the mechanisms of sympathoexcitation with sleep apnea are poorly understood and thus make effective therapeutic approaches difficult to develop.

Intermittent hypoxia (IH) has been implicated in animal models as the primary stimulus for evoking increases in sympathetic activity with recurrent apneas. Thus, the overall goal of this application is to better understand the effect of IH on sympathetic discharge patterns in humans as well as the mechanisms mediating persistent sympathoexcitation with IH. By better understanding the effect of IH on sympathoexcitation, targeted therapeutic approaches might be devised to mitigate the effects of sympathetic over-activity on the cardiovascular system in conditions such as sleep apnea.

Eligibility Criteria:
Inclusion Criteria:

* healthy adult men and women;
* 18-45 years of age;
* BMI \<30 kg/m2;
* non-pregnant/non-breastfeeding;
* non-smokers.

Exclusion Criteria:

Subjects will be excluded if they are:

* taking any medications known to affect the cardiovascular or autonomic nervous system (e.g. alpha-blockers, beta-blockers, etc);
* Apnea Hypopnea Index \>10 events/hr

Self-reported history of:

* hepatic, renal, pulmonary, cardiovascular, or neurological disease;
* stroke or neurovascular disease;
* bleeding/clotting disorders;
* sleep apnea or other sleep disorders;
* diabetes;
* smoking;
* history of alcoholism or substance abuse;
* hypertension.
Modifications in Retinal Microvascularization With Targeted Anti-angiogenic Therapy in Colorectal Cancer

Retinal microvascularization can provide important informations to systemic vascular phenomena. The non-invasive quantitative description of the retinal vascularization is now possible by performing OCT-angiography and their image analysis software (vascular density and retinal perfusion). Systemic microvacular changes during the establishment of oncological treatment by targeted antiangiogenic therapy are little described in the literature. The objective of this pilot study is to describe the evolution of the retinal vascular density of patients with antiangiogenic drugs. In addition, the evolution of the retinal vascular density of patients on antiangiogenic drugs will study as a function of the response to the treatment and the toxicity of these treatments.

The main objective of this study is to describe the change in retinal vascular density of patients with first-line colorectal cancer treated with Bevacizumab.

Eligibility Criteria:
Inclusion Criteria:

1. Patient over 18 years old starting first-line treatment for metastatic colorectal cancer including BEVACIZUMAB (AVASTIN®)
2. Systemic or intraocular anti-VEGF treatment naïve
3. ECOG ≤ 2

Exclusion Criteria:

1. Pregnant woman,
2. Minor patient or under legal protection
3. Person deprived of liberty or under guardianship
4. Inability to undergo medical monitoring of the trial
5. Impossibility of carrying out the OCT-A
6. Patient with a contraindication to Tropicamide 0.5% eye drops
7. Patient with a history of degenerative macular pathology, vascular macular pathology or presenting an epiretinal membrane with traction phenomenon.
8. Diabetes
9. Patient for whom it is not possible to schedule an ophthalmology consultation before the start of treatment.
Dopaminergic Function and Food Reward

The broad aim of the study is to obtain a better understanding of alterations in mesolimbic reward pathways in adiposity based on the hypothesis of a hypofunctioning reward system in obesity.

This will be achieved by integrating a functional neuroimaging (fMRI) with behavioral reward tasks and the modulation of the dopamine level by dopamine depletion.


Eligibility Criteria:
Inclusion Criteria:

* female
* healthy

Exclusion Criteria:

* fMRI contraindications
* claustrophobia
Topical Adrenaline Versus Warm Saline Solution for Minimizing Intraperitoneal Bleeding During Caesarian Delivery for Placenta Previa / Accreta Spectrum ( PAS)

Placenta accreta spectrum (PAS), encompassing the terms placenta accreta, increta, and percreta; abnormally invasive placenta; morbidly adherent placenta; and invasive placentation, is a leading cause of life-threatening obstetric haemorrage . Currently, more than 90% of women diagnosed with PAS also have a placenta praevia , and the combination of both conditions leads to high maternal morbidity and mortality due to massive haemorrhage at the time of birth . Maternal mortality of placenta praevia with percreta has been reported to be as high as 7% of cases .

Adrenaline has also been demonstrated to be a reasonable hemostatic agent because of its low cost, low risk, powerful vasoconstrictor, and platelet aggregation. Topical use of adrenaline is an effective and reasonable hemostatic agent in tonsillectomy.

* Population of study: A total of 84 pregnant patients with placenta previa / Accreta spectrum.
* Study location: Obstetrics and Gynecology Kasr Al-Ainy Hospital , Faculty of Medicine , Cairo University.

This is a randomized controlled trial including a total number of 84 patients representing study group , randomized in 2 equal groups , using computer generated randomization sheet on (Medcalc ®) .

Group A : Topical adrenaline group (n=42)

Group B : Warm saline Group (control) (n=42)

The aim of the study is to evaluate the efficacy of topical adrenaline for decreasing intraperitoneal bleeding during caesarian section for placenta previa/ Accreta spectrum (PAS).

Eligibility Criteria:
Inclusion Criteria:

* Age from 18 to 40 years.
* BMI \< 35.
* Pregnant patients with placenta previa .
* Placenta accrete spectrum.
* Vitally stable .

Exclusion Criteria:

* Vitally unstable .
* Massive pre- or intra-operative bleeding.
* Medical disorders ( e.g. : hypertension , cardiac .... )
Sirolimus Blood Concentrations on Conversion From Oral Solution to Tablets

The purpose of this study is to understand the pharmacokinetics of sirolimus tablets in different regimens in newly renal transplant patients, and the effect of dosage form conversion on the concentration of sirolimus in stable renal transplant patients. So that we can design a better tacrolimus or cyclosporine/sirolimus/steroid dose regimen for Taiwanese.

Sirolimus tablets will be available more than one year after the launch of sirolimus solution. Most patients on sirolimus solution will use sirolimus tablet instead.

The purpose of this study is to understand the pharmacokinetics of sirolimus tablets in different regimens in newly renal transplant patients, and the effect of dosage form conversion on the concentration of sirolimus in stable renal transplant patients. So that we can design a better tacrolimus or cyclosporine/sirolimus/steroid dose regimen for Taiwanese.

Eligibility Criteria:
Inclusion Criteria:

* ages of 18 and 65, renal transplant patients

Exclusion Criteria:

* pregnancy, tuberculosis, hepatitis B or C carrier status, human immunodeficiency virus-positive status, retransplantation or multiorgan transplantation, or history of rheumatoid arthritis before transplantation
Observational Study on Plasma Glutamine Levels Before and After Cardiac Surgery

Earlier studies showed that a low glutamine level at acute admission on the ICU is associated with a poor outcome \[3,4\]. Recently, we found that a low plasma glutamine is correlated with severity of illness and presence of an infection after non-elective ICU admission \[5, submitted\].

It is known that major surgery induces a stress response characterised by hormonal release and inflammatory processes \[6,7\]. This surgical stress response resembles the catabolic stress which is found in other forms of critical illness. We did not measure plasma glutamine before surgery so it is unknown whether the plasma glutamine level was already low before surgery in these patients or that the lowering of plasma glutamine level is a consequence of surgery. Most of the patients in the elective surgery group in our study underwent cardiac surgery with use of cardiopulmonary bypass; it is known that extracorporeal circulation induces an inflammatory response but there are no clinical data on the effects on plasma glutamine or on post-operative course in relation to plasma glutamine levels \[8,9\].

Eligibility Criteria:
Inclusion Criteria:

* patients undergoing elective cardiac surgery

Exclusion Criteria:

* none
A Randomised Controlled Trial of Healthier Wealthier Families in Sweden

Healthier Wealthier Families is a way of working, where child health nurses ask parents about their financial situation and connect them to a free financial help service, if needed. To test whether it helps families, the investigators will randomly select half of the families who want to take part to go to the service straight away and half around 3 months later. Both groups of parents will receive a book about parenting and finances straight away. The investigators will compare how the groups of parents answer on survey questions about meeting the costs of their children's needs, their financial knowledge, financial control, readiness to change, success on personal finance goals, mental health and financial stigma. The investigators predict that the parents who are offered the financial help service straight away will answer more positively on the survey questions. The investigators will ask all parents the survey questions again around 12 months later to see how they are doing.

The Healthier Wealthier Families (HWF) model implements universal screening for economic hardship into child health services and creates a referral pathway to economic support services. To test this, the investigators will conduct a randomised control trial. A longitudinal follow-up with the cohort will explore whether any effects are maintained in the longer-term. The study hypotheses are that families who have received municipal budget and debt counselling services via the HWF model will report a lower rate of child material and social deprivation. Also, that the intervention arm will report greater financial knowledge, financial control, readiness for change, attainment of personal goals to improve one's financial situation, parental mental health and less financial stigma than the waitlist-control arm

Eligibility Criteria:
Inclusion Criteria:

* Parent / caregiver of at least one child aged 0-5 years
* The family is listed at the participating child health care centre
* Parent / caregiver reports at least one risk factor for economic hardship on specified screening questions
* Parent / caregiver lives within the geographical areas served by the participating financial counselling service
* Parent / caregiver has given informed consent

Exclusion Criteria:

* Parent / caregiver does not understand the recruitment invitation.
* Parent / caregiver is already an active user of a financial counselling service.
Comfort Evaluation of Non-Invasive Respiratory Monitor Interfaces

This research study will test the comfort of two noninvasive respiratory monitoring sensors (the connection to a monitor worn by a person-not the monitor). The two sensors, Masimo Rainbow Acoustic Monitoring sensor and Oridion Smart Capnoline Plus H sensor, are cleared by the U.S. Food and Drug Administration (FDA) and currently used in the clinical setting. People who enter into the study will wear the two interfaces, one after the other, for 20 minutes each (10 minutes with a small flow of air to the nostrils and 10 minutes without) and rate the comfort of each with a seven question survey. A total of 30 participants will be recruited.


Eligibility Criteria:
Inclusion Criteria:

* Normal body temperature
* Between the ages of 19-65 years
* Self-report as feeling to be in typical health
* No skin irritation face or neck where a sensor would be placed.
* School of Health Professions student

Exclusion Criteria:

* Any injury or condition that would affect assessment of comfort.
Clinical Trials to Validate the Use of Additioned Endoscopy in Endoscopic Retrograde Cholangiopancreatography

Validation of clinical use of additioned endoscopy in Endoscopic Retrograde Cholangiopancreatography(ERCP) treatment.

Investigators recently developed a device named additioned Endoscopy. The purpose of current clinical trial is to evaluate the use of additioned endoscopy in ERCP treatment, specifically in shortening the duration of ERCP operation and lowering incidence of complications.

Eligibility Criteria:
Inclusion Criteria:

* People who are indicated to ERCP treatment.

Exclusion Criteria:

* People who are not suitable for ERCP treatment.
Dexamedtomidine in Control of Intracranial Pressure in Preeclampsia

The present study is designed to evaluate the differences in the effect of Mg sulphate alone and dexmedetomidine as an adjuvant to Mg sulphate on intracranial pressure when administered intravenously in cases of pre-eclampsia

Preeclampsia remains one of the leading causes of maternal morbidity and mortality in pregnant women. preeclampsia occurs in 7% to 8% of pregnancies. Preeclampsia is a multisystem progressive disorder characterized by the new onset of hypertension and proteinuria or the new onset of hypertension and significant end-organ dysfunction with or without proteinuria after 20 weeks of gestation or postpartum. Preeclampsia is a potentially severe disease associated with maternal complications. Cerebral oedema is predominantly vasogenic and may be related to failure of cerebral autoregulation with subsequent hyperperfusion, blood brain barrier disruption, and endothelial cell dysfunction.

The optic nerve with its dural sheath cover is considered a window to central nervous system. The subarachnoid space surrounds the optic nerve and communicates freely with the cerebral subarachnoid space. Changes in the optic nerve sheath diameter (ONSD) mirror the changes in the ICP as increases in the ONSD correlates with increase in the ICP.

Magnesium sulphate (MgSO4) is a drug that is routinely used in the treatment of preeclampsia and prevention of eclamptic fits. Currently, several mechanisms have been proposed by researchers to explain the neuroprotective effect of MgSO4 .Dexmedetomidine is a potent alpha-2 adrenergic receptor agonist. dexmedetomidine-induced stimulation of postsynaptic alpha-2 adrenergic receptor on the cerebral blood vessels can cause cerebral vasoconstriction and decrease cerebral blood flow.

Eligibility Criteria:
Inclusion Criteria:

Female patients aged 25-43 and the gestational age above 34 weeks, with diagnostic preeclampsia (Hypertension and proteinuria) occurring after the 20th week of gestation and cesarian section is indicated with systolic blood pressure above 160 and diastolic blood pressure above 100.albumin in urine ++ or +++. No cardiac, hepatic,renal nor neurological problems.

Exclusion Criteria:

1. Age: younger than 25 or older than 43.
2. Pregnant females with mild preeclampsia.
3. Patients with cerebro-vascular diseases, Glaucoma, Hepatic failure, Renal failure .
4. patient who got their MgSO4 medication before the first reading of Optic nerve sheath diameter ONSD were also excluded.
5. History of allergy to dexamedotomidine.

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BIO monitorinG in Patients With Preserved Left ventricUlar Function AfteR Diagnosed Myocardial Infarction

The BIO\|GUARD-MI study investigates whether continuous arrhythmia monitoring and the consequent treatment after detected arrhythmias in patients after myocardial infarction with preserved cardiac function, but other risk factors, decreases the risk of major adverse cardiac events.

Patients randomized to the BioMonitor arm will receive an implantable cardiac monitor (ICM; BioMonitor) with remote monitoring function (Home Monitoring®). If the device detects and reports an arrhythmia, patients will be appropriately examined and treated. Patients randomized to the control arm will receive best proven treatment, but no implantable cardiac monitor.

Eligibility Criteria:
Inclusion Criteria:

* Patient has a history of MI according to guidelines
* CHA2DS2-VASc-Score ≥ 4 in men / ≥ 5 in women
* LVEF \> 35 % as estimated within 6 months before enrollment but after conclusion of AMI treatment
* Patient accepts activation of Home Monitoring®
* Patient is able to understand the nature of the clinical study and has provided written informed consent

Exclusion Criteria:

* Patients with hemorrhagic diathesis
* Permanent oral anticoagulation treatment for atrial fibrillation
* Indication for chronic renal dialysis
* Pacemaker or ICD implanted or indication for implantation
* Parkinson's disease
* Life expectancy \< 1 year
* Participation in another interventional clinical Investigation
* Age \< 18 years
* Woman who are pregnant or breast feeding
BDNF Gene Polymorphism and Antidepressants Treatment

The main hypothesis is that the therapeutic response and pharmacological resistance to ADs in depressed patients can be associated with a polymorphism for the BDNF gene. The research of allelic forms associated to lesser efficiency or inefficiency of ADs could add to the body of evidence that BDNF mediates the mechanism of action of ADs, and could have important practical implications. We propose to compare in a group of patients with major depression, the allelic variability of the BDNF gene between responders and non-responders after a 3-week period and a 6-week period of SSRI treatment.

* The main objective is to research an association between polymorphism for the BDNF gene and the 3-week and 6-week response to a SSRI treatment (escitalopram) in major depression.
* A case control pilot study without any direct individual benefit (200 patients).
* Study period: 24 months.
* Scores from reliable and validated psychometric scales (Montgomery and Asberg Depression Scale, Mini International Neuropsychiatric Interview) specifically analysing depression dimension at the time of inclusion, after three and six weeks of antidepressant treatment.
* Genetic analysis researching a polymorphism of the BDNF gene is done by a blood sample at the baseline.

Eligibility Criteria:
Inclusion Criteria:

* Patient suffering a severe depressive episode (according to DSM-IV), evolving since at least 2 weeks before entering the study
* Age superior to 18 years
* Caucasian type
* In absence of any medicinal treatment that could enhance depression: methyldopa, beta-blockers, reserpine,
* In absence of hypothyroidia or anaemia
* Without comorbidity that could affect therapy response : e.g. food disorder, substance abuse or dependence syndrome

Exclusion Criteria:

- Will be excluded from the study the patients for which a modification of the depression diagnosis (according to the DSM-IV criteria) takes place during the period of study