cyrilzakka/clinical-trials huggingface dataset:
Ultrasonic Weaning Criteria in Prolonged Ventilation

compare and evaluate the effect of use of ultrasonic criteria of weaning versus the conventional ways of weaning in post-traumatic acute respiratory distress syndrome (ARDS) patients who were ventilated for a long time. And compare their effect on the duration of ICU stay.

It is a prospective double blind study done on total 200 patients. Who were weaned from ventilator after being ventilated for \> one week due to respiratory failure. This respiratory failure was selected in our study to be from severe lung contusion and post-traumatic acute respiratory distress syndrome. Patients were randomly allocated in one of two groups each group contain 100 patients. Group A considered control group. Those patients weaned from the ventilator by the conventional criteria of weaning. While group B weaned from the ventilator by the ultrasound criteria of weaning. All patients weaned from both groups followed for six days for signs of failure of weaning ,signs of post-extubation respiratory failure. And number of patients who were re-ventilated and who discharged from ICU in both groups recorded and compared.

Eligibility Criteria:
Inclusion Criteria:

* adult patients between 18-65 years old,
* with Acute respiratory distress syndrome,
* any ventilated patients for more than one week

Exclusion Criteria:

* young or pediatric patients below 18 years.
* patients older than 65 years
* patients had Chronic Respiratory Disease
Phenylephrine Dose and Mode of Administration for Spinal Anesthesia Induced Hypotension

Three different regimens of phenylephrine are being evaluated to see if one is superior over the other in the maintenance of cardiac output while keeping normotension and/or treating hypotension experienced when receiving spinal anesthesia for cesarean delivery.

Phenylephrine will be administered in one of 3 regimens: Intermittent bolus of 50 mcg, Intermittent bolus of 100 mcg, or continuous infusion of 100 mcg/min. The infusion will contain either phenylephrine or normal saline (placebo). Subjects who are randomized to receive a bolus dose will receive placebo in the infusion. Subjects who are randomized to receive the phenylephrine infusion will have normal saline (placebo) in the bolus syringe. Baseline blood pressures will be obtained prior to surgery and then maintained using these drugs. Blood pressure and heart rate will be monitored as usual standard of care. Continuous cardiac output and hemodynamic monitoring will be obtained using CNAP (Tm) or similar (equivalent) monitoring device. Blood pressure will be maintained at 90-120% of baseline utilizing infusion and/or bolus with the 3 regimens.

Eligibility Criteria:
Inclusion Criteria:

* scheduled for cesarean delivery age \>/=18 years of age \>/= 37 weeks EGA ASA status I-III

Exclusion Criteria:

* allergy to medications used in the study non-English speaking
The Availability of the Enhanced Liver Fibrosis (ELF) Test Affects the Rate of Diagnosis of Nonalcoholic Steatohepatitis (NASH) With Fibrosis in Patients Referred to Hepatology

Background: During the hepatology evaluation, vibration-controlled transient elastography (VCTE) is often used as a clinical decision aid to target high-risk patients for liver biopsy. The enhanced liver fibrosis (ELF) test is expected to be approved in the US. We tested the hypothesis that making the ELF results available to the treating hepatologist will result in more appropriate and targeted use of liver biopsy in patients with elevated liver enzymes or fatty liver, and will result in more cases of advanced fibrosis/cirrhosis being diagnosed. Methods: During the hepatology evaluation for elevated liver enzymes or fatty liver at the University of Kansas Medical Center, the hepatologists (8 total) make a clinical decision on whether patients shall receive VCTE. At the end of the clinic visit, patients were enrolled and randomized to receiving an ELF test. Patients with liver biopsy within the last five years or decompensated cirrhosis were excluded. The primary outcome is the rate of a diagnosis of F3-4 fibrosis based on liver biopsy or clinical diagnosis of cirrhosis with the initiation of hepatocellular carcinoma surveillance. Four hundred fifty patients are to be enrolled over two years.


Eligibility Criteria:
Inclusion Criteria:

* Patients from hepatology clinic undergoing new evaluation for NAFLD.

Exclusion Criteria:

* Patients with liver biopsy within the last five years or decompensated cirrhosis were excluded. Patients known to have other liver diseases were also excluded. Patients consuming \> 14 drinks in the past 6 months were excluded. Patients may be subsequently found to have positive viral or autoimmune serologies after enrollment because the serology result is typically not available at the time of enrollment. These patients will be excluded from the analysis.
The PATHFINDER Study: A Feasibility Trial

The main purpose of this study is to determine whether a rational strategy of EEG guided multimodal general anesthesia using target specific sedative and analgesics could result in enhanced recovery after anesthesia and surgery, decrease in postoperative delirium, and decrease in long term postoperative cognitive dysfunction up to 6 months following cardiac surgery.

The main purpose of this study is to determine whether a rational strategy of EEG guided multimodal general anesthesia using target specific sedative and analgesics could result in enhanced recovery after anesthesia and surgery, decrease in postoperative delirium, and decrease in long term postoperative cognitive dysfunction up to 6 months following cardiac surgery.

Specific Aim 1: The feasibility of implementing multimodal general anesthesia strategy in the Operating Rooms (OR) Specific Aim 2: The feasibility of implementing EEG guided sedation until extubation in the Intensive Care Unit (ICU) Specific Aim 3: The enhancement of recovery after surgery (shorter ventilation time, ICU stay, hospital length of stay) Specific Aim 4: To estimate the effect size of decrease in postoperative day (POD) and postoperative cognitive dysfunction (POCD) to power future large randomized trials

Eligibility Criteria:
Inclusion Criteria:

1. Age ≥ 60 years
2. Undergoing any of the following types of surgery with cardiopulmonary bypass limited to coronary artery bypass surgery (CABG), CABG+valve surgeries and isolated valve surgeries.

Exclusion Criteria:

1. Preoperative left ventricular ejection fraction (LVEF) \<30%
2. Emergent surgery
3. Non-English speaking
4. Cognitive impairment as defined by total MoCA score \< 10
5. Currently enrolled in another interventional study that could impact the primary outcome, as determined by the PI
6. Significant visual impairment
7. Chronic opioid use for chronic pain conditions with tolerance (total dose of an opioid at or more than 30 mg morphine equivalent for more than one month within the past year)
8. Hypersensitivity to any of the study medications
9. Known history of alcohol (\> 2 drinks per day) or drug abuse Active (in the past year) history of alcohol abuse (≥5 drinks/day for men or ≥4 drinks/day for women) as determined by reviewing medical record and history given by the patient
10. Liver dysfunction (liver enzymes \> 4 times the baseline, all patients will have a baseline liver function test evaluation), history and examination suggestive of jaundice.
Enteral Nutrition in Acute Pancreatitis

The purpose of this prospective randomised clinical trial is to compare beneficial and harmful effects of the use enteral nutrition versus a nil-by-mouth and intravenous fluid replacement principle of treatment in patients with moderate to severe acute pancreatitis (AP).

The hypothesis:

* enteral nutrition is no significantly better compared with the nil-by-mouth principle regarding mortality, incidence of local and systemic complications, length of hospital stay, and intensity of the inflammatory response in patients with moderate to severe AP
* enteral nutrition has the same safety as nil-by-mouth principle in patients with moderate to severe AP

Patients with first attack of AP irrespective of etiology will be enrolled in the study, if they are eligible according to the following criteria:

Inclusion criteria:

* onset of symptoms consistent with AP within 72 hours before admission to the hospital
* an 3-fold elevation of serum amylase or serum lipase over the upper limit of normal
* APACHE II score 6 or more
* a signed informed consent

Exclusion criteria:

* patients \< 18 years of age
* pregnant and breastfeeding women

Eligibility Criteria:
Inclusion Criteria:

* onset of symptoms consistent with AP within 72 hours before admission to the hospital
* an 3-fold elevation of serum amylase or serum lipase over the upper limit of normal
* APACHE II score 6 or more
* a signed informed consent

Exclusion Criteria:

* patients \< 18 years of age
* pregnant and breastfeeding women
Motivational Interview Intervention to Help Patients Formulate Their Goals for Medical Care in the Emergency Department

Test the acceptability and feasibility of a brief motivational interview intervention to facilitate advance care planning (ACP) conversations for older adults with serious co-morbid illness being discharged from the emergency department (ED). The investigators will interview the participants to understand their perception of the intervention and collect patient-reported outcomes data after leaving the ED.

This study is designed to engage seriously ill older adults in conversations about their goals of care. Our intervention is intended to help these patients understand the significance of ED visits in the course of their illnesses.

Eligibility Criteria:
Inclusion Criteria:

* ≥65 years of age
* English-speaking
* Capacity to consent
* AND ≥1 Serious illness (New York Heart Association stage 3 or 4 heart failure, oxygen-dependent chronic obstructive lung disease, chronic kidney disease on dialysis, and metastatic cancer.) OR determined by the emergency department provider that the patient has a high likelihood of death in the next 12 months ("I would not be surprised if this patient died in the next 12 months.").

Exclusion Criteria:

* Acute physical or emotional distress
* Determined by emergency department provider not to be appropriate
* Clearly documented goals for medical care already exists (e.g. medical order for life sustaining treatment - MOLST).
* Already enrolled in this study
PrOgnosis Following Esophageal FisTula FormaTion in Pts Undergoing CathetER Ablation for AF Study

Pulmonary vein isolation emerged as an effective and safe strategy to treat atrial fibrillation patients. Atrio-oesophageal fistula (AOF) represents a rare but devastating complication of AF ablation procedure. This complication (0.016-0.07%) requires an international effort to allow for better understanding of the factors contributing to its occurrence and the best management strategies. A worldwide, retrospective, multicenter registry focusing on the incidence, diagnosis and management of this complication.

Data about the incidence, optimal management and outcome of AOF is sparse. The largest national and international surveys report on less than 50 AOF. The latest worldwide survey was conducted in 2015 and managed to include 31 patients who developed AOF after atrial fibrillation ablation procedure. In the meanwhile, the total number of AF ablation procedures increased significantly. Additionally, AF ablation technology changes significantly with e.g. increasing numbers of cryoballoon ablation and contact force guided radiofrequency ablation.

The study is designed as a worldwide, multi-centre, anonymised registry study to evaluate the incidence, optimal management and outcome of this AOF. More than 50 patients with AOF following percutaneous catheter ablation will be included in the register.

Eligibility Criteria:
Inclusion Criteria:

* Atrio-oesophageal fistula after Ablation
* Indication for AF ablation as per current guidelines
* Performing the ablation at an ablation centre

Exclusion Criteria:

* No Atrio-oesophageal fistula after Ablation
Comparison of Effectiveness and Safety of Sublingual Immunotherapy in Children With Allergic Rhinitis

The purpose of the trial is to compare the efficacy and safety of sublingual seasonal and annual immunotherapy in children with allergic rhinitis allergic to grass pollens.

Allergen immunotherapy is currently the only one method of cause treatment of the IgE-dependent allergic diseases. Sublingual immunotherapy (SLIT) is the method which allows to give allergens via alternative oral route in patients home. Due to the possibility of avoiding injection this therapy allows to have better relationship with patient, and reduce the costs of therapy thanks to reducing the numbers of visits in out-patient clinic.However efficacy and safety of sublingual immunotherapy are still important issues, especially in children.

The purpose of trial is to compare the efficacy and safety of sublingual seasonal and annual immunotherapy in children with allergic rhinitis allergic to grass pollens.

Eligibility Criteria:
Inclusion Criteria:

* Children with seasonal allergic rhinitis, allergic to grass pollens, first diagnosed at least 2 years before inclusion into the study

Exclusion Criteria:

* Active upper respiratory tract infection within 3 weeks before the study and acute sinus disease requiring antibiotic treatment within 1 month before the study
* Allergic rhinitis hospitalisation during the 3 months before the first visit.
* Additional criteria were other clinically significant pulmonary, hematologic, hepatic, gastrointestinal, renal, endocrine, neurologic, cardiovascular, and/or psychiatric diseases or malignancy that either put the patient at risk when participating in the study or could influence the results of the study or the patient's ability to participate in the study as judged by the investigator.
* Excluded medications were systemic corticosteroids.
* Patients who were receiving immunotherapy were also excluded.
Respiratory Muscle Fatigue at Different Breathing Modes

The study aims at investigating if time to respiratory muscle fatigue and metabolism are influenced by the pressure wave form mode applied during resistive breathing.

In healthy subjects fitted with a nasogastric double balloon catheter and breathing at a resistance, the investigators will measure time to failure, Borg ratings, VO2, VCO2, flow, esophageal-, gastric- and airway-pressure. This will be done during breathing at either a square wave or triangle wave pressure waveform, in random order and trials separated by \>two days. Further respiratory muscle fatigue will be investigated pre and post intervention by maximal esophageal pressure generation (voluntary and with cervical magnetic stimulation).

Eligibility Criteria:
Inclusion Criteria:

* Healthy men or women
* Age ≥18 and ≤60 years
* BMI ≥ 20 and ≤30

Exclusion Criteria:

* Drug addiction defined as the use of cannabis, opioids or other drugs
* Previous and present neurologic (e.g. ataxia), musculoskeletal (e.g. muscular dystrophy) or mental illnesses (e.g. schizophrenia)
* History of mechanical ventilation, COVID-19 with respiratory complications, lung cancer
* Part of lung resected
* Presence of dyspepsia/heart-burn/abdominal pain
* Presence of esophageal varices
* Presence of liver disease
* Presence of esophageal hernia
* Pregnancy
* Failure to comply with transcranial magnetic stimulation adult safety screen
* History of epilepsy, metal implants in head or jaw
* Acute or chronic lung diseases, e.g. asthma, COPD, bronchitis etc.
* Lack of ability to cooperate
Advanced Provision of Care

This study aims to evaluate advanced provision of an anti-progestin with a prostaglandin for future use (in the next 12 months) in individuals at risk for pregnancy but not desiring a pregnancy.

The purpose of this study is to learn more about counseling via telemedicine and advanced provision of medications to individuals at risk for pregnancy but before they are pregnant. If they experience this event, then they may subsequently have immediate access to the care they need plus an established connection with a health provider.

Eligibility Criteria:
Inclusion Criteria:

* 18 to 40 years old at time of consent
* Anatomically capable of pregnancy
* Self-reported a history of regular menses (\>24 and \<38 days) in the past 3 years (other than during pregnancy)
* Not currently pregnant and not desiring to be pregnant in the next year
* Say they would seek to end the pregnancy if they became pregnant in the next year and who do not express a preference for an in office procedure
* At-risk for unintended pregnancy defined as:
* those who report being sexually active (vaginal sex with partners with sperm)
* have not been told by a clinician that they cannot become pregnant
* have not had a permanent contraception procedure and whose current sexual partner(s) has not had a permanent contraception procedure
* who are not using a long-acting reversible contraceptive (LARC)
* Willing and able to provide informed consent
* Willing/able to receive phone calls from study staff and complete electronic surveys distributed by EMR or email
* Planning to live within the state of Oregon or Washington for the 12 month study period.

Exclusion Criteria:

* Less than 18 and older than 40 years old at the time of consent
* Any medical contraindications to MAB (hemorrhagic disorder or will be taking anticoagulants during study period, chronic adrenal failure or will be taking long term corticosteroids \>1 week during study period, inherited porphyria, or an allergy to mifepristone or misoprostol)
* Currently pregnant or desiring pregnancy in the next year
* State they would not seek to end a pregnancy if they became pregnant in the next year or who express a preference for an in office procedure
* History of ectopic pregnancy
Effect of Curcumin Addition to Standard Treatment on Tumour-induced Inflammation in Endometrial Carcinoma

This therapy aims to determine whether curcumin can inhibit tumor induced inflammation in patients with endometrial carcinoma. In addition, curcumin could possibly induce a better functioning of chemotherapy and a decrease in toxicity from chemotherapy. Various studies have demonstrated that curcumin can have an effect on tumor growth and the development of metastases.

Various cancer types are associated with chronic inflammation. During the formation of cancer the immune system is being activated by the tumor in order to evoke an anti-tumor immune response. However, as the tumor develops, this gives rise to a chronic inflammation, causing the immune system to malfunction. This is being highlighted by the fact that different chronic inflammatory diseases are associated with an increased risk of cancer (f.i. chronic inflammatory bowel diseases and colon cancer, prostatitis and prostate cancer, hepatitis and liver cancer). Endometrial cancer reveals different aspects of inflammation, including cytokine secretion and the infiltration of immune cells in this type of tumors. It is presumed that hormonal fluctuations and genetic changes contribute to the formation of a pro-inflammatory environment that stimulates tumor growth. Cancer cells of endometrial tumors do not only produce immunomodulatory mediators, but also attract different sorts of cells of the immune system that stimulate tumor growth.

It has already been demonstrated in mice models and in vitro experiments that curcumin shows strong anti-inflammatory effects that can slow down tumor growth and/or prevent formation of metastases. In addition, it has been noticed in these models that curcumin also has a positive effect on the functioning of various chemotherapeutic drugs, causing their effect to enhance or their toxicity to decrease.

Clinical studies investigating the anti-inflammatory effect of curcumin are rare, but these studies do reveal a suppression of the inflammation. The primary reason why clinical studies with curcumin are rare is because of the bad intake of curcumin in the human body. Recently, there has been a lot of research carried out regarding the development of new formulations of curcumin that lead to a better intake in the human body. The best nutritional supplement containing curcumin that has been developed so far is Meriva®, which is commercialized in Belgium under the name "CurcuPhyt".

Eligibility Criteria:
Inclusion Criteria:

* Endometrial carcinoma at time of recurrence
* No life-threatening metastases

Exclusion Criteria:

* Other active malignancy
* Documented autoimmune disease
* Currently ongoing immunosuppressive therapy
* Simultaneous treatment according to other clinical trials
* Documented immune deficiency
IRIS-BioFreedom Cohort in the IRIS-DES Registry

The objective of this study is to evaluate effectiveness and safety of BIOFREEDOM™ FAMILY stent in the "real world" daily practice as compared with other drug-eluting stents.

BIOFREEDOM™ FAMILY stent means that Biofreedom stent, Biofreedom Ultra and the other stents with names starting with Biofreedom.

Eligibility Criteria:
Inclusion Criteria:

* Age 19 and more
* Patient with BIOFREEDOM™ FAMILY stent
* Written consent

Exclusion Criteria:

* Intervention with BIOFREEDOM™ FAMILY stent and other drug eluting stent at the same time
* Life-expectancy less than 1 year
* Cardiac shock
Team PLAY (Positive Lifestyles for Active Youngsters)

The purpose of this study is to determine whether an intense family-centered program to help children, 4 to 7 years old, control their weight is more effective than the advise and referrals their health provider gives in the primary care office.

This randomized controlled trial is designed to determine whether an intense 6 month family-centered intervention to increase physical activity and health eating patterns, primarily directed at parents, followed by a 6 month maintenance period, will be significantly more successful in controlling weight in overweight/obese children, ages 4-7 years, than usual standard care, at 2 years after enrollment. The intervention group (180 children with a BMI \> 85% percentile) will receive standard of care, as well as, additional parental counseling. Parents will receive intense counseling regarding developmentally appropriate physical activity, strategies for reducing sedentary behaviors, nutritional counseling, and behavioral counseling including a self-management program to use with their children at home. The group will meet once a week for the initial 8 weeks, biweekly for 8 weeks, and monthly for 2 months. Following this period (the next 6 months), a case manager will call the family on a monthly basis and the family will be sent educational and support information by mail. The control group (60 children with a BMI \> 85% percentile) will receive standard care provided by their primary care provider and be offered a six week optional parenting class. All children will have a medical history, physical examination, and anthropometric measures, nutritional assessment, measurement of physical activity, and behavioral/psycho-social measures provided by study personnel. Outcome measurements will be done at baseline, 6, 12, 18, and 24 months.

Eligibility Criteria:
Inclusion Criteria:

* Children 4 to 7 years of age, male or female, of any race who have a BMI \> 85% for age.
* All participants and parents must be able to speak and understand English.

Exclusion Criteria:

* History of diabetes mellitus
* History of significant renal, hepatic, cardiovascular,or gastrointestinal disease
* Receiving drugs known to alter glucose homeostasis
* Physical disabilities that limit physical activity (i.e. orthopedic, congenital)
* Diagnosis of hypertension by a medical provider that requires limited physical activity
* Psychological disabilities that might limit participation;
* Lack of access to a telephone
* Lack of access to transportation for the intervention
* Current participation in another clinical trial (current participation in an observational study is not an exclusion.)
* Other medical or behavioral factors that in the judgment of the Principal Investigator may interfere with study participation or the ability to follow the intervention protocol.
* Unable to speak and understand English