cyrilzakka/clinical-trials huggingface dataset:
Feasibility of Improving Cerebral Autoregulation in Acute Intracerebral Haemorrhage

In the UK, 23,000 (15%) of the 150,000 people who suffer a stroke each year have bleeding in the brain, also referred to as acute intracerebral haemorrhage (ICH). An Autoregulation Index (ARI) can be assigned between 0 and 9 (0 being poor and 9 being the most efficient CA observed) to gauge how good the control over blood flow is at a given time. Dynamic CA (dCA) is a measure of the response of cerebral blood flow (CBF) to rapid changes in blood pressure (BP), and several key studies have shown impaired dCA post-acute ICH. The most recent study demonstrated that dCA impairment lasts up to 12 days. This is particularly important to understand, since our preliminary work has recently shown that changes in carbon dioxide using simple breathing exercises can improve Autoregulation.

Unfortunately, there are limited non-pharmacological management options and significant opportunities to improve patient outcome in ICH. The proposed study addresses this area, by investigating whether a simple breathing exercise in survivors of ICH is safe, feasible and effective in reducing brain injury by improving cerebral autoregulation.


Eligibility Criteria:
Inclusion Criteria:

* Clinical diagnosis of a haemorrhagic stroke within 48 hours of onset (for patients waking with a stroke, time of onset will be taken to be the time when the patient was last asymptomatic)
* Able and willing to give informed consent
* Male or female, aged 18 years or above
* Able (in the Investigator's opinion) and willing to comply with all study requirements
* Willing to allow his or her General Practitioner (GP) to be notified of participation in the study

Exclusion Criteria:

* Male or Female, aged under 18 years
* Significant previous airways disease (formal diagnosis of moderate or severe airways disease and having treatment for this respiratory condition - via inhalers or specialist input)
* Unable (in the Investigator's opinion) or unwilling to comply with any study requirements
* Female participants who are pregnant, lactating or planning pregnancy during the course of the study
* Clinical diagnosis of stroke greater than 48 hours from onset
* Having had a resolved transient ischaemic attack (TIA) (i.e. neurological symptoms completely resolved upon hospital presentation)
* Co-morbidity with anticipated life expectancy less than 3 months
Study of Retinal Vascular Changes After Ocular Blunt Trauma

This study evaluates the retinal vascular features using optical coherence tomography angiography in patients that received ocular blunt trauma.

To investigate, using optical coherence tomography angiography, early retinal vascular features 48 hours after ocular trauma and to detect their changes during 6 months' follow up.

The optical coherence tomography angiography represents a novel and noninvasive diagnostic technique that allows a detailed analysis of retinal vascular features.

Eligibility Criteria:
Inclusion Criteria:

* age older than 40 years
* diagnosis of previous ocular blunt trauma
* absence of previous ocular surgery, congenital eye disease, high myopia (\>6 dioptres), actual or previous diagnosis of glaucoma, optic disc anomaly, macular or vitreoretinal diseases.
* absence of significant lens opacities, low-quality OCT and OCT-A images.

Exclusion Criteria:

* age younger than 40 years
* absence of previous ocular blunt trauma
* presence of previous ocular surgery, congenital eye disease, high myopia (\>6 dioptres), actual or previous diagnosis of glaucoma, optic disc anomaly, macular or vitreoretinal diseases.
* presence of significant lens opacities, low-quality OCT and OCT-A images.
Glucose Monitoring to Predict and Treat High Glucose Levels After Steroid Treatment

The purpose of this study is to see if continuous glucose monitoring can identify how often people who have pre-diabetes or medical obesity or well-controlled diabetes experience very high glucose values while receiving chemotherapy for breast cancer or pancreatic.


Eligibility Criteria:
Inclusion Criteria:

* Patient aged 18 or older undergoing neoadjuvant chemotherapy regimens including taxane and/or anthracycline for breast cancer.
* Patient aged 18 or older undergoing any chemotherapy regimen for pancreatic cancer
* Have 'high metabolic risk(either pre-diabetes, obesity, or well-controlled diabetes) defined as either:

  * Pre-diabetes and/or obesity group: one or more of known HbA1c 5.7-6.5%, fasting glucose \> 100 mg/dL, or BMI \> 30
  * Well-controlled diabetes: Known HbA1c \< 7.5 on lifestyle alone or up to one oral antidiabetic agent
  * Any patient undergoing treatment for pancreatic adenocarcinoma on either no antidiabetic agent or up to one oral antidiabetic agent

Exclusion Criteria:

* Patients with type 1 diabetes, a history of hospitalization for either hyperglycemia or ketoacidosis, a history of hypoglycemia requiring hospitalization, rashes or other skin reactions that would preclude placement of the CGM
* Use of anticoagulants or antiplatelet agents other than aspirin
* Platelet count \< 50 K/μL within 60 days prior to enrollment.
IONSYS Feasibility Study

The treatment of postoperative pain continues to be a challenge after posterior spinal fusions. There is considerable evidence demonstrating that a multi-modality approach including patient controlled analgesia (PCA) with opioids for postoperative pain management compared to conventional opioid analgesia provides a greater analgesic effect even when the amount of opioids consumed is similar between both groups. However, the PCA modality is often discontinued prior to all the patients' pain needs being met. The IONSYS system uses the concept of PCA-delivered narcotics and may be used for postoperative pain management.

Following posterior spinal fusions, many patients are treated with analgesics or other modalities for prolonged periods before choosing the surgical alternative. In addition, the narcotic-based anesthetic required for the procedure may induce postoperative hyperalgesia (1). Inadequate treatment of this pain can result in prolonged hospitalization, cardiopulmonary complications, and poor surgical outcome (2).

Pain during the immediate postoperative period is usually managed with IV narcotic PCA and then transitioned to a combination of long-acting and short-acting oral analgesics. Because of the requirement for continuous carrier fluid infusion, cumbersome pump technology restricting mobility and supervision by a dedicated pain team to control programming of the pump, the PCA modality is often discontinued prior to all the patients' pain needs being met.

The investigators' most recent study evaluated the addition of pregabalin to the pain regimen after spinal fusions. The study found that after the removal of the PCA modality, these patients had considerable pain during physical therapy (PT), and their pain was not improved with the addition of pregabalin.

The IONSYS system might alleviate some of the problems encountered with conventional PCA systems (3,4). The system is an iontophoretic transdermal (needleless) system preprogrammed to deliver upon activation 40 mcg fentanyl over a 10-minute period, with up to 6 doses per hour. The system performs for 24 hours. The drug is embedded in a matrix gel and is only delivered when a current is propagated between the two poles of the system. Other than the usual narcotic side effects, the only specific side effect is a local dermatological reaction to the patch (5% had a rash, which cleared after removal). The system was designed with fentanyl, since hydromorphone cannot be incorporated in this type of matrix. Unlike hydromorphone, fentanyl is quick acting and doesn't hang around. The in-house chronic pain service currently puts many of their patients on IV fentanyl, because of the belief that it works when they have pain but is quickly metabolized.

Eligibility Criteria:
Inclusion Criteria:

* Patients 18-70 years old undergoing elective multi-level lumbar-sacral posterior spinal fusions

Exclusion Criteria:

* Chronic pain patients taking more than 20-mg equivalents of oxycodone daily
* Allergy to either hydromorphone or fentanyl
* Other chronic orthopedic pain complaints, which will confound the results of the study
* Issues with cognitive ability
High Intensity Interval Training in Chronic Stroke

The objective of this study was to compare the effectiveness of high intensity interval training (HIT) and traditional aerobic training for persons with stroke.

Participants were randomized to either HIT or traditional aerobic training; each 25 minutes, 3 times per week for 4 weeks. Outcomes were measured before and after training by a blinded rater.

Eligibility Criteria:
Inclusion Criteria:

* 1) age 35-90 years
* 2) unilateral stroke experienced \>6 months prior to enrollment
* 3) able to walk 10m overground with assistive devices as needed and no physical assistance
* 4) able to walk 3 minutes on the treadmill at \>.13m/s (0.3mph) with no aerobic exercise contraindications
* 5) stable cardiovascular condition (American Heart Association class B, allowing for aerobic capacity \<6 metabolic equivalents)
* 6) discharged from formal rehabilitation

Exclusion Criteria:

* 1) significant resting ECG abnormalities
* 2) evidence of significant arrhythmia or myocardial ischemia on treadmill ECG stress test
* 3) hospitalization for cardiac or pulmonary disease within 3 months
* 4) pacemaker or implanted defibrillator
* 5) lower extremity claudication
* 6) unable to communicate with investigators or correctly answer consent comprehension questions
* 7) severe lower extremity spasticity (Ashworth \>2)
* 8) lower extremity weight bearing pain \>4/10 on visual analogue scale

For the transcranial magnetic stimulation substudy, additional exclusions will also be applied. These include large cerebral infarcts or other structural defects with the potential to increase seizure risk, uncontrolled seizures, metal implants and previous craniotomy.
Analysis of Risk Factors for Surgical Site Infections in Patients With Acute Abdomen at Hospital of State University of Haiti

The purpose of this study is to identify the risk factors associated with surgical site infection.

87 patients medical records from January 2018 to December 2020 will be analyzed to detect the risk factors linked to the occurence of surgical site infection. Then the strength of their association with surgical site infection will be determined via multivariate analysis.

Eligibility Criteria:
Inclusion Criteria:

* Female or male patients over 12 years of age.
* Admitted to the Surgery Department for acute surgical abdomen and having undergone surgery

Exclusion Criteria:

* Patients who have undergone abdominal surgery for urological or gynecological pathologies
* Files with missing information on preoperative, operative and post-operative arrangements
Germline Mutations in Patients With Head and Neck Cancer and a Family History of Cancer

RATIONALE: Studying gene mutations in samples of DNA from patients with head and neck cancer and a family history of cancer may help doctors learn more about the development of cancer in families.

PURPOSE: This clinical trial is studying germline mutations in patients with head and neck cancer and a family history of cancer.

OBJECTIVES:

* Measure the incidence of p16\^INK4a germline mutations in patients with squamous cell carcinoma of the head and neck and a family history of cancer.
* Determine biologic activity of identified p16\^INK4a germline mutations.

OUTLINE: DNA specimens are collected for genetic and mutation analysis and examined by PCR and flow cytometry. The activity of cells with p16 mutations is determined by cell cycle arrest functional assay.

Eligibility Criteria:
DISEASE CHARACTERISTICS:

* Diagnosis of squamous cell carcinoma (SCC) of the head and neck
* Must have ≥ 1 first-degree relative with any of the following cancers:

  * Non-small cell lung cancer
  * Melanoma
  * Pancreatic cancer
  * SCC of the head and neck
  * Lymphoma (controls)

PATIENT CHARACTERISTICS:

* Not specified

PRIOR CONCURRENT THERAPY:

* Not specified
Effect of Addition Oral Montelukast to Standard Treatment in Acute Asthma in Hospitalized Preschool Children

Leukotriene receptor antagonists (LTRAs) are well established in the management of outpatient asthma. Montelukast is a potent, specific, orally active, cysteinyl leukotriene receptor antagonist with a rapid onset of action.However, there is very little information as to their role in acute asthma exacerbations.

The purpose of this study is to determine if adding oral montelukast to the maximal standard treatment in children hospitalized for acute asthma has any additive benefit.

Background: Montelukast is a potent, specific, orally active, cysteinyl leukotriene receptor antagonist with a rapid onset of action.

Objective: To evaluate the effect of the addition of a single dose of oral montelukast to standard therapy in acute asthma. Design: Double-blind, randomised, controlled, parallel group trial. Setting: Pediatric service of Education and training Hospital Patients: Children with the ages of 6-60 months who were hospitalized for acute asthma Intervention: Children received montelukast 4 mg or placebo orally in addition to the standard therapy. Clinical asthma score was recorded before administering study medication and thereafter, 4 hourly until discharge. Main outcome measure: The primary outcome was discharge rates.

Eligibility Criteria:
Inclusion Criteria:

* Medical history of at least 4 wheezing attacks
* Children with the ages of 6-60 months
* Children whose parents accept to give written informed consent

Exclusion Criteria:

* Chronic diseases (e.g. malnutrition, anatomic malformation of the respiratory tract, chronic lung or heart disease, gastroesophageal reflux disease and cystic fibrosis)
* Children with a history of chronic drug use (e.g. antiepileptics and immune suppressives)
Screening of Coexistence Between Sickle Cell Anaemia and G6PD Deficiency

G6PD deficiency may have a subtle effect on the severity of hemolysis and also worsen the degree of anaemia in SCD when the two disorders coexist. Therefore, selective decision should be taken in patients in whom the two conditions coexist in the choice of drug and in the treatment of infections.The prevalence of the G-6-PD deficiency is high in SCD patients, but does not differ from that observed among non-SCD subjects .However, the G-6-PD deficiency appears to worsen the clinical features of SCD, there were more hospitalizations, major vaso-occlusive crises among G-6-PD deficient sickle cell patients.

Sickle cell disease (SCD) is not frequent in Egypt except in the Oases where the carrier rate varies from 9 to 22%. It is a hereditary blood disorder characterized by the production of abnormal hemoglobin molecules that cause red blood cells to take on a crescent or sickle shape. This haemoglobin called haemoglobin S, which causes red blood cells to become stiff and sticky, leading to various health complications as recurrent pain, fatigue, anaemia, and increased infection susceptibility.prevalence of G6PD deficiency is 4.3% with a male:female ratio of 3.2:1. Enzyme activity was significantly higher in males than females. It is located on X chromosome which leads to a lower level of reduced glutathione, an antioxidant, in red blood cells (RBCs). Most of the time, those who are affected have no symptoms. However, they should avoid specific triggers that may promote oxidative stress such as fava beans, that may fragilize RBCs and cause hemolysis. G6PD deficiency may have a subtle effect on the severity of hemolysis and also worsen the degree of anaemia in SCD when the two disorders coexist. Therefore, selective decision should be taken in patients in whom the two conditions coexist in the choice of drug and in the treatment of infections. The prevalence of the G-6-PD deficiency is high in SCD patients, but does not differ from that observed among non-SCD subjects .However, the G-6-PD deficiency appears to worsen the clinical features of SCD, there were more hospitalizations, major vaso-occlusive crises among G-6-PD deficient sickle cell patients.

Eligibility Criteria:
Inclusion Criteria:

- All new born with good general health

Exclusion Criteria:

* 1-new born with high reticulocytic count 2-new born with bad general health
Prospective Biceps Study

The primary goal of this study is to determine if surgical repair of the distal biceps fully restores the supination strength of the forearm. Secondarily, the investigators want to examine the insertion site location of the tendon and determine if it correlates with the patients' functional outcome as determined by Disabilities of the Arm, Shoulder, and Hand (DASH), Visual Analog Pain Scale (VAPS), and isometric supination torque testing.


Eligibility Criteria:
Inclusion Criteria:

* primary distal biceps repair with endobutton

Exclusion Criteria:

* any ipsilateral wrist, forearm, or elbow condition
* any contraindication to having an MRI
Preventing Hypotension in the Spine During Cesarean Delivery.

Examining the advantages associated with the utilization of noradrenaline in preventing spinal hypotension during cesarean births. This involves assessing the positive outcomes and potential benefits derived from incorporating noradrenaline into the medical approach.

Spinal anesthesia is used during cesarean section to provide rapid onset and dense block of motor and sensory nerves, intraoperative analgesia, and help patients remain conscious (1,2).Hypotension is common during induction of spinal anesthesia for cesarean delivery (CD) (3).If not promptly treated, a decrease in blood pressure (BP) can have deleterious effects, which include maternal nausea, vomiting, dizziness, and cardiovascular instability as well as decreased uteroplacental blood flow with resultant fetal acidosis, hypoxia, and bradycardia.In the last decade, the α-agonist phenylephrine (PE) has been the vasopressor of choice for the prevention and treatment of spinal induced hypotension (4).To prevent and treat postspinal anesthesia hypotension during cesarean section, vasopressors are recommended. Vasopressors (especially potent α-adrenergic receptor agonists) help offset the decrease in arteriolar dilation and peripheral vascular resistance caused by sympathetic nerve blockade after spinal anesthesia and may be associated with decreased incidence of neonatal acidosis.(5,6). Norepinephrine is another vasopressor that was recently introduced in obstetric anesthesia (7). Norepinephrine is characterized by α-adrenergic agonistic activity in addition to a weak β-adrenergic agonistic activity; thus, norepinephrine is considered a vasopressor with minimal cardiac depressant effect(7).; these pharmacologic properties would make norepinephrine an attractive alternative to phenylephrine and ephedrine in obstetric anesthesia. Although the use of norepinephrine for prophylaxis against postspinal hypotension has shown promising results,(7,8) evidence is lacking on the optimum dose for norepinephrine infusion during cesarean delivery.

Eligibility Criteria:
Inclusion Criteria:

* The subject is scheduled for elective cesarean section .
* No obvious abnormalities in preoperative ECG, blood routine, electrolytes, and other tests.
* ASA class 1-3.

Exclusion Criteria:

* Patients have body mass index (BMI) \>35 kg/m2. -Patients are known hypersensitivity to any of the drugs that would be used in the study. -
* Severe cardiac, renal, lung, or liver diseases.
* Eclampsia or preexisting hypertension (baseline systolic blood pressure ≥160 mmHg)
* hemoglobin \<7 g/dL, or fetal distress.
* Patients that are immunologically compromised.
* Sleep apnea syndrome or difficult airway. 8.preexisting hypoxemia (Spo2\< 90 %).
* Patient refusal.
Sildenafil in Acute Pulmonary Embolism

To investigate if acute pulmonary vasodilation by sildenafil improves right ventricular function in patients with acute intermediate-high risk pulmonary embolism (PE).

Patients with PE randomized to a single oral dose of sildenafil 50mg (n=10) or placebo (n=10) as add-on to conventional therapy. Right ventricular function evaluated immediately before and shortly after (0.5-1.5h) randomization by right heart catheterization (RHC), trans-thoracic echocardiography (TTE), and cardiac magnetic resonance (CMR). The primary efficacy endpoint was cardiac index measured by CMR.

Eligibility Criteria:
Inclusion Criteria:

* Patients with acute pulmonary embolism confirmed by contrast enhanced computed tomography (CT)
* symptom duration of less than 14 days
* older than 18-80 years
* right ventricular/left ventricular ratio (RV/LV) \>1 measured by trans-thoracic echocardiography (TTE, 1 cm above the atrio-ventricular valves in the four-chamber view at end-diastole).

Exclusion Criteria:

* pregnant
* cardiac arrest that required cardiopulmonary resuscitation
* a life expectancy \<120 days
* systolic blood pressure \<90 mmHg
* metal implants, obesity or claustrophobia that excluded the patient from cardiac magnetic resonance (CMR)
* altered mental status making the patient unable to provide informed consent
* recent use of drugs with influence on the Nitric oxide-cyclic guanosine monophosphate pathway
* known or suspected chronic thromboembolic pulmonary hypertension
* inability to perform study protocol \< 72 hours after conventional PE treatment was instituted
* active bleeding after thrombolysis.
Tolerability and Efficacy of Modified VCD Regimens in Previously Untreated Multiple Myeloma.

This phase 2 study will be conducted at 10 centers and enroll patients from August 2013 to August 2017.Firstly, All patients included will provide written informed consent. Secondly, they will be randomized equally to receive modified VCD regimen arm 1 or modified VCD regimen arm 2. In total, 47 patients per arm (or 94 in total) are required. The treatment consists of four 4-week cycles of induction therapy followed by intensive therapy with another five modified VCD regimens and maintenance treatment with CP regimen. Then, patients will be followed up for 24 months after chemotherapy. The investigators will record all the laboratory and clinical investigations to assess response at different points of the study. We also monitor and assess adverse events (AEs), as graded according to NCI-CTCAE Version 3.0.Response categories were based on the International Myeloma Working Group uniform response criteria.In addition, 20 patients (10 in VCD regimen arm 1 group, 10 in VCD regimen arm 2 group) from ten centres will be enrolled in the pharmacodynamic substudy.


Eligibility Criteria:
Inclusion Criteria:

* Patients with previously untreated symptomatic MM
* 18 years of age or older, regardless of gender
* secretory MM with measurable diseases
* Karnofsky Performance Status≥50%（pathological fractures excluded）
* Patients without heart and pulmonary dysfunction ≤class I

Exclusion Criteria:

* peripheral neuropathy of grade 2 or higher according to NCI-CTCAE Version 3.0
* Relapse and refractory MM
* MM without symptom
* Non-secretory MM without measurable diseases
* Karnofsky Performance Status\<50%（pathological fractures excluded）
* Patients with heart and pulmonary dysfunction\> class I
I-123-MIBG for Imaging of Neuroblastoma and Pheochromocytoma

I-123-MIBG is used to image patients with neuroblastoma, pheochromocytoma and other neural crest tumors

Entry criteria--Histologically documented neuroblastoma or pheochromocytoma or strong suspicion of neuroblastoma or pheochromocytoma.

Exclusion criteria--Pregnancy Randomization--None Procedure--Patients will receive a dose of I-123-MIBG by intravenous injection. Images will obtained at 18-24 hours after administration of the drug and at 42-48 hours as needed. SSKI will be used to block thyroid uptake of free I-123-iodide

Eligibility Criteria:
Inclusion Criteria:

* Histologically proven neuroblastoma or pheochromocytoma or strong suspicion of neuroblastoma or pheochromocytoma

Exclusion Criteria:

* Pregnancy