cyrilzakka/clinical-trials huggingface dataset:
Mulligan Mobilization in Rheumatoid Hand

The goal of this randomized-controlled study is to learn about the effectiveness of the Mulligan mobilization in rheumatoid hands. The main question it aims to answer are:

-Does mulligan mobilization reduce effusion in wrist joints with rheumatoid arthritis? Participants will take Mulligan mobilization application and active ROM exercises for their hands. Researcher will compare treatments group ith sham mobilization.

Rheumatoid arthritis (RA) is a systemic disease that can lead to chronic pain, bone and soft tissue damage, and disability retirement. Alleviating pain and maintaining joint range of motion in RA are important for reducing disability. Joint mobilizations are manual therapy techniques used to increase range of motion and reduce pain. The aim of this study is to investigate the effects of rheumatoid hand exercise and protective approach and joint mobilization applications on pain, functional status and quality of life.

Eligibility Criteria:
Inclusion Criteria:

* Having been diagnosed with RAS according to ACR and EULAR criteria,
* Being under the control of a physiatrist for at least 1 year,
* Have not had any upper extremity surgery in the last 6 months
* Have the cognitive capacity to understand commands,
* Not to be involved in any other rehabilitation program or study,

Exclusion Criteria:

* Presence of soft tissue injury and chronic bone damage in the hand,
* Presence of acute inflammation in any joint in the previous week,
* Presence of a degenerative or non-degenerative neurological condition that causes a change in pain perception,
PREoPerAtive pREhabilitation in Patients With Head and Neck Cancer or Liver Cancer (PREPARE)

The objective of this study is to determine the feasibility (main aim) and effectiveness (secondary aim) of a prehabilitation program in patients with head and neck cancer or liver cancer. Participating patients will participate in a 3-to-6 week rehabilitation program consisting of training and nutritional, smoking cessation and psychosocial counselling.

In patients diagnosed with head and neck cancer (HNC) or liver cancer, (major) surgery is the standard of care. Nevertheless, surgery may result in complications that have a substantial impact on the physical and psychological state of the patient. Detrimental postoperative outcomes are influenced by unhealthy lifestyle behaviors such as a sedentary lifestyle, smoking and malnutrition. Prehabilitation programs focusing on these lifestyle aspects have been suggested as a promising intervention to improve pre- and postoperative outcomes. Therefore, the obective of this study is to determine the feasibility (main aim) and effectiveness (secondary aim) of a prehabilitation program in patients with HNC or liver cancer

This study concerns a prospective cohort study in 60 patients with HNC or liver cancer that participate in a 3 to 6-week pilot prehabilitation program consisting of training and nutritional, smoking cessation and psychosocial counselling.

Data on feasibility (program satisfaction, program compliance and percentage of patients willing to participate in the prehabilitation program) and effectiveness (e.g. complications, health status, compliance to healthy lifestyle) is collected at three time points (pre- and post the prehabilitation program and 30 days post-surgery).

Eligibility Criteria:
Inclusion Criteria:

* Age ≥18 years
* Diagnosis of head and neck cancer or liver cancer
* Scheduled for surgery in Erasmus MC
* Provision of written informed consent
* Only patient with a waiting time of at least 3 weeks till surgery can participate in this study

Exclusion Criteria:

* Patients that do not understand the Dutch language
* Patients with severe physical or psychological comorbidities that limit participation in the prehabilitation program
Treating Deep Seizure Foci With Noninvasive Surface Brain Stimulation

The overall goal of this study is to open up the promising treatment of repetitive transcranial magnetic stimulation (rTMS), which has been shown to be effective against seizures in patients with surface neocortical foci, to a much larger population of patients with mesial temporal lobe epilepsy (MTLE) and other forms of epilepsy with deep foci, who are not currently considered good rTMS candidates.

The investigators hypothesize that rTMS can modulate the hyperexcitable state in patients with deep seizure foci by targeting its usage to accessible cortical partner regions. In this study the investigators aim 1) to map the functional connectivity of the epileptogenic mesial temporal lobe in patients with medically refractory mesial temporal lobe epilepsy; and 2) to perform a randomized controlled assessment of repetitive transcranial magnetic stimulation protocols applied to specific neocortical targets in mesial temporal lobe epilepsy. The methods used in this study will include magnetic resonance imaging (MRI) of the brain, electroencephalography (EEG), and transcranial magnetic stimulation (TMS).


Eligibility Criteria:
Inclusion Criteria:

* Diagnosis of mesial temporal lobe epilepsy based on the combination of clinical semiology, neuroimaging findings, and electroencephalogram results.
* At least 1 seizure with loss of awareness per 4-week period, on average, despite the use of antiepileptic drugs

Exclusion Criteria:

* Prior brain surgery or exposure to transcranial magnetic stimulation
* Rapidly progressive brain lesions
* Inability to tolerate MRI or TMS
* Specific MRI or TMS contraindication as set forth in standard protocols of our institution
Prospective and Retrospective Cohort Study of New Prognostic Factors With Peripheral Blood and Bone Marrow Evaluation at the Time of Diagnosis and During Treatment or Thereafter in Acute Leukemia (Acute Leukemia HSCT Cohort)

The objective of this study is to evaluate the prognostic factors of acute leukemia patients received stem cell transplantation and to invent the molecular genetic test for sensitive detection of minimal residual disease, and thereby this study would contribute to plan the risk adapted treatment. Patients will have samples of blood and/or bone marrow collected during treatment or thereafter


Eligibility Criteria:
Inclusion Criteria:

* Patients diagnosed with acute leukemia who underwent allo-HSCT in Severance Hospital.
* Both genders of 16 Years and older
* sign a written informed consent document
* exemption of consent in patient who died in study period.

Exclusion Criteria:

* No comprehension or willingness to sign a written informed consent document.
Localization of Nonpalpable Breast Lesions

Each year the Danish mammography-screening programme identifies a large number of patients with small non-palpable breast cancers or precancerous lesions. The majority of these patients are suitable for breast conserving surgery (BCS). The object of BCS is to remove the suspicious lesion completely without removing excess healthy breast tissue. To obtain this accurate lesion localization is essential.

Until today the standard procedure in Denmark has been wire guided localization (WGL). Although the method has been utilized for a number of years it has several disadvantages. Often inaccurate lesion localization leads to incomplete lesion removal (positive margin) and subsequently reoperation. It can postpone the additional systemic treatment, offered after the operation. Other disadvantages are poor cosmetic outcome and inconvenient planning for the patient and the departments involved. The wire needs to be placed on the day of the operation, which decreases the flexibility of the procedure.

The purpose of this study is to test a new method named radioactive seed localization (RSL). The method uses a small titanium seed containing radioactive iodine. It will be placed in the centre of the lesion, and during the operation, the surgeon can locate it with a handheld gamma probe. The seed can be placed a few days in advance, which means a more flexible course of treatment. The method seems promising with regards to reoperation rates, but it needs further testing.

Hypothesis:

RSL is a more accurate method, for localization of nonpalpable breast lesions, than WGL. Using RSL obtains, to a great extent, adequate negative margins, resulting in a reduced number of re-operations.

The study will be performed as a randomised clinical trial, where the two methods will be compared to each other. The trial will be performed at the department of breast surgery at Rigshospitalet and include patients with nonpalpable breast lesions. Besides reoperation rates, duration of the surgical procedure and the amount of removed breast tissue will be compared.


Eligibility Criteria:
Inclusion Criteria:

* Patients with nonpalpable breast lesions, carcinoma in situ or invasive carcinoma, where preoperative lesion localization is necessary.
* All age groups, minimum 18 years

Exclusion criteria:

* Patients with benign nonpalpable breast lesions.
* Patients who are unable to comprehend the information.
* Patients who are pregnant, breastfeeding or have children \< 3 years.
* Patients who have lesions, which requires more than two wires or seeds for localization.
STOP HCC: Mailed HCV Treatment Outreach Program for HCC Prevention

Aim 1: The investigators will conduct a randomized controlled trial comparing two strategies to promote HCV screening, follow-up testing, and treatment among baby-boomers (i.e. persons born between 1945-1965): inreach with electronic medical record alerts and provider education vs. combination of inreach and provider education plus mailed outreach and patient navigation.

Aim 2: The investigators will evaluate patient navigation strategies to promote follow-up testing and treatment evaluation among non-baby boomer Parkland patients (i.e. born before 1945 or after 1965) who are either: a) HCV antibody positive but have not completed follow-up viral load testing or b) HCV viral load positive and who have not completed in-clinic treatment evaluation.


Eligibility Criteria:
Inclusion Criteria:

* born between 1945 and 1965
* ≥ 1 outpatient visit during 12 months prior to randomization at Parkland
* no prior HCV screening (prior HCV antibody, viral load, or genotype).
* any active medical coverage
* speaks Spanish or English

Exclusion Criteria:

* a life expectancy less than one year including end stage CHF, end stage COPD, metastatic cancer, and those who received a palliative care or hospice referral in the past year
* history of HCC.
* non-English or Spanish speakers
* no address or phone number on file
Effects of Relaxation and Guided Imagery Training on Pain at Childbirth

The purpose of this study is to determine whether relaxation and guided imagery techniques are effective in reducing childbirth pain.


Eligibility Criteria:
Inclusion Criteria:

* women who carry their first child
* women that carry only one embryo
* women who speaks hebrew

Exclusion Criteria:

* women who experienced complications in pregnancy.
* women who planning on having an elective Caesarean section.
* women who suffer from background systematic condition (such as high-BP, diabetes).
* women who have psychiatric background.
* women who take chronic medication that might effect childbirth, woman or baby's health.
Physiopathology and Sequelae of COVID-19 Infection

The data obtained from Covid-19 infections seem to suggest that the immunogenesis of Covid-19 could in some cases be the result of immune dysregulation. On the other hand, endocrine damage is possible at the tile of Covid-19 infection (mainly thyroid,adrenal, and hypothalamus). These disorders are autoimmune or linked to degeneration.

The main objective is to assess the thyroid function (thyrotropic axis) as well as the corticotropic adrenal function of patients who have had Copvid-19 pneumonia. The secondary objectives is to describe the pathophysiological mechanisms of pulmonary and vasculothrombotic involvement of Covid-19


Eligibility Criteria:
Inclusion Criteria:

* patient having a covid19 infection hospitalized at the Amiens Picardie University Hospital
* Patient who is seen in Pneumology consultation for a respiratory assessment at 3 months of his hospitalization (between M2 and M4) to evaluate presence of respiratory sequelae
* Patient who agreed to participate in the protocol
* Patient affiliated to a Social Security

Exclusion Criteria:

* patient under guardianship or curators
* patient refusing to participate
Obesity Study to Assess Induction of Labor

There are more and more pregnant women who are obese. It is very difficult for obese women to get into labor. That is why when women are obese, half are likely to need a Cesarean delivery(C-section). Unfortunately, C-sections are more dangerous for obese women. There may be a combination of issues that cause obese women to need C-sections. We believe one of those reasons is that the womb of obese women respond differently to medications and devices compared to non-obese women. There are commonly two ways to help women get into labor. One way is a medication called misoprostol. The second way is a device called Foley balloon. In most studies, both ways are equally effective in helping women get into labor. However, these studies included everyone, and didn't focus on obese women.

So far there are no studies in this area that focus only on obese women. Therefore we need to design this study to focus just on obese women and what is the best way to help them get into labor and avoid a C-section.


Eligibility Criteria:
Inclusion Criteria:

* Morbidly obese patient (BMI≥40kg/m2) at admission for induction of labor Speaks English Gestational age between 37and0 weeks and 41and6 weeks Cervical exam: dilation \<4cm and Bishop score 6 or less Contractions \< 2 per 10 minutes

Exclusion Criteria:

* History of cesarean delivery Maternal contraindications to labor Fetal contraindications to labor Maternal age \<18yo Fetal growth restriction with abnormal umbilical artery Doppler indexes Cervical dilation ≥4cm or Bishop score ≥7 Contractions ≥3 per 10 minutes Non-reassuring fetal status Latex allergy
The Association of Gut Microbiota With COVID 19 Infection in Children

Although COVID-19 infects gastrointestinal tissues, little is known about the roles of gut commensal microbes in susceptibility to and severity of infection. The investigators will analyze the alterations in fecal microbiomes of patients with COVID-19 infection during hospitalization.


Eligibility Criteria:
Inclusion Criteria:

* patients infected with COVID 19

Exclusion Criteria:

* congenital heart, renal, intestinal disease
* malignancy
* immunologic disease
Small-diameter Closed Thoracic Drainage Tube Fixation Method

Objective: To explore the design feasibility and application effect of triple-buffer-system-fixed small-diameter (18 F) thoracic closed drainage tubes following lung wedge resection. Methods: A total of 136 patients with indwelling thoracic drainage tubes following pulmonary wedge resection were recruited, with 70 patients allocated to the control group and 66 to the experimental group. The drainage tube in the experimental group was fixed with the triple-buffer system, while that in the control group was fixed using the conventional lifting platform method. The incidence of unplanned extubation, the indwelling time of the drainage tube and the time and material costs, as well as information regarding any subcutaneous emphysema and skin tension blisters, were recorded following the operation. The pain and degree of comfort were assessed using a chi-square test and a rank sum t-test to compare the differences between the two groups.


Eligibility Criteria:
Inclusion Criteria:

* Single-port thoracoscopic wedge resection of the lung was performed for the first time
* No air leak in the lung tissue was detected
* The patient could communicate and cooperate normally.
* No local skin allergy or scar could be observed.

Exclusion Criteria:

* Patients with wide adhesion of the whole thoracic mucosa.
* Patients with postoperative or intraoperative bleeding.
* Patients with severe postoperative hypoproteinaemia or chylothorax with massive pleural effusion.
* Patients diagnosed with emphysema.
(PEKK) Framework for Mandibular Implant-supported Complete Fixed Prostheses

This clinical study aims to evaluate the effect of using PEKK (Pekkton) framework in mandibular implant-supported complete fixed dental prostheses with All-on-four treatment concept on peri-implant tissues health

The aim of this clinical study is to evaluate the effect of using PEKK (Pekkton) framework in mandibular implant-supported complete fixed dental prostheses with All-on-four treatment concept on peri-implant tissues health regarding the following parameters:

* Modified Plaque index
* Modified Gingival index
* Peri-implant probing pocket depth

Radiographic evaluation (periapical x-ray):

Marginal bone height changes

Eligibility Criteria:
Inclusion Criteria:

* Maxillary and mandibular alveolar ridges were covered with healthy, firm, relatively even thickness and even compressible mucosa and free from any signs of inflammation or flabbiness.
* Patients had completely edentulous maxillary and mandibular ridges with sufficient mandibular bone height not less than 15 mm in the interforaminal area and at least 12mm posteriorly
* All patients had sufficient inter-arch space
* All patients complained of insufficient retention and stability of their conventional mandibular dentures.
* All patients were of Angel's class I maxillo-mandibular relationship.

Exclusion Criteria:

* Patients with absolute contraindications for implant placement, such as active cancer and diseases of the immune system.
* Patients with metabolic diseases that are directly related to bone resorption, such as uncontrolled diabetes, osteoporosis, and hyperparathyroidism.
* Patients with general contraindications for surgical procedures, such as hematologic diseases, hepatic patients, patients with bleeding disorders, and serious problems with coagulation.
* Patients with a history of irradiation of the head and neck region or chemotherapy in the last 3 years were also excluded.
* Patients with relative contraindications such as a history of parafunctional habits (such as bruxism and clenching), smoking, alcoholism, and patients with any physical reasons that could affect follow-up.
* Patients with local contraindications for implant placement, such as localized bone defects.
Early Diagnosis of Diastolic Dysfunction and Reliability of DSE in Detecting Stress Diastolic Dysfunction

The heart becoming "stiff" due to increased fibrous tissue or decreased elasticity of the heart tissue is one of the earliest changes caused by heart failure. These changes can be detected by simple non-invasive echocardiogram techniques. However, these techniques usually detect the increased "stiffness" of the heart only after it has progressed to a significant extent. The investigators hypothesize that if they stress the heart using a Dobutamine infusion and measure the filling pressure using echocardiogram, it will provide them with tools to identify these changes earlier.

The heart becoming "stiff" due to increased fibrous tissue or decreased elasticity of the heart tissue is one of the earliest changes caused by heart failure. These changes can be detected by simple non-invasive echocardiogram techniques. However, these techniques usually detect the increased "stiffness" of the heart only after it has progressed to a significant extent. The investigators hypothesize that if they stress the heart using a Dobutamine infusion and measure the filling pressure using echocardiogram, it will provide them with tools to identify these changes earlier.

The investigators are planning to include people have normal heart function. It is standard procedure to measure cardiac pressure during catheterization. Simultaneously, the investigators will infuse Dobutamine (standard drug used for chemical stress testing, DSE). This drug increases the heart rate and mimics exercise in normal humans who are unable to exercise for various reasons. The investigators would continue to monitor the pressure inside the heart as they infuse Dobutamine and see of there is an increase in filling pressure. The investigators will correlate the invasive pressures with their echo derived measurements.

The investigators plan to include 25 veterans in this study. For each individual the study would increase the amount of time they will spend in the Catheterization Lab from 30 to 120 minutes. The entire procedure will be monitored by Advanced Cardiac Life Support (ACLS) certified nurses and doctors.

Eligibility Criteria:
Inclusion Criteria:

* Prospectively enroll 25 veterans age range from 18 to 65 who are found to have normal left ventricular (LV) systolic function and no significant coronary artery disease by cardiac catheterization.
* Subjects identified during routine cardiac testing to have significant diastolic dysfunction may also be enrolled to rule out coronary disease and study DSE -invasive pressure correlations.

Exclusion criteria:

* Patients with LV systolic dysfunction, severe coronary lesions (\> 50%), uncontrolled hypertension (BP \> 160/100) and significant pulmonary hypertension (PASP \> 50 mmHg) would be excluded.
* Subject will not be included if they have a significant rhythm abnormality, frequent premature ventricular complexes, atrial fibrillation and technical reasons in the catheterization laboratory which preclude the study protocol.
The Potential Role for Adenosine in the Haemodynamic Effects of Free Fatty Acids

The metabolic syndrome is associated with hyperdynamic circulation and sympathetic activation. Recently, Bakker et al. (Atherosclerosis 2002) described the hypothesis that free fatty acids are responsible for this association. The investigators hypothesize that in patients with obesity and the metabolic syndrome, an increased intracellular concentration of long-chain fatty acyl (LCFA)-CoA (the intracellular equivalent of free fatty acids) induces an increase in adenosine. Adenosine receptor stimulation, in turn, induces vasodilation and sympathetic activation.

The investigators aimed to assess this effect of free fatty acids on the adenosine system in healthy volunteers.


Eligibility Criteria:
Inclusion Criteria:

* Healthy volunteers

Exclusion Criteria:

* Pregnancy
* Asthma
* Use of medication
* Cardiovascular/pulmonary disease and diabetes