cyrilzakka/clinical-trials huggingface dataset:
Piloting a Virtual Navigation (VN) System for Bronchoscopic Lung Nodule Sampling

The overall goal is to evaluate the role of a Virtual Navigation (VN) system (the Virtual Navigator) in the bronchoscopic evaluation and tissue sampling of lung cancer and other chest lesions at the Penn State Hershey Medical Center (HMC). The Virtual Navigator is a software package that runs on a mobile Windows-based computer. The computer takes in up to four clinical image/video sources, ordered by the clinician for clinical purposes: 1) 3D CT (computed tomography) imaging scan; 2) 3D PET (positron emission tomography) imaging scan (optional); 3) Bronchoscopic video of the airway tree interior; 4) Ultrasound video of scanned anatomy outside the airways, as provided by an endobronchial ultrasound (EBUS) probe (optional). During a live guided procedure, the Virtual Navigator presents images that assist with navigating the bronchoscope to predesignated chest lesions.

Lung cancer patients that present a suspicious peripheral tumor on their chest CT scan are often prescribed to undergo a diagnosis-and-staging bronchoscopy, whereby the bronchoscopist examines both the suspect tumor and any identified central-chest lymph nodes. For the clinical study, we consider bronchoscopy performance for two cohorts: 1) a cohort of consented patients who undergo image-guided bronchoscopy via the Virtual Navigator; and 2) a historical controls cohort consisting of patients who underwent bronchoscopy recently at our medical center (state-of-the-art bronchoscopy practice). The study's general hypothesis is that an image-guided bronchoscopy system (the Virtual Navigator) that integrates 3D imaging, bronchoscopy, and EBUS images enables more complete evaluation and sampling of chest lesions than current state-of-the-art clinical techniques. More specifically, for peripheral-tumor diagnosis, the sub-hypothesis is that the VN system increases diagnostic biopsy yield as compared to state-of-the-art bronchoscopy practice; for central-chest nodal staging, the sub-hypothesis is that the VN system enables the sampling of more lymph nodes than state-of-the-art bronchoscopy practice.


Eligibility Criteria:
Inclusion Criteria:

* patients from age 18 and over
* a planned clinical bronchoscopy to evaluate abnormal lung parenchyma and/or central chest lymph nodes
* a clinical CT scan performed at Hershey Medical Center that meets technical specifications and is available on the Radiology research server
* (Optional, use if available) CT/PET images that meet technical specifications and are available on the Hershey Medical Center clinical image storage system

Exclusion Criteria:

* inability to give consent
* the CT scan does not meet technical specifications
Empagliflozin and Dapagliflozin in Patients Hospitalized for Acute Decompensated Heart Failure

National, multicenter, randomized, double-blind, parallel-group, stratified by SGLT-2 inhibitor type, placebo-controlled trial, - a Phase III study. Primary objective of the study is to investigate the impact of SGLT-2 inhibitors (Empagliflozin and Dapagliflozin) on clinical endpoints in patients hospitalized with acute/decompensated HF.


Eligibility Criteria:
Inclusion Criteria:

* Patients 18 years of age with the capacity to provide written informed consent
* Currently hospitalized for a primary diagnosis of acute/decompensated HF (HFrEF, HFmrEF,HFpEF), including symptoms and signs of fluid overload regardless of ejection fraction or diabetes status
* In patients with HFpEF the diagnosis has to be confirmed according to the current HFpEF definition (by non-invasive testing: evidence of structural or functional changes in the heart as evidenced on echocardiography or by invasive testing as LVEDP assessment or right heart catheterisation).
* Randomized no earlier than 24 hours and up to 10 days after initial presentation while still hospitalized
* Stable as defined by: systolic blood pressure (SBP\>100 mmHg for the preceding 6 hours)
* No intensification of IV diuretics within the last 6 hours,
* No use of IV vasodilators within the last 6 hours,
* No use of IV inotropes or levosimendan within the last 24 hours prior to randomization
* Elevated NT-proBNP \>600 pg/mL during the current hospitalization in patients with HFrEF and \>300 pg/mL in patients with HFmrEF or HFpEF (or above 900 pg/ml if atrial fibrillation is present at admission independently from EF).
* eGFR \>20 ml/min/1,73m2

Exclusion Criteria:

* History of ketoacidosis
* Type 1 diabetes
* SGLT-2 Inhibitor at baseline or known allergy to SGLT-2 Inhibitors
* Current active cancer with less than 2 years of life expectancy
* Pulmonary embolism, cerebrovascular accident as the primary trigger for the current hospitalization
* Cardiomyopathy based on infiltrative diseases (e.g. amyloidosis), accumulation diseases (e.g. haemochromatosis, Fabry disease), muscular dystrophies, cardiomyopathy with reversible causes (e.g. stress cardiomyopathy), hypertrophic obstructive cardiomyopathy or known pericardial constriction
* Any severe (obstructive or regurgitant) valvular heart disease, expected to lead to surgery during the trial period
* Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant
* Blood pH\<7.32
* \>1 episode of severe hypoglycaemia within the last 6 months under treatment with insulin or sulfonylurea
* Acute symptomatic urinary tract infection or genital infection
Evaluation of Communication Functions in Children With Cerebral Palsy

In this study, investigators aimed to evaluate the communication functions of children between 2-18 with cerebral palsy. Investigators planned to investigate the relationship between communication skills and clinical characteristics and socio-demographic status of the family.

Cerebral palsy (CP) is a non-progressive, movement-limiting loss of permanent motor function, posture and movement disturbance in the developing brain due to lesion or injury that occurs during the intrauterine period or in the first months of life. Secondary medical problems such as epilepsy, mental retardation, behavior disorder, swallowing problems and musculoskeletal disorders may be seen in these patients. Neuroanatomical problems in the muscles associated with the mouth and speech, and the presence of central pathologies, are important problems in patients with cerebral palsy. Monitoring the communication level of these patients is very important for determining treatment protocols and monitoring their effectiveness. Difficulties in communication significantly affect the rate and level of recovery in patients with cerebral palsy. There are many different scales to analyze communication level and problems in children with cerebral palsy. The most commonly used ones are the Communication Function Classification System (CFCS) and the Functional Communication Classification System (FCCS). By examining the communication level in 5 categories in both scales, it helps to monitor the communicative development of the child and also provides a common language among clinicians. They are defined by the World Health Organization (WHO) and focus on the levels of activity and participation defined in the international classification of function, disability and health.

The aim of this study was to evaluate the communication level in children over 2 years of age with cerebral palsy. In addition, the relationship between communication skills and general functional levels and demographic characteristics will be investigated. In this way, both the general communication level of this patient group and the possible factors affecting this skill will be analyzed. Thus, these relationships and measurements can be utilized in determining treatment and rehabilitation protocols.

Eligibility Criteria:
Inclusion Criteria:

* Patients whose parents agreed to participate in the study.
* Patients with confirmed cerebral palsy.
* Patients aged 2-18 years.

Exclusion Criteria:

* Patients without definite cerebral palsy.
* Patients whose family refused to participate in the study.
* Patients with another neurological disorder that may affect their physical and neurological capacity.
HP 129Xe MRI for Evaluation of CLAD in Lung Transplant Recipients

To evaluate the feasibility of hyperpolarized 129Xe MRI in lung transplant recipients and assess structural and functional pulmonary changes using hyperpolarized 129Xe MRI

Lung transplantation is an effective treatment for end-stage lung disease. However, median survival post-LTx is 6 years. This is primarily due to chronic lung allograft dysfunction (CLAD).

Clinical management of LTx recipients is focused on identifying early risk factors for CLAD, by monitoring graft function with spirometry and transbronchial biopsies. However, both have significant limitations.

Hyperpolarized (HP) noble gas lung MRI (3He and 129Xe) allows mapping of both lung anatomy and function. 129Xe-MRI could provide a diagnostic tool that is able to detect CLAD more sensitively and earlier than the current gold standard measurements of spirometry and plethysmography, and thus allow a means to detect and prevent /slow down irreparable and irreversible damage to the lungs in the early stages of disease.

Eligibility Criteria:
Inclusion Criteria:

* Patients, deemed clinically stable by the lung transplant team at UHN Toronto Lung Transplant Program (TLTP), 18 years of age or older
* Double lung transplant recipient
* For the 5 CLAD-free participants - at least 1 year of follow-up post-LTx and no substantial and persistent FEV1 decline (as per the ISHLT CLAD definition).
* For the 10 participants with CLAD - prior diagnosis of CLAD made by the clinical team (member of the TLTP).
* PFT measurements within 1 month of scan visit.
* FEV1 \> 1.0 L

Exclusion Criteria:

* Currently pregnant or lactating
* Psychiatric or addictive disorders that would preclude obtaining informed consent or adherence to protocol
* Inability to travel to obtain MRI scan
* Any contraindications to MRI including but not limited to severe claustrophobia, implanted devices, aneurysm clips, neurostimulators (patients will be prescreened prior to registration).
* Baseline oxygen saturation of less than 88%.
* Requiring supplemental oxygen at baseline
An Investigational Study to Evaluate Experimental Medication BMS-986165 Compared to Placebo in Participants With Plaque Psoriasis (POETYK-PSO-3) in Mainland China, Taiwan, and South Korea

The purpose of this study is to investigate the experimental medication BMS-986165 compared to placebo in participants with moderate to severe plaque psoriasis in mainland China, Taiwan, and South Korea


Eligibility Criteria:
Inclusion Criteria:

* Plaque psoriasis for at least 6 months
* Moderate to severe disease
* Candidate for phototherapy or systemic therapy

Exclusion Criteria:

* Other forms of psoriasis
* History of recent infection
* Prior exposure to BMS-986165

Other inclusion/exclusion criteria may apply.
Bone Marrow Transplantation in Treating Patients With Multiple Myeloma, Chronic Phase Chronic Myelogenous Leukemia, or Agnogenic Myeloid Metaplasia

RATIONALE: Bone marrow transplantation may be able to replace immune cells that were destroyed by the chemotherapy or radiation therapy that was used to kill cancer cells.

PURPOSE: Phase II trial to study the effectiveness of allogeneic bone marrow transplantation in treating patients who have multiple myeloma, chronic phase chronic myelogenous leukemia, or agnogenic myeloid metaplasia.

OBJECTIVES:

* Determine the efficacy of allogeneic bone marrow transplantation (BMT) following high-dose cyclophosphamide and total body irradiation in patients with multiple myeloma, agnogenic myeloid metaplasia, or chronic myelogenous leukemia in first or second chronic phase.
* Determine the efficacy of BMT following busulfan and cyclophosphamide in these patients.
* Determine the toxic effects of these preparative regimens in these patients.

OUTLINE: Patients are stratified by remission (first vs second vs third).

Patients who have not undergone prior radiotherapy receive cyclophosphamide IV on days -6 and -5 and then undergo total body irradiation twice a day on days -4 to -1. Allogeneic bone marrow is infused on day 0.

Patients who have undergone prior radiotherapy receive oral busulfan every 6 hours on days -7 to -4 or -6 to -3 and cyclophosphamide IV over 2 hours on days -3 and -2. Allogeneic bone marrow is infused on day 0.

Patients are followed at days 30 and 90, at 6 months, and then annually thereafter.

PROJECTED ACCRUAL: A total of 20-30 patients will be accrued for this study within 2 years.

Eligibility Criteria:
DISEASE CHARACTERISTICS:

* Cytologically proven disease of one of the following types with transfusion-dependent anemia or thrombocytopenia (less than 50,000/mm\^3):

  * Multiple myeloma
  * Agnogenic myeloid metaplasia
  * Chronic myelogenous leukemia in first or second chronic phase

    * Philadelphia chromosome with BCR gene rearrangement
* Suitable sibling bone marrow donor available

PATIENT CHARACTERISTICS:

Age:

* 15 to physiologic 55

Performance status:

* ECOG 0 or 1

Life expectancy:

* Not specified

Hematopoietic:

* See Disease Characteristics

Hepatic:

* Bilirubin no greater than 2.0 mg/dL
* SGOT less than 2 times normal
* Alkaline phosphatase less than 2 times normal

Renal:

* Creatinine less than 2 mg/dL

Cardiovascular:

* Ejection fraction normal by MUGA
* No acute myocardial infarction within the past 6 months
* No active angina pectoris
* No active congestive heart failure

Pulmonary:

* FEV greater than 50% predicted
* DLCO at least 50%

Other:

* HIV negative
* No active infection
* No concurrent organ damage or medical problems that would preclude therapy

PRIOR CONCURRENT THERAPY:

* Not specified
High Fiber in Parkinson's Disease

The purpose of the research is to determine the effects of a high-fiber nutritional supplement (HFS) on the bacteria, viruses, and fungi that live in different regions of the body in those with Parkinson's disease (PD). We will compare the bacteria, viruses, and fungi of those with PD to those without PD (healthy controls). We will also examine the effects of transplanting stool from humans into laboratory mice with or without Parkinson-like pathology to understand how the microbiome influences the brains of animals. We can use this information to get a better understanding of how changing the microbiome might help humans.


Eligibility Criteria:
Inclusion Criteria:

* Parkinson's disease patients who are untreated

Exclusion Criteria:

* Occupation expected to change the microbiome (e.g. sanitation worker)
* Treatment with medications that may induce parkinsonism (e.g. metoclopramide, typical or atypical antipsychotic agents)
* Treatment within 12 weeks with oral or intravenous antibiotics
* Known diagnosis of inflammatory bowel disease
* Symptomatic organic gastrointestinal (GI) disease (other than hemorrhoids and hiatal hernia) or abdominal surgeries for symptomatic gastrointestinal disease such as bowel resection, diverticular surgery, colostomy; subjects with a history of an appendectomy or gallbladder removal for non-cancerous disease more than 5 years prior to presentation are allowed.
* Symptomatic functional GI disease that significantly impairs intestinal motility such as scleroderma or use of GI motility drugs
* Acute illness requiring immediate hospitalization
* Pre-existent conditions as below:
* Liver disease (cirrhosis or persistently abnormal AST or ALT that are 2X\> normal);
* Kidney disease (creatinine\>2.0 mg/dL);
* Uncontrolled psychiatric illness;
* Clinically important lung disease or heart failure;
* HIV disease;
* Alcoholism, unreliable drinking history; or consumption of alcohol more than 3 times a week or binge drinking or drinking more than or equal to 3 drinks per occasion;
* Transplant recipients;
* Diabetes;
* BMI \> 30
* Clinically significant dehydration or clinically detectable ascites or peripheral edema or cardiac failure
* Presence of short bowel syndrome or severe malnutrition with ideal body weight \< or = 90%
* Use of immunosuppressive medications in 3 months prior to enrollment
* Anti-inflammatory medication use within 3 weeks of enrollment.
* Chronic use of diuretics
Influence of the Education in Layperson in Out of Hospital Resuscitation

Cardiac arrest occurs frequently and the outcome after out-of-hospital resuscitation is often fatal. Disturbing is that more than half of the surviving patients suffer from permanent impairment of cognitive functions, such attention, memory and executive functioning. With all the efforts to achieve a high quality initial resuscitation management the time delay between cardiac arrest and the beginning the initial resuscitation maneuver is the main reason for the still poor outcome. To shorten this fatal time delay, current efforts of national and supranational health authorities aime at the non-medically trained lay person, who should carry out basic life support directly on the scene supported by the use of public available semi-automatic defibrillators (AED).

It is a combined retrospective and prospective observational single center study. Data of all Out of Hospital patients suffered a cardiac arrest in Zurich city will be collected according to the Utstein criteria. The aim of this study is to investigate the impact of trained police forces in the resuscitation outcome.

Eligibility Criteria:
Inclusion Criteria:

* All Out of hospital patients suffering cardiac arrest in Zurich City, resuscitated by lay persons, city police and or trained emergency medical services

Exclusion Criteria:

* individuals with cardiac arrest occurring in the presence of EMS
* individuals in whom there were apparent toxic, traumatic or suicidal etiologies for unconsciousness
* drowned individuals and individuals with terminal illness
* documented negation of data collection
Magnesium Sulphate in the Ultrasound-guided Supraclavicular Brachial Plexus Block

This study evaluated the motor and sensory block duration and the postoperative analgesic effects of adding Magnesium Sulphate to bupivacaine in the ultrasound-guided supraclavicular brachial plexus block Anesthesia. Motor and sensory block duration were considered as a primary endpoint.

The supraclavicular approach to the brachial plexus provides more consistent and effective regional anesthesia to the upper extremity than other approaches to brachial plexus blockade. However, the fear of pneumothorax is often cited by anesthetists as a reason to avoid this approach. With increasing affirmation on patient safety and better patient outcomes, ultrasound guided regional anesthesia (UGRA) is becoming more widely popular. Ultrasound provides clinicians with a real time image suitable for visualizing anatomical structures, needle placement, and local anesthetic spread. Ultrasound-guidance to supraclavicular brachial plexus block has shown to increase success rates, reduce the volume of local anesthetic (LA) used and has the potential to minimize the risk of complications.

Although there are many treatment choices for postoperative pain, a gold standard has not been established. Prolonging the duration of peripheral nerve blocks using long-acting Local Anesthesia or perineural catheters can be used. However, perineural catheters are more time-consuming, costly, has possible higher complication rates (e.g. Infection), and needs more postoperative care.

Several adjuvants such as fentanyl, alpha-2 adrenergic agonists (clonidine or dexmedetomidine), tramadol, and magnesium have been used to extend the duration of peripheral nerve blocks. 5-7 Magnesium has antinociceptive effects in animal and human models, principally related to blocking the N-methyl-D-aspartate (NMDA) receptors and regulation of calcium influx into cells. Calcium influx leads to a sequence of central sensitization such as windup phenomenon and long term potentiation which are crucial mechanisms that determine the duration and intensity of post-operative pain. Magnesium prevents central sensitization triggered by peripheral nociceptive stimulation in response to painful stimuli.

The investigators designed this study to evaluate the effect of adding magnesium sulphate to bupivacaine in the ultrasound-guided supraclavicular brachial plexus block anesthesia. The sensory and motor block durations were evaluated as primary endpoints and the postoperative analgesic effects as a secondary endpoint.

Eligibility Criteria:
Inclusion Criteria:

1. - ASA physical status I to II,
2. - Patients listed for elective forearm or hand surgery using supraclavicular brachial plexus block anesthesia

Exclusion Criteria:

1 - evidence of severe cardiovascular, renal, or hepatic diseases, preexisting neurological or psychiatric illnesses.

2- patients have allergy to the study drugs. 3 - patients who have any contraindications to brachial plexus block anesthesia.

4- pregnant or lactating women, or 5- if the BMI was \> 35 kg/m2.
Assess the Safety, Efficacy, and Pharmacokinetics of Immediate and Delayed Release Weekly Risedronate

To compare the efficacy 50 mg delayed-release risedronate tablet, dosed immediately after breakfast, to a 35 mg immediate-release tablet, administered according to labeling instructions.

To compare the efficacy, based on the bone turnover marker (BTM) serum Type I collagen C-telopeptide (CTx), of a 50 mg delayed-release risedronate tablet, administered immediately after a typical breakfast, to that of a 35 mg immediate-release tablet, administered according to labeling instructions (ie, at least 30 minutes prior to breakfast) in postmenopausal women after 13 weeks of treatment.

Eligibility Criteria:
Inclusion Criteria:

* In generally good health, as determined by medical history, physical examination, and laboratory test results
* Postmenopausal greater than 2 years, naturally or surgically based on medical history.

Exclusion Criteria:

* Used any of the following medications within 3 months prior to dosing or used any of the following medications for more than 1 month at any time within 6 months prior to dosing:

  * oral or parenteral glucocorticoids (5 mg prednisone or equivalent/day)
  * anabolic steroids
  * estrogens (oral, skin patch, or gel), except for low dose vaginal products or insertable estrogen ring, selective estrogen-receptor modulators, or estrogen-related drugs
  * progestins
  * calcitonin
  * vitamin D supplements
  * calcitriol, calcidiol, or alfacalcidol at any dose
  * any bisphosphonate
  * fluoride
  * strontium
  * parathyroid hormone, including teriparatide
Awareness of Parents About Management of Dental Avulsion

Aim of the study:

assessment of level of awareness of parents about emergency management of permanent teeth avulsion in children

our study asses level by awareness of parents about emergency management of dental avulsion through questionnaire , the study will be done in diagnosis clinic of faculty of oral and dental medicine Cairo university

Eligibility Criteria:
Inclusion Criteria:

* parents who have children aged from 6 to 12 years

Exclusion Criteria:

* parents who refused to participate in questionnaire
* parents who have children above or below this age