cyrilzakka/clinical-trials huggingface dataset:
Use of Combined Prone Positioning and High-Flow Nasal Cannula, and Non-invasive Positive Pressure Ventilation to Prevent Intubation in COVID-19 Infection

This research aims to understand if prone positioning combined with high-flow nasal cannula (HFNC) or non-invasive positive pressure ventilation (NIPPV) safely reduce the rate of intubation in acute hypoxemic and/or hypercapnic respiratory failure secondary to COVID-19 infection.


Eligibility Criteria:
Inclusion Criteria:

* Patients with confirmed COVID19 infection or suspected COVID19 infection.
* Patients requiring HFNC or NIPPV
* Patients who are clinically stable and able to tolerate the changes in position that are routinely conducted as part of the standard of care in the medical ICU.
* Patient should be able to provide informed consent to the study. Any participant speaking any language will be offered participation.
* Able to actively participate in Assisted Manual Pronation Therapy per nursing assessment.

Exclusion Criteria:

Contraindication for prone positioning:

* Intracranial pressure \>30 mm Hg or cerebral perfusion pressure \<60 mmHg
* Massive hemoptysis requiring an immediate surgical or interventional radiology procedure
* Tracheal surgery or sternotomy during the previous 15 days
* Serious facial trauma or facial surgery during the previous 15 days
* Deep venous thrombosis treated for less than 2 days
* Cardiac pacemaker inserted in the last 2 days
* Unstable spine, femur, or pelvic fractures
* Hemodynamic instability or severe cardiac arrhythmia (chronic AFib is not a contraindication). Mean arterial pressure lower than 60 mm Hg, \>1 vasopressor agent or Norepinephrine equivalent dose \>0.06 mcg/kg/min
* Pregnant women
* Single anterior chest tube with air leaks
* Burns on more than 20 % of the body surface
* Delirium or altered mental status increasing fall risk while in prone position.
* End-of-life decision before inclusion
* Subject deprived of freedom, minor, subject under a legal protective measure
* Unable to actively participate in Assisted Manual Pronation Therapy per nursing assessment
* Lacking capacity to provide informed consent.
* Individuals with mechanical or vascular disease precluding safe displacement of the head, for example: cervical spinal fusion, limited range of motion, or severe vascular occlusive disease of the head and neck.
* Body mass index (BMI) greater than 70 kg/m2, or unable to actively participate in Assisted Manual Pronation Therapy per nursing assessment at any BMI value.
Stroke - Sleep Disorders, Dysfunction of the Autonomic Nervous System and Depression

The purpose of this study is to investigate sleep disordered breathing, autonomic dysfunction, and post stroke depression in acute and chronic stroke patients. Furthermore, to explore the interaction between these comorbidities, and their relation to stroke aetiology.

Up to fifty percent of stroke patients suffer less noticeable comorbidities after the acute phase of a stroke and often the rest of their life. It concerns sleep disordered breathing (SDB), post stroke depression (PSD), and dysfunction of the autonomic nervous system. These comorbidities are seldom recognized, but are associated with a poorer outcome after stroke, reduced quality of life as well as an increased risk of new vascular events.

Little is known about the course of the comorbidities, the relationship between the mentioned diseases or which patients are more commonly affected.

The investigators will investigate the following hypotheses, and assess the results compared to the stroke aetiology:

1. Stroke patients with SDB have an impaired autonomic function
2. Stroke patients with SDB have an increased risk of PSD
3. Stroke patients with autonomic dysfunction have an increased risk of PSD

The investigators will examine stroke patients for signs of sleep disordered breathing, autonomic dysfunction and depression, both in the acute phase (days), in the chronic phase (months) and the very chronic state (years). Thereby the investigators can map the comorbidities course over time. At the same time the patients will be tested for peripheral small and large artery disease as well as MRI will be used to investigate sign of cerebral small vessel disease.

Based on power calculations 335 individuals will be enrolled in order to satisfy the project requirements.

Eligibility Criteria:
Inclusion Criteria:

• Clinical stroke either ischaemic or haemorrhagic

Exclusion Criteria:

* Transitory ischemic attac
* Congenital or acquired brain disease, other than stroke
* Dementia
* Mental retardation
* Fatal stroke or severe comorbidities with short expected life
* Pregnancy or breastfeeding
* Altered consciousness e.g. delirium or status epilepticus
* Other cause of the patient, according to the investigator believes, can not complete the study
Adjunctive Game Intervention for Anhedonia in MDD Patients

This is a pilot study using game intervention as an adjuvant treatment, to evaluate the effect of the video game on anhedonia and associated functional change of brain in patients with depression. Participants will be randomized to Experimental group receiving a 8-week treatment of antidepressant drugs and game intervention, or Control group receiving a 8-week treatment of antidepressant drugs. Magnetic resonance imaging scanning and assessment of clinical characteristics and cognitive function were conducted before and after the intervention.

Depression is a serious mental health problem that affects millions of people globally. Anhedonia, a core symptom of depression, is the loss of pleasure or interest in enjoyable activities. The presence of anhedonia is a risk factor of poor outcome of depression. Although some patients reach remission after treatment, anhedonia still persists as a residual symptom. It is generally believed that the frontal-striatal pathway plays an important role in the reward system of brain in patients with depression. The mechanism of anhedonia is closely related to the function of the brain's reward system dopamine. There have been some research showed benefits of playing video games on brain. Video games can modulate negative emotions and increase positive feelings. Previous studies have confirmed that playing games will activate the release of dopamine in striatum. "Dancing Line" is a commercial music game. Participants need to change the direction of target according to the music by tapping the screen and manage to finish the routes and get the gems along the route as much as possible. Sometimes the view of participants would change during the game. The game is simple for participants to pick up and there is no need for prior gaming experience. The main purpose of the study is to explore the effect of game as an adjuvant treatment on anhedonia, depressive symptoms, cognitive function and associated functional change of brain in patients with depression.

Eligibility Criteria:
Inclusion Criteria:

* a diagnosis of Major Depressive Disorder according to DSM IV or V and validated via Mini International Neuropsychiatric Interview (M.I.N.I.)
* right handedness
* capability of understanding and finishing self-rating scales
* capability of providing informed consent

Exclusion Criteria:

* any other major psychiatric disorders following DSM-5 diagnostic criteria
* neurological diseases
* a history of drug abuse
* suicidal risk
* pregnancy
* any contraindication for brain MRI scan.
Combination COMBO Endoscopy Oropharyngeal Airway with High-Flow Nasal Cannula Oxygenation in Sedated Gastrointestinal Endoscopy for Obese Patients

Hypoxia is the most common adverse event during propofol sedation for gastrointestinal endoscopy, particularly in obese patients.

A recent innovation in this domain is the COMBO Endoscopy Oropharyngeal Airway-a multifaceted device that encompasses capnography monitoring, bite block , oxygenation support, and oropharyngeal airway management.

This device has been purposefully designed to cater to the unique requirements of endoscopic procedures. The principal objective of this study is to evaluate the efficacy of the COMBO Endoscopy Oropharyngeal Airway in combination with High-Flow Nasal Cannula Oxygenation for reducing the incidence of hypoxia in obese patients undergoing gastrointestinal endoscopy under sedation.


Eligibility Criteria:
Inclusion Criteria:

* Age 18≤ Age ≤70.
* BMI ≥ 35 kg/m².
* The ASA classification ranges from I to III.
* Patients have signed the informed consent form.
* Patients undergoing gastroendoscopy and colonoscopy procedure.
* The estimated duration of the procedure does not exceed 45 minutes.

Exclusion Criteria:

* Patients who exhibit contraindications to oropharyngeal airway ventilation, such as coagulation disorders, a predisposition to oral and nasal bleeding, mucosal damage, or anatomical constraints impeding oropharyngeal channel placement.
* Severe cardiac insufficiency, defined as a maximal exercise capacity of less than 4 metabolic equivalents (METs).
* Profound renal insufficiency necessitating preoperative dialysis.
* A confirmed severe liver dysfunction.
* Patients diagnosed with chronic obstructive pulmonary disease (COPD) or those presently experiencing other acute and chronic pulmonary conditions necessitating prolonged or intermittent oxygen therapy.
* Elevated intracranial pressure.
* Upper respiratory tract infections, encompassing the oral, nasal, and pharyngeal regions.
* Fever, defined as a core body temperature exceeding 37.5 degrees Celsius.
* Pregnancy or lactation.
* Hypersensitivity reactions to sedatives like propofol or medical equipment such as adhesive tape.
* Urgent surgical intervention.
* Polytrauma.
* Peripheral oxygen saturation (SpO2) levels below 95% while breathing room air preoperatively.
* BMI\<35 kg/m².
* Patients with a documented history of substance abuse, specifically drugs and/or alcohol, within the two years preceding the commencement of the screening period. Substance abuse in this context is defined as consuming more than three standard alcoholic beverages daily, roughly equivalent to 10g of alcohol or 50g of Chinese Baijiu.
* Patients with a history of mental and neurological disorders, including but not limited to depression, severe central nervous system depression, Parkinson's disease, basal ganglia lesions, schizophrenia, epilepsy, Alzheimer's disease, and myasthenia gravis.
* Presently engaged in concurrent participation in additional clinical trials.
* Patients considered ineligible by researchers for inclusion in this clinical trial.
Prevention of Paclitaxel-induced Peripheral Neuropathy in Breast Cancer Patients

Paclitaxel-induced peripheral neuropathy (PIPN) is one of the most dose-limiting side effects; it causes patients discomfort and pain and sometimes causes the termination of the chemotherapy cycles, leading to treatment failure. A lot of interventions have been tried to prevent PIPN, ensure complete administration of the chemotherapy cycles, and increase the survival rate. One of the promising interventions in the prevention of PIPN is Losartan. Losartan is an angiotensin receptor blocker (ARBs) and is used to treat hypertensive patients. There is strong evidence from different preclinical studies and retrospective cohort studies that Losartan has a neuroprotective effect.

The purpose of our study is to investigate the efficacy of Losartan in the prevention of peripheral neuropathy associated with Paclitaxel treatment in Breast Cancer patients.


Eligibility Criteria:
Inclusion Criteria:

* Females older than 18 years diagnosed with biopsy-confirmed breast cancer (Early breast cancer eligible for adjuvant or neoadjuvant) who are scheduled to receive paclitaxel 80 mg/m2.

Exclusion Criteria:

* Known hypersensitivity to Losartan.
* Not Known Hypertensive patients
* Not Known Diabetic patients
* Treatment with Losartan/ARBs/ACE-I prior to the study.
* Previous neuropathy
* Renal impairment (Serum creatinine \> 2 mg/dl)
* Significant liver disease: liver enzymes 2 folds the upper normal limit
* Metastatic breast cancer
* Pregnancy or lactation
* Taking other medication for neuropathic pain
* Significant Hypotension
Effects of a Rehabilitation Program on Immune Activation and Mood in Heart Failure Patients

The aim of this descriptive study is to examine potential changes regarding inflammatory cytokine levels, depressive symptoms and quality of life over the course of the 4-week inpatient rehabilitation program which includes a cassette of modalities including counseling, psychosocial education and supervised exercise training as a main pillar, and to further investigate if there are correlations between changes in immune regulation, depressive symptoms and quality of life.


Eligibility Criteria:
Inclusion Criteria:

* Diagnosis of heart failure with reduced ejection fraction (HFREF) with an EF ≤ 45%, NYHA (New York Heart Association) I - III; ACC/AHA (American College of Cariology/ American Heart Association) stage C, irrespective of etiology
* Clinically stable patients without deterioration or hospitalization due to heart failure within the last 4 weeks
* Neuro-hormonal medication according to the ESC (European Society of Cardiology) guidelines for the treatment of chronic heart failure consisting of antagonists of the Renin-Angiotensin-Aldosterone System (RAAS) and beta-blockers as indicated.
* Ability to fully understand all elements of and sign the written informed consent before initiation of the study

Exclusion Criteria:

* Fluid retention of cardiac decompensation, necessitating i.v. diuretic therapy
* Myocardial infarction within the last 2 months
* Surgery including cardiovascular or valvular surgery within 3 Months
* Uncontrolled proinflammatory comorbidities (e.g. Diabetes mellitus HbA1c \>9%, COPD ( chronic obstructive pulmonary disease) \>II, active rheumatic diseases and autoimmune disorders)
* Current infectious diseases ( e.g. pneumonia, COPD exacerbations or urinary tract infections)
* Morbid obesity: BMI \> 40
* Alcohol or drug abuse
* psychiatric disorders
A Study of Ibandronate [Bonviva/Boniva] and Alendronate in Female Patients With Post-Menopausal Osteoporosis

This observational study will assess the compliance and persistence of patients, real life efficacy and safety of intravenously quarterly administered 3 mg ibandronate \[Bonviva/Boniva\] in comparison to oral alendronate generics in female patients with post-menopausal osteoporosis. The anticipated time of assessment is 12 months. The target sample size is 5000-7000 patients.


Eligibility Criteria:
Inclusion Criteria:

* Adult patients, \>/= 55 years of age
* Postmenopausal osteoporosis
* Patients who are in the opinion of the physician eligible to participate in this study

Exclusion Criteria:

* N/A
Musculoskeletal Disorders Among Egyptian Anesthesiologists

This cross-sectional online survey questionnaire based study for Prevalence and risk factors of work related musculoskeletal disorders among Egyptian anesthesiologists.

This cross-sectional online survey questionnaire based study will be approved by medical ethical committee of Sohag faculty of medicine. Survey participants will be reassured that all data collected are for research purposes. Responses will be voluntary anonymous and have no identifying data. Egyptian anaesthesiologists will be invited through social media to participate in the survey.

Eligibility Criteria:
Inclusion Criteria:

* Egyptian anesthesiologists on clinical practice

Exclusion Criteria:

-
Efficacy of Chinese Ocular Exercise on Visual Acuity and Ocular Accommodation in Myopic Teenager

To assess whether Chinese ocular exercise is effective in altering distant and near visual acuity, ocular accommodation and visual symptoms in myopic teenager, and thus might have the possibility of slowing myopia progression in teenager through a weak but long-term effect.

Myopia is a public health problem worldwide, especially in some Asian countries like China, Singapore, and Japan. Chinese ocular exercise, originating in 1963 with the theory of Traditional Chinese Medicine, is a kind of massage on acupuncture points around the eye to prevent myopia and alleviate visual fatigue. The exercise has been spread as a community ritual and living habit of primary and high school students for nearly half a century. However, the prevalence of myopia in Chinese children increased remarkably in recent years. Therefore, the efficacy of Chinese ocular exercise on preventing myopia or alleviating visual fatigue is widely questioned. Evidence from clinical trials of high level is needed to clarify that whether Chinese ocular exercise is effective in slowing and preventing myopia progression, or at least in part in easing the symptoms related to myopia and visual fatigue.

Eligibility Criteria:
Inclusion Criteria:

1. Visual acuity: 20/20 or better in each eye;
2. Spherical error ranging from +0.5 D to -6.0 D and astigmatism less than 1.5 D in each eye, anisometropia less than 1.0 D between the two eyes Contact lens
3. No strabismus, amblyopia and any other ocular or systematic diseases that may affect refractive development

Exclusion Criteria:

1. Currently using other interventions to control myopia progression (acupuncture, massage, drugs, ear needles and so on)
2. Unable to cooperate with the ocular examination and questionnaire survey
Trial in Periodontal Tissue Regeneration Using Fibroblast Growth Factor-2

The present clinical trial clarified that basic fibroblast growth factor-2 (FGF-2) can induce regeneration of periodontal tissue lost by progression of periodontitis and evaluated the safety of such induction.


Eligibility Criteria:
Inclusion Criteria:

* diagnosed as 2- or 3-walled vertical intrabony defect \>=3 mm deep from the top of the remaining alveolar bone
* with mobility of the tooth of degree 2 or less
* with width of attached gingiva appropriate for Guided Tissue Regeneration

Exclusion Criteria:

* concomitant administration of adrenal cortical steroid within 4 wks after the surgery
* administeration of calcium antagonist during the 4 weeks preceding administration of the investigational drug
* coexisting malignant tumour or history of the same
* coexisting diabetes (HbA1C \>= 6.5%)
* an extremely poor nutritional condition (serum albumin concentration \<2 g/dL)
* pregnancy or lactation
N-Acetyl Glucosamine as Therapeutic Intervention for Coronavirus Disease-19 (COVID-19)

This study examines the efficacy of N-acetylglucosamine (NAG) in treating patients with novel coronavirus (COVID-19) infection.

This is a single center, prospective, observational cohort study. A total of 150 cases who test positive for the novel coronavirus (COVID-19) will be recruited. Presenting to the emergency room of the study site, these cases will be treated with N-acetylglucosamine (NAG) in 700 mg doses every 12 hours as first-line treatment for 30 days. Standard of care (e.g., remdesivir approved for emergency use in severe cases, ventilator for patients with respiratory failure, etc.) will be provided based on the patient's clinical needs, which will be at the discretion of the treating physician. Upon admission, the research team will record patient demographics, comorbidities, symptoms, disease severity (as assessed by the World Health Organization Ordinal Scale for Clinical Improvement), need for supplemental oxygen, and time from symptom onset until hospital arrival. The research team will also collect bloodwork for the following at admission: white blood cell count (WBC), hematocrit (HCT), hemoglobin (HBG), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), and erythrocyte sedimentation rate (ESR). During the study period, discretionary treatments and interventions will be recorded daily until study exit. The primary outcomes of interest are rate of intubation, hospital length of stay, and mortality. Secondary outcomes of interest include intensive care unit (ICU) admission, ICU length of stay (LOS), supplemental oxygen duration, rate of hospice initiation, and poor clinical outcome (defined as combined death/hospice initiation).

Eligibility Criteria:
Inclusion Criteria:

* ≥18 years old
* Treated with N-acetyl glucosamine (NAG) as first-line treatment
* Present with coronavirus disease 2019 (COVID-19) symptoms (including but not limited to fever, cough, shortness of breath, sore throat, nasal congestion, malaise, headache, muscle pain, loss of taste and/or smell, diarrhea, and vomiting)
* Clinically diagnosed with COVID-19 by reverse transcription polymerase chain reaction (RT-PCR)
* No intubation prior to hospitalization and enrollment in the current study.

Exclusion Criteria:

* \<18 years old upon admission
* Allergy to NAG
* Allergy to shellfish
* Currently taking warfarin
* Currently pregnant or lactating
Dexmedetomidine Compared to Ondansetron for Postanaesthetic Shivering in Patients Undergoing a Cesarean Section

Evaluate the efficiency of management with intravenous dexmedetomidine compared to intravenous ondansetron to achieve the disappearance of post-anesthetic shivering in a shorter time in the obstetric patient undergoing cesarean section under regional anesthesia.

Randomized clinical trial with 40 pregnant patients, between 18 and 45 years old with ASA (American Society of Anesthesiologist) II or III, undergoing scheduled or emergency cesarean section with regional anesthesia and who presented grade tremor 1 based on the BSAS (Bedside shivering assessment scale) scale, at the Hospital Central from San Luis Potosi, Mexico. The main objective of this study was to quantify the time that elapsed from the end of the administration of the medication until the disappearance of the tremor, which was measured in minutes; The evaluation of the disappearance, persistence or reappearance of the tremor was solely visual by the anesthesiology staff.

Eligibility Criteria:
Inclusion Criteria:

* ASA II or III, undergoing scheduled or emergency cesarean section with regional anesthesia (hyperbaric bupivacaine 0.5% with morphine at 1 mcg Kg-1) and who presented tremor grade \>1 based on the BSAS scale

Exclusion Criteria:

* Hemodynamic instability, heart disease or sinus bradycardia, allergy to any of the medications applied, psychiatric diseases or hypothermia \<35.2 ºC measured by tympanic temperature.
The Prognostic Value of Human Papilloma Virus in Nasopharyngeal Carcinoma

It is well established that HPV infection has a casual and is a prognostic factor in several cancer types, including oropharynx. We wish to examine if HPV infection has a prognostic significance in nasopharyngeal carcinoma.


Eligibility Criteria:
Inclusion Criteria:

* nasopharyngeal carcinoma patients treated in our institute between 2008-2018

Exclusion Criteria:

* missing clinical data
* 2nd Head and neck primary cancer
* very locally advanced or distant metastatic nasopharyngeal carcinoma
* Prior radiation therapy to the head and neck region
Investigation on the Dynamic Changes in Air Microbiome in Intensive Care Unit

The microbiome of ICU, especially the air microbiome of ICU is not clear. The relationship between the microbiome of ICU and the hospital- acquired infection needs to be clarified. In this study, we try to outline the dynamic changes of microbiome in ICU and give some advice on the prevention of HAI.


Eligibility Criteria:
Inclusion criteria: no patients were enrolled in this study. Exclusion criteria: no patients were enrolled in this study.