cyrilzakka/clinical-trials huggingface dataset:
Interest of the Echocardiography in the Management of Cirrhotic Patients With Acute Kidney Injury

This prospective study focuses on the interest of the echocardiography for cirrhotic patients, who present acute kidney injury corresponding to the criteria of hepatorenal syndrome. This echocardiography will be done before the volemic expansion and the final diagnostic of hepatorenal syndrome or prerenal azotemia. The primary endpoint is to describe the hemodynamic characteristics of this population at the time of acute kidney injury and their association with diagnostic of hepatorenal syndrome or prerenal azotemia. Patients with elevated filling pressure, predicting poor outcome of volemic expansion will be excluded of the study after the echocardiography and will not undergo volemic expansion but appropriate management.


Eligibility Criteria:
Inclusion Criteria:

* patients \> 18 years
* written consent for the participation of the study
* cirrhosis with portal hypertension and ascite
* acute kidney injury according to AKIN criteria (rapid increase of creatinine (48 hours) \> 26.4 µmol or \> 50% comparing with baseline). Baseline creatinine is the last value of creatinine before admission or creatinine at the admission if stable during 5 days.
* absence of argument for acute tubular necrosis or other organic acute renal injury
* absence of argument for shock

Exclusion Criteria:

* pregnant women
* volemic expansion before echocardiography
* portal thrombosis
* presence of TIPSS
* history of cardiac or renal pathology
* atrial fibrillation
* cardiac valvulopathy
* technical limitation due to echogenicity
Anorectal Dysfunction in Patients Suffering From Spina Bifida : From Clinic to Neuro-epithelial Function (ANOSPIN)

The purpose of this study is to assess and explain (at least apart) anorectal disorders of patients with Spina Bifida by an automatic neuropathy responsive of enteric nervous system and epithelial barrier dysfunctions. The investigators' aim hypothetics is that autonomic neuropathy of patients with Spina Bifida induce enteric nervous sytem and epithelial barrier dysfunctions which explain anorectal disorders of these patients. Thexpect to show a decreased of 5% of enteric neurons per ganglia.

Spina Bifida is rare disease related to a failure of the closure of neural tube during the embryonic period. This malformation results in a variety of clinical disorders (neurologic, urologic, orthopedic, anorectal), depending on the level of the spinal cord lesion. Anorectal functional disorders remain underestimated and unknown from a pathophysiological point of view with subsequent uncodified therapeutic strategy.

Patients with Spina Bifida always present autonomic neuropathy that contributes partially to the anorectal disorders. These disorders may be related to a closed relationship between autonomic and enteric nervous system. Both nervous systems play a key role in anorectal disorders during others neurological disaeses have a common and simultaneous development from neural crest and induce colonic epithelial changes related to the closed connection between epithelial barrier and enteric nervous system. All of this remains hypothetic because no data regarding the impairment of enteric nervous system and epithelial barrier are available and no study are ongoing on this topic.

Eligibility Criteria:
Inclusion Criteria:

* patient aged between 18 and 65 years old
* patient who consulted to the national Spina Bifida Center for multidisciplinary assessment or for a proctology/urologic clinic
* need of colonic biopsies during endoscopy
* free, written and informed consent

Exclusion Criteria:

* pregnancy or breastfeeding
* protected adults (judicial protection, guardianship and truesteeship) and persons deprived of liberty
* patient unable to giving their consent
* anticoagulants therapy or coagulation disorders
FFS - Far Field Sensing Test Study in Cardiac Dual Chamber Pacemakers

The purpose of this study is to evaluate the effect of individual adjustment of the postventricular atrial blanking period in avoiding inappropriate mode switch of dual chamber pacemakers.

Far-field R-wave sensing (FFS) in the atrial channel of dual chamber pacemakers is a relevant source for inappropriate mode switch from the DDD mode to the DDI or VDI mode. Inappropriate loss of atrioventricular synchrony due to false positive mode switch is hemodynamically disadvantageous, may induce atrial tachyarrhythmias, can lead to pacemaker syndrome, and impairs the reliability of pacemaker Holter data. The aim of the study is to determine whether individual adjustment of the postventricular atrial blanking period (PVAB) based on an additional test is effective in avoiding inappropriate mode switch due to FFS when compared to standard programming of the PVAB

Eligibility Criteria:
Inclusion Criteria:

* Indication for dual chamber pacing
* Implantation of an Identity DR pacemaker (St. Jude Medical)
* Bipolar atrial pacing electrode

Exclusion Criteria:

* Heart failure NYHA III and IV
* Unstable angina pectoris
* Indication for the implantation of an ICD
* Cardiac surgery within previous 6 months
* Cardiac surgery planed for the next 3 months
The Effects of Familiar Toy and Parental Presence Combination on Perioperative Pediatric Anxiety

This study will evaluate the effect of presence of favorite toy and parent during perioperative period on pediatric anxiety and emergence delirium. Half of the patients patients will be accompanied with their ownselected parent and the other half will be accompanied with their favorite toy in addition to their own selected parent.

To reduce the incidence of preoperative anxiety in children, anesthesiologists have used a number of prevention strategies, including sedative premedication, parental presence during anesthetic induction, behavioral preparation programs, music therapy, hypnosis, and acupuncture.One of these distraction tool is familiar toy, children may also be comforted by familiar toys. Therefore, parent presence during perioperative period or playing with a favorite toy seems likely to alleviate preoperative anxiety in children. Until now, combination of these two method to reduce anxiety is not observed in literature. Then, the aim of this observational study is to evaluate the effect of both presence of favorite toy and parental presence compare to only parental presence during perioperative period on anxiety and emergence delirium in patients undergoing ambulatory surgery in our hospital's otorhinolaryngology department.

Eligibility Criteria:
Inclusion Criteria:

Patients with ASA 1 and 2, Those who have the ability to speak and obey commands will be included.

Exclusion Criteria:

Mentally challenged Deaf Child Cerebral Palsy Premedicated Child Language Problem Unco-operative Previous surgery or anesthesia history
Ba Duan Jin for Depression and Anxiety

In recent years, the number of people with symptoms of depression or anxiety are on the rise. The aims of the present study is to examine the effects of Ba Duan Jin on reducing symptoms of depression or anxiety.

There is growing interest in mind-body therapy that could potentially improve patients' psychological health.

Ba Duan Jin, a traditional Chinese health-preserving technique, combines techniques regulating body, breath and spirit. The effects of Ba Duan Jin on patients with symptoms of depression and anxiety are yet to be further investigated.

The present pilot clinical study aims to apply Ba Duan Jin to patients with symptoms of depression and anxiety, and to evaluate the psychological effects.

Participants allocated to the Health Education Group take part in the 16-week health education including work, rest, diet and other basic programs according to the different conditions of participants. Participants allocated to the Ba Duan Jin Group take part in the 16-week Ba Duan Jin plus health education program. The study plans to enroll 60 participants (30 for Ba Duan Jin plus health education program, and 30 for health education program), expecting that Ba Duan Jin has a better effect on improving psychological condition.

Eligibility Criteria:
Inclusion Criteria:

* Subject with depression or anxiety symptom diagnosed by ICD-10.
* Subject is male or female, age 18 to 75.
* Subject has a clear mind and the ability to read, to talk and to communicate.
* Subject agrees to participate in this study and sign to the informed consent

Exclusion Criteria:

* Subject has severe somatic disease.
* Subject has history of organic mental disorder, epilepsy, schizophrenia.
* Subject takes any medication of food having effect on gut microbiota within 1 month of screening.
* Subject has history of alcohol abuse.
* Subject is pregnant, lactating or breast-feeding women.
Micro-embolic Signals Detection With Transcranial HOLter in Acute Ischemic STroke

In acute ischemic stroke, the identification of an etiology is of major importance to prevent recurrence by providing the best treatment. Because of numerous possible underlying etiologies, the etiological work-up of ischemic stroke includes a wide range of diagnostic tests, which can be invasive, long and expensive. Moreover, many patients receive a diagnosis of undetermined stroke even after all available diagnosis tests are done, precluding optimal treatment.

Asymptomatic MES detected by transcranial doppler have been reported in patient with ischemic stroke. It has been previously demonstrated that MES predict stroke recurrence and that the frequency of MES depends on stroke etiology. However, the pattern of MES has never been correlated to stroke etiology. Transcranial-holter is a novel ambulatory system which allows prolonged recording (up to 4 hours) leading to an increased detection of MES.

Therefore, transcranial holter with an 4 hour-recording will be performed for consecutive eligible patients hospitalized in our stroke care unit. During the recording, the patient will be able to continue their usual activities (eating, walking, speaking and sleeping).

All the included patients will have a classical follow-up at 3, 6 months and 12 months. The neurologist, blinded to the results of transcranial-holter, will have to prescribe and analyze the results of diagnostic tests to identify stroke etiology. Stroke etiology will be established according to the ASCOD classification. Questioning and neurological exam (NIHSS score) will be performed looking for potential recurrent stroke.

Eligibility Criteria:
Inclusion Criteria:

* Ischemic stroke in the middle cerebral artery territory
* Acute ischemic stroke within the 7 first days from the onset of the symptoms
* Patient hospitalized in our stroke care unit
* Man or woman older than 18 years
* Patient affiliated to a social security system
* Free Consent, informed writing signed by the participant or the person of confidence and the investigator (no later than the day of inclusion and before any examination required by research)

Exclusion Criteria:

* Transient ischemic stroke
* Ischemic stroke in the vertebro-basilar or anterior cerebral artery territory.
* Proximal middle cerebral artery occlusion leading to the impossibility of recording
* Patient who could not express his consent
* Patient under guardianship or judicial protection
* Pregnant or breastfeeding woman
* Emergency situation
* Life expectancy under 6 months

Exclusion criteria (after inclusion) :

* Absent of bilateral Acoustic window
* Analyzable Recording \<30min
Analgesia Nociception Index for Pain Monitoring in Intensive Care Units

The aim of this study is to examine the usability of ANI in patients who will be treated in intensive care unit.

The aim of this study is to examine the usability of Analgesia Nociception Index in patients who will be treated in intensive care unit ( a- Cardiovascular b- surgical c- internal diseases), mechanically ventilated and lacking communication. The investigators will examine whether the positive inotropic/vasoconstrictor agents will have any effect on Analgesia Nociception Index.

Eligibility Criteria:
Inclusion Criteria:

* Intensive Care Cardiovascular Patients Group 1 - Patients aged from 18 to 80 years, scheduled for elective isolated coronary bypass graft (CABG) for 2-4 vessel disease, without any perioperative complications, and who were postoperatively monitored via the analgesia nociception index in the cardiovascular intensive care will be included.
* Intensive Care Internal Diseases Group 2 - Patients aged from 18 to 80 years, intubated or tracheostomized, In mechanical ventilation with Pressure-Controlled Ventilation mode, under perfusion neuromuscular blocker, Normothermic, non-cooperative and/or sedated and neuromuscular blocker
* Intensive Care Patients (Obese) Group 3 - Post Bariatric surgery, over 40 BMI

Exclusion Criteria:

* Intensive Care Cardiovascular Patients Group 1 Patients who required emergency surgery, had significant preoperative chronic pain, had autonomic nervous system anomalies and patients with rhythm will be excluded from the study.
* Intensive Care Internal Diseases Group 2 Ramsey sedation scale under 5, cooperative, with spontaneous breathing effort and extremity movement, non sinusal cardiac rhythm
* Intensive Care Patients (Obese) Group 3 - patients under 40 BMI
Tolerability and Safety and Health Outcomes in Relapsing Multiple Sclerosis (MS) Patients

This study will assess tolerability and safety and health outcomes in relapsing MS patients taking FTY720.


Eligibility Criteria:
Inclusion Criteria:

* 18-65 years of age, must have relapsing MS

Exclusion Criteria:

* Patients with a type of MS that is not relapsing
* Patients with history of chronic immune disease
* Patients with a history of certain cancers
* Diabetic patients with certain eye disorders
* Patients who are on certain immunosuppressive medications or heart medications
* Patients with certain heart conditions
* Patients with certain lung conditions

Other protocol-defined inclusion/exclusion criteria may apply.
Prospective 4D CTA of BAV Competence

The study involves annual 4D CTA imaging of the bicuspid aortic valve for a period of 5 years. CTA is often standard of care for BAV patients, but patients in this study will receive a higher radiation dose with a 4D imaging protocol. There may also be patients enrolled in the study who have a 4D CTA for research purposes when a routine CTA is not required for clinical care.

The bicuspid aortic valve (BAV) is the most common congenital heart disease. The purpose of this study is to better understand the anatomy of physiologically normal, or competent, BAVs without stenosis or insufficiency (AI) in order to support evidence-based standardization of BAV repair surgery. Men and women over 18 years of age with a diagnosis of BAV and minimal aortic valve calcification at baseline will undergo annual 4D computed tomography angiography (CTA) scans, routine transthoracic echocardiograms, and history and physical assessments over the course of the 5-year study period. Patients who are pregnant, have renal insufficiency (creatinine 2 mg/dL), or who have a contraindication to intravenous contrast will be excluded. Patients will be stratified into study groups according to baseline AI: approximately half of patients will have no to mild AI at baseline and the other half will have moderate to severe AI at baseline. Anatomical measurements will be obtained from the 4D CTA scans and analyzed at each phase of the cardiac cycle, as well as longitudinally. The 4D CTA imaging and analysis will not impact medical care of the study participants; the anatomical measurements will be used in the future as evidence-based standards for determining valve repair candidacy for BAV patients with AI.

Eligibility Criteria:
Inclusion Criteria:

* At least 18 years of age
* Documented bicuspid aortic valve identified via clinical imaging (e.g., CT, MRI, or echocardiogram) with minimal calcification at the time of enrollment
* Participant must sign the informed consent form

Exclusion Criteria:

* Pregnancy (determined by point of care urine pregnancy test)
* Renal failure (estimated Glomerular Filtration Rate (eGFR) \< 30), precluding them from receiving intravenous contrast)
* Documentation of previous intravenous contrast allergy (unless they are having a CT with steroid preparation as part of routine clinical care)
* Previous aortic valve replacement
Perioperative Blood Transfusion in Open Liver Resection

This observational study is specifically designed to identify the pre-operative risk factors that significantly contribute to perioperative packed red cell transfusions in open liver resection procedures.

The main question it aims to answer are:

1. What are the risk factors of peri-operative blood transfusion in open liver resection procedures
2. What are the difference outcomes between patients who receive blood transfusion and the other group.

Researcher will compare perioperative factor and post operative outcomes between transfused and non-transfused group

After approval of the study protocol from the institutional review board of Chiangmai University (Approval number: ANE-2564-08020), we performed a retrospective review of all patients who underwent an elective open liver resection in our specialized hepato-biliary center from January 2006 through December 2017. This retrospective inquiry comprised 808 patients.

The data was systematically retrieved from electronic medical records. Baseline characteristics including age, gender, body mass index (BMI), co-morbidity, American Society of Anesthesiologists (ASA) classification, diagnosis, hepatitis profile, Child-Pugh classification, cirrhosis, the largest tumor size, previous liver resection, and pre-operative laboratory investigations were collected.

The following intra-operative data were collected: type of liver resection, hilar resection, vascular reconstruction, volume and type of fluid administration, estimated blood loss, packed red cell and blood product transfusion, and operation time. The definitions of liver resection and the type of hepatectomy were aligned with the anatomic classification of the Brisbane 2000 Terminology

Eligibility Criteria:
Inclusion Criteria:

* All genders age above 18 year old who underwent open liver resection from 2006-2017
* Elective open liver resection

Exclusion Criteria:

* Patients who death during the course of a surgical operation
The Efficacy of Manual Therapy and Pressure Biofeedback Guided Strength Training on Pain and Functional Limitations

Cervicogenic headache (CGH) is a widespread illness that results in excruciating pain and a sizable functional handicap. Deep cervical flexor muscle (DCFM) strength and endurance were also worse in CGH patients. This study aimed to determine the efficacy of manual therapy and pressure biofeedback-guided DCFM strength training on pain intensity and functional limitations in individuals with CGH.

The study followed a two-arms parallel group randomized comparative design, including sixty individuals with CGH, and they were allocated into two groups at random. For three consecutive weeks, in addition to the conventional treatment common to both groups, groups 1 and 2 received pressure biofeedback-guided DCFM strength training and manual therapy, respectively. At baseline, the first week, the second week, and the third week post intervention, pain intensity and functional limitations were evaluated using the visual analog scale (VAS), the number of headache days per week, and the headache disability inventory (HDI) questionnaire. The main effects of the intervention were evaluated for a between-group factor, within-group factor, and interaction between time and groups over/at multiple time points. Data was analyzed using an independent t-test, mixed design 2-way ANOVA, with keeping the level of significance 'p' at 0.05.

Eligibility Criteria:
Inclusion Criteria:

* Individual with a diagnosed case of cervicogenic headache with unilateral head pain without side shift or bilateral head pain with a dominant side that hurts more than the other side, sustained awkward head positioning, external pressure over the upper cervical or occipital region on the symptomatic side.
* Aged between 25 and 50 years
* Patients with recurrent CGH and chronic mechanical neck discomfort that has persisted for longer than three months.
* A positive cervical flexion rotation test.

Exclusion Criteria:

* a negative cervical flexion rotation test.
* Subjects had a history of any of the following conditions: a fractured vertebral column or previous surgery on it; spinal stenosis; a prolapsed disc; temporomandibular joint dysfunction or headaches involving the autonomic nervous system; vertigo or visual disturbance; or a congenital condition of the cervical spine.
* Showed non-cooperation
Study of Optimal Clopidogrel Duration in Patients Receiving Drug Eluting Stents (SCORE Trial)

Although the optimal duration of clopidogrel (an anti-platelet agent) therapy has been established after bare metal stent implantation in the blood vessels of the heart, there is lack of consensus regarding the optimal duration of therapy after implantation of a drug eluting stents (DES). Current American College of Cardiology guidelines recommend clopidogrel use for at least one year in the absence of contraindications after DES implantation, while recognizing that the optimal duration remains unknown. While an extended clopidogrel therapy (that is beyond the current 1 year recommendation) may increase bleeding complication, it may reduce the rates of adverse cardiovascular events like heart attacks and repeat revascularization procedures. A clinical trial which randomizes patients with an uneventful one year course after a DES implantation, to an additional year of clopidogrel and aspirin therapy versus aspirin alone, will be able to answer the important question about the role of extended (2y) dual anti-platelet therapy with clopidogrel and aspirin after DES implants. The investigators hypothesize that clopidogrel discontinuation at 1 year post-DES implantation is associated with an increase in cardiovascular events during the one year of follow-up period.

SCORE is a multicenter, prospective randomized study of post-percutaneous coronary intervention (PCI) patients with an uneventful 1 year post-PCI course on dual anti-platelet therapy (DAPT) with clopidogrel and aspirin. Patient will be randomized to an additional 1 year of DAPT (treatment arm) vs. aspirin alone (control arm)to assess the following endpoints during the 1 year follow-up period:

1. Death / Myocardial infarction (MI) (Primary end-point)
2. Combined endpoints of death, myocardial infarction, repeat revascularization, stroke, and major/minor bleeding (Secondary end-point)

During the year of follow up, subjects will be contacted once every three months. This will enable us to track study endpoints in the study population. In addition the patients' medical records will be screened to investigate if any of the aforementioned endpoints have been reached.

Eligibility Criteria:
Inclusion Criteria:

* Post-PCI patients receiving at least 1 DES
* Completed 9-15 months follow-up free of MI, repeat revascularization
* Able to provide informed consent
* Have continued dual anti-platelet therapy with aspirin and clopidogrel for 1 year post-PCI

Exclusion Criteria:

* Patients allergic to aspirin
* Patients with aspirin resistance
* Patients with allergy to clopidogrel
* Patients on concomitant warfarin therapy
* History of bleeding diathesis, coagulopathy, and/or platelet count \< 100,000 cubic mm
* Patients with a life expectancy less than 1 year due to active cancers (except basal cell carcinoma)
* Pregnancy