cyrilzakka/clinical-trials huggingface dataset:
Is One Pass Enough for the Diagnosis of the Pancreatic Masses During EUS-FNB?

Endoscopic ultrasonography (EUS) with tissue acquisition (TA) is nowadays a well-established technique for the sampling of solid lesions pancreatic and non-pancreatic lesions. Major complications after EUS-TA of solid masses are rare. Several studies have been published in the last recent years aimed to identify factors related to a non-diagnostic or false-negative EUS-FNA, and to improve its diagnostic yield using different needle gauge and different tissue acquisition technique as fanning technique, slow-pull stylet extraction or suction technique.

To overcome this problem, new EUS-TA needles entered in clinical practice to obtain histological specimens increasing the accuracy of the EUS-TA. Preliminary result with these new needles, called EUS-fine needle biopsy (FNB) are promising with an accuracy rate more than 90%.

Recently, Leungh et al. conducted an observational study to evaluate the role of macroscopic on-site evaluation (MOSE) on the diagnostic accuracy of 22G Franseen-tip needle. The study demonstrated that MOSE using the 22G Franseen tip needle could limit needle passes by accurately estimating histologic core fragments. However, the study limitations such as the small sample size and the lack of control group, hampered the value of the conclusions.

So, nowadays, no definitive data regarding how many needle passes need to be performed with FNB needles, neither regarding the use of MOSE to evaluate the specimens obtained with FNB needle. The MOSE technique of the acquired tissue was proposed for the first time by Iwashita et al, using a 19G needle and is nowadays a well-established technique with high accuracy in the final diagnosis.

The aim of our study is to evaluate if during EUS-FNB of pancreatic masses only one needle pass with MOSE evaluation can be satisfactory to obtain a correct diagnosis.


Eligibility Criteria:
Inclusion Criteria:

* Age greater than 18, both genders.
* Both in-patient and out-patients.
* Presence of a solid lesion. In the presence of a cystic component, the solid part of the lesion should be more 75% of the total.
* FNB performed by a 22G needle Acquire® (Boston Scientific).
* Tissue acquisition with fanning technique.
* Able to obtained informed consent.

Exclusion Criteria:

* Patients underwent EUS-FNA with or without ROSE
* Patients underwent EUS-FNB plus ROSE.
* Previous biopsy of the lesion with diagnosis of malignancy
* Presence of an uncorrectable coagulopathy as defined by abnormal prothrombin time (PT) or partial thromboplastin time (PTT) that does not normalize after administration of fresh frozen plasma.
* Pregnancy or breast-feeding.
* Patients unable to understand and/or read the consent form.
Impact of COVID-19 on Pregnancy Outcomes: a Systematic Review

This systematic review aims to evaluate the impact of COVID-19 on pregnancy outcomes. It synthesizes data from various studies to provide insights into the effects of the virus on maternal and fetal health. The review focuses on key outcomes such as preterm birth, maternal complications, and neonatal health, utilizing comprehensive literature from peer-reviewed journals. By analyzing existing studies, we aim to identify trends and gaps in research regarding COVID-19 and pregnancy. This review is intended to inform healthcare providers and pregnant individuals about potential risks and considerations during the pandemic.


Eligibility Criteria:
Inclusion Criteria:

* Pregnant individuals diagnosed with COVID-19.
* Studies reporting pregnancy outcomes related to COVID-19 published between January 2020 and the present.
* Articles that include quantitative data on maternal and fetal outcomes.

Exclusion Criteria:

* Studies that do not report on COVID-19-related pregnancy outcomes.
* Non-peer-reviewed articles or grey literature.
* Research focusing on non-pregnant populations.
The Effect of Snacks on Glycaemic Regulation in Children

Dairy products have a potential to be healthy snack foods for children. The purpose of this project is to investigate the short-term effects of Greek yogurt, a new popular dairy product on the regulation of glucose homeostasis, satiety and energy intake in normal weight and overweight/obese children.


Eligibility Criteria:
Inclusion Criteria:

* The children must be born at full-term within the normal weight range

Exclusion Criteria:

* food sensitivities or allergies, dietary restrictions, health, learning, emotional or behavioural problems, of if children are receiving medication
Sex Difference Effects on Postoperative Sleep, Inflammation and Cognition in Patients Undergoing General Anesthesia

Video-Assisted Thoracoscopic Surgery(VATS) is among the most common and disabling persistent pain and inflammation conditions, with increasing prevalence in the developed world, and affects women to a greater degree than men. And sleep disruption also remains a challenging problem in surgical settings. Postoperative sleep disturbances (POSD) are defined as changes in the sleep structure and quality of patients during the early stages after surgery, which are manifested as significantly shortened rapid eye movement (REM) sleep, prolonged awake time, and sleep fragmentation. Long-term POSD may increase the risk of postoperative delirium or cognitive dysfunction and delay recovery, thereby worsening the patient's physical condition. The aim of the study was to investigate the effect of sex differences on postoperative pain, inflammation, sleep quality and cognitive function among patients who have undergone video-assisted thoracoscopic surgery under general anesthesia.


Eligibility Criteria:
Inclusion Criteria:

* 18-75 years old
* ASA I-III
* under general anesthesia

Exclusion Criteria:

* patients with central nervous system and mental diseases;
* patients with preoperative sleep disturbances;
* patients with a history of sedative, analgesic, or antidepression drug use;
* patients with sleep apnea or moderate and severe obstructive sleep apneahypopnea syndrome;
Reduced Occupational Sitting in Type 2 Diabetes Using mHealth (Mobile Health)

Type 2 diabetes mellitus (T2DM) patients are suboptimal treated due to low uptake of physical activity. Recent research shows promising beneficial health effects from reducing sitting time by regular short bouts of light-intensity physical activity. These findings open up for a new focus in T2DM treatment but conclusive evidence is missing as studies have been short-term trials, mainly conducted in laboratory environments. Recent research suggest that reduced sitting and increased physical activity can be supported at a low cost by mHealth (mobile health) technology such as activity tracker armbands that warns of prolonged sitting and SMS text messages that reminds of activity breaks.

The overarching purpose of the project is to evaluate the effects of an intervention aimed to reduce occupational sitting in T2DM using mHealth (mobile health). It is hypothesized that the intervention will lead to (1) Activity changes - reduced sitting time and/or increased number of steps (primary outcome measures) and (2) Health effects - lower fatigue, improved health-related quality of life, reduced cardiometabolic risk, less sick leave, less medication, less musculoskeletal problems (secondary outcome measures)


Eligibility Criteria:
Inclusion Criteria:

* Type 2 Diabetes Melltitus
* 40-64 years
* HbA1c 48-100 mmol/mol
* BMI ≥ 25 kg/m2
* Working at least 75% of full-time in a mainly seated job.

Exclusion Criteria:

* Pregnancy
* Regular vigorous intensity exercise
* Severe disease or for other reason unable to follow the study protocol
A Safety, Tolerability and Preliminary Efficacy Study of LiRIS® 400 mg in Women With Interstitial Cystitis (IC) and Hunner's Lesions

The purpose of the study is to evaluate if LiRIS 400 mg is safe and tolerable when administered to women with Interstitial Cystitis with Hunner's lesions, and to evaluate any change in the bladder or in IC symptoms, following LiRIS administration.


Eligibility Criteria:
Inclusion Criteria:

* Women age 18 and older
* Interstitial Cystitis with history of Hunner's lesions in the bladder
* Moderate to severe bladder discomfort
* Confirmation of Hunner's lesions in Bladder
* Able to report symptom (pain and voiding frequency) in a diary throughout the study

Exclusion Criteria:

* Pregnant women
* History or presence of bladder cancer
* History or presence of any condition that would make it difficult to evaluate bladder symptoms
ACCEL-LOADING-ACS Study

The purpose of this study is to determine whether adjunctive cilostazol loading/maintenance to standard treatment (aspirin, clopidogrel, and statin) is effective in reduction of major adverse cardiovascular events, platelet activation, inflammation and myonecrosis in patients with non-ST-elevation acute coronary syndrome (ACS)undergoing percutaneous coronary intervention (PCI).

In ACS patients, platelet activation, inflammation, and ischemia-reperfusion injury can be closely associated with the risk of post-PCI myonecrosis and ischemic events occurrence. In the ACCEL-AMI (Adjunctive Cilostazol versus high maintenance-dose ClopidogrEL in patients with Acute Myocardial Infarction)study, adjunctive cilostazol increased platelet inhibition compared with double-dose clopidogrel. Meanwhile, statins can reduce the extent of myonecrosis via limiting inflammation and myocardial infarct size by activating phosphatidylinositol-3-kinase (PI3K), ecto-5'-nucleotidase, Akt/endothelial nitric oxide synthase (eNOS), and the downstream effectors inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2). Inhibition of PI3K, adenosine receptors, eNOS, iNOS, or COX-2 abrogates the protective effects of statins. In animal study, the combination of low-dose statin with cilostazol synergistically limits infarct size. Multiple studies have shown that cilostazol can influence inflammation and RISK pathway using the similar pathway with statin. This study will be performed to evaluate the role of adjunctive cilostazol in platelet inhibition, inflammation, and myonecrosis compared with standard treatment.

Eligibility Criteria:
Inclusion Criteria:

* at least 18 years of age
* Non-ST-elevation ACS patients undergoing PCI within 48 hours after hospitalization

Exclusion Criteria:

* ST segment elevation acute myocardial infarction
* NSTE ACS with high-risk features warranting emergency coronary angiography
* Oral anticoagulation therapy with warfarin
* Use of pre-procedural glycoprotein IIb/IIIa inhibitor
* Contraindication to antiplatelet therapy
* AST or ALT ≥ 3 times upper normal
* Left ventricular ejection fraction \< 30%
* WBC \< 3,000/mm3, platelet \< 100,000/mm3
* Creatinine ≥ 3 mg/dl
* stroke within 3 months
Behavioral Relaxation Approaches for Insomnia in Pregnant Patients

This study will evaluate the effect of a simplified behavioral relaxation intervention to improve insomnia in pregnant women

This is a randomized, 60-day research study that is evaluating the effect of a simplified behavioral relaxation intervention in pregnant and postpartum patients aimed to improve their insomnia symptoms. The investigators will be enrolling a total of 20 patients who indicate self-reported insomnia symptoms.

Eligibility Criteria:
Inclusion Criteria:

* Age between 18 and 55
* In second or third trimester of pregnancy (Gestation weeks 18-32)
* Able to speak, read and write fluent English
* Has regular access to a smartphone and/or smart tablet
* sleep onset latency (SOL) or nocturnal awakening need be 30 min or more for ≥3 nights/week, must persist for at least 1 month

Exclusion Criteria:

* Participants with fixed night shift work between midnight and 5 am, or rotating work schedules requiring night shifts during the study period.
* Medical or other factors that, in the opinion of the study research team, would interfere with their ability to participate in the intervention (such as inability to participate in the ART due to blindness)
The Effect of Manual Lymphatic Drainage

In venous ulcer, venous insufficiency is accompanied by lymphatic insufficiency. Manual lymphatic drainage (mld) technique cause to increase contraction rate of lymphatic collector and venous flow. It is known that Manual lymphatic drainage accelerates microcirculation, enabling nutrients and oxygen to reach tissues and at the same time removing residual substances from the tissue. We hypothesis that if we inrease to lypmhatic activity with MLD, we could stimulate healing of ulcer. The aim of this study to investigate the effect of manual lymphatic drainage on venous ulcer healing.


Eligibility Criteria:
Inclusion Criteria:

* with venous ulcer unhealing for at least 6 weeks
* Without enfection
* vascular surgery is not indicated
* There is no obstruction to apply MLD and compression to lower extremty

Exclusion Criteria:

* with diabetic mellutus
* with enfection
* with ABI\<0,7
* Patients who have undergone venous vascular surgery
* Patients undergoing active wound closure treatment
Survey of Anesthesiology Residents' Perceptions of Critical Care Medicine as a Career

This study's goal is to investigate the reasons behind the decline in interest in critical care fellowships among anesthesia residents.

Anesthesia-based critical care medicine (CCM) is at a crossroads at the turn of the millennium. Although anesthesiologists were pioneers in the field of critical care, their surgical and pulmonary medicine counterparts have now eclipsed them in terms of both numbers and influence. In the United States, anesthesia-based CCM is a niche specialization of anesthesiology, while in Europe, anesthesiologists play a central role in critical care. Anesthesia-based critical care physician production has remained low on an annual basis. Some medical students join anesthesiology residencies with an interest in critical care training, but this enthusiasm appears to diminish as the number of years of residency grows. In the United States, anesthesiology residents have been unable to fill many critical care fellowship spots consistently. This survey aims to investigate the factors that influence residents' decision to pursue a career as a critical care physician, as it is essential to comprehend the underlying reasons for such a decline.

Eligibility Criteria:
Inclusion Criteria:

* Anesthesiology residents at Stanford

Exclusion Criteria:

* Non-anesthesiology residents at Stanford
Patient Outcomes of Staged Ridge-splitting Using Piezo-electric Surgery in Atrophic Posterior Mandible

This study aims to evaluate the clinical and radiographic outcomes of different staged ridge-splitting techniques for management of severely resorbed lower jaws in the posterior region. The study is designed as a clinical trial, so that three different interventions would be compared for a conclusion highlighting the relative best of them.

In the context of the care of severely resorbed lower jaws in the posterior region, the purpose of this study is to evaluate the clinical and radiographic outcomes of several stepwise ridge-splitting procedures. The study is supposed to be a clinical trial, with the purpose of comparing three distinct therapies in order to get a result that highlights which of them is the most effective in comparison to the others.

Eligibility Criteria:
Inclusion Criteria:

* Patients were free from any relevant systemic diseases according to American society of Anesthesiologists classifications.
* Patients of single or multiple missing teeth in the posterior mandible.
* A ridge width of minimum 4mm and a 10 mm ridge height with 2mm minimum above Inferior Alveolar Nerve (IAN) were present in CBCT images.
* Absence of buccal concavities at the planned implant site.

Exclusion Criteria:

* History of any systemic diseases or medication that alters bone metabolism.
* Poor oral hygiene.
* Heavy smoker (more than 20 cigarettes/day) or alcoholic patients.
* Chemotherapy or radiation therapy to the head and neck region in the last 12 months prior to the proposed implant therapy.
* Patients currently on or with a history of bisphosphonate therapy.
The Significance of Ambrosia in Allergic Rhinitis and Asthma in Israel

Ambrosia is known for its allergenicity in the USA causing hay fever and asthma. Israel has always been considered "clean" of Ambrosia but over the past years growth of Ambrosia plants has been detected in several locations in Israel.

In the proposed study, patients referred for routine allergic evaluation will also be skin tested with Ambrosia allergens, in addition to their regular prick skin tests with all other airborne allergens.


Eligibility Criteria:
Inclusion Criteria:

* Patients with allergic rhinitis, asthma, allergic conjunctivitis or atopic dermatitis who undergo prick skin tests with airborne allergens
Investigation of Sarcopenia and Physical Fitness Levels of Geriatric Individuals Living in Nursing Homes and at Home

To examine the sarcopenia and physical fitness levels of geriatric individuals living in nursing homes and at home. Considering these aims, our working hypotheses are;

H1: There is a difference in sarcopenia level between geriatric individuals living in a nursing home and at home.

H2: There is a difference in dynapenia levels between geriatric individuals living in a nursing home and at home.

H3: There is a difference in physical fitness between geriatric individuals living in a nursing home and at home.

Geriatric individuals living in the Nursing Home and at home will be included in the research. Within the scope of the study, anterior thigh thickness of geriatric individuals will be evaluated by ultrasonography and the presence of sarcopenia will be determined according to the Sonographic T-high Adjustment Rate (STAR) method, and the presence of dynapenia will be determined according to hand grip strength in individuals without sarcopenia. Additionally, the physical fitness of geriatric individuals in both groups will be evaluated with the Senior Fitness test. The study will be carried out with 100 geriatric individuals. As a result of the study, individuals in the groups will be compared in terms of the presence of sarcopenia and dynapenia and physical fitness.

Eligibility Criteria:
Inclusion Criteria:

* Getting a score between 24 and 30 on the Mini Mental State Exam
* Living in a nursing home for at least six months (for nursing home residents)
* Ability to stand without assistance for at least 90 seconds

Exclusion Criteria:

* Inability to communicate verbally
* Using a walking aid
* Elderly people with severe visual impairment, neurological disorders and/or congestive heart failure
* Older adults for whom exercise is not recommended
Optimal Surgery and MRI Based Radiochemotherapy in Rectal Carcinoma

The objective of the study is to provide proof that a MRI based preoperative radiochemotherapy in patients with locally advanced rectal carcinoma allows limiting RCT to high risk patients without increase of locoregional recurrence rate and decrease of overall survival provided there is a high quality of mesorectal excision.

The criteria for application of RCT is the distance of the tumor from mesorectal fascia in preoperative MRI of the pelvis. In case of a T 4 tumor or a tumor with a distance of 1mm of less form mesorectal fascia long-course radiochemotherapy is applied followed by surgery, in all other cases primary surgery is done.

Eligibility Criteria:
Inclusion Criteria:

* Patients with histologically confirmed invasive carcinoma of the rectum infiltrating beyond the submucosa (cT3, cT2N+, cM0)
* Elective surgery
* Fit for surgery
* Preoperative MRI of pelvis

Exclusion Criteria:

* uT1 Tumors
* provided for local excision
* previous or synchronous malignant tumors (except squamous and basal cell carcinoma of the skin and carcinoma in situ of the cervix)
* previous irradiation of the pelvis
* ulcerative colitis or Crohn's disease
The Impact of Equine-Assisted Psychotherapy on Depression, Anxiety, and Stress in Patients with Substance Use Disorder in a Psychiatric Hospital

This study aims to assess whether an EAP program affects anxiety, depression, and stress, which are often associated with substance use disorder. The management of these conditions has a major impact on the control of the addiction.

This study aimed to evaluate the effect of an EAP program on 32 respondents in the experimental group and 36 in the control group. These respondents were patients in a psychiatric hospital who were taking part in an addiction treatment program. The EAP program was conducted weekly over four weeks, with each session lasting three hours. The treatment effects were assessed using the STAI-Y modules 1 and 2, BAI, PSS, and DASS-21 questionnaires. The groups were compared before and after the four-week observation period.

Eligibility Criteria:
Inclusion Criteria:

Patients of psychiatric hospital of Kosmonosy with substance use disorder

Exclusion Criteria:

Exclusion criteria were possible cognitive deficit or reluctance to work with animals. Participants who did not complete all required materials or left the treatment program before completion were excluded from the study (N = 9).
Pueraria Lobata and Pueraria Thomsonii for Mild Dyslipidemia

Dyslipidemia is an important risk factor for atherosclerotic cardiovascular disease. Maintaining normal levels of lipid indicators can significantly reduce the risk of atherosclerotic cardiovascular disease and mortality. Empirical evidence suggests that adherence to Pueraria lobata and Pueraria thomsonii is useful for improving dyslipidemia, but evidence from randomized controlled trials is lacking. This randomized, double-blind controlled trial is therefore designed to evaluate the efficacy and safety of Pueraria lobata and Pueraria thomsonii for dyslipidemia.

Pueraria is an important Chinese herbal medicine. The Pharmacopoeia of the People's Republic of China classifies the Pueraria as Pueraria lobata and Pueraria thomsonii according to the different sources of the plant, both of them is sweet, pungent and cool in nature, and has the effects of relieving fever, quenching thirst, penetrating rashes, raising the Yang to stop diarrhea, activating the meridians and detoxifying alcohol. As early as in the Han Dynasty, Zhongjing Zhang's "Treatise on Febrile Diseases" described the famous formula "Pueraria Tang", which is still an important formula for relieving exterior syndromes.

In clinical practice, the preparations of Pueraria lobata and Pueraria thomsonii are widely used to treat headache, dizziness, hypertension, coronary heart disease, angina pectoris, myocardial infarction and other diseases. For example, the puerarin injection has the effects of dilating blood vessels, slowing down heart rate, reducing myocardial oxygen consumption and improving blood circulation in the heart and brain.

Although the puerarin has been shown to be effective in a variety of cardiovascular diseases, as of now, it is unclear whether Pueraria lobata and Pueraria thomsonii can be used as part of the daily diet to regulate blood lipids and improve dyslipidemia. Therefore, the aim of this study is to conduct a randomized, double-blind controlled trial that includes patients with mildly elevated lipids to evaluate the efficacy and safety of Pueraria lobata and Pueraria thomsonii for dyslipidemia.

Eligibility Criteria:
Inclusion Criteria:

* Marginally elevated low-density lipoprotein (LDL-C), 3.4 to 4.1 mmol/L
* Informed consent to the study and signed the informed consent form

Exclusion Criteria:

* Patients who have a history of allergy to Pueraria Lobata or Pueraria Thomsonii.
* Patients who have taken lipid-lowering drugs within a week
* Patients with secondary dyslipidemia caused by other diseases or medications taken.
* Pregnant or lactating women.
* Patients who combine cognitive dysfunction, disorders of consciousness, psychiatric disorders, dyslexia or verbal communication dysfunction
* Patients with a combination of other serious diseases, such as malignant tumors, hepatic or renal insufficiency, cardiovascular or cerebrovascular disease, etc.