cyrilzakka/clinical-trials huggingface dataset:
Awake Tracheal Intubation in Critical Care Patients

Tracheal intubation in critical care is a high-risk procedure requiring significant expertise and airway strategy modifications, such as awake intubation with video laryngoscope or flexible endoscope intubation. Furthermore, delayed sequence intubation can be used by experts in certain high-risk subgroups. The investigators hypothesise that awake tracheal intubation is associated with a lower incidence of severe adverse events than standard tracheal intubation in critical care patients.

Intubation records from 2020 to 2022 were acquired to examine all tracheal intubations of critical care patients at a tertiary hospital. Each awake tracheal intubation (awake) case - all of which were performed using a videolaryngoscope with a hyperangulated blade - was propensity matched with two controls (1:2 ratio; standard intubation videolaryngoscopy (VL) and direct laryngoscopy (DL) undergoing general anaesthesia), with similar comorbidities and intubations performed after the induction of anaesthesia (asleep).

Eligibility Criteria:
Inclusion Criteria:

* Data for all critical care patients requiring tracheal intubation during the study period

Exclusion Criteria:

* included incomplete data reports
Accuracy of AOBP in a Chinese Population

Background: Traditional office blood pressure (BP) measurement is often inaccurate and is inferior to out-of-office measurements, such as ambulatory blood pressure monitoring (ABPM), in predicting cardiovascular outcomes. A relatively new BP measurement method, called Automatic Office Blood Pressure measurement (AOBP), may provide similar BP readings to ABPM (latest clinical gold standard for BP measurements) and can easily be conducted in clinics. AOBP machines measure BP repeatedly 3-5 times with 1-min intervals and automatically provide the mean BP value. While AOBP was used in landmark trials (e.g. SPRINT trial) and was shown to eliminate white-coat effect, AOBP is rarely used in Hong Kong partly because there is no data concerning the accuracy of AOBP in Chinese. Almost all previous AOBP research used BpTRU (AOBP model), but BpTRU manufacturer was shut down permanently.

Aim: To assess if WatchBP Office (another AOBP model) has superior diagnostic accuracy than traditional office BP measurements, when compared to ABPM readings.

Method: 150 Chinese adult patients with a diagnosis of essential hypertension will be recruited consecutively from a Government-funded primary care clinic. All patients will have their BP measured by a 48-hour ABPM, a WatchBP office, and two traditional office blood pressure measurements.

ABPM will be considered the gold standard; sensitivity, specificity, positive and negative predictive values of AOBP and traditional BP to diagnose elevated BP level, masked hypertension and white-coat hypertension will be calculated and compared

Implication: if WatchBP provides closer BP readings to ABPM, this can lead to its implementation in routine clinical practice


Eligibility Criteria:
Inclusion Criteria:

* diagnosis of essential hypertension

Exclusion Criteria:

* (i) severe hypertension as defined by clinical systolic BP ≥180 mmHg and/or diastolic BP ≥110 mmHg (because they may need emergency treatment and it is unethical to delay such treatment due to the proposed project), (ii) inability to provide consent, (iii) pregnancy, (iv) night-time occupations (we need to compare AOBP and clinic BP readings to daytime ABPM average when the patient should be awake), (v) are occupational drivers (because potential dangers in driving could occur when patients are asked to remain still), (vi) receiving anti-coagulants (to prevent bruises when using ABPM), (vii) with known atrial fibrillation (as ABPMs and AOBP use have not been validated in this group)
Effect of Upstream High Bolus Dose of Tirofiban in Primary PCI for the Patients With STEMI on Short Term Outcome

The goal of the study to investigate the impact of upstream HBD of Tirofiban on short outcome of STEMI patient.

* Primary percutaneous coronary intervention (PPCI) is the gold standard of treatment of ST segment elevation myocardial infarction (STEMI).1 PPCI restores thrombolysis in myocardial infarction flow 3 (TIMI 3) in over 90% of patients. However ,there remains a small proportion of patients, who continue to exhibit overt impairment of myocardial reperfusion despite successful opening of infarct related epicardiual artery (IRA). This phenomenon is called no-reflow, which is largely because of severe microvascular obstruction (MVO).
* Belonging to the class of glycoprotein IIb/IIIa inhibitors (GPIs), tirofiban, can be useful in primary PCI for acute coronary syndrome (ACS).1,2The administration of tirofiban is an efficacious treatment option to reduce ischemic events in patients with The ACS and/or those undergoing PCI.2,3 In most guidelines, abciximab is recommended as the drug of first choice4 due to the finding that tirofiban is less effective than abciximab in platelet inhibition within 60 min of intravenous administration. However, some recent systemic reviews of randomized trials have not demonstrated obvious difference between smGPIs (eptifibatide or tirofiban) and abciximab in terms of angiographic, electrocardiographic, and clinical outcomes of patients undergoing primary PCI.5,6 Tirofiban may provide similar efficacy with an improved safety profile when compared with abciximab, particularly with a high-dose bolus regimen.7,8 In the new guideline, the recommended class of smGPIs has changed from IIb to IIa, but tirofiban remains with a pre-PCI indication of IIb, B.4 Although early treatment was associated with a significantly better TIMI flow and superior TIMI myocardial perfusion grades (TMPG) in some trials,9,10 no difference in clinical outcome was found between the 2 strategies in later study.11 One potential cost of administration of GPIs could be increased bleeding, although both major bleeding and minor bleeding rate are low in the tirofiban-treated patients..

Eligibility Criteria:
Inclusion Criteria:

* - Acute STEMI patient within 12 hours of chest pain

Exclusion Criteria:

* -previous infarction in the same infarct- related artery
* ISR
* Resistent cardiogenic shock
* Known CKD with Cr cl less than 60 ml/min
* Uncontrolled HTN more than 180/110 mmHg
* Suspected aortic dissection
* Traumatic or prolonged CPR
* Severe trauma or major surgery within 3 month
* Active peptic ulcer within past 3 month
* Known history of coagulopathy
Substance Use and Lifestyle-related Health Problems in Ageing Patients in OMT Treatment

The overall aim of the study is to explore substance use, tobacco use and lifestyle-related health problems among ageing patients in Opioid Maintenance Treatment (OMT), and other SUD treatment.

The study will use already collected data from the multi-center, longitudinal, observational NorComt study (Norwegian Cohort of Patients in Opioid Maintenance Treatment and Other Drug Treatment study).

NorComt is the largest longitudinal study of SUD patients in Norway. The data consists of data from OMT and other substance use disorders (SUD) treatment (N=548).

The overall aim of the study is to explore substance use, tobacco use and lifestyle-related health problems among ageing patients in Opioid Maintenance Treatment (OMT), and other SUD treatment.

The study will use already collected data from the multi-center, longitudinal, observational NorComt (Norwegian Cohort of Patients in Opioid Maintenance Treatment and Other Drug Treatment) study.

NorComt is the largest longitudinal study of SUD patients in Norway. The data consists of data from OMT and other substance use disorders (SUD) treatment (N=548).

The present doctoral research degree project is financed by the Southern and Eastern Norway Regional Health Authority, and hosted by Sørlandet hospital in collaboration with the Norwegian Centre for Addiction Research (SERAF).

Ethical approval for analysis of NorComt data and for the planned registry data linkages of NorComt data has been granted by the Norwegian Regional Ethics Committee (REK 2012/1131).

Eligibility Criteria:
Inclusion Criteria:

* Admittance to a substance use disorder treatment facility, either standardized opioid maintenance treatment (OMT) or other substance use disorder treatment (in-patient)

Exclusion Criteria:

* None
Effect of Physician Peer Coaching on Burnout in Hospital-Based Physicians: A Pilot Randomized Clinical Trial

The prevalence of burnout symptoms among physicians is high, especially for acute care physicians. Physician burn out is a long-term stress reaction marked by emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment. The healthcare environment, due to its demanding pace and emotional intensity, puts physicians at high risk for burnout.

Physician-Led Professional Coaching is a one-on-one intervention between a physician coach and an individual physician that is systematic, collaborative, future-focused, goal-oriented and is meant to help coaches attain valued professional or personal development. The trial will be conducted with 25 participants in an intervention cohort and 25 participants in a control. The intervention cohort will receive 6 individual coaching sessions over 6 months. Coaching sessions will use the CHEER acronym for conducting the coaching sessions: Celebrate, Hear, Executive coaching, Engage, and Recharge. The control group will be eligible for coaching sessions after the completing of the interventional arm. Physicians randomized to the control arm will be offered the same individualized coaching sessions as those that were in the intervention group. Te Maslach Burnout Inventory survey will be used to measure burnout and will be collected at baseline, 3 months, 6 months, and 9 months. The physician coach will be blinded to all survey data as it is being collected.

Eligibility Criteria:
Inclusion Criteria:

* Geisinger Physician
* Practicing medicine at least 6 months in the Geisinger system

Exclusion Criteria:

* Currently seeking professional coaching sessions
* Planning to leave the Geisinger system within 1 year
Evaluation of Placental Transfusion Techniques in Prevention of Prematurity Related Complications

The objective of this study is to evaluate the general course and prognosis associated with different methods of placental transfusion (Intact umbilical cord milking, cut- umbilical cord milking and delayed cord clamping) in premature neonates over the first days of life


Eligibility Criteria:
* Inclusion Criteria:

Premature neonates ≤ 32 weeks gestational age regardless birth weight who will be admitted to neonatal intensive care unit in the first day of life

Exclusion criteria:

* Exclusion Criteria:

Patient with any of the following will be excluded:

1. Preterm babies \>32 weeks
2. Major congenital anomalies (complex cyanotic heart disease, major central nervous system anomalies).
3. Evidence of head trauma causing major intracranial hemorrhage.

5. Concern for abruptions, placenta previa or retroplacental hematoma. 6. Cord accident, or avulsion at the time of delivery. 7. Refusal to perform the intervention by the obstetrician
OSA in Never Smokers With Lung Cancer

Previous studies have yielded inconsistent findings regarding the association between obstructive sleep apnea and the prevalence and mortality of lung cancer. Smoking history, a common risk factor for lung cancer, chronic obstructive pulmonary disease, and obstructive sleep apnea, may act as a confounding variable, limiting interpretation of the results. The aim of this study is to evaluate the prevalence of obstructive sleep apnea in never smokers with lung cancer and to determine the effect of obstructive sleep apnea on the prognosis of lung cancer. Enrolled patients will undergo respiratory polygraphy before beginning treatment for lung cancer. This prospective cohort includes both cross sectional and longitudinal analyses.


Eligibility Criteria:
Inclusion Criteria:

- Never smokers who are admitted to the Seoul National University Hospital and newly diagnosed with lung cancer, with ECOG Performance Status 0 or 1

Exclusion Criteria:

* Patients who have received treatment for lung cancer before the enrollment
* Patients who have received treatment for OSA before the enrollment
* Patients with an expected life expectancy of less than 3 months
* Patients with neuromuscular disease, chronic opioid medication use, or severe insomnia not controlled by medication
* Patients receiving supplemental oxygen therapy due to underlying diseases including heart failure, chronic obstructive pulmonary disease, interstitial pulmonary disease, hypoventilation syndrome, stroke, or whose baseline oxygen saturation is less than 90%
* Patients with unstable medical conditions within the preceding 3 months (hospitalization due to acute exacerbation of underlying lung disease, diagnosis of unstable angina or myocardial infarction, history of percutaneous coronary intervention or coronary artery bypass surgery, or diagnosis of transient ischemic attack or stroke)
* Patients with an inability or unwillingness to provide informed consent
Effect of a Nickel Free Diet and Nickel Sensitization on GERD Patients.

There is little evidence on the effect of a nickel-free diet on gastroesophageal reflux disease (GERD). We hope to determine if a nickel-free diet improves GERD symptoms in patients with a nickel allergy by having patients complete a questionnaire on their GERD symptoms before and after initiation of 8 weeks on a nickel-free diet.


Eligibility Criteria:
Inclusion Criteria:

* age 18 years or older with a history of GERD
* owns a phone with a camera
* has access to or is willing to sign up for MyChart
* is symptomatic for GERD at time of visit as determined by a score of \>12 on the GERD Health Related Quality of Life (GERD-HRQL) questionnaire. (Patients that are currently taking a proton pump inhibitor (PPI) they must have been on the PPI for at least 3 months.)

Exclusion Criteria:

* less than 18 years of age
* no not have access to MyChart
* are not willing to sign up for MyChart
* have taken an oral steroid within 4 weeks
* have experienced a sunburn or had significant sun exposure within the last 4 weeks, or applied a topical steroid to the area that the past test will be applied (i.e. upper back or arm) in the last 4 weeks. No vulnerable populations will be included.
Patient Experience of Transoral Versus Transnasal Awake Tracheal Intubation

Airway management problems are key drivers for anesthesia-related adverse events. Awake tracheal intubation using flexible bronchoscopy and preserved spontaneous breathing (ATI:FB) is a recommended technique to manage difficult tracheal intubation in anaesthesia, intensive care and emergency medicine. ATI:FB is regarded as the gold standard of tracheal intubation in many scenarios, however there is insufficient data on the patients experience while undergoing this form of airway management. ATI:FB can be facilitated using either a transnasal or transoral route. The study aims to compare patient-centred and operator-focused outcome parameters between these two different approaches with a focus on patient discomfort.


Eligibility Criteria:
Inclusion Criteria:

* patients scheduled for surgery requiring tracheal intubation
* patients with an anticipated difficult airway requiring ATI:FB
* consent by the patient
* minimum 18 years of age

Exclusion Criteria:

* patients scheduled for surgery requiring tracheal intubation
* patients not scheduled for ATI:FB
* pregnant or breastfeeding patients
* consent withheld or not possible to obtain by the patient
Compare the Efficacy and Tolerability of the Combination of Aripiprazole and Selective Serotonin Reuptake Inhibitors (SSRIs) Used in Major Depression

FDA has accepted atypical antipsychotics of olanzapine and aripiprazole as the adjuvant medications for refractory major depression. But there is still no trial about atypical antipsychotics combined with antidepressant of SSRI used in fresh major depressive patients. This project aims to compare the efficacy and tolerability of sertraline with or without low-dosed aripiprazole added in fresh major depression.

This double-blind, placebo-control, fixed dose, randomized study will be conducted at a tertiary clinical setting. Patients over 18 y/o fulfilled DSM-IV criteria for major depression, having a baseline HAM-D score ≧ 14 and a HAM-D item 3 score \< 3 will be recruited into the groups. The study group of patients will receive ten weeks of treatment with a combination of fix-dosed sertraline and aripiprazole. The control group will received sertraline only. The score reduction in HAM-D17, CGI, SF-36 and Brief Symptom Rating Scale (BSRS-50) will be periodically estimated as an efficacy following the use of a SSRIs or and aripiprazole.

Eligibility Criteria:
Inclusion Criteria:

* Male or female subjects 18 to 65 years inclusive.
* Fulfilled DSM-Ⅳ criteria for major depressive disorder.
* Onset ≧2 weeks.
* Baseline score ≧14 on the HAM-D17.
* Written informed consent prior to entry into the study.

Exclusion Criteria:

* HAM-D17 item 3 score≧3.
* Life-time history of bipolar disorders, schizophrenia or schizoaffective disorder.
* Current history of panic disorder, obsessive-compulsive disorder, alcohol or substance abuse.
* Mood disorder due to general medical condition.
* Treatment with antidepressants at entry into the study before 2 weeks.
* Need for psychoactive medications other than the study drugs, except for one benzodiazepine or hypnotic given at a stable dose.
* Known intolerance or inefficacy to either drug.
* Previous lack of response to two or more antidepressants at adequate dosage.
* Subjects who have acute or unstable medical illness or organic failure.
* Pregnancy and breast-feeding.
Bronchoalveolar Immune Response Determination

The purpose of this study is to establish if cells present in lung tissue during extrinsic allergic alveolitis (EAA) are able to elicit an immune response against specific antigens. The hypothesis is: cells in BAL lavage fluid from patients with EAA will be responsive to specific antigens and this response can be measured using ELISPOT.

Subjects suffering from extrinsic allergic alveolitis caused by pigeons will undergo a broncho alveolar lavage. Cells obtained from this BAL will be used for ELISPOT technique with pigeon specific antigens

Eligibility Criteria:
Inclusion Criteria:

* suspicion of pigeon induced extrinsic alveolitis

Exclusion Criteria:

* use of oral steroids
* unable to give informed consent
* age below 18
Efficacy and Safety Study of Abatacept to Treat Lupus Nephritis

The purpose of this clinical research study is to learn if addition of abatacept is safe and improves the effectiveness of treatment of patients with active lupus nephritis who are also taking mycophenolate mofetil (MMF) and corticosteroids.

Double Blind Period: Treatment, Parallel Assignment, Double Blind (Subject, Investigator), Randomized, Active Control, Safety/Efficacy Study

Open Label Period: Prevention, Single Group Assignment, Open Label, Uncontrolled, Safety/Efficacy Study

Eligibility Criteria:
Inclusion Criteria:

* Systemic Lupus Erythematosus (SLE) as defined by meeting at least 4 of the 11 classification criteria of the American College of Rheumatology for the classification of Systemic Lupus Erythematosus, either sequentially or coincident. The 4 criteria need not be present at study entry
* Renal biopsy within 12 months prior to screening visit indicating active proliferative lupus glomerulonephritis (met ISN/RPS Class III or IV classification criteria \[2003\], excluding Class III \[C\], IV-S \[C\] and IV-G \[C\], or the World Health Organization Class III or IV classification criteria \[1982\], excluding Class IIIc, IVd). If the renal biopsy was performed \>3 months but ≤12 months prior to screening visit, at least 1 of the following 3 serologies (performed locally) must have been abnormal prior to screening visit: complement (C3 or C4) level below normal range OR anti-dsDNA \>upper limit of normal range.
* A stable serum creatinine ≤3 mg/dL

Exclusion Criteria:

* Subjects with a rise in serum creatinine of ≥1 mg/dL within 1 month prior to the screening visit
* Subjects with drug-induced SLE, as opposed to idiopathic SLE
* Subjects with severe, unstable and/or progressive Central nervous system (CNS) lupus
* Subjects with autoimmune disease other than SLE as their main diagnosis (e.g.; Rheumatoid arthritis (RA), Multiple Sclerosis \[MS\])
* Subjects who have received treatment with cyclophosphamide within 3 months of randomization (Day 1).
* Subjects who have received treatment with rituximab \< 6 months prior to the screening visit
Effects of an Antimicrobial Stewardship (AMS) Program, on the Prevalence of Multidrug-resistant Gram - Negative Pathogens, in an Area of High Consumption of Antibiotics and High Resistance Rates

1. To evaluate the long-term effect of the AMS program on the consumption of broad-spectrum antibiotics and on the consumption of antibiotics in general (sustainability of the efficacy of the program). More specifically, the investigators shall examine the consumption of protected antibiotics during the years 2019 - 2020 and they shall compare it with the consumption of antibiotics before the implementation of the AMS program.
2. To evaluate the impact of the AMS program, combined with an infection control program, on the incidence of MDRGN infections in a hospital with high MDR incidence. Confounding factors are a barrier to analyze the impact of ASPs on antibiotic resistance. In a hospital setting, one of the most important confounding factors is the implementation of infection control practices at the same time as the ASPs. It is extremely difficult to infer causality between an ASP and antibiotic resistance reduction when infection control is a confounding factor, especially if the study intervention combines an ASP and infection control practices performed at the same time. The way to go around the problem is to implement ASP and IC at different time points. The investigators implemented the ASP program in September 2015 and they added the IC program in September 2018. Therefore, the investigators shall be able to compare the two-time periods (i.e. ASP alone vs. ASP/IC) by using the time series analysis and delineate the impact of each intervention.
3. To evaluate the effect of the AMS program on patient outcomes (in-hospital mortality, length of stay)


Eligibility Criteria:
Inclusion Criteria:

NA

Exclusion Criteria:

NA
Limb Salvage in Peripheral Arterial Trauma Patients

The aim of this study is to determine risk factors associated with failure of limb salvage in patients with periphral arterial injuries with or without attempts of revascularization.

Trauma to the vascular system can be devastating. Peripheral arterial traumatic injuries rarely occur in isolation, often complicated by bone fractures and nerve injuries. As a result of these complex injury patterns, vascular extremity trauma presents unique challenges to injury management and is associated with significant morbidity.

In all trauma- related injuries , trauma is now the third leading cause of death and number one cause of death in people between the ages of 1 and 44 years . Vascular injuries comprise 3% of all civilian trauma and have significant potential morbidity. Leg trauma is common. However, it is associated with a significant vascular injury.The high energy of crushing trauma can cause extensive tissue damage with detrimental outcome such as high morbidity and mortality.\[3\] Management of associated life-threatening injuries takes priority which might lead to delay in definitive vascular repairs with subsequent limb loss.The most important risk factor for early limb loss is failed revascularization which is time dependent

Eligibility Criteria:
Inclusion Criteria:

* peripheral arterial trauma patients

Exclusion Criteria:

* trauma patients with vascular injuries other than peripheral arteries