cyrilzakka/clinical-trials huggingface dataset:
Rt-PA Infusion Versus Catheter Exchange for Dialysis Catheter Malfunction Due to Fibrin Sheath

Treating central venous dialysis catheter malfunction due to fibrin sheath formation with rt-PA(TPA)infusion will give equal patency rates in a more cost effective manner when compared to catheter exchange.

Subjects are randomized to TPA infusion or catheter exchange and then followed for catheter function at the post treatment dialysis session, 30-day dialysis session and 60-day dialysis session. Costs and treatment results will be compared.

Patients who come to the Hospital of the University of Pennsylvania, Presbyterian Medical Center or American Access in Northeast Philadelphia with a dialysis catheter that's not functioning well, will be screened for this study.

If the patient qualifies and consents to participate, an envelope will be opened that tells us to exchange the catheter for a new one OR infuse TPA (clot-dissolving drug) into the 2 ports for two and a half hours. Some dialysis patients have had a TPA "dwell" at the dialysis clinic to help increase blood flow during dialysis. The motion of the "infusion" of TPA is expected to be more effective than a "dwell" that sits still. Also, there is more TPA used during "infusion" than during the "dwell".

Once the catheter is functioning, the patient goes home as usual and follow-up is done by phone after the next dialysis session, at 30 days and at 60 days. Follow-up is done to check for flow rates during dialysis and to check for any problems related to the catheter treatment. Participation is complete after the 60-day follow-up phone call.

Eligibility Criteria:
Inclusion Criteria:

* Patients with tunneled hemodialysis catheters who have clinical evidence of catheter tip clot and fibrin sheath formation

Exclusion Criteria:

* Malpositioned or kinked catheter requiring catheter change
* Complete thrombosis of the catheterized vein
* Evidence of catheter related infection
* GI bleed within 6 weeks
* Cerebral Infarct within 6 months
* Major surgery within 4 weeks
* Platelet count below 25000
* INR above 2.0
* Sepsis
* Pregnancy
* Inability to give consent
Pre-Approval Access to Pimodivir for the Treatment of Patients With H7N9 Influenza A Infection

The purpose of this program is to provide pre-approval access to pimodivir for the treatment of a patient(s) with H7N9 influenza A infection. Pre-approval access pertains to provision for therapeutic use of an investigational product prior to its marketing authorization. Such access may be considered for eligible patients with serious/life-threatening diseases or conditions, where alternative treatments do not exist or have been exhausted.


Eligibility Criteria:
Inclusion Criteria:

* The patient has an H7N9 Influenza A infection
* The patient has no known severe hepatic impairment

Exclusion Criteria:

- Any other Influenza A sub-strains other than H7N9
Effect of I-Shape Incısıon Technique on Inter-Implant Papilla: A Prospective Randomized Clinical Trial

Regenerating a predictable inter-implant papilla is the most complex and challenging aspect of implant dentistry. The aim of the study was to compare the efficacy of I shaped incision technique and conventional midcrestal incision technique for interimplant papilla reconstruction in a 6 month clinical trial.

A total of 40 implants were placed in 12 patients. Groups were determined at second stage surgery, I shape technique used in test group and mid-crestal technique used in control group. The clinical parameters, including modified plaque index, modified sulcus bleeding index, probing depth, keratinized tissue level were recorded baseline, 3 and 6 month. The vertical distance between the crests top-contact point was evaluated with digital periapical radiographs at baseline 3 and 6 month. Also the clinical photographs were taken baseline, 3 and 6 month. Two T shaped full-round hexagonal straight filaments, each 5 mm, were used in the taking of standardized images. With these images the ratio of the papilla area in proportion to the embrasure area and the papilla classification was measured. Non-parametric test were used for statistically analysis.

Eligibility Criteria:
Inclusion Criteria:

* No sistemic condition, and age \> 18 years,
* healthy soft tissue (bleeding on probing (BOP) ≤ 20%, Plaque Index ≤ 15%,
* in a need of at least two collateral implants in the maxilla from second premolar to second premolar
* sufficient keratinized tissue
* no bone augmentation procedures before implant placement
* use of tobacco 10N ≥ cigarettes daily
* sufficient distance between opposite occluding dentition at the proposed implant sites

Exclusion Criteria:

* history of aggressive periodontitis,
* systemic diseases such as diabetes
* pregnant or lactating women
* radiation therapy in the head and neck area wihtin the previous 12 months,
* heavy smokers
* bruxism.
the Effect of Speed Dependent Treadmill Training on Dual Task Performance in Patient With Parkinson's Disease.

The aim of this randomized clinical trail is to identify the impact of treadmill training on walking while doing dual task in patients with Parkinson's disease. By improving walking speed, bradykinesia would be reduced in Parkinson's patients. So, the findings of this study can help in formulation of future guidelines for management of Parkinson's that will help the clinicians to treat such patients in more efficient way.

A RCT that investigated the effect of Treadmill training and physiotherapy in patient with PD using dual tasking as outcome measure.105 Parkinson's disease (PD) patients; these are the subject who received treadmill training and physiotherapy for 14 days. Both intervention helps the patients to enhance the dual task gait velocity.

A study is to identify the effects of incremental speed-dependent treadmill training on postural instability and fear of falling in Parkinson's disease to observe the postural stability by incremental speed dependent treadmill training. 54 patient of Parkinson's disease (PD) was randomly allocated in to experimental and control group. 8-week training program was conducted including stretching, Range of motion exercises (ROM), and treadmill training. Walking distance of the training group was gradually increased after 16 training sessions. The training group's scores on the Berg Balance Test, Dynamic Gait Index, and Falls Efficacy Scale dramatically improved after the training program. While the control group, shows no significant improvement in outcome measurements. Specific exercise regimens, such as incremental speed-dependent treadmill training, may increase mobility and minimize fear of fall in-patient with Parkinson's disease.

GAP:The study's relatively small sample size is one of its limitations. There is least work done on speed dependent treadmill training and its effect on dual task performance in-patient with Parkinson's disease. More research is require, to compare various treatment options with incremental speed-dependent treadmill training for Parkinson's disease patients.

Eligibility Criteria:
Inclusion Criteria:

* Able to walk on treadmill for 20 min
* Cognitively able to perform required task
* Hoehn and yarn disease stage between I to III.

Exclusion Criteria:

* Gait impairment
* Cardiac impairment
* Dementia
* History of fall
* Severe Freezing episodes
* Camptocormia (axial deformity)
* Central or peripheral paresis
* Score less than 20 in mini mental scale.
Noninvasive Monitoring of Uterine Activity and Fetal Heart Rate

A clinical study designed to validate the safety and performance of the TrueLabor™ device in monitoring labor vs. current standard of care.


Eligibility Criteria:
Inclusion Criteria:

* Women who are on \>=37w0d of gestation
* Maternal age \> 18 years old
* Singleton pregnancy
* Cephalic presentation
* Patient requiring internal monitoring for obstetric indications
* Informed consent

Exclusion Criteria:

* Major fetal anomalies
* Patients with implanted electronic devices of any kind
* Patients using exterior electronic devices of any kind during the procedure
* Patients with irritated skin or open wound on the abdominal wall
Safety Study of AVP-923 in the Treatment of IEED (Involuntary Emotional Expression Disorder) Also Known as Pseudobulbar Affect (Episodes of Uncontrolled Crying and/or Laughter)

The purpose of this study is to evaluate the long-term safety of AVP-923 in the treatment of Involuntary Emotional Expression Disorder (IEED) also known as Pseudobulbar Affect (episodes of uncontrolled crying and/or laughter).

This is an "open label" study which means there is no placebo group. Each subject enrolled into the study will receive AVP-923.

Eligibility Criteria:
Inclusion Criteria:

* 18 to 75 years of age, inclusive
* Clinical diagnosis of PBA (pseudobulbar affect)
* If female, must not be pregnant or breast feeding

Exclusion Criteria:

* Sensitivity to quinidine or any opiate drugs
* Current or prior history of major psychiatric disturbance
* Currently participated in a trial within the past 30 days
Strategies to Increase HIV Testing, Linkages to Care, and Male Circumcision in Africa

The purpose of this study is to determine efficient, scalable, evidence-based strategies to link HIV positive individuals to care and HIV negative individuals to prevention measures, such as voluntary male circumcision.

New strategies for HIV testing and linkages to care are needed, since only a minority of African adults have been tested in many settings and a drop-off occurs at each step from HIV and CD4 testing, remaining in pre-ART (antiretroviral therapy) care, ART initiation, and adherence over the long term.

This study aims to determine the effects of Point-of-Care (POC) CD4 testing, POC viral load (VL) testing and several linkage strategies (lay-counselor follow-up, accompaniment to HIV clinic by lay counselor, or clinical referral) on linkage to care and treatment adherence for HIV positive persons.

This study also aims to determine the uptake of voluntary circumcision among HIV uninfected males with either promotion at point of HIV testing, Short Message Service (SMS) follow-up or lay counselor follow-up visits.

Eligibility Criteria:
Inclusion Criteria:

* Reside in the study community
* Must be 16 years or older
* Able and willing to provide informed consent/assent for study procedures
* HIV negative uncircumcised men must be age 16 - 49 years and have access to secure text messaging to be randomized to strategies for male circumcision.

Exclusion Criteria:

* N/A
Correlation Between Vitamin D and Symptoms Severity of Autonomic Nervous Mediated Syncope Child and it 's RAAS

children ; autonomic nervous mediated syncope； vitamin D ; symptom score ; renin-angiotensin-aldosterone-system

children with autonomic nervous mediated syncope have seriously affects children's physical and mental health and quality of life, and the incidence rate is also increasing year by year. But the current treatment measures are not ideal, Therefore, we need to look for new biological indicators, according to different biological indicators to develop different treatment options, so as to improve the current situation of poor treatment of children with NMS

Eligibility Criteria:
Inclusion Criteria:

* Children diagnosed with OI;
* Compliance with the diagnostic guidelines for Syncope in children (2016 edition) and 2018 syncope in children and adolescents in the cardiovascular group of the Society of Pediatrics, Chinese Medical Association The diagnostic criteria of Oi in the Diagnostic and therapeutic guidelines.

Exclusion Criteria:

* Taken 3 months prior to admission Vitamin D or hormone drugs;
* Heart, brain, nerves, metabolism, blood and other apparatus Syncope or aura of syncope caused by a qualitative disease;
10 Prescriptions an Hour. Group Treatment and Physical Activity Referral in a Primary Health Care Setting

The purpose of this study is to determine the effects of group treatment including physical activity referral (PAR) on level of physical activity and quality of life in patients diagnosed with type 2 diabetes and/or hypertension in a primary health care setting

A sedentary lifestyle and low levels of physical activity in populations are major health problems today and contribute substantially to poor health and diseases such as type 2 diabetes and hypertension. An increased and systematic effort to increase physical activity in the Swedish population in general, and in patients with type 2 diabetes/hypertension in particular, is important. Written prescriptions of physical activity with follow-up (i.e., PAR), is a cost-efficient way to increase physical activity in individuals.

The aim of this trial is to study whether physical activity is increased by a group method involving PARs in patients with hypertension and/or type 2 diabetes compared with a control group that receives usual care in the same primary care setting. Follow-up will be performed at 6 and 12 months.

This trial is being conducted to determine whether it is possible to offer PARs to more patients in a way that requires less effort and resources. The intervention in this study requires 10 minutes of a health care worker's time per patient during a 6-month period. Each patient requires 100 minutes with an instructor who oversees the group intervention.

Group treatment is given 3 weeks after baseline and at 6 months. Follow-up at 12 months involves data collection, but no intervention.

An empowerment process, with the 5-A-model as framework, will be used in the clinical intervention.

All participants will be required to fill in questionnaires and wear an ActiGraph GTM1/GTM3 for 7 days at baseline and at 6 and 12 months.

Eligibility Criteria:
Inclusion Criteria:

* Clinical diagnosis of hypertension or type 2 diabetes since 10-09-2009 at St Hans Primary Health Care Center, Lund, Sweden

Exclusion criteria:

* Dementia
* Psychosis
* Drug abuse
* Mental retardation
* Inability to walk without assistance
* Inability to speak Swedish
Prehabilitation for Pelvic Cancer: Changes in Setup Variability

The investigators hypothesize that two pelvic relaxation exercises will be feasible and safe to perform by subjects daily before radiation during the participant's treatment and will decrease variability of sacral slope measurements on daily port films. The investigators will observe trends in the daily variability and change in the sacral slope in each participant to determine if this could decrease variability. The investigators will compare these measurements to a retrospective cohort that did not have the exercises, but did demonstrate variability. Reducing set-up variability (which inadvertently occurs during radiation) is important to improve radiation targets and diminish potential adverse effects. The investigators will query participants for objective and subjective feedback on the exercises and record frequency and duration of the two exercises.


Eligibility Criteria:
Inclusion Criteria:

* Patients will be \>21 yrs of age and will have an oncologic diagnosis that requires a course of pelvic radiation therapy for a minimum of 5 weeks.
* They will have an ECOG Performance Status (This scale, developed by the Eastern Cooperative Oncology Group (ECOG), now part of the ECOG-ACRIN (American College of Radiology Imaging Network) Cancer Research Group, describes a patient's level of functioning in terms of their ability to care for themselves, daily activity, and physical ability (walking, working, etc.)) of 1 or better as determined by patient history.
* They will be ambulatory without needing any ambulatory aids such as a cane or walker.
* Both men and women will be eligible as there is no significant anatomical difference in sacral slope measurement. Joint replacement patients will not be excluded.

Exclusion Criteria:

* Adults unable to consent
* Individuals who are not yet adults (infants, children, teenagers)
* Pregnant women
* Prisoners
* Non-English speaking subjects
Non-Invasive Ventilation Preoperative Lung Resection Surgery

Surgical treatment is the standard treatment for localized forms of lung cancer non-small cell. It allows a 5-year survival exceeding 50% for complete resection of the tumor. This is a heavy treatment, resulting in a mortality of 4 to 8% and a morbidity of 20-60%. Securing this procedure is a major public health issue. The non-invasive ventilation is a technique commonly used postoperatively in acute respiratory distress and in the treatment of sleep apnea syndromes. Through its effect on oxygenation and pulmonary function parameters, the non-invasive ventilation achieved during 7 days minimum before the intervention could significantly reduce postoperative complications in patients with an obstructive or restrictive disorder, obesity or chronic heart failure.

The aim of the study is to demonstrate that the non-invasive ventilation in two pressure levels achieved during at least 7 days before surgery lung resection (lobectomy or segmentectomy) halved the pulmonary and cardiovascular postoperative patients with obstructive ventilatory disorder or restrictive, obesity or chronic heart failure.


Eligibility Criteria:
Inclusion Criteria:

* Patient over 18 years, to benefit from surgery scheduled for lung resection (lobectomy or segmentectomy) for primary lung cancer and having signed an informed consent.

AND

* Trouble obstructive (FEV / FVC \<70% and FEV \<80% predicted)

Or restrictive (FVC \<80% or TLC \<80%)

Or decrease in the ratio TLCO / VA \<60%

Or history of respiratory failure with hypercapnic Pa CO2\> 45 mmHg in the year preceding surgery

Or long-term oxygen

Or heart failure (clinical signs of heart failure and LVEF \<55% or disorder of relaxation on echocardiography or atrial fibrillation)

Or history of acute cardiogenic pulmonary edema.

Or obesity (BMI\> 30 kg/m2)

Exclusion Criteria:

* Inability to consent
* Patient declared inoperable given the comorbidities or refusing surgery or with unresectable tumors.
* Patient operable but with no comorbidities described in the inclusion criteria
* Contraindications to the non-invasive ventilation:

  * Lack of understanding of the technical
  * facial malformation
  * Tight stenosis of the upper airway
  * uncontrollable vomiting
  * Unable to remove the mask
  * Cognitive impairment or severe psychiatric jeopardizing the observance of the NAV
* Patient non-insured
* Patient already on invasive ventilation or non-invasive
* During Pregnancy
Evaluating the Effectiveness of a Chronic Disease Management Program for Gout

The aim of this study is to test the effectiveness of a pharmacist-staffed, protocol-based chronic disease management program compared to patients receiving usual care in achieving a target serum uric acid level in patients with recurrent gout.

Gout is a chronic condition with intermittent symptoms and should be managed through an outcome-based disease management approach. Unlike other common chronic conditions, strategies for population management in gout patients have not been tested. The study will identify adult members of Kaiser Permanente (KP) Northern California with a diagnosis of gout and 3 or more outpatient or Emergency Department visits for gout over a 1-year period preceding study enrollment. These patients will be randomized to either an active management group, or to usual care. The participants will be enrolled and followed over a period of 26 weeks. The primary outcome to be measured will be the attainment and maintenance of a uric acid lowering regimen targeted to achieve serum uric acid level of 6.0 mg/dl or less. The treatment protocol will use standard treatment guidelines to lower and maintain uric acid levels to less than or equal to 6.0 mg/dl (or maximum doses of uric acid lowering medications) and provide patient education and dietary counseling. Monitoring and medication management will be carried out by a licensed clinical pharmacist under the supervision of an experienced rheumatologist. Control subjects will have regular monitoring of serum uric acid levels and will be provided with educational material and dietary counseling, but otherwise receive usual care. The demonstration that a chronic disease management approach to gout care can improve the health and reduce morbidity in patients with gout may illuminate a simple path towards improved quality of life and reduced morbidity in this growing population of patients.

Eligibility Criteria:
Inclusion Criteria:

Three or more outpatient/ED visits in a 24-month period prior to selection for study with one of these primary visit diagnoses:

* Gouty arthropathy
* Gout, unspecified
* Gout with other specified manifestations
* Tophaceous gout of ear (274.81) or other sites
* Gouty nephropathy

At least 2 years of continuous Kaiser Foundation Hospital Plan membership

Baseline uric acid level above 7.0mg/dl

Exclusion Criteria:

* Current cancer diagnosis with active treatment
* End stage renal disease
* Pregnant or lactating
* Patients with a diagnosis of dementia
* Terminally ill patients
Sensorimotor Integration Underlying Balance Control in Individuals With Incomplete Spinal Cord Injury

The objectives of the study are to evaluate a 4-week mixed training paradigm consisting of explosive strength training and balance perturbation training efficacy on balance control during standing and locomotion, and to understand the mechanisms of neuroplasticity that would improve sensorimotor integration at supraspinal and spinal levels.

After obtaining their consent, participants will undertake evaluations at different times:

1. Assessment 1 week prior to training
2. Training over 4 weeks (nature of the training depends on the group)
3. Assessment 1 week after training
4. Assessment 1 month after training (follow-up)

Each assessment will be divided in 2 sessions and data will be collected over 2 days, at one session per day. Days can be consecutive or non-consecutive but will be within a given week. The assessment consists of:

* Session 1 (S1; duration: 3h) will include presentation of the Study and obtainment of consent, clinical tests, galvanic vestibular stimulation testing, postural reactions and gait assessment.
* Session 2 (S2; duration: 3h) will include muscle strength, short-afference inhibition, paired pulse and trans cranial magnetic stimulation conditioning of H reflex.

After the initial assessment, iSCI participants will be separated in 2 groups and will receive combination of explosive strength and balance training or no intervention. The training will span over 12 sessions (3 times per week for 4 weeks) and each training session will last approximately 1h (including effective training and installation periods).

Eligibility Criteria:
FOR PARTICIPANTS WITH SPINAL CORD INJURY

Inclusion Criteria:

* Have an incomplete lesion of spinal cord
* Level of spinal cord lesion between C5 and T12
* At least, 6 months post-injury
* Be considered as AIS C or D
* Be able to stand without support for 15 seconds
* Be able to provide informed consent in English or in French

Exclusion Criteria:

* To have cognitive deficits
* To have personal or family history of epilepsy
* To have suffered moderate or severe traumatic brain injury
* To have cochlear implant

FOR CONTROL PARTICIPANTS

Exclusion Criteria:

* To have orthopedics problems
* To have cognitive deficits
* To have neurological problems