cyrilzakka/clinical-trials huggingface dataset:
Diaphragmatic Tissue Doppler During Weaning From Mechanical Ventilation

Weaning from mechanical ventilation is a critical issue and the diaphragmatic disfunction has been demonstrated to play an important role in extubation failure. the aim of present investigation is to evaluate diaphragmatic excursion velocity during in patients undergoing spontaneous breathing trial through tissue Doppler analysis in both inspiration and expiration.

Tobin Index (RSBI), which is the ratio between respiratory rate (RR) and tidal volume (VT), is one of the most used indices to predict weaning outcome. The diaphragm plays a key role in generating VT and, in the case of diaphragmatic dysfunction, inspiratory accessory muscles may contribute to support ventilation. If this occurs during a spontaneous breathing trial (SBT), it will probably result in delayed weaning, since the accessory muscles are more fatigable than the diaphragm.

The diaphragmatic tissue Doppler imaging (TDI) is an ultrasonographic technique derived from ultrasound evaluation of heart's motility. Being a muscle doppler assessment, it can be easily used on the diaphragm to calculate the speed of muscles displacement that could be associated with patient's respiratory drive, as well as other derived index of muscle function.

The aim of the study is to measure the variations of diaphragmatic displacement velocities before and during the spontaneous breathing trial, useful to check if the patient is ready to breathe spontaneously. An observational study will be performed. Patients who are ready to be weaned will be subjected to a spontaneous breathing test (Cpap 5), that consists of applying a positive end-expiratory pressure of 5 cm H2O for 20 minutes. A tissue Doppler evaluation will then be performed by analyzing the diaphragmatic displacement velocity during inspiration and expiration in the modality of ventilation which precedes the trial and during the SBT.

Vital parameters will be monitored during the study. Mechanical ventilation length, incidence of tracheostomies, ICU and hospital recovery duration and hospital mortality will also be acquired.

Eligibility Criteria:
Inclusion Criteria:

* mechanical invasive ventilation ≥ 24 h
* readiness for extubation

Exclusion Criteria:

* refusal to grant consent
* pregnancy
* hemodynamic instability
* difficult management of secretions
* request for inotropy and/or vasoactive drugs at high doses
Research of the Application of Triple Antibiotic Paste in Primary Teeth With Pericpical Periodontitis

The triple antibiotic paste is widely used in young permanent teeth and permanent teeth root canal therapy with excellent antiantimicrobial effect.We hypothesize that its application in the treatment of periapical periodontitis of deciduous teeth is superior to other drugs currently in use as creosote.

We design to collect a group of patients presenting primary teeth with periapical periodontitis in certain criterion. We will divide the patients into two groups randomly.One group will get treated with triple antibiotic paste while the other with creosote.We want to evaluate the short-term and long-term effects of the two groups to get a conclusion of the clinical value of triple antibiotic paste.

Eligibility Criteria:
Inclusion Criteria:

* clinical diagnosis of periapical periodontitis
* must be primary teeth
* must be 3\~8 years old
* the permanent tooth germ is complete and didnot be involved

Exclusion Criteria:

* blood disease
* residual root that is advised to extract
* serious periodontitis
* allergy to the triple antibiotic paste
Necrotizing Enterocolities

Haematological disturbances in neonates with necrotizing enterocolities

Necrotizing enterocolitis (NEC) is an acquired, multifactorial and devastating gastrointestinal disease associated with high morbidity and mortality in preterm neonates. With an incidence of about 7% in infants with BW \&lt; 1500 g and mortality up to 30%, NEC presents as a medical and surgical emergency It is characterized by ischemia, necrosis, and inflammation of bowel wall with invasion by gas-forming organisms and intramural dissection of gas ,characteristicall appearing as pneumatosis intestinalis in radiological and pathological studies. While exact etiology is undetermined, the pathogenesis is believed to be an anomalous innate immune response to an altered, less diverse intestinal microbiota by the highly immunoreactive enterocytes of premature infants, leading to inflammation and tissue necrosis

* in this devastating disease with undetermined etiology. Breast milk feeding, prolonging gestation to avoid prematurity, antenatal steroid, and the use of probiotics/prebiotics are established prevention strategies in NEC
* The hematological abnormalities associated with NEC were first described 25 years ago by Hutter et al.The abnormalities observed in a series of 40 patients with NEC included thrombocytopenia, with
* and without disseminated intravascular coagulation (DIC), neutrophilia or neutropenia, and hemolytic anemia.

Eligibility Criteria:
Inclusion Criteria:

* preterm less than 36 weeks
* Or very low birth weight less than 1500 gram

Exclusion Criteria:

* full term
* Normal birth weight ,Preterm with early breast feeding or more than 1500 gm
Thermal Ablation Versus Parathyroidectomy for Primary Hyperparathyroidism

This study is a prospective, multicenter study designed to compare the efficacy and safety of surgical treatment versus ablation therapy (including radiofrequency ablation and microwave ablation) for patients with primary hyperparathyroidism (PHPT). The study will assess the impact of both treatment modalities on serum parathyroid hormone (iPTH) and calcium levels, clinical symptom improvement, bone mineral density enhancement, reduction in the incidence of urinary system stones, and postoperative complication rates. While surgical treatment has been the standard of care for PHPT, offering definitive cure, it carries inherent surgical risks and complications. Ablation therapy, as a minimally invasive approach, presents a novel alternative with reduced trauma and fewer complications. The outcomes of this study will inform clinical decision-making and potentially optimize treatment strategies for patients with PHPT.


Eligibility Criteria:
Inclusion Criteria:

* Symptomatic patients with primary hyperparathyroidism, such as those with symptoms in any system including the kidneys, bones, gastrointestinal tract, psychoneurological system, or those with atypical symptoms such as muscle weakness, dysfunction, and sleep disorders.
* Asymptomatic PHPT patients with any of the following conditions:

  ① Serum calcium is higher than the upper limit of the normal value by 1 mg/dL (0.25 mmol/L);

  ② There is objective evidence of renal involvement, including asymptomatic kidney stones, nephrocalcinosis, hypercalciuria (24 - hour urinary calcium level \> 400 mg/dL) on renal imaging, or impaired renal function (glomerular filtration rate \< 60 mL/min);

  ③ There is evidence of osteoporosis (bone mineral density decreased by 2.5 standard deviations at any site) and/or radiographic evidence of fragility fractures.

  ④ Age \< 50 years

  ⑤ The patient cannot accept routine follow - up observation.
* Imaging examination shows that at least one parathyroid gland is enlarged.

Exclusion Criteria:

* diagnosis of secondary or tertiary HPT
* severe coagulation disorder
* severe cardiopulmonary insufficiency
Improving Adolescent Health Outcomes Through Preventive Care Transformation

Preventive care for adolescents is vitally important for maximizing their health and well-being. Unfortunately, pediatric primary care frequently fails to meet the preventive needs of adolescents as demonstrated by poor health outcomes for this population.

In this grant application, the investigators propose to expand an existing computer decision support system (CDSS) into the investigators adolescent primary care practices for the purpose of implementing a comprehensive, and developmentally appropriate, screening and physician decision support process. Prior work completed by the investigators research group has demonstrated the feasibility of using CDSS to implement and evaluate clinical guidelines. The investigators seek to positively impact the effectiveness of preventative primary care visits by applying this previous success to the investigators adolescent practice. The investigators hypothesize that the implementation of developmentally appropriate universal screening practices, using tablet technology, and enhanced physician decision support regarding clinically relevant guidelines for all annual adolescent preventive care visits will result in better health outcomes, including higher rates of adherence to physician recommendations and improved patient functioning.

The specific research aims of this proposal are:

Aim 1: Expand and modify an existing CDSS to include an Adolescent Preventive Care Module comprised of developmentally appropriate screening tools for adolescents aged 11 to 21 years and tailored evidence-based clinical decision support for physicians.

Aim 2: Evaluate the impact of the Adolescent Preventive Care Module on the identification of specific mental and physical health problems and treatment outcomes in an adolescent primary health care setting.

Adolescent primary care issues of interest for this project include sexually transmitted infection (STI), depression, substance use and Human Papillomavirus (HPV) immunization. The investigators expect this project to improve the health outcomes of adolescents, guide future efforts to implement universal screening and CDSS in a variety of primary care settings, and provide additional evidence to support broad-based electronic screening and computerized decision support for use in preventive care as a method for improving adolescent health.


Eligibility Criteria:
Inclusion Criteria:

* 11-21 years
* attending primary care clinic

Exclusion Criteria:

* none
Study of Abemaciclib in Dedifferentiated Liposarcoma

The purpose of this study is to test any good and bad effects of the study drug called Abemaciclib. Abemaciclib could shrink your cancer but it could also cause side effects. Researchers hope to learn if the study drug will delay the growth of the cancer or shrink the cancer by at least one quarter compared to its present size. Abemaciclib is not FDA approved and has not been tested in liposarcoma, but it has shrunk tumors in patients with breast cancer, lymphoma, and lung cancer.


Eligibility Criteria:
Inclusion Criteria:

* A diagnosis of dedifferentiated liposarcoma confirmed at MSKCC.
* Metastatic and/or locally advanced or locally recurrent disease that is not surgically resectable.
* All patients must have measurable disease as defined by RECIST 1.1. Patients must also have evidence of disease progression by RECIST 1.1 within 6 months of first dose of study drug.
* Any number of prior therapies (including none) is permitted. The last dose of systemic therapy (include targeted therapies) must have been given at least 2 4 weeks prior to initiation of therapy. Patients receiving BCNU or mitomycin C must have received their last dose of such therapy at least 6 weeks prior to initiation of therapy.
* Patients with brain metastasis that have been treated with definitive surgery or radiation and have been clinically stable for 3 months are eligible.
* Age ≥ 18 years.
* ECOG performance status 0 or 1
* Adequate organ and marrow function as defined below (ULN indicates institutional upper limit of normal):
* Absolute neutrophil count ≥ 1.510\^9/L
* Hemoglobin ≥ 8.0 g/dL
* WBC ≥ 3.0 x 10\^9/L
* Platelets ≥ 100 x 10\^9/L
* Total bilirubin ≤ 1.5 x ULN except for patients with known Gilbert syndrome
* AST(SGOT)/ALT(SGPT) ≤ 3 x institutional ULN
* Creatinine ≤ 1.5 x ULN or Creatinine Clearance \> 50 mL/min (calculated by Cockcroft-Gault method)
* Patients must not have current evidence of another malignancy that requires treatment.
* Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence). Women must not breast feed while on study.
* Ability to understand and the willingness to sign a written informed consent document.
* Ability to swallow capsules

Exclusion Criteria:

* Patients who have not recovered from adverse events of prior therapy to ≤ NCI CTCAEv4.0 Grade 1.
* Patients receiving any other investigational agents.
* Patients who have received prior treatment with a selective CDK4 inhibitor
* Uncontrolled intercurrent illness including, but not limited to, known ongoing or active infection, including HIV, active hepatitis B or C, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia (specifically, atrial fibrillation or ventricular dysrhythmias except ventricular premature contractions), or psychiatric illness/social situations that would limit compliance with study requirements.
* Pregnant women and women who are breast-feeding.
Mindfulness-Based Intervention in Breast Cancer Patients Undergoing Chemotherapy

There is evidence that mindfulness-based interventions (MBIs) such as meditation, mindfulness-based stress reduction (MBSR) and yoga might improve Quality of Life (QOL) and reduce stress in breast cancer survivors. These interventions are becoming increasingly popular in cancer survivors. However, little is known about the feasibility and effect of MBIs administered during the interval of time of chemotherapy, on QOL and stress. The investigators are planning a MBI intervention study developed specifically for breast cancer survivors receiving chemotherapy (usually 4-5 months) at the investigators institution, for at least 8 sessions combined with at least 8 weeks of home-practice, in 25 women receiving chemotherapy for breast cancer.


Eligibility Criteria:
inclusion criteria:

* Women 20-75 years old
* Diagnosed with breast cancer
* Scheduled to begin chemotherapy at Mayo Clinic Rochester

Exclusion criteria

* Pregnant
* Practicing mindfulness
A Study to Compare the Efficacy, Safety, Immunogenicity, and Pharmacokinetic Profile of HLX17 Vs. Keytruda® in the First-Line Treatment of Advanced Non-squamous Non-small Cell Lung Cancer

This is a multicentre, randomized, double-blind, parallel-controlled integrated phase I/III clinical study to evaluate the similarity in efficacy, safety, PK profile, and immunogenicity of HLX17 vs. Keytruda®( US- and EU-sourced) in the first-line treatment of advanced non-squamous non-small cell lung cancer.

This study includes three treatment groups. Patients will be randomly assigned at a 2:1:1 ratio to the HLX17, US-sourced Keytruda® and EU-sourced Keytruda® group to receive the treatment of IMPs in combination with Carboplatin Plus Pemetrexed until disease progression, initiation of new anti-tumor therapy, withdrawal of informed consent form, death, unacceptable toxicity, or up to 17 cycles (whichever occurs first).

Eligibility Criteria:
Inclusion Criteria:

* Histologically or cytologically confirmed diagnosis of stage IV inoperable to surgery or radiotherapy (AJCC 8th edition) non-squamous NSCLC.
* Without any tumor activating EGFR mutation or ALK or ROS1 gene rearrangement.
* Have not received prior systemic treatment for their advanced/metastatic NSCLC.
* At least one measurable lesion as assessed by IRRC based on RECIST v1.1.
* Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Status.
* Have adequate organ function.

Exclusion Criteria:

* Subjects with NSCLC of other histopathological types, such as mixed adenosquamous carcinoma, and subjects with small cell lung cancer or neuroendocrine carcinoma.
* Subjects with other active malignancies within 5 years or at the same time prior to screening.
* Active central nervous system metastases.
* Known interstitial pneumonia, pneumoconiosis, radiation pneumonitis, drug-related pneumonitis, and severe lung function abnormalities that may impede the investigators' diagnosis and management of drug-related pulmonary toxicity.
* Known active or suspected autoimmune diseases.
* History of immunodeficiency, including HIV antibody positive, active hepatitis B; or hepatitis C virus infections.
* Have received pembrolizumab or any other immune checkpoints inhibitors (PD-1, PD-L1, CTLA4, etc.) before screening.
* Pregnant or breastfeeding female.
* The investigator has a clear reason to believe that participation in this study would be detrimental to the subject.
Single Port Colic Laparoscopic Surgery

This study aims to compare the results of colonic surgery performed by single and multiport laparoscopy.

The aim of this study is to compare surgical results of colonic resection performed by single port and multiport laparoscopic approaches. Primary endpoint is the length of postoperative hospital stay. Secondary endpoints include postoperative mortality, postoperative morbidity, conversion rates, postoperative recovery, aesthetic results, postoperative pain, and costs

Eligibility Criteria:
Inclusion Criteria:

* Age ≥ 18
* Colonic resection performed for benign or malignant colonic neoplasm, Crohn's disease, or diverticulitis
* Informed consent signed
* Social Insurance

Exclusion Criteria:

* Digestive stoma in place or planned during the intervention
* Body mass index \> 30 kg/m2
* History of previous laparotomy, except Mc Burney, Pfannenstiel ou subcostal
* Subtotal colectomy
* Transverse colectomy
* Proctectomy or total coloproctectomy
* Synchronous metastasis
* Preoperative suspicion of T4 colorectal cancer
* Emergency procedure
* Associated resection (except appendectomy or liver biopsy)
* Pregnancy or current breast feeding.
Genetics of Progressive Multifocal Leukoencephalopathy and Acquired Immunodeficiency Syndrome

This study will identify genetic factors associated with the development of progressive multifocal leukoencephalopathy (PML) in patients with acquired immunodeficiency syndrome (AIDS). PML is a life-threatening infection of the brain that affects about 5 percent of untreated patients with AIDS. Its symptoms include mental deterioration, vision loss, speech disturbances, ataxia (inability to coordinate movements), paralysis, and coma. PML is caused by a polyomavirus called the JC virus.

It is estimated that up to 80 percent of the human population has been exposed to the JC virus, but the disease is very rare. The virus only becomes active in people who have compromised immune systems, such as those undergoing immune suppressive chemotherapy for cancer and those with damaged immune systems due to HIV.

Patients who have participated in the Multicenter AIDS Cohort Study may be eligible for this study, as well as healthy normal volunteers who will serve as controls. The study will review clinical information from patients and analyze genetic factors from both patients and control subjects to investigate genes associated with AIDS and JC virus infection.

The purpose of this study is to identify host genetic factors that contribute to the development of Progressive Multifocal Leukoencephalopathy (PML) associated with JC virus. JC virus is one of many opportunistic infections that arise in AIDS patients. JC virus is widely distributed in the general population, with estimates of population exposure ranging from 30-80%. JC virus remains latent in the host, and in profoundly immunosuppressed patients, JC virus can cause PML, a fatal disease associated with neurotropic JC virus that lytically infects oligodendrocytes. In untreated AIDS populations, the frequency of PML has been estimated at roughly 5%. This study will identify host genetic factors that may contribute to the development of PML in the AIDS population.

Eligibility Criteria:
* No available subjects will be excluded.
The Efficacy, Safety And Toleration Of CP-866,087 In Pre-Menopausal Women With Female Sexual Arousal Disorder.

CP-866,087 is a non-hormonal compound, acting on the central nervous system, which has been shown in animal models to restore sexual function.


Eligibility Criteria:
Inclusion Criteria:

* healthy pre-menopausal women
* primary female sexual arousal disorder causing distress
* on stable use of oral contraceptives

Exclusion Criteria:

* any other significant disease causing Female Sexual Dysfunction including psychiatric disease
* subjects on drugs known to cause Female Sexual Dysfunction
* subjects who have given birth in the last 12 months or who are planning to become pregnant during the study
Retinal Redetachment After Silicone Oil Removal : a Risk Factor Analysis

To report the rate of retinal redetachment after silicone oil removal (SOR) following rhegmatogenous retinal detachment (RRD) surgery and to determine potential risk factors


Eligibility Criteria:
Inclusion Criteria:

* patients with successfully repaired rhegmatogenous retinal detachment and subsequent silicone oil removal
* minimum follow-up period of 6 months after silicone oil removal

Exclusion Criteria:

* Silicone oil tamponade for indications other than rhegmatogenous retinal detachment
* Retinal redetachment during silicone oil tamponade
* Prior history of silicone oil tamponade
Action Observation Therapy in Hemiparetic CP: Impact on Balance & Lower Limb Function

Background:

Action Observation Therapy (AOT) leverages the mirror neuron system to enhance motor learning and is anticipated to improve upper extremity function in children with cerebral palsy. However, its effects on balance, lower extremity function, and gait performance in children with hemiparetic cerebral palsy remain underexplored. The planned study aims to evaluate whether the addition of AOT to conventional physiotherapy will positively influence balance, lower extremity function, and gait performance in this population.

Objective:

The study is designed to assess the efficacy of incorporating AOT as an adjunct to conventional physiotherapy in improving balance, lower extremity function, and gait performance in children with hemiparetic cerebral palsy.

Methods:

A patient cohort consisting of children with hemiparetic cerebral palsy (GMFCS levels I and II) is planned to be assembled.

It is expected that a total of 20 patients will be recruited and then randomly allocated into an experimental group and a control group.

The experimental group is scheduled to receive conventional physiotherapy in addition to AOT sessions, while the control group is planned to receive conventional physiotherapy only.

The intervention period is planned for 6 weeks, during which both groups will participate in 12 physiotherapy sessions.

Additionally, the experimental group is scheduled to undergo AOT sessions twice weekly, with each session lasting 30 minutes.

Outcome measures to be employed will include the Timed Up and Go (TUG) test, Pediatric Balance Scale, Five-Step Stair Climbing and Descending Test, and the 6-Minute Walk Test (6MWT).

This study is expected to systematically evaluate the potential benefits of adding AOT to standard physiotherapy regimens for enhancing balance, lower extremity function, and gait performance in children with hemiparetic cerebral palsy.


Eligibility Criteria:
Inclusion Criteria:

* Diagnosed hemiparetic type of cerebral palsy

Exclusion Criteria:

* Any other types of cerebral palsy