cyrilzakka/clinical-trials huggingface dataset:
Effect of Propofol and Sevoflurane Anesthesia on HSP70 Expression in Tumor Cells

The goal of this clinical trial is to learn if sevoflurane-based inhalational anesthesia (s-IA) and propofol-based total intravenous anesthesia (p-TVA) have different effects on HSP70 expression in different types of tumour cells. The main questions it aims to answer are:

* if p-TVA/s-IA increase or suppress HSP70 expression in tumor cells in comparison with a pre-anesthesia level;
* does this change in HSP70 expression cause any difference in vital characteristics of tumor cells, such as proliferation, apoptosis, colony formation and migration.

Researchers will compare p-TVA with s-IA by ability of these types of anesthesia to change the HSP70 expression level and modulate HSP70-mediated effects in tumor cells.

Participants will:

* be randomly allocated to p-TVA or s-IA groups;
* donate 12 ml of blood before anesthesia induction and 12 ml after 2 hours of anesthesia.

The blood serum will be used to prepare cell medium. After exposure to this medium, cells from different tumor types will be investigated using cytological and molecular biological methods.

This study will be conducted in adult cancer patients who undergo planned radical or palliative tumor resection and signed informed consent. Patients with diabetes mellitus, HIV, hepatitis B and C, as well as patients who undergo emergency surgery will not be included to the study. Patients will be randomly allocated to propofol-based TVA (p-TVA) and sevoflurane-based IA (s-IA) groups. After the collection of blood before the anesthesia induction and in 2 hours of anesthesia, probes will be centrifuged to prepare serum. Cell medium will contain 50% of blood serum. Different tumor cell lines (human lung adenocarcinoma A549, large cell lung carcinoma NCI-H460, human colorectal adenocarcinoma DLD1) will be exposed to the cell medium for 4 hours what corresponds to an approximate duration of anesthesia for oncology surgery. HSP70 expression level will be determined using SDS-PAGE (polyacrilamide gel electrophoresis) and Western-blot analysis (intracellular HSP70 content), ELISA of cell medium (extracellular HSP70 expression) and confocal microscopy.

The A549 cell line with stable knockdown of HSP70 developed by shRNA will be used to distinguish HSP70-based effects of cell medium from p-TVA and s-IA groups on vital characteristics of tumor cells, including proliferation (MTT assay), apoptosis (LDH cytotoxicity assay), colony formation and migration (the Wound healing assay).

Researchers will compare HSP70 expression levels and vital characteristics of tumor cells exposed to patient serum before and after each type of anesthesia, as well as p-TVA group with s-IA group.

Eligibility Criteria:
Inclusion Criteria:

* Diagnosed malignant neoplasm
* Planned surgery for radical or palliative tumor resection
* Age over 18 years
* Signed informed consent

Exclusion Criteria:

* Diabetes mellitus type 2
* HIV, hepatitis B or C
* Emergency surgery
* Known or suspected allergy to studied drugs
* Other conditions when one of the types of anesthesia is more preferable (hemodynamic disorders, bronchial asthma etc)
Bortezomib for the Treatment of Refractory Rheumatoid Arthritis

This is a single-center, single-arm, prospective study on the efficacy and safety of Bortezomib in addition to standard therapy in patients with refractory rheumatoid arthritis.


Eligibility Criteria:
Inclusion Criteria:

1. Age between 18\~70 years.
2. Fulfilling the 2010 ACR/EULAR classification criteria for RA.
3. Failed to at least two bDMARDs (including but not limited to TNF inhibitors, IL-6 receptor inhibitors, T cell costimulation inhibitor and anti-B cell biologics) or tsDMARDs (including but not limited to JAK inhibitors) in combination with a csDMARD for at least 12 weeks. The dosage of cs/b/tsDMARDs needs to be stable for at least 6 weeks.
4. For patients receiving glucocorticoids, the dosage of GC needs to be less than or equal to 10mg prednisone equivalent and stable for at least 6 weeks.
5. For patients receiving non-steroid anti-inflammatory drugs, the dosage of NSAID needs to be stable for at least 2 weeks.
6. Neutrophil≥1.0×10\^9/L, platelet≥100×10\^9/L, alanine transaminase (ALT) and aspartate aminotransferase (AST) within 3 ULN, total bilirubin within 1.5 ULN.
7. Informed consent obtained.

Exclusion Criteria:

1. Other concomitant autoimmune diseases (except for Sjogren's syndrome secondary to rheumatoid arthritis).
2. The presence of severe uncontrolled cardiovascular, cerebrovascular, respiratory, hepatic, renal, gastrointestinal, endocrine, hematological or neuropsychiatric disorders, or abnormal laboratory tests. The investigators consider that participation in the study may make unacceptable risks to the subjects.
3. A history of malignancy with a clinical cure time of less than 5 years.
4. Pregnant or breast-feeding women, or planning to get pregnant or start breastfeeding during the study.
5. Vaccinated with live attenuated virus within 4 weeks before entering the study.
6. Allergic to bortezomib or mannitol.
7. Participated in any other investigational drug trial within 12 weeks before study initiation.
8. Active hepatitis or liver disease at the time of screening: Hepatitis B surface antigen (HBsAg) or anti-hepatitis C virus antibodies (HCVAb) positive; (Note: If Hepatitis B Core Antibody, (HBcAb) is positive and HBsAg is negative, HBV-DNA detection will be performed, patient is eligible if HBV-DNA was negative).
9. Active herpes zoster infection, or severe infection requiring intravenous antibiotics or hospitalization occurred 12 weeks before study initiation.
10. Other conditions that not suitable for inclusion in the study, assessed by the investigators.
Soft Tissue Volume Gain and Stability Comparing Palate and Tuberosity

The goal of this study is to compare clinical and histologically the soft tissue changes in terms of volume gain and stability around dental implants in cases where a subepithelial connective tissue graft from the palate or from the tuberosity is used randomly

Understanding the importance of the soft tissue around implants have lead clinicians to develop surgical approaches to augment it. The majority of them, are described as bilaminar techniques obtaining a subephitelial connective tissue graft (SCTG) from the palate (P). However, recent studies have demonstrated that tuberosity (T) tissue is a very dense and coarse tissue that seems to contain more collagen and less fat and glandular tissue than that from the P, and therefore may have better tissue qualities for soft tissue augmentation, but there is limited scientific evidence comparing these areas.

The main goal of this study is to compare the soft tissue volume gain and stability around implants in cases where a SCTG of the same dimensions from the P or T is used randomly. To calculate volume changes and stability an intraoral optical scan is used and three-dimensional images superimposed.

The secondary goal is to compare histologically both tissues and changes in clinical parameters. Histomorphometry and immunohistochemistry evaluating levels of Type I-III collagen, long lysyl hydroxylase, matrix metalloproteinase 1-2, and monoclonal antibody against cytokeratin 4-10-13 is performed.

Eligibility Criteria:
Inclusion Criteria:

* Patient must be ≥18 years and able to understand the nature of the proposed surgery and to a signed informed consent.
* Implant must be located between 2 fixed reference points i.e. clinical crowns.
* All implants locations with a need of a soft tissue volume augmentation.
* Palate must have ≥2mm of thickness at premolar area.
* Tuberosity \> 12mm in length.
* Full mouth plaque and bleeding score \<20%.

Exclusion Criteria:

* Previous soft tissue augmentation in the area.
* Heavy Smokers (\> 10 cigarettes per day).
* Local or systemic conditions that would interfere with routine periodontal therapy (non controlled diabetes, liver function disorder, immunosuppressant disease, autoimmune disease).
* Allergy to Non-Steroidal Anti-Inflammatory Drugs.
* Patients taking medications that cause gingival enlargement
* Gingival idiopatic overgrowth
Dapaglifozin to Avoid Acute Kindey Injury (AKI) to Chronic Kidney Disease (CKD) Transition: DAKI-CKD Study

Justification: Studies in recent years have shown that suffering an episode of acute kidney injury (AKI) is an independent risk factor for developing chronic kidney disease (CKD), which is associated with cardiovascular complications, increases medical care costs, and decreases survival. These AKI to ERC transition cases add to the growing number of CKD cases already being seen globally. It is for them that in recent years therapeutic strategies have been sought to reduce or stop this process of transition from AKI to CKD.

Objective: To evaluate the efficacy and safety of the use of dapagliflozin plus standard medical treatment (TMS), compared with only TMS for 21 days, in hospitalized patients with a diagnosis of severe AKI (KDIGO 3) in reducing the incidence of CKD to 18 months of follow-up.

Design: Randomized, single center, open study. 100 hospitalized patients with a diagnosis of AKI KDIGO 3, without previous CKD, will be randomized to receive 10 mg of dapagliflozin every 24 h for 21 days + TMS or only TMS. During their follow-up, baseline blood and urine samples will be taken and at 3, 6, 12 and 18 months. At 18 months, the development of CKD will be assessed using the KDIGO clinical criteria and with the determination of urinary biomarkers (Serpina A3, HSP72, KIM 1 and NGAL).

It is planned to randomize 100 patients, 50 for each arm of the study. The randomization will be 1: 1 based on an open access computer program.

Group 1: Dapagliflozin 10 mg, will be administered orally or by nasogastric tube every 24 h for 21 days.

Group 2: Standard of care strategy, patients will receive the usual treatment for their pathology according to the judgment of their treating physician and the Institutional practices, without receiving any of the interventional drugs.

Eligibility: Adults (aged \>18 years) with AKI 3 diagnosis for less than 24 h (KDIGO classification, creatinine level or urine output criteria), hospitalized in general admission floor and/or intensive care unit. AKI diagnosis must be compatible with the diagnosis of acute tubular necrosis in a context of ischemic or toxic aggression.

Eligibility Criteria:
Inclusion Criteria:

* Adults (aged \>18 years) with AKI 3 diagnosis for less than 24 h (KDIGO classification, creatinine level or urine output criteria), hospitalized in general admission floor and/or intensive care unit. AKI diagnosis must be compatible with the diagnosis of acute tubular necrosis in a context of ischemic or toxic aggression.

Exclusion Criteria:

* CKD Stage 3b (KDIGO) or more, renal transplant, urinary tract obstruction, thrombotic microangiopathy, acute glomerulopathy, cardiac arrest without awakening, oncological diagnosis with a life expectancy of less than 5 years, use of norephinephrine \>0.30 mcg/kg/min for 6 h or more, use of two vasopressors, PaO2/FiO2 ratio \<150, Type 1 DM, fasting for more than 48 h, previous inclusion in other study, pregnant or breastfeeding woman.
Fascial Release on Upper Cross Syndrome.

This study will be a randomized controlled trial conducted to investigate the effect of release of upper track of deep front fascial line on patients with Upper Cross Syndrome.A sample size of 40 will be randomly allocated to two group ,(20 participants in each group), by using computer-generated random number list method.

Experimental group will receive release of upper track of deep front fascial line in addition supervised corrective exercises for upper crossed syndrome and Control group which will receive supervised corrective exercise only. Both groups will receive eight sessions (2 sessions per week for 4 weeks).

Upper Cross Syndrome is a characterized by muscular imbalance of skeletal muscles activation and inhibition rather than just single muscle involvement. Individuals who present with upper crossed syndrome will show a forward head and neck posture Working in abnormal posture for prolonged duration is the main risk factor.

Although this posture does not necessarily lead to pain, but when prolonged, individuals do often experience upper back and neck pain.Stress on cervico-cranial and Cervico-thoracic junction is caused by the poor posture .Some postural patterning of forward shoulders, increases kyphosis, forward head posture, and loss of cervical lordosis is created by this poor posture.

Many researches studied effect of Exercises, stretching ,muscle energy technique,active release technique.Research on fascia gains more and more attention in basic science.

Fascial tissue plays an important role not only in functional anatomy,but also in sport and exercise science as well as in numerous therapeutic approaches as well as in clinical rehabilitation.Accordingly,There is no studies in the literature investigated the the effect of release of upper anterior track of deep front fascial line in subjects with upper cross syndrome, therefore this is the purpose study.

Eligibility Criteria:
Inclusion Criteria:

1. Age ranged from 18 to 40 years.
2. Body Mass Index ≤30 kg/m².
3. All participants have forward head ,craniovertebral angle less than 48-50 degrees.
4. All participants have round back(kyphosis angle ≥ 42°).
5. The subjects were chosen from both genders.
6. Based on assessment for upper cross syndrome by photogrammetric analysis

Exclusion Criteria:

1. History of trauma or surgery in cervical region.
2. Bone fractures or acute soft tissue injuries .
3. Osteoporosis .
4. Heart attack .
5. Unstable angina pectoris .
6. Implanted pacemaker or defibrillator .
7. Pregnant women.
8. Cancer .
9. Rheumatoid arthritis.
10. Connective tissue disease: This includes diseases such as osteomyelitis, lupus and scleroderma.
11. Neurological conditions.

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Combined Screening for Gastrointestinal Tumors

All participants are required to complete a questionnaire, a Helicobacter pylori (H. pylori) test, and a fecal immunochemical test (FIT). The questionnaire covers nine aspects: basic information of the participants, symptoms and previous examinations, medical history and surgical history, medication history, smoking history, alcohol consumption history, dietary habits, physical exercise, and family history. After quality control, the data is entered by staff into the Zhejiang Province Cancer Screening Information Platform. Risk assessments are performed based on the data collected and high-risk individuals are recommended for clinical screening. Additionally, tongue image, stool, urine, blood, tongue coating, saliva, gastric juice, and fresh tissue (gastric mucosa tissue and/or intestinal polyp tissue) samples are collected from all participants undergoing clinical screening.

Participants are required to complete at least one passive follow-up annually. Active follow-ups are conducted for those with positive screening results to ensure timely completion of endoscopic examinations. For those who have not undergone endoscopic examinations despite positive screening results, health education is provided, and they are mobilized at least four times within one month to complete endoscopic examinations. For participants diagnosed and treated for precancerous lesions and tumors, diagnostic and treatment data must be collected, and they are encouraged to follow up as per medical advice. Both active and passive follow-up results must be recorded in the screening follow-up information record form and reported to the Zhejiang Province Cancer Screening Information Platform.

This is a government collaboration project. All subjects will also be followed by record linkage to Cancer Register and Population Register.


Eligibility Criteria:
Inclusion Criteria:

* Subject residents from Zhejiang Province.
* Subject is able to comprehend, sign, and date the written informed consent document to participate in the study.
* Subject has psychical condition and well consciousness, and also accept and cooperate with the follow-up of this study.

Exclusion Criteria:

* Subject has heavy cardiovascular, liver or kidney disease.
* Subject is already suffering from malignant tumors of the digestive tract.
* Subject has severe intellectual disabilities or language communication barriers.
* Subject has had gastrointestinal endoscopy in the past year.
Software-guided Cognitive Stimulation to Prevents Delirium

This study is a pilot randomized controlled trial, comparing a group of older patients with standardized non-pharmacological delirium prevention plus a basic tablet versus a group with standardized non-pharmacological delirium prevention plus a tablet with a software of cognitive stimulation (PREVEDEL).

Software:It is a local development, including a interprofessional team of delirium healthcare experts, older patients and a team og engineers. The software was developed during the first year of this project and was inscribed for author rights.

Inclusion criteria: Older patients \> 65 y.o. Admitted to medicine room or intermediate care unit \> 48 hrs, and informed consent to participate.

Exclusion Criteria:Delirium positive, neuroleptic use, dementia, and non-spanish speakers.

The study was approved by ethical committee of Hospital Clinico University of Chile Standardized Non-pharmacological intervention: Health workers were previously educated in delirium, and environmental issues were implemented. This intervention coverage in nine different domains: orientation, early mobilization, environmental noise and light, sensorial deficit, sleep, hydratation, drug reduction, and family participation.

Intervention: All patients will have a tablet with or without the software PREVEDEL between 09:00-19:00 hrs.

Measures: delirium will be monitoring with CAM (Confusion Assessment Method) twice a day for 5 days.

Primary outcome: Delirium rate between both groups Secondary outcomes:Long of stay, severity od delirium, time of use of electronic device, and Barthel to discharge.


Eligibility Criteria:
Inclusion Criteria:

Older patients \> 65 y.o. Admitted to medicine room or intermediate care unit \> 48 hrs, and informed consent to participate.

Exclusion Criteria:

Delirium positive, neuroleptic use, dementia, and non-spanish speakers.
A Study of RO5093151 in Patients With Ocular Hypertension Or Open Angle Glaucoma

This randomized, double-blind, placebo-controlled, multi-center study will evaluate the safety and the effect of RO5093151 on intraocular pressure in patients with ocular hypertension or open angle glaucoma. Patients will be randomized to receive oral doses of RO5093151 or placebo twice daily. The anticipated time on study treatment is 7 days with the possibility to extend to 28 days.


Eligibility Criteria:
Inclusion Criteria:

* Adult patients, at least 21 years of age, inclusive
* Diagnosis of ocular hypertension or primary open angle glaucoma in at least one eye
* Able to participate and willing to give informed consent

Exclusion Criteria:

* Presence of extreme narrow angle with complete or partial closure
* Progressive retinal or optic nerve disease from any cause other than glaucoma
* History or signs of penetrating ocular trauma
* Uncontrolled hypertension
* Clinically significant abnormalities in laboratory test results
* Positive test results on hepatitis B, hepatitis C, or HIV 1 and 2
* Kidney disease or dysfunction
Effect of Abdominal Myofascial Release on Pain and Functional Outcomes of Neck in Females with Cesarean Section

To investigate the effect of abdominal myofascial release on pain, ROM and functional abilities of neck in females with CS scar.

irty females with neck pain will participate in this study. Subjects will receive treatment session of thirty minutes in length in order to minimize tissue irritation and avoid increased tension of the scar area, which would counter the goal of the session.

Treatment sessions will be provided biweekly for two weeks apart in order to allow physiological and biomechanical healing time between treatment sessions.

MFR techniques will be employed to release the caesarean scar and myofascia of the DFL of each subject.

The depth of the scar in this study takes us through all the layers from the skin to the uterus, following the surgical incision procedure.

MFR was the primary treatment applied to the accessible structure of the patients' DFL, through Myers's MFR techniques of DFL. MFR in its simplest form targeted restoration of mobility of myofascial and fascial layers from within, and with the surrounding structure.

Eligibility Criteria:
Inclusion Criteria:

1. Female patients suffering from chronic neck pain since more than 3 months.
2. They underwent CS since at least 2 year before entry into study.
3. Not suffering from neck pain before CS
4. Their age will range from 20 to 35 years.
5. They will be primiparous
6. Body mass index (BMI) will range from 20-30 kg/m2.

Exclusion Criteria:

1. Pregnancy.
2. BMI over 30 kg/m2.
3. Less than six months after CS.
4. History of pathologies resulting in weakening of connective tissue (diabetes, neoplasms, rheumatic illnesses).
5. Any abdominal surgeries other than caesarean sections.
6. Any head or neck trauma.
7. Skin irritation/inﬂammation at the site of scar.
8. Any spinal deformity as kyphosis or scoliosis.
Diagnosis of Adrenal Insufficiency in Liver Cirrhosis Patients

Patients with liver cirrhosis (LC) often exhibit fatigue, poor oral intake, and abdominal discomfort, which are the symptoms that are also shown in subjects with adrenal insufficiency (AI). Controversy exists upon over-diagnosis of adrenal insufficiency in patients with LC, because decreased albumin and/or cortisol binding protein lower total cortisol levels while free cortisol increases/or is preserved. The investigators assumed that measuring salivary cortisol or direct free cortisol using mass-spectrometry would provide a more accurate level of cortisol in LC patients. 50 patients with LC will be recruited and undergo a rapid ACTH stimulation test and their blood/ saliva will be collected and analyzed. The difference between serum free cortisol and total cortisol, as well as between salivary cortisol and total cortisol will be investigated to find the optimal way to diagnose AI in LC patients.


Eligibility Criteria:
Inclusion Criteria:

* patients diagnosed of liver cirrhosis

Exclusion Criteria:

* pregnant
* history of getting surgery of pituitary resection or adrenalectomy
* patients with diagnosis of pituitary adenoma or adrenal adenoma
* patients take steroid within 3 months
* patients take medication related to synthesis of steroid or cortisol binding protein within 3 months (i.e. ketoconazole, etomidate, sex hormone, oral contraceptive)
* patients take albumin, free frozen plasma, terlipressin, glypressin within 1 month
* patients with acute medical condition
Personalized Rehabilitation Program for Elderly Patients That Fall

The risk of falling affects more than one third of people over 65 years old and over 50% of persons over 80 years. These falls have important consequences for the autonomy of the elderly patient and also increase the risk of sequelae and death.

The goal of this study is to evaluate a personalized rehabilitation program for elderly patients that fall for the first time and to measure the impact on the fear of falling of these patients. This intervention is a home-based program combining exercises, home modifications and education on fall risk factors.


Eligibility Criteria:
Inclusion Criteria:

* Persons who have fallen minimum twice the last year
* 60 years old or more
* Mini Mental State Examination (MMSE) equal or superior to 23/30
* Persons who gave consent to participate in the study
* Persons with severe visual or hearing impairment

Exclusion Criteria:

* Patients with severe disease that might interfere with walking or with program monitoring