cyrilzakka/clinical-trials huggingface dataset:
Ultra Sounded Guided Posterior Transverse Abdominis Plane & Lateral FEMORAL Cutaneous Nerve Blocks Analgesia Post Hip Hemiarthroplasty

COMBINED ULTRASOUND GUIDED POSTERIOR TRANS VERSUS ABDOMINAL PLANE \& LATERAL FEMORAL CUTANEOUS NERVE BLOCKS FOR POSTOPERATIVE ANALGESIA AFTER HIP HEMIARTHROPLASTIC SURGERY

TO EVALUATE THE EFFECTIVENESS OF POSTOPERATIVE ANALGESIA FOR HIP HEMIARTHROPLASTIC SURGERIES BY USING ULTRASOUND GUIDED POSTERIOR TRANS VERSUS ABDOMINAL PLANE \& LATERAL FEMORAL CUTANEOUS NERVE BLOCKS

Eligibility Criteria:
Inclusion Criteria:

* Hemiarthroplaty surgery
* ASA 1 - ASA 4

Exclusion Criteria:

* ALLERGIC TO LOCAL ANESTHETICS
* PATIENT REFUSAL
Multidisciplinary Approach to Fatigue

Prospective longitudinal, single-center, non-randomized study for the implementation of an integrated multidisciplinary fatigue follow-up for young patients with breast cancer or germ cell tumour

Each patient will receive a full evaluation by a multidisciplinary evaluation by a multidisciplinary team during one day. This evaluation will take place between 1 and 3 months after the end of "acute" treatments. The team is composed of an oncologist, a psychologist, a physiotherapist, a dietician and a nurse-coach. The goal of this comprehensive evaluation is to :

* to detect organic or psychological factors (severe depression,...) contributing to fatigue.
* to evaluate in detail the impact of fatigue on the patient's daily life.
* to evaluate the patient's level of physical activity in order to propose an adequate and and personalized management. During this evaluation, the patient will be asked to discuss which aspects of his or her daily life he or she would like to improve as a priority. At the end of this complete evaluation, each patient's case will be will be discussed in a multidisciplinary meeting with all the people involved in the program in order to propose a detailed and personalized treatment plan.

This plan will be explained in detail to the patient by the nurse-coach who will organize and coordinate the patient's care. The patient will receive the detailed management plan in writing.

The patient will receive the detailed management plan in writing, which will also be communicated to the patient's treating physicians.

Eligibility Criteria:
Inclusion Criteria:

* Age between 18 and 39 years at the time of signing the informed consent
* Patient who speaks and understands French
* Signed study informed consent form obtained prior to any study related procedures
* At minimum, a moderate (\>3) fatigue level according to the Standard Rating Scale (NRS) 1 month after completion of acute treatment; as measured at the Survivorship of the standard program
* Patient with either: curative breast cancer (AJCC stage I-II-III) or a germ cell tumor

Exclusion Criteria:

* Refusal to participate in the study
* Patient having chosen to participate in another psychosocial intervention study for the duration of the study.
* Patients with AJCC stage IV breast cancer
A Study to Evaluate the Efficacy and Safety of SPN-810 as Adjunctive Therapy in Children With Impulsive Aggression Comorbid With Attention-Deficit/Hyperactivity Disorder (ADHD)

This will be a randomized, double-blind, placebo-controlled, dose-ranging, efficacy and safety study in children with impulsive aggression comorbid with Attention-Deficit/Hyperactivity Disorder (ADHD). The target subjects are healthy male and female children aged 6 to 12 years, inclusive, with a diagnosis of ADHD. A total of 120 subjects will be randomized across approximately 30 US centers to one of four treatment groups.


Eligibility Criteria:
Inclusion Criteria:

1. Healthy pediatric male or female subjects, age 6 to 12 years.
2. Diagnostic and Statistical Manual of Mental Disorders - IV -Text Revision (DSM-IV-TR) diagnosis of ADHD.
3. R-MOAS score \>=24 at screening and R-MOAS score \>=20 for randomization
4. IQ greater than 71.
5. Weight of \>=20kg
6. current treatment with psychostimulant (1 month prior to screening)
Height Adjusted Versus Standardized Dose of Bupivacaine for Spinal Anesthesia

General anesthesia during pregnancy is associated with several major risks including unanticipated difficult airway, pulmonary aspiration, and specific anesthetic effects on the newborn. Thus, intrathecal anesthesia is the technique of choice for cesarean section.

Nevertheless, the main side effect of intrathecal anesthesia is arterial hypotension which depend mainly on the dose of local anesthetic administered intrathecally.

To date there is no guidelines nor evidences whic help the anesthetist to precisely estimate the required dose. Most often a "standardized dose" of 8 to 10 mg of bupivacaine is administered. However, some data suggest that a lower dose may be administered resulting in less frequent arterial hypotension. Nevertheless, a well designed randomized study is lacking.

The present controlled randomized double blind trial was designed to compare 2 intrathecal dose of bupivacaine for cesarean section

* a "standard" dose of 10 mg of intrathecal bupivacaine associated with morphine 100 micrograms and sufentanil 3 micrograms
* a height-calculated dose of bupivacaine (0.05 mg per cm of height) on associated with morphine 100 micrograms and sufentanil 3 micrograms

The main outcome is the rate of hypotension defined as a 20% or more decrease in systolic arterial pressure.

Secondary outcomes focused on intrathecal anesthesia efficacy, success or failure and on interventions required to manage arterial hypotension

Eligibility Criteria:
Inclusion Criteria:

* scheduled cesarean section with intrathecal anesthesia
* term pregnancy \> 35 weeks
* signed informed consent

Exclusion Criteria:

* unscheduled or emergent cesarean section
* any contra indication to intrathecal anesthesia
* any antihypertensive drug prescribed to control arterial pressure during pregnancy
* pre-eclampsia and eclampsia
* history of Marfan or Ehlers Danlos disease
Assesment of New Devices for the Diagnostic Evaluation of Diaphragmatic Dysfunction

this study aim to evaluate wether new, non-invasive and non-contact devices such as Structured Light Plethysmography (SLP) and Sonar would be able to accurately detect and quantify diaphragm dysfunction (mono-or-bilateral) by assessing the asymmetric chest wall motion generated during spontaneous breathing as compared with a classic, standard and invasive technique.

The measurements of chest and abdominal wall movements during quiet tidal breathing will be performed simultaneously using SLP and Sonar devices.

Subjects will be asked to sit down on a chair with their neck in a neutral position and their back as straight as possible. The SLP and the Sonar will be lined up to project the grid of light and the ultrasonic wave sonar over the participant's chest and abdomen. Data will be collected during 5 minutes of tidal breathing. The same procedure will be repeated while having the patient lying down in supine position on the same chair for 5 additional minutes. During both sessions (sitting and supine), patients will be asked to perform a gentle inspiratory capacity (IC) maneuver to better appreciate the thoraco-abdominal asymmetry and distortion.

Eligibility Criteria:
FOR HEALTHY VOLUNTEERS

Inclusion Criteria:

* no respiratory disease
* no neurologic disease
* no thoracic deformation

Exclusion criteria

* respiratory disease
* neurologic disease
* thoracic deformation

FOR PATIENTS

Inclusion Criteria:

* patients with a suspicion of diaphragmatic dysfunction

Exclusion Criteria:

* pregnant women
* contraindications to standard procedure requiring transdiaphragmatic measurement
Total Body Irradiation for Bone Marrow Transplants: Collaborative Efforts

Most bone marrow transplantations for malignant and non-malignant disease include whole body irradiation. Techniques for administering that treatment, including patient positioning, lung and soft tissue compensation, dose rate, total dose and fractionation differ between institutions. These differences are optimized at each institution to limit toxicity and maximize therapeutic outcome.

Technically complex procedures such as total body radiation are subject to equipment failures. Such failures mid-treatment could be catastrophic to the patient, since therapy must be timely and compatible therapy may not be available elsewhere in the community. The purpose of this protocol is to provide backup between George Washington University Medical Center and the Radiation Oncology Branch of the NCI to allow for orderly, safe, and compatible therapies in the event of equipment failure; or replacement of a linear accelerator or any other malfunctioning equipment necessary to deliver TBI; or any emergent situation.

Most bone marrow transplantations for malignant and non-malignant disease include whole body irradiation. Techniques for administering that treatment, including patient positioning, lung and soft tissue compensation, dose rate, total dose and fractionation differ between institutions. These differences are optimized at each institution to limit toxicity and maximize therapeutic outcome.

Technically complex procedures such as total body radiation are subject to equipment failures. Such failures mid-treatment could be catastrophic to the patient, since therapy must be timely and compatible therapy may not be available elsewhere in the community. The purpose of this protocol is to provide backup between George Washington University Medical Center and the Radiation Oncology Branch of the NCI to allow for orderly, safe, and compatible therapies in the event of equipment failure; or replacement of a linear accelerator or any other malfunctioning equipment necessary to deliver TBI; or any emergent situation.

Eligibility Criteria:
INCLUSION CRITERIA:

Patients must sign informed consent.

Supporting institution physicians must agree that therapy is appropriate and safe.
Acute and Chronic Effect of His-pacing in Consecutive Patients With AV-block

Conventional right ventricular (RV) apical pacing may result in asynchronous ventricular contraction with delayed left ventricular activation, interventricular motion abnormalities, and worsening of left ventricular ejection fraction. His pacing is preserving a synchronous contraction and may prevent a decrease in left ventricular ejection fraction.

Hypothesis: His-pacing preserves left ventricular function and is a feasable alternative compared to RV septal septal pacing in patients with AV-block.

Conventional right ventricular apical pacing may result in asynchronous ventricular contraction with delayed left ventricular activation, interventricular motion abnormalities, and worsening of left ventricular ejection fraction. His pacing is preserving a synchronous contraction and may prevent a decrease in left ventricular ejection fraction.

The aims of our crossover, double-blinded, randomized study is to evaluate the feasibility and long-term safety of permanent His pacing and to compare the effects on left ventricular ejection fraction of permanent His pacing with those of conventional right septal stimulation after 12 months treatment in patients with 2nd or 3rd degree AV-block.

Eligibility Criteria:
Inclusion Criteria:

* 2nd or 3rd degree Av block

Exclusion Criteria:

* QRS \> or = 120 ms
* Indication for cardiac resynchronization therapy (CRT) or implantable cardioverter defibrillator (ICD)
* chronic atrial fibrillation
* Pregnant
* Expected heart surgery \< 2 years
* Expected survival \> 2 years
* Patients that have been His ablated
* Serious comorbidity
A Phase I Trial of Tecogalan Sodium ( DS-4152 ) Administered as an Infusion Twice Weekly for 21 Days.

To evaluate the safety of different doses and dosing regimens of tecogalan sodium (DS-4152) and to establish the MTD at each of the different dosing schedules.

Patients receive intravenous DS-4152 by infusion twice weekly for 21 days, followed by 2 weeks of rest; courses may repeat. Patients undergo weekly follow-up. A punch biopsy will be obtained from patients with Kaposi's sarcoma.

Eligibility Criteria:
Inclusion Criteria

Patients must have:

* Kaposi's sarcoma plus HIV infection OR metastatic solid tumor.
* Life expectancy of at least 12 weeks.
* NO symptomatic AIDS-defining opportunistic infection within the past 4 weeks.
* Recovered from toxicity of any prior anticancer therapy.

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms or conditions are excluded:

* Leukemia or lymphoma.
* Current gastrointestinal bleeding by stool guaiac.
* Extensive bone metastases or significant radiographic osteoporosis in patients with solid tumors.
* Active heart disease such as uncontrolled angina, uncompensated congestive heart failure, or dysrhythmias requiring antiarrhythmics.
* Acute intercurrent infection other than genital herpes.
* Symptomatic or known central nervous system involvement (including brain metastases) unless stable and off therapy.

Concurrent Medication:

Excluded:

* Other anticancer therapy.
* Other investigational agents.

Patients with the following prior conditions are excluded:

* History of acute or chronic gastrointestinal bleeding or inflammatory bowel disease.
* History of myocardial infarction within past 6 months.

Prior Medication:

Excluded:

* Anticancer therapy within the past 3 weeks (6 weeks for nitrosourea or mitomycin C).
* Investigational agents within the past 4 weeks.
SPYRAL DYSTAL Renal Denervation Global Clinical Study

The objective of this single arm interventional study is to determine if renal denervation performed in the distal main and first order branch renal arteries is as effective in reducing blood pressure as the procedural approach used in the SPYRAL HTN-OFF MED clinical study.


Eligibility Criteria:
Inclusion Criteria:

- Individual has office systolic blood pressure (SBP) ≥ 150 mmHg and \<180 mmHg and a diastolic blood pressure (DBP) ≥ 90 mmHg after being off medications.

* Individual has 24-hour Ambulatory Blood Pressure Monitoring (ABPM) average SBP ≥ 140 mmHg and \< 170 mmHg.
* Individual is willing to discontinue current antihypertensive medications

Exclusion Criteria:

* Individual has estimated glomerular filtration rate (eGFR) of \<45.
* Individual has type 1 diabetes mellitus or poorly-controlled type 2 diabetes mellitus.
* Individual has one or more episodes of orthostatic hypotension.
* Individual requires chronic oxygen support or mechanical ventilation other than nocturnal respiratory support for sleep apnea.
* Individual has primary pulmonary hypertension.
* Individual is pregnant, nursing or planning to become pregnant.
* Individual has frequent intermittent or chronic pain that results in treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) for two or more days per week over the month prior to enrollment.
* Individual has stable or unstable angina within 3 months of enrollment, myocardial infarction within 3 months of enrollment; heart failure, cerebrovascular accident or transient ischemic attack, or atrial fibrillation at any time.
* Individual works night shifts.
Two Different Exercise Methods in Geriatrics

The aim of the study is to compare slow rhythmic exercises with large amplitude exercises in elderly people


Eligibility Criteria:
Inclusion Criteria:

* Being 65 years or older
* living in a nursing home
* Knowing how to read and write Turkish
* Cognitive functions are sufficient for communication (Standardized Mini Mental Test score over 21 points)
* Being between 1-5 on the Clinical Fragility Scale
* Not taking medical medications regularly due to pain
* Volunteering to participate in the study

Exclusion Criteria:

* Having vision and hearing problems that affect communication (except for individuals who communicate with glasses and hearing aids)
* Having a disease that causes neurological, orthopedic and musculoskeletal problems
* Having uncontrolled hypotension/hypertension, cardiovascular problems, metabolic and chronic diseases
* anemic individuals
* Having severe cerebrovascular and peripheral venous insufficiency
* Having had an operation in the last year
Clinical, Molecular and Electrophysiological Profiling of Parkinson's Disease: the Role of Non-pharmacological Therapies

In Parkinson's disease (PD), direct evidence linking inflammation to the harmful activities of alpha-synuclein (a-syn) aggregates, the disease onset, and its progression is still lacking. This translational project aims to reveal the causal relationship between a-syn and inflammation. The investigators will also investigate the mechanisms underlying the beneficial effects of two non-pharmacological approaches, motor exercise and neuromodulation, with particular focus on neuroinflammation and brain-derived neurotrophic factor (BDNF) production. the investigators will investigate the molecular pathways and synaptic alterations underlying disease progression. This will be paralleled by a clinical study, in which clinical assessment will be associated with cerebrospinal fluid (CSF) and blood neurodegeneration and inflammatory biomarkers measures. Then, the investigators will test the hypothesis that intensive exercise and neuromodulation may reduce neuroinflammation and a-syn spreading via the activation of BDNF-related pathways.


Eligibility Criteria:
Inclusion Criteria:

* clinically established diagnosis of PD according to the Movement Disorders Society (MDS) diagnostic criteria
* Hoehn \& Yahr (H\&Y) stage between 1 and 3

Exclusion Criteria:

* Pregnancy
* Oncological or autoimmune comorbidities
Ultrasound Guided Erector Spinae Block Versus Thoracic Para-vertebral Block Versus Quadratus Lamborum Block in Open Renal Surgeries

Open renal surgeries are associated with substantial postoperative pain, pain relief in patients undergoing this procedure is usually provided either by thoracic epidural analgesia (EA) or by systemic analgesics. EA is a very useful option for the management of postoperative pain in patients undergoing abdominal surgeries, but the risks and contraindications linked to EA like hypotension, headache, nerve damage or infection may limit its use. Systemic analgesics in the form of opioid analgesics may give rise to side effects like nausea ,vomiting , constipation , allergy or drowsiness and often provide insufficient analgesia. Hence, other methods of postoperative pain management are desired. Sensory level target according to the incision site Flank (T9-T11) , Thoraco-abdominal (T7-T12 ) and Trans-abdominal (T6-T10). Ultrasound (US) guided erector spinae plane (ESP) block is one of the interfascial plane blocks that target the dorsal and ventral rami of the spinal nerves. Although there is no sufficient evidence for the spread of local anesthetic to the ventral rami, recent reports demonstrated effective postoperative analgesia after thoracic and lumbar surgeries affecting both the ventral and dorsal rami. Paravertebral block (PVB) is a technique where a local anesthetic is deposited into a space found on both sides of the spine, called the paravertebral space. It is a block with a dermatomal distribution of pain relief depending on the level of the spine at which the block is sited and the quantity and type of deposited local anesthetic.

PVB is effective for pain relief in the thoracic, abdominal and limb regions. primary aim was to compare postoperative opioid consumption rates at 24 h. Secondary end points were to compare pain scores and hemodynamic variables.

This was randomized, controlled, single-blinded study, conducted in urology operating theatre, Al-Azhar university hospital. Forty eight patients of both sex and aged from 21-65 years in period between February 2022 to January 2023 scheduled for elective open renal surgeries under general anesthesia were enrolled in this study. The procedure was explained to the patient and informed consent was signed after his agreement then the patient was classified to one of three groups

Eligibility Criteria:
Inclusion Criteria:

* Inclusion criteria: Adult patients of both sex, (21-65 years) with renal surgeries with ASA I , II score.

Exclusion criteria

* Patient's refusal.
* Patients with ASA (III , IV) score.
* Coagulopathy to be cancelled if ( INR\>1.4 , Platelets count \<100x109 )
* Infection at the injection site.
* Allergy to local anesthetics.
* Patients receiving opioids for chronic analgesic therapy
OCT in Retinal Vein Occlusions

Retinal blood vessel disease encompasses a wide variety of vision-threatening conditions. Of these conditions, retinal vein occlusions are the most common. Vision loss can occur as a result of macular ischemia (loss of blood flow to the macula) or macular edema (fluid build-up at the macula).

OCT is an imaging technology that can perform non-contact cross-sectional imaging of retinal and choroidal tissue structures in real time. It is similar to ultrasound imaging, except that OCT measures the intensity of reflected light rather than sound waves.

The purpose of this study is to see if non-invasive OCT technology can changes due to retinal vein occlusions as well as the more invasive fluorescein angiography, which requires an injection of dye into the vein of an arm of a patient. The study will also compare the mapping of blood vessels (angiography) and loss of blood flow (ischemia) by fluorescein angiography and OCT. These studies will be evaluated to see how they relate to vision loss.


Eligibility Criteria:
Inclusion Criteria:

* Diagnosis of branch or central retinal vein occlusion

Exclusion Criteria:

* Inability to give informed consent
* Inability to complete study tests within a 30 day period from date of enrollment
* Significant renal disease, defined as a history of chronic renal failure requiring dialysis or kidney transplant
* A prior history of reaction to fluorescein or other dyes.
* A condition that, in the opinion of the investigator, would preclude participation in the study (e.g., unstable medical status including blood pressure, cardiovascular disease, and glycemic control).
* Blood pressure \> 180/110 (systolic above 180 OR diastolic above 110). If blood pressure is brought below 180/110 by anti-hypertensive treatment, subject can become eligible.
* Systemic anti-VEGF or pro-VEGF treatment within 4 months prior to treatment.
* Women of child-bearing potential: pregnant or lactating or intending to become pregnant within the next 12 months due to unknown safety of fluorescein angiography.
* Prior PRP or focal laser that would alter the macular perfusion and retino-vascular features.
* Inability to maintain fixation for OCT imaging.
* Other ocular condition is present such that, in the opinion of the investigator, may alter the retinal perfusion.
* An ocular condition is present that, in the opinion of the investigator, might affect or alter visual acuity during the course of the study (e.g., cataract).
* Substantial cataract that, in the opinion of the investigator, is likely to decrease visual acuity by 3 lines or more (i.e., cataract would be reducing acuity to 20/40 or worse if the eye was otherwise normal).
* Media opacity or otherwise that would prevent either fixation or ability to obtain adequate images as determined by the examiner.
* History of major ocular surgeries (including vitrectomy, cataract extraction, scleral buckle, any intraocular surgery, etc.) within 4 months prior to enrollment.