cyrilzakka/clinical-trials huggingface dataset:
Serum Biomarker of Plaque Vulnerability and Contrast Ultrasound of Carotid Artery

No serum biomarker has qualified for clinical use until now. However several biomarkers, especially markers of inflammatory or proteolytic activity seem to promising in the identification of vulnerable plaques. Moreover, recent study confirmed that contrast-enhanced ultrasound imaging(CEUS) can visualize intraplaque neovascularization and represent the plaque vulnerability. In this study we try to identify indicators through analysis of the relationship between plaque neovascularization seen by CEUS and well known biomarkers such as serum matrix metalloproteinase(MMP)-2, MMP-9, cathepsin family(L,S,V), cystatin C, lipoprotein phospholipase A2, and hs-crp


Eligibility Criteria:
Inclusion Criteria:

* patients with carotid plaques size more than 2mm by carotid ultrasound

Exclusion Criteria:

* known allergy to albumin, or to the ultrasound contrast agent
* the patients with history of carotid endarterectomy and carotid stent
* acute myocardial infarction, cardiogenic shock
* connective tissue disease and malignancy
* creatinine clearance lower than 30ml/min and the history of dialysis
Biomarkers for the Prognosis of Influenza in Children

Context: Seasonal influenza affects 2.5 to 3 million people each year in France, resulting in 1500 to 2000 severe cases seen in intensive care units. The severity of influenza is related to, among other things, its respiratory or neurological complications, observed especially in children. Early determination of the severity of influenza is a critical step to avoid in appropriate treatment and care for patients and to improve their survival. Viral, human but also environmental factors have been described as having an important role in determining this severity. Several studies suggest that the nasopharyngeal microbiome may be involved in the incidence and severity of respiratory viral infections. During influenza infection, the respiratory microbiota is significantly altered. In animal models, particularly murine models, the microbiota regulates the immune response to influenza virus infection. In a retrospective preliminary study, the investigators showed that the composition of the nasopharyngeal bacterial microbiota is different between children who develop a severe or moderate influenza. This difference was observed on respiratory specimens at admission to pediatric emergencies within two days of onset of symptoms.

Hypotheses :

* The respiratory microbiome is a determining factor in the clinical course of influenza infection (benign vs. severe with respiratory or neurological complication)
* The respiratory microbiome can be used as a prognostic biomarker of the clinical course of influenza Originality: There are currently no clinical and / or virological markers to predict the clinical course of influenza infection. This study will define biomarkers of the respiratory microbiome to discriminate patients who will develop a severe influenza from those who will develop a moderate influenza. These prognostic biomarkers could be used to rapidly refer patients at risk to intensive care units, thus improving patient management and care. Moreover, at the fundamental level, this study will specify the role of the microbiome in the severity of influenza infection.


Eligibility Criteria:
Inclusion Criteria:

* Age \< 5 years
* Seen in an emergency department with influenza confirmed by a positive test (polumerase chain reaction, rapide antigen detection test).

Exclusion Criteria:

* Presence of associated significant comorbidity (chronic respiratory, cardiac, neurological or metabolic pathology, prematurity, known immunodeficiency)
* Documented non-respiratory bacterial infection
* No consent
* Patient not affiliated to a national health cover
GVAX Pancreas Vaccine (With CY) and CRS-207 With or Without Nivolumab

The primary objective of this study is to compare the overall survival (OS) of subjects with previously treated metastatic pancreatic cancer treated with cyclophosphamide (CY)/nivolumab/GVAX pancreas vaccine followed by nivolumab/CRS-207 (Arm A) to subjects treated with CY/GVAX pancreas vaccine followed by CRS-207 (Arm B).


Eligibility Criteria:
Inclusion Criteria:

* Age ≥18 years.
* Have histologically- or cytologically-proven adenocarcinoma of the pancreas. Patients with mixed histology will be excluded.
* Have metastatic disease.
* Have failed only 1 prior chemotherapy regimen for metastatic pancreatic cancer.
* Patients with the presence of at least one measurable lesion.
* Patients acceptance to have a tumor biopsy of an accessible lesion at baseline and on treatment if the lesion can be biopsied with acceptable clinical risk (as judged by the investigator).
* ECOG performance status 0 or 1.
* Life expectancy of greater than 3 months.
* Patients must have adequate organ and marrow function defined by study-specified laboratory tests.
* Must use acceptable form of birth control while on study.
* Ability to understand and willingness to sign a written informed consent document.

Exclusion Criteria:

* known history or evidence of brain metastases.
* Had surgery within the last 28 days
* Have received any non-oncology vaccine therapy used for prevention of infectious diseases including seasonal vaccinations within 28 days of study treatment.
* Prior treatment with anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA4, GVAX or CRS-207
* Systemic steroids within the last 14 days
* Use more than 3 g/day of acetaminophen.
* Patients on immunosuppressive agents.
* Patients receiving growth factors within the last 14 days
* Known allergy to both penicillin and sulfa.
* Severe hypersensitivity reaction to any monoclonal antibody.
* Have artificial joints or implants that cannot be easily removed
* Have any evidence of hepatic cirrhosis or clinical or radiographic ascites.
* Have significant and/or malignant pleural effusion
* Infection with HIV or hepatitis B or C at screening
* Significant heart disease
* Conditions, including alcohol or drug dependence, intercurrent illness, or lack of sufficient peripheral venous access, that would affect the patient's ability to comply with study visits and procedures
* Unable to avoid intimate contact with another individual known to be at high risk of listeriosis (e.g., newborn infant, pregnant woman, HIV-positive individual) during the course of CRS-207 treatment until completion of antibiotic regimen.
* Are pregnant or breastfeeding.
* Have rapidly progressing disease
A Study of LY2409021 in Participants With Type 2 Diabetes Mellitus

The intent of this study is to assess the safety of LY2409021 in participants with Type 2 diabetes mellitus taking metformin and sulfonylurea as prescribed by their personal physician. The study treatment is expected to last 12 months (52 weeks).


Eligibility Criteria:
Inclusion Criteria:

* Have been treated with a stable dose of metformin for at least 3 months and have been treated with an optimally effective and stable dose of an sulfonylurea for at least 6 months prior to screening.
* HbA1c value between 7.0% and 10.0%, inclusive.
* Body mass index (BMI) between 20 and 45 kilograms/square meter (kg/m\^2), inclusive.

Exclusion Criteria:

* Known type 1 diabetes mellitus.
* More than 1 episode of severe hypoglycemia within 6 months prior to screening.
* Two or more emergency room visits or hospitalizations due to poor glucose control in the 6 months prior to screening.
* Severe gastrointestinal disease that may significantly impact gastric emptying or motility or having undergone gastric bypass or gastric banding surgery.
* Previous history or active diagnosis of pancreatitis.
* Positive hepatitis B surface antigen or hepatitis C antibody.
* Clinical signs or symptoms of liver disease, or hepatic aminotransferases (aminotransferase or alanine aminotransferase) greater than 2.0× upper limit of normal (ULN) or elevated alkaline phosphatase (greater than ULN) unrelated to bone metabolic disease.
* Elevated total bilirubin level (greater than ULN), clinically suspicious signs/symptoms of cirrhosis or history of cirrhosis.
* Current diagnosis, personal history of neuroendocrine tumors, family history of any type of multiple endocrine neoplasia (MEN), or Von Hippel-Lindau.
* Contraindications for magnetic resonance imaging.
Speed of Increasing Milk Feeds Trial

Survival of preterm infants has increased greatly over the years, so a major aim now is to improve the long term outlook for these babies and to avoid serious complications. The way babies are fed in early life affects short and long-term health and survival.

Because the bowels of preterm infants have not matured, they cannot digest large volumes of milk feeds straight away. Until the gut matures, nutrition is provided by intravenous drip while the amount of milk given is gradually increased over time. Increasing the amount of milk rapidly may increase the risk of gut complications. Increasing the amount of milk given more slowly means that intravenous nutrition is needed for longer; there is an associated risk of infection proportional to the time the intravenous line is present in the bloodstream of these infants. Despite the importance of milk feeding preterm infants, there have been few studies to inform how best to balance these risks, and what the best way to increase feeds in these infants is - this study sets out to address this missing information.

The study will compare two different speeds of milk feed increase, one 'faster' and one 'slower', both within rates currently used in United Kingdom neonatal units. The study aims to find out if either speed of milk feed increase gives better outcomes for the infants. Investigators will measure a variety of outcomes, such as survival without disability, infection, bowel problems, growth and long-term physical and mental development, as well as the impact on families and the National Health Service, including costs.

The study is being led by an established team of researchers who have run similar studies before, and uses an established network of neonatal units that have taken part in previous studies.


Eligibility Criteria:
Inclusion Criteria:

* Gestational age at birth \<32 weeks, or birth weight less than 1,500 g
* Receiving ≤30 ml/kg/day of milk at randomisation
* Written informed parental consent is obtained

To ensure the widest applicability to preterm infants across the United Kingdom, those exclusively breast milk fed, formula milk fed, or receiving mixed feeds will be included

Exclusion Criteria:

* Infants with a severe congenital anomaly
* Infants who, in the opinion of the treating clinician, have no realistic chance of survival
* Infants who are unlikely to be traceable for follow-up at 24 months of age corrected for prematurity (for example, infants of non-United Kingdom residents)
Establish Tolerance In MS With Peptide-Coupled, Peripheral Blood Mononuclear Cells

Open-label, single center, phase I clinical trial to assess the safety, tolerability and preliminary efficacy and in vivo mechanisms of action of i.v. administration of autologous peripheral blood mononuclear cell (PBMC) chemically coupled with a cocktail containing seven immunodominant myelin peptides to which T cell responses are demonstrable in early RR MS patients.

Open-label, single center, phase I dose-escalation study to assess the safety, tolerability and preliminary efficacy and in vivo mechanisms of action of a single infusion of autologous peripheral blood mononuclear cells chemically coupled with seven myelin peptides (MOG1-20, MOG35-55, MBP13-32, MBP83-99, MBP111-129, MBP146-170, and PLP139-154) in Multiple Sclerosis patients who were off-treatment for standard therapies. Neurological, magnetic resonance imaging, laboratory, and immunological examinations were performed to assess the safety, tolerability, and in vivo mechanisms of action of this regimen.

Eligibility Criteria:
Inclusion Criteria:

1. Between the ages of 18 and 55 years.
2. Patients with relapsing-remitting (Phase I/II) or secondary progressive MS (Phase I) according to published criteria
3. EDSS score between 1 and 5.5.
4. Patients are off-treatment for standard therapies (interferon-beta, glatiramer acetate, natalizumab, mitoxantrone)
5. Patients are able to provide written, informed consent prior to any testing under this protocol, including screening and baseline investigations that are not considered part of routine patient care.
6. Disease duration ≤ 5 years (Only Phase II)

Exclusion Criteria:

1. Diagnosis of secondary-progressive (Phase II) or primary-progressive MS, as defined by published diagnostic criteria.
2. Abnormal screening/baseline blood tests exceeding any of the limits defined
3. Pregnant or breast-feeding female.
4. History or signs of immunodeficiency.
5. Concurrent clinically significant (as determined by the investigators) cardiac, immunological, pulmonary, neurological, renal or other major disease.
6. Splenectomy
7. History of HIV or positive HIV antibody testing
8. Serology indicating active Hepatitis B or C infection.
9. Patients with cognitive impairments who are unable to provide written, informed consent prior to any testing under this protocol, including screening and baseline investigations that are not considered part of routine patient care
Transcutaneous Laryngeal Ultrasound as an Alternative to Direct Flexible Laryngoscopy in Assessment of Vocal Cords

To evaluate the diagnostic value of ultrasound in the assessment of the vocal cords compared with direct flexible laryngoscopy

Thyroid and parathyroid surgery are the most common procedures in endocrine surgery worldwide. They are mainly associated with two major complications: recurrent laryngeal nerve (RLN) palsy and hypoparathyroidism, The preservation of recurrent laryngeal nerve (RLN) is an essential part of thyroid surgery {1}. The various methods to test the normal functionality of vocal cords (VCs) include direct visualisation under the fiber bronchoscope, indirect laryngoscopy, laryngeal muscles electromyography, computed tomography (CT), and magnetic resonance imaging (MRI). We aimed to assess the usefulness of ultrasound (USG) in the examination of VC morphology and movement.

Recurrent laryngeal nerve injury ranges from 1.4 to 5.1% following surgery involving the thyroid gland.

Otolaryngology and Head and Neck Surgery suggested that all patients undergoing thyroid and parathyroid procedures should undergo routinely preoperative and postoperative DFL \[6\].

Laryngoscopy is considered the golden standard to evaluate vocal fold mobility preoperatively. As it can demonstrate a paralysis of the recurrent laryngeal nerve,. Yet it is not common practice for many endocrine surgery teams because it is time consuming, imposes extra costs, and is in general, an unpleasant experience for some patients.{2} head and neck ultrasonography is a cost effective imaging tool that is currently used as an extension of patient physical examination. That is based on its safety (non invasive and non ionizing radiation dependent), repeatability, availability and good patient compliance (pain less and require no sedation). {3} recently portable ultrasound devices became widely available with dramatic improvement of the imaging quality rendering to increased diagnostic accuracy. Availability, usability and mobility of the devices encourage bedside examination which is essential in non mobile patient and ICU patient \[4\] .

However, the experience is limited and the reliability of the TLUS in thyroid and parathyroid surgery is still being debated

Eligibility Criteria:
Inclusion Criteria:

* Patients scheduled for thyroid surgery
* Patients underwent thyroid surgery

Exclusion Criteria:

• Patients with vocal cord paralysis because of any cause other than thyroid surgery complications
Can Tendon Autograft Function As a Meniscal Transplant

Purpose: To evaluate the functional outcomes after using peroneus longus (PL) tendon autograft as meniscal transplantation in patients with knee joint line pain exaggerated with weight bearing following prior total or subtotal meniscectomy.

This research design is a single center prospective study carried out at a tertiary trauma center hospital between May 2022 and December 2022. This research had ethical Committee Approval which was granted by the Ethics Committee of Cairo University (Institutional Review Board (IRB) number N 207-2024). All patients signed an informed consent before joining this study. This study included 25 patients, with previous history of subtotal or total meniscectomy medially or laterally, who underwent meniscus transplantation using PL tendon autograft.

Eligibility Criteria:
Inclusion Criteria:

* Skeletally mature patients with a history of prior subtotal or total (medial or lateral meniscus) meniscectomy.
* Post meniscectomy symptoms (medial or lateral knee joint line pain exaggerated with weight bearing).

Exclusion Criteria:

* Multi-ligamentous knee injuries.
* Skeletally immature patients.
* Significant osteoarthritic changes on radiographs (Ahlbäck II- V).
* Malalignment on full-length radiographs showing increased stress in the involved knee compartment.
* Presence of associated ipsilateral ankle joint problem.
Evaluation of Stents to Open Restricted Airways in Patients With Centrally Placed Non-small Cell Lung Cancer

To investigate whether the use of airways stents (metal tubes to open and keep open narrowed airways) together with the standard treatment increases the proportion of patients who can complete a 6min walking distance (6MWD) test at 2 weeks +/- 2days in patients with breathlessness due to lung cancer, when compared to standard treatment alone.


Eligibility Criteria:
Inclusion Criteria:

* Able to give informed written consent in the English language
* Able and willing to attend St Georges Hospital / Royal Marsden Hospital for stent insertion (if allocated) and documentation of 6 minute walking distance.
* Willing to re-attend for follow-up and 6 minute walking distance at St Georges Hospital / Royal Marsden Hospital 2 weeks later (all patients)
* Diagnosis of non-small cell lung cancer with centrally placed tumour with some degree of airway obstruction from information from bronchoscopy or CT scan.
* ECOG Performance status: 0-3

Exclusion Criteria:

* Relative contraindications to stenting, e.g. bleeding abnormality or anticoagulation problems.
* Pregnancy
* Radically treatable disease.
Using Different Amplitude-modulated Frequencies of IFC for the Treatment of Trigger Points

the authors of this work will conduct a randomized controlled trial intended to examine different amplitude-modulated frequencies of interferential current on different measures related to chronic trigger points located in the upper trapezius muscle.

this randomized controlled trial was designed to fill a gap in the literature regarding the most effective amplitude-modulated frequency of interferential current on pain pressure threshold, cervical ROM, and function of the neck region.

this study will be consisted of 4 groups, all groups will receive standard manual treatment commonly used for the treatment of chronic trigger points. this treatment will be conducted 3 times per week for 4 weeks. The standard treatment will consist of an intermittent neuromuscular inhibition technique.

the 3 experimental groups will receive interferential current sessions (3/week) for 4 weeks with the same parameters except for the amplitude-modulated frequency.

outcome measurements will be assessed at baseline, at 4 weeks, and at 4 weeks of the end of the treatment (follow-up).

Eligibility Criteria:
Inclusion Criteria:

* males or females,
* 17 - 50 years of age,
* unilateral pain in the cervical, neck, and upper shoulder, pain persists for 3 months or more,
* pain should be not less than 2 on the visual analog scale (VAS),
* having positive signs of chronic (latent) trigger point(s) in the upper trapezius muscle

Exclusion Criteria:

* cervical and or shoulder pathologies such as disc lesions, arthritis, or compression problems.
* neurological symptoms in the upper limb such as radiculopathy.
* previous cervical, thoracic, or shoulder surgery.
* regular sports practice.
* heavy work-related activities.
* trauma to the cervical spine (whiplash injury).
* osteoporosis.
* complex regional pain syndrome.
* thoracic outlet syndrome
* regular analgesic drugs.
Predictors of Pulmonary Hypertension in Patients With Hypersensitivity Pneumonitis

Hypersensitivity pneumonitis (HP) is a complex immune mediated disorders caused by repeated inhalation of and sensitization to wide range of antigens including organic particles and chemical compounds, leading to exaggerated immuneresponse. Hypersenstivity pneumonitis is a common form of diffuse parenchymal lung diseases in Egypt .Pulmonary hypertension has been found as a complication of a number of diseases affecting the lung interstitium, including hypersensitivity pneumonitis, with subsequent affection of the life expectancy Rationale of the study: to find predictors for the development of pulmonary hypertension in patients with hypersensitivity pneumonitis

Cross sectional study included 60 patients with established diagnosis of HP , work up includes history of exposure, clinical examination, HRCT chest, ABGs,6MWD, desaturation degree , spirometry, echocardiography and right heart catheter in patients with high echo probability of PH.

Eligibility Criteria:
Inclusion Criteria:

* All patients with confirmed diagnosis of Hypersensitivity pneumonitis

Exclusion Criteria:

* Other interstitial lung diseases
3D Ultrasound-guided Labor Epidural Analgesia in the Morbid Obese Parturient

This study will be a randomized control study, with the objective to evaluate epidural analgesia success rates between the two methods (Blind Approach versus Accuro Device).

Worldwide obesity has become an epidemic. The obstetrical population is no exception. This made more challenging for anesthesiologists on labor and delivery units to administer epidural analgesia. According to the World Health Organization, more than 30% of U.S. adults are obese with a body mass index (BMI; in kg/m2) ≥ 30. Recent data has shown that increased BMI has been associated with increased neuraxial analgesic failure and difficulty with prolonged epidural placement time.

The 'Blind approach' is the current standard of care in administering neuraxial anesthesia. The physician palpates the patient's spinal bony landmarks; the needle is placed in relation to identified landmarks and inserted until loss of resistance is felt. In the obese population, the success rates are as low as 68%. Recently the FDA has approved a handheld device "The Accuro" as an adjunct for neuraxial analgesia (Rivanna Medical, LLC). It consists of a three-dimensional ultrasound device. By utilizing sound waves it constructs three-dimensional images of the spinal column, allowing the physician to better see the spine in order to perform spinal/epidural anesthesia.

Hypothesize that this device will enable clinicians to assess epidural spaces for epidural needle placement compared with the traditional Blind approach in the morbidly obese parturient.

This study will be a randomized control study, with the objective to evaluate epidural analgesia success rates between the two methods (Blind Approach versus Accuro Device). Also, will determine if ultrasound based landmarks would reduce the needle tract and thereby reduced the amount of post-procedure pain at the insertion site in the peripartum period by using the algometer.

Eligibility Criteria:
Inclusion Criteria:

* American Society of Anesthesiologists physical status class I, II, or III.
* Term pregnancy.
* Requesting epidural analgesia for anticipated vaginal delivery.
* BMI\>or = 40.

Exclusion Criteria:

* Contraindication for epidural analgesia
* Inability to adequately understand the consent form.
* Incarcerated patients.
* Patients with known spinal deformities.
* Allergies to ultrasound gel.
* Allergies to local anesthetics