cyrilzakka/clinical-trials huggingface dataset:
Transcranial Direct Current Stimulation Associate to Constraint Induced Movement Therapy Over Premotor Cortex in Severe Stroke

The purpose is to compare the effects of tDCS and constraint induced movement therapy (CIMT) in the premotor cortex vs. primary motor cortex in severely subacute stroke survivors.

Stroke survivors experience one or more movement-related impairments and activity limitations. In this sense, the premotor cortex (PMC) can be considered as an alternative locus for post-stroke rehabilitation. In relation to physical rehabilitation protocols, associate to neuromodulation, the investigators have chosen a standardized physical therapy protocol for this study, the Constraint Induced Movement Therapy (CIMT), which presents evidence of good therapeutic results. The investigators hypothesized that applying tDCS and CIMT over the PMC promotes motor restoration in stroke patients.

Eligibility Criteria:
Inclusion Criteria:

* Age between 18 and 65 years
* Diagnosis of unilateral, non-recurring, subacute stroke
* Participants also had to be able, by using any method of pinch, to grasp a washcloth from a table top, lift it up a few inches, and release it.

Exclusion Criteria:

* Patients with difficulty to follow the procedures or understand the instructions; cognitive deficits
* tDCS criteria:

  * use of modulators of the Central Nervous System drugs
  * patients with implanted metallic or electronic devices
  * pacemaker
  * seizures
  * pregnancy
  * any other condition that might limit or interfere in the sensorimotor system
Acute Myocardial Infarction Study in Northeastern China

This is a real-world prospective cohort study aiming to generate knowledge about the characteristics, treatments, and outcomes of hospitalized AMI patients in Jilin Province. The study includes hospitalizations diagnosed of AMI, including ST segment-elevation myocardial infarction (STEMI) and non-ST-segment-elevation myocardial infarction (NSTEMI).


Eligibility Criteria:
Inclusion Criteria:

* patients admitted within 7 days of acute myocardial ischemic symptoms with a primary clinical diagnosis of AMI, meet Fourth Universal Definition for Myocardial Infarction (2018)

Exclusion Criteria:

* Types 4a and type 5 AMI
A Study of MabThera (Rituximab) in Patients With Rheumatoid Arthritis Who Have Had an Inadequate Response to Methotrexate

This study will evaluate the safety and efficacy of MabThera in patients with active rheumatoid arthritis who have had an inadequate response or were intolerant to treatment with methotrexate. Eligible patients will receive MabThera (1000mg by intravenous infusion) on days 1 and 15, and background methotrexate (oral or subcutaneous dose of 10-25mg weekly). After the initial study period of 24 weeks, eligible patients may receive up to 3 re-treatments with MabThera. The anticipated time on study treatment is 1-2 years, and the target sample size is \<100 individuals.


Eligibility Criteria:
Inclusion Criteria:

* adult patients, \>=18 years of age;
* receiving out-patient treatment;
* experienced an inadequate response to previous or current treatment with methotrexate.

Exclusion Criteria:

* rheumatic autoimmune disease other than RA, or significant systemic involvement secondary to RA;
* history of, or current, inflammatory joint disease other than RA;
* previous treatment with any cell-depleting therapies.
Upper Extremity Rehabilitation Training Using Brain-Machine Interface Biofeedback in Stroke Patients With Hemiplegia

This is a study to evaluate the efficacy of upper extremity rehabilitation using Brain-Machine Interface (BMI) on individuals with hemiplegia due to stroke. BMI is a device that can record and analyze human brain signals (in this study Functional near-infrared spectroscopy was used) and also provide live feedback (by pneumatic glove movement) to the individual wearing it. This device hypothetically enables more accurate training by reinforcing the correctly activated brain signal repeatedly then conventional therapy.

In phase 1 study investigators will evaluate the feasibility of BMI on chronic stroke participants. 5 sessions of BMI-assisted occupational therapy (OT) will be performed and the Fugl Meyer Assessment-Upper Limb (FMA-UL) score change between the pre-treatment and post-treatment will be analyzed by paired t-test.

In phase 2 study, a randomized controlled study will be performed by randomly allocating participants to either control (OT plus OT) or experimental group (BMI-assisted OT plus OT) and the difference of FMA-UL score change between the two groups will be analyzed by Student's t-test.


Eligibility Criteria:
Inclusion Criteria:

* Subcortical stroke with hemiplegia
* 1st stroke
* Time since onset is less than 3 months
* Brunnstrom stage 2,3

Exclusion Criteria:

* Recurred stroke
* MMSE score below 10
* Delirium
* Unstable medical condition
* Pregnancy
* Cannot sustain sitting position for 30 minutes
* Pain that limits upper extremity exercise
Dexmedetpmidine Versus Ketamine for Postoperative Sore Throat in Sinus Surgery

The aim of this randomized clinical trial is to evaluate the impact of dexmedetomidine versus ketamine soaked pharyngeal packing on postoperative sore throat in functional endoscopic sinus surgery (FESS).

A written informed consent was taken from the patients.patients will be randomly assigned to three groups of 40 subjects each; dexmedetomidine or ketamine or saline soaked pharyngeal packs were situated under direct vision. Throat packs made of gauze with a length of 20 cm and a width of 10 cm (folded transverse four times) and medications were diluted with 20 ml normal saline. The packings were placed by the surgeon blinded to the study groups.

1-Dexmedetomidine group: 75 µg dexmedetomidine soaked pharyngeal pack (Group D) putted in the posterior pharyngeal wall after induction of anesthesia and \& endotracheal tube (ETT).

2-Ketamine group: 50 mg ketamine soaked pharyngeal pack (Group K) putted in the posterior pharyngeal wall after induction of anesthesia and ETT.

3-Control group: 20 ml 0.9% saline soaked pharyngeal pack (Group C) putted in the posterior pharyngeal wall after induction of anesthesia and ETT.

Eligibility Criteria:
Inclusion Criteria:

* Adults of both sex with American Society of Anesthesiologists (ASA) physical status I-II
* Elective functional endoscopic sinus surgery (FESS) with endotracheal intubation.

Exclusion Criteria:

* A history of preoperative sore throat.
* Upper respiratory tract illness
* Potentially difficult airway
* Patients with history of neck, respiratory or digestive tract pathology
* Chronic smokers
* Using steroid within the last 48 hour
* Pregnant women
Effects of Exercise Therapy on Pectus Carinatum

Pectus Carinatum (PC); deformity in which the front wall of the chest protrudes forward. Non-invasive treatment approaches for PC include compression orthosis and exercises that target the deformity itself and concurrent postural impairment and scoliosis. In addition, the formation of muscles can help close the deformity. Although exercise training is recommended, there is no randomized study showing its effectiveness in the literature. Therefore, in our study, the investigators aimed to investigate the effectiveness of exercise therapy in addition to compression orthotics.

A chest wall deformity is a structural abnormality of the chest that can range from mild to severe. Chest wall deformities occur when the cartilage that connects the ribs grows unevenly. It is not clear why this happens, but the condition tends to run in families. The two most common types of chest wall deformity are Pectus excavatum and Pectus carinatum, Pectus carinatum goes far beyond a simple esthetical problem. It can be responsible of physical signs and symptoms and also has significant psychological impact. Defects tend to worsen during pubertal growth spurts and even during adult life. Recent evidence shows that these patients are at risk for a disturbed body image and reduced quality of life and many patients refer feelings of discomfort, shame, shyness, anxiety, anguish, and even depression, which can lead to social isolation. Chest pain or discomfort, especially when lying in prone position, intolerance to physical exercise, scoliosis, impaired shoulders and kyphotic position are some of the physical signs and symptoms.Non-invasive treatment approaches for PC include compression orthosis and exercises that target the deformity itself and concurrent postural impairment and scoliosis. In addition, the formation of muscles can help close the deformity. Most evidence of non-invasive treatment is retrospective or prospective case series. In a prospective case series, patients were instructed to perform chest wall strengthening exercises, but the effects of the exercises were not investigated . Although, exercise training is recommended, there is no randomized study showing its effectiveness in the literature. Therefore, in our study, the investigators aimed to investigate the effectiveness of exercise therapy in addition to compression orthotics.

Eligibility Criteria:
Inclusion Criteria:

* Patients diagnosed with PC by doctor and indicated for the first time orthotic use
* A correction pressure of less than 10 pounds per square inch in the compression test
* 10-18 years old,
* Discontented with this deformity

Exclusion Criteria:

* Previous orthosis use
* Severe scoliosis (Cobb angle above 20 degrees)
* Having chronic systemic disease
* Having serious psychiatric illness
* Having complex mixed pectus deformity
Treatment of Polydrug-Using Opiate Dependents During Withdrawal

Managed detoxification is a first and necessary step prior to treatment and rehabilitation. Detoxification can be a major obstacle for some patients, and the availability of managed and safe withdrawal is a prerequisite for long-term treatment.

In our clinical practice we have felt the need for a standardised and safe detoxification treatment regimen for our opioid addicts, as dependence on multiple drugs is so common.

Objectives

1. To assess whether a novel standardised treatment regimen - Buprenorphine (BPN) combined with Valproate (VPA) - will result in fewer withdrawal symptoms during detoxification of opiate-polydrug users than the existing treatment regimen, i.e. Clonidine (CLN) combined with Carbamazepine (CBZ).
2. To determine whether there are differences in treatment retention between the BPN/VPA and the CLN/CBZ groups.
3. To assess differences in clinical side-effects and biochemical interactions between the two treatment regimens.


Eligibility Criteria:
Inclusion Criteria:

- Polydrug dependency (at least opiate and benzodiazepine dependency)

Exclusion Criteria:

* No severe psychiatric illness
* No history of epilepsy seizures
* No pregnancy or breastfeeding
* Fertile women must use contraceptives
Prostate Cancer Detection Rate of Targeted Biopsies With PCaVision

The primary objective is to demonstrate non-inferiority of the detection rate of clinically significant prostate cancer (csPCa) in targeted biopsies based on PCaVision imaging (PCaVision pathway) in comparison with the detection rate of clinically significant cancer in targeted biopsies based on MRI (MRI pathway).

All patients will undergo imaging using MRI and PCaVision during which suspicious lesions will be identified based on each imaging technique independently with readers being blinded for the results of the other imaging technique. Thereafter, a MRI targeted 3-core biopsy per lesion (maximum of 2 lesions) and/ or a PCaVision targeted 3-core biopsy (maximum of 2 lesions) will be performed by a one physician if suspicious lesions have been identified based on imaging. If lesions have been identified with both PCaVision and MRI in the same patient, the order of the targeted biopsies will be randomized. If the same lesion has been identified on both MRI and PCaVision, both a MRI-targeted and a PCaVision targeted biopsy will be separately performed. Histological examination of the targeted biopsies will be performed to determine presence of clinically significant prostate cancer.

Eligibility Criteria:
Inclusion Criteria:

* be male
* have an age of 18 years or older
* be biopsy naïve
* have a clinical suspicion of prostate cancer
* be scheduled for evaluation by prostate MRI based on a suspicious DRE and/or elevated serum PSA
* have signed informed consent

Exclusion Criteria:

* active (urinary tract) infection or prostatitis
* a patient history with a cardiac right-to-left shunt.
* allergic to sulphur hexafluoride or any of the other ingredients of the ultrasound contrast agent SonoVue
* current treatment with dobutamine
* known severe pulmonary hypertension (pulmonary artery pressure \>90 mmHg), uncontrolled systemic hypertension or respiratory distress syndrome
* any (further) contraindication to undergo MRI or 3D mpUS imaging
* incapable of understanding the language in which the patient information is given.
* medical history of prostate surgery
* treatment of 5 alpha-reductase inhibitors for at least 3 months
Regional Kidney Paired Donor Exchange in Sensitized Patients

This is a prospective, multi-center, observational study to determine if a combination of desensitization and enrollment in a regional kidney paired donor (KPD) exchange program improves the overall rate of kidney transplantation in sensitized patients.


Eligibility Criteria:
Inclusion Criteria:

* A. Potential Recipients must meet the following inclusion criteria:

  1. Willing and able to sign an informed consent form
  2. Must be at least 18 years old
  3. Meet all recipient selection criteria of the transplant center
  4. Listed on the deceased donor kidney waiting list for renal transplant at a participating center
  5. Potential recipients must:

Group 1: have one or more medically suitable donors who are ABO incompatible or HLA incompatible (defined as positive serologic cross-match); or

Group 2: have a medically suitable donor that is otherwise deemed incompatible due to age, size, or other mismatch by their respective transplant center; or

Group 3: be listed on the deceased donor waiting list for ≥ one year without an identifiable living donor and have a PRA% ≥ 60%

B. Potential Living Donors must meet the following inclusion criteria:

1. Must provide informed consent in accordance with the process outlined in the Informed Consent Requirements Section of the KPD Program Manual of Operations
2. Must be at least 18 years old
3. Meet all living donor selection criteria of the transplant center
4. Meet the evaluation requirements set forth in the Living Donor Evaluation Section of the KPD Program Operational Guidelines

Exclusion Criteria:

* C. Recipients

  1. Do not meet selection criteria of the transplant center
  2. Eligible compatible donor at the time of enrollment
  3. Inactive (not eligible to receive a kidney) on the deceased donor waitlist
  4. Pregnant or breast feeding

D. Donors

1. Unwilling or unable to provide informed consent
2. Have identified barriers to donation as set forth in the Living Donor Evaluation Section of the KPD Program Manual of Operations (Appendix A)
3. Must not be currently listed as a potential living donor for any other recipient registered in the KPD system
4. Pregnant or breast feeding
Effectiveness of Pharmacopuncture for Chronic Neck Pain

In this study, the investigators will evaluate the efficacy and safety of pharmacopuncture therapy for chronic neck pain compared to physical therapy.

This study is prgmatic RCT of pharmacopuncture therapy for chronic neck pain compared to physical therapy.

Eligibility Criteria:
Inclusion Criteria:

* Neck pain more than 6 months
* VAS of neck pain more than 5
* Age between 17 and 70 years old
* Participants who wrote informed consent

Exclusion Criteria:

* Migration of cancer reaching to spine, fracture of spine
* Progressive neurologic deficits or severe neurologic deficits
* Cancer, fibromyalgia, RA, or goat
* Stroke, MI, kidney disease, dimentia, diabetic neuropathy, or epilepsy
* Participants taking steroid, immunosuppressant, or psychotropic medication
* Hemorrhagic disease, severe diabetes or taking anticoagulant drug
* Participants who took NSAIDs or pharmacopuncture within 1 week
* Pregnant or lactating women
* Participants who had undergone cervical surgery within 3 months
* Participants who had participated in other clinical trial within 1 month, or have plan for participation in other trial during follow up period of this trial
* Participants who can not write informed consent
* Participants who is difficult to participate in the trial according to investigator's decision
Effectiveness of a Walking Intervention on Impact Loading and Pain

This study investigates the feasibility of a gait-retraining program for older adults with knee osteoarthritis. The study will enroll 40 participants, with 20 receiving a gait retraining intervention and 20 receiving a graded walking program without gait retraining.

Knee osteoarthritis (OA) is a chronic condition affecting \~12% of older adults in the United States and is a leading cause of disability. Knee pain is a common clinical manifestation that leads individuals with OA to seek medical care. Current rehabilitation approaches (e.g., bracing, taping, foot orthoses, strengthening, etc.) aim to reduce knee joint loading, a well-accepted risk factor for knee OA and pain, but are not always effective. Altering gait mechanics to reduce knee loading has also been suggested. Gait retraining studies for individuals with knee OA have focused on increasing trunk lean and toe out angle to reduce the knee adduction moment (a surrogate measure of joint loading). However, these strategies create an abnormal gait pattern and may not be the best long-term solutions due to the potential injury to other joints which may limit their overall effectiveness and applicability to clinical practice. Impact loading, another mechanical factor related to knee OA, has been reduced using gait retraining strategies in runners with knee pain. It is unknown if gait retraining strategies to decrease impact loading can reduce symptoms of knee OA. Thus, the purpose of this study is to determine the feasibility of a gait retraining program focusing on decreasing impact loading in individuals with knee OA.

At baseline, following 8 intervention sessions, and at 1-month follow-up, participants will complete questionnaires, undergo three-dimensional gait analysis, and assessment of pressure pain threshold.

Note: For participants enrolled during COVID-19 outbreak, only questionnaires will be collected at follow-up assessments.

Eligibility Criteria:
Inclusion Criteria:

Subjects with a clinical definition of knee OA using NICE guidelines:

* Age ≥ 45
* Walking related joint pain in the last week that averages ≥ 4 on 11-point numeric rating scale, where 0 = no pain and 10 = worst pain possible
* History of knee pain for at least 3 months
* Morning stiffness in the morning lasting less than 30 minutes

Exclusion Criteria:

* Walk with an assistive device
* Current use of oral opiates or centrally acting pain medications
* History of lower extremity surgery
* Underwent an intra-articular knee joint injection in the past 3 months
* Suffer from inflammatory arthritis or other conditions that affect lower extremity functions
* Currently receiving treatment for their knee and unwilling to stop this treatment for the duration of the study
* Currently pregnant
* Skin allergies to adhesives
Prevention Through Intervention: Telehealth Solution to Deter 911 Calls Due to Hypoglycemia

This study aims to standardize and evaluate the benefits of the Prevention to Intervention program offered by the Birmingham Fire and Rescue Service. This will accomplished by standardizing the educational materials used, offering phone based follow-up and pre-post data collection.


Eligibility Criteria:
Inclusion Criteria:

1. Be a citizen of Birmingham
2. Be 18 years or older
3. Receive Dextrose-50 IV (intravenous treatment provided by EMS personnel for hypoglycemia)
4. Understand and speak English

Exclusion Criteria:

a) Enrolled currently in any diabetes related educational programs
A Study of the Effects of an Employee Wellness Program

Ochsner employees with a body mass index (BMI) greater than or equal to 30 will be enrolled in a fitness program consisting 90 days of a structured exercise program and dietary counseling. Measures of fitness including weight, BMI, cholesterol, HDL, blood pressure, and absenteeism rates will be measured at 0, 90 days, in one year.


Eligibility Criteria:
Inclusion Criteria:

* Ochsner employees with a BMI greater than or equal to 30

Exclusion Criteria:

* Failure to pass initial physical exam
Comparing the Effects of Ondansetron Versus Dexamethasone on the Incidence of Post-dural Puncture Headache (PDPH) , Nausea and Vomiting After Spinal Anaesthesia of Parturients Undergoing Caesarean Section

Comparing dexamethasone and ondanestrone injection in ncidence of postdural puncture headache and post-partum nausea and vomiting


Eligibility Criteria:
Inclusion Criteria:

* A total of one hundred and fifty parturients in child bearing period (20-40 years), with BMI of 23-27, and ASA physical status II, who were candidate for elective caesarean section, were enrolled in this prospective randomized study.

Exclusion criteria

Exclusion Criteria:

1 - Lady refusal to participate. 2. All pregnant women candidate for emergency caesarean section elligible for general anaesthesia (GA).

3.presence of any contraindications of dexamethasone (as DM and uncontrolled infection ) or any contraindication of ondansetron (as prolonged QT interval 6. Presence of cardiac, respiratory, hepatic, renal and mental diseases. 7. Coagulopathy, or any contraindication to spinal anaesthesia. 8. Presence of complicated pregnancies (such as pregnancy induced hypertension, placenta previa or eclmpsia).