cyrilzakka/clinical-trials huggingface dataset:
Early Antiplatelet for Minor Stroke Following Thrombolysis (EAST)

The current guideline recommends to give antithrombotic treatment 24 hours after intravenous thrombolysis in acute ischemic stroke. However, early neurological deterioration will occur in some patients due to no antithrombotic treatment, which is closely associated with poor outcome. The current trial aims to investigate the effectiveness and safety of early antithrombotic treatment after intravenous thrombolysis in minor stroke.


Eligibility Criteria:
Inclusion Criteria:

* Age ≥ 18 years old;
* Acute ischemic stroke patients who received intravenous thrombolysis within 4.5 hours of onset;
* NIHSS ≤ 5 within 6 hours after the end of intravenous thrombolysis, and no bleeding transformation was found in head CT examination;
* Premorbid mRS ≤ 1;
* Signed informed consent.

Exclusion Criteria:

* Premorbid mRS≥2;
* Uncontrolled severe hypertension (systolic pressure \>180 mmHg or diastolic pressure \>110 mmHg after drug treatment);
* Antithrombotic treatment within 24 hours before randomization;
* Significant dysphagia and inability to take the experimental drug orally;
* Allergy or contraindication to study drugs;
* Comorbidity with any serious diseases and life expectancy is less than half a year;
* Participating in other clinical trials within three months;
* Patients not suitable for this clinical study considered by researcher
Protocol Establishment for the Prevention of Lamotrigine-induced Skin Rash in Epilepsy Patients

The investigators intend to find a way to lower drug rash occurrence by applying drug tolerance induction protocol at the beginning of lamotrigine administration.

Genotyping of participants with rash and those without rash after taking lamotrigine and genetic testing to find common gene mutations in these participants.


Eligibility Criteria:
Inclusion Criteria:

* Adults aged 18-85 years old
* Epilepsy patients
* Patients who started Lamotrigine first time

Exclusion Criteria:

* Those who do not agree with prior consent
* Women taking oral contraceptives.
* history of drug rash
* Taking enzyme-inducing antiepileptic drugs (EIAED) or valproate (VPA)
Effectiveness of Standard Exercises and Wall Angels Exercise in Young Adults With Kyphotic Posture

Kyphosis-oriented exercise programs consist of isolated stretching, strengthening, and breathing exercises. However, the literature emphasizes that the body is a kinetic chain in many musculoskeletal disorders and supports holistic exercise approaches. To our knowledge, the effects of a complex exercise such as the Wall Angels exercise have not been studied in the kyphotic population. The aim of our study is to investigate whether the Wall Angels exercise combined with standard kyphosis exercises performed at home has additional effects and to contribute to the optimization of kyphosis rehabilitation programs.

The study was planned as a randomized controlled double-blind study and will consist of two groups: intervention (Wall angels exercise combined with kyphosis and breathing exercises) and control (Only kyphosis and breathing exercises). The G-Power version-3.1.9 power analysis measurement method was used to determine the sample size. According to the Power Analysis conducted by taking into account the results of the studies of Elpeze and Usgu (15), it was calculated that at least 38 volunteers would be included in the study for a p\<0.05 with an effect size of 0.5 and a power of 85%. The outcome measures of the study will be demographic characteristics, pain (Visual Analog Scale), trunk flexibility assessment, thoracic range of motion assessment, kyphosis index, scapula protraction, upper extremity function, respiratory capacity, postural habit and postural awareness level, and quality of life assessment. Statistical analyses will be performed using SPSS version 23.0 (IBM SPSS Statistics; IBM Corporation, Armonk, NY, USA) software. Descriptive statistics of the data will be given using mean and standard deviation for numerical variables; and percentages for qualitative variables. The Kolmogorov-Smirnov test will be used to examine the conformity of the data to normal distribution as a result of descriptive analyses. Intra-group comparisons will be evaluated using the Dependent Groups T test for groups with normal distribution, and the Wilcoxon signed ranks test for those not with normal distribution. In order to compare pre-post training values between groups, the Independent Groups T test for data with normal distribution, and the Mann Whitney-U test for data not with normal distribution will be used. The level of statistical significance will be accepted as p\<0.05.

Eligibility Criteria:
Inclusion Criteria:

1. Volunteering to participate in the study and giving written consent
2. Being a woman/man between the ages of 18-25
3. Having a kyphotic posture

Exclusion Criteria:

1. Having a musculoskeletal disorder (scoliosis, etc.)
2. Having a neurological system disorder
3. Having a cardiopulmonary system disorder
4. Having a fracture or surgery related to the spine, rib cage, or upper extremity within the last year
5. Participating in an exercise program for kyphosis within the last 6 months
Oral Manifestations of Coronavirus Disease 2019(COVID-19) :a Multicentre Study

online questionnaire will be distributed in different country to detect the oral change in patient diagnosed with COVID-19

an online survey will be performed through google form. Investigators in different country will share the questionnaire with patient diagnosed positive COVID-19.

data collected will be statically analyse to detect the oral picture of the virus.

Eligibility Criteria:
Inclusion Criteria:

* positive COVID-19

Exclusion Criteria:

* children
* patient not confirmed by swab
Prolonged Protection From Bone Disease in Multiple Myeloma

Main hypothesis: Patients who continue zoledronic acid after year 2 have longer time until progression in bone disease compared to patients who stop treatment after two years?

Secondary hypothesis: Serum will bone markers increase prior to progression in bone disease in the individual patient?

Secondary hypothesis: Low-dose CT will detect more cases of osteolytic bone disease in Multiple Myeloma compared to conventional radiography

Newly diagnosed myeloma patients will be followed for 4 years. The first two years they will be treated with zoledronic acid monthly. At year 2 they will be randomized to A continue treatment for 2 more years or B stop treatment. The primary outcome of the study will be time to progressive bone disease from year 2 and onward.

Serum bone markers will be measured throughout the study. In patients who experience progressive bone disease, development of bone markers prior to the radiological progression will be investigated to see the if it could have been predicted with the use of serum markers

During the four year period patients will have low-dose CT superior and conventional radiography made at predefined time points. The secondary outcome of the study is to compare the sensitivity of the two modalities

Eligibility Criteria:
Inclusion Criteria:

* Symptomatic Multiple Myeloma regardless of bone disease status
* Signed Informed Consent
* Age ≥ 18 years
* Remaining life expectancy ≥ 2 years
* Any concurrently anti-myeloma treatment are allowed

Exclusion Criteria:

* Previous treatment with bisphosphonate within the last 6 months
* Severely reduced renal function (creatinine clearance \<30 mL/min despite fluid replacement)
* Known concurrent malignancy, excluding skin cancer
* Known hypersensitivity to zoledronic acid
* Pregnant or lactating women
* Women of childbearing potential or men engaging in sexual activity with a woman of childbearing potential who refuse to use contraception
Acupressure for Reducing Anxiety in Patients Undergoing Chemotherapy

This clinical trial evaluates whether acupressure is helpful to reduce anxiety related to chemotherapy. Anxiety is experienced by many patients with cancer. Anxiety can be related to chemotherapy and may contribute to other symptoms, such as nausea and poor quality of life. Some patients diagnosed with cancer express interest in non-medicinal ways to manage symptoms. Acupressure is a noninvasive intervention that can be used for many different symptoms. Acupressure is well tolerated with minimal reports of adverse reactions, making it a good choice for patients with cancer. This study may help researchers learn whether acupressure is useful for managing anxiety in patients undergoing chemotherapy.

PRIMARY OBJECTIVES:

I. Evaluate the feasibility of a nurse- and patient-applied acupressure intervention for patients with anxiety associated with active cancer-directed therapy.

II. Patient-reported changes in acute anxiety associated with both the nurse and self-led acupressure interventions will be ascertained.

OUTLINE:

Patients undergo acupressure over 15-120 seconds at a time for up to 15 minutes. After completion of the session, patients may optionally receive an education session on using acupressure at home.

After completion of study intervention, patients who opted to receive education about using acupressure at home are followed up at 1 week.

Eligibility Criteria:
Inclusion Criteria:

* Be over 18 years of age
* Be actively undergoing chemotherapy in the Mayo Clinic chemotherapy unit
* Report anxiety as a 1 or higher, on a scale from 0 (no anxiety) to 4 (severe anxiety)
* Be willing to undergo a short acupressure session

Exclusion Criteria:

* Does not meet the inclusion criteria
Mindfulness-Based Stress Reduction, Health Education and Exercise

The purpose of this research is to examine the effects of four interventions on age-related cognitive decline in healthy older adults. The investigators will examine the effects of Mindfulness Based Stress Reduction (MBSR) psychotherapy, multi-component intensity-based aerobic exercise, and their combination, compared to a discussion group.

MBSR teaches mindfulness, or the focusing of attention and awareness, through various meditation techniques. Mindfulness meditation practices appear to produce neurocircuitry changes that are the reverse of those seen in age-related cognitive decline. It is widely available, acceptable to older people, and carries minimal risk of side effects or adverse events. Exercise - specifically, intense, multi-component exercise - also appears to affect brain structure and function and improve cognitive performance.

The investigators will randomize 580 non-demented healthy adults aged 65 to 84 to one of four conditions: MBSR alone, exercise alone, MBSR + exercise, or a health education discussion group control condition.

The study will consist of a 6-month acute intervention phase with weekly visits followed by a 12-month maintenance phase with weekly or monthly visits and other prompts to maintain intervention behaviors.

Assessments include cognitive tests, biomarkers, neuroimaging assessments, functional assessments to examine real-world benefits of the interventions, and other behavioral assessments to characterize participants and pave the way for further exploratory analyses.

Eligibility Criteria:
Inclusion Criteria:

* Community-living men and women age 65 to 84.
* Self-reported cognitive complaints that are a normal part of aging.
* No current meditation practice nor prior training in it.
* Sedentary.

Exclusion Criteria:

* Known diagnosis of dementia, mild cognitive impairment, other clinical neurodegenerative illness (e.g., Parkinson's disease, cerebrovascular disease), psychotic disorder, or any unstable psychiatric condition.
* Medical conditions that suggest shortened lifespan, such as metastatic cancer; or would prohibit safe participation in the interventions, including cardiovascular disease or musculoskeletal conditions; or would interfere with the assessments, such as taking medications for diabetes or ferromagnetic metal/bridgework that would interfere with MRI signal.
* IQ \<70 as estimated by the Wechsler Test of Adult Reading
* Sensory impairment (language, hearing, or visual) that would prevent participation.
* Alcohol abuse within 6 months.
* Current illicit drug use.
* Concurrent cognitive training, such as brain-training software, or other interventions expected to affect neuroplasticity.
* Medications that interfere with measurements, including cancer chemotherapy, glucocorticoids, and interferon.
* Inability to cooperate with protocol.
Multidetector Coronary CT In Vasospastic Angina

The purpose of this study is to compare the extent of coronary vessel stenosis between coronary spasm-induced angina attacks (named vasospastic angina, VSA) patients and health volunteers by multi-detector computed tomography angiography (MDCTA), and to evaluate the diagnostic efficacy of MDCTA in patients with VSA.

Vasospastic angina (VSA) was characterized by transient ischemic ST-segment change during angina attacks. Coronary spasm provocation test, as a diagnostic golden standard, has been widely used for the management of VSA according to JCS 2013 guidelines.

With regard to the characteristics of spasm segment, had been clearly described by other invasive imaging methods including intravascular ultrasound and optical coherence tomography. However, there is potential risk during these invasive procedures, such as severe myocardial ischemia or fatal arrhythmia.

Presently available imaging test for coronary artery disease including multi-detector computed tomography angiography (MDCTA) with high diagnostic accuracy to evaluate coronary artery stenosis. However, the diagnostic accuracy of MDCTA in patients with VSA is lacking.

Therefore, more efficient and safe noninvasive diagnostic method is required for the detection of angina-like attacks patients.

Eligibility Criteria:
Inclusion Criteria:

* Onset of angina-like attack at rest, during effort, or during rest and effort.
* Patients will be scheduled to undergo multi-detector computed tomography angiography and coronary angiography with an ergonovine provocation test.

Exclusion Criteria:

* Evidence of acute coronary syndrome, cardiomyopathy and valvular heart disease.
* More than 50% stenosis detected by coronary angiography .
* Renal insufficiency (serum creatine\>2.5 mg/dl).
Comparison of Two Sedation Regimens for Awake Fiberoptic Intubation

The purpose of this study is to examine the effects of different sedation drugs used for the awake fiberoptic intubation procedure. Benzodiazapines and narcotics (such as midazolam and fentanyl) are standard drugs used for sedation during awake fiberoptic intubation. Dexmedetomidine, midazolam, and fentanyl are approved by the Food and Drug Administration (FDA) procedural sedation. These drugs might be given to the patient regardless of their participation in the study.

In addition to midazolam and fentanyl study subjects will also receive either dexmedetomidine or a placebo (a salt solution that contains no drug). It is believed that dexmedetomidine will not slow down breathing as much as the combination of the valium-like drug and narcotic. In our study, we are trying to determine if this is the best drug for sedation during an awake fiberoptic procedure.

This is an observational study designed to evaluate effectiveness of two standard of care protocols used for patients with potentially difficult airway during awake fiberoptic intubation.

After obtaining informed consent, patients will be randomized into one of two groups. The first group will receive placebo, midazolam, and fentanyl (titrated to effect) to facilitate the intubation. The second group will receive dexmedetomidine, midazolam, and fentanyl (titrated to effect) to facilitate intubation. Both groups will have a transtracheal injection and/or direct topical application of lidocaine to decrease irritation of the trachea and vocal cords.

As the patients in the study all have potentially difficult airways, the usual precautions will be taken to minimize the risks to the patients. These include the availability of alternative airway devices (including LMAs and Intubating LMA systems). Doses of dexmedetomidine will conform to the recommended dosing schedules of between 0.3 and 0.7 mcg/kg/hour.

All the drug stated above are currently FDA approved and are used according to the standard of care.

Patient medical records will be reviewed to determine the amount of fentanyl that was used to facilitate intubation as well as homodynamic stability during the procedure and oxygen saturation. A brief 5-minute survey will be conducted 24 hours after the surgery to access patient satisfaction with intubation procedure. Intubation conditions stated below will be recorded by the anesthesiologist during the procedure.

The intubating conditions (gagging, discomfort of patient, and oxygen saturation) and hemodynamic stability during the procedure will be recorded by the research assistant and the patient's satisfaction with the undertaking (after the surgery is completed) will be determined as well. The amount of fentanyl used to facilitate intubation will also be recorded.

Eligibility Criteria:
Inclusion Criteria:

* Subjects with potentially difficult airways who require awake fiberoptic intubations will be identified from the OR schedule and the pre-operative clinic workups.

Exclusion Criteria:

* Anyone who does not meet the inclusion criteria
New Echocardiographic Parameters for Assessment of Longitudinal Left Ventricular Function

Assessment of left ventricular systolic function is the most frequent indication for routine echocardiography. Qualitative eyeball method and biplane modified Simpson's rule, both measuring radial ventricular function, are the currently recommended methods to meet this challenge. Due to the complexity of the myocardial architecture, global left ventricular function also has longitudinal and torsional components.

The aim of this study is to evaluate new echocardiographic parameters for longitudinal left ventricular function. A special focus is set on strain imaging by speckle tracking, which is a relatively new technique. Patients with different cardiac pathologies (e. g. dilated cardiomyopathy, coronary artery disease, diastolic dysfunction) will be included and compared to healthy individuals.


Eligibility Criteria:
Inclusion Criteria:

* persons of 18 years and older who receive a transthoracic echocardiography at our department
* written consent

Exclusion Criteria:

* permanent pacemaker rhythm
* moderate/severe valvular heart disease
Active Comparator Study of Generex Oral-lyn™ Spray and Injected Human Insulin

To compare the efficacy of Generex Oral-lyn™ RapidMist™ System and standard regular human insulin therapy as measured by HbA1c, in type-1 diabetes mellitus subjects on BID NPH intermediate acting insulin therapy.

This is a 26 week open-label, randomized, multi-center, active comparator study to compare oral spray insulin (Generex Oral-lyn™) with regular human insulin therapy as measured by HbA1c, and number of hypoglycaemic episodes in type-1 diabetes mellitus subject. All subjects will be on BID NPH intermediate acting insulin therapy. If subject is using long acting insulin (Glargine, Detemir, etc.), he/she must be switched to NPH intermediate acting insulin. If on insulin analogue (Novolog, Lispro, Aspart, Aphidra, Glulisine, or any other analogue available in the subject's geographical area), the subject must be switched to regular human insulin 3 times a day.

Eligibility Criteria:
Inclusion Criteria:

* Be male or female between the ages 18 to 75 years
* Type 1 diabetes mellitus patients (according to ADA and/or WHO classification) who have \>1 year history of type 1 DM and are currently managed with daily insulin injections totalling 0.3 to 0.8 IU/kg of body weight;
* Current physical examination, vital signs and ECG at screening that reveals no clinically significant abnormalities;
* Have a body mass index (BMI) \<27;
* 8.5% (inclusively)\<Have a glycosylated haemoglobulin HbA1c
* Willing and able to follow the American Diabetes Association diet guidelines for type 1 diabetes; be able to commit to perform home blood glucose monitoring and record values as well as hypoglycemic events
* Willing to give written informed consent prior to admission into the study.

Exclusion Criteria:

* Have a significant active asthma or suspected abnormalities of buccal mucosa; cardiovascular, cerebrovascular, hepatic, renal, gastrointestinal, hematological, or auto-immune disease (other than auto-immune thyroid disease); history of athopy or drugs allergy
* Have evidence of unstable retinopathy (defined as pre-proliferative or proliferative retinopathy currently requiring photocoagulation therapy), nephropathy or neuropathy (gastroparesis or orthostatic hypotension);
* Have hypoglycemia unawareness;
* Have had more than one episode of severe hypoglycemia with seizure or coma or ketoacidosis within the past 12 months;
* Have a blood pressure in excess of 160/100 mmHg at the Screening visit;
* Have had any acute illness within the 2 weeks prior to screening;
* Have a history of drug or alcohol abuse that in the opinion of the Investigator would interfere with participation in the protocol
Effect of Fetal Ovarian Cyst Aspiration to Prevent Torsion

The purpose of this study is to determine whether prenatal ovarian cyst aspiration is effective and safe to prevent perinatal ovarian torsion.

With the widespread use of routine sonography during pregnancy, the incidence of fetal ovarian cysts detected in utero has increased in the past decades. However

Eligibility Criteria:
Inclusion Criteria:

* Pregnant women having an uneventful single pregnancy and a female fetus diagnosed with anechoic ovarian cyst (diameter at least 30mm)

Exclusion Criteria:

* Multiple pregnancy
* Complicated pregnancy (PE, diabetes, PROM, fetal malformation)
* Echoic cyst (fluid debris level, septated, retracting clot, globally echoic)
* Unability to give informed consent
B7 Coreceptor Molecules in Hyper IgD Syndrome Form of Mevalonate Kinase Deficiency

The hyper IgD syndrome (HIDS) is an inflammatory disease caused by mevalonate kinase deficiency. There is no cure, and available treatments of HIDS febrile episodes have shown limited clinical efficacy. The development of effective interventions for HIDS is limited by our poor understanding of the disease. The goal of the study is to better characterize the inflammatory response during HIDS episodes and to determine the relationship between this response and blood and urine markers of mevalonate kinase deficiency. This knowledge will help us learn more about the cause of the disease and should lead to the identification of new disease biomarkers that can be used to evaluate clinical efficacy in future therapeutic trials.

The primary hypothesis is that the costimulatory B7 glycoprotein abnormalities identified in the murine MKD model will be recapitulated in sera obtained from human HIDS patients, either before, during or after febrile episodes. The secondary hypothesis is that B7 glycoprotein molecule levels will correlate with clinical symptomatic severity score, other known biomarkers of HIDS, markers of inflammation and or markers of isoprenoid metabolism.


Eligibility Criteria:
Inclusion Criteria:

* any race or ethnicity
* diagnosed with HIDS

Exclusion Criteria:

* parents' inability to donate blood
* currently having cancer, renal failure, diabetes, liver disease, thyroid diseases, major infectious diseases or immunodeficiency
* pregnancy
* inability to provide consent
A Multiple Ascending Dose Study of RO4998452 in Patients With Type 2 Diabetes Mellitus.

This study will evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of multiple ascending doses of RO4998452 compared to placebo in patients with type 2 diabetes mellitus. Successive cohorts of patients will be randomized to receive either active drug, at escalating doses, or placebo. The anticipated time on study treatment is \<3 months, and the target sample size is \<100 individuals.


Eligibility Criteria:
Inclusion Criteria:

* adult patients, 18-65 years of age;
* type 2 diabetes;
* either treated by diet and exercise alone or with metformin.

Exclusion Criteria:

* type 1 diabetes mellitus;
* uncontrolled hypertension;
* clinically severe diabetic complications.