cyrilzakka/clinical-trials huggingface dataset:
Relation of Functional ındependence to Balance, Exercise Capacity, and Peripheral Muscle Strength

Stroke is one of the leading causes of death worldwide and is among the most important diseases that cause long-term disability in adults. In high-income countries, the incidence of stroke has decreased significantly with increased use of preventive therapies and control of risk factors. Stroke has a significant impact on individuals' independence and productivity.

Walking capacity is limited due to motor control, balance, and muscle strength disorders after stroke. In addition, it was determined that the functional exercise capacity of stroke patients decreased when compared to healthy individuals of the same age. The quantitative decrease in muscle mass due to physical inactivity is accompanied by sarcopenia, which worsens the situation. Although the primary impairments affecting gait are muscle strength weakness and loss of coordination, impaired cardiorespiratory fitness can also affect walking performance by limiting endurance. Depending on the change in each parameter after stroke, the functional independence and daily living activities of individuals are affected.

A correlation was found between balance and functional mobility and the level of functional independence in stroke patients. It has been found that having a good balance function after stroke significantly increases the likelihood of being functionally independent. When the studies in the literature were examined, no study was found that directly showed the relationship between functional exercise capacity and muscle strength in stroke patients. Therefore, in our study, we aimed to investigate the relationship between balance, functional exercise capacity, peripheral muscle strength, and functional independence level in stroke patients.


Eligibility Criteria:
Inclusion Criteria:

* Having had a stroke for the first time at least 6 months ago
* Being 40 years or older
* Having a Mini-Mental Test result of more than 24 points
* The lower extremity score for Brunnstrom is 5-7
* Being 3 and above according to the functional ambulation scale
* Willingness and willingness to work
* Being able to speak and understand Turkish

Exclusion Criteria:

* Having a different neurological, orthopedic, and rheumatological disease
* Having a visual or hearing impairment
* Having uncontrollable cardiopulmonary and unstable chronic diseases
* Having had a transient ischemic attack or multiple strokes
* Lack of independent sitting and standing balance
Comparison of Biocompatibility of Plasmapheresis Procedures With Citrate and Heparin Anticoagulation

Membrane plasmapheresis is one of the methods for treating immune diseases. Plasmapheresis removes autoantibodies and immune complexes, paraproteins, lipoproteins and reduces the concentration of cytokines. In membrane plasmapheresis, plasma is separated from blood cells by a highly permeable membrane. The filtered plasma is then discarded and replaced with replacement fluid. During the procedure, there is an activation of the coagulation system, because of the extracorporeal blood circulation. The anticoagulation during the procedure is therefore necessary.

Standard heparin or citrate is routinely used as a method of anticoagulation in plasmapheresis. Citrate provides effective anticoagulation that is completely limited to extracorporeal circulation. Patients who are at increased risk for bleeding, anticoagulation with citrate is a more appropriate method than standard heparin, while in other patients both methods are equivalent.

Citrate anticoagulation is performed by infusing citrate into the arterial line of the extracorporeal system. Citrate binds to plasma calcium and thus inhibits coagulation in the system. Calcium is added to the venous line of the system (when blood returns to the patient) to maintain a normal plasma ionized calcium concentration. Lowering the ionized calcium in the blood in the extracorporeal circulation inhibits the coagulation and activation of other systems (platelets, leukocytes, complement), which affects the biocompatibility of the artificial material and the whole procedure. Biocompatibility is extremely important, since the contact of blood with artificial material activates both the humoral and cellular systems. As part of the humoral immune system, complement is activated by the production of C3, C4 and C5, factor XIIa, there is also an increase in the production of bradykinin, kallikrein, quinine and plasmin, and some proteins are denatured (gamma globulins, fibrinogen, albumins). When the cellular immune system is activated, lymphocytosis can occur and the is also change in function of phagocytes.

All previous studies show that regional anticoagulation with citrate improves biocompatibility in hemodialysis procedures (compared to heparin anticoagulation), but no direct comparison in plasmapheresis has been observed in the literature so far.

Therefore, the investigators want to conduct a prospective randomized study comparing several parameters of heparin and citrate anticoagulation biocompatibility during plasmapheresis. The aim of the study is to demonstrate better biocompatibility in citrate anticoagulation compared to heparin.

Eligibility Criteria:
Inclusion Criteria:

* older than 18 years
* an indication for plasma exchange (plasmapheresis) with albumin solution as a replacement solution

Exclusion Criteria:

* contraindication for systemic heparinisation
* acute bleeding
* known active malignancy
* severe infection
* anticoagulant therapy at therapeutic dose
The Use of Laser in the Treatment of Atrophic Vulvovaginitis

This study evaluates the efficacy and security of laser for atrophy treatment. Half of participants will receive the laser treatment and the other half placebo.

Thermal laser treatments are proposed as the newest treatments for atrophy. Through the thermal effect it would stimulates de mucosa, enhances the collagen component and the vascularization. Collagen remodeling and new collagen synthesis has been suggested as a mechanism of laser induced skin resurfacing and remodeling of vaginal connective tissue.

Eligibility Criteria:
Inclusion Criteria:

* Menopause women with vulvovaginal symptoms of atrophy
* No previous estrogen treatment for the last 30 days
* Active sexual life (vaginal penetration)
* Accept to participate
* Pap atrophy or hypotrophy in the last year

Exclusion Criteria:

* Vulvovaginal diseases
* Abnormal uterine bleeding
* Antidepressants drugs
* Uncontrolled diabetes
* Cervical intraepithelial lesions or cancer
* Photosensitized or under treatment with photosensibilized drugs
* Collagen diseases
* Vulvovaginal infections in the last 15 days
* Immunosuppressed patients or under immunosuppressed treatments
mHealth Intervention to Support Diabetes Medication Adherence (Pilot Study)

This study aims at evaluating the feasibility of an intervention based on the use of a mobile-device based system delivering automated, tailored brief text messages to offer support for medicine use and lifestyle recommendations alongside usual care to people with type 2 diabetes.

A list of patients registered in primary care centers of the Balearic Islands and potentially meeting the eligibility criteria will be obtained from electronic health records (EHRs). A research assistant will contact the potential participants via phone to invite them to the study and confirm eligibility. All eligible participants will complete informed consent followed by baseline assessment over the phone before randomization. Participants will be randomly allocated using a computer-generated randomization sequence. All participants will continue with their usual diabetes care including all medical visits, tests, and diabetes support programs throughout the study. In addition, the intervention group will receive the text messaging intervention. Control participants will receive usual care only. After three months of follow-up, all participants will complete post-intervention assessments via phone interview. Data on glycemic control (HbA1c) at baseline and post-intervention will be extracted from EHRs, as according to the protocol used for primary care providers in the Balearic Islands, patients with poor glycemic control (HbA1c \>8% ) must request an HbA1c determination every six months. Results of the most recent determination will be extracted from electronic medical records. For those patients with no recorded HbA1c within the previous three months, the research assistant will contact the primary care center and the patient to arrange blood test analyses.

Eligibility Criteria:
Inclusion Criteria:

* Patients registered in the Public Health Service of the Balearic Islands
* With type 2 diabetes
* At least one prescription of an oral glucose-lowering drug
* With results of HbA1C\>8% from 3 months prior to recruitment.

Exclusion Criteria:

* Younger than 18 years old
* With insulin treatment.
Postural Stability, Balance and Fall Risk in Patients With Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a clinical condition characterized by the repetitive obstruction of the upper airway during sleep, resulting in nocturnal hypoxaemia and fragmented sleep. Fragmented sleep leads to daytime sleepiness that causes alterations in reaction times and reflexes . Postural stability is an important function of the human body. It is shown that the sleep deprivation disturbs daytime postural stability and balance. Aim of this study is to examine the influence of OSA severity and daytime sleepiness on postural stability, balance and fall risk.


Eligibility Criteria:
Inclusion Criteria:

* Subjects with recent diagnosis of OSA (AHI≥5)
* BMI of ≤35 kg/m2
* Being sedentary

Exclusion Criteria:

* Having OSA treatments (CPAP, oral devices, nasal surgery, tennis ball/positional therapy, diuretic),
* Having a disease that can affect balance (vestibular, neurological, orthopedic ...) performing regular exercise
* Morphological defect (facial malformation, etc.) which may cause sleep disorders
* Uncontrolled hypertension or arrhythmia
* History of smoking or alcoholism
* Orthopedic, neurological or musculoskeletal problems which impede exercising
* Pregnancy
* Uncompensated clinical conditions such as chronic obstructive pulmonary disease, interstitial lung disease, heart failure, or rheumatic and psychiatric diseases
Pilot of Lifestyle Behavior Intervention for Non-Alcoholic Fatty Liver Disease

The purpose of this study is to pilot test a behavioral lifestyle intervention for Hispanic/Latino patients with non-alcoholic fatty liver disease (NAFLD)


Eligibility Criteria:
Inclusion Criteria:

* Self-reported Hispanic/Latino
* Have been diagnosed with NAFLD
* Able to speak English or Spanish
* Have access to internet, either on their phone, at home or at some other location convenient to the participant

Exclusion Criteria:

* Does not have a working telephone number
The Norwegian Adult Achondroplasia Study

The study aims to investigate the Norwegian adult achondroplasia population regarding degree and extent of symptoms and clinical manifestations and how this population manages in daily life, including demographics, physical function, and work participation.

The present study aims to investigate the degree and extent of spinal stenosis, chronic pain, sleep apnoea, impaired hearing, cardiovascular risk factors and body composition in Norwegian adults with achondroplasia. The study will also explore these factors' impact on physical function, ability to perform daily activities, work participation and needs for assistive devices and social benefits. The study is conducted in collaboration with the Norwegian Restricted Growth Association, and TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Lovisenberg Hospital and Oslo University Hospital.

Eligibility Criteria:
Inclusion Criteria:

* Residents of Norway
* Aged 16 years or older
* Clinical and genetic diagnosis of achondroplasia
* Speak and understand the Norwegian language.

Exclusion Criteria:

* Severe cognitive deficits, mental illness or substance abuse
* Having a medical condition making them unable to participate in the study.
A Pilot Study Assessing EmSam in Bipolar Depression

This pilot study will evaluate the efficacy of the monoamine oxidase inhibitor (MAOI)EmSam, a selegiline transdermal system (STS), in bipolar depression.

Most current treatments for bipolar depression have been shown to be of modest effectiveness. There is some literature which suggests that Monoamine Oxidase Inhibitors (MAOIs) have greater efficacy than tricyclic antidepressants, and that they are effective for treatment-resistant depression of all types, both unipolar and bipolar. The MAOI selegiline has demonstrated antidepressant efficacy. EmSam, a selegiline transdermal system, provides central nervous system but not intestinal/liver MAO inhibition without clinically significant increases in sensitivity to dietary tyramine. This transdermal system appears to be associated with fewer side effects and increased safety relative to oral MAOI's. This pilot study will evaluate the efficacy of EmSam in bipolar depression.

Eligibility Criteria:
Inclusion Criteria:

1. Ages 18 - 65
2. DSM-IV Bipolar Disorder (I, II, NOS), Depressed Phase
3. DSM-IV Bipolar Disorder (I,II, NOS), Mixed state with adequate mood stabilization (ie, resolution of manic or hypomanic symptoms for 8 weeks with a minimum of 4 weeks on a stable dose of mood-stabilizing medication that will be continued through all phases of the study).
4. Prior failure of or inability to tolerate at least one other antidepressant treatment
5. Physically healthy
6. Agrees to participate in the study
7. HAM-D 24 \> 10

Exclusion Criteria:

1. Bipolar Disorder (I, II, NOS), Mixed State without adequate mood stabilization
2. Prior significant adverse reaction to EmSam
3. Unstable medical disorder
4. History of epilepsy (febrile seizure o.k.)
5. Current use of any medication that might interact with EnSam.
6. Use within 2 weeks of other antidepressant medication (6 weeks for fluoxetine)
7. Inability to adhere to a tyramine-free diet
8. Recent (past 6 months) suicide attempt
9. Serious suicidal ideation
10. Pregnant
11. Breast feeding
12. Fecund, sexually active females, without adequate contraception
13. Prior failure to respond to 2 or more adequate oral MAOI trials (2/3 PDR maximum dose, minimum 4 weeks)
14. Non-nicotine substance abuse/dependence within the past 6 months (1 year for amphetamines/cocaine)
Study of Tissue Samples From Patients With Glioma or Other Brain Tumors

RATIONALE: Studying the genes expressed in samples of tissue from patients with cancer in the laboratory may help doctors learn more about changes that occur in DNA and identify biomarkers related to cancer. It may also help doctors predict how patients will respond to treatment.

PURPOSE: This research study is looking at tissue samples from patients with glioma or other brain tumors.

OBJECTIVES:

Primary

* To better understand the pathophysiology of gliomas and identify molecular markers that may predict prognosis and progression or that could identify new therapeutic approaches.

Secondary

* To compare gene expression profiles, in terms of response to treatment, and attempt to isolate subgroups of patients with objective response to certain types of chemotherapy or radiotherapy.

OUTLINE: This is a multicenter study.

Biological samples are collected from patients at time of surgery for diagnostic and/or treatment purposes.

Eligibility Criteria:
Inclusion Histologically confirmed glioma of any grade or rare primary brain tumor No urgent situation No known or suspected active infection Must not be deprived of liberty or protected by law Not pregnant or nursing

Exclusion :

No concurrent participation in other trials that require a period of exclusion
STEP-IT-UP - Peanut Allergy Study for Infants

Multicenter randomized (1:1) trial of strict avoidance versus sub-threshold dietary introduction of peanut in peanut allergic infants 4-14 months of age who react at a minimum cumulative dose of at least 430 mg of peanut protein at initial oral food challenge (OFC) for 12 months, followed by cross-over to sub-threshold dietary introduction of peanut in those randomized initially to avoidance.


Eligibility Criteria:
Inclusion Criteria:

* Children age 4-14 months suspected to be peanut allergic

Exclusion Criteria:

* Significant medical problems
Patients With Hemorrhoids Referred to a Surgical Specialist Department

Hemorrhoids is the most common disease in rectum with a prevalence of 30 % of population. This means that many patients are referred to surgical specialist reception with diagnosis hemorrhoidal disease. The aim of this study is to describe population of patients with hemorrhoidal disease that are referred to a specialised colorectal unit and to determine what treatment they are given at a general practitioner as well as in colorectal unit.


Eligibility Criteria:
Inclusion Criteria:

* all patients with diagnosis hemorrhoidal disease that are referred to a surgical specialist department

Exclusion Criteria:

* none
CCTAP: Cognitive Control Training for Treatment of AUD-PTSD

The primary objective of this study is to evaluate the feasibility of the revised brain training program with individuals diagnosed with Alcohol Use Disorder (AUD) and Post-Traumatic Stress Disorder (PTSD).


Eligibility Criteria:
Inclusion Criteria:

* Participant is a Veteran and is enrolled in outpatient Substance Use Disorder treatment within Veteran Affairs Palo Alto Health Care System
* Participant meets Diagnostic and Statistical Manual of Mental Disorders-5 criteria for current Alcohol Use Disorder and seeking treatment for Alcohol Use Disorder
* Participant meets Meet Diagnostic and Statistical Manual of Mental Disorders-5 criteria for current PTSD
* Participant must be willing to perform daily home-based computer exercises for 6 weeks
* Participant must demonstrate mild cognitive deficit on neuropsychological tests at the screening visit
* Participant must be a fluent English speaker from the age of 12
* Participant must have adequate sensorimotor capacity to perform the program, including visual capacity adequate to read from a iPad screen at a normal viewing distance, auditory capacity adequate to understand normal speech, and motor capacity adequate to control a touchpad

Exclusion Criteria:

* Participant with diagnosis of an illness or condition with known cognitive consequences (e.g., schizophrenia, bipolar disorder, cancer, multiple sclerosis, Traumatic Brain Injury, mental retardation or pervasive developmental disorder, epilepsy, Parkinson's Disease, delirium or dementia)
* Participant with active suicidal ideations as measured by the Columbia-Suicide Severity Rating Scale (C-SSRS)
* Participant with problems performing assessments or comprehending or following spoken instructions
* Participant who has been treated within 5 years of the date of consent with a computer-based cognitive training program manufactured by Posit Science
* Participant with current severe traumatic brain injury
* Participant with any type of dementia
* Participant with any type of mental retardation
* Participant with limited ability to speak/read/write/understand English
The Efficacy of Shear-wave Elastography-guided Biopsy for Diagnosis in Pleural Disease

To investigate the information from shear-wave elastography on pleural tissues will improve the diagnosis of pleural diseases, as to increase the diagnostic yield in ultrasound-guided transthoracic pleura biopsy.


Eligibility Criteria:
Inclusion Criteria:

* Patients with radiographic evidence of pleural disease

Exclusion Criteria:

* Age \< 18 y/o
* Patients who cannot hold their breath for 5 seconds
Effect of Whole Grain Diet on Insulin Sensitivity, Advanced Glycation End Products and Inflammatory Markers in Pre-diabetes

Food products derived from cereal grains constitute a major part of the daily diet of many Americans . For example, a typical Chinese American eats rice about 9.5 times a week on an average. However, most of these foods are derived from refined grain. During the refining process grains are stripped of their bran and germ which results in depletion of several biologically active constituents including fiber, anti-oxidants, phytoestrogens and minerals. From observational studies there is evidence for a protective effect of whole-grain foods with regard to the development of type 2 diabetes. More recently, higher intake of whole grains was also associated with decreases in insulin resistance - a risk factor related to the development of type 2 diabetes.

In this randomized study the investigators plan to replicate this beneficial effect of improving insulin sensitivity in patients with pre-diabetes and go a step further by exploring the potential mechanisms by which this benefit may occur. The investigators will assess the effect of consuming a whole-grain-rich diet on levels of advanced glycation endproducts (AGE), RAGE (receptor for AGE) and markers of inflammation and oxidative stress - all of which have been shown to play an important role in the pathogenesis of diabetes mellitus. The investigators will also look for correlations between the levels of these markers with insulin sensitivity to identify potential mechanisms of pathogenesis.


Eligibility Criteria:
Inclusion Criteria:

1. Age ≥ 18 years to unlimited, both genders.
2. At least one meal per day included rice in the seven days prior to enrolment.
3. No current diagnosis of Diabetes Mellitus (DM).
4. Fasting blood glucose value between 100 to 125 mg/dl and/or Hemoglobin A1c levels between 5.7%-6.4%.
5. ≥ 2 visits with primary care physician to establish compliance

Exclusion Criteria:

1. Special diets (e.g. vegetarian)
2. Use of medications that would affect blood sugar levels (e.g. steroids)
3. Allergy to any type of grain
4. Body weight fluctuation over the past 180 days of ≥ 10%
5. Planning to significantly change level of physical activity during the time of study.
6. Planning to move out of town or take a vacation for ≥ 14 days during the time of the study
7. Current smoker
8. Consumption of greater than 2 alcoholic drinks per day
9. History of malignancy and overt cardiovascular disease (apart from hypertension).