cyrilzakka/clinical-trials huggingface dataset:
Predictive Factors of Inadequate Bowel Preparation in Inpatients

About 50-70% only of inpatients who undergo colonoscopy have an adequate bowel cleansing, which is far below the recommended threshold of 90%. Variables associated to inadequate colon preparation have not been assessed yet. Identifying such variables would allow to augment the diagnostic yield of colonoscopy, and also to reduce costs related to the need to repeat colonoscopy. Aim of the present study is to find variables independently associated to an inadequate bowel cleansing and to subsequently build and validate a predictive model, which could prove useful in clinical practice to identify hard-to-prepare inpatients. Secondary endpoints are (i) to assess the proportion of patients with inadequate colon cleansing, (ii) to run a cost-effectiveness analysis between patients with adequate cleansing and patients who need to repeat colonoscopy. Patients undergoing urgent colonoscopy, and patients who take the preparation at home will be excluded.


Eligibility Criteria:
Inclusion Criteria:

* Inpatient ≥18 y.o. who are scheduled elective colonoscopy during hospitalization irrespective of the indication.

Exclusion Criteria:

* Urgent colonoscopy
* Patients who are not hospitalized when taking bowel preparation or when undergoing colonoscopy
Transcranial Direct Current Stimulation on Cortical Plasticity in Patients With Anti-NMDA Receptor Encephalitis

Patients suffering from anti-NMDA receptor encephalitis show impaired NMDA-receptor dependent neuronal transmission. Furthermore, they often have cognitive deficits of different magnitude. Impaired neuronal signaling of NMDA-receptors very likely result in decreased cortical synaptic plasticity. Thus, this represents one major reason of cognitive deficits. Synaptic plasticity can be assessed in humans via the non-invasive technique of transcranial magnetic stimulation (TMS).

The current study aims to investigate whether learning ability and also cortical plasticity can be changed by applying sessions of transcranial direct current stimulation (tDCS). Therefore, we are recruiting 10 to 15 patients suffering from anti-NMDA receptor encephalitis as well as healthy controls in order to compare tDCS effects. Learning ability is assessed by motor sequence tasks, whereas cortical plasticity is measured via TMS.

tDCS is a novel non-invasive technique allowing induction of changes in cerebral excitability level and also cortical plasticity. Previous studies showed positive outcome of anodal stimulation on learning tasks. Especially motor learning seems to be an important target for tDCS treatment since it showed best results for both post-stroke patients and healthy subjects. Multiple sessions of tDCS are inducing long-term effects and improved learning function, which were present three months after stimulation.

In this study we hope to reveals new insights into the pathomechanisms of impaired cognitive and learning abilities in patients having anti-NMDA receptor encephalitis. Moreover, we evaluate whether tDCS is an effective treatment for patients with cognitive and learning deficits.


Eligibility Criteria:
Inclusion Criteria:

* Patients suffering from anti-NMDA receptor encephalitis
* healthy (control) subjects

Exclusion Criteria:

* Any metal inside the body/head, e.g. clips, pace maker, medical pumps, cochlear implant etc.
* Traumatic brain injury
* Stroke
* Cerebral tumor
* Pregnancy
* untreated severe internal or psychiatric diseases
Effect of Preoperative Budesonide Inhalation on Arterial Blood Oxygenation and Intrapulmonary Shunt During OLV

The purpose of this study is to conduct a randomized controlled trial to evaluate the effect of preoperative budesonide inhalation on arterial blood oxygenation and intrapulmonary shunt in patients received one-lung ventilation

Population:

The target population comprises all adult aged 45-65 years who was diagnosed lung cancer and to receive video-assist thoracoscopic lobectomy under general anethesia.The study sample will include 50 subjects of both gender and any race or ethnicity.

Procedures:

Eligible and consented patients will be enrolled into the study if all eligibility criteria are met and will be randomly allocated to one of the two study arms:Budesonide inhalation group vs Normal saline inhalation group

Study Duration:

Overall duration of the study is 10 months.

Eligibility Criteria:
Inclusion Criteria:

* Aged 45 yr to 65 yr ,height 155-176cm,weight 45-75kg,body mass index(BMI)18-27kg/m2,ASA Physical Status Classifications I to II,left-lateral position during OLV ,normal cardiac and pulmonary function ,and no cardiac,hepatic,renal and endocrine diseases.Diagnosed with uncomplicated lung cancer and was to receive video-assist thoracoscopic lobectomy under general anesthesia.

Exclusion Criteria:

* FEV1/FVC\<70%,asthma,chronic obstructive pulmonary disease,acute lung infection,past history of thoracic surgery. preoperative glucocorticoid medication,preoperative chemotherapy,SpO2 kept below 90% for more than 15 minutes during operation,blood transfusion during operation,OLV less than an hour,occurrence of severe complications like allergic shock.
Therapy of Ventilator-associated Tracheobronchitis Caused by Gram Negative Bacteria With Nebulized Colistin

The purpose of this study is to determine whether inhaled colistin is effective in the treatment of ventilator associated tracheobronchitis due to gram negative organism susceptible to colistin.

Patients diagnosed ventilator-associated tracheobronchitis due to gram negative organism are included to the study.The patients will be received colistin inhalation 75 mg every 12 hours at least 5 days.

The primary objective is to evaluate clinical outcome of inhaled colistin. The secondary objectives are microbiological clearance and toxicity of inhaled colistin.

The sample size was estimated to 62 patients.

Eligibility Criteria:
Inclusion Criteria:

* Clinical diagnosis of ventilator-associated tracheobronchitis caused by gram negative organism.
* Expected to survive more than 48 hours after enrollment.
* Received intravenous colistin not more than 48 hours prior enrollment.

Exclusion Criteria:

* Pregnancy and Lactation
* Allergy to colistin
* Serum creatinine \> 4 mg/dl or GFR decreased more than 75% from baseline
Timing of PDA Closure and Respiratory Outcome in Premature Infants

The investigators propose the present study with the following aims:

* to determine whether early patent ductus arteriosus (PDA) treatment with ibuprofen treatment at the onset of clinical symptoms is superior to late ibuprofen treatment only when symptoms of a hemodynamically significant PDA are present in the evolution of bronchopulmonary dysplasia (BPD) defined as duration of supplemental oxygen exposure during the first 28 days
* to determine whether early PDA treatment with ibuprofen will be superior to late treatment with ibuprofen in efficacy of PDA closure, need for rescue therapy, need for PDA ligation and incidence of major complications of prematurity.

Hypothesis: Early pharmacologic closure of PDA with ibuprofen will improve respiratory course and reduce BPD as reflected by a reduction in duration of supplemental oxygen during the first 28 days of age vs. late pharmacologic treatment with ibuprofen.

Outcome variables: The primary outcome of this study is the number of days spent on supplemental oxygen by each infant during the first 28 days.

Other outcomes to be determined between groups include:

* Mortality
* Other respiratory variables: total days on supplemental oxygen, days on mechanical ventilation, oxygen dependence at 36 weeks post menstrual age, age at final extubation.
* Other respiratory complications: pneumothorax, pulmonary interstitial emphysema, need for high frequency ventilation, pulmonary hypertension
* Efficacy of PDA closure: number of courses of medication required, need for ligation
* Other neonatal complications: intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), intestinal perforation, sepsis, renal dysfunction (oliguria, elevated creatinine)
* Time to achieving full enteral feedings, time to regain birth weight, weight at discharge.
* Length of hospital stay

Study terminated when intravenous (IV) ibuprofen withdrawn for both clinical and research use.

Eligibility Criteria:
Inclusion Criteria:

* Inborn patients at JHS hospitals (admitted to the NICU at JMH within the first 72 hrs of age
* BW 500-1250 grams
* 23-32 wks gestational age
* \> 1d but \< 14d of age.

Exclusion Criteria:

* Major congenital malformations
* Proven sepsis (positive blood culture)
* Contraindications to the use of Ibuprofen or Indomethacin
* Terminal condition, not expected to survive beyond 48 h
* Infants born excessively SGA(3 S.D. below the mean for GA)
* Infants with initial PDA presentation that is hemodynamically significant
Effects of Hemoperfusion With a Polymyxin B Membrane in Peritonitis With Septic Shock

The purpose of this randomized, comparative, open and multi-centre study is to show that two sessions of hemoperfusion with Toraymyxin performed within maximum 36 hours after the surgery of a peritonitis by hollow organ perforation reduce the mortality in patients suffering from septic shock.

The mortality rate due to peritonitis associated to a severe sepsis or a septic shock remains high (between 40 and 60% as per the studies). The recent complementary therapies for severe sepsis have been reassessed (strict glycaemic control, substitutive corticotherapy, activated protein C). Early neutralisation of the endotoxaemia related to gram-negative bacilli sepsis in contact with hemoperfusion membrane covered with polymyxin B (Toraymyxin™) may enable reduction of the inflammatory reaction caused by sepsis and improve its prognosis. 30 studies, including 10 randomized studies, have compared hemoperfusion with Toraymyxin™ to the standard treatment, showing an improvement in the patients' haemodynamic state, oxygenation conditions and reduction in mortality. This treatment is commonly used in Japan. However, the studies conducted either include only a limited number of patients or are not randomized prospective studies. The post-hoc analysis of a recent randomized study conducted on a limited number of patients with abdominal septic shock shows a significant reduction in mortality after factor adjustment. Though the side effects of such a treatment are limited, its cost is high. Hence, extensive prospective studies are necessary to confirm its effectiveness.

Eligibility Criteria:
Inclusion Criteria:

* Confirmed community or nosocomial acquired peritonitis due to organ perforation
* Septic shock requiring catecholamine infusion started or maintained 2 hours after surgery

Exclusion Criteria:

* Pregnancy
* No severity criteria within the 8 hours following surgery
* Neutropenia due to chemotherapy or malignancy
* Abdominal sepsis without peritonitis
* Mesenteric ischemia without perforation
* Peritonitis due to appendicitis
* Perforation linked to trauma
* Cirrhosis child C
* Impossibility to use heparin
* Prolonged cardiac arrest within 72h before surgery
* Terminal disease diagnosed during surgery
* Moribund subjects
Inpatient Package to Reduce HIV and AIDS-related Death in Zambia

Early post-discharge mortality is high among HIV-infected Zambians admitted to the hospital. Likely this is in part due to missed opportunities to identify lethal coinfections and optimize HIV care during admission (and before discharge). In this study the investigators will develop and pilot a new approach to inpatient HIV care that follows international guidelines for management of advanced HIV disease.


Eligibility Criteria:
Inclusion Criteria:

* 18+ years old
* HIV-positive (by self-report or DCT result in UTH file)
* Resident of Lusaka
* Admitted to the hospital

Exclusion Criteria:

* Too sick to provide informed consent (based on clinician opinion)
* Likely to be discharged in the next 48 hours (based on clinician opinion)
High Dose Omeprazole in Patients With Pancreatic Cancer

The purpose of this study is to test the safety of high dose omeprazole and see what effects that it has on patients with exocrine pancreatic cancer.

During this study patients will receive treatment of omeprazole at the dose depending on group enrollment

* Group A will receive omeprazole 80 mg, twice a day for 14 days unless unacceptable toxicity
* Group B, will receive omeprazole 20 mg, once a day for 14 days

Patients will receive treatment for 2\~3 weeks during the study, and 2 months of follow up.

Total accrual is anticipated to take 2 years.

Eligibility Criteria:
Inclusion Criteria:

* Newly diagnosed exocrine pancreatic cancer with pathology confirmed as adenocarcinoma
* Patient is a candidate for surgical resection of pancreatic cancer
* ≥ 18 years old at the time of informed consent
* ECOG Performance Status 0-2
* Patients with or without neoadjuvant chemotherapy will be eligible
* Ability to provide written informed consent and HIPAA authorization
* Women of childbearing potential definition must have a negative pregnancy test within 14 days of registration. All women (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) are considered to have childbearing potential unless they meet one of the following criteria:
* Prior hysterectomy or bilateral oophorectomy;
* Has not had menses at any time in the preceding 24 consecutive months
* Adequate organ function for surgical therapy

Exclusion Criteria:

* Patients with pancreatic malignant tumor histologically confirmed as neuroendocrine or any other type of malignancies
* Positive pregnancy test, pregnant, or breastfeeding
* Known hypersensitivity to any component of the formulation or substituted benzimidazoles
* Any other clinically significant laboratory abnormality that would compromise patient safety or the outcome of the study
* Any clinically significant and/or uncontrolled cardiac-related abnormality that would compromise patient safety or the outcome of the study
* Medical condition that might affect the absorption of study medications in the opinion of the investigator.
An Exploratory Investigation of a Supplement to Promote Brain Health

Providing a combination of synergistic dietary supplements, such as vitamins B6, B12, and folate, as well as curcumin, lemon balm, and American ginseng is hypothesized to promote brain health and aid with brain fog, mental clarity, ability to handle stress, mood, focus, and productivity, as well as promote overall well-being.


Eligibility Criteria:
Inclusion Criteria:

* In good general health with no major chronic conditions (e.g., diabetes, coronary heart disease, etc.)

Exclusion Criteria:

* Females who are pregnant or breastfeeding
* Anyone currently taking other supplements
* Anyone with a known allergic reaction
* Previous head trauma
* Anyone with chronic diseases such as diabetes, coronary heart disease, or cancer.
* Any psychological, mental, or neurodevelopmental disorders
* Consumes nicotine or marijuana in any form
* Previous or current alcohol addiction
* Consume more than 10 drinks per week
Antenatal COVID 19 Vaccination and Pregnancy Outcomes

Effect of COVID 19 vaccinations on pregnancy outcomes must be clear and identified to detect their safty

in this study we will discuss side effects of COVID 19 vaccine on pregnant women including the incidence of miscarrage , intrauterine fetal deaths, liquor abnormalities, preeclampsia, accidental hemorrhage , we also will follow up pregnant women who received any type of COVID 19 vaccine till delivery and discuss the effect of the vaccine on fetus and newborn

Eligibility Criteria:
Inclusion Criteria:

* pregnant women aged 18 years or older who received any type of COVID 19 vaccine during current pregnancy

Exclusion Criteria:

* comorbidities,women who refused participqtion,pregnant women with previous COVID 19 infection during current pregnancy
Using Biomarkers to Optimize Antibiotic Strategies in Sepsis

The proposed work will provide critical insights into the potential impact of a biomarker-based algorithm on reducing unnecessary antibiotic use in different adult and pediatric/neonatal ICU's. This proposal will also assess the costs (or savings) of a biomarker-based intervention. Overall, the results of this work will be critical in informing future strategies to eliminate unnecessary antibiotic use and curb the continued rise in antimicrobial resistance.

The goal of this project is reduce unnecessary use of antibiotics in the ICU. The purpose of Phase I of the study is to identify the biomarker, or combination of biomarkers, that provides optimal test characteristics in identifying adults and children/neonates with presumed sepsis who have a very low likelihood of bacterial infection. Results of Phase I will result in development of a biomarker-based algorithm to inform need for antibiotic use in ICU patients. In Phase II, the impact of this biomarker-based algorithm on reducing antibiotic use in the ICU will be determined. Costs or savings associated with the algorithm will also be assessed.

Eligibility Criteria:
Inclusion Criteria:

1. SIRS Criteria

   SIRS is considered to be present when patients have more than one of the following clinical findings:
   * body temperature \>38°C or \<36°C
   * heart rate \>90 min-1
   * respiratory rate of \>20 min-1 or a Paco2 of \<32 mm Hg
   * and a white blood cell count of \>12,000 cells µL-1 or \<4,000 µL-1
2. new empiric antibiotic therapy is initiated, indicating the suspicion of infection. Accepted criteria for SIRS will be used for the Medical Intensive Care Unit and Surgical Intensive Care Unit populations, with appropriate age-specific vital signs definitions to help make the definitions relevant for the Pediatric Intensive Care Unit population.

Exclusion Criteria:

1. a code status of "do not resuscitate"
2. absence of initiation or expansion of antibiotic therapy despite meeting criteria for sepsis
3. presence of an immunocompromising condition.

An immunocompromising condition will be defined as one of the following:

* human immunodeficiency virus (HIV) infection with a t-helper cell (CD4) count \<200 cell/mm3; 2) immunosuppressive therapy after organ transplantation
* neutropenia (\<500 neutrophils/mm3)
* active chemotherapy within the 3 months preceding eligibility or
* diagnosis of cystic fibrosis.

These criteria all represent conditions in which antibiotic use is much less likely to be decreased regardless of the results of a biomarker and are consistent with exclusion criteria used in past studies of the impact of biomarkers.
Mechanisms of Immunosurveillance for Lung Cancer

The purpose of this research study is to investigate the differences in "natural killer (NK) blood cells, a type of white blood cell that fights infection in the body, among different types of patients that have lung surgery. The four different groups of patients are:

* smokers with lung cancer
* smokers without lung cancer
* non-smokers with lung cancer
* non-smokers without lung cancer.

Research has shown that different strains of mice possess varying susceptibility to lung cancer. C3H and C57BL6 mice are highly resistant to lung cancer, whereas A/J and 129 mice are very susceptible to lung cancer. Data from our lab shows that the mice have different numbers of natural killer (NK) cells as well as different characteristics of those cells. C3H and C57BL6 mice have higher numbers of NK cells as well as higher expression of CD11b, whereas A/J and 129 mice have lower numbers and lower expression.

These findings justify parallel investigation of NK cells in human populations resistant and susceptible to lung cancer. Through blood samples, circulating NK cells can be counted and phenotypically analyzed. Smoking can be used as a factor to establish lung cancer risk. Additionally, non-smokers suffering from lung cancer provide an opportunity to investigate whether lung cancer patients have lower abundance of NK cells and lesser expression of CD11b, independent of the effects of smoking.

Objective:

The main goal of this study is to investigate the quantitative and phenotypic differences in circulating NK cells among human populations. Participants will be classified as heavy smokers (HS), non-smokers (NS), those suffering from lung cancer (LC), and those free from lung cancer (NC).

Hypothesis #1: NS/LC participants will have fewer NK cells and lower expression of CD11b compared to HS/NC and NS/NC participants.

Hypothesis #2: NS/LC participants will have more numerous NK cells and higher expression of CD11b compared to HS/LC participants.

Eligibility Criteria:
Inclusion Criteria:

* Age equal or greater to 18 years
* Ability to read and write in English
* Able to participate in the informed consent process

Exclusion Criteria:

* Known active hepatitis B, hepatitis C, or HIV/AIDs (found in medical record)
* Chemotherapy or radiation therapy within 3 months of enrollment
* Type 1 Diabetes Mellitus
* Rheumatoid arthritis, Lupus, Multiple Sclerosis, or any other autoimmune disease as deemed necessary for exclusion by the Principal Investigator
* Previous organ transplant
* Blood transfusion within 3 months prior to enrollment
* Any previous cancer, excluding a previous lung cancer
* Steroid use within 4 weeks of enrollment
Micrometastasis in Gastrointestinal Cancer

Prognostic and predictive value of assessing the patients micrometastasis status in blood and bone marrow when diagnosed GI cancer. 2 different patient subgroups are currently studied, patients with cancer of the pancreas and patients with liver metastasis secondary to colorectal cancer.

Our hypothesis is that patients with detective circulating tumor cells in the blood or disseminated tumour cells in their bone marrow at diagnosis have a more advanced disease than negative patients. This information may be of therapeutic interest.

Oncological and overall outcome of the included patients are consecutively registrated at the out-patient clinic. At end of follow-up these survival data are analysed according to the presence of tumor cells in blood and bone marrow, and the prognostic impact of their presence are assessed.

Eligibility Criteria:
Inclusion Criteria:

1. Histological proven adenocarcinoma of the pancreas
2. Histological/radiological verified colorectal liver metastases
3. Consent capable patient
4. Signed written, informed consent

Exclusion Criteria:

1. Patient'history of other malignancy