cyrilzakka/clinical-trials huggingface dataset:
The Difference Between Using Local and General Dexamethasone in Arthroscopic Anterior Cruciate Ligament Repair

Arthroscopic knee injuries, such as the anterior cruciate ligament (ACL) injury, are common and often result in postoperative pain. Regional anesthetic techniques, such as femoral nerve block (FNB) and adductor canal block (ACB), can help alleviate pain and reduce opioid consumption. ACB, which blocks the saphenous nerve and obturator nerve branches, is preferred over FNB due to its potential to decrease mobility and increase falls risk. Dexamethasone, a potent glucocorticoid, is used as an adjuvant for ACB, but its perineural administration may carry neurotoxicity risks. Some pain physicians prefer intravenous administration to prolong the action of local anesthetics used in peripheral nerve blocks.


Eligibility Criteria:
Inclusion Criteria:

* Patients diagnosed with ACL injury;
* Patients in class I, II according to American Society of Anesthesiologists (ASA) classification.

Exclusion Criteria:

* Patients free of all Inclusion Criteria.
MRI and CT in Gastroesophageal Junction or Upper Gastric Adenocarcinoma

Accurate preoperative Siewert classification, precise assessment of the extent of esophageal involvement, and staging is crucial for determining the appropriate surgical approach and achieving negative resection margins. The purpose of this study is to investigate the diagnostic performance of the Multi-parametric magnetic resonance imaging (mpMRI) and computed tomography (CT) in gastroesophageal junction and upper gastric cancers.

Despite a continuous decline in the incidence of gastric cancer in recent years, the morbidity and mortality rates associated with the gastroesophageal junction and upper gastric cancers remain elevated. Consequently, it is imperative to develop more refined and individualized precision strategies for screening, diagnosis, surgical intervention, and comprehensive treatment. Due to the unique anatomical location, considerable debate exists regarding the critical aspects of its surgical management in clinical practice. Multiparametric MRI offers significant anatomical benefits due to its high soft tissue resolution, and its functional imaging capabilities present promising applications. With advancements in abdominal imaging technology, novel techniques such as high-order diffusion imaging and compressed sensing technology have facilitated high-resolution MRI of the stomach during free breathing, which is now implemented in clinical practice. Prior research has demonstrated that individualized gastric MRI scanning consistently yields superior image quality, and MRI provides greater accuracy than CT in preoperative staging assessments. Nonetheless, the comparative study of MRI and CT in patients with gastroesophageal junction and upper gastric cancers remains to be elucidated.

Eligibility Criteria:
Inclusion Criteria:

1. patients with gastric cancer confirmed by preoperative gastroscopic biopsy;
2. underwent standardized mpMRI and CT examination;
3. patients with complete postoperative pathological data and pathological results of gastroesophageal Junction or upper gastric adenocarcinoma;

Exclusion Criteria:

1. combined with other tumors;
2. Clinical and imaging data were missing or could not meet the research needs;
3. the location of lesions could not be determined;
Trial of a Distal Targeting System for Cephalomedullary Nails as Part of Surgical Repair of Hip and Femoral Shaft Fractures

This study will be a prospective, case - control trial looking at the use of a previously FDA approved device made by Stryker, a distal targeting system that eases the distal targeting of screws in cephalomedullary nails in hip and femoral shaft fractures. Patients who consent to participate in the study will either be in the control or device arm of the study depending on their surgeon.

Surgeries conducted by Dr. Konda or Dr. Leucht will be done using the device technique, surgeries completed by Dr. Egol or Dr. Tejwani will be done without the device, "free hand" technique. Each arm of the study will contain 29 patients. Patients who consent to participation will be enrolled in the study and placed in the correct arm based on who their surgeon is. Demographic and injury data will be collected. Intra-operatively, control patients will receive the SOC procedure. Device arm patients will have the distal targeting device used in their procedure, but the implant, will not be different than SOC.

Eligibility Criteria:
Inclusion Criteria:

* The patient must be greater than or equal to 18 years of age.
* The patient must have sustained a hip or femur fracture that is indicated for cephalomedullary nailing as the primary and definitive treatment measure.
* The patient must be medically cleared for operative fixation of their fracture.

Exclusion Criteria:

* The patient does not meet all of the inclusion criteria.
Low-dose CD20 Monoclonal Antibody Injection in Preemptive Treatment of PTLD in Patients With EBV-HLH/CAEBV

This is a clinical study on the efficacy and safety of low-dose CD20 monoclonal antibody injection in preemptive treatment of EBV positive lymphoproliferative diseases after allo-HSCT in patients with EBV-HLH and CAEBV

Purpose: To comprehend the efficacy and safety of low-dose CD20 monoclonal antibody injection in preemptive treatment of EBV positive lymphoproliferative diseases after allo-HSCT in patients with EBV-HLH and CAEBV Study subjects: PTLD patients undergoing allo-HSCT with CAEBV or EBV-HLH met the following conditions: (1) EBV-DNA (PBMC or plasma) \> 1000 copies/ml in peripheral blood after transplantation; (2) no PTLD symptoms; (3) presence of aGVHD or clinicians believe that RI treatment is not suitable, or EBV-DNA persists \> 1000 copies/ml after RI; (4) EBV infected lymphocytes; (4) B cell infection, or B cell copy number higher than other cell lines by 2 logs.

Therapeutic regimen: CD20 monoclonal antibody injection 100 mg/m2 was intravenously infused once a week. It can be discontinued after EBV-DNA negative for 2 consecutive times. Total dose≤ 4 applications per patient

Eligibility Criteria:
Inclusion Criteria:

* PTLD patients undergoing allo-HSCT with CAEBV or EBV-HLH met the following conditions: (1) EBV-DNA (PBMC or plasma) \> 1000 copies/ml in peripheral blood after transplantation; (2) no PTLD symptoms; (3) presence of aGVHD or clinicians believe that RI treatment is not suitable, or EBV-DNA persists \> 1000 copies/ml after RI; (4) EBV infected lymphocytes; (4) B cell infection, or B cell copy number higher than other cell lines by 2 logs.

Exclusion Criteria:

* Patients with active infection except for EBV; Active hepatitis B or C (positive HBV-DNA or HCV-RNA) ; Known life-threatening allergic reactions to CD20 Monoclonal Antibody Injection or its preparation ingredients; Participate in other clinical studies.
Disparities Among Liver Transplant Patients

The purpose of this study is to inform healthcare interventions to reduce the disparities in liver transplant listing and in transplantation.

Aim 1. Establish a longitudinal cohort of patients with end-stage liver dysfunction.

Aim 2. Examine interpersonal and structural factors associated with liver transplant evaluation and listing by patient characteristics (e.g., race, ethnicity, SES, gender).

Aim 3. Examine the use of stigmatizing language among patients undergoing liver transplant based on their demographic characteristics (e.g., race, ethnicity, SES, gender).

Eligibility Criteria:
Inclusion Criteria:

- Patients with end-stage liver, kidney, or cardiac dysfunction.

Exclusion Criteria:

* Patients with more than one system with end stage organ dysfunction, dementia, cognitive or sensory impairment, prior solid organ transplant.
* Patients with potential medical exclusions for transplant.
Biofilms on Short-term Indwelling Ureteral Stents

This study is performed to analyze various aspects of biofilms on ureteral stents.

The study is performed to provide a better understanding of the influence of biofilms on ureteral stents on the entire spectrum of stent-associated morbidity.

Moreover, it could provide more detailed knowledge about the correlation of the occurrence of biofilms on ureteral stents and findings in urinary analysis, which could serve as a decision support whether patients with ureteral stents undergoing further interventions (for example ESWL or simple secondary URS) should receive antibiotic prophylaxis.

Correlation of results of urinary bacteriologies (assessed pre- and intraoperatively) and biofilm analysis on stents could provide information if "targeted antibiotic treatment" based on urinary bacteriology only is possible at all.

Correlation of urinary analysis and conventional urinary bacteriology could provide a valuable contribution regarding the prediction of bacteriuria and the necessity of postponing operations.

Additionally, the study is intended to provide an overview over the recent bacterial species that are involved into biofilms on ureteral stents and their resistance to antibiotics. This could provide valuable information about the choice of antibiotics in cases were treatment has to be performed empirically.

Eligibility Criteria:
Inclusion Criteria:

* Patients temporarily undergoing ureteral stenting
* Informed consent

Exclusion Criteria:

* Bilateral stenting
* Ureteral obstruction due to malignancies
* Additionally performed procedures/operations during stent indwelling time -Cognitively impaired patients
* UTI at the time of stent insertion (\>10 to the power of 2 cfu/ml)
The Efficacy of PSB and Recto-intercostal Block Combination on Postoperative Pain in Patients Undergoing Cardiac Surgery Via Sternotomy: Case Series

The aim of this study was to investigate the effectiveness of the combination of Superficial Parasternal Block and Recto-Intercostal Fascial Plane Block in patient groups undergoing cardiac surgery via sternotomy by evaluating postoperative pain scores and analgesic consumption.

Ten patients received a combination of parasternal block and recto-intercostal fascial plane block as an intervention. Patients received bilateral parasternal block and recto-intercostal fascial plane block with 0.25% bupivacaine (total volume 60 ml) in the operating room before surgery. All blocks will be performed after general anesthesia induction, before skin incision. All patients included in the study will be given 50 mg dexketoprofen and 1 g paracetamol intravenously (i.v.) 10 minutes before skin closure. All patients will be given 3x1 g iv paracetamol and 2x50 mg dexketoprofen within the first 24 hours postoperatively. Numerical rating scale (NRS) was used to assess pain at the 1st, 6th, 12th, 18th and 24th hours after surgery. Total morphine consumption was calculated using a patient-controlled analgesia (PCA) device. Tramadol was planned as rescue analgesic medication (maximum dose: 300 mg/day).

Eligibility Criteria:
Inclusion Criteria:

* Adult patients over 18 years of age who will undergo cardiac surgery with sternotomy under general anesthesia and who are in classes I-II-III according to the American Society of Anesthesiologists (ASA) risk classification.

Exclusion Criteria:

* Patients who did not give consent,

  * patients with coagulopathy,
  * patients with signs of infection at the block application site,
  * patients using anticoagulants,
  * patients with local anesthetic drug allergies,
  * patients with unstable hemodynamics,
  * patients who could not cooperate during postoperative pain assessment
Expanded Access Program for Idebenone in Participants With Duchenne Muscular Dystrophy (DMD)

The primary objective of this Expanded Access Program is to provide idebenone as a treatment for eligible participants with Duchenne Muscular Dystrophy before it is commercially available in the United States (U.S.) for the indication of DMD.


Eligibility Criteria:
Inclusion Criteria:

* Documented diagnosis of DMD (severe dystrophinopathy) and clinical features consistent of typical DMD at diagnosis (i.e., documented delayed motor skills and muscle weakness by age 5 years) and who in the opinion of the Treating physician would benefit from treatment with idebenone. DMD should be confirmed by mutation analysis in the dystrophin gene or by substantially reduced levels of dystrophin protein (i.e., absent or \<5% of normal) on Western blot or immunostaining.
* Minimum 8 years old at Prescreening.
* PEF or FVC ≤80% and \>25% of predicted value based on most recent assessment noted in the patient's medical record and subsequently confirmed at the Enrollment Visit.
* Able to understand program requirements and swallow program medication.
* Signed and dated Informed Consent Form (to be obtained at the Enrollment Visit from patient or parent/legal guardian (if applicable) prior to performing any program-specific procedures and dispensing idebenone to the patient).

Exclusion Criteria:

* Eligible for and able to participate in an ongoing clinical trial of idebenone.
* Is at high-risk of a fatal outcome from lung infection and/or advanced cardiomyopathy in the opinion of the Treating physician.
* Known moderate or severe impairment of hepatic function or severe impairment of renal function.
* Prior or ongoing medical condition or laboratory abnormality which in the Treating physician's opinion may put the patient at significant risk or may interfere significantly with the patient's participation in the program.
* Abuse of drugs or alcohol, which in Treating physician's opinion would interfere with the compliance to treatment.
* Known individual hypersensitivity to idebenone or to any of the ingredients/excipients of the program medication.
Vertical Gingival Display Changes Associated With Upper Premolars Extraction

To investigate and compare vertical gingival display (VGD) changes associated with upper premolars extraction during orthodontic treatment.

Seventy-six subjects who met the inclusion criteria were divided into one of 3 groups according to their treatment modalities as follows: group 1: upper first premolars extraction (24 patients, aged 21.56±3.19 years); group 2: upper second premolars extraction (26 patients, aged 22.16±3.59 years) and group 3: no orthodontic intervention was performed (happy with their teeth) (26 subjects, aged 20.45±3.29 years).

Initial records (radiographs, study casts and clinical photographs) were taken for all subjects. The same records were taken post treatment for treated subjects only. The Pre- and post- treatment VGD and lip length in static and dynamic positions and the amount of upper teeth retractions were recorded.

The paired t-test and ANOVA test were used to detect treatment changes and differences between studied groups, respectively. Factors affecting VGD were investigated using backward stepwise linear regression analysis.

Eligibility Criteria:
Inclusion Criteria:

* age 17 years or more
* skeletal class I or class II malocclusion
* upper premolars extraction treatment plan
* high smile line 2mm or more
* no previous orthodontic treatment.

Exclusion Criteria:

* poor oral hygiene
* lower arch extraction treatment plan
* smoking
* Any systemic or periodiontal disease.
Sarcopenia and Combined-modality Exercise

This study examined the effects of combined-modality exercise training (resistance, endurance, flexibility and balance) on muscle mass, muscle function and physical activity in community-dwelling elderly living in Jamaica who had been characterised as having sarcopenia.

Community-dwelling seniors aged 60 years and older were screened for muscle mass and function (grip strength and walk speed) and persons with sarcopenia were identified using the European Working Group on Sarcopenia in Older Persons (EWGSOP) algorithm for case finding (N=1344). Of the 77 seniors with sarcopenia, 38 consented to participate and were randomly allocated to receive 6 months combined-modality high intensity treadmill based exercise and a 'usual care' home exercise programme. A comparison of the effects of treatment assignment on muscle mass, function, fitness, physical activity level and disability was done. Participants in the supervised combined-modality high intensity group were required to attend sessions 3 times per week; participants in the home exercise programme were required to attend 1 supervised session at the start of their 6-month intervention. Outcomes were assessed at baseline and at the end of the 6-month intervention. Data were analysed using standard statistical parametric and non-parametric methods including repeated measures analysis of variance to determine changes in outcomes and regression to establish determinants of outcomes.

Eligibility Criteria:
Inclusion Criteria:

* over 60 years old,
* independently ambulant, with or without an assistive device
* mentally competent to give informed consent and follow exercise instructions

Exclusion Criteria:

* a history of stroke with residual disability
* a diagnosis of cancer
* neuromuscular disorders
* auto-immune disorders
* dementia
* severe arthritis rendering participation in an exercise programme difficult
* unstable cardiovascular disease which renders exercise unsafe
Home Accidents Training For Parents of CWSN

The main objective of this project is to raise awareness and equip parents of children with special needs with the knowledge and skills necessary to prevent home accidents through virtual reality applications. Additionally, the project aims to provide parents with basic first aid training and transfer training to ensure appropriate responses in the event of an accident. It also seeks to assess the balance status of children with special needs and to identify potential fall-related risks that may lead to home accidents.

The primary research questions this project aims to address are as follows:

* What is the level of awareness among parents of children with special needs regarding home accidents?
* What is the effect of virtual reality simulation on parental awareness of home accident risks?
* How does first aid training influence parents' ability to respond to home accidents?
* What is the impact of transfer training on parents' preparedness for home accident scenarios?
* What are the balance and gait levels of children with special needs, and how might these relate to fall risk at home?

As part of the eligibility process, participants will complete the System Usability Scale, a Likert-type questionnaire, once at the beginning of the study. Only individuals scoring in the A+ category (96th-100th percentile) will be included in the intervention phase.

Eligibility Criteria:
Inclusion Criteria:

* Being able to understand and speak Turkish
* Being a parent of a child with special needs
* Having a child registered at a Barrier-Free Life Application and Research Center
* Scoring in the A+ category on the System Usability Scale, with a percentile rank between 96 and 100
* Volunteering to participate in the study

Exclusion Criteria:

- Failure to meet one or more of the inclusion criteria
Cognitive Behavioural Therapy Software for the Treatment of Depression in People With Multiple Sclerosis

Guidance issued by the United Kingdom (UK) National Institute for Health and Clinical Excellence (NICE) recommends the use of computerised cognitive behavioural therapy (CCBT) 'Beating the Blues' (BtB) in treatment of depression. However CCBT has not been designed specifically for use by people with Multiple Sclerosis (MS) and may not be effective or appropriate for use by people with physical disabilities or cognitive symptoms. There would therefore be value in conducting a trial of the effectiveness of CCBT for depression in people with MS. The aim of this pilot study is to test the feasibility of a randomised control trial (RCT) of CCBT for depression in people with MS. The objective is to undertake a pilot RCT of comparison of CCBT with usual care including 3 month follow up to identify a realistic patient recruitment rate and provide reliable estimates of other parameters needed for designing a definitive RCT including the sample size. Other outcomes to be measured include estimates of the effect on depression and quality of life. Participants will be assessed as experiencing clinical levels of depression and be recruited from two participating MS Centres. The outcomes of the study will be (1) preliminary indication of the impact of CCBT on depression in MS; and, (2) a well researched protocol for a definitive RCT of the effectiveness of CCBT in treating depression in people with MS.


Eligibility Criteria:
Inclusion Criteria:

* Aged 18+
* Diagnosis of MS confirmed by neurologist
* Beck Depression Inventory-II score of at least 14 on two consecutive occasions
* Not currently or within past three months receiving any treatment from a psychologist, psychotherapist or psychiatrist.
* Willingness to be randomised to CCBT, at home or primary care facility or treatment as usual.

Exclusion Criteria:

* Unable to read or write English
* Beck Depression Inventory score of at least 29 on two consecutive occasions
* Active suicidal ideas
* Current or life-time diagnosis of any of the following:

  * psychosis
  * organic mental disorder;
  * alcohol or drug dependency
* Kurtzke Expanded Disability Status Scale (EDSS) score of 8.5 or above
* Unable to use the CCBT package due to physical disability
* Unable to use the CCBT package due to cognitive symptoms (mini-mental state of 20 below or if, in the opinion of the study psychologist, the individual would be unlikely to benefit from CCBT)
Effects of Sevoflurane and Propofol on Light Flash Evoked Pupillometry

Null hypothesis (HO): There will be no difference in pupillometry readings when using any of the maintenance anesthetic techniques within subjects.

Alternate hypothesis (HA): Pupillometry readings will be affected by a change in the anesthetic technique

Postoperative visual loss resulting from a surgical procedure not performed on the eye is a devastating outcome for the patient and poorly understood by the medical community. It is potentially a preventable complication. Diminished blood supply to the optic nerve, affecting both the anterior or posterior portions of the optic nerve, is the most common cause of postoperative visual loss. Other, less common causes include occlusion of the retinal artery and vein, a retinal embolism and cortical blindness. The incidence of postoperative visual loss increases in patients undergoing cardiopulmonary bypass and prone spine surgery. Although the etiology of post-operative visual loss is unknown, it is thought to be multifactorial, and several potential risk factors have been identified, including degree of low blood pressure, preoperative hematocrit, external compression of the eye, amount of blood loss, prolonged duration of surgical time and increased pressure in the eye associated with positioning. To date studies have focused on the mechanism associated with the visual loss. We would like to focus on the feasibility of using a monitor which may signal loss of visual function intraoperatively.

Eligibility Criteria:
Inclusion Criteria:

* Patients between the ages of 18 and 70 years of age who are mentally capable of providing an informed consent and who are medically classified as ASA 1 or 2.
* Planned elective orthopedic extremity surgery in the supine position with the head in the neutral position.

Exclusion Criteria:

* Failure to provide an informed consent
* Known history of eye disease which cannot be corrected with lenses
* Surgery lasting less than 45 minutes