cyrilzakka/clinical-trials huggingface dataset:
Differential Effects of Various Anesthetic Agents on Cognitive Function in Patients With Alzheimer's Disease

The objective of the study is to determine the effects of different anesthetic agents on cognitive function in patients with Alzheimer's disease (AD). The investigators will test the hypothesis that anesthesia with desflurane or propofol, compared to isoflurane or sevoflurane, will have less of an effect on post-operative cognitive dysfunction in patients with AD.

Patients with mild-to-moderate Alzheimer's disease who are scheduled to have elective noncardiac, nonneurologic, nonvascular surgery will be recruited at the Massachusetts General Hospital (MGH). The study will first be introduced to patients at their preoperative surgical clinic appointment by his/her surgeon. If patients are interested in participating, they will notify their surgeons, and subsequent recruitment will take place at the MGH Pre-Admission Testing Area (PATA), a clinic for preoperative evaluation and medical optimization. Patient contact and recruitment, however, will only proceed with permission from (1) the patient him/herself and (2) the patient's surgeon. Per the Partners Human Research Committees-approved criteria, if patients do not have capacity for clinical-decision making but express a willingness to participate in the study, a surrogate (i.e. healthcare proxy and/or family member) co-signature will be required on the consent form. On the day of the subject's surgery, the anesthesia team will be allowed to choose one of four anesthetic options (i.e. propofol anesthesia, isoflurane anesthesia, sevoflurane anesthesia, or desflurane anesthesia) based on clinical preference and appropriateness. The research team will be blinded to the anesthetic to which subjects are assigned. Finally, patients will be followed for one year post-operatively with a battery of cognitive tests to determine differences in cognitive trajectory.

Eligibility Criteria:
Inclusion Criteria:

* Patients diagnosed with Alzheimer's disease (AD) per Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria.
* Patient recruitment permission granted by his/her surgeon
* Requires general anesthesia for elective noncardiac, nonneurologic, nonvascular surgery.

Exclusion Criteria:

* History of neurologic or psychiatric disease (i.e. stroke, psychosis, etc.)
* Non-native English speaker
* Severe visual or auditory disorder
* Sensitivity to sulfites (some propofol formulations at MGH may contain sodium metasulfite).
* Asthma (sulfite sensitivity is seen more frequently in asthmatic than in non-asthmatic people).
ASL in Brain Metastasis MRI Following Gamma Knife Treatment

Arterial spin labeling (ASL) is a non-invasive MRI technique that could help the radiologists to distinguish brain metastasis progression versus radionecrosis following gamma-knife treatment.

The primary target of the study is to establish the diagnostic performances (specificity, sensitivity) of quantitative measures of ASL in brain metastases suspected of progression/radionecrosis after GK treatment

The metastasis progression versus radionecrosis following GK treatment can sometimes be difficult to distinguish. 60 patients will be included in this prospective, monocentric study. 3 MRI (baseline, 1month and 6 month follow-ups) will be performed. Two neuroradiologists will blindly analyse the MRIs comparing ASL sensibility and specificity to the standard morphological evaluation and T2 perfusion.

Eligibility Criteria:
Inclusion Criteria:

* Brain metastasis from histologically proven tumor
* GK treatment within 4 month prior to the inclusion
* Lesions suspected of progression/ radionecrosis :

  i.e.≥ 25% of the size progression
* Lesion size: gadolinium enhanced part of the tumour ≥1 cm

Exclusion Criteria:

* Pregnancy
* Medical history of primitive brain tumour
* MRI incompatibility/ medical history of contrast agent allergy
* Claustrophobia
* Patient unable to consent
* Epilepsia/recent stroke
* Patients participating in other studies
* Patients without health care insurance
The Impact of Anesthesia on the Absorption of Glycine in Operative Hysteroscopy: a Randomized Controlled Trial

This study aimed to compare two types of anesthesia (general anesthesia and local anesthesia with sedation) on the absorption of glycine in operative hysteroscopy.

As a minimally invasive procedure, operative hysteroscopy has gained popularity in the past two decades and became a standard surgical treatment for abnormal uterine bleeding unresponsive to medical management. Despite its increasing use, little information is known on the predictors of its potential complications. The absorption of glycine has been reported as the most common complication of this procedure and it remains an unpredictable complication that may lead to life-threatening conditions.

This randomized controlled trial is conducted in two centers: a tertiary care center and in a community hospital over a period of 18 months. This study aimed to compare two types of anesthesia on the absorption of glycine in operative hysteroscopy. Eligible patients undergoing operative hysteroscopy for abnormal uterine bleeding are randomized in two groups: group general anesthesia and group local anesthesia with sedation.

Eligibility Criteria:
Inclusion Criteria:

* Abnormal uterine bleeding with clinical indication for operative hysteroscopy according to an obstetrician-gynecologist.
* American Society of Anesthesia (ASA) class 1 or 2

Exclusion Criteria:

* Any contraindications to hysteroscopy (suspicion of pelvic or vaginal-cervical infection, severe hemorrhage, pregnancy, suspicion of neoplasia and previous uterine perforation)
* ASA class 3 or more
* Women who had a previous endometrial resection
* Diabetic patients
* Women requiring a predetermined type of anesthesia because of a specific medical condition
Comparison of Diuretic Effect With Furosemide Alone Versus the Combination of Furosemide and Albumin in Cirrhotic Patients

A common complication of the progression of cirrhosis is fluid retention (ascites, edema, or pleural effusion). Loop diuretics are the treatment of choice for fluid retention in cirrhotic patients; however, many of these patients demonstrate diuretic resistance, requiring higher doses of the diuretics to achieve adequate diuresis. The cause of this diuretic resistance is hypothesized to be secondary to hypoalbuminemia which has led some providers to give human albumin in combination with loop diuretics to increase intravascular volume and facilitate diuresis. However, this practice remains controversial because minimal data exists to support its efficacy. The purpose of this study is to compare the efficacy of diuretics alone versus diuretics in combination with albumin in cirrhotic patients presenting with fluid retention.

The purpose of this single center, prospective study is to compare the efficacy of two strategies for diuresis in patients with cirrhosis, the use of furosemide (Lasix®) alone versus the combination of furosemide (Lasix ®) and albumin (25%). The investigators will perform a single-center, prospective study with data collected as result of standard of care at Rush University Medical Center (RUMC). Patients who are 18 years of age and older, have diagnosed cirrhosis, and present to RUMC with fluid retention will be identified by the Hepatology and/or Surgery attending and be screened for inclusion in the study. Each patient will be randomized into one of the two cohorts and will have 50% chance of being placed into either cohort. Cohort 1 will receive furosemide (Lasix) 40 to 80 mg intravenous push (IVP) twice a day (BID) for at least 48 hours and cohort 2 will receive combination of furosemide (Lasix) 40 to 80 mg IVP BID and albumin (25%) 12.5 grams BID for at least 48 hours.

Eligibility Criteria:
Inclusion Criteria:

* Adult patients (age \>18 years old)
* Diagnosis of cirrhosis
* Presents with fluid retention as defined as ascites, edema, or pulmonary effusions requiring diuresis.

Exclusion Criteria:

* Patients who are younger than 18 years of age
* Patients who are currently pregnant
* Patients who present with a serum creatinine greater than 2 mg/dL
Artificial Intelligence for Early Detection of Peripheral Artery Disease

The goal of this clinical trial is to test an AI-based screening tool that will help to identify patients at high risk of having undiagnosed peripheral artery disease. The primary outcome measure is overall rate of new PAD diagnoses. Secondary outcomes include rate of new secondary prevention measures initiated for PAD, which will include new prescriptions for antiplatelets, PAD-dosed rivaroxaban, statins, smoking cessation counseling or referrals, and/or supervised exercise therapy referrals also aggregated at a clinic and site level.

After providers consent to participate in this study, a screening tool will be deployed for their weekly clinics to identify patients at high risk of having undiagnosed PAD. These high risk alerts will be provided after a patient has checked in for their outpatient appointment. The alert will be sent to their treating provider once the visit is initiated in the electronic health record system (EHR). The primary outcome measure is overall rate of new PAD diagnoses. Secondary outcomes include rate of new secondary prevention measures initiated for PAD, which will include new prescriptions for antiplatelets, PAD-dosed rivaroxaban, statins, smoking cessation counseling or referrals, and/or supervised exercise therapy referrals also aggregated at a clinic and site level. For secondary analysis we will specifically evaluate patients who generated an alert and assess how patient demographics and/or clinical factors are associated with likelihood of ABI testing, rate of abnormal ABIs (i.e. true positive rate), and subsequent initiation of secondary prevention measures.

UC San Diego Health (UCSDH), VA San Diego Health Care (VASDHC), and Stanford Health Care (SHC) will be the sites for study enrollment. UCSDH - La Jolla campus, UCSDH - Hillcrest campus, and VASDHC will begin a pre-intervention observation period at the same time, and then each site will be randomized to begin screening tool intervention in a stepped wedge pattern at 13-week intervals for a total of 52 weeks. We will enroll 10 clinics per site based on power calculations for number of patients needed to screen each week and to minimize the number of alerts per clinic/ provider. After this 52 week period, the Stanford site will serve as a validation site and will undergo randomization of 10 clinical sites to three 13 week intervals for a total of 52 weeks.

Eligibility Criteria:
Inclusion Criteria:

* Aged 50-85 years
* Presenting to an outpatient appointment at UCSDH, SDVA, or SHC
* No previous diagnosis of PAD
* No prior PAD alert triggered for a previous visit

Exclusion Criteria:

* \<50 years of age or \> 85 years of age
* Prior diagnosis of PAD
Safety and Tolerability of LX101 for Inherited Retinal Dystrophy Associated With RPE65 Mutations

The purpose of the study is to evaluate the safety, tolerability and efficacy of LX101 in subjects with biallelic RPE65 mutation-associated inherited retinal dystrophy.


Eligibility Criteria:
Inclusion Criteria:

Subject and/or their guardian signing a written informed consent.

Diagnosed with biallelic RPE65 mutation-associated inherited retinal dystrophy.

Subjects are 6 years of age or older.

Visual acuity of ≤ 20/63 or visual field less than 20 degrees in the eye to be injected.

Exclusion Criteria:

Prior gene therapy for IRD and other hereditary eye diseases.

Pre-existing eye conditions that would interfere with interpretation of study endpoints.

Active intraocular or periocular infections in the study eye.

Lacking of sufficient surviving retinal cells.

Prior ocular surgery within six months.

Complicating systemic diseases or clinically significant abnormal baseline laboratory values.

Pre-existing systemic diseases that should not discontinue the use of any retinal toxic compounds.
Role of Low Inferior Mesenteric Artery Ligation During Laparoscopic Surgery for Rectosigmoid Cancer

During sigmoid or rectal cancer surgery, dissection of lymphnodes at the origin of inferior mesenteric artery is mandatory. Nevertheless, ligation of the origin of IMA should compromise blood supply to left colon and affect anastomosis. The aim of this retrospective evaluation is to compare high and low IMA ligation with preservation of LCA, with or without skeletonization of the origin of IMA in laparoscopic colorectal resection.


Eligibility Criteria:
Inclusion Criteria:

* stage I-III carcinoma

Exclusion Criteria:

* stage IV
* Urgent resection
* conversion to open surgery
Treatment of Vesico-vaginal Fistula by a Robot Assisted Laparoscopy : Results of a Multicentric Series (FFVLARO)

Robot-assisted Vesico-Vaginal fistula (VVF) repair was described a few years ago as an alternative to the open approach to minimize the morbidity of this surgery. Very little series have reported the results of robotic VVF repair. The objective of this work was to evaluate the results of robotic VVF repair.


Eligibility Criteria:
Inclusion Criteria:

* presence of a vesico-vaginal fistula

Exclusion Criteria:

-
Depression Prevention Program for Adolescents

This study will compare the effectiveness of two programs designed to prevent depression in adolescents.

Major depression is one of the most common psychiatric disorders in adolescents. In many cases, the condition is recurrent and can result in serious psychological impairment. A high number of depressed adolescents never receive treatment; therefore, it is crucial to develop prevention programs for this disorder that are effective and can be easily disseminated. This study will evaluate and compare the effectiveness of cognitive behavior therapy (CBT) and supportive/expressive (S/E) therapy in preventing depressive symptoms in adolescents.

This study will last 2 years. Participants will be randomly assigned to receive six sessions of CBT, S/E therapy, or standard depression education over 2 years. The CBT intervention will focus on reducing negative thoughts and increasing engagement in pleasant activities. S/E therapy is designed to allow adolescents to express their negative emotions and talk about recent stressful events in a supportive environment of their peers. Surveys and psychiatric interviews will be completed by all participants and their parents at the beginning and the end of the study. The surveys and interviews will assess depressive symptoms.

Eligibility Criteria:
Inclusion Criteria:

* Beck Depression Inventory score higher than 10
* Parent or guardian willing to provide informed consent

Exclusion Criteria:

* Diagnosis of depression
The Effects of Combined Neuro-vestibular-ocular Exercises and Myofascial Release on Proprioception and Performance in Soccer Players With Chronic Ankle Instability

Chronic ankle instability was first defined by Freeman as recurrent ankle sprains following an ankle sprain and the feeling of dislocation in the ankle lasting longer than six months. The recurrence of ankle sprains in athletes leads to the realization of ankle instability. Functional ankle instability gives the feeling that a re-sprain will occur at any time due to decreased static and dynamic support in the joint.Neuro-vestibular-ocular exercises is an approach that combines neuromuscular training and vestibular-ocular training techniques.At the same time, we are doing this study because of the mixed studies on the effect of fascial relaxation on the performance and proprioception of a specific group of football players.

A total of 60 football players with instability \<27 according to the CAIT scale, whose proprioception and performance (jump, sprint, zig-zag test, kick speed) values were taken at the beginning, will be divided into two groups.Myofascial release will be applied to the lower extremity posterior line chain described by Myers by the physiotherapist to the first group.The other group (30 people) will be given neuro-vestibular-ocular exercises.Both groups will continue their training programme as ready.The training will be done in 2 sessions and 30 minutes per week.

Eligibility Criteria:
Inclusion Criteria:

* a history of 'giving way' and/or recurrent sprains and/or 'feeling of instability' in the injured ankle joint within the last 6 months.
* decreased function due to ankle sprain history
* "feeling of instability" will be defined as ≤27 points on the Cumberland ankle instability scale (CAIT) and the most affected side will be determined as the relevant limb for testing. CAIT score between right and left foot The dominant ankle will be selected.
* Having had at least two previous lateral sprains in the same ankle.

Exclusion Criteria:

* history of musculoskeletal surgery and/or fractures in the lower extremities;
* acute injury to the musculoskeletal structures of other lower extremity joints in the last three months that affects joint integrity and function and causes interruption of desired physical activity for at least one day;
* having a history of balance and vestibular disorders.
The Effects of Programmed Death-ligand 1 on Postoperative Pain for Lung Cancer Patients

The concentration of plasma programmed death-ligand 1(PD-L1) for lung cancer patients before video-assisted thoracoscopic surgery is detected. According to the distribution of plasma concentration, patients are divided into high or low expression of PD-L1. Differences in acute and chronic postoperative pain are compared between two groups of patients. And effects of PD-L1 expresion on postoperative pain in lung cancer patients are explained.

Chronic pain after video-assisted thoracoscopic surgery (VATS) has been a major concern for lung cancer patients. The relationship between plasma programmed cell death ligand-1 (PD-L1) concentration and chronic pain in post-VATS is uncertain. This study aims to explore the effects of PD-L1 levels on chronic pain and provide proactive pain management regimen according to individual genetic differences.

The concentration of plasma PD-L1 for lung cancer patients before video-assisted thoracoscopic surgery is detected. According to the distribution of plasma concentration, patients are divided into high or low expression of PD-L1. Differences in acute and chronic postoperative pain are compared between two groups of patients. And effects of PD-L1 expresion on postoperative pain in lung cancer patients are explained.

Eligibility Criteria:
Inclusion Criteria:

1. American Society of Anesthesiologists physical status I-IV (males and females).
2. 18-80 years of age.
3. Patients undergoing video-assisted thoracoscopic surgery for malignant lung disease.

Exclusion Criteria:

1. History of opioid abuse.
2. Known psychiatric disorders.
3. Unexpected conversion to thoracotomy or transferred to intensive care unit for further treatment.
4. Combined with other surgeries or sites.
Study of Vilazodone to Treat Social Anxiety Disorder

The purpose of this study is to determine whether Vilazodone is effective in the treatment of symptoms of Social Anxiety Disorder among adults.

The proposed study is a 12 week double-blind, placebo-controlled trial in which daily doses of vilazodone 20 to 40 mg/day or matching placebo will be administered on a 1:1 ratio. The study will include 30 outpatients age 18-75 with SAD, generalized subtype who return for at least one post randomization visit where efficacy evaluations are conducted.

Eligibility Criteria:
Inclusion Criteria:

* Diagnosis of Social Anxiety Disorder, generalized subtype
* LSAS total score of 70 at visits 1 and 2

Exclusion Criteria:

* Lifetime history of Bipolar disorder or Schizophrenia
* Current suicidal risk
* Current unstable medical condition
Internet Obesity Treatment Enhanced With Motivational Interviewing

Internet-based weight control programs have been shown effective in producing weight loss, but in-person delivery of behavioral weight control produces significantly greater weight loss than on-line delivery of the same program. Motivational Interviewing has been shown to increase weight loss when delivered as an adjunct to in-person weight loss programs but has not been examined in conjunction with web-based obesity treatment. Therefore, the overall goal of this project is to determine if the addition of on-line Motivational Interviewing to a web-based group behavioral obesity treatment program will augment weight loss outcomes.

This randomized controlled trial is designed to determine whether weight losses in a group behavioral weight loss intervention conducted over the Internet are increased with the inclusion of individual, online MI sessions. All participants will receive the same online 6-month group-based behavioral weight loss program followed by 12 months of weight maintenance. Overweight and obese adults at two study sties (N=426) will be randomized to (1) Internet intervention; or 2) Internet intervention with individual MI sessions occurring at three month intervals on a fixed schedule (Internet+MI-Fixed). Assessments will be conducted every six months and will include measures of body weight and height, diet and exercise behaviors, Quality of Life, adherence measures (eg., attendance, compliance with self-monitoring), social influence components, motivation, treatment satisfaction, demographic data and descriptive information regarding use of website components. A third arm was added for the final 3 intervention cohorts. All participants received the program as described above with the addition of motivational interviewing contingent on participants' attendance in classes.

Eligibility Criteria:
Inclusion Criteria:

* must be over 18
* must have a BMI between 18 and 50
* must live within 60 minutes driving distance of University of Arkansas, Little Rock, AR, or University of Vermont, Burlington, Vermont
* must be able to walk for exercise

Exclusion Criteria:
Weight Maintenance Through Physical Activity and Social Support in Rural Middle-Aged Women

The purpose of this study is to compare an technology-based weight maintenance intervention using action plans, videos discussion boards and health behavior tracking (weight, calories in and out, pedometer steps) with a technology-based standard advice group to facilitate health management, resourcefulness and health status for rural middle-aged women.

The purpose of this research project is to evaluate the influence of a theory-based intervention using the Health Effects of Life Transitions for Women Model to promote maintenance of initial weight loss. The intervention will be designed to promote physical activity to prevent weight regain among an underserved and vulnerable population of rural, mid-life women. The intervention delivered through action plans, videos, discussion boards and health behavior tracking (weight, calories in and out, pedometer steps) to facilitate health management, resourcefulness and health status will be compared with the standard advice group who receives newsletters and health behavior tracking (weight) to initiate, increase, or sustain physical activity for weight maintenance.

Eligibility Criteria:
Inclusion Criteria:

Women:

* aged 40-64 years;
* reported intentional weight loss of 5-10% of initial body weight within previous 6 months;
* residing in a rural county (population \< 50,000 residents) or rural community (population less than 2,500) within driving distance of a UNMC College of Nursing campus;
* ability to communicate in English (verbal and written);
* ambulatory and can walk at least one block without the use of an assistive device, such as a cane, walker, or wheelchair;
* have access to the internet and current email account; and
* answer 'no' to all questions on the Physical Activity Readiness Questionnaire (PAR-Q) or obtain clearance from their physician to become more active.

Exclusion Criteria:

* instructed by a physician not to exercise;
* presence of chest pain, shortness of breath, or feelings of light-headedness upon exertion.