cyrilzakka/clinical-trials huggingface dataset:
The Role of Preoperative Ureteral Diameter Measurements in Predicting Difficult Access During Retrograde Intrarenal Surgery: A Retrospective Analysis of 234 Patients

This study investigates the role of preoperative ureteral diameter measurements in predicting difficult access during retrograde intrarenal surgery (RIRS) in patients with kidney stones. A retrospective analysis was conducted on 234 patients who underwent RIRS, evaluating factors such as preoperative ureteral diameters (measured at distal, iliac, and upper ureteral levels via CT scans), stone size, patient demographics, operation duration, and surgical success rates. The findings aim to determine whether ureteral diameter measurements can serve as reliable predictors for surgical challenges, ultimately improving preoperative planning and patient outcomes.

This retrospective study evaluates the role of preoperative ureteral diameter measurements in predicting difficult access during retrograde intrarenal surgery (RIRS) in patients with kidney stones. A total of 234 patients who underwent RIRS were included in the analysis. Preoperative computed tomography (CT) scans were used to measure ureteral diameters at three levels: distal ureter, iliac ureter, and upper ureter. The relationship between ureteral diameter and intraoperative access difficulty was assessed.

The study also analyzed patient demographics (age, gender, BMI), stone characteristics (size, location), operative parameters (duration, access attempts), and outcomes (surgical success and complication rates). Difficult access during RIRS was defined based on the number of attempts required to achieve successful ureteral access, need for secondary procedures, or inability to complete the planned surgery.

The primary aim was to determine whether preoperative ureteral diameter measurements can serve as predictive markers for challenging surgical access. Secondary objectives included identifying other patient or stone-related factors contributing to access difficulty and evaluating their impact on surgical outcomes. The findings may assist clinicians in preoperative planning, improving patient selection for RIRS, and optimizing intraoperative strategies to minimize complications and enhance procedural success rates.

Eligibility Criteria:
Inclusion Criteria:

Patients aged 18 years or older. Diagnosed with kidney stones (nephrolithiasis) requiring surgical intervention. Underwent retrograde intrarenal surgery (RIRS). Available preoperative CT scans for ureteral diameter measurements. Complete medical records, including demographic, clinical, and surgical data.

Exclusion Criteria:

History of open or laparoscopic renal surgery. Presence of ureteral strictures or congenital anomalies. Patients with incomplete or missing medical records. Active urinary tract infection at the time of surgery. Pregnant or lactating individuals.
Physiological Effects of Lactate in Individuals With Chronic Heart Failure

Background:

Lactate is continuously produced in the human body through two primary processes: glycolysis and microbial fermentation in the gastrointestinal tract. At rest, its concentration in the bloodstream typically ranges from 1 to 2 mmol/L. However, during periods of physical exertion or insufficient oxygen supply, such as during intense exercise, lactate levels significantly increase. Traditionally, lactate was perceived as a byproduct of anaerobic metabolism. Nevertheless, emerging research has illuminated its vital role as both a signaling molecule and a crucial energy source for vital organs like skeletal muscle, brain, and the heart.

Objectives:

The primary aim of this study is to investigate the impact of physiological levels of circulating lactate on the hemodynamics of individuals with chronic heart failure. This research seeks to understand how lactate affects the cardiovascular response in this specific patient population.

Design and Endpoints:

The study design employs a double-blind, randomized crossover approach involving 12 heart failure patients. Each participant will undergo two separate visits.

Visit 1: Participants will receive a three-hour intravenous infusion of either a racemic (D/L) mixture of sodium lactate or an intravenous isotonic sodium chloride placebo, with a subsequent crossover to the opposite infusion on the same day.

Visit 2: Similar to the first visit, participants will receive either an orally administered racemic (D/L) mixture of sodium lactate or an isocaloric, isovolumic oral placebo (maltodextrin), with a crossover to the opposite administration after three hours.

The study's endpoints include cardiac output (primary), mixed venous saturation (SVO2), pulmonary wedge pressure, resting echocardiography (left ventricular ejection fraction and myocardial work efficiency), and measurements of vasoactive substances in blood samples.

Methods:

The study employs invasive Swan-Ganz monitoring to measure cardiac output, echocardiography, and frequent venous blood sample collections. These measurements and samples will be taken at specific intervals during the study visits.

Intervention:

To investigate the isolated hemodynamic and physiological effects of lactate, the study utilizes lactate infusion and ingestion to induce a state of hyperlactatemia within the physiological range. The intended dosages aim to stay within the physiological range, with no values expected to exceed 3-4 mmol/L.


Eligibility Criteria:
Inclusion Criteria:

* Chronic heart failure
* NYHA II-III
* Left ventricular ejection fraction \<40%
* Negative urine-HCG for women with childbearing potential

Exclusion Criteria:

* Diabetes or HbA1c \>48 mmol/mol
* Significant cardiac valve disease
* Severe stable angina pectoris
* Severe comorbidity as judged by the investigator
* Inability to give informed consent
* Age \<18 years
* Other disease or treatment making subject unsuitable for study participation as judged by the investigator.
Influence of Losartan and Diphenhydramine on Emotional and Cognitive Functions in Healthy Human Subjects

This project aims at identifying novel pharmacological targets for the treatment of memory disorders.

To investigate the effects of the histamine H1 receptor antagonist diphenhydramine and the angiotensin II receptor antagonist losartan on emotional and cognitive functions in healthy human subjects.

Eligibility Criteria:
Inclusion Criteria:

* healthy
* native or fluent German-speaking
* BMI between 19 and 27 kg/m2
* able and willing to give written informed consent and comply with the requirements of the study protocol
* willing to donate saliva sample for DNA-analysis
* female: willing to perform a pregnancy test at the beginning of both test visits

Exclusion Criteria:

* acute or chronic psychiatric or somatic disorder
* pathological ECG
* known hypersensitivity to the IMP under investigation (losartan, diphenhydramine)
* hypotension (RR \< 110/70 mmHg)
* bradycardia (\< 50 bpm)
* pregnancy, breast-feeding
* long-term medication within last 3 months (oral contraceptives are disregarded)
* smoking (\> 3 cigarettes per day)
* concurrent participation in another study
* participation in one of our previous studies using the same memory tests
* inability to read and understand the participant's information
The Effect of Auditory Stimuli on Heart Rate Variability (HRV) Among Patients With Acquired Brain Injury (ABI)

Heart Rate Variability (HRV) reflects the responsiveness of the autonomic system to an external stimuli. The aim of this system is to maintain homeostasis.The variability implies on the interaction between the sympathetic and the parasympathetic systems to maintain the ongoing changes of the autonomic system. Following Acquired Brain Injury (ABI), there can be a damage to the Central Nervous System (CNS) function. The damages described in the literature are cognitive, motor and behavioural function, while there is less relation to the autonomic system. The autonomic system can influence the ability of patient with ABI to participate in the rehabilitation program. The aim of this work is to investigate the activity of the autonomic system activity as manifested by HRV among patients with ABI in different conditions: resting, during activity and while listening to different auditory stimuli.


Eligibility Criteria:
Inclusion Criteria:

* 2-4 months from acceptance to rehabilitation medical stable

Exclusion Criteria:

* medical unstable a significant hearing deficit premorbid neurological or mental condition
Substantially Improving the Cure Rate of High-risk BRCA1-like Breast Cancer

Investigator-initiated, international, multicentre, randomized, open-label, (neo)adjuvant phase III study in target population (stage III, HER2-negative, BRCA1-like breast cancer patients) comparing optimized standard-dose chemotherapy with intensified, alkylating chemotherapy with stem cell rescue.


Eligibility Criteria:
Inclusion Criteria:

* Women and men with stage III adenocarcinoma of the breast harboring signs of a breast cancer with features of homologous recombination deficiency (HRD)
* Age of 18-65 years
* The tumor must be HER2-negative
* Treatment must start within 8 weeks after the last surgical resection
* Eastern Cooperative Oncology Group (ECOG) performance status 0-1

Exclusion Criteria:

* Previous radiation therapy
* Previous chemotherapy
* Any previous treatment with a PARP-inhibitor, including olaparib
* Pre-existing neuropathy from any cause in excess of Grade 1
* Chronic concomitant use of known strong or moderate CYP3A inducers
Measuring Cyclotorsion on Scanning Laser Ophthalmoscopy (SLO)-Fundus Photographs

Pre-Study: Evaluation of the inter- and intrarater reliability of the integrated algorithm by Heidelberg Spectralis for measuring cyclotorsion on SLO-fundus fotographs, and assessment of the influence of measuring with or without eye tracker.

Study: Comparison of cyclotorsion measurements in patients with forth nerve palsy and in healthy controls on SLO-fundus fotographs using the integrated algorithm by Heidelberg Spectralis


Eligibility Criteria:
Inclusion Criteria:

* ≥ 18 years old
* best corrected visual acuity ≥ 0.8

Exclusion Criteria:

* strabismus except for forth nerve palsy
* previous strabismus surgery
* monocle
* best corrected visual acuity ≤ 0.6
* hyperopia or myopia \> 6dpt
COX-2 Inhibitor Versus Glucocorticoid Versus Both Combined

Recent studies on molar surgery have shown that a combination of a glucocorticoid and NSAID or COX-2 selective inhibitor gives better pain relief than either of the drugs used separately. The investigators group has also shown that adding dexamethasone on top of a regimen of paracetamol, NSAID and local anesthesia resulted in 45% painfree patients at rest after ambulatory breast cancer surgery.

The goal of this study is to test the NSAID + glucocorticoid concept in ACl repair. The investigators want to evaluate whether a selective COX-2 selective inhibitor or a glucocorticoid or a combination of both drugs, as part of a multimodal analgesic regime, can provide improved pain relief and shorter hospital stay in patients undergoing outpatient ACL surgery.


Eligibility Criteria:
Inclusion Criteria:

* Arthroscopic reconstruction of the anterior crucial ligament (ACL)
* At least 18 years old
* ASA I + II

Exclusion Criteria:

* Known renal impairment
* Liver failure and/-or an asthmatic condition
* Pregnancy
* Breast feeding
Shoulder Pain and Its Effects on Joint Position, Strength, Tactical Sensory and Posture in Hemiplegia

The main purpose of this study is to reveal the effects of shoulder pain in chronic hemiplegic patients with a more comprehensive and holistic perspective through evaluation and correlation methods. It is thought that these evaluations can make significant contributions to the understanding of the etiology and treatment of post-stroke shoulder pain. The focus of the study is to deeply examine the effects of shoulder pain on joint position sense, postural control, tactile sense and muscle strength in chronic hemiplegic patients.

This study aims to investigate the effects of shoulder pain on joint position sense, postural control, tactile sensation, and muscle strength in chronic hemiplegic stroke patients. Designed as a cross-sectional descriptive study, it involved participants divided into two groups based on the presence or absence of shoulder pain. The assessments included joint position sense , postural control , tactile sensation , gross grip strength, and pinch grip strength . The findings of this study are expected to contribute to clinical practice by aiding in the development of more effective interventions for managing post-stroke shoulder pain. Additionally, it aims to serve as a foundation for future comprehensive research, emphasizing the critical role of addressing pain in the rehabilitation process.

Eligibility Criteria:
Inclusion Criteria:

* At least 3 months post-stroke, diagnosis of hemiplegia after stroke, aged 18 or older, having cognitive abilities and cooperation required to fulfill the study requirements, and willingness to participate in the study.

Exclusion Criteria:

* Mini Mental State Examination (MMSE) score \< 24, patients with aphasia, major neurological or rheumatological diseases affecting the musculoskeletal system other than stroke, and patients who had surgery on the affected shoulder prior to the stroke diagnosis.
Prospective Study on Quality of Life in Patients With Intracranial Germ Cell Tumors

The primary purpose of this study is to characterize the quality of life in patients with intracranial germ cell tumors. Those findings can contribute towards a better understanding of the impact of the current treatment strategy on survivors.

The characteristics of the quality of life in patients with intracranial germ cell tumors are far from understood. The main reason is the rare occurrence of the disease. As a result, most findings came from retrospective studies in which only dozens of patients participated. Generally, patients with intracranial germ cell tumors have a good prognosis, especially those with germinoma.

Over 90% of patients with germinoma will survival after ten years of follow-up. Thus, the quality of life in long-term survivors is of concern. The investigators designed this prospective study to address this issue to understand better the characteristics of the quality of life in patients with intracranial germ cell tumors and provide information for optimizing the current treatment strategy.

Eligibility Criteria:
Inclusion Criteria:

* 3 years ≤ age ≤ 21 years
* Newly diagnosed primary intracranial germ cell tumors
* Written informed consent

Exclusion Criteria:

* Relapsed disease
* Poor compliance
Randomized Controlled Trial of Shang Ring Male Children Circumcision: Comparison Between Flip and No Flip Technique

This is a prospect, randomized control trial to evaluate merits between flip and no flip technique in Shang Ring children circumcision.

The boys between 7 and 12 years old seeking for circumcision in The Affiliated Hospital of Medicine School of Ningbo University will be evaluated. Those who match the inclusion criteria and without exclusion criteria will be recruited.

The investigators will perform randomization preoperatively. participants were distributed into No Flip Group and Flip Group correspondingly according to a table of random number.

All of the procedures will be performed by a specific study surgeon in the hospital operation room. An assistant will take the pictures and recorder the parameters needed. In both groups, participants will be measured twice by a scale plate of holes, the diameter of penis with the foreskin noneverted and the diameter of exposed glans. Local anesthesia will be administered to the dorsal penile nerve using 2% lidocaine. The operation will not begin until the anesthesia is satisfied. The proper ring will be chosen according to different strategies of two groups. Participants will stay in hospital for 24 hours after operation. Pain during operation, half a hour post-operation and 24 hours will be evaluated, adverse events at hospital will be recorded carefully as well.

Participants will be advised to return usually at 7th, 14th, 21st, 28th and 90th post-operative days. However, if the wound does not heal completely 28 days post-operatively, the participant will be asked come to visit weekly until complete healing. All of the assessments will be performed and recorded by the lead investigator.

Eligibility Criteria:
Inclusion Criteria:

* Aged between 7 years and 12 years(inclusive);
* Must be accompanied by the parent or legally acceptable representative (LAR), who freely agrees with participation of the child into the study;
* Must tolerate local anesthesia;
* Must be in good general health;
* Parent or LAR and if possible the client must be able to understand study procedures and requirements of study participation;
* Parent or LAR must agree to return the client to the study site for the full schedule of follow-up visits after his circumcision;
* Parent or LAR must agree the study staff to take photos during operation or follow-up if necessary, and
* Parent or LAR must agree to provide the study staff with an address, phone number, or other locator information

Exclusion Criteria:

* Has a known allergy or sensitivity to lidocaine or other local anesthesia;
* Takes a medication that would be a contraindication for elective surgery (e.g anticoagulant , steroid);
* Has known bleeding/clotting disorder (e.g. hemophilia);
* Has an active genital infection, anatomic abnormality or other condition(e.g. concealed penis, hypospadias, epispadia, micropenis);
* Is currently participating in another biomedical research study; or
* Participants under other condition (e.g. severe obesity, diabetes or sickle cell anemia) should be excluded from this study in the opinion of the surgeon.
It's Not JUST Idiopathic Pulmonary Fibrosis Study

Study of progression of fibrosis in ILD

The overall aims of this study are

* Identify biomarkers and gene expression profiles that determine progressive fibrotic lung disease regardless of aetiology
* To prospectively assess biomarkers which predict progressive fibrosis in patients with fibrosing lung disease of alternate aetiology, including RA-UIP, Asbestosis, Chronic Hypersensitivity Pneumonitis and Unclassifiable fibrotic lung disease
* Investigate genetic associations and epigenetic modifications which affect fibrotic disease severity and progression
* Prospectively evaluate longitudinal disease behaviour in patients with non IPF-fibrotic lung diseases with a view to developing composite clinical end-points for subsequent use in intervention studies in patients

Eligibility Criteria:
Inclusion Criteria

* Male or female aged ≥ 18 years old
* Able and willing to give written informed consent
* Recently diagnosed \[defined as diagnostic CT scan or surgical lung biopsy (if applicable) \>1st May 2017\]
* An MDT diagnosis of fibrotic interstitial lung disease (reticulation, traction +/- honeycombing)

Sub Groups

* Rheumatoid arthritis (rheumatologist diagnosed with anti-CCP antibodies and/or Rheumatoid Factor positive)
* Asbestosis (appropriate occupational history and radiological evidence of asbestos exposure)
* Chronic HP in accordance with consensus criteria (appropriate exposure history, radiological features +/- avian and fungal precipitins)
* Unclassifiable fibrotic lung disease (fibrotic lung disease otherwise unclassifiable despite extensive clinical and radiological examination)
* IPF in accordance with consensus criteria (ATS/ERS/JRS/ALAT guidelines) as controls

Exclusion Criteria:

* Participating in an interventional clinic trial
* Asymptomatic Interstitial Lung Abnormalities (ILA) and normal lung function.
* Change in clinical phenotype from initial radiological diagnosis to screening
* Acute Hypersensitivity Pneumonitis.
* Participants who do not possess a smartphone or have a valid email address (necessary for the home FVC readings)
Internet-delivered Transdiagnostic Intervention for Anxiety and Depression

Objectives

1. To test the effectiveness and acceptability of an augmented internet-supported transdiagnostic intervention in Romania.
2. To assess the cost-effectiveness of the Internet version of the transdiagnostic program as compared to a standard treatment/usual care.

The effectiveness of a transdiagnostic intervention will be compared with a wait list control group using a randomized control trial (RCT) design in a culture where this has not been tested before. The treatment approach is mainly emotion-focus, teaching participants how to confront and experience uncomfortable emotions, and how more adaptive coping mechanisms could be used. Because internet-delivered interventions represent an effective way to disseminate evidence-based programs, investigators decided to present our intervention online.

Eligibility Criteria:
Inclusion Criteria:

* be fluent in Romanian
* be over 18 years
* have the principal diagnostic of generalized anxiety disorder and/or obsessive-compulsive disorder and/or panic disorder and/or social anxiety disorder and/or major depression disorder and/or dysthymia (or any combination of these diagnostics) on Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders (SCID-I)
* have access to an Internet connected computer

Exclusion Criteria:

* suicidal ideation
* ongoing psychological treatment for generalized anxiety disorder and/or obsessive-compulsive disorder and/or panic disorder and/or social anxiety disorder and/or major depression disorder and/or dysthymia
* other primary disorder that need treatment
* obstacle to participation (i.e., long travel plans)
* recent change in psychiatric medication (i.e., during the last 6 weeks)
Multi-center Clinical Application of Hangzhou Criteria in Liver Transplantation for Hepatocellular Carcinoma

Liver transplantation is an optimal radical therapy for selected patients with hepatocellular carcinoma. Hangzhou criteria could safely and effectively expand Milan criteria with expanded population and comparable survival. The purpose of this study was to evaluate the Hangzhou criteria in a multi-center cohort.

Liver cancer is the sixth most commonly diagnosed cancer and the fourth leading cause of cancer-related deaths worldwide. Among all the liver cancer cases, hepatocellular carcinoma (HCC) constitutes 75-85%. Liver transplantation is the most effective treatment for HCC and is in high demand in China. The advent of Milan criteria has helped to select the recipients reasonably. However, the organ allocation system driven by the Milan criteria seemed to be too strict so that many centers worldwide have expanded the criteria in the aspects of morphological features, histopathology and biomarkers. Hangzhou criteria introduce the covariables of histopathologic grading and α-fetoprotein (AFP) into the selection of recipients for the first time. Based on the multi-center HCC patient cohort undergoing transplantation, this study aims to characterize an ideal candidate selecting system beyond the Milan criteria.

Eligibility Criteria:
Inclusion Criteria:

* Aged ≥18 years and \<=75 with HCC confirmed by histopathology;
* Undergoing a primary whole or split liver transplant from a deceased donor;

Exclusion Criteria:

* Incomplete follow-up;
* Missing essential data for analysis (tumor size, number, differentiation grade, α-fetoprotein (AFP)) ;
* Vascular invasion according to radiological criteria;
* Perioperative mortality (\<30 days) ;