cyrilzakka/clinical-trials huggingface dataset:
Xray Volume Imaging (Cone Beam CT) - Prostate Cancer

Conformal dose escalated radiotherapy was adopted as the standard treatment technique at PMH for intermediate risk patients with localised disease in 1997. This technique provides a much smaller margin of error for treatment set-up and delivery than with conventional techniques. One way to ensure the accuracy of treatment delivery is to image the prostate position daily, prior to therapy, to allow for appropriate set-up corrections. To do so, imaging markers are implanted into the prostate under guided ultrasound (a standard procedure at PMH). However, there are disadvantages in using imaging markers which include added time to the treatment planning process, and an invasive procedure with a potential for discomfort, bleeding and infection. This study will investigate and compare X-ray volume imaging to the gold standard imaging markers.


Eligibility Criteria:
Inclusion Criteria:

* Diagnosis of adenocarcinoma of the prostate
* Patient undergoing escalated dose conformal external beam radiotherapy.
* Patient has low or intermediate risk prognostic factors: all of PSA \<21, Gleason score \<8, clinical T category \<T3, clinical N category 0 or X, M category 0 or X.
* Informed consent

Exclusion Criteria:

* No diagnosis of adenocarcinoma of the prostate
* Patient not undergoing escalated dose conformal radiotherapy
* Patient does not have low or intermediate risk prognostic factors
Observational Study of the Safety and Efficacy of Norditropin® in Adult Patients With Growth Hormone Deficiency

This study is conducted in Japan. The aim of this observational study is to collect information about the safety and efficacy of Norditropin® long-term treatment of growth hormone deficiency in adults.


Eligibility Criteria:
Inclusion Criteria:

* Severe adult growth hormone deficiency

Exclusion Criteria:

* Known or suspected allergy to study product(s) or related products
* Previous participation in the study
* Diabetes Mellitus
* Presence of malignant tumor(s)
* Pregnant or likely to get pregnant
Biofeedback Therapy Versus Botox Injection in Treatment of Dyssynergic Defecation.

assessment the Improvement symptoms of obstructed defecation after biofeedback training versus botulinum toxin injection

This is a randomized controlled trial including 78 patients diagnosed with obstructed defecation syndrome confirmed by detailed history talking, full clinical examination, anorectal manometry and defecography.

Included patients divided into two equal groups: first group ( biofeedback therapy group) patients recieved biofeedback therapy for six sessions over one month, the second group:( botulinum toxin group) received botulinum toxin injection 100 IU in buborectalis muscle.

The primary outcome is improvement of symptoms after one year

Eligibility Criteria:
Inclusion Criteria:

* patients of both genders
* age of 18 years or older
* fulfillment of the Rome 3 constipation criteria for the past 3 months, symptom onset as a maximum six months prior to diagnosis, patients suffer from prolonged, incomplete and challenging evacuation

Exclusion Criteria:

* Anismus cases with secondary reason for constipation
* patients who undergone anorectal surgery Patients with colonic inertia
* conditions that make biofeedback training impossible
* cases with primary illness causing constipation as hypothyroidism
The Effect of Alpha-tocopherol in Hemolysis and Oxidative Stress Marker on the Red Cell Membrane Beta-thalassemia Major

The accumulation of unpaired α-globin chains in β-thalassemia major patients may clinically create ineffective erythropoiesis, hemolysis, and chronic anemia. Multiple blood transfusions and iron overload cause cellular oxidative damage. However, α-tocopherol, an antioxidant, has been known as a potent scavenger of lipid radicals in the red cell membrane of β-thalassemia major patient. By this randomized controlled trial, the investigators would like to evaluate the effects of α-tocopherol in hemolysis and oxidative stress on the red cell membrane of β-thalassemia major.

Background: The accumulation of unpaired α-globin chains in β-thalassemia major patients may clinically create ineffective erythropoiesis, hemolysis, and chronic anemia. Multiple blood transfusions and iron overload cause cellular oxidative damage. However, α-tocopherol, an antioxidant, has been known as a potent scavenger of lipid radicals in the red cell membrane of β-thalassemia major patients.

Purpose: To evaluate the effects of α-tocopherol in hemolysis and oxidative stress on the red cell membrane of β-thalassemia major.

Methods: In this randomized controlled trial, the investigators allocated subjects in the placebo and α-tocopherol groups. Doses of α-tocopherol were based on the recommendation of Institute of Medicine: 4-8 years old 200 mg/day; 9-13 years old 400 mg/day; 14-18 years old 600 mg/day. Hemolysis, oxidative stress, and antioxidant variables were evaluated before and after 4 weeks of consuming either α-tocopherol or placebo, performed prior to blood transfusions.

Eligibility Criteria:
Inclusion Criteria:

* received frequent transfusions,
* iron chelation
* aged 5 - 18-year-olds
* with no other hematologic disorders
* does not consume any other antioxidants or herbal supplements

Exclusion Criteria:

* the acute or chronic infection including hepatitis B or hepatitis C,
* splenectomy
* liver failure
* abnormality level of lipid test
Lung Cancer Diagnosis and Staging Using Ultrasound Guidance

To collect data of all patients who have undergone Endobronchial ultrasound for diagnosis or staging of suspected lung cancer

Introduction: Endobronchial Ultrasound (EBUS) is a procedure that is performed via flexible bronchoscopy under moderate sedation for visualization of lymph nodes in the chest and biopsy under real-time guidance for the staging of lung cancer or evaluation of enlarged lymph nodes. In addition, lung lesions or masses can be visualized and biopsied in the same sitting. The use of EBUS has enhanced the safety and diagnostic yield of flexible bronchoscopy.

Aim: The data of patients with suspected lung cancer or undiagnosed lymph node enlargement in whom bronchoscopy with EBUS guidance is clinically indicated will be collected prospectively.

Results from EBUS are considered positive if a specific diagnosis is obtained ( eg malignancy) or if lymphocytes are present in the lymph node biopsy, indicating accurate sampling of lymph node. In patients with non-diagnostic EBUS, the results from other procedures will be compared for analysis.

Eligibility Criteria:
Inclusion Criteria:

* Patients who have undergone endobronchial ultrasound

Exclusion Criteria: None
Effects of Dry Needling on Spasticity and Functional Ability

This study investigates the effects of dry needling on spasticity and its impact on functional ability in individuals with neuromuscular disorders. Using the Modified Ashworth Scale (MAS), Timed Up and Go (TUG) test, and Gross Motor Function Measure (GMFM), the research evaluates changes in muscle tone, mobility, and overall motor performance following dry needling intervention. The findings aim to provide evidence on the clinical benefits of dry needling as a therapeutic approach for improving movement efficiency and functional outcomes in patients with spasticity.

Spasticity is a common impairment in individuals with neuromuscular disorders, often leading to limitations in movement, balance, and overall functional performance. Dry needling has emerged as a promising intervention for managing spasticity by targeting hyperactive muscle fibers and reducing abnormal muscle tone. This study aims to explore the therapeutic effects of dry needling on muscle spasticity and functional ability using standardized clinical measures.

Participants will undergo pre- and post-intervention assessments using the Modified Ashworth Scale (MAS) to quantify changes in muscle tone, the Timed Up and Go (TUG) test to evaluate mobility and balance, and the Gross Motor Function Measure (GMFM) to assess functional motor skills. The intervention will focus on specific muscle groups affected by spasticity.

By analyzing the relationship between changes in spasticity and functional mobility, this study seeks to determine whether dry needling contributes to measurable improvements in movement efficiency, postural control, and daily functional activities. The findings will provide valuable insights into the role of dry needling as an adjunct therapy in rehabilitation programs, supporting its integration into clinical practice for individuals with neuromuscular disorders.

Eligibility Criteria:
Inclusion Criteria:

* Hypertonia score 2 according to MAS
* Able to understand and follow instructions
* Able to stand and walk independantly

Exclusion Criteria:

* Participants with neurological conditions that involve significant cognitive deficits or severe uncontrolled epilepsy
* Participants who have undergone surgical procedures within the last 3 months
Digital Cervical and Cesarean Section

Cesarean delivery is one of the most commonly performed surgical operations worldwide Cesarean delivery even as an elective procedure has been associated with considerable maternal risks compared with vaginal delivery. Some of the complications include postpartum hemorrhage, uterine infection, urinary tract infection, wound infection, septicemia and maternal death. Over the years, many variations in the surgical technique of Cesarean delivery have been employed with the main purpose of improving its safety. A woman's cervix is firm and undilated at the beginning of pregnancy, but progressive remodeling occurs during gestation until the cervix is soft at term, especially the nulliparous cervix . The progressive dilatation of the cervix needs uterine contraction during labor. A mechanical dilatation of the cervix at cesarean section is defined as an artificial dilatation of the cervix performed by finger, sponge forceps or other instruments at non-labor cesarean section. According to a cochrane view The information currently available about the advantages of cervical dilatation at cesarean section is inconclusive. This may be due to small sample sizes and low power of statistic.


Eligibility Criteria:
Inclusion Criteria:

1. All women scheduled for elective cesarean section will be approached.
2. Women accepted to participate in the study participation after discussing the nature of the study.

Exclusion Criteria:

1. Immuno-compromised women.
2. Women suffering from any coagulation disorder or Blood disease.
3. Blood transfusion during surgery or before it.
4. History of wound infection or endometritis .
5. Ante partum hemorrhage.
6. History of long corticosteroid use.
7. Women refuse to participate in the study.
8. Suspected clinical evidence of infection.
9. anemic women
10. Multiple pregnancy
11. Preterm births
12. Rupture of membranes or chorioamnionitis
13. Women who use antibiotics during the last 24 hours due to any infection but not prophylactic antibiotic during caesarian section
14. Emergency caesarean section
Adult Idiopathic Inflammatory Myopathy With Cardiac Injury

Adult patients with suspected or confirmed idiopathic inflammatory myopathy (IIM) will be recruited. Patients will be approached, consented, have baseline demographics, diagnostics and disease activity measures recorded, and blood taken. The collection of data and biological material will mirror usual clinical practice as far as possible. Subjects will ideally attend further visits at 3, 6 and 12 months to have bloods taken, outcome measures recorded and questionnaires completed.In addition, blood, muscle biopsies and imaging undertaken as part of usual care will also be collected for research purposes to measure a number of biomarkers for the assessment of diagnostic accuracy and clinical utility evaluation. As per usual practice, a muscle biopsy will be performed at baseline, and a further biopsy offered at 6 months to assess treatment response. A magnetic resonance (MR) muscle protocol will also be performed as per usual clinical practice, and a gadolinium-enhanced MR heart scan offered. Both these scans will be repeated at 6-12 months. An existing electronic database entry system will be used for data entry and capture on an anonymised basis.


Eligibility Criteria:
Inclusion Criteria:

* All patients who had a confirmed (muscular biopsy, electromyogram, magnetic resonance imaging) or suspected clinically myositis
* Age over 18 years old
* Signature of the informed consent form for the study

Exclusion Criteria:

* Patients with disease duration \>2 years
* Patients \< 18 years
* Confirmed non-inflammatory myopathies
* Myositis secondary to alcohol or drug abuse
* Patients unwilling or unable to give consent
* Patients with poor or no venous access
Effects of an Oral GH Secretagogue (MK-677) on Body Composition and Functional Ability of Older Adults

The purpose of this study is to determine whether treatment of healthy older men and women with oral MK-677 for 12 months will enhance pulsatile GH release and increase mean GH and IGF-I concentrations into the range of young adults and will have favorable effects on body composition and functional ability on older adults.

This is a two year, double-blind, placebo-controlled cross-over trial of once daily administration of MK-677, an oral GH secretagogue, to healthy older adults. During the first year, subjects will be randomized to MK-677 or placebo treatment. In each of three subgroups of subjects (men, women off and women on hormone replacement therapy), 16 subjects will receive MK-677 and 8 will receive placebo. After 1 year, the subjects who received placebo will be switched to MK-677 treatment; the subjects who received MK-677 for the first year will be randomized to either placebo or MK-677 for the second year of the study.The study will test changes in GH, IGF-I, body composition and function.

Eligibility Criteria:
Inclusion Criteria:

* Healthy men and women  60 years of age, with a body mass index of \< 35 kg/m2.

Exclusion Criteria:

* Medication known to affect GH secretion, other than estrogen replacement therapy
* Coronary artery disease,
* Congestive heart failure,
* Peripheral vascular disease,
* Diabetes mellitus (requiring insulin or an oral hypoglycemic agent),
* Significant hypertension (BP \>180 systolic or \>100 diastolic at rest);
* Renal, hepatic, pulmonary disease;
* Untreated hypothyroidism, untreated hyperthyroidism;
* History of seizure disorder;
* History of malignancy (other than some skin cancers), history of active chronic infections (e.g., HIV, tuberculosis).
* Hematocrit \< 40%, men, \< 36%, women
* History of daily tobacco use within past 3 months
* Chronic alcohol abuse
* Strenuous exercise for average of more than 60 min/day
* Investigational drug within past 6 weeks
* Psychiatric history, especially anorexia nervosa
* Transmeridian travel within 2 weeks prior to or during study
fMRI in CardiaC arrEst With Uncertain Prognosis

The goal of this observational study is to determine whether specific advanced MRI measures are associated with functional outcomes in patients who are comatose after cardiac arrest. The main question\[s\] it aims to answer are:

Aim 1: Determine if stimulus-based functional MRI (fMRI)-measured activations are independently associated with favorable neurological outcomes after cardiac arrest

Aim 2: Determine if resting state functional MRI (rs-fMRI)-measured functional network connectivity is independently associated with favorable neurological outcomes after cardiac arrest.

Aim 3: Determine if diffusion tensor imaging (DTI)-measured white matter integrity is associated with favorable neurological outcomes after cardiac arrest.

Participants will undergo advanced MRI sequences at time of clinical MRI, and will be followed for 6 months post-arrest.

Our goal here is to determine whether advanced functional MRI and DTI sequences add actionable prognostic information relative to standard clinical MRI in patients who remain comatose after cardiac arrest. We plan the following specific analyses:

Aim 1: We will use logistic regression to measure the association between our primary outcome and fMRI BOLD response to (a) passive language stimuli, (b) motor imagery or (c) passive sensory stimuli, in a model with age, Glasgow Coma Scale (GCS) score at time of MRI, and presence of anoxic injury on clinical diffusion weighted MRI.

Aim 2: We will use logistic regression to measure the association between our primary outcome and default mode network resting state functional connectivity, in a model with age, Glasgow Coma Scale (GCS) score at time of MRI, and presence of anoxic injury on clinical diffusion weighted MRI.

Aim 3: We will use logistic regression to measure the association between our primary outcome and diffusion tensor imaging (DTI)-measured mean white matter fractional anisotropy, in a model with age, Glasgow Coma Scale (GCS) score at time of MRI, and presence of anoxic injury on clinical diffusion weighted MRI.

Eligibility Criteria:
Inclusion Criteria:

* survive of an in or out of hospital cardiac arrest

Exclusion Criteria:

* Drug overdose
* Opinion of medical team patient unlikely to survive more than 24 hours (severe concurrent medical illness, dilated and unreactive pupils, etc..)
* Following verbal commands (MD or RN note) once TTM is complete and normothermia is achieved (Day 2 or 3; Day of admission is Hospital Day 0). If no TTM is administered, this can be assessed on Hospital Day 2.
* Following verbal commands (study team assessment) at time of MRI
* Family planning to WLST at time of enrollment
* Non English speaker (okay if English not primary language, as long as they can understand it)
* Permanent Contraindication to MRI (some kind of implanted metal)
* Pregnant
Educational Counseling in Improving Communication and Quality of Life in Spouses and Breast Cancer Patients

This randomized clinical trial studies educational counseling in improving communication and quality of life in spouses and breast cancer patients. An outpatient education and behavior skills training program may help spouses and patients with breast cancer communicate better and improve quality of life. It is not yet known whether educational counseling is more effective than an educational booklet in improving communication and quality of life.

PRIMARY OBJECTIVES:

I. To test whether the intervention has a beneficial effect on spouses' outcome variables.

II. To test whether the intervention has a beneficial effect on ill partners (patients') outcome variables.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Participants receive the "What's Happening to the Woman I Love?" booklet, which focuses on ways to understand and deal with marital communication and relationship issues arising from breast cancer diagnosis.

ARM II: Participants undergo the Helping Her Heal educational counseling program comprising 5 1-hour sessions 2 weeks apart.

SESSION I: Participants learn stress management skills and discover ways stress affects themselves and their partner.

SESSION II: Participants practice attentive listening and reduce the tendency to try to distract patients from talking about sad or difficult aspects of the cancer experience.

SESSION III: Patients learn to help their spouse talk when she is quiet or withdrawn, to add to their understanding of what she is thinking and feeling, and to add to their ways of supporting her during especially difficult times with the cancer.

SESSION IV: Participants learn strategies for physically reconnecting with spouses.

SESSION V: Participants review skills from prior sessions, identify strategies he or she will continue to use to manage their personal stress, and identify ways to maintain connection and support.

After completion of study, patients are followed up at 3 and 6 months.

Eligibility Criteria:
Inclusion Criteria:

* Spouses (in both heterosexual couples and same-sex couples) of women diagnosed within the past 6 months with stage 0, I, II or III breast cancer (in situ/local/regional disease) will be eligible to participate, as will the diagnosed wife/partner
* Spouses and patients must be married or cohabiting for at least 6 months
* Spouses and patients must have English as one of their languages of choice (they can be multilingual)
* Spouses and patients must live within 25 miles of the University of Washington (UW) study center
* Spouses/partners must be willing to give a sample of blood and/or sputum at time of first and second data collections

Exclusion Criteria:

* Woman diagnosed with stage IV or recurrent breast cancer or who is \> 6 months post-diagnosis
* Woman and/or spouse not able to read and write in English
* Spouses could not participate if the ill partner refused participation
CD133 Transplantation to Generate Oocytes in Poor Ovarian Reserve

Women delay maternity and, as a consequence, available oocyte number and their quality decrease (9-18% of all IVF patients). Different treatment protocols have been developped nevertheless none of them optimal: the number of oocytes retrieved depends on the present ones. New generation of oocytes and follicles has been defended by some authors and bone marrow seems to be involved. What seems crucial is the niche that produces paracrine signals able to activate dormant cells and to attract undifferentiated cells from other tissues (homing). This phenomenon has been described by our group in other human reproductive tissues like endometrium. The purpose of the study is to improve ovarian reserve in unfertile women with poor ovarian reserve by means of bone marrow protective capacity.

CD133+ cells obtained from bone marrow will be delivered into the ovarian artery allowing them to colonize ovarian niche.

The study hypothesis is that CD133+ cells will improve ovarian reserve differentiating themselves into germ cells or, more likely, stimulating the niche to activate dormant follicles.


Eligibility Criteria:
Inclusion Criteria:

* \< or= 40 years old
* FSH\<15UI/L
* poor ovarian response after controlled ovarian stimulation with conventional doses (\<3 oocytes) or two episodes of poor ovarian response after ovarian stimulation with maximal doses even if young or normal ovarian reserve study.
* Antral follicle count\>2
* \>1 antral follicle in the perfunded ovary
* AMH between 0,5 and 1pmol/L
* regular menstrual bleeding each 21-35 days
* To be candidate to autologous hematopoietic progenitors transplantation

Exclusion Criteria:

* Ovarian endometriosis
* Anovulation
* Any ovarian surgery considered risk factor of low ovarian response.
* Genetic factors associated to low ovarian response (Turner syndrome, FMR1 mutations...)
* Adquired conditions determining low response (chemotherapy, radiotherapy...)
* BMI \> or = 30kg/m2
* Allergie to iodine
* Kidney failure
Virtual Reality in Invasive Techniques in Physiotherapy

Dry needling is a common physical therapy technique that uses solid acupuncture needles that are repeatedly inserted and removed into the human body. These techniques, despite their benefits, can cause pain. The objective of this study is to analyze the use of virtual reality as a distractor in invasive techniques in physiotherapy. The hypothesis is that the use of immersive virtual reality, evoking relaxation situations, will reduce the sensation of pain during and/or after the technique. To do this, healthy participants will be recruited and the participants will be divided into two groups (experimental and control). Participants in the experimental group will undergo the dry needling technique on latent myofascial trigger points along with the use of immersive virtual reality. The same technique will be performed on participants in the control group but without the use of virtual reality. Pain during and after puncture and strength after puncture will be evaluated.


Eligibility Criteria:
Inclusion Criteria:

* Have at least one identifiable latent myofascial trigger point in the muscles studied

Exclusion Criteria:

* Suffer any musculoskeletal or neural alteration that could alter the results obtained
* Suffer from belonephobia or extreme and uncontrollable fear of sharp objects