cyrilzakka/clinical-trials huggingface dataset:
Animal Bite Victims Seeking Medical Services at Concerned Hospitals

The goal of this observational study is to study the magnitude of the animal bite problem during one year ,to determine the percentage of compliance for full PEP doses and factors affecting the health seeking behavior among these victims.

To assess the management of the wound (first aid management done by the patient and in the hospital).

Participants will be asked to answer a questionnaire consisting of five parts and followed for completing their anti-rabies vaccination schedule.

Animal bites pose a major public health problem in children and adults worldwide. Numerous animal species have the potential to bite humans leading to rabies which is a disease of mammals , including dogs, wolves, foxes, cats, lions, mongooses, bats, monkeys and humans, However, the use of dogs as pets or companions, and for security, hunting, and breeding has contributed to their growing population.

Surveillance data revealed that people in Egypt experience a large number of animal bites annually with more than 200,000 animal bites recorded each year mostly from dogs. On average 60 people die annually from rabies in Egypt.

Rabies is 100% fatal disease but can be prevented with successful rabies control program which comprise of three pillars:1. Community participation; education, public awareness. 2. Access to mass vaccination of dogs. 3. Access to post bite treatment.

PEP is the administration of wound care and immunization after potential exposure to the rabies virus.

As a part of zero by 30 strategy set by WHO to control dog-mediated human rabies by 2030, the strategic advisory group of experts of the WHO needed the current scenario of health-seeking behavior of exposed individuals and the use of rabies vaccines and immunoglobulin in rabies endemic countries. In this regard, perception of victims and their attitude towards treatment forms an important role for prevention against rabies. It is also necessary to detect trends to evaluate the effect of preventive efforts implemented by the Ministry of Health.

Eligibility Criteria:
Inclusion Criteria:

* victims recently exposed to bite by any animal causing rabies

Exclusion Criteria:

* other types of animal bites
MISA to NRDS：a Multicenter Study in China

BACKGROUND Treatment of neonatal respiratory distress syndrome with exogenous surfactant and mechanical ventilation made millions of preterm infants survived in neonatal intensive care unit (NICU). Endotracheal intubation surfactant administration is related to invasive intubation and short periods of positive pressure ventilation and implies the risk of lung injury. Continuous positive airway pressure (CPAP) or NIPPV (Non-invasive positive pressure ventilation) with surfactant but without intubation may work synergistically. This randomized trial investigated a minimal invasive surfactant administration (MISA). To test the hypothesis that MISA increases survival without bronchopulmonary dysplasia (BPD) at 36 weeks' gestational age in very low birth weight infants.

DESIGN, SETTING, AND PARTICIPANTS The Minimal Invasive Surfactant Administration (MISA) was a multicenter, randomized, clinical, parallel-group study conducted between July 1st, 2017, and November 30, 2018, in 8 level III neonatal intensive care units in Beijing, Tianjin, and Hebei province, China. The final follow-up date was March 30, 2019. Participants enrolled spontaneously breathing preterm infants born between 26.1 and 31.9 weeks' gestational age with signs of respiratory distress syndrome. In an intention-to-treat design, infants were randomly assigned to receive surfactant (Calf pulmonary surfactant, Double-Crane Pharmaceutical Co., China) either via a 5Fr nasogastric tube during CPAP/NIPPV-assisted spontaneous breathing (minimal invasive surfactant administration group, MISA group) or after conventional endotracheal intubation during mechanical ventilation (endotracheal intubation surfactant administration group, EISA group).

INTERVENTION MISA via a 5Fr nasogastric tube with an ophthalmic surgery straight forceps.


Eligibility Criteria:
Inclusion Criteria:

1. preterm infants born before 32 weeks gestational age
2. spontaneously breathing receiving continuous positive airway pressure (CPAP) or NIPPV (Non-invasive positive pressure ventilation) without intubation
3. clinical diagnosis of respiratory distress syndrome.

Exclusion Criteria:

1. with obvious malformations
2. with asphyxia requiring intubation during resuscitation
3. need endotracheal intubation or mechanical ventilation before surfactant administration.
Thermal Biofeedback for the Treatment of Diabetic Neuropathy

The purpose of this study is to examine potential treatment options for a condition in diabetics that causes tingling, pain, and numbness in the hands and /or feet, also known as diabetic peripheral neuropathy.

Participants attend 6 sessions lasting from 35 minutes to 2 hours (depending on the session). Sessions can be scheduled once or twice per week. Sessions involve a walking task, filling out questionnaires, and having temperature of hands and feet monitored. This study involves no drugs, blood draws, or any other invasive procedures. Participants are urged to continue the treatment of diabetes and diabetic neuropathy as directed by their physician for the duration of their involvement with the study. After 3 months, a packet of questionnaires will be mailed with a stamped addressed envelope to be returned.

Eligibility Criteria:
Inclusion Criteria:

* Clinical Diagnosis of Diabetic Neuropathy in Hands and/or Feet
* Must have some sensation left in hands and feet

Exclusion Criteria:

* Any partial or total amputation of an limb or digit
* Any previous experience with biofeedback
* Prior treatment for alcohol abuse
* Severe Psychopathology
Functional Instability in Patients Suffering From Collagen Disease and Joint Hypermobility

A joint is considered "hypermobile" when it has a greater range of motion than normal for a given age, ethnicity or gender. Many people have asymptomatic hyperlaxity in multiple joints, a condition called Generalized Joint Hypermobility (GJH).

Conversely, hyperlaxity can be symptomatic, a condition that has been defined "Joint Hypermobility Syndrome" - JHS.

Diagnosis of JHS is commonly performed by applying the revised Brighton criteria. Based on these criteria, an individual is diagnosed with JHS with a Beighton score \>/= 4/9, and arthralgia for 3 or more months in 4 or more joints (major criteria).

The dynamic body balance test (i.e. the stability test with multiple single-leg jumps) can provide information regarding the effectiveness of the feedforward and feedback mechanisms in correcting the postural deviations necessary to achieve successful performance during daily and sporting activities. Such assessment may also be useful to demonstrate deficiencies in balance, especially in young patients with increased physical activity.

The aim of this study is to examine the postural balance of individuals with JHS by performing stability tests in monopodalic and bipodalic stance with the "Delos Postural Proprioceptive System"


Eligibility Criteria:
Inclusion Criteria:

* Patients with moderate (Beighton-Horan Joint Mobility Index score from 3 to 4) or severe (Beighton-Horan Joint Mobility Index score from 5 to 9) joints hyperlaxity at the clinical evaluation

Exclusion Criteria:

* Obesity (BMI \> 25) and weight \> 90 kg
* Practice of competitive sport
* Orthopedic (complex surgery of the spine and lower limbs), neurological (spasticity, stroke), and oncological comorbidities
* Orthostatic / walking inability
* Absence of joints hyperlaxity at the clinical evaluation (Beighton-Horan Joint Mobility Index score from 0 to 2)
Dexamethasone for Reduction of Post Thoracotomy Pain Syndrome

Post thoracotomy pain syndrome still affects 50% of patients after a thoracic surgery. Pathogenesis is unclear but there is growing evidence that neuro inflammation may play a significant role. Dexamethasone is a very potent anti-inflammatory drug. The hypothesis of this study is that dexamethasone, given pre operatively, would help reduce the incidence of post thoracotomy pain syndrome 3 months after surgery, by reducing the inflammatory response, in patients undergoing elective thoracic surgery that includes thoracic epidural analgesia.


Eligibility Criteria:
Inclusion Criteria:

* elective thoracic surgery using a thoracotomy incision and thoracic epidural analgesia
* ASA I-III
* age 18-75 yo

Exclusion Criteria:

* contra-indication to thoracic epidural analgesia
* patient refusal
* patients already taking cortisone or dexamethasone
* patients on chronic opioid medication
The Association Between Central Aortic Blood Pressure Indices and Severity of Coronary Artery Disease

Abstract

Objectives:

Primary: To study the association between central aortic blood pressure indices and coronary artery disease in patients undergoing elective angiography. Secondary: (a) To study whether any association exists between central aortic pressure indices and the incidence of major adverse cardiovascular events (MACE) in the same patients during a 6 month follow up period. (b) To study whether any association exists between the central aortic pressures and peripheral pressures.

Methods: The investigators conducted a prospective observational study in consecutive patients undergoing coronary angiography. Central and peripheral pressures were invasively recorded and coronary artery disease (CAD) classified into obstructive and non-obstructive group. CAD severity was graded using the Gensini score and subjects were divided into tertiles. Patients were followed up and the role of central aortic pressure indices in the prediction of cardiovascular events were analysed.


Eligibility Criteria:
Inclusion Criteria:

* Patients undergoing elective angiography for diagnosis of CAD.
* Age \> 18 years

Exclusion Criteria:

* Patients with acute myocardial infarction, unstable angina or thromboembolism in the preceding 3 months.
* More than mild valvular heart disease.
* Renal impairment with serum creatinine \> 1.5 mg%.
* Unable to obtain a full study of the coronary arteries.
* Peripheral vascular occlusive disease.
* Post coronary artery bypass grafting( CABG)
* Heart rate \< 50/min and \> 120/min and other arrhythmias.
* Contraindications for coronary angiography.
* Unable to provide written informed consent
Magnetic Resonance Thermal Image Guided Laser Interstitial Thermal Therapy in Treating Patients With Breast Cancer

This pilot clinical trial studies magnetic resonance thermal image guided laser interstitial thermal therapy in treating patients with breast cancer. Magnetic resonance thermal image guided laser interstitial thermal therapy may be able to kill tumor cells by heating up the tumor cells without affecting the surrounding tissue

PRIMARY OBJECTIVES:

I. To evaluate the procedural success rate of using the Visualase magnetic resonance (MR)-guided laser system to target, access, thermally monitor, and focally ablate MR-visible breast cancer lesions.

2. To obtain preliminary data on ablative success using pathologic assessment for specimen excised subsequent to the ablation.

OUTLINE:

Patients undergo MR-thermal image guided laser interstitial thermal therapy (LITT) over 1 hour.

After completion of study treatment, patients are followed up at 3-7 days.

Eligibility Criteria:
Inclusion Criteria:

* Postmenopausal state
* Histological diagnosis of breast invasive ductal carcinoma with receptor profiles obtained
* MRI visible breast lesion
* Unifocal cancer, less than 1.5 cm in maximum diameter (clinical stage T1), with no evidence of extensive in situ cancer surrounding the main tumor; the eligibility will be determined by the MR imaging appearance of the tumor; if the tumor (proven invasive ductal carcinoma) is a unifocal mass without additional enhancement, it will be judged eligible; however, if the tumor is associated with additional enhancement and/or a satellite focus, it will not judged ineligible, as these are signs of additional in situ or invasive cancer
* Clinical stage N0 (no metastatic axillary lymph node on physical examination or imaging work-up)
* Ability to give informed consent

Exclusion Criteria:

* Previous surgery or radiation for the ipsilateral breast cancer
* Presence of any condition (e.g., metal implant, shrapnel) not compatible with MRI
* Tumor located less than 1 cm from the skin or the pectoralis muscle
Volume Kinetics of Gelofusine 4% During Vascular Surgery

The volume kinetics of the commercially available colloid fluid, Gelofusine 4%, have not been previously studied. Adult patients undergoing open vascular surgery, including femoral and carotid endarterectomy as well as bypass surgery, received general anesthesia. Following the induction of anesthesia, Gelofusine 4% was administered at a dosage of 10 ml/kg over a 30-minute period. Hemoglobin concentration was monitored for up to 180 minutes post-administration to construct a plasma hemodilution profile.

Gelofusine 4% was administered at a dosage of 10 ml/kg over a 30-minute period to adult patients undergoing uncomplicated vascular surgery. Arterial blood samples were taken to measure blood hemoglobin concentration and hematocrit at baseline and at 5-minute intervals up to 60 minutes after the infusion began, followed by 10-minute intervals up to 90 minutes, and then at 30-minute intervals up to 180 minutes. Urine output and total intraoperative blood loss were continuously monitored. The plasma hemodilution data were fitted to a bicompartmental model to derive the intercompartmental kinetics of Gelofusine 4%.

Eligibility Criteria:
Inclusion Criteria:

* Informed consent.
* Elective open vascular surgery with a minimal risk of perioperative complications.
* Hemodynamic stability before induction (no chest pain, SBP \> 100 mmHg, MAP ≥ 60 mmHg, 50 \< HR \< 100 bpm).

Exclusion Criteria:

* Known allergy to 4% Gelofusine.
* Patient refusal to participate in the study.
* Non-elective/emergency surgical interventions.
* The American Society of Anesthesiologists (ASA) \> 3.
* Any preoperative hemodynamic support (mechanical or pharmacological).
* Moderate or severe left ventricular dysfunction (LVEF ≤ 44%).
* Moderate or severe right ventricular dysfunction.
* Diastolic dysfunction of any degree.
* Baseline hypoxemia index \< 300 mmHg.
Embedded Palliative Care in the MICU

The goal of this study is to investigate whether embedding a hospice and palliative care practitioner within a medical intensive care unit will improve patient outcomes and healthcare usage. The practitioner will work solely within the medical intensive care units and offer timely as well as proactive consultations based on clinical criteria and estimated mortality risk. The study team will compare patients seen by the practitioner to patients in an adjacent ICU and historical patients to determine whether patient care is improved by this intervention.

The study goal is to determine whether an embedded palliative care practitioner in the medical ICU improves patient outcomes, palliative care/hospice utilization, and healthcare quality metrics. The medical ICUs included in this study are comprised of two geographically co-located units that provide care for medically complex patients from a large tertiary referral area. Palliative care services are currently available as a consultative service at the ICU clinicians' discretion for patients with palliative needs such as complex goals of care, advanced symptom management, or chronic critical illness. Under the current consultation model, palliative care consultation is requested in a minority of critically ill patients and consults occur on average 5-14 days after a patient's admission. Hospice services are similarly available on a consultative basis for patients that the primary team has determined are suitable for hospice, however, logistical limitations of hospice consultation may lead to delays in inpatient hospice transfers and home hospice discharges.

This study's intervention is to embed a palliative care/hospice practitioner within the medical ICUs as a dedicated palliative care and hospice consultant who will offer proactively triggered palliative care consultations early in a patient's ICU stay as well as immediate availability for standard-of-care palliative care and hospice consultations.

Eligibility Criteria:
Inclusion Criteria:

* Patients admitted to the medical intensive care units at a tertiary referral center
* Patients must be at least 18 years of age

Exclusion Criteria:

* None
Obstructive Sleep Apnea and Neurocognitive and Cardiovascular Function in Children With Down Syndrome

Many individuals with Down syndrome (DS) have breathing problems during sleep. This is called obstructive sleep apnea syndrome (OSAS). OSAS is very common in individuals with Down syndrome because of the shape of their face and tongue and because of their low muscle tone. OSAS can cause a lot of health problems including behavioral and learning problems as well as heart problems.

The purpose of this research study is to look at the effects of treating OSAS in individuals with Down syndrome with a machine called Continuous Positive Airway Pressure (CPAP). The investigators want to see if treatment of OSAS improves learning, behavior and heart problems.

All individuals participating in the study will be evaluated for obstructive sleep apnea syndrome (OSAS) with a baseline sleep study. Based on the results of the sleep study,individuals with OSAS will be randomly assigned into two groups. One group will receive continuous positive airway pressure (CPAP) and the other intervention group will receive sham CPAP(placebo) for four months. CPAP is a machine with a mask that fits over the nose, is worn during sleep and helps keep the airway open. Sham CPAP (placebo) is a machine that looks and sounds like a CPAP machine but does not give pressure so it does not treat OSAS. Individuals with normal breathing during the sleep study will not receive a machine, and will serve as controls.

Individuals will also have baseline tests including blood tests, an echocardiogram (pictures of the heart), a walking test and learning tests. After 4 months, the baseline tests will be repeated in all participants. At the end of the study, all individuals with OSAS will get treatment.

Eligibility Criteria:
Inclusion Criteria:

1. Aged 8-20 years
2. Down syndrome (based on the characteristic phenotype)
3. Families provide informed consent and child provides assent

Exclusion Criteria:

1. Subjects and families who do not speak English well enough to undergo psychometric testing.
2. Subjects living in institutions where there is no primary caregiver to participate in the neurocognitive/behavioral battery.
3. Major chronic lung disease such as chronic aspiration.
4. Previous or current CPAP therapy.
5. Participation in a weight loss program.
6. Craniofacial or neuromuscular conditions other than those associated with DS.
7. Untreated hypothyroidism. Participants with normal thyroid function tests will be included in the study.
Echocardiography During Ajmaline Test

In this study the investigators analyse echocardiographic images before and during Ajmaline test. The purpose is to know if any echocardiographic modifications are present during either negative or positive Ajmaline testing.

The diagnosis of Brugada Syndrome is made when a type 1 pattern is present on the electrocardiogram (ECG), either spontaneously or after administration of a sodium channel blocker. For pathofysiological understanding, the investigators will analyse echocardiography images before and during the administration of Ajmaline. Comparing echocardiographies before and during negative Ajmaline test, will allow the investigators to indentify the effect of Ajmaline administration on cardiac function. The comparison between images of negative and positive Ajmaline tests will expose differences related to the occurence of a type 1 ECG.

Eligibility Criteria:
Inclusion Criteria:

* \>17 years old
* clinical indication for Ajmaline test

Exclusion Criteria:

* History of right ventricular outflow tract ablation
Community Partnership to Examine Racial and Ethnic Differences in Health Care for Hypertension and Diabetes

Hypertension and diabetes are among the most common chronic diseases in the United States. Racial and ethnic minority groups are more at risk for these diseases than the Caucasian population. This study will attempt to identify factors that contribute to racial and ethnic differences in hypertension and diabetes care among minority patients of community health centers (CHCs). This information will be used to design and implement programs to improve quality of care in these communities.

Hypertension and diabetes are the primary contributors to today's high rates of heart disease and stroke, which are the first and third leading causes of death in the United States, respectively. African Americans and Hispanics have a higher risk of developing hypertension and diabetes than do Caucasians. They are also less likely to know that they have high blood pressure, are more prone to organ damage, and are more likely to die as a result of these chronic conditions. A significant number of African Americans and Hispanics are uninsured and receive care through publicly supported CHCs. It is important to identify factors that contribute to healthcare differences among the lower income, uninsured, and minority populations that are typically served by CHCs. In this study, a collaborative partnership will be developed between CHCs, health service research organizations, and academic researchers. The goal of the study is to examine the barriers that minority CHC patients face in receiving appropriate hypertension and diabetes care.

This study will develop a collaborative partnership between various health organizations and seven CHCs located in Boston neighborhoods that have a large percentage of African American and Hispanic residents. Researchers will conduct focus groups with CHC patients who are receiving care for hypertension or diabetes. CHC staff members will be interviewed to collect information regarding the relationship between CHC organizational structure and disparities in heart disease risk factors among minority patients with hypertension or diabetes. Researchers will then develop, implement, and evaluate a patient- and CHC-focused intervention aimed at reducing the cardiovascular risks of minority patients at four CHCs in Boston.

Eligibility Criteria:
Inclusion Criteria:

* Diabetes
* Hypertension, as diagnosed by the average of two or more blood pressure measurements taken during two or more study visits following an initial screening
* Race is 'Black' or ethnicity is 'Hispanic'
* Patient at participating Community Health Center
Efficacy of Botox Injection of the Masticatory Muscles in Head &Neck Cancer Patients with Trismus After Radiotherapy

Trismus is a common side effect in head and neck cancer patients after radiation therapy. This project aims to explore the therapeutic effect of Botulinum toxin (Botox) injection to the masticatory muscles in the above-mentioned patients.

In this project, Botulinum toxin will be injected into the masticatory muscles (medial pterygoid and masticatory muscles), combined with oral rehabilitation exercises, to reduce the patient's masticatory muscle tension and spasm. Patient's mouth opening range, quality of life, trismus condition and pain will be evaluated to understand its efficacy.


Eligibility Criteria:
Inclusion Criteria:

1. Aged over 18 years old;
2. Head and neck cancer patients must have completed radiotherapy for at least 3 months;
3. Those whose mouth-opening distance is less than or equal to 3.5 cm (the functional cut-off point of trismus) and who have tightness or pain in the masticatory muscles;
4. Medical condition is stable;

Exclusion Criteria:

1. Those who have undergone surgery on their masticatory muscles;
2. Patients with obvious muscle atrophy or complete fibrosis of masticatory muscles ;
3. Those with tumor recurrence at the time of admission;
4. Those whose vital signs are unstable due to acute illness.