cyrilzakka/clinical-trials huggingface dataset:
Fixation of Glenoid Fractures

Scapula fractures are uncommon but make up 3-5% of all shoulder girdle injuries. Moreover, intraarticular glenoid fossa fractures represent only 1% of scapula fractures.

They are frequently found with concomitant injuries to chest, head, brachial plexus and humerus.

The glenoid is an oval shaped portion on the lateral border of the scapula that articulates with the circular rounded end of the humeral head.

Superiorly the glenoid is part of the superior shoulder suspensory complex (SSSC) consisting of superior glenoid, coracoid process, coracoclavicular ligaments, distal end of the clavicle, acromioclavicular joint, coracoacromial ligament and acromial process.

Subsequently, stability of the shoulder is a complex mechanism in which muscles, ligamentous and capsular restraints, the labrum and joint vacuum, each play a role depending on position and activity.

The history of patients with glenoid fractures will mostly consist of either shoulder dislocation or direct trauma to the humeral head. The affected arm is "pseudo-paralysed" and supported in adduction and internal rotation.

Because of a thick layer of soft tissue, only mild swelling and ecchymosis may be seen .

For the diagnosis of scapular injuries X-rays are routinely taken , MSCT scanning , MRI \& Nerve conduction velocity may be done.

Main parameters defining operative treatment are instability, the articular surface fragment size and the degree of displacement. However, concomitant injuries (e.g. thorax, head, extremity fractures, plexus lesion), age, occupation, level of activity and dominance, play a key role in management.


Eligibility Criteria:
Inclusion Criteria:

* 1-Fracture Pattern:

  1. All partial \& complete articular Glenoid Fractures: with Non congruent articular surface; \>20° deviation in angle between the glenoid and lateral scapular rim compared to the anatomical angle.
  2. All Extra articular Glenoid fractures: with \>20° deviation in angle between the glenoid and lateral scapular rim compared to the anatomical angle.
  3. All Extra articular Glenoid fractures e \>20° difference In GPA compared to The GPA of the normal side.
  4. Fractures e an intra-articular gap or step-off of 4 to 10 mm or more.
  5. If glenohumeral instability is present after dislocation. 2-Age: skeletally mature patients (\>18-60y)

Exclusion Criteria:

* 1- Fractures e an intra-articular gap or step-off \< 4 mm. 2- Timing of surgery not more than 2 weeks from the initial trauma 3- Polytraumatized patients e ISS\>14. 4- Associated Neurovascular Injury. 5- Open Fractures. 6- Associated comorbidities e.g. (Uncontrolled DM, Renal impairment).
Intervention to Enable Stroke Survivors in Los Angeles County Hospitals to "Stay Within the Guidelines"

The purpose of this study is to test a newly developed outpatient care intervention called SUSTAIN (Systematic Use of Stroke Averting Interventions) for improving delivery of stroke preventive services at Los Angeles County hospitals and to measure the costs of running such an intervention.

Patients randomized to SUSTAIN will participate in group clinics about stroke, given self-management tools about stroke, and will be called by nurse practitioners to coordinate their stroke care. Patients randomized to the control arm will be mailed educational materials about stroke. Subjects in either arm are eligible to receive their usual source of care.

Eligibility Criteria:
Inclusion Criteria:

* Patients of LAC+USC, Rancho Los Amigos, Olive View-UCLA, or Harbor-UCLA
* Patients who have had an acute transient ischemic attack (TIA) or ischemic stroke or carotid procedure within the last six months
* English or Spanish speaking
* At least 40 years of age
* Capable of giving informed consent (no proxies will be used to obtain consent)
* Blood pressure not optimally controlled (\>120/80, at least 72 hours post-stroke)

Exclusion Criteria:

* Age 39 years or younger
* Hemorrhagic stroke
* Patients with severe global disability which would preclude him/her from participating in group clinics
* Patients with advanced dementia
High-intensity Training for Improving Physical Performance of Aged Women

This study evaluates the adaptations on the functional capacity and cardiovascular in elderly after a physical activity program circuit training. The participants were divided into three groups: Circuit training based on high-intensity interval training group (HIICT), Circuit training at moderate intensity group (MICT) and Control group (CG).

Three groups of participants (circuit training based on high-intensity interval training, circuit training at moderate intensity and not training group) will enter the study. The intervention will consist of a physical exercise program in day centers.

Intensity progression will be encouraged according to the rate of perceived exertion. Progression of exertion will be "very hard", "extremely hard" and "maximal exertion" for HIT group, and "light", "somewhat hard" and "hard" for group. Assessment will be undertaken at two-time points: baseline and after 16 weeks of exercise training.

Assessment will include VO2 peak, functional capacity, health-related quality of life, cognitive state and daily physical activity.

Eligibility Criteria:
Inclusion Criteria:

1. Having 50 - 90 years old.
2. Not suffering chronic heart, respiratory or joint disease, taking medication or having a deteriorated level of mental health that could interfere in carrying out exercise programs.
3. Having 0 or 1 responses positive in the Physical Activity Readiness Questionnaire (ParQ). Only item 6, related to mild vascular diseases.
4. Being physically independent according to the scales Lawton and Brody, and Katz.

Exclusion Criteria:

1. Having uncontrolled arterial hypertension.
2. Having practiced during the previous 3 months or practicing at present a similar exercise to the one proposed in the study.
3. Attending sessions less than 80%.
Validation of Pupillary Response to Nociceptive Stimulation in Cardiac Surgery During Extracorporeal Circulation Period

The relationship between the target effect site concentration of remifentanil and the pupil diameter and reactivity in response to a standard noxious stimulus in cardiac surgery during extra corporeal circulation will be evaluated.

Anaesthesia will be induced with propofol to obtain loss of consciousness LOC in 30 patients who will undergo cardiac surgery requiring extracorporeal circulation and standardized support will be given to them till the extracorporeal circulation period. Thereafter, remifentanil will be titrated by increments of 0,5, from 1 up to 5 ng ml-1 during the extra corporeal circulation period. In the awake state, at LOC and at each plateau level of remifentanil CeT, mean arterial pressure, and BIS will be recorded. Pupil size and dilatation after a 60 mA, 100 Hz tetanic stimulation will be measured at LOC and at each plateau level of remifentanil.

Eligibility Criteria:
Inclusion Criteria:

* general anesthesia for cardiac surgery programmed requiring the realization of a sternotomy and the use of extra corporeal circulation
* age\> 18 years

Exclusion Criteria:

* contraindication to the use of the products defined in the protocol of anesthesia (alprazolam, remifentanil, propofol, atracurium)
* sedation in progress with use of morphinomimetics
* urgent surgery
* preoperative existence of circulatory assistance
* preoperative existence of an intra-aortic balloon pump,
* bilateral ocular pathology (severe cataract, amblyopia, glaucoma, keratitis, conjunctivitis) and / or history of bilateral ocular surgery affecting the iris
* history of epilepsy, cerebral palsy
* peripheral neuromuscular diseases
* pathology with dysautonomia impairing the pupillary dilation reflex: insulin-dependent type 1 or type 2 diabetes with diabetic retinopathy, multiple sclerosis, systemic amyloidosis, uncontrolled hypertension, advanced Parkinson's disease
* ongoing treatment interfering with the autonomic and central nervous system likely to alter the pupillary dilation reflex: antiemetic (droperidol, metoclopramide), alpha-2 agonist (clonidine, dexmedetomidine), high doses of nitrous oxide
* treatment with severe anticholinergic effect: such as amitriptyline, amoxapine, atropine, benztropine, chlorpheniramine, chlorpromazine, clemastine, clomipramine, clozapine, darifenacin, desipramine, dicyclomine, diphenhydramine, doxepin, flavoxate, hydroxyzine, hyoscyamine, imipramine, meclizine, nortriptyline, orphenadrine, oxybutynin, paroxetine, perphenazine, procyclidine, promazine, promethazine, propentheline, pyrilamine, scopolamine, thioridazine, tolterodine, trifluoperazine, trihexyphenidyl, trimipramine
* pregnant or lactating women
* Patient having objected to the processing of his data
Exergame Balance Training for Patients With Mild Cognitive Impairment

This study will be a randomized control trial, which will be conducted on older adults with mild cognitive impairment. A specially designed Exergame balance training will be used for cognitive enhancement in patients with MCI. This training will determine the improvement in executive functioning, balance, speech and electrical activity of the brain.

From last few years the line of research for cognitive enhancement has been shifted towards balance training as balance training is considered to directly stimulate the neuronal activity as compare to aerobic training. The previous finding also proposed that in aerobic training it is the intensity of training that improves the neuroplasticity and cognition but it is the neuro-cognitive demands and complexity of the task in balance training that affects the relationship between exercise and cognition in balance training. There is a need to determine the effect of the level of complexity of balance training on neural activity and executive functioning. Exergame augmented balance training is expected to have a better physical and cognitive outcome as compared to traditional balance training.

Eligibility Criteria:
Inclusion Criteria:

* Age ≥ 55
* MoCA =20-24
* CDR ( dementia rating scale)≤ 1.0
* No unstable disease precluding planned exercise.
* Able to see and hear sufficiently to participate in planned physical and computer-based cognitive training.
* Patients score \>45 on Berg Balance Scale.

Exclusion Criteria:

* Participation in any cognitive training activity
* Participation in \> 150 min/wk of moderate or greater intensity planned exercise of any kind.
* Non-ambulatory or major mobility disorder.
* Other neurological conditions associated with cognitive impairment such as stroke, Parkinson disease, and head injury
* Any clinically significant psychiatric condition, current drug or alcohol abuse, or laboratory abnormality that would interfere with the ability to participate in the study.
* Individual with any musculoskeletal impairment.
* Unwillingness to participate.
High Intensity Interval Versus Continuous Moderate Intensity Training: Maximizing the Benefits of Exercise in Overweight Adolescents

6-week, single site, two parallel arm, randomized, controlled trial comparing the effectiveness of a High Intensity Interval Training (HIIT) versus a continuous Moderate Intensity Training (MIT) program on cardiovascular and metabolic health outcomes in overweight adolescent males. HIIT training may be a potent time-efficient strategy to induce similar metabolic and cardiovascular adaptations typically associated with MIT.


Eligibility Criteria:
Inclusion Criteria:

* Ages 17-22
* Men
* BMI (25.0 - 35.0 kg/m2)
* Interested in improving health and fitness

Exclusion Criteria:

* Weight loss or gain of \>10% of body weight in the past 6 months for any reason.
* Currently taking medication that suppresses or stimulates appetite.
* History of prior surgical procedure for weight control or liposuction.
* Current smoker.

Any major disease, including:

* Active cancer or cancer requiring treatment in the past 2 years (except nonmelanoma skin cancer).
* Active or chronic infections, including self-reported HIV positivity and active tuberculosis.
* Diagnosed heart conditions.
* Uncontrolled hypertension: systolic blood pressure 160 mm Hg or diastolic blood pressure 95 mm Hg on treatment.
* Gastrointestinal disease, including self-reported chronic hepatitis or cirrhosis, any episode of alcoholic hepatitis or alcoholic pancreatitis within past year, inflammatory bowel disease requiring treatment in the past year, recent or significant abdominal surgery (e.g., gastrectomy).
* Asthma.
* Diagnosed diabetes (type 1 or 2), fasting impaired glucose tolerance (blood glucose 118 mg/dL), or use of any anti-diabetic medications.

  * Conditions or behaviors likely to effect the conduct of the trial: unable or unwilling to give informed consent; unable to communicate with the pertinent clinic staff; unwilling to accept treatment assignment by randomization; current or anticipated participation in another intervention research project that would interfere with the intervention offered in the trial; likely to move away from participating clinics before trial completed; unable to walk 0.25 mile in 10 minutes.
  * Currently taking antidepressant, steroid, or thyroid medication, unless dosage is stable (no change for 6 months).
  * Any active use of illegal or illicit drugs.
  * Excessive alcohol intake defined as an average consumption of 3 or more alcohol containing beverages daily.
  * Unwilling to limit alcohol intake to ≤2 drink per day (one drink = 4 oz. wine, 12 oz. beer, or ½ shot of liquor).
  * Current exerciser (\>30 min organized exercise per week).
  * Indication of unsuitability of current health for exercise protocol (PARQ).
  * Any other conditions which, in opinion of the investigators, would adversely affect the conduct of the trial.
Effect of Probiotics on the Preterm Delivery Rate in Pregnant Women at High Risk for Preterm Birth

Preterm birth (PB) continues to be the main cause of perinatal morbidity and mortality, with emotional and economic consequences. Despite improvements in health, PB prevalence remains stable, possibly due to complex causes such as maternal age, stress, multiparity, etc. Shortening of the uterine cervix in early stages of gestation is a risk factor for PB. The presence of abnormal vaginal microbiota in the early stages of pregnancy is als a risk factor for PB. However, no studies have analysed the impact of probiotics (live microorganisms which, in adequate amounts, confer a health benefit on the host) on the PB in high-risk PB patients (pregnant women with threatened preterm delivery, i.e., uterine contractions and cervical shortening, with a 30% PB risk before 34 weeks, and 50% PB prior to 37 weeks (\> 6-10% PB). Similarly, the effect of probiotics on vaginal flora dominated by lactic acid-producing bacteria could be analysed.

Hypothesis

* Pregnant women with threatened preterm labour (TPL) will present vaginal microbiome different from those without TPL.
* Treatment with probiotics will modify the vaginal microbioma of pregnant women with TPL.
* The PB rate before 37 weeks in pregnant women with TPL who have received probiotics since their diagnosis will be reduced by at least 30%.

Goals

* To correlate the use of probiotics of pregnant women with TPL with the PB rate before 37 weeks.
* To ascertain the PB rate before 28, 30, 32 and 34 weeks in both groups.
* To assess neonatal morbidity between both groups.

Methods

Prospective, randomised, longitudinal, prospective, double-blind study.

Relevance

This study will determine whether the use of probiotics in pregnant women with TPL is associated with a lower risk of PB before 37 weeks. If so, it would allow us to act on the tertiary prevention of PB and treatment of TPL, the main cause of perinatal morbidity and mortality in our setting. It will also facilitate understanding of the pathophysiology of PB, influence of vaginal microbiota and the mechanism of action of probiotics.

Eligibility Criteria:
Inclusion criteria

* Threatened preterm labour: regular clinical and cardiotography-registered uterine dynamics, and cervical modifications (cervical shortening ≤ 25 mm between 24 and 29 weeks, and ≤ 15 mm between 30 and 34 weeks) according to our care protocol.
* Single gestation.
* Echographically-normal foetal morphology.
* Minimum age 18 years.
* Ability to understand informed consent.
* Signed informed consent.

Exclusion criteria

* Multiple gestations.
* Pregnant women with diagnosis of chorioamnionitis.
* Cervical dilation.
Decompression Versus Heat and Decompression in Knee OA

a randomized controlled trial tends to compare the effects of adding superficial heating during the application of knee decompression session to the results of decompression alone without heating.

Osteoarthritis (OA) is a progressive multifactorial joint disease characterized by chronic pain and functional disability due to the degeneration of the articular cartilage. The knee joint is the most vulnerable joint in the human body and occupies four-fifths of the burden of OA worldwide. Subjects having KOA demonstrate deferent clinical and radiological characteristics such as narrowed joint space, osteophytes around the articular surface, subchondral sclerosis, pain, limited range of motion (ROM), and declined functional status.

Except for the arthroplasty for the severely arthritic knee joint, there is no cure for the degeneration of joint cartilage. Medications, exercises, and physical agents can be used to address the associated pain, muscular tightness, weakness, and physical disability.

Interestingly, previous efforts that applied traction (decompression) on the arthritic knee joint demonstrated favorable results even on the thickness of the articular cartilage. However, these methods were mainly invasive surgical procedures that encountered disadvantages like the risk of infection and prolonged bedridden that might affect the general health of the patients

Eligibility Criteria:
Inclusion Criteria:

* Both sexes
* age between 45 to 60 years.
* Normal and or overweight categories of BMI 19-30 kg/m2
* Unilateral (grade 2 and 3) knee OA according to the Kellgren-Lawrence radiological rating scale

Exclusion Criteria:

* lower limb deformities as genu varum, valgus, flat foot
* leg length discrepancy
* previous trauma and or surgery to the knee joint
* Bone disease
* Inability to refrain from analgesic/anti-inflammatory medications for 6 weeks
Comparison of Different Neural Blockade Techniques in Postoperative Analgesia After Total Hip Arthroplasty

To compare the different analgesic protocols for patients receiving total hip arthroplasty(THA). Patients will divided into 3 groups, which are 1. fascia iliaca compartment block with IV-PCA(patient controlled analgesia), 2. femoral nerve and lateral femoral cutaneous nerve block with IV-PCA, 3. IV-PCA only.

90 patients will be enrolled and randomized to the 3 different groups.

1. Inclusion criteria:

   Patient undergoing THA: 20-75 years old, ASA I-III, general anesthesia with intubation, fentanyl IV PCA.
2. Exclusion criteria Alcohol/substance abuse Rheumatoid arthritis Severe coagulation disorder(PLT\<80000 or INR \> 1.5) Peripheral neuropathy Allergy to opioids or local anesthetics BMI\>35
3. The outcome followers are blinded to the intervention provided.
4. Outcome parameters:

   1. Opioid consumption of IV PCA in first 24 hrs.
   2. NSAID consumption
   3. NRS of pain, the timings of follow-up should be: pre-block, 30

      mins post-block, 60 mins post-block, 2 hours post-block, 24hours post-block
   4. sensory block in FN, Obturator Nerve and LFCN
   5. First request of supplemental IV analgesia

Eligibility Criteria:
Inclusion Criteria:

* ASA I-III, general anesthesia with intubation.
* fentanyl IV PCA

Exclusion Criteria:

* Alcohol/substance abuse
* Rheumatoid arthritis
* Severe coagulation disorder(PLT\<80000 or INR \> 1.5)
* Peripheral neuropathy
* Allergy to opioids or local anesthetics
* BMI\>35
Evaluation of Two Surgical Scopinaro Techniques in the Treatment of Obesity

The purpose of this study is to show that the modified technique Scopinaro surgery allows a better control or reduction of complications often found in nutritional pancreatic and biliary derivations, starting from the assumption of a modified technique is as effective as Scopinaro classical technique for reducing overweight and control of comorbidities in obese patients with grade II and III.

28 participants Will be recruited and will be divided into 2 groups of 14 subjects each one. One group will receive the Classic Scopinaro surgery and the other, Modified Scopinaro Surgery. In Scopinaro Surgery Modified will be held with laparotomy and median opening in layers. It will also be performed at the manufacturing drifting pancreatic and biliary derivations, Roux-en-Y, dividing the small stomach.A communication portal to be implemented and calibrated through a nasogastric tube of 10mm where a retaining ring is placed horizontal gastroplasty, in order to avoid an expansion of this communication.

In the Classical Scopinaro surgery will be done the same procedures of Scopinaro Modified surgery , but the gastroplasty will be replaced by horizontal gastrectomy.

Eligibility Criteria:
Inclusion Criteria:

* Body Mass Index (BMI) \> 35;
* Body Mass Index greater than or equal to 40;
* Be indicated for bariatric surgery after other attempts at treatment;
* If BMI \> 35 and \<40, must submit AT LEAST one of comorbidities below: Type II diabetes, dyslipidemia, hypertension, joint arthropathy in average or great, sleep apnea, hypothyroidism.

Exclusion Criteria:

* Pregnant or breastfeeding
* Had undergone bariatric surgery before.
* Diagnostic of psychiatric disorders, according to the evaluation of especialist.
* Be user of illegal drugs or alcohol abuse.
* Be severe disease carrier, according to an evaluation specialist.
* Have severe lung disease or liver cirrhosis, according to the evaluation of especialist.
* Being active virus carrier - HIV.
* Has any condition that prevents surgery
Effect of Optimized PEEP on Mechanical Ventilation During Robot Assisted Laparoscopic Prostatectomy

Steep trendelenburg posture or pneumoperitoneum for surgery causes ventilation problems during surgery, so finding a way to overcome is a challenging task for anesthesiologists. In this study, for patients undergoing robot assisted laparoscopic prostatectomy under general anesthesia, anesthesia is going to perform by applying conventional positive end-expiratory pressure (PEEP 5cmH2O) or individually determined positive end-expiratory pressure values for each patient using electrical impedance tomography. We plan to compare intraoperative ventilation through arterial blood gas analysis to find out the way to improve intraoperative ventilation.


Eligibility Criteria:
Inclusion Criteria:

1. 20 - 70 years of age who are scheduled for robotic assisted laparoscopic prostatectomy at the Department of Urology, Gangnam Severance Hospital,
2. ASA-PS (American Society of Anesthesiology Body Rating) I-IlI,
3. Patients with a BMI of 35 kg/m2 or less

Exclusion Criteria:

1. Patients with lung disease
2. BMI \>35kg/m2
3. Patients for whom positive end-tidal pressure cannot be applied (large bullae, severe cardiac disease)
4. patient refusal