Kornimate/medical-research-clean huggingface dataset:
ct scan using iv contrast alone for pediatric appendicitis

Conditions: Appendicitis; Child; Contrast Media

Summary: computed tomography (ct) scan using intravenous contrast (ct iv) as the sole type of contrast material, was studied as one method of evaluating children with suspected appendicitis. we felt that this technique could provide physicians with a faster and better-tolerated alternative to ct imaging which involves patients drinking oral contrast or needing rectal contrast administered. specific aims 1. to test an imaging protocol using ct iv for the evaluation of suspected appendicitis in children in the setting of a pediatric emergency department (ed). 2. to determine test performance characteristics (specificity, sensitivity and diagnostic accuracy) of ct iv in detecting appendicitis in children.

this was to be a prospective cohort study imaging pediatric patients (3-18 years old) in whom the diagnosis of appendicitis was suspected, but not clinically apparent. patients that were to have a ct performed would be invited to participate and if enrolled, would be imaged using ct scan with iv contrast alone. ct scans would be interpreted in real time by a resident radiologist and/or an attending radiologist. ed evaluation would remain unchanged and patient disposition would be based on the discretion of the ed provider using all information (patient exam, labs, surgical consultation as needed and the results of the ct scan). ct scan performance would be determined by comparison of the ct interpretation with patient final outcomes as determined by either (1) pathology reports - in patients that went on to have surgery (appendectomy) or (2) clinical phone follow up at 24 hrs and then 1 week after ed discharge. performance of ct would be compared between the resident and the attending radiologists. further, we would compare the time to obtain a ct scan (defined as ed triage time - time to ct) between our study cohort and a retrospective cohort of patients who had received ct scan in the ed for evaluation of appendicitis pre-study (ct using both iv and oral contrast).

Eligibility criteria:
inclusion criteria: * age 3- 18 years * signs/symptoms for \< 72 hours * ct scan requested for evaluation by attending or fellow exclusion criteria: * clinically apparent appendicitis * pregnancy * sickle cell disease * known contrast allergy * previous enrollment * signs/symptoms for \> 72 hrs * known abdominal disease (e.g. crohn's) * exam unreliable (neurologically impaired patient)

Keywords: appendicitis computed tomography pediatric child sensitivity specificity contrast administration route time factors
trial of oral karenitecin in patients with solid tumors and lung cancer

Conditions: Carcinoma; Carcinoma, Non-Small-Cell Lung

Summary: the purpose of this study is to determine the maximum safe dose of orally administered karenitecin (bnp1350) in patients with solid tumors.

initially, the safety, side effects and recommended phase 2 dose of oral karenitecin in patients with advanced solid tumors will be determined. when the recommended phase 2 dose has been determined, the specified dose will be used to determine if karenitecin is effective in the treatment of patients with relapsed or refractory non-small cell lung cancer.

Eligibility criteria:
inclusion criteria * patients entering the phase 1 portion of the study must have a histologically or cytologically documented diagnosis of cancer (solid tumors) refractory to conventional therapeutic modalities or for which no conventional treatment exists. * patients entering the phase 2 portion of the study must have a histologically or cytologically documented diagnosis of advanced (stage iiib/iv) nsclc. * patients entering the phase 1 portion of the study can have either measurable or evaluable disease. * patients entering the phase 2 portion of the study must have measurable disease meeting recist criteria. * patients must have an ecog performance status of less than or equal to 1. * more than 2 weeks must have elapsed since previous chemotherapy and 6 weeks from previous treatment with nitrosoureas or mitomycin-c. * patients must have fully recovered from the toxic effects of prior therapy. * patients entering the phase 1 portion of the study may have received up to two prior chemotherapy programs including adjuvant or neoadjuvant therapy. * patients entering the phase 2 portion of the study may have received only one prior chemotherapy program including adjuvant or neoadjuvant therapy for nsclc. * more than 2 weeks must have elapsed since previous radiation therapy and prior radiation must be less than or equal to 15% of the bone marrow. * required initial laboratory data: \*anc ≥ 1,500/mm3, \*platelet count ≥ 100,000/mm3, \*sgpt \< 1.5 times uln, \*alkaline phosphatase \< 2.0 times uln, \*bilirubin \< 1.5 mg/dl, \*serum creatinine \< 1.5 times uln exclusion criteria: * pregnant or lactating women. * uncontrolled high blood pressure, uncontrolled diabetes mellitus, unstable angina, symptomatic congestive heart failure (chf), myocardial infarction (mi) within 6 months, or uncontrolled arrhythmia. * phase 2 no previous or concurrent malignancy * central nervous system (cns) metastasis if neurologically unstable or requiring steroid use. * active infection. * known positive hiv status. * conditions requiring use of h2 blockers or other antacids. * inability to provide informed consent.

Keywords: carcinoma, non-small-cell lung solid tumors oral
airway injuries after intubation using videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation

Conditions: Airway Trauma; Airway Complication of Anesthesia

Summary: abstract background successful tracheal intubation during general anesthesia requires a direct laryngoscope to retract the tongue and soft tissues of the mouth to achieve a line of sight for the larynx. generally, macintosh blade laryngoscopy is used to achieve the tracheal intubation. however, difficulties with the tracheal intubation arise the need to use alternative laryngoscopes that use digital or fiberoptic technology, to improve the larynx visibility. among these devices, highly curved blade videolaryngoscope uses a curved blade to retract the soft tissues of floor of the mouth and transmits a video image to a screen, achieving better larynx visibility. also, the decrease of the force in the soft tissues with videolaryngoscope could reduce airway injures. objectives our primary objective is to assess whether use of videolaryngoscopy using highly curved blades for tracheal intubation in adults requiring general anesthesia reduces risk of airways injuries compared with macintosh direct laryngoscopy. our secondary aim is to assess postoperative satisfaction of the patients, successful intubation at the first attempt, successful global intubation, degree of larynx visibility according to classification cormack - lehane and time taken to perform intubation in videolaryngoscopy vs direct laryngoscopy. finally, we assess the risk of presenting serious adverse event with the use of videolaryngoscopy compared with macintosh laryngoscopy in hypoxemia, bradycardia and heart arrest.


Eligibility criteria:
inclusion criteria: * over 18 years of age. * scheduled for a procedure or surgery that requires general anesthesia that requires orotracheal intubation. * scheduled for non-cardiac surgery. * elective surgery. exclusion criteria: * women in pregnancy. * patient refuses to participate in the study before surgery. * patients with predictors of anticipated difficult airway. * head and neck surgery. * go to intensive care unit with endotracheal intubation.

Keywords: video laryngoscopy airway injury direct laryngoscopy intubation endotracheal
single-dose nicotine pharmacokinetics with a new oral nicotine replacement product

Conditions: Tobacco Dependence

Summary: a comparison of three products for oral nicotine replacement with respect to pharmacokinetics after single-dose of nicotine.

this study compares a new oral nicotine replacement therapy (nrt) product with niquitin™ lozenge 4 mg and nicorette®gum 4 mg, after 12 hours of nicotine abstinence, with respect to nicotine pharmacokinetics, during 12 hours after start of administration. single doses of each treatment are given once in the morning during five separate treatment visits scheduled in a crossover setting with randomized treatment sequences. the study will include 45 healthy smokers between 18-50 years, who have been smoking at least 15 cigarettes daily during at least one year preceding inclusion. subjects and study personnel will be aware of which treatment is administered at a given visit.

Eligibility criteria:
inclusion criteria: * healthy smokers, smoking at least 15 cigarettes daily during at least one year preceding inclusion and bmi between 17.5 and 30.0 kg/m2. * female participants of child-bearing potential are required to use a medically acceptable means of birth control. * a personally signed and dated informed consent document, indicating that the subject has been informed of all pertinent aspects of the study. exclusion criteria: * pregnancy, lactation or intended pregnancy. * treatment with an investigational product or donation or loss of blood within 3 months preceding the first dose of study medication.

Keywords: smoking cessation nicotine pharmacokinetics
simvastatin with or without ezetimibe and atherothrombotic biomarker assessment

Conditions: Metabolic Syndrome

Summary: to determine whether the combination of ezetimibe and simvastatin improves biomarkers of atherothrombosis compared to simvastatin alone in patients with the metabolic syndrome.

1. to assess the ex vivo effects of ezetimibe/simvastatin (e/s) (vytorin 10/40mg) and simvastatin (s) (zocor 40mg) on platelet and inflammation biomarkers in patients with documented metabolic syndrome. 2. to compare platelet-related effects including par-1 receptor inhibition of e/s with those of the established anti-platelet agents including aspirin, clopidogrel, intravenous and oral glycoprotein iib/iiia inhibitors. 3. to determine whether the addition of ezetimibe will yield extra protection beyond lipid modulation in the reduction of inflammation and platelet activation.

Eligibility criteria:
inclusion criteria: 1. men and women greater than or equal to 21 years of age 2. diagnosis of metabolic syndrome. we defined the presence of metabolic syndrome based on the us national cholesterol education program's adult treatment panel iii guidelines. specifically, metabolic syndrome will be diagnosed and documented when 3 of the following 5 characteristics will be present: * abdominal obesity, given as waist circumference for men \> 102 cm, and for women \> 88 cm * triglycerides \> 150 mg/dl * hdl cholesterol \< 40 mg/dl for men, and \< 50 mg/dl for women * blood pressure \> 130/85 mm hg * fasting glucose \> 100 mg/dl exclusion criteria: 1. patients will be excluded for a history of bleeding diathesis 2. drug or alcohol abuse 3. prothrombin time greater than 1.5 times control 4. platelet count \< 100,000/mm3 5. hematocrit \< 25% 6. creatinine \> 4.0 mg/dl 7. surgery or angioplasty performed within 3 months or planned for the future 8. history of gastrointestinal or other bleeding 9. history of drug-induced disorders 10. trauma, cancer, rheumatic diseases, coronary artery disease or stroke 11. patients participating in other investigational drug trials within one month of completion will be also excluded 12. patients treated with intravenous platelet glycoprotein iib/iiia inhibitors or thienopyridines, within past 6 months 13. patients treated with statins or aspirin within past four weeks

Keywords: triglycerides hypertension low hdl obesity
corneal endothelial changes associated with phacoemulsification in diabetes mellitus type ii

Conditions: Diabetes; Cataract

Summary: some studies indicated that the diabetic corneal endothelium is morphologically abnormal and may be at risk in any intraocular surgical procedure, while others showed no significant differences between diabetic and non-diabetic corneal endothelium.the purpose of this study is to investigate the differences in corneal endothelial cell density and morphology in diabetic patients and normal patients after phacoemulsification with intraocular lens implantation.to investigate if haemoglobin a1c can be used as a predictor of corneal endothelial cell changes after phacoemulsification.

some studies indicated that the diabetic corneal endothelium is morphologically abnormal and may be at risk in any intraocular surgical procedure, while others showed no significant differences between diabetic and non-diabetic corneal endothelium.the purpose of this study is to investigate the differences in corneal endothelial cell density and morphology in diabetic patients and normal patients after phacoemulsification with intraocular lens implantation.to investigate if haemoglobin a1c can be used as a predictor of corneal endothelial cell changes after phacoemulsification. specular microscopy photos will be taken pre-. and 3 month postoperatively. cellular parameters will be compared between the two groups prior and post surgery. clinical significant difference is defined as 1 sd (300 cell/mm2)

Eligibility criteria:
inclusion criteria: * cataract, diabetes exclusion criteria: * corneal disease * uveitis * previous intraocular surgery and diabetes type i

Keywords: diabetes mellitus cornea endothelium cell loss cataract surgery
anticoagulation for non-occlusive portal vein thrombosis in patients with liver cirrhosis

Conditions: Liver Cirrhosis; Portal Vein Thrombosis; Anticoagulation

Summary: the purpose of this study is to determine the safety and efficacy of anticoagulation in the treatment of non-occlusive portal vein thrombosis in patients with liver cirrhosis.

portal vein thrombosis is a common complication of liver cirrhosis, especially at the decompensated or advanced stage. the reported prevalence was 10-25% by ultrasound. the effect of pvt on the natural history of liver cirrhosis is not clear, especially the non-occlusive pvt. according to a recent large prospective study (n=1243), the development of pvt and the progression of liver disease are two separate consequences of a common mechanism. it was hypothesized that the activation of coagulation factors in the cirrhotic liver or the portal venous system is the common mechanism for the progression of liver disease, on the one hand, and the development of pvt on the other. a recent randomized clinical trial has shown that enoxaparin therapy for 48 weeks can prevent disease progression and pvt in patients with child class b-c cirrhosis. besides, emerging evidences have shown that 30-50% of patients with cirrhosis and partial pvt can achieve this spontaneous recanalization. so what the role of anticoagulation played in the management of pvt in liver cirrhosis is still contraversal. anticoagulation therapy was also shown very effective with a high recanalization rate of 42-100%. but this data was mostly derived from retrospective, non-randomized study and no well-designed randomized controlled trial has been conducted to evaluate the safety and efficacy of anticoagulation for non-occlusive pvt.

Eligibility criteria:
inclusion criteria: * informed consent was obtained * liver cirrhosis * non-occlusive portal vein thrombosis * no history of variceal bleeding or receive endoscopy or β-blocker for the prevention of patients with g3 or g2 with red marks within 3 months before enrollment * no plan for liver transplantation * age between 18 and 70 * child-pugh score ≤ 11 exclusion criteria: * acute pvt * fibrotic cord of pv * isolated splenic vein thrombosis or isolated superior mesenteric vein thrombosis * extensive superior mesenteric vein thrombosis involving the distal part * known coagulation disorder besides liver cirrhosis * hcc or other malignant tumor * patients with g2 varices with red mark or g3 but did not underwent any preventive endoscopy or β-blockers * platelet count \< 10×109/l * receive contraceptive, anticoagulation or antiplatelet drug * receiving thrombolysis treatment * receiving tips or shunting surgery * bleeding tendency * recent gastrointestinal bleeding like digestive ulcer or hemorrhagic stroke * severe portal hypertension，for example, refractory ascite or acute variceal bleeidng * spontaneous bacterial peritonitis * severe cardiovascular disorder, endocrine disorder, or mental disease * major surgery within 6 months * history of organ transplantation * pregnancy or breast-feeding * history of hiv * poor compliance
telehealth treatment for alcohol use disorder

Conditions: Alcohol Use Disorder; Alcohol Dependence; Alcoholism

Summary: participants with alcohol use disorder will be randomly assigned to either the ria treatment platform or a waitlist control. the ria treatment platform is a telehealth approach that incorporates medical assessment, medications for alcohol use disorder, individual and group coaching, educational video modules, and a bluetooth-enabled breathalyzer. patients are followed for three months during which data are collected, including measures of alcohol consumption and its consequences.


Eligibility criteria:
inclusion criteria: * alcohol use disorder exclusion criteria: * inability to provide informed consent
a study of the effect of hu3f8/gm-csf immunotherapy plus isotretinoin in patients in first remission of high-risk neuroblastoma

Conditions: Neuroblastoma

Summary: the purpose of this study is to test see the combined effects of the study drug called humanized 3f8 (hu3f8) when used with granulocyte-macrophage colony stimulating factor (gm-csf). hu3f8 plus gm-csf could prevent your neuroblastoma from growing, but it could also cause side effects.


Eligibility criteria:
inclusion criteria: * diagnosis of nb as defined by a) histopathology (confirmed by the msk department of pathology), or b) bm metastases or mibg-avid lesion(s) plus high urine catecholamine levels. * patients must have high-risk nb (mycn-amplified stage 2/3/4/4s of any age and mycn-nonamplified stage 4 in patients greater than 18 months of age). * patients must be in first cr/vgpr * patients must have a negative human anti-hu3f8 antibody (haha) titer exclusion criteria: * existing major organ dysfunction, i.e., renal., cardiac, hepatic, neurologic, pulmonary, or gastrointestinal toxicity ≥ grade 3, with the exception of hearing loss and hematologic toxicity. * active life-threatening infection. * inability to comply with protocol requirements

Keywords: hu3f8 gm-csf isotretinoin 16-1643
incentivizing buprenorphine-naloxone initiation in emergency departments

Conditions: Opioid Use

Summary: this study seeks to test standard and behavioral economic-enhanced training strategies to bolster first-time emergency department-initiated buprenorphine-naloxone administration among emergency department providers.

philadelphia is experiencing a significant opioid crisis. through this novel pilot study, critical training about opioid use disorder and medication-assisted treatment with buprenorphine-naloxone will be provided to emergency providers and changes in clinical practice will be incentivized in order to optimize treatment engagement for patients with opioid use disorder in the emergency department. participants will be invited to participate in a brief in-person training session, will receive a pre- and post-session knowledge and attitude assessment, and will be invited to self-report first-time buprenorphine-naloxone emergency department administration within the 3 month study period. participants will be randomized to one of two arms: standard training arm and behavioral economic enhanced arm. the standard training arm will receive the aforementioned intervention. the behavioral economic enhanced arm will additionally receive an opt-out invitation, loss-framed incentivization, and weekly tailored text message-based reminders. endpoints of interest include retained knowledge and change in provider attitudes regarding emergency department buprenorphine-naloxone administration and treatment following training and again at 3 months, and first-time emergency department administration of buprenorphine-naloxone.

Eligibility criteria:
inclusion criteria: * residents and advanced practice providers and attending clinicians working in emergency departments in pennsylvania. exclusion criteria: -
nilotinib versus imatinib in treatment of patients with newly diagnosed chronic myeloid leukemia

Conditions: Chronic Myeloid Leukemia

Summary: nilotinib vs imatinib in patients with newly diagnosed cml-cp

study size is 100 patients in 2 arms 50 patients in nilotinib ttt 50 patients in imatinib ttt

Eligibility criteria:
inclusion criteria: * chronic phase cml not received treatment * pts with no heart disease * pts with no abnormal cholesterol level exclusion criteria: * any pts treated before with diff. treatment * pts. with past history of heart problems * pts. with abnormal cholesterol level
role of photon counting ct in detecting liver metastatis from colorectal cancer

Conditions: Colorectal Cancer

Summary: colorectal cancer is the first leading cause of cancer death in men and second in women. its incidence rates also increased by 1%-2% annually in young adults (ages \<55 years). the liver is the most common site of colorectal cancer metastasis, with approximately 25% 50% of patients developing liver metastases during the disease. maximising resection of liver metastasis using all available techniques remains a key objective and provides the best chance of long-term survival and cure. for unresectable patients, optimal systemic and locoregional chemotherapeutic, biological and radiotherapeutic treatments improve survival, and may convert initially unresectable patients to operability. computed tomography is currently the modality of choice for patients staging and restaging for high spatial resolution providing accurate delineation of lesion, vascular structure and relation with surrounding structure. the portal venous phase (approximately 60-70 s after administration of contrast agent) is the most reliable phase for detection of liver metastasis with a detection rate of 85% with lower performance for lesion \<1 cm which are interpreted as too small to characterize. compared to computed tomography, mri has superior soft tissue contrast and the possibly of a multiparametric characterization of lesion thanks to the evaluation of diffusivity and the uptake of hepatospecific contrast media, resulting in higher accuracy also for lesion smaller than \< 10 mm. photon-counting detector computed tomography (pcd-ct), used as standard clinical practice, by employing a reduced radiation dose, allows the acquisition of ultra-high resolution images (up to 169 microns) and spectral information, with a high detection rate of liver metastases and their characterization. therefore, aim of the present study is to evaluate the value of pcd-ct in the detection of liver metastasis from colorectal cancer in comparison to mri as reference standard.


Eligibility criteria:
inclusion criteria: * adult (\>18 years) * non- biopsy-proven colon/colorectal carcinoma * ct performed on a pcd-ct * mri with multiparametric protocol and hepatospecific contrast media exclusion criteria: * pregnancy and breastfeeding * ct exam performed on a scan different from pcd-ct * absence of multiparametric mri * mri with non hepatospecific contrast agent * absent informed consent signed