Kornimate/medical-research-clean huggingface dataset:
trends in the epidemiology and treatment of atopic dermatitis in the united kingdom (uk)

Conditions: Atopic Dermatitis Eczema; Atopic Dermatitis; Eczema

Summary: atopic dermatitis (ad), commonly called eczema, is one of the most frequently occurring skin conditions. it is estimated to affect around one fifth of children in developed countries and is also becoming increasingly common in less developed countries. exact estimates of how common eczema is, vary considerably and there has not been an in-depth analysis of the number of people with eczema in the uk. it is also unclear which groups of people are most affected and which treatment options are being used. most people with eczema are managed by their general practitioner (gp) with only a few people requiring specialist care. gp records therefore provide an excellent opportunity to explore how common eczema is and which treatments are being used currently.

objective the study aims to describe the health care resource utilisation of patients with active ad in terms of prescription use, primary care appointments, and specialist referrals. method this study will define ad cases using a previously validated algorithm for case identification use clinical codes form primary care in the uk (read codes). the study will analyse a cohort of prevalent active ad cases over a one year period (2018). the annual use of topical and oral medications used for the treatment of ad, primary care appointments, and specialist referrals will be reported.

Eligibility criteria:
inclusion criteria: * all paediatric and adult patients registered with an royal college of general practitioners (rcgp) research and surveillance centre (rsc) contributing gp practice during the study period (2008-2018) and with at least one year of follow-up. exclusion criteria: * the presence of psoriasis, photodermatitis, or ichthyosis
the significance of release of t-follicular helper and t-follicular regulatory cells in autoimmune haemolytic anemia before and after tratment

Conditions: Autoimmune Hemolytic Anemia

Summary: we study the circulating t-follicular regulatory and t-follicular regulatory cells in autoimmune hemolytic anemia.

autoimmune hemolytic anemia (aiha) is an acquired autoimmune disease resulting in the production of antibodies directed against the patient's red blood cells (rbcs) causing shortened erythrocyte lifespan. the main pathogensis of the disease is autoantibodies (ab) that directed against erythrocytes, with or without complement (c) activation. the most common form of aiha is warm aiha characterized by the presence of warm-type autoantibodies-immunoglobulin g (igg) which reacts optimally at 37 °c, causing rbc extravascular destruction by tissue macrophages . previous studies of the etiology and pathogenesis of aiha have focused on the autoreactive b cells that have escaped tolerance mechanisms and regulatory t cells (treg). the main treatment of aiha includes rbc transfusion and immune system inhibitors such as corticosteroids. during an immune response, cd4 th cells can differentiate into several unique effector lineages that promote different immune responses via the secretion of distinct types of cytokines. t follicular helper (tfh) cells are a cd4 t cell lineage whose major function is to help b cells form germinal centers (gcs) and produce high-affinity antibodies(6). tfh cells are characterized by expression of the cxcr5, the transcriptional repressor b cell lymphoma 6 (bcl-6), programmed death 1 (pd-1), and inducible costimulator (icos). follicular regulatory t (tfr) cells are a newly identified subset of treg cells that coexpress markers of both treg cells and tfh cells. in addition to expressing tfh-related markers, tfr cells also express regulatory markers, such as foxp3, cd25, ctla-4, il-10, and transforming growth factor β (tgfβ). tfr cells represent a highly specialized subpopulation of foxp3+ tregs that co-express tfhfeatures, such as bcl-6, cxcr5, icos, pd-1 and treg features cd25 and foxp3. tfr cells have the ability to inhibit tfh activation and cytokines production and suppress b cell gl7 and b7-1 expression and limited class switch recombination occurring in the gc via high expression of cytotoxic t-lymphocyte-associated protein 4 (ctla-4) and production of inhibitory cytokine- interleukin 10 (il-10) and transforming growth factorβ (tgfβ)(5). the involvement of tfr cells in the pathogenesis of human autoimmune diseases remains speculative, but an alteration of the tfr:tfh ratio is observed in the blood of patients suffering from several autoimmune diseases, such as child immune thrombocytopenia, and rheumatoid arthritis.

Eligibility criteria:
inclusion criteria: * patients diagnosed as autoimmune hemolytic anemia, primary or secondary, male or female, any age but not on treatment exclusion criteria: * pregnancy or breast-feeding women * patients treated with corticoids or immunosuppressant. * patients with hematological malignance. * patients with alloimmune hemolytic anemia as abo incompatibility or transplant patients
metformin treatment, renal function and lactic acidosis

Conditions: Type 2 Diabetes Mellitus

Summary: from a central registry at the national board of health and welfare in sweden collect all patients in the city of malmö prescribed metformin during two years. glomerular filtration rate (egfr) was estimated from the ckd-epi formula (n=5408) and compared to a control material (n=2815) from the same town. all cases of severe lactic acidosis rendering icu admission were also sought. the study hypothesis is that metformin is prescribed to patients with lower gfr than anticipated with very few cases of lactic acidosis registered.


Eligibility criteria:
inclusion criteria: * patients in the city of malmö prescribed metformin at least three times during two years * available at least one p-creatinine during the two years exclusion criteria:

Keywords: metformin type 2 diabetes e-gfr creatinine lactic acidosis
clinical study of biokinetic model of iodine-131 in total(near) thyroidectomy patients.

Conditions: Thyroidectomy

Summary: thyroid cancer patients who have undergone total thyroidectomy, postoperative iodine 131 treatment to ablation residual thyroid tissue, is the current clinical practice. the effective half-life of the iodine 131 in the human body and in vivo exposure dose can be assessed by the in vivo kinetic model published by icrp, but this model is based on standard healthy people and can not be corrected for patients undergoing total thyroidectomy. in this study, the investigators will use the actual clinical data to revise the biokinetic model of iodine-131 in patients with total thyroidectomy.

methods patients:all patients undergoing thyroidectomy and are about to be treated with iodine 131 30mci will be invited to join the study. exclusion with gastrointestinal surgery. preparation:the patient of this study, their medication and diet and other matters needing attention, are in accordance with the original to accept iodine -131 30mci treatment of the standard treatment. imaging protocol:after oral administration of iodine 131, patients must undergo whole body scan, for 1 hour, 4 hours, 24 hours, 48 hours, 72 hours, 168 hours, respectively. image collection will use ge infinia hawkeye 4 spect / ct with high energy general purpose collimator. the imaging parameters use the original i-131 whole body scan protocol. expected results:image data is further analyzed by matlab software to obtain iodine 131 in the body of individual organs of the biological half-life and path strength percentage. this analysis can revise the iodine -131 biokinetic model of patients with total thyroidectomy, providing more accurate calculations and subsequent studies.

Eligibility criteria:
inclusion criteria: * all patients undergoing thyroidectomy and are about to be treated with iodine 131 30mci will be invited to join the study. exclusion criteria: * exclusion with gastrointestinal surgery.

Keywords: thyroid thyroidectomy iodine biokinetic ablation
blue enriched versus standard light treatment for seasonal affective disorder(sad)

Conditions: Seasonal Affective Disorder

Summary: one of the most frequently investigated hypothesis of the pathophysiology underlying seasonal affective disorder(sad) or so called winterdepression is a disturbance of circadian rhythms. since the circadian system is especially sensitive for the blue portion of the light spectrum, a new light therapy device with more blue light (blue enriched polychromatic light) was tested for its efficacy to treat sad. in chronobiological terms this light is hypothesized to be more potent in inducing non-visual effects. in the present study fluorescent tubes that emit a high portion of short wavelength light on top of the normal wavelengths are tested for its superiority in treating sad. this blue-enriched light (colour temperature 17000 ºk) is compared to standard light treatment (5000 º k) in sad patients., the investigators hypothesise that blue- enriched light improve the therapeutic effects of light treatment leading to a higher response or the same response in a shorter time schedule compared to standard light treatment.


Eligibility criteria:
inclusion criteria: * age 18-65; * diagnosis of seasonal affective disorder, winter type according to dsm-iv; * sigh sad rating higher then or equal to 18 on day 1; * no other treatments for mood disorder during the study * stay in the netherlands during the study exclusion criteria: * other axis 1 disorder according to dsm-iv * acute suicide risk * use of psychotropic drugs or photosensitizing drugs * eye diseases other then usual effect of aging * diabetes or epilepsy * regular shift work

Keywords: seasonal affective disorder phototherapy circadian rhythms blue enriched light melanopsin primary disease: seasonal affective disorder, winter type
a study on the effectiveness of wechat-based online education to reduce perioperative anxiety in breast cancer patients

Conditions: Breast Cancer Female

Summary: patients who meet the enrollment criteria will be randomly assigned to the wechat education group and the regular group. in addition to the regular preoperative visits, the wechat education group will also watch science videos through wechat before the surgical procedures. the regular group only received regular preoperative visits and education by ward nurses. the main observation indicator is the incidence of preoperative anxiety defined as the scores of state anxiety inventory more than 40 points.

patients who meet the inclusion criteria will be randomly assigned to the wechat online education group or the regular group. two researchers will conduct preoperative education, preoperative evaluation and postoperative follow-up respectively.the patients in wechat group will be first assessed by a researcher on admission about anxiety and sleep (base on the state-trait anxiety inventory (stai) scale and the sleep quality scale (sqs)). once the assessment completed, the patients are required to follow the wechat public platform to watch the education videos when they are free. the content of the videos is jointly decided by the breast surgeon, anesthetists, and ward nurse including the overall prognosis, surgical approach, postoperative rehabilitation exercises, preparation for anesthesia, anesthesia approach and possible effects of anesthesia, which covers all aspects of surgery, anesthesia, and perioperative care. the videos are presented in an easy-to-understand pattern to ensure participants of all ages and levels of education comfortably understand the content. participants can simply click on the video dialogue box in the public platform for playback and watch it unconditionally.patients in regular group will be also assessed by the same researcher on admission for anxiety and sleep (base on state-trait anxiety inventory (stai) scale; sleep quality scale (sqs) scale). upon completion of the assessment, they received oral instruction from the ward nurse covering the same contents as above instead of the education video.

Eligibility criteria:
inclusion criteria: * female patients scheduled for elective breast cancer resection; * aged 18 to 80 years,; * american society of anesthesiologists (asa) physical status i-iii. exclusion criteria: * patients diagnosed with primary breast cancer combined with malignant tumors of other organs (such as lung, kidney, intestine, etc.); * patients with tumor recurrence after reoperation; * patients failing to cooperate with the study for any reason, such as communication disorders.

Keywords: periperative anxiety
quality of life after stroke using a telemedicine-based stroke network

Conditions: Stroke

Summary: to study the effect of a telemedicine model of stroke care on patient-based outcomes.

approximately 750,000 patients suffer from ischemic stroke (ais) annually in the united states. ais is a a leading cause of long-term disability and the third-leading cause of mortality. effective therapies exist to ameliorate the disability associated with ais, but implementation of these therapies is time-sensitive. currently, there is a shortage in health care professionals with expertise in the treatment of stroke and such expertise tends to be concentrated in large community-based or academic medical centers. to respond to this shortage, stroke networks are being organized in a "hub-and-spoke" model to facilitate the rapid delivery of time-sensitive interventions such as intravenous (i.v.) tissue plasminogen activator (tpa) or rapid evaluation for ais. some networks are also using telemedicine to facilitate this approach and bring the needed expertise via robotic tele-presence (rtp). though the accuracy of stroke diagnosis and i.v. tpa utilization may be higher in rtp based networks, the impact of this model on patient's outcomes has been difficult to elucidate. to this end, meaningful validated outcome assessments are crucial to understand the impact of stroke interventions including telemedicine or rtp based networks. the objective of this study is to translate evidence-based practice of healthcare, patient-centered outcome assessments, and patient-family perceptions of delivery of care into meaningful data. this will aid in the validation of the role of interventions such as "hub-and-spoke" rtp based models in stroke care.

Eligibility criteria:
inclusion criteria: * patients with suspected acute ischemic stroke (ais) * age \>17 years exclusion criteria: * hemorrhagic strokes (ich or sah) * transient ischemic attacks (tia) * trauma * inability to obtain informed consent * participation in another study

Keywords: ischemic tpa tele-medicine robot tele-stroke
a study to investigate the effects of end stage renal disease and hemodialysis on the pharmacokinetics of ropinirole

Conditions: Restless Legs Syndrome

Summary: this study will investigate the effects of severe renal impairment and hemodialysis on the characteristics of the drug, ropinirole.


Eligibility criteria:
inclusion: * patients and subjects between 18-79 years old. * end stage renal patients who are consistently receiving dialysis for a minimum of 3.5 hours, three times per week, with hemodialysis blood flow rates of \>200ml/min may be eligible to enter the study. * patients must also have systolic blood pressure 100-190mmhg and diastolic blood pressure \<120mmhg. * healthy subjects must have systolic blood pressure 100-150mmhg. exclusion: * female subjects who are pregnant and/or breast-feeding must not participate in this study.

Keywords: end stage renal impairment tolerability ropinirole pharmacokinetics hemodialysis
cladribine and rituximab in treating patients with hairy cell leukemia

Conditions: Hairy Cell Leukemia; Recurrent Hairy Cell Leukemia

Summary: this phase ii trial studies the side effects and how well cladribine and rituximab work in treating patients with hairy cell leukemia. drugs used in chemotherapy, such as cladribine, work in different ways to stop the growth of cancer cells either by killing the cells, by stopping them from dividing, or by stopping them from spreading. immunotherapy with monoclonal antibodies, such as rituximab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. giving cladribine together with rituximab may kill more cancer cells.

primary objectives: i. to demonstrate the efficacy in achieving complete response of combination of cladribine administered intravenously over 2 hours for 5 days followed by rituximab weekly for 8 weeks in patients with untreated or previously treated hairy cell leukemia. ii. to examine the efficacy of rituximab to eradicate minimal residual disease (mrd) after cladribine therapy (as assessed by immunophenotyping of bone marrow and peripheral blood). iii. to examine the effect of addition of rituximab to cladribine on the long term disease-free (dfs) and overall survival (os) (as compared with historical controls). iv. to evaluate potential predictors of outcome including molecular and flow evaluations of mrd, as well as other potential molecular predictors such as v-raf murine sarcoma viral oncogene homolog b1 (braf). outline: patients receive cladribine intravenously (iv) over 2 hours once daily (qd) on days 1-5 and rituximab iv once weekly for 8 weeks beginning on day 28 in the absence of disease progression or unacceptable toxicity. after completion of study treatment, patients are followed up every 3 months for 1 year.

Eligibility criteria:
inclusion criteria: * age 18 years and older * diagnosis of hairy cell leukemia (hcl) established by bone marrow examination * patients with relapsed disease are eligible if they have had no more than one prior therapy * women of child-bearing potential must use birth control (oral contraceptive, barrier, abstinence or any other acceptable method) for the duration of the study * performance status =\< 3 * creatinine less than or equal to 2.0 unless related to the disease * bilirubin less than or equal to 3.0 * transaminases less than or equal 3 x upper limit of normal unless related to the disease * no prior investigational agent in the 4 weeks prior to initiation of therapy exclusion criteria: * unable or unwilling to sign the consent form * known infection with human immunodeficiency virus (hiv), hepatitis b or c * presence of active infection * presence of central nervous system (cns) metastases * new york heart association classification iii or iv heart disease * prior chemotherapy (last 4 weeks)
music therapy and psycho-behavioral disorders in the elderly population

Conditions: Behavioral Disorder; Music Therapy

Summary: since the 1990s, neuroscience, with functional mri, has made it possible to understand the beneficial neurophysiological effect of music on man and his brain. they have shown that music stimulates brain plasticity and contributes to the reorganization of the affected neural circuits. the concept of cerebral plasticity and cerebral symphony have thus been developed. in march 2008, the has (high authority for health) proposed in its recommendations good practices concerning the management of neurodegenerative diseases that "music therapy, aromatherapy, multisensory stimulation ... could improve certain of behavior's aspects ". music has shown that memory capacity can remain present in people with alzheimer's disease even in the advanced stages. music also improves the well-being of patients with alzheimer's or mixed dementia living in institutions and reduces the suffering of caregivers. it improves communication with others, including those who have lost the usual codes of communication and improves the quality of sleep of elderly people living in institutions. however, although musical interventions have recently gained popularity as a non-pharmacological treatment for dementia, the scientific evidence warrants further research.


Eligibility criteria:
inclusion criteria: * patients over the age of 60 present in the reinforced hospital unit during the study period * patients over 60 years hospitalized in follow-up care and rehabilitation with behavioral disorders in the context of a neurocognitive disorder exclusion criteria: * unpaired deafness * refusal to participate
chemoimmunotherapy with early central nervous system (cns) prophylaxis

Conditions: Primary Disease

Summary: the purpose is to test whether early central nervous system (cns) prophylaxis given at the beginning of therapy for young high risk diffuse large b-cell lymphoma (dlbcl) patients is feasible and could reduce the risk of cns relapses. early cns prophylaxis with two courses high dose methotrexate (hd-mtx) in combination with rituximab-cyclophosphamide-doxorubicin-vincristine-prednison (r-chop) is followed by four courses of r-chop14 and etoposide (e) and one course of hd-ara-c. in addition the patients will receive three courses of liposomal cytarabine intrathecally. the results will be compared to a recent nordic cry-04 study. shifting of cns prophylaxis to the beginning of the therapy offers a potential to overcome the subclinical disease and thus reduce the risk of early clinical cns recurrence. as flow cytometry (fcm) can improve the sensitivity for detecting occult leptomeningeal disease over cytology , fcm from cerebrospinal fluid will be incorporated into the staging procedures.


Eligibility criteria:
inclusion criteria: * age ≥ 18 - \< 65 years. histologically confirmed cd20+ diffuse large b-cell lymphoma (dlbcl) based on who 2008 lymphoma classification * follicular lymphomas (fls) grade 3b is allowed patients in at least stage ii with age adjusted international prognostic score (ipi score) of 2 or 3: * stage iii /iv and elevated ldh * stage iii/iv and who performance status 2 - 3 * stage ii and elevated ldh and who performance status 2 - 3 and/or patients with * more than one extranodal site * testicular lymphoma, stage iie and higher * paranasal sinus and orbital lymphoma with destruction of bone * large cell infiltration of the bone marrow exclusion criteria: * severe cardiac disease: cardiac function grade 3-4 * impaired liver, renal or other organ function not caused by lymphoma, which will interfere with the treatment schedule * pregnancy/lactation * men and women of reproductive potential not agreeing to use an acceptable method of birth control during treatment and for six months after completion of treatment * patients with other severe medical problems and with an expected short survival for non-lymphoma reasons * known hiv positivity * uncontrolled infectious disease, including meningeal infection * active cancer except basal cell carcinoma and cervical carcinoma in situ during the last five years * earlier treatment containing anthracyclins * psychiatric or mental disorder which make the patient unable to give an informed consent and/or adhere to the protocol * cns disease as diagnosed by mri or cerebrospinal fluid (csf) cytology. positive csf flow cytometry below diagnostic threshold level by cytology is allowed * pleural or peritoneal fluid that cannot be drained safely * hypersensitivity to the active substance or any of the other ingredients * patients participating in other clinical studies, unless followed for survival

Keywords: dlbcl fl grade 3b high risk cns prophylaxis chemoimmunotherapy