Kornimate/medical-research-clean huggingface dataset:
multimodal magnetic resonance imaging in evaluation of diabetic kidney disease

Conditions: Diabetic Kidney Disease

Summary: the goal of this study is to investigate the value of noninvasive evaluation of multimodal magnetic resonance imaging in diagnosis and treatment of diabetic kidney disease (dkd). we aim to explore the feasibility of multimodal magnetic resonance imaging in the staging diagnosis of dkd, and establish a non-invasive method for evaluating the progression of dkd disease by combining imaging and biochemical indicators. multimodal magnetic resonance examinations will be performed on diabetic patients with different stages as well as regular follow-up during treatment, in order to investigate the relationship between imaging findings and pathophysiological changes of the kidneys.

at present, the clinical diagnosis of diabetic kidney disease (dkd) relies mainly on the detection of urine microalbumin，which is influenced by many other factors. renal biopsy is another modality to detect dkd, but it cannot be widely used in clinical practice because of its invasiveness. thus, a reproducible and reliable noninvasive method is needed for more accurate diagnosis. multimodal magnetic resonance imaging, which including but not limited to magnetic resonance elastography (mre), blood oxygen level-dependent magnetic resonance imaging (bold-mri), arterial spin labeling (asl), incoherent motion diffusion-weighted imaging (ivim-dwi), t1mapping and t2mapping, is able to provide valuable information about subtle structural and functional changes, and has shown promising potential in the diagnosis, classification and prediction of pathological and molecular features. in this clinical trial, multimodal magnetic resonance examinations will be performed on diabetic patients with different stages as well as regular follow-up during treatment, in order to investigate the relationship between imaging findings and pathophysiological changes of the kidneys. we aim to explore the feasibility of multimodal magnetic resonance imaging in the staging diagnosis of dkd and establish a non-invasive method for evaluating the progression of dkd disease by combining imaging and biochemical indicators, in order to provide reference for clinical medication. this research could be helpful for better understanding and management of dkd, and pave the way for more accurate diagnosis, improved clinical decision-making, personalized treatment approaches for dkd patients.

Eligibility criteria:
inclusion criteria: * diagnosed diabetes * no other diseases that affect renal function (such as gout, blood related diseases, primary hypertension, nephrotic syndrome, etc.), * no contraindications for magnetic resonance imaging examination exclusion criteria: * image quality does not meet the measurement requirements. * renal function damage caused by non-diabetes factors * combined with other important organ dysfunction * combined with malignant tumor * combined with other metabolic diseases anemia

Keywords: diabetic kidney disease magnetic resonance imaging magnetic resonance elastography diabetes
open label pharmaco- magnetic resonance spectrography (mrs) study of clavulanic acid

Conditions: Cocaine Dependence, in Remission; Cocaine Abuse, in Remission; Cocaine-Related Disorders

Summary: the main purpose of this study is to determine how the study drug, clavulanic acid, affects glutamate in the brain using magnetic resonance (mr/mri) scans. in this study, subjects will receive the study drug, clavulanic acid and undergo 4 mri scans. this is being studied to determine the correct dosing of clavulanic acid, and to gather data so future studies can be done to find out if this drug is helpful in treating cocaine dependence. currently, there is no available medication treatment for cocaine dependence.


Eligibility criteria:
inclusion criteria: * meet dsm-5 criteria for cocaine use disorder, moderate to severe in early remission. * be male or female adult volunteers ages 18-65 inclusive. * if female and of childbearing potential, must have a negative pregnancy test within 48 hours of beginning the study and be willing to use acceptable contraception or be abstinent for 14 days prior to study, through the entire study and 30 days after study participation. exclusion criteria: * be unable to complete an mri scan (for full inclusion/exclusion criteria or for more information, please contact the site directly.)
bl infusion trial:beta-lactam continuous versus intermittent infusion and associated bacterial resistance and therapy outcomes in critically ill patients with severe pneumonia

Conditions: Pneumonia

Summary: the study plans to randomize a total of 240 patients infected with gram-negative bacterial pneumonia to receive beta-lactam (meropenem, cefepime, or piperacillin/tazobactam) continuous or intermittent infusion and collect baseline and regular follow-up respiratory cultures to assess the development of new resistance. the investigators will measure beta-lactam concentration to assess the impact of drug exposure on the bacterial resistance.


Eligibility criteria:
inclusion criteria: * admission to the icu with severe pneumonia (idsa/ats 2016/2019): presence of signs, symptoms and confirmatory chest imaging consistent with pneumonia (e.g. fever, cough and pulmonary infiltrate by chest radiograph) * age ≥18 years * positive respiratory culture (with or without an initial positive rapid identification test and/or gram stain) for gram-negative bacteria including, but not limited to, p. aeruginosa, k. pneumoniae, e. coli, s. marcescens, h. influenzae, enterobacter spp., m. catarrhalis, a. baumannii, achromobacter spp., p. mirabilis, and/or b. cepacia * received within the last 72 hours or will receive meropenem, cefepime, or piperacillin/tazobactam therapy exclusion criteria: * pregnancy * prisoners * allergy to the beta-lactams to be administered in this study * on renal replacement therapy at the time of randomization * baseline culture resistant to the beta-lactams in the study * covid patients enrolled in other trials
the effect of insoles on functional performance in pediatric flexible flatfoot

Conditions: Flatfoot, Flexible

Summary: flexible flatfoot is a condition that increase the load of the foot structure.with prolonged standing or walking, some children with flatfoot experience rapid discomfort or fatigue in the foot in this study, the investigators investigated the short-term effects of customized insoles on body functions and structures, and activities and participation in children with flexible flatfoot.

flexible flatfoot is a condition that involves the collapse of the medial longitudinal arch of the foot during weight-bearing stress and the restoration of the arch after the removal of body weight. flatfoot may increase the load of the foot structure, potentially interfering with normal foot function. with prolonged standing or walking, some children with flatfoot experience rapid discomfort or fatigue in the foot, pain in the plantar foot, and instability of the medial foot structure. treatment effect of corrective shoes or insoles on flexible flatfoot in children remain uncertain. in this study, the investigators investigated the short-term effects of customized insoles on body functions and structures, and activities and participation in children with flexible flatfoot. the investigators hypothesized that the short-term use of customized insoles improves the scores for measures of body functions and structures and activities and participation. the investigators hypothesized that the short-term use of customized insoles improves the scores for measures of body functions and structures and activities and participation.

Eligibility criteria:
inclusion criteria: * children presenting symptomatic flexible flatfoot only exclusion criteria: * children with a history of foot injury or surgery, foot abnormalities or a confirmed diagnosis such as neurological deficits.
home-based progressive resistance exercise to enhance physical performance of older adults with possible sarcopenia

Conditions: Sarcopenia

Summary: the overall aim of the proposed project is to improve muscle strength in older adults with possible sarcopenia by promoting home-based progressive resistance exercise. the target population for health talks is community-dwelling older adults. a three monthly home-visits and weekly phone calls will be made. a waitlist randomised controlled trial will be conducted to evaluate effectiveness, and qualitative feedback will be collected from participants. a pilot study will be conducted first.


Eligibility criteria:
the inclusion criteria are: * aged 65-89; * possible sarcopenia (defined by awgs 2019); * no cognitive impairment (abbreviated mental test score ≥8); and * no communication problems. the exclusion criteria are: * having engaged in a structured exercise programme in the past 6 months or planning to do so within the intervention period; * mobility-limiting injury of the hands or lower limbs, surgery or hospitalisation within the intervention period; * contraindications such as musculoskeletal/cardiorespiratory disorders, or any advanced diseases that inhibit them from exercising.
effect of preop nutritional status on outcomes of staged bilateral total knee arthroplasty

Conditions: Arthritis

Summary: to determine if preop nutritional status is an indicator for outcomes of bilateral staged total knee arthroplasty. the investigators expect that patients having staged bilateral total knee arthroplasty with the second procedure performed within one week of the first and have a total lymphocyte count \>1500 per cubic millimeter and serum albumin level \>35 grams per liter will have the same or less complications and shorter length of stay than those with lower lymphocyte count and albumin level.

association of malnutrition with postoperative complications after tka has been reported in the form of increased rate of periprosthetic infection, longer hospital stay, etc. reduced serum albumin and total lymphocyte count are commonly used to define malnutrition. the goal was to evaluate the impact of the nutritional status on the outcomes of primary staged bilateral tkas performed one-week apart during two separate hospitalizations. fifty consecutive patients with mean age of 67 years, mean bmi of 28.9 and 2.3 mean asa score were followed for one year. prior to the first surgery 32% had a tlc \<1500 cells/mm3 and 84% had a sa \<3.5 g/dl. before the second surgery 62% had a reduced tlc and all but one had a reduced sa. nine patients had a total of 12 perioperative blood transfusions (2 after the first surgery and 10 after the second surgery). the average length of stay was 3 days after each tka. none of the patients with the lowest tlc or sa before the first or the second stage had a revision. bilateral tkas performed seven days apart in two separate hospitalizations is a safe and practical approach for qualified patients. the postoperative course was similar after each surgery. the preoperative nutritional status defined by tlc and sa did not influence the postoperative outcomes.

Eligibility criteria:
inclusion criteria: * patient is a male or non-pregnant female over the age of 21. * patient requires a bilateral staged knee arthroplasty (within 7 days) * patient has signed and dated an irb approved consent form. * patient is able and willing to participate in the study according to the protocol for the full length of expected term of follow-up, and to follow their physician's directions. * patient has failed to respond to conservative treatment modalities. exclusion criteria: * patient's bone stock is compromised by disease or infection, which cannot provide adequate support and/or fixation to the prosthesis. * patient is a prisoner. * surgery on the second side cancelled or delayed past 7 days by patient request subject will be terminated from the study. * bmi \>35
a study of changes in fdg- and flt-pet imaging in patients with non-small cell lung cancer following treatment with erlotinib

Conditions: Non-Small Cell Lung Cancer

Summary: this is a single-arm, open-label, multicenter, international pilot study to evaluate changes that occur in 2-deoxy-2-\[18f\]fluoro-d-glucose (fdg)- and 3'-deoxy-3'-\[18f\]fluorothymidine(flt)-pet (positron emission tomography) imaging as a result of treatment with erlotinib in patients with recurrent or refractory non-small cell lung cancer (nsclc). the study will enroll approximately 30 patients at approximately 4 sites in australia and 2 sites in the united states.


Eligibility criteria:
inclusion criteria: * signed informed consent form(s) * histologically confirmed nsclc * recurrent or progressive disease after receiving at least one chemotherapy regimen for advanced or metastatic nsclc * eastern cooperative oncology group (ecog) performance status 0, 1, or 2 * age ≥ 18 years * recovery from reversible acute effects of prior anti-cancer therapy (chemotherapy, radiotherapy, or investigational treatment) to nci common toxicity criteria for adverse events (nci ctcae) grade ≤ 1 (excluding alopecia) * ability to comply with the study and follow-up procedures, including all specified imaging studies * ability to take oral medication * availability of archival diagnostic paraffin-embedded tumor tissue and willingness to provide sufficient tissue for testing for egfr levels in tumor by both immunohistochemistry (ihc) and fluorescence in situ hybridization (fish) * life expectancy ≥ 3 months * measurable disease on computed tomography (ct) * at least one detectable lesion on fdg-pet scan and/or flt-pet scan that is measurable on ct * use of an acceptable means of contraception (men and women of childbearing potential) or documentation of infertility exclusion criteria: * prior treatment with an investigational or marketed agent for the purpose of inhibiting epidermal growth factor receptor (egfr) (including, but not limited to, erlotinib and gefitinib) * chemotherapy, radiotherapy, or investigational treatment within 14 days or within 5 half-lives of the active molecules in the chemotherapy or investigational treatment, whichever is longer, prior to study entry or from which patients have not yet recovered * inability to take oral medications, disease affecting gastrointestinal absorption, or prior surgical procedure affecting gastrointestinal absorption * uncontrolled diabetes * any unstable systemic disease (including active infection, unstable angina, congestive heart failure, myocardial infarction within 1 month prior to study entry, hepatic, renal, or metabolic disease) * pregnancy or lactation * history of another malignancy in the past 2 years, unless the malignancy has been adequately treated, is currently not detectable, and is associated with a 5-year survival \> 90% * claustrophobia * any other disease, condition, physical examination finding, or clinical laboratory finding which, in the opinion of the investigator, makes the patient inappropriate for the study

Keywords: nsclc tarceva positron emission technology pet computerized tomography ct
identification of heritable cteph

Conditions: Chronic Thromboembolic Pulmonary Hypertension

Summary: some patients who have blood clots come down with a life-threatening condition known as chronic thromboembolic pulmonary hypertension (cteph), which is high blood pressure only in the arteries of the lungs. this study seeks to understand more about the genetics causes of cteph by obtaining blood samples and examining family histories.

this project proposes to identify a cohort of utah patients with cteph, and to perform a comprehensive analysis of family history and cteph risk factors in these patients, and in controls with acute pulmonary embolism (pe) and pulmonary arterial hypertension (pah). detailed family history interviews will be performed with all patients, and all enrolled patients will provide a blood sample for thrombophilia testing and for gene sequencing with the goal of identifying novel genetic variants that contribute to cteph risk.

Eligibility criteria:
inclusion criteria: * cteph cohort: 1. confirmed cteph based on having undergone pea surgery. 2. strongly suspected cteph based on right heart catheterization data showing mpap\>26 and pcwp\<15, and imaging demonstrating chronic thromboembolic disease (either ventilation/perfusion scan, ct pulmonary angiography, or conventional pulmonary angiography). * pe cohort: 1. pe diagnosed by ct pulmonary angiography or ventilation/perfusion scan within the preceding 24 months. 2. no evidence of ph at the time of enrollment (based on absence of dyspnea, exertional chest pain, or exertional presyncope on history, lack of physical exam findings of ph or right heart failure, and lack of signs of ph on objective data including echocardiography and/or right heart catheterization). 3. no evidence of chronic thromboembolic disease at the time of enrollment (based on chronic appearing thrombus on ct pulmonary angiography or conventional pulmonary angiography, or based on prior high probability ventilation/perfusion scan showing a similar pattern of perfusion defects). * pah cohort: 1. diagnosis of group 1 pah. 2. prior normal or low probability ventilation/perfusion scan. 3. no reported history of prior vte events. 4. if available, all prior evaluations for vte (including ct pulmonary angiography and doppler ultrasound exams) must also be negative. exclusion criteria: * under the age of 18
blood sample collection and health information collection from patients with invasive breast cancer and their brothers and sisters

Conditions: Breast Cancer

Summary: rationale: collecting blood samples and health information from patients with invasive breast cancer and from their brothers and sisters over time may help the study of cancer in the future. purpose: this study is collecting blood samples and health information over time from patients with invasive breast cancer and from their brothers and sisters.

objectives: * collect blood samples and medical and background information from patients with invasive breast cancer and their affected or unaffected siblings. outline: patients and their siblings undergo blood collection. they also complete medical and background questionnaires. patients and their siblings are followed annually for 5 years. projected accrual: a total of 1,000 patients and siblings will be accrued for this study.

Eligibility criteria:
disease characteristics: * meets 1 of the following criteria: * pathologically confirmed invasive breast cancer (patient) * no ductal carcinoma in situ * affected or unaffected sibling * affected sibling must have had (or currently has) breast cancer only * unaffected sibling must be female * no deceased siblings * must be a full-blood related sibling * patients receiving treatment on clinical trial ecog-e1y97 or ecog-e3y92 are not eligible patient characteristics: * not specified prior concurrent therapy: * not specified

Keywords: male breast cancer recurrent breast cancer stage ia breast cancer stage ib breast cancer stage ii breast cancer stage iiia breast cancer stage iiib breast cancer stage iiic breast cancer stage iv breast cancer
faecal analyses in spondyloarthritis therapy

Conditions: Spondyloarthropathies; Ankylosing Spondylitis

Summary: this study evaluates the intestinal microbiome and disease activity in patients with spondyloarthropathies receiving immunosuppressive therapy. patients will be analysed at two time points in reference to two predefined primary endpoints: * changes in intestinal microbiome * response to therapy the investigators want to evaluate if successful treatment of spondylarthropathy coincide with specific changes in the gut flora.

tumor necrosis factor (tnf)-inhibition is an efficient medication for the treatment of spondyloarthropathy. in a substantial number of cases however, these medications remain ineffective. at present, the scientific community has limited understanding of why some patients are resistant to this medication. the purpose of this study is to understand if the gut flora may associate with treatment response. spondyloarthropathies are associated with inflammatory bowel diseases in terms of epidemiology and molecular pathogenesis. recent studies have also associated spondyloarthropathies with intestinal dysbiosis. this study is of observational character and integrated in the routine clinical care of patients with spondyloarthropathies at the rheumatology clinic, skane university hospital, lund, sweden. study participants are asked to deliver blood and fecal sampling at two time-points together with clinical evaluation of disease activity. with an estimated inclusion of 50 patients, at least 20 responders and 20 non-responders are expected to be included and to be compared to each other. our primary goal is to investigate the association between change in intestinal microbiome and clinical response to therapy. in our secondary analyses we will investigate if intestinal microbiome and intestinal inflammation at baseline may predict response to, and adherence to, therapy in these patients. if successful treatment response of spondyloarthropathy is associated with specific alterations of the gut flora, these results may guide future studies on the impact of dysbiosis and probiotics on this disease.

Eligibility criteria:
inclusion criteria: * fulfilling the assessment of spondyloarthritis international society classification criteria for spondyloarthropathy. * about to commence treatment with tnf-inhibition exclusion criteria: * failure to understand protocol * a history of alcohol abuse * any history of diverticulitis * a history of failure to comply with prescribed medication * ongoing biological therapy
efficacy of diode laser in maturogenesis of immature teeth with necrotic pulps

Conditions: Effects of the Elements

Summary: recruited patients with immature permanent maxillary anterior teeth with non-vital pulp, and periapical radiolucency, age ranging from 8 to16 years old were randomly allocated into three groups (n=13): group i, disinfected using the triple antibiotic paste, group ii, disinfection was done using diode laser, and group iii, were disinfected using the triple antibiotic paste, diode laser was used for biostimulation. all groups were evaluated for the increase in root length and thickness and decrease in apical diameter at baseline, 3, 6, 9, and 12 months after treatment

* the investigator recruited patients who are found eligible to the criteria then randomly allocated into three groups (n=13) * group i: thirteen teeth were disinfected by triple antibiotic paste then revascularization was done using the blood clot method. * group ii: thirteen teeth were laser disinfected; revascularization was done using the the blood clot method. * group iii: thirteen teeth were disinfected by triple antibiotic paste then revascularization was done using the the blood clot method followed by diode laser bio-stimulation. * periapical x rays was taken at baseline, 3, 6, 9, and 12 months after treatment for the increase in root length and thickness, decrease in apical diameter evaluation

Eligibility criteria:
inclusion criteria: * medically free patients. * immature permanent maxillary anterior teeth. * non vital pulp. * patents age between 8-16 years. * both sexes. * restorable teeth. * no internal or external root resorption. * no horizontal or vertical root fracture * radiographic periapical radiolucency * no history of previous endodontic treatment of the tooth. exclusion criteria: * medically compromised patients * previous endodontic therapy of the affected tooth. * teeth diagnosed with vital pulp. * teeth with periodontal pocket more than 3mm deep. * teeth with caries below the bony level (non-restorable tooth). * mature teeth with complete apices.

Keywords: diode laser, revascularization, immature necrotic teeth.