Kornimate/medical-research-clean huggingface dataset:
pilot project of virologic and immunologic correlates of galt immune reconstitution following raltegravir therapy

Conditions: HIV Infections; AIDS

Summary: this research is being done to study how the immune system in the small intestine improves after taking antiretroviral (anti-hiv) medications. the main purpose is to measure the increase in the numbers of immune cells in the intestine to see if one type of hiv medication gives different results than other types of hiv medications.

while the world-wide aids epidemic continues to impact millions of individuals, effective anti-hiv medications have substantially reduced morbidity and mortality for those patients able to adhere to combination regimens. despite improved survival, durable virologic suppression, and increases in peripheral cd4+t-cell counts in patients receiving potent antiretroviral therapy (art), immune reconstitution remains incomplete as measured by a number of additional surrogate markers. perhaps critically important among areas of apparent incomplete immune recovery is the gastrointestinal-associated lymphoid tissue (galt), where cd4+t-cells repopulate very slowly, if at all. raltegravir is a new art agent from a novel class of hiv inhibitors, integrase inhibitors, that results in rapid suppression of hiv and recovery of peripheral cd4+t-cells. this project proposes to examine whether volunteers receiving raltegravir recover galt immune cells more completely than those taking comparator art.

Eligibility criteria:
inclusion criteria: * willing to sign consent form * no known gi pathology * no anticipated antiretroviral therapy adjustments or changes * males \& females between the ages of 18 \& 50 years * no active opportunistic infections (oi) or therapy for oi within 30 days of entry * can be on secondary prophylaxis with a history of aids defining illness * per standard of care requirements, all females of child-bearing potential must agree to use barrier methods to prevent pregnancy or be abstinent from activity while on study exclusion criteria: * abnormal coagulation parameters (pt \> or equal to 1.2 uln) * thrombocytopenia (platelet count \< 50,000 within 6 weeks) * contra-indications to upper endoscopy or conscious sedation * anemia (\> or equal to grade 1) * aspirin, ibuprofen, warfarin or other agents that interfere with the coagulation cascade are prohibited within 1 week of endoscopy

Keywords: hiv positive aids antiretroviral therapy gastrointestinal-associated lymphoid tissue immune reconstitution treatment experienced
evaluation of migraine management mobile app combined with electrophysiological measurements for identification of migraine attack risk and beneficial preventive actions.

Conditions: Migraine

Summary: evaluation of migraine management mobile app combined with electrophysiological measurements for identification of migraine attack risk and beneficial preventive actions.


Eligibility criteria:
inclusion criteria: * diagnosed with migraine by a neurologist. * male or female, aged 18 -50 years. * having 3-10 migraine attacks per month. * able and willing to comply with all study requirements. * having android based smartphone exclusion criteria: * diagnosed with chronic pain, neurological or psychiatric disorders. * current or past use of anti-depressants. * a user of recreational or illicit drugs or has had a recent history of drug or alcohol abuse or dependence. * history of seizures. * head injury with consciousness loss in the last three months. * diagnosed as adhd and/or use of ritalin. * hearing disorder and/or known eardrum impairment. * having migraine attacks occurring only during the menstruation.
lifevest safety and efficacy in real life settings in france

Conditions: Sudden Cardiac Death; Left Ventricular Dysfunction; Cardiac Event; Cardiac Arrythmias

Summary: this post-market study is a prospective observational study evaluating the efficacy and safety of the lifevest in real-life settings.

lifevest has obtained coverage for 4 indications: (i) implantable cardiac defibrillator (icd) removal due to cardiac device infections, (ii) a bridge to heart transplantation, (iii) in the early post-myocardial infarction period with left ventricular (lv) dysfunction (lvef \<30%), (iv) and a recent coronary revascularization with lv dysfunction (lvef \< 30%). there is no current comparator to lifevest. in france, patients at high risk for sudden cardiac arrest (scd) and waiting for heart transplant or icd are hospitalized or discharged home without any particular ecg monitoring. lifevest has been demonstrated to automatically detect and terminate rapid ventricular arrhythmias. introduction of lifevest into the current patient management would definitely improve the clinical outcomes and benefit the patients with temporary risk of scd. the use of lifevest was shown to be effective in protecting patients against scd in the united states. however, the clinical impact of using lifevest in france remains unassessed. therefore we are planning to conduct a post-market study in france to provide efficacy and safety data for the reimbursement dossier renewal before april 2017.

Eligibility criteria:
inclusion criteria: * patients receiving a lifevest prescription in clinical routine for the following indications: 1. implantable cardiac defibrillator (icd) removal due to cardiac device infections, 2. a bridge to heart transplantation, 3. in the early post-myocardial infarct (mi) period with left ventricular (lv) dysfunction (lvef \<30%), 4. a recent coronary revascularization with lv dysfunction (lvef \< 30%). * patients who have given their consent to participate. exclusion criteria: - there are no exclusion criteria for this study
an investigation of dexamethasone with different doses in the management of immune thrombocytopenia (itp)

Conditions: Immune Thrombocytopenia

Summary: the project was undertaking by qilu hospital of shandong university and other 7 well-known hospitals in china. in order to report the efficacy and safety of different dose dexamethasone in treating the immune thrombocytopenia (itp).

the investigators are undertaking a parallel group, multicentre, randomised controlled trial of 60 adults with itp from 7 medical centers in china. part of the participants are randomly selected to receive dexamethasone (given at a dose of 40mg per day for 4 consecutive days) ,the others are selected to receive dexamethasone(given at a dose of 20 mg daily for 4 days). platelet count, bleeding and other symptoms were evaluated before and after treatment. adverse events are also recorded throughout the study. in order to report the efficacy and safety of different dose dexamethasone for the treatment of adults with immune thrombocytopenia (itp).

Eligibility criteria:
inclusion criteria: 1. meet the diagnostic criteria for immune thrombocytopenia 2. untreated hospitalized patients, may be male or female, between the ages of 18 \~ 75 years 3. to show a platelet count \<30 \* 10\^9/l, and with bleeding manifestations 4. willing and able to sign written informed consent exclusion criteria: 1. received chemotherapy or anticoagulants or other drugs affecting the platelet counts within 3 months before the screening visit 2. received second-line itp-specific treatments (eg, cyclophosphamide, 6-mercaptopurine, vincristine, vinblastine, etc) within 3 months before the screening visit 3. received high-dose steroids or ivig in the 3 weeks prior to the start of the study 4. current hiv infection or hepatitis b virus or hepatitis c virus infections 5. severe medical condition (lung, hepatic or renal disorder) other than chronic itp unstable or uncontrolled disease or condition related to or impacting cardiac function (e.g., unstable angina, congestive heart failure, uncontrolled hypertension or cardiac arrhythmia) 6. female patients who are nursing or pregnant, who may be pregnant, or who contemplate pregnancy during the study period 7. have a known diagnosis of other autoimmune diseases, established in the medical history and laboratory findings with positive results for the determination of antinuclear antibodies, anti-cardiolipin antibodies, lupus anticoagulant or direct coombs test 8. patients who are deemed unsuitable for the study by the investigator

Keywords: immune thrombocytopenia dexamethasone efficacy safety
efficacy and safety of butorphanol tartrate injection for the patients with mechanical ventilation

Conditions: Analgesia; Hospital-acquired Infections

Summary: to compare the incidence of hospital-acquired infections between butorphanol and fentanyl.

butorphanol can improve inflammation and promote the recovery of pro-inflammatory/anti-inflammatory cytokine balance.however, there is still a lack of relevant clinical studies on butorphanol and fentanyl for the incidence of hospital-acquired infections in icu mechanically ventilated patients.the objective of this study was to evaluate the analgesic efficacy,safety and the incidence of nosocomial infection of butorphanol in mechanical ventilation patients between butorphanol and fentanyl.

Eligibility criteria:
inclusion criteria: * need mechanical ventilation for more than 48 hours * more than 18 years old * without hospital-acquired infection before admission to icu * volunteer to participate in this study exclusion criteria: * allergic or contraindicated to the drug * severe cardiac insufficiency, conduction block and bradycardia * recent use of analgesic, sedative and antidepressant drugs * psychiatric or neurological diseases or neurosurgery-related diseases * history of steroid cortisol and immunosuppressants * severe liver dysfunction or renal dysfunction * pregnancy * refuse to enrollment
a biomarker study for immunotherapy in advanced or locally advanced dmmr/msi-h colorectal patients

Conditions: Colorectal Cancer

Summary: dmmr/msi-h colorectal cancer patients are the dominant population of immunotherapy/neoadjuvant immunotherapy, but imaging evaluation of immunotherapy efficacy is insufficient. there are some cases, although no disease remission was found on imaging,pathological complete response (pcr) was confirmed after surgery. meanwhile,previous studies have shown that dynamic changes in ctdna can help assess immunotherapy efficacy. therefore, we propose to conduct a multicenter, prospective, observational clinical study to explore the efficacy prediction and monitoring value of ctdna in immunotherapy for advanced or locally advanced dmmr/msi-h colorectal cancer.


Eligibility criteria:
inclusion criteria: - advanced or locally advanced dmmr/msi-h colorectal cancer expected to receive/be receiving immune checkpoint inhibitor therapy ecog performance score is 0-1, life expectancy ≥12 weeks exclusion criteria: - the presence of other uncured malignancies patients with one or more serious concomitant systemic diseases that, in the investigator's opinion, impair the patient's ability to complete the study patients with autoimmune disease are not suitable for pd1 monoclonal antibody therapy
the effects of glucagon on renal regional blood flow in humans measured by magnetic resonance.

Conditions: Kidney Diseases

Summary: this study will investigating the effects of glucagon on renal blood flow in humans using mri technology. glucagon, a hormone produced by the pancreas, plays a key role in regulating blood sugar levels. it has been shown to affect renal function, including electrolyte balance and blood flow, especially in conditions like type 2 diabetes where abnormal glucagon levels are common. the study aims to understand how glucagon affects regional blood flow in the kidneys, specifically the cortex and medulla, and whether these effects are mediated by glucagon receptors. the study will be conducted on 10 healthy male participants aged 20-60 years. it involves three test days where participants will receive either glucagon, glucagon with a glp-1 receptor antagonist, or placebo. blood flow, glomerular filtration rate, and other renal functions will be measured using mri. the study seeks to clarify whether glucagon's effects on the kidneys are linked to changes in regional blood flow and to determine if these effects are mediated solely by glucagon receptors.


Eligibility criteria:
inclusion criteria: * normal health confirmed through; interview and medical examination * normal values with respect to blood concentrations of fasting plasma glucose, fasting plasma total cholesterol, fasting triglycerides, hdl, ldl, creatinine, liver function tests, and electrolytes * informed consent exclusion criteria: * immunosuppressive treatment in the previous 12 months * alcohol abuse * medical treatment with oral glucocorticoids, dipeptidyl peptidase-4 (dpp-4) inhibitors, or glp-1 receptor agonists, which, in the opinion of the principal investigator, may interfere with glucose metabolism * use of lithium * medical treatment that affects insulin secretion or the renin-angiotensin-aldosterone system * liver disease (alt \> 2x normal value) * renal impairment (serum creatinine \> 130 µm and/or albuminuria) * individuals with severe claustrophobia * individuals with mr-incompatible foreign bodies * individuals with hypertension
effect of tele-exercise on cardiorespiratory fitness in paediatrics

Conditions: Cardiorespiratory Fitness; Insulin Resistance

Summary: the goal of this clinical trial is to learn if telemedicine exercise programme can improve the cardiorespiratory fitness (how well your body delivers oxygen to muscles and organs) and insulin resistance in asian children with low cardiorespiratory fitness levels. the main questions it aims to answers are: * does telemedicine exercise programme improve the number of 20-metre laps the participant is able to run? * does telemedicine exercise programme improve the insulin sensitivity using the homeostatic model assessment for insulin resistance (homa-ir) formula? researchers will compare the telemedicine exercise programme to current active lifestyle programme (e.g., daily step count monitoring) to see if telemedicine exercise programme is more effective in improving cardiorespiratory fitness. participants will: * participate in weekly telemedicine exercise programme or adhere to current active lifestyle recommendations through daily step count reporting for 10 weeks * visit the clinic for pre- and post-programme cardiorespiratory fitness assessments and blood taking

this study is to investigate the effectiveness of delivering exercise intervention programme to improve cardiorespiratory fitness through telemedicine for paediatric patients with low cardiorespiratory fitness levels. conventionally, exercise programme for these patients are conducted within hospital premises. however, some challenges may deter patients from enrolling into these programmes, such as long travelling distance, lack of available caregiver and unsuitable timings. understanding the impact of a shorter-term programme (i.e., 10-week programme) on cardiorespiratory fitness and glucose metabolism also allows us to customise programmes of appropriate length to deliver the require health impact instead of subjecting all patients to a lengthy programme. therefore, evaluating the effectiveness of telemedicine-based exercise programme will enable us to fine-tune our programme and provide an alternative mode of exercise intervention so as to cater for a wider range of paediatric patients.

Eligibility criteria:
inclusion criteria: * 12 to 17 years (secondary school students) * able to participate in school physical education lessons exclusion criteria: * less than 12 years or older than 17 years (non-secondary school students) * has medical or musculoskeletal condition(s) preventing participation in school physical education lessons or exercise

Keywords: paediatric cardiorespiratory fitness telemedicine insulin resistance
early administration of aspirin in patients with acute ischemic stroke treated with systemic thrombolysis

Conditions: Stroke; Brain Ischemia

Summary: the aim of this study is to determine whether early administration of aspirin in acute ischemic stroke patients treated with systemic thrombolysis is safe and can improve outcomes due to decreasing the number of early rethromboses.

according to the current guidelines (european stroke organisation, 2009; american heart association-american stroke association, 2013) on the systemic thrombolysis in ischemic stroke patients it is recommended (class c) to start antithrombotic therapy (including antiplatelets and anticoagulants) when 24 hours go after alteplase (rtpa, recombinant tissue plasminogen activator) administration. meanwhile rtpa has wery short lifetime in blood (t1/2 4-6 minutes). some retrospective studies have found that early administration of antithrombotics (8-16 hours) after systemic thrombolysis can improve functional outcome and does not increase the risk of haemorrhage. the investigators suggest a controlled prospective trial to recognise risks and benefits of early administration of aspirin (in 12 hours) after rtpa therapy in patients with acute ischemic stroke.

Eligibility criteria:
inclusion criteria: * acute ischemic stroke patients treated with rtpa * mrs score before current stroke \<4 * nihss score after rtpa treatment \<25 exclusion criteria: * contraindications for treatment with aspirin * contraindications fot iodinated radiocontrast agents administration * intracranial haemorrhage after rtpa treatment

Keywords: thrombolytic therapy tissue plasminogen activator aspirin
ultra-low dose chest computed tomography: a rule-out tool for community-acquired pneumonia

Conditions: Pneumonia; Diagnoses Disease

Summary: this is a randomized study that sought to compare the rule-out capacity and antibiotics prescriptions associated with two different diagnostic imaging strategies (ultra-low-dose chest computed tomography versus chest radiography) in a group of healthy adults presenting to the emergency department (ed) with suspected community-acquired pneumonia (cap).

between october 2017 and december 2018, we prospectively enrolled consecutive adult patients with suspected community-acquired pneumonia based on at least one respiratory symptom and focal auscultatory findings and at least one sign related to infection, for whom no definitive diagnosis was possible by clinical judgment. eligible patients were randomly assigned to their imaging evaluation in a 1:1 ratio to either ultra-low-dose chest computed tomography (uldct) or the standard evaluation strategy using conventional chest radiography (cr). this study sought to compare the rule-out capacity and antibiotics prescriptions associated with those two different diagnostic imaging strategies (uldct versus cr) in a group of healthy adult patients presenting to the ed with suspected cap.

Eligibility criteria:
inclusion criteria: * suspected cap; * at least one respiratory symptom (new or increasing cough, expectoration, dyspnea or chest pain) and * at least one symptom related to infection (fever ≥ 38°c, chills, sweating, myalgia, mental confusion or headache) and * focal auscultatory findings during physical examinations (crackling rales) * no definitive diagnosis possible by clinical judgment. exclusion criteria: * score in at least one clinical part of the curb-65 or psa scores * clinical diagnosis of rhinosinusitis and acute nasopharyngitis and who had already been treated with antimicrobial therapy for this episode of disease * pregnancy; * the presence of other respiratory diseases such as chronic obstructive pulmonary disease (copd), asthma, interstitial lung disease, chronic diseases or other chronic airway conditions; * diagnosis of congestive heart failure; * body mass index (bmi) greater than 30; * inability to hold the breath for at least 10 seconds

Keywords: pneumonia
efficacy of telmisartan and the combination of telmisartan and ramipril in type1 diabetes patients with nephropathy

Conditions: Diabetic Nephropathy

Summary: hypothesis: the angiotensin receptor blocker telmisartan is effective at reduction of albumin excretion rate(aer) in patients with type1 diabetes and micro or macroalbuminuria. dual blockade with the addition of ramipril an angiotensin receptor blocker gives added efficacy for reduction of aer. arb telmisartan gives a 24 hr bp lowering effect. summary: this is an open label cross over study involving 30 patients who were initially treated with telmisartan 80 mg for eight weeks followed by addition of ramipril 10 mg for a further eight weeks. albuminuria reduction and bp reduction with both clinic and ambulatory bp records were studied at the end of each phase.

to evaluate the antialbuminuric efficacy of an angiotensin receptor blocker (arb) telmisartan and the combination of telmisartan and ramipril in patients with type1 dm and either micro or macroalbuminuria.to evaluate the same drugs for their antihypertensive efficacy and their influence on dipping patterns using ambulatory bp monitoring. methods: open label cross over study involving 30 patients who were initially treated with telmisartan 80 mg for eight weeks followed by addition of ramipril 10 mg for a further eight weeks. albuminuria reduction and bp reduction with both clinic and ambulatory bp records were studied at the end of each phase overnight urine samples of nine hours duration were collected . the volume of urine was verified by measurement in a jar with accuracy of 50ml by the study investigator on every occasion. . albuminuria was estimated by immuno-turbidimetry hemocue albumin system angelholm ad, sweden (inter assay cv 4.3% ). the albumin excretion rate(aer) at baseline evaluation was determined as the mean aer of the positive urine samples. during subsequent evaluations at the end of 8weeks and at the end of 16 weeks the mean albumin excretion rate from two successive overnight urine samples was taken as the mean .ambulatory bp (abp) measurement :abp was measured using spacelabs device 90207 spacelabs inc. use of which is described before(14) .a uniform protocol of inflation once in every 30 min was used. cuff was applied to the nondominant arm. recordings were started in all patients between seven and ten am.

Eligibility criteria:
inclusion criteria: * diabetes mellitus by ada criteria * clinical history of dka * hba1c \ /= 20 mcg/min on two overnight urine samples exclusion criteria: * pregnancy * unwillingness to use contraception during time of study * creatinine \>3 mg/dl * suspected/proven non diabetic nephropathy * active urinary sediment

Keywords: type1 dm microalbuminuria nephropathy albumin excretion rate dual blockade acei arb