Kornimate/medical-research-clean huggingface dataset:
evaluation of 20% betulinic acid ointment for treatment of dysplastic nevi (moderate to severe dysplasia)

Conditions: Dysplastic Nevus Syndrome

Summary: the purpose of this study is to evaluate the safety and effectiveness of an experimental 20% betulinic acid ointment (ba ointment) as a treatment for dysplastic nevi with the potential to transform into melanoma.

approximately 200 patients may be enrolled and screened in order to find twenty-eight (28) patients who qualify to be involved in this research at uic. dysplastic melanocytic nevus (dmn) is a histopathologic term implying a disordered proliferation of melanocytes associated with discontinuous and variable cellular atypia. dmn is graded into mild, moderate, and severe based on standard histological criteria. dmn is considered to be a likely precursor for melanoma, and individuals with dmn often have multiple instances of it scattered over their trunk and extremities. for this study, only dmn where the dysplasia is either moderate or severe will be included.

Eligibility criteria:
inclusion criteria: * all races are eligible for entry into the study. * all patients must have been histologically documented (by a punch biopsy) for dysplastic nevi with moderate to severe dysplasia (dmn). a similar biopsy proven dmn that will serve as the control needs to be available. * patients must be healthy and active in normal pursuits of life and be able to provide informed written consent. * localized dermatological conditions like psoriasis or actinic keratosis will not be an exclusion criteria. * patients must be ambulatory with an ecog status \< 2; they will not be hospitalized as part of the study. * all patients in this study will have, in addition to a normal clinical examination, a thorough skin examination. whenever possible, periodic photographs of their lesions will be taken. additional tests for all patients within 30 days of the initiation of topical application include urinalysis, a liver function test (lft), and blood tests for complete blood count (cbc), bun, and creatinine. exclusion criteria: * women who are pregnant and/or nursing will be excluded. a pregnancy test will be performed on each pre-menopausal woman within two days of entry into the study, and a negative pregnancy test must be recorded on the case report form prior to initiating use of the topical application. * patients who are being treated for other chronic debilitating diseases (cardiac, pulmonary, or any other organ specific diseases). * immuno-suppressed patients, either due to chemotherapy and radiation therapy or known immunodeficiency diseases (e.g., aids). * patients with other active malignancies within the past five years, excluding noninvasive skin or cervical carcinoma. * patients with any other serious medical or psychiatric illness that would prevent informed consent. * patients with extensive chronic skin diseases such as extensive psoriasis, atopic dermatitis, or xeroderma pigmentosa will be excluded from the study.
atorvastatin as adjunctive therapy in covid-19

Conditions: COVID-19

Summary: objective: to assess whether adjunctive therapy of covid-19 infection with atorvastatin reduces the deterioration in hospitalized patients and improves clinical outcome.

covid-19 is caused by sars-cov-2, a β-coronavirus that binds to the zinc peptidase angiotensin-converting enzyme 2 (ace2). no drug is licensed to treat covid-19, but adjunctive pharmacologic interventions have been proposed for their immunomodulatory effects, including statins. about 5% of cases are considered critical, with severe respiratory failure as well as myocarditis, and thromboses, and are associated with high fatality rate. statins affect endothelial dysfunction and have anti-inflammatory and immunomodulatory effects. this prospective, randomized, open-label trial of atorvastatin as adjunctive treatment of covid-19 in hospitalized patients aims to study: 1. will atorvastatin reduce progression to severe or critical covid-19 disease and death compared to standard care? 2. will atorvastatin lead to improved clinical outcome of covid-19 disease at 30 days compared to standard care?

Eligibility criteria:
inclusion criteria: * patient aged 18-85 years, admitted with suspected covid-19 disease based on clinical criteria (typical upper respiratory symptoms, e.g. runny nose, sore throat, dry cough, associated with covid-19 infection). exclusion criteria: * already on chronic statin therapy, known hypersensitivity or adverse events to statins, negative nasopharyngeal (np) swab for sars-cov-2, pregnancy and lactation, need for icu admission, alt or ast \>2x upper limit of normal; cpk \> 5x upper limit of normal; and creatinine clearance \<50%, chronic treatment with colchicine, cyclosporin, digoxin, fusidic acid, azole antifungals, niacin.
feasibility, acceptability, and preliminary efficacy of a mobile app (nocd) for ocd

Conditions: Obsessive Compulsive Disorder (OCD)

Summary: the purpose of this study is to evaluate the feasibility, acceptability, and potential usefulness of using a mobile application (nocd) for treatment of obsessive compulsive disorder (ocd) in a sample of 25 adults (ages 18-65) in an 8 week trial. nocd is a free ios/android application that provides treatment strategies. the study team will evaluate the effect of the application using gold-standard clinician-administered and self-report measures. prior to downloading the application, participants will receive 4 (up to 5) in-person visit (orientation to the app and psychoeducation) and receive brief weekly phone check-ins. the long-term goal of this study is to use this information to develop new treatments for patients with ocd. all study procedures will be conducted on site at the new york state psychiatric institute.

the purpose of this study is to evaluate the feasibility, acceptability, and potential usefulness of using a mobile app (nocd) for treatment of ocd in a sample of 25 adults (ages 18-65). nocd is a free ios/android app that provides ex/rp-consistent treatment strategies. the study team will evaluate the effect of the app using gold-standard clinician-administered and self-report measures. prior to downloading the app, participants will receive 4 (up to 5) in-person visits and receive brief weekly phone check-in. the long term goal of this line of research is to increase access to evidence-based treatment and to ultimately reach more patients giving them access to tools to reduce their ocd symptoms and improve their quality of life.

Eligibility criteria:
inclusion criteria: * primary dsm-5 diagnosis of obsessive-compulsive disorder * age 18-65 * not currently receiving psychotherapy focused on ocd symptoms, and no ex/rp within the past 12 weeks * for those currently on medication: on a stable dose of psychiatric medication (for at least 12 weeks) * capacity to provide informed consent exclusion criteria: * comorbid psychiatric conditions that significantly elevate the risk of study participation (e.g. psychotic disorders, bipolar disorder, evidence of dementia or other cognitive disorder, suicidality).

Keywords: ocd mobile technology cbt cognitive-behavioral therapy
effects of intensive chiropractic care to usual care for children with cerebral palsy.

Conditions: Cerebral Palsy

Summary: to determine the effects of chiropractic care on spasticity, functional outcomes and quality of life in spastic cerebral palsy children.


Eligibility criteria:
inclusion criteria: participants will be recruited into the study according to the following criteria. * both gender (male and female). * age between 2 to 15 years. * spastic cerebral palsy children. exclusion criteria: participants will be excluded from the study according to the following criteria. * cerebral palsy children due to traumatic brain injury. * patients having cognitive impairments. * patients having associated neurological pathologies. * patients who are unable to follow treatment plan.
functional implications of rare gene mutations in ahus open the door to personalized therapy

Conditions: Atypical Hemolytic Uremic Syndrome

Summary: hemolytic uremic syndrome (hus) is a rare disease characterized by rupture of red blood cells (hemolytic anemia), low platelet count (thrombocytopenia), and thrombotic occlusion of small vessels (thrombotic microangiopathy), with prevalent involvement of the kidneys. seu, in its typical form is caused by gastrointestinal infection with escherichia coli. the atypical form of seu (aseu), which is not caused by an escherichia coli infection, is a very rare disease that may have a genetic origin; it affects both children and adults and may occur in a sporadic or familial form. many studies have shown that about 60% of cases of atypical hus are associated with genetic abnormalities of the complement system (particularly the so-called "alternative pathway"), which is a key part of the immune system for responding to infection. complement consists of a series of proteins that, when activated, create a so-called "cascade," which leads to the elimination of the infectious agent, either directly or through other cells. complement is finely regulated in such a way as to prevent damage to healthy cells in one's own body. genetic defects in some of these complement regulatory proteins cause reduced protection of the endothelial surface (thus the vessel wall) against complement activation. recently, new mutations have been described in a gene unrelated to the complement pathway, the dkge gene, which codes for the intracellular isoform of diacylglycerol kinase . in these patients, small renal vessel occlusion appears to occur as a result of altered endothelial cell proliferation and angiogenesis through mechanisms apparently unrelated to complement activation. however, to date these mechanisms are poorly studied. throughout the entire project statistical methods will be applied to optimize the characterization of the abnormalities in phenotype and function of ipsc-ec derived from ahus patients with either dgke or mcp genetic abnormalities as compared with control ipsc-ec, including identifying potential drugs that could correct the abnormalities


Eligibility criteria:
inclusion criteria: * adults and children with ahus defined by history of microangiopathic hemolytic anemia and thrombocytopenia (hematocrit (ht) \ 500 iu/l, undetectable haptoglobin, fragmented erythrocytes in the peripheral blood smear with negative coomb's test, and platelet count \<150,000/microl), associated with acute renal failure. * written informed consent exclusion criteria: * ttp (adamts13 activity \<10%) * stec-hus (presence of stx and eae genes or shiga-toxin in the stools and/or serum antibodies against shiga-toxin and/or stec lps). * disseminated intravascular coagulation (prolonged thromboplastin time and lower than normal fibrinogen levels).

Keywords: atypical hemolytic uremic syndrome induced pluripotent stem cells endothelial cells alternative complement pathway eculizumab drug screening (in vitro)
effectiveness of nalbuphine as an adjuvant to subarachnoid block on postoperative analgesia in turp surgery

Conditions: Transurethral Resection of Prostate

Summary: the goal of this clinical trial is to compare pain after surgery in patients undergoing transurethral resection of prostate. the main question it aims to answer are: intrathecal nalbuphine as an adjuvant to local anesthetic will better provide pain relief after turp surgery. participants will be given a combination of nalbuphine and local anesthetic when getting a spinal block. researchers will compare control group, given look-alike solution that contains no active drug to see if nalbuphine will better provide pain relief after surgery.

this study aims to evaluate the efficacy and side effects of nalbuphine, with the goal of providing anesthesiologists with evidence-based guidance for selecting the most appropriate pharmacological agents for their patients. participants will be given a combination of nalbuphine and local anesthetic when getting a spinal block. researchers will compare control group, given look-alike solution that contains no active drug to see if nalbuphine will better provide pain relief after surgery.

Eligibility criteria:
inclusion criteria: * patients scheduled for transurethral resection of prostate under spinal anesthesia * american society of anesthesiologists (asa) physical status i-iii exclusion criteria: * allergy to study medications or hypersensitive to local anesthetics * contraindicated for neuraxial anesthesia * inability to self-report pain * chronic opioid used

Keywords: anesthesia, spinal pain, postoperative nalbuphine
r-eshap followed by autologous transplantation for refractory or relapsed diffused large b-cell lymphoma

Conditions: Diffuse Large B-cell Lymphoma

Summary: the aim of study is to prove r-eshap regimen followed by autologous stem cell transplantation as salvage treatment in patients with refractory or relapsed diffuse large b-cell lymphoma is effective.

the standard treatment in patients with refractory or relapsed diffuse large b-cell lymphoma is salvage chemotherapy followed by autologous transplantation for responsive patients. however, the standard of salvage chemotherapy remains uncertain. this study is to evaluate the efficacy and safety of r-eshap regimen in a multi-center basis.

Eligibility criteria:
inclusion criteria: * age range: 18-65 years old * histological confirmed diffuse large b-cell lymphoma * refractory or first relapsed disease * prior anthracycline exposure * measurable disease * ecog performance status 0-1 * life expectancy of more than 3 months * bone marrow function: anc≧1.5×109/l, plt≧100×109/l, hb≧90g/l * liver function: total bilirubin, alt and ast \<1.5×unl * renal function: cr\<1.5×unl, ccr≧50ml/min * no contraindication for transplantation exclusion criteria: * evidence of cns and bone marrow involvement * more than 1 type of chemotherapy regimens exposure * high level of hbv dna * contraindication of high-dose methylprednisolone * pregnant or lactating women * history of other malignancies except cured basal cell carcinoma of skin and carcinoma in-situ of uterine cervix * history of allergic reaction/hypersensitivity to rituximab * significant active infection

Keywords: diffuse large b-cell lymphoma chemotherapy r-eshap autologous stem cell transplantation
long-term longitudinal qol in patients undergoing eea

Conditions: Pituitary Tumor; Meningioma; Rathke Cleft Cysts; Chordoma; Chondrosarcoma; Craniopharyngioma; Encephalocele; Esthesioneuroblastoma

Summary: this is a prospective longitudinal study to access postoperative 2-year quality of life in patients who undergo endonasal endoscopic approach surgeries of the skull base.

this is a prospective single-institution longitudinal study to access quality of life in patients who undergo endonasal endoscopic approach surgeries of the skull base. patients will be followed before surgery and up to twenty-four months post-surgery. the primary goal of the study is to assess the alterations to patient quality of life following endoscopic endonasal surgery using modern sinonasal reconstruction techniques. secondary goals are to better understand the time course of normal healing and patient/procedural risk factors associated with poorer quality of life outcomes.

Eligibility criteria:
inclusion criteria: * patient is scheduled to undergo endoscopic endonasal surgery. multiple, staged surgeries are not exclusionary * 18 years of age or older * the subject must in the investigator's opinion, be psychosocially, mentally, and physically able to fully comply with this protocol including the required follow-up visits, the filling out of required forms, and have the ability to understand and give written informed consent exclusion criteria: * patient is a prisoner * patient is not english speaking * patient is not expected to survive until the 2-year follow-up

Keywords: endoscopic endonasal approach surgery
effect of the dietary supplement taxifolin aqua on the recovery period after covid-19 pneumonia

Conditions: Covid19

Summary: objective of the study is to evaluate the effect of taxifolin aqua therapy on the indicators of respiratory function, the state of the arterial wall, the contractile function of the myocardium, as well as to assess the effect of taxifolin aqua therapy on markers of biological age, quality of patients life.

the study will include 100 patients who had covid pneumonia 3 months ago. if the inclusion / exclusion criteria are met, the patient is asked to sign an informed consent to participate in the study. consenting patients are randomized to an intervention group or a control group. the control group (n = 50) will receive standard therapy, patients from the intervention group (n = 50) will be prescribed taxifolin aqua 30 mg per day in addition to standard therapy. patients will be randomized to the control and main group using random number spreadsheets, assuming that the control and main groups will be homogeneous in the main demographic and clinical parameters. patient monitoring will be carried out within 2 months from the date of inclusion. a follow-up visit is scheduled in 2 months. during the study, the patient will be regularly monitored for tolerance and safety of therapy with taxifolin aqua.

Eligibility criteria:
inclusion criteria: patients of both sexes who had covid pneumonia 3 months ago and signed an informed consent and aged 18+. exclusion criteria: standard contraindications to taxifolin aqua use.
self-management for dual sensory impaired

Conditions: Hearing Loss; Low Vision

Summary: this study aims to determine the effectiveness of a self-management program for elderly with an acquired and concurrent hearing and visual impairment due to age-related disease processes.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of hearing loss and low vision * at least one sensory loss acquired after the age of 55 * living in a home for the elderly exclusion criteria: * congenital deaf persons * a dual sensory loss before the age of 55

Keywords: aged homes for the aged self management personal autonomy disease management self efficacy participation
precision dosing of beta-lactam antibiotics in critically ill children

Conditions: Amoxicillin-clavulanate; Piperacillin-tazobactam; Meropenem

Summary: the overall objective of this study is to investigate the impact of early model-informed precision dosing (mipd) on target attainment of three beta-lactam antibiotics (amoxicillin-clavulanic acid, piperacillin-tazobactam and meropenem) in critically ill children. this evaluation includes a comparison with the more standard approach on clinical and patient-oriented measures.


Eligibility criteria:
inclusion criteria: * subject aged between 0 - 17 years 10 months. * subject admitted to a participating ward unit (neonatal intensive care unit, pediatric intensive care unit, pediatric hematology-oncology unit). * strongly suspected or confirmed systemic infection. * subject planned to start on intravenous amoxicillin-clavulanic acid, piperacillin-tazobactam or meropenem treatment at least aimed for a minimum duration of two days at time of inclusion. if the subject was previously treated with the same beta-lactam, the minimum interval to the previous beta-lactam treatment episode is * 40 hours for amoxicillin-clavulanic acid (based on elimination half-life) * 8 hours for piperacillin-tazobactam and meropenem (based on elimination half-life) subject planned to start on intravenous amoxicillin (without clavulanic acid) will not be included. * informed consent/assent signed by parents or legal representatives of the subject. * not previously enrolled in this trial. exclusion criteria: * subject with serum creatinine level ≥ 2 mg/l at inclusion. * subject receiving (or planned to receive) haemofiltration, extracorporeal membrane oxygenation, hemodialysis or peritoneal dialysis, molecular adsorbent recirculating system or any other exchange technique. * subject receiving (or planned to receive) body cooling. * subject death is deemed imminent and inevitable. * reporting of first dosing advice (based on blood sampling) is not possible within 28 hours (\*) after start treatment. * the subject is known or suspected to be pregnant. * the subject has a known allergy to the specific beta-lactam antibiotic. (\*) the first (a posteriori) dose calculation and dose adjustment if necessary, is performed within a maximum timeframe of 28 hours after start of treatment (i.e. maximum timeframe to first dose adjustment).

Keywords: amoxicillin-clavulanate piperacillint-tazobactam meropenem model-informed precision dosing dose calculator critically ill children
implementation of a web-based decision aid for breast cancer surgery

Conditions: Breast Cancer; Surgery

Summary: routine incorporation of decision aids into oncology practice has the potential to significantly improve patients' experiences with cancer by increasing the likelihood that they make informed treatment decisions aligned with their values. unfortunately, only a minority of the more than 1.6 million patients diagnosed annually with cancer ever receive one due to limited clinic resources for administration and challenges in timely identification of appropriate patients. online delivery directly to patients addresses some of these barriers but is insufficient on its own to ensure accessibility for patients at the time they most benefit from support.19 it is critical that active, multi-faceted implementation strategies that target barriers to the widespread use of web-based decision aids be identified, as these tools have the potential to significantly improve the quality of oncologic care. based on strong preliminary work, the investigators have developed and piloted a package of implementation strategies that effectively overcomes barriers to delivery of a web-based breast cancer surgery decision aid in an academic and community clinic. although the strategy was successful, patients were white and educated; further investigation is imperative in settings that provide care to underserved patients to ensure the intervention will mitigate, rather than worsen, existing disparities in breast cancer care. this is especially critical given that underserved patients may benefit most from shared decision-making interventions such as the one described. to study this, the investigators propose a pilot study within a clinic that serves a catchment area with a high proportion of african american, rural and low income patients. the investigators will iteratively assess and enhance our implementation package using concepts outlined in the knowledge-to-action cycle, which emphasizes local context in balancing fidelity and flexibility. the specific aims are: 1) to identify patient and clinic level barriers to implementation of a web-based breast cancer surgery decision aid in a clinic that cares for underserved patients, and 2) to test and expand our current implementation package's ability to address barriers in a clinic that cares for underserved patients. the investigators will determine the reach of implementation and acceptability of this method of decision aid delivery to stakeholders.


Eligibility criteria:
patients: inclusion criteria: * patients newly diagnosed with stage 0-3 breast cancer. exclusion criteria: * none clinic stakeholders: inclusion criteria: clinical staff, clinic leadership, and surgeons involved in implementation exclusion criteria: none