Kornimate/medical-research-clean huggingface dataset:
antifungal drugs in pulmonary mucormycosis

Conditions: Pulmonary Mucormycosis

Summary: pulmonary mucormycosis (pm) poses a substantial clinical challenge, particularly among immunocompromised patients. the aim of the study is to determine the effectiveness and safety of administering ambisome at a dose of 5mg/kg/day combined with isavuconazole versus using ambisome for the management of pulmonary mucormycosis


Eligibility criteria:
inclusion criteria * patients aged 18 years or older diagnosed with pulmonary mucormycosis (pm). * individuals with probable or proved pm, as indicated by clinical and radiological findings. exclusion criteria: * patients with a history of pulmonary mucormycosis (pm) who have previously been treated with amphotericin b for a duration exceeding 5 days. * patients who have documented allergies to azoles or amphotericin b regimens * patients with serum aspartate aminotransferase (ast), alanine aminotransferase (alt), alkaline phosphatase, or bilirubin levels exceeding five times the upper limit of normal (uln). * patients with irreversible heart or liver failure, or those experiencing massive, fatal hemoptysis. * patients who have experienced a myocardial infarction or cerebral infarction. * patients currently receiving extracorporeal membrane oxygenation (ecmo) treatment. * pregnant or breastfeeding individuals. 8.patients with individual reasons that may prevent them from completing the treatment protocol.

Keywords: pulmonary mucormycosis amphotericin b liposome isavuconazole
advancing nursing practices in hospital oncology care

Conditions: Gastrointestinal Cancer; Gastrointestinal Disease; Nurse's Role

Summary: the purpose of this study is to find out if a new training program for nurses called pact (partnership, assessment, care, and transition) will be effective and relevant in helping nurses gain the skills needed to provide high-quality family-centered care. family-centered care skills include engaging family caregivers as partners in patient care, and strengthening their capacity for caregiving by assessing family support needs and facilitating access to resources when needed. the study will also look at whether the quality of nurses' family-centered care skills is associated with improved outcomes for family caregivers. both nurses and family caregivers will be enrolled in this study. participants will be nurses/caregivers who care for advanced gi cancer patients admitted to memorial sloan kettering.


Eligibility criteria:
inclusion criteria: nurses: * mskcc day-shift nurses and/or night-shift nurses (clinical nurse i to iv) assigned to the gi inpatient unit (m16) at the time of study, all of whom provide initial and ongoing assessment of patients' physical, psychosocial, cultural and informational needs * nurse is comfortable speaking and reading english as per self report family caregivers (fc) - phases 1b, 2, 4: * adult (≥18 yrs) family caregiver (family caregiver is defined here as any informal caregiver who is a relative, friend or legal representative) who self-identifies and/or is identified by the nursing staff as involved in the care of an msk cancer patient who either: * is currently admitted to the m16 unity for at least 12 hours or * has been discharged from the m16 unit within the last 2 weeks * english-speaking as per self-report * only one fc per patient case will be invited to participate. m16 patients (chart review only): * adult (≥18 yrs) cancer patient who is currently admitted in the m16 unit at memorial hospital for at least 12 hours o english speaking as per self-report exclusion criteria: nurses: * nurse plans to leave msk or the gi unit within 3 months as per self-report * \[phases 2-4\] nurse refuses observation of consultations as per self-report family caregivers (fc) - phases 1b, 2, 4: * fc participated in an earlier study phase * fc's patient is deceased at time of consent

Keywords: family caregiver family centered care inpatient oncology care nursing practices 20-448 memorial sloan kettering cancer center
safety and tolerability of fcm vs standard of care in treating iron deficiency anemia in chronic kidney disease patients

Conditions: Anemia

Summary: the objective of this study is to study the safety of fcm in patients with anemia caused by chronic kidney failure


Eligibility criteria:
inclusion criteria: * male or female 18 to 85 years of age * ndd-ckd patients * tsat \</= 25% * hgb \</= 11.5 * ferritin \</= 300 * hd-ckd patients * tsat \</= 30% * hgb \</= 12 * ferritin \</= 500 exclusion criteria: * previous participation in a fcm trial * known hypersensitivity to fcm * history of anemia other that anemia due to chronic renal failure * current history of gi bleeding * received iv iron within the last 30 days * anticipated need for surgery * malignancy history * ast or alt greater than normal * received an investigational drug within 30 days of screening * pregnant or sexually active females who are not willing to use an effective form of birth control
gynacological imaging reporting and data system in ovarian masses by ultrasonography

Conditions: Ovarian Neoplasms

Summary: ovarian masses are common problems in clinical practice. sonography is considered the firstline imaging technique for discriminating between malignant and benign lesions, and it has been shown to be useful for determining optimal treatment.

transvaginal ultrasonography has been demonstrated to be the most sensitive and effective technique, being also non-invasive and in-expensive maneuver.since in early reports, a standardized method for the description of the sonographic appearance of the ovarian masses was not used, the data of different studies are not easily compared. in addition, there is no consensus on sonographic diagnostic criteria for ovarian cancer, despite many ultrasonography features being considered to be predictive of malignancy, such as presence of septations, internal nodularity, wall thickening, solid areas, free fluid or bilaterality.usually the clinical management decision is based on data provided in the sonographic report. many sonographers and sonologists use scoring systems to characterize ovarian masses, whereas others use the so called pattern recognition approach however, sometimes sonographic reports are misleading and confusing for the clinician. although some groups have made considerable efforts in establishing terms and definitions for sonographic findings in ovarian masses . in this study, we proposed a new data reporting system for sonographic findings in ovarian masses. this system is based on the concept developed for breast imaging, namely the breast imaging reporting and data system classification. originally developed for mammographic findings, it has been successfully applied to breast sonography. like its breast sonographic counterpart, the gynacological imaging reporting and data system in ovarian masses by ultrasonography lexicon is intended to provide a unified language for sonographic reporting and for avoiding confusion in communication between the sonographer / sonologist and the clinician.. this system is based on a description of the ovarian mass using the pattern recognition approach and color doppler blood flow location and the prior risk for malignancy in each group. on this basis, the proposed classification enables the sonologist or sonographer to give the clinician as much information as possible in a summarized way, as well as an estimated risk of malignancy, based only on the sonographic characteristics of the images. currently, there is enough evidence to indicate that when an experienced examiner performs the sonographic examination, such accuracy is achievable for most types of ovarian masses.

Eligibility criteria:
inclusion criteria: * all women of different age groups diagnosed as having an ovarian mass. * accidentally discovered ovarian mass in non-complaining female. * patients known to have primary that may give metastasis to the ovaries. exclusion criteria: * patients receive neo adjuvant chemotherapy * recurrent ovarian masses
comparison of new combination inhaler (flutiform hfa mdi 100/10 µg) versus fluticasone and formoterol administered alone, and placebo, in patients with asthma

Conditions: Asthma

Summary: the purpose of this study is to compare the efficacy and safety of the fixed combination asthma drug flutiform hfa mdi with its two components administered alone, fluticasone propionate and formoterol fumarate, and with placebo in adult and adolescent patients with mild to moderate asthma.


Eligibility criteria:
ages eligible for study: 12 years and above; genders eligible for study: both; prior steroid use: steroid-requiring or steroid-free. inclusion criteria: * history of asthma for at least 12 months. * for steroid-requiring patients, documented use of inhaled corticosteroid for at least 4 weeks prior to screening visit * for steroid-free patients, no history of inhaled steroid asthma medication for at least 12 weeks prior to screening visit. * demonstrate fev-1 of 60-85% of predicted normal values at screening and baseline visit. * documented reversibility of 15% within 12 months of screening or at screening visit (15% increase from pre-fev-1 levels following albuterol inhalation or nebulized albuterol administration). * symptoms of asthma during run-in * females of childbearing potential must have a negative urine pregnancy test at screening and baseline visits. females are eligible only if they are not pregnant or lactating, and are either sterile, or using acceptable methods of contraception. * must otherwise be healthy. * provide written informed consent. wishes of minors must be respected. exclusion criteria: * life-threatening asthma within past year or during run-in period. * history of systemic corticosteroid medication within 3 months before screening visit. * history of omalizumab use within past 6 months. * history of leukotriene receptor antagonist use, e.g. montelukast, within past week. * current evidence or history of any clinically significant disease or abnormality including uncontrolled hypertension, uncontrolled coronary artery disease, congestive heart failure, myocardial infarction, or cardiac dysrhythmia. * upper or lower respiratory infection within 4 weeks prior to screening visit or during run-in period. * significant, non-reversible, pulmonary disease (e.g., chronic obstructive pulmonary disease \[copd\], cystic fibrosis, bronchiectasis). * known human immunodeficiency virus (hiv)-positive status. * smoking history equivalent to "10 pack years". * current smoking history within 12 months prior to screening visit. * current evidence or history of alcohol and/or substance abuse within 12 months prior to screening visit. * patients who are confined in institution

Keywords: asthma fluticasone propionate formoterol fumarate pressurized metered dose inhaler hydrofluoroalkane mild to moderate asthma
reliability and validity of the iasp clinical criteria for identifying patients with nociplastic pain

Conditions: Chronic Pain; Central Sensitisation; Nociplastic Pain

Summary: this protocol will report on the validation of iasp clinical criteria for indentifying nociplastic pain. the study will include 2 phases. in the first phase, the vignette method will be used while the second phase will include the use of the algorithm in the evaluation of patients with chronic pain.

for the purposes of the study, in the first phase, clinical vignettes will be created, ie short hypothetical scenarios of patients with chronic musculoskeletal pain. the vignettes will feature patients with and without nocipalstic pain. initially, two experts will evaluate and characterize which vignettes concern patients with nociplastic pain. next, a team of physiotherapists with knowledge of chronic pain and cs will evaluate vignettes twice according to the iasp criteria. there will be an interval of 1 month between the two measurements. one month later, the evaluation will be repeated. the investigators will design an android application "algo (s) rithm" to enter the questions of the algorithm. in the second phase, algo (s)rithm app will use to evaluate patients with chronic pain (including patients with fibromyalgia) and healthy. the investigators will compare the result with ppt measurements in the same population.in the present study the inter-rater and test-retest reliability, criterion validity, construct validity will be examined.

Eligibility criteria:
inclusion criteria: * adult patients 18-65 years * with pain \> 3months, intensity of at least 3 on a 0-10 numerical pain rating scale on most days * or patients with fibromyalgia (according to the "criteria for classification of fibromyalgia" by the american college of rheumatology (wolfe et al 1990)). exclusion criteria: * patients who follow a physical therapy program * recent surgery or trauma * pregnant women, * patients with neurological disorders or systemic diseases

Keywords: algo(s)rithm vignette method central sensitisation chronic pain categorization iasp criteria nociplastic pain
neuroprotection of pioglitazone in acute ischemic stroke

Conditions: Stroke

Summary: pioglitzone, an oral anti-diabetic drug which can reduce insulin resistance and decrease inflammation. it has been proven to be an effective neuroprotective agent in animal model of ischemic stroke. in this study, the investigators will conduct a phase ii clinical trial (double-blind, randomized placebo controlled study) to survey the neuroprotection effect of pioglitazone in stroke patients with hyperglycemia. a total of 152 acute ischemic stroke patients with hyperglycemic will receive insulin or sulfonyurea for blood sugar control, and will be randomly randomized into intervention (pioglitazone 30mg once a day p.o,) and control group (placebo). the investigators expect to prove the neuroprotective efficacy of pioglitazone in acute stroke with hyperglycemia and identify the biomarkers associated with good neurological outcome in patients with pioglitazone treatment from the investigators clinical trial.


Eligibility criteria:
inclusion criteria: 1. acute ischemic stroke onset within 48 hours 2. age≧20 years 3. stroke severity with at least one point for limb weakness in national institutes of health stroke scale (nihss). 4. the patients with no known history of diabetes with admission serum glucose ≧130 mg/dl. exclusion criteria: 1. the patients who have history of urinary bladder cancer or hematuira. 2. the patients who have history of congestive heart failure or myocardial infarction. 3. the patients who have known history of using pioglitazone before the onset of stroke. 4. the patients who have mrs≧3 before stroke onset.
study of new biological markers for prediction of severe acute pancreatitis

Conditions: Acute Pancreatitis

Summary: acute pancreatitis refers to inflammation of the pancreas and is associated with sudden onset of severe abdominal pain, often accompanied by transient systemic manifestations, including fever. in the majority of cases, the inflammatory process is self limiting and patient recovers uneventfully; however, in about 20% to 30% of the cases, a protracted clinical course ensues and the disease may progress to a severe necrotizing form, often triggering a systemic inflammatory response syndrome during which time, acute respiratory distress syndrome, renal failure, shock, and disseminated intravascular coagulation may occur. in the worst sequelae, multiple organ dysfunctions may follow and death supervene. the clinical outcome of patients suffering from severe acute pancreatitis depends to a great extent on the early diagnosis and prediction of severity and timely therapeutic intervention to prevent local and systemic complications. however, the course of the disease is often difficult to predict from the outset. currently, there is still no single clinical or laboratory test that can be considered the "gold standard" for diagnosis and/or assessment of severity of acute pancreatitis. for a disease that may progress rapidly without apparent sign, the ideal marker for the prediction of disease severity in a patient would be one that is measurable rapidly and easily, besides being able to fulfill all the other criteria required of a good biological marker. to identify such a potential marker for acute pancreatitis requires understanding of the pathophysiological process underlying the rapid progression of a fulminant course of the disease. although much remains to be elucidated, recent studies in animals have suggested that inflammatory mediators substance p and hydrogen sulfide may play critical roles. this study will evaluate if inflammatory mediators substance p and hydrogen sulfide are upregulated early on in the disease process, and if the levels of their elevation predict disease severity.


Eligibility criteria:
inclusion criteria: the patient should fulfill all of the following criteria: * the subject should be at least 18 years of age. * clinical features compatible with acute pancreatitis. * first symptoms of acute pancreatitis not more than 72 hours before enrolment. * serum amylase level above 480 u/dl (normal 60-160 u/dl or 2-hour urinary amylase greater than 1120 u (normal 280 u). * serum lipase levels greater than 2 u (normal \< 1 u). * patient has signed consent form regarding participation in the study. exclusion criteria: the patient should not present any of the following criteria: * symptoms of acute pancreatitis present for more than 72 hours * clinical evidence of sepsis or other inflammatory diseases. * clinical evidence of disorders/disease known to affect endogenous regulation of substance p, e.g. asthma, immune-complex-mediated lung injury, arthritis. * age under 18 years * pregnancy

Keywords: acute pancreatitis biological markers substance p hydrogen sulfide disease severity index
molecular genetic lesions and clinical outcomes in children with acute lymphoblastic leukemia

Conditions: Leukemia

Summary: rationale: the identification of gene mutations may allow doctors to better determine the prognosis of children with acute lymphoblastic leukemia. purpose: this clinical trial is studying gene mutations to see if they are related to prognosis of cancer in children with acute lymphoblastic leukemia.

objectives: * examine the prognostic significance of deletion of the p16 (mts1, cdkn21) gene in children with acute lymphoblastic leukemia. * attempt to correlate the incidence of specific, nonrandom combinations of molecular genetic lesions with clinical outcome in these patients. outline: patients are stratified by risk (standard vs high). bone marrow specimens from patients enrolled in ccg-1922, ccg-1882, or ccg-1901 are analyzed for the following genetic lesions: p16 deletion, p14 deletion, and p15 deletion. patients do not receive the results of the genetic testing and the results do not influence the type or duration of treatment. patients are followed for at least 3 years. projected accrual: a total of 200 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * newly diagnosed acute lymphoblastic leukemia (all) * meets criteria for 1 of the following: * standard risk, as defined by the following: * 1 to 10 years old at diagnosis * wbc less than 50,000/mm\^3 * high risk, as defined by the following: * less than 1 year old or over 10 years old at diagnosis * wbc greater than 50,000/mm\^3 * enrolled on ccg-1922 (standard-risk all) or ccg-1882 or ccg-1901 (high-risk all) patient characteristics: age: * see disease characteristics performance status: * not specified life expectancy: * not specified hematopoietic: * see disease characteristics hepatic: * not specified renal: * not specified prior concurrent therapy: biologic therapy: * not specified chemotherapy: * not specified endocrine therapy: * not specified radiotherapy: * not specified surgery: * not specified

Keywords: untreated childhood acute lymphoblastic leukemia
health behavior-related outcomes with diaphragmatic breathing retraining in heart failure patients

Conditions: Chronic Heart Failure

Summary: the purpose of this study is to provide information on how the practicing of deep breathing ("dbr" - diaphragmatic breathing re-training) may improve the health outcomes and likelihood of heart failure patients to engage in health-promoting activities by successfully controlling their shortness of breath (dyspnea).

in heart failure (hf) patients, dyspnea (shortness of breath), a key contributor to and the strongest predictor of a chief reason for hospital readmission with fatigue, are the primary reasons for modification in function leading to decreased physical activity (pa). dyspnea and fatigue lead to activity avoidance, subsequent muscle de-conditioning, and further increases of dyspnea at even lower levels of activity. depression, because of its moderate relationship both with perceived functional status and dyspnea, can further diminish pa and increase disability in activities of daily living (adls). strategies to minimize or mitigate dyspnea and to boost motivation are imperative for improving adherence to pa, and, in turn, improving fatigue, muscle weakness, pa itself, functional status, disability, and depression in hf patients. thus, diaphragmatic breathing retraining (dbr) or deep breathing with a slow breathing pattern, a focus on decreasing dyspnea, and mediated by self-efficacy for dbr and informal caregiver support during the dbr provide an innovative approach to positively impact the spiraling effects of hf. the purpose of this pilot/feasibility study is to evaluate a diaphragmatic breathing retraining (dbr) intervention that incorporates informal caregiver coaching to improve the primary outcomes of dyspnea, fatigue, and muscle weakness, and the secondary outcomes of pa, functional status, depression, disability, and depression.

Eligibility criteria:
inclusion criteria: * adults age 19 or older who have class iii through iv heart failure as classified by the new york heart association (nyha) * cognitively intact indicated by being able to describe what participation in the study will involve * have a consistent informal caregiver, who is willing to provide support to the participants, and a telephone * residing in a rural area (population less than 2,500) (u.s. census, 1995). exclusion criteria: * myocardial infarction or coronary bypass surgery within the last three months * active chest pain * uncontrolled arrhythmia (atrial fibrillation or ventricular tachycardia) * on transplant list or has ventricular assist device * skeletal or neurological conditions that would impact muscle strength or interfere with 6 minute walk test (6mwt) (amputation, severe arthritis, parkinson's, stroke, or severe neuropathy) * history of severe copd.

Keywords: heart failure dyspnea diaphragmatic breathing retraining fatigue health-related outcomes