Kornimate/medical-research-clean huggingface dataset:
decoding risks and rewards in ischemic stroke surgery

Conditions: Ischemic Stroke

Summary: in the high-stakes battle against ischemic cerebrovascular disease, where every second counts and the margin for error is slim, how do the investigators tip the scales in favor of patient survival and improved outcomes? this groundbreaking study, the first nationwide, population-based analysis with long-term follow-up in an asian context, dives deep into this critical question. leveraging an expansive dataset from taiwan's national health insurance research database, the investigators scrutinize the efficacy and risks of aggressive surgical interventions-specifically, ec-ic bypass, cea, and cas-in a cohort of over 84,000 patients. this paper serves as a milestone, bridging the gap between medical idealism and clinical reality. it calls for a surgical renaissance, emphasizing the need for refining techniques and enhancing patient selection protocols. if participants're looking for a comprehensive, nuanced, and, above all, actionable insight into the surgical treatment of ischemic cerebrovascular disease, this is the study that could redefine the paradigm.


Eligibility criteria:
inclusion criteria: - all participants underwent either a computed tomography (ct) scan or magnetic resonance imaging (mri) within two days before or after hospital admission. the date of the first ischemic stroke hospitalization served as the index event. among these patients, those who underwent surgical interventions post-hospitalization were categorized into three distinct groups: cea (icd-9-cm code 3812), cas (icd-9-cm code 3990), and ec-ic (icd-9-cm code 3928), with the operation date being the index date. those who did not receive any surgical interventions were considered the non-intervention control group and had their first hospitalization date as the index date. exclusion criteria: - patients with a history of: any stroke subtype (icd-9-cm codes 430-434), moyamoya disease (icd-9-cm code 437.5), cancer (icd-9-cm codes 140-239), trauma (various icd-9-cm codes), transient ischemic attack (icd-9-cm code 435), unruptured cerebral aneurysm (icd-9-cm code 437.3), or subarachnoid hemorrhage (icd-9-cm code 430).

Keywords: ischemic cerebrovascular disease ec-ic bypass carotid endarterectomy carotid artery stenting nationwide cohort study risk-benefit analysis
prevalence of non celiac gluten sensitivity among patients spontaneously adherent to gluten free diet

Conditions: Non Celiac Gluten Sensitivity

Summary: the purpose of this study is to assess the prevalence of gluten sensitivity, by a double-blind placebo-controlled challenge with gluten, followed by two months period of low-fodmaps (fermentable oligosaccharides disaccharides monosaccharides and polyols) diet, in patients spontaneously adherent to gluten free diet because of symptoms upon gluten exposure and in whom diagnosis of celiac disease and wheat allergy has been ruled out.


Eligibility criteria:
inclusion criteria: * adherence to gluten free diet without medical need * negative celiac disease related serology (while on gluten containing diet) * normal villous structure at duodenal biopsy (while on gluten containing diet) exclusion criteria: * diagnosis of celiac disease * diagnosis of wheat allergy * diagnosis of organic gastrointestinal disease * severe concomitant disease

Keywords: celiac disease gluten sensitivity gluten double-blind challenge, placebo-controlled challenge gluten free flour
evaluation of ambulatory monitoring of patients after high-risk acute coronary syndrome using two different systems: biomonitor-2 and kardia mobile

Conditions: Atrial Fibrillation; Syncope; Tachycardia; Arrhythmias, Cardiac; Heart Diseases

Summary: the objective of the study is to evaluate the efficacy of monitoring after discharge of patients with high-risk acute coronary syndrome.

the objective of the study is to evaluate the efficacy of monitoring after discharge of patients with high-risk acute coronary syndrome.

Eligibility criteria:
inclusion criteria: * patient is able to understand the nature of study and has provided written informed consent. * patient with acute coronary syndrome, with or without elevation of the st segment at the ekg (the last with elevation of troponins). * patient with coronariography at the episode of acs showing severe lesions treated with stent. * patient with risk index for 6-month mortality (grace score) of more than 118. * patient with risk index for stroke (cha2ds2-vacs score) of more than 2. exclusion criteria: * patient with history of af. * patient with episodes of af during admission at the current episode. * patient with pacemaker or icd (implantable cardioverter-defibrillator) previously. * patient with indication of pacemaker or icd in current or short-term phase. * patient is participating in another interventional clinical investigation. * patient is pregnant or breast feeding. * patient´s life-expectancy is less than 24 months.

Keywords: cardiac monitor
senior peer alliance for rural research on wellness

Conditions: MDD

Summary: dr. brooke hollister, ph.d. from the department of social and behavioral sciences at the university of california, san francisco is conducting a study comparing two types of interventions for treating depression in rural older adults.

if you are eligible to participate in the study after completing the screening assessment, and if you choose to continue on, we will randomize you (like a flip of a coin) to receive either 12 weeks of case management combined with problem solving therapy (cm-pst) with a social worker or 12 weeks of self-guided problem solving therapy (sg-pst) with support from a senior peer counselor. as part of your participation in the study you will participate in three 1.5 hour assessment interviews of psychological and neuropsychological functioning (similar to your screening assessment) prior to your first week of treatment (baseline), two weeks after your final session (week 14), and three months after your final session (week 24). additionally, you will participate in three shorter assessment interviews of psychological functioning, which will be conducted at weeks 3 and 6. these assessments will take approximately 30-45 minutes.

Eligibility criteria:
inclusion criteria: * residence in rural tuolumne, calaveras, san joaquin or stanislaus counties; * diagnosis: major depression, unipolar (by scid ascertained dsm-iv criteria); * severity of depression: a phq-9\>10 or a 24-item hdrs\>19; * need for social services: cane score\> 2, i.e. at least one unmet need; exclusion criteria: * psychotic depression by scid-iv, i.e., presence of delusions; * high suicide risk, i.e. intent or plan to attempt suicide in near future; * presence of any axis i psychiatric disorder or substance abuse other than unipolar major depression; * axis ii diagnosis of antisocial personality (by scid-p and dsm-iv); * history of psychiatric disorders other than unipolar major depression or generalized anxiety disorder (including bipolar disorder, hypomania, and dysthymia); * dementia: mmse below 24 or clinical diagnosis of dementia by dsm-iv; * acute/severe medical illness (delirium, metastatic cancer, de-compensated cardiac, liver or kidney failure, stroke or myocardial infarction) 3 months prior to entry; or use of drugs causing depression, (steroids, reserpine, alphamethyl-dopa, tamoxiphen, vincristine); * inability to perform any of the adls (mai: adl subscale) even with assistance (walking with a cane is not an exclusion criterion) * inability to speak english; * aphasia interfering with communication;
target site pharmacokinetics of ertapenem after multiple doses in diabetes patients with soft tissue infection

Conditions: Soft Tissue Infection

Summary: background/rationale: ertapenem is an innovative antimicrobial agent, which is approved in the european union for diabetic foot infections of the skin and soft tissue. although its antimicrobial spectrum and activity against esbl-strains are promising to treat infected ulcers associated with diabetes, there is a lack of data on tissue pharmacokinetics of ertapenem in this patient population. however, for antimicrobial efficacy it is important to show that the antibiotic achieves sufficient concentrations at the site of infection, i.e. in tissue. a recent clinical study by burkhardt et al. (journal of antimicrobial chemotherapy, 2006) using the microdialysis technique showed that the free tissue concentrations after a single dose of 1 g ertapenem are sufficient and adequate to kill most relevant bacteria, suggesting efficacy of ertapenem for soft tissue infections. it is well known that there is no accumulation of ertapenem in plasma after multiple doses of 1 g every 24 h in patients without significantly impaired renal function. the single dose study by burkhardt et al. also suggests that only negligible drug accumulation can be expected in soft tissues of healthy young volunteers after multiple doses. however, it was shown for other antibiotics that tissue pk may be significantly different under pathologic conditions, leading to impaired penetration, but subsequent accumulation after multiple doses due to a longer tissue half life than in healthy volunteers. since the properties of inflamed tissue may diverge from those of healthy tissue it is important to evaluate which concentrations of ertapenem are reached in inflamed tissue after multiple doses. clinical study: in the present study we will measure the concentrations of ertapenem over time in plasma and infected tissue of 10 diabetes patients after multiple doses. the microdialysis technique will be used. the ertapenem concentrations will be measured in inflamed tissue and in non-inflamed subcutaneous tissue to identify the effect of inflammation on pharmacokinetics. the findings of the present study will help to confirm the efficacy of ertapenem for the indication of diabetic soft tissue infections.


Eligibility criteria:
inclusion criteria: * male or female, aged between 18 and 85 years * diagnosis of diabetes mellitus * clinically diagnosed skin or soft tissue infection and/or infected ulcers of the leg, requiring antimicrobial therapy * prescription of ertapenem for therapeutic reasons * willingness and ability to comply with the protocol * signed informed consent exclusion criteria: * hiv, hepatitis b or c positive * allergy or hypersensitivity against study drug * severe renal impairment, defined by a serum creatinine level \> 1.6 mg/l * pregnancy, or women of child bearing potential not willing to apply adequate contraception during study period * any disease considered relevant for proper performance of the study, or risks to the patient, at the discretion of the investigator

Keywords: ertapenem tissue pk
microrna markers in head and neck cancers

Conditions: Squamous Cell Carcinoma of Head and Neck

Summary: the purpose of this study is to investigate the presence of mirna markers in saliva, blood, fna and tissue specimens in patients with and without head and neck cancer and evaluate whether these mirna markers can provide prognostic or diagnostic clinical significance in the treatment of head and neck cancer patients.

micro rna (mirna) markers were initially discovered in 1993 and recent research has shown that they have great potential for use as both surveillance and prognostic markers in cancer treatment, as well as potential targets for cancer therapy. recent research has identified several mirna markers which appear to be potential markers for head and neck squamous cell carcinoma, and these have been tested in both mouse and human banked tumor samples. these investigators hypothesize that these markers may also be present in other tissues, including fine needle aspiration biopsy, blood, and saliva specimens, and will be sensitive and specific to patients with known head and neck cancer.

Eligibility criteria:
inclusion criteria: 1. subjects between the ages of 18 and 100 2. patients who are seen and evaluated by a provider within the adult ent clinic at university of colorado hospital 3. patients that present with a current or past diagnosis of head and neck cancer -or-patients undergoing tonsillectomy or sleep surgery as standard of care (control group) exclusion criteria: 1. under the age of 18 or over the age of 100 2. unwilling to participate
camovid : evaluation of efficacy and safety of camostat mesylate for the treatment of sars-cov-2 infection - covid-19 in ambulatory adult patients

Conditions: Covid19

Summary: the overall objective of the study is to determine the therapeutic effect and tolerance of camostat mesylate, compared to placebo in adult patients with ambulatory covid-19 disease, presenting with risk factors of severe covid-19. camostat mesylate is a serine protease tmprss2 (transmembrane serine protease 2) inhibitor which has been successfully and safely used to treat pancreatitis-associated pain and post-operative reflux oesophagitis in japan. more recently, it has been shown to inhibit sars-cov-2 viral entry and reduce infection of human primary pneumocytes and lung cell lines. camostat mesylate or placebo will be administered to consenting adult patients with virologically confirmed covid-19, not requiring initial hospitalization. all patients will receive standard of care along with randomized treatments. outcomes of included patients will be compared between the 2 groups.


Eligibility criteria:
inclusion criteria: * patients ≥ 18 years old * patients with an increased risk of severe covid-19 belonging to one or more of the following groups : * age ≥ 50 years * body mass index ≥ 30 kg/m² * diabetes * hypertension * chronic renal failure (egfr \<60 ml/min) * chronic heart disease * asthma/chronic obstructive pumonary disease/cystic fibrosis * chronic liver disease * chronic neurological disease * solid organ transplant * bone marrow transplant * sickle cell anemia/ major thalassemias * active or currently treated or \<1 year diagnosed cancer * active or currently treated or \<1 year diagnosed malignant blood disease * immunosuppressive treatment observed for more than 1 month * laboratory confirmed sars-cov2 infection with mild covid-19, fulfilling all the following criteria: * positive sars-cov-2 rt-pcr nasal swab samples and * clinical symptoms and signs consistent with sars-cov2 infection including but not limited to, fever, upper respiratory tract infection signs, digestive signs, muscle pain, anosmia, dysgueusia...(1) * informed consent to participate to the trial * patients must be able and willing to comply with study visits and procedures exclusion criteria: * initial need for hospitalization for covid-19 management * pregnancy and breastfeeding * participation to another interventional drug trial * subject protected by law under guardianship or curatorship * absence of health insurance * known hypersensitivity to camostat mesylate * known person sharing the same household already included in the study * participation to another covid-19 ambulatory interventional study * patients having completed a full sars-cov2 vaccine immunization procedure less than 4 weeks prior to covid-19 diagnosis (last vaccine injection performed less than 4 weeks prior to covid-19 diagnosis)
open-label, extension study of cdp870 in patients with rheumatoid arthritis

Conditions: Rheumatoid Arthritis

Summary: this is a phase ⅲ multicenter, open-label, follow-up study, to assess the safety and efficacy of certolizumab pegol (czp) as additional medication to methotrexate (mtx), in patients with active rheumatoid arthritis (ra) who participated in study (protocol) # 101-koa-0801i.


Eligibility criteria:
inclusion criteria: * failed to achieve an acr20 response at week 12 in the study 101-koa-0801i or completed the entire study 101-koa-0801i through week 24 * have a clear chest x-ray at the entry visit * negative urine pregnancy test at the entry * continue treatment on methotrexate exclusion criteria: * any other inflammatory arthritis (e.g., psoriatic arthritis, ankylosing spondylitis or reactive arthritis) * secondary, non-inflammatory type of arthritis (eg, osteoarthritis, fibromyalgia) * at study entry taking any of the prohibited medications as detailed in the study (protocol) # 101-koa-0801i * nyha (new york heart association) class iii or iv congestive heart failure * current or history of tuberculosis * history of chronic infection, recent serious or life-threatening infection or any current sign or symptom that may indicate an infection (e.g., fever, cough) * history of a lymphoproliferative disorder including lymphoma or signs and symptoms suggesting lymphoproliferative disease * high risk of infection * female breast feeding, pregnant or plan to become pregnant during the trial or for 12 weeks following the last dose of study drug
thyroid function and autoimmunity in subfertility women and assisted reproductive therapy

Conditions: Ovarian Failure; Thyroid Diseases

Summary: the assessment of ovarian reserve is well established based on the dosage of anti-mullerian hormone (amh). the clinical applicability of detecting thyroid autoantibodies levels has been discussed as a potential marker of low-grade inflammation. there are no studies about the detection of these autoantibodies in infertile women. our objective is to evaluate the association between ovarian reserve and thyroid function and its autoimmunity in infertile women seeking for assisted reproductive treatment (art).evaluation ot thyroid function in the first trimester in also be evaluated in women submitted to art.

the assessment of ovarian reserve is well established based on the dosage of anti-mullerian hormone (amh). the clinical applicability of detecting thyroid autoantibodies levels has been discussed as a potential marker of low-grade inflammation. there are no studies about the detection of these autoantibodies in infertile women. evaluation of tsh profile during ovarian stimulation in art is also debated in literature with conflicting results. our objective is to evaluate the association between ovarian reserve and thyroid function and its autoimmunity in infertile women seeking for assisted reproductive treatment (art) and tsh profile during ovarian stimulation and during the first trimester.

Eligibility criteria:
inclusion criteria: * inclusion criteria were: women attended in the outpatient clinic with baseline exams before art and during ovarian stimulation between july 2021 and july 2023 exclusion criteria: * exclusion criteria were: patients with known clinical hypothyroidism, patients using medications that may influence the hypothalamic-pituitary-thyroid axis, such as glucocorticoids in supraphysiological doses; or that could interfere with thyroid hormone metabolism (lithium, amiodarone and aspirin in anti-inflammatory dosages).

Keywords: anti mullerian hormone thyroid autoimmunity antithyroid antibodies infertility
interest of cryotherapy or cortisone aerosol therapy in early post-operative swallowing disorders following total thyroidectomy

Conditions: Thyroidectomy; Post-operative Swallowing Disorders

Summary: the scientific interest of this study is to improve post-operative comfort in patients after thyroid surgery using simple, inexpensive techniques. the investigator expects that local applications of ice or cortisone aerosols will reduce swallowing discomfort and control post-operative pain (pop). the investigator hopes that local cryotherapy will decrease post-operative oedema (vasoconstriction) and the volume of liquid drained (action on the serous fluid at the site of the thyroidectomy).


Eligibility criteria:
inclusion criteria: * patients about to undergo total thyroidectomy by cervicotomy * single surgeon: dr osmak-tizon liliana * patients who have provided written consent to take part in the research * hospitalized in the endocrine surgery unit * whose mental and physical state allows them to participate in the quantification of a symptom using a visual analogue scale(vas) exclusion criteria: * patients under 18 or adults under guardianship * patients about to undergo unilateral thyroid surgery (thyroid lobectomy) * patient who have had parathyroid surgery * history of cervicotomy * intolerance to, contra-indication for or allergy to any of the treatments tested. * pregnant or breast-feeding women * patients without national health insurance cover
effects of oral supplement containing l-histidine and antioxidants on the skin barrier function and systemic inflammation in rosacea

Conditions: Rosacea; Systemic Inflammation

Summary: the purpose of this study is to evaluate how supplementation will alter the skin and the gut barrier and inflammation in those with rosacea.

rosacea is a chronic inflammatory condition that widely prevalent in the general population and is associated with both inflammation and dysfunction of the skin barrier. gut dysfunction has been shown to be present in those with rosacea. this study evaluates how the use of a supplement may improve the gut and skin barrier as well as reduce general inflammation.

Eligibility criteria:
inclusion criteria: * males and females 30 to 70 years of age * the presence of mild to moderate rosacea (erythematotelangiectatic or papulopustular) * high sensitivity c-reactive protein (hs-crp) that is greater than or equal to 1.0 mg/l exclusion criteria: * the presence of severe rosacea as noted by the investigator global assessment. * those who are unwilling to discontinue oral supplementation, or supplement ingredients found in the study's oral product 1 month prior to enrollment. * discontinuation of oral l-glutamine or l-glutamine containing supplement 1 month prior to enrollment * those who are unwilling to discontinue topical benzoyl peroxide or retinoids for 2 weeks prior to enrollment. * those who are unwilling to keep their facial regimen the same throughout the study. * individuals who have been on an oral antibiotic within the previous one month. * individuals who are pregnant or breastfeeding. * individuals who have changed any of their hormonal based contraception or therapies within 3 months prior to joining the study. * individuals on oral contraceptive pills or progesterone or estrogen containing therapies. * use of isotretinoin within the three months prior to enrollment. * individuals on finasteride or dutasteride * current tobacco smoker, smoker within the past year, or greater than 5 pack-year tobacco smoking history.

Keywords: rosacea l-histidine antioxidants