Kornimate/medical-research-clean huggingface dataset:
an evaluation of post discharge utilization among patients with an acute exacerbation of copd

Conditions: Chronic Obstructive Pulmonary Disease

Summary: patients who are hospitalized at select carolinas healthcare system (chs) sites with chronic obstructive pulmonary disorder (copd) acute exacerbation symptoms will be treated per the chs copd clinical pathway. patient outcomes will be followed, including but not limited to readmission. patients on the pathway will also have access to navigator services.

patients hospitalized at participating chs sites with copd acute exacerbation symptoms, will be treated per the chs copd clinical pathway. the copd clinical pathway will include four components: (i) discrete, evidence-based care steps (ii) patient navigation, (iii) daily data driven care gap identification, (iv) monthly leadership huddles. these components are all part of usual care for patients in this population, but each component is not applied to patients consistently across the system. for this reason, the pathway will be applied consistently and completely in patients meeting copd acute exacerbation criteria at participating sites. patients will be followed for 60 days in total after discharge from their copd acute exacerbation symptoms to determine the potential effectiveness of complete implementation of all 4 components in the care of copd patients. patients on the pathway will also have access to navigator services.

Eligibility criteria:
inclusion criteria: * identified as having an acute exacerbation of copd within 24 hours of admission exclusion criteria: * death during the index encounter * no initial discharge as of the end of the study period
personalized evidence-based treatment in patients with invasive breast cancer

Conditions: Breast Cancer-specific Survival

Summary: a population-based case-cohort study of breast cancer-specific survival among all first invasive breast cancer cases


Eligibility criteria:
inclusion criteria: all women with stage i-iii disease who survived at least 12 months post-diagnosis exclusion criteria: unknown cause of death treatment outside the region (thus precluding the treatment assessment)
managing of missed meal bolus by hcl systems

Conditions: Diabetes Mellitus, Type 1

Summary: the goal of this interventional study is to compare glycemic outcomes after missed meal bolus in children and adolescents with type 1 diabetes (cwd) treated by one of the three most common used types of hybrid closed loop (hcl) systems - medtronic minimed 780g, tandem control-iq, ypsomed camaps. the main questions it aims to answer are: * do the glycemic outcomes (area under the curve of glucose concentration change, maximal glucose rise from baseline, time to maximal glucose rise from baseline, cgm parameters) vary after missed meal bolus among different types of hcl systems? * does the type of insulin analog influence glycemic outcomes after a missed meal bolus? participants will have a precisely defined amount of enteral nutrition (resource fibre, 2 kcal/ml) for breakfast during eight different days under predetermined conditions. they will administer premeal bolus only for half of these meals.


Eligibility criteria:
inclusion criteria: * children with type 1 diabetes (cwd) 9.00-18.99 years old * use of continuous glucose monitoring (cgm) \>70% of the time 14 days before a regular check-up in the outpatient clinic * hcl use (minimed 780g, tandem control-iq or ypsomed camaps) \>3 months * duration of t1d \>2 years * baseline hba1c level \<58 mmol/mol (7.5%) * weight \> 30 kilograms * without any medication influencing glycemia (f.e. gliflozins, systemic corticosteroids...) * signed informed consent form with the study
adequacy of perioperative cefuroxime dosage according to the bmi

Conditions: Obesity; Drug

Summary: this study evaluates the dosage of perioperative cefuroxime for obese patients. dosage was increased if the bmi was over 30kg/m\*m and as well over 50kg/m\*m. drug levels were measured in blood and tissue.

cefuroxime is an often used antibiotic for surgery antibiotic prophylaxis to avoid surgical wound infection. in this study the dosage of cefuroxime was adjusted to the bmi: less than 30kg/m\*m: 1,5g 31-50kg/m\*m: 3,0g more than 50kg/m\*m: 4,5g cefuroxime was applicated 30 to 60 minutes before the begin of surgery. drug levels in blood and fat tissue were measured at skin cut (30-60 minutes after application of cefuroxime), 45 minutes after skin cut (75-105 minutes after minutes after application of cefuroxime) and at the end of surgery (up to 150 minutes after application of cefuroxime) . the hypothesis of this study is that adequate drug levels are reached in all groups.

Eligibility criteria:
inclusion criteria: * elective laparoscopic intervention * bmi \< 90 kg/m\*m * age: 18-85 years exclusion criteria: * known history of allergy to cefuroxime or other cephalosporines * absent consent skill * elective open surgery * preoperative therapy with antibiotics * patient's denial of the study

Keywords: surgery obesity drug antibiotics cefuroxime
enhanced magnifying endoscopy for diagnosis of early gastric cancer

Conditions: Stomach Neoplasms

Summary: when performing screening endoscopy, small focal gastric lesions are frequently encountered. novel techniques in endoscopy, such as magnifying endoscopy (me) with narrow-band imaging (nbi) and chromoendoscopy with acetic acid-indigocarmine mixture (aim), are developing to enhance images of gastrointestinal tumor. furthermore, observation of the microstructures of gastric mucosa by me, including microvascular pattern and microsurface pattern, has been proposed in the recognition of early gastric cancer (egc). this study is based on the hypothesis as follow: 1. the microvascular structure could be clearly observed with magnifying endoscopy enhanced by narrow-band imaging (me-nbi). 2. the microsurface architecture could be clearly observed with magnifying endoscopy enhanced by acetic acid-indigocarmine mixture (me-aim). 3. enhanced me (combining me-nbi and me-aim), as compared to white-light endoscopy (wle), has higher sensitivity and specificity for the differential diagnosing small focal gastric lesions.

patients who received surveillance endoscopy for egc using a zoom endoscope were eligible for inclusion. wle without magnification was performed first in eligible patients. based on an assessment of the shape (such as flat, depressed or elevated) and color (pale or reddened), small focal gastric lesions were identified and included for evaluation by experienced endoscopists. when such a lesion was detected during non-magnifying observation with wle, the mode was then changed to me-nbi for observation of microvascular pattern and me-aim for observation of microsurface pattern subsequently. all endoscopic images of the whole procedure were recorded in digital filing system for later evaluation. to avoid possible selection bias and to maintain the quality of the study, all images of each endoscopic modality (including wle, me-nbi, me-aim), which were arranged randomly on one slide and displayed independently of the images of other endoscopic modality, were evaluated by 4 skilled endoscopists, who were not access to the clinical and pathological data. the general consensus was established for an assessment of each lesion. two forceps biopsy specimens were taken from each lesion and pathological diagnosis were used as the criterion standard for cancer diagnosis.

Eligibility criteria:
inclusion criteria: * patients, in which small focal gastric lesions were identified with conventional wle, were enrolled in this study. before being enrolled, all patients provided written informed consent. exclusion criteria: * patients who cannot undergo gastroscopies due to unsuitable conditions * referred patients with a history of having being diagnosed as gastric cancer * patients with a personal history of gastric surgery * patients who cannot provide informed consent * patients with advanced gastric cancer

Keywords: stomach neoplasms early gastric cancer magnifying endoscopy narrow band imaging acetic acid indigocarmine
detection of coronary vulnerable plaque with contrast-enhanced magnetic resonance imaging

Conditions: Coronary Artery Disease; Stable Angina; Unstable Angina

Summary: mri has the ability to visualize the arterial vessel wall. wall thickening and atherosclerotic plaque components can be visualized in the carotid arteries and the aorta. previous studies also demonstrated the ability of mri to visualize the coronary vessel wall. the ultimate goal of coronary vessel wall imaging is to detect vulnerable atherosclerotic plaque thereby. this might prevent complications, e.g., chest pain (angina) or myocardial infarction. the goal of this study was to validate mri of the coronary vessel wall by comparing it to intravascular ultrasound (ivus), to detect atherosclerotic plaque in the coronary vessel wall and to look at the uptake of the albumin-binding contrast agent gadofosveset in atherosclerotic plaques. the main hypothesis is that due to the albumin binding characteristics, uptake of the contrast agent will take place in the more vulnerable plaques compared to less vulnerable plaques. mri will be compared to x-ray coronary angiography and intravascular ultrasound, two techniques currently considered as the standard of reference for imaging of the coronary arteries and vessel wall.


Eligibility criteria:
inclusion criteria: * scheduled x-ray angiography for known coronary artery disease, valvular disease or chest pain with unknown origin * age \> 18 yrs and \< 90 yrs * informed consent exclusion criteria: * arrhythmia * hemodynamic unstable patients * contra-indications for (contrast-enhanced) mri * age \ 90 yrs

Keywords: coronary artery mri vessel wall imaging
effect of buffered numbing solution on patients with toothaches

Conditions: Irreversible Pulpitis (Toothache)

Summary: the purpose of this study is to determine the effect of buffered lidocaine (a numbing solution) on the ability to numb patients with toothaches. buffered anesthetic (numbing) solutions have shown promise in some medical and dental research. patients presenting with toothaches will be given either a buffered numbing solution or a nonbuffered numbing solution. neither the patient nor the operator will know which solution they will receive. root canal treatment will be performed on the tooth and the ability of the buffered versus non-buffered numbing solutions will be compared.


Eligibility criteria:
inclusion criteria: * patients with a diagnosis of irreversible pulpitis (toothache) in a mandibular posterior tooth (back/bottom tooth) with moderate to severe pain * ages 18 -65 years of age * in good health (asa i or ii) * able to grant informed consent. exclusion criteria: * allergy to lidocaine (numbing solution * significant medical problem (asa iii or iv) * have taken cns depressants or analgesic medications within the last 24 hours * pregnancy or lactating * non-english speaking * inability to give informed consent
flavoring oral contrast for mr enterography

Conditions: Taste, Altered

Summary: to determine if patient satisfaction, participation, and image quality improves with flavored oral contrast for mr enterography.

volumen is an oral contrast agent used in mr imaging of the bowel. it has an unpleasant taste which makes it difficult for pediatric patients, especially sick pediatric patients, to drink. there are other contrast materials used in the department that are flavored to improved patient participation. the investigators hope to determine a way to flavor volumen to improve patient participation. in doing so, the investigators hope to also improve patient satisfaction as well as imaging quality.

Eligibility criteria:
inclusion criteria: * pediatric patients having a mr enterography exclusion criteria: * sedated patients
epigenetic effects elicited by lactobacillus gg in children with cow's milk allergy

Conditions: Cow's Milk Allergy

Summary: lactobacillus gg (lgg) is able to exert long lasting effects in children with atopic disorders. we have shown that nutramigen lgg accelerates tolerance acquisition in infants with cow's milk allergy (cma). the mechanisms of these effects are still largely undefined. the effect of lgg could be related at least in part by the immunoregulatory role played by lgg. this probiotic can balance the generation of cytokines possibly involved in ige- or non-ige-mediated cma (i.e., il-4, il-5, il-10, ifn-γ , tgf-beta, and tnf-alfa), which can contribute to modulation of inﬂammatory processes. we have demonstrated that children with ige-mediated cma produce significantly higher level of il-4 and il-13 in response to cow's milk protein, and that tolerance is associated with a marked reduction of il-13 production and a concomitant increased frequency of ifn-γ releasing cells. epigenetics studies the heritable (and potentially reversible) changes of the genome inherited from one cell generation to the next which alter gene expression but do not involve changes in primary dna sequences, highlighting the complexity of the inter-relationship between genetics and nutrition. there are three distinct, but closely interacting, epigenetic mechanisms (histone acetylation, dna methylation, and non-coding micrornas) that are responsible for modifying the expression of critical genes associated with physiologic and pathologic processes. the profile of epigenetic modifications associated with th lineage commitment, coupled with the sensitivity of the early developmental period, has led to speculation that factors that disrupt these pathways may increase the risk of allergic diseases. specifically, effects on dna methylation and endogenous histone deacetylase inhibitors acting on specific pathways (th1 and t regulatory cell differentiation) may favour th2-associated allergic differentiation. micrornas are another structural components of an epigenetic mechanism of post-transcriptional regulation of messenger rna translation. it has been recently identified a specific th2-associated mirna (mir-21) that is critical for the regulation of th cell polarization.


Eligibility criteria:
inclusion criteria: * children aged 4 months-4 years with cow's milk allergy exclusion criteria: * age higher than 4 years, * concomitant chronic systemic diseases, * congenital cardiac defects, * active tuberculosis, * autoimmune diseases, * immunodeficiency, * chronic inflammatory bowel diseases, * celiac disease, * cystic fibrosis, * metabolic diseases, * malignancy, * chronic pulmonary diseases, * malformations of the gastrointestinal tract, * suspected eosinophilic esophagitis or eosinophilic enterocolitis, * suspected food-protein-induced enterocolitis syndrome, * suspected cow's milk protein-induced anaphylaxis.
non inferiority study of a reduced dose of activated charcoal on rivaroxaban pharmacokinetics.

Conditions: Healthy

Summary: rivaroxaban is a direct oral anticoagulant that target specifically activated factor x. bleeding events related to rivaroxaban are the consequence of physiopathologic, pharmacokinetic issues or poisoning. a recent study, in healthy subjects, shows that activated charcoal can reduce significantly exposition to rivaroxaban. however, no results are available on the minimal dose of activated charcoal necessary in rivaroxaban poisoning. the objective of this study is to evaluate the effect of 4 dosing regimen activated charcoal on rivaroxaban pharmacokinetics. it corresponds to a randomised open trial with an incomplete cross over design (3 occasions). it will enrol 12 healthy subjects. four treatments modalities will be studied: rivaroxaban with 50g, 24g, 12g and 6g of activated charcoal administrated 3 hours after rivaroxaban intake.


Eligibility criteria:
inclusion criteria: * affiliated or beneficiary of a social security category * having signed the inform consent form * having signed the biologic consent form * men aged between 18 and 40 years * weight between 55 and 92 kilogram * normal clinical exam * normal biological exam exclusion criteria: * contra-indication to rivaroxaban * contra-indication to activated charcoal * with a history of hemorrhagic disease * smoker * organic lesion likely to bleed * severe liver disease * severe kidney failure * gastroduodenal ulcers * any medication taken during the week prior to the start of the study * consumption of grapefruit juice * routine ingestion of excessive amounts of coffee, tea, chocolate and/or caffeinated beverages * practice of violent sports * fructose intolerance * glucose-galactose malabsorption syndrome or sucrase-isomaltase deficiency syndrome * notable medical history (cardiovascular pathology, pulmonary, neurology ...)

Keywords: rivaroxaban, activated charcoal pharmacokinetics poisoning
assessment of the diagnostic performance of the detection system and establishment of an intelligent and rapid triage model

Conditions: Coronary Heart Disease (CHD)

Summary: the rapid triage of patients with acute chest pain remains an important issue in clinical practice. this study will establish a cohort of patients suspected of acute coronary syndrome (acs) to construct a multi-marker dynamic combined intelligent triage model. this model will triage the risk of nstemi in patients with chest pain at their first visit. it will also stratify the risk of patients with chest pain using major adverse cardiovascular events (mace) within 30 days as the endpoint.


Eligibility criteria:
inclusion criteria: * adults aged 18 years or above from china, regardless of gender; * presence of symptoms such as chest tightness and chest pain, with the need to determine whether they are patients with acute coronary syndrome; * ability to obtain informed consent. exclusion criteria: * - patients with stemi at the time of presentation; * patients with a clear diagnosis after tests such as troponin; * patients who have undergone major surgery or trauma within the past four weeks; * pregnant women or patients with tumors undergoing radiotherapy or chemotherapy; * patients who have previously participated in this study.

Keywords: acs
exercise training in individuals with peripheral arterial disease

Conditions: Peripheral Arterial Disease; Intermittent Claudication

Summary: in this controlled trial, patients with peripheral arterial disease will be randomized to either maximal walking, submaximal walking, or usual care groups.

exercise training (walking) is a recommended therapeutic intervention for patients with peripheral arterial disease (pad). studies have shown that exercise training improves walking distance, pain-free walking distance, endothelial function and quality of life in these patients. however, to date the most effective exercise training option in terms of improvement of cardiovascular parameters has not been clearly identified. in this controlled trial, patients with pad will be randomized to either maximal walking group, submaximal walking group, or usual care. the aim of the study is to compare the effect of maximal vs. submaximal walking training programmes on i) walking ability, ii) vascular function, iii) arrhythmogenic potential, iv) parameters of inflammation, hemostasis and heart failure severity, v) health-related quality of life in individuals with pad.

Eligibility criteria:
inclusion criteria: * diagnosed peripheral arterial disease, * fontaine stage ii, * not included in a cardiovascular rehabilitation programme for at least 3 months. exclusion criteria: * contraindications for physical activity, * uncontrolled dysrhythmias, * uncontrolled heart failure (new york heart association (nyha) stage iv), * unstable coronary or other arterial disease, * intellectual development disorder, * pregnancy.

Keywords: exercise training
histscanning- based pdr brachytherapy in prostate cancer histoscanning- based interstitial pdr brachytherapy

Conditions: Prostate Cancer

Summary: this is a phase ii trial looking at the feasibility of histoscanning- based dose-painting image- guided interstitial brachytherapy in non- metastatic prostate cancer endpoints: primary endpoint evaluation of the feasibility of histoscanning- based dose-painting image- guided interstitial brachytherapy secondary endpoints 1. evaluating tumor response using histoscanning 2. evaluating locoregional recurrence rates by measuring psa 3. analysis of the correlation between tumor response as determined by histoscanning and psa response 4. evaluating the safety dose-painting image- guided interstitial brachytherapy by recording serious adverse events

rationale: the study is designed as a prospective monocentric phase ii trial. the choice of the therapeutic concept is governed by the risk group that the patient falls into. risk groups are defined according to the classification by d' amico. the following concepts will be used: hdr brachytherapy: 19,0- 38 gy / 2-4 fractions (2-4 x 9,5 gy) pdr brachytherapy: 35-70 gy / 50 --100 pulses(1 puls/h, 24 h/d) dose painting the timorous areas as seen in histoscanning as covered with a dose dref2\>130-150% external beam radiotherapy will be used in addition to brachytherapy for intermediate and high risk patients. the following concepts will be used 50,40 gy / 28 fractions at 1.8 gy

Eligibility criteria:
inclusion criteria: * histologically proven prostate cancer * all ct1-3 carcinomas independent of grading and psa value * prostate volume\< 70cc * no distant metastases * karnofsky \> 60 * written informed consent from the patient regarding study participation exclusion criteria: * all patients who do not meet the inclusion criteria * t4 carcinomas * proven metastases n+ and/or m1 * epidural or general anaesthesia not possible * pathological clotting parameters

Keywords: histoscanning brachytherapy
assessing exercise capacity after pulsehaler™ treatment in gold ii-iv copd patients

Conditions: COPD

Summary: prospective, sham controlled, interventional study to evaluate the extent to which pulsehaler improves the functional status of chronic obstructive lung disease (gold) ii-iv chronic obstructive pulmonary disease (copd) patients.

pulsehaler™ is a pulsating positive expiratory pressure ventilation device for treatment of copd . pulsehaler™ is pre-programmed to deliver airflow at pre-defined frequencies and for pre-defined lengths of time. the study is intended to evaluate the extent to which pulsehaler improves the functional status of gold ii-iv copd patients after 4 weeks of treatment 3x / day. and to evaluate the extent to which improvements are maintained over a subsequent 2 weeks when treatments are tapered to 1x daily.

Eligibility criteria:
inclusion criteria: * investigator confirmation of gold ii-iv copd * successful completion of incremental exercise test (iet) * fev1 \< 60% predicted * post-bronchodilator fev1/fvc ≤ 0.7 * 55-75 years old * signed informed consent by subject (required cognitive capacity) exclusion criteria: * spo2\<80% at iet * unable to achieve a cwr test duration at visit 2 between 3 and 8 minutes * exercise limitation unrelated to diagnosis of copd * systemic (oral, iv, im) steroid use for acute exacerbation in the 30 days prior to screening * baseline cat score \<10 * women at the age of fertility, who are pregnant, or plan pregnancy, or do not use contraceptives * severe cardiac disease, e.g., congestive heart failure grade , hemodynamic instability, * acute myocardial infarction within last 3 months * coronary artery bypass graft within last 3 months * epilepsy, raised intracranial pressure, acute sinusitis or nosebleed * pulmonary embolism, untreated air leaks, tension pneumothorax, bronchopleural fistula, active hemoptysis, pulmonary haemorrhage, large pulmonary bullae, intrathoracic obstruction from tumor or foreign body * unhealed dental, head, neck, ear, nose \& throat, thoracic or upper gastro-intestinal tract surgery or trauma * unhealed broken ribs * esophageal varices * anxiety, depression, history of mental illness * dependence on positive pressure ventilation (i.e. 24/7 non-invasive ventilation). * cannot perform spirometry * enrollment in another interventional study * any medical condition for which the investigator deems the subject unable to participate in the study