Kornimate/medical-research-clean huggingface dataset:
jak inhibitor in acquired hemophagocytic syndrome in the intensive care unit

Conditions: Hemophagocytic Syndromes

Summary: hemophagocytic syndrome (hs) is a rare condition that can be responsible for severe organ failure. therapeutic guidelines are mainly based on observational studies and expert opinions: no therapeutic advance has been developed for years, explaining why mortality in hs remains high (intensive care unit mortality ranging from 40 to 70%). if etoposide remains the gold standard in critically ill hs patients, nearly 20% of patients are refractory to this therapy: treatment escalation is common, most often requiring the administration of intensive treatments generating high toxicity. ruxolitinib is the first approved jak inhibitor. it has been associated with improvement of hs manifestations and survival in a pre-clinical murine model. data in humans are scarce but promising. the aim is to demonstrate that ruxolitinib, in association with standard of care, may reverse organ failure (as represented by sequential organ failure assessment (sofa) score) better than standard of care alone in critically ill patients with acquired hs.


Eligibility criteria:
inclusion criteria: * adult patients older than 18 years * acquired hemophagocytic syndrome, regardless of etiology, defined by the presence of 5 or 6 hlh-2004 criteria or hscore ≥ 200 * admission in the icu * need for symptomatic treatment of hs in relation with organ failure, as defined by sofa score ≥ 4 * informed consent signed: * by the patient, * or informed consent signed by a family members/trustworthy person if his condition does not allow him to express his consent in written * or in an emergency situation and in the absence of family members/trustworthy person, the patient can be enrolled. the consent to participate to the research will be requested as soon as the condition of the patient will allow). * the inclusion of women of childbearing potential requires the use of a highly effective contraceptive measure. contraception should be maintained during treatment and one day after exclusion criteria: * moribund, defined by a life expectancy \< 48 hours; * pregnant or lactating patients (women of childbearing potential must have a negative urine or blood human chorionic gonadotropin pregnancy test prior to trial entry); * no affiliation to health insurance; * known hypersensitivity to ruxolitinib; * lactose intolerance; * hypersensitivity to cellulose, microcrystalline; magnesium stearate; silica, colloidal anhydrous; sodium starch glycolate (type a); povidone k30; hydroxypropylcellulose 300 to 600 cps, * pre-existing decisions of withholding/withdrawing care, * history of progressive multifocal leukoencephalopathy * uncontrolled cutaneous cancer * persons under psychiatric care that would impede understanding of informed consent and optimal treatment and follow-up * adults subject to a legal protection measure (guardianship, curatorship and safeguard of justice) * patients deprived of their liberty by a judicial or administrative decision * participation in another interventional research
dynamic stability exercises in patients with hypermobile ehlers-danlos syndrome and hypermobility spectrum disorder

Conditions: Hypermobility Syndrome; Hypermobile Ehlers-Danlos Syndrome

Summary: background: symptomatic hypermobility may lead to a number of restrictions in daily life. so far, there is a lack of effective treatments. a whole-body dynamic stability exercise intervention targets to stimulate the dynamic stability and activation of the proprioceptive system and thereby intends to improve patients' health. the aim of the current study was to examine the feasibility, acceptability and impact of a whole-body dynamic stability exercise intervention in patients with hypermobile ehlers-danlos syndrome and hypermobility spectrum disorder. the aim of the current study was to examine the feasibility, acceptability and impact of a dynamic stability exercise intervention in patients with hypermobile ehlers-danlos syndrome and hypermobility spectrum disorder. methods: this is a mixed-methods feasibility study. fifteen patients (14 women and 1 man) with hypermobile ehlers-danlos syndrome or hypermobility spectrum disorder and chronic pain were recruited from two pain specialist clinics in the south-east of sweden. a dynamic stability exercise program for daily home-exercise was applied during five physiotherapist led sessions distributed over seven weeks. patient reported outcome measures (proms) included pain and function, psychological well-being and quality of life. the clinical tests included walking and balance. through qualitative interviews patients and physiotherapists described their experiences of the assessments and intervention. assessments were done at baseline, after the intervention, and at the 3-month follow-up.

the specific research questions are: 1. do retention rates, adherence rates and adverse events allow continuation to a large scale rct? 2. what are the tendencies of impact of the exercise program on pain, function, psychological well-being and quality of life? 3. which of the outcome measures used are appropriate and acceptable? 4. what are the patients' and physiotherapists' experiences of the exercise program and protocol.

Eligibility criteria:
inclusion criteria: inclusion criteria were adults aged 18 to 67 years old, with generalized hypermobility (castori. a framework), persistent pain (i.e. longer than three months) in at least two of four quadrants of the body and ability to perform the exercises. exclusion criteria: exclusion criteria were cancer-related pain, underlying neurological disease, presence of severe psychiatric disorders, known substance abuse, patients in the process of finding optimal medication as well as patients with previous experience of similar exercises.

Keywords: hypermobility, exercise intervention, feasibility study, eds
clinical observation of technologic application of no-touch fluid-air exchange in surgery of idiopathic macula hole

Conditions: Idiopathic Macula Hole

Summary: the purpose of this study is to observe the technologic application of no-touch fluid-air exchange in surgery of idiopathic macula hole.


Eligibility criteria:
inclusion criteria: * all patients were diagnosed as having an idiopathic macular hole(imh) by optical coherence tomography(oct). exclusion criteria: * myopia of \>6 diopters * ocular trauma and other systematic or ocular issues associated with imhs，such as the other macula disease, for example the degeneration of macula.
radiofrequency ablation plus botulinum toxin injection versus radiofrequency ablation only in patients with atrial flutter

Conditions: Atrial Flutter

Summary: the aim of this randomized study was to assess the effectiveness of endomyocardial botulinum toxin injection for preventing post-procedural atrial fibrillation in patients undergoing the radiofrequency ablation of atrial flutter.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years * ecg documented paroxysmal or persistent afl * no prior documented history of af * patient undergoing rfa of afl. * no indication (other than afl) for continued anticoagulation with warfarin. * no existing implantable cardiac device (pacemaker, defibrillator, cardiac resynchronization therapy device) exclusion criteria: * a history of atrial fibrillation * previous af ablation procedure * congestive heart failure * left ventricle ejection fraction less than 35% * unwillingness to participate
a prospective natural history study in uveal melanoma

Conditions: Uveal Melanoma

Summary: the overall objective of this proposal is to develop and utilize a multicenter um registry that will, in a longitudinal fashion, capture prospective data in order to characterize the natural history of um and provide data that will be used to support the development of novel therapies for this disease. the care of patients with um requires a multi-disciplinary team of physicians that commonly requires the involvement of both radiation oncology and interventional radiology, and is typically directed by an ophthalmologic oncologist at time of initial diagnosis of primary disease. overall management is transitioned to a medical oncologist when distant recurrence is identified. in the case that a patient presents with metastasis at the time of diagnosis, a medical oncologist typically directs overall management. the management of surveillance for the development of metastasis following the treatment of primary disease is variable and, if performed at all, is managed by either an ophthalmologic oncologist or medical oncologist. thus, the successful development of a registry that aims to capture the data regarding the full natural history of um requires a collaborative effort including leaders from both the um ophthalmologic oncology and medical oncology fields. to this end, the investigators have built an initial consortium of key ophthalmologic oncology and medical oncology leaders from multiple major um centers in the united states.

uveal melanoma (um) is the most common primary intraocular malignancy in adults, accounting for 85% to 95% of ocular melanoma cases. however, um represents only about 3% to 5% of all melanomas in the united states (us). um most commonly arises from choroidal melanocytes (85-90%), but can also arise from the iris (3-5%) and ciliary body (5-8%). the median age of diagnosis is approximately 62; however, the peak range for diagnosis is between 70 and 79. males have a 30% greater incidence than females. a variety of putative risk factors have been identified, including the presence of light eyes, fair skin, an inability to tan, ocular melanocytosis, dysplastic nevus syndrome, and germline brca1-associated protein 1 (bap1) mutations. importantly, there are no recent or on-going multi-center natural history studies being conducted in this disease, and this effort is the only one to be launched with the goal of capturing the complete course of this disease, from diagnosis, initial management, surveillance, and treatment of recurrent disease in a national and international setting. this registry is especially important in providing such needed data.

Eligibility criteria:
inclusion criteria * diagnosis of uveal melanoma * ability to provide written informed consent for participation in the prospective registry or an institutional waiver by the irb/ethics committee for retrospective data collection without written informed consent exclusion criteria \*none

Keywords: uveal melanoma
effects of artificial sweeteners on gut microbiota and glucose metabolism

Conditions: Impaired Glucose Tolerance

Summary: the objectives of this study is to determine the effect(s) of daily non-caloric artificial sweetener (nas) consumption (sucralose or aspartame) on the composition of the bacteria and also to determine the changes in glucose metabolism.

the trial will be 12 weeks randomized, cross-over and double blinded with 2 treatment intervention ( sucralose and aspartame) , there will be a run in period (4 weeks), then phase 1 treatment period for two weeks followed by four weeks washout period then phase 2 treatment period(2 weeks). healthy, normglycemic (\<5.6 mmol/l) males and females ( 17 total) of age 18-45 y with a body mass index (bmi) 20-25 kg/m2 will be recruited. each participants will be given the dose of sweetener aspartame or sucralose during the treatment phase in a double-blind procedure. the participant will be asked to consume the sweetener in a mixed flavoured beverage during each visit in the treatment phase. blood and stool sample collection will take place before after the run-in period, and after the washout period, as well as after each two-week treatment period. glucose measurement: capillary blood will be collected during each visit by registered nurse. blood will be collected at fasting and at 12,30,45,60,90 and 120 minutes after the participants drink a glucose drink (75g glucose) for oral glucose tolerance test. a food frequency questionnaire will be given to each participant in order to estimate how often each sweetener is consumed on a daily basis. participants will also be asked to complete weekly food diaries of food and drink consumption.

Eligibility criteria:
inclusion criteria: * bmi between 20-25 kg/m2 * fasting blood glucose (fbg) \< 5.7 mmol/l * women with regular menstrual cycle. exclusion criteria: * probiotic or antibiotic use within 6 months prior to the start of the study * metabolic or gastrointestinal disorders (diabetes mellitus types 1 and 2, inflammatory bowel disease (ibd), irritable bowel syndrome (ibs), celiac disease, phenylketonuria) * pregnant or lactating women

Keywords: non-nutritive sweeteners artificial sweeteners glucose metabolism microbiota dysbiosis
atrial fibrillation screening and education study

Conditions: Atrial Fibrillation

Summary: the purpose of this study is to evaluate the outcomes of a community placed atrial fibrillation (af) screening and education program

background/significance: atrial fibrillation (af) is a global epidemic that accounts for 15%-20% of 795,000 strokes occurring annually in the us, at a cost of $3.2 billion per year. atrial fibrillation-related stroke will rise with the aging population and places enormous strain on healthcare resources and quality of life; yet they are highly preventable, by early detection of af. timely treatment reduces af-related stroke risk by 68%, yet treatment is often delayed because people may not recognize the symptoms of af or may be asymptomatic. given the number of people at risk for development of af and the dire consequences of untreated af, efforts to promote early detection of af through proactive screening of older adults at risk for af have been successfully undertaken in europe and australia. however, little is known about the outcomes of conducting programs to screen for and educate people about af in community settings in the us. purpose: the purpose of this descriptive pragmatic study to evaluate the outcomes of a community placed af screening and education program. primary outcomes include feasibility, number of participants who screen positive for af, and changes in participants' knowledge, attitudes, and beliefs about atrial fibrillation self-monitoring (kabaf-sm) scores from baseline to two-weeks after enrollment. methods: up to 250-participants who have at least two risk factors for developing af and have no previous diagnosis of af will be recruited from midwest community settings and will be screened for af using a mobile ecg recorder and will receive written information sheet about af. a portion (up to 125) of those 250 participants will be invited to complete the kabaf-sm at baseline and 2-weeks after enrollment. participants will have the option to participate in a variety of af educational activities to reinforce and enhance the written information. participants will be surveyed about their perceptions of the educational program after the screening and participating in the educational activities. evaluation methods: descriptive statistics will be used to analyze feasibility (enrollment numbers, participants perception of the value of the educational activities, time required for study procedures,and af detection.t-tests will be used to test for differences between kabaf-sm baseline and two-week scores for those who completed the kabaf-sm.

Eligibility criteria:
inclusion : any two of the following: * hypertension * diabetes * sleep apnea * obesity * age \> 75 years * peripheral arterial disease * female exclusion : * previous diagnosis of atrial fibrillation or atrial flutter * uncompensated visual impairment * uncompensated hearing impairment * inability to communicate verbally in english

Keywords: screening education afib awareness stroke prevention
safety of desloratadine in children with allergy sensitivity and chronic hives, who are poor metabolizers of desloratadine (study p02994)

Conditions: Chronic Idiopathic Urticaria; Atopy

Summary: this study was conducted to evaluate the safety and tolerance of desloratadine after 5 weeks of repetitive dosing in children ages 2 to 12 years old with allergic hypersensitivity or chronic hives. all of the subjects enrolled in this trial were previously identified in an earlier trial to be poor metabolizers of desloratadine.


Eligibility criteria:
inclusion criteria: subjects must: * have been previously identified through the previous study p03031 to be atopic or with chronic idiopathic urticaria and be a poor metabolizer of desloratadine. * have clinical laboratory tests within normal limits. * be in good health, free of any clinically significant disease that could interfere with the study. * normal 12-lead ecg exclusion criteria: subjects who: * have a history of any clinically significant local or systemic infectious disease within 4 weeks prior to treatment. * have taken any medication that is restricted by the protocol or failed to satisfy washout requirements. * are allergic to desloratadine. * have used a loratadine- or desloratadine-containing product within the past 30 days. * are female and menstruating.
early intervention for adolescents with patellofemoral pain syndrome

Conditions: Patellofemoral Pain Syndrome

Summary: self-reported, unspecific knee pain is highly prevalent among adolescents. a large proportion of the unspecific knee pain can be attributed to patellofemoral pain syndrome (pfps). there are a number of treatment options for pfps. physical therapy has been advocated as one of the cornerstones in rehabilitation of patients with pfps. twenty-five years ago, mcconnell proposed a multimodal approach that combined several treatment options. the regimen included retraining of the vastus medialis oblique muscle through functional weight bearing activities. this exercise is combined with patellar taping, patellar mobilization, and stretching to improve patellar tracking, reduce pain, and enhance vastus medialis oblique muscle activation. short term results (\<12 months) indicates that multimodal physiotherapy is more effective than placebo treatment. while treatment for pfps may be successful for the short-term, long-term results are less promising. a recent review covering the long term prognosis for patients diagnosed with pfps, reported that only 1/3 of those diagnosed with pfps and treated conservatively were pain free 12 months after diagnosis. further ¼ stopped participating in sports because of knee pain. predictors of long term outcome (\>52weeks) indicate that a long symptom duration, higher age and greater severity at baseline are associated to poorer outcome after treatment. these prognostic factors suggest that an early initiation of treatment might lead to a better long-term prognosis. the purpose of this study is to examine the short and long-term effectiveness of multi-modal physiotherapy compared to standard wait-and-see treatment applied at a very early state of disease among adolescents. the investigators hypothesized a significantly larger proportion of completely recovered patients at three-month follow-up in the interventions group compared to the control group.


Eligibility criteria:
inclusion criteria: * age 15-19 years * insidious onset of anterior knee or retropatellar pain of greater than six weeks' duration * provoked by at least two of prolonged sitting or kneeling, squatting, running, hopping, or stair walking * tenderness on palpation of the patella, or pain with step down or double leg squat * worst pain over the previous week of at least 30 mm on a 100 mm visual analogue scale. exclusion criteria: * concomitant injury or pain from the hip, lumbar spine, or other knee structures * previous knee surgery * patellofemoral instability * knee joint effusion * use of physiotherapy for treating knee pain within the previous year * use of weekly use anti-inflammatory drugs.

Keywords: anterior knee pain
registry of coronary artery ill patients with platelet test results

Conditions: Acute Coronary Syndrome; Percutaneous Coronary Intervention; Myocardial Infarction

Summary: onassist is a registry of coronary ill patients who have had a functional test measuring anti-platelet effect and/or a genetic profile of response to anti-platelet drugs.

the onassist project is an assistance for cardiologists that establishes an individual risk of stent thrombosis for each patient based on: * a functional approach (evaluation of the antiplatelet effect of the antiplatelet regimen by multiple tests) and * a pharmacogenomic approach (genetic profile of response to antiplatelet agents) it provides advices for specific therapeutics after identification of adverse drug interactions, treatment compliance issues and true genetic, functional or mixed resistance. this individualized strategy allow to adjust the choice of the drugs and their optimal dosage considering the best benefit - risk ratio. follow up are regularly made to identify markers of mace (major adverse cardiac event) or bleeding.

Eligibility criteria:
inclusion criteria: * coronary disease * antiplatelets testing performed as part of usual care and / or gentic profile of antiplatelet response done exclusion criteria: * patient refusing to be part of the registry

Keywords: antiplatelet stent thrombosis
study to evaluate the effect of intravenous (iv) paricalcitol (zemplar) on cardiac morbidity in patients with chronic kidney disease (ckd) stage 5 over 2 years

Conditions: Secondary Hyperparathyroidism; Chronic Kidney Disease Stage V; Cardiac Morbidity

Summary: the purpose of this study was to ascertain the percentage of cardiac patients with chronic kidney disease (ckd) stage 5 treated with paricalcitol iv achieving intact parathyroid hormone (ipth) levels in target range of kidney disease outcomes quality initiative (k/doqi) treatment guidelines (150 - 300 pg/ml) after 2 years.

secondary hyperparathyroidism (shpt) is a frequent complication in patients with chronic kidney disease (ckd) stage 5 receiving dialysis. shpt is an adaptive response to ckd and is characterized by an elevation in parathyroid hormone (pth) and consecutively high calcium levels. elevations in calcium levels, phosphate levels, and pth are correlated with ckd disease progression as well as development or aggravation of cardiovascular impairment. many ckd patients cannot be treated well with vitamin d analogues because of effects on calcium. hypercalcemia is a well - known factor for cardiac disease. no data are available in austria for a cohort with cardiac disease treated with zemplar (paricalcitol iv).

Eligibility criteria:
inclusion criteria: * patients aged at least 18 years * patients with secondary hyperparathyroidism associated with ckd stage 5, serum ipth \> 150 pg/ml, * cardiac disease as described by medical dictionary for regulatory activities (meddra) terms: * cardiac disorder as cardiac arrhythmias * cardiac disorder signs and symptoms * cardiac neoplasm * cardiac valve disorder * heart failures * myocardial disorder * pericardial disorder * serum phosphate level \< 6.5 mg/dl and serum calcium level \< 10.5 mg/dl exclusion criteria: * patients who meet contraindications as outlined in the latest version of zemplar (paricalcitol iv) summary of product characteristics * patients with known hypersensitivity to paricalcitol or any component of the formulation, vitamin d intoxication, hypercalcemia; cinacalcet as concomitant medication.

Keywords: secondary hyperparathyroidism (shpt) paricalcitol chronic kidney disease stage 5 (ckd stage 5)