Kornimate/medical-research-clean huggingface dataset:
high flow oxygen therapy in patients suffering from chronic obstructive pulmonary disease exacerbation: effects and mechanisms of action

Conditions: COPD Exacerbation

Summary: acute exacerbation of chronic obstructive pulmonary disease (copd) is associated with poor outcome, especially when intubation is required, thus underlining the importance of optimizing non-invasive ventilatory support to avoid intubation. practically, because of treatment intolerance, non-invasive ventilation (niv) cannot be administered 24-hour a day for a long period of time and alternative solutions must be found to deliver oxygen as efficiently as possible to allow niv interruptions. high flow humidified oxygen therapy (hfho) consists of delivering a high-flow (15-60 l/minute) heated air-oxygen mixture (fio2 21-100%) through a dedicated nasal cannula and can be interesting in this context. this well tolerated technique improves oxygenation and decreases respiratory rate and dyspnea in patients suffering from acute hypoxemic respiratory failure. in chronic copd patients, using hfho can decrease respiratory rate and paco2. in copd exacerbation, using hfho can conceptually be interesting. first, the high air-oxygen flow delivered well matches the patient's inspiratory demand and should decrease the work of breathing. second, as during hfho a high flow is continuously delivered in the airways, a wash-out of the anatomical dead space should occur and co2 clearance should be enhanced. despite this strong physiological rational for the use of hfho in patients suffering from copd exacerbation, the effects of using hfho instead of conventional oxygenotherapy in combination with non-invasive ventilation (niv) in this context has never been explored. the main objective of the study is to explore the effects of using hfho in combination with niv in acute copd exacerbation and to assess the underlying mechanisms of action.


Eligibility criteria:
inclusion criteria: * copd patients suffering from acute hypercapnic respiratory failure (paco2 \> 50 mmhg) due to copd exacerbation and requiring intermittent niv treatment can be included in the study provided they do not require immediate intubation. exclusion criteria: * patients younger than 18 years old * inability to give informed consent or denied informed consent * severe acute respiratory failure requiring immediate intubation defined as respiratory rate \> 40/minute, severe hypoxemia with pao2/fio2 ratio \< 150 mmhg despite high fio2, severe respiratory acidosis with ph\< 7.2, altered mental status) * very intensive niv treatment required defined as an impossibility to stop niv treatment during more than one hour. * severe hypoxemia requiring more than 4l/minute of conventional oxygenotherapy between niv treatments * poor short term prognosis (defined by the clinician in charge as a high risk of death during the next 7 days) or ongoing palliative treatment. * patients with "do not resuscitate" order already established
phase iib study of ifn-k in systemic lupus erythematosus

Conditions: Systemic Lupus Erythematosus

Summary: the safety and immunogenicity of the ifnα-kinoid (ifn-k) have been evaluated in a phase i clinical study conducted in subjects with systemic lupus erythematosus (sle). preliminary results showed acceptable safety profile and patients developped antibodies response. the principal aim of the present study is to confirm the neutralization of the interferon gene signature and the clinical efficacy of ifn-k in subjects with sle. in addition, the immune responses and the safety elicited by ifn-k will also be evaluated.


Eligibility criteria:
inclusion criteria: * has had a diagnosis of sle according to current american college of rheumatology (acr) criteria (4 of 11 acr criteria) * has sledai-2k ≥ 6 * has at least 1 bilag a and/or at least 2 bilag b * has a positive ifn gene signature by reverse transcription quantitative polymerase chain reaction (rt-qpcr) * has anti-nuclear antibodies (ana) ≥ 1:160 and/or anti-dsdna antibodies ≥ 7.0 iu/ml * currently receiving at least one treatment for sle exclusion criteria: * has active, severe lupus nephritis as defined either by the immediate need for cyclophosphamide treatment or by renal bilag a * has active, severe, neuropsychiatric sle, defined as neuropsychiatric bilag a * has been treated with corticosteroids (cs) at a dose of \>20 mg of prednisone equivalent/day for \> 7 consecutive days * is currently receiving or has received pulse dose cs (≥ 250 mg prednisone equivalent/day) * has received potent immunosuppressive drugs * has received abatacept, sifalimumab, rontalizumab, anifrolumab, belimumab, tumor necrosis factor (tnf) antagonists or another registered or investigational biological therapy * has received anti-b-cell therapy (e.g., rituximab, epratuzumab) * has frequent recurrences of oral or genital herpes simplex lesions * is at high risk of significant infection and/or has any current signs or symptoms of infection at entry or has received intravenous antibiotics * has received any live vaccine * has used any investigational or non-registered product or any investigational or non-registered vaccine * is high-risk human papilloma virus (hpv) positive by rrt-qpcr on a cervical swab * has cytological abnormalities ≥ high grade squamous intraepithelial lesions (hsil) on a cervical swab
effect of corticosteroid injections on blood glucose

Conditions: Diabetes Mellitus; Steroid Diabetes; Shoulder Osteoarthritis; Knee Osteoarthritis; Adhesive Capsulitis; Hip Osteoarthritis

Summary: the purpose of this study is to measure the effect of various corticosteroids administered to the shoulder, knee and hip joints in diabetic patients on resultant blood glucose readings.

the purpose of this study is to measure the effect of various corticosteroids administered to the shoulder, knee, and hip joints in diabetic patients on resultant blood glucose readings. corticosteroid injections (csi) are frequently used in orthopedic settings in order to treat a wide array of orthopedic issues, including osteoarthritis, bursitis, tendinitis, and many others. the effect of diabetes on the musculoskeletal system and its role in orthopedic disease has been well-documented. current evidence demonstrates that corticosteroids, even when administered through a local musculoskeletal injection, can lead to temporary increases in blood glucose. ultrasound guidance was not explicitly used in any of the studies examining the impact of steroids on blood glucose. the utilization of ultrasound guidance has been shown to increase accuracy when performing injections into the subacromial space as well as the glenohumeral joint when compared to palpation/landmark-guided injections.

Eligibility criteria:
inclusion criteria: * known diabetic patients ages 40-75 undergoing clinically indicated standard of care corticosteroid shoulder, knee and hip joint injection * ability to perform daily blood glucose testing * can receive and send text messages exclusion criteria: * previous joint arthroplasty * corticosteroid injection at other sites in the body within the past month * systemic corticosteroid within the last month other than asthma inhaler * anyone who are unable to read and/or understand english * pregnant women (self-report)

Keywords: diabetes corticosteroids injection shoulder pain osteoarthritis knee hip
the effects of orchiectomy and age on vascular and metabolic health in older versus younger transgender women

Conditions: Transgender; Gender Identity; Vascular Stiffness; Vascular Inflammation; Insulin Sensitivity; Blood Pressure; Lipid Disorder; Appetitive Behavior

Summary: this study plans to learn more about differences in heart disease risk after gender-affirming orchiectomy (i.e., testes removal) in older transgender (trans) women compared to younger trans women.

the global aim of this study is to characterize cardiometabolic risk (measured by vascular, metabolic and biochemical factors-which have not been extensively studied prospectively) in trans women before and after orchiectomy. trans women appear to be at greater risk for cardiovascular disease (cvd) and blood clots compared to non-trans adults. the effect of orchiectomy on cvd risk among trans women is unknown, but orchiectomy may change blood vessel function and metabolic health. the investigators will examine blood vessel function and metabolic profiles of trans women before and at several timepoints after orchiectomy to identify age-related differences in cvd risk factors. this knowledge may lead to new approaches to prevent cvd in trans women as well as all people regardless of gender identity.

Eligibility criteria:
inclusion criteria: * aged 18 years and older * identify as a transgender woman * have taken estradiol and spironolactone for at least one year * currently taking oral or transdermal or injectable estradiol * have not yet undergone but desire orchiectomy exclusion criteria: * under 18 years of age * don't identify as a transgender woman * not currently taking estradiol or spironolactone * have been on estradiol and spironolactone for less than one year * history of orchiectomy * not deemed a candidate for orchiectomy * current tobacco smoker * current illicit drug use * history of prior or active estrogen-dependent neoplasms * acute liver or gallbladder disease * venous thromboembolism * hypertriglyceridemia \>500 mg/dl * fasted plasma glucose \>7.0 mmol/l or previously treated diabetes * resting blood pressure \>140/90 mmhg
increasing covid-19 vaccine uptake in developing countries (bihar)

Conditions: Vaccination Refusal

Summary: working with governments in bihar, india, we will evaluate a number of mechanisms to increase vaccine uptake. these include household vaccination visits instead of community vaccination clinic.monetary and non-monetary incentives, and concurrent mask promotion. this clinicaltrials entry contains results only for the study in bihar.

the goal of the study is to identify strategies that best promote and support covid vaccine uptake in developing countries, we propose to test a range of scalable social and behavioural interventions. this could help policy makers design and employ interventions that are effective. this is especially valuable in resource constrained contexts where funds and institutional resources can be diverted towards interventions that have proven to work. in bihar the intervention will be village-level social mobilization involving community promotion, including in-person vaccine reinforcement, and household-level social mobilization. some treatment villages will receive household- level interventions with varying intensity (different proportion of households will be visited). there will also an accompanying mask distribution campaign during household visits where the importance of mask-wearing as a complement to vaccine use will be explained. this clinicaltrials entry contains results only for the study in bihar.

Eligibility criteria:
inclusion criteria: * lives in study village exclusion criteria: * does not live in study village

Keywords: covid-19 vaccination masks incentives
a study of combination thalidomide plus dexamethasone therapy vs. dexamethasone therapy alone in previously untreated subjects with multiple myeloma

Conditions: Multiple Myeloma

Summary: to compare the efficacy of combination oral thalidomide plus oral dexamethasone treatment to that of oral dexamethasone-alone treatments as induction (first-line) therapy for subjects with active multiple myeloma


Eligibility criteria:
inclusion criteria: * active multiple myeloma stage ii or iii durie salmon * measurable levels of myeloma paraprotein in serum (≥1.0g/dl) or urine (≥ 0.2g excreted in a 24-hour collection sample) * eastern cooperative oncology group (ecog) performance status of 0, 1, 2 * women of child bearing potential must agree to abstain for heterosexual intercourse or use 2 methods of contraception, one effective (for example hormonal or tubal ligation) and one barrier (for example latex condom, diaphragm) * males must agree to use barrier contraception (latex condoms) when engaging in reproductive activity exclusion criteria: * pregnant or lactating females * peripheral neuropathy ≥ to grade 2 of the nci ctc. * prior history of malignancy unless subject has been free of disease for ≥ 3 years * lab abnormality: absolute neutrophil count (anc) \<1,000 cells/mm\^3 (1.0 x 10\^9/l) * lab abnormality: platelet count \<50,000/mm\^3 (50.0 x 10\^9/l) * lab abnormality: serum creatinine \>3.0 mg/dl (265 µmol/l) * lab abnormality: serum glutamic oxaloacetic transaminase (sgot) /aspartate aminotransferase (ast) or serum glutamic pyruvic transaminase (sgpt)/alanine transaminase (alt) \>3.0 x upper limit of normal (uln) * lab abnormality: serum total bilirubin \> 2.0 mg/dl (34 µmol/l)

Keywords: newly diagnosed multiple myeloma multiple myeloma
improving sleep in cancer patients: a feasibility trial

Conditions: Cancer; Insomnia

Summary: the purpose of this study is to determine if cbt-i (cognitive behavioral therapy for insomnia) is a feasible treatment for insomnia in individuals undergoing cancer treatment.

this research study is a single arm feasibility trial in which all eligible participants receive five weekly sessions of cbt-i (cognitive behavioral therapy for insomnia) delivered before or during their cancer treatments. cbt-i is a non-drug behavioral treatment for insomnia and is considered the most effective treatment for insomnia. however, cbt-i is not routinely offered to cancer patients due to unknowns about its feasibility in this population. data will be obtained at pre- and post-cbt-i and at eight-week follow-up, and will focus on acceptability, implementation, and efficacy in order to assess feasibility. the study will focus on cancer patients who are diagnosed with gastro-intestinal (gi) cancer.

Eligibility criteria:
inclusion criteria: 1. 18+ years of age 2. have insomnia disorder (sol or waso greater than 30 minutes for more than 6 nights in two weeks + daytime impairments) 3. are diagnosed with gastro-intestinal cancer; 4. have life expectancy \> 6 months; 5. are fully ambulatory indicated by the provider-rated score of greater than 2 on the eastern cooperative oncology group (ecog) performance measure; 6. will complete cancer treatments in no less than seven weeks, allowing for two weeks of assessments and five weeks of cbt-i; 7. are english-speaking and able to provide voluntary, written consent. exclusion criteria: 1. unmanaged sleep apnea indicated by the scores on the stop-bang questionnaire suggesting high risk for sleep apnea and not receiving any sleep apnea treatment; 2. other sleep disorders; 3. bipolar disorder; 4. unmanaged serious mental illnesses; 5. suicidal ideation/intent/plan; 6. unstabilized pharmacological treatment for insomnia; 7. night-shift employment.

Keywords: cancer insomnia cbt cbt-i cognitive behavioral therapy
preventive effects of ginseng against atherosclerosis

Conditions: Ischemic Stroke; Atherosclerosis

Summary: this study is a 12-month, double-blind, randomized, placebo-controlled trial. the purpose of this study is to determine whether ginseng is effective in the prevention of atherosclerosis and subsequent ischemic stroke. high-risk patients with severe atherosclerosis in the major intracranial arteries and extracranial carotid artery were enrolled.


Eligibility criteria:
"inclusion criteria" patients were included if they 1. were aged 20 to 80 years; 2. had occlusion or severe stenosis (≥ 70%) of extracranial carotid artery and major intracranial arteries (intracranial carotid artery, middle cerebral artery, anterior cerebral artery, intracranial vertebral, basilar, or posterior cerebral artery) as documented by cerebral catheter angiography; 3. had any risk factor for stroke, such as hypertension, diabetes mellitus, hypercholesterolemia, smoking, alcohol drinking, or previous stroke history; 4. had no adverse reactions to administration of ginseng; and 5. agreed to participate in the trial. "exclusion criteria" patients were excluded if they 1. did not agree to participate in the trial; 2. had any genetic cerebrovascular diseases; 3. had adverse reactions to contrast medium; 4. were pregnant or planning to be pregnant; 5. had a history of cardioembolic stroke; 6. had an emboligenic cardiac disease such as atrial fibrillation, valve disease, congestive heart failure, or recent myocardial infarction; 7. had a risk of stroke of other determined etiology according to the toast classification; 8. had undergone any neurointervention procedure or surgery, such as intra-arterial thrombolysis, angioplasty procedures, carotid endarterectomy, or bypass surgery; 9. had chronic kidney disease (gfr \< 30 ml/min); or 10. had severe hepatic dysfunction.

Keywords: ginseng stroke quantitative magnetic resonance flow analysis
comparison of multiple oxygenation targets with different oximeters in chronic obstructive pulmonary disease (copd) and non-copd patients- impact on oxygen flows

Conditions: COPD Exacerbation; Pneumonia; Hypoxemia; Respiratory Disease

Summary: the oximeter is an instrument for monitoring patients receiving oxygen therapy. it displays pulse oxygen saturation (spo2), which is a reflection of arterial oxygen saturation (sao2). an accurate spo2 value is essential for optimal management of the o2 flow delivered to patients. several factors can influence this measurement and the choice of ventilatory support: the type of oximeter used, skin pigmentation and the oxygenation goal. the objective of our study is to evaluate the impact of the oxygenation goal and the oximeter used on oxygen flows in patients with copd (or with hypercapnia, or at risk of hypercapnia) and in patients without copd (in particular pneumonia, pulmonary fibrosis and other pathologies) our hypothesis is that the spo2 target and oximeter used will have an impact on oxygen flows and that these effects will be synergistic in these different populations.


Eligibility criteria:
inclusion criteria: * ≥ 18 years old * on conventional oxygen therapy with spo2 between 88 and 100% with the usual oximeter and nasal cannula. * spo2 \< 92% in ambient air with the usual oximeter exclusion criteria: * no availability of the spo2 signal with the usual oximeter * false nails or nail polish * severe anemia documented on the last blood count during the current hospitalization (hb \< 80g/l)

Keywords: oxygen, oximeter
evaluation of different methods of posterior flap management in external dacryocystorhinostomy

Conditions: Acquired Nasolacrimal Duct Obstruction

Summary: the aim of dcr is to form a new, mucosa-lined pathway between the lacrimal sac and the nasal cavity where tears can bypass a lacrimal obstruction and drain directly in the nose. the original external approach was described in 19046. in 1920s, mucosal flap anastomosis was added to the procedure as a modification7, and since then, many new modifications have been made to improve the original procedure.

aim of the study • to compare intraoperative details and postoperative endonasal endoscopic findings and their effects on success rate of external dacryocystorhinostomy with and without anastomosis of posterior mucosal flaps. patients and methods study design: this will be a prospective interventional comparative clinical study. it will include two groups according to the surgical procedure:- group a: includes 30 eyes that will be treated with external dcr with anastomosis of posterior mucosal flaps . group b: includes 30 eyes that will be treated with external dcr with amputation of posterior mucosal flaps . study population: study participants will be: 60 eyes undergo external dcr . all patients included in this study will be verbally briefed about the details and the nature of the study \& will sign a written consent according to the local ethics committee of minia university faculty of medicine. the study will be conducted in ophthalmology department, minia university hospital, egypt.

Eligibility criteria:
inclusion criteria * patients with chronic dacryocystits, * primary nasolacrimal duct obstruction * lacrimal mucocele * lacrimal fistula exclusion criteria: * recurrent cases. * age under 5 years. * associated nasal pathology. * sever dry eye * patients unfit for general anaesthesia

Keywords: posterior flap dcr nldo
st elevation myocardial infarction hemodynamic outcomes: role of non-invasive cardiac system (shock-nicas) study

Conditions: ST Elevation Myocardial Infarction (STEMI) Patients

Summary: proposed novel solution for high-risk heart disease overall in-hospital mortality among st elevation myocardial infarction (stemi) patients is 3-4%, but \>50% patients experiencing cardiogenic shock (cs) secondary to stemi die in the hospital. evidence suggests early diagnosis and treatment of cs results in improved outcomes, albeit, there is no tool to diagnose cs reliably in a timely fashion in stemi patients through the continuous monitoring. we hypothesize that bioimpedance-derived hemodynamic measures obtained using the non-invasive cardiac system (nicas) can facilitate early detection of cs, predict outcomes, and revolutionize the stemi patient management. the objectives of shock-nicas study in stemi patients are to: a) identify the cs early, using nicas derived cardiac index of ≤1.8l/min/m2 or ≤2.2l/min/m2 with the use of vasopressor and/or inotropes, and compare it with the incidence of cs based upon lactate level ≥2mmol/l, and systolic blood pressure \ 72hrs), and use of inotropic or mechanical circulation support is a primary outcome. methodology this is a multi-center, double-blind, prospective cohort study enrolling stemi patients aged ≥18years visiting at 4 cardiac centers (st boniface, st. michael's, mcgill university hospital). using validated nicas protocol, hemodynamic parameters will be recorded at baseline, during the ppci procedure, and within 24-hour post ppci without altering the standard care. statistical analysis: baseline data will be reported as mean±sd or median±interquartile range. the outcomes will be assessed using multivariable logistic regression. we will analyze the impact of age, sex, gender, and ethnicity on hemodynamic measures. the targeted 500 patients will ensure a margin of error of 5% at a 95% ci. so far recruited 76 stemi patients mark the study feasibility. significance this novel study in high-risk stemi patients will provide a promising cost-effective, rapid, and non-invasive tool to identify cs early; a prompt intervention may curtail the high morbidity and mortality. the meticulously designed pragmatic study outcomes may revolutionize stemi patient management.


Eligibility criteria:
inclusion criteria: * patients aged ≥18 years, presenting with ekg confirmed diagnosis of stemi * able to understand, and consent to participate in the study exclusion criteria: * patients unwilling to participate in the study * patients with any life-threatening medical condition with an expected life span of ≤1 year (e.g., metastatic cancer, terminal copd)