Kornimate/medical-research-clean huggingface dataset:
impact of ultra-early intracranial aneurysm treatment in sah

Conditions: Subarachnoid Hemorrhage

Summary: this is the first prospective study in hong kong that recruit patients with poor neurological status after intracranial aneurysm rupture in all seven public neurosurgical services in hong kong. this study assesses whether ultra-early aneurysm treatment improves outcomes in patients with poor neurological status after intracranial aneurysm rupture in hong kong. these data are essential to understand the impact of the disease and for future service development in hong kong.

objectives: 1. to evaluate outcomes in patients admitted with poor neurological status after intracranial aneurysm rupture in hong kong; 2. to evaluate whether ultra-early aneurysm treatment improves outcomes in patients admitted with poor neurological status after intracranial aneurysm rupture. hypothesis to be tested: ultra-early aneurysm treatment increases chance of favorable outcomes in in patients admitted with poor neurological status after intracranial aneurysm rupture. design and subjects: prospective observational study to recruit consecutive poor grade aneurysmal subarachnoid hemorrhage patients in the seven public neurosurgical services in hong kong. study instruments: modified rankin scale, montreal cognitive assessment, stroke-specific quality of life, short form-36, return to work, and hospital resource utilization. groups: ultra-early (within initial 24 hours) and non-ultra early aneurysm treatment. main outcome measures: favorable outcome at six months. data analysis and expected results: comparisons are carried out with adjustments for age, sex, admission glasgow coma scale, hypertension, and modality of aneurysm treatment with appropriate regression analyses.

Eligibility criteria:
the inclusion criteria for this study are: 1. adult patients (aged \>18 years) with spontaneous subarachnoid hemorrhage 2. admission into hospital authority neurosurgical services 3. the glasgow coma scale on admission ≤12 (world federation of neurosurgical societies grade 4-5) the exclusion criteria for this study are: 1. patients are likely to leave hong kong shortly after episode 2. patients (or next-of-kin as appropriate) refuse to participate into the study
combinaison of virtual reality and rehabilitation to improve muscle function, exercise tolerance, exertional symptoms and dyspnea in patients with chronic respiratory disease: a randomized cross-over trial

Conditions: Chronic Obstructive Pulmonary Disease

Summary: chronic respiratory diseases, such as chronic obstructive pulmonary disease (copd), are a leading cause of death globally. these diseases not only contribute significantly to mortality but also lead to a decline in physical capacity, limiting daily activities and perpetuating a vicious cycle of deconditioning. dyspnea (shortness of breath) is a major symptom, seen in 56 to 98% of copd patients, and is linked to decreased exercise tolerance and muscle dysfunction. it often leads to reduced physical activity, further worsening respiratory function and quality of life. dyspnea severity is associated with increased mortality, hospitalizations, and anxiety. the main therapeutic approach for these patients is pulmonary rehabilitation, which improves exercise tolerance, quality of life, and reduces hospitalizations and exacerbations. however, dyspnea limits exercise and is often a barrier to continued physical activity. virtual reality (vr) technology has shown promise in managing symptoms like pain, anxiety, and dyspnea by providing a distraction. studies suggest that vr can improve dyspnea and anxiety, particularly in patients hospitalized for conditions like covid-19. however, research on vr's immediate effects on exercise capacity is limited, with most studies focusing on non-immersive exergames rather than immersive vr. the potential of vr to improve exercise tolerance in patients with chronic respiratory diseases remains uncertain. our study aims to test this hypothesis through a randomized crossover trial to assess vr's impact on dyspnea and exercise tolerance in these patients.


Eligibility criteria:
inclusion criteria: * patient aged 18 years or older * patient with a chronic respiratory disease requiring pulmonary rehabilitation * patient with dyspnea assessed as mmrc ≥ 0 (annex 3) * patient undergoing pulmonary rehabilitation at the paris saint-joseph hospital * patient affiliated with a health insurance plan * french-speaking patient * patient who has provided informed, explicit, and voluntary oral consent exclusion criteria: * contraindications for an endurance reconditioning program (neurodegenerative diseases, severe neurological deficits, unstable cardiovascular diseases) * history of motion sickness, vertigo, vestibular impairment, labyrinthitis * history of seizures or other neurological or psychiatric comorbidities * severe visual impairments * patient already included in a type 1 interventional research protocol (riph1) * patient under guardianship or curatorship * patient deprived of liberty * patient under legal protection * pregnant or breastfeeding patient
clopidogrel high dose evaluation for the patient with coronary artery disease in japan

Conditions: Coronary Artery Disease

Summary: the purpose of this study is to evaluate the effect of high dose clopidogrel as the antiplatelet therapy on inhibition of platelet aggregation in japanese patients scheduled for percutaneous coronary intervention due to ischemic heart disease.

dual antiplatelet therapy of aspirin and thienopyridine is used to prevent stent thrombosis after percutaneous coronary intervention (pci). clopidogrel is the most popular thienopyridine. following the 300mg clopidogrel loading dose (ld) at first day, patients take 75mg maintenance dose (md) to inhibit platelet aggregation after coronary stent implantation. 600mg high ld inhibit platelet aggregation more rapidly and strongly than standard ld and prevent thrombotic event around the pci. similarly high md inhibit platelet aggregation more strongly. interindividual variability of clopidogrel anti-platelet effect has been reported. in japanese, there are many non or hyporesponders to clopidogrel compared to the western population. the purpose of this study is to evaluate the effect of high dose clopidogrel as the antiplatelet therapy on inhibition of platelet aggregation in japanese patients scheduled for pci due to ischemic heart disease.

Eligibility criteria:
inclusion criteria: * patients scheduled for percutaneous coronary intervention due to ischemic heart disease * patients taking aspirin 81-100mg at least 1 week. exclusion criteria: * patients with st elevation myocardial infarction * patients have contraindication of aspirin or clopidogrel * patients taking warfarin * patients received thrombolytic therapy within 2 weeks * patients taking anti-platelet agents except aspirin within 1 month * patients taking corticosteroid. * patients taking proton pump inhibitor

Keywords: coronary artery disease
clinical study of relationship between granulocyte activation, hdac2 and severe asthma

Conditions: Asthma

Summary: program： clinical study of relationship between granulocyte activation, hdac2 and severe asthma aim：the early prediction of severe asthma, early intervention on the disease, reduce the family and the national finance. design:this study is a single center randomized controlled trial designed by the department of respiratory medicine, xijing hospital, as the main research unit.compare the case group(severe asthma group and mild-and-moderate asthma group) and control group(healthy control group) by detecting the activity of mpo、ne、mmp-9 and ecp in the peripheral blood and the activity of hdac2 in pbmcs of patients. case:60 case selection: inclusion criteria: age 18-75 years old; diagnosis of asthma was clear; informed consent was signed. exclusion criteria: poor compliance; cognitive ability is low; psychiatric disorders need to be combined with psychotropic medication.

application of spss 19 statistical software. measurement data were expressed as mean ± standard deviation. first the data is normality tested and homogeneity of variance tested, according to the measurement data of normal distribution by snk single factor analysis of variance; does not conform to the normal distribution of measurement data, using the kruskal wallis non parametric test. p \< 0.05 for the difference was statistically significant.

Eligibility criteria:
inclusion criteria: healthy control group： * mainly from students, * family members of patients without chronic lung disease, * healthy population, * age 18-75 years old, the gender is not limited. case group： * the patient has been diagnosed with asthma in the outpatient clinic. the diagnostic criteria are in accordance with the guidelines for prevention and treatment of bronchial asthma in the respiratory disease branch of the chinese medical association. in the past 1 year need guidelines of global asthma record instrument 4-5 drug treatment of asthma \[high dose inhaled corticosteroid with long-acting beta2 receptor agonist or leukotriene modifiers / theophylline or systemic hormone therapy is more than or equal to 50% of the time, in order to prevent into uncontrolled asthma, or even in the treatment is to control asthma patients for severe asthma. exclusion criteria： * poor treatment compliance, or low cognitive ability to impact the self rating scale ; * there are serious heart, liver, renal dysfunction, or other infectious diseases ; * the individual who refuse to sign the informed consent.

Keywords: granulocyte activation hdac2 severe asthma
pilot rct comparing effectiveness of two decision aids for hip and knee osteoarthritis

Conditions: Hip Osteoarthritis; Knee Osteoarthritis

Summary: this pilot rct study is to examine the comparative effectiveness of two decision aids for hip and knee osteoarthritis.

this pilot rct study is to examine the comparative effectiveness of two decision aids for hip and knee osteoarthritis. the vendors employ different design features (e.g. use of video for patient narratives, interactive values clarification exercise) and the study will examine the relative impact of the different features on decision quality. eligible subjects will be randomly assigned to receive one of two decision aids before their upcoming clinic visit with a participating provider. immediately before the visit, participants will complete a short questionnaire about the decision aid. this pilot study will assist with determining the potential difference between these two decision aids on improving knowledge and use of decision aids.

Eligibility criteria:
inclusion criteria: * diagnosis of either hip or knee osteoarthritis * scheduled visit with participating orthopedic surgeon exclusion criteria: * prior partial or total knee or hip replacement surgery * hip fracture or aseptic necrosis in the last 12 months * rheumatoid arthritis or psoriatic arthritis * unable to read or speak english

Keywords: decision making decision aids decision quality instruments osteoarthritis shared decision making
decrease type ii diabetes in gestational diabetes population

Conditions: Gestational Diabetes; Diabetes Mellitus, Type 2; Breastfeeding; Diabetes Mellitus, Type 1; Impaired Glucose Tolerance

Summary: the goal of the study is to examine the impact of an educational video on the rate of breastfeeding in mothers who had gestational diabetes mellitus, and the rate of type-ii diabetes mellitus diagnosed postpartum.


Eligibility criteria:
inclusion criteria: * pregnant individuals aged over 18 years old * diagnosed with gestational diabetes mellitus (gdm) by 100gm oral glucose tolerance test (ogtt) done between week 24-28 of gestation, or by other criteria (50gm glucose challenge test (gct) \>200 mg/dl22 or having one abnormal value in ogtt ) * having pregestational diabetes (dm-i or dm-ii) * can read and understand hebrew exclusion criteria: * delivery of a non-viable fetus
lipitor in the prevention of stroke, for patients who have had a previous stroke

Conditions: Cardiovascular Disease

Summary: to determine whether lipitor reduces stroke, compared to placebo in patients who have had a previous stroke or transient ischemic attack.


Eligibility criteria:
inclusion criteria: * previous stroke or tia exclusion criteria: * coronary heart disease
safety and efficacy of php in the treatment of shock associated with systemic inflammatory response syndrome (sirs)

Conditions: Shock; Systemic Inflammatory Response Syndrome

Summary: to determine the safety and effectiveness of pyridoxylated hemoglobin polyoxyethylene conjugate (php) administered by continuous intravenous (iv) infusion in systemic inflammatory response syndrome (sirs) patients with shock. php is a human-derived chemically modified hemoglobin preparation. php selectively scavenges excess nitric oxide (no) and does so in a catalytic, concentration-dependent reaction that results in the formation of the non-toxic no metabolite, nitrate. php is postulated to reduce excess, toxic levels of no while allowing critical beneficial levels of the molecule to persist.

this phase 3, randomized, placebo controlled, multi-center study is designed to evaluate the safety and efficacy of continuous iv infusion of php plus conventional vasopressor treatment, as compared to continuous iv infusion of plasma-lyte a plus conventional vasopressor, as a treatment for restoring hemodynamic stability in sirs patients with shock. conventional vasopressors include dopamine \> 5 mcg/kg/min; or norepinephrine, phenylephrine or epinephrine at any dose. the study consists of a screening period, a pre-treatment period, and a 28-day treatment period. efficacy will be determined by evaluating objective clinical measures of mortality and organ function over the 28-day treatment period. the safety and tolerability of php will be evaluated over the continuous 28 days using a number of measures including an evaluation of: * all cause mortality, * median patient survival time and * adverse event rates and duration.

Eligibility criteria:
determination of study eligibility will be made by the investigator on the basis of the inclusion criteria listed below: sirs inclusion criteria patients with sirs as characterized by two or more of the following conditions (worst values in a 24 hour period): * either respiratory rate \>/= 20 breaths/minute, partial pressure of arterial carbon dioxide (paco2) \</= 32 torr, or mechanical ventilation, * heart rate \>/= 90 beats/minute, * either hyperthermia \>/= 38 degrees c, or hypothermia \</= 36 degrees c or * either white blood cell (wbc) \>/= 12,000 cells/mm3, \ /= 10% immature (band) forms shock inclusion criteria patients with adequate fluid resuscitation (pcwp \>/= 12mmhg) and with one or more conventional vasopressors (continuing up to the time of randomization) being used to treat hypotension (mbp \< 60 mmhg or sbp \< 90 mmhg). patients cannot be entered if they have been in shock for more than 24 hours.

Keywords: pyridoxalated hemoglobin polyoxyethylene conjugate (php) systemic inflammatory response syndrome (sirs) nitric oxide (no) shock
mirena® iud's effect on fallopian tube fimbriae and ovarian cortical inclusion cyst cell proliferation

Conditions: Epithelial Ovarian Cancer

Summary: combination-type oral contraceptives (cocs) have been shown to significantly reduce the risk of invasive epithelial ovarian cancer (ieoc); this protective effect may be achieved to a large extent through cocs ability to reduce cell proliferation in the fallopian tube fimbriae (ftf). the progestin-releasing mirena® intra-uterine device (iud) is an increasingly popular method of contraception, but it is not known if its use will reduce a woman's risk of ieoc. mirena® use does not block ovulation in most women but it may release sufficient progestin to also reduce cell proliferation in the ftf. this study aims to evaluate the effects of the mirena® iud on cell proliferation in the ftf as a possible biomarker of protection against ieoc.


Eligibility criteria:
inclusion criteria: * women between 35 and 50 years of age (inclusive) * women who will be scheduled to undergo an rrso or rrs * women who will have at least one fallopian tube removed for risk-reducing reasons (with or without removal of ovar(ies)) * women who are willing to have a mirena® iud inserted at least prior to risk-reducing surgery or who already have the mirena® in place * women using non-hormonal forms of contraception (note: if a copper iud is being used, the iud must be removed prior to or at time of mirena insertion.) exclusion criteria: * any medical contraindication to use of a mirena® iud, including: * pregnancy (a pregnancy test is required prior to study entry) * known uterine anomaly that distorts the shape of the uterine cavity * acute pelvic inflammatory disease * postpartum endometritis or endometrial infection * known or suspected uterine or cervical neoplasia * known history or suspected breast cancer or other progestin-sensitive cancer * uterine bleeding of unknown etiology. * untreated acute cervicitis, vaginitis, or other lower genital tract infections * acute liver disease or liver tumor (benign or malignant) * use of tamoxifen, raloxifene, or chemotherapy within the previous 6 months * positive pregnancy test * breastfeeding * use of a copper iud if the patient is not willing to have it removed prior to surgery and replaced with a mirena® iud

Keywords: mirena® iud's women risk-reducing salpingo-oophorectomy risk-reducing salpingectomy
coronary angioplasty in octogenarians with emergent coronary syndromes

Conditions: Non-ST Elevation Myocardial Infarction (NSTEMI); Angina, Unstable

Summary: a multicenter, randomized clinical trial in elderly patients (over 80 years old) with unstable angina pectoris or non-st elevation myocardial infarction (nstemi). a total of 200 patients will be randomized to medical treatment (100 patients) or coronary angiography with revascularization if feasible (100 patients). information regarding prior history, frailty, clinical presentation, in-hospital events, complications, angina, quality of life and mortality will be collected. follow up time is 1 year.


Eligibility criteria:
inclusion criteria: 1. \>80 years of age 2. acute coronary syndrome with ischemic symptoms (mainly chest pain) lasting over 10 minutes during the last 72 hours. and at least one of the following: 1. st-segment depression on ecg \> 1mm 2. elevated cardiac troponins 3. written informed consent before randomization exclusion criteria: 1. percutaneous coronary intervention (pci) within 30 days prior to randomization 2. suspected ongoing active internal bleeding 3. st segment elevation of \>1mm in two contiguous leads on ecg 4. enrollment in another study that has not completed the follow up phase. 5. known allergy to aspirin or clopidogrel 6. severe dementia 7. expected limited 1 year survival due to other disease(s) 8. unwillingness to participate in the trial or expected problems with compliance

Keywords: elderly octogenarians pci myocardial infarction nstemi unstable angina pectoris
pci and brain mri follow-up vs brain mri follow-up alone in limited-stage sclc patients

Conditions: Small Cell Lung Cancer Limited Stage

Summary: at present, prophylactic cranial irradiation (pci) is part of standard care for patients with limited-stage small cell lung cancer (sclc) who have achieved good response after definitive thoracic radiotherapy and chemotherapy. however, the value of pci is being challenged in the era when mri examination of brain has been popularized. the goal of this clinical study is to compare pci and regular brain mri follow-up (control arm) and regular brain mri follow-up alone (study arm) in patients with limited-stage sclc who have received definitive radiotherapy and chemotherapy and acheived complete remission (cr) of tumor. the main questions to answer are: 1. whether the 2-year brain metastasis-free survival rate of the study group is not inferior to that of the control group. 2. the difference of 2-year overall survival rate between the control group and the study group. 3. whether the patients in the study group have better overall quality of life than those in the control group. participants will randomly receive either pci and regular brain mri follow-up or regular brain mri follow-up alone.


Eligibility criteria:
inclusion criteria: * histologically/cytologically proven diagnosis of sclc. * age ≥ 18 years. * karnofsky performance status ( kps) ≥80. * the limited-stage is defined as the tumor confined to one side of the chest, including ipsilateral hilar, bilateral mediastinum, and bilateral supraclavicular lymph nodes. (the definition of metastatic lymph nodes is that the short diameter ≥ 1cm or pet-ct shows increased metabolism with suv≥2.5, or proved by mediastinoscopy/ebus/tbna biopsy. the thickness of pleural effusion on chest ct is less than 1cm (unless cytology proves to be malignant pleural effusion). according to 8th ajcc/uicc tnm staging system, it is the i-iiic without intrapulmonary metastasis. * patients who have received definitive chest radiotherapy and chemotherapy and achieved complete remission of tumor within 4-6 weeks after the end of radio-chemotherapy (in accordance with the response evaluation criteria in solid tumors v.1.1 including enhanced ct scan of chest and abdomen, enhanced brain mri, bone scan and tumor markers). * good follow-up compliance; * fully understand this study, and voluntarily sign the informed consent form. exclusion criteria: * patients with a history of malignant tumors (past or concurrent) within 5 years, excluding papillary thyroid cancer, non-malignant melanoma skin cancer and cervical carcinoma in situ. * patients who have received radical surgery (excluding biopsy). * patients with psychiatric history, pregnancy and lactation. * uncontrolled diabetes, hypertension, severe active infection. * patients with chronic diseases of central nervous system. * patients with contraindications of brain mri examination. * other situations deemed unsuitable by the doctor in charge.

Keywords: prophylactic cranial irradiation brain mri follow-up prognosis
transfusion in sickle cell disease: risk factors for alloimmunization

Conditions: Sickle Cell Disease

Summary: sickle cell patients have a high prevalence of alloimmunization. this high rate of alloimmunization can be partially explained by the existence of an antigenic difference between the predominantly caucasian donor population and the sickle cell patients of african origin. genetic and environmental risk factors have also been described. the main risk factors that have been shown in retrospective or cross-sectional studies are some hla alleles, the age of the patient, the number of leukocyte-depleted erythrocyte concentrates (ced) transfused, the number of transfusion episodes, the age of the ceds, the existence of an inflammatory event at the time of transfusion and the presence of anti-erythrocyte autoantibodies.there is also evidence of an impaired th response but the underlying immunological mechanism is not fully understood. the aim of this study is to study the prevalence and the risk factors for anti-erythrocyte alloimmunization and to try to understand the immunological mechanisms.


Eligibility criteria:
inclusion criteria: sickle cell disease patients treated within the chu brugmann or queen fabiola children's hospital exclusion criteria: none

Keywords: sickle cell disease allo-immunization blood transfusion