Kornimate/medical-research-clean huggingface dataset:
prospective study on the efficacy and safety of bronchoalveolar lavage combined with pathogen metagenomic sequencing technology in the diagnosis of immune checkpoint inhibitor associated pneumonia

Conditions: Immune Checkpoint Inhibitor Associated Pneumonia

Summary: immune checkpoint inhibitor associated pneumonia (cip) is a common immune related adverse reaction, accounting for 35% of all deaths. however, due to the lack of typical clinical symptoms and imaging manifestations, cip needs to be differentiated from other diseases such as pulmonary infections and lung cancer progression. currently, there is a lack of diagnostic gold standards, which belongs to exclusive diagnosis. empirical diagnosis and treatment in clinical practice can easily lead to the abuse of hormones and antibiotics, and even misdiagnosis and mistreatment, resulting in patient death. therefore, early identification of cip and pulmonary infection is the key to successful diagnosis and treatment. the cip diagnosis and treatment guidelines recommend performing bronchoalveolar lavage as appropriate, but there is still a lack of large-scale prospective clinical studies. the beneficial pathogen metagenomic sequencing technology for the diagnosis of pulmonary infections has not been mentioned. our research group conducted a prospective clinical study for the first time to evaluate the effectiveness and safety of bronchoalveolar lavage combined with pathogen metagenomic sequencing technology in diagnosing cip, explore biomarkers for diagnosing cip, in order to improve the early diagnosis rate and treatment efficiency of cip, and reduce the abuse of antibiotics and hormones.


Eligibility criteria:
inclusion criteria: 1. voluntarily sign an informed consent form; 2. age range from 18 to 75 years old, regardless of gender; 3. immunosuppressive host; 4. symptoms, signs, or imaging signs of pneumonia are visible, and empirical anti infection treatment is ineffective. exclusion criteria:
enhancing tobacco abstinence following hospitalization

Conditions: Hospitalized Smokers; Chronic Diseases; Tobacco Use Disorder

Summary: the primary aim of this study is to examine the efficacy of a 12-week nurse-delivered relapse management intervention designed with conceptual underpinnings from self-efficacy theory to enhance smoking abstinence of hospitalized smokers following their hospital discharge. specifically this study asks, does a 12-week self-efficacy theory driven relapse management intervention enhance smoking abstinence following hospitalization by increasing smoking abstinence point prevalence as measured by carbon monoxide validated self-reports of smoking, when compared to subjects receiving only enhanced usual care?

a randomized controlled two-group design with an intent-to-treat approach for handling protocol deviations will be used to examine the primary aim of this project. the sample will consist of 80 consenting smokers prospectively recruited during hospitalization. subjects will be randomly assigned by equal allocation to an intervention group or an enhanced usual only group. a baseline adaptive randomization procedure will adjust the random equal ratio of treatment assignment to maintain sampling balance of the groups for race (white/black/other), gender (male/female), and three comorbid categories (only tobacco related illnesses/ tobacco related and unrelated to tobacco illnesses/ unrelated to tobacco illnesses). all subjects will receive enhanced usual care, which will consist of receiving a supportive message to quit smoking and smoking cessation materials. subjects assigned to the intervention group will receive 9 intervention sessions with a nurse aimed to enhance their self-efficacy in self-management of tobacco abstinence. these sessions will occur over 12 weeks following hospital discharge. all but the initial session will occur by telephone. subjects will be asked to participate with follow-up activities 12 weeks and 24 weeks following their hospital discharge, which requires the measurement of exhaled carbon monoxide and the completion of questionnaires by self-administration and interview with study personnel. subjects will exit from study following the 24-week follow-up.

Eligibility criteria:
inclusion criteria: * smoked one cigarette within 30 days of hospital admission * admission to a medical/surgical patient care unit * 18 years of age or older exclusion criteria: * diagnosis of cancer in a terminal state, * under evaluation for organ transplantation or awaiting transplantation, * cerebral vascular disorders, * senile dementia, * alzheimer's disease, * abstinence from smoking greater than one month, * non-english speaking, * lack of a home telephone, * lack of a mailing address, * lack of any ability to participate with self-care activities, * and transfer to a rehabilitation hospital or nursing home following their hospital admission.

Keywords: nicotine addiction relapse smoking chronic disorders randomized controlled trial intervention
thoracodorsal artery perforator flap versus conventional free flaps

Conditions: Trauma

Summary: the purpose of this study is to assess the efficacy of the thoracodorsal artery perforator flap versus other conventional free flaps for reconstruction of soft tissue defects.

the field of plastic surgery, unlike most other surgical specialties, has no anatomic or functional area to which it can lay claim; the plastic surgeon practices methods and techniques applicable to all specialties and anatomic areas. reconstructive surgery is the process of restoring the human body to "whole" following tumor extirpation, infection, trauma or congenital or acquired deformity - restoring both form and function. the purpose of this study is to assess the efficacy of the thoracodorsal artery perforator flap versus other conventional free flaps for reconstruction of soft tissue defects.

Eligibility criteria:
inclusion criteria: • soft tissue loss anywhere in the body. exclusion criteria: • patients with chronic debilitating diseases e.g. chronic renal failure, uncontrolled diabetes mellitus
effects of fructose and exercise on hepatic lipid metabolism

Conditions: Metabolism

Summary: 8 healthy male volunteers will be studied each on 3 occasions, ie * after 4 days on a weight maintenance diet containing 5% simple sugars + low physical activity * after 4 days on a weight maintenance diet containing 30% fructose + low physical activity * after 4 days on a weight maintenance diet containing 30% fructose + high physical activity at the end of each of these 3 periods, fructose induced hepatic de novo lipogenesis (13c palmitate synthesis in response to ingestion of a 13c fructose load) and plasma vldl-triglyceride kinetics (measured with a bolus of 2h-labeled glycerol) will be measured


Eligibility criteria:
inclusion criteria: * age between 18 and 30 years * males * bmi between 19 and 25 * low to moderate physical activity (\< 3 sessions/week) exclusion criteria: * smoking * consumption of alcohol\>50g/week * consumption of drugs or illicit substances * food allergies

Keywords: fructose vldl-triglycerides de novo lipogenesis human metabolism
non-ablative diode laser therapy for genitourinary syndrome of menopause: a prospective study on efficacy, safety, and quality of life and sexuality impact

Conditions: Genitourinary Syndrome of Menopause

Summary: the goal of this observational study is to evaluate the efficacy, safety, and impact on quality of life and sexuality of non-ablative dual-wavelength diode laser treatments in managing genitourinary syndrome of menopause (gsm) in sexually active post-menopausal women who cannot use or have not benefited from local estrogen-based therapies. the main questions it aims to answer are: does non-ablative dual-wavelength diode laser therapy improve vaginal dryness, burning sensation, and dyspareunia in post-menopausal women? what is the impact of this therapy on the vaginal health index and sexual function? researchers will compare the laser-treated group to their baseline measurements to see if non-ablative dual-wavelength diode laser therapy effectively treats gsm. participants will: undergo three monthly sessions of dual-wavelength diode laser therapy. participate in follow-up evaluations at three and six months post-treatment. complete self-assessments of gsm symptoms and questionnaires evaluating sexual function and quality of life at each follow-up. this study aims to provide preliminary evidence that non-ablative dual-wavelength diode laser therapy is a safe and effective non-hormonal treatment for gsm, addressing a gap in existing treatments for women who cannot use or have not benefited from hormonal therapies.


Eligibility criteria:
inclusion criteria: * post-menopausal women aged 45-73 years. * sexually active. * experiencing physiological amenorrhea for more than 12 months. * exhibiting at least one symptom of genitourinary syndrome of menopause (gsm). * not using lubricants or hormonal therapy in the previous 6 months. * able to provide written informed consent. exclusion criteria: * untreated uterine or vulvovaginal cancers. * pacemaker or other implanted electrode carriers. * severe multi-organ or neurological diseases. * active sexually transmitted infections. * moderate to severe uterine prolapse. * active urinary tract infections. * acute or chronic dermatological conditions in the vulvar or vaginal area. * active genital herpes. * active high-risk human papillomavirus (hpv). * ischemic tissues, unhealed wounds, sores, or undiagnosed mucosal or epithelial alterations. * recent unhealed invasive or ablative surgeries. * bleeding disorders or anticoagulant therapy. * immunodeficiencies. * uncontrolled diabetes.

Keywords: genitourinary syndrome of menopause diode laser vaginal atrophy menopause sexual function
research study for major depressive disorder: investigation of glutamate medications

Conditions: Major Depression

Summary: this study is examining the safety and effectiveness of two medications, ketamine and riluzole, in treating patients with treatment resistant major depressive disorder. this study will also examine the effectiveness of an fda approved drug called lamotrigine in decreasing the potential side effects associated with ketamine.

this research proposal will investigate a glutamate-modulating agent, riluzole, in treatment-resistant patients who exhibit an acute, sustained response to a single dose of intravenous (iv) racemic ketamine. fifty ketamine-responders will be randomized to riluzole or placebo in a 4-week, randomized, double-blind, continuation-phase study.

Eligibility criteria:
inclusion criteria: 1. male or female patients, 21- 70 years of age 2. subjects have a history of at least one previous episode of depression prior to the current episode (recurrent major depressive disorder) or have chronic major depressive disorder (at least two years' duration) 3. subjects have not responded to an adequate trial of one antidepressant in the current episode exclusion criteria: 1. female subjects who are either pregnant or nursing 2. serious, unstable illnesses 3. any previous use or treatment with ketamine, or riluzole 4. past intolerance to lamotrigine, including drug rash
efficacy in ablative fractional laser assisted photodynamic therapy according to ablative depth for actinic keratosis

Conditions: Actinic Dermatosis

Summary: er:yag ablative fractional laser-assisted photodynamic therapy (afl-pdt) has shown significant benefit for the treatment of actinic keratosis(ak). er:yag ablative fractional laser ablates the epidermis and dermis without significant thermal injury, creating microscopic ablation zones (maz) in the portion of the skin that the laser is applied to. the formed maz depends on the laser parameters such as laser depth, laser density and laser passes, which affect the treatment outcome.

the investigators aimed to investigate whether the use of increased laser ablative depth affects the efficacy, side effects, cosmetic outcomes, and ppix accumulation of afl-pdt for facial ak in a randomized clinical trial.

Eligibility criteria:
inclusion criteria: * korean patients aged ≥ 18 years who had biopsy-confirmed actinic keratosis lesions exclusion criteria: * photosensitivity disorder patients * lactating or pregnant women * patients with porphyria or a known allergy to any of the constituents of the mal cream and lidocaine * patients with systemic disease, history of malignant melanoma, tendency of melasma development or keloid formation, any ak treatment of the area in the previous 4 weeks, or any conditions associated with a risk of poor protocol compliance; and patients on immunosuppressive treatment

Keywords: actinic keratosis ablative fractional laser photodynamic therapy ablative depth protoporphyrin ix
diet, genetics, and cvd risk factor response in blacks

Conditions: Cardiovascular Diseases; Heart Diseases

Summary: to test the hypothesis that the responsiveness of major and emerging cardiovascular disease risk factors to changes in diet composition clusters within families depending on genetic susceptibility factors.

background: reduction in risk of cardiovascular disease (cvd) through dietary change has considerable potential for a beneficial impact on public health. on a population basis, moderation of both lipid profiles and blood pressure can be accomplished readily with a prudent diet. nevertheless, individual response to dietary impact on cvd risk factors varies widely, presumably as a result of genetic differences. in particular, blacks who constitute a subpopulation with documented increased risk of morbidity and mortality from cvd would disproportionately benefit from interventions designed to maximize the impact of dietary change tailored to individual genetic makeup. therefore, study of the influence of diet on cvd risk factors, along with enhanced understanding of the genetic components involved, would greatly potentiate chronic disease interventions. the study is conducted in response to a request for applications issued in october, 2001 on the interaction of genes and the environment in shaping risk factors for heart, lung, blood, and sleep disorders. design narrative: two-generational family lines will be identified in blacks with elevated low density lipoprotein-c (ldlc) in probands. the population will be fed a controlled diet contrasting an established heart healthy regimen with a typical american one. concomitant rigorous genetic, anthropometric, and behavioral evaluation will provide data with which to analyze individual differences in response to consistent dietary intake. in specific aim 1, black, two-generational, families will be recruited and provided interventional diets designed to reduce (or not) ldl-c and blood pressure. in specific aim 2, non-genetic predictors of cvd risk factor response will be identified through extensive assessments of baseline behavioral characteristics, anthropometric features, and metabolic factors. in specific aim 3, the underlying genetic factors that predispose to response (or the lack of) to dietary interventions will be identified through the examination of polymorphisms in candidate genes and the identification of susceptibility loci by linkage analyses. in specific aim 4, interactions between diet, cvd risk factor response and genetic factors will be dissected through measures of potential mediating metabolic pathways.

Eligibility criteria:
no eligibility criteria
clinical neuropharmacology of pain in spinal cord injury- dextromethorphan/lidocaine combination clinical trial

Conditions: Central Neuropathic Pain; Allodynia; Spinal Cord Injury

Summary: this randomized, placebo-controlled, double-blind 4x4 crossover clinical trial was part of a larger nih-funded study to evaluate the analgesic efficacy of multiple dose-combinations of chronic oral (po) dextromethorphan and intravenous (iv) lidocaine in central neuropathic pain following spinal cord injury.

this trial has several objectives: primary objective to determine which combination (dose-ratio) of dextromethorphan and lidocaine provides the best balance of pain reduction and toxicity. secondary objectives include to evaluate the analgesic efficacy of both dextromethorphan and lidocaine in attenuating pain related to central nervous system sensitization, specifically spontaneous pain, mechanical allodynia, and hyperalgesia.

Eligibility criteria:
inclusion criteria: 1. healthy male or female adults, age 18 to 70 with central neuropathic pain for a minimum of 3 months following sci as confirmed by neurologic evaluation, with an average pain intensity score of at least moderate over at least 50% of the day for the 7 days prior to the screening visit and over the 7 days prior to starting study medication. 2. subjects used no medication or a stabilized medication regimen for chronic and well-controlled medical conditions 3. serum laboratory examination obtained at study entry: 4. normal cognitive function. 5. signed informed consent. exclusion criteria: 1. pregnancy or breast-feeding. 2. renal or hepatic dysfunction. 3. significant cardiac disease (e.g. mi within 1 year). 4. signs or symptoms of central neurological disorder, excluding sci. 5. severe psychological disorder requiring treatment. 6. history of hypersensitivity or intolerance to dextromethorphan or lidocaine. 7. participation in a study of an investigational drug or device within 30 days prior to screening for this study.

Keywords: chronic pain central neuropathic pain spinal cord injury dextromethorphan lidocaine combination therapy analgesia
comparison of surgical site infection rate between primary, delayed primary and vacuum assisted closures.

Conditions: Surgical Wound Infection

Summary: the objective of the study is to compare infection rates between primary, delayed primary and vacuum assisted closures in contaminated and dirty/infected laparotomy wounds.

the objective of this study is to compare infection rates between primary, delayed primary and vacuum assisted closures in contaminated and dirty/infected laparotomy wounds. social, demographic, surgical, postsurgical and medical variables were registered. a descriptive analysis expressed as total and percentages, medians and interquartile ranges. comparison between groups was made using the kruskal-wallis, u-mann whitney or chi-squared as appropriate. a p value of less than 0.05 was considered significant.

Eligibility criteria:
inclusion criteria: * laparotomy wound classified as class iii or iv according to cdc's criteria for defining a surgical site infection. exclusion criteria: * patient refusal to participate in the trial

Keywords: surgical wound infection negative-pressure wound therapy wound closure techniques laparotomy. abdominal wound closure techniques
3d transperineal ultrasound of the pelvic floor muscles in women with pelvic floor disorders: a cross-sectional study.

Conditions: Pelvic Floor Disorders

Summary: the present study aimed to evaluate the levator ani muscle in both morphology (rest), and function (contraction and valsalva) in symptomatic women using 2d, 3d trans-perineum ultrasound (tpus), to compare these features to clinical digital palpation and symptoms, and helping in diagnosis of muscle dysfunction.

the prevalence of pelvic floor dysfunction is high, affecting millions of women worldwide in different conditions (social, sexual, physical, psychological, domestic relationships, financial, etc.), many people still have no, limited knowledge, or awareness of pelvic floor health and so do not have, or seek how to prevent or correct these disorders . this dysfunction may be presented as pelvic organ prolapse, stress urinary incontinence, fecal incontinence , chronic pelvic pain, sexual problems, and/or chronic constipation . assessment of pelvic floor muscle activity plays a major role in urogynecology and physiotherapy as a part of the conservative treatment of pelvic floor disorders (pfd) . presence of levator avulsion is a major risk factor for female pelvic organ prolapse (pop) and recurrence after surgical correction . this dysfunction can be diagnosed clinically using vaginal palpation . palpation is subjective, less reproducible, and difficult to teach than imaging methods \[6\]. studies that used ultrasound for assessment of pelvic floor muscle activity and strength are still few . the present study aimed to evaluate the levator ani muscle in both morphology (rest), and function (contraction and valsalva) in symptomatic women using 2d, 3d trans-perineum ultrasound (tpus), to compare these features to clinical digital palpation and symptoms, and helping in diagnosis of muscle dysfunction.

Eligibility criteria:
inclusion criteria: * women complaining of any of the pelvic floor disorder symptoms. exclusion criteria: * women with a history of chronic intestinal disease (crohn's disease, ulcerative colitis), acute gastroenteritis within the week preceding consultation women who underwent any surgical or diagnostic procedure involving the anal canal
comparison of 18f-rhpsma-7.3 pet/ct with and without furosemide in biochemical recurrence of prostate cancer

Conditions: Prostate Adenocarcinoma; Recurrent Prostate Carcinoma

Summary: this phase ii trial evaluates fluorine-18 radiohybrid prostate-specific membrane antigen (18f- rhpsma)-7.3 positron emission tomography (pet)/computed tomography (ct) scans with and without furosemide for the reduction of bladder activity in patients with prostate cancer that has come back (recurrent) based on elevated levels of prostate-specific antigen (psa) in the blood (biochemical) after prostate surgery (prostatectomy). furosemide is a diuretic substance that increases the urine flow into the bladder, thereby decreasing the level of radioactivity within the bladder, which may help to see any abnormal areas that could be masked by the radioactivity within the bladder. pet is an established imaging technique that utilizes small amounts of radioactivity attached to very minimal amounts of tracer, in the case of this research, rhpsma ligand. ct utilizes x-rays that traverse body from the outside. ct images provide an exact outline of organs and potential inflammatory tissue where it occurs in patient's body. adding furosemide to 18f-rhpsma 7.3 pet/ct scans may help to better detect and treat patients with biochemically recurrent prostate cancer.

primary objective: i. to determine if administering 20 mg furosemide intravenously (iv) at the time of radiotracer injection significantly reduces bladder activity compared with the same patient scanned without furosemide as internal control. secondary objectives: i. to compare detection rates of recurrent disease in blinded interpretations between the furosemide and non-furosemide 18frhpsma-7.3 pet/ct scans, with patients serving as their own internal controls. ii. to compare reader confidence in identifying prostate bed and other recurrent lesions on a 18f-rhpsma-7.3 pet/ct with furosemide compared with 18f-rhpsma-7.3 pet/ct without furosemide. outline: patients receive 18f-rhpsma 7.3 tracer iv and then undergo pet-ct scans with and without furosemide iv on study.

Eligibility criteria:
inclusion criteria: * adenocarcinoma of the prostate, post-prostatectomy * biochemical recurrence of prostate cancer following radical prostatectomy (rp) with or without adjuvant or salvage therapy: psa \>= 0.2 ng/ml followed by a subsequent confirmatory psa value \>= 0.2 ng/ml * age over 18 * ability to provide written informed consent * patients with standard of care creatinine =\< 1.3 mg/dl performed within 90 days prior to enrollment exclusion criteria: - inability to undergo 18f-rhpsma pet-ct, contraindications to furosemide or urinary incontinence