Kornimate/medical-research-clean huggingface dataset:
pet/mr scan with [68ga]ga-pentixafor (cxcr4) vs standard of care (soc) for initial staging and follow up in multiple myeloma (mm)

Conditions: Multiple Myeloma

Summary: multiple myeloma is a disease mainly located in participants bones. usually a participants physician arrives at this diagnosis by doing blood tests and ordering standard of care imaging tests (18f-fdg pet/ct and maybe additional mri) to see how many bones (and/or other organs) are affected. while these two imaging tests are already very good, recent research indicates that even more precise imaging methods could be used to diagnose participants disease more precisely. the purpose of this study is to learn if a combined pet/mr scan with a new radiotracer, \[68ga\]ga-pentixafor, can provide more accurate and precise diagnostic information in patients with multiple myeloma, a type of cancer primarily affecting the bones. this study aims to improve the accuracy of diagnosing and monitoring multiple myeloma using more advanced imaging techniques.

the investigators will be focusing on multiple myeloma patients, a disease mainly located in the participants bones. the goal of this clinical trial is to evaluate the diagnostic and prognostic value of cxcr4-targeted pet/mr imaging in patients with multiple myeloma (mm), comparing it to the standard 18f-fdg-pet/ct and mri imaging for the initial staging, follow-up, and treatment decision-making. the study will focus on newly diagnosed mm patients and those who may undergo stem cell transplantation. the investigators will compare the performance of \[68ga\]ga-pentixafor pet/mr to standard imaging methods (18f-fdg-pet/ct and mri) to see if cxcr4-targeted imaging offers improved accuracy, better tumor detection, and a greater influence on treatment decisions. this study aims to establish whether combining cxcr4-targeted pet/mr imaging could become a comprehensive diagnostic tool for mm, enhancing disease monitoring, guiding therapeutic decisions, and reducing patient burden by eliminating the need for multiple imaging sessions.

Eligibility criteria:
inclusion criteria * patient older than 18 years of age * clinical diagnosis of (nonsecretory, oligosecretory, suspicion for extramedullary mm) mm. mm diagnosis is based on imwg (international myeloma working group) criteria.no treatment received beyond first course of exclusion criteria * any contra-indications for mri or 18f-fdg pet/ct imaging according to institutional guideline * pregnancy (will be ruled out as per institutional protocol) * inability to lie still in prone position in mri for at least 30 min or pet/ct for at least 30 min * patients or unwilling to use contraception during study and breastfeeding women can also not partake in this study * inability to provide consent * any hypersensitivity or known allergy to any component of the investigational product (\[68ga\]ga-pentixafor)no concomitant other malignant hemato-oncological disease being diagnosed (i.e. additional lymphoma or leukemia)
foveal sparing of the ilm

Conditions: Retinal Sensitivity

Summary: to compare the retinal sensitivity of complete internal limiting membrane (ilm) peeling versus foveal sparing ilm peeling during vitrectomy for epiretinal membrane or macular hole.


Eligibility criteria:
inclusion criteria: * provision of written informed consent * age \> 60 years * presence of idiopathic macular pucker or macular hole documented by oct exclusion criteria: * any prior intraocular surgery * pathologic myopia (\> 7 diopters) * age related macular degeneration * glaucoma and diabetic retinopathy or any other retinal vascular disease
houston emergency opioid engagement system

Conditions: Opioid Use Disorder

Summary: the houston emergency response opioid engagement system (heroes) is a community-based research program integrating assertive outreach, medication-assisted treatment, behavioral counseling, peer recovery support, and paramedic follow-up in houston texas. the objective is to compare differences in engagement and retention in treatment for individuals with opioid use disorder.

the houston emergency response opioid engagement system (heroes) is a non-randomized cohort study based at the university of texas health science center of houston. this study seeks to develop an emergency- initiated opioid system of care for individuals with prior opioid overdose and opioid use disorder. the study involves both assertive outreach on individuals who have recent overdoses within the last 72 hours, as well as individuals who are admitted to local hospital emergency departments. the study explores the effect of the combination of assertive outreach, same-day induction into medication-assisted treatment, ongoing maintenance treatment, behavioral counseling, peer recovery support, and paramedic follow-up on patient outcomes. the primary outcome is engagement and retention outpatient treatment. secondary outcomes include quality of life assessment as well as subsequent relapses and overdoses. the hypothesis is that patients with earlier induction into mat treatment in the emergency department, who receive routine follow-up, are more likely to engage and be retained in a longer-term treatment program for their addiction.

Eligibility criteria:
inclusion criteria: * in otherwise good health based on physician assessment and medical history * tests positive in urine sample for opioids * patients express a willingness to stop opioid use * meet diagnostic and statistical manual of mental disorders - text revision (dsm-iv-tr) criteria for opioid dependence * patients must be able to speak english * be agreeable to and capable of signing informed consent exclusion criteria: * non-english-speaking patients * have a known sensitivity to buprenorphine or naloxone * be physiologically dependent on alcohol, benzodiazepines or other drugs of abuse that require immediate medical attention. other substance use diagnoses are not exclusionary. * have a medical condition that would, in the opinion of the study physician, make participation medically hazardous, including unstable cardiovascular disease, neurological deficits, trauma, acute hepatitis, stroke, and liver or renal disease) * be acutely psychotic, severely depressed, and in need of inpatient treatment, or is an immediate suicide risk * be a nursing or pregnant female
safety and effectiveness of eye90 microspheres™ in the treatment of unresectable hepatocellular carcinoma (hcc) and metastatic colorectal cancer (mcrc)

Conditions: Hepatocellular Carcinoma Non-resectable; Metastatic Colorectal Cancer; Liver Cancer

Summary: the purpose of this study is to evaluate the safety of treatment with eye90 microspheres in patients with unresectable hepatocellular carcinoma (hcc) and metastatic colorectal cancer (mcrc). both cause tumors, known as malignant hyper-vascular hepatic neoplasia, that have an abnormally large number of blood vessels attached to them. eye90 is internal radiation brachytherapy for treatment of malignant hyper-vascular hepatic neoplasia that uses microspheres, tiny glass beads smaller in diameter than a human hair, to provide radiation. the microspheres contain yttrium-90 (y90) as the radiation source, which are used to to kill cancer cells and shrink tumors. the microspheres are also radiopaque, which means that they can be seen during imaging procedures. the visibility of the microspheres allows the study doctor to confirm the microspheres have been delivered in the tumor; this may help to improve the outcome of treatment.


Eligibility criteria:
inclusion criteria: * measurable disease defined as at least one unidimensional measurable lesion by computed tomography (ct) or magnetic resonance imaging (mri). * must have at least one lesion \> 2 cm within the target perfused volume. * at least one lesion must meet the definition of target lesion as defined by recist 1.1 or mrecist. * total linear length of all lesions must be ≤ 9 cm. * must have preservation of \>700cc of normal liver parenchyma outside of treated volume. * hypervascular lesions on ct scan with 99mtc maa spect/ct t:n ratio 3:1 or higher and hypervascular on cbct. * no prior locoregional therapies in the liver other than previous drug eluting bead tace and/or local hcc recurrence after thermal ablation. last tace and/or ablation treatment must be at least 3 months prior to informed consent. prior lumi or lipiodol tace is not allowed. * life expectancy of ≥ 6 months. * ≥ 18 years old. exclusion criteria: * hemoglobin ≤ 85 mg/l. * platelet count \ 50% normal * inr \> 1.4 (if anticoagulated, reversal must be achieved prior to any angiographic procedures). * alt \> 2.5x upper limit * ast \> 2.5x upper limit * for hcc subjects, bilirubin ≥ 2 mg/dl. * for mcrc subjects, bilirubin ≥ 1.2 mg/dl. * egfr ≤ 60 ml/min/1.73 m2. * portal vein thrombosis (pvt). * incompetent biliary duct system, prior biliary intervention, or a compromised ampulla of vater * estimated lung dose \> 30 gy as calculated using the lung shunt % and partition model.

Keywords: hepatocellular carcinoma metastatic colorectal cancer liver neoplasms liver diseases internal radiation brachytherapy radioembolization y90 yttrium-90 eye90 microspheres
pharmacists management of diabetes

Conditions: Diabetes Mellitus

Summary: the hypothesis is that patients with poorly controlled diabetes would have greater improvement in their blood sugar control when managed by a clinical pharmacist than when managed with usual medical care. patients with poor control are randomized to pharmacist management or to usual medical care for one year.


Eligibility criteria:
inclusion criteria: * age 18 years or older * a1c greater than or equal to 9.0 exclusion criteria: * not expected to live for the duration of the study * managed by an endocrinologist * unwillingness to participate and attend pharmacist visits

Keywords: diabetes mellitus pharmacist
validation of a simultaneous ocular/cervical vemp with mastoid vibration by b250

Conditions: Vertigo

Summary: a validation study in which the standard separate cvemp and ovemp will be compared with a new protocol in which the cvemp and ovemp can be recorded simultaneously in response to a mastoid vibration by bone transducer b250


Eligibility criteria:
inclusion criteria: -) dizzy patients attending the balance laboratory - exclusion criteria: -) age \< 18 years old
early ifnb-1a and atorvastatin combination therapy of isolated clinical syndrome suggestive of multiple sclerosis

Conditions: Multiple Sclerosis

Summary: the primary purpose is to determine the changes in gene expression induced by ifnb-1a (rebif) and atorvastatin (lipitor) combination therapy in patients with an isolated clinical syndrome suggestive of multiple sclerosis (ms), to identify markers of therapeutic response, and to predict patients' clinical response based on their in vitro response to this combination therapy measured by the gene expression levels in activated peripheral blood mononuclear cells (pbmcs).

multiple sclerosis (ms) is a chronic neurologic disease, characterized pathologically by focal areas of inflammation, demyelination, axonal injury and degeneration in the central nervous system. ms follows several different disease courses. approximately, 90% of patients have a relapsing form of the disease. we propose that atorvastatin (lipitor) may enhance the immunomodulatory effects of infb-1a (rebif) in patients with clinically isolated neurological syndrome suggestive of ms. this combination may be more effective in preventing development of definitive relapsing-remitting ms if administered early in the course of the disease. the study will identify markers of disease activity that are selectively affected by this combination therapy. identified markers may be used in future clinical trials to predict patient's clinical response and to monitor the response to treatment as a secondary outcome measure.

Eligibility criteria:
inclusion criteria: * patients with isolated clinical syndrome suggestive of ms * at least three out of four magnetic resonance imaging (mri) findings on the initial scan: * one gd-enhancing lesion or nine t2 hyperintense lesions; * at least one infratentorial lesion; * at least one juxtacortical lesion; and * at least three periventricular lesions. * expanded disability status scale (edss) 0-5.5 * 18 to 60 years of age * at least one relapse in previous 12 months exclusion criteria: * patients with a diagnosis of clinically definitive relapsing-remitting (rr) ms, secondary progressive, or primary progressive ms. * patients who have ever been treated with mitoxantrone, cytoxan, cyclophosphamide, or total lymphoid irradiation (tli). * patients treated with ifnb-1a, ifnb-1b, glatiramer acetate, intravenous immunoglobulins (ivig), plasma exchange, methotrexate, or azathioprine in the previous 3 months. * patients treated with intravenous or oral steroids within 30 days prior to baseline mri. * patients who have been treated with statins in the previous 3 months. * pregnant or breast-feeding women. * patients with a history of severe cardiac, hepatic, pulmonary, gastrointestinal, or renal disease. * abnormal baseline blood tests including alanine transaminase (alt) or aspartate transaminase (ast) greater than twice the upper limit of normal

Keywords: clinically isolated syndrome
carnosine loading and periodized training in ms and hc

Conditions: Multiple Sclerosis; Exercise Therapy; Dietary Supplement

Summary: increasing evidence favours exercise therapy as an efficient tool to counteract inactivity related secondary symptoms in ms. furthermore, exercise therapy may affect ms-associated muscle contractile and energy supply dysfunctions. so far, low to moderate intensity exercise rehabilitation has shown to induce small but consistent improvements in several functional parameters. high intensity exercise training in ms seems to further improve this. however, although results are promising, impairments in both muscle contraction and energy supply probably attenuate therapy outcome. in keeping with the above described physiological role of skeletal muscle carnosine and because muscle carnosine content may be lower in ms, the primary aim of the present project is to investigate whether carnosine loading improves exercise therapy outcome (exercise capacity, body composition) and performance in ms. if the latter hypothesis can be confirmed, muscle carnosine loading could be a novel intervention to improve exercise capacity and muscle function in this population.

pilot data from the (co-)applicants' laboratories suggest that eae rats (animal ms model) and ms-patients suffer from significantly reduced muscle carnosine levels compared to healthy counterparts. the potential of β-alanine supplementation to elevate muscle carnosine content has been shown in healthy volunteers. furthermore, the investigators have recently investigated β-alanine and carnosine supplementation in eae animals. in ms, this has not been investigated yet. therefore, the researchers' next step is to investigate the impact of β-alanine intake on exercise performance in ms patients. the investigators hypothesize that oral β-alanine supplementation improves exercise therapy outcomes in ms patients. so far, it is clear that β-alanine intake enhances exercise capacity of untrained, trained and aged individuals by improving contractile properties, maintaining higher intracellular energy levels and optimizing training adaptations. because early fatigue of contracting musculature during rehabilitation is the predominant cause of exercise cessation, postponing exercise-induced fatigue by β-alanine supplementation will be clinically very relevant (improving exercise therapy efficiency). consequently, the investigators aim to research the ergogenic potential of β-alanine intake in ms rehabilitation and hypothesize that β-alanine supplementation optimizes exercise therapy outcome (exercise capacity, muscle contractile characteristics) in this population.

Eligibility criteria:
inclusion criteria: diagnosis multiple sclerosis. healthy control. aged \>18y. written informed consent. exclusion criteria: contraindications to perform moderate to high intensity exercise. participation in another study. experienced acute ms related exacerbation \ 3.5
comparison of laparoscopic endometrioma stripping versus ethanol sclerotherapy( cless)

Conditions: Endometrioma

Summary: the aim of this study is to compare two different laparoscopic surgical techniques (endometrioma stripping vs ethanol sclerotherapy) in terms of ovarian reserve (amh levels), recurrence rate and pain relief.

patients with pelvic pain (vas score≥4) and ultrasound diagnosis of endometrioma \> 4cm candidate to surgical removal of endometrioma will be randomized into 2 group. one group will undergo laparoscopical stripping technique; the other one will undergo laparoscopic aspiration and sclerotherapy using 95% ethanol. the women will be introduced with both operative options and they will be informed about the randomization . after an elaborate explanation about the study they will sign an informed consent form. the following data will be collected prior the operation: age, gravity \& parity, operative history, general medical history, the cyst size, amh (anti mullerian hormone), symptoms related to endometriosis (through vas score), fertility history including any fertility treatment in the past and planned pregnancy after the operation. the laparoscopy will take place in fondazione policlinico gemelli ircss, roma. in the study group the cyst content will be aspirated and flushed with normal saline. 95% sterile ethanol will be instilled into the cyst through a nelathon catheter. ethanol will be left in the cyst for 15 min then aspirated as completely as possible following normal saline flushing. in the control group we will follow the standard treatment which is cystectomy. the women will be followed at 1 , 3 , 6 and 12 months after the surgery.

Eligibility criteria:
inclusion criteria: * women between 18-35 years old * women with ultrasound diagnosis of ovarian endometrioma ≥4cm (with or without deep infiltrating endometriosis) * history of dysmenorrhea and/or chronic pelvic pain * candidates for elective laparoscopy due to endometriosis. exclusion criteria: * - previous surgery for ovarian endometriosis * evidence of premature ovarian failure (follicle stimulating hormone ≥40 international units/l) * endocrinal disorders that might affect ovarian function (e.g., polycystic ovary syndrome, thyroid dysfunction, hyperprolactinemia) * ultrasound suspicious of ovarian malignant disease according iota criteria * endometrial cyst \< 4 cm. • ethanol sensitivity.

Keywords: endometrioma ethanol sclerotherapy aspiration ovarian reserve endometriosis amh
observational study of efficiency of cytoflavin, in patients with ischemic stroke not receiving reperfusion therapy

Conditions: Stroke, Acute; Stroke, Ischemic

Summary: stroke remains one of the main socially significant problems in the healthcare in the third millennium. the lethality in persons with history of stroke by the end of the 1st year of disease is high. a trend to increased frequency of stroke in the young age is observed during the last decade; third of patients is working-age individuals, out of whom only 15-20% returns to labor, and others remain disabled persons requiring constant medical and social support


Eligibility criteria:
inclusion criteria: 1. signed informed consent form 2. age from 18 years and older 3. diagnosis: acute cerebrovascular accident of ischemic type (ischemic stroke) developed within 36 hours before enrollment in the study 4. motor neurologic deficit measurable using the nihss scale (score for item 5 and/or 6 at the time of starting the therapy ≥ 1)) 5. conservative stroke treatment tactics (without reperfusion therapy thrombolysis/thrombus extraction) 6. according to the routine clinical practice, the patient is scheduled to receive the treatment as per one of the following regimens: * cytoflavin® 20-40 ml/day as a course of not less than 10 days or * another neuroprotector - course of not less than 10 days (or without neuroprotector) exclusion criteria: 1. nihss 1a (coma) score 3 at the time of enrollment 2. initial severe disablement (corresponding to mrs \> 2) requiring external assistance in everyday life before development of stroke 3. history of parkinson's disease, dementia, multiple sclerosis, and other significant diseases accompanied by neurologic deficit 4. severe comorbidity with expected lifespan of not more than 6 months 5. pregnancy and breastfeeding 6. any other concomitant medical or serious psychic conditions, which make the patient ineligible for participation in the study, restrict lawfulness of obtaining the informed consent, or can influence the patient's ability to participate in the study

Keywords: stroke сytoflavin
macular edema incidence/severity reduction with nevanac

Conditions: Diabetic Retinopathy

Summary: the purpose of this study is to evaluate nevanac in patients with diabetic retinopathy who developed macular edema (me) within 90 days following cataract surgery.


Eligibility criteria:
inclusion criteria: * planned cataract extraction by phacoemulsification with the implantation of a posterior chamber intraocular lens (iol) into the lens capsule. * history of type 1 or type 2 diabetes. * history of nonproliferative diabetic retinopathy (npdr), mild, moderate, or severe, in the study eye as defined by the international clinical diabetic retinopathy disease severity scale. * able to understand and sign an informed consent approved by an irb/iec. * central subfield macular thickness less than or equal to 320 μm in the study eye prior to cataract surgery. * absence of clinically significant macular edema in the study eye as detected by clinical exam. * other protocol-defined inclusion criteria may apply. exclusion criteria: * signs of vitreomacular traction or epiretinal membrane in the study eye as detected by the reading center or investigator. * current or previous ocular disease other than diabetic retinopathy in the study eye that, in the opinion of the investigator, would have confounded the assessments of the macula, the retina, or central vision. * planned multiple procedures for the study eye during the cataract/iol implantation surgery (eg, trabeculoplasty, corneal transplant). * corneal transplant in study eye. * baseline cumulative corneal fluorescein staining score (ie, sum of scores for all 5 corneal regions) for the study eye greater than or equal to 5, or baseline corneal fluorescein staining score in any single region for the study eye greater than or equal to 3. * other protocol-defined exclusion criteria may apply.

Keywords: cataract surgery macular edema prevention