Kornimate/medical-research-clean huggingface dataset:
safety and efficacy of topical platelet rich plasma and thrombin coagulum

Conditions: Stasis Ulcer

Summary: the aim of this study is to * to evaluate the safety and tolerability of platelet rich plasma(prp)/thrombin mixture in treating chronic venous ulcers * to evaluate efficacy of prp/thrombin mixture in treating chronic venous ulcers

study rationale in normal wound healing, platelets activate macrophages to produce endogenous platelet derived growth factor (pdgf) and other growth factors which are responsible for would healing. in chronic wounds, macrophage activation is suppressed which leads to an inappropriate growth factor response causing failure of positive autocrine feedback loop which normally controls the healing process. the regular application of exogenous prp and thrombin, to chronic wounds, restores the autocrine feedback loop of tissue repair which appears to accelerate the normal cascade of tissue repair objectives * to evaluate the safety and tolerability of prp/thrombin mixture in treating chronic venous ulcers * to evaluate efficacy of prp/thrombin mixture in treating chronic venous ulcers

Eligibility criteria:
inclusion criteria: * willing and able to give written informed consent * age 18 years to 75 years. * both males and females. * ankle branchial index of 0.8 or above. exclusion criteria: * diabetics will be excluded as the ankle branchial index (abi) result is considered an unreliable due the possible presence of arteriosclerotic plaques (lead pipe rigidity). * patients who have participated in experimental drug studies within 30 days of entering this study. * receiving chemotherapy or radiotherapy for malignant diseases or any other indication * patients taking corticosteroids or other immunosuppressive medications * clinically malnourished patients or those with recent (last 4 weeks without treatment) serum albumin of less than 30g/l. * patients with current or past history of acute deep vein thrombosis. * patients with current signs and/or symptoms of cardiac, renal or hepatic failure. renal failure defines as creatinine * patients with signs and/or symptoms of peripheral neuropathy. * patients with signs and/or symptoms of atrophie blanche or other conditions associated with non-chronic venous insufficiency ulceration of the lower leg. * patients with signs and/or symptoms of immunocompromized sates or recent (last 4 weeks ) t cell subset (cd4) count of less than 200 cells / ml. * patients showing clinical signs and/or symptoms of anaemia or current or recent(last 4 weeks without treatment) haemoglobin level of less than 8g/dl
effectiveness of a combined pressure and silicone intervention for hypertrophic scar treatment

Conditions: Cicatrix, Hypertrophic; Rehabilitation

Summary: pressure therapy (pt) and silicone therapy are recommended as first-line non-invasive treatments hs, yet the effectiveness of the combination of these two treatments through an rct trial has not been established yet. this study aims to examine the effectiveness of the combination of adequate pressure therapy and silicone gel sheeting implemented by smart scar care pad (sscp) + smart pressure monitored suit (spms) versus conventional pressure garment (pg in the management of severe hs in adult. it is hypothesized that the combination of adequate pressure therapy and silicone gel sheeting will demonstrate its superiority in improving scar parameters than conventional pressure garment therapy.


Eligibility criteria:
inclusion criteria: * the vancouver scar scale (vss) will be used to screen candidates for the study.10 isolated scars with a total score of 4 or higher and the score of each item equal to or greater than 1 will be included. * the scar size should also reach 2\*2 cm2 or above to allow adequate area for assessment tool attachement. * consenting adult's age between 19 to 60 years old who is able to provide written consent, cooperative, and good compliance with treatment. exclusion criteria: * the hs area have an open wound or infection; * the hs have been treated with steroid injections or other intervention (such as traditional chinese medicine or laser therapy) prior to the study; * the patients have a medical condition that might affect wound healing (e.g., diabetes mellitus or another serious medical problem); * the patients with comorbidities that might affect their compliance to treatment: such as severe scar contracture at adjacent area that might be scheduled for reconstructive surgery.

Keywords: insert pressure therapy silicone gel
total hip arthroplasty outcomes with regional and multimodal analgesia

Conditions: Arthroplasty; Replacement, Hip; Arthritis

Summary: the goal of this retrospective chart review is to evaluate if the implementation of lumbar plexus block placement for postoperative pain and administration of multimodal oral analgesia have improved conditions in the postoperative period for patients undergoing total hip arthroplasty when compared to the placement of epidurals for postoperative pain management.

primary outcome: 48 hour opiate consumption in patients following tha. ' secondary outcome: time to first ambulation, assitstance needed with ambulation, opiate and regional related side effects, time to discharge orders.

Eligibility criteria:
inclusion criteria: 1. primary total hip arthroplasty, (identified by current procedural terminology (cpt) code 27130) and 2. either a) epidural or b) lumbar plexus peripheral nerve block with the administration of multimodal medication after july 2012. - exclusion criteria:exclusion criteria include tha revision, icu admission postoperatively, and dementia, not allowing pain score communication. -

Keywords: arthroplasty replacement, hip
the efficacy and safety of liraglutide adjunct to insulin treatment in type 1 diabetes

Conditions: Diabetes; Diabetes Mellitus, Type 1

Summary: this trial is conducted in africa, europe and north america. the purpose of the trial is to investigate the efficacy and safety of liraglutide adjunct to insulin treatment in type 1 diabetes.


Eligibility criteria:
inclusion criteria: * informed consent obtained before any trial-related activities. trial-related activities are any procedures that are carried out as part of the trial, including activities to determine suitability for the trial * male or female, aged equal to or greater than 18 years at the time of signing informed consent * type 1 diabetes mellitus (as diagnosed clinically) 12 months or longer prior to visit 1 (i.e. screening) * treatment with basal bolus or csii (continuous subcutaneous insulin infusion, insulin pump) treatment 6 months or longer prior to visit 1 (i.e. screening) * stable insulin treatment 3 months or longer prior to visit 1 (i.e. screening), as judged and documented by the investigator * hba1c 7.0-10.0 percent (diabetes control and complications trial (dcct)), both inclusive, by central laboratory analysis (visit 1, screening) corresponding to 53-86 mmol/mol (international federation of clinical chemistry (ifcc)) exclusion criteria: * prior use of glucagon-like peptide-1 (glp-1) receptor agonist or dipeptidyl peptidase iv (dppiv) inhibitors * use of any medication, which in the investigator's opinion could interfere with the glycaemic control (e.g. systemic corticosteroids, pramlintide (symlin®)) or affect the subject's safety. premix insulin is not allowed * known proliferative retinopathy or maculopathy requiring acute treatment * severe neuropathy, in particular autonomic neuropathy, i.e. gastroparesis, as judged by the investigator * uncontrolled/untreated blood pressure at screening (visit 1) (after resting for 5 minutes) while sitting greater than 160 mmhg for systolic or greater than 100 mmhg for diastolic (repeated measurement at visit 2 (prior to performing the trial related activities) is allowed to exclude white-coat hypertension) * history of acute or chronic pancreatitis * screening (visit 1) calcitonin value equal to or greater than 50 ng/l
effect of c-peptide on hypoglycemic counterregulation

Conditions: Hypoglycemia; Type 1 Diabetes

Summary: iatrogenic hypoglycemia is the most prominent barrier to the safe, effective management of blood sugar in people with type 1 diabetes due to periodic over-insulinization. during insulin-induced hypoglycemia, glucagon secretion is diminished in type 1 diabetes which, in turn, reduces hepatic glucose production and increases the depth and duration of hypoglycemic episodes. we have observed that the naturally occurring protein c-peptide increases glucagon secretion in dogs during insulin-induced hypoglycemia, which increases hepatic glucose production; the experiments in this application will shed light on the translation of this finding to the human.

iatrogenic hypoglycemia is recognized as a primary barrier to the safe, effective management of blood glucose in people with type 1 diabetes (t1d). in previous experiments in the dog, we observed that c-peptide infusion augmented glucagon secretion and hepatic glucose production during insulin-induced hypoglycemia. the proposed experiments will determine the translational impact of this finding in patients with and without t1d. specific aim #1 is to determine, in healthy control subjects, the effect of c-peptide co-infusion with insulin on endogenous glucose production (egp) and counterregulatory hormone levels during hypoglycemia. this will be addressed by studying a single group of healthy subjects two times. in both studies, hypoglycemia will be induced with an intravenous (iv) infusion of insulin. during one study, c-peptide will be infused during the hypoglycemic period, and in the other study, saline will be infused. egp is our primary variable, with secondary analyses including counterregulatory hormones and metabolic substrates. specific aim #2 is to determine, in t1d patients, the effect of c-peptide co-infusion with insulin on egp and counterregulatory hormone levels during hypoglycemia. the research plan for this aim is very similar to that of aim #1, with the main exception being that we will study t1d patients instead of healthy controls (e.g., two hypoglycemic clamp studies where c-peptide is administered during one study and saline during the other). in addition, the glycemic levels of these t1d patients will be monitored for 10 days prior to this visit to ensure that they do not experience hypoglycemia which could confound the data for the metabolic studies. similar to aim #1, egp is our primary outcome variable, with secondary analyses including hormone and substrate levels.

Eligibility criteria:
inclusion criteria: * bmi less than 30 kg/m2 exclusion criteria: * pregnant or lactating women cigarette smoking presence of hiv or hepatitis presence of cardiovascular disease presence of microvascular disease

Keywords: glucagon hepatic glucose production c-peptide
predictive value of contrast volume to creatinine clearance ratio

Conditions: Contrast Induced Nephropathy

Summary: to determine a relatively safe contrast media volume to creatinine clearance cut-off value to avoid contrast-induced nephropathy in patients following coronary angiography

contrast media volume to creatinine clearance (v/crcl) ratios were obtained from consecutive consenting patients after coronary angiography. receiver-operator characteristic (roc) curves were used to identify the optimal sensitivity for the observed range of v/crcl. the predictive value of v/crcl for the risk of contrast-induced nephropathy was assessed using multivariate logistic regression.subgroup analysis was performed on patients with creatinine clearance \< 60 ml/min,diabetes,emergent angiography.

Eligibility criteria:
inclusion criteria: * patients who agreed to stay in the hospital for 2-3 days after coronary angiography * provided written informed consent exclusion criteria: * pregnancy * lactation * intravascular administration of an contrast medium within the previous seven days * treatment with metformin,aminoglycosides,n-acetylcysteine (nac),nonsteroidal anti-inflammatory drugs within the previous 48 h * intake of nephrotoxic drugs within the previous seven days * history of serious reactions to contrast mediums， severe concomitant disease renal transplantation , or end-stage renal disease necessitating dialysis * patients who died during coronary angiography

Keywords: contrast-induced nephropathy contrast medium creatinine clearance coronary angiography diabetes chronic kidney disease
sleep, hiv disease progression, and function in hiv infected children and adolescents

Conditions: Sleep; HIV Infections

Summary: this study is a first step in approaching the gap existing between understanding sleep abnormalities, alterations in sleep-regulating cytokines and hiv-1 disease regulating cytokines, and abnormal higher cortical function.

background: in the growing number of hiv infected youth and young adults, it is important to study the effects of haart treatment on sleep patterns and related neurocognitive and psychosocial function. design narrative (including primary and secondary outcomes): using validated sleep questionnaires and actigraphy measurements, overnight polysomnography (psg, sleep study) will assess the degree of abnormal sleeping patterns and daytime sleepiness in hiv infected children and hiv uninfected children (control group). the following peripheral blood levels will be measured over a 24-hour period, at multiple time points, in all participants: tnf-alphari and il-6 (sleep-regulating cytokines); ifn-gamma and il-12 (cytotoxic or th1 cytokines); and il-10 and il-1ra (inflammatory or th2 cytokines). this will help to determine the association between alterations in sleep-regulating cytokines and hiv disease progression (cd4+ t-cell count, hiv-1 rna level). neurocognitive and neuropsychological tests will be performed on all participants to determine if there is an association between lack of normal sleeping habits, alterations in sleep-regulating cytokines and hiv-1 disease progression cytokines, and neurocognitive/neuropsychological performance. computer analysis of electroencephalography (eeg) will be performed during wakefulness and all stages of sleep to determine if greater disease severity, sleepiness, sleep disruption, and neurocognitive impairment is associated with increased amounts of slow activity. improvement in these related factors will be associated with normalizations of these parameters. for some of these quantitative measures, the findings may be more significant for particular brain regions; for example, frontal regions in the case of attention problems.

Eligibility criteria:
inclusion criteria: hiv group * hiv-1 infection control group * family members and friends of hiv-1 infected children exclusion criteria: hiv group * pregnancy control group * pregnancy * asthma * sleep apnea
observational study on gep-and pulm-net treated at fpg

Conditions: Neuroendocrine Tumors; Gep Net; Pulmonary Neuroendocrine Neoplasm

Summary: observational ambispective monocentric study on the clinical, laboratory, pathological and molecular characteristics of patients suffering from gastroenteropancreatic tract and pulmonary neuroendocrine tumors and their prognostic and predictive value.

neuroendocrine tumors (nets) are a heterogeneous group of rare epithelial neoplasms arising from cells of the diffuse neuroendocrine system. in recent years their incidence has been constantly increasing and up to 80% of cases already begin in an advanced stage. the most frequent site of primary localization is the gastroenteropancreatic tract (gep-net) in 60% of cases, followed, in 25%, by the lung (l-net). clinically, nets are classified as functioning (f) or non-functioning (nf) based on the presence of symptoms caused by hormonal secretion produced by tumor cells. nets are characterized by great clinical and biological, inter- and intra-tumoral heterogeneity. the who classification identifies four categories: well-differentiated nets, g1, g2 and g3, and poorly differentiated neuroendocrine carcinomas (necs), which represent 10%-20% of all neuroendocrine neoplasms. this classification, together with the tnm stage according to the american joint committee on cancer (ajcc 8th edition) takes on an important prognostic value. however, these two criteria are not exhaustive in predicting the aggressiveness of the pathology nor the response to oncological therapies. there is therefore a clear clinical need, to date unsatisfied, for new prognostic and predictive biomarkers, which can better define the heterogeneity of nets by implementing classification and staging, to guide prognosis and support therapeutic decisions. the main feature of all well-differentiated nets is the overexpression of the somatostatin receptor, measured by pcr-based or immunohistochemistry (ihc)-based methods or by imaging. among these receptors, the sstr2a subtype is the most commonly expressed. diagnostic and therapeutic approaches aimed at sstr have shown advantages but it is not clear how much the degree of expression of sstr in positive patients influences the response to treatment and whether it has a correlation with survival, regardless of the oncological treatments used. furthermore, since the expression of this receptor appears inversely proportional to the degree of differentiation and can be different within the same disease between primary tumor and metastatic disease, this receptor could have a further role as a measure of tumor heterogeneity and disease progression.

Eligibility criteria:
inclusion criteria: * histological diagnosis of gastroenteropancreatic or pulmonary net * age ≥ 18 years; * radiological evidence of resectable/locally advanced/metastatic disease; * signing of informed consent; * at least one visit following the first oncological visit. exclusion criteria: * absence of clinical data that allow adequate definition of survival (primary endpoint of the study); * absence of histological diagnosis; * failure to sign the informed consent.
prediction of stroke risk in patients with atrial fibrillation based on chest ct images

Conditions: Atrial Fibrillation (AF); Ischemic Stroke

Summary: this study aims to create and assess a deep learning framework for extracting left atrial appendage features in atrial fibrillation patients and combining them with clinical data to predict ischemic stroke risk. clinical data and chest ct images from patients diagnosed with non-valvular atrial fibrillation will be collected. patients will be categorized into stroke and non-stroke groups to build a data repository. the dataset will be divided into training and validation sets, with missing data handled and pulmonary vein ctv and virtual non-contrast images annotated. a deep learning model will be used for image segmentation and feature extraction to develop a prediction system.

this study aims to develop and evaluate a deep learning framework that can automatically extract imaging features of the left atrial appendage in patients with atrial fibrillation and combine them with clinical features to predict the risk of ischemic stroke in these patients. the study intends to retrospectively collect clinical data (including patients\&#39; general information, medical history, laboratory tests, etc.) and chest ct images, as well as pulmonary vein ctv images (if available), from patients diagnosed with non-valvular atrial fibrillation between january 2018 and june 2024. the patients will be divided into stroke and non-stroke groups based on whether they have experienced an ischemic stroke, and a data analysis repository will be established. the dataset will be split into training and validation sets. missing data will be handled, and data labeling will be performed on the pulmonary vein ctv sequence images and virtual non-contrast (vnc) sequence images. the left atrial morphology will be delineated, and a deep learning-based image segmentation network model will be developed to extract and select radiomic features for the prediction system.

Eligibility criteria:
inclusion criteria: diagnosed with atrial fibrillation by ecg, 24-hour holter monitor, or recordable ecg monitor; atrial fibrillation confirmed by an implanted pacemaker or defibrillator, lasting at least 30 seconds available chest ct images and complete clinical data. exclusion criteria: incomplete clinical data or diagnosis of valvular atrial fibrillation (e.g., rheumatic heart valve disease, post-valve replacement) poor-quality ct images that prevent complete assessment of left atrial appendage morphology patients who have undergone left atrial appendage closure patients who have had radiofrequency ablation or cardioversion with no evidence of recurrence post-procedure

Keywords: atrial fibrillation ischemic stroke deep learning chest ct left atrial appendage
implementation of a tool to identify social weaknesses in the cancer care pathway

Conditions: Cancer

Summary: social inequalities in the face of cancer are significant in all countries. they are characterized by higher mortality among people may be in the lower socioeconomic category. the care pathway may also be a source of inequality or accentuate inequalities. socially vulnerable patients must be provided with appropriate care. it is therefore necessary to identify patients with such social vulnerabilities as early as possible and to take them into account throughout the care process. to meet this need, the defco project ("detection of social frailties and coordination of the path of patients in cancer: a new approach by an expert computer system") was designed and conducted by the centre hygée at the lucien neuwirth cancer institute (icln) in 2014 and 2015, in partnership with an industrial engineering research laboratory, the disp ("décision \& information pour les systèmes de production"). its objective was to develop a tool for systematic screening of social fragility, involving few caregivers and making it possible to identify patients most at risk of social maladjustment. the choice was made to develop a self-administered questionnaire using tablets connected to a neural network. since its implementation, the deployment of the defco project ("detection of social frailties and coordination of the path of patients in cancer: a new approach by an expert computer system") tool at the lucien neuwirth cancer institute (icln) has required several training and awareness-raising activities to strengthen the motivation of the various stakeholders. these same actors have also implemented different strategies to optimize the functioning of the tool. developed in a specialized institution, this tool must demonstrate, in this second stage of the project, it transferability and it possibilities of implementation in other structures. it is also necessary to evaluate it in terms of it is impact, particularly on the fluidity of care pathways and on the social consequences of the disease.

the aim of this study is to evaluate the implementation of the defco ("detection of social frailties and coordination of the path of patients in cancer: a new approach by an expert computer system") social fragility tracking tool over one year.

Eligibility criteria:
inclusion criteria: * patient diagnosed for cancer (solid or hematological) since 15 days maximum * age over 18 years * affiliated with or entitled to a social security scheme exclusion criteria: * refusal to participate * patient unable to understand the study process * patient with documented history of cognitive or psychiatric disorders. * patient under tutorship or curatorship * patient not understanding french

Keywords: cancer social fragilities social inequalities defco machine learning cancer care pathway