Kornimate/medical-research-clean huggingface dataset:
diagnosis and treatment of pheochromocytoma

Conditions: Pheochromocytoma

Summary: pheochromocytoma is a tumor of the adrenal gland. this tumor is typically benign (not cancerous) and can be cured by surgical removal. however, pheochromocytomas produce neurohormones called cateholamines (epinephrine and norepinephrine). high levels of catecholamines can result in high blood pressure, headaches, sweating, heart palpitations, nausea, vomiting, and other symptoms. these tumors are considered dangerous because of their unpredictable behavior. patients with pheochromocytoma may experience blood pressures high enough to cause a stroke or heart attack in patients. this study is designed to take patients suspected of having pheochromocytoma and confirm the diagnosis. this will be done using a variety of laboratory tests including a clonidine suppression test and glucagon stimulation test. these tests use drugs that can stimulate or reduce the activity of the tumor if it is present in the body. once a diagnosis is confirmed, patients participating in this study will undergo standard procedures to find the exact location of the tumor and receive standard therapy for the condition.

patients suspected of having a pheochromocytoma will be studied via a series of tests in an attempt to ascertain biochemically whether or not they really have such a tumor. these procedures will include a standard clonidine suppression test and a standard glucagon stimulation test. once the diagnosis has been made on the basis of biochemistry, then localization and therapy will be done via standard procedures. measurement of plasma metanephrines on mailed samples is available for physicians who seek further evidence for the diagnosis of pheochromocytoma.

Eligibility criteria:
patients of any age and either sex who are suspected of having a pheochromocytoma on the basis of one or more of the following: 1. hypertensive episodes in a normotensive subject, 2. abnormal levels of blood and/or urinary catecholamines or their metabolites, or 3. an otherwise unexplained abdominal mass. patients without any evidence of pheochromocytoma are excluded.

Keywords: calcium-pentagastrin clonidine glucagon pheochromocytoma
evaluation of an anti-hiv drug combination that includes a coated form of didanosine (ddi ec) compared to a typical anti-hiv drug regimen

Conditions: HIV Infections

Summary: this study tests a new form of didanosine, ddi ec, a coated pill that passes through the stomach before dissolving. the purpose of this study is to compare the effectiveness of an anti-hiv drug combination that includes ddi ec versus another anti-hiv drug combination.

patients are randomized to 1 of 2 groups for 48 weeks of open-label treatment. group 1 receives ddi ec plus d4t plus nfv. group 2 receives combivir plus nfv. antiviral activity is determined by the proportion of patients with hiv rna levels of less than 400 copies/ml at week 48.

Eligibility criteria:
inclusion criteria patients may be eligible for this study if they: * are hiv-positive. * have a viral load of at least 2,000 copies/ml and a cd4 count of at least 200 cells/mm3. * are at least 18 years old. * agree to practice sexual abstinence or to use effective barrier methods of birth control (such as condoms). exclusion criteria patients will not be eligible for this study if they: * have had severe diarrhea within 30 days of study entry. * have a history of pancreatic disease or any other serious condition. * have hepatitis within 30 days of study entry. * are diagnosed with an opportunistic (aids-related) infection at the time of enrollment. * are unable to take medications by mouth. * have received certain medications. * are pregnant or breast-feeding.

Keywords: didanosine drug therapy, combination stavudine rna, viral nelfinavir reverse transcriptase inhibitors anti-hiv agents
physical exercise, endothelial function and progenitor endothelial cells in systemic lupus erythematosus patients

Conditions: Systemic Lupus Erythematosus

Summary: the purpose of this study is to evaluate the effect of supervised physical exercise on endothelial function and number of endothelial progenitor cells (epcs) in patients with systemic lupus erythematosus, as well as evaluate the effect of supervised physical exercise on endothelium derived growth factor (vegf) levels, disease activity, quality of life, fatigue, perceived exertion and cardiopulmonary exercise test variables.

several studies have shown that cardiovascular morbimortality is more frequent and early in sle patients than in the general population and cardiovascular disease is an important cause of morbidity and mortality in systemic lupus erythematosus patients. disturbances in endothelial function are implicated in its pathogenesis. endothelial function also depends on endothelial progenitor cells (epcs) that enhance angiogenesis, promote vascular repair and have potential as a marker of cardiovascular disease. systemic lupus erythematosus patients have endothelial dysfunction and fewer epcs. there are studies showing improvement of endothelial function and epcs after physical exercise program in individuals with heart failure, diabetes and coronary arterial disease, but there isn't studies evaluating endothelial function and epcs after.

Eligibility criteria:
inclusion criteria: * female systemic lupus erythematosus patients * 18 to 45 years of age * fulfilled at least four criteria classification for lupus (acr criteria, 1997) - signed the consent form approved by the ethics committee of the institution exclusion criteria: * hemoglobin \< 10 mg/dl * neuropsychiatric, pulmonary, articular or vascular damage that would prevent the practice of exercise * coronary disease or heart failure, functional class ≥ ii * pulmonary hypertension * uncontrolled hypertension * creatinine ≥ 1.4 mg/dl * body mass index (bmi) ≥ 35 kg/m2 * diabetes mellitus * uncontrolled hypothyroidism * smoking in the last 12 months * pregnancy * menopause * use of statins in the last three months * practice of physical exercise in past three months * overlap with other autoimmune rheumatic diseases, except antiphospholipid syndrome.

Keywords: systemic lupus erythematosus endothelium exercise
a phase iii trial of zd4054 (zibotentan) (endothelin a antagonist) in hormone resistant prostate cancer with bone metastases

Conditions: Prostate Cancer

Summary: enthuse m1 is a large phase iii clinical trial studying the safety and efficacy of zd4054 (zibotentan) in patients with hormone resistant prostate cancer and bone metastases. * this clinical trial will test if the endothelin a receptor antagonist zd4054 (zibotentan) can improve survival compared with placebo. * zd4054(zibotentan) is a new type of agent, which is thought to slow tumour growth and spread by blocking endothelin a receptor activity. this trial will look at the effects of zd4054 (zibotentan) in hormone resistant prostate cancer patients with bone metastases. * all patients participating in this clinical trial will receive existing standard prostate cancer treatments in addition to trial therapy. * half the patients will receive zd4054 (zibotentan), and half the patients will receive placebo in addition to standard prostate cancer therapy. by participating in this trial there is a 50% chance that patients will receive an agent that may slow the progression of the tumour. * no patients will be deprived of standard prostate cancer therapy.


Eligibility criteria:
inclusion criteria: patients who answer true to the following criteria may be eligible to participate in this trial. 1. confirmed diagnosis of prostate cancer (adenocarcinoma of the prostate) that has spread to the bone (bone metastases) 2. increasing prostate specific antigen (psa) over a one month period 3. no pain, or mild pain from prostate cancer 4. currently receiving treatment with surgical or medical castration exclusion criteria: patients who answer true to the following may not eligible to participate in this trial. 1. currently using opiates based pain killers) 2. previous treatment with chemotherapy (paclitaxel, docetaxel, and mitoxantrone) 3. suffering from heart failure or had a myocardial infarction within last 6 months 4. a history of epilepsy or seizures

Keywords: hormone resistant prostate cancer endothelin a receptor antagonist endothelin a endothelin a antagonist
comparison of optic nerve sheath diameter on retrobulbar ultrasound before and after drainage of cerebrospinal fluid in patient with hydrocephalus

Conditions: Hydrocephalus

Summary: studies in patients with intracranial hypertension have shown a good relationship between optic nerve sheath diameter measured by retrobulbar ultrasound and invasively measured intracranial pressure. the aim of this study was to evaluate changes in optic nerve sheath diameter before and after drainage of cerebrospinal fluid in patients with hydrocephalus.


Eligibility criteria:
inclusion criteria: 1. asa ⅰ-ⅱ 2. aged between 20 and 70 year 3. hydrocephalus 4. general anesthesia for undergoing drainage of cerebrospinal fluid exclusion criteria: 1. an anatomical or functional abnormality in optic nerve

Keywords: optic nerve sheath diameter hydrocephalus intracranial hypertension
geranylgeraniol supplementation in patients with mevalonate kinase deficiency

Conditions: Mevalonate Kinase Deficiency

Summary: mevalonate kinase deficiency (hyperigd syndrome, hids) is an inborn error of immunity caused by a block in the mevalonate pathway. the subsequent lack of isoprenoids with antiinflammatory properties might contribute to the autoinflammatory nature of the disease. a pilot study aims to verify the safety and efficacy of the dietary supplement geranylgeraniol, aiming at a mitigation of isoprenoids deficiency caused by the above-mentioned block in the mvk pathway.

mevalonate kinase (mvk) deficiency, a rare autosomal recessive disease, significantly impacts metabolism and immunity, leading to mevalonic aciduria in severe cases and hyper-igd syndrome (hids) in partial deficiency. these conditions arise due to disruptions in the mevalonate pathway, which is an essential metabolic pathway responsible for the synthesis of non-sterol isoprenoids and other molecules. the resulting metabolic blockade triggers autoinflammatory responses, primarily due to deficient isoprenoid intermediates such as geranylgeranyl pyrophosphate (ggpp). this study evaluates the safety and efficacy of dietary geranylgeraniol (gg) supplementation in patients with genetically confirmed mevalonate kinase deficiency. the pilot study consists of a month of a pre-supplementation period to monitor the level of inflammation and clinical status in patients with mvk deficiency(hids). this period is followed by 3 months of supplementation of 150mg of geranylgraniol (gg pure (extendlife natural products) containing gg gold®30 annatto extract, 500 mg capsule (30% geranylgeraniol, 150 mg per capsule).

Eligibility criteria:
inclusion criteria: * patients older than 12 years with genetically confirmed mvk deficiency * overall good clinical status apart from the clinical presentation of the mvk deficiency * normal liver tests * compliance with the study protocol exclusion criteria: • children below 12 years

Keywords: immunoglobulin d mevalonate kinase isoprenoids geranylgeraniol
tolerance and practicality of module aox

Conditions: Gastrointestinal Diseases; Nutrition

Summary: the primary objective of this clinical trial is to test the tolerance and practicality of the new device module aox. the secondary objective is to determine the changes in oxidative, antioxidative status, plasma free amino acids, and various immune parameters in critically ill patients receiving the enteral nutrition with and without using module aox.

surgery and trauma induce hypercatabolism accompanied by a systemic immunoinflammtory response and massive production of reactive oxygen species at the site of injury. in these situations, requirements for certain amino acids (glutamine, cysteine) and antioxidant micronutrients (zinc, vitamin e, vitamin c, beta-caroteen, selenium) are markedly increased and may not be covered by the levels normally present in standard enteral diets, especially in the early phase when enteral nutrition is introduced gradually. thus, supplementation with amino acids and antioxidant micronutrients may be appropiate in order to optimize nutritional support in such patients. the administration of selected nutrients via modular devices added to a standard enteral formulation is an attractive means of providing optimized nutrition support for specific disease states. module aox is intended for supplementation of patients requiring nutritional support for a condition in which oxidative stress is expected. the module contains: * glutamine: to support gut mucosal and immune function, to minimize early depletion of glutamine stores and preserve body protein * cysteine: to support synthesis of glutathione, an important cellular antioxidant, and to support the synthesis of acute phase proteins * vitamin e, vitamin c and beta-caroteen: water- and lipid-soluble antioxidant micronutrients to boost antioxidant defenses * zinc: to compensate for increased losses and to support protein synthesis, immune function and wound healing * selenium: to compensate for increased losses, support antioxidant defenses and immune function

Eligibility criteria:
inclusion criteria: * patients who will undergo major surgery of esophagus, stomach or pancreas * patients who will be eligible for jejunostomy feeding * age \>18 and \<75 y * bmi \< 35 * having obtained his/her or his/her legal representative's informed consent exclusion criteria: * patients with a history of main cardiovascular or kidney disease * weigth loss \>10% during the last 6 months * patients who have received corticosteroids, or investigational drugs, in the last 6 weekd prior to surgery * patients with hiv infection * patients who are participating in another clinical trial
impact of preoperative endoscopic ultrasound-guided fine-needle aspiration in cholangiocarcinoma patients

Conditions: Cholangiocarcinoma Patients

Summary: primary objective of this study is to evaluate the number of patients with positive ln detected by eus and precluded from further surgical interventions. secondary objective of this study is to evaluate the eus-related adverse events.

cholangiocarcinoma (cca) is a rare malignancy originating from the bile duct epithelium. the incidence of cca ranges from 0.5-2.5 cases per 100.000 people in west-european countries and 1.6 cases per 100.000 people in the united states of america. cca is classified based on anatomical site and is divided into intrahepatic (icca), perihilar (pcca) and distal (dcca). survival is limited, as cca is often recognized in a relatively late stadium in which potential curative treatment is not an option anymore. currently, surgical resection is the only potentially curative treatment. the resectability of cca depends on multiple factors: e.g. biliary extension, vascular involvement and presence of metastatic disease. patients with metastatic disease, including both distant lymph nodes and metastases, are ineligible for surgical resection and palliative treatment should be initiated instead. therefore, correct lymph node (n) staging is crucial. n staging depends on cca subtype and differs between the 7th and 8th edition of the american joint committee on cancer (ajcc) staging system. the most important difference between the two staging systems is the location of the regional (n1) versus distant lymph nodes (n2) in the 7th edition for pcca and dcca, while in the 8th edition distant n locations are considered m1 metastases and the number of lymph nodes determines the n stage. in both editions n locations in icca are subdivided for the left and right sided liver segments.the ajcc staging system is used to determine treatment and is correlated to survival. the 5-year survival for patients with regional or non-regional positive lymph nodes is worse compared to patients with negative lymph nodes. to identify distant and lymph node metastases computed tomography (ct) or magnetic resonance imaging (mri) is performed. however, it is difficult to accurately identify suspicious lymph nodes on both ct and mri since sensitivity and specificity is 61% and 88% respectively for ct and 64% and 68% respectively for mri. to assess lymph node staging more accurately, endoscopic ultrasound (eus) with fine needle aspiration (fna) might be of added value. only a few retrospective studies have described the yield of preoperative eus for cca. it is clear that eus is an effective technique for lymph node staging for cca, but data is inconsistent about the exact value and impact of eus on clinical decision making.

Eligibility criteria:
inclusion criteria: in order to be eligible to participate in this study, a patient must meet the following criteria: * suspected resectable cca * patient underwent eus preoperatively exclusion criteria: a patient who meets any of the following criteria will be excluded from inclusion: • history of treated cca
clinical performance of posterior glass ionomer restorations in adolescents (ketac)

Conditions: Dental Caries

Summary: the purpose of this study is to determine whether two tooth-colored glass ionomer materials are effective for load-bearing dental fillings.

in this post-market longitudinal prospective randomized control clinical trial, posterior class ii restorations will be evaluated for their clinical performance. the study will investigate the efficacy of two high-strength glass ionomer restorative materials for a period of up to 3 years.

Eligibility criteria:
criteria: * inclusion criteria: * needs 2 class ii posterior restorations * in good health * sufficient oral hygiene * vital tooth * caries in the outer and/or middle third of dentin * teeth must have at least one proximal contact to be restored * isthmus is less than half the intercuspal distance * has one or more enamel-supported antagonistic contact. * both study restorations are not in contact with each other exclusion criteria: * pregnant or breast feeding * erosion/eating disorders * bruxism/traumatic malocclusion * pulpitis * cusp replacement * radiographic bone loss/increased tooth mobility

Keywords: dental caries proximal surfaces posterior teeth carious lesions tooth diseases dental restorations glass-ionomer
icotinib in combination with chemotherapy versus chemotherapy alone in patients progressed after icotinib treatment

Conditions: Non-small Cell Lung Cancer

Summary: this phase ii randomised, double blind, placebo controlled, multicentre trial is designed to assess the efficacy and safety of continuous icotinib plus chemotherapy versus chemotherapy alone in patients who have progressed after benefiting from previous second or third-line icotinib treatment (more than 6 months) in locally advanced or metastatic non-small cell lung cancer.


Eligibility criteria:
inclusion criteria: * histologically or cytologically confirmed stage iiib/iv lung cancer(exclude patients confirmed by sputum cytology) * no previous targeted treatment such as gefitinib, erlotinib. * with a measurable disease(longest diameters \>=10mm with spiral computed tomography (ct)and \>=20mm with conventional ct) according to recist criteria * who performance status(ps)\<= 2 * n\>=1.5×109/l, plt\>=1.0×109/l,hb\>=10g/dl;ast\&alt should \<3uln(without liver metastasis) or \<5uln(with liver metastasis).tbil\<=1.5uln. * signed and dated informed consent before the start of specific protocol procedures. exclusion criteria: * allergic to icotinib * patients with metastatic brain tumors with symptoms. * experience of anti-egfr(the epidermal growth factor receptor) monoclonal antibody or small molecular compounds therapy such as gefitinib, erlotinib or cetuximab. * severe systemic disease out of control such as unstable or uncompensated respiratory,cardiac,liver,renal diseases.
community-associated uropathogen antimicrobial resistance among emergency department patients with acute pyelonephritis

Conditions: Pyelonephritis

Summary: pyelonephritis is a serious infection that manifests with fever, back pain, nausea, and vomiting. in the u.s., it is estimated that there are 20 cases of pyelonephritis per 10,000 annually, with the highest incidence in young women. escherichia coli (e. coli) causes over 80% of these infections. over the last two decades, e. coli resistance has emerged to commonly prescribed antimicrobials, such as ampicillin and trimethoprim-sulfamethoxazole (tmp/smx). most recently, resistance to fluoroquinolones and strains producing extended-spectrum beta-lactamases (esbl) have been observed. in order to better understand the evolution and current state of antibiotic resistance among e. coli urinary tract isolates so as to better inform treatment decisions, the investigators propose to conduct an investigation to: a) determine the prevalence of antimicrobial resistance among e. coli causing acute pyelonephritis in various patient groups, and specifically healthy community-dwellers with uncomplicated infections, b) determine the specific prevalence of fluoroquinolone-resistance and esbl-producing e. coli, and c) determine potential risk factors for fluoroquinolone and esbl-producing e. coli infections.


Eligibility criteria:
inclusion criteria: * patients \> 18 years of age with flank pain and/or costovertebral angle tenderness * documented temperature in the emergency department of ≥38°c/100.4°f by any method of measurement, * documented temperature in the emergency department of ≥38°c/100.4°f by any method of measurement, exclusion criteria: * complicated pyelonephritis
a randomized double blind vehicle controlled dose ranging parallel design multiple site clinical study

Conditions: Plaque Psoriasis

Summary: the objectives of this study are to evaluate the therapeutic efficacy and safety of dsxs and a placebo in patients with moderate to severe scalp psoriasis.

this randomized, double-blind, vehicle-controlled, dose-ranging, parallel-group multi-site study is designed to evaluate the therapeutic efficacy and safety of the investigational product, dsxs, for the treatment of moderate to severe scalp psoriasis at different application times up to 30 minutes.

Eligibility criteria:
inclusion criteria: * male or non-pregnant, non-lactating females age 12 and older. * clinical diagnosis of moderate to severe scalp psoriasis, defined by a investigator's global assessment score of at least 3 at screening. exclusion criteria: * under 12 years of age. * patients whose scalp and/or non-scalp psoriasis necessitates systemic or other concomitant topical therapies during the study. * has a scalp skin condition that would interfere with the diagnosis or assessment of plaque psoriasis of the scalp.