Kornimate/medical-research-clean huggingface dataset:
autologous stem cell transplantation for progressive systemic sclerosis

Conditions: Scleroderma; Cardiac Involvement; Autologous Stem Cell Transplantation

Summary: autologous stem cell therapy has been shown to be effective in patients with systemic sclerosis. nevertheless treatment is associated with treatment related mortality and patients die during follow up despite successful transplantation. intention of this trial is to improve overall survival by modifying the existing protocol used for the astis trial. to reduce treatment toxicity we reduce the dose of cyclophosphamide (cyc) for mobilisation to 2x1g. especially in patients with cardiac manifestations we also modify the conditioning regimen by adding thiotepa and reducing cyc; as cyc has known cardiotoxic side effects.


Eligibility criteria:
inclusion criteria: * diagnosis of progressive systemic sclerosis \<7 years * progressive course despite cyclophosphamide pretreatment * cyclophosphamide i.v.: at least 3 x with 500-1000 mg/m² every 3-4 weeks or * cyclophosphamide p.o. with at least 100mg/day for at least 2 months or * contraindication to treatment with cyclophosphamide * progress defined as at least one of the following criteria: * increase in the mrss * worsening of the lung function * increase in fibrosis/alveolitis in thorax ct * worsening kidney function through manifestation of systemic sclerosis * limited or diffuse cutaneous progressive form of ssc with organ manifestation in the lungs/heart or kidneys exclusion criteria: * age \<18 years * pregnancy or inadequate contraception * severe heart failure with ejection fraction (ef) \< 30% in echo * pulmonary arterial hypertension with systolic pulmonary arterial pressure (papsys) \>50mm hg * kidney insufficiency: creatinine clearance \<30 ml/min * reduced lung function * inspiratory vital capacity (ivc) \< 50% of normal * carbon monoxide (co)-diffusion capacity sb \< 40% * previously damaged bone marrow * leukopenia \< 2,000/µl * thrombopenia \< 100,000/µl * previous myelotoxic treatment: * cyclophosphamide \> 50g cumulative (relative) * infection (hepatitis b/c, hiv, salmonella carrier, syphilis, relative: history of tuberculosis) * severe concomitant psychiatric illness (depression, psychosis) * substance dependence * continued nicotine abuse * continued alcohol abuse * continued drug abuse * consent not given * poor compliance

Keywords: scleroderma autologous stem cell transplantation thiotepa cluster of differentiation (cd) 34 selection
a dose-ranging clinical study to assess the safety and efficacy of subconjunctival injection of sirolimus in patients with dry eye in the controlled adverse environmental (cae) model

Conditions: Dry Eye

Summary: the purpose of this study is to determine the safety and efficacy of an ocular sirolimus (rapamycin) formulation compared to placebo on the signs and symptoms of dry eye in the cae model.


Eligibility criteria:
inclusion criteria include, but are not limited to: * have a reported history of dry eye in both eyes; * have a history of use of or desire to use an eye drop for dry eye symptoms within the past 6 months. exclusion criteria include, but are not limited to: * have contraindications to the use of the study medications; * have known allergy or sensitivity to the use of the study medications or diagnostic dyes;

Keywords: dry eye sirolimus rapamycin
the effect of epogen and venofer dosing management on hemoglobin stability

Conditions: Anemia; End Stage Renal Disease

Summary: hypothesis: routine clinical tests with feedback control based epogen(epo)/venofer(iron) protocol will improve hemoglobin (hgb) stability and increase the time that patients remain in target objectives: 1. decreased variability of hgb 2. increase the % of patients in target range c increase in time that hgb remains target range

study design one dialysis unit shift comprising up to 200 patients. study participation will last for 12 months broken into 3 phases as described below. phase 1 (1-3 months): develop individualized patient models and anemia management protocols (amp) while patients are receiving standard medical care. phase 2 (9 months): individualized amp study period. phase 3 (9 months): follow up period: return to standard-care amp. the individual amp will be utilized weekly during the 9 months of phase 2. the 3 objectives will be evaluated and updated weekly, baseline to year 1. all epo dosing recommendations must be reviewed by the treating physician who can either accept or modify doses at his/her discretion based on clinical event that are not includes in the transmitted data such as bleeding, infection, and hospitalization.

Eligibility criteria:
inclusion criteria: * 18 years old or older * receiving hemodialysis in an out-patient dialysis unit exclusion criteria: * not receiving epogen as part of their standard medical care * patient refusal

Keywords: anemia end stage renal disease
pars plana vitrectomy for diabetic fibrovascular proliferation with and without internal limiting membrane peeling

Conditions: Patients With Proliferative Diabetic Retinopathy Who Have Active Fibrovascular Proliferation

Summary: internal limiting membrane peeling in diabetic vitrectomy will help prevent postoperative epiretinal membrane formation

progressive fibrovascular proliferation may occur despite appropriate panretinal photocoagulation in diabetic patients. fibrovascular proliferation may lead to persistent or recurrent vitreous hemorrhage, macular traction, or traction macular detachment, and becomes a major indication for vitrectomy.1 during the past 25 years, anatomical and visual results of vitrectomy for severe proliferative diabetic retinopathy have improved as a result of improved understanding of the pathoanatomy and improvements in surgical instrumentation.2-5 although anatomical success is high after complete vitrectomy, recurrent epiretinal membrane may cause macular thickening, cysts formation, preventing good functional outcome.6 an epiretinal membrane (erm) is a non-vascular cellular membrane that may cause symptomatic visual disturbances due to retinal wrinkling and distortion.7 these epiretinal membranes have been found to be composed of fibroblasts, glial cells, macrophages, myofiboblasts, nad retinal pigment epithelial cells.8-9 studies have suggested removal of internal limiting membrane (ilm) may decrease the likelihood of post-operative erm formation in cases of diabetic macular edema and idiopathic erm. it is postulated that removal of the ilm removes the scaffold upon which myofibroblasts would proliferate.10 efficacy of vitrectomy including removal of ilm was mostly described as facilitating resolution of diffuse diabetic macular edema11 and improvement of visual acuity or in macular hole surgery in diabetic patients.12however, it is unknown if removal of ilm during vitreoretinal surgery in diabetic patients with active fibrovascular proliferation is useful in preventing postoperative erm formation. the purpose of this study is to compare the postoperative epiretinal membrane (erm) formation and visual outcome in diabetic patients with active fibrovascular proliferation who underwent vitrectomy with or without ilm peeling.

Eligibility criteria:
inclusion criteria: * active fibrovascular proliferation with or without tractional detachment * previous pan-retinal photocoagulation at least 3 months before exclusion criteria: * biomicroscopic evidence of macular hole * combination of tractional and rhegmatogenous retinal detachment * location of fibrovascular proliferation anterior to the equator * major ocular surgery history(including, scleral buckle, glaucoma filter, cornea transplant, vitreoretinal surgery etc * the presence of other ocular conditions such as glaucoma, uveitis, or other ocular inflammatory diseases.
comparative study of osteosynthesis for chevron osteotomy of hallux valgus using degradable versus non-degradable metallic device

Conditions: Hallux Valgus

Summary: the purpose of the study is to show the equivalence of a new degradable metallic device to a non-degradable metallic device in patients with hallux valgus.


Eligibility criteria:
inclusion criteria: * female and male patients with an age of 40 to 79 years at the day of surgery * symptomatic hallux valgus * radiological criterium area of proximal joint angle * normal motorically functions * female patients of childbearing age must be using two reliable contraception methods exclusion criteria: * previous bone and/or soft tissue surgeries of the the first metatarsal of the respective foot * bmi \> 32 * cysts of the first metatarsal of the respective foot * neurological disorders with modified motorically functions * clinical evidence of osteoporosis * chronic renal impairment * known hypersensitivity to components of the implants * regular administration of medications containing the metallic elements of the degradable implant * pregnant or lactating women * current participation in another clinical trial or within 30 days before surgery
the effectiveness of low calorie low salt lunch for weight reduction of workers of a health promoting hospital

Conditions: Overweight; Obesity

Summary: the aim of this study is to evaluate the effectiveness of low calorie low salt lunch for weight reduction in overweight or obese workers of a health promoting hospital.


Eligibility criteria:
inclusion criteria: * overweight or obese * hospital workers exclusion criteria: * history of major medical problems such as heart disease in the last 6 months * orthopaedic or joint problems that would be a barrier to physical activity * pregnancy * recent weight change of ≥10% of baseline weight * taking medications that might affect body weight * participation in other program about weight control * alcohol or substance abuser * other uncontrolled psychiatric problems * eating disorders

Keywords: overweight obesity caloric restriction diet, reducing diet, sodium-restricted body weight changes energy intake feeding behavior
electroacupuncture of different treatment frequency in chronic urinary retention caused by lower motor neuron lesions

Conditions: Urinary Retention; Lower Motor Neurone Lesion

Summary: the aim of this study is to compare the effects of electroacupuncture of different frequency in patients with chronic urinary retention caused by lower motor neuron lesions


Eligibility criteria:
inclusion criteria: * diagnosed with urinary retention caused by lower motor neuron lesions (e.g., sacral plexus, cauda equina, or sacral cord lesions). * 18 years or older. * baseline post void residuals (pvr) ≥150 ml. * the course of urinary retention ≥1 month. * having normal bladder sensation. * using clean intermittent catheterization (cic), indwelling catheterization (ic), manual assisted voiding including putting pressure on abdomen, or cystostomy catheterization. * signed informed consent and voluntary participation in the study. exclusion criteria: * having a lower urinary tract obstruction, such as bladder neck contracture, urethral stricture, prostatic hyperplasia, or large urinary stones that can cause obstruction. * having any type of malignant tumors not removed. * having severe systemic disorders not controlled. * having implanted electrodes of cardiac pacemaker, pudendal nerve stimulation, bladder stimulation, or snm. * pregnancy or lactation. * eletroacupuncture treatment duration \< 2 weeks.

Keywords: electroacupuncture chronic urinary retention cohort study
deformable image registration for breast adaptive tomotherapy

Conditions: Breast Cancer

Summary: the radiotherapy treatment plan (also called dosimetry) used for all treatment sessions is based on the dosimetric scanner. during the sessions, the anatomy of the breast may vary, and these variations may impact the quality of the treatment. adaptive radiotherapy is a new technique that allows these changes to be taken into account during treatment by automatically rescheduling the treatment for each session. the proposed trial aims to clinically evaluate one of these adaptive radiotherapy tools (preciseart) based on deformable registration in order to determine if it can be used in daily practice in the treatment of breast cancer by tomotherapy. the trial will also clarify whether factors, such as duration of treatment, impact the quality of this algorithm.

the dosimetric scanner needed to calculate the dose to be delivered to the tissues will be carried out according to the standard practice. the treatment plan will be carried out by the physicist in accordance with the dose constraints and validated by the radiation therapist. each treatment session is preceded by positioning imaging to ensure high precision in the treated area. during the first session, the acquisition of the positioning scanner will take into account the entire region of the target volume in accordance with the classic treatment protocol. usually, the positioning scans of the remaining sessions are carried out on a smaller area around the operating bed in order to reduce the acquisition time. however, in the context of this study, mid- and end-of-treatment positioning scans will be acquired over the same exploration range as on the first day. these scanners will make it possible to compare the contouring work carried out manually by the radiotherapist and that obtained by the deformable registration algorithm.

Eligibility criteria:
inclusion criteria: female * with invasive breast carcinoma (or axillary lymphadenopathy whose pathological examination is compatible with the origin of breast cancer but without an identified primary breast tumor) * breast surgery (conservative surgery or mastectomy) * treated by (neo)adjuvant chemotherapy or hormonotherapy * eligible to normo-fractionated breast radiotherapy in 25 sessions of 2 gray or 15 sessions of 2.67 gray, associated or not to bed irradiation whatever the delivered dose * eligible to an irradiation of sus-clavicular, inner mammary chain or axillary lymph nodes * with helicoidal tomotherapy exclusion criteria: * absence of indication for breast radiotherapy * absence of indication for lymph nodes irradiation * partial irradiation of breast * in situ carcinoma * intranodal isolated tumor cells * radiotherapy on prosthesis or surgically reconstructed breast * antecedent of breast irradiation opr homolateral lymh node irradiation * bilateral breast cancer
fournier's gangrene and the origin of the infection as a prognostic of morbidity and mortality, an analysis of 121 patients

Conditions: Fournier Gangrene; Fournier's Gangrene of Penis; Fournier's Gangrene of Scrotum

Summary: background: fournier's gangrene it's a necrotizing infection of the genital area, with high morbidity and mortality. the site of infection its the origin of the necrotizing fasciitis. there are 4 well known origins of fournier's gangrene: testicular, intestinal, urinary and cutaneous, and its prognostic value has not been established yet, that's because the lack of case series with adequate number of patients. this is a retrospective study in which we evaluate the prognostic factors of every patient and its mortality compared with its origin area and multiple scores with their survival rates and hospital stay.

objective: to evaluate origins of fournier's gangrene as a prognostic value in the morbidity and mortality. patients and methods: this is a retrospective study where patients from a single hospital from 2007 to 2016 were included. they were categorized in 4 groups matching the origin of infection. in every group categorizing with the origin of infection and determined severity factors, days of hospital stay, fournier's gangrene severity index and mortality. a statistic analysis will be done using lineal multivariable analysis.

Eligibility criteria:
inclusion criteria * male patient * fournier's gangrene * all patients treated with two antibiotics * all patients undergone with aggressive debridement exclusion criteria * female * not having fournier's gangrene

Keywords: fournier's gangrene
use of the brainport® balance device to improve balance in adults with balance deficits due to stroke

Conditions: Cerebrovascular Accident

Summary: the purpose of this study is to evaluate the safety and efficacy of the brainport balance device in improving balance in people with balance deficits due to stroke.

following baseline assessments, subjects participate in 5 consecutive days (10 hours) of clinic training with the brainport balance device with a physical therapist. assessments are repeated at the end of clinic training. following clinic training, subjects take the device home to use for two (2) 20 minute training sessions each day. subjects return to the clinic for one (1) day of testing after using the device at home for 7 weeks.

Eligibility criteria:
inclusion criteria: * at least 18 years old. * diagnosis of stroke for at least 6 months. * reached a plateau and been discharged from physical therapy. * able to ambulate with or without assistance. * ongoing balance problem. * able to read and understand the informed consent form, and willing to sign the informed consent form. exclusion criteria: * current oral health problems as determined by health questionnaire and an examination of the oral cavity. * any medical condition that would interfere with performance on the assessments. * history of seizures. * pregnancy. * cognitive deficits (mini-mental 25 or below), joint replacements, cervical vertigo, or major neurologic disease, major depression or disabling psychiatric disorder. * known neuropathies of tongue or skin tactile system. * prior exposure to brainport® balance device. * subjects who are unwilling or unable to adhere to all study requirements, including completion of the training period, evaluation tests, and return to clinic for a follow-up visit. * subjects who have undergone middle ear or other surgery with sacrifice or damage to the chorda tympani nerve, lingual nerve, or hypoglossal nerve.

Keywords: physical therapy modalities electric stimulation postural balance
physician reasoning on diagnostic cases with large language models

Conditions: Diagnosis

Summary: this study will evaluate the effect of providing access to gpt-4, a large language model, compared to traditional diagnostic decision support tools on performance on case-based diagnostic reasoning tasks.

artificial intelligence (ai) technologies, specifically advanced large language models like openai's chatgpt, have the potential to improve medical decision-making. although chatgpt-4 was not developed for its use in medical-specific applications, it has demonstrated promise in various healthcare contexts, including medical note-writing, addressing patient inquiries, and facilitating medical consultation. however, little is known about how chatgpt augments the clinical reasoning abilities of clinicians. clinical reasoning is a complex process involving pattern recognition, knowledge application, and probabilistic reasoning. integrating ai tools like chatgpt-4 into physician workflows could potentially help reduce clinician workload and decrease the likelihood of missed diagnoses. however, chatgpt-4 was not developed for the purpose of clinical reasoning nor has it been validated for this purpose. further, it may be subject to disinformation, including convincing confabulations that may mislead clinicians. if clinicians misuse this tool, it may not improve diagnostic reasoning and could even cause harm. therefore, it is important to study how clinicians use large language models to augment clinical reasoning prior to routine incorporation into patient care. in this study, we will randomize participants to answer diagnostic cases with or without access to chatgpt-4. the participants will be asked to give three differential diagnoses for each case, with supporting and opposing findings for each diagnosis. additionally they will be asked to provide their top diagnosis along with next diagnostic steps. answers will be graded by independent reviewers blinded to treatment assignment.

Eligibility criteria:
inclusion criteria: * participants must be licensed physicians and have completed at least post-graduate year 2 (pgy2) of medical training. * training in internal medicine, family medicine, or emergency medicine. exclusion criteria: * not currently practicing clinically.

Keywords: computer-assisted diagnosis large language models clinical reasoning
near infrared spectroscopy and testicular torsion in children

Conditions: Diagnostic Test; NIRS; Testicular Torsion; Diagnosis; Child

Summary: nirs estimates tissue saturation of oxygenation in tissue beds. animals studies suggested that transscrotal nirs measurements can quantify testicular hypoxia and differentiate between torsed and non torsed testicles. the results of human studies are not conclusive. the hypothesis is that the difference in nirs values between torsed and healthy testicles would not be zero and that this difference would be zero in control group and that nirs could help to detect rapidly a tt testicular torsion (tt) is a functional emergency. the diagnosis is sometimes difficult to make. no paraclinical examination can eliminate it with certainty. the investigators aimed to evaluate the interest of transscrotal near-infrared spectroscopy (nirs) for the diagnosis of tt of child


Eligibility criteria:
inclusion criteria: * step 1: healthy boys between 0 and 16 years old * step 2testicular pain group (group 1 and 2): boy under 18 years, testicular pain exclusion criteria: * cutaneous scrotal lesion, * fever (for the control group), * hypertension
insulin glargine combination therapies in type ii diabetics

Conditions: Diabetes Mellitus, Type 2

Summary: to compare efficacy of combination therapy of insulin glargine plus glimepiride and metformin versus 2 injections insulin monotherapy with premixed insulin nph 30/70 bid in terms of change of hba1c (baseline to endpoint) to show non-inferiority of insulin glargine plus glimepiride and metformin.


Eligibility criteria:
inclusion criteria: * diabetes mellitus patients type 2, poorly controlled with oral antidiabetic drug treatment(glimepiride 3 or 4 mg od or any sulfonylurea similar to glimepiride 3 or 4 mg in combination with metformin in a dose at least similar to 850 mg once daily) * hba1c value ≥ 7.5 % to ≤ 10.5 % * fbg ≥ 120 mg/dl (6.6 mmol/l) * bmi ≤ 35 kg/m² the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
laryngeal disorders and gerd in assiut university

Conditions: Laryngeal Disease

Summary: study laryngeal disorders by laryngoscopic examination by two physicians on gerd patients diagnosed by gastroenterology department by endoscopy and effect of gerd treatment for 3 months on these laryngeal disorders without any treatment to laryngeal disorders


Eligibility criteria:
inclusion criteria: patients diagnosed gerd by gastroenterology department before start of treatment and have laryngeal symptoms exclusion criteria: * voice abusers as singers ,teachers and readers.