Kornimate/medical-research-clean huggingface dataset:
non-invasive neurological evaluation during cpr

Conditions: Cardiac Arrest

Summary: cardiac arrest remains a leading cause of death, currently affecting \>250,000 europeans outside the hospital each year. manual cardiopulmonary resuscitation (cpr) provides between 15 to 30 % of normal blood flow to the heart and brain. for out-of-hospital cardiac arrest, the return of spontaneous circulation (rosc) is possible only for 20-40% of patients with trained resuscitation teams. however, only 5-10% of patients will survive with good neurological status. a good quality cpr, a short time before initiation of the resuscitation and a short delay before the first defibrillation have been associated with improved neurological outcome. unfortunately it is currently impossible to obtain reliable information on the quality of the perfusion and oxygenation of organs during cpr. the current monitoring during cpr is limited to heart rhythm analysis, pulse rate evaluation and end tidal co2 (etco2). the last one is the only parameter which have been linked with probability of rosc and its value gives no indication of the long-term prognosis nor the neurological status. cerebral spectroscopy (near-infrared spectroscopy - nirs) allows to measure with a noninvasive method the local oxygen saturation of the prefrontal cortex (rso2), reflecting the balance between need and supply of brain oxygenation. this technique has been recently used in cardiac arrest showing a possible association between rso2 measured during cpr and the occurrence of rosc or survival. the quantitative measurement of the pupillary light reaction has been described to predict neurological outcome in the hospital for patient successfully reanimated after out-of-hospital cardiac arrest (ohca). recently, a feasibility study has shown that its use was also possible during cpr in the pre-hospital setting. the investigators aim to study a composite prognostic factor combining quantitative rso2 and automated pupillometry measured during cpr. the investigators hypothesized that the rate of survival with good neurologic outcome at 30 days will be lower in patients with rso2 \<30% for more than 5 min and an absent pupillary reflex more than 5 min or decreasing during cpr .


Eligibility criteria:
inclusion criteria: * all adults with nontraumatic, out-of-hospital cardiac arrest exclusion criteria: * traumatic cardiac arrest * patients who had achieved rosc before inclusion patients with a do-not-attempt resuscitation order * patients \< 18 years old * subjects known to be pregnant or breastfeeding

Keywords: cardiac arrest near-infrared spectroscopy automated infrared pupillometry prognostication
study of the glymphatic system in migraine

Conditions: Migraine

Summary: this study aimed to investigate the role of the glymphatic system in the initiation of migraine attacks, using non-invasive magnetic resonance imaging techniques and a validated model of migraine induction by nitroglycerin administration. secondarily, the relationship between the function of the glymphatic system during nitroglycerin-induced migraine attacks and sleep architecture and plasma levels of migraine-involved neuropeptides will be investigated.


Eligibility criteria:
inclusion criteria: for patients: • diagnosis of migraine, by the ichd-3 criteria; for both patients and healthy controls: * age between 18 and 60 years; * willing and able to comply with scheduled visits. exclusion criteria for patients: * overuse of acute medications for headache; * continuous or daily headache; * other primary headache disorders, with the exception of infrequent tension-type headache. for healthy controls: • any subject with frequent tension type headache, migraine, cluster headache, other pain syndromes or neurological conditions. for both patients and healthy controls: * allergy to nitroglycerin; * major psychiatric disorders such as bipolar affective disorder and schizophrenia; * cardiovascular diseases that contraindicated the use of nitroglycerin; * intracranial hypertension; * cerebral haemorrhage; * cerebral trauma; * pulmonary toxic oedema; * closed angle glaucoma; * anaemia; * pregnancy and breastfeeding; * aortic stenosis or significant hypotension (sbp\<90mmhg or \<100mmhg and symptomatic) precluding nitroglycerin administration; * use of sildenafil; * any person unable to lie still within the environment of the mri scanner for the required period to perform the study; * any person where mri scanning is contraindicated (metal implants, pacemaker, claustrophobia, etc.); * use of illicit drugs; * mri head showing any brain pathology, such as space-occupying lesions; * any person unable to understand and follow the instructions of the investigators.

Keywords: migraine mri glymphatic system sleep neuropeptides
a prospective pilot study to evaluate a new marker of ischemia in chest pain triage

Conditions: Acute Coronary Syndrome

Summary: a single-center prospective pilot study enrolling chest pain patients. cd 26 measurement will be performed and compared to troponin µs for early triage of these patients. this novel biomarker of myocardial ischemia (cd26) will be measured at the time of first medical contact (t0) and after 30 min simultaneously o troponin ic. all patients aged over 18 years with chest pain which may be related to acute coronary syndrome requiring pre hospital medical contact through the emergency medical service.

first objectives: demonstrating the early positivity of cd26 compared to ultra-sensitive troponin.

Eligibility criteria:
inclusion criteria: * subject with compatible symptoms with an acute coronary syndrome, for at least 15 minutes and not older than 3 hours (eg discomfort, tightness or chest pain, pain radiating to the left arm or two arms, pain in the jaw, pain in the back / neck / stomach, breathlessness , cold sweats, nausea / vomiting , dizziness ) * man or woman, * patient did not receive heparin or low molecular weight heparin (lmwh ) before the initial blood sample , * patient agreeing to participate in the study and who signed an informed consent exclusion criteria: * minor or major patient trust * patient not having signed informed consent (refusal , physical or mental disability ... ) * patient who received anticoagulation before carrying blood samples * patient with a progressive septic processes , neoplasia undergoing treatment, dialyzed kidney failure, a history of surgery or coronary angioplasty less than six months. * transplanted heart, renal or hepatic * heart attack * subject whose symptoms clearly eliminates acute coronary syndrome ( penetrating trauma, traumatic injury by crushing ... ) * patient died between the time of inclusion and arrival in the cardiology intensive care ( sic ) * patient withdrawing consent under study
a multi-site study of autologous cord blood cells for hypoxic ischemic encephalopathy

Conditions: Moderate or Severe Hypoxic-ischemic Encephalopathy in Newborns

Summary: this study will test the safety and efficacy of an infusion of a baby's own (autologous) umbilical cord blood as compared with placebo in babies born with history and signs of hypoxic-ischemic brain injury.

the purpose of this phase ii study is to assess the safety and efficacy of up to two intravenous infusions of autologous volume and red blood cell reduced nucleated umbilical cord blood cells as compared with placebo in neonates with neonatal encephalopathy undergoing hypothermia treatment. efficacy will be estimated by one year survival and score on bayley iii scores in all three domains equal to or greater than 85. this will be a randomized, double-blind, placebo controlled multi-site trial of up to 160 infants who qualify for cooling.

Eligibility criteria:
inclusion criteria: 1. nichd neonatal research network hypothermia trial inclusion criteria 2. mothers must have consented or given verbal assent for cord blood collection at delivery, and cord blood must be available for volume and red blood cell reduction before 45 hours of age 3. the infant must be able to receive at least one dose of autologous cord blood before 48 hours of age 4. all infants must have signs of encephalopathy within 6 hours of age exclusion criteria: 1. major congenital or chromosomal abnormalities 2. severe growth restriction (birth weight \<1800 g) 3. opinion by attending neonatologist that the study may interfere with treatment or safety of subject 4. moribund neonates for whom no further treatment is planned 5. infants born to mothers are known to be hiv, hepatitis b, hepatitis c or who have active syphilis or cmv infection in pregnancy 6. infants suspected of overwhelming sepsis 7. ecmo initiated or likely in the first 48 hours of life

Keywords: hypoxic-ischemic encephalopathy autologous cord blood cells newborn infants
effects of a digital patient platform (cmylife) for patients with chronic myeloid leukemia (cml) on information provision, patient empowerment, medication compliance, guideline adherence and quality of life

Conditions: Neoplasms; Chronic Myeloid Leukemia; Patient Portals; Telemedicine

Summary: a controlled before-after study is performed in order to gain insights into the effectiveness of the cmylife platform in terms of medication compliance, guideline adherence, quality of life, information provision and patient empowerment. participants who agreed to use the cmylife platform for at least 6 months, were enrolled in the treatment group and participants who did not agree to use the platform were enrolled in the control group. after signing informed consent, participants received a baseline questionnaire by mail. upon completion of the baseline questionnaire, participants used (intervention group) or did not use (control group) the cmylife platform for at least 6 months, after which they were asked to complete the post-intervention questionnaire.


Eligibility criteria:
inclusion criteria: * newly diagnosed cml patients in chronic phase cml * participants were treated with first or second line tki's at the haematology department of the participating hospitals. patients treated with second line tki's were only allowed to participate if they switched tki's as a result of side effects and not if they did not respond to the first line tki exclusion criteria: * participants in acceleration phase * participants in blastcrise * participants with planned pregnancy in the study period
safety and efficiency study of loading dose atorvastatin in cardiac surgery

Conditions: Acute Kidney Injury

Summary: statins were reported to have pleiotropic effects including antiinflammatory, anti-oxidative stress effects and stabilise plaque in some conditions. some researches indicate loading dose statin can reduce contrast induced nephropathy, and the levels of inflammatory markers were significantly decreased. the investigators hypothesis loading dose atorvastatin may attenuate inflammatory response during cardiopulmonary bypass (cpb) and therefore reduce postoperative acute kidney injury in cardiac surgery.

acute kidney injury occurs up to 30% in cardiac surgery which influenced patients' mid-term and long-term outcomes. furthermore, evidence shows patients who initiate renal placement therapy in hospital have higher mortality and morbility. the pathologies of cardiac surgery-associated acute kidney injury (csa-aki) is not clear yet ,many researches find cardiopulmonary bypass is an independent risk factor in developing aki, and inflammatory bursts during cardiopulmonary bypass (cpb) may play an important role in csa-aki. statins are reported to have anti-inflammatory reaction in many researches. in some multicenter rcts, statins are reported to reduce myocardial infarction,atrial fibrillation and have renoprotective effects due to pleiotropic effects in percutaneous coronary intervention. while in the cardiac surgery settings, the renoprotective effect of statin is still controversial. the investigators believe the differences between surgery and pci may contribute to the discrepancy. the investigators plan to test the renoprotective effect of atorvastatin in a randomized,double-blind control manner and try to explore the mechanism of this protective effect. the investigators hypothesise loading dose atorvastatin pretreatment in elective coronary artery bypass grafting surgery may attenuate inflammatory response in cpb and therefore reduce postoperative aki or help recovery from aki. the investigators randomize patients into two arms, the atorvastatin group takes atorvastatin 80mg 12h before surgery with another 40mg 2h before operation, the control arm takes placebo in the same regime. the investigators plan to compare the inflammatory cytokines at different time points and the incidence of aki between the two groups. the investigators hope atorvastatin group can decrease aki incidence and has a lower level of inflammatory cytokines, what's more, the two have a good correlation in the time frame.

Eligibility criteria:
inclusion criteria: * age \> 18 years old * elective coronary artery bypass surgery in cpb exclusion criteria: * emergent surgery * re-operation * acute kidney dysfunction * chronic kidney disease * gfr \< 60ml/min * liver dysfunction * existing myopathy * levf \< 40% * statin allergic or contradictive * pregnancy * breast feed period

Keywords: statin kidney function antiinflammatory effect
evaluation of effectiveness of two dosing regimens of fostamatinib compared to placebo in patients with rheumatoid arthritis (ra) who are taking methotrexate and have had inadequate response to single tnf-alpha antagonist

Conditions: Rheumatoid Arthritis

Summary: the purpose of the study is to evaluate the effectiveness of two dosing regimens of fostamatinib compared to placebo, in patients with rheumatoid arthritis (ra) who are taking methotrexate and have had an inadequate response to a single tnf-alpha antagonist. the study will last for approximately six months.

sub-study: full title: optional genetic research date: 18 june 2010 version: 1 objectives: to collect and store, with appropriate consent ,dna samples for future exploratory research into genes/genetic variation that may influence response (ie, absorption, distribution, metabolism and excretion, safety, tolerability and efficacy) to fostamatinib disodium and/or methotrexate; and/or susceptibility to, progression of and prognosis of ra

Eligibility criteria:
inclusion criteria: * active rheumatoid arthritis (ra) diagnosed after the age of 16 * currently taking methotrexate * 6 or more swollen joints and 6 or more tender/painful joints (from 28 joint count) and either erythrocyte sedimentation rate (esr) blood result of 28mm/h or more, or c-reactive protein (crp) blood result of 10mg/l or more * at least one of the following: documented history of positive rheumatoid factor (blood test), current presence of rheumatoid factor (blood test), radiographic erosion within 12months prior to study enrolment, presence of serum anti-cyclic citrullinated peptide antibodies (blood test) exclusion criteria: * females who are pregnant or breast feeding * poorly controlled hypertension * liver disease or significant liver function test abnormalities * certain inflammatory conditions (other than rheumatoid arthritis), connective tissue diseases or chronic pain disorders * recent or significant cardiovascular disease * significant active or recent infection including tuberculosis * previous failure to respond to anakinra or previous treatment with biological agent (other than tnf alpha antagonists including rituximab, abatacept and tocilizumab) * severe renal impairment * neutropenia

Keywords: rheumatoid arthritis
china gender-affirming hormone therapy study

Conditions: Transgender; Gender Incongruence

Summary: data about transgender medical care, especially the gender-affirming hormone therapy (gaht) is extremely insufficient in china. few evidence exists in the physical and psychological effects of the hormonal treatment in chinese transgender population. cgaht is designed to describe the social and mental condition of transgender people who are seeking for formal gaht, and to investigate the physical and psychological effects of gaht on this population in china.

cgaht will be conducted in one of the main transgender medical centers in chinese mainland. participants who are seeking for the start of gaht will be enrolled from clinical visitors. before gaht, participants will be interviewed with questionaries about their life experience, gender identity and social economic conditions. evaluations on mental and physical health will be performed at baseline and during the gaht. participants will be followed up to 12 months. gaht will be given to transgender people according to the protocol recommended by the international guideline (doi: 10.1210/jc.2017-01658) .

Eligibility criteria:
inclusion criteria: * transgender men and women * meet criteria of diagnostic and statistical manual of mental disorders (fifth edition) for gender dysphoria * aged between 18 to 40 years * people desire to start the gaht * no previous history of gender-affirming interventions * having full ability to make informed consent * dextromanual exclusion criteria: * disorders of sex development * who has fertility demand but have not made fertility preservation * with contradictions of gaht * comorbid diseases are not under control * alcohol or drug abuse * hormonal and chromosomal disorders * history of gender affirming surgery * current psychiatric disorders * history of brain trauma or neurological pathologies * current use of medications with psychotropic effects within two weeks (antipsychotic or antiepileptic agents, lithium, benzodiazepines or opioid analgesics) * claustrophobia * implanted metal and medical devices (pacemakers, ceramic teeth, etc.), * tattoos or eyebrow tattooing (heavy metal dye)

Keywords: transgender persons gender-affirming hormone therapy
6-week study treatment to evaluate the safety and effectiveness of azd2066 in patients with major depressive disorder

Conditions: Major Depressive Disorder

Summary: this is a 6-week study treatment to evaluate the safety and effectiveness of azd2066 in patients with major depressive disorder.

a phase iia, multi-centre, randomized, double-blind, double-dummy, active and placebo controlled, parallel group study to assess the efficacy and safety of azd2066 after 6 weeks of treatment in patients with major depressive disorder - d0475c00020.

Eligibility criteria:
inclusion criteria: * provision of signed, written, and dated informed consent * documented primary clinical diagnosis of major depressive disorder exclusion criteria: * patients with a secondary psychiatric disorder including bipolar disorder, psychotic disorders (i.e. schizophrenia, schizoaffective disorder, depression with psychotic features), gad and social anxiety disorder * patients whose current episode of depression started less than 4 weeks before enrollment * history of inadequate response of antidepressants during current depressive episode

Keywords: depression
treatment of depression in the elderly

Conditions: Depression

Summary: the study is designed to establish the efficacy and tolerability of escitalopram in the treatment of depressive episodes of mild to moderate severity in the elderly. the study is designed as a mainly naturalistic study including all patients of 65 years of age or above that judged by the clinician would benefit from treatment by an antidepressant medication. the study is designed as a double-blind, randomised placebo controlled study with two groups of active treatment (escitalopram in two doses, 5 or 10 mg daily) in a twelve week period.


Eligibility criteria:
inclusion criteria: * in- or out-patients of 65 years of age or above fulfilling the international classification of diseases-tenth edition (icd-10) diagnosis of depressive single episode (f32.00-32.11. 32.8 or 32.9), depressive recurrent episode (f33.00-33.11, 33.8 or 33.9) or organic depressive episode (f06.32). * the depressive state should be mild to moderate and reach a score on ham-d6 of ≥ 7 and ≤ 11 * patients with dementia can be included provided they have a mini mental state exam (mmse) score of ≥ 17 exclusion criteria: * patients with a current depressive episode of a severity reaching a score of ≥ 12 on the ham-d6-item depression factor. this is to exclude patients with severe or psychotic depression * patients with suicidal thoughts or behaviour * patients with conditions where treatment with escitalopram is contraindicated: e.g. hypersensitivity to escitalopram or other contents of escitalopram tablets, concomitant treatment with non-selective, irreversible mono-amine-oxidase inhibitors, such as marplan * patients who in the current depressive episode have had a failed trial of treatment with escitalopram * co-morbid dementia with a severity corresponding to a score on the mmse of less than 17 as these patients will often be without the ability to give informed consent * patients with sensory defects rendering psychometric assessment impossible, e.g. deafness, blindness, severe aphasia * patients who cannot speak danish well enough to make psychometric assessment possible and meaningful * patients with congenital or early acquired intellectual deficits
recovery after fast track tha / tka

Conditions: Hip and Knee Osteoarthritis

Summary: the development and implementation of "fast-track" principles in total knee and hip arthroplasty have resulted in early recovery and rehabilitation alongside a reduced length of hospital stay. this without a concomitant increase in morbidity or readmissions for medical or surgical complications and with reduced mortality. however, only little is known about function in the subacute period after arthroplasty, and there is a need for further data on physical and psychological functioning following discharge from hospital.this to ensure, that the positive results from the perioperative setting are carried forward in the subacute phase.

data will be published in three papers: 1. "physical function and related factors following discharge from tha and tka" luna ie, kehlet h, aasvang ek. 2. "postoperative hypoxemia following fast-track hip and knee arthroplasty" luna ie, kehlet h, aasvang ek. 3. "cognitive dysfunction after fast-track hip- and knee arthroplasty - prevalence and related factors". luna ie, kehlet h, aasvang ek.

Eligibility criteria:
inclusion criteria: * primary total hip or knee arthroplasty * age 55 to 80 years exclusion criteria: * deficient written or spoken danish * alcohol abuse (\>21 u per week) * immunocompromised * anticoagulant therapy * asa class 4-5 * functional impairment from psychological or neurological disease * sleepapnea