Kornimate/medical-research-clean huggingface dataset:
stress multidetector computed tomography (mdct) an new diagnostic tool for myocardial disease

Conditions: Coronary Artery Lesion

Summary: the goal of this study is to evaluate the ability of mdct under stress to assess myocardial ischemia. there is some preliminary data in the literature showing the ability of mdct under stress to bring relevant information about myocardial ischemia. stress mdct will have several advantages over single photon emission computed tomography (spect) imaging namely: shorter acquisition time, lower irradiation dose, lower cost. the feasibility of such experiment is still debated and need to be address in a clinical study.

hypothesis: cardiac dual source computed tomography (dsct) performed during dipyridamole infusion allows for 1) myocardial perfusion analysis and detection of myocardial ischemia and 2) good quality evaluation (artefact free) of the coronary artery anatomy. cardiac dsct during dipyridamole infusion may assess in a single volume acquisition relevant information about coronary anatomy and myocardial ischemia that required today two different examinations each with a cost and side effects. recently investigators showed on animal models as well as in humans that mdct during stress test could detect myocardial ischemia. purposes: 1) to evaluate the diagnostic potential sensitivity, specificity of coronary dsct during dipyridamole infusion for the assessment of myocardial ischemia with myocardial single photon emission computed topography (spect) as standard of reference. 2) to evaluate the feasibility (presence of artefact, number of coronary segment assessable) of coronary dsct during dipyridamole injection. methods: this prospective study will include patients referred from the department of cardiology of nord hospital. inclusion criteria will be: patients who required functional evaluation of a known coronary artery lesion. patients will be successively include. each patient will undergo myocardial spect and coronary dsct during dipyridamole injection. coronary dsct image analysis will determine the severity and the extension of the ischemic territory. statistical analysis will determine the reproductibility of the described technique, compared the dsct with spect as standard of reference and determined sensitivity, specificity and predictive values (positive and negative) of the described technique.

Eligibility criteria:
inclusion criteria: * patients who required functional evaluation of a known coronary artery lesion exclusion criteria: * disorders of the heart rhythm * myocardial infarct dating less than a month * unstable anger * congestive heart failure stages 3 and 4 of nyha * renal failure * pregnancy and feeding * history of anaphylactic reaction in the injection of iodized product

Keywords: patients functional evaluation known coronary artery lesion
the stavanger osteoarthritis study

Conditions: Knee Osteoarthritis; Hip Osteoarthritis

Summary: the start study will implement osteoarthritis (oa) treatment recommendations to increase the use of recommended treatment modalities and reduce non-desired events (e.g. unnecessary referrals to secondary care, unnecessary use of costly imaging modalities and use of treatment modalities supported by low quality of evidence). the purpose of the stavanger osteoarthritis (start) study is to improve the quality of oa care and increase the collaboration between health care professionals in primary health care and across health care levels.

previous research has shown that the osteoarthritis care for persons with hip or knee osteoarthritis in norway has a potential for improvement as the provided care may not necessarily reflect evidence-based guideline recommendations. the purpose of the stavanger osteoarthritis (start) study is to improve the quality of oa care and increase the collaboration between health care professionals in primary health care and across health care levels. based on international treatment recommendations for oa care and previous research, a tailored implementation strategy targeting high quality, integrated care for people with oa in stavanger municipality will be developed, implemented and evaluated. the care will mainly be provided in the stavanger primary health care services by physiotherapists (pt) (in private practice) and general practitioners (gp), but will also include collaboration with orthopaedic surgeons in specialist health care at stavanger university hospital. the main aim of the present study is to develop, implement and evaluate effects of a tailored implementation strategy for the start study in stavanger municipality. to evaluate the effects of the start implementation strategy, an interrupted time series design method will be applied. the study period will be divided into three phases: pre-implementation, implementation/transition and post-implementation. data will be collected at 16 time points; 8 before and 8 after the implementation/ transition phase.

Eligibility criteria:
inclusion criteria: * pt working in private practice in stavanger municipality * gp working in stavanger municipality * person with complaints due to hip and/or knee osteoarthritis referred to physiotherapy in stavanger municipality * person with complaints due to hip and/or knee osteoarthritis referred for assessment of joint replacement at stavanger university hospital exclusion criteria: * persons referred to physiotherapy after a total joint replacement * persons who do not understand the norwegian language * persons with cognitive dysfunction
gimema lal 0496: high-dose anthracycline in the induction regimen for the treatment of adult all.

Conditions: Acute Lymphoblastic Leukemia

Summary: the present study aims at verifying the state of the art in what this illness concerns and at organizing a centralized samples analysis.

the present trial is a prospective multicentric gimema study, in which adult all patients are extensively analyzed at diagnosis by a multiparametric approach including cc and molecular analysis for the following gene rearrangements: bcr-abl, mll-af4, e2a-pbx1, tel-aml1, mll, p15 and p16 deletion in order to give place to a carefully characterization of the genetic lesions occurring in adult all and to evaluate their prognostic significance in a large cohort of patients homogeneously treated. this study requires a central handling and analysis of bone marrow (bm) or peripheral blood samples at presentation.

Eligibility criteria:
inclusion criteria: * patients aged 16-60 * diagnosed with previously untreated t-all and b-all exclusion criteria: * previously treated all patients * l3 b-all

Keywords: all
effect of liraglutide or glimepiride added to metformin on blood glucose control in subjects with type 2 diabetes

Conditions: Diabetes; Diabetes Mellitus, Type 2

Summary: this trial is conducted in asia. the trial is designed to compare the effect on glycaemic control of liraglutide or glimepiride added to metformin in subjects with type 2 diabetes


Eligibility criteria:
inclusion criteria: * type 2 diabetes * subjects diagnosed with type 2 diabetes and treated with one or more oral antidiabetic drugs (oads) for the last 3 months * hba1c: 7.0-11.0% (both incl.) for subjects on oad alone * hba1c: 7.0-10.0 % (both incl.) for subjects on oad combination therapy * bmi less than 45.0 kg/m\^2 exclusion criteria: * treatment with insulin within the last 3 months prior to the trial * impaired liver or/and renal function * significant cardiovascular disease over the last 6 months * known retinopathy or maculopathy * recurrent major hypoglycaemia or hypoglycaemic unawareness
novel biomarkers for risk prediction of contrast-induced acute kidney injury post coronary angiography

Conditions: Acute Kidney Injury; Renal Insufficiency; Kidney Diseases

Summary: contrast-induced acute kidney injury (ci-aki) has been recognized as the third most common cause of hospital acquired aki, after hypotension-associated hypo-perfusion and post-operative aki. the development of ci-aki after cardiac catheterization is associated with a significant increase in both short-term and long-term mortality and morbidities, as well as an increase in length of stay and cost. the only marker of renal function that has predictive ability is creatinine and it has significant limitations in identifying patients who will develop aki. therefore, a diagnostic test for predicting ci-aki risk would have widespread clinical utility. the primary purpose of this study is to measure the association between baseline expression of senescence markers in blood using senescetest and the occurrence of ci-aki post cardiac catheterization.


Eligibility criteria:
inclusion criteria: * adult patients (\>18 yo) undergoing invasive coronary angiography with or without percutaneous coronary intervention (pci), that are predicted to have ≥14% risk of developing aki as defined by mehran et al. * medically compliant and able to consent and follow detailed directions * agree to additional collection of blood sample 48-72h post cardiac catheterization exclusion criteria: * presence of acute, active infection (e.g. hiv, pneumonia, septic shock). * contrast media exposure within last 48h * presenting with systolic time-segment elevation myocardial infarction. * presence of cardiogenic shock * presence of hemodynamic instability or requiring pressors or intra-aortic balloon pump * severe kidney disease with estimated glomerular filtration rate \<30 ml/min/1.73m2 or receiving dialysis for end stage renal disease * kidney transplant and liver transplant patients and all patients currently on immunosuppressants * severe heart failure with known ejection fraction \<25% * prior heart transplant * chronic liver disease /cirrhosis * patients actively undergoing chemotherapy or radiation treatment for any indication.

Keywords: acute kidney injury acute renal failure
hystrolaparoscopic findings in infertile women with previous uterine surgery

Conditions: Hystrolaparoscopic Findings in Infertile Women with Previous Uterine Surgeries

Summary: 1. to determine the rate and pattern of abnormal laparoscopic finding among the infertile women with history of previous uterine surgery. 2. to detemine the rate and pattern of abnormal hysteroscopic finding among infertile women with with history of previous uterine sergery 3. to evaluate the value of doing combined laparoscopy and hysteroscopy in infertile women with with history of previous uterine surgery. 4. to determine possible risk factors of pelvic adhesions detected during laparoscopy. 5. to determine possible risk factors causing cs niche.

nfertility(1), which refers to the inability of a couple to conceive after one year of regular unprotected sexual intercourse, is the commonest indication for gynacological consultation. primary infertility - where someone who's never conceived a child in the past. secondary infertility(2) - where someone has had 1 or more pregnancies in the past, but is having difficulty conceiving again.there are many causes for infertility. (3)uterine causes as uterine fibroids or malformations.tubal factors as tuboperitoneal adhesions,unilateral or bilateral proximal occlusion unilateral or bilateral hydrosalpinx or pyosalpinx.ovarian factors ovarian cyst,polycystic ovaries.pelvic causes as adhesions ,endometriosis and miscellaneous. laparoscopy can be used as the gold standard diagnostic tool which allows direct visualization of all pelvic organs. it also helps in detailed assessment of fallopian tubes. the advantage behind using laparoscopy is that the treatment of certain conditions such as tubal obstruction, endometriosis, and pelvic adhesions can be done at the same time during diagnosis. if needed, laparoscopic chromopertubation can also be done for tubal patency during the same sitting. (4)hysteroscopy is the direct visualization of the uterine cavity using an endoscope. uterine cavity evaluation is very much needed to do achieve total infertility workup. uterine abnormalities are present among 10-15% of couples who seek treatment of infertility. for evaluation of endometrial factors,(5) hysteroscopy considered to be a gold standard. diagnostic h hysteroscopy can detect uterine anomalies which remain undetected in usg and other routine investigations. many studies reported the occurrence of pelvic adhesions following cesarean section with its related consequences. pelvic adhesions may affect both reproductive system anatomy and function, causing various associated conditions. pelvic adhesions may cause secondary infertility, which might be due to dyspareunia, disturbing tubo-ovarian relationship, or disturbing peristaltic movement of fallopian tube.

Eligibility criteria:
inclusion criteria: * all women between20 to 35 yrs old with secondary infertiliy for 2 years * women with previous uterine surgery exclusion criteria: * female with major medical illness(uncontrolled daibetes, cardiac diseases, uncontrolled thyroid disorders) * abnormal semen parameter of the husband.
analgesia-nociception index guided intraoperative remifentanil administration versus standard practice:evaluation of perioperative opioid use

Conditions: Pain; Anesthesia

Summary: this study compares two groups of patients undergoing a gynecological surgey under general anesthesia: one group in which intraoperative analgesia is guided by the analgesia-nociception index, and another group in which intraoperative analgesia is managed as in standard practice. the objective is to assess if the analgesia nociception index may result in a decrease in total analgesic drugs consumption, a decrease in post-operative pain and in chronic pain development.


Eligibility criteria:
inclusion criteria: * elective gynecological surgery under general anesthesia * duration of surgery 1-7 hours * duration of hospital stay \> 24 hours exclusion criteria: * chronic pain * chronic analgesic medication * neurologic disease * psychiatric disease * history of addiction * kidney or liver failure * allergy to any anesthetic or analgesic drug * bmi \> 35

Keywords: analgesia-nociception index (ani) general anesthesia opioids remifentanil pain monitoring
molecular typing of community-acquired pneumonia based on multiple-omic data analysis

Conditions: Respiratory Infections; Genetic Disorder; Community-Acquired Infections; Host-Pathogen Interactions

Summary: community-acquired pneumonia (cap) is a heterogeneous disease causing great morbidity, mortality and health care burden globally. typing methods for discriminating different clinical conditions of the same disease are essential to a better management of cap. traditional typing systems based separately on clinical manifestations (such as psi and curb-65), pathogens(bacterial types, virulence, drug resistance, etc) or host immune state (immunocompetent, immunocompromised or immunodeficiency). thus, they are barely able to represent the real disease status nor to precisely predict the mortality. as the development of multi-omic technologies, the relatedness of different phenotypes at a molecular level have revolutionized our ability to differentiate among patients. our study is aimed at establishing a novel molecular typing method of cap. multi-omic (including genomics, transcriptomes, and metabolisms) data obtained from enrolled cap patients and isolated pathogens would be integrated analyzed and interpreted. tthe investigators believe that an appropriate molecular typing method would lead to revolutionary changes in current arrangements of cap.


Eligibility criteria:
inclusion criteria: * adult (aged \> 16 years) * diagnosed as community-acquired pneumonia exclusion criteria: * being immunocompromised, including history of glucocorticoid taken for more than 1 month, history of immunosuppressive therapy, history of human immunodeficiency virus (hiv) infection, solid tumor or hematological malignancy * history of long-term nursing home stays * history of recently hospitalized (\<90 days)
cognitive therapy to improve word finding

Conditions: Anomia; Aphasia; Traumatic Brain Injury; Cerebrovascular Accident

Summary: adults who sustain brain damage due to stroke, traumatic injury or surgery may develop difficulty finding words. this study compares the effectiveness of two behavior-based programs to improve picture naming ability in these individuals.

difficulty finding words is common in patients with aphasia subsequent to left hemisphere stroke. this study will compare two cognitive therapies for the treatment of acquired word finding difficulties. the therapies use different types of cues. all participants will receive both therapies. participants in this study will undergo a comprehensive and detailed assessment of language and other cognitive skills. the two treatments will be compared for their efficacy.

Eligibility criteria:
inclusion criteria: * word finding difficulty subsequent to stroke, traumatic brain injury, brain surgery or other brain damage occuring at least 6 month prior to participation * ability to attend 2 sessions per week for several months at georgetown university in washington, dc exclusion criteria: * history of learning disabilities * best corrected vision less than 20/40 * corrected hearing within functional limits * less than 10 years formal education * significant memory or comprehension problems

Keywords: anomia aphasia traumatic brain injury cerebrovascular accident
sorafenib in treating patients with metastatic kidney cancer that has not responded to sunitinib or bevacizumab

Conditions: Kidney Cancer

Summary: rationale: sorafenib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. purpose: this phase ii trial is studying how well sorafenib works in treating patients with metastatic kidney cancer that has not responded to sunitinib or bevacizumab.

objectives: primary * to determine the tumor burden reduction rate in patients with sunitinib malate- or bevacizumab-refractory, metastatic clear cell renal cell carcinoma treated with sorafenib tosylate. secondary * to determine the safety of sorafenib tosylate in these patients. * to record the duration of tumor reduction, time to disease progression, and overall survival of patients treated with sorafenib tosylate. outline: patients receive oral sorafenib tosylate twice daily on days 1-28. courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Eligibility criteria:
disease characteristics: * histologically confirmed renal cell carcinoma with a component of clear cell histology * metastatic disease * disease progression, as defined by recist criteria, after prior treatment with sunitinib malate or bevacizumab * patients must have received ≥ 1 course (4 weeks) of sunitinib malate or ≥ 2 doses of bevacizumab and have recist-defined objective progression during or within 4 months after completing treatment with sunitinib malate or bevacizumab * measurable disease by recist criteria * cns metastases allowed provided patient has undergone prior surgery and/or radiotherapy and has no evidence of further cns disease progression by ct scan or mri ≥ 2 weeks after treatment of cns metastases patient characteristics: * ecog performance status (ps) 0-1 or karnofsky ps 70-100% * wbc ≥ 3,000/μl * absolute neutrophil count ≥ 1,500/μl * platelet count ≥ 75,000/μl * total bilirubin ≤ 1.5 times upper limit of normal (uln) * ast/alt ≤ 2.5 times uln * creatinine ≤ 2.0 times uln * negative pregnancy test * no significant cardiovascular disease, including any of the following: * congestive heart failure (new york heart association class iii-iv heart disease) * active angina pectoris requiring nitrate therapy * uncontrolled dysrhythmias * cardiovascular event within the past 6 months (e.g., transient ischemic attack/cerebrovascular accident, myocardial infarction, or vascular surgery) prior concurrent therapy: * see disease characteristics * at least 2 weeks since prior systemic therapy, radiotherapy, or major surgery and recovered * no prior sorafenib tosylate * no other concurrent investigational agents * no other concurrent anticancer therapy * no concurrent prophylactic growth factors

Keywords: clear cell renal cell carcinoma recurrent renal cell cancer stage iv renal cell cancer
vr therapy for psychosis negative symptoms (v-nest)

Conditions: Psychosis; Schizophrenia

Summary: background: negative symptoms are typically observed in people with schizophrenia and indicate a loss or reduction of a normal function (e.g. reduced motivation and affect display). despite being important predictors of people's recovery the development of interventions for negative symptoms received only very limited attention. there are currently no evidenced based therapies for these symptoms. aims: to test the feasibility and acceptability of a novel virtual reality assisted therapy, called virtual reality supported therapy for the negative symptoms of psychosis (v-nest). methods: this is a single (rater) blind randomised study with two conditions; v-nest plus treatment-as-usual (tau) vs. tau alone. the study will recruit people with psychosis from nhs community care teams (in england). assessments will be at baseline and 3-month post-randomisation. a nested qualitative study to identify the key themes associated with the acceptability of the overall study and intervention will be conducted. the study will assess key feasibility parameters such as: consent and availability for screening; eligibility; availability for assessment, randomisation and treatment retention. acceptability will be assessed by considering: therapy session attendance and drop-out; in-depth feedback from service users interviews; acceptability of the research procedures and measures. participants will be assessed with measures of functioning levels and, negative symptoms . analyses will evaluate the feasibility and analyses of clinical outcomes will be focused on descriptive statistics and confidence intervals for treatment effects. population variances of the main outcomes will be estimated for future power calculations. a semi-structured interview will explore participants' experience of being recruited to the study, receiving v-nest and identify barriers (and potential solutions) to treatment engagement.


Eligibility criteria:
inclusion criteria: * service users currently under the care of nhs psychosis services; * aged over 18; * in a stable clinical condition (as judged by primary clinician) * with a documented episode of psychosis and/or a diagnosis of schizophrenia. exclusion criteria: * recent antipsychotic medication change (i.e. in the last 3 weeks); * moderate to severe learning disability * insufficient english for therapy * organic impairment.