Kornimate/medical-research-clean huggingface dataset:
prospective feasibility study of point-of-care ultrasound in suspected aortic dissection

Conditions: Aortic Dissection; Emergency Ultrasound

Summary: aortic dissection is an uncommon and serious pathology. its diagnosis is difficult because of the varied and silent clinical presentations. the development of ultrasound in emergency medicine is an asset in certain pathologies. the aim of this study is therefore to study the feasibility of a protocol integrating clinical ultrasound in the suspicion of acute aortic dissection in the hospital setting. this study is a single-center prospective interventional study. in which the investigators perform ultrasound in patients with suspected acute aortic dissection in the emergency department. if the protocol is feasible and if it allows a saving of time in the diagnosis or an increase in diagnoses, the investigators will be able to evoke a profitability to the systematic realization of this examination.

h0: patient selection and inclusion: * presentation of the study * delivery of the information note / no objection to the patient if he/she is in a state to consent * emergency procedure: in accordance with article l-1122-1-3 of the public health code, patients may be included in the study at the initiative of the physician without seeking prior consent. this procedure will be associated with a prior call to the relatives to obtain an oral consent in principle (traced in the patient's medical file), while waiting for the delivery of the information note / no objection to the relatives and then to the patient as soon as his condition allows it. h1: inclusion interview then : medical interrogation (retrospective collection if already done / but additional requests if missing data). clinical examination (complementary if missing data). ultrasound with 3 ultrasound sections to be performed: parasternal long axis, supra-sternal and abdominal, looking for the following signs: direct signs: presence of an intimal flap, intramural aortic hematoma \> 5mm, penetrating aortic ulcer. indirect signs: pericardial effusion, aortic dilatation ≥ 4 cm, tamponade (1). h4: retrospective collection of the results of complementary examinations if any, biological and radiological, and collection of the final diagnosis retained.

Eligibility criteria:
inclusion criteria: * men and women aged 18-95 years included * non-opposition of the subject to participate in the study * all patients admitted to the emergency department of the besançon university hospital with chest, abdominal, back, lumbar pain, or acute headache * aorta score ≥ 1 * clinical suspicion of ad by the emergency physician exclusion criteria: * legal incapacity or limited legal capacity * subject unlikely to cooperate with the study and/or poor cooperation anticipated by the investigator * subject without health insurance * pregnant woman * ecg showing acute coronary syndrome and/or ventricular rhythm disturbances * traumatic context, or traumatic cause of pain * chronic / subacute dissection (patient with incidental discovery of aortic dissection (city assessment) and then referred to the emergency room). * patient refusal to participate in the study
bnhl-2015 for children or adolescents in china

Conditions: Mature B-cell Non-Hodgkin Lymphoma

Summary: the purpose of this study is to test whether adding 4 injections of rituximab and increasing the intensity of chemotherapy regimens in advanced patients can improve the efs compared with the historical study cccg-nhl-2010.

in our previous study (cccg-nhl-2010), two-year efs was 100% for stage i, 91.3% ± 6.1% for stage ii, 75.8% ± 4.4% for stage iii, 56.3% ± 13.5% for stage iv, and 36.4% ± 14.5% for b-al, respectively. to improve survival for pediatric patients with b-nhl/b-al, the investigators launched a new study in china. compared with our previous treatment regimens (cccg-2010), patients with stage iii and ldh\>4 times nl, any stage iv or b-al were stratified into r4. the dose of methotrexate was increased to 5000mg/m2 for patients in r3 or r4 (previously 3000mg/m2). four injections of rituximab was added to the chemotherapy for patients in r4. our aim is to test whether adding rituximab or high dose of methotrexate (5000mg/m2) would improving 2-year efs for patients in advanced groups.

Eligibility criteria:
inclusion criteria: * histology or cytologically confirmed matureb-cell nhl/al(burkitt, dlbcl, pmlbl,or aggressive mature b-cell nhl non other specified or specifiable) * able to comply with scheduled follow-up and with management of toxicity * signed informed consent exclusion criteria: * follicular lymphoma, malt and nodular marginal zone are not included into this therapeutic study * patients with congenital immunodeficiency, chromosomal breakage syndrome, prior organ transplantation, previous malignancy of any type, or known positive hiv serology. * -evidence of pregnancy or lactation period. * past or current anti-cancer treatment except corticosteroids during less than one week. exclusion criteria related to rituximab: * tumor cell negative for cd20. * prior exposure to rituximab. * hepatitis b carrier status history of hbv or positive serology.

Keywords: lymphoma non-hodgkin b-lymphocytes child multicenter study
augmented reality smart glasses technology for immersive learning in the emergency department

Conditions: Augmented Reality

Summary: the covid-19 pandemic has disrupted traditional clinical teaching, depriving medical students of valuable clinical engagement with patients who required an aerosol-generating procedure (agp) in the emergency department (ed). because of the infection control restrictions, medical students are not allowed to enter resuscitation room where agps takes place, even in the aftermath of the pandemic. the microsoft hololens 2 is an augmented reality (ar) head-mounted device (hmd) which enables a single clinical teacher to facilitate real-time distant immersive learning by medical students on critically ill ed patients while insulating them from infection risks. our team has successfully developed an ar hmd prototype based on hololens for clinical teaching and conducted 10 pilot teaching sessions. overall, the audio-visual quality of the video-laryngoscope image captured by the hololens were rated satisfactorily by the students. cybersickness symptoms such as dizziness, nausea, and eye strain were infrequent among the viewers. the investigators conduct a pilot randomised controlled trial (rct) which aims to evaluate the feasibility of conducting a full-scale rct. the investigators collect data of the impact of ar learning and bedside learning on student knowledge gain, cognitive load, motivation and adverse effects. the investigators invite 33 year 5 or 6 medical students to participate in this study during the emergency medicine specialty clerkship rotation at the accident and emergency department (a\&e) of queen mary hospital (qmh). consented medical students are randomly assigned in clusters based on their existing student group assignment (around 10 students per each small group) in a 1:1 to two arms: ar clinical learning arm and the control arm (bedside clinical learning). randomisation is performed by a research assistant not directly involved in the study using sequentially numbered opaque, sealed envelopes. given the first-person perspective through the hololens, it is not possible to blind the medical students. to standardise the teaching content of all study sessions, all such sessions are delivered by the principal investigator (pi) of this study during the study period and the pre-reading materials are the same for both groups. the pi will demonstrate endotracheal intubation using video laryngoscope and other agps on a manikin in the resuscitation room.


Eligibility criteria:
inclusion criteria: * year 5 or 6 medical students during the emergency medicine specialty clerkship exclusion criteria: * refusal to consent

Keywords: augmented reality smart glasses emergency airway management learning emergency department
ghrelin resistance in adolescents with idiopathic scoliosis

Conditions: Scoliosis

Summary: adolescent idiopathic scoliosis (ais) is the most common spine pathology. it is opposed to secondary scoliosis due to chronic diseases. many hypotheses have been made to elucidate the origin of this illness. recently, the melatonin pathway has been investigated as pinealectomy of the chicken creates a scoliosis that resembles ais and melatonin supplementation reverses the process. in addition administration of melatonin to ais patients improved the pathology. however this hypothesis has shown controversial results. recent studies have demonstrated melatonin cellular resistance in osteoblastic cells from ais patients. melatonin acts through g protein coupled receptor (gpcr), mainly using the gi pathway. in ais osteoblasts, this pathway is blocked leading to a decrease in the inactivation of the adenylyl cyclase and therefore maintenance of high level of cyclic adenosine monophosphate (camp) concentrations in the cells. as modulation of camp is important for osteogenesis such resistance may be critical for the initiation or the development of ais. gi signalization is used by several other gpcr, thus, this hormonal resistance could logically be found in other hormonal or mediator pathways. a precedent study previously focused on ghrelin in ais, and demonstrated that ais patients possess elevated plasmatic values of ghrelin. this study also observed decreased response to ghrelin in ais cultures osteoblasts.


Eligibility criteria:
inclusion criteria: group 1 : * ais : spine deformity with angle above 10°,without detected cause * informed consent obtained group 2 : * secondary scoliosis due to chronic illness, neurologic or syndromic, eligible for spine surgery * spine surgery for reason other than scoliosis * informed consent obtained exclusion criteria: * not primary scoliosis * no consent * legal obstacle

Keywords: adolescent idiopathic scoliosis ghrelin
assessment of intestinal inflammation by infrared thermography in pediatric crohn disease

Conditions: Crohn Disease; Infrared Thermography; Child

Summary: the assessment of digestive inflammation and disease activity in paediatrics crohn's disease (cd) is currently based on anamnestic, clinical and paraclinical elements such as the paediatric cd activity index (wpcdai) , faecal calprotectin measuring or digestive endoscopy. infrared thermal imaging is based on capturing electromagnetic waves, on a specific wavelength, emitted by the human body surface and representing local thermic-metabolic activity. it concern metabolic activity in digestive inflammations. infrared imaging is a non-invasive, contactless, stressless technique that assess the variations in skin surface temperature of the patient's entire abdomen or more targeted areas in a single photography. this technique would be useful for determination of crohn's disease activity, inflammation's degree and partial mapping of inflammatory lesions. in a specific room with a patient lying, the investigators will determine the abdominal infrared radiation with a flir® thermal camera. this will be correlated with the measurement of the faecal calprotectin concentration and the composite cd activity index wpcdai. all measurements will be performed during the standard follow-up of crohn disease. no additional follow will be necessary.


Eligibility criteria:
inclusion criteria: * patients diagnosed with cd according to the porto criteria \[6\] * aged from 4 years to 17 years-old * follow-up at the amiens picardie university hospital (chu amiens picardie) * child's affirmative agreement and assent and permission of their parents to participate in research exclusion criteria: * recent abdominal surgery * other inflammatory bowel disease

Keywords: crohn disease infrared thermography faecal calprotectin pcdai child
surgical treatment in diabetic patients with grade 1 obesity

Conditions: Obesity; Type 2 Diabetes Mellitus

Summary: there will be a randomized clinical trial, non-blind, 3-arm treatment (medical, surgical, gastric bypass and ileal transposition surgery with and sleeve), which will be conducted in a single center - s.b.s. hospital sirio libanês, including 75 research subjects with type 2 diabetes mellitus and obesity class i. in order to compare the effect of weight loss on glycemic control among medical and surgical groups, and after 2 years of follow up, the results of efficacy, safety and maintenance will be compared between the three groups.


Eligibility criteria:
inclusion criteria: * man or woman with type 2 diabetes mellitus (dm) aged between 25 and 65 years, with time since diagnosis of diabetes less than 10 years. * grade i obesity (bmi between 30-35) * inadequate glycemic control with hba1c between 7.0 to 9.5% at baseline, in the presence of drug treatment for diabetes in the last year. * reserve pancreatic c-peptide\> 1.0 at baseline. * overweight stable defined as bmi\> 30 in the last two years. exclusion criteria: * history ketoacidosis, diabetes mellitus type 1, diabetes followed by pancreatitis. * repetition of measurements (ie, 2 or more within 1 week) fasting plasma glucose(fpg) \> 240 mg / dl during the pre-treatment. * history of severe proliferative diabetic retinopathy. * autonomic neuropathy. * loss or gain significant weight within the last 12 weeks (range, 5% body weight) * renal insufficiency * history of renal disease treated with immunosuppressive therapy, history of dialysis or kidney transplantation. * presence of other renal diseases (eg nephrotic syndrome, glomerulonephritis) * acute myocardial infarction, unstable angina (nyha class iii-iv), revascularization or stroke within the previous 3 months of the initial visit. * uncontrolled hypertension defined as diastolic blood pressure\> 100mm/hg and diastolic blood pressure\> 160mm/hg at the initial visit. * history of hepatitis b or hepatitis c. * criteria for hepatic insufficiency defined as child b and c liver disease clinically active and aspartate aminotransferase (ast) and alanine aminotransferase (alt) above 3 times the upper limit of normal. * history of prior bariatric surgery. * inflammatory bowel disease. * history neoplasm within the last 5 years (except for squamous cell carcinoma and basal skin and cervical carcinoma in situ) * clinically important hematologic disorder (symptomatic anemia, bone marrow proliferative disorders, thrombocytopenia, ..) * history antibody positive human immunodeficiency virus (hiv) * surgery with general anesthesia within 12 weeks prior to the initial visit or incomplete recovery from prior surgery. * history of drug or alcohol abuse within 3 years before the initial visit. * pregnancy or breastfeeding or planning pregnancy in the next two years.

Keywords: type 2 diabetes mellitus grade i obesity inadequate glycemic control
healthy4baby: preventing postpartum weight retention among low-income, black women

Conditions: Pregnancy; Weight Loss; Behavioral; Obesity

Summary: the purpose of this study is to assess the feasibility and efficacy of an electronically-mediated, pregnancy and postpartum, behavioral intervention program, compared to usual obstetric care, on changes in weight and cardiometabolic biomarkers among overweight and obese black women.

black women are in particular need for obesity prevention and treatment. targeting the childbearing period has the potential to slow the accumulation of weight gain among this high risk group. previous interventions to prevent postpartum weight retention among blacks are sparse and limited by poor intervention adherence, high attrition, and failure to include pregnancy in the study design. the proposed research aims to overcome these shortcomings by developing an intervention that 1) focuses solely on black women, 2) incorporates black mothers' information needs, values, and social context, 3) uses technology to facilitate participant engagement, and 4) includes both the pregnancy and postpartum periods.

Eligibility criteria:
inclusion criteria: 1. pregnant african-american women at least 18 years of age 2. bmi at recruitment between 25.0-44.9 kg/m2 3. singleton pregnancy 4. gestational age of ≤ 20 weeks as determined by last menstrual period 5. plan to carry the pregnancy to term and keep the baby 6. own a cell phone with a text messaging plan 7. member of facebook social networking site 8. able to participate in physical activity 9. participants must be willing to comply with all study-related procedures exclusion criteria: 1. bmi ≤ 24.9 or ≥ 45.0 2. uncontrolled hypertension (systolic blood pressure \> 160 or diastolic blood pressure \> 95 mmhg). participants with controlled hypertension on medication for at least three months are allowable. 3. known atherosclerotic cardiovascular disease 4. known congestive heart failure 5. known diabetes mellitus (type 1 or type 2) 6. uncontrolled thyroid disease. participants with controlled thyroid disease on medication for at least three months are allowable. 7. known cancer 8. any major active rheumatologic, pulmonary, hepatic, dermatologic disease or inflammatory condition requiring steroids or immune modulating medications 9. history of testing hiv positive 10. current smoker or tobacco user 11. current or recent history (past 6 months) of drug or alcohol abuse or dependence 12. participation in any weight control or investigational drug study within 6 weeks of screening 13. serious or unstable medical or psychological conditions that, in the opinion of the investigator, would compromise the subject's safety for successful study participation 14. gastrointestinal disorders (gallbladder disease, crohn's disease, etc) 15. previous weight loss surgery 16. history of bulimia or anorexia

Keywords: pregnancy postpartum weight retention behavioral electronically-mediated
tourniquets type combat application tourniquet: proximal or distal location, simple or staggered on upper and lower limb

Conditions: Hemorrhage

Summary: a tourniquet is used to stop abundant bleeding when simple compression is not effective. the investigators will study the vascular suffering of the tourniquets according to their location on the limb: limb (arm / thigh) or distal (forearm / leg). vascular suffering will be evaluated by the loss of the radial doppler flux for the tourniquets placed on the upper limb and in the tibial anterior to the lower limb by the loss of the pulse oximetry pulse and the collection of the signs described by the volunteers (pain, paresthesia, cold sensation).


Eligibility criteria:
inclusion criteria: * age greater than or equal to 18 years (major) * volunteer to participate in research exclusion criteria: * age less than 18 years * known coagulation disorder * known vascular disorder * known neurological disorder of the limbs * known muscle disorders of the limbs * presence of an implant in one of the limbs (vascular, contraceptive ...) * simultaneous participation in research involving anticoagulant therapy * history of phlebitis * persons of full age who are subject to legal protection (safeguard of justice, person placed in curatorship, guardianship), persons deprived of their liberty. * pregnant women
biological response to tamoxifen (tam) in patients with breast cancer non metastatic rh+

Conditions: Non Metastatic Breast Cancer

Summary: the biological response to treatment with tamoxifen in the preoperative situation is studying in this protocol. this study will enrolls patients with non-metastatic breast cancer hr +. the relationship between the cyp2d6 polymorphism, pharmacokinetics and biological efficacy of tam will be studied.


Eligibility criteria:
inclusion criteria: * adult females (≥ 18 years), with effective contraception. the contraceptive should not use estrogen to a derivative. it must be continued during treatment with tamoxifen for at least two months after his arrest. * histologically confirmed diagnosis of invasive breast cancer, previously untreated. patients have been supported for a breast cancer may be included if a period of at least 2 years between the last systemic treatment of inclusion in the study. * primary tumor hormonopositive: er and / or pr ≥ 50% by immunohistochemistry. * lack of her2 overexpression * palpable primary tumor or greater than or equal to 20 mm in diameter, measured by ultrasound * patient scheduled to undergo breast cancer surgery * no metastases * clinical stage m0 * performance index ≤ 1 (oms) * neutrophils wbc \> or = 1500 / mm3, platelets \> or = 100 000/mm3 hemoglobin ≥10 g/dl * normal liver function: bilirubin ≤ 1.5 x uln, aspartate aminotransferase (ast) and alanine aminotransferase (alt) ≤ 2.5 x uln (≤ 5 x uln if liver metastases). * normal renal function (creatinine ≤ 1.5 mg / dl or creatinine clearance ≥ 60 ml / min) * cardiac function (muga scan or ultrasound february\> 55%) and lung function, 5.2.2 criteria related to participation in the study: * patient affiliated to social security, patient has signed and dated consent non-inclusion criteria: 1. pregnant or breastfeeding women 2. use of st. john's wort (herbal tea ...) within 5 days before starting treatment 3. consumption of grapefruit juice in the last 5 days of starting treatment 4. congenital galactosemia 5. glucose and galactose malabsorption 6. lactase deficiency 7. co-medications that may interfere with cytochrome p450: 8. ongoing enzyme inducers: * antiepileptic drugs: carbamazepine, phenobarbital, phenytoin * antinfectieux: rifampin, rifabutin, névrirapine, griséofilvine, efavirenz 9. ongoing enzyme inhibitors: * inhibitors of serotonin reuptake: fluoxetine, paroxetine * thioridazine. quinidine * amiodarone * ca antagonists: diltiazem, verapamil * azole antifungals ketoconazole, fluconazole, miconazole. * no protease inhibitors: ritonavir, nelfinavir, amprenavir, indinavir. * macrolides: erythromycin, clarithromycin, josamycin

Keywords: tamoxifen, breat cancer pharmacogenetic non metastatic breast cancer, hr +