Kornimate/medical-research-clean huggingface dataset:
effectiveness of an immune-guided cytomegalovirus infection preventive strategy compared to a universal prophylactic strategy in renal transplant patients

Conditions: Kidney Transplant Infection

Summary: cytomegalovirus (cmv) establishes a chronic infection in 60% of the general population. in renal transplant recipients, it is responsible for morbidities occurring mainly in the first 6 months after transplantation. these include viral reactivations linked to immunosuppressive treatment inhibiting the anti-cmv t lymphocyte response. cmv infection, a sign of uncontrolled viral replication, is defined by the detection of viral dna in the peripheral blood (dnaemia). cmv disease is defined as the association of an infection and symptoms attributable to the virus. in transplant recipients carrying the virus before transplantation (positive serology: cmv+), two infection prevention strategies are recommended: either close monitoring of dnaemia with antiviral treatment in the event of positive detection (pre-emptive strategy), or antiviral treatment for the first 3 months following the transplant (prophylactic strategy). both strategies result in the occurrence of cmv infection in 15 to 20% of patients within the first 6 months, with the majority of events occurring between 3 and 6 months. numerous studies show that the evaluation of the anti-cmv t lymphocyte response, either before (d0) or early after transplantation (d15), or when antiviral prophylaxis is stopped, allows the identification of patients at risk of cmv infection. no study has yet demonstrated the contribution of such an evaluation in a preventive strategy. we therefore propose such a study.


Eligibility criteria:
inclusion criteria: * renal transplant patient for 1 to 12 days * cmv seropositivity on the day of transplantation: igg threshold =6 au/ml cmia cmv igg, architect i4000 (abbott)) (serology performed on d0, before the transplant) * non-depleting inducing immunosuppressive treatment (basiliximab) (implementation before the transplant) * affiliation to a social security scheme * patient having read and understood the information letter and signed the consent form exclusion criteria: * active cmv infection (detectable cmv dnaemia - peripheral cmv dnaemia ≥ 305 iu/ml) * patient with hypersensitivity to valganciclovir, ganciclovir, aciclovir or valaciclovir or to any of the excipients * lympho-depleting inducing immunosuppressive treatment (antithymoglobulins) * neutropenia (neutrophils \< 500/mm3) or thrombocytopenia (platelets \< 25,000/mm3) or anemia (hemoglobin \< 8g/l) identified on routine care samples taken on the day of inclusion
observational study in japanese type 2 diabetes patients

Conditions: Diabetes Mellitus, Type 2

Summary: this study is designed to address the gap in the literature related to changing treatment regimen or formulation between different types of insulin, and how this change impacts quality of life, adherence, individual patient treatment satisfaction and glycemic control.

to measure changes in health related quality of life (as measured by the insulin therapy related-quality of life: itr-qol) in insulin treated type 2 diabetes over a 12 weeks period following a significant change in insulin treatment regimen. definition of significant change is a) increase or decrease the in number of injections per day, or/and b) change in formulation of insulin (human or analog insulin, basal or bolus, rapid or mix insulin), and/or c) change in administration method (syringe or pen, disposal or re-usable).

Eligibility criteria:
inclusion criteria: * inpatients or outpatients with type 2 diabetes, aged 20 years or older, on insulin therapy who have planned to change insulin therapy during the registration period of the study * patients who have provided written informed consent to participation in the study after receiving explanations about the objective and other details of the study * patients who have received the same insulin therapy for 3 months or longer before informed consent. (i.e. receiving the same type of insulin preparation at the same dosing frequency regardless of insulin dose) exclusion criteria: * patients who have planned to discontinue insulin therapy * patients incapable of completing the itr-qol, dtsq and patient's questionnaire based on their self-ratings * patients with type 1 diabetes * patients who have used csii or have planned to switch to csii(continuous subcutaneous insulin infusion ) * patients with poor treatment compliance as determined by their investigators based on the treatment history

Keywords: insulin itr-qol dtsq diabetes mellitus, type 2
prediction of peripheral neuropathy with functional testing

Conditions: Chronic Kidney Disease Stage 3 and 4; Diabetes

Summary: diabetes and chronic kidney disease (ckd) are two distinct pathologies. the former is defined as an impairment in insulin production and/or utilization, while the latter refers to structural or functional abnormalities of the kidneys. however, these two diseases share a common complication: peripheral neuropathy. this condition affects between 50% and 60% of patients with diabetes or ckd. peripheral neuropathy involves the destruction of sensory and motor neurons, leading to a wide range of painful symptoms while also reducing force production capacity. among the diagnostic tests used, the most accessible clinical tests suffer from high variability due to human subjectivity (e.g., the tuning fork test, which requires examiner expertise and verbal patient feedback), whereas laboratory electrophysiological tests can only detect the largest neurons, which are affected at later stages. although composite clinical tests have been developed to improve neuropathy screening performance, they still inherit the limitations of their individual components. in other words, they remain subject to variability related to the examiner's experience and the patient's ability to understand instructions, while also being performed through various procedures that lack a standardized consensus. moreover, these composite scores are particularly time-consuming and are therefore rarely used in clinical practice. as a result, no method currently allows for large-scale, early, and reliable screening of peripheral neuropathy. our recent work and emerging studies suggest that assessing functional capacities could serve as an objective and early marker of neuropathic impairment, even before clinical diagnosis. specifically, the quantification of postural balance performance using stabilometric methods (i.e., center of pressure displacement area) and unipedal balance time could predict the presence of diabetes-related peripheral neuropathy with over 95% accuracy compared to diagnosis with a composite clinical method (unpublished results). therefore, the aim of this study is to evaluate physical and balance capacities assessed during routine care in adapted physical activity settings, in order to determine whether the development of a composite score could help estimate the risk of peripheral neuropathy in individuals with diabetes and ckd.


Eligibility criteria:
inclusion criteria: * ckd stage 4-5 and / or diabetes (type i or ii) * able to walk 20 m * bmi \< 35 exclusion criteria: * currently or planning dialysis * musculoskeletal, osteorarticular and neurological disease(s) * cognitive impairment * low-limb amputation
trans-thoracic ultrasound vs invasive pressure of the left atrium

Conditions: Myocardial Dysfunction

Summary: as part of cardiac and hemodynamic evaluation of patients, echocardiographic measurements allow indirect evaluation of left ventricular filling pressures (lvfp). these ultrasound parameters, including mitral valve doppler and mitral ring doppler (in particular the e / e 'ratio), are well validated in medical cardiology and in some resuscitation patients. the measurement of filling pressures is an important daily element in the medical management of patients in intensive care, in particular on the hemodynamic and respiratory levels. no studies have evaluated the relevance of these markers in a postoperative context of cardiac surgery. indeed, the surgery alters the cardiac function, which could modify the values of the echocardiographic parameters and their predictability. left atrium pressure (lap) directly reflects lvfp and is measured in cardiac surgical resuscitation by a surgically placed catheter as part of routine institutional care and will serve as gold-standard. to study the clinical significance of these lap and lvfp values estimated by cardiac ultrasound, we will study their correlation with clinical and ultrasound signs of acute lung edema (ale).


Eligibility criteria:
inclusion criteria: * patient hospitalized in surgical resuscitation for cardiac surgery with heart-lung bypass machine exclusion criteria: * no consent * mitral valve surgery * severe mi / severe mitral narrowing. * absence of pog catheter * urgent surgery * heart transplant / mechanical assistance * classics: minors, pregnant women, guardianship / curatorship / safeguarding,

Keywords: myocardial dysfunction left ventricular mitral valve doppler mitral ring doppler ultrasound signs lung edema
to compare the efficacy and safety of ins068 and insulin glargine in subjects with type 2 diabetes mellitus not adequately controlled with oral antidiabetic drugs

Conditions: Type 2 Diabetes

Summary: the study is being conducted to evaluate the efficacy and safety of ins068 once daily (qd) in subjects with type 2 diabetes not adequately controlled with oral antidiabetic drugs compared to insulin glargine qd for 26+26 weeks.


Eligibility criteria:
inclusion criteria: 1. diagnosed with type 2 diabetes ≥ 6 months； 2. stable daily dose(s) for ≥8 weeks prior to screening of any of the following anti-diabetic drug(s) or combination regimen(s): 1) any metformin formulations ≥1500 mg daily or maximum tolerated (≥1000mg daily). 2) any of the following oral antidiabetic drugs with dose ≥half of the maximum approved dose according to local label or maximum tolerated): sulfonylureas, meglitinides (glinides), dipeptidyl peptidase-4 (dpp-4) inhibitors, sodium-glucose co-transporter-2 (sglt2) inhibitors, thiazolidinediones and alpha-glucosidase inhibitors. 3. glycated hemoglobin was 7.0%\~11.0% (both inclusive) at screening exclusion criteria: 1. known or suspected allergy or intolerance to the investigational medicinal products or related products； 2. hospitalization for diabetic ketoacidosis or hyperglycemic hyperosmolar syndrome during the previous 6 months； 3. potentially unstable diabetic retinopathy or maculopathy requiring treatment (e.g., laser, surgical treatment or injectable drugs) during the previous 6 months； 4. have used insulin therapy anytime in the past 2 years, except for short-term insulin treatment and prior treatment for gestational diabetes. 5. participation in any clinical trial of an approved or non-approved investigational product/treatment within the last 1 month or 5 half-lives, whichever is longer, prior to screening; 6. women who are pregnant, breastfeeding or planning to conceive, or women of childbearing potential are reluctant to use appropriate contraception during the trial and for at least 14 days after the last dose of the investigational medicinal drug; 7. any conditions that the investigator judges might not besuitable to participate in the trial.
photographic assessment of eyebrow position and range of motion

Conditions: Brow Ptosis

Summary: forehead and eyebrow surgery is a frequently performed cosmetic surgical procedure in which the eyebrows are raised to a more aesthetically pleasing position. typically, this position is judged by the surgeon pre-operatively based on traditional aesthetic concepts, some of which date to the classical era. this study is designed to assess the variance of the eyebrow from the desired aesthetic position (as determined by the subject), as wel as to assess the distance of normal excursion of the brow from maximum voluntary depression to maximum voluntary elevation.

a set of 5 digital photographs will be taken of 100 (30 male, 70 female) adult study participants. prior to photography, water soluble ink will be used to mark the inferior aspect of the superior orbital rim above the medial and lateral canthi and in the mid pupillary line. photographs taken will image patients from crown to chin and will be taken with eyes open and closed, brows raised, maximally contracted and at rest. a final photograph will be taken with the subject manually holding both brows in the position he/she finds most aesthetically pleasing as seen in a mirror. during all photography, a ruler will be held against the face for later calibration, all photographs will be taken with a camera mounted flash and with the patient in a frankfort horizontal plane. all photographs will be analyzed with proprietary computer software.

Eligibility criteria:
inclusion criteria: * adults, * aged 18-85 years exclusion criteria: * prior forehead, eyebrow or eyelid surgery, * neurotoxin treatment to the forehead or eyes within the past 6 months, * injectable soft tissue filler used within the last 12 months, * photosensitivity.

Keywords: brow ptosis, facial aesthetics, browlift, facelift
ekos in patients with pulmonary embolism (pe)

Conditions: Pulmonary Embolism

Summary: a retrospective cohort study assessed patients who underwent ekos intervention following the failure of initial therapeutic anticoagulation for managing acute pulmonary embolism at a tertiary hospital.

a retrospective cohort study assessed patients who underwent ekos intervention following the failure of initial therapeutic anticoagulation for managing acute pulmonary embolism at a tertiary hospital. patients aged at least 18 years with a diagnosis of submassive or massive acute pe were included. patients were excluded if they either did not receive ekos intervention or were presented with stable pe. the primary outcome was the change in rv/lv diameter ratio from baseline to first outpatient follow-up.

Eligibility criteria:
inclusion criteria: * patients ≥ 18 years diagnosed with massive or submassive acute pe. exclusion criteria: 1. patients presented with stable pe 2. patients did not receive ekos intervention.

Keywords: ecos
the combination of atorvastatin, acetylcysteine and danazol as the treatment of steroid-resistant/relapse immune thrombocytopenia

Conditions: Immune Thrombocytopenia

Summary: single-arm, open-lable, multicentre study to compare the efficacy and safety of atorvastatin, acetylcysteine plus danazol with danazol monotherapy in patients with corticosteroidresistant/relapsed itp.

immune thrombocytopenia (itp) is a severe bleeding disorder. approximately 2/3 of patients achieve remission from first-line therapies. however, the underlying mechanism of corticosteroid-resistant or relapsed itp is not well understood; thus, treatment remains a great challenge. atorvastatin was shown to enhance bone marrow endothelial cell function and n-acetylcysteine (nac) was shown to inhibit plt binding to endothelial cell. a multicentre prospective study was performed in non-splenectomized itp patients who were either resistant to a standard dose of corticosteroids or had relapsed. patients were randomized to atorvastatin, acetylcysteine plus danazol with danazol monotherapy group. platelet count, bleeding and other symptoms were evaluated before and after treatment. adverse events are also recorded throughout the study, in order to compare the efficacy and safety of atorvastatin, acetylcysteine plus danazol with danazol monotherapy in patients with corticosteroid-resistant/relapsed itp.

Eligibility criteria:
inclusion criteria: * itp confirmed by excluding other supervened causes of thrombocytopenia; * platelet count of less than 30×10\^9/l at enrollment; * patients who did not achieve a sustained response to treatment with full dose corticosteroids for a minimum duration of 4 weeks or who relapsed during steroid-tapering or after its discontinuation; * ecog\<2. * epcs in bone marrow less than 0.02% exclusion criteria: * secondary immune thrombocytopenia (e.g., patients with hiv, hcv, helicobacter pylori infection or patients with systemic lupus erythematosus) * congestive heart failure * severe arrhythmia * nursing or pregnant women * aspartate aminotransferase and alanine transaminase levels ≥ 3× the upper limit of the normal threshold criteria * creatinine or serum bilirubin levels each 1.5 times or more than the normal range * active or previous malignancy * unable to do blood routine test for the sake of time, distance, economic issues or other reasons.

Keywords: steroid-resistant refractory atorvastatin acetylcysteine danazol
effects of transcutaneous spinal cord stimulation on residual voluntary motor control in individuals with incomplete spinal cord injury

Conditions: Motor Control in Incomplete Spinal Cord Injured Persons

Summary: recently, a transcutaneous protocol of electrical spinal cord stimulation (tscs) has been developed. it was suggested, that this method could be used to improve the therapy process after a spinal cord injury (sci). the aim of this study is to investigate the immediate effects of tscs with different stimulation modalities on voluntary motor control in patients with incomplete sci.


Eligibility criteria:
inclusion criteria: * patients with incomplete sci * chronic (≥ 12 months post-injury) or subacute (≥ 3 months post-injury) stage of recovery * age: ≥18 years * able to complete the 10mwt with walking aids as required but no physical assistance * neurological level of sci: above t12 * preserved segmental and cutaneo-muscular reflexes in the lower limbs * bodyweight \> 20 kg and \< 120 kg * mini-mental state examination score 6 (test only performed if cognitive deficits are suspected) exclusion criteria: * any other neurological diseases * current orthopedic problems * premorbid major depression or psychosis * history of significant autonomic dysreflexia with treatment * dermatological issues (e.g. decubitus) at the stimulation or harness attachment site (back, abdomen, upper legs) * active implants (e.g. cardiac pacemaker, implanted drug pump) * passive implants at vertebral level t9 or more caudal vertebrae (metal screws and plates for surgical stabilization of spinal fractures) * malignant diseases * heart insufficiency nyha iii-iv * potential pregnancy (pregnancy test must be conducted before each session) * unlikely to complete the intervention or return for follow-up * participation in another training study * contraindications for bws training using the float (according the manual): * no responsiveness * severe muscle contractures * acute fractures * osteoporosis or osteogenesis imperfecta * body size shorter than 1 meter or taller than 2 meters
examining tolerance to cns stimulants in adhd

Conditions: Attention-deficit/Hyperactivity Disorder

Summary: although stimulant medication is a well-established treatment for adhd, it is often necessary for doctors to increase the dose over time to maintain the benefits of the medication. while medication can be very effective for improving symptoms of adhd during the first year of use, it has not been found to significantly improve the long term course of children with adhd. for example, in large research studies, groups of children who take medication for ten years do not have consistently better academic grades than groups of children who never used medication (individual results will vary from child to child). in order to help children with adhd achieve the best possible outcomes, it is important for doctors to study why this happens. one possible reason is development of tolerance to the medication. tolerance means that a drug's effects decrease when it is taken consistently over time, so that an increased dose is needed to continue showing effects. some doctors believe that children who take stimulant medication for adhd develop tolerance to it which would explain why benefits may not persist over time, but no research studies have been done to measure whether this occurs. this study aims to see if children show a tolerance effect to stimulant medication and whether that tolerance can be prevented by taking short breaks from the medication called medication holidays.

this is an innovative evaluation of tolerance using an objective measure in an analog classroom. each subject will complete the a 10-minute math test twice a day for three weeks on optimal dose or placebo, and then be crossed over to the other condition. within-subject drug/placebo differences will be compared over the three weeks of exposure to assess tolerance in the analog setting. when school commences, 50% of the sample will be randomized to 7-day-a-week (continuous) dosing and 50% to 5-day-a- week (weekend holidays) dosing to examine the efficacy of prescribed weekend drug holidays for combatting need for dose escalations (tolerance) during the school year. participants will be assessed monthly to detect deteriorating functioning. using a standardized protocol, study physicians will increase dose for subjects in either arm who meet defined impairment thresholds. the difference between the two dosing conditions will inform regarding how best to deal with tolerance in clinical application.

Eligibility criteria:
inclusion criteria: * diagnosis of attention-deficit/hyperactivity disorder * full scale iq above 80 exclusion criteria: * psychotropic medications for conditions other than adhd * active medical or psychiatric conditions that could be worsened by stimulants * diagnosis of autism or asperger's disorder * documented intolerance fo methylphenidate or failed trial of oros mph

Keywords: tolerance to stimulant medication
cns involvement in primary mediastinal large b-cell lymphoma (pmlbcl)

Conditions: Primary Mediastinal Large B-cell Lymphoma (PMBCL)

Summary: this is a retrospective, multicenter study designed to collect data on the diagnostic, therapeutic management and outcome of patients diagnosed with primary mediastinal lymphoma who have progressed or relapsed with central nervous system (cns) involvement. through this study, an international data set from 6 different countries will be collected on clinical factors, anti-lymphoma therapy administered alone or in conjunction with cns prophylaxis, re-biopsy site information when available, dose intensity of lymphoma therapy received at recurrence, and patient outcome. in addition, to better characterize the pathologic features of this rare entity, a central pathologic review of the initial diagnosis and, if available, histologic confirmation of recurrence will be performed.


Eligibility criteria:
inclusion criteria: to be eligible for inclusion each patient must fulfil all of the following criteria: 1. histologically confirmed diagnosis of primary mediastinal large b cell lymphoma (pmlbcl) according who classification 2. had a recurrence/progression with central nervous system (cns) involvement 3. availability of details on clinical presentation, treatment details and outcome 4. availability of details on pathological data for central review 5. age ≥18 years exclusion criteria: * patients with cns lymphoma other than pmlbcl subtype

Keywords: pmlbcl cns