Kornimate/medical-research-clean huggingface dataset:
evaluation of association between apical dysfunction and trans apical access for tavr, in patients with severe aortic stenosis, undergoing trans apical trans catheter aortic valve replacement (tap-tavr).

Conditions: Severe Symptomatic Aortic Stenosis

Summary: the asses and evaluate whether trans apical access for tavr is associated with apical dysfunction.


Eligibility criteria:
inclusion criteria: 1. severe aortic stenosis defined as aortic valve area of less than 1 cm2 or index area of 0.6 cm2/m2 by echocardiography. 2. symptomatic patients with aortic stenosis referred for medically indicated avr 3. signed informed consent to participate in the study. exclusion criteria: 1. inability to sign written informed consent. 2. abnormal apical dysfunction at baseline 3. lvef \< 20% 4. pregnancy or breast feeding. 5. need for emergency surgery for any reason. 6. any case in which the practicing physician asserts that enrollment in the protocol will
mr-based hypofractionated adaptive igrt of prostate cancer (m-base hypro 2.0)

Conditions: Prostate Cancer

Summary: single-centre single-armed, non-randomized interventional phase ii-study of hypofractionated image-guided radiotherapy "igrt" with weekly magnetic resonance imagings "mri" for personalized adaptation of the treatment plan depending on individual mr-anatomy of prostate/organ at risks "oar" during course of igrt.

igrt-schedule: 20 fractions to a total dose of 60 gy personalized adaption of treatment plan dependning on volume-/ and constraint-thresholds and evaluation of biomarkers (multiparametric mri, blood, tissue, stool, urine). treatment at mr-linac allowed

Eligibility criteria:
inclusion criteria: * biopsy-proven prostate cancer with indication for rt * ct1b-ct3a cn0 cm0 * ecog performance score 0-2 * ipss≤12 (before planning computed tomography i.e. reached after neoadjuvant androgen deprivation therapy or tamsulosin) * age\>18 years * informed consent exclusion criteria: * not fulfilled inclusion criteria * contraindication against curative rt * age\<18 years * previous pelvic radiotherapy or planned pelvic radiotherapy * comorbidities interfering with image-guided radiotherapy * contraindications against multiparametric mri (like hio prosthesis, pacer, allergy against contrast media) * prior transurethral resection, highly focussed ultrasound or other pre-treatment of prostate

Keywords: hypofractionation mr-based igrt mbase hypro
dose-finding study to evaluate the efficacy, tolerability and safety of fesoterodine in comparison to placebo for overactive bladder.

Conditions: Overactive Bladder

Summary: to evaluate the efficacy and safety of fesoterodine in comparison to placebo for overactive bladder.


Eligibility criteria:
inclusion criteria: * adult oab patients who present with oab symptoms, including micturitions \>= 8 per day and urgency urinary incontinence \>= 1 per day. exclusion criteria: * patient has known hypersensitivity to the active substance (fesoterodine fumarate) or to peanut or soya or any of the excipients. * patient has a known neurological disease influencing bladder function. * patient has a complication of lower urinary tract pathology potentially responsible for urgency or incontinence, clinically relevant bladder outlet obstruction or pelvic organ prolapse.
a randomized, double-blind active-controlled, dose-ranging study of the safety and efficacy of chronically administered mdl 28,574a in the treatment of hiv-infected patients

Conditions: HIV Infections

Summary: to characterize the safety and efficacy of fixed doses of mdl 28,574a administered alone and in combination with zidovudine ( azt ) in patients with asymptomatic or mildly symptomatic hiv infection. to examine the demographic effects on population pharmacokinetics and pharmacodynamics of mdl 28,574a alone and in combination with azt.


Eligibility criteria:
inclusion criteria concurrent medication: allowed: * prior antiretroviral agents for up to 6 months per agent. patients must have: * hiv infection. * asymptomatic or mildly symptomatic. * cd4 count 301 - 500 cells/mm3. exclusion criteria co-existing condition: patients with the following condition are excluded: unable or unwilling to comply with study procedures. concurrent medication: excluded: * chemoprophylactic therapy for mycobacterial infection. * any nonstudy prescription medications without approval of investigator. patients with the following prior conditions are excluded: * history of grade 3 or 4 toxicity to \<= 600 mg/day azt. * history of intolerance to lactose. * chronic diarrhea within 6 months prior to study entry. * unexplained intermittent or chronic fever, defined as temperature \>= 38.5 c for any 7 days within the 30 days prior to study entry. prior medication: excluded: * antiretroviral therapy within 2 weeks prior to study entry. * prior hiv vaccines. * biological response modifiers within 30 days prior to study entry. * prior foscarnet. * any investigational drug with a washout \< 5 half-lives prior to study entry. * any medications known to alter renal, hepatic, or hematologic / immunologic function (such as barbiturates, phenothiazines, cimetidine, immunomodulators, etc.) within 14 days prior to study entry. recent history of alcohol and/or drug abuse.

Keywords: drug therapy, combination aids-related complex zidovudine mdl 28574
advance aso amplatzer™ atrial septal occluder post market surveillance study

Conditions: Atrial Septal Defect Secundum

Summary: prospective, multicenter, case-cohort study.to identify potential risk factors associated with the occurrence of erosion due to implantation of the amplatzer™ septal occluder (aso.)

this study will enroll 8000 subjects. the sub-cohort will consist of 160 (2%) subjects, randomly selected from the full cohort. the analysis population will consist of all subjects in the sub-cohort, combined with all subjects with erosion events who are not in the sub-cohort. a detailed assessment of risk factors will be conducted on the subjects in this analysis population.

Eligibility criteria:
inclusion criteria: to participate in this clinical investigation, the patient must meet all of the following inclusion criteria: 1. patient indicated for asd closure who has echocardiographic evidence of ostium secundum atrial septal defect and clinical evidence of right ventricular volume overload (such as, 1.5:1 degree of left-to-right shunt or rv enlargement) and is implanted with the aso device note: this does not include the indication for closure of a fenestration following a fenestrated fontan procedure 2. patient is willing and able to complete the follow-up requirements of this study 3. patient signs the informed consent (or a legal representative signs the informed consent.) exclusion criteria: patient is not eligible for clinical investigation participation if he/she meets any of the following exclusion criteria: 1. patient is known to have extensive congenital cardiac anomaly which can only be adequately repaired by way of cardiac surgery 2. patient is known to have sepsis within 1 month prior to implantation, or any systemic infection that cannot be successfully treated prior to device placement 3. patient is known to have a bleeding disorder, untreated ulcer, or any other contraindications to aspirin therapy (unless another anti-platelet agent can be administered for 6 months) 4. patient is known to have a demonstrated intracardiac thrombus on echocardiography 5. patient whose size (such as, too small for transesophageal echocardiography probe, catheter size) or condition (active infection, etc.) would cause the patient to be a poor candidate for cardiac catheterization 6. patient has margins of defect that are less than 5 mm to the coronary sinus, av valves or right upper lobe pulmonary vein
assessing relapse in multiple sclerosis (arms) questionnaire

Conditions: Multiple Sclerosis

Summary: this phase 4 pilot cross-sectional descriptive/exploratory study is to be conducted in clinical practice settings (including ms (multiple sclerosis) specialty clinics, general neurology practices, or other academic or private practice settings) in the united states to assess the psychometric properties of the arms questionnaire in approximately 100 adult patients with ms who are experiencing a confirmed relapse, as identified by the investigator or designee at each site. neither efficacy nor safety of treatment will be evaluated in this study. the arms questionnaire is a 2-part, 2-page survey, with each part comprising 7 questions on 1 page. part 1 is designed to evaluate the patient's relapse symptoms and how the symptoms affect daily activities and overall function, as well as patient's response to past treatments for previous relapses, as a means of guiding treatment selection. part 2 is designed to evaluate treatment response in terms of symptom relief and functioning, as well as treatment tolerability. part 1 of the survey is to be completed when the patient presents with new relapse of ms. part 2 of the survey is to be completed 1 month (± 1 week) after initiation of treatment for relapse of ms. treatment for relapse will be at the sole discretion of the investigator.


Eligibility criteria:
inclusion criteria: * informed consent and hipaa authorization must be obtained from the patient prior to any study-related procedures. * patient is ≥ 18 years of age at the time of participation * patient has confirmed ms relapse. * patient must have been treated with oral or iv corticosteroids for their previous relapse. * willingness to comply with all procedures and assessments. exclusion criteria: * patient has pseudorelapse. * patient was treated with any therapies other than corticosteroids for their previous relapse. * any other condition which, in the opinion of the investigator, would not allow proper completion of this study.

Keywords: relapse in multiple sclerosis psychometric properties of the patient self-report questionnaire evaluation of arms questionnaire
telephone-delivered exercise for multiple sclerosis fatigue

Conditions: Multiple Sclerosis; Fatigue; Physical Activity

Summary: multiple sclerosis (ms) is a progressive demyelinating disorder that damages white matter in the central nervous system. although individuals experience mobility (e.g., walking, balance) impairments that lower quality of life and limit participation in daily activities, one of the most prominent symptoms is fatigue. up to 92% of individuals report fatigue that manifests as lack of energy, exhaustion or worsening of ms symptoms and ultimately contributes to increasing disability. the currently available pharmaceutical treatments fail to fully control fatigue in the majority of individuals with ms; non-pharmacologic therapies such as exercise and behavioral therapies offer the best hope for combating ms fatigue in the majority of individuals. exercise therapy is effective in reducing ms fatigue. however, access to exercise therapy is seriously limited for many individuals with ms due to geographical location, limited resources (e.g., financial, transportation), and/or disability. thus, the development and evaluation of an alternative delivery method for exercise therapy to target ms-related fatigue that increases participation and reduces barriers is critical. in this study, the investigators will compare traditional in-person delivered exercise therapy to telephone-delivered exercise therapy to target fatigue in persons with ms.


Eligibility criteria:
inclusion criteria: * diagnosis of rrms, spms, or ppms * ambulatory for at least 5 minutes at a time * self-reported fatigue on fatigue severity scale * able to follow study-related commands * able to attend study appointments exclusion criteria: * ms exacerbation within the past 30 days * evidence of another neurological disorder or orthopedic disorder that would interfere with exercise participation * acute illness or injury that prevents participation in the intervention * pregnancy
pulse diagnosis and anemia: exploring integrated traditional chinese and western medicine approaches

Conditions: Moderate to Severe Anemia; Traditional Chinese Medicine (TCM); Pulse Diagnosis

Summary: this observational study evaluates the efficacy and safety of integrated traditional chinese medicine (tcm) and western medicine in managing moderate to severe anemia. the study examines hemoglobin (hb) level improvements and correlations with tcm pulse diagnosis parameters at six diagnostic positions (right and left chung, guan, and chi). conducted at taichung tzu chi hospital, it aims to explore tcm's role as a complementary approach to anemia care while maintaining a focus on patient safety and integrated diagnostic techniques.

the study included 28 patients with moderate to severe anemia (hb \< 10 g/dl) treated between february 26, 2021, and december 31, 2022. participants were divided into two groups: those receiving tcm-based interventions (herbal formulations tailored to address systemic imbalances) and those following standard western medicine protocols. data collection involved monthly monitoring of hb levels and pulse diagnosis parameters using the huang-t1 sphygmograph, which provided detailed insights into frequency-domain and waveform-derived characteristics. primary outcomes included hb level improvements and safety assessments, while secondary outcomes focused on the correlations between pulse parameters and hematological changes. results indicated consistent hb improvements in the tcm group, with notable trends observed in pulse diagnosis correlations. these findings highlight tcm's potential as a diagnostic and therapeutic adjunct in anemia care, emphasizing its role in bridging traditional and modern medical practices. the study adheres to ethical guidelines, with approval from the taichung tzu chi hospital research ethics committee (approval number: rec109-61). all participants provided written informed consent prior to study inclusion. future directions include larger-scale studies and randomized controlled trials to further validate findings and expand their clinical applicability.

Eligibility criteria:
inclusion criteria: * confirmed diagnosis of moderate to severe anemia (hb \< 10 g/dl). * age between 18 and 90 years. * willingness to provide informed consent and comply with study procedures. * ability to attend monthly follow-up visits and provide clinical data for analysis. exclusion criteria: * presence of psychiatric disorders affecting compliance. * significant organ diseases, such as chronic obstructive pulmonary disease, advanced liver disease, or heart failure. * pregnancy or lactation. * concurrent participation in other clinical trials or use of investigational drugs within the past 30 days. * non-compliance with follow-up schedules or study protocols.
the role of 18f-fdg-pet/ct scan in lung cancer patients

Conditions: Lung Cancer

Summary: describe strengths and limitations of fdg pet/ct for staging. evaluate the utility of pet/ct in assessment of therapy response and restaging

lung cancer is one of the most common cancers and it represents the main cause of cancer mortality worldwide. it is histopathological classified into main groups: small cell lung cancer (15%) and non-small cell lung cancer (85%). nsclcs are generally subcategorized into adenocarcinoma, squamous cell carcinoma (sqcc), and large cell carcinoma. positron emission tomography (pet) is now an important cancer imaging tool, both for diagnosis and staging, as well as offering prognostic information based on response. pet sets the gold standard in the evaluation of an indeterminate solitary pulmonary nodule or mass, where pet has proven to be significantly more accurate than computed tomography (ct). for nsclc chest ct is the standard imaging modality for assessing primary tumor size and identifying its margins. pet-ct may be helpful in assessing a nodule located in same lobe. it can also provide information on parietal or mediastinal involvement. pet is useful for differentiating tumor tissue from atelectasis, which may be helpful if radiotherapy is planned to determine the target volume . in the evaluation of metastatic spread to loco-regional lymph nodes, pet is significantly more accurate than ct, so that invasive surgical staging may be omitted in many patients with negative mediastinal pet images. in patients with positive mediastinal pet images, invasive surgical staging remains mandatory because of the possibility of false-positive findings due to inflammatory nodes or granulomatous disorders. forty percent of patients with nsclc have distant metastases at presentation, most commonly in the adrenal glands, bones, liver, or brain . in the search for metastatic spread, pet is a useful adjunct to conventional imaging. this may be due to the finding of unexpected metastatic lesions or due to exclusion of malignancy in lesions that are equivocal on standard imaging. however, at this time, pet does not replace conventional imaging. the diagnostic accuracy of initial pre-therapy pet-ct results in improved staging, and thus is of high prognostic value. many studies conducted the value of using semi-quantitative measures as metabolic tumor volume (mtv) and total lesion glycolysis (tlg) in predicting prognosis and survival rather than the traditional method of measuring standard uptake value (suv). several studies have demonstrated that pet imaging proves useful for assessing the response to chemo therapy or targeted therapy in patients with metastatic nsclc.

Eligibility criteria:
inclusion criteria: * patients with pathologically proven lung cancer and referred to nuclear medicine unit to perform pet/ct for staging and patient referred for assessment of response of therapy and re staging. exclusion criteria: * pregnant women. * patients unable to sleep in a fixed position for 20 minutes. * severely ill patients who aren't capable of complying with study procedures or comatose patients. * patients with known second primary
precision pain management for major abdominal surgery in colorectal surgery

Conditions: Colorectal Cancer; Diverticular Disease; Crohn Disease; Ulcerative Colitis

Summary: the primary objectives of this study are to evaluate the potential for preoperative pharmacogenomics (pgx) testing to positively influence postoperative opioid use through visual analog scale (vas) guided administration of narcotic equivalent and lower pain scores as measured by obas in patients undergoing major abdominal surgery.


Eligibility criteria:
inclusion criteria: * subject capable of giving consent * age 18-80 * scheduled for open colorectal resection at cleveland clinic main campus (with preoperative appointment scheduled at least five days before date of surgery) exclusion criteria: * patient does not speak english * patient with substance-use disorder (including alcohol) * patient diagnosed with major depression * patient currently taking opioids * previous long-term opioid use (\> 3 months) * previous opioid use with a dose of \>100 milligram morphine equivalent (mme) * patient has pain-related disorder (e.g. fibromyalgia, sympathetic dystrophy, etc.) * documented allergy to pain medication

Keywords: pain management pharmacogenomics
relationship between intracranial blood flow and peripheral perfusion in patients with craniocerebral injury

Conditions: Brain-injury; Intracranial; Blood Vessel, Injury

Summary: neurocritical care is a major branch in the field of critical care medicine, and more than 50% of the neurocritical care patients in the tibet autonomous region people's hospital (tarph) are in neurocritical care, of which cranial damage accounts for about 30%, and paroxysmal sympathetic hyperexcitability syndrome (psh) after traumatic brain injury（tbi）is a common complication, which affects the cardiorespiratory and cerebral functions to varying degrees, and optimizing the cerebral perfusion and oxygenation supply is the key point in the treatment of tib, and the maintenance of the cerebral homeostasis and the functional homeostasis is currently an international hotspot for treatment. maintaining cerebral homeostasis and body function homeostasis is an international hotspot in the treatment of tib. this study intends to elaborate on the relationship between psh and intracranial blood flow in patients with tbi, as well as the effect of anti-stress treatment on intracranial blood flow. implementation patients with brain injury admitted to our department from january 2021 to january 2022 were included. non-invasive transcranial doppler ultrasound was applied to measure cerebral blood flow, non-invasive local cerebral oxygen saturation monitor to measure local cerebral oxygen saturation, and an electroencephalography bispectrometer to measure bis score to quantify the depth of sedation during the experimental process. bedside ultrasound monitored the right heart function and lung water status, and the data of each monitoring index were monitored and recorded throughout the whole process, and the relationship between concomitant psh and intracranial blood flow in tbi patients was found according to the statistical analysis. ultimately, to achieve the control of tbi complications and improve patient rescue. to expect to achieve the purpose of improving the prognosis of tbi patients.


Eligibility criteria:
inclusion criteria: * craniocerebral injury patients; * the middle cerebral artery blood flow spectrum can be clearly displayed with a bedside tcd; exclusion criteria: * age under 18 years; * history of cardiovascular disease such as coronary artery disease, heart failure, or atrial fibrillation; * presence of severe valvular disease or ejection fraction (ef) \<30%; * chronic lung disease; * chronic liver failure or renal insufficiency; * persons with co-morbidities of malignant neoplasms; * persons who had co-morbidities with acute and chronic infectious diseases prior to craniocerebral injuries; * women who were pregnant and breastfeeding; * history of psychiatric disorders; * history of drug abuse or alcohol misuse; * history of β-blockers; * co-morbidities with spinal cord injuries; and persons who had died or been discharged from hospital within 1 week of hospitalization or who had not been able to obtain a clear image with ultrasonography.