Kornimate/medical-research-clean huggingface dataset:
rural ct examination and thrombolytic treatment for stroke

Conditions: Stroke

Summary: to counteract long term sequelae from stroke, ultrarapid diagnosis and treatment, high quality multidiciplinary in-hospital care and optimal long term rehabilitation is required. in this study, the investigators are moving the essential first diagnosis and treatment out into the community close to where the patient live, thus shortening the all important time from debut of symptoms to thrombolytic treatment improving the prognosis of stroke patients.

stroke is an acute, potentially mutilating disease. to counteract long term sequelae three factors are essential: ultrarapid diagnosis and treatment, high quality multidiciplinary in-hospital care and optimal long term rehabilitation. initial diagnosis and treatment has up to now been completed within the hospital domain. this study will change that: moving the essential first diagnosis and treatment out into the community close to where the patient lives thus shortening the all important time from debut of symptoms to thrombolytic treatment. we will operate a local computer tomography (ct) service in the hands of community based non-specialized health care personnel (md and nurse) acting under direct telemetric guidance from on call hospital specialists. thus, the investigators will show that by combining current technological advances in real time video communication with an acutely well functioning cooperation between the community and hospital health service personnel the prognosis of stroke patients is improved.

Eligibility criteria:
inclusion criteria: 1. patients over 18 years being investigated by ct within 24 hours for acute symptoms of stroke. 2. fullfilling criteria for the diagnosis acute stroke as described by the norwegian stroke registry. 3. giving informed consent. exclusion criteria: 1. symptoms not due to ischaemic or haemorrhagic stroke as adjudicated at discharge. 2. not able to cooperate to 3 months follow up. 3. not giving informed consent

Keywords: stroke, thrombolysis, rural ct
regional prophylactic vancomycin with restricted tourniquet time in primary total knee replacement

Conditions: Arthropathy of Knee Joint

Summary: the purpose of this study is to determine whether or not giving a lower dose of antibiotics (vancomycin) in the area where it is needed (the knee joint) is more effective at obtaining adequate tissue levels of the antibiotic than the current standard dose which is given intravenously (iv) through a wrist vein. the use of intraosseous regional administration (iora) of vancomycin requires the use of a tourniquet for the duration of the procedure. many surgeons prefer to perform the surgery with tourniquet use minimised or without a tourniquet at all. the aim of this study is to evaluate whether iora vancomycin can achieve effective tissue concentrations with tourniquet use minimised.

patients are assigned to one of two groups by chance (like a coin toss): group a - will receive 15mg/kg based on actual body weight (maximum of 2g) of vancomycin via the systemic route at a rate of 15mg/kg as per hospital guidelines. systemic iv vancomycin is given via a forearm vein, given over an infusion timed to finish immediately prior to surgery. group b - will have the limb exsanguinated and an above knee tourniquet inflated to 300 mmhg. immediately following tourniquet inflation, group b will receive 500mg of vancomycin, via an ez-io intraosseous cannula. the vancomycin would be administered in 150ml of saline solution. the intraosseous cannula would be placed into the epiphysis of the proximal tibia. the tourniquet will be left inflated for 10 minutes following completion of the iora injection then deflated. both groups will receive weight-based dose of systemic cefazolin ( or alternative antibiotic if allergic to cefazolin 15 minutes prior to inflation of tourniquet. this ensures all patients in the study receive effective antibiotic prophylaxis regardless of randomization. both groups of patients would then undergo routine prep and draping for both groups, total knee replacement would then be carried out as normal and the tourniquet will be inflated for cementation of the implants. tissue samples ten (10) tissue samples will be taken from each patient, 6 'fat' samples and 4 'bone' samples. each sample is very small, around the size of a pinhead. bone samples will be taken from the femur only to ensure no direct contamination from the site of injection (tibia) in addition, drain samples will be taken from the intra-articular drain site to measure vancomycin concentration the morning following surgery. three blood samples will be taken in both groups, intraoperatively, in recovery, and the following morning. these samples are frozen and sent to a lab for analysis.

Eligibility criteria:
inclusion criteria primary total knee arthroplasty for osteoarthritis informed consent given exclusion criteria current or treatment with iv vancomycin within preceding 7 days previous hypersensitivity to vancomycin significant cardiac or respiratory abnormality patient has contraindications to io vascular access using the ez-io
use of poc pocket ultrasound in the estimation of left and right atrial pressures

Conditions: Heart Failure; Acute Decompensated Heart Failure

Summary: this study will assess the reliability of poc ultrasound in estimating right and left atrium pressures in patients with acute decompensated heart failure. this study will compare hemodynamic measurements obtained from pulmonary artery catheters with those estimated from poc ultrasound using inferior vena cava (ivc) measurements and the presence of atrial septal bulge.

for those patients admitted to the ccu who have pulmonary artery catheters placed by the primary team as part of their medical care, the investigators will collect hemodynamic data from their pulmonary artery catheters and echocardiographic data. echocardiographic and hemodynamic data obtained from pulmonary artery catheters will be simultaneously collected at baseline (within 24 hours of catheter placement) and after 24 and 48 hours of intensive medical therapy if the pulmonary artery catheter is still in place at those times. the placement of the pulmonary artery catheter and the taking of hemodynamic measurements from the catheter will be done as per the primary medical team. the research team will not place any pulmonary artery catheters.

Eligibility criteria:
inclusion criteria: * patients with advanced systolic heart failure (as defined by left ventricular ejection fraction of less than or equal to 35% and new york heart association class iii to iv symptoms) who are admitted to the ccu and require hemodynamic monitoring with a swan-ganz catheter. exclusion criteria: * patients supported by mechanical ventilation (intubation or positive pressure ventilation) * patients requiring temporary mechanical circulatory support devices (intra-aortic balloon pump, impella, centrimag, extracorporeal membrane oxygenation) * patients requiring permanent mechanical circulatory support devices (right or left ventricular assist devices) * post-cardiac transplantation patients.

Keywords: echocardiography pulmonary artery catheter point of care ultrasound
assessment of musculoskeletal pain and psychosocial status of athletes

Conditions: Pain

Summary: the sporty performance exhibited by an athlete faces physiological, biomechanical and psychological activity of the athlete. it depends on both the psychological state and the elevation of the musculoskeletal system to a certain level so that the athlete can perform optimally and excellently. for this reason, we aimed to evaluate the musculoskeletal system pain of amateur and professional athletes in different disciplines and the psychosocial states such as sports confidence, depression and quality of life.

this study consists of 80 amateur and 80 professional sportsmen who are participating in sports by doing sports in soccer, basketball, volleyball, athletics, table tennis, field tennis, folk dances, kickboxing and archery branches between the ages of 15 and 36. the expanded scandinavian muscle skeleton questionnaire (nmq) and visible analogue scale (vas) will be used to identify and assess the symptoms of musculoskeletal discomfort as 'pain'. the participant will be evaluated with the algometer, the sporty trust will be questioned with the sporty trust continuous inventory, and the quality of life will be assessed with the world health organization quality of life scale short form and depression will be evaluated with beck depression inventory.

Eligibility criteria:
inclusion criteria: * the athletes and their coaches must be voluntary and willing. * during the evaluation, the athletes must give careful and relevant answers to the measuring instruments. * they have to actively run the sport they belong to. exclusion criteria: * having undergone a surgical operation due to sports injuries in the last 3 weeks * the athletes do not want to answer the surveying instruments

Keywords: musculoskeletal system pain athlete psychosocial problems algometer
gls-1027 for the prevention of severe pneumonitis caused by sars-cov-2 infection (covid-19)

Conditions: Pneumonitis; SARS-CoV Infection

Summary: this clinical trial will evaluate the safety, tolerability and efficacy of gls-1027 in the prevention of severe pneumonitis caused by sars-cov-2 infection

this phase ii randomized, double-blind, placebo-controlled, study will assess 2 different doses of gls-1027 in the prevention of severe pneumonitis among those hospitalized with pcr confirmed sars-cov-2 infection. subjects will be randomized at a 1:1:1 ratio to either standard of care (soc) plus placebo, or soc plus gls-1027 at either 120 mg or 360 mg daily. clinical status will be monitored through 56 days from the initiation of treatment.

Eligibility criteria:
inclusion criteria: * age 18 years or older * able to provide consent * able and willing to comply with study procedures * diagnosis of pcr confirmed sars-cov-2 * enrollment within 72 of hospitalization * who covid-19 classification level 3 or 4 exclusion criteria: * pregnant or lactating * need for mechanical ventilation, non-invasive ventilation (niv), or high-flow o2 (≥60%) via face mask * calculated gfr \< 60 (cockcroft-gault) * meets treatment algorithm criteria for treatment with a non-study immune modulator * pre-study or planned treatment with a non-study immune modulator * participation in a covid-19 clinical trial that includes prescription of a drug with anti-cytokine activity * status post transplantation of an organ, bone marrow, or body part * treatment within the past 60 days with a chemotherapeutic agent * diagnosis of leukemia or lymphoma * who covid-19 classification level of 5 or greater * unable to take oral medication * grade 3 or greater laboratory abnormalities as characterized by ctcae v5

Keywords: covid-19
logistic regression and elastic net regularization for the diagnosis of fibromyalgia

Conditions: Fibromyalgia

Summary: this study will utilize ultrasound image texture variables to construct an elastic net regularized, logistic regression model to differentiate between healthy and fibromyalgia patients. the collected ultrasound data will be from participants who are healthy, and from participants who have fibromyalgia. the predicted performance accuracy of the diagnostic model will be validated and this will confirm or deny the hypothesis that differentiation between the two cohorts is possible.

fibromyalgia (fm) diagnosis remains a challenge for clinicians due to a lack of objective diagnostic tools. one proposed solution is the use of quantitative ultrasound (us) techniques, such as image texture analysis, which has demonstrated discriminatory capabilities with other chronic pain conditions. the investigators propose the use of us image texture variables to construct an elastic net regularized, logistic regression model, for differentiating between the trapezius muscle in the healthy and fm patients. 162 ultrasound videos of the right and left trapezius muscle were acquired from healthy participants and participants with fm. the videos will then be put through a mutli-step processing pipe including converting them into skeletal muscle regions of interest (roi). the roi's will be then filtered by an algorithm utilizing the complex wavelet structural similarity index (cw-ssim), which removes roi's that are too similar to one another. eighty-eight texture variables will be extracted from the roi's, which will be used in nested cross-validation to construct a logistic regression model with and without elastic net regularization. the generalized performance accuracy of both models will be estimated and confirmed with a final validation on a holdout test set. depending on the predicted, generalized performance accuracy it will be validated or not by the final, holdout test set (confirming the model construction is accurate). these models should then confirm or deny the hypothesis that a regularized logistic regression model built on ultrasound texture features can accurately differentiate between healthy trapezius muscle and that of patients with fm.

Eligibility criteria:
inclusion criteria: * gender independent; chronic widespread pain, fitting the 2016 fm criteria, absence of myofascial pain syndrome trigger points and between the ages of 20 and 65 years (44.3 ± 13.9 years). * healthy asymptomatic volunteers who were age matched (n = 17) with no physical complaints or abnormality on physical examination also participated. exclusion criteria: * participants were excluded if they demonstrated clinical evidence of another cause for widespread pain, such as polymyositis, dermatomyositis, endocrine disorders, etc. none of the participants had performed any physical exercise during the two to three days prior to entry into the study.

Keywords: fibromyalgia ultrasound regularization logistic regression imaging
barriers to cervical cancer screening

Conditions: Cervical Carcinoma

Summary: this study evaluates barriers to cervical cancer screening among non-compliant women.

primary objective: i. to further identify barriers to cervical cancer screening in women, we will identify non-compliant patients and survey them to better understand barriers that have led to inadequate screening. outline: this is an observational study. participants complete a survey on study.

Eligibility criteria:
inclusion criteria: * women between the ages of 21-65 * non-compliant for cervical cancer screening within mayo clinic primary care exclusion criteria: * women less than 21 or older than 65 * complaint for cervical cancer screening within mayo clinic primary care * women who decline participation
pharmacokinetically-driven dosing of mycophenolate mofetil for the treatment of pediatric proliferative lupus nephritis

Conditions: Lupus Nephritis

Summary: meta-analyses in adults suggest equivalence of clinical efficacy of intravenous cyclophosphamide and mycophenolate mofetil when dosed based on patient weight or body-surface-area (mmfbsa), as is the current standard for the treatment of proliferative lupus nephritis (ln) treatments in the u.s. pharmacokinetically-guided precision dosing of mmf (mmfpk) may offer a beneficial modification of the current standard treatment in that mmkpk promises over 30% higher ln response rates than mmfbsa. the objective of the proposed randomized, controlled study is to compare the efficacy and safety of pharmacokinetically-guided precision dosing of mmf (mmfpk) with conventional dosing regimens of mmf (mmfbsa) among children with proliferative ln.


Eligibility criteria:
inclusion criteria: new diagnosis with proliferative ln based on kidney biopsy done within 4 weeks of enrollment diagnosis with childhood-onset sle (csle) as per the acr criteria95, 96 age 8 - 17 years at the time of enrollment96 tolerates oral mmf exclusion criteria: perceived or stated inability to adhere to study protocol, lack of use of highly effective birth control method. presence of csle features that a-priori suggest that the patient benefits from other therapy than that suggested by the study protocol, history of significant kidney disease prior to the diagnosis with csle, need for renal replacement therapy at the time of enrolment, concurrent therapy with cyc or rituximab.
the use of ligasure (r) for hydrocelectomy surgery

Conditions: Hydrocele

Summary: hydrocele is a condition of fluid retention around the testes, which causes swallowing, pain, with interfering with the normal testes function. however, during activity, this can interfere with everyday activity (running, sexual intercourse). the treatment for hydrocele i surgical. the study aim to test the safety and efficacy of the ligasure (r) device for cutting and coagulating tissues during hydrocelectomy.

hydrocele is a condition of fluid retention around the testes, which causes swallowing, pain, with interfering with the normal testes function. however, during activity, this can interfere with everyday activity (running, sexual intercourse). the treatment for hydrocele i surgical. the study aim to test the safety and efficacy of the ligasure (r) device for cutting and coagulating tissues during hydrocelectomy. during the study, males, 18 - 81 who suffer from hydrocele underwent hydrocelectomy using ligasure (20 cm) without using sutures.

Eligibility criteria:
inclusion criteria: * 18 - 81 males * diagnosed with unilateral hydrocele exclusion criteria: * bilateral hydrocele * infected hydrocele * hydrocele secondary to tumor
investigation of the efficacy of treatments with backup device in spine pathologies

Conditions: Spine Disease; Back Pain; Disc Herniation

Summary: our aim in this study is to examine the effectiveness of the backup spine health device in spinal problems and compare it with traditional physical therapy methods.

the investigators study was planned as a randomized controlled study. participants will be divided into 2 groups as conventional physiotherapy and backup group by simple randomized method. participants will be taken to a treatment program for 12 weeks, 3 days a week. parameters such as pain, posture, sleep quality, quality of life, muscle shortening at the beginning and end of the study. the results will be analyzed statistically.

Eligibility criteria:
inclusion criteria: * being between the ages of 20-60 * sick individuals with spinal problems * persons who have filled out the consent form exclusion criteria: * people with spinal pathology for whom physiotherapy is contraindicated * having a neurological problem

Keywords: backup physiotherapy
impact of amyloidosis on tavi patients

Conditions: Valve Stenoses, Aortic; Amyloidosis Cardiac

Summary: to analyze the prevalence and impact on the prognosis of amyloidosis due to transthyretin in patients with severe aortic stenosis who undergo percutaneous aortic valve implantation.

type and design of the study: multicentric, prospective cohort, observational. number and characteristics of the patients: 321 patients to whom tavi has been implanted due to severe degenerative as. duration of the study * recruitment period: all consecutive patients undergoing a non-invasive diagnostic study of amyloidosis (scintigraphy with technetium pyrophosphate99 and blood protein electrophoresis) will be recruited before discharge, in centers with proven experience, will accept non-invasive diagnosis with resonance) and have an implanted percutaneous aortic prosthesis for severe aortic stenosis. * follow-up period: clinical and echocardiographic follow-up will be carried out before discharge, in consultation at three, six, twelve and twenty-four months. inclusion: 1 year follow up: 2 years data analysis: 6 months total: 3 years and 6 months events * main event: cardiovascular events (cardiovascular death, stroke, infarction) * secondary events: death from any cause, readmission due to heart failure, pacemaker implantation, functional class evaluation countries and participating centers: various spanish and international centers will be invited to participate.

Eligibility criteria:
inclusion criteria: * aortic valve replacement with a percutaneous prosthesis due to severe aortic stenosis after evaluation by the heart team. * ability to understand and sign informed consent. * they do not meet any of the exclusion criteria. exclusion criteria: * death as a complication of the procedure during hospitalization. * associated mitral valve disease requiring intervention * tavi valve-in-valve implant. * does not sign informed consent.

Keywords: tavi aortic stenosis cardiac amyloidosis
weight loss counseling for african american women who are breast cancer survivors

Conditions: Breast Cancer; Obesity; Weight Changes

Summary: rationale: a culturally sensitive weight loss program for obese african american breast cancer survivors may be more effective than a standard weight loss program in helping women lose weight. purpose: this randomized clinical trial is studying personalized weight loss counseling to see how well it works in african american women who are breast cancer survivors.

objectives: * to develop a weight loss intervention for obese african american women who are breast cancer survivors. outline: this is a randomized study. participants are randomized to 1 of 2 intervention groups. * group 1: participants receive traditional individual dietary and exercise counseling in combination with the weight watchers weight loss program for 18 months. * group 2: participants receive individual dietary and exercise counseling in combination with the weight watchers weight loss program as in group 1. they also receive spiritual counseling that incorporates meditation, readings, and the recording of thoughts into a long-term weight management program. the program addresses coping with stress, setting priorities, dealing with emotional issues that trigger old behavior patterns, and developing accountability for following desired diet and exercise patterns.

Eligibility criteria:
disease characteristics: * diagnosis of breast cancer within the past 5 years * stage i-iiia disease * no recurrence of cancer * identified as african american * body mass index 30-40 * hormone receptor status not specified patient characteristics: * menopausal status not specified * stable body weight * not currently following a special diet * no uncontrolled congestive heart failure, untreated hypertension, disabling osteoarthritis, drug or alcohol abuse, or psychiatric conditions that may interfere with counseling prior concurrent therapy: * more than 3 months since prior chemotherapy or radiotherapy

Keywords: weight changes obesity stage i breast cancer stage ii breast cancer stage iiia breast cancer
radiologic features of invasive pulmonary aspergillosis

Conditions: Hematologic Disease; Solid Organ Transplantation

Summary: invasive pulmonary aspergillosis (ipa) is an opportunistic infection that primarily affects recipients of solid organ transplants (sots) and patients with chemotherapy- induced neutropenia.although both of these populations are at high risk for ipa, they differ with regards to the specific defects in host defense mechanisms that increase their risk for ipa. chemotherapy- induced neutropenia is the principal defect affecting patients with hematologic malignancies, whereas transplant recipients tend to have dysfunctional t cells and phagocytes, as a result of immunosuppressive drug therapy. thus, the patterns of ipa-related infection and inflammation may differ according to the type of underlying immune defect. although the clinical and radiological features of ipa in patients with neutropenia have been extensively studied, little is known about the characteristics of ipa in sot recipients. the investigators therefore compared the ipa- related clinical and radiological findings in sot recipients with those of neutropenic patients.


Eligibility criteria:
inclusion criteria: * ipa cases with solid organ transplant recipients and hematologic disease patients * proven and probable invasive pulmonary aspergillosis by modified eortc/msg criteria exclusion criteria: * under 16 years old * possible cases of invasive pulmonary aspergillosis

Keywords: invasive pulmonary aspergillosis solid organ transplantation hematologic disease