Kornimate/medical-research-clean huggingface dataset:
mutations of the pre-core region of hepatite b virus (hbv)

Conditions: Hepatitis B Virus

Summary: hepatitis b virus (hbv) infection constitutes a major public health threat worldwide. a total of 92 patients with hbeag-negative chronic hepatitis b infection were recruited at amiens university hospital. the diagnostic workup included a physical examination.in conclusion, the study results confirmed that the hbv dna level is associated with liver fibrosis status and that hbv viral load is strongly correlated with bcp and pc mutations, and it demonstrated that the impaired base pairing 1858-1896 mutations at the base of the bulge in the e encapsidation signal is independently associated with high serum hbv dna levels.

the progression of liver disease in hepatitis b virus (hbv) infection is fostered by active virus replication. mutations in the basal core promoter (bcp) and precore (pc) regions of the hbv genome are known to have an impact on viral replication. the aim of the present study was to assess the correlation of mutation profiles in the bcp and pc regions with the viral load in hbeagnegative chronically infected patients. the hbv genotype, bcp/pc mutations, serum hbv dna levels, and associated serological markers were analyzed in 92 hbeagnegative chronically infected patients.

Eligibility criteria:
inclusion criteria: * patients included will be chronic carriers (hbsag + for more than 6 months) of hbv, with detectable serum viral load greater than or equal to 100 iu / ml, included in the queue followed by drs. dominique capron and eric n'guyen-khac. these patients will not be on anti-hbv treatment. exclusion criteria: * patients under 18 years old * patients with their hepatitis b * patients with hbv viral load undetectable or less than 100 iu / ml. * immunosuppressive treatments such as corticosteroids or other * the co-infection with the hepatitis c and / or hiv virus * patients with cancer

Keywords: mutations infected patients
folic acid supplementation in women of child bearing age

Conditions: Obesity

Summary: the objective of this study is to identify genes whose expression is potentially modifiable due to changes in folate intake and help delineate mechanisms accounting for the variability in individual response to folic acid supplementation. the study will be conducted in normal weight and obese women of childbearing age, supplemented for 8 weeks with 800 mcg/day folic acid. it is hypothesized that (1) a change in folate status, induced by the supplementation, will influence the dna methylation of specific genes and (2) the dna methylation response to folic acid supplementation may differ between the normal weight and the obese women of childbearing age.

this study will be conducted in two phases. an initial screening study will be performed to determine folate status, mthfr677 genotype and body composition of potential participants of the intervention study. both folate status and mthfr677 genotype are known independent predictors of response to folic acid supplementation. blood samples will be collected, after an overnight fast, for determination of serum folate concentration and for mthfr677 genotyping. body composition and 24-hr dietary recalls will also be conducted during the screening visit. the second phase is an eight week supplementation trial with 800 mcg/day folic acid. screened individuals determined to have a serum folate \< 30 nmol/l (\< 50th percentile of nhanes 1999-2004) and of the cc or ct genotype (for mthfr677) will be eligible for inclusion in the supplementation trial. participants will be instructed to avoid dietary supplements, fortified ready-to-eat cereals, and other high folate content foods during intervention. blood samples will be collected, after an overnight fast, at baseline and after 4 and 8 weeks of supplementation for determination of primary (dna methylation profile) and secondary (nutritional, metabolic and health status biomarkers) outcome measures.

Eligibility criteria:
inclusion criteria: * screening phase: * female 18-40 yr * body mass index 18.5 to 24.9 or \> 30 kg/m2 * intervention study: * serum folate \< 30 nmol/l * mthfr677cc or mthfr677ct genotype exclusion criteria: * currently pregnant, pregnancy within past 12 months * greater than 2 previous pregnancies * use of prescription drugs other than oral contraceptives * chronic disease (diabetes, hypertension,epilepsy,cancer, kidney disease, cvd) * acute illness (pneumonia, urinary tract infection, mononucleosis) * use of antibiotics in past 30 days * current smoker * use of dietary supplements including multivitamins in past 30 days * habitual consumption of fortified ready-to-eat cereals * significant weight change in past 12 months * typical alcohol consumption of 2 or more drinks per day * intervention: all above plus serum folate \> 30 nmol/l; mthfr677tt genotype

Keywords: folate status folate biomarkers
nirs vs tcd for cerebrovascular autoregulation during non-cardiac surgery

Conditions: Cerebrovascular Circulation

Summary: postoperative neurocognitive disorders (ncd) are of high priority in perioperative management. the risk of suffering from ncd after surgery may be increased due to perioperative impairment of cerebrovascular autoregulation and thereby inadequate cerebral perfusion. cerebrovascular autoregulation refers to the ability of cerebral arterioles to ensure constant cerebral blood flow independently of fluctuations in systemic blood pressure. cerebrovascular autoregulation can be measured based on mean arterial pressure (map) and a surrogate for cerebral blood flow using the correlation method. until today, measurement of cerebral blood flow velocity assessed with transcranial doppler sonography (tcd) is most commonly used as a non-invasive surrogate for cerebral blood flow. alternatively, cerebral oxygenation measured with near-infrared spectroscopy (nirs) can be used as another surrogate. the study includes three substudies: 1. to compare nirs and tcd for the assessment of perioperative cerebrovascular autoregulation in patients undergoing major non-cardiac surgery with an increased risk of bleeding. 2. to compare map for optimal cerebrovascular autoregulation before induction of general anesthesia with map for optimal cerebrovascular autoregulation during or after general anesthesia. 3. to analyze the association between the time-weighted average map below the map for optimal cerebrovascular autoregulation and postoperative ncd.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years * elective surgery with a minimum duration of 120 minutes * general anesthesia * expected blood loss \> 500 ml exclusion criteria: * temporal bone window failure * cerebrovascular disease * cardiac surgery * neurosurgery

Keywords: postoperative neurocognitive disorders postoperative delirium near-infrared spectroscopy transcranial doppler sonography non-cardiac surgery
use of the scolioscan for quantitative evaluation of spinal deformity - a validity study on patients with scoliosis

Conditions: Scoliosis

Summary: the purpose of the study is to investigate the validity of scolioscan for quantitative assessment of curve severity in scoliosis using x-ray radiographs as the gold standard.

scoliosis is a three dimensional spinal deformity, in both the coronal plane, sagittal and transverse planes. quantitative assessment of curve severity in scoliosis is important for patient management. at present, cobb angle measurement in the frontal plane using standing postero-anterior x-ray radiograph is the gold standard for scoliosis evaluation. taking x-ray involves irradiation and is not without risk especially over repeated exposures for follow-up visits. with advancement of ultrasound technology which is radiation-free and noted to be useful as a tool for musculoskeletal imaging, an ultrasound system designed for evaluation of spinal deformity called scolioscan has been developed. it comprises of a freehand 3d ultrasound imaging system with an enhanced frame structure for supporting the patient to maintain the posture during scanning and a software for measuring curve deformity in terms of cobb angles. previous studies on validity of ultrasound assessment for back deformity involved a pilot group of subjects. based on these promising pilot results, we plan to carry out a formal study to investigate the validity of scolioscan for quantitative assessment of curve severity in scoliosis using x-ray radiograph as the gold standard for comparison.

Eligibility criteria:
inclusion criteria: * scoliosis patients between 8-40 years old * patients with body mass index (bmi) \<23 kg/m2 * patients with standing height between 1 m - 2 m exclusion criteria: * pregnant women or women after pregnancy before return of the menstrual period. * subjects with skin disease such as skin cancer, psoriasis or a history of skin disease * subjects with fracture or wound that affect application of the probe of scolioscan during scanning * subjects with ferromagnetic implants * subjects with pacemakers, implanted pain modulators, implanted insulin delivery systems, cochlear implant, and any defibrillator * subjects with surgery done for the spine * subjects with winged scapula or other irregularity of back contour that precludes satisfactory skin contact of the machine probe during the scanning procedure * subjects who cannot stand steadily on the device during the examination * subjects with allergy to aqueous gel used for ultrasound scanning

Keywords: scoliosis spinal deformity cobb angle assessment ultrasound
short and medium term postoperative complications after hallux valgus surgery

Conditions: Hallux Valgus

Summary: the aim of this study is to make a precise inventory of the complications that may occur postoperatively in the more or less long term in a cohort of patients who should benefit from surgical management of hallux valgus.

hallux valgus surgery is one of the most common foot surgeries. the surgical procedure itself has evolved a lot and is now, in almost all cases, on an outpatient basis with greatly improved pain management. however, various postoperative complications, more or less severe and more or less long term, can worsen the final result. the literature describing these complications comes mainly from meta-analysis, retrospective studies or studies targeting a particular type of complications. as a result, there are few complete and objective descriptions of these complications. in addition, studies reporting postoperative consequences always assess the "serious" long-term complications responsible for a poor functional outcome, primarily the recurrence of the initial deformity, defined as surgical failure. it seemed relevant to try to assess early complications, "less serious", not necessarily worsening the final result but directly impacting the postoperative recovery period. the evaluation of this recovery period and the length of time off work based on these "less severe" complications could improve the quality of surgical management of hallux valgus. this is why it seemed interesting to carry out a precise inventory of the complications that may occur postoperatively in the more or less long term in a cohort of patients.

Eligibility criteria:
inclusion criteria: * patient with medical insurance. * patient who recieved information about study and signes a consent to participate in the study. * major patient requiring surgical management of a hallux valgus. exclusion criteria: * minor patient. * patient participating in another interventional study. * patient with one of the following pathologies: rheumatoid arthritis, haemophilia, inflammatory rheumatism or neurological spasticity. * patient to undergo a one-step bilateral hallux valgus surgical treatment (surgery of both feet on the same day). * patient refusing to sign the consent form. * patient for whom it is impossible to give informed information. * patient under the protection of justice, under curatorship ou under tutorship.

Keywords: hallux valgus complications
teicoplanin allergy testing using autologous serum (tatas)

Conditions: Drug Allergy

Summary: allergy testing for teicoplanin is much more unreliable than for other similar drugs. this means that we run the risk of missing serious teicoplanin allergy, and these patients will be given another dose in future, not knowing that they are seriously allergic. serious allergic reactions, also known as anaphylaxis, can be life threatening. the patients which we recruit to our study will come to us through the perioperative allergy service. they will have had a reaction to a general anaesthetic, but will also have had teicoplanin as part of the anaesthetic. we are not sure why allergy skin testing, which is fairly reliable for most other drugs, is so unreliable in detecting teicoplanin allergy. we do know that some drugs need to mix with proteins in the blood before they trigger an allergy. we would like to replicate this by mixing the teicoplanin with the patients' own blood and using this for the skin testing, to see if we get a more reliable result compared with the plain drug. using the patient's own serum to do skin testing is an established test (the 'autologous serum test') used in certain immunological conditions, we are simply going to use it as a vehicle to test our theory. we will recruit 20 adult patients referred with a recent history of anaphylaxis under anaesthesia, where teicoplanin has been given and is one of the drugs under suspicion of having caused the allergy. in addition to the usual allergy skin testing, which would be done anyway as part of standard allergy investigation, we will perform extra tests using autologous serum for this trial. we hope to find a better way of testing for teicoplanin allergy, so that patients are not put at risk where the allergy has been missed because of an unreliable test.


Eligibility criteria:
inclusion criteria: * adult patients 18 years old and above who have suffered suspected anaphylaxis under anaesthesia (the 'index episode'), where teicoplanin has been given exclusion criteria: * patients unable to stop drugs that would interfere with skin tests prior to study- e.g. antihistamines or certain anti-psychotics * pregnancy * patients under age 18 years * patients with elevated baseline mast cell tryptase requiring further investigation * patients with blood-borne viruses such as hep b, c and hiv

Keywords: teicoplanin allergy testing autologous serum
inspiratory muscle training in people with long covid-19- a pilot investigation.

Conditions: Long COVID

Summary: this pilot investigation will recruit people with long covid to participate in a 4 week individualized inspiratory muscle training intervention with pre and post spirometry testing and additional functional outcomes to assess the effectiveness of the intervention.

the study design is a 4 - week parallel-arm intervention, randomised controlled trial. participants will attend 2 testing days, baseline and follow-up 4 weeks apart. participants will first be screened over the phone to assess eligibility. participants will then be randomly allocated using minimisation, into either control or intervention arm. baseline testing: participants will undergo baseline testing in the laboratory. participants will be measured for their anthropometrics; height and weight. participants will complete a series of questionnaires for 15 mins. following 15 minutes rest, participants will then have three resting blood pressure and heart rate measurements and averaged via a sphygmomanometer and polar hr watch. mip will be measured using the microrpm care fusion 3 times and the highest value reported (10 minutes). forced expiratory value in 1 second (fev1) and peak expiratory flow (pef) will be measured using vitalograph 700 (spirotrac 6). participants will undergo a 6-minute-walk-test self-paced where rating of perceived exertion (rpe) and borg dyspnea scale (bds) will be assessed each minute. then a sub-maximal exercise test using a cycle ergometer and vyntuscpx, where ventilatory threshold (vt) and maximal heart rate (hrmax)will be measured. participants will be asked to cycle until they reach a 17 rpe on a ramp test of 10-15w/min (\>20mins). heart rate (hr), rating percieved exertion (rpe) and borg dyspnea scale bds) measured each minute. the intervention arm will receive a handheld pro2 device and will participate in two unsupervised sessions and one supervised via microsoft teams sessions per week. participants will complete 3 sessions per week, for 4 weeks. each session will include 6 x 6 inspirations at 80% of mip. mip will be measured on the supervised session day. the control group will be asked to continue as normal throughout the 4 weeks.

Eligibility criteria:
inclusion criteria: * experiencing self reported dyspnea (breathlessness) following covid-19 infection over 3 months ago. * aged between 18 and 65 exclusion criteria: * are pregnant * receiving treatment following a previous cardiac event (myocardial-infarction and non-st elevation mi), * have a dementia diagnosis, * have a high risk of falls, * have an additional chronic respiratory disease diagnosis such as (chronic obstructive pulmonary disease) copd or cf (cystic fibrosis) * are receiving respiratory muscle training * are receiving steroid inhaler treatment

Keywords: dyspnea long covid
kinetic biomarker for chronic lymphocytic leukemia prognosis

Conditions: Chronic Lymphocytic Leukemia

Summary: this project will attempt to validate the utilization of a stable isotope kinetic biomarker (kinemarkertm) as a predictive test for disease progression in early stage chronic lymphocytic leukemia (cll).

chronic lymphocytic leukemia (cll), the most common leukemia in the western world, is characterized by a pathological expansion of leukemic b cells. the clinical course of cll is remarkably heterogeneous; some patients have relatively aggressive disease requiring early treatment, others have highly indolent disease that does not require current anti-leukemia therapy until many years after diagnosis. current staging systems have not been able to predict which patients in early or intermediate risk stages will undergo disease progression and which will undergo an indolent course. universal treatment of all patients with early stage disease has been shown to be more harmful than beneficial. as such, early identification of patients who will have more aggressive disease soon after diagnosis has been a major goal in cll research. in response to this need for a reliable prognostic marker, kinemed is investigating the use of cll kinetics as a biomarker for subsequent disease progression. this test assesses b-cell kinetics directly through an in vivo kinetic measurement of tumor dna synthesis and catabolism by combining 2h2o labeling and state of the art analytic instrumentation.

Eligibility criteria:
inclusion criteria: * \>18 years of age * clinical diagnosis of chronic lymphocytic leukemia * diagnosis within previous 3 years * stage 0, i, or ii disease * willingness and capacity to give informed consent exclusion criteria: * current or prior cll treatment * serious co-morbid medical condition * patient likely to need treatment in the next 16 weeks * pregnancy

Keywords: chronic lymphocytic leukemia biomarker prognosis apoptosis neoplasm/cancer diagnosis stable isotope diagnosis evaluation outcomes cd19 cd5
individualized study of refeeding to optimize inpatient gains

Conditions: Atypical Anorexia Nervosa

Summary: the primary purpose of the trial is to compare the efficacy and safety of individualized caloric refeeding (icr) to the new standard of care, higher calorie refeeding (hcr), in hospitalized patients with atypical anorexia nervosa (aan), and clinical remission over one year of follow-up.

atypical anorexia nervosa (aan) is a new diagnosis describing patients with malnutrition and significant weight loss yet "normal" weight. these patients responded poorly to hcr, the superior refeeding treatment in the parent trial, which was designed for low-weight patients with typical an. the proposed trial will examine the safety and efficacy of a new treatment for aan with the potential to improve treatment outcomes for this diverse and growing patient population. the major finding motivating the proposed trial is that participants with aan gained weight 40 percent slower and required 3.0 additional days in hospital to restore medical stability on hcr, as compared to an. the research team has developed individualized caloric refeeding (icr), which doses calories to weight consistent with other pediatric treatments (e.g. medication). the primary purpose of the proposed trial is to compare the efficacy and safety of icr to the new standard of care (hcr) in hospitalized patients with aan. the investigators hypothesize that icr will restore medical stability faster than hcr with no increase in electrolyte abnormalities. after hospitalization, the major barrier to care in aan is lack of consensus on clinical remission and whether these formerly overweight patients should gain weight to recover. the research team will examine metabolic, hormonal and psychological markers during long-term follow-up, toward the goal of developing a definition of clinical remission in aan. design summary: randomized controlled trial in n=74 participants age 12-24 with aan, consented upon hospital admission, randomly assigned to icr or hcr, followed daily in hospital and at 3, 6, 9 and 12 mo.

Eligibility criteria:
inclusion criteria: * age 12-24 yrs * meets diagnostic and statistical manual of mental disorders (dsm-5) criteria for aan * hospitalized with medical instability, as defined by: 1. night time heart rate (hr) \<45 bpm, 2. systolic blood pressure (sbp) \<90 mmhg, 3. temperature \<35.6° c, 4. orthostatic δ hr \>35 bpm, or 5. orthostatic δ sbp \>20 mmhg exclusion criteria: * bulimia nervosa * current pregnancy * chronic disease (e.g. immune, renal disease) * acute/active suicidality or psychosis * hospital admissions for refeeding in the prior 6 mo.

Keywords: malnutrition refeeding nutritional rehabilitation adolescent medicine