Kornimate/medical-research-clean huggingface dataset:
effectiveness of the standing algorithm for the differential diagnosis of vertigo

Conditions: Vertigo

Summary: differential diagnosis of vertigo is complex especially in emergency department, nevertheless it is crucial. the aim of this study is to assess the accuracy of standing algorithm for discriminate central from peripheral type of vertigo, identifying more easily the presence of ischemic stroke.

vertigo represents a common medical problem which afflicts about 20-30% of the population and it is a frequent cause of abstention from work and disability. in most cases it is provoked by a benign disease of inner ear, however it can be the main symptom of a more dangerous illness like ischemic or hemorragic stroke, cerebral neoplasm or demyelinating disease. indeed, vertigo is the prevailing clinical problem in patients with misdiagnosed ischemic stroke, leading to an increase of mortality in the acute phase of disease. in the current state, two diagnostic algorithm have been proposed for the evaluation of acute vertigo, named with the acronyms hints and standing. the former is characterized by high sensibility and specificity when utilized by a specialist physician, but it is cumbersome to used in emergency department. conversely, the latter has been validated exactly in this setting and comprises the evaluation of benign paroxysmal positional vertigo and of upright position. the aim of this study is to estimate the accuracy of standing algorithm in differentiating peripheral vertigo from central from, in particular ischemic stroke, and its potential usefulness in decreasing the use of neuroimaging and specialist consultant.

Eligibility criteria:
inclusion criteria: * patients over 18 years of age. * patients affected by vertigo, dizziness or balance disorder. exclusion criteria: * age under 18. * patients unable to cooperate (with severe dementia or incapable to provide consensus). * patients affected by disease of cervical spine or any trauma of this part of body that contraindicate the manipulation of neck. * impractical follow-up. * dying patient (less three estimated months to live). * patients with neurologic deficit identified during triage examination (cincinnati prehospital stroke scale, cpss\>0) of suffering from another disease that can be the cause of dizziness/balance disorder (e.g. anemia, arrhythmia, hypoglycemia, alcoholic intoxication). * patients without symptoms at the time of examination. * patients who deny the participation in the study.

Keywords: central vertigo peripheral vertigo ischemic stroke
efficacy and safety of dysport in the treatment of upper limb spasticity in children

Conditions: Upper Limb Spasticity (Altered Skeletal Muscle Performance) in Children

Summary: the purpose of this study is to assess the efficacy and safety of multiple doses of dysport used in the treatment of upper limb spasticity (altered skeletal muscle performance) in children with cerebral palsy (cp).


Eligibility criteria:
inclusion criteria: * upper limb spasticity due to cerebral palsy * body weight 10 kg or over * mas score of 2 or more in affected elbow or wrist flexors exclusion criteria: * fixed myocontracture * previous phenol or alcohol injection within 1 year * severe athetoid or dystonic movements * previous or planned surgery for spasticity in elbow or wrist flexors * neuromuscular disorders * previous rhizotomy within 6 months * intrathecal baclofen within 30 days
prediction of low birth weight infants using ultrasound measurement of placental diameter and thickness

Conditions: Intrauterine Growth Restriction

Summary: prediction of low birth weight infants using ultrasound measurement of placental diameter and thickness

the aim of the present study is to assess the value of using ultrasound measurement of placental diameter and thickness as a predictor of low birthweight.

Eligibility criteria:
inclusion criteria: 1. singleton viable pregnancy. 2. gestational age at least 36 complete weeks as calculated by lmp. 3. non scared uterus. exclusion criteria: 1. multiple fetal pregnancy. 2. intrauterine fetal death. 3. known congenital fetal anomalies. 4. presence of uterine or adnexal gross pathology. 5. presence of any medical disorder e.g. diabetes mellitus \& hypertension.
a study in elderly subjects with pneumonia to support the development of bacteriological diagnostic assays

Conditions: Infections, Streptococcal

Summary: gsk biologicals is working on the development of a vaccine to protect elderly people from bacterial pneumonia. diagnostic of bacterial pneumonia is difficult, and for the future studies in that project, it would be useful to have some easy non invasive tests. new clinical read-outs are needed to detect and identify the causative pathogen. these assays will be based on specific antigen detection in the urine or specific pathogen dna detection in the blood. technical and clinical validation of these assays will be realised at later stage with samples coming from epidemiological and/or phase iii studies. to allow the development of such tests in gsk biologicals laboratories, urine and blood samples are needed from subjects aged 65 or above who have diagnosed pneumonia. the protocol posting has been updated in order to comply with the fda amendment act, sep 2007.


Eligibility criteria:
inclusion criteria: * subjects who the investigator believes that they can and will comply with the requirements of the protocol should be enrolled in the study. * a male or female aged 65 or above at the time of the study. * written informed consent obtained from the subject. * clinical pneumonia diagnosed by chest x-ray detected within 7 days before study entry. exclusion criteria: * vaccination with a pneumococcal or haemophilus vaccine within the last 3 months before study entry. * antibiotherapy started more than 7 days before screening. * a negative culture for streptococcus pneumoniae or non-typable haemophilus influenza. * a urine sample at screening less than 40 ml.
exercise and coronary microvascular disease

Conditions: Coronary Microvascular Disease

Summary: exercise cmd is a prospective single-center, open-label, parallel arms randomized controlled trial. this trial aims to assess the impact of cardiac rehabilitation on top of optimal medical therapy on patient-reported outcomes in subjects with coronary microvascular disease and non-obstructive coronary artery disease. patients will undergo a microvascular assessment using bolus thermodilution techniques and those with criteria for microvascular angina (imr ≥ 25) will be invited to participate. patients will be randomized in a 1:1 ratio to either optimal medical therapy (omt) or omt plus a program of cardiac rehabilitations (cr). after randomization, spiro-ergometry and a saq-19 will be performed in all patients. medical therapy will be standardized in both arms and the cr group will follow 36 sessions of the personalized physical training program of cardiac rehabilitation. approximately 204 subjects (102 in each group) will be included at one site (olv aalst, belgium). clinical follow-up will be planned at 4 months. patients with ccta performed in standard of care will be invited for control ccta 6 +/- 1 month after the invasive procedure.


Eligibility criteria:
inclusion criteria: * non obstructive cad (diameter stenosis \ 0.80) * angina at presentation * evidence of microvascular dysfunction (imr ≥ 25) exclusion criteria: * inability to give consent * acute coronary syndrome (acs) * severe valve disease * permanent af * history of coronary artery bypass grafting (cabg) * cardiomyopathies * intolerance to adenosine * hemodynamic instability * not able to exercise

Keywords: exercise training
vemurafenib (r05185426) in poor performance status patients with unresectable locally advanced or metastatic melanoma harboring a v600e/k mutation

Conditions: Melanoma

Summary: the purpose of this study is to find out what effects, good and/or bad, vemurafenib has on the patient and the melanoma. specifically, the investigators want to know how well vemurafenib shrinks melanoma. the investigators also want to find out how well vemurafenib can improve how well the patient functions.


Eligibility criteria:
inclusion criteria: * age \>18 years old. * histologic proof of melanoma reviewed and confirmed by mskcc. * a confirmed ebrafv600e or kbrafv600k mutation. * stage iv melanoma, or advanced stage iii not curable by surgery. patients with active cns metastases will be allowed on the study. * measurable disease by recist v1.1. * ecog performance status 3 or 4. the basis for the grading of performance is strict; there must be clear justification of the performance status grade (e.g. patient is confined to bed \> 50% of time, or cannot carry out adls, or is otherwise disabled by burden of disease such as requiring supplemental o2). * patients must be able to swallow pills * adequate hematologic, hepatic and renal function as defined by the following: * absolute neutrophil count ≥ 1.0 x 109/l * hemoglobin ≥8.0g/dl, occasional transfusions are acceptable as vemurafenib does not have significant hematologic toxicities. * total bilirubin ≤2.0x the upper limit of normal, ≤3.0x the upper limit of normal if the patient has gilbert's syndrome. * alkaline phosphatase ≤2.0x the upper limit of normal. * ast and alt ≤2.0x the upper limit of normal. * serum creatinine ≤ 1.5x the upper limit of normal. exclusion criteria: * uveal melanoma as primary. * concurrent chemotherapy, immunotherapy, or radiotherapy. * prior treatment with a raf inhibitor. other prior chemotherapy, immunotherapy, or radiotherapy will be allowed including prior treatment with a mek inhibitor patients must have had complete recovery from any adverse events or toxicities of prior cancer-directed therapies. * pregnant or lactating women. * a second active malignancy. prior malignancy will be allowed as long as the patient is known to be free of disease for at least 2 years. patients with indolent b-cell malignancies will not be eligible. * qtc interval \> 500 msec.

Keywords: vemurafenib skin cancer stage iv advanced stage iii 11-091
the effect of gcsf in the treatment of als patients

Conditions: Amyotrophic Lateral Sclerosis

Summary: the aim of this study is to evaluate the effect off granulocyte colony stimulating factor (gcsf) in the treatment of amyotrophic lateral sclerosis (als) patients.


Eligibility criteria:
inclusion criteria: * age between 18 and 85 * definite or probable als according to revised el escorial criteria * maximum 2 years from initiation of symptoms to study entry * mild to moderate disability according to revised als functional rating scale (alsfrs-r) exclusion criteria: * familial als * pregnancy or lactation * myeloproliferative or hematologic disorders * active immunological disease * liver or renal or heart disease * hiv positive * significant cognitive disorder * hypersensitivity to gcsf

Keywords: amyotrophic lateral sclerosis granulocyte colony stimulating factor
effects of short-term fasting on tolerance to chemotherapy

Conditions: Breast Cancer

Summary: the purpose of this study is to determine the effect of short-term fasting on tolerance to adjuvant chemotherapy in breast cancer patients

evidence from experimental animals provides strong support for the concept that caloric restriction (cr) increases resistance to multiple forms of stress. cr decreases plasma levels of growth factors, e.g. insulin-like growth factor-i (igf-i), thereby diverting energy from growth to maintenance. accordingly, the currently available information suggests that short-term fasting protects normal cells against the perils of (high dose) chemotherapy. in contrast, cancer cells are not (or less) protected as a result of their self-sufficiency in growth signals. this phenomenon is termed differential stress resistance (dsr). dsr reduces the severity of side-effects caused by the toxicity of chemotherapy, without interfering with its effect on reduction of tumour volume or tumour markers. a recent report, sketching a case series of 10 cancer patients, suggests that short term fasting protects against the side effects of chemotherapy in humans. indeed, the majority of patients preferred fasting over feeding in preparation of their therapy. this study aims to further evaluate the impact of fasting on tolerance to chemotherapy in humans.

Eligibility criteria:
inclusion criteria: * female breast cancer patients, receiving adjuvant tac-chemotherapy * age ≥ 18 years old * who performance status 0-2 * adequate bone marrow function: white blood cells (wbcs) ≥ 3.0 x 109/l, neutrophils ≥ 1.5 x 109/l, platelets ≥ 100 x 109/l * adequate liver function: bilirubin ≤ 1.5 x upper limit of normal (unl) range, alat and/or asat ≤ 2.5 x unl, alkaline phosphatase ≤5 x unl * adequate renal function: the calculated creatinine clearance should be ≥ 50 ml/min * survival expectation \> 3 months * patients must be accessible for treatment and follow-up * written informed consent according to the local ethics committee requirements exclusion criteria: * serious other diseases such as recent myocardial infarction, clinical signs of cardiac failure or clinically significant arrhythmias * diabetes mellitus * body mass index (bmi) \< 19 kg/m2 * pregnancy or lactating * medical or psychological condition which in the opinion of the investigator would not permit the patient to complete the study or sign meaningful informed consent

Keywords: short-term fasting adjuvant chemotherapy toxicity side-effects
gene-environment interactions in rheumatoid arthritis autoimmunity disease severity

Conditions: Rheumatoid Arthritis

Summary: the objective of the proposed study is to assess the role of smoking and complex gene-smoking interactions in two understudied rheumatoid arthritis (ra)groups.

rheumatoid arthritis (ra) is a systemic inflammatory disease affecting over 2 million people in the u.s. alone, a condition characterized by progressive joint destruction, significant work-related disability and accelerated mortality. while the precise cause of ra is unknown, it is clear that the disease does not result from a single heritable factor or single environmental exposure. of the many environmental exposures that have been studied, cigarette smoking is the factor most consistently shown to be associated with ra onset. in addition to its role in disease susceptibility, recent studies have found that smoking, along with genetic factors, contribute to ra-related autoimmunity and disease severity. moreover, studies to date looking at disease severity in ra have exclusively involved women of caucasian/european ancestry. this is an important distinction since although ra is more common in women, smoking appears to be most closely linked to ra risk in men. additionally, the burden of other smoking-related illnesses appears to be greatest among non-caucasian populations. for this reason and because smoking rates and prevalence of risk-alleles differ in ethnic/racial minorities (i.e. se and gstm1-null polymorphism), further studies are needed to define the association of smoking and possible gene-smoking interactions and their role in autoimmunity and disease severity in these understudied populations.

Eligibility criteria:
inclusion criteria: * meeting acr criteria for ra exclusion criteria: * no exclusions

Keywords: rheumatoid arthritis cigarette smoking gene-environmental interactions autoimmunity disease severity
a survey for long-term use of prograf capsules in patient with interstitial pneumonia

Conditions: Interstitial Pneumonia Associated With Polymyositis/Dermatomyositis

Summary: this study is to evaluate the safety and the efficacy of prograf in patients with interstitial pneumonia associated with polymyositis / dermatomyositis in acute clinical setting.


Eligibility criteria:
inclusion criteria: * hospitalized patient * patient diagnosed with interstitial pneumonia associated with polymyositis/dermatomyositis

Keywords: tacrolimus interstitial pneumonia prograf
comparison of oxygen reserve index and regional cerebral oxygen saturation indetermining hypoxia in obese patients

Conditions: Oxygen Deficiency

Summary: the primary aim of this study is to compare the effectiveness of ori and rcso2 in predicting hypoxia early in obese patients who are sensitive to hypoxia. our secondary aim is; to determine whether there is a correlation between the changing trend of ori and rcso2 in obese patients.

standard noninvasive monitoring will be applied to the patients taken to the operating table, and heart rate, mean arterial pressure, peripheral oxygen saturation (spo2), oxygen reserve index (ori), regional cerebral oxygen saturation, etco2 values will be recorded. cerebral oximeter probe placed in the middle of the forehead (every second cerebral oxygen saturation will be continuously monitored using a rcso2 reading) (massimo)preoxygenation will be performed until the expiratory o2 concentration is 90% (during spontaneous ventilation, fio2 will be kept between 100% 6 lt7min flow rate and etco2 30-35 mmhg). 2 mg midazolam, 2 ug general anesthesia with /kg fentanyl, 3 mg/kg propofol, 0.6 mg/kg rocuronium and 100% o2 will be applied and intubated with a videolaryngoscope. the breathing circuit will be disconnected from the endotracheal tube until the spo2 drops to 94%. at that time, the breathing circuit will be connected and the patients will be ventilated with 100% fio2, 8 ml kg-1 ideal body weight, targeted tidal volume, and 5 cm h2o positive end-expiratory pressure until the ori plateaus. throughout this process, ori and cerebral oxygen saturation will be recorded continuously. ori and rco2 data will be compared at seven specific time points ( (1) during the basal period; (2) at the end of preoxygenation when ori reaches a plateau; (3) at the beginning of intubation; (4) when spo2 reaches 97%; (5) when spo2 reaches 94% (6) ori reaches a plateau again (during ventilation with 100% fio2), and (7) spo2 reaches baseline

Eligibility criteria:
inclusion criteria: * asa i-iii patients * the ages of 18-75 * obese bmi (40\>bmi\>30 kgm\^2) * undergoing intubated elective surgery exclusion criteria: * patients with significant cardiopulmonary comorbidities * bmi\>40 kgm\^2 and bmi\<30 kg m\^2 * asa\>3 * patients under 18 years and over 75 years of age

Keywords: oxygen reserve index, preoxygenation cerebral oxygen saturation
the detection and factors of brown adipose tissue in different locations of adults

Conditions: Obesity

Summary: retrospective studies have combined positron-emission tomography and computed tomography (pet-ct) to identify adipose tissue with a high rate of uptake of 18f-fluorodeoxyglucose(18f-fdg) as active brown adipose tissue(bat). in addition, biopsy specimens and immunohistochemical staining with a ucp1-specific antiserum were used to indicate that normal adults were able to have bat. however,these studies only chose few subjects and limited to the neck tissue. therefore, the investigators intend to test bat in different parts of adults and analyse the clinical factors.

the investigators will promote the cross-sectional study from 2010 to 2013 in shanghai. data on demographic statistics, medical history,physical examination and fasting blood sample will be collected for all patients. adipose tissue of adults will be collected from different regions, such as cervical, perirenal, along the large blood vessels and trachea, because they are included in the range of surgical therapy and are the major locations of bat. adipose tissue samples will be used to immunohistochemical stain, to detect the expression of bat related genes.

Eligibility criteria:
inclusion criteria: * subjects who underwent surgical therapy and the operation scope includes bat sample sites. exclusion criteria: * pregnant women * with implantable medical electronic instrument * younger than 18 years

Keywords: brown adipose tissue different regions chinese adults
internet-based cognitive behaviour therapy (cbt) for persons diagnosed with bipolar ii

Conditions: Bipolar Disorder, Type II

Summary: the aim of the study is to test the feasibility and acceptability of internet-based cognitive behaviour therapy (cbt) for persons diagnosed with bipolar disorder, type ii. the idea is to treat residual depressive symptoms as well as using psychoeducation to improve their prognosis. each participant will have a personal therapist that will provide guidance and support throughout the treatment.


Eligibility criteria:
inclusion criteria: * a diagnosis of bipolar disorder type ii * mild to moderate depressive symptoms * 18 years of age * stable medication with a mood stabiliser * access to the internet exclusion criteria: * diagnosis of psychosis * having received psychiatric in-patient care during the past year * ongoing psychotherapy * previous manic episode * previous suicide attempt * previous parasuicidal behavior documented in patient record (e.g. self-injury)
access: ai for pediatric diabetic eye exams study

Conditions: Type 1 Diabetes; Type 2 Diabetes

Summary: the purpose of this study is to determine if providing in clinic point-of-care autonomous ai diabetic retinopathy exams improves screening rates compared to standard of care referral to an eye care provider, in a randomized control trial in a racially and ethnically diverse cohort of youth.

this study will recruit 164 individuals ages 8-21 with type 1 and type 2 diabetes. participants will be randomized to usual care (referral to an eye care provider for a dilated eye exam) or the intervention arm and undergo a point-of-care diabetic eye exam using autonomous ai software on a non-mydriatic fundus camera. participants in the intervention group will receive the diabetic eye exam results immediately from the autonomous ai system, and if abnormal will be referred to an eye care provider for a dilated eye exam. participants in the standard of care group will have 6 months to complete the diabetic eye exam.

Eligibility criteria:
inclusion criteria: meets american diabetes association (ada) criteria for diabetic retinopathy screening: * diagnosis of type 1 diabetes for ≥3 years, and age 11 or in puberty * diagnosis of type 2 diabetes exclusion criteria: * diabetic eye exam within the last 6 months * known diabetic retinopathy

Keywords: diabetic retinopathy