Kornimate/medical-research-clean huggingface dataset:
the impact of anti-thrombosis on cerebral microbleeds and intracranial hemorrhage in ischemic stroke patients

Conditions: Ischemic Stroke

Summary: the purpose of this prospective cohort study is to investigate whether antithrombotic therapy in the secondary prevention of ischemic stroke increases the risk of the emerging cmbs and whether the change is associated with an increased risk of intracranial hemorrhage, providing an imaging evidence for individualized antithrombotic therapy in such patients.

cerebral microbleeds（cmbs） is a subclinical lesion caused by microvascular disease in the brain, characterized by microleakage of blood. about 30% of ischemic stroke patients, 40% of the healthy people over 80 years old, and 60% of intracranial hemorrhage patients have microbleeds. with the development of imaging technology, clinically more and more patients have found microbleeds in the brain. how these patients are treated with antithrombotic drugs is not yet clear and is in urgent need of evidence. there are only a few prospective cohort studies to determine whether antithrombotic therapy increases the risk of intracranial hemorrhage in ischemic stroke patients with cmbs, but the results are uncertain. more importantly, whether antithrombotic therapy increases the incidence of the emerging cmbs, and whether the change of increased microbleeds is associated with increased intracranial hemorrhage has not been reported.

Eligibility criteria:
inclusion criteria: 1. patient age ≥18 years; 2. acute ischemic stroke patient confirmed by imaging; 3. time of onset: within 3 months; 4. baseline swi sequence is completed before starting the secondary prevention of ischemic stroke; 5. baseline swi sequence must have at least one cmb ; 6. nihss≤10 exclusion criteria: 1. mri contraindication; 2. hemorrhagic transformation after acute ischemic stroke; 3. contraindication for antiplatelet or anticoagulation therapy; 4. severe head trauma or intracranial hemorrhage occurred in the past six months; 5. obvious coagulopathy; 6. other intracranial lesions associated with (such as tumor, cerebral vascular malformation); 7. other unqualified patients judged by the investigator

Keywords: cerebral hemorrhage anti-thrombosis
safety study of repeat doses of sustol in adults

Conditions: Chemotherapy-Induced Nausea and Vomiting (CINV)

Summary: this is a repeat-dose, single-arm, open-label study that will evaluate the potential impact of subject-reported injection-site reactions (isrs) on activities of daily living (adl) in adult subjects with cancer receiving sustol® (granisetron) extended-release injection, for subcutaneous use for prevention of chemotherapy induced nausea and vomiting (cinv) for up to 4 sequential cycles of chemotherapy (moderately emetogenic chemotherapy \[mec\] or anthracycline and cyclophosphamide \[ac\] combination regimen).


Eligibility criteria:
inclusion criteria: 1. has cancer and is scheduled to receive mec or ac regimen for at least 4 cycles of chemotherapy, and is prescribed sustol for cinv prevention. 2. has an eastern cooperative oncology group performance status of 0 or 1. 3. has life expectancy of greater than 6 months. 4. able to receive standardized doses of dexamethasone for the prevention of emesis. 5. females are eligible only if not pregnant, not lactating, not planning to become pregnant during the study. exclusion criteria: 1. has hypersensitivity to granisetron, any component of sustol, or any other 5-ht3 receptor antagonists. 2. severe renal impairment (creatinine clearance \[clcr\] \<30 ml/min). 3. symptomatic primary or metastatic central nervous system (cns) disease. 4. has participated in an interventional clinical study within 30 days of cycle 1 day 1. 5. investigator assessment that subject would not be a good fit for the trial.

Keywords: htx-100 apf530
biological markers of functional effects of physical activity in an elderly population

Conditions: Fragility

Summary: circulating biomarkers are promising tools for the early diagnosis of aging-associated pathologies. inflammation and immunity are associated with the risk of sarcopenia and frailty in elderly patients. the investigators investigate the effect of an adapted physical activity program on the metabolism and function of circulating immune cells and mirna in frail and non-frail elderly subjects. induced immune changes are analyzed together with that of motor abilities and of frailty status.

circulating biomarkers are promising tools for early diagnosis of pathologies associated with aging. inflammation and immunity are associated with the risk of sarcopenia and frailty in elderly patients. the investigators investigate the effect of an adapted physical activity program on the metabolism and function of circulating immune cells and mirna in frail and non-frail elderly subjects. the main objective is to establish the link between biological markers of aging (immune cells phenotypes and function, mirna) and motor capacities alteration/improvement. the secondary objectives are: (1) to characterize the functional and immunometabolic dimensions of frailty from objective indicators; (2) to propose a management system through adapted and individualized physical activity, based on objective indicators; (3) to evaluate the clinical impact of both frailty and its preventative management through physical activity; and (4) to identified new biomarkers of frailty. a total of 100 patients categorized as frail, pre-frail, and non-frail after a standardized geriatric evaluation are included in a comparative and interventional study. exercise intervention consists in a 12-weeks physical activity program. blood sample and physical/psychological functional measurements are performed before and after the 12-weeks physical activity program. anova tests and correlational analysis will be performed. the finality of the study is to improve the medical prescription of physical activities in elderly patients.

Eligibility criteria:
inclusion criteria: * patient who signed the informed consent * older men and women ≥ 65 years * can walk without technical help exclusion criteria: * patient with protective measures (guardianship, curatorship, and deprivation of liberty). * patient with a neurological problem * no affiliation to a social security scheme (beneficiary or assignee) * knee and / or hip prosthesis * orthopedic complications with repercussions on walking activities
transition from ticagrelor to clopidogrel following acute coronary syndrome: to bolus or not?

Conditions: Acute Coronary Syndrome

Summary: after a heart attack patients are routinely started on drugs to inhibit platelets. ticagrelor is a powerful anti-platelet drug with clinical benefits. however it must be discontinued in some, because of increased risk of bleeding or intolerance. these patients need to be transitioned to another agent, such as clopidogrel. at present, there is no clinical consensus on the optimal strategy for this switch. some clinicians elect to give a bolus dose of clopidogrel with 600mg, while others start directly with a 75mg daily dose, with no evidence regarding the benefits or potential complications associated with each strategy. the present proposal will evaluate the pharmacodynamics of 2 strategies with specialized platelet function testing. we hypothesize that a bolus dose of clopidogrel during the switch will confer better ischemic protection without increasing bleeding risk for patients undergoing a switch in therapy.

the overall objective is to evaluate the need for a clopidogrel bolus dose among patients being switched from a regimen of ticagrelor to clopidogrel. in a randomized pharmacodynamics study of 48 patients, we will conduct serial measurements of platelet function/inhibition using the accumetrics verifynow assay (platelet inhibition will be expressed as p2y12 reaction unit \[pru\]). platelet inhibition will be assessed at specific time points over the first 72 hours following the change in medications, which will enable us to determine whether patients in the 2 different strategies may be at increased ischemic or bleeding risks. we hypothesize that a bolus dose of clopidogrel during the switch will confer better ischemic protection without increasing bleeding risk for patients undergoing a switch in therapy. specific aims: 1. primary aim: to determine with platelet function testing the pharmacodynamics effects of a 600mg bolus dose of clopidogrel compared with no bolusing among patients being switched from ticagrelor to clopidogrel. 2. to determine if patients receiving a clopidogrel bolus have improvement in ischemic protection relative to patients without a bolus dose. 3. to determine if patients receiving a clopidogrel bolus may be exposed to increase bleeding risk relative to those without a bolus dose.

Eligibility criteria:
inclusion criteria: * age \> 18, * admission for acute coronary syndrome, * on dual anti-platelet therapy (including ticagrelor) * being transitioned to clopidogrel by their treating physician * provided informed consent exclusion criteria: * bleeding/intolerance to clopidogrel * thrombocytopenia (platelet count \< 100, 000 per ul) * hematocrit \ 52% * treatment with glycoprotein iib/iiia inhibitor, 24 hours prior to randomization

Keywords: acute coronary syndrome coronary artery disease antiplatelet therapy ticagrelor clopidogrel
oxygen therapy in depression

Conditions: Depression, Normobaric Hyperoxia.

Summary: the major objective of the present study is to examine the influence of normobaric hyperoxia treatment on the symptoms of patients diagnosed with depression members of clalit health services. the investigators hypothesize that normobaric hyperoxia treatment will improve the symptoms of patients with depression.


Eligibility criteria:
inclusion criteria: * men and women aged 18-65 years diagnosed with mild to moderate depression. exclusion criteria: * patients with oxygen saturation below 95%; * an unstable mental (psychiatric) condition * a psychiatric condition that requires a change in pharmacotherapy (importantly - medications will not be changed in patients who will be enrolled to the study) * acute or chronic respiratory disease * any severe physical illness * suicidal thoughts or attempts * drug abuse * obesity (bmi over 30) * inability to cease smoking during night hours while participants are supposed to be using the oxygen/air supplementing machine.
syncope decision aid for emergency care

Conditions: Syncope

Summary: syncope, or transient loss of consciousness/fainting, is a common emergency department (ed) complaint responsible for over 1 million ed visits yearly. potential causes include benign conditions such as dehydration or vaso-vagal syncope. rarely, syncope is the result of serious cardiac conditions. in older patients without a clear cause of syncope hospital admission is frequently initiated at very low risk thresholds, though there is little evidence that these admissions improve patient outcomes. these decisions are often made without significant patient input or discussion of reasonable alternatives. in this situation, a patient's values, preferences, and particular circumstances should be taken into account. this mutualistic approach to clinical management is referred to as shared decision-making. shared decision-making (sdm) is a joint process of choice selection between providers and patients in clinical scenarios where multiple reasonable management options exist. to improve syncope emergency care, the researchers can leverage recent advances in risk stratification to engage patients in sdm and deliver superior, patient-centered care. this study will provide the groundwork for a larger, randomized controlled trial evaluating the effects of the decision aid for management of low-risk syncope.

setting: mount sinai hospital (msh) has a 61-bed adult emergency department with a volume of over 100,000 patient visits/year or approximately 300 visits/day. msh is a large academic tertiary care medical center located in east harlem and serves a large black and hispanic community. projected recruitment: there are approximately 60 msh ed visits for syncope per month of which 35 per month are by patients above age 30. roughly half of these do not have a clear etiology of their syncope discovered in the ed. the researchers project that of the 17 potentially eligible patients per month, three will be successfully enrolled for a projected 72 patient enrollees at the completion of the 24-month recruitment period. the pi, clinical research coordinators, and sras will monitor the real-time electronic tracking system for all ed patients and will identify any patient over age 30 with a chief complaint of syncope or loss of consciousness.

Eligibility criteria:
inclusion criteria: * emergency department patient * age 30 years or above * chief complaint of syncope * capacity to make medical decisions * speak and read english * working phone number and fixed address exclusion criteria: * altered mental status * cognitive impairment * serious acute diagnosis: (e.g. clinically significant cardiac dysrhythmia, structural heart disease, gastrointestinal hemorrhage, myocardial infarction, pulmonary embolism, pneumonia, arterial dissection, serious infection, ectopic pregnancy, subarachnoid hemorrhage, or stroke.) * hemodynamic instability * inability to read or speak english * major communication barrier * lack of phone number or fixed address * too high risk as per physician judgment

Keywords: syncope shared decision-making emergency medicine decision aid
advanced glycation end-products, inflammation and vascular health in chronic kidney disease

Conditions: Chronic Kidney Disease

Summary: the purpose of the study is to learn more about how advanced glycation end-products can affect insulin resistance, inflammation and blood vessel health in people with kidney disease.

advanced glycation end-products (ages) are compounds that form when sugars abnormally attach to proteins or lipids. high levels of ages in the blood may cause inflammation, problems with controlling blood sugar, and problems with the health of blood vessels. many of the foods we commonly eat have high amounts of ages, which may increase ages in the blood of people with kidney disease. the amount of ages in foods can be lowered when prepared using special cooking techniques such as using moist heat or longer cooking times at lower temperatures. new research has shown that preparing food in this way can lower inflammation and improve blood vessel health in people with normal kidney function. in this study, the investigators would like to examine the effect of lowering the age content of foods on inflammation, blood sugar control, and blood vessel health in individuals with mild to moderate chronic kidney disease.

Eligibility criteria:
inclusion criteria: * patients with mild to moderate ckd (estimated glomerular filtration rate 15 - 59 ml/min/1.73m2). exclusion criteria: * current or past use of anti-glycemic medications * fasting glucose \> 126 mg/dl on screening visit or positive glucose on urine dipstick * nephrotic-range proteinuria (≥ 3.5 grams per day as assessed by a spot urine albumin to creatinine ratio obtained at the screening visit) * pregnancy or breast-feeding * clinical need for a specialized diet (low sodium, low potassium, etc.) or religious dietary restrictions. * new or recent change (\< 3 months) in dosage of medications known to affect vascular reactivity- angiotensin converting enzyme inhibitors, angiotensin ii receptor blockers, beta-blockers, calcium channel blockers, hmg-coa reductase inhibitors, etc. * current smoking or recent (\< 6 months) cessation of smoking. * poorly controlled hypertension (≥ 140 mm hg systolic or 90 mm hg diastolic), or prior history of malignant hypertensive episode (sbp \> 200) off of blood pressure medications. * participants with rapidly advancing renal failure. * severe anemia, defined as a hemoglobin \< 8 g/dl for men and \< 6 g/dl for women.

Keywords: advanced glycation end-products chronic kidney disease nutrition inflammation insulin resistance endothelial function
prevalence of gastric motor dysfunction and upper gi symptoms in gastric antral vascular ectasias

Conditions: Gastric Antral Vascular Ectasia; Cirrhosis; Chronic Kidney Disease

Summary: the researchers are trying to find out more about gastric antral vascular ectasia (gave). this is a condition that affects the blood vessels in the stomach, leading to their enlargement and possible bleeding. it can also cause symptoms such as abdominal pain and nausea. by participating in this study, you will help us learn how often these symptoms occur and how they relate to stomach functioning.


Eligibility criteria:
inclusion criteria: * patients \>18 years of age with endoscopic evidence of gastric antral vascular ectasia. * willingness to participate in the study * capacity to provide informed consent. * no evidence of organic, systemic, or metabolic disease (e.g. diabetes mellitus) to explain the symptoms on routine investigations exclusion criteria: * patients with transfusion dependent blood loss. * patients with severe decompensated liver disease. * patients with end stage renal disease. * presence of other diseases (structural or metabolic) which could interfere with interpretation of the study results. * pregnant or lactating women. * patients who have not had a cbc and differential blood draw completed within the last six months. * current heavy alcohol use.
canadian adaptive dbs trial

Conditions: Parkinson Disease

Summary: parkinsonian symptoms, such as freezing of gait (fog) or hypophonia, play a significant role in reducing quality of life for parkinson disease (pd) patients, and are poorly responsive or can worsen with deep brain stimulation (dbs). repeated adjustments of stimulation parameters may be beneficial however, continuous dbs (cdbs) does not adapt to the patients' rapidly fluctuating clinical status and does not take into account reliable and consistent state-trait biomarkers. these biomarkers can be recorded by the electrode itself as local field potentials (lfp). these lfps can be used to guide stimulation output by means of a 'closed loop' or 'adaptive' dbs (adbs). this is a pilot, two-phase, double-blinded, cross-over study of chronic adaptive vs. continuous stn dbs in patients with pd by using a novel implantable dbs system that can automatically adjust stimulation parameters based on the patient's clinical condition. the study will test the hypothesis that adbs stimulation will treat motor fluctuations similarly to continuous stimulation but it will be superior to the latter in the treatment of speech, gait impairment and falls.


Eligibility criteria:
inclusion criteria: * pd treated with bilateral stn dbs using medtronic lead * able to provide informed consent and comply with study protocol * need to replace the implantable pulse generator (ipg) due to battery end of life * presence of disabling gait and/or balance and/or speech issues, as clinically judged by the pi and the patient * evidence that these disabling gait and/or balance and/or speech issues are worsened by dbs, i.e. they improve after turning dbs off. * use of contact 1 and/or 2 on one hemisphere and/or 9 and/or 10 on the other one * good lfp signal (assessable only after ipg replacement with percept) in at least one hemisphere exclusion criteria: * previous dbs surgery without medtronic products * potential use of any therapeutic stimulation configuration (such as bipolar) during the study which will prevent the use of adbs * presence of any other disorders potentially impacting the outcome measures (e.g. orthopaedic issues) * medically unstable * severe non-motor problems, such as depression, dementia, etc.
covid-19 vaccine hesitancy among rheumatic diseases patients

Conditions: Covid19

Summary: rheumatological diseases (rd) are an important group of different clinical entities and specific diseases that affect a significant proportion of the world population. in mexico, the rd have a relevant representation in the adult population. covid-19 vaccination has been proposed as a measure to contain the covid-19 pandemic. the vaccines have been shown to be effective and reasonably safe in the population without significant risk factors, which has allowed their approval to attend the health emergency. at present, there is little scientific information that allows a solid recommendation on vaccination for covid-19 in patients with rd, although most authorities have spoken in favor of vaccination in immunocompromised patients, as are a relevant number of patients with rd. however, it is desirable to achieve herd immunity to facilitate the impact of vaccination on the transmission of sars-cov-2 infection. for this, it is required that around 70% -80% of the target population be vaccinated, which implies not only access to the vaccine but also accepting to be vaccinated. vaccine hesitancy is defined as the delay or refusal to accept the vaccine when it is available by health services. sometimes, they conceptualize it as a continuum and also includes the high demand from the population for the vaccine; in this continuum, there are variations in acceptance and rejection and multiple possible combinations, from acceptance with great concern about the decision to rejection of certain vaccines but not others. it is a complex, contextual, changing phenomenon, specific for each vaccine and the referred disease and probably influenced by cultural determinants.

the objectives are: 1. - to measure the phenomenon of vaccine hesitancy in mexican patients with rd from two health institutions in mexico city. 2. - translate and adapt the "oxford covid-19 vaccine hesitancy scale" to patients with rd and validate this version in a population of patients with rd from two health institutions in mexico city 3. explore factors associated with the phenomenon of vaccine hesitancy.

Eligibility criteria:
inclusion criteria: * patients with a rheumatic disease diagnosis according to their primary rheumatologist who agree to participate exclusion criteria: * patients with a not confirmed rheumatic disease

Keywords: vaccines, rheumatic diseases