Kornimate/medical-research-clean huggingface dataset:
the balance control mechanism of dpn patients

Conditions: Diabetic Neuropathy

Summary: this study will evaluate the balance ability of dpn (diabetic peripheral neuropathy)patients, which will help us to understand the relationship between peripheral and central nervous system, in order to early diagnosis and prevent the fall in dpn patients.

dpn is one of the most common complications of diabetes. the clinical manifestation of dpn contains sensory reduction, pain, muscle wastage and so on. sensory and motor nervous are one of the most important factors in balance control, the reduction of balance ability will result in high risk of fall. most studies about dpn are focus on peripheral nervous, however, the central nervous system may also be involved in dpn patients. in this study, force platform, proprioception test and fmri will be used to evaluate balance ability, proprioception and the brain function information of dpn patients, which will help to understand the relationship between peripheral and central nervous system.

Eligibility criteria:
inclusion criteria: * diabetics * normal cognitive ability * walk normally * normal vision exclusion criteria: * other nervous system disease, foot ulcer

Keywords: dpn fall fmri balance
instillation of gentamicin and dexamethasone in bronchiectasis compared to conventional treatment

Conditions: Bronchiectasis With Acute Exacerbation

Summary: safety and efficacy of local instillation of gentamicin and dexamethasone in acute exacerbation of bronchiectasis in mechanically ventilated patients

bronchiectasis is a chronic suppurative and inflammatory lung disease of diverse etiology characterized by pathological and irreversible dilatation of the bronchial tree. the impairment of the mucociliary clearance, which results from chronic airway inflammation, may cause long-term colonization or recurrent infection of bacteria, especially pseudomonas aeruginosa (pa), while bacterial colonization and recurrent infection can aggravate airway inflammation. sputum retention caused by the impairment of mucociliary clearance can result in mucous plugs, which in turn contribute to airflow obstruction and dyspnea. clinically, the major manifestations of bronchiectasis are chronic cough with purulent sputum, dyspnea, and fatigue that may diminish the patients' quality of life. the frequency of exacerbation and the decline in lung function may lead to poor prognosis and decrease quality of life. the purpose of bronchiectasis management is to reduce exacerbation, prevent complications, and improve the quality of life. long-term instillation of gentamicin can reduce the concentration of bacteria in the airways, decrease sputum production, attenuate lung function decline, and reduce acute pulmonary exacerbations without nephrotoxicity or ototoxicity. dexamethasone is one of the most common glucocorticoids which can inhibit the expression levels of inflammatory factors in the airway and reduce the secretion of airway mucus. topical administration could also reduce the systemic side effects.

Eligibility criteria:
inclusion criteria: * patients with bronchiectasis confirmed by high resolution ct chest(hrct) * patients with acute exacerbation of bronchiectasis who need antibiotic treatment at hospital due to exacerbation * mechanically ventillated patients at respiratory icu * age more than or equal 18 years exclusion criteria: * patients with active pulmonary tuberculosis * patients with allergic bronchopulmonary aspergillosis * patients who underwent interventional bronchoscopy for hemoptysis * age less than 18 years
peri-operative chemotherapy with ecx or xp in the treatment of advanced gastric cancer

Conditions: Gastric Cancer

Summary: the purpose of this study is to evaluate the safety and the effect of perioperative chemotherapy in the treatment of advanced gastric cancer.

to evaluate the security and the relapse-free survival time/rate(1,2,3 yrs) of perioperative chemotherapy with ecx (epirubicin + cisplatin + capecitabine) and xp (capecitabine + cisplatin）in advanced gastric cancer

Eligibility criteria:
inclusion criteria: * male and female aged 18 to 70 years old. * the preoperative evaluation: gastric cancer patients, ≥ t2 or n +; or staging ii, iiia, iiib. * karnofsky score ≥ 70, life expectancy \> 6 months. * endoscopic biopsy diagnosis of gastric cancer, excluding non-hodgkin's lymphoma, leiomyosarcoma and other mesenchymal tumors. * the blood and biochemical indicators of the subjects must meet the following criteria: hb ≥ 9 g / dl; wbc ≥ 4,000 / mm3, ≤ 12000 / mm3; plt ≥ 100,000/mm3; got, gpt within twice the institutional limit,serum total bilirubin \< 1.5 times the upper limit of normal, serum creatinine\< 1.25 times the upper limit of normal and creatinine clearance rate ≥ 60ml/min, lvef ≥ 60%. * have not received prior chemotherapy, radiotherapy and biological therapy. * signed informed consent. * must accept the standard d2 or d2 + radical gastrectomy. * with good compliance. exclusion criteria: * pregnancy, breast-feeding women. * allergy with chemotherapy drugs or metabolic disorder. * the history of organ transplants (including bone marrow transplantation and autologous peripheral stem cell transplantation). * had long received systemic steroid treatment (note: short-term users of withdrawal \> 2 weeks can be selected.) * the existence of the peripheral nervous system disorders or significant neurological disorders and a history of central nervous system disorders. * patients with severe infection requires treatment. * patients associated with dysphagia, active peptic ulcer, incompleteness intestinal obstruction, active gastrointestinal bleeding, perforation. * severe liver disease (such as cirrhosis), kidney disease, respiratory disease or uncontrollable diabetes. * with other malignancies which were not cured. * ekg abnormalities or heart disease with apparent clinical symptoms, including congestive heart failure, coronary heart disease with symptoms, uncontrollable arrhythmia, hypertension, and heart attack within 12 months or iii or iv grade myocardial infarction. coronary heart disease with symptoms, uncontrollable arrhythmia, hypertension, and heart attack within 12 months or iii or iv grade myocardial infarction.

Keywords: gastric cancer peri-operative chemotherapy
effects of vanilla on hypoxic intermittent events in premature infants

Conditions: Premature Birth; Neonatal Hypoxic Conditions

Summary: the purpose of this study is to evaluate the effect of vanilla odor on hypoxic intermittent events in premature infants born between 32.0 and 33.6 weeks of gestational age.

a weekly screening will be done on all new hospitalized infants at the neonatal care unit of the chus born between 32.0 and 33.6 weeks of gestational age. at the beginning of their 2nd week in the neonatal care unit, infant's medical record will be consulted for inclusion and exclusion criteria. at this moment, no information will be noted. then, team research will discuss with neonatologist to have their opinion concerning the inclusion of a patient in the study. if they agree, the doctor or the nurse having a therapeutic link with the infant will ask parents' infant if they agree to meet the research team to discuss about the research project. once the agreement will be obtained, parents will be approached by a member of the research team. project will be explained, questions will be answered and consent form will be obtained. when an infant will be enrolled in the study, a code will be attributed to him and a randomization will established the order of the intervention. option a) night 1: a 12h cardiorespiratory recording with vanilla, night 2: no recording and night 3: a 12h cardiorespiratory recording without vanilla or option b): night 1: a 12h cardiorespiratory recording without vanilla, night 2: no recording and night 3: a 12h cardiorespiratory recording recording with vanilla. all data will be entered in a secured database and a double checked will be done by team members to assess the accuracy.

Eligibility criteria:
inclusion criteria: * infants born between 30.0 and 34.0 weeks of gestational age; * postnatal age between 3 and 4 weeks; * no current respiratory or ventilatory support; * stable state for at least the last 48 hours; * parental consent to enroll in the study. exclusion criteria: * respiratory diseases other than apnea; * intraventricular hemorrhage grade 3 or 4 or leukomalacia; * chromosomal abnormality; * congenital malformations which may result in cardiorespiratory or neurodevelopmental abnormality; * clinical deterioration during the study.

Keywords: late preterm vanilla hypoxic intermittent events
prophylactic intravenous injection of neostigmine plus atropine versus ketorolac on post-dural puncture headache in patients undergoing infraumbilical surgeries

Conditions: Post-Dural Puncture Headache

Summary: post-dural puncture headache (pdph) or spinal (or post-spinal) headache is one of the most common side effects of spinal anesthesia, with an incidence of 6-36%. the incidence of this complication was reported to be 76-85% after accidental dural puncture in epidural anesthesia. it usually starts within several hours after spinal anesthesia, but sometimes it can be delayed for up to 2 weeks, which usually resolves within a few days

the usual symptoms of pdph other than headache are photophobia, neck stiffness, nausea and vomiting, diplopia, tinnitus, and dizziness. the headache is usually throbbing and severe, starting from the forehead and extending to the occiput, and is aggravated by standing or sitting. this is due to meningeal traction associated with cerebrospinal fluid (csf) pressure reduction or dilation of cerebral arteries as an indirect effect of lowering csf pressure as a result of csf leakage from the punctured dura. current treatments or preventive measures for pdph other than bed rest and hydration include theophylline, sumatriptan, caffeine, etc. in resistant or severe cases, epidural blood patch (ebp) is a well-described technique used to provide relief of pain. the co-administration of neostigmine and atropine is a common treatment for terminating the effects of non-depolarizing muscle relaxants in the setting of general anesthesia with minimal side

Eligibility criteria:
inclusion criteria: * bmi less than 35 kg/m2 * scheduled for infraumbilical surgeries * american society of anesthesiologists (asa) physical status: i and ii exclusion criteria: 1. asa physical status more than ii. 2. history of allrgic response to local anaesthetics or any of the medications used in the study 3. patients with cognitive impairment 4. pregnancy 5. basal body temperature of more than 38°c or less than 36°c 6. bmi more than 35 kg/m2

Keywords: neostigmine ketorolac
prophylactic infrapatellar saphenous neurectomy in primary total knee arthroplasty

Conditions: Knee Pain Chronic

Summary: researchers are trying to determine if knee pain can be reduced by proactively protecting the free end of the saphenous nerve versus leaving it in the standard position during total knee arthroplasty.

subjects scheduled for total knee arthroplasty will be randomized to two arms. one arm will have the standard saphenous nerve neurectomy during their surgery. the other arm will have the same neurectomy procedure with the free end of the nerve tucked into soft tissue to protect the nerve ending.

Eligibility criteria:
inclusion criteria: * primary unilateral total knee arthroplasty candidate exclusion criteria: * body mass index (bmi) \>40 * inflammatory arthritis * unable to follow up visits (long distance from mayo clinic) * poor compliance risk * health condition deemed by physician to preclude patient's ability to participate in the trial
plasma n-terminal probnp concentrations and patent ductus arteriosus in preterm babies

Conditions: Ductus Arteriosus, Patent

Summary: premature babies are affected by a condition known as "patent ductus arteriosus" in which the ductus arteriosus (a normal structure) fails to close after birth as it should. a very large ductus can put extra strain on the heart and lungs, making the baby's breathing dependent on a mechanical ventilator. attending physicians can close the duct with medical\\or surgical treatment but assessing whether this is justified can be difficult. the physician usually bases this decision on assessment of the baby's general condition and an ultrasound evaluation of the heart (called an "echocardiogram") but the last is particularly dependent on availability of skilled operators. the investigators have examined whether blood levels of a hormone called b-type natriuretic peptide (nt pro-bnp)in the first week of life predict the need to treat a ductus arteriosus. this hormone is produced by the heart if it is under strain. if the test is helpful it could reduce dependence of physicians on echocardiography by skilled operators. babies who were recruited had blood samples collected on days 1, 2, 3 and 7 for measurement of nt pro-bnp. each baby also had an echocardiogram performed between the fifth and seventh day of life. decisions about treatment of the duct were made by attending physicians independent of the study. physicians, investigators and echocardiographers were blinded to knowledge of the nt pro-bnp concentration. nt pro-bnp was also measured before and after treatment in all babies who had a pda treated and echocardiography performed to confirm closure. receiver operating characteristics (roc) curves were used to assess the predictive value of nt pro-bnp for samples collected at each time point. the investigators also compared the nt pro-bnp levels in samples collected before and after treatment to assess the usefulness of nt pr-bnp as an indicator of duct closure.


Eligibility criteria:
inclusion criteria: * preterm babies under 34-weeks gestation admitted to the neonatal intensive care unit exclusion criteria: * known structural heart abnormality other than pda

Keywords: n terminal b type natriuretic peptide echocardiography diagnosis atrial natriuretic peptides preterm infant
safety and efficacy study of intramuscular uricase-peg 20

Conditions: Gout; Hyperuricemia

Summary: the purpose of this study is to assess the safety, pharmacokinetics and pharmacodynamics of single and multiple intramuscular doses of uricase-peg 20

uricase is an enzyme (found in most mammals but not humans) that converts poorly soluble uric acid into highly soluble allantoin. because humans lack uricase, they are prone to develop elevated levels of uric acid, which can form crystals in the joints and soft tissues. in those which chronically elevated uric acid, gout may develop. in the setting of acute rises in uric acid, seen for example in tumor lysis syndrome, uric acid crystals can damage the renal tubules. uricase-peg 20 is a recombinant uricase conjugated with multiple peg molecules designed to prolong the half-life and decrease the immunogenicity of uricase. this study will characterize the safety, pharmacokinetics and pharmacodynamics of intramuscular uricase-peg 20, the anticipated route of administration to be used in future clinical development in gout.

Eligibility criteria:
inclusion criteria: * serum uric acid \> 6 mg/dl (men) or \> 5 mg/dl (women) * clinical laboratory values within normal limits or not clinically significant * women should be menopausal or peri-menopausal exclusion criteria: * prior exposure to uricase * history of severe allergic reactions, or any allergy to peg or pegylated products * g6pd or catalase deficiency * medical condition that may interfere with ability to complete the study (e.g., uncontrolled diabetes or hypertension, congestive heart failure nyha class iii or iv, history of myocardial infarction, immunosuppression, pregnancy)
observational and diagnostical study on transient allostatic responses of thyroid function after syncopation and seizure

Conditions: Syncope; Seizures

Summary: changes of thyroid function may occur after short loss of consciousness, but they haven't been systematically evaluated up to now, although occasional observations suggest temporal increases in tsh concentration. this study aims at assessing transient changes of biomarkers of thyroid function after syncopation and seizure. results of the study might contribute to an improved detection rate of thyrotoxicosis.

transient allostatic responses of thyroid function have been described in critical illness. own observations suggest similar reactive responses after syncopation and cerebral seizures. they are marked especially by increased concentration of serum thyrotropin (tsh), suggesting a type 2 allostatic response. however, changes of thyroid function after temporal loss of consciousness haven't been systematically evaluated up to now. current diagnostic guidelines recommend primarily the determination of serum tsh concentration for screening of thyroid function, and the measurement of peripheral thyroid hormones (t4 and/or t3) is only recommended if tsh determination results in pathological values. this tsh reflex strategy may be misleading after short-term loss of consciousness. this study aims at assessing the prevalence of allostatic responses of thyroid function after events of syncopation or seizure and at investigating the consecutive temporal development of biomarkers of thyroid function. an additional aim includes the diagnostic value of tsh determination, compared to measurement of free thyroid hormones, for thyroid dysfunction after syncopation or seizure. results of this study might contribute to an improved detection rate of thyrotoxicosis. in cases of medical emergencies and in-patient treatment interventions with a significant iodine load are common, including the application of iodinated radiocontrast agents and amiodarone. in this setting, undetected hyperthyroidism may lead to thyroid storm, which is associated with a high mortality.

Eligibility criteria:
inclusion criteria: * admission after syncope or seizure * age of 18 years or older * first bleed not later than two hours after event (syncope or seizure) * written informed consent obtained exclusion criteria: * results of thyroid hormones not available within two hours after event * pituitary dysfunction * thyroid dysfunction * use of iodinated radiocontrast agents less than three months ago * therapy with amiodarone in the previous three years * pregnancy

Keywords: thyroid allostasis tacitus syncope seizure loss of consciousness
a study of biweekly pemetrexed and gemcitabine in patients with metastatic breast cancer

Conditions: Breast Cancer

Summary: this study is designed to determine the efficacy of the biweekly pemetrexed/gemcitabine regimen when given to patients with metastatic breast cancer. each agent has well demonstrated antitumor activity in patients with locally advanced or metastatic breast cancer. in addition, in the phase i combination trial of the two agents, a durable tumor response was seen in one out of three heavily pretreated breast cancer patients (adjei et al. 2000). therefore, it is reasonable to expect that the combination of pemetrexed and gemcitabine administered may be associated with considerably more anti-tumor activity than either agent alone. if such activity is seen in this study, randomized studies comparing this combination with other active agents or combinations of active agents will be considered.


Eligibility criteria:
inclusion: 1. have a performance status of 0 to 2 on the ecog performance status schedule. 2. patients may have had up to one prior systemic chemotherapy for metastatic disease is allowed. prior adjuvant therapy is allowed if it has been more than one year since the end of therapy. 3. patients must have measurable disease as defined by recist criteria (therasse et al. 2000): 4. have adequate organ function including the following exclusion: 1. have serious concomitant systemic disorders (eg, active infection) that, in the opinion of the investigator, would compromise the safety of the patient or compromise the patient's ability to complete the study.
epidemiology and cytokines analysis of severe asthma patients in taiwan

Conditions: Bronchial Asthma; Cytokines

Summary: severe asthma is a heterogeneous disease characterized by the need for treatment with high doses of inhaled corticosteroids. it affects 5%-10% of asthmatic patients, although it accounts for a significant percentage of the consumption of health care resources. severe asthma comprises various clinical and pathophysiological phenotypes. in this current study, we aimed to clinical characteristics and cytokes profile in severe asthma patients.

to investigate the clinical phenotypes and inflammatory endotype by analyzing cytokines in severe asthma patients, it may improve characterization of the disease and contribute to improved selection of appropriate treatment. it could also help link genotypes with their phenotypic manifestations and their natural history and prognosis. a greater understanding of the phenotypes of severe asthma could enable identification of biomarkers for each phenotype, and identify the association between biokarkers and clinical outcomes in severe asthma patients.

Eligibility criteria:
inclusion criteria: 1. asthma which requires treatment with guidelines suggested medications for gina steps 4-5 asthma (high dose ics and laba or leukotriene modifier/theophylline) for the previous year or systemic cs for 50% of the previous year to prevent it from becoming ''uncontrolled'' or which remains ''uncontrolled'' despite this therapy 2. uncontrolled asthma defined as at least one of the following: (1). poor symptom control: acq consistently\>1.5, act\ 3 days each) in the previous year (3). serious exacerbations: at least one hospitalization, icu stay or mechanical ventilation in the previous year (4). airflow limitation: after appropriate bronchodilator withhold fev1\<80% predicted (in the face of reduced fev1/fvc defined as less than the lower limit of normal) exclusion criteria: * (1). mild to moderate persistent asthma (2). copd or other lung diseases (3). malignancy (4). long-term o2 therapy more than 15 hours/day (5). long-term nippv use (\> 6 hours/day) (6). no inform consent and cannot be followed regularly (7). active tb or other infection diseases

Keywords: severe asthma
assessing functional status needs via pro measures for pts with metastatic breast cancer

Conditions: Breast Cancer; Metastasis

Summary: the purpose of this single-site non-randomized study is to identify areas of need related to functional status and overall health, including nutrition and mental health in subjects with metastatic breast cancer (mbc). a decline in functional status is observed after breast cancer diagnosis and exacerbated by treatment. declining functional status impacts the quality of life and can lead to increased comorbidity burden, hospitalization, and increased mortality. functional status is assessed by specific provider-graded scales. patient reported outcome (pro) measures may better assess certain aspects of patient health and symptom domains. thus, potentially supporting the future implementation of effective prehabilitation strategies. this study explores whether a pro-based survey will identify the physical and emotional health and the social and financial status of patients newly diagnosed with mbc.


Eligibility criteria:
in order to participate in this study a subject must meet all of the eligibility criteria outlined below. inclusion criteria: 1. written informed consent was obtained from participants in the study and hipaa authorization for release of personal health information. 2. subject is willing and able to comply with study procedures based on the judgment of the investigator or protocol designee. 3. age ≥ 18 years at the time of consent. 4. recent diagnosis of new metastatic breast cancer at time of screening. exclusion criteria: 1. exclusion criteria 2. inability to read or speak english. 3. dementia, altered mental status, or any psychiatric condition as determined by clinical or study team that would prohibit the understanding or rendering of informed consent. 4. current incarceration. 5. subject has already received treatment for metastatic breast cancer prior to screening.

Keywords: patient reported outcomes quality of life functional status