Kornimate/medical-research-clean huggingface dataset:
imatinib in systemic sclerosis

Conditions: Scleroderma, Systemic

Summary: systemic sclerosis (ssc) is an autoimmune disease characterized by fibrosis of the skin and internal organs and widespread vasculopathy. patients with ssc are classified according to the extent of cutaneous sclerosis: patients with limited ssc have skin thickening of the face, neck, and distal extremities, while those with diffuse ssc have involvement of the trunk, abdomen, and proximal extremities as well. the disease course varies depending on the subtype of ssc. however, common features that result in significant morbidity and mortality, in addition to cutaneous fibrosis, include raynaud's phenomenon and digital ulcerations, interstitial lung disease (ild), and pulmonary arterial hypertension (pah). current therapeutic options for patients with ssc and these clinical manifestations have shown limited efficacy. imatinib antagonizes specific tyrosine kinases that mediate fibrotic pathways involved in the pathogenesis of ssc, including c-abl, a downstream mediator of transforming growth factor (tgf)-beta, and platelet derived growth factor (pdgf) receptors. the efficacy of imatinib has also been reported in the treatment of patients with refractory idiopathic pah through its effects on vascular remodeling. based on the mechanism of action and preliminary patient data, we hypothesize that imatinib may be effective in the treatment of the fibrotic and vasculopathic features of patients with ssc. this is an open label pilot study to evaluate the safety and efficacy of imatinib in patients with progressive ssc refractory to other treatment(s). validated measures of skin thickness and disease activity will be determined over 6-months of therapy and compared with baseline measures.


Eligibility criteria:
inclusion criteria: adults with refractory diffuse or limited ssc and any or all of the following: progressive cutaneous fibrosis, interstitial lung disease, pulmonary arterial hypertension, digital ulcerations. exclusion criteria: uncontrolled congestive heart failure, hypertension, or coronary artery disease. hiv, hepatitis b, and/or hepatitis c infection. serious infection within the past month. significant hematologic, renal, or hepatic abnormalities. concurrent use of intravenous immunoglobulin or cyclophosphamide within 4 weeks of the first treatment dose. concurrent use of a biologic agent (ie. etanercept, infliximab, adalimumab, abatacept) within 8 weeks of the first treatment dose (6 months for rituximab). women who are pregnant or breastfeeding.
implantable cardioverter defibrillator versus optimal medical therapy in patients with variant angina manifesting as aborted sudden cardiac death

Conditions: Angina Pectoris, Variant; Sudden Cardiac Death

Summary: the purpose of this study is to determine whether icd(implantable cardioverter defibrillator) implantation on the top of optimal medical therapy in patients with variant angina manifesting as aborted sudden cardiac death reduces the incidence of the death from any cause compared with optimal medical therapy alone.

all participants will be monitored over a span of five years and the time point of the year of last subject last visit. the term "year of last subject last visit" refers to the time point of the last visit for all participants. at this specific time point, event occurrence check will be conducted to determine the occurrence of endpoint events among all participants.

Eligibility criteria:
inclusion criteria: * age 18 years or older * patients experienced successfully resuscitated cardiac arrest due to documented ventricular fibrillation or sustained rapid ventricular tachycardia * diagnosed as variant angina, defined by spontaneous coronary spasm with st elevation (≥0.1mv) in the coronary angiogram and/or documented coronary spasm on ergonovine provocation coronary angiography exclusion criteria: * significant (\>50%) coronary artery stenosis on coronary angiography * organic heart disease known to be associated with sudden cardiac arrest. * heart failure with reduced ejection fraction (left ventricular ejection fraction \< 35%) * presence of lv akinesia or aneurysm * hypertrophic cardiomyopathy * arrhythmogenic right ventricular dysplasia * chronic heart failure new york heart association functional class iii or iv * prior history of atrial or ventricular arrhythmia requiring class i or iii antiarrhythmic drugs (flecainide, propafenone, amiodarone, sotalol and dronedarone) * prior catheter ablation for ventricular arrhythmia * primary cardiac electrical diseases (long qt syndrome, brugada syndrome, catecholaminergic polymorphic ventricular tachycardia) * prior pacemaker or implantable cardioverter defibrillator * 2nd or 3rd degree av block not related to coronary ischemia, requiring permanent pacemaker * patients with poor neurologic outcome (defined as cerebral performance category scale ≥3) * life expectancy \<2 years * psychiatric illnesses that may be aggravated by device implantation or that may preclude systematic follow-up

Keywords: variant angina aborted sudden cardiac death implantable cardioverter defibrillator optimal medical therapy icd
a study to compare caries detection in the pediatric population between the itero element 5d system and bitewing radiographs

Conditions: Dental Caries; Patient Compliance

Summary: this is a non-significant risk, single site, prospective clinical study. the study will be conducted in the department of pediatric dentistry of the faculty of dental medicine of the hebrew university, israel

this is a non-significant risk, single site, prospective study to be conducted in the department of pediatric dentistry of the hadassah medical center, faculty of dental medicine, hebrew university of jerusalem, israel. subject participation will require one visit during which consent, screening, enrollment, and imaging will be performed. clinical and diagnostic methods to be used during this study are those that are routinely used in the diagnosis of caries in this site, which include bitewing radiographs (bwr). this standard of care is provided for all site's patients, including the patients who don't participate in this clinical study. a standard set of bwr for subjects ages 4-9 years will be taken to include the complete dentition of the subjects. no additional x-ray should be taken for the sole purpose of this trial. in addition to the routine clinical diagnostics, the subjects will be scanned using the 5d system. the investigator will capture a full arch scan of the maxillary arch and mandibular arch of each subject with the itero element 5d system. for each subject, the investigator will grade carious lesions in the bwr and element intra-oral scan according to ada staging guidelines. the results will be documented using caries evaluation forms. the investigator will assess and document the findings of each diagnostic test separately before reviewing the next test. in cases where caries debridement is indicated, carious lesion depth will be documented during and compared to niri and bwr images. all treatment decisions will be made according to the standard of care in the clinic and no treatment will be conducted for the sole purpose of the study

Eligibility criteria:
inclusion criteria: * ages 4-9 years * subjects scheduled for bilateral bwr as part of their standard of care * subjects with a recent bilateral bwr which were obtained up to 14 days prior to study visit exclusion criteria: * subjects who have been diagnosed with epilepsy * subjects with a known allergy to latex or plastic * subjects with allergies to any dental or oral health products * subjects who have undergone a dental treatment since the acquisition of the recent bilateral bwr
diacutaneous fibrolysis, effects on tension type headache

Conditions: Tension-Type Headache

Summary: tension type headache (tth) is a frecuent type of headache disorder (about 1 person in 5 worldwide). individuals with tth typically present pericraneal tenderness and an increased cervical muscle tone. the most common treatment in primary care consists mainly on analgesic medication. however, different techniques of manual therapy have been shown to be effective in the treatment of these patients. diacutaneous fibrolysis shows clinical benefits in relieving symptoms of tension type headache, but there is no scientific evidence that analyzes this effects. the hypothesis of this study was that adding treatment with diacutaneous fibrolysis to the usual conservative treatment has beneficial effects on different variables of the headache. the aim of the study was to assess the effect of diacutaneous fibrolisis on intensity, frequency, duration of headache and cervical function in patients with tension type headache. a randomized controlled clinical trial has been designed to evaluate the effectiveness of diacutaneous fibrolysis technique compared to usual general practicioner care in patientes with tension type headache. the study protocol has been approved by the clinical research ethics committee from the aragon community and all patients provided written consent. eighty-two people with clinical diagnosis of tth were randomized into a intervention group or a control group. intervention group received three sessions of diacutaneous fibrolysis, while control group was advised to maintain their usual pharmacologic treatment. pain intensity (vas), frecuency, location, cervical range of motion, head forward position and pressure pain thresholds (ppts) were measured at baseline, postintervention, and 1 month follow-up after treatment. the spanish version of the hit-6 questionnaire was used to measure disability/function at baseline and follow-up.


Eligibility criteria:
inclusion criteria: * diagnosis of tension-type headache according to the criteria of icdh-iii. exclusion criteria: * currently undergoing physiotherapy treatment for headache * modification of pharmacological treatment in the last month * presence of red flags
variations in anesthesia care for hip fracture surgery

Conditions: Hip Fractures; Anesthesia; Death

Summary: the investigators will use health administrative data to examine the variation of anesthesia type for hip fracture surgery, as well as sources of variation and predictors of variation.

to evaluate the sources of variance in utilization of neuraxial anesthesia the investigators will use multilevel multivariable modeling strategies. this will allow identification of sources of variation (hospital, vs physician, vs patient characteristics), as well as identification of independent predictors of neuraxial use at each of these three levels. the investigators will also evaluate the independent association of hospital level variation in neuraxial use on our outcomes of interest using multilevel multivariable regression.

Eligibility criteria:
inclusion criteria: * had hip fracture surgery * admitted to hospital on a non-elective basis exclusion criteria: * do not hold a valid provincial health insurance account

Keywords: hip fracture geriatric epidemiology practice variation anesthesia
effects of upper extremity rehabilitation robot and transcranial direct current stimulation in chronic stroke

Conditions: Stroke

Summary: comparison of real transcranial direct current stimulation (tdcs) and sham tdcs combined with robot training for upper extremity rehabilitation in subjects with chronic stroke - delayed start study.


Eligibility criteria:
inclusion criteria: * hemiplegic patients secondary to first cerebrovascular accidents * onset ≥ 6 months * fugl-meyer assessment score ≥ 19 * cognitively intact enough to understand and follow the instructions from the investigator exclusion criteria: * severe upper extremity pain that could interfere with rehabilitation therapy * neurological disorders other than stroke that can cause motor deficits * uncontrolled severe medical conditions.

Keywords: stroke transcranial direct current stimulation upper extremity rehabilitation robot
the pharmacologic profile of sodium thiosulfate in renal failure and healthy volunteers

Conditions: Renal Failure

Summary: the pharmacokinetics of sodium thiosulfate in humans with different degrees of renal failure and in healthy volunteers will be after two single shot applications.

two single shot applications of i.v. sodium thiosulfate will be given to dialysis patients. one application will be given immediately before a dialysis session and the second dose will be given after the consecutive dialysis session. in healthy volunteers sodium thiosulfate will be given only once. in both groups, dialysis patients and healthy volunteers, blood and urinary/dialysate samples will be collected at defined time points.

Eligibility criteria:
inclusion criteria: * healthy volunteer or patient with renal failure exclusion criteria: * pregnancy * withdrawal of consent

Keywords: renal failure sodium thiosulfate pharmakokinetic
hemodynamic variations during remote ischemic conditioning in critical ill patients

Conditions: Critical Illness

Summary: the main objectives of this study are to evaluate the changes in hemodynamics occurring during the remote ischemic conditioning (ric) procedure and to compare the hemodynamic responses elicited by passive leg raising before and after the ric intervention.

the investigators hypothesized that the inflation of the blood pressure cuff during the remote ischemic conditioning (ric) procedure would lead to an increase in stroke volume (sv), cardiac index (ci), and peripheral perfusion index and that these changes would correlate with the hemodynamic changes induced by passive leg raising (plr). furthermore, the clinical relevance of the ric effect in critically ill patients, particularly in terms of determining their hemodynamic responsiveness, remains uncertain. the investigators hypothesized that the ric procedure influences hemodynamic changes during plr.

Eligibility criteria:
inclusion criteria: * aged over 18 years, * admitted to the intensive care unit, * monitored with a transpulmonary thermodilution device with calibrated pulse contour analysis (pulsion medical systems, munich, germany), * decision by the physician in charge to perform passive leg raising. exclusion criteria: * pregnancy, * advanced malignancy, * peripheral artery disease affecting both arms, * head trauma, * deep vein thrombosis in the lower limbs, * intra-abdominal hypertension, defined as an intra-abdominal pressure greater than 12 mmhg.

Keywords: remote ischemic conditioning passive leg raising hemodynamic perfusion index fluid responsiveness
special care patterns for elderly hnscc patients undergoing radiotherapy

Conditions: HNSCC; Oral Cavity Cancer; Oropharynx Cancer; Hypopharynx Cancer; Larynx Cancer

Summary: the number of elderly head-and-neck squamous cell carcinoma (hnscc) patients is increasing; however, the evidence regarding the ideal treatment for this often vulnerable and frail patient cohort is limited. although the benefit of concomitant chemotherapy has been reported to decrease in elderly hnscc patients based on the mach-nc meta-analysis, it remains unknown whether state-of-the art radiotherapy techniques such as intensity-modulated radiotherapy (imrt), modern supportive treatments and alternative chemotherapy fractionation (e.g., cisplatin weekly) may have altered this observation. the objective of this retrospective multinational multicenter study is to determine the oncological outcomes of elderly patients (≥65 years) with locally advanced hnsccs undergoing definitive (chemo-)radiation and to investigate the influence of concomitant chemotherapy on overall survival and progression-free survival after adjusting for potential confounder variables such as age, performance status and comorbidity burden.


Eligibility criteria:
inclusion criteria: * definitive (chemo-)radiotherapy of locoregionally advanced (ct3-4 and/or cn+) head-and-neck squamous cell carcinomas (hnscc) of the oral cavity, oropharynx, hypopharynx or larynx * primary treatment since 2005 * age ≥65 years at the time of (chemo-)radiotherapy exclusion criteria: * adjuvant (chemo-)radiotherapy * history of previous head-and-neck cancers or radiotherapy in the head-and-neck region * distant metastases at (chemo-)radiotherapy initiation (cm1) * hnsccs of the nasopharynx, salivary glands, skin or with unknown primary

Keywords: elderly radiotherapy chemotherapy chemoradiotherapy cisplatin cetuximab real-world data
radiomics model for the diagnosis of pneumocystis jirovecii pneumonia in non-hiv patients

Conditions: Pneumocystis Jirovecii Pneumonia

Summary: to evaluate the performance of radiomics in differentiating pneumocystis jirovecii pneumonia (pcp) from other types of pneumonia and to improve the diagnostic efficacy of non-invasive tests in non-hiv patients.

retrospective study, including non-hiv patients hospitalized for suspected pcp from january 2010 to december 2022. the included patients were randomized in a 7:3 ratio into training and validation cohorts. radiomic features were extracted from semi-automatically identified infected areas in computed tomography (ct) scans and used to construct a radiomic model, which was then compared to a clinical-imaging model built with clinical and semantic ct features in terms of diagnostic performance of pcp. the combination of the radiomic model and serum β-d-glucan levels was also evaluated for pcp diagnosis.

Eligibility criteria:
inclusion criteria: * aged over eighteen years; * presence of an underlying disease known to be associated with pcp * symptoms of lower respiratory tract infection, such as fever, cough or dyspnea * signs of lung infection on high resolution ct at the on-set of the disease * received bal examination within three days after ct scans * underwent qpcr and if staining tests on the bal fluid sample. exclusion criteria: * with hiv infection * taking trimethoprim-sulfamethoxazole for prophylaxis * undiagnosed by qpcr and if staining tests

Keywords: computed tomography diagnostic tests pneumocystis jirovecii pneumonia radiomics
prune consumption and bone health in young women using hormonal contraceptives

Conditions: Osteoporosis Risk

Summary: the primary objective of this study is to determine if 12 months of consuming 50 grams of dried plum daily will prevent bone loss or augment bone accrual of young adult oral contraceptive (oc) users.

eligible participants will be assigned among three groups 1) control non-oc users, 2) control oc users, and 3) dried plum oc users. oc users will be randomly allocated to the dried plum oc group, which will consume 50 g dried plum daily for 12 months, or a control group, for which dried plums will not be allowed and no control food will be provided.

Eligibility criteria:
inclusion criteria: * age 18-25 exclusion criteria: * metabolic bone disease, renal disease, cancer, cvd, diabetes mellitus, respiratory disease, gastrointestinal disease, liver disease or other chronic diseases, heavy smoking (more than twenty cigarettes/day) and current use of any prescription medications known to alter bone and calcium metabolism * regularly consumed dried plum or prune juice

Keywords: prune bone health oral contraceptives women health
efficacy of digital problem solving application in reduction of anxiety, depression and substance use disorder symptoms

Conditions: Anxiety; Depressive Symptoms; Substance Use Disorders

Summary: the focus of this study is the impact of usage of a mobile application to support problem-solving therapy on symptoms of anxiety, depression and substance use.

tribal communities have a problem. they experience a disproportionate rate of substance use and mental illness. research shows that customized digital tools designed with the community, integrating local culture and resources are more effective in reducing symptoms of anxiety and depression. however, the cost of design and development renders quality app creation for small markets infeasible. digital support for problem-solving therapy in a tribal community (dspt) solves this problem through dramatically reducing software design time by using ai for task analysis and to combine tasks, service programs' geographic coordinates and hours and applying the proprietary 7 gen blocks software components to reduce development time. the resulting mobile application will be used by intervention groups on two reservations. at baseline, three months and six months post, both the intervention and randomly assigned control group (total n =100) will complete standardized, validated measures of depression, anxiety and substance use disorder symptoms. all participants will be enrolled members in a federally recognized tribe, over 18 years of age and have a diagnosis of an anxiety, depression or substance use disorder.

Eligibility criteria:
inclusion criteria: * diagnosis of anxiety, depression or substance use disorder. resident on or near turtle mountain or spirit lake reservation. enrolled in federally recognized tribe. exclusion criteria: * literacy below fourth-grade level. diagnosis of personality disorder or schizophrenia, or other impaired perception of reality.
tangji gastric bypass stent study for obesity

Conditions: Obesity

Summary: the gastric bypass stent system is intended to be used in weight loss treatment for obesity in patients with a bmi ≥ 30 kg/m2. in this clinical investigation the sponsor seeks to demonstrate the safety and performance of the gastric bypass stent system for its proposed indication in weight loss treatment for obesity in the china.


Eligibility criteria:
inclusion criteria: 1. aged 18-60 years, both male and female; 2. obese patients with bmi ≥ 30 kg/m2, who are willing to be treated with gastric bypass stent system or dietary intervention; 3. patients with asa i\~ii grade; 4. the patient understands the onjective of the trial and is volunteered to participate in the trial and has signed the informed consent form (icf). exclusion criteria: 1. have a weight loss of more than 4.5 kg in the past three months, or take weight-loss drugs in the past month; 2. patients who used non-steroidal anti-inflammatory drugs (nsaids) and corticosteroids in the past month; 3. patients diagnosed with type 1 diabetes; 4. patients with the function of islet β cell basically lost, c-peptide ≤ 1/2 of the normal low limit or low and flat c-peptide release curve under glucose load; 5. patients with iron deficiency or iron deficiency anemia; 6. patients with coagulation dysfunction who used aspirin and other anticoagulants in the past month; 7. patients with severe liver and kidney dysfunction, and the serum creatinine concentration of greater than 180 μmol/l; 8. patients with class iii heart function of nyha or higher, or pulmonary dysfunction; 9. patients who have undergone ercp procedure, or have a history of cholecystitis or liver abscess; 10. patients with duodenal ulcer, gastric ulcer or previous and existing pancreatitis; 11. patients with gallstones (diameter ≥ 20 mm) with clinical symptoms; 12. patients with thyroid dysfunction; 13. patients with hemorrhage or potential hemorrhage in the digestive tract; 14. patients with gastrointestinal tract anomalies, such as gastrointestinal tract atresia, or other conditions that would result in failed placement in the gastrointestinal tract; 15. patients with a history of bowel obstruction or related diseases in the past year; 16. patients with a history of systemic lupus erythematosus or scleroderma; 17. patients with severe infections that are not controlled, not suitable for a procedure; 18. patients with poor general condition and having endoscopic contraindications (as evaluated by the investigator); 19. pregnant women or women having the plan for pregnancy; 20. drug abusers or alcohol addicts or patients with uncontrollable mental illness; 21. patients who participated in other clinical trials of drugs or medical devices before enrollment and do not reach the endpoint time limit; 22. patients who participated in other clinical trials of drugs or medical devices before enrollment 3 months. 23. patients with any other conditions evaluated by the investigators as unsuitable for participating in the trial.