Kornimate/medical-research-clean huggingface dataset:
combating diagnostic wandering and impasse for cystic fibrosis

Conditions: Cystic Fibrosis

Summary: after cystic fibrosis (cf) neonatal screening, some children remain with a not concluded diagnosis. in france, the medical follow-up is not standardized, some of them may be lost of follow-up. the aim of the study is to identify children at risk of developing cf. other children carry mutation at risk of cftr related disorder (cftr-rd) but remain asymptomatic during childhood. the aim of the study is to evaluate those children by microbiology, respiratory function test and lung imaging tests to reclassify them in the cftr spectrum.

cystic fibrosis (cf) is a life-limiting genetic disorder related to the mutation of the cf transmembrane conductance regulator (cftr) gene. cystic fibrosis neonatal screening in france has been generalized in 2002. patients with hypertrypsinemia and two cf mutations are diagnosed cf and followed in cf center with standards of care. but some children with hypertrypsinemia may have an intermediate chloride sweat test and only one cftr mutation, or a negative sweat test and two cftr mutations at least one of which is of unknown pathogenicity. some other patients may present with two cftr-rd mutations and may unravel a monosymptomatic disease in adulthood (cftr-related disorder) such as congenital bilateral absence of vas deferens (cbavd), acute recurrent or chronic pancreatitis, disseminated bronchiectasis, chronic rhinosinusitis...we have very few data about age of onset, type of symptoms, and infraclinical disease. patients will be identified according to neonatal screening data and genetic database, and will undergo clinical evaluation, pancreatic and lung disease evaluation to reclassify them in the cftr spectrum.

Eligibility criteria:
inclusion criteria: * undiagnosed patients with hypertrypsinemia at cf neonatal screening and : 1. either an intermediate chloride sweat test (30-59 mmol/l) and at most one cftr mutation 2. or negative chloride sweat test (\< 30 mmol/l) and two cftr mutations one of wich is of unknown significance (vus) * patients with two cftr mutations at least one of which is of varying clinical consequence according to "cftr2" database or "cftr-rd" according to "cftr-france" database. exclusion criteria: * cf patients with 2 cf causing mutations
avx754 (a new nucleoside reverse transcriptase inhibitor [nrti]) to treat drug-resistant hiv

Conditions: HIV Infections

Summary: the study will measure how safe and effective avx754 (a new drug for the treatment of hiv) is in treating hiv-1 infected people who have failed treatment with lamivudine.

lamivudine or emtricitabine are commonly used in combination with other drugs for first-line treatment of hiv infection. although effective initially, many people later on develop resistance to some or all of the drugs (including lamivudine) leading to virological failure. resistance is associated with characteristic mutations, which for lamivudine is the m184v mutation. a change to new, active drugs must take place when patients fail their current regime, to regain control of the virus. although there are other types of drugs available for second line treatment, there is currently no fully active, well tolerated cytidine analogue that can replace lamivudine in a second-line regimen when patients fail first line treatment. this study will measure the efficacy and safety of avx754 (a novel cytidine analogue with activity against hiv resistant to other nucleosides) as part of a new regimen to treat patients who have failed treatment containing lamivudine, compared to the best alternative new regimen which continues to include lamivudine.

Eligibility criteria:
inclusion criteria: * hiv-1 infected * m184v mutation in reverse transcriptase * currently taking lamivudine * viral load \>2000 copies/ml exclusion criteria: * hepatitis b surface antigen positive * pregnant or breastfeeding females * hepatitis c rna positive and requiring treatment

Keywords: human immunodeficiency virus anti-retroviral therapy nucleoside analogue reverse transcriptase lamivudine resistance mutation treatment experienced
sexual health counseling based on the better model

Conditions: Health Knowledge, Attitudes, Practice; Sexuality

Summary: in this study, the investigators wanted to examine the effect of sexual health counseling to women in the postpartum period on the quality of life of the participants.


Eligibility criteria:
inclusion criteria: * primiparous, * have had a vaginal birth, * those who will live with their partner in the period after birth, * having started sexual intercourse before starting training, * without a diagnosed chronic disease (dm, ht, heart disease, etc.), * 18 years or older, * able to speak and understand turkish, exclusion criteria: • edinburgh postpartum depression scale score of 12 and above,

Keywords: sexual health counseling sexual life quality postpartum postpartum sexual life quality better model
epigenetics and ncd prevention in kazakhstan: personalized approaches and biological age prediction

Conditions: Cardiovascular Diseases (CVD); Type 2 Diabetes; Chronic Respiratory Diseases; Obesity (Disorder); Chronic Kidney Diseases

Summary: this study aims to enhance personalized and preventive care for non-communicable diseases (ncds) in kazakhstan by examining epigenetic factors, predicting biological age and reproductive function using machine learning, and developing health improvement recommendations.


Eligibility criteria:
inclusion criteria: * adults aged 18 to 69 years. * residents of 17 regions of kazakhstan. * willingness to participate and provide informed consent. exclusion criteria: * age less than 18 years old or over 69 years old. * failure to provide informed consent or incomplete participation in data collection procedures.

Keywords: dna methylation precision medicine preventive medicine artificial intelligence biomedical modeling
stress inoculation training (sit): an evidence-based, military aligned psychological performance and health sustainment prototype

Conditions: Stress, Psychological

Summary: the purpose of this study is to demonstrate the feasibility of augmenting existing/traditional navy military training with the manualized sit core protocol (cp) utilizing the established augmentation procedure set as measured by feasibility, utility, and satisfaction metrics (csq-8) and to examine the relative effectiveness of the sit-cp by comparison to standard military training in a controlled trial examining outcomes of stress tolerance, psychological health, resilience and occupational performance in sailors undergoing dca firefighting training (pre- to post-training), while collecting implementation data.


Eligibility criteria:
inclusion criteria: * us navy service members on active duty or reserve status * be fluent in english. * be capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form and in this protocol. * have access to a smartphone, computer, or tablet to utilize and access the virtual classroom. * agree to undergo psychometric and operational performance testing and participate in ongoing assessments throughout the study duration. * be willing to comply with all study procedures, able to complete all assessments independently, and available for the duration of the study (with reasonable accommodations for military operational demands as they arise). exclusion criteria: * active suicidal ideation as assessed by the investigator at screening or as identified during the study. * clinically significant history of psychotic disorder, bipolar spectrum disorder, or neurodegenerative disease/dementia as assessed by the investigator. * active severe substance abuse as assessed by the investigator in accordance with the diagnostic and statistical manual of mental illnesses (dsm-5) substance abuse disorder criteria, or presence of illicit substance abuse. * they are currently undergoing another form of treatment other than supportive therapy (\>2 times per month). * any other condition/situation that the investigator believes may interfere with participant safety, study conduct, or interpretation of study data.

Keywords: psychological health resilience warfighter performance
a study of safety, tolerability, and immunogenicity of the mrkad5 gag/pol/nef vaccine in healthy adults (v520-016)

Conditions: HIV-1; HIV Infections

Summary: the goal of this study is to understand the safety, tolerability and immunogenicity of the merck trivalent adenovirus serotype 5 hiv-1 gag/pol/nef vaccine (mrkad 5 hiv-1 gag/pol/nef) vaccine in healthy human volunteers compared to placebo. the study will also evaluate a number of dose levels and the necessity for and timing of booster injections.

the study will proceed in four stages. following stages i, ii and iii, all subjects will have the postdose 1 (pd1) clinical and laboratory safety data reviewed by the safety evaluation committee (sec). if these data are acceptable, the next stage will be initiated. * in stage i, participants will be randomized to receive 3 doses of the 3x10\^9vp/dose level trivalent vaccine or placebo. * in stage ii, participants will be randomized to receive 2 or 3 doses of the 3x10\^10vp/dose level trivalent vaccine or placebo. * in stage iii, participants will be randomized to receive 3 doses of the trivalent vaccine with titers of 1x10\^11vp/dose, 3x10\^6vp/dose, 3x10\^7vp/dose, or 3x10\^8vp/dose or placebo. * in stage iv, participants will be randomized to all treatment groups. in addition, some participants will be randomized to an mrkad 5 hiv-1 gag monovalent vaccine. in this stage, participants will be pre-stratified by baseline ad5 titers (=\ 200), to ensure an even distribution of participants with high and low ad5 titers across the various treatment groups.

Eligibility criteria:
inclusion criteria: * subjects 18 years to 45 years in stages i-iii and 18 years to 50 years in stage iv. * subject is in good general health * subjects of reproductive potential agree to use acceptable method of birth control through study * subject tests negative for hepatitis b, hepatitis c, and hiv exclusion criteria: * subject has a recent history of fever at time of vaccination * subject has received immune globulin or blood product 3 months prior to injection * subject has been vaccinated with live virus vaccine 30 days prior to receipt of first dose * subject has been vaccinated with inactivated vaccine with 14 days prior to receipt of first dose * subject has a chronic medical condition that is considered progressive * subject has history of malignancy * subject weighs less than 105 lb. * female subject is pregnant or breast feeding, male subject is planning to impregnate during the first year of study * subject has contraindication to intramuscular injection * subject has a tattoo on the deltoid region of the arm or the injection of depo-provera * subject is unlikely or unwilling to adhere to lower risk sex practices during the course of the study

Keywords: hiv seronegativity preventive vaccine
optimizing the use of prophylaxis in patients with severe haemophilia a

Conditions: Hemophilia A

Summary: mypkfit is a web-based application recently developed by baxalta for the use in patients treated with advate. mypkfit has its basis in bayesian forecasting, which allows estimation of individual pk parameters by a sparse sampling schedule, where only 2-3 samples are taken between 4 and 48 hours post infusion. with mypkfit, it will, therefore, be possible to define an individual pk curve for each patient based on just a few sampling points and hence, taking the bleeding phenotype and the life style into account, potentially adjust the prophylactic treatment accordingly to optimize cost-effectiveness.

as detailed in brief summary patients will, after accurate information verbally and written according to ethics approval, report bleeding events during previous 6 months. blood samples are taken, fviii analyzed (advate patients) and the individual pk curve determined using mypkfit. the curve will be discussed together with the patient and levels related to bleed events determined. if needed dose adjustment is done based on the curve. after a further 6 month follow-up bleeds will again be evaluated as well as factor consumption. in this way a better personalized treatment based on pk and clinical phenotype will hopefully be achieved.

Eligibility criteria:
inclusion criteria: * children and adults with severe hemophilia a (fviii:c \<1 %), being treated with advate for more than 50 exposure days (eds exclusion criteria: * current evidence of inhibitor as measured by the nijmegen-modified bethesda assay * use of another investigational fviii product in the previous month
comparison of multiphase and monophasic arterial hepatic mri in the detection of arterial enhancement of chc nodules

Conditions: Hepatocellular Carcinoma

Summary: the detection and diagnosis of hepatocellular carcinoma is a public health issue. mri is the most sensitive examination for diagnosis and especially hypervascularization in the arterial phase. several studies have shown that mri multiphase arterial sequences are superior to single phase to capture the arterial phase. the purpose of this study is to compare arterial enhancement sensibilities between multi and single phase sequences.


Eligibility criteria:
inclusion criteria: * patient included in chic study with histology of hepatocellular carcinoma exclusion criteria: * nodules already treated by chimioembolization
supermicrosurgery for breast cancer survivors with lymphedema.

Conditions: Secondary Lymphedema; Breast Cancer

Summary: a randomised prospective investigation of volume and quality of life results with lymphovenous anastomosis in patients with unilateral arm lymphedema after breast cancer using indocyanine green lymphangiography and md anderson staging.

this is a randomized study comparing lymphovenous anastomosis versus conservative (compression) treatment for lymphoedema after breast cancer surgery - 50 patients to be included in each study arm. the primary endpoint is volume change measured by submersion and changes in arm circumference at defined levels from the wrist. secondary endpoint is health related quality of life measured by questionnaire short form 36 (sf-36), hospital anxiety depression score (hads), fatigue questionnaire (fq) and a disease-specific questionnaire, upper limb lymphedema score (ull27).

Eligibility criteria:
inclusion criteria: * unilateral lymphedema of the arm secondary to breast cancer treatment. stage 1-3 operable lymphedema. exclusion criteria: * frequent or severe cellulitis. all other lymphedema.

Keywords: lymphovenous bypass lymphovenous anastomosis supermicrosurgery lymphangiography md anderson lymphedema stage
epipericardial fat necrosis: a misdiagnosed condition

Conditions: Epipericardial Fat Necrosis

Summary: epipericardial fat necrosis is a benign and self-limited condition that mainly curses with acute pleuritic chest pain and therefore must be an important differential diagnosis for patients in emergency department (ed). the knowledge of characteristics symptoms and correct management may avoid misdiagnosis or mistakes with other severe conditions like pulmonary embolism, pericarditis or acute coronary disease. despite the importance of this entity, only fewer than 40 cases have been reported since 1957, when the condition was first described. we have seen a couple of similar cases in our institution during a short period of time, and we suspect that these numbers doesn't mean the real prevalence of epipericardial fat necrosis, so maybe this condition could be underdiagnosed. instead, there isn't a study that tried to estimate an incidence of this entity.


Eligibility criteria:
inclusion criteria: * patients with imaging criteria of efn (defined as a round fat attenuation lesion with peripheral stranding located in the epipericardial fat) exclusion criteria: * no exclusion criteria

Keywords: epipericardial fat necrosis fat necrosis chest pain pericardial necrosis pleuritic pain
vital pulp therapy to treat irreversible pulpitis

Conditions: Pulpitis

Summary: the purpose of this study is to demonstrate non-inferiority of pulpotomy treatment (with new endodontic bio-materials) as a new treatment with one-visit root canal therapy as reference treatment in pain relief and clinical and radiographic success, for irreversible pulpitis of human permanent molar teeth.

in one visit rct (arm 1): the teeth were anesthetized, isolated and endodontic access and instrumentation of all canals was done. canal preparation was conducted using a step-back technique. the working lengths were determined and confirmed by radiography. sterile normal saline solution was used for intra-canal irrigation. root canals were obturated with gutta-percha and sealer using lateral condensation technique. after placing a cotton pellet in the pulp chamber, the access cavity was closed with cavit. in pulpotomy treatment with cem/mta (arm 2): the teeth were anesthetized. pulpotomy procedure of removing inflamed pulp tissue to the stump level was done. homeostasis was achieved by irrigating the cavity with sterile normal saline and application of small pieces of sterile cotton pellets. the pulpal wound was covered with an approximately 2-mm-thick layer of mta/cem cement. pulp chambers were then covered with a wet cotton pellet and sealed with cavit.

Eligibility criteria:
inclusion criteria: * diagnostic criteria: 1. patient reports pain of endodontic origin 2. diagnosis of irreversible pulpitis * eligibility criteria: 1. molar tooth 2. patient chooses to have tooth extraction for pain relief 3. age 9-65 years 4. both gender 5. the patient had read and thoroughly understood the questionnaires; and 6. written informed consent * exclusion criteria: 1. moderate or severe periodontitis 2. none restorable tooth 3. internal or external root resorption 4. root canal calcification 5. no bleeding after access cavity preparation 6. analgesic taken within the last 4 h 7. active systemic disease 8. the patient was pregnant or nursing 9. history of opioid addiction or abuse 10. temporary residency

Keywords: endodontics cem cement calcium enriched mixture mta root canal therapy pain pulpotomy human permanent molar teeth
biological response of trauma patients to standard trauma resuscitation therapy

Conditions: Hemorrhagic Shock

Summary: overall aim of this work is to evaluate new methods of resuscitation that can be applied by front-line responders on the battlefield, in civilian life, or which can be used during initial resuscitation in the first fixed facility to which the injured patient is brought.

shock is a leading cause of death among american forces in battle, with many trauma victims dying of early hemorrhagic shock or from late septic shock.1 shock is defined as circulatory collapse, when the arterial blood pressure is too low to maintain an adequate supply of blood to the body's vital organs and tissues. specifically, hemorrhagic shock results when blood vessels are physically damaged while septic shock results when microbes or microbial products enter the blood stream. despite advances in medical science, including the development of improved antibiotics, treatments for hemorrhagic and septic shock have changed little in the past 30-40 years. a wounded soldier bleeding on the battlefield, or a trauma victim in the united states, is treated today largely as he or she would have been treated in 1970. the overall aim of this work is to evaluate new methods of resuscitation that can be applied by front-line responders on the battlefield (medical corpsmen, combat medics), in civilian life (emergency medical system), or which can be used during initial resuscitation in the first fixed facility to which the injured patient is brought. this might be a fire support specialist (fist) team in a combat theater or a trauma center in the civilian health care system.

Eligibility criteria:
inclusion criteria: * blunt or penetrating trauma patients who meet truman medical center criteria for a trauma activation. * these patients will typically be in shock and have blunt injuries or penetrating trauma. * patients must be alert, awake, oriented, and responsive and be english speaking males or females between the ages 21-65. exclusion criteria: * traumatic cardiac arrest patients, * pregnant patients, * interhospital transfer patients, * non-english speaking patients, * patients with suspected or confirmed human immunodeficiency virus (hiv) or aids based on clear history, * prior laboratory tests, or strong clinical suspicion; patients with clinical evidence of impaired mental function; * patients with continuing hypotension or tachycardia after resuscitation; * patients with blood alcohol in excess of 80mg/dl; * signs suggestive of coagulopathy; * allergy to glutamine; * liver disease or renal disease.

Keywords: hemorrhagic shock glutamine trauma resuscitation department of defense trauma
fractionated 1927-nm non ablative thulium laser in treating post inflammatory hyperpigmentation

Conditions: Healthy

Summary: to study the effect of fractionated 1927-nm non ablative thulium laser in reduction of post inflammatory hyperpigmentation (pih) using a validated and reproducible model for studying pih. * determine if there is aa reduction in pih in patients treated with three (3) monthly sessions of fractionated 1927-nm non ablative thulium laser * determine if there is efficacy of post-procedure clobetasol propionate 0.05% ointment in the management of pih * determine the histological and molecular changes that occur with laser and laser plus topical steroid treatment compared to untreated skin

the design of the study consists of a total of six visits including one initial screening visit within 107-127 days depending on the scheduling of your screening and subsequent visits. assessments such as visual examination, photography, investigatory global assessment (iga) of pigmentation and erythema; colorimetry; and diffuse reflectance spectroscopy of the intended treatment area will be conducted at visits 1-5. optional biopsies will be taken at various time points.

Eligibility criteria:
inclusion criteria: * patient age 18 and older * patient with skin phototypes iv-vi * patient able to understand requirements of the study and risks involved * patient able to sign a consent form * patient to have discontinued all oral medications used to treat pigmentary abnormalities and all topical medications, except for sunscreen, used to treat pigmentary abnormalities on the buttocks one month prior to treatment exclusion criteria: * a patient who has skin dyspigmentation, birth marks, tattoos, or other skin findings at baseline on either buttock that may obscure study results * a patient who is lactating, pregnant, or planning to become pregnant