Kornimate/medical-research-clean huggingface dataset:
clinical decision-support reminders to improve ipt initiation among hiv positive adults in western kenya

Conditions: Tuberculosis

Summary: the overall research objective is to evaluate the impact of implementing a reminder system for medical providers to improve tb case-finding and isoniazid preventative therapy (ipt) for adults living with hiv in western kenya

the purpose of this study is to evaluate the impact of implementing a clinical decision support reminder system for medical providers (i.e., nurses, clinical officers, medical officers, consultants) to improve tuberculosis case-ﬁnding and the use of isoniazid preventative therapy for adults living with hiv in western kenya.

Eligibility criteria:
clusters: inclusion criteria * active * uses hiv initial and return encounter paper forms * enters data into the ampath medical records system (amrs) or sends forms to central location for data entry * prints or receives printed paper summary sheets with reminders * interprets chest x-rays * interprets sputum smear results * prescribes ipt and dispenses inh * completed an average of 10 initial adult hiv positive encounters per month in 2012 * hiv care clinic exclusion criteria - patients: inclusion criteria * hiv positive * complete an adult initial encounter at an hiv care clinic during the enrollment period * attend at least one additional appointment within 90 days after the initial encounter exclusion criteria - history of tb or ipt

Keywords: tuberculosis isoniazid preventative therapy clinical decision support hiv kenya ehealth
pearl study: improvement of non-hodgkin's lymphoma care

Conditions: Non-Hodgkin Lymphoma

Summary: the main objective of the proposed study is to assess the effectiveness, feasibility and costs of a tailored strategy (developed in accordance with the barriers found and current practice) to improve care for patients with non-hodgkin's lymphomas (nhl), compared to a common strategy of 'audit \& feedback'.

in a previous study among 22 dutch hospitals many gaps in the care for patients with non-hodgkin's lymphomas (nhl) were found, compared to best evidence as described in guidelines. in a problem analysis study, barriers and facilitators for good quality of nhl-care were assessed and a tailored implementation strategy was developed, based on these findings. the proposed study aims at the effectiveness, feasibility and costs of this tailored strategy to improve quality of care for patients with an nhl in a clustered randomized controlled trial in 19 dutch hospitals. multilevel regression analyses will be performed to evaluate the effectiveness of both strategies. exposure to and experiences with the strategy elements will be analysed descriptively. regarding the costs, the two strategies are compared with a health care perspective. the input of resources will be assessed by collecting volumes of consumed resources and multiplying these by the price of each resource unit; the implementation process and consequently costs will be estimated by an activity based costing (abc) approach. the output will be determined by the level of adherence to the nhl quality indicators.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of non-hodgkin lymphoma * diagnosed in one of the participating hospitals * able to read and understand dutch

Keywords: non-hodgkin lymphoma (nhl) quality of health care oncology service hospital patient-centredness proms
identification of new immune factors specific of relapse in childhood b lineage acute lymphoblastic leukemia

Conditions: B Acute Lymphoblastic Leukemia; Leukemia Relapse

Summary: b-acute lymphoblastic leukaemia (all) is the most common childhood malignancy. despite enhancement of childhood b-all outcome, relapses remain difficult to treat. several studies in adult acute myeloid leukaemia have shown that proliferation of immunosuppressive cells -particularly t regulatory (treg) cells and deficient natural killer (nk) cells- was associated with poor response to chemotherapy. however, few studies have been done on childhood all and none on relapse of b-all. moreover, a newly described immunosuppressive b cells subset (breg cells) seems to have a role in oncogenesis in mice model, but its significance has never been evaluated in human cancers. the purpose of this study is to prospectively evaluate the immune status of children newly diagnosed with first relapse of b-cell all, and to compare results with those of children treated for b-all in complete remission. classic lymphocytic phenotype, proportions of immunosuppressive cells (treg cells, deficient nk cells, cytotoxic t-lymphocyte-associated protein 4 and/or programmed t cell death 1) and thymopoiesis will be evaluated. the investigators assume that increase of immunosuppressive cells proportions could be associated with b-all relapse.


Eligibility criteria:
1. inclusion criteria for relapse group : * children aged from 1 to 18 years at the time of first b-all relapse diagnosis * obtention of oral and written consent of the parents * parents affiliated with the social security system 2. inclusion criteria for control group : * children aged from 1 to 18 years enrolled into fralle or eortc treatment protocols, treated for b-all and who are in complete molecular remission * obtention of oral and written consent of the parents * parents affiliated with the social security system 3. exclusion criteria for control group are the same as for relapsed group : * children with hematologic syndrome predisposing to hematologic neoplasia (such as fanconi's anaemia, diamond blackfan anaemia ...) or acute leukemia secondary to previous treatment, or who have had allogenic hematopoietic stem cell transplantation before relapse

Keywords: b acute lymphoblastic leukemia leukemia relapse pediatric onco-hematology
computerized tomographic colonography compared with standard diagnostic procedures in detecting colorectal neoplasia

Conditions: Colorectal Cancer

Summary: rationale: new diagnostic procedures such as computed tomographic colonography may provide a less invasive method of identifying patients who have colorectal neoplasia. purpose: diagnostic study to compare the effectiveness of computerized tomographic colonography with that of standard diagnostic procedures in detecting colorectal neoplasia.

objectives: i. compare retrospectively the accuracy of computerized tomographic colonography (ctc) vs pathology and colonoscopy in the detection of clinically important colorectal neoplasia, defined as at least one proven lesion with a diameter measuring at least 1 cm. ii. compare the physician image display preferences and interpretation time across three viewing platforms for ctc images. outline: this is a retrospective, multicenter study. radiologists evaluate each patient's optimal diagnostic computerized tomographic colonography (ctc) data. patients' ctc findings are evaluated by a radiologist at a central facility using an imaging display software platform from general electric, vital images, or the mayo clinic. ctc findings are compared with conventional colonoscopy findings and pathologic analysis. a comparison is made between physician image display preferences and interpretation time across three viewing platforms for ctc images. projected accrual: a total of 90 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: the following case material must be submitted for each patient: no colonic diseases except polyps, cancer, or diverticulosis optimal diagnostic computerized tomographic colonography (ctc) data with computed tomography acquisition parameters that meet the following minimal standards: slice thickness no greater than 5 mm reconstruction interval no greater than 3 mm pitch no greater than 2 anatomic coverage of the entire colorectum supine and prone data sets complete colonoscopy performed within 30 days following ctc by a board certified gastroenterologist or a physician with at least 3 years of colonoscopic experience pathology reports for all endoscopically or surgically removed colorectal lesions with the exception of polyps that are inadvertently dropped at the time of retrieval photograph or videotape record of dropped lesion allowed as proof of its existence all studies are allowed including those with lesions less than 1 cm, lesions at least 1 cm, or no lesions report documents size, site, stage, grade, and type of colorectal cancers; size, site, degree of dysplasia, and type of colorectal adenomas; and types of other lesions (e.g., inflammatory, vascular, ulcerative) demographic data including patient's age, sex, ethnic background, symptoms, risk factors, and relevant clinical history patient characteristics: age: 18 and over performance status: not specified life expectancy: not specified hematopoietic: not specified hepatic: not specified renal: not specified prior concurrent therapy: see disease characteristics

Keywords: colon cancer rectal cancer
enhancing skin cancer early detection and treatment in primary care

Conditions: Cutaneous Melanoma

Summary: skin cancer screening may help find melanoma sooner, when it may be easier to treat. if found early melanoma and other types of skin cancer may be curable. multi-component education may be an effective method to help primary care physicians (pcps) learn about skin cancer screening. this clinical trial examines whether a clinician-focused educational intervention can improve pcp's knowledge and clinical performance to identify and triage skin cancer. this intervention may increase the pcp's ability to diagnose, treat and/or triage early-stage melanoma.

primary objective: i. evaluate whether a multi-component education strategy improves the ability of pcps to identify and triage skin cancer. outline: participants are assigned to 1 of 2 groups. pcp participants complete group training. all training participants will also be offered series of short booster teaching points delivered virtually. participants who complete the training also take part in pre-post knowledge assessments. pcp participants may also participate in a qualitative interview. pcps at the two clinics who do not receive the group training will serve as study comparators.

Eligibility criteria:
inclusion criteria: * clinicians at two oregon health \& science university (ohsu) primary care clinics will be invited to receive exposure to the melanoma early detection intervention * clinicians at the two clinics who do not receive the intervention will serve as study comparators * these individuals are all aged 18 years or older * all practice members speak english exclusion criteria: * no one will be intentionally excluded
effect of feeding positions of preterm infants on some physiological characteristics

Conditions: Feeding Behavior

Summary: the purpose of this study is to determine the effect of semielevated side-lying (esl) and semielevated supine position (esu) positions used in bottle-feeding of very preterm infants upon their physiological characteristics and feeding performances.

semielevated supine position (esu) is a position frequently used in neonatal intensive care units. in this position, infant is laid and fed on its back and the head is elevated to an angle of 45-60° in order to reduce the respiratory load of lungs. the esl position, head of the infant is elevated to an angle of 45-60° and the infant is fed in the side-lying position. since this position mimics the breast-feeding position, very preterm infants are supported to utilize the advantages of breast-feeding. a randomization was provided in the sample group consisting of totally 80 infants and while 38 infants were included in the esl (experimental) group, 42 infants were included in the esu (control) group.in the power analysis repeated at the end of the study, the power of the study was determined as 87% at a reliability of 95%.

Eligibility criteria:
inclusion criteria: * to be born between 26-31+6 gestational weeks according to mother's last menstruation date, * to be between 32-39+6 postmenstrual weeks during the study, * have a body weight above 1500 g, * have a full enteral feeding, * to be in a transition from orogastric catheter feeding to oral feeding for less than 24 hours, * have an oral feeding in this process for at least once, * tolerate at least 80% of amount of food given lastly during oral feeding, * voluntarily signing of the written informed consent form by parents exclusion criteria: * infants suffering from craniofacial abnormalities like cleft palate, * cleft lip and facial muscle paralysis; gastrointestinal, neurological and genetic disorders (necrotising enterocolitis, intracranial haemorrhage, periventricular leukomalacia, hydrocephalia, down syndrome, omphalocele, gastroschisis, short bowel syndrome etc.) * moderate and severe bronchopulmonary dysplasia (bpd) (jobe \& bancalari, 2001) * patent ductus arteriosus requiring surgical therapy were excluded from the study

Keywords: feeding preterm infant physiological characteristics position esl esu
argatroban plus r-tpa for posterior circulation infarction（ar-pci）

Conditions: Argatroban, Rt-PA

Summary: acute ischemic stroke (ais) is the most common type of stroke, which has high rate of morbidity, mortality and disability. a large number of studies have confirmed that the thrombolytic therapy can effectively open blood vessels and improve the functional prognosis of acute ischemic stroke. therefore, all guidelines recommend giving thrombolysis treatment to acute ischemic stroke patients within 4.5 hours of onset. however, about 1/3 patients receiving thrombolysis will have good prognosis, while a large number of patients will still be disabled and even dead. how to improve the neurofunction prognosis of thrombolytic patients has been a hot topic in the world. recent studies have found that the combined application of argatroban and rt-pa in the treatment of acute anterior circulation infarction might improve the clinical prognosis and not significantly increase bleeding. some studies have reported that the combined application of argatroban and rt-pa could improve the blood vessel opening rate, and prevent re-occlusion after opening. based on the discussion, the present study is designed to explore the efficacy and safety of argatroban plus rt-pa in the treatment of acute posterior circulation infarction.


Eligibility criteria:
inclusion criteria: 1. 18-80 years old; 2. diagnosis of posterior circulation ischemic stroke; 3. time from onset to treatment ≤6 hours; 4. nihss: 4-25; 5. signed informed consent by patient self or legally authorized representatives. exclusion criteria: 1. mrs≥2; 2. history of stroke within 3 months; 3. history of intracranial hemorrhage; 4. suspected subarachnoid hemorrhage; 5. intracranial tumour, vascular malformation or arterial aneurysm; 6. major surgery within 1 month; 7. systolic pressure ≥180 mmhg or diastolic pressure ≥110 mmhg; 8. platelet count \< 105/mm3; 9. heparin therapy or oral anticoagulation therapy within 48 hours; 10. abnormal aptt; 11. thrombin or xa factor inhibitor; 12. severe disease with a life expectancy of less than 3 months; 13. blood glucose \< 50 mg/dl (2.7mmol/l); 14. patients who have received any other investigational drug or device within 3 months; 15. pregnancy; 16. researchers consider patients inappropriate to participate in the registry.
extended half-life (ehl) clotting factor for improving the musculoskeletal health of patients with hemophilia

Conditions: Haemophilia

Summary: background. hemophiliac arthropathy is the main long-term physical damage in patients with hemophilia, causing disability and functional limitations. objective. assessment of the efficacy of a prophylactic treatment with ehl products for improving the musculoskeletal health of adult patients with hemophilia. study design. multicenter observational clinical study. method. 40 patients with hemophilia a will be included in this study. patients will be recruited from 5 centers located in various regions of spain (community of madrid, galicia, community of valenciana, málaga and vizcaya). the dependent variables will be: bleeding frequency (self-report of bleeding), changes in the dosage of factor viii with ehl products (rfviiifc), pain (measured with the visual analog scale and a pressure algometer), degree of kinesiophobia (tampa scale of kinesiophobia), degree of adherence to treatment (veritas-pro scale), joint health (using the hemophilia joint health score), muscle strength (using a dynamometer) and functionality (using the 6-minute walking test). three evaluations will be carried out: baseline, at 6 months, and at the end of the study period, at 12 months. the evolution of quantitative variables shall be analyzed by parametric tests (t-student test) or non-parametric tests (wilcoxon test). pearson's correlation coefficient shall be used to obtain the correlation between the dependent and independent variables. by means of a linear regression analysis we will record the percentage influence of the clinical variables relative to the dependent variables measured in this study expected results. the aim is to establish the effectiveness of the prophylactic treatment in the improvement of the state health, joint pain, muscle strength and functionality in patients with hemophilia.


Eligibility criteria:
inclusion criteria: * patients diagnosed with hemophilia a * patients over 18 years * patients under prophylactic treatment with rfviiifc concentrates. exclusion criteria: * patients with neurological or cognitive disorders preventing the understanding of the various measuring instruments * patients who are scheduled for major orthopedic surgery (total arthroplasty) * not signed the informed consent document
assessment of tristetraprolin expression in lesional skin of patients with non segmental vitiligo

Conditions: Non-segmental Vitiligo

Summary: vitiligo is characterized by the selective loss of melanocytes, which in turn leads to totally amelanotic, non-scaly, chalky-white macule with distinct margins vitiligo is the most common depigmenting skin disorder, with an estimated prevalence of 0.5-2% of the population in both adults and children worldwide tumor necrosis factor (tnf-α), a pro-inflammatory cytokine is necessary for th1 mediated response and immune homeostasis and the up-regulation of tnf-α can result in chronic inflammatory and autoimmune diseases . previous studies revealed a rise in transcript and protein levels of tnf-α in vitiligo patients the prime location of melanocytes, keratinocytes and fibroblasts is the epidermal microenvironment and these cells are capable of tnf-α expression and secretion tnf-α acts as an autocrine as well as a paracrine manner to suppress the melanocyte growth and proliferation ( tristetraprolin (ttp) zinc finger protein 36 (zfp36) is ribonucleic acid (rna) binding protein that preferentially binds to adenylate-uridylate-rich (au-rich) regions in the 3' untranslated regions (3'utr) of target genes . additionally, tristetraprolin functions by destabilizing mrnas encoding for oncogenes, cytokines (as tnfα), and chemokines involved in the inflammatory processes, by favoring their degradation and/or preventing their efficient translation the expression of proinflammatory mediator genes is tightly controlled by post-transcriptional regulation, which is mediated by a set of immune-related rna binding proteins, such as tristetraprolin, roquin, and regnase


Eligibility criteria:
inclusion criteria: * this study will include adult patients\>18 yrs with non -segmental vitiligo attending the dermatology outpatient clinics at sohag university, egypt. a group of participants will be included as a control group.this control group will be taken from patients seeking for abdominoplasty in plastic surgery department at sohag university hospital. exclusion criteria: - 1)pregnancy. 2)patients with chronic inflammatory skin disorders. 3)patients on antioxidants or anti-inflammatory drugs. 4)patients on topical or systemic treatment for vitiligo in the last 4 weeks prior to enrollment in the study. 5)patients with other autoimmune diseases as thyroiditis. lupus erythematosus and rheumatoid arthritis 6)patients with diabetes mellitus (dm).
analysis of the sweat response according to the pathology in neurologic patients

Conditions: Neurological Disorder

Summary: cardiovascular autonomic neuropathy (can) has been shown to be an important risk factor for cardiac diseases, particularly in diabetes. can may be investigated by a battery of laboratory cardiovascular autonomic reflex tests(initially described by ewing). first screening for can (as proposed in diabetic patients) can be performed by assessing heart rate (hr) response to deep breathing, blood pressure (bp) and hr response to a 5 minutes stand test

sweat glands are innervated by thin and un myelinated sympathetic c-fibers that can be impaired in neuropathies,especially length-dependent ones. sweating dysfunction has been shown in several neurological peripheral disorders and it has been suggested that sweating function should be included among the diagnostic tests for the early detection of autonomic neuropathies. several methods have been developed, but the lack of easy and quick tests to diagnose sweating dysfunction has restricted widespread use in clinical practice. measurement of electrochemical skin conductance (esc) using sudoscan® is a new method for quick, non-invasive and quantitative assessment of sweating. this technique has demonstrated its usefulness in detecting autonomic and small fiber neuropathy, especially in diabetic patients.the aim of this study was to evaluate the performance of the laboratory battery of cv tests and of sweating dysfunction by sudoscan®, alone or in combination, to differentiate msa-p from pd. among the cv tests, the present study particularly looked at those tests already recommended as screening bedside tests in diabetic patients (hr variations with deep breathing and bp variations during stand test) ; these tests are rapid and easy to perform. hr variations with deep breathing depend on parasympathetic tone and bp variations depend on vasomotor sympathetic response.

Eligibility criteria:
inclusion criteria: * patients with msa-p or pd exclusion criteria: -

Keywords: sweat gland
covid-19 in patients with chronic inflammatory rheumatism, auto-immune or auto-inflammatory rare and non-rare diseases

Conditions: Sars-CoV2; Chronic Inflammatory Rheumatism; Autoimmune Diseases

Summary: since december 2019, an international outbreak of respiratory illnesses caused by sars-cov-2 called covid-19 has become a global challenge. in france, while the first cases were reported in january, more than 20 000 cases were confirmed at end of march. early estimations from epidemiological data seem to show that 18-20% of patients with confirmed covid-19 are admitted in an intensive care unit (icu). patients with chronic inflammatory rheumatism, auto-immune or auto-inflammatory rare and non-rare diseases are susceptible to severe covid-19 (i.e icu) due to the specific therapeutic management of their illness (corticosteroid, immunosuppressive and immunomodulatory drugs,..). no data are available for this particular population in france. this retrospective multicentre observational study aims to evaluate the frequency of severe forms of covid-19 and risk factors associated with specific outcomes in covid-19 in patients with chronic inflammatory rheumatism, auto-immune or auto-inflammatory rare and non-rare diseases.


Eligibility criteria:
inclusion criteria: * all patients, children and adults * patients with known chronic inflammatory rheumatism, auto-immune or auto-inflammatory rare and non-rare diseases with proven/suspected sars-cov-2 infection (covid-19) (by biological data (serological or positive cov-2 pcr) or ct scan images or clinical observations consistent with covid-19) exclusion criteria: * patients opposed to the use of their data * patients under guardianship, protected persons

Keywords: covid-19 chronic inflammatory rheumatism auto-immune diseases auto-inflammatory diseases intensive care unit