Kornimate/medical-research-clean huggingface dataset:
diagnostic yield of deep learning based denoising mri in cushing's disease

Conditions: Pituitary ACTH Secreting Adenoma

Summary: negative mri findings may occur in up to 40% of cases of acth producing microadenomas. the aim of the study is to evaluate if detection of acth producing microadenomas can be increased using deep learning based denoising mri.

detecting acth producing microadenoma in mri is important in establishing the diagnosis of cushing disease and may enable patients to avoid additional diagnostic tests such as inferior petrosal sinus sampling. however, detecting acth producing microadenoma in mri remains as a diagnostic challenge due its small size with its median diameter of 5-mm. many attempts have been made in order to improve the sensitivity of detecting acth producing microadenoma. it is generally accepted as standard clinical practice to perform dynamic contrast enhanced t1 weighted image to delineate delayed enhancing microadenonoma in comparison to the background enhancement of the normal gland. despite these attempts, negative mri findings may occur in up to 40% of cases of acth producing microadenomas and there is a need to improve its detection rate. theoretically, performing thin slice thickness scans should help detecting the lesion but this is unavoidably accompanied with increased level of noise. deep learning based denoising algorithm can be applied to reduce the noise level and potentially increase the detection rate of acth producing microadenomas. the aim of the study is to evaluate if detection of acth producing microadenomas can be increased using deep learning based denoising mri.

Eligibility criteria:
inclusion criteria: * patients suspected of cushing disease undergoing mri * signed informed consent exclusion criteria: * patients who have any type of bioimplant activated by mechanical, electronic, or magnetic means (e.g., cochlear implants, pacemakers, neurostimulators, biostimulates, electronic infusion pumps, etc), because such devices may be displaced or malfunction * patients who are pregnant or breast feeding; urine pregnancy test will be performed on women of child bearing potential * poor mri image quality due to artifacts
prevalence of oral mucosal alterations in mucocutaneous ocular disorders

Conditions: Oral Disease; Muco-Cutaneo-Ocular Syndrome

Summary: the patients will be selected from the pool of the clinics (rheumatology, ophthalmology and dermatology) of faculty of medicine and (diagnostic center and oral medicine) of faculty of dentistry -cairo university. for each eligible participant, a full history will be obtained followed by thorough clinical examination.


Eligibility criteria:
inclusion criteria: * adult patients diagnosed with one of the mucocutaneous disorder. * patient who will agree to participate in the study. * patients who will accept to sign the informed consent. exclusion criteria: * patients not physically able to participate in survey or clinical oral examination.

Keywords: oral health status oral findings oral manifestations patient with mucocutaneous ocular disorders mucocutaneous ocular disorders
social adjustment and quality of life after very preterm birth

Conditions: Low Birth Weight; Premature Birth

Summary: the major aim is the follow-up of the highest risk group (\< 32 weeks gestation/ \< 1500 birthweight) and their controls of the bavarian longitudinal study (bls) at the age of 24-27 years. the focus will be the identification of risk, protective and resiliency factors for cognitive and behavioural development and quality of life. mris of the central nervous system will be conducted to examine aberrant activation patterns during the "attention network task" in stratified subgroups. data driven mri methods will be evaluated in relation to clinical, behavioural and developmental parameters.

the major aim is the follow-up of the highest risk group (\< 32 weeks gestation/ \< 1500 birthweight) and their controls of the bavarian longitudinal study (bls) at the age of 24-27 years. all probands have been assessed previously, neonatally and at additional six time points, the last time at the age of 12-13 years. the focus will be the identification of risk, protective and resiliency factors for cognitive and behavioural development and quality of life. on the basis of previously assessed data statistical modelling of child development until age 8.5 years will be conducted across the total range of gestation from 26-42 weeks to identify social factors amenable to intervention which could be associated with a positive development especially in moderate prematurity. in addition, cross-validation of the findings is planned by means of comparisons with three international studies (millenium cohort, gb; pops, nl; epicure, gb). mris of the central nervous system will be conducted to examine aberrant activation patterns during the "attention network task" in stratified subgroups. data driven mri methods will be evaluated in relation to clinical, behavioural and developmental parameters. in line with the objectives of funding there will be a further follow-up of the bls to answer important questions regarding health and development of very small preterms.

Eligibility criteria:
inclusion criteria: * very low birth weight vlbw (\< 1500g birthweight)and/ or * very preterm birth vpt (\< 32 weeks of gestation) * members of the bavarian longitudinal study exclusion criteria: * missing compliance

Keywords: very low birthweight/ very preterm children bavarian longitudinal study (bls) quality of life and social adjustment in adulthood
study to determine the utility of fes-pet in the prediction of response to fulvestrant in women with estrogen positive metastatic breast cancer

Conditions: Metastatic Breast Cancer

Summary: effects of fulvestrant on the ers may be evaluable by molecular imaging using positron emission tomography with the er-specific fes tracer. in this study we will determine the utility of fes-pet in the prediction of response to fulvestrant 500 mg in women with estrogen positive metastatic breast cancer

more than 70% of patients with metastatic breast cancer present with hormone receptor positive disease and for whom hormonal therapy is the preferred treatment approach. first-line treatment recommendations for women with hormone receptor positive locally advanced or metastatic disease includes a generation aromatase inhibitors or tamoxifen. fulvestrant, a 17β-estradiol analog, is an antiestrogen that suppresses estrogen signaling by binding to er and inducing oestrogen receptor degradation and has estrogen antagonistic activity but no estrogen agonistic effect. fulvestrant has been shown to have superiority over other endocrine therapy in a series of randomized controlled trials. the whole-body imaging of the availability of er using fes-pet may prove valuable to evaluate the effects of fulvestrant on the er non-invasively in individual patients. this potentially allows early prediction of therapy efficacy to fulvestrant in women with estrogen positive metastatic breast cancer. in this pilot-study we will evaluate 35 patients who received fulvestrant as treatment for metastatic breast cancer. all patients will undergo fes-pet/ct at baseline and fes-pet after 28 days. whenever possible, tumor biopsies will be performed to correlate to fes-pet results.

Eligibility criteria:
inclusion criteria: 1. patients with a history of histological proven er-positive primary breast cancer and, whenever available, histological proven er-positive recurrence. 2. no previous fulvestrant treatment 3. er-antagonists should be discontinued for 5 weeks prior to fes-pet. the use of aromatase inhibitors is allowed. 4. age \> 18 5. ecog 0-2 6. life expectancy \> 6 months 7. informed consent obtained 8. able to comply with the protocol exclusion criteria: 1. presence of life-threatening visceral metastases 2. evidence of central nervous system metastases 3. \> 3 lines of endocrine therapy for metastatic disease 4. isolated liver metastasis (high fes uptake by normal liver)

Keywords: fulvestrant 500 mg fluorine-18 fluoroestradiol pet-ct
a study in adults with inflammatory bowel disease (ibd) receiving vedolizumab in the patient support program (psp) in brazil

Conditions: Ulcerative Colitis; Crohn's Disease

Summary: the primary reason of this study is to observe current and past treatment in adult participants receiving vedolizumab, intravenous (iv) or subcutaneous (sc), for ibd in brazil. there is no treatment involved in this study, this is only an observational review of past and ongoing treatment data relating to vedolizumab treatment for ibd (including ulcerative colitis \[uc\] and crohn's disease \[cd\]).

this is a non-interventional, observational study in participants with ibd participating in the psp. this study will enroll approximately 2160 participants. the study is divided into two cohorts according to data collection: * retrospective cohort * prospective cohort the retrospective cohort is for participants that were included in the psp prior to study start. this retrospective cohort will have data of participants that are actively participating in the program and only their retrospective data will be collected. the prospective cohort is for participants that are starting their participation in the psp using their data from the consent date until the end of the study or until the discontinuation in the psp or in the study. retrospective and prospective cohorts will be collected from the psp database, which will be the only source of participants for this study. this single country trial will be conducted in brazil. the duration of this observational study will be approximately 26 months.

Eligibility criteria:
inclusion criteria: • who participated or who will participate in the "entre nós" program and participant who consent to participate in the study. exclusion criteria • no exclusion of participants is expected in the present study and the quality of the data relies in participant reported outcomes for the "entre nós" program.

Keywords: drug therapy
effect of high-intensity laser therapy on patients with myogenic temporomandibular joint dysfunction

Conditions: Temporomandibular Joint Dysfunction Syndrome

Summary: this study will be conducted to investigate the effect of high-intensity laser therapy on the temporalis and masseter muscles activity in patients with myogenic temporomandibular joint dysfunction.

temporomandibular joint dysfunction (tmd) is one of the problems that affect the quality of lifestyle through the presence of pain around the joint radiated in the face, neck, or shoulders muscles and a decrease in function of the temporomandibular joint that leads to difficulty in mastication, swallowing, earaches, dizziness, and hearing problems may sometimes be associated with tmd. high-intensity laser therapy (hilt) is a laser with a wavelength of 1064 nm and has recently been used in the treatment of musculoskeletal diseases. its primary effect is the analgesic effect and reactive vasodilation by affecting the cutaneous nerve endings. another mechanism of action is based on tissue stimulation. this stimulation occurs at the level of cells, vascular tissue, interstitial tissue, and the immune system. it increases regeneration and beta-endorphin release by inducing protein synthesis in synovial fluid, thus exerting analgesic and anti-inflammatory effects. since there is a lack of literature studying the effect of hilt on masseter and temporalis muscles activity in patients with myogenic tmd so, this study may provide a baseline for a new technique in rehabilitation intervention in patients with myogenic tmd.

Eligibility criteria:
inclusion criteria: * patients from both gender with unilateral myogenic temporomandibular dysfunction (tmd) with trismus diagnosed and referred from maxillofacial specialist. * aged between 20 to 45 years old . * visual analogue scale (vas) score \>3 for unilateral myogenic pain of the temporomandibular joint (tmj). * pain lasting at least 3 months. * patients were diagnosed as unilateral myogenic pain. exclusion criteria: * previous tmj surgery. * history of jaw dislocation. * history of jaw fracture. * previous therapy with occlusal splint. * concomitant therapy of bruxism. * presence of removable oral prosthesis. * metal implants in the skull. * presence of hearing aids. * malignancy. * pregnancy. * diabetic patients. * hypertensive patients. * systemic rheumatologic disease * systemic infection. * inserted cardiac pacemaker. * presence of coagulation disorders. * trigeminal neuritis. * cognitive dysfunction. * bilateral tmd.
anti-vegf gene therapy trial for vestibular schwannoma

Conditions: Vestibular Schwannoma

Summary: this trial will evaluate the safety and tolerability of a single unilateral administration of one of three dose levels of aavanc80-antivegf and will evaluate the akouos delivery device to safely achieve the intended product performance.


Eligibility criteria:
criteria for inclusion: 1. presence of unilateral, progressive vestibular schwannoma. 2. vestibular schwannoma larger than 2 mm. 3. profound hearing loss, defined by pure-tone audiometry thresholds or word recognition score, in the affected ear. 4. able and willing to comply with all trial requirements, including willingness to participate in a separate long term follow-up study after completion of this trial. criteria for exclusion: 1. prior diagnosis of nf2 and/or bilateral vestibular schwannoma. 2. prior surgery or radiation therapy for vestibular schwannoma. 3. clinical history consistent with endolymphatic hydrops (documented fluctuating sensorineural hearing loss and/or episodic vertigo) in the affected ear. 4. profound hearing loss, defined by pure-tone audiometry thresholds or word recognition score, in the unaffected ear. 5. prior participation in a clinical trial with an investigational drug within six months prior to administration (day 0), or any prior participation in a gene therapy clinical trial.

Keywords: vestibular schwannoma hearing loss acoustic neuroma anti-vegf
inhalation therapy in ambulant and hospitalized patient using available film sequences from the internet

Conditions: Obstructive Lung Disease; COPD; Asthma

Summary: there are different therapy strategies for patients suffering on obstructive lung disease like chronic obstructive pulmonary disease (copd), and asthma bronchial available. one of these strategies includes inhalative drugs, e.g. ß2-mimetics, anticholinergic drugs, or glucocorticoids, which are indicated often and which can be used with different inhalation devices. dry powder inhalators, and dosieraerosol are used the most in clinical routine. further strategies in treating obstructive lung disease are innovative systems like respimat or systems with liquid inhalation. however, the success of the therapy depends on the correct application technique. in the clinical routine a high error rate was observed. consequently, the initiative of the german league of respiratory tracts published internet-based film sequences in order to demonstrate how to use an inhalator correctly. these films are available in the internet for everyone and can be watched as often as needed in order to improve technique and facilitate training. therefore, in this study we aim to evaluate the following aspects: * amount of wrong applications in ambulant and hospitalized patients (wrong in terms of lack of knowledge on how to use the inhalator or incorrect utilization) * amount of correct applications in patients who had first used the inhalator incorrectly but improved technique by watching the film sequences * evaluation of learning success within 2 weeks to 2 months (follow-up visit in the ambulance)


Eligibility criteria:
inclusion criteria: * male and female patients indicated for inhalative treatment with ß2-mimetics, inhalative steroids, anticholinergic drugs, or a combination of these drugs * patient was already trained on how to use the inhalator before participating in the study * age \> 18 * obtained written consent exclusion criteria: * patients who are incapable to consent or are unable to understand the scope of the trial * patients who indicate that they do not know how to use the inhalator
impact of nutritional counselling in children with autism

Conditions: Autism Spectrum Disorder

Summary: autism spectrum disorder (asd) is a complex group of behavioral disorders characterized by defects in social interaction and communication associated with restricted and repetitive behaviors and activities. the prevalence in pediatric age is continuously increasing in western countries (58-67 / 10,000). the diagnostic and statistical manual of mental disorders version 5 (dsm-5) describes a worldwide population prevalence of approximately 1%. according to the latest data from the national observatory for the monitoring of asd, in italy 1 child out of 77 (age 7-9 years) has the disease with a higher prevalence in males: males are affected 4.4 times more than females . the clinical manifestations of asd are the result of complex interactions between genetic, epigenetic, environmental and microbiological factors. alterations in nutritional status, eating habits and adverse reactions to food appear to be more frequent in children with asd. it is estimated that 46-89% of children with asd have feeding problems which can include unusual eating patterns, rituals and food selectivity. these types of eating behaviors can lead to severe alterations in nutritional status. furthermore, the data present in the literature concerning the eating habits of children with asd suggest a high consumption of "junk food" and foods rich in calories together with a refusal of fruit, vegetables or proteins. these data suggest that the dietary and behavioral problems frequently present in these children could favor a condition of obesity. finally, a high percentage of children with asd undergo elimination diets, characterized by exclusions of foods relevant to the diet of a child such as milk and gluten to alleviate the symptoms of the disease. such elimination diets are only rarely supervised by a nutritionist with further consequences on nutritional status.


Eligibility criteria:
inclusion criteria: * diagnosis of autism spectrum disorders exclusion criteria: * age at enrollment \ 48 months. * concomitant presence of other chronic diseases * epilepsy, * neurological syndromes, * immunodeficiencies, * diabetes, * congenital heart disease, * autoimmune diseases, * inborn errors of metabolism, * tuberculosis, * cystic fibrosis, * chronic respiratory tract diseases, * inflammatory bowel disease, * celiac disease, * eosinophilic pathologies of the gastrointestinal tract, * functional gastrointestinal disorders, * obesity, * tumors, * malnutrition • major malformations or previous surgery of the gastrointestinal / urinary / respiratory tract.
genotype and phenotype in early onset breast cancer in young women on the two shores of the mediterranean sea

Conditions: Breast Cancer

Summary: breast cancer are common on mediterranean basin. epidemiological data suggest that breast cancer in young women (\< 40years old) is more aggressive in the maghreb countries comparatively to western countries. this aggressiveness could be associated with phenotypic and genotypic differences between this two populations.

the object of this study is to compare the genotypic and phenotypic differences between south and north shore of the mediterranean sea.

Eligibility criteria:
inclusion criteria: * patient have or have had a breast cancer diagnosed before 40 years old * breast cancer proven by histology * brca1/2 analysis proposed, realized, ongoing * women \>18 years old * patient with insurance * patient informed and no-opposed exclusion criteria: * patient have or have had a breast cancer diagnosed after 40 years old * patient requiring tutorship or guardianship * adult patient protected by law

Keywords: breast cancer
an oral p38 inhibitor investigating safety, efficacy, and pk in subjects with active rheumatoid arthritis

Conditions: Arthritis, Rheumatoid

Summary: investigating the safety and tolerability of a p38 inhibitor as monotherapy in subjects who have failed at least 1 dmard.


Eligibility criteria:
inclusion criteria: * diagnosed with ra and has failed at least 1 dmard therapy exclusion criteria: * any other inflammatory arthritis and any significant history of acute or chronic infection with immunomodulatory etiology.

Keywords: arthritis rheumatoid
early oral immunotherapy in infants with cow's milk protein allergy

Conditions: Hypersensitivity, Milk

Summary: cow's milk (cm) allergy is the most frequent food allergy in the first years of life, with prevalence rates estimated in the range of 2-3%. the elimination of cm is the mainstay of treatment, but accidental exposure to cm proteins is not uncommon, with a considerable risk of severe allergic reactions. recent evidence suggests that early oral exposure in young children may protect to the development of allergy. on the same way, strategies have been developed for the use of oral exposure as immunotherapy for the treatment of children with established food allergy even if available data on the use of oral immunotherapy in infants with food allergy are very limited. the aim of this study is to evaluate the feasibility of an oral immunotherapy protocol, started in the first year of life, in children with cm allergy.


Eligibility criteria:
inclusion criteria: • children between 3-12 months with cm allergy (defined as the association of typical clinical manifestations in the first hour after cm ingestion and evidence of sensitization of cm proteins on both skin prick test and specific serum ige levels) exclusion criteria: * children with not ige-mediated clinical manifestations * children with a known immunodeficiency

Keywords: hypersensitivity, milk cow's milk immunotherapy infant
placenta accreta spectrum outcome after uterine conservation

Conditions: Placenta Accreta Spectrum

Summary: study will be carried out on patients with placenta accreta spectrum having done uterine conservation and recording immediate outcome of conservation regarding success of the procedure, amount of blood loss and amount of blood transfused and followed up to check the return of menses, any uterine abnormalities by ultrasound or hysteroscopy especially isthmocele and intrauterine synechia.

after institutional review board approval and written informed consent, recruited cases will be subjected to the following: 1. data registration including: * age. * obstetric history including gravidity, parity, number of previous cesarean deliveries, and number and gender of living children. * details of the current pregnancy including duration in menstrual weeks, any problems encountered during its course. * desire for future fertility. * medical, surgical, and medication history. 2. anthropometry including weight, height, and body mass index (bmi) before pregnancy and at the time of operation. 3. general examination including vital signs, and signs of any associated problems. 4. routine laboratory investigations with particular emphasis on complete blood count, coagulation profile and including blood glucose level, renal and liver function tests. 5. detailed sonographic examination to evaluate fetal biometry, and wellbeing rule out exclusion factors, and confirm diagnosis of pas and assess the degree of invasion, and its severity using both trans-abdominal transducer with frequency of 2-5 megahertz (mhz) and trans-vaginal transducer with frequency of 4-10 mhz. intraoperative details will be documented. follow up of patients will be recorded. sample size was calculated by estimating a single proportion distribution at a significance level of 0.05.

Eligibility criteria:
inclusion criteria: * • diagnosed sonographically to have placenta accreta spectrum. * pregnancy is singleton and fetus is alive. * elective caesarean section done from 35 gestational weeks. exclusion criteria: * • patients requesting hysterectomy. * coexisting uterine pathology such as fibroids or gynaecological malignancies. * patients with bleeding diathesis. * morbid obesity of bmi \>40. * patients having labour pains or vaginal bleeding before scheduled intervention.

Keywords: pas