Kornimate/medical-research-clean huggingface dataset:
the prevalence and incidence of dvt in general icu

Conditions: Deep Venous Thrombosis

Summary: deep venous thrombosis (dvt) represents a major problem in intensive care unit (icu) patients. despite the use of recommended pharmacological prophylaxis with low molecular weight heparin (lmwh), the incidence of dvt during icu stay has been reported between 5 and 15 %. the incidence may vary due to many factors, for example the type of icu population, the type of protocol of pharmacological prophylaxis and also the type of diagnostic approach. before formerly planned clinical study targeted to lower dvt incidence by individualizing the dose of lmwh, the investigators decided to evaluate the real dvt incidence in the investigated icu. the prevalence and incidence will be assessed by ultrasound testing in general icu patients. on the sample of 200 patients. the investigators hypothesize dvt incidence of 5 %. the compliance to the local dvt prophylaxis protocol will be also evaluated.

type of the study: observational prospective cohort study. hypothesis: despite appropriate prophylaxis of deep venous thrombosis in general icu patients in accordance with the current guidelines, the incidence of deep venous thrombosis is 5 - 10%. sample size: 200 consecutive general icu patients. inclusion and exclusion criteria: defined in the eligibility section. protocol description: all patients admitted to icu with expected period of the stay longer than 72 hours will be evaluated for the presence of deep venous thrombosis by ultrasound testing during the first 48 hours of icu stay. thereafter, each participant will be examined by ultrasound testing twice a week until the discharge from icu. all patients will receive deep venous thrombosis prophylaxis following the current guidelines. all patients with positive finding of deep venous thrombosis will be managed in accordance with the current guidelines. ultrasound examination for deep venous thrombosis: ultrasound compression test at the following locations: common femoral vein at the groin, deep femoral vein, popliteal vein, both extremities.

Eligibility criteria:
all general icu patients meeting exclusion and inclusion criteria. inclusion criteria: 1. general icu patient with expected length of stay more than 72 hours exclusion criteria: 1. inability to perform ultrasound investigation for deep venous thrombosis (for medical or technical reasons) 2. icu stay shorter than 72 hours
natural experiment: "gentle nudge" intervention, eliminating phone call requirement

Conditions: Back Pain; X-rays; MRI; CT Scan; Clinical Decision Support Tool

Summary: back pain costs the u.s. over $100 billion annually, and much of this spending is wasteful due to the overuse of advanced diagnostic imaging. despite prominent clinical guidelines and the nationally recognized choosing wisely campaign discouraging use of costly and low value imaging, magnetic resonance imaging (mri) and computed tomography (ct) studies remain frequently overused. real-time electronic clinical decision support (cds) at the point of care has been increasingly emphasized as an important strategy to improve the value of back pain management; however, studies suggest that cds at best only modestly influences practice patterns. the aim is to implement a behavioral economic-based intervention in the ed to promote the use of cds system.

despite prominent clinical guidelines and the nationally recognized choosing wisely campaign discouraging use of costly and low value imaging, magnetic resonance imaging (mri) and computed tomography (ct) studies remain frequently overused. few studies have rigorously investigated the causes of cds' limited influence on care as well as interventions to enhance cds' impact on reducing low value imaging. the implementation of cds to reduce low value mri and ct imaging studies for back pain at a large safety net health system was monitored. the cds systems was integrated into the electronic health record system. clinicians answered several questions and select from a list of basic imaging indications and cds provides an american college of radiology appropriateness criteria score. appropriate scores ranged from 7-9, borderline scores ranging from 4-6, and inappropriate scores ranging from 1-3 (clinicians are encouraged to cancel inappropriate orders). electronic order data on imaging studies was pulled using cpt billable data and imaging studies were categorized as appropriate, canceled, changed, and unscored orders. early observation of cds implementation revealed that lac+usc medical center (one of 16 sites) had high percentages of unscored orders. at this intervention site, a "nudge" grounded in behavioral economic theory (nudge=gentle incentive, preserving freedom of choice) was provided where clinicians ordering medium or high scoring studies could bypass the usual mandatory phone call to radiology. this natural experiment was evaluated using a quasi-experimental difference-in-differences (dind) analysis to measure whether high scores increased and unscored studies decreased at the intervention site vs. 15 control sites over time. generalized linear regression models were used that accounted for clustering by practice site and adjusting for patient and clinician characteristics.

Eligibility criteria:
inclusion criteria: * adults with lower back pain receiving treatment at los angeles department of health services facility (lac-dhs) * adults whose physicians order imaging studies (ct scans and mris) exclusion criteria: * non-lac-dhs patients * patient without lower back pain
cytokine profile of allergic bronchopulmonary aspergillosis

Conditions: ABPA

Summary: the main aim of this study is to determine whether the levels of different inflammatory cytokines in the serum and balf (bronchoalveolar lavage fluid) are relative to the severity and exacerbations of abpa (allergic bronchopulmonary aspergillosis).

the study would record patients' medical data at baseline and follow them up for different period of time. updated data would be recorded and blood( or balf) of the patients would be drawn for tests or stored as whole blood or serum at -80℃ when patients visit the hospital. then the cytokine (a panel set by the manufacturer) of the serum and balf would be tested . the secretion ability of peripheral blood mononuclear cells would also be verified. the investigators would then analyze the data and see if any cytokine is relative to the exacerbation or other indicators of the severity of abpa.

Eligibility criteria:
for abpa patients inclusion criteria: * patients diagnosed as allergic bronchopulmonary aspergillosis (abpa). the diagnosis criteria of abpa is as following: clinical diagnosis of asthma, elevated total ige levels (\> 1,000 iu/ml), presence of specific ige against a fumigatus detected (\> 0.35 kua/l) or type 1 skin reaction to aspergillus antigen. other criteria(at least two of three): presence of serum igg antibodies (precipitins) against a. fumigatus; radiographic pulmonary opacities consistent with abpa(it might be transient consolidation, nodules, finger-in-glove opacities. or it could be permanent bronchiectasis and pleuropulmonary fibrosis) patients who sighed consent forms. for asthma patients: diagnosis according to gina. for healthy control: people with ongoing chronic allergic disease such as allergic rhinitis, asthma and allergic dermatitis are excluded. exclusion criteria: * patients who are unwilling to sign the consent form.

Keywords: cytokine abpa type 2 immune response pbmc
a study of ontak and chop in newly diagnosed, peripheral t-cell lymphoma

Conditions: Lymphoma, T-Cell, Peripheral

Summary: study of ontak and chop (chemotherapy drugs) to find out their ability to make peripheral t-cell lymphoma disappear (for any period of time) and potentially lengthen life. the study will also compare what kind of side effects these drugs cause and how often they occur. the hypothesis is that patients with newly diagnosed peripheral t-cell lymphoma, when given ontak + chop, will tolerate the treatment and will have a 20% improvement in response rate when compared to chop alone.


Eligibility criteria:
inclusion criteria: * pathological diagnosis of peripheral t-cell lymphoma of one of the following histologies as per the real classification: peripheral t-cell lymphoma (unspecified), anaplastic large cell lymphoma cd30+, angioimmunoblastic t-cell lymphoma, nasal/nasal type t/nk cell lymphoma, intestinal t-cell lymphoma, hepatosplenic t-cell lymphoma, subcutaneous panniculitic t-cell lymphoma. * treatment naïve except for prior radiation or a single cycle of chop. * patients must have at least one clear-cut bidimensionally measurable site by physical exam and/or computed tomography. * prior radiation therapy for localized disease is allowed as long as the irradiated area is not at the mediastinal area or at the only site of measurable disease. therapy must be completed at least 4 weeks before the enrollment in study. * eastern cooperative oncology group (ecog) performance status of 0 to 2. * at least 18 years of age. * adequate bone marrow reserve, indicated by absolute neutrophil count (anc) \> or equal to 1000/microl, platelets \> or equal to 50,000/microl (25,000/microl if thrombocytopenia secondary to bone marrow involvement by lymphoma), and hemoglobin \> or equal to 8 g/dl. * adequate liver function, indicated by bilirubin \ or equal to 3.0 g/dl. * adequate renal function, indicated by serum creatinine \< or equal to 2.5 mg/dl. * women of childbearing potential and sexually active males agree to use an accepted and effective method of contraception. * able to give informed consent. exclusion criteria: * diagnosis of mycosis fungoides or sezary syndrome. * active hepatitis b or hepatitis c infection. * known hiv infection (hiv testing is not required). * patients with active infections requiring specific anti-infective therapy are not eligible until all signs of infections have resolved and any continuing treatment if appropriate is given on an outpatient basis. * previous doxorubicin therapy with cumulative dose of \>100 mg/m2. * left ventricular ejection fraction (lvef) \< 50%. * patients who are pregnant or breast-feeding. * prior invasive malignancies within past 5 years. * allergy to or history of allergy to diphtheria toxin or il-2. * preexisting severe cardiovascular disease (e.g. chf, severe cad, cardiomyopathy, mi within the past 3 months, arrhythmia) requiring ongoing treatment. * ongoing antineoplastic chemotherapy, radiation, hormonal (excluding contraceptives) or immunotherapy, or investigational medications within past 30 days. * patients with deep vein thrombosis within 3 months.
nat2 genotyping in re-challenge protocol of inh titration in patients with anti-tb medications-induced hepatitis

Conditions: Hepatotoxicity

Summary: to improve the treatment outcome in patients with tuberculosis and integrate the pharmacogenetics into clinical practice, the information of nat2 genotyping was used in re-challenge protocol for isoniazid (inh) titration in patients with anti-tuberculosis medication-induced hepatitis.


Eligibility criteria:
inclusion criteria: 1. \>= 18 years. 2. take inh for at least a week. 3. abnormal liver function (alt (alanine, transaminase) increased by more than three times the upper limit of normal, or alt higher than twice the upper limit of normal and total bilirubin higher than 2.0 mg / dl exclusion criteria: 1.taking inh before liver function abnormalities. 2.

Keywords: pharmacogenetics anti-tuberculosis drug genetic polymorphism isoniazid
effect of auditory stimulation on spike waves in sleep

Conditions: Epilepsy; Sleep

Summary: background: close relationship exists between sleep slow wave (ssw) and the generation of spike wave in nrem-sleep. ssw are cortically generated oscillations alternating between excitatory depolarization ("up-phase" of the ssw) and inhibitory hyperpolarization ("down-phase" of the ssw). it has been shown experimentally that with increasing synchrony of slow neuronal oscillations ssw turn into spike waves. acoustic pulses applied in correspondence to the ssw "up-phase" enhance the amplitude of the subsequent ssw. conversely, tones delivered at the ssw "downphase" have a disruptive effect on the following ssw. participants: patients with epilepsy and spike waves in nrem-sleep. objective: modification of spike wave frequency, amplitude and spreading during nrem sleep by acoustic pulses applied at the "up-" or "down-phase" of ssw.


Eligibility criteria:
inclusion criteria: * participants with rolandic epilepsy/bects * participants with eses/csws * participants with generalized spike waves in sleep * eeg within 6 months before study night consistent with the diagnosis exclusion criteria: * clinically significant concomitant acute or chronic disease * seizure frequency \>1/week, history of convulsive status epilepticus or seizures provoked by sleep deprivation * severe sleep problems * treatment with corticosteroids, immunosuppressive or vagus nerve stimulation

Keywords: benign epilepsy with centro-temporal spikes continuous spike waves in slow wave sleep electroencephalography sleep, slow wave
efficacy of subcutaneous ivermectin with or without zinc in covid-19 patients

Conditions: Coronavirus Infection; COVID; Sars-CoV2

Summary: to measure the effect of ivermectin (sub-cutaneous) with or without zinc in treating the covid-19 patients to clear viral load of sars-cov-2 along with reduction in severity of symptoms and length of hospitalization of patients with covid-19.

this is a parallel assigned, randomized, controlled, multi-armed, investigator initiated interventional study is designed to demonstrate efficacy to lower the viral load of covid-19 and to demonstrate the antiviral effects of subcutaneous ivermectin with or without zinc in mild to moderate symptomatic patients who consent to randomization following a new diagnosis in pakistan with covid-19 (pcr positive). investigators will follow up with participants daily and pcr will be done on alternate days in bsl-3 lab. dose will only be repeated if test remained positive..

Eligibility criteria:
inclusion criteria: * nasopharyngeal rt-pcr positive sars-cov-2 patient with mild to moderate disease * age 18 and above * bmi 18-28 kg/m exclusion criteria: * allergy to any drug * co-morbidities: any pre-existing cardiac disease, pulmonary disease * arrhythmias * pregnancy * rt-pcr performed \>3 days prior to enrollment

Keywords: sars-cov-2 covid-19 coronavirus ivermectin zinc
fast track diagnosis of skin cancer by advanced imaging technologies and tumour tapestripping

Conditions: Skin Cancer; Malignant Melanoma

Summary: in this clinical feasibility study the investigators will test and compare two advanced optical imaging technologies, lipid and rna tape stripping with regards to diagnostic accuracies for fast bedside diagnosis of pigmented skin tumours.

this original clinical research project utilizes cutting-edge medical imaging technologies for diagnosis of pigmented skin tumours, combined for the first time in denmark, with molecular rna and lipid analysis of superficial tumours cells. the scanning technologies are reflectance confocal microscopy (rcm), which is a microscope applied directly to the skin surface, and photoacoustic imaging, also termed multispectral optoacoustic imaging (msot), which is an imaging technology actually listening to the skin for immediate bedside diagnosis of pigmented skin tumors. the hypothesis is that treatment guided by diagnostic bedside skin scanning, combined with tumour tape-stripping and rna and lipid analysis can increase diagnostic accuracy compared to visual inspection of the skin tumour and thus decrease time delay from diagnosis to efficient treatment

Eligibility criteria:
inclusion criteria: 1. 75 patients with histologically verified pigmented skin tumours on areas of the body where scanning is feasible with both imaging systems 2. patients with clinically suspicious skin tumours, that are not yet biopsied, if the patient is willing to undergo a skin biopsy from the suspicious lesion 3. \> 18 years of age at baseline 4. legally competent, able to give verbal and written consent 5. communicate in danish verbally as well as in writing 6. subject in good general health, is willing to participate and able to give informed consent and can comply with protocol requirements. exclusion criteria: 1. individuals with other skin diseases in the skin area of interest 2. individuals who´s skin tumour is not accessible for imaging e.g. inside the ear, inside nostrils, on eyelids 3. subjects who will not undergo a skin biopsy after imaging of the suspicious skin tumour and who have not had a skin biopsy taken from the tumour prior to referral 4. pregnancy 5. women of child-bearing potential not using a contraceptive agent at the time of inclusion

Keywords: diagnostic imaging pigmented skin neoplasm tape-stripping photoacoustic techniques confocal microscopy
effect on kidney function recovery guiding decongestion with vexus in patients with cardiorenal syndrome 1

Conditions: Cardiorenal Syndrome; Acute Kidney Injury; Decompensated Heart Failure; Fluid Overload; Ultrasound Therapy; Complications

Summary: during cardiorenal syndrome type 1 (crs1) vascular congestion is the major contributor to worsening renal function, but promoting decongestion with routine clinical evaluation is ineffective in some patients. the venous evaluation by ultrasound (vexus) may optimize its management when evaluating for improvement in kidney function and other metrics related to decongestion.

background: in cardiorenal syndrome type 1 (crs1) vascular congestion is a common complication, the venus evaluation by ultrasound system (vexus) could guide decongestion effectively and thereby improve kidney function outcomes. methods: in this double-blind randomized clinical trial, patients with crs1 were randomized to guide decongestion with vexus compared to usual clinical evaluation. the primary and secondary endpoint was to assess kidney function recovery (kfr), days of hospitalization, mortality, changes in brain natriuretic peptide (bnp) and ca-125. protocol register hcg/cei-0836/22.

Eligibility criteria:
inclusion criteria: * cardiorenal syndrome type 1 exclusion criteria: * kidney transplantation, chronic kidney disease (ckd) grade 4 or 5, dialysis and pregnancy. ckd was defined according to the kdigo guidelines
emla and sterile water injections - pain from injections

Conditions: Pain

Summary: the aim is to study the effect of local anaesthesia (emla®) on pain associated with sterile water injections.

sterile water injection (swi) was previously shown to give good pain relief for lower-back pain during childbirth, chronic neck pain and ureterolithiasis. however, the pain associated with the injections remains problematic, and therefore it is important to find a less painful injection technique.

Eligibility criteria:
inclusion criteria * woman * age 18-45 years * healthy * ability to understand information and instructions exclusion criteria: * pregnancy * previous experience of swi * on-going pain * use of medication for depression, pain, or sleeping disorder 24 hours prior to the experiment * smoking, snuffing, physical activity, and intake of caffeinated beverages (coffee, tea, or energy drink (e.g., red bull) 2 hours prior to the experiment

Keywords: sterile water injections pain vas complementary method
virtual reality in the management of pain in pediatrics: a multi-center randomized clinical trial (realped)

Conditions: Virtual Reality; Pediatric ALL; Pain, Procedural

Summary: the goal of this clinical trial is to test if the use of virtual reality glasses reduces the pain and anxiety that children feel when they perform a blood test. children between 7 and 12 years old from 5 health centers and 2 hospitals will participate, and the children will be divided into two groups. in the control group, the analysis will be done in the usual way (for example, distracting with questions) and in the intervention group, the analysis will be done while the children use virtual reality. the satisfaction of parents and nursing will also be analyzed.


Eligibility criteria:
inclusion criteria: * children between 7 and 12 years old who attend participating centers for scheduled blood tests. * consent to participate by signing the informed consent. exclusion criteria: * children younger than 7 years old. * children older than 12 years old. * children that don't sign the informed consent. * children with psychomotor and neurocognitive delay. * children with visual or hearing impairment.
a study to compare insulin intensification of biphasic insulin aspart 30 and insulin analogues (insulin glargine and insulin aspart) in insulin naïve type 2 diabetic patients

Conditions: Diabetes; Diabetes Mellitus, Type 2

Summary: this trial is conducted globally. the aim of this trial is to compare stepwise insulin intensification of biphasic insulin aspart (biasp) 30 and basal-bolus therapy with insulin glargine and insulin aspart in insulin naïve type 2 diabetic patients inadequately controlled on oral anti-diabetic therapy.


Eligibility criteria:
inclusion criteria: * informed consent obtained before any trial-related activities. trial-related activities are any procedures that are carried out as part of the trial, including activities to determine suitability for the trial * male or female, age at least 18 years at the time of signing informed consent * type 2 diabetes subjects clinically diagnosed at least 6 months prior to screening * treatment with stable daily dose (for at least 90 days prior to screening) of: - metformin (equal or above 1000 mg or maximum tolerated dose documented in the patient medical record) and - sulfonylurea - and willing to discontinue any other oral antidiabetic drugs containing insulin secretagogues, dpp4i (dipeptidyl peptidase-4 inhibitor), sglt2 (sodium glucose co-transporter 2), colesevelam, bromocriptin and/or combination products at randomisation * insulin-naïve. short term insulin treatment for acute illnesses for a total of 14 days or less is allowed as is prior insulin treatment for gestational diabetes * hba1c (glycosylated haemoglobin) 7.0-9.5 % (both inclusive) analysed by central laboratory * willing to consume 3 main meals daily (morning, mid-day and evening) throughout the entire trial. the definition for 'main meal' will be according to the investigator's discretion exclusion criteria: * anticipated initiation or change in concomitant medications known to affect weight or glucose metabolism, in excess of 14 days (i.e. sibutramine, orlistat, thyroid hormones, systemic corticosteroids and other weight loss/modifying agents) * impaired liver function, defined as alt (alanine aminotransferase) at least 2.5 times upper limit of normal (central laboratory value measured at screening visit) * inadequately treated high blood pressure defined as class 2 hypertension or higher (i.e. systolic blood pressure equal to or above 160 mm hg or diastolic equal to or above 100 mm hg) in accordance with the national high blood pressure education program, 7th joint national committee1 and esh/esc 2013 guidelines2 * within the past 180 days prior to randomisation, any of the following: myocardial infarction, stroke or hospitalization for unstable angina and /or transient ischemic attack