Kornimate/medical-research-clean huggingface dataset:
improving diagnosis of tuberculosis in hiv infected children in asia (cambodia, vietnam)and africa (burkina faso, cameroon)

Conditions: HIV; Tuberculosis; Pediatrics

Summary: childhood tuberculosis (tb) accounts for 11% of the total 9 million annual tb cases and the difficulty of its diagnosis is increased in case of hiv infection in children. the aim of this study is to improve tb diagnosis in hiv-infected children by developing a new diagnostic algorithm incorporating new tools available such as: * interferon gamma release assays (igras), as alternative to the tuberculin skin test * alternative specimen collection methods such as string test (or enterotest (r)), nasopharyngeal aspirates and stools samples, as alternatives to gastric aspirate * the xpert mtb/rif assay


Eligibility criteria:
inclusion criteria: * children aged from 0 to 13 years * confirmed hiv infection * suspicion of tuberculosis * informed consent signed by at least one parent or guardian * on arvs or not exclusion criteria: * history of anti tb treatment started in the past 2 years * on going tuberculosis treatment * suspicion of exclusive extra-thoracic tuberculosis

Keywords: hiv tuberculosis diagnosis pediatrics asia africa
navicam for detection of barrett's esophagus

Conditions: Barrett's Esophagus

Summary: using a non-invasive capsule system to achieve optimal viewing angles of the esophagus for detection of barrett's esophagus


Eligibility criteria:
inclusion criteria * adults greater than or equal to 22 years of age with or without barrett's esophagus * all patients: o have had an endoscopy within 1 year of baseline enrollment * patients with barrett's esophagus: * presence of at least 1cm of salmon colored mucosa with corresponding biopsies showing intestinal metaplasia who are treatment naïve and undergoing surveillance or * chronic gastro esophageal reflux disease (gerd) patients with at least 3 additional risk factors that meet barrett's esophagus screening criteria per latest clinical guidelines exclusion criteria * inability to comprehend or read the consent form * have an oropharynx, esophageal, or gastro-esophageal tumor * ongoing symptoms of dysphagia * presence of active clinically significant stricture * history of stricture requiring dilation * presence of pacemaker or implanted cardiac defibrillator * history of esophageal surgery with the exception of fundoplication * pregnancy * history of surgery or obstructive process of the small bowel * bmi \> 38
nerve morphology in diabetic patients

Conditions: Peripheral Neuropathy; Carpal Tunnel Syndrome; Entrapment Neuropathies; Diabetes Complications

Summary: the underlying basis of carpal tunnel syndrome and the basis of its increased incidence in diabetes are unknown. the aim of this study was to quantified pathology in an uncompressed nerve (posterior interosseous nerve in the forearm between diabetic and non-diabetic patients with cts.


Eligibility criteria:
inclusion criteria * diagnosis of carpal tunnel syndrome based in clinical history and symptoms * confirmed by nerve conduction studies exclusion criteria * other focal nerve entrapments * cervical radiculopathy * inflammatory joint disease * renal failure * thyroid disorders * previous wrist fracture * long-term exposure to vibrating tools * age under 18
trial of five versus six fractions per week for head and neck cancer

Conditions: Head and Neck Cancer

Summary: this trial compares the use of 6 fractions versus the standard 5 fractions of radiotherapy used in the treatment of head and neck cancer.

the purpose of this trial is to study the clinical effects of increasing the weekly fraction number for locally advanced head and neck cancers by a multi-institutional prospective randomised trial. the primary endpoint is to clarify whether a six fraction per week protocol has a greater effect on the survival, as compared to the conventional five fraction per week protocol.

Eligibility criteria:
inclusion criteria: * head and neck cancer exclusion criteria: * unable to give an informed consent
safety and effectiveness of giving combinations of three or four anti-hiv drugs to hiv-infected patients

Conditions: HIV Infections

Summary: the purpose of this study is to see if it is safe and effective to give combinations of three or four anti-hiv drugs to hiv-infected patients. the drugs used in this study are delavirdine (dlv), nelfinavir (nlf), didanosine (ddi), and stavudine (d4t).

this is a multicenter, open-label study. patients are stratified by hiv-1 rna levels (20,000 to 200,000 copies/ml and greater than 200,000 copies/ml). patients are equally randomized to one of four groups and receive antiretroviral therapy for 24 weeks. group 1 receives delavirdine (dlv) plus nelfinavir (nfv) plus stavudine (d4t). group 2 receives dlv plus nfv plus didanosine (ddi). group 3 receives nfv plus d4t plus ddi. group 4 receives dlv plus nfv plus d4t plus ddi. patients are evaluated for drug safety and viral burden. patients may opt to continue on the study for 24 additional weeks, at the discretion of the investigator.

Eligibility criteria:
inclusion criteria you may be eligible for this study if you: * are at least 18 years old. * are hiv-positive. * have a cd4 count of at least 50 cells/mm3. * have a viral load of at least 20,000 copies/ml. exclusion criteria you will not be eligible for this study if you: * have taken d4t. * have taken protease inhibitors, including nfv. * have taken nonnucleoside reverse transcriptase inhibitors. * have taken ddi for 1 month or more.

Keywords: hiv-1 didanosine stavudine hiv protease inhibitors rna, viral delavirdine reverse transcriptase inhibitors viral load nelfinavir
fertility after diagnosis and management of acquired uterine arteriovenous malformation

Conditions: Arteriovenous Malformations

Summary: uterine arteriovenous malformations (uavm) are short circuits between systemic arterial and venous networks within the uterus. they are congenital or acquired (in the course of an endo-uterine gesture such as curettage or interventions such as caesareans or myomectomies). they can be manifested by severe metrorrhagia that can go as far as to put the patient's vital prognosis at risk. there are no recommendations for the management of uavm since this pathology is rare and therefore series are performed with few cases. if some of these uavm disappear spontaneously after a therapeutic abstention, when the clinical context allows it, in case of symptomatic uavm, a selective embolization with arteriography is often carried out to postpone the hysterectomy of hemostasis. there are also more marginal management options such as gonadotropin-releasing hormone agonists, methotrexate or curettage that are decided on a case by case basis depending on the symptoms and protocols of each medical team. regarding subsequent fertility and pregnancy outcomes after conservative treatment, the number of studies is even lower.


Eligibility criteria:
inclusion criteria: * major patient * diagnosis of uavm, symptomatic or not, between january 1st, 2000 and march 30th, 2017 confirmed by imagery performed at the rennes university hospital * not against her participation in research exclusion criteria: * minor patient at the time of diagnosis * congenital uavm * uterine malformation * patient under legal protection (guardianship, curatorship, safeguard of justice).

Keywords: uterine avm
the use of tidal volume challenge of dynamic parameters during laparoscopic surgery

Conditions: Laparoscopic Surgery

Summary: laparoscopy is increasingly used for major abdominal and pelvic surgery. as this approach is also recommended in elderly patients with serious comorbidities, optimal fluid therapy guidance during this procedure is important. many studies have reported that less invasive dynamic indices such as pulse pressure variation (ppv) and stroke volume variation (svv), which are derived from the arterial pressure waveform, are superior to static indices to predict fluid responsiveness. ppv and svv are based on the heart-lung interaction and reflect cyclic changes in stroke volume induced by mechanical ventilation in the closed-chest condition. therefore, their ability to predict fluid responsiveness can be affected by factors that influence the arterial tone or the compliance of the respiratory system. laparoscopic surgery for the abdominal visceral organs requires pneumoperitoneum and the trendelenburg position to optimize surgical conditions, and can reduce cardiac output and respiratory compliance. accordingly, the usefulness of ppv and svv in predicting fluid responsiveness during laparoscopic surgery under these conditions may be questioned. it has been clearly shown that the values of dynamic parameters are significantly correlated with the magnitude of vt. min et al. reported that augmentation of ppv and svv via a temporary increase in vt from 8 to 12 ml/kg improved their predictive power in the inconclusive zone with respect to fluid responsiveness (ppv values of 9% and 13%, respectively). another recent study reported that on increasing vt from 6 to 8 ml/kg, augmented ppv and svv, as well as their absolute changes, predicted fluid responsiveness with high sensitivity and specificity, even in critically ill patients receiving low vt. therefore, the aim of the current study was to investigate whether increasing vt from 6 to 8 ml/kg would improve the predictive power of ppv and svv in patients undergoing robot-assisted laparoscopic surgery in the trendelenburg position under lung-protective ventilation. we also assessed the ability of absolute changes in ppv and svv values induced by a temporary increase in vt from 6 to 8 ml/kg to predict fluid responsiveness.


Eligibility criteria:
inclusion criteria: * adult patients who performed robot assisted laparoscopic surgery under trendelenburg position exclusion criteria: * preoperative arrhythmia * severe bradycardia * moderate to severe valvular disease * left ventricular ejection fraction \< 50% * poorly controlled hypertension (systolic bp \> 160 mmhg) * patients with renal insufficiency (creatinine \> 1.5 mg/dl) * moderate to severe liver disease * bmi \>.30 or \< 15 kg/ m2 * preexisting pulmonary disease * fev1 \< 60% of predicted value * contraindications to oesophageal doppler (oed) monitoring probe insertion (i.e. oesophageal stent, carcinoma of the oesophagus or pharynx, previous oesophageal surgery, oesophageal stricture, oesophageal varices, pharyngeal pouch, and severe coagulopathy)
observation of italian patients with heart failure being treated with dapagliflozin in clinical practice

Conditions: Heart Failure, Reduced Ejection Fraction

Summary: this is an observational, non-interventional, longitudinal prospective descriptive study including participants diagnosed with heart failure with reduced ejection fraction (hfref) in italy and initiated on treatment with dapagliflozin according to the approved hfref indication. the study is aimed at providing insights into real-world drug utilization and treatment patterns of dapagliflozin in the italian hfref setting, as well as patient-reported outcomes including quality of life.

heart failure (hf) is a significant burden for public health, affecting more than 63 million people worldwide and expected to increase as the population ages; in italy, the estimated prevalence of hf is 1-3% and the incidence rate 2-5 cases per 1000 persons per year. despite advancements in treatment, a hf diagnosis still leads to significant morbidity and mortality and impacts on patients' quality of life (qol). dapagliflozin is the first in a novel class of glucose-lowering agents known as sodium-glucose co-transporter-2 (sglt2) inhibitors, approved for the treatment of heart failure with reduced ejection fraction (hfref). as with all new drugs introduced into clinical practice, there is a strong scientific interest in producing evidence from observational studies regarding the use of dapagliflozin for the treatment of hfref in real-world settings with detailed clinical data on heart failure symptoms, outcomes, and health-related qol. the overall aim of this observational study is to describe the characteristics of patients in italy initiating dapagliflozin for the treatment of hfref and to provide early insights into real-world dapagliflozin treatment patterns (primary objectives) as well as patient-reported outcomes including quality of life (secondary objectives). this study is part of a multicountry study programme, including similar studies that will be conducted in other countries with similar objectives. data from each of the individual studies may be combined in a pooled analysis.

Eligibility criteria:
inclusion criteria: * age equal or above 18 years old at the initiation of treatment with dapagliflozin * participant received/receiving treatment with dapagliflozin for heart failure with reduced ejection fraction (hfref) in accordance with the approved local dapagliflozin product label, i.e. with an ejection fraction of 40 percent or less * signed and dated informed cconsent obtained prior to enrollment into the study exclusion criteria: * participant is enrolled less than 14 days or more than 45 days following the initiation of treatment with dapagliflozin * prior treatment with dapagliflozin or other treatment with a medicine of the same drug class (sodium-glucose co-transporter-2 - or sglt2 - inhibitors) * initiation of dapagliflozin outside of the approved local dapagliflozin product label for hfref * diagnosis of type 1 diabetes
trial to investigate the influence of the homeopathic remedy naja-comp on stroke therapy in geriatric rehabilitation

Conditions: Stroke

Summary: the homeopathic remedy 'naja-comp' will improve functional outcome measured by the barthel-index. the homeopathic remedy 'naja-comp' will decrease complications during geriatric rehabilitation measured by rate of unplanned discharge to hospital.

secondary outcome for functional improvement are scandinavian stroke scale, 4d+s-scale and timed-up\&go-test.

Eligibility criteria:
inclusion criteria: * stroke within 60 days after onset exclusion criteria: * stroke by injury or tumor * stroke older than 60 days * missing consent for participation * participation at other clinical trials

Keywords: stroke rehabilitation outcome barthel-index geriatrics elderly
effect of acetazolamide on postural control in patients with respiratory disease at altitude

Conditions: Chronic Obstructive Pulmonary Disease

Summary: in this trial, the investigators will evaluate the effect of acetazolamide (375 mg per day) vs. placebo on postural control at acute altitude exposure in patients with copd.

this is a randomized, placebo-controlled, double-blind parallel trial evaluating the effect of acetazolamide (375 mg per day) vs. placebo on postural control at altitude (tuja ashu, 3200 m). participants living in the bishkek area, kyrgyzstan (760m), will be transferred by car within 4h to the tuja ashu high altitude clinic (3200 m), and stay there for 2 days. acetazolamide 375mg/day (or placebo) will be administered 24 hours before departure at 760 m and during the stay at altitude. outcomes will be assessed during the stay at 3200 m. randomization to acetazolamide or placebo will be carried out after baseline measurements in bishkek (760 m). postural control will be assessed by a rectangular, stable balance platform (wii balance board) measuring the body's center of gravity. the movement of the body's center of gravity will be recorded in a two-dimensional coordinate system and indicated as path length.

Eligibility criteria:
inclusion criteria: * male and female patients, age 18-75 yrs. * copd diagnosed according to gold, fev1 40-80% predicted, spo2 ≥92% at 750 m. * born, raised and currently living at low altitude (\<800m). * written informed consent. exclusion criteria: * copd exacerbation, very severe copd with hypoxemia at low altitude (fev1/fvc \<0.7, fev1 \<40% predicted, oxygen saturation on room air \<92% at 750 m). * comorbidities such as uncontrolled cardiovascular disease, i.e., unstable systemic arterial hypertension, coronary artery disease; previous stroke; osa; pneumothorax in the last 2 months. * internal, neurologic, rheumatologic or psychiatric disease including current heavy smoking (\>20 cigarettes per day) * known renal failure or allergy to acetazolamide and other sulfonamides

Keywords: postural control balance performance airway disease altitude prevention acetazolamide
the patients journey through surgical admission ward versus emergency department

Conditions: Waiting Time in Emergency Department

Summary: emergency departments are established in 20 hospitals in denmark in order to improve the quality for the acute patients. a group of acute patients which require timely assessment and plan from a specialist is patients with abdominal pain. the aim of the present study is to evaluate whether the admission of the group of patients to emergency departments reduces the time to doctor, specialist and plan compared to the traditional admission to a surgical acute ward.


Eligibility criteria:
inclusion criteria: * age more than 15 years exclusion criteria:
nutritional status and body composition of adult patients with crohn's disease

Conditions: Crohn Disease

Summary: patients with crohn's disease generally have nutritional risks and malnutrition. the investigators will conduct a multicenter cross-sectional study to discover nutritional status and body composition of chinese adult patients with cd.

several studies have found that the body composition of cd patients is related to disease and therapies. due to lack of a prospective multicenter cross-sectional observational study on the nutritional status and body composition of adult patients with cd in china. evaluating the nutritional status and body composition of these patients can help formulate individualized nutritional support strategies for adult cd patients.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years old; * diagnosis of cd; * admission time \<48 hours; * subject has voluntarily signed and dated an informed consent form. exclusion criteria: * emergency surgery for intestinal fistula or abdominal abscess; * unstable vital signs or unstable hemodynamics; * pregnant or lactating women; * admission to hospital due to other critical illnesses (such as tumor, hiv, severe infections requiring ventilator or crrt treatment); * dying patients whose life expectancy does not exceed 24 hours; * severe liver insufficiency (liver function score 11-15 or total bilirubin\> 3mg/dl or tissue biopsy diagnosed as liver cirrhosis, hepatic encephalopathy, portal hypertension with history of gastrointestinal hemorrhage, etc.); * severe renal insufficiency (creatinine value is 2 times higher than the upper limit of normal); * severe metabolic diseases (such as metabolic syndrome, hyperthyroidism, etc.); * patients whose burn area exceeds 20% of the body surface area; * immunodeficiency, autoimmune disease, or receiving immunosuppressive treatment for diseases other than cd (such as organ transplantation, etc.); * those who are not suitable for body composition analysis * patients who have been selected for other clinical studies or have been selected for this study; * subjects are unwilling to participate in this study or refuse to sign informed consent.
results from objective brushing data saved from a powered toothbrush related to values for oral health

Conditions: Gingivitis; Periodontal Diseases

Summary: for this study, 213 individuals were recruited. during the baseline examination, each participant received a powered toothbrush and was carefully instructed on how to use the toothbrush and recommended using it for at least 2 minutes every morning and evening. no restrictions were imposed on the use of other oral health products. the study lasted from june 2018 to october 2020 and included a screening, a baseline examination, and additional reexaminations at 6 and 12 months. the oral-b application was installed on the participant's mobile phones or computer tablets. participants were instructed verbally and in writing on transferring data from the powered toothbrush to the application. the present study aimed to investigate how the true use of the powered toothbrush, in terms of frequency and duration, affects plaque index (pi), bleeding on probing (bop), and periodontal pocket depth (ppd) ≥4 mm in a group of elderly individuals with mci. a second aim was to compare the registered time and brush frequencies to the individual's self-estimated usage of the powered toothbrushes.


Eligibility criteria:
inclusion criteria: * being 55 years or older * having experienced memory problems in the last six months before inclusion * having a mini-mental state examination score of 20-28 * are not receiving any formal care * having at least ten teeth of their own exclusion criteria: * having a terminal illness with less than three years of expected survival * having another known significant cause of disease explaining cognitive impairment

Keywords: mild cognitive impairment oral health powered toothbrush
biomarker feedback to motivate cessation in pregnancy

Conditions: Nicotine Dependence; Pregnancy

Summary: phase 3 pilot clinical trial.

developing effective tobacco cessation interventions during pregnancy for american indian and alaska native people is a national priority and will contribute to the u.s. public health objective of reducing tobacco-related cancer health disparities. the proposed project builds on the investigators' successful partnership with the alaska native community and previous work with alaska native pregnant women. the investigators propose to develop and test a novel biomarker feedback intervention relating cotinine levels in the urine of pregnant women with the woman and infant's likely exposure to the tobacco specific nitrosamine and carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone) (nnk). this 5-year project will be conducted in three phases. in phase 1 the investigators will utilize a non-randomized, clinical observational trial to examine biomarkers of nicotine and carcinogen exposure (urine cotinine and total nnal \[a metabolite of nnk\], respectively) among 150 maternal-infant pairs with assessments conducted during pregnancy and at delivery. in phase 2, the investigators will obtain qualitative feedback on the findings from phase 1 through individual interviews conducted with 32 women who use tobacco to develop the biomarker feedback intervention messages. phase 3 will consist of a formative evaluation of the biomarker feedback intervention with 60 pregnant women using a two-group randomized design to assess the intervention's feasibility and acceptability, and the biochemically confirmed abstinence rate at the end of pregnancy. all phases of the project will be guided by a community advisory committee. each phase is an important step to advance the investigators' understanding of the potential for biomarker feedback as a strategy to help alaska native pregnant women quit tobacco use. the potential reach of the intervention is significant from a public health perspective as over 600 tobacco users deliver each year at the alaska native medical center in anchorage where the proposed project will take place. developing effective interventions for tobacco cessation during pregnancy is important to reduce adverse health consequences for the mother and neonate and future risk of tobacco-caused cancers. this is the third and final phase of the project.

Eligibility criteria:
inclusion criteria: * alaska native * 18 years or older * provide written informed consent * be currently pregnant and at \<24 weeks gestation * reside in anchorage and plan to deliver at the anmc * current tobacco user defined as any use of iqmik, commercial st, and/or cigarettes during the past 7 days. exclusion criteria: * use of using nicotine replacement therapy or medications for tobacco cessation or participation in a behavioral cessation program within the past 30 days * another woman from the same household has enrolled.