Kornimate/medical-research-clean huggingface dataset:
the role of morphological phenotype in ards

Conditions: Respiratory Distress Syndrome, Adult

Summary: although most of the information focuses on understanding how the ventilator produces lung damage, the pulmonary factors that predispose to ventilator-induced lung injury (vili) have been less studied. acute respiratory distress syndrome (ards) can adopt different morphological phenotypes, with its own clinical and mechanical characteristics. this morphological phenotypes may favor the development of vili for same ventilatory strategy

the lung in acute respiratory distress syndrome ards) is a heterogeneous viscoelastic system, in which areas with different time constants coexist, causing tidal volume to be distributed unevenly within an anatomically and functionally reduced lung. the administration of a disproportionately high tidal volume for this lung predisposes to the over-distension of the better ventilated alveoli and to the injury by tidal opening and closing of the alveoli more unstable. in this sense, using low tidal volume and homogenizing the lung by means of the prone position have proven beneficial in ards. tidal volume, driving pressure, inspiratory flow and respiratory rate have been identified as responsible for mechanical ventilation-induced lung injury (vili). these factors together represent the mechanical power, the insulting energy which is repeatedly applied to a vulnerable lung parenchyma. although most of the information focuses on understanding how the ventilator produces lung damage and/or amplifies the existing one, the pulmonary factors that predispose to vili have been less studied. acute respiratory distress syndrome can adopt different morphological phenotypes, with its own clinical and mechanical characteristics. understanding how each subgroup of ards responds to the protective ventilatory strategy could help to personalize treatment. objectives: to compare the risk of vili in two groups of ards with different morphological phenotypes (focal and non-focal), ventilated with the same protective strategy. design: patients with ards were ventilated under the same conditions of both tidal volume (tv) and plateau pressure (pplat). positive end expiratory pressure (peep) was adjusted to reach 30 cmh2o of pplat. a ct was performed in inspiration and expiration. transpulmonary pressures (tp) were measured and lung volumes calculated (volume analysis software,toshiba, japan). stress was defined as tp at the end of inspiration (tpinsp) and strain: tidal volume/end expiratory lung volume patients were classified into focal and non-focal according to the distribution of aeration loss in ct. mann - whitney u test was used to compare variables and pearson correlation coefficient to compare its correlation. significant: p \<0.05

Eligibility criteria:
inclusion criteria: acute respiratory distress syndrome (ards). exclusion criteria: emphysema asthma pneumothorax oxygen saturation ≤ 88% severe shock ventricular arrhythmia myocardial ischemia. -

Keywords: respiratory insufficiency ventilator-induced lung injury ventilators, mechanical
evaluation of the efficacy and tolerability of treatment with interleukin-2 in severe and resistant alopecia areata

Conditions: Alopecia Areata

Summary: alopecia areata is an autoimmune disease associated with infiltration of cluster of differentiation 4(cd4 +) and cluster of differentiation 8 (cd8) + cells around the hair follicles. one of the therapeutic approaches of inflammatory diseases such as alopecia areata is the induction of tolerance. this tolerance induction can be obtained by stimulating regulatory t cells (treg). the low-dose interleukin-2 plays a central role in the development, expansion, regulation and survival of regulatory t cells cd4 + cluster of differentiation 25 (cd25) + forkhead box protein 3 (foxp3). recently, recombinant interleukin 2 (il2-r) with low dose showed very promising results in two inflammatory disease (gvhd vasculitis and cryoglobulinemia secondary to hepatitis c): clinical efficacy, increased population treg in the blood and an excellent safety profile. we hypothesized that administration of il2-r in patients with severe alopecia areata might allow regrowth via activation of treg and thus induce regrowth of the air.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years, 60 ≤ years. * male or female * clinical diagnosis of alopecia areata, * severe alopecia areata (\> 50% of the surface of the scalp reached) * alopecia areata resistant to at least one systemic therapy: phototherapy (uvb or puva), methotrexate or corticosteroids * signature of the informed consent and authorization of the right image * effective contraception will be maintained for the duration of the study. * affiliation to the social security exclusion criteria: * pregnancy or refusal of contraception in women of childbearing age, * refusal of contraception for men * local treatment (corticosteroids, minoxidil) or systemic (oral corticosteroids, methotrexate or other immunosuppressive agents) for less than 2 months, * cancer or autoimmune disease or in remission evolutionary * excessive alcohol intake (more than 3 glasses of wine a day or a drink per day) * hiv, hepatitis c virus, hepatitis b virus * patient with renal and / or hepatic impairment, * patient with shingles, chickenpox, herpes, tuberculosis, an infectious disease scalable, respiratory failure ... * vulnerable person (anyone younger, adults under guardianship, deprived of liberty) * indication against treatment with il2-r * presenting an indication against the proleukin
platelet function in resuscitated patients-2

Conditions: Acute Myocardial Infarction; Cardiac Arrest

Summary: approx. 65% of resuscitated patients at the intensive care unit for internal medicine are due to myocardial infarction. almost all patients are initially diagnosed and treated in the cath lab. therapy usually consists of one or more stent implantations. after implantation of a coronary stent, dual platelet inhibition is necessary for 12 months. insufficient platelet inhibition causes an pronounced increase in risk of stent thrombosis. therefore, secured inhibition and knowledge of the individual platelet function is valuable.

patients after successful resuscitation associated to a myocardial infarction will be included into the study the morning after the index event. patients get dual platelet inhibition using cangrelor as p2y12 (purinergic g protein-coupled receptors-12) inhibitor plus acetylsalicylic acid (ass). patients are treated with therapeutic hypothermia according to the local standard operating procedure for 24h and rewarming is performed within an additional 5 to 20h. platelet function is measured every morning and ass mediated as well as p2y12 mediated platelet function inhibition is recorded. all relevant clinical data including apache (acute physiology and chronic health evaluation) and sofa (sequential organ failure assessment score) scores are collected. the degree of platelet inhibition over time (4 days) and differences between the three drugs tested will be evaluated by optical aggregometry and by using the commercial verifynow test system.

Eligibility criteria:
inclusion criteria: * myocardial infarction * dual platelet inhibition * resuscitation * therapeutic hypothermia exclusion criteria: * none
metabolic syndrome in young patients with acute lymphoblastic leukemia in remission

Conditions: Fatigue; Leukemia; Long-term Effects Secondary to Cancer Therapy in Children

Summary: rationale: gathering information about metabolic syndrome from young patients with acute lymphoblastic leukemia may help doctors learn more about the disease. purpose: this phase i trial is studying the metabolic syndrome in young patients with acute lymphoblastic leukemia in remission.

objectives: primary * to determine the incidence and prevalence of the components of metabolic syndrome (e.g., obesity, hypertension, dyslipidemia, and insulin resistance) in pediatric patients with acute lymphoblastic leukemia in remission. * to determine the trajectory of the onset of these components over a 1-year period in patients undergoing maintenance therapy. secondary * to identify potential associations between components of metabolic syndrome and fatigue, health-related quality of life, family history, nutrition, and physical activity. * to identify potential biomarkers that are associated with clinical features of metabolic syndrome. * to evaluate whether patients will show a decrease in igf-1 levels. outline: this is a two-part study. patients are enrolled in either part 1 or part 2. * part 1: patients undergo physical exam measurements (e.g., body mass index, waist circumference, and blood pressure) at baseline (during maintenance course 1) and at 12 months (during maintenance course 5). patients also undergo blood sample collection at baseline and at 12 months to measure laboratory markers (e.g., fasting lipid profile, fasting insulin and glucose, igf-1, leptin, and adiponectin levels). patients or their parents complete a family history questionnaire at baseline and questionnaires to assess physical activity, quality of life, nutritional intake, and fatigue at baseline and at 6 and 12 months. * part 2: patients or their parents complete a family history questionnaire at baseline.

Eligibility criteria:
disease characteristics: part 1 * diagnosis of precursor b-cell acute lymphoblastic leukemia (all) * in first remission * in first 3 months of maintenance therapy * no t-cell all, very high-risk all, or infant all (\< 1 year old at diagnosis) part 2 * diagnosis of precursor b-cell or t-cell all * in first remission * must have been diagnosed and treated (at least to the maintenance phase) at the division of pediatric oncology at the vanderbilt-ingram cancer center within the past 7 years * no very high-risk all or infant all (\< 1 year old at diagnosis) patient characteristics: * not specified prior concurrent therapy: * see disease characteristics * no prior or concurrent cranial radiotherapy (part 1)

Keywords: fatigue long-term effects secondary to cancer therapy in children childhood acute lymphoblastic leukemia in remission b-cell childhood acute lymphoblastic leukemia t-cell childhood acute lymphoblastic leukemia
zinc supplementation in alcoholic cirrhosis

Conditions: Alcoholic Cirrhosis

Summary: the purpose of this study is to determine if zinc therapy: (1) strengthens your intestine's defensive barrier preventing damaging substances from reaching your liver, (2) decreases liver injury (inflammation, oxidative stress, cell death) and scarring, and (3) improves your liver-related health. based on our preliminary animal data and other published reports, we expect zinc therapy to achieve all of these goals. zinc is affordable, available over the counter or by prescription, and has an excellent safety profile. positive results from this study will show that zinc is a significant therapy for millions of americans with alcoholic liver disease.

two-thirds of americans consume alcohol, and an estimated 14 million americans are alcoholics. it has been estimated that 15%-30% of heavy drinkers develop advanced alcoholic liver disease (ald). the prevalence of ald in the united states is conservatively estimated at 2 million persons. nearly 50% of liver-related deaths and 30% of hepatocellular carcinomas in the us are due to alcoholic cirrhosis. despite recent advances in our understanding of ald, there is currently no fda approved medication for any stage of ald. zinc sulfate is inexpensive, available over the counter, and has an excellent safety profile. if zinc positively influences the mechanisms postulated to play a role in human ald, this affordable treatment would become relevant to millions of people worldwide.

Eligibility criteria:
inclusion criteria: 1. ability to provide informed consent. 2. clinical diagnosis of alcoholic cirrhosis. 3. between the ages of 18 years and 70 years. 4. ability to attend all clinic visits and participate in monthly telephone calls. 5. child-pugh score of a or b. exclusion criteria: 1. allergy or intolerance to zinc sulfate. 2. hospitalization within the previous 28 days. 3. pregnancy. 4. illicit drug use within the past 12 months. 5. infection with hepatitis b, hepatitis c, or hiv. 6. known or suspected cancer within the past 5 years. 7. serum creatinine greater than 1.5 mg/dl within the past month. 8. any severe chronic disease other than liver disease. 9. impairment (slowness) of behavior, intelligence, and neuromuscular function which may indicate hepatic encephalopathy (slow or confused thinking due to your liver disease). 10. participation in another clinical trial. 11. any type of infection within the past month.

Keywords: cirrhosis alcohol
safety and tolerability of intravenous vit-45 in patients with iron deficiency anemia

Conditions: Anemia

Summary: the objective of this study is to evaluate the safety and tolerability of vit-45 in the treatment of iron deficiency anemia

evaluate the safety and tolerability of vit-45 in the treatment of iron deficiency anemia

Eligibility criteria:
inclusion criteria: * subjects \> or = 18 years of age and able to give informed consent * historical laboratory hgb indicative of anemia within 3 months prior to screening visit * screening visit laboratory hgb indicative of anemia * screening visit ferritin indicative of iron deficiency anemia exclusion criteria: * known hypersensitivity to vit-45 * previously received vit-45 * parenteral iron in the 4 weeks prior to screening * chronic or serious active infection * malignancy history * aspartate aminotransferase (ast) or alanine transaminase( alt) greater than the upper limit of normal * anticipated need for surgery or initiation of dialysis during the study * pregnant or sexually active females who are not willing to use an effective form of birth control
an internet-based self applied treatment program for prolonged grief disorder (pgd)

Conditions: Prolonged Grief Disorder

Summary: the purpose of this study is to investigate the feasibility, acceptability and preliminary efficacy of an internet delivered cognitive behavior treatment (icbt) for people with prolonged grief disorder (pgd) compared to a face-to-face intervention for pgd.

grief is an intense emotional reaction to the loss of a loved one. it produces feelings of regret and longing that usually decrease over time. however, some people have difficulty adapting to the loss and develop prolonged grief disorder (pgd). an open clinical trial will be conducted to investigate the feasibility \[initial efficacy and acceptability\] of an internet delivered cognitive behavior treatment (icbt) for adult people diagnosed with prolonged grief disorder (pgd). there will be at least 24 participants that will be randomly assigned to experimental group (internet-based treatment for pgd) or active control group (traditional face- to-face intervention for pgd). four assessment moments will be included (pre-treatment, post-treatment, 3 months follow-up and 12 months follow-up). the present study aims to improve knowledge about the feasibility, acceptability and preliminary efficacy of an icbt for pgd and conduct a preliminary comparison between two intervention conditions (internet-based intervention vs. traditional face-to-face intervention). also, the investigators aim to collect information that can help to improve the efficacy and acceptability of internet-based interventions in general.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * meeting diagnostic criteria for pgd * sign an informed consent * ability to understand and read spanish * ability to use a computer and having access to the internet * having an e-mail address exclusion criteria: * presence of risk of suicide or self-destructive behaviors * presence of another severe mental disorder (substance abuse or dependence, psychotic disorder, dementia o bipolar disorder) * presence of severe personality disorder * presence of a medical condition whose severity or characteristics prevent the performance of treatment * receiving other psychological treatment during the study for pgd * an increase and/or change in the medication during the study period
nvt allegra tavi system tf in failing calcified aortic heart valves in a real-world patient population

Conditions: Transcatheter Aortic Valve Implantation

Summary: the study collects real-world data of patients who were treated with the allegra tavi system tf and evaluates early and midterm clinical and quality of life outcome.


Eligibility criteria:
inclusion criteria: 1. symptomatic degeneration of severe calcified aortic heart valve or failing surgical aortic bioprosthetic valve 2. acceptable candidate for elective treatment with the allegra tavi system tf (according to the most recent version of the allegra instructions for use) 3. high risk for surgery as assessed by the heart team 4. has signed the patient informed consent form \>= 18 years exclusion criteria: general: 1. echocardiographic evidence of intracardiac thrombus or vegetation 2. significant aortic disease such as severe obstructive calcification or marked tortuosity or kinking which will preclude a safe advancement of the allegra tavi system tf 3. iliofemoral vessel conditions such as severe obstructive calcification, severe tortuosity or kinking that would preclude safe placement of an 18 fr introducer sheath or make endovascular access to the aortic valve impossible 4. severe ventricular dysfunction with lvef \<20% 5. evidence of active endocarditis or other acute infections 6. renal failure requiring continuous renal replacement therapy 7. known hypersensitivity to contrast media, which cannot be adequately pre-medicated or contraindication to anticoagulant or anti-platelet medication or to nitinol alloy or to bovine tissue 8. life expectancy ≤ 12 months due to other medical illness 9. currently participating in another investigational drug or device study patients with native aortic valve disease: 1. unicuspid or bicuspid aortic valve 2. non-calcified aortic stenosis 3. combined aortic valve disease with predominant aortic regurgitation \> 3 4. distance between aortic valve basal plane and the orifice of the lowest coronary artery \< 8 mm patients with degenerated surgical bioprosthetic aortic valves: 1. low position of the coronary ostia, especially in combination with shallow sinuses 2. internal diameter of the bioprosthesis is ≤16 mm or \>28 mm 3. partially detached leaflets that in the aortic position may obstruct a coronary ostium

Keywords: tavi aortic valve stenosis allegra
vegans health status and exposure to pesticides and nitrate

Conditions: Malnutrition

Summary: this research concerns nutritional and toxicological health risk evaluation among long-term vegans. research focus is in cumulative exposure to pesticides.

the main objective of the study was nutritional and toxicological health risk evaluation among long-term vegans with emphasis on cumulative exposure to pesticides. main research methods include: measurement of food intake by using three days food record, measurement of nutritional and toxicological bio-markers on blood, serum and plasma. nutritional biomarkers include following plasma/ serum measurements: concentrations of vitamins (vitamin e, d2, d3, b12 and beta-carotene), iron, iodine, selenium, fatty acids and polyphenols. toxicological measurements include nitrate, pesticides and dna-adducts. we recruited the participants (n = 41) through an advertisement published in the finnish vegan association's monthly newspaper and via an online discussion forum. the selection criteria were as follows: the participants had to (1) have followed a vegan diet for at least a year, (2) be between 18 and 50 years of age, (3) be apparently healthy, and (4) be nonusers of regular medications (except oral contraceptives or hormone replacement therapy). further, we matched the non-vegetarian participants by age and sex. the study was approved by the ethical committee of kuopio university hospital (69//2011) we assessed the consumption of foods at baseline with a three-day food record using household measures. the participants received the instructions on how to complete this record, and a dietician checked the completed food records. the participants also filled out a health questionnaire inquiring into their long-term healthy eating habits, including vitamin supplementation. we collected fasting peripheral venous blood samples, plasma and serum, and stored them at -70 °c before the analysis. further, urine samples 24 hours were collected prior to phlebotomy and divided into aliquots. for one of the subjects, only a spot urine sample was available. we carried out the hematological and chemical analyses at laboratory (hematological data), helsinki university central hospital (folate, vitamin b12, vitamin d, and homocysteine), and the national institute for health and welfare (alfa-tocopherol, beta-carotene, selenium, iodine, fatty acid profile, and polyphenols). nitrate, nitrite were measured by capillary electrophoresis and dna adducts by elisa at finnish food safety authority.

Eligibility criteria:
inclusion criteria: the selection criteria were as follows: the participants had to 1. have followed a vegan diet for at least a year, 2. be between 18 and 50 years of age, 3. be apparently healthy, and 4. be nonusers of regular medications (except oral contraceptives or hormone replacement therapy). further, we matched the non-vegetarian participants by age and sex. exclusion criteria: * age \ 50y, * regular medication, * illnesses

Keywords: nutritional status pesticides nitrate
the comparison of hypotension incidence between remimazolam and propofol in hypertensive patients undergoing neurosurgery

Conditions: Patients Undergoing Neurosurgery

Summary: this study aims to find an excellent drug in terms of hemodynamic stability when comparing the propofol and remifentanil with the combined use of remimazolam and remifentanil. when the mean blood pressure falls by 20% or more from the baseline mean blood pressure, it is considered hypotension, and a vasopressor such as ephedrine, phenylephrine, or norpin is used to control the blood pressure to within 20% of the baseline blood pressure. if the blood pressure increases by 20% or more above the baseline mean blood pressure, nicardipine infusion or remimazolam, propofol or remifentanil should be increased to control the blood pressure.


Eligibility criteria:
inclusion criteria: 1. hypertension 2. patients undergoing neurosurgery 3. asa i-iii 4. 19-75 year-old patients exclusion criteria: 1. emergency 2. patients admitted on the day of surgery 3. cardiac disease 4. liver failure or liver cirrhosis 5. increased intracranial pressure(iicp) 6. mental change 7. foreigner 8. iliteracy