Kornimate/medical-research-clean huggingface dataset:
nifedipine vs telmisartan on prevention of atrial fibrillation (af) recurrence in hypertensive patients with af

Conditions: Atrial Fibrillation

Summary: different lowing blood pressure strategies have a different clinical efficacies. blocking the angiotensin ii type 1 receptor (telmisartan) reduces the incidence of episodes of atrial fibrillation in hypertensive patients with paroxysmal atrial fibrillation during 24 months than 30% compared to nifedipine( adalat gits ). a total of 160 subjects will be included in two study groups. the group 1 will receive 80-160mg telmisartan per day, the remaining patients will receive nifedipine ( adalat gits). follow-up is 24 months. the conventional 12-lead ecg recordings at twice weeks interval and 24hrs holter monitor will determine the cardiac rhythm and asymptomatic episodes of atrial fibrillation. the target of blood pressure after 3 months is less than 130/80mmhg. concomitant therapy with b-blocker and acethydrazide are allowed for the target blood pressure during the study.


Eligibility criteria:
inclusion criteria: * documented hypertensive patients with paroxysmal atrial fibrillation: ecg documentation of atrial fibrillation at least in one ecg recorded during the last 2 months prior to randomization plus additional ecg recording of sinus rhythm at least 12 hours after the above mentioned ecg documentation. * patients with hypertensive history were at least 5 years. systolic pressure \> 140mmhg, \ 85mmhg. \< 110mmhg. * 40 \< age \< 65 years exclusion criteria: * strong clinical evidence for therapy with at ii/ace inhibitors before 3 months of screening * therapy with antiarrhythmic agents of class i or class iii within the last month, therapy with amiodarone within the last 3 months * direct current (dc) cardioversion within the last 3 months * symptomatic bradycardia * implanted pacemaker or implanted cardioverter/defibrillator with any antitachycardiac algorithm in use * cardiac surgery or cardiac catheter ablation within the last 3 months * typical angina pectoris symptoms at rest or during exercise * known coronary artery disease with indication for intervention * valvular disease \> ii degree * left ventricular ejection fraction \< 40% * diastolic blood pressure \> 110mm hg at rest * symptomatic arterial hypotension * known renal artery stenosis * serum creatinine \> 1.8 mval/l * relevant hepatic or pulmonary disorders * hyperthyroidism manifested clinically and in laboratory * known drug intolerance for at ii inhibitors * females who are pregnant or breast feeding * females of childbearing potential who are not using a scientifically accepted method of contraception * participation in a clinical trial within the last 30 days * drug addiction or chronic alcohol abuse * legal incapacity, or other circumstances which would prevent the patient from understanding the aim, nature or extent of the clinical study * evidence of an uncooperative attitude

Keywords: paroxysmal atrial fibrillation, hypertension
a trial testing early vs late onset of epo alfa treatment in lower risk mds

Conditions: Myelodysplastic Syndromes

Summary: this is an open-label, randomized, multicenter, phase iii study patients with baseline hb comprised between 9 and 10.5g/dl will be randomized to receive epo alfa 60000 ui/week for at least 12 weeks: * either at diagnosis or * at the hb threshold chosen for rbc transfusions (must be \< 9g/dl)

in this trial we will compare the early introduction of epo alfa to the delayed introduction in lower risk mds with non rbc transfusion dependent anemia. at enrollment patients will be randomised in the 2 arms (early and delayed start of epo alfa). treatment regimen epoetin alfa 60000 ui/week for at least 12 weeks 1. early onset arm: early onset of epo alfa 60000 iu/week , at patient inclusion 2. delayed onset arm: late introduction of epo alfa 60000 iu/week, whenever the patient reaches the level chosen rbc transfusions (based on age, comorbidities, anticipated tolerance of anemia).

Eligibility criteria:
inclusion criteria: 1. age ≥ 18 years 2. mds according to who 2016 criteria, with low or int 1 classical ipss 3. non-rbc transfusion dependent anemia 4. hb level between 9 and 10.5g/dl (at the center's lab) 5. hb level should be at least 1g/dl higher than the hb threshold chosen to start rbc transfusions based on age, comorbidities and predicted clinical tolerance of anemia (this transfusion threshold should be chosen between 8 and 9g/dl) 6. serum epo level \<500u/l 7. no other cause of anemia (including iron deficiency, vitamin b12 or b9 deficiency, hemolysis, hypothyroidism....) 8. performance status \<=2 exclusion criteria: 1. higher risk mds (ipss intermediate-2 or high) 2. del 5q 3. baseline hemoglobin level \> 10.5 g/dl or \<9g/dl 4. transfusion threshold (based on age , comorbidities...) \>9g/dl 5. transfusion threshold less than 1 g/dl below baseline hb level 6. rbc transfusion dependence. patients may have received only one transfusion series for mds prior to inclusion 7. cmml , if \>10 % bm blasts or wbc\>13.000/mm3 8. uncontrolled hypertension 9. uncontrolled cardiovascular disease including angina pectoris or cardiac failure 10. renal failure: creatinine clearance\<40ml/min (using mdrd formula) 11. pregnancy (positive bettahcg) or nursing

Keywords: myelodysplastic syndrome erythropoetin
natural language processing (nlp) analysis of free text notes to investigate coronavirus (covid-19)

Conditions: COVID-19

Summary: a retrospective cohort study investigating clinical notes using natural language processing in combination with structured data from the electronic health record (ehr) to create a database for analytics to identify features associated with outcomes.

patients admitted to cambridge university hospitals (cuh)with covid-19 have undergone routine clinical documentation and specific investigation and testing for covid-19. the pathway for these patients ranges from supportive measures on the ward to deterioration requiring intensive therapy unit (itu) admission and ventilatory support. patients are also at risk of developing complications such as acute kidney injury and thromboembolism. identification of the risk factors for these and other outcomes such as the requirement for ventilation remain a challenge and reviewing the clinical data for these patients is critical in the understanding of the relationship between patient characteristics and outcomes. there is data available in structured fields in the ehr, however, this is sometimes incomplete and inaccurate. an assessment of the free text clinical notes provides an opportunity to fill in the gaps and provide a much richer dataset for evaluation. we plan to use natural language processing (nlp) (a field of machine learning that allows computers to analyse human language) to review discharge summaries of patients admitted to hospital with covid-19 and convert free text data into structured data for analysis. the nlp techniques developed by dr collier's team include methods for coding of free texts to snomed ct and other biomedical ontologies. these methods, based on statistical machine learning from human annotated texts, have been benchmarked for scientific texts and social media. in this project we intend to adapt these techniques for patient records. the techniques will require a number of human annotated patient records in order to adapt. the nlp output will be combined with structured data from the ehr and undergo statistical analysis to identify the rates of complications in patients with covid-19 and risk factors associated with these. this may help to guide management decisions by earlier intervention to prevent poor outcomes in these patients.

Eligibility criteria:
inclusion criteria: * male and female * age range: 18 to 100 years * patients admitted to cambridge university hospitals with confirmed covid-19 on lab testing exclusion criteria: children and patients with a negative covid test.

Keywords: natural language processing
liver transplant for larger hepatocellular carcinoma in malatya: the role of ggt and afp

Conditions: Hepatocellular Carcinoma; Liver Transplant Disorder

Summary: retrospective data on 50 prospectively-collected hcc patients with beyond-milan criteria with \>6cm tumors were analyzed. 5-year os of 76.2% was found in patients with both afp \<200 ng/ml and ggt \<104 iu/ml with tumors less than 10 cm diameter. thus, ggt values add to afp in patient prognosis.

background:a retrospective analysis was performed of prospectively-collected transplant data on outcomes of patients with large size hccs,to examine possible prognostically-useful factors.methods:a total of 50 patients having tumors greater than 6cm maximum diameter were identified. their survival and full clinical characteristics were examined, with respect to serum afp and ggt levels.results:using roc analysis, cutoff values of afp 200 ng/ml and ggt 104 iu/ml were identified and used in this study. significantly longer overall-survival and disease-free-survival were found for patients who had lower values of either parameter, compared with higher values.even greater differences in survival were found when the 2 parameters were combined, with best survival (5-year os of 76,2% versus 0%, p=0.002).the most consistent clinical correlates for these longer survivals were degree of tumor differentiation and absence of microscopic portal venous invasion.two tumor size bands were identified,to search for the limits of this approach with larger tumors, namely 6-10 and \>10cm.combination parameters in 6-10cm band reflected 5-year os of 76,2% vs. 0%,in patients with low afp plus low ggt vs. other groups.beyond 10cm,no patients had low afp plus low ggt.conclusions:afp and ggt,both singly and together, represent a simple prognostic identifier for patients with large size hccs being treated by liver transplantation.

Eligibility criteria:
inclusion criteria: * liver transplant patients with maximum tumor diameter greater than 6 cm of hepatocellular carcinoma exclusion criteria: * early postoperative mortality (within 90 days) * advanced stage tumors (explant patology revealed that tumor continues in the surgical cite such as positive lymph node metastases, macroscopic portal vein trombosis, diaphragmatic invasion, etc)

Keywords: hepatic malignancy ggt living donor
study of cg0070 given in combination with pembrolizumab, in non-muscle invasive bladder cancer, unresponsive to bacillus calmette-guerin

Conditions: Non Muscle Invasive Bladder Cancer

Summary: to evaluate the activity of intravesical administration of cg0070 and intravenous administration of pembrolizumab in patients with tissue pathology-confirmed non-muscle invasive bladder cancer (nmibc) who have bacillus-calmette-guerin (bcg) unresponsive disease with carcinoma in situ (cis) with or without ta/t1 papillary disease.

an opened label trial designed to evaluate cg0070 and ddm in combination with pembrolizumab in patients with nmibc who have failed prior bcg therapy. the target population of 37 subjects with cis with or without concomitant high-grade ta or t1 papillary disease will be enrolled. bcg failure is defined as persistent or recurrent disease within 12 months of completion of adequate bcg therapy.

Eligibility criteria:
key inclusion criteria: * eastern cooperative oncology group (ecog) performance status 0 to 2 * pathologically confirmed nmibc with cis (with or without ta/t1 disease) * unresponsive to prior bcg therapy (lerner 2015) defined as persistent or recurrent cis alone or with recurrent ta/t1 (noninvasive papillary disease/tumor invades the sub- epithelial connective tissue) disease within 12 months of completion of adequate bcg therapy. an assessment within 15 months can also qualify when no assessment was performed within 12 months after completion of adequate bcg therapy. * adequate bcg is defined as at least 5 treatments with induction bcg followed by at least 2 bcg treatments as reinduction or maintenance * ineligible for radical cystectomy or refusal of radical cystectomy * adequate organ function key exclusion criteria: * immuno-deficient due to chronic steroid or other immunosuppressant use, hiv, or prior organ transplant * prior treatment with adenovirus-based cancer therapy * prior therapy with or intolerant to prior checkpoint inhibitor therapy * clinically significant or active cardiac disease * active autoimmune disease

Keywords: high-grade ta papillary disease high-grade t1 papillary disease carcinoma in situ bacillus-calmette-guerin unresponsive
early-onset obesity and cognitive impairment in children with pseudohypoparathyroidism

Conditions: Pseudohypoparathyroidism; Albright Hereditary Osteodystrophy

Summary: pseudohypoparathyroidism type 1a (php1a) is a rare disease that causes childhood obesity and learning difficulties. this study will investigate eating behaviors and perform cognitive testing on children with php1a. the investigators will compare their results to those of healthy siblings and other obese children.

pseudohypoparathyroidism type 1a (php1a) is a genetic disorder that causes early-onset, syndromic obesity and cognitive impairment. this study aims to evaluate eating behaviors, cognition and executive function in children with php1a, compared with healthy siblings and matched obese controls.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of php1a, sibling of a patient with php1a or matched obese control exclusion criteria (php1a): * treatment with appetite-altering drug or initiation of a new weight loss program in the past 3 months * type 2 diabetes exclusion criteria (controls): * obesity due to a genetic syndrome, growth hormone deficiency, untreated hypothyroidism, cushing syndrome or exogenous glucocorticoid administration * weight loss greater than 10% over the previous 6 months * autism or other significant learning disorder * type 2 diabetes * other significant medical condition

Keywords: pediatric obesity pseudohypoparathyroidism albright hereditary osteodystrophy
burosumab and 1-25 (oh) vitamin d on human osteoclasts

Conditions: Hypophosphatemic Rickets

Summary: fibroblast growth factor 23 (fgf23) is the cornerstone of phosphate / calcium / vitamin d metabolism: it is synthesized mainly by osteocytes and acts as a phosphating agent, inhibitor of dihydroxyvitamin d, and inhibitor of synthesis and secretion of parathyroid hormone (pth) in most tissues. the specific role of fgf23 on bone has yet to be demonstrated. in some diseases such as hypophosphatemic rickets (hr), the direct role of fgf23 on bone has not yet been studied to our knowledge, whereas these genetic hypophosphatemias are secondary to overexpression of fgf23, whether an activating mutation of fgf23 or inhibitory mutations of its inhibitors (dentin matrix acidic phosphoprotein 1 (dmp1) and phosphate-regulating neutral endopeptidase, x-linked (phex)). however, patients with x-linked hypophosphatemic rickets (xlh) have higher circulating fgf23 levels than healthy controls and these levels are higher in treated patients. management of xlh consists primarily of correcting the native vitamin d defect by prescribing active vitamin d analogs as well as phosphate supplementation to improve bone mineralization and decrease dental complications, growth, and bone deformities. recently, a new therapeutic option has been developed for xlh, burosumab, a human monoclonal antibody that binds and inhibits fgf23 activity. the use of burosumab is currently authorized in france in some pediatric patients with severe forms of xlh. independently of the indirect bone effects of phosphate correction and vitamin d levels, the direct role of burosumab on bone cells has never been studied. the objective of this project is to study the osteoclastic biology of patients with hr compared to control patients, and to evaluate the direct impact of the treatments used in this pathology on human osteoclasts.


Eligibility criteria:
hypophosphatemic rickets patients: inclusion criteria: * children from 2 yars-old to 18 years old and adults * patients with hr followed in the center of calcium and phosphorus metabolism rare diseases in lyon- * patients and parent / holder of parental authority who have been informed of the study and do not object to participate exclusion criteria: * patient being treated with oral corticosteroid or having received more than 3 months of corticosteroid treatment before surgery. * patients under tutorship or curatorship * pregnant and / or breastfeeding woman * patient deprived of liberty controls patients: inclusion criteria: * children from 2 years-old to 18 years old and adults * patients with normal renal function (schwartz glomerular filtration rate (gfr) \>90 ml/min/1.73m²) * patients and parent / holder of parental authority who have been informed of the study and do not object to participate exclusion criteria: * patient being treated with oral corticosteroid or having received more than 3 months of corticosteroid treatment before surgery. * patients under tutorship or curatorship * pregnant and / or breastfeeding woman * patient deprived of liberty * patient treated with immunosuppressive drugs * patient with inflammatory disease
molecular epidemiology of clostridium difficile infections in children

Conditions: Clostridium Difficile Infections

Summary: objectives: 1. describe the molecular epidemiology of clostridium difficile infection in children in the chicago area. 2. determine the clinical spectrum and risk factors for clostridium difficile infection secondary to particular endemic strains in children. 3. define the risk factors for recurrent and community-associated clostridium difficile infection in children.


Eligibility criteria:
inclusion criteria: * clostridium difficile infection exclusion criteria: * age \< 1 year * age \> 18 years
multicomponent lifestyle intervention for depression supported with digital health technologies to promote adherence

Conditions: Depression

Summary: the proposed study will be a randomized, assessor-blind controlled trial embedding both outcome and process evaluations of a 6-week group lm intervention with/without self-tracking tools (study i). the outcome evaluation will examine the effects of lm-s and lm alone vs. cau, and the process evaluation will enhance the understanding of the causal assumptions that underpin lm to inform policy and clinical practice. eligible participants with at least a moderate level of depression will be randomly assigned to the lm- s, lm alone, and cau groups in a 1:1:1 allocation ratio. the study period will be 18 weeks. assessments at baseline, week 7 (1-week post-intervention), and week 18 (12-week post-intervention) will be managed by an independent assessor (a research assistant, ra) who is blind to the group allocation. the proposed trial and the nested pilot study will follow the consort and strobe guidelines, respectively. the intervention will be provided free of charge.


Eligibility criteria:
inclusion criteria: 1. at least 18 years of age 2. cantonese language fluency and readability 3. a phq-9 score of at least 10, indicating a moderate level of depression 4. current dsm-iv diagnostic criteria of major depressive episode based on the mini international neuropsychiatric interview (mini) 5. possession of an internet-enabled mobile device (ios or android operating system) 6. willingness to provide informed consent and comply with the trial protocol. exclusion criteria: 1. the presence of other current psychiatric disorders as assessed by the mini 2. any medical or neurocognitive disorder(s) that makes participation unsuitable based on the team's clinical experience or interferes with adherence to the lifestyle modification (e.g., where exercise or a change in diet are not recommended by physicians) 3. current serious suicidal risk (non-fleeting intent or plan) as assessed by a phq-9 item 9 score \> 2 (referral information to professional mental health services will be provided) 4. current involvement in lifestyle changes supervised by professionals 5. intake of medication or current participation in any psychotherapy for depression 6. pregnancy 7. hospitalization 8. current participation in any other trial(s).

Keywords: lifestyle medicine depression
evaluation of preventive effect of sealants and laser therapy on dental caries and posteruptive breakdown on molars affected with molar incisor hypomineralisation (randomized clinical trial)

Conditions: Molar Incisor Hypomineralization

Summary: background: molar incisor hypomineralisation (mih) is a qualitative defect of enamel that shows asymmetrical involvement of one to four permanent first molars (pfm) with or without incisor teeth involvement. mih molars are prone to post-eruptive breakdown (peb) and to the development of atypical caries lesions. aim of the study: to evaluate and compare the preventive effect of glass ionomer sealant and laser therapy (lt) against dental caries and peb on molars affected by molar incisor hypomineralisation (mih) materials and method: this study is a two-arm, parallel group, randomized clinical trial. a sample of children (n=134) with an age range of 6-9 years old, having a first permanent molar erupted with mih without peb or carious lesion, will be selected from the outpatient clinic of pediatric dentistry and public health department, faculty of dentistry, alexandria university after securing necessary consents. all selected 134 first permanent molars will be randomly and equally allocated into two groups. group 1(n=67): lt and group 2 (n=67): glass ionomer sealant (fuji triage). dental caries, peb, retention of sealant and child-self-reported discomfort will be clinically evaluated after 6, 12 and 18months. associations between dental caries and peb with independent variables will be evaluated using logistic regression analysis (p \< 0.05).


Eligibility criteria:
inclusion criteria: * 6-9 years old children (29) * one tooth with mih with no peb according to evaluation criteria proposed by ghanim (2017) (appendix i) (30) and icdas scores 0, 1 and 2 (appendix ii) (31) * good overall health (asa i) (appendix iii) (32) exclusion criteria: * first permanent molars with active carious lesions with icdas scores 5 and 6 (appendix ii) or defective restorations (31) * sufficient dentin loss that requires restorative therapy * any clinical signs of failure (abscess, fistula)

Keywords: molar incisor hypomineralisation laser sealant
neurescue device as an adjunct to cardiac arrest

Conditions: Cardiac Arrest; Cardiopulmonary Arrest; Cardiovascular Diseases

Summary: the neurescue device is the first intelligent balloon catheter for aortic occlusion, an emergency technique that supercharges blood flow to the heart and brain within one minute from deployment. the catheter-based device is delivered via the femoral artery, temporarily inflating a soft balloon in the descending to redirect blood flow towards the upper body. the objective of the study is to investigate the safety and performance of the neurescue device as an adjunct to advanced life support (als) in adults with cardiac arrest.


Eligibility criteria:
inclusion criteria: 1. age ≥18 and ≤79 years 2. witnessed cardiac arrest 3. cpr initiated within 7 min of presumed arrest 4. cardiac arrest not responding to standard als 5. total cpr time ≤ 40 min at the time of screening for enrollment exclusion criteria: 1. traumatic cardiac arrest 2. known pregnancy 3. known terminal disease 4. known do-not-resuscitate (dnr) order 5. subjects whose femoral arterial access site cannot accommodate an 8 fr introducer sheath 6. subjects currently on mechanical circulatory support