Kornimate/medical-research-clean huggingface dataset:
meibomian gland probing in the sub-acute phase of patients with stevens-johnson syndrome/toxic epidermal necrolysis

Conditions: Stevens-Johnson Syndrome; Toxic Epidermal Necrolyses; Ocular Surface Disease; Meibomitis; Meibomian Gland Dysfunction; Dry Eye

Summary: the investigators' aim is to study the effects of mechanical expression of meibomian glands on eyelid disease, ocular surface health in the subacute phase of sjs/ten. the primary outcome is to use meibomian gland imaging to assess the health and caliber of the meibomian glands of both lower eyelids, between the treated and non-treated eyes before and after the intervention. monitoring of outcomes will be measured by comparing the results of meibography at the initial visit and at the 6-month follow-up. the secondary outcome assessed will be patient symptoms. the ocular surface disease index survey will be administered before each treatment and patients will be asked to differentiate their symptoms between the two eyes, both before and after the intervention. the investigators hypothesize that mechanical expression of meibomian glands within the first 6 months of sjs/ten onset will significantly improve ocular surface disease and symptoms in those patients.


Eligibility criteria:
inclusion criteria: * patients with sjs/ten presenting to the massachusetts eye and ear infirmary (meei) ophthalmology clinic or who were seen by the ophthalmology team acutely at the massachusetts general hospital (mgh). * patients must be in the sub-acute phase of ocular sjs (within 6 months) * patients must have evidence of meibomitis * patients must be adults (18 years of age or older) exclusion criteria: * patients with unconfirmed diagnosis of sjs vs. erythema multiforme (or other condition). * patients beyond the sub-acute phase of sjs * patients without evidence of meibomitis (see above criteria) * patients under the age of 18

Keywords: stevens-johnson syndrome
imidapril and candesartan on fibrinolysis and insulin-sensitivity in patients with mild to moderate hypertension

Conditions: Essential Hypertension

Summary: background the effects of ace-inhibitors on fibrinolysis are well documented. experimental and clinical studies have shown that ace inhibitors induce a reduction in plasma pai-1 levels in many cardiovascular diseases, like hypertension, coronary heart disease, and heart failure. their effects on t-pa are more controversial, due to the fact that t-pa exists in several forms, including free and bound to pai-1. indeed an increase in t-pa activity has been observed in humans and it seems related to bradykinin increase which is known to stimulate endothelial t-pa synthesis. these favourable effects on fibrinolysis could be related not only to the angiotensin ii reduction and the bradykinin increase but also to the improvement in insulin sensitivity, as insulin has been suggested as one of the main regulators of fibrinolytic activity. to date conflicting results have been reported about the effects of arbs on fibrinolysis. some studies have reported small improvements, others no significant effect. these conflicting results may be due to possible methodological bias but a possible pathophysiological explanation might be that receptor subtypes other than at1 mediate the effect of angiotensin-ii on endothelial pai-1 expression, i.e. the at4 receptors, and during at1 receptor blockade there is an important increase not only of angiotensin-ii, but also of all its catabolites including angiotensin iv. the dissimilar effects on of ace is and arbs may also depend on their different action on the ras and their different effect on insulin sensitivity: ace-is improve insulin sensitivity, while the majority of arbs have been reported to have a neutral effect. moreover, unlike ace-is, arbs do not affect the metabolism of bradykinin, which is known to stimulate t-pa synthesis and release. aim of the study the aim of this study is to verify the effect of imidapril compared to candesartan on insulin sensitivity, evaluated through the euglycemic hyperinsulinemic clamp, and on fibrinolysis, evaluated through the plasma pai-1 and t-pa activity, in mild to moderate hypertensive patients.


Eligibility criteria:
inclusion criteria: * age 18-65 years * dbp ≥ 90 \< 110 mmhg and sbp ≥ 140 \< 180 mmhg * normal body mass index (bmi) (≤ 25 kg/m2) * normal kidney function (creatinine clearance \> 80 ml/min) * normocholesterolemia (tc \< 250 mg/dl) * at least one of the following risk factor: * age (m \> 55 years) * smoking * family history of premature cv disease * echocardiographic lvh * carotid wall thickening (imt \> 0.9 mm) * ankle/brachial bp \< 0.9 exclusion criteria: * secondary hypertension * overweight or obese state (bmi ≥ 25 kg/m2) * suspected history of allergy to the arbs, or aces * malignancy * renal, hepatic, endocrine, or gastrointestinal disease * women who are pregnant and lactating * women child-bearing potential * heart failure * ami and/or stroke in the previous 6 months * chd * diabetes mellitus

Keywords: hypertension insulin sensitivity fibrinolysis
impact of decision quality by using question prompt list

Conditions: Decision Making

Summary: to investigate the effects of a question prompt list (qpl) on a shared decision-making consultation among facing decision for dialysis in end-stage renal disease (esrd) patients. a randomized controlled trial was conducted at the university medical center of north taiwan. subjects were randomized assigned to qpl group or usual care group. decisional quality and decision control preferences were assessed with questionnaires. measurements were performed at before the counseling (t0), immediately after counseling (t1), and evaluate decision regret at one month after treatment.

the aim of this study was to investigate the effectiveness of decisional quality and decisional control preferences by using a specific question prompt list (qpl) during a shared decision-making consultation among facing decision for dialysis in end-stage renal disease (esrd) patients. a randomized controlled trial was conducted at the university medical center of north taiwan. recruit subjects are those who are about to receive the nurse-led coaching of shared decision-making (sdm) for patients with esrd and attend the program. by using blocked randomization design, the investigators assigned participants to qpl group or usual care. prior to a clinic visit to discuss treatment, two-pages esrd qpl leaflets are provided to qpl group, while usual care group without receiving provision of qpl. measurements of outcome included decision quality (decision conflict, decisional self-efficiency) and decision control preference at before the counseling (t0), immediately after counseling (t1), and evaluate decision regret at one month after treatment (t2), at this time the patient has decided and started to accept the selected treatment (hemodialysis, peritoneal dialysis or conservative treatment). all statistical analyses were performed in sas statistical software, version 9.4 (sas, cary, nc). the effects of the intervention were assessed by generalized estimating equation (gee) analysis with the coefficient of interaction ( group × time) term. statistical tests were two-sided with a significance level of 0.05. hierarchical linear model was used to detect the impact of nested within physician.

Eligibility criteria:
inclusion criteria: * patients with stage 5 chronic kidney disease who facing decision for dialysis; * normal cognitive functions; * be able to read, communicate in mandarin or taiwanese; * ability to express willingness; exclusion criteria: * vision or hearing function impairment; * severe illness; * urgent to dialysis for extend life; * dialysis modalities already decided.

Keywords: question prompt list shared decision making end-stage renal disease health literacy
bladder lavage as decontamination method for asymptomatic bacteriuria with uropathogens in catheterized patients

Conditions: Catheter Related Infections

Summary: in patients with advanced multiple sclerosis, permanent urinary catheters are often used to manage the urinary incontinence and bladder emptying problems. these catheters will lead to urinary tract infection, blocking of the catheter etc.. especially infections with certain bacteria such as proteus, enterobacteriaceae and esbl producing enterobacteriaceae and pseudomonas can pose a problem for the hospital infection control and for the patient. this study wants to evaluate the potential role of regular bladder lavage with saline, a solution of betadine, an acid solution of acetic acid and of urotainer twin suby g ( braun)in the decontamination of these bladders and the prevention of clinically relevant urinary tract infections.

patients will be selected from the catheterised patient population of the national ms center in belgium for this prospective randomised comparative pilot studyon bladder lavage. the potential benefit for the patient is a reduction in number of clinical urinary tract infections and a reduction of antibiotic use. according to the type of bacteria that is cultured from the urine, patients will be allocated to one of 4 subgroups: * 30 patients will recieve bladder lavage with a isobetadine dermicum solution * 20 patients will revieve bladder lavage with acetic acid solutions * 10 patients will recieve bladder lavage with saline * 10 patients will receive bladder lavage with urotainer suby g the effect will be measured by two repeat urine cultures after the bladder lavage( 2days and 5 days). from a safety perspective and to assess the irritation caused by the lavage, white blood cell counts in the urine will be done. adverse events will be monitored according to gcp regulations.

Eligibility criteria:
inclusion criteria: * patients with an indwelling catheter * catheter associated bacteriuria with proteus, enterobacteriaceae or pseudomonas * willing and able to give informed consent to the study exclusion criteria: * patients with a clinically relevant uti ( fever, pain or cloudy urine) * cognitively impaired patients * patients not able or willing to give informed consent * patients with allergies for isobetadine dermicum or other substances used in the protocol * patients who only have a catheter for less than 1 month * patients taking systemic antibiotics during the last 48h

Keywords: urinary catheter uti bladder lavage
improvement of humoral immune response with hemodialysis on bk-f membrane: correlation to soluble cd40 clearing

Conditions: Chronic Renal Failure; Humoral Immune Alterations

Summary: the aim of this study is to improve the humoral immune response efficiency of hemodialyzed patient by the use of pmma membrane (bk-f) able to clear the soluble form of cd40 in a model of anti-hbv vaccination

chronic renal failure is associated with humoral immune alterations characterized by a diminished vaccine response notably against hepatitis b virus (hbv). defects in cellular contact between immunological cells have been hypothesized to explain this observation but the precise mechanism leading to this "immunocompromised" status is not clear. the soluble form of cd40 (scd40) is dramatically increased in the serum of uremic patients, particularly in the hemodialyzed patients. this molecule acts like an inhibitor of the cd40/cd154 contact, which is pivotal in the establishment of a proper humoral immune response. it has been shown that the most elevated scd40 levels are associated with a lack of response to hbv vaccination in the hemodialyzed patients. the majority of the hemodialysis membranes, including high flux polysulfone membranes are unable to clear scd40 from the sera. however, we found that the high flux polymethylmetacrylate (pmma) membrane (bk-f toray medical company, japan) allows for scd40 clearing. the aim of this study is to assess the effect of dialysis on pmma membrane on the improvement of humoral immune response through the efficiency of hbv vaccination in hemodialysed patients who were non responders to one ore more previous vaccination and its link to scd40 clearing.

Eligibility criteria:
inclusion criteria: * age 18 to 80 years, male or female * patient not immunized against hepatitis b despite complete well done anterior vaccination according to recommendations * hemodialyzed patients with hemodialysed sessions performed three times a week * patient able to give informed consent and affiliated to the medical insurance exclusion criteria: * pregnant woman * patient never vaccinated against hbv * previous known hepatitis b even without anti hbs antibody (anti hbc antibody or hbs antigenemia positive) * active neoplasia or plasma cell dyscrasia * vih infection * known allergy to vaccine or to pmma membrane * patient dialysed with pmma membrane within three months before screening * necessity of acetate free biofiltration or hemodiafiltration as the technique of extrarenal epuration * vascular access problem with necessity of unipuncture for more than 30% of dialysis sessions. * patient under judicial protection
mri study of tic remission in tourette syndrome

Conditions: Tourette Syndrome

Summary: doctors provide a ray of hope to children and their parents with the knowledge that, for most patients, symptoms of tourette syndrome improve by the time they are young adults. the investigators do not know why some improve and others do not. this study is designed to help answer that question. the investigators will use magnetic resonance imaging (mri) techniques to test whether individuals who experience improvement of their tourette's (tic remission) have more mature brain connections than those who do not.

one of the most interesting aspects of tourette syndrome is a virtual remission of tics by early adulthood in about half of patients. information is needed to clarify the mechanism of tic remission in order to guide development of better treatments for this disabling condition. for this cross-sectional study, 10 individuals with tic remission and 10 individuals with persistent tourette syndrome are being recruited for a one-time study visit. 10 neurologically normal (non-ts) controls have also been recruited to obtain control neuroimaging data. all participants will complete a study questionnaire and a 60-minute mri procedure. sequences used to compare the groups will be volumetric, diffusion tensor, resting state functional connectivity mri and mr spectroscopy. our primary hypothesis is that the pattern of functional connectivity in individuals with tic remission will be more mature than that of those with persistent tics. secondary hypotheses tested will explore whether the other modalities can be used to differentiate tic remission from persistent ts.

Eligibility criteria:
inclusion criteria: all subjects: males aged 18-35 with history of tourette syndrome and at least moderately disabling tics during childhood. persistent tourette's subjects: history of disabling tics during childhood but no longer taking tic suppressing drugs. tic remission subjects: no longer experiencing any disability (even social discomfort) from tics. must have had sustained improvement of tics for at least 3 years. normal controls: no longer recruiting. exclusion criteria: tourette's subjects still taking tic suppressing drugs are excluded. also excluded are any patients with a condition (such as a pacemaker, recent tattoo, implantable metal device, or claustrophobia) that could make the mri examination unsafe.

Keywords: tourette tic tourette's tourette syndrome tourette's syndrome
effect of polyphenol extract on cardiovascular health markers: a 4 way randomised crossover study

Conditions: Cardiovascular Diseases; Endothelial Dysfunction; Blood Pressure

Summary: endothelial dysfunction is an early predictor of cardiovascular events in at-risk patients. it is characterized by impaired endothelium-dependent dilation and is primarily caused by reduced nitric oxide bioavailability secondary to oxidative stress and inflammation. finding dietary/dietary supplement-oriented approaches to improving endothelial function is of public health interest. a randomized double-blind placebo controlled 4-way crossover study will be conducted to determine if acute consumption of a proprietary polyphenol extract (156 mg / 222 mg / 333 mg) will have a dose dependent response on endothelium-dependent flow-mediated dilation (ed-fmd) in fasting conditions, in comparison to a placebo (maltodextrin) in male smokers (20 - 45 years; n=20).fmd and blood pressure will be assessed at 0 \& 2 hour timepoints following consumption of a single dose of polyphenol extract, accompanying blood samples will be collected to assess a range of endpoints including nitric oxide metabolites, angiotensin and polyphenols metabolites. endothelium-independent vasodilation will also be measured 2 hours post consumption.


Eligibility criteria:
inclusion criteria: * at least two of the following risk markers; a bmi 25-30, waist circumference \>94 cm, high normal blood pressure defined as either systolic 85-89 mmhg or diastolic 130-139 mmhg and have a normal ecg. exclusion criteria: * an individual who has tested positive (self reported) 2 weeks before the study period. * a covid-19 vaccinated individual who while receive the 1st or 2nd dose or booster 2 weeks before v0 or during the study period, due to the potential interaction of vaccine on markers assessed

Keywords: polyphenols cardiovascular disease endothelial function flow mediated dilation
afamelanotide in patients suffering with acne vulgaris

Conditions: Acne Vulgaris

Summary: this study aims to evaluate the effect of afamelanotide on the facial inflammatory acne-related lesions in patients with mild to moderate acne vulgaris, including tolerability of afamelanotide by patients with moderate acne vulgaris and effects of the treatment on quality of life in eligible patients.


Eligibility criteria:
inclusion criteria: * male subjects with a diagnosis of mild to moderate acne vulgaris, defined as an investigator's global assessment (iga) score of 2-3; * chronic course of acne vulgaris; * acne-related lesions both on the face, chest and back; * indication for treatment of acne vulgaris; * aged 18-30 years (inclusive); * fitzpatrick skin types i-iii; * providing written informed consent prior to the performance of any study-specific procedure. exclusion criteria: * female subjects; * diagnosis of severe acne vulgaris; * allergy to afamelanotide or the polymer contained in the implant or to lidocaine or other local anesthetic to be used during the administration of the implant; * use of topical acne medication such as retinoids, benzoyl peroxide or topical antibiotics within 2 weeks prior to the first dose; * use of oral antibiotics for acne within 4 weeks prior to the first dose; * use of topical corticosteroids on the face, chest and back or systemic corticosteroids within the past 4 weeks prior to the first dose; * use of systemic retinoids within 6 months prior to the first dose; * use of anti-androgenic agents such as finasteride within 4 weeks prior to the first dose; * use of phototherapy devices for acne such as clearlight™ or zenozapper within 1 week prior to the first dose; * use of tanning booths or lamps within 1 week prior to the first dose; * active skin disease that may interfere with evaluation; * other forms of acne such as acne rosacea, acne excoriée, chloracne, acne conglobata, acne fulminans, acne inversa or drug-induced acne; * participation in a clinical trial for an investigational agent within 30 days prior to the screening visit.
epidemiology of young lung cancer - survey

Conditions: NSCLC

Summary: this is a 100% virtual (remote), case-case study to explore potential environmental, lifestyle and genetic factors that may be associated with driver mutations of young lung cancer in the u.s.


Eligibility criteria:
inclusion criteria: 1. male or female aged 18 years and over; or the age of majority for their residential state at the time of enrollment 2. documentation of primary nsclc, any stage 3. less than 50 years of age at the time of nsclc diagnosis 4. documentation of testing by a clia certified lab for genomic drivers of lung cancer 5. willingness to undergo all study procedure 6. provision of written informed consent exclusion criteria: 1. male or female aged less than 18 years; or less than the age of majority for their residential state 2. greater than or equal to 50 years of age at the time of nsclc diagnosis 3. no documentation of mutation testing 4. unwilling to undergo all study procedures 5. unable or unwilling to provide consent
multi-disciplinary participatory design of a process to deliver a ckd diagnosis in primary care

Conditions: Chronic Kidney Disease

Summary: this study will use an adapted education worksheet to support patient-centered chronic kidney disease (ckd) communication, shared decision making, and patient engagement and will test its impact on intermediate patient modifiable characteristics in a primary care practice with patients who have pre-dialysis ckd. the study team will enroll up to 100 patients with chronic kidney disease (ckd) from a primary care clinic to start. patients will receive the intervention, which consists of the physicians using the education worksheet during appointments with patients, and patients and providers will complete surveys about its use and to measure impact on knowledge and other areas related to patient outcomes. once initial user testing is complete, the study team plans to submit an amendment to expand on this trial and incorporate comparison sites. this will be submitted and receive irb approval prior to participant involvement. the study hypothesis is that patients who receive the intervention will have greater knowledge about their ckd diagnosis, higher satisfaction with provider communication, and higher scores related to managing ckd to keep themselves healthy compared to control populations.

amendment on 12/2018: the enrollment numbers were updated to include the control group. clarification 9/2021: after initial feasibility was assessed, the initial site was used additionally to enroll for the "second arm", rather than a new site as originally intended. a second site was then used for the control population.

Eligibility criteria:
inclusion criteria: * 18 years old or older * have an estimated glomerular filtration rate (egfr) of less than 60 ml/min/1.73 m2 * able to read and understand english without an interpreter * diagnosed with chronic kidney disease on record exclusion criteria: * patients with renal transplant or on dialysis * patients who have documented or provider known cognitive impairment or vision impairment that will prohibit meaningful interaction with education activation worksheet * patients who are not aware of their ckd diagnosis