Kornimate/medical-research-clean huggingface dataset:
combination of cryosurgery and nk immunotherapy for advanced kidney cancer

Conditions: Metastatic Renal Cell Cancer

Summary: the aim of this study is the safety and efficacy of cryosurgery plus nk immunotherapy to advanced kidney cancer.

by enrolling patients with kidney cancer adapted to enrolled criteria, this study will document for the first time the safety and the short and long term efficacy of the combined therapy using cryosurgery and nature killer (nk) cells for advanced kidney cancer. the safety will be evaluated by statistics of adverse reactions. the efficacy will be evaluated according to local relief degree, progress free survival (pfs) and overall survival (os).

Eligibility criteria:
inclusion criteria: * all standard therapies have failed according to nccn guidelines or the patient refuses standard therapies after cancer recurrence * body tumor 1-6, the maximum tumor length \< 5 cm * kps ≥ 70, lifespan \> 6 months * platelet count ≥ 80×109/l，white blood cell count ≥ 3×109/l, neutrophil count ≥ 2×109/l, hemoglobin ≥ 80 g/l exclusion criteria: * patients with cardiac pacemaker * patients with brain metastasis * patients with grade 3 hypertension or diabetic complication, severe cardiac and pulmonary dysfunction

Keywords: kidney cancer cryosurgery nk immunotherapy
mitigating response to stressors in pregnant women

Conditions: Pregnancy

Summary: stress-induced pregnancy complications are significant contributors to preterm labor as well as maternal and perinatal morbidity and mortality. the goals of this study are two folds: first it aims to capture the pregnant woman's journey to seek and receive prenatal care. second, this study aims to develop models that 1) assess the adverse health and biological effects of social factors on pregnant women who experience repeated or chronic stress, 2) address how stress can be mitigated in pregnant women from different backgrounds who experience high stress.

maternal stress-induced complications are correlated with gestational hypertension, infant low birth weight, and developmental disruption. various social determinants of health are contributors to stress in pregnant women; factors such as socioeconomic status, education, access to prenatal care, and neighborhood conditions are some of the most identified psychosocial causes of prenatal stress. further, chronic psychosocial stress is identified as a significant contributor to biophysiological damages such as accelerated telomere shortening in the mother as well as the offspring. using a public health approach, this research study proposes to gather evidence to assess how response to stress is modulated and how it is captured in and affects pregnant women, with history of prolonged exposure to harmful stressors. more relevant to this study, individuals who have repeated exposure to stressors have poorly managed response to stress and display frequent elevated heart rates due to biological and physiological disruptions. evidence from the literature suggests that having a support system and utilizing stress management techniques moderate and buffer the effects of stress on physiological measures while facilitating emotional recovery.

Eligibility criteria:
inclusion criteria: in 24 weeks gestation or more * between 21 and 37 years of age exclusion criteria: * in less than 24 weeks gestation * high risk pregnancies

Keywords: stressors, chronic stress, pregnancy, stress regulation, stress management
impact of montelukast on allergic rhinitis and its inflammatory makers

Conditions: Allergic Rhinitis

Summary: to examine the efficacy of montelukast as an adjunct to incs in patients with allergic rhinitis.

allergic rhinitis (ar) is a non-infectious inflammatory disease occurring in nasal mucosa with nasal itching, nasal congestion, rhinorrhea, and sneezing as its main clinical symptoms, which are induced by immunoglobulin e-mediated chemical mediators with the participation of various immunologically competent cells and cytokines after allergen exposure. (1) according to statistics, ar affects 10% to 25% of the global population. (2). ar could be investigated by skin prick test, a blood test to check for the immunoglobulin e (ige) antibody, and total blood eosinophil count. (3) current guidelines suggest that intranasal corticosteroids should be used as the first line of treatment (4). surgical care may be indicated for comorbid or complicating conditions such as chronic sinusitis and nasal polyps. (5) many studies have proven that the abnormality of inflammatory factors such as(tnf-α, il-6, and il-12)are closely related to the pathogenesis of ar. (6)these inflammatory factors participate in the regulation of immune response through media leucocyte chemotaxis and activate, so elevate of levels of these 3 factors can reflect the aggravation of inflammatory markers in the patient with ar. (7) montelukast is belonging to the leukotriene receptor antagonists with the effect of inhibiting the expression of cysteinyl leukotriene involved in the pathogen of ar. thus, the inhibition of the inflammatory marker can effectively reduce airway inflammatory response, nasal mucosal edema, and inflammatory exudation etiologically \[8\].

Eligibility criteria:
inclusion criteria: adult patients (aged 18 years and over) with ar. clinical diagnosis of allergic rhinits must be able to swallow tablets exclusion criteria: bronchial asthma patients. patients already on antihistamine combined treatment patients who are allergic to this medication advanced liver or kidney diseases.

Keywords: montelukast allergic rhinitis
physical fitness, exercise capacity and activities of daily living in primary ciliary dyskinesia: a retrospective study

Conditions: Primary Ciliary Dyskinesia; Kartagener Syndrome; Immotile Cilia Syndrome

Summary: decreased pulmonary function, peripheral muscle strength, and exercise capacity were reported in primary ciliary dyskinesia (pcd) in recent studies. we aimed to investigate the data conducted between 10 july 2015 and 10 january 2015 of pulmonary function, respiratory muscle strength, exercise capacity, physical fitness, and activities of daily living (adl) in pcd and healthy counterparts retrospectively at the first stage of the study and the effects of inspiratory muscle training on pulmonary function, respiratory muscle strength, and exercise capacity in pcd patients with decreased inspiratory muscle strength from the database recorded between 10 july 2015 and 10 january 2015 retrospectively at the second stage of the study.


Eligibility criteria:
inclusion criteria: * clinically stable * being able to cooperate with the assessments * not having any orthopedic, or neurological problems exclusion criteria: * not being clinically stable * not being able to cooperate with the assessments * having any orthopedic, or neurological problems

Keywords: primary ciliary dyskinesia kartagener syndrome immotile cilia syndrome pulmonary function respiratory muscle strength exercise capacity physical fitness inspiratory muscle strength training
comparison the effects of 3 different intraarticular ketamine doses on postoperative pain.

Conditions: Arthroscopy

Summary: the aim is to compare the effects of two different doses of intraarticular ketamine on postoperative pain scores and analgesic requirements.in knee artroscopy

all pateints are going to be operated under general anesthesia. at the end of the study patients are going to be randomyl seperated into 3 groups. the surgeon is going the following drugs intraarticulary. group kl1: 0.5 mg/kg ketamin in % 0..9 nacl at a total volume of 20 ml group kl2: 1 mg/kg ketamin in % 0.9 nacl at a total volume of 20 ml group sl: 20 ml % 0.9 nacl ll patients are going to receive a periarticula injection of 10 ml 0.5 bupivacaine and patient controlled analgesia with morphine. vas scores and total analgesic requirement is going to be evaluated.

Eligibility criteria:
inclusion criteria: * artroscopic surgery * asa i-ii exclusion criteria: * long time nsaid use * travmatic knee injury * long ter analgesic use * intraartiular catheter insertion at the end of surgery

Keywords: injection intra-articular arthroscopy ketamine
primary care ckd registry

Conditions: Hypertension; Chronic Kidney Diseases

Summary: this study examines whether a safety-net primary care ckd registry directed at the entire primary care team can enhance the delivery of guideline concordant ckd care, including bp control, acei/arb use and albuminuria quantification.


Eligibility criteria:
inclusion criteria: all pcps who worked in practice teams and provided longitudinal primary care to patients were eligible to participate in this study. practice teams that consisted of several physicians (+/- trainees), one nurse, nurse practitioners, medical assistants and behaviorists, were randomized 1:1 to one of two arms with a random number generator: access to an electronic ckd registry or a usual care registry for 12 months. exclusion criteria: pcps who solely provided specialty care, for example hiv services or urgent care, were excluded.
dexmedetomidine pharmacokinetics during continuous renal replacement therapy (crrt)

Conditions: Acute Kidney Injury

Summary: the purpose of this study is to determine dexmedetomidine pharmacokinetics during continuous renal replacement therapy on critically ill patients.

dexmedetomidine is a selective alpha-2-adrenergic agonist with sedative properties indicated for sedation of patients in the intensive care setting. icu patients with acute kidney injury requiring renal replacement therapies frequently have changes in volume status causing alterations in drug pharmacokinetics. although dexmedetomidine pharmacokinetics have been studied earlier on icu patients, there is no information on its pharmacokinetics in critically ill patients needing continuous renal replacement therapy.

Eligibility criteria:
inclusion criteria: * age ≥ 18 * clinical need for sedation * acute kidney injury requiring renal replacement therapy (according to icus standard operating procedures) exclusion criteria: * severe bradycardia (hr \< 50/min) * av conduction block ii-iii (unless pacemaker installed) * severe hepatic impairment (bilirubin \> 101 umol/l) * pregnancy or lactation * age \< 18

Keywords: dexmedetomidine pharmacokinetics critical illness continuous renal replacement therapy
investigating covid-19 vaccine immunity in children in the melbourne infant study of bcg for allergy and infection reduction

Conditions: COVID-19; Vaccine Reaction; Immunization; Infection

Summary: the cosi bair trial will involve approximately 60 children, aged 5 to 8 years old, comprising a subset of participants from the melbourne infant study bcg for allergy and infection reduction (mis bair) randomised controlled trial. the overall aim of this trial is to investigate the specific and heterologous effects of covid-19 vaccination on immunity in children. cosi bair will aim to recruit its participants from the mis bair bacillus calmette-guérin (bcg)-naïve group. these children will be followed up until 28 days after their final coronavirus disease 2019 (covid-19) vaccination. venous blood samples will be collected at two study visits, at murdoch children's research institute (mcri): 1. day 0 - baseline (day of covid-19 vaccination #1), and 2. day 84 (28 days after covid-19 vaccination #2).


Eligibility criteria:
inclusion criteria: * age between five and eleven years (i.e. prior to the twelfth birthday) at the time of enrolment, * participant who was randomised in the mis bair trial, and * was randomly allocated to receive and received bcg as part of the mis bair trial, or, * was randomly allocated to not receive and did not receive bcg; * is an individual whose parent/legally acceptable representative (lar) consented to be contacted about future ethically approved research, during the mis bair trial consent process, and * has a parent/lar capable of understanding the parent/lar information statement and consent form (picf) document and providing consent on the participant's behalf. exclusion criteria: * has a known hypersensitivity to the active ingredient or any of the excipients in tozinameran, * has a prior polymerase chain reaction (pcr)-confirmed diagnosis of covid-19 whether symptomatic or not, * has received a covid-19 vaccine (approved by the tga or otherwise) prior to trial enrolment, * an individual and/or parent/legally acceptable representative who is unwilling or unable to give written informed consent, * an individual and/or parent/legally acceptable representative who is unwilling or unable to consent to attend all scheduled study visits, * an individual and/or parent/lar who is unwilling or unable to give consent for blood samples to be taken from the trial participant at each study visit, and * has or has had a clinically significant medical morbidity (e.g. immunocompromised because of congenital or acquired disorders or immunosuppressive medical treatment; a bleeding disorder; a recent history of inflammatory cardiac illness within the past 6 months, e.g., myocarditis, pericarditis, endocarditis, acute rheumatic fever (with active myocardial inflammation) or acute rheumatic heart disease, or acute decompensated heart failure), and * has received bcg at any other time than as part of the mis bair trial.

Keywords: non-specific effects covid-19 vaccination paediatric vaccination heterologous immunity mrna vaccine
improving latent tuberculosis (tb) diagnosis in thai children

Conditions: Latent Tuberculosis; HIV Infections

Summary: the study is a prospective study to improve the diagnosis and management of latent tb in hiv-infected and hiv uninfected children in thailand. the objectives are to assess the sensitivity and specificity of igras (t-spot®.tb, a t-cell-based assay, and quantiferon®-tb gold in-tube, a whole blood assay), tst, and a refined symptom-based questionnaire in diagnosing latent tb in 166 hiv-infected and hiv uninfected children in thailand, and to evaluate the influence of age, nutritional and immune status on children's response to the igras. these children will be screened for tb with a detailed tb contact history, symptom-based questionnaire, physical examination, tst, chest radiograph (and abdominal ultrasound for those with abdominal symptoms), igras, and clinical specimens for acid fast bacilli stain and culture. a diagnostic algorithm will be generated using the combination of test modalities with the highest sensitivity and specificity results.

study objectives * to compare the utility of igras, t-spot®.tb and quantiferon®-tb gold in-tube, and tst for screening of latent tb in hiv-infected children * to compare these different screening modalities in hiv-infected children to hiv uninfected children * to assess the influence of age, nutritional and immune status, prior bcg and tst status on children's response to igras * to assess the prognostic value of igras vs. tst in predicting development of active tb in children over 9 months research questions: primary: what is the sensitivity and specificity of igras and tst in screening for latent tb in hiv-infected and hiv uninfected children in thailand? secondary: how do age, nutritional and immune status, prior bcg and ppd status influence children's response to igras? what is the prognostic value of igras vs. tst in predicting development of active tb in children over 9 months? this is a prospective cohort study conducted at two sites in bangkok, thailand: hiv netherlands australia thailand (hiv-nat) clinic/chulalongkorn hospital and queen sirikit national institute of child health.

Eligibility criteria:
inclusion criteria: 1. have close contact with a person \> 15 years of age who had active pulmonary (± extrapulmonary), sputum afb positive tb (household member or non-household member with contact \> 120 hours/month) during the past year 2. are between the ages of 2 months and 16 years 3. parents or caregivers provide informed consent to participate 4. provide child assent for children aged ≥ 7 years exclusion criteria: 1. child and/or parent/caregiver who refuse study participation 2. are currently receiving antituberculosis medications for tb disease 3. have recently been diagnosed with active tb within past 6 months

Keywords: latent tuberculosis hiv children interferon gamma release assays thailand quantiferon tb gold in-tube t-spot.tb
effect of different depths of neuromuscular blockade on respiratory mechanics in patients with moderate-severe acute respiratory distress syndrome

Conditions: ARDS; Lung Protective Ventilation

Summary: acute respiratory distress syndrome (ards) is characterized by acute diffuse alveolar injury caused by a variety of pulmonary and extrapulmonary factors, leading to refractory hypoxemia. it has high incidence and mortality rates. neuromuscular blocking agents (nmbas) play a crucial role as adjunctive therapy for ards, aiding in lung-protective ventilation by inhibiting excessive spontaneous breathing, improving patient-ventilator synchrony, and reducing barotrauma. determining the appropriate depth of muscle relaxation in moderate to severe ards patients receiving nmbas remains a clinical challenge. research has shown that partial neuromuscular blockade is feasible in certain ards patients. however, large randomized controlled trials (rcts) and clinical practices often use higher doses of nmbas to ensure complete cessation of spontaneous breathing. this indicates an ongoing debate regarding the optimal depth of neuromuscular blockade necessary for lung-protective ventilation in ards patients. it also raises the question of whether the optimal depth of neuromuscular blockade varies among patients with different severities of ards. this study aims to investigate changes in respiratory mechanics and other physiological parameters in moderate to severe ards patients under different depths of neuromuscular blockade. the investigators will evaluate the impact of targeted neuromuscular blockade depth on lung protection in these patients.


Eligibility criteria:
inclusion criteria: 1. patients with moderate to severe ards requiring the use of nmbas, as assessed by clinicians (berlin definition 2012: pao2/fio2 \< 150 mmhg, peep ≥ 5). 2. age: 18-85 years. 3. signed informed consent. exclusion criteria: 1. history of allergy to nmbas. 2. open chest or abdominal injuries. 3. patients with pulmonary masses, lung transplantation, or lung resection. 4. contraindications to esophageal catheter placement. 5. pregnant patients. 6. contraindications to tof measurement (e.g., history of neuromuscular disease, presence of a cardiac pacemaker). 7. severe dysfunction of other organs with an expected short-term mortality (within 7 days) or palliative care. 8. previous inclusion in this study.

Keywords: ards lung protective ventilation neuromuscular blockade respiratory mechanics
positive imaging study for distant metastases in patients with castration-resistant prostate cancer

Conditions: Castration-Resistant Prostate Cancer

Summary: the primary purpose of this research is to describe patient characteristics predictive of an imaging study positive for distant metastases in patients with castration-resistant prostate cancer and no known distant metastases.


Eligibility criteria:
inclusion criteria: * written informed consent obtained prior to the initiation of study procedures. * men ≥ 18 years of age. * histologically documented prostatic adenocarcinoma. * history of castration-resistant prostate cancer. exclusion criteria: * known m1 disease. * undergone imaging study for metastatic prostate cancer ≤ 3 months. * ecog performance status ≥ 3. * known malignant pleural effusions or ascites. * current or prior treatment with investigational therapy for m0 castration-resistant prostate cancer (taxotere (docetaxel), provenge® (sipuleucel-t), zytiga (abiraterone acetate), xtandi (enzalutamide), jevtana (cabazitaxel), or xofigo (radium ra 223 dichloride).
single-arm, open-label, phase ii trial of hd-tdcs in fibromyalgia patients

Conditions: Fibromyalgia; Chronic Pain

Summary: the purpose of this study is to investigate the mean number of stimulation (high definition-transcranial direct current stimulation) sessions (up to 26) needed to achieve a clinical response with this response defined as a 50% decrease in visual analog scale (vas) for pain. these data will be important in defining the optimal number of sessions for future fibromyalgia subjects in phase iii trials.


Eligibility criteria:
inclusion criteria: * providing informed consent to participate in the study * 18 to 85 years old, both male and female * have a diagnosis of fibromyalgia * existing pain for more than 3 months with an average of at least 4 on a 0-10 vas scale * pain resistant to common analgesics and medications for chronic pain such as tylenol, aspirin, ibuprofen, soma, parafon forte dcs, zanaflex and codeine. exclusion criteria: * pregnancy * contraindications to tdcs: metal in the head or implanted brain medical devices * history of alcohol or drug abuse within the past 6 months as self-reported * use of carbamazepine within the past 6 months as self-reported * severe depression (with a score of \>30 in the beck depression inventory) * any history of epilepsy, stroke, moderate-to-severe traumatic brain injury or severe migraines * history of unexplained fainting spells as self-reported * neurosurgery as self-reported

Keywords: transcranial stimulation direct current
prp injections for genitourinary syndrome of menopause

Conditions: PRP; Sexual Function Disturbances; Genitourinary Syndrome of Menopause; Postmenopausal Symptoms; Vaginal Atrophy

Summary: platelet-rich plasma (prp) is autologous blood which has been centrifuged to separate the supernatant resulting in a solution with high concentration of platelets. injection of prp stimulates cell growth and can has been proven safe and effective for uses in orthopedics, dermatology, and gynecology. despite the relative paucity of data, the use of prp as a therapy for sexual dysfunction and genitourinary symptoms in the setting of menopause has been patented as the o-shot and v-shot. this is a single-blinded randomized control trial to determine if prp injections into the anterior vaginal wall improve sexual functioning in women diagnosed with the genitourinary syndrome of menopause (gsm) characterized by vaginal dryness/irritation.


Eligibility criteria:
inclusion criteria: * women (assigned female at birth) at least 18 years old with a clinical diagnosis of gsm * sexually active with at least one episode of sexual activity per week in the preceding 4 weeks defined as follows: partnered or solo penetrative or non-penetrative stimulation of the clitoris or vagina * english-speaking * willingness and able to comply with the study requirements exclusion criteria: * symptomatic pelvic organ prolapse protruding beyond the hymen) * history of prior vaginal mesh or midurethral mesh sling surgery * history of pelvic radiation or genital tract malignancy * current symptomatic pelvic organ prolapse (stage ii or greater) * active vulvar dermatoses or genitourinary infection * unable to hold anticoagulation * hormonal replacement therapy (systemic, local, or vaginal) within 3 months of participation * pregnancy or pre-menopausal status