Kornimate/medical-research-clean huggingface dataset:
pathogenic mechanisms in c diff infection and colitis

Conditions: Clostridium Difficile Infection

Summary: the purpose of this study is to learn more about infection by clostridium difficile (also known as c. difficile). c. difficile is a common bacterium (a germ that may cause disease) that can live in the human gut. some people have it without having any symptoms. in other people it can cause illness ranging from mild diarrhea to severe colitis (infection of the colon). c. difficile makes toxins that damage the cells that line the colon. the study doctors want to find out how these toxins cause damage to the cells in the colon.

the purpose of this study is to examine pathogenic mechanisms of clostridium difficile toxin-mediated intestinal injury and inflammation. two primary mechanisms will be examined. * to examine the hypothesis is that microrna expression profiles are dysregulated by clostridium difficile toxin exposure and that dysregulation of mirna expression plays a role in the pathogenesis of c. difficile associated diseases. * to examine the hypothesis is that the tlr9 receptor mediates key inflammatory events in response to clostridium difficile toxin exposure.

Eligibility criteria:
inclusion criteria: * age greater than 18 yrs and less than 75 years * undergoing a clinically indicated colonoscopy exclusion criteria: * known, active or recurrent colonic disease including: clostridium difficile infection, inflammatory bowel disease, microscopic colitis, colon resection for any reason, ischemic colitis, recurrent diverticulitis, colon cancer. note: diverticulosis without recurrent diverticulitis, colonic adenomatous or hyperplastic polyps or colonic arteriovenous malformations will not constitute an exclusion * diarrhea (an average of more than 3 bowel movements per day at baseline) * constipation (an average of fewer than 2 bowel movements per week at baseline). * use of systemic steroid or systemic immunosuppressive medication * severe renal impairment * relative contraindication to colon biopsy including a bleeding diathesis or anti-coagulant use. note: nonsteroidal antiinflammatory drug or asprin use will not constitute a contra-indication.

Keywords: clostridium difficile infection
the breathe well program for adults with asthma

Conditions: Asthma

Summary: the breathe well study is a pragmatic, controlled trial to assess the effectiveness, cost-effectiveness, and implementation of the breathe well intervention, which combines evidence-based ehr and interactive behavior-change technologies (ibct) and team-based care to improve asthma outcomes.

breathe well uses the kaiser permanente electronic health record (ehr) to identify asthma exacerbation risk factors. for patients with a history of frequent exacerbations or b-agonist overuse, the ehr notifies a nurse who uses an ehr-generated tailored clinical report and patient directed decision support tool to engage and empower patients to develop an action plan in collaboration with providers. ehr-templated notes and order sets facilitate care plan execution. poor controller medication adherence or unaddressed smoking results in the patient being automatically enrolled in an ibct medication refill or smoking cessation program. breathe well uses multiple ehr functions and a patient and provider team to address barriers to evidence-based asthma care for providers.the study will be conducted in 26 primary care clinics of kaiser permanente colorado (kpco) using a pragmatic clinical trial design. up to 15,000 high-risk asthma patients will be assigned to breathe well or guideline-based usual care based on their clinic.

Eligibility criteria:
inclusion criteria: adults with ≥1 ehr of these indicators of an asthma care gap in the ehr will be eligible. 1. b-agonist overfilling 2. inhaled corticosteroid (ics) underfilling 3. current smoker 4. asthma exacerbation in the last year exclusion criteria: 1. limited life expectancy 2. diagnosis of chronic obstructive pulmonary disease 3. lack of a pharmacy benefit because medication use cannot be captured.
post-market clinical trial of the dominus® stent-graft

Conditions: Thoracic Aortic Dissection

Summary: real-world clinical trial evidence post-market, evaluating the safety and efficacy of the dominus® stentgraft endoprosthesis in treating thoracic aortic diseases, following the instructions for use

the multicenter study aims to collect post-market clinical data on the dominus® stent-graft in the treatment of thoracic aortic diseases. with the goal of assessing safety and efficacy, the prospective follow-up study will include 100 patients undergoing endovascular treatment of thoracic aortic diseases, following the product's instructions for use

Eligibility criteria:
inclusion criteria: 1. 18 years of age or older; 2. patients treated with the dominus® stent-graft endoprosthesis in accordance with its instructions for use; 3. patient available for appropriate follow-up times for the study duration; 4. informed patient about the nature of the study, agreeing to its provisions, and signing the informed consent. exclusion criteria: 1. patient currently participating in another clinical study of drug or medical device; 2. life expectancy less than 12 months.

Keywords: aneurysm acute aortic syndrome aortic dissection aortic diseases cardiovascular diseases
interventional study for detection of prognosis of blood based biomarkers in intracerebral hemorrhage

Conditions: Intracerebral Hemorrhage

Summary: explore blood based biomarkers in patients with intracerebral haemorrhage \[cbc. pt. ldh.crp. cholesterol. na. k.. mg. urea ca. uric acid\]

spontaneous intracerebral hemorrhage (ich) is a common subtype of stroke and accounts for nearly 10% to 30% of all strokes \[1\]. ich posed a significant health burden in china in 2019, contributing to 25 million disability-adjusted life years (dalys). it is associated with an early mortality rate of approximately 30-40% and has shown no reduction in prevalence in recent decades \[2\]. the higher incidence and mortality of ich in middle-income and low-income countries may be attributed to limited public awareness regarding preventive measures, as well as challenges in accessing healthcare services \[3\]. so far, few treatment possibilities have yielded conclusive benefits. however, numerous predictors of poor outcomes after ich have been suggested, including hematoma volume, hematoma expansion, perihematomal edema (phe), and the presence and quantity of intraventricular hemorrhage growth \[4,5,6,7\]. similarly, researchers continue to search for various blood-based biomarkers to guide management and predict outcomes after acute ich \[8,9,10,11,12\]. a growing number of studies have shown that many novel biomarkers, such as c-reactive protein (crp), s100a12, and interleukin-6, are associated with adverse outcomes in patients with ich \[8,9,10\]. thus, the application of blood-based biomarkers may improve risk stratification and aid clinical decisions in patients with ich. therefore, in this review, we assessed the data available in the literature regarding the diagnostic and prognostic value of circulating blood biomarkers in patients with ich. for each biomarker, we depicted the detailed characteristics in order to shed light on potential future clinical applications intracerebral hemorrhage (ich) is the second most common subtype of stroke and a critical disease usually leading to severe disability or death. ich is more common in advanced age, male sex, and low- and middle-income countries. the case fatality rate of ich is high, and only 12% to 39% of survivors can achieve long-term functional independence. risk factors of ich are hypertension, current smoking, excessive alcohol consumption, hypocholesterolemia, and drugs. clinical presentation varies according to the size and location of hematoma, and intraventricular extension of hemorrhage.

Eligibility criteria:
* inclusion criteria: 1. both sex 2. age between 25 to 40 years old. 3. symptoms suggestive of intracerebral hemorrhage exclusion criteria: 1. age group below 25 years and above 40 years 2. traumatic cerebral haemorrhage 3. extradural,subdural,subarachnoid hemorrhage 4. hemorrhagic infarction

Keywords: hemorrhage biomarkers detection
cardiovascular risk factors in patients with diabetes -a prospective study in primary care

Conditions: Diabetes Mellitus Type 2; Cardiovascular Diseases

Summary: the purpose of this study is to prospectively explore the impact from the different cardiovascular risk factors on early cardiovascular organ damage in 761 middle aged patients with type 2 diabetes.

cardipp (cardiovascular risk factors in patients with diabetes - a prospective study in primary care) was launched in 2005 with the aim of identifying markers for cardiovascular disease to facilitate earlier and individually adjusted intervention in middle aged patients with type 2 diabetes. the patients in cardipp were consecutively recruited from primary health care centres in the counties of östergötland and jönköping, sweden from november 2005 through december 2008. the study enrolled 761 patients with type 2 diabetes, aged 55-65 years and the participation in the study was performed as an extended annual follow up. blood pressure was measured as the average of three seated measurements taken 1 minute apart and standard anthropometric and clinic evaluations were performed including measurement of waist circumference and sagittal abdominal diameter which is a new and promising measurement of abdominal obesity that may serve as a surrogate marker of insulin sensitivity. we also obtained a recording of 24-hour ambulatory blood pressure. the patients filled out a detailed questionnaire for evaluation of life style factors and exercise habits. pedometer-determined ambulatory activity for three consecutive days in combination with the questionnaires was used for quantification of daily physical activity. the cardiovascular investigations were performed at the department of physiology, linköping university hospital and at county hospital ryhov, jönköping, sweden. the patients were subjected to cardiac ultrasonography for calculation of left ventricular mass and ejection fraction as well as diastolic cardiac function. measurement of the carotid, femoral and radial pulse pressure wave form is performed by aid of tonometry, with pressure wave analysis and calculation of central blood pressure. furthermore, pulse wave velocity in both central elastic and muscular peripheral arteries is defined as an index of arterial wall stiffness. the intima-media thickness (imt) and the lumen diameter (ld) of the carotid arteries were evaluated using a b-mode ultrasound. cardipp-r comprises a re-investigation of the cohort four years after the completion of the baseline examination and will thus start in november 2009 and will be completed by 2012. in cardipp-r, all participants from the baseline study will be invited to the re-investigation. the cardipp-r study protocol for the cardiac ultrasonography, the carotid ultrasonographic investigations and tonometry for measurements of the carotid, femoral and radial pulse pressure wave form and pulse wave velocity will follow the cardipp baseline protocol.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of type 2 diabetes exclusion criteria: * not able to understand swedish
convalescent plasma donor vaccine study an observational antibody level study.

Conditions: Healthy

Summary: there is a need to understand antibody responses following sars-cov-2 infection and subsequent vaccination.

this is an observational study to determine changes in antibody levels in individuals who have previously donated covid-19 convalescent plasma (ccp) and have now received at least one dose of a covid-19 vaccine. at present these donors could no longer donate ccp as their virus-neutralising antibody levels do not reach the level required (euroimmun of at least 6 igg signal/control cutoff). two blood samples (9 ml total) will be collected at a local nhsbt donor centre to test the levels of the virus-neutralising antibodies in the plasma against different viral strains. the results of this study will: 1. determine whether nhsbt will collect ccp or plasma for medicines (pfm) from vaccinated members of the public that could have boosted antibody levels following vaccine administration. 2. understand if antibody levels rebound to a concentration suitable for ccp and pfm. 3. provide the evidence to support the use of ccp for the early treatment in covid (currently under consideration as a collaboration with european partners). 4. assist in development of recording vaccination status on nhsbt databases of donors.

Eligibility criteria:
inclusion criteria: * individuals who have had a previous sars-cov-2 infection * individuals who have previously donated covid-19 convalescent plasma (ccp) * received at least one dose of a sars-cov-2 vaccine (any type of vaccine) exclusion criteria: * not received a sars-cov-2 vaccine

Keywords: anti-sars-cov-2 antibodies covid-19 convalescent plasma
optimal positive end-expiratory pressure in robotic-assisted thoracic surgery without capnothorax

Conditions: Robotic Thoracic Surgery; Mechanical Ventilation; Positive End Expiratory Pressure (PEEP)

Summary: the aim of this study is to assess the impact on lung mechanics during robotic lung resection when no capnothorax is used.

assess the improvement of oxygenation, ventilation and lung mechanics in patients ventilated with individualized peep without capnothorax. peep requirement and lung mechanics without capnothorax will be compared with a historical cohort population of robotic surgery with capnothorax.

Eligibility criteria:
inclusion criteria: * patients undergoing uniportal robotic lung resection under no capnothorax exclusion criteria: * refusal to participate * contraindications to recruitment maneuvers

Keywords: robotic lung surgery peep capnothorax
molecular imaging modality by positron emission tomography using 18f-x : study of microglial activation in amyotrophic lateral sclerosis

Conditions: Amyotrophic Lateral Sclerosis; Bulbar Disease; Spinal Disease

Summary: pet imaging of activated microglia offers a tool of investigation of a range of brain diseases where neuroinflammation is a component. amyotrophic lateral sclerosis is the most frequent motoneuronal disease in adult. this study was designed to explore the feasibility of molecular imaging modality by positron emission tomography using 18f-x as an in vivo marker of activated microglia for the assessment of neuroinflammation in amyotrophic lateral sclerosis. pet may help in the diagnosis of the disease and, further, may allow assessment of the efficacy of antiinflammatory treatment.

18f-x pet will be carried out requiring arterial sampling in 2 patients suffering from als and 2 normal subjects in order to evaluate the 18f-x quantification. then simplified pet using 18f-x will be carried out in 13 patients and 13 normal subjects. binding potential maps showing specific binding of 18f-x will be generated for each subject. regional binding potential values will be calculated for anatomically defined regions of interest after coregistration to and special transformation into the subject's own mri.

Eligibility criteria:
inclusion criteria: * suffering from probable or definite form of amyotrophic lateral sclerosis according to el escorial criteria. spinal or bulbar site of the disease. * information and signature of the written consent form * french social security registration exclusion criteria: * family history of als * riluzole treatment before the first petscan. * psychiatric disorders * evolution of the disease older than 18 months * antiinflammatory or antibiotic treatment in the last month

Keywords: neurology sclerosis imaging tomography
observational study of long-term joint health outcome in hemophilia patient

Conditions: Hemophilia; Arthropathy

Summary: patients with severe hemophilia a can experience repeated bleeding into the same joint (ie, a target joint; most frequently in the ankle, knee, and elbow), which can contribute to hemophilic arthropathy and, over time, ultimately result in chronic pain, functional limitations, deformities, reduced joint of motion and decreased quality of life. early use of prophylaxis is recommended following diagnosis of severe hemophilia a to maintain joint health and prevent joint destruction. eloctate is produced using a human cell line and an addition of an fc fusion protein to recombinant fviii (rfviiifc) with prolonged half-life and was launched in taiwan from nov. 2018. the pivotal studies of rfviiifc show that patients maintained a low bleeding rate, with most experiencing a median annualized bleeding rate (abr) of 0 and 97% of target joints were resolved across adult, adolescent, and pediatric subjects during 4 years of prophylaxis rfviiifc treatment. however, in taiwan we are still lacking the real world treatment outcome data on rfviiifc, especially for the joint health evidence in asian hemophilia a patients. therefore the objective of this study is to evaluate the effectiveness of rfviiifc treatment on joint health over a long observational period of 36 month focused on physical and functional changes in hemophilia a patients.

thermographic assessment has been proposed to be a potential tool in evaluating the inflammatory arthritis patients. thermography has advantages of simple, time-saving, low skill demanding, no radiation exposure and non-invasiveness. it is possible to conduct a quantitative analysis with thermography. however, it is still unknown whether thermography evaluation can provide clinical information regarding the joint health in hemophilia arthropathy patients. the project will focus on: 1. investigate the association among thermography findings and functional status in hemophilia arthroplasty 2. investigate the novel biomarkers in predicting function in hemophilia arthropathy including: soft tissue ultrasound, body composition, thermographic findings of joints, muscle composition and serum biomarkers of joint degeneration.

Eligibility criteria:
inclusion criteria: 1. willing to sign inform consent form and complied with study procedure 2. patient received confirmative diagnosis of hemophilia a disease 3. severe hemophilia a patient currently who are on treatment with eloctate prior to enrolment visit (note: prescription based on physician's clinical judgement and discussion with patients) exclusion criteria: 1. unwilling to sign inform consent form. 2. history of major neurological disease (eg. stroke, parkinson's disease, neuropathy, etc.) 3. history of major psychiatric disease (eg. schizophrenia, bipolar disorder) 4. significantly impaired vision / hearing 5. cannot communicate in mandarin chinese 6. recent joint bleeding and trauma 3 months prior to study
biological significance of the bloom's syndrome protein

Conditions: Bloom Syndrome

Summary: since 1960, persons with the very rare disorder bloom's syndrome (bs) have been followed clinically, documenting clinical matters as obtained from their doctors. this has been a worldwide search for cases, though a few in the new york city area are seen (personally, by us) perhaps once every 2-3 years. bs is a rare genetically-determined disorder described in nyc in 1954. the clinical courses of the 169 persons diagnosed bs by 1991 are followed in a program referred to as the bloom's syndrome registry. bs is the prototype of the "chromosome-breakage syndromes." bs cells mutate at a greater rate than any other, and the consequence is the greatest known predisposition to cancers of the types that affect the general human population. we are defining the clinical syndrome and at the same time are studying cells from affected families in the experimental laboratory. bs is a model for learning about cancer. our contact with families lets us know of cancers arising, but blood, and sometimes tiny biopsies of skin, is taken if available so that (a) the chromosomes can be studied and (b) the gene mutations can be defined in molecular terms.

although an occasional person with bs will be admitted to the hospital for special study (endocrine evaluation mainly)--two in the last 25 years--the registry does not develop a doctor/patient relationship with affected persons. they have their own doctors. we gather information about the affected persons and publish reports. we also publish reports of experiments carried out in the research laboratory using bs cells. because we are a central repository for information on bs, families or their physicians find contact with us beneficial, and we provide them with information requested. sometimes pregnancies at risk occur, and we have on occasion made cytogenic (chromosome) analysis of cultured cells of amniotic fluid (the cultures being initiated elsewhere and sent to us for cytogenetic study). although the accessioning of new cases to the registry was closed in 1991, 4-5 new patients are referred to us each year, and their clinical courses also are being followed. to date, the 169 officially registered and 36 additional cases are under our surveillance.

Eligibility criteria:
1. families include those ascertained by physician referral and those families already accessioned to the bloom's syndrome registry 2. the family has at least one affected member with bs

Keywords: bloom syndrome protein
inspiratory flow parameters of easyhaler and diskus inhalers (salif)

Conditions: Asthma; Chronic Obstructive Pulmonary Disease

Summary: the purpose of this study is to characterise inspiratory flow parameters across 2 easyhaler® (eh) inhaler versions and diskus® inhaler in patients with asthma (including children, adults, and the elderly) and in patients with chronic obstructive pulmonary disease (copd).


Eligibility criteria:
inclusion criteria: * written informed consent (ic) obtained * documented diagnosis of asthma and/or copd * age: 4 years and above exclusion criteria: * any severe chronic respiratory disease other than asthma or copd * acute respiratory infection * any medical condition that in the opinion of the investigator would endanger the subject if he/she participates in the study