Kornimate/medical-research-clean huggingface dataset:
atp in alzheimer disease

Conditions: Alzheimer's Disease

Summary: to check whether systemic treatment with atp alters the profile of cerebral metabolism in patients with alzheimer's disease using mrs techniques (magnetic resonance spectroscopy) and adjust the infusion (minimum effective dose) that promotes this metabolic change.


Eligibility criteria:
inclusion criteria: * 1. men and women aged 55-85 years * 2. diagnosis of possible or probable alzheimer disease according to nia-aa 2011 criteria. * 3. global deterioration scale stadium 5-6 / 15-5 mini-mental state examination * 4. the patient is living with a family as a primary caregiver or a caregiver trained to accompany adequate and all intervention and follow-up visits. patient and caregiver knowledge of local languages sufficient. * 5. the patient and caregiver willing to participate in the study. there is a high probability that patient and caregiver to complete the study. * 6. the patient has no sensory deficits preventing evaluation. * 7. the patient receives a stable alzheimer disease conventional medication. no change in treatment at least 90 days prior to selection. * 8. the patient receives a conventional stable medication for possible comorbidities. no change in treatment at least 90 days prior to selection. * 9. the subject or his legal representative give prior informed consent that includes genetic studies of apolipoprotein e and rs11870474. exclusion criteria: * 1. concomitant severe neurological disease alzheimer disease. * 2. presence or history of psychiatric disorders with an emphasis on positive behavioral disorders associated with alzheimer disease (aggressiveness, agitation, delusions, hallucinations, anxiety). * 3. current severe systemic disease that may prevent completion of the study. * 4. history stroke. * 5. history of convulsions and use of anticonvulsants. * 6. history of myocardial infarction, angina pectoris, cardiac arrhythmias and other serious cardiovascular disorders such as congestive heart failure, and valvular aneurysms. * 7. background diabetes mellitus and / or pictures of hypoglycemia. * 8. uncontrolled hypertension (systolic\> 160 mmhg and / or diastolic\> 95 mmhg). * 9. systemic hypotension (sbp \<86 mmhg) or bradycardia (\<50 beats per minute) * 10. bronchial asthma history or lung diseases that cause bronchospasm or bronchoconstriction * 11. kidney failure (patients with medical restrictions or income parenteral intake of fluids). * 12. liver failure. * 13. respiratory failure (need supplemental oxygen supply) * 14. blood donation in the last 90 days or anemia (hb \<10g/dl) * 15. use connection (\<30 days prior to screening) of antidepressants, sedatives and hypnotics. * 16. using alzheimer disease experimental drugs in the last 60 days prior to screening. * 17. women who are pregnant or fertile * 18. inadequate venous access to prevent parenteral administration of infusions.

Keywords: alzheimer
evaluation of ketamine and multi-modal analgesics

Conditions: Pain

Summary: the purpose of this research study is to see if pain can be better controlled with fewer side effects. the new drug regimen will study several different medicines that have different ways of treating pain.

the investigators plan to study an analgesic regimen of ketamine and lidocaine as infusions with neurontin and acetaminophen delivered orally for postoperative analgesia and the subsequent effect on ventilator days and icu stay. the investigators expect that pain scores will be either unchanged or better than historic controls. in addition, the investigators expect that ventilator days and icu stay will be improved due to reduced incidence of delirium and bowel dysfunction.

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists (asa) status 1-4 * undergoing planned surgery for cardiac problems * 18 years of age and not older than 85 years of age exclusion criteria: * severe liver disease (alanine aminotransferase (alt) , aspartate aminotransferase (ast), or bilirubin \> 2.5 times upper limit of normal) * pregnancy or currently breastfeeding * history of schizophrenia or other hallucinatory psychiatric disorder * history of chronic or pre-existing pain disorder * history of heart block * severe renal impairment creatinine clearance (crcl)\<30 milliliter(ml)/min
efficacy and safety of bicifadine in the treatment of chronic low back pain

Conditions: Chronic Low Back Pain

Summary: the primary objectives of this placebo-controlled clinical trial are to evaluate the analgesic efficacy and safety of bicifadine at three oral dose levels compared with placebo in patients with moderate to severe chronic low back pain. the secondary objectives are to investigate the dose-response relationship of three dose levels of bicifadine, to evaluate the clinical meaningfulness of bicifadine efficacy, to evaluate the effect of bicifadine on function and general quality of life, to describe the population pharmacokinetics of bicifadine in patients with chronic low back pain, and to evaluate safety following discontinuation of bicifadine treatment.


Eligibility criteria:
main inclusion criteria: * patients with low back pain assessed as class 1, class 2 or class 3 according to the quebec task force classification for spinal disorders and without detectable leg weakness on neurological examination. * patients must have required on average daily analgesics for the treatment of low back pain for at least 3 months prior to dosing. main exclusion criteria: * patients may not have moderate or severe pain in a location other than the lower back (with the exception of radiation to the lower extremity). * patients must not have had lower back surgery within 6 months prior to baseline, nor epidural corticosteroid injections within 3 months prior to baseline. * patients may not have an unstable medical condition.

Keywords: bicifadine chronic low back pain
cryopreserved human meniscus transplantation

Conditions: Osteoarthritis

Summary: the purpose of this study is to determine the long-term survivorship and clinical outcomes of all cryopreserved meniscus transplants performed by dr. frank noyes.

all patients receiving cryopreserved meniscus transplants will be followed at 1, 2, 5, 10, and 15 years postoperatively. study examination will include comprehensive knee examination by dr. noyes, x-rays, and potentially mri. patients will complete the following forms of the cincinnati knee rating system: symptom rating form, sports activity and function form, and occupational rating form. all patient identification will be kept confidential. patient data will be entered into the knee registry database according to their unique study number by the clinical research assistant.

Eligibility criteria:
inclusion criteria: * patient post-meniscectomy * patient symptomatic with activities * patient has early articular cartilage degeneration in affected tibiofemoral compartment * patient understands goals of operation, willing to undergo lengthy rehabilitation exclusion criteria: * patient has no symptoms with activities * patient has advanced degeneration in affected tibiofemoral compartment or other compartments * patient is obese (bmi \> 30) * patient has uncorrected lower limb axial malalignment or knee ligament deficiency * patient has active infection * patient has pre-existing knee arthrofibrosis or lower limb muscular atrophy * patient has symptomatic patellofemoral articular cartilage deterioration * patient is unwilling to undergo lengthy rehabilitation after surgery
oral vitamin a supplementation in neonates with birth weight < 1500 g

Conditions: Bronchopulmonary Dysplasia; Retinopathy of Prematurity

Summary: vitamin a is essential for optimal growth, and development. in the newborn, especially if preterm, it is necessary for the cellular differentiation, for the health of the anterior eye, it is a constituent of visual pigment, and it is essential for surfactant synthesis. immune response vitamin a supplementation demonstrated to reduces infancy mortality, but very low (\<1500g birth weight) and extremely low (\<1000g birth weight) preterm infants are born with low body stores of vitamin a and are at high risk of vitamin a deficiency. nevertheless, optimal vitamin a supplementation for these infants is not clearly defined, despite evidence of benefit of an early supplementation. prematurity is associate to the risk for bronchopulmonary dysplasia (bpd) which is a disease marked by respiratory compromise associated with high mortality and severe long-term morbidity, as well as prematurity is associate to the risk for retinopathy, a pathology that may be related to less rhodopsin quantity which seem dependent on vitamin a concentration. vitamin a can be given enterally, intramuscularly, or intravenously. recently an oral administration as drops is available resulting particularly convenient avoiding the pain associated with repetitive intramuscular injections, or the discomfort of parenteral administration. studies of vitamin a in the infant population suggest that plasma retinol concentrations \>0.7 µm/l indicate vitamin a sufficiency, nevertheless preterm infants have lower concentration and concentration \< 0.35 µm/l are very dangerous. vitamin a deficiency at this level may constitute a problem for preterm newborn, resulting for example, in histological alterations in the respiratory epithelium leading to chronic lung disease, retinopathy of prematurity, patency of the ductus arteriosis, and immune competence deficiency. the aim of the present study is to verify efficacy and tolerability of a new oral administration of vitamin a as drops, 3000 iu/kg/die for 4 weeks, in infants \< 1500g weight at birth, verifying the competence of the supplementation reaching ideal blood concentration (≥0.7 µm/l) and relating the blood achieved concentrations of vitamin a to the outcome in typical pathologies, as bpd and rop. not treated group of matched newborn infants is the controlarm.


Eligibility criteria:
inclusion criteria: * parents signed informed consent * very low birth weight infants undergoing ventilation for at least 24 hours * infants able to receive adequate breast or formula milk exclusion criteria: * parents denied informed consent * congenital malformations * infants not able to receive breast or formula milk

Keywords: vitamin a blood concentration retinopathy of prematurity
anti-angiogenesis agent ag-013736 in patients with metastatic renal cell carcinoma

Conditions: Kidney Neoplasms

Summary: the primary purpose of this protocol is to determine the activity of ag 013736 in patients with metastatic renal cell cancer who have received 1 prior cytokine-based therapy.


Eligibility criteria:
inclusion criteria: * histologically documented rcc with metastases. * failure of 1 prior cytokine-based therapy (interleukin-2 and/or interferon) due to disease progression or unacceptable treatment-related toxicity exclusion criteria: * any prior systemic treatment for renal cell carcinoma \[rcc\] other than 1 prior cytokine-based treatment regimen. cytokine-based regimens containing thalidomide or an anti-angiogenesis agent are not allowed. * inability to take oral medication
continuous renal replacement therapy doses in critically ill patients with acute kidney injury

Conditions: Renal Replacement Therapy for Acute Kidney Injury in ICU; Continuous Renal Replacement Therapy (CRRT)

Summary: acute kidney injury in critically ill patients admitted to the icu is a common complication associated with high mortality or long-term chronic kidney damage. some of these patients require continuous renal replacement therapy (low-intensity hemodialysis for 24 hours) until renal function recovery is achieved. continuous renal replacement therapy (crrt) is a crucial treatment for icu patients with acute renal failure. it offers continuous toxin removal and prevents fluid accumulation in the patient's body. the therapy not only eliminates toxins but also physiological substances, including micronutrients and essential elements for cellular metabolism and organ function. currently, there is limited information available to adjust the renal therapy dose and avoid or balance the loss of these substances without causing toxin accumulation. some studies suggest that high doses of therapy do not provide benefits and increase complications. the objective of this study is to evaluate two doses of continuous renal therapy in terms of internal environment control (sodium, potassium, and acids and bases), micronutrient loss, and toxin elimination. after 48 hours of therapy, patients will be assigned to continue with a dose equal to the initial dose or a decrease in the initial dose. these two options are part of the current standard practice in our center. patients participating in the study will be randomly assigned one of the continuous renal therapy doses. the study is open, so treating physicians will always know the therapy the patient is receiving and can freely adjust it if deemed necessary. the intervention duration is 96 hours, after which the dose will be at the discretion of the treating medical team. a follow-up will be conducted through medical records or phone calls approximately 90 days after starting therapy. the risks for the patient are minimal, as toxin elimination monitoring will be even more intensive than usual. the study plans to include approximately 100 patients.


Eligibility criteria:
inclusion criteria: * patients 18 years of age or older * acute renal failure (akin 3) requiring continuous renal replacement therapy * requirement of vasoactive drugs (norepinephrine \> 0.1 mcg/kg/min) * written informed consent (patient or family) exclusion criteria: * lack of informed consent. * possibility of using plasma exchange or mars therapy at the at the time of inclusion. * baseline renal function with an estimated glomerular filtration rate (ckd-epi) less than 30 ml/min.

Keywords: continuous renal replacement therapy (crrt) renal replacement therapy for acute kidney injury in icu dialytrauma
contrast-enhanced cone beam breast ct for diagnostic breast imaging

Conditions: Breast Cancer

Summary: up to one hundred (100) female patients will be enrolled and consented to participate in the study. these women will be enrolled from screening assigned birads 0, patient complaint, or referral for second opinion. the enrolled patient will accept ce-cbbct scans within 4 weeks of her diagnostic mammography and before breast biopsy if biopsy is needed. the final diagnostic workup outcome of these enrolled patients needs to include at least 30 confirmed cancers cases.


Eligibility criteria:
inclusion criteria: * female sex * age 35 years or older * any ethnicity * have an abnormality detected by breast self exam (bse), or clinical breast exam (cbe), or have an abnormality detected by an imaging modality. * will undergo study imaging within four weeks from the date of diagnostic mammography, prior to breast biopsy (if needed). * able to provide informed consent * post-menopausal, surgically sterile, or effective birth control. for women of childbearing potential, negative pregnancy test or has signed pregnancy test waiver * if required by standard of care, egfr \>45 within 48 hours to 6 weeks of ce-cbbct exam exclusion criteria: * pregnancy * lactation * unknown pregnancy status and * has refused pregnancy testing and * has refused to sign a pregnancy test waiver * women who are unable or unwilling to understand or to provide informed consent * women with physical limitations that may prohibit resting prone on the exam table, such as, but not limited to: frozen shoulder, recent heart surgery, pace maker. * women who are unable to tolerate study constraints. * women who have received radiation treatments to the thorax or breast area for malignant and nonmalignant conditions, such as (but not limited to): * treatment for enlarged thymus gland as an infant * irradiation for benign breast conditions, including breast inflammation after giving birth * treatment for hodgkin's disease * women who have participated in a prior breast clinical trial that gave additional radiation dose, such as an additional mammogram. * women who have received large numbers of diagnostic x-ray examinations for monitoring of disease such as (but not limited to): * tuberculosis * severe scoliosis additional exclusion criteria due to contrast injection: * allergic to iodinated contrast material * previous non-ionic contrast reaction * any conditions below regardless of egfr * renal disease * chronic renal dysfunction * renal transplant (or waiting for a transplant) * one kidney or other birth defect * polycystic kidneys * renal tumor/renal cancer * history of liver failure/cirrhosis/liver transplant/pending liver transplant * congestive heart failure * multiple myeloma * hyperthyroidism * pheochromocytoma * sickle cell disease * asthma requiring daily use of inhaler additional exclusion criteria due to machine limitations * patient's body weight is over the limit of the scanner table (440 lbs or 200kg)
subcostal transversus abdominis block versus erector spinae block in open cholecystectomy

Conditions: Post Operative Pain, Acute

Summary: open cholecystectomy is a surgical procedure involving the removal of the gallbladder through a traditional, open abdominal incision the surgeon makes an incision in the upper abdomen, exposes the gallbladder, and carefully disconnects and removes it. postoperative pain management is a critical aspect of patient care following cholecytectomy surgery. inadequate pain control can lead to a cascade of complications, including atelectasis, pneumonia, and delayed mobilization. these complications can prolong hospital stays, increase healthcare costs, and lead to patient dissatisfaction. regional anesthesia techniques, such as subcostal transversus abdominis plane (tap) block abd erector spinae block are commonly used to provide effective analgesia after cholecystectomy surgery. these techniques target the nerves that supply the surgical site, providing pain relief without the need for opioids. opioids are associated with a number of side effects, including nausea, vomiting, constipation, and respiratory depression. subcostal tap block is a relatively new technique that has been shown to be effective in providing postoperative analgesia after upper abdominal surgery. this technique involves injecting local anesthetic into the tap, a fascial plane that lies between the internal oblique and transversus abdominis muscles. the tap block provides anesthesia to the nerves that supply the abdominal wall, including the subcostal nerves. erector spinae plane block is a newer technique targeting the dorsal rami of the t7-t12 spinal nerves, potentially offering broader analgesia encompassing the abdominal wall, thorax, and diaphragm. early studies suggest improved pain control and respiratory function compared to traditional methods.


Eligibility criteria:
inclusion criteria: * age between 18 and 65 years * both sex. * american society of anesthesiologists (asa) i-ii undergoing elective open cholecystectomy surgery. * patients who need at least 24hrs hospital admission. exclusion criteria: * known allergy to local anesthetics * coagulopathy or bleeding disorders * severe respiratory disease * neurological disorders * pregnancy
advancing antimicrobial photodynamic therapy to prevent infection in osseointegrated prosthesis patients

Conditions: Amputation; Osseointegration

Summary: this will be a prospective observational trial enrolling 20 patients with osseointegrated prostheses. participants will be recruited from the orthopaedic outpatient clinic at walter reed national military medical center in bethesda, md. all eligible consenting patients will undergo daily stoma management per standard of care. patients will integrate antimicrobial photodynamic therapy into their stoma management program. the first treatment will take place in the orthopaedic clinic. all others will take place at home. topical 5-ala will be applied to the metal at the penetration site. after 2 hours, the light delivery device will be utilized and light will be administered for 15 minutes. data collection: after obtaining informed consent, study personnel will record injury-specific variables, surgery-specific variables, other variables related to their hospital course, demographic variables as well as comorbidities on the study case report forms (crfs). they will obtain this information directly from the participant, from the participant's medical record, and the participant's treating orthopaedic surgeon or other health care providers. baseline data collection points include participant characteristics and amputation details such as age, sex, comorbidities, highest education level achieved, social support, initial reason for amputation, type of amputation and all surgical dates. study participants will be followed at 1 and 2 weeks after initiation of pdt treatment. to ensure research participant safety, serious adverse events (saes) will be documented and promptly submitted to the local irb as per the required reporting processes. follow-up: study participants will be followed at 1 week and 2 weeks.


Eligibility criteria:
inclusion criteria: * all patients with osseointegrated prostheses 18 years of age or older exclusion criteria: * ongoing infection * pregnant * anticipated issues with compliance or follow-up
a study of low dose vs standard dose of ticagrelor on platelet function after intervention for acute coronary syndrome in diabetes mellitus patients

Conditions: Acute Coronary Syndrome Patients With Diabetes After PCI

Summary: in this study, the investigates try to confirm the hypothesis that low dose ticagrelor(60mg) had similar anti-platelets function compared with the standard dose ticagrelor in acute coronary syndrome patients with diabetes. totally 40 acs patients with diabetes will be divided into 2 groups randomly after pci for one month. group 1 will be treated with ticagrelor 90mg and aspirin 100mg after pci for 12 months as the standard group; group2 will be treated with ticagrelor 60mg plus aspirin 100 mg for 11 months after one month standard dapt treatment. the platelets function will be tested in vasp and teg methods at 1 and 2 months after pci as the primary endpoints.the clinical events will be observed 12 months after pci.


Eligibility criteria:
inclusion criteria: 1. subject must be at least 18 years of age and less than 90 years old 2. patients should have undergone successful percutaneous coronary intervention with drug-eluting stent for acute coronary syndrome with diabetes mellitus. 3. subject understand the study requirements and the treatment procedures and 4. provided informed consent before the procedure exclusion criteria: 1. female of childbearing potential, unless a recent pregnancy test is negative, who possibly plan to become pregnant any time after enrollment into this study 2. active bleeding 3. known hypersensitivity or contraindication to study medications 4. female of childbearing potential, unless a recent pregnancy test is negative, who possibly plan to become pregnant any time after enrollment into this study 5. non-cardiac co-morbid conditions are present with life expectancy \<2 year or that may result in protocol non-compliance (per site investigator's medical judgment). 6. subjects with cerebral hemorrhage history 7. subjects with stroke history in half a year 8. subjects with active malignant tumor 9. subjects with whom oral anticoagulants are needed 10. other conditions which the investigators think not applicable to the study.