Birch allergic patient receiving 3 consecutive nasal challenges with birch extract (Allergopharma). Total dose of 1.5ug of Bet v 1 per challenge

Birch allergic patient receiving 3 consecutive nasal challenges with sterile NaCl 0.9%. Total dose of 100ul per nostril per challenge

Allergic Rhinitis

Allergic Inflammation

Nasal spray containing birch extract from Allergopharma

Nasal Provocation with Birch Extract

Nasal spray containing sterile sodium chloride 0.9%

Nasal Provocation with NaCl 0.9%

8H1.02, ENT Lab, Department of Otorhinolaryngology, Vienna General Hospital

Changes in Adaptive Immune Responses and Effector Cell Responses Upon Nasal Allergen Exposure - a Pilot Study

To assess changes of allergen specific IgE levels after challenge with Birch pollen extract

To assess changes in allergen-specific IgE levels in nasal secretions after nasal provocation with birch pollen extract

To assess changes in total IgE levels after nasal provocation with birch pollen extract

To assess changes in allergen-specific and total IgA, IgD, IgG (including subtypes) and IgM levels in sera and nasal secretions after nasal provocation with birch pollen extract by ELISA

To assess changes in TH2 cytokine patterns in sera and nasal secretions after nasal provocation with birch pollen extract. This we be determined by ELISA or Luminex assay which will mean cytokine measurements will have the same units of measure.

To assess presence and changes in IgE production (i.e., by RT-PCR with primers specific for IgE) in nasal mucosa

To assess changes in nasal symptoms using the validated scoring system, Total Nasal Symptom Score (TNSS). On this scale 4 nasal symptoms are assessed namely sneezing, rhinorrhea, nasal itching and nasal blockage on a scale of 0 (no symptoms) 1 (mild symptom burden), 2 (moderate symptom burden) or 3 (severe symptom burden). The scores a totaled and a score out of 12 is produced. Higher values represent greater allergic symptom burden.

To objectively assess the degree of change in nasal blockage by PNIF

To assess the changes in skin reactivity to allergen in a titrated skin prick test to birch pollen extract

Ass.Prof.Dr.med. Josef Toth

Associate Professor, Doctor of Medicine

Medical University of Vienna

In this single-center, randomized, placebo-controlled, double-blind study a total of 36 patients will be recruited into this study on a voluntary basis and will be randomised to receive a nasal challenge with either birch pollen extract or placebo.

patients undergoin transcatheter aortic valve implantation

patient undergoing diagnostic coronary angiography

Transcatheter Aortic Valve Implantation Prosnosis and Complications

patients will be asked for a venous blood sample

venous blood withdrawl

Tel Aviv Medical Center

Tryptase Level as a Marker of Complications in Transcatheter Aortic Valve Replacement

Tryptase Levels as a Marker of Mast Cell Activity and the Prognostic Implication in Patients Post Transcatheter Aortic Valve Replacement

Post procedural complications - major stroke, acute kidney injury, paravalvular regurgitation, permanent pacemaker implantation, coronary artery obstruction, heart block, vascular injury, pericardial hemorrhage

Only the principle investigator will have access to IPD

Tel-Aviv Sourasky Medical Center

Pantoprazole intravenous 40mg q daily as part of standard of care for stress ulcer prophylaxis along with current standard of care.

Famotidine 40 mg intravenous BID (maximum dose of 80 mg/day) for 4 days as part of standard of care for stress ulcer prophylaxis along with current standard of care.

Dextromethorphan 60 mg QID orally (maximum dose of 240 mg/day) for 2 days (total of 4 doses) along with current standard of care.
If the drug can't be given orally, then feeding tube (G-tube, NG Tube or DHT) will be used for drug administration.

Diphenhydramine 12.5 mg BID intravenous or 25 mg BID oral for 4 days along with current standard of care.

Famotidine

Pantoprazole intravenous 40mg q daily as part of standard of care for stress ulcer prophylaxis along with current standard of care

Pantoprazole

Diphenhydramine

Total

Sex: Female, Male

Region of Enrollment

The modified Rankin Scale (m-RS) is a commonly used scale for measuring the degree of disability or dependence in the daily activities of people after they have suffered a stroke.It is one of the most widely used clinical outcome measure for stroke clinical trials. The score is given according to following scale.
0- No symptoms at all
No significant disability despite symptoms; able to carry out all usual duties and activities
Slight disability; unable to carry out all previous activities, but able to look after own affairs without assistance
Moderate disability; requiring some help, but able to walk without assistance
Moderately severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance
Severe disability; bedridden, incontinent and requiring constant nursing care and attention
Dead

Modified Rankin Score

NIHSS is a tool used by healthcare providers to objectively quantify the degree of impairment caused by a stroke. It is composed of 11 items. Each item scores a specific ability between a score of 0-4. Usually, for each item, a score of 0 indicates normal function in that specific ability, while a higher score indicates some level of impairment. The individual scores from each item are added together to calculate a patient's total NIHSS score. The maximum possible score is 42, with the minimum score being a 0.

National Institutes of Health Stroke Severity (NIHSS) Scale

Glasgow Coma Scale (GCS) is assessed by physical neurological examination of the subject by a qualified neurologist. GSC is a common scoring system used to describe the level of consciousness in a person following a traumatic brain injury. The initial score correlates with the severity of brain injury and prognosis. It estimates Coma severity based on Eye (4), Verbal (5), and Motor (6) criteria with the following total score of between 3 (indicating deep unconsciousness) and 15 (indicating no issues).

Glasgow Coma Scale (GCS)

It is an ordinal scale used to measure performance in activities of daily living (ADL). Each performance item is rated on this scale with a given number of points assigned to each level or ranking. It uses ten variables describing ADL and mobility. A higher number is associated with a greater likelihood of being able to live at home with a degree of independence following discharge from hospital. It yields a score of 0-20.
The ten variables addressed in the Barthel scale are:
presence or absence of fecal incontinence
presence or absence of urinary incontinence
help needed with grooming
help needed with toilet use
help needed with feeding
help needed with transfers (e.g. from chair to bed)
help needed with walking
help needed with dressing
help needed with climbing stairs
help needed with bathing

Barthel Index

MRI of head or CT head done as part of your follow up care at 3 months. This will give us the information about the effect of dextromethorphan effect on the final brain damage from stroke.

CT or MRI of Head Without Contrast

Dextromethorphan- 60 mg QID orally (maximum dose of 240 mg/day) for 2 days (total of 4 doses) + current standard of care

Dextromethorphan

Overall Study

Dr. Vishnumurthy Shushrutha Hedna

Acute Cerebrovascular Accident

Cerebral Edema

Dextromethorphan 60 mg QID orally (maximum dose of 240 mg/day) for 2 days (total of 4 doses) along with current standard of care. If the drug can't be given orally, then feeding tube (G-tube, NG Tube or DHT) will be used for drug administration.

Shands Hospital at University of Florida

Histamine Glutamate Antagonism in Stroke

Glutaminergic and Histaminergic Pathway Modulation in Acute Ischemic Stroke as an Effective Neuroprotection Strategy.

University of Florida

Upper GI tract symptoms are evaluated. Patients are asked to report to gastroenterologist if they have persistent ulcer symptoms and to report to the emergency room if they have evidence of GI bleeding or ulcer complications (melena, hematemesis, or sudden onset of severe epigastric pain). Endoscopy will be undergone to document any gastroduodenal ulcers with or without ulcer complications. If the hemoglobin level has decreased by 2g/dL or more, or stool check shows occult blood at each visit, endoscopy will be undergone to check the presence of gastroduodenal ulcers with or without bleeding. Patients without persistent ulcer symptoms or without evidence of ulcer complications will be invited to undergone scheduled endoscopy at the 3-month end of follow-up in each subjective.

Upper GI tract symptoms are evaluated at each visit. Patients are asked to report to gastroenterologist if they have persistent ulcer symptoms and to report to the emergency room if they have evidence of GI bleeding or ulcer complications (melena, hematemesis, or sudden onset of severe epigastric pain). Endoscopy will be undergone to document any gastroduodenal ulcers with or without ulcer complications. An ulcer is defined as a circumscribed mucosal break at least 3 mm in diameter. If the hemoglobin level has decreased by 2g/dL or more, or stool check shows occult blood at each visit, endoscopy will be undergone to check the presence of gastroduodenal ulcers with or without bleeding. Patients without persistent ulcer symptoms or without evidence of ulcer complications will be invited to undergone scheduled endoscopy at the 3-month end of follow-up in each subjective.

Peptic Ulcer

Ulcer Complications

lansoprazole

aluminum hydroxide 334 mg and Mg hydroxide 166 mg

Taipei Veterans General Hospital

Peptic Ulcer Disease in Ischemic Heart Patients Taking Aspirin and Clopidogrel With or Without Proton Pump Inhibitor

The Occurrence of Peptic Ulcer Disease and Its Complications in Ischemic Heart Patients Taking Aspirin and Clopidogrel With or Without Co-prescription of Proton Pump Inhibitor

histamine/stroke

Changes in Adaptive Immune Responses and Effector Cell Responses Upon Nasal Allergen Exposure - a Pilot Study

Tryptase Level as a Marker of Complications in Transcatheter Aortic Valve Replacement

Histamine Glutamate Antagonism in Stroke

Peptic Ulcer Disease in Ischemic Heart Patients Taking Aspirin and Clopidogrel With or Without Proton Pump Inhibitor

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