Kornimate/medical-research-clean huggingface dataset:
evaluation of baroreflex activation therapy in patients with advanced heart failure

Conditions: Heart Failure

Summary: the objective of this single center prospective clinical trial is to evaluate the safety and efficacy of carotid baroreflex activation therapy (bat) in advanced heart failure (hfref). beyond that, the primary aim of this study is to identify patients of the whole hfref population that are most likely to benefit from this new promising therapy.

baroreflex activation therapy (bat) is a new treatment option for patients (pts) suffering from heart failure with reduced left ventricular ejection fraction (hfref) to improve functional status and quality of life. yet it is unknown which pts of the whole hfref population are most likely to benefit from this new promising therapy. as this invasive technique should definitely not be proposed for all hfref pts with left ventricular ejection fraction of 35 % or less the aim of this single center prospective clinical trial is to evaluate to which extent possible factors (e.g. cardiac resynchronization therapy (crt), atrial fibrillation) may influence the response to bat. to analyze any possible differences concerning the modulation of the autonomic nervous system caused by bat in the presence of atrial fibrillation or cardiac resynchronization therapy, heart rate variability (hrv) analyses will be performed additionally. as autonomic nervous activity plays a pivotal role in the genesis and termination of atrial fibrillation any possible impact of baroreflex activation therapy on atrial fibrillation will be examined.

Eligibility criteria:
inclusion criteria: * chronic heart failure (nyha functional class iii) * lvef of 35% or less * chronic stable guideline-directed medical therapy (diuretic agent, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker and a beta blocker, if tolerated) * resting heart rate between 60 and 100 beats/min * systolic blood pressure of at least 100 mmhg exclusion criteria: * estimated glomerular filtration rate \< 30 ml/min/1.73 m² * plaque and atherosclerosis reducing the linear diameter of the internal or distal common carotid arteries by 50% or more * acute pulmonary edema within the last six weeks * implantation of pacemakers, icds or crts within the last 3 months or planned for the next three months * life expectancy \< 1 year * body mass index \> 40 kg/m² * symptomatic uncontrolled bradyarrhythmias * severe asthma, chronic obstructive pulmonary disease or restrictive lung disease * active malignancy * pregnancy
effect of pilates exercises on menopausal symptoms

Conditions: Menopausal; Obese Patients; Pilates Exercise; Quality of Life and Menopause

Summary: menopause, a significant transition in a woman's life characterized by the cessation of menstruation and a decline in ovarian function, leads to reduced levels of estrogen and progesterone. this hormonal shift is associated with a range of symptoms that can adversely affect women's quality of life, including vasomotor symptoms such as hot flashes and night sweats, psychological symptoms like mood swings and depression, as well as urogenital symptoms such as vaginal dryness and sexual dysfunction. these symptoms, collectively referred to as menopausal symptoms, can vary in severity and duration and frequently require intervention to alleviate their impact on daily life.

the aim of our study was to determine the effect of pilates exercises on menopausal symptoms in postmenopausal obesity and to compare it with the control group. the study was designed as a single-blind randomized controlled trial. 45 obese individuals in the postmenopausal period were included in the study. the patients were randomly divided into 3 groups and a total of 16 treatment sessions were applied to both groups for 8 weeks, 2 days a week. no exercise intervention was applied to the control group. reformer pilates exercises were applied to group 1, and mat pilates exercises were applied to group 2. a physical activity-based brochure including lifestyle changes was distributed to group 3. a total of two evaluations were made before and after exercise. in the evaluation, the menopausal symptoms ratingscale (mrs) for menopausal symptoms, the menopause-specific quality of life assessment scale (menqol) for quality of life assessment, the beck depression inventory (bdi) for depression, the pittsburgh sleep quality index (psqi) for assessing sleep quality, the six-minute walking test (6 mwt) for assessing aerobic capacity, the body analysis scale (tanita) for assessing body composition, and laboratory analyses of blood samples taken for assessing blood lipid profile were used. statistical analyses were performed to compare the data.

Eligibility criteria:
inclusion criteria: * women who have entered menopause * being diagnosed with obesity (30 kg/m2 ≤ bmi ≤ 40 kg/m2 ) * having the physical or cognitive ability to exercise * being sedentary ('international physical activity questionnaire' will be used. those in the inactive category group will be included.) * those who agree to participate in the study exclusion criteria: * bmi below 30 * those with serious heart disease, dm, kidney, liver, thyroid disease and cancer * those receiving hormone therapy * those using antipsychotic drugs * those using steroids and derivatives * those using insulin-sensitizing drugs * those with musculoskeletal diseases that will prevent exercise • cognitive problems that will affect cooperation

Keywords: menopause obese women pilates exercises blood lipid profile
an iliopsoas plane block after total hip arthroplasty

Conditions: Total Hip Arthroplasty

Summary: nielsen et al. reported that when iliopsoas plane block was performed on healthy volunteers, the injection solution in hip mri was confined to the myofascial compartment, which was known to include all sensory branches of the femoral nerve that control the hip joint. the maximal muscle strength of knee extension did not decrease before and after iliopsoas plane block in volunteer. since there is no clinical study conducted on patients after the volunteer study, the investigators intend to evaluate the analgesic and motor preserving effects of the iliopsoas plane block in a group of patients undergoing total hip arthroplasty.


Eligibility criteria:
inclusion criteria: 1. patients 19 years of age or older who are expected to undergo unilateral hip arthroplasty 2. asa ps 1-3 exclusion criteria: 1. revision total hip arthroplasty 2. allergy to drugs used in the study 3. patients with moderate or more hepatic impairment (ast/alt is more than 2.5 times the upper limit of normal) 4. estimated glomerular filtration rate \< 30 ml/min/1.73m2 5. opioid dependence 6. prolongation of pt and aptt more than twice the upper limit of normal 7. pre-existing neurological or anatomical disorders of the lower extremities 8. serious psychiatric disorders
psychoeducation versus cognitive-behavioral therapy in bipolar disorder

Conditions: Bipolar Disorder

Summary: to examine the impact of cognitive-behavioural therapy on both the episodic and functional outcome of bipolar disorder, in combination with pharmacotherapy. primary hypothesis is twofold: 1. cognitive behavioural therapy will reduce the total symptom burden, as measured both by percentage of time spent ill (both syndromic and subsyndromal) and number of episodes, as compared to psychoeducation 2. cognitive behavioural therapy will reduce social and occupational disability to a greater extent than psychoeducation.

objective: to compare the impact of cognitive -behavioral therapy to that of properly structured psycho education on the 'illness burden' and functional outcome of bipolar disorder, in combination with pharmacotherapy. interventions: subjects will be randomized to either a "control" treatment group cosisting of 6 sessions of group psycho-education (topics include illness recognition, treatment approaches, and monitoring and coping strategies; based on manual by bauer \& mcbride, 2002: life goals phase i) or they will be randomized to the "experimental" treatment group: 20 sessions of individual cognitive behavioural therapy for bipolar disorder (topics include limited psychoeducation, activity scheduling/behavioural interventions, cognitive techniques, including thought monitoring and challenges to dysfunctional assumptions and other coping techniques; based on manual by lam et al., 1999: cognitive therapy for bipolar disorder)

Eligibility criteria:
inclusion criteria: 1. bipolar i or ii 2. currently either in remission or subsyndromally ill (hamilton depression scale-17\<14; clinician administered rating scale for mania\<12). 3. age eighteen to sixty. 4. significant symptoms and/or episodes on at least two occasions in the past three years. 5. grade six education, able to understand english, and folstein minimental score exam \> 26 to ensure cognitive ability to participate. 6. on mood-stabilizing medication. exclusion criteria: 1. substance dependence meeting diagnostic and statistical manual of mental disorders-iv criteria within the last three months. 2. acutely highly suicidal or homicidal. 3. serious other medical condition that would render pharmacotherapy or psychotherapy very difficult such as cancer, severe diabetes, etc. 4. severe antisocial or borderline personality disorder (personality disorder per se is not exclusionary). subjects may have other axis i disorders, but bipolar disorder must be the principal disorder requiring treatment.

Keywords: bipolar disorder psychosocial factors mania depression social adjustment coping skills
pain in breast surgery intervention

Conditions: Opioid Use; Pain, Postoperative

Summary: this study will be a randomized control trial providing an educational component to study participants and a pre-operative and post-operative survey with a goal to show an improvement in pain control, decrease in narcotic use, and increase in patient knowledge in the study group.

the use of opioid pain medications in surgical patients is contributing to an epidemic of opioid pain medication use. it is known that the quality of pain control after surgery is a large factor of the patient's perception of their experience. however, little research has been done to improve pain control in plastic surgery patients. to the investigators knowledge, no study has yet looked at education of breast surgery patients to improve pain experience. the study goal is to survey breast surgery patients in the plastic surgery department before and after surgery to evaluate the participants experience with pain and pain medications. half of the participants in the study will be randomized to receive an information sheet about pain control at the participants pre-operative appointment.

Eligibility criteria:
inclusion criteria: * female patients presenting for the first stage of breast reconstruction using tissue expanders * patients 18 years of age and older exclusion criteria: * male patients * patients under age 18 * patients who have had previous breast reconstruction or tissue expansion * patients who are not able to read english will be excluded from this study as the study materials will be in written english

Keywords: opioid use breast reconstruction pain control mastectomy
infraclavicular block: decreased incidence of tourniquet pain, compared to axillary brachial plexus block?

Conditions: Tourniquet Pain

Summary: the purpose of this study is to determine whether the incidence of tourniquet pain is decreased if infraclavicular nerve block is administered, compared to axillary brachial plexus block, for surgical interventions at the level or distal to the elbow.

pneumatic tourniquets are often used in orthopedic surgery to ensure bloodless surgical field. besides their obvious positive effects, arterial tourniquets have some unfavorable properties. one of these is tourniquet pain, which can manifest in the presence of an otherwise adequate neuraxial or peripheral nerve block. if it develops, it is usually difficult to manage, and can be severe enough to necessitate conversion to general anaesthesia. in the past the incidence of tourniquet pain, associated with different nerve blocks has been estimated in clinical trials for which it was a secondary outcome measure. one recent meta-analysis addressed the question: is infraclavicular block (icb) associated with a lesser incidence of tourniquet pain compared to other brachial plexus blocks. the studies selected by this meta-analysis used different types of nerve block. however it did not address the clinically relevant question: using standard techniques for ultrasound guided brachial plexus block (usgbpb) is the infraclavicular approach associated with a lesser incidence of tourniquet pain than the axillary approach? the following nerves contribute to the perception of tourniquet pain: musculocutaneous, radial, medial cutaneous brachial (mcbn) and intercostobrachial (icbn). the potential advantage of the icb over the axillary brachial plexus block (abpb) in regards to tourniquet pain comes from anatomical reasons. in the pyramid shaped infraclavicular space the cords are much closer to each other; thus the likelihood of achieving effective mcbn and icbn block is greater. the infraclavicular route has proven to result in an equally effective, reliable and safe block of the brachial plexus, compared to the axillary approach. we hypothesize that the incidence of tourniquet pain is less with infraclavicular block compared to axillary brachial plexus block. the aim of the study is, to compare the incidence and severity of tourniquet pain associated with ultrasound guided icb and abpb in patients undergoing orthopedic surgery at the level or distal to the elbow, with a tourniquet time longer than 45 minutes.

Eligibility criteria:
inclusion criteria: * asa i-iii * orthopedic surgery at the level or distal to the elbow * expected tourniquet time \> 45 min (k-wiring not suitable) exclusion criteria: * contraindication of regional anaesthesia, patient is allergic to local anesthetics * clinically significant cognitive impairment (minimental state score \< 24) * chronic pain syndrome * preexisting nerve damage in the operated arm (sensory or motor deficit) * axillary clearance in the past * history of peripheral neuropathy) * pregnancy

Keywords: brachial plexus block regional anesthesia ultrasound
the use of castor oil as a labor initiator in post-date pregnancies

Conditions: Prolonged Pregnancy

Summary: the purpose of the study is to determine whether castor oil is effective in inducing labor.

castor oil is traditionally given by midwives in order to induce labor. its efficacy as an initiator of labor was previously tested only in one clinical trial. unfortunately this study (by garry et al.) was not sufficiently controlled. we intent to recruit 84 healthy pregnant women with no contraindication to vaginal delivery that had past their due date. women will be randomly and blindly divided into equal sized intervention group and control group. intervention group will be given 60 ml of castor oil in 140 ml of orange juice, while control group will be given a placebo with similar texture. primary outcome to be tested is the percentage of women entering active labor within 24 hours of administration.

Eligibility criteria:
inclusion criteria: * pregnant women at 40-42 weeks gestation * good obstetrical dating * singleton * intact membranes * preinterventional bishop score less than or equals 4 * no evidence of effective uterine contractions by external tocography * living close to hospital exclusion criteria: * multiple gestation * oligohydramnios or polyhydramnios * abnormal fhr tracing * obstetric complication (hypertension, bleeding) * ruptured membranes * suspected intrauterine growth restriction * biophysical score \< 8 * previous cesarean section / myomectomy / other uterine operation * fever, malaise at recruitment * chronic illness (renal, hepatic, endocrine)

Keywords: pregnancy post-date induction of labor castor oil
early renal replacement therapy and the outcome of acute kidney injury

Conditions: Acute Renal Failure

Summary: this research project is a prospective study to compare mortality between early renal replacement therapy (rrt) and late renal replacement therapy by using plasma neutrophil gelatinase associated lipocalin (pngal) as a tool in decision- making.


Eligibility criteria:
inclusion criteria: * the patient must have given his/her informed and signed consent * patients with acute kidney injury in the intensive care ward. exclusion criteria: * the patient refuses to sign the consent * the patient is pregnant, parturient, or breastfeeding * end stage renal disease * chronic renal failure * previous kidney transplant
efficacy of sublingual versus subcutaneous allergen immunotherapy in patients with bronchial asthma

Conditions: Efficacy, Self

Summary: asthma is characterized by airway inflammation and is manifested by acute episodes of obstruction related to loss of control of airway inflammation mostly in response to a viral respiratory tract infection .the significance of eosinophilic inflammation in asthma is well established. late clinical reactions in asthma are associated with increase of immunoglobulin e (ige) in serum. serum ige can be used as a measure of allergen provocation causing increased eosinophil activity. serum ige can be used to assess the exposure to environmental allergens, or decreasing presence of allergen in the environment and the need for increase or reduction of therapy. allergen immunotherapy is defined as the repeated administration of specific allergens to patients with ige-mediated conditions for the purpose of providing protection against the allergic symptoms and inflammatory reactions associated with natural exposure to these allergens. the aim of this work is to evaluate the effect of sublingual versus subcutaneous allergen immunotherapy as regard clinical response, serum ige and sputum eosinophils

study was conducted in mansoura university hospitals, chest medicine department on patients attended to asthma and allergy clinic. the asthma symptoms and leukotrienes antagonist, inhaled b2 agonist, inhaled steroid and systemic steroid usage recorded throughout the study period. venous blood and sputum samples were collected before and at the end of the study for determination of ige and sputum eosinophil levels respectively. fifty asthmatic patients recruited from mansoura university allergy outpatient clinic were included before treatment with subcutaneous immunotherapy (scit) vaccines and another fifty asthmatic patients were included before treatment with sublingual immunotherapy (slit) vaccines. in this study, all of patients were symptomatic and on medications either bronchodilators or inhaled corticosteroids (ics). all patients were diagnosed by previous pulmonary function test (pft) with reversibility test and follow up with our outpatient clinic (opc). each patient underwent spirometry to determine forced expiratory volume at 1st second (fev1) and to ensure that his condition is stable before starting immunotherapy. serum ige and sputum eosinophil count were measured in 100 patients with asthma before and after 6 , 12 , 18 months of treatment with immunotherapy vaccines.

Eligibility criteria:
inclusion criteria: * new cases of allergic asthma indicated for immunotherapy (partially controlled by medical treatment with frequent exacerbations) * age \>18 years exclusion criteria: * pregnancy * co morbidity such as diabetes, hypertension, ischemic heart, malignancy * other causes of the increase in eosinophil as: parasitic infestation * acute exacerbation of ba * smoker * severe persistent asthma

Keywords: sublingual subcutaneous allergen immunotherapy
lymph drainage in heart failure

Conditions: Heart Failure

Summary: this study aims to test the safety and efficacy of lymph fluid drainage on heart congestion and shortness of breath symptoms among patients participants with heart failure.


Eligibility criteria:
inclusion criteria: * age 18 years or older * subjects with informed consent to participate * nyha iii- iv patients * patients with heart failure volume overload * planned for elective right heart catheterization exclusion criteria: * active coronary syndrome (type i myocardial infarction) * local infection or ongoing systemic infection(s) * thrombotic coagulation disorder * on continuous blood thinners that cannot be discontinued or held * allergy or contraindications to the use of iodine-based contrast agents * subjects deemed to be high risk for performing a cardiac catheterization by study investigator

Keywords: heart catheterization heart failure
chronic pediatric pain

Conditions: Pain

Summary: the purpose will be to study the functional impact of pediatric chronic pain on children, and their families. focus will be on the impact of pain on school functioning, social functioning, psychological functioning and family functioning of pediatric chronic pain.


Eligibility criteria:
inclusion criteria: * all patients who have completed parent surveys before coming to the multidisciplinary pain management clinic evaluations. exclusion criteria: * if the patient's surveys are missing or incomplete (i.e. more than half of the survey was not completed, they will be excluded from entry into the data base.
remote ischemic preconditioning and postoperative myocardial ischemia

Conditions: Myocardial Ischemia; Inflammatory Response

Summary: high-risk abdominal surgery is frequently complicated by postoperative complications, such as sepsis, pneumonia or anastomotic dehiscence. asymptomatic myocardial injury after abdominal surgery (mins) predicts non-cardiac complications. the etiology of mins in abdominal surgery patients is unknown. remote ischemic preconditioning (ripc) is a physiologic mechanism that exposes tissues to brief periods of non-lethal ischemia and reperfusion, creating resistence for future serious ischemic insults. ripc in patients after cardiac or aortic surgery is associated with a protective effect on the heart. the effect of ripc in abdominal surgery patients is unknown. objective of the study: to determine the effect of ripc on mins in patients after pancreatic sugery. study design: randomised controlled parallel group mono-center pilot study. study population: 90 adult patients scheduled for elective pancreaticoduodenectomy in st. antonius hospital (45 in the intervention group and 45 in the control group). intervention: ripc: 3 periods of 5 minutes of ischemia followed by 5 minutes of reperfusion are created by inflating a blood pressure cuff on the upper extremity after induction of anesthesia and prior to surgery. in the control group a non-inflated blood pressure cuff is placed on the upper extremity for 30 minutes. primary study parameters/outcome of the study: maximum postoperative concentration of high-sensitive cardiac troponin t. secondary study parameters/outcome of the study: markers of inflammatory, intestinal and renal injury, postoperative complications during 30 days, length of stay and hospital mortality.


Eligibility criteria:
inclusion criteria: * elective pancreaticoduodenectomy * age \>18 exclusion criteria: * no informed consent