Kornimate/medical-research-clean huggingface dataset:
impact of different treatment in multivessel non st elevation myocardial infarction (nstemi) patients: one stage versus multistaged percutaneous coronary intervention (pci)

Conditions: Non ST Segment Elevation MI and Unstable Angina

Summary: patients with nstemi and multivessel disease will be scheduled to undergo early invasive strategy (pci within 72 hours) of de novo native coronary artery lesions were considered for recruitment into the study. inclusion criteria are the following: diagnosis of nstemi according to current guidelines presenting with multivessel disease. we will exclude patients with cardiogenic shock at presentation (systolic blood pressure \ 50% diameter stenosis), previous coronary artery bypass grafting (cabg) surgery, patients with syntax score \>32 and candidated to by-pass surgery (10), severe valvular heart disease and unsuccessful procedures. procedure success was defined as the achievement of an angiographic residual stenosis of less than 30% and a thrombolysis in myocardial infarction (timi) flow grade iii after pci. patients randomized to one-stage group were completely revascularizated in one time pci, whereas patients randomized to multi-staged group were completely revascularizated in more time pci, during the same hospitalization. patients received a clopidogrel loading dose of 600 mg before the pci (for loading dose administered more than 6 h prior to procedure). post-procedural antiplatelet regimen consisted of aspirin at 100 mg/day indefinitely and clopidogrel 75 mg/day for at least one month.


Eligibility criteria:
inclusion criteria: * diagnosis of nstemi * presenting with multivessel disease exclusion criteria: * patients with cardiogenic shock at presentation * left main coronary disease (\>50% diameter stenosis) * previous coronary artery bypass grafting (cabg) surgery * patients with syntax score \>32 * candidated to by-pass surgery * severe valvular heart disease * unsuccessful procedures

Keywords: nstemi pci onestage multistaged
comparison of hemi-shoulder arthroplasty and philos in treating three or four-part fractures of proximal humerus

Conditions: Humeral Fracture, Proximal

Summary: to explore clinical effectiveness of philos plate fixation and hemi-shoulder arthroplasty in treating three or four-part fractures of proximal humerus

from april 2015 and april 2017, patients from multi-center aged over 60 years old with three and four-part fractures of proximal humerus were treated with proximal humerus internal locking system(philos) and hemi-shoulder arthroplasty in multi-center. all the patients received the same rehabilitation course. at 6 months after surgery, postoperative complications were observed, eq-5d was used to evaluate quality of life, and ases score was used to assess functional outcomes.

Eligibility criteria:
inclusion criteria: three or four part fractures of proximal humerus exclusion criteria: 1. severe comminuted fractures of proximal humerus 2. past history of injured-side shoulder surgery 3. patients who cannot tolerate surgery

Keywords: humeral fractures, proximal arthroplasty, shoulder replacement bone plates
core stabilization exercises in patients with knee osteoarthritis

Conditions: Exercise Training; Osteoarthritis, Knee; Core Stability; Muscle Thickness of the Quadriceps Femoris; Balance

Summary: exercise plays a key role in the treatment of knee osteoarthritis, but there is no clear evidence on which type of exercise is most effective. recent studies highlight the benefits of core stabilization exercises for improving knee stability. this study aims to demonstrate the effects of adding core stabilization exercises to conventional exercise therapy for patients with knee osteoarthritis.

knee osteoarthritis is becoming a significant public health problem with the aging population. while there is no definitive cure, exercise is the main approach to treatment. various types of exercises are being studied for their effectiveness in osteoarthritis treatment, and recently, core stabilization exercises have been highlighted for their role in lower extremity pathologies. in this study, we aimed to investigate the effects of these exercises on pain, balance, quality of life, function, and quadriceps muscle thickness in patients with knee osteoarthritis. this study was designed as a randomized controlled double-blind clinical trial. thirty-two patients were randomly divided into two groups: a conventional exercise group and a conventional+core group. a total of 18 home exercise sessions, performed three times per week for six weeks, were planned.

Eligibility criteria:
inclusion criteria: * diagnosis of bilateral stage ii or iii knee osteoarthritis according to the kellgren and lawrence grading system * aged between 50 and 65 years * having a complaint of knee pain for at least 6 months * no systemic diseases that may hinder exercise (such as uncontrolled hypertension, cardiac arrhythmia, heart failure, neurological sequelae, joint deformities, malignancy, etc.) exclusion criteria: * having received physical therapy in the last 6 months * having undergone knee injection in the last 6 months * having had knee surgery * morbid obesity * presence or history of malignancy * individuals with severe visual impairment * individuals with a history of neurological or vestibular diseases that could cause balance problems, or patients using medications that may affect balance * individuals with serious cardiac, respiratory, or uncontrolled metabolic diseases
loss of independence - a rapid alternative to frailty screening in a swedish ed setting

Conditions: Frailty; Frailty Syndrome; Emergency Department; Geriatric Assessment

Summary: this prospective observational study will investigate the correlation of a surrogate marker of frailty in relation to serious outcomes. serious outcomes are defined as: mortality within 30 days, admission to hospital, length of stay in the emergency department (ed), in-hospital length of stay and revisits to the ed. the exposure, frailty, will be assessed according to loss of independence (loi) a possible low-cost quick tool to identify frailty in patients. the study population will be ed patients, \>65 years of age in a swedish regional health care system (region östergötland, sweden), comprising three eds in linköping, norrköping and motala. the outcomes will be compared according to the degree of frailty and censored over 7, 30 and 90 days.

frailty is a common clinical syndrome in older adults that carries an increased risk for poor health outcomes including falls, incident disability, hospitalization and mortality. the loss of independence (loi) defined as inability to rise from a chair with or without existing aids, is a possible low cost surrogate marker to measure frailty. several studies on triage scores for predicting mortality and need of hospital admission have identified loi as one of the most important variables. loi was prognostic in ed populations regarding mortality within 1-30 days in denmark, ireland and tanzania. data from the american college of surgeons (acs) national surgical quality improvement program (nsqip) geriatric surgery pilot project showed that loi was associated with higher rates of readmission and death after discharge in geriatric patients undergoing surgical procedures6. the aim of this study will be to investigate if the frailty, as assessed with loi, is associated with increased 30-day mortality in a swedish ed context. secondary outcomes include 7- and 90-day mortality, ed-length of stay, hospital admission, in-hospital length of stay, subsequent falls and medication changes. additionally, we collect data on morbidity and comorbidities to assess the association with the level of frailty. since this is a multicentre study, possible geographic differences will be studied as well. based on the results of this study, possible interventions could be identified to improve the care of the frail geriatric patients presenting at the ed.

Eligibility criteria:
inclusion criteria: * ≥ 65 years * able to answer questions to estimate frailty * or have a proxy to answer questions exclusion criteria: * \<65 years * unable to answer questions to estimate frailty
evaluation of the safety and efficacy of standard intravenous immunoglobulins in pregnant women with primary cytomegalovirus infection

Conditions: Cytomegalovirus Congenital Infection

Summary: because the potential benefit of standard intravenous immunoglobulins (ivig) - obtained from unselected donor pools including a varying proportion of donors previously exposed to cmv - has not yet been explored in pregnant women, the investigators performed a longitudinal prospective study on the possible efficacy of ivig for prevention or therapy of fetal cmv infection.

human ivig are offered monthly to consecutive enrolled pregnant women with confirmed primary cmv infection at any stage, for the prevention and treatment of fetal cmv infection. primary infection is defined by positive cmv igm antibodies with absent or low titres of cmv igg antibodies, and either low (\<40%) cmv igg avidity indexes with positive cmv igm and igg antibodies. in addition women with indefinite avidity index and positive cmv dna detection in urine and/or blood samples are also considered for treatment. standard human intravenous immunoglobulins were chosen for their safety and efficacy, well documented in other settings. ivigs were used to perform all of the infusions in the study, undiluted after reconstitution, in accordance with instructions of the manufacturer. we chose to perform ivig infusions using 0.5 g/kg of body weight, to make sure that a dose of specific cmv igg at least comparable with that carried by hig were infused at each time point. infusions last 4 to 5 hours, using a double lumen line to infuse approximately 1500 ml of either 5% glucose or saline solution in parallel with the undiluted ivig preparation, to reduce the risk of infusion reactions. cmv igg and igm antibodies and igg avidity indexes are assayed before and after each ivig infusion, within 15 minutes. quantitative cmv dna is amplified from whole blood and urine samples from pregnant women and neonates, using the real-time pcr, and on samples of amniotic fluid from women who required amniocentesis. the newborns will be followed for five years after delivery.

Eligibility criteria:
inclusion criteria: * pregnant women with confirmed primary cmv infection at any stage of gestation. exclusion criteria: * pregnant women with falsely positive cmv igm antibodies or high (\>40%) cmv igg avidity indexes

Keywords: congenital cmv infection standard immunoglobulins immunoglobulin therapy igg cmv avidity index cytomegalovirus
technical feasibility study on screening sleep related breathing disturbances and sleep apnoea with wearable sensors

Conditions: Sleep Apnea; Sleep Disorder

Summary: in this study the feasibility of detecting sleep apnoeas with unobtrusive wearable sensors and sounds recorded with a smartphone is studied by making an overnight recording to patients with high probability of sleep apnoeas. the data acquired with the aforementioned devices is: ecg, acceleration, bioimpedance of thorax and processed and raw audio. in data analysis phase it will be studied which combinations of these signals would enable detecting sleep apnoeas with high enough sensitivity and specificity when compared to a night polygraphy reference (nox t3 device using airflow, breathing movements, audio, position, movement, oxygen saturation, pulse and leg emg).


Eligibility criteria:
inclusion criteria: * high a priori probability for sa based on previous pg findings, bmi, and ess and medical history * clinical reason i.e. potential benefit of repeating the pg due to e.g. technical challenges in the previous pg and/or unclear findings or diagnosis. participation may be offered also in cases where first pg is diagnostic. in these cases accuracy of sleep apnoea grading will be improved. * adequate finnish language skills to comprehend study-related instructions and questionnaires. the study materials are available only in finnish. * signed written informed consent exclusion criteria: * medical history of a major cardiovascular event (myocardial infarction, coronary artery bypass graft (cabg), percutaneous coronary intervention (pci), stroke, or transient ischemic attack) within the previous 6 months * use of cardiac pacemaker or history of atrial fibrillation

Keywords: apnea apnoea sleep
cancer parenting program for the enhancement of the quality of life of patients with advanced cancer and their children

Conditions: Parenting; Parent-Child Relations; Cancer; Survivorship; Hematopoietic and Lymphoid System Neoplasm; Malignant Solid Neoplasm

Summary: this trial examines the usefulness of two educational programs for parents with late-stage cancer who have a 5 - 17 year old child. the programs are designed to enhance the quality of the parent-child relationship and add to the parent's confidence in managing the impact of their cancer on their child. educational programs may reduce anxiety and depression and improve the well-being and quality of life of parents with advanced cancers and their children. recruitment occurs nationally via referral to the fred hutch/university of washington cancer consortium team.

outline: patients are randomized to 1 of 2 groups. group i (enhancing connections-palliative care \[ec-pc\] program): patients receive the 5-session ec-pc program bi-weekly with a patient educator about ways to help them talk to and support their child. group ii (control): patients receive carefully selected educational booklet that discuss ways to talk about their cancer with their child and a scripted phone call from a trained phone counselor on study.

Eligibility criteria:
inclusion criteria: * parents with any type of late-stage, non-curable cancer (determined by tnm stage iv cancer for solid tumors or 2 or more cycles of treatment failure with disease relapse in non-solid tumors) * all therapies are allowable * 23 years (yr.) to 68 yr. age restriction exists for the patient based on parent having a child ages 5-17 * patient must have a child (5yr. -17 yr.) living in the home at least 50% of the time and residential with non-ill parent or parent surrogate * read and write english as one of their languages of choice * have access to a telephone * ability to understand and the willingness to sign a written informed consent document. read and write english as one of their languages of choice exclusion criteria: * patient is in hospice at time of enrollment * non-ill co-parent does not consent to join study
safety study of early infusion of vitamin c for treatment of novel coronavirus acute lung injury (safe evict corona-ali)

Conditions: COVID-19; Lung Injury, Acute; Kidney Injury

Summary: this study will evaluate the safety of a 96-hour intravenous vitamin c infusion protocol (50 mg/kg every 6 hours) in patients with hypoxemia and suspected covid-19.

the intravenous vitamin c treatment protocol will be comprised of four intravenous infusions a day, that is 50 mg/kg every 6 hours in patients with laboratory-confirmed sars-cov-2 infection manifesting covid-19 (novel coronavirus disease 2019) with hypoxemia. treatment protocol will continue for 4 days (96 hours), and, if needed, the last study-specific bloodwork with being collected on day 7. all subjects will be followed to day 28 (phase i) and day 90 (phase ii) for collection of clinical outcomes data through electronic health records (ehr) even though the treatment protocol will be completed by 96 hours from randomization at the latest. secondary outcome data will also be collected either during in-person (clinic) visit or via telephone at the 60 and 90-day follow-up.

Eligibility criteria:
inclusion criteria: * adults of 18 years or older * patients hospitalized with a diagnosis of covid-19 based on central laboratory-confirmed covid-19 novel coronavirus disease-2019, based on a positive sars-cov-2 rt-pcr confirmed within 72 hours prior to enrollment of nasal, oropharyngeal, or bal specimen with hypoxemia, (i.e., decrease in oxygenation, as outlined below) * pulse oximetry saturation (spo2) \< 93% on room air in who covid-19 ordinal scale 3 patients, regardless the need for assisted ventilation, or oxygenation. * any new requirement of supplemental oxygen, with any oxygen device (who covid-19 ordinal scale 4-7, regardless of pulse oximetry reading) * in patients with supplemental oxygen at home, any increase in the requirement of supplemental oxygen. * in icu level care exclusion criteria: * age less than 18 years * known allergy to vitamin c * inability to obtain consent from patient or next of kin * presence of diabetic ketoacidosis * any history of oxalate stones at any time * patients with kidney disease improving global outcomes (kdigo), ckd stage 4 (egfr \< 30 ml/min, ckd stage 5 and end-stage renal disease on dialysis patients are excluded. * patients with acute kidney injury, stage 3. * pregnant, or lactating * known diagnosis of glucose-6-phosphate dehydrogenase (g6pd) deficiency * patients who received the following medications within 7 days prior to enrollment, or plan to receive during enrollment, or 7 days after enrollment: aluminum hydroxide, bortezomib, copper, deferoxamine, amphetamines including derivatives such as fluphenazine. * patients with active sickle cell crisis * prisoners * patients outside icu level care
surveillance of humira in korean jia patients

Conditions: Polyarticular Juvenile Idiopathic Arthritis

Summary: approximately 600 pediatric patients prescribed humira injection in usual practice according to the approved korean product label will be registered into this observational study. baseline data will be obtained at enrollment including demographics, underlying diseases and complications especially in regard to purified protein derivative (ppd) skin test, and chest x-ray. at routine visits for humira injection administration, which will occur according to usual medical practice, concomitant medication information and adverse events information will be collected for up to 70 days after the last administration of humira.


Eligibility criteria:
inclusion criteria: * patients from 2 years of age who were diagnosed with polyarticular juvenile idiopathic arthritis (jia) or patients from 6 years of age who were diagnosed with enthesitis-related arthritis (era). * polyarticular juvenile idiopathic arthritis (jia) patients for whom the response to previous disease-modifying anti rheumatic drug therapy has been inadequate * patients who give written authorization form to use their personal and health data from legal parents or representative. * physician will refer to the product market authorization (label) for inclusion criteria. exclusion criteria: * patients with known hypersensitivity to humira or any of its excipients. * patients who is participating on other clinical trials. * physician will refer to the product market authorization (label) for exclusion criteria.

Keywords: korean regulatory required postmarketing surveillance
effect of ultimaster stents treated to the most dilated coronary vessels

Conditions: Vasodilation; Coronary Artery Disease

Summary: in patients with vasospasm or with negative remodeling, various vasodilator drugs used during coronary angiography can dilate the diameter of the reference vessel to measure the exact vessel size. in particular, nitrates are well known to induce pharmacological vasodilatory effects through vascular smooth muscle relaxation in actual clinical practice, it has been reported that when oral or spray-type nitrate preparations are administered to coronary artery stenosis lesions, the diameter of the reference vessel expands by about 10% compared to the existing vessel diameter. this may enable larger stenting in coronary artery stenosis lesions. although many patients with vascular stenosis are accompanied by vasospasm and voice remodeling, in actual clinical practice, administration of vasodilators is only used in a small number of patients at the discretion of the surgeon. nitrate vasodilators administered during coronary angiography are low-dose and short-acting drugs, and although a small number of patients may experience side effects such as short-term lowering of blood pressure, no serious side effects are reported . on this background, this study is to evaluate whether there is a difference in the diameter of the ultimaster® stent treated with the conventional method compared to the maximally dilated coronary artery, and to evaluate the stability and effectiveness after the procedure.


Eligibility criteria:
inclusion criteria: * over 19 years old * evidence of coronary artery disease including asymptomatic ischemia stable angina acute coronary syndrome (unstable angina, non-st segment elevation * myocardial infarction, st segment elevation myocardial infarction). * coronary artery diameter 2.25\~3.5mm, stenosis 50% or more * those who voluntarily agreed in writing to participate in this clinical study exclusion criteria: * instability or psychogenic shock within 24 hours before percutaneous coronary intervention * life expectancy no longer than 1 year * hypersensitivity or contraindications to the following drugs or substances: heparin, aspirin, clopidogrel * patients whom researchers think unsuitable for participation in this study
pharmacologically active constituents of chocolate and their symptomatic effects in patients with idiopathic parkinson's disease

Conditions: Parkinson Disease

Summary: this study evaluates plasma concentrations of pharmacologically active constituents of chocolate and their effects on motor and non-motor symptoms of parkinson's disease. following one week of abstinence from cocoa-containing products, patients with parkinson's disease will be randomized to receive either dark or white chocolate. after one week of chocolate consumption, patients will then cross over to white or dark chocolate, respectively, and take the corresponding chocolate product for another week. blood samples will be taken at baseline, week 1 and week 2 to examine plasma concentrations of pharmacologically active constituents of chocolate at all three timepoints. moreover, patients will be clinically examined for motor and non-motor symptoms at all visits.


Eligibility criteria:
inclusion criteria: * female or male individuals aged 40 years and above * parkinson's disease according to the uk parkinson's disease society brain bank clinical diagnostic criteria * hoehn and yahr stage i-iii * minimum score of 16 points in the motor part of the unified parkinson disease rating scale (updrs part iii) * stable antiparkinsonian medication for at least 4 weeks prior to study inclusion * ability to provide informed consent exclusion criteria: * clinical signs for a secondary or atypical parkinsonian syndrome * treatment with any investigational medical product within 30 days prior to study inclusion * intake of chocolate or other cocoa-containing products within the last 7 days prior to study inclusion (patients can be re-screened after 7 days of abstinence from chocolate and other cocoa-containing products) * known intolerance or allergies against chocolate or other cocoa-containing products * diabetes mellitus and/or impaired glucose tolerance in the medical history * alcohol or drug abuse in the medical history * presence of levodopa-induced motor complications * other neurological, psychiatric or miscellaneous conditions that would significantly impair study participation, medical assessments or the consenting process

Keywords: parkinson disease cacao biogenic amines xanthines neurodegenerative diseases