Kornimate/medical-research-clean huggingface dataset:
low-level laser therapy in chronic kidney disease

Conditions: Kidney Failure, Chronic

Summary: chronic kidney disease is a renal injury and progressive and irreversible loss of kidney function and in its most advanced stage is called chronic renal failure. although hemodialysis replace some kidney function, patients suffer some alterations characterized by "uremic syndrome" typically expressed by: motor neuropathy and/or autonomic neuropathy, cardiac or musculoskeletal myopathies, peripheral vascular changes, among others. thus, the functional capacity and ability to exercise presents diminished these patients. the aim of this study is to verify the acute effect of low level laser therapy on the functional capacity of these individuals. the research will be developed in the hemodialysis unit of the santa clara hospital of santa casa de misericordia de porto alegre and the patients will be evaluated before and immediately after the application of laser therapy protocol. before the protocol will be evaluated pain in the lower limbs, borg scale, level of physical activity through the international physical activity questionnaire (ipaq) and blood collection will be held for later analysis parameters of biochemical oxidative stress and deoxyribonucleic acid (dna) damage. the laser therapy protocol will be applied in 6 points in quadriceps and 4 points in the gastrocnemius, bilaterally. after application, will be held the 6-minute walk test, effort subjective perception by borg scale, assessment of pain in the lower limbs with visual analog scale and a new blood sample for further analysis. patients will be randomized in two groups. the intervention group (ig), which will be held laser therapy and placebo group (pg), where the laser therapy will be placebo mode applied. the application will take place with the chattanooga device, with the laser diode cluster probe from the same manufacturer consisting of five diodes 850 nanometers (nm) and power output of 200 milliwatts (mw). it is irradiated 6 points in quadriceps and 4 points in gastrocnemius, bilaterally.


Eligibility criteria:
inclusion criteria: * patients with chronic kidney disease on hemodialysis for more than 3 months; * clearance of urea during hemodialysis (kt/v ≥ 1.2). exclusion criteria: * cognitive impairment that prevents conducting evaluations, as well as inability to understand and sign the informed consent form; * epidermal lesions at the site of application and/or intolerance stimulator and/or skin sensitivity change; * patients with recent sequel of stroke; * disabling musculoskeletal disease; * uncontrolled hypertension (systolic blood pressure \> 230 mmhg and diastolic blood pressure \> 120 mmhg); * grade iv heart failure (nyha) or decompensated; * uncontrolled diabetes (blood glucose \> 300 mg/dl); * unstable angina; * fever and/or infectious disease; * recent acute myocardial infarction (two months); * active smokers; peripheral vascular disease in the lower limbs as deep vein thrombosis or obliterates thromboangiitis.
histology post-endoscopic eradication therapy (eet)

Conditions: Esophageal Reflux; Barrett Esophagus

Summary: this study is looking at a cohort of patients who have undergone treatment for barrett's esophagus (be) and who have experienced complete eradication of the disease. the aim of the proposed study is to evaluate the histologic features of the neosquamous epithelium (nse) following complete eradication of intestinal metaplasia (ce-im) in patients undergoing routine surveillance biopsies and compare these data to a direct measure of reflux using 24hr ph impedance, to determine the correlation between histology and persistent reflux. these data will allow us to more accurately risk stratify patients for recurrence of be following eet.


Eligibility criteria:
inclusion criteria: * - patients who have undergone endoscopic eradication therapy and 24hr ph impedance testing as part of standard of care between 2009 and 2014. * - individuals who have signed a consent to be part of the prospective evaluation of barrett's esophagus study population. exclusion criteria: * - individuals who are not yet adults (infants, children and teenagers), pregnant women and prisoners will be excluded from the study. * - patient who were previously unable or unwilling to give consent to the prospective evaluation of barrett's esophagus study will be excluded.
extended iasd investigation: reduce lap-hf iv

Conditions: Heart Failure With Preserved Ejection Fraction; Heart Failure With Mid Range Ejection Fraction

Summary: multicenter, prospective, open label, single arm, clinical trial. the primary objective of this clinical trial is to further evaluate the safety and clinical efficacy of the iasd system ii in symptomatic heart failure patients with an left ventricular ejection fraction (lvef) ≥ 40%, and elevated left sided filling pressures despite standard guideline directed medical therapy (gdmt); and to compare the safety and efficacy results to those from the treatment arm of the reduce lap-hf randomized trial ii (corvia protocol 1601).

participants are screened against non-invasive eligibility criteria and scheduled for a hemodynamic evaluation. following right heart catheterization at rest and during supine bicycle exercise, patients will undergo a brief intracardiac echocardiography (ice) or transesophageal echocardiography (tee) exam for septal suitability. eligible patients continue with, fluoroscopically and echo guided transseptal puncture and iasd system ii implant procedure. if a previously unknown protocol exclusion is discovered during the index procedure, and device is not implanted, participant is followed for 30 days, and then exits the study. participants return for follow-up exams 30 days after the implant procedure and annually for 5 years after the implant procedure. in-person visits will take place for the first 2 years. telephone follow-up and medical chart review will be conducted for years 3-5.

Eligibility criteria:
select inclusion criteria: * chronic symptomatic heart failure with preserved or mid-range left ventricular ejection fraction (hfpef or hfref) * participant is willing to comply with clinical investigation procedures and agrees to return for all required follow-up visits, tests, and exams select exclusion criteria: * myocardial infarction and/or percutaneous cardiac intervention within past 3 months; coronary artery bypass surgery in past 3 months, or current indication for coronary revascularization; avr (surgical avr or tavr) within the past 12 months * advanced heart failure * history of stroke, transient ischemic attack (tia), deep vein thrombosis (dvt), or pulmonary emboli within the past 6 months * significant heart valve disease * chronic pulmonary disease * women of childbearing potential * severe obstructive sleep apnea not treated with cpap or other measures
standing tall (yima nkqo)

Conditions: HIV

Summary: the investigators propose the standing tall study, a prospective randomised study of strategy to optimize community-based art initiation in south africa. investigators will work closely with community members to integrate community-based art. one hundred participants will be enrolled and followed for a total of up to 6 months. those in the intervention arm will be provided with the st intervention which includes a behavioral component and access to art. the intervention will be linked to a clinic through a "nurse initiated management of art."

the premise for our study is based on three decades of hiv research that supports the need for multi-component, multisystem interventions to promote testing, and adherence to treatment and care for young people living with hiv. the proposed intervention, standing tall, is informed and guided by social action theory - a conceptual framework reflecting a holistic understanding of health behavior and motivational factors that foster and maintain behavior change. standing tall, a pilot randomized controlled trial, is designed to address multi-factorial barriers using (1) a socio-behavioral group intervention; (2) social support; (3) provision of immediate art and refills. the primary outcome is art initiation at three months, and the secondary outcome is viral load suppression at six months. other tertiary/exploratory outcomes include behavioral outcomes and process evaluation of the intervention itself, and the use of point-of-care diagnostics. the administrative supplemental funding provides support for an additional objective of this study: to understand how best to use point-of-care (poc) testing in clinical practice in order to improve hiv care and treatment for south african young people. understanding patient perspectives and perceived barriers is critical to developing feasible, acceptable, and effective protocols for implementing poc testing. the primary aim for achieving this objective is to assess patient perspectives regarding poc testing through in-depth, semi-structured interviews among study participants enrolled in standing tall's second aim.

Eligibility criteria:
inclusion criteria: * complete an assessment of understanding * provide informed consent * are between ages 18-24 * present to tutu tester vans in cape town or east london dthf clinics (duncan village day hospital, empilweni gompo health centre, gompo c clinic) and test hiv+ * are art-naïve * are english or isixhosa speakers * reside in the cape town or east london metro area exclusion criteria: * are pregnant (must be referred to antenatal clinic if living with hiv) * test positive for tuberculosis (must be referred to clinic for tb treatment prior to art initiation) * are unable to understand the process of informed consent
involvement of steatosis-induced glucagon resistance in hyperglucagonaemia

Conditions: Non-alcoholic Fatty Liver Disease

Summary: the purpose of this study is to examine whether non-alcoholic fatty liver disease (nafld) is associated with hepatic glucagon resistance and hyperglucagonemia.

hyperglucagonemia is a common condition in obesity, prediabetes and type 2 diabetes. it increases the hepatic glucose production, thus contributing to type 2-diabetic hyperglycemia. in the current study we wish to examine whether non-alcoholic fatty disease (nafld) results in hepatic glucagon resistance. this could result in hyperglucagonemia through a feedback mechanism acting on the level of pancreatic alpha cells. cirrhosis and type 1 diabetes, respectively, has previously been shown to be associated with hepatic glucagon resistance but it has not been examined in relation to nafld in humans so far.

Eligibility criteria:
inclusion criteria: * normal fasting plasma glucose and hba1c \< 6.0% * between 18.5 and 25 kg/m2 or between 30 and 40 kg/m2 * normal haemoglobin * normal coagulation factor ii, vii and x, inr and thrombocytes * age above 25 years * informed consent exclusion criteria: * diabetes * prediabetes (impaired glucose tolerance and/or impaired fasting plasma glucose) * first-degree relatives with diabetes * nephropathy (egfr \< 60ml/min and/or albuminuria) * liver disease (alat and/or serum asat \>2x normal values) * use of anticoagulative medicine like clopidogrel og warfarin * pregnancy and/or breastfeeding * age above 80 years * any condition that the investigator feels would interfere with trial participation
the effect of cognitive function as measured by repeated cognitive measures after 12 weeks treatment with donepezil

Conditions: Alzheimer's Disease

Summary: the purpose of this study is to determine if there is improvement or measurable change in cognition after only one month of treatment with donepezil when using a computerized test battery. the results at one month will be compared with the results at 3 months to evaluate this.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of probable ad according to nincds-adrda criteria. * the patient should live with an appropriate caregiver at home, or in a community dwelling. a caregiver should be capable of accompanying the patient to clinic visits or attending study visits in the patient's home. * patient and caregiver should understand, speak, and read local language. exclusion criteria: * significant neurological disease or dementia other than ad, e.g., mixed dementia, frontotemporal dementia, and parkinson's disease. * females of child bearing potential * impaired vision or hearing

Keywords: patients with mild to moderate alzheimer's disease
safety study of a novel wearable phototherapy system for the management of acute burn wounds

Conditions: Burn Wound

Summary: the primary purpose of this first-in-human, early feasibility study is to assess safety and feasibility of the low-irradiance monochromatic biostimulation (limb) system as a phototherapeutic intervention for the management of acute burn wounds. the prototype limb device will be evaluated for the occurrence of adverse events (treatment-related or otherwise) of the limb system, a portable, wearable, light-emitting system developed by rogers sciences, inc. (rsi). the device will be administered in the small feasibility pilot to confirm design, usability and operating specifications that will inform procedures and endpoints of a subsequent large, multicenter clinical trial.


Eligibility criteria:
inclusion criteria: * patients receiving care at shriners hospitals for children-boston for a skin tissue injury. * patients who have at least one wound with exposed area sufficient, in the investigator's opinion, to receive limb therapy. * willing and able to adhere to daily limb therapy protocol. exclusion criteria: * patients deemed not medically stable by the treating investigator. * patients with clinical signs and symptoms of systemic infection at baseline. * patients with burn wounds limited to their head and genitalia. * patients who, in the opinion of the investigator, will not require daily dressing changes. * patients receiving photosensitizing agents that result in cutaneous phototoxicity prior to enrollment. patients who have received one or more of the following photosensitizers cannot be enrolled into the study: photofrin, amiodarone, chloropromazine, fluoroquinolone antibiotics, thiazide diuretics, quinine, demethylchlortetracycline, psoralens, nalidixic acid, tetracycline, naproxen. * patients currently enrolled or participating in another investigational device, drug or biological trial within 30 days of the screening visit. * patients currently receiving any bandages or devices containing silver compounds. * patients on a ventilator, who have fluid resuscitation or are in any terminal condition.

Keywords: acute burn, thermal injury, wound, phototherapy, wound healing, antimicrobial
sevoflurane, propofol and desflurane on pod/pocd

Conditions: Sevoflurane; Propofol; Desflurane

Summary: the investigators will perform clinical studies to test the hypothesis that participants who have total hip/knee replacement under sevoflurane, propofol or desflurane anesthesia will have different effects on the incidence and severity of pod/pocd, and pod/pocd is associated with retinal nerve fiber layer (rnfl) thickness, as well as serum level of vitamin b12, folic acid, homocysteine and human myeloid differentiation protein-2 (md-2s). the investigators plan to perform the studies in 300 participants at shanghai 10th people's hospital.

postoperative delirium (pod) and postoperative cognitive disorder (pocd) are the most common complications of geriatric surgical patients, which could cause long-term social dysfunction, high mortality and increased medical cost. currently, there is no efficient biomarker for pod/pocd, and it also remains largely unknown whether different anesthesia might lead to different incidence and severity of pod/pocd. the investigator's previous studies showed that thickness of retinal nerve fiber layer thickness (rnfl-t) measured by optical coherence tomography (oct) was associated with pod/pocd; change of rnfl thickness (rnfl-c) in certain period correlated with cognitive deterioration. thus, the investigators consider that rnfl might be a potential biomarker of pod/pocd. in the proposed large-scale longitudinal studies, the investigators will clinically validate rnf-lt as pre-operative pod/pocd biomarker, and rnfl-c as post-operative biomarker of pod/pocd. finally, the investigators will compare the effects of surgery (total hip/knee replacement) under general anesthesia with sevoflurane, propofol and desflurane on the incidence and severity of pod/pocd in patients. results from the proposed studies will likely establish rnfl as a potential pod/pocd biomarker, promote the clinical utilization of oct-rnfl in early screening and outcome prediction of pod/pocd, and finally optimize anesthesia care of geriatric surgical patients to avoid or reduce pod/pocd incidence. these findings will lead to better postoperative outcomes of geriatric patients.

Eligibility criteria:
inclusion criteria: * 60 years old or older * chinese mandarin as the native language * scheduled to undergo hip/knee surgery under general anesthesia * american society of anesthesiologists (asa) class i-ⅲ exclusion criteria: * prior diagnoses of neurological diseases according to icd-10 * history of severe psychiatric disorders according to dsm-iv * visual or auditory defects * participating in the investigation of another study

Keywords: general anesthesia postoperative delirium postoperative cognitive dysfunction retinal nerve fiber layer biomarker
ideal drainage output of post-operative neck suction drain

Conditions: Head and Neck Neoplasms; Drain Site Complication; Neck Dissection

Summary: a precautionary measure that is frequently used after a neck surgery is the usage of suction drains, which allow the evacuation or air and fluids accumulated at the site of the surgery using negative pressure. theoretically this helps promote better healing of the wound. usage of suction drains, however, requires keeping some patients hospitalized after surgery for drain surveillance while they could have otherwise been discharged to safely begin their convalescence at home. in other cases, patient hospitalisation can be prolonged by the usage of suction drains, because surgeons wait for the output of the drain to fall below a certain quantity before removing them. this of course results in additional costs to the health system. the quantity below which the drain output should fall before drain removal is however not something agreed upon in the medical literature and is generally based on a surgeon's personal experience or that of the institution in which they practice. it would be important to better define this value, since prolonged usage of suction drains is not risk-free. indeed, they constitute, among other things, an access for bacteria to cause an infection to develop inside the neck, which compromises wound healing and may result in more pronounced scarring. this study aims to compare a frequently used output value (30 ml per 24 hours) with a more permissive one of 50 ml per 24 hours. the investigators will look more specifically at wound complications, length of hospitalisation and cost-effectiveness for the health system. this study will recruit patients undergoing neck surgery at the centre hospitalier de l'université de montréal to compare both of these suction drain output values.


Eligibility criteria:
inclusion criteria: * 18 years and older of age * patient having undergone neck surgery at the chum * patient operated by an ear nose and throat - head and neck surgeon at the chum * patient with at least one suction drain left post-operatively exclusion criteria: * non-suction drain (e.g. capillarity) * free-flap reconstruction cases * patient with past surgical history of neck dissection * patient with pas medical history of radiation therapy in the head and neck
brain tissue collection for neuropathological studies

Conditions: Bipolar Disorder; Depression; Anxiety Disorders; Schizophrenia; Tourette's Syndrome; Brain Diseases

Summary: the purpose of this study is to collect and study the brain tissue of deceased individuals to learn more about the nervous system and mental disorders. information gained from donated tissue may lead to better treatments and potential cures for nervous system and mental disorders. this study will ask relatives of deceased individuals to donate the brains of their deceased relatives to allow further study of neurological and psychiatric disorders. we do not accept prospective donations.

the knowledge of how affected tissue deviates from normal control tissue is an integral part of fully understanding a neurological or psychiatric disorder. the purpose of this protocol is to establish a coordinating program with the office of the chief medical examiner in washington, dc, the virginia office of the chief medical examiner, central district, and virginia the office of the chief medical examiner, northern district for the donation of brain tissue. dissected brain tissue from selected brain regions, including but not limited to the dorsolateral prefrontal cortex and hippocampal formation, will be assembled from large cohorts of normal controls and schizophrenic subjects. the expression of mrna and protein for selected molecules, chosen on the basis of their genetic association with schizophrenia, will be measured with a variety of assays including but not limited to qpcr and western blots. outcome measures are the statistical comparison within normal controls of mrna and/or protein levels in groups segmented by genotype. similar comparisons will be made between schizophrenic cohorts and normal controls, in a diagnosis by genotype analysis with an anova, or when appropriate an ancova (controlling for variables such as age, race, gender, and postmortem interval).

Eligibility criteria:
* inclusion criteria: brain tissue is needed from individuals suffering from a variety of neuropsychiatric disorders, especially schizophrenia, but also anxiety disorders, suicide, bipolar disorder, depression, tourette's syndrome, drug addictions (pcp, cocaine, alcohol, heroin or the like) and any form of dementia. in addition, brains from normal individuals without a history of neuropsychiatric disease will be needed for controls. exclusion criteria: no living subjects are enrolled in this protocol. tissue is obtained after death, with the permission of next of kin, or from existing institutions with appropriate samples via an mta or other applicable agreement. brain tissue is excluded from collection if there is a previously known history of strokes, lesions, or other major neuropathological abnormalities prior to the consenting process.

Keywords: schizophrenia neuropathology neurochemistry substance abuse bipolar disorder aging normal development depression anxiety disorders suicide dementia neuropsychiatric disorders tourette's syndrome normal controls