Kornimate/medical-research-clean huggingface dataset:
feasibility trial to maintain normal cerebral oxygen saturation in high-risk cardiac surgery

Conditions: Cerebral Hypoxia

Summary: using the brain and the heart as index organs, perioperative interventions to optimize cerebral oxygen saturation and cardiac contractility in high-risk patients undergoing cardiac surgery should have a beneficial systemic effect for enhancing global tissue perfusion and improve outcomes.

the proportion of high-risk patients requiring cardiac surgery and of high-risk cardiac surgeries is increasing. these populations of patients are at increased risk of perioperative morbidity and mortality. transesophageal echocardiography (tee) evaluation in cardiac surgery has been shown to impact on the perioperative management of patients and to improve outcomes. near infrared-reflectance spectroscopy (nirs) is a technique that has been employed since the mid-1970's and that can be used as a non-invasive and continuous monitor of the balance between cerebral oxygen delivery and consumption. two recent randomized trials have shown an association between correction of cerebral desaturation and shorter recovery room and hospital stay in non-cardiac surgery, and with a decrease in major organ dysfunction and in intensive care length of stay after coronary artery bypass. by combining nirs and tee in high-risk patients, optimal tissue perfusion could be achieved and perioperative morbidity and mortality could be reduced.

Eligibility criteria:
inclusion criteria: * patients with euroscores ≥ 10. * planned complex surgery including more than one procedure, or redo procedures. * patient able to read and understand the consent form. * patients ≥ 18 years of age. exclusion criteria: * high risk patients undergoing of off pump coronary artery bypass. * emergency surgeries less than 6 hours from diagnosis. * patient unable to read and understand the consent form. * patients with and iabp or a ventricular assist device * planned circulatory arrest * planned surgery of the descending aorta. * patients with acute endocarditis.

Keywords: cerebral hypoxia
pilot study of the cova™ monitoring of patients with congestive heart failure

Conditions: Congestive Heart Failure

Summary: the purpose of this study is to obtain observational data allowing for the preliminary assessment of the utility of a noninvasive physiologic monitor for monitoring of patients with congestive heart failure.

the study proposes to utilize the cova™ monitoring system, a novel body-worn sensor that remotely monitors thoracic fluid, heart rate, heart rate variability, respiration rate, skin temperature, posture, and, using transmitted waveforms, stroke volume and cardiac output to evaluate the system's monitoring capabilities in individuals recently hospitalized for congestive heart failure. the data acquired through this study will play a critical roll in developing future interventional studies that will allow patients with hf to potentially receive better and more timely treatment in the home setting, decreasing hospitalizations and improving quality of life.

Eligibility criteria:
inclusion criteria: * adults over age 18 * have wireless internet access within their homes. * acute hospitalization with a primary diagnosis of acute decompensated heart failure (adhf) diagnosed on the basis of all of the following: 1. symptoms: * onset or worsening of dyspnea within the past 2 weeks 2. physical exam (at least 1 present): * rales/ crackles on auscultation * elevated jvp \> 8 cmh2o * weight gain * le edema 3. diagnostic imaging/ labs (at least 1 present): * evidence of pulmonary congestion or edema on chest x-ray/ chest ct * elevated nt-pro-bnp (age-adjusted) (\>1000) * patients of particular interest will be those who already have a medtronic implantable cardioverter defibrillator or cardiac resynchronization therapy device with the optivol feature that tracks transthoracic impedance. exclusion criteria: * allergy to ecg electrodes * psychological or social situation that would make the study difficult for the patient * inability to consent * pregnant women * pneumonia - currently, or within the past 30 days * non-cardiogenic pulmonary edema (e.g. ards) * interstitial lung disease * end-stage renal disease and on hemodialysis * for any reason unable to wear or place the cova™ device, e.g. pectus excavatum, fragile skin, severe arthritis.

Keywords: noninvasive physiologic monitoring acute decompensated heart failure (adhf)
different volumes of erector spinae plane block for breast surgery

Conditions: Breast Cancer; Breast Neoplasms; Breast Diseases

Summary: postoperative pain is an important issue in female patients underwent breast surgery. postoperative effective pain treatment provides early mobilization and shorter hospital stay. the us-guided erector spina plane block (espb) may be used for postoperative pain treatment following breast surgery. it is a relatively novel interfascial block that was defined by forero et al. it has been reported that espb provides effective analgesia management for several breast surgeries.

various methods may be performed to reduce the use of systemic opioids and for effective pain treatment following mastectomy and axillary dissection surgery. ultrasound (us)-guided interfascial plane blocks have been used increasingly due to the advantages of ultrasound in anesthesia practice. the us-guided erector spina plane block (espb) provides thoracic analgesia at t5 level and abdominal analgesia at t7-9 level. espb contains a local anesthetic injection into the deep fascia of erector spinae. visualization of sonoanatomy is easy, and the spread of local anesthesic agents can be easily seen under the erector spinae muscle. thus, analgesia occurs in several dermatomes with cephalad-caudad way. in the literature, it has been reported that esp block provides effective analgesia after several surgeries such as open heart surgery, breast surgery, thoracoscopic and abdominal operations. the aim of this study is to compare the efficacy of the different volumes of us-guided espb for postoperative analgesia after mastectomy and axillary dissection surgery. the primary aim is to compare postoperative opioid consumption, and the secondary aim is to evaluate pain scores (vas), and adverse effects related with opioids (allergic reaction, nausea, vomiting).

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists (asa) classification i-ii * scheduled for mastectomy and axillary dissection surgery under general anesthesia exclusion criteria: * anticoagulant treatment, * known local anesthetic allergy, * infected skin around the block site, * pregnancy or breast-feeding, * back abnormalities

Keywords: mastectomy and axillary dissection surgery postoperative pain management erector spinae plane block
bilirubin increases the risk of nosocomial infection in cirrhotic patients

Conditions: Nosocomial Infection

Summary: nosocomial infection (nis) is a major challenge in healthcare facilities and has been associated with prolonged hospital stay as well as increased morbidity and mortality. this research aimed to estimate the impact of acute decompensation (ad) consequences on the successive risk of nosocomial infections (nis) and the go after outcome.

cirrhosis is the 14th most widespread cause of mortality worldwide \[1\], cirrhosis can take one of the following forms: compensated and decompensated phases \[2\]. the latter is related to subsequent complications such as ascites, hepatic encephalopathy (he), gastrointestinal hemorrhage (gih), jaundice, or spontaneous bacterial peritonitis (sbp) \[2\]. decompensated cirrhosis is a common cause of frequent hospital admission and high fatality rate \[3\]. patients with cirrhosis and decompensation have bacterial translocations (bt) and immune deterioration \[4\]. therefore, they are susceptible to getting infections and septic shock \[5\]. on the other hand, the infection can worsen the course of cirrhosis and hasten the progression of related morbidities with a subsequent increase in death rate owing to its ability to accelerate organ failure \[6\]. for cirrhotic patients, the occurrence of nis is an essential standpoint \[7\]. several studies on cirrhotic patients revealed that the incidence of nis is much higher in patients with cirrhosis and thus worsens the prognosis \[8,9\]. recent studies showed that around 30 to 50% of bacterial infections (bis) in patients with decompensated cirrhosis are nis which is related to a higher risk of acute-chronic liver failure (aclf), severe sepsis, and mortality \[10-12\]. nevertheless, current studies have not clarified how decompensation differentially predisposes to the occurrence of nis and affects the outcomes. henceforth, this study aimed to assess the incidence of nis in cirrhosis with differential decompensation consequences, the bond between the type of decompensation at admission and the progress of nis, and the synergism between decompensation and subsequent nis on the outcome.

Eligibility criteria:
inclusion criteria: * cirrhotic patients both sex exclusion criteria: * pregnancy * lactation * hcc
frequent dosing regimen of lucentis for subjects with persistent diabetic macular edema despite standard antivegf dosing

Conditions: Persistent Diabetic Macular Edema

Summary: the investigators would like to investigate the efficacy of more frequent treatment with lucentis for subjects with persistent diabetic macular edema despite standard dosing regimen.

this is an open-label, subject masked, phase ii study of intravitreally administered ranibizumab in subjects with persistent diabetic macular edema. persistent diabetic macular edema is defined as subjects who still have central subfield thickness on sd-oct of greater than 320 microns after having received at least 3 previous doses of antivegf therapy in the past 5 months. consented, enrolled subjects will be randomized into two subgroups: (1) standard dosing of monthly 0.3mg ranibizumab or (2) 0.3mg ranibizumab given 2 weeks apart for 5 doses followed by monthly dosing.

Eligibility criteria:
inclusion criteria: subjects will be eligible if the following criteria are met: * ability to provide written informed consent and comply with study assessments for the full duration of the study * age \>18 years * diagnosis of type 1 or type 2 diabetes * bcva score using the etdrs method of \>24 and \<78 in the study eye at the screening visit * 3 or more intravitreal injections of antivegf over the 5 months prior to screening * presence of diabetic macular edema defined as sd-oct cst \>320 microns on spectral domain machine exclusion criteria: * subjects who meet any of the following criteria will be excluded from this study: * anti-vegf treatment in the study eye within 3 weeks prior to screening * intravitreal ozurdex treatment in the study eye within 12 weeks prior to screening * intravitreal steroid treatment in the study eye within 8 weeks prior to screening * prp or focal laser in the study eye within 4 months prior to screening * active iris neovascularization in the study eye * any ocular condition in the study eye that, in the opinion of the investigator, is severe enough to compromise the study result. * history of cataract surgery in the study eye within 3 months prior to screening visit * uncontrolled systemic disease * current enrollment in an investigational drug study or participation in such a study within 30 days prior to the screening visit * female patients who are pregnant, nursing or planning a pregnancy or who are of childbearing potential and not using a reliable means of contraception. * any condition or reason (including inability to read etdrs chart or language barrier) that precludes the patient's ability to comply with study requirements including completion of the study. * known allergy, hypersensitivity or contraindication to the study medications, its components, fluorescein or povidone iodine.

Keywords: diabetic macular edema
intermittent fasting and metabolic dysfunction associated fatty liver disease

Conditions: Intermittent Fasting; Metabolic Dysfunction-Associated Fatty Liver Disease

Summary: previous studies have investigated the effect of different dietary patterns on metabolic dysfunction-associated fatty liver disease (mafld), for which lifestyle modification remains the primary treatment. the present study sought to determine the effect of intermittent fasting on anthropometric measurements, fibroblast growth factor (fgf)-21, and autophagy markers including autophagy-related protein (atg)-5 and beclin-1 levels, as well as on hepatic steatosis and fibrosis levels in overweight or obese patients with mafld to elucidate the efficacy of intermittent fasting in the management of mafld. the study included 48 patients diagnosed with mafld. patients were randomly assigned into two groups: 22 received a dietary treatment involving 22-25 kcal/kg/day of energy for 8 weeks (energy-restricted diet group), and 26 followed the same dietary intervention and a 16:8 pattern (energy + time-restricted diet group). the patients were assessed for various parameters at baseline (t0) and at the end of the week 8 (t8). the extent of hepatic steatosis and fibrosis was determined using transient elastography on a fibroscan® device. serum levels of fgf-21, beclin-1, and atg-5 were determined using enzyme-linked immunosorbent assay.


Eligibility criteria:
inclusion criteria: * diagnosed with mafld * aged 18-65 years * bmi ≥ 25 kg/m² * a stable body weight (\<5 kg weight loss or gain) over the last 3 months preceding the start of the study * signed the informed consent form. exclusion criteria: * an average daily alcohol consumption \>20 g for females and \>30 g for males * pregnant or lactating women * patients with ischemic heart disease or heart failure, chronic inflammatory diseases, chronic viral infections, cancer, moderate-to-severe kidney disease, uncontrolled hypertension, and eating disorders * those with a history of bariatric surgery * those on insulin due to increased risk of hypoglycemia.

Keywords: intermittent fasting fibroblast growth factor 21 autophagy fatty liver time-restricted eating
cardiovascular risk factors and severe covid-19. a nationwide registry-based case-control study

Conditions: COVID-19

Summary: in this study we cross-reference several nationwide high-quality swedish registers in order to study risk factors for severe covid-19 outcomes.

in this nationwide, case-control study we cross-reference several detailed, high-quality swedish registers in order to study risk factors associated with severe covid-19 as well as different disease outcomes, with a focus on cardiovascular disease, chronic kidney disease, different treatments and socioeconomic factors. cases are identified through the swedish intensive care register (sir) and controls through the swedish population register (rtb). further information on the study participants is gathered by linkage to registers on: prescribed drugs; history of in- and outpatient care; income, education and migration. follow-up data such as future hospitalization and mortality will be gathered prospectively.

Eligibility criteria:
inclusion criteria: * cases: admitted to intensive care unit in sweden and registered admission in the swedish intensive care register (sir) with a main diagnosis of covid-19 confirmed by laboratory testing (icd10: u07.1). (cases) * control subjects matched for age, gender,residency: for each case 10 controls matched for age, gender and district of residence will be identified by statistics sweden (scb) in the swedish population register (rtb). * control subjects matched for age and gender: for each case 5 controls matched for age and gender will be identified by by statistics sweden (scb) in the swedish population register (rtb). exclusion criteria: * no valid swedish personal identity number (pin)
evaluation of the potential effects of ssr149415 on the hypothalamic-pituitary-adrenal axis in outpatients with major depressive disorder

Conditions: Major Depressive Disorder

Summary: primary objective: - to evaluate the effects of two fixed doses of ssr149415 (250 mg bid and 100 mg bid) on hypothalamic-pituitary-adrenal axis function in patients with major depressive disorder. secondary objectives: * to evaluate the tolerability and safety of ssr149415 in patients with major depressive disorder. * to evaluate the efficacy of two fixed doses of ssr149415 compared to placebo in patients with major depressive disorder. * to evaluate plasma concentrations of ssr149415.

the study consisted of three segments (a, b and c). segment a was a 1 to 4-week, drug-free, screening and baseline period. segment b was a 4-week, double-blind period. after the last dose of double-blind study medication in segment b, all patients had to enter segment c, a 1-week drug-free, follow-up period. the total study duration for one patient participating in all segments of the study was 6 weeks.

Eligibility criteria:
inclusion criteria : * diagnosis of major depressive disorder as defined by the diagnostic and statistical manual of mental disorders, 4th edition-text revision (dsm-iv-tr) and the mini international neuropsychiatric interview (mini) criteria. exclusion criteria: * outpatients unwilling to be hospitalized a total of 6 nights and 8 days. * total score of less than 21 (\<21) on the 17-item hamilton depression rating scale (ham-d) at visit 1 (day -7) or visit 5 (day -1). * patients whose current depressive episode is diagnosed with psychotic features, catatonic features, seasonal pattern or post-partum onset or is secondary to a general medical disorder. * patients with alcohol dependence or abuse or substance dependence or abuse in the past 12 months according to the mini, except nicotine or caffeine dependence. * patients who have used the following prior to entry into segment b: any antipsychotic within 3 months; fluoxetine within 1 month; any monoamine oxidase inhibitor (maoi) within 2 weeks; any other antidepressant, anxiolytic, sedative-hypnotic, or mood-stabilizer (lithium, anticonvulsants) within 7 days except permitted concomitant medications * the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
role of the radiologist in management of pulsatile tinnitus

Conditions: Pulsatile Tinnitus (Diagnosis)

Summary: the aim of this study is to detect the role of interventional radiology in management of pulsatile tinnitus and to detect the best imaging modality for diagnosis.

tinnitus is a broad and complex subject concerning a symptom rather than a syndrome or a disease (1 ),new studies indicate that prevalence of tinnitus is 14.5% among those less than 40 years old and 17.5 - 35% among age over 40 years old( 2-3 ). vascular tinnitus causes are multiple , arterial causes like atherosclerosis , fibromuscular dysplasia or dissection of the carotid or vertebral artery , arteriovenous causes like cerebral head and neck arteriovenous malformation , dural arteriovenous fistula and carotid cavernous fistula venous like systemic diseases with hyperdynamic circulation . chronic anemia, pregnancy, thyrotoxicosis , idiopathic intracranial hypertension and dural venous sinus stenosis , tumors also like paraganglioma which some authors believe that para-gangliomas are the most common cause of vascular tinnitus and vascular metastasis and other miscellaneous causes like paget's disease m otosclerosis or otomastoiditis , but others see dural arteriovenous fistula (avf) ,idiopathicvenous tinnitus, or idiopathic intracranial hypertension the most common causes. (4 - 9) , also one of the most important arterial causes is atherosclerosis , atherosclerotic plaques ma produce turbulence of carotid flow and occasionally cause pulsatile tinnitus (10 ) , fmd ( fibromuscular dysplasia ) seen in 0.5% to0.6% of carotid angiograms and autopsies, is the second most common cause of extracranial carotid narrowing (11) information obtained from both ct and mri is complementary in some casesthe angiographic findings may include luminal stenosis, abrupt reconstitution of the lumen, dissecting aneurysm, intimal flap, slow flow, occlusion, and distal emboli (12-15)

Eligibility criteria:
inclusion criteria: * patients with pulsatile tinnitus of unknown origin referred by a physician to diagnostic radiology to be assessed by imaging will be included in the study. * patient's with clinical diagnosed pulsatile tinnitus. * patient refused surgical intervention. exclusion criteria: * history of allergy to the contrast media , contraindication to mri and refusal to sign a consent * pregnant women * patients with atherosclerosis cause only or vascular loop more than 50% in internal auditory canal
effects of ilaprazole on ulcer healing rate and prevention of gastrointestinal bleeding in the patients undergone esd.

Conditions: Gastric Cancer

Summary: this study compared ulcer healing rate of ilaprazole 20mg or rabeprazole 20mg in the patients undergone endoscopic submucosal dissection for gastric adenoma or early gastric cancer and investigated prevention of gastrointestinal bleeding.

this study is a multicenter, randomized, parallel and prospective study to compare ulcer healing rate of ilaprazole 20mg or rabeprazole 20mg in the patients undergone endoscopic submucosal dissection for gastric adenoma or early gastric cancer and to investigate prevention of gastrointestinal bleeding. participants are defined as persons who underwent a endoscopic submucosal dissection for gastric adenoma or early gastric cancer. for 8 weeks, participants treated as ilaprazole 20mg or rabeprazole 20mg once a day. after treatment, the ulcer healing rate was evaluated by endoscopy at 4, 8 weeks.

Eligibility criteria:
inclusion criteria: * 19 year old ≤ male or female \< 85 year old * subject who underwent endoscopic submucosal dissection for gastric adenoma or early gastric cancer * subject who agrees to participate and spontaneously sign the informed consent form(icf). exclusion criteria: * known hypersensitivity to any component of ilaprazole * subjects who are taking contraindicated medications(ex. atazanavir) for experimental and concomitant drug. * subjects with abnormal levels in the laboratory tests * total bilirubin, creatinine\> 1.5 times upper limit of normal * alanine transaminase(alt), aspartate transaminase(ast), alkaline phosphatase, blood urea nitrogen(bun)\> 2 times upper limit of normal * subjects diagnosed with other cancer within 5 years other than stomach cancer. * subjects with a history of zollinger-ellison syndrome, barrett's esophagus, primary esophageal motility abnormality, esophageal strictures, pancreatitis, malabsorption, severe cardiovascular or pulmonary disease * subjects with a history of major surgery that can affect gastric acid secretion. * subjects should continue taking the following medicine during the study period : anticholinergics, promoting motility agents, prostaglandin analogs, sucralfate, aspirin, steroid, nsaids drug * subjects with uncontrolled organ failure (liver dysfunction, renal dysfunction) * pregnant and/or lactating women * subjects participating in a clinical trial before another trial within 30 days * inconsistency judged subject by researcher

Keywords: ilaprazole gastric adenoma early gastric cancer endoscopic submucosal dissection