Kornimate/medical-research-clean huggingface dataset:
implementation strategies for self-measured blood pressure monitoring in racially and ethnically diverse populations

Conditions: Blood Pressure Monitoring, Home; Hypertension

Summary: this clinical trial aims to assess the impact of patient-focused and clinical-focused implementation strategies on blood pressure control. the investigators will assess the costs of these strategies and how effective they were at safely and equitably increasing home blood pressure monitoring.

this study will focus on assessing implementation strategies to increase adoption of self-monitored blood pressure (smbp) monitoring among low-income, culturally and linguistically diverse patients with hypertension in an urban safety net. the investigators propose a hybrid type 1 effectiveness-implementation trial of implementation strategies to increase use of smbp monitoring with clinical support in an urban safety net system. 330 patients will be randomized to a low-intensity vs high-intensity implementation strategy for smbp monitoring. the low-intensity strategy will replicate frequently used implementation efforts (provision of bp monitor with training on using a monitor) while the high-intensity strategy will address additional factors identified in prior work (e.g., digital literacy, social support). in six adult primary clinics, the investigators will concurrently provide a stepped-wedge clinic-level implementation strategy (clinical champions, electronic health record \[ehr\] tools) to increase provision of clinical support for smbp data. to guide dissemination in other under-resourced settings, an economic evaluation will also be conducted.

Eligibility criteria:
inclusion criteria: * 18 years old/order * any sex or gender * any race or ethnicity * must be receiving primary care at any of the six enrolled clinics * have uncontrolled hypertension (bp \>=140/90 mmhg at any two encounters in the previous 18 months, including the most recent encounter prior to enrollment) * can read and write english, spanish, or cantonese * be able to provide consent * must own a cell phone that receives sms or text messages exclusion criteria: * those with conditions that might complicate remote bp monitoring: * pregnancy (and 12 months postpartum) * acute myocardial infarction or stroke in the last 12 months * end-stage renal disease on dialysis * stage d heart failure * active treatment for cancer (except for nonmelanoma skin cancers) * pacemaker use * those with dementia, in hospice care, or with serious behavioral health conditions impeding participation

Keywords: inspired
the effect of connective tissue massage in patients with migraine

Conditions: Migraine With Aura; Migraine; Migraine Without Aura; Connective Tissue Diseases

Summary: the aim of this study was to investigate the effectiveness of connective tissue massage in patients with migraine


Eligibility criteria:
inclusion criteria: * clinical diagnosis of migraine disease * being volunteer exclusion criteria: * serious psychiatric problems with mental and / or communication problems neurological, inflammatory or endocrine disease
prospective randomized trials of gastric bypass surgery in patients with type ii diabetes mellitus

Conditions: Type II Diabetes Mellitus

Summary: although intensive medical treatment of diabetes has clearly been demonstrated to be worthwhile, it has not been a total success in diabetes treatment for a variety of reasons including lack of response to medication. diabetes has been well demonstrated as a co-morbidity illness of obesity patients. in observation, with exclusion stomach and duodenum of bariatric surgery (gastric bypass), most morbidly obese patients (about 80%) with diabetes had a significant improved of sugar control. base of this observation, we will try to find out the role surgical intervention (gastric bypass \& sleeve gastrectomy) in obese-related diabetes.

in observation, with exclusion stomach and duodenum of bariatric surgery (gastric bypass), most morbidly obese patients (about 80%) with diabetes had a significant improved of sugar control. base on this observation, we will try to find out the role surgical intervention (gastric bypass and sleeve gastrectomy) in obese-related diabetes. with restriction of stomach volume and with or without duodenal exclusion, this randomized trials will find out the role of duodenal exclusion and the role of ghrenin in obese-related type ii dm patients. the initial observation of previous morbidly obese patients with type ii dm, the dm seems a chronic disease which could be treated or controlled by surgical intervention, that's what we try to know more.

Eligibility criteria:
inclusion criteria: * patient with diagnosis of t2dm for at least 6 months * mild to moderate obesity status(bmi 27 - 35 ) * age : 30 - 60 year-old * hba1c \> 8 % exclusion criteria: * with co-morbidity illness of cardiovascular system * dm related nephropathy (cre \>2.0 mg/dl) * pulmonary embolism or uncontrolled coagulopathy in 6 months * hbv or hcv hepatitis or liver cirrhosis, inflammatory colon disease, cushing syndrome * s/p organ transplantation * previously bariatric surgery, gastrointestinal surgery, or abdominal sepsis * alcoholic or drug abuser * psychological disease. * hiv or tb patient

Keywords: type ii diabetes mellitus gastric bypass obese-related diabetes mellitus sugar control treatment of obesity related diabetes mellitus
comparative study of the optical biometer for measurements of the eye

Conditions: Normal Non-fluency; Cataract; Aphakic Eye; Eyes With Corneal Abnormality

Summary: the primary purpose of this comparative clinical study is to collect clinical data to demonstrate the equivalence of the investigational device to the predicate device for measurements of the eye. the secondary purpose is to evaluate any adverse events that occur during the clinical study.

this is a prospective clinical study to be conducted at a single clinical site located in the united states. this study will assess the agreement of an investigational device to the predicate device and an ultrasound reference device and the precision of the investigational device with a comparison to the precision of the predicate. any adverse events associated with the investigational device can or the predicate device will be assessed.

Eligibility criteria:
inclusion criteria: 1. subjects who can follow the instructions by the principal/clinical investigator or clinical staff at the clinical site, and can visit on scheduled examination dates. 2. subjects who sign an informed consent form to participate in the clinical trial. 3. subjects who agree to take the qualifying eye examination and a series of devices measurements. 4. subjects able to fixate on a target. 5. subjects must meet at lease one of the following criteria: * normal eyes: subjects with a natural lens without a cataract, corneal abnormalities or prior keratorefractive surgery. * eyes with cataracts: subjects with a pre-existing cataract without corneal abnormalities or prior keratorefractive surgery. * eyes without a natural lens: subjects that are pseudophakic or aphakic without corneal abnormalities or prior keratorefractive surgery. * eyes with corneal abnormality: subjects with a corneal abnormality and a natural lens without a cataract, or subjects post keratorefractive surgery and a natural lens without a cataract. exclusion criteria: 1. pregnancy. 2. any eye condition preventing use of any of the instruments used in the study. 3. any eye condition which might impair the validity of results from any of the instruments used in the study. 4. any medical condition, which, in the investigator's judgment, interferes with the subject's ability to comply with the protocol, compromises subject safety, or interferes with the interpretation of the study results.
perioperative complications linked to covid-19 history in elective cardiac surgery patients

Conditions: Postoperative Complications; COVID-19

Summary: a. primary objective identifying risk factors for peri-operative complications in patients who have had covid-19. b. secondary objectives identifying peri-operative complications in patients who have had covid-19. follow-up of peri-operative complications during hospitalization. identifying the safe distance at which a patient can be operated after a sars cov2 infection without having an increased risk of peri-operative complications. c. study inclusion and exclusion criteria 1. inclusion criteria patients should be included if: * are scheduled for elective cardiac surgery with extracorporeal circulation (bypass); * they give their consent for their data to be included in studies; 2. exclusion criteria patients should be excluded if: * they have emergency surgery; * have had sars cov 2 infection more recently than 3 months; d. data collection it is done in an excel table. data collection is done anonymously. no patient-identifying data will be collected. the collected data will be about comorbidities, covid-19 status - disease and vaccination, postoperative complications.

types of data collection from the patients: the type of surgery age sex smoking diabetes history of renal disease preoperative anemia preoperative creatinine preoperative urea bmi nyha class asa score euroscore i preoperative lvef disease covid -19 date of illness hospitalization for covid-19 covid 19 vaccination status necessary vasopressor peri-operative duration and maximum dose perioperative positive inotrope required bypass duration duration of aortic clamping intraoperative transfusions post operative creatinine - peak level post-operative urea peak level duration of post-operative oro-tracheal intubation niv required duration of hospitalization in cardiac intensive care unit duration of postoperative hospitalization

Eligibility criteria:
inclusion criteria: * are scheduled for elective cardiac surgery with extracorporeal circulation (bypass); * they give their consent for their data to be included in studies; exclusion criteria: * they have emergency surgery; * have had sars cov 2 infection more recently than 3 months;
effect of probiotics on gut-liver axis of alcoholic liver disease

Conditions: Alcoholic Liver Disease

Summary: background/aims: the investigators explored the therapeutic effects of probiotics in patients with ah. methods: between september 2010 and april 2012, the investigators conducted a 7-day, double-controlled, randomized, prospective clinical trial comparing the efficacy of probiotics in improving liver enzymes, lps, pro-inflammatory cytokines. ah was defined as an aspartate aminotransferase (ast)/alanine aminotransferase (alt) \> 2 and elevated ast (alt) level with an alcohol consumption history within 48 hours. patients were randomized to receive 7 days of probiotics (1500 mg/day) or placebo. the levels of liver enzymes, modified discriminant function (mdf), lps, and pro-inflammatory cytokines were checked at baseline and again after therapy.

background/aims: alcoholic hepatitis (ah) is one of the leading causes of liver diseases. gut-derived microbial lipopolysaccharide (lps) has been known as a central role in the pathogenesis of ah. some animal studies suggested an emerging role of probiotics in restoration of the bowel flora and improving liver enzymes. we explored the therapeutic effects of probiotics in patients with ah. methods: between september 2010 and april 2012, we conducted a 7-day, double-controlled, randomized, prospective clinical trial comparing the efficacy of probiotics in improving liver enzymes, lps, pro-inflammatory cytokines. ah was defined as an aspartate aminotransferase (ast)/alanine aminotransferase (alt) \> 2 and elevated ast (alt) level with an alcohol consumption history within 48 hours. patients were randomized to receive 7 days of probiotics (1500 mg/day) or placebo. the levels of liver enzymes, modified discriminant function (mdf), lps, and pro-inflammatory cytokines were checked at baseline and again after therapy.

Eligibility criteria:
inclusion criteria: * alcoholic hepatitis exclusion criteria: * cancer * viral hepatitis, other hepatitis

Keywords: hepatitis, alcohol
does the single use of intravenous dexamethasone enhance analgesic quality of pudendal analgesia in children undergoing hypospadias surgery?

Conditions: Pediatric Patients Undergoing Hypospadias Surgery

Summary: hypospadias is a congenital malformation that occurs in an embryological process, and occurs with an incidence of about 1/300 in male children. the caudal block was the most commonly performed method for pain control after hypospadias surgery, and showed very good analgesic effect in the immediate postoperative stage. however, the caudal block is a neuraxial block that has a limitation in its duration with single shot and shows complications and adverse effects. in recent studies, the pudendal nerve block has been suggested as an alternative method. in children undergoing hypospadias surgery, the pudendal nerve block showed a longer duration compared to the caudal block, decreased the use of analgesics within 24 hours after surgery, and showed higher parental satisfaction. on the other hand, there have been many studies to prolong the duration of the relatively short duration of caudal block. among them, dexamethasone administered intravenously is known to improve the duration of various regional blocks and reduce the administration of additional analgesics. the aim of this study is to verify whether a single administration of dexamethasone can enhance the effect of the pudendal nerve block in children 0.5-3 years of age undergoing hypospadias surgery.


Eligibility criteria:
inclusion criteria: 1. pediatric patients aged 6 months to 3 years who are planning to undergo hypospadias surgery 2. american society of anesthesiologists (asa) classification 1\~2 exclusion criteria: 1. patients who are having uncorrected heart deformity 2. patients who are having vertebrae deformity in which the pudendal nerve block cannot be performed 3. patients with blood coagulopathy 4. patients with diagnosed diabetes 5. patients with diagnosed adrenal disease 6. patients with fever above 37.5 degrees before surgery 7. patients currently taking steroids 8. patients contraindicated for dexamethasone administration
observation of therapy with micardis® (telmisartan) in patients with essential hypertension in hospitals

Conditions: Hypertension

Summary: the aim of the observational study was to supplement the data on efficacy, safety and tolerability of telmisartan under daily conditions in hospitals


Eligibility criteria:
inclusion criteria: * patients with diagnosis of essential hypertension * minimum age of 18 years exclusion criteria: * na
effect of the subconscious on mohs micrographic surgery

Conditions: Basal Cell Carcinoma; Squamous Cell Carcinoma

Summary: the goal of this study is to determine if relaxation therapy improves patient satisfaction with mohs micrographic surgery.

patients are instructed in relaxation techniques. the goal of this study is to determine how relaxation techniques affect the patient's mohs micrographic surgery experience.

Eligibility criteria:
inclusion criteria: * age 25 and older * subjects are undergoing micrographic mohs surgery for facial basal and squamous cell carcinoma. * the subjects are in good health. * the subjects have willingness and the ability to understand and provide informed consent for the use of their tissue and communicate with the investigator. exclusion criteria: * subjects who have wound healing problems. * subjects who have had prior mohs surgery. * subjects who are smokers. * subjects who are currently using anticoagulation therapy * subjects who have a history of bleeding disorders. * subjects who are unable to understand the protocol or to give informed consent * subjects with known mental illness or other psychological conditions, such as psychotic disorders, mood disorders, anxiety disorders, cognitive disorders, depression with psychotic features, dissociative disorders. * subjects who are taking medications that may affect healing such as prednisone, or any immunosuppressants. * subjects who are immunocompromised. * subjects who have diabetes mellitus or any other condition determined by the pi to affect healing.

Keywords: mohs surgery
effect a honey, spice-blended baked good has on salivary inflammation markers in adults: a pilot study

Conditions: Chronic Kidney Diseases; Overweight and Obesity

Summary: the purpose of this research is to determine the effect a spiced-infused baked good has on inflammatory biomarkers in adults who are overweight and/or who has chronic kidney disease. participants will be involved for 10 days in this research study.

the dietary intervention will for 10-days, in which participants will eat a baked good each day for a total of 10 days. this baked good contains honey and spices (cinnamon and turmeric). at the first day of the study, participants will provide a urine sample, saliva sample, be weighed, take a pregnancy test, complete a total of 3 surveys - dietary and spice intake and demographics. each survey will take no more than 10 minutes for a total of 30 minutes. at the end of the 10 days, participants will provide a saliva sample and complete 2 surveys - dietary and spice intake. each survey will take no more than 10 minutes for a total of 20 minutes. each day of the baked good intervention, participants will tick off the amount of baked good consumed (100%, 75%, 50%, 25%, 0%).

Eligibility criteria:
inclusion criteria: * adults who have been diagnosed with ckd and/or have a bmi \>24.9 * have no additional chronic diseases or gi disorders or gi disturbances * age 18 years or older * no food allergies or dietary restrictions * all with no contraindications to consuming anything by mouth as per their physician exclusion criteria: * no diagnosis of ckd or bmi \<24.9 * gi disorders, diagnosed with other chronic diseases and conditions, gastrointestinal disturbances * pregnant and/or lactating * under 18 years old * food allergies to wheat, almonds, or aversion to turmeric, cinnamon, and honey. -dietary restrictions as medically indicated * trouble chewing/swallowing as confirmed by physician
vital signs and pain during insertion of iud

Conditions: Contraception; Acute Pain

Summary: cross-sectional cohort study to evaluating pain and vital signs variations (blood pressure and radial pulse) during the placement of the intrauterine device.

the intrauterine device (iud), which is one of the most effective and safe contraceptives is still little used by women. it is considered a long action reversible contraception (larc). among the many reasons for this resistance stands the fear of pain, the complications that can occur during the insertion. objective: to evaluate the intensity of pain on outpatient insertion of iud. in addition to evaluating changes in vital signs and detect which are the factors associated with pain on outpatient insertion of iud. methods: cross sectional retrospective study of 285 procedures of outpatient insertion of iud. inclusion criteria were age older than 18 years, cervical cytology without abnormalities, classification for category 1 or 2 of the who eligibility criteria for iud. the criteria for non inclusion were patients with cardiac arrhythmias and gynecological disorders. the insertions of iud were conducted on an outpatient basis without the use of painkillers. evaluation of vital signs ( blood pressure and radial pulse) was performed pre and five minutes after the procedure. the pain assessment was performed using the scale visual analog (vas), five minutes after the procedure.correlations of the pain's score with clinical factors as age, parity, bmi, hysterometry, previous vaginal delivery were also performed.

Eligibility criteria:
inclusion criteria: * age older than 18 years * cytology without abnormalities * classification for category 1 or 2 of the who eligibility criteria for iud / ius. exclusion criteria: * patients with cardiac arrhythmias * gynecological disorders

Keywords: contraception contraception behavior intra uterine device intra uterine system iud ius acute pain
prevention of fascial dehiscence with prophylactic onlay mesh in emergency laparotomies

Conditions: Surgical Wound Dehiscence

Summary: facial dehiscence elicit high morbidity and mortality. this complication may arise in more than 8.5% of high-risk patients. addressing risk factors and optimizing surgical technique are guarded as mainstay measures for prevention, but their efficacy is questionable. the aim of this study is to analyze the influence of using a polypropylene onlay prophylactic mesh on the incidence of fascial dehiscence in emergency surgery and associated complications.

fascial dehiscence is associated with high morbidity and mortality rates. it occurs in more than 8.5% of high-risk patients. current preventive measures described are control of risk factors and optimization of surgical technique. despite that, the incidence of such complication remained stable in the last decades, highlighting the low efficacy of such measures. polypropilene onlay mesh has been used to avoid incisional hernias in selected elective patients, and could be useful in the prevention of fascial dehiscence. in emergency situations, especially in contaminated and infected surgical procedures, safety and efficacy of mesh is controversial. in this study the investigators aimed to evaluate the influence of polypropilene prophylactic onlay mesh on the incidence of fascial dehiscence in high-risk patients undergoing midline emergency laparotomy. as secondary outcome, the associated morbidity, including surgical site occurence, will be analyzed. the study design will be a randomized controlled trial.

Eligibility criteria:
inclusion criteria: * emergency laparotomy by midline incision * high risk for abdominal wound dehiscence: risk index\*\* ≥ 4,0 or ≥ 2,2 in combination with at least one of the following: smoking, obesity, malnutrition or malignant neoplasia. * risk index is the sum of values associated with high-risk characteristics, based in the risk score for abdominal wall dehiscence published by van ramshorst et. al. in world journal of surgery, 2010 (rotterdam risk model): age category (in years) * 40-49: 0.4 * 50-59: 0.9 * 60-69: 0.9 * ≥70: 1.1 male gender: 0.7 chronic pulmonary disease: 0.7 ascites: 1.5 jaundice: 0.5 anemia: 0.7 emergency surgery: 0.6 type of surgery: * gallbladder/bile duct 0.7 * esophagus 1.5 * gastroduodenum 1.4 * small bowel 0.9 * large bowel 1.4 * vascular 1.3 exclusion criteria: * non-midline incisions or midline laparotomy measuring less than 1/4 the distance between the xyphoid and the pubis, including laparoscopic surgery. * diagnosis of incisional hernia or presence of previous mesh on site. * midline laparotomy performed in less than 30 days. * pregnancy * severe trauma with hemodynamic instability * need for open abdomen or relaxing incisions * need for re-laparotomy during the first 30 postoperative days, except cases in which an abdominal wall dehiscence was diagnosed. * death during the first 30 postoperative days, except cases in which an abdominal wall dehiscence was diagnosed before the event.

Keywords: laparotomy emergency surgery abdominal wound dehiscence prophylactic mesh