Kornimate/medical-research-clean huggingface dataset:
early care after discharge of hf patients

Conditions: Heart Failure

Summary: after decompensated heart failure, a number of patients have high risk of early rehospitalization as well as death. specialized medical management for a short period but very early after discharge could be critical for optimizing care and improving early outcome. this study aims to compare such early intensive medical management with usual care in high-risk patients after discharge.

at discharge, high-risk hf patients are selected and randomized in two groups: * control group: usual disease management according to guidelines and including first medical consultation and biological test within the 4-week time following discharge. * active group: consultations with hf specialist including biological test at weeks 1, 2 and 4 are planned in addition to usual management.

Eligibility criteria:
inclusion criteria: * 18 years or more * consent signed * acute or decompensated heart failure with one or more of following criteria:: * discharge bnp \> 350 pg/ml or ntprobnp \> 2200 pg/ml * discharge serum creatinine ≥ 180µm * discharge systolic blood pressure ≤ 110mmhg * previous hospitalisation for acute heart failure \< 6 months exclusion criteria: * acute coronary syndrome, * acute myocarditis, * isolated right hf, * transient hf, * planned cardiac surgery, * high risk of short-term non-cardiac death, * planned management within rehabilitation center/hf clinic at discharge

Keywords: heart failure disease management program
serratus anterior plane block, ultrasound vs anatomical landmark guided.

Conditions: Serratus Anterior Plane Block

Summary: this prospective, double-blinded randomized controlled trial aims to compare the efficacy of the serratus anterior plane block (sapb) ultrasound guided versus anatomical landmark guided for gynecomastia surgery. and to detect if the anatomical landmark technique is inferior or not to the ultrasound guided technique. we hypothesize that anatomical landmark guided sapb is not inferior to ultrasound guided sapb.

gynecomastia means enlarged male breast. minimally invasive liposuction and surgical intervention are possible remedies for such cases. postoperative pain can be controlled by opioids or regional blocks like serratus anterior plane block. ultrasound guided blocks are associated with high success rate; however, anatomical landmark guided blocks may give similar results. our hypothesis was that landmark guided serratus anterior plane block would be non-inferior to ultrasound plane block. subjects presenting for gynecomastia surgery will receive ultrasound guided block in one side (us group) and landmark guided block in the other side (lm group) with the same volume (25) ml and concentration (0.25 %) of bupivacaine. the primary outcome will be visual analogue score. secondary outcomes include patient satisfaction and incidence of complications like pneumothorax. it will be carried out over 40 male patients, aged from (18 - 60) year-old, with asa i or ii classes who will undergo elective gynecomastia surgery. patient with bmi ≥ 35, history of previous chest surgery, drug abuse, allergy to local anesthetics, psychiatric problems or patient refusal will be excluded from participation

Eligibility criteria:
inclusion criteria: * male patients, aged from (18 - 60) year-old, with asa i or ii classes who will undergo elective gynecomastia surgery exclusion criteria: * patient with bmi ≥ 35, history of previous chest surgery, drug abuse, allergy to local anesthetics, psychiatric problems or patient refusal will be excluded from participation.

Keywords: serratus anterior block gynecomastia anatomical landmark
randomized study of pregabalin for pain reduction in patients with rest pain and lower limb ischemia

Conditions: Critical Limb Ischemia; Arterial Occlusive Disease; Pain; Ischemia

Summary: the hypothesis behind the trial is the concept that pregabalin is effective in reducing pain at rest in lower limb ischemia, and the study evaluates active treatment or placebo added to the regular pain regimens for these patients.

critical limb ischemia (cli) is the end stage of peripheral arterial disease in the legs and is a consequence of deteriorating blood flow supply to the lower limbs. the clinical definition of cli includes peripheral arterial disease and recurrent rest pain for at least two weeks with or without ulcers or gangrene. in patients not amenable to revascularization - around 35% - amputation or palliative conservative care remains the options. pain control is a vital part of any treatment of these patients. besides being the principal conservative treatment, also patients undergoing revascularization experience severe pain both during work up and after surgery. experimental data indicate that pain in cli is multimodal and to a large extent neuropathic. still, current therapy is mostly based on opioid treatment, which clinically often affects pain moderately. the doses required to influence pain are also associated to severe side effects. accordingly, there is a great need to improve pain control in the rather common disease cli. comparisons: pregabalin up to 600mg daily in addition to regular pain regimens compared to placebo and regular pain regimens.

Eligibility criteria:
inclusion criteria: * rest pain, gangrene or ulcers located below the patella for a duration of at least two weeks (either one of these criteria are sufficient). * one measurement of: ankle blood pressure(abp) \<70 mm hg, an toe blood pressure(tbp) \<50, or a tcpo2\<45 mm hg, or an ankle/brachial pressure index \<0.7 (either one of these criteria are sufficient). * informed consent obtained exclusion criteria: * age \< 55 years * women of childbearing potential * patients already medicating with pregabalin or gabapentin * creatinine clearance \<30ml/min * amputation necessary within two weeks * revascularization necessary within two weeks (open vascular surgery or endovascular) * a medical history of clear dizziness * nyha class iv heart failure * known hypotension, or having a systolic arm blood pressure \<120 mm hg (two consecutive measurements with the patient lying supine) * simultaneous or previous (within 30 days prior to study entry participation in a clinical study using experimental drugs or devices * mental condition making the subject unable to understand the concepts and risk of the study * known allergies against pregabalin

Keywords: critical limb ischemia pain control rest pain in lower limb ischemia pregabalin randomized controlled study ischemia, therapy lower extremity, blood supply pain, prevention & control pain, therapy
acute coronary syndrome sri lanka audit project

Conditions: Acute Coronary Syndrome; Unstable Angina; Non ST Elevation Myocardial Infarction; ST Elevation Myocardial Infarction

Summary: acsslap is the first island wide audit project in sri lanka on acs.

acute coronary syndrome is a leading cause of morbidity and mortality in the world. even though up-to-date epidemiological data are not available, as per the institutional level experiences this is not differ much in the local settings. having a free health care system, government of sri lanka has to allocate billions of funds and resources from the annual budget for the maintenance of health care system. being a developing nation this is a considerable burden to the economy of the country. however, prioritization during resource allocation will prevent mal-distribution of limited resources. health care system in sri lanka should deliver free as well as quality care to the nation. however, lack of updated guidelines in sri lanka for the management for acute coronary syndrome (acs) is a drawback. american college of cardiology (acc) and the european heart association (eha) have developed evidence based and most up to date guidelines to standardize clinical practices in the management of acs. it is recommended to adhere to local or international guidelines to deliver optimal and quality care to acs patients. in sri lanka, no audits have been conducted in the health sector in relation to patient management practices in the past. even though institutional level audits have been carried out time to time for the purpose of allocating medicines and other diagnostic resources, island wide large scale audits have not been carried out. therefore, conducting an audit on health recourse allocation and patient management clinical practices has become a high priority. investigators selected acs as the most important clinical discipline to conduct an audit based on the institutional level data. this audit is included as a well-designed set of clinical criteria derived from the myocardial ischemia national audit project (minap) in uk, snapshot acs study in australia and new zealand, american college of cardiology and european health association guidelines. these criteria have been extensively reviewed by a panel of cardiologists and physicians to customize it according to the local requirements. this project will be coordinated by the department of pharmacology, faculty of medicine, university of colombo in collaboration with the sri lanka heart association, ceylon college of physicians and will be carried out through the quality and safety unit of the ministry of health, sri lanka. funding is sought from the ministry of health

Eligibility criteria:
inclusion criteria: -patients who are diagnosed with acute coronary syndrome before/after admission to the hospital. exclusion criteria: * patient who refuse to give consent * patients who are less than 18 years of age * patients whose diagnosis later changed to another diagnosis * patient who are enrolled in any other study.
fecal microbiota transplantation for ulcerative colitis

Conditions: Ulcerative Colitis; Intestinal Bacteria Flora Disturbance; Fecal Microbiota Transplantation

Summary: ulcerative colitis is a common digestive system disease, the incidence is increasing in recent years.it is reported that the occurrence and development of ulcerative colitis is closely related to imbalance of intestinal flora .moreover,intestinal mucosal immunity may be related to intestinal flora. fecal microbiota transplantation as a new technology to rebuild intestinal flora has been used for several disease，but the efficacy of ulcerative colitis by fecal microbiota transplantation needs to be further explored.

patients who meet the inclusion crit ulcerative colitisby will be separated into two parts depending on accepation or refuse of fecal microbiota transplantation.blood specimen from patients will be collected to analysis intestinal mucosal immunity.

Eligibility criteria:
inclusion criteria: 1. subjects voluntarily participate in the trial and sign informed consent; 2. sex is not limited,ranging from 18 to 75 years old; 3. meet the diagnostic criteria for ulcerative colitis in patients; 4. be able to communicate well with the researchers and follow the verification requirements. exclusion criteria: 1. pregnancy or people who are not to give informed consent; 2. use of major immunosuppressive agents, including the use of large doses of glucocorticoids, calcineurin inhibitors, mtor inhibitors, depleted lymphocyte biological agents, anti-tumor necrosis factor and other conditions; chemotherapy of antineoplastic drugs; 3. decompensated cirrhosis, progressive aids and hiv infectionor other serious immunodeficiency disease; 4. use of antibiotics and probiotics within six weeks; 5. with severe complications such as local stenosis, intestinal obstruction, intestinal perforation, toxic colon expansion, colon cancer, rectal cancer patients; 6. combined with cardiovascular, cerebrovascular, liver, kidney and hematopoietic system and other serious primary disease, mental illness.

Keywords: ulcerative colitis intestinal bacteria flora disturbance fecal microbiota transplantation intestinal mucosal immunity
intensive insulin for severe/moderate hypertriglyceridemia pancreatitis.

Conditions: Acute Pancreatitis; Hypertriglyceridemia

Summary: the aim of this study is to investigate the therapeutic efficacy of intensive insulin in patients with hypertriglyceridemia induced moderate/severe acute pancreatitis on the course and outcome of disease.

hypertriglyceridemia-induced acute pancreatitis occurs in about 1-4% of the cases. it is the third leading cause of pancreatitis after biliary and alcoholic etiology. hypertriglyceridemia can be caused by primary causes, lipid metabolism disorders and secondary causes. hyperlipidemic pancreatitis can be provoked when triglyceride levels (tgl) exceed 11.3 mmol/l (1,000 mg/dl). except for standard symptomatic treatment, plasmapheresis and insulin have been performed to rapidly reduce tgl and chylomicron levels in the blood.the therapeutic efficacy of intensive insulin, standard insulin, and plasmapheresis in patients with hypertriglyceridemia induced moderate/severe acute pancreatitis on the course and outcome of disease.after acceptance patients will be randomized by random envelope in the 3 groups: group a: intensive insulin (glycemic control 4.4-6.1mmol/l), group b: standard insulin (glycemic control 7.8-10.0 mmol/l), and group c: plasmapheresis.

Eligibility criteria:
inclusion criteria: * diagnosis of hypertriglyceridemia induced acute pancreatitis (ap): typical pain increase in serum lipase or amylase with serum tg\> 1,000 mg/dl (11.3mmol/l) or serum was milky with serum tg\> 500 mg/dl(5.65 mmol/l) * onset of abdominal pain within \<=48h before admission * moderate severe or severe acute pancreatitis according to atlanta criteria * except for other ap causes, such as cholelithiasis, alcohol, drugs and so on exclusion criteria: * other etiologies other than hyperlipidemia leading to ap * at the same time combined with other etiologies of ap * appear difficult to reverse respiratory failure, severe systemic circulatory failure, coma and other the endangered symptoms, patients expected to die within 24hours * disseminated intravascular coagulation, or patients with severe active bleeding * without informed consent, the patient refused to plasma replacement, and other circumstances may bring significant bias.

Keywords: hyperlipidaemic pancreatitis plasmapheresis insulin
predictors for bronchoalveolar lavage (bal) recovery rate derived from quantified computed tomography (qct)

Conditions: Interstitial Lung Disease; Pneumonia; Malignant Neoplasm

Summary: bronchoalveolar lavage (bal) is an important diagnostic method. the percentage of fluid extracted after instillation (recovery rate) is crucial for following diagnostic tests. the investigators aimed to compare novel quantified airway parameters from pre-interventional lung computed tomography (ct) with recovery rates to find possible predictive markers.


Eligibility criteria:
inclusion criteria: * retrospective analysis of all patients undergoing bal and complete documentation exclusion criteria: * incomplete documentation
effect of casein phosphopeptide amorphous calcium phosphate fluoride varnish on remineralization of white spot lesion in primary teeth

Conditions: White Spot Lesion

Summary: the aim of this study is to evaluate the effectiveness of casein phosphopeptide-amorphous calcium phosphate fluoride varnish (cpp-acp fv) in comparison to fluoride varnish (fv) as a remineralizing agent for white spot lesions in primary teeth (wsls).

the study is a two parallel arms double blinded randomized controlled clinical trial. a total of 180 wsl in primary teeth in chikdren aged 2-5 y and satisfying the inclusion criteria were selected. patients will be randomly allocated into 2 groups allocated to two varnishes: study group: cpp-acp fv (mi varnish), control group fv (duraphat). both fluoride varnishes applications are applied with identical intensive protocols every 2 weeks for 6 weeks. the application of each varnish will be according to manufacturer's instructions. the operator is not blinded to treatment type. only the participants and statistician are blinded to treatment groups. the whole sample (n=180) will be followed up at 6 weeks and at 18 and 30 weeks for visio-tactile assessment and diagnodent measurements

Eligibility criteria:
inclusion criteria: * healthy children with no systemic diseases. * high caries risk children with the presence of at least one visible active wsl in primary teeth with icdas ii score of 1,2 or 3 * completion of a parental consent to participate in the study. exclusion criteria: * selected tooth with cavitated lesion. * selected tooth with enamel defects. * participants allergic to milk products.

Keywords: fluoride varnish casein mi varnish
black pooling project

Conditions: Cardiovascular Diseases; Coronary Disease; Heart Diseases

Summary: to conduct a person-level meta-analysis by pooling 9 united states studies with both black and white cohorts.

background: over the last three decades a sustained and marked decline in death rates from coronary heart disease (chd) has occurred for all major demographic groups of the us population. recently, however, the decline has proceeded less rapidly in blacks than in whites, and in women than men. these trends have focused further attention on possible heterogeneity in the risk factor patterns among the demographic sub-groups. as is well recognized, the knowledge on chd risk factors and statistical models used to predict personal risk of chd have been based on studies among white populations. in some epidemiological studies with samples from black populations, large variation in the effect of specific factors has been noted. given the small sample of blacks under investigation, however, low statistical power exists for many of the black-white comparisons. the fundamental obstacle to progress in this area remains the absence of the cohorts of sufficient size that is representative of all four major groups. hence, a strong rationale exists to undertake a "pooling project" to clarify a set of important unanswered questions in cardiovascular disease epidemiology. design narrative: person-level meta-analysis will be conducted by pooling 9 large united states epidemiologic studies with both black and white samples: the first national health and nutrition examination survey (nhanes i) epidemiological follow-up study, the nhanes ii mortality follow-up study, the charleston heart study, the evans county heart study, the chicago heart association detection project in industry, the atherosclerosis risk in communities study (aric), the follow-up study of the screenees for the multiple risk factors intervention trial (mrfit), the follow-up study of the participants from the mrfit, and the follow-up study of the participants from the hypertension detection and follow-up program (hdfp). black-white comparison will be performed on the chd incidence and mortality, exposure-outcome relationship, patterns of co-morbidity (or coexistence of risk factors) and population attributable risk. multivariate risk functions will also be examined in blacks and whites in the three contexts: ordering risk, magnitude of relative risks, and estimation of absolute risk.

Eligibility criteria:
no eligibility criteria
cardiac injury in patients with influenza

Conditions: Influenza, Human; Myocardial Injury

Summary: this study investigate the prevalence of elevated biomarkers of cardiac injury in patients with suspected influenza infection and the prognostic implication on the composite endpoint of death of any cause, hospitalization due to myocardial infarction, unstable angina, heart failure and stroke.

the relationship between influenza and cardiovascular events was described in an early study of influenza epidemics from 1915 to 1929 including the 1918-1920 pandemic. retrospective studies have shown increased risk for acute myocardial infarction (ami) during the first week following an infection with influenza. biochemical markers of cardiac injury such as high sensitive cardiac troponins may be increased during infection with influenza. increased levels of cardiac troponins are associated with adverse outcome in many different populations.

Eligibility criteria:
inclusion criteria: * adult patients (\>18 years) presenting with influenza-like illness. * written informed consent. exclusion criteria: * inability to provide informed consent. * age \<18 years. * symptoms indicating an acute coronary syndrome, acute heart failure, rapid atrial fibrillation or acute stroke.

Keywords: cardiac troponin
arnuity® ellipta® drug use investigation

Conditions: Asthma

Summary: the aim of this post-marketing investigation is to collect and assess the information about safety and effectiveness of arnuity® ellipta® (hereinafter referred to as "arnuity") in daily clinical practice. the investigation will include subjects with a diagnosis of asthma bronchial who are naïve to arnuity. the investigator will monitor the information about safety and effectiveness of arnuity for one year from the start date of arnuity administration and pneumonia will be considered as the priority investigation matter. 300 subjects, from approximately 150 medical institutions, will be included in this analysis. arnuity ellipta is the registered trademark of glaxosmithkline (gsk) group of companies.


Eligibility criteria:
inclusion criteria: * the investigation will include subjects with a diagnosis of asthma bronchial, for which arnuity is indicated and who are naïve to arnuity. exclusion criteria: * not applicable

Keywords: drug use investigation gw685698 asthma post-marketing surveillance arnuity ellipta
prosthetic motility and complications in pegged versus unpegged hydroxyapatite orbital implants

Conditions: Anophthalmos; Orbital Implants

Summary: pegging the hydroxyapatite for increasing prosthetic motility sometimes leads to some complications for the patient. these complications ranging from discharge, granuloma formation, exposure, implant infection to socket discomfort and etc. we are going to compare prosthetic motility, objectively and subjectively (patients satisfaction) before and after pegging the hydroxy- apatite, and evaluate the complications after pegging.


Eligibility criteria:
inclusion criteria: * orbital hydroxyapatite implants exclusion criteria: * history of systemic disease * history of radio therapy * secondary hydroxapatite implant * complications lead to re-surgery

Keywords: hydroxyapatite peg prosthetic motility orbital implant