Kornimate/medical-research-clean huggingface dataset:
pde5 inhibition for obesity-related cardiometabolic dysfunction

Conditions: Healthy; Obese

Summary: obesity and its adverse cardiometabolic consequences are major public health problems. several features of obesity contribute to the associated cardiovascular risk and are potential targets for intervention. these include insulin resistance and beta cell dysfunction, reduced metabolic rate, and impaired aerobic capacity.the purpose of this study is to examine if the phosphodiesterase type 5a inhibitor tadalafil improves cardiometabolic health in individuals who are obese and insulin resistant.

obesity is a risk factor for nearly all cardiovascular (cv) disease including coronary artery disease, hypertension, and heart failure. increased cv risk in obese individuals appears to depend largely on the degree of metabolic dysregulation and metabolic risk factors (glucose intolerance, dyslipidemia, etc.). notably, interventions that improve insulin sensitivity and cardiorespiratory fitness can reduce cv risk in obese individuals, even in the absence of weight loss. the cyclic guanylate monophosphate pathway (cgmp) is involved in energy homeostasis and systemic metabolism. multiple lines of evidence suggest that increasing cgmp activity is beneficial from a metabolic standpoint. tadalafil is a clinically-available drug that inhibits the enzyme that breaks down cgmp. the study investigators hypothesize that chronic pde5 inhibition in obese, insulin-resistant adults will improve cardiometabolic health. aim 1: to examine the effect of pde5 inhibition on energy expenditure. aim 2: to examine the effect of pde5 inhibition on insulin sensitivity and secretion. aim 3: to examine the effect of pde5 inhibition on cgmp tone and circulating mediators of cardiometabolic risk.

Eligibility criteria:
inclusion criteria: * adults (ages 21-50) * obesity (bmi ≥ 30 kg/m2) * prediabetes on oral glucose tolerance test. exclusion criteria: * age \ 50 * bmi \< 30 kg/m2 * systolic blood pressure (sbp) \ 150 mmhg * current anti-hypertensive medication use, including diuretics * current use of organic nitrates * current use of pde-5 inhibitors (sildenafil, tadalafil, vardenafil) * history of reaction to pde-5 inhibitors * known hiv infection * use of medications that strongly alter cyp3a4 activity * history of myocardial infarction, angina, uncontrolled cardiac arrhythmia, stroke, transient ischemic attack, or seizure * known non-arteritic ischemic optic retinopathy (naior) * history of hearing loss * estimated glomerular filtration rate (egfr) \< 60 ml/min/1.73 m2 by the modified diet in renal disease (mdrd) equation * hepatic transaminase (ast and alt) levels greater than three times the upper limit of normal * known pregnancy or breastfeeding or those unwilling to avoid pregnancy during the course of the study * history of priapism * use in excess of four alcoholic drinks daily * history of diabetes mellitus or use of anti-diabetic medications * known anemia (men, hct \< 38% and women, hct \<36%) * menopause * inability to exercise on a bicycle * weight \> 300 pounds
photoplethysmography (ppg) algorithm with smartwatch in evaluation of atrial fibrillation burden

Conditions: Atrial Fibrillation (AF)

Summary: the purpose of this study is to evaluate the monitoring effect of a smart electrocardiogram watch based on the ppg algorithm on atrial fibrillation burden.


Eligibility criteria:
inclusion criteria: 1. atrial fibrillation patients diagnosed by electrocardiogram 2. willing to use long-range electrocardiogram monitoring equipment exclusion criteria: 1.patients who are allergic to electronic devices or unable to wear watches

Keywords: atrial fibrillation burden photoplethysmography wearable devices.
phenotyping mechanistic pathways for adverse health outcomes in sleep apnea

Conditions: Sleep Apnea

Summary: obstructive sleep apnea (osa) is a highly prevalent disorder with adverse neurocognitive and cardio-metabolic outcomes. continuous positive airway pressure (cpap) is the gold standard therapeutic option to treat airway obstructions during sleep and thus, prevent its adverse cardiovascular and neurocognitive outcomes. previous clinical trials, however, have largely failed to show a consistent impact of cpap on these health outcomes. one of the main limitations of these trials may be the inadequate characterization of osa and its acute physiological consequences. by characterizing osa based on the "apnea-hypopnea index (ahi)", there is a potential risk of negative results. in this trial, the investigators intend to tackle this issue, by better characterization of osa-related physiological consequences during sleep using physiologically driven metrics to capture the burden of osa-related hypoxemia ("hypoxic burden"), autonomic response ("heart rate burden"), and sleep fragmentation ("arousal burden").


Eligibility criteria:
inclusion criteria: * adults aged 21-80 years. * participants with a previous diagnosis of moderate to severe obstructive sleep will be eligible to enroll and attend the baseline study. patients with a total apnea-hypopnea index greater than 15 events/hr on the baseline study will be eligible for further participation. exclusion criteria: * current treatment for obstructive sleep apnea (including cpap, oral appliances, supplemental oxygen). patients must be untreated prior to the baseline visit. * use of medications that might depress respiration (including opioids, barbiturates, benzodiazepines, and z drugs, including zolpidem, zopiclone, eszopiclone, and zaleplon). * active use of non-prescription opioids (e.g., cocaine, methamphetamine) * uncontrolled medical problem or major organ system disease, which, in the opinion of the investigators (pi and co-is), would interfere with the evaluation of the subject (e.g., uncontrolled hypertension, unstable coronary heart disease, etc.). * history of congestive heart failure, renal insufficiency, systemic neurological condition that could affect respiration. * sleep disordered breathing or respiratory disorders other than obstructive sleep apnea: * central sleep apnea (\>50% of respiratory events scored as central), * chronic hypoventilation/hypoxemia (awake sao2 \< 92% by oximetry) due to chronic obstructive pulmonary disease or other respiratory conditions. * other sleep disorders: periodic limb movements (periodic limb movement arousal index \> 10/hr), narcolepsy, or parasomnias. * patients unable or unwilling to use cpap. * insomnia or insufficient sleep (self-reported inability to sleep \>6 hrs night). * pregnancy (women)

Keywords: sleep apnea hypoxic burden arousal intensity post-event tachycardia positive airway pressure apnea hypopnea index
avonex pen satisfaction and patients experience clinical trial

Conditions: Multiple Sclerosis

Summary: this is an open-label, multicenter, survey-based study to determine subject satisfaction with using the single-use autoinjector for the delivery of avonex ps. enrollment will consist of 200 subjects in a single cohort who have been prescribed avonex pen in accord with its product monograph. all subjects must be experienced avonex ps users (i.e., using it for at least 12 weeks without any support person to help with the injections administered in the vastus lateralis) and enrolled in ms alliancetm program (hereinafter, ms alliance). the clinic nurse investigator will instruct the patient on the correct method of using avonex pen and the first injection with autoinjector, using the subject's own supply, will be completed in the clinic, with the clinic nurse investigator present. all further injections of avonex pen will be self-administered at home. the subjects will complete the first set of questionnaires, including subject satisfaction questionnaire, ease of use grading scale and the autoinjector instructions grading scale, within 10 minutes after the first injection at the clinic, and will be given another set of questionnaires to be completed at home within 10 minutes following the last study injection 2 months later, provided the subjects still continue to self-administer their avonex pen. the first set of questionnaires will be left with the clinic nurse investigator to be sent to the cro by fax or e-mail, while the second set will need to be mailed to the cro by study subjects using the provided self-addressed, postage-paid envelope.


Eligibility criteria:
inclusion criteria: * must give written informed consent. if required by local law, candidates must also authorize the release and use of protected health information (phi) * must be 18 to 65 years old, inclusive, at the time of informed consent * must be on avonex ps for at least 12 consecutive weeks * must be self-injecting avonex ps at the vastus lateralis site without any help, with or without use of personal injector * must be prescribed avonex pen as per local labeling (product monograph) and enrolled in ms alliance * must be able to physically demonstrate use of the autoinjector device and be able to self-administer the injections * must be able to understand and comply with the protocol exclusion criteria: * female subjects considering becoming pregnant while in the study or who are currently pregnant or breast-feeding * other unspecified reasons that, in the opinion of the investigator or sponsor, make the subject unsuitable for enrollment

Keywords: patient satisfaction multiple sclerosis autoinjector avonex
intravenous exenatide in patients with acute brain injury

Conditions: Brain Injuries

Summary: the purpose of this study is to assess the feasibility of exenatide infusion for the treatment of high blood sugars following acute brain injury.


Eligibility criteria:
inclusion criteria: * adults ≥18 years * acute brain injury resulting in admission to the neurosciences intensive care unit for an anticipated length of stay \>48 hours * two blood glucose concentrations \> 150 mg/dl and ≤300 mg/dl * informed consent obtained via proxy exclusion criteria: * pregnant (verified by urine or serum pregnancy test within 24 hours of initiation of infusion) or lactating females * type 1 diabetes mellitus * history of pancreatitis or risk factors for acute pancreatitis (i.e ethanol abuse, gall stones) * renal insufficiency defined as creatinine clearance (crcl) \< 45 ml/min * known history of gastroparesis * history of surgery on stomach, esophagus or duodenum * diabetic ketoacidosis or hyperosmolar hyperglycemic nonketotic syndrome * concurrent steroid use or planned post-operative steroid use * history of organ transplantation * brain death or suspected imminent brain death within the next 72 hours * refractory intracranial hypertension defined as intracranial pressure (icp) \> 25 mmhg for greater than 15 minutes and refractory to medical intervention * currently enrolled in another investigational drug or device protocol * insulin infusion within 3 hours of study drug administration or confirmed long acting insulin or sulfonylurea use prior to admission within 24 hours of study drug administration * known allergy to exenatide
effect of repeated removal and re-placement of abutments around dental implants

Conditions: Peri-implant Mucositis

Summary: repeated removal and re-placement of healing and prosthetic abutments result in frequent injuries to the soft tissues. the purpose was to evaluate the effect of repeated removal and re-placement of laser microgrooved and smooth/machined healing and prosthetic abutments during restorative stages, and 1 year after functional loading, on proinflammatory cytokine levels around dental implants.

twenty-four patients each received 2 one-stage implants in a split mouth design on the same jaw. in each patient one healing and prosthetic abutments with a laser microgrooved surface (lms group) and one healing and prosthetic abutments with smooth/machined surface (s/ms group) were used. four months following implant placement \[baseline (bsl)\], the healing abutments were disconnnected and reconnected three times to carry out the impression procedures and metal framework try-in. four weeks later (t0), definitive prosthetic abutments were installated with screw retained crowns. samples for immunological analyses were taken from the sulcus around each implant at bsl, t0, and 1 year after functional loading (t1). peri-implant crevicular fluid samples were analyzed for interleukin-1beta (il-1β), interleukin-6 (il-6) and tumor necrosis factor (tnf)-α levels using the elisa kit.

Eligibility criteria:
inclusion criteria: * 18 years or older, in good general health, and with sufficient amount of bone available to place a standard implant exclusion criteria: * natural teeth adjacent to surgical area affected by untreated periodontal or endodontic infections, peri-implant bone defects requiring bone augmentation, absence of opposing occlusion,

Keywords: peri-implant mucositis
neonatal admission in assuit university children hospital

Conditions: Neonatal Disease

Summary: there are many causes of admission of neonates in neonatal intensive care unit.so knowing such causes and their outcomes will give us knowledge about different risk factors of each disease and the prognosis of each cause.

the rapid decline in neonatal mortality during the past 4 decades has been attributed to improvements in neonatal intensive care. this decline was attributable to improved condition of the infants on nicu(neonatal intensive care unit) admission (improved birth weight, higher apgar scores, and better physiologic ability). there are multiple risk factors related to admission of newborns at nicu as low birth weight , neonatal sepsis , hypothermia , hypoglycemia , respiratory distress and other factors. these risk factors are also considered as causes of death beside prematurity and congenital malformations. one of the most important risk factors for admission and is considered as a major cause of death is premature infants. neonatal intensive care has become a cornerstone for treatment of premature infants worldwide. another group is low birth weight (lbw) infants. lbw babies face increased risk of a myriad of physical and developmental problems. before the era of neonatal intensive care units, few vlbw infants survived. today, babies who weigh as little as a pound and developed in the uterus for as early as 26 weeks have been known to survive. lbw babies need high cost of intensive neonatal care and adequate nursing coverage. neonatal respiratory morbidity in term infants is another cause of admission and death in neonates and is multifactorial in aetiology. neonatal sepsis as well is one of the most common reasons for admission to neonatal units in developing countries. it is also a major cause of mortality in both developed and developing countries. hypoglycaemia also plays an important role as it accounts for approximately one-tenth of term admissions to neonatal units can cause long-term neurodevelopmental impairment and is associated with the significant burden to the affected infants, families and the health system. knowing the disease patterns and causes in the neonatology unit and the disease-wise outcome can inform the required efforts to reduce morbidity and mortality. thus, in this study we will assess the causes and risk factors for neonatal admission at nicu of assuit university children hospital (auch) and the outcome of them.

Eligibility criteria:
inclusion criteria: * all neonates delivered in assuit university hospital and admitted at nicu of assuit university children hospital. exclusion criteria: * patients delivered outside assuit university hospital. * patients with missing diagnosis or died before reaching diagnosis. * patients with missing clinical outcomes. * patients admitted for observation and discharged at the same day of admission.

Keywords: neonatal morbidity
mobile phone in hypertension management

Conditions: Hypertension

Summary: the purpose of this study is to examine if a mobile phone-based self-report system, using the patient's own mobile phone, will improve adherence to treatment of hypertension and lead to personal involvement of the patient in the treatment.


Eligibility criteria:
inclusion criteria: * diagnosis of arterial hypertension * prescribed antihypertensive treatment * alert and oriented * swedish-speaking * access to a functioning cell phone * agreeing to regular controls at the national prescribed drug register of drugs

Keywords: self-report self-management hypertension adherence cell phone drug treatment medical adherence
ketone production with acute caffeine intake

Conditions: Healthy Adults

Summary: evaluate the effect of a caffeine supplement on the stimulation of lipolysis and the production of ketones in healthy adults (n=10).

the aim of the study is to evaluate the effect of a caffeine supplement on the stimulation of lipolysis and the production of ketones in healthy adults (n=10). two different doses of caffeine (2.5 mg/kg of bw and 5 mg/kg of bw) are compared. all the participants have to follow three sequential visits of four hours each, which included a breakfast with one of the doses (2.5 or 5 mg/kg) of the caffeine supplement or without any supplement (baseline) and repeated blood sampling in order to evaluate ketone concentrations.

Eligibility criteria:
inclusion criteria: * healthy adults * 18 years old and over exclusion criteria: * drinking more than 300 mg of caffeine per day * diabetes or prediabetes * abnormal liver and kidney function * uncontrolled dyslipidemia, blood pressure * use of drugs known to influence the metabolism of lipids and carbohydrates (steroid, beta-blockers, diuretics, insulin sensitizer, etc.) * severe inflammation or infection * pregnancy * smoking

Keywords: ketones glucose caffeine
gastroparesis registry

Conditions: Gastroparesis

Summary: the gastroparesis registry (gpr) is an observational study to clarify the epidemiology, natural history, clinical course, and other outcomes of gastroparesis.

the gastroparesis registry (gpr) is an observational study to clarify the epidemiology, natural history, clinical course, and other outcomes of gastroparesis. the gastroparesis registry will also provide a resource to inform the development of clinical trials and ancillary studies of the epidemiology, etiology, pathophysiology, and impact of gastroparesis.

Eligibility criteria:
inclusion criteria: * symptoms of gastroparesis of at least 12 weeks duration (do not have to be contiguous) with varying degrees of nausea, vomiting, abdominal pain, early satiety, post-prandial fullness, * completion of a 4-hour scintigraphic low fat egg beaters gastric emptying study * patients with either or both abnormal 2 hour (\>60% retention) and 4 hour (\>10% retention) gastric emptying will be enrolled and classified as definite gastroparesis (gp) * patients with normal gastric emptying, but with symptoms of gastroparesis may be enrolled and classified as possible gastroparesis or gastroparesis-like with normal gastric emptying (glnge) * age at least 18 years at initial screening visit * ability and willingness to participate in follow-up exclusion criteria: * inability to comply with or complete the gastric emptying scintigraphy * presence of other conditions that could explain the patient's symptoms: * pyloric or intestinal obstruction * active inflammatory bowel disease * eosinophilic gastroenteritis * neurological conditions such as increased intracranial pressure, space occupying or inflammatory/infectious lesions * acute liver failure * advanced liver disease (child's b or c) * acute renal failure * untreated chronic renal failure (serum creatinine \>3 mg/dl) * total or subtotal gastric resection (patients with prior fundoplication or postvagotomy gastroparesis after pyloroplasty or antrectomy with billroth i, billroth ii, or roux-en-y gastrojejunostomy will be eligible for enrollment) * any other plausible structural or metabolic cause * any other condition, which in the opinion of the investigator would interfere with study requirements * inability to obtain informed consent

Keywords: gastroparesis
comparison of self adjustment versus standard of care treatment in subjects with type 2 diabetes

Conditions: Diabetes; Diabetes Mellitus, Type 2

Summary: this trial is conducted in the united states of america (usa). this trial aims for a comparison of the safety and efficacy in subjects with type 2 diabetes using either self titration or physician guided titration according to the local standard of care.


Eligibility criteria:
inclusion criteria: * diagnosis of type 2 diabetes hba1c \<= 12.0% within the past 12 months; * bmi \<= 45.0 kg/m2 * initiation, addition of, change to, or continuation of basal insulin therapy with insulin detemir as deemed necessary by investigator exclusion criteria: * anticipated change in concomitant medication known to interfere with glucose metabolism such as systemic steroids, non-selective beta-blockers or mono amine oxidase (mao) inhibitors. * proliferative retinopathy or maculopathy that has required acute treatment within the last 6 months. * any glucose lowering medication that is not indicated in combination with insulin, such as glp-1 analogues * known hypoglycemia unawareness or recurrent major hypoglycemia, as judged by the investigator
cyphertm stent post-marketing surveillance registry (us-pms)

Conditions: Coronary Artery Disease

Summary: the purpose of this pms registry, named e-cypher stent registry, is to collect post marketing surveillance data on the cyphertm sirolimus-eluting coronary stent following marketing approval, when used in normal clinical practice within the labeled indications.


Eligibility criteria:
inclusion criteria: * cypher stent exclusion criteria: * n/a
genetic susceptibility factors for candidemia.

Conditions: Invasive Candidiasis; Candidemia; Genetic Predisposition to Disease

Summary: this is a prospective case-control physiopathological study, which main objective is to determine the genetic host factors predisposing to candidemia. secondary objectives are to develop new diagnosis tools using the biological collection, to describe and update epidemiology, to analyse the influence of genetic polymorphisms on prognosis.


Eligibility criteria:
inclusion criteria: * patient older than 18 years. * informed consent. * positive blood culture with isolation of candida sp. exclusion criteria: * no informed consent. * patient younger than 18. * no insurance coverage.

Keywords: gene expression profiling genome-wide association study polymorphism, single nucleotide drug resistance, fungal