Kornimate/medical-research-clean huggingface dataset:
quality improvement in stroke prevention (quisp)

Conditions: Ischemic Stroke

Summary: is a secondary prevention intervention, focused on implementation of standardized pre-printed discharge orders for hospitalists, effective at increasing utilization of the following evidence-based treatments 6 months after discharge for ischemic stroke: 1. treatment with statins, 2. control of hypertension, and 3. anticoagulation in patients with atrial fibrillation.

there are several proven strategies for prevention of recurrent ischemic stroke, including use of statins, treatment of hypertension, and anticoagulation in patients with atrial fibrillation. preliminary analyses suggest that only 9-15% of kaiser permanente northern california's ischemic stroke patients receive optimal care for secondary prevention of stroke. the purpose of this study is to determine whether or not a quality improvement (qi) intervention can improve the care received by stroke patients. this project consists of a randomized trial of standardized stroke discharge order forms to improve adherence with best practices in secondary stroke prevention. the primary research question is: is a secondary prevention intervention, focused on implementation of standardized pre-printed discharge orders for hospitalists, effective at increasing utilization of the following evidence-based treatments 6 months after discharge for ischemic stroke: (1) treatment with statins, (2) control of hypertension, and (3) anticoagulation in patients with atrial fibrillation. the primary outcome will be the proportion of patients receiving optimal treatment, as defined by these three goals. the impact of the intervention will be measures as a change after-to-before at intervention hospitals compared to non-intervention (control) hospitals, with the institution as the unit of analysis. secondary analyses will evaluate the impact of the intervention on each of these components and on 6-month and 1-year rates of mortality, readmission for stroke, and costs of care after discharge.

Eligibility criteria:
inclusion criteria: ischemic stroke kaiser-permanente health plan member with pharmacy benefit discharged alive to home exclusion criteria: tpa patients hemorrhagic stroke tia significant comorbidities

Keywords: cva ischemic stroke
retrospective study assessing molecular features predicting response to cetuximab

Conditions: Colorectal Neoplasms

Summary: the primary objective is to identify molecular features predicting response or resistance to cetuximab

secondary objective is to investigate association of genomic status of egfr and her-2 genes with clinical outcome, including objective response, time to progression and survival

Eligibility criteria:
inclusion criteria: * histologically confirmed diagnosis of colorectal cancer with available tumor tissue and clinical data; presence of at least one measurable lesion. exclusion criteria: * less than 3 weeks after completion of previous radiotherapy

Keywords: egfr kras braf met igfr1
prebiotic effects of a polyphenol-rich food product

Conditions: Dysbiosis

Summary: the specific aim for this project will be to investigate a cranberry beverage as a means to restore balance in terms of the relative proportions of the various bacteria that inhabit the large intestine.


Eligibility criteria:
inclusion criteria: * bmi 27-35 kg/m2 * high waist circumference (men \>102 cm and women \>88 cm) exclusion criteria: * cigarette smoking * regular intensive exercise * pregnancy or lactation * chronic diarrhea, constipation, or other gastrointestinal complaint * diabetes mellitus, autoimmune disease, or other chronic disease known to alter the gut microbiota * use of medications that affect inflammation or the gut microbiota * use of prebiotics, probiotics, synbiotics, vitamins, or other dietary supplements known to affect the gut microbiota * aversion to cranberries * food allergies * lactose intolerance * vegetarianism
metal or plastic stents to relieve obstruction of obstructive jaundice prior to resection of periampullary tumors.

Conditions: Obstructive Jaundice; Periampullary Tumour

Summary: patients with obstructive jaundice due to periampullary tumor can temporarily be relieved of their jaundice with transpapillary stenting at endoscopic retrograde cholangio-pancreatography (ercp) prior to operation. usually plastic stents are used. hypothesis: self expanding metallic stents offer a be a better alternative for preoperative stenting in patients with obstructive jaundice due to periampullary tumour obstruction.

patients who present with obstructive jaundice and have a periampullary tumor and where the patient seems to be in good condition for surgical resection are offered the opportunity to become randomized to either endoscopic drainage with self expanding metallic or plastic stents. before randomization they are informed about the study details and have to give their consent to participate. the metallic as well as plastic stents are standard commercially available stents. within four weeks after stent placement the patient will be operated and the following parameters will be evaluated: quality of life, clinical symptoms and lab tests. at the operation the surgeon will make an evaluation of the inflammatory reaction in the area of the bile ducts. a culture from the bile is sampled close to the area where the anastomosis will be sutured. a tissue sample is also taken from the bile ducts to evaluate inflammation. a lymph node is also sampled for the same reason. the surgeon also evaluates the difficulty with which the stent had to be removed. postoperative complications are monitored in line with the regular routines at the clinic.

Eligibility criteria:
inclusion criteria: * obstructive jaundice in periampullary tumor. exclusion criteria: * not willing to participate. * not a resectable tumor.
self-management behaviors and resilience among chronic obstructive pulmonary disease patients

Conditions: Chronic Obstructive Pulmonary Disease; Self-management Behavior; Resilience

Summary: this study conducted an assessment of the influencing factors and correlations that affect self-management behaviors and resilience in the copd population.

a total of 100 participants with copd from a medical center in northern taiwan were recruited from february 2020 to january 2021 in this cross-sectional study. each subject completed self-reported questionnaires through face-to-face interviews, including 20-item copd self-management scale (csms-20) and a 25-item connor-davidson resilience scale (cd-risc-25). a multiple linear regression model was used to examine the relationship between the levels of self-management behavior and resilience, controlling for sociodemographic and clinical factors.

Eligibility criteria:
inclusion criteria: the recruited participants have been diagnosed with copd for at least a month by thoracic physicians based on the guidelines of the global initiative for chronic obstructive lung disease (gold). exclusion criteria: participants who were diagnosed with serious mental disorders, cancer, terminal illness, or end-stage diseases were excluded from this study.

Keywords: chronic obstructive pulmonary disease self-management behavior resilience
prognostic markers of patients with stemi

Conditions: STEMI - ST Elevation Myocardial Infarction

Summary: to analyze the relationship between the clinical data and the outcomes of stemi patients.


Eligibility criteria:
inclusion criteria: * patients diagnosed with st-segment elevation myocardial infarction(stemi). exclusion criteria: * patients with concurrent infection or any documented inflammatory illness, such as arthritis or connective tissue diseases,or any other malignancy. * pregnant women. * severe hepatic dysfunction. * uncontrolled hypertension.
post approval study to evaluate the safety and performance of genta-foil resorb® in hand surgery

Conditions: Tissue Adhesions, Surgery-Induced

Summary: single arm study to evaluate the safety and performance of genta-foil resorb® for the prevention of tissue adhesions

genta-foil resorb® is an implantable, absorbable collagen barrier foil, which forms a temporary barrier between the functional structures during the critical phase of wound healing. as a result, the ability of the tissue layers to slide against each other is retained. the objective of hand surgery is to promote wound repair, and regeneration of all motor and sensory functions of the hand and to restore the subject's hand mobility, and improve their quality of life. however, hand trauma and operations often lead to the formation of adhesions between the various tissue layers of the hand (e.g. muscles, tendons and nerves). even with minimally invasive procedures and optimal aftercare, development of adhesions in the suture and wound areas is often unavoidable. adhesion formation between repaired tendons and the surrounding tissue has been thought to be one of the most important factors that disturbs functional restoration. it is estimated that the adhesion, which can cause significant disability, occurs in about 30% of cases. the purpose of this study is to investigate the use of genta-foil resorb® for the prevention of tissue adhesions measured by restoration in digital function in subjects undergoing hand surgery. the functional outcome of tendon injury after a repair depends on multiple factors such as age, injury level and type, type of repair, and post repair therapy.

Eligibility criteria:
inclusion criteria: 1. subject is male or female, ≥18 years of age; 2. subject is willing and able to give written informed consent; 3. subject is scheduled for one if the following surgical procedures: * 3a. extensor tendon repair zones i to vi. * 3b. flexor tendon repair zones i to vi. * 3c. open reduction and internal fixation to repair hand fractures of proximal phalanx, and/or middle phalanx, and/or metacarpals 4. subject is willing and able to comply with the study procedures during surgery and the post-surgical follow up period. exclusion criteria: 1. subject is known to be sensitive to any of the device components e.g. gentamicin (aminoglycosides) or equine collagen. 2. subject is known to be non-compliant with medical treatment. 3. subject has any known impaired renal function/autoimmune illness/neuromuscular disease (such as parkinson's or myasthenia gravis). 4. subject is currently taking an aminoglycoside antibiotic as stand-alone treatment or in combination with other antibiotics 5. subject is pregnant or actively breastfeeding. 6. subject has active infection at surgical site 7. subject has any significant or unstable medical or psychiatric condition that, in the opinion of the investigator, would interfere with their ability to participate in the study, or affect the study outcomes. 8. subject is currently enrolled in another clinical study that would interfere with their ability to participate in this study

Keywords: hand mobility, wound healing, functional restoration
study to assess changes in the number of nerves in the skin at the site where where tanezumab is injected

Conditions: Osteoarthritis Pain; Chronic Low Back Pain; Pain Due to Interstitial Cystitis

Summary: subcutaneous administration of tanezumab can result in changes in the number of nerves around the injection site in the thigh.


Eligibility criteria:
inclusion criteria: * healthy subjects only * female subjects can not be pregnant or be nursing. * females and males need to use two types of birth control methods during the length of the study and one of the two methods needs to be a barrier method. * subjects who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures. exclusion criteria: * subject can not have any chronic or acute medical condition or have had any chronic illness in the past * can not have any problematic skin condition. * females can not have more than 7 alcoholic drinks per week and males can not have more than 14 alcoholic drinks per week

Keywords: intraepidermal nerve fiber density ienf tanezumab subcutaneous healthy volunteers
nevirapine vs ritonavir-boosted lopinavir in art naive hiv-infected adults in a resource limited setting

Conditions: HIV-1 Infection

Summary: in resource-limited setting, concerns remain regarding the emergence of virologic failure and high-level drug resistance mutations (drm) during who recommended first-line antiretroviral therapy (art) with non-nucleoside reverse transcriptase inhibitors (nnrti) based regimens for human immunodeficiency virus 1 (hiv1) infected patients. the study hypothesis is that a boosted-protease inhibitor regimen has a better outcome than a nnrti-based regimen with a low genetic barrier to resistance. the study is a randomized, multicenter, factorial trial (conducted in congo), in treatment- naïve adults receiving for 96 weeks ritonavir- boosted lopinavir(lpv/r) or nevirapine (nvp) each in combination with tenofovir (tdf) /emtricitabine (ftc) or zidovudine (zdv)/lamivudine (3tc). the primary end point is the incidence of therapeutic (clinical and/or virologic)failure by study week 24.


Eligibility criteria:
inclusion criteria: * antiretroviral-therapy naïve hiv-1 infected adults * who clinical stage 3 and cd4 \<350/mm3 or * who clinical stage 4 or * cd4 cell count \< 200/mm3 * negative pregnancy test exclusion criteria: * hemoglobin \< 8.5 g/dl (female) or 9.0 g/dl (male) * estimated glomerular filtration rate \< 50 ml/ minute (cockcroft-gault equation) * hepatic transaminases (ast and alt)\> 3 x upper limit of normal * active tuberculosis * pregnancy * females who are breastfeeding

Keywords: first-line therapy protease inhibitor non-nucleoside reverse transcriptase inhibitor resource-limited setting
intrinsic foot muscle with and without hip abductor muscle strengthening training in overweight females

Conditions: Pronation Distotion Syndrome

Summary: pronation distortion syndrome is a common postural distortion of the lower extremity, involving the anterior part of the leg. it may cause pain in the leg and disturbances in the tarsal part, in addition to distal and proximal parts. in this deformity, the head of the talus and navicular bones are rotated inward and downward, and the body's center of gravity shifts inward, resulting in flat feet. it is also associated with a union and increased pressure on the medial parts of the first and second metatarso phalangeal joints. the characteristics of pronation distortion syndrome due to excessive foot pronation include inward rotation of the tibia, internal rotation of the thighs associated with flat feet, genu valgum (knock-knee), and increased lordosis in case of hyperpronation. the randomized clinical trial study design will be used with the sample of 48 womens. the data will be collected from ganga ram hospital and mukhtara rafique welfare hospital by using convenient sampling technique.the inclusion criteria ages 30-35 years, female gender, bmi of overweight women (25-29.9). foot pronation on observation, navicular drop test more than 10mm (measured in weight bearing and non-weight bearing positions distance between ground and navicular tuberosity and difference calculated), increased q angle :females 15-18. the exclusion criteria is other deformities such as tarsal coalition and vertical talus, bmi under weight,normal,obese.any history of surgery involving both lower extremities.and neuromuscular disorder(gbs,mg,muscular dystrophies extremities)\|.the tools used is numeric pain rating scale (nprs), navicular drop test, goniometer for q angle measurement, and lower extremity functional scale (lefs). data will be analyzed by using spss version 26,0.


Eligibility criteria:
inclusion criteria: * ages 30-35 years * female gender * bmi of overweight women (25-29.9) * foot pronation on observation * navicular drop test more than 10mm (measured in weight bearing and non-weight bearing positions distance between ground and navicular tuberosity and difference calculated).(16) * increased q angle :females 15-18 exclusion criteria: * • other deformities such as tarsal coalition and vertical talus. * bmi underweight,normal ,obese. * any history of surgery involving both lower extremities. * neuromuscular disorder(gbs,mg,muscular dystrophies extremities.).

Keywords: intrinsic foot muscle hip abductor pronation distortion syndrome
japan central aortic pressure prospective study

Conditions: Healthy

Summary: purpose of the study 1. the predictive value of central aortic pressure and aortic pulse wave velocity (pwv) in a japanese population is not known. the purpose of this study is to quantify the predictive value of these indices in the determination of cardiovascular risk. 2. recently, a non-invasive method to separate the aortic pressure waveform into the separate ejection pressure wave and reflected pressure wave has become available. with this decomposition method, it is possible to estimate aortic pwv (named avi). the second objective of this study is to determine if avi can be a substitute for carotid-femoral pwv (cf-pwv), the current gold standard for aortic pwv measurement. 3. to study vascular aging of the japanese population by evaluating central blood pressure and aortic pwv by age, and compare these values to similar studies done in caucasian and chinese patient populations. 4. to study the relationship between the magnitude of the aortic reflected pressure wave and the degree of left ventricular (lv) hypertrophy and lv diastolic function.


Eligibility criteria:
inclusion criteria: * subjects who visit hospital for their health checks * healthy volunteers who agree to participate in this study exclusion criteria: * history of coronary artery disease, cerebrovascular disease, congestive heart failure, aortic dissection * subjects taking vasoactive drugs (antihypertensive and/or nitrates) * atrial fibrillation or atrial flutter * renal dysfunction (serum creatinine ≥3 mg/dl) * type i diabetes mellitus * hepatic dysfunction (ast and/or alt ≥100 iu/l) * a history of malignant tumor within 5 years of enrollment or suspected * pregnancy, possible pregnancy * chronic inflammation disease * not suited to the clinical trial as judged by a collaborating physician * inability to give informed consent

Keywords: central aortic pressure aortic pulse wave velocity aortic pwv using a single pressure recording vascular aging left ventricular hypertrophy left ventricular diastolic function
vaccine social media randomized intervention trial

Conditions: Communicable Diseases

Summary: this study will assess the effectiveness of social media website devoted to vaccines to change immunization knowledge, perceptions and behavior. if effective, this intervention will represent an innovative, low cost and broadly applicable resource to reduce parental vaccination concerns. the study has two hypothesis: 1. parents receiving usual care plus social media website will demonstrate higher early childhood immunization rates to parents receiving either usual plus non interactive website or usual care only. 2. parents receiving usual care plus social media website will demonstrate positive changes in knowledge, attitudes and beliefs supporting vaccination compared to parents receiving either usual care plus non-interactive website or usual care only.

participants will be enrolled in the study, stratified based on hesitancy and randomly assigned to 1 of 3 study arms and followed for 1-2 years.

Eligibility criteria:
inclusion criteria: * women \>20 weeks pregnant (including parents of children up to 1 year of age). * \>18 years of age exclusion criteria: * non english speak * do not intend to use kaiser insurance for the child

Keywords: social media vaccine immunization
dietary lipids, energy expenditure and obesity biomarkers

Conditions: Obesity

Summary: the purpose of this study is to determine whether the modulation of dietary lipids are effective in the treatment of obesity and comorbidities.

obesity is a complex disease of multifactorial etiology and difficult to control. among lifestyle changes proposed to the treatment of this disease and comorbidities, there is the modulation of dietary lipid composition. this study aimed to evaluate the effects of the modulation of fatty acid (fa) polyunsaturated (pufa) and monounsaturated (mufa) in energy expenditure (ee), weight loss, body composition, lipid and glycemic profile, free fatty acids (ffa), glycerol, adiponectin, leptin, blood pressure (bp), feeding behavior and expression of pparα and pparγ2 genes in adipose tissue (at) of obese women. it was conducted a parallel, randomized, controlled, single-blind study with dietary intervention (di) for 60 days, where 32 women with obesity classes i and ii were distributed into three groups: g1 = diet rich in n-3 pufa and n-6 (n = 10); g2 = mufa-rich diet (n = 11); and g3 = control (n = 11). for g1 and g2 were prescribed normocaloric diets with similar macronutrient composition, varying only the type of lipids offered. in order to achieve the desired intake of unsaturated fa, both groups received individual portions of vegetable oils in the form of sachets, which were consumed for lunch and dinner (g1 = mix of virgin olive oil \[voo\] and soybean oil \[so\], overall of 35.2g to 52.8g / day; g2 = voo, overall of 35.2g to 50.6 g / day), besides gelatin capsules (g1 = 2 g of fish oil / day; g2 = 1 capsule of 1g of so / day). g3 was instructed to keep their eating habits and consuming placebos (1 sachet of 2g of so and 1 capsule of 1g of so / day).

Eligibility criteria:
inclusion criteria: * obesity grades i and ii (body mass index between 30 and 39,99 kg/m2); * completion of basic education (former 4th primary series). exclusion criteria: * menopausal; * weight loss more than three kilograms (3 kg) in the last three months; * diagnosis of diabetes mellitus, heart disease, hypertension, nephropathy, liver diseases , thyroid dysfunction; gastrointestinal disorders , acquired immunodeficiency syndrome or cancer; * cholecystectomy in the past 12 months and other recent surgeries; * pregnancy or lactation; * smokers; * drugs to lipid-lowering, diabetes, hypertension, depression, or obesity; * food history of allergy or intolerance to vegetable oils (olive oil, soy or canola), fish oil, fish and / or seafood.

Keywords: obesity lipids energy expenditure gene expression
assessment of diastolic function in high risk patients undergoing major vascular surgery

Conditions: Diastolic Dysfunction; Heart Failure; Aneurysm Aortic

Summary: patients scheduled for thoracic endovascular aortic repair (tevar) surgery will have transthoracic echocardiography evaluation of left ventricle diastolic function during the perioperative period.

patients undergoing tevar surgery are a high risk group of developing perioperative cardiovascular complications. left ventricle diastolic dysfunction is common in this group of patients because of the prevalence of risk factors: \> 60 years old, hypertension, smoking history and diabetes. because of many predisposing factors that occur during the surgery: stress respond, fluid shifts, anaesthesia and mechanical ventilation. deterioration of the diastolic function is likely to occur in perioperative period in this study, the investigators will evaluate change in left ventricle diastolic function as a marker for early detection of a myocardial failure in patients scheduled for an elective tevar surgery. the examination will be performed preoperatively, shortly after the surgery and 24 hours after the surgery. aim: the aim of the study is to evaluate the diastolic function of left ventricle in perioperative period after high risk surgery. this may provide a valuable information in preoperative risk stratification and postoperative therapy guidance.

Eligibility criteria:
inclusion criteria: * scheduled tevar * \>60 years old exclusion criteria: * atrial fibrillation or other non-sinus rhythms * atrioventricular blocks * heart rate change more than 25% postoperatively * not adequate transthoracic view * postoperative shock * sepsis

Keywords: diastolic dysfunction anesthesia preoperative assessment postoperative care tevar