Kornimate/medical-research-clean huggingface dataset:
determining the effect of abacavir on platelet activation

Conditions: HIV; Cardiovascular Disease

Summary: hiv positive patients have a two fold increased risk of developing cardiovascular disease (such as heart attacks and strokes). cardiovascular disease appears to be due in part to both hiv and the side effects from anti-hiv medications. abacavir (an important component of current hiv treatment regimens) is one medication shown to be associated with an increase the risk of heart attacks in some studies. the mechanism by which abacavir does this is unknown. we hypothesise that abacavir is leading to heart disease by interacting with platelets, which then form blood clots within the arteries supplying the heart, the subsequent blockage of the artery causing a heart attack. this study aims to determine if abacavir increases the activity (or "stickiness") of platelets, and thus provide evidence as to how it may be promoting heart attacks. it will consist of 23 hiv positive men who currently have well controlled hiv. participants will take abacavir for 15 days in addition to their usual anti-hiv medications. a blood sample to assess platelet activity will be taken at baseline, following the 15 days of therapy (i.e. at the time of maximal abacavir effect) and again after a 28 day washout period (to determine if any effects are reversible).


Eligibility criteria:
inclusion criteria: * \> 18 years of age * male * hiv positive * stable non-abacavir containing anti-retroviral regimen * undetectable hiv viral load exclusion criteria: * hla-b\*57\*01 allele positivity * previous allergy to abacavir * known cardiovascular disease * high baseline cardiovascular risk (framingham risk score \> 20%) * current or recent antiplatelet therapy * pre-existing platelet or bleeding disorder (i.e. thrombophilia, thrombocytopenia, von willebrands disease, haemophilia) * significant chronic liver disease * current methadone use

Keywords: platelets hiv cardiovascular disease acute myocardial infarction abacavir antiretrovirals
rural alliance for diabetes prevention

Conditions: PreDiabetes

Summary: the purpose of this randomized controlled trial is to compare the effectiveness of cooperative extension implementing two delivery methods (group video vs. self-directed) and participant recruitment strategies of the national diabetes prevention program (ndpp) to adults in rural communities. exploratory assessments of implementation facilitators and barriers will be completed to determine strategies that may impact intervention effectiveness and that may support or impede the implementation, dissemination, and effectiveness of cooperative extension to deliver the ndpp to prediabetic adults in rural areas.

this 12 mo. type ii hybrid effectiveness-implementation trial will compare effectiveness (weight loss, physical activity, hba1c) of cooperative extension delivering the diabetes prevention program (dpp) by group video using zoom® (gv) vs. a self-directed (sd) control. active vs. passive participant recruitment strategies will be compared on recruitment outcomes including time to full enrollment, participant yield, and retention rates. ten cooperative extension local units/districts serving rural kansas counties will be allocated to either active or passive recruitment. each of the sites will recruit adults with prediabetes living in the county served by kansas state research and extension site and will be randomized to one of the 2 intervention arms. a centralized team of cooperative extension agents who complete ndpp lifestyle coach training will serve as interventionists for both the gv and sd arms. primary (weight) and secondary outcomes (hba1c, the proportion of participants meeting weight loss (≥ 5%) and physical activity goals (≥150 min./wk.) will be assessed at baseline, 6 and 12 mos. findings will inform best practices in the delivery of the dpp through cooperative extension in rural communities that could reach this high risk population.

Eligibility criteria:
inclusion criteria: * age 18 years or older * bmi ≥25 kg/m2, ≥23 kg/m2 if asian * blood test results in the pre diabetic range within the last year (hba1c = 5.7%-6.4% or fasting plasma glucose= 100-125 mg/dl or 2-hr. plasma glucose following a 75-gm glucose load = 140-199 mg/dl) or have previous diagnosis of gestational diabetes or a positive screening for pre diabetes based on cdc pre diabetes risk test * willing to travel to ksre site for orientation and outcome testing * available to attend pre-specified meeting time of gv for their respective ksre location * medically stable as deemed by primary care provider consent * english speaking exclusion criteria: * previous diagnosis of type i or ii diabetes * taking fda-approved weight loss medications * primary care provider stating that patient should not participate * self-report as currently pregnant or within 6 weeks of having given birth (or planning to become pregnant in the next 12 months) * unable to engage in physical activity

Keywords: diabetes prevention program hba1c physical activity weight loss
evaluation of the surgical pleth index during spinal and general anesthesia

Conditions: Stress; Pain

Summary: the surgical pleth index (spi) has been introduced as a non invasive tool to "measure" stress and pain during surgery. preliminary studies were performed in patients under general anaesthesia with propofol and remifentanil. these trials showed a good correlation between spi and aching procedures and a negative correlation between spi and the remifentanil dosage. hence, it was concluded that spi may be a bedside tool to measure 'pain' during surgery. so far, no study investigated spi during regional anaesthesia.

1. spinal anaesthesia secures full pain relieve and muscle relaxation usually in the lower part of the body. thus, spi - a measure that reflects pain during surgery - may not exceed significantly compared to baseline. it may slightly increase only during administration of the block. 2. increasing spi values due to surgery under subarachnoid block may reflect intraoperative patient's stress mediated by activation of the autonomic nervous system, specifically sympathetic activation. 3. in consistence with previously published data no changes of spi should occur due to standardized sedation with propofol.

Eligibility criteria:
inclusion criteria: * surgical procedures feasible under general or spinal anesthesia * duration between 30 and 90 min * asa status i,ii or iii exclusion criteria: * contraindications against one of the anesthesia methods * age under 18 * emergencies * chronical pain history * lack of sinus rhythm

Keywords: analgesia sedation spinal stress surgical surgical stress pain
the effect of wound edge eversion on cosmesis

Conditions: Surgical Incisions

Summary: aesthetic appearance of repaired incisions is very important to surgical patients. it has been stated that if the edges of a wound are closed in such a manner that will result in eversion, or pouting of the edges that the end cosmetic result will be superior when compared to wound edges that are simply approximated. the purpose of this study is to compare cosmetic outcomes of incisions that are closed with everted edges to those in which the edges are simply approximated.

surgical incisions will be split into two halfs and each half will be randomized to standard or everting sutures. 3 months later the cosmetic outcome of the healed wounds will be determined using a validated scar evaluation scale.

Eligibility criteria:
inclusion criteria: * age over 18. * able to consent. * scheduled for elective plastic or cardiothoracic surgery. exclusion criteria: * history of keloids, hypertrophic scarring, diabetes, or peripheral vascular disease. * those requiring systemic steroids or undergoing chemotherapy, and those unable or unwilling to consent.

Keywords: wound edge eversion cosmetic outcomes surgical incisions
comparison of oral health related quality of life changes between clear aligners and vestibular fixed appliances

Conditions: Teeth Crowding

Summary: patients who have severe crowding that required four premolars extraction will be treated in this study. the effects of clear aligners therapy on oral health related quality of life (ohrqol) in comparison with vestibular fixed appliances using the validated ohip-14 tool during orthodontic treatment. so the aim of the study was to compare the changes in ohrqol between patients receiving clear aligners or fixed appliances during the first year of the orthodontic treatment. there are two groups: first group (experimental): the patients in this group will be treated using clear aligners. second group (control): the patients in this group will be treated using fixed appliances.

for years, orthodontists and dentists have used removable appliances for orthodontic treatment. today, with the cad/cam technology, clear aligners treat a broader range of cases with greater precision. they consists of a series of plastic aligners that are intended to replace conventional wire and bracket technology for many orthodontic cases. each custom manufactured aligner exerts gentle, continuous forces to move teeth incrementally from their original state to a final, treated state. each aligner is worn for about two weeks, then replaced by the next in the series until the final position is achieved.

Eligibility criteria:
inclusion criteria: * class i malocclusion with severe crowding (more than 5 mm of tooth-size-arch-length-discrepancy). * good oral hygiene and periodontal health. * no congenitally missing or extracted teeth (except for the third molars). * no history of previous trauma to the maxillofacial region or surgical interventions. exclusion criteria: * previous orthodontic treatment. * subject with psychological abnormalities. * subject with systemic diseases. * subject has known allergy to latex and plastic

Keywords: clear aligners oral health related quality of life orthodontic vestibular fixed appliances oral health impact profile
the effect of n-3 polyunsaturated fatty acid supplements in patients with non-alcoholic fatty liver disease

Conditions: Non-alcoholic Fatty Liver Disease

Summary: the principal purpose of this study is to determine whether increased intakes of n-3 polyunsaturated (omega-3) fatty acids will reduce the amount of fat stored in the liver in patients with non-alcoholic fatty liver disease.

non-alcoholic fatty liver disease (nafld) is present in 10-24% of the general adult population. the first step of nafld involves the accumulation of fat within the liver (steatosis). steatosis occurs either due to defective generation, metabolism or excretion of fatty acids by the liver. the next step in nafld progression is inflammation, which commonly occurs due to pro-inflammatory stimuli. persistent inflammation results in end-stage liver disease. nafld is associated with the metabolic syndrome, which is characterised by central obesity, insulin resistance, raised triglycerides and hypertension. with the current obesity epidemic, there is predicted to be greater numbers of patients with nafld in the future. polyunsaturated fatty acids (pufas) are essential components of our diet, though standard western intakes are lower than the recommended amounts. supplementing the long chain n-3 pufas (commonly termed omega-3), epa and dha, improves many of the metabolic syndrome features. they lower plasma triglycerides, and may improve insulin resistance. the diet of nafld patients tends to be deficient in n-3 pufas and have an excessive intake of the harmful n-6 pufas. this pattern is mirrored in their liver lipid content as assessed at biopsy. currently there is no proven treatment for nafld. animal studies and limited studies in patients have been supportive of a benefit with n-3 polyunsaturated fatty acids. this needs to be further assessed.

Eligibility criteria:
inclusion criteria: 1. age greater than 18 years 2. liver biopsy diagnosis of nafld exclusion criteria: 1. excessive alcohol intake - \> 21 units per week in men and \> 14 in women 2. a further liver disease diagnosis 3. poorly controlled diabetes - hba1c \> 8.0%, or use of insulin sensitisers 4. pregnancy 5. cirrhosis 6. contraindications to mr scanning - pacemaker or metallic foreign body etc. 7. changes in the dose or initiation of lipid altering medication within the preceding three months, such as statins, fibrates or systemic steroids 8. use of n-3 pufa supplements within the prior 4 months, an adequate washout period 9. significant co-morbid inflammatory illnesses as determined by research team

Keywords: non-alcoholic fatty liver disease polyunsaturated fatty acids omega-3
psychotherapy feasibility pilot of the carolina recovery from depression protocol

Conditions: Depression, Unipolar

Summary: the goal of this clinical trial is to learn whether an single session intervention can reduce psychological impairment in adult individuals with moderate depression. the main questions it aims to answer are: is this evidence-based intervention acceptable to study participants? is this evidence-based intervention feasible to implement in a single session? is there evidence that the evidence-based intervention reduces psychological impairment in adults with moderate to severe depression? participants will complete: * an in-depth diagnostic screening interview prior to enrollment * a set of mental health questionnaires at baseline and two weeks post-intervention * a 3-hour, evidence-based, single session psychotherapeutic intervention with a trained clinician


Eligibility criteria:
inclusion criteria: * age of 18 years or older * able to provide informed consent * willing to comply with all study procedures and be available for the duration of the study * speak and understand english * diagnostic and statistical manual (dsm)-5 diagnosis of major depressive disorder (mdd) as confirmed by semi-structured clinical assessment * meet a cutoff of at least a moderate depression score on the beck depression inventory (bdi-ii) (≥ 20) exclusion criteria: * participants must not have current active suicide intent as determined by the columbia suicide severity rating scale (c-ssrs) * participants must not meet criteria for current severe substance use disorder, anorexia nervosa, or active psychosis as assessed by psychodiagnostic assessment * any participants taking psychotropic medication must be on a stable dose for at least 4 weeks with no planned dose changes within the next 4 weeks. * participants able to birth must not be pregnant or breastfeeding. * participants may not have any medical or neurological illness for which symptom presentation or treatment could interfere with study participation * participants may not have undergone prior brain surgery * participants may not have any brain devices/implants, including cochlear implants and aneurysm clips * participants may not have had brain injury or concussion within the last three months * participants may not have a history of brain injury requiring current treatment

Keywords: depression major depressive disorder psychotherapy single session intervention
soft tissue detection on mri, cone beam ct and fan beam ct and integration of functional mri

Conditions: Lung Cancer; Prostate Cancer

Summary: this clinical trial studies magnetic resonance imaging (mri), cone beam computed tomography (ct), and fan beam ct in detecting soft tissue in patients with prostate and lung cancer undergoing radiation therapy. comparing results of diagnostic procedures done before and during radiation therapy may help doctors predict a patient's response to treatment and help plan the best treatment.

primary objectives: i. establish the technical feasibility of mri for performing functional soft-tissue targeting of radiotherapy in the pelvis and thorax. (group i) ii. acquire clinical mr imaging data to evaluate image quality tradeoffs and operational parameter settings. (group i) iii. validate the selection of mri technique factors by comparing visibility of soft tissue structures in mris, cone beam (cb)cts and fan beam (fb)cts of the same patient. (group ii) iv. assess the feasibility of using deformable image registration to map contours from fbct to mri, cbct to mri, mri to mri and vice versa. (group ii) v. compare morphologic and functional changes in target and normal structures, visualized on mri, cbct and fbct images, in response to radiation therapy and identify opportunities for treatment adaptation. (group ii) outline: patients undergo mri and fbct at baseline, within the first 3 weeks of radiotherapy and between week 4 and 6 of radiotherapy. patients with lung cancer may undergo 4 dimensional (4d) cbct on the same day as the second and third mri and fbct.

Eligibility criteria:
inclusion criteria: * patients with lung cancer visible on ct who are scheduled to receive radiation treatment to the area of the primary tumor will be eligible for this study - renal function tests (blood urea nitrogen \[bun\], creatinine \[cr\], glomerular filtration rate \[gfr\]) within 30 days of mri with gfr \> 59 ml/min * all patients must give written informed consent on a form that includes health insurance portability and accountability act (hipaa) authorization; patient therapy will not be directed by enrollment in this study; participation in this study will not preclude patient participation in additional therapy protocols; subjects will all be recruited from patients undergoing radiotherapy at one of the virginia commonwealth university (vcu)-affiliated radiotherapy clinics exclusion criteria: * patients requiring continuous supplemental oxygen * patients with metal implants including pace makers and defibrillators * patients with cerebral aneurysm clips or middle ear implant * patients with pain pump, a programmable shunt, or non-surgical metal (i.e. a foreign body) * claustrophobic patients * prior radiotherapy to body area under investigation * no vulnerable populations will be enrolled (prisoners, children, pregnant females, or institutionalized individuals); women of childbearing potential will undergo a pregnancy test
impact of measures taken to contain covid-19 on hospital surgical care services and clinical outcomes

Conditions: COVID-19

Summary: swift and decisive actions on the part of healthcare and hospital authorities are required to effectively contain the current covid-19 pandemic. these measures firstly allow personnel and facilities leeway to provide surge capabilities to meet anticipated increased demands on the healthcare service. in addition, by deferring none urgent hospital visits, admissions and investigations, such measures support social distancing and aid attempts to control disease transmission. deferring perceived non-urgent patient services may however lead to unintended delayed diagnoses and exacerbation of current patient conditions and lead to increased emergency admissions and surgeries. a policy decision was made that essential surgical services pertaining to cancer and urgent cardiovascular surgery were allowed but that surgeons had the option to postpone what is assessed to be less urgent cases. increasingly patients also postpone their surgeries or visits because of anxieties over the developing situation. elective surgical services at the outram campus were thus significantly reduced from january 2020 as part of the measures to contain the covid-19 outbreak. the surgical philosophy during this period was that a judicious policy that allowed surgeons to proceed with surgery deemed critical but to postpone those deemed less so will at the system level, avoid poor outcomes for patients who required surgery and yet successfully re-allocate resources required to address the unfolding pandemic.

cohort of patients who were treated will be analysed via retrospective medical records review. these patients are classified according to the institution, type of surgical procedures, the medical condition and the dates of surgical treatment. the study will be compared across four time periods as listed: -1jan-31dec2020 -1jan-31dec2019 -1jan-31dec2018 -1jan-31dec2017 the study focus on surgical indices for selected high-volume cancer and non-cancer diagnoses over the period 1st january 2020 to 31 december 2020 and compare them with similar indices across the same period of time in the preceding 3 years in particular, for the following surgical procedures: 1. surgeries for the following cancer diagnoses: 1. breast cancer, \[xiv- n60, no malignancy\], \[malignant, ii neoplasms- c50\], colorectal cancer, \[c18, 19, 20\], 2. hepatocellular carcinoma, \[c22\] 2. selected non-cancer surgeries: a. cholecystectomy b. abdominal hernia repair

Eligibility criteria:
inclusion criteria: * patients who had the following surgeries during the period 01 jan 2017 to 31 december 2020. from the identified surgical procedure type as shown surgeries for the following cancer-related procedures. 1. breast cancer 2. colon cancer 3. liver 4. rectum selected non-cancer surgeries. 1. abdominal wall 2. gall bladder patients from sgh and its releated institute ncc only local singapore citizens exclusion criteria: no exclusion criteria -

Keywords: impact of measures hospital surgical care services
tllsh2910 for ataxia and gut microbiota alteration in patients of multiple system atrophy

Conditions: Ataxia, Cerebellar; Multiple System Atrophy

Summary: multiple system atrophy (msa) is a fetal, rare neurodegenerative disease presenting with parksinonism, autonomic dysfunction, and cerebellar ataxia. numerous anti-parkinsonism agents have been developed. however, no medication has yet been proven effective for the symptomatic or even causative treatment in cerebellar ataxia. to our knowledge, cerebellar n-methyl-d- aspartic acid (nmda) receptors play a special role in the modulation of motor learning and coordination. tllsh2910, a nmda modulator, has been found to attenuate the ataxic gait in the mouse model. here, we designed a large-scale double-blind randomized controlled, cross-over phase iii trial to investigate the efficacy of tllsh2910 in neurodegenerative ataxic patients and the association of gut microbiota change.

the study is terminated prematurely due to project replanning and difficulty in recruitment during the pandemic. the overall sample size is not adequate to meet the requirement of estimated power. the statistical results will be investigated. no severe drug-related adverse events were reported during the study period.

Eligibility criteria:
inclusion criteria: * 1. clinically confirmed cerebellar ataxia with a sara total score ≥ 3 (range 0-40). * 2. clinical diagnosis of probable or possible msa-c. * 3. patients older than 18 years old and younger than 80 years old. exclusion criteria: * 1. major systemic diseases such as hepatic, renal or heart failure, malignancy, stroke. * 2. concomitant medication which inhibit cyp2c19 enzyme such as clopidogrel, cimetidine, fluconazole, ketoconazole, voriconazole, etravirine, fluoxetine, fluvoxamine, ticlopidine. * 3. pregnancy and/or breastfeeding. * 4. acute diseases that might interfere with the trial.

Keywords: multiple system atrophy, cerebellar ataxia, nmda, microbiota
add-on to cognitive, event-related potentials (erp) and electroencephalogram (eeg) asymmetry in affective disorders

Conditions: Depressive Illness

Summary: depressed patients unremitted after monotherapy with citalopram or bupropion will remit following six weeks treatment with the combination of citalopram and bupropion.

participants in another study who did not remit during 12 weeks treatment with citalopram (to 40 mg/d) or bupropion (to 450 mg/d) will have citalopram (to 40 mg/d) or bupropion (to 450 mg/d) added for six weeks.

Eligibility criteria:
inclusion criteria: * non-remission in protocol #6559r * age 18-66 * signs informed consent * physically healthy exclusion criteria: * bipolar disorder * history of psychosis * history of anorexia nervosa or bulimia * history of seizure disorder, significant brain trauma or other medical reason to suspect increased seizure risk

Keywords: depression citalopram bupropion combination therapy