Kornimate/medical-research-clean huggingface dataset:
long-term results of ddd pacing in obstructive hypertrophic cardiomyopathy

Conditions: Cardiomyopathy, Hypertrophic

Summary: ddd pacing improves symptoms and relieves lv outflow tract (lvot) obstruction in most patients with hypertrophic cardiomyopathy (hcm). notably, when pacing is temporarily discontinued, the beneficial effects of pacing are evident in sinus rhythm. the long term results of this novel therapy are, however, uncertain. we propose (1) to record the hemodynamic changes following \>4 years of pacing; and (2) to determine whether ddd pacing continues to be necessary in patients who have had a substantial relief of their lvot obstruction. patients who have had \>50% reduction in lvot pressure gradients will be randomized to two pacing modalities: ddd at 70 beats per minute and aai pacing at 70 beats per minute (ddd switched off), and reevaluated after a six-month period.

ddd pacing improves symptoms and relieves lv outflow tract (lvot) obstruction in most patients with hypertrophic cardiomyopathy (hcm). notably, when pacing is temporarily discontinued, the beneficial effects of pacing are evident in sinus rhythm. the long term results of this novel therapy are, however, uncertain. we propose (1) to record the hemodynamic changes following \>4 years of pacing; and (2) to determine whether ddd pacing continues to be necessary in patients who have had a substantial relief of their lvot obstruction. patients who have had \>50% reduction in lvot pressure gradients will be randomized to two pacing modalities: ddd at 70 beats per minute and aai pacing at 70 beats per minute (ddd switched off), and reevaluated after a six-month period.

Eligibility criteria:
group 1: hcm patients, aged grater than 20 years of either gender who received ddd pacemakers at the nih at least 4 years ago, for relief of lvot obstruction and drug-refractory symptoms. group 2: hcm patients selected from group 1 who at the follow-up cardiac catheterization are demonstrated to have either (1) no significant lvot obstruction (less than 30mm hg at rest and less than 50mm hg with isuprel); or (2) a substantial reduction of the lvot obstruction (greater than 50% reduction in lvot gradient). patient who have developed a heart block will be excluded from group 2. females must have a negative pregnancy test.

Keywords: cardiac hypertrophy drug-refractory hemodynamic benefits obstruction pacemaker therapy hypertrophic cardiomyopathy
risk factors for linezolid resistance in staphylococcus aureus

Conditions: Linezolid Resistance; Staphylococcus Aureus

Summary: this is a retrospective chart review study. the proposed study aims to document the risk factors for quinolone resistance in bloodstream isolates of klebsiella species. additionally, the adequacy of empiric antibiotic therapy for klebsiella bloodstream infections will be assessed.

this is a retrospective chart review study. the proposed study aims to document the risk factors for quinolone resistance in bloodstream isolates of klebsiella species. additionally, the adequacy of empiric antibiotic therapy for klebsiella bloodstream infections will be assessed. this research is important because identification of risk factors may allow earlier initiation of appropriate therapy in patients infected with these bacteria. additionally, we will identify whether horizontal spread is responsible for this increasing trend.

Eligibility criteria:
inclusion criteria: * patients with linezolid resistance to staphylococcus aureus exclusion criteria: * those that don't meet entry criteria

Keywords: linezolid staphylococcus aureus infections
a study of adipose tissue in adaptive responses to exercise

Conditions: Healthy; Obesity

Summary: the purpose of this research is to determine how exercise affects fat (adipose) tissue and how changes to adipose tissue that occur during and after exercise might improve health in aging and obesity.

adipose tissue has important endocrine functions that influence metabolic health. early evidence shows that adipose adapts to physiological stress, including exercise. the objective here is to determine how exercise-induced alterations in adipose tissue cellular composition and endocrine signaling may contribute to the beneficial adaptations to exercise in aging and obesity. immune cell populations and inflammatory signatures will be assessed in subcutaneous abdominal adipose tissue biopsies collected from obese and normal weight young and older adults before, immediately after, and 3 hours after a 30-min bout of cycling exercise at 70% of maximal oxygen consumption (vo2max). mass spectrometry, olink targeted inflammation assays, and rna sequencing will be used for full proteomic and transcriptomic characterization of the adipose tissue secretome (the proteins and molecules secreted from the adipose tissue) and the cargo of extracellular vesicles isolated from plasma and media collected from cultured human adipose tissue explants generated from each time point. overall, the primary hypothesis of the proposed work is that a single bout of exercise triggers transient changes in adipose tissue paracrine/endocrine signals and immune cellular composition. the investigators propose that these responses contribute to the beneficial effects of exercise locally and in distal tissues and that the cumulative effects of acute changes in adipose tissue likely contribute to the positive alterations in adipose tissue associated with exercise training.

Eligibility criteria:
inclusion criteria: * adults between the ages of 18-35 or 65-85. * bmi 18.5 kg/m2 - 40 kg/m2 * weight stable (≥ 3 months) * generally healthy exclusion criteria: * participation in ≥ 30 minutes of structured physical activity ≥ 2 days per week. * smoking/tobacco use. * alcohol/substance abuse. * pregnancy and breastfeeding. * anemia. * abnormal renal function. * blood clotting disorders. * coronary artery disease. * uncontrolled thyroid disease. * liver disease. * use of medications known to influence the main outcomes of the study. * orthopedic problems that may be aggravated by exercise. * chronic disease at the discretion of the investigators.

Keywords: exercise adipose cytokines
functional changes after upper blepharoplasty

Conditions: Eyelid Diseases

Summary: upper blepharoplasty is a common eyelid procedure. it associated with visual, cosmetic and functional changes .investigator will evaluate outcome of this procedure.

baseline and postoperative 1,3,6 and 12 months full ophthalmic examination was done. procedure is upper blepharoplasty.

Eligibility criteria:
inclusion criteria: • upper eyelid dermatochalasis exclusion criteria: * eyelid diseases * previous eyelid surgery

Keywords: blepharoplasty, visual field
study vitamin d in healthy individuals

Conditions: Vitamin D Deficiency

Summary: to obtain sufficient specimens and correlating clinical data from a well-controlled prospective clinical trial collecting specimens from healthy subjects t on vitamin d assays, and to establish a collection of specimens that will support future assay discovery and validation efforts.

1. obtain matched serum and plasma specimens collected from a minimum of 50 healthy subjects in two geographic areas. specimens will be used to determine a reference range for a vitamin d assay, used as an aid in the assessment of vitamin d sufficiency in adults. 2. obtain serum specimens collected from a minimum of an additional 450 healthy subjects in two geographic areas. specimens will be used to determine a reference range for a vitamin d assay, used as an aid in the assessment of vitamin d sufficiency in adults. 3. to store any remaining specimens for use in future vitamin d assay development and to evaluate as yet undetermined assays for the development of ivds, including additional vitamin d assays

Eligibility criteria:
inclusion criteria: males and females, age≥ 18 years able to understand and willing to provide informed consent exclusion criteria: males and females, age \<18 years current use of dietary supplements (tablet, liquid gel or liquid form only) containing high concentrations, greater than 2,000 iu per day, of vitamin d. has a history of vitamin d deficiency has a history or current diagnosis of any clinically significant cardiac, respiratory, neurological, immunological, hematological, liver disease, renal disease, gastrointestinal (gi) disorder, including any history of peptic or gastric ulcers or gi bleeding, or any other condition which, in the opinion of the investigator is considered chronic. personal history of seizures personal history of bariatric surgery personal history of parathyroid and thyroid disease pregnancy or lactation is receiving systemic chemotherapy or radiation treatment, has an active malignancy of any type, or has been diagnosed with cancer within 5 years before screening other than basal or squamous cell skin cancers or in-situ cervical cancer. family history of parathyroid or calcium regulatory disease medications known to affect absorption e.g. drugs that inhibit cholesterol absorption medications known to increase catabolism such as anticonvulsants, glucocorticoids, haart (aids treatment) and anti-rejection medications unable to provide informed consent
diastolic dysfunction in aortic regurgitation

Conditions: Aortic Regurgitation

Summary: follow-up study in patients with severe aortic regurgitation after successful valve replacement. systolic and diastolic function were assessed and persistent diastolic dysfunction was observed late (7-10 years) after operation.

background patients with severe aortic regurgitation show eccentric lv hypertrophy and structural changes of the myocardium. reversibility of functional and structural changes after successful valve replacement may be limited. persistent diastolic dysfunction has been observed in the present study late after aortic valve replacement. this finding has been explained by incomplete regression of the extra-cellular matrix 7 years after valve replacement. interstitial fibrosis remains unchanged compared to the preoperative situation but was increased early after operation due to the reduction in lv muscle mass. regression of lv hypertrophy was 40% after 2 and 55% after 7 years of valve replacement. myocardial muscle fibers decreased slightly but remained hypertrophied even late after operation. interstitital fibrosis was found to be positively correlated to myocardial stiffness and inversely to lv ejection fraction. thus, persistent diastolic dysfunction with maintained systolic ejection performance can be observed late after successful valve replacement in patients with severe aortic regurgitation. altered diastolic function has been associated with increased filling pressures during strenuous exercise with signs of dyspnea. objective evaluation of myocardial structure and function in patients with chronic volume overload before and after valve replacement(lv-remodeling). methods pressure-volume measurements and myocardial biopsy samples for assessing myocardial function and structure.

Eligibility criteria:
inclusion criteria: * severe aortic regurgitation * successful valve replacement * informed consent * sinus rhythm * no comorbidities * no bundle branch block * no pregnancy exclusion criteria * unwillingness to undergo postop. cath * diabetes mellitus * arterial hypertension * bleeding disorder * pulmonary hypertension

Keywords: diastolic function aortic regurgitation aortic valve replacement left ventricular hypertrophy myocardial structure lv remodeling muscular regression lv fibrous tissue
early and objective assessment of neurological prognosis in cardiac arrest patients

Conditions: Cardiac Arrest; Neurologic Symptoms; Intensive Care Neurological Disorder

Summary: cerebral lesions are responsible for two thirds of deaths in patients admitted to intensive care following cardiac arrest. patients with neurological lesions should be the priority target for neuroprotective interventions, which are the cornerstone of post-cardiac arrest care (allowing a reduction in the burden of care for patients without this type of lesion). furthermore, these interventions must be based on a precise assessment of the severity of these brain lesions: carrying out neuro-protective interventions in patients without brain lesions exposes these patients to unnecessary treatment potentially associated with adverse effects without any possible benefit. however, the early assessment of neurological prognosis, particularly on admission to intensive care, is an area where there is little research and where it is not possible to obtain a precise and reproducible assessment. several tools can be used to assess this prognosis at an early stage: anamnesis and characteristics of the cardiac arrest and the patient's comorbidities, imaging, electrophysiology and biomarkers. to assess the predictive value of early biomarker testing in patients resuscitated after cardiac arrest, whatever the cause, the investigators plan to conduct a prospective observational multicentre trial. it is important to bear in mind that the aim of this study is not to assess the long-term prognosis of patients suffering cardiac arrest in order to take measures to limit or discontinue active therapies, but simply to provide a reliable tool, simple and quick to use, in order to be able to identify a sub-population of patients who should be the subject of preferential neuro-protection measures, and conversely to simplify management (moderate temperature control, early cessation of sedation, early extubation) for patients with no neurological lesions.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years * admitted to intensive care with out-of-hospital cardiac arrest * comatose on admission (defined by a glasgow score ≤ 8) * informed relative who has consented to the patient's participation in the study or inclusion under emergency procedure if the relative is absent at the time of inclusion exclusion criteria: * in-hospital cardiac arrest * age \< 18 years * person under guardianship or legal protection * prior inclusion in the study
sensitivity and specificity of a mobile lead-one ecg like device for the detection of atrial fibrillation (af)

Conditions: Atrial Fibrillation

Summary: atrial fibrillation(af) is one of the most common abnormal heart rhythms and approximately 3% of the general population have af. the prevalence increases with age of the population and is increased in people with diabetes, hypertension and those who are overweight. af is a major risk factor for stroke; people with af are five times more likely to suffer an ischaemic stroke; however this can be reduced significantly with appropriate interventions which depends on detection of the abnormal rhythm. although the national institute of health and care excellence (nice) currently recommends screening patients with symptoms of af, including syncope, heart palpitations, and chest discomfort, as well as patients who have suffered a stroke or heart attack, many patients remain symptomless and are not managed for their increased stroke risk. guidelines for af screening include manual palpation of a peripheral pulse, followed up by an ecg for patients who have an irregular pulse. although almost all patients with af have an irregular pulse, only about 12 in 100 patients with an irregular pulse have af. use of an improved screening tool for af could both cut down the number of people undergoing unnecessary ecgs, and also lead the way for a wider screening programme for af. the aim of this study is to investigate the sensitivity and specificity of a new ecg like device for the detection of af, the plessey impulse. participants referred or admitted to secondary care with stroke symptoms and other indicators of increased prevalence of af will be recruited. participants will undergo three methods of af screening, a peripheral pulse, a lead-one like ecg using the impulse device, and the gold-standard for af detection, a 12-lead ecg. by comparing to the ecg results specificity and sensitivity will be established for both methods in this population.


Eligibility criteria:
inclusion criteria: patients with af or suspected af referred or admitted to hospital (secondary care setting). able to hold the impulse device with both hands. able to give informed consent. exclusion criteria: patients who are unable to give informed consent either through lack of capacity or lack of ability to understand study documentation. patients who are unable to hold the impulse device for 2mins. presence of artificial pacemaker or cardioverter defibrillator.
understanding quality of life among patients with cancer receiving palliative care

Conditions: Cancer

Summary: this randomized controlled trial will assess the effects on quality of life of two approaches to symptom management among new patients referred to a palliative care oncology clinic.


Eligibility criteria:
inclusion criteria: * be a new patient at an outpatient palliative care clinic * resident of pennsylvania * over 18 years of age exclusion criteria: * prior use of certain symptom focused therapies * currently pregnant
dose-response study to evaluate safety, efficacy, and pharmacokinetics of pf-00217830 compared with placebo in acute exacerbation of schizophrenia

Conditions: Schizophrenia

Summary: the objective of this study is demonstrate efficacy and a dose-response in the treatment of acute exacerbation of schizophrenia in comparison to placebo.


Eligibility criteria:
inclusion criteria: key inclusion criteria include: * have a current diagnosis of schizophrenia. * increase in symptoms over the past 2-4 weeks. * willing to remain inpatients for the duration of the trial. exclusion criteria: * subjects with a current dsm-iv axis i diagnosis other than schizophrenia * subjects who meet the dsm-iv criteria for psychoactive substance abuse and dependence * subjects with a history of treatment resistant schizophrenia * females of childbearing potential
proton pump inhibitor (ppi) responsive eosinophilic esophagitis eoe: gastroesophageal reflux disease (gerd) or eosinophilic esophagitis (eoe)?

Conditions: Erosive Esophagitis

Summary: the investigators would like to determine if there are patients with ppi responsive eosinophilic esophagitis infiltration that have significant loss of esophageal distensibility suggestive of esophageal fibrosis typical of classic eosniophilic esophagitis. if this group of patients exists, the investigators would like to determine if they have the typical endoscopic features of eoe rather than those of gerd.


Eligibility criteria:
inclusion criteria: * age 18 or older * have either mild-to-moderate los angeles (la) classification system grade b, moderately severe la grade c, or severe la grade d erosive reflux esophagitis * or patients having a clinically indicated ph/impedance monitoring on proton pump inhibitor therapy for indications of gastroesophageal reflux disease. exclusion criteria: * neoplasm of the esophagus or stomach * inability to read due to: blindness, cognitive dysfunction, or english language illiteracy * disorders which predispose to unreliable responses such as schizophrenia, alzheimer's disease or significant memory loss

Keywords: erosive esophagitis gastroesophageal reflux disease
validation of the french version of the score on quality of life (hisqol) in hidradenitis suppurativa (qualiver)

Conditions: Hidradenitis Suppurativa

Summary: validation of the french version of the score on quality of life in hidradenitis suppurativa. the french hisqol will be completed by 60 patients with hidradenitis suppurativa a first time, and a second time 1 week later.


Eligibility criteria:
inclusion criteria: * age ≥18 years * patient with verneuil disease * beneficiary of or affiliated to a social security insurance * participation agreement exclusion criteria: * patients physically or mentally unable to complete questionnaires. * refusal to participate * patient under legal protection (guardianship, curatorship) or deprived of liberty
blood flow stimulation in the lower limbs by application of different external devices

Conditions: Venous Stasis; Deep Vein Thrombosis

Summary: in this study, four different devices which stimulate the blood in the lower extremities are used in ten healthy persons while measuring the blood flow with ultrasound. the aim is to study the haemodynamic effects in the lower extremities of each modality and also to compare those effects between the four modalities in order to identify those which most effective than the others.

three intermittent pneumatic compression (ipc) devices were selected: foot-ipc, rapid calf-ipc and a slow, sequential calf-ipc. a neuromuscular electrical stimulation (nmes) device was also used in the calf. blood flow measurements in the right popliteal vein of ten healthy individuals were performed using doppler ultrasound before (control) and while using ipc or nmes. the blood flow parameters measured where: peak systolic velocity (cm/s), time-averaged mean velocity (cm/sec), volume flow (ml/min) and ejected volume per individual stimulus (ml). the tolerability of each device was also assessed using an analogue scale from zero to ten. differences between modalities regarding the pattern as well as the absolute values of velocity and volume are being assessed. power calculation: recent studies showed that the peak venous velocity (pv) at baseline is around 11 cm/s and after applying foot-ipc the pv rises to 50 cm/s with a maximum standard deviation of 15 (broderick et all, 2014). thus, three patients per group would be required to detect a difference of 39 cm/s in pv (two-sided type-i error rate = 5%; power = 80%). to reach an even higher power we choose to include 10 patients in study, which resulted in a power of 99.7% for the above calculation.

Eligibility criteria:
inclusion criteria: * healthy volunteers exclusion criteria: * pregnancy * previous lower limb operation involving the vascular system * current thromboprophylactic or thrombolytic therapy * vascular abnormalities in the lower limbs * cardiorespiratory or renal failure causing pitting oedema

Keywords: intermittent pneumatic compression devices electric stimulation therapy blood flow velocity hemodynamics