Kornimate/medical-research-clean huggingface dataset:
high power short duration radiofrequency ablation of atrial fibrillation using the qdot micro™ catheter

Conditions: Atrial Fibrillation (AF)

Summary: atrial fibrillation (af) is the most common cardiac arrhythmia worldwide, characterized by rapid and disorganized atrial activation leading to an irregular heart rhythm. pulmonary vein isolation (pvi) ablation is the gold standard for catheter ablation based therapy. however, recurrence of af after pvi is common, often due to the inability to create durable ablation lesions surrounding the pulmonary veins (pv). conventional radiofrequency (rf) ablation is typically performed with power set at 30-40 watt for a duration of 20-30 seconds. previous studies have shown that ablation with very higher power and shorter duration (vhpsd, 90w/4sec) may result in more continuous and more durable ablation lesions with a similar safety profile as compared to conventional ablation lesions. this new technique may consequently improve outcomes of rf ablation for af. moreover, hpsd ablation of af may significantly reduce rf duration, which could lead to shorter anaesthesia, fluoroscopy and procedure duration. cardiac magnetic resonance imaging (cmr) enables studying cardiac volumes, function and atrial tissue characteristics. by applying this imaging strategy before ablation, and directly (\<72 hours) and later (3 months) after ablation, transient (edema) and persistent (fibrosis) effects of rf ablation in the left atrial wall and surrounding tissues may be visualized and quantified. the q-power study aims to assess the effects of vhpsd rf ablation on 1) procedural characteristics, 2) acute and long-term ablation lesion formation and collateral tissue damage as assessed by cmr and 3) clinical outcomes in af patients.


Eligibility criteria:
inclusion criteria: * \>18 years of age * af and eligible for index pvi according to current esc guidelines exclusion criteria: * unwilling or unable to give written informed consent * prior left atrial ablation * other left atrial arrhythmias including atrial flutters * prior left atrial surgery * severe mitral valve regurgitation * contraindication for gadolinium-based contrast agents * contraindications for cmr (including metallic implants, cochlear implants, cardiac devices, neurostimulation systems, claustrophobia) * renal insufficiency (egfr \< 30 ml/min)

Keywords: atrial fibrillation; pulmonary vein isolation; very high power short duration ablation; cardiac magnetic resonance
does bicarbonate in addition to theophylline reduce cin?

Conditions: Radiographic Contrast Agent Nephropathy

Summary: contrast-induced nephropathy (cin) is the third most frequent cause of hospital-acquired acute renal failure. different regimes in the prophylaxis of cin have been investigated in the last years. recent meta-analysis show a reduced incidence of cin when theophylline is administered to the patients especially in patients with already existing renal impairment. furthermore hydration with bicarbonate seems to to be superior to hydration with sodium chloride alone. the combination of the two prophylaxis has not been investigated yet. aim of this prospective randomized trial is to investigate the effect of hydration with sodium bicarbonate compared to saline in addition to theophylline prophylaxis which all patients receive.


Eligibility criteria:
inclusion criteria: increased risk for contrast induced nephropathy defined as: * serum creatinine level ≥ 1.1 mg/dl or * serum creatinine level ≥ 0.8 mg/dl plus an additional risk factor like diabetes mellitus, renal failure in past medical history or nephrotoxic medication (aminoglycoside, vancomycin, amphotericin b, diuretic) exclusion criteria: * pre-existing renal replacement therapy * unstable serum creatinine levels (difference of more than ±0.4 mg/dl within 3 days before contrast application) * contraindications for theophylline or sodium bicarbonate (allergies, tachycardia, alkalosis, hypokalemia) * additional interventions that might influence renal function
regional distribution of ventilation in patients with chronic heart failure

Conditions: Chronic Heart Failure

Summary: inspiratory muscle dysfunction is a reduction in the ability to generate pressure and force by the inspiratory muscles. this decrease in the strength of these muscles can be attributed to biochemical and histological changes. some patients with chf showed a reduction of maximal inspiratory pressure (mip) and inspiratory muscle endurance, and such factors known to exercise limitation and deterioration in quality of life and worsens the prognosis of these patients. this study aims to evaluate the regional pulmonary distribution volume and the influence of enclosures system thoracoabdominal in chf patients with cardiomegaly associated with diaphragmatic weakness during quiet breathing and during exercise for inspiratory muscle and its correlation with functional data. the investigators evaluated a total of 31 individuals divided into two groups: chf and control. in the control group, twelve volunteers participated with similar age, gender and body mass index in relation to the group of patients with chf. the control group participants had an ejection fraction of left ventricle (ef)\> 50% without cardiac abnormalities of the cameras and mip over 80% of predicted. to conduct the exercise to the inspiratory muscles (emi) was used for imt threshold ® device (threshold inspiratory muscle trainer, healthscan products inc., cedar grove, new jersey) is one of the most used for training of inspiratory muscles in patients with several pathologies such as chf. the exercise time was 3 minutes. during this period, participants were encouraged to only breathe through the mouth and maintain a respiratory rate between 12 and 16ipm. opto-electronic plethysmography measures the volume changes of thoracoabdominal system by placing 89 markers formed by hemiesferas covered with retro-reflective paper, taking the place of each of these hemiesferas determined by anatomical landmarks on the anterior and posterior regions of the chest and abdomen. according to our study, a lower ventilation on diaphragmatic region would lead to an increased perception of dyspnea during submaximal exercise in this population. moreover, the observed changes in the pattern of regional distribution of ventilation in chf patients compared to healthy individuals can serve as a basis for prospective cohort studies using imt.


Eligibility criteria:
inclusion criteria: * diagnosed as chf associated with cardiomegaly * class ii and iii (nyha) * left ventricular minor 45% (method teicholtz) * inspiratory muscle weakness (pimáxima \<70% predicted) * duration of symptoms \> 1 year * body mass index (bmi) \< 35kg/m2 * non-smokers or former smokers with a smoking history \< 10 pack-years exclusion criteria: * patients with chronic heart failure who had unstable angina, myocardial infarction or heart surgery until three months before the survey * orthopedic diseases or respiratory comorbidities such as asthma and copd
pulmonary embolism warsaw registry

Conditions: Acute Pulmonary Embolism

Summary: initiated in january 2008, the pe-aware (pulmonary embolism warsaw registry) is an on-going single-centre prospective observational study of patients with confirmed acute pulmonary embolism (ape). extensive data on consecutive patients with pulmonary embolism is collected and stored. the main objective is to collect and provide information on patients' characteristics, management, and outcome with the purpose of decreasing mortality in ape, the occurrence of bleeding, and the frequency of thromboembolic recurrences. moreover, the pe-aware registry serves as a basis for creating predictive scores for clinicians which aid patient management. the study endpoints comprise clinically recognized (and objectively confirmed) recurrences of pe, major and minor bleeding complications classified according to the international society on thrombosis and haemostasis classification, need for cardiopulmonary resuscitation or catecholamines, and death.

the pulmonary embolism warsaw registry (pe-aware) is an on-going prospective observational study of patients with confirmed acute pulmonary embolism (ape). carried out since january 2008, the registry includes consecutive patients hospitalized at a single centre. the primary data recorded include details of each patient's clinical status, co-morbidities, the prescribed treatment, the results of additional studies (ie ekg, imaging studies), and the outcome. the study endpoints comprise clinically recognized (and objectively confirmed) recurrences of pe, major and minor bleeding complications classified according to the international society on thrombosis and haemostasis classification, need for cardiopulmonary resuscitation or catecholamines, and death. collecting the fore mentioned data allows for clinicians to better manage the diagnostic workup and treatment and thus facilitates the prevention of possible future complications in ape patients.

Eligibility criteria:
inclusion criteria: * objectively confirmed pulmonary embolism * informed consent for the participation in the study, according to the requirements of the ethics committee exclusion criteria: * lack of consent

Keywords: acute pulmonary embolism
ha residents with pvd, 6mwd assessed at ha (2840m) vs la (sea level)

Conditions: Pulmonary Vascular Disease; Pulmonary Artery Hypertension; Chronic Thromboembolic Pulmonary Hypertension

Summary: to study the effect of relocation from 2840m (quito) to sea level (pedernales) in patients with pulmonary vascular diseases (pvd) defined as pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension (ph) who permanently live \>2500m on 6-minute walk distance (6mwd)

this research in patients with pvd diagnosed with precapillary ph with right heart catheterization and classified to groups 1 and 4 (pah or cteph) who permanently live at ha \>2500 (pvdha) will have 6-minute walk distance near their living altitude in quito at 2840m and at sea level in pedernales the day after the first and the second night after relocation.

Eligibility criteria:
inclusion criteria: * adult patients 18-80 years old of both genders, * residence \> 2500m of altitude * diagnosed with precapillary ph (mean pulmonary artery pressure (mpap) \>20 mmhg, pulmonary artery wedge pressure (pawp) ≤15 mmhg and pulmonary vascular resistance (pvr) ≥2 wu (wood units) by right heart catheterization) with ph being classified as pah or cteph according to guidelines * patients stable on therapy * nyha (new york heart association) functional class i-iii * provided written informed consent to participate in the study. exclusion criteria: * age \ 80 years * unstable condition * patients who cannot follow the study investigations, patient permanently living \< 2500m. * patients with moderate to severe concomitant lung disease (fev1\ 20 igarettes/day) * severely hypoxemic patients at quito permanently have persistent spo2 (oxygen saturation by pulseoximetry) \<80% on ambient air. * patients with chronic mountain sickness (hemoglobin \> 19 g/dl in women, \>21 g/dl in men) * patient with a non-corrected ventricular septum defect * relevant concomitant other disease of the heart, kidney, liver, blood (anemia hemoglobin\<11 g/dl)

Keywords: pulmonary hypertension hypoxia 6-minute walk test high altitude pulmonary artery hypertension chronic thromboembolic pulmonary hypertension
feasibility and acceptability of an internet-based cognitive-behavioral treatment for insomnia in adults with asthma

Conditions: Asthma; Insomnia Chronic

Summary: the purpose of the proposed study are to explore changes in sleep and asthma outcomes from baseline to post-treatment in adults with asthma and comorbid insomnia who underwent internet-based cognitive-behavioral treatment for insomnia (cbt-i).


Eligibility criteria:
inclusion criteria: * primary diagnosis of moderate-severe persistent asthma * not well controlled asthma (score ≤ 19 on the asthma control test) * age 18-75 years * meets criteria for diagnostic and statistical manual of mental disorders (dsm-5) insomnia disorder * at least moderate insomnia severity (score ≥ 10 on insomnia severity index) * telephone number, email address, and reliable internet access exclusion criteria: * history of bipolar or psychosis * substance abuse disorder within past 3 months * dementia or probable dementia diagnosis * plans to move or leave present source of care during the following 6 months. * non-english speaking, illiterate, or possesses sensory deficits

Keywords: asthma insomnia cognitive-behavioral treatment
microbiome and rectal cancer

Conditions: Rectal Cancer; Locally Advanced Malignant Neoplasm

Summary: the purpose of our study is to determine if an association exists between the microbiome of those with rectal adenocarcinoma who are complete pathologic responders and those who have a partial or no response to neoadjuvant therapy.

this study will help to further elucidate the association of bacteria with rectal cancer, while also characterizing the genes associated with that risk. furthermore it will attempt to better understand which patients may have an optimal response to neoadjuvant chemoradiation allowing for possible predictive metagenomics evaluation, investigators may be able to augment treatments as well as provide recommendations for the success and cost effectiveness of cancer care.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years old * locally advanced rectal adenocarcinoma (t3) * standard 5fu based chemoradiation * total neoadjuvant therapy per opra protocol guidelines exclusion criteria: * age \< 18 years * stage i or stage iv rectal adenocarcinoma * rectal cancer other than adenocarcinoma * genetically associated cancer (hnpcc, fap etc.) or highly suspicious for genetically associated cancer * prior history of rectal adenocarcinoma (i.e. recurrent colorectal adenocarcinoma)
motion sickness on astrolabe's vessel

Conditions: Sea Sickness

Summary: sea sickness syndrome is present for 80% of persons on board when the boat rotation missions astrolabe, sometimes there is a risk of very significant dehydration. a special unit specialized in the fundamental study of the vestibular system (inner ear), sensory organ at the base of visual-vestibular conflict inducing this syndrome, also provides medical support for parabolic flights (flight reproducing weightlessness) where this syndrome is strongly present. the goal of the study is to assess the frequency of occurrence of this sea sickness syndrome on the astrolabe, to understand the triggers (type of boat movements, personality traits, anxiety / stress) without changing habits on board for those on board taking a antinaupathique treatment given by the ship's doctor. this study will be done in collaboration between inserm u 1075 (france) and the laboratory of military research viper specialized in extreme environments (belgium). the ultimate goal will be to provide the best recommendations and the best treatment regimen to alleviate as best as possible the symptoms of people on board of the astrolabe so scientists on board can perform their work.

background: the objectives were to assess the prevalence, severity, medication taken and to look for predictive factors, in order to better identify characteristics of passengers at risk of motion sickness during transport scientists travelling from hobart in tasmania to the french polar stations in antarctica. methods: two hundred and thirty-nine passengers were surveyed over 4 years with 4 round trips per year using motion sickness susceptibility questionnaire (mssq), simulator sickness questionnaire (ssq), state-trait anxiety test (stai-trait and stai-state), and general parameters (age, gender, number of trips, jet-lag, direction of the trip), medication, calculation of the distance of each passenger's cabin to the centre of gravity (cog.).

Eligibility criteria:
inclusion criteria: * participant aged of 18 or older but younger than 70 who received their medical ability to travel to terre adélie or making a research cruise aboard the astrolabe * particpant signing the informed consent. exclusion criteria: * none
a safety, tolerability, and plasma concentration study of levodopa/carbidopa subcutaneous solution (nd0612) in parkinson's disease (pd) patients

Conditions: Parkinson's Disease

Summary: in this phase i/iia study, the effect of continuous subcutaneous administration of ld/cd solution (nd0612) on the safety and pk profile of ld will be examined.

design: single center, double-blind, randomized, placebo-controlled, crossover study. study drug: subcutaneous (sc), nd0612 (ld/cd solution) or placebo (saline) to be administered via a continuously via the crono five sc pump. a 1-week washout period will apply between the treatments. population: eight (8) pd subjects.

Eligibility criteria:
main inclusion criteria: * men and women with idiopathic parkinson's disease * subjects must experience motor fluctuations associated with ld/cd dosing * modified hoehn and yahr stage \< 5 * subjects must be taking optimized and stable levodopa/dopa decarboxylase inhibitor therapy * women must be postmenopausal, surgically sterilized, or using adequate birth control. women of childbearing potential must have a negative pregnancy test (serum beta-hcg) at screening. * subjects must be age 30 or older. * subjects must be willing and able to give informed consent. main exclusion criteria: * subjects with a clinically significant or unstable medical or surgical condition * subjects with clinically significant psychiatric illness. * pre-menopausal women, not using birth control method. * subjects who have taken experimental medications within 60 days prior to baseline. * subject who have undergone a neurosurgical intervention for parkinson's disease (e.g., pallidotomy, thalamotomy, transplantation and deep brain stimulation).
coagulation factors and postpartum hemorrhage

Conditions: Postpartum Hemorrhage

Summary: objective is to analyze a possible association of coagulation factors peripartal with the occurrence of postpartum hemorrhage.


Eligibility criteria:
inclusion criteria: * pregnant women \> 22 weeks of gestation exclusion criteria: * age \< 18 years, no informed consent

Keywords: pph
value of fetal scalp lactate sampling during labour in cases of abnormal fetal heart rate

Conditions: Metabolic Acidosis

Summary: st-analysis of the foetal ecg (stan®) is another second line technique for intrapartum foetal monitoring. combining st-analysis with standard ctg interpretation aims to identify hypoxic foetuses more accurately than ctg alone. the stan® method identifies changes in the st-interval of the foetal ecg that occur in the presence of foetalcentral hypoxia the aim of this studie is to investigate if the foetal lactate blood sampling is still useful when stan® monitoring is already being used as a second line technique for intrapartum foetal monitoring if the fetal heart rate is abnormal without a significant st event nowadays in the montpellier hospital's protocol, the investigators have to check the value of lactate sampling in case of le stan doesn't detect an st event. so this studie can change the montpellier hospital's protocol and avoid useless fetal blood sampling


Eligibility criteria:
inclusion criteria: * patient with labor monitoring by st segment analysis (stan) according to current guidelines * patient who received a fetal lactate sample for fetal heart rate classified as pathological for more than 60 minutes exclusion criteria: * stan guidelines not respected before installation and during work * misclassification of fetal heart rate * obstetrical complications during labor

Keywords: serious metabolic acidosis t segment analysis blood samples instrumental delivery apgar score admission to a neonatal ward
autologous fecal microbiota transplantation for patients with acute graft-versus-host disease

Conditions: Fecal Microbiota Transplantation in Graft vs. Host Disease

Summary: this study aims to assess the safety and efficacy of autologous fecal microbiota transplantation (fmt) in gastrointestinal (gi) related graft-versus-host disease (gvhd). stool for fmt will be prepared from pre-allogeneic stem cell transplantation (allo-sct) period. this strategy might offer a novel and safe therapeutic approach for these patients, who suffer from high disease related morbidity and mortality and are refractory to multiple treatments.

all candidates for allo-sct at bmt unit in rhcc will be screened for study inclusion and exclusion criteria. seven to fourteen days prior to allo-sct (before initiation of sct related antimicrobials), all consenting patients will supply stool sample (first stool sample), which will serve as the autologous fmt sample, and clinical data will be collected. patients who will develop gi related gvhd will be asked to supply another stool sample 7±2 days after the appearance of gvhd related symptoms (second stool sample). clinical and laboratory data will be collected. another stool sample will be collected 7-14 following autologous fmt (third stool sample), and clinical data and outcome will be documented. day 1 of the study will be defined as day of allo-sct, and follow up period is 6 months. complementary data will be collected from the electronic medical records.

Eligibility criteria:
inclusion criteria: \* allo-sct patients above 18 years of age with acute steroid-resistant gi-related gvhd grade iii-iv. exclusion criteria: * prior inclusion to an interventional study * pregnant or lactating women * previous allo-sct * known multi-drug resistance carriage prior to stool collection * severe colitis of any etiology or a history of inflammatory bowel disease (ibd) * uncontrolled infection (hemodynamic instability, ongoing fever or bacteremia within 3 days after antibiotics administration) * active gi bleeding * absolute neutrophil count \< 500 cells/microl * patients who cannot give informed consent

Keywords: fecal microbiota transplantation allogeneic stem cell transplantation microbiome
pharmacogenetics in primary care psychotropics

Conditions: Depression; Obsessive-Compulsive Disorder; Generalized Anxiety Disorder

Summary: pragmatic trial of pharmacogenetic testing at the time of prescription for a selective serotonin reuptake inhibitor, tricyclic antidepressant or atypical antipsychotic. does real time intervention improve patient outcomes?


Eligibility criteria:
inclusion criteria: * over 18 * prescribed a drug of interest for the first time exclusion criteria: * previous pharmacogenetic testing available
thermocool® smarttouch™ catheter for the treatment of symptomatic paroxysmal atrial fibrillation

Conditions: Heart Diseases; Arrhythmia; Atrial Fibrillation

Summary: the purpose of this study is to demonstrate the safety and effectiveness of the thermocool® smarttouch™ catheters with contact force sensing capability in the treatment of drug refractory symptomatic paroxysmal atrial fibrillation (af) during standard electrophysiology mapping and rf procedures.


Eligibility criteria:
inclusion criteria: * have had at least 3 atrial fibrillation episodes within 6 months of this study * have failed at least one antiarrhythmic drug shown by repeated atrial fibrillation episodes * 18 years of age or older exclusion criteria: * have had previous ablation for atrial fibrillation * have take amiodarone within 6 months of this study * have had any heart surgery within the last 60 days * have had a heart attack within the last 60 days * females who are pregnant or breast feeding

Keywords: atrial fibrillation paroxysmal atrial fibrillation