Kornimate/medical-research-clean huggingface dataset:
effects of remote ischemic preconditioning in off-pump versus on-pump coronary artery bypass grafting(ripcon)

Conditions: Myocardial Injury

Summary: purpose remote ischemic preconditioning (ripc) with transient upper limb ischemia reduces myocardial injury in patients undergoing on-pump coronary artery bypass (cabg) surgery with cross-clamp fibrillation or blood cardioplegia for myocardial protection. the molecular mechanisms leading to these effects are yet not fully understood. the purpose of the present study is to validate previous studies and gather further evidence for ripc during cabg with blood cardioplegia, furthermore to determine, whether or not ripc is still operative during off-pump coronary artery bypass surgery (opcab), finally to elucidate intra-cellular mechanisms involved in myocardial protection by ripc and their possible systemic mediators.

remote ischemic preconditioning (ripc) protocol before cabg (study arm a) or opcab (study arm b) consists of 3 cycles of 5 minutes left upper arm ischemia by inflation of a blood pressure cuff to 200 mmhg and 5 minutes of reperfusion after induction of anesthesia before coronary artery bypass surgery. for myocardial molecular analyses, left ventricular biopsies are taken before induction of cardioplegic cardiac arrest (a) or first coronary incision (b), and 5 to 10 minutes after aortic unclamping during reperfusion of the myocardium (a) or 5 to 10 minutes after the completion of the last anastomosis (b). blood samples are taken prior to ripc and during the first three postoperative days.

Eligibility criteria:
inclusion criteria: * confirmed triple vessel coronary artery disease * indication for surgical coronary revascularisation * written informed consent * age ≥ 18 years exclusion criteria: * age \> 80 years * instable angina/acute coronary syndrome * emergency surgery * recent myocardial infarction within 7 days prior to surgery * recent major infection/sepsis within 7 days prior to surgery * significant hepatic, renal oder pulmonary disease * other concomitant surgical procedures

Keywords: remote ischemic preconditioning coronary artery bypass grafting myocardial injury
acute effects of lbbp versus bvp for crt

Conditions: Heart Failure; Cardiac Pacing, Artificial; Cardiac Resynchronization Therapy

Summary: the study was designed to compare the acute effects of left bundle branch pacing (lbbp) with biventricular pacing (bvp) in patients with left ventricular ejection fraction (lvef) \<=35% with left bundle branch block (lbbb).

the metrics include electrocardiographic, echocardiographic and hemodynamic parameters to evaluate and compare lbbp with bvp for resynchronization therapy in patients with heart failure and lbbb.

Eligibility criteria:
inclusion criteria: * nyha class ii-iv; * lvef \<=35%; * lbbb with qrs duration \>=130ms. exclusion criteria: * moderate-to-severe aortic stenosis; * frequent premature ventricular complexes; * signiﬁcant peripheral vascular disease.
study on the current situation and related factors of hypertension management in a poor county in shanxi province

Conditions: Hypertension

Summary: this project aims to understand the current situation of hypertension management in a poor county in shanxi province, and explore the factors that affect patients' blood pressure control based on local reality, and provide a basis for further promoting the standardized management of hypertension in poor areas and the comprehensive prevention and control of chronic diseases at the national grassroots level.


Eligibility criteria:
inclusion criteria: （1）clinical diagnosis of hypertension (2) permanent population or floating population who have lived for more than 6 months in the area; (3) in the case of not taking antihypertensive drugs, after 3 different daily blood pressure measurements, the systolic blood pressure ≥140 mmhg and/or the diastolic blood pressure ≥90 mmhg were achieved in all 3 times, and it has been diagnosed by the community and above medical institutions in the past. residents with high blood pressure; (4) as of october 2020, all research subjects have been included in the national basic public health service projects by medical institutions and have received standardized management of hypertension for one full year. exclusion criteria: 1. pregnant and lactating women; 2. those who are critically ill, mentally ill, cognitively impaired, etc.
effect of panretinal photocoagulation on optic nerve head topography

Conditions: Diabetic Retinopathy

Summary: the purpose of this study is to evaluate the optic nerve head changes consequent to panretinal photocoagulation done for diabetic retinopathy.

panretinal photocoagulation thermally ablates the retina to effect the regression of the neovascular process seen with diabetic retinopathy.2-6 photocoagulative damage also damages the nerve fiber layer in the process. since this should theoretically be associated with loss of nerve fibers it is expected to manifest as changes in optic nerve head cupping. there is no available literature to support this hypothesis. in fact the only available study done of the subject refuted the hypothesis.7 the study had a retrospective design and was done before any of the current technology to evaluate optic nerve head morphology was available. patients with concurrent glaucoma and diabetes often undergo panretinal photocoagulation as a part of their diabetes treatment. optic disc cupping is a standard outcome measure for glaucoma diagnosis and progression. if prp were to cause increased cupping, this can be a significant confounder in determining glaucoma progression based on optic nerve cupping. the findings of the study will help us determine as to how much cupping can be attributed to the prp, if any at all.

Eligibility criteria:
inclusion criteria: * any patient with proliferative diabetic retinopathy or severe non-proliferative diabetic retinopathy otherwise undergoing panretinal photocoagulation for treatment. exclusion criteria: * any patient with uncontrolled glaucoma (iop above target on any occasion in the preceding 6 months) or other optic neuropathy that may confound the analysis of optic nerve head morphology. * patients with media opacities (significant cataract, corneal opacity, vitreous hemorrhage) precluding imaging of the optic nerve. * no prp done in the previous 6 months.

Keywords: panretinal photocoagulation diabetic retinopathy optic nerve head changes
music during the reduction of distal radius fractures as an adjunctive therapy for pain and anxiety management.

Conditions: Distal Radius Fracture Reduction

Summary: fractures of the distal end of the radius are one of the most frequent fractures diagnosed in the emergency room. the initial management, and in many cases definitive, is carried out through manipulation, closed reduction and immobilization in the emergency room. different methods of anesthesia have been described to reduce pain during the manipulation and reduction procedure, such as: hematoma block, periosteal block, general anesthesia, intravenous regional anesthesia, nitrous oxide, intramuscular sedation, and conscious sedation. despite the use of different methods of anesthesia, none is fully effective and each of these methods is not free of complications. adjuvant measures could play an important role in improving the patient's experience during the procedure, however, there is little evidence in this regard. music is increasingly being studied and developed as an adjunctive therapy in the management of pain and anxiety in different medical procedures, demonstrating a statistically significant reduction in pain and anxiety. however, in the literature there is no evidence of studies that evaluate the effect of music during the reduction of fractures in traumatology as an adjuvant therapy for the management of pain and anxiety. in our experience, despite the anesthesia used, reductions of distal radius fractures are usually a painful procedure that involves a certain degree of discomfort for the patient. for this reason, the investigators believe this study is necessary, as it could demonstrate a new adjuvant therapy that reduces pain and anxiety and improves the overall experience of the patient, in addition to being music, a low-cost tool with no risks for patient safety.


Eligibility criteria:
inclusion criteria: * patients older than 18 years. * clinical and radiological diagnosis of a fracture of the distal end of a closed radius that has an indication for closed reduction. exclusion criteria: * diagnosis of other concomitant fractures. * allergy to local anesthetics. * significant hearing impairment and/or use of hearing aids. * patients whose comorbidities prevent correct participation in the procedure (such as cognitive impairment, diagnosis of psychiatric diseases, patients under the influence of drugs...).
hydrocortisone, vitamin c, and thiamine for the treatment of sepsis and septic shock

Conditions: Sepsis

Summary: in this prospective clinical study, the investigators compare the outcome and clinical course of consecutive septic participants treated with intravenous vitamin c, hydrocortisone, and thiamine (treatment group) with a control group treated in the investigators' icu. the primary outcome is hospital survival. a propensity score is generated to adjust the primary outcome.there is 70 participants in each group.

a prospective randomized controlled trial is conducted.one hundred and forty severe sepsis or septic shock participants admit to the department of critical care medicine of zhujiang hospital,southern medical university from september 2017.the participants are divided into control group ( n = 70 ) and treatment group ( n = 70 ).the participants in both groups are treated according to "2016 international guidelines for management of sepsis and septic shock",and the participants in treatment group receive intravenous vitamin c, hydrocortisone, and thiamine. the participants in control group receive normal saline.the patients' clinical and demographic data, including age, sex, admitting diagnosis, comorbidities, requirement for mechanical ventilation, use of vasopressors, daily urine output, fluid balance after 24 and 72 h, length of icu stay (los),and laboratory data (serum creatinine, white blood cell (wbc), platelet count, total bilirubin, procalcitonin(pct), and lactate levels), are recorded.the primary outcome is hospital survival. secondary outcomes include duration of vasopressor therapy,requirement for renal replacement therapy in patients with acute kidney injury (aki), icu los, and the change in serum procalcitonin and sepsis-related organ failure assessment (sofa score) over the first 72 h. summary statistics are used to describe the clinical data and are presented as means±sd, medians and interquartile range, or percentages as appropriate.statistical analysis is performed with ncss 11 (ncss statistical software) and spss statistics version 24 (ibm).

Eligibility criteria:
inclusion criteria: * a primary diagnosis of sepsis or septic shock (the diagnoses of sepsis and septic shock are based on the 2016 the third international consensus definitions for sepsis and septic shock (sepsis-3)) and a procalcitonin (pct) level≥2ng/ml. sepsis: sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. septic shock: septic shock is a subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality. exclusion criteria: * patients \< 18 years of age, pregnant patients, and patients with limitations of care.

Keywords: corticosteroid hydrocortisone septic shock thiamine vitamin c
strategies for protamine dosing after anticoagulation in cardiovascular surgery

Conditions: Anticoagulant Antagonist Toxicity

Summary: in cardiovascular surgery, patients are anticoagulated with heparin during cardiopulmonary bypass, subsequently, anticoagulation is reversed with protamine to reduce bleeding due to residual heparin-induced coagulopathy, which can last more than four hours. protamine reverses the effect of heparin by binding to each heparin molecule, therefore an amount of protamine equivalent to residual heparin is required at the time that anticoagulation is desired to be reversed, but generally, the dose of protamine is calculated from the total dose of heparin, ignoring that heparin is metabolized and cleared during of the extracorporeal circulation, this excess of protamine produces anticoagulant effects that increase postoperative bleeding. residual heparin can be estimated from heparin pharmacokinetic models and therefore, from these models, a dose closer to the amount necessary to reverse the effect of heparin can be estimated, avoiding protamine excess. in this study, a protamine dosage strategy based on residual heparin determined by a pharmacokinetic model of heparin versus total administered heparin will be compared regarding bleeding and use of blood components in the postoperative period.


Eligibility criteria:
inclusion criteria: * patients over 18 years of age who undergo scheduled cardiovascular surgery or scheduled urgency at the shaio clinical foundation in the city of bogotá, who require extracorporeal circulation. * asa classification, between 1 - 4 * informed consent read and signed by the patient * no history of known blood dyscrasia, with inr values \<1.5 * platelet count greater than 100,000 * no history of heparin-induced thrombocytopenia * no history of adverse reaction to protamine * no use of dual anti-aggregation therapy acetylsalicylic acid (asa) + adp receptor inhibitors (clopidogrel) at the time of surgery * suspension of adp receptor inhibitor drugs (clopidogrel) according to institutional protocol. * no use of bridging therapy with tirofiban * patient with chronic use of oral anticoagulants (warfarin, dabigatran), complete the suspension time according to the institutional protocol, * no requirement for renal replacement therapy in the last month * patient with bmi between 18 - 41 kg / cm2 * not pregnant exclusion criteria: * emergency surgery * anticoagulated patient at the time of the intervention * procedure not performed under extracorporeal circulation. * procedure requiring circulatory arrest and / or profound hypothermia * intraoperative death before protamine administration * inability to complete data collection.

Keywords: heparin protamine dose extracorporeal circulation cardiopulmonary bypass
efficacy, pk, immunogenicity and safety of wilate in severe von willebrand disease vwd) patients <6 years of age

Conditions: Von Willebrand Disease

Summary: the wil-33 study aims to determine the efficacy, pharmacokinetics, immunogenicity and safety of wilate as routine prophylaxis in up to 12 paediatric patients (eight evaluable) with severe von willebrand disease vwd (defined as screening von willebrand factor ristocetin cofactor activity \[vwf:rco\] \<20%) under the age of 6 years, over a period of 12 months.


Eligibility criteria:
inclusion criteria: 1. patients aged \<6 years at the time of screening 2. type 3 (at least four patients), severe type 2 (except 2n) or severe type 1 vwd (any of which with vwf:rco \<20%) according to medical history, requiring substitution therapy with a vwf-containing product 3. minimum body weight 12.5 kg at the time of screening 4. voluntarily given, fully informed written and signed consent obtained before any study-related procedures are conducted (obtained from the patient's parent(s)/ legal guardian(s)) exclusion criteria: 1. history or current suspicion of vwf or fviii inhibitors 2. injection of ddavp or vwf-containing product within 72 hours prior to inclusion 3. medical history of a thromboembolic event 4. platelet count \<100,000/µl at screening (except for vwd type 2b) 5. patients receiving, or scheduled to receive, immunosuppressant drugs (other than antiretroviral chemotherapy), such as prednisone (equivalent to \>10 mg/day), or similar drugs 6. treatment with any investigational medicinal product (imp) in another interventional clinical study currently or within four weeks before enrolment 7. other coagulation disorders or bleeding disorders 8. known hypersensitivity to any of the components of the study drug
impact of armodafinil on neurocognition and cognitive fatigue in multiple sclerosis (ms)

Conditions: Multiple Sclerosis

Summary: the investigation will involve a double-blind, placebo controlled, cross-over study examining the efficacy of armodafinil in improving neurocognitive functioning and reducing cognitive fatigue in ms. patients who report ms-related cognitive difficulties and perform at least 1 standard deviation below the mean on a brief cognitive screen will be given a thorough neuropsychological evaluation at two time points. half of the patients will be randomized to receive a single oral dose of lactose placebo prior to the first testing session. after a washout period of one week, they will then receive 250mg of armodafinil prior to a second testing session (p/a group). the other half of patients will be randomized to receive the active drug first. after a washout period of one week, they will receive the placebo prior to a second testing session (a/p group). as plasma levels of armodafinil peak between 2-4 hours after administration, participants will be asked to take a single 250mg capsule 2 hours prior to the scheduled testing sessions.


Eligibility criteria:
inclusion criteria: * relapsing remitting and secondary progressive ms patients * between the ages of 18 and 60 * report cognitive difficulties. * perform 1 sd or more below cut-off on cognitive screening measure exclusion criteria: * no history of alcohol/drug abuse or nervous system disorder other than ms * no sensory impairments that might interfere significantly with cognitive testing * no developmental history of learning disability or attention-deficit/hyperactivity disorder * no medical condition other than ms that could substantially affect cognition * no relapse and/or corticosteroid use within four weeks of assessment; * no current use of modafinil, armodafinil or other psychostimulants.
home program practice for people with language disorders after stroke

Conditions: Aphasia; Stroke

Summary: logbooks are one of the most commonly used methods to both support and track adherence in research studies. this study will look at using logbooks to support adherence to reading practice for individuals with post-stroke aphasia. it is thought that using a logbook will increase practice time.


Eligibility criteria:
inclusion criteria: * at least 6 months post left hemisphere stroke with a diagnosis of aphasia * must have self-reported interest in working to improve reading comprehension * access to the internet * speak english as a primary language exclusion criteria: * significant visual or hearing impairment as determined by "aphasia-friendly" and age-appropriate screening * actively receiving speech-language pathology services in which computerized or reading comprehension home practice activities are assigned/requested * severe auditory comprehension impairment that limits understanding of one-step directions (i.e., western aphasia battery-revised sequential commands subtest score below 8).
description and prognostic evaluation of four biological parameters of blast cells in adult acute lymphoblastic leukemia

Conditions: Adult Acute Lymphoblastic Leukemia

Summary: adult acute lymphoblastic leukemia treatment approaches relie on risk stratification, including cytogenetics. we want to study at diagnosis several blast cells parameters on frozen samples of graall protocols enrolled patients: 1. a cd45-dna double staining analysed by flow cytometry will allow mesurement for each blastic clone of dna ploidy, percentage of cells in s-phase, cd45 fluorescence index. 2. the proteine p16 metabolic way, involved in cell cycle regulation, will be studied by western blot analysis. the comparison between these parameters, and main haematological data, will be followed by a prognostic analysis, based on blast corticosensibility in vivo, chimiosensibility, complete remission, and survival. combination of the studied parameters will allow to appreciate a clonal diversity. this will help to predict, at diagnosis, high probability of resistance to treatment.


Eligibility criteria:
inclusion criteria: * all graall 2003 and 2005 enrolled patients with available frozen blast cells exclusion criteria: * none
is our microbiome a predictor of cardiac risk

Conditions: Coronary Artery Disease

Summary: the purpose of this study is to determine a relationship between a person's flora/bacteria in their gut (the intestinal microbiome) and their risk of cardiovascular disease. investigators will look at inflammatory markers in the blood and also look at the genome of the bacteria in the gut.

investigators will look at inflammatory markers in the blood and also look at the genome of the bacteria in the gut. this research is being done because investigators believe that there is a connection between the way food is digested by a person's gut bacteria and the development of atherosclerosis (hardening of the arteries) and cardiovascular disease. the ultimate goal of this research is to eventually determine if changes to the gut bacteria can prevent cardiovascular disease or disease progression.

Eligibility criteria:
inclusion criteria: anyone undergoing cardiac catheterization for suspected coronary artery disease over age 18. exclusion criteria: 1. patients currently on long-term antibiotics who cannot stop them for at least 2 weeks prior to providing a stool sample. 2. patients on chronic laxatives who cannot stop for at least 2 weeks prior to stool collection. 3. patients on probiotics and cannot stop for 2 weeks prior to giving a stool sample (yogurt is ok). 4. patients who are unable to provide a stool sample to mayo clinic within 24 hours of collection utilizing fed ex overnight mail (i.e. people overseas who are unable to provide a sample before leaving the usa.)