Kornimate/medical-research-clean huggingface dataset:
effects of breathing patterns on post-prandial vascular function

Conditions: Healthy

Summary: the purpose of this study is investigate the effects of two different breathing styles on postprandial vascular function and oxidative stress markers. participants will complete 2 breathing conditions in random order.


Eligibility criteria:
inclusion criteria: • male participants ages 18-35 years exclusion criteria: * infection within the previous 4 weeks * renal disorders * any cardiovascular disorders such as prior myocardial infarction, known coronary artery disease, personal history of stroke, heart failure, cardiac arrhythmias * chronic obstructive pulmonary disease * diabetes * inflammatory bowel disease * hiv, rheumatoid arthritis, chronic or other inflammatory conditions * currently taking steroids or other anti-inflammatory medications * current use of nonsteroidal anti-inflammatory drugs * smoking * stage 2 hypertension or higher (systolic bp of 140 mm hg or higher and/or diastolic bp of 90 mm hg or higher) * lactose intolerance

Keywords: breathing yogic breathing
evaluation of wnt5a and lrp5 levels in serum and saliva samples and the relationship between clinical periodontal parameters

Conditions: Periodontal Disease; Periodontitis (Stage 3); Periodontitis Stage III

Summary: objectives: wnt5a is a secreted wnt ligand that plays an important role in cellular homeostasis. wnt interaction with coreceptor low-density lipoprotein receptor-related protein 5 (lrp5) induces the proliferation of osteoblasts and prolongs their functional life. the aim of this study is evaluating the levels of wnt5a and lrp5 in serum and saliva samples and relationship between clinical periodontal parameters. method: saliva and serum samples were collected from 20 systemically healthy patients with stage iii periodontitis and 20 periodontally healthy controls. wnt5a and lrp5 levels were measured using enzyme-linked immunosorbent assay (elisa). clinical periodontal parameters including plaque index (pi), probing pocket depth (ppd), bleeding on probing (bop), and clinical attachment level (cal) were recorded.


Eligibility criteria:
inclusion criteria: * \>18 years old, * at least 16 permanent teeth except 3rd molars, * individuals who do not use orthodontic appliances, * individuals who are not pregnant or lactating, * individuals without any systemic disease that may affect periodontal health, * systemically healthy individuals, * individuals who have not used anti-inflammatory and/or anti-microbial drugs in the last 6 months, * individuals who have not received periodontal treatment in the last 1 year exclusion criteria: * pregnant/lactating individuals, * individuals who have used anti-inflammatory and/or anti-microbial drugs in the last 6 months, * individuals who have undergone periodontal treatment in the last 1 year, * individuals with psychiatric illness, * individuals with any oral infection, * individuals with \<16 teeth, excluding molars, * individuals with alcohol dependence, * individuals with active infectious disease (acute hepatitis, aids, tuberculosis), cancer or any systemic condition that may affect periodontal tissues, * individuals receiving treatment with drugs known to affect periodontal tissues (phenytoin, cyclosporine a, calcium channel blockers)

Keywords: wnt5a lrp5 periodontitis
diaphragmatic pacemaker in tetraplegic patients with spinal cord injuries

Conditions: Respiratory Paralysis; Diaphragmatic Paralysis; Spinal Cord Injury

Summary: permanent dependency of breathing apparatus due to spinal cord injury is traditionally treated with different types of mechanical ventilation. however, the electric ventilation became a possibility through their most current versions, such as diaphragmatic pacemakers. diaphragmatic pacemakers rhythmically stimulates the diaphragm to replace the functions of the respiratory center that doesn't works well or is inaccessible. however, this modality has the prerequisite that the phrenic nerve and diaphragm muscle are normal. the reason for the development of diaphragmatic pacemaker freeing the patient from the ventilator. by using the mechanical energy of the diaphragm of the patient, the patient may come not need the ventilator tubing, tracheostomy, and with the help of their caregivers, the inconvenient mechanical ventilators.


Eligibility criteria:
inclusion criteria: * 18 years old or more * cervical spinal cord injuries patients under mechanical ventilation * clinically stable after spinal cord injury * clinical acceptable bilateral phrenic nerve function demonstrated with electromyography and neural conduction time * fluoroscopic visible diaphragmatic movements under stimulation * hemodynamically stable * no co-morbidities that can interfere with pacemaker implantation or function * pregnancy negative test for women * patient or legal representative informed consent exclusion criteria: * active pulmonary disease * active cardiovascular disease * active cerebral disease * hemodynamic instability or low oxygen levels in ambient air * hospitalization for infection in the last 3 months * significant scoliosis or chest disease * obesity * poor compliance to the protocol from the patient or the caregiver
adherence to nintedanib among idiopathic pulmonary fibrosis patients

Conditions: Idiopathic Pulmonary Fibrosis

Summary: this is a non-interventional cohort study using existing administrative data from the u.s. medicare program. this study has two objectives: * identification of adherence trajectories of nintedanib among idiopathic pulmonary fibrosis (ipf) patients. * understanding characteristics of patients within each nintedanib adherence trajectory among ipf patients.


Eligibility criteria:
inclusion criteria: * newly initiated nintedanib during 10/01/2014 to 12/31/2018 * were at least 66 years old as of the date of their first nintedanib prescription claim (index date) * qualified for medicare based on age * had at least 12 months (365 days) of continuous enrollment in medicare parts a, b and d before (baseline period) and 12 months (360 days) after the index date (follow-up period) * had at least one inpatient or two outpatient claims (\>14 days apart) with a diagnosis code for idiopathic pulmonary fibrosis (ipf) during the baseline period exclusion criteria: * had any history of pirfenidone or nintedanib use during the baseline period * had any history of lung transplant during the baseline, index date or follow-up periods * had any claims for skilled nursing facility, long-term care facility or hospice during the baseline, index date or follow-up period * had evidence during the baseline period of any of the following conditions: lung cancer, autoimmune, or connective tissue diseases (i.e. rheumatoid arthritis (ra), sarcoidosis, systemic lupus erythematosus (sle), dermatopolymyositis, systemic sclerosis, sjogren's, and mixed connective tissue disease (ctd)) during the baseline period * had dual eligibility of medicare and medicaid * had history of using pirfenidone at the same time with nintedanib during follow-up
evaluating the impact of different methods of hpv dna testing for cervical cancer screening in primary care settings

Conditions: Uterine Cervical Neoplasms

Summary: primary objective of the study is to determine the extent that offering of self-sampling in addition to clinician-sampling human papillomavirus (hpv) dna testing will increase detection of hpv dna through an increase in uptake rates of cervical cancer screening as compared to offering clinician-sampling hpv dna testing alone. the hypothesis is that offering additional self-sampling will increase the detection of high-risk hpv dna by at least 7.7%.

this study is a pragmatic, multi-center, 1:1 randomized controlled trial designed to evaluate the impact of self-sampling hpv dna testing on clinical outcomes and cost-effectiveness in cervical cancer screening. the trial will compare 2 approaches to hpv dna testing within public primary care settings. participants in the intervention arm will first be offered a clinician-sampling hpv dna test. if they decline, they will be offered the option of self-sampling hpv dna test. the control arm will follow the standard protocol of offering only the conventional clinician-sampling hpv dna test, reflecting the current standard of care in cervical cancer screening. this study seeks to provide robust evidence on whether self-sampling can improve clinical outcomes, be cost-effective and be feasibility implemented in routine public primary healthcare settings. the findings are expected to inform future guidelines and policies for cervical cancer screening programs.

Eligibility criteria:
inclusion criteria: * 30-69 years old female singapore citizens * due for cervical cancer screening * engaged in sexual intercourse before * able to give informed consent * able to read and communicate in english, chinese or malay exclusion criteria: * virgo intacta * pregnancy * history of cervical cancer, precancerous cervical lesions and total hysterectomy
prophylactic versus therapeutic caffeine for apnea of prematurity

Conditions: Apnea

Summary: investigators hypothesized that the timing of caffeine administration in either prophylaxis or treatment of apnea of prematurity will affect the apnea response to caffeine

it will be a randomized control trial, patients will be randomly assigned to receive caffeine in a loading dose of 20 mg/kg (equivalent to 10 mg/kg caffeine base) and a maintenance dose of 10 mg/kg/day (equivalent to 5 mg/kg caffeine base) either as a prophylaxis group (1) or therapeutic group (2). prophylactic caffeine (group 1) will be defined as caffeine prescribed for preterm infants within the first 72 hours of life prior to manifest apnea , therapeutic caffeine ( group 2 ) will be defined as caffeine prescribed for manifest apnea within or after the first 72 hours of life . preparation and administration of caffeine will be performed by a neonatal intensive care unit (nicu) nurse. statistical evaluation: statistical analyses will be performed with the statistical package for social sciences-spss version 16 software (spss inc, chicago, illinois). for categorical variables, the x2 test will be used. for group comparisons, the student t test will be used in normal distribution and the mann-whitney u test will be used in case of abnormal distribution. for repeating measurements, variance analyses and friedman variance analyses will be used. for descriptive statistics, percent, minimum-maximum-median, mean, and standard deviation will be used in accordance with the type and distribution of the variable. a p value \<.05 was considered statistically significant. informed consent will be obtained from parents, and the study will be approved by the local ethical committee.

Eligibility criteria:
inclusion criteria: * infants eligible for this study will be newborn infants ≤ 32 weeks with or without a diagnosis of apnea . exclusion criteria: * newborn infants with gestational age \> 32 weeks. * newborn infants with congenital malformations and chromosomal anomalies. * newborn infants with apnea of other causes .

Keywords: caffeine apnea preterm infant
re-introduction of pemetrexed and cisplatin with prolonged angiogenic blocking by bevacizumab in advanced lung cancer.

Conditions: Non-small Cell Lung Cancer Metastatic; Nonsquamous Nonsmall Cell Neoplasm of Lung

Summary: at present, the treatment of non-squamous cell lung cancer is based on chemotherapy with platinum eventually associated with bevacizumab. a new treatment begins at progression. in colo-rectal metastatic cancer, it was demonstrated that the first-line of treatment could be administered according to a stop and go strategy respecting therapeutic breaks between sequences of identical treatment. during these therapeutic breaks, a treatment of maintenance is possibly better than an absence of treatment. these plans benefit to the patients in terms of efficiency but also in terms of toxicity, in particular neurological. the question is to know if this strategy is feasible in lung cancer.


Eligibility criteria:
inclusion criteria: * non squamous non small cell lung cancer histologically or cytologically confirmed with no egfr mutation. * stage iv nsclc. patient with cerebral metastasis are eligible if the metastasis is asymptomatic. * measurable disease (recist criteria) * age ≥18 years * ps0 or 1 exclusion criteria: * mixed cancer small cells and non small cells or squamous lung cancer . egfr mutated cancer * history of malignant tumour excepted cervical and basocellular cancer and cancer cured for at least 5 years. * tumor invaded the big vessels or the proximal visible in tdm. * history of adjuvant or neoadjuvant chemotherapy

Keywords: stop and go non-small cell lung cancer non-squamous bevacizumab ifct
bowel prep vs non-bowel prep for laparoscopic colorectal surgery

Conditions: Anastomotic Leak; Surgical Site Infection

Summary: research question: are anastomotic leak and surgical site infection rates equivalent in patients having laparoscopic bowel resections without bowel preparation vs those having bowel preparation? bowel preparation is a distressing and uncomfortable procedure for patients undergoing laparoscopic colorectal surgery, and also carries some risk of morbidity due to dehydration, electrolyte inbalance and possible infectious complications. if it is found that there is no difference between those patients who have preoperative bowel preps and those who do not have them, then we can save these patients this additional distress and risk at the time of their surgery.

rationale: the question of whether a bowel prep is needed for colon resection in open surgery has been answered. however, in laparoscopic colorectal resections, it has not been prospectively investigated. usually, reasons for still using a bowel prep in laparoscopic colon resections is that small instruments grasping the colon can tear it, and without a prep, stool spillage can result. as well, it may be difficult to manipulate a colon filled with stool, and difficult to identify lesions to be resected. there are no previous randomized trials in the laparoscopic literature comparing laparoscopic colorectal resections with and without bowel preparations. there are a number of trials for open resections and one trial including both laparoscopic and open resections. unfortunately this trial does not separate the data analysis for these two groups. primary and secondary outcomes: the question to be identified is whether anastomotic leaks, and surgical site infection rates are equivalent in patients having laparoscopic resections without bowel prep versus prepped patients. methodology: once consent is obtained, the patients will be randomized into two groups-the study group who will eat a low residue diet prior to surgery and who will not undergo bowel preparation, or the control group who will complete the standard bowel preparation protocol. both groups will have the scheduled surgery. all patients will be monitored for signs of anastomotic leak and surgical wound infection daily while in hospital and at routine follow up visits at 2 and 6 weeks postoperative. if these two complications are observed, standard treatment will be followed.

Eligibility criteria:
inclusion criteria: * patients undergoing elective laparoscopic colorectal resection for benign or malignant disease * adults aged 18-85 years * asa 1-3 exclusion criteria: * contraindications to laparoscopic surgery * patients undergoing procedures that result in creation of a stoma or ileostomy or loop ileostomy * patients with pre-operative perforation of established infection * patients who cannot understand the directions for bowel preparation or low residue diet * patients with gi obstructions * patients who will not be able to attend the followup appointments

Keywords: colorectal bowel preparation laparoscopic surgery
using gut microbial gbu gene testing to estimate host tmao production capacity

Conditions: Gut Dysbiosis for TMAO Production From L-carnitine Consumption

Summary: the risk of cardiovascular diseases from red meat consumption varies among individuals due to variations in gut microbiota. l-carnitine in red meat can be converted to tmao in the body by certain bacteria. not everyone experiences a significant increase in tmao levels after consuming carnitine. gut microbiota differences are observed between high and low tmao producers. the presence of the gbu gene in gut microbiota is linked to tmao production. this clinical research aims to determine if the gbu gene can predict tmao levels after dietary carnitine intake.

the risk of developing cardiovascular diseases due to the consumption of red meat varies among individuals, and this may be attributed to differences in the composition and function of gut microbiota. studies have found that red meat, rich in l-carnitine, may be metabolized by certain anaerobic bacteria in the intestines to produce trimethylamine n-oxide (tmao) in the human body. previous research utilizing the oral carnitine challenge test (occt) revealed that not everyone experiences a significant increase in blood tmao levels after consuming carnitine. moreover, individuals with high tmao production and low tmao production showed distinct differences in their gut microbiota. furthermore, we have discovered a significant correlation between the abundance of the gbu gene in gut microbiota and the production of tmao in response to dietary carnitine intake. therefore, through the design of clinical research, we aim to investigate and assess whether the abundance of the gbu gene in gut microbiota can predict the levels of tmao produced in the human body under dietary carnitine intake.

Eligibility criteria:
inclusion criteria: * adult with age between 18 to 70 * must be able to swallow tablets exclusion criteria: * antibiotics use within one month * l-carnitine supplement use within one month * chronic diarrhea * myasthenia gravis * diabetes mellitus * parathyroid disorders * chronic kidney disease * epilepsy * severe anemia * cardiovascular diseases.

Keywords: gbu gene cluster tmao gut microbiota red meat cardiovascular disease
arthroscopy and manipulation vs a home therapy program in the treatment of adhesive capsulitis

Conditions: Adhesive Capsulitis of the Shoulder

Summary: the purpose of this study is to compare two treatments used for treating frozen shoulder which are arthroscopy and forceful stretching of the shoulder and home stretching therapy to see if one relives pain and improves shoulder motion more quickly. the other purpose is to try and understand what causes frozen shoulder. for this purpose, tissue will be taken from the shoulder during surgery and studied for the presence and level of a protein called cytokine (connective tissue growth factor)

adhesive capsulitis of the shoulder is a relatively common entity which is poorly understood and produces a significant amount of morbidity in afflicted patients. the natural history of adhesive capsulitis is only just beginning to be understood. it is a self-limiting disease, but may take 18 to 36 months to resolve. during that time, individuals can suffer a significant amount of pain and miss a large amount of work. many surgeons have treated this process with early manipulation with the outcome never being reported in a prospective manner. some authors have advocated conservative non-operative treatment, knowing the natural history in most of these shoulders will be near resolution. the primary purpose of this study is to examine in a prospective randomized manner the results of continuous non-operative management versus arthroscopic capsulectomy. this study will determine if operative intervention with an arthroscopic capsulectomy can shorten the natural history of adhesive capsulitis, and give comparable results with non-operative management at final follow-up of 2 years. a second purpose of the study is to try and identify the mechanism(s) responsible for adhesive capsulitis. recent research suggests that cytokines and connective tissue growth factor (ctgf) may be involved in the inflammatory and fibrotic processes. the second purpose of this study involves histological and immunohistochemical analysis of capsular and synovial tissue routinely removed during an arthroscopic capsulectomy. tissue taken from subjects in the surgical treatment group will be compared to tissue from patients undergoing an arthroscopic capsulectomy for reasons other than adhesive capsulitis (control group). location and concentration of ctgf will be compared between these groups. if levels of ctgf are elevated in the treatment group as hypothesized, development and testing of agents that specifically reduce the action of ctgf may be indicated. a specific agent blocking ctgf has been developed and is nearing clinical trials.

Eligibility criteria:
inclusion criteria: * frozen shoulder (pain and stiffness) experienced for at least four months and treatment has not helped. exclusion criteria: * none
rheopheresis for raynaud's and digital ulcers in systemic sclerosis

Conditions: Systemic Sclerosis; Raynaud Phenomenon; Digital Ulcer; Scleroderma

Summary: in this feasibility study, we aim to explore therapeutic rheopheresis (rheop) as a novel treatment option for ssc-associated raynaud's phenomenon and/or digital ulcers and compare it to the standard of care treatment (intravenous iloprost. rheop has been used for rp/du with some success in observational studies, nevertheless, the optimal treatment modality, duration, or frequency of rheop (and pex in general) in ssc has not been established as of yet.


Eligibility criteria:
inclusion criteria: 1. adult patients fulfilling acr/eular classification criteria for ssc 2. presence of rp with or without du 3. failure of at least one standard of care treatment (ccb or iloprost) for at least three months 4. rcs \> 4 5. possibility to obtain venous access (either through a peripherally or centrally inserted catheter) exclusion criteria: 1. significant anemia (\<8 g/dl) 2. clinically relevant hemorrhagic diathesis or coagulopathy 3. diabetes mellitus 4. serious acute or chronic kidney (egfr\<30 ml/min/1.73m2) or liver failure 5. hypotension with systolic blood pressure \<100 mmhg 6. chronic viral infections (hiv, hepatitis b, c) 7. epilepsia, psychosis, dementia, or other relevant neurologic condition precluding the conduct of plasmapheresis 8. malignant disease or any other condition with life expectancy \<12 months 9. known history of alcohol or drug abuse 10. long-term serious tobacco abuse with documented severe vascular disease (fontaine \>iii). 11. severe hyperlipoproteinemia, defined as a significant elevation of lp(a) or ldl cholesterol despite standard doses of medical therapy

Keywords: rheopheresis raynaud phenomenon systemic sclerosis digital ulcers therapeutic plasma exchange