Kornimate/medical-research-clean huggingface dataset:
high water intake in polycystic kidney disease

Conditions: Autosomal Dominant Polycystic Kidney Disease

Summary: drink is an open-label randomised controlled feasibility trial of high versus ad libitum water intake in adpkd.

autosomal dominant polycystic kidney disease (pkd) affects 12.5 million people worldwide, and accounts for 7% of those requiring renal replacement therapy. the hormone vasopressin drives cyst growth until ultimately most of the normal functioning kidney tissue is replaced and compressed by cysts over the life course. half of those affected will require dialysis by the age of 55 years. vasopressin blockade has emerged as a viable strategy for altering disease course. high water intake suppresses vasopressin, and may therefore slow cyst growth and consequent disease progression. however, evidence to support high water intake in pkd is lacking, and it is not clear whether patients can adhere sufficiently to a high water intake. drink is a single-centre prospective, open label, parallel group randomised controlled feasibility trial. the primary objective is to establish whether a definitive large randomised trial comparing high versus ad libitum water intake on long-term disease progression is deliverable. fifty patients will be recruited from the renal genetics service at addenbrooke's hospital. participants will be randomly allocated to the high water intake (high) or the ad libitum (standard) water intake group. for the high intake group the aim is to drink large enough volumes of water to achieve and maintain dilute urine (urine osmolality \< 270 mosmo/kg or urine specific gravity ≤ 1.010 ). multiple methods will be employed to promote adherence these include instruction and education as well as self-monitoring of urine specific gravity twice weekly by participants and the recording of results via a trial specific smartphone application.

Eligibility criteria:
inclusion criteria: * have given written informed consent to participate * aged 16 years or older * have a diagnosis of adpkd (fulfilling radiological diagnostic criteria ± genetic evidence) * egfr ≥ 20ml/min/1.73m2 * able to self-monitor urine sg exclusion criteria: * inability to provide informed consent * egfr \< 20ml/min/1.73m2 * fluid overload states e.g. heart failure, cirrhosis, or requirement for fluid restriction * confounding illness impacting on renal disease e.g. concomitant diabetes or glomerulonephritis * treatment with diuretics for fluid overload (those on diuretics for hypertension may participate in the trial after a run-in period of 2 weeks) * treatment with tolvaptan in the last 4 weeks * pregnancy or breastfeeding

Keywords: autosomal dominant polycystic kidney disease polycystic kidney disease adpkd water vasopressin dietary
nutrition and physical exercise study

Conditions: Gastrointestinal Cancer; Lung Cancer

Summary: the purpose of this study is to investigate the effect of a combined treatment of nutritional therapy and physical exercise in palliative cancer out-patients. the investigators hypothesize that this combined intervention consisting of an increased energy- and protein intake and physical exercise level improves quality of life (qol), functional and clinical status.


Eligibility criteria:
inclusion criteria: * histologically or cytologically confirmed metastatic lung cancer or gastrointestinal cancer * who performance status 0, 1 or 2 * able to walk at least 100 meters independently without crutches or walking frame assessed by the treating physician on the basis of the patient's history and physical condition * receiving palliative treatment exclusion criteria: * enteral and/or parenteral nutrition within 1 month previous to study participation * history of ileus within one month * known brain metastases or symptomatic bone metastases * psychiatric disorder precluding understanding of information on trial related topics and giving informed consent. * any serious underlying medical condition which could impair the ability of the patient to participate in the trial
the gut microbiome and sorafenib maintenance therapy in flt3-itd positive aml after allo-hsct

Conditions: Acute Myeloid Leukemia With FLT3/ITD Mutation; Allogeneic Hematopoietic Stem Cell Transplantation

Summary: this prospective trial investigates the effect of sorafenib maintenance therapy in flt3-itd positive aml patients after allo-hsct in terms of gut microbiome.

hematopoietic stem cell transplantation (hsct) is used as a potentially curative therapy for patients with hematopoietic malignancies. sorafenib, an inhibitor of multiple kinases including flt3, has shown promising activity in flt3-itd-positive aml. our previous studies demonstrated that sorafenib maintenance post-transplantation could improve the outcomes of flt3-itd-positive aml patients, which is associated with sorafenib enhancing the graft-versus-leukemia (gvl) effect. some studies show that gut microbiome is associated with graft-versus-host-disease (gvhd) and gvl. however, the effect of gut microbiome on sorafenib maintenance after allo-hsct remains unknown.

Eligibility criteria:
inclusion criteria: * flt3-itd positive aml * allo-hsct recipients exclusion criteria: * intolerance to sorafenib pretransplantation * cardiac dysfunction (particularly congestive heart failure) * hepatic abnormalities (bilirubin ≥ 3 mg/dl, aminotransferase\> 2 times the upper limit of normal) * renal dysfunction (creatinine clearance rate \< 30 ml/min) * any abnormality in a vital sign (e.g., heart rate, respiratory rate, or blood pressure) * patients with any conditions not suitable for the trial (according to the investigators' decision)

Keywords: hematopoietic stem cell transplantation gut microbiome sorafenib flt3-itd acute myeloid leukemia
dynamics of pelvic floor muscles with different phonation patterns among female students

Conditions: Pelvic Floor Dyssynergia; Phonation Disorder

Summary: the purpose of the study is to know if there is relation between the dynamics of pelvic floor muscles and different phonation pattern.

some pelvic floor physical therapists are beginning to experiment with using phonation and vocalization cues to elicit different pelvic floor movements . however, there is a significant gap in the literature about the coordination and movement between the pelvic floor and glottis during speech and phonation, and there is an urgent need to identify the voices accompanied by increasing pelvic floor tone and integrating them into pelvic floor strengthening programs and voices accompanied by lowering pelvic floor tone and integrating them into pelvic floor down-training programs. to date, there has been only one study describing pelvic floor displacement during vocalization tasks. so this study aims to investigate pelvic floor muscle displacement during respiratory and phonatory tasks using trans-abdominal ultrasound to assess respiratory and phonatory tasks that can relax or enhance pelvic floor tone and be integrated into clinical practice.

Eligibility criteria:
inclusion criteria: - 1. they should be virgin, healthy female physiotherapy students. 2. they have regular menstruation (3-8 days in duration, with 21-35 days in-between). 3. their ages will range from 18 to 25 years old. 4. their body mass index (bmi) will range from 18 to 24.9 kg/m2. 5. their waist- hip ratio will be less than (0.8). exclusion criteria: 1. any urological, gynecological, respiratory, or vocal disorders in the previous 12 weeks. 2. pelvic floor dysfunction. 3. professionally trained singers. -
a trial of complete versus selective hepaticvascular clamping in hepatectomy

Conditions: Hepatocellular Carcinoma

Summary: intraoperative bleeding remains a major concern during liver resection. pringle maneuver is the most frequently used method to occlude inflow blood of the liver.however, experimental and clinical studies have shown than even short periods of clamping produce some degree of ischemia-reperfusion injury that can result in hepatocellular damage,this damage being especially important in patients with abnormal liver parenchyma such as steatosis and cirrhosis. the aim of this study was to evaluate whether the use of selective vascular clamping should be generalized to hcc patients and help to reduce the ischemia-reperfusion injury.

from recent animal studies, it can be easily concluded that i/r injury of the liver may be a significant factor, which can promote the primary liver tumor recurrence and metastasis. if it is a truth in human, there must be a big challenge to the pringle maneuver which was adopted routinely in hepatectomy in the past years. pringle maneuver during hepatic resection may do harm to the liver function, make the tumor cell more aggressive and tend to recurrence. it is suggested that further strategies may be needed for the prevention and treatment of i/r injury ,early and late recurrences.selective hepatic vascular clamping (svc)such as hemihepatic vascular occlusion have been used to minimize ischemic injury during liver surgery, especially in patients with abnormal liver parenchyma. however,these procedure used is likely to depend on the surgeon's training or preference rather than on objective data, there is not any further reported data or rct studies conducted about the postoperative outcome ,especially liver function.to address these issues,we designed a prospective randomized controlled trial comparing the complete hepatic vascular clamping (pringle maneuver) and selective hepatic vascular clamping ( portal vein or hemi-hepatic occlusion) in patients undergoing hepatectomy. the main objective was to compare the liver i/r injury of two procedures to the postoperative liver function. the secondary objective was to evaluate the feasibility, safety, efficacy, amount of hemorrhage,postoperative complications ,disease-free and overall survival rate of the 2 procedures.

Eligibility criteria:
inclusion criteria: 1. with a clinical diagnosis of primary liver cancer, without any adjuvant therapy; 2. age:18-70years; 3. suitable for partial hepatectomy without other malignancies; 4. compensated cirrhosis with child-pugh class a, or b. exclusion criteria: 1. reject to attend； 2. with any preoperative adjuvant therapy. 3. with intrahepatic or extrahepatic malignancies; 4. cirrhosis with child-pugh class c

Keywords: hepatectomy selective hepaticvascular clamping
nourish: a digital health program to promote the dash eating plan among adults with high blood pressure

Conditions: Hypertension; Health Behavior

Summary: the goal of nourish is to help adults with high blood pressure enjoy an eating pattern called dash (dietary approaches to stop hypertension) to lower blood pressure and improve health. nourish will use a mobile app and information about dash to help study participants follow the dash dietary plan by tracking what they eat and drink every day. the primary outcome of the study is 6-month change in following the dash eating plan, as measured by 24-hour dietary recalls. the secondary outcome is change in blood pressure. study participation will last one year.

over 100 million americans suffer from high blood pressure and are at increased risk for cardiovascular disease. evidence supports the dash (dietary approaches to stop hypertension) dietary pattern to reduce blood pressure. dash is rich in fruits and vegetables, legumes, lean protein, and low-fat dairy, and reduced in red meats, sweets and processed foods. the nourish trial will look at the effect of the intervention on changes in dietary quality and blood pressure among men and women with high blood pressure. participants who join nourish will be asked to track what they eat and drink every day through a smartphone app and to participate in online study visits. some participants will also receive additional support from a registered dietitian. we are doing this study to understand how technology can help adults with high blood pressure follow a heart-healthy eating plan to improve their blood pressure.

Eligibility criteria:
inclusion criteria: * systolic blood pressure of 120-159 mmhg or diastolic blood pressure of 80-99 mmhg, whether or not taking blood pressure medications. * bmi ≥ 18.5 kg/m2 * smartphone with a data plan * willing to receive daily text messages * valid email address * willing and able to participate in online study videoconferencing visits (zoom) * lives in the u.s. * reads and writes in english exclusion criteria: * participating in another related research study * cardiovascular disease event (e.g. stroke, myocardial infarction) in prior 6 months * bariatric surgery in the last 12 months or planned during the study period * active cancer * recent hospitalization due to psychiatric condition or event * pregnancy- current or planned during the study period * documented dementia * lives with someone else participating in the nourish study to learn more about the study and to see if eligible to participate, visit www.nourishstudy.org

Keywords: blood pressure hypertension dash nutrition dietary change mobile health digital health e-health
description of patients with acute venous thromboembolism in the uk's clinical practice research datalink linked with hospital episode statistics dataset (cprd-hes)

Conditions: Venous Thromboembolism

Summary: this study will utilize a retrospective cohort design. using the clinical practice research datalink (cprd) linked with hospital episode statistics (hes) datasets, all patients with a record of vte diagnosis between 1 april, 2008 and 31 march, 2013 will be identified and followed from the occurrence of vte (index date) to the first of 24 months after the index date, end of the study period, leaving the database, or death.


Eligibility criteria:
inclusion criteria: vte events will be included if: * they are identified by at least one read code diagnosis of acute vte in the cprd, or one icd-10 code of vte in the hes database, during the study period; and * they occurred in patients ≥ 18 years old at time of vte occurrence; and * cprd acceptability quality criteria are present exclusion criteria: vte events will be excluded if: * patients have fewer than 12 months of computerized data available prior to vte occurrence. the date of start of computerized records will be the latter of the patient's date of current registration with the practice or the practice's up-to-standard (uts) date (date from which practice data is of research quality)
assessment of pao2/fio2 ratio pre and post intubation

Conditions: Acute Hypoxemic Respiratory Failure

Summary: we designed this study to dtermine whether invasive mechanical ventilation (mv) would have an impact on the reclassification of patients with acute hypoxemic respiratory failure (ahrf) -treated previously with non-invasive respiratory support- into categories of severity (mild, moderate, and severe). our hypothesis is that the assessment of pao2/fio2 ratio on peep greater or equal to 5 cmh2o after intubation, in patients labeled as mild/moderate/severe ahrf while on non-invasive respiratory support, would identify that a marked proportion of patients would change the degree of severity after a brief period of invasive mv

current criteria for definition of the acute respiratory distress syndrome (ahrf) are inadequate for inclusion of patients into clinical trials due to: (i) the lack of standardization for measuring the oxygenation defect (as assessed by the pao2/fio2 ratio) and (ii) the inclusion of non-intubated patients into the mild category of severity. we questioned whether the pao2/fio2 (p/f) ratio calculated before endotracheal intubation in non-intubated patients who otherwise meet ahrf criteria, would still meet the severity threshold once patients are intubated. we will examine at 24 after intubation and initiation of mv whether adult patients with ahrf remained in the same ahrf category of severity (mild, moderate, severe) or do not meet the pao2/fio2 criterion for ahrf. if our hypothesis is supported, it would suggest that stratification of patients labeled based on p/f ratio while treated with non-invasive respiratory support is of limited utility for testing specific therapies for ahrf in non-intubated patients. this is a high quality screening, longitudinal, defined population, retrospective study.

Eligibility criteria:
inclusion criteria: * patients meeting criteria for ahrf while they are on non-invasive respiratory support. * we will only include patients who had arterial blood gases (abg) within a time-frame of the last 5 hours of niv and the first 5 hours of invasive mv. * we will only include patients treated with high-flow oxygen nasal cannula (hfnc), or continuous positive airway pressure (cpap), or bilevel positive pressure (bipap). exclusion criteria: * patients who never required hfnc, or cpap, or bipap before intubation. * patients with no abg during the last 5 hours of niv before intubation. * patients with no abg during the first 5 hours after initiation of invasive mv. * patients treated with inhaled pulmonary vasodilator only before or only after intubation.

Keywords: acute respiratory failure non-invasive ventilatory support mechanical ventilation
efficacy of an online educational program to change back pain beliefs in physical therapists

Conditions: Low Back Pain

Summary: the goal of this clinical trial is to investigate the efficacy of an online educational program for physical therapists to change back pain beliefs. the main questions it aims to answer are: - what is the effect of an online educational program to change beliefs about the management of back pain in physical therapists? a total of 106 physical therapists will be recruited for this study. participants will be randomized into two groups: intervention and control groups. the intervention group will receive a 6-week online educational program including recommendations from international clinical practice guidelines for the management of back pain. the control group will not receive any intervention. the outcomes of this trial include beliefs about management of back pain and imaging exams and will be assessed at baseline and 6 weeks after randomization.


Eligibility criteria:
inclusion criteria: * must be a licensed physical therapist; * currently managing patients with low back pain, regardless of the duration of symptoms, in clinical practice; * if not currently managing patients with low back pain, participants must have treated at least one patient in the last month. (patients with low back pain are defined as those patients reporting pain between the lower border of the last vertebral ribs and the gluteal fold, with or without pain referred to the lower limb). exclusion criteria: * not having access or reporting difficulty in accessing the internet.

Keywords: low back pain online educational program beliefs physical therapists
blood endothelium biomarkers to predict major adverse cardiovascular events after percutaneous coronary intervention

Conditions: Atherosclerosis; Percutaneous Coronary Intervention; Cardiovascular Diseases

Summary: in stent restenosis and myocardial infarction are have been linked the balance between injury and healing of the endothelium these processes can be measured respectively using the number of circulating endothelial cells and endothelial progenitor cells. we therefore aimed to evaluate the relationship between the balance of injury and healing of the endothelium at the time of pci and major adverse cardiovascular events including death, myocardial infarction and target lesion revascularization at 6 and 12 months follow-up.

following percutaneous coronary intervention with bare metal stents, the rate of major adverse cardiovascular events including death, myocardial infarction and target lesion revascularization is high ranging between 20 and 25%.

Eligibility criteria:
inclusion criteria: * age\>18 years old * scheduled for pci * clinical evidence of ischemic heart disease and/or abnormal functional study * new coronary artery lesion \>50% * treatment with bare metal stent planned * informed consent explained, red, understood and signed by the patient exclusion criteria: * pregnancy, birth or lactation period \<6 months ago * women of childbearing age who do not intend to use accepted anticonceptive measures or who wish to get pregnant * left ventricular ejection fraction \<30% * acute coronary syndrome (st-elevation or not) in the past month * planned drug eluting stent implantation * lesion in arterial or venous bypass or anastomosis with coronary * severe renal insufficiency (creatinine clearance \<30 ml/') * severe hepatic insufficiency * systemic inflammatory pathology of any kind * hematologic or other malignancy, prior radio- or chemotherapy * use of corticosteroïds or immune suppression therapy * contrast allergy * life expectancy \<1 year * participation in other clinical study which has not ended yet

Keywords: major adverse
predictors of pain chronicity in patients with gunshot and mine-explosive wounds

Conditions: Chronic Pain, Widespread

Summary: 82.1% of patients with gunshot and mine-explosive wounds during hostilities in ukraine have negative results of pain treatment, which leads to its chronicity. identifying predictors of pain chronicity in these patients may improve their treatment outcomes.

the study of predictors of pain chronicity in patients with gunshot and mine-explosive wounds requires in-depth study, because the subjective feelings and emotional experiences experienced by patients during the wounding in combat conditions have their own characteristics. since pain becomes chronic in 82.1%, the data of our study will play an important role in preventing the chronicity of pain.

Eligibility criteria:
inclusion criteria: * the presence of gunshot and mine-explosive injuries exclusion criteria: * absence of gunshot and mine-explosive injuries

Keywords: chronic pain, gunshot wounds, mine-explosive wounds
study of ibrutinib vs placebo, in combination with nab-paclitaxel and gemcitabine, in the first line treatment of patients with metastatic pancreatic adenocarcinoma (resolve)

Conditions: Metastatic Pancreatic Adenocarcinoma

Summary: this is a phase 3 study to evaluate the efficacy of ibrutinib in combination with nab-paclitaxel and gemcitabine for the first line treatment of patients with metastatic pancreatic adenocarcinoma.


Eligibility criteria:
inclusion criteria: 1. histologically or cytologically confirmed diagnosis of pancreatic adenocarcinoma. 2. stage iv disease diagnosed within 6 weeks of randomization 3. adequate hematologic function: * absolute neutrophil count (anc) ≥1.5 x 109/l * platelet count ≥100 x 109/l * hemoglobin ≥9 g/dl 4. adequate hepatic and renal function defined as: * ast and/or alt ≤5.0 x upper limit of normal (uln) if liver metastases, or ≤3 x uln without liver metastases * alkaline phosphatase \<3.0 x uln or ≤5.0 x uln if liver or bone metastases present * bilirubin ≤1.5 x uln (unless bilirubin rise is due to gilbert's syndrome or of non-hepatic origin, such as hemolysis) * estimated creatinine clearance ≥30 ml/min 5. pt/inr \<1.5 x uln and ptt (aptt) \<1.5 x uln 6. kps ≥70. 7. eastern cooperative oncology group (ecog) 0-1 exclusion criteria: 1. prior therapies: btk inhibitor, radiotherapy, radiotherapy in the adjuvant setting, or cytotoxic chemotherapy for primary disease of pancreatic adenocarcinoma. 2. neuroendocrine (carcinoid, islet cell) or acinar pancreatic carcinoma 3. known brain or leptomeningeal disease (ct or mri scan of the brain required only in case of clinical suspicion of central nervous system involvement). 4. major surgery within 4 weeks of first dose of study drug. 5. history of stroke or intracranial hemorrhage within 6 months prior to enrollment. 6. treatment with a strong cytochrome p450 (cyp) 3a inhibitor.