Kornimate/medical-research-clean huggingface dataset:
perioperative insulin, gik or glp-1 treatment in diabetes mellitus

Conditions: Diabetes Mellitus Type II

Summary: the incidence of diabetes mellitus type ii is increasing. more and more patients who need surgery have diabetes mellitus type ii. despite an enormous amount of glucose lowering protocols and the proven negative effects of hyperglycaemia. there is no evidence for the optimal glucose lowering protocol. this study investigates the optimal intraoperative treatment algorithm to lower glucose in patients with diabetes mellitus type 2 undergoing non-cardiac surgery, comparing intraoperative glucose-insulin-potassium infusion (gik), insulin bolus regimen (br) and glp-1 (liraglutide, lg) treatment.

diabetes mellitus is associated with poor outcome after surgery. the prevalence of diabetes in hospitalised patients is up to 40%, meaning that the anaesthesiologist will encounter a diabetes patient in the operating room on a daily basis. multiple protocols for perioperative glucose regulation have been developed, ranging from intravenous glucose-insulin-potassium infusion to subcutaneous bolus regimens. despite this abundance of published glucose lowering protocols and the proven negative effects of intraoperative hyperglycaemia in diabetes, there is no evidence regarding the optimal intraoperative glucose lowering treatment. recently, incretins have been introduced to lower blood glucose. the main hormone of the incretin system is glucagon-like peptide-1 (glp-1). glp-1 increases insulin and decreases glucagon secretion in a glucose-dependent manner, resulting in low incidence of hypoglycaemia. this study investigates for the first time the optimal intraoperative treatment algorithm to lower glucose in patients with diabetes mellitus undergoing non-cardiac surgery. objective: this study investigates the optimal intraoperative treatment algorithm to lower glucose in patients with diabetes mellitus type 2 undergoing non-cardiac surgery, comparing intraoperative glucose-insulin-potassium infusion (gik), insulin bolus regimen (br) and glp-1 (liraglutide, lg) treatment.

Eligibility criteria:
inclusion criteria: * signed informed consent * known diabetes mellitus type ii for \> 3 months * aged 18-75 years * scheduled for elective non-cardiac surgery exclusion criteria: - daily insulin dosage of \> 1 iu/kg body weight * oral corticosteroid use * planned for day-care (ambulant) surgery * planned icu stay post-operatively * planned bowel surgery * history of chronic pancreatitis or idiopathic acute pancreatitis * impaired renal function defined as serum-creatinine ≥ 133 μmol/l for males and ≥ 115 μmol/l for females * females of child bearing potential who are pregnant, breast-feeding or intend to become pregnant or are not using adequate contraceptive methods (adequate contraceptive measures as required by local law or practice) * known or suspected allergy to trial product(s) or related products * any condition that the local investigator feels would interfere with trial participation or the evaluation of results

Keywords: glucose diabetes mellitus perioperative
primary parkinsonian pain diagnostic questionnaire: development and validation of this questionnaire

Conditions: Parkinson Disease

Summary: development and validation of a diagnosis questionnaire of parkinsonian primary pain: the "primary parkinsonian pain diagnostic questionnaire" (3pdq)

the aim of this study is to develop and validate a french self-questionnaire to diagnose parkinsonian primary : the "primary parkinsonian pain diagnostic questionnaire" (3pdq). it will allow clinicians to distinguish this pain from the other pain of the parkinsonian patient (whether or not related to parkinson's disease). the development and validation of the 3pdq self-questionnaire will take place in 3 sequential steps: 1. design of the self-questionnaire 2. appearance validity study 3. validation of the self-questionnaire participants : appearance validity study: 40 painful parkinsonian patients validation study: 200 painful parkinsonian patients (10 patients per item) duration of the study : duration of the inclusion period: * appearance validity study : 6 months * validity study : 20 months duration of participation for each patient: * appearance validity study : about 30 min * validity study : 3 days maximum total duration of the study: (with results analysis): 3 years

Eligibility criteria:
inclusion criteria: * patients with parkinson disease (pd) * patients who have chronic pain (for at least 3months) moderate to severe (intensity ≥ 4/10 on visual analogue scale from 0 to 10) specific or unspecific to pd * patients who have one type of pain or different type of pain: in this case, patients should suffered from one predominant pain and be able to identify it * patients who have stable analgesic medication during the study * patients who understand and speak fluently french * patients with health insurance * patients who signed the written informed consent form exclusion criteria: * patients with severe depression according to diagnostic and statistical manual (dsm) v criteria * analgesic medication modified recently (less than 1month) * patients with psycho-actives substances or alcohol abused * patients with cognitive impairment (moca score \< 25)

Keywords: parkinson disease parkinsonian central pain diagnosis primary parkinsonian pain diagnostic questionnaire
hypercapnia and gas exchange under the avalanche snow model (hyperavasm)

Conditions: Accident Caused by Snow Avalanche

Summary: the aim of the study is to investigate respiratory parameters of a person in the simulated avalanche snow and consequent use of the measured data for development of a mathematical-physical model of breathing during increasing hypercapnia in the avalanche.

the study is a part of a university research project aimed at studying physiological conditions and development of breathing parameters of a person breathing in the simulated avalanche snow. presence of an air pocket and its size play an important role in survival of victims buried in the avalanche snow. even small air pockets facilitate breathing, yet they do not provide a significant amount of fresh air for breathing. the investigators hypothesize that the size of the air pocket significantly affects the airflow resistance and work of breathing. the aim of the study is to investigate the effect of the air pocket volume on gas exchange and work of breathing in subjects breathing into the simulated avalanche snow and to test, whether it is possible to breathe with zero air pocket.

Eligibility criteria:
inclusion criteria: * participants were volunteers from the czech army forces, studying at the military department of the faculty of physical education and sport, charles university in prague. all subjects were healthy and fit, classified as asa i, all without a smoking history. the volunteers were highly motivated to participate in the experiment. the entrance examination, completed before the start of the study, included these tests: electrocardiography, blood pressure, spirometry, and assessment of the health conditions and family anamnesis by a physician with a specialty in anesthesia and critical care. exclusion criteria: * the exclusion criteria were tiffeneau index less than 0.70 and any cardiovascular or respiratory condition.
early therapeutic effects of statins and fibrates on unstable atherosclerotic plaques

Conditions: Atherosclerosis

Summary: rupture of unstable atherosclerotic plaques is the underlying pathophysiologic mechanism of acute coronary syndromes and thus also of perioperative myocardial ischemia. lipid lowering drugs such as statins and fibrates have been shown to improve the outcomes of patients with atherosclerosis. this is not only mediated through their therapeutic actions on lipid metabolism, but relies on a multitude of pleiotropic effects of these substances. one of the most interesting of these effects is the stabilisation of atherosclerotic plaques. to investigate these effects in a perioperative setting, patients scheduled for thromboendarterectomy of the carotid artery will be recruited. they will be randomised to receive either atorvastatin 10mg/d, gemfibrozil 1200mg/d or placebo for two weeks preoperatively. specimens of carotid plaques will be obtained intraoperatively. after microscopic characterisation of plaques, dna-microarray analyses will be done to gain insights into the transcriptional regulation and expression profiles of various types of atherosclerotic plaques under different pharmacological circumstances (stable or unstable with statin/fibrate/placebo).


Eligibility criteria:
inclusion criteria: * atherosclerosis * stenosis of carotid artery exclusion criteria: * therapy with statine or fibrate * pregnancy
investigation into the pathophysiology and treatment of varicose veins

Conditions: Varicose Veins

Summary: chemical sclerotherapy is commonly used to treat varicose veins which affect superficial veins in the leg. sclerotherapy is injected directly into veins where it causes damage to the vein wall. if sufficient damage occurs, the vein is transformed into a fibrous cord which does not re-open. this study will investigate the structural changes caused to the wall of veins following injection with sclerotherapy ex vivo. vein samples will be obtained from the whiteley clinic in guildford from patients undergoing phlebectomy operations. these will then be injected with sclerotherapy and the extent of damage will be investigated. samples will also be used for laboratory analysis into the pathophysiology of varicose veins.

varicose veins affect up to 40% of the population and are associated with significant discomfort, skin damage, and complications including ulceration and perforation. in recent years, there has been a move towards minimally invasive treatment, including chemical sclerotherapy. despite their widespread use,the fundamental effects of sclerosants have not been fully characterised. furthermore, their use is associated with significant rates of re-canalisation and clinical recurrence. there is therefore significant scope for researching the effects of sclerosants on the vein wall and the mechanisms of cell death. furthermore, the pathophysiology of varicose veins has not been fully characterised. it is the aim of this study to research a number of themes related to the use of sclerotherapy and the pathophysiology of varicose veins in order to provide information which will both further scientific knowledge and further develop clinical practice by optimising the use of sclerotherapy. this research will be conducted by a phd student based at the university of surrey, in conjunction with the whiteley clinic in guildford. veins and blood samples removed following varicose vein surgery at the whiteley clinic will be provided for laboratory-based research at the university. a range of methodologies will be employed to analyse cellular responses to sclerosants to determine the precise structural and biochemical changes which lead to destruction of the vein and clinical efficacy, and to investigate a number of key themes implicated in the pathophysiology of varicose veins.

Eligibility criteria:
inclusion criteria: * gives consent * over 18 years * undergoing phlebectomy operation exclusion criteria: * does not give consent
circulatory management and acute kidney injury in patients undergoing partial nephrectomy

Conditions: Acute Kidney Injury

Summary: the purpose of this study is to investigate whether circulatory management based on lidcorapid hemodynamic monitoring can reduce the incidence of acute kidney injury in patients undergoing partial nephrectomy when compared with routine circulatory management based on blood pressure and urine output monitoring

previous studies found that the incidence of acute kidney injury afer partial nephrectomy is higher than 30%. in addition to nephron loss induced by renal parenchyma resection, ischemia/reperfusion injury produced by clamping/unclamping of renal arteries is also an important reason. however, studies investigating the effect of circulatory management on the incidence of acute kidney injury after partial nephrectomy are limited. it has been shown that perioperative hemodynamic optimization protected renal function in surgical patients. and in patients undergoing renal transplantation, adequate hydration and optimal perfusion enhances early graft function. the investigators hypothesize that hydration and circulatory management to guarantee optimal renal perfusion may decrease the occurrence of acute kidney injury after partial nephrectomy. the purpose of this study is to investigate whether circulatory management based on lidcorapid hemodynamic monitoring can reduce the incidence of acute kidney injury in patients undergoing partial nephrectomy when compared with routine circulatory management based on blood pressure and urine output monitoring.

Eligibility criteria:
inclusion criteria: 1. age \> 18 years; 2. planning to undergo partial nephrectomy; exclusion criteria: 1. patients with renal function damage (chronic kidney disease stage 3-5) before surgery; 2. patients with arrhythmia or aortic valve diseases (moderate or higher degree stenosis/regurgitation); 3. patients who has participated in other trials.

Keywords: partial nephrectomy acute kidney injury lidcorapid circulatory management
identification and therapy efficacy of type 2 diabetes in hispanic patients

Conditions: Diabetes Mellitus, Non-Insulin-Dependent

Summary: the two major types of diabetes are type 1 and type 2 diabetes. although most patients with type 2 diabetes are older than age 40, type 2 diabetes has been reported with increasing frequency among patients under the age of 20. this form of diabetes has been called type 2 diabetes of youth, abbreviated type 2y. little is known about the etiology of type 2y; however, clinicians believe that it occurs most commonly in obese children of particular ethnic groups. a positive family history appears to be one major risk factor for developing type 2y diabetes. the individual contribution of ethnicity, obesity, and genetics to type 2y have yet to be elucidated. there is no consensus regarding treatment with type 2y diabetes. observation of our hispanic patients in the houston area reveals a large number with type 2y. the major purpose of this study is to examine the genetic and environmental risk factors such as family history, ethnicity, and obesity in hispanic children with type 2y diabetes. specific aims: 1) to examine the genetic and environmental risk factors and clinical signs associated with type 1 diabetes and type 2 diabetes of youth. 2) to compare the efficacy of the treatment modalities, insulin and oral agents, in type 2y patients. methods: we will undertake a retrospective case study, to include a review of hypothesized risk factors in all the medical records of pediatric diabetes patients seen at university of texas. we anticipate that approximately 200 patients with type 1 diabetes and 30 patients with type 2y diabetes will be identified. a sustacal challenge test will be done in patients with a suspected diagnosis of type 2y in order to confirm the clinical diagnosis. parents will be contacted by phone for a detailed pedigree intake. type 1 and type 2y patients will be compared for each of the studied features. a retrospective review of diabetes type 2 therapies used in type 2y patients will be undertaken through further examination of the medical records in order to compare insulin treatment to oral agents. we will also test a subset of the patients for the gene identified in adult hispanics with type 2 diabetes.


Eligibility criteria:
inclusion criteria: * approximately 30 pediatric patients (ages 10-18) believed to have a diagnosis of type 2y. each subject must have been diagnosed for at least one year. exclusion criteria: * patients over the age of 18 or under the age of 10 * patients in whom intellectual functioning is impaired sufficiently to interfere with the understanding of the protocol.

Keywords: type 2 diabetes
inter-relationship between vitamin d requirements and calcium intake in older adults

Conditions: Vitamin D Deficiency

Summary: this winter-based placebo-controlled, single-dose vitamin d randomized controlled trial (rct) aims to examine the impact of various levels of habitual calcium intake on dietary vitamin d requirements in older adults stratified by calcium intake. this will provide new data on the impact of different levels of calcium intake, ranging from low/moderate to high, on winter serum 25(oh)d levels, and their utilization and catabolism in adults.

the aim of this study is to perform a randomised controlled vitamin d3 intervention study in apparently healthy, free-living adults (aged 50+ y) to investigate whether different levels of habitual calcium intake, ranging from low-moderate to high, influence serum 25(oh)d concentrations and indices of vitamin d activation and catabolism during winter, when vitamin d intake is adequate versus inadequate. this research will provide new data and scientific understanding in relation to the impact of different levels of dietary calcium intake on vitamin d requirements in the older adult population. as such, this new data will inform dietary reference values for vitamin d.

Eligibility criteria:
inclusion criteria: consenting white men and women aged ≥ 50 y exclusion criteria: * unwilling to discontinue consumption of vitamin d-containing supplements 4 wks before the initiation of the study and throughout the study. * planning to take a winter vacation (during the course of the 15-wk intervention) to a location at which either the altitude or the latitude was predicted to result in significant cutaneous vitamin d synthesis from solar radiation (e.g., a winter sun coastal resort or a mountain ski resort) * use of tanning facilities of any type. * pregnancy or planning to become pregnant during the study * a severe medical illness, * hypercalcaemia, * known intestinal malabsorption syndrome, * excessive alcohol use, * taking medications known to interfere with vitamin d metabolism

Keywords: vitamin d status 25-hydroxyvitamin d vitamin d3 rct calcium intake dietary requirement
relation of consummatory and anticipatory food reward to obesity

Conditions: Weight Gain; Food Habits

Summary: obesity is associated with increased risk for mortality, atherosclerotic cerebrovascular disease, coronary heart disease, colorectal cancer, hyperlipidemia, hypertension, gallbladder disease, and diabetes mellitus, resulting in over 111,000 deaths annually in the united states ). in the us, 65% of adults are overweight or obese. unfortunately, the treatment of choice for obesity (behavioral weight loss treatment) only results in a 10% reduction in body weight on average and most patients regain this weight within a few years. further, most obesity prevention programs do not reduce risk for future weight gain. the limited success of treatment and prevention interventions may be due to an incomplete understanding of the processes that increase risk for obesity. recent data suggest that obese adults show abnormalities in reward from food intake and anticipated food intake relative to lean adults, but the precise nature of these abnormalities is unclear and it has not been established whether these abnormalities predate obesity onset or are a consequence. it is vital to elucidate risk factors for obesity onset to advance understanding of etiological processes and determine the content of prevention and treatment programs. the goals of this study are to (1) determine whether adolescents at high-risk for obesity, by virtue of having two obese parents, show abnormalities in reward from food intake (consummatory food reward) and anticipated reward from food intake (anticipatory food reward) compared to adolescents who are at low-risk for obesity, (2) determine whether abnormalities in consummatory and anticipatory food reward increase risk for weight gain and obesity onset, (3) examine moderators that may amplify the relations of consummatory and anticipatory food reward to unhealthy weight gain, and (4) examine changes in consummatory and anticipatory food reward in those participants who show obesity onset relative to those not showing obesity onset. each of these goals is described in more detail below.


Eligibility criteria:
inclusion criteria: * we will require that adolescents have age- and sex- adjusted standardized body mass index (bmi) scores between the 25th and 75th percentile at baseline for inclusion. * low risk youth: lean parents will have a bmi between 18 and 25. * high risk youth: obese parents will have a bmi value of greater than 30. exclusion criteria: * students who report contraindicators of fmri (e.g., metal implants, braces, or pregnancy). * current major psychiatric disorders (including substance use disorders, conduct disorder, oppositional defiant disorder, adhd, major depression, bipolar disorder, panic disorder, agoraphobia, or generalized anxiety disorder) * current use of analgesics and other psychoactive drugs (e.g., cocaine) * serious medical complications (e.g., diabetes) * relevant food allergies * current smoking * current weight loss dieting
the blood glucose control in patients with type 2 diabetes treated with glargine

Conditions: Type2 Diabetes

Summary: glargine is commonly used in insulin supplemental therapy in patients with type 2 diabetes(t2d) at present. this study aims to investigate the current status of blood glucose control in patients with t2d treated with glargine. glycated hemoglobin(hba1c) will be tested in these patients to assess the blood glucose control and continuous glucose monitoring system (cgms) will be used to investigate the glucose variability. islet function, duration of diabetes, complications, exercise, insulin dose, oral medication regimen and insulin antibodies will be recorded in detail. this study will analysis the association between these clinical characteristics and blood glucose control.


Eligibility criteria:
inclusion criteria: 1. patients with t2dm, which was defined bypublished criteria of world health organization in 1999; 2. patients were using glargine with or without oral hypoglycemic drugs and having a stable dose of glargine for more than 2 month would be recruited into this study; 3. patients had relatively constant diet and exercise in 2 month before the study; 4. fasting blood glucose was between 6.1 and 16mmoll, and postprandial (or random) blood glucose \<22.2mmol/l. exclusion criteria: 1. patients with severe cardiovascular diseases, such as stroke, transient ischemic attack, myocardial infarction, unstable angina, coronary artery bypass grafting, percutaneous coronary intervention, and heart failure; 2. patients with severe infectious diseases; 3. patients with acute complications of diabetes on admission, such as diabetic ketoacidosis, diabetic hyperosmolar nonketotic coma, and lactic acidosis; 4. patients with history of psychiatric disorders and were unsuitable to use cgms; 5. any other situations that made patients unsuitable to participate in the study, such as alcoholism and drug abuse.