Kornimate/medical-research-clean huggingface dataset:
continuous rhythm monitoring with implantable cardiac monitors and wearable devices with real-time smartphone alerts during af episodes

Conditions: Atrial Fibrillation

Summary: atrial fibrillation (af) is the most common arrhythmia affecting 1.3 million people in the uk. af causes an irregular and fast heartbeat, which makes the heart pump poorly. as a result, blood clots may form inside the heart and, if they travel to the brain, can lead to an af-related stroke. patients with af have a risk of stroke five-times higher than patients with normal rhythm. anticoagulants make the blood less likely to clot and, thus, reduce the chances of an af-related stroke. for most people, once anticoagulation is started it must be taken for the rest of their lives irrespective of the amount of af someone has. however, anticoagulants make patients more prone to bleeding. new studies have reported a lower stroke risk in patients with short and infrequent af episodes. if there are long time gaps in between af episodes, short periods of anticoagulation around the time of af may be enough to avoid clots from forming and reducing the overall risk of bleeding. to use anticoagulants only when needed will require an accurate and reliable way to detect af when it occurs and alert patients. new technologies, such as small heart monitors placed under the skin, watches and rings, can track the heart rhythm continuously and send real-time alerts to patients via mobile phone message if af is detected. the purpose of this study is to investigate if implantable cardiac monitors (linq ii) and wearable devices (apple watch and cart-i ring) can detect af episodes, send real-time alerts to patients and who will respond to these alerts within a short timeframe. the investigators will recruit 50 patients and follow them for six months. all participants will receive a linq ii and a wearable device.


Eligibility criteria:
inclusion criteria: * participant is willing and able to give informed consent for participation in the trial. * male or female aged 18 years or above. * paroxysmal af with symptoms, holter recording and/or implantable device evidence of \>1 but \<15 episodes of af in the last 3 months. * persistent af scheduled for repeat cardioversion (i.e. having had at least one prior cardioversion). * currently have an apple ios or android smartphone. exclusion criteria: * diagnosis of permanent af. * contra-indications for implantable cardiac monitor. * visual or physical impairment that prevents ability to read and acknowledge smartphone/watch notifications. * unable to comply with the follow-up schedule. * do not have apple ios or android smartphone.

Keywords: af apple watch cart-i ring linq ii wearable
vitamin d oral replacement in asthma

Conditions: Asthma; Vitamin D Deficiency; Pediatric Obesity

Summary: the overall objective of the study is to determine the pharmacokinetics of vitamin d supplementation in children who have asthma and are overweight or obese.

this study has two parts. in part 1, study participants will be randomized to receive one of four doses of vitamin d supplementation in international units (iu) over at 16-week period: 1) single 50,000 iu loading dose + 6000 iu daily dose; 2) single 50,000 iu loading dose + 10,000 iu daily dose: 3) 6000 iu daily dose; or 4) 600 iu daily dose. based on pharmacokinetic analysis, one of the doses (1-3) will be selected to use in part 2. in part 2, study participants will be randomized to the dose selected in part 1 or the 600 iu daily dose of vitamin d supplementation to be administered over a 16-week dosing period. across both parts, safety of each dose regimen of vitamin d supplementation will be evaluated, and the effectiveness of each dose to achieve a serum level of 25(oh)d greater than or equal to 40 ng/ml will be assessed.

Eligibility criteria:
inclusion criteria: * body mass index greater than or equal to 85% for age and sex * physician-diagnosed asthma * ongoing relationship with asthma provider responsible for asthma care * serum 25(oh) d level 10 ng/ml to less than 30 ng/ml at screening visit based on local laboratory test * ability to swallow pills similar in size to the vitamin d preparation to be used * signed consent form from parent, legal guardian or caregiver and signed assent from participant (as appropriate) * females of childbearing years must not be pregnant, must not be lactating and must agree to practice adequate birth control method * child and parent, legal guardian, or caregiver must speak english or spanish exclusion criteria: * known diseases of calcium metabolism or the parathyroid * history of renal insufficiency or kidney stones * known liver failure or history of abnormal liver function tests * history of williams syndrome, sarcoidosis, or granulomatous disease * active tuberculosis * spot urine calcium/creatinine ration greater than 0.37 (calcium and creatinine measured in mg/ml). this can be repeated following adequate hydration * clinical evidence of rickets * taking supplemental vitamin d greater than equal to 1000 iu per day

Keywords: pediatric obesity
anterior vaginal wall reconstruction

Conditions: Vaginal Prolapse

Summary: the purpose of this study is to assess the effectiveness of the polypropylene tape in preventing cystocele recurrence when placed underneath the bladder base as a concomitant measure to the anterior colporrhaphy procedure.

objective: the purpose of this study is to assess the effectiveness of the polypropylene tape in preventing cystocele recurrence when placed underneath the bladder base as a concomitant measure to the anterior colporrhaphy procedure. methods: fifty caucasian women 50 to 77 years old (mean age 66.6 years), 2 pre and 48 post menopausal with stage ii-iv pelvic organ prolapse, enrolled into the study. vaginal reconstructive surgery included an anterior colporrhaphy in all patients, posterior colpoperineorrhaphy in 28 patients and hysterectomy in 36 patients. they were randomly divided in a control group of 22 women and a study group of 28 women. as reinforcement to the anterior colporrhaphy procedure a polypropylene tape (tvt-o) was placed not under the midurethra, as originally described in case of stress incontinence, but underneath the bladder base and was fixed there with polyglactin sutures, in the study group. the postoperative follow up was carried out in frequent intervals of 4 months (total 48 months). the assessment of the anatomic result included evaluation of the operated sites and of the position of the tapes inserted on clinical grounds and after perineal sonography, which measured the distance of the bladder base to the inferior edge of the symphysis pubis. results: in all patients the postoperative correction of the anterior vaginal wall was sufficient; the mean distance of the bladder base to the inferior edge of the symphysis pubis was 1.5 cm (range 1.0-2.2 cm). mean residual urine volume was 30 ml. there were postoperatively 2 cases of stress incontinence and two cases of urge incontinence one in each group. there was no case of tape erosion noted, no dyspareunia and no recurrent cystocele in the study group. four cases of recurrent cystocele (20%) were reported in our control group. conclusion: the tension free vaginal tape, particularly tvt-o, placed underneath the bladder base, when performed concomitantly to the anterior colporrhaphy appears to be safe and effective. while the preliminary results of our study are encouraging, larger series of patients and longer follow up are required to verify the effectiveness of the aforementioned modification.

Eligibility criteria:
inclusion criteria: * women 50-77 years old with stage ii-iv organ prolapse

Keywords: cystocele tension free vaginal tapes urinary incontinence
an efficacy study of secukinumab in enthesitis of psoriatic arthritis patients

Conditions: Psoriatic Arthritis

Summary: given the role of il-17 in the development of entheseal-driven pathology, a therapeutic strategy aimed at blocking il-17 would be a logical option for the treatment of enthesitis in psoriatic arthritis patients. this study will be the first randomized trial of a biologic therapy in participants with psoriatic arthritis, using imaging test.


Eligibility criteria:
inclusion criteria: * aged 18 years or older,; * had received a diagnosis of psoriatic arthritis at least 6 months previously, fulfilled the classification criteria for psoriatic arthritis (caspar); * had at least 1 active enthesitis (confirmed by ultrasound) ; * had active arthritis (at least 3 tender/painful and 3 swollen joints) ; * had active plaque psoriasis (there was no criteria for minimum psoriasis severity) at screening and baseline. exclusion criteria: * history of surgery or trauma at the site examined by ultrasound (hand, elbow, knee, ankle, etc.); * local injection of glucocorticoids or other drugs at the site examined by ultrasound in recent 6 weeks; * peripheral neuropathy; * use of il-17 or il-12/23 inhibitors in the last 12 months;use of infliximab, adamumab, golimumab, and cetuzumab in the last 10 weeks;puva treatment for the last 4 weeks;use of topical treatment or uvb phototherapy that may have an effect on psoriasis in the last 2 weeks; * recent history of severe, progressive, or uncontrolled renal, hepatic, hematological, gastrointestinal, metabolic, endocrine, pulmonary, cardiovascular, or neurologic disease; evidence of active or latent or inadequately treated mycobacterium tuberculosis; aspartate transaminase (ast) or alanine transaminase (alt) \>3x upper limit of normal (uln) at screening; estimated creatinine clearance \<40 ml/min.
circulating tumor cells (ctcs): a potential screening test for clinically undetectable breast carcinoma

Conditions: Breast Abnormality

Summary: with an estimated \> 2 million women with undetected breast cancer in the united states, the need for improved early detection is imperative. early diagnosis for these women is key to minimizing quality life-years lost to disease and optimizing success of treatment. evidence now exists supporting the finding that systemic spread is an early event in the natural history of breast cancer, manifested as a release of single cancer cells from the incident, clinically undetectable tumor, which circulate through the bloodstream and deposit within remote tissues. reliable and accurate detection of these circulating tumor cells (ctcs) is now possible with a simple peripheral venous blood draw. this study hypothesizes that women with ctcs and no other signs of malignancy have clinically undetectable disease. this study will attempt to validate this technology as a breast cancer screening test and acquire data to determine the clinical validity and utility of this proposed screening methodology on a relatively young, ethnically diverse population who are eligible military health care beneficiaries. furthermore, this study will attempt to bank identified ctcs in order to perform additional molecular analyses in the future. the specific aims are to develop a simple, reliable, cost-effective, and clinically relevant breast cancer screening test in order to identify subclinical disease early in its natural history in subjects at risk of progression to clinically apparent disease over the ensuing decade. the ultimate goal is to decrease the treatment-related morbidity and cause-specific mortality of breast cancer. an experienced team devoted to the care of patients with breast disease has been assembled to achieve this goal.


Eligibility criteria:
inclusion criteria: * adults 18 years of age or older * mentally competent and willing to provide written informed consent prior to entering the study * military healthcare beneficiary * undergoing a diagnostic or therapeutic procedure (biopsy, lumpectomy, mastectomy) in the breast clinic or operating room. * present to the cbcp and willing to be followed at the cbcp during the course of treatment and follow-up exclusion criteria: * prior history of invasive carcinoma * presence of clinically-apparent metastatic disease * participants with known human immunodeficiency virus (hiv), any history of hepatitis, prion-mediated disease, drug resistant tuberculosis or other infectious disease presenting a significant risk to personnel handling tissue or blood-derived products shall be excluded from participation * participants with pre-existing coagulopathies or all other conditions, for whom invasive biopsy or surgery is medically contraindicated
prevalence of chronic kidney disease in tunisian diabetics

Conditions: Chronic Kidney Diseases; Diabetes Mellitus; Diabetes Type 2

Summary: in tunisia, diabetes is a serious public health problem, its prevalence reaches 22.9% of people aged 18 and over and is likely to affect a quarter of the population by 2045. diabetic kidney disease is the most common and severe complication of diabetes. it is both a major cause of end-stage renal disease and a risk factor for mortality and cardiovascular morbidity, thus becoming an additional public health concern. early diagnosis of diabetic kidney disease makes it possible to manage patients more effectively and in a multidisciplinary way, to delay its progression to chronic renal failure.

in tunisia, little data exist concerning the epidemiology of chronic kidney disease in diabetics. it is then relevant to assess the incidence of chronic kidney disease among the tunisian diabetic population. the study is an observational, multicentric, cross-sectional, and national project. the study will be carried out for one month at medical departments and ambulatory clinics of general physicians, family medicine specialists, endocrinologists, specialists in nutrition and metabolic diseases, nephrologists, internal medicine physicians, cardiologists, or any healthcare providers in charge of diabetic patients. a steering committee helps investigators to monitor their patient inclusions, performs audit trails and prepares the statistical analysis plan for the study. collected data are managed by the dacima clinical suite®, the electronic data capture platform which complies with the fda 21 cfr part 11 requirements (food and drug administration 21 code of federal regulations part 11), the hipaa specifications (health insurance portability and accountability act), and the ich standards (international conference on harmonisation).

Eligibility criteria:
inclusion criteria: * age \> 18 years old * diabetes type 1 or type 2 * follow-up at the consultation for at least more than 3 months * informed consent of the patient exclusion criteria: * kidney transplant * chronic dialysis

Keywords: chronic kidney disease diabetes survey
exhaled breath condensate biomarkers in caras

Conditions: Combined Allergic Rhinitis and Asthma Syndrome

Summary: to explore the differences in the expression of biomarkers in different sample types between the healthy population and different subgroups of the disease, and to screen for potential biomarkers in a more simple, direct and objective way. to screen the biomarkers that can be identified by caras chinese medicine symptoms and different stages, and to provide a reference basis for individualised diagnosis and treatment of the disease.


Eligibility criteria:
inclusion criteria: * patients with ar, ba and caras who meet the western medical diagnostic criteria; * chinese medical evidence consistent with lung qi deficiency evidence, phlegm-heat congestion of the lung evidence, or wind-heat offending the lung evidence; * age 18 to 80 years; * voluntarily accepted the study and signed an informed consent form; * not participated in other clinical studies within 1 month before enrollment. exclusion criteria: * patients with combined vasomotor rhinitis and eosinophilic non-allergic rhinitis, other non-allergic rhinitis diseases that can cause symptoms such as nasal congestion and runny nose; * patients who are participating in other drug trials; * patients with a combination of other serious systemic diseases; * pregnant or lactating women; * patients with confusion, disorders of consciousness, dementia, and various psychiatric disorders.

Keywords: caras ebc biomarkers combination of disease and evidence
the effect of desflurane vs sevoflurane on perioperative respiratory complications in laryngeal mask airway anesthesia

Conditions: Anesthesia; Adverse Effect; Laryngeal Masks; Respiratory System Abnormalities

Summary: the effects of desflurane versus sevoflurane in adult patients undergoing lma anesthesia on respiratory events during a less than 2-hour elective surgery.

laryngeal mask airway (lma) anesthesia is generally performed for ambulatory surgery to avoid the use of neuromuscular blocking agents and to facilitate rapid emergence from anesthesia. inhaled anesthetics are simply and popularly used during maintenance of anesthesia. the two most recent volatile anesthetic agents, desflurane and sevoflurane, are the two most commonly used in clinical practice for an ambulatory setting. desflurane is the volatile agent with low blood: gas partition coefficient (0.42). desflurane's uptake and elimination from the body of a patient are rapid, which results in a fast onset of anesthesia and a fast recovery from anesthesia. this property provides desflurane as an ideal agent for the ambulatory anesthesia. however, its pungent odor is concerned to irritate the upper airway and may cause significant respiratory complications. sevoflurane has a blood: gas partition coefficient of 0.65, which is slightly greater than desflurane. the major advantage over desflurane is the better scent. it is considered to be less airway irritation in lma anesthesia with smooth induction and recovery. the limitation of desflurane on its odor leads to a controversy if desflurane is similar to or worse than sevoflurane for lma anesthesia. this is non-inferiority study designed to compare the occurrence of respiratory complications between desflurane and sevoflurane during lma anesthesia.

Eligibility criteria:
inclusion criteria: * patients with american society of anesthesiologists physical status classification of i-iii * elective surgery * surgery with expected duration of operation of less than 2 hours * surgery that anesthesiologist plans to use laryngeal mask airway during anesthesia exclusion criteria: * patients with gastroesophageal reflux disease * patients with hiatal hernia * patients with history of upper respiratory tract infection within 1 month before surgery * heavy smoker (\> 20 cigarettes per day) * obese patients with body mass index \> 30kg/m2 * pregnant patients * unable to provide a written informed consent patients * surgery requiring non-depolarizing muscle relaxants

Keywords: desflurane sevoflurane respiratory complications
validation of peripheral pressure volume loops and ultrasound-derived "cardiac power" by comparison with invasive left ventricular pressure volume loops

Conditions: Cardiovascular Disease

Summary: the investigators will generate pressure-flow loops and pressure-volume loops from aortic and left ventricular pressure waveforms and doppler (desc. aorta) flow waveforms and compare left ventricular to arterial pressure-flow and pressure-volume loops as well as to cardiac power from the uscom 1a device. the goal of this study is to test the hypothesis that non-invasive estimates of cardiac pressure-volume work (derived from ultrasound-based measurements) correlate with invasive estimates.

extensive animal work by suga et al. in the 1980s clearly demonstrate a relationship between left ventricular pressure volume area (pva) and myocardial consumption of oxygen (mvo2). pva can be measured by combining radial artery pressures with ultrasound-derived estimates of aortic blood flow. because the aorta and peripheral artery compartments are separated from the left ventricle by the aortic valve, the peripheral arterial pressures cannot perfectly approximate left ventricular pressures. however, because the majority of variation in the pressure volume loops is made up of changes in height and width (changes in the left ventricular end-diastolic curve are, by contrast, relatively small), both of which can be readily detected by changes in the peripheral arterial blood pressure tracing, this loss of information may be clinically insignificant. uscom, has developed a portable suprasternal doppler probe (model 1a) capable of estimating left ventricular stroke volume; a unique feature of this device is its ability to utilize both stroke volume, heart rate, and mean arterial pressure in an attempt to measure cardiac power. this device has not been validated against invasive estimates of cardiac power. knowledge of mvo2 would be a useful clinical variable but is not widely available. the ability to non-invasively estimate mvo2 intraoperatively would give anesthesiologists the ability to measure the effect of hemodynamic interventions on myocardial consumption of oxygen and, when combined with stroke volume, estimate myocardial efficiency. non-invasively estimates of mvo2 may also allow cardiologists a novel means of assessing the myocardium of patients with cardiovascular disease.

Eligibility criteria:
inclusion criteria: * adult (18 or older) * undergoing left heart catheterization exclusion criteria: * unable to visualize ascending aorta using ultrasound

Keywords: pressure volume area pressure flow area myocardial work
a prospective multicenter study of different surgical methods in the treatment of high myopic macular schisis

Conditions: Macular Schisis

Summary: in view of the current problem of treating high myopic macular schisis, the main purpose of our study is to find out the most appropriate time of surgical intervention, to compare the effectiveness and safety of various surgical methods in the treatment of high myopic macular schisis, and to find out the advantages and disadvantages of each surgical method in the treatment of mf. as well as the outcomes and complications of long-term follow-up.


Eligibility criteria:
inclusion criteria: 1. diopter ≤-6.00d or axial length ≥ 26.00mm; 2. oct showed macular schisis with or without macular retinal detachment; 3. agreed to participate in this project and signed informed consent form. exclusion criteria: 1. oct confirmed full-thickness macular hole with or without macular retinal detachment； 2. submacular active or inactive cnv; 3. previous vitreoretinal surgery and anti-glaucoma surgery； 4. with rhegmatogenous retinal detachment, ocular trauma, glaucoma, corneal opacity and other ophthalmic diseases; 5. complicated with severe systemic disease can not tolerate surgery or follow-up; 6. do not agree to participate the project or disagree with the follow-up.
electronically recorded national early warning scores, pain scores and ponv scores among hospitalized patients

Conditions: Prevention of In-hospital Adverse Events

Summary: national early warning score (news) enables early detection of patient deterioration in hospital floors. however, there is limited data on the prognostic value of news among actual general ward patients. further, there is no data on how changes in news-values impact patient outcomes. very little is known on how post-operative nausea and vomiting (ponv) and pain influences news values and vital signs in general.

the investigators aim to collect detailed data on patients' vital signs, newss, pain scores and ponv scores through electronic data records, where these values are automatically stored with mobile mobile smart devices used by nursing staff. the expected volume of the cohort is 50,000 patients and 300,000 recordings of vital signs. in addition to the scores and vital signs, the registry will include patients' identification numbers (ids), dates and times of the recordings, and ward numbers. with the ids, mortality data up to 90-days for the patients will be obtained from the national population register centre. all data will be handled in a pseudonymized form in a secure computer inside hospital, and approval to use the registry in study purposes will be obtained from the ethics committee of tampere university hospital.

Eligibility criteria:
inclusion criteria: * adult in-hospital patients with recordings of vital signs exclusion criteria: * patients under 18 years

Keywords: national early warning score prevention of serious adverse events patient deterioration