Kornimate/medical-research-clean huggingface dataset:
prepare-ibd: physician responses to disease flares and patient adaptation in relation to events in inflammatory bowel disease during covid-19 pandemic

Conditions: Inflammatory Bowel Diseases; Coronavirus Infection

Summary: to find out what adaptations have been made by inflammatory bowel disease physicians and patients in relation to therapies in flaring ibd patients during severe acute respiratory syndrome 2-cov and what the impact of these is on ibd patients with no symptomatic covid-19 and in suspected/confirmed covid-19. also whether there any ibd related factors impacting the outcome of patients with covid-19 symptoms or covid-19 disease

an observational, retrospective, case-controlled study to determine the status of ibd during development of covid-19 symptoms/positive covid-19. the aim is to describe the adaptations in therapies for active ibd during sars cov 2 in patients with active ibd and positive or negative covid-19 symptoms. it will evaluate ibd outcomes following development of covid-19 symptoms / positive covid-19 and determine any predictors of outcomes in ibd patients with covid-19 symptoms / positive covid-19 as well as determine the impact on ibd outcomes resulting from adaptations to treatments during covid-19

Eligibility criteria:
inclusion criteria: * patients with ibd +/- flare +/- covid 19 positivity exclusion criteria: * patients below 16 * patient with inactive ibd
vitreous levels of cysteine-rich 61 in patients with proliferative diabetic retinopathy

Conditions: Proliferative Diabetic Retinopathy

Summary: to determine the vitreous levels of fractalkine, cysteine-rich 61 (cyr61), and vegf in patients with pdr. verifying that it is greater to that found in non-diabetic patients with different non-angiogenetic diseases.

introduction: angiogenesis, the growth and proliferation of new blood vessels, is an important aspect of the vascular proliferation found in tumor growth, wound repair, inflammatory states, and ischemic sequel in the ocular angiogenetic diseases. intraocular neovascularization, the major eventually complication of diabetic mellitus, may result in vitreous hemorrhage, tractional retinal detachment, neovascularization glaucoma and eventually blindness. the involved factors include basic fibroblast growth factor (bfgf), insulin-like growth factor-i (igf-i), vascular endothelial cell growth factor (vegf), and connective tissue growth factor (ctgf)/cysteine-rich protein (cyr61)/nephroblastoma overexpressed gene (ccn) family. vegf is a primary angiogenic factor that mediates ischemic-induced retinal neovascularization. vegf level are elevated in the vitreous fluid in patients with proliferative diabetic retinopathy (pdr). the unselective anti-vegf antibody bevacizumab has been used for the treatment of diabetic retinopathy. problem: in spite of its potent anti-vegf property, it does not completely inhibit ischemia-induced retinal neovascularization. several other factors which were detected to have increased vitreous levels in the pdr patients might participate in the angiogenic process of diabetic retinopathy. one of the member of the ccn family, connective tissue growth factor (ctgf), was found to be involved in the angiogenesis and fibrosis mechanism of pdr. it is unclear if the other factors in the ccn family might also control the development of retinal angiogenesis and fibrosis.we measured vitreous cysteine-rich 61 (cyr61) levels in pdr patients, non-diabetic patients,and pdr patients pretreated with bevacizumab. we further correlated the cysteine-rich 61 levels with different stages of pdr. concomitant vegf level was also measured to better understand the interaction of different factors.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * patients with type 1 or type 2 diabetes mellitus * not eligible for any currently approved treatments or experimental protocols * patients with pdr who receiving vitreoretinal surgery. exclusion criteria: * a condition that would preclude a patient for participation in the study in opinion of investigator, e.g., unstable medical status including glycemic control and blood pressure * panretinal laser photocoagulation in the study eye * previous treatment with intravitreal or sub-tenon triamcinolone * history of submacular surgery or other surgical intervention for diabetic
identification of neurological prognostic markers of cardiac arrest patients alive on 3rd day

Conditions: Cardiac Arrest

Summary: the aim of the study is to identify prognostication predictors of 6-months neurological outcome in survivors at day 3 after cardiac arrest (ca) treated with therapeutic hypothermia (th).

cardiac arrest (ca) management remains challenging. as fewer than 20% of patients survive to discharge, early prognostication of functional outcome needs accurate prediction.survivors outcome depends on initial ca conditions (cause, duration and severity of ischemic injury) that may lead to the post-cardiac arrest syndrome, associated with high mortality. hypoxic-ischemic encephalopathy is the second cause of poor outcome after ca. indeed, most survivors remain comatose or in a vegetative state leading to decisions to withdraw life support. thus, the american academy of neurology had proposed a decision algorithm for use in prognostication of comatose survivors published in 2006.before the widespread use of therapeutic hypothermia (th), predictor factors of neurological outcome were: serum neuron-specific enolase (nse), n20 somatosensory-evoked potentials (ssep), status epilepticus, pupil and corneal reflexes and glasgow coma score motor response (gcs-m). therapeutic hypothermia is recommended in the management of ca.it has been associated with improved outcome after ventricular fibrillation out-of-hospital cardiac arrest (ohca). however, th may interfere with clinical examination and electrophysiological predictors (eeg, ssep) making prognostication of functional outcome hardiest.the use of sedative drugs and muscle paralysis during th is another cause of delayed neurological assessment and prognostication.the nse cutoff values to predict poor neurological outcome are not well defined and can be influenced by th either.the present study aims at identifying clinical, electrophysiological and biological prognostication predictors of 6-month neurological outcome in survivors at day 3 after ca treated by th. neurological functional status was assessed using the 5-item scale cerebral performance category (cpc). neurological status was retrospectively assessed at 6 months: cpc of 1 or 2 was defined as good neurological outcome and cpc of 3 to 5 were defined as poor neurological outcome. deaths in the first 3 days and decisions to withdraw or to withhold life support were also collected. the following prognostication factors were tested: neurological examination at day 3 and 7 including corneal and pupillary reflexes, gcs-m, status epilepticus, electro-encephalogram (eeg), sseps and nse levels between day 2 and day 3.

Eligibility criteria:
inclusion criteria: * ≥ 18 years * successfully resuscitated of out-of-hospital cardiac arrest (ohca) * patients admitted to icu exclusion criteria: * in-hospital cardiac arrest patients * death before icu admission
a study of tirzepatide compared with intensified conventional care in adult participants with type 2 diabetes

Conditions: Type 2 Diabetes

Summary: this study aims to investigate the efficacy and safety of tirzepatide in participants with type 2 diabetes (t2d) compared to other existing treatment options when treatment is initiated early.


Eligibility criteria:
inclusion criteria: * have, within the last 4 years, been diagnosed with t2d based on the world health organization classification or other locally applicable diagnostic standards. * have hba1c ≥7% to ≤9.5% as determined by the central laboratory. * have been on a stable treatment of metformin only at least 90 days preceding baseline * with the minimum effective dose of ≥1500 mg/day, but not higher than the maximum approved dose per country-specific label, or * \<1500 mg/day in case of intolerance of full therapeutic dose. exclusion criteria: * have type 1 diabetes mellitus * have a history of chronic or acute pancreatitis any time prior to study entry * have a history of * proliferative diabetic retinopathy * diabetic macular edema, or * no proliferative diabetic retinopathy requiring immediate or urgent treatment * are at high risk for cardiovascular disease (cvd) in the investigator's opinion or have a history of any of these cv conditions prior to study entry * myocardial infarction * percutaneous coronary revascularization procedure * carotid stenting or surgical revascularization * nontraumatic amputation * peripheral vascular procedure (e.g., stenting or surgical revascularization) * cerebrovascular accident (stroke), or congestive heart failure * have family or personal history of medullary thyroid carcinoma (mtc) or multiple endocrine neoplasia syndrome type 2 (men2) * have within 90 days prior to screening received treatment with medications intended to promote weight loss. this includes prescribed, over the counter, or alternative remedies * have an estimated glomerular filtration rate (egfr) \<30 ml/minute/1.73 m2 (or lower than the country-specific threshold for discontinuing metformin therapy per local label), calculated by chronic kidney disease-epidemiology equation as determined by central laboratory at screening. * have been treated with any injectable glucagon-like peptide-1 (glp-1) receptor agonists and insulin prior to screening. * exception: use of insulin for gestational diabetes or short-term use (\<14 days) for acute conditions such as acute illness, hospitalization, or elective surgery.

Keywords: t2d diabetes
co administration of gnrh agonist and hcg for final oocyte maturation

Conditions: Infertility

Summary: all the studies, demonstrating improved oocyte maturity and high pregnancy rate with the dual trigger are all retrospective. the investigators therefore aim to perform a prospective randomized controlled study in normal responders, comparing cycles triggered with hcg to those triggered with hcg+gnrh agonist.

a prospective, randomized, double blinded clinical trial. patients will undergo standard clinical and hormonal investigation as usual for ivf. patients that will be given the standard gnrh antagonist ivf protocol will be prospectively randomized into two groups: 1. hcg group- will be triggered for final follicular maturation with hcg (pregnyl 10,000iu) as is usual and placebo (normal saline) - 36 hours prior to oocyte aspiration. 2. the double trigger group- will receive gnrh agonist (suprefact 0.5 mg) and hcg (pregnyl 10,000iu) 36 hours prior to the oocyte aspiration. all patients will be supplemented with the usual progesterone preparation (vaginal progesterone suppositories) for luteal support. in order to increase the rate of mii from to 65% to 80% with an alpha error of 5% and beta error of 80% the sample size needed is 276 total patients in both groups or 138 patients in each group.

Eligibility criteria:
inclusion criteria: * women during one of their first 3 ivf cycle attempts * women between the ages of 18-42. * bmi (body mass index) of 18-35. * amh (anti mullerian hormone) \> 1 ng/ml * fsh˂ 20 iu/l. * informed consent. exclusion criteria: * women with low ovarian response * previous enrollment in this study. * afc\>20 * e2 above 15,000 pmol/l at the trigger day. * hypersensitive to suprefact/pregny/gonal f/purigon/menopur/progesterone, and/or their ingredients/components of the formulation * primary ovarian failure * pregnancy and breast-feeding * active blood clots * undiagnosed uterine or genital bleeding * endometriosis * uncontrolled hypertension; * uncontrolled diabetes * abnormal liver and kidney functions * abnormal ecg, e.g. qt prolongation and torsades de pointes * cancers/tumors, e.g. pituitary adenomas, ovarian cysts, etc. * hiv, hbv and hcv infections * low bone mineral density (bmd) and an increased risk of bone fracture, such as chronic alcohol and/or tobacco use, presumed or strong family history of osteoporosis or chronic use of drugs that can reduce bone mass such as anticonvulsants or corticosteroids * suicidal tendency, history or disposition to seizures, state of confusion, clinically relevant psychiatric disorders, and brain lesions * use of an investigational drug or participation in an investigational study within 30 days prior to this study.

Keywords: double trigger
hypotension in neonates

Conditions: Infant, Newborn; Hypotension; Blood Pressure

Summary: this observational study collects information on the current incidence and management of hypotension in babies born at term or late preterm that are admitted to neonatal intensive care units (nicus) within the neonatal research network (nrn). participants include all newborn infants born at 34 0/7 weeks gestation or greater who are admitted to nicu network centers and intubated and mechanically ventilated at less than 72 hours of age. the information gathered will provide a framework for the design of a potential randomized controlled trial for the treatment of hypotension in neonates. this observational study is for a time-limited enrollment period of 4-6 months; nrn centers will continue to enroll until at least 50 patients are enrolled per center (for approximately 800-1,000 subjects total).

an estimated 30-50 percent of infants born at or near term who require ventilation for respiratory failure also receive therapy for hypotension and associated clinical instability, such as poor urine output, poor circulation to the tissues, and metabolic acidosis (a ph imbalance in which the body accumulates too much acid). emerging evidence, although limited, suggests that the underlying cause of hypotension in many of these infants is that their adrenal glands do not produce adequate amounts of cortisol. this observational study is to determine the current incidence and management of hypotension in infants born at least 34 0/7 weeks gestation who are intubated and mechanically ventilated at less than 72 hours of age. the goal is to define a target population for a potential randomized controlled trial for the treatment of hypotension in such infants. in this study, 16 nichd neonatal research network centers are enrolling at least 50 infants each, collecting basic demographic and baseline data on the mother and baby. in those infants treated for hypotension, data is collected on the dose, duration, and type of therapy, age and blood pressure at the time therapy is started, and the indication for the therapy.

Eligibility criteria:
inclusion criteria: * ≥34 0/7 weeks gestational age * intubated and mechanically ventilated within 72 hours of postnatal age exclusion criteria: * major congenital heart disease * acute hypotension resulting directly from known acute maternal and/or fetal hemorrhage within 24 hours prior to delivery * pituitary hypoplasia * congenital adrenal hyperplasia * known chromosomal disorders

Keywords: nichd neonatal research network blood pressure management
cardiac computed tomography (ct) scan compared to transesophageal echocardiogram (tee) in endocarditis

Conditions: Endocarditis

Summary: the purpose of this study is to assess the effectiveness of cardiac ct versus tee in endocarditis patients.


Eligibility criteria:
inclusion criteria: * acute endocarditis with positive tee exclusion criteria: * renal failure * contrast dye allergy * beta-blocker allergy
feasibility and effectiveness of telehealth in patients with chronic obstructive pulmonary disease in taiwan

Conditions: Chronic Obstructive Pulmonary Disease

Summary: recent studies have demonstrated the promising potential that telehealth has in management of chronic disease. for copd patients, implementation of telehealth reduced readmissions, emergency room visits, and exacerbations and was cost-effective. telehealth as a method of delivering healthcare to remote, resource-deprived areas is not lacking in evidence of benefit; however, the situation about its more widespread use for monitoring purposes is much less clear. to date, most of the studies dealing with telehealth in copd were conducted in countries covering vast territories. therefore, it needs to be investigated whether telehealth conveys similar advantages for copd patients in a small island country.


Eligibility criteria:
inclusion criteria: * admissions for chronic obstructive pulmonary disease * age 20 or more exclusion criteria: * discharge against medical advice * enrolled in other trials * not being discharged to home * unconsciousness
arrhythmias in hemorrhagic myocardial infarction during the acute post-pci phase

Conditions: Acute Myocardial Infarction

Summary: prevalence of arrhythmias in hemorrhagic myocardial infarction during the acute post-pci phase


Eligibility criteria:
1. age 18-85 years 2. index stemi 3. coronary angiogram with primary coronary intervention 4. no contraindications for cardiac mri

Keywords: hemorrhagic myocardial infarction ccs-ami reperfusion injury arrhythmia
individualized precise localization of rtms on primary motor area

Conditions: Parkinson Disease

Summary: parkinson's disease (pd) patients have some problem with self-initiated movement task. compared with health controls, task meta-analysis found that pd patients showed abnormal activation in pre-supplementary motor area (pre-sma) and putamen. and the functional connectivity has already been reported between pre-sma and putamen in 2013. repetitive transcranial magnetic stimulation (rtms) is a sage and painless technique to activate cortical areas. the deep brain structure can be activated via stimulating superficial cortex by rtms. for investigating the mechanism of self-initiated movement, this project is using functional magnetic resonance imaging (fmri) to individualize the precise localization in motor area and combining rtms to activate putamen.

healthy subject is recruiting in this project. high and low frequency rtms will be performed, respectively. for the l-hz sessions (low frequency), stimulation is delivered at 100% of the subject's resting motor threshold at 1 hz continuously over 30 min for a total of 1,800 pluses. the 10-hz stimulation is delivered at 100% of the subject's resting motor threshold via 60 trains of 3-s 10-hz rtms (30 pulses per train).

Eligibility criteria:
inclusion criteria: * there are activation in motor area during the task fmri * the head motion less than 2 mm in translation or 2 degrees in rotation in any direction during the resting-state fmri exclusion criteria: * without any neuropsychiatric conditions * no head injury or history of epilepsy * not on any medications

Keywords: fmri rtms functional connectivity
bibr 277 capsules in hypertensive patients with nephropathy

Conditions: Hypertension

Summary: the antihypertensive effect, safety and usefulness of treatment with bibr 277 capsules were evaluated in hypertensive patients with nephropathy


Eligibility criteria:
inclusion criteria: * condition: either of the following criteria is satisfied in laboratory tests: * presence of a renal parenchymal disorder such as chronic glomerulonephritis is confirmed (serum creatinine \< 3.0 mg/dl) * presence of a renal function disorder (serum creatinine ≥ 1.5 mg/dl to \< 3.0 mg/dl) * age: ≥ 20 years * sex: either male or female * patient status: either outpatients or inpatients. however, the patient status should remain unchanged throughout the study period * blood pressure (bp): * \[outpatients\] the last 2 measurements of sitting bp out of at least 3 taken during the observation period (2 - 4 weeks) should be stable and a mean of the two measurements should be ≥160 mmhg for systolic bp (sbp) and ≥95 mmhg for diastolic bp (dbp) * \[inpatients\] the last 2 measurements of supine bp taken during the observation period (1 week) should be stable and a mean of the 2 measurements should be ≥ 150 mmhg for sbp and ≥ 90 mmhg for dbp exclusion criteria: * renovascular hypertension * undergoing haemodialysis * severe hypertension (diastolic bp ≥ 120 mmhg) * severe heart failure, angina pectoris, or history of myocardial infarction * atrioventricular conduction disturbance (degree ii to iii), atrial fibrillation, or serious arrhythmia * symptoms of cerebrovascular disorder * serious hepatic dysfunction * uncontrolled diabetes * peptic ulcer * history of hypersensitivity to drugs * hyperkalaemia * undergoing treatment with a digitalis preparation * pregnant, breast feeding, possibly pregnant or planning to become pregnant during this study * otherwise judged ineligible by the investigator
prevena incision management

Conditions: Cardiac Event; Arrest; Cardiac, Complicating Surgery; Coronary Bypass Graft Stenosis; Complication of Coronary Artery Bypass Graft

Summary: the question this research project wants to explore is whether using the prevena incision management system (prevena) will improve sternal wound edge oxygenation in patients undergoing coronary artery bypass surgery with bilateral internal mammary artery grafts.

coronary artery bypass is the gold standard surgical treatment of patients with complex coronary disease. it is a common operation and more than 16000 procedures per year are carried out in the uk. recent publications suggest that during the bypass procedure both left and right internal mammary arteries should be used to bypass coronary stenoses. it was noted that using both internal mammary arteries will result in even better long term survival with improved freedom from cardiac events such as myocardial infarction or further coronary intervention than using. the major drawback of using both internal mammary arteries is the increased risk of sternal wound infection and breakdown. the investigators will use near infra-red spectroscopy (nirs) to assess the wound edge oxygenation delivery. the nirs invos system the investigators use within sheffield teaching hospitals can measure oxygenation of soft tissue to a certain depth making it suitable for the assessment of wound edge oxygen delivery. prevena is commercially available and has a ce mark. the prevena wound management system differs from conventional wound dressings, it applies negative pressure to the closed wound for 7 days. wound complications/infections are decreased when this type of wound management system is used. studies suggest that prevena achieves these outcomes because of an increase of perfusion in the wound edges and keeping the wound dry. patients will be randomised to either the prevena wound management or their standard of care nhs wound management for their procedure. the oxygenation and outcomes of the wounds will be compared through data collection and the patients followed up during their routine inpatient care and 6 week outpatient appointment.

Eligibility criteria:
inclusion criteria: * eligible patients are those who require isolated coronary artery bypass surgery, who need at least 2 bypass grafts, and who are deemed suitable by the operating surgeon to have both right and left internal mammary arteries harvested as conduits exclusion criteria: * require additional procedures in addition to the coronary bypass or need for internal mammary artery harvest for feasibility study * who are deemed by the operating surgeon as unsuitable for bilateral internal mammary artery harvest because of * age (75 or older where prognostic benefit of using both internal mammary arteries has been questioned), * obesity with a bmi which is higher than 35 (increased risks of wound infection) * diabetes (of any type) (increased risks of infection.)