Kornimate/medical-research-clean huggingface dataset:
metabolic analysis for treatment choice in gestational diabetes mellitus

Conditions: Gestational Diabetes; Diabetes, Gestational; Pregnancy in Diabetes

Summary: gestational diabetes (gdm) is a significant clinical and public health burden, affecting over 400,000 pregnant women in the united states each year. without adequate treatment, women with gdm and their infants are at risk for substantial morbidity. because of this, experts recommend treatment focused on normalization of hyperglycemia to improve outcomes. however, providers have limited capacity to predict which treatment will achieve glycemic goals. this results in a choice based on provider and patient preference and a trial and error approach, which can create delays in glycemic control within the short (8-10 weeks) window between diagnosis and delivery. maternal and fetal morbidity may be related to a mismatch between glycemic pathophysiology and the mechanism of action of glucose-lowering agents. in fact, gdm is heterogeneous, with predominant insulin resistance (ir) in 50%, insulin secretion deficit (isd) in 30%, and a combination of both in 20% of women as underlying mechanisms of hyperglycemia. this variation in gdm pathophysiology and clinical outcomes supports the use of an individualized treatment approach. the overall goal of this project is to investigate an individualized treatment approach for gdm where treatment is based on each woman's gdm mechanism. the study will employ the same treatment in both arms, but choice of treatment will differ based on study arm (matched or unmatched to gdm mechanism).


Eligibility criteria:
inclusion criteria: * pregnant women beyond 24 weeks of gestation who are scheduled for a 3-hour oral glucose tolerance test. exclusion criteria: * fetal anomaly * pregestational diabetes * gdm diagnosis without a 3-hour ogtt * multifetal gestation * treatment with non-inhaled steroids within 7 days * allergy to glyburide, metformin or sulfa * history of severe pulmonary (pulmonary requirement for oxygen therapy or daily treatment for restrictive of obstructive pulmonary disease) * hepatic (lft's greater than two times of upper normal range) * renal (serum creatinine higher than 1.2 mg/dl) disease * history of heart failure or myocardial infarction

Keywords: gestational diabetes diabetes in pregnancy insulin resistance insulin secretion deficiency
a study of the safety and tolerability of abbv-467 in adult participants with relapsed/refractory (r/r) multiple myeloma

Conditions: Multiple Myeloma (MM); Cancer

Summary: this first-in-human study will evaluate the safety and tolerability of abbv-467 in adult participants with relapsed/refractory multiple myeloma (mm).


Eligibility criteria:
inclusion criteria: * documented diagnosis of multiple myeloma (mm). * measurable disease defined as at least 1 of the following: * serum monoclonal protein \>= 1g/dl. * urine m-protein \>= 200mg/24 hours. * serum immunoglobulin free light chain (flc) \>= 10 mg/dl (100 mg/l), provided serum flc ratio is abnormal. * relapsed after or are refractory or intolerant to all established mm therapies that are both known to provide clinical benefit and locally available. * received at least 3 prior lines of therapy including 1 or more immunomodulatory agents, 1 or more proteasome inhibitors, and 1 or more anti-cd38 monoclonal antibodies. * eastern cooperative oncology group (ecog) performance status of 0, 1, or 2. * adequate hematologic, renal and hepatic function as described in the protocol. * echocardiogram with ejection fraction \>= 50% and no other clinically significant findings that would increase the participant's susceptibility to cardiac toxicity. exclusion criteria: * prior exposure to any targeted myeloid cell leukemia-1 (mcl-1) inhibitor. * antineoplastic therapy (including any cytotoxic, targeted and/or investigational therapy; but not including corticosteroids), within 28 days or 5 half-lives, whichever is shorter, prior to the first dose of study drug and through the last dose of study drug. * autologous stem cell transplant within 90 days prior to start of study drug. * allogenic stem cell transplant within 180 days prior to start of study drug. * history of acute or chronic pancreatitis. * significant unresolved liver disease. * history of hepatitis b or human immunodeficiency virus (hiv) infection.

Keywords: multiple myeloma (mm) relapse/refractory cancer abbv-467
comparison of epidural, combined and dural puncture labor epidural on pain, and course of vaginal delivery

Conditions: Labor Pain; Analgesia

Summary: the three standard techniques used for labor analgesia, thus epidural, combined spinal-epidural and dural puncture epidural will be compared regarding their impact on pain intensity, analgesic and local anesthetic consumption and course of vaginal delivery in a prospective, randomised, double blind manner


Eligibility criteria:
inclusion criteria: * parturients requiring regional labor analgesia * dilation less than 5cm exclusion criteria: * contraindication for regional technique * refuse to participate * language barriers * obesity * no pain
phospholipid and sphingolipid composition of high-density lipoproteins (hdl) in obese non-diabetic patients with metabolic syndrome

Conditions: Metabolic Syndrome

Summary: hdl in obese non-diabetic patients show major alterations in their function and thus their cardio-protective effects. these alterations could be explained by the quantitative and qualitative anomalies in the phospholipids and sphingolipids in the hdl. these molecules play a major role in hdl function and probably present early modifications in obesity, even before the onset of glycaemia deregulation. the aim of this study is to show the presence of qualitative and quantitative modifications of phospholipids and sphingolipids in hdl from obese patients compared with hdl from non-obese controls.


Eligibility criteria:
inclusion criteria: * aged \> 18 years * fasting glycaemia \< 1.10 g/l * waist circumference \> 102 cm for men and 88 cm for women (criteria ncep/atp iii) * 2 criteria among the following 3 (ncep/atp iii criteria for metabolic syndrome): * triglyceridaemia ≥ 1.50 g/l * hdl cholesterol \< 0.40 g/l for men and 0.50 g/l for women * arterial blood pressure ≥ 130/85 mmhg or treatment for arterial hypertension * patients who have provided written consent inclusion criteria for healthy subjects * age \> 18 years * fasting glycaemia \< 1.10 g/l * waist circumference \< 102 cm for men and 88 cm for women * triglyceridaemia \< 1.50 g/l * hdl cholesterol ≥ 0.40 g/l for men and 0.50 g/l for women * healthy subjects who have provided written consent exclusion criteria: * persons without national health insurance cover * diabetes * diseases that interfere with lipoprotein metabolism (dysthyroidism not controlled with the treatment, kidney or liver disease) * treatments that interfere with lipoprotein metabolism (lipid-lowering agents, oestrogens, corticoids, retinoids, antiretroviral agents) * pregnancy/breast feeding
tracheobronchomalacia: treatment outcomes

Conditions: Tracheomalacia; Tracheobronchomalacia

Summary: the purpose of this study is to evaluate respiratory symptoms and their impact in the quality of life and after treatment of the respiratory condition (tracheobronchomalacia - tbm).

tbm is an abnormal collapse of the tracheal and bronchial walls. it is characterized by flaccidity of the supporting tracheal and bronchial structures and a significant reduction of airway diameter on expiration seen in the trachea and/or in the mainstem bronchi. currently there is no available data on the efficacy of central airway stabilization for treating tbm. our study would provide this important information and would establish the effect of central airway stabilization on symptoms, functional status, quality of life, lung function and exercise capacity in patients with symptomatic and severe tbm.

Eligibility criteria:
inclusion criteria: * suspicion of symptomatic tracheal and/or bronchial collapse during bronchoscopy or dynamic computed tomographic study. * chronic obstructive pulmonary disease (regardless of severity) and suspicion of tracheal and/or bronchial collapse exclusion criteria: * inability to follow commands * focal extrinsic compression of the trachea/bronchi by mass or other

Keywords: tracheomalacia tracheobronchomalacia airway stabilization bronchoscopy stent placement tracheobronchoplasty copd
nurse-led bedside trunk control care program

Conditions: Stroke

Summary: this study aimed to apply care for stroke survivors by establishing trustable professional activities competency indicators and a trunk control care module for rehabilitation ward nurses during our second year.

thus, the purposes of this study were: (1) to evaluate the effect of a stepwise nurse-led bedside trunk control care module intervention on improving trunk control, respiratory function, and quality of life in patients with stroke and (2) to modify and confirm the milestones and trustable professional activities of competence in trunk impairment care for patients with stroke to provide evidence-based nursing education and cultivate new nurses' competence in trunk injury care in the future.

Eligibility criteria:
inclusion criteria: * (a) patients hospitalized for stroke in rehabilitation or neurology wards, currently in stable condition; (b) trunk impairment scale score below 21; (c) aged 20 or above; (d) patients willing to participate. exclusion criteria: * patients with trunk impairment scale score above 21, as this indicates that they can perform daily activities independently

Keywords: trunk impairment diaphragmatic breathing quality of life respiration function
efficacy of a physical and respiratory rehabilitation program for patients with persistent covid-19 (sars-cov-2).

Conditions: SARS-CoV-2 Infection; COVID-19 Recurrent; Cognitive Dysfunction; Fatigue

Summary: the pandemic caused by sars-cov-2 infection has resulted, in addition to the well-known acute symptoms, in the emergence of a plethora of persistent, diffuse and heterogeneous symptoms such as fatigue, shortness of breath and cognitive dysfunction among others, that have come to be called persistent covid. patients have reported that physical activity, stress and sleep disturbances often trigger exacerbations of their symptoms related by some authors to the so-called post exertional malaise (pem) characteristic of myalgic encephalomyelitis. similarly, by analogy with other pathologies, it has been hypothesized that optimal exercise prescription would benefit these people with persistent covid-19 symptoms but in practice, the rehabilitation of these patients runs the risk of collapsing respiratory and physical rehabilitation services. this is why coperia proposes the construction of a platform for respiratory, cardiac and muscular telerehabilitation, to compare with face-to-face rehabilitation treatment and to try to predict the influence of physical activity in the prediction of pem.


Eligibility criteria:
inclusion criteria: * age ≥18 and ≤70 years of age. * patients with a diagnosis according to who criteria of persistent covid-19 until 03/28/2022 * patients with a post covid functional status (pcfs) ≥ 2. * patients who present a need for physical rehabilitation and agree to perform it. * patients with capacity to consent and who agree to participate in the study. * patients who know how to use smartphone and/or tablet and have at least one of these devices. * patients who have access to the rehabilitation tools at home or are willing to go to the gyms proposed in the study to perform the rehabilitation exercises. exclusion criteria: * minors or persons judicially incapacitated. * previous neurological or psychiatric pathology involving neuropsychological compromise. * active covid19 infection. * home oxygen therapy \> 16 hours or home cpap- bipap. * previous diagnosis of arrhythmia or blockage. * previous coronary pathology. * decompensated renal or metabolic disease. * signs or symptoms of unknown cardiac disease. * undergoing another physical or cognitive rehabilitation process at the time of inclusion. * patients who do not agree to participate in the study.

Keywords: covid-19 sars-cov-2 persistent covid cardiac rehabilitation respiratory rehabilitation physical rehabilitation
trial to evaluate efficacy of magnetic resonant therapy (mrt) in ptsd

Conditions: Stress Disorders, Post-Traumatic

Summary: the purpose of this study is to establish the efficacy of magnetic resonant therapy in treating post traumatic stress disorder in veterans.

this clinical trial is a prospective, randomized, double-blinded, placebo-controlled study designed to evaluate the safety and efficacy of eeg/ecg-guided magnetic resonant therapy (mrt) in combat veterans with posttraumatic stress disorder. a total of 2004 subjects will be treated in two phases: double-blind and open label.

Eligibility criteria:
inclusion criteria: * willing and able to adhere to the treatment schedule and all required study visits. * any non-active duty military are included. * pcl-m \> 45 * primary diagnosis of posttraumatic stress disorder rendered by the clinician administered ptsd scale (caps) exclusion criteria: * individuals diagnosed by the investigator with the following conditions (current unless otherwise stated): history of open skull traumatic brain injury. history of clinically significant seizure disorder. * individuals with a clinically defined neurological disorder including, but not limited to: any condition likely to be associated with increased intracranial pressure. space occupying brain lesion. history of cerebrovascular accident. cerebral aneurysm. * eeg abnormalities that indicate risk of seizure, i.e., abnormal focal or general slowing or spikes during the eeg recording. * any type of rtms treatment within 3 months prior to the screening visit. * currently under antipsychotic medication treatment. * intracranial implant (e.g., aneurysm clips, shunts, stimulators, cochlear implants, stents, or electrodes) or any other metal object within or near the head, excluding the mouth, which cannot be safely removed. * clinically significant abnormality or clinically significant unstable medical condition that in the investigator's judgment might pose a potential safety risk to the subject or limit interpretation of the trial results. * clinically significant medical illness, including any uncontrolled thyroid disorders, hepatic, cardiac, pulmonary and renal malfunctioning. * any condition which in the judgment of the investigator would prevent the subject from completion of the study. * inability to acquire a clinically satisfactory eeg/ecg on a routine basis. * grossly abnormal electrolyte or cell blood count panels suggestive of other pathology at study initiation. * active duty military are excluded.

Keywords: ptsd tms eeg
polypodium leucotomos extract for the treatment of melasma

Conditions: Melasma

Summary: we will assess whether oral supplementation with polypodium leucotomos, a commercially marketed fern extract, improves facial melasma in hispanic women with moderate to severe melasma. subjects will be randomized to either group 1, which will receive oral polypodium leucotomos extract plus topical sunscreen, or group 2, which will receive oral placebo plus topical sunscreen. the study will last 12 weeks, and we hypothesize that the polypodium leucotomos group will have more improvement in their melasma compared to the placebo group.


Eligibility criteria:
inclusion criteria: * hispanic female with moderate to severe facial melasma exclusion criteria: * currently pregnant or breastfeeding * recent use of hydroquinone, topical retinoids, topical steroids, or mechanically abrading procedures (such as laser therapy or dermabrasion) to the face * frequent use of tanning parlors

Keywords: melasma sunscreen polypodium leucotomos
ketamine associated with opioids in refractory cancer pain treatment

Conditions: Pain

Summary: long-term opioid therapy is commonly administered for the management of severe cancer pain. increasing doses of opioids are titrated against effects until analgesia is achieved or intolerable adverse effects occur. ketamine, an n-methyl-d-aspartate (nmda) receptor antagonist, has been reported to improve analgesia in patients with uncontrolled pain receiving high doses of opioids. this study aims at determining the effectiveness of ketamine as an adjuvant to opioids in relieving cancer pain.

main objective : to show that low analgesic doses of ketamine associated with opioids better relieve refractory cancer pain than opioids without ketamine. secondary objectives : * determine whether ketamine use allows to reduce opioid consumption * evaluate the adverse effects of opioids-ketamine association versus opioids-placebo. 100 patients are expected : 50 will be treated with opioids and ketamine ; 50 will be treated with opioids and a placebo. treatment will be administered for 4 days. patients will be followed-up for 5 days. success is defined by a decrease of the daily pain score of 50 % after 4 days. the expected rate of success in the placebo group is 10 % whereas the expected rate of success in the ketamine group is 35 %. primary outcome (pain score on a 11-point numerical scale) will be evaluated everyday as well as secondary outcomes (patient and clinician global impression of change, opioid consumption, adverse reactions, patient satisfaction on pain relief, sleep interference score). vital parameters (cardiac frequency, respiratory frequency and arterial blood pressure) will be checked everyday, many times a day : every hour for the four hours after the beginning of the treatment and then, every four hours ; every hour for the two hours following a dose shift).

Eligibility criteria:
inclusion criteria: * hospitalised cancer patients (informed and conscious of the cancer diagnostic) * undergoing opioid treatment for one month at least * refractory pain (score higher than 5 on an 11-point numerical pain rating scale) * ability to score pain on a numerical pain rating scale * patient written agreement exclusion criteria: * ketamine contraindications * methadone or other nmda-antagonist treatment * karnofsky index under 10 * pregnancy

Keywords: cancer refractory pain uncontrolled pain ketamine uncontrolled cancer pain
prospective decision impact clinical utility trial of kidneyintelx

Conditions: Diabetic Kidney Disease; Chronic Kidney Diseases; Chronic Kidney Disease Stage 1; Chronic Kidney Disease Stage 2; Chronic Kidney Disease Stage 3

Summary: the clinical utility trial is designed to evaluate how the results of kidneyintelx test / platform impacts on the clinical management of type 2 diabetes patients identified as increased risk for rapid kidney function decline within 5-years.


Eligibility criteria:
inclusion criteria: * 23 years of age or older. * clinical history of confirmed type 2 diabetes. * evidence of dkd stages 1-3: * baseline egfr of 30-59 ml/min/1.73m2 (confirmed 3 months apart with at least one value within 1 year prior to enrollment) * individuals with egfr ≥60 ml/min/1.73m2 and albuminuria (uacr ≥30mg/g) * all patients will have a hba1c, egfr, urine albumin and urine creatinine, egfr, available from within 12 months of enrollment (to be obtained if not clinically available prior). * the subject must be able to comprehend and sign an approved informed consent form and other applicable study documents. exclusion criteria: * patients with egfr \<30 or ≥ 60 ml/min/1.73m2 without albuminuria. * patients with esrd or on renal recovery treatments at time of enrollment. * patients who are pregnant at the time of enrollment. * patients who are currently hospitalized. * patients who are currently on enbrel.
suvorexant and alcohol

Conditions: Alcohol Use Disorder

Summary: this research will translate findings from preclinical research and provide the initial clinical evidence that orexin antagonism reduces motivation for alcohol, as well as other alcohol-associated maladaptive behaviors in people with alcohol use disorder. this study will also provide basic science information about the orexinergic mechanisms underlying the pharmacodynamic effects of alcohol in humans. as such, the outcomes will contribute to our understanding of the clinical neurobiology of alcohol use disorder. overall, the proposed work seeks to expand the scope of current clinical neuroscience research on alcohol addiction by focusing on orexin, which has strong preclinical evidence supporting its critical role in addiction but remains unstudied in humans.


Eligibility criteria:
inclusion/exclusion criteria: 1. able to speak and read english. 2. not seeking treatment at the time of the study. 3. between the ages of 21 and 55 years. 4. engaging in at least one binge drinking episode, per the niaaa definition, in the last 30 days. 5. fulfillment of moderate or severe dsm-5 diagnostic criteria for aud based on computerized scid results reviewed by a psychiatrist or psychologist. 6. ecg, read by cardiologist, within normal limits. 7. body mass index of 19 - 35. 8. birthing individuals using an effective form of birth control and not pregnant or breast feeding. 9. judged by the medical staff to be psychiatrically and physically healthy (i.e., no current severe sud or psychiatric diagnoses other than aud or tobacco use disorder; no current physical diagnoses that would interfere with study participation according to study physician judgment). 10. not currently physiologically dependent on any substances. 11. able to abstain from alcohol during admission (i.e., not physically dependent on alcohol and scores less than 8 on clinical institute withdrawal assessment for alcohol \[ciwa-ar\] at screening). 12. not currently taking any prescribed medications for a chronic condition (other than birth control). 13. no indication of sleep apnea on the stop-bang questionnaire (score of 5 or greater). 14. no contraindications/allergies to suvorexant.