Kornimate/medical-research-clean huggingface dataset:
thrombin generation in liver transplant surgery

Conditions: Liver Transplantation; Thrombin; Hemostasis, Surgical; Blood Coagulation Disorder Due to Liver Disease; Blood Coagulation Disorders

Summary: this is a prospective observational study of 100 patients undergoing liver transplantation at a single centre. thrombin generation and kinetics will be assessed using a novel point-of-care device, and compared to conventional measures of hemostasis as well as viscoelastic tests to pinpoint specific coagulation deficits and identify potential therapeutic targets. the clinical course of patients will be followed for major bleeding and transfusion outcomes.

liver transplantation is the only curative option for end stage liver disease, but is associated with high morbidity and mortality. end stage liver disease is known to be accompanied by dysregulated coagulation, which is further exacerbated in the immediate perioperative period by transplantation, leading to both coagulopathic bleeding and thrombosis. altered thrombin generation is thought to play a key role in the predisposition of these patients for both severe coagulopathic hemorrhage and life-threatening thromboembolic complications. despite this, thrombin generation during the immediate transplant period in patients with end-stage liver disease is poorly characterized, in part because it is not well reflected by conventional measures of coagulation. this study aims to characterize changes in thrombin generation capacity pre, intra- and post-transplant utilizing a novel point-of-care thrombin generation assay. other specific aims of the study are to identify risk factors for patients with impaired thrombin generation and will assess the association of impaired thrombin generation with overall clinical bleeding risk. the overarching goal of this work is to develop a point-of-care-testing guided algorithm addressing dysregulated thrombin formation that improves coagulation management without increasing the risk of thromboembolic complications. ultimately, this line of research will improve the outcomes of liver transplantation.

Eligibility criteria:
inclusion criteria: * all adult patients (\> 18 years of age) proceeding to imminent (within 24 hours) liver transplantation surgery at toronto general hospital will be offered participation. * patients should have end stage liver disease necessitating transplantation. all etiologies of end stage liver disease will be accepted. exclusion criteria: - patients who are unable to consent to the study or who refuse participation will be excluded.
endometrial preparation before operative hysteroscopy in premenopausal women

Conditions: Uterine Fibroids

Summary: the presence of a thin endometrium has an important role in allowing the best conditions for hysteroscopic surgery. the aim of this study is to evaluate the efficacy of a 21 day administration of 2 mg of dienogest versus ulipristal acetate 5 mg, in rapid endometrial preparation to operative hysteroscopy.


Eligibility criteria:
inclusion criteria: * diagnosis at office hysteroscopy of symptomatic submucous myomas with intramural development (g1 and g2) exclusion criteria: * pregnancy * other hormonal therapy in the previous 8 weeks * hepatic or renal impairment * any medical condition that would increase the surgical risk * refusal or unable to sign written consent
a phase i/iia clinical study to assess the single and multiple ascending doses of mdr-001 tablets in healthy participants and obese/ overweight participants

Conditions: Overweight and Obese Volunteers

Summary: to investigate the safety and tolerability after single and multiple ascending doses of mdr-001 tablets administered orally in healthy participants and obese/ overweight participants.


Eligibility criteria:
inclusion criteria: * participants who are aged ≥ 18 and ≤ 55 years at the time of signing the informed consent; no gender restriction. * participants with 27 ≤ body mass index (bmi) ≤ 45 kg/m2. * for male participants, a waist circumference ≥ 90 cm is required, while female participants ≥ 85 cm. exclusion criteria: * participants with any condition that increases the risk of bleeding, such as hemorrhoids, acute gastritis, or gastric and duodenal ulcers. * participants with personal or family history of medullary thyroid carcinoma (mtc) or multiple endocrine neoplasia 2 (men2), or those with hereditary diseases that easily induce to medullary thyroid carcinoma. * participants with a history of pancreatitis or symptomatic gallbladder disease. * serum calcitonin \> uln at screening. * participants with systolic blood pressure \> 160 mmhg or diastolic blood pressure \> 100 mmhg at screening. * participants with alt \>2 × uln and /or ast \> 2 × uln at screening. * participants whose fasting triglycerides \> 5.7 mmol/l, total cholesterol \> 7.75 mmol/l, low-density lipoprotein cholesterol \> 4.9 mmol/l at screening. * participants with abnormal uric acid levels accompanied by clinical symptoms (those without clinical symptoms can be included). * participants with fasting blood glucose levels \> 7 mmol/l. * participants with creatinine clearance \< 60 ml/min at screening \[calculation formula: clcr: (140 - age) × weight (kg) / \[72 × 0.0113 × scr (μmol/l)\], × 0.85 for females\]. * participants have experienced significant changes in diet or exercise habits or within ≥5% changes in body weight within 3 months prior to screening. * participants with clinically significant ecg abnormality deemed unsuitable participation for study by the investigator; or with ecg qtcf values \> 450 ms for male participants or \> 470 ms for female participants.
effects of immunonutrition in patients with pneumonia

Conditions: Pneumonia; Lung Infection; Muscle Loss; Malnutrition; Pulmonary Disease

Summary: the project is a randomized controlled trial taking place in the north zealand hospital in the city hilleroed, denmark. the aim is to investigate the potential beneficial effects of immunonutrition containing fish oil, arginine and rna, on the acute immune response in patients with pneumonia.

immunonutrition has a well-documented beneficial effect on surgical patients by strengthening the immune system and reducing the following: inflammation, the number of infections as well as hospitalization time. a study in operated patients demonstrated the benefit of immunonutrition by reducing unwanted inflammation, measured by the pro-inflammatory signalling protein, interleukin-6. the same study saw a smaller decrease in immune function (measured as the level of phagocytosis) in the group receiving immunonutrition than in the control group. this project will investigate whether similar effects can be detected in patients with pneumonia. the project is being carried out in a collaboration between the university of copenhagen, the main hospital of copenhagen (rigshospitalet) and north zealand hospital. the project is a randomized clinical intervention study, which spans 10 days. participants are allocated to the intervention group or the control group. the project is being carried out at the north zealand hospital, at the department of pulmonary- and infectious diseases. the intervention group receives the department's standard treatment (standard of care) + immunonutrition, while the control group receives the hospital department's standard treatment (standard of care). on a daily basis, the patient's clinical condition and the activity of the immune system is measured for the purpose of determine whether there is an effect of immunonutrition.

Eligibility criteria:
inclusion criteria: * authorized individuals diagnosed with pneumonia who speak and write in danish exclusion criteria: * individuals with immunodeficiency * individuals with another primary diagnose * individuals with an allergy against product ingredients * individuals with dementia * individuals with dysphagia * individuals with cancer in treatment * individuals with chronic obstructive pulmonary disease on continuing steroid treatment or home administered oxygen treatment
effect of sodium bicarbonate solution in decreasing the incidence of contrast induced nephropathy (cin)

Conditions: Contrast Induced Nephropathy

Summary: radio contrast induced nephropathy (rcin) remains a well recognized complication in patients undergoing diagnostic or interventional procedures requiring radiographic contrast agents. recent studies have shown benefit in administering sodium bicarbonate over normal saline( the uniformly accepted prophylaxy) in preventing rcin.therefore the aim of the study is to evaluate the efficacy of sodium bicarbonate solved in normal saline compared with infusion of normal saline in prevention of rcin.

radio contrast induced nephropathy (rcin) remains a well recognized complication in patients undergoing diagnostic or interventional procedures requiring radiographic contrast agents and is the third leading cause of acquired acute renal failure in hospitalized patients. strategies for the prevention of radiocontrast nephropathy have focused on countering vasoconstriction (pre-hydration, fenoldopam, and theophylline), enhancing flow through the nephron (diuretics), or protection against oxygen-free-radical injury (urinary alkalinization and n-acetylcysteine). among all prophylactic measures that have been proposed, adequate preprocedural and postprocedural hydration has demonstrated effectiveness in the prevention of radiocontrast nephropathy. thus, it remains the most frequently applied measure in clinical practice. a recent study in may 2004 have shown benefit in administering sodium bicarbonate over normal saline as a prophylaxy.since alkalizing renal tubular fluid with bicarbonate may reduce injury. comparisons: iv 154 meq/l solution of nacl 0.9% or iv 154 meq/ l sodium bicarbonate solved in 154 meq/ l nacl 0.9%. each fluid is infused at the rate of 3 ml/kg/ hour one hour before the angiographic procedure, continuing at the rate of 1 ml/kg/ hour for 6 hours after the procedure. maximum rate of fluid permitted is that for a body weight of 110 kg.

Eligibility criteria:
inclusion criteria: * individuals aged 18 years or older with stable serum creatinine levels of at least 1.5 mg/dl , who were scheduled to undergo diagnostic or therapeutic coronary artery angiography during the next 24 hours of hospitalization and were available until 5 days after the procedure for serum creatinine measurements. exclusion criteria: * serum creatinine levels of more than 8 mg/dl * previous history of dialysis * egfr \< 20 * emergency catheterization * recent exposure to radiographic contrast agents (within previous two days of the study) * radiocontrast agent dosage needed more than 300 cc during the procedure * allergy to radiocontrast agent * pregnancy * administration of dopamine, mannitol , fenoldopam or n-acetyl cystein during the intended time of study * need for continuous hydration therapy (e.g. sepsis ) * history of multiple myeloma , pulmonary edema , uncontrolled hypertension (treated systolic blood pressure more than 160 mmhg, or diastolic blood pressure more than 100mmhg.) ,severe heart failure (ef \< 30% or nyha 3-4).

Keywords: angiography complications contrast media kidney prevention
admission of adult-onset still disease patients in the icu

Conditions: Adult-Onset Still Disease; Critically Ill

Summary: since its first description in 1971, diagnosing adult-onset still's disease (aosd), a rare multisystemic disorder considered as a multigenic autoinflammatory syndrome, remains challenging. rarely, aosd may present severe systemic manifestations and require intensive care. the main purpose of the stil icu study is to make the first description of the epidemiology of critically ill aosd patients. the investigators will use a retrospective cohort study design with dual recruitment strategies: (1) via the aosd referral centres network and (2) via a french academic medical icu network.


Eligibility criteria:
inclusion criteria: * aosd (history of newly diagnosed) * icu admission between january 2001 and june 2017 exclusion criteria: * adults under protection * admission in step-down unit
evaluation of safety and efficacy of anticoagulation treatment in patients with splanchnic vein thrombosis: sapient study

Conditions: Splanchnic Vein Thrombosis

Summary: prospective single-centre, observational study with medical products. patients with a medical history of svt will be observed for at least 24 months after inclusion. the study will begin when the patient is referred to our centre for svt and will end at the 24-month follow-up or at the occurrence of a study outcome event, or in case of death objective: to prospectively define the incidence of recurrent thrombosis and bleeding events during anticoagulant therapy in patients with diagnosed svt, regardless of whether they will be hospitalized or treated as outpatients


Eligibility criteria:
inclusion criteria * age ≥ 18 years * ability to provide informed consent; * confirmed diagnosis of deep vein thrombosis involving splanchnic veins in liver cirrhosis (with or without hepatocarcinoma); * confirmed diagnosis of deep vein thrombosis involving splanchnic veins in absence of liver cirrhosis (with or without portal cavernoma); * pregnant patients will be eligible for inclusion in the study; * ongoing anticoagulant treatment with vitamin k-antagonists (vka), direct oral anticoagulants (doac), low molecular weight heparin (lmwh), fondaparinux exclusion criteria * splanchnic vein tumor thrombosis; * absence of antithrombotic prophylaxis
smartphone video-assisted advanced life support of patients with out-of-hospital cardiac arrest by ems under physician direction

Conditions: Out-of-Hospital Cardiac Arrest

Summary: direct medical control using video conferencing capabilities of smartphones has never been conducted in out-of-hospital cardiac arrest patients. this study was conducted to investigate its feasibility and treatment effectiveness in out-of-hospital cardiac arrest (ohca) patients using a real-time smartphone video call.

if cardiac arrest is suspected, the ems personnel contacted the medical director before arriving at the scene. upon the arrival at the scene of the two activated paramedic teams, they rapidly switch to als under teamwork-based bls and video medical control. using this video medical control, high-quality cpr, cardiac arrest rhythm confirmation, defibrillation, proper drug administration instructions, advanced airway insertion, etc. are performed. the medical director then decides on patient transfer if the asystole and pulseless electrical activity findings are persistent even after more than 20-minutes of als. after initiating the transfer, the medical director contacts the hospital where the patient is to be transferred to after completing the video medical control. the medical director provides an explanation of the treatment to the caregiver via video. after returning to the fire station, the ems personnel who had completed the patient's transfer the enters the information by hand on the separate form, takes a picture of the document, and uploads it to sns within 24 hours. through this information shared via sns, the research staff the provides a direct feedback to the ems personnel, and further discussion performed within the sns. all the incident cases of ohca during the before and during interventional periods were registered using an ems run sheet for basic ambulance operation information, the ems cardiac arrest registry for the utstein factors, and the ohca registry for the hospital care and survival outcomes. the ems run sheet and ems cardiac arrest registry were collected by the ems providers. the medical records for hospital care and outcomes were abstracted by the trained reviewer for this study

Eligibility criteria:
inclusion criteria: * all ems-treated ohca patients older than 18 years transported to the hospital unless otherwise diagnosed with trauma, poisoning, asphyxia, hanging, or any other non-disease-origin factors. exclusion criteria: * patients with do-not-resuscitate (dnr) orders and with obvious signs of irreversible death, including rigor mortis and corruption

Keywords: emergency medical services smartphone survival
non-surgical spinal decompression in patients with chronic low back pain

Conditions: Low Back Pain; Sciatica; Lumbar Disc Herniation

Summary: the goal of this quasi-experimental trial was to evaluate the effects of non-surgical spinal decompression on disability and pain in patients with chronic low back pain and sciatica throughout a two-month follow-up, and to analyze the relationship between demographic factors and clinical outcomes after a program of non-surgical spinal decompression. the main questions it aims to answer were: * non-surgical spinal decompression is effective to reduce pain intensity and self-reported disability in patients with chronic low back pain and sciatica? * age, level of education and work activities are related with clinical outcome in patients treated with non-surgical spinal decompression? participants underwent eight sessions, three per week, with the btl-6000 spinal decompression system. the study did not have a comparison group.


Eligibility criteria:
inclusion criteria: * age between 18 and 55 years old. * chronic (at least six months) low back pain (lbp) and/or sciatica. * abnormalities of intervertebral disc on magnetic resonance imaging (mri). exclusion criteria: * patients with prior spine surgery. * vertebral instability. * cancer. * current infectious disease. * pregnancy. * kinesiophobia. * fibromyalgia.
intraoperative hyperspectral imaging in gastrointestinal anastomoses

Conditions: Surgical Anastomosis

Summary: in this study, gastrointestinal anastomoses are examined with a hyperspectral camera.

the anastomoses were examined under standardized conditions directly after creation. the measurements were performed like described before, using the tivita tissue system (diaspective vision gmbh, am salzhaff, germany). this hsi-camera provides hyperspectral images with a high spectral resolution (5 nm) in the visible and near infrared range (500-1000 nm). the distance between camera and object was 30 cm for all measurements. the number of effective pixels at this distance is 640 × 480 (x-, y-axis. the resulting field of view (fov) has the dimensions 6.4 × 4.8 cm2 and a spatial resolution of 0.1 mm/pixel. the fov is illuminated by 8 halogen spots (20 w each). the ceiling lights and other light sources were switched off, to avoid artifacts during the measurement (approximately 10 seconds). a rgb image and 4 false color images that represent physiologic parameters are intraoperatively provided by an analysis software. this work is focused on tissue oxygenation (sto2), which represents the relative blood oxygenation in the microcirculation of superficial tissue layers (approximately 1 mm) and the near-infrared (nir) perfusion index, representing tissue layers in 4-6 mm penetration depth.

Eligibility criteria:
inclusion criteria: * all gastrointestinal anastomoses exclusion criteria: * inability to consent

Keywords: anastomotic perfusion, tissue oxygen saturation
oral sedation during cervical dilator placement

Conditions: Oral Sedation and Cervical Dilator Pain

Summary: this will be a randomized, double-blind, placebo-controlled trial involving 2 arms. it will be comparing the effects of placebo compared to 1 mg oral lorazepam/5 mg oral oxycodone on pain scores during cervical dilator placement prior to dilation and evacuation (d\&e).

potential participants will be first introduced to the study via routine intake call. participants will be identified at the participant's office visits to the johns hopkins' women's center for family planning. if a patient desires d\&e for a second trimester pregnancy, the patient will first receive standard counseling. only after providing written informed consent for the procedure will the patients be screened for eligibility in the study. if the patient is eligible the participant will be asked by a member of the research team if the patient is interested in participating. if the patient is, the study will be explained to the participant and written consent will be obtained after participant is given the opportunity to have all questions answered. the study is randomized, double-blind, placebo-controlled trial involving 2 arms. participants will first complete a survey to collect demographic data. participants in both arms will receive the institution's current standard analgesia for cervical dilator placement. in addition to this standard regimen, participants will be randomized to receive either: (1) a dose of two oral placebo pills, or (2) 1mg of oral lorazepam with 5 mg of oral oxycodone prior to cervical dilator placement.

Eligibility criteria:
inclusion criteria: * women aged 18-50 years * english speaking * with an intrauterine pregnancy (either viable or non-viable) between the gestational ages of 17w0d and 23w6d * have a support person present with participant * have a cell phone capable of text messaging (optional) exclusion criteria: * non-english-speaking * taking a daily benzodiazepine or opiate * have a known allergy or contraindication to nsaids, opiates, or benzodiazepines

Keywords: oral sedation lorazepam oxycodone
effects of home-based emotional disclosure in rheumatoid arthritis

Conditions: Rheumatoid Arthritis

Summary: the purpose of the study is threefold: 1) to develop a home-based emotional disclosure intervention inducing core elements of change (emotional engagement, cognitive restructuring, and positive future directedness); 2) to examine in a randomized controlled trial in patients with rheumatoid arthritis the induction of the core elements and the feasibility of the intervention for home application; and, 3) to examine the psychological, clinical, and physiological effects of the adapted emotional disclosure intervention and the modulating role of cognitive-emotional change and individual differences in emotion regulation.

emotional disclosure has been suggested to alleviate psychological and physical stress in chronically ill people. emotional engagement, cognitive restructuring, and positive future directedness are considered core elements to induce change in emotional disclosure interventions. the aim of our randomized controlled trial in patients with rheumatoid arthritis is to examine the psychological, clinical, and physiological effects of an emotional disclosure intervention adapted for home application and the modulating role of cognitive-emotional change and individual differences in emotion regulation.

Eligibility criteria:
inclusion criteria: * diagnosis of rheumatoid arthritis according to the criteria of the american college of rheumatology (arthritis rheum 1988;31:315-24 * written informed consent

Keywords: arthritis, rheumatoid expressed emotion randomized controlled trial affect blood sedimentation psychophysiology feasibility studies intervention studies time management