Kornimate/medical-research-clean huggingface dataset:
spontaneous coronary artery dissection analysis of the brazilian updated registry

Conditions: Coronary Artery Dissection, Spontaneous

Summary: a retrospective and prospective registry will evaluate demographic and angiographic data in patients with spontaneous coronary artery dissection (scad) using medical records, invasive coronary angiography, intravascular imaging and/or computed multislice coronary tomography. the type of treatment applied during index hospitalization (i.e., clinical management, percutaneous coronary intervention or coronary artery bypass grafting) will be evaluated. long-term follow-up (up to 10 years) will be also reported.


Eligibility criteria:
inclusion criteria: * patients with coronary manifestations due spontaneous coronary artery dissection * angiographic findings of scad in coronary angiogram or coronary tomography * agreement between two or more invasive cardiologists (adjudicated committee) for the diagnosis. exclusion criteria: * non-agreement for scad diagnosis * coronary dissections due other mechanisms: unstable atherosclerotic plaque or trauma-induced.

Keywords: spontaneous coronary artery dissection acute coronary syndrome coronary angiography coronary tomography
study to investigate the safety, tolerability, and pharmacokinetics of dsta4637s in participants with staphylococcus aureus bacteremia receiving standard-of-care (soc) antibiotics

Conditions: Bacteremia

Summary: this is a phase ib, randomized double-blind, placebo-controlled multiple-ascending dose study to investigate the safety, tolerability, and pharmacokinetics of multiple doses of dsta4637s when given in addition to anti-staphylococcal soc antibiotics to participants with methicillin-resistant staphylococcus aureus (mrsa) and methicillin-sensitive staphylococcus aureus (mssa) bacteremia requiring at least 4 weeks of anti-staphylococcal soc antibiotics.


Eligibility criteria:
inclusion criteria: * body mass index greater than or equal (\>/=) 18 to less than or equal to (\</=) 40 kg/m\^2 * at randomization, participants must have \>/=1 blood culture or molecular diagnostic that is positive for staphylococcal aureus (s. aureus) collected in the previous 120 hours * in the investigator's judgment, an expected treatment duration for s. aureus intravenous infection with anti-staphylococcal soc antibiotics \>/= 4 weeks exclusion criteria: * the presence of an intravascular catheter that is not planned to be removed within 96 hours of study randomization * s. aureus bacteremia associated with an intracardiac device and/or intravascular prosthetic material (including hemodialysis access graft) * in the investigator's judgement, s. aureus bacteremia involving infection of a prosthetic joint or vertebral hardware * in participants with cirrhosis, a child-pugh score of class b or c * known rifampicin-resistant s. aureus * anticipated receipt of a rifamycin class (excluding rifaxamin) antibiotic from day 1 to study completion/discontinuation * in the investigator's judgment, the need for emergent valve surgery at the time of randomization or a high likelihood of cardiac surgery within 3 days after randomization * polymicrobial bacteremia * participants with significant immune suppression * participants with evidence of liver disease * history or presence of an abnormal electrocardiogram (ecg) * exposure to any biological therapy or investigational biological agent within 90 days prior to the screening evaluation or have received any other investigational treatment 30 days prior to the screening evaluation
a study of triple-site ventricular pacing in patients who have not responded to conventional dual ventricular site cardiac resynchronization therapy

Conditions: Heart Failure

Summary: patients are randomised to receive ongoing optimised device and medical therapy or triple ventricular site resynchronisation. the hypothesis states that patients receiving triple-site resynchronization will exhibit a better response.


Eligibility criteria:
inclusion criteria: * implanted with a crt device \> 6 months previously according to current and conventional crt indications * device optimization \> 1 months previously * aged 18yrs or older * able to attend outpatient follow up exclusion criteria: * recent mi (\<2 months) * women who are pregnant or planning pregnancy * severe co morbid illness (where patients are not expected to survive duration of follow up period or where repeated outpatient visits may not be in best interest of patients) * upgrade procedure is contraindicated for safety reasons. * class iv inotropic agents * patient unwilling to comply with required follow-up protocol including randomization scheme

Keywords: cardiac resynchronizton therapy crt heart failure dyssynchrony echocardiography pacemakers nonresponders
epidemiology of neonatal sepsis in neonatal intensive care unit in assiut university children hospital

Conditions: Neonatal SEPSIS

Summary: neonatal sepsis is an important cause of morbidity and mortality in the pediatric age group . it is one of the leading causes of death in the first 28 days of life both in the developed and developing countries.

more than 40% of under-five deaths globally occur in the neonatal period, resulting in 3.1 million newborn death each year. the majority of these deaths usually occur in low income countries . on the other hand, the survivors of neonatal sepsis are vulnerable to short- and long term neurodevelopmental morbidity . neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. it includes various systemic infections of the newborn such as septicemia, meningitis, pneumonia, arthritis, osteomyelitis, and urinary tract infections. superficial infections like conjunctivitis and oral thrush are usually not included under neonatal sepsis. diagnosis of sepsis in neonates is challenging due to nonspecific signs and symptoms. the salient clinical features include systemic signs of infection such as fever, hypothermia, tachycardia, failure to thrive, lethargy, irritability, restlessness in addition, laboratory diagnosis until recently was time-consuming. this, therefore, necessitates the initiation of empirical antibiotic therapy pending a definitive diagnosis . neonatal sepsis is caused by gram-positive and gram-negative bacteria and candida. the diversity of organisms causing sepsis varies from region to another and changes over time even in the same place .

Eligibility criteria:
inclusion criteria: • all admitted inborn and out born neonates during this study period will be screened for sepsis exclusion criteria: • all cases that mimic neonatal sepsis such as; * inborn errors of metabolism * congestive heart failure * hemolytic disease of newborn * hypoxic ischemic encephalopathy * congenital diaphragmatic hernia * intra cranial hemorrhage * respiratory distress syndrome
brain networks and consciousness

Conditions: Loss of Consciousness; Parkinson Disease; Essential Tremor; Anesthesia

Summary: general anesthesia (ga) is a medically induced state of unresponsiveness and unconsciousness, which millions of people experience every year. despite its ubiquity, a clear and consistent picture of the brain circuits mediating consciousness and responsiveness has not emerged. studies to date are limited by lack of direct recordings in human brain during medically induced anesthesia. our overall hypothesis is that the current model of consciousness, originally proposed to model disorders and recovery of consciousness after brain injury, can be generalized to understand mechanisms of consciousness more broadly. this will be studied through three specific aims. the first is to evaluate the difference in anesthesia sensitivity in patients with and without underlying basal ganglia pathology. second is to correlate changes in brain circuitry with induction and emergence from anesthesia. the third aim is to evaluate the effects of targeted deep brain stimulation on anesthesia induced loss and recovery of consciousness. this study focuses on experimentally studying these related brain circuits by taking advantage of pathological differences in movement disorder patient populations undergoing deep brain stimulation (dbs) surgery. dbs is a neurosurgical procedure that is used as treatment for movement disorders, such as parkinson's disease and essential tremor, and provides a mechanism to acquire brain activity recordings in subcortical structures. this study will provide important insight by using human data to shed light on the generalizability of the current model of consciousness. the subject's surgery for dbs will be prolonged by up to 40 minutes in order to record the participant's brain activity and their responses to verbal and auditory stimuli.


Eligibility criteria:
inclusion criteria: * willingness and ability to cooperate during conscious operative procedure for up to 40 minutes * clinical diagnosis of parkinson's disease or essential tremor * preoperative mri without evidence of cortical or subdural adhesions or vascular abnormalities exclusion criteria: * patients with recent use (within one week) of anticoagulant or antiplatelet agent use * neurocognitive testing indicating amnestic cognitive deficits * history of intolerance of propofol or medical indications to use an anesthetic other than propofol

Keywords: general anesthesia deep brain stimulation basal ganglia thalamus sensorimotor cortex
enoxaparin dosing in obesity

Conditions: Obesity

Summary: the purpose of this study is to determine an effective enoxaparin dosing strategy in medically ill, morbidly obese patients. this study will include adult patients greater than 18 yrs of age being admitted to grady hospital in atlanta, ga. potentially vulnerable patients such as prisoners, children, and pregnant women will not be enrolled in the study. study participants will be contacted in person by the study personnel once inclusion criteria are met. written informed consent will be obtained in person while hospitalized. once the patient is consented they will be given enoxaparin and blood samples will be drawn. the data collected will be from the electronic medical record which is accessed only with a username and password so it is not publicly available. the data will be identifiable upon collection and will be kept on a password protected file on a computer in a locked office. the data will be de-identified after data analysis and only the study personnel will have access to the code that links identifiers to subjects. a hipaa waiver will be requested to access existing data in order to identify patients for enrollment. all data will be collected in an office in the hospital. the study participants' burden will be minimal and dependent only on time of consent process since morbidly obese patients would be receiving this blood sample collection regardless of their participation in the study.


Eligibility criteria:
inclusion criteria: * planned treating with twice daily enoxaparin * bmi \>= 40 kg/m2 exclusion criteria: * \< 18 years of age * crcl \< 30 ml/min * pregnancy * prisoner * active bleeding * already received 3 consecutive doses of enoxaparin * use of therapeutic enoxaparin for more than 5 consecutive days within the last 3 months

Keywords: enoxaparin dosing obesity
high fat diet ii on weight loss

Conditions: Obesity

Summary: to evaluate two different diets and their effects on weight loss and measurements of several risk factors for cardiovascular disease. one diet will be a high saturated fat diet (hsfd) and the other is a low saturated fat diet (lsfd) that limits fat but especially saturated fat as red meat. all participants in this study must eat both diets as this is a randomized cross-over design.


Eligibility criteria:
inclusion criteria: in order to qualify, participants must have metabolic syndrome: * triglycerides greater than 150 mg/dl * blood pressure greater than 130 mmhg and/or diastolic blood pressure greater than 85 mmhg * fasting glucose greater than 110 mg/dl * waist circumference greater than 40 inches in men or 35 inches in women * reduced hdl less than 40 mg/dl in men and less than 50 mg/dl in women. participants must be capable of performing symptom-limited maximal exercise capacity study. blood and urine samples collected at baseline will be analyzed for cbc, serum glucose and electrolytes, hepatic panel and tsh. exclusion criteria: participants will be excluded for any significant blood dyscrasia, fasting glucose greater than 200 mg/dl, creatine greater than 2 mg/dl, any significant electrolyte disorder, hepatic functions greater than two times normal or abnormal tsh.

Keywords: cardiovascular disease weight loss
preoperative point of care ultrasound guided fluid optimization and intravenous ondansetron to prevent general anesthesia-induced hypotension

Conditions: Intra-operative Hypotension

Summary: hypotension is a common side-effect of general anesthesia induction and is related to adverse outcomes including significantly increasing risk of one-year mortality. even short durations of intraoperative hypotension have been associated with acute kidney injury (aki) and myocardial injury.half of all the patients were fluid-responsive, pointing to volume status as a significant risk factor. ultrasound measurements of inferior vena cava (ivc) diameter with respiration, including the maximal diameter of the ivc (divcmax) at the end of expiration during spontaneous respiration and the collapsibility index (ci), have been recommended as rapid and noninvasive methods for estimating volume status. in attempt to prevent hypotension after spinal anesthesia induction, ondansetron, a serotonin receptor antagonist, has been used effectively . research question can preoperative ivc-us guided fluid optimization and intravenous ondansetron reduce the incidence of general anesthesia-induced hypotension in adult patients undergoing elective non-cardiac non-obstetric surgery?


Eligibility criteria:
inclusion criteria: 1. age \> 18 2. elective, non-cardiac, non-obstetric surgery under general anesthesia 3. american society of anesthesiologists physical status classification i - iii exclusion criteria: 1. map below 60 mmhg prior to the induction of general anesthesia. 2. patients treated with angiotensin converting enzyme inhibitors (ace-i) or angiotensin receptor blockers (arb) on the day of surgery. 3. patients with heart failure with ejection fraction (ef) \< 40%. 4. patients with documented acute or chronic renal failure. 5. patients with hepatic failure. 6. patients with neuraxial (spinal/epidural) anesthesia performed before induction of general anesthesia. 7. patients with suspected difficult airway. 8. patients with documented allergy to ondansetron or prolonged qt-syndrome. -
implementing fragmentomics into real world screening interventions to evaluate clinical utility among individuals with elevated risk for lung cancer

Conditions: Lung Cancer

Summary: the purpose of this study is to determine whether availability of dna evaluation of fragments for early interception (delfi) lung cancer screening test, firstlook™ to practicing physicians affects overall lung cancer screening rates among their patients who are recommended and eligible for screening based on 2021 united states preventive services task force (uspstf) but are not up to date with it. delfi hypothesized that patients in the care of physicians or practice groups who have firstlook™ will have increased lung screening rates compared to patients in the care of physicians or practice groups who do not have access to firstlook™.

despite compelling evidence of the benefits of lung cancer screening, rates among eligible individuals in the united states remain stubbornly low. using a cluster randomized controlled trial, delfi plans to evaluate whether lung screening rates can be increased if physicians and practice groups have the ability to order a validated, commercially available firstlook™ as an initial test for eligible individuals who are not up to date with lung screening recommendations.

Eligibility criteria:
inclusion criteria: 1. practice offers primary care services. primary care services may include, but are not limited to: community health centers, academic outpatient facilities, private practices of family or general internal medicine, and veterans administration outpatient primary care clinics. 2. practice has a lung cancer screening population of a minimum of 50 individuals. a. lung cancer screening eligible population is defined as meeting the 2021 uspstf guideline recommendations (current and former smokers 50-80 years of age, 20 pack-year or more smoking history, have not quit more than 15 years ago) b. individuals have had a clinic visit in the past 12 months, and c. individuals have not had a ct for lung cancer screening in the last 15 months. 3. practice can complete emr data extraction and edc entry during the study. 4. practice scores a 4 (agree) or 5 (strongly agree) on a 5-point likert scale for physical and payer benefit access to ldct. 5. practice can identify a central phlebotomy site. exclusion criteria: 1. practice is currently participating or has previously participated in other delfi studies. 2. practice is participating in any other cancer screening blood-based biomarker studies which includes return of results.

Keywords: lung cancer screening early diagnosis low dose ct scan ct scan lung neoplasms respiratory tract neoplasms thoracic neoplasms lung diseases respiratory tract diseases biomarkers lung cancer prevention fragmentomics cat scan early detection nsclc adenocarcinoma lung malignancy liquid biopsy ldct
simvastatin and diastolic dysfunction

Conditions: Diastolic Dysfunction; Hypertension

Summary: diastolic dysfunction (dd) is an increasingly frequent condition in hypertensive individuals whose treatment remains unclear. its presence is related to higher morbidity and mortality independent of blood pressure levels. the aim of this study is to investigate the additive effect of simvastatin on enalapril on dd in hypertensive patients with average cholesterol levels. for this aim, hypertensive patients with dd and ldl-cholesterol \<160 mg/dl will undergo a run-in phase to achieve a systolic blood pressure (sbp) \<135 mmhg and diastolic blood pressure (dbp) \<85 mmhg with enalapril. hydrochlorothiazide could be added when need to achieve sbp or dbp control. four weeks after reaching the optimum anti-hypertensive regimen patients will be randomized to receive 80 mg simvastatin or placebo for a period of 20 weeks. echocardiograms will be performed before and after treatment with measurement of left atrial volume, conventional and tissue doppler velocities in early diastole and late diastole. the evaluation of these will allow to identify changes of dd severity after treatment.


Eligibility criteria:
inclusion criteria: * men or postmenopausal women aged between 40 and 65 years old * normal fasting blood glucose (\<100 mg/dl) and glucose tolerance test (\<140 mg/dl) * waist circumference \< 102 cm (men) or \< 88cm (women) * triglycerides \<150 mg/dl, ldl cholesterol ≤ 160 mg/dl * creatinine \<1.2 mg/dl, sinus rhythm * the presence of grade 1 or 2 of dd with an ejection fraction of left ventricle \> 55% * absence of myocardial ischemia during dobutamine stress echocardiography exclusion criteria: * thyroid dysfunction * acute or chronic liver disease * regular use of 3 or more antihypertensive drugs * secondary hypertension * symptoms or history of atherosclerotic disease * valvular dysfunction * lvh 14 and use of statins in the last 6 months

Keywords: diastolic dysfunction hypertension statins ace inhibitor echocardiography
phase ii randomised controlled trial of memory work therapy at pasada, tanzania

Conditions: HIV

Summary: memory work therapy (mwt) has been developed to improve psycho-social outcomes for children living with hiv who are orphaned. this phase 2 trial aims to determine whether attending the intervention improves outcomes compared to standard care. we aim to test the hypothesis that attendance at mwt improves psychological symptoms, self-esteem, emotional and behavioural difficulties, and self-efficacy compared to standard care.


Eligibility criteria:
inclusion criteria: * aged 14-18 years * hiv positive * orphaned * naïve to the intervention exclusion criteria: * adults * children under 14 * hiv negative * parent(s) living * previously attended the intervention

Keywords: children hiv orphans
comparison of biologicals in treatment of severe asthma

Conditions: Asthma

Summary: this is a retrospective clinical study on adult patients (18 years or more) with biological therapy for severe asthma at the helsinki university central hospital (huch). this is a real-life study with a broader patient population than in a randomized controlled trial. omalizumab has been used for treatment of asthma in huch since january 2009, anti-il5 therapies starting with mepolizumab since april 2016.

the investigators collect and analyse results of anti-il5/il5r and anti-ige therapies in asthma until october 2019.the investigators compare number of exacerbations, number of glucocorticoid courses, dose of per oral glucocorticoid, number of antibiotic courses, need of emergency care and hospitalizations because of asthma before use of biologicals and at the latest visits of the participants when using biologicals.

Eligibility criteria:
inclusion criteria: * asthma that remains uncontrolled despite moderate to high dose inhaled corticosteroid and additional therapy with at least one other controller medication and need for continuous per oral corticosteroids (ocs) or contraindications (or clinically significant side effects of ocs) against ocs and/or frequent courses (two or more per year) of ocs exclusion criteria: * patients without asthma
a study to investigate the safety, pharmacokinetics, and efficacy of combination treatment of al-335, odalasvir, and simeprevir in japanese participants with chronic hepatitis c genotype 1 or 2 virus infection, with or without compensated cirrhosis who are direct acting antiviral treatment-naive

Conditions: Hepatitis C, Chronic

Summary: the main purpose of this study is to evaluate the safety and tolerability of a combination treatment of al-335, odalasvir (odv), and simeprevir (smv) for 8 weeks in japanese participants with genotype 1 or 2 chronic hepatitis c virus (hcv) infection without cirrhosis and for 12 weeks in direct-acting antiviral (daa)-naive japanese participants with genotype 1 or 2 chronic hcv infection with compensated cirrhosis.


Eligibility criteria:
inclusion criteria: * chronic hepatitis c virus (hcv) infection * all participants must have hcv genotype 1 or 2 infection, determined at screening * hcv ribonucleic acid (rna) plasma levels greater than or equal to (\>=)10,000 international units per milliliter (iu/ml), determined at screening * direct-acting antiviral (daa)-naive participants, defined as not having received treatment with any approved or investigational daa drug for chronic hcv infection; prior hcv therapy consisting of interferon (ifn, pegylated or nonpegylated) with or without ribavirin (rbv) is allowed * participants without cirrhosis or with compensated cirrhosis exclusion criteria: * infection with hcv genotype - 3, 4, 5, or 6 * co-infection with human immunodeficiency virus (hiv 1 or hiv 2 antibody positive) or hepatitis b virus (hbv) (hepatitis b surface antigen \[hbsag\] positive) * prior treatment with any investigational or approved hcv daa, either in combination with pegifn or ifn free * any evidence of liver disease of non-hcv etiology. this includes, but is not limited to, acute hepatitis a infection (immunoglobulin m), drug or alcohol related liver disease, autoimmune hepatitis, hemochromatosis, wilson's disease, alpha 1 antitrypsin deficiency, primary biliary cirrhosis, or any other non-hcv liver disease that is considered clinically significant by the investigator * evidence of hepatic decompensation as assessed with child-pugh class b or c or any of the following: history or current clinical evidence of ascites, bleeding varices, or hepatic encephalopathy