Kornimate/medical-research-clean huggingface dataset:
highlighting the medico-economic interest of an adapted physical activity for haemodialysis patients

Conditions: Chronic Renal Failure; Renal Insufficiency, Chronic

Summary: chronic hemodialysis is often associated with a reduction in the quality of life of patients and a reduction in physical activity, due to the repeated frequency of sessions. various studies conducted in hemodialysis patients have shown the beneficial effects of physical exercise during hemodialysis sessions on reducing cardiovascular risk, the number of hospitalizations and improving quality of life. it also contributes to improved patient adherence to care. finally, it has been shown that exercise during the hemodialysis session is safe for the patient and does not disrupt dialysis parameters. nevertheless, there are no data on the medico-economic impact of such a program. based on the investigators' experience, the investigators have developed a specific protocol linking the different types of physical activity that have provided evidence of their efficiency and used in standard practice in the investigators' institutions. from tests and questionnaires assessing the physical abilities of patients have already validated for this population in this pathology. the objective of this project is to show the medico-economic interest of an adapted physical activity program for hemodialysis patients.


Eligibility criteria:
inclusion criteria: * patient dependent on the cpam haute garonne, * patient affiliated to or beneficiary of a french social security scheme, * haemodialysis patient for more than 12 months and in front of benefiting/benefiting from a physical activity program, * patient age ≥ at 18 years old, * french speaking patient. exclusion criteria: * patient with cancer, hepatitis, stage 4 arterial disease, arteritis or amputation of a limb * pregnant or breastfeeding women according to article l.1121-5 of the csp, * vulnerable persons according to article l.1121-6 of the csp, * persons of full age under guardianship or curatorship or under safeguard of justice, * patient unable to personally give his or her consent, or age of majority protected by law, * opposition expressed to inclusion in the study.
translational manipulation under interscalene block for adhesive capsulitis of the shoulder (tmacs)

Conditions: Shoulder Adhesive Capsulitis; Frozen Shoulder; Adhesive Capsulitis of Shoulder

Summary: this study evaluates the addition of translational manipulation under interscalene block, to a course of orthopaedic manual physical therapy for treatment of adhesive capsulitis of the shoulder. half the patients will receive a translational manipulation under interscalene block, plus 6 sessions of orthopaedic manual physical therapy. the other half will receive 7 sessions of physical therapy. the investigators hypothesize that the translational manipulation under interscalene block will provide additional benefit beyond the effect of in-clinic orthopaedic manual physical therapy alone.

both translational manipulation under interscalene block and in-clinic orthopaedic manual physical therapy are thought to be useful for treating adhesive capsulitis of the shoulder. however, no single intervention for this condition has been proven to be superior to others. the translational manipulation under interscalene block may improve pain-free motion of the involved shoulder, by releasing tight tissue without the guarding and motion-limiting effect of active muscle tension. the interscalene block prevents the patient from actively contracting the muscles that control the involved shoulder, during the manipulation procedure. one additional possible benefit of the translational manipulation under interscalene block, is that the technique loads the joint structures--bone, joint capsule--in a safer way with less angular torque than conventional/traditional manipulation under anaesthesia. this minimizes the risk of physical/mechanical harm from the procedure.

Eligibility criteria:
inclusion criteria: * military healthcare system beneficiaries 18 years old or older * chief complaint of loss of shoulder range of motion * passive glenohumeral abduction less than 75 degrees * sufficient english-language skills to understand the study protocol. exclusion criteria: * clinical diagnosis of diabetes (type i or ii) * clinically evident and symptomatic rotator cuff tear or cervical radiculopathy * pain as the primary impairment (versus limitation of motion as the primary impairment) * having contraindications to an interscalene block.

Keywords: adhesive capsulitis clinical trial manipulation
comparative study of photodynamic therapy vs. co2 laser therapy in treatment of actinic keratoses

Conditions: Actinic Keratosis

Summary: the purpose of this study is to determine whether photodynamic therapy or co2 laser therapy is superior in the treatment of actinic keratoses with respect to efficacy and side effects.

ablative laser therapy and photodynamic therapy are widely used and accepted therapeutic methods to treat multiple actinic keratoses, yet comparative studies are rare. the purpose of this study is to compare both treatments intraindividually with respect to treatment efficacy and side effects.

Eligibility criteria:
inclusion criteria: * men and women with clinical and histological diagnosed, symmetrical distributed actinic keratoses * at least 2 actinic keratoses, on each of both treatment areas at least one * patients must be 18 years or older. exclusion criteria: * age 17 years or younger * lack of patient's informed consent for any of the two treatments * contraindication for co2 therapy or for photodynamic therapy * skin infection in the treatment area

Keywords: actinic keratosis field cancerisation
the effect of act and tranexamic acid on bleeding in cardiac surgery

Conditions: Surgery, Cardiac; Tranxemic Acid; Activated Clotting Time; Heparin; Cardiopulmonary Bypass

Summary: the goal of this clinical trial is to the dose effect of tranexamic acid and the level of act on bleeding in adult cardiac surgery. the main questions it aims to answer are: 1. does higher dose of tranexamic acid reduce the amount of bleeding and blood transfusion? 2. does lower act level during cardiac surgery reduce the amount of bleeding and blood transfusion? participants will divided into four groups which have different tranexamic acid dose and act level during cardiac surgery to see if there is any different in the amount of bleeding and blood transfusion.

this study is going to analyze the medical records of patients who underwent cardiac surgery between december 1, 2023, and december 31, 2026. the investigators will categorize patients into four groups based on anticoagulation indices (act 400-600 seconds; act \> 600 seconds) and tranexamic acid dosages (low dose; high dose) within the range considered safe for cpb. the primary outcome will be the volume of postoperative bleeding within 24 hours for each group. the findings of this study will contribute to the existing clinical evidence and provide insights for the monitoring and pharmacological management in cardiac surgery.

Eligibility criteria:
inclusion criteria: * adult, cardiac surgery with cardiopulmonary bypass exclusion criteria: * pregnant * emergency procedure * immune compromised * aortic surgery * end-stage renal disease * liver disease * critical status * incomplete clinical data
"safeguard your smile" an oral health literacy intervention promoting positive oral hygiene self-care behavior

Conditions: Gingivitis; Dental Plaque

Summary: the purpose of the investigators' study is to assess effectiveness of community based oral health literacy intervention promoting positive oral hygiene self-care behavior among montreal's punjabi immigrants.

there will be 140 participants in this study who will be randomly allocated into either intervention group (70) or control group (70).the intervention group will receive one hour long "safeguard your smile" intervention and control group will receive no intervention and only a conventional pamphlet. data will be collected at baseline and after 3 months using three research instruments. i) oral hygiene self-care knowledge and oral hygiene self-care behavior will be assessed using self administered questionnaire. ii) using loe and sillness indices, plaque and gingival index scores will be measured. iii) and oral health literacy of participants will be measured with the ts-reald tool.the data analysis will include descriptive statistics and frequency tables will be provided for both baseline and endpoint data of the both groups. continuous variables will be summarized with mean, standard deviation and range and for the categorical variables; frequency counts and percentage of subjects within each category will be provided. an array of data analysis including t-test, correlations and logistic regression will be performed assessing effectiveness of the safeguard your smile intervention.

Eligibility criteria:
inclusion criteria: * punjabi immigrants who are montreal residents * be in good general health * will give written informed consent exclusion criteria: * non permanent residents e.g. refugees * presence of orthodontic appliances * having any disease of soft/ hard oral tissues e.g. advanced periodontitis * having any systemic disease e.g. diabetes * on certain medications such as phenytoin.

Keywords: oral health literacy intervention oral hygiene behavior
severe cav mri in heart transplant recipient

Conditions: Cardiac Allograft Vasculopathy

Summary: hypothesis: cav is associated with fibrotic changes on cardiac mri, altered levels of pathogenetically-related biomarkers, and specific rna expression changes in the blood

cardiac allograft vasculopathy (cav) is a major limitation to longevity after heart transplantation (ht), accounting for almost 30% of deaths after year 5. the only cure is re-transplant which is associated with a 30-day mortality of 30%, and raises ethical issues due to limited resources. standard preventive measures, such as statin therapy, have limited success due to the multi-factorial nature of the process and influence of transplant-specific risk factors. consensus regarding the management of cav is lacking due to the absence of prospective studies evaluating timing of initiation of therapy, effect of therapies on long-term outcomes, and effective diagnostic strategies. primary prevention of cav, which will be evaluated in the proposed study, could improve longevity of heart transplant recipients and optimize use of a limited resource. the current gold standard for evaluation of cav is surveillance coronary angiogram, which is highly insensitive, particularly in early disease. intravascular ultrasound (ivus) is the most sensitive tool for the diagnosis of cav, providing specific information such as the appearance and thickness of the intima and media, however it is not widely used in the clinical setting. physiologic studies of the coronary arteries are also useful in assessing risk, but are not practical in a clinical setting. these invasive studies expose the heart transplant recipient to radiation, nephrotoxic contrast, and potential vascular complications. during the evolution of cav, there are important structural, functional, and genomic changes that occur in parallel and possibly before. study objectives 1. determine the structural, functional and genomic changes associated with severe cav 2. identify novel and noninvasive markers of cav study design this is a cross-sectional study which will evaluate structural, functional and genomic changes associated with severe cav in heart transplant recipients within 15 years of transplant. 30 heart transplant recipients identified via our study database and the transplant clinic will be enrolled into the study. we will enroll 15 heart transplant patients with severe cav and 15 without cav. subjects will undergo a one-time assessment of radial artery elasticity, blood draw for gene expression profiles, and cardiac mri.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * provide informed consent * successful orthotopic heart transplant within 15 years of enrollment exclusion criteria: * chronic kidney disease with creatinine \>2.5 mg/dl * ejection fraction \<45% if cav or \<50% if no cav * iv contrast allergy or reaction (gadolinium) * active infection (febrile illness, cytomegalovirus or other significant infection) * treated humoral rejection or cellular rejection grade 3a/2r or greater within 3 months * contraindication to mri
effects of incomplete eras on clinical outcomes in patients with colorectal cancer

Conditions: Colorectal Neoplasms; Enhanced Recovery After Surgery

Summary: enhanced recovery after surgery (eras) has been reported to be associated with improved outcomes in many studies, most of which involve short-term effects. only a few studies have reported the long-term effects of highly compliant eras. however, to the best of our knowledge, there are no large-scale comparisons between incomplete eras (compliance \< 70%) and non-eras. the aim of this comparative study is to analyze and evaluate the long-term outcomes of incomplete eras in laparoscopic colorectal cancer surgery.


Eligibility criteria:
inclusion criteria: * 1. age older than 18 years;2. pathological diagnosis of colorectal cancer;3. radical surgery was performed; and 4. laparoscopic surgery was performed. exclusion criteria: * 1. eras compliance ≥70%; 2. open surgery; 3. switch to laparotomy after laparoscopic surgery; 4. pregnancy or lactation; 5. severe mental illness; 6. simultaneous malignant tumors of multiple organs; 7. history of other malignant tumors; and 8. emergency radical colorectal resection due to obstruction, perforation or bleeding.
standard of care versus urine testing with selective pharmacogenomics for effective drug and dosing regimens

Conditions: Target Drug-related Adverse Events

Summary: the purpose of this study is to determine whether the addition of selective pharmacogenomic (pgx) testing as determined by urine drug testing (udt) adds a clinical benefit as evidenced by a reduction in target drug-related adverse events (tdrae) over the period following enrollment.


Eligibility criteria:
inclusion criteria: 1. subject is 12 years of age or older; 2. subject or legal representative is able and willing to provide informed consent; 3. subject has had a tdrae including ineffective therapeutic response within the last 60 days or is a new patient to the treating healthcare provider's practice; 4. subject is scheduled for or is planned to be scheduled for udt, ordered as per the treating healthcare provider's local standard of care; 5. subject is currently receiving or the subject's treating healthcare provider is considering treatment with at least one target drug listed below and metabolized by one or more genes considered in this study: amitriptyline, imipramine, diazepam, alprazolam, codeine, hydrocodone, oxycodone, methadone, meperidine, fentanyl and carisoprodol. exclusion criteria: 1. prior history of pgx testing for genes specific to any of the target drugs in the past; 2. pgx testing is deemed mandatory in the opinion of the treating healthcare provider; 3. history of liver or renal transplantation; 4. receiving chronic hemodialysis or peritoneal dialysis; 5. currently hospitalized or in a long-term care facility; 6. participation in another clinical trial that would, in the investigator's opinion, interfere with the conduct of this study; 7. subject or subject's guardian or advocate is unable to provide an accurate history of the subject's medical history, medications, and symptoms.

Keywords: pharmacogenomics urine drug testing antidepressants benzodiazepines opioids muscle relaxants non-steroidal anti-inflammatory agents tdrae
national epidemiological study of the possible impact of stress on glycaemic control in patients with type 1 diabetes

Conditions: Diabetes Type 1

Summary: the epistress2 study is a one-off cross-sectional epidemiological survey, carried out via an online form in patients with type 1 diabetes followed up by participating investigating centres. in type 1 diabetes (t1dm), studies on stress and its impact on glycaemia have led to ambiguous results, mainly because there are no solid epidemiological or experimental data in the literature. the aim of this study was to assess the impact of perceived stress on blood glucose levels in a population of subjects with t1dm at 10 national centres.


Eligibility criteria:
inclusion criteria: * patients with type 1 diabetes; * do not have a psychiatric pathology; * at least 18 years old; * affiliated to the social security; * having read the non-opposition form and not objecting to it. exclusion criteria: * patient who has declared his opposition using the electronic non-opposition form * patient with type 2 diabetes

Keywords: stress glycemic control
microelectrodes in epilepsy

Conditions: Epilepsy

Summary: the purpose of this study is to test microelectrodes in intracranial monitoring to see if they will provide novel information on the epileptic potential of the implanted brain tissue. a secondary objective is to investigate the activity of single neurons during specific cognitive tasks.

the standard-of-care for medically refractory epilepsy is resective brain surgery. in certain patients, precise localization of the epileptic focus is done using intracranial eeg (ieeg) recording. in this type of eeg recording, electrodes are placed on the brain surface or inserted into the brain through an opening in the skull. in addition to standard electrode recording, this study will use ultra thin microelectrodes. microelectrodes are only several micrometers thick and are useful because they are able to record the activity of single neurons in isolation. such recordings have tremendous clinical potential in epilepsy surgery and tremendous research potential in cognitive neuroscience.

Eligibility criteria:
inclusion criteria: * 18-65 year old * male or female * right or left handed * iq\>70 * medically refractory focal epilepsy requiring intracranial eeg for pre-surgical evaluation deemed medically necessary * no contraindications to intracranial electrode study * able and willing to participate in research exclusion criteria: * does not meet the inclusion criteria
functional dyspepsia: validation of a questionnaire for symptom assessment in fd pds subgroup

Conditions: Functional Dyspepsia; Postprandial Fullness Syndrome

Summary: fuctional dyspepsia is defined as the presence of symptoms thought to originate from the gastroduodenum, in the absence of any structural or metabolic disease that is likely to explain these symptoms. to facilitate its diagnostic and therapeutic approach, the rome consensus proposed to distinguish 2 subgroups: postprandial distress syndrome (pds), is characterized by meal-related symptoms such as early satiation and postprandial fullness. at present, no validated instrument is available for the assessment of the symptom responsiveness in patients suffering from pds. to develop a new pro questionnaire, we have previously conducted focus group sessions and cognitive interviews in pds patients to identify all relevant symptom items that characterize pds. in this study we aim to validate the provisional leuven postprandial distress scale (lpds) through the assessment of its consistency, reliability and ability to detect change in the framework of a controlled treatment trial.


Eligibility criteria:
inclusion criteria: * patients with pds diagnosis as per rome iii by rome iii questionnaire (see appendix 1b) * patients must provide witnessed written informed consent prior to any study procedures being performed * patients aged between 18 and 70 years inclusive * male or female patients * patients who are capable to understand the study and the questionnaires, and to comply with the study requirements exclusion criteria: * patients with any condition which, in the opinion of the investigator, makes the patient unsuitable for entry into the study * patients with an active major psychiatric condition (depression, anxiety disorder, alcohol or substance abuse). patients who are taking a stable dose of a single antidepressant (with the exception of amitryptiline) during the last 3 months are eligible. * females who are pregnant or lactating. * patients who are h. pylori positive or patients who received treatment for hp eradication during the last 3 months. * patients suffering from diabetes type 1 or type 2. * patients taking medication for functional dyspepsia will need a wash-out period of 2 weeks before they can be screened * patients with known hypersensitivity to gastroprokinetic drugs. * patients with confirmed gastro-intestinal disease. * patients with former digestive surgery affecting upper gut motility. * patients affected by concomitant disease responsible for digestive symptoms * patients presenting with predominant symptoms of irritable bowel syndrome (ibs) * patients presenting symptoms of eps several times a week according to rome iii questionnaire * patients presenting daily symptoms of cin on rome iii questionnaire * patients presenting vomiting more than one day a month. * patients presenting daily symptoms of excessive belching according to rome iii questionnaire * patients presenting predominant gerd according to gerd questionnaire
echocardiographic evaluation of hypertensive acute pulmonary edema

Conditions: Pulmonary Edema; Hypertension

Summary: acute cardiogenic pulmonary edema (acpe), one of the most severe forms of acute heart failure, represents 5% of hospital admissions. one of the most frequent phenomena encountered during acpe is hypertensive crisis (hypertensive acpe) but the mechanisms and causes of hypertensive acpe are insufficiently understood. few studies have evaluated the cardiac function during hypertensive acpe, and these studies used only conventional echocardiography methods. new methods of evaluation of cardiac function in hypertensive acpe (such as tissue doppler imaging) have not been used. the objectives of this study are to evaluate presence and role of the following potential mechanisms of hypertensive acpe: 1. acute myocardial dysfunction (systolic and diastolic); 2. silent transient myocardial ischemia; 3. acute mechanical left ventricular dyssynchrony; 4. dynamic mitral regurgitation; 5. inter-ventricular interaction. conventional and tissue doppler echocardiography will be used to assess cardiac function.


Eligibility criteria:
inclusion criteria: * acute onset of dyspnea within the preceding 8 hours * respiratory distress and pulmonary rales at any level * pulmonary congestion confirmed by chest radiography * systolic blood pressure \> 160 mmhg before treatment * sinus rhythm * signed informed consent exclusion criteria: * acute myocardial infarction confirmed by myocardial necrosis markers (either ckmb or troponin i). angina pectoris alone will not be excluded * significant left sided valvular disease (more than moderate). mitral regurgitation of any severity will not be excluded, due to the hypothesis of the role of dynamic mitral regurgitation in the pathogenesis of acute hypertensive pulmonary edema * congenital heart disease * cardiac tamponade * rhythm and conduction disturbances that may have precipitated pulmonary edema, like sustained ventricular tachycardia and complete heart block

Keywords: pulmonary edema hypertension echocardiography