Kornimate/medical-research-clean huggingface dataset:
integration of follow-up by first and second line practitioners by telemonitoring in heart failure.

Conditions: Chronic Heart Failure

Summary: the aim of this study is to evaluate this model of telemonitoring-assisted close supervision and interaction between first and second line health professionals versus a model of telemonitoring without this integrated approach.

the incidence of acute decompensated heart failure is increasing. patients with severe heart failure are rehospitalised for decompensation several times each year, increasing the cost for health care. in these cases of recurrent decompensation, the medical intervention in hospital is often limited to increasing the dosage of diuretics or vasodilators until the patient reaches a compensated state. after discharge, a readmission can be expected within a few months. a multidisciplinary approach by primary physician, heart failure nurse, rehabilitation team and cardiologist has been shown to decrease rehospitalisation rate and increase quality of life. very recently, our study group showed that an intense collaboration between first line practitioner and heart failure clinic, facilitated by the use of telemonitoring, can reduce mortality and hospitalisation rate. this study was a riziv sponsored trial of 6 months follow-up in patients with chronic heart failure. however, a large randomised multicentre trial investigating the use of telemonitoring in a population of heart failure (nyha ii-iii) patients did not find any difference between telemonitoring and usual care (chaudry et al nejm 2010). in contradiction with this study, a cochrane meta-analysis (ingliss 2010) in more than 5000 patients confirmed our finding with a reduction in mortality and morbidity. the question therefore remains which factors are responsible for success or failure of the use of telemonitoring. based on our previous experience, the approach of close monitoring by telemonitoring, with first line intervention by the patient's general practitioner (gp) and supervision by the heart failure clinic, might be the critical success factor. therefore, the aim of this study is to evaluate this model of telemonitoring-assisted close supervision and interaction between first and second line health professionals versus a model of telemonitoring without this integrated approach.

Eligibility criteria:
inclusion criteria: * patients hospitalized for decompensation of systolic heart failure * lvef \< 40% during hospitalization. exclusion criteria: * reversible forms of acute heart failure (acute ischemia, myocarditis,..) * heart failure due to severe aortic stenosis * participation in cardiac rehabilitation after discharge * previous or actual residency in a nursing home * creatinine clearance \<15 ml/min * planned dialysis in the next 6 months * planned biventricular pacemaker or cardiac surgery * life expectancy of less than 1 year due to other diseases * severe obstructive pulmonary disease (gold iii) * significant mental or cognitive problems interfering with the daily measurements or intake of medication.

Keywords: chronic heart failure telemonitoring first line practitioners integrated approach efficacy
a study to evaluate the glycemic effects, safety, and tolerability of exenatide once weekly in subjects with type 2 diabetes mellitus (duration-5)

Conditions: Type 2 Diabetes Mellitus

Summary: this study will compare the effects of commercially manufactured exenatide once weekly and exenatide bid in subjects whose type 2 diabetes is managed with diet and exercise alone or with oral antidiabetic medications. the study will examine glycemic control (as measured by hba1c), safety, and tolerability.


Eligibility criteria:
inclusion criteria: * has been diagnosed with type 2 diabetes mellitus * has hemoglobin-specific a1c fraction (hba1c) of 7.1% to 11.0%, inclusive, at screening * has a body mass index (bmi) of 25 kg/m2 to 45 kg/m2, inclusive, at screening * has been treated with diet and exercise alone or in combination with a stable regimen of metformin (met), a sulfonylurea (su), a thiazolidinedione (tzd), a combination of metformin and an su, a combination of metformin and a tzd, or a combination of an su and a tzd for a minimum of 2 months prior to screening * either is not treated with or has been on a stable treatment regimen with any of the following medications for a minimum of 2 months prior to screening: * hormone replacement therapy (female subjects) * oral contraceptives (female subjects) * antihypertensive agents * lipid-lowering agents * thyroid replacement therapy * antidepressant agents * drugs known to affect body weight, including prescription medications (e.g. orlistat \[xenical®\], sibutramine \[meridia®\], topiramate \[topamax®\]) and over the counter antiobesity agents exclusion criteria: * has ever been exposed to exenatide (exenatide once weekly \[exenatide lar\], exenatide bid, byetta, or any other formulation) or any glucagon-like peptide-1 (glp-1) analog * has received any investigational drug within one month (or five half-lives of the investigational drug, whichever is greater) of screening * has been treated, is currently being treated, or is expected to require or undergo treatment with any of the following treatment excluded medications: * any dipeptidyl peptidase 4 (dpp-4) inhibitor within 3 months prior to screening * alpha glucosidase inhibitor, meglitinide, nateglinide, or pramlintide (symlin®) within 30 days of screening * insulin within 2 weeks of screening or for more than 1 week within 3 months of screening * systemic corticosteroids by oral, intravenous, or intramuscular route; or potent, inhaled, or intrapulmonary (including advair®) steroids known to have a high rate of systemic absorption

Keywords: diabetes exenatide once weekly byetta amylin lilly bydureon
the effects of lumbar stabilization exercise on transversus abdominis muscle activation capacity and function in chronic low back pain patients

Conditions: Low Back Pain

Summary: purpose: the purpose of this study is to investigate the effects of lumbar stabilization exercises on pain intensity, transversus abdominis muscle (tra) activation capacity, functional disability, and tra thickness in patients with chronic low back pain (clbp). subjects: the subjects of this study were 30 clbp patients. methods: the experimental group performed diverse lumbar stabilization exercises in different postures, and the control group conducted an ordinary trunk muscle strengthening exercise. results: there were significant differences in pain intensity, tra activation capacity, functional disability, and tra thickness between before and after the intervention in both groups. significant differences between the two groups were shown in the pain intensity, tra activation capacity, and functional disability after the intervention. however, there were no significant differences between the two groups in tra thickness. conclusion: lumbar stabilization exercises in different postures could reduce pain, functional disability, and increase tra activation capacity and thickness in clbp patients.


Eligibility criteria:
inclusion criteria: * patients who felt low back pain exclusion criteria: * orthopedic surgery within 6 months
a clinical investigation of the m2a- 38™ hip system

Conditions: Non-inflammatory Degenerative Joint Disease; Osteoarthritis; Avascular Necrosis

Summary: the purpose of this prospective clinical data collection is to document the performance and clinical outcomes of the m2a- 38™ hip system


Eligibility criteria:
inclusion criteria: * patients having primary cemented or cementless total hip replacement for non-inflammatory degenerative joint disease (nidjd) or any of its composite diagnosis of osteoarthritis, avascular necrosis, traumatic arthritis, subcapital fracture, legg perthes, slipped capital epiphysis, fracture of the pelvis, diastrophic variant. * patients with full skeletal maturity * patients undergoing unilateral total hip arthroplasty or bilateral total hip arthroplasty, either staged or simultaneously * patients of all races and gender * patients who are able to follow postoperative care instructions * patients who are able and willing to return for follow-up evaluations * patients have preoperative total harris hip score less than 70 with at least moderate pain. exclusion criteria: * patients diagnosed with inflammatory degenerative arthritis (idjd) to include the following composite diagnoses: rheumatoid arthritis, systemic lupus erythematous, pigmented villonodular synovitis, juvenile rheumatoid arthritis and other arthritic processes of inflammatory or autoimmune etiology. * patients less than 18 years. * patients with the presence of a previous prosthetic hip replacement device (any type, including surface replacement arthroplasty, endoprosthesis, etc.)in the hip joint to be operated. * patients with previous girdlestone procedures. * patients with above the knee amputation of the contralateral and/or ipsilateral leg. * patients with osteoporosis, or marked bone loss which would preclude proper fixation of the prosthesis. * patients who are pregnant. * patients with an active or suspected infection in or around the hip. * patients with parkinson's disease. * patients with vascular insufficiency, muscular atrophy, or neuromuscular disease in the affected limb. * patients with severe instability or deformity of the ligaments and/or surrounding soft tissue which would preclude stability of the prosthesis. * patients with a highly communicable disease or diseases that may limit follow-up (e.g. immuno-compromised conditions, hepatitis, active tuberculosis, neoplastic disease, etc.). * patients unwilling or unable to comply with a rehabilitation program for a cemented or cementless total hip replacement or who indicate difficulty or inability to return for follow-up visits prescribed by the study protocol. * patients with previous hip surgery or conditions that may interfere with the total hip replacement's survival or outcome, e.g., paget's disease, charcot's disease, severe osteoporosis compromising bone stock (dorr type c bone). * patients who qualify for inclusion in the study, but refuse consent to participate in the study. * patients with a "fused" hip. * patients who have had a total hip arthroplasty on the contralateral hip within the last year.

Keywords: metal on metal total hip arthroplasty total hip replacement
pilot study of abbreviated chemotherapy based on positron emission tomography (pet) scan in hodgkin's lymphoma

Conditions: Hodgkin's Lymphoma

Summary: the primary objective of the study is to determine the progression-free survival \[pfs\] at 36 months for patients with hodgkin lymphoma who achieve a complete metabolic response as demonstrated by a negative fluorodeoxyglucose (fdg)-pet scan after one cycle of abvd (adriamycin, bleomycin, vinblastine, dacarbazine) who undergo abbreviated abvd chemotherapy (3 cycles).

the proposed study is based on the repeated demonstration that patients with hodgkin lymphoma who attain a negative pet scan early in therapy (after one or 2 cycles of chemotherapy) have a uniformly excellent outcome, with long term disease free survival of 90-95%. we propose to abbreviate chemotherapy in those patients showing a complete metabolic response as measured by fdg-pet after one cycle of abvd. these patients will undergo two more cycles of abvd chemotherapy, for a total of 3 cycles. those patients failing to achieve a complete metabolic response as demonstrated by residual fdg avidity will go off study and be treated as per their primary treating physician.

Eligibility criteria:
inclusion criteria: * histologically documented classical hodgkin lymphoma according to the who classification. nodular lymphocyte predominant hodgkin lymphoma is excluded * no prior treatment (chemotherapy or radiation therapy) for hodgkin lymphoma * measurable disease must be present either on physical examination or imaging studies. any tumor mass measurable in two dimensions and \> 2 cm is acceptable (or 1.5 cm if 0.5 cm slices are used as in spiral ct scans) * age ≥ 18 * patients must have at least one hypermetabolic lesion identifiable on initial pet scan * lvef by echo or muga within institutional normal limits * initial laboratory data should be compatible with the administration of standard doses of abvd chemotherapy exclusion criteria: * patient has no known hiv infection * patient is non-pregnant and non-lactating. due to the teratogenic potential of the agents used in this study, pregnant or nursing women may not be enrolled. women and men of reproductive potential should agree to use an effective means of birth control * no other history of lymphoproliferative disorder or granulomatous disease
plasma tmao and choline levels in individuals with metabolic syndrome - comparison between eggs and choline supplement.

Conditions: Coronary Artery Disease; Diabetes; Metabolic Syndrome

Summary: the objective of this study is to determine the effects of consuming either 3 eggs per day and compare it to daily choline supplement (choline bitartrate) for a dose of approximately 400 mg/day on plasma concentrations of high density lipoprotein cholesterol (hdl-c), trimethylamine n oxide (tmao) and plasma choline. the goal is to determine if choline given as phosphatidyl choline (from eggs) will have a more beneficial effect on plasma choline and microbiota.

epidemiological data suggests that egg intake does not increase the risk for cardiovascular disease (cvd). in fact eggs are a good source of phosphatidyl choline (pc) and choline has a number of metabolic roles including lipid metabolism, membrane structure, liver health and a neurotransmitter. recent reports that choline may be metabolized by the intestinal microbiota into tmao, a compound that may increase the risk for heart disease. it is not clear how much egg contribute to tmao formation in individuals with metabolic syndrome. therefore the objective of this study is to determine the impact of daily intake of 3 eggs versus a choline supplement on plasma tmao and other biomarkers for cvd risk and also to assess if there are changes in microbiota with these interventions that might lead to the increases of tmao in plasma.

Eligibility criteria:
inclusion criteria: * all genders * 35-70 years * metabolic syndrome (based on 3 out of 5 characteristics: waist circumference \> 88 cm for women and \> 102 cm for men, plasma triglycerides \> 150 mg/dl, fasting glucose \> 100 mg/dl, blood pressure \> 135/85 and hdl \< 40 mg/dl for men and \< 50 mg/dl for women), * willing to consume 3 eggs per day for 4 weeks * willing to consume choline supplement (400 mg/day for 4 weeks) exclusion criteria: * self-reported diaberes, cardiovascular disease, history of stroke, liver disease or cancer * taking glucose lowering medications * taking antibiotics in the previous 1 month * triglycerides \> 500 mg/dl, * cholesterol \> 240 mg/dl, * blood pressure \> 145/100 mm of hg * allergic to eggs or to choline

Keywords: eggs, choline metabolic syndrome tmao
clinical, biochemical and neurophysiological consequences of intraoperative tourniquet during total knee arthroplasty

Conditions: Muscles Ischemia

Summary: clinical, biochemical and neurophysiological consequences of intraoperative tourniquet during total knee arthroplasty: womac-score knee-score radiographic evaluations and scoring system biochemical muscle biopsy analysis

biochemistry: analysis of the muscles biopsies clinical: bloodloss, complications, womac-score, knee-score radiographics: evaluations and scoring system neurophysiology evaluation of n. femoralis

Eligibility criteria:
inclusion criteria: * age = 55-85 years * osteoarthritis of knee joint (degree iii or iv) * physical status (asa i or ii) * body mass index \< 45 kg/m² * written informed consent exclusion criteria: * age \ 85years * osteoarthritis knee joint (degree i or ii) * physical status (asa iii or iv) * body mass index ≥ 45 kg/m² * unable to provide written consent * malignant disease * rheumatoid disease * infectious disease * coagulation disorder * history of deep vein thrombosis or pulmonary embolism * peripheral arterial disease * immune deficiency * medication (glucocorticoid, aspirin, heparin, cumardine, wafarin) * neurological dysfunction * liver insufficiency * coronary heart disease * immobility
precision imaging to evaluate kaposi sarcoma

Conditions: Kaposi Sarcoma

Summary: aim 1: in uganda and kenya, kaposi sarcoma (ks) is one of the most common cancers and a leading cause of cancer-related deaths in men. however, tracking how well patients are responding to treatment is challenging, especially in busy clinics. doctors must measure the size and changes in the areas affected by the cancer by hand, which can take a lot of time and can vary depending on the doctor. this method does not work well for patients with dark skin, which can lead to biases in treatment compared to patients with fairer skin. to solve this problem, the investigators suggest the use of a simple, low-cost device that uses artificial intelligence (ai), the skinscan3d (ss3d) device, to measure the cancer spots accurately and monitor changes over time. the goal of this study is to improve the skinscan3d (ss3d) tool and the how it is used. the investigators will do this by talking to healthcare workers and patients, giving them surveys, and holding design workshops. the feedback from these activities will be shared with the device maker and local research teams to make the device better and ensure it is used properly. aims 2 \& 3: in this study the investigators seek to formally compare reproducibility and accuracy of ks lesion size measurements between skinscan3d and the current standard of care manual measurement method. the investigators will then test the ss3d device on 100 patients in a variety of real-world practice locations to determine whether the device will be usable, acceptable, appropriate, and feasible in routine care settings.


Eligibility criteria:
inclusion criteria - aim 2 (patients): * adults age ≥18 years old * histopathology-confirmed kaposi sarcoma * at least 3 skin lesions * capable of informed consent * on treatment for kaposi sarcoma exclusion criteria - aim 2 (patients): * patients not initiating kaposi sarcoma treatment * very ill patients requiring hospitalization inclusion criteria - aim 3 (patients): * adults age ≥18 years old * histopathology-confirmed kaposi sarcoma * capable of informed consent * initiating treatment for kaposi sarcoma exclusion criteria - aim 3 (patients): * patients with kaposi sarcoma that participated in aim 1 or aim 2 * prior or ongoing kaposi sarcoma treatment

Keywords: global oncology kaposi sarcoma affordable cancer technologies cancer in people with hiv human centered design discrete choice experiment medical devices low-cost design global health
doll therapy on patients with moderate and severe dementia

Conditions: Dementia

Summary: doll therapy is one of the non-pharmacological methods that can be practiced in managing the symptoms of dementia patients. nurses can practice doll therapy independently, and literature reports that it has positive effects on the behaviors, moods, emotions, cognitive states and social life of patients with moderate and severe dementia. our country had no study that investigated the effect of doll therapy in managing the cognitive and behavioral symptoms of dementia patients. this project is a randomized controlled trial that aims to investigate the effect of doll therapy on the cognitive states and agitation levels of patients with moderate and severe dementia.

dementia is a progressive neurodegenerative disease increasing in prevalence due to the aging population that grows in parallel with the increased life expectancy at birth in recent years. it is characterized with a progressive deterioration in cognitive abilities and memory. due to the increasing losses in cognitive and physical functions, people with dementia become in need of nursing over time. agitation is the most common behavioral symptom. agitation is defined as improper verbal, vocal and motor activity that are not purposeful and are not caused by confusion. verbal and physical aggression, restlessness, aimless wandering, profanity, self-harm, continuous and repetitive questioning behavior emerges.agitation should be managed with reliable and tolerable, effective methods in order to affect the quality of life of both the patient and the caregiver negatively. doll therapy is one of the non-pharmacological methods that can be practiced in managing the symptoms of dementia patients. nurses can practice doll therapy independently, and literature reports that it has positive effects on the behaviors, moods, emotions, cognitive states and social life of patients with moderate and severe dementia.our country had no study that investigated the effect of doll therapy in managing the cognitive and behavioral symptoms of dementia patients. this study is a randomized controlled trial that aims to investigate the effect of doll therapy on the cognitive states and agitation levels of patients with moderate and severe dementia.

Eligibility criteria:
inclusion criteria: * diagnosed with moderate to severe dementia (those with a smmt score of 17 or less) * having dexterity to hold or caress a baby * no problem with communication obstruction * dementia patients who agree to participate in the study exclusion criteria: * mild stage dementia, * diagnosed with neurological or psychiatric diseases other than dementia, not accepting the baby despite two attempts, * rarely agitated dementia patients with baby dolls

Keywords: dementia agitation cognitive status doll therapy
postpartum evaluation of antihypertensives for control of hypertension: a randomized controlled equivalence study

Conditions: Hypertension in Pregnancy

Summary: this is an open label, randomized controlled trial designed to compare nifedipine and enalapril in the management of postpartum hypertension. this is an equivalence study- meaning we don't think one medication is better than the other. nifedipine has been shown to be better than another common blood pressure medicine, labetalol, for postpartum hypertension but enalapril which is also used worldwide to manage blood pressure postpartum, has not yet been evaluated or compared to nifedipine. we will identify and offer enrollment to women who are admitted for delivery with documented hypertension- patients with either chronic hypertension or pregnancy related hypertension will be included. our hypothesis is both medications are safe and effective in managing blood pressure and preventing readmission for hypertensive complications during the postpartum period so evaluating the rate of readmission will be the primary goal of the study. the only intervention of the trial will be to assign which medication the patient starts taking. any decisions after that point- stopping medication, changing doses, additional medications, discharge from the hospital, etc, will all be at the discretion of the patient's primary provider.


Eligibility criteria:
patient inclusion: any patient admitted for delivery by cesarean or vaginal delivery at 24 weeks gestation or greater with hypertension(htn). hypertension will be defined during the study as either a systolic blood pressure ≥140mmhg or diastolic blood pressure ≥90mmhg on two occasions at least 4 hours apart. this definition is consistent with the acog definition for pregnancy related htn in patients without chtn. patients with chtn who also meet this criteria will be included. following enrollment, treatment will be escalated at discretion of primary provider with the goal of normotension. patient exclusion: * absolute contraindication to either nifedipine or enalapril relative contraindications will be reviewed with pi. * persistent hr \ 110 * native language other than english

Keywords: hypertension postpartum enalapril nifedipine readmission