Kornimate/medical-research-clean huggingface dataset:
comprehensive esophageal diagnostics study

Conditions: Achalasia

Summary: the prospective clinical trial will study muscle fibrosis in relation to lower esophageal sphincter (les) measurements on functional lumen imaging probe (flip) topography (the novel technology that utilizes impedance planimetry) after pharmacologic challenge. a better understanding of achalasia will allow intervention at an earlier stage.

achalasia is a disease characterized by inadequate opening of the lower esophageal sphincter. achalasia is presumed to be due to neuronal dysfunction (active), however there are other variables such as muscle layer fibrosis (passive) that may contribute, particularly in milder or earlier achalasia variants. a new technology, impedance planimetry, may be able to measure active vs passive features of the lower esophageal sphincter (les). the prospective clinical trial will study muscle fibrosis in relation to lower esophageal sphincter (les) measurements on functional lumen imaging probe (flip) topography (the novel technology that utilizes impedance planimetry) after pharmacologic challenge. a better understanding of achalasia will allow intervention at an earlier stage.

Eligibility criteria:
inclusion criteria: 1. male or female patients, age 18 and above. 2. evaluated by emory digestive diseases clinic, emory motility lab, the emory endoscopy unit, or emory surgery department from october 1, 2020, to september 30, 2024. 3. has a diagnosis of achalasia or an esophageal motility disorder with confirmed evaluation by one of the following modalities: functional lumen imaging probe (flip) or high-resolution esophageal manometry (for aim 1) 4. undergoing a diagnostic functional lumen imaging probe (flip) study at emory university hospital with anesthesia assistance (for aim 1) 5. undergoing heller myotomy or per oral endoscopic myotomy for the treatment of their esophageal motility disorder (for aim 2) exclusion criteria: 1. patients younger than 18 years old 2. pregnant women 3. prisoners 4. non-english speaking - the rationale is that the symptom characterization and outcome data are measured on detailed and fairly lengthy (5-7 pages) of questionnaires written in english with some medical terms. these are standardized questionnaires and do not have short forms available. 5. cognitively impaired adults unable to provide informed consent 6. cardiac disease in the form of - arrhythmia requiring icd or pacemaker, baseline bradycardia with hr \ 90, congestive heart failure with ejection fraction \ 140, asthma or chronic obstructive pulmonary disease, urinary retention requiring the use of foley catheterization (including intermittent use), narrow-angle glaucoma, myasthenia gravis, gfr \<60 \[exclusions for aim 1 only\]

Keywords: lower esophageal sphincter functional lumen imaging probe topography anti-fibrosis agents anti-inflammatory agents
trial to demonstrate the efficacy and safety of internet-delivered behavioral treatment for adults with tic disorders

Conditions: Tics; Tourette Syndrome

Summary: gilles da la tourette syndrome (ts)\* is a common chronic neuropsychiatric disorder characterized by motor and vocal tics. in most adult patients, quality of life is significantly impaired. ts, therefore, is a cost-intensive disease (in germany: mean total costs=€3404/year). despite significant adverse effects, dopamine receptor antagonists were recommended as first choice treatment for many years. although efficacy could be demonstrated only recently, today, behavioral therapy with face-to-face comprehensive behavioral intervention for tics (cbit) (including psychoeducation, habit reversal training, function-based assessment and intervention, and relaxation training) is recommended as first line treatment for tics. in germany, however, dissemination of cbit is restricted due to a considerable lack of well-trained therapists. the aim of this study is to overcome this deficiency by creating a new and sophisticated internet-delivered cbit (icbit) program. in addition, internet-delivered cbit will shorten waiting time, will reach additional groups of patients and will be - once developed and established - highly cost-effective (about € 100 vs. € 1450 for face-to-face cbit). investigators want to perform a multicenter, randomized, controlled, observer-blind trial including 160 adult patients in order to demonstrate that 8 sessions (10 weeks) of icbit are superior to internet-delivered psychoeducation/relaxation in adult patients with ts. both immediate (1 week after end of treatment) and long-term effects (after 3 and 6 months) will be evaluated.


Eligibility criteria:
inclusion criteria: * chronic tic disorder or tourette syndrome according to dsm-5 * age ≥18 years; yale global tic severity scale (ygtss) total tic score (tts) \> 14 or \> 10 (for patients only with motor or vocal tics) * clinical global impression-severity score (cgi-s) \> 4 * medication for tics and comorbidities must be on a stable dose for at least 6 weeks before entering the study * fluent german in speaking and writing * ability to give informed consent and signed informed consent exclusion criteria: * history of schizophrenia or pervasive developmental disorder * comorbid obsessive-compulsive disorder (ocd), attention deficit hyperactivity disorder (adhd), depression, anxiety disorder when unstable and/or in need of an initial adjustment for a therapy * history of behavioral treatment for tics * current illicit substance abuse or addiction (clinically diagnosed) * secondary tic disorder or other significant neurological and psychiatric disease * no internet access or ability to use the internet * participation in a study with medicinal products or devices is not allowed within 6 weeks before inclusion or concurrent to this study

Keywords: chronic tic disorders tourette syndrome
epidemiology and management of malnutrition of patients hospitalized at the pitié-salpêtrière hospital: a one-day survey combined with focus groups (mixed methods)

Conditions: Malnutrition

Summary: according to the literature, malnutrition affects between 30% and 50% of hospitalized patients. the most recent survey on the prevalence of malnutrition in hospitals in france dates back to 2003, and at the pitié salpêtrière hospital to 2015. malnutrition is a pathological process that can lead to complications for patients and prolong their length of stay. main objective: evaluate the prevalence of malnutrition in adult patients hospitalized on a given day at pitié-salpêtrière hospital (psl) according to has ( high authority for health) criteria for 2019 (if age \<70 years) and 2021 (if age ≥ 70 years).

according to the literature, malnutrition affects between 30% and 50% of hospitalized patients. the most recent survey on the prevalence of malnutrition in hospitals in france dates back to 2003, and at the pitié salpêtrière hospital to 2015. malnutrition is a pathological process that can lead to complications for patients and prolong their length of stay. main objective: evaluate the prevalence of malnutrition in adult patients hospitalized on a given day at pitié-salpêtrière hospital (psl) according to has (high authority for health) criteria for 2019 (if age \<70 years) and 2021 (if age ≥ 70 years).

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * hospitalized for at least 2 days in a pitié salpêtrière department of the 8 selected dmus. * patient informed and not objecting to participation in the study. exclusion criteria: * be hospitalized in a prm, smr, radiotherapy or adult psychiatry department * be hospitalized in an intensive care or resuscitation unit of the 8 selected dmu * be at the end of life, as determined by the referring clinician * have a communication barrier preventing the collection of declarative data * pregnancy in progress; 6. patient under guardianship.

Keywords: malnutrition
endothelial dysfunction in renal disease and exercise training

Conditions: Chronic Kidney Disease

Summary: chronic kidney disease (ckd) is a prevalent disorder and a major health concern. cardiovascular disease is the most prevailing and life-threatening complication observed in patients with ckd. the diagnosis of ckd places a patient at the highest cardiovascular risk level irrespective of the stage of renal decline. therefore, fatal cardiovascular events are more likely to occur than the evolution to final stages of kidney disease with the need for dialysis. counter intuitively, treatment of classical cardiovascular risk factors does not affect cardiovascular prognosis in ckd, which suggests that the missing link between these two entities has not been elucidated yet. in the present project, the investigators focus on endothelial dysfunction in patients with ckd. endothelial dysfunction precedes overt atherosclerotic changes by many years. in the absence of structural changes, endothelial dysfunction is still reversible, which offers therapeutic perspectives to tackle the progression towards atherosclerosis in an early stage. the purpose of this study is to determine whether an exercise training program is effective in ameliorating endothelial dysfunction in patients with chronic kidney disease.


Eligibility criteria:
inclusion criteria: * patients with ckd stage 3-4 (egfr (15-59 ml/min/1.73m2) without cardiovascular disease. exclusion criteria: * patients \< 18 years * pregnancy * warfarin therapy * glucocorticoid therapy * clinically active malignant disease * heart failure (ejection fraction \< 50%) * peripheral vascular disease, defined as a history of intermittent claudication, abnormal peripheral angiography or doppler ultrasound, lower limb artery bypass surgery/angioplasty/stenting or non-traumatic lower extremity amputation * cerebrovascular disease, defined as a history of transient ischemic attack (tia) or stroke, significant stenosis of the a. carotis on ultrasound/ct angiography or carotid endarterectomy/stenting * coronary artery disease (cad), defined as a history of myocardial infarction, coronary artery angioplasty/stenting/bypass surgery, significant structural coronary lesions on angiography or high suspicion of cad on a maximal exercise test
study to evaluate the pharmacokinetics, safety, and tolerability of seladelpar in subjects with hepatic impairment and healthy subjects

Conditions: Hepatic Impairment

Summary: this phase 1 open label study is being conducted to directly characterize the pharmacokinetic (pk) profiles of seladelpar following administration of a single oral dose in subjects with varying degrees of hepatic impairment (hi) compared to healthy matched control subjects with normal hepatic function.


Eligibility criteria:
inclusion criteria: * must have given written informed consent (signed and dated) and any authorizations required by local law. * willing to be confined to cru for the entire duration required by the protocol. * male or female, between 18 and 80 years of age. * healthy subject with normal liver function must be non-smoker and no use of other tobacco or nicotine-containing products. subject with hi must be non-smoker, or smoke ≤10 cigarettes per day during the study. * healthy subject must not be taking any prescribed or non-prescribed medications unless permitted. subject with hi will be allowed to take their chronic medications unless excluded by the protocol. exclusion criteria: * pregnant or lactating women. * treatment with another investigational drug or device within 30 days prior to study drug administration. * has donated or lost a significant volume of blood within 56 days or plasma within 7 days prior to check-in day. * inability to swallow medication. * positive test for drugs of abuse and/or positive alcohol test at screening or day -1. * positive test at screening for hbsag, hepatitis c virus (hcv), or hiv.

Keywords: hepatic impairment
ventilator-driven alveolar recruitment maneuver

Conditions: Postoperative Atelectasis; Ventilator Lung; Atelectasis; Recruitment

Summary: during laparoscopic surgery, gas infiltration and head down position cause pulmonary atelectasis. alveolar recruitment maneuvers are beneficial in reopening collapsed alveoli and improving lung mechanics. ventilator-driven alveolar recruitment maneuvers may restore lung volume but it remains unknown which method is most effective. the primary aim was to compare the efficacy of two ventilator-driven arms method using incremental tidal volume or positive end expiratory pressure(peep) until plateau pressure 30 cmh20 (within driving pressure 20 cmh20).

general anesthesia promotes the formation of atelectasis, which negatively impacts respiratory function and may be associated with subsequent pulmonary complications. especially, during laparoscopic surgery, gas infiltration and head down position cause pulmonary atelectasis. alveolar recruitment maneuvers are beneficial in reopening collapsed alveoli and improving lung mechanics, suggesting that performing an alveolar recruitment maneuvers after intubation, circuit disconnection, position change, intraabdominal gas infiltration. conventional manual arm is performed by sustained lung inflation using the reservoir bag on the anaesthesia machine with the adjustable pressure-limiting valve set to the desired inflation pressure. however, the manual arm can lead to brief loss of positive pressure when switching back to the ventilator circuit, which results in re-collapse of alveoli. for this reason, investigators try to compare the methods of the ventilator-driven arm.

Eligibility criteria:
inclusion criteria: * patients who receive laparoscopic surgery in trendelenberg position exclusion criteria: * patients who are simultaneously participating in other studies * patients who are scheduled to leave the intensive care unit after surgery * patients with obstructive or restrictive pattern of severe or moderate grade on pulmonary function test * high risk in cardiovascular events (expected postoperative cardiovascular event \> 5%) * patients with emphysema confirmed by imaging test * patients with obesity bmi \> 35 kg / m2
comparison of anatomic results between bilateral and conventional abdominal sacral hysteropexy

Conditions: Pelvic Organ Prolapse

Summary: investigators separated 20 patients with uterovaginal prolapse into 2 groups according to random numbers table. in one group, conventional abdominal sacral hysteropexy will be perform and another group bilateral abdominal sacral hysteropexy will be perform with polypropylene mesh. after 1 mont operation vaginal configuration will be evaluate with mri on three plane (axial, sagittal, coronal). then the results of thus two groups will be compare to results of nullipara patients. investigators will investigate which technique keep the vaginal axis is closer to the original anatomic position.

since vaginal hysterectomy and mc call culdoplasty, many techniques have been described. before, correcting only prolapsed part, now, we can measure anatomical and functional results more objectively by using different tool such us mri, perineal ultrasonography, pisq-12, iiq-7 (incontinence impact questionnaire). hence pelvic organ prolapse surgery is important in terms of anatomic and functional results. unilateral abdominal sacral hysteropexy can put vaginal axis to right side slightly. therefore investigators hypothesized that bilateral sacral hysteropexy which mimic sacrouterine ligament can be more suitable in terms of anatomic results.

Eligibility criteria:
inclusion criteria: * women with stage 3 or more pelvic organ prolapse exclusion criteria: * women with abnormal uterine bleeding, abnormal cervical screening test, myoma uteri and want to hysterectomy
interventricular cardiac septal thickness in fetus of diabetic mother correlated to postnatal outcome

Conditions: Maternal Diabetes Mellites Effect on Fetus

Summary: good glycemic control is superior to poor glycemic control in reducing risk of interventricular septal thickness among fetuses of diabetic mothers.

thick interventricular septum is thought to be related to poor glycemic control during pregnancy, and it causes variable degree of left ventricular outflow obstruction and hypertrophic cardiomyopathy. hypertrophic cardiomyopathy requires specific management as digoxin and inotropic agents usually used in heart failure are contraindicated. so high index of suspicion is required in fetus of diabetic mother having thick inter ventricular septum.

Eligibility criteria:
inclusion criteria: * above 35 weeks pregnancy * diabetic mothers * single intrauterine pregnancy exclusion criteria: * any other medical disorder
morphine consumption in joint replacement patients, with or without gabapentin treatment

Conditions: Post Operative Pain; Total Knee Replacement

Summary: total knee arthroplasty is amongst the most painful procedures postoperatively, and pain management can be a challenge. different measures have been introduced to manage severe postoperative pain int hese patients. previous studies have investigated gabapentin in acute postoperative pain and demonstrated reducted pain, postoperative morphine consumption, morphine related side effects, and postoperative pain scores. to date, this analgesia adjunct has yet to be investigated in total joint arthroplasty patients.

the study was submitted to health canada and received the letter of no objection. a randomized, double-blind, placebo-controlled study. the randomization scheme will be prepared and will be done by the pharmacy department at mcmaster university. ninety patients undergoing primary knee arthroplasty will be recruited from the preoperative clinic. forty-five patients in each population will be allocated to a gabapentin group and the other forty-five to a placebo group.

Eligibility criteria:
inclusion criteria: * participants aged 19-90 * elective single joint, primary total knee arthroplasty * use of pca with morphine for postoperative pain control has been discussed and agreed upon between patient and anesthetist exclusion criteria: * bilateral total knee arthroplasty * revision knee arthroplasty * underlying disease of epilepsy, seizure, or chronic pain syndrome * active gastrointestinal bleeding within the last 6 months * history of non-steroidal anti-inflammatory drug (nsaid) induced asthma * known or suspected history of drug or alcohol abuse * participant currently takes gabapentin or pregabalin for any reason * participant currently takes pain medication that is more potency than codeine or oxycodone (morphine, hydromorphone, meperidine, methadone, fentanyl, including any long acting narcotics) * known allergy to study medications: gabapentin, morphine, nsaid, acetaminophen * unable to tolerate morphine * liver impairments * kidney impairment or calculated creatinine clearance by cockcroft-gault formula is \<=60ml/min * pregnancy or breast-feeding * participant currently receives associated worker's compensation benefits (wsib) * participant unable or unwilling to give written or informed consent * unable to use pca

Keywords: knee arthroplasty postoperative pain gabapentin
healthy eating in women at risk of gestational diabetes

Conditions: Gestational Diabetes; Pregnancy Complications

Summary: healthy eating during pregnancy has favorable effects on markers related to diabetes (glucose tolerance) and is associated with lower gestational diabetes mellitus (gdm) risk. the cornerstone of gdm treatment is nutrition therapy but the latter often starts late in pregnancy and thus may not have the expected effects on glucose tolerance. what if an intervention promoting healthy eating was initiated at the beginning of pregnancy in all women at risk, would it improve glucose homeostasis? to answer this important question, the investigators will perform a randomized controlled trial in 150 pregnant women. women receiving the nutritional intervention will be compared to a control group receiving standard care. the nutritional intervention, which will start in the first trimester, is based on the 2019 canada's food guide and is composed of 4 individual sessions with a registered dietitian (12, 18, 24 and 30 weeks). between those follow-ups, informative nutritional web capsules and phone calls with the registered dietitian will be provided. to ensure that the women remain motivated and receive social support, a private facebook group will be used. the investigators hypothesize that the nutritional intervention will be effective at improving glucose homeostasis. the investigators expect the results will show the importance of nutritional care starting early in pregnancy in women at risk of gdm.

individuals will participate in three on-site research visits during which a 2-hour oral glucose tolerance test will be performed. at each of these trimesters and 3 months after the delivery, participants will also complete three validated web-based 24-h recalls from which diet quality will be assessed. subjects will be randomized to two arms after the first oral glucose tolerance test at the first visit. for all participants, on-site follow-ups by the research team will occur at each trimester and 1 virtual follow-up will be done 3 months after delivery for both groups. the total duration of participation for all is approximately 9 months.

Eligibility criteria:
inclusion criteria: * ≤ 14 gestational weeks; * singleton pregnancy; * at risk of gdm according to diabetes canada (being 35 years of age or older or from a high-risk group (african, arab, asian, hispanic, indigenous, or south asian) or having a bmi ≥ 30 kg/m2, prediabetes, gdm in a previous pregnancy, given birth to a baby that weighed more than 4 kg, a parent, brother or sister with type 2 diabetes, polycystic ovary syndrome or acanthosis nigricans (darkened patches of skin). exclusion criteria: * having a diabetes diagnosis in the 1st trimester; * pre-existing diabetes mellitus; * diseases requiring active nutritional treatment or influencing glucose metabolism (including previous bariatric surgery); * taking part in a nutritional intervention program; * corticosteroid use; * previous or current diagnosis of an eating disorder; * inability to give informed consent; * inability to communicate in french.

Keywords: nutrition healthy eating gestational diabetes
variation of genes controlling carbohydrate and lipid metabolism

Conditions: Diabetes Mellitus, Type 2; Cardiovascular Diseases; Obesity; Insulin Resistance; Lipid Metabolism Disorders; PreDiabetes

Summary: aim of the study is to investigate genes regulating glucose and lipid metabolism in subjects whose glucose metabolism, lipid metabolism, blood flow, or body fat distribution has been measured using positron emission tomography (pet), magnetic resonance imaging (mri), magnetic resonance spectroscopy (mrs) or computed tomography (ct) as part of their previous participation in clinical trials conducted at turku pet centre. by combining information from pet, mri, ct, proteomics, metabolomics and genetics analyses we aim to find connection between genetic variation and metabolic and cardiovascular disease.

the data is collected as a separate part of the clinical imaging study protocols using a separate inform consent approved by the local ethics committee. the participation for this study consists of drawing whole blood, serum and plasma samples for genetics, proteomics and metabolomics analyses. the results from these studies are combined with baseline data from the original clinical imaging studies to find connections between genetic variation, metabolism, blood flow and body fat distribution in a cross-sectional setting.

Eligibility criteria:
inclusion criteria: * previous participation of studies measuring glucose metabolism, lipid metabolism, bloow flow and adiposity at turku pet centre exclusion criteria: -

Keywords: positron emission tomography skeletal muscle liver adipose tissue brain genetics