Kornimate/medical-research-clean huggingface dataset:
flexible vs. fixed diuretic regimen in the management of chronic heart failure: a pilot study

Conditions: Heart Failure; Heart Diseases

Summary: heart failure is a major cause of death and hospitalization in canada. many of the symptoms experienced by patients with heart failure relate to having fluid accumulate in the lungs causing difficulty breathing, swelling in the legs, and an increase in weight. thus, one of the cornerstones of managing heart failure includes the use of medications known as diuretics that target the kidneys to reduce fluid accumulation via urination. deciding on the correct dose of this medication can be quite nuanced as under-dosing can lead to accumulation of fluid, and over-dosing can dehydrate patients and potentially result in lightheadedness/fainting and damage to the kidneys. currently, options for prescribing diuretics for heart failure include 1) giving patients a regular, fixed dose or 2) having patients monitor their daily weight as a surrogate of their fluid status and then take a dose of diuretic based on a pre-prepared scale. the rationale behind the flexible weight-based diuretic scale is that it can potentially detect early fluid accumulation and thus possibly prevent hospitalization or ed visits, and it also avoids over-dosing and potentially dehydrating patients. currently, it is not clear whether the flexible diuretic regimen is better than the fixed-dose regimen in preventing ed visits, hospitalizations, kidney damage, or death and as such, this pilot study will directly compare the two commonly used regimens in the management of chronic heart failure patients.


Eligibility criteria:
inclusion criteria: 1. diagnosis of heart failure, either reduced (left ventricular ejection fraction \[lvef\] ≤ 40%) or preserved (lvef \> 40%) ejection fraction as measured by echocardiography performed within the last 2 months 2. prescribed and tolerating furosemide with a minimum daily dose of 40mg oral daily 3. new york heart association (nyha) class ii or higher symptoms 4. nt-probnp cutoff of ≥ 1000 pg/ml performed within 30 days prior to randomization 5. age \> 18 years 6. english speaking 7. access to a scale and ability to weigh themselves daily and reliable telephone access exclusion criteria: 1. myocardial infarction, coronary artery bypass graft surgery, stent insertion and/or angioplasty within 14 days 2. pregnancy 3. inability to follow directions and self-monitor as part of a flexible diuretic regimen as discerned by the clinician 4. allergic reaction to loop diuretics 5. unable to provide informed consent

Keywords: diuretic furosemide flexible diuretic regimen weight-based
improving service delivery through access points

Conditions: Hypertension; Angina; Diabetes

Summary: cbocs represent one of va's main managed care strategies for shifting the focus of care from the inpatient to the outpatient setting and for improving the health of our nation's veterans. hypothesis-driven research is critically needed to test the basic assumptions motivating the expansion of cbocs throughout the va health care system.

background: cbocs represent one of va's main managed care strategies for shifting the focus of care from the inpatient to the outpatient setting and for improving the health of our nation's veterans. hypothesis-driven research is critically needed to test the basic assumptions motivating the expansion of cbocs throughout the va health care system. objectives: the purpose was to determine how increased geographic access to primary care services affects service use and costs. two specific aims addressed were: 1) to determine how cbocs impact the service use of all existing users and existing users with the following ambulatory care sensitive conditions (acsc): alcohol dependence, angina, chronic obstructive pulmonary disease (copd), depression, diabetes and hypertension; and 2) to describe how cbocs affect the workload and costs of the va health care system from the visn's perspective. methods: a quasi-experimental pre-post study design with intervention and reference groups was employed to compare service use and costs in the 18 months following the establishment of a new cboc. fifteen cbocs from 11 visns were included in the analysis. for specific aim 1, the intervention group was defined as existing users in the catchment area of a new cboc and the reference group was defined as matched existing users outside cboc catchment areas. multivariate statistical regression analyses were used to estimate the impact of residing within the cboc catchment area on use and cost in the post-period, controlling for patient casemix and use/cost in the 18 month pre-period. for specific aim 2, the intervention group was defined as zip codes in the catchment area of a new cboc and the reference group was defined as matched zip codes outside cboc catchment areas. average use and costs for all users, existing users and new users from intervention zip codes and reference zip codes were compared. status: complete.

Eligibility criteria:
inclusion criteria: subjects must live in the catchment area of a specified cboc and have been diagnosed with a tracer condition. exclusion criteria:
study to compare the efficacy and safety of celbesta® and celebrex® in patients with rheumatoid arthritis

Conditions: Rheumatoid Arthritis

Summary: this phase iv clinical study is to compare the efficacy and safety of celbesta® and celebrex® in rheumatoid arthritis patients

thisi is a multi-center, double-blind, active-controlled, randomized, parallel-group clinical trial to compare the efficacy and safety of celbesta® and celebrex® in patients with rheumatoid arthritis. the subject will receive two tablets twice daily for 6 weeks.

Eligibility criteria:
inclusion criteria: * anyone over the age of 19 * subjects who are diagnosed as established rheumatoid arthritis at screening visit and before * pain greater than 40/100mm-vas(visual analgue scale) after wash-out period * patients who are taking oral corticosteroids without dosage change (within a range of prednisolone 10mg a day) at least 4weeks and more than 1 dmards at least 3 months from screening test * patients willing and able to provide signed informed consent after the nature of the study has been explained exclusion criteria: * history of angina pectoris or congestive heart failure at rest or minimum activity * history of myocardial infarction or artherosclerosis * patients who had a coronary angioplaty or coronary artery bypass graft within 1 year * history of stroke, transient ischemic attack or hepatitis within 2 years * patients who have uncontrolled hypertension at screening * patients who take the medicines that might effect the test results by study investigators or might cause a excessive risk to the patients * intra-articular corticosteroid injection within 4 weeks from screening * biological dmards such as infliximab, adlimumab, entanercept, anakinara or abatacept wihin 6 months from randomization * biological dmards such as rituximab within 1 year from randomization * history of a malignant tumor (except for the patients whose tumor was removed and there's no recurrence within 5 years) * patients who have gastrointestinal bleeding or peptic ulcer (except scar) within 30 days * history of a gastroesophageal surgery such as antigastric-secretion surgery or esophagogastrectomy (except a simple perforator surgery) * patients who have severe disability in gi, kidney, liver and blood * pregnant women, lactating women and women of child-bering potential who are not using adequate means of contraception * history of allergy to cox-2 inhibitors or sulphonamides or other nsaids * any condition that, in the view of the investigator, would interfere with study participation

Keywords: celecoxib celbesta
pre-surgical trial of the combination of metformin and atorvastatin in newly diagnosed operable breast cancer

Conditions: Breast Cancer; Breast Tumors; Cancer of Breast

Summary: the purpose of this study is to determine the effects of combining metformin and atorvastatin treatment in patients with newly diagnosed breast cancer during the interval between breast biopsy and surgery. this study is designed to assess whether tumor proliferation, as measured by the natural log expression of ki-67 staining of breast tumor cells, is reduced following approximately 2 weeks of treatment with the combination of metformin plus atorvastatin in patients with newly diagnosed breast cancer.

breast cancer cells require energy homeostasis shifts with enhanced anabolism to enable rapid growth and continued proliferation. the main energy regulatory system in eukaryotes and breast cancer cells is the amp-activated kinase (ampk) pathway. ampk is triggered by changes in the amp/adenosine triphosphate (atp) ratio thus impacting energy reserves and requirements. ampk pathway closely interacts with the phosphoinositide 3-kinase (pi3k)/akt signaling pathway, affecting the downstream function of the master regulator mammalian target of rapamycin (mtor). activation of ampk has been shown in vitro to result in inhibition of proliferation of various cancer cell lines. utilizing a pre-surgical model, the investigator plans to conduct a pilot study of 40 women with newly diagnosed invasive breast cancer or ductal carcinoma in-situ (dcis) who will receive oral metformin and atorvastatin daily in the interval between diagnostic breast biopsy and definitive breast surgery. the goal is to determine if dual combination treatment with metformin plus atorvastatin significantly impacts tumor-based markers, such as proliferation, and blood-based biomarkers.

Eligibility criteria:
inclusion criteria: * female subjects with histologically-confirmed operable invasive breast cancer or dcis, who undergo core needle biopsy followed by surgical excision at least 2 weeks after enrollment * ≥ 5 mm by imaging/pathology of core to ensure enough pre- and post-treatment tissue for analysis * age ≥ 21 years. breast cancer is uncommon in patients less than this age. * no prior chemotherapy, radiation therapy, or breast resection within 6 months of study entry * eastern cooperative oncology group (ecog) performance status 0-1 * signed informed consent exclusion criteria: * currently on medication for diabetes or hypercholesterolemia * treatment with other investigational drugs within 6 months of study entry * strong cytochrome p450 3a4 (abbreviated cyp3a4) (e.g., clarithromycin, hiv protease inhibitors, and itraconazole), given potential interactions with atorvastatin * renal impairment with a creatinine \> 1.4 mg/dl * hepatic impairment: aspartate transaminase (ast)/(sgot), alanine transaminase(alt)/(sgpt) ≥ 2.5 x upper limit of normal range (uln), or total bilirubin ≥ 1.5 x uln (subjects with gilbert's syndrome can have bilirubin of up to 1.5 x uln), or alkaline phosphatase \> 2.5 x uln

Keywords: breast cancer metformin atorvastatin ki-67
study of efficacy of levofloxacin 0.5% ophthalmic solution administered three times a day for bacterial conjunctivitis

Conditions: Bacterial Conjunctivitis

Summary: the aim of the study is to evaluate the clinical and microbiological efficacies of three times daily administration of levofloxacin 0,5% eye drops as compared to the more frequent dosing (up to 8 times a day during the first 2 days and up to 4 times a day during the next 3 days) in patients with bacterial conjunctivitis.


Eligibility criteria:
inclusion criteria: * male and female patients between 18 and 70 years of age * patients with conjunctivitis (defined as the presence of three cardinal signs: conjunctival discharge, bulbar conjunctival injection and palpebral conjunctival injection) * patients who have given and signed informed consent * the ability and willingness to comply with all study procedures exclusion criteria: * insulin dependent diabetes mellitus (iddm) * patients with keratitis or hordeolum * glaucoma * sjogren's syndrom and "sick eye's syndrom". * ectropion, entropion; * using contact lenses during the study * poor visual acuity in the other eye * prior and concurrent concomitant treatment glycocorticosteroids, immunosupressive therapy, if these treatments have not stopped at least 3 months prior to the start of the study; * concurrent use of non- steriodal anti- inflammatory drugs (nsaids), with the exception of low- dose aspirin. (see par. 11.5) * prior and concurrent systemic antibiotic treatment during last 7 days before the beginning the study.(see par. 11.5) * concurrent other eye drops * all ocular surgeries which were performed less than 6 months before the beginning of the study. * any clinical condition, which, in the opinion of the investigator would not allow safe completion of the protocol. * history of any malignancy within the past 5 years prior to study entry, except basal cell or squamous cell skin carcinoma. * hypersensitivity to fluoroquinolons and benzalkonium chloride; * intended or ascertained pregnancy or lactation; * participation in a clinical trial within last 30 days.

Keywords: bacterial conjunctivitis levofloxacin fluoroquinolone
pulp capping in primary molars using theracal (lc)

Conditions: Deep Caries; Indirect Pulp Capping; Direct Pulp Capping; Reversible Pulpitis; Decayed Teeth; Vital Pulp Therapy

Summary: a randomized clinical trial that aims to evaluate clinical and radiographic success rates of indirect pulp capping and direct pulp capping in primary molars with reversible pulpitis using a light-cured tri-calcium silicate base material (theracal (lc)).

participating primary molars will be randomly allocated to one of the following groups: indirect pulp capping group or direct pulp capping group. a light-cured tri-calcium silicate base material (theracal (lc) ) will be used in the two groups as a dressing material. patients will be recruited from the outpatient clinic of the pediatric dentistry department, faculty of dentistry ain shams university. the participant will be recalled for follow-up assessments at 3, 6,9, and 12 months.

Eligibility criteria:
inclusion criteria: 1. age: 4-7 years. 2. free medical history. 3. complete physical and mental health. 4. patient cooperation 5. restorable mandibular primary molars exclusion criteria: 1. clinical symptoms or irreversible pulpitis as (spontaneous pain, throbbing pain) 2. soft tissue swelling, draining fistula or sinus tracts. 3. tenderness to percussion. 4. pathological tooth mobility. 5. widening of periodontal membrane space

Keywords: ipc , dpc
validation of respilife for detection of respiratory suppression

Conditions: Respiration Disorders

Summary: the purpose of this study is to evaluate the accuracy of respilife diagnostic technology for detection of respiratory rate and oxygen saturation in human subjects. this includes evaluation of bioresp's respilife and its accuracy for measurement of respiratory rate and oxygen saturation.

the purpose of this study is to evaluate the accuracy of respilife diagnostic technology for detection of respiratory rate and oxygen saturation in human subjects. this includes evaluation of bioresp's respilife and its accuracy for measurement of respiratory rate and oxygen saturation.

Eligibility criteria:
inclusion criteria: * able to understand and sign the informed consent * english speaking. * able to comply with visits and follow ups included in this protocol * ages 18-80 years exclusion criteria: * mentally or cognitively incompetent persons who cannot understand the procedures or consent to the procedures. * an unstable medical condition, acute of chronic, that in the opinion of the investigator puts the subject at health risks related this trial or interferes with the clinical trial and data collection. * if a subject is not able to stop his cpap or bipap therapy at least one week prior to the sleep study night. this will be determined ty the principal investigator based on her judgment. * skin rash on the forehead. * a history of skin allergy to medical tape, even hypoallergenic tape. * a history of skin cancer on the forehead.
bp-mri based multi-planar vi-rads

Conditions: Bladder (Urothelial, Transitional Cell) Cancer; MRI

Summary: this study is a prospective, single-center, observational clinical trial, enrolling 100 patients with malignant bladder tumors admitted to the department of urology at the people's hospital of jiangsu province for treatment with transurethral resection or radical cystectomy. all enrolled patients underwent multiparametric magnetic resonance imaging, including t2-weighted imaging (t2wi) in coronal, sagittal, and axial planes and diffusion-weighted imaging (dwi) in the same planes. the vascular invasion- and invasion into the detrusor muscle assessment and reporting system (vi-rads) scores were evaluated for the enrolled patients. diagnostic thresholds for muscle-invasive bladder cancer (mibc) were set at vi-rads scores ≥3 and ≥4, respectively. descriptive statistics including sensitivity, specificity, positive predictive value (ppv), and negative predictive value (npv) were calculated and compared against the surgical pathology gold standard results. this study preliminarily validates the diagnostic performance of the 3d magnetic resonance-derived vi-rads score in the assessment of muscle-invasive bladder cancer.


Eligibility criteria:
inclusion criteria 1. patients with indications of bladder cancer from preoperative assessments; 2. unrestricted by gender; 3. age of 18 years or older; 4. absence of contraindications for magnetic resonance imaging (mri); 5. provision of informed consent for the use of personal clinical data, pathology, and imaging for research purposes. exclusion criteria 1. time lapse exceeding one month between multiplanar bp-mri examination and surgical intervention; 2. compromised mri image quality due to significant artifacts, inadequate bladder filling, or absence of identifiable lesions within the bladder; 3. postoperative histopathology confirming non-urothelial bladder cancer; 4. inability to undergo surgery due to severe medical conditions, including heart failure, acute myocardial infarction, and severe cardiac or pulmonary diseases, rendering the patient unable to withstand routine surgical procedures; 5. recent surgical procedures (e.g., transurethral resection of bladder tumor, turbt) prior to mri examination; 6. any conditions identified by investigators that could potentially harm subjects or impede their ability to meet the study requirements; 7. inability to provide written informed consent for participation.
surgical wound infection prevention bundle in patients undergoing coronary bypass graft surgery

Conditions: Infection Due to Coronary Artery Bypass Graft (Diagnosis)

Summary: estimate the utilization of locally customized surgical wound infection bundle to prevent and or control of infection in patients undergoing cabg surgery in sohag


Eligibility criteria:
inclusion criteria: * coronary artery disease ,diebetes mellitus,hypertension, exclusion criteria: * patients who have cancer , immunocompromised patients, cardiac surgeries other than cabg
bronchi dilation in polynesian patients: monocentric retrospective study

Conditions: Polynesian Bronchiectasis

Summary: the study hypothesis is that dilations of idiopathic bronchi are particularly common in french polynesia, and that there are arguments in favour of an underlying genetic factor. the study will retrieve retrospective data in the history of bronchial dilation, patients' personal and family history, microbiological and scannographic data, and the latest cardio respiratory checkup.


Eligibility criteria:
inclusion criteria: * polynesian patient * patient with bronchial dilation followed by centre hospitalier de polynesie francaise or patient with bonchial dilation no longer consulting in the hospital over the study period jan 1, 2010 to dec 31, 2020 exclusion criteria: * expressed refusal to participate in the study for patients undergoing follow-up

Keywords: bronchi dilatation
vitamin d zinc fever

Conditions: Sepsis; Fever; Vitamin D

Summary: zinc and vitamin d deficiency are associated with a state of inflammation/atherosclerosis. there are studies demonstrating an association between vitamin d deficiency and respiratory illnesses. both zinc and vitamin d are associated with oxidative stress and inflammation.

both vit. d and zinc share anti inflammatory and anti oxidative actions. vit. d deficiency is associated with an increase in serum levels of proinflammatory cytokines and decreased levels of anti inflammatory cytokines. there are reports concerning the association of vit. d deficiency with infections.

Eligibility criteria:
inclusion criteria: * age\>18 years exclusion criteria: * cct\<90 * taking calcium * hyper/hypoparathyroidism * active malignancy.

Keywords: zinc sepsis fever vitamin d
campylobacter spp. bone and joint infection: a retrospective cohort study

Conditions: Campylobacter Infections

Summary: campylobacter bacteria, a gram-negative bacillus commensal in the digestive tract of many animals and mainly responsible for human infections with digestive origins, has been little studied in the field of osteoarticular infections (oai). campylobacter spp. are, however, well described, mainly for c. fetus, and pose a dual therapeutic problem: i) a capacity for persistence due to the capacity of most strains to form biofilm; and ii) potential resistance to many antibiotics. the management of ioa caused by campylobacter spp. is not codified, and is based on small series of cases reported in the literature.


Eligibility criteria:
inclusion criteria: * \> 18 years * osteoarticular infection (whatever its type), mono or polymicrobial with campylobacter spp., diagnosed between 01/01/2013 and 12/31/2022: * septic arthritis: compatible clinical signs + joint fluid sample positive in culture and/or pcr positive for campylobacter * spondylodiscitis: clinical signs and mri compatible + blood cultures and/or disco-vertebral biopsy puncture positive in culture and/or pcr positive for campylobacter * osteitis/osteomyelitis: compatible clinico-radiological picture + bone sample (biopsy or intraoperative sample) positive in culture and/or positive pcr for campylobacter * infection on joint prosthesis or osteosynthesis equipment: documented campylobacter infection and meeting the definition of probable or confirmed jibs infections * patient who was informed and did not object to participating in the study exclusion criteria: -

Keywords: management risk factors campylobacter spp.