Kornimate/medical-research-clean huggingface dataset:
cardiac fibrosis and risk prediction in cancer treatment-related cardiotoxicity

Conditions: Cardiotoxicity

Summary: the purpose of this study is to determine whether pre-existing cardiac fibrosis is a predictor of cancer treatment-related cardiotoxicity.


Eligibility criteria:
inclusion criteria: * stage i-iii breast cancer or lymphoma with a \>2 year life expectancy * a treatment plan that includes anthracyclines and/or trastuzumab * age \>45 years * able to hold breath for 10 seconds * eastern cooperative oncology group (ecog) performance status 0 or 1 exclusion criteria: * refusal or inability to provide informed consent * known heart failure or lvef \<50% * heart rate over 100 bpm * renal dysfunction with gfr \<30 ml/min/1.73m2 * participants with pacemakers, defibrillators, functioning neurostimulator devices or other implanted electronic devices * symptomatic claustrophobia * plans to move within 24 months of enrollment
ablation and left atrium reduction during mitral valve surgery for atrial fibrillation

Conditions: Atrial Fibrillation

Summary: the purpose of this study is to estimate left atrial volume reduction surgery concomitant with the maze procedure and mitral valve repair/replacement in patients with atrial fibrillation with an enlarged left atria.

the cox-maze procedure has been a gold standard for the treatment of atrial fibrillation. success of the modified maze procedure after valvular operation with an enlarged left atria and persistent and longstanding persistent atrial fibrillation remains suboptimal. the question addressed was: in adults undergoing a maze procedure for atrial fibrillation does left atrial size reduction compared to maze surgery alone improve maze surgery success?

Eligibility criteria:
inclusion criteria: * able to sign informed consent and release of medical information forms * age ≥ 18 years * clinical indications for mitral valve surgery for organic mitral valve disease note: may include need for surgical management of functional tricuspid regurgitation or patent foramen ovale. surgical intervention may be performed via sternotomy or minimally invasive procedure. * a) persistent atrial fibrillation (af) within 6 months prior to randomization, defined as non self-terminating af lasting greater than 7 days but no more than one year, or lasting less than 7 days but necessitating pharmacologic or electrical cardioversion. duration of af must be documented by medical history and presence of af must be documented by a direct electrocardiographic assessment within 6 months prior to randomization. b) longstanding persistent af is defined as continuous af of greater than one year duration. duration of af must be documented by medical history and presence of af must be documented by a direct electrocardiographic assessment upon arrival in the or. * left atrial diameter \> 65mm * able to use heart rhythm monitor exclusion criteria: * af is paroxysmal * af without indication for mitral valve surgery * concomitant coronary artery bypass grafting (cabg), aortic arch or aortic valve procedure * previous catheter ablation for af * redo cardiac surgery * left ventricle ejection fraction (lv ef) \< 35% * life expectancy of less than one year * mental impairment or other conditions that may not allow subject to understand the nature, significance, and scope of study

Keywords: atrial fibrillation mitral valve
left bundle branch area pacing in patients after tavr

Conditions: Aortic Valve Stenosis; AV Block; Pacing-Induced Cardiomyopathy

Summary: prospective, randomized, single center clinical trial to compare the outcome of left bundle branch area pacing versus right ventricular apical pacing in patients with higher degree atrio-ventricular block and a normal left ventricular function after transcatheter aortic valve replacement.

transcatheter aortic valve replacement (tavr) is a well-established treatment of aortic valve stenosis. yet, requiry of permanent pacing due to new onset atrio-ventricular conduction block remains a frequent complication. standard right ventricular pacing (rvp) at high pacing burden may lead to deterioration of left ventricular function. left-bundle-area pacing (lbbp) is a new, innovative method of physiological ventricular stimulation resulting in narrow, physiological qrs complexes. in this prospective, randomized, single center clinica trial, patients are included after tavr and with normal left ventricular function who require pacing due to a higher degree atriao-ventricular block with an anticipated high pacing burden. patients will be randomized to receive either left bundle branch area pacing (intervention) or right ventricular apical pacing (control). the results will confirm the feasibility of lbbp in patients following tavr. results will further investigate the primary outcome of a clinically relevant qrs narrowing and a combination of exploratory secondary endpoints including clinical outcomes, functional status, laboratory biomarkers, and quality of life.

Eligibility criteria:
inclusion criteria: * successful tavr implantation for classical (high flow high gradient), symptomatic aortic valve stenosis * lvef ≥50% * guideline-based indication for pacing due to av block iii°, av block ii°, or symptomatic bradycardic atrial fibrillation with an expecteed ventricular pacing burden \>20% * signed informeed conseent to study participation exclusion criteria: * lvef \<50% * expected pacing burden \<20% * pre-existing implanted cardiac device * participation in a concurring interventional trial * age \<18 years * current preegnancy * life expectancy \<6 months

Keywords: left bundle branch area pacing av block right ventricular pacing aortic valve stenosis tavr ecg
11c-5-htp pet in clinical islet transplantation

Conditions: Type 1 Diabetes

Summary: in people with type i diabetes, the insulin producing cells in the pancreas have been destroyed. presently one can only evaluate the function of the graft through laboratory tests, blood sugars and the insulin requirements. the mass of the insulin producing cells and their location are not known. the possibility to study the mass of insulin producing cells is of importance when developing new treatment regimes, in order to evaluate their efficacy on this parameter. the researchers in this study are aiming to develop methods to measure the mass of insulin producing cells. a method (positron emission tomography, pet) previously used for the diagnosis of tumors of insulin producing cells may also be used to measure the amount of insulin producing cells in patients with type i diabetes. they plan to evaluate participants with type 1 diabetes that have undergone islet transplantation, to evaluate if pet can be used to measure the beta cell mass after islet transplantation.


Eligibility criteria:
inclusion criteria: subjects must meet all of the following criteria to be considered eligible for participation in the study: 1. subjects who are able to provide written informed consent and comply with the procedures of the study protocol. 2. patient that has received an islet transplant in or outside the cit01 trial (post primary endpoint). exclusion criteria: subjects who meet any of these criteria are not eligible for participation in the study: 1. for female subjects: positive serum pregnancy test, presently breast-feeding, or unwillingness to use effective contraceptive measures at the time of pet scan +/- 2 weeks. 2. known history of severe co-existing cardiac disease, characterized by any one of the following conditions: 1. recent myocardial infarction (within past 6 months). 2. evidence of ischemia on functional cardiac exam within the last year. 3. left ventricular ejection fraction \<30%. 3. persistent elevation of liver function tests at the time of study entry. persistent aspartate aminotransferase (serum glutamic-oxaloacetic transaminase), alanine aminotransferase (serum glutamate pyruvate transaminase), alkaline phosphatase or total bilirubin, with values \>1.5 times normal upper limits will exclude a patient. 4. treatment with any anti-diabetic medication, other than insulin, within 4 weeks of enrollment. 5. use of any investigational agents within 4 weeks of enrollment. 6. any medical condition that, in the opinion of the investigator, will interfere with the safe completion of the trial.

Keywords: clinical islet transplantation positron emission tomography (pet) computed tomography (ct) imaging
use of β-hydroxy-β-methylbutyrate to counteract muscle loss in men with prostate cancer on androgen ablation

Conditions: Prostate Cancer

Summary: this is a study of hmb plus amino acids in older men with prostate cancer starting androgen deprivation therapy (adt). the investigators hypothesize that the use of this nutritional supplementation will decrease the loss of muscle mass and strength that occurs when men start adt.

it is well established that older patients experience age-related loss of muscle mass and function (sarcopenia), presumably due to an imbalance of protein synthesis versus protein breakdown. in addition, studies have shown that men who start on adt experience increased muscle protein breakdown and decreased synthesis. β-hydroxy-β-methylbutyrate (hmb), a leucine metabolite, has been shown to slow protein breakdown. when hmb is given with arginine and lysine (which support protein synthesis) in randomized trials, researchers have shown that elderly men and women who receive this nutritional supplementation experience improvement in fat-free mass, strength, functionality and protein synthesis when compared with controls. in addition, patients with advanced cancer who experienced weight loss of at least 5% have also been shown to benefit from hmb, with supplementation resulting in a significant increase of fat-free mass when compared to controls. thus, it seems reasonable that older men with prostate cancer starting on adt who experience lean muscle loss as a result of aging and adt, may achieve some benefit from supplementation with hmb as well. use of hmb in men with prostate cancer has not been reported.

Eligibility criteria:
inclusion criteria: 1. histologically confirmed adenocarcinoma of the prostate 2. age 60 years or older 3. patients with asymptomatic or minimally symptomatic prostate cancer for which they are about to start androgen deprivation therapy (adt) per provider recommendation * asymptomatic or minimally symptomatic (as judged by treating physician) metastases allowed * men receiving adt for localized prostate cancer are allowed 4. patient able to give informed consent. exclusion criteria: 1. patient already on adt 2. patients who are visiting clinic for a second opinion only 3. patients with a diagnosis of dementia 4. patients with a diagnosis of a neuromuscular disorder (i.e. multiple sclerosis)

Keywords: prostate cancer men androgen deprivation therapy elderly geriatric nutritional supplementation
a prospective cohort study of proton and photon therapy for left-sided breast cancer.

Conditions: Breast Cancer

Summary: the goal of this study is to investigate the differences in toxicity and efficacy between proton and photon hypofractionated radiotherapy following lumpectomy or mastectomy for breast cancer. the main questions it aims to answer are: 1. what is the difference in the incidence of radiation-related grade 2 or higher adverse events within two years following proton versus photon therapy after breast-conserving surgery? 2. what is the difference in the incidence of radiation-related grade 2 or higher adverse events within two years following proton versus photon therapy after mastectomy?


Eligibility criteria:
inclusion criteria: 1. histologically confirmed invasive breast cancer. 2. indications for adjuvant radiotherapy following lumpectomy or mastectomy for left breast cancer: 1. post lumpectomy: patients who have undergone lumpectomy with postoperative pathology staged as pt1-3 n1-3, excluding n3c. 2. post mastectomy: patients who have undergone mastectomy, with postoperative pathology staged as pt1-3 n1-3, excluding n3c, and who have had an implant (prosthesis or tissue expander) placed. 3. neoadjuvant therapy patients: patients who have received neoadjuvant chemotherapy or endocrine/targeted therapy and have a postoperative stage of ypt1-3 n0-3, excluding n3c, requiring radiotherapy to the chest wall/breast and regional lymphatic drainage areas. 4. no distant metastasis. 5. age range: 18-80 years. 6. performance status: eastern cooperative oncology group (ecog) score of 0-2. 7. non-pregnant and non-lactating women. 8. informed consent: patients must provide written informed consent prior to receiving radiotherapy. exclusion criteria: 1. presence of ductal carcinoma in situ (dcis). 2. tumor staging: patients presenting with t4, n0, or n3c disease. 3. history of prior radiotherapy to the ipsilateral chest or breast. 4. surgical margin status: margins are either positive or close, defined as: invasive carcinoma within 1 mm of the surgical margin. 5. bilateral breast cancer: patients with synchronous or previous contralateral breast cancer.

Keywords: breast cancer proton therapy photon therapy
flapless mini-incision implant surgery

Conditions: IMPLANTATION; Dental Implant; Dental Implant Placement; Peri-Implant Tissues

Summary: evaluate the clinical efficacy of the flapless mini-incision method compared to conventional flap and flapless punch methods


Eligibility criteria:
inclusion criteria: * adult patients with adequate bone height and width at the site of implant 120 placement, and good quality bone to support a primary stability of at least 30 ncm and d2 bone quality according to lekholm and zarb classification), based on preoperative radiographic assessment * clinical evidence of optimal periodontal health with no active periodontal disease in adjacent teeth * no history of systemic illnesses that could affect bone health and wound heal- ing (e.g. uncontrolled diabetes mellitus, osteoporosis, renal osteodystrophy...etc.) * no history of or requirement for bone grafting and augmentation at the implant site * willingness to participate in the study and attend prescribed follow-up appointments exclusion criteria: * patients with history of radiation therapy for head and neck cancer * patients with history of allergy and hypersensitivity to local anesthetic agents, and biomaterials used in dental implants * pregnant women and lactating mothers * history of smoking (\>2 cigarettes per day) * patients under treatment with anti-resorptive or anti-neoplastic medication such as bisphosphonates, chemotherapeutic agents, and monoclonal antibodies (e.g. denosumab

Keywords: flapless surgery mini-incision surgery peri-implant soft tissue dental implant
exercise as an adjuvant to aphasia therapy

Conditions: Aphasia

Summary: the purpose of the study is to reveal if individuals who participate in aerobic activity demonstrate greater improvement in language abilities than patients who do not participate in aerobic activity.

the objective of this research project is to reveal if individuals who participate in aerobic activity demonstrate greater improvement in language abilities with treatment than patients who do not participate in aerobic activity. as secondary objectives, we will determine if there is a direct relationship between either brain efficiency or increases in brain derived neurotrophic factor (bdnf) after exercise and higher learning rates in aphasia.

Eligibility criteria:
inclusion criteria: * post-stroke aphasia * at least 6 months post-stroke * at least minimally intact auditory verbal comprehension * pre-morbidly right handed * native english speaker exclusion criteria: * contraindications for fmri (metal implants, claustrophobia) * inability to pass an exercise tolerance test * significant depression * uncorrected hearing or vision problems * severe apraxia of speech * regularly perform 20 minutes of cardiovascular exercise 3 times per week

Keywords: rehabilitation aphasia exercise bdnf
flossing technique with neuromuscular reeducation exercises in trained subjects

Conditions: Weight, Body

Summary: introduction. a deficit of dorsiflexion and motor control can limit the performance of a squat. neuromuscular reeducation exercises, mobility and elasticity are used in the neuromuscular control and mobility of the kinetic chain. the flossing technique is applied to improve ankle mobility and the perception of effort. objective. to compare the efficacy of a protocol for neuromuscular reeducation exercises, mobility and elasticity, and the flossing technique in ankle mobility and perception of effort when performing squats. study design. randomized, multicenter, single-blind clinical study with a follow-up period. methodology. 40 weightlifters included in the study will be assigned randomly to the study groups: experimental (protocol of reeducation exercises plus the application of the flossing technique) and control (protocol of reeducation exercises). the intervention will last 4 weeks, with two weekly sessions of 15 minutes each. the variables of the study will be the range of movement of ankle dorsiflexion (weight bearing lunge test) and the perception of the effort during the squat (borg scale). a descriptive statistical analysis will be carried out calculating the main statistical characteristics. the distribution of the sample will be analyzed using the kolmogorov-smirnof test. in case of homogeneity, parametric tests will be used to calculate changes after each evaluation (t-student) and the intra- and intersubject effect (repeated measures anova). expected results. improvement in dorsiflexion of the ankle and decrease in the perception of effort during the squat.


Eligibility criteria:
inclusion criteria: * from 18 to 24 years old * male * that they be weight lifters with at least one year of experience * that they do not present musculoskeletal injury or pathology in the three months prior to the beginning of the study exclusion criteria: * can not be present during the 6 weeks of the intervention and the evaluations will be excluded * under pharmacological treatment * who are performing another physiotherapy study * not sign the informed consent document.

Keywords: weightlifters flossbands clinical trial physical therapy squat
evaluation of the quality of care in the emergency department by studying the appropriateness of hospitalizations

Conditions: Quality of Care; Evaluation; Emergency Department; Appropriateness

Summary: the aim of this study is to develop, study and validate a rigorous and sustainable method for assessing the clinical appropriateness of the decision taken in the emergency department to admit or not to admit patients.

the information normally recorded in the emergency department medical record will be used, as well as the available clinical and administrative databases. for reasons of feasibility, the investigators will also restrict the analysis to patients coming to the emergency department with non-specific manifestations in the pulmonary, cardiovascular and abdominal districts, represented by one or more of the following symptoms: dyspnoea, chest pain, transient loss of consciousness, abdominal pain.

Eligibility criteria:
inclusion criteria: all patients aged 18 years and over who arrived at participating centres between 1 january 2023 and 31 december 2024. exclusion criteria: all patients under 18 years of age arriving at participating centers between january 1, 2023 and december 31, 2024 and all patients arriving at participating centers outside the time frame january 1, 2023 - december 31, 2024.
inflammatory targeted laser treatment of knee osteoarthritis

Conditions: Knee Osteoarthritis

Summary: this study is conducted to evaluate the effectiveness of low-level laser therapy (lllt) as an adjunct to exercise therapy in knee osteoarthritis (koa).


Eligibility criteria:
inclusion criteria: * any gender * age ≥ 50 years * pain on movement ≥ 40 mm visual analog scale * knee pain for the last ≥ 3 months * koa verified with the american college of rheumatology criteria using a history and physical examination, i.e. knee pain and at least three of the following: ≥ 50 years old, ≤ 30 minutes of morning stiffness, crepitus on active range of motion, bony tenderness, bony enlargement, and no palpable warmth of synovia exclusion criteria: * knee alloplastic * total meniscectomy * intra-articular steroid injection and/or oral steroid treatment within the last six months * cancer * rheumatoid arthritis * severe cognitive deficit * neurological deficits affecting the knee * inability to speak and understand english/norwegian

Keywords: knee osteoarthritis inflammation photobiomodulation low-level laser therapy double-blind randomized clinical trial rct
insulin action during pregnancy in woman at high risk for gestational diabetes

Conditions: Gestational Diabetes Mellitus

Summary: the project objective is to validate a new indirect estimate of insulin status in both pregnant african-american women and caucasian women in southern louisiana who are at risk for gestational diabetes mellitus. there are racial differences in carbohydrate metabolism that are potentially linked to complications during pregnancy and to increased risks of obesity and diabetes in later life. the investigators will explore the use of indexes of insulin status to identify the metabolic risk profile of pregnant women which may vary by race. understanding whether there are differences which vary by race may influence clinical screening and treatment of pregnant women.

the major goal of our proposed study is to validate a new approach to estimating insulin sensitivity and ß-cell function in african-american women compared to non-hispanic white women in southern louisiana who are at a high risk for gestational diabetes mellitus (gdm). we will determine whether the whole body insulin sensitivity index (wbisi) and insulinogenic index (igi) \[derived from an oral glucose tolerance test (ogtt)\] can be used during 24-28 weeks of pregnancy to accurately estimate the degree of insulin resistance relative to ß-cell function in women with gdm in those with impaired glucose tolerance (igt) as well as those who are glucose tolerant. fasting values will also be assessed using the homeostasis model assessment (homa-ir and homa-%b) to evaluate insulin resistance and ß-cell function. we will explore the potential use of these measures to define the metabolic risk profile of these pregnant women and compare them with obstetric outcomes. we will determine if there are differences in risk that vary by race. second, given the high likelihood that women who manifest gdm will develop type 2 diabetes mellitus (dm), identification of these patients by ethnic group or other independent determinants will permit intervention after delivery that might delay or prevent the onset of type 2 dm.

Eligibility criteria:
inclusion criteria: * 18-42 years of age * at 20-30 weeks of gestation * caucasian or african-american and non-users of medications known to influence carbohydrate metabolism. exclusion criteria: * \ 42 years of age * non-caucasian or non-african-american ethnicity * use of drugs that could interfere with glucose or insulin metabolism; or health problems such as diabetes mellitus or liver, heart, lung and kidney diseases

Keywords: insulin sensitivity insulin secretion infant outcome