Kornimate/medical-research-clean huggingface dataset:
prospective descriptive study of injuries associated to anterior shoulder dislocations in patients over 40 years

Conditions: Anterior Glenohumeral Dislocations

Summary: the glenohumeral joint has the highest rate of dislocation of the whole body, due to its high mobility and the special characteristics of its anatomy. it is estimated that every year between 1-2% of the population will suffer from glenohumeral dislocation. the vast majority of studies are based on young patients under the age of 40, given that at this age they have the higher incidence and at the same time, they have higher redislocation index. however, the investigators are in front of a more active population with a longer life expectancy. that is why the cases of anterior glenohumeral dislocations are increasing in people older than 40 years. given that most studies focus on younger patients, the investigators lack knowledge about which injuries are associated with dislocation at this age and whether these influence its clinical evolution.


Eligibility criteria:
inclusion criteria: * more than 40 years old * first episode of traumatic anterior gelnohumeral dislocation seen in rx * acceptance to be checked over 2 years * acceptance to be submitted to tac, nmr, emg and bilateral ultrasound exclusion criteria: * previous fractures in this extremity * previous neurovascular lesions in this extremity * other associated lesions * cognitive alterations or dementia which prevent completing the protocols. patients with \<14 points in mini-mental test.
brain dynamics in different stages of arousal and anesthesia

Conditions: Epilepsy

Summary: the principle aim of this project is to characterize the changes in relative stability of the intrinsic brain dynamics during onset of sleep and induction of general anesthesia. the investigators hypothesize that brain dynamics in the awake state are critical akin to physical systems close to a second order phase transition and that during loss of consciousness the dynamics move away from the critical point.

1. once the electrode array is placed during the first surgery (on the day of admission) we will record brain activity as subjects are waking up from anesthesia 2. while subjects are staying at new york presbyterian hospital before the second surgery we will record brain activity. most of the recordings will be performed as subjects are going to sleep naturally, but other recordings will be acquired during waking hours. this will not interfere with normal monitoring of seizure activity. 3. final recording session is immediately before the second operation as general anesthesia is gradually induced. during this time subjects may be asked to follow simple commands like: "open your eyes" in order to determine the level of consciousness. also during this session, if arterial line is placed by the anesthesiologist for real-time blood pressure monitoring we will collect several small (\~1 ml) blood samples to determine blood concentration of anesthetics. approximately 1 teaspoon of blood will be obtained in total. no additional venipuncture will be necessary. no additional invasive procedures will be performed for the purposes of the study. we will use the same electrode array as is typically used for monitoring and mapping of epilepsy. subjects will receive the same anesthetic agent as is commonly used for induction of anesthesia for this surgery (propofol). subjects will be monitored in the same way as is normally done during surgical procedures and during your stay at new york presbyterian hospital. as a part of the study subjects may be asked simple questions as they go under anesthesia. we may collect several small blood samples (described above) to determine the concentration of anesthetic agents.

Eligibility criteria:
inclusion criteria: 1.patients referred for epilepsy resection surgery with dr. theodore schwartz exclusion criteria: 1. patient refusal. 2. patients requiring rapid sequence induction because of concerns about delayed gastric emptying as a result of diabetes or other medical conditions. 3. age less than 15 or greater than 65 years old. 4. pregnant or nursing. 5. inability to follow simple commands such as "open your eyes" and "squeeze my hand" for any reason. 6. severe mental disability. 7. allergy to propofol or any components of the formulation. 8. poor suitability for propofol infusion because of other medical concerns such as severe heart disease. 9. patients deemed to have a difficult airway thus necessitating awake fiberoptic intubation. 10. patients with severe sleep apnea requiring cpap/bipap.

Keywords: epilepsy
evaluating image quality and comfort of an investigational curved paddle compared to a standard paddle

Conditions: Breast Cancer

Summary: the goal of this study is to evaluate patient comfort during compression with a standard flat mammographic paddle and an investigational curved paddle. this is a study that will be performed with x-ray imaging and will be used to determine if an overall reduction in pain can be appreciated in patients without loss in image quality as compared to the current standard mammogram. another benefit of the curved paddle may be an increase of perceivable and measurable tissue capture.

the study will be conducted in the united states at up to 5 centers. the study will enroll up to 600 subjects. the number of subjects was chosen to allow evaluation of screening and diagnostic patients with a variety of breast densities (fatty, scattered densities, heterogeneously dense or extremely dense) and women with a range of breasts sizes that fit on the current detector. the evaluation of pain reduction will be the primary endpoint, while examining the potential of increased tissue capture without a compromise in image quality will be assessed as secondary endpoints. the enrollment will be consecutive for subjects who sign informed consent to participate. women participating in the study will present for a screening or diagnostic imaging exam.

Eligibility criteria:
inclusion criteria: * subject is female of any race and ethnicity * screening subject is at least 40 years old, diagnostic subjects are at least 25 years old * subject will be referred for a screening or a diagnostic work-up with tomosynthesis as part of the exam exclusion criteria: * subjects who are pregnant or who think they may be pregnant * subjects lactating or presenting with discharge * women too large for the detector * subjects who cannot give informed consent

Keywords: breast cancer tomosynthesis 3d mammogram diagnostic mammogram
kaletra or lexiva with ritonavir combined with epivir and abacavir in naive subjects over 48 weeks

Conditions: HIV Infection; Infection, Human Immunodeficiency Virus

Summary: this study will compare the ability of fosamprenavir 700 mg with ritonavir 100 mg twice a day or lopinavir 400 mg with ritonavir 100 mg twice a day both combined with a fixed dose combination tablet of abacavir 600 mg and lamivudine 300 mg once a day to suppress virus levels of hiv to less than 400 copies/ml of blood. in addition we will study the safety and tolerability of these compounds over the 48 week study period in patients naive to anti-hiv therapy.

a phase iiib, randomized, open-label, multicenter study of the safety and efficacy of gw433908 (700mg bid) plus ritonavir (100mg bid) versus lopinavir/ritonavir (400mg/100mg bid) when administered in combination with the abacavir/lamivudine (600mg/300mg) fixed-dose combination tablet qd in antiretroviral-naive hiv-1 infected adults over 48 weeks

Eligibility criteria:
inclusion criteria: * hiv infected subjects that are naive to anti-hiv therapy. * history of a positive hiv test. * at least 1000 copies/ml of hiv in their blood as screening. exclusion criteria: * active hiv-related diseases. * taking other investigational drugs. * pregnant or breastfeeding females. * not be suitable to participate per investigator opinion.

Keywords: ritonavir abacavir hiv lopinavir lamivudine fosamprenavir epzicom
efficacy and safety of local glucocorticoids for the treatment of acute radiation-induced intestinal injury

Conditions: Radiation-Induced Intestinal Injury

Summary: due to the increasing number and prolonged survival of malignant tumor patients treated with radiotherapy, the complication, such as acute radiation-induced intestinal injury, has become increasingly significant. glucocorticoids may play a therapeutic role by regulating the inflammatory response in patients with acute radiation-induced intestinal injury. however, the conclusions of related studies were controversial.

a total of 60 patients with acute radiation-induced intestinal injury will be enrolled. they will be randomly assigned at a 1:1 ratio into glucocorticoid group and standard treatment group. the primary endpoint is the recovery and improvement of acute radiation-induced intestinal injury. the secondary study endpoints include the recurrence and aggravation of radiation-induced intestinal injury, and adverse events.

Eligibility criteria:
inclusion criteria: 1. grade ii-iii acute radiation-induced rectosigmoid injury 2. signed informed consents 3. age ≥18 years 4. rstimated survival time \>1 year exclusion criteria: 1. absolute contraindications to glucocorticoids 2. a history of glucocorticoids treatment within 3 months 3. inflammatory bowel disease or infectious intestinal disease 4. recurrence of malignant tumor 5. colorectal cancer or metastasis 6. severe heart or lung diseases 7. recent history of surgery or trauma 8. poorly controlled hyperglycemia and hypertension 9. active tuberculosis 10. ssevere gastrointestinal ulcers 11. glaucoma 12. sychiatric diseases 13. pregnant or lactating

Keywords: radiation-induced intestinal injury glucocorticoid
a cross-sectional study looking at the effect of radiotherapy on carotid intima-medial thickness in head and neck cancer

Conditions: Head and Neck Tumours

Summary: some patients with head and neck cancer or benign tumours of the head and neck receive radiotherapy to their neck as part of their treatment. the carotid arteries are often included in the radiotherapy as collateral structures. there is some evidence to show that radiotherapy to these blood vessels can result in thickening of the artery walls some years after treatment and increased risk of stroke or tia in the future. current research is now aimed towards detecting radiotherapy-related changes to the carotid arteries at an earlier stage and towards using new radiotherapy techniques to avoid treating these blood vessels if possible. the question of whether or not the use of preventive medicines like aspirin and cholesterol-lowering tablets helps to reverse this process is currently unanswered. the aim of this study is to measure the thickness (intima-medial thickness) of irradiated carotid artery walls and compare this to unirradiated arteries. there are many other causes for thickening of arteries (such as high blood pressure, high cholesterol levels and diabetes) and these may affect the ability to measure the effect of radiotherapy change to the artery wall. in order to address this, it is ideal to look at this process in patients who have only had one side of their neck treated and use the other side as a comparison. the study will also be looking for earlier signs of radiotherapy-related changes, such as stiffening of the artery wall, inflammation in the artery wall (a very early sign of radiotherapy-related change) and some markers in the blood that may indicate that this process is taking place. the null hypotheses of this study are: * in irradiated carotid arteries, the mean intimal-medial thickness will be the same compared to unirradiated arteries. * serum biomarkers will not be elevated in radiation-induced carotid atherosclerosis. * development of radiation-induced carotid atherosclerosis is not affected by risk factor modulation (aspirin, hmgcoa reductase inhibitors, smoking cessation). * there is no difference in carotid arterial wall strain in irradiated carotid arteries versus unirradiated carotid arteries. * microbubble ultrasound will not be able to detect inflammation in the carotid arteries as an early marker of atherosclerosis.


Eligibility criteria:
inclusion criteria: * be 18 years or older * histologically confirmed cancer or benign tumours of the head and neck area treated with hemi-neck radiotherapy to ≥ 50gy * received radiotherapy to the neck area more than 24 months previously * intervening neck dissection allowed * be able to provide written informed consent exclusion criteria: * patients who have active head and neck cancer * patients with a prior history of carotid endarterectomy or carotid angioplasty and stenting
to demonstrate non-inferiority of combination of 5 mg amlodipine/ 80 mg valsartan to 160 mg valsartan alone

Conditions: Hypertension; High Blood Pressure

Summary: the purpose of the study was to assess efficacy and safety of fixed dose combination of 5 mg amlodipine/80 mg valsartan compared to 160 mg valsartan monotherapy in lowering blood pressure in taiwanese patients.


Eligibility criteria:
inclusion criteria: * participants over 18 years of age with hypertension defined as sitting systolic blood pressure between 140 mmhg and 180 mmhg or sitting diastolic blood pressure between 90 mmhg and 120 mmhg. * high risk participants ( defined as having: (diabetes mellitus, chronic renal disease, framingham 10-year risk score \>10%, established coronary artery disease (cad), or cad equivalents including carotid artery disease, peripheral arterial disease (pad), abdominal aortic aneurysm (aaa))with hypertension defined as sitting systolic blood pressure between 130 mmhg and 180 mmhg or sitting diastolic blood pressure between 80 mmhg and 120 mmhg. exclusion criteria: * known or suspected secondary hypertension * known new york heart association (nyha) functional class iv heart failure * history of myocardial infarction, transient ischemic attack or cerebrovascular accident within the preceding 3 months * clinically significant valvular disease * women who are pregnant, intend to become pregnant or are breastfeeding * participants who have severe medical condition(s) that in the view of the investigator prohibits participation in the study * participants who have hypersensitivity to the investigational/ reference drug or any of the components in the formulation. * other protocol-defined inclusion/exclusion criteria may apply

Keywords: hypertension valsartan amlodipine high blood pressure
the effect of home-based exercise on functional capacity of covid-19 survivor with cardiovascular comorbidity

Conditions: Covid19; Breathing Exercise; Cardiovascular Diseases

Summary: objective propose: to investigate the effect of home based breathing exercise and chest mobilization on the cardiorespiratory functional capacity of covid-19 survivors with cardiovascular comorbidity. breathing exercise and chest mobilization are proven to increase lung functional capacity in covid-19 survivors. it is hypothesized that breathing exercise and chest mobilization in covid-19 survivors will give benefits to covid-19 survivors with cardiovascular disease.

lung restrictive disorder is one of the reasons that induce chronic fatigue in covid-19 (corona virus disease-19) survivors. it also gives a significant effect on cardiovascular patients who are in the second phase of cardiac rehabilitation. breathing exercise and chest mobilization are proven to increase lung functional capacity in covid-19 survivors. on the other hand, there is still no research that shows the effectiveness of breathing exercises and chest mobilization in covid-19 survivors who are suffering from cardiovascular problems. patients in national cardiac center hospital, jakarta, with a history of covid-19 and have cardiovascular disease are recruited. they will undergo pre and post-exercise examinations such as blood sampling, do 6 minutes walking test, peak cough flow and peak flow rate test, measuring the chest dimension, treadmill, and answer the european quality of life five dimension (eq-5d) questions. with randomization, patients will be determined to treatment or control group. they will be prepared about what exercises should they do at home. subjects will be supervised digitally and regularly through zoom meetings. exercises will be done for 3 months.

Eligibility criteria:
inclusion criteria: * patients who got infected by covid-19 in 3 months before recruitment and suffering cardiovascular disease * able to communicate and operate youtube and zoom. exclusion criteria: * limitation to move any part of the body that causes the inability to do the instructed exercise. * feel pain in extremities (visual analog scale \>3) * chronic obstructive pulmonary disease * neuromuscular disorder (stroke, peripheral neuropathy with significant motoric control disturbance * musculoskeletal disorder (fracture, post amputation, severe arthritis in support joints)
cryotherapy for breast cancer trial

Conditions: Breast Carcinoma

Summary: the purpose of this study is to evaluate the clinical feasibility and safety of the icesense3tm cryotherapy system for the ablation of small malignant invasive breast tumors.


Eligibility criteria:
inclusion criteria: * unifocal primary invasive ductal breast carcinoma diagnosed by core needle biopsy. patients with contralateral disease will remain eligible. note: results of er, pr, her-2/neu must be obtained on pre-registration needle core biopsy material. * tumor size ≤ 2.0 cm in greatest diameter as measured by breast ultrasound, mri and mammogram. the largest dimension measured will be used to determine eligibility. * tumor enhancement on mri * tumor with \<25% intraductal components in the aggregate. * non-pregnant and non-lactating patients. patients of childbearing potential must have a negative serum or urine pregnancy test. note: peri-menopausal women must be amenorrheic for \> 12 months to be considered not of childbearing potential. * adequate breast size for safe cryoablation. patients with breasts too small to allow safe cryoablation are not eligible as the minimal thickness of the breast tissue does not lend itself to cryoablation. note: the minimal distance of tumor margins from the breast skin should be analogous to the surgical margins of a lumpectomy. exclusion criteria: * patients with multifocal and/or multicentric ipsilateral breast cancer, multifocal calcifications, or evidence of excessive dcis. * history of rotational vacuum assisted core biopsies, en bloc open surgical biopsy and/or lumpectomy for diagnosis/treatment of the index breast cancer. * prior or planned neoadjuvant chemotherapy for breast cancer. * patients with thrombocytopenia and or any other coagulation abnormality

Keywords: small malignant invasive breast tumors
clinical characteristics and prognosis of stemi patients undergoing primary percutaneous coronary angioplasty and angiographic data

Conditions: STEMI - ST Elevation Myocardial Infarction

Summary: gensini score (gs) provides valuable information on severity and prognosis of coronary artery disease (cad). we aim to evaluate the relationship between the severity of cad determined by the gs and short and long term of st-elevation myocardial infarction (stemi) patients undergoing primary percutaneous coronary intervention.


Eligibility criteria:
inclusion criteria: * patients with stemi underwent primary pci within 24 hours after first symptoms exclusion criteria: patients with stemi 24 hours after first symptoms pregnant patient \<18 years old

Keywords: stemi, gensini,
an open label trial to decrease signs and symptoms of orthostatic hypotension using midodrine or intravenous fluid bolus in patients following total hip arthroplasty

Conditions: Orthostatic Hypotension

Summary: orthostatic hypotension following total hip arthroplasty is known to limit the ability of patients to perform physical therapy (pt) and increase the length of hospital stay and costs. our goal is to prospectively study the effects of oral midodrine on the signs and symptoms of orthostatic hypotension in 20 patients and the effects of intravenous fluid on the signs of symptoms of orthostatic hypotension in 10 patients. midodrine will be administered to patients with suspected low svv, and an intravenous fluid bolus will be administered to patients with low co. 120 patients will be consented with a view to studying 30 patients who meet the inclusion criteria for orthostatic hypotension. patients who receive midodrine or the fluid bolus will undergo hemodynamic measurements at 30 min, 1 hr, 2 hrs, 3 hrs, and 4 hrs post-intervention. all patients will undergo measurements for blood pressure, arterial augmentation index, and heart rate at baseline (pre-op; holding area) and the time of first pt attempt. patients will be monitored up to post-operative day 3. the working hypothesis is that midodrine or fluid therapy will significantly raise the mean arterial blood pressure (map) by 5 mmhg+ and/or cause a significant change in the orthostatic hypotension questionnaire (characterized by a two-point improvement in symptom score).


Eligibility criteria:
inclusion criteria: * patients of participating surgeons undergoing unilateral primary total hip arthroplasty * ages 18-90 * english-speaking * if the patients are diagnosed with orthostatic hypotension (fall in sbp of at least 20 mmhg or dbp of at least 10 mmhg within 3 min of assuming a sitting/standing position) exclusion criteria: * body mass index \> 40 * low ejection fraction (\<50%) * clinical diagnosis of congestive heart failure * aortic insufficiency characterized as greater than moderate * severe uncontrolled hypertension * symptomatic bradycardia (hr \< 50 bpm and symptoms) * creatinine \> 1.2 mg/dl * hepatic insufficiency * severe respiratory disease in which supplemental oxygen is required * history of severe urinary retention * use of mao inhibitors * severe supine hypertension (sbp \>= 150 mmhg or dbp \>= 90 mmhg) * history of visual problems and using fludrocortisone acetate * contraindication for repeated bp measurements * revision tha and additional procedures * clonidine use
short-course antimicrobial therapy in sepsis

Conditions: Infection; Sepsis; Severe Sepsis; Septic Shock

Summary: the purpose of this study is to compare the effect of a short course antimicrobial therapy (5-days) versus a 10-days therapy on sepsis-related organ dysfunction.


Eligibility criteria:
inclusion criteria: * patients who received antibiotics for presumed infection exclusion criteria: * prolonged therapy (eg, endocarditis) * severe immunosuppression * severe infections (due to viruses, parasites, or mycobacterium tuberculosis) * patients previously infected or colonized with multidrug resistant pathogens and moribund patients.
hand grip test and transradial coronary procedures

Conditions: Radial Artery Occlusion

Summary: transradial coronary procedures are gaining in popularity worldwide. a possible complication of transradial approach is the occlusion of the radial artery that in most cases is asymptomatic. however the investigators do not know if the radial artery occlusion may impact over the muscle force of the hand or fingers. to evaluate if transradial approach for percutaneous coronary procedures may affect muscle force of the hand, thumb and index finger the investigators use a standardized hand-grip manometer and a pinch gauge before the transradial procedure, the day after the procedures and after few months.


Eligibility criteria:
inclusion criteria: stable patients who undergo elective percutaneous transradial coronary procedures exclusion criteria: * hemodynamic instability, * acute coronary syndromes, * haemodialysis patients with an arteriovenous fistula, * sheath diameter \> 6 french, * age \< 18 years

Keywords: transradial approach radial occlusion hand grip coronary angiography