Kornimate/medical-research-clean huggingface dataset:
utility of ultrasound in identification of midline and placement of epidural in severely obese parturients

Conditions: Epidural Anesthesia; Spinal Ultrasound; Obesity

Summary: this study will address the utility of ultrasound in the placement of an epidural catheter in severely obese parturients. identification of midline can often be difficult using the standard method of palpation in obese patients. the investigator will determine if the use of ultrasound decreases the amount of time and number of attempts required to place the epidural.

the use of ultrasound has expanded into many areas of medicine including the identification of bony landmarks to facilitate epidural placement in obstetric anesthesia. using ultrasound for epidural placement has become popular over the last decade with several studies being published on the topic. the likely increase in popularity for ultrasound use in the obstetric population is the need to more reliably locate bony landmarks as the traditional palpation technique has been shown to be an inaccurate way to accomplish this. given the fact that the long-taught palpation technique can be inaccurate and studies have validated the use of ultrasound for epidural placement, ultrasound technique is routinely taught by the obstetric anesthesiologists to the anesthesiology residents at the university of alabama at birmingham (uab). also, since both techniques are considered standard practice at uab, anesthesia providers (residents, fellows, and faculty) are free to choose either technique to locate bony structures of the back prior to epidural placement. since no current study has specifically addressed its use in the obese pregnant patient, the investigators would like to validate its use in this population. in this study, investigators will evaluate the use of ultrasound in the obese population to determine if its use will decrease the time it takes to place the epidural and number of attempts required when compared to the traditional palpation technique. the study will also determine the success rate of epidural placement in both the palpation and ultrasound groups.

Eligibility criteria:
inclusion criteria: * patient request for a labor epidural * bmi≥35 exclusion criteria: * bmi\<35 * patient refusal of a labor epidural * coagulopathy * platelets\<80,000 * prior spine procedure or instrumentation * a diagnosis of scoliosis * an intracranial or spinal mass
oral treprostinil in subjects with pulmonary hypertension associated with pulmonary fibrosis

Conditions: Pulmonary Hypertension; Pulmonary Fibrosis

Summary: this multicenter, randomized, open-label study will assess the safety and efficacy of oral treprostinil in subjects diagnosed with pulmonary hypertension associated with pulmonary fibrosis.

this study will evaluate how oral treprostinil can affect pulmonary vascular resistance, as assessed by right heart catheterization, and exercise capacity, as assessed by the six-minute walk test. this is a 16-week study that will involve at least 10 clinical trial centers. the expected enrollment period is around 24 months and 52 subjects will be entered into the study.

Eligibility criteria:
inclusion criteria: * voluntarily gives informed consent * must meet criteria for lung transplant referral but is not required to be on an active lung transplant list * stable and significant diffuse parenchymal lung disease with a diagnosis of interstitial lung disease * 6mwd greater than or equal to 75 meters * right heart catheterization with a mean pulmonary arterial pressure \>= 30 mghg, pulmonary capillary wedge pressure \ 240 dynes * echo-doppler examination showing evidence of right ventricular dysfunction and normal left diastolic ventricular function * either not receiving any pah-approved oral therapy, or is receiving monotherapy (era, pde-5i, or riociguat) for \> 60 days and receiving a stable dose for \> 30 days prior to enrollment * able to communicate effectively with study personnel and will to be cooperative with protocol requirements exclusion criteria: * history of repaired or unrepaired congenital heart disease * received prostanoid therapy in the past 30 days, or has shown an intolerance or lack of efficacy to prostanoid therapy resulting in discontinuation or inability to titrate prostacyclins * diagnosis of sarcoidosis * history of thromboembolic disease * chronic renal insufficiency * pregnancy or lactating * currently receiving an investigational drug, has an investigational device in place, or has participated in an investigational drug or device study within 30 days prior to screening
klotho in chronic kidney disease-associated pruritis (ckd-ap)

Conditions: Chronic Kidney Disease-associated Pruritus

Summary: studying whether klotho and fgf23 have a role in up and whether their expression change by bb-uvb with the improvement of pruritus.

uremic pruritus (up), also known as chronic kidney disease-associated pruritus (ckd-ap), is the most common cause of generalized pruritus (gp). up is multifactorial; not due to a single cause but as a result of combined action of multiple factors. up has a major clinical impact because it is strongly associated with poor quality of life, impaired sleep, depression, and increased mortality. up patient always feels he is drained and distressed. alpha klotho is the protein product of the anti-aging klotho gene. this protein exists in two forms: soluble klotho (s-klotho) and membranous klotho (m-klotho). the kidney is the principal organ that produces, regulates, and metabolizes klotho. membranous klotho acts as a co-receptor to enhance the binding of fibroblast growth factor 23 (fgf23) to fgf receptors (fgfrs) through the formation of klotho/fgfr/fgf23 complex. interestingly, soluble klotho can also bind to fgf23/fgfr, but it prevents high fgf23-induced toxicity. in chronic kidney disease( ckd), soluble klotho is still detectable although it is much lower than in healthy human beings, suggesting that it is produced from extrarenal organ(s) or tissue(s) not yet identified which may be the skin. fgf23 is a peptide released from bone tissue osteocytes and osteoblasts. it plays an important role in the bone-kidney axis and the regulation of calcium and phosphate homeostasis. in ckd, klotho is linearly decreased prior to the rise of fgf23 so it is considered a biomarker for early detection of kidney damage. klotho deficiency contributes to vascular and soft-tissue calcification in ckd patients. in ckd-ap patients, there is metastatic micro-calcification due to calcium deposition in skin and this is one of the etiological causes of up. whether klotho has a role in this assumption is still unclear. phototherapy is a proven method for the management of many pruritic disorders. narrowband ultraviolet b (nb-uvb) can be considered as a feasible treatment option for ckd-ap. one of its possible mechanisms is the reduction of skin calcium-ion content. whether this is via changing klotho expression is still unknown. therefore, our study aims at knowing whether klotho and fgf23 have a role in up and whether their expression change by nb-uvb with the improvement of pruritus.

Eligibility criteria:
inclusion criteria: * patients with ckd on dialysis. * age \>18 years old. * both sexes. exclusion criteria: * age \<18 years old. * any contraindication to phototherapy (e.g, past skin cancer) for those with pruritus.
effect of rtms in combination with a low-carbohydrate diet in patients with obesity

Conditions: Obesity; Anxiety

Summary: in the present study the investigators want to evaluate if the application of rtms can reduce the anxiety and craving in patients with obesity helping them to follow a low carb-diet, as well as, to assess the changes in weight, body mass index and quality of life before and after rtms or sham rtms.

participants completed a written, informed consent and rtms adult safety questionnaire. the inclusion criteria are: individuals between 25 and 60 years of age with obesity in stage 1, 2 or 3. the exclusion criteria were: subjects with metabolic disorders, neurological condition, epilepsy, or pregnancy. the study conformed to the declaration of helsinki and was approved by the institutional medical research ethics committee (hospital ajusco medio, mexico df). the protocol will be applied as follows: 10 rtms or sham sessions during two weeks. following these two week, patients will receive 8 more sessions on weeks 4, 6, 8, 10, 12, 16, 20 and 24. diet will be indicated during all the protocol. the sham group will receive sham rtms sessions for two weeks, the additional sessions will be performed in the same manner thar in rtms group.

Eligibility criteria:
inclusion criteria: * bmi \> 30 exclusion criteria: * thyroid problems, anorexia, bulimia, epilepsy, schizophrenia

Keywords: transcranial magnetic stimulation obesity diet
incidence of cholelithiasis after bariatric surgery in sohag university hospital

Conditions: Cholelithiasis

Summary: to study the incidence and predictors of developing symptomatic gallstone disease following bariatric surgery.

to study the incidence and predictors of developing symptomatic gallstone disease following bariatric surgery. a retrospective study with prospective collective data will be conducted including all patients underwent bariatric surgery in general surgical department, sohag university between january 2015 and december 2022 who did not have gallstones in the preoperative abdominal ultrasound examinations. medical records will be reviewed. demographic data such as age, gender, bmi, comorbidities as ( dm, hypertension and hyperlipidemia ) and time elapsed between the surgery to post-surgery us examination. the findings of the us examinations will be collected and analyzed. data will be analyzed to obtain descriptive and inferential statistics.

Eligibility criteria:
inclusion criteria: * all adult patients underwent bariatric surgery with minimum postoperative follow up period of one year duration will be included in the study. exclusion criteria: * patients who had cholecystectomy during the bariatric surgery. * pediatric age.
study of d-mapps™ ophthalmic solution, safety, tolerability, and efficacy in the treatment of chronic ocular graft-versus-host disease (ogvhd)

Conditions: oGHVD

Summary: a double-masked, randomized, placebo-controlled study of the safety, tolerability, and efficacy of d-mapps™ ophthalmic solution in the treatment of chronic ocular graft-versus-host disease (oghvd)


Eligibility criteria:
inclusion criteria: * age ≥ 18 years. * willing and able to provide written informed consent. * willing and able to comply with study assessments for the full duration of the study. * patients may be using bilateral scleral lenses and/or bilateral punctal plugs at the time of accrual. * minimum oxford schema grad of ≥ 1 in at least one eye. * osdi scored of ≥ 22. * unc dems score of ≥ 3. * in good stable overall health. exclusion criteria: * history of rheumatoid arthritis, lupus, scleroderma. * ocular or periocular malignancy. * significant change, as judged by the principal investigator, in systemic immunosuppressive regimen within 2 weeks of study entry. * any history of topical tacrolimus use. * any change in dosage of tetracycline compounds (tetracycline, doxycycline, and minocycline) within the last month. * any change in frequency of preserved anti-glaucoma medications within 2 weeks of study entry. * current use of topical steroids more than twice a day. * corneal epithelial defect \> 1mm2. * any history of herpetic keratitis. * participation in another simultaneous medical research study. * signs of current infection, including fever and current treatment with antibiotics. * all vaccination including covid are prohibited during this study. * signs of current infection, including fever and current treatment with antibiotics. * all vaccinations including covid are prohibited during this study. * intra-ocular surgery or ocular laser surgery within 3 months. * women who are pregnant, breastfeeding, or plan to become pregnant while participating in the study. if of childbearing potential, unwillingness to use effective birth control while participating in the study. * any condition (including language barrier) that precludes patient's ability to comply with study requirements including completion of study.
clinical trial to evaluate the effect of valsartan on insulin sensitivity in subjects with impaired glucose tolerance

Conditions: Hypertension; Impaired Glucose Tolerance

Summary: the purpose of this study is to determine if 24 weeks of treatment with valsartan (80 mg - 320 mg) improves insulin sensitivity in subjects with higher than normal glucose levels using a test called the euglycemic clamp.


Eligibility criteria:
inclusion criteria: history or presenting hypertension elevated fasting blood glucose levels - exclusion criteria: pregnancy potential diabetes mellitus other criteria apply -
breath hold techniques for radiotherapy of esophageal carcinoma

Conditions: Esophageal Cancer

Summary: the main objective of the first part of the study is to determine the most optimal method for dibh (active breathing control vs voluntary coached) and its reproducibility. based on these findings, one of these methods will be selected for part 2 of this study.


Eligibility criteria:
inclusion criteria: * histologically proven esophageal cancer of the mid or distal esophagus * scheduled for external-beam photon radiotherapy with curative intention. * who 0-2. * age \>= 18 years * written informed consent. exclusion criteria: * serious respiratory distress * contra-indication for fiducial marker placement * noncompliance with any of the inclusion criteria
randomized trial of active vs passive splinting for extensor tendon injuries in zones iv to vi

Conditions: Hand Injuries; Tendon Injuries

Summary: this study compares two methods of post-operative immobilization after surgical repair (tenorrhaphy) of extensor tendons in the fingers. patients were randomly assigned to receive either a standard plaster splint or an alternative splinting method that allows controlled finger movement (icams). the main goal was to determine which method leads to better recovery in terms of finger mobility, grip strength, pain, and patient comfort.

extensor tendon injuries of the hand are commonly treated with immobilization for 4-6 weeks using a plaster splint in the intrinsic plus position. however, prolonged immobilization may lead to tendon adhesions, joint stiffness, and delayed return to function. this randomized controlled clinical trial evaluated the efficacy of an immediate controlled active motion splinting protocol (icams) compared to classic immobilization (ci) following extensor tendon tenorrhaphy in zones iv, v, and vi. thirty patients were randomly assigned to either group. functional outcomes were assessed at 4 and 6 weeks post-injury, including grip strength, joint range of motion, pain (vas), quick-dash score, and patient satisfaction. the icams group showed significantly better results in all main functional parameters. these findings support the use of early active motion protocols in selected cases of extensor tendon injury to enhance recovery and patient comfort.

Eligibility criteria:
inclusion criteria: * adults aged 18 years or older * patients from the chuvi health area * diagnosed with an acute, single, complete extensor tendon laceration in zones iv, v, or vi of the long fingers * treated with primary tenorrhaphy * provided signed informed consent * agreed to attend follow-up visits and comply with the study protocol exclusion criteria: * more than one extensor tendon laceration in the same hand * injuries involving the thumb * tendon injuries with loss of substance * associated injuries at the same level (e.g., bone fracture, nerve lesion) * patients with cognitive impairment or inability to follow the protocol * presence of other injuries or medical conditions that could interfere with assessment

Keywords: classic immobilization hand surgery postoperative rehabilitation extensor tendon repair icams finger tendon zones iv to vi controlled motion splint
simplification of oral sodium loading test in the diagnosis of primary aldosteronism: 2-day replacing 3-day method

Conditions: Primary Aldosteronism

Summary: to compare the consistency of 24-hour urinary aldosterone in the diagnosis of primary aldosteronism by oral sodium loading test between the second day method and the third day method

this is an exploratory and prospective study of 17 healthy controls and 15 patients with primary aldosteronism, in which each participant will receive a high-sodium diet for 3 days to conduct a confirmatory test for primary aldosteronism. the consistency between the 2-day and 3-day oral sodium loading test for the diagnosis of primary aldosteronism is compared by measuring the 24-hour urinary aldosterone levels of the participants on the second and third days of the high-sodium diet. the study aims to explore whether the 24-hour urinary aldosterone level on the second day can replace the 24-hour urinary aldosterone level on the third day for the diagnosis of primary aldosteronism.

Eligibility criteria:
pa patients: inclusion criteria: * patients with hypertension and hypokalemia who have been diagnosed with primary aldosteronism following the latest version international guidelines for primary aldosteronism. * age: 20-70 years old, male and female; * bmi: 18.5-23.9 kg/m2; exclusion criteria: * other causes of endocrine hypertension including pheochromocytoma, cushing syndrome, etc. * renal artery stenosis and low potassium due to other factors, such as renal tubular acidosis, bartter syndrome, gitelman syndrome, etc. * history of hyperthyroidism, hepatic and renal insufficiency, malignant tumors, metabolic diseases, cardiovascular diseases, and mental diseases,menstrual disorders healthy volunteers inclusion criteria: * age: 20-70 years old, male and female; * bmi: 18.5-23.9 kg/m2; * blood pressure: 90-120/60-80 mmhg on three consecutive office blood pressure readings; * female must have regular menstrual cycle (blood and urine samples should be taken during the non-menstrual period); * regular dietary habits; * no medications taken within the past 1 month. exclusion criteria: * history of hypokalemia. * history of liver and kidney dysfunction, malignant tumors, metabolic disorders, cardiovascular diseases, and psychiatric disorders, etc. * menstrual irregularities and taking contraceptive pills. * history of hypertension * have taken any drugs including anti-inflammatory drugs, potassium diuretics, or special health products in the 4 weeks prior to the examination,

Keywords: diagnose the oral sodium loading test
a study to evaluate persistence of immune responses after post-exposure prophylaxis of rabipur® (purified chicken-embryo cell rabies vaccine) in chinese children

Conditions: Virus Diseases

Summary: the purpose of this study is to evaluate the long-term persistence of immune responses approximately 5 years or more after simulated rabies post-exposure prophylaxis provided in 2012 according to essen (1-1-1-1-1) or zagreb (2-1-1) intramuscular (im) regimens in the subset of subjects who participated in the parent study (v49_24 \[nct01680016\]) who were aged ≥6 and ≤17 years at the time of enrollment. this study is aimed to respond to a post-marketing commitment by the china food and drug administration (cfda) requested at the time of the renewal of the purified chicken-embryo cell rabies vaccine license in china, granted in august 2015.


Eligibility criteria:
inclusion criteria: 1. subjects with age ≥ 6 and ≤17 at the time of enrollment in the parent study who signed the informed consent prior to the extension study entry, who received the full pep in the parent study according to either the zagreb or essen intramuscular regimens. 2. subjects who or whose parent(s)/legal guardian(s) have voluntarily given written informed consent/assent for this extension study after the nature of the study has been explained according to local regulatory requirements, prior to study entry. 3. individuals who can comply with study procedures. exclusion criteria: prior to extension study entry, each subject must not have: 1. documented medical history of exposure to rabies or rabies prophylaxis after completion of the parent study (v49_24 \[nct01680016\]) and before study start. 2. participated in the parent study (v49_24 \[nct01680016\]) but not received the full pep vaccination course (or received it out of window) following assignment to either zagreb or essen regimen during the parent study. 3. progressive, unstable or uncontrolled clinical conditions. 4. clinical conditions representing a contraindication to blood draws. 5. abnormal function of the immune system resulting from: 1. clinical conditions. 2. systemic administration of corticosteroids for more than 14 consecutive days within 90 days prior to informed consent for all age groups. 3. administration of antineoplastic and immunomodulating agents or radiotherapy within 90 days prior to informed consent for all age groups. 6. received immunoglobulins or any blood products within 180 days prior to informed consent for all age groups. 7. study personnel as an immediate family or household member. 8. any other clinical condition that, in the opinion of the investigator, might pose additional risk to the subject due to participation in the study.

Keywords: persistence purified chicken-embryo cell rabies vaccine rabies virus neutralizing antibody (rvna) immunogenicity post-exposure prophylaxis (pep) rabipur
neuromuscular ultrasonography utility for detection of peripheral neuropathy in systemic lupus erythematosus

Conditions: Peripheral Neuropathy; System; Lupus Erythematosus

Summary: this study aims to evaluate the rule of nmus in detection of peripheral neuropathy in sle patient and to correlate it to traditional neurophysiological studies, clinical signs and activity of sle.

the frequency of sle peripheral neuropathy documented by electrophysiology has been estimated to be approximately 30%. the term peripheral neuropathies include symmetric polyneuropathy, single and multiple mononeuropathy, and radiculopathy. there has been increasing interest in using ultrasonography (us) to aid peripheral neuropathy diagnosis and studies have shown good correlation with other imaging modalities. us is a non-invasive and inexpensive imaging device that has become widely available as a diagnostic tool at many fields. so systemic lupus patients were enrolled in the study , performed nerve conduction study and neuromuscular ultrasound for bil. median, ulnar, peroneal, tibial and sural nerves , on statistics the cross sections were compared in neurophusiologically affected and non affected nerves, also the sensitivity and specifity of nmus in comparison to the traditional ncs was calculated

Eligibility criteria:
inclusion criteria: 1. all adult sle patients who was admitted to rheumatology \& rehabilitation department of assuit university hospital during time frame of study. 2. apparently healthy subjects with normal electrophysiological study 3. verbal consent, free and informed exclusion criteria: * • other causes of peripheral neuropathy: 1. traumatic 2. purely degenerative 3. diabetic 4. toxic 5. infections 6. drug induced

Keywords: neuromuscular ultrasound sle peripheral neuropathy