Kornimate/medical-research-clean huggingface dataset:
role of eplerenone in reducing recurrence of atrial fibrillation in patient with structural heart disease

Conditions: Paroxysmal Atrial Fibrillation

Summary: the aim of this study is to study synergistic effect of eplerenone as selective aldosterone receptor antagonist with amiodarone compared with amiodarone only in reducing recurrence of atrial fibrillation in patient with structural heart disease

atrial fibrillation is the most common sustained arrhythmia, with a rising prevalence that substantially increases the risk of stroke and heart failure (1,2), the rate of recurrences without antiarrhythmic treatment is 71%-84%, and it can be reduced to 44%-67% with antiarrhythmic drug therapy(3) mineralocorticoid receptor blockers (mrbs) are beneficial in systolic hf\[ 4,5,6\]. specifically, the mrb eplerenone (epl) has been shown to reduce new onset af and recurrent af in hf patients (7). both angiotensin ii and aldosterone elevations may lead to atrial fibrosis and contribute to human af (8). experimental results suggest that aldosterone may cause a substrate for atrial fibrosis and af (9). aldosterone increases the expression of 11β-hydroxysteroid dehydrogenase type 2 (11b-hsd2) leading to up-regulation of profibrotic mediators and collagen synthesis, which is prevented by mrbs (10). the european society of cardiology (esc) guidelines identify af as secondary to structural heart diseases (shds)when a left ventricle (lv) systolic or diastolic dysfunction is demonstrated or lv hypertrophy, valvular disease, and/or other shds are documented \[11\].currently, shd includes: (a) heart failure with reduced ejection fraction (hfref, previously severe or moderate lv systolic dysfunction); (b) heart failure with preserved ejection fraction (hfpef, previously lv diastolic dysfunction); (c) valvular heart disease (vhd) and (d) specific cardiomyopathies, such as hypertrophic cardiomyopathy (hcm) \[12\]. electrical remodelling is the first mechanism that occurs at the onset of af and promotes af through a re-entry-prone substrate. changes in atrial frequency are determined by changes in the physiology of ion channel activation\[13\] amiodarone is an antiarrhythmic medication used to treat and prevent a number of types of cardiac dysrhythmias,it blocks the channels that are upregulated by remodelling such as inward-rectifying k1 current (ik1) or by stimulation of the sympathetic nervous system.\[14\]

Eligibility criteria:
inclusion criteria: - paroxysmal af who reverted to sinus rhythm either medically or electrically without appropriate secondary cause of primary af •af attack should be documented with ecg exclusion criteria: * 1-patients are currently on eplerenone or spironolactone 2-hyperkalemia 3-impaired renal function(if crcl \ 2 mg/dl) 4-patient on beta blocker and calcium channel blocker (non- dihydropyridine) 5-prosthetic valve 6-severe mitral stenosis 7-thyroid dysfunction 8-wpw 9-severe liver disease 10-persistent or permanent af 11-pregnancy or breast feeding 12-lv ef\<50% 13-known hypersensitivity or drug reaction to amiodarone 14-acute coronary syndrome 15-refusal of consent
study of periodontitis and blood stream infection in aml patients receiving chemotherapy

Conditions: Acute Myeloid Leukemia

Summary: this is a prospective, observational study to establish the connection between periodontitis and bsi in aml patients planning to receive intensive chemotherapy.

once eligibility is confirmed, participants will undergo a specialized baseline periodontal examination, gingival sulcus microbiota sampling and saliva sample at baseline before starting chemotherapy. patients will be separated into 2 cohorts, with periodontitis (arm a) and without periodontitis (arm b). all patients will receive standard oncologic supportive care including antibiotic prophylaxis. serum samples will be obtained at baseline, at the onset of neutropenic fever, and weekly until day 28 or discharge (whichever sooner). study participation will continue during the duration of standard of care chemotherapy for 28 days or until discharge from hospital, whichever later.

Eligibility criteria:
inclusion criteria: * age \>18 years * diagnosis of aml, new diagnosis or relapsed/refractory disease * planned intensive inpatient chemotherapy, defined as expected hospitalization for 4 weeks or longer * sufficient time to perform periodontal examination and treatment by the end of day 1 of chemotherapy without delaying chemotherapy * written informed consent prior to performance of any research related activities exclusion criteria: * unstable for transfer to the school of dentistry * fever at the time of enrollment * documented blood stream infection at the time of enrollment * inherited bleeding diathesis * periodontitis requiring treatment before starting chemotherapy * anc \<0.5 x 10\^9/l at the time of enrollment * unstable for transfer to the school of dentistry * fever at the time of enrollment * documented blood stream infection at the time of enrollment * inherited bleeding diathesis * periodontitis requiring treatment before starting chemotherapy

Keywords: bsi periodontitis aml
optimization lumbar puncture in children

Conditions: Spinal Puncture Complications

Summary: the study is carried out in a prospective randomized controlled way. in the context of informed understanding from parents, compared with traditional process(no anesthesia; lying without the pillow and fasting water and food for four hours after lumbar puncture), randomly select lidocaine surface anesthesia and postoperative management (lying without the pillow for half an hour after lumbar puncture) . all children will be evaluated by the flacc(the face,legs,activity,cry,consolability behavioral tool) scale to assess the degree of pain during and after lumbar puncture. lumber puncture time, success rate and any postoperative condition will be recorded and analyzed.a questionaire about the operation for all parents and children will be investigated in order to establish an optimized lumbar puncture management process.

the purpose of this study is to establish an optimized lumbar puncture management process on the basis of fully understanding of parents and children. an improved process consisting of painless lumbar puncture (lp),less postoperative complications and comfortable lp will be anticipated.

Eligibility criteria:
inclusion criteria: * children with indications of lumbar puncture; * voluntarily signed the informed consent exclusion criteria: * topical anesthetic skin allergies; * skin infection in lumbar puncture site; * severe intracranial hypertension; * unstable vital signs; * coagulopathy; * intracranial hemorrhage and occupying; * low back pain; * headache and low back pain before lumbar puncture; * past headache after lumbar puncture; * mental retardation, neuropsychiatric symptoms; * children could not immediately act after the lumbar puncture(such as disturbance of consciousness or suffering from underlying diseases or drainage); * the case with repeated puncture in one operation
transection versus ligation of internal spermatic vessels in laparoscopic fowler-stephens orchidopexy

Conditions: Cryptorchidism

Summary: this is a comparative study to see the outcome of yransection versus ligation of internal spermatic vessels in first stage laparoscopic fowler-stephens orchidopexy for intra-abdominal testis in assisting the descent of the testis to the base of scrotum during the second stage

cryptorchidism is one of the most commin congenital deformities of male newborns, known as undescended testis (udt). the incidence ranges according to gestational age, affecting 1.0-4.6% of full-term infants and 1.1-45% of preterm infants. (udt) is a condition in which the testicles are not found at the base of the scrotum. studies have shown that the undescended testicle has a potential of spontaneous descent during the first 3 months of life and is less likely to do so after 6 months of age. in almost 20% of cases the undescended testes are not palpable, increasing the difficulty of investigations and treatment, and 30% of these cases are also intra-abdominal. if udt left untreated, it can cause histological alterations of the testicular cells and increasing of the risks of infertility. as of treatment of udt, laparoscopic surgery is ,for most surgeons, the preferred technique. several techniques have been described for laparoscopic orchidopexy. after spermatic vascular transection, single-stage testicular descent fixing was carried out, as fowler and stephens (fso) first described in 1959. since 1996, a two-stage laparoscopic fowler-stephens technique involving preservation of the gubernacular vessels and performing an entirely laparoscopic second stage. the second stage is presently performed 6-9 months after the first. recently, laparoscopic fso has been adopted to treat high-level iats, for its minimally invasive wound and acceptable success rate.

Eligibility criteria:
inclusion criteria: all patients with unilateral or bilateral impalpable testis exclusion criteria: 1. previous laparotomy surgery 2. previous ventriculo-peritoneal shunt 3. previous laparoscopy for impalpable testis (outside study) 4. previous inguinal/scrotal surgery 5. disorder of sexual differentiation 6. abnormal karyotyping 7. intra-operative inguinal testis 8. ipsilateral testis : peeping/ vas internal internal ring / vanished / streak / ovotestis / ovary. 9. contralateral : streak/ ovotestis/ ovary
non-invasive hemodynamic monitoring during blood donation for developing models of early blood loss

Conditions: Hemorrhage

Summary: this study is part of a phase ii sttr project to develop an algorithm called ciphersensor to apply feature extraction and machine learning techniques to non-invasive hemodynamic data to identify early signs of acute blood loss. the availability of this information may help to establish required interventions for treating trauma patients and battlefield casualties. study hypothesis: hemodynamic changes measured non-invasively during the blood donation process can be modeled to provide early estimations of blood loss.


Eligibility criteria:
inclusion criteria: * approved by children's hospital colorado blood donation center for blood donation * age 18 -89 years * previously donated blood (lower likelihood of vasovagal response) exclusion criteria: * pregnant * incarcerated * limited access to or compromised monitoring sites for non-invasive sensors: finger, ear and forehead sensors, oral/nasal cannula, 3 ecg electrodes.

Keywords: hemorrhage
3-week study to evaluate efficacy and safety of ziprasidone with either lithium or divalproex in acutely manic subjects

Conditions: Bipolar Disorder

Summary: 3-week study to evaluate efficacy and safety of ziprasidone with either lithium or divalproex in acutely manic subjects


Eligibility criteria:
inclusion criteria: * subjects must have a primary diagnosis of bipolar i disorder, most recent episode manic (296.4x), or mixed (296.6x) as defined in diagnostic and statistical manual of mental disorders - text revision (dsm-iv tr) and determined by the mini international neuropsychiatric interview (mini). * at screening and at baseline (within 12 hours prior to the first dose of double-blind medication) subjects must have a young mania rating scale score of 18 or higher. * subjects must be actively receiving lithium or divalproex for their bipolar disorder in order to be considered for this study. exclusion criteria: * subjects with a diagnostic and statistical manual of mental disorders iv- text revision (dsm-iv tr) diagnosis of schizophrenia (295.xx), schizoaffective disorder (295.70), schizophreniform disorder (295.40), delusional disorder (297.1), or psychotic disorder not otherwise specified (nos) (298.9). * subjects with other dsm-iv-tr axis i or axis ii disorders (in addition to bipolar i disorder) are ineligible if the comorbid condition is clinically unstable, requires treatment, or has been a primary focus of treatment within the 6-month period prior to screening.
the combined effect of 2,3-dimercaptosuccinic acid and multi-nutrients on children in lead poisoning

Conditions: Lead Poisoning

Summary: lead poisoning remains a common disease among children despite successful public health efforts that reduced its prevalence.our study was designed to test the hypothesis that lead-poisoning children (blls:100-440µg/l) who were given dmsa and multi-nutrients would have a greater fall than children of other groups at 12 weeks of follow-up.


Eligibility criteria:
inclusion criteria: * initial blls 100-440µg/l * age 3-6y * no more than two main residences * house cleaned (no lead contaminated) * normal intake history and physical exclusion criteria: * chelation in the past 12 weeks * concomitant fe deficiency(ferritin\<16ng/ml) * hemoglobin\<10.5g/dl * medications affecting mineral metabolism

Keywords: 2,3-dimercaptosuccinic acid blood lead levels children multi-nutrients
antihypertensive and pap treatment in obstructive sleep apnea patients with hypertension (ahpap)

Conditions: Obstructive Sleep Apnea; Hypertension; Death, Cardiac; Treatment Compliance; Heart Failure; Stroke

Summary: the investigators will perform a long term registry based prospective analysis on incidence of major cardiovascular events or death in hypertensive patients with obstructive sleep apnea . effects of pap (positive airway pressure) compliance, antihypertensive medication and blood pressure control will be investigated in the study.

by using swedish personal id numbers the investigators can combine data from several quality registries in sweden and will start with patients from a primary care registry (qregpv) that had or received a hypertension diagnosis during the period 2008-2012. the investigators will compare those who got an osa diagnosis in the sesar (swedish sleep apnea registry) stratified by high/low pap compliance with an intraoral device group, a non treated osa group as well as a control group without osa until 2021. main outcome variables will be major cardiovascular events or death. outcome data will be collected from the national patient registry and cause of death registry. groups will be matched by propensity score for known confounders. secondary analysis will consider modifying effect of different antihypertensive drugs (the swedish prescribed drug register, type of therapy; ddd comparison) and the actual degree of hypertension control (blood pressure levels) on cv risk. it is intended to stratify the analysis for bp levels in order to evaluate if lower bp targets further reduce cv risk in hypertensive osa patients. these analyses will likely be reported in separate publications. hypothesis 1. pap treatment in hypertensive osa patients reduces the long term risk of major cardiovascular events (mce) and premature death. the risk reduction is modified by pap compliance, hypertension control and osa severity. 2. in hypertensive osa patients, the investigators previously identified betablockade as a drug class leading to better pressure control (1). the investigators hypothesize that any risk reduction by pap treated osa is influenced by the types of antihypertensive drugs used. 3. lower blood pressure targets (ie better bp control) may reduce the risk of cardiovascular events in pap treated osa patients.

Eligibility criteria:
inclusion criteria: * all hypertensive and obstructive sleep apnea patients present in qregpv and sesar 2008-2021. exclusion criteria: * patients in the hypertensive control group (without osa) will be excluded if they have osa diagnosis but are not present in the sesar registry. * subjects with missing data on any of the variables in the fitted model unless the missing data can be accurately imputated. * patients with low life expectancy (age\>75 at study start, malignant disease). * patients no longer living in vgr 2021.

Keywords: continous positive airway pressure antihypertensive treatment risc prevention
prospective register on the etiologies of cardiogenic shock and their prognosis at one year.

Conditions: Cardiogenic Shock

Summary: cardiogenic shock (cc) is one of the major challenges of current cardiology. despite the difficulty of establishing a strict and consensual definition, it is accepted that the cc clinically corresponds to persistent hypotension (systolic blood pressure 90 mmhg for at least 30 minutes or need for vasopressor support) associated with signs of visceral hypoperfusion (confusion, mottling, oliguria, hyperlactatemia), and hemodynamic with a lowered heart index ( 1.8 l/min/m2) despite appropriate or high filling pressures. this definition of the european society of cardiology (esc) masks however the great variability of hemodynamic tables grouped under the term of cc and severity levels, also variable.however, it was suggested that the etiology of cc influenced both its hemodynamic profile and therefore its therapeutic management but also its prognosis in the medium and long term.

cc diagnosis remains difficult to carry on admission and is sometimes delayed. therefore, we would like to compare hemodynamic data from patients with cc status to those admitted for acute heart failure (ica) to determine if a hemodynamic variable at entry would facilitate the diagnosis of cc.

Eligibility criteria:
inclusion criteria: * patients in cardiac shock : * 90 mmhg hypotension or requiring inotropic or vasopressor support, * owered cardiac output ( 1.8 l/min/m2) to trans-thoracic cardiac ultrasound with high or normal filling pressures * peripheral hypoperfusion. patients admitted for acute heart failure (ica) (acute pulmonary edema chart or left congestive heart failure without cc sign and with ultrasound fevg at entry 40%.) exclusion criteria: * pregnant or nursing women * age 18 years * person of full age under guardianship * staying in a health or social facility * person not covered by a social security scheme * person deprived of liberty * shocks from other etiologies * patient with initial cardiac arrest * patient with cardiogenic shock due to right ventricular dysfunction * patient with pulmonary embolism * patient with tamponade * refusal to participate
intracoronary cocktail injection combined with thrombus aspiration in stemi patients treated with primary angioplasty

Conditions: ST-elevation Myocardial Infarction

Summary: this is a randomized, double blind, placebo controlled study of intracoronary cocktail injection combined with thrombus aspiration versus thrombus aspiration alone in st-elevation myocardial infarction patients treated with primary angioplasty.

this is a randomized, double blind, placebo controlled study of intracoronary cocktail injection combined with thrombus aspiration versus thrombus aspiration alone in st-elevation myocardial infarction patients treated with primary angioplasty. patients with stemi will be randomized into the cocktail group or the control group. patients in the cocktail group will receive cocktail injection combined with thrombus aspiration. patients in the control group will receive thrombus aspiration alone. the primary outcome of the cocktail i study is the composite of death, myocardial infarction or class iv heart failure within 1 year. the secondary outcome of the cocktail i study include slow reflow/no reflow during pci, left ventricular function, quality of life, stroke or life-threatening bleeding within 1 year.

Eligibility criteria:
inclusion criteria: * 18-80 years of age adult patients with stemi referred for primary pci within 5d of symptom onset exclusion criteria: * patients who had undergone previous coronary artery bypass surgery or pci or had received fibrinolytic therapy history of stroke active bleeding severe hepatic or renal dysfunction cardiogenic shock contraindications for primary pci or dapt
effect of instability on power and speed in bench press

Conditions: Instability, Joint

Summary: the aim of this study was to analyse and compare the speed and power parameters in bench press training in different degrees of instability: 1) stable (pbe), 2) with asymmetric load (pba), 3) with oscillating load (pbo), 4) on fitball (pbf) and 5) on bosu (pbb). for this purpose, 20 male subjects (10 trained and 10 untrained) with specific experience in training under unstable conditions were evaluated with respect to mean propulsive velocity (mpv), maximum velocity (mv) and power (pot) with different types of external load: low load (40% of 1rm), medium load (60% of 1rm) and high load (80% of 1rm) in each condition.

therefore, the aim of this study was to analyse the effect of different degrees of instability on power and speed of execution in the bench press exercise. for the design of this quasi-experimental research, with an ad hoc protocol, an intersubject comparison was used in 5 different conditions. 20 male participants were grouped into two groups based on their previous experience with unstable training and volunteered for this study. expert group (n= 10; 23.70 ± 4.30 years; 81.40 ± 9.67 kg; 179.50 ± 8.95 cm; 3.5 ± 4.10 years of strength training experience; 9 ± 10.60 months of unstable training experience) novice group (n= 10; 25.60 ± 6.50 years; 77.80 ± 4.44 kg; 176.40 ± 2.80 cm; 3.40 ± 1.96 years of strength training experience; 0.90 ± 0.99 months of unstable training experience). subjects with no experience in training with unstable loads (having implemented unstable loads in their training at some point) or current or recent injuries (within the last 6 months) that caused them to alter their normal physical activity were excluded from this study. this study was in accordance with the declaration of helsinki (2013). all participants gave written informed consent prior to the study. subjects performed the bench press exercise by assessing mean propulsive velocity and power with 3 different loads for each of the unstable situations: light (40% of 1rm), moderate (60% of 1rm) and high (80% of 1rm). in a familiarisation session, subjects performed the relative loads with each condition to determine their strength-velocity profiles and their optimal work percentages. in addition, an incremental load test was performed to determine the 1rm of each of the participants to determine the external load for each load percentage in each of the subjects.

Eligibility criteria:
inclusion criteria: * two years of continuous strength training experience * a minimum of 6 months of suspended training experience exclusion criteria: * athletes who presented pain or skeletal or neuromuscular disorder

Keywords: strength training unstable devices balance speed training core
the effects of adding expiratory muscle strength training in voice therapy

Conditions: Dysphonia; Unilateral Vocal Cord Paralysis

Summary: evaluate if adding expiratory muscle strength training to traditional voice therapy for individuals with dysphonia due to glottal insufficiency improves maximal expiratory pressure, acoustic and aerodynamic measures (i.e. amplitude, maximum phonation time, peak expiratory flow), and voice related quality of life.


Eligibility criteria:
inclusion criteria: * individuals with glottic insufficiency. * adequate cognition evidenced by score of 24 or higher on the mini-mental state examination (mmse) survey to determine if the subject has the mental capacity to participate in therapy * completed voice combination evaluation with speech pathologists and otolaryngologist. * individuals 18 years of age or older exclusion criteria: * adults unable to consent * non english or spanish speakers * pregnant women * prisoners * individuals with significant uncontrolled chronic and progressive respiratory diseases including copd, interstitial lung disease, and cystic fibrosis. * individuals with uncontrolled blood pressure. * individuals with significant gi disease and/or gastroesophageal surgery with the exception of well-controlled gerd. * individuals with a history of abdominal hernia. * individuals with difficulty complying due to neuropsychological dysfunction (e.g., severe depression, psychosis). * individuals with other neurological disorders and/or neuromuscular disease other than parkinson's disease