Kornimate/medical-research-clean huggingface dataset:
monitoring of hemodynamics in heart failure patients by intracardiac impedance measurement

Conditions: Heart Failure

Summary: heart failure (hf) is one of the most frequent diagnoses upon hospitalization and is a major cause of death. cardiac resynchronization therapy (crt) using an implantable device for synchronous bi-ventricular stimulation leads to improvement of hemodynamic parameters, physical capacity and quality of life. a continuous measurement of the left-ventricular volume would provide information about heart performance and could be used for both heart failure monitoring and optimization of crt-therapy.


Eligibility criteria:
inclusion criteria: * de novo crt-patients * planned implantation with a lumax 740 hf-t device, a bipolar lv-lead and a true bipolar rv-lead * nyha class ii or iii * qrs ≥ 150 ms * lvef between 15% and 35% * lvedd ≥ 55 mm * evaluable echo measurements exclusion criteria: * persistent or permanent atrial fibrillation * heart surgery within the previous 3 months or planned for the time of study participation; post-heart transplantation or listed for heart transplantation * non-ambulatory patients * chronic renal dialysis * life expectancy less than 1 year due to a non-cardiac disease * age \< 18 years and/or limited contractual capability * addiction to alcohol, medical drugs or illegal drugs * pregnant or breast-feeding women * participation in another clinical trial

Keywords: heart failure implantable cardioverter-defibrillator intracardiac impedance measurement cardiac resynchronization therapy home monitoring reverse remodeling
piloting y-ambient: a quality of life intervention for young african american breast cancer survivors

Conditions: Breast Cancer; Anatomic Stage I Breast Cancer AJCC v8; Anatomic Stage IA Breast Cancer AJCC v8; Anatomic Stage IB Breast Cancer AJCC v8; Anatomic Stage II Breast Cancer AJCC v8; Anatomic Stage IIA Breast Cancer AJCC v8; Anatomic Stage IIB Breast Cancer AJCC v8; Anatomic Stage III Breast Cancer AJCC v8; Anatomic Stage IIIA Breast Cancer AJCC v8; Anatomic Stage IIIB Breast Cancer AJCC v8; Anatomic Stage IIIC Breast Cancer AJCC v8; Prognostic Stage I Breast Cancer AJCC v8; Prognostic Stage IA Breast Cancer AJCC v8; Prognostic Stage IB Breast Cancer AJCC v8; Prognostic Stage II Breast Cancer AJCC v8; Prognostic Stage IIA Breast Cancer AJCC v8; Prognostic Stage IIB Breast Cancer AJCC v8; Prognostic Stage III Breast Cancer AJCC v8; Prognostic Stage IIIA Breast Cancer AJCC v8; Prognostic Stage IIIB Breast Cancer AJCC v8; Prognostic Stage IIIC Breast Cancer AJCC v8

Summary: the purpose of this two-arm pilot rct is to evaluate processes and preliminary outcomes of a targeted qol intervention vs. an attention control among young aa survivors post-treatment for early (i-ii) \& late (iii) stage breast cancer.

primary objectives i. evaluate feasibility and acceptability of y-ambient and an attention control among young african american breast cancer survivors. ii. explore the degree to which the y-ambient vs. attention control affects preliminary health-related outcomes among young african american (aa) survivors. outline: patients are randomized to 1 of 2 arms. arm i (y-ambient): patients receive three themed education sessions over 1 hour each, written materials, and videos at month 1. patients also participate in 3, 20 minutes telephone reinforcement calls to discuss how they are doing and discuss any concerns that they are still managing at months 2, 3, and 4. arm ii (attention control): patients receive three themed education sessions over 1 hour each, written materials, and videos at month 1. patients also participate in 3, 20 minutes telephone reinforcement calls to discuss how they are doing and discuss any concerns that they are still managing at months 2, 3, and 4. after completion of study, patients are followed up at 1 month.

Eligibility criteria:
inclusion criteria: * biologically born women * self-identify as aa * are aged 18 to 44 years on study entry * are diagnosed with breast cancer stage i-iii * have completed treatment with chemotherapy and/or radiation for stage i-iii breast cancer prior to study entry * are english- speaking * have telephone and internet access exclusion criteria: * participation in formal survivorship navigation programs because they are associated with improved health- related outcomes, which could be a confounder
comparison of beta-blocker versus angiotensin receptor blocker for suppression of aneurysm expansion in patients with small abdominal aortic aneurysm and hypertension (base trial)

Conditions: Small Abdominal Aortic Aneurysm

Summary: various medical therapies have been proposed to prevent abdominal aortic aneurysm expansion. however, there have been very few randomized clinical trials to support use of any of these treatments. several animal studies and observational reports suggest that arbs can be useful in reducing abdominal aortic aneurysm (aaa) growth. however, so far, arbs have not been evaluated in a randomized clinical trial. therefore, the purpose of the study is to evaluate the effect of valsartan, an arb, on annual growth rate in comparison with atenolol, a beta-blocker. our hypothesis is that valsartan is superior to atenolol in the suppression of the aneurysm growth at 12 months. the base trial is designed as a investigator-initiated, multi-center, randomized controlled open-label trial. patients with small aaa (aorta diameter \ 4 cm or ≤4 cm). patients will receive either valsartan (daily dose 80 mg or more) or atenolol (daily dose 50 mg or more) for 12 months. a ct scan will measure the maximal diameter of aaa at baseline and 12 months. the annual growth of aaa will be compared between the valsartan and the atenolol group.


Eligibility criteria:
inclusion criteria: * age ≥20years * abdominal aortic aneurysm with maximal diameter less than 5cm * hypertension * patient with signed informed consent exclusion criteria: * saccular type aneurysm, inflammatory aneurysm, or infected aneurysm * aortic dissection * planned surgery or endovascular therapy for abdominal aortic aneurysm within 1 year * previous aorta surgery or endovascular therapy * contraindications to beta-blocker or arb (allergic reactions, asthma, severe bradycardia, angioedema, hyperkalemia) * allergic reaction to contrast dye * known genetic aorta disease or autoimmune or connective tissue disease: marfan syndrome, shprintzen-goldberg syndrome, loeys-dietz syndrome, takayasu's arteritis, behcet's disease * pregnancy * life expectation \<1 year * renal failure (serum cr \>2.0 mg/dl) * liver disease (alt or ast \> 3 x upper limit) or liver cirrhosis (child b or c) * malignancy requiring surgery or chemotherapy within 1 year after enrollment * status post transplantation or chronic inflammatory disease requiring immune suppressive drugs over 4 weeks
comparing pneumatic versus ultra-sonic percutaneous nephrolithotomy in large kidney stones

Conditions: Kidney Stone

Summary: the purpose of this study is to determine which type of percutaneous nephrolithotomy is better in large kidney stones

while there are several retrospective studies evaluating the efficacy of different lithotripter in percutaneous nephrolithotomy, there are few prospective studies in this regard. this study was designed to compare the efficacy and safety of ultrasonic versus pneumatic percutaneous nephrolithotomy in treatment of large kidney stones.

Eligibility criteria:
inclusion criteria: - patients with \>2cm kidney stone exclusion criteria: * pregnant women * patients with coagulopathies * patients with scattered stones who needed several accesses

Keywords: pneumatic ultra-sonic percutaneous nephrolithotomy
instrument assisted soft tissue mobilization versus myofascial release in patients with chronic non¬specific low back pain

Conditions: Myofascial Release; Instrument Assisted Soft Tissue Mobilization; Chronic Low-back Pain

Summary: this study was done to compare the effect of instrumental-assisted soft tissue mobilization versus the effect of myofascial release on pain intensity, pressure pain threshold, back function, and back range of motion in patients with chronic nonspecific low back pain.

low back pain affects 20% of the workforce annually, leading to increased work absenteeism. chronic non specific low back pain restricts functional and occupational activities, impacting society and the economy. treatment is often unsatisfactory, and there is no consensus on the optimal approach. further scientific research is needed to understand the effects of facial tissue manipulation on chronic non specific low back pain patients. the literature has not addressed the distinctions between myofascial force transmission instrumental assisted soft tissue mobilization and myofascial release on chronic non specific low back pain patients, which could help physical therapists find effective treatments. this study is the first to include pain, pressure pain threshold, back function, and range of motion as outcome measures and compare instrumental assisted soft tissue mobilization and myofascial release in chronic non specific low back pain patients.

Eligibility criteria:
inclusion criteria: 1. patients with chronic non-specific low back pain for more than 3 months. 2. age between 25-45 years. exclusion criteria: 1. patients who have serious spinal pathologies, such as fractures, tumors or inflammatory diseases (such as ankylosing spondylitis) 2. patients who have nerve root compromise, disk herniation, spondylolisthesis with neurological involvement, or narrowing of spinal canal 3. pregnant women 4. cancer patients . 5. lower limb injuries. 6. body mass index (bmi) greater than 25.
fatigue in multiple sclerosis: evaluated with 3 mri and transcranial magnetic stimulation

Conditions: Multiple Sclerosis; Fatigue

Summary: the purpose of this study is to investigate fatigue in patients with multiple sclerosis (ms) and to determine the correlation between the symptom and cerebral changes.

only recruiting from: department of neurology, aarhus university hospital, denmark

Eligibility criteria:
inclusion criteria: * relapsing remitting-multiple sclerosis (rr-ms) according to poser criteria * edss: max 3.5 * right handed * normal function of the right hand exclusion criteria: * disease interfering with ms * known dementia * drug or alcohol abuse * treatment with psychoactive drugs within one week before study entry * major changes of medical treatment within 3 weeks before study entry * attack within 4 weeks before study entry * pregnancy * conditions interfering with 3,4-diaminopyridine treatment * conditions interfering with mri * conditions interfering with transcranial magnetic stimulation

Keywords: motor fatigue cognitive fatigue
influence of sensory block duration on rebound pain after outpatient foot surgery under popliteal sciatic nerve block.

Conditions: Rebound Pain; Sciatic Nerve Block; Foot Surgery; Outpatient Surgery

Summary: rebound pain after surgeries under peripheral nerve block is defined as the appearance of severe acute postoperative pain after regression of the sensory block. the incidence of this condition can reach up to 40-50% in patients undergoing ambulatory surgeries. rebound pain represents a clinically significant issue that may outweigh the benefits of regional anaesthesia. this is particularly significant for painful outpatient surgeries, where inadequately managed pain can result in distress, potentially affecting patient satisfaction and recovery. it may also lead to unplanned utilization of healthcare resources or readmissions. orthopaedic foot surgery is a prevalent outpatient surgery, potentially painful, where rebound may be a difficult challenge. however, to date, prospective studies focusing specifically on rebound pain in outpatient foot surgery are limited. identifying conditions associated with rebound pain or at-risk patients could facilitate the development of preventive and treatment strategies, thereby enhancing pain management or relief. younger age, female sex and bone surgery are non-modifiable factors associated with severe rebound pain. perioperative intravenous dexamethasone has been identified as a modifiable independent risk factor associated with a reduced incidence of rebound pain. regarding anaesthetic factors, the duration of the peripheral block has been proposed as a potentially modifiable factor influencing rebound pain; however, current evidence does not support this hypothesis. the goal of this prospective observational study is to evaluate the incidence of rebound pain specifically in outpatient orthopaedic foot surgery involving bone under popliteal sciatic nerve block and to assess the possible association between sensory block duration and the incidence of rebound pain.


Eligibility criteria:
inclusion criteria: * adult patients (\>18 years old), asa physical status 1 to 3, scheduled for elective outpatient orthopaedic foot surgery involving bone under popliteal sciatic nerve block. exclusion criteria: * age younger than 18 years, asa physical status greater than 3, surgery not performed under popliteal sciatic nerve block or cases of failed sciatic nerve block, patients with type-1 diabetes or those under treatment for chronic pain.

Keywords: acute pain pain, postoperative rebound pain sciatic nerve block orthopedic procedures foot surgery outpatient surgery
reappraisal of the therapies of refractory autoimmune hemolytic anemia in systemic lupus erythematosus

Conditions: Autoimmune Hemolytic Anemia; Systemic Lupus Erythematosus

Summary: there is a deficiency in guidelines about the treatment of autoimmune hemolytic anemia in systemic lupus erythematosus (sle), especially in refractory cases. mycophenolate mofetil (mmf) showed promising results in those patients but still, the data available are in form of case reports. so, investigators will investigate the efficiency of mmf against a well-established treatment rituximab in the treatment of refractory autoimmune hemolytic anemia in sle patients.

there is a deficiency in guidelines about the treatment of autoimmune hemolytic anemia in systemic lupus erythematosus (sle), especially in refractory cases. mycophenolate mofetil (mmf) showed promising results in those patients but still, the data available are in form of case reports. so, the investigators will investigate the efficiency of mmf against a well-established treatment rituximab in the treatment of refractory autoimmune hemolytic anemia in sle patients.

Eligibility criteria:
inclusion criteria: * diagnosis of erythematosus (sle) according to the american college of rheumatology (acr) and the european league against rheumatism (eular) guidelines. * secondary autoimmune hemolytic anemia (aiha) that does not respond properly to corticosteroid or when the patients are intolerant to treatment, or refuse standard treatment. exclusion criteria: * pregnant or breastfeeding women. * any contraindication of the used drugs. * any known hypersensitivity of the used drugs. * congenital hemolytic anemia. * chronic renal failure.

Keywords: autoimmune hemolytic anemia systemic lupus erythematosus mycophenolate mofetil
propofol-induced eeg changes in hypoxic brain injury

Conditions: Hypoxic-Ischemic Encephalopathy; Cardiac Arrest

Summary: propea3 is a prospective observational study investigating the recovery of propofol-induced eeg slow-wave activity and its association with neurological outcome after cardiac arrest.

propea3 is a prospective observational study investigating the recovery of propofol-induced eeg slow-wave activity and its association with neurological outcome after cardiac arrest. comatose adult patients admitted to intensive care unit (icu) after cardiac arrest are included. patients with previous neurological disease expected to affect substantially eeg are excluded. the patients' relatives are asked for an informed written consent to participate. in the intensive care, the patients are sedated using continuous infusion of propofol while receiving temperature management/hypothermia treatment following the icus' common practice. eeg is recorded continuously from the admission to the icu until 48 hours from the cardiac arrest. eeg slow-wave activity is determined offline by calculating the low-frequency (\<1 hz) power from the signal. the neurological recovery of the patients is defined 6 months after cardiac arrest from patient documents and/or by phone call to the patient/relative using cerebral performance category. after the follow-up period patient or the relative is also asked to fill a survey (sf-36) to estimate the health and quality of life.

Eligibility criteria:
inclusion criteria: * comatose patients admitted to intensive care after cardiac arrest exclusion criteria: * previous neurological disease expected to affect eeg substantially

Keywords: eeg intensive care propofol
unwinding physician anxiety

Conditions: Anxiety; Burnout, Professional

Summary: the purpose of this study is to test an app-based mindfulness training program to see if it can reduce anxiety and burnout in physicians.

in this study, 50 clinicians will be provided access to the unwinding anxiety program. the intervention period will last 3 months and changes in anxiety and burnout along with program engagement will be assessed at baseline, 1 month, and 3 months.

Eligibility criteria:
inclusion criteria: * currently employed as a physician * direct patient interaction * owns a smartphone * endorsed anxiety based on answering yes to following questions: 1. do you feel nervous, anxious, or on edge? 2. do you feel you worry too much about different things? * endorsed willingness to use smartphone app for 10+ minutes/day for 30 days * endorsed willingness to complete online surveys exclusion criteria: * none

Keywords: physicians
monitoring side effects of pain medication prescribing by emergency department in patients over 65

Conditions: Acute Pain; Analgesics; Elderly

Summary: half of the people over the age of 65 are not functioning at their optimal level because of interference from pain. \> 50% of older adults had taken prescriptions of pain medication beyond a 6-month period. in emergency department 80% of visits involving conditions with painful component. the study aims to observe and check side effects of most frequently pain killers prescribing at home to patients over 65 years old after a visit in emergency department.

- observe side effects of pain medications prescribed in emergency department to patient over 65 yo

Eligibility criteria:
inclusion criteria: * 65 years or older * new analgesic treatment po following emergency department visits * easily reachable by phone exclusion criteria: * age under 65 * pt may not able to hear, or answer the phone * pt with a history of dementia * pt who already takes pain killer, or neuroleptics

Keywords: medication adherence medication compliance medication therapy management side effects analgesics emergency medicine home care aged acetaminophen codeine ibuprofen oxycodone
diagnostic algorithm for appendizitis (dialapp)

Conditions: Reduction of Negative Appendectomy Rate

Summary: the diagnosis of acute appendicitis remains a challenge in daily clinical practice. the high incidence of appendicitis drives the need to reduce morbidity and unnecessary costs due to negative appendectomies. the aim of the present observation study is to evaluate a diagnostic and therapeutic algorithm for suspected acute appendicitis. the investigators believe that this diagnostic algorithm helps to simultaneously avoid unnecessary operations, costs and radiation exposure.

this prospective observation study will be performed in the university hospital frankfurt with a 24-h emergency service, with surgery and radiology readily available. the data will be compiled on patients older than 18 years who will be admitted to the emergency unit with suspected appendicitis. during the study period, the clinical workflow is standardized. in all cases a resident of surgery and/or consultant surgeon clinically evaluate and perform an ultrasound scan on all patients with suspected appendicitis. with the use of clinical and laboratory results the physician (surgeon) will calculate the alvarado score and depending on the result the next diagnostic steps or the treatment will be chosen. additionally, the department of gynecology of the university hospital routinely evaluate all women of childbearing age. upon other terms following variables will be collected: age, gender, white blood cells (wbc), c-reactive protein (crp), alvarado score, visuell pain scale, ct scan results, pathologic findings, time between admission and operation, operation procedure, treatment and diagnosis of patients without operation, length of hospital stay, and 30-day complication rate. furthermore, there will be a follow-up of all patients (with and without operation) after 30 days and 6 months. the investigators assume that the use of a diagnostic and therapeutic algorithm reduces unnecessary negative appendectomies and optimizes the duration of the hospital stay and the costs.

Eligibility criteria:
inclusion criteria: * complete evaluation, examination and diagnostic pathways of the patients with suspected appendicitis in our university hospital exclusion criteria: * appendectomy during other operations

Keywords: acute appendicitis alvarado score negative appendectomy right abdominal pain
changes in attentional control after a focal seizure.

Conditions: Temporal Lobe Epilepsy; Frontal Lobe Epilepsy; Others Subtypes

Summary: epilepsy is frequently associated with cognitive and attentional disorders. several studies have pointed out that there are modifications of brain activity in resting state during peri-ictal period in eeg and functional mri. however, to date, no study has assessed the changes in attentional control after a seizure. the investigators hypothesize that a localized discharge is associated with a disorganization of the networks engaged in attentional control. in this regard, the investigators propose a prospective longitudinal study assessing the changes in attentional control after a focal seizure.


Eligibility criteria:
inclusion criteria: * age superior to 18 and under 80 * focal epilepsy with indication to pre-surgery work-up and 5 days programmed hospitalization dedicated to this work-up * normal global cognitive performance (standard progressive raven matrices score \> 5th percentile) * be affiliated to the social security system * have signed an informed consent exclusion criteria: * pregnancy or breastfeeding * not able to give consent (article 1121-8 of the csp) * vulnerable person * being deprived of liberty by judicial or administrative decision (article l 1121-6 of the csp) * guardianship * have a high probability of not respecting the protocol or of abandoning the study * absence of any epileptic seizure recorded during the hospitalization * recurrent seizures preventing the recording of at least 24 hours without any seizure following a seizure.

Keywords: attentional control focal epilepsy event related potentials functionnal connectivity high-resolution eeg