Kornimate/medical-research-clean huggingface dataset:
comparison between the effects of high doses statin on ventricular remodeling in stemi patients

Conditions: ST-segment Elevation Myocardial Infarction

Summary: stemi is a serious type of coronary heart disease, which is a major cause of disability and death. morphologically the key feature of remodeling is myocyte hypertrophy, myocyte loss from necrosis or apoptosis, as well as interstitial cell growth especially fibroblast proliferation leading to myocardial fibrosis . elevated serum ldl-cholesterol concentrations play a proatherogenic role by stimulating inflammation and oxidative processes. statins have been documented to retard fibrosis and ventricular hypertrophy by the cessation of myofibroblast activity. clinical studies have proven that statins not only regulate lipids but also improve myocardial fibrosis, regulate cell proliferation and apoptosis, regulate ventricular remodeling, and protect the myocardium

1. ethical committee approval will be obtained from ethics committee of faculty of pharmacy, damanhour university. 2. all participants should agree to take part in this clinical study and will provide informed consent. 3. (80) patients diagnosed with stemi will be enrolled from alexandria university hospital. 4. serum samples will be collected from patients at the time of admission for measuring the biomarkers. 5. echocardiogram also will be obtained at the time of admission. 6. all enrolled patients will be divided into two group to receive either atorvastatin (40 mg) or rosuvastatin (20mg). 7. all patients will be followed up during 3 months' period. at the end of 3 months, serum samples will be collected from patients for measuring the biomarkers and echocardiogram will be repeated. 8. statistical tests appropriate to the study design will be conducted to evaluate the significance of the results. 9. results, conclusion, discussion, and recommendations will be given.

Eligibility criteria:
inclusion criteria: 1. electrocardiogram showed abnormal elevation of the st segment. 2. first myocardial infarction occurred. 3. the patients received one-stage percutaneous coronary intervention (pci) therapy within 12 h. exclusion criteria: 1. severe cardiac insufficiency. 2. hepatic insufficiency (continuous increase of serum transaminase more than 3 times of the upper limit of normal level). 3. renal insufficiency (creatinine clearance rate \<30 ml/min). 4. addition of others blood lipid lowering and antioxidant drugs during follow up period. 5. familial hypercholesterolemia. 6. malignant tumor. 7. immune system disease. 8. acute infectious disease. 9. hypersensitivity to rosuvastatin and atorvastatin.

Keywords: statin remodeling stemi
use of the leva incontinence system in treating bladder incontinence.

Conditions: Stress Urinary Incontinence

Summary: this open-label proof-of-concept study is designed to evaluate the impact of the leva digital incontinence system on the treatment of stress and mixed urinary incontinence in women over a six week period. subjects will participate in a 2.5 minute exercise program twice daily (performed at a clinic with therapist assistance 5x weekly, and at home once daily on weekdays and twice daily on weekends. validated surveys (udi-6, iiq-7 and pgi-i) will be used to evaluate symptom relief. a battery of pelvic floor muscle exercises will be performed weekly to evaluate progress in muscle strengthening.


Eligibility criteria:
inclusion criteria * subjects must be female. * subjects must be capable of giving informed consent. * subjects should be at least 18 years of age and less than 89 years of age * subjects must have a diagnosis of or symptoms of predominant mild to moderate urinary incontinence based on the results of the completed urinary incontinence surveys. exclusion criteria: * absence of a vagina. * positive drug or alcohol test at the screening visit. * post-menopausal defined as absence of a period for over 12 months. * pregnancy or being less than 12 months post-partum. * greater than three vaginal deliveries or prior operative delivery (e.g. use of vacuum, forceps or abdominal pressure). * symptoms of stage ii or greater pelvic organ prolapse. * bmi \>31 kg/m2. * diagnosis of any neurological disorder. * prior lower back or pelvic surgery, including prior surgery for stress urinary incontinence (sui). * prior pelvic radiation. * current or recurrent vaginal infections (\>three per year). * painful bladder syndrome, active or chronic pelvic pain. * concurrent pelvic floor muscle exercises (pfme) under a supervised therapeutic plan of care. * previous supervised pelvic floor muscles rehabilitation in the past 12 months for the treatment for urinary incontinence or any other pelvic floor disorder. * currently taking medication to treat incontinence. * impaired cognitive function. * unable to tolerate use of the leva device.

Keywords: female
acromegaly: patient and physician perspectives

Conditions: Acromegaly

Summary: the purpose of the study is to assess the experiences of individuals with acromegaly who are receiving injections as part of their treatment regimen. another objective of the study is to compare the patients' perception with their doctors' perceptions. the answers are important to help researchers and physicians understand what it is really like to take currently available treatments so that they can make efforts to improve patients' healthcare experiences, reduce treatment burden and, ultimately, improve patient's quality of life.


Eligibility criteria:
inclusion criteria: * age \>=18 years-old and \<95 years-old * patient self-reported acromegaly diagnosis which will be further confirmed by a knowledge screening based on current medications and doses * currently on injectable somatostatin analogues (ssa), sandostatin® lar or somatuline® depot, for \>=12 months * have not had a change in dosage of their acromegaly treatment at the time of or since their last office visit * have seen their treating acromegaly physician within the past 12 +/-2 months note: this timeframe allows two additional months for scheduling an appointment with their physician, since most patients should see their acromegaly physician at least once every 12 months * ability to read and understand english * live and receive acromegaly treatments in the us * willing to provide signed informed consent exclusion criteria: * previous or current participant in mycapssa® (octreotide capsules) trial * use of pegvisomant (somavert®) monotherapy * use of pasireotide (signifor®)
effect of stabilization shoes on balance in elderly

Conditions: Elderly

Summary: movement during everyday activities most often requires stable posture. postural control corresponds to a complex motor ability to maintain / re-establish balance and orient one's body in the environment. postural stability and equilibrium deteriorate with age. more than 30% of people over 65 years old fall per year. falls represent 90% of hip fractures and sometimes result in lasting psychological effects. shoes are our direct link between the ground and our feet. wearing shoes plays a major role in postural control. the characteristics of shoes usually worn by elderly people are identified with those of shoes known to be 'dangerous'. in order to improve stability and reduce the risk of falling for the elderly, axis-comfort development® has developed "experimental balance shoes". their shoes have technical characteristics presented in the scientific literature as beneficial for postural stability. therefore, the aim of this study was to investigate the effects of wearing experimental balance shoes on postural balance compared with the people's own shoes. we assumed that postural balance would be improved by experimental balance shoes in an acute way and improved by a familiarization phase. this was a controlled, randomized, blind and cross-over study. three sessions were held in our center, each time interspersed with a phase of familiarization at home (7 to 10 days) during which the people had to wear either the experimental balance shoes or their own personal shoes. 21 volunteers in total participated in this study, all between 65 and 75 years old. five tests were presented randomly for each session and all tests were carried out on a huber 360 ® (lpg system, france) stabilometric platform. the mains criteria were static equilibrium on one foot and two feet (with eyes open and closed) and secondary criteria were stride frequency during the walk on the spot and stability limits. an improvement of these multiple criteria during the different sessions would be proof of the positive effect of experimental balance shoes on postural balance in the elderly.


Eligibility criteria:
inclusion criteria: * subjects from 65 to 75 years old * healthy subjects * having given their written informed consent exclusion criteria: * subject who has fallen during the six months prior to the study. * subject who moves with walking aids. * subject with severe balance problems or unable to stand up without help * subject who takes sedatives or sleeping pills * subject with neurological disease (dizziness including turning dizziness, multiple sclerosis, parkinson's, etc.) * subject with history of heart attack * subject who is short of breath when inactive. * subject who has pains limiting walking and standing * subject who takes neuroleptics except anti-depressors if the treatment is long-standing and well-balanced.

Keywords: postural balance accidental falls footwear stability force platform unipedal stance bipedal stance shoe
smart monitoring assessing spasticity-related health

Conditions: Multiple Sclerosis

Summary: this observational study seeks to investigate the underlying of spasticity in patients with multiple sclerosis (ms) by employing multimodal monitoring techniques. by integrating digital biomarkers alongside clinical monitoring, the investigators aim to evaluate whether digital measurements are suitable for monitoring spasticity-related everyday limitations and to compare them with established clinical scores, blood analyses and questionnaires including sores on quality of life, sleep quality or activities of daily living.

the symptomatic treatment of spasticity in patients with multiple sclerosis (ms) is a major challenge for both patients and healthcare providers. however, monitoring and measuring the success or failure of treatments in clinical practice remains difficult. this is mainly due to the lack of clinical scores and biomarkers that can be easily and longitudinally collected. existing scores (such as questionnaires and the modified ashworth scale) are rarely used in practice. in addition, the monitoring of side effects (such as dizziness, nausea and fatigue) is difficult in routine clinical practice and often leads to premature discontinuation or switching of treatment. as a result, therapeutic options are often exhausted prematurely. continuous monitoring with sensitive assessments could enable a better understanding of spasticity treatment. approximately 50 patients with moderate and severe spasticity due to ms are to be included in the study. after inclusion, follow-up examinations are carried out every 12 weeks; a total of 3 visits are planned, including the baseline examination. the study aims to improve the understanding of spasticity symptoms and assess them in patients through multimodal clinical and longitudinal digital measurements.

Eligibility criteria:
inclusion criteria: patients must meet all the following criteria to be eligible to participate in the study: * ≥ 18 years of age * diagnosis of multiple sclerosis according to the mcdonald criteria of 2017 * presence of spasticity that requires medical treatment from a medical point of view * own and use a smartphone with android 8.1 (or higher version) or ios 12.3 (or higher version) * able to operate a smartphone exclusion criteria: * missing informed consent * lack of declaration of consent * unwillingness or inability to use the smartphone app * any comorbidity that leads to impaired understanding or successful completion of the study, such as (but not limited to) psychiatric comorbidities or dementia. the decision will be made at the discretion of the investigators.

Keywords: multiple sclerosis spasticity smartwatch wearables digital health tools
intrawound vancomycin prophylaxis for neural stimulator

Conditions: Vancomycin; Implantable Neural Stimulator; Deep Brain Stimulation; Surgical Site Infection

Summary: the implantable pulse generator (ipg) is a device that generates electrical current to stimulate the spine, heart, or brain for various chronic conditions. in neurosurgery, the ipg is implanted in a subcutaneous pocket under the collarbone. this pocket is highly avascular and thus, antibiotics administered intravenously cannot reach a potential surgical site infection (ssi). ssis cause millions of health care dollars to be wasted due to repeat surgery and hospital re-admissions. the investigators hope to to determine the effects of "intrawound vancomycin-saline and iv antibiotics" compared to "saline and iv antibiotics" on the incidence of ipg ssi rates 6-months post-surgery.

patients requiring neurosurgical ipg replacements will be recruited into this trial on a volunteer basis. the participants meeting the inclusion criteria will be randomized to either the treatment arm (intrawound vancomycin-saline + iv antibiotics) or control arm (intrawound saline + iv antibiotics alone) by site in a 1:1 ratio. a sample size calculation using stplan determined that 405 patients per arm is required to reduce overall infection rate from 3.5% to 0.5% (80% power, α=0.05, two-tailed). final sample size per arm will be 410 after generously accounting for loss to follow-up, non-compliance, and unrelated death. the primary outcome will be a binary yes/no on if ipg explantation due to infection was required within 6-months post-surgery. this is a superiority trial and the investigators hypothesize intrawound vancomycin-saline + iv antibiotics is superior to intrawound saline + iv antibiotics alone. an intention-to-treat analysis will be applied in a blinded manner once all patients have completed the trial and the database is locked. the results of this trial will not only be applicable to neurosurgery, but also spine and cardiology.

Eligibility criteria:
inclusion criteria: * individuals who require ins replacement from dr. c.r. honey * individuals who are between the ages of 18 to 80. * individuals who consent to report any redness or swelling to their primary caregiver and follow-up as requested by their surgeon * individuals who consent to keeping the study team informed of any medical concerns they may have regarding their ins for a minimum of 6 months postoperatively * individuals who are capable of providing informed consent exclusion criteria: * individuals who have a history of autoimmune disease * individuals who are undergoing any surgery or procedural intervention within six-months post-operatively of entrance into this study * individuals who are on immunosuppression or any medication that would influence infection susceptibility * individuals who are allergic to vancomycin or cefazolin

Keywords: vancomycin implantable neural stimulator deep brain stimulation surgical site infection
digital health literacy on covid-19 for all: co-creation and evaluation of interventions for ethnic minorities and chinese people with chronic illnesses in hong kong

Conditions: Digital Health Literacy; COVID-19

Summary: during the pandemic, people are anxious for information, and electronic platform serves the purpose of having first-hand health information and spreading it to massive population within a short time. however, the source and credibility of the influx of online information are hard to be verified. digital health literacy (dhl) is the capacity to access, understand, evaluate, and apply health information from electronic sources, which is an important attribute that everyone should possess. recent studies from our group in hong kong have shown that, during the covid-19 pandemic, dhl is an issue facing people of all ages, especially ethnic minorities (ems), people with chronic illnesses (pwci), and professional and lay caregivers (cgs). considering that, the present research project aims to co-create dhl interventions with these three groups of people to meet their specific needs in dhl, in addition, to assess the efficacy of the dhl interventions on ehealth literacy, vaccine literacy, and actions taken for covid-19 prevention. the present research is a 4-year project, involving three phases. phase 1 involves focus group interviews and cognitive interviews with the three groups of people for developing interventions and evaluating the proposed interventions. phase 2 involves individual interviews with the three groups of people for testing the feasibility and acceptability of the interventions. phase 3 involves a 6-month longitudinal quantitative research, testing for the efficacy of the interventions in three dimensions: literacy, attitude, and behavior. participants from the three groups will be invited to join virtual or face-to-face training, watch short videos on social media, participate in virtual bi-weekly group discussion, and fill in questionnaires for five times during the course of the study. this co-creation of new knowledge by stakeholders and researchers is expected to increase the uptake of the research outcomes and adoption of the dhl interventions.


Eligibility criteria:
inclusion criteria: * ethnic minorities (ems), people with chronic illnesses (pwci), and caregivers (cgs) * able to use a computer, smartphone, or laptop to access the internet at home exclusion criteria: * diagnosis of an acute psychotic disease or life-limiting condition; having a visual, auditory, or fine motor disorder.

Keywords: digital health literacy covid-19 ethnic minorities chinese people with chronic illnesses
the effect of tavns on the prognosis of patients undergoing pancreatoduodenectomy

Conditions: Delayed Gastric Emptying

Summary: to explore the effects of transcutaneous auricular vagus nerve stimulation (tavns) during the perioperative period on the incidence of delayed gastric emptying after pancreatoduodenectomy and its possible mechanisms.

patients are recruited one week prior to the start of the trial, during which they are informed about the experimental protocol and associated risks. after obtaining informed consent and signatures, they are enrolled as study participants. patients who meet the trial criteria are randomly assigned in a 1:1 ratio to the control group (sham tavns group) and the intervention group (tavns group, with tavns intervention starting 30 minutes prior to anesthesia induction and continuing until the end of surgery, terminating after the removal of the endotracheal tube in the pacu), in a double-blind manner (with tavns intervention and postoperative follow-up conducted by different researchers).

Eligibility criteria:
inclusion criteria: * age ≥18 years; * diagnosed with pancreatic tumors or periampullary tumors by imaging or pathology and scheduled for pancreaticoduodenectomy; * no distant metastases and tumors are resectable; * classified as american society of anesthesiologists (asa) physical status i to iii; * capable of understanding the study procedures and various assessment scales and able to effectively communicate with the researchers; * willing to participate in the study and provide written informed consent. exclusion criteria: * patients with other malignant tumors; * patients who have undergone chemotherapy or radiotherapy before surgery; * patients with chronic organ dysfunction; * patients with a history of gastrectomy or other gastric surgeries; * patients diagnosed with chronic gastrointestinal inflammation, peptic ulcers, or a history of gastroparesis, pyloric, or other gastrointestinal obstructions; * patients with a history of autonomic dysfunction (e.g., peripheral neuropathy, vagotomy, thyroid dysfunction, amyloidosis, asthma, heart failure, renal dysfunction, or alcoholism); * patients with implanted stimulators (e.g., pacemakers, implanted vagus nerve stimulators, deep brain stimulators, spinal cord stimulators), cochlear implants, or metallic implants (excluding dental work); * patients who recently used prokinetic agents, cholinergic or anticholinergic drugs, or hormones; * patients who received vagus nerve stimulation or acupuncture within 1 month before the study; * patients with skin damage or dermatological conditions at the stimulation site; * patients with a preoperative heart rate below 60 beats per minute; * patients unable to cooperate with assessments; * patients participating in other clinical trials.
cohort of well-differentiated grade 3 neuroendocrine digestive tumors

Conditions: Neuroendocrine Tumors

Summary: the purpose of this study is to analyse clinical data of well-differentiated grade 3 digestive neuroendocrine tumors. these rare tumors may have a different disease evolution, response to chemotherapy and prognostic.

digestive neuroendocrine tumors are rare tumors and cell differentiation is a major prognostic marker of neuroendocrine tumors. the 2010 who classification defined three groups of tumor according to the combination of the morphological characteristics and the mitotic index and/or the ki-67 index: grade 1 and 2 corresponded to well differentiated neuroendocrine tumors whereas grade 3 corresponded to poorly differentiated lesions entitled neuroendocrine carcinomas (nec). it was assumed that no well-differentiated neuroendocrine tumor with a mitotic- or a ki-67- index above 20% existed. recently, a proportion of neuroendocrine tumors corresponding to grade 3 neuroendocrine tumors with a proliferation- or ki-67 index \> 20% and with a well-differentiated morphology have been identified. this entity has been partially explored and may have a different survival than grade 3 nec. furthermore, targeted therapies, and used in pancreatic neuroendocrine tumors have not been assessed in this case. the tenpath network is a pathological network whose goal is the systematic reading of all diagnosed cases of neuroendocrine tumors. as part of this network, nearly 3.000 neuroendocrine tumors were reviewed by pathologist experts. of all the reviewed tumors, 167 were identified as well-differentiated grade 3 neuroendocrine tumors, observed ki-67(5.6%) confirming the existence of this entity. treatment and follow-up of well-differentiated grade 3 tumors are not consensus-based and recommendations are exclusively based on experts' opinions. the purpose of this study is to define the characterization of this entity and evaluate the efficacy of chemotherapy on well-differentiated grade 3 digestive neuroendocrine tumors identified from the tenpath network.

Eligibility criteria:
inclusion criteria: * well-differentiated grade 3 neuroendocrine digestive tumors * patient of 18 years old and more exclusion criteria: * patient opposed to data collection as part of the study * digestive neuroendocrine tumors grade 1-2 * grade 3 poorly differentiated digestive neuroendocrine tumors * malignant disease diagnosed in the last 5 years (except basal cell of the skin and in situ cervical carcinoma) * other non-digestive neuroendocrine tumors * mixed neuroendocrine non neuroendocrine neoplasm

Keywords: neuroendocrine tumors epidemiology