Kornimate/medical-research-clean huggingface dataset:
patient centered comprehensive medication adherence management system in patients with sickle cell disease

Conditions: Sickle Cell Disease

Summary: the purpose of this research study is to learn about ways to help children and adults with sickle cell disease who are taking the medication, hydroxyurea.

sickle cell disease (scd) is an inherited chronic multi-organ system disorder that affects approximately 100,000 individuals in the united states, mostly belonging to minority, under-served populations. scd is associated with substantial morbidity, premature mortality, individual suffering, health care costs and loss of productivity. hydroxyurea (hu) the only disease modifying therapy for scd is efficacious in reducing complications such as pain crisis and acute chest syndrome and improving survival. it is however, vastly underutilized and poorly adhered to because of barriers at the health care system, provider, treatment, socioeconomic, and patient levels. the investigator's overarching hypothesis is that barriers to acceptance and adherence to hu are multi-factorial and that a structured set of interventions can lead to improved adherence to medication and patient centered outcomes.

Eligibility criteria:
inclusion criteria: * be \>2 years of age up to 65 years of age, inclusive * have a diagnosis of scd, with either βs/βs, βs/βc, βs/βd, βs/β0, βs/βo-arab, or βs/β+ genotype * prescribed hydroxyurea for at least the 6 months prior to study entry * have daily access to a smart phone, tablet, personal computer or other device capable of producing and transmitting videos over the internet * be willing and able to record and transmit videos exclusion criteria: * patient or caregiver refuses to take hydroxyurea as treatment for scd * diagnosis of significant psychiatric disorder of the subject that could seriously impede the ability to participate in the study * an assessment by the investigator that the subject will not comply with the study procedures outlined in the study protocol * patients receiving automatic home delivery of medications since medication possession ratio is reflective of the patient initiation the refill when they have exhausted the home supply of hu
investigating the role of active versus chronic coronary artery calcification on acute myocardial infarct

Conditions: Chest Pain

Summary: the investigator aims to determine the feasibility of understanding the process of active versus chronic calcification using na-f pet scan and contrast ct scan of the heart. the patient cohort will consist of patients diagnosed to have either acute coronary syndrome (acs) (comprising of either unstable angina pectoris or acute myocardial infarction) or suspected coronary artery disease (cad). the pet images will be compared to images obtained from standard contrast ct of the coronaries. this study will provide additional insights about active versus non-active calcification amongst patients with acs or suspected cad.

contemporary techniques used to visualize coronary artery calcification include standard non-contrast computed tomography (ct) of the coronaries measuring amount of calcium deposition in the coronaries, contrast ct and more recently, using sodium-fluoride (na-f) positron emission tomography (pet) to image coronary and valvular calcification. na-f has been shown to accumulate in areas of active calcification where contrast ct of the heart has been shown to accumulate in areas of chronic calcification. the investigator aims to determine the feasibility of understanding the process of active versus chronic calcification using na-f pet scan and contrast ct scan of the heart. the patient cohort will consist of patients diagnosed to have either acute coronary syndrome (acs) (comprising of either unstable angina pectoris or acute myocardial infarction) or suspected coronary artery disease (cad). the pet images will be compared to images obtained from standard contrast ct of the coronaries. this study will provide additional insights about active versus non-active calcification amongst patients with acs or suspected cad.

Eligibility criteria:
inclusion criteria: * patients with a diagnosis of acute coronary syndrome * patients referred for workup of suspected coronary syndrome * able to provide written, informed consent. * age between (including) 50 years to 89 years old. exclusion criteria: * pregnant \& lactating women * weight \<=180kg
adverse childhood experiences in patients with ms: impact on quality of life and on coping strategies towards the disease and its treatment

Conditions: Multiple Sclerosis

Summary: the goal of this observational study is to evaluate the presence of adverse childhood experiences (ace) in patients with multiple sclerosis. the main questions it aims to answer are: * does the presence of ace impact on quality of life of patients with multiple sclerosis? * does it influence how the patients cope with the disease and with disease course-modifying therapies? during follow up visits, planned as part of their regular medical care, participants will answer survey questions on a tablet .

multiple sclerosis is a chronic inflammatory, demyelinating, and neurodegenerative disease of the central nervous system, typically affecting young adults. its etiopathogenesis is multifactorial, with the interaction of genetic susceptibility and environmental risk factors. among these, childhood trauma and other forms of adverse childhood experiences (ace) such as divorce or parental loss have been called out as possible risk factors in the development of ms and disease relapse. adverse childhood experiences are a heterogeneous group of negative experiences occurred during childhood, that may have an unfavorable impact on the later course of life in terms of physical and mental health. these effects may be related to changes in the prefrontal, limbic, and hypothalamic-pituitary-adrenal areas and may cause repercussions on the immune system, as documented on experimental models of autoimmune encephalitis. in addition to that, a history of ace has been associated with the development of poor coping strategies during adulthood . since multiple sclerosis represents a chronic and progressive disease, the kind of coping strategies developed from childhood may affect how the patient perceives the disease and may affect his or her adherence to treatment. to date, data on the prevalence of traumatic events during childhood in patients with multiple sclerosis are limited to a few studies, while the impact of such events on how the patient copes with the diagnosis of disease and acceptance of therapy. has not yet been explored. this study represents a preliminary analysis of the impact of ace in a cohort of multiple sclerosis patients and aims to evaluate how early negative life experiences may affect patients' coping strategies towards the disease and their compliance to treatment.

Eligibility criteria:
inclusion criteria: * age older than 18 years; * diagnosis of relapsing-remitting multiple sclerosis according to mcdonald criteria (2017 revisions) made between 2014 and 2024. * signature of informed consent exclusion criteria: * presence of language barrier * presence of conditions that prevent or limit understanding and proper completion of questionnaires

Keywords: ace multiple sclerosis treatment adherence adverse childhood experiences quality of life
exploring the characteristics of epileptogenic foci in drug-resistant epilepsy based on multimodal imaging technology

Conditions: Drug Resistant Epilepsy; Magnetic Resonance Imaging; Electroencephalogram (EEG)

Summary: using multimodal imaging technology, this study aims to explore the characteristics of epileptogenic foci in patients with drug-resistant epilepsy and identify key network nodes (such as central nodes) to provide more assistance for the diagnosis of drug-resistant epilepsy.

this study is a prospective observational cohort study. it prospectively recruited 50 patients with drug-resistant epilepsy from the epilepsy center of the department of neurology at xijing hospital, all aged 18 years or older. it collected general information and clinical baseline data such as magnetic resonance imaging; gathered multimodal imaging data once; analyzed the characteristics of epileptogenic foci in patients with drug-resistant epilepsy; and performed statistical analysis.

Eligibility criteria:
inclusion criteria: 1. aged ≥18 years old; 2. meet the 2010 international league against epilepsy (ilae) diagnostic criteria for drug-resistant epilepsy; 3. duration of epilepsy ≥2 years, with an average seizure frequency of ≥2 times per month in the 3 months prior to enrollment; 4. adequate intake of two or more anti-epileptic drugs, with no intervention in the treatment plan during the trial period; 5. capable of cooperating to complete treatment and related examination items; the patient and family fully understand and voluntarily sign the informed consent form. exclusion criteria: 1. in a state of continuous epileptic seizures; 2. complicated with severe infections, cerebrovascular diseases, malignant tumors, and other diseases, accompanied by severe dysfunction of the heart, liver, kidney, or other organs, or with mental disorders, or with uncorrectable hyperglycemia, or 3.patients on long-term use of corticosteroid medications; 4.pregnant or lactating women; 5.contraindications for pet, mr, eeg examinations; 6.patients with examinations (with ferromagnetic metal implants in the body; high fever); 7.participating in other clinical trials at the same time; 8.the patient or family withdraws the informed consent form.
arthroscopic rotator cuff tear repair: single versus double layer fixation

Conditions: Rotator Cuff Tear

Summary: retear rates after arthroscopic rotator cuff repairs remain unsatisfactorily high. recently, attention has been paid to restore the rotator cuff's native anatomy by reconstructing the superior joint capsule. however, the debate whether to reconstruct only the superficial tendinous part or also the deeper capsulo-ligamentous part of the rotator cuff is ongoing. thus, the intention of the present study is to compare double-layer versus single-layer arthroscopic rotator cuff repair regarding retear rate and clinical outcome.


Eligibility criteria:
inclusion criteria: * patients with repairable supra- and infraspinatus tears scheduled for arthroscopic rotator cuff fixation * tear size of at least 2.5 cm and up to 4.0 cm * signed informed consent exclusion criteria: * axillary nerve palsy
prospective evaluation analysis and kinetics registry

Conditions: Atrial Arrhythmia

Summary: in a cohort of patients electively treated for atrial arrhythmia with iv sotalol (initiation or dose escalation), this study will describe patient characteristics, short-term safety and efficacy, electrocardiographic monitoring, and pk and pd parameters (in a subset) associated with iv dosing approach.

antiarrhythmic drug therapy plays a vital role in the achievement of rhythm control in patients with atrial arrhythmias. class iii antiarrhythmic drugs are frequently used in these patients. however, these drugs are associated with a nontrivial risk of qt interval prolongation and associated risk of life-threatening ventricular arrhythmias. in this setting, initiation and dose titration of these drugs is often performed on an inpatient basis for the first five oral doses, typically requiring hospitalization for two days or longer. the availability of sotalol in intravenous (iv) form, recently approved for initiation or dose increase among patients with atrial arrhythmias, affords an opportunity to shorten hospitalization for these patients. this approach was approved based on translational science research that used computer-based simulation modeling to predict sotalol concentrations. there remain knowledge gaps regarding the use of iv sotalol in these patients, specifically around real-world outcomes, as well as pharmacodynamic and pharmacokinetic profiles in patients. the purpose of this registry is to collect data among patients and centers using iv sotalol loading for initiation or dose titration in the treatment of atrial arrhythmias, in order to fill the above knowledge gaps.

Eligibility criteria:
inclusion criteria: 1. adults age 18 years and older 2. eligible for the use of elective intravenous sotalol loading to treat atrial arrhythmias, per the treating clinician 3. iv sotalol infusion started for the treatment of atrial arrhythmias, in the setting of initiation or dose titration of chronic sotalol therapy 4. elective hospital admission primarily for loading with intravenous sotalol with/without cardioversion, with no other planned therapy or procedures exclusion criteria: 1. study materials not available in the subject's preferred language. 2. patients undergoing treatment for active concomitant ventricular arrhythmias 3. standard exclusions for elective sotalol use (at the time of initiation): * heart rate \< 40 bpm or 2nd/3rd degree av block without pacemaker * qtc ≥ 450 in absence of bundle branch block (≥ 500 in the presence of a bundle branch block) * severe left ventricular hypertrophy (thickness \>1.5 cm) 4. patients who were previously intolerant to antiarrhythmic class iii therapy 5. patients missing key data elements in their electronic health record (for retrospective subjects only).

Keywords: atrial arrhythmia sotalol
heparin binding protein as a prognostic biomarker of sepsis severity

Conditions: Sepsis; HBP

Summary: the aim of the study is to correlate between the severity of sepsis and serum heparin binding protein in the patients admitted to icu with sepsis., and detect its value as a prognostic biomarker in sepsis


Eligibility criteria:
inclusion criteria: * adult whose age between 20 to70 years old * patients suffered from sepsis or septic shock (under the third international consensus definition of sepsis and septic shock) exclusion criteria: * any pregnancy female * any patient who is neutropenic secondary to malignancy * patients who is taking immunosuppressive therapy * patients who is suffering fromhematological malignancy
online education programme for people with type 1 diabetes and suboptimal metabolic control

Conditions: Diabetes Mellitus, Type I

Summary: the aim of this study is to evaluate the effectiveness of an online intervention for people with type 1 diabetes who present not optimal control of the disease.

study area: adults with type 1 diabetes, hba1c \>7.5%, \>3 years diagnosed. methods: randomized clinical trial. it will include 60 participants . the improvement of glycated haemoglobin in both groups before and after intervention will be compared; adherence to the treatment, quality of life, time in the glycaemic range, perception of hypoglycaemia and knowledge about diabetes.

Eligibility criteria:
inclusion criteria: * hba1c ≥7,5% * more than 3 years of diagnosis * ability to follow online sessions * having a device to follow up the education programme exclusion criteria: * pregnants * people on corticosteroid treatment * people with severe disease * people with continuous subcutaneous insulin infusion (csii)

Keywords: diabetes mellitus, type i education programme online
the role of preoperative oral immunonutrition in major vascular surgery

Conditions: Undernutrition

Summary: the role of preoperative oral immunonutrition in major vascular surgery. the mean purpose of this study was to determine the prevalence of post-operative infection complications after major vascular surgery in group of patients with preoperative oral immunonutrition. this group was compared to a control group. secondary purpose was to evaluate the effect of preoperative oral immunonutrition on postoperative mortality (30 days), the medium length of stay in the hospital and the cost of treatment in the two groups


Eligibility criteria:
inclusion criteria: * intervention planned since at least 5 days before surgery * duration of hospitalization of at least 5 days exclusion criteria: * pregnant or lactating woman * patient with severe renal insufficiency * patient under 18 years old * patient infected with hiv,hépatitis b or c

Keywords: patients suffering undernutrition requiring vascular surgery
impact of covid 19 pandemic on anesthesia resident's training program in cairo university hospitals. a cross-sectional study.

Conditions: COVID-19; Anesthesia

Summary: in december 2019, a cluster of pneumonia cases, caused by a newly identified βcoronavirus, occurred in wuhan, china.1 the world health organization (who) officially named the disease as coronavirus disease 2019 (covid-19), and the international committee on taxonomy of viruses named the virus as severe acute respiratory syndrome coronavirus 2 (sars-cov-2).2 on 11 march 2020, the who declared the epidemic of covid-19 as a pandemic.3 the pandemic crisis prioritises critical care for those coronavirus (covid-19) patients who have been most profoundly affected, and hospitals, staffing, and working practices have been radically adjusted to accommodate this.4,5 the healthcare industry, in particular, has been overwhelmed by the effect of covid-19 on healthcare resources. this has been underscored by providers concerned about emotional strain and physical exhaustion, access to personal protective equipment (ppe) and medical equipment, workplace exposure to covid-19 and disease transmission to family members.6 physicians are essential for any health-care system and at the frontline defense against the covid-19 pandemic. they play a crucial role in diagnosis, treatment, prevention of disease spread, and public education during this pandemic. moreover, they are frequently exposed to infected individuals with covid-19, making them at higher risk of infection than others.7 anesthesia is one such specialty whose residents are uniquely at risk of exposure to infection in the operating room or icu. residents reported that their learning schedule is distorted in our hospital regarding skills because of increase icu rotations, cancelled elective surgeries, missing one or two of the major rotations. also, lecturers were stopped and replaced by e-learning after a long period. examination schedule was changed and so the research schedule. infection of the trainees (or a member of a family) had a great emotional and physical impact on them. covid-19 will not go away any time soon, and therefore the new balance between service provision and training needs to be agreed in a sensitive way to avoid further frustration amongst trainees. adaptations to these circumstances have delivered new forms of teaching and supervision. we design this cross-sectional study and implement a survey that included a 58-question to accomplish the specific aims of the present study through comparisons of two groups of residents and to provide plans for the training programme to be less affected by pandemics.


Eligibility criteria:
inclusion criteria: * residents of either sex, in the last year or completed their residency (class 2016, and 2017) in cairo university hospitals spending 2 years in the pandemic. residents who completed their residency before the pandemic (class2013, 2014). exclusion criteria: * residents who did not pass the first part of residency or who did not complete their residency for any other cause rather than the pandemic.
intraoperative electroencephalographic biomarkers of postoperative pain

Conditions: Pain Postoperative; Nociceptive Pain

Summary: the goal of this study is to explore whether specific intraoperative eeg signals (brain waves or neuronal electrical activity) are associated with the severity of acute postoperative pain.

this is a prospective minimal-risk observational study to collect and analyze eeg data during intraepidermal electrical stimulation in patients receiving general anesthesia (ga) for abdominal surgery. to collect nociception-related eeg signal during ga the investigators designed a standardized intraepidermal electrical stimulation (ies) protocol. the intensity of the electrical stimulus will be calibrated to each participant perception pre-surgery, with 3 different intensities: sensitivity threshold, mild-pain threshold, and moderate-pain threshold. the ies will be administered several times throughout the surgical procedure: a) at baseline, prior to induction of ga, b) three minutes after loss of consciousness, c) five minutes after fentanyl administration and orotracheal intubation, d) five minutes after first incision and every 20 minutes until the end of the surgery, and f) after surgery ends and before extubation. to standardize the anesthesia management as much as possible, all patients will be attended by a reduced number of anesthesiologists. the hypnosis will be achieved with propofol, while analgesia will be mainly achieved with either fentanyl or remifentanil. eeg will be recorded with a 32-channel high standard equipment. once the patient arrives to the post-anesthesia care unit (pacu), the investigators will record the pain reported by the patient using the numeric pain rating scale every 15 minutes during the first hour, and every 30 minutes until patient is discharged from the pacu. also, the investigators will both, record opioid administration through the surgery and estimate their effect-site concentration with pharmacokinetic/pharmacodynamic models. besides, the investigators will measure opioid plasmatic concentrations.

Eligibility criteria:
inclusion criteria: * american society of anesthesiologist performance status i or ii * scheduled for elective laparoscopic abdominal surgery under general anesthesia exclusion criteria: * body mass index \> 35 kg/m2 * past history or suspected difficult airway * craniofacial malformations * use of regional anesthesia technique during or after the surgery * severe arrhythmia or use of a pacemaker device * severe neuropsychiatric illness (mayor depression, bipolar disorder, schizophrenia) * regular use of psychoactive drugs * any injury in the right hand * past history of peripheral neuropathy * diabetes mellitus * known lesion in the spinothalamic tract. * analgesics used in the past 72 hours * known allergy to propofol * previous diagnosis of a condition associated with chronic pain (such as fibromyalgia, rheumatoid arthritis, osteoarthritis, migraine)

Keywords: pain nociception electroencephalogram
amlodipine as add-on to olmesartan in hypertension

Conditions: Essential Hypertension

Summary: test the efficacy and safety of the combination of olmesartan and amlodipine in hypertensive patients whose blood pressure is not adequately controlled with olmesartan alone.


Eligibility criteria:
inclusion criteria: * mean sitting bp of greater than or equal to 140/90-115 mmhg and mean 24h dbp greater than or equal to 80 mmhg with at least 30% of daytime readings greater than 85 mmhg prior to randomization. exclusion criteria: * secondary hypertension of any aetiology; * any serious disorders which may limit the ability to evaluate the efficacy or safety of the test drug(s); * history of myocardial infarction, unstable angina pectoris, percutaneous coronary intervention, congestive heart failure, hypertensive encephalopathy, stroke or tia within the last 6 months.