Kornimate/medical-research-clean huggingface dataset:
quantitative liver function tests using cholates

Conditions: End Stage Liver Disease

Summary: as the treatments for liver disease and the availability of liver transplantation have progressed, the number of patients with end stage liver disease continues to increase. this has increased the need to risk-stratify patients with cirrhosis to better direct their treatments and provide an accurate prognosis for their outcomes. the traditional assessment of the liver patient has been limited to imaging, static measures of "liver function tests" and liver biopsy. this protocol is designed to increase the spectrum of tests in the evaluation of the patient with end stage liver disease.

this study involves using the dual cholate test as our quantitative liver function test of choice. clearance of the oral cholate provides an assessment of portal blood flow. clearance of the intravenous (iv) cholate provides an assessment of the systemic blood flow. the ratio of these clearances indicates the fraction of cholate that is shunted to the systemic circulation, and is called the cholate shunt fraction.2 this study will measure cholate elimination rate constant (cholate kelim), clearance of orally administered cholate, clearance of intravenously administered cholate and cholate shunt. this study will compare the presence and extent of the cholate clearances and shunt fraction with the presence and extent of hepatic fibrosis and portal hypertension (as measured by a hepatic venous pressure gradient \[hvpg\] procedure.) the patients who will be enrolled in this study may or may not be those who are undergoing clinically indicated hepatic venous pressure gradient (hvpg) measurements at baylor university medical center, with or without a liver biopsy. patients having the hvpg measurements will be admitted to baylor university medical center (bumc) and prepared in the routine clinical fashion for their clinically-indicated hvpg measurement. the cholate test, including blood draws, will be performed after the hvpg procedure. the cholate test may also be performed in the hepatology clinic

Eligibility criteria:
inclusion criteria: * end-stage liver disease patient or living liver donor or congenital heart disease patients * age: 18 yr to 80 yr * patients or legal authorized representative (lar) must provide written consent and be willing and able to adhere to study requirements * stage 3-4 fibrosis by metavir score or clinical evidence of advanced fibrosis (end-stage liver disease patients only) exclusion criteria: * hepatic encephalopathy grade 3 or 4 * pregnancy or intent to become pregnant * subjects with inability to provide consent for one's self * subjects with a life expectancy \< 1 year * subjects who have participated in an investigational drug study within the past 30 days

Keywords: liver function tests end stage liver disease cirrhosis living liver donor
ultrasound guided treatment of steroids for capsular contracture in patients with reconstructed/augmented breast

Conditions: Capsular Contracture, Implant

Summary: ultrasound guided treatment of steroids for capsular contracture in patients with reconstructed/augmented breast

the aim of this study is to evaluate ultrasound (us)-guided treatment of capsular contracture (cc) in patients with reconstructed/ augmented breast. capsular contraction is the one of the most common complications of both esthetic and reconstructive breast surgery with an incidence of 0.5-30% and 1-38%, respectively. in irradiated patients the incidence is higher, in the range of 30-67%. it appears most commonly in the first year but in some patients, belated capsular contracture has been noticed. the more severe forms of contraction, baker grades 3 and 4 with a firm often deformed and painful breast, have been shown to recur as often as 67% after capsulotomy steroid injection has been demonstrated to be effective for the treatment of this condition. 20-30 female with grade iii\\iv cc will be included. patients will be treated with peri-implant us-guided injection of dexamethasone the purpose of our study is to use a longer acting steroid (dexamethasone) injected intra capsular with us-guide. by that getting a better effect on the level of fibrosis. this clinical study will be conducted in the tertiary academic rabin medical center. several measures will be taken, including: capsular contracture grading by two plastic surgeons, a vas-score of breast pain, maximal capsular thickness (mct) in sonography

Eligibility criteria:
inclusion criteria: • female patient with grade 3-4 capsular contraction after alloplastic breast reconstruction\\ augmentation exclusion criteria: * intake of steroids, anti-inflammatory, anti-coagulate or immunomodulatory medications on a regular basis * patients with skin atrophy of the breast

Keywords: breast capsular contructure
volatile non-invasive biomarkers of epileptic seizures

Conditions: Epilepsy; Non-Epileptic Seizure

Summary: breath and sweat samples will be collected from people who have been admitted to hospital after a potential seizure and analysed by the team. the researchers then hope to identify a pattern of small molecules that can distinguish seizures from other events, and perhaps determine the severity of the seizure.

determining whether someone has had an epileptic seizure, or another event, can be challenging and result in the wrong diagnosis. a 'seizure test' used after the event would therefore be very helpful. researchers have used small molecules released from the body in breath and sweat to detect cancers and other diseases; this study will determine whether a similar method can be used to detect whether someone has had an epileptic seizure.

Eligibility criteria:
inclusion criteria: 1. patients who have been admitted to either university college london's queen's square eeg-telemetry unit or chalfont centre for epilepsy, for diagnosis of seizure events. 2. patients aged 18 years or above exclusion criteria: 1. patients with active infection or who have taken antibiotics within 4 weeks 2. patients on immunosuppressive medications 3. patients with co-morbidities preventing breath collection 4. patients unable to provide informed consent.
effect of materials for subcuticular suture (quill vs. monocryl) on complications after liver resection

Conditions: Liver and Intrahepatic Bile Duct Neoplasm

Summary: this study investigates the effect of materials used in subcuticular suture on patients' outcomes after surgery. the prevention of surgical site wound infection is important to decrease the length of hospital stay and the post-operative risk of incisional hernia, especially in patients undergoing open hepatectomy (surgical removal of the liver). the purpose of this study is to compare the impact of the use of quill versus monocryl for subcuticular suture on patients' outcomes after surgery.

primary objective: i. to investigate the impact of materials for subcuticular suture (quill versus \[vs.\] monocryl) on complications after liver resection. outline: patients' medical records are reviewed retrospectively.

Eligibility criteria:
inclusion criteria: * patients \>= 18 years of age undergoing liver resection at md anderson cancer center from june 1, 2020 through january 31, 2021 exclusion criteria: * patients who have a history of previous abdominal surgery will be excluded * pregnant women will not be included in this chart review
bexarotene augmentation of antipsychotic treatment for chronic schizophrenia

Conditions: Schizophrenia

Summary: background: bexarotene (targretin) is a synthetic retinoid mainly used for treatment of patients suffer from oncological or dermatological diseases. the present study is based on: evidence that retinoids are involved in neurodevelopment ("the retinoid dysregulation hypothesis"); an assumption that the combined effect of antipsychotic agents and bexarotene will have a beneficial effect on schizophrenia patients; and the positive findings from our pilot open-label clinical trial (clinicaltrials.gov identifier: nct00141947). however, clinical efficacy of bexarotene should be investigated in a placebo-controlled trial. methods: in a 6-week, randomized, double-blind placebo-controlled trial targretin (75 mg/day) or placebo capsules will be added to the stable ongoing antipsychotic treatment of 90 schizophrenia patients. participants will be assessed at baseline and after 2, 4 and 6 weeks of treatment. a battery of research instruments will be used for assessment of psychopathology, side effects, general functioning and quality of life. in addition, cholesterol and triglyceride levels, liver and thyroid function tests and a blood cell count will be monitored at baseline and during the study

recruiting was beginning on november 2008

Eligibility criteria:
inclusion criteria: 1. age 18-60 years, male or female 2. dsm-iv criteria for schizophrenia, or schizoaffective disorder. 3. ability and willingness to sign informed consent for participation in the study 4. stable blood parameters including adequate hematologic function, defined as wbc ≥ 4.300/μl, absolute neutrophil count ≥3.000/μl (\> 50%), and platelet count ≥ 180,000/μl; normal coagulation parameters; bilirubin ≤1.5 times the upper limit of normal (uln); ast/alt ≤ 2.5 × uln; and serum creatinine ≤1.5 mg/dl. 5. only patients who had a normal baseline fasting triglyceride (ftg) level will be entered into the study; triglycerides may be normalized before study entry with use of an antilipemic agent. exclusion criteria: 1. lipid abnormalities. fasting triglyceride normal (normalization with an antilipemic allowed prior to study entry). 2. leucopenia or neutropenia. hematopoietic: hemoglobin at least 12.5 g/dl; wbc\< 4300/μl; absolute neutrophil count \< 3000/μl; platelet count \< 155,000/μl 3. evidence of organic brain damage, mental retardation, alcohol or drug abuse 4. impairment of renal function 5. hepatic dysfunction 6. a history of pancreatitis 7. thyroid axis alterations 8. suicide attempt in past year. 9. cataracts. 10. systemic treatment with more than 15,000 iu of vitamin a daily. 11. patients with a known hypersensitivity to bexarotene or other components of the product. 12. pregnant women or a woman who intends to become pregnant.

Keywords: retinoids bexarotene schizophrenia panss positive and negative symptoms of schizophrenia
ablation of the pulmonary veins for paroxysmal afib

Conditions: Paroxysmal Atrial Fibrillation

Summary: the purpose of this trial was to investigate and confirm the safety, efficacy, and efficiency of the ablation frontiers® cardiac ablation system when used in the treatment of paroxysmal atrial fibrillation. (paf)

this trial was a non-randomized, multi-center, prospective study of subjects with symptomatic, paroxysmal atrial fibrillation (paf). the purpose of this study was to investigate and confirm the safety, efficacy and efficiency of the medtronic ablation frontiers® cardiac ablation system when used for the treatment of paroxysmal af. the trial was conducted over a 2 year period with enrollment occurring between 4 october 2007 and 1 december 2008.

Eligibility criteria:
inclusion criteria: history of symptomatic paroxysmal atrial fibrillation defined as: * self terminating af lasting no more than 7 days * af events demostrating spontaneous conversion back to sinus rhythm * documentation of one or more events with paf tracings by ecg, event recordings, pacemaker strips or monitor rhythm strips within the past year * af symptoms defined as the manisfestation of any of the following: palpitations, fatigue, exertional dyspnea, effort intolerance * age between 18 and 70 * willingness, ability and commitment to participate in baseline and follow-up evaluations for the full length of the study exclusion criteria: * structural heart disease of clinical significance * prior ablation for arrhythmias other than af within the past three months * prior left sided af ablation * enrollment in any other ongoing arrhythmia study protocol * any ventricular tachyarrhythmias currently being treated where the arrhythmia or the management may interfere with this study * active infection or sepsis * any history of cerebral vascular disease including stroke or tias * pregnancy or lactation * untreatable allergy to contrast media * any diagnosis of atrial fibrillation secondary to electrolyte imbalance, thyroid disease, or any other reversible or non-cardiovascular causes * history of blood clotting (bleeding or thrombotic) abnormalities * known sensitivities to heparin or warfarin * severe copd (identified by an fev1 \< 1) * severe co morbidity or poor general physical/mental health that, in the opinion of the investigator, will not allow the patient to be a good study candidate (i.e. other disease processes, mental capacity, substance abuse, shortened life expectance, etc.)

Keywords: atrial fibrillation
natural history of covid-19-related atrial fibrillation

Conditions: COVID-19; Atrial Fibrillation New Onset

Summary: the uncover-af prospective, multicenter registry aims at determining the natural history of atrial fibrillation (af) via continuous cardiac rhythm monitoring in patients with a first arrhythmic episode during covid-19 hospitalization.

coronavirus disease 2019 (covid-19) is a novel coronavirus strain disease, which has rapidly spread worldwide with more than 100 million confirmed cases to date. covid-19 is mainly characterized by respiratory symptoms; however, patients can exhibit a wide range of clinical manifestations, including cardiovascular complications. among them, supraventricular and ventricular arrhythmias have been described in patients at different stages of disease severity. according to a recent study on 9564 covid-19 patients, 17.6% developed af during hospitalization, 65.7% of whom without a past arrhythmic history. several factors (e.g., hypoxia, systemic inflammatory response, myocardial injury) may interact with a preexisting substrate and act as a trigger for af initiation. nonetheless, the pathophysiology of covid-19-related new-onset af remains elusive. it is unknown whether the disease merely acts as a transient arrhythmia initiator or promotes long-term atrial electrophysiological and structural changes which may facilitate af recurrence and progression. therefore, the investigators designed a multicenter, prospective registry to assess the natural history of af via continuous cardiac rhythm monitoring (ilr, pmk, icd) in patients with a first af episode during covid-19 hospitalization.

Eligibility criteria:
inclusion criteria: * age\> 18 years; * confirmed infection with sars-cov-2; * patients with a first clinical episode of af ≥30 s at admission or during hospitalization for covid-19; * patients with: 1. implantation of an ilr, a pmk, or an icd during covid-19 hospitalization or within 30 days after hospital discharge, or 2. an ilr, a pmk, or an icd implanted before covid-19 hospitalization. exclusion criteria: * history of af or flutter irrespective of type; * moderate/severe mitral stenosis; * mechanical prosthetic heart valve(s); * kidney failure treated with permanent dialysis; * any condition (e.g. psychiatric illness, dementia) or situation, that in the investigators opinion could put the subject at significant risk, confound the study results, or interfere significantly with the subject participation in the study; * unwillingness to participate.

Keywords: atrial fibrillation covid-19 natural history stroke loop recorder cardiac implantable electronic device remote monitoring
an fmri study of brain response in patients with fibromyalgia

Conditions: Fibromyalgia

Summary: the purpose of this study is to explore how pregabalin works in patients with fibromyalgia by evaluating brain imaging signals. to find out whether fmri (functional magnetic resonance imaging) is an efficient way to show whether new pain medications are effective in treating fibromyalgia.

methodology study

Eligibility criteria:
inclusion criteria: * women must have pain due to fibromyalgia * fibromyalgia must have been diagnosed at least 6 months prior to be eligible for this study exclusion criteria: * patients with severe depression or other serious illness, who are left-handed, or who are pregnant or nursing are not eligible for this study.

Keywords: fibromyalgia; fmri; pain; pregabalin; lyrica; imaging
point of care 3d ultrasound for pediatric appendicitis: a pilot study

Conditions: Appendicitis

Summary: 1. purpose and objective: the purpose of this study is to test the feasibility of rapid acquisition of point of care 3d ultrasound for pediatric appendicitis. the study will use a newly developed acquisition method and post-processing technique to create three dimensional image models of the abdomen. 2. study activities and population group. the study population will be a convenience sample of patients 18 years and younger with suspected appendicitis, whose clinical care (unrelated to the study) includes ultrasound and/or ct of the abdomen. the study intervention includes acquisition of research ultrasound images, which will not be used for clinical care, and comparison of these images with clinically obtained images. other clinical data such as surgical and pathology reports will also be reviewed. if not evident from the patient medical record, the final diagnosis will be confirmed by a telephone call to the subject 2 weeks after the initial visit. 3. data analysis and risk/safety issues. this is a pilot study intended to determine feasibility and to refine image reconstruction algorithms. research images will be compared to clinical images to determine the frequency of visualization of the appendix and whether the appendix was deemed normal or abnormal. comparison of research images with final diagnosis will also occur. the research intervention, an ultrasound exam, has no known safety risks. the only risk to subjects is loss of confidentiality. this study is observational, not interventional, because the experimental ultrasound will be performed in all subjects and will not be used in the clinical care of patients (consequently, will not have the opportunity to affect clinical outcomes). experimental images will be reviewed after completion of clinical care and will not be provided to the clinicians caring for the subjects. we are not measuring the effect of the ultrasound examination on the subjects' outcomes.


Eligibility criteria:
inclusion criteria: * potential subjects must be 0-18 years of age, presenting to the pediatric emergency department for evaluation of right lower abdominal pain and suspected appendicitis. * the clinical diagnostic plan before subject enrollment must include abdominal ultrasound and/or abdominal ct. exclusion criteria: * because ultrasound does not involve the use of ionizing radiation or contrast agents, it is not contraindicated in any patients, although image quality may be nondiagnostic in obese patients. the focus of this study is on acquisition of research 3d poc us images to determine feasibility of use in pediatric patients with suspected appendicitis. * patients with bmi \>30 or mass \>70kg, as these patients are anticipated to have nondiagnostic ultrasound images. * ultrasound also requires a gel material be applied to the skin surface as an acoustic transmission medium. allergy to such gel will be an exclusion criterion.

Keywords: appendicitis pediatric ultrasound
latin america cardiac resynchronization therapy study

Conditions: Heart Failure.

Summary: the latin america crt study is a prospective, multicenter, interventional post-market release study conducted in latin america. the geography includes puerto rico and the caribbean, mexico and central america, and south america.

the purpose of this study is to provide local evidence regarding cardiac resynchronization therapy (crt), in both pacing and defibrillation devices across latin america. the primary objective will focus on changes in left ventricular heart size and function measurements in subjects receiving crt therapy. the following additional parameters will also be collected: * data on referral patterns in latin america; * data on device implant (including delivery system, device information, and lead information); * clinical data on subject outcomes and changes (improved, unchanged, or worsened) in heart failure status as assessed by heart failure (hf) hospitalizations, new york heart association (nyha) class, mortality, and quality of life (qol) measured by the patient global assessment;

Eligibility criteria:
inclusion criteria: implant of new crt-d or crt-p device (first-time implant), acc/aha/hrs/esc guidelines for implant, nyha class ii, iii or iv, qrs duration \>120 ms, lvef \ 21 years of age, must be able to return for follow-up visits as required, are not pregnant or do not plan to get pregnant within the next 6 months, have no physical limitations to perform echo studies exclusion criteria: previous or existing crt system implanted, unwilling or unable to comply with specified follow-up schedule, enrolled or intending to participate in another device study during the course of this study that requires specific treatment or device programming, medical condition that may limit life expectancy to \< 6 months
safety and efficiency of combined extracorporeal blood purification in neurosurgical icu. prospective rct

Conditions: Septic Shock

Summary: to assess the efficiency and safety of combined extracorporeal blood purification in patients with septic shock in neurosurgical icu in comparison with the efficiency and safety of the continuous renal replacement therapy (crrt).

according to studies and modern sepsis treatment guidelines, conventional crrt has not proved effective in the septic shock treatment. effectiveness of other extracoporeal blood purification methods, such as hemoadsorption or combined blood purification (hemoadsorption combined with crrt) is widely pointed out in current publications: contemporary studies in general icu patients demonstrated that the use of hemoadsorption or combined extracorporeal blood purification methods is effective for septic shock patients treatment. it has been proven that cytokines discharged into the systemic blood flow are the key pathophysiological mechanism of septic shock. hemoadsorption allows for significantly more effective removal of different inflammatory mediators than the traditional methods of crrt. the combined extracorporeal blood purification method demonstrated similar efficacy in general icu patients. the aim of this study is to assess the efficiency and safety of combined extracorporeal blood purification in with septic shock in neurosurgical icu in comparison with the efficiency and safety of the continuous renal replacement therapy (crrt) with an69 membrane. study novelty: we have not encountered published studies evaluating the efficiency of combined extracorporeal blood purification methods in neurosurgical patients with septic shock. furthermore, currently there is not enough data to compare combined extracorporeal blood purification with crrt for septic shock treatment. the planned study is the first to investigate the safety and efficiency of combined extracorporeal blood purification in patients with septic shock in neurosurgical icu.

Eligibility criteria:
inclusion criteria: * diagnosis of septic shock according to sepsis 3 definition * glasgow coma scale of 4 and more on admission * invasive hemodynamics monitoring * norepinephrine \> 0,1 µg/kg/min or use of 2 vasopressors exclusion criteria: * age \<18 years * \>24 hours after diagnosis of septic shock

Keywords: blood purification crrt septic shock neurosurgery cytokine removal