Kornimate/medical-research-clean huggingface dataset:
myocardial dysfunction at early phase of traumatic brain injury : evaluation by two dimensional and speckle tracking transthoracic echocardiography

Conditions: Traumatic Brain Injury

Summary: traumatic brain injury (tbi) is a frequent pathology leading to major morbidity and mortality in young people. cerebral flood flow maintenance is a major goal directed therapy to improve the prognosis of the patient. due to cerebral-myocardial interaction, a myocardial dysfunction might occur at the early phase of the traumatic brain injury. this myocardial dysfunction could be partly responsible for a decrease in cerebral blood flow. in such case, improving myocardial dysfunction may help to increase cerebral blood flow and improve patient prognosis. in clinical practice the easiest and non invasive way to explore myocardial dysfunction is with transthoracic echocardiography. the objective of this trial is to investigate myocardial dysfunction at the early phase of traumatic brain injury, compared with a controlled group without tbi.


Eligibility criteria:
tbi patients inclusion criteria: * isolated and non opened traumatic brain injury * 18 - 65 years old * intubated and mechanically ventilated * glasgow score \< or = 9 or * glasgow score between 9 and 13 (included) and following traumatic coma data bank tomographic damages diffuse injuries type iii or iv or mass lesion over 25ml and/or neurosurgical injuries * medical insurance exclusion criteria: * treated major cardiovascular risks factors * cardiovascular past medical history (acute cardiovascular event) * cardio thoracic surgery * brain dead status * inotrope drugs * severe polytraumatism * acute haemorrhage * non echogenic patient * high level athlete * incapacitated person by law and pregnant women * discovery during echocardiography of underlying cardiomyopathy * urgent neurosurgery required control patients inclusion criteria: * isolated and non opened traumatic brain injury * 18 - 65 years old * intubated and mechanically ventilated * paired with tbi patient on age, bmi and sex * undergoing urgent non severe surgery * medical insurance exclusion criteria: * traumatic brain injury * treated major cardiovascular risks factors * cardiovascular past medical history (acute cardiovascular event) * cardio thoracic surgery * inotrope and vasopressive drugs * circulatory failure * non echogenic patient * high level athlete * incapacitated person by law and pregnant women * discovery during echocardiography of underlying cardiomyopathy * urgent neurosurgery required

Keywords: traumatic brain injury myocardial dysfunction transthoracic echocardiography speckle tracking
effect of slc30a8 rs13266634 genetic polymorphism on zinc supplementation and glycemic control in egyptian patients with type 2 diabetes mellitus

Conditions: Diabetes Mellitus, Type II

Summary: study whether slc30a8 rs13266634 polymorphism is associated with type 2 diabetes mellitus (t2dm) susceptibility in egyptian patients and study effect of zn supplementation on glycemic control in patients with type 2 diabetes


Eligibility criteria:
inclusion criteria: * established diagnosis of type 2 diabetes mellitus. * age between 20 and 64 years. * bmi \< 40 kg/m2. * on fixed oral hypoglycemic dosage for at least 3 months. * normal serum creatinine (0.5 to 1.3 mg/dl) with no clinical evidence suggestive kidney disease. * normal liver function tests (alt 7 to 55 u/l, and albumin ˃ 3.5 g/dl). exclusion criteria: * those diagnosed of osteomalacia, chronic alcoholics. patients with type 1 diabetes mellitus. * those who were taking multivitamin containing zinc or magnesium or any sort of mineral supplements in the previous three months or hormone replacement therapy (estrogen, progesterone) or chelating therapy such as penicillamine, or anticonvulsant (phenytoin, valproate). * those with a history of recent surgery or with concurrent acute illness including infectious disease, trauma, inflammatory bowel disease, malignancy, and active immunological diseases, using corticosteroids. * pregnant or intend to be pregnant for t least 3 months or lactating women. * those who were receiving insulin preparations as a part of diabetes management.
the effects of scalp block on haemodynamic response and postoperative pain in posterior fossa surgery

Conditions: Posterior Fossa Tumors

Summary: this study evaluate the effects of scalp block versus local infiltration on haemodynamic response to head pin replacement and skin incision and postoperative analgesia in posterior fossa surgery

in this study 15 patients will receive scalp block with bupivacaine, 15 patients will receive local infiltration with bupivacaine and 15 patients will receive placebo before surgery. the haemodynamic response to head pin replacement and skin incision will be recorded. postoperatively all patients will have a patient controlled analgesia (pca) device containing morphine (1 mg/ml) for analgesia. visual analogue scale (vas) for pain evaluation, sedation scores, and also postoperative morphine consumption will be evaluated and recorded.

Eligibility criteria:
inclusion criteria: * posterior fossa surgery * preoperative glasgow coma score: 15/15 exclusion criteria: * allergy to bupivacaine * uncontrolled hypertension * coagulopathy * cerebrovascular disease * earlier craniotomy

Keywords: scalp block local infiltration
monoclonal antibody plus cyclophosphamide in treating patients with metastatic cancer

Conditions: Unspecified Adult Solid Tumor, Protocol Specific

Summary: rationale: monoclonal antibodies can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. purpose: phase i/ii trial to study the effectiveness of monoclonal antibody and cyclophosphamide in treating patients with metastatic cancer.

objectives: i. evaluate the clinical feasibility and toxicity of monoclonal antibody okt3 given with low-dose cyclophosphamide in patients with advanced malignancies. ii. perform serial immune monitoring on patients treated with this regimen. iii. identify any clinical responses produced by this regimen. outline: biological response modifier therapy with suppressor cell inhibition. anti-cd3 murine monoclonal antibody okt3, moab okt3; with cyclophosphamide, ctx, nsc-26271. projected accrual: at least 9 evaluable patients per diagnostic category will be required initially; if any response is seen during the dose-finding portion of the study, a total of 24 patients with that diagnosis will be entered.

Eligibility criteria:
disease characteristics: metastatic cancer considered incurable by standard therapy and for which no higher priority protocol is available locally progressive primary brain tumors (e.g., astrocytoma, glioma) are also eligible brain metastases allowed patient characteristics: age: 18 and over performance status: ecog 0-4 (poor performance status brain tumor patients specifically eligible) life expectancy: at least 2 months hematopoietic: not specified hepatic: not specified renal: not specified pulmonary: no history of adult asthma no emphysema no pulmonary insufficiency no pulmonary edema other: no aids or positive hiv serology no pregnant women prior concurrent therapy: biologic therapy: not specified chemotherapy: not specified endocrine therapy: not specified radiotherapy: not specified surgery: not specified

Keywords: unspecified adult solid tumor, protocol specific
locally delivered 1% metformin gel in peri-implantitis

Conditions: Peri-Implantitis

Summary: this study evaluates the efficacy of 1% local metformin gel in deep periimplant pockets of type 2 diabetes mellitus patients. half of the participants will receive 1% metformin gel with manual debridement while the other half will receive a placebo with manual debridement.

metformin is an oral hypoglycemic drug categorized under biguanide and are considered the most efficient agents widely used in the treatment of type 2 diabetes mellitus.the general clinical benefits observed in therapy with mf seem to be greater than expected. they induce osteoblast cells to promote early bone formation through amp kinase (ampk) activity. moreover, in a recent in vitro study, mf facilitated in the proliferation of mg63 osteoblast like cells. thus, their action in stimulating bone formation has justified their use in the treatment of perimplantitis.

Eligibility criteria:
inclusion criteria: * type 2 diabetes mellitus patients. * patients with peri-implantitis exclusion criteria: * history of any other systemic diseases * cigarette smokers * smokeless tobacco users * patients who underwent scaling in the last 1 year * patients who took antibiotics in tje past 6 months
macro- and microvascular response to cocoa flavanols in healthy and type 2 diabetes

Conditions: Microangiopathy, Diabetic; Polyphenol; Optical Tomography; Vascular Endothelium; Arterial Stiffness; Healthy Participants

Summary: the greatest challenge in our ageing society are cardiovascular diseases such as stroke, heart attack, peripheral artery disease of the legs with non-healing wounds (ulcers), or diabetes. specific diets with high polyphenol content are associated with lower incidence of cardiovascular disease and can improve macrovascular function when consumed acutely and chronically. which role the smallest blood vessels (microcirculation) play in this and if the microcirculation responds to therapies is not well understood. one reason for this is that no generally available medical instrument has the resolution to study the microcirculation. the recently developed optical coherence tomography angiography (octa), currently mainly used by eye doctors, is able to visualise the microcirculation. the current randomised controlled cross-over proof-of-concept study will test the acute effect of a cocoa flavanol intervention on cutaneous microvascular structure and function of hands and feet together with macrovascular function of upper and lower extremities in healthy and type 2 diabetes participants. it is the hypothesis that cocoa flavanol intervention as compared to placebo can acutely increase microvascular vasodilation and macrovascular endothelial function in arms and legs together with arterial stiffness in both healthy and type 2 diabetes participants.


Eligibility criteria:
healthy: inclusion criteria: * healthy, 20-70 years * bmi 20-30 kg/m\^2 exclusion criteria: * diabetes mellitus * symptoms of acute infection * cardiac rhythm other than sinus * active malignancy * clinical signs or symptoms of cardiovascular disease (coronary artery disease, lower extremity artery disease, cerebrovascular disease): angina pectoris, dyspnea, palpitation, syncope, claudication * active vasoactive medication. type 2 diabetes: inclusion criteria: * type 2 diabetes mellitus * 20-70 years * bmi 20-30 kg/m\^2 exclusion criteria: * symptoms of acute infection * cardiac rhythm other than sinus * active malignancy * clinical signs or symptoms of cardiovascular disease (coronary artery disease, lower extremity artery disease, cerebrovascular disease): angina pectoris, dyspnea, palpitation, syncope, claudication * active vasoactive medication.
surgical results of resection of locally advanced pancreatic cancer

Conditions: Pancreas Cancer

Summary: the aim is to compare the surgical outcomes between upfront surgery and surgery after neoadjuvant chemotherapy in terms of morbidity and mortality

pancreatic cancer is the fourth leading cause of cancer death in the united states. while surgical resection remains the only curative option, more than 80% of patients present with unresectable disease. unfortunately, even among those who undergo resection, the reported median survival is 15-23 mo, with a 5-year survival of approximately 20%. disappointingly, over the past several decades, despite improvements in diagnostic imaging, surgical technique and chemotherapeutic options, only modest improvements in survival have been realized. nevertheless, it remains clear that surgical resection is a prerequisite for achieving long-term survival and cure. the concept of borderline resectable pancreatic cancer has evolved from several clinical observations made over decades. it has been recognized for some time that the prognosis for patients undergoing surgical resection for pancreatic ductal adenocarcinoma (pdac) is highly dependent on margin status, with total gross excision and histologically negative margins (r0 resection) being associated with the best outcomes. survival for patients who undergo total gross excision but have histologically positive margins (r1 resection) have a reduced survival in most series

Eligibility criteria:
inclusion criteria: * patients under surgical management for pancreatic cancer * patients whose radiological findings are compatible with resectability of the tumour including vascular encasement exclusion criteria: * patients who are medically unfit for surgery * patients whose radioliogical findins suggestive of unresectability of the tumour including vascular abutment or infiltration more than 180 dergree
levobupivacaine for epidural analgesia in labour

Conditions: Analgesia, Epidural

Summary: in a prospective randomised study involving primiparous women in spontaneous uncomplicated labour with cervical dilatation \> 7 cm, epidural analgesia will be given with an initial volume of 20 ml anaesthetic solution, followed by a standardised algorithm of top-up manual injections to achieve analgesia, then by a patient-controlled regimen with 5-ml self-administered boli in addition to a continuous infusion of 5 ml.hr-1. the anaesthetic solution will be levobupivacaine presented in 100-ml bags from the market, 0.0625%, or 0.125%, in which 10 ml (50 µg) of sufentanil will be added. the final concentrations will be 0.568 and 1.136 mg.ml-1 respectively, both with sufentanil 0.45 µg.ml-1. parturients and midwifes assessing pain during labour will be blinded to the design

since epidural analgesia has been developed to relieve labour pain, many solutions have emerged to lower risk / efficacy ratio, by using low-concentrated and/or less toxic local anaesthetics. levobupicaine emerges as a safer alternative than its racemic parent . it is available on the french market in pre-filled bags with two different concentrations (0.625 and 1.25 mg.ml-1), both indicated for analgesia in postoperative context and in labour, without more precision. presentation in bags allows preparing once at the initiation of epidural analgesia a solution usable throughout labour, leading the anaesthetist to a univocal choice, mostly following his/her personal beliefs. our aim is to compare the effects of epidural analgesia under these two presentations. sufentanil will be added to levobupicaine whatever the concentration used. this trial is conducted in primiparous, in which pain during labour is commonly more resistant to relief.

Eligibility criteria:
inclusion criteria: * parturient \> 18 years old * asa physical status 1 or 2 * primiparity * singleton * gestational age \> 36 weeks * spontaneous labour with cervical dilatation \> 7 cm exclusion criteria: * gestational age \< 36 weeks

Keywords: labor epidural analgesia local anesthetics levobupivacaine opiates patient-controlled active spontaneous labor requiring epidural analgesia
cognitive intervention for delirium in dementia

Conditions: Delirium; Dementia

Summary: the purpose of this study is to test the effectiveness of cognitively stimulating activities for resolving delirium in people with dementia.

the primary aim in this rct is to test the efficacy of recreational stimulation for elders as a vehicle to resolve dsd (reserve- dsd). the investigators will randomize 256 subjects, newly admitted to post acute care, to intervention (reserve-dsd) or control (usual care). intervention subjects will receive 30-minute sessions of tailored cognitively stimulating recreational activities for up to 30 days. the investigators hypothesize that subjects who receive reserve-dsd will have: decreased severity and duration of delirium; greater gains in attention, orientation, memory, abstract thinking, and executive functioning; and greater gains in physical function compared to subjects with dsd who receive usual care. the investigators will also evaluate potential moderators of intervention efficacy (lifetime of complex mental activities and apoe status). the secondary aim is to describe the costs associated with reserve-dsd.

Eligibility criteria:
inclusion criteria: * presence of delirium * mild to moderate cognitive impairments * 65 years of age or older * english speaking * community-dwelling * legally authorized representative available exclusion criteria: * severe vision or hearing problems * diagnosis of 1. major depression 2. parkinson's with lewy body disease 3. huntington's disease 4. normal pressure hydrocephalus 5. seizure disorder 6. subdural hematoma 7. head trauma 8. known structural brain abnormalities 9. acute cva/stroke 10. acute psychiatric condition * life expectancy \< 6 months

Keywords: delirium dementia non-pharmacological intervention post-acute care
study of the use of hearing protection equipment in the occurence of acute acoustic trauma in the army

Conditions: Acoustic Trauma

Summary: each year, military epidemiological surveillance counts approximately 1,000 acute acoustic injuries. most are caused by exposure to weapon noise during training sessions while military personnel are provided with hearing protection. several hypotheses could explain the occurrence of acute acoustic trauma despite wearing protections: * a lack of practices or knowledge about the use of hearing protection equipment that could facilitate the occurrence of acute acoustic trauma (improper fitting, use of an inappropriate type of protection, dropping of protectors, inappropriate removal) * a failure to seal the external ear canal due to an inappropriate plug size. these hypotheses will be explored using a questionnaire distributed to a population of army soldiers training to shoot. the main objective is to determine the predictive factors corresponding to practices or knowledge related to the use of hearing protection equipment in the occurrence of acute acoustic trauma in a population of army soldiers.


Eligibility criteria:
inclusion criteria: * be a member of the army * having performed at least one shooting session in the last 12 months exclusion criteria: * inability to read and/or write in french language
reducing delay in vaccination of children: logistic barriers

Conditions: Communicable Disease

Summary: this study will assess the impact of automated reminders for the 6 month and 12 month vaccine visits to increase vaccination in parents experiencing logistic barriers to vaccination.

parents of children less than 11 months of age will be identified as delayed or missing vaccinations due to logistic barriers in the kaiser permanente colorado population. parents identified will be randomized to the intervention arm or the usual care arm. those in the intervention arm will receive automated reminders for the 6 month and 12 month vaccine visits. reminders will include scheduling information as well as access to a website with vaccine and scheduling information. they will also have an opportunity to provide preferences in how they receive the automated reminders (text, phone or email). there will be 2 reminders before the 6 and 12 month visits and 2 after the 6 and 12 month visits. parents will be excluded from receiving reminders if they have received vaccines within the time frame when they are eligible to receive another vaccine or have a well child visit scheduled.

Eligibility criteria:
inclusion criteria: * parents of children less than 11 months of age * currently enrolled at kaiser permanente colorado at the time of identification * the child is missing recommended vaccinations exclusion criteria: * non-english speaking * diagnosis code indicating parent vaccine refusal

Keywords: logistic barriers to vaccination
treatment resistant depression in america latina

Conditions: Depressive Disorder, Treatment-Resistant

Summary: the purpose of this study is to estimate the prevalence of treatment resistant depression (trd) among major depressive disorder (mdd) participants being treated in a psychiatry reference site (example, clinic, ambulatory, hospital, day-hospital) in 4 latin american countries: argentina, brazil, colombia and mexico; and to evaluate all and depression-related healthcare resource utilization in trd participants.


Eligibility criteria:
inclusion criteria: phase 1: * major depressive disorder (mdd) diagnosis according to the diagnostic and statistical manual of mental disorders, 4th edition (dsm-iv), that was confirmed by mini international neuropsychiatric interview, 5.0 version (mini) * treated or untreated participants with a new or continued episode of depression at the time of the enrolment * participants must be capable of completing the corresponding assessments in the study * participants must be capable of signing the informed consent form phase 2: * diagnosis of treatment resistant depression (trd), to be described by the investigator, based on the criteria: 1. adequate follow-up and treatment with at least 2 antidepressants 2. without complete response to treatment (based on montgomery-asberg depression rating scale \[madrs\]) exclusion criteria: * participants diagnosed of psychosis, schizophrenia, bipolar disorder, schizoaffective disorder, or dementia * participants with substance dependence considered serious by the investigator * participant currently participating in another clinical study
parent-child interaction therapy (pcit) for children with traumatic brain injury (tbi): a stepped-care model

Conditions: Traumatic Brain Injury; Disruptive Behavior

Summary: the purpose of this study is to understand how a stepped-care model of parent-child interaction therapy (step-up pcit) addresses child behavioral problems among children between the ages of 2 and 7 with a traumatic brain injury (tbi).


Eligibility criteria:
child inclusion criteria: * child is between the ages of 2 and 7 * child has a mild to moderate tbi primary caregiver inclusion criteria: * primary caregiver is 18 years or older * primary caregiver speaks and reads in either english or spanish child exclusion criteria: - children with major sensory impairments (e.g., deafness, blindness) primary caregiver exclusion criteria: - primary caregiver with major sensory impairments (e.g., deafness, blindness)
a cafeteria based study of weight gain prevention

Conditions: Obesity; Overweight

Summary: the dramatic rise in overweight and obesity during the past several decades can be explained by environmental changes that foster increased energy intake and decreased energy expenditure. there are several reasons to suggest that the most effective approach to weight gain prevention is the incorporate reduced-fat eating into an overall strategy of lowering the energy density of the diet. our energy density manipulations will be designed to reduce both the fat content and the caloric density of foods served at a cafeteria, which serves as the "food environment" for hospital employees.


Eligibility criteria:
inclusion criteria: * works at one of the two hospitals and eats lunch in the cafeteria 2x per week * bmi between 23 and 25 exclusion criteria: * current diagnosis of a chronic disease or condition known to affect appetite or body weight * currently taking medication known to affect appetite or body weight * current pregnancy or plans to become pregnant within the next 24 months * current enrollment or plans to enroll within the next 24 months in an organized weight management program * plans to terminate employment at the hospital within the next 12 months

Keywords: weight gain prevention obesity overweight food environment the intervention group received the education in rede techniques the control group received no intervention at all. both groups were exposed to the food labels and the new lower ed foods. only the intervention group received the education sessions and only they were eligible for the price reductions.