Kornimate/medical-research-clean huggingface dataset:
a longitudinal study to identify mechanisms of menopause on cardiovascular disease risk

Conditions: Menopause; Cardiovascular Diseases; Vascular Dilation; Physical Activity

Summary: with the cessation of estrogen production at menopause, the risk of cardiovascular disease like arthrosclerosis, myocardial infarction and stroke increases dramatically. physical activity is the single most powerful "drug" for maintaining and improving cardiovascular health, but recent data suggest that the positive effect of physical activity is lost at menopause. in this project the investigators will follow a cohort of 200 women from before the women enter menopause and until at least 10 years past menopause. by advanced invasive methodologies the investigators will monitor the changes that occur in the blood vessels of the circulation, the heart and the brain and combine this with microrna sequencing of blood and tissue samples.


Eligibility criteria:
inclusion criteria: * normal ecg * regular menstruation exclusion criteria: * participation in other clinical projects * smokes or has smoked within the last 10 years * on hormone therapy * has chronic diseases that are not expected, cf. the groups sought. including heart problems, atrial fibrillation, cancer, immune diseases and previous strokes with functionally significant sequelae * being treated with oral steroids * has alcohol / drug abuse or is being treated with disulfiram (antabus) * is unable to understand the contents of the document with informed consent or the experimental procedures * pregnancy or breastfeeding * systolic blood pressure ≥140 mmhg and/or diastolic blood pressure ≥90 mmhg * ovariectomy * bmi\>28
cirqpod shoulder study

Conditions: Hypotension on Induction

Summary: intrathoracic pressure regulation (ipr) therapy, delivered by impedance threshold devices (itds) or intrathoracic pressure regulators (itprs), increases venous return, preload, cardiac output, blood pressure, and cerebral perfusion pressure by intermittently creating negative intrathoracic pressure, which improves circulation in hypotensive animals and humans. by increasing systemic pressure and cerebral perfusion as well as promoting venous return, ipr therapy potentially improves cerebral oxygenation. the lower intrathoracic pressures may also reduce pulmonary artery pressure, although there is currently little evidence one way or the other. use of an itpr can counteract the multifactorial intraoperative hypotension common during surgeries under general anesthesia, and reduce the need for other measures to treat such hypotension; however, they might simultaneously promote pulmonary complications. the investigators will therefore assess whether the use of intrathoracic pressure regulation in adults having shoulder surgery under general anesthesia in the sitting position reduces vasoactive medication requirements compared with routine clinical practice. simultaneously, the investigators will assess the effect of intrathoracic pressure regulation on pulmonary circulation, cerebral oxygenation, and postoperative atelectasis.


Eligibility criteria:
inclusion criteria: * age ≥18 years * american society of anesthesiologists (asa) physical status class ≤3 * scheduled for surgery in sitting/ beach-chair positions under general anesthesia in the cleveland clinic main campus * planned length of surgery \>60 minutes exclusion criteria: * severe peripheral vascular disease or other contraindication for use of vasopressor infusion * obstructive lung disease - moderate or severe asthma or copd * baseline hypoxemia (spo2\<92% on room air) * body mass index (bmi) \>35 * congestive heart failure * pneumothorax or hemothorax * uncontrolled hemorrhage * planned intraoperative hypotension * contraindication to trans-esophageal echocardiography (esophageal stricture, surgery involving the esophagus or stomach)

Keywords: intraoperative hypotension
thd versus open haemorrhoidectomy

Conditions: Hemorrhoids

Summary: a randomised study comparing transanal haemorrhoidal dearterialization (thd) and open haemorrhoidectomy (oh) for the treatment of prolapsing haemorrhoids. the primary aim of the study is to evaluate the long-term effect on haemorrhoidal symptoms one year postoperatively. secondary endpoints are postoperative pain, complications, effect on anal continence, recovery and return to normal activity, quality of life and health cost analysis.


Eligibility criteria:
inclusion criteria: * the patient has grade iii-iv haemorrhoids or grade ii haemorrhoids with bleeding resistant to rubber band ligation or sclerotherapy * the patient has a haemorrhoidal symptom score of 4 or more * the patient has an american society of anaesthesiologists (asa) score i-ii * the patient's age is 18-85 years at inclusion * the patient has had a colonoscopy, sigmoidoscopy or rigid rectoscopy within 3 months before inclusion exclusion criteria: * the patient has had previous operation for haemorrhoids within the last 2 years * the patient has had previous operation for anal incontinence * the patient has an active anal fistula * the patient has an active anal fissure * the patient has anal incontinence for solid stools

Keywords: hemorrhoids haemorrhoids transanal haemorrhoidal dearterialization transanal hemorrhoidal dearterialisation open haemorrhoidectomy open hemorrhoidectomy
periodontal therapy in a primary prevention of cardiovascular disease

Conditions: Periodontitis; Coronary Disease

Summary: cardiovascular diseases (cvd) are still considered the main cause of mortality and morbidity all over the world. in the last years, efforts have been made to define more effective therapeutic and preventive strategies.periodontal diseases have been considered a probable risk factor for cvd with a great amount of evidence from observational studies. although there are some interventional studies evaluating the systemic effects of periodontal therapy, there is little information regarding the impact of periodontal treatment on the prevention of cardiovascular events. to the best of our knowledge, there are no randomized controlled trials published to date assessing the effect of periodontal therapy in primary prevention of cvd.


Eligibility criteria:
inclusion criteria: * individuals having at least 50% of their dentition with periodontal probing pocket depths n4 mm and * with documented radiographic alveolar bone loss were included exclusion criteria: * known systemic diseases * history and/or presence of other infections * systemic antibiotic treatment in the preceding 3 months * treatment with any medication known to affect the serum level of inflammatory markers, lipids, or bp * pregnant or lactating females * allergy to tetracyclines
directstim deep brain stimulation system study

Conditions: Parkinson Disease

Summary: the purpose of this study is to obtain clinical outcome data on safety and effectiveness of the directstim dbs system when used on-label, according to the instructions for use. all participants will undergo bilateral implant in the subthalamic nucleus (stn) and data collected in common practice will be recorded during six months post-implant and analyzed.

directstim dbs therapy for movement disorders is indicated for patients with disabling tremor or symptoms of parkinson's disease. subjects selected to participate in the study will be parkinson's disease (pd) patients who are eligible for bilateral dbs for stn therapy and meet the inclusion criteria and none of the exclusion criteria. primary safety and effectiveness endpoints data will be collected through 6 months of follow-up. the values used for comparison are derived from a review of literature spanning from 2001 to 2019. after completing the 6 month follow-up, subject will exit the study, and continue to be followed by their physician per usual care.

Eligibility criteria:
inclusion criteria: * established diagnosis of idiopathic parkinson's disease for 4 years or more according to the united kingdom parkinson's disease brain bank criteria, with disabling motor complications despite optimal medical treatment. * patient is eligible for bilateral dbs for stn therapy according to center's routine criteria and according to the directstim dbs system indications for use statement. * patient who is willing to provide a written informed consent. * patient complies with the study follow-up, in particular the follow-up visits, and other study requirements. exclusion criteria: * patient is not eligible for dbs per center criteria. * patient has a cognitive impairment, or exhibits any characteristic, that would limit study candidate's ability to complete study assessments, such as: * active major psychiatric disorder. * dementia (moca dementia rating scale score \<26 or otherwise not capable of discernment). * presence of an electrical or electromagnetic implant (e.g. cochlear implant, pacemaker). * previous surgery for the treatment of parkinson's disease. * previous brain ablation procedure. * epilepsy. * coagulopathies. * abuse of drugs or alcohol. * patient is participating in another clinical study that would confound data analysis. * patient is pregnant or nursing. as for other dbs systems, the effects of the device on an unborn child are not established.

Keywords: deep brain stimulation dbs pd
retrospective clinical trial comparing radiologists' diagnosis accuracy in lung cancer screening population with and without the help of an ai/ml tech-based samd

Conditions: High Risk Cancer; Lung Cancer

Summary: this is a two arm, randomized, controlled, blinded, multi-case multi reader (mrmc), retrospective study for the evaluation of the efficacy and safety of an ai/ml technology-based cade/x developed to detect, localize and characterize malignancy score of pulmonary nodules on ldct chest scans taken as part of a lung cancer screening program. ldct dicom images of patients who underwent routine lung cancer screening will be selected and enrolled into the study. enrolled scans analyzed by radiologists with the assistance of the median lcs (formerly ibiopsy) device are compared to the analysis by radiologists without the assistance of the median lcs device. figures of merit for patient level and lesion level detection and diagnostic efficacy will be calculated and compared, sub-class analysis will be performed to ensure device generalizability.


Eligibility criteria:
inclusion criteria: * ≥50-80 years of age; * current or ex-smoker (\>=20 pack years); * patient screened and surveilled for lung cancer screening following lung cancer screening guidelines (equivalent to united states preventive services task force (uspstf) 2021 criteria); * received ldct due to inclusion in high-risk category for lung cancer. exclusion criteria: * prior lung resection; * pacemaker or other indwelling metallic medical devices in the thorax that interfere with ct acquisition; * patients/images used during ai model development; * patients with only hilar and/or mediastinal cancer(s); * patients with only ground glass cancer(s); * patients with nodules, solid or part-solid \>30mm (masses); * patients that are not accompanied with the required clinical information; * patients with imaging with any of the following: missing slices, slice thickness \>3mm; * partial cover of the lung.
comparative clinical evaluation of soft toric lens designs

Conditions: Astigmatism; Myopia

Summary: this study is evaluating the initial fit of toric contact lenses.


Eligibility criteria:
inclusion criteria: * be greater than or equal to 18 years old. * read, understand, and sign written statement of informed consent. * appear able and willing to adhere to the instructions set forth in this clinical protocol. * be existing soft contact lens wearers (no extended wear in the last 3 months, but silicone hydrogels in daily wear are allowed). * require a visual correction in both eyes (monovision allowed but no monofit). * have a spherical contact lens requirement in the range -0.50d to -6.00d. * have astigmatism of between -0.50 and -2.00dc in both eyes. * monocular distance visual acuity correctable to 6/9 (0.2 logmar) or better in each eye with best sphero-cylindrical refraction. * have normal eyes with no evidence of any ocular abnormality or disease. for the purposes of this study a normal eye is defined as one having: clear cornea, no anterior segment disorder, no clinically significant slit lamp findings (i.e. oedema, staining, scarring, vascularisation, infiltrates or abnormal opacities), no other active ocular disease or recent surgery exclusion criteria: * having worn rgp contact lenses within the last 30 days or pmma contact lenses within the last 3 months. * clinically significant corneal oedema, corneal vascularisation, corneal staining, tarsal abnormalities, bulbar injection or any other abnormality of the cornea that would contraindicate contact lens wear. * extended lens wear in last 3 months. * any systemic or topical medications that will in the investigator's opinion affect ocular physiology or contact lens performance. * any systemic disease affecting ocular health. * abnormal lacrimal secretions. * keratoconus or other corneal irregularity. * pregnancy, lactating or planning a pregnancy at the time of enrolment. * participation in any concurrent clinical trial. * any previous anterior ocular surgery. * subjects who are known to have an infectious systemic disease (e.g., hepatitis, tuberculosis). * subjects who are known to have an immunosuppressive disease (e.g., hiv positive). * subjects who are known to have diabetes. * employees or family members of the research site, principal investigator or study team.
effectiveness of alveogyl and cutanplast dressing on postoperative pain following tooth extraction: a clinical trial

Conditions: Facial Pain; Pain, Postoperative; Pain, Orofacial

Summary: this study aims to assess the post-dental extraction pain following the application of two different dressing materials. alvogyl® and absorbable gelatin sponges

effective postoperative pain relief improves the quality of recovery and the resumption of normal activities. many options are available for postoperative pain relief following tooth extraction including systemic analgesic, intra-alveolar socket dressing medicaments, and follow the postoperative instructions; the choice of the medication determined by drug availability, chance of side effect of some drugs and financial considerations. the use of intra-alveolar dressing materials is widely suggested in the literature such as alvogyl® that used as palliative treatment which includes eugenol (analgesic, anti-inflammatory), iodoform (antimicrobial), and butamen (anesthetic). absorbable gelatin sponges contain haemostatic material and may be used for local application in surgical procedures where traditional haemostasis is difficult. in addition to its haemostatic effect, an absorbable gelatin sponge can be used as a drug reservoir to provide sustained release of drugs the aim of this study is to measure the pain intensity after using socket dressing materials following tooth extraction.

Eligibility criteria:
inclusion criteria: * single tooth extraction * upper and lower teeth exclusion criteria: * surgical extraction * medically compromised patients * presence of active infection * presence of pathology

Keywords: alveogyl eugenol dental extraction post extraction pain
prehabilitation and rehabilitation in pad

Conditions: Peripheral Arterial Disease

Summary: to determine the effectiveness of pre and post-operative exercise therapy in patients undergoing peripheral artery stenting for peripheral arterial disease.

peripheral artery disease (pad) is a form of cardiovascular disease that affects the arteries supplying blood flow to the legs. the prevalence of pad is increasing rapidly in the united states. when pad is severe, it can cause pain with movement and limit a person's ability to walk or perform their normal daily activities. with severe pad, a procedure is often performed in which an artery is held open with a small tube called a stent. programs of exercise-based rehabilitation have been shown to greatly help these patients in terms of the pain they experience with walking, their ability to perform daily activities or those required by work, and improved quality of life. there is also a newer form of therapy, called prehabilitation, which has been shown to have important benefits for patients with pad. prehabilitation involves four to six weeks of exercise therapy and lifestyle recommendations before undergoing a stent procedure. prehabilitation helps patients improve exercise tolerance and make lifestyle changes that improve risk factors before the procedure. those who participate in prehabilitation programs have fewer complications with the stent procedure, spend fewer days in the hospital, and have a better ability to exercise and return to work more quickly. although the benefits of prehabilitation and rehabilitation are well established, most doctors neglect to recommend these treatments to their patients who undergo a stent procedure for pad. the research team will study the impact of prehabilitation, rehabilitation or both forms of therapy. the results will likely encourage more doctors to recommend the best option for their patients, and possibly to recommend both prehabilitation and rehabilitation among patients who are having a stent procedure.

Eligibility criteria:
inclusion criteria: * male or female adult diagnosed with peripheral artery disease (pad) * experiencing leg pain while walking * scheduled to have a stent for pad * able to perform exercise safely * postmenopausal and not of child bearing capacity exclusion criteria: * medically unstable patients * recent mi within 3 months * malignancy * uncontrolled diabetes mellitus (hba1c ≥8 mmol/l) * alcoholism or other recreational drug use
interleukin 6-guided antibiotic prescriptions in aecopd inpatients

Conditions: Chronic Obstructive Pulmonary Disease, COPD

Summary: in this multicenter, prospective, randomized controlled study, we aimed to figure out, compared with the global chronic obstructive pulmonary disease initiative (gold) guideline -guided antibiotic therapy, whether interleukin 6 (il6)-guided antibiotic therapy for acute exacerbation of chronic obstructive pulmonary disease (aecopd) can lead to a reduction in the use of antibiotics without increasing the rate of treatment failure.

acute exacerbation is the first leading cause of hospitalization and mortality among patients with copd. infection of bacteria has been detected in 49.59% of patients with aecopd. antibiotic prescriptions for aecopd patients are usually based on gold guideline. however, the newest study reported that more than 85% of aecopd inpatients received antibiotic prescription in the united states, europe and china. not all patients will equally experience benefit from antibiotics. interleukin 6 (il6) was determined as a reliable clinical biomarker in guiding antimicrobial use. it remains unclear whether il6-guided antibiotic therapy is safe and effective for hospitalized patients with aecopd. the study will recruit 440 aecopd inpatients from at least six hospitals based in china. eligible participants will be assigned to receive either il6-guided antibiotic therapy or gold-guided antibiotic therapy in 1:1 ratio randomly. the hypothesis for this study is that il-6 guided antibiotic therapy will reduce the rate of antibiotic prescriptions for aecopd without increasing the rate of treatment failure, compared with the group treated with gold-guided antibiotic therapy.

Eligibility criteria:
inclusion criteria: 1. aecopd patients admitted to hospitals 2. the exacerbation has lasted for at least 24 hours but equal to or less than 21 days 3. ≥40 years of age but no more than 80 years old 4. with at least 10 pack-year history of smoking 5. able to provide written informed consent and ensure the completion of the trial exclusion criteria: 1. axillary temperature≥38°c 2. acute pneumonia identified by x-ray or ct of the chest 3. severe respiratory failure requiring admittance to icu 4. comorbidities require antibiotic therapy (i.e. infection at another site, systematic infection, active chronic inflammatory condition, specific viral infection) 5. immunosuppression status (i.e., patients with hiv infection, with malignant tumor of blood system, receiving chemotherapy) 6. concurrent diseases requiring corticosteroids (equivalent to 60mg prednisone/day or more than 30 days) 7. antibiotic use in the previous four weeks 8. current tracheotomy status 9. bronchiectasis of origin other than copd 10. invasive mechanical ventilation 11. patients diagnosed malignant tumors 12. pregnant or lactating women, or women of childbearing age not using an acceptable method of contraception. 13. newly diagnosed pulmonary embolism 14. participation in another clinical trial

Keywords: aecopd interleukin 6 antibiotic therapy
induction chemoimmunotherapy combined with chemoradiotherapy in esophageal cancer

Conditions: Esophageal Cancer; Immunotherapy; Induction Therapy; Chemoradiotherapy; Surgery

Summary: although unprecedented advances have been made in the field of esophageal cancer in recent decades, the prognosis for patients with locally advanced esophageal squamous cell carcinoma (escc) remains extremely poor, accounting for 30-40% of overall survival at 5 year. in recent years, multimodal treatments have proven to be an appropriate therapeutic approach for locally advanced escc. recently, immunotherapy developed rapidly. the purpose of this study was to observe the efficacy and safety of cardonilizumab combined with chemoradiotherapy in the treatment of locally advanced escc.


Eligibility criteria:
inclusion criteria: * 18-80 years old； * eligible patients were histologically confirmed esophageal squamous cell carcinoma; * eligible patients were proven locally advanced escc (ct1-2n1-3m0-1, ct3/t4n0-3m0-1, m1 was limited to supraclavicular lymph node metastasis）diagnosed by computed tomography \[ct\] and/or endoscopic ultrasonography \[eus\] according to the american joint committee on cancer (ajcc) 8th edition staging system； * ecog ps score: 0\~1； * main organs and bone marrow function are normal: routine blood tests: hemoglobin (hb) ≥100g/l ; absolute neutrophil count (neut)≥1.5×109/l; platelets (plt) ≥100×109/l; white blood cell (wbc)≥3.5×109/l,biochemical examination: alanine aminotransferase (alt) and aspartate aminotransferase (ast) ≤1.5×unl; serum total bilirubin (tbil) ≤1.5×unl; serum creatinine ( cr) 1.0×1.5unl, and bun≤1.0×unl; exclusion criteria: * those combined with other primary malignant tumors other than esophageal cancer (except cured basal cell carcinoma of the skin and carcinoma in situ of the cervix); * patients who had previously received other treatments * at the time of diagnosis, there were distant and hematogenous metastases beyond the supraclavicular lymph node region, including retroperitoneal multiple lymph node metastasis, bone metastasis, brain metastasis, lung metastasis, liver metastasis, malignant pleural effusion and ascites * those who already have esophageal perforation or are at high risk of esophageal perforation * patients whose tumors invade close to large blood vessels and are at risk of bleeding in the * there are active infections, such as active tuberculosis and hepatitis * there are contraindications to immunotherapy. * pregnant or lactating women and women of childbearing age do not take reliable contraceptive measures * combined with serious cardiovascular diseases, such as uncontrolled heart failure, coronary heart disease, cardiomyopathy, uncontrolled arrhythmia, uncontrolled hypertension, or a history of myocardial infarction within the past 6 months; and those combined with other uncontrolled acute and chronic diseases such as hypertension and diabetes. * violation of inclusion and exclusion criteria, or other reasons that the researcher believes cannot continue the study of drug treatment.