Kornimate/medical-research-clean huggingface dataset:
impact of subclinical hypothyroidism on short-term outcomes in patients with acute coronary syndrome in sohag university hospitals

Conditions: Subclinical hypothyroïdism; Acute Coronary Syndrome

Summary: introduction: subclinical hypothyroidism (sch) is defined biochemically as a normal serum free thyroxine (t4) level in the presence of an increased serum thyroid stimulating hormone (tsh) concentration.(1) its prevalence ranges from 4 to 15 percent and is higher in females and increasing age.(2) overt hypothyroidism was associated with accelerated atherosclerosis and an increased risk of cardiovascular abnormalities. (3) some studies have reported a higher atherosclerotic cardiovascular disease risk in patients with sch. (5-8) elevated tsh levels were observed to be associated with higher cholesterol levels.(9) higher mortality was also reported in some studies (6,10) especially with tsh ≥ 10.0 miu/l, in contrast to other studies.(11,12) heart failure events and myocardial infarction have been reported to be higher.(13,14) these findings in sch patients could be explained by mitochondrial oxidative stress due to elevated inflammatory markers, hypercoagulability, endothelial dysfunction, insulin resistance, increased vascular resistance and left ventricular diastolic and systolic dysfunction.(3,15,16) as is the case with overt hypothyroidism, sch was observed to be associated with elevated peripheral vascular resistance and diastolic dysfunction.(17) there are a few studies evaluating the effects of subclinical hypothyroidism on the outcomes of acute coronary syndrome patients.


Eligibility criteria:
inclusion criteria: * adult patients (age ≥18 years) diagnosed with acute coronary syndrome exclusion criteria: 1. patients with overt hypothyroidism or hyperthyroidism. 2. pregnant and lactating females 3. patients with severe comorbid conditions e.g. malignancy decompensated liver diseases or end stage kidney diseases. 4. patients with a history of taking medications affecting thyroid function
response to donepezil, drug plasma concentration and the cyp2d6 and apoe genetic polymorphisms

Conditions: Late Onset Alzheimer Disease

Summary: pharmacological treatment of ad is currently based on cholinesterase inhibitors (chei) and memantine, which have been shown to lead to modest, although effective, clinical benefits. donepezil is a chei metabolized through the cytochrome p (cyp) 450, primarily by the 3a4 and 2d6 isoforms. the cyp2d6 gene presents polymorphisms that can alter its expression. the plasma therapeutic level ranges from 30 to 75 ng/ml, and 50% of acetylcholinesterase inhibition is achieved when the concentration reaches 15.6 ng/ml. an optimal plasma level is greater than 50 ng/ml. these polymorphisms may influence the individual's response to treatment with donepezil and the concentration of the drug in ad patients, without achieving the desired effect. however, most of the individuals are em, i.e., the metabolism of the drug occurs according to the expected kinetics and is associated with the presence of one or two wild-type alleles. objective: investigate the pattern of clinical response to donepezil in a group of patients with ad and ad with cerebrovascular disease (cvd) in relation to the plasmatic concentration of donepezil and polymorphisms of the cyp2d6 and apolipoprotein e (apoe) genes.

patients taking donepezil were seen four times (from june 2009 to march 2013) and were submitted to the mmse test, the consortium to establish a registry for alzheimer'sdisease battery (cerad), and the pfeffer functional activities questionnaire. cerad memory evaluation was further divided into five components: incidental recall (cerad151 inc), immediate recall 1 and 2 (cerad-rm1, cerad-rm2, respectively) and delayed recall after five minutes (cerad-r). each aspect was analyzed individually and compared between groups at baseline and after 12 months of treatment with donepezil. all patients had blood samples (10ml) collected to obtain donepezil plasmatic concentration (dpc) measurements and for apoe and cyp2d6 genotyping.

Eligibility criteria:
inclusion criteria: * patients fulfilling the national institute on aging and the alzheimer's association diagnostic criteria of probable ad dementia or the ninds-airen (national institute of neurological disorders and stroke and association internationale pour la recherché et l'enseignement en neurosciences) diagnostic criteria of ad with cerebrovascular disease (ad + cvd) * patients presenting mild or moderate dementia according to the clinical dementia rating (cdr), i.e., cdr 1 or 2, respectively exclusion criteria: * patients treated with chei or memantine before study entry * patients diagnosed with frontotemporal dementia, dementia with lewy bodies or vascular dementia, * patients classified as cdr 3 or with mild cognitive impairment * illiterate patients * disagreement between the first investigator and the treating physician regarding the diagnosis

Keywords: alzheimer apoe cyp2d6 donepezil genetics
ultrasound-ct fusion image-guided minimally invasive interventional treatment of lumbosacral nerve roots

Conditions: Low Back Pain

Summary: the study is aimed at patients with low back and leg pain. the patients in the experimental group were guided by ultrasound-ct fusion imaging to insert the lumbar nerve root puncture needle. patients in the control group underwent the insertion of the lumbar nerve root puncture needle under the guidance of ultrasound alone.

a total of 80 patients with low back and leg pain were randomly divided into two groups, 30 people in each group. the patients in the experimental group were guided by ultrasound-ct fusion imaging to insert the lumbar nerve root puncture needle.patients in the control group underwent the insertion of the lumbar nerve root puncture needle under the guidance of ultrasound alone.follow-up of vas pain score after lumbar nerve root block treatment. this study aims to establish a standardized operation method and process for lumbosacral nerve ultrasound-ct fusion guided interventional pain treatment.

Eligibility criteria:
inclusion criteria: 1. patients who need lumbar nerve root block treatment exclusion criteria: 1. tumor patients 2. patients who have had lumbar spine surgery before
inter-observer reliability and accuracy of tricuspid annular plane systolic excursion in patients with suspected pe in the ed

Conditions: Pulmonary Embolism

Summary: the purpose of this study will be to evaluate the measurement of tricuspid annular plane systolic excursion (tapse) by emergency physician performed echocardiogram on patients with suspected pulmonary embolism (pe) who are scheduled to get a computed tomography of the pulmonary arteries (ctpa)

this will be a prospective observational cohort study aimed at determining the utility and reproducibility of tapse, in patients who present to the emergency department with suspected pulmonary embolism (pe). the gold standard diagnostic test for pe is computed tomography of the pulmonary arteries (ctpa). any patient for whom a ctpa is ordered because of suspected pe is eligible for study inclusion

Eligibility criteria:
inclusion criteria: * concern for pe by attending physician and ctpa ordered exclusion criteria: * if patient is under the age of 18, a prisoner, or a ward of the state * ctpa ordered but not performed
small airway disease and bronchial hyperreactivity in patients with post acute covid-19 syndrome

Conditions: COVID-19

Summary: the aim of this work is to estimate the frequency of small airway disease and/or the bronchial hyperreactivity in follow up of postacute covid survivors.

this is a observational longitudinal study investigating pulmonary sequelae of covid-19. study site: mansoura university hospital, chest department and post covid outpatient clinic. elmahalla chest hospital and outpatients clinic. time of study : two years from september 2021 to september 2023 target population: adults with confirmed covid 19 who remaining symptomatic after 30 days from the diagnosis. sample size the study will include 100 selected cases during period from 2021 to 2023 patients : the enrolled patients are adults who survived acute covid-19 and presented for clinical follow up.

Eligibility criteria:
inclusion criteria: * ambulatory adult patients confirmed diagnosis of covid -19 either on typical ct chest basis or pcr and passed period of acute illness (28 days from start of symptoms) but still with clinical symptoms. exclusion criteria: * hospitalized or requiring intensive care unit. known patients with chronic lung diseases uncontrolled comorbidities
analgesic efficacy of different nerve blocks in postoperative cesarean section

Conditions: Post Operative Pain

Summary: comparing analgesic efficacy of different nerve blocks on post operative cesarean sections.

analgesic efficacy of erector spinae, quadratus lumborum and intrathecal morphine for post operative pain relief after cesarean section,

Eligibility criteria:
inclusion criteria: * 18-40 years old * more or equal 37 weeks of gestation * asa 1,2 * elective cesarean delivery exclusion criteria: * patient refusal * inability to cooperate with or understand the study * local infection. * bleeding disorder * known anaphylaxis to any drug used in the trial * asa physical status more than 2 * emergency operations * chronic opioid use (opioid use in the past 3 months) * neurologic deficit or disorder * contraindication to regional anesthesia.
study to test the feasibility, acceptability, and weight change of take off pounds sensibly (tops) in a safety net clinic

Conditions: Obesity

Summary: the purpose of this pilot proposal are the following: 1) to determine the feasibility and acceptability of integrating the tops weight loss program into underserved populations through an urban safety net clinic and 2) to gather preliminary data of weight change to inform the design of a future randomized, controlled trial to determine the efficacy of the tops program in safety net clinics. to achieve these goals, the investigators will pursue the following specific aims: specific aim 1. assess the feasibility and acceptability of integrating the tops program into an urban safety net clinic, with process measures (i.e., recruitment/refusal rates and retention/dropout rates) and focus groups. hypothesis 1. integrating the tops program into an urban safety net clinic is feasible and acceptable to participants. specific aim 2. assess the percent of participants in the tops intervention arm with clinically significant weight change (i.e., weight loss of ≥5% of initial body weight) at 12, 26, and 52 weeks. hypothesis 2. 10%, 25%, and 33% of participants in the tops intervention arm will lose ≥5% of initial body weight at 12, 26, and 52 weeks, respectively.


Eligibility criteria:
inclusion criteria: * participants must be patients of the doc. * bmi: asian patients with a bmi of ≥23 kg/m2 and patients of other racial and ethnic backgrounds will be included if have a bmi of ≥25 kg/m2. asian patients are allowed to participate at a bmi in the normal range because they are more likely to develop diabetes (or insulin resistance or glucose intolerance at a bmi of 23 kg/m2). exclusion criteria: * mental illness that would cause disruptions to group meetings * cognitive impairment that would preclude participants from understanding the program * type 2 diabetics on insulin or sulfonylureas without provider approval * untreated hyper- or hypothyroidism * current cancer diagnosis * history of cancer (other than skin cancer) * gastrointestinal disorders affecting food intake * use of medications thought to effect metabolism, body weight, energy expenditure, or appetite * women currently pregnant or lactating, planning to become pregnant, or less than 6 months post-partum * weight loss of \> 5% in past 6 months * major psychiatric disorder * current moderate to severe symptoms of depression * eating disorders * current alcohol or substance abuse.
efficacy of vitamin c administration for the prevention of postpolypectomy bleeding

Conditions: Postpolypectomy Bleeding

Summary: postpolypectomy bleeding is the most common major complication following a colonoscopic polypectomy procedure. the incidence rate ranging from 0.3 to 6.1%. several preventive methods such as detachable snare and adrenaline injection have been proposed in the management of postpolypectomy bleeding in large colonic polyps. it has been demonstrated that administration of ascorbic acid (vitamin c) in abdominal surgeries could reduce the blood loss during the procedure, operation time and days of hospitalization. so the investigators designed a prospective, randomized study to compares the efficacy of vitamin c administration with application of prophylactic clip and detachable snare in the prevention of postpolypectomy bleeding in large polyps.

in this prospective, randomized clinical trial, patients diagnosed with colon polyps with a diameter \> 10 mm will randomized to receive either a 500 mg vitamin c in normal saline injection or a normal saline injection 2 hours before polypectomy. this administration will continued for 3 days after polypectomoy. postpolypectomy bleeding is defined either as (1) early: occurring either during an endoscopic procedure or immediately after as hematochezia within 24 h or (2) delayed: any bleeding event that occurring between day 2 and day 30 following the polypectomy procedure.

Eligibility criteria:
inclusion criteria: * colorectal polyps larger than 10 mm. exclusion criteria: bleeding tendency poor preparation
effectiveness of a program with aquatic therapy in patients with parkinson's disease clinical trial

Conditions: Parkinson Disease; Physical Disability

Summary: the aim of this study is to determine the effect of an aquatic ai chi training program on the perception of pain, the maintenance of balance and the functional independence of patients with parkinson's disease. fifteen patients diagnosed with parkinson's disease (hoehn and yahr range: 1-3) participated in a program of aquatic ai chi lasting ten weeks with sessions held twice weekly. these were compared to a group of 15 parkinson patients (control group) who received therapy on dry land.

all study participants met the following inclusion criteria: individuals diagnosed with pd in stages 1 to 3 (hoehn and yahr scale), older than 40 years, in the off phase (not medicated) and with a score greater or equal to 24 on the mini-mental state examination scale, without any medical contraindications and who accepted the study norms (regular assistance and active participation). the exclusion criteria were: individuals who did not comply with the above mentioned criteria, and the presence of articular and/or muscular lesions in the lower limbs affecting independent gait. the procedure of randomization was performed for the overall sample using stratified randomization controlling for the hoehn \& yahr stage employing excell software (microsoft excell 2013: microsoft corp. redmond wa). the participants received an initial assessment on dry land lasting 30-45 minutes, performed by a physiotherapist not involved in the study. timetable norms were disclosed as well as recommendations regarding appropriate clothing for the activity. a baseline assessment was performed prior to commencing therapy. this was repeated upon completion of all sessions while a follow-up assessment took place one month later.

Eligibility criteria:
inclusion criteria: * individuals diagnosed with pd in stages 1 to 3 (hoehn and yahr scale), older than 40 years, in the off phase (not medicated) and with a score greater or equal to 24 on the mini-mental state examination scale, without any medical contraindications and who accepted the study norms (regular assistance and active participation). exclusion criteria: * individuals who did not comply with the above mentioned criteria, and the presence of articular and/or muscular lesions in the lower limbs affecting independent gait.
contrast-enhanced ultrasound ability in the characterization of ovarian masses

Conditions: Ovarian Tumor

Summary: this study intends to assess the ability of contrast-enhanced ultrasound in the detection of benign and malignant ovarian masses compared to unenhanced ultrasound. by using an intravascular contrast agent, this noninvasive and feasible imaging technique will allow the investigators to define specific microcirculation patterns in 100 women with ovarian lesions. the intravascular contrast agent properties will be compared between benign and malignant adnexal masses. the final purpose of this ultrasonography is to allow the early detection of tumors and to improve the characterization between benign and malignant lesions.

sonovue (sulphur hexafluoride microbubbles) is a microbubbles preparation that is stable, resistant to pressure and specifically designed to be used as a contrast agent for ultrasound imaging. study design : one contrast-enhanced ultrasonography is proposed before any surgery to patients with ovarian mass.

Eligibility criteria:
inclusion criteria: * 18 years of age or older * patient with adnexal mass detected by ultrasound * any programmed surgery exclusion criteria: * any contraindication to surgery * injection of another contrast agent within 24 hours before the study examination * pregnancy, breastfeeding * patient known to have a coronary syndrome * unstable angina and myocardial infarction * acute cardiac failure, class iii/iv cardiac failure * severe rhythm disorders * acute endocarditis * prosthetic valves * patient previously having received an investigational drug within 30 days prior to admission into this study

Keywords: contrast-enhanced ultrasound ultrasound contrast agent, microbubbles ovarian tumor vascularization
effects of il-1 beta on the hpa-axis in obese persons

Conditions: Metabolic Syndrome; Hypersecretion; Cortisol

Summary: in obese individuals cortisol production and secretion is increased but the underlying mechanism is not known. obesity leads to a pathological activation of the innate immune system partly driven by tissue production of il-1β. furthermore, il-1β is also known to stimulate the release of adrenocorticotropin hormone (acth). therefore, the investigators hypothesise that in obese individuals tissue inflammation stimulates acth via il-1β, thereby explaining the observed hypercortisolism.


Eligibility criteria:
inclusion criteria: * age 18-80 years * bmi \>30kg/m2 and at least 1 manifestations of the metabolic syndrome (i.e. diabetes/ prediabetes, hypertension, dyslipidemia) * willingness to use contraceptive measures adequate to prevent becoming pregnant exclusion criteria: * medication with glucocorticosteroids * known cushing syndrome * pregnancy or breast feeding * clinical signs of infection in the week before inclusion or history of a severe infection during the last 2 months * hematologic disease (leukocyte count \< 1.5x109/l, hemoglobin \<11 g/dl, platelets \<100 x 103/ul) * kidney disease (creatinine-clearance \< 30ml/min)) * liver disease (transaminases \>4x upper normal range) * active carcinoma * history of tuberculosis * alcohol consumption \>40g/d for men, \>30g/d for women * known allergy towards anakinra * subject refusing or unable to give written informed consent
safety and efficacy of mem 1003 versus placebo for the treatment of patients with bipolar i disorder

Conditions: Bipolar Disorder With Manic or Mixed Episodes

Summary: the purpose of this study is to establish the potential of mem 1003 as a safe and effective treatment for patients with an acute manic or mixed episode of bipolar disorder.

bipolar affective disorder is one of the most common, severe, and persistent mental illnesses. it is characterized by periods of deep, prolonged, and profound depressions that alternate with periods of excessively elevated and/or irritable mood (mania). the pathophysiology of bipolar disorder is complex, and can include an inheritable component, administration of antidepressant medications, behavioral sensitization processes, and neuronal calcium dysregulation that leads to apoptosis of critical brain circuitry that regulates emotion. addressing the dysregulation in calcium levels in the central nervous system by administering compounds such as mem 1003 may have the potential for altering the cyclical course or progression of bipolar disorder. mem 1003 is the (+)-enantiomer of a dihydropyridine that has been optimized for central nervous system activity. it inhibits l-type ca2+ channels and within the anticipated human dosing range has more benign cardiovascular effects than other dhp l-type calcium channel modulators.

Eligibility criteria:
inclusion criteria: * bipolar i disorder with acute manic or mixed episode, with or without psychotic features * ymrs score of at least 20 * history of at least one previous manic or mixed episode requiring treatment in the last 10 years exclusion criteria: * history of failing to respond to treatment with two or more adequate trials of approved anti-manic medications for the current episode * axis i or axis ii disorder (other than bipolar i disorder) that requires treatment or has been the primary subject of treatment in the past 3 months * defined substance abuse or dependency within the 3 months * schizophrenia, schizoaffective disorder, delusional disorder, mental retardation or pervasive developmental disorder * suicidal or danger to others

Keywords: bipolar mania mixed