Kornimate/medical-research-clean huggingface dataset:
predictive elements of trauma and its after-effects: importance of the quality of neurobiological response to stress

Conditions: Stress Reaction

Summary: the neurobiological response to stress is an adaptive response allowing us to cope with the multiple aggressions of daily life. this response orchestrates the body's systemic reaction. the intensity of response to stress can modify the body's functioning, which implies a variety of fields where biomarkers may be isolated: immunity, psychology, neurophysiology, integrative physiology. when stress is too intense or prolonged, response to stress may become misfitted and deleterious. this study is based on the hypothesis that a severe physical or psychological trauma is associated with an intense and misfitted stress that is responsible from an undue immuno-inflammatory activation (through sympathetic activation). the result is a subinvasive state of systemic and tissue inflammation (low-noise inflammation), responsible for the mid-term deleterious consequences of the traumatic event. the objective of this study is to understand how the dysregulation of intense stress simultaneously generates an initial pathological state and an alteration of mid-term evolution (which is considered as a poor prognosis and/or as responsible for after-effects). the investigators wish to identify relevant biomarkers of the mechanisms activated during intense stress and influencing the immuno-inflammatory and epigenetic spheres with deleterious consequences on physiological and psychological functions.


Eligibility criteria:
inclusion criteria: * fracture of the upper end of the femur * cognitive state allowing the understanding of questionnaires exclusion criteria: * traumatic brain injury * chronic inflammatory or immune pathologies * on anticoagulants * on neuroleptic or antidepressant treatment * pathology or health condition not allowing 1-year survival
tübingen high altitude ophthalmology study

Conditions: Altitude; Hypoxia

Summary: tuebingen high altitude ophthalmology study to investigate the effects of high altitude on retinal structure and function as well as anterior chamber in regard to acute mountain sickness.


Eligibility criteria:
inclusion criteria: * healthy subjects, non-smokers, physical fitness, exclusion criteria: * ocular pathologies, ascent above 2000m 2 weeks prior to study and 2 weeks before post-examination
clinical and electrophysiological predictors of arrhythmic recurrence in patients with paroxysmal af undergoing first ablation procedure of af by pulmonary vein isolation

Conditions: Atrial Fibrillation Paroxysmal

Summary: from the literature, the success rate (i.e., absence of af recurrence) of ablation in cases of paroxysmal af at one year changes between 70 and 85 percent. this rate is considered suboptimal. currently there are no data that can assess which factors are predictive of recurrence both clinically and electrophysiologically. in particular, it is not known whether and to what extent the atrial substrate present under baseline conditions affects the success rate of the procedure and what relationships exist with other predictors such as age, sex, atrial size at echo, and duration of arrhythmia.

this is a multicenter prospective and retrospective observational study aimed at examining the role of the left atrial substrate and other baseline clinical variables on the efficacy of transcatheter ablation in patients with paroxysmal atrial fibrillation (af) who underwent pulmonary vein isolation regardless of the power source and balloon or "point by point" catheters used. the study will evaluate whether there are baseline clinical or electrophysiological features that can predict the success of transcatheter atrial fibrillation ablation even before it is performed, so as to assess which patients may actually benefit, and which patients should instead undergo more extensive ablative procedures in conjunction with pulmonary vein isolation to achieve an optimal success rate.

Eligibility criteria:
inclusion criteria: * patients with indication for af ablation * adequate anticoagulation therapy according to chads vasc exclusion criteria: * patients who had already undergo an af ablation procedure * presence of intracavitary thrombus * ejection fraction \<35% * pregnancy * hematologic contraindications to ionizing radiation exposure * congenital heart diseases * cardiac surgery \< 1month * uncontrolled heart failure * valvular disease * contraindications to general anesthesia

Keywords: pulmonary vein isolation atrial fibrillation catheter ablation electroanatomical map
dexmetomedine as an adjuvant to bupivacaine in ultrasound guided pecs block

Conditions: Post Operative Pain

Summary: regional anesthesia is an essential component of anesthesia and analgesia. it has many advantages, it decreases pain post operatively, improves patient outcome and allow early recovery and ambulation post-operative pain following breast surgery results from injured muscles and nerves, management of acute post operative pain is a consistent factor for better outcome and patient satisfaction

all patients will be monitored by standard intraoperative monitoring that includes continuous electrocardiography (ecg), capnography, pulse oximetry, and non invasive blood pressure. induction of general anesthesia will be done by propofol 1.5-2 mg/kg and fentanyl 3µg/kg. tracheal intubation will be facilitated by administration of rocuronium 0.8 mg/kg. anesthesia will be maintained with isoflurane 1mac (pecs block):the block will be performed with the patients in the supine position.the infraclavicular and axillary regions will be cleaned with antiseptic solution. the in plane technique will be used from proximal and medial to distal and lateral in an oblique manner at dermatome level t2 and t3.the puncture site was infiltrated with 2%lidocaine and once the structures is identified with ultrasound

Eligibility criteria:
inclusion criteria: * adult patients * aged 18-60years old * asa class 1 to 3 * scheduled for elective modified radical mastectomy exclusion criteria: * patients refusal, * coagulopathies * concurrent anticoagulant therapy * allergy to local anaesthetics * infection at puncture site
description of relugolix use in patients with prostate cancer within the vha

Conditions: Prostate Cancer

Summary: the purpose of this real-world study is the learn about the demographics and clinical characteristics of patients with prostate cancer who initiated relugolix

prostate cancer (pc) is the most common cancer and the second leading cause of cancer death among men in the united states. androgen deprivation therapy (adt) such as injectable luteinizing hormone-releasing hormone (lhrh) agonists (e.g., leuprolide) is the standard of care for pc patients. adt treatment can suppress testosterone level to castrate level and delay the progression of the disease. relugolix is a recently approved oral gnrh antagonist. while the introduction of relugolix has offered a unique opportunity for patients with pc, it's vital to understand how it is being used in real-world.

Eligibility criteria:
inclusion criteria: * male with ≥ 1 diagnosis for pc * had ≥ 2 prescriptions of relugolix on or after the first observed pc diagnosis. * index date: the initiation date of relugolix * at least 18 years old at the index date exclusion criteria: * had surgical castration (bilateral orchiectomy) any time before the index date

Keywords: relugolix
a study of ly3209590 on low blood sugar in participants with type 2 diabetes mellitus

Conditions: Type 2 Diabetes Mellitus

Summary: the main purpose of this study is to evaluate the effect of study drug known as ly3209590 compared to insulin glargine administered in participants with type 2 diabetes mellitus (t2dm). side effects and tolerability will be documented. the study will last almost six months and 21 visits for each participant including screening period.


Eligibility criteria:
inclusion criteria: * have been diagnosed with type 2 diabetes mellitus (t2dm) for at least 1 year prior to screening * body mass index (bmi) of 18.5 to 40.0 kilograms per meter squared (kg/m²) * be treated for t2dm with stable dose of metformin, a stable dose of a dipeptidyl peptidase-4 (dpp-4) inhibitor with or without metformin, or a stable dose of a glucagon-like peptide-1 (glp-1) receptor agonist with or without metformin for at least 3 months prior to screening exclusion criteria: * have an abnormality in the 12-lead ecg * have a supine blood pressure at screening * have alanine aminotransferase (alt) or aspartate aminotransferase (ast) \>2.5x upper limit of normal (uln) * have a history of or current cardiovascular, respiratory, hepatic, renal, gastrointestinal, endocrine (except t2dm and controlled thyroid disease), haematological, or neurological disorders * are receiving chronic (lasting longer than 14 consecutive days) systemic or inhaled glucocorticoid therapy * have an average weekly alcohol intake
effect of early prosthetic fitting in patients with below knee amputation

Conditions: Amputation of Knee

Summary: a randomized control trial of 50 patients to identify the effect of early prosthetic fitting and physical rehabilitation. previous studies show a significant impact of early induction of prosthetic rehabilitation of amputation.

delayed rehabilitation may cause severe physical complications like joint contracture, muscle strength loss. along with physical complications delayed in rehabilitation may also significantly affect psychological, economical and quality of daily life. pakistan is a low income under developed country and major cause of amputation in here is traumatic amputation, that will effect mostly the younger age people. after missing a precious body part if the amputee comes along with such kind of physical and psychological complications, his/her whole daily life will be effected. there is a keen need of implementation of global rules for physical rehabilitation of amputees and disables including the duration of induction of prosthetic as well as overall physical rehabilitation after surgical and traumatic removal of limbs.

Eligibility criteria:
inclusion criteria: * male and female below-knee amputees due to trauma and diabetes exclusion criteria: * patients with comorbidities * old user of prosthesis
oxaloacetate supplementation for emotional pms

Conditions: Premenstrual Syndrome (PMS)

Summary: emotional premenstrual syndrome (pms) affects millions of women worldwide. for emotional pms, including depression, anxiety, perceived stress and aggression, there are very few options. recent observational data suggest that nutritional supplementation with oxaloacetate, a human energy metabolite, greatly reduced the symptoms of emotional pms. the aim of this study was to confirm these observations on the effects of oxaloacetate on emotional pms symptom severity within a controlled clinical trial setting.

oxaloacetate is an energy metabolite found in every cell of the human body. it holds a key place in the krebs cycle within the mitochondria, providing energy to the cells. it is also a critical early metabolite in gluconeogenesis, which provides glucose for the heart and brain during times of low glucose. it is critical to human metabolism, proper cellular function and it is central to energy production and use in the body. oxaloacetate may affect emotional pms through multiple mechanisms. during pms, there is a large increase in glucose utilization in the cerebellum of the brain in women who are affected with emotional mood swings. oxaloacetate supplementation has been shown to support proper glucose levels in the body. having an excess of oxaloacetate allows gluconeogenesis take place upon demand, thereby fueling the brain, and perhaps meeting cerebellum glucose need. in addition to oxaloacetate's ability to support proper glucose regulation, oxaloacetate affects two chemicals in the brain, gaba and glutamate. altering the gaba/glutamate ratio can affect mood. oxaloacetate supplementation can reduce glutamate levels in the brain via a process called "glutamate scavenging". in addition, oxaloacetate supplementation was shown to increase gaba levels in animal models. by both lowering glutamate and increasing gaba, the gaba/glutamate ratio is affected, which may also help women with emotional pms. this study will investigate oxaloacetate's effect on emotional pms using patient completed surveys to measure depression, anxiety, perceived stress, and aggression, and statistically compare these results against placebo (rice flour) and baseline measurements.

Eligibility criteria:
inclusion criteria: * women with emotional premenstrual syndrome (pms), * women who speak english as their primary language * women who understand the human consent form * ability to swallow capsules exclusion criteria: * formal diagnosis of clinical depression * formal diagnosis of premenstrual dysphoric disorder (pmdd).
the association between physical symptoms and depression among medical students in egypt

Conditions: Depression Anxiety Disorder; Physical Disorders

Summary: to examine the association between depression and physical symptoms among medical students in egypt.

the google form will be open for one week from the start of the academic term. it is divided into three parts: demographic data - which includes age, academic level, relationship status, and whether the student intends to work while studying. patient health questionnaire phq-9: assesses symptoms of poor mental health in the two weeks prior to the start of term. patient health questionnaire phq-15: this is a measure of physical symptoms felt in the week prior to the commencement of the academic term. the questionnaire will be distributed among different medical faculties in egypt and all students will be required to fill it out. data analysis will be done through spss to explore the relationship between psychological and physical symptoms.

Eligibility criteria:
inclusion criteria: * medical students enrolled in any medical program in egypt. * age range: typically 19 to 30 years (or based on your study's demographic focus). * willingness to participate and provide informed consent. * self-reported symptoms of depression: those who indicate moderate to severe symptoms on screening tools (e.g., phq-9). * physical symptoms: those who report experiencing physical symptoms (e.g., headaches, fatigue, gastrointestinal discomfort, etc.) on a checklist. exclusion criteria: * non-medical students (students outside of the medical program). * students with a history of major medical conditions that may confound the physical symptoms (e.g., chronic diseases like diabetes, hypertension, or neurological disorders). * students with a diagnosed psychiatric disorder (e.g., bipolar disorder, schizophrenia, etc.) or those already undergoing psychiatric treatment. * non-consenting individuals: students who decline to participate in the study or do not provide informed consent. * incomplete responses: students who fail to provide adequate or valid responses in the questionnaires.
predictors of an unfavorable outcome in patients with heart failure

Conditions: Heart Failure

Summary: the subject of the study is the factors of unfavorable prognosis in heart failure. we would like to identify independent variables associated with a bad prognosis of patients hospitalized for heart failure with a reduced vs. a mid range and preserved left ventricular ejection fraction based on specific predictive models. it is planned to create multifactorial models that can be used to predict prognosis for individual patients.

about 100 adult patients hospitalized for hf in the department of cardiology will be included in the study, including: the study group with hfref, hfmref and hfpef. selected prognostic factors will be analyzed, among others: demographic data of the patient, physical examination, symptoms, etiology and history of hf, co-morbidities, results of selected laboratory tests, selected electrocardiographic and echocardiographic data, patient's cooperation with the doctor, treatment applied, parameters in the spiroergometric study and distance in 6mwt and subjective assessment of quality of life according to the kccq questionnaire. one year after inclusion in the study, a telephone interview will be conducted with patients. these will be questions about death, cardiovascular adverse events, hospitalization for heart failure and re-evaluation of the quality of life according to the kccq questionnaire.

Eligibility criteria:
inclusion criteria: * age equal to or older than 18 years * hf (ischemic and non-ischemic) diagnosed according to the 2016 european society of cardiology (esc) guidelines on hf \[1\], with hf class i, ii or iii according to the nyha classification * current hf hospitalization * left ventricular ejection fraction (lvef) documented in echocardiography during the current hospitalization exclusion criteria: * advanced liver failure (class b and c according to child-pugh score * advanced chronic kidney disease (stages g4 and g5 according to the 2012 kidney disease: improving global outcomes (kdigo) classification * cerebrovascular accident (transient ischemic attack (tia) / stroke / intracerebral haemorrhage) within 3 months prior to the hospitalization * current pregnancy or lactation * alcohol and drug abuse * active autoimmune disease * surgery or a serious injury within 1 months prior to the hospitalization * other important medical condition that could have shortened the survival time during the study * impaired cognitive status that compromises the understanding of the steps and completion of the study
effect of chronic catecholamine overproduction on brown adipose tissue

Conditions: Pheochromocytoma; Adrenal Incidentaloma

Summary: * to investigate the effect of catecholamine excess on brown fat. * to evaluate the effect of brown fat on energy expenditure and lipid and glucose metabolism


Eligibility criteria:
inclusion criteria: * 10 patients with pheochromocytoma * 5 patients with incidentaloma without hormone production * age \> 18 years exclusion criteria: - none
peroxisome proliferator-activated receptor-gamma (ppar-gamma) agonist in diabetic end-stage renal disease patients

Conditions: Endstage Renal Disease; Diabetes

Summary: to test the hypothesis that ppar-gamma agonist, rosiglitazone, induces carotid plaque regression in diabetic esrd patients on maintenance pd via its anti-inflammatory property.

end-stage renal disease (esrd) patients are at an increased risk of accelerated atherosclerosis and cardiovascular morbidity and mortality. non-traditional risk factors such as inflammation and insulin resistance have important contributions to accelerated atherosclerosis in esrd patients receiving long-term peritoneal dialysis (pd). the peroxisome proliferator-activated receptor-g (ppar-g) is a member of the nuclear receptor family of ligand-dependent transcription factors. activation of the ppar-g has been shown in both clinical and experimental studies to have anti-inflammatory and anti-atherosclerotic properties other than insulin-sensitizing effects. recent study also showed that ppar-g agonists reduce plaque inflammation by inhibiting the activation of proinflammatory genes responsible for plaque development and growth. hence, this study aims to examine the effects of ppar-g activation on the progression of carotid plaque in diabetic esrd patients receiving long-term pd using high-resolution magnetic resonance imaging (mri).

Eligibility criteria:
inclusion criteria: * diabetic esrd patients receiving long-term pd treatment, with carotid plaque (defined as focal intima-media thickening \>1mm) present on screening ultrasonography * patients who provide informed consent for the study exclusion criteria: * patients with systemic inflammatory disease such as systemic lupus erythematosus * patients with chronic liver disease or cirrhosis * patients with current active malignancy * patients with chronic rheumatic heart disease or congenital heart disease * patients with poor general condition * patients with plan for living related kidney transplant within coming 1 year * patients with pre-existing class iii/iv heart failure, * patients with recurrent hypoglycemia * patients already on glitazone treatment * female patients with pregnancy * patients with contraindications for mri examination including those with pacemaker or metallic implant.

Keywords: ppar-gamma, diabetic, kidney disease, atherosclerosis
effect of f2695 on functional recovery after ischemic stroke

Conditions: Ischemic Stroke

Summary: the purpose of the study is to assess the efficacy of a new serotonin-norepinephrine reuptake inhibitor (snri) nin functional recovery after ischemic stroke.


Eligibility criteria:
inclusion criteria: * male or female patient, 18 to 80 years of age * confirmed acute ischemic stroke within the past 2 - 10 days * unilateral motor deficit, * national institutes of health stroke scale (nihss) motor score \>= 5 * modified rankin scale (mrs) of 4 or 5 * able and willing to comply with the site rehabilitation program requirements exclusion criteria: * aphasia * severe post-stroke condition * active depressive episode * intra-cerebral hemorrhage * use of anti-depressant drugs * cardiac rhythm disorder * uncontrolled arterial hypertension * other severe acute or chronic medical or psychiatric condition.
adaptive design study of nest stms in subjects with major depressive disorder

Conditions: Depressive Disorder; Depression; Depressive Disorder, Major; Depressive Episode; Major Depressive Disorder

Summary: this is a double-blind, sham controlled, multi-center study to confirm the safety and efficacy of synchronized transcranial magnetic stimulation (stms) for the treatment of patients currently experiencing an episode of depression who have failed to respond to at least one (1) antidepressant medication. patients will be randomly assigned to either active or sham therapy and will undergo daily treatments for a period of time. following completion of blinded treatments, patients may be eligible for a course of open label treatments.

prospective, randomized, double-blind, sham-controlled, parallel group adaptive design study to confirm the safety and efficacy of stms in subject with major depressive disorder (mdd) who have not responded to at least one antidepressant medication in the current episode. mdd was diagnosed according to dsm-iv criteria rendered by structured interview using the mini international neuropsychiatric interview (mini). subjects must have discontinued any antidepressant medication a minimum of 1 week prior to initiation of treatment with the active stms or sham device. following wash-out of the antidepressant medication, an additional evaluation was performed to determine whether the protocol eligibility criteria were met before randomization and treatment. randomized subjects were treated 5 days per week for 6 weeks. subjects who completed 6 weeks of double-blind treatment may have been eligible to receive up to 6 weeks of open-label treatment as clinically indicated during the follow-up phase of the study. follow-up evaluation visits were conducted during those six weeks, with frequency of the visits determined by the treatment choice during that time frame (open label subjects had weekly evaluation visits for 6 weeks).

Eligibility criteria:
inclusion criteria: * current episode of major depressive disorder * inadequate response to at least one antidepressant medication in the current episode (treatment resistant depression) * investigator able to identify iaf using eeg * willingness and ability to adhere to treatment schedule (5 treatments per week for six weeks) exclusion criteria: * unable to unwilling to give informed consent * diagnosed with excluded conditions or treatment histories * currently hospitalized due to severity of depression symptoms * use of prohibited medications (as defined by protocol) within specified time frame of randomization * use of certain cardiac devices * use of certain intracranial devices * currently pregnant or unwilling to practice acceptable means of birth control, and women who are breastfeeding

Keywords: transcranial magnetic stimulation tms stms