Kornimate/medical-research-clean huggingface dataset:
enhancing cardiac rehabilitation through behavioral nudges

Conditions: Acute Myocardial Infarction; Percutaneous Coronary Intervention; Coronary Artery Disease; Valvular Disease; Chronic Stable Angina; Chronic Stable Heart Failure

Summary: adherence to cardiac rehabilitation is poor, and worse for minorities, women, and those with lower levels of education. patients less likely to be referred to and complete cardiac rehab are at highest risk of adverse outcomes and thus have the most to gain from participation in cardiac rehab. to improve participation, healthcare systems need to limit barriers to enrollment and promote adherence to rehabilitation.

this study aims to (1) iteratively develop and program a theoretically informed technology-based nudge message library for a diverse patient population using multiple and iterative n of 1 within subject studies. investigators will also engage patient, provider and health systems stakeholders in designing and refining the messages. (2)develop a one-page decision aid tool to present information designed with principles of shared decision making including pros and cons of hospital and home-based rehabilitation. investigators will engage patients, providers, and health systems stakeholders to provide feedback on the information sheet. (3) conduct a 2x2 factorial design randomized trial of a) choice and b) nudge messaging to improve primary outcome of cr adherence. secondary outcomes will include enrollment and completion of cr, exercise capacity, patient engagement, quality of life, hospitalizations, and healthcare utilization. the study will additionally evaluate the interventions using a mixed methods approach applying the re-aim (reach, effectiveness, adoption, implementation, and maintenance) framework and a cost-effectiveness analysis. the cost-effectiveness analysis sub-study will evaluate the implementation cost of home-based and hospital-based cardiac rehabilitation programs in addition to the incremental cost effectiveness ratios for each intervention.

Eligibility criteria:
inclusion criteria: * diagnosis of acute myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, valvular heart surgery, chronic stable angina, and/or chronic stable heart failure with left ventricular systolic dysfunction. * 18 year of age or older * access to a cell phone with text messaging capability * english or spanish speaking exclusion criteria: * medical director's decision based on high-risk assessment * enrolled in hospice or palliative care * being intoxicated or otherwise unable to consent to participate
rosiglitazone-metformin combination versus metformin-sulfonylurea combination on beta-cell function in type 2 diabetes

Conditions: Type 2 Diabetes Mellitus

Summary: it has been shown in previous study that progressive glycemic deterioration was associated with progressive loss of b-cell function, measured by the decrease in plasma insulin levels, irrespective of the therapy used (diet, sulfonylureas or metformin).there is growing evidence that thiazolidinediones could have a positive action on the b-cell function. but it has not yet been demonstrated that they could protect from a deterioration in insulin secretion in the long term. so, it appears interesting to study the long term evolution of the b-cell function and the possible protection with rosiglitazone in patients with type 2 diabetes showing evidence of loss of b-cell function with metformin alone.


Eligibility criteria:
inclusion criteria: * males and females 40 to 75 years of age (inclusive at the time of screening) * type 2 diabetes mellitus as defined by the who criteria, diagnosed for at least 1 year * subjects receiving 1.5 to 3g of metformin alone at a constant dose for at least 8 weeks prior to visit 1 * patients with 6.5% \ 8% at visit 1 and visit 2 * 25 \< bmi \< 35 exclusion criteria: * patient with type 1 diabetes * treatment with other hypoglycaemic agents than metformin in the last 3 months * fpg \>200 mg/dl at visit 2 * hypersensitivity to the studied treatments (rosiglitazone, metformin chlorhydrate, gliclazide) * congestive heart failure (nyha class i to iv), unstable or severe angina, recent myocardial infarction * respiratory insufficiency * subjects who have required the use of insulin for glycaemic control in the past 6 months prior to visit 1 (except during pregnancy or acute episodes such as hospitalization, trauma or infection) or subjects with a history of metabolic acidosis including diabetic ketoacidosis * anemia defined by haemoglobin concentration \<11.0 g/dl for males and \<10.0 g/dl for females * renal disease or renal dysfunction, e.g. as suggested by serum creatinine levels ≥135.0 µmol/l in males and ≥110.0 µmol/l in females and/or creatinine clearance \<40 ml/min * presence of clinically significant hepatic disease, with alt, ast, total bilirubin, alkaline phosphatase \>2.5 times the upper limit of the normal reference range * subjects with chronic diseases requiring periodic ot intermittent treatment with oral or iv corticosteroids * subjects receiving danazol, miconazole or phenylbutazone * active alcohol, drug or medication abuse within the last 6 months or any condition that would indicate the likelihood of poor subject compliance * women who are lactating, pregnant or planning to become pregnant * any clinically significant abnormality identified at screening which, in the investigator's judgement, makes the subject unsuitable for inclusion in the study * use of any other investigational agent within 30 days or 5 half-lives (whichever is longer) prior to visit 1 * subjects who receive or anticipate receiving radiocontrast dye during the study

Keywords: beta cell function type 2 diabetes combination treatment
comparison of terlipressin, somatostatin, and octreotide for control of variceal bleeding

Conditions: Variceal Bleeding, Cirrhosis

Summary: this study is performed to compare the efficacy of terlipressin, somatostatin, and octreotide in patients with variceal bleeding for the control of variceal bleeding in combination with endoscopic therapy.

in patients who are suspected to have variceal bleedings, pharmacologic therapy with vasoactive drugs such as terlipressin, somatostatin, and octreotide is recommended as soon as possible, even before endoscopy. however, it is still unclear whether the efficacies of these drugs are same or not. this study is performed to compare the efficacy of terlipressin, somatostatin, and octreotide in patients with variceal bleeding for the control of variceal bleeding in combination with endoscopic therapy.

Eligibility criteria:
inclusion criteria: * liver cirrhosis * age between 16 and 75 years * patients who have upper gi bleeding symptoms (hematemesis or melena) within 24 hours before enrollment * patients whose systolic blood pressure \ 100/min at the enrollment * patients who were not performed endoscopic or pharmacologic therapy for varices * signed informed consent exclusion criteria: * pregnancy * positive anti-hiv ab * a history of severe side-effects or contraindications to study drugs * severe cardiovascular diseases: acute myocardial infarction, a-v block, congestive heart failure, ischemic heart disease, hypertension (systolic blood pressure \>170 mmhg or diastolic pressure \>100 mmhg) * chronic renal failure * hepatocellular carcinoma with protal vein thrombosis * coexisting malignancy except hepatocellular carcinoma

Keywords: cirrhosis, esophagus disorders, varicose veins
apotransferrin in atransferrinemia

Conditions: Congenital Atransferrinemia

Summary: atransferrinemia is a very rare disorder, which is caused by a deficiency of the protein transferrin. no regular treatment is available for these patients. the objective of this study is to investigate the pharmacokinetics, efficacy and safety of apotransferrin replacement therapy in atransferrinemia patients.


Eligibility criteria:
inclusion criteria: * established diagnosis of atransferrinemia, defined as serum levels of transferrin below 40 mg/dl * informed consent exclusion criteria: * known with allergic reactions against human plasma or plasma products * having detectable anti-immunoglobulin a antibodies

Keywords: transferrin anemia iron overload
safety and efficacy of concurrent administration of influenza vaccine in patients undergoing anti-pd-1 immunotherapy (nivolumab, pembrolizumab)

Conditions: Influenza Virus Vaccine Adverse Reaction (Disorder); Influenza; Malignancy

Summary: the objective of this study is to evaluate the safety and efficacy of concurrent administration of influenza vaccine in patients receiving anti-pd1 immunotherapy (nivolumab or pembrolizumab). this will be a prospective observational study, aiming to assess patient tolerance of treatment, adverse events (incidence, grade, need for hospitalization), incidence of influenza infections, and seroconversion rates.


Eligibility criteria:
inclusion criteria: * 18 years or older * currently receiving immunotherapy with anti-pd-1 agents (nivolumab or pembrolizumab) * have not received influenza vaccination prior to study entry date for the upcoming flu season 2016-2017 * no previous contraindication to receiving influenza vaccination * histologically proven cancer * expected lifetime of at least 12 weeks exclusion criteria: * previous cancer * autoimmune disease or immunosuppressive treatments * corticosteroid treatment * those who have a potential indication to change chemotherapy treatment in 42 days following start of treatment * history of clinically or virologically confirmed influenza infection in the previous six months * previous contraindication to receiving influenza vaccination * previous allergic/adverse reaction with influenza vaccination * have received influenza vaccination prior to study entry date for upcoming 2016-2017 flu season * positive anti influenza antibody titers as determined by the baseline blood determination (day 0)
evaluating a digital tool for supporting breast cancer patients

Conditions: Breast Cancer

Summary: this is a prospective randomised controlled trial that aims to understand the impact of the owise breast cancer digital tool in newly diagnosed breast cancer patients. half the patients will receive the digital tool and half the patients will receive standard information. the study will look at the impact of the digital tool on patient activation, health related quality of life (hrqol), health status, psychological distress, nhs resource utilisation and health care costs.


Eligibility criteria:
inclusion criteria: * female * adult (age 18 years or over) * newly diagnosed * early breast cancer * first primary cancer diagnosis * under treatment at one of the participating sites. exclusion criteria: * have started anti-cancer treatment * private patients * unable to read or write in english * significant cognitive impairment * poor mental health * do not have access to the internet * confirmed metastatic disease

Keywords: breast cancer digital ehealth supportive care patient activation resource utilisation
peripheral perfusion index (ppi) as monitor during deliberate hypotensive anesthesia

Conditions: Monitoring During Deliberate Hypotensive Anesthesia

Summary: hypotensive anesthesia is effective in reducing the intraoperative blood loss. the risk of hypoperfusion of vital organs continues to be a concern. an adequate monitoring of tissue perfusion and oxygenation is crucial issue. peripheral perfusion index (ppi) as a noninvasive new monitoring, can reflect the peripheral perfusion dynamics. this study is designed to explore the behaviour and trend of ppi during nitroglycerine induced deliberate hypotensive anesthesia in adult patients undergoing functional endoscopic sinus surgery (fess).


Eligibility criteria:
inclusion criteria: * patients, aged from 18-50 years, asa physical status i and ii, undergoing functional endoscopic sinus surgery (fess) under deliberate hypotensive anesthesia exclusion criteria: * patients with systemic hypertension, cardiovascular disease, cerebrovascular insufficiency, coagulation defects, renal or hepatic insufficiency, and hypersensitivity to the study drugs will be excluded from the study. patients receiving vasoactive drugs or beta blockers will be also excluded from the study.
clinical study to compare the efficacy of erbium-yag laser or co2re intimate laser with sham (coer)

Conditions: Vaginal Atrophy

Summary: this trial compares the efficacy of two different laser treatments for vaginal atrophy symptoms between them and with sham treatment. patients will be randomized to one of the two lasers or sham treatment.

patients over 45 years of age with one or more avv symptoms who wish to participate in the study will be included, 2 laser sessions spaced one of another 4-6 weeks, and final tracking visit 4-6 weeks of the last laser session. each patient shall be randomly assigned an arm of tto, with laser co2, or laser erbium, or sham group

Eligibility criteria:
inclusion criteria: * women older than 45 years with at least one year of amenorrhea and at least one symptom of vulvovaginal atrophy of moderate and / or severe intensity. exclusion criteria: * hormone treatment in the last three months for vulvovaginal atrophy * treatment with vaginal moisturizers in the last week for vulvovaginal atrophy * laser treatment in the last 12 months. * acute and recurrent infections of the urinary tract in the last 3 months. * acute genital infections * vaginal prolapse * alterations in the area to be treated, such as lacerations, abrasions or ulcers (time of resolution at medical discretion) * chronic decompensated noncommunicable diseases * women who are pregnant or have given birth in the last 3 months
does vitamin d deficiency associated with hypercoagulability & increased thrombin generation?

Conditions: Chest Pain

Summary: cardiovascular disease is the most common cause of mortality and morbidity worldwide. recently, a growing body of evidence has identified vitamin d deficiency as a potential risk factor for cardiovascular disease. therefore, there is an increasing interest to explore the mechanism in which vitamin d deficiency affect the cardiovascular system. the investigators want to examine the relationship between serum vitamin d levels and the coagulation status in the subjects. the applied the calibrated automated thrombogram (cat) to assess thrombin generation in plasma as a measure of overall thrombotic activity, and thus to suggest a mechanism that may explain the link between vitamin d deficiency and cardiovascular disease. our study population are going to include 100 patients from the internal departments in emek hospital, who present with chest pain but without acute coronary syndrome (acs). the investigators will take blood samples from the subjects to measure the serum vitamin d levels and the generation of thrombin. the patients will be divided into four groups according to the level of vitamin d to evaluate the effect of vitamin d levels in the blood on coagulability and thrombotic activity in these patients.


Eligibility criteria:
inclusion criteria: •hospitalized patient with diagnosed of chest pain exclusion criteria: •recent myocardial ischemia - (in the last 30 days)
acute effects of self-correcting movement on the balance and spine of patients with scoliosis.

Conditions: Scoliosis Idiopathic

Summary: the purpose of this study is to evaluate the acute effects of the self-elongation movement on the balance of patients (aged 8-16 years) suffering from adolescent idiopathic scoliosis,

recruitment will be carried out by the physician during the scheduled follow-up. the participant and both parents, or the legal guardian, will receive information on the purpose and methods of this study. the informed consent of both parents, or the legal guardian, and of the minor will be requested. balance data (oscillations, sway area) will be collected by letting participants get on a stabilometric platform and placing their feet on the landmarks; position will not change for the duration of the assessments. at the same time, the modification of the amplitude of the scoliotic curves will be evaluated with the use of the spine 3d (medical class system) which uses micro-pulse laser technology to make a three-dimensional reconstruction of the spine. three 10-seconds assessments will be made. in the first the subject will reproduce the position hold for the scheduled radiography and an acquisition will be performed with the spine3d. the obtained image will be compared with the radiographic one to improve the accuracy of the next evaluations. during the last two acquisitions, the stabilometric platform and the 3d spine will be used simultaneously and the data for the study will be collected. the second acquisition will be performed in a physiological position and the third in self-lengthening, a position used in most of the rehabilitation methods for scoliosis. the full evaluation will take approximately 15 minutes.

Eligibility criteria:
inclusion criteria: * diagnosis of idiopathic scoliosis, carried out by the physician with the adams test and the scoliometer; * age between 8 and 16 years, both sexes; * ability to perform the self-elongation movement; * amplitude of the major scoliotic curve \<40 degrees cobb; * scheduled annual follow-up which requires a radiograph. exclusion criteria: * secondary scoliosis; * obesity; * orthopedic pathologies that modify the plantar supports; * pathologies that modify balance (neurological and / or vestibular); * inability to understand and sign informed consent / assent.

Keywords: scoliosis self elongation movement balance spine curves
remote surveillance of postpartum hypertension

Conditions: Hypertension in Pregnancy

Summary: women with hypertensive disorders of pregnancy need postpartum blood pressure (bp) surveillance to detect persistent hypertension. various barriers result in only 30% attendance at postpartum bp visits. a more effective strategy is needed. women with hypertension of pregnancy will be randomized to either text-based monitoring or office visits. those randomized to the intervention will receive a bp cuff and text in their bp to an automated, clinician derived, hipaa compliant text-based algorithm.

hypertension is a leading cause of maternal morbidity, mortality and obstetrical readmissions. peak blood pressure usually occurs 3-6 days postpartum, and is typically unaccompanied by warning symptoms. although there is a clear need for effective and reliable blood pressure surveillance after delivery, there are significant obstacles to in-person visits in the immediate postpartum period, including sleep deprivation, newborn care, and transportation needs. these barriers have proven real as we observed only 30-50% attendance to office blood pressure visits following delivery. this proposal will investigate whether text-based communication between patients and providers is an effective alternative method for monitoring postpartum hypertension in at risk women. women with hypertensive disorders of pregnancy with access to a cell phone with unlimited text message capabilities will be randomized to either office visit blood pressure checks after discharge or receive a blood pressure cuff and text in blood pressures for two weeks postpartum using a standardized, hipaa compliant, physician derived automated platform.

Eligibility criteria:
inclusion criteria: * women with chronic hypertension, gestational hypertension, or preeclampsia who deliver at the hospital of the university of pennsylvania will be eligible to participate. all patients must be \> 18 years old, able to speak and read english, have a hypertension diagnosis, and have access to a cell phone with unlimited text message capabilities. exclusion criteria: * women without access to a cell phone with unlimited text message capabilities will be excluded from the study in order to eliminate barriers to participate in remote surveillance. however, we will track the number of women not eligible for this reason in order to understand generalizability in an urban population.

Keywords: hypertension pregnancy text
study on the effects of an amp challenge on asthmatic patients following treatment with fluticasone propionate

Conditions: Asthma

Summary: inhaling amp causes an inflammatory response in the lung. this study will investigate whether 5-days of treatment with fluticasone propionate protects the lung from responding to the amp in this way.

a randomised, double-blind, placebo-controlled, incomplete block, 4-period crossover study to investigate the effects of 5-day repeat inhaled doses of fluticasone propionate (bid, 50-2000 mcg) on airway responsiveness to adenosine-5'-monophosphate (amp) challenge when delivered after the last dose in mild asthmatic subjects

Eligibility criteria:
inclusion criteria: * female of non-childbearing potential * using appropriate contraception. * mild asthmatic, non (or ex) smokers. * has inflammatory response to amp. * otherwise healthy, not using any steroids. exclusion criteria: * have a history of life-threatening asthma, defined as an asthma episode, which required intubation and/or was associated with either hypercapnea, respiratory arrest or hypoxia seizures. * have a known sensitivity to corticosteroids. * have a history of milk protein allergy. * test positive at the screening visit for hepatitis b or c or hiv

Keywords: asthma amp challenge
the effect of device closure of patent foramen ovale in elderly patients with crytogenic stoke/tci

Conditions: Patent Foramen Ovale; PFO; Stroke; TIA

Summary: the primary objective is to evaluate if patent foramen ovale (pfo) closure and antiplatelet medical management can reduce the risk of recurrent stroke or transient ischemic attack (tia) when compared to antiplatelet medical management alone in elderly patients above 50 years of age with a pfo and a history of cryptogenic stroke or tia.

prior to birth the fetal heart has a connection between the two atrias of the heart. after labour this connection often closes. about 10-15 % these connections remains open. this phenomenon is called patent foramen ovale or pfo, and is in most cases unsymptomatic. the prevalence of pfo in patients with crytogenic (without known causes) stroke is much higher (about 40%)than the general population (about 10%). this has led to the theory that the presence of pfo can lead to stroke, by the passage of emboli from the peripheral venous circulation through the pfo to the brain by right-to-left shunting of the blood. there are no existing data from prospective randomized studies focusing on the effect of device closure pfo in patients with cryptogenic stroke. some observational retrospective studies have shown a beneficial effect in the reduction of recurrent stoke in patients younger that 50 years with cryptogenic stroke when pfo has been closed with a percutaneous device closure(pcd). some studies have reported an 0% to 3.4% annual recurrence rate of stroke or tia in patients treated with pdc. the recurrence rate of stroke or tia in patients with crytogenic stroke or tia in ordinary antithrombotic treatment is about 5-15 %. the primary objective of this study is to assess whether percutaneous device closure of patent foramen ovale is superior to conventional antithrombotic treatment in preventing stroke recurrence in elderly patients above 50 years of age.

Eligibility criteria:
inclusion criteria: * stroke or tia within 30 days * above 50 years of age exclusion criteria: * deceases og the esophagus * dementia * allergy to aspirin * risk of non-compliance * lacking ability to give written or oral consent * atrial fibrillation * neurological deficit lasting less than 6 hours

Keywords: patent foramen ovale pfo stroke tia percutaneus closure intervention