Kornimate/medical-research-clean huggingface dataset:
left ventricular volume index in the adjustment of initial dose of dobutamine in heart failure and cardiogenic shock

Conditions: Cardiogenic Shock; Heart Failure

Summary: recent studies have suggested that the use of left ventricular ejection volume index calculation may aid in the hemodynamic management of critically ill patients. however, a prospective and randomized comparison in patients with heart failure for inotropic dose adjustment has not been described. the objective of this study was to evaluate the efficacy and safety of ejection volume index versus liberal strategy in adjusting dobutamine dose in patients with heart failure and low cardiac output. methodology: a unicentric, randomized and prospective study will be performed in a comparative manner. hospital data (test results, medical outcomes, dobutamine dose, complications) of patients will be analyzed for safety and effectiveness. expected results: the use of ejection volume index is not inferior to the liberal strategy in the initial adjustment of the dose of dobutamine in patients with heart failure.


Eligibility criteria:
inclusion criteria: * lvef ≤ 40% documented on echocardiography * bnp\> 500 pg / ml * need for initiation of dobutamine and signs or symptoms of low cardiac output at admission defined by the presence of 2 or more of the following: * sbp ≤ 95 mmhg * fc\> 100 bpm * peripheral vasoconstriction, * cold extremities, * reference of decrease of urine output, * nausea, vomiting and food intolerance, * presence of organic dysfunction exclusion criteria: * pregnancy. * copd * hepatical cirrhosis * atrioventricular block of 2nd or 3rd degree. and. sbp \<80 mmhg or need for vasopressor. * use of definitive pacemaker. * body mass index greater than 40 kg / m2. * use of oral anticoagulant. * acute coronary syndrome. * indication of use of another inotropic other than dobutamine. * orotracheal intubation. * presence of significant pericardial effusion. * obstruction of left ventricular outflow tract. * serum creatinine\> 5.0 mg / dl or hemodialysis. * presence of 2 or more clinical / laboratory / radiological criteria of infection
protein intake and resistance training in aging

Conditions: Frail Elderly Syndrome

Summary: resistance training combined with protein or amino acids supplementation has been shown to be promising for mitigating age-related disabilities and comorbidities. randomized controlled trials supporting this possibility are still scarce. these series of clinical trials aim to investigate the chronic effects of different strategies of protein and derivatives supplementation in association with resistance training on selected health-related parameters in pre-frail and frail elderly.this is a 16-month, double-blind, randomized, placebo-controlled, parallel-group clinical trial involving a series of investigations. participants will be divided into nine groups, allowing the assessement of the effects of (1) isolated leucine supplementation; (2) protein source (whey vs. soy); (3) combination of whey protein and creatine; and (4) sexual dimorphism to the response of protein intake plus resistance training (men vs. women). all participants will undergo a supervised, resistance training program.


Eligibility criteria:
inclusion criteria: * elderly people * frailty or pre-frailty, according to fried et al., (2001) criteria. exclusion criteria: * on exogenous insulin and steroid-based drugs * chronic obstructive pulmonary disease or respiratory failure * use of protein and /or amine-based dietary supplements * on restrictive diets (e.g. calorie or food group restrictions) * on resistance training * untreated cardiovascular, metabolic, or other chronic disease * any musculoskeletal condition precluding resistance training

Keywords: resistance exercise protein creatine leucine aging
a comparison of two sedation techniques in children undergoing transthoracic echocardiography (tte)

Conditions: Heart Disease

Summary: the study will examine the quality of two sedation techniques (dexmedetomidine and pentobarbital) used for children aged 3 to 24 months who are undergoing a transthoracic echocardiography (tte).

currently there are two sedation methods used for children less than 24 months of age undergoing transthoracic echocardiography (tte). * one method provides sedation by mouth with the drug pentobarbital, * the other provides sedation through the nose with the drug dexmedetomidine. the choice of which method is used is based on evaluation of the patient's medical history and the preference of the anesthesiologist. to our knowledge, no study has compared these two sedation techniques for quality of care. the proposed study will help us determine which method yields the best quality and will allow us to improve the healthcare experience of our patients.

Eligibility criteria:
inclusion criteria: * outpatients, scheduled to receive sedation for elective transthoracic echocardiography * the subject must be a candidate for both anesthetic techniques. a staff member of the division of cardiac anesthesiology will make this decision. * the subjects must be 3 months to 24 months (inclusive of the 24th month). * the subject's legally authorized representative has given written informed consent to participate in the study. exclusion criteria: * the subject has a history of cardiac conduction system disease (e.g. 1st or 2nd degree atrioventricular block) or channelopathy (e.g. long qt syndrome). * the subject is taking digoxin, alpha-adrenergic or beta-adrenergic agonist or antagonist (e.g., clonidine, propranolol, albuterol), anti-arrhythmic medications, or vasodilators (e.g. ace inhibitors) on the day of the study procedures. it is routine for children taking these medications to hold them on the day of their procedure, as requested by the clinical team. * the subject has received a dose of any other sedative within 48 hours. * the subject has life-threatening, medical conditions (american society of anesthesiologists physical status 4, 5). the american society of anesthesiologists (asa) classification scale is a measure of physical status or how healthy the patient is. for our study, we will focus on children which are defined as asa i, ii or iii which means a healthy child (asa i), a child with a systemic disease that is mild and well controlled (asa ii) or a child with systemic disease that is severe and controlled (asa iii). * the subject is allergic to or has a contraindication to any of the drugs or masking flavored syrup used in the study. * the subject has previously been treated under this protocol. * the subject has trisomy 21 (exaggerated risk of bradycardia) * the subject has severe coarctation of the aorta (risk of exaggerated vasoconstriction) * the subject has moyamoya disease (risk of recurrent stroke)

Keywords: pediatric sedation transthoracic echocardiography tte dexmedetomidine pentobarbital
alternative exercise program to improve skeletal muscle function and fatigue in cancer survivors

Conditions: Breast Cancer

Summary: exercise training has beneficial effects in cancer survivors to minimize some of the side effects of cancer and its treatment and improve long-term prognosis, but there are numerous hurdles for individuals diagnosed with, and being treated for, cancer to participate in exercise programs. the goal of this research study is to begin to evaluate whether exercise training via neuromuscular electrical stimulation (nmes) has beneficial effects on skeletal muscle size and function in cancer survivors.


Eligibility criteria:
inclusion criteria: 1. stage i, ii or iii breast cancer 2. receiving neoadjuvant or adjuvant chemotherapy with or without radiation 3. a body mass index \<35 kg/m2. exclusion criteria: 1. metastatic disease, a prior history of cancer, excluding non-melanoma skin cancer, or prior receipt of chemotherapy 2. autoimmune, vascular or neuromuscular disease that could alter skeletal muscle 3. prior knee or hip replacement 4. contraindications for use of neuromuscular electrical stimulation, including an implanted cardiac defibrillator or pacemaker, lower extremity blood clot or coagulopathy 5. pregnancy
fractional co2 laser therapy in minimizing genitourinary syndrome of menopause in gynecological cancer survivors

Conditions: Cervical Carcinoma; Dyspareunia; Endometrial Carcinoma; Ovarian Carcinoma; Vaginal Carcinoma; Vaginal Dryness; Vulvar Carcinoma

Summary: this randomized pilot trial studies how well fractional carbon dioxide (co2) laser therapy works in minimizing genitourinary syndrome of menopause (gsm) in gynecological cancer survivors. fractional co2 laser therapy may reduce symptoms of gsm in survivors of gynecologic cancers.

primary objectives: i. to conduct a pilot trial to estimate the proportion of gynecologic cancer patients with vaginal dryness or dyspareunia, who will have an improvement in their symptoms with vaginal laser therapy compared to sham treatment based on the vaginal assessment scale (vas). secondary objectives: i. to evaluate toxicity associated with vaginal laser therapy in this population. ii. to determine how many women with the defined patient eligibility will complete all treatments. iii. to determine the feasibility of the crossover design for potential use in a phase iii trial. iv. to determine improvement in objective findings of vaginal atrophy with vaginal laser therapy versus sham treatment. v. to determine improvement in sexual function as measured by female sexual function index (fsfi), female sexual distress scale-revised (fsds), and scales for sexual satisfaction and behavior with vaginal laser therapy versus sham treatment. vi. to determine improvement in urinary symptoms of urogenital atrophy with vaginal laser therapy versus sham treatment using the urogenital distress inventory (udi). vii. to demonstrate satisfaction with vaginal fractional co2 laser therapy. outline: patients are randomized in to 1 of 2 arms. arm i: patients undergo fractional co2 laser therapy at 3 time points 30 days apart. arm ii: patients undergo sham laser therapy at 3 time points 30 days apart. patients may then crossover to arm i. after completion of study, patients are followed up at 1 month.

Eligibility criteria:
inclusion criteria: * women with cervical, endometrial, vaginal, vulvar or ovarian cancer who have completed all cancer related treatment \>= 6 months prior to enrollment * any form of hysterectomy, including radical hysterectomy permitted * must have no evidence of recurrent disease on pelvic exam within past 3 months * radiation therapy is permitted but not required * patient reported dyspareunia and/or vaginal dryness with severity of \>= 4 on a scale from 0 (none) to 10 (most severe) that has been persistent over \>= 4 weeks and/or the inability to be sexually active due to pain exclusion criteria: * patients with recurrent or metastatic endometrial, vaginal, vulvar, cervical, or ovarian cancer * pelvic organ prolapse stage ii or higher * prior reconstructive pelvic surgery involving mesh * hormone replacement therapy or vaginal estrogen therapy within 6 weeks prior to enrollment
isomaltulose vs sucrose - postprandial effect on incretin profile and second meal effect

Conditions: Diabetes Mellitus, Type 2; Metabolic Syndrome

Summary: this study evaluates the different postprandial effect of isomaltulose and sucrose on the incretin profile and as an determinant for the second meal effect. in this nutritional intervention study, healthy participants and t2dm patients ingest 2 standardized meals for breakfast and lunch in combination with either sucrose or palatinose on 2 separate days. in addition, blood samples are taken to analyze markers of the carbohydrate metabolism, incretins and specific inflammation markers.

isomaltulose is a natural occurring disaccharide with a similar structure to sucrose. it is composed of glucose and fructose, but is linked by an α-1,6-glycosidic bond instead of α-1,2. due to its binding, isomaltulose is slowly hydrolysed, which results in a rather weak postprandial glycemic-insulinemic response, accompanied by a minimal gip secretion and a stimulated secretion of glp-1. in addition, several studies have shown that the intake of foods with a low glycemic index, such as isomaltulose, tend to improve the metabolic reaction to a subsequent meal. as the exact mechanism of this "second meal effect" is still unknown, the investigators hypothesize that the modified release and action of gip and glp-1 are key players in regard to the described effects.therefore, isomaltulose could be a suitable tool for reducing the risk of developing diabetes, obesity and cvd as well as improve blood glucose control in people with diabetes. in summary, this study evaluates the different postprandial effect of isomaltulose and sucrose on the incretin profile and as a determinant for the second meal effect. in this nutritional intervention study, healthy participants and t2dm patients ingest 2 standardized meals for breakfast and lunch in combination with either sucrose or palatinose on 2 separated days. in addition, blood samples are taken to analyze markers of the carbohydrate metabolism, incretins and specific inflammation markers.

Eligibility criteria:
inclusion criteria: * for t2dm patients: insulin-independent * for healthy subjects: at least 1 component of the metabolic syndrom: * body mass index (bmi) ≥ 30 kg/m² * waist-hip ratio (whr) ≥ 85 for women and ≥ 90 for men * hypertension * dyslipidemia * glucose / insulin intolerance exclusion criteria: * medications: intake of medications which influence glucose metabolism * alcohol / drug abuse * physical diseases: endocrinological, malign, serious cardiovascular diseases * acute / chronic communicable disease * psychic diseases

Keywords: isomaltulose palatinose second meal effect incretin gip glp-1 postprandial inflammation
post operative atrial fibrillation post cardiac surgery ( cabg and valve replacement )

Conditions: Post Operative Atrial Fibrillation

Summary: this study aims to assess the percent and risk factors of postoperative atrial fibrillation in patients undergoing cardiac surgery in assiut university heart hospital

arrhythmias are common complications after cardiac surgery, with postoperative atrial fibrillation (poaf) being the most frequently observed arrhythmia. the incidence rate of poaf ranges from 20% to 50%, depending on factors such as the type of surgery, patient population, and criteria used for diagnosis. notably, poaf has been associated with increased morbidity, mortality, and health care costs. patients who develop poaf are at a higher risk of experiencing complications such as stroke, heart failure (hf), and prolonged hospital stays. moreover, poaf has been linked to long-term adverse outcomes, including a greater risk of recurrence of af/atrial flutter and increased mortality. the accurate prediction of poaf can help guide therapy and facilitate targeted interventions to prevent its occurrence. early identification of patients at risk for poaf allows for the timely initiation of prophylactic measures, such as the use of β-blockers, amiodarone, or other antiarrhythmic drugs, which have been shown to reduce the incidence of poaf. in this study we are searching for the percent and risk factors of poaf in patients undergoing cardiac surgery in assiut university hospital.

Eligibility criteria:
inclusion criteria: 1. ≥18 years scheduled for first-time planned cardiac surgery ( cabg and valve replacement) 2. patients who are in sinus rhythm and not taking any antiarrhythmic medication, other than beta-adrenergic blocking agents, at the time of surgery. 3. willingness to participate and provision of informed consent exclusion criteria: 1. prior history of cardiac surgery. 2. pediatric population less than 18 years. 3. patients with history of hyperthyroidism 4. patients with electrolyte disturbance 5. where follow-up is not possible. 6. the patient refused to sign the informed consent to participate in the research.

Keywords: post operative atrial fibrillation cardiac surgery
gender dependent difference in lipemia after 6 x oftt in young healthy subjects

Conditions: Hyperlipidemia

Summary: the investigators wanted to study the postprandial lipemia after six oral fat tolerance test with varying amounts of saturated fat in young healthy subjects.

with six different types of butter added in random order to potatoes the investigators studied postprandial lipemia (ppl), lipoprotein, glucose, and insulin increments for eight hours in 14 young, lean, healthy students, seven of each gender. the six, isocaloric meals contained 55.1 g carbohydrate, 5.8 g protein, 82.3 g fat, and 4177 kj. the potatoes, without skin, were boiled in 20 minutes in excess of water with 5 g of salt added, were blended in 4 minutes and served hot. the meals were ingested over 10 minutes, with 250 ml tap water. the following 8 hours the participants stayed at the clinic to watch television, read or take a short walk of 10 minutes. blood samples were drawn at -15, 0, 30, 60, 90,120,180,240,300,360, 420 and 480 minutes after the meals and processed after each drawing. after blood collection, plasma was immediately separated by centrifugation at 3000 rpm for 10 minutes at 4°c. the area under the curve (auc) were determined for tg, hdl, ldl, total cholesterol, ffa, insulin, and glucose concentrations by the trapezoid method. multiple regression was performed to adjust for age, gender, meals, and bmi to the variance of postprandial responses. the difference between meals were tested with anova. if p\<0.05 in anova, post-hoc-testing with student-newman-keul's test was performed to identify, which meal was significantly different from the other, and to minimize the risk of error by multiple testing.

Eligibility criteria:
inclusion criteria: * accept healthy volunteers exclusion criteria: * hypercholesterolemia, * hypertension, * abuse of drugs or alcohol, * known kidney, liver, heart and metabolic disease * hormonal therapies including oral contraceptives

Keywords: postprandial lipemia glycemic response
sleep deprivation : effects on driving performance and central fatigue

Conditions: Healthy Volunteers

Summary: the effects of sleep deprivation (sd) on performance, while contradictory at first glance, are in reality rather clear when exercise duration is considered, i.e. intense/supramaximal versus prolonged exercises. this latter type of exercise leads to the most important performance decrements after sd.

the effects of sleep deprivation (sd) on performance, while contradictory at first glance, are in reality rather clear when exercise duration is considered, i.e. intense/supramaximal vs. prolonged exercises. this latter type of exercise leads to the most important performance decrements after sd. however, the causes of this accentuated fatigability in endurance exercise with sleep deficit are not known. several hypotheses have been proposed such as lower ph before exercise, lower ventilation due to depreciated response to hypercapnia/hypoxia, or haemodilution. yet the most plausible explanation is a lower tolerance to prolonged exercise because sd increases the rate of perceived exertion. another potential effect of sd is an alteration of central command during exercise. the literature is rather scarce on this topic and is only based on a few animal studies. in humans, no effect of sd on maximal strength has been reported so that maximal voluntary activation should in theory not be altered. transcranial magnetic stimulation (tms), that allows to induce a motor response from its cortical origin (and to measure the resulting contraction), is a promising tool to explore neuromuscular function. tms has been used only in three studies after sd, none of them involving exercise and none of them measuring mechanical responses (i.e. only emg responses, such as motor evoked potential, were measured). in addition, the results of these three studies are contradictory. the effects of sd on central fatigue (i.e. increase of the activation deficit during exercise) have never been investigated. the goal of this experiment is thus to test the hypothesis that an increase in central fatigue (at supraspinal level) in sd can participate to performance alteration during a prolonged exercise. for that purpose, measurements of neuromuscular function particularly dedicated to assess central fatigue will be performed before and after sd but also when combining sd and a fatiguing exercise conducted until exhaustion.

Eligibility criteria:
inclusion criteria: * no smoking and drugs * regular physical activity exclusion criteria: * insufficiency cardiac or respiratory * carrying a cardiac pacemaker

Keywords: effects of sleep deprivation transcranial magnetic stimulation male, healthy volunteers
online positive emotion skills intervention for symptoms of depression

Conditions: Depression; Psychological Stress; Affect

Summary: major depressive disorder affects over 120 million people worldwide. only 50% of americans with depression receive adequate treatment, and one-third of those receiving treatment do not benefit. in this pilot project investigators will bring together two approaches that have the promise to reach large numbers of depression sufferers: a skills-based intervention for increasing positive affect and experiences in depressed individuals, delivered in an inexpensive self-paced mobile format. the study will make use of smartphone technology to improve conventional outcome measurement via in-the-moment emotion sampling and mobile assessment of heart rate variability, a predictor of cardiac health that may mediate some of the health effects of depression. the aims are: 1) retool the existing web-based positive emotion intervention for use on smartphones, with innovative exercises that help participants bring the skills they are learning into real- life situations; 2) measure heart rate variability and emotions using existing smartphone software; and 3) perform a randomized pilot trial of the mobile intervention on individuals with clinical depression recruited online.


Eligibility criteria:
inclusion criteria: * daily internet access * cell phone ownership * score of 10 or greater on the phq-8 depression scale exclusion criteria: -
a multicenter retrospective review of management strategies in small bowel obstruction

Conditions: SBO - Small Bowel Obstruction

Summary: the objective of the study is to review performance of water soluble contrast study in patients admitted with small bowel obstruction(sbo), will improve quality and safety, and decrease length of stay and morbidity.

performance of contrast study has been a part of the protocols at multiple institutions of the southwestern surgical congress. plan to perform a retrospective review of management protocols at these institutions. wish to know whether the implementation of a standardized, protocol-driven pattern of practice involving the performance of water soluble contrast study in patients admitted with sbo, will improve quality and safety, and decrease length of stay and morbidity. the objective of the study is to review performance of water soluble contrast study in patients admitted with sbo, will improve quality and safety, and decrease length of stay and morbidity. performance of contrast study has been a part of the protocols at multiple institutions of the southwestern surgical congress. hypothesize that implementation of a standardized, protocol-driven pattern of practice involving the performance of water soluble contrast study in patients admitted with sbo, will improve quality and safety, and decrease length of stay and morbidity.

Eligibility criteria:
inclusion criteria: * • adults aged 18-89 years of age * patients presenting with sbo exclusion criteria: * • prisoners * pregnant women