Kornimate/medical-research-clean huggingface dataset:
examining the effect of exogenous ketone supplementation on glucose control in type 2 diabetes

Conditions: Diabetes Mellitus, Type 2

Summary: ketone bodies are a fuel source and signaling molecule that are produced by the body during prolonged fasting or if an individuals consistently eats a low-carbohydrate "keto" diet. blood ketones can be used as a source of energy by the body, but they may also act as signals that impact the functioning of different cells in the body. recently, the availability of ketone supplements that can be taken orally allows for raising blood ketones without having to fast or eat a "keto" diet. the investigators' studies and those of other researchers have shown that ketone supplementation can lower blood sugar without having to make any other dietary changes. oral ingestion of ketones may therefore be an effective strategy to improve blood sugar control and influence how cells function. the main objective of this study is to determine if consuming a ketone supplement 3 times per day (before meals) for 14 days lowers blood sugar and impacts how the body's cells function. the results of this study will be used to guide future recommendations on the utility of ketone supplements for improving health in individuals with, or at elevated risk of, type 2 diabetes.


Eligibility criteria:
inclusion criteria: * have a type 2 diabetes diagnosis from a physician * have stable use of glucose-lowering medications for at least 3 months exclusion criteria: * are a competitively trained endurance athlete * are actively attempting to gain or lose weight * have a history of mental illness or existing neurological disease(s), cardiovascular events (i.e., heart attack, stroke) in the last 2 years * have hypoglycemia, irritable bowel syndrome or inflammatory bowel disease * are currently using insulin or sglt2 inhibitors * are using more than 2 classes of glucose-lowering medication * are currently following a ketogenic diet or taking ketone supplements * are unable to commit for a 29-day trial * are unable to follow a controlled diet

Keywords: 3-hydroxybutyric acid glycemic control hyperglycemia ketones glucose control inflammation immune cell function cognition
early hgh treatment of sga infants to prevent irreversible neurologic and psychological damage and sequelae

Conditions: Infant, Small for Gestational Age; Growth Hormone Treatment; Infant, Premature, Diseases

Summary: sga infants who do not show a developmental catch-up growth within the first 6 months of life fall in the category of sga children shown to have defects in the gh/igf-i axis, resulting in partial hgh/igf-i deficiency. up to 1/4 of children born sga have neurodevelopmental deficits. the partial hgh/igf-i deficiency in sga children can be the major or contributory cause of to their neurodevelopmental deficits to assess the effect of early growth hormone treatment given to symmetrical small for gestational age (sga) infants not demonstrating catch-up growth on neurodevelopment and growth between birth and 6-12 months. the study is an innovative research not previously performed for improving neurodevelopmental outcome of sga infants. as this is the first study of its kind, the safety of use of gh has not been reported, however based on multiple studies assessing use of gh in infants and young children, it is reasonable to similarly expect no short and long-term adverse effects. the study will take place at the tel aviv medical center only.


Eligibility criteria:
inclusion criteria: * symmetrical small for gestational age at birth: weight + length+ head circumference below -2 sd for gestational age. * birth weight of 1200-2200 gr * follow-up of growth until age of 6-12 months * growth parameters below -2 sd at age of 6-12 months and absence of sufficient catch-up. * low growth hormone levels. exclusion criteria: * chromosomal aberration * any congenital syndrome and any syndrome that shows a tendency to uncontrolled cell growth and to develop tumors * major congenital malformation (affecting growth or development) * congenital infection * exposure to teratogenic drugs or drugs affecting development during pregnancy * maternal drug or alcohol abuse. * maternal cancer as well as cancer in 1st degree relatives.

Keywords: small for gestational age (sga) human growth hormone (hgh)
laparoscopic transversus abdominis plane block versus erector spinae plane block in bariatric surgery

Conditions: Pain, Postoperative; Obesity; Analgesia

Summary: the aim of this work is to compare the analgesic efficacy of laparoscopic transversus abdominis plane block, performed by the surgeon to ultrasound-guided erector spinae plane block, performed by the anesthetist, in patients with obesity undergoing bariatric surgery.

this is a randomized controlled trial which will include patients with obesity undergoing bariatric surgery. the patients will be randomly allocated into two groups: transversus abdominis plane block group and erector spinae plane block group. the block will be performed after induction of general anesthesia. preoperative evaluation and preparation will include history-taking, laboratory investigation, fasting recommendations, and optimization of the medical status. the two groups will receive standard induction and maintenance of anesthesia. after the end of the operation, patients will receive standard care according to the local protocols and the enhanced recovery recommendations. patients will be monitored according to the pain-related outcomes as well as hemodynamic parameters.

Eligibility criteria:
inclusion criteria: * patients with obesity undergoing laparoscopic bariatric surgery under general anesthesia. exclusion criteria: * allergy to local anaesthetic. * bleeding disorders. * obstructive sleep apnea. * inability to understand the numerical rating scale for pain assessment.
microneedle lesion preparation prior to aminolevulinic acid photodynamic therapy (ala-pdt) for ak on face

Conditions: Actinic Keratosis

Summary: the purpose of this study is to determine the viability of microneedle lesion preparation (mn) to enhance treatment benefit when performed prior to ala pdt to an actinic keratosis (ak) field on the face.


Eligibility criteria:
inclusion criteria: * four to eight aks on the face exclusion criteria: * pregnancy * history of cutaneous photosensitization, porphyria, hypersensitivity to porphyrins or photodermatosis * lesions suspicious for skin cancer (skin cancer not ruled out by biopsy) or untreated skin cancers within the treatment area * skin pathology or condition which could interfere with the evaluation of the test product or requires the use of interfering topical or systemic therapy * subject is immunosuppressed * currently enrolled in an investigational drug or device study * has received an investigational drug or been treated with an investigational device within 30 days prior to the initiation of treatment * known sensitivity to one or more of the vehicle components (ethyl alcohol, isopropyl alcohol, laureth 4, polyethylene glycol) * has an active herpes simplex infection or a history of 2 or more outbreaks within the past 12 months, on the face * use of the following topical preparations on the extremity to be treated: * keratolytics including urea (greater than 5%), alpha hydroxyacids \[e.g.glycolic acid, lactic acid, etc. greater than 5%\], salicylic acid (greater than 2%) within 2 days * curettage or cryotherapy within 2 weeks of initiation of treatment * retinoids, including tazarotene, adapalene, tretinoin, within 4 weeks * microdermabrasion, laser ablative treatments, ala-pdt, chemical peels, 5 fluorouracil, diclofenac, ingenol mebutate, imiquimod or other topical treatments for ak within 8 weeks * use of systemic retinoid therapy within 6 months

Keywords: actinic keratosis
the efficacy and safety of mk0724 iv for improvement of neurological damage and recovery from middle cerebral artery ischemic stroke (0724-018)

Conditions: Middle Cerebral Artery Stroke

Summary: the safety and efficacy of mk0724 will be assessed in patients with acute middle cerebral artery stroke using the action reach arm test (arat). this test allows measurement of a specific functional deficit and subsequent recovery correlating with the specific area of stroke in the brain.


Eligibility criteria:
inclusion criteria: * 18-80 yrs of age inclusive * patient is able to receive iv infusion 8-36 hours after stroke onset * baseline nihss of 6-18 inclusive exclusion criteria: * patient had another stroke within 3 months preceding current stroke, patient's stroke is of origin other than mca (e.g., non-ischemic, hemorrhage), significant cerebral edema, abnormal liver enzymes and abnormal renal and hepatic functions
analysis of the epidemiology, clinical presentation and therapy as well as therapy-associated risk of demyelination syndrome in patients with profound hyponatremia in the emergency department

Conditions: Hyponatremia

Summary: hyponatremia is a frequent cause for presentation to the emergency department (ed). while patients with chronic hyponatremia often exhibit minor symptoms, acute development of hyponatremia can lead to global cerebral edema, transtentorial herniation and death. the time course of hyponatremia development is usually not known to the treating physician at presentation. hence, type and extent of therapy depend on the presence or absence of severe symptoms such as coma, seizures, obtundation or vomiting. it is believed that these are suggestive of increased cerebral pressure and indicative of cerebral edema. international guidance thus demands aggressive therapy with hypertonic saline at their occurrence. however, severe symptoms can also be found in patients with chronic hyponatremia (i.e., development in more than 48 hours) which are not at risk for developing cerebral edema due to adaptive counter measures in the brain. although the percentage of patients with severe symptoms in chronic hyponatremia is considerably smaller than in acute hyponatremia, a higher incidence of chronic hyponatremia may lead to a larger overall number of severely symptomatic patients with chronic hyponatremia. the precise distribution of acute and chronic cases in the ed has not been established yet. in consequence, many patients with hyponatremia presenting with severe symptoms receive aggressive treatment in order to raise sodium levels, exposing them to the risk for overly rapid correction and osmotic demyelination syndrome (ods). current u.s. recommendations limit the sodium increase to a maximum of 8 mmol/l and 10-12 mmol/l in the first 24 hours in patients with high or low-to-moderate ods risk, respectively. similarly, the 2014 european clinical practice guideline (ecpg) recommends a limit of 10 mmol/l in each 24h-period. these limits are often not accomplished in the real-world setting. in summary, weighing the risk of hyponatremia against complications associated with its (over-)correction constitutes a dilemma for the clinician. it will be strived to refine guidance on management of hyponatremia in patients with profound hyponatremia. therefore, a better understanding of the proportions and characteristics of patients at risk for both cerebral edema and ods is needed. the primary objective of this study is to determine the rate of hyponatremic patients who had already developed cerebral edema on admission and to identify patients who developed ods during the index hospital stay. a secondary objective is a more detailed characterization of these subsets.


Eligibility criteria:
inclusion criteria: * adult patients ≥18 years * plasma sodium ≤125 mmol/l in the initial blood sample after admission to the emergency department exclusion criteria: * lack of follow-up sodium analyses within the first 24 hours after admission * initial blood glucose \>300 mg/dl

Keywords: hyponatremia ods demyelination overcorrection
scalpel versus diathermy skin incision in repeated cs

Conditions: Benifits of Using Diathermy in Skin Incision

Summary: this study was performed to compare both methods of skin incisions to determine differences in postoperative pain, hemodynamic changes, incisional time, blood loss during incision, wound healing, and wound complication.

our study aims to compare the use of diathermy versus scalpel in making skin incision during cesarean section to judge the variations in 1. incision time, 2. incision blood loss, 3. hemodynamic changes, 4. postoperative pain, 5. wound healing 6. wound complications.

Eligibility criteria:
inclusion criteria: * women with a history of only one previous cesarean section * age between 18 and 40 years * gestational age of 38 to 41 weeks * body mass index less than 30. exclusion criteria: * any medical disorder that can affect wound healing as diabetes, chronic anemia, chronic skin conditions, history of allergy, or history of an infected surgical wound. * women who conducted primary or emergency cesarean deliveries * cardiac patients on pacemakers * patients on anticoagulants * women refusing to participate in the study
anifrolumab malignancy and serious infections study

Conditions: Systemic Lupus Erythematosus

Summary: this is an observational study, in which the main research question is to evaluate the risk of malignancies and serious infections among moderate/severe sle patients who receive anifrolumab compared with a comparable population of moderate/severe sle patients on standard of care who do not initiate anifrolumab.

this is an observational study, in which the main research question is to evaluate the risk of malignancies and serious infections among moderate/severe sle patients who receive anifrolumab compared with a comparable population of moderate/severe sle patients on standard of care who do not initiate anifrolumab.

Eligibility criteria:
inclusion criteria: * first prescription of anifrolumab in the study period (no anifrolumab prescription prior to index date): date of first anifrolumab prescription will be the index date * a minimum data availability of 12 months prior to index date * age ≥18 years at index date * sle severity: patients with moderate to severe sle at index date * sle activity: patients with at least a flare (uncontrolled sle) in the 6 months prior to index date exclusion criteria: * a diagnosis of any malignancy prior to index date * a diagnosis of hiv/aids or congenital immunodeficiency prior to index date * organ or bone marrow transplant procedure prior to index date * a diagnosis of serious infection in the previous 6 months

Keywords: malignancies, infections, anifrolumab
clinical study evaluating safety and efficacy of fluticasone furoate and fluticasone propionate in people with asthma

Conditions: Asthma

Summary: a randomised, double-blind, double-dummy, placebo controlled multi-centre study to evaluate the efficacy and safety of fluticasone furoate inhalation powder and fluticasone propionate inhalation powder in the treatment of asthma in adults and adolescents not currently treated with inhaled corticosteroids

this will be a multi-centre, randomised, placebo and active controlled (with rescue medication), double-blind, double-dummy, parallel-group study. subjects meeting all the inclusion criteria and none of the exclusion criteria during visit 1 (screening visit) will enter a two week run-in period. subjects failing screening will not be eligible for re-screening. during the run-in and double-blind treatment periods subjects will maintain an electronic daily diary to record morning and evening peak expiratory flow (pef), asthma symptom scores and rescue albuterol/salbutamol use. at visit 2 (end of run-in/randomisation visit), subjects meeting the eligibility criteria will be randomised receive treatment with either fluticasone furoate 50 mcg once daily, fluticasone propionate 100 mcg twice daily or placebo. in addition all subjects will be supplied with albuterol/salbutamol inhalation aerosol to use as required to treat symptoms. subjects will attend 6 on-treatment visits at visits 3, 4, 5, 6, 7 and 8 (weeks 2, 4, 8, 12, 18 and 24 respectively). subjects will receive treatment for 24 weeks. a follow-up contact will be performed 1-week after completing study medication (visit 9). subjects will participate in the study for up to a maximum of 27 weeks (including screening, treatment and follow-up contact).

Eligibility criteria:
inclusion criteria: * signed informed consent * outpatient at least 12 years of age with a diagnosis of asthma at least 12 weeks prior to first visit * both genders; females of child bearing potential must be willing to use appropriate contraception during the study * pre-bronchodilator fev1 of at least 60% predicted * fev1 reversibility of at least 12% and 200ml * current asthma therapy that includes a non-corticosteroid controller and/or short acting beta-agonist exclusion criteria: * history of life-threatening asthma exacerbation with the past 10 years * asthma exacerbation requiring oral corticosteroids within the past 3 months or overnight hospital stay within the past 6 months * current or recent respiratory infection or current oral candida infection * presence of a significant respiratory disease or other medical condition that is uncontrolled or that could affect subject safety or study outcome * known or suspected allergy to study medication or materials * taking another investigational medication or prohibited medication during the study * current smokers or former smokers with significant tobacco exposure * previous treatment with fluticasone furoate in a phase ii or iii study * children in care
a study of mabthera/rituxan (rituximab) alone and in combination with roferon-a in patients with follicular or other cd20+ low-grade (indolent) lymphoma

Conditions: Lymphoma

Summary: this randomized, open-label study will compare the efficacy and safety of mabthera/rituxan (rituximab) alone, and in combination with roferon-a (interferon alfa-2a) in patients with follicular or other cd20+ low-grade lymphoma. patients will be randomized to receive either mabthera/rituxan 375 mg/m2 intravenously weekly for 4 weeks or roferon-a 3 miu/day subcutaneously in week 1 followed by 4.5 miu/day sc in weeks 2-5 plus mabthera/rituxan 375 mg/m2 weekly iv in weeks 3-6. patients who have a response will receive an additional cycle of treatment. the anticipated time on study treatment is up to 6 months.


Eligibility criteria:
inclusion criteria: * adult patients \>18 years of age * cd20+ low-grade (indolent) lymphoma of follicular and marginal zone type, small lymphocytic lymphoma without a b-cll phenotype, or indolent lymphoma not otherwise specified * stage ii (with bulky disease), iii, or iv lymphoma * no previous chemotherapy or a maximum of 6 months chlorambucil or cyclophosphamide * indication for treatment: symptomatic enlarged lymph nodes, spleen or other lymphoma manifestations, progression \>6 months of lymphadenopathy or splenomegaly, anemia or thrombocytopenia or decreased hemoglobin or platelets due to lymphoma, general symptoms (weight loss, night sweats or fever) * who performance status 0-2 exclusion criteria: * prior treatment with rituximab or an interferon * b-cll, mantle cell lymphoma, lymphoplasmacytic lymphoma (waldenstroem's disease), or central nervous system lymphoma * indolent lymphoma transformed into aggressive lymphoma * indolent lymphoma with bulky tumor requiring urgent therapy * prior malignancies, except non-melanoma skin tumors, in situ cervical cancer, or curative surgery \>5 years ago * positive for hiv infection * uncontrolled asthma or allergy requiring corticosteroids
comparison of femoral and obturatory nerve joint branches conventional radiofrequency thermocoagulation ,intraarticular steroid injection and pericapsular nerve group (peng) block in chronic hip pain

Conditions: Chronic Hip Pain

Summary: in this study ,the investigators aimed to show the decrease in pain levels and the effect on quality of life of patients who underwent chronic hip painrft , intraartıcular steroid injection and peng block.

hip pain is a common medical condition with increasing age.the effectiveness of conservative methods used in hip pain is limited.since the lifespan of prostheses used in hip surgery is limited, new methods are needed in the treatment of pain.the anterior sensory innervation of the hip joint is provided by the articular branches of the femoral and obturatory nerve. today, the most commonly used techniques for hip pain are corticosteroid administration into the hip joint, pericapsular nerve group (peng) block application, and radiofrequency thermocoagulation to the articular branches of the femoral and obturatory nerves. the aim of this study is to compare the effects of these three procedures in hip pain.

Eligibility criteria:
inclusion criteria: 1. be over 18 years old 2. written consent has been obtained 3. those with chronic hip pain for more than 3 weeks exclusion criteria: 1. major psychiatric illness 2. the patient has lumbar compression pain or referred pain 3. patients using anticoagulant agents 4. patients with infection in the area to be treated 5. those who are allergic to local anesthetics 6. those who are allergic to betamethasone 7. pregnancy 8. patients who underwent hip surgery during the 3-month follow-up period during the study

Keywords: femoral and obturatuar nerve chronic hip pain radiofrequency thermocoagulation intraartıcular steroid injection pericapsular nerve group (peng) block
effects of stress doses of hydrocortisone on coagulation dysfunction in patients with septic shock

Conditions: Coagulation Dysfunction in Septic Shock; Hemodynamic Improvement Induced by Hydrocortisone

Summary: the purpose of this study is to find out whether stress doses of hydrocortisone attenuate coagulation dysfunction in patients with septic shock. and discuss the probable mechanism by which little doses of hydrocortisone influence coagulation system in sepsis.

patients were randomized to receive either low-dose hydrocortisone or matching placebo.severity of coagulopathy was estimated using isth dic score. we determined the complications and mortality in two groups, and analyzed the relationship between hydrocortisone and coagulopathy.

Eligibility criteria:
inclusion criteria: * all patients(age≧18y) * admitted for septic shock were considered eligible if they had no life-threatening systemic disease (asa groups 1\~3) exclusion criteria: * lactation * mental disorders * disseminated cancer * secondary cancers * inflammatory bowel disease, or diseases hindering epidural analgesia

Keywords: coagulopathy hydrocortisone organ failure