Kornimate/medical-research-clean huggingface dataset:
a study evaluating the effects of lipid lowering treatment on steroid synthesis

Conditions: Coronary Heart Disease; Diabetes Mellitus; Non-Coronary Atherosclerotic Disease; Hypercholesterolemia

Summary: cholesterol is the precursor of glucocorticoids, mineralocorticoids and sex steroids. both adrenal and non-adrenal (ovarian + testicular) all steroid hormones are primarily synthesized using the ldl-cholesterol in the circulation. additionally there is 'de novo' cholesterol synthesis in both the adrenals and gonads controlled by the hmg-coa reductase enzyme. a third pathway is the use of circulatory hdl-cholesterol by the adrenal and gonadal tissues for the synthesis of steroids. since statins both decrease circulatory ldl and inhibit de novo cholesterol synthesis, they are likely to affect the synthesis of steroid hormones. in this study we aim to investigate the effects of lowering ldl levels below 70 mg/dl on steroid hormone synthesis.

today atherosclerotic diseases are among the most important causes of death in the world. epidemiological, clinical, genetic, experimental and pathological studies have clearly shown the role of lipoproteins in atherosclerosis. ldl is the major atherogenic lipoprotein and has been defined as the primary target of lipid lowering treatment by ncep. although the level of ldl, the primary target in the treatment of dyslipidemia, has been set as below 100mg/dl in coronary heart diseases (chd) and chd risk equivalents, this level has been pulled down to below 70mg/dl for the group defined as very high risk group by the atp (adult treatment panel) guide that has been updated following the new clinical studies. as we already know, cholesterol is the precursor of glucocorticoids, mineralocorticoids and sex steroids, besides being a structural component of the cell membrane. both adrenal and non-adrenal (ovarian+testicular) all steroid hormones are primarily synthesized using the ldl-cholesterol in the circulation. in addition to this, there is 'de novo' cholesterol synthesis in both the adrenals and gonads controlled by the hmg-coa reductase enzyme. a third pathway, which under normal circumstances has little contribution as compared to the first two, is the use of circulatory hdl-cholesterol by the adrenal and gonadal tissues for the synthesis of steroids. our knowledge on extremely lowered ldl levels is quite limited. however, since statins both decrease circulatory ldl and inhibit de novo cholesterol synthesis, they are likely to affect the synthesis of steroid hormones.

Eligibility criteria:
inclusion criteria: * patients in the very high risk group according to the atpiii guide. exclusion criteria: * patients having a major disease involving hepatic, gastrointestinal and endocrinologic diseases other than diabetes. * patients having a known muscle disease * pregnancy, breast-feeding * patients having a history of allergy to statins or ezetimibe * nephropathic patients

Keywords: very low level of ldl steroid hormones atorvastatin ezetimibe lipoprotein-a
local assessment of ventilatory management during general anesthesia for surgery

Conditions: Surgery; Anaesthesia; Ventilator-Induced Lung Injury; Lung Injury; Pneumonia; Pneumothorax; Respiratory Distress Syndrome, Adult; Respiratory Insufficiency

Summary: objectives 1. to characterize mechanical ventilation practices during general anesthesia for surgery 2. to assess the dependence of intra-operative and post-operative pulmonary complications on intra-operative mechanical ventilation (mv) settings

research questions * what mv-settings are used during general anesthesia for surgery? * do mv-settings vary in and/or between centers? * do mv-settings vary internationally? * are mv-settings associated with incidence of intra-operative pulmonary complications? * are mv-settings associated with incidence of post-operative pulmonary complications?

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * all surgical procedures requiring invasive mechanical ventilation (mv)during general anesthesia for laparoscopic or non-laparoscopic surgery. * this includes mv performed with supra-glottic devices (e.g. laryngeal mask) * this includes patients receiving mv at the onset of the procedure (e.g. intensive care unit patients) * this includes patients who will receive one-lung ventilation during the procedure exclusion criteria: * obstetric surgical procedures or any procedure during pregnancy * surgical procedures outside the operating room * surgical procedures involving extra-corporal circulation

Keywords: ventilatory management mechanical ventilation post operative pulmonary complications intra-operative complications general anesthesia surgery las vegas esa (european society of anaesthesiology) european society of anaesthesiology
incidence and neonatal outcome of eclamptic parturient in tertiary hospital.

Conditions: Eclampsia

Summary: eclampsia is a rare but serious disease that can happen during the pregnancy. both general and regional anesthesia can both be performed in eclamptic patients. eclamptic patients has greater risk if undergo general anesthesia such as risks associated with general anesthesia in pregnancy and also cerebral hemorrhage risks from hypertension during laryngoscope application and thrombocytopenia that can happen in eclamptic patients. so, most of anesthesiologists tend to avoid performing general anesthesia in these patients. but spinal anesthesia also has side effects such as hypotension or epidural hematoma. and nowadays there's minimal evidence on suitable anesthesia in eclamptic patients. our study wants to review on how choice of anesthesia affects these patients both mothers and their neonates


Eligibility criteria:
inclusion criteria: * patient who diagnosed with eclampsia. exclusion criteria: * incomplete medical record.
a rct study in schizophrenia relapse prevention

Conditions: Relapse Schizophrenia

Summary: the aim of the project the main aim lies in the prevention of frequent relapses typical for schizophrenia and schizoaffective disorder by means of simple, highly cost-effective information technology-aided approach research hypothesis a the end of 18 months study duration, patients in the active group enrolled in itareps will demonstrate statistically significantly reduced risk of hospitalization, decreased number of hospitalization days and reduced direct inpatient costs in comparison to control group not using the program.

the itareps 2.0 program employs telecommunication and information technologies in order to detect fluctuations in longitudinal mental health status of patient with schizophrenia and thus signalize the very early stages of prodromes preceding relapse. this approach opens an avenue towards early pharmacological intervention. subjects (150 patients with diagnosis of schizophrenia and schizoaffective disorder and their family members) will be randomized at a 1:1 ratio into the active or control group. participants from the active group will be completing two separate versions of the 10-item early warning signs questionnaire (ewsq) upon a weekly sms request generated automatically by the system during 18 months study duration. in this group, automatically generated e-mail alert message feedback to the investigator will be activated in case of prodrome detection, prompting investigator to antipsychotic dose increase by 20%. the control (treatment-as-usual) group will not use itareps system.

Eligibility criteria:
inclusion criteria: for entry into the study, the following criteria must be met: * men and women, ages 18 to 60 years, inclusive. * a diagnosis of schizophrenia or schizoaffective disorder according to icd-10 classification. * having at least two psychiatric hospitalization for psychosis before the study enrollment. * severity (cgi-s) ≤ 3 at study visit 1. * all patients must be on stable doses of antipsychotic medication during the study entry. exclusion criteria: * organic mental disorder, * mental disorder due to psychoactive substance use or mental retardation. * participation in another relapse prevention program. * hayward compliance rating scale score \< 2 at visit 1.

Keywords: schizophrenia; relapse prevention; information technology
a study of e7080 in subjects with advanced thyroid cancer

Conditions: Thyroid Cancer

Summary: this study is to evaluate the safety, efficacy, and pharmacokinetics of e7080 when orally administered once daily (qd) in subjects with advanced thyroid cancer.


Eligibility criteria:
inclusion criteria 1. histologically or clinically diagnosed with thyroid cancer 2. eastern cooperative oncology group performance status (ecog-ps) 0-2 3. adequate laboratory values/organ function tests exclusion criteria participants with following complication or disease history 1. brain metastasis 2. systemic severe infection 3. significant cardiovascular impairment 4. qtc greater than 480 milliseconds 5. active hemoptysis 6. bleeding or thrombotic disorders 7. having greater than 1+ proteinuria on urine dipstick testing will undergo 24 hour urine collection for quantitative assessment of proteinuria 8. gastrointestinal malabsorption or any other condition in the opinion of the investigator that might affect the absorption of e7080 9. major surgery within 3 weeks before enrollment 10. with co-existing effusion requiring drainage

Keywords: thyroid cancer
value of von willebrand factor in portal hypertension

Conditions: Liver Cirrhosis; Portal Hypertension

Summary: in patients with liver cirrhosis elevated levels of von willebrand factor antigen (vwf-ag) are found frequently but the clinical significance is unclear. vwf-ag plays an important role in primary haemostasis and development of thrombotic vascular obliteration is discussed as a possible mechanism leading to portal hypertension. invasive measurement of hepatic venous pressure gradient (hvpg) is the current gold standard for the diagnosis of portal hypertension. the investigators hypothesize that vwf-ag levels in plasma may correlate with portal pressure and predict clinically significant portal hypertension (csph, hvpg \>=10mmhg) and its complications.

patients with alcoholic, viral (chronic hepatitis c), and cryptogenic liver cirrhosis are included. portal hemodynamics are assessed by hvpg measurement, vwf-ag levels were measured by elisa. results will be compared. 3 and 6 months mortality will be recorded.

Eligibility criteria:
inclusion criteria: * liver cirrhosis exclusion criteria: * no hvpg measurement

Keywords: liver cirrhosis portal hypertension survival von willebrand factor hepatic venous pressure gradient
telithromycin in acute exacerbation of chronic bronchitis

Conditions: Bronchitis, Chronic

Summary: study objectives: * to document the clinical efficacy of telithromycin(800 mg per day for 5 days) at test of the cure (toc)visit (d12-d19), in acute exacerbation of chronic bronchitis. * to assess the long-term clinical efficacy of telithromycin by telephone at d25-d35 (v3) * to assess the safety of telithromycin


Eligibility criteria:
inclusion criteria: * outpatients, * with a documented history of chronic bronchitis defined by one expectoration daily for at least three consecutive months over at least two consecutive years * presenting with an evident acute exacerbation of their disease defined by the presence of at least two of anthonisen's criteria: * exacerbation of dyspnea, * increase in the expectoration volume, * increase in the expectoration purulence, exclusion criteria: * acute bronchitis, * chronic obstructive pulmonary disease, those having fev1 value \<35% (fev1: forced expiratory volume in 1 second) * suspected pneumonia or bronchial pneumonia, * paroxysmal asthma or continuous dyspnea in asthma, * cystic fibrosis, * active tuberculosis, * lung cancer or lung metastasis, * severe bronchiectasia, * acute respiratory decompensation, * chronic respiratory insufficiency associated with resting hypoxemia, * patients requiring hospitalization for parenteral antibiotic treatment * patients with suspected or known bacterial infection other than study diseases, as well as associated systemic or intra-tracheal antibiotic treatment other than study treatment, * participating in another clinical study with any product within 30 days before the inclusion of study * known immunosuppression (aids and/or cd4+ lymphocytes \< 200/mm3, neutropenia \<1500/mm3, blood diseases or terminal stage cancer) * cardiovasculary, neurologic or other severe diseases interfering with the compliance with study protocol or confusing with results. conditions associated with study medications: * hypersensitivity against telithromycin , macrolides or any of the excipients, * congenital long qt syndrome or family history of congenital long qt syndrome (this possibility should be excluded with normal ecg) or known acquired qt interval prolongation, * treatment with cyp3a4 inducers (rifampicin, carbamazepine, phenytoin, phenobarbital, st-john's-wort) within 2 weeks prior to the study inclusion * possibility of treatment with ergot alkaloid derivatives, terfenadine, astemizole, pimozide, cisapride, simvastatin, athorvastatin or lovastatin during studies * congenital galactosemia, lactase deficiency glucose or galactose malabsorption syndrome, * pregnant or lactating women, * women with childbearing potential (e.g. ovulating, pre-menopausal or not surgically sterilized) and do not employ any effective contraception method the patients may not participate to the study more than once. the patients who were treated with study drugs previously may not participate to the study. the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
feasibility of blood glucose control with the space tgc system in medical icu patients

Conditions: Critical Illness

Summary: hyperglycemia is common in critically ill patients and associated with an adverse outcome. thus, glycaemic control is an important issue in critical care. despite extensive efforts of the intensive care unit staff difficulties were experienced in achieving efficient and safe glucose control. a fully automated algorithm may help to overcome some of these limitations by excluding intuitive interventions and integrating relevant clinical data in the decision-making process. space glucosecontrol (tgc system) is a decision support system which helps to achieve safe and reliable blood glucose control in the desired ranges. information on parenteral and enteral nutrition is automatically integrated into the calculations. the primary objective of the current study is to investigate the performance and usability of the space tgc system for glucose control in medical icu patients.


Eligibility criteria:
inclusion: * age: \> 18 years of age * stay in the icu expected to be \> 72 h * blood glucose \> 110 mg/dl or patient on insulin treatment exclusion: * patients with hyperglycaemic crisis/ketoacidosis due to insulin deficiency. * known or suspected allergy to insulin * any disease or condition which the investigator or treating physician feels would interfere with the trial or the safety of the patient (i.e., liver failure, other fatal organ failures) * moribund patients likely to die within 24 hours

Keywords: algorithm tight glycemic control glucose control intensive care insulin icu
role of ratio of progesterone to number of follicles as a prognostic tool for intracytoplasmicsperm injection outcome

Conditions: Infertility, Female

Summary: this study will be conducted at the in vitro fertilization unit at ain shams university maternity hospital. women will be recruited from the in vitro fertilization unit who will fulfill the inclusion criteria. they will be counseled to be included into the study the study will assess role of ratio of progesterone to number of follicles as a prognostic tool for intracytoplasmic sperm injection outcome.

blood samples were collected on the day of final oocyte maturation, and serum progesterone levels were measured using a chemiluminescent immunoassay for quantitative determination of the hormone . the p/f ratio was calculated according to the equation (p(ng/ml)/number of follicles) and was defined by the measurements obtained on the day of final oocyte maturation. all ultrasounds were performed at our in vitro fertilization center, and we included the number of follicles ≥14mm on the day of final oocyte maturation in the ratio calculation oocytes were retrieved 36 hours after injection and were subsequently fertilized by in vitro fertilization or intra cytoplasmic sperm injection. on day 2 - 5, all embryos were evaluated for cell number and morphology. each embryo transferred was evaluated for blastomere size and fragmentation. embryos were graded as follows. those with equal blastomere size and no fragmentation were considered grade 1; those with blastomeres of equal size with slight fragmentation (\ 50 %) were grade 5. the embryos were transferred on postretrieval day (2 - 5). pregnancy was defined by human chorionic gonadotropin titers within 11 days following embryo transfer. clinical pregnancy was defined by the observation of intrauterine embryo heart motion by 7 weeks gestation.

Eligibility criteria:
inclusion criteria: 1. women with any type of subfertility undergoing ivf treatment. 2. age between (20-40) years old 3. body mass index between (20-40) 4. selected embryo are of grade 1 and 2 quality. exclusion criteria: 1. age above 40 years old 2. bmi above 40 3. bad quality embryo 4. uterine anomalies or malformation that affect embryo transfer.
efficacy and safety of two fixed dose combinations of aclidinium bromide with formoterol fumarate

Conditions: Chronic Obstructive Pulmonary Disease

Summary: the purpose of this multicenter, dose-ranging study is to compare two fixed-dose combinations of aclidinium bromide and formoterol fumarate with placebo, aclidinium bromide and formoterol fumarate, all administered bid in patients with stable, moderate to severe copd. every treatment period is 14-days long and there is a 7-days wash-out period in between them. the trial starts with a run in phase of 10 to 17-days duration and it ends up with a follow up contact 14-days after last treatment dose.


Eligibility criteria:
inclusion criteria: 1. adult male or non-pregnant, non-lactating female aged between 40 and 80 years old, both inclusive. 2. patient with a clinical diagnosis of stable moderate to severe copd according to the gold classification 3. current, or ex-cigarette smoker with a smoking history of at least 10 pack-years. 4. patient whose fev1 at the screening visit measured between 10-15 minutes post inhalation of 400 mcg of salbutamol is 30% fev1 \<80% of the predicted normal value (i.e., 100 x post-salbutamol \< fev1/ predicted fev1 must be \< 80% and ≥ 30%). 5. patient whose fev1/fvc at the screening visit measured between 10-15 minutes post inhalation of 400 mcg of salbutamol is \< 70% (i.e., 100 x post-salbutamol fev1 /fvc \< 70%). 6. patient who is eligible and able to participate in the trial and who consent to do so in writing after the purpose and nature of the investigation have been explained. 7. patient whose copd symptoms and fev1 values at the time of randomisation are stable compared to the screening visit, according to the investigator's medical judgment exclusion criteria: 1. history or current diagnosis of asthma or exercise-induced bronchospasm. 2. clinically significant respiratory conditions at the time of inform consent signature 3. hospitalisation due to copd exacerbation within the previous 3 months. 4. signs of a copd exacerbation or respiratory infection (including the upper respiratory tract) within the previous 6 weeks. 5. patient who has a resting systolic blood pressure ≥ 200 mmhg, a resting diastolic blood pressure ≥ 120 mmhg or a resting heart rate ≥ 105 bpm at screening visit. 6. clinically significant cardiovascular conditions 7. presence of symptomatic prostatic hypertrophy and/or bladder neck obstruction. 8. presence of narrow-angle glaucoma. 9. qtc \[calculated according to bazett's formulae (qtc=qt/rr1/2) above 470 milliseconds in the ecg performed at screening visit, 10. patient who does not maintain regular day/night, waking/sleeping cycles

Keywords: bronchitis chronic emphysema
aspirin for exercise in multiple sclerosis (aspire)

Conditions: Multiple Sclerosis

Summary: this study investigates the use of aspirin as an exercise pre-treatment to reduce overheating and exhaustion, which may potentially allow many more people with multiple sclerosis to participate in and benefit from exercise. the design is double-blind, within-subject, with three arms: participants will receive one of three treatments at three separate study visits: aspirin, acetaminophen, and placebo, followed by completion of a maximal exercise test.

persons with multiple sclerosis benefit from exercise, but many avoid it because of exhaustion and overheating. this randomized controlled trial (rct) tests aspirin as a method to increase time to exhaustion for persons with ms, through its antipyretic mechanism. participants will be seen at our laboratory for maximal exercise tests on three separate days. at each session, they will be given one of three treatments: aspirin, acetaminophen (a drug that is anti-inflammatory but not antipyretic, thereby allowing for isolation of the antipyretic action of aspirin), and placebo. primary outcome is increased time to exhaustion, secondary outcome is reduced body temperature increase during exercise.

Eligibility criteria:
inclusion criteria: * diagnosis of relapsing-remitting ms * self-reported heat-sensitivity to exercise * expanded disability status scale (edss) total score ≤ 6.0 * exacerbation-free (and no use of corticosteroids) for 6 weeks prior * bmi ≤ 40 exclusion criteria: * prior history of significant head injury, stroke, or other neurological disease/disorder * current daily use of antipyretics or pain medication * currently in a major depressive episode * vascular disease of the legs, uncontrolled high blood pressure * uncontrolled diabetes mellitus or problem with blood sugar levels * contraindications to aspirin use (history of confirmed peptic ulcer, gastrointestinal or severe gynecological bleeding) * tarry stool or known fecal occult blood * uncontrolled syndrome of asthma, rhinitis, or nasal polyps * contraindications to acetaminophen use (severe active hepatic disease, hepatitis c virus)

Keywords: exercise aspirin cooling antipyretic
effects of exercise therapy on ventricular and endothelial function in patients after coronary artery bypass surgery

Conditions: Diabetes Mellitus, Type 2

Summary: the purpose of this study was (1) to compare the peak exercise capacity and left ventricular diastolic function between patients with and without diabetes and (2) to investigate the interrelation among peak oxygen consumption, left ventricular diastolic function, blood sugar, and lipid profile.


Eligibility criteria:
inclusion criteria: * well-controlled diabetes * no history of myocardial infarction * stable post coronary artery bypass surgery for at least 3 months exclusion criteria: * heart failure, * valvular disease, * abnormal kidney or liver function, * cerebrovascular disease, * primary pulmonary disease, * other systemic or acute illness that may impede the testing or training

Keywords: coronary artery bypass graft diabetes mellitus, type 2