Kornimate/medical-research-clean huggingface dataset:
new psychoactive substances in intoxicated patients during the winter activities

Conditions: Acute Intoxication; Psychoactive Substance Use

Summary: the purpose of this research is to identify the new psychoactive substances (nps) that are responsible for intoxicating patients in ski resort during winter activities.

the new psychoactive substances expose to an additional risk of overdose or death due to their potency. these new psychoactive substances are used voluntarily by users wishing to test new substances, but also involuntarily because of association (unknowingly users) with more "conventional" drugs such as cocaine or heroin in the self-administered powder. these intoxications are still poorly known and the investigators believe that the identification of new psychoactive substances among the drugs consumed, and the association of their consumption with the appearance of a particular symptomatology allow the physician to guide the diagnosis and facilitate the care of future patients.

Eligibility criteria:
inclusion criteria: * admission to emergency, resuscitation or intensive care departments involved in the study * anamnestic and / or clinical suspicion of acute drug poisoning according to international classification of diseases-10 criteria * patient coming from a ski resort from the pre-established list * urine sample available as part of the treatment * person understanding french or english * non-opposition to the study exclusion criteria: * suspicion of alcohol intoxication alone * suspicion of voluntary drug poisoning * suspicion of intentional intoxication by others * pregnant or breastfeeding women * major mentioned in articles l1121-6 and 1121-8 of french public health code * patients in the exclusion period of another research involving the human person type 1 or 2

Keywords: intoxication; psychoactive substance ; ski
power (pulse width optimized waveform evaluation trial)

Conditions: Sudden Cardiac Death

Summary: the objective of this study is to compare the ulv (upper limit of vulnerability)/dft (defibrillation threshold) efficacy between the 2.5, 3.5 and 4.5 ms membrane time constant based biphasic defibrillation waveforms. this comparison will result in identifying the optimal membrane time constant when programming the "tuned" defibrillation waveform.

sudden cardiac death (scd) continues to be a significant cause of cardiac mortality with annual deaths ranging from 250,000 to 400,000 in the united states. accordingly, implantable cardioverter-defibrillators (icd's) have proven to be an important therapeutic option for patients susceptible to scd. successful therapy and generator longevity are greatly dependent on proper defibrillation threshold (dft) determination. all modern icd's utilize a biphasic waveform for defibrillation. it has been clearly shown that biphasic waveforms reduce the energy required for internal defibrillation of the heart. however, there is no consensus on which pulse widths are best for defibrillation. st. jude medical icd's (implantable cardioverter defibrillators) have programmable pulse widths, which allow the physician multiple options in dealing with icd patients. by implanting icd's with programmable pulse widths, this study utilizes the tissue rc resistance/capacitance) model to try to identify the optimal pulse widths. to determine the efficacy of an optimal membrane time constant estimate for the "tuned" waveform, defibrillation testing must be performed. upper limit of vulnerability (ulv) has been proposed as an alternative means of predicting the dft and it has been shown that ulv guided dft testing can achieve a defibrillation success rate of 95%.

Eligibility criteria:
inclusion criteria: * patient is a candidate for icd/crt-d implantation. * patient has a compatible transvenous defibrillation lead system. * patient has had an echocardiogram, muga, or cath procedure within 6 months of icd/crt-d implant. * patient is able to tolerate ulv guided dft testing. exclusion criteria: * patient has a mechanical valve in the tricuspid position. * patient has epicardial defibrillation electrodes. * patient is pregnant. * patient is less than 18 years old.

Keywords: icd defibrillation ulv tuned
motorized mechanical massage associated with cosmetics in improving body contour and appearance of gynoid lipodystrophy

Conditions: Cellulitis of Leg

Summary: purpose: to evaluate the efficacy of motorized mechanical massage associated with cosmetics in improving body contour and appearance of gynoid lipodystrophy. subjects and methods: a prospective and comparative longitudinal clinical study will be performed in 30 women with localized fat and gynoid lipodystrophy. patients will be submitted data collection and assessments and before and after treatment. hypotheses: it is expected that the patients will present improvement in the body contour and in the picture of the gynoid lipodystrophy after the association of the therapies. statistical analysis: a descriptive analysis will be done before and after vibration-oscillatory therapy, with frequency tables for categorical and descriptive variables (mean, standard deviation, median, minimum and maximum values) for continuous or numerical variables. in order to compare the main variables between the groups and the collection times, the analysis of variance (anova) for repeated measurements will be used. tukey's test will be used to compare groups. the level of significance adopted for the statistical tests will be 5% or p \<0.05.

after signing the informed consent, the participants will be evaluated by two physiotherapists where the data collected will be from personal data, anthropometric and complementary diagnostic tests such as: ultrasound diagnosis in order to evaluate the thickness of the adipose tissue and cutomiter analysis of the viscoelasticity of the skin. afterwards they will be divided and started the treatment with another physiotherapist who will perform the following protocol of the study: exfoliation of the skin, application of the motorized mechanical massage with the device dermotonus slim with 550mg of vacuum, continuous mode, for 20 minutes subdivided into region abdominal and posterior thigh, after the end will be applied the creams for lipolytic purposes. the protocol will be performed twice a week for 1 hour each, totaling 10 sessions.

Eligibility criteria:
inclusion criteria: * female gender, over 18 years of age; * with a body mass index up to 29.9 considered overweight; * carriers of gi lipodystrophy; * non smokers; * that they agree to participate and sign the term of free and informed commitment - tcle exclusion criteria: * male gender; * performed esthetic treatment in the gluteal region and thighs in the last month; * patients with skin lesions, such as dermatitis and dermatoses; * patients with capillary fragility; * patients with acute deep vein thrombosis (dvt); * on or near cancerous lesions; * patients with cardiac pacemaker or other implanted electronic device.

Keywords: cellulits of leg motorized power massage massage
risk benefit ratio of hirudotherapy: retrospective single-center study of 37 cases over a period of 9 years

Conditions: Leeches; Healthcare Associated Infection

Summary: venous congestion in transplanted or re-implanted tissues remains a common and chal-lenging complication in plastic and reconstructive surgery. local application of medicinal leeches is effective to reduce postoperative venous congestion of the flap and to restore normal blood flow. however, leech therapy is associated with a number of risks, including infections. indeed, leeches maintain a symbiotic relationship with aeromonas species in order to digest blood in their gut. aeromonas spp. infections can occur 1 to 30 days post-application of leeches and are associated with a dramatic decrease in flap salvage rates (88 to 30%). for these reasons, prophylactic antibiotics and, external decontamination are widely recommended throughout the course of leech therapy. the aim of this study is to investigate the prevalence of side effects (anemia and infection) from patients treated with leeches in french hospital.


Eligibility criteria:
inclusion criteria: * patient who received leeches (for more than 2 days) at the amiens university hospital over a period of 9 years (2010-2018) exclusion criteria: * hirudotherapy outside the inclusion period * hirudotherapy or less than 2 days of treatment

Keywords: leeches healthcare-associated infection hirudo medicinalis
early diagnosis of acute myocardial infarction: impact of an educational and organizational intervention

Conditions: STEMI; Myocardial Infarction; Nurses; Education; Emergency Room

Summary: the hypothesis is that an educational program aimed at emergency nurses and the implementation of measures at the organizational level reduce the time between arrival at the emergency room and the opening of the artery or balloon by 40% in patients attending for acute myocardial infarction.

the time between arrival in the emergency room (er) and balloon time (d2b) in st segment elevation myocardial infarction (stemi) is one of the best indicators of quality care in patients with stemi. hospitals with more strategies to improve this quality of care have a shorter door-to-balloon time. the aim is to evaluate the effectiveness, in the time between the arrival in the er and the balloon time, of an educational and organizational intervention for the early diagnosis of myocardial infarction for emergency nurses. the aim of this study is to improve the time between arrival to er and balloon time. the study consists of two phases: phase i (pre): in this phase, the aim is to describe the attendance times and to evaluate the causes of delay in attendance in stemi patients. with the findings, a plan will be drawn up that includes the integration of an educational program for emergency nurses and organizational measures; oriented to improve the early diagnosis and delays in stemi. phase ii (post): in this phase, the aim is to evaluate the effectiveness in improving delays in the care of patients with stemi after the implementation of the educational and organizational intervention developed in phase 1. on the other hand, will evaluate the satisfaction of the emergency nurses with the training they received through educational and organizational intervention.

Eligibility criteria:
inclusion criteria: * patients ≥18 years * admitted to the emergency room of the same center exclusion criteria: * pregnant women * patients who did not receive coronariography were excluded
specialist conferences between general practitioners and endocrinologists

Conditions: Diabetes Mellitus, Type 2

Summary: to support the primary care sector in delivering high-quality type 2-diabetes (t2d), literature reviews emphasize the need for implementing models of collaboration that in a simple and effective way facilitate clinical dialogue between general practitioners (gps) and endocrinologists. the overall aim of the project is to study if an intervention consisting of structured cross-sectoral and virtual conferences between gps and endocrinologists about t2d improves diabetes care and increases diabetes competencies and management in general practice. this aim will be studied in a pragmatic randomized controlled trial design. this potential is yet to be fully tapped because of methodological limitations. studies have also not yet systematically evaluated virtual conferences in the context of chronic care using a high-quality research design.

the overall aim is to study if cross-sectoral and virtual specialist conferences improves diabetes care and increases diabetes competencies and management in general practice. the expectation is that the intervention will: at the patient level: * improve adherence to international recommendations on diabetes medication for patients with type 2-diabetes (t2d) * improve the risk profile of patients with t2d with a reduction in glycated haemoglobin, blood pressure and cholesterol at the general practice level: - improve the self-reported competence and confidence in management of patients with t2d among general practitioners and practice staff the intervention consists of four virtual and thematic conferences: (1) t2d and cardiovascular disease and heart failure, (2) t2d and lipids, (3) t2d and kidney disease and blood pressure, and (4) t2d and a free topic selected by the general practitioner (gp). before having the first virtual conference, an introductory webinar is held to learn gps about how to use the electronic "diabetes overview" to identify and manage patients with t2d. each general practice is assigned to an endocrinologist who they meet at all four conferences. the intervention was developed using the medical research framework for developing complex interventions. all general practices located in the municipality of aarhus, denmark are invited (n = 100). block randomization is performed at the general practice level, and general practices will be randomized in a 1:1 ratio to either the intervention or the control group.

Eligibility criteria:
inclusion criteria: * general practices are eligible for inclusion if licensed and located in the municipality of aarhus. * gps must consent to participate in the intervention and collect the data needed to measure patient and general practice outcomes. * gps must agree to bring patient cases to the virtual conferences who are ≥18 years, diagnosed with t2d and who they would like to discuss with the endocrinologist. exclusion criteria: * none

Keywords: specialist conferences virtual conferences family physician endocrinologist type 2-diabetes randomized controlled trial
effects of evolocumab on platelet reactivity in patients with diabetes mellitus

Conditions: Diabetes Mellitus, Type 2; Dyslipidemia Associated With Type II Diabetes Mellitus; Percutaneous Coronary Intervention

Summary: prospective, single center, double-blind, randomized pharmacodynamic experimental study. the study will enroll 150 subjects with ascvd on optimal statin therapy as per physician and diabetes mellitus (dm) undergoing elective percutaneous coronary intervention (pci). eligible patients will be randomized for 30 day treatment to either 1) evolocumab 420 mg ; or 2) placebo.

this is a double-blind randomized clinical trial of evolocumab versus placebo in patients with ascvd and dm on clopidogrel and aspirin undergoing pci. the study is aimed to assess 1. the effect of evolocumab therapy on platelet activation and reactivity; 2. the effect of evolocumab on biomarkers of platelet activation and inflammation. eligible patients will be randomized prior to start the pci equally to either: 1. 420 mg evolocumab ; or 2. placebo. the randomized treatment will be administered in subcutaneous injections. the laboratory assessments will be performed before (baseline), and 16-24 hours and 30-days after randomization. subject participation will be 30 days from the randomization.

Eligibility criteria:
inclusion criteria: * diabetes mellitus * dyslipidemia * undergoing elective pci exclusion criteria: * patients with recent acute coronary syndrome (≤1 month) * patients on dual antiplatelet treatment (dapt) with ticagrelor or prasugrel * patients undergoing urgent/emergent pci for stent thrombosis * severe acute or chronic medical or psychiatric condition * pregnancy * participation in another experimental clinical trial, without formal approval * unwillingness or inability to comply with the requirements of this protocol
adaptive crt effect on electrical dyssynchrony

Conditions: Cardiomyopathy; Heart Failure; Left Bundle Branch Block

Summary: the purpose of this study is to better understand how adaptive cardiac resynchronization therapy (acrt) might benefit patients. acrt works by sometimes giving stimulation to only the left side of the heart, rather than to both sides, depending on how it senses the heart is functioning. crt without the adaptive algorithm works by giving stimulation to both sides of the heart. acrt has already been approved by the fda and is being used in patients now, but it is not clear which patients it should be used in compared to normal crt. this study will include patients who are already scheduled to get a crt device. the investigators will then randomize patients to the acrt study arm or to the crt study arm. after 6 months, the investigators will assess the electrical activity of the patients' hearts. after this time, the patient and their doctors will be able to decide if they would like to change the type crt they have been designated.


Eligibility criteria:
inclusion criteria: * patient has a standard class i or class ii indications for crt-p or crt-d implantation in accordance with acc/aha/hrs guidelines (2012 accf/aha/hrs focused update incorporated into the accf/aha/hrs 2008 guidelines for device-based therapy of cardiac rhythm abnormalities)2.at least 18 years of age at the time of consent * is willing and able to comply with the protocol exclusion criteria: * chronic atrial arrhythmias defined as: "atrial fibrillation is permanent when it has resisted all attempts to restore sinus rhythm or when the physician and patient decide that no such attempt should be made." * patient has ever had a previous or has an existing crt system, icd, or pacemaker. * gfr \<30ml/min * patient has had unstable angina, acute myocardial infarction, coronary artery bypass graft surgery, or percutaneous transluminal coronary angioplasty within 30 days prior to study enrollment * patient has primary valvular disease and is indicated for valve repair or replacement * patient is enrolled in ≥1 concurrent studies that would confound the study results (any other interventional trial) * patient is pregnant or of childbearing potential and not on a reliable form of birth control. all women of child-bearing potential must undergo a pregnancy test. * patient status post heart transplant * patient has been classified as nyha functional class iv within 3 months prior to study enrollment * concomitant conditions other than cardiac diseases that were associated with a higher likelihood of death during 1 year after enrollment * patient, legal guardian or authorized representative is unable or unwilling to cooperate or give written informed consent
outpatient administration of high dose methotrexate (hd mtx) in patients with osteosarcoma

Conditions: Osteosarcoma

Summary: the primary purpose of this study is to determine the safety and feasibility of delivering hdmtx in an outpatient setting.

high dose methotrexate (hdmtx) is an integral part of osteosarcoma therapy whose main toxicities include myelosuppression, mucositis, nephrotoxicity, and hepatitis. in order to deliver hdmtx therapy safely, patients require urinary alkalinization, hydration, monitoring of renal function, therapeutic drug monitoring, and leucovorin rescue. due to the required supportive care needs, hdmtx has historically been given as an inpatient. in some centers however, hdmtx is being given safely as an outpatient in order to reduce health care costs, improve patient quality of life and to deliver timely therapy with limited inpatient chemotherapy beds available.

Eligibility criteria:
inclusion criteria: * ≥ 6 years of age; * localized or metastatic osteosarcoma; * adequate renal function (gfr \> 70 ml/1.73m2) prior to each cycle; * no grade iii/iv renal toxicity, mucositis or vomiting with most recent prior inpatient mtx cycle; * parent and/or patient must be able to provide written consent, and complete patient flow sheets in english. exclusion criteria: * patients, in the opinion of the primary healthcare team, may not be able to comply with the safety monitoring requirements of the study, or in whom compliance is likely to be suboptimal. * pregnant females * breastfeeding females

Keywords: pediatrics osteosarcoma methotrexate outpatient
a safety and efficacy study of relamorelin in diabetic gastroparesis study 03

Conditions: Gastroparesis; Diabetes Mellitus

Summary: a 46-week study to compare the efficacy of relamorelin with that of placebo in participants with diabetic gastroparesis (dg). at the end of the 40-week treatment period, participants will either continue on relamorelin or placebo for 6 additional weeks.


Eligibility criteria:
inclusion criteria: * participants are eligible to be included in the study only if all the following criteria apply: * participant met all inclusion/exclusion criteria of either protocol rlm-md-01 (nct03285308) or protocol rlm-md-02 (nct03426345) and successfully completed the study * able to provide written informed consent (ic) prior to any study procedures and willing and able to comply with study procedures * in the opinion of the investigator, the participant demonstrated adequate compliance with the study procedures in study rlm-md-01 or rlm-md-02 exclusion criteria: * participants are excluded from the study if any of the following criteria apply: * participant is not willing or able to abide by the restrictions regarding concomitant medicine use * participant is planning to receive an investigational drug (other than study treatment) or investigational device at any time during study rlm-md-03 * participant has an unresolved adverse event (ae) or a clinically significant finding on physical examination, clinical laboratory test, or 12-lead electrocardiogram (ecg) that, in the investigator's opinion, would limit the participant's ability to participate in or complete the study * any other reason that, in the investigator's opinion, would confound proper interpretation of the study or expose a participant to unacceptable risk, including renal, hepatic or cardiopulmonary disease

Keywords: diabetic gastroparesis vomiting
gestational diabetes and sleep-disordered breathing

Conditions: Gestational Diabetes Mellitus

Summary: this study is designed to evaluate the amount of heart rate variability (hrv) for women with gestational diabetes mellitus (gdm) and to determine whether women with gdm have transient sleep-disordered breathing (sdb) during pregnancy.


Eligibility criteria:
inclusion criteria: 1. pregnant women aged 18-40 years old. 2. pregnant women at gestational age 30 to 34 weeks. exclusion criteria: 1. pregnant women with known type 1 or type 2 diabetes mellitus. 2. pregnant women carrying more than one fetus. 3. pregnant women with pre-gestational hypertension. 4. pregnant women with pre-eclampsia during current pregnancy. 5. pregnant women with a history of coronary artery disease or acute ischemia. 6. pregnant women who currently smoke. 7. pregnant women without results for the 3 hour 100 gram oral glucose tolerance test. 8. pregnant women with preterm labor, cervical shortening, premature rupture of membranes or any other obstetric complications that may predispose to preterm labor. 9. pregnant women using 17-p (progesterone) to prevent recurrent pre-term labor. 10. pregnant women with known sdb.

Keywords: gdm