Kornimate/medical-research-clean huggingface dataset:
physician perceptions about parenteral hydration in latin america and spain

Conditions: Dehydration; Advanced Cancers

Summary: the purpose of this study is to assess palliative care physicians' attitudes, beliefs and practice patterns related to parenteral hydration at the end of life in latin america and spain. objectives: 1. to assess palliative care physicians' attitudes, beliefs and practice patterns related to parenteral hydration at the end of life in latin america and spain. 2. to assess cross-national differences in practice patterns related to parenteral hydration at the end of life. (latin america vs. spain). 3. to determine the percentage of physicians who practice parenteral hydration at the end-of-life in the hospital setting and the home setting. 4. to examine the association between providers' parenteral hydration practice patterns and: * 1. provider demographic characteristics; * 2. specific characteristics of their practice settings; and * 3. training and experience in end of life care; 5. to determine which factors most predict the practice of parenteral hydration at the end of life among palliative care physicians.

this study is a collaboration between md anderson's departments of palliative care and rehabilitation medicine, health disparities research, the latin american association for palliative care (alcp) and the spanish society for palliative care (secpal). the proposed study involves a 10-15 minute online survey of palliative care physicians from latin america and spain to assess their attitudes, beliefs and practice patterns related to parenteral hydration at the end of life.

Eligibility criteria:
inclusion criteria: 1. palliative care physicians practicing in latin america and spain and affiliated with either the alcp or secpal. 2. physicians must report dedicating at least 30% of their practice to palliative care. 3. physician must be 18 years of age or older. exclusion criteria: 1) none

Keywords: parenteral hydration latin american association for palliative care alcp spanish society for palliative care secpal online survey palliative care physicians' attitudes end of life latin america spain
the effects of protein supplementation and resistance exercise in hemodialysis patients

Conditions: End Stage Renal Disease

Summary: the objective of this study is to determine how protein supplementation, with or without exercise, affects functional capacity, strength, body composition, and physical activity in hemodialysis patients.


Eligibility criteria:
inclusion criteria: * on hemodialysis for more than 3 months, on a thrice weekly hemodialysis program; * adequately dialyzed (kt/v \> 1.4). * age \> 18 years old. * properly functioning av graft exclusion criteria: * patients unable to perform exercise due to cardiovascular disease, osteoarthritis, etc. * pregnant women. * severe unstable underlying disease besides commonly associated with esrd. cardiac patients that are stable will be included. * patients hospitalized within the last month prior to the study. * patients will not perform the mri if contraindication as determined using the vumc mri procedure screening form (attached) or prior claustrophobic reaction in an mri scanner.
does subacromial injection with glutamate receptor antagonist, ketamine, attenuate pain in rotator cuff tendinopathy?

Conditions: Rotator Cuff Tendinitis; Chronic Pain

Summary: the hypothesis of the present study is that in patients with rotator cuff tendinopathy a specific pharmacological blocking of peripheral glutamate-receptor n-methyl-d-aspartate receptor type1 (nmdar) glutamate receptors will result in pain alleviation. activated nmdar1 has been demonstrated to be crucial for pain regulation in various pain disorders, and in biopsies from patients with tendinopathy, nmdar1 was found to be activated. to test this hypothesis a specific nmda receptor antagonist, ketalar (ketamine), will be injected guided by ultrasound into the subacromial space in patients with rotator cuff tendinopathy, and subsequently the pain response will be assessed.


Eligibility criteria:
inclusion criteria: * diagnosis of rotator cuff tendinopathy by exercise-related shoulder pain with positive impingement tests as described by hawkins and neers, and mri findings consistent with tendinopathy. * symptom duration at least 1 year to ensure neuronal ingrowth and nmdar expression exclusion criteria: * previous surgery in any shoulder. * previous cortisone use, either as injections or orally * symptoms or signs of cervicobrachialgia or polyneuropathy * full thickness rotator cuff ruptures verified by mri * primary inflammatory mediated pain, hence, patients with glenohumeral arthrosis, glenohumeral arthritis or systemic disorders predisposing for arthritis * a central component of pain perception manifested by radiating pain in the involved limb; implying worse outcome after subacromial decompression. * pregnancy * breastfeeding * reduced liver function (increased serum bilirubin, asat or alat), decompensated heart failure (nyha class 3-4) * increased intracranial pressure or disease of the central nervous system (cns) * chronic alcoholism * epilepsy * psychiatric disease, increased intraocular pressure * acute intermittent porphyria * hyperthyroidism * use of thyroid hormones * upper respiratory tract infections * pneumonia * intracranial lesions * acute head injuries * ocular injuries * hydrocephalus * risk factors predisposing for intra-articular bleeding * increased risk of infection

Keywords: ketamine analgesics excitatory amino acid antagonists receptors, glutamate shoulder
study of antenatal thyrotropin-releasing hormone in women in premature labor to prevent lung disease in preterm infants

Conditions: Respiratory Distress Syndrome

Summary: objectives: i. assess the efficacy and safety of antenatal administration of thyrotropin-releasing hormone to women in premature labor to improve pulmonary outcomes in preterm infants.

protocol outline: this is a randomized, double blind, multicenter study. patients are randomized to receive antenatal thyrotropin-releasing hormone or placebo. patients receive thyrotropin-releasing hormone or placebo intravenously over 20 minutes every 8 hours for 4 doses. infants are assessed for survival and chronic lung disease until day 28 after birth, and again at 36 postmenstrual weeks.

Eligibility criteria:
* pregnant women in active labor with 24-29 weeks gestation * not eligible if any of the following is present: bleeding infection hypertension (greater than 140/90 mmhg) fetus with hydrops or life-threatening anomalies one dead fetus in multiple pregnancy

Keywords: cardiovascular and respiratory diseases neonatal disorders rare disease respiratory distress syndrome
patient and physician perspectives on non-alcoholic fatty liver disease

Conditions: Nonalcoholic Fatty Liver Disease; Physician

Summary: this trial studies patient and physician perspectives on non-alcoholic fatty liver disease. using questionnaires and interviews, this trial may help researchers understand physicians' knowledge about the diagnosis, prognosis, treatment and management of non-alcoholic fatty liver disease, as well as gain an in-depth understanding of hispanic patients' perceptions about the disease and investigate how cultural factors may play a role in its diagnosis, treatment and management.

primary objectives: i. explore the perceptions of non-alcoholic fatty liver disease (nafld), including knowledge, current practices for diagnosis and management, and additional disease-related perceptions amongst both primary care physicians. ii. explore the perceptions of nafld, including knowledge, diagnosis and management, and additional disease-related perceptions amongst hispanic patients. outline: patients and physicians complete a questionnaire over 5 minutes and an interview over 30-45 minutes about thoughts on nafld, including what they know about nafld and its diagnosis, management, and monitoring, and other thoughts on nafld.

Eligibility criteria:
inclusion criteria: * be a self-reported practicing physician, who is a primary care physician (internal medicine, family medicine, etc.) * self-reported hispanic ethnicity from the greater houston metropolitan area (patient) * have been diagnosed with nafld by a doctor (patient) * be an adult \>/= 18 (patient) * able to speak english (patient) exclusion criteria -none
accelerated corneal collagen crosslinking protocols

Conditions: Keratoconus

Summary: to evaluate and compare the effect of pulsed light (pl-acxl) accelerated and continuous light accelerated (cl-acxl) epithelium-off cross-linking in halting the progression of keratoconus.

keratoconus (kc), which was first described in detail in 1854, is the most common corneal primary ectasia and is characterized by progressive bilateral and asymmetric corneal thinning and bulging outward into a cone-like shape that can severely impact patients' vision. keratoconus usually develops in the second and third decades of life and progresses until the fourth decade. it was thought to be a rare corneal disease. despite a great deal of research, no one theory explains it all and it may be caused by a combination of things. however, meek proposed that the loss of structural integrity in the kc cornea was caused by the presence of abnormal keratocytes and matrix proteins and upregulated proteolysis triggered an unravelling of lamellae along their length and from their anchors at the limbus, with an opening of the lamellar bifurcations. this theory is supported by observations following riboflavin/uva collagen cross-linking, where the proposed cross-linkage of the tissue increases both the resistance of the stroma to enzymatic digestion and the cohesiveness between collagen fibrils and the non-collagenous matrix. conventional cxl (cxl) with a continuous irradiation of 3 mw/cm2 for 30 min is considered safe and effective in the prevention of keratoconus progression according to different clinical trials. nevertheless, the procedure is time-consuming, lasting around 1 h, which may lead to patient discomfort and reduced physician working efficiency. with evolving technical advances, commercially available uv light sources have been developed, making cxl more efficient with shorter uv exposure times, higher uv intensities, and pulsed light compared with continuous light settings. various accelerated cxl protocols have been described and its effect on biomechanical properties on corneas stated as equal to the standard protocol. ex-vivo studies also suggest a distinction between various accelerated cxl protocols by providing evidence for a drop in efficiency with increased uv illumination intensity while maintaining equal surface energy. in this study we evaluate the two types of "accelerated crosslinking".

Eligibility criteria:
inclusion criteria: 1. patients with mild to moderate progressive keratoconus with maximum keratometry value kmax \< 56.0 d, corneal thinnest pachymetry ≥ 400 µm and corrected distance visual acuity (cdva) equal to or better than 20/200 snellen's acuity. 2. established keratoconus progression: increase of 1.0d or more in the manifest cylinder increase of 0.5d or more in the manifest refraction spherical equivalent increase of 1.0d or more in kmax increase of 0.75d or more in kmean decrease of 2% or more in central thickness 3. age: 18-40 y 4. clear cornea exclusion criteria: 1. corneal scarring 2. previous corneal surgery 3. severe keratoconus wit non measurable refraction or kmax ≥ 56 d or corneal thinnest pachymetry \< 400 µm
hpi algorithm for the prevention of ioh during spinal surgery [hpifpioh]

Conditions: Intraoperative Hypotension

Summary: the aim of this study is to investigate the hypothesis that the use of the hypotension prediction index algorithm (hpi) can reduce intraoperative hypotension (ioh) in adult patients undergoing spinal surgery in the prone position under general anesthesia, as well as to explore its effect on in-hospital postoperative morbidity and mortality.

the study is a prospective randomized clinical trial. adult patients (\>18y) undergoing spinal surgery in the prone position under general anesthesia will be included. the patients will be randomized using a computer-generated, permuted block randomization with a 1:1 allocation into two groups. intervention group: in this group, the hpi algorithm will be used in order to prevent hypotensive episodes control group: in this group standard anesthetic care will be provided. hypotensive episodes will be treated with vasoactive agents and fluids. all patients will receive the same type of anaesthesia (tiva with propofol) and monitoring including patient state index (psi), non-invasive monitoring of blood pressure, spo2, continuous electrocardiographic monitoring, etco2 and urinary output. additionally, invasive continuous measurement of the patient's blood pressure will be available via radial artery catheterization. the arterial catheter will be connected to both the standard monitor and the platform which includes the hpi software. arterial blood gas testing will be performed on an hourly basis. intraoperative recordings include psi values, hemodynamic parameters every 10-15 minutes and urinary output every hour. hemodynamic parameters will also be collected electronically from the monitor. the total doses of propofol, opioids/sedatives, fluids and vasoactive agents will also be recorded, as well as the estimated blood loss. in this study, time-weighted average (twa) in hypotension will be calculated in all patients.\[twa= depth of hypotension x time spent in hypotension / total surgery time\]. postoperatively blood sampling for hs-tropi will be collected after the surgical procedure and during the following 3 postoperative days. if an increase in the levels hs-trop i is noted the patient will be inquired for symptoms of myocardial ischemia and a new ecg will be performed. a cardiology consultation will be requested, if necessary. creatinine levels and urinary output will be monitored during the first 2 postoperative days. acute kidney injury will be assessed according to the akin classification. all in-hospital incidents and in-hospital mortality will also be documented.

Eligibility criteria:
inclusion criteria: * adult patients undergoing scheduled spine surgery performed in prone position under general anaesthesia exclusion criteria: * heart failure with reduced ejection fraction (lvef\<35%) * severe aortic and/or mitral regurgitation * persistent atrial fibrillation or other significant cardiac arrhythmias * significant preoperative hypotension * end-stage renal disease on dialysis/rrt
an observational cohort study evaluating fatty liver disease and liver fibrosis in moderate to severe psoriasis

Conditions: Psoriasis Chronic; Liver Fibrosis; Fatty Liver; Non-alcoholic Fatty Liver Disease

Summary: • main objectives and outcome measures. 1. establish prevalence of and factors contributing to fatty liver disease and liver fibrosis in patients with psoriasis. fatty liver disease diagnosed via ultrasound. liver fibrosis diagnosed by liver biopsy or non-invasive tests of fibrosis including transient elastography, ultrasound, serum markers of fibrosis including procollagen-3-n-terminal peptide (p3np). 2. evaluate non-invasive markers of liver fibrosis in the psoriasis population. namely transient elastography, standard liver function tests and p3np. 3. evaluate the impact of psoriasis disease severity and comorbidities including metabolic syndrome on response to treatment in patients with psoriasis. data on co-morbid disease collected through questionnaires and review of medical records. response to treatment assessed using psoriasis area and severity index (pasi) physician global assessment (pga) and dermatology life quality index (dlqi). * study population: 380 patients with moderate to severe psoriasis will be prospectively recruited to the study. * chief investigator: professor jonathan barker. co-investigator: professor catherine smith * sponsor/funding organization: pfizer and biomedical research centre (brc) at guys and st thomas hospitals trust


Eligibility criteria:
inclusion criteria: * patients who have given written informed consent * psoriasis patients - chronic plaque-type psoriasis; pasi of 10 or above currently or in past. * 18 yrs. of age exclusion criteria: * patients who have not given written informed consent * patients under 18 yrs. of age * patients with a pasi less than 10. * pregnant women

Keywords: chronic plaque psoriasis liver fibrosis fatty liver disease non-alcoholic fatty liver disease transient elastography fibroscan procollagen-3 n-terminal peptide alanine aminotransferase liver function tests
phase 2 study to evaluate safety & efficacy of vpi-2690b in diabetic nephropathy patients

Conditions: Diabetic Nephropathy

Summary: the purpose of this study is to determine whether vpi-2690b injection is effective in the treatment of diabetic nephropathy.


Eligibility criteria:
inclusion criteria: * documented diabetic nephropathy in patients with either type 1 or type 2 diabetics * hba1c of 7.5-10.5% * egfr 30-110 ml/min/1.73m2 * stable acei/arb dose regimen * stable blood pressure * bmi less than or equal to 45 kg/m2 exclusion criteria: * non-diabetic renal disease * history of solid organ or islet cell transplant * history of malignancy within previous 5 years * systemic immunosuppression therapy * clinically significant liver disease, hepatitis b or c or hiv * monoclonal antibody treatment within previous year * recent acute renal injury or major surgery * significant, recent body weight change * biopsy proven glomerular disease
effects of mandala coloring on anxiety in pregnant women

Conditions: Anxiety; Pregnancy Related

Summary: this research was planned as a randomized controlled experimental study in order to reduce the anxiety felt by expectant mothers in relation to pregnancy during pregnancy.

pregnancy is an important period in a woman's life in which she experiences different spiritual, physical and emotional experiences. while experiencing this process, women may face many factors that may affect their mental health, such as stress, anxiety and depression. when the literature is examined, it is stated that approximately 10% to 24.2% of pregnant women experience anxiety or stress during their pregnancy.it is very important to diagnose it in the early stages of pregnancy, as anxiety in pregnancy can have negative effects on maternal and newborn health, especially in the birth and postpartum period. a number of alternatives have been found to reduce anxiety, one of which is using it in the form of art therapy.in the opinion of art psychotherapists, mandala painting is one of the main tools of other art psychotherapy techniques that focus on healing.a number of studies have been conducted to determine the effect of drawing or coloring a mandala on anxiety. amelia et al conducted research that proved that drawing and coloring mandalas effectively reduces students' anxiety levels. in turkey, a study was conducted by sezen and ünsalver on the fear of childbirth in pregnant women, including art therapy. in the study, 7 types of art therapy were applied to the women, including listening to music and singing, making masks, drawing, making mandalas, making dolls, taking photographs and making collages. as a result of the research, it was determined that art therapy was effective in reducing anxiety. when the studies are examined, there are studies on the application of mandala to reduce the anxiety felt by children in cancer patients, but there are no studies on reducing pregnancy-related anxiety of women during pregnancy. this research was planned as a randomized controlled experimental study in order to reduce the anxiety felt by expectant mothers in relation to pregnancy during pregnancy.

Eligibility criteria:
inclusion criteria: * ability to read and understand turkish * being between the ages of 20-35, * single pregnancy * don't be primiparous * having 40 or more from stai * volunteering to participate in the research * fully answering survey and scale forms. * being in the first, 2nd or 3rd trimester exclusion criteria: * having been diagnosed with a risky pregnancy * unwilling to continue working * having a chronic disease (diabetes, hypertension, thyroid etc.), * having any problem that prevents communication (such as hearing, speaking, and understanding abilities), * using one of the pharmacological or non-pharmacological methods to reduce anxiety and receiving psychiatric treatment (pharmacotherapy or psychotherapy). * lack of a smart phone and internet

Keywords: pregnancy anxiety mandala coloring
comparison of laboratory changes, food intake and metabolic profile in patients with obesity and type2 diabetes mellitus: before, during and after taking aphoelinebrake

Conditions: Diabetes Mellitus, Type 2

Summary: the primary objective is to determine if subjects taking the natural product aphoelinebrake™ in addition to their standard treatment experience differences in metabolic disease control, gastrointestinal hormones and inflammatory markers diet, hunger, satiety, weight, compared to patients taking a placebo in addition to their standard treatment. the secondary objective is to study the effect of aphoeline brake on oxidative and inflammatory stress markers.


Eligibility criteria:
inclusion criteria: * age ≥21 years * diagnosis of t2dm * metformin as first line treatment * hba1c ≥7 * calculated homa-ir ≥3.0, * bmi 25-45 * triglyceride level ≥ 2.26 mmol/l exclusion criteria: * age \<21 years of age * bmi ≤ 25 * pregnant * subjects on chronic nonsteroidal anti-inflammatory drugs or systemic corticosteroids. * subjects treated with liraglutide (victoza®). * renal, hepatic or cardiac failure. * subjects with a significant clinical illness within a month before the first administration of aphoeline brake™ * subjects diagnosed with irritable bowel syndrome. * subjects diagnosed with ulcerative colitis or crohn's disease. * history of significant gastrointestinal disease. * poor venous access. * poor likelihood to adhere with study procedures, as documented during the myfitnesspal procedures prior to use of aphoeline brake™