Kornimate/medical-research-clean huggingface dataset:
whole exome sequencing in finding causative variants in germline dna samples from patients with hypertension receiving bevacizumab for breast cancer

Conditions: Breast Carcinoma

Summary: this research trial studies whole exome sequencing in finding causative variants in germline deoxyribonucleic acid (dna) samples from patients with hypertension receiving bevacizumab for breast cancer. studying samples of germline dna in the laboratory from patients with hypertension receiving bevacizumab for breast cancer may help doctors learn about changes that occur in dna and identify biomarkers related to hypertension.

primary objectives: i. to identify, using next generation sequencing, rare variants of large effect size that impact the risk of hypertension in patients from the clinical trial eastern cooperative oncology group (ecog)-5103 (e5103). outline: previously collected germline dna samples are analyzed via whole exome sequencing.

Eligibility criteria:
inclusion criteria: * european american patients with deoxyribonucleic acid (dna) available and designated case or control * patients who developed grade 3-4 bevacizumab-induced hypertension during their treatment with bevacizumab * patients who did not develop hypertension following a full course of treatment with bevacizumab
prevalence of mental health disorders in junior anesthetists and intensivists

Conditions: Mental Disorder

Summary: mental health disorders are rapidly growing nowadays and it is well known that people who are subjected to a long term stress are among the highly vulnerable group. of those, doctors come first specially those working in anesthesia and icu field owing to the nature of their work where heavy work load, exposure to occupational hazards and competitive environment predominate. more care is needed to identify the magnitude of the ongoing problem and to stand on its determinants to be able to prevent or treat the negative impact on their health and patients as well.

the mental health of physicians is a concern that is gaining popularity and international attention nowadays. physicians are not immune to mental disorders and even we can say that they are more vulnerable. mental disorders increases as stress increases, and working as a physician carries stressors like other highly skilled occupations and that unique to the medical field work demands are always high and the work environment is relatively poor with insufficient support. they work for long hours with little appreciation and more blaming. many of them also share the feeling of mental illness stigma that keep them away from seeking help usually physicians face most of the stress in their first years of experience that require more learning and working time accompanied by more financial burden with more incidence of mental illness in those working in the frontline as anesthetists and intensivists. common mental disorders that frequently affect junior anesthetists and intensivists include burn out, anxiety and depression . caring for the mental health of physicians goes beyond caring for a colleague, it is a requisite for a powerful functioning health system. suffering from mental disorders may lead to more sick absences, less productivity, substance abuse and even suicidal thoughts. patients are at risk of negligence and more medication errors. this requires structured approach to clarify the misinformation regarding physician well-being, and which individual or intervention that should be prioritized. this is not an easy task as the problem is complex and needs systematic approach to know the magnitude of the problem in reality and study its determinants and put applicable solutions.

Eligibility criteria:
inclusion criteria: * working as anesthetist or intensivist * working experience less than or equal 5 years exclusion criteria: * personality disorders * psychiatric diseases
watering of the eyes following uneventful phacoemulsification cataract surgery

Conditions: Watery Eyes

Summary: an observational study aiming to assess the incidence and possible causes of post phacoemulsification watery eye.

this study will be conducted on patients who will undergo cataract extraction at sohag university hospitals to evaluate the incidence of watery eyes in patients after phacoemulsification by one week , one month and three month. * study design: observational study. * inclusion criteria: patients with age-related cataract. * exclusion criteria: 1. patients with watering of eyes or ocular surface diseases or watering of the eyes . 2. patients with previous ocular surgeries. 3. patients with glaucoma, uveitis, corneal or retinal pathologies. * preoperative evaluation: each patient will be subjected to the following: detailed history taking and full ophthalmological examination. fluorescein dye disappearance test. syringing and probing. schirmer's test. tear break up time test. measurement of punctal diameter by as-oct. * operative procedures: 1. regional anesthesia. 2. phaco technique : stop and shop. 3. cumulative dissipated energy (cde ) \&fluid flow. * follow-up regimen: will be as follows: 1. patients will be examined after surgery on: 1st postoperative week, 1st month, 3rd month. 2. the following will be recorded for each patient: 1. symptoms of watery eyes, visual acuity, iop, slit lamp examination. 2. dye disappearance test. 3. schirmer's test. 4. tear break up time test. 5. anterior segment oct.

Eligibility criteria:
inclusion criteria: * patients with age related cataract. exclusion criteria: * patients with watering of the eyes or ocular surface disease. * patients with previous ocular surgeries . * patients with glaucoma, uveitis, cornealor retinal pathologies.
treatment of diabetes and depression in hispanics and african americans and its effect on a1c and quality of life.

Conditions: Diabetes; Depression

Summary: this proposed study will test the following hypothesis: treating depression in hispanics and african americans with diabetes will improve their hba1c and quality of life while on intervention and six months after intervention.

the medication to be used will be sertraline (zoloft). sertraline (zoloft)has been proven in clinical trials to be an effective and well tolerated prescription medication that improves the quality and enjoyment of life for adults suffering from depression . sertraline is an antidepressant and a member of the family of medications known as selective serotonin reuptake inhibitors (ssris). it has excellent tolerability and minimal drug-drug intereactions. the hypothesis will be tested by the following specific aims: 1. to determine if treating mild to moderate depression with sertraline (zoloft) in patients with diabetes improves hba1c. 2. to determine if treating mild to moderate depression with sertraline (zoloft) in patients with diabetes improves quality of life. if our hypothesis proves correct and this treatment of depression is efficient and easy in a county hospital population of african americans and hispanics, researchers can move forward in finding fast and efficient means of diagnosing depression in vulnerable populations, including low-literate patients. this study is critical in that it stands to improve the hba1c (and other metabolic parameters) and quality of life of our underserved minority community, which sadly suffers from a higher rate of almost every disease, including diabetes. treating mild to moderate depression in a county hospital population of african americans and hispanics may improve quality of life and reduce/prevent complications and early death. secondary outcomes include reduced hospitalizations, fewer missed appointments, and improved adherence to medication.

Eligibility criteria:
inclusion criteria: * all patients (men, women) who are african american or hispanic over the age of 21 who have been diagnosed with type 2 diabetes and have a hba1c of greater than 8.0%. subjects with neuropathic pain will be included in the study. their pain will be assessed via a validated pain scale. their primary care providers will treat their pain as necessary. exclusion criteria: * pregnant women, patients on dialysis, patients with liver disease or liver enzymes elevated three times above normal, patients with blood pressure greater than 160 systolic or 95 diastolic on two consecutive visits, patients with history of severe depression (as determined by hospitalization or the ham-d survey) or suicide attempts, patients on therapy for depression, patients already taking ssri's, and patients with psychotic features or bipolar disease.

Keywords: diabetes depression diabetes outcomes quality of life
an open-label treatment protocol to provide metreleptin for the treatment of diabetes mellitus and/or hypertriglyceridemia associated with lipodystrophy

Conditions: Lipodystrophy

Summary: this is an open-label study to provide metreleptin for the treatment of diabetes mellitus and/or hypertriglyceridemia associated with lipodystrophy. this study intends to provide guidance to investigators with respect to identification of appropriate subjects for metreleptin treatment, guidance on metreleptin dosing, and collection of safety and efficacy data following metreleptin treatment in this population


Eligibility criteria:
inclusion criteria: * is male or female ≥5 years old * if female of childbearing potential (including perimenopausal women who have had a menstrual period within one year): 1. not breastfeeding 2. negative pregnancy test result 3. must practice and be willing to continue to practice appropriate birth control (defined as a method which results in a low failure rate, i.e., less than 1% per year, when used consistently and correctly, such as implants, injectables, oral contraceptives, some intrauterine contraceptive devices, sexual abstinence, tubal ligation, or a vasectomized partner) during the entire duration of the study (double barrier methods including the use of female diaphragm and male condom with spermicide can also be used.) * has physician-confirmed lipodystrophy as defined by evidence of generalized (whole body) or partial (limbs) loss of body fat outside the range of normal variation * has been diagnosed with at least one of the following 2 metabolic disorders: 1. diabetes mellitus 2. hypertriglyceridemia as defined by fasting triglyceride concentrations \>200 mg/dl * if ≥18 years of age, is able to read, understand, and sign the informed consent form (icf) and an authorization to use and disclose protected health information form, communicate with the investigator, and understand and comply with protocol requirements * if \<18 years of age, has a parent or legal guardian to read and understand the icf and child assent form, communicate with the investigator, and understand and comply with protocol requirements. adolescent subjects must also read and understand the child assent form; if the child is too young or unable to read, then the child assent form must be explained to the child. exclusion criteria: * has been diagnosed with hiv infection * has known infectious liver disease * has known allergies to e. coli-derived proteins or hypersensitivity to any component of study treatment

Keywords: metreleptin leptin amylin diabetes mellitus hypertriglyceridemia lipodystrophy
drugs to reduce the side effects of chemotherapy

Conditions: Nausea and Vomiting; Unspecified Adult Solid Tumor, Protocol Specific

Summary: rationale: antiemetic drugs may help to reduce or prevent nausea and vomiting in patients treated with chemotherapy. it is not known whether receiving dexamethasone with granisetron is more effective than receiving dexamethasone with metoclopramide for reducing the side effects of chemotherapy. purpose: randomized phase iii trial to compare the effectiveness of dexamethasone with either granisetron or metoclopramide in patients treated with chemotherapy.

objectives: i. compare the clinical efficacy and safety of granisetron or metoclopramide in combination with dexamethasone in the prophylaxis of delayed nausea and vomiting induced by emetogenic cancer chemotherapy in patients with or without emesis in the acute phase. outline: this is a randomized, double blind study. patients are stratified by prior chemotherapy (yes vs no), regular alcohol consumption (yes vs no), and prior chemotherapy regimen (cisplatin/carboplatin vs others). patients receive dexamethasone and granisetron by mouth bid on day 0. patients are then randomized to receive either granisetron or metoclopramide with dexamethasone concurrently with chemotherapy. arm i: patients receive granisetron by mouth bid on days 1-5. dexamethasone and a placebo are administered by mouth once daily on days 1-5. arm ii: patients receive metoclopramide by mouth tid on days 1-5. dexamethasone is administered by mouth once daily on days 1-5. patients must complete a diary card daily for 6 days. projected accrual: this study will accrue 360 patients.

Eligibility criteria:
disease characteristics: scheduled to receive a first course of highly emetogenic single day cancer chemotherapy regimens including: cisplatin at least 50 mg/m2 carboplatin at least 300 mg/m2 dacarbazine at least 500 mg/m2 doxorubicin at least 40 mg/m2 epirubicin at least 60 mg/m2 ifosfamide at least 1200 mg/m2 cyclophosphamide at least 600 mg/m2 patient characteristics: age: 18 and over performance status: not specified life expectancy: not specified hematopoietic: not specified hepatic: not specified renal: not specified other: must be able to complete diary card (fluent in german, french, or italian) no severe concurrent illness no other etiologies that cause vomiting, including: gastrointestinal obstruction hypercalcemia cns metastases no active peptic ulceration no prior gastrointestinal bleeding due to peptic ulcer no moderate to severe nausea or any vomiting in the 24 hours prior to chemotherapy not pregnant or lactating prior concurrent therapy: biologic therapy: not specified chemotherapy: at least 6 months since prior chemotherapy concurrent etoposide and fluorouracil allowed (days 1-5) no chemotherapy before day 0 of study endocrine therapy: not specified radiotherapy: not specified surgery: not specified other: no other concurrent antiemetics no concurrent high dose benzodiazepines no concurrent psychotropic agents

Keywords: unspecified adult solid tumor, protocol specific nausea and vomiting
effect of acupuncture on postoperative nausea and vomiting

Conditions: Cholelithiasis

Summary: the aim of the study is to investigate if p6 acupuncture made after induction of general anaesthesia might be effective for the prevention of ponv as ondansetron and if the acupuncture-ondansetron combination could enhance single therapy efficacy in patients undergoing laparoscopic cholecystectomy.


Eligibility criteria:
inclusion criteria: * patients asa i-ii scheduled for elective laparoscopic cholecystectomy. exclusion criteria: * patient's refusal * patients with history of carpal tunnel syndrome or eczema at p6 point * pregnant patients * female patients in a phase of the menstrual cycle other than premenstrual, nausea and vomiting within 24 hours before anaesthesia * known allergy to anti-inflammatory drugs, opioids and ondansetron. * patients with a pre-existing chronic pain disorder or with a gastrointestinal disease.

Keywords: patients undergoing laparoscopic cholecystectomy for cholelithiasis
clinical and physiological assessment of a nearly ultra-protective lung ventilation strategy: a quasi-experimental preliminary study in ards patients

Conditions: ARDS; Volumetric Capnography

Summary: this study aims to determine whether a protective mechanical ventilator strategy generates a reduction in the bohr´s dead space in patients with moderate or severe acute respiratory distress syndrome (ards). commonly used ventilatory strategies in the clinical practice were applied sequentially to assess their impact. data obtained from volumetric capnography will be recorded after each ventilatory strategy is applied

protective mechanical ventilation strategies are currently the cornerstone of treatment for patients undergoing mechanical ventilatory support. among them, we can mention the reduction in tidal volume, the reduction in driving pressure, the peep setting, and the respiratory rate reduction. all of these strategies are aimed at preventing ventilator-induced lung injury. few clinical studies have evaluated the effects of protective mechanical ventilation strategies on dead-space. this study was designed to evaluate dead space and alveolar ventilation with a sequence of protective ventilatory strategies, keeping peep levels constant. the ventilatory strategy was developed to reduce tidal volume, set an end-inspiratory pause, and reduce the frequencies of lung tissue impact. baseline: all the patients kept the variables under study constant for 60 minutes. each of the participants was studied for a period of 150 minutes. peep programming was set with transpulmonary end-expiratory pressures to maintain between 0 and 5 cmh2o and was remained constant throughout the study. protocol design: baseline: vt 7 ml/kg/pbw phase i: vt 6 ml/kg/pbw. phase ii: vt 5 ml/kg/pbw. phase iii: end-inspiratory pause prolongation until achieving i:e ratio equal to 1, maintaining a constant vt level (5 ml/kg/pbw) phase iv: respiratory rate reduction by 20% of basal conditions, maintaining constant vt level (5 ml/kg/pbw). after 30 minutes of continuous monitoring, minute ventilation, mechanical power, variables obtained by volumetric capnography, and arterial blood gases were recorded in each study phase. this study will be performed in the intensive care unit of a university hospital.

Eligibility criteria:
inclusion criteria: * age older than 18 years * the requirement of invasive mechanical ventilation for more than 4 hours and less than 72 hours * severe hypoxemia (pafi \< 200) secondary to ards exclusion criteria: * heart failure stage iv * chronic obstructive pulmonary disease (copd) on home oxygen * bronchopulmonary fistula * hypovolemic shock with active hemorrhage * gastrointestinal bleeding * oesophageal varices * nasopharynx surgery, recent oesophageal or gastric surgery * massive pulmonary thromboembolism * catastrophic respiratory failure requiring urgent extracorporeal life support * respiratory acidosis. hydrogen potential (ph) is less than 7.20 and paco2 higher than 60 mmhg at baseline.

Keywords: dead space, end-inspiratory pause, respiratory rate, ards
heparin solution versus anti-adhesion barrier gel for intrauterine adhesions prevention after operative hysteroscopy

Conditions: Intrauterine Adhesion

Summary: the aim of this study is to compare the efficacy of intrauterine application of heparin solution to the use of hyaluronic acid barrier gel for the prevention of intrauterine adhesion formation after operative hysteroscopy.

in this trial the investigators aim to evaluate and compare the effect of heparin solution to anti-adhesive hyaluronic barrier gel administration immediately after operative hysteroscopy on post-surgical complications (incidence, extent and severity of intrauterine adhesions, abnormal menstrual cycle pattern) and fertility. patients undergoing operative hysteroscopy will be identified and invited to participate in the trial. at 4 to 8 weeks after the initial surgery, a follow-up, diagnostic hysteroscopy will be performed to identify indications for subsequent operative procedure and classify intrauterine adhesions according to extent of uterine cavity affected and type of formation found. data on subsequent persistent irregular menstrual bleeding and pregnancy success up to 12 months following treatment will also be collected.

Eligibility criteria:
inclusion criteria: * female sex * indication for operative hysteroscopy including one or more of the following: * infertility, * irregular bleeding, * oligo-/amenorrhea, * asherman syndrome, * g0-g3 fibroids, * dysmorphic uterus. exclusion criteria: * ongoing pregnancy, * genital cancer, * pelvic inflammatory disease, * excessive uterine bleeding.

Keywords: operative hysteroscopy heparin anti-adhesion barrier gel intrauterine adhesion hyaluronic acid
extracellular vesicles for hd

Conditions: Huntington Disease

Summary: the primary objective of this study is to discover blood-based biomarker of brain huntingtin (htt) protein using extracellular vesicles to be used in evaluating target engagement in htt lowering clinical trials. secondary objectives of this study include developing more accurate biomarkers of huntington disease (hd) progression or conversion and to develop standard practices for extracellular vesicle biomarker discovery research. the investigators hypothesize that brain-derived extracellular vesicles (evs) isolated from human biofluids contain biological cargo specific to their tissue of origin that could allow their use as brain biomarkers for hd. evs are lipid bilayer-delimited particles that are naturally released from cells in the brain. the investigators will investigate if evs contents reflect the pathological alterations occurring with disease progression when compared with evs isolated from biofluids of healthy non-hd persons.


Eligibility criteria:
inclusion criteria: 1. 18 - 75 years of age 2. can provide informed consent 3. able to read and speak english 4. agree to comply with study procedures (including overnight fasting, blood collection and lumbar puncture); and 5. has been diagnosed with hd (hd carriers) or not been diagnosed with hd (non-hd carriers). exclusion criteria: 1. younger than 18 or older than 75 years old 2. known to carry an intermediate cag repeat between 27 and 39 or a larger expansion of 60 or more cag repeats 3. receiving nutrition through a tube 4. pregnant 5. participated in a clinical drug trial within 30 days 6. use prescribed or non-prescribed medications that are not compatible with collection of the study samples (those that may cause excessive bleeding or prevent clotting) 7. positive for hiv, hepatitis b or c 8. have a confirmed or suspected immunodeficient condition/state 9. significant medical, psychiatric, or neurological morbidity is observed by the clinic physician on the day of sample collection that might impair completion of the study procedures 10. have needle phobia, frequent headache, significant lower spinal deformity or major surgery 11. received antiplatelet or anticoagulant therapy within 14 days prior to sample collection (including but not limited to: aspirin, clopidogrel, dipyridamole, warfarin, dabigatran, rivaroxaban and apixaban) 12. have a blood clotting or bruising disorder 13. do not comply with or are unwilling to undertake any of the study procedures

Keywords: hd huntington disease healthy
colloid osmotic pressure and osmolality in hyponatremia

Conditions: Hyponatremia

Summary: hyponatremia (serum sodium of less than 135 mmol/l)is a very common electrolyte disorder. the reasons for the disorder varies as well as if it is acute or chronic. in this study we wish to follow changes in colloid osmotic pressure and osmolality during the initial treatment hours. we also wish to use mass balance for the calculation of body compartments and to detect fluid translocation between these.

patients with hyponatremia arriving att the intensive care unit are asked to participate in the study. the first blood samples are collected before initializing the treatment as well as measurements of body compartments with a bioimpedance analyzer. collected blood samples are electrolytes (sodium, potassium and chloride), colloid osmotic pressure, osmolality and hemoglobin. these samples are repeated at 4 and 8 hours after start of the study. amount of infused fluid as well as electrolytes are recorded. urine volume is measured and urine samples are analyzed for the loss of electrolytes. additional samples for guidance of treatment are collected every hour. hopefully the addition of colloid osmotic pressure, osmolality and mass balance can be beneficial in the diagnosis of the reason for the disorder as well as for the treatment.

Eligibility criteria:
inclusion criteria: * patients treated for hyponatremia at the intensive care unit. exclusion criteria: * circulatory instable patients in need of treatment for more than the hyponatremia.