Kornimate/medical-research-clean huggingface dataset:
ventricular pacing site selection (v-pass)

Conditions: Atrioventricular Block

Summary: the purpose of this study is to determine whether there is a relationship between ventricular lead position and the incidence of heart failure and atrial fibrillation in patients with indication for permanent pacemaker stimulation.

av-block of higher degree is the primary indication for pacing therapy for about 20% of pacemaker patients. pacing systems with only ventricular stimulation (vvi and vdd) have a fraction of about 40% of all pacemakers in germany. about 50% of the implanted pacemakers in germany are dual-chamber pacemakers and one half of them is used for treatment of av blocks. picture 1: fractions of pacing indications in germany picture 2: fractions of used pacing modes in germany /1/ a lot of studies proved in the past that the pacing site influenced the development of hemodynamics, heart failure (hf) and atrial fibrillation (af). unfortunately, the results are not commonly applicable or statistically assured. due to this, further examinations are required in order to get explicit statements regarding application of alternative, nonapical ventricular lead positioning. 1. pilotphase it shall be determined whether a randomized positioning of ventricular leads at 2 defined positions (either group a: positioning at right ventricular apex or group b:. positioning at right ventricular high septum) is feasible. included patients will already by examined and followed according to protocol. after having proved feasibility of randomized positioning, the data of these patients shall be used for evaluation of the v-pass study. 2. study phase it shall be evaluated how far 2 defined different ventricular lead positions for permanent pacemaker therapy can influence the combined study endpoint mortality and clinically relevant symptoms of heart failure. further more the development of hemodynamics and the incidence of atrial fibrillation shall be studied.

Eligibility criteria:
inclusion criteria: patients with an expected ventricular stimulation rate of \>60% in planned pacing therapy. this will be the following pacing indications * symptomatic first-degree av block, pq time \>250ms * second-degree av block with permanent 2:1 conduction * permanent third-degree av block * paroxysmal first-degree to third-degree av block, with an anticipated rate of ventricular stimulation \>60% * symptomatic bradyarrhythmia absoluta with permanent atrial fibrillation, with an anticipated rate of ventricular stimulation \>60% exclusion criteria: * heart failure acc. nyha iii or iv * intra-atrial conduction delay (p-wave \> 150ms) * myocardial infarction less then 6 months before pacemaker implant * hypertrophic obstructive cardiomyopathy * cardiogenic shock * pregnancy * lactation period * patients under 18 years of age

Keywords: cardiac pacing, artificial atrial fibrillation heart failure pacemaker leads lead position higher degree av-block
medrol dose packs for post-operative pain control

Conditions: Pain

Summary: the investigators primary purpose of this study is to determine if the addition of a short course use of steroids following surgery for adolescent idiopathic scoliosis (ais) will improve post-operative pain management and shorten hospital length of stay.

post-operative pain control following ais surgery is challenging. sub-optimal pain management results in emotional distress and prolonged hospital length of stay. previous studies have shown that a short course of steroids following spine surgery is safe and improves pain control. to better understand the effects of the addition of steroids to a routine pain management strategy, a randomized prospective study with and without steroids will determine the benefit, if any, to the addition of steroids to the investigators already used pain protocol.

Eligibility criteria:
inclusion criteria: * age range of 10-21 * received ais surgery exclusion criteria: * participants out of the age range 10-21 * other forms of scoliosis (not ais)

Keywords: adolescent idiopathic scoliosis (ais) steroid medrol placebo pain
compete: a clinical evaluation of chrono carbostent carbofilm™ coated stent

Conditions: Coronary Atherosclerotic Disease; Coronary Occlusive Diseases; Coronary Artery Diseases; Myocardial Ischemia; Coronary Stenosis

Summary: the compete study is a prospective,randomized,two-arm multi-center clinical trial comparing two commercially available coronary stents: chrono carbostent carbofilm™ coated vs driver/micro-driver coronary stent system. in this study, 204 subjects will be included (2:1 randomization chrono:driver/micro driver) in 6 italian sites.


Eligibility criteria:
inclusion criteria: * patients with clinical evidence of ischemic heart disease; * no clinical and ecg changes suggestive of ongoing acute infarction; * de novo lesion \> 50% and \ = 1. * reference diameter \> 2.5 mm or \< 4.0 mm; * patients with a maximum of two coronary lesions to be treated with a maximum of 2 study stents; exclusion criteria: * lesion length \> 30 mm; * significant (\>50%) stenosis proximal or distal to the target lesions that might impede run off; * lesions located in saphenous vein graft; * lesions located in unprotected left main; * presence of \> 40% stenosis in the left main; * ostial lesion; * lesion located in a bifurcation; * target lesion with visible thrombus; * chronic total occlusion; * treatment of restenotic lesions; * previous implantation of a stent (bms/des) in the target vessel.

Keywords: stents bare metal stents pci coronary artery disease coronary artery stenosis stent thrombosis vascular disease myocardial ischemia
calcium chloride for prevention of uterine atony during cesarean

Conditions: Uterine Atony; Uterine Atony With Hemorrhage; Cesarean Section Complications

Summary: in this pilot study, investigators will administer calcium chloride or placebo to pregnant women undergoing cesarean delivery who have been identified as high risk for hemorrhage due to poor uterine muscle contraction, or atony. they will assess whether a single dose of calcium given immediately after the delivery of the fetus decreases the incidence of uterine atony and bleeding for the mother. the pharmacokinetics of calcium chloride in pregnant women will also be established. data from this pilot study of 40 patients will be used to determine sample size and appropriateness of a larger randomized clinical trial.

poor contraction of the uterus, also known as uterine atony, is the leading cause of severe blood loss during cesarean section, both in the us and worldwide. exogenous calcium has been shown to increase uterine muscle contraction in in vitro and in animal studies. calcium is also an essential factor in normal blood clotting. anesthesiologists commonly administer intravenous calcium chloride during cesarean as well as other types of surgery, but formal randomized studies to determine efficacy in improving uterine tone have not been performed. in this pilot, randomized controlled study, the anesthesiologist will administer a one-time dose of intravenous calcium chloride 1gram versus placebo at the time of fetal delivery to women identified as having high risk of hemorrhage during cesarean delivery. primary outcome assessed will be a composite measure of uterine atony. data from the pilot study will be used to perform power and sample size calculations for a larger study. secondary outcomes assessed will include total blood loss, subjective assessment of uterine tone by the blinded obstetrician performing surgery, safety, side effects, and pharmacokinetic profile of calcium chloride in pregnant women.

Eligibility criteria:
inclusion criteria: pregnant female subjects at lucile packard children's hospital / stanford hospital undergoing cesarean will be screened for inclusion in the study based upon presence of at least 2 risk factors for uterine atony/ postpartum hemorrhage. the risk factors include the following: * intrapartum cesarean delivery * failed operative vaginal delivery with forceps or vacuum * magnesium infusion * chorioamnionitis * multiple gestation * polyhydramnios * preterm delivery \<37 weeks * prior history of postpartum hemorrhage * labor induction or augmentation with oxytocin * advanced maternal age * obesity with body mass index \>40 exclusion criteria: * a degree of case urgency to which taking time to consent for the study could compromise patient care, determined by anesthesiologist or obstetrician * patient age \ 50 years * renal dysfunction with serum creatinine \> 1.0 * abnormal cardiac function or history of arrhythmia * patient taking digoxin * patient currently taking a calcium channel blocker for a cardiovascular indication
acute excposure of high altitude on ecg and non-invasive blood pressure.

Conditions: Pulmonary Hypertension

Summary: randomized crossover trial in patients with pulmonary hypertension (pah, cteph) to assess the acute response of high altitude (säntis, 2500m above sea level) on ecg repolarizations and non-invasive blood pressure measurements by finapres® nova technology.

low altitude baseline measurements will be performed in zurich (460m asl) including echocardiography, right heart catheterization, 6mwt, pulmonary function test, clinical assessment and blood gas analysis. randomly assigned to the order of testing, the participants will be tested in low altitude (zurich, 470m) and at high altitude (2500m). during the exposure high alitude (2500m above sea level) and low alitude (zurich) up to 5 hours, the participants' ecg and non-invasively assessed blood pressure by finapres at rest and under exercise will be collected.

Eligibility criteria:
inclusion criteria: * informed consent * ph diagnosed according to internation guidelines: mpap ≥ 25 mmhg along with a pawp ≤15 mmhg during right heart catheterization at the time of initial diagnosis * ph class 1 (pah) or 4 (cteph) * stable condition, on the same medication for \> 4 weeks * patient live permanently at an altitude \< 1000m asl. exclusion criteria: * resting pao2 ≤7.3 kpa corresponding to the requirement of long-term oxygen therapy \> 16hour daily (nocturnal oxygen therapy alone is allowed) * severe daytime hypercapnia (pco2 \> 6.5 kpa) * susceptibility to high altitude related diseases (ams, hape, etc.) based on previous experienced discomfort at altitudes. * exposure to an altitude \>1500m for ≥3 nights during the last 4 weeks before the study participation * residence \> 1000m above sea level * inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, neurological or orthopedic problems with walking disability * women who are pregnant or breast feeding

Keywords: high altitude exercise electrocardiography non-invasive blood pressure finapres
self-management intervention for breathlessness in lung cancer

Conditions: Lung Cancer; Breathlessness

Summary: the purpose of this study is to investigate the suitability and practicality of a coaching and support intervention in helping patients to use daily strategies for managing breathlessness. also, the investigators will try to understand how useful it is in helping patients to reduce intensity of breathlessness and its impact their quality of life.

lung cancer is common worldwide and is a leading cause of death. breathlessness (dyspnea or shortness of breath) is a highly prevalent clinical problem in lung cancer, developing early in 25-50% of patients due to advanced stage at presentation. it persists in 60% of survivors' post-lung resection and worsens with progressive disease with rates as high as 90% reported in the final months of life. breathlessness is associated with a high degree of unpleasantness, negatively impacts on daily functioning, and multiple domains of quality of life, triggers fear and anxiety in patients and their family, and contributes to symptom specific and psychological distress. it is also costly to the health system as it contributes to urgent care use and hospitalization. the purpose of this pilot trial is to evaluate feasibility and acceptability of a self-management intervention for breathlessness in lung cancer.

Eligibility criteria:
inclusion criteria: eligible participants are women and men with lung cancer (stage i to iv) receiving chemotherapy and/or radiotherapy 1. report breathlessness occurrence (any score \>=3) on a numerical rating scale (0-no breathlessness; 10 - worst breathlessness) during standardized routine distress screening and/or report breathlessness as a symptom to their health care provider 2. normal cognitive function as measured by a score of \<20 on the short orientation memory cognitive test (somc) 3. ecog performance score of 0 to 2 4. estimated life expectancy of \>3 months as per physician 5. reside within a 45 kilometre driving radius of princess margaret hospital 6. oxygen saturation \>90% at rest on room air or with oxygen 7. available for 8 consecutive weeks of the study. exclusion criteria: 1. patients who have received surgery alone as the primary treatment for lung cancer 2. unstable acute asthma or left heart failure or coronary artery or valvular heart disease or neuromuscular disease 3. inability to comply with the study protocol including completion of the questionnaires in english 4. major psychiatric disorder identified by the physician.

Keywords: lung cancer breathlessness self-management
to assess the utility of the point partial in a clinical take-home study of partial hand amputees

Conditions: Amputation; Traumatic, Hand

Summary: this study will allow us to assess whether the point partial confers functional and psychological benefit to persons with partial finger amputations in an unconstrained environment. the use of the point partial outside of the laboratory will allow for a wider variety of uses and for a more realistic simulation of the product being used in the field. this well-controlled trial (without randomization of subjects) will produce the first level ii-1 medical evidence in our field of partial hand prosthetic design as described by the 1989 u.s. preventive services task force. furthermore, this study will provide important data to support providers who are requesting reimbursement from payers.


Eligibility criteria:
inclusion criteria: * partial finger amputees with partial absence of index and/or middle fingers and presence of thumb. additional finger loss is acceptable if all other criterion are met. * fluent in english * individuals aged 18 or greater * patients may present with either fused or mobile mcp joints. exclusion criteria: * significant cognitive deficits as determined upon clinical evaluation * significant neurological deficits as determined upon clinical evaluation * significant physical deficits of the residual limb impacting full participation in the study as determined upon clinical evaluation * uncontrolled pain or phantom pain impacting full participation in the study as determined upon ot evaluation * serious uncontrolled medical problems as judged by the project therapist.
the effect of enhanced recovery after surgery (eras) in gastric cancer surgery

Conditions: Anesthesiology; General Surgery

Summary: the investigators aimed to clarify the clinical relevance of the eras protocol by evaluating the perioperative course in patients undergoing laparoscopic gastric cancer surgery.

gastric cancer is 7th common malignant disease in taiwan, accounting for 3000 new cases per year. the main treatment of gastric cancer is radical gastrectomy and lymph nodes dissection, which is associated with 13.0\~46 % of surgical morbidities. to minimize the surgical morbidities and enhance patients' recovery, perioperative management is mandatory. enhanced recovery after surgery (eras) is a multimodal, multidisciplinary approach to the care of the surgical patient. eras process implementation involves a team consisting of surgeons, anesthetists, an eras coordinator, and staff from units that care for the surgical patient. the main elements of eras include carbohydrate loading before surgery, minimally invasive approaches, balanced management of intravenous fluids, multimodal pain management, early mobilization, and early oral feeding, etc. some prospective studies have shown its effectiveness in reduce surgical morbidity and hospital stay in colorectal surgery. in taiwan, there was only limited report to study the use of eras in gastric cancer surgery. the investigators would like to integrate these perioperative interventions into the eras program, and test its effectiveness in gastric cancer patients undergoing radical gastrectomy at ntuh.

Eligibility criteria:
inclusion criteria: * pathological confirmed as gastric adenocarcinoma; * gastric cancer patients who will undergo subtotal gastrectomy. exclusion criteria: * advanced gastric cancer with gastric outlet obstruction; * epidural catheter placement contraindicated or inexecutable; * have other cancers that have received chemotherapy or radiation therapy; * coagulation abnormalities; * pregnancy; * severe dysfunction of major organs (e.g., heart failure, chronic obstructive pulmonary disease, liver cirrhosis, end-stage renal disease)

Keywords: eras postoperative complications
investigations of dementia in parkinson disease

Conditions: Parkinsons

Summary: the purpose of this study is to use a brain imaging method called pittsburgh b (pib) positron emission tomography (pet) and vesicular cholinergic transport (vat) pet to determine dementia subtypes in patients with parkinson disease (pd). the ultimate goal of this project is to be able to identify individuals with pd who are at risk of developing dementia, and to distinguish the underlying cause of dementia.

the purpose of this study is to use a brain imaging method called pib pet and vat pet to determine dementia subtypes in patients with parkinson disease (pd). the ultimate goal of this project is to be able to identify individuals with pd who are at risk of developing dementia, and to distinguish the underlying cause of dementia. the investigators will be including both pd and normal subjects in this study. this a long term study and we are considering including a total of 320 participants in this protocol.

Eligibility criteria:
inclusion criteria: * pd patients must exhibit three of the following cardinal signs: rest tremor, rigidity, bradykinesia, or postural instability; or two of these features with one of the first three displaying asymmetry. exclusion criteria: * history of head trauma, major neurological or psychiatric diseases other than parkinson disease and dementia, e.g. stroke, multiple sclerosis, depression or schizophrenia. * severe systemic diseases. * inability to lie still for 90 minutes. * metallic implants, pacemakers, or any other contraindication to mri. * refusal to consent to brain donation.

Keywords: parkinsons disease pet imaging pib vat dementia
oxygap : comparison between different pulse oximeter and with the arterial blood gase

Conditions: Respiratory Failure; Hypoxemia; Hyperoxemia

Summary: the oximeter is used to monitor intensive care patients undergoing oxygen therapy. it indicates pulsed oxygen saturation (spo2), a reflection of arterial oxygen saturation (sao2) which enables detection of hypoxemia and hyperoxia, both deleterious state. current spo2 recommendations aim to reduce both risk of hypoxemia and hyperoxia. spo2 is considered the 5th vital sign. current recommendations for spo2 targets do not consider the variability of oximeters used in clinical practice. this variability and lack of specification represent an obstacle to an optimal practice of oxygen therapy. thus, this study aims to compare the spo2 values of different oximeters (nonin, masimo, philips, nellcor) used in clinical practice with the sao2 reference value obtained by an arterial gas in order to specify the precision and the systematic biases of the oximeters studied. this data will also make it possible to refine the recommendations concerning optimal oxygenation


Eligibility criteria:
inclusion criteria: * ≥ 18 years old * patients admitted to the intensive care unit * artery catheter already installed exclusion criteria: * no signal with the oximeter * pigmented nails or nail polish * methemoglobinemia * patient in isolation (multi-resistant bacteria, c-difficile, covid-19...) * prone position
memantine augmentation of targeted cognitive training in schizophrenia

Conditions: Schizophrenia; Schizoaffective Disorder

Summary: treatment of schizophrenia currently includes antipsychotic medications and cognitive therapies which improve some symptoms, but do not sufficiently restore cognitive functioning or reduce psychosocial disability. we hypothesize that medications that specifically target sensory information processing deficits, rather than psychotic symptoms per se, will significantly enhance the benefits of a sensory-based targeted cognitive training (tct) intervention in patients with schizophrenia. we will complete a randomized, double-blind clinical trial to: 1) confirm that the drug memantine augments tct learning; 2) determine whether memantine enhances the clinical benefits from a full 30 session course of tct vs. tct plus placebo in antipsychotic- medicated schizophrenia patients, and 3) determine if memantine's enhancement of tct is most effective in biomarker-defined subgroups of patients.

treatment of schizophrenia (sz) currently includes antipsychotic medications and cognitive therapies which improve some symptoms, but do not sufficiently restore cognitive functioning or reduce psychosocial disability. we propose and will test a novel "augmentation strategy" for using medications to specifically enhance the benefits of targeted cognitive training (tct) in schizophrenia. this project tests a rational and empirically supported platform for augmenting the benefits of tct in antipsychotic medicated sz patients by adjunctive daily treatment of 20 mg memantine, an fda approved medication for the treatment of cognitive dysfunction in alzheimer's disease. we hypothesize that medications that specifically target sensory information processing deficits, rather than psychotic symptoms per se, will significantly enhance the benefits of a sensory-based targeted cognitive training (tct) intervention in patients with schizophrenia. we will complete a randomized, double-blind clinical trial to: 1) confirm that the drug memantine augments tct learning; 2) determine whether memantine enhances the clinical benefits from a full 30 session course of tct vs. tct plus placebo in antipsychotic- medicated schizophrenia patients, and 3) determine if memantine's enhancement of tct is most effective in biomarker-defined subgroups of patients.

Eligibility criteria:
inclusion criteria: * dsm-iv diagnosis of schizophrenia or schizoaffective disorder * written informed consent to participate in the study * age 18-65 * absence of dementia or mental retardation * urine toxicology negative for recreational drugs * fluent and literate in english exclusion criteria: * meets dsm-iv criteria for current substance abuse or dependence and has been substance abstinent for less than 30 days * a history of traumatic brain injury * auditory or visual impairments severe enough to prevent study participation * under conservatorship (determined by anasazi) * pregnancy

Keywords: schizophrenia cognitive training eeg
evaluation of efficacy and tolerability of micardis® / micardisplus® under usual daily-practice prescribing in patients with hypertension

Conditions: Hypertension

Summary: to evaluate efficacy and tolerability of micardis® / micardisplus® under usual daily-practice prescribing conditions with a special emphasis on controlling morning blood pressure


Eligibility criteria:
inclusion criteria: - age ≥ 18 years, insufficiently treated hypertension exclusion criteria: - age \< 18 years