Kornimate/medical-research-clean huggingface dataset:
study of four different treatment approaches for patients who have mycobacterium avium complex disease (mac) plus aids

Conditions: Mycobacterium Avium-intracellulare Infection; HIV Infections

Summary: to compare the safety and efficacy of two doses of clarithromycin in combination with ethambutol and either rifabutin or clofazimine for the treatment of disseminated mycobacterium avium complex (mac) disease in aids patients. recommendations have been issued for aids patients with disseminated mac to be treated with at least two antimycobacterial agents and for every regimen to include a macrolide (clarithromycin or azithromycin). however, the optimal treatment for disseminated mac remains unknown.

recommendations have been issued for aids patients with disseminated mac to be treated with at least two antimycobacterial agents and for every regimen to include a macrolide (clarithromycin or azithromycin). however, the optimal treatment for disseminated mac remains unknown. patients are randomized to receive clarithromycin at one of two doses plus ethambutol and either rifabutin or clofazimine. patients are followed at 1, 2, and 4 months and every 4 months thereafter for a minimum of 1.5 years to a common closing date.

Eligibility criteria:
inclusion criteria concurrent medication: recommended in patients with cd4 count \<= 200 cells/mm3: * antiretroviral therapy. * pcp prophylaxis. allowed in all patients: * isoniazid preventive therapy. patients must have: * hiv infection. * evidence of disseminated mac infection. note: * pregnant women are permitted to enroll following counseling by their clinician regarding the potential negative side effects of the study medications. these drugs should be used in pregnancy only when the potential benefits outweigh the risks. exclusion criteria co-existing condition: patients with the following symptoms or conditions are excluded: * known hypersensitivity to the study drugs. * other concurrent mycobacterial disease requiring therapy, i.e., disseminated nontuberculous mycobacterial infection or active tuberculosis. concurrent medication: excluded: * additional medications with antimycobacterial activity (unless patient is failing or intolerant of assigned study regimen). * drugs with potential additive toxicity or with potential interaction with study drugs (e.g., fluconazole).

Keywords: rifabutin mycobacterium avium-intracellulare infection drug therapy, combination ethambutol clofazimine acquired immunodeficiency syndrome clarithromycin
reducing concurrent opioid-benzodiazepine prescriptions

Conditions: Adverse Drug Effect of Opioids; Adverse Drug Effect of Benzodiazepines

Summary: the purpose of this effort is to use informative e-mails to improve the process of prescribing of opioids and benzodiazepines within the national capital region/military health system (ncr/mhs), with the aim of decreasing concurrent opioid and benzodiazepine prescribing.

the purpose of this effort is to use low-cost informative e-mails to improve the process of prescribing of opioids and benzodiazepines within the national capital region/military health system (ncr/mhs), with the aim of decreasing concurrent opioid and benzodiazepine prescribing. both the va/dod clinical practice guideline for opioid therapy for chronic pain (2017) and the cdc guideline for prescribing opioids for chronic pain (2016) strongly recommend against the concurrent use of opioids and benzodiazepines. taken together, these drugs could cause respiratory depression, enhanced sedation, and death. the intervention population will be prescribers and primary care managers associated with patients who have recently received concurrent prescriptions of opioids and benzodiazepines. using a randomized approach, we will allocate the ncr/mhs providers associated with patients with concurrent prescriptions for opioids and benzodiazepines to one of two conditions: 1. e-mail alert - a messaging approach, in which we will send encrypted emails to the patient's opioid and benzodiazepine prescriber(s) and primary care manager that identify the concurrent prescriptions and detail the patient's prescription history, inform them of the va/dod guideline and risk to patient, and provide action steps and relevant resources. when multiple providers are involved, the email message will also encourage coordination across providers and provide relevant contact information 2. as-usual - an as-usual approach, in which providers are not sent messages. these providers can access patient information through the mhs opioid registry as before.

Eligibility criteria:
inclusion criteria: * patient had an overlapping opioid-benzodiazepine prescription * at least one of the patient's providers (opioid prescribers, benzodiazepine prescribers, and/or pcm) is in the ncr exclusion criteria: * patient has a cancer diagnosis * patient is receiving palliative care * patient is under 18 * patient was previously allocated to a study condition

Keywords: care coordination opioid benzodiazepine behavioral science behavioral economics nudge fragmentation of care concurrent prescribing
effects of bile acids on glp-1 secretion after roux-en-y gastric bypass

Conditions: Severe Obesity

Summary: the purpose of this study is to examine the effects of bile acids on glp-1 secretion after roux-en-y gastric bypass.


Eligibility criteria:
inclusion criteria: * uncomplicated rygb performed minimum 3 months prior to the study. * fasting plasma glucose \< 7.0mm, hba1c \< 48mmol/mol 3 months after rygb. exclusion criteria: * fasting plasma glucose \> 7.0mm, hba1c \> 48mmol/mol 3 months after rygb. * dysregulated hypothyroidism, use of antithyroid treatment. * late diabetic complications as retinopathy, renal insufficiency, neuropathy or previous pancreatitis. * complications to rygb: documented reactive hypoglycaemia, severe dumping (vomiting, diarrhea, severe abdominal pain after food intake).
predisposing factors for post-stroke epilepsy

Conditions: Post Stroke Epilepsy; Stroke; Epilepsy; Seizures

Summary: the goal of this observational study is to learn about epilepsy after a stroke (post-stroke epilepsy). the main questions it aims to answer are: * what make some patients develop epilepsy after a stroke? * does sleep have an impact on the development of post-stroke epilepsy? participants will undergo: * electroencephalography (eeg) * magnetic resonance imaging (mri) * polysomnography (only patients) blood tests will also be taken. the patient group will be compared to the healthy controls. researchers will also look into medical records of stroke patients hospitalized at st. olavs hospital and collect relevant information.

this study aims to study risk factors and clinical factors which might contribute to the development of post-stroke epilepsy. researchers will look at the volume and size of the stroke-induced brain lesions and analyze inflammation markers. patients and controls will undergo eeg and mri. the correlations between sleep and epilepsy after a stroke will also be investigated through polysomnography. relevant information about for instance age, comorbidities and nihss will be collected. researchers will also collect relevant information from medical records of stroke patients hospitalized at st. olavs hospital.

Eligibility criteria:
inclusion criteria: * first time stroke patients with capacity to consent, admitted to the stroke unit at st. olavs hospital. * modified rankin scale (mrs) ≤ 2 before the stroke exclusion criteria: * previous stroke or brain surgery * traumatic brain injuries * neurodegenerative diseases * brain tumors * epilepsy before the stroke * hydrocephalus * aphasia * serious psychiatric disorders * mri incompatibility and claustrophobia

Keywords: cerebrovascular disorders brain diseases central nervous system diseases nervous system disorders vascular diseases
effect of laser acupuncture on insulin resistance in obese women with polycystic ovarian syndrome

Conditions: Polycystic Ovary Syndrome

Summary: this study will be conducted to investigate the effect of laser acupuncture on insulin resistance in obese women with polycystic ovarian syndrome.

women with polycystic ovary syndrome (pcos) face an increased risk of various health issues, including glucose intolerance, type 2 diabetes, hypertension, dyslipidemia, and subfertility. the prevalence of insulin resistance (ir) in pcos can range from 44% to 70%, with longitudinal studies indicating that worsening ir over time in obese women with pcos is associated with an increased risk of early-onset type 2 diabetes. conventional interventions, such as oral contraceptives, metformin, and hormonal therapy, have been developed to address the effects of pcos. however, these treatments can have adverse side effects, including an increased risk of estrogen-related cancers. consequently, lifestyle modifications to prevent aberrant immune activation and minimize exposure to inflammatory agents have emerged as a more sustainable approach. emerging evidence suggests the potential of alternative physical therapy modalities, such as transcutaneous electrical nerve stimulation, electro-acupuncture, and laser acupuncture, in managing pcos. laser acupuncture, in particular, has been shown to reduce sympathetic activity, decrease ovarian androgen release, and modulate the activity of higher centers, ultimately influencing gonadotropin-releasing hormone secretion and the menstrual cycle. additionally, laser acupuncture may reduce the levels of pro-inflammatory cytokines, which contribute to insulin resistance and atherosclerosis. while a few studies have investigated the effects of laser acupuncture on insulin resistance in obese women with pcos, further research is needed to provide deeper insights into the benefits of this intervention and its role in managing insulin resistance in this population, which could expand the clinical applications of laser therapy in physical therapy.

Eligibility criteria:
inclusion criteria: * forty obese women with pcos as clinically diagnosed by gynecologist. * their ages will be ranged from 20 to 35 years old. * their bmi will be ranged from 30-40 kg/m2 * their waist/hip ratio will be \>0.8 * all of them should have at least two criteria of the rotterdam diagnostic criteria of pcos. exclusion criteria: * cushing syndrome, diabetes mellitus, thyroid dysfunction, hypothalamic amenorrhea, ovarian hyperplasia * respiratory, renal and liver dysfunction. * skin diseases and any other condition that may prevent the usage of laser (skin cancer, active acne and skin infections). * malignancy
ketogenic diet survey in patients with mcardle disease (gsdv)

Conditions: McArdle Disease

Summary: the purpose of this survey is to report experiences with variants of a ketogenic diet in a group of individuals diagnosed with mcardle disease (glycogen storage disease type v). further more the survey will report on physical activity, fatigue, sleep and quality of life in this cohort.

currently, there is no satisfactory treatment for mcardle disease. the limitation in people with mcardle disease is due to a limited availability of energy in the muscle due to affected carbohydrate metabolism. a key element in improving muscle function is therefore to introduce alternative energy sources. ketone bodies are a well-known source of energy for both brain and muscle. ketone bodies are produced during fasting or when following a ketogenic diet. a ketogenic diet is a diet high in fat and low in carbohydrates. the classic ketogenic diet contains up to 90% fat, but there are several alternative diets with less fat, including a modified ketogenic diet, atkins diet, lchf (low carb high fat), omad (one meal a day) and more. this survey will collect information on all variations. the rationale for a ketogenic diet for persons with mcardle disease makes good sense in theory, as the diet would contribute with a new source of energy (ketone bodies) independent of the affected carbohydrate breakdown. however, evidence is sparse on whether the diet actually works. the primary purpose of this survey is to report experiences with variants of the ketogenic diet in a group of individuals diagnosed with mcardle disease. secondarily this survey will collect information on physical activity, fatigue, sleep and quality of life in this cohort

Eligibility criteria:
inclusion criteria: * verified gsdv diagnosis exclusion criteria: * age under 18 years
quantra point-of-care hemostasis monitoring

Conditions: Bleeding; Hemostatic Disorder

Summary: the investigators will test the hypothesis that utilization of a blood and blood component transfusion algorithm guided by the poc quantra qplus system in patients undergoing complex cardiac surgery will reduce rbc, plasma, cryoprecipitate, and platelet transfusion during surgery and the first 12 postoperative hours, compared to standard of care (central laboratory transfusion monitoring at the primary anesthesia provider's discretion).

the investigators propose a randomized control trial to assess patients scheduled for aortic surgery or high-risk cardiac surgery requiring cardiopulmonary bypass. patients will be randomized 1:1 to routine care or poc quantra qplus system. the total number of blood and blood component transfusions (including rbc, plasma, cryoprecipitate, and platelets) during and after cardiac surgery until 12 hours after icu arrival will be analyzed between the groups.

Eligibility criteria:
inclusion criteria: 1. adults aged 18 years or more 2. scheduled for aortic surgery or high-risk cardiac surgery requiring cardiopulmonary bypass (high-risk surgery includes reoperative surgery, active endocarditis, expected need for intraoperative circulatory arrest, radiation heart disease, end-stage kidney disease requiring renal replacement therapy, combination surgery including more than one valve or valve plus cabg, low left ventricular ejection fraction \[ef\<30%\] with potential need for mechanical circulatory support with intra-aortic balloon pump, extracorporeal membrane oxygenation \[ecmo\], pulmonary thromboembolectomy or percutaneous left ventricular assist device (vad), and planned placement of a durable left vad with or without placement of rv assist device. exclusion criteria: 1. preoperative diagnosis of a pre-existing coagulation or bleeding disorder 2. preoperative abnormal coagulation disorder (platelet count below 100,000/ul and/or aptt \>40 seconds in the absence of heparin therapy. prolonged aptt \>40 seconds in the acceptable if due to heparin therapy.) 3. liver disease, defined as a history of cirrhosis, liver enzymes \>3x normal range or manifested by elevated pt suggesting abnormal liver synthetic function not explained by other comorbidities 4. pregnancy or breastfeeding 5. refusal to accept red blood cells and blood component transfusions. 6. contraindications to proposed interventions. 7. unable to understand english as a first language or unable comprehend the study and/or the consent forms. 8. vulnerable patients including prisoners, human fetuses, and neonates
a multi-center study of near-infrared spectroscopy (nirs) for hematoma detection

Conditions: TBI (Traumatic Brain Injury)

Summary: the purposes of this study are: 1. to determine the sensitivity and specificity of the near-infrared spectroscopy (nirs) measurements for identifying intracranial hematomas due to trauma. 2. to determine the reproducibility of the near-infrared spectroscopy (nirs) measurements with different operators and at different centers

the principle used in identifying intracranial hematomas with near-infrared spectroscopy (nirs) is that extravascular blood absorbs near-infrared light more than intravascular blood since there is a greater (usually 10-fold greater) concentration of hemoglobin in the acute hematoma then in the brain tissue where blood is contained within vessels. therefore, the absorbance of near-infrared light is greater (and therefore the reflected light less) on the side of the brain containing a hematoma, than on the uninjured side. the nirs sensor is placed successively in the left and right frontal, temporal, parietal, and occipital areas of the head and the absorbance of light at selected wavelengths is recorded. the difference in optical density in the different areas is calculated.

Eligibility criteria:
inclusion criteria: * undergoing a ct scan within 12 hours of their head injury. the criteria for obtaining a ct scan will be based on the standard of care, but generally all patients with a moderate or severe head injury will receive a ct scan on admission to the hospital, and only patients who undergo a ct will be enrolled into the study. the non-contrast ct will be performed according to standard methods. exclusion criteria: * 12 hours or more since injury. * massive scalp lacerations, avulsions, and hematomas the limitation to injury within 12 hours is necessary because as hematoma blood is metabolized, the absorbance characteristics change.

Keywords: tbi nirs hematoma
radiotherapy with extreme hypofractionation in patients with breast cancer in brazil: a retrospective cohort study

Conditions: Radiotherapy Side Effect

Summary: the radiotherapy scheme with extreme hypofractionation has gained space in clinical practice and, therefore, it is necessary to analyze the brazilian national experience in selected patients with breast cancer, with the aim of evaluating the oncological outcomes and toxicities with the use of this treatment protocol.

all patients diagnosed with breast cancer who meet the eligibility criteria at participating centers will be included. data will be collected from medical records at selected centers. data collection will start from the location activation date. data from up to 500 patients are expected to be collected at centers across brazil. patients recruited for this study will be identified at participating centers. data on clinical, demographic and socioeconomic variables will be collected, as well as data on treatments performed and outcomes. the patient data sources will be the patients' medical records. patients will continue to receive treatment and clinical evaluations for their illness as determined by their medical team, in accordance with the standards of care and usual clinical practice at each center. no intervention is proposed in this study.

Eligibility criteria:
inclusion criteria: * women over 18 years old; * diagnosis of breast cancer of any molecular subtype; * undergoing extreme hypofractionated radiotherapy (5 x 5.2gy) postoperatively; * treated from december/2019 onward; * with clinical and treatment data available in medical records. exclusion criteria: * the protocol does not provide exclusion criteria.
telemonitoring in cpap treatment

Conditions: Sleep Apnea

Summary: wireless telemonitoring was used during the habituation phase of continuous positive airway pressure (cpap) treatment in obstructive sleep apnoea (osa) patients. patients were allocated either to the telemonitoring group (n=50) or the usual care group (n=61). nursing time, patient satisfaction and treatment efficiency and efficacy were compared between the groups at baseline and after one year treatment the cpap adherence and treatment efficacy were recorded.

wireless telemonitoring was used during the habituation phase of continuous positive airway pressure (cpap) treatment in obstructive sleep apnoea (osa) patients. patients were allocated either to the telemonitoring group (n=50) or the usual care group (n=61). nursing time, patient satisfaction and treatment efficiency and efficacy were compared between the groups at baseline and after one year treatment the cpap adherence and treatment efficacy were recorded. this study was part of our regular testing and quality assurance procedure when developing and revising clinical treatment protocol of sleep apnoea patients. when planning remarkable changes in treatment protocol we have to test whether it is feasible and cost-effective to change the protocol. the data was retrospectively collected from hospital records and nurses' notes (nursing time). according to instructions of our hospital, the ethics committee approval is not required. the approval of the hospital (head of the division of medicine) for testing the wireless telemonitoring system of cpap treatment was applied and received (protocol record t200/2013, diary number to5/049/13). written informed consent was obtained from those patients allocated to the telemonitoring group.

Eligibility criteria:
inclusion criteria: * consecutive adult patients commencing cpap therapy for osa exclusion criteria: * patient not able to co-operate

Keywords: sleep apnea cpap telemonitoring telecare
dise-hns effect study

Conditions: Obstructive Sleep Apnea

Summary: the purpose of this study is to assess the site, pattern and degree of upper airway collapse before and during hypoglossal nerve stimulation (hns) treatment using clinical standard drug-induced sleep endoscopy (dise) and using a novel, non-invasive method predicting site of collapse from raw polysomnography (psg) data. furthermore, outcomes will be compared between responders and non-responders.

patients who will receive hypoglossal nerve stimulation therapy will be recruited at the pre-operative consultation at the department of ent. as part of the standard procedure, all patients who are eligible for hns have already undergone dise. to be included in the study, the patient should have undergone or is scheduled to undergo a baseline psg within two years of hns implantation. all patients will undergo hns-implantation and receive hns-therapy as part of the standard pathway. one year after hns-therapy, patients will undergo another psg as part of routine practice in these patients. an additional dise will be performed to assess the effect of hns on the site, pattern and degree of upper airway collapse.

Eligibility criteria:
inclusion criteria: * 18 years or older. * eligible for hns-therapy: * ahi between 15 and 65 events/hour * bmi under 32 kg/m2 * absence of complete concentric collapse of palate (ccc) on dise * intolerance or failure of continuous positive airway pressure (cpap)-treatment * intolerance or failure of mandibular advancement device (mad)-treatment * combination of central and mixed apneas less than 25% of total apneas on recent psg (not older than two years) * scheduled for hns-implantation at the antwerp university hospital * capable of giving informed consent * baseline polysomnography planned or performed in the last 2 years at the antwerp university hospital exclusion criteria: * patients will not receive hns-therapy at the antwerp university hospital * known medical history of intellectual disability, memory disorders or current psychiatric disorders (psychotic illness, major depression, or acute anxiety attacks as mentioned by the patient).

Keywords: hypoglossal nerve stimulation drug-induced sleep endoscopy