Kornimate/medical-research-clean huggingface dataset:
reflectometric measurement of retinal oxygen saturation in patients with chronic obstructive pulmonary disease (copd) grade iv and healthy subjects

Conditions: Retinal Artery; Retinal Veins

Summary: an adequate oxygenation and retinal perfusion is essential for the function of the inner retina. there is a wide range of autoregulation mechanisms to ensure a sufficient ocular blood and oxygen supply during changes in systemic blood pressure or intraocular pressure (iop). nonetheless, various retinopathies such as diabetic retinopathy, which is the leading cause of blindness in people aged 20-65 in the western world, are highly associated with hypoxia (pemp and schmetterer 2008). hence, measurements of oxygen levels in retinal vessels are needed to further our understanding of these ischemic diseases. it is a well known fact and a commonly employed method to measure oxygen saturation of blood through light transmission (kramer 1934). however, this approach is not feasible in the human eye. therefore, reflection must be used, meaning the amount of incident light must be estimated based on the amount of light reflected (for a review see harris 2003). this is a difficult task and investigators in this field have encountered several problems, including optical complexities, nonlinear sensors and eye movement (beach et al 1999; delori 1988). nonetheless considerable progress has been made over the past decades and the development of an reliable oximeter reported (hardarson et al 2006). in the present study this technique will be applied in healthy subjects as well as in patients with copd during room-air conditions. the procedure takes approximately 15 minutes in each subject and will be performed in only one eye.


Eligibility criteria:
inclusion criteria: inclusion criteria for healthy subjects: * men and women aged between 18 and 99 years * tiffeneau index \> 70 % * body mass index between 15th and 85th percentile * normal ophthalmic findings, ametropia \< 3 dpt. inclusion criteria for copd patients: * men and women aged between 18 and 99 years * copd grade iv, oxygen dependent and with a forced expiratory volume in 1 second (fev1) \< 30 % * body mass index between 15th and 85th percentile * normal ophthalmic findings, ametropia \< 3 dpt. exclusion criteria: healthy subjects: * regular use of medication, abuse of alcoholic beverages, participation in a clinical trial in the 3 weeks preceding the study * treatment in the previous 3 weeks with any drug except oral contraceptives * symptoms of a clinically relevant illness in the 3 weeks before the study day * blood donation during the previous 3 weeks copd patients: * abuse of alcoholic beverages, participation in a clinical trial in the 3 weeks preceding the study * health status which does interfere with study procedure or their safety * blood donation during the previous 3 weeks * symptoms of a clinically relevant illness other than copd or copd related in the 3 weeks before the study day
quality assurance of cognitive-behavioral therapy

Conditions: Depression, Anxiety

Summary: the study examines associations between competence in cognitive-behavioral therapy (cbt) and adherence to evidence-based generic cbt in therapists and treatment outcome in patients with depression or an anxiety disorder in psychiatric outpatient care.


Eligibility criteria:
inclusion criteria: * primary diagnosis of major depression or an anxiety disorder (panic disorder, agoraphobia, social anxiety, generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder) exclusion criteria: * psychosis, bipolar disorder, eating disorder, substance use disorder, high risk of suicide, any simultaneous psychological treatment
neoadjuvant therapy for esophageal cancer and cardiopulmonary physiology

Conditions: Esophageal Cancer; Radiation Pneumonitis; Pulmonary Fibrosis; Respiratory Failure; Pneumonia; Surgery; Chemotherapy Effect; Radiation Fibrosis; Radiation Toxicity; Adenocarcinoma; Squamous Cell Carcinoma

Summary: although recent global trends indicate reduced postoperative mortality after esophagectomy, major morbidity, in particular pulmonary, remains high, with considerable health and economic costs. in a recent modern international collaborative series of 2704 patients from high-volume centers, with an approximate equal mix of open and minimally invasive approaches, respiratory complications were evident in 28% of patients, pneumonia in 15%, and respiratory failure in 7%.1 in other series, respiratory failure is reported in up to 15% of patients and is the most common cause of mortality. prediction of risk and prevention of respiratory morbidity is therefore of considerable importance, and in this context baseline assessment of respiratory physiology compliments clinical assessment, history and enhanced recovery pathways representing key elements of current patient management. in this study, which will include all prospective patients with locally advanced esophageal cancer treated at a national center, pulmonary function will be systematically measured before and after neoadjuvant therapy. the investigators seek to evaluate the incidence of radiation induced lung injury (rili), as well as subclinical changes in pulmonary physiology that may be linked to postoperative complications, and quality-of-life in survivorship, and to compare cohorts who received radiation therapy or chemotherapy alone, preoperatively.


Eligibility criteria:
inclusion criteria: * locally advanced esophageal cancer undergoing multimodal therapy with curative intent at study centre during study period * pulmonary function assessed at a minimum of one preoperative timepoint exclusion criteria: * salvage, palliative or emergency surgery
the effects of nanomicelles curcumin on glycemic control, serum lipid profile ,blood pressure and anthropometric measurements in patients with metabolic syndrome

Conditions: Metabolic Syndrome

Summary: metabolic syndrome is a condition which is recognized by abdominal obesity, dyslipidemia, hyperglycemia, and hypertension. curcumin has beneficial effects such as antioxidant and anti-inflammatory effects. nanomcielle curcumin will be used in this study because of the low bioavailability , fast metabolism and low absorption of curcumin powder. therefore, this study is planned to determine the effects of supplementation of nanomicelle curcumin on glycemic control, serum lipid profile ,blood pressure and anthropometric measurements in patients with metabolic syndrome.


Eligibility criteria:
inclusion criteria: * 25\ 40 * waist circumference \>102 cm in men or \>88 cm in women * fasting blood glucose \>100 mg/dl * triglycerides (tg) \> 150 mg/dl * high density lipoprotein cholesterol (hdl-c) \<50 in women or \<40 in men * systolic blood pressure (sbp) \>130 mmhg and diastolic blood pressure (dbp) \>85mmhg exclusion criteria: * insulin administration for diabetes control * hypo- or hyperthyroidism, * renal failure or other chronic diseases * pregnancy and breastfeeding * taking weight loss supplements and obeying unusual weight loss plans
efficacy/safety of antibiotic steroid combination in prevention of post operative inflammation in lasik surgery

Conditions: Post Lasik Surgery Inflammation

Summary: efficacy/safety of antibiotic steroid combination compared with individual administration in inflammation post-lasik

antibiotic/steroid combination compared to individuals components 15 days of treatment

Eligibility criteria:
inclusion criteria: * patients having lasik surgery; * men or women of any race, between 18 and 50 years old, presenting up to 8 degrees of myopia or up to 4 degrees of hypermetropia, or up to 3 degrees of astigmatism, without any other associated ocular problems exclusion criteria: * uncontrolled glaucoma or intraocular hypertension; * use of any ocular anti-infectious drugs or any topical or systemic ocular nsaids during the study but study drugs; * a history of chronic or recurrent ocular inflammatory disease; * uncontrolled diabetes mellitus and diabetic retinopathy ; * patients with sight in a single eye; * iris atrophy in the eye to be operated; * pregnant or lactating women, or women of childbearing potential who are not using proper birth-control methods; * known or suspected allergy or hypersensitivity to any component of study medication; * a history or any other evidence of severe systemic disease

Keywords: prevention of post inflammation in lasik surgery
lactate metabolism in the hypoperfused critically ill

Conditions: Lactate; Metabolism; Hypoperfusion; Metabolomics; Metabolic Acidosis

Summary: investigating lactate metabolism in critically ill patients whom are hypoperfused by preforming metabolomics via liquid chromatography-mass spectrometry.

lactate concentration is well known to be directly correlated with risk of death during admission to intensive care. however, lactate by itself is not considered toxic. the study is observational. the breakdown of lactate is being investigated by collecting blood- and urinsamples from patients with hyperlactatemia as a result of hypoperfusion. levels of lactate, and known as well as unknown metabolites will be identified and quantified by metabolomics. metabolomics is performed using a combination of liquid chromatography and mass spectrometry. data will be analysed via statistical analysis to investigate corelations between lactate, a given metabolite and hard outcome such as mortality. and thereby lay the groundwork for potential further research regarding specific lactate-metabolites.

Eligibility criteria:
inclusion criteria: * diagnosed with sepsis/septic shock or severe heart failure. * clinical and paraclinical signs of hypoperfusion in relation to abovementioned diagnosis. * metabolic acidosis with s-lactate equal-to-or-above 4 mmol/l. * incapacitated exclusion criteria: * only regional hypoperfusion such as a leg. * receiving intravenous lactate as part of treatment. * going in to dialysis. the exclusion is only during dialysis treatment.

Keywords: lactate metabolism hypoperfusion metabolomics metabolic acidosis
electroconvulsive therapy in clozapine refractory schizophrenia

Conditions: Schizophrenia

Summary: this study will evaluate electroconvulsive therapy (ect) in patients who have not responded adequately to clozapine.

ect augmentation of clozapine will be compared to clozapine monotherapy in schizophrenic patients who continue to have psychotic symptoms despite optimal treatment with clozapine.

Eligibility criteria:
inclusion criteria: * diagnosis of schizophrenia according to dsm-iv criteria * duration of illness 2 years or greater * resistance to at least 2 antipsychotics * clozapine resistance * capacity to give informed consent * for women of childbearing capacity, a negative pregnancy test and patient agreement to use a medically accepted form of contraception * brief psychiatric rating scale score of at least a 4 on one of the four psychotic items on the psychotic sub-scale or a score of 12 on these 4 items combined. * clinical global impressions (cgi) - severity rating of at least moderate (score of 4) * receiving at least two 400 mg doses of chlorpromazine equivalents for at least 4 weeks (may include newer antipsychotics) * having substantial psychotic symptoms despite at least 12 weeks of treatment (at least 8 weeks at a consistent dose) exclusion criteria * schizoaffective disorder; bipolar disorder; * current affective episode; * electroconvulsive therapy (ect) within the past 6 months * history of epilepsy; severe neurological or systemic disorder that could significantly affect cognition, behavior, or mental status (other than tardive dyskinesia or neuroleptic-induced parkinsonism); psychoactive substance dependence (other than nicotine or caffeine) within 1 month prior to entering the study * a score of less than 18 on the 24-item hamilton depression rating scale (ham-d) * clinical determination that mood stabilizers were necessary and therefore could not be discontinued. * pregnancy. * affective disorders and prominent depressive symptoms because ect is well known to be effective in those situations, and we wanted to avoid contamination of our results by improvement solely driven by the treatment of the affective symptoms.

Keywords: electroconvulsive therapy
trekking poles to aid multiple sclerosis gait impairment

Conditions: Multiple Sclerosis

Summary: in this study, the investigators will examine a sample of persons with multiple sclerosis (ms) to determine whether their walking function and ability is different depending on which walking assistive device is used.

in this study, the investigators will examine a sample of persons with multiple sclerosis (ms) to determine whether their walking function and ability is different depending on which walking assistive device is used. in addition, the investigators will examine the psychosocial impact and amount of fatigue induced by each assistive device. data collection will consist of a series of assessments via survey and physical performance. the analyses will consist of appropriate comparisons of means to determine if the use of different assistive devices alters any of the outcomes.

Eligibility criteria:
inclusion criteria: * be 18-64 years old with a confirmed diagnosis of ms * have perceived walking difficulty * have an edss score of \< 6, calculated by the physician * ability to understand study procedures and to comply with them for the entire length of the study exclusion criteria: * have had a ms exacerbation in the prior 8 weeks * have other serious medical conditions that would impair their ability to participate in gait performance testing (i.e. severe rheumatoid arthritis or osteoarthritis) * if the physician deems a participant unsafe to go home with devices * cannot communicate in english * possess greater than a mild decrease in mentation (i.e. a score of \>2 on the mental functions item of the fss) * inability or unwillingness of individual to give written informed consent

Keywords: multiple sclerosis walking gait
myobloc atrophy study

Conditions: Spasticity Secondary to Either a Disorder or Trauma; Spinal Cord Injury (SCI); Brain Injury; Tumor; Stroke

Summary: the present pilot study is designed to assess the extent to which botox and myobloc cause muscle atrophy in spastic patients. the primary objective is to assess whether there is statistically significant difference in muscle atrophy between the two groups over a one year period.

botulinum toxin has long been used as a clinical application for the treatment of overactive skeletal and smooth muscles, i.e. spasticity. the benefits of botulinum therapy are indisputable, however, muscle atrophy is one main adverse effect that may hinder a patient's strength and decrease the ability for the practitioner to accurately administer botulinum toxin to a specific muscle group. this, in turn may cause unintentional weakness of adjacent muscle groups through inaccurate targeting or diffusion of botulinum toxin. currently, only two serotypes (abbreviated to btx-a (botox, xeomin and dysport) and btx-b (myobloc), respectively) are used in clinical practice for spasticity. research has shown that both btx-a and btx-b are efficacious in the treatment of spasticity. however, there is no documented literature evaluating if there is a statistically significant difference in the degree of muscle atrophy using btx-a versus btx-b.

Eligibility criteria:
inclusion criteria: * men and women aged 18 or older with spasticity secondary to either a disorder or trauma, such as a spinal cord injury (sci), a brain injury, a tumor, a stroke, multiple sclerosis (ms), or a peripheral nerve injury. * participants must have the ability to provide written consent to participate in the study. exclusion criteria: * patients who have received btx-a or btx-b in the past in the skeletal muscle group under investigation or patients who have had an allergic response to btx-a or btx-b in the past. * diagnosis of myasthenia gravis, eaton-lambert syndrome, or amyotrophic lateral sclerosis. females who are pregnant or breastfeeding. subjects taking aminoglycosides or other agents interfering with neuromuscular function.

Keywords: spasticity modified ashworth scale myobloc botox muscle atrophy
evaluation of the prognostic value of biological markers, coll2-1 and coll2-1no2 in patients with symptomatic knee osteoarthritis

Conditions: Knee Osteoarthritis

Summary: the purposes of this study are to assess the prognostic value of serum and urinary biomarkers coll2-1 and coll2-1no2 at baseline, and their change over the first year, on the progression of knee osteoarthritis mri scores at 12 months, on the progression of knee osteoarthritis clinical score at 12 months. additionally, this study will search for correlations between serum and urinary biomarkers coll2-1 and coll2-1no2 at baseline with the radiographic, mri and clinical severity of knee osteoarthritis.


Eligibility criteria:
inclusion criteria: * male or female, aged 45 to 80 years with a bmi ≤ 40 * with an uni- or bilateral femorotibial knee osteoarthritis associated or not with a femoro-patellar knee osteoarthritis * responding to clinical and radiological criteria of the acr * symptomatic for more than 6 months (for the most painful knee) * k\&l radiological grade of felson ii or iii * with a cartilage lesion identified during mri and either at least 1 out of 4 mri severity criteria: * bone oedema * meniscal lesion in the central region of the medial compartment * effusion without answer to corticosteroids * zone without cartilage * or at least 1 out of 3 clinical severity criteria: * genu varum\>3° * previous meniscal surgery * known polyarthritis * effusion on the target knee * sign an informed consent after being informed * able to follow the instructions of the study * with an agreement from the physicians having established the diagnosis of osteoarthritis (if any) to give relevant information to the investigator * with health insurance (for france). exclusion criteria: for osteoarthritis: * isolated patellofemoral arthritis * chondromatosis or villo-nodular synovioma of the knee * recent trauma-induced knee pain * joint disease due to joint dysplasia, aseptic osteonecrosis, acromegaly, paget's disease, hemophilia, hemochromatosis, ... * inflammatory pathologies as rheumatoid polyarthritis, gout arthritis, infectious arthritis * diseases that may interfere with the evaluation of osteoarthritis (radiculalgia of lower limbs, arteritis, ...) * genu valgum (degree considered as pathological by the physician) for previous treatments: • treatment with strontium ranelate, bisphosphonates, serm and pth for known associated diseases: * serious associated diseases: severe liver or renal failure, uncontrolled cardiovascular disease, hiv, hepatitis b or c * knee tumor for patients: * patient who participated to a therapeutic clinical trial 3 months before the t0 inclusion visit * patient who are the subject of a judicial protection measure or under guardianship * pregnant woman for mri contraindications: * patient with a pacemaker, an implantable defibrillator, neurosurgical clips, a neurostimulator, cochlear implant, a stent, an insulin pump * patient with a ferromagnetic splinter in the body, or having wire sutures * serious mobility problem (parkinson, tremors)
integrating a mental health intervention into primary health care for refugees

Conditions: Medication Adherence; Mental Health Issue; Self Efficacy; Hypertension; Epilepsy; Diabetes

Summary: the objective of this study is to evaluate the impact of an evidence-based mental health intervention (common elements treatment approach) on medication adherence, behavioral improvement and clinical outcomesamong adults taking medication for hypertension, diabetes and epilepsy using a two-arm randomized wait-list controlled trial among adult refugees in mae la camp, thailand.


Eligibility criteria:
inclusion criteria: * a. inclusion criteria: 1. patients who was diagnosed by physician based on icd 10 to have diabetes, hypertension or diabetes with hypertension comorbidity, or epilepsy. 2. registered in chronic database system of the camp. b. exclusion criteria: 1. who are younger than 18 years old 2. who have severe physical illness 3. who have severe mental disorders 4. who will not stay in the camp until the end of the program 5. who are not willing to participate in the program exclusion criteria: -
investigations into sepsis-associated acute kidney injury

Conditions: Acute Kidney Injury

Summary: in this study the investigators would like to study systemic and regional disturbances in patients with sepsis-associated acute kidney injury and in healthy controls undergoing laparoscopic abdominal surgery. specifically study metabolic, hemodynamic and oxygen transport variables.

acute kidney injury (aki) in patients with sepsis has a very poor prognosis with up to 60% mortality. the pathobiology remains to be fully understood. creatine and phosphocreatine, products of arginine metabolism through l-arginine:glycine amidinotransferase (agat) and its sister enzyme guanidinoacetate n-methyl-transferase (gamt), provide an energy-buffering system that is essential for intracellular adenosine triphosphate (atp) supply. we hypothesized that sepsis associated aki may be caused by failure of this energy-buffering system. in series of pilot studies, we explored metabolic and bioenergetic patterns in patients and animals with high risk of developing aki. these data suggest that sepsis associated aki may be caused by failure of this alternative renal energy source. in the current application we propose a clinical investigation of renal metabolism and renal bioenergetics in patients with high and low risk of developing sepsis associated aki. the primary objective is to directly investigate renal agat activity through the arginyl metabolites homoarginine, guanidino acetate, and creatine. secondary objectives are to study renal and systemic hemodynamics, renal oxygenation, glomerular filtration rate (gfr), renal tubular function, and mitochondrial respiration.

Eligibility criteria:
inclusion criteria sepsis group: * sepsis diagnosed or suspected * normal premorbid serum creatinine measured or anticipated (if data are not available) * normovolemia as indicated by a pulse pressure variation less than 12% comparator group * previously healthy individuals scheduled for laparoscopic colon cancer resection * normal creatinine levels within 3 months before admittance to hospital. * patients admitted to the intensive care unit with sepsis diagnosed or suspected * previously healthy patients listed for elective colon cancer surgery exclusion criteria: -