Kornimate/medical-research-clean huggingface dataset:
genetic markers of chd risk in men and women

Conditions: Cardiovascular Diseases; Coronary Disease; Heart Diseases; Myocardial Infarction; Inflammation

Summary: to investigate the association of selected genetic markers of inflammation and endothelial activation with the occurrence of non-fatal acute myocardial infarction (mi).

background: coronary artery disease is a major cause of death and disability in westernized societies, and is growing in importance in countries with emerging economies. inflammation and endothelial dysfunction are now recognized as important contributors to coronary artery disease. however, the genetic basis and specific genes involved in the expression of the hyperinflammatory phenotype are not yet well-understood. identification and further characterization of variation in candidate loci that are associated with coronary artery disease would contribute to the understanding of the genetic basis underlying acute myocardial infarction, and may provide novel pathways for prevention and treatment. design narrative: this case-control study will determine whether the variability in several genes that influence inflammation and endothelial dysfunction is related to the odds of myocardial infarction (mi) among 700 men and 229 postmenopausal women from the western new york health study. the study performs the following: 1) to test the hypothesis that cases of acute mi will have a higher frequency of specific haplotypes at the c-reactive protein locus composed of alleles associated with higher levels of crp production (-732g/a), 1059g/c, and +1444c/t) than matched controls. mi cases will have a greater frequency of haplotypes composed of alleles associated with higher levels of interleukin (il) production, specifically il-6 production (-597g/a, -572g/c, and -174g/c) than controls, and a lower frequency of specific haplotypes in the il1a/il1 bill1rn gene region; 2) cases will have a higher frequency of alleles and haplotypes for specific functional polymorphisms of the e-selectin gene (128r and g98t) than controls; 3) to utilize dna pooling strategy for rapid screening of large numbers of single nucleotide polymorphisms (snps) in 29 candidate genes in relevant biological pathways and test selected loci for association with risk of acute mi; 4) for those loci with evidence of association, to identify haplotype tagging single nucleotide polymorphisms (htsnps) that capture the variation at each locus and test for association between these snps and haplotypes and risk of mi. secondary aims will a) explore the above associations among men with premature mi (55 years of age or less) and b) explore gene- gene and gene- environment interactions. mi case subjects were identified from hospital record review in erie and niagara counties (95% of all eligible cases, icd9 410-410.9) an average of 4 months post mi. they were interviewed and examined in 1996-2001. control subjects were randomly selected from the same counties (59.5% response rate) and had a contemporaneous clinical exam. controls will be individually matched to cases by age, sex, and ethnicity.

Eligibility criteria:
no eligibility criteria
treatment adherence of home parenteral nutrition in patients with chronic intestinal failure. (qanpic)

Conditions: Chronic Intestinal Failure

Summary: this observational, cross-sectionnal, multicentric study evaluates treatment adherence of home parenteral nutrition in patients with chronic intestinal failure.

chronic intestinal failure (cif) is a chronic disease and its main treatment is home parenteral nutrition. this disease is defined by a small bowel dysfunction preventing absorption of nutrients and water inputs. a " normal " oral diet is then insufficient, and must be supplied by an " artificial " parenteral nutrition. this treatment is administered at home, by a central veinous catheter, with varying volumes and frequencies. the quality of life of patients treated by home parenteral nutrition is significatively altered . the constraints linked to this treatment may make it difficult to follow. the patients can be lead to ask their doctor for a relief or a modification of this treatment during office visits, to improve their quality of life. poor treatment adherence concerns 25% of patients with chronic disease . it has never been assessed in france in cif. the goal of this study is to evaluate the treatment adherence for home parenteral nutrition in two of its components: negotiation during office visits, and compliance at home. the negociation component will be assessed during an office visit with the help of forms, by the difference between " ideal " parenteral nutrition prescription proposed by prescriber and the " final " prescription, that the patient ultimately receives at the end of the office visit. the compliance component will be assessed by a telephone interview, 8 weeks after the office visit.

Eligibility criteria:
inclusion criteria: * age 18 or older. * diagnosis of cif (insufficiency of intestinal absorptive, motor or vascular functions that require parenteral nutrition). * home parenteral nutrition treatment for at least 6 months. * with home parenteral nutrition treatment stable for at least 3 months. * agreeing to participate in research protocol. exclusion criteria: * any condition that does not let a telephone interview (example : deafness, severe neurocognitive impairment).

Keywords: chronic intestinal failure treatment adherence
the impact of ic-guided feeding protocol on clinical outcomes in critically ill patients (the ic-study)

Conditions: Critical Illness

Summary: adequate nutritional support is an essential element for achieving favourable outcomes in critically ill patients. therefore, an accurate determination of patients' energy needs is required to optimize nutritional support and reduce the harmful effects of under- and over-feeding. currently, indirect calorimetry is considered as a gold standard for measuring energy expenditure during critical illness. this randomized study aims to investigate the impact of indirect calorimetry guided nutrition therapy on clinical outcomes such as icu. mortality, hospital mortality, duration of mechanical ventilation, length of i.c.u./hospital stay and mascle wasting. the investigators hypothesis that nutrition therapy guided by ic will improve clinical outcomes in severely ill patients

this is a single-blind randomized control study. eligible participants are randomly assigned within 24 hrs of icu. admission in two groups * intervention group: the calorie needs will be determined by indirect calorimetry. * control group: a routine standard weight-based equation (20-25kcal/kg ideal body weight/day) will be used to estimate the energy requirements of critically ill patients. daily energy and protein data will be recorded for a maximum of 12 evaluable days (nutritional days) or until death or discharge from icu.while outcome data will be collected for a maximum of 28 days.

Eligibility criteria:
inclusion criteria: * adult patients aged over 18 years old * critically ill patients with me ical ventilation * expected to have an icu. stay of more than (3) days exclusion criteria: * requirement for inspired oxygen content (fio2) greater than 0.6 * patients on high-frequency ventilation * patients with chest tubes that leak air/ bronchopleural fistula * patients with incompetent tracheal cuff * patients inhaled nitric oxide therapy * patients receiving continuous renal replacement therapy (crrt) during ic measurement * patients with pregnancy * patients with burn injury * patients infected with human immunodeficiency virus (hiv) * patients with severe liver disease (child-pugh score c) * seizure activity * patients suffering from significant head trauma (gcs \<8) * patients with paraplegia and quadriplegia

Keywords: indirect calorimetry, energy expenditure, critical illness
type vi secretion system in klebsiella pneumoniae

Conditions: Detection of Type VI Secretion System in K.Pneumoniae; Detection of Relation to Ab Resistance, Biofilm

Summary: klebsiella pneumoniae (k. pneumoniae) is an important opportunistic pathogen contributing to nosocomial and antimicrobial-resistant infections. the increasing prevalence of infections caused by multidrug-resistant k. pneumoniae has emerged as a major clinical and public health threat, while the serous organ and life-threatening infections caused by highly virulent k. pneumoniae have also emerged( russo and marr, 2019; wyres et al., 2020).

both drug-resistant and highly virulent k. pneumoniae have brought major challenges to clinical treatment and stimulated interest in studying k. pneumoniae. however, knowledge of the genomics, ecology, and pathogenicity of k. pneumoniae is relatively limited. recently, the type vi secretion system (t6ss) was identified as a virulence factor in k. pneumoniae (martin and bachman, 2018). furthermore, k. pneumoniae was found to exploit the t6ss nano-weapon to destroy bacterial competitors and fungi (storey et al., 2020). the bacterial type vi secretion system (t6ss) is a membrane-attached contractile phage tail that is physically and mechanistically similar to a membrane-linked intracellular contractile phage tail. t6ss spike and tube elements, as well as anti-bacterial and anti-eukaryotic effectors, are propelled out of predatory t6ss positive cells and into target cells by a fast conformational shift in the structural framework of a sheath protein complex, according to recent research (kudryashev et al., 2015). however, the limited studies and lack of information on the t6ss in k. pneumoniae necessitate further exploration to clarify the physiological metabolism and pathogenic information of this clinically important bacterial species.

Eligibility criteria:
inclusion criteria: * all patients suffering from infections that can be caused by klebsiella pneumoniae. exclusion criteria: * samples diagnosed to have organisms other than klebsiella pneumoniae

Keywords: type iv secretion system klebsiella pneumoniae
lifestyle therapy for youth with type 2 diabetes

Conditions: Type 2 Diabetes Mellitus

Summary: background: little is known about the efficacy of intensive lifestyle therapy (i.e. increased physical activity and dietary changes) for the management of glycemia and cardiometabolic risk factors in children and adolescents with type 2 diabetes (t2dm). our hypothesis is that education regarding healthy lifestyle changes will significantly reduce blood sugars in youth with t2dm that do not require insulin therapy. our secondary hypothesis is that the intensive lifestyle therapy will cause quick and sustained reductions in health risk measured by body mass index (bmi), blood pressure, waist circumference, ldl cholesterol, serum triglycerides and apolipoprotein b.

youth between the ages of 10-20 years living with type 2 diabetes and not currently on insulin therapy will be randomly assigned to either a lifestyle intervention group or a control group. the lifestyle intervention group will meet 2-3 times per week for 16 weeks to take part in healthy living education sessions involving physical activity, healthy cooking, healthy gardening and how to start and sustain a healthy lifestyle change. at the beginning and end of the 16 weeks the investigators will measure the participants' blood sugars, height, weight, cholesterol, triglycerides and liver enzymes. the investigators will also take a picture of their kidney, heart and blood vessels using ultrasound. those youth assigned to the control group will receive the 16 week intervention following their 16 week control period.

Eligibility criteria:
inclusion criteria: * youth with a bmi considered overweight according to the international obesity task force * diagnosed with type 2 diabetes, confirmed with a 2-hour oral glucose tolerance test within two years of enrollment exclusion criteria: * youth with type 1 diabetes * use of insulin or other anti-diabetic drugs * youth with medication-induced diabetes * youth who have recently been admitted to hospital with ketoacidosis * youth have experienced weight loss or enrolled in a weightloss program in the last 6 months * youth with an orthapaedic injury preventing them from exercising * youth who have a history of alcohol or drug abuse

Keywords: adolescent type 2 diabetes peer mentorship
psychotherapeutic text messaging for depression pilot study

Conditions: Major Depression

Summary: major depression is the leading cause of disability in the united states and is a major contributor to suicide, a leading cause of premature death. the majority of individuals with depression do not receive adequate pharmacologic or psychotherapeutic treatment due to difficulty accessing services or stopping treatment due to side effects, non-response, or the stigma associated with attending mental health clinic visits. mobile health information technology services, such as text messaging, have the potential to provide effective self-management support for depression to nearly every adult in the us with depression. guided self-help via text messaging has been shown to be effective for improving a range of health behaviors as well as symptoms of depression. however, previously studied depression text messaging services have not utilized the breadth of psychotherapeutic techniques shown to be effective for depression nor have they attempted to tailor the psychotherapeutic content to the individual in order to improve acceptability and outcomes. advanced artificial intelligence methods (e.g., reinforcement learning) offers the capability to weed out ineffective messages and to target messages to individuals in order to substantially improve program effectiveness. this pilot study is the first step in towards developing an artificially intelligent text message service for depression. the specific aims of the study are to: 1) demonstrate the feasibility of recruiting and enrolling participants from the general population of us adults and delivering a text-messaging intervention for depression, 2) determine whether there are differences in the perceived helpfulness of messages derived from different psychotherapeutic treatment modalities, and whether these differences are moderated by participant characteristics (e.g., age, gender, depression symptom severity), 3) determine whether messages derived from different psychotherapeutic treatment modalities or their perceived helpfulness are associated with changes in depression symptoms, and whether these relationships are moderated by participant characteristics.


Eligibility criteria:
inclusion criteria: * us resident * age 18 or older * phq-9 screening score of 10 or more * has a personal cellular phone with a text messaging plan that would allow for as many as 200 additional text messages per month, and agreement that the participant would be responsible for any related charges * has a valid e-mail address * fluent in english exclusion criteria: * unable to provide voluntary informed consent for any reason

Keywords: major depression text messaging guided self-help
d mannose for prevention and treatment of rutis

Conditions: Recurrent Urinary Tract Infections; Antibiotic Prophylaxis; Antibiotic Resistance

Summary: the aim of this review is to address clinical reliability, efficacy and safety of long-term treatment with oral d mannose for the prevention of recurrent urinary tract infections (rutis) in females.

a comprehensive systematic medline, embase, cochrane search was performed for english language reports published before december 2018 using the term "recurrent urinary tract infections and d mannose." we searched medline, embase, and the cochrane register of controlled trials since january 2010 to december 2018. eligible studies did not include non-oral therapy, local (vaginal) treatment in women with rutis. study eligibility criteria- we identified eligible original articles. the heterogeneity of the available studies, their different rationale and aim, the assumption of d mannose for prophylaxis or treatment of recurrent utis need to be taken into account.

Eligibility criteria:
inclusion criteria: recurrent urinary tract infections (rutis) exclusion criteria: upper urinary tract infections, severe clinical symptoms, fever \> 37,5 with lumbar pain

Keywords: recurrent urinary tract infections d mannose prophylaxis antibiotic prophylaxis
benefit of the flying transport of patients requiring mobile intensive care unit

Conditions: Stress, Psychological; Emergency Medicine, Transport; Critical Care

Summary: patient care who requires fast and intensive care by a mobile intensive care unit in a rescue helicopter is a common practice in auvergne since more than 3 years. indeed, a complete team (nurse and emergency physician) is on dragon 63 and helismur 63 (smur = emergency medical services ). there are multiple fields of action, with a primary rescue activity (patient care directly at the site of the operation) but also secondary transport (transfer of patients from one hospital to another). this allows a reduction in transport time and therefore unavailability of the micu team in general hospitals, which are in short supply of attending physicians. in addition, this allows patients to be repatriated to the clermont-ferrand university hospital center, which is the reference center for many pathologies and has the level 3 adult and pediatric trauma center.

this is an observational study using a redcap® questionnaire via an internet link, which will be distributed by any means (institution mailing lists via a referent, flash codes distributed to physicians, etc.). the questionnaire will assess the type of medicalisation, the type of activity, the different hours of intervention, the age, the type and the severity of the patient's disease, the type of care practiced and the stress of the physician.

Eligibility criteria:
inclusion criteria: * every emergency physician that participate to the helicopter rescue exclusion criteria: * every emergency physician non-voluntary to participate

Keywords: stress, psychological emergency medicine, transport critical care
non-inferiority study comparing mini well ready® and finevision® in patients with cataract surgery

Conditions: Cataract; Presbyopia

Summary: interventional, multicentre, controlled, randomized, single blind, twoarmed non-inferiority trial

to evaluate the non-inferiority of the progressive extended depth of focus intraocular lens mini well ready® in terms of visual performance, quality of vision and subjective outcomes versus the trifocal intraocular lens finevision® after a follow up period of 2-6 months.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * bilateral cataract surgery required, no other ocular comorbidities * healthy corneas, not treated surgically * available for second-eye surgery within 1 week of the initial operation * spherical refraction between -8.00d and +6.00d * willing to adhere to the study visit schedule * normal anterior and posterior segments * clear intraocular media - other than cataract * to benefit from a social security system before being enrolled * written informed consent consistent with local regulation research in human subjects exclusion criteria: * any previous history of ocular trauma or prior ocular surgery (including previous cataract surgery and clris) * ocular comorbidities determining potential postoperative visual acuity less than 0.50 decimal (0.3 logmar) * expected to require retinal laser treatment * a history of retinal detachment or predisposition for such disorder * psudoexfoliation * abnormal pupil size and position * pupil size \> 7 mm under mesopic condition * use of contact lenses 30 days before the preoperative visit * corneal warpage (e.g. keratoconus, pellucid marginal corneal degeneration or keratoglobus) * corneal astigmatism greater than 0.75d * zonular laxicity * absence of adequate capsular support for the implant of the intraocular lens in the capsular bag * microphthalmus * active ocular disease in the operative eye, for example, chronic uveitis, proliferative diabetic retinopathy, chronic glaucoma unresponsive to medication, corneal decompensation and corneal endothelial cell insufficiency (such as fuch's endothelial dystrophy) * suspected microbial infection * irregularities and capsulorexis decentralization * surgical difficulties that may increase the risk of complications such as persistent bleeding, significant iris damage, an uncontrollable intraocular hypertonia, or damage due to significant vitreous loss * patients in whom the intraocular lens may interfere with the ability to observe, diagnose or treat diseases of the posterior segment * patients in whom neither the posterior capsule nor the zonula can provide adequate support to the lens * subjects with any systemic disease that could increase operative risk or confound the outcome * pregnant or lactating or planning a pregnancy at the time of enrolment * vulnerable subjects (children \<18 years, people in guardianship or trusteeship or inability to give an informed consent) * subjects participating in a concurrent clinical trial or if they have participated in an ophthalmology clinical trial within the last 30 days
efficacy of inhalation technique training.

Conditions: Asthma; Chronic Obstructive Pulmonary Disease

Summary: pharmacologic treatment of asthma and copd is based mainly on inhalations. the aim of the study is to determine if short training of inhalation technique in patients with obstructive diseases may influence the course of asthma and copd.

both asthma and copd are common medical problems. pharmacologic treatment of asthma and copd is based mainly on inhalations. the inhalation technique is the key factor for effective management of bronchial obstruction. at the same time, a significant proportion of patients with asthma or copd do not use inhalers properly. the aim of the study is: * to analyze the frequency and type of common mistakes in inhalation technique and * to determine the impact of short individual training of inhalation technique on the course of asthma and copd. fifty patients with asthma and 50 patients with copd treated in the out-patient clinic or in the department of internal medicine, pneumonology and allergology will be enrolled to the study. the stage of severity (copd) and control of the disease (asthma), quality of life, proper inhaler intake will be assessed at the study onset and at a second visit after 6 months. at the second visit all patients will get a short, individual information about the etiology, course and general treatment plan of asthma / copd. patients will be randomized into two groups: a. group of patients trained in proper inhalation technique b. group of patients without inhalation technique training control visits will be held 3 and 6 months after training.

Eligibility criteria:
inclusion criteria: * age of 18 - 80 years * asthma or copd diagnosed at least 6 months before study enrollment * everyday usage of at least one of the following: pressured meter dose inhaler (pmdi) or dry powdered inhaler (aerolizer, handihaler, disc or turbuhaler) * no other comorbidities that could influence learning of inhalation technique (psychiatric or neurologic disorders) exclusion criteria: * age less than 18 or above 80 years * lack of informed consent * asthma or copd diagnosed less than 6 months prior to screening visit * coexistence of respiratory diseases other than asthma or copd * irregular use (not every day) of at least one inhaled drug * treatment with inhalers other than: pmdi, disc, turbuhaler, handihaler or aerolizer

Keywords: asthma and copd treatment inhalation techniques training of inhalation