Kornimate/medical-research-clean huggingface dataset:
the rates of overtreatment and deintensification in patients with diabetes mellitus

Conditions: Diabetes Mellitus

Summary: this study evaluates the overtreatment and deintensification rates of antidiabetic and antihypertensive medications in patients with diabetes mellitus in turkey.

diabetes mellitus is one of the most common chronic diseases which lead to serious public health problems and a significant economic burden worldwide. the prevalence of diabetes in elderly patients is very high and is predicted to increase dramatically. prior studies have generally been concerned with the inadequate treatment of diabetes however, over the last few years the overtreatment of diabetes has also come to the fore. unfortunately, there are very few data worldwide and no data in turkey about the overtreatment of patients with type 2 diabetes. this study aimed to assess the rates and predictors of overtreatment and undertreatment of glycemia and blood pressure in older adults with t2dm. treatment deintensification or intensification by the physicians were also investigated.

Eligibility criteria:
inclusion criteria: * patients with diabetes mellitus type i or ii * age 65 years or older * to be under follow-up in the same center for at least one year. exclusion criteria: * younger than 65 years old * having decompensated liver disease * psychiatric disorders interfering cognition or compliance * having bariatric surgery or on renal replacement therapy

Keywords: diabetes mellitus polypharmacy overtreatment undertreatment
systemic microvascular function in patients with resistant hypertension after renal sympathetic denervation

Conditions: Arterial Hypertension; Resistant Arterial Hypertension

Summary: it has been proposed that the modulation of the activity of the sympathetic nervous system, through renal sympathetic denervation, besides reducing blood pressure, would promote an improvement in vascular reactivity and consequent improvement of macro and microcirculation. the present study aimed to investigate the influence of the renal sympathetic denervation on the skin microvascular function of patients presenting with resistant arterial hypertension.

arterial hypertension is still a serious public health problem with considerable social and economic impact. arterial hypertension is the result from a complex interaction between environmental and genetic factors that initiate and perpetuate elevated blood pressure. studies show that about 10% of patients undergoing treatment have resistant hypertension, defined as high blood pressure refractory to at least three antihypertensive drugs. it is known that the sympathetic nervous system plays a fundamental role in the pathophysiology of hypertension, contributing to metabolic and vascular changes. the sympathetic nervous system has also a major role in the pathophysiology of arterial hypertension. arterial hypertension has also been associated with functional microcirculatory alterations as well as systemic microvascular endothelial dysfunction in hypertensive patients, confirmed by different microcirculatory flowmetry techniques. in this context, it has been proposed that the modulation of the sympathetic nervous system through renal sympathetic denervation, besides reducing blood pressure, would promote an improvement in vascular reactivity and consequent improvement of macro and microcirculation. the present study aimed to investigate the influence of the renal sympathetic denervation on the skin microvascular function of patients with resistant hypertension.

Eligibility criteria:
inclusion criteria: * resistant arterial hypertension under pharmacological treatment exclusion criteria: * secondary arterial hypertension * renal dysfunction * severe kidney disease * congestive heart failure

Keywords: arterial hypertension microcirculation sympathetic nervous system
18f-fluoroestradiol (18f-fes) pet/ct guided first-line treatment for hr+/her2- metastatic breast cancer patients

Conditions: Breast Cancer

Summary: a single-center, real world study to evaluate the role of fes-pet in guiding the first-line treatment of hr+/her2- mbc patients.


Eligibility criteria:
inclusion criteria: 1. age \>= 18 years old; 2. patients who were diagnosed as hr positive, her2 negative recurrent unresectable (local or regional) or stage iv (m1) breast cancer between january 2020 to february 2024; 3. received cdk4/6 inhibitor plus endocrine treatment or chemotherapy as first-line therapy for at least one cycle; 4. complete medical history was available. exclusion criteria: 1. medical history was incomplete.

Keywords: chemotherapy cdk4/6 inhibitors 18f-fluoroestradiol (18f-fes) pet/ct hr positive her2 negative
the safety and efficacy of the buprenorphine transdermal system (btds) in subjects with chronic back pain.

Conditions: Back Pain

Summary: the objective of this study is to assess the safety of the buprenorphine transdermal system (5, 10, and 20) in comparison to placebo transdermal system and immediate release oxycodone/ acetaminophen in subjects with chronic back pain. the double-blind treatment intervention duration is 84 days during which time supplemental analgesic medication (non-steroidal anti-inflammatory drugs) will be allowed for all subjects in addition to study drug.

buprenorphine is a synthetic opioid analgesic with over twenty-five years of international clinical experience indicating it to be safe and effective in a variety of therapeutic situations for the relief of moderate to severe pain.

Eligibility criteria:
inclusion criteria: * clinical evidence of stable, chronic (\>2 months) back pain related to intervertebral disc disease, nerve root entrapment, spondylolithesis, and osteoarthritis or other, similar nonmalignant conditions. * unacceptable pain control despite currently taking a nonsteroidal anti-inflammatory drug considered at a therapeutic and/or tolerated dose or, subjects currently taking \</=2 short-acting opioid doses per day, or subjects taking 3-12 short-acting opioid doses per day. exclusion criteria: * receiving opioids at an average daily dose of \>90 mg of oral morphine equivalents or receiving more than 12 tablets per day of short-acting opioid-containing products. * scheduled to have surgery (including dental) involving the use of preoperative or postoperative analgesics or anesthetics during the study period. other protocol-specific exclusion/inclusion criteria may apply.

Keywords: chronic back pain opioid transdermal
hla-b*5701 and hypersensitivity to abacavir

Conditions: HIV Infection

Summary: this retrospective case-control study is being conducted to estimate the sensitivity of the pharmacogenetic marker, hla-b\*5701 for hypersensitivity to abacavir (abc hsr). the specificity of the marker, and its association with abc hsr, as measured by odds ratios and 95% confidence intervals, will be evaluated as secondary endpoints. cases will be defined in two ways - subjects who have clinically-suspected abc hsr and a positive abacavir skin patch test reaction (cs-sptpos) and subjects with clinically-suspected abc hsr (cs-hsr), regardless of the results of skin patch testing. the study will include 40 cs-sptpos black cases matched with up to 200 abacavir-tolerant controls. in parallel, 40 cs-sptpos white cases will be matched with up to 200 white controls. some of the secondary analyses will use cases defined by clinical criteria alone (cs-hsr). black and white subjects will be analyzed separately because of the differences in abc hsr rates and in the carriage frequency of hla-b\*5701.


Eligibility criteria:
inclusion criteria: * subjects with hiv-1 infection with clinically-suspected hypersensitivity to abacavir. * subjects must provide consent for skin patch testing and pharmacogenetic evaluation. exclusion criteria: * women found to be pregnant at baseline. * subjects with hiv-1 infection who have tolerated abacavir for at least 12 weeks without experiencing hypersensitivity to the drug.

Keywords: hla-b*5701 pharmacogenetic marker hypersensitivity to abacavir, retrospective analysis
validation of new tests for gastrointestinal (gi) permeability

Conditions: Gastrointestinal Diseases

Summary: introduction: the primary function of the gastrointestinal (gi) wall is digestion and absorption of nutrients that are important for growth and development. the second important function of the gi wall is forming an effective barrier to prevent penetration of potentially harmful components from the inside of the gut (lumen), via the gi wall, into the body. a compromised barrier function may play an important role in the development of a range of inflammatory gi diseases such as coeliac disease, inflammatory bowel disease (ibd), food allergy, but also in the pathophysiology of postoperative complications. it is important and clinically relevant to have reliable gi permeability tests, however the existing test leave room for improvement. rationale/aim: three new tests are developed to assess gastrointestinal permeability in both normal controls with and without raised permeability, and in patients with coeliac disease. in the current study these new permeability tests will be evaluated and compared with the golden standard permeability test, the dual sugar test.


Eligibility criteria:
inclusion criteria: * healthy controls, female/male, 18-75 years of age, or: * coeliac disease without taking medicine, female/male, 18-75 years of age exclusion criteria: * cardiac and/or vascular disease * chronic obstructive pulmonary disease (copd) * rheumatic arthritis (ra) * inflammatory bowel disease(ibd); crohn's colitis or colitis ulcerosa * irritable bowel syndrome (ibs) * inflammatory systemic disease * obesity (body mass index ≥ 30 kg/m²) * diabetes mellitus * thyroid disease * kidney disease * cancer * smoking * substance abuse (alcohol, drug, cocain, opioids, and others) * use of drugs * operations to the gi system, apart from appendectomy * allergy to eggs or milk * hypersensitivity to any of the following: lactulose, l-rhamnose, sucrose, sucralose of erythritol * acute porphyria or phenylketonuria (pku) * pregnancy

Keywords: gi gastrointestinal permeability indometacin indomethacin coeliac
the senstivity and specificity of using salivary mirnas in detection of malignant transformation of oral lesions.

Conditions: Oral Premalignant Lesions

Summary: due to cancer is a leading cause of death world wide , we will coduct the study to evaluate the diagnostic accuracy of using salivary mirnas (412,512) from the salivary extracellular vesicles (index test) in detection of the malignant transformation of the premalignant lesions using the qualitative real time polymerase chain reaction (qrt-pcr) analysis in comparison to taking biopsy .

our study is a case control study,we will coduct our study to evaluate specificity and sensitivity of using salivary extracellular vesicles mirnas (412,512) in detection of malignant transformation in potientially malignant oral lesions by using qrt-pcr analysis ,participants will be selected and arranged in 3 groups the control group, potentially malignant group and malignant group ,the salivary samples from the participants will be collected and then microrna extraction steps will be done through the laboratory steps ,that include extracellular vesicles isolation, pcr analysis for mirna-412 and mirna-512 expression ,also the histopathologic diagnosis and examination of all specimens were confirmed by pathologist.

Eligibility criteria:
inclusion criteria: * clinically evident lesions as morphologically altered tissue noted at conventional visual tactile examination * clinically evident suspicious lesions which are morphologically altered tissue noted at comprehensive visual ductile examination ( cvte) with a definitive diagnosis of a potentially malignant disorders (pmd) or even a malignant disorder to be a distinct possibly. * healthy subjects presenting no clinically detectable oral lesions matched for age, gender, and risk factors will recruited as controls. exclusion criteria: .\<18 years of age. * pregnant or breast feeding. .psychiatrically or mentally unstable.
operant conditioning after acl reconstruction

Conditions: Anterior Cruciate Ligament Injuries

Summary: the purpose of this study is to examine if the changes in corticospinal function that accompany acl reconstruction can be improved through a form of mental coaching and encouragement, known as operant conditioning.

it is theorized reduced corticospinal excitability contributes to quadriceps dysfunction after knee injury and joint disease. current rehabilitation does not directly target the alterations in corticospinal excitability, which may limit recovery. operant conditioning is an emerging approach capable of increasing corticospinal excitability by directly targeting the corticospinal pathways. however, it remains to be determined whether operant conditioning of the corticospinal pathway may improve corticospinal function after knee trauma. therefore, this study will evaluate the ability of operant up-conditioning of the corticospinal pathway to improve corticospinal function after acl reconstruction.

Eligibility criteria:
inclusion criteria: * aged 14-45 years * suffered an acute, complete acl rupture * have undergone acl reconstructive surgery * willingness to participate in testing and follow-up as outlined in the protocol exclusion criteria: * have suffered a previous acl injury on the contralateral leg * have undergone previous major surgery to the contralateral knee * have a history of recent significant knee injury (other than acl) or lower-extremity fracture * have a history of uncontrolled diabetes or hypertension * be pregnant or plan to become pregnant * have metal implants in the head * have electronic devices in their ear or heart (e.g., cochlear implants or cardiac pacemakers) * have unexplained recurrent headaches * have a recent history of seizure * have a history of repeated fainting spells

Keywords: acl quadriceps
intraoperative methadone for the prevention of postoperative pain

Conditions: Orthopedic Surgery

Summary: the pain felt after orthopedic surgery in the absence of adequate locoregional anesthesia is often insufficiently controlled, especially during the first 24 hours postoperatively. methadone, due to its long half-life, may provide better pain control after orthopedic surgery when associated locoregional anesthesia cannot be performed. it may be impossible to perform loco-regional anesthesia in various contexts: patient refusal, pre-existing neurological impairment, infection at the injection site, coagulopathies, inability to cooperate, total language barrier, allergy to anesthetics, unavailability of equipment (ultrasound, etc.) or equipped room, lack of experience of nursing staff in performing the block and in the postoperative management of the patient. intraoperative administration of methadone in these settings may be superior to sufentanil for pain control during the 24 hours post orthopedic surgery, and the pain control provided by methadone does not appear to imply a higher likelihood of adverse events related to opioids.


Eligibility criteria:
inclusion criteria: * age between 18 and 80 years old * asa 1-3 status * elective partial or total hip and knee arthroplasty exclusion criteria: * patient refusal * preoperative renal failure (serum creatinine \> 2 mg/dl or 1.5-fold * increase in basal plasma creatinine or gfr \< 90 ml/min/1.73m2) * significant hepatic dysfunction (pt \<50% or increase in 3 times basal transaminases) * known heart failure * preoperative hemodynamic instability (preoperative use of inotropes or vasopressors) * known methadone or sufentanil allergy * preoperative opioid use or history of opioid abuse * pregnancy and breastfeeding.
a continuous glucose monitor based insulin bolus calculator

Conditions: Diabetes Mellitus, Type 2; Diabetes Mellitus, Type 1

Summary: this study examines the safety of an app-based insulin bolus calculator that utilizes glucose values from a continuous glucose monitor

individuals with type 1 diabetes and those with type 2 diabetes who are prescribed bolus insulin must decide on an insulin dose for any given meal. this dose is often based on what they are eating and their glucose value. insulin bolus calculators may be helpful in recommending an insulin dose. this study examines the safety of an app-based insulin calculator manufactured by welloc (columbia, md). this app uses the glucose value and trend arrow, in certain circumstances, to recommend a bolus insulin dose. this study is a single arm trial where continuous glucose monitoring metrics such as time in range will be measured before and after the study participants are given the app.

Eligibility criteria:
inclusion criteria: * type 1 diabetes * type 2 diabetes * using dexcom g6 cgm system * injecting bolus insulin exclusion criteria: * pregnancy, * insulin pump use

Keywords: continuous glucose monitor insulin calculator
suicidal thought and biological markers

Conditions: Suicidal Intention

Summary: thought markers (tm) and biomarkers(bm) to accurately predict the likelihood of a repeated suicide attempt.

the purpose of this study is to develop a predictive model that includes thought markers (tm) and biomarkers(bm) to accurately predict the likelihood of a repeated suicide attempt.

Eligibility criteria:
inclusion criteria: obe able to understand the requirements of the study and provide written informed consent to participate in this study. signed and dated informed consent will be obtained from each patient before participation in the study, ohave provided written authorization for the use and disclosure of their protected health information, obe 13 years of age or older, obe diagnosed with: osuicide ideation/attempts/gestures, or onon-suicidal and having other mental disorders, onon-mentally ill, and non-suicidal controls, ospeak english as the primary language in the home, oagree to abide by the study protocol and its restrictions and be able to complete all aspects of the study. exclusion criteria: osignificant unstable medical condition that may obscure the scientific interpretability of the study or unduly increase the risks of the protocol, oanticipated inability to attend follow-up phone interview, opatients whose level of consciousness precludes consent and research assessments, opatients unable to assent because of severe mental retardation, opatients who in the judgment of the investigator may be unreliable or uncooperative with the evaluation procedure outlined in this protocol, ofor control patients a diagnosis of depression or another non-mental illness, or a history of suicidal behavior or suicidal attempt, opatients who are unwilling to provide the dna sample.

Keywords: suicide suicidal intent thought markers
belatacept compared to tacrolimus in deceased donor renal transplant recipients

Conditions: Implant or Graft; Rejection

Summary: the main purpose of this study is to ﬁnd out whether treatment to prevent kidney rejection with belatacept in presence of thymoglobulin induction and withdrawal of steroids will result in less delayed graft function or "sleepy kidney" after transplant than that seen in patients who get tacrolimus as their main drug to prevent rejection instead of belatacept. the investigators will also look at whether patients who get belatacept have the same, lesser or more problems that those who get tacrolimus.

new york presbyterian hospital-columbia university medical center (nyph-cumc) performs nearly 250 renal transplants annually; of these approximately half are recipients of a variety of deceased donor kidneys, usually with cold ischemia time (cit) \>24 hours leading to an approximate incidence of delayed graft function (dgf) of 50%. the main focus of this study will be to determine whether initial immunosuppression with belatacept with thymoglobulin induction will result in lower incidence and/or more rapid disappearance of dgf than that observed in patients who receive tacrolimus based immunosuppression. ngal determinations will bne made in the first months after transplantation to correlate with clinical dgf.

Eligibility criteria:
inclusion criteria: * patients must have known epstein-barr virus (ebv) serostatus, and that status must be positive * adult patients ≥18 years of age, receiving a deceased donor kidney transplant at columbia university medical center (cumc) * patients with a pra ≤ of 50 * primary or re-transplant candidates (no more than 5th renal transplant) * deceased donor renal transplant recipients * candidates eligible for ratg induction * patients fully consented prior to transplantation * women of reproductive age who are willing to delay pregnancy for the duration of the study and use appropriate recommended contraception exclusion criteria: * seronegative or unknown ebv serologic status (due to the risk of post-transplant lymphoproliferative disorder, ptld), predominantly involving the central nervous system. * patients with tuberculosis who have not been treated for latent infection. * scheduled to undergo multi-organ transplantation * recipients of previous non-renal organ transplant * patient receiving 5th renal transplant at the time of screening. * patients with a pra \> 50 * recipient is pre-emptive status. * recipient with positive flow crossmatch. * history or known hiv * known hypersensitivity or contra-indications to belatacept, tacrolimus, mycophenolate mofetil (cellcept), or mycophenolic acid * use of an investigational drug in the past 30 days before day of surgery * enrolled in a clinical trial other than the current * lactating or pregnant women * donor specific antibodies (dsa) identified at the time of transplantation * abo incompatible renal transplant

Keywords: kidney renal transplant belatacept delayed graft function thymoglobulin tacrolimus kidney function immunosuppression ngal
study to look for artifact on computed tomography (ct) representing kidney stones

Conditions: Kidney Stones

Summary: patients suspected of having a kidney stone are usually evaluated by computed tomography (ct) scan. the investigators hypothesize that ultrasound (u/s) should be sufficient to evaluate kidneys for suspected renal stones.

all patients aged 18 years of age and over who are undergoing a renal stone protocol for evaluation of flank pain will be included. pregnant patients will not be included.

Eligibility criteria:
inclusion criteria: * adult, able to consent, flank pain exclusion criteria: * pregnant, unable to consent

Keywords: renal calculi
differences in atorvastatin metabolite ratios as a diagnostic tool in detecting atorvastatin induced myotoxicity

Conditions: Muscular Diseases

Summary: the primary objective of the study is to investigate whether differences in atorvastatin metabolite ratios might have a positive or negative predictive value in diagnosing atorvastatin muscle toxicity. a muscle biopsy is also collected and investigated.

the primary objective of the study is to investigate whether differences in atorvastatin metabolites ratios might have a positive or negative predictive value in diagnosing atorvastatin muscle toxicity. a muscle biopsy is also collected and investigated.

Eligibility criteria:
inclusion criteria: * suspected atorvastatin induced muscle adverse events * signed informed consent * 18 years of age or older * able to donate blood samples * ongoing treatment with atorvastatin (not necessary if patients only donate a muscle biopsy)

Keywords: statin statins statin therapy adverse events side effect myotoxicity atorvastatin atorvastatin therapy