Kornimate/medical-research-clean huggingface dataset:
home blood pressure telemonitoring linked with community health workers to improve blood pressure

Conditions: Hypertension; High Blood Pressure

Summary: the linked-bp program is a patient-centered, multi-level intervention linking home blood pressure monitoring (hbpm) with a telemonitoring platform (sphygmo) that links with all bluetooth-enabled validated blood pressure (bp) devices, support from community health workers (chws), and bp measurement training at community health centers serving high-risk adults to prevent stage 2 hypertension (bp ≥ 140/90 mm hg). the linked-bp program study will recruit a total of 600 adults (30 from each practice) with elevated bp (120-129/\<80 mm hg) or untreated stage 1 hypertension (130-139/80-89 mm hg) across 20 community health centers or primary care practices serving high-risk adults. this cluster-randomized trial consists of two arms: (1) enhanced "usual care arm," wherein patients will be provided with omron 10 series home bp monitors (hbpm) and will be managed by the patients' primary care clinicians as usual; and (2) the linked-bp program or "intervention arm," which will include training of patients on hbpm, sphygmo bp telemonitoring app, and chw visits for education and counseling on lifestyle modification. the intervention period for each study participant is 12 months.


Eligibility criteria:
inclusion criteria: * 18 years of age as of the date of data extraction * self-identify as non-hispanic white, non-hispanic african-american or hispanic * have elevated bp (120-129/\<80 mm hg) or untreated stage 1 hypertension (130-139/80-89 mm hg) (defined by aha's 2017 hypertension clinical guidelines) * receives primary medical care at one of the participating community health centers and primary care practices exclusion criteria: * age \<18 years * prescribed antihypertensive medication * diagnosis of end-stage renal disease (esrd) * condition which interferes with outcome measurement (e.g., dialysis) * serious medical condition which either limits life expectancy or requires active management (e.g., cancer) * patients with serious cognitive impairment or other conditions preventing their participation in the intervention * upper arm circumference \>50 cm (maximum limit of the extra-large bp cuff) * those planning to leave the practice or move out of the geographic area in 18 months * those who no longer consider the practice site the location where they receive primary care * unwillingness to provide informed consent
von willebrand factor to predict postoperative outcome

Conditions: Liver Dysfunction; Morbidity; Mortality; Hospitalisation

Summary: vwf is stored in weibel-palade-bodies of endothelial cells as well as alpha-granula of platelets and is released upon their activation. endothelial cell dysfunction as well as platelet activation often occur in liver disease and portal hypertension, which may lead to an increase in circulating vwf levels. indeed, multiple studies have reported that liver disease is associated with increased circulating vwf- antigen (vwf-ag). furthermore, increased circulating vwf -ag levels have been shown to be associated with increased mortality rates in patients with chronic liver disease. within a prospective evaluation cohort, the investigators were able to document that patients with increased vwf-ag levels prior to liver resection suffered from an increased incidence of postoperative liver dysfunction and morbidity. within this prospective multicenter validation study, the investigators now aim to prospectively validate that circulating vwf-ag prior to liver resection is a valuable marker to predict postoperative clinical outcome.


Eligibility criteria:
inclusion criteria: * patients undergoing liver resection * only patients with either hepatocellular carcinoma, cholangiocellular carcinoma or colorectal cancer liver metastasis will be included exclusion criteria: * inherited coagulopathy * age \> 85

Keywords: vwf liver resection liver dysfunction liver regeneration postoperative outcome
nurse-led follow-up in patients undergoing catheter ablation for atrial fibrillation

Conditions: Atrial Fibrillation

Summary: the study aims to examine the effect of nurse-led education program on quality of life, atrial fibrillation (af) risk factors, af symptomatology, arrhythmia recurrence rate, and readmission rate after af catheter ablation.


Eligibility criteria:
inclusion criteria: * derivatives from the outpatient clinic of the center itself, as well as patients referred from other centers that have ours as a reference for a first af ablation procedure. * have signed the informed consent. exclusion criteria: * patients with cognitive impairment or disorientation. * patients with problems of comprehension or expression of spanish or catalan. * patients who are part of the medical or nursing group. * patient with defined heart failure with a left ventricular ejection fraction (lvef) less than 40% and a nyha iii or iv.

Keywords: atrial fibrillation nurse-led educational intervention risk factors quality of life
varenicline pregnancy cohort study

Conditions: Malformations

Summary: a prospective population-based cohort study to examine whether varenicline use during pregnancy is associated with an increased risk of major congenital malformations in infants above that associated with smoking during pregnancy.

sampling will not be employed. the data sources record nearly all (\>98.6%) births in denmark and sweden.

Eligibility criteria:
inclusion criteria: all live and stillbirths between may 2007 and december 2012 in denmark and sweden. exclusion criteria: births less than 22 weeks of gestation in denmark and 28 weeks in sweden are not recorded by the registers.

Keywords: varenicline smoking smoking cessation cohort study drug safety prospective study
efficacy of continous regional anesthesia using m. erector spinae catheter after vats procedures

Conditions: Neoplasm of Lung; Thoracic Surgery, Video-Assisted

Summary: investigators will analyze the efficacy of continuous regional anesthesia through a catheter under erector spinae muscle in a prospective, randomized, double blind, placebo-controlled study. investigators will include 50 adults, predicted for elective lung surgery with video-assisted thoracic surgery (vats) technique. patients will be randomly assigned to group a or b. investigators will insert a catheter under the erector spinae muscle (esc) at the t4 level of the operated side under ultrasound guidance. all patients will receive an initial bolus of 20ml levobupivacaine 0,5% through the catheter. group a will receive a continuous infusion 5ml/h of ropivacaine 0,2% and intermittent boluses of the same local anesthetic 15ml/4h through the esc. group b will receive a continuous infusion of 0,9% saline in the same doses. all patients will have a pca pump with piritramide 1mg/ml to cover the pain. all patients will receive regular doses of paracetamol and metamizole as part of multimodal analgesia. investigators will compare pain, assessed with the vas scale in resting and coughing and piritramide usage in both groups. investigators will compare the incentive spirometry results at 24 and 48 hours postoperatively and observe for possible late complications.


Eligibility criteria:
inclusion criteria: * signed written informed consent * asa i-iii * elective video-assisted thoracic surgery with 3 ports technique * no contraindications for regional anesthesia exclusion criteria: * allergy to local anesthetic * pregnancy, breastfeeding * bmi\>35 * inflammation in the area of es catheter insertion * inability to use the pca pump

Keywords: anesthesia, conduction
emergency treatment of coral snake envenomation with antivenom

Conditions: Coral Snake Bite; Toxic Effect of Coral Snake Venom

Summary: the purpose of this study is to see whether a new f(ab')2 antivenom will prevent injury and death from the bite of a coral snake. funding source - fda oopd.

coral snake bites may be trivial in effect, or they may cause profound and life-threatening respiratory paralysis, depending on the severity of the envenomation. venom toxins target the neuromuscular junction, where effects typically become apparent hours following the bite, by which time the clinical syndrome may be irreversible. unless neurotoxicity is prevented, ventilatory paralysis may cause death or require intensive care for weeks after the bite. prevention of paralysis, historically, has involved treating all bite victims with antivenom. this protocol will enable the therapeutic use of a new f(ab')2 antivenom in the management of coral snake envenomation. following a coral snake bite, patients who meet inclusion/exclusion criteria and who provide informed consent will receive 5 vials of antivenom intravenously over no less than 30 minutes. blood assays for venom levels and clinical assessments of neurologic status before and after treatment will be conducted and patients will be followed for 22 days for safety and survival endpoints. the primary endpoint of this phase 3 trial will be survival, for comparison with a historical mortality rate of 15%.

Eligibility criteria:
inclusion criteria: * male or female of any age. presenting for emergency treatment of coral snake bite. exclusion criteria: * prior use of coral snake antivenom for this envenomation. allergy to horse serum.

Keywords: envenomation coral snake antivenom micrurus fulvius
ct biomarkers identification by artificial intelligence for covid-19 prognosis

Conditions: Covid-19

Summary: the study hypothesis is that low-dose computed tomography (ldct) coupled with artificial intelligence by deep learning would generate imaging biomarkers linked to the patient's short- and medium-term prognosis. the purpose of this study is to rapidly make available an early decision-making tool (from the first hospital consultation of the patient with symptoms related to sars-cov-2) based on the integration of several biomarkers (clinical, biological, imaging by thoracic scanner) allowing both personalized medicine and better anticipation of the patient's evolution in terms of care organization.


Eligibility criteria:
inclusion criteria: * patients positive for sars-cov-2 according to rt-pcr test between 1st march and 31st may 2020 * patients undergoing low dose ct scan to establish covid-19 lung damage * available for at least 8 days follow-up exclusion criteria: • patients opposing the retrospective use of their data

Keywords: low dose ct scan biomarkers artificial intelligence
conventional vs. optimised periprocedural analgosedation vs. total intravenous anaesthesia for pulsed-field ablation (cooperative-pfa)

Conditions: Atrial Fibrillation

Summary: a prospective single blinded (subject blinded) 1:1:1 randomised control trial with three parallel arms testing superiority of analgosedation regimen based on remimazolam and total intravenous anesthesia over propofol based analgosedation. the primary composite endpoint consists of hypoxaemia, hypotension, or hypertension requiring intervention.


Eligibility criteria:
inclusion criteria: * atrial fibrillation (af) (paroxysmal, persistent or long standing persistent) with indication for catheter ablation * age above 18 years * capacity to give informed consent exclusion criteria: * heart failure (nyha iii-iv), irrespective of left ventricular ejection fraction * left ventricular ejection fraction \< 20% * significant valvulopathy (moderate or severe aortic stenosis, severe mitral regurgitation, severe aortic regurgitation, moderate and severe mitral stenosis, severe tricuspid regurgitation) * obstructive sleep apnoea syndrome (ahi \>30) * low oxygen saturation (\<93%) at baseline * high aspiration risk (hiatal hernia, gastroesophageal reflux disease on chronic pharmacotherapy) * hypersensitivity to the study drugs * chronic kidney disease (stage 4 and 5 of ckd), liver cirrhosis * anticipated difficult airways * asa (american society of anaesthesiologists) score \> 4 * schizophrenia * epilepsy * other individual contraindications (will be reported in detail)

Keywords: analgosedation remimazolam atrial fibrillation pulsed field ablation
laser acupuncture and acupressure for low back pain

Conditions: Low Back Pain

Summary: background: low back pain (lbp) is a common, huge health and socioeconomic health problem that affects physiological functions and reduces work efficiency in nurses. objective: this study aimed to evaluate the effect of low-level laser acupuncture combined with acupressure (laa) on pain intensity, pain interference and life dysfunction in hospital nurses with lbp. methods: this single-blinded randomized controlled trial enrolled a convenience sample of nurses from one teaching hospital. seventy-six participants were randomly assigned to the laa group (n=38) receiving low-level laser acupuncture and auricular acupressure for four weeks, and a control group (n=38) receiving a similar intervention but without laser energy and acupressure. data were collected using the short form of the brief pain inventory (bpi-sf) and roland-morris disability questionnaire (rdq) at three time points: baseline before the intervention, and week 2 and week 4 during the intervention.

the enrollment criteria were age more than 20 years, low back pain with visual analogue scale (lbp_vas) ≧3, no regular treatment for low back pain within six weeks, and willing to participate in this study. exclusion criteria were open wounds on lower back, tumor on the back, ankylosing spondylitis, previous lumbar surgery, coagulopathy or bleeding tendency, or pregnancy.

Eligibility criteria:
inclusion criteria: * age more than 20 years, low back pain with visual analogue scale (lbp_vas) ≧3 * no regular treatment for low back pain within six weeks * willing to participate in this study exclusion criteria: * open wounds on lower back * tumor on the back * ankylosing spondylitis * previous lumbar surgery * coagulopathy or bleeding tendency * pregnancy

Keywords: acupuncture acupressure low back pain low-level laser life dysfunction hospital nurses
levonorgestrel-releasing intrauterine system in patients with endometriosis

Conditions: Endometriosis

Summary: the hemostatic and inflammatory systems may activate each other. endometriosis is a chronic inflammatory disease affecting 10% of women. the objective of this study is to compare the hemostatic effects of two treatments widely prescribed to women with endometriosis: the levonorgestrel intrauterine system (lng-ius) and the gonadotropin-releasing hormone analog (gnrha) leuprolide acetate. hypothesis: h0: there is no alteration in hemostatic system with the use of gnrha or lng-ius h1: there is alteration in hemostatic system with the use of gnrha or lng-ius

materials and methods: in this randomized open-label controlled trial, 44 women with endometriosis will be randomly allocated to one of two groups: 22 women will be assigned to use lng-ius and 22 to use gnrha. the assessed variables will be d-dimers, fibrinogen, prothrombin time, activated partial thromboplastin time, coagulation factors (f) ii, v, vii, viii, ix, x, and xi, antithrombin (at), protein c, free protein s, tissue plasminogen activator (t-pa), α2-antiplasmin, thrombin-antithrombin complex, and prothrombin fragment 1+2. all variables will be assessed before treatment and six months after treatment onset.

Eligibility criteria:
inclusion criteria: * to have endometriosis * aged 18 to 40 years * being without contraceptives for at least 3 months or with depot medroxyprogesterone acetate or gnrha for at least 6 months at the time of randomization. exclusion criteria: * obese patients with a body mass index (bmi) ≥30 kg/m2 * smokers * diabetics * alcohol or drug users * patients currently wishing to conceive * patients with chronic diseases (except endometriosis) * patients with infectious processes * patients with a personal and/or family history of thromboembolic events * patients taking medications known to interfere with inflammation markers (such as hormonal and nonhormonal anti-inflammatory agents) within the 15 days before the study.

Keywords: endometriosis blood coagulation levonorgestrel gnrh agonist progesterone-releasing intrauterine device
comparison of the effects of oxycodone versus fentanyl on airway reflex to tracheal extubation and postoperative pain

Conditions: Coughing Responses at Tracheal Extubation

Summary: this study was performed to compare the effects of oxycodone and fentanyl on airway and hemodynamic responses and postoperative pain during recovery period in patients undergoing laparoscopic cholecystectomy.

this study was approved by the committee of institutional review board of the yeungnam university hospital, daegu, republic of korea. 90 patients were enrolled in this study and written informed consent was obtained from all patients. we included patients with asa physical status classification i or ii, and aged 18-65 years scheduled for elective laparoscopic cholecystectomy. patients were assigned to one of three groups by computer-generated randomization, fentanyl group (group f, n=30), oxydodone group (group o, n=30), or control group (group c, n=30). 10 minutes before completion of surgery, patients received 2 ml mixture of fentanyl 1 ㎍/kg or oxycodone 0.08 mg/kg with isotonic saline or isotonic saline 2 ml intravenously in accordance with allocated study groups by an anesthesiologist who was blinded to group treatment. airway reflex responses including coughing, breath holding, bucking, and laryngospasm were recorded at point of awareness, extubation, and 3 min after tracheal extubation. hemodynamic responses were recorded at the completion of surgery (t1), at the point of awareness (t2), at the point of extubation (t3), and 3 min after tracheal extubation (t4). coughing severity was assessed using a 5-point scale. in the recovery room, hemodynamic responses were evaluated every 5 min for 30 min. the postoperative pain intensity was assessed 5 and 30 min in the postanesthetic care unit (pacu) using numerical rating scale (nrs) ranging from 0 (no pain) to 10 (worst possible pain).

Eligibility criteria:
inclusion criteria: * asa physical status classification i or ii, and aged 18-65 years scheduled for elective laparoscopic cholecystectomy exclusion criteria: * allergy to either fentanyl or oxycodone, history of chronic other opioids or analgesics use, history of cardiac, hepatic, or renal disease, other comorbid conditions, cognitive impairment or body mass index more than 35 kg/m2

Keywords: oxycodone, fentanyl, tracheal extubation
bilaco trial: biliary atresia - a severe complex congenital liver disease

Conditions: Biliary Atresia; Cognitive Impairment

Summary: biliary atresia is the most severe form of cholestatic liver disease. the children have high morbidity and mortality and get devastating pruritus and fatigue, failure to thrive, progressive hepatic failure and impaired neurodevelopment. the etiology is mostly unknown. more than half need a new liver from a living or deceased donor during childhood. however, correct timing of the transplantation is extremely difficult because of lack of consensus based on clinical assessment tools. all though the incidence is low, the cost of this disease is tremendous from both a clinical and human perspective. so far, protocolized neurodevelopment tests, genetic profiling, precise malnutrition evaluation based on clinical appearance, biochemical markers and brain mri-scans, body composition, immunological function, level of physical activity and optimal time of transplantation in cholestatic children are unknown. the aim is to determine risk factors for neurocognitive impairment in children suffering from severe cholestasis in order to determine optimal time for liver transplantation from a brain perspective. in a prospective study, the investigators will investigate risk factors related to brain-, heart-, gut- and immunological function in the danish cohort. this cohort consists of 75 children aged 0-18 years. in addition, 30 aged and gender matched healthy and 20 tetra fallot children will serve as control groups. the children will undergo extensive and advanced liver function evaluation, genetic profiling, nutrition and immunological status, neuro-imaging and neurocognitive evaluation at time of diagnose, 2 years of age, pre-school, pre-teenage, and teenage. in case of a liver transplantation, additional neuro-cognitive tests will be performed


Eligibility criteria:
inclusion criteria: * biliary atresia * tetralogy of fallot * healthy controls exclusion criteria: - not able to participate in exams
functional outcome in two types of total knee replacement surgery for people with osteoarthritis

Conditions: Osteoarthritis

Summary: when performing total knee replacement surgery, the surgeon has a choice as to which type of surgical technique to use. the standard technique at the royal infirmary in edinburgh is the so-called 'medial parapatellar' exposure. and alternative and more recently introduced technique is the 'mid-vastus approach' in which the surgeon will cut through less of the muscle at the front of the leg. in this study we compare the two surgical techniques in a so-called randomized trial. this means that we put people randomly into two groups, one group will receive surgery with the 'mid-vastus approach' and the other group the surgery with the 'medial parapatellar approach'. it is hypothesized that people who receive the mid-vastus approach recover quicker and have a better short-term functional outcome than people who receive the 'medial parapatellar approach'.

this study is a prospective randomized controlled double blind trial in which both immediate post-operative recovery and functional outcome at 6 weeks, 3 and 6 months after total knee replacement surgery will be assessed for two different types of surgical approach; medial parapatellar and mid-vastus. functional outcome will be assessed by recording the kinematics of the lower limb joints in addition to muscle activity (electromyography) during walking, stair ascending and descending and getting up from a chair through computerized 3d motion analysis. outcome measures will be recorded immediate post surgery and at medium follow-up and will cover all areas of the world health organisation, international components of functioning, disability and health (icf) components 'body structures and functions/impairments' ,'activities and participation' and 'personal factors'. it is hypothesized that by minimizing the damage to the quadriceps, patients operated using the mid-vastus approach will have better muscle function and will therefore have more normal knee range of motion, knee joint loading and muscle activity patterns compared to those with the medial parapatellar approach.

Eligibility criteria:
inclusion criteria: * total knee arthroplasty * osteoarthritis * surgery at royal infirmary edinburgh by participating surgeons exclusion criteria: * a body mass index of more than 40 * fixed valgus deformity of more than 15 degrees * inflammatory polyarthritis * disorders of the feet, ankles or hips or spine causing abnormal gait or significant pain * dementia * severe visual impairment * neurological conditions affecting movement * inability to give informed consent

Keywords: total knee arthroplasty function