Kornimate/medical-research-clean huggingface dataset:
right ventricular metabolism in pulmonary arterial hypertension

Conditions: Pulmonary Arterial Hypertension; Healthy

Summary: the purpose of this study is to use non-invasive imaging to determine the metabolic phenotype of the right ventricle in patients with pulmonary arterial hypertension across a spectrum of disease severity.

current medical therapy for pulmonary arterial hypertension (pah) is aimed at reducing pulmonary vascular resistance (pvr) but not ameliorating right ventricular (rv) failure, the major cause of death. there are no rv-specific therapies currently available for pah, in part because the pathophysiology of rv failure is poorly understood. the investigators hypothesize that the rv in pah develops a distinct metabolic pattern characterized by increased glycolysis, impaired oxidative metabolism and lipid deposition, which are associated with rv failure. specific aim 1. to test the hypothesis that the rv in human pah exhibits lipid deposition, increased glycolysis and impaired fatty acid oxidation. the investigators will measure rv oxidative metabolism and glycolysis in pah patients and controls using positron emission tomography 11c acetate and \[18f\]fluoro-deoxy-d-glucose imaging and measure myocardial lipid accumulation using magnetic resonance spectroscopy imaging. specific aim 2. to test the hypothesis that an abnormal rv metabolic profile is associated with rv dysfunction and reduced exercise capacity in pah. pet and mrs findings will be correlated with rv function, patient exercise capacity and a blood metabolic profile.

Eligibility criteria:
inclusion criteria: * heritable or idiopathic pah * 18 years or older * able to give informed consent exclusion criteria: * pregnancy * type 1 diabetes mellitus * prednisone use * pah associated with any condition other than idiopathic or heritable * implanted ferromagnetic material incompatible with mri

Keywords: pulmonary arterial hypertension right ventricle right ventricular function metabolism non-invasive imaging healthy subjects
observational study on the course of plasma glutamine levels during critical illness

Conditions: Glutamine Levels

Summary: blood sampled for standard evaluation will be used for determination of plasma glutamine by bioprofile flex glutamine sensor at icu admission

all patients who are admitted to the icu after elective surgery and non-elective admissions. in both groups a total of 80 patients will be included. (in the trials we mentioned in the introduction 80, 174 and 66 patients were included. in the study performed by oudemans-van straaten a decent distribution between lower and higher levels of glutamine was achieved in 80 non-elective patients.) exclusion criteria are patients younger then 18 years and patients who need total parenteral nutrition (tpn). the patients will receive standard care during their treatment on the icu. blood sampled for standard evaluation will be used for determination of plasma glutamine by bioprofile flex glutamine sensor at icu admission. hereafter plasma glutamine will be measured daily, a plasma sample will be taken from a standard evaluation blood sample at 6.00 am during admission on the icu.

Eligibility criteria:
inclusion criteria: * all patients admitted to the icu exclusion criteria: * younger then 18 years and patients who need total parenteral nutrition
study of anx005 in adults with amyotrophic lateral sclerosis (als)

Conditions: Amyotrophic Lateral Sclerosis

Summary: this study is a multi-center, open-label study of intravenous (iv) anx005 in participants with als.

in this phase 2a, multi-center, open label, proof-of-biology study, anx005 will be administered to participants with als. the study consists of approximately 22 weeks of treatment and approximately 14 weeks of follow-up. all participants will be contacted by phone 6 months after study completion.

Eligibility criteria:
key inclusion criteria: * diagnosis of als according to the world federation of neurology revised ei escorial criteria. * onset of weakness within 3 years prior to day 1 visit. * slow vital capacity ≥ 50% of predicted normal adjusted for sex, age, and height (from the sitting position). * als functional rating scale-revised (alsfrs-r) ≥ 30 at the screening visit (week -2). * if female, must be postmenopausal, surgically sterilized, or childbearing potential must agree to use highly effective methods of contraception from screening until 3 months after the last infusion with study medication. * males with a woman partner of childbearing potential must agree to use highly effective methods of contraception from screening until week until 3 months after the last infusion with study medication. * documented history of vaccinations within 5 years prior to screening visit against encapsulated bacterial pathogens or willing to undergo vaccinations. key exclusion criteria: * clinically significant intercurrent illness, medical condition, or medical history that would jeopardize the safety of the participant, limit participation, or compromise the interpretation of the data derived from the participant. * participants with body weight \> 150 kilograms. * antinuclear antibodies (ana) titer ≥ 1:160 (for either of the 2 ana results a minimum of 2 weeks apart) during the screening period.
effect of kidney replacement therapy with polymethylmethacrylate membranes on pruritus-related quality of life in patients receiving maintenance haemodialysis

Conditions: CKD (Chronic Kidney Disease) Stage 5D; Hemodialysis; Pruritis

Summary: this randomized controlled trial aims to evaluate the effect of polymethylmethacrylate dialysis membranes use on the intensity of pruritus in patients with ckd stage 5d receiving maintenance hemodialysis. the main question it aims to answer is: does the use of polymethylmethacrylate (pmma) membranes reduce the intensity of pruritus in dialysis patients? researchers will compare pmma membranes to standard polysulfone-based membranes to see if pmma works to reduce moderate-to-severe pruritis and pruritis-related quality of life. participants will: * receive maintenance hemodialysis with pmma or polysulfone membranes for 2 months; * fill in questionnaires about intensity of pruritis and its impact on daily life.


Eligibility criteria:
inclusion criteria: * diagnosis of ckd stage 5d, maintenance hemodialysis not less than 3 months prior screening; * moderate-to-severe pruritis (wi-nrs score ≥ 4); * adequate dialysis dose (spkt/v≥1,4 and/or ekt/v≥1,2); * dialysis treatment regimen: three sessions per week of at least 4 hours duration; * signed informed consent. exclusion criteria: * presence of active skin disease, cholestasis, severe secondary hyperparathyroidism and other conditions that, in the investigator's opinion, may be responsible for pruritus. * noncompliance of the patient with the protocol (in the investigator's opinion). * use of haemodiafiltration.

Keywords: polymethylmethacrylate membranes ckd-associated pruritis pmma membranes
utility of thermal imaging in diagnosis of cellulitis for lower extremity complaints in the emergency department

Conditions: Cellulitis; Skin and Subcutaneous Tissue Infection

Summary: the overall purpose of the study is to determine how providing physicians with a quantitative measure of skin surface temperature influences diagnoses and diagnostic confidence in potential cellulitis cases when added to the standard evaluation.

previous literature estimates the emergency department misdiagnosis rate for cellulitis exceeds 30% due to conditions which can mimic cellulitis (termed pseudocellulitis). these diagnostic errors are associated with an estimated $195 to $515 million dollars in avoidable healthcare spending each year. objective skin surface temperature measurement, obtained via thermal imaging cameras, has been proposed as a diagnostic adjunct that may reduce diagnostic error in cases of suspected cellulitis. one recent study, identified that the maximum affected skin temperature in cellulitis is significantly higher than in pseudocellulitis, and the temperature gradient between affected and unaffected sites in patients with cellulitis is significantly higher than in patients with pseudocellulitis. the overall purpose of the study is to determine how providing physicians with a quantifiable measure of skin surface temperature information influences diagnoses and diagnostic confidence in potential cellulitis cases when added to standard physical exam techniques the aims of the study are to : specific aim 1: to characterize the temperature difference between affected and unaffected limbs in patients with cellulitis in the emergency department. specific aim 2: to characterize the temperature difference between cases of cellulitis and pseudocellulitis specific aim 3: to determine how quantifying temperature gradients changes diagnostic confidence and accuracy when added to the standard diagnostic evaluation for potential cellulitis. the investigators will prospectively enroll a maximum of 560 patients with non-traumatic lower extremity dermatologic complaints with visible erythema (potential cellulitis) in the university of wisconsin emergency department. a thermal image and a photograph of the affected and the unaffected limbs will be taken.

Eligibility criteria:
inclusion criteria: * participant is presenting to the university of wisconsin emergency department * participant has an acute skin complaint on the lower extremity exclusion criteria: * participant is has limited english and spanish proficiency * there was an acute traumatic injury of affected area in last 5 days- includes burns * affected area has a confirmed fracture * participant is pregnant * participant is a prisoner * current complaint is in an area of past surgical procedure (within past 4 weeks) * participant has implant or hardware at site * animal or human bite is cause of complaint * temperature of the leg has been altered in the last one hour * unable to provide informed consent

Keywords: diagnostic confidence diagnostic accuracy diagnostic error
fibroblast before and after neoadjuvant chemo-radiotherapy in patient with locally advanced rectal adenocarcinoma

Conditions: Rectum Adenocarcinoma

Summary: single center interventional study to explore activity of fibroblasts in the tumor and away in the healthy rectal tissue.

patients included in the trial will have new biopsy performed before starting the radiation therapy and chemotherapy (rt-ct). these biopsies will study the activity of fibroblasts in the tumor and away in the healthy rectal tissue. within 8 to 10 weeks after the end of rt-ct, patients will have cancer surgery by proctectomy (with complete removal of the meso-rectum). on the resection specimen, new samples will be taken at the level of the tumor and away from the rectum.this study is single center interventional exploratory .

Eligibility criteria:
inclusion criteria: 1. middle rectum adenocarcinoma tumor(t)x node (n)+ or t3 /t4 n0 or n+ 2. classification done on pelvic magnetic resonance imaging (mri) and rectal ultrasonography 3. age ≥ 18 4. no contraindication to treatment with capecitabine 5. able to receive radiotherapy 50 grays in 5 weeks 6. no contraindication for surgery after chemoradiotherapy which will be 8 to 10 weeks after completion of chemoradiotherapy 7. patient or legal representative provided with information and signature of informed consent exclusion criteria: 1. high rectum adenocarcinoma 2. contraindication to rectal biopsy: including anti-coagulants or anti-platelet agents (vitamin k antagonists, clopidogrel, aspirin \> 160 grams) that cannot be interrupted 3. pregnant woman or breastfeeding 4. persons deprived of their liberty, or under guardianship 5. impossibility of undergoing the trial's medical follow-up for geographical, social or psychological reasons. 6. patient already included in another therapeutic trial with an experimental medication during the realization of protocol biopsies and surgery 7. patient not covered by health insurance

Keywords: rectoscopy proctectomy fibroblasts
nonvisual foot examination for people with diabetes and visual impairment

Conditions: Diabetes; Visual Impairment

Summary: because people who have both diabetes and visual impairment have high risk for foot problems, prevention of ulcers and amputation is a high priority. usual care in diabetes self-management education (dsme) is to teach them to seek sighted assistance for regular foot examination, yet clinical experience suggests that this advice is seldom heeded. one possible solution is to teach use of the nonvisual senses of touch and smell for a systematic, thorough foot self-examination. the purpose of this pilot study was to compare the efficacy, acceptability, and feasibility of nonvisual foot examination with usual care (examination of the visually impaired person's feet by a sighted family member or friend).


Eligibility criteria:
inclusion criteria: * over age 18 * diagnosed with either type 1 or type 2 diabetes * stated they had visual impairment exclusion criteria: * unable to pass a brief decisional capacity test * had a score above 80 on the near vision scale of the national eye institute visual functioning questionnaire * had bilateral lower extremity amputations * by self-report were unable to sense light touch on two or more fingers or either hand

Keywords: diabetes visual impairment foot care diabetes self-management education
how clinicians manage their patients who may need antithrombotic care

Conditions: Thrombosis

Summary: this study aims to assess the knowledge and provide an opportunity for education to clinician attendees of the canadian cardiovascular congress (ccc) meeting using a series of simulated patient case scenarios.

health conditions requiring antithrombotic therapy are highly prevalent in canada, contributing substantially to healthcare costs and patient quality of life. for example, over 60,000 canadians will experience a heart attack per year.1 alarming statistics such as this warrant appropriate treatment approaches from clinicians who specialize in cardiovascular conditions. the ccc is a national conference during which individuals with an interest or expertise in cardiovascular health from across the country attend. leveraging this unique opportunity by implementing a simple educational endeavour during the 2023 event can provide instrumental insights on the most appropriate treatments recommended from the latest clinical practice guidelines to a wide set of practitioners; this could, in turn, potentially improve patient health outcomes. this endeavour will take place at a set date from october 25th to 29th, 2023. attendees of the ccc who approach a booth set up by the lead investigator of this project will be presented with the study letter of information and consent form on a tablet (i.e., an ipad). after providing an electronic informed consent to participate, a series of patient case scenarios that require antithrombotic care and therapy will be shown. for each case scenario, the attendee (now, considered a study participant) will be asked to indicate the treatment approach that he/she would choose. and finally, after reviewing all case scenarios and selecting the best treatment approach to his/her knowledge, the participant will be asked to provide an email address (which could be an anonymized one) to send the most appropriate treatment approaches for each case scenario. this last step allows the participant an educational opportunity to learn what the best practice approach is based on the most up-to-date clinical practice guidelines. the approximate total duration of the study is one-hour in total.

Eligibility criteria:
inclusion criteria: * any clinician (i.e., licensed medical doctor, nurse practitioner) attending the ccc's 2023 event from october 25th-29th, 2023 will be included in this endeavour so long as they have the ability to provide informed consent (i.e., can read, write, and understand the english language). exclusion criteria: * none

Keywords: clinical practice guidelines
impact of sleep extension in adolescents

Conditions: Insulin Sensitivity; Sleep; Dietary Habits

Summary: many teenagers do not get enough sleep. obesity and diabetes are increasing in teenagers as well. this study plans to learn more about sleep and insulin resistance (insulin not working) in teenagers, and how these things may be related depending on sleep. this is important to know so that the investigators understand how sleep may play a role in health conditions like extra weight gain (increased food intake and less physical activity) and diabetes. to answer this question, the investigators plan to enroll teenagers who get \<7 hours of sleep on school nights and measure changes in insulin sensitivity and dietary intake after a week of typical sleep (sleeping on their normal school schedule) and a week of longer sleep (spending 1+ hour longer in bed each night).


Eligibility criteria:
inclusion criteria: 1. high school students between the age of 14-19 years 2. have typically insufficient sleep, defined by ≤ 7 hours per night on school days 3. bmi 5th-84th percentile for age and sex 4. habitually sedentary (\< 3 hours of regular physical activity per week) 5. tanner stage 4 or 5, based on breast development for girls and testicular size for boys. exclusion criteria: 1. any medications that affect ir or sleep (e.g., metformin, stimulants, atypical antipsychotics, current use of oral steroids) 2. regular use of melatonin or other sleep aids 3. a prior diagnosis of a sleep disorder (e.g. insomnia, delayed sleep phase syndrome, obstructive sleep apnea) 4. type 2 diabetes or prediabetes 5. iq\<70 or severe mental illness that may impact sleep or ability to consent/assent (e.g., schizophrenia, psychotic episodes) 6. teens not enrolled in a traditional high school academic program (e.g., home school students) 7. schedules that would preclude participants from adhering to the sleep manipulation (e.g. night shift employment) 8. travel across more than two time zones in the 2 weeks prior to the study.
comparison of quality of supraclavicular, infraclavicular and axillary approach of ultrasound-guided brachial plexus block

Conditions: Pain

Summary: the aim of this study is to compare the quality of 3 methods of ultrasound-guided brachial plexus blocks for surgical anesthesia


Eligibility criteria:
inclusion criteria: * asa i-iii physical status * surgery of distal arm, forearm or hand exclusion criteria: * skin infection near block injection site * allergy to local anesthetics * peripheral neuropathy upper limb * inr of more than 1.4 * thrombocytopenia * opioid dependency * chronic pain syndrome * lack of orientation to person, place and time * patient refusal

Keywords: relief intra-operative
comparing polypropylene mesh and "small bites" technique in emergency colorectal surgery's midline laparotomy closure. study for incisional hernia prevention.

Conditions: Colorectal Cancer; Incisional Hernia; Wound Infection

Summary: the 2023 world journal of emergency surgery guidelines couldn't provide a recommendation for emergency abdominal wall closure due to insufficient consensus (\>80% required). available evidence, predominantly retrospective and heterogeneous, lacks differentiation between urgent and elective colorectal surgeries. therefore, we advocate for a study comparing laparotomy closures in emergency colorectal surgery to contribute evidence on incisional hernia incidence and subsequent complications.


Eligibility criteria:
inclusion criteria: * patients diagnosed with colorectal pathology requiring urgent surgical treatment via midline laparotomy. * patients undergoing urgent laparoscopic surgery but necessitating conversion to midline laparotomy. * urgent surgical intervention required at the level of the colon and/or rectum, even in the presence of other abdominal pathologies. * age over 18 years. * signed informed consent (ic) from the patient and the investigator. exclusion criteria: * severe chronic obstructive pulmonary disease (copd) according to the gold classification or decompensated copd. * bmi ≥ 35 kg/m2. * re-laparotomies. * patients with psychiatric illnesses, addictions, or any disorder hindering the understanding of the informed consent. * inability to read or comprehend any of the languages in the informed consent (catalan, spanish).

Keywords: colorectal cancer hernia incisional wound infection small bites
midsagittal tongue measurement to predict difficult airways

Conditions: Difficult Airway; Ultrasonography

Summary: an unanticipated difﬁcult airway is a potentially life-threatening event during elective surgery or management of critical conditions. however, the common clinical screening tests, show low sensitivity and specificity with a limited predictive value. recently, ultrasound has been used to identify difficult airway. tongue volume is one of the parameters evaluated by ultrasound. in this study, we aim to evaluate the capacity of mid-sagittal tongue csa and tongue width to predict difficult laryngoscopy and difficult intubation.

anatomical changes that adversely affect airway accessibility due to increased adipose tissue in obese patients make it difficult to establish an advanced airway by orotracheal intubation. difficulty with airway management for anesthesia has potentially serious implications, as failure to secure a patent airway can result in hypoxic brain injury or death in a matter of minutes. there have been no effective methods to predict difficult airways accurately. ultrasonography is a non-invasive, safe, and painless modality for evaluating soft tissues. in recent years, studies have been carried out on the parameters that can be used in determining the difficult airway with ultrasound. these include the distance from the skin to the epiglottis, the tongue thickness, the tongue volume, the mandibular condylar mobility, and the visibility of the hyoid. few studies have whether midsagittal tongue cross section area and tongue width can also be used to predict difficult airways similarly to tongue volume. therefore, this study was designed to evaluate the predictive value of accurately measured tongue thickness and cross-sectional tongue area using ultrasonography for predicting difficult tracheal intubation and difficult laryngoscopy.

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists (asa) physical condition i-ii-iii * patients are required general anesthesia with tracheal intubation for bariatric surgery. exclusion criteria: * patients with maxillofacial deformity, trauma, or tumor * patients with identified difficult airway or difficult airway history * patients with cancellation of tracheal intubation for a non-difficult airway reason

Keywords: airway management ultrasonography tongue widht