Kornimate/medical-research-clean huggingface dataset:
impact of two different types of sedation on iceb

Conditions: Propofol; Dexmedetomidine; Electrophysiological Balance Index; QT Interval, Variation in; Tp-e Interval; QT Dispersion; Knee Osteoarthritis

Summary: the qt interval is a measure of the combination of cardiac depolarization and repolarization as it encompasses both the qrs complex and the j-t interval. qt, qtc, qtd prolongation or shortening has been associated with ventricular arrhythmias . in order to define non-torsogenic drug-induced arrhythmias, the index of cardio-electrophysiological balance (iceb), which is a new marker calculated with the qt/qrs formula, has been defined. in our study, we planned to evaluate the effects of dexmedetomidine and propofol on cardiac electrophysiology with all these parameters, especially the newly defined iceb.

seventy patients who underwent operation under regional anesthesia and received intraoperative sedation will be included in the study. the patients will be divided into two groups, group d (dexmedetomidine) and group p (propofol). sedative agent infusion will be started immediately after spinal anesthesia is administered. preoperative asa (american society of anesthesiologists) scores, demographic data, comorbidities and medications used will be recorded. vitals and ecg prior to spinal anesthesia will be recorded. after that, spinal anesthesia will be applied and vitals and ecg will be recorded at 1, 5, 10, 15, 45 and 75 minutes. the sedation levels of the patients will be measured noninvasively by bispectral index (bis) monitoring. patients will be kept within the limits of light sedation. the maximum dose of 1.4 micrograms/kg/hour in the dexmedetomidine group (group d, n=35) and 4.5 milligrams/kg/hour in the propofol group (group p, n=35) will not be exceeded. the following parameters were set as the safety endpoint during sedation: * respiratory rate ≤8 * spo2; 95 * heart rate; 40 * systolic blood pressure;80 at these endpoints, the patient's sedation dose will be reduced regardless of the bis value. during sedation, patients will be given 3 liters of nasal oxygen per minute, which can be increased according to need. just before and 1st, 5th, 10th, 15th, 45th, 75th minutes after spinal anesthesia systolic arterial pressure, diastolic arterial pressure, mean arterial pressure,peak heart rate, oxygen saturation, bispectral index, qt time, qtc, qt distribution, tpe, iceb will be evaluated.

Eligibility criteria:
inclusion criteria: * patients with asa ⅰ-ⅱ , * 18-80 years old, who will be operated under spinal anesthesia exclusion criteria: * hypersensitivity to the propofol,dexmedotimidine * preoperative qtc prolongation * preoperative heart disease * use of drugs that affect the qt interval * severe sinus bradycardia * preoperative electrolyte abnormalities * liver and kidney function abnormalities * non-sinus rhythm
effects of motor imagery in pain modulation and median nerve mechanosensitive in healthy patients

Conditions: Median Nerve Injury

Summary: the aim of this study are 1) to determinate the effectiveness of motor imagery or strength training in differens aspects of pain modulation. 2) evaluate the functional improvement of the hand by a motor imagery protocol.


Eligibility criteria:
inclusion criteria: * healthy exclusion criteria: * be under 18 * any pathology which provoke pain.
a randomized, placebo-controlled clinical trial of intravitreal triamcinolone for refractory diabetic macular edema

Conditions: Diabetic Macular Edema

Summary: to determine the efficacy and safety of intravitreal triamcinolone acetonide for refractory diabetic macular edema.

overall 80% of diabetic patients with low vision are in the nonproliferative stage and the main cause of decreased visual acuity is macular edema. according to the early treatment diabetic retinopathy study (etdrs), the treatment of choice for diabetic macular edema (dme) is laser therapy, which may be neither effective nor curative in some patients.there are many cases which are refractory to laser treatment or not suitable candidates for it. corticosteroids might have a beneficial effect on dme. they have been used with different doses and routes (periocular,intravitreal,and slow released implants) for a variety of retinal diseases. recently, a few prospective randomized studies, concerning the effect of intravitreal triamcinolone acetonide (ivt) on dme have been published. in their two-year results, gillies et al. concluded that ivt improved vision and reduced macular thickness in eyes with refractory diabetic macular edema. they showed that this beneficial effect persisted for up to 2 years with repeated treatment. we also conducted a randomized placebo-controlled clinical trial to determine the safety and efficacy of ivt for intractable dme. besides, we tried to evaluate the effect of this intervention on angiographic findings of these patients.

Eligibility criteria:
inclusion criteria: * clinically significant macular edema(csme) * clinically significant macular edema(csme)refractory to initial or supplemental macular photocoagulation exclusion criteria: * mono-ocular patients * history of vitrectomy * glaucoma or ocular hypertension * significant media opacity * traction on the macula

Keywords: cystoid macular edema diabetic macular edema hard exudates intravitreal triamcinolone macular thickness
genetic testing to understand and address renal disease disparities

Conditions: Hypertension; Chronic Kidney Disease; Genomics

Summary: in this genomic medicine implementation pilot project, the investigators aim to conduct a randomized trial in a network of community health centers and primary care facilities to study processes, effects and challenges of incorporating information for apolipoprotein l1 (apol1)-attributable genetic risk for end stage kidney disease in patients of african ancestry with hypertension .

ckd is most commonly associated with diabetes (40%) and hypertension (28%), and affects 26 million american adults. african ancestry populations with hypertension (htn) have 2- to 3-fold higher risk of developing ckd, and a 5-fold increased risk to progress to end stage renal disease (esrd) when compared with whites. htn is a risk factor for progression of ckd and for increased cardiovascular risk with ckd. thus targeting blood pressure control as a modifiable risk factor may both reduce cvd in people with ckd and reduce progression of ckd to end stage disease. recent discoveries demonstrate that testable alleles of the apol1 locus on chromosome 22 have a major effect on and explain almost all of the excess risk for hypertension-associated ckd and its progression to esrd in african ancestry populations. we will use community-engaged approaches to enroll patients of african ancestry with htn from a network of community health centers and primary care facilities in harlem and the bronx and randomize them on a 7 to 1 ratio to receive apol1 genetic testing and emr-enabled provider clinical decision support incorporating apol1 genomic risk information.

Eligibility criteria:
inclusion criteria: * ages18-65 * self-identifies as black/african american * history of hypertension * patient at a participating site exclusion criteria: * history of chronic kidney disease * history of diabetes * pregnant * cognitively impaired/unable to provide consent * terminally ill * planning to leave area of study permanently during the one year study period

Keywords: hypertension chronic kidney disease end stage renal disease apol1 genomics genetics community-engaged
study to investigate luveltamab tazevibulin in adults with advanced or metastatic non-small cell lung cancer

Conditions: Lung Cancer; Lung Cancer Metastatic; Lung Cancer, Nonsmall Cell; Lung Cancer Non-Small Cell Stage IIIB; Lung Cancer Non-small Cell Stage IV; Lung Cancer, Non-small Cell

Summary: a phase 2 study evaluating stro-002 in subjects with previously treated advanced or metastatic non-small cell lung cancer expressing folr1

this is a multicenter, open-label study. the study is designed to assess the preliminary efficacy and safety of luveltamab tazevibulin, an anti-folr1 antibody drug conjugate (adc) in previously treated subjects with advanced or metastatic nsclc that expresses folr1. subjects will receive luveltamab tazevibulin administered intravenously every 3 weeks until disease progression, intolerable toxicity, elective withdrawal from the study, or study termination.

Eligibility criteria:
inclusion criteria: * histologically or cytologically confirmed non-squamous/adenocarcinoma or adenosquamous nsclc that is either unresectable stage iiib/c disease not amenable for definitive chemoradiation, or stage iv. * age ≥ 18 years * ecog performance status 0 to 1. * received at least 2 but no more than 4 prior lines of systemic therapy for advanced nsclc * disease progression during or following the most recent systemic anti-cancer therapy. * positive folr1 expression per central testing * at least 1 measurable target lesion per recist 1.1 * adequate organ function exclusion criteria: * prior treatment with a folr1- targeting adcs or with adcs that contain a tubulin inhibitor * untreated central nervous system metastases * ongoing immunosuppressive therapy, except for treated brain metastases, per criterion above. * history of severe allergic or anaphylactic reactions to monoclonal antibody therapy or to antibody-related fusion protein treatment * pre-existing clinically significant ocular disorders, severe chronic obstructive pulmonary disease or asthma, clinically significant cardiac or cerebrovascular disease, or other significant concurrent, uncontrolled medical condition * previous solid organ transplantation * concurrent participation in another therapeutic treatment trial

Keywords: folr1 folate receptor alpha folrα frα antibody drug conjugate adc luveltamab tazevibulin stro-002 luvelta
evaluation of patient coach support for older adults with obesity

Conditions: Obesity

Summary: the purpose of the present pilot is to evaluate the outcomes of adding a patient coach to support the optimal health weight and lifestyle (ohwl) clinic plan developed by pi dewar, specifically to address barriers and facilitators of adherence to the plan. this will be accomplished via a coach who is not embedded in clinic care and is supported by pilot research funds. evaluation of the coach activities, conducted by research personnel, will include compiling data from the electronic health record, a short set of patient report and performance measures, and qualitative interviews.

a patient coach added to the ohwl clinic plan as part of the pilot will help patients who are being treated for weight loss to achieve their goals, help address barriers and facilitators of adherence to referred services such physical therapy and nutritionist appointments and various specialists and links to community services as needed. evaluation of the coach activities will be conducted by research personnel, which will also include data compilation from the electronic health record, a short set of patient report and performance measures, and qualitative interviews. this project will provide pilot data for future funding proposals.

Eligibility criteria:
inclusion criteria: * body mass index (bmi) equal to or greater than 35 * ability to walk across a room with or without an assistive device * willingness and ability to follow instructions * interest in weight management * at least two of the following conditions: hypertension, cardiovascular conditions including heart failure, diabetes mellitus, hyperlipidemia, non-alcoholic steatohepatitis, obstructive sleep apnea, osteoarthritis exclusion criteria: * active mental health disorder, such as major depression * moderate to severe cognitive impairment * mobility limited to bed-bound status

Keywords: health coach aging
whole-body vibration on mucus clearance, the quality of life, and exercise capacity for patients with chronic obstructive pulmonary disease

Conditions: COPD

Summary: although whole body vibration (wbv) is mainly designed to promote neuromuscular function, however, because of its vibration characteristics, whether it can provide additional effects on the sputum clearance for chronic obstructive pulmonary (copd) disease patients, thereby improving the quality of life, and exercise capacity is still unknown.


Eligibility criteria:
inclusion criteria: * confirmed diagnosis of copd at the outpatient thoracic medicine clinic * need hfcwo as judged by the doctor exclusion criteria: * acute copd exacerbation within the previous 4 weeks, * contraindication for wbvt (e.g., artificial joint replacement, a history of deep vein thrombosis, or known aortic aneurysm) * inability to perform squatting exercises * acute disc disease * inability to complete the 6mwt
motor deficits and signal conduction in individuals with williams syndrome

Conditions: Williams Syndrome

Summary: the current study aims to validate basic research findings of abnormal conductivity and motor abilities from a mouse model in humans. the study will measure nerve conduction properties in ws individuals and characterize motor symptoms in individuals with ws.

50 individuals with ws will take part in the study. all participants will be recruited from the williams syndrome clinic at edmond and lili safra children's hospital, sheba medical center directed by prof. doron gothelf, md, that coordinates treatment and research of ws in israel. 20 control age-matched subjects will be recruited as well. a motor questionnaire, designed especially for this study will be filled by parents. it includes questions about gross motor, fine motor, gait and coordination characteristics of the children (bellugi, bihrle et al. 1990, wilson, kaplan et al. 2000, wilson, crawford et al. 2009) (general references regarding motor abilities and health). in addition, participants will undergo the following assessments at the neuromuscular clinic and at the movement laboratory, sheba medical center in collaboration with dr. amir dori, dr. uri givon and dr. meir plotnik: (1) nerve conduction study (2) nerve ultrasound (3) neurological assessments (4) gaitrite walkway for gait analysis (5) 3-d motion analysis.

Eligibility criteria:
inclusion criteria: * ws patients. exclusion criteria: * ws patients suffering from additional neurological condition (such as epilepsy). * participants who will have difficulties preforming the tests may ask to be excluded.

Keywords: williams syndrome nerve conduction motor deficits
patient-centered smartphone-based diabetes care

Conditions: Type 2 Diabetes Mellitus

Summary: the investigators developed a patient-centered smartphone-based diabetes care system (psdcs). this study was aimed to test the feasibility of the psdcs.


Eligibility criteria:
inclusion criteria: * type 2 diabetes * hba1c levels ≥ 6.5% exclusion criteria: * severe diabetic complication including severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy, chronic kidney disease stage 4-5, severe diabetic neuropathy, history of diabetic foot, history of angina pectoris, myocardial infarction, and cerebrovascular disease, and peripheral arterial disease * type 1 diabetes * insulin therapy other than insulin glargine * subjects with insulin pump * history of drug addiction * history of psychotic disorder * pregnancy

Keywords: health care systems mobile applications self-care diabetes mellitus smartphone
telelifestylecoaching for weight loss

Conditions: Overweight

Summary: lifestyle changes often fail due to loss of motivation. telemedicine and personal coaching have the potential to support lifestyle change and weight loss. therefore, the aim of our randomized controlled trial was to examine the effect of telemedicine with and without coaching in comparison to a control group on weight loss in overweight participants.

in an occupational health care setting overweight employees were randomized into a three arm 12-week trial. participants in the telemedical (tm) and telemedical coaching (tmc) group got a weighing machine and a step counter, with automatic transfer into a personalized online portal, which could be monitored from both, the participant and the study centre. the tmc group weekly got care calls from the study centre aiming to discuss measured data and to fix target agreements. the control group remained in routine care. wilcoxon signed rank test was used to determine if differences (baseline vs. after 12 weeks) were significantly different from 0 and anova test for determination of inter group differences.

Eligibility criteria:
inclusion criteria: * bmi ≥27 kg/m2 exclusion criteria: * hypoglycemia inducing medication * severe disease with hospital stay during the last 3 months * smoking cessation for less then 3 months * planned smoking cessation during study phase * acute infects * chronic diseases

Keywords: telemedicine coaching lifestyle change weight loss
effect of an educational intervention on cardiac patients' participation rate in cardiac rehabilitation programs

Conditions: Coronary Artery Disease

Summary: the main aim of the study is to determine the effectiveness of an educational intervention designed to increase attendance of coronary artery bypass grafting (cabg) patients at cardiac rehabilitation programs (crps) on actual crp participation rate and; examine patient-related factors (demographic, health, psychosocial, awareness) influencing patients' attendance at crps. we hypothesized that the proportion of cabg patients participating in crps will increase significantly to 20-30% following the educational intervention employed.

coronary heart disease (chd) is a major cause of disability and economic burden in western societies. ample evidence exists to suggest that participation of these patients in structured cardiac rehabilitation programs (crps) is beneficial in terms of improved prognosis and quality of life. despite inclusion of cardiac rehabilitation (cr) in the medical insurance basket (mib) as a treatment for patients after an acute myocardial infarction (mi), for those after coronary artery bypass grafting (cabg), and more recently for patients suffering from congestive heart failure, only a small proportion (5%-7.5%) of patients take part in crps in israel. several factors have been identified as barriers to crp in israel, two of which are lack of patients motivation to participate in crps stemming, in part, from lack of awareness regarding the importance of cr and its availability and; lack of motivation of medical staff to refer patients to cr resulting from a unawareness of the importance of cr and its availability across israel, to name a few. the present study accords with such recommendations, by proposing a simple intervention designed to improve patients' and medical staff's awareness to the importance of cr participation. it is expected that crp participation will significantly increase to 20-30% following the educational intervention employed. this intervention will provide the basis for the implementation of an intervention to increase crp participation in cardiac patients at a national level. in addition to increasing the proportion of cabg patients attending at crps, the study aims to measure the effect of crp participation on subsequent 1-year health and behavior related outcomes, and 3-year mortality. we expect to find differences in outcome measures between participating patients and those who do not.

Eligibility criteria:
inclusion criteria: * patients undergoing coronary artery bypass grafting with or without valve replacement exclusion criteria: * institutionalized patients * patients with severe co-morbidities for whom cardiac rehabilitation (cr) is contra-indicated * patients who sustained a severe surgical complication preventing them from participating in cr (general stroke with severe disability) * patients residing farther than 30 km from a rehabilitation center

Keywords: intervention awareness cardiac rehabilitation (cr) coronary artery patients coronary artery bypass grafting surgery (cabg)
determinants of patients' uptake of therapeutic education programme

Conditions: Chronic Disease; Patient Education as Topic; Patient Adherence; Empathy; Quality of Healthcare

Summary: therapeutic patient education (tpe) refers to programs that help patients to manage life with a chronic disease in the best possible way. in spite of the effectiveness of therapeutic patient education, few patients uptake tpe when it is proposed to them. therefore, our main aim was to identify patients' beliefs that will predict patients' uptake of tpe. according to the health belief model, patient will participate in tpe if they perceive their disease as a serious threat (with possible serious complications), but which can be controlled however, and that tpe is efficient and represents little burden. secondary aims are as follows: 1. to test whether the way tpe is presented to patients impact patients' decision to uptake tpe. the way tpe is presented comprises the time between diagnosis and the proposal of tpe, whether patient is a remission or crisis period in the disease, the time between the proposal and the next tpe session, and what is said by healthcare professionals to present tpe. 2. to test whether healthcare professionals' empathy impact patients' decision to participate in tpe 3. to test whether patients' intention to participate in tpe will predict their actual participation. the ultimate goal of the study is to identify patients whose beliefs will not favor participation in tpe in order to accompany those patients more carefully. best practices will be proposed according the results.


Eligibility criteria:
inclusion criteria: * patients to whom tpe was proposed in diabetes, hemophilia, obesity, cardiac failure, chronic inflammatory bowel disease, parkinson, rare diseases, epilepsy, peripheral arterial diseases * belong to a social security scheme * pregnant women to whom tpe for gestational diabetes is proposed exclusion criteria: * cognitive impairment declared by healthcare professionals * inpatients * patients for whom tpe is coupled with rehabilitation * psychiatric disorders * patients who cannot give informed consent * patients in jail

Keywords: psychological theory
rhopressa for corneal edema associated with fuchs dystrophy

Conditions: Fuchs Endothelial Dystrophy

Summary: the study objective is to determine whether use of rhopressa improves the ability of corneal endothelial cells to maintain appropriate corneal hydration in patients with fuchs endothelial corneal dystrophy (fecd), which could help delay or prevent the need for a corneal transplant.


Eligibility criteria:
inclusion criteria: * at least 18 years of age * male or female patient diagnosed with fecd and corneal edema evident by slit lamp exam and/or corneal tomography. * patient is able and willing to administer eye drops. * patient is able to comprehend and has signed the informed consent form. exclusion criteria: * active intraocular inflammation, corneal ulceration, keratitis, or conjunctivitis. * known sensitivity to any of the ingredients in the study medications. * abnormal eyelid function. * history of herpetic keratitis. * history of non-compliance with using prescribed medication. * current or planned pregnancy within the study duration. * concurrent involvement or participation in another randomized clinical trial within 30 days prior to enrollment in this study. * any ocular or systemic condition (i.e., uncontrolled systemic disease) or situation which in the investigator's opinion may put the patient at significant risk, confound the study results, or interfere significantly with the patient's participation in the study.