Kornimate/medical-research-clean huggingface dataset:
the platform for interdisciplinary cardiovascular-metabolic-neurovascular diseases (picman)

Conditions: Cardiometabolic Syndrome

Summary: background changes in metabolism and mitochondrial function appear to precede cardiac dysfunction, with much evidence supporting metabolic dysregulation as one of the earliest precursors of cardiovascular disease. we hypothesise that quantifiable metabolic inflexibility may be representative of an individual in his/her silent, but high-risk progression towards insulin resistance, diabetes and cardiovascular disease. the platform for interdisciplinary cardiovascular-metabolic-neurovascular diseases (picman) across national university health system (nuhs) is a pilot, prospective, multi-ethnic cohort study in singapore. through extensive phenotyping in a preventive cardiology cohort, the central aim is to define the metabolic flexibility range in a cohort of individuals at elevated risk of atherosclerotic cardiovascular disease, to correlate metabolic flexibility to measures of cardiometabolic health, including diastolic dysfunction, coronary and cerebral atherosclerosis, body fat distribution and severity of non-alcoholic fatty liver disease.

aims 1. define norms for metabolic flexibility in a multi-ethnic southeast asian cohort of individuals without manifest ascvd 2. understand the association of metabolic inflexibility with cardiovascular measures of diastolic dysfunction and coronary and cerebral atherosclerosis 3. understand the association of metabolic inflexibility with measures of body fat distribution 4. understand the correlation between metabolic flexibility and insulin sensitivity along the spectrum of subclinical cardiovascular disease and severity of non-alcoholic fatty liver disease 5. associations of the gut microbiome as well as metabolomic and molecular markers with cardio-cerebrovascular measures, metabolic flexibility and liver fibrosis the picman study seeks to lay the foundations for further future larger scale and more experimentally ambitious studies based on the overarching hypothesis that metabolic flexibility is an early marker in subclinical cardiovascular disease, indicating a point of timely intervention where the disease process is still reversible. the importance of a deeply-phenotyped local cohort will allow us to study the progression of cvd in seemingly well adults, converging imaging, biochemical, metabolic markers, and 'omics analysis.

Eligibility criteria:
inclusion criteria: * patients aged 21-70 at screening * 10-year ascvd risk \> 5% measured by qrisk 3 calculator exclusion criteria: * established dm (prior diagnosis, long term medications or hba1c \>=6.5) * established cvd, such as ischemic heart disease, cerebrovascular accident, heart failure, atrial fibrillation * pregnancy * known contraindications to ct scan, such as allergy to contrast
omission of intact parathyroid hormone testing during surgery in treating patients with primary hyperparathyroidism

Conditions: Parathyroid Gland Adenoma; Primary Hyperparathyroidism

Summary: this clinical trial studies the omission of intact parathyroid hormone testing during surgery in treating patients with primary hyperparathyroidism. omission of intact parathyroid hormone testing during parathyroid gland removal may help patients with primary hyperparathyroidism to decrease their time under anesthesia, and decrease the overall time and cost of surgery.

primary objectives: i. determine the non-inferiority of omission of parathyroid hormone (pth) in patients who meet the biochemical and radiological criteria compared to current standard of care (i.e. use of intraoperative parathyroid hormone testing). secondary objectives: i. cost-analysis to determine savings of omission of intraoperative pth testing. outline: patients undergo standard minimally invasive parathyroidectomy without pth testing during surgery. after completion of study, patients are followed up at 2 weeks.

Eligibility criteria:
inclusion criteria: * positive 4 dimensional computed tomography (4d ct) for single gland (adenoma) primary hyperparathyroidism * preoperative serum calcium levels \>= 10.9 mg/dl * preoperative parathyroid hormone (pth) elevated beyond normal range or inappropriately high for associated calcium level * patient has no history of prior neck surgery or external radiation to neck for malignant conditions * have an eastern cooperative oncology group (ecog) performance status of =\< 2 * subject or legal representative must understand the investigational nature of this study and sign an independent ethics committee/institutional review board approved written informed consent form prior to receiving any study related procedure exclusion criteria: * patient has recurrent hyperparathyroidism * 4d ct positive for multiple gland disease * patient has inability to tolerate 4d ct scan (for example; contrast intravenous (iv) allergy, claustrophobia, renal disease) * uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements * pregnant or nursing female subjects; may be determined in the preoperative evaluation * unwilling or unable to follow protocol requirements * any condition which in the investigator's opinion deems the subject an unsuitable candidate to undergo observational study (may also include preoperative testing results including electrocardiography \[ekg\], chest x-ray, or pulmonary function tests that preclude a wide excision in the operating room)
spironolactone to improve apnea and cardiovascular markers in obstructive sleep apnea patients

Conditions: Obstructive Sleep Apnea

Summary: the purpose of this study is to test whether spironolactone can improve the severity of obstructive sleep apnea and improve cardiovascular biomarkers in people who are not regularly using their positive airway pressure (pap) therapy.


Eligibility criteria:
inclusion criteria: * body mass index (bmi) greater than or equal to 30 * diagnosis of moderate to severe osa via diagnostic polysomnography (ahi≥15) or home sleep apnea test (respiratory event index (rei)≥15). * diagnosis of cardiovascular disease * meet criteria for hypertension (minimum systolic blood pressure ≥ 140 but \<180) * prescribed pap therapy but non-adherent (failure to use pap for at least 4 hours per night on minimum 5/7 nights per week on average over a one-month period) exclusion criteria: * diagnosis of congestive heart failure; resistant hypertension; hepatic disease; addison's disease; cancer; or recent (past 3 months) myocardial infarction, or stroke * diagnosis of central sleep apnea * patients who are not using pap at all (untreated) or using another form of treatment for osa * currently taking, recent trial (past month), or allergy for spironolactone * severe respiratory disease (e.g., diagnosis of chronic obstructive pulmonary disease, uncontrolled asthma) * history of leukopenia and/or thrombocytopenia * current use of another potassium sparing diuretic (e.g., amiloride or eplerenone) * current use of lithium, barbiturates, narcotics, muscle relaxants, pressor amines, or cholestyramine * patients who plan to have surgery during the time period of the study

Keywords: spironolactone positive airway pressure
feasibility and safety of miwendo-assisted colonoscopy

Conditions: Colorectal Cancer; Colorectal Polyp; Colorectal Adenoma; Colorectal Neoplasms; Colorectal Adenomatous Polyp; Colorectal Adenocarcinoma

Summary: the study involves the planned use of a new microwave-based device during colonoscopy procedures in a small group of patients to assess the preliminary safety of its use and lack of normal clinical practice modification. the device is a final design version, which has been previously tested in several preclinical studies, including: phantom studies, an ex vivo study with human tissues, and an in vivo study with animal model (pig).

this study is designed as a single-center prospective, non-comparative, first in human pilot safety and feasibility study with few patients, whereby data will be subject to an analytical description, rather than to a statistical treatment (refer to statistical design and analysis). in this study the principal aim is to assess the clinical safety of the device and the feasibility of its use in assisted colonoscopy. relevant claims to verify in this study are that the device can be used without ades, without any change in the current clinical practice, as well as without any major difficulty by the endoscopist, neither in the preparation nor in the use of the device during exploration. in addition, the study aims to gather real clinical data with the use of the device to optimise the processing software that will be key to demonstrate miwendo's performance on a subsequent clinical investigation (pivotal study). consequently, principal and secondary objectives of this investigation, are: * principal objectives: * to assess the feasibility of performing a complete colonoscopy using the miwendo system. * to assess the safety of miwendo colonoscopy. * secondary objectives: * to assess the perception of difficulty by the endoscopist when the device is used. * to assess the patient's comfort. * to collect data on polyp detection performance to guide possible further improvements of the software before starting the pivotal study.

Eligibility criteria:
inclusion criteria: * men and women older than 50 years referred for a diagnostic or surveillance colonoscopy and having signed the informed consent form. exclusion criteria: * patients at a high risk of having major complications as perforation or hemorrhage or in whom the possibility of performing a complete colonoscopy is reduced, including: patients with known colonic strictures, total colectomy, acute diverticulitis, inflammatory bowel disease, suspected or proven lower gastrointestinal bleeding, non-correctable coagulopathy or anticoagulant/clopidogrel therapy during procedure, inadequate bowel cleansing or previous incomplete colonoscopy. * asa-iv patients * urgent colonoscopy

Keywords: microwave imaging colonoscopy early diagnosis colorectal cancer screening
frailty, outcomes, recovery and care steps of critically ill patients (forecast) study multi-center study

Conditions: Frailty; Critical Illness

Summary: a prospective observational study of critically ill patients over the age of 50, studying the occurrence of frailty as measured by a variety of frailty measures, processes of care and long term outcomes.

frailty is common in critically ill elderly patients, and is associated with adverse impacts on outcomes and is becoming increasingly common in intensive care unit (icu) populations. however it is not clear as to how to best measure frailty and when to do so. it is also not clear as to how processes of care impact on the outcomes observed. we hypothesize that frailty in survivors of critical illness will be measurable at hospital discharge, will correlate with processes of care while in icu and will better discriminate long term outcomes when compared to severity of illness or the degree of frailty present on icu admission.

Eligibility criteria:
inclusion criteria: must meet both 1 and 2 * 1. age \> 50 years. we have selected \>50 years in keeping with prior descriptions of critically ill patients \[17\]. 2. receipt of at least one of the following life support interventions for over 24 hours: 1. mechanical ventilation: both invasive and non-invasive either solely or in combination are acceptable. high flow oxygen (e.g. optiflow) as a form of non-invasive ventilation (niv) is acceptable but the patient's fraction of inspired oxygen (fio2) at the time of enrollment must be greater \> 50%. 2. vasoactive medications (vasopressors or inotropes). 3. acute renal replacement therapy (rrt). patient must have been admitted to icu for the receipt of renal replacement therapy, either intermittent or continuous and after 24 hours of icu admission, there is a continued need for further rrt. exclusion criteria: 1. icu admission greater than 5 days at the time of enrollment. 2. expected to survive for less than 72 hours after study enrollment. 3. no family or caregivers available to collect collateral history. 4. family or caregivers not able to speak english or french. 5. projected inability to complete 6 month follow-up either by telephone or in-person.

Keywords: outcomes frailty
pre-rosc intra-nasal cooling effectiveness

Conditions: Cardiac Arrest

Summary: the purpose of the study was to demonstrate the safety and feasibility of early intranasal cooling prior to return of spontaneous circulation (rosc) in the emergency medical services (ems) environment. it was hypothesized that cooling during the resuscitation attempt would increase rosc and subsequent survival. the study was not powered to demonstrate statistically-significant differences in any outcome parameter, but was intended as an exploratory study only.

out of hospital cardiac arrest remains a significant cause of death. mild hypothermia induced after resuscitation from cardiac arrest has been shown to improve neurologically intact survival. studies in dogs and rodents have demonstrated improved outcomes when cooling is initiated intra-arrest. the rhinochill is a non-invasive cooling device through which rapid cooling is achieved via the intranasal delivery of an evaporative coolant into the nasopharynx. due to its non-invasive and portable nature, the rhinochill can be used to begin cooling earlier than other cooling devices. studies performed using the rhinochill in a porcine model of cardiac arrest suggest that cooling with the rhinochill prior to the first defibrillation attempt facilitates resuscitation and improves resuscitation rate and neurologically intact survival. this study is being performed to assess the feasibility of using the rhinochill device in the pre-hospital setting to improve resuscitation from cardiac arrest.

Eligibility criteria:
inclusion criteria: * ≥18 years * collapse was witnessed * no pulse * unresponsive to external stimuli exclusion criteria: * have an etiology of cardiac arrest due to trauma, severe bleeding, drug overdose (od), cerebrovascular accident (cva), drowning, smoke inhalation, electrocution, hanging * already hypothermic * head trauma * cannot place intra nasal catheters * do not attempt to resuscitate (dnar) orders * known or clinically apparent pregnancy * have a known coagulopathy (except therapeutically induced) * are known to have a need for supplemental oxygen * achieve return of spontaneous circulation (rosc) prior to initiating cooling * are reached by emergency medical services (ems) personnel more than 20 minutes after collapse

Keywords: cardiac arrest pre-hospital mild hypothermia resuscitation
masitinib in patients with gastro-intestinal stromal tumour resistant to imatinib

Conditions: Gastro Intestinal Stromal Tumor

Summary: the objective is to compare efficacy and safety of masitinib at 12 mg/kg/day to sunitinib at 50 mg/day in treatment of patients with gastro-intestinal stromal tumor resistant to imatinib.


Eligibility criteria:
inclusion criteria: 1. histological proven, metastatic, or locally advanced and non-operable gist 2. measurable tumor lesions with longest diameter ≥ 20 mm using conventional techniques or ≥ 10 mm with spiral ct scan according recist criteria 3. c-kit (cd117) positive tumors detected immuno-histochemically and documented mutation of c-kit at any time if available 4. patients resistant to imatinib at dose of 400 mg/day exclusion criteria: 1. patient treated for a cancer other than gist cancer within 5 years before enrolment, with the exception of basal cell carcinoma or cervical cancer in situ 2. patient with active central nervous system (cns) metastasis or with history of cns metastasis

Keywords: gist resistant imatinib gastro intestinal stromal tumor resistant to imatinib
home-based respiratory physiotherapy and telephone-based psychological support in severe covid-19 patients

Conditions: Covid19; Respiratory Disease; Mental Health Disorder

Summary: some covid-19 survivors may have respiratory and mental health sequelae, especially those who required hospitalization. the investigators hypothesize that the participation of a rehabilitation program composite by home-based respiratory physiotherapy and telephone-based psychological support will improve respiratory function, quality of life, and psychological status in severe covid-19 patients.

in peru, almost one million persons have survived covid-19 and initial reports indicate that could exist long-term health damage. this study aims to assess the efficacy of a 6-week rehabilitation program following hospital discharge for patients who had severe covid-19. the program includes 12 sessions of home-based respiratory therapy that the patient will carry out with a physiotherapist and 7 sessions of telephone-based psychological support bring by a psychologist.

Eligibility criteria:
inclusion criteria: * age between 18 and 75 years * be discharged from hospitalization with a covid-19 confirmed diagnosis * be able of understanding study procedures * be able to give informed consent * required oxygen flow greater than 6lt/min or through a high flow device at any time during hospitalization * have been evaluated by the rehabilitation service at least once during the hospitalization exclusion criteria: * contraindications to six-minute walk test * contraindications to spirometry * complications during the baseline six-minute walk test * have neurological pathology, neuropathy, limb dysfunction, or other underlying physical disability that makes physical exercise impossible * be pregnant or breastfeeding * do not have access to the internet or a telephone line * have previous lung diseases like asthma, copd, fibrosis, or tuberculosis * moderate or severe heart disease (grade iii or iv, new york heart association) * have had another severe disease in the last six months * severe depression or suicidal intention * be taking any medication for depression, anxiety, or other medication prescribed by a psychiatrist prior to the onset of a covid-19 condition * have cognitive impairment or sensory disturbance

Keywords: covid-19 mental health respiratory function tests physical and rehabilitation medicine quality of life
research study investigating how well semaglutide works in people from thailand and south korea living with obesity

Conditions: Obesity

Summary: this study looks at how well semaglutide helps people lose weight. this study will look at the change in the participants' body weight from the start to the end of the study. the study compares the weight loss in people who get semaglutide to the weight loss in people who get placebo. placebo is a "dummy" medicine that looks like the study medicine, but has no effect on the body. participants will either get semaglutide or "dummy" medicine - which treatment participants get is decided by chance. participants will need to take 1 injection once a week. the study medicine is injected with a thin needle in a skin fold in the stomach, thigh or upper arm. participants will also have talks with study staff about healthy food choices, how to be more physically active and what participants can do to lose weight. the study will last for about a year (50 weeks). participants will have 10 clinic visits and 8 phone calls. at 6 of the clinic visits participants will have blood samples taken. participants cannot take part if participants have or have had diabetes. women cannot take part if pregnant, breast-feeding or plan to get pregnant during the study period.


Eligibility criteria:
inclusion criteria: * age above or equal to 18 years at the time of signing informed consent. * bmi at least 25.0 kg/m\^2 at screening. * both parents of asian descent. * history of at least one self-reported unsuccessful dietary effort to lose body weight. exclusion criteria: * hba1c at least 48 mmol/mol (6.5%) as measured by the central laboratory at screening. * history of type 1 or type 2 diabetes mellitus. * a self-reported change in body weight above 5 kg (11 lbs) within 90 days before screening irrespective of medical records. * any participant where a substantial weight loss, in the investigator's opinion, might jeopardise the participant's safety. * renal impairment with estimated glomerular filtration rate (egfr) below 15 ml/min/1.73 m\^2 at screening.
type 1 diabetes and eating disorder diurnal glucose patterns

Conditions: Type I Diabetes Mellitus Without Complication; Eating Disorder

Summary: the purpose of this study is to use data from the continuous glucose monitor (cgm) to determine the degree of variation in glucose levels of individuals with an eating disorder and type 1 diabetes and only an eating disorder.

the specific aims of the proposed research are to: 2.1 determine the degree of variation in glycemic profiles of individuals with an eating disorder and type 1 diabetes (ed-dmt1) and an eating disorder only (ed/only); and 2.2 determine the impact of nutritional intake and planned physical activity on glucose profiles of individuals with ed-dmt1 and ed/only. these aims will be examined by characterizing: * glucose exposure, as measured by area under the ambulatory glucose profile (agp) median curve; * glucose variability, as measured by the agp inter-quartile range; and * glucose stability, as measured by change in the agp median curve.

Eligibility criteria:
inclusion criteria: * admitted to the isl unit at melrose institute * diagnosed with an eating disorder (anorexia nervosa, bulimia nervosa or eating disorder not otherwise specified) 1. for ed-dmt1 group: diagnosis of an eating disorder and diagnosis of type 1 diabetes. 2. for ed/only group: diagnosis of an eating disorder and no history/diagnosis of type 1 or type 2 diabetes. * female. * at least 14 years of age. * able to provide informed consent. 1. if the potential participant's age is at least 18 years she must be able to provide informed consent. 2. if the potential participant is less than 18 years she must have a parent or guardian able and willing to provide written informed consent on the participant's behalf. in addition, the participant must be willing to sign a consent on her own behalf. * participants must be able and willing to utilize the cgm system and perform required calibrations using self-monitored blood glucose. exclusion criteria: * male. * age \< 14 years. * history of self-injurious behavior that the senior clinician feels precludes participation. * unable to understand the study protocol. * unwilling to follow the study protocol. * participation in any competing research study. * planned isl admission for \<4 days. * pregnant. * not able to communicate in english. * regular use of acetaminophen or acetaminophen containing medications and not able to modify their medication to a non-acetaminophen based medication.

Keywords: continuous glucose monitoring type 1 diabetes and an eating disorder eating disorder only