Kornimate/medical-research-clean huggingface dataset:
clopidogrel resistance and the possibility of its affection

Conditions: Coronary Artery Disease

Summary: the purpose of the study is to determine, whether the resistance to clopidogrel could be affected by higher doses of this drug, or by replacement of clopidogrel with another adp-antagonist ticlopidine.

patients after percutaneous coronary intervention (pci) with stent implantation have to be treated by dual antiplatelet therapy, which standard part represents clopidogrel. the response to clopidogrel in population exhibits wide interindividual variability. according to some recent works, patients with clopidogrel resistance are in higher risk for recurrence of myocardial infarction in comparison with the patients with sufficient clopidogrel effectiveness. the treatment of clopidogrel resistance is still unknown. our project should contribute to the better understanding of the clinical impact of clopidogrel resistance and its genetical determination. we will test the hypothesis, whether the clopidogrel resistance could be influenced by higher dose of this drug or by replacement to ticlopidine (adp antagonist with different biotransformation in the liver). therefore, 500 pts. will be tested to clopidogrel resistance. we expect 5-10% of resistent pts. this pts. will be treated by higher dose (150mg or 225mg/day) with repeated tests of clopidogrel effectiveness after each dose enhancement. if 225mg/day will be insufficient, clopidogrel will be replaced by ticlopidine with repeated test. we expect, that better definition of clinical and and genetic correlate of clopidogrel resistance will improve our knowledge of this disorder. nevertheless, the achievement of sufficient effect of clopidogrel in some still resistant patients will lead to the improvement of the treatment

Eligibility criteria:
inclusion criteria: * written informed consent * coronary artery disease verified by coronary angiography * percutaneous coronary intervention with stent implantation * standard indication for dual antiplatelet therapy exclusion criteria: * scheduled surgical revascularization by aortocoronary bypass * insufficient cooperation of the patient * coagulopathy in history with a higher risk of bleeding * life expectancy shorter than 1 year * severe anemia with hemoglobin level\< 10,0 g/dl * platelet count \< 100,000)

Keywords: platelet clopidogrel verifynow ticlopidine thrombosis
recurrent atrial fibrillation

Conditions: Atrial Fibrillation

Summary: this study will evaluate the recurrence rates of atrial fibrillation that develops in the hospital following non cardiac procedures or surgeries or acute medical illnesses.

eligible individuals with no previous history of atrial fibrillation or flutter who develop a limited episode of atrial fibrillation during a hospital stay for an acute medical illness or non-cardiothoracic surgery or procedure. patients will be monitored for a period of 1 month using medtronic seeq monitors for recurrence. subjects will self assign to wear the seeq monitor or standard of care. individuals with implanted cardiac devices capable of detecting atrial fibrillation will also be included.

Eligibility criteria:
inclusion criteria: * development of atrial fibrillation or flutter during a hospital stay following a non-cardiac procedure or acute medical illness * chads2vasc score of 2 or more exclusion criteria: * prior history of atrial fibrillation of flutter * requiring ventilator support or in shock * acute decompensated heart failure or ef =/\< 40% * greater than mild valvular heart disease * other structural heart disease such as more than mild lvh, constrictive or restrictive cardiomyopathy * hyperthyroidism uncontrolled at the time of diagnosis if known * pulmonary embolism that requires thrombolysis or resulted in shock * use of antiarrhythmic drugs (class i or iii) at the time of discharge * cardiothoracic surgery in the last 6 months
long-term outcomes of hypopituitarism following gamma knife radiosurgery for pituitary adenomas

Conditions: Long Term; Hypopituitarism; Gamma Knife Radiosurgery; Pituitary Adenomas

Summary: this study aims to assess long-term outcomes of hypopituitarism following gamma knife radiosurgery (gkrs) for pituitary adenomas.

pituitary adenomas (pas) are one of the most common intracranial neoplasms, accounting for 10-20% of diagnosed brain tumors. initial gamma knife radiosurgery (gkrs) can be an alternative treatment for selected nfpa patients with comorbidities, documented growth small tumors, cavernous sinus invasion, or advanced age. hypopituitarism is one of the most common complications of radiosurgery (cordeiro et al., 2018). long-term follow-up is crucial to assess new pituitary deficits. typically, hypopituitarism presents within the first 2-4 years after the treatment with radiosurgery, but the risk of pituitary insufficiency increases to up to 80%. reports on the highest incidence of new-onset hypopituitarism also mentioned the longest follow-up period.

Eligibility criteria:
inclusion criteria: * age ≥18 years. * both sexes. * patients treated with gamma knife radiosurgery (gkrs). exclusion criteria: * patients with inadequate endocrine follow-up (\<12 months). * patients who had undergone previous radiation therapy. * pituitary insufficiency which presents before gamma knife radiosurgery (gkrs). * patients without visible glands.
sympathetic innervation of the heart and cardiac resynchronization therapy(crt)

Conditions: Sympathetic Innervation; Chronic Heart Failure

Summary: the purpose of this study is to assess whether baseline sympathetic innervation in patients with chronic heart failure (chf) is predictive for response to cardiac resynchronization therapy (crt). and to assess whether response to crt coincides with restoration of regional sympathetic innervation.


Eligibility criteria:
inclusion criteria: * indication for crt * stable optimal medication * non ischemic cardiomyopathy exclusion criteria: * age less then 18 years * previous crt * clinically relevant valvular heart disease or coronary artery disease * acute or chronic infection * untreated clinical hypo- or hyperthyroidism or \< 3 months euthyroidism * uncontrolled hypertension, defined as a systolic blood pressure \> 160 mm hg and/or a diastolic blood pressure \> 95 mm hg * a concurrent medical condition (i.e. alcohol or drug abuse or a severe progressive extra cardiac disease or m. parkinson) or is unlikely to comply with the protocol * participation to a previous protocol involving radioactivity in the past year * pregnancy
a prospective, randomized, multicenter study of comparison of tace combination with and without ebrt for hepatocellular carcinoma with portal vein tumor thrombi

Conditions: Carcinoma, Hepatocellular

Summary: the 1-year and 2-year overall survival rate (os), local control rate (fflp), disease-free progression time (pfs), and side effects were compared in patients with hepatocellular carcinoma limited to intrahepatic unresectable hepatocellular carcinoma with portal venous thrombosis combined with or without external radiotherapy, providing a basis for the development of relevant guidelines.


Eligibility criteria:
inclusion criteria: 1. confirmed by pathology or met the clinical diagnostic criteria of hepatocellular carcinoma. 2. after the joint consultation between the interventional department and the radiotherapy department, the patients who were considered to be interventional were considered. meeting the following criteria: the tumor was confined to the liver (meeting the liver tolerance dose), and was diagnosed as type ii or type iii portal vein tumor thrombi according to chang's classification criteria, without extrahepatic metastasis. number of tumors in liver parenchyma: less than or equal to 3. the main portal vein is not completely blocked or the compensatory collateral vessels of the portal vein are abundant although it is completely blocked. 3. patients who meet all the following criteria: child-pugh score ≤7, plt\>30×109/l, wbc\>3×10\^9/l/anc\>1.5×10\^9/l,hb\>90g/l, cr\<2.0mg/dl. 4. ecog score 0-2 points. 5. estimated survival time \> 3 months. 6. age \> 18. 7. sign the informed consent. exclusion criteria: 1. patients with the following condition: the number of intrahepatic tumors \>3 or total tumor diameter\>15cm. 2. patients with signs of extrahepatic metastasis, including but not limited to inferior vena cava carcinoma thrombus, bone metastasis, brain metastasis or regional lymph node metastasis. 3. patients with west haven standard grade iii/iv hepatic encephalopathy or ascites. 4. patients with a history of malignancy other than primary hcc, except for cutaneous squamous cell carcinoma or basal cell carcinoma. 5. patients with a history of upper abdominal radiotherapy. 6. in the radiotherapy plan, patients who failed to follow the radiation dose limit of important organs, including those whose normal liver tissue was less than 700 ml in the radiotherapy plan. 7. screening patients who have received other study drugs within 4 weeks prior to the start of the visit. 8. screening: patients who had received treatment for other local or systemic hepatocellular carcinoma within 4 weeks before the visit. 9. patients with significant concurrent diseases. 10. lactating or pregnant female patients.
does minimally invasive surgery reduce anxiety?

Conditions: Anxiety

Summary: the purpose of this study was to identify factors that may contribute to anxiety of patients undergoing total abdominal hysterectomy(tah) or total laparoscopic hysterectomy(tlh) before and after the operation. thus, we aimed to learn whether anxiety levels change according to the type of hysterectomy.

hysterectomy is the most common gynecological procedure worldwide. . there has been a increasing interest towards to more minimally invasive procedures in the past decade. hysterectomy operation anxiety is a complex phenomenon affected by various parameters. patients' anxiety may be affected by their age, gender, educational status,type of operation and personality. each patient's anxiety was measured using spielberger's state-trait anxiety inventory immediately before, immediately after the operation.

Eligibility criteria:
inclusion criteria: undergone hysterectomies for benign reasons. exclusion criteria: malignancy, additional operation beside hysterectomy( such as salpingo-oophorectomy), history of two or more previous caesarean sections, history of previous abdominal surgery, autoimmune disease, coagulation disorders, with known systemic or psychiatric disease, those receiving any regular sedative medication at the time of the procedure
class i medical device on post-surgical scars

Conditions: Cicatrix; Post-Surgical Complication; Scar Itching; Keloid; Hypertrophic Scar

Summary: to compare the effect of a class i pullulan based medical device containing allium cepa \& ha versus a class i medical device silicone gel on new post-surgical wounds

a head-to-head, randomised, pivotal controlled trial evaluating the appearance of post-surgical scars for 12 weeks. the study was developed in 10 months, including recruitment, evaluation every 4 weeks and evaluation of the secondary objective in the third month (t2). the primary endpoint was the evaluation of the effectiveness of the class i medical device contain onion (allium cepa) extract compared to the silicone gel used in the treatment of post-surgical scars for the prevention of hypertrophic scars. objective scar assessment using the vancouver scar scale (vss), manchester scale, patient and observer scar assessment scale (posas), itching, redness and pliability were performed after 4,8 and 12 weeks of treatment. safety was also evaluated by gathering adverse events related to application of the gel. the statistical analysis of the data was carried out by applying parametric or non-parametric tests depending on the distribution of the data that was going to be obtained. the one-way analysis of variance anova test was used to evaluate the reduction/increase of clinical parameters in the pre-established observation times (t0, t2, t3 and t4) for each treatment, whereas comparison between treatments was performed via t-test analysis. correlation tests were also used. the differences were considered statistically significant for p values \<0.05.

Eligibility criteria:
inclusion criteria: * subjects aged between 18 and 70 who have undergone surgery for the excision of skin lesions at least 20 days before the start of the protocol. exclusion criteria: * subjects affected by spontaneous keloids * diabetic subjects with a previous history of disorders in the repair of wounds; * subjects with overinfected wounds after the first week after surgery; * subjects with documented sensitivity to silicone gel; * subjects affected by collagen disorders (e.g. pseudoxantoma elasticum, poikilodermatosis).

Keywords: scar keloid cicatrix allium cepa silicone
outreach: a programme for timely treatment of critically ill patients in a university hospital

Conditions: Patient Centered Care; Postoperative Care; Critical Illness

Summary: the identification of patients with potential early organ failure is the key in preventing admission or readmission to a critical care facility. the primary goal of the outreach project is to ensure that all patients with threatening organ failure receive appropriate and timely treatment in a suitable area; avoid admission to the intensive care unit (icu); and share icu skills by a partnership in education. the objectives of the study are to determine whether the introduction of an intensive care unit based medical emergency team, responding to hospital-wide preset criteria of physiologic instability, will decrease the number of predefined serious adverse events (saes) and to investigate the effects on quality of life and costs in a general surgery population. study hypothesis: the outreach intervention will decrease the number of predefined serious adverse events; increase quality of life; and decrease costs.

design: a multi centre longitudinal intervention trial with a before and after design in a university hospital. the intervention consists of three parts: 1. the introduction of a hospital-wide intensive care unit based medical emergency team to evaluate and treat patients deemed at risk for developing an adverse outcome. 2. education and training of ward staff in the recognition and basic management of patients developing a critical illness. 3. the development of an intensive care (nurse and physician staffed) consultancy service for general wards. study population: the population for this study consists of patients undergoing major general surgery with an admission stay of more than 48 hours. it includes patients undergoing central or peripheral vascular surgery, major oncological surgery, lung surgery, major abdominal surgery and trauma surgery. measurements and outcomes: in total, 1500 patients will be included. (750 patients in the control period and 750 patients in the intervention period). measurements include the incidence of serious adverse events, hrqol (quality of life eq-5d), costs of care and icu logistics. time-schedule: data collection starts january 1, 2006 and stops no later than three months after the inclusion of 1500 patients or april 1, 2008. the final report of the study will be in december 2008.

Eligibility criteria:
inclusion criteria: * major general surgery. * admitted to the hospital 48 hours after surgical intervention exclusion criteria: * not able to communicate in the dutch language. * younger than 18 years old. * pregnancy

Keywords: outreach major general surgery intensive care serious adverse events
combination of immunization and radiotherapy for malignant gliomas (insituvac1)

Conditions: High Grade Glioma; Glioblastoma; Glioma of Brainstem; Glioma, Malignant

Summary: the study will investigate combined radiotherapy and immunotherapy on malignant gliomas. immune adjuvants will be injected intratumorally and systemically to induce antitumor-specific immunity after radiation induced immunological tumor cell death (icd). with radiation, tumor cells release tumor antigens that are captured by antigen presenting dendritic cells. immune adjuvants promote the presentation of tumor antigens and the priming of antitumor t lymphocytes. the combined treatment induces and amplifies the specific antitumor immunity in patients with malignant gliomas, prolonging survivals of patients.

high grade gliomas, such as glioblatoma (gbm) is an aggressive malignancy with a poor prognosis. the current strategy for newly diagnosed gbm patients includes surgery, chemotherapy and radiotherapy. unfortunately, after the standard treatmetn,the median survival of gbm is only about one year. once relapsed, there is no standard therapy and survival is less than 9 months. recently, personalized cancer immunotherapy has shown great promise in treating different types of cancers. however, effective immunotherapies for high grade gliomas, especially after progression, have yet to be established. newly diagnosed gbm patients experience recurrence in five or seven months after standard treatment. we will investigate whether combining radiotherapy with intratumoral and systemic administration of immune adjuvants will improve the treatment outcome of high grade gliomas. we will use several immune adjuvants that activate innate and adaptive immunity.

Eligibility criteria:
inclusion criteria: 1. histopathologically confirmed glioma 2. age18-65 3. participants had undergone maximal surgical resection 4. amount of dexamethasone was not more than 2mg/ days 5. ability and willingness to sign informed consent 6. karnofsky performance score of 70 or more 7. normal liver and kidney function 8. not accepted other treatment plan during the immunotherapy exclusion criteria: 1. not conforming to the standard 2. systemic illness or medical condition may pose additional risk,including cardiac, incompensated renal or liver function abnormalities;inflammatory and immune system diseases of rheumatic arthritis 3. received other drugs for glioma therapy 60days before participated 4. allergy to immune adjuvant 5. nervous system disease and diffuse leptomeningeal disease 6. amount of dexamethasone was more than 2mg/days during the immunotherapy 7. pregnant or lactation

Keywords: gliomas radiotherapy immunetherapy
safety and impact of low resistance exercise training on quality of life in pulmonary arterial hypertension

Conditions: Pulmonary Arterial Hypertension; Frailty

Summary: the purpose of the study is to learn more about how low-resistance training impacts frailty and the quality of life of people with pulmonary arterial hypertension (pah). low-resistance training is an evidence-based approach that may help patients improve their functional ability.

patients with pulmonary arterial hypertension and their caregivers will be asked to participate in the study. the study consists of a baseline in-person visit (week 1) where quality of life and physical performance will be assessed, and subjects will be shown low-resistance training exercises to perform at home. the exercises will then be performed at home, as instructed, for 12 weeks. at week 12, subjects return for a follow-up in-person visit, where quality of life and physical performance will be reassessed. patients and caregivers will also be asked to participate in separate exit interviews, where investigators will ask how they felt about the resistance training.

Eligibility criteria:
inclusion criteria: * diagnosis of pah: idiopathic, heritable, associated with connective tissue disease, congenital heart disease, human immunodeficiency virus, drug- or toxin, or portopulmonary hypertension * on stable pah therapy for 3 months exclusion criteria: * world health organization (who) functional class iv * left ventricular ejection fraction \< 40% (via transthoracic echocardiogram (tte) within one year of screening) * moderate or severe concomitant lung disease: chronic obstructive pulmonary disease (copd) or interstitial lung disease * enrollment in a clinical trial * recent hospitalization (within 4 weeks of screening) * inability to perform the short physical performance battery or wheelchair bound
a one-arm open trial of a smartphone delivered treatment for suicidal thoughts and behavior

Conditions: Suicide Attempt; Suicide Ideation

Summary: this study aims to evaluate the acceptability, safety, and preliminary efficacy of a smartphone-delivered intervention called therapeutic evaluative conditioning for suicide (tec-s) in reducing suicidal thoughts and behaviors (stb) among adults with recent and frequent suicide ideation.

the present study is a one-arm open trial designed to evaluate the safety, acceptability, and preliminary efficacy of therapeutic evaluative conditioning for suicide (tec-s), a smartphone-delivered intervention aimed at reducing suicidal thoughts and behaviors (stb). participants in this study will be 20 adult participants (ages 18+) who report recent and frequent stb, residing within the greater-boston, ma area. participants will receive 3x/daily ema and optional access to active tec-s. evaluative conditioning uses classical conditioning to alter attitudes. the aim of tec-s is to alter attitudes toward suicide and, in turn, reduce stb. emas will monitor stb, safety, and acceptability, and efficacy. weekly behavioral and self-report assays will assess hypothesized treatment mechanisms. the study's aim is to evaluate the safety, acceptability, and preliminary efficacy of therapeutic evaluative conditioning for suicide (tec-s).

Eligibility criteria:
inclusion criteria: * adults ages 18+ * relatively frequent and recent (≥5 days within the past-month) active suicidal thoughts as assessed via sitbi-r. * willing and able to provide at least one emergency contact (name, phone number, relation). * owns an android or ios smartphone. * possesses at least occasional access to wi-fi-enabled internet for data down/uploads. * fluent in english and willing to provide informed consent. * living in the boston metropolitan area (i.e., \~50 mile radius around boston, ma) exclusion criteria: * recent (past 3-month) hypo/manic symptoms or homicidal ideation or lifetime psychosis spectrum diagnosis as assessed via mini 7.0.2. * recent acute suicide risk operationalized as affirmative responses to both below items during structured clinical interview and evaluation by the pi in consultation with mentors/advisor drs. wilhelm, kleiman, and/or bentley: * at any time in past week: ≥ 8/10 current intent to act on suicidal thoughts (0 \["not at all"\] to 10 \["extremely strong"\]); and * at any time in past week: thought of a specific suicide plan (i.e, known method/means and/or location) with access to lethal means * impaired vision (e.g., legal blindness), technological illiteracy, or intellectual disability that might impair ability to provide valid data and/or informed consent.

Keywords: suicide ecological momentary assessment (ema) therapeutic evaluative conditioning (tec)