Kornimate/medical-research-clean huggingface dataset:
fatty liver patient registry

Conditions: Non-Alcoholic Fatty Liver Disease

Summary: the purpose of the non-alcoholic fatty liver disease (nafld) registry is to collect demographic and clinical data on patients being treated for nafld and to determine the factors affecting the progression of the disease as well as the success of different treatment strategies.

the nafld registry is a local database provided by the principal investigator, dr. j. allard, which will be stored on the research intranet at the university health network, toronto. the database will be password protected. only clinic personnel and members of dr. allard's research team involved in the study will have access to the database. a code and date of birth will be used to identify each patient. all patients entering the nafld clinic at toronto general hospital will be consented for the registry. only data from their regular clinic visits will be used for entry into the registry. data entered into the registry will include: 1) patient demography: age, sex, ethnicity, medical history; 2) anthropometry: weight, height, bmi, waist circumference; 3) nutritional assessment: food records and food frequency questionnaires are kept by the subjects and data will be analyzed to assess the intake of macro- and micronutrients. amount of alcohol and number of cigarette smoked will also be recorded; 4) physical activity will be assessed using the paffenbarger physical activity questionnaire; 5) medications: insulin, non-steroidal anti-inflammatory drugs, corticosteroids, statins, medications used to treat diabetes/obesity (e.g. metformin, thiazolidinediones, orlistat...), medication to treat liver disease (eg. urso, carnitine, choline...), antioxidant vitamin or fish oil supplementation; 6) blood work, currently including: complete blood count, biochemistry including liver enzymes, total protein, albumin, glucose, insulin, and blood lipid profile; other diagnostic blood work done to exclude other causes of liver disease, e.g. ceruloplasmin, anti-smooth muscle antibodies,... one plasma sample will be stored for assessment of cytokeratin 18 (ck-18) fragments as a novel marker for nash in patients with nafld; 7) presence of metabolic syndrome; 8) disease categorization: ss, nash, cirrhosis; 9) survival: alive, death: causes, nafld-related or not nafld-related; 10) liver biopsy results, nafld fibrosis score, and elastography results. data will be entered after every clinic visit. case report forms will be used to collect the data from the patient charts and facilitate data input into the registry database all patients will be followed prospectively until withdrawal from the clinic or death. descriptive statistics will be performed. for the entire nafld population, probability of survival, cirrhosis, as well as liver and non-liver related morbidity will be calculated using the kaplan meier method.

Eligibility criteria:
inclusion criteria: - patients being treated for nafld at the toronto general hospital nafld clinic exclusion criteria: * none

Keywords: nafld
progestrone and doppler indices

Conditions: Preterm Labor

Summary: the aim of our study is to assess the effect of vaginal progestrone on fetal and maternal doppler indices

a complete doppler ﬂow assessment of the maternal and fetal circulation was conducted by an independent investigator blinded to the treatment, before and 48 hours after the ﬁrst administration of 400mg of vaginal progesterone, voluson e8 (ge healthcare, zipf, austria) ultrasound machine,equipped with a 3.5- mhz curvilinear abdominal transducer with color imaging capabilities, was used in all cases.

Eligibility criteria:
inclusion criteria: * gestational age: 18-33 weeks * willing and able to give informed consent * history of preterm labor (\<34 weeks) * at risk for preterm labor ( increased amniotic fluid volume) * short cervical length (\<25mm) as incidental finding * presenting with actual cervical changes ( dilatation and\\or effacement) in current pregnancy exclusion criteria: * pprom * contraindication to progesterone use * diabetic patients, have glucose intolerance * multiple pregnancies

Keywords: progestrone doppler indices
phacoemulsification and 25 gauge (25g) vitrectomy versus phacoemulsification only in idiopathic epiretinal membranes

Conditions: Epiretinal Membrane

Summary: the purpose of the study is to evaluate the difference in early treatment diabetic retinopathy study (etdrs) visual acuity, oct retinal thickness and microperimetry in 2 groups of 30 eyes each affected by idiopathic epiretinal membranes that underwent phacoemulsification and 25g pars-plana vitrectomy with internal limiting membrane (ilm) peeling (group 1) versus phacoemulsification only (group 2), with a follow-up length up to 5 years.

idiopathic epiretinal membranes represent a common cause of visual loss in elderly population. vitrectomy with membrane peeling is nowadays considered the gold standard in the management of such pathology, with very good results either at short-time or at long-time follow up. in case of mild visual impairment due to epiretinal membrane and associated cataract, it is reasonable to treat only the lens pathology (with phacoemulsification and intra-ocular lens (iol) implantation). in case of symptoms or ophthalmoscopic finding worsening it is always possible to submit patients who only underwent cataract surgery to vitrectomy with membrane peeling. there are, by now, no comparative studies between these two different approaches in medical literature.

Eligibility criteria:
inclusion criteria: * idiopathic epiretinal membranes symptomatic exclusion criteria: * absence of ocular symptoms, previous retinal interventions

Keywords: idiopathic epiretinal membranes 25-g surgery in idiopathic epiretinal membranes
recovery and aftercare in post intensive care therapy patients - rapit study

Conditions: Intensive Care (ICU) Patients

Summary: in 2010 alone were admitted 33,361 patients for treatment in danish intensive care units. there is evidence to former intensive care patients have a significant symptom burden that affect recovery, function and activity for up to several years after admission to the intensive care unit. for the individual patient involves the low quality of life, delayed recovery, prolonged illness and healing process, and increased mortality. it requires that health professionals should provide support so patients quicker return to their usual life. follow-up interviews with the staff after hospitalization in icu have been shown to support the patient and identify individual needs and symptoms that can lead to more realistic expectations and increased well-being after admission in icu. follow-up in denmark is being inconsistent in both the number of hospitals that offer this service, and in the offered type of service. follow-up interviews with and without diaries suggest to improve physical and mental well-being and health, with limited scientific evidence of the efficacy of these interventions. we will investigate the effect of a standardized follow-up program after admission to the intensive care unit, consisting of written information, patient photos taken during hospitalization and three follow-up calls compared with standard care (discharge without follow-up). during a clinical study conducted in several intensive care units in denmark examined whether follow-up calls can improve patients' well-being and health, as well as the meaning of the follow-up program has on the patient's everyday life in the first year after hospitalization in the icu. the investigation contribute knowledge to the international research by revealing symptom burden and efficacy of a follow-up program for up to 1 year after admission to the icu in order to be able to target rehabilitation efforts and improved the quality of life. it will be innovative to use the results from a clinical study as a foundation for a database, and the method can serve as a precedent for evidence-based introduction of guidelines, database registration and create the groundwork for future research in intensive care. this study is expected to be profitable to society by preventing frequent readmissions, reduce medication costs and fewer referrals to specialists and have a positive effect on retention to the labor market. this will provide overall better use of society's expenses.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years * non-invasive or invasive ventilation ≥ 48 hours (non-invasive ventilation (niv) from current guidelines). * apache ii score ≥ 12 ≤ 29 * unrecognized dementia diagnosis exclusion criteria: * delirium at randomization (positive cam-icu score) * participation in scientific projects which include patient interviews * not speak and understand danish

Keywords: icu follow-up consultations quality of life sense of coherence rct multicenter study
assessment of volume status by doppler us

Conditions: Fluid Assessment by Doppler us Changes

Summary: fluid are used to increase cardiac output (co) and blood pressure in patients admitted to the intensive care unit (icu) .fluid is an important line of therapy that needed in shocked patient, hypovolemic and following surgery to correct the volume state and avoid acute kidney injury. however, excess fluid administration may be harmful leading itself to increase rates of acute kidney injury (aki), prolonged days of mechanical ventilation and death . excess fluid administration may increase right and left atrial pressure leading to congestion and edema.

increasing cardiac output more than 15% following fluid administration was used as fluid responsiveness method by the surviving sepsis campaign (ssc) guidelines. however, these strategies may promote over-resuscitation as most recommend continuing fluid administration until the patients are no longer vr. vr-based strategies do not assess elevations in right atrial pressure (rap) or assess for venous congestion which could occur earlier. the elevations of left atrial pressure can be seen clinically with hypoxia, cephalization on chest x-ray and b-lines on ultrasound resulting from pulmonary edema, while the elevation in right-sided pressure is much more difficult to detect. it is possible that rightsided venous flow changes detect clinically important elevations in right atrial pressure that lead to venous congestion and end organ injury . doppler flow patterns of hepatic veins (hv), portal vein (pv) and intra-renal veins (rv) are noninvasive and accurately identify early stages of right-sided venous congestion in patients who have cardiac dysfunction and congestive heart failure with elevated right atrial pressures . if hv, pv and rv can be validated as reliable measures of elevated rap, such indicators might have utility in modulating fluid resuscitation in other critically ill patient populations.

Eligibility criteria:
inclusion criteria: * - adult patients who admitted to critical care unit and intermediate critical care unit of internal medicine department after obtaining consent. exclusion criteria: * 1- children below 18 yr. 2- patients could not be scanned within 24-h after icu admission. 3- patients with transplanted kidney or liver. 4- patients with end stage renal disease.
myofascial release with and without support belt for sacroiliac joint pain in pregnant females.

Conditions: Sacroiliac Joint Pain

Summary: this study will be a randomized controlled trial that will include myofascial release interventions with and without a support belt. 34 patients will be randomly divided into 2 groups. assessment will be done by using numeric pain rating scale, quebec scale for functional disability, and pelvic girdle pain questionnaire (pgq).

sacroiliac joint dysfunction is a particularly common source of pain during pregnancy and is often an undiagnosed cause of low back pain. in this study, the effects of myofascial release with and without a support belt for sacroiliac joint pain and activity in pregnant females will be analyzed. group a of 17 patients will get a myofascial release technique for up to 600 seconds and total treatment sessions will be 12 in 4 weeks with a support belt a support belt should not be worn for longer than two to three hours at a time and it will be used 4 times a week. group b of 17 patients will also get a myofascial release technique for up to 600 seconds and total treatment sessions will be 12 in 4 weeks but without a support belt. data will be collected and analyzed at baseline and at 4 weeks follow-up.

Eligibility criteria:
inclusion criteria: * age 20-40 years. * 2nd and 3rd trimesters of pregnancy. * the diagnosis of sij pain based on tenderness localized to the posterior inferior iliac spine bilaterally with provocative maneuvers of the sij in posterior pelvic pain provocation/thigh thrust test, compression test, gaenslen's test and patrick's faber test eliciting considerable pain. * positive results from at least three of those provocative tests signified the presence of sij pain. exclusion criteria: * history of rheumatic disease. * lumbar spine disc herniation or back injury. * previous lumbar spine surgery. * high risk pregnancy. * any bony or soft tissue systemic disease. * malignancy.
multispectral optoacoustic tomography (msot) for the evaluation of disease activity in inflammatory bowel diseases (ibd)

Conditions: Crohn's Disease; Ulcerative Colitis; IBD

Summary: monocentric, prospective interventional study to assess the degree of disease activity with a multispectral optoacoustic tomography (msot) handheld scanner in patients with crohn's disease or ulcerative colitis.

the proposed study is designed as a pilot study to evaluate the usefulness of msot for the evaluation of disease activity in ibd patients. as current methods for the evaluation of intestinal inflammation in ibd have relevant restrictions, new, non-invasive, quantitative, and accurate modalities are urgently needed. in comparison to other techniques, msot provides relevant advantages such as non-invasive imaging, high spatial resolution (this is of special importance for the evaluation of the intestine, which can be only a few millimeters thick), and highly sensitive detection of specific molecules such as total hemoglobin or oxy- /deoxygenated hemoglobin. these advantages suggest msot as an outstanding technique for evaluating disease activity in ibd. the proposed study incorporates nearly no risk for participating patients and might provide relevant data for more a more in depth analysis of msot for ibd diagnosis.

Eligibility criteria:
inclusion criteria: * histological verified crohn's disease or ulcerative colitis * age \> 18 years exclusion criteria: * age \< 18 years * mental retardation of the patient with restriction of general judgment and awareness

Keywords: photoacoustics optoacoustics ultrasound
metabolic manipulation in chronic heart failure

Conditions: Chronic Heart Failure

Summary: conventional measures used for the treatment of chronic heart failure act predominantly by reducing the work performed by the heart. in a recent study, the investigators showed that one drug (perhexiline) substantially improved symptoms and cardiac function in heart failure. the investigators wish to confirm these findings and test whether or not this drug acts by altering the heart's energy source thus augmenting the energetic status and work efficiency of the heart.

perhexiline maleate is an antianginal agent which increases the efficiency of energy production by shifting substrate utilisation from free fatty acids towards glucose. we showed that perhexiline therapy was highly effective in improving exercise capacity, symptoms and cardiac function in patients with systolic heart failure of both ischaemic and non ischaemic aetiology. perhexiline acts by inhibiting both carnitine palmitoyl transferase-1 (cpt-1) and cpt-2, which are key enzymes in mitochondrial free fatty acid uptake. this leads to increased myocardial glucose substrate utilization. further we wish to ascertain whether or not this drug improves cardiac energetics and efficiency by altering substrate utilization. in this proposal we will assess the cardiac function (by cardiac magnetic resonance imaging mri), cardiac energetic status (by cardiac magnetic resonance spectroscopy mrs), cardiac efficiency (via pressure-volume loops) and substrate utilization (via left and right heart catheterization), following one month of perhexiline therapy or placebo in patients with symptomatic idiopathic dilated cardiomyopathy on optimal conventional heart failure medications. an interim analysis is planned after 20 patients.

Eligibility criteria:
inclusion criteria: * optimally-medicated idiopathic dilated cardiomyopathy * symptomatic ( nyha iib-iii) * impaired left ventricular systolic function (ef \< 40%) exclusion criteria: * abnormal liver function tests (defined as above twice the upper limit of normal (uln)) * concomitant use of amiodarone , quinidine , haloperidol or selective serotonin (5ht) uptake inhibitors such as fluoxetine and paroxetine which may inhibit the cyp2d6 enzyme. * pre-existing evidence of peripheral neuropathy. * women of childbearing potential. * patients with implantable cardiac devices (or any other contraindication to mri). * obesity ( bmi \> 32) * obstructive sleep apnea syndrome * patients with known hypersensitivity to perhexiline * patients with impaired renal function (creatinine \> 250 µmol/l) * valvular heart disease defined as more than moderate valvular stenosis or regurgitation. * atrial fibrillation

Keywords: perhexiline idiopathic dilated cardiomyopathy magnetic resonance spectroscopy cardiac energetics
pacific: providing adults collaborative interventions for ideal changes

Conditions: Overweight; Obesity

Summary: the objective of this proposed study is to collect initial efficacy data on roc and roc + bwl compared to an active comparator (ac) and to bwl.

the investigators have developed a new model for the treatment of obesity, called regulation of cues (roc), which is based on schachter's externality theory. the roc program targets two theorized mechanisms for overeating in schachter's theory; decreased sensitivity to appetitive cues and increased sensitivity to external food cues. considering that bwl has merit for some people, but fails to facilitate maintenance, this study will compare roc, bwl, roc+bwl combined and an active comparator (ac). the investigators will recruit overweight/obese adults and will assess them at baseline, mid-treatment (month 6), post-treatment (month 12), mid-follow-up (month 18) and follow-up (month 24). assessments will include body mass index (bmi), body composition, and binge eating over the course of treatment and follow-up. this study will contribute to the study of basic behavioral mechanisms and food intake, could provide a novel model for the treatment of obesity, and could inform clinical decision making regarding obesity treatment.

Eligibility criteria:
1. all participants will be between the ages of 18-65 meeting criteria for overweight, with a bmi between 25 and 45. 2. participants will provide written informed consent for study participation. 3. participants will possess english language skills at the 5th grade reading level. 4. participants will be free of major medical conditions such as a recent history of coronary heart disease; recent history of myocardial infarction; recent symptoms of angina, diabetes, recent stroke, orthopedic problems that would limit activity during the following twelve months; or any other serious medical condition that would make physical activity unsafe. 5. participants will not have bulimia or anorexia, significant cognitive impairment, a known psychotic disorder, or unstable psychiatric illness (e.g., recent psychiatric hospitalization, acute suicidal ideation) as derived from their intake interview and questionnaires. 6. participants will not be moving out of the san diego area for the duration of their study enrollment (24 months). 7. participants will not be pregnant, planning to get pregnant in the 2 year study period or lactating. 8. participants will not be taking medication for weight loss or that may impair physical activity tolerance or performance. 9. participants with medical or psychological problems, or taking medications that could make adherence with the study protocol difficult or dangerous will not be included. 10. participants cannot have a history of bariatric surgery 11. participants cannot currently be enrolled in an organized weight control program.

Keywords: overweight obesity overeating body mass index weight treatment cravings intervention behavioral treatment
mesa versus esa in the treatment of early stage nk/t-cell lymphoma

Conditions: Extranodal NK/T-cell Lymphoma, Nasal Type

Summary: extranodal natural killer (nk)/t-cell lymphoma (enktl), nasal type, is a distinct and heterogeneous histopathologic subtype of non-hodgkin lymphoma (nhl), accounting for 5%\~10%. the frequency of enktl among nhl patients is significantly higher in asia than in western countries, with poor prognosis. radiotherapy plus chemotherapy has improved the survival for these patients. but the optimal treatment schedule is controversial. the previous protocols usually contained high dose methotrexate, but the application of them is limited for the toxicity.

in mid-2016, we had the final evaluation of the phase 2 study of mesa with sandwiched radiotherapy in newly diagnosed early stage nktcl (nct02825147). we obtained the final overall response rate of mesa with sandwiched radiotherapy, while the 2-year progression free survival rate was not available at that timepoint. to make the study design of sample size more accurate, we changed the primary outcome endpoint from 2-year progression free survival rate to overall response rate. the change had been approved by the ethics committee in august 10, 2016. at that time, only fourteen patients were enrolled in nct02631239.

Eligibility criteria:
inclusion criteria: * pathological diagnosis of extranodal nk/t cell lymphoma, nasal type, previously untreated * age 14 \~ 70 years old * ecog(eastern cooperative oncology group）performance status 0\~2 * stage i to ii * life expectancy\>6 months * informed consented exclusion criteria: * chemotherapy before * bone marrow transplantation before * history of malignancy * uncontrollable cardio-cerebral vascular, coagulative, autoimmune, serious infectious disease * lvef≤50% * other uncontrollable medical condition that may that may interfere the participation of the study * lab at enrollment alt or ast \>3\*uln, akp or bilirubin \>2.5\*uln creatinine\>1.5\*uln * not able to comply to the protocol for mental or other unknown reasons * pregnant or lactation * hiv infection
the new strategy for pharmacological treatment in people with schizophrenia

Conditions: Schizophrenia

Summary: switching from risperidone to aripiprazole in early stage of pharmacotherapy will demonstrate the same efficacy as compared to risperidone continuation treatment in the treatment of schizophrenia.

it has been thought that d2 blocking agent is necessary in acute as well as maintenance phase of pharmacological treatment of patients with schizophrenia. however, this classical strategy produces long term adverse events of drug such as td, osteoporosis and some metabolic syndrome. to overcome these adverse events, new strategy for pharmacological treatment is needed.

Eligibility criteria:
inclusion criteria: * schizophrenia, dsm-iv * acute phase exclusion criteria: * refractory schizophrenia * substance abuse * high risk for suicide

Keywords: schizophrenia switching early stage risperidone aripirazole