Kornimate/medical-research-clean huggingface dataset:
leg elevation for prevention of post spinal hypotension in cesarean section

Conditions: Effects of; Anesthesia, Spinal and Epidural, in Pregnancy

Summary: prospective trial including full term parturients scheduled for a cesarean section under spinal anesthesia. patients are being randomly assigned into 2 groups: le group: will be positioned in 15° left tilt with leg elevation with a 30cm height pillow under the heels, this position will be hold after spinal anesthesia until fetal extraction. control group: will be positioned in supine with 15° left tilt. the 2 groups will receive a 10ml/kg of crystalloid co-load intravenously, and the spinal anesthesia will be performed in sitting position with the same dose of bupivacain, morphine and sufentanil.

prospective trial including full term parturients scheduled for a cesarean section under spinal anesthesia. patients are being randomly assigned into 2 groups: le group: will be positioned in 15° left tilt with leg elevation with a 30cm height pillow under the heels, this position will be hold after spinal anesthesia until fetal extraction. control group: will be positioned in supine with 15° left tilt. the 2 groups will receive a 10ml/kg of crystalloid co-load intravenously, and the spinal anesthesia will be performed in sitting position with the same dose of bupivacain, morphine and sufentanil. we will record the demographic data, pre and intraoperative hemodynamic parameters, the dose of ephedrine required to treat post spinal hypotension and fetal parameters: ph and blood lactates

Eligibility criteria:
inclusion criteria: * full term parturients * age\> 18 y * scheduled of elective or urgent cesarean section under spinal anesthesia exclusion criteria: * patients who had general anesthesia
dietary antioxidants, redox tone and health promotion: an orthomolecular study of interactions

Conditions: Type 2 Diabetes Mellitus

Summary: aging is associated with increased risk of various diseases, and much attention is given to the use of natural products (like herbs) and 'functional food', such as teas, for healthy aging. the body is continuously exposed to potentially damaging agents (known as free radicals). the imbalance between the amount of free radicals and that of antioxidants in the body is known as oxidative stress. it is known that type 2 dm is a state of increased oxidative stress, which is thought to lead to many long term complications of type 2 dm, such as heart disease, vision problems and kidney failure. antioxidant therapy, including increased consumption of antioxidant rich foods and beverages such as green tea, has been suggested as possibly beneficial in lowering the risk of these complications. the purpose of this study is to examine the effects of regular intake of green tea on indices of oxidative stress and antioxidant defense within cells, plasma and urine so as to investigate if regular intake of green tea can be recommended for health promotion.


Eligibility criteria:
inclusion criteria: * type 2 dm subjects * genotyped for polymorphism in the heme-oxygenase gene promoter region to be homozygous for long (\> 26) or short (\< 24) gt repeats exclusion criteria: * smokers * have suffered dm related complication * already taking antioxidant or herbal supplements

Keywords: type 2 diabetes mellitus antioxidant oxidant balance activation of antioxidant response element
preventing central catheter-associated bloodstream infections

Conditions: Catheter Infection; Catheter Infections Related

Summary: the research is an algorithm study focused on nursing care in order to prevent central catheter-associated bloodstream infections in intensive care units. the algorithm prepared with infection control measures related to central catheter care will be applied with intensive care nurses and the effect of the algorithm on central catheter-related bloodstream infections will be examined. in practice, a 20-day preliminary assessment, a three-month intervention period, and a three-month post-intervention planning were made.

in the light of literature review and guidelines, intensive care nurses will care for central catheters through an algorithm created with infection control measures. nurse-focused algorithm content to prevent central catheter-related bloodstream infections hand hygiene practice use of personal protective equipment according to infection control measures evaluation of the catheter insertion site in terms of redness, swelling, tenderness, discharge, bleeding use of \>0.5% chlorhexidine solution containing 70% alcohol for skin antisepsis at the catheter insertion site (if there is no chlorhexidine, povidone iodine + 70% alcohol solution is used) changing the transparent, semi-permeable dressings every 5-7 days and gauze dressings every 48 hours for catheter dressing catheter dressing with aseptic technique use of sterile, preservative-free saline for flushing and locking in order to ensure the lumen of the catheter. aseptic conditions should be observed if the junction of the catheter and the infusion set (hub) is to be touched. keeping the used triple taps closed changing iv fluid sets and connection tools at appropriate times daily assessment of cvc requirement the research will be carried out in the 1st, 2nd and 3rd level intensive care units of bilecik training and research hospital in bilecik, turkey. infection rates will be compared in the study. in the study, the date of june 2021 will be taken as a preliminary assessment and training time for nurses. july-september 2021 will be the intervention period of the study, and october-december 2021 will be the post-intervention period.

Eligibility criteria:
inclusion criteria: * a central venous catheter was inserted in the intensive care unit or before the intensive care unit admission, and being followed up in the intensive care unit with a central venous catheter. exclusion criteria: * patients whose central venous catheter was terminated during intensive care follow-up.

Keywords: catheter algorithms sepsis
comparison of safety and efficacy of intravenous iron versus oral iron in chronic renal failure subjects with anemia

Conditions: Anemia

Summary: to assess the safety and efficacy of two forms of iron therapy for the treatment of anemia in non-dialysis dependent, chronic renal failure in patients receiving or not receiving erythropoietin.

the intent of this study was to assess the safety and efficacy of two forms of iron therapy for the treatment of anemia in non-dialysis dependent, chronic renal failure patients receiving or not receiving erythropoietin. after an extensive enrollment period, patients were randomized to receive oral iron (ferrous sulfate, 325mg three times daily (tid) for 56 days) or iv iron sucrose (total 1000mg, 500mg x 2 or 200mg x 5 within two weeks). erythropoietin schedule was to remain unchanged during the 56 day study.

Eligibility criteria:
inclusion criteria: * hemoglobin \< or = 11.5 gm/dl * stable dose or not receiving epo * renal anemia exclusion criteria: * iv iron with last 6 months * chronic infection, malignancy,major surgery within last month * blood transfusion with last two months * significant blood loss within last 3 months * concomitant sever diseases of the liver

Keywords: ckd iron anemia
outcomes of tamis-total mesorectal excision versus transanal loco-regional excision for t2 low rectal cancer

Conditions: Low Rectal Cancer

Summary: cases with stage t2 n0 low rectal cancer will undergo either transanal minimally invasive total mesorectal excision or transanal minimally invasive locoregional resection.


Eligibility criteria:
inclusion criteria: * t2 n0 low rectal cancer exclusion criteria: * patients unfit for laparoscopic resection * unwilling to share in the study
variable resistance training in patients with osteoarthrosis of the knee

Conditions: Resistance Training

Summary: this is a randomized controlled trial investigating the effect of variable load training in patients with knee osteoarthrosis. the intervention will consist of resistance training with variable load in knee extension- and flexion. the control group will receive conventional strength training with rubber band. outcome measures will be the knee osteoarthrosis outcome score, functional capacity measured in a sit to stand test, 30m. pace walk and a 9 step stair climb test. additionally isometric strength in knee flexion- and extension will be measured.


Eligibility criteria:
inclusion criteria: * knee pain and minimum three of the following * \>50 years * morning stiffness \< 30 min * crepitation * bone tenderness * bone osteophytes * absence of inflammation exclusion criteria: * other causes of symptoms to the knee
functional respiratory imaging study

Conditions: Chronic Obstructive Pulmonary Disease

Summary: the purpose of this study is to evaluate the stepping-up effect from a double ics/laba dpi therapy to a triple dpi therapy on airway geometry and lung ventilation


Eligibility criteria:
inclusion criteria: 1. subject's signed informed consent form; 2. male or female ≥ 40 years of age; 3. current smokers or ex-smokers of at least 10 pack-years, 4. established diagnosis of copd 5. post-bd forced expiratory volume in one second/forced vital capacity (fev1/fvc) \< 0.7 and fev1 ≤ 60% of predicted at v1 6. on a stable dose any non-extra fine ics/laba dpi twice daily regimen for at least 8 weeks before screening; 7. presence of lung hyperinflation 8. symptomatic subjects with copd assessment test (cat) score ≥ 10; 9. documented history of ≥ 1 moderate or severe copd exacerbation in the previous 12 months exclusion criteria: 1. pregnant or lactating woman; 2. exacerbations defined as a sustained and acute deterioration of subject's symptoms and signs 30 days before screening; 3. a current asthma diagnosis; 4. respiratory disorders other than copd: 5. cardiovascular diseases; 6. evidence or history of other concurrent disease such as but not limited to hyperthyroidism, diabetes mellitus or other endocrine disease; 7. medical history or current diagnosis of narrow-angle glaucoma; 8. history of lung transplant or lung reduction surgery; 9. ecg criteria: any clinically significant abnormal 12-lead ecg that in the investigator's opinion would affect efficacy or safety evaluation or place the subjects at risk; 10. laboratory abnormalities; 11. alcohol/drug abuse; 12. contra-indications to investigational medical products (imps), based on investigator judgement; 13. documented covid-19 diagnosis or its complications which have not resolved within 14 days prior to screening; 15. positive molecular covid-19 test within the last 72 hours before the remaining of screening activities.
omacor and cardiovascular risk factors in hiv patients on haart treatment

Conditions: Human Immunodeficiency Virus; Ischemic Heart Disease

Summary: the purpose of this study is to evaluate the effect of omacor 4g/day on blood lipid parameters and on the function and stiffness of blood vessels in hiv infected patients on antiretroviral therapy (haart)

results from recent studies show increasing numbers of ischemic heart disease (ihd) incidents among patients on haart treatment (highly active antiviral therapy). three elements have received special attention: 1. the immunodeficient effects of the hiv infection itself may influence the progression of arteriosclerosis 2. the higher levels of risk behaviour in this group of patients (i.e. high prevalence of smokers in this group) 3. the haart treatment itself increases plasma levels of cholesterol, ldl cholesterol and triglycerides, resulting in hiv related lipodystrophy. the cardioprotective effects of n-3 pufas are well established both through epidemiological studies and through small and large clinical trials. clinical trials have shown positive effects of n-3 pufa on plasma triglycerides, and statistically significant reductions in cardiovascular death and sudden cardiac death. moreover n-3 pufas have been shown to have beneficial effects on endothelial function. based on the above rationale it is expected that omacor (omega-3-acid ethyl ester 90) will have positive effects on risk factors related to ischemic heart disease in hiv patients on haart treatment. approximately 50 patients will be randomized to omacor 4 grams/day or placebo. treatment period is 12 weeks.

Eligibility criteria:
inclusion criteria: * man/women \> 18 years of age * documented hiv infection * on active treatment with haart for at least 3 months. * written informed consent. this implies that the patient can read and understand danish or english exclusion criteria: * age \< 18 years * malign disease * patients assessed as not cooperative * patients planning to be pregnant or who are already pregnant or breast feeding. * patients who have been taking fish oil capsules prior to randomization. however, patients who have discontinued fish oil supplements at least 8 weeks prior to the first visit will be included * patients allergic to fish proteins * statin treatment that has been ongoing for less than three months, or a change in statin treatment dose within the last three months

Keywords: human immunodeficiency virus (hiv) highly active antiviral therapy (haart) ischemic heart disease omacor triglycerides endothelial function treatment experienced
examining effects of a therapeutic focus on positive memories on post-trauma health

Conditions: Stress Disorders, Post-Traumatic; Affect; Memory

Summary: posttraumatic stress disorder (ptsd) has devastating health consequences. evidence-based ptsd interventions address the substantial burden of ptsd on the health of individuals and societies; however, several individuals receiving these interventions drop out and not all individuals experience improvement in ptsd symptoms. moreover, these current ptsd interventions primarily target trauma memories. notably, growing evidence suggests that ptsd symptoms are related to difficulties in the encoding and retrieving of positive memories as well. thus, the proposed study will examine effects of and targets underlying a novel ptsd technique focused on narrating and detailing positive memories - processing of positive memories technique (ppmt). methodologically, 70 individuals will be randomly assigned to ppmt vs. supportive counseling (sc) for this study. the aims of the proposed study include (1) examining ppmt's effects on ptsd symptom severity and stress systems' dysregulation (i.e., awakening salivary alpha amylase \[saa\] and cortisol); (2) examining mechanisms underlying ppmt's effects; and (3) refining ppmt. it is hypothesized that the ppmt arm will report greater decreases in ptsd severity and saa/cortisol ratios. further, it is hypothesized that ppmt-related improved affect will mediate the association between study arm (ppmt vs. sc) and changes in ptsd severity. lastly, feedback will be obtained from study participants on ppmt's feasibility, format, and content to refine ppmt. the proposed study may contribute preliminary evidence on the potential significance of targeting positive memories in ptsd interventions.


Eligibility criteria:
inclusion criteria: * 18-65 years old * willing/able to provide informed consent * past month dsm-5 posttraumatic stress disorder (ptsd) diagnosis * working knowledge of english exclusion criteria: * active suicidal intent or attempts * active psychosis * currently receiving mental health therapy (past 3 months) * dosage changes in psychiatric medications (past 3 months) * currently pregnant
dysfunctional renin-angiotensin system in septic shock

Conditions: Septic Shock

Summary: despite best therapy efforts, sepsis and septic shock are associated with mortality rates of up to 40%. this clinical trial will determine the benefit of exogenous angiotensin ii versus norepinephrine (conventional care) treatment in septic shock patients. this trial will determine whether there are better predictors of septic shock severity. this approach may inform more appropriate treatment regimens and improve outcomes for these patients.

this study will determine whether normalization of renin-angiotensin-aldosterone system (raas) signaling in sepsis occurs more rapidly with treatment with angiotensin ii compared with conventional vasopressors. trial samples will be used to identify the best raas biomarker predictor of treatment response via in-depth longitudinal analysis of raas component and to determine the extent and mechanisms of angiotensin ii impact on innate immune function during sepsis. successful accomplishment of our aims will provide the capability to improve endotyping of septic patients by establishing the most precise and robust measurement of renin (and raas dysfunction). this work will improve staging and clinical precision and will facilitate the criteria for therapeutic development of targets in septic shock.

Eligibility criteria:
inclusion criteria: * the presence of septic shock, defined by sepsis-3 criteria * the requirement for norepinephrine of at least 10 micrograms/minute up to 35 micrograms/minute for at least 1 hour, with or without vasopressin, to maintain a mean arterial pressure of 65 mmhg * clinical suspicion or proven evidence of infection exclusion criteria: * age \<18 years * prisoners * pregnant women * patients for whom urgent surgery is anticipated * leukocyte count \<1,000 cells/μl * absolute monocyte count \<200 cells/μl * bone marrow transplant within the past 30 days * patients that will be withdrawing aggressive resuscitation

Keywords: sepsis kidney disease intensive care
anakinra in infants and children with coronary artery abnormalities in acute kawasaki disease

Conditions: Kawasaki Disease

Summary: kawasaki disease (kd) is the leading cause of acquired heart disease in children in the developed world. despite available treatment, 25% of children in san diego county appropriately treated for kd develop coronary artery abnormalities that may lead to complications later in life, including heart attack. although the investigators can identify children with kd that have these coronary artery abnormalities, there is no approved additional treatment to decrease coronary artery inflammation and arrest or prevent damage to the coronary arteries. anakinra, a therapy that blocks the high levels of interleukin 1 (il1) that lead to inflammation during acute kd, has been shown in the kd mouse model to prevent the development of coronary artery damage. therefore, the investigators propose to study the safety and activity of anakinra in infants and children \< 2 years old with coronary artery abnormalities from kd.


Eligibility criteria:
inclusion criteria: 1. infant or child aged 1 month to 17 years, who meets clinical criteria for kd according to american heart association guidelines (table 2): fever (t≥38oc or 100.4oc) ≥ 3 days and ≥ 2 clinical criteria with left anterior descending (lad)/right coronary artery (rca) z score ≥ 3.0 or an aneurysm (≥ 1.5 x the adjacent segment) of one of the coronary artery segments 2. patient presents within the first 20 days after fever onset 3. parent or legal guardian able and willing to provide informed consent; adolescent or child assent as appropriate 4. post-menarchal females: negative pregnancy test at screening and willing to use two forms of contraception during the study 5. males engaging in sexual activity that could lead to pregnancy willing to use a condom. exclusion criteria: 1. use of an il-1 antagonist within the 3 months prior to enrollment 2. history of chronic disease, except asthma, atopic dermatitis, autism or controlled seizure disorder 3. history of hypersensitivity to anakinra 4. history of tuberculosis (tb) or tb exposure

Keywords: kawasaki disease anakinra il-1
hypoparathyroidism natural history

Conditions: Hypoparathyroidism

Summary: this is a prospective three year natural history study of adults with hypoparathyroidism. the goal is to monitor patients with hypoparathyroidism to define end-organ damage in the context of the disease. funding source- fda oopd

the goal of this study is to prospectively collect data on the natural history of hypoparathyroidism (hpt). this will enable longitudinal data collection of complications in this disease, specifically defining the epidemiology of end-organ complications of hpt that are related to high calcification propensity. it will also determine relationships between calcification burden and end-organ disease severity and progression risk and assess the utility of traditional and novel biomarkers of mineral and bone metabolism on disease diagnosis and monitoring. these data will inform future investigations on the development, study, and implementation of hpt end-organ disease modifying strategies and impact clinical practice in hypoparathyroidism.the study objectives are to: 1. build a prospective cohort of patients to study hpt-associated end-organ damage. 2. determine end-organ physiologic consequences of hpt. 3. elucidate determinants of hpt-associated end-organ damage.

Eligibility criteria:
inclusion criteria: * an understanding, ability and willingness to fully comply with study procedures and restrictions. * ability to voluntarily provide written, signed and dated informed consent as applicable to participate in the study. * male or female ≥18 years of age with hpt. all hpt sub-types are eligible, including surgical (hpt-s) and nonsurgical (hpt-ns) hpt: autoimmune, genetic (including but not limited to: digeorge syndrome, autoimmune polyendocrine syndrome type 1, hypoparathyroidism sensorineural deafness and renal disease syndrome, kearns-sayre syndrome, mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes \[melas\] syndrome, mitochondrial trifunctional protein \[mtp\] deficiency syndrome, kenny-caffey syndrome, sanjad-sakati syndrome, autosomal dominant hypocalcemia), infiltrative (granulomatous), mineral deposition (copper, iron), metastatic, radiation and idiopathic hpt. * diagnosis of hpt established based on historic hypocalcemia in the setting of inappropriately low serum pth levels on two occasions. * all treatment regimens are permitted, including but not limited to conventional management with calcium (e.g. calcium citrate, calcium carbonate, etc), active vitamin d (calcitriol, alfacalcidol), parent vitamin d, magnesium, phosphate binders and thiazides. use of pth-like drugs are permitted. exclusion criteria: * functional hpt * transient hpt * pseudohypoparathyroidism * pregnancy