Kornimate/medical-research-clean huggingface dataset:
guideline directed medical therapy in patients with heart failure

Conditions: Heart Failure

Summary: the team-mgh study will formerly evaluate impact of the gdmt clinic versus matched usual care patients on the proportion of gdmt administration over a 12 week period in approximately 300 total patients with hf across the spectrum of lvef (with a minimum of 150 with hfref). the study will also assess impact of the gdmt clinic on health status, functional capacity, biomarker profiles, cardiac remodeling and cardiovascular events.

the lack of adherence to goal-directed medical therapy (gdmt) is a major problem in modern hf care. despite advances in therapies for those with hf along with well-articulated goals for achieving guideline-directed medical therapy (gdmt) for affected individuals, the treatment of persons with hf lags behind current recommended guideline approaches, with 30% of ambulatory patients with hfref not being prescribed angiotensin receptor/neprilysin inhibitors (arni), angiotensin converting enzyme inhibitors (acei), angiotensin ii receptor blockers (arb), or evidence based beta blockers (ebbb) and the majority not receiving target doses of these medications despite lack of medical contraindications. the reasons for gaps in care include hesitancy to change medical programs in ostensibly stable patients, concerns about risk of drug intolerances, worries about drug costs, as well as uncertainty about benefits. additionally, complexity of medical therapy, rapid evolution in the currently recommended therapeutic options, and challenges in care coordination also result in missed treatment opportunities. given that most individuals with hf are cared for by specialists other than those trained in advanced hf therapies, this intersection of increasing complexity of care results in substantial gaps in care. the proposed research is to study impact of the gdmt clinic for patients across the spectrum of hf.

Eligibility criteria:
inclusion criteria: * diagnosis of hf, including new onset disease * established cardiovascular follow up at mgh * receiving sub-optimal medical care defined as \<50% target doses of gdmt agents * age ≥18 years * for hfpef: * presence of structural heart disease (lavi \>34 ml/kg2, e/e' \>14, or lvh) * recent hf hospitalization or historical nt-probnp \>300 pg/ml exclusion criteria: * planned referral to the advanced hf program * decompensated hf * end-stage kidney disease * egfr \<15 ml/min/1.73m2 or on renal replacement therapy * untreated severe valvular heart disease * advanced hf * inotropic support * transplant or mcs planned * enrolled in hospice or palliative care * life expectancy \<12 months due to non-cv disease * pericardial constriction * hypertrophic cardiomyopathy * unwillingness or inability to take gdmt * pregnancy or breast feeding

Keywords: heart failure quality improvement angiotensin converting enzyme inhibitors angiotensin receptor/neprilysin inhibitors angiotensin ii receptor blockers evidence based beta blockers
comparison of sensory cuing modalities for freezing of gait

Conditions: Parkinson Disease

Summary: the investigators intend to compare the effects on the resolution of visual and auditory sensory cues on the resolution of freezing of gait in patients with idiopathic parkinson's disease.

as parkinson's disease progresses, the patients develop 'freezing of gait', which make it difficult to initiate gait, turn at the corner, and enter a narrow space. this is considered to be a very important symptom, as it is related to the performance of daily activities, independence of life, and serious injuries caused by falls while walking in parkinson's disease patients. it has been found that the use of external sensory stimulation (visual, auditory) can reduce the symptoms of freezing of gait, and is used as rehabilitation treatment and instant symptomatic resolution. however, the relative effectiveness of sensory stimulation is not studied yet. accordingly, the investigators intend to compare the effects of visual and auditory sensory cues on the resolution of freezing of gait in patients with idiopathic parkinson's disease.

Eligibility criteria:
inclusion criteria: 1. diagnosed with idiopathic parkinson's disease with freezing of gait according to the united kingdom (uk) brain bank. 2. scored more than 15 points of korean version of mini-mental status exam (k-mmse). 3. independent gait for at least a minute without walking assistance device. exclusion criteria: 1. history of concomitant brain disease other than idiopathic parkinson's disease. 2. other neurologically deteriorated states, such as neuromuscular disease, which can cause gait disturbance. 3. other psychiatric disorders.

Keywords: freezing of gait parkinson disease functional near-infrared spectroscopy
comparison of insulin glargine/insulin glulisine regimen to insulin aspart/insulin aspart protamine 30/70 in type 2 diabetes mellitus patients (t2dm)

Conditions: Diabetes Mellitus, Type 2

Summary: primary objective: to demonstrate the non-inferiority of hemoglobin a1c (hba1c) control at six months between the basal plus one and the biphasic insulin regimen. secondary objective: to demonstrate favorable outcome for basal plus over biphasic insulin when it comes to comparing when both hemoglobin a1c (hba1c) target goal achievement and non-hypoglycemic event is taken into account.


Eligibility criteria:
inclusion criteria: 1. sub-optimally controlled type 2 diabetes mellitus (t2dm) patients treated with insulin glargine for a minimum of 3 months: * sub-optimal: hba1c level \>7% and fasting blood glucose \<130mg/dl 2. male or female ≥18 years old 3. body mass index (bmi) \<40 4. 10% ≥hba1c ≥7% 5. if taking oral anti-diabetics (oads), must be on stable dose for at least 1 months 6. patients willing to sign data release consent form exclusion criteria: 1. diabetes other than t2dm 2. enrolled in other clinical trials 3. previous treatment with an insulin other than insulin glargine 4. treatment with glucagon-like peptide-1 (glp-1) receptor agonists or with di peptidyl peptidase 4 (dpp-iv) inhibitors 5. pregnant or lactating women 6. contraindicated to lantus (insulin glargine) / apidra (insulin glulisine) / novomix 30 (insulin aspart) 7. treatment with systemic corticoid steroids within the last 3 months prior to study enter 8. treatment with any investigational product within the last 3 months prior to study entry the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
effect of different obturation techniques on postoperative pain

Conditions: Pain, Postoperative; Pain; Endodontic Inflammation

Summary: this study evaluated the postoperative pain after the endodontic treatment by using three different obturation techniques. ( cold lateral condensation (clc), thermoplasticized solid-core carrier method (guttacore) and cold free-flow compation tecnique ( guttaflow2))


Eligibility criteria:
inclusion criteria: 1. participants between 18 - 72 years of ages, 2 good oral hygiene, 3. have not taken any analgesic in the last 7 days, 4. have not taken any antibiotics in the last 7 days, 5. positive response to both cold test (endoice; coltene/whaledent inc, cuyahoga ), 6. patients diagnosed with asymptomatic irreversible pulpitis with his/her single-rooted teeth caused by a deep carious lesion, 7. patients have single-rooted teeth requiring endodontic treatment according to the pre-prosthetic reason, 8.the presence of profusely pulp bleeding with a thick consistency, which is exposed during caries removing. 9. the periapical region was healthy in radiographic diagnosis. exclusion criteria: 1. patients who refuse to participate in this study, 2. medically compromised patients (with immunosuppressive/systemic diseases, patients on medications), 3. devital teeth that have no response to pulp test, 4. the presence of advanced periodontal disease (probing depth \> 4 mm), 5. the presence of open apex, 6. the presence of calcification, 7. the presence of resorption, 8. patients who had multiple teeth requiring endodontic treatment, 9. patients with allergic sensitivity to materials and agents that should be used during the root canal treatment, 10. allergic sensitivity to local anesthetics, 11. patients who had systemic or allergic sensitivity for the nsaids, 12. pregnant participants or participants in the lactation period, 13. teeth cannot be applied to a rubber-dam.

Keywords: cold lateral condensation postoperative pain guttacore guttaflow 2 obturation techniques
thinking skills for work in severe mental illness

Conditions: Schizophrenia; Schizoaffective Disorder; Major Depression; Bipolar Disorder; Anxiety Disorder

Summary: the purpose of this study is help people with serious mental illness and receiving vocational rehabilitation get and keep the job they want by improving their thinking skills, such as attention and memory, using computer exercises and other strategies. one half of the participants in the study will receive vocational rehabilitation and the exercises to improve thinking skills, and the other half will receive just vocational rehabilitation. all participants will receive an assessment of symptoms and thinking skills at the beginning of the study and 6, 12, and 24 months later. work activity during the 24 months in the study will be collected. it is expected that those participants who receive the practice of their thinking skills will be more likely to get and keep the job they want compared with people who do not receive this treatment.

this randomized controlled trial is evaluating the effectiveness of a pilot-tested, manualized cognitive remediation intervention entitled the "thinking skills for work program" by comparing it to enhanced supported employment services in clients with severe mental illness (smi) who are participants in high fidelity supported employment programs at the greater mental health center of manchester and thresholds, inc., chicago, il, but who have had difficulty getting or keeping jobs. participants are randomized to either the thinking skills for work (cognitive remediation +supported employment; ct+se) or enhanced supported employment (e-se), with cognitive, symptom, and quality of life assessments performed at baseline, 3 months (following the completion of the computerized cognitive training component of the thinking skills for work program), 12 months, and 24 months, and employment data gathered over the full 2-year period. for the e-se condition, supported employment services are enhanced by training provided to the employment specialists regarding to recognize cognitive problems related to work performance, and how employment specialists can teach clients coping strategies for managing these problems. primary analyses will focus on testing the hypotheses that the thinking skills for work program (ct+se) leads to better cognitive functioning and better competitive work outcomes over the 2-year follow-up period compared to the e-se program.

Eligibility criteria:
inclusion criteria: * chronic mental disorder * minimum age 18 * unemployed * wants employment * must be a recipient of services at one of two participating agencies * fluent in english * willing and legally able to provide informed consent to participate in study -subjects with court appointed legal guardians will be included exclusion criteria: * history of neurological conditions that impair cognition

Keywords: schizophrenia chronic mental disorder employment cognitive remediation vocational rehabilitation
bedside screening method for patients with potential swallowing impairment

Conditions: Deglutition Disorders; Dysphagia

Summary: previous studies have shown that most patients with functional oropharyngeal dysphagia could be quickly, safely and accurately recognized by using a clinical bedside method developed by the investigative team as the volume-viscosity swallow test (v-vst) that systematically evaluates the main clinical signs and symptoms of safety and efficacy of swallowing and monitors pulse oximetry to improve the detection of patients with silent aspirations.the aim of this study is to validate this test for persons suspected of having swallowing impairment, using a new thickener, with respect to the videofluoroscopy (vfs) method (treated as the gold standard).


Eligibility criteria:
inclusion criteria: * history of swallowing difficulties associated with aging and/or neurological diseases including patients with: -neurodegenerative diseases. -non-progressive neurological diseases including stroke. -older patients including nursing home patients. * age \> 18 y * ability to give informed consent exclusion criteria: * patients suffering idiosyncratic phenomena or who are allergic to any medication, especially iodinated contrast media * patients suffering major respiratory disease or undergoing any type of surgery in the three months prior to the study * patients with a background of alcohol dependence or other drug dependence * patient who cannot be expected to comply with treatment * patient currently participating or having participated in another clinical trial during the last 4 weeks prior to the beginning of this study
targeting the skeletal muscle to treat metabolic dysfunction-associated steatotic liver disease

Conditions: Metabolic Dysfunction-associated Steatotic Liver Disease

Summary: muscle changes including myosteatosis are reported as highly prevalent in metabolic dysfunction-associated steatotic liver disease (masld). recent studies highlighted a link between muscle fat content and liver disease severity. conversely, masld histological remission though diet or metabolic surgeries is also linked to a decrease in muscle fat content. therefore, skeletal muscle appears as a potential target to treat masld.

in this monocenter interventional study, we will assess the impact of physical activity on muscle fat content and liver disease severity in masld as well as the mechanisms mediating the potential beneficial effects of exercise.

Eligibility criteria:
inclusion criteria: * confirmed masld at abdominal imaging * confirmed excessive muscle lipid content at imaging * stable weight exclusion criteria: * severe comorbidities including active malignancies, neuromuscular degenerative diseases * contraindications to physical activity * excessive alcohol consumption

Keywords: metabolic dysfunction-associated steatotic liver disease masld physical activity myosteatosis magnetic resonance imaging magnetic resonance specroscopy muscle biopsy
genicular nerve block for total knee arthroplasty

Conditions: Post-operative Pain

Summary: this study seeks to examine the analgesic efficacy of genicular nerve blocks for pain after total knee replacement.

part of the way in which pain is controlled during total knee replacement surgery is through a nerve block. the investigators have developed an effective protocol for pain control after knee replacement, but know that many patients still experience pain around the knee after knee replacement. there are nerves around the knee that carry pain impulses from behind the knee. the investigators believe that placing numbing medicine around these nerves can help with pain in front of the knee after surgery, in addition to the standard nerve block placed for knee replacement surgery. this may result in taking less pain medication by mouth,and having less pain with movement. for this study, before the operation, either a placebo solution or the local anesthetic bupivacaine (a numbing solution) will be placed at three sites around the knee where these nerves reside. the investigators will evaluate how participants feel in recovery after surgery, during the stay in the hospital, and call at home one week after surgery. knowing if numbing these nerves helps with pain after surgery will help us further refine our postoperative care plan for patients.

Eligibility criteria:
inclusion criteria: * subjects scheduled for primary elective total knee arthroplasty * american society of anesthesiologists physical status i-iii * bmi 18-40 kg/m2 exclusion criteria: * inability to cooperate with protocol * inability to understand or speak english * allergy to ropivacaine, bupivacaine or other local anesthetic * contraindication to peripheral nerve block (e.g. local infection, neurologic deficit or disorder, previous trauma or surgery to ipsilateral knee, etc.) * revision knee surgery * chronic opioid consumption (daily morphine equivalent of \>30 mg for at least four weeks prior to surgery) * history of chronic pain * history of psychiatric disorder * history of diabetes mellitus

Keywords: total knee replacement
the role of cxcr4hi neutrophils in influenza

Conditions: Influenza; Acute Respiratory Distress Syndrome

Summary: influenza is still responsible for more than 650,000 deaths per year worldwide and no major improvements in patients' care has been made despite 50 years of research. especially, there is no therapeutic strategy targeting the dysregulated host response. cxcr4-expressing neutrophils seem to be involved in the rupture of host resistance. the aim of this study is thus to compare the percentage of blood cxcr4-expressing neutrophils between influenza survivors and non-survivors.

influenza is still responsible for more than 650,000 deaths per year worldwide and no major improvements in patients' care has been made despite 50 years of research. most of severe influenza patients suffer from acute lung injury due to a dysregulated immune response. neutrophils are involved in both host resistance and disease tolerance. thanks to advances in technologies, the vast variety in neutrophils subpopulations has been revealed. in particular, the subpopulation of cxcr4-expressing neutrophils has been suggested to be involved in the rupture of disease tolerance in lung infections. nevertheless, these data are from murine models and remain to be confirmed in humans. moreover, the underlying mechanisms remain unknown as well as the place of primum movens, i.e. vascular or alveolar compartment. the aim of this study is thus to compare the percentage of blood cxcr4-expressing neutrophils between influenza survivors and non-survivors. percentage of bal cxcr4-expressing neutrophils will also be compared. to this aim, blood sampling and bal within the 24 hours and at day 3 after admission to icu, neutrophils isolation, immunostaining and flow cytometry acquisition will be performed within the 24 hours and at day 3 after admission to icu. mortality rate will be collected at day 28 and day 90.

Eligibility criteria:
inclusion criteria: * patient aged 18 yo or above. * acute respiratory distress syndrome as defined by the berlin classification. * invasive mechanical ventilation for less than 24 hours. * cause of ards: * influenza infection proven by polymerase chain reaction or * bacterial infection (tracheal aspirate with more than 105 cfu/ml and bal with more than 104 cfu/ml. * pancreatitis according to the 2013 working group iap/apa acute pancreatitis guidelines. * peritonitis according to the 2018 sfar guidelines. * health insurance. * written informed consent from legal relative or representative. exclusion criteria: * neutropenia (\< 500/mm3) * neutrophils qualitative defect. * patient included in an interventional research assessing an immunomodulatory or antiviral drug. * acquired immunodeficiency syndrome. * contraindication to bal: * severe bronshospasm. * out-of-control shock. * intracranial high pressure. * refractory hypoxemia (pao2/fio2 \< 60 mmhg). * legal restriction: prisoners, pregnancy, legal protection.

Keywords: neutrophils cxcr4 host resistance disease tolerance
pharmacokinetics of glpg3067 in male subjects with cystic fibrosis.

Conditions: Cystic Fibrosis

Summary: this clinical study is a phase i, open-label, single-center study designed to evaluate the pharmacokinetics profile of a single oral dose of glpg3067 in adult male subjects with cystic fibrosis in fed state.


Eligibility criteria:
inclusion criteria: * male subject ≥18 years of age on the day of signing the icf. * a confirmed clinical diagnosis of cf. * exocrine pancreatic insufficiency (documented in the subject's medical record). * stable concomitant medication regimen for pulmonary health for at least 2 weeks prior to study drug administration exclusion criteria: * history of clinically meaningful unstable or uncontrolled chronic disease that makes the subject unsuitable for inclusion in the study in the opinion of the investigator. * unstable pulmonary status or respiratory tract infection (including rhinosinusitis) requiring a change in therapy within 2 weeks prior to study drug administration. * need for supplemental oxygen during the day, and \>2 l/minute while sleeping. * history of solid organ or hematopoietic cell transplantation. * history of hepatic cirrhosis with portal hypertension (e.g., signs/symptoms of splenomegaly, esophageal varices). * use of cftr modulator therapy (e.g., lumacaftor or ivacaftor) within 2 weeks prior to study drug administration. * abnormal liver function test at screening, defined as aspartate aminotransferase (ast) and/or alt and/or alkaline phosphatase and/or gamma-glutamyl transferase (ggt) ≥3x the upper limit of normal, and/or total bilirubin ≥1.5x the upper limit of normal.
cvd risk and health in postmenopausal phytoestrogen users

Conditions: Bone Diseases; Cardiovascular Diseases; Coronary Disease; Depression; Heart Diseases; Myocardial Ischemia; Osteoporosis; Postmenopause

Summary: to determine the acceptability and benefits of use of a dietary supplement of the phytoestrogen, genistein, versus placebo on heart disease risk factors, bone density, and psychosocial outcomes in postmenopausal women.

background: estrogen replacement therapy is beneficial for heart disease risk factors as well as for bone density. however, a large proportion of postmenopausal women are not compliant with therapeutic regimens. phytoestrogens are naturally occurring compounds found in plants and soy products that have estrogenic effects, and may represent an alternative treatment for the prevention of heart disease and osteoporosis in postmenopausal women. however, few intervention trials have examined the extent to which it is possible to improve heart disease risk factors, bone density, and quality of life in postmenopausal women through use of a dietary supplement of phytoestrogen. design narrative: randomized, double-blind, placebo-controlled study. a total of 210 women were enrolled in the study to be followed for one to two years. the women were randomized to phytoestrogen treatment or to placebo. data are collected at baseline visits, at one and three month follow-up telephone calls, and at 6, 12, and 24 month follow-up clinic visits. measures of high density lipoprotein and other heart disease risk factors, hip and spine bone density, and depression, life satisfaction, and quality of well-being are obtained. cross-sectional and longitudinal comparisons of treatment and placebo groups are performed before and after adjustment and stratification for potentially confounding covariates. the study was renewed in march 2002 to assess whether the women treated with phytoestrogens had lowered homocysteine, interleukin-6, c-reactive protein, e-selectin, and decreased obesity and fat mass over two years. the study completion date listed in this record was obtained from the "end date" entered in the protocol registration and results system (prs) record.

Eligibility criteria:
postmenopausal women, ages 45 to 74.