Kornimate/medical-research-clean huggingface dataset:
optical monitoring with near-infrared spectroscopy for spinal cord injury trial

Conditions: Acute Spinal Cord Injury; Spinal Cord Injuries

Summary: the study involves the 'first-in-human' evaluation of a novel optical sensor which uses near-infrared spectroscopy (nirs) technology to assess oxygenation and hemodynamics of the injured spinal cord. the nirs sensor is laid on top of the dura, at the site of the sci, and emits near-infrared light signals into the cord to measure tissue oxygenation and tissue hemodynamics in real-time. our testing of this novel nirs sensor in patients with acute sci represents the first step in translating this technology for human use.

this single-center, prospective observational study will enroll 10 patients admitted to vancouver general hospital (vgh) for treatment of an acute traumatic spine injury. promising preclinical data demonstrates that the oxygenation and hemodynamic measures of our near infra-red spectroscopy (nirs) system closely match the invasive intraparenchymal measures obtained within the injured spinal cord. further, the nirs sensor is responsive and reflective of systemic hemodynamic changes. this clinical protocol represents the first application of this novel nirs sensor in human sci. following operative decompression of the spinal cord via a posterior approach, the nirs sensor will be placed over the dura for 7 days to monitor spinal cord oxygenation and tissue hemodynamics. patients will be followed for 6 months and data collection for safety, feasibly and efficacy of the nirs system. the specific aims of this project are to: 1. establish the safety, feasibility, and efficacy of our nirs system in monitoring tissue oxygenation and hemodynamics of the injured spinal cord in human participants. 2. complete the technical refinement of the nirs system utilizing an iterative process guided by participant recruitment and data accrual during the trial.

Eligibility criteria:
inclusion criteria: * male or female aged 17 years or older * spinal injury between bony levels c3 and l1 inclusive * motor complete acute traumatic sci (ais a or b) or motor incomplete sci (ais c) with a total lower extremity motor score of less than 5 * blunt (non-penetrating) sci requiring posterior laminectomy with stabilization/fusion surgery within 72 hours of injury * able to communicate in english and provide informed consent exclusion criteria: * isolated radiculopathy or cauda equina injury * spinal cord impairment secondary to tumour, infection, epidural bleeding, or ischemia (in * any condition or injury (e.g. morel-lavellee lesion) that would interfere with the application or readings of the nirs sensor * associated traumatic condition that would interfere with the informed consent process or outcome assessments (e.g. traumatic brain injury, pelvic, abdominal, or thoracic injuries) * any other medical condition that, in the investigator's opinion, would render the protocol procedures dangerous * female patients who are pregnant
hydra single-centre experience - copenhagen, denmark

Conditions: Aortic Valve Stenosis

Summary: the present study aims to evaluate the efficacy and safety of tavi using the hydra transcatheter aortic valve (thv) series, in patients with severe aortic stenosis up to 1-year after the procedure. additionally, the study will assess the role of geometry in the development of new conduction abnormalities based on the analysis of post-operative ct scan at 1-month in patients who had undergone transcatheter aortic valve replacement with a self-expanding hydra thv series.


Eligibility criteria:
inclusion criteria: 1. age ≥ 18 years 2. patients affected by severe aortic stenosis (nyha class ≥ ii) eligible for tavi procedure as per local heart team evaluation 3. full understanding and willing to provide informed consent to study enrolment exclusion criteria: 1. contraindications to tavi (e.g., anatomically phenotypes, intracardiac mass, thrombus, vegetation, endocarditis) 2. refusal to provide informed consent to study enrolment 3. patients with severe aorta or peripheral artery disease precluding transfemoral approach of tavi 4. patients with calcification on the annulus and in the left ventricular outflow tract (lvot), or/and excess calcium within each cusp, or those who are deemed unsuitable for the hydra thv series based on the clinical judgment of the investigator

Keywords: aortic valve stenosis tavi hydra
immediate and long-term induction of incretin release by artificial sweeteners 1

Conditions: Pre-diabetes; Diabetes

Summary: epidemiological data suggest, that not only sugar-based, but also artificially sweetened soft drinks may play a role in the development of diabetes. recent studies in animals and humans have shown, that artificial sweeteners (as) influence metabolic responses after glucose ingestion, possibly alter the intestinal microbiome and even modulate incretin release. however, it is unclear, if these findings are valid for all kinds of as, as they are chemically different. furthermore, data on human subjects are sparse and controversial. the investigators will therefore conduct 7 consecutive single oral stimulations with glucose or as alone or a combination. three different as will be tested.

epidemiological data suggest, that not only sugar-based, but also artificially sweetened soft drinks may play a role in the development of diabetes. recent studies in animals and humans have shown, that artificial sweeteners (as) influence metabolic responses after glucose ingestion, possibly alter the intestinal microbiome and even modulate incretin release. however, it is unclear, if these findings are valid for all kinds of as, as they are chemically different. up to now, no single study has ever compared metabolic responses to different as in the same subjects. furthermore, data on human subjects are sparse and controversial. this is partially explained by different methodical approaches such as intragastral/intraduodenal application of as, rather than conventional oral consumption. the investigators will therefore conduct 7 consecutive single oral stimulations with glucose or as alone or a combination. three different as will be tested: saccharin, aspartame and sucralose.

Eligibility criteria:
inclusion criteria: * healthy exclusion criteria: * metabolic disorders such as diabetes, hypothyroidism, corticoid therapy, heart or lung disease

Keywords: incretin release
optimizing propofol in obese patients

Conditions: Hysterectomy

Summary: an accurate dosage of anesthetics during surgery is important. usually this is achieved through close observation of the patient, but a new monitor (csm-monitor) can measure the level of anesthesia more closely. in obese patients dosage of drugs is difficult due to the change in body composition. the csm-monitor may provide a more accurate dosage of propofol (an anesthetic agent) during surgery, and as a consequence of that, also reduce the postoperative need for analgesics. main objective: to optimise propofol dosing in obese patients undergoing hysterectomy. main hypothesis: monitoring the depth of anesthesia using the csm-monitor reduces time to opening eyes in obese patients after hysterectomy in propofol anesthesia. secondary hypotheses: csm-monitoring reduce propofol dose in obese patients undergoing hysterectomy. patients with a high csm-level during hysterectomy have higher postoperative consumption of analgesics. supplementary, an algorithm for the dose of propofol that most frequently results in a csm-level between 40 and 60 is calculated.


Eligibility criteria:
inclusion criteria: * elective abdominal non-laparoscopic hysterectomy * age \> 18 years * asa physical status i-iii * body mass index 30 or above exclusion criteria: * allergic towards propofol * daily consumption of benzodiazepines (more than at nighttime), opioids or amphetamine preoperatively. * disease with expected eeg-abnormality or impaired auditory function: epilepsy, deafness, previous neurosurgery, previous or actual neurologic disease with neurologic deficit.
co2 as a stress agent for perfusion imaging

Conditions: Coronary Artery Disease

Summary: myocardial perfusion imaging (mpi) is a nuclear scan using a radioisotope to see blood flow to the muscles of the heart when the heart is at rest and when it is under stress. the stress test in mpi can be done using medications, such as persantine, that dilate coronary arteries and increase blood flow. similarly, elevated carbon dioxide (co2) levels in the blood, or hypercapnia, also dilates arteries and increases blood flow. thornhill research inc. has developed the ra-mr™ sequential gas delivery system used to control co2 levels in the blood. the ra-mr™ can deliver precise amounts of co2 through a mouthpiece for inhalation to increase co2 levels in the blood and thereby increasing blood flow like during stress. the objective of this study is to compare the differences in blood flow through the arteries of the heart during stress with hypercapnia and adenosine mpi. the imaging will be done using positron emission tomography (pet) with the radioisotope, or tracer, called rubidium (rb-82). the rb-82 is given through a pump, or elution system. the investigators hypothesize that hypercapnia will induce a stress-to-rest increase in myocardial blood flow by a factor of 2 or more in myocardial regions supplied by non-stenotic arteries in normal volunteers and participants with coronary artery disease.


Eligibility criteria:
inclusion criteria: for all participants * age ≥ 18 years old * bmi ≤ 40 kg/m2 * able and willing to comply with the study procedures * written informed consent * participants with documented coronary artery disease * stable coronary artery disease on a stable medication regime. * healthy volunteers without known heart disease * low risk of coronary artery disease (cad) exclusion criteria: * history or risk of severe bradycardia (heart rate \< 50 beats per minute) not related to chronotropic drugs * known second- or third-degree atrio-ventricular block without pacemaker * atrial flutter or atrial fibrillation * dyspnea (nyha iii/iv), wheezing asthma or chronic obstructive pulmonary disease (copd) * coronary artery bypass graft (cabg) surgery within 60 days prior to screening or at any time after consent * percutaneous coronary intervention (pci) within 30 days prior to screening or at any time following consent * acute myocardial infarction or acute coronary syndrome within 60 days prior to screening or at any time following consent * recent use of dipyridamole, dipyridamole-containing medications (e.g. aggrenox) * known hypersensitivity to adenosine * breastfeeding or pregnancy * claustrophobia or inability to lie still in a supine position * unwillingness or inability to provide informed consent

Keywords: myocardial perfusion imaging myocardial blood flow pharmacologic stress agents carbon dioxide rubidium 82 radioisotope positron emission tomography
epo for postop delirium in elderly patients

Conditions: Postoperative Delirium

Summary: postoperative delirium is a common complication after surgery. the underlying pathophysiology of this complication is unclear, however neuroinflammation and oxidative stress secondary to surgery had shown to be the cause of postoperative cognitive dysfunction and delirium. erythropoietin represents non-erythropoietic effects of anti-inflammatory properties. the aims of this study were to determine the role of erythropoietin toward the development of postoperative delirium, in terms of changes in inflammatory reaction by affecting the innate immunity in elderly patients undergoing total joint arthroplasty surgery.


Eligibility criteria:
inclusion criteria: * age 65 years and older * patients scheduled for elective total knee arthroplasty, total hip arthroplasty exclusion criteria: * unable to communicate * cognitive impairment * unable to pre-screen delirium due to underlying central nervous system disease * history of hypersensitivity related to erythropoietin and other anesthesia-related drugs * history of myocardial infarction, pulmonary infarction, cerebral infarction, ischemic vascular disease, epilpesy, chronic liver disease, chronic kidney disease * uncontrolled high blood pressure * within one month of starting anti-hypertensive medication
fluorescein vs. imri in resection of malignant high grade glioma

Conditions: High Grade Malignant Neoplasm; Glioblastoma Multiforme; Anaplastic Astrocytoma

Summary: this study plans to learn more about if fluorescein with intraoperative magnetic resonance imaging (mri) is as good as intraoperative mri (imri) alone in detecting the presence of tumor tissue during surgery. both fluorescein and intraoperative mri have been studied and routinely used to aid the neurosurgeon in distinguishing normal brain from tumor, helping the neurosurgeon to safely resect more tumor tissue during surgery. this study will enroll patients with malignant high grade glioma who are going to have a surgery to remove their brain tumor. for half of the patients, fluorescein and intraoperative mri will be used together during surgery. for half of the patients, only intraoperative mri will be used during surgery. imri is used as final verification of complete, safe resection in both arms.

extent of surgical resection of malignant high grade glioma has been established as one of the most important predictors of overall survival and six-month progression free survival. unfortunately, it is often difficult in surgery to distinguish between tumor and normal brain. various technologies have been developed to help the surgeon more readily safely increase extent of resection in order to achieve an improved survival after glioblastoma resection. fluorescein has been used at some institutions for a number of years to improve visualization of high-grade gliomas enabling their better resection. intraoperative mri has also been developed with similar intent, allowing the patient to be imaged intraoperatively to determine extent of resection and any need for further resection prior to leaving the operating room. while there is some evidence these technologies improve extent of resection in comparison to historical controls, they have never been tested against each other in any prospective fashion. intraoperative mri has significant cost and significantly increases operative time. fluorescein is a very inexpensive injectable agent and, if as good at achieving gross total resection as intraoperative mri, would offer patients similar surgical outcomes with less anesthetic time and cost than intraoperative mri. this study aims to investigate the value of fluorescein or intraoperative mri in malignant glioma patients' extent of tumor resection in a prospectively randomized manner.

Eligibility criteria:
inclusion criteria: * presents with presumed or pathologically proven enhancing primary or secondary high grade glioma for surgical resection * eligible for gross total resection of enhancing component of tumor * karnofsy performance status \>/= 70% exclusion criteria: * presence of multi-focal disease * disease that crosses the mid-line * history of adverse reaction to flourescein * known ongoing pregnancy * inability to grant consent * contraindication to perform imri * contraindication to flourescein

Keywords: high grade glioma glioblastoma multiforme anaplastic astrocytoma flourescein flourescence-guided surgery intraoperative mri imri
the effect of alcohol on abca1 expression and lipid metabolism

Conditions: Type 2 Diabetes; Heart Disease

Summary: the purpose of this study is to investigate the effects of red wine on abca1 levels


Eligibility criteria:
inclusion criteria: * healthy participants * aged 18-65 years * free of overt coronary disease * bmi \< 35 * fasting plasma glucose \<6.1 mmol * unmedicated * no major illness exclusion criteria: * unable to give informed consent * smokers * participants with alcoholism
prevalence of fetal congenital anomalies among pregnant women attending university hospital

Conditions: Fetal Anomaly

Summary: congenital anomalies occur in 2-3% of births. they account for 20-30% of perinatal deaths. the aim is to assess the prevalence of fetal malformations in pregnant women attending university hospital

this prospective cohort study of 20225 pregnant women attended obstetrics department of beni-suef university hospital during period (january 2016 to january 2019). a full history taking was obtained according european surveillance of congenital anomalies euro-cat core data. all women underwent abdominal and transvaginal us (toshiba xario 200 unit): ▪ females presented early in first trimester were scheduled for routine first trimester scan in accordance with international society of ultrasound in obstetrics and gynecology guidelines. ▪ females presented early in second trimester were scheduled for a routine second trimester scan. ▪ females presented afterwards, had a routine ultrasound scan for fetal malformations.

Eligibility criteria:
inclusion criteria: * pregnancy exclusion criteria: * medical conditions, chronic drug intake.

Keywords: fetal anomalies
indego exoskeleton after sci

Conditions: Spinal Cord Injury

Summary: the purpose of this study is to assess the use of indego as a gait training tool for subjects with complete or incomplete paraplegia as a result of spinal cord injury (sci) who have preserved lower extremity function. it is hypothesized that subjects with complete or incomplete paraplegia who have preserved their lower extremity function will experience functional improvements after gait training with the indego exoskeleton. subjects will complete a total of fifteen (15) sessions which include a combination of the following; physical therapy evaluation, indego training, mid-way assessment, and post-assessment. the aim of this study is to measure the impact of gait training with the indego device on body structure, function, and participation. additionally it will assess the perceptions of physical therapists and subjects with sci on the effectiveness of gait training with the indego exoskeleton in subjects with preserved limited function.


Eligibility criteria:
inclusion criteria: * 18 years or older * height 5'1" to 6'3" (acceptable height may vary by a few inches depending on femur length) * weight 250 lbs or less * present with paraplegia resulting from a complete or incomplete (ais a, b, c, or d) spinal cord injury (\>1 year post-injury), with preserved le function * uses wheelchair as primary means of mobility in the community * able to ambulate 14 meters with assist of 2 people and no orthostasis. subjects may use any combination of stability aids and/or bracing. * medical clearance for weight bearing and locomotor training * bone density exams will be at the discretion of each sites' principle investigator * passive range of motion (prom) at shoulders, trunk, hips, knees and ankles within functional limits for safe gait and use of appropriate assistive device/stability aid * skin intact where interfaces with the indego device * modified ashworth scale 3 or less in bilateral les * blood pressure and heart rate within locomotor training guidelines * at rest: systolic 150 or less diastolic 90 or less and heart rate 105 or less * exercise: systolic 180 or less diastolic 105 or less and heart rate 145 or less exclusion criteria: * inability to meet all inclusion criteria * currently participating in physical therapy for gait training * joint contractures of the shoulders, trunk, hips knees or ankles deemed unsafe for locomotor training by pt and or md * edema that would put skin at risk for breakdown * modified ashworth spasticity of 4 * inability to achieve adequate fit of the indego device * pregnancy * colostomy bag

Keywords: paraplegia gait exoskeleton
functional outcomes after nerve sparing surgery for deep endometriosis

Conditions: Endometriosis

Summary: patients who underwent surgery for deep endometriosis were submitted to procedures aiming at sparing the pelvic autonomic nervous system. they were observed prospectively followed and interviewed in order to evaluate functional outcomes after surgery.

surgical tretament for deep endometriosis can produce lesions at the level of the pelvic autonomic system. before surgery and 3-12 months after the nerve-sparing surgical procedures, patients were assessed for urinary, sexual and fecal function, in order to evaluate whether sparing of the nerves during the intervention had a beneficial impact on post-operative pelvic function.

Eligibility criteria:
inclusion criteria: * deep endometriosis * surgical treatment * single surgeon exclusion criteria: * lost to follow-up * unwillingness to answer the interview

Keywords: surgery pelvic function
exercise and nutrition program in improving physical activity and dietary behavior in non-active, overweight, or obese latinas

Conditions: Obesity; Overweight

Summary: this pilot clinical trial studies how well an evidence-based exercise and nutrition program adapted for latinas works in improving physical activity and dietary behavior in non-active, overweight, or obese rural latinas. an exercise and nutrition program may reduce the risk for developing certain cancers, obesity, and chronic health conditions in latinas who are non-active, overweight, or obese.

primary objectives: i. adapt an effective evidence-based exercise and nutrition program to meet the needs of rural latinas. ii. implement the adapted program in a rural latina population. iii. evaluate feasibility and potential to improve physical activity and dietary behavior of the adapted program in a rural latina population. outline: phase i: create a community advisory board to adapt strong women healthy hearts program (swhhp) using feedback on the existing swhhp from latinas residing in the community. phase ii: conduct a small pilot study to assess effectiveness of the adapted program (one group pre-post design, with data collected at three time points). intervention group: participants undergo instructor-led exercise and nutrition education classes for 60 minutes each twice a week for 12 weeks.

Eligibility criteria:
inclusion criteria: * phase i: * bilingual latina * live in the community * phase ii: * latina * currently non-active (exercise two days or less per week) * overweight or obese (body mass index \[bmi\] of 24 or greater) exclusion criteria: * a medical condition that precludes moderate-vigorous physical activity as determined by health care provider * pregnancy