Kornimate/medical-research-clean huggingface dataset:
prevention of microvascular complications in overweight diabetics with surgery or best medicine

Conditions: Diabetic Kidney Disease

Summary: background: diabetic kidney disease (dkd) is chronic and often progresses to kidney failure,heart disease and premature death. unfortunately, the best medical therapies available for dkd today are ultimately unable to prevent its progression, especially in obese patients.surgical rerouting of food within the gut with a gastric bypass operation (rygb), improves diabetes and some of its complications. the investigators propose to investigate whether rygb in combination with best medical therapy in patients with dkd and obesity prevent further deterioration of kidney function over a 3 years follow up period. study design: this is an international collaboration with leading centres in sweden and switzerland in which100 obese type 2 diabetic patients with established dkd will volunteer to be randomly assigned to receive best medical therapy with rygb or best medical therapy without surgery. participants will be 18-65 years with type 2 diabetes and impaired kidney function. yearly measurements of kidney function will then be done over a period of 3 years as a primary outcome to determine whether differences in dkd can be detectable. the study will also examine and compare a) safety of the interventions, b) the health economic impact on direct healthcare costs and quality of life in patients as well as c) the value of a new marker of dkd in determining which patients are most likely to benefit from surgery. overall the study will strengthen the evidence base guiding clinical decisions about the usefulness of rygb as an add on therapy to best medical therapy in stopping progressive dkd in patients with obesity and diabetes.


Eligibility criteria:
inclusion criteria: * • bmi 28 - 35 kg/m2 * age: 18-65 years, with t2dm * estimated glomerular filtration rate (egfr; by mdrd) between 30 and 60ml/min/1.73m2 * urine albumin creatinine ratio (acr) of at least 30mg/g (microalbuminuria) in first void urine on two separate days. exclusion criteria: * • type 1 diabetes or a positive gad antibody test * known renal artery stenosis * renal impairment for reasons unrelated to diabetes * suspicion of glomerulonephritis as determined by urine sediment (\>10 erythrocytes/visual field) * post-renal obstruction diagnosed by ultrasound * severe retinopathy (defined as high-risk proliferative diabetic retinopathy and severe visual loss according to the "early treatment diabetic retinopathy study severity scale") * severe dkd (ckd 4 or 5, requirement of renal replacement therapy such as dialysis or kidney transplantation) * severe neuropathy (peripheral neuropathy stage 3) * unacceptably high risk for general anesthesia * prior extensive intra-abdominal surgery making laparoscopy complicated * myocardial infarction, cerebrovascular accident, transient ischemic attack, coronary-artery bypass grafting or percutaneous transluminal coronary angioplasty within the previous 6 months * cardiac failure (nyha stage \> 2) * inability to stop smoking prior to inclusion * pregnancy or breast feeding
regional treatment flow and prognosis oftraumatic thoracic aortic injuries：a multi-center retrospective analysis in zhejiang province during 11 years

Conditions: Severe Trauma; Blunt Thoracic Aortic Injury; Interventional Therapy; Treatment Protocal

Summary: using keywords (main) artery dissection aneurysm (main) artery haematoma (main) to diagnose x-ray imaging reports and medical record home page is a search, check the unit 11 hospitals in zhejiang province during the year aortic injury clinical data of 11 years, through the electronic questionnaire to fill in the form of information, information of diagnosis and treatment of the basic information for the patient injury mechanism and so on carries on the statistical analysis. basic information includes gender, age, history of hypertension. injury information includes injury mechanism information and trauma information. injury mechanism refers to injuries caused by car accidents, high falls and other causes. injury information includes diagnosis, injury severity score, glasgow coma index, and stanford classification of aortic injury. the information of diagnosis and treatment includes the method of treatment, the reason for referral, the time of definitive treatment and the prognosis. the method of treatment is divided into the first treatment group and the referral group. the first treatment group refers to the patients admitted by the hospital for the first time, and the referral group refers to the patients transferred from other hospitals. the reasons for referral include: the suggestion of the hospital after comprehensive consideration, the lack of diagnosis and treatment qualification of the hospital, the subjective will of the patient's family members. deterministic treatment time refers to the time from injury to imaging examination and the time from injury to surgery and other data to be statistically analyzed.


Eligibility criteria:
inclusion criteria: * diagnosis of trauma patients with aortic dissection (aortic aneurysm) (aortic hematoma) exclusion criteria: * patients with primary aortic dissection, limb pseudoaneurysm, non-aortic associated hematoma, etc.incomplete or lost data, patients refused
preoperative administration of tamsulosin for prevention of post operative urinary retention in males undergoing elective inguinal hernia repair

Conditions: Postoperative Urinary Retention

Summary: double blinded, randomized controlled prospective study looking at 2 preoperative doses of tamsulosin an alpha-adrenergic blocker in preventing post-operative urinary retention. a previous study was conducted called "effectiveness of tamsulosin inprevention of postoperative urinary retention: a randomized double-blind-placebo controlled study" this study involved a tertiary care center involving mostly urological surgical procedures. we look to specifically look at inguinal hernia surgeries in males. the aim of this study is to compare the prophylactic effect of tamsulosin with placebo on postoperative urinary retention. the drug is fda approved for benign prostatic hypertrophy and urinary retention. it is on formulary at genesys. currently there is no standard procedure of prophylactic tamsulosin for urinary retention. most often post operative patients are given tamsulosin to augment smooth muscle relaxation and spontaneous voiding if the patient is having urinary retention post operatively. we often straight catheterize patients once and start tamsulosin with the goal of avoiding urinary retention and future straight catheterizations or placement of foley catheters


Eligibility criteria:
inclusion criteria: * healthy males, who are not taking tamsulosin regularly who are undergoing elective inguinal hernia repair (laparoscopic, open, and robotic assisted) exclusion criteria: * patients who are already taking tamsulosin, terazosin (alpha blocker treatement for bph) , finasteride, dutasteride ( both 5 alpha reductase inhibitors), sulfa allergy, and lactose allergy
remote physical and cognitive training effects in older adults at increased risk of clinical-functional vulnerability

Conditions: Aging; Functional Status

Summary: this study is a randomized, single-blind, parallel, controlled, superiority trial. the main objective is to verify the chronic effects of a remote 12-week low-intensity physical training program alone or in combination with cognitive training on functional, cognitive, and occupational capacity, as well as on the self-reported quality of life.

participants over 60 years of age at increased risk of clinical-functional vulnerability will be recruited in the city of pelotas/rs, brazil and randomized to two different arms. the intervention group will receive low-intensity physical training combined with a cognitive training program using neurobic exercises, whereas the active comparator group will only receive the low-intensity physical training program. participants from both groups will perform their training sessions remotely for a total of 12 weeks. outcomes of interest include handgrip strength, functional and cognitive capacity, occupational performance, clinical-functional vulnerability level, self-reported quality of life, and depressive symptoms, which will be assessed in a pre-post fashion. the study hypothesis is that remote low-intensity physical training combined with cognitive training will result in additional benefits to those of low-intensity physical training alone in the physical and cognitive capacity outcomes, and as a consequence, improved quality of life, occupational performance, decreased level of clinical-functional vulnerability and symptoms of depression will be observed.

Eligibility criteria:
inclusion criteria: * 60 years of age or older, * mmse score equal to or greater than 19 points, * elementary school education complete or over, * sedentary (no current or previous participation in structured exercise (\>1x/week) in the past 6 months), * increased risk of clinical-functional vulnerability, as determined by the clinical-functional vulnerability index-20 (ivcf-20) questionnaire. * access to a cell phone or notebook with internet access, * resident in the city of pelotas, brazil. exclusion criteria: * individuals who have been affected by covid-19, * not retired, or those retired individuals who maintained continuous or sporadic work activities, * neuromuscular deficits or any medical diagnosis that prevents the individuals from performing physical exercises, * individuals with decompensated or untreated blood pressure (\> than 140x90 mmhg) and, * individuals with visual problems that prevent them from watching the training sessions on their cell phone or notebook screen.

Keywords: exercise cognitive training aging frailty occupational performance
kids + adolescents research learning on tablet teaching aachen

Conditions: Chronic Inflammatory Intestinal Diseases (CED)

Summary: the aim of this study plan is to implement a tablet quiz in the german-speaking area, in order to test the specific knowledge about chronic inflammatory intestinal diseases (ced) concerning pediatric patients in the context of an age-appropriated and interesting digital playing environment, and to process knowledge gaps at the subsequent doctor's contact. the quiz should be combined with a game and can be performed by the patients, while they wait in the ambulance for their doctor's appointment. the investigator's goals are to grasp playfully gaps in the ced knowledge regarding the patients and to use these in the following consulting hour for clarification and advice in line with a better understanding of the disease. with this, the specific knowledge, the understanding of the disease, the therapeutic adherence, and the self-efficacy should improve the self-responsible handling of the disease. in particular, the willingness of the group of older teenagers to transit into the adult medicine can be collected and processed. the investigators want to check the efficacy in a randomized, controlled study with two groups of 15 pediatric ced patients. the hypothesis is that the additional play of the tablet-ced-quiz and the individualized advice have a positive impact on the ced knowledge, the disease activity, the ced-related life quality and the willingness of teenagers for transition.


Eligibility criteria:
inclusion criteria: * female and male children and young adults between 8-21 years * diagnosis morbus crohn, colitis ulcerosa or colitis indeterminate * clarification and signed informed consent form * patients must know how to write and read in german * patients must be able to play independently on the tablet exclusion criteria: * age \ 21 years * illiteracy * mental or psychomotor disability
a study of avastin with chemotherapy for treatment of metastatic or advanced and unresectable colorectal adenocarcinoma

Conditions: Colorectal Cancer

Summary: this is an observational study designed to follow patients with metastatic or locally advanced and unresectable colorectal cancer who are receiving avastin in combination with chemotherapy and whose cancer has been either previously untreated or treated \<=4 months prior to enrollment.


Eligibility criteria:
inclusion criteria: * signed informed consent and authorization document * metastatic, or locally advanced and unresectable, adenocarcinoma of the colon or rectum * receiving avastin as a component of first-line chemotherapy * first-line chemotherapy plus avastin initiated \<=4 months prior to enrollment in the study exclusion criteria: * patients who have contraindications for treatment with avastin (see the avastin package insert) or who would incur excessive risks with avastin treatment are ineligible for this study.
coronary hemodynamics by coronary angiography

Conditions: Coronary Artery Disease

Summary: study for developing techniques to evaluate coronary artery hemodynamic profiles by conventional angiography without more dedicated measuring devices.

\* methods: compare timi frame count, coronary clearance frame count in baseline/hyperemic coronary angiography with ffr, cfr, imr and derive correlation, receiver-operating characteristic curve to find new tools estimating coronary hemodynamics by conventional angiography only. a timi frame count is measured by counting the angiographic image cine frames during a head of radiocontrast column runs from the entry of left anterior descending artery (lad) to the distal end. a coronary clearance frame count is measured by counting the angiographic image cine frames during a tail of radiocontrast column runs from the entry of lad to the distal end. baseline angiography is performed without any stimulation and hyperemic angiography is performed after intracoronary injection of adenosine 300ug or nicorandiol 2mg. inclusion criteria * patient who underwent physiologic study using a pressure wire for intermediate coronary lesion after coronary angiography exclusion criteria * st elevation myocardial infarction * cardiogenic shock * congestive heart failure with pulmonary edema * lvef \< 30% * previous history of coronary revascularization * chronic total occlusion * 3 vessel disease * target lesion at distal segments or branches

Eligibility criteria:
inclusion criteria * patient who underwent physiologic study using a pressure wire for intermediate coronary lesion after coronary angiography exclusion criteria * st elevation myocardial infarction * cardiogenic shock * congestive heart failure with pulmonary edema * lvef \< 30% * previous history of coronary revascularization * chronic total occlusion * 3 vessel disease * target lesion at distal segments or branches

Keywords: coronary artery disease index of microcirculatory resistance timi frame count fractional flow reserve coronary flow reserve
neuromuscular electrical stimulation for the treatment of diabetic neuropathy

Conditions: Diabetic Peripheral Neuropathy; Diabetic Neuropathies; Diabetic Polyneuropathy; Diabetic Complication

Summary: diabetic neuropathy (dn) is the most common complication of diabetes, affecting almost 50% of people with diabetes over the course of their lives. symptoms vary from numbness to burning, aching and hypersensitivity in the lower limbs, indicative of sensory nerve loss. motor neurons can also be affected, leading to muscle weakness and mobility issues, thus preventing patients from engaging in daily routines. further sequelae include foot ulceration and charcot neuroarthropathy, which are risk factors for lower limb amputation and mortality. in the united kingdom, the annual costs of dn alone exceed £300 million, with further complications expected to cost an additional £1 billion. currently, management strategies for dn focus on prevention and pain management. neuromuscular electrical stimulation (nmes) is a novel nonpharmacological intervention for people with dn. nmes is the application of electrical impulses which are of sufficiency intensity to improve artificial contraction of the muscle tissue and may help with dn by improving nerve conductivity through direct stimulation of the nerves.


Eligibility criteria:
inclusion criteria * aged ≥18 (no upper limit) * diagnosis of type 1 or type 2 diabetes based on world health organisation (who) definition * diagnosis of diabetic neuropathy based on validated screening questionnaire michigan neuropathy screening instrument score of ≥4 * access to internet at home to use the revitive app (study smartphones will be provided) exclusion criteria * lacks capacity to provide informed consent * pregnant * implanted electronic, cardiac or defibrillator device * other cause of peripheral neuropathy * current foot ulceration * severe vascular disease requiring invasive intervention * being treated for, or have the symptoms of, an existing deep vein thrombosis (dvt) * used a neuromuscular electrical stimulation (nmes) device within 1 year of randomisation

Keywords: neuromuscular electrical stimulation nerve conduction
conversion from standard phosphate binder therapy to fosrenol® (lanthanum carbonate) in chronic kidney disease stage 5

Conditions: Kidney Diseases

Summary: the main aim of this research study is to see if giving fosrenol®, a chewable tablet, to patients on haemodialysis works as well as other treatments currently used to lower blood phosphorus levels.


Eligibility criteria:
inclusion criteria: * male or female subjects greater than or equal to 18 years of age receiving a stable regimen of haemodialysis for chronic kidney disease (ckd) stage 5 (defined as haemodialysis two or three times per week for at least two months prior to screening). * females of child bearing potential (focp) must be non-pregnant, non-lactating, have a negative serum beta human chorionic gonadotropin (hcg) test, and agree to comply with any applicable contraceptive requirements of the protocol. * subjects on a stable phosphate binder dose (defined as no change in medication or dosage for at least the one month prior to screening) with a serum phosphorus level between greater than 1.78 and less than or equal to 2.43 mmol/l (5.5 and 7.5 mg/dl). exclusion criteria: * subjects with a corrected serum calcium level less than 2.1 mmol/l (8.5 mg/dl). * subjects with an intact parathyroid hormone (ipth) level greater than 500 pg/ml, or a history of previous parathyroidectomy within 12 months of screening. * subjects with any significant bowel obstruction, active inflammatory bowel disease, gastrointestinal (gi) motility disorders, abnormal or irregular bowel motion, or a history of major gi surgery within the last 6 months will be excluded. * subjects receiving aluminium, magnesium, or combination therapy other than sevelamer hydrogen chloride (hcl) and calcium as a phosphate binder at the time of screening will be excluded.

Keywords: hyperphosphataemia
opioid-free pain control regimen following robotic radical prostatectomy

Conditions: Pain Management; Opioid Use; Prostate Cancer

Summary: the objective of this study is to conduct a randomized clinical trial to evaluate an opioid versus an opioid-free pathway of perioperative use of ketamine, ketorolac, and iv acetaminophen followed by the postoperative use of ketorolac, and oral acetaminophen for pain associated with robotic-assisted radical prostatectomy. escalation to use of opioid treatment for the opioid-free constituents will be available if needed.

primary objective(s): compare the effectiveness of opioid and opioid-free pathways in treating post-surgical pain following robotic-assisted radical prostatectomy. secondary objective(s) * to determine the opioid usage in the opioid and non-opioid group from the start of the pain treatment administration until discharge in patients following robotic-assisted radical prostatectomy. * determine and analyze preoperative and perioperative measures for opioid and non-opioid groups in patients following robotic-assisted radical prostatectomy. * examine and evaluate adverse effects of opioid and opioid-free pathways in patients following robotic-assisted radical prostatectomy using a standardized scale for common post-operative adverse effects including bodily functions.

Eligibility criteria:
inclusion criteria: * all men ages 40-75 undergoing robot assisted radical prostatectomy (rarp) with or without bilateral lymph node dissection with low, intermediate, or high-risk prostate cancer. * patients must have normal organ function as defined below: * ast(sgot)/alt(sgpt) ≤ 2.5 x institutional upper limit of normal * creatinine clearance ≥ 30 ml/min/1.73 m2 for patients with creatinine levels above institutional normal. * ability to understand and the willingness to sign an irb-approved informed consent document (either directly or via a legally authorized representative). exclusion criteria: * participants with known allergies to any medication involved in the study or its excipients, * participants who are incarcerated persons, * participants with a chronic narcotic dependence, * participants with any prescription for narcotics in the past 30 days, * participants who have had only major pelvic or abdominal surgeries as bowel, rectal colon, bladder, liver, gallbladder, kidney, etc. in the past 6 months. * patients may not be receiving any other investigational agents. * patients with known metastatic disease or brain metastases are excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events. * uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.