Kornimate/medical-research-clean huggingface dataset:
trial in cardiac resynchronization therapy (crt): right ventricular apex versus high posterior septum

Conditions: Heart Failure

Summary: in heart failure patients we hypothesised that right ventricular high posterior septum is superior to right ventricular apex in crt and ddd pacemaker. in two separate trials we prospectively randomized the right ventricular lead placement to find evidence of differences in heart failure symptoms (nyha-class), 6 minute hall walk and echocardiographic measurements of reverse remodelling and dyssynchrony.


Eligibility criteria:
inclusion criteria: * crt: * lvef \< 35% * lvedd \> 5.5 cm * nyha 3-4 * qrs \> 120 ms * optimal medical treatment * both crt-pacemakers (crt-p) and crt combined with icd (crt-d) exclusion criteria: * not fulfilling inclusion criteria or not written consensus

Keywords: pacemaker treatment in heart failure cardiac resynchronization therapy ddd pacemakers
assessing the diagnostic accuracy of corrected flow time (ftc) and pleth variability index (pvi) as predictors of fluid responsiveness in patients in the prone position using the jackson table

Conditions: Elective Posterior Lumbar Spinal Fusion for Spinal Stenosis; Spondylolisthesis; Spinal Fractures; Scoliosis or Tumors

Summary: appropriate fluid management is an important part of anesthesia in patients undergoing surgery, and several dynamic indices have been suggested to have high predictability for fluid responsiveness in patients receiving mechanical ventilation. among various surgical positions, the prone position is known to cause unique physiologic and hemodynamic changes and affect the predictability and cut-off values of dynamic indices for fluid responsiveness. a previous study reported that pulse pressure variation (ppv) and corrected flow time were able to predict fluid responsiveness with relatively high accuracy in patients undergoing spine surgery in the prone position using a wilson frame. however, the jackson frame is known to have less effects on the cardiovascular system compared to the wilson frame, and therefore may be physiologically more appropriate in patients undergoing surgery in the prone position. the pleth variability index (pvi) is a dynamic index that can be monitored non-invasively in patients under mechanical ventilation. the present study aims evaluate the validity of ppv and pleth variability index (pvi) as predictors of fluid responsiveness in the supine and prone positions in patients undergoing posterior lumbar spinal fusion using the jackson table.


Eligibility criteria:
inclusion criteria: 1. patients between the age of 19 and 75, scheduled for spine surgery under general anesthesia using the jackson table exclusion criteria: 1. patient refusal 2. patients that are not normal sinus rhythm on preoperative ecg 3. patients with moderate\~severe cardiac valve disease 4. patients with an ejection fraction under 50% 5. significant lung disease 6. obesity (bmi\>35kg/m2) 7. patients with contraindications to esophageal doppler probe insertion 8. illiterate patients or foreigners

Keywords: fluid responsiveness corrected flow time pleth variability index prone position
effect of cutting blades for total knee arthroplasty on implant migration

Conditions: Osteoarthritis

Summary: there have been considerable efforts to control rising health care costs. one of the more recent developments is the practice of reprocessing single use medical devices. this practice has been shown to provide considerable savings for health care payers. medical devices have been reprocessed in a number of different medical fields including orthopaedic surgery. one of the devices that has been reprocessed are the precision saw blades from stryker inc. these saw blades are used during total knee arthroplasty (tka) surgery. the reprocessed precision saw blades are health canada approved and are available at capital health. beyond the benefits to the environment and cost savings, the investigators do not know if the reprocessed saw blades work better, work worse or the same as non reprocessed saw blades. this study is designed to determine if the reprocessed saw blades used during a tka work as well as a new saw blade.


Eligibility criteria:
inclusion criteria: 1. symptomatic osteoarthritis of the knee indicating surgical intervention 2. between the ages of 21 and 80 inclusive 3. ability to give informed consent exclusion criteria: 1. significant co-morbidity affecting ability to ambulate 2. flexion contracture greater than 15° 3. extension lag greater than 10° 4. tibial subluxation greater than 10 mm on standing ap radiograph 5. prior arthroplasty, patellectomy or osteotomy with the affected knee 6. lateral or medial collateral ligament instability (\> 10° varus/valgus) 7. leg length discrepancy greater than 10 mm 8. bone quality precluding uncemented fixation 9. pregnancy 10. active or prior infection 11. morbid obesity (bmi \> 40) 12. medical condition precluding major surgery 13. severe osteoporosis or osteopenia 14. neuromuscular impairment
mowi amulet mobile health technology validation

Conditions: Obesity

Summary: this study aims to adapt a mobile health device (amulet) for use in older adults. it is the second in a series of four research studies whose overarching goal is to conduct a program of pilot research aimed at developing and evaluating a technology-assisted wellness intervention for older adults with obesity who may or may not live in a rural area.


Eligibility criteria:
inclusion criteria: * age 18-64; and age≥65 years * body mass index (bmi) ≥ 30kg/m\^2 for those aged≥65 years * waist circumference ≥88cm in females or ≥102cm in male for those aged≥65 years exclusion criteria for those aged ≥65 years: * severe mental or life-threatening illness * dementia * substance use * history of bariatric surgery * suicidal ideation * unable to perform measures * reside in nursing home

Keywords: elderly telemedicine obesity rural health health promotion
treatment for anxiety in children

Conditions: Obsessive-Compulsive Disorder; Anxiety Disorders; Generalized Anxiety Disorder; Social Phobia; Separation Anxiety

Summary: the purpose of this study is to see if it is effective to treat children with anxiety disorders with fluvoxamine. fluvoxamine has been successfully used to treat obsessive-compulsive disorder (ocd) in adults and children. anxiety disorders other than ocd, such as generalized anxiety disorder, social phobia, or separation anxiety, are very common in youth and are not always responsive to behavioral therapies alone. these disorders may respond to fluvoxamine. a child will be evaluated for 3 weeks before he/she is assigned randomly (like tossing a coin) to receive either fluvoxamine or an inactive placebo for 8 weeks. after this double-blind phase (neither the child/parents nor the doctor know which treatment is being given), the child will have the option of continuing treatment during a 4-month open-label extension period (both the child/parents and the doctor know which the child is receiving). a child may be eligible for this study if he/she: is 6 to 17 years old and has been diagnosed with an anxiety disorder (i.e., generalized anxiety disorder, social phobia, or separation anxiety).

to evaluate fluvoxamine in the treatment of children and adolescents with anxiety disorders. fluvoxamine is a serotonin reuptake inhibitor that is fda-approved for the treatment of obsessive-compulsive disorder (ocd) in adults and children. anxiety disorders other than ocd are very common in youth and are not always responsive to psychosocial therapies. fluvoxamine is an alternative treatment. after a 3-week period of evaluation, patients meeting study entry criteria are randomized to receive either fluvoxamine or placebo for 8 weeks. after this double-blind phase, patients can enter a 4-month open-label extension.

Eligibility criteria:
- patients must have: dsm -iv diagnosis of generalized anxiety disorder, social phobia, or separation anxiety.

Keywords: adolescence anxiety disorders child female fluvoxamine human male serotonin uptake inhibitors anxiety disorders -- *drug therapy fluvoxamine -- *therapeutic use serotonin uptake inhibitors -- *therapeutic use
ace inhibition and novel cardiovascular risk factors

Conditions: Cardiovascular Diseases; Heart Diseases; Hypertension

Summary: to determine the effects of an angiotensin converting enzyme inhibitor (ace inhibitor), fosinopril, on multiple blood markers in 286 adults at high risk for cardiovascular disease.

background: angiotensin converting enzyme inhibitors (ace inhibitors) may prevent cardiovascular events in high risk persons and improve skeletal muscle function in heart failure patients by means of mechanisms that are independent of blood pressure changes. however, there is limited knowledge of all the mechanisms underlying the therapeutic benefits of ace inhibition. ace inhibitors may favorably modify markers of fibrinolysis, inflammation, endothelial function, and extracellular tissue remodeling, all of which are associated with atherosclerosis and cardiovascular disease. but, clinical trial evidence on these effects is limited. in addition, polymorphisms of the ace, angiotensinogen, pai-1 and il-6 genes may modify the therapeutic response to ace inhibitors. design narrative: this was a double-blind cross-over, randomized, placebo controlled trial in 286 persons with high cardiovascular risk to compare the effects of 6 months of treatment with fosinopril and 6 months with placebo on the following primary outcomes: plasma plasminogen activator inhibitor-1 (pai-1) antigen, c- reactive protein (crp), interleukin-6 (il-6) and soluble vascular cell adhesion molecule-1 (svcam-1). the secondary objectives were (a) to assess the effects of fosinopril on il-6/il-6 soluble receptor ratio, pai-1 activity, tissue plasminogen activator (tpa) antigen, fibrinogen, endothelin-1, tnf-alpha, soluble intercellular cell adhesion molecule-1 (sicam-1), e-selectin, matrix metalloproteinase-1 (mmp-1) and tissue inhibitor of metalloproteinase-1 (timp-1); and (b) to explore the effects of ace, angiotensinogen, pai-1, and il-6 gene polymorphisms on these biomarkers, and test the interaction of the gene polymorphisms with the effects of fosinopril. the study had sufficient power to detect small changes in several biomarkers compared to placebo. the assessment of these biological mechanisms had clinical relevance for identifying the patients who may benefit the most from ace inhibition. while the focus of the study was on novel cardiovascular risk factors, the results may also have future implications for developing new indications for ace inhibitors, such as, for example, the prevention of age-related muscle wasting and physical disabilities in older persons, for which inflammation may be a causal factor.

Eligibility criteria:
no eligibility criteria
epidemiological study of vulvovaginal candidiases strain types and risk factors among gynecological outpatients in china

Conditions: Vulvovaginal Candidiases

Summary: we has proposed to conduct a national epidemiological study on the pathogenic strains and high risk factors of vulvovaginal candidiasis in china , and conduct drug resistance analysis.

vulvovaginal candidiasis is a mucosal infectious disease, which rarely occurs fatal infection, but has high recurrence rate. vulvovaginal candidiasis often leads to decreased life quality and serious economic burden. however, we known little about the pathogenesis of vulvovaginal candidiasis. so better diagnosis and treatment methods are needed to decrease the impact on women's health. in 2017, the national vulvovaginal candidiasis epidemiological survey led by professor liao showed that 543 strains of fungi were isolated from different patients from 12 hospitals in 10 cities in china, of which recurrence vulvovaginal candidiasis strains accounted for 15.7%. the most common pathogenic strain was candida albicans (460 species, 84.71%), and the most common non-albicans was candida glabra (47 species, 8.66%). in addition, 92 isolates (20.4%) belonged to the new branch endemic to north china. vaginal symptoms of vulvovaginal candidiasis caused by non-albicans are usually milder compared to vulvovaginal candidiasis caused by candida albicans. however, inherent resistance to azoles, as well as acquired resistance mechanisms, can complicate the treatment of non-albicans and often requires a long-term antifungal treatment or other treatments to clear non-albicans. given that the resistance rate of different types of candida to antifungal drugs changes over time, common antifungal drugs have selective induction of resistance to fungi, and fungi have cross-induction of resistance to antifungal drugs, it is very important to evaluate the distribution and resistance of candida species in a long-term . accurate and effective acquisition of candida epidemiological data to understand the recent status and drug resistance of candida infection can effectively guide clinical treatment to improve the therapy, and play a very important role in clinical diagnosis and treatment. therefore, professor liao has proposed to conduct a national epidemiological study on the pathogenic strains and high risk factors of vulvovaginal candidiasis in china once again, and conduct drug resistance analysis, in order to guide clinicians to better vulvovaginal candidiasis treatment.

Eligibility criteria:
inclusion criteria: 1. outpatients of gynecology 2. age≧18 years 3. signed informed consent form voluntarily 4. with diagnosis and symptomatology of vulvovaginal candidiasis (all types of vulvovaginal candidiasis can be included) 5. history of sexual life exclusion criteria: 1. antifungal medication was used within 7 days (oral or topical) 2. with contraindications of vaginal sampling 3. other conditions deemed unsuitable for inclusion by clinicians
allogenic stem cell therapy in patients with acute burn

Conditions: Burns

Summary: burn trauma,especially extensive ones, remains a life-threatening local and general inflammatory condition destroying the skin and underlying tissues, and resulting in serious sequelae. remarkable progress has been achieved during last 30 years，stem cell therapy plays an important role in this progress. human umbilical cord mesenchymal stem cells (hucmscs) and human cord blood mononuclear cells (hcbmncs) have been shown to have the ability to modulate the immune response and enhance angiogenesis, suggesting the novel and promising therapeutic strategy for burn. in this study, the safety and efficacy of hucmscs and hcbmncs transplantation will be evaluated in patients with acute burn.

to investigate the safety and efficacy of human cord blood mononuclear cells and human umbilical cord mesenchymal stem cells transplantation in patients of acute, moderate-severe, full-thickness burn.

Eligibility criteria:
inclusion criteria: * between age 18- 65 years, both gender. * diagnosed with acute, moderate-severe, full-thickness burn: burn occurring within the 72 hours prior to administration. tbsa 20-55%, third degree wounds surface area \< 19 % ; * willing to sign the informed consent form. exclusion criteria: * all other burns except thermal origin. * chronically malnourished, poor medical condition or shock * systemic inflammatory response syndrome (sirs) or septicopyemia * moderate-severe inhalation injury airways to lung * hiv+ * autoimmune disease, e.g. lupus erythematosus, multiple sclerosis. * severe pulmonary and hematological disease, malignancy or hypo-immunity. * currently undertaking other treatment that may affect the safety/efficacy of stem cells. * pregnancy or lactation * enrollment in other trials in the last 3 months. * other criteria the investigator consider improper for inclusion.

Keywords: extensive burn human cord blood mononuclear cells human umbilical cord mesenchymal stem cells
endoscopic stomach and pouch reduction in patients with weight regain following roux-en-y bypass surgery

Conditions: Obesity

Summary: the roux-en-y gastric bypass procedure is the most commonly performed bariatric procedure in the united states. despite initial weight loss, some patients experience weight regain that may be related to an increase in the size of the gastric pouch and/or stoma. a second surgical procedure to reduce the size of the pouch and/or stoma is typically associated with a higher risk of death or complications than the original gastric bypass procedure. this study will evaluate a less invasive, endolumenal alternative to pouch and stoma revision as a means of producing weight loss in patients who have regained weight following gastric bypass.


Eligibility criteria:
inclusion criteria: * 18 yrs of age or older and \< 65 yrs of age * at least 2 yrs post-roux-en-y gastric bypass surgery * initially achieved at least 50% weight loss * at enrollment, has regain at least 15% of weight loss * bmi 40 or greater or 35 or greater with one or more co-morbidities * stoma diameter at least 20 mm * completes successful nutritional screening * is a candidate for a surgical revision procedure * is a reasonable risk to undergo general anesthesia * completes successful cardiopulmonary evaluation * asa classification of less than or equal to iii * able to provide written consent * able to return for protocol-specified evaluations exclusion criteria: * esophageal stricture or other anatomy/condition that precludes passage of endolumenal instruments * previous bariatric revision procedure * has another causal factor for weight regain other than stoma or pouch dilatation * non-mobile or has significant impairment of mobility that will limit compliance with post-op exercise program
influence of preoperative fear on pain and postoperative outcomes

Conditions: Fear; Pain Management; Anxiety; Complications of Surgical Procedures or Medical Care

Summary: fear of anesthesia plays a crucial role in the perioperative setting and can negatively affect recovery. the main objective is to assess the relationship between fear of anesthesia, surgeries, and hospitals and poorer postoperative pain control in patients undergoing scheduled surgery, as well as to relate preoperative anxiety to postoperative analgesic assessment in this population. this is a prospective observational study including all patients scheduled for surger between january 20 and may 30, 2025

fear is a response that arises in the face of immediate threats, such as medical procedures, while anxiety is related to uncertainty about treatment and prognosis. these factors can negatively affect recovery. assessing anxiety levels using specific tools may be essential to predict clinical outcomes and facilitate patient recovery after surgery. this prospective observational study will assess the relationship between fear of anesthesia, surgeries, and hospitals and poorer postoperative pain control in patients undergoing scheduled surgery. it will also relate preoperative anxiety to postoperative analgesic assessment in this population. disease or disorder under study: fear of anesthesia and postoperative pain control using two preoperative questionnaires. patients will be followed up until discharge to assess postoperative pain and postoperative outcomes. 103 patients scheduled for surgery between january 20 and may 30, 2025 will be included.

Eligibility criteria:
inclusion criteria: * all patients older than 18 years old scheduled for surgery with admission during the study period will be included. * verbal and written informed consent. exclusion criteria: * minors * cognitive impairment * patients not being able to understand and respond to preoperative questionnaires * patients not being able to respond to postoperative pain assessment * patients not giving informed consent.

Keywords: preoperative fear postoperative pain postoperative outcomes preoperative anxiety
efficacy of naltrexone treatment as augmentation to ssri in ocd patients

Conditions: Obsessive Compulsive Disorder

Summary: assessing the efficacy of naltrexone as augmentation to ssri in patients with ocd


Eligibility criteria:
inclusion criteria: * diagnosis of ocd * treatment with ssri for at least 10 weeks with no response exclusion criteria: * suffering from any medical condition * treatment with opiates * chronic use of drugs * hepatitis or other liver related diseases * incapability to sign an informed consent
fibromyalgia and circadian blood pressure

Conditions: Blood Pressure

Summary: fibromyalgia syndrome (fms) is a chronic and multicomponent illness with unknown etiology and is considered the most frequent cause of diffuse chronic musculoskeletal pain. there is little evidence to confirm if the condition is fully improved after a specific treatment program. thus a multifactorial understanding of the pathology is crucial to propose new alternative treatments. in this regard, an alteration in circadian blood pressure and persistent nocturnal sympathetic hyperactivity have been shown in patients suffering from fibromyalgia syndrome, leading to malfunctioning in the autonomic nervous system. this is a common pathogenesis shared also by patients with non-dipping blood pressure pattern, which has been closely associated with cardiovascular morbidity. finally, a significant relationship between fibromyalgia syndrome and non-dipping blood pressure pattern has been shown. therefore, alterations in circadian blood pressure appear as an additional risk factor in patients with fibromyalgia syndrome, and treatments focus on recovering such blood pressure pattern may be indicated.

studying variations of blood pressure is a way of assessing the master circadian clock, through the diurnal/nocturnal bp ratio. when alteration of the circadian rhythm appears, neurohumoral factors that affect autonomic nervous and cardiovascular systems are affected, which presents persistent changes in the blood pressure pattern. these alterations caused by a disturbed circadian rhythm could contribute to the pathogenesis of chronic disorders in general and especially to fibromyalgia syndrome. the aim of the study is to analyze changes in blood pressure and central sensitisation (pain pressure threshold) after a whole-body photobiomodulation treatment in patients suffering from fibromyalgia syndrome, as well as in pain, quality of life and autonomic symptoms. furthermore, to study the level of association between blood pressure changes and pain perception, quality of life and autonomic symptoms after the end of the treatment. finally, to study the effects of the treatment 3 months after the end of the treatment.

Eligibility criteria:
inclusion criteria: * patients diagnosed from fm presenting generalized pain in at least four or five regions. * present symptoms for at least 3 months at similar levels. exclusion criteria: * inflammatory, neurological, or orthopedic disease which can alter balance, hearing, and vision, and cognitive impairment in terms of the ability to answer questions.

Keywords: blood pressure autonomic symptoms pain fibromyalgia