Kornimate/medical-research-clean huggingface dataset:
hemoperfusion in extracorporeal membrane oxygenation (ecmo) patients

Conditions: Cardiogenic Shock

Summary: extracorporeal membrane oxygenation (ecmo) is a temporary mechanical circulatory support device for cardiogenic shock (cs) patients. during extracorporeal membrane oxygenation (ecmo) support, the inflammatory response is intense and complex. it may cause infection, cell damage, organ dysfunction and even death. hemoperfusion can adsorb inflammatory factors and reduce the inflammatory reaction. cs patients who are likely to receive veno-arterial extracorporeal membrane oxygenation (va-ecmo) support will be enrolled and randomized with a 1:1 allocation to a simultaneous hemoperfusion arm vs. standard care arm. 1. the patients in the simultaneous hemoperfusion arm will receive hemoperfusion when extracorporeal membrane oxygenation (ecmo) is commenced. 2. the patients in the standard care arm will not receive hemoperfusion when extracorporeal membrane oxygenation (ecmo) is commenced. the primary outcome is the change of plasma interleukin (il)-6 level after hemoperfusion is commenced.


Eligibility criteria:
inclusion criteria: 1. age ≥ 18 and ≤ 75 years. 2. admission to icu. 3. criteria for the diagnosis of cs as follows: (1) systolic blood pressure less than 90 mmhg for 30 min, a mean arterial pressure less than 65 mmhg for 30 min, or vasopressors required to achieve a blood pressure ≥ 90 mmhg; (2) pulmonary congestion or elevated left-ventricular filling pressures; and (3) signs of impaired organ perfusion with at least one of the following criteria: (a) altered mental status; (b) cold, clammy skin; (c) oliguria; and (d) increased serum lactate. 4. ecmo will supply cardiopulmonary support to the patient 5. the patients will be enrolled and randomized when ecmo is commenced less than 24 hours. exclusion criteria: 1. refusal of consent. 2. active hemorrhage or thrombocytopenic purpura 3. bmi≥40 4. received ecmo bridging to a long-term ventricle assist device or heart transplantation. 5. infection

Keywords: veno-arterial extracorporeal membrane oxygenation (va-ecmo) hemoperfusion inflammatory factor
global longitudinal peak systolic strain (glpss) derived from transesophageal echocardiography - a reliable measure of systolic function?

Conditions: Surgery

Summary: systolic function is a substantial determinant of overall hemodynamics and organ function. therefore assessment of left ventricular systolic function (lvf) has been of central interest in echocardiography. ejection fraction (ef) measurement has been the gold standard echo-derived measure to describe lvf. however, ef is a blood pool derived and therefore load dependent measure. global longitudinal peak systolic strain average is a new parameter derived from speckle tracking tachnique. as a primarily myocardial deformation parameter it is considered to be an equivalent to ef measurement, but maybe less load dependend. the aim of the study is to investigate the reliability of glpss average to quantify lvf in the perioperative setting (in cardiac and non-cardiac cases).


Eligibility criteria:
inclusion criteria: * adult patients in the age from 19-90 years * cardiac and non-cardiac surgery, where intubation is indicated * surgical procedures with a minimum duration of 30 min * elective cardiac surgery on patients scheduled for correction of: * coronary artery disease with and without previous myocardial infarction * dilated cardiomyopathy; hocm * disorders of the atrial or ventricular septum * disorders of the aortic root or the aorta * left and right heart valvular disease including stenotic and/or regurgitant valvular diseases. exclusion criteria: * no patient´s consent * contraindications for tee (esophageal-, gastric disorders, haematologic disorders with increased bleeding incidence; ent-surgery, surgery of the esophageus or stomach) * contraindications for positioning (e.g. clinical signs of acute lung edema/acute failing left or right heart, acute coronary syndrome, myocardial infarction in recent history = within 2 weeks prior to operation date)

Keywords: lvf left ventricular systolic function
effects of respiratory muscle training on pulmonary function

Conditions: Chronic Neck Pain

Summary: the study was conducted to determine the effects of respiratory muscle training on pulmonary function and musculoskeletal parameters in patients with chronic neck pain. it included 43 patients, 20-40 years old males and females having non-specific chronic neck pain for more than three months and with low maximum voluntary ventilation (mvv) values were included. control group (n=21) received conventional physiotherapy with diaphragmatic breathing exercises and experimental group (n=23) received conventional physiotherapy with specially designed respiratory exercise protocol. it concluded that rmt in addition to conventional physiotherapy is effective to improve musculoskeletal and pulmonary parameters in cnp patients.

to determine the effects of respiratory muscle training on pulmonary function and musculoskeletal parameters in patients with chronic neck pain. study design: a randomized controlled trial place and duration of study: riphah rehabilitation and research center in railway general hospital and benazir bhutto hospital, rawalpindi from january 2019 to july 2019. methodology: 43 patients, 20-40 years old males and females having non-specific chronic neck pain for more than three months and with low maximum voluntary ventilation (mvv) values were included. control group (n=21) received conventional physiotherapy with diaphragmatic breathing exercises and experimental group (n=23) received conventional physiotherapy with specially designed respiratory exercise protocol. they were assessed prior to, at 2nd week and after 4 weeks of treatment.

Eligibility criteria:
inclusion criteria: * . patients having non-specific chronic neck pain with or without headache for more than three months with pain complaints at least once a week 2. males and females both of age 20 to 40 years old 3. patients with low maximum voluntary ventilation (mvv) values i.e., less than 110 l/min in males and 80 l/min in females exclusion criteria: * patients already participating in physiotherapy program 2. patients with past history of * surgery to the cervical spine * traumatic cervical injuries * clinical abnormalities or surgeries of the thoracic cage or vertebral column * severe obesity (bmi\>40) * pregnancy * smoking history/occupational industrial exposures * chronic neuro-musculoskeletal pain in any other non-related body area * respiratory or cardiac illness, diabetes mellitus and serious comorbidities
outcomes of the use of co2 (carbon dioxide) laser in the treatment of chronic anal fissure

Conditions: Chronic Anal Fissure

Summary: outcomes of using co2 (carbon dioxide) laser in the management of chronic anal fissure as an alternative to conventional methods

the use of co2 laser in management of chronic anal fissure as a new alternative technique. interventional study of 236 patients. comparison to other techniques was made with respect to pain scores and healing time.

Eligibility criteria:
inclusion criteria: * have chronic anal fissure exclusion criteria: * acute anal fissure pregnancy
social deprivation and initial presentation of 12 cardiovascular diseases: a caliber study

Conditions: Abdominal Aortic Aneurysm; Coronary Heart Disease NOS; Unheralded Corronary Death; Intracerebral Haemorrhage; Heart Failure; Ischemic Stroke; Myocardial Infarction; Stroke; Peripheral Arterial Disease; Stable Angina Pectoris; Subarachnoid Haemorrhage; Transient Ischemic Attack; Unstable Angina; Cardiac Arrest, Sudden Cardiac Death

Summary: study of heterogeneity in associations between social deprivation and the initial presentation of 12 cardiovascular diseases.

this study is part of the caliber (cardiovascular disease research using linked bespoke studies and electronic records) programme funded over 5 years from the nihr and wellcome trust. the central theme of the caliber research is linkage of the myocardial ischaemia national audit project (minap) with primary care (gprd) and other resources. the overarching aim of caliber is to better understand the aetiology and prognosis of specific coronary phenotypes across a range of causal domains, particularly where electronic records provide a contribution beyond traditional studies. caliber has received both ethics approval (ref 09/h0810/16) and ecc approval (ref ecc 2-06(b)/2009 caliber dataset).

Eligibility criteria:
inclusion criteria: * one year prior to study entry (up-to-standard follow-up, cprd quality research standard). * 30 years or older * recorded sex * free of symptomatic cvd at inclusion. exclusion criteria: * pregnant women in the 6 months before the eligibility date
pathway-rct: preventing admission to hospital with attr cardiomyopathy

Conditions: Cardiac Amyloidosis

Summary: cardiac amyloidosis is a condition where the heart muscle, amongst other tissues, is infiltrated by the abnormal build-up of proteins called amyloid. this stiffens and thickens the heart muscle over time which makes it less efficient and puts further stress and strain on the other chambers of the heart, leading to heart failure. the commonest form, that affects predominantly the elderly, is called 'wild-type' attr amyloid (ttr is the protein that accumulates). in this condition a patient has a 60% chance of admission to hospital each year after diagnosis. there is no current treatment for attr amyloid other than using water tablets to reduce excess fluid and prevent more serious fluid build up in lungs and other tissues. increasing body weight is the most reliable clinical sign of this fluid build up. tele-monitoring is the practice of monitoring patients from a distance and has been shown to reduce heart failure admissions and death in patients with heart failure from any cause. due to reduced access to primary and secondary care during covid-19 the investigators instigated tele-monitoring of heart failure in attr amyloid patients. this appeared to be an effective intervention in the pilot study. the investigators propose to monitor the weight of patients with cardiac amyloidosis at home and intervene where a build up of fluid is observed by telephone discussion with a doctor. the investigators propose to evidence this in a prospective clinical trial. the investigators will evaluate the effect fairly by comparing tele-monitoring with usual care.


Eligibility criteria:
inclusion criteria: 1. adults aged ≥18 at the date of signing informed consent which is defined as the beginning of the screening period. 2. an established diagnosis of attr cardiomyopathy as defined by protocol. 3. ability to provide written, personally signed and dated informed consent to participate in the study, in accordance with the ich good clinical practice (gcp) guideline e6 (r2) (2016) and applicable regulations, before completing any study-related procedures. 4. an understanding, ability, and willingness to fully comply with study procedures and restrictions. 5. currently a patient at a study site (nac). exclusion criteria: 1. an inability to have or use bodytrace device scales at usual residence (for example no mobile network cellular signal) 2. on dialysis or end-stage renal failure (egfr \<25ml/min) 3. serum albumin \<20g/dl or other non-hypervolaemia cause of tissue oedema (e.g. protein-losing enteropathy, nephrotic syndrome) 4. use of greater than 2 oral diuretics (e.g. on maximum oral diuretic therapy)
french multicentre observational study on sars-cov-2 infections (covid-19) icu management study

Conditions: Pneumonia, Viral; Critically Ill; Corona Virus Infection

Summary: since december 2019, a new agent, the sars-cov-2 coronavirus has been rapidly spreading from china to other countries causing an international outbreak of respiratory illnesses named covid-19. in france, the first cases have been reported at the end of january with more than 60000 cases reported since then. a significant proportion (20-30%) of hospitalized covid-19 patients will be admitted to intensive care unit. however, few data are available for this special population in france. we conduct a large observational cohort of icu suspected or proven covid-19 patients that will enable to describe the initial management of covid 19 patients admitted to icu and to identify factors correlated to clinical outcome.


Eligibility criteria:
inclusion criteria: * patients admitted to icu for suspected or proven sars-cov-2 infection, defined by positive sars-cov-2 pcr or ct scan images * patient \> or= 18 years exclusion criteria: * patient study refusal * patient already enrolled in the present study * patient with respiratory illness with negative covid-19 ct scan images and negative covid_19 pcr

Keywords: covid-19 sars-cov-2 intensive care unit
shared mental health care linking mental health services with family medicine groups

Conditions: Psychosocial Factors

Summary: the purpose of this study is to assess how a multidisciplinary team of mental health professionals provides services to patients from two family medicine practices.


Eligibility criteria:
inclusion criteria: * patients referred by family physicians

Keywords: psychosocial
mri study of bay 43-9006 in metastatic renal cell carcinoma

Conditions: Metastatic Renal Cell Carcinoma

Summary: the purpose of this study is to determine maximum tumor shrinkage, time to progression, survival, drug concentration, and degree of skin toxicity.


Eligibility criteria:
inclusion criteria: * histologically or cytologically confirmed metastatic clear cell renal cell cancer; * at least one lesion that can be accurately measured in at least one dimension; * patients must not have been treated with prior anti-timor kinase inhibitors or vegf pathway inhibitors; * age 18 and older; * ecog performance status 0-2; * blood pressure higher than 140/90 on 2 separate occasions not more than 6 weeks prior to enrollment and not less than 24 hours apart; * normal organ function: total bilirubin less than upper limit of normal, ast less than 2.5 x upper limit of normal, creatinine less than 2.8 mg/dl; * women of child-bearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation; * ability to understand and the willingness to sign a written informed consent document. exclusion criteria: * chemotherapy or radiotherapy within 4 weeks prior to entering the study; * any other investigational agents; * known brain metastases; * uncontrolled intercurrent illness including 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; * pregnancy.

Keywords: renal, metastatic, carcinoma
observational study on intubation in septic shock

Conditions: Septic Shock

Summary: septic shock is common in intensive care and its mortality remains high. while new treatments have not improved survival, optimization of known and widely used techniques has allowed reduction in mortality. thus improving care given to patients starts with making better use of existing resuscitation techniques. among these practices, mechanical ventilation is widespread in the management of patients with septic shock. in large studies published in recent years in europe and north america, 40 to 85% of patients receive invasive mechanical ventilation. it therefore appears that a significant proportion of patients are never intubated during treatment and management of their septic shock. there is no specific recommendation from critical care societies concerning mechanical ventilation in the treatment of septic shock. apart from indisputable situations such as impaired consciousness or acute respiratoire distress, the decision whether to ventilate mechanically or not is left to the discretion of the physician. the aim of this study is to analyze intubation practice in septic shock patients and its impact on 28-day survival. this multicentric and observational study will be conducted in 30 french icus.


Eligibility criteria:
inclusion criteria: * older than 18 years old * admitted in the icu for septic shock * introduction of vasopressors ( norepinephrine or adrenaline ) in the icu or within 24 hours of icu admission * suspected or proven infection exclusion criteria: * intubation before the introduction of vasopressors * decision of withdrawing or withholding care at admission * pregnant woman * patient not affiliated to the social security insurance * refusal of participation in the study

Keywords: septic shock endotracheal intubation outcome
a trial of oral bez235 and bkm120 in combination with paclitaxel with or without trastuzumab

Conditions: Metastatic or Locally Advanced Solid Tumors

Summary: the purpose of the trial is to determine the maximum tolerated dose (mtd) of bez235 and bkm120 in combination with weekly paclitaxel and weekly paclitaxel/trastuzumab.


Eligibility criteria:
inclusion criteria: * adult patients with metastatic or locally advanced solid tumors, for whom weekly paclitaxel treatment is indicated (bez235-paclitaxel /bkm120-paclitaxel treatment) * her2+ metastatic or locally advanced breast cancer patients eligible for weekly paclitaxel and trastuzumab (bez235-paclitaxel-trastuzumab /bkm120-paclitaxel-trastuzumab treatment) * adult patients (≥ 18 years) (males, females) * world health organization (who) performance status ≤ 2 * adequate bone marrow function: * adequate hepatic and renal function: exclusion criteria: * patients with primary central nervous system (cns) tumor or cns tumor involvement. however, patients with a metastatic cns lesion may participate in this trial, if the patient is \> 4 weeks from therapy (including radiation and/or surgery) completion, clinically stable with respect to the tumor at the time of study entry, and not receiving enzyme-inducing antiepileptic drugs or corticosteroid therapy or taper, as treatment of the brain metastases * patients who have received prior systemic anticancer therapy within the following time frames * cyclical chemotherapy: ≤ 3 weeks before study treatment (6 weeks for patients treated with nitrosoureas) * biological therapy: ≤ 4 weeks before study treatment, except treatment with trastuzumab (both parts of the trial) * investigational drug: ≤ 4 weeks before study treatment * patients who have undergone major surgery ≤ 4 weeks before study treatment * patients receiving chronic treatment with corticosteroids or other immunosuppressive agents * patients with uncontrolled, unmanageable, treatment-refractory diabetes mellitus * active or history of major depressive episode, bipolar disorder, obsessive-compulsive disorder, schizophrenia, history of suicide attempt or ideation, or homicide, as judged by the investigator and/or based on recent psychiatric assessment other protocol-defined inclusion/exclusion criteria may apply

Keywords: cancer bez235 bkm120 paclitaxel trastuzumab
opiate detoxification using the combined hemoperfusion-hemodialysis

Conditions: Opiate Addiction

Summary: the purpose of this study is to determine whether combined hemoperfusion-hemodialysis treatment is an alternative drug-free, effective, and safe treatment for opiate detoxification.

drug abuse remains a major society problem in our community and is also a major health problem in our modern society. thus, education to prevent the young generation to avoid drug abuse and detoxification to help those to quite from the drug abuse are two major key steps in the controlling drug abuse program. currently, medications for opiate detoxification, such as methadone, are commonly used worldwide. however, methadone is also an addictive medication. when it is stopped suddenly, patients usually produce unpleasant withdrawal symptoms. meanwhile, methadone is also potentially to be abused too. thus, it is urgently needed to seek an alternative safer, effective, drug-free method for opiate detoxification. based on our clinical observation, the timely clearance of toxicities from the body or blood is a safe and effective detoxification method. thus, we hypothesized that the use of combined hemoperfusion-hemodialysis may be an alternative drug-free, effective, and safe treatment for opiate detoxification. this will be tested in patients who have severe drug abuse and are under custodial conditions by a daily combined hemoperfusion-hemodialysis for 3 days. the efficacy and safety of the hemoperfusion-hemodialysis will be compared to a 10 day standard methadone detoxification treatment.

Eligibility criteria:
inclusion criteria: * be fulfilled dsm-iv criteria(american psychiatric association) for opiate dependence. * a history of current dependence on heroin, which was supported by laboratory results from urine drug screening, using both chromatographic and radioimmunoassay methods. * opioid dependent patients who inject heroin from 0.5g to 1.0g daily by veins for at least 1 year. * haven't received methadone treatment for at least 2 months before entry to this study. * be able to understand and have signed the informed consent. exclusion criteria: * take heroin for the first time. * positive for hiv. * the function of cruor or hemorrhage is badly damaged. * the number of platelets is lower than 70×10\*9. * co-dependent on substances other than opiates (including alcohol, benzodiazepines, cocaine, or amphetamines). * methadone dose requirement is over 70 mg/day as determined by the 3-day dose assessment period. * have serious physical illness or major psychiatric illness. * pregnant woman.

Keywords: opiate addiction withdrawal symptoms hemoperfusion hemodialysis methadone
12 weeks intensive lifestyle intervention program in primary care obesity clinic for obese adults: jeddah 2015

Conditions: Obesity

Summary: with low carbohydrate dietary approach for both arms, the investigators will examine the effectiveness of 12-weeks intensive lifestyle intervention program provided in individual sessions in primary health care obesity clinic in jeddah with aim to achieve 5% reduction of baseline weight for experimental participants in comparison with active comparator group (only one health education session).

the study has two arms: active comparator arm: only health education. one session regarding diet restriction and physical activity with printed health education papers. experimental arm: intensive lifestyle intervention weekly individual session in obesity clinic (15 to 20 min.) for the first 4 weeks then one individual session in obesity clinic (10 to 20 min.) every two weeks (week 5 to week 12). total sessions in 12 weeks: 8 (including the final data collection visit).the components of the program: 1) low carbohydrate (aim to achieve spontaneous reduction in calorie intake) 2) increased physical activity; 3) behavioral strategies to facilitate adherence to diet and activity prescriptions.

Eligibility criteria:
inclusion criteria: * 20 years old or older * arabic male or female * body mass index in kg/m2 (bmi) ≥30 exclusion criteria: * had recent weight loss equal or more than 5% of baseline weight * currently take weight loss medication or enrolled in another weight loss program * undergone or scheduled (within study duration) weight loss surgery * history of diabetes, thyroid dysfunction or any other endocrine abnormality, gout, coronary heart disease, stroke, malignancy or psychological condition * medical condition that limits ability to comply with the program's physical activity recommendations * pregnant or lactating women * if one participant had recruited in the study, his family members who live with him in the same home will be ineligible (to avoid contamination from the ripple effect on weight loss)