Kornimate/medical-research-clean huggingface dataset:
pasos: improving the health of immigrant workers

Conditions: Overweight and Obesity; Diabetes

Summary: this is a cluster randomized trial (crt) to assess the effectiveness of a culturally appropriate behavioral intervention to reduce obesity levels and ultimately the risk of developing diabetes type ii in immigrant latino farm workers. randomization is at the farm ranch level. individuals at intervention ranches will receive a multi-week curriculum at the work-site on diabetes, diet and physical activity and optional supplemental sessions in the evening and weekends. the investigators will adopt the intent-to-treat principle for the primary analysis. individuals on control ranches will receive no health educational instruction. the primary outcome is bmi. the investigators hypothesize that intervention ranches will achieve significant improvement in obesity and diabetes risk factors as compared to control ranches.


Eligibility criteria:
inclusion criteria: * work at reiter brothers inc. (rbi), a partner, or affiliate company * able to speak and understand spanish * willing to attend weekly sessions for length of intervention * plan to stay in the area for the next three months exclusion criteria: * workers without spanish language comprehension * pregnant women and those planning a pregnancy within six months * women who are breastfeeding, unless discontinuing breastfeeding within one month * individuals who, without health care provider approval, are: unable to undertake moderate physical exercise, taking medicine for high blood pressure or heart conditions, have bone or joint problems, lose consciousness or fall due to dizziness, or have developed chest pain within the last month * individuals taking medications that affect weight * individuals with therapeutic diets * diabetic status determined by health care professional after hba1c testing result is \>6.5% * if spouse / cohabitant is already in the study
effect of sevelamer on p-cresol levels in ckd

Conditions: Chronic Kidney Disease Stage 3-5

Summary: the accumulation of p-cresol, a product of the metabolism of aromatic aminoacid operated by resident intestinal bacteria increases the cardiovascular risk of chronic kidney disease (ckd) patients. therefore, therapeutic strategies to reduce plasma p-cresol levels are highly demanded. it has been reported that the phosphate binder sevelamer sequesters p-cresol in vitro, while in vivo studies on dialysis patients showed controversial results. aim of our study was to evaluate the effect of sevelamer on p-cresol levels in ckd patients.


Eligibility criteria:
inclusion criteria: * age \>18 years, * ckd stage 3-5 exclusion criteria: * existing or previous treatment within the last 1 year with a phosphate binder; * hyperphosphatemia (\>5.6 mg/dl); * hypophosphatemia (\<2.5 mg/dl); * malnutrition, * malignant neoplasms, * current history of gastrointestinal and/or endocrine diseases.
effects of karate in adolescents with down syndrome

Conditions: Down Syndrome

Summary: this randomized control study will investigate the health outcomes of adolescents with down syndrome who participate in a karate class as measured by alpha fitness testing and various promis parent proxy questionnaires to assess participants mobility, physical activity, and overall affect.

adolescents with down syndrome suffer from a set of health problems including heart disease, sleep disturbances, and obesity. their decreased cardiovascular fitness and exercise capacity limits their ability to perform activities of daily living. exercise interventions in this population of children have been shown to improve muscle strength, balance, and cardiovascular fitness. prior research has helped better define physical activity barriers in this population which include: requiring parental supervision, lack of accessible programs, seasonal activities and reduced physical skills of the child. karate is an indoor activity that can be performed at different skill levels without parental involvement. the investigators hypothesize that adolescents with down syndrome who participate in karate will show improved health outcomes compared to those who did not participate. furthermore, the investigators hypothesize that the majority of participants will continue the activity outside of the research window. this randomized controlled trial will enroll 30 adolescents with down syndrome. participants will be randomly assigned to a 3 month karate program or the control group with no intervention. measurements are taken at baseline, 3 months, and 6 months using validated alpha fitness testing and in addition parents will complete promis questionnaires to assess overall participant's activity level, mobility, and generalized affect. an independent statistician will analyze the groups. this research will help physicians provide adolescents with down syndrome appropriate recommendations for an individualized physical activity regimen that does not have similar limitations to other exercise programs.

Eligibility criteria:
inclusion criteria: * males \& females with a diagnosis of down syndrome * ability to participate in 2 hours of exercise per week * no involvement in formal martial arts classes over the past 3 months exclusion criteria: * behavior problems that would prevent them from participating in organized classes * health problems that preclude them from participating in moderate physical activity programs (e.g. uncontrolled seizures) * no co-existing diagnosis (e.g. asd)
tumor grade determines pd-1/pdl-1 expression

Conditions: Endometrial Cancer; Ovarian Cancer

Summary: endometrial carcinoma is the most common gynecologic cancer in the western world. two types are usually described. type i is the endometrioid and is usually estrogen dependent. type ii is usually more aggressive than type i and is estrogen independent. type ii endometrial cancer is usually characterized as high grade while type i as low intermediate and high grade. ovarian carcinoma as opposed to endometrial carcinoma is not characterized by types but by different histological backgrounds. it is also divided into high and low grade tumors. ovarian carcinoma is considered to be the most aggressive of all gynecological malignancies resulting in most yearly deaths. our immune system usually responds to foreign intruders entering our body or formed inside and attacks it in order to destroy it. cancer cells are considered to be foreign to the body hence the immune system is expected to destroy it . the immune mediated cells which are supposed to attack the cancer are called tumor infiltrating lymphocytes or "tils". many different cancers possess the ability to evade tils in order to survive and grow. many studies have demonstrated that the presence of large number of tils improved cancer prognosis. one of these evasive methods is the pd-1/pdl-1 expression. the question whether more aggressive tumors possess better capabilities to evade an immune response via the pd-1/pdl-1 mechanism is currently unknown. all tumor types possess antigens on their cell surface which triggers an immune response to some extent. even though, the tumor needs different methods in order to be able to avoid the immune system attack. tils express the pd-1 receptor on their cell surface and when it binds to pdl-1 or pdl-2, the cells which express the ligand deactivate tils hence deem the lymphocyte incapable of inducing programmed cell death. pdl-1 which is expressed on tumor cells to evade an immune response can be targeted by immunotherapy.


Eligibility criteria:
inclusion criteria: all ages endometrial carcinoma ovarian carcinoma all grades all stages all races female patients pd-1/pdl-1 staining positive - exclusion criteria: any cancer which is not endometrial or ovarian cancer which do not stain positive for pd-1/pdl-1 -
intertrochanteric femoral fracture fixation trial

Conditions: Intertrochanteric Fracture; Hip Fracture

Summary: the main goal of the study is to determine which cephalomedullary nail results in a better functional outcome for the patient with an unstable intertrochanteric hip fracture. subjects will be randomized to fixation with either a gamma3 cephalomedullary nail or an intertan cephalomedullary nail. outcomes will be reviewed over a 12 month follow-up period.

primary hypotheses: patients who maintain their initial fracture reduction and subsequent position over time with minimal femoral neck shortening and varus will demonstrate significantly improved functional abilities, including gait and abductor function. secondary objective: * whether radiographic differences in femoral neck shortening and varus collapse translate into a worse functional outcome to the patient. * whether there are differences in mortality between treatments * whether there is a time frame follow up after which there is no difference in outcomes. * evaluate the device used for fracture stabilization as a potentially contributing factor for maintenance of normal or near-normal abductor function and gait. primary outcome: the primary outcome will be functional abilities at 3, 6 and 12 months after injury. the following measures of functional ability will be utilized: methods: this is a prospective, randomized non-blinded study. patients will be identified as they present to the orthopaedic trauma service of tampa general hospital with a qualifying injury to determine their interest in participating in the study. written informed consent will be obtained prior to initiation of any study procedures. group a will undergo cephalomedullary nail-based single screw intertrochanteric hip fracture fixation device (gamma 3 nail). group b will receive the integrated dual screw intertrochanteric hip fracture fixation device (intertan nail). patient outcomes will be analyzed using intention to treat principles. following randomization assignment, surgeons will all follow the identical described surgical technique, with the only variable being the implant used. post-operative immobilization and time to weight bearing and rehabilitation protocols will be again identical for all patients regardless of fixation technique.

Eligibility criteria:
inclusion criteria: * patients surgically treated for an intertrochanteric femur fracture at tampa general hospital. * skeletally mature patients over the age of 60; both genders. * community ambulators. exclusion criteria: * patients with ipsilateral lower extremity injury * patients under age 60 * co-existent, severe knee or back problems * muscle contracture around the knee or hip joint * individuals who have had tka within 6 months * body mass index (bmi; kg/m2) \>40 * suspicious of pathologic fracture (tumor in origin) * pre-op mobility: non ambulatory; ambulatory indoors with living support * cognitive impairment or dementia * prisoners or impending incarceration * homeless or no stable address.
association of multiple medications with the severity of dyspepsia

Conditions: Dyspepsia

Summary: dyspepsia is a very common gastrointestinal disease. some medications, were associated with higher frequent incidences of dyspepsia, including non-steroid anti-inflammatory drugs (nsaids), bisphosphonates, tetracyclines, et al. multiple medications were suggested to be strongly relate to adverse drug events (ades), adverse drug reactions (adrs), drug-drug interactions, and drug-disease interactions, which may cause gastrointestinal(gi) dysfunction or injury to the gi mucosa. however, it was unclear whether multiple medications was associated with more severe symptoms of dyspepsia and dyspepsia-based score systems.


Eligibility criteria:
inclusion criteria: 1. aged ≥18 years old 2. patients who met broad criteria of dyspepsia exclusion criteria: 1. organ failure defined by marshall standard 2. severe psychiatric illnesses 3. suspected or identified bowel obstruction 4. known malignancy 5. pregnancy or lactation 6. unable to provide consent
high protein intake in critically ill ventilated patients

Conditions: Intensive Care Unit Syndrome

Summary: this prospective interventional randomized control study was conducted on forty patients with respiratory failure; all patients were intubated and mechanically ventilated for at least three days. twenty patients received high protein intake using whey protein, with daily follow-up of the blood sugar level, serum electrolytes, and chemistry. icu outcome regarding food intolerance, 30-day mortality, length of mv and icu-stay was recorded


Eligibility criteria:
inclusion criteria: * age \>18 years * mechanically ventilated patients (for three days or more ) exclusion criteria: * age \< 18 years old * contraindication for enteral nutrition (gut ischemia, obstruction, or perforation) * expected intolerance for enteral nutrition (paralytic ileus) * inability to start enteral nutrition within 24-hours(i.e. surgery or other interventions) * short bowel syndrome * hemodynamic instability ( i.e shock state, need for vasopressors ) * child c liver cirrhosis or acute liver failure * dialysis dependency
characteristics of patients with amyloidosis & heart failure being evaluated for a heart transplant

Conditions: Cardiomyopathy

Summary: the purpose of this study is to describe the characteristics of patients with amyloidosis and severe heart failure being evaluated for cardiac and stem cell transplantation.

systemic amyloidosis is a progressive disease leading to organ failure and death. treatment has improved survival with stem-cell transplantation. unfortunately, patients with amyloidosis and severe heart failure are not eligible for stem-cell transplantation. the average rate of survival for patients with amyloidosis who receive a heart transplant is decreased. previous trials have raised the possibility that survival may be increased in patients with amyloidosis, if chemotherapy and stem-cell transplantation is performed after a heart transplant. we plan to review data of patients with amyloidosis and heart failure who were being evaluated for a heart transplant.

Eligibility criteria:
inclusion criteria: * patients with amyloidosis * nyha class iii or iv heart failure * patients undergoing heart transplant evaluation * patients less than 18 years of age exclusion criteria: * patients who have unstable pulse and blood pressure

Keywords: amyloidosis heart failure heart transplant stem cell transplant
what to-be-discard biomaterials from art cycles can tell us about the treatment cycle outcome?

Conditions: IVF; Infertility

Summary: various to-be-discard material from ivf treatment cycle will be collect and examined, aiming to identify potential reasons of successful outcome or cycle failure.

usually around 2/3 of ivf material will be discarded at the end of each treatment cycle, including immature oocytes, abnormal fertilized zygotes, poor grading embryos, spent culture medium, etc. next generation sequencing will be performed for dna / rna analysis including the length and the quantity, rna-seq will be applied for transcriptome profiling, and protein profile will be investigated in a pool sample. by applying various diagnostic tools against those to-be-discard biomaterials, we aim to identify potential underlying reasons of indicating either for an ivf failure or a successful cycle, and try to develop a non-invasive testing method for embryo quality check; better detection of the embryo implantation potential and eventually further increase the ivf clinical outcome.

Eligibility criteria:
inclusion criteria: * patients attending the assisted reproductive technology (art) unit of the chinese university of hong kong for art treatment. * participant able to give voluntary, written, informed consent to participate in the study. exclusion criteria: * patient using donor gamete in ivf treatment * patient refuses to join and failed to giving consent for any reasons
remotely observed methadone evaluation

Conditions: Opioid Use Disorder

Summary: opioid addiction, which affects 16 million individuals worldwide, can be treated using methadone, a proven and effective opioid medication for treating oud that extends retention in care, reduces mortality, and inhibits illicit drug use. however, methadone treatment is limited to federally certified opioid treatment programs (otps), which must meet complex regulatory requirements, and require new patients to take their dose in person six days per week, presenting significant barriers to treatment. to address these barriers, sonara heath has developed the sonara software platform, which will enable otps to offer accelerated take-home methadone regimens while maintaining safety and diversion prevention.


Eligibility criteria:
inclusion criteria: * receiving methadone for the treatment of opioid use disorder exclusion criteria: * patients with \>13 take-homes * patients with positive toxicology results in last 30-60 days * patients involved with drug court ineligible for take-homes * patients without adequate access to technology * patients with \<30 days in treatment * patients with mental health instability * patients with recent diversion attempts * patients using buprenorphine for agonist therapy * patients guest dosing at another clinic during trial period
dietary sodium intake in children on chronic dialysis

Conditions: Chronic Dialysis in Children

Summary: cardiovascular disease is common in patients with end-stage renal disease that began in childhood, and volume overload plays a key role in the development of hypertension, left ventricular hypertrophy (lvh) and alterations. cardiovascular disease in this population. thus, inter-dialytic weight gain is correlated with blood pressure and left ventricular mass index in children on hemodialysis (hd). significant inter-dialytic weight gain in dialysis patients is largely due to thirst secondary to salt ingestions: attempts at water restriction without concomitant sodium restriction will probably be in vain. additionally, sodium overload negatively affects blood pressure and cardiovascular status through various mechanisms unrelated to volume expansion. soda extraction by dialysis is often difficult, and sodium control is largely dependent on restricting dietary sodium intake. some studies in adults have shown that a low sodium diet reduced inter-dialytic weight gain, reduced intra-dialytic complications, improved blood pressure values, and lowered index. left ventricular mass and mortality in dialysis patients. for children with chronic kidney disease, data from the american chronic kidney disease (ckid) study show that the median sodium intake in children without dialysis with chronic kidney disease exceeds the maximum recommended intakes for all patients. age groups. no study to date has investigated the average dietary sodium intake of children on dialysis. and, more importantly, the relationship between dietary sodium intake and cardiovascular morbidity has never been studied in children on dialysis.


Eligibility criteria:
inclusion criteria : * minor patient (≥ 3 months and \<18 years) * under the care of the university hospitals of strasbourg * having benefited from chronic dialysis (\> 3 months) * having undergone hemodialysis (hd) or hemodiafiltration (hdf), 3 sessions / week, or automated peritoneal dialysis (pd) * subject (and / or his parental authority) not having expressed, after being informed, his opposition to the reuse of his data for the purposes of this research. non-inclusion criteria : * patient or one of the parents who expressed their opposition to participating in the study * intensive hemodialysis (hd at home, hd at night, ≥ 4 sessions / week) * intercurrent illness or clinical instability (left to the judgment of the physician) * non-nephrological diseases causing loss of salt (eg cystic fibrosis, etc.) * any physical or psychosocial situation that prevented the 24-hour ambulatory bp measurement from being taken, or poor compliance with the dietetic collection, etc.).

Keywords: chronic dialysis in children cardiovascular diseases renal diseases left ventricular hypertrophy hemodialysis complication
local and intravenous dexamethasone on post operative pain a after cs

Conditions: Postoperative Pain

Summary: a prospective, randomized study conducted on 120 pregnant women attending the labour wards in kasr al ainy and fayoum maternity hospitals from may 2014 to december 2015. all participants were scheduled for elective cesarean section under spinal anaesthesia and were randomly divided into 3 equal groups. group 1(40 women) received 16 mg dexamethasone iv drip. group ii (40 women) received 16 mg dexamethasone subcutaneous injection around the caesarean section scar after skin closure and group iii received placebo in the form of iv fluids 500 cc saline infusion. all cases were followed up for 48 hours for assessment of level of pain by using a 10-cm visual analog scale (vas). primary outcome parameters were vas score and the need for additional analgesics. other parameters were hemodynamic changes and occurrence of side effects or complications

the patients were subjected to history taking, including age, parity, menstrual history for verification of gestational age and medical history for confirmation of inclusion and exclusion criteria. full general and abdominal and obstetric examinations were done. investigations including complete blood picture, liver functions and coagulation profile to exclude those not fitting with the above listed criteria. ultrasound was done to assess gestational age. patients were checked for coagulation abnormalities. large gauge (18g) cannula was inserted in cephalic or ante cubital veins. patients were preloaded with haes- steril 6% (hydroxyl ethyl starch) fresenius. or, preloaded with ringer's lactate 20 ml/kg. patients were positioned in the sitting position for spinal anaesthesia and sterilization of the back was done using betadine. l3-l4 space was determined for the insertion of spinal needle. then 25g spinal needle was used to perform a single shot spinal anaesthesia using 10mg of 0.5% hyperbaric bupivicaine and fentanyl 20 micrograms. all surgeons had close surgical skills and used the same technique transverse lower segment incision. the procedure is then completed using traction on cord to deliver the placenta, exteriorization of uterus, closure of uterine incision in 2 layers, closure of both visceral and parietal peritoneum, closure of rectus sheath, no subcutaneous closure and finally subcuticular skin closure. follow up for all cases for 48 hours. primary outcome parameters were vas score and the need for additional analgesics. other parameters were hemodynamic changes and occurrence of side effects or complications.

Eligibility criteria:
inclusion criteria: * all participants were scheduled for elective cesarean section under spinal anaesthesia exclusion criteria: * women with neurological disorders * psychologically disturbed * those with uncontrolled hypertension, diabetes mellitus, peptic ulcer, liver cirrhosis or glaucoma * women with systemic infections * allergy to dexamethasone * contraindications to spinal anaesthesia

Keywords: postoperative pain dexamethasone cesarean section
the influence of health beliefs and uncertainty on diabetes type ii patient compliance

Conditions: Diabetes Type II

Summary: to determine the predicting factors and indicators of compliance with insulin treatment in diabetes type ii patients.


Eligibility criteria:
inclusion criteria: * with complete cognitive abilities * independent functioning * take insulin exclusion criteria: * critically ill patients * psychiatric patients