Kornimate/medical-research-clean huggingface dataset:
conscious sedation vs general anesthesia in tavr patients

Conditions: Aortic Stenosis

Summary: this is a randomized controlled trial investigating the effect of general anesthesia versus conscious sedation on operative times in patients undergoing transcatheter aortic valve replacement.


Eligibility criteria:
inclusion criteria: 1. signed informed consent, signed health insurance portability and accountability act (hipaa) documentation) 2. age over 18 years of age. 3. women of child bearing age must have a negative urine or serum pregnancy test. 4. clinical indication for a transfemoral aortic valve replacement. 5. english or spanish speaking 6. no evidence of neurological impairment as defined by a nihss ≤ 1 and modified rankin scale (mrs) ≤ 2 within 7 days prior to randomization. exclusion criteria: 1. bmi \> 40 2. diagnosis of severe obstructive sleep apnea based on previous polysomnography, with severe defined as an apnea-hypopnea index (ahi) \>30 episodes/hr. 3. high risk for aspiration such as severe esophageal disease (e.g. achalasia, gastroparesis, etc). 4. inability to lie supine for more than 30 minutes. 5. marginal femoral vessels with concern for possible conversion to transapical or transaortic access. 6. patient refusal 7. patient involved in another research study 8. psychiatric condition precluding ability to provide informed consent 9. history of clinical stroke within 3 months prior to randomization
intravitreal mesenchymal stem cell transplantation in advanced glaucoma.

Conditions: Retinal Degeneration; Primary Open-angle Glaucoma

Summary: bone marrow-derived mesenchymal stem cells (msc) therapy is a promising treatment for several degenerative diseases, including retinopathies and glaucoma, however no previous safety study involving humans has been conducted. the objective of this study is to evaluate effects of autologous bone marrow-derived msc transplantation in the worst eye of 10 patients with legal bilateral blindness due to glaucoma. primary outcome are types and severity of adverse effects. secondary outcomes are changes in visual field, visual acuity, optical coherence tomography, and retinal ganglion cells function.


Eligibility criteria:
inclusion criteria: * diagnosis of advanced bilateral open-angle glaucoma; * best corrected visual acuity less than 0,1 in the better eye; * social and cognitive ability to participate. exclusion criteria: * severe systemic morbidities; * other ocular blind conditions associated; * impossibility in performing any of the proposed examinations.
predictive factors for major bleeding risk in patients admitted in a palliative care unit

Conditions: Hemorrhage

Summary: even if most patients in palliative care units presented with well-recognized risks factors of venous thromboembolism (vte) (eg: active cancer, bed rest, previous history of venous thrombosis), the incidence of vte in palliative setting is unknown. by consequence, the efficacy and safety of antithrombotic prophylaxis in such a population is not established. indeed, patients admitted in palliative care units were not included in trials evaluating the potential effect of antithrombotic drugs in regard to their poor prognosis at short term. in addition, the main role of prophylaxis is to prevent sudden death from pulmonary emboli and is thus a life prolonging therapy which is viewed as counterintuitive to palliative care philosophy and inappropriate on grounds of futility. nevertheless, the current use of low molecular weight heparin in palliative care units seems to increase particularly in patients with advanced malignancy. the identification of high hemorrhagic risks in palliative care patients could help the decision of antithrombotic prophylaxis initiation. for this, the investigators conducted a multicenter prospective longitudinal study.


Eligibility criteria:
inclusion criteria: * 18 years * admitted in a palliative care unit for a cancer, a pulmonary, a cardiac or a neurologic advanced disease exclusion criteria: * life prognosis less than 48 hours * patients treated with curative doses of antithrombotic therapy * patients with follow up of 3 months is not possible

Keywords: palliative care unit bleeding thromboembolic hemorrhagic risk antithrombotic prophylaxis
high intensity interval inspiratory training effect on ventilatory functions and diaphragmatic excursion in forward head posture

Conditions: FHD

Summary: purpose: ......... the purpose of the study is to investigate the effect of interval inspiratory muscle training on respiratory functions in subjects with forward head posture associated with chronic nonspecific neck pain background: alteration of head and neck positions can have an immediate negative effect on respiratory function. clinicians should be prompted to assess respiratory function when assessing individuals with fhp and decrease the tension on respiratory system to avoid consequence. also fhp has a negative effect on chest expansion and diaphragmatic function the incidence of forward head posture increases nowadays due to increase using of smartphones hypotheses:: there will be no a significant effect of interval inspiratory muscle training on respiratory functions in chronic forward head posture subjects. research question: will the interval inspiratory muscle training improve respiratory functions in subjects forward head posture associated with chronic nonspecific neck pain?

* for evaluation: we will assess 1-diaphragmatic excursion using ultrasonography 2- ventilatory functions using spirometer 3- chest expansion using tape measurement 4- height and weight scale to detect bmi 5- craniocervical angle * for treatment: we will use 1- threshold inspiratory muscle trainer and they will be randomly allocated into two groups: experimental group: thirty subjects will receive combined program containing interval inspiratory muscle training and conventional exercise program for fhp 12 weeks (3 sessions/ week) control group : twenty subjects will receive conventional exercise program for fhp 12 weeks (3 sessions/ week)

Eligibility criteria:
inclusion criteria: * sixty subjects (female) have forward heads and their craniocervical angle is from 30 to 50° * their body mass index ranged from (24.9 -29.9) kg/m2 exclusion criteria: * chest diseases (either obstructive or restrictive). * smoker patient. * clinical signs of a severe cardiac event. (eg, congestive heart failure), * neurological disorders affecting respiratory muscles or any muscular dystrophies (cervical disc or bulge). * patient with haemodynamic instability.
efficacy and safety of dipeptidyl peptidase-4 inhibitors in diabetic patients with established covid-19

Conditions: COVID 19; Coronavirus; Diabetes Mellitus, Type 2; Diabetes Mellitus; Glucose Metabolism Disorders; Metabolic Disease; Endocrine System Diseases; Dipeptidyl-Peptidase IV Inhibitors; Linagliptin; Severe Acute Respiratory Syndrome Coronavirus 2; Sars-CoV2; Hypoglycemic Agents; Respiratory Tract Diseases; Incretins; Hormones

Summary: the coronavirus disease 2019 (covid-19) is an emerging pandemic in 2020 caused by a novel coronavirus named sars-cov2. diabetes confers a significant additional risk for covid-19 patients. dipeptidyl peptidase 4 (dpp-4) is a transmembrane glycoprotein expressed ubiquitously in many tissues. in addition to its effect on glucose levels, dpp-4 has various effects on the immune system and several diseases, including lung diseases. this trial aims to assess the safety and efficacy of linagliptin, a dpp-4 inhibitor, in the treatment of covid-19. the trial will be randomized without blinding, with one are treated by insulin only for glucose balance and the other by insulin and linagliptin. the trial will assess the effects of linagliptin on different measures of covid-19 recovery.


Eligibility criteria:
inclusion criteria: 1. age ≥ 18 years. 2. history of or type 2 diabetes mellitus or a diagnosis of type 2 diabetes during hospitalization. 3. confirmation of infection with sars-cov-2 by pcr testing. 4. patients within 10 days from symptom onset or patients within 48 hours after laboratory diagnosis (sars-cov-2 pcr). exclusion criteria: 1. who covid-19 ordinal scale for clinical improvement ≥ 6. 2. respiratory failure requiring mechanical ventilation prior to randomization. 3. use of vasopressor or inotropic medications prior to randomization. 4. intolerance/hypersensitivity to dipeptidyl peptidase-4 inhibitors. 5. patients expected to require intensive care unit admission or immediate surgical intervention. 6. participation in another trial assessing any treatment for covid-19. 7. current treatment with a dpp-4 inhibitor. 8. pregnancy.
antimicrobial activity of two mouthwashes

Conditions: Periimplantitis; Dental Plaque; Periodontal Diseases; Caries; Oral Surgical Wound Infection

Summary: this is a three arm randomized trial. the aim is to evaluate the antimicrobial activity of chlorhexidine and polyhexamethylene biguanide oral antiseptics on the microorganisms of the oral cavity. a total of 30 healthy volunteers will be enrolled and randomly allocated to control group (cg, n=10), which will be instructed to rinse the mouth with 10ml of a sterile saline solution for one minute, to chlorhexidine group (clg, n=10), which will be instructed to rinse the mouth with 10ml of an 0.12% chlorhexidine solution, for one minute, or to polyhexamethylene biguanide group (pg, n=10), which will be instructed to rinse the mouth with 10ml of an 0.07% polyhexamethylene biguanide solution, for one minute. samples of saliva will be collected before the mouth wash and after 30, 60 and 180 minutes. samples will be plated on manitol agar, mitis salivarius agar, emb agar and sabouraud agar. samples will be processed by a blinded microbiologist.


Eligibility criteria:
inclusion criteria: * patients aged 18-30 years exclusion criteria: * patients with a hypersensitivity or allergic response by some component of the formula antiseptics, * pregnant women, * lactating, * history of periodontal disease, * smoking, * decompensated diabetics, * patients undergoing chemotherapy, * radiotherapy patient, * transplanted patient and refuses to participate, * not signing a term of free and informed concentiment

Keywords: anti-infective agents local/therapeutic use chlorhexidine dental desinfectants polyhexamethylene biguanide mouthrinse
motor interference therapy for traumatic memories

Conditions: Trauma, Psychological; Post Traumatic Stress Disorder

Summary: the aim of the study is to compare the effect of motor interference therapy (tim) to reduce the intensity of discomfort (distress) generated by a traumatic memory compared to a relaxation control maneuver, immediately after the intervention, a week, a month and six months after intervention.

the investigators treated 10 patients with autobiographical traumatic memories using finger tapping tasks, (motor interference therapy \ )in a pilot study with amazing results and a solid size effect. the investigators decided to challenge the intervention using a control task (jacobson´s progressive relaxation exercises) the hypothesis consists in achieving a 30% reduction of the distress, (measured with visual analogue scale) by using tim compared with the control task. patients with traumatic memories will be enrolled in to one of two treatment modalities. the first group will receive motor interference therapy and the second group will receive a control task (relaxation exercises). both groups will be assessed using the spanish version of the ptsd symptom severity scale-revised (egs-r), the visual analogue scale (eq-vas) from euroqol 5d (eq-5d), and a simple visual-analogue scale (vas) immediately after, a week after, a month after and six months after the treatment for follow up.

Eligibility criteria:
inclusion criteria: * patients older than 16 years * spanish as a native language * give written informed consent * having at least 1 traumatic memory causing distress exclusion criteria: * neurological or psychiatric disorders that affect the capacity of verbal comprehension and judgment, such as dementia, psychosis, mental retardation or other cognitive alteration that does not allow them to perform the tasks indicated in the tim or sham * history of recent substance abuse * patients with significant hearing loss or some other hearing impairment

Keywords: traumatic memories post traumatic stress disorder motor interference therapy non pharmacological therapy trauma related disorders
intensive drug therapy for ischemic stroke caused by severe intracranial arterial stenosis

Conditions: Ischemic Stroke

Summary: to observe the safety and efficacy of intensive drug therapy for ischemic stroke caused by severe intracranial arterial stenosis.patients with acute stroke caused by intracranial arterial stenosis (stenosis rate ≥70%) were enrolled and accept dual antiplatelet therapy (dapt) (aspirin 100 mg/d and clopidogrel 75 mg/d for 90 days, followed by aspirin 100 mg/d for long term) under the guidance of platelet function analysis (verifynow) combined with the intensive statin therapy (40 mg/d for 14 days, followed by 20 mg/d for long term).

patients (35 to 80 years ) with acute ischemic stroke, who can be treated within 72 hours of symptom onset will be enrolled. patients fulfilling all of the inclusion criteria and none of the exclusion criteria will be randomly selected.patients were treated with dual antiplatelet therapy (dapt) (aspirin 100 mg per day and clopidogrel 75 mg per day were administered for 90 days, followed by aspirin 100 mg per day for long term) and atorvastatin (40 mg per day for 14 days, followed by 20 mg per day long term) after enrollment. patients with aspirin resistance (aspirin reaction units \[aru\] ≥550) or clopidogrel resistance (p2y12 reaction units \[pru\] ≥208) were excluded on the 7th day of therapy.the primary objective is to observe the safety and efficacy of intensive drug therapy for ischemic stroke patients. a data and safety monitoring board (dsmb) will regularly monitor safety during the study. the trial has been approved by ethics committee of yueyang hospital of integrated traditional chinese and western medicine affiliated to shanghai university of traditional chinese medicine.

Eligibility criteria:
inclusion criteria: * age between 35 and 80 years; * onset \<72 hours; * new-onset ischemic stroke confirmed by skull magnetic resonance diffusion weighted imaging (mr-dwi); * severe icas (stenosis ≥70%) indicated by time-of-flight magnetic resonance angiography (tof-mra). exclusion criteria: * ischemic stroke caused by other etiological factors (e.g., cardio-embolism, arterial dissection, vasculitis, etc.); * post-infarction hemorrhagic transformation and intraplaque hemorrhage as indicated by imaging examination; * contraindications to aspirin, clopidogrel, or atorvastatin; * intracranial hemorrhage within 3 months and a recent history of surgery or trauma; * severe organ impairment, liver insufficiency, and renal insufficiency; * complicated with tumors or hemorrhagic diseases; * use of drugs forbidden to use in combination after onset, including other antiplatelet drugs, anticoagulants, thrombolytic drugs, and drugs affecting antiplatelet agents and statin metabolism.
vertebral fracture and osteonecrosis associated with high-dose glucocorticoid

Conditions: Vertebral Fracture; Osteonecrosis; Rheumatic Diseases

Summary: osteoporotic vertebral fracture (vf) and osteonecrosis of the femoral head (ofh) are major concerns in patients with systemic rheumatic diseases treated with high-dose glucocorticoids (gcs). the investigators examined and compared the incidence and risk factors of vf with those of ofh in patients who had recently received high-dose gc therapy to clarify the relationship between these two complications.

patients with rheumatic diseases receiving gcs (≧0.5 mg/kg/day for prednisolone equivalent) within the past 2 months were enrolled in this study, and treated with 200 mg/day of etidronate cyclically. the bone mineral density (bmd) of lumbar spines (l2-4) was examined by qdr2000. ofh was evaluated by magnetic resonance imaging (mri). clinicaltrials.gov identifier: nct00679978. forty-four patients completed the 2-year study including annual x-rays and the bmd analysis. mri evaluation at entry and 2 years was performed in 41 patients. the bmd values with anteroposterior (ap) and lateral views decreased by 6.4% and 9.7% respectively in the first year, but were stable in the second year. eleven patients developed vf and 9 patients developed ofh. the risk factors for vf included previous vf and a low bmd value (t score \ 1.2 mg/kg/day versus ≦; or=7.7, 95%ci 1.3-45.5) and the decrease in bmd value of lateral view (\>15% versus ≤; or=6.7, 95% ci 1.2-36.1) in the first year.

Eligibility criteria:
inclusion criteria: * patients admitted to our hospital for the treatment of active systemic rheumatic diseases taking at least 0.5 mg/kg/day for psl equivalent between january 2001 and june 2003 were eligible for this prospective study exclusion criteria: * patients who were not appropriate for this study

Keywords: osteoporosis glucocorticoid bone mineral density osteonecrosis of the femoral head
tolerance to immunomodulatory nutritional therapy in oncology patients undergoing chemotherapy and radiotherapy

Conditions: Nutritional Deficiency; Breast Cancer; Anal Cancer

Summary: the importance of nutritional support is established in some types of neoplasms, especially those involving the digestive tract. recently, nutritional supplements containing substances with proposed immunomodulatory action have been developed. it is still unclear whether the use of immunomodulatory supplements can reduce the occurrence of treatment-related toxicities in oncology, such as radiodermatitis and mucositis. the aim of this study is to investigate whether the use of supplements with immunomodulatory action could reduce the occurrence of cutaneous and mucosal toxicities in oncology treatment, such as radiodermatitis and diarrhea.

a prospective pilot study will be conducted to assess the use of immunomodulatory nutritional therapy in patients undergoing chemotherapy and radiotherapy for adjuvant or definitive cancer treatment at a service affiliated with oncologia d'or or at the instituto do câncer do estado de são paulo.

Eligibility criteria:
inclusion criteria: 1. histological confirmation of carcinoma from one of the following two primary sites: breast (cohort a); anal canal (cohort b); 2. localized disease, stages i-iii, according to the 8th edition of tnm classification; 3. indication for neoadjuvant tc-hp treatment, surgery, and adjuvant radiotherapy for breast cancer (cohort a) or definitive chemoradiotherapy for anal canal cancer (cohort b). exclusion criteria: 1. metastatic disease; 2. inability to intake food orally; 3. conditions that compromise the ability to ingest or absorb nutritional therapy, such as inflammatory bowel disease, intestinal perforation, intestinal obstruction, or uncontrolled lower gastrointestinal bleeding; 4. previous radiotherapy in the same field where the current treatment will be performed.
atacand (candesartan) real life study

Conditions: Hypertension

Summary: this study is a swedish historical cohort study in patients prescribed atacand or cozaar for hypertension by selected primary care centres. data will be extracted anonymously from electronic medical records. in addition, data regarding morbidity and mortality will be collected by merging the cohort with the following national registries: the hospital discharge register (slutenvårdsregistret), the cause of death register and the heart intensive care admission (riks-hia)


Eligibility criteria:
inclusion criteria: * recorded blood pressure prior to therapy of \> 140 and/or 90 mmhg * diagnosed as hypertensive within 15 months * first prescription of cozaar or atacand between 1 january 1999 and 31 december 2007, inclusive exclusion criteria: * previous prescription within 15 months any drug from the atc groups c02, c03, c07 - c09 inclusive

Keywords: candesartan losartan blood pressure cardiovascular disease health care consumption
ultrasound in muscle biopsy

Conditions: Myopathy; Myositis; Muscular Dystrophy

Summary: the objective of the proposed study is to evaluate the clinical utility of muscle ultrasonography for improving the diagnostic yield and safety of core muscle biopsy. our facility currently uses core (needle) biopsy to obtain muscle samples in patients 18 years old or older. currently, there is no imaging tool used to guide the actual biopsy. as muscle biopsy is an invasive and potentially painful procedure, improving the diagnostic yield of this test is important.


Eligibility criteria:
inclusion criteria: * consecutive subjects scheduled for a biopsy at our emg laboratory will be asked if they would like to participate until a total of 40 participants are obtained. exclusion criteria: * age under 18 years. * inability to provide consent for participation.
low-dose s-ketamine and postpartum depression in parturients with prenatal depression

Conditions: Prenatal Depression; Ketamine; Postpartum Depression

Summary: prenatal depression is an important risk factor of postpartum depression. low-dose ketamine has been used for depression treatment. as a stereoisomer of ketamine, s-ketamine has similar effects to ketamine in anti-depression. we speculate that, for pregnant women with prenatal depression, low-dose s-ketamine infusion after childbirth may reduce the incidence of postpartum depression.

studies have shown that prenatal depression symptoms are important predictors of postpartum depression. screening of pregnant women's mental condition before giving birth, early identification of pregnant women with symptoms of prenatal depression, and providing appropriate interventions may play an important role in reducing the incidence of postpartum depression. ketamine is an nmda-receptor antagonist. in recent years, many studies confirmed that ketamine has a significant antidepressant effect. as a stereoisomer of ketamine, s-ketamine has similar effects to ketamine in anti-depression. in clinical application, s-ketamine has stronger analgesic effect, better anesthetic effect and lower incidence of adverse psychological reactions. we speculate that, for pregnant women with prenatal depression, low-dose s-ketamine infusions after childbirth may reduce postpartum depression. evidence is lacking in this regard.

Eligibility criteria:
inclusion criteria: * parturients with age ≥18 years; * presence of prenatal depression (epds score ≥10); exclusion criteria: 1. a clear history of mental illness (depression, schizophrenia, etc.) or communication difficulties; 2. severe pregnancy complications, such as severe preeclampsia, placental implantation, hellp (syndrome hemolytic anemia, elevated liver function and low platelet count) syndrom, placenta previa, and placental abruption; 3. american society of anesthesiologists classification ≥iii; 4. presence of contraindications to ketamine/s-ketamine use, such as refractory hypertension, severe cardiovascular disease (new york heart association classification ≥iii), and hyperthyroidism.

Keywords: prenatal depression s-ketamine postpartum depression