Kornimate/medical-research-clean huggingface dataset:
outcome of patients with thoraco-abdominal injury and stress-induced hyperglycemia or diabetic hyperglycemia

Conditions: Abdominal Injury; Thoracic Injury; Hyperglycemia; Hyperglycemia Stress

Summary: this study aimed to measure the effects of sih and dh on the mortality outcomes of the adult patients with moderate to severe thoracoabdominal injury

because the pathophysiologic response of the patients with a thoracoabdominal injury is different from those who had a traumatic brain injury, this study aimed to measure the effects of hyperglycemia induced by stress or by diabetes on the outcomes of patients with thoracoabdominal injuries in comparison with those who had non-diabetic normoglycemia (ndn). the primary study hypothesis stated that, following thoracoabdominal injuries, the patients with sih had a worse outcome than patients with dh. the primary outcome was mortality rate of these patients.

Eligibility criteria:
inclusion criteria: * adult patients with moderate to severe thoracoabdominal injuries exclusion criteria: * patients with a thoracic and abdominal abbreviated injury scale (ais) \< 3 * patients who had polytrauma which was defined as there was additional ais scores ≥ 3 points in other regions of the body * patients less than 20 years old * patients who had sustained a burn injury

Keywords: admission hyperglycemia stress-induced hyperglycemia diabetic hyperglycemia diabetes mellitus thoracoabdominal trauma mortality
mobile diabetes management

Conditions: Diabetes

Summary: the mobile diabetes intervention study trial is evaluating a diabetes coaching system, using mobile phones and patient/ physician internet portals to allow patient-specific treatment and communication by their primary care physician. we hypothesize that timely information provided to patients and their physicians can result in reduction of a1c over 1 year.


Eligibility criteria:
inclusion criteria: * type 2 diabetic \[patient\] * a1c equal to or greater than 7.5 \[patient\] * 18-64 years of age at time of recruitment \[patient\] * access to the internet (does not need to be at their home, elsewhere is fine e.g. work) \[patient\] * e-mail account \[patient\] * must speak english \[patient\] exclusion criteria: * no insulin pump \[patient\] * no current alcohol or drug abuse- must be sober 1 year \[patient\] * not currently pregnant \[patient\] * no terminal diagnosis \[patient\] * no dementia or alzheimer's \[patient\] * no active chemotherapy \[patient\] * no significant hearing impairment \[patient\] * poorly corrected vision that would impede use of phone \[patient\] * no mute or aphasia \[patient\] * no diagnosis of schizophrenia, bipolar disorder, or major psychosis \[patient\] * no medicaid or medicare * no uninsured

Keywords: diabetes glucose control diabetes monitoring care management electronic communication mobile phone technology self care
methadone associated with morphine for cancer pain

Conditions: Cancer

Summary: the study was prospective, randomized. patients with cancer pain were evaluated, one group receiving methadone with morphine and another group receiving morphine as the only opioid. pain intensity, total morphine dose and adverse effects were evaluated.

opioids are the most important analgesics for the relief of cancer pain. in addition tolerance and hyperalgesia may ocurr as a consequence of treatment with these drugs. medications for pain relief may also cause increased pain. nmda receptor blockers may prevent or reduce the development of hyperalgesia. methadone is a weak nmda receptor antagonist and therefore its association could prevent hyperalgesia. the primary endpoint of the study was whether the administration of low dose methadone associated with morphine promotes better analgesic effect in patients with cancer pain, and secondarily to assess whether there is a reduction in the total dose of opioid needed for pain relief, and whether reduction of the opioid-related adverse effects occurs.

Eligibility criteria:
inclusion criteria: * approved by the ethics committee * signed the informed consent * cancer pain * starting the who thirth analgesic ladder, exclusion criteria: * cognitive impairment * psychiatric disease * illicit drug user * hypersensitivity to the study drugs * pregnant

Keywords: morphine methadone pain
internet-delivered cognitive behavioural therapy for persons with stroke

Conditions: Stroke; Depression; Anxiety

Summary: approximately 30% of people with stroke experience symptoms of depression. many may benefit from access to mental health services that target unhelpful thoughts, such as cognitive behaviour therapy (cbt), but go untreated due to lack of access to specialized care, costs, remote location, or stigma related to seeking care. internet cognitive behavioural therapy (icbt) may overcome these barriers. the stroke icbt program teaches skills such as challenging unhelpful thoughts, memory and attention, managing related physical symptoms, and pacing through a mix of online learning and weekly contact with a trained guide. while the program's content was found to be acceptable among individuals after stroke, the program's effectiveness still needs to be evaluated. thus, the primary purpose of this study is to evaluate if the stroke icbt program will improve symptoms of depression compared to an attention control group. individuals in both groups will answer questions about themselves and their injury and describe symptoms of depression, quality of life, and health service use to evaluate its impact on people's wellbeing. the study results will be useful in determining if the icbt program is effective and whether it should be part of routine clinical practice.


Eligibility criteria:
inclusion criteria: * 18 years of age or older; * canadian residents; * diagnosed with a stroke at least 6 months ago; * endorsing symptoms of depression (phq-9≥5); 5) suicide risk score \<8 (suicide behaviours questionnaire); * speak and read english; * able to access and be comfortable using computers and the internet; * willing to provide a physician as an emergency contact. exclusion criteria: * significant cognitive impairment, a score of \<21 on the telephone interview for cognitive status; * aphasia, with significant language impairment; * currently involved in another psychotherapeutic intervention; * present with a severe mental health disorder requiring in-person therapy (e.g., severe suicidal ideation, severe substance abuse, a recent history of psychosis or mania).

Keywords: stroke depression anxiety internet-delivered cognitive behaviour therapy
non-invasive cardiac output monitor in young adults

Conditions: Fluid Overload; Hypovolemia

Summary: the investigators would like to study cardiac output, stroke volume, and fluid responsiveness on young adult pediatric patients undergoing anesthesia and surgery with the use of the nicom, a non-invasive monitor. the nicom method is non-invasive and provides reliable trending of cardiac output and stroke volume. measuring cardiac output in conjunction with routine monitoring will provide a better assessment of intra-operative status.

this study will involve measurements of cardiac output, stroke volume, and fluid responsiveness (change in stroke volume of ≥ 10%) obtained via passive leg raise (plr) before and after anesthesia induction.

Eligibility criteria:
inclusion criteria: * 18 -30 years of age * presenting for surgery at riley or university hospital exclusion criteria: * younger than 18 * severely mentally handicapped * orthopedic cases with leg injuries * any other contraindications that would prevent or discourage passive leg raises * if deemed ineligible by an investigator for any other reason.

Keywords: cardiac monitoring, cheetah medical, passive leg raises
correlation between shoulder impingement and cervical proprioception

Conditions: Shoulder Impingement

Summary: this study will be conducted to evaluate the correlation between shoulder impingement and cervical proprioception

shoulder pain is one of the most common complaints in musculoskeletal practice, whether it comes from impingement syndrome or a defect in rotator cuff muscles .shoulder pain is considered to be the third most common complaint in musculoskeletal practice, with a prevalence of 7% to 34% .shoulder impingement is a syndrome where there is entrapment of soft tissue through the shoulder joint, with a prevalence of 44% to 65% of all shoulder complaints. shoulder impingement has multiple causes, whether functional, degenerative, and anatomical and mechanical causes .shoulder impingement classified to primary and secondary. secondary impingement is subdivided into internal and external impingement .proprioception components are joint position sense, kinesthesia, sense of force, sense of change of velocity. joint position sense is our perception of position of the joint or limb it divided to active/passive joint position sense, it means that the person can relocate the position of the joint or the limb to the same position after the joint or limb is moved.the muscle receptor helping in identifying the limb position and movement through changeling in neural signaling in the sensory receptor, giving the neurological control and basis of proprioception to sensory receptors located in the skin, muscles, and joints, so the proprioception is considered to be a loop of feedforward and feedback signals between sensory receptor and the nervous system. sixty eight subjects with shoulder impingement syndrome will be joined to this study.

Eligibility criteria:
inclusion criteria: * diagnosis: patients diagnosed with shoulder impingement * age: patients aged between 25 and 45 years. * pain and mobility issues: patients must report mild to moderate pain and/or restricted range of motion (rom) in shoulder joint . * ability to provide informed consent: participants must be able to understand the study protocol and provide written informed consent to participate. * medical stability: patients must be medically stable and able to engage in physical assessment exclusion criteria: * any patient aged below 25 or above 45 years old * subjects have malignancy: patients with severe neurological, musculoskeletal, disorders that could interfere with the study interventions * subjects have history of shoulder trauma, fractures and surgeries: * subjects have neck dysfunction * cognitive impairment: patients with significant cognitive impairment or mental health conditions that would hinder their ability to understand or comply with the study protocol.

Keywords: shoulder impingement neck proprioception correlation cervical proprioception
vitamin d level and it's association with disease activity in egyptian rheumatoid arthritis patients

Conditions: Rheumatoid Arthritis (RA)

Summary: vitamin d level and its association with disease activity in egyptian rheumatoid arthritis (ra) patients

rheumatoid arthritis (ra) is a chronic inflammatory disease that affects about 1% of the human population. its incidence increases between 25 and 55 years and is the most common type of chronic inflammatory arthritis . it affects joints bilaterally with synovial hyperplasia, cartilage erosion, bone destruction, and progressive loss of function . also characterized by systemic features and joint involvement. it can lead to significant morbidity and mortality so early diagnosis and proper treatment are crucial in decreasing the burden of this disease . according to the world health organization mortality database of 31 countries, ra accounts for almost 18% of all deaths caused by different types of arthritis and other musculoskeletal diseases, but the exact cause of ra remains unknown

Eligibility criteria:
inclusion criteria: * both males and females in the age group of 1875 years having ra according to the american college of rheumatology european league against rheumatism 2010 criteria (meena et al., 2018). will enrolled in this study exclusion criteria: * patients with malnutrition, hepatic and renal dysfunction, hyperparathyroidism, hyperthyroidism, diabetes mellitus, and patients on vitamin d supplementation in the past 6 months or on medications that can affect bone and vitamin d metabolism (anticonvulsants, diuretics, and thyroxin) were excluded from this study. * patients with overlap syndrome * known allergy to dmards, 1,25 dihydroxy vitamin d3 or calcium supplements
evaluation of the efficacy and safety of bempedoic acid (etc-1002) in patients with hyperlipidemia and statin intolerant

Conditions: Hypercholesterolemia; Atherosclerotic Cardiovascular Disease; Statin Adverse Reaction

Summary: the purpose of this study is to determine if bempedoic acid (etc-1002) is effective and safe versus placebo in patients with elevated ldl cholesterol and who are statin-intolerant.


Eligibility criteria:
inclusion criteria: * require lipid-modifying therapy for primary or secondary prevention of cardiovascular disease * fasting ldl-c ≥130 mg/dl for primary prevention or ldl-c ≥100 mg/dl for secondary prevention (history of hefh and/or ascvd) * be statin-intolerant (unable to tolerate 2 or more statins) exclusion criteria: * total fasting triglyceride ≥500 mg/dl * renal dysfunction or nephrotic syndrome or history of nephritis * body mass index (bmi) ≥50 kg/m2 * significant cardiovascular disease or cardiovascular event in the past 3 months

Keywords: hyperlipidemia cholesterol familial hypercholesterolemia atherosclerotic cardiovascular disease ascvd hefh ldl statin intolerance
clinical response and safety following fmt for uc

Conditions: Inflammatory Bowel Diseases; Fecal Microbiota Transplantation

Summary: the study aims to evaluate the clinical efficacy and safety of fecal microbiota transplantation by automatic methods in the treatment of moderate to severe active ulcerative colitis. there are two groups according to fmt pathway ( through a naso-jejunal tube or transendoscopic enteral tubing). patients were followed up until 2 weeks after the final fmt in hospital.


Eligibility criteria:
inclusion criteria: - eligible patients required a diagnosis of ulcerative colitis made by a primary gastroenterologist based upon history, physical exam, laboratory/radiological studies and gastrointestinal histology. all patients were age ≥ 18 year old at the time of enrollment. they had moderate to severe symptoms with a mayo score between 6\~12 and an endoscopic subscore ≥2. patient medication for uc could not have changed for at least one month prior to fmt. exclusion criteria: - active or history of intraabdominal abscess, acute abdomen or other clinical emergencies requiring emergent management, pregnancy, prior history of fmt, prior history of tnf inhibitors use, or other serious systemic disease.
physical activity effects on health care utilization

Conditions: Cardiovascular Diseases; Heart Diseases

Summary: to determine the magnitude of the relationship between physical activity level and subsequent health care utilization over a seven to ten week period in a general population.

background: in recent years, the benefits of a physically active lifestyle have been well established with respect to chronic health problems such as coronary heart disease, hypertension, obesity and osteoporosis. however, the extent to which physical activity influences health care utilization is less clear. if physical activity levels are inversely associated with utilization patterns, then policies encouraging exercise may produce short-term reduction in health care costs. design narrative: a multivariate regression analysis was conducted for a representative sample of more than 600 adults who participated in a longitudinal field trial of health risk appraisal instruments. using the harvard alumni activity survey as the physical activity measure, the analysis controlled for a variety of predisposing, enabling, and need characteristics that also influenced utilization behavior. the study completion date listed in this record was obtained from the "end date" entered in the protocol registration and results system (prs) record.

Eligibility criteria:
no eligibility criteria
comparative effectiveness of stress tests

Conditions: Coronary Artery Disease

Summary: the primary objective of this project is to demonstrate that a new approach to cardiac stress imaging that combines treadmill exercise with cardiac magnetic resonance (cmr) provides valuable clinical information in a cost-effective manner.


Eligibility criteria:
inclusion criteria: * any patient referred for stress spect * known or suspected ischemic heart disease * ability to perform adequate treadmill stress exclusion criteria: * any contraindication to mri (e.g. ferromagnetic foreign body, cerebral aneurysm clip, pacemaker/icd, severe claustrophobia) * renal insufficiency (gfr \< 40) * known allergy to gadolinium-based contrast or iodinated contrast (because of the research cta in patients not referred for cath after 2 weeks)
effects of sglt2 inhibition on the mechanisms of cardiac damage in the diabetic patient with hfpef

Conditions: Diabetes Mellitus, Type 2; Heart Failure With Preserved Ejection Fraction

Summary: the main aim of this study is to identify the underlying mechanisms of sodium-glucose co-transporter-2 (sglt2) inhibitors which are associated to better outcomes in patients with diabetes mellitus type 2 and heart failure with preserved ejection fraction.

double design study including a clinical trial and a nested case-control study. a) experimental study (clinical trial): phase iv, prospective, randomized, double-blind placebo-controlled with 12 months follow-up. inclusion criteria are: 1) diagnosis of dm2, 2) hf with preserved ef with a hospital admission in the previous 6 months with demonstration of diastolic dysfunction. 3) stable clinical situation at inclusion. 4) clinical indication of cardiac catheterization. patients will be randomized 1:1 to received dapagliflozin 10 mg/day or placebo. the main objective is to compare the impact of the drug on lv diastolic properties at the peak of effort and in levels of plasma deposit and cross-linking biomarkers of type i collagen between the two treatment groups at baseline and after 12 months. 52 patients will be recruited. b) descriptive study: nested case-control study, considering patients from the experimental study as cases and 10 additional patients with hf with preserved ef but no type 2 dm as controls. the main aim will be compare the histological, molecular, biochemical and biomechanical features of the hfpef patients with and without dm2.

Eligibility criteria:
inclusion criteria: * diagnosis of dm2 based on the established criteria: hba1c ≥ 6.5% (48 mmol / mol) and fasting plasma glucose ≥ 7.0 mmol / l (≥126 mg / dl) or 2-h after overload ≥ 11.1 mmol / l ( ≥ 200 mg / dl). * lvef ≥ 50%. * diagnosis of icfep according to clinical criteria, with a hospital admission in the previous 6 months with demonstration of diastolic dysfunction according to the echocardiographic criteria. * stable clinical situation (\> 1 month after hospitalization due to ic decompensation). * clinical indication of cardiac catheterization. * signature of informed consent. exclusion criteria: * previous treatment with isglt2. * significant coronary disease. * aortic or mitral valve disease ≥ moderate (grades 3 or 4/4 for valve regurgitations) * contraindications for dapagliflozin treatment according to the data sheet (hereditary galactose intolerance, lapp lactase insufficiency or glucose-galactose malabsorption, moderate-severe renal failure -crcl \<60 ml / min or egfr \<60 ml / min / 1 , 73 m2-, severe hepatic insufficiency). the inclusion/exclusion criteria for descriptive study will be the same as previously described without the diagnosis of dm2.

Keywords: diabetes mellitus heart failure
association between body composition and digestive system cancer survival

Conditions: Digestive System Cancer

Summary: investigators intend to utilize clinical data from the department of oncology at jiangsu provincial people's hospital to analyze changes in body composition in digestive system tumor patients before and after receiving anti-tumor drug treatment. investigators aim to uncover the association between baseline body composition and overall/progression-free survival in patients with digestive system tumors. additionally, investigators plan to investigate the relationship between changes in body composition during anti-tumor drug treatment (chemotherapy and immunotherapy) and the prognosis of tumor patients.


Eligibility criteria:
inclusion criteria: * male or female patients aged between 18 and 85 years old. * patients with histologically confirmed digestive tract cancers, such as esophageal cancer, gastric cancer, small intestinal cancer, colorectal cancer, as well as pancreatic cancer, liver cancer, gallbladder cancer, etc. * patients admitted for anti-tumor-related drug treatment. * expected survival period of more than three months. * ecog ps score: \< 4. * no severe psychological disorders, physical disabilities, dementia, alzheimer's disease, pulmonary tuberculosis, hiv/aids, or other infectious diseases. * patients must have sufficient organ and bone marrow function, meeting the following criteria: 1. hematological criteria: hemoglobin (hb) ≥ 90 g/l (without blood transfusion in the past 28 days). absolute neutrophil count (anc) ≥ 1.5×109/l. peripheral blood monocytes \> 1500mm3. platelet count (plt) ≥ 100×109/l. 2. biochemical criteria: total bilirubin (tbil) ≤ 1.5 × the upper limit of normal (uln). alt and ast ≤ 2.5×uln; if there is liver metastasis, alt and ast ≤ 5×uln. creatinine (cr) ≤ 1.5×uln or creatinine clearance rate (ccr) ≥ 60 ml/min (cockcroft-gault formula). 3. coagulation function is sufficient, defined as international normalized ratio (inr) or prothrombin time (pt) ≤ 1.5 × uln. * women of childbearing potential must have a negative pregnancy test (serum or urine) within seven days before enrollment and must voluntarily use appropriate contraception methods during the observation period and within six months after the last dose. * signed informed consent. exclusion criteria: * female patients who are pregnant or breastfeeding. * patients with accompanying diseases, as judged by the investigator, pose a serious risk to patient safety or may affect the patient's ability to complete the study. * patients with poor compliance who refuse to undergo body composition measurements. * patients who experience a severe adverse event judged by the investigator as no longer suitable for continued participation in the study or those who become unexpectedly pregnant. * patients who are unwilling to continue in the clinical trial and insist on withdrawal. * the investigator deems it necessary to terminate the study. * patients who were mistakenly included but did not meet the criteria.
prospective, randomized study of the impact of a education program for patients suffering from low back pain

Conditions: Low Back Pain

Summary: according to the who, therapeutic education is intended to help patients acquire or maintain the skills they need to optimally manage living with a chronic disease. low back pain is frequent and therapeutic education could be a promising option. the purpose of the study is to evaluate the impact of a therapeutic education program for patients suffering from low back pain.


Eligibility criteria:
inclusion criteria: * low back pain * treatment with transcutaneous electrical nerve stimulation (tens) exclusion criteria: * contra-indication of tens * patients with mental disorders * lack of autonomy or patients living alone at home without help * concomitant inclusion in another research on the treatment of pain