Kornimate/medical-research-clean huggingface dataset:
computer decision support to achieve glycemic control in the icu

Conditions: Burns; Hypoglycemia

Summary: this study is intended to fill the knowledge gap regarding the burn population with research that achieves scientific merit. we will determine the effectiveness of the computer decision support system (cdss) to facilitate glucose management in the critically ill burn patient. the endotool™ computer decision support system will achieve glycemic control (defined as 80-110 mg/dl) in a shorter time, reduce glycemic excursion outside of target range, and reduce incidence of hypoglycemia (blood glucose less than 50 mg/dl) in the critically ill burn patient compared to the standard of care usaisr insulin titration protocol (appendix a).

this is a prospective, paired, randomized, cross-over design, with two groups: current standard of care using the usaisr burn center insulin titration nomogram (appendix a) and insulin management using endotool™ (md scientific, llc) decision support software. patients will thus serve as their own controls. upon admission to the burn icu, patients expected to require continuous insulin infusion for a minimum of 7 days will be placed on endotool™ cdss for the first 24 hours of glycemic management. at the 24 hour mark the patients will be randomly assigned to either the cdss or standard of care group in pairs. thus, the first subject will be randomized to a group and the second subject will be placed in the alternate group. this method will ensure equal numbers of patients are enrolled in each group to eliminate bias of timing of intervention due to the effect of increasing insulin resistance over time demonstrated in the burn population (pidcoke, unpublished, usaisr).

Eligibility criteria:
inclusion criteria: * 18 years or older * military or civilian burns on continuous insulin infusion for 7 days exclusion criteria: * not expected to receive insulin for 7 days * less than 18 years old * enrolled in the continuous glucose monitoring study

Keywords: burns hypoglycemia hyperglycemia glucose monitoring
glucagon-like peptide-1 (glp-1) suppression of alpha cell secretion in type 2 diabetes mellitus (t2dm)

Conditions: Hyperglycemia; Hyperglucagonemia; Glucose Intolerance

Summary: the incretin hormone glucagon-like peptide-1 (glp-1) has known insulinotrophic and glucagonostatic properties. however, inpatients with type 2 diabetes mellitus (t2dm)it is shown, that the beta cell sensitivity towards glp-1 is decreased, when comparing to healthy controls. further, these patients have decreased glp-1 response to a meal. the aim of this study is to elucidate if the diabetic hyperglucagonemia, seen in these patients both during fasting and in a postprandial condition, is coursed by a decreased sensitivity to glp-1 in the diabetic alpha cell. ten t2dm patients and ten matched healthy control subjects will be examined on two separate days. day 1: increasing glp-1 infusions and day 2: saline. during both days plasma glucose (pg) will be clamped at fasting level (fpg). patients with t2dm will be submitted til a day 3, here pg will be normalized over-night by an adjustable insulin infusion, on the following day the glp-1 infusion of day 1 will be repeated. the hypothesis is that these patients have decreased alpha cell sensitivity to glp-1 as is the case with the beta cell sensitivity. this decreased sensitivity, the investigators speculate, contributes the defect suppression og glucagon and thereby to the increased pg levels seen in t2dm. further the investigators will elucidate if this sensitivity can be increased by normalizing the diabetic pg to a normal fpg level.


Eligibility criteria:
inclusion criteria: * t2dm according to who criteria * written consent * age \> 18 years exclusion criteria: * kidney or hepatic disease * treatment with insulin or glitazone

Keywords: glucagon glp-1 hyperglycemia
clinical effect and safety of tamsulosin 0.4mg in patients with luts/bph refractory to tamsulosin 0.2mg

Conditions: Benign Prostatic Hyperplasia

Summary: the purpose of this study is to explore the efficacy and safety of tamsulosin 0.4mg (harnal® d. 0.2mg, 2t) in patients with luts/bph refractory to tamsulosin 0.2mg (harnal® d 0.2mg, 1t).

alpha-adrenoreceptor antagonists have become the primary medical treatment for lower urinary tract symptoms (luts) associated with benign prostatic hyperplasia (bph). the next treatment method is trans-urethral resection of prostate (turp). turp is the most efficient bph treatment for relieving symptoms and improving uroflow, but it is also the invasive and morbid. tamsulosin has higher selectivity for the pharmacological a1-adrenoceptor subtype and the cloned a1a subtype than for the a1b subtype. tamsulosin 0.4 mg improved qmax to a slightly greater extent than alfuzosin 10 mg.(26% and 16% versus baseline, respectively)(http://www. fda.gov/cder/approval/ index.htm;accessed october 27, 2003.) and tamsulosin 0.4 mg o.d. has been reported to be well tolerated irrespective of age and/or cardiovascular comorbidity/co-medication (michel et al 1998) and no interaction with several antihypertensive agents has been reported. (lowe et al. 1997) our study is to explore the efficacy and safety of tamsulosin 0.4mg (harnal® d. 0.2mg, 2t) in patients with luts/bph refractory to tamsulosin 0.2mg (harnal® d 0.2mg, 1t).

Eligibility criteria:
inclusion criteria: * male ≥ 45years * (luts/bph patients refractory to tamsulosin 0.2mg during 4 weeks) \*all of the following: * moderate to severe luts : ipss ≥ 13 * an enlarged prostate (≥ 20ml, or moderately enlarged) * decreased peak flow rate : qmax ≥4ml/s, ≤15ml/s volume voided ≥ 125 ml) exclusion criteria: * post voided residual urine ≥ 200ml * patients performing catheterization * urinary tract infection patients * patients taking 5 alpha reductase inhibitor * known hypersensitivity to tamsulosin * history of postural hypotension or syncope * hypertension patients treated with other alpha1-blockers * patients newly taking anticholinergic medication within 1 month * hepatic insufficiency (ast/alt ≥ 2 times of normal range) * renal insufficiency (s-cr ≥ 2mg/dl)
body composition, bone health and hormonal status in hiv-1-infected individuals

Conditions: HIV-1; Treatment-naïve

Summary: improved survival of people living with hiv has resulted in an increased occurrence of other comorbidities, such as cardiovascular, renal, bone and endocrine pathologies. the data that is currently available on cart-associated changes in bone mineral density, body composition and hormonal values is short-term and mainly derived from patients initiating cart in accordance with previous treatment guidelines. as current guidelines recommend earlier cart initiation and as pi-based regimens are becoming less frequently used, a favorable outcome on bone health, body composition measures and endocrine status might be expected. this study will therefore prospectively document alterations in bone mineral density, body composition and endocrine status in hiv-infected patients in whom, in the current treatment era, an insti-based cart regimen is initiated as a first line regimen.

patients will be included at the initiation of cart. the follow up for this study is planned to fit within the routine follow up consultations and includes some extra experimental investigations, such as the medical body composition measurements, resting energy expenditure measurement, achilles bone ultrasonometer and dxa scans. standard blood and urine samples will be taken, including standard analyses and some extra analyses for the study. physical activity will be monitored for 5 consecutive days using a bracelet device while patients will be asked to record their food intake using a standardized diet agenda. total follow up time will be 144 weeks and includes 12 visits in total.

Eligibility criteria:
inclusion criteria: * documented and confirmed hiv-1-infection * aged 18 years or above * naïve to anti-retroviral treatment, unless anti-retrovirals were taken in the context of occupational or non-occupational post-exposure prophylaxis or in the context of prevention of mother-to-child transmission * willingness to sign the written informed consent exclusion criteria: * pregnancy and breastfeeding * patients receiving medical care through an 'emergency care package'
review of anaesthetic practice in orthognathic surgery

Conditions: Maxillofacial Abnormalities; Blood Pressure; Anesthesia

Summary: orthognathic surgeries for maxillofacial deformities are commonly performed globally. however, they are associated with significant blood loss which can affect the surgical field and result in blood transfusion and its risks. we aim to review the different hypotensive anaesthetic practices for orthognathic surgeries, and their effects on intraoperative blood loss and transfusion requirements.


Eligibility criteria:
inclusion criteria: * all patients who were scheduled for orthognathic surgeries from january 2014 to march 2017 exclusion criteria: * surgery was not done * there were missing anaesthetic records
aspergillus-specific igg assays for the diagnosis of chronic pulmonary aspergillosis (cpa)-multicenter study

Conditions: Chronic Pulmonary Aspergillosis

Summary: aspergillus-specific igg assays for the diagnosis of chronic pulmonary aspergillosis (cpa)

chronic pulmonary aspergillosis (cpa) is one of the most refractory pulmonary infectious diseases, and the incidence is increased rapidly in recent years. serum detection of aspergillus-specific igg is considered to be the most reliable method for diagnosing cpa, however, there is no formal report on the appropriate cut-off value for aspergillus-specific igg assay in chinese patients. this study aimed to establish the datum. besides aspergillus-specific igg, there are two other specific antibodies igm and iga. igm is associated with the acute phase of an infection and iga is associated with mucosal immunity. their diagnostic values in cpa are still not clear. meanwhile, whether detection of antibody levels in bronchoalveolar lavage fluid (balf) could be useful in diagnosis of cpa has not been investigated. in this study, the serum and balf levels of igg, igm and iga would be detected simultaneously by the commercial available kits. the investigators will establish the cut-off values of three antibodies by proven cpa patients and negative controls. then, the cut-off values will be assessed in participants who have a suspected cpa, and the sensitivity, specificity, positive and negative predict value of the antibodies assays will be compared with that of standard diagnostic methods. after performing the above diagnostic tests, cpa could be diagnosed more accurately and rapidly, so that the antifungal therapy could be evaluated more correctly and timely.

Eligibility criteria:
inclusion criteria: 18 years to 85 years lesions presented as cavity, nodule，mass or "destroyed lung" caused by fibrosis in ct imaging exclusion criteria: * seriously immunocompromised patients 1. recent history of neutropenia (\ 10 days) temporally related to the onset of fungal disease 2. receipt of an allogeneic stem cell transplant 3. prolonged use of corticosteroids (excluding among patients with allergic bronchopulmonary aspergillosis) at a mean minimum dose of 0.3 mg/kg/day of prednisone equivalent for \>3 weeks 4. treatment with other recognized t cell immunosuppressants, such as cyclosporine, tnf-a blockers, specific monoclonal antibodies (such as alemtuzumab), or nucleoside analogues during the past 90 days 5. inherited severe immunodeficiency (such as chronic granulomatous disease or severe combined immunodeficiency) * antifungal drug use within 3 months of screening * dropout * pregnancy or lactation * no inform consent

Keywords: aspergillus-specific igg
evaluation of repetitive transcranial magnetic stimulation as an adjunct to modified constraint induced movement therapy in improving upper limb function in children with hemiparetic cerebral palsy aged 5 - 18 years

Conditions: Hemiparetic Cerebral Palsy

Summary: the investigators aim to evaluate efficacy of tms as an adjunct to cimt, assess its safety and tolerability and study cortical excitability with help of tms which are both rehabilitative therapies for hemiplegic cerebral palsy.

cerebral palsy is the most common motor disability of childhood and hemiparetic cerebral palsy accounts for about one third of cases. improving spasticity and upper limb function in these children can lead to better functional outcome and quality of life. tms is an upcoming rehabilitative modality which has shown promising results in western studies. it has benefits of being non-invasive and has shown to have additive effect when used with cimt which is standard of care in hemiparetic cp. however, randomized controlled clinical trials comparing it with cimt alone in hemiparetic cp are very few, none from india so far. the dose, type and duration of tms and its feasibility in resource limited set up needs to be investigated in children .therefore, the investigators aim to evaluate efficacy of tms as an adjunct to cimt, assess its safety and tolerability and study cortical excitability with help of tms.

Eligibility criteria:
inclusion criteria: * • age 5 - 18 years * hemiparetic cerebral palsy (perinatal brain injury) * intelligence quotient \>70 (binet kamat test/malin's intelligence scale for children) * modified ashworth scoring 1-3 for affected limb * can sit independently or with support (gmfcs stage : 1-4 and manual ability classification system stage: 1-3) * preserved vision and hearing (with or without correction) exclusion criteria: * • uncontrolled epilepsy as defined by seizure frequency \>1/month for preceding 3 months * severe concurrent illness or disease not associated with cp or unstable medical conditions like pneumonia * genetic or syndromic associations * children diagnosed with autistic spectrum disorders * modified ashworth scale score more than 3 at shoulder/elbow/wrist * contractures of affected limb * severe movement disorder like dystonia, choreo-athetosis or ballismus interfering with purposeful limb movement * any congenital brain malformation detected on conventional mri brain * recent surgery/cast/splint in affected limb * botulinum toxin/phenol block in affected limb in past 6 months or planned to receive in study period * those receiving tone modifying agents within two weeks before enrolment (tizanidine, baclofen, benzodiazepines, dantrolene) * mcimt received in last 6 months * any contraindications for tms - implanted electronic device and non-removable metallic objects near coil e.g. pacemaker, cochlear implant

Keywords: transcranial magnetic stimulation (tms) modified constraint induced movement therapy (mcimt)
to assess and compare the performance two approach for sentinel lymph node (snld) biopsy for endometrial cancer

Conditions: Endometrial Cancer; Sentinel Lymph Node; Indocyanine Green

Summary: to assess and compare the performance two approaches for sentinel lymph node ( slnd) biopsy

endometrial cancer is the most common gynecologic cancer. most patients diagnosed in early stages because cancer causes remarkable symptoms such as postmenopausal or abnormal bleeding. mostly, it does not spread, detects no metastasis. endometrial carcinoma is surgically staged. laparotomy or minimally invasive surgery can be performed for treatment and staging. patients have been operated for staging surgery, have a larger surgical incision, longer operation period, more complications, more intensive care units need. nowadays, researchers show us that there is no difference in overall survival and prognosis between surgery with or without lymphadenectomy in endometrial cancer. with all these improvements in gynecologic oncology leads us to minimally invasive surgery. patients undergo sentinel lymph node detection by using fluorescence imaging with an indocyanine green solution. two different ways used to assess slnd. the first group who the cervix is injected superficially with 1 ml of icg ( indocyanine green) at 4 and 8 o'clock quadrans. the second group who icg has injected the uterine cavity during hysteroscopy. the investigator's aim is to assess and compare the performance of two approaches for sentinel lymph node ( slnd) biopsy.

Eligibility criteria:
inclusion criteria: * the patient must be willing and able to provide informed consent * the patient is willing and able to comply with the study protocol * the patient has endometrial cancer and is performed slnd * the patient agrees to follow-up examination out to 5-years post-treatment exclusion criteria: * the patient is not a candidate for surgery * the patient has metastasis * the patient has known or suspected allergies to iodine, indocyanine green( icg)
observational study of efficacy and safety of travogen cream and travocort cream in the treatment of mycoses

Conditions: Skin Mycoses

Summary: an assessment of the efficacy and safety of travogen cream and travocort cream in the treatment of local skin mycoses


Eligibility criteria:
inclusion criteria: * diagnosis of skin mycosis exclusion criteria: * allergies to study medication

Keywords: mycoses
vertical distance between medial and lateral malleolus in normal population

Conditions: Ankle Fractures

Summary: determine variation in vertical distance between the medial and lateral malleolus in the normal population subjected to x-rays for any other causes than ankle fracture determine the effect of weight bearing on this variation

there is gap of knowledge about determination of vertical distance between medial and lateral malleolus our research will cover this gap of knowledge ,so our research question will be what is the normal variation of vertical distance between medial and lateral malleolus fractures of ankle are common injuries,approximately 2% of the general population will sustain an ankle fracture during their life time .many can be successfully treated non operatively however,for those injuries that require surgical intervention ,restoration of the anatomy is the main principle the importance of anatomic restoration of the fibula ,specially in preserving normal length has been appreciated by several authors data will be obtained from measuring the vertical distance between lateral and medial malleolus in ap view of ankle in traumatic non ankle fractured people in standing and non standing position

Eligibility criteria:
inclusion criteria: * non ankle fractured people non arthritic ankle age more than 18 years old non diabetic people normal ankle x-rays as determined by tibiocrural angle and tibiofibular overlap exclusion criteria: * people with fracture ankle (united \&non united) arthritic ankle diabetic people abnormal ankle x-rays

Keywords: radiological standard f ankle fixation
retrospective multicenter study of elderly patients with ovarian cancer treated with trabectedin and pld

Conditions: Ovarian Cancer

Summary: the median age at which ovarian cancer is diagnosed is 63 years (50-75). this is still a significant adverse factor for survival results. seventy years can be considered the lower limit for the elderly term, since most of age-related changes occur later. because of this, this group of patients is often not included in clinical trials and sometimes they do not receive adequate treatment. little information is available on chemotherapy treatments in elderly patients. data on the use of first-line chemotherapy in this population have recently been published. trabectedin in combination with pld is indicated for platinum-sensitive relapsed ovarian cancer and is an option for those patients in whom platinum is not the best option. there are some studies with trabectedin in combination with pld in which some patients with this profile have been included, although not exclusively. therefore, it is of interest to study the safety and efficacy profile of this treatment in elderly patients. with this information we will be able to know its real use in routine clinical practice at the national level in spain in this population for which not much information is available. safety and efficacy data (e.g. pfs, orr, os) will be collected retrospectively in order to draw conclusions about the combination of trabectedin + pld, as a treatment option in this patient profile.


Eligibility criteria:
inclusion criteria: * written informed consent must be signed by all patients participating in the study who can be interviewed in the hospital (accessible, alive patients) or absence of consent sheet must be signed by the investigator. informed consent may not be required from unaccesible patients (dead, lost, etc.) according to ethics committee permissions and applicable law for retrospective studies in spain. * adult women (≥70 years at the time of treatment initiation with trabectedin and pld). * histological diagnosis of platinum-sensitive relapsed ovarian cancer (pfi ≥ 6 months). * treatment started with trabectedin and pld (at least one cycle) as standard of care between january 1st 2015 and december 31st 2019. * patients must have received at least one cycle of trabectedin + pld. exclusion criteria: * patients without medical record available (lost, empty or unretrievable clinical information). * patients who explicitly refuse to participate in the study.
adapt study: assessing diet, appetite and physiology throughout weight loss study)

Conditions: Obesity

Summary: behavioral weight loss programs for obesity can result in weight loss and health benefits. however, behavioral weight loss often stops despite efforts to continue losing weight, this can be called an involuntarily weight loss plateau. this study investigates changes in metabolism and/or the brain that contribute to the occurrence of an involuntary weight loss plateau.

participants will be asked to enroll for 18-months. each participant will complete 3 in-person study visits, then participate an a 6-month weight loss program delivered remotely. some participants may be invited to complete 3 additional in-person visits. study visit activities include questionnaires, blood draws, brain mris, body measurement and dual energy x-ray absorptiometry (dxa) scan for body composition measurement, a breathing test, and biopsies of muscle and fat tissue. each participant will be provided a fitness tracker and body weight scale to use throughout the study.

Eligibility criteria:
inclusion criteria: * bmi 30.0 - 50.0 kg/m2 * able to attend study intervention classes and study visits/assessments * independently living with access to food preparation facilities exclusion criteria: * current smoker or regular use of nicotine containing products and/or cannabis * heavy alcohol use (≥2 drinks/d for females, ≥3 drinks/d for males) or drug use * known cognitive impairments or h/o stroke * type 2 diabetes (known diagnosis or by screening a1c (≥6.5%)) * medical conditions (chronic diseases, cancer, ms) or labs limiting ability to participate * females: currently pregnant (or 6-months postpartum of full-term pregnancy) and/or current breastfeeding * use of medications with significant effects on appetite (e.g., weight loss medications, atypical antipsychotics, stimulants) and/or chronic use of anticoagulants * history of bariatric surgery * history of eating disorder * current participation in a formal weight loss program * prior or current participation in a research study involving weight loss * weight-reduced by \>10% within past year * weight \> 330 pounds (mri limit) * allergy or intolerance to or unwillingness to consume study foods provided at visit * mri contraindication (e.g., implanted metal, claustrophobia) * do not have a phone compatible with activity tracker or access to videoconferencing platform that will be used for the dietary intervention or other appropriate technology needed to complete study procedures * any condition(s) found by the study team and confirmed with the pi(s) that make it unsafe to participate

Keywords: gloisis weight change