Kornimate/medical-research-clean huggingface dataset:
urinary prostaglandin as a potential predictive marker for thiazide-induced hyponatremia

Conditions: Thiazide-induced Hyponatremia (TIH)

Summary: thiazides and thiazide-like diuretics are one of the five major classes of antihypertensive drugs. this study is to investigate whether urinary pge2 concentration at baseline (prior to thiazide initiation) is associated with the development of tih within the first four weeks of treatment.

thiazides and thiazide-like diuretics are one of the five major classes of antihypertensive drugs. they act by inhibiting the apical na+-cl- -cotransporter in the distal convoluted tubules of the kidneys. thiazides and thiazide-like diuretics often cause adverse effects, importantly a drop in plasma sodium levels that is called thiazide-induced hyponatremia (tih). data suggest a crucial role of urinary pge2 in water reabsorption. since urinary pge2 concentrations were higher in patients with tih, quantification of urinary pge2 prior and after thiazide initiation might allow identification of patients at risk for tih, presenting pge2 as a potential novel predictive marker for the development of tih. this study is to investigate whether urinary pge2 concentration at baseline (prior to thiazide initiation) is associated with the development of tih within the first four weeks of treatment. hospitalized and ambulatory patients in whom a thiazide or thiazide-like diuretic will be newly prescribed are screened for inclusion. the study procedure contains the screening and inclusion, visit 1 before thiazide initiation, visit 2 4 weeks (+/-7days) after thiazide initiation and a 3-months follow-up (visit 3). an additional visit (visit 2.1) will only be added in case of a dose change of the thiazide or thiazide-like diuretic (4 weeks +/- 7 days after the dose change). the 2 hours- challenge is optional if the patient agrees to additional testing.

Eligibility criteria:
inclusion criteria: * newly prescribed thiazide or thiazide-like diuretic * ≥ 18 years of age * informed consent as documented by signature exclusion criteria: * intake of thiazide or thiazide-like diuretic in the preceding month * hyponatremia (plasma sodium \<135 mmol/l) at baseline * acute infectious / inflammatory disease (crp ≥ 20 mg/l \[1, 11\]) * symptomatic urinary tract infection * chronic treatment with nsaid and / or nsaid intake 48 hours prior to urine sampling at visit 1 and 2 (intake of acetylsalicylic acid will be no exclusion criteria) * end of life care, no informed consent or inability to follow the procedures of the study, e.g., due to language barriers, psychological disorders, dementia

Keywords: thiazide thiazide-like diuretics hyponatremia prostaglandin e2 (pge2) urinary pge2 concentration plasma sodium level urinary prostaglandins
dual task training in spastic cerebral palsy

Conditions: Spastic Cerebral Palsy

Summary: cerebral palsy(cp) is a non-progressive disorder, undergoing mishap to the developing brain and it affect a person's ability to move and maintain balance and posture. old name of cp is "little's disease". in spastic diplegic, muscle stiffness is mainly in the legs, with the arms less affected or not affected at all. there could be secondary musculoskeletal problems due to muscle weakness resulting from poor alignment, limited range of motion, and asymmetrical posture. these deformities are negatively affected by biomechanical movements and can affect balance and gait functions. the main goal of rehabilitation in children with cerebral palsy is to restore independent walking. however, children with cerebral palsy have limited mobility, which leads to gait disorders (short steps, slow walking speed, increased swing phase and postural instability). therefore, it is important to choose an effective training method to improve the balance and gait of children with cerebral palsy. walking training can help improve muscle tone, postural control and gait function as well as improve muscle strength, endurance, and coordination of the lower extremities. a growing body of evidence supports implementing dual-task gait training for enhancing functional mobility and cognitive performance. this will be a randomized controlled trial, data will be collected from rising sun institute, mughalpura campus. a study will be conducted on 32 patients. inclusion criteria of this study is spastic diplegic cp children with age between 6 to 12 years, with gmfcs level 1 to 3 and those who can walk 50 m without mechanical walking aids and maintain standing for more than 5 seconds without falling will be included. exclusion criteria of this study is low intellectual ability (iq \< 80) and behavioral symptoms which might affect participation in the protocol, none of the children had surgery or botulinum toxin injections during the year prior to the assessment. group1 will receive conventional therapy for 30 minutes a day, 3 times a week for 8 weeks. and group 2 will receive conventional therapy with dual-task training for 30 minutes a day, 3 times a week for 8 weeks. for the pre- and post-evaluation of all participants berg balance scale and gait outcome assessment list-(goal) will be used. data will be analyzed through spss version 23.00.


Eligibility criteria:
inclusion criteria: * participant's age will be between 6-12 years. * patient should be diagnosed with spastic diplegic cerebral palsy. * gmfcs i-iii exclusion criteria: * low intellectual ability (iq \< 80) and behavioral symptoms which might affect participation in the protocol. * if patient had any progressive neurological disorder disease. * if he/she had surgery or botulinum toxin injections during the year prior to the assessment will also be excluded

Keywords: cerebral palsy dual-task training gait, balance cognitive-motor interference
autism spectrum disorders (asd) driving study

Conditions: Autism Spectrum Disorder

Summary: the proposed pilot study will begin to assess whether driving impairments are included in the functional deficits associated with autism spectrum disorders (asds). this will be completed by obtaining data on velocity, collision risk, and visual attention of subjects with asds who drive in a simulator. the study includes 2-3 visits for the screening period (approximately 6 hours of assessments) and one driving simulation visit (approximately 2.5 hours). the investigators expect to enroll 20 adolescents and adults (ages 16-50, inclusive) who have been identified as having an asd from a prior diagnosis or participation in community conferences for individuals with asds.


Eligibility criteria:
inclusion criteria: * male and female patients, aged 16-50 years * identification as having asd from a prior diagnosis or participation in community conferences for individuals with asd exclusion criteria: * major sensorimotor handicaps (e.g. deafness, blindness) * inadequate command of the english language * individuals who have never held a valid driver's license * mental retardation (iq \< 80)

Keywords: driving autism spectrum disorders asd attention deficits adults adolescents pervasive developmental disorders
" evaluation of erythropoietin therapy in patients with end-stage kidney disease on regular hemodialysis: hemoglobin outcomes, and metabolic syndrome as a risk factor for erythropoietin resistance "

Conditions: Erythropoietin Resistant Anemia (EPO Resistant Anemia)

Summary: the primary aim of this study is to investigate the association between metabolic syndrome and erythropoietin resistance in patients with end-stage kidney disease (eskd).

chronic kidney disease (ckd) is a common condition that has significant implications for patients' health and healthcare budgets. ckd is a major contributor to morbidity and mortality across the globe. the incidence and prevalence of ckd are rising steadily all over the world. along with many adverse effects on different body organs, ckd and end-stage kidney disease (eskd) are associated with body will beting and malnutrition. patients with eskd require maintenance hemodialysis (mhd) to sustain their life. patients with chronic kidney disease (ckd) have a relatively deficient erythropoietin (epo) production, and this is the main cause of anemia in this group. in its severe form, anemia decreases quality of life and increases the risk of cardiovascular diseases and mortality in dialysis patients, so the implementation of prevention and control measures is recommended \[4\]. erythropoiesis-stimulating agents (esas) are generally used to control anemia and reduce the need for blood transfusions in patients with ckd. esa resistance or hyporesponsiveness occurs when the patient does not reach the desired serum hemoglobin (hb) concentration even with the use of esa at doses higher than usual or when increasingly higher doses are necessary to maintain the recommended hb concentration. the main causes of epo resistance are iron deficiency, chronic inflammation, inadequate dialysis, hyperparathyroidism, hemolysis, vitamin b12, and folate deficiency. observational studies have shown that nutritional status is associated with epo resistance in hd patients, mainly because of malnutrition-inflammation status. while treating anemic patients with αepo can increase hemoglobin levels to recommended values and decrease complications in hemodialysis patients, the treatment of anemia with an esa can increase the risk of mortality; high dosages of the esa and treatment resistance are the primary factors for this outcome. thus, it is important to determine which factors limit the ability of αepo to correct anemia in hemodialysis patients so that treatment can be optimized.

Eligibility criteria:
inclusion criteria: * patients (and replacements) will be randomly selected by a raffle. * all participants should be 18 years of age or older and agree to participate in the study after due clarification. * patients with end stage kidney disease (eskd) on regular hemodialysis for more than 3 months. exclusion criteria: * - patients with neoplasm, severe cardiovascular, cerebrovascular and liver diseases. * females with polycystic ovarian syndrome, those on hormonal replacement therapy and pregnant women. * patients with infection or autoimmune diseases.
treatment of obesity with vitamin d (40.000 ie per week for 1 year)

Conditions: Obesity

Summary: the purpose of the study is to evaluate if supplementation with vitamin d in doses of 20.000iu per week and 40.000 iu per week will result in weight loss in obese subjects as compared to placebo during 1 year.

we will include 450 obese subjects that will be devided in 3 groups: 40.000iu cholecalciferol per week, 20.000 iu cholecalciferol per week, and placebo. all subjects will be given 500 mg calcium per day. there will be visits every tird month. in addition to weight reduction, we will also evaluate the calcium metabolism (blood test and urin samples), insulin sensitivity, muscle strenght, blood pressure and depression.

Eligibility criteria:
inclusion criteria: * bmi 30 - 40 * serum calcium \< 2.55 mmol/l exclusion criteria: * serious diseases * reduced kidney function * renal stone disease * using psychopharmaca * using drugs for weight reduction
partial heart transplantation

Conditions: Congenital Heart Disease

Summary: the purpose of this study is to determine if a partial heart transplantation in patients with congenital heart disease is safe and feasible. participants will have a partial heart transplant involving surgical replacement of the pulmonary valve with the heart valve and supporting blood vessels from an organ donor. the procedure, tests, medications, and follow-up visits will all be done per standard of care. medical data will be collected to look at outcomes after surgery.

the purpose of this study is to determine if a partial heart transplantation in patients with congenital heart disease is safe and feasible. potential participants are patients 12 and younger with congenital heart defects in need of pulmonary valve replacement.participants will have a partial heart transplant involving surgical replacement of the pulmonary valve with the heart valve and supporting blood vessels from an organ donor. the study procedure, tests, medications, and follow-up visits will all be done per standard of care for heart transplant patients. data will be collected from chart review, before, during and after surgery and at standard of care follow-up visits. study data will be compared to historical data of patients who have undergone other types of pulmonary valve replacement surgery.

Eligibility criteria:
inclusion criteria: * congenital heart patient referred for a cardiac operation that involves valve replacement in pulmonary position * deemed acceptable for partial heart transplantation based on the standard evaluation process exclusion criteria: * contraindication for heart transplantation * severe bliateral long segment pulmonary arterial hypoplasia * bilateral pulmonary vein stenosis * persistent acidosis with a ph \< 7.1 * failure to pass psychosocial evaluation * parental (custodial) alcohol and/or substance abuse * documented parental (custodial) child abuse or neglect * parent (custodian) with cognitive/psychiatric impairment severe enough to limit comprehension of medical regimen * infection disease exclusion criteria * evidence of active sepsis * hepatitis b surface antigenemia * hiv positivity * pregnancy * financial hardship or insurance non-approval
gut microbiome modification through dietary intervention in patients with colorectal cancer: response to surgery

Conditions: Colorectal Cancer

Summary: the investigators will conduct an open, controlled, randomized clinical trial, in patients with scheduled surgical intervention for crc in the general surgery and digestive system unit of the virgen de la arrixaca university hospital (murcia, spain). all the included individuals must have passed the protocol of the virgen de la arrixaca university hospital to be candidates for elective major surgery for crc and must sign the informed consent after being informed of the objectives and the methodology of the study. the helsinki declaration will be followed during the duration of the project. patients will be randomized in a 1:1 ratio after receiving a diagnosis of crc in the endoscopic evaluation; in the control arm, patients will receive standard nutritional recommendations, while patients in the intervention arm will be advised to follow a high-fiber diet rich in pufas (total dietary intake of at least 30 grams of fiber per day, and of at least 3 grams of pufas per day from food, not supplements) at least 4 weeks before surgery


Eligibility criteria:
inclusion criteria: * age between 18-80 years old. * after clinical diagnosis of crc (stage i-iii), the doctor has recommended and arranged for crc surgery exclusion criteria: * clinical diagnosis of stage iv crc. * current gastrointestinal illness other than gastroesophageal reflux disease or hemorrhoids (such as celiac disease, inflammatory bowel disease, malabsorptive bariatric procedures, etc.). * chronic liver or kidney disease. * history of cardiac disease. * positive genetic test for inherited polyposis syndromes (such as familial adenomatous polyps, hereditary non-polyposis colon cancer syndromes, etc). * alcoholism or illicit drug use. * antibiotic use within the past 2 months. * dietary supplement use including pre- or probiotics within the past month. * history of intestinal cancer, inflammatory bowel disease, celiac disease, or malabsorptive bariatric surgery. * inflammatory or connective tissue disease (such as lupus, scleroderma, rheumatoid arthritis, etc.).

Keywords: microbiome surgery
t-dm1 combined with cdk4/6 inhibitor ribociclib

Conditions: HER2-positive Advanced Breast Cancer

Summary: to explore the efficacy and safety of t-dm1 combined with cdk4/6 inhibitor ribociclib in the treatment of her2-positive advanced breast cancer.

this is a multicenter, single-arm,phase ii clinical trial to explore the efficacy and safety of trastuzumab emtansine (t-dm1) combined with cdk4/6 inhibitor ribociclib in the treatment of unresectable locally advanced or metastatic her2-positive breast cancer.

Eligibility criteria:
inclusion criteria: * age ≥18 at the time of signing the informed consent. * patient's ability to follow the study protocol as determined by the investigator. * a representative tumor tissue sample is required to confirm a her2-positive diagnosis. her2 expression status and er expression status of invasive cancer lesions were determined based on previous pathological sections or current pre-treatment biopsy materials, and the her2 ihc assay was locally confirmed to be consistent with 3+, or ihc assay with 2+, and further fish detection was positive before study enrollment. * at least one evaluable lesion was detected by ct or mri (see protocol for additional details). * for metastatic or recurrent breast cancer, there is currently no opportunity for surgical radical resection. * metastatic or recurrent breast cancer that has received at least first-line rescue therapy in the past must have been treated with trastuzumab and taxanes. * the physical status (ecog) score of the eastern tumor collaboration group was 0 or 1. * sufficient haematology and organ function to meet the definition of laboratory test results, which must be provided within 14 days before the start of study therapy. * fertile women should remain abstinent (no heterosexual intercourse) or use contraceptive methods. exclusion criteria: * past treatment with other antibody-drug conjugate (adc) drugs or anti-tumor therapy with cdk4/6 inhibitors. * past treatment with other anti-her2 drugs other than trastuzumab, pertuzumab and tyrosine kinase inhibitors (tki). * advanced breast cancer with central nervous system metastasis. * patients who have developed other malignancies in the 5 years prior to screening, except adequately treated cervical cancer in situ, non-melanoma skin cancer, localized prostate cancer, ductal carcinoma in situ, or stage i uterine cancer. * severe dysfunction of vital organs prior to enrollment (see protocol details). * received an investigational drug within 28 days prior to initiation of study therapy. * known hypersensitivity or hypersensitivity to cdk4/6 inhibitors. * the results of the serum pregnancy test were positive.

Keywords: her2-positive advanced breast cancer trastuzumab emtansine ribociclib
multifaceted comparison of ultrasound-guided ablation and laparoscopic adrenalectomy for aldosterone-producing adenoma

Conditions: Aldosterone-producing Adenoma; Radiofrequency Ablation

Summary: the purpose of this study is to retrospectively and prospectively analyze the efficacy and safety of ultrasound-guided radiofrequency ablation and laparoscopic adrenalectomy in the treatment of aldosterone-producing adenoma (apa). it is planned to retrospectively collect 30 patients with adrenal radiofrequency ablation for apa and 15 patients with age - and sex-matched laparoscopic adrenalectomy for apa in our hospital from january 2020 to june 2024, and continue to follow up for 3 years.

primary aldosteronism is the most common cause of secondary hypertension, and aldosterone-producing adenoma (apa) is a benign adrenal tumor, accounting for about 35% of primary aldosteronism. according to clinical guidelines, laparoscopic adrenalectomy is the preferred treatment for unilateral apa. recently, radiofrequency ablation, as a new technique, has been applied to the treatment of apa. however, there are few relevant studies, the sample size is generally small, and basically belong to retrospective studies, lacking the comparison of long-term postoperative effects. our hospital is the first to carry out ultrasound-guided radiofrequency ablation of apa in guangdong, china, with satisfactory results. the purpose of this study is to retrospectively and prospectively analyze the efficacy and safety of ultrasound guided radiofrequency elimination and laparoscopic adrenalectomy in the treatment of apa. it is planned to retrospectively collect 30 patients with adrenal radiofrequency ablation for apa and 15 patients with age - and sex-matched laparoscopic adrenalectomy for apa in our hospital from january 2020 to june 2024, and continue to follow up for 3 years.

Eligibility criteria:
inclusion criteria: 1. apa was confirmed with unilateral lesions; 2. benign tumor without adrenal metastasis and endovascular tumor embolus; 3. receive ultrasound-guided adrenal rfa treatment or laparoscopic resection, and sign the informed consent for surgery; 4. age ≥ 18; 5. age ≥ 40 years old should meet the following criteria: blood potassium ≤3.5mmol/l; pac≥20ng/dl; prc≤5μiu/ml; a unilateral adrenal nodule of 10mm or more was completely normal on the opposite side. exclusion criteria: 1. bilateral adrenal diseases; 2. multiple adrenal tumors; 3. other adrenal diseases, such as adrenal hyperplasia, cushing's syndrome, pheochromocytoma, etc.; 4. imaging suggests that the tumor may be difficult to reach; 5. imaging showed potential malignant adrenal tumor; 6. pregnant and/or planning a pregnancy; 7. refusing to participate in follow-up visits.

Keywords: aldosterone-producing adenoma radiofrequency ablation laparoscopic adrenalectomy
relationship of balance, functional capacity and fear of movement with lower extremity muscle strength in elderly

Conditions: Elderly

Summary: aging is a period in which the morphological, physiological and pathological changes progress negatively, accompanied by various diseases and regression of physical and mental abilities. in this period, the individual experiences biological and physiological losses as well as social problems in his/her life. from the age of 65, approximately 80% decrease in muscle strength can be observed and this decrease is especially noticeable in the leg and trunk muscles. decreases in the strength of the muscles in the lower extremities may cause deterioration in physical function, decrease in mobility, increase in falling related accidents, also can cause osteoporosis and physical deficiencies. determining the structures with which the lower extremity muscle strength is related will facilitate the precautionary measures for the inadequacies that will arise in the later stages of aging. this study was performed to analyze the relationship of lower extremity muscle strength with balance, functional capacity, fear of movement and quality of life in elderly individuals living in nursing homes.


Eligibility criteria:
inclusion criteria: * the participant must be 65-88 years old, * the participant must have a minimus score of 24 on the mini-mental state examination (mmse), * no cognitive impairment, * the participant must be independent of daily life activities (must not use an assistive device for walking). exclusion criteria: * having a disease that can affect balance (vestibular, neurological, orthopedic ...) performing regular exercise * uncontrolled hypertension or arrhythmia * uncontrolled diabetes mellitus * orthopedic, neurological or musculoskeletal problems * postural hypotension * obesity (body mass index\>40) * uncompensated clinical conditions such as chronic obstructive pulmonary disease, interstitial lung disease, heart failure, or rheumatic and psychiatric diseases

Keywords: balance elderly fear of movement functional capacity lower extremity muscle strength quality of life