Kornimate/medical-research-clean huggingface dataset:
fifteen year follow-up of 5,500 black and 5,500 other hypertensives

Conditions: Cardiovascular Diseases; Heart Diseases; Hypertension; Kidney Failure, Chronic

Summary: to seek predictors of mortality, hospitalization, and dialysis using data from a hypertensive population which began treatment in 1974.

design narrative: patients dying before 1989 were identified using the va's beneficiary identification records location subsystem and the national death index (ndi). using ndi information to locate them, death certificates were obtained on all dead patients. arrangements were made to collect data on the va hospitalizations occurring after antihypertensive treatment had begun, and application was made to match patients against the usrds dialysis and transplant registry. the basic clinical data were collected in 32 va hypertension screening and treatment program (hstp) clinics during the 40 month period beginning in 1974. approximately 30,000 completed screening and evaluation forms and 75,000 treatment visit forms were completed during the 40 months of data collection. the collected information was entered into the hstp master file at the va computer center in austin, texas. predictors were sought for (1) all-cause mortality, (2) cause-specific mortality (obtained from death certificates and hospitalization and clinic records), (3) endstage renal disease (obtained from the usrds dialysis and transplant registry), (4) va hospital usage combined with other data related to cost care. 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
efficacy of hydrotherapy in peripheral neuropathy

Conditions: Peripheral Neuropathy

Summary: the purpose of the study is to evaluate the efficacy of hydrotherapy on pain and balance in patients affected by neuropathy.


Eligibility criteria:
inclusion criteria: * patients affected by peripherical neuropathy able to walk exclusion criteria: * pain of water * medical contraindications at treatment in heated swimming pool
sglt2 inhibition: uric acid excretion study

Conditions: Type 2 Diabetes

Summary: the current study investigates the effects of sglt2 inhibitor empagliflozin on uric acid excretion.

sgtl2 inhibitors improve cardiovascular and kidney outcomes. the underlying mechanisms are incompletely understood. sglt2 inhibitors are known to reduce plasma uric acid likely by enhanced urinary uric acid excretion. in this study the investigators will study the effects of sglt2 inhibit on uric acid levels and excretion in detail, linking it to the role of glucosuria and uric acid transporter (urat1) which in rodents was indispensable for the glucose-lowering effects of sglt2 inhibition.

Eligibility criteria:
inclusion criteria: caucasian men or post-menopausal women age 35 to 75 diagnosed with t2d hba1c from 6.5% to 9.0% (48-75 mmol/mol) body mass index \>25 kg/m2 treated with metformin monotherapy (stable dose for ≥3 months) with or without sulfonylurea well-controlled blood pressure (i.e., \<140/90 mm hg). in case of previously diagnosed hypertension and/or albuminuria treatment at least a stable dose of a renin-angiotensin system (ras) inhibitor for ≥3 months at maximal tolerable dose. exclusion criteria: history of gout history of unstable or rapidly progressing renal or malignant disease (excluding basal cell carcinoma) egfr \ 300 mg/g. current/chronic use of the following medication: thiazolidinediones, sulfonylurea derivatives, glp-1 receptor agonists, dpp-4 inhibitors, sglt-2 inhibitor, oral glucocorticoids, immune suppressants, antimicrobial agents, chemotherapeutics, antipsychotics, tricyclic antidepressants (tcas) and monoamine oxidase inhibitors (moais). patients on diuretics will only be excluded when these drugs cannot be stopped 3 months prior randomization and for the duration of the study. chronic use of non-steroidal anti-inflammatory drugs (nsaids) will not be allowed, unless used as incidental medication (1-2 tablets) for non-chronic indications (i.e. sports injury, head-ache or back ache). however, no such drugs can be taken within a time-frame of 2 weeks prior to renal-testing pregnancy history of or actual severe mental disease history of or actual severe somatic disease (e.g. systemic disease) history of or actual malignancy (except basal cell carcinoma) history of or actual pancreatic disease (unstable) thyroid disease severe hepatic insufficiency and/or significant abnormal liver function defined as aspartate aminotransferase (ast) \>3x upper limit of normal (uln) recent (\ 3 units alcohol/day) history of diabetic ketoacidosis (dka) requiring medical intervention (e.g., emergency room visit and/or hospitalization) within 1 month prior to the screening visit. recent blood donation (\< 6 months) allergy to any of the agents used in the study inability to understand the protocol and/or give informed consent individuals who are investigator site personnel, directly affiliated with the study, or are immediate (spouse, parent, child, or sibling, whether biological or legally adopted) family of investigator site personnel directly affiliated with the study
interest in spirituality and oncology: is it an international phenomenon?

Conditions: Stress

Summary: primary objective: -to assess correlations between spiritual and religious beliefs and physician burnout using the work related stress inventory. secondary objectives: * to assess relationships between a physician's spiritual/religious beliefs and age, race, sex, marital status, and nationality. * to explore differences in survey responses among oncologists from different countries: duke university religion index (durel), hoge (intrinsic religiosity scale), templer's death anxiety scale, locus of control scale, work related strain inventory, and non-validated case scenarios. * to correlate survey responses to management of specific patient case situations.

few studies have explored the spiritual/religious beliefs of physicians and almost none have been done outside of the united states until the last two years. therefore, this is the first study of its kind to evaluate this subject internationally. in the next few weeks individuals will be receiving an on line survey from survey monkey. the purpose of the survey is to explore the spiritual/religious beliefs of oncologists from a world side perspective, to identify areas in which spiritual/religious beliefs may affect medical decision making, and to explore any correlation that may exist between spiritual/religious beliefs of oncologists and physician burn out. the surveys will take about 30 to 40 minutes to complete. survey results will be encrypted even in transmission and sent to a secure server for anonymity. even if one chooses not to fill out the surveys investigators ask that each person complete the demographic questionnaire. without input, investigators will lose the opportunity to further an understanding of how spirituality and religious beliefs impact patient care and physician well being. investigators welcome any feed back.

Eligibility criteria:
inclusion criteria: * physician members of the international gynecologic oncologists society or the society of gynecologic oncologists exclusion criteria: * none

Keywords: spirituality work related stress religious beliefs survey
trial of microplasmin intravitreal injection for non-surgical treatment of focal vitreomacular adhesion. the mivi-trust (tg-mv-007) trial.

Conditions: Vitreomacular Adhesion

Summary: this trial will evaluate the safety and efficacy of microplasmin, administered as an intravitreal injection, in subjects with focal vitreomacular adhesion. in previously performed clinical trials, some patients treated with intravitreal microplasmin have had resolution of their underlying condition, including macular hole closure, without need for vitrectomy. this clinical trial is justified because the sponsor believes the potential benefits outweigh the potential risks.


Eligibility criteria:
inclusion criteria: * presence of focal vitreomacular adhesion (i.e., central vitreal adhesion within 6 mm optical coherence tomography (oct) field surrounded by elevation of the posterior vitreous cortex) that in the opinion of the investigator is related to decreased visual function (such as metamorphopsia, decreased visual acuity, or other visual complaint) exclusion criteria: * any evidence of proliferative retinopathy (including proliferative diabetic retinopathy (pdr)) or other ischemic retinopathies involving vitreoretinal vascular proliferation) or exudative age-related macular degeneration (amd) or retinal vein occlusion in the study eye * subjects with any vitreous hemorrhage or any other vitreous opacification which precludes either of the following: visualization of the posterior pole by visual inspection or adequate assessment of the macula by either oct and/or fluorescein angiogram in the study eye * subjects with macular hole diameter \> 400 µm in the study eye * aphakia in the study eye * high myopia (more than 8d) in study eye (unless prior cataract extraction or refractive surgery that makes refraction assessment unreliable for myopia severity approximation, in which case axial length \>28 mm is an exclusion).
effectiveness and cost-effectiveness of the diabetes integrated care breakthrough collaborative

Conditions: Diabetes Mellitus, Non-Insulin-Dependent

Summary: the study tests whether implementing professional evidence-based guidelines and best practices for diabetes care -through participation of multidisciplinary teams in a breakthrough collaborative- results in an improvement of diabetes care, its health outcomes and economic costs. determinants of success are studied. data on diabetes will also be used to better understand breakthrough as an implementation or improvement method.

diabetes mellitus as a chronic disease is a major and growing health care problem. studies on the prevention of severe complications provide evidence for the necessity of tight control. different interventions and models to achieve strict control and reduce diabetes related risks of complications are available. these are, however, not implemented in daily practice. our study focuses on this implementation problem: it tests whether implementing professional evidence-based guidelines and best practices -through participation of multidisciplinary teams in the breakthrough collaborative- results in an improvement of diabetes care, its health outcomes and economic costs. data on diabetes will also be used to explore and better understand the breakthrough model as an implementation method. only uncontrolled observational studies have, so far, described the outcomes of breakthrough collaboratives. they also describe significant differences between teams in specific improvements made in patient care and organisational performance, resulting in different implementation and medical costs. there is hardly any information regarding these costs and the cost-effectiveness of collaboratives, and little knowledge about how they could be made more effective. insight is also needed into the factors that influence the success of individual teams. there are no data regarding the sustainability of improvements.

Eligibility criteria:
inclusion criteria: * each patient, male or female, visiting the hospital outpatient clinic or general practice with type ii diabetes mellitus during a specified period. patients should be able to read and write the dutch language. exclusion criteria: * pregnancy * patients with a life expectancy \< 1 year

Keywords: quality assurance health care diabetes breakthrough collaborative (ihi) evaluation
internet-based cognitive behavior therapy for stress disorders: a randomized trial

Conditions: Adjustment Disorder; Burnout Syndrome

Summary: stress disorders in form of adjustment disorder and burnout syndrom are highly prevalent and cause substantial suffering. prior evidence suggest that these disorders may be effectively treated with cognitive behavior therapy (cbt), but access to psychological treatment is limited. one possible solution is to provide therapy via the internet, which has been shown to be effective for anxiety disorders and depression. in the present study, we will investigate the efficacy of internet-based cbt (icbt) for adjustment disorders and burnout syndrom in a randomized controlled trial (n=100). participants will be randomized to active treatment (n=50) or a control condition on waiting list.

stress disorders in form of adjustment disorder and burnout syndrom are highly prevalent and cause substantial suffering. prior evidence suggest that these disorders may be effectively treated with cognitive behavior therapy (cbt), but access to psychological treatment is limited. one possible solution is to provide therapy via the internet, which has been shown to be effective for anxiety disorders and depression. internet-based cbt can be described as online bibliotherapy with therapist support via a secure messaging system. in this study psychologists will deliver the treatment. we will investigate the efficacy of internet-based cbt (icbt) for adjustment disorder and burnout syndrom in a randomized controlled trial (n=100). participants will be randomized to active treatment (n=50) or a control condition on waiting list. we expect that participants who receive icbt will make superior improvements compared to the control condition on measures of stress, burnout, depressive symptoms, general anxiety and general functioning.

Eligibility criteria:
inclusion criteria: to be included in the study participants must be between 18 and 65 years of age and suffer from primary stress-related disorders by meeting diagnostic criteria for adjustment disorder or burnout syndrome. participants must have access to a computer and to the internet, as well as being able to write and write in swedish. exclusion criteria: exclusion criteria include (a) meeting the criteria for another axis-1 diagnosis that is assessed to be the primary area of difficulty, (b) suffering from substance abuse/dependence in the past 6 months, (c) suffering from current or past psychosis or bipolar disorder, (d) moderate to high suicide risk, (e) initiated or changed pharmachological treatment for depression or anxiety in the past month and (f) other on-going psychological treatment for stress-related difficulties, and (g) not having received cbt for stress-related ill-health in the past year.
respiratory monitoring of intrathecal baclofen- a feasibility study

Conditions: Intrathecal Baclofen; Multiple Sclerosis; Respiratory System; Cerebral Palsy

Summary: the methodology is a feasibility study to determine the feasibility of assessing people in the community with a neurological condition before proceeding towards a full powered community trial evaluating the influence of intrathecal baclofen.

the purpose of this proposed research will evaluate a feasible method to assess the respiratory status of people with neurological conditions receiving or scheduled to receive intrathecal baclofen. the use of intrathecal baclofen to manage severe spasticity is a developing treatment option with a limited research base, particularly when evaluating the influence of intrathecal baclofen on the respiratory system. the proposed research is derived from clinical practice and involves joint collaboration between clinical team, research professionals and patients. in order for the study to evaluate the influence of intrathecal baclofen has on the respiratory system, the proposed research will need to develop and evaluate a method of assessing people in the community ensuring it's feasible for people with neurological conditions. prior to implementing a full powered community trial to evaluate the influence of intrathecal baclofen on people with neurological conditions.

Eligibility criteria:
inclusion criteria: * -adults over the age of 18 * a person who is able to provide consent or a family member/ close friend who is able to assent on behalf of the participant * a person or a family member/ close friend who is able to understand english (understand written english and spoken instructions) * a person currently receiving intrathecal baclofen or is scheduled to receive intrathecal baclofen (awaiting fitting of pump) therapy to manage spasticity * a patient of the solent/ university hospitals southampton nhs foundation trust intrathecal baclofen service exclusion criteria: * -pre-existing use of overnight non-invasive ventilation (niv) and is compliant with niv treatment * a person who is unable to consent to the study and does not have a family/ close person to assent * the study will exclude a person who is unable to independently remove the polysomnography and is also without supervision from another person (carer or partner) during the night. this ensures the participant is able to take off the polysomnography (or assisted by a carer) if it becomes uncomfortable and/or causes distress.
safety and immunogenicity of sequential pneumococcal immunization in preschool asthmatics

Conditions: Asthma

Summary: asthma is a major health problem in preschool children. infections by pneumococci a the most frequent cause of airway infections, which tend to cause worsening of asthma. vaccination against pneumococci is recommended by scientific boards and the medical community, in order to reduce the burden of disease. data on the immunogenicity and safety of pneumococcal immunization in preschool asthmatics are scarce.

respiratory infections are major triggers of exacerbations in preschool asthma. many countries' guidelines recommend immunization against pneumococci for patients suffering from chronic airway disease. also the interval between priming and booster is a matter of debate. we immunize a large group of preschool asthmatics (2-5 years old) sequentially: one dose of seven-valent pneumococcal conjugate vaccine (pcv-7) followed by a single dose of 23-valent pneumococcal polysaccharide vaccine (ppv-23). we randomly assign half of the vaccinees to receive ppv-23 eight weeks after pcv-7 (group a), and the rest to a 10-month interval (group b). pneumococcal antibody concentrations to serotype 4, 5, 6b, 7, 9v, 14, 18c, 19f, and 23f are determined initially, after two, and 12 months after pcv-7. local and systemic reactions to each vaccine are recorded.

Eligibility criteria:
inclusion criteria: * asthma classified according to the global initiative on asthma (gina) °1-2 exclusion criteria: * antecedent pneumococcal immunization

Keywords: preschool asthma sequential pneumococcal immunization immunogenicity safety
pain assessment by pupil dilation reflex (pdr) and pupillary pain index (ppi) in response to noxious stimulation in anesthetized adults

Conditions: Nociceptive Pain; Monitoring, Intraoperative

Summary: after conduction a pilot study, pupillary dilation reflex (pdr) is measured in response to nociceptive stimulation perioperatively.

an infrared camera of the video pupillometer measures the pupillary dilation reflex (pdr) in response to incremental nociceptive stimuli. the pdr is a robust reflex, even in patients under general anesthesia, and may provide a potential evaluation of the autonomous nociceptive circuit. american society of anesthesiologists (asa) classification i or ii patients undergoing elective surgery under general anesthesia are recruited. enrolled patients perioperative undergo pdr measurement at 2 different standardized times (before and after opioid administration) generated by an inbuilt pupillary pain index (ppi) protocol. ppi, as a surrogate for nociception includes noxious stimulations from 10 up to 60 milli ampere (ma) until pupil dilation is larger than 13% from baseline diameter. therefore, no inappropriate high stimulation is executed.

Eligibility criteria:
inclusion criteria: * scheduled abdominal or gynecological surgery * asa i-ii exclusion criteria: * history of eye deformity, invasive ophthalmologic surgery * known cranial nerve(s) deficit * infection of the eye * predicted difficult airway management (daf guidelines) * chronic opioid use (\>3 months) * ongoing treatment with beta-blockers, dopamine antagonists, topical atropine * preoperatively administrated benzodiazepins or antiemetics
intervention for toddlers at risk for autism spectrum disorders (asd)

Conditions: Autism Spectrum Disorder

Summary: this research is being done to test the effectiveness of an early intervention model for very young children at high risk for autism spectrum disorders (asd) and their families. if children show improvement in this intervention, the investigators hope that the availability of public services of this type will be increased. children between 11 months and 21 months old with autism spectrum disorders, or with social and communication delays that indicate high risk for autism spectrum disorders, and their parents may join the study. treatment must start prior to the second birthday.


Eligibility criteria:
inclusion criteria: * children will be ascertained between 11 months and 21 months of age * must be able to enter the study prior to their second birthday * must then pass an eligibility assessment to determine whether the child meets criteria for asd and thus qualifies for the study. this assessment will consist of the baby ados and the mullen scales of early learning. children must meet criteria for asd or autism on the ados, score more than one standard deviation below the mean on the receptive or expressive language scale of the msel, and have a clinical judgment of asd to be eligible for enrollment into treatment. * parents must agree to participate in the study and commit to having their child participate in the intervention to which they are randomized for 6 months * the parent (or other primary caregiver, such as grandparent) in the parent enrichment/training condition must agree to attend the training sessions exclusion criteria: * fail hearing or vision screening (by pediatrician's office, audiologist, or ophthalmologist) * family's first language being other than english (language measures are normed on english speakers, putting non-english speakers at a disadvantage. in addition, the treatment is delivered in english. children from non-english speaking homes may not make progress, but for reasons other than the efficacy of the intervention.) * head injury (because this may cause some of the symptoms, which may not be due to autism and therefore we would not be able to assess the effects of the intervention on autism) * identified reason for the autism (e.g., fragile x syndrome, rett syndrome, tuberous sclerosis) * inability of the family to attend the playgroup sessions and parent trainings * parents whose hearing or vision is not within normal limits after correction (e.g., hearing aid, glasses) * parents with developmental delays, language or learning impairments, or a psychiatric diagnosis if the impairment would interfere with parent training (pi will assess on a case by case basis by talking to the parent) * foster children * refusal to allow videotaping of the children's assessments or intervention or to allow videotaped footage to be used for teaching purposes.

Keywords: autism spectrum disorder language social toddlers