Kornimate/medical-research-clean huggingface dataset:
shock trial: should we emergently revascularize occluded coronaries for cardiogenic shock.

Conditions: Cardiovascular Diseases; Coronary Disease; Heart Diseases; Myocardial Infarction; Myocardial Ischemia; Shock, Cardiogenic

Summary: to test if early revascularization, primarily with angioplasty (ptca) or bypass surgery (cabg), reduced all-cause in-hospital mortality from cardiogenic shock compared to conventional treatment, including thrombolysis.

background: approximately 7.5 percent of all acute myocardial infarctions which are diagnosed in an emergency room or in-hospital lead to cardiogenic shock and an in-hospital death rate of 70 to 80 percent, usually within one to two days of diagnosis of cardiogenic shock. the high death rate has not changed in the last two decades. non-random clinical series and animal studies suggest that rapid revascularization following cardiogenic shock complicating acute myocardial infarction may substantially improve survival. however, the apparent benefit reported in the non-random clinic studies could have resulted partly from a selection bias towards patients with a better prognosis. design narrative: randomized, multicenter, phase iii, controlled clinical trial. patients with shock due to left ventricular failure complicating myocardial infarction were randomly assigned to emergency revascularization or initial medical stabilization. revascularization was accomplished by either coronary-artery bypass grafting or angioplasty. a total of 152 patients were randomized to early revascularization and 150 patients to conventional therapy consisting of thrombolytics and a possible late attempt at revascularization. intraaortic balloon counterpulsation was performed in 86 percent of the patients in both groups. the primary endpoint was mortality from all causes at 30 days. secondary endpoints included all-cause mortality at six months and assessment of the quality of life in survivors after discharge. all patients with a clinically suspected diagnosis of cardiogenic shock complicating myocardial infarction formed a registry, with limited information collected on in-hospital procedures, medications, length of stay and vital status at discharge. the study has been extended through june, 2005 for patient follow-up and data analyses. long-term survival rates (6 to 11 years post-mi) will be estimated and the quality of life of survivors of acute mi complicated by cardiogenic shock will be studied. extended trial data analyses will be conducted: a) to determine the early echocardiographic parameters which are associated with one year survival in cardiogenic shock patients, and to assess the interaction of these parameters with early revascularization; b) to examine differences in disease course and patient outcome as a function of age, gender, national practice, and changes in serial hemodynamic measurements, as well as to better characterize the related conditions and complications of cardiogenic shock.

Eligibility criteria:
men and women with myocardial infarction and cardiogenic shock.
the effect of eye exercises in individuals with eye refractive defects

Conditions: Individuals With Eye Refraction Defects

Summary: according to the world health organization's statement published in 2014, 43% of visual impairment is overhauled by uncorrected refractive errors. the change of body and angle of light waves while undergoing changes in the environment due to the temperature difference between the environments is called refraction. the refractive errors found in the eye can be discovered as myopia, astigmatism, hyperopia, and presbyopia. as there are different prevalence methods in eye refractive errors in various publications. according to many studies in the literature, eye exercises in many conditions such as convergence collapse, accommodation dysfunction, movement center of the eye, digital eye strain and dry eye are curative and therapeutic without any control. with eye exercises, blood is applied to the ocular region, the humor is stimulated, the tension of the extraocular muscles is reduced, the coordination between the eye muscles is increased, the eye fatigue and stress are reduced. depending on the effects of these effects, positive changes are seen on vision tests. although there is a different view in the literature that includes these eye exercises and their benefits, it has been found to be insufficient in current studies. more work needs to be done in this area so that these results can be stated better and more clearly. with this study, investigators aim to shed light on what can be done in this field by filling these residents in the literature and to examine the visual function and quality of life of eye exercises.


Eligibility criteria:
inclusion criteria: be between the ages of 18-65, having any refractive or visual impairment (myopia, hyperopia, astigmatism) by an ophthalmologist, not have other eye problems in addition to these vision defects, to score at least 24 on the standardized mini mental test. exclusion criteria: having undergone any eye surgery (including laser operations), have a prosthetic eye have congenital vision loss, have any disease that will affect the eyesight. individuals meeting these criteria will not be included in the study.

Keywords: ocular refraction eye exercise life quality ocular vision
a study of lidocaine pertubation as a treatment for unexplained infertility

Conditions: Unexplained Infertility

Summary: the present investigation is evaluating a method for improving pregnancy outcome of couples with unexplained infertility. the method utilizes an adjuvant pre-treatment prior to insemination, that is pertubation, i.e. flushing the uterus and fallopian tubes before insemination with a specially developed solution with the aim to increase fertility. the clinical trial is a phase ii double blind, randomized, controlled and multi-center trial .

couples interested in participating in the clinical study must have undergone a complete investigation for their infertility and have at least one year of unsuccessful attempts to achieve pregnancy. following inclusion in the study, patients will be monitored with vaginal ultrasound to ensure a leading follicle of at least 18 mm.the subjects with one or two follicles ≥18 mm will be given ovitrelle® (merck), dose 250 ug (6500 iu) of human chorionic gonadotropin (hcg), subcutaneously for ovulation induction. 12-24 h after the hcg injection, patients will be randomized and pertubated with either test or control solution. 12 -24 hours after the pertubation insemination (iui) will be given to all patients. a blood sample is taken 14-17 days after iui, for analysis of serum hcg level and possible pregnancy. in case of positive answer a second confirmatory sample will be obtained 48-72 hours later. in case of confirmed elevated hcg, the clinical pregnancy (cp) will be assessed with vaginal ultrasound examination 6-7 week after iui. baby take home rate data will be collected for couples with clinical pregnancy.

Eligibility criteria:
inclusion criteria: females with, unexplained infertility, 20-38 years of age. normal menstrual cycle length of 26-35 days, male partner 20-70 years of age, duration of infertility should have lasted more than one year and subject should have signed informed consent. couples must fulfil all laboratory tests for inclusion, negative hiv-1, hcv, hbv, cmv virology, chlamydia and syphilis. for female also negative toxoplasmosis, rubella and hormonal screen within normal range. furthermore patent fallopian tubes should be confirmed by ultrasound hysterosalpingography and males should present a normal semen analysis exclusion criteria: continuous treatment with nsaid, corticosteroids or other drugs, which can cause an increased risk of infection, clinical signs of pid, known hypersensitivity to local anaesthetics, non-patent fallopian tubes, abnormal uterine cavity, submucous myoma \> 2 cm in diameter, any disease or laboratory finding considered of importance by the investigator not to include the patient, laparoscopically confirmed endometriosis of greater severity than mild, endometriosis of any severity with adhesions. more than 2 previous inseminations or previous unsuccessful ivf treatment.
relative impacts on preventative primary care--a longitudinal evaluation of covid-19:phase 1

Conditions: Diabetes Mellitus; Congestive Heart Failure; Chronic Kidney Diseases; Chronic Obstructive Pulmonary Disease; Depression, Anxiety; Osteoarthritis; Dementia

Summary: the goal of this observational study is to describe the impacts of covid-19 on primary care chronic condition management in canada within various patient populations. this will be done by analyzing primary care electronic medial record (emr) data from the canadian primary care sentinel surveillance network (cpcssn) database, including data on primary care encounters, as well as various markers for chronic conditions. the research questions to be investigated are: 1a) what are the changes to the management of chronic conditions in primary care since the onset of the covid-19 pandemic? 1b) how do these changes differ by age, health status, and socioeconomic status?

this is a retrospective closed cohort study, using a single-arm, pre-post design. the objectives of this study are to describe the impacts of covid-19 on access, comprehensiveness and appropriateness among adult patients with chronic diseases, and to determine whether changes were associated with socio-demographic characteristics and multi-morbidity. this will be done using using electronic medial record (emr) data made available by the cpcssn network. cpcssn is a research network supported by a primary care emr database, comprising over 1500 physicians, and nearly 2 million patients from across canada. we will be examining prevention and management activities for several exemplar chronic conditions that have a validated cpcssn case definition and substantial prevalence in primary care (e.g. diabetes, heart failure, etc.). cpcssn data between 2018-2021 will be analyzed for changes in management of various chronic conditions prior to, and through phases of the pandemic. changes will also be examined among specific sub-groups of adults, including those with multi-morbidity and socio-economic vulnerabilities. the primary exposure is the onset of the pandemic: march 13, 2020 to december 3, 2021 versus the equal time frame prior. march 13, 2020 was selected as the date when canadian provincial governments began enforcing various public health and safety measures in response to the world health organization formally declaring the circulating sars-cov-2 as a pandemic on march 11, 2020. we will be examining whether there have been changes in overall access, comprehensiveness, continuity and appropriateness of care (including potential decreases in burdensome or unnecessary care) by applying indicators that incorporate chronic condition monitoring (physical measures, lab tests and investigations), prescriptions, referrals and preventive care, to chronic condition patient populations.

Eligibility criteria:
inclusion criteria: * 18 years of age or older as of 2018 * records included in the cpcssn database * patient had at least one encounter with their clinic between march 13, 2018 and march 13, 2020 exclusion criteria: * patients aged 105 or older as of 2018 will be excluded due to possibility of data entry error
swallowing characteristics of pediatric patients with eosinophilic esophagitis

Conditions: Eosinophilic Esophagitis

Summary: eosinophilic esophagitis (eoe) can affect patients all age group and clinical symptoms of the disease varies depending on the patient's ages. infants and toddlers with eoe generally have food refusal, vomiting and poor weight gain. older school-aged children and adolescents may have abdominal and chest pain, difficulty in swallowing (dysphagia) especially in solid foods. in the meantime, many children especially infants and toddlers, are not perceptive of their dysphagia, because they have the ability to compensate. such as, avoiding certain textures or increases liquid intake in the meal.to date, to our knowledge, there is no study in the literature has investigated complex swallowing behaviour (including all phases), oral-motor evaluation and/or swallowing safety. thus, the present study purposed to investigate (a) descriptive and clinical swallowing characteristics of children with eoe (b) the relation between disease characteristic and swallowing function.


Eligibility criteria:
inclusion criteria: * children and adolescents aged 2-17 years with a diagnosis of eosinophilic esophagitis exclusion criteria: * do not accommodate the study * do not want to attempt the study
ultrasound-guided lmbb by caudal-cranial approach: radiographic comparison of a new ultrasound-guided method

Conditions: Chronic Low-back Pain; Lumbar Facet Joint Syndrome

Summary: the current standard technique is radiography requiring three uni- or bilateral punctures (transverse-axial plane). the ultrasound technique is also described mainly in this plan but a new "caudal-cranial" ultrasound-guided technique was described by chang et al in 2018 in which the major axis is used to conduct the needle to the desired area. the investigators would like to confirm that this new technique in a single puncture is also possible under ultrasound.

the convex probe is first positioned in the median longitudinal plane opposite the spinous processes of the lower lumbar vertebrae l4 and l5 with the coordinate system on the cranial side and the side opposite the mark on the sacrum side. the latter is visualized as a hyperechogenic continuous line. the probe is then moved away from the midline, the probe is slightly inclined in an oblique paramedian position looking towards the midline, and gradually slid towards laterality in order to reveal successively, the plane of the laminar interlines of the l3, l4 and l5 vertebrae, then the plane of the facelet spacing of these same vertebrae at the junction of the upper and lower articular processes, finally the plane of their transverse processes

Eligibility criteria:
inclusion criteria: * chronic low back pain compatible with facet lumbar syndrome with chronic pain of at least 3 months * who have not responded to conservative treatment after at least 4 weeks * patients without signs of dissociated pain, radiculitis, neurological diseases including stroke and parkinson's disease, spinal instability or deformities such as scoliosis, ankylosing spondylitis, history of lumbar surgery, fracture or lumbar tumor exclusion criteria: * pregnant or breastfeeding women * allergy to injected products (depomedrol or linisol) * psychiatric disorders hindering understanding of the protocol * local or systemic infection * coagulation disorder * obese with a bmi\> 35 kg / m²

Keywords: pain fluoroscopy ultrasound injection site infiltration chronic facet infiltration
imaging inflammation in autoimmune diabetes

Conditions: Diabetes Mellitus, Type 1

Summary: the purpose of this study is to determine whether magnetic resonance imaging (mri) with ferumoxtran-10 can be used to detect changes in the pancreas associated with autoimmune diabetes.

approximately one million individuals are afflicted with autoimmune type 1 diabetes mellitus (t1dm) in the united states. this disease results from the autoimmune destruction of the insulin-producing beta-cells of the islets of langerhans of the pancreas. initially, diabetes is usually clinically occult with localized pancreatic inflammation characterized by a lymphocytic infiltration of the pancreatic islets, termed insulitis, which leads to beta-cell specific destruction of the islets. this is often followed by the clinically overt phase that ensues when the bulk of beta cells have been destroyed and the pancreas is no longer able to produce sufficient insulin to maintain glycemic control. the purpose of this study is to assess the ability of magnetic resonance imaging with ferumoxtran-10, a functional molecular imaging agent consisting of iron oxide nanoparticles, to detect changes in the pancreas associated with the insulitis of t1dm.

Eligibility criteria:
inclusion criteria: * recent onset type 1 diabetes as defined by clinical diagnosis within the last 6 months and age less than 30 or at least one islet autoantibody marker (gad, iaa, or ia-2). or * high risk of pre-type 1 diabetes as defined by first degree family relative with type 1 diabetes and at least one islet autoantibody marker (gad, iaa, or ia-2). or * individuals with established type 1 diabetes of greater than 6 months duration who were under age 30 or at least one islet autoantibody marker positive (gad, iaa, or ia-2) at time of diagnosis or who currently are gad or ia-2 autoantibody marker positive. or * normal control as defined by no family history of type 1 diabetes and normal tolerance test (tolerance testing to be performed as part of protocol). exclusion criteria: * individuals under 18 years of age * individuals unable or unwilling to give informed consent/hipaa authorization * individuals who are clinically unstable * individuals with any contraindications to mri examination, for example, individuals with pacemakers * pregnant or lactating women * individuals with allergies to iron or dextran * individuals with a history of cirrhosis
effect of prebiotics on blood pressure management

Conditions: Hypertension; Gastrointestinal Microbiome

Summary: this survey is designed to investigate the effect of highland barley β-glucan supplementation on the regulatory of blood pressure, gut microbiota and cardiovascular risk fators in subjects with hypertention.

highland barley β-glucan belongs to the group of prebiotics and has been found to be associated with multiple health benefits. however, its protective role in subjects with hypertension are remain unclear. this study aims to examine the effect of 12-week prebiotics supplementation on blood pressure management in subjects with hypertension. by understanding the mechanism by which prebiotics exert the beneficial effects, we can better control the rising prevalence of hypertension, which is a major risk factor for cardiovascular diseases.

Eligibility criteria:
inclusion criteria: 1. age:30-65 years old 2. newly diagnosed hypertension did not use antihypertensive drugs or systolic blood pressure ≥140mmhg on the physical examination or diastolic blood pressure ≥90mmhg on the physical examination. 3. bmi≥18 kg/m2 exclusion criteria: 1. receiving or have been treated with antihypertensive drugs. 2. complications including cardiovascular and cerebrovascular diseases such as coronary heart disease and stroke. 3. severe liver or renal insufficiency (alanine aminotransferase, aspartate aminotransferase or alkaline phosphatase is greater than 3 times the upper limit of normal or gfr\<30ml/min/1.73m2). 4. autoimmune diseases or thyroid diseases. 5. women who are pregnant, nursing, or prepare to give birth during the trail. 6. malignant disease, infectious disease, inflammatory disease and advanced liver disease. 7. mental or intellectual abnormalities, unable to sign informed consent. 8. complications including chronic gastrointestinal disease; or suffered from acute gastrointestinal diseases within 1 months before screening visit. 9. received antibiotics, probiotics within 3 months before screening visit or throughout the trail. 10. major operations were performed within six months of screening visit, or will be made during the trial. 11. alcohol abuse (alcohol intake\>60g/d for male and alcohol intake\>40g/d for female)

Keywords: hypertension gastrointestinal microbiome prebiotics
role of hla genes and innate immunity in the phenotypic variability of covid-19

Conditions: COVID-19

Summary: case-control, prospective retrospective association study of patients infected with sars-cov2 and cured by covid19. recruited patients were divided into two cohorts (cases: patients with respiratory failure that required hospitalization and ventilatory assistance. controls: patients who had oligo-asymptomatic forms of covid19). patients' blood samples were collected on bibula paper, from which genomic dna was extracted. next-generation sequencing of hla and innate immunity genes was performed on these samples. genetic risk and protective variants were identified, based on the distribution of allele frequencies in the two cohorts. the aim of the study is to evaluate the role of genes of the hla system and innate immunity in modulating the host response to sars-cov2 infection. the identification of these factors is essential from the perspective of public health (identifying individuals most in need of protection from infection as they are at higher risk of severe forms), basic research (characterization of molecular mechanisms of disease) and therapeutics (through knowledge of basic mechanisms, identify potential therapeutic targets and optimize the protective efficacy of vaccines).


Eligibility criteria:
inclusion criteria: * oxygen saturation (sao2) \<94% on room air; \<90% if known chronic hypoxic conditions or receiving chronic supplemental oxygen * respiratory rate \>24 breaths/min exclusion criteria: * patients who still test positive for the presence of sars-cov-2 genome at the recruitment. * patients who cannot understand the meaning of the study and/or do not sign the informed consent form.
acute-on-chronic liver failure in zagazig university hospitals

Conditions: Acute-On-Chronic Liver Failure

Summary: rationale: to identify the prevalence of acute-on-chronic liver failure in zagazig university hospitals. the question of the research: how much the prevalence of acute-on-chronic liver failure in zagazig university hospitals? the aim of the work: the aim of the study is to identify the presence of acute-on-chronic liver failure in zagazig university hospitals objectives: to estimate the prevalence of acute-on-chronic liver failure in zagazig university hospitals. subjects and methods: i . technical design: * site of the study: gastroenterology and hepatology unit- zagazig university hospitals * sample size: ''all patients admitted to gastroenterology and hepatology unit with the criteria of aclf according to easl-aasld from june 2017 to december 2017 were included in this study''. ii . operational design: * type of the study: a prospective study. * full medical history - taking. * full clinical examination. * laboratory investigations including routine laboratory investigation " cbc, liver functions test, kidney functions test and prothrombin time " iii. administrative design: * approvals obtained for performing the study from the official or governmental department. * an ethical committee from the faculty of medicine and patients included in the study. results: collected data will be presented in tables and suitable graphs and analyzed according to standard statistical methods


Eligibility criteria:
inclusion criteria: * all patients admitted to gastroenterology and hepatology unit with the criteria of aclf according to easl-aasld will be included in this study. exclusion criteria: * no any exclusion criteria

Keywords: aclf sofa zagazig university