Kornimate/medical-research-clean huggingface dataset:
ischemic preconditioning. prospective comparison

Conditions: Ischemic Lesions

Summary: vascular occlusion is used to reduce blood loss during liver resection (lr), but may cause ischemic damage to the remnant liver and can lead to liver failure in case of chronic liver disease. this restriction of blood flow (ischemia) and subsequent restoration (reperfusion) causes a harm that is called ischemia- reperfusion injury. injuries sustained during the ischemic phase are related to a lack of oxygen to reduce cellular respiratory events can lead to, in a few minutes, irreversible damage. ischemic preconditioning as a technique to protect the liver parenchyma during liver resection consists of an initial flow clamping for 10 minutes, with subsequent reperfusion for 10-15min, followed by a complete portal triad clamping during transection.

detailed description: this is a prospective controlled trial, conducted between july 2011 and july 2012. this study has been initiated by liver \& transplant division, hospital dr cosme argerich, buenos aires argentina. the protocol was approved by ethics committees and an informed consent was obtained from each patient before they were enrolled. sixty patients were randomized to either receive ischemic preconditioning prior to liver resection under intermittent pedicle clamping or intermittent pringle ischemia. ischemic preconditioning was performed through a sequence of 10 minutes vascular inflow occlusion and 10 minutes of reperfusion prior to continuous pedicle clamping during resection. intermittent pedicle clamping was conducted through a sequence of 15 minutes of vascular inflow occlusion and 5 minutes of reperfusion. the randomization process which was centralized was held in the operating room after inclusion criteria had been check and exclusion criteria ruled out.

Eligibility criteria:
inclusion criteria: * patients' age ≥ 18 years old * portal vein embolization allowed exclusion criteria: * laparoscopic liver resection * pregnant women * lack of patient consent * lack of acceptance of the operating surgeon * hilar cholangiocarcinoma * simultaneous hepaticojejunostomy

Keywords: ischemic preconditioning liver resection
safety, efficacy and tolerability study of paliperidone extended-release (er) in participants with schizophrenia

Conditions: Schizophrenia

Summary: the purpose of this study is to explore the efficacy of flexibly dosed paliperidone extended-release (er) in participants with schizophrenia (psychiatric disorder with symptoms of emotional instability, detachment from reality, often with delusions and hallucinations, and withdrawal into the self) who were previously unsuccessfully treated with other oral antipsychotics.

this is a single arm (one group of participants), multi-center, 6-month study to explore the tolerability, safety and efficacy of flexibly dosed paliperidone er in participants with schizophrenia previously unsuccessfully treated with an oral antipsychotic medication. antipsychotic medications are drugs that are helpful in the treatment of psychosis and have a capacity to ameliorate thought disorders. unsuccessfully treated means that, despite the participant was treated with an adequate dose of an appropriate oral antipsychotic for an adequate period of time, previous treatment is considered unsuccessful due to lack of efficacy, lack of tolerability or safety, lack of compliance and/or other reasons. throughout the study the investigators will adjust the dosage of each participant based on the individual needs. in general, the recommended paliperidone er dose will be 6 milligram once daily. participants can be either in- or outpatients and they may take their study drug with or without food. participants who will complete this 6-month study and would like to continue will be eligible to be enrolled in an extension phase until paliperidone er is available.

Eligibility criteria:
inclusion criteria: * participant diagnosed with schizophrenia * participant's previous treatment of schizophrenia is considered unsuccessful * participant is healthy on the basis of a physical examination and vital signs * women must be postmenopausal, surgically sterile, abstinent, or, if sexually active, agree to practice an effective method of birth control before entry and throughout the study * be willing and able to fill out self-administered questionnaires exclusion criteria: * have used clozapine or risperdal consta during the last month, or have received any other conventional drug used to treat psychosis during the last 3 months * judged to be at high risk for adverse events, violence or self-harm * inability to swallow the study medication whole with the aid of water * pregnant or breast-feeding female * history or current symptoms of tardive dyskinesia (involuntary movements of the facial muscles and tongue)

Keywords: schizophrenia paliperidone paliperidone extended-release (er)
the tetrad bmi, leptin, leptin/adiponectin (l/a) ratio and ca-15-3 is a reliable biomarker of breast cancer

Conditions: Female Breast Carcinoma

Summary: objective: evaluate body mass index (bmi), leptin, leptin/adiponectin (l/a) ratio and cancer antigen (ca) 15-3 together as reliable biomarkers for breast cancer. patients: consecutive patients aged between 40 - 60 years, with breast disease and informed consent. interventions: patients' anthropometric and laboratorial characteristics classified by bmi in the group of cancer and patients with benign breast disease as well as biochemical tests of leptin, adiponectin,ca 15-3, hemoglobin, glucose low-density lipoprotein cholesterol (ldlc), high-density lipoprotein cholesterol (hdlc) levels were obtained as well as a blood sample to analyze ca 15-3 levels with a electrochemiluminescence immunoassay. hypothesis: using together leptin, l/a ratio, ca 15-3 and bmi could offer a reliable approach to detect high risk women to develop breast cancer.

serum levels of leptin, adiponectin and ca 15-3, as well as anthropometric and biochemical parameters were analyzed in 88 female patients attending mammography study. predictive values of bmi, leptin, l/a ratio and ca 15-3 were determined with 95% confidence interval (ci).

Eligibility criteria:
inclusion criteria: * female patients attending mammography, average age of the fourth and fifth decades. exclusion criteria: * patients with hormonal therapy.

Keywords: biomarker bmi breast cancer ca-15-3 leptin
hepatitis b virus reactivation after withdrawal of preemptive antiviral therapy in hematologic malignancy

Conditions: Lymphoma; Chronic Hepatitis B

Summary: previous studies dealt with patients who maintained antiviral drugs for 2 \~ 6 months after final chemotherapy and they revealed that many of the patients who stopped preemptive antiviral drug within 6 months experienced viral reactivation. based on the study results, guidelines recommend that preemptive antiviral therapy should be maintained for at least 6 months. nevertheless, many clinicians apply the preemptive antiviral drugs for 1\~2 years or longer after final chemotherapy without definite evidences, and this practice increases the medical expenditure a lot. therefore, the investigators are going to find out the proper and safe duration of preemptive antiviral therapy which can be a good reference in the future practice.

hbv reactivation in cancer patients is important not only for directly affecting severe hepatic failure but also for delaying of the further cancer treatments which may cause reduction of overall survival. thus the guidelines according to the previous studies and other follow-up of randomized studies revealed that patients with positive hbsag should be administered with preemptive antiviral therapy at least 6 month or more. however, ideal duration for preemptive antiviral therapy to suppress viral reactivation and withdrawal hepatitis is not clearly identified at present time. it is because previous data just dealt with the efficiency of preemptive antiviral therapy, but most of them did not analyze the outcomes after withdrawal of antiviral therapy. frequent late-onset reactivation hepatitis in association with preemptive antiviral therapy is mainly due to drug-resistance or post-withdrawal manifestation. drug-resistance was mainly associated with lamivudine which is now substituted by entecavir or tenofovir which produce lower incidence of resistance (\< 1.2% at 6 years). therefore, the only issue at present is withdrawal hepatitis which may be due to early cessation of the antiviral drug.

Eligibility criteria:
inclusion criteria: * 18 years old or older * ecog performance status 0, 1, 2 * hodgkin's or non-hodgkins lymphomas according to the who 2008 classification * patients who received standard cytotoxic chemotherapies * patients who finished chemotherapy (duration not exceeded 6 months) or who will finish the planned chemotherapy * patients who achieved at least partial response and do not need further chemotherapy * hbsag (+) patients who received preemptive antiviral therapies exclusion criteria: * anti-hcv ab(+), hiv(+), or autoimmune hepatitis * complications due to uncompensated liver cirrhosis * child pugh score : 10 points or more * hepatocellular carcinoma * patients who finish the lymphoma treatments with only radiotherapy

Keywords: preemptive antiviral treatment lymphoma chronic hepatitis b
investigation of simvastatin in secondary progressive multiple sclerosis

Conditions: Secondary Progressive Multiple Sclerosis

Summary: to determine whether simvastatin at a dose of 80mg can reduce the rate of whole brain atrophy, as measured by mri, over a 2-year time-period when compared to placebo.

the study has now completed see primary publication: effect of high-dose simvastatin on brain atrophy and disability in secondary progressive multiple sclerosis (ms-stat): a randomised, placebo-controlled, phase 2 trial. chataway j, schuerer n, alsanousi a, chan d, macmanus d, hunter k, anderson v, bangham cr, clegg s, nielsen c, fox nc, wilkie d, nicholas jm, calder vl, greenwood j, frost c, nicholas r. lancet. 2014 jun 28;383(9936):2213-21. doi: 10.1016/s0140-6736(13)62242-4.

Eligibility criteria:
inclusion criteria: * patients must have a confirmed diagnosis of multiple sclerosis and at randomisation have entered the secondary progressive stage. steady progression rather than relapse must be the major cause of increasing disability in the preceding 2 years. progression can be evident from either an increase of at least one point on the edss or clinical documentation of increasing disability. * edss 4.0 - 6.5 inclusive * women of childbearing age will be required to use appropriate methods of contraception to avoid the unlikely teratogenic effects of simvastatin. * able to give written informed consent * 18 - 65 years exclusion criteria: * unable to give informed consent * primary progressive ms * those that have experienced a relapse or have been treated with steroids (both i.v. and oral) within 3 months of the screening visit. these patients may undergo a further screening visit once the 3 month window has expired and may be included if no steroid treatment has been administered in the intervening period. * patient is already taking or is anticipated to be taking a statin. * any medications that unfavourably interact with statins: fibrates, nicotinic acid, cyclosporine, azole anti-fungal preparations, macrolideantibiotics, protease inhibitors, nefazodone, verapamil, amiodarone, large amounts of grapefruit juice or alcohol abuse. * the use of immunosuppressants (e.g. azathioprine, methotrexate, cyclosporine) or disease modifying treatments (avonex, rebif, betaferon, glatiramer) within the previous 6 months. * the use of mitoxantrone if treated within the last 12 months. * if the patient has ever been treated with alemtuzumab. * if screening levels of alanine aminotransferase (alt), aspartate aminotransferase (ast) or creatine kinase (ck) are three times the upper limit of normal patients should be excluded. * patient unable to tolerate baseline scan or scan not of adequate quality for analysis (e.g. too much movement artefact). * if a female patient is pregnant or breast feeding

Keywords: secondary progressive multiple sclerosis simvastatin mri
evaluation of web-based transition education to enhance transition readiness

Conditions: Congenital Heart Disease; Transition; Pediatric Congenital Heart Disease

Summary: the study looks to learn more about the helpfulness of web-based transition education and its effect on transition readiness and health service utilization in the adolescent and young adult congenital heart disease population.


Eligibility criteria:
inclusion criteria: * diagnosed with congenital heart disease * ages 13-25 * routine outpatient cardiology follow-up visit exclusion criteria: * new patients to cardiology clinic * patients being evaluated for an acute medical problem * patients who do not speak english * severe neurocognitive impairment that precludes ability to complete the questionnaire
sjm mri diagnostic imaging registry (ide)

Conditions: Cardiac Arrhythmia

Summary: this study is a prospective, non-randomized, multi-center study of subjects implanted with an sjm pacemakers, implantable cardioverter defibrillator (icd), and cardiac resynchronization therapy (crt) devices who are clinically indicated for a non-thoracic mri scan.

this study will be performed as part of a regulated, prospective, non-randomized, multi-center clinical study. subjects will be enrolled, undergo a clinically-indicated mri scan, and have an assessment of adverse events, device measurements, and clinical utility of the mri scan images.

Eligibility criteria:
inclusion criteria: 1. patient is implanted with a market-released st. jude medical pacemaker, icd, or crt current generation device listed in the study protocol and any market-released pacing or defibrillation lead. 2. patient's device and all leads must be implanted for at least 6 weeks prior to the scheduled date of the mri. 3. patient has a clinical indication for a non-thoracic mri scan, where mri is the imaging modality of choice that will give adequate results to manage the patient. 4. patient is scheduled for a non-thoracic mri scan up to 1.5t. 5. patient has a pacemaker, icd, or crt device implanted pectorally. 6. patient has the ability to provide informed consent for study participation and be willing and able to comply with the study procedures. 7. patient is 18 years or above, or of legal age to give informed consent specific to state and national law. exclusion criteria: 1. patient has an icd/crt-d and is pacemaker dependent 2. capture threshold is greater than 2.5 volts at 0.5 ms for ra and rv leads 3. pacing lead impedance is not within range (i.e. ≥ 200 and ≤ 2000 ohms) 4. high voltage lead impedance (hvli) is not within range (i.e. ≥ 20 and ≤ 200 ohms) 5. patient has a device generator battery voltage at elective replacement interval (eri) 6. patient has another existing active implanted medical device (e.g. neurostimulator, infusion pump, etc.) that has mr labeling that will not allow the mri scans to be completed. 7. patient has other non-mri compatible device or material implanted note: * mri compatible knee replacements, hip replacements, stents, etc. may be included as long as the labeling of these devices allow mri scans conducted per this protocol * mri compatible mechanical, prosthetic, and bioprosthetic heart valves may be included as long as the labeling of these devices allow for mri scans conducted per this protocol * non-removable dental implants may be included 8. patient has a lead extender, adaptor, or capped/abandoned lead 9. patient is pregnant

Keywords: mri scan, pacemakers, icd, crt
online chronic pain therapy for adults

Conditions: Chronic Pain

Summary: this study will evaluate the usefulness of an online, self-directed treatment for chronic pain that has been designed specifically for individuals who are currently or have previously served in the military.

this study will evaluate the efficacy of an eight-module, online, self-directed treatment for chronic pain using acceptance-based behavioural therapy (abbt) as the treatment modality. the online modules are tailored to the unique issues of individuals with a military background. the modules will be delivered via the webcapsi therapy program, an online, password-protected program that allows participants to anonymously progress through all modules at their own pace. abbt modules cover the following: introduction, acceptance, values, cognitive defusion, mindfulness, exercise/pacing/communication skills, self-as-context, and willingness. modules encourage understanding of the information through audio files, military-specific vignettes, written materials, and homework exercises. modules are designed to be completed in 60 minutes or less. participants will have access to the online treatment for a three month period and will be encouraged to complete one module per week.

Eligibility criteria:
inclusion criteria: * chronic pain condition of duration 6 months or longer * patient at osi clinic in winnipeg * access to a computer with internet at least once per week for 60 minutes exclusion criteria: * active psychosis * actively suicidal * unstable living conditions * seriously impaired concentration * inability to read and write in english

Keywords: chronic pain military veteran online acceptance
myeloperoxidase and multi-markers in the diagnosis of diagnoses of acute coronary syndrome (midas) - sample procurement

Conditions: Acute Coronary Syndrome (ACS)

Summary: the purpose of the study is to procure blood samples from patients who present to the emergency department with suspected acs (acute coronary syndrome).

this is a prospective, multi-center, observational, and sample procurement study of adult subjects presenting to an emergency department (ed) in whom acs is in the differential diagnosis. subjects must present to one of the participating eds within 6 hours or less from the time of symptom onset, and must have experienced at least 30 minutes of chest discomfort. those ed patients with possible acs who meet the inclusion/exclusion criteria will be approached for study enrollment by trained research personnel. the patient's diagnostic work-up and treatment will continue per the standards of the treating institution. as indicated by their clinical presentation, all subjects in the study will have objective cardiac testing for evidence of coronary artery disease (cad) during or in close proximity to the index ed visit or hospital admission. for this study, objective cardiac testing will consist of one of the following tests: exercise treadmill, coronary angiography, myocardial stress imaging, stress magnetic resonance imaging (mri), sestamibi scan, or dobutamine echocardiogram. cardiac events and procedures, such as angioplasty-stenting and coronary artery bypass surgery (cabg), will be recorded during the index ed visit, hospitalization and post-hospital follow-up period. subjects will have a 30-day and 6-month follow-up contact by phone to collect this information on cardiac events, procedures, and survival.

Eligibility criteria:
inclusion criteria: * age 18 years or older at time of enrollment * patient presenting to the ed within 6 hours or less from symptom (chest discomfort consistent with possible acs) onset * patient experiencing at least 30 minutes of chest discomfort, consistent with possible acs, from time of symptom onset; patients who have symptoms of shorter duration due to pharmacologic intervention may be included * physician plans to perform objective cardiac testing as defined by the protocol exclusion criteria: * patient (or legal representative) unable or unwilling to provide informed consent * patient (or legal representative) refusal of medical record review or telephone follow-up at 30 days or 6 months * patient (or legal representative) refusal of multiple blood sample collection over the study period * prisoners or other institutionalized individuals

Keywords: heart cardiac acute coronary syndrome sample procurement
adverse events with magnesium sulfate

Conditions: Lung Diseases

Summary: to investigate in pregnant women the adverse pulmonary effects of magnesium sulfate (mgso4), a commonly used drug for tocolysis or arrest of labor.

background: preterm labor is a major public health concern in the united states. the delay of labor, particularly for idiopathic preterm labor, is important because it allows further fetal development and the opportunity to administer steroids which improve fetal lung maturity. it is now common for mgso4 to be administered to delay labor. the most dangerous adverse event with mgso4 treatment is the development of pulmonary edema which may lead to maternal adult respiratory distress syndrome and death with associated fetal morbidity and mortality. the estimates of the frequency of this complication vary from 0 to 8 percent. therefore, improved understanding of the pulmonary toxicity of this therapeutic agent is clinically important. design narrative: there were three phases in the study. the first, a retrospective cohort study, examined the incidence rate of pulmonary edema when mgso4 was administered as a tocolytic agent. the second, a case-control study nested within the cohort, examined the relationship between the patient and other clinical factors and the incidence of pulmonary edema in patients treated with mgso4. the third phase used the results of the case-control study to develop and validate a predictive index to define a group of patients at increased risk of developing pulmonary edema associated with mgso4. patients were identified using icd-9-cm codes for preterm labor and delivery. the medical record was reviewed to determine exposure to mgso4 as a tocolytic agent, excluding patients who received mgso4 for other indications. cases were defined as probable when patients met the clinical definition for pulmonary edema, including chest x-ray findings. the medical charts of both cases and a random sample of non cases were then reviewed in detail and the data from these groups were compared. the primary analysis of these case-control data included unadjusted analysis and multivariable explanatory models to provide insight into the risk factors for pulmonary edema associated with mgso4. the data from the case-control study were used to develop a clinical predictive index. the predictive rule was then validated in a separate patient population.

Eligibility criteria:
no eligibility criteria
clinical efficacy and safety of intravenous infusion of nicorandil during primary percutaneous coronary intervention

Conditions: ST Elevation Myocardial Infarction; Percutaneous Coronary Intervention

Summary: the investigators evaluate the efficacy and safety of intravenous administration of nicorandil as adjuncts to reperfusion treatment in acute st-segment elevation acute myocardial infarction (stemi) patients undergoing primary percutaneous coronary intervention (pci).


Eligibility criteria:
inclusion criteria: * 18-80 years; * acute st-segment elevation myocardial infarction within 12 hours of symptom onset; exclusion criteria: * systolic blood pressure\<100mmhg; * cardiac shock; * aortic dissection; * history of myocardial infarction or percutaneous coronary intervention or coronary artery bypass grafting (\<6 month); * history of the treatment of nicorandil (\<6 month); * history of intravenous nitrates before percutaneous coronary intervention; * contraindicated or intolerable to nicorandil; * pregnant or lactation period; * patients with an estimated survival time of less than 1 year.