Kornimate/medical-research-clean huggingface dataset:
management of ta in vas-patients and ht

Conditions: VTE After Stroke

Summary: stroke is an independent risk factor for venous thrombosis (vte), which leads to a significant increase in the mortality and disability rate after stroke. for patients with high risk factors for vte such as advanced age, paralysis, infection, dehydration, etc., the incidence of death and disability is higher. studies have shown that the incidence of deep vein thrombosis in bedridden ischemic stroke patients is about 20%, and the incidence of pulmonary embolism is about 2%, and causes 10% of post-stroke deaths. in order to prevent the occurrence of vte, the american heart association, the american stroke association, the cerebrovascular disease group of the neurology branch of the chinese medical association, etc. pointed out in the guidelines that heparin or low molecular weight heparin should be used for stroke patients with "restricted mobility" or "incapable mobility" to prevent vte. for patients with evidence of thrombosis or symptoms of dvt, antithrombotic therapy should be initiated immediately. paradoxically, ischemic stroke significantly increases the risk of cerebral hemorrhage. besides there is an increased risk of primary intracerebral hemorrhage (ich) associated with aspirin or antiplatelet agent monotherapy and it is difficult to achieve a balance between preventing blood clots and reducing the risk of bleeding complications. in addition, stroke patients are elderly and have speech and intellectual impairment, and the non-specific symptoms and signs of intracranial hemorrhage caused by improper antithrombotic therapy make the rate of misdiagnosis and missed diagnosis extremely high. therefore, clarifying the clinical characteristics of stroke patients with vte and launching targeted interventions to effectively balance the risk of anti-thrombosis and bleeding have become the key to improving the prognosis of patients. this study is based on real-world data to study the bleeding risk and antithrombotic treatment options in vas (1) the risk factors associated with hemorrhage in patients with vte after stroke; and (2) the characteristics and pharmacotherapeutics regimen of high-risk populations with vte after stroke; and(3) the optimal antithrombotic treatment regimen for patients with vte after stroke, including the timing of starting and stopping the antithrombotic treatment, selection of varieties, dosage, and course of treatment, etc.


Eligibility criteria:
inclusion criteria: * patients diagnosed with vte after stroke * use at least one antithrombotic drug exclusion criteria: * case information is incomplete * non-spontaneous cerebral hemorrhage * suffer from serious blood system disease * do not accept follow-up
use of a compression device for ring removal: a prospective trial

Conditions: Wounds and Injuries; Hand Injuries; Device Malfunction

Summary: the usual treatment for stuck rings includes a variety of techniques including use of ice to reduce swelling, use of lubricants, and sometimes the use of string or ring cutters. the success rate of these techniques is variable and cutting the ring is usually reserved as a last resort. sometimes removal of a ring can take time, and can cause some small injury to the patient. because of this, it is important to consider other methods for ring removal. this study is looking at using a device that uses compression to reduce swelling of the finger causing the ring to be stuck. this device has been approved for use in canada. the purpose of this study is to evaluate how effective a compression device is at removing stuck rings. the study question is: how effective is a compression device at removing stuck rings? a compression device (cd) is a device that uses circumferential compression to reduce swelling around a stuck ring. the device is used by placing it near, but not over-top, the offending ring, and then is inflated compressing the finger. the device is applied, and the hand elevated, for approximately five minutes. the device is then removed, and with a small amount of lubricant, the ring is removed. all patients requiring ring removal at the qeii emergency department, if a compression device can be used safely, will be asked if they would like to be included in the study and have their ring removal attempted by a compression device. following removal attempt, the clinician will document information about the ring removal. this will include some questions regarding the patient's experience with the removal. no identifying information or personal health information will be recorded. the investigators plan to collect information about use of the compression device for a period of one year. following this time, the data will be analyzed to determine how effective the compression device is at removing rings including statements regarding patient experience. this information will be documented in a manuscript intended for publication and may be presented at academic conferences or other continuing education events. the investigators will be measuring the success rate of ring removal with the compression device. in addition, the investigators will record information on any side effects of use of the compression device, as well as patient experience including pain and satisfaction.


Eligibility criteria:
inclusion criteria: * individuals presenting to the qeii emergency department with a chief complaint of a stuck ring on a finger, or with heath conditions that necessitate removal of a ring that cannot be removed without clinician assistance. exclusion criteria: * contraindications to compression device use including certain bone, nerve or blood vessel conditions.
evaluation of fluid resuscitation in shocked patients by electrical cardiometry in comparison to transthoracic echocardiography.

Conditions: Fluid Resuscitation; Electrical Cardiometry; Transthoracic Echocardiography; Shock

Summary: the aim of this study is to evaluate the diagnostic accuracy of electrical cardiometry (ec) for the noninvasive determination of fluid responsiveness in critically ill shocked patients and agreement of ec compared to transthoracic echocardiography (tte)

electrical cardiometry (ec), based on thoracic electrical bioimpedance, can measure sv continuously and non-invasively. the ec"s working principle of estimation of sv is to utilize changes in thoracic electrical impedance, which is mainly influenced by erythrocyte orientation and peak flow velocity in the ascending aorta throughout the cardiac cycle. electrical cardiometry (ec) has been validated to monitor sv and other hemodynamic parameters non-invasively compared to different techniques such as thermodilution technique, transesophageal doppler echocardiography and cardiac catheterization including critically ill patients, intra-operative settings, in pregnant women, in children with congenital heart diseases, even in obese children

Eligibility criteria:
inclusion criteria: * age from 25 to 65 years old. * both sexes. * patients with clinical criteria of shock \[mean arterial pressure (map) ≤ 65 mmhg and tissue hypoperfusion (scvo2 \ 2mmol/l). exclusion criteria: * refusal to sign the consent by a first degree relative. * previous cardiac disease, rhythm other than sinus rhythm or heart rate \> 140 beat/min. * renal failure (acute or chronic).
e-health cognitive behavioral therapy in women treated by in vitro fertilization (ivf)

Conditions: Depression; Anxiety; Infertility

Summary: yearly, 15,000 dutch in vitro fertilization (ivf) cycles are performed for subfertility with a pregnancy rate of 26%. a failed cycle has great emotional impact; 20-25% of the women has relevant forms of depression/anxiety even after 6 months. for such maladjustment a risk profile has been identified and translated into a screening tool. identification of women at risk enables a timely and tailored (individual's needs) cognitive behavioral therapy (cbt), which reduces more serious maladjustment and corresponding costs. aim: to investigate the effectiveness of an e-health cbt (digital coaching, digicoach) in women ongoing ivf and having been screened at risk. design: a single-centered randomised controlled trial comparing digicoach (intervention) with standard care (control). digicoach: an e-health cbt with 4-12 weekly sessions starting before an ivf cycle, following a woman's ivf course and covering in modules the main problems: depressed mood, anxiety, strong focus on child wish and acceptance. main outcome measures: anxiety and depression occurrence rate 3 weeks after an unsuccessful ivf cycle. secondary outcome measures: 1. (para)medical consumption, 2. quality of life, 3. productivity loss and 4. ivf outcome. data are collected by questionnaires, diaries, medical record audit and page view registrations. process evaluation: individual's use (e.g. module progress, completion rate), experiences, (e.g. satisfaction and usability) and potential barriers for implementation are evaluated. economic evaluation: studied during the digicoach exposures from a societal perspective. incremental costs (costs/%avoidance of depression/anxiety) are determined by comparing both study groups. power/data analysis: to detect a 29% difference in the depression/anxiety occurrence rates (alfa=0.05 and beta=0.80) 58 unpregnant ivf women are evaluated.


Eligibility criteria:
inclusion criteria: * women screened as 'at risk' for emotional maladjustment after in vitro fertilization (ivf) by a screening tool exclusion criteria: * impossibility to use internet * impossibility to write or read the dutch language * high screening scores requiring immediate intervention

Keywords: in vitro fertilization e-health cognitive behavioral therapy psychosocial risk profile emotional maladjustment
immediate effect of non-invasive auricular acupoint stimulation for the performance and the meridian activities of archery athletes

Conditions: Stress, Physiological; Sport Injury

Summary: in our hypothesis, auricular acupoint stimulation might improve the attention and heart rate variability in archery athletes. the meridian activities regarding the attention and action in chinese medicine systems might be influenced.

during the execution of archery, attention is the key of performance in elite players, especially in the initial period. auricular acupoint stimulation is one of the therapeutic methods of traditional chinese medicine. it is widely applied in various diseases. researches had concluded the use of auricular acupoint stimulation on amplifying the anesthesia effect, weight reduction and the cessation of substance abuse. this study aimed to investigate the immediate effect of non-invasive auricular acupoint stimulation on the performance and the meridian activities of archery athletes. the investigators will collect the meridian activities and balance index with ryodoraku device, the continuous heart rate record and the scores of the two sections as the performance. the participants will rate their attention and fatigue levels through filling the self-reported questionnaires.

Eligibility criteria:
inclusion criteria: * health volunteers, age between 13-26 years old * received training of archery for more than one year exclusion criteria: * history of psychiatric disorders * history of cardiovascular diseases * previous operation history of dominant hand * unwilling or unable to sign the informed consent of this study

Keywords: archery ryodoraku heart rate variability auricular acupoint
the efficacy of oral melatonin in preventing postoperative delirium for patients undergoing orthopedic surgery under general anesthesia

Conditions: Delirium, Anesthesia Emergence; Delirium

Summary: postoperative delirium is a complication that should not be underestimated. as it elaborates many complications that could be avoided when an accurate assessment of the risk factors and interventional measures are taken appropriately when needed.

delirium is a variation in concentration capabilities that occurs acutely in association with a disturbed level of consciousness. delirium is more common in orthopaedic surgery patients than in general surgery patients. as delirium ratios range from 44% to 55% in hip surgery patients, otherwise only 10%-14% of general surgery patients. several studies were carried out and found that melatonin levels correlate with the development of delirium postoperatively. this study was conducted to determine the efficacy of administering melatonin preoperatively in patients undergoing orthopedic surgery to prevent postoperative delirium.

Eligibility criteria:
inclusion criteria: 1- patients in good general health. 2. baseline mdas \<13. 3. no seizure disorder. exclusion criteria: 1. patients with a neurological disorder (e.g., dementia, stroke, epilepsy). 2. patients with a history of acute or chronic confusion. 3. patients taking centrally acting drugs (e.g., antidepressants, antiparkinsonian drugs, sedatives, monoamine oxidase inhibitors), or alcohol abusers. 4. patients who have medical disorders predisposing to delirium (e.g. cachexia, thyroid dysfunction, renal failure).

Keywords: delirium melatonin patients surgery postoperative benzodiazepines orthopedic preoperatively
subcutaneous icd therapy combined with vt ablation for the secondary prevention of sudden cardiac death

Conditions: Sudden Cardiac Death

Summary: this study evaluates the feasibility and safety of a management approach that incorporates vt-ablation and s-icd implantation in secondary prevention patients. this is a single arm prospective study with 30 patients eligible for implantation of an icd for the secondary prevention of sudden cardiac death.

the subcutaneous icd (s-icd) is a system without transvenous leads that has been proven to safely provide defibrillation for patients at risk of sudden cardiac death due to ventricular tachyarrhythmias. however this system is currently not able to perform anti tachycardia pacing (atp) which can terminate some vt, thus avoiding painful shocks. ideally slow vt should be managed with rf ablation while fast vt causing hemodynamic consequences should be treated with icd shocks combined with medications. typically, icds in secondary prevention patients are programmed to intervene at 10 msec at least above the clinical vt. in cases of hemodynamically stable vt this can result in unnecessary therapies and lead to icd shocks. s-icd can safely manage fast vts while slower hemodynamically vts can be managed with ablation. this approach can avoid transvenous icd related complications and unnecessary icd interventions such as atp which can accelerate vt to icd shock zone. however, the benefit of this management strategy compared to conventional transvenous icd programming has not been studied in patients who receive the device for the secondary prevention of sudden cardiac death.

Eligibility criteria:
inclusion criteria: * any scar related sustained vt or vf * class i, iia, or iib indication for secondary prevention icd therapy per esc guidelines * age ≥ 22 years on a date of consent * lvef ≤ 40% * positive ecg screening for s-icd exclusion criteria: * a requirement for antibradycardia pacing or crtd * subjects with an existing icd, crt, crt-d, or pacemaker device. * contraindications for s-icd implantation * contraindications for vt ablation * serious known concomitant disease with a life expectancy of \< 1 year * elderly patients \>80 years of age * nyha class iv or need for mechanical lv support (ecmo) * pregnancy or nursing * unwilling or unable to give informed consent

Keywords: subcutaneous icd therapy vt ablation
foot controlled robotic endoscope enabled robot fess

Conditions: Sinusitis; Polyp of Nasal Sinus

Summary: to evaluate the safety and feasibility of a foot controlled robotic endoscope enabled robot (free) in performing functional endoscopic sinus surgery to answer the two key questions: 1. is the free robot feasible to use in patients for endoscopic sinus surgery? 2. is the free robot safe to use in patients for endoscopic sinus surgery?

through previous cadaver experiments we have demonstrated and experimentally validated a new foot-controlled robotic endoscope holder prototype that allows the surgeon to directly manipulate surgical instruments with both hands at all times. the conducted ex-vivo cadaver test, corroborated the feasibility of the robotic prototype. however the next step requires further clinical trials to evaluate its use in endoscopic sinus surgery in patients that is the purpose of this study

Eligibility criteria:
inclusion criteria: * undergoing fess surgery for benign pathology exclusion criteria: * pregnant/ lactating female patients * younger than 18 years of age * cognitive impairment or unable to provide informed consent * malignant sinus pathologies * previous endoscopic sinus surgery * contraindication to general anaesthesia * untreated active infection * non-correctable coagulopathy * emergency surgery

Keywords: free robotic
thiamine supplementation to improve cardiac function in patients with congestive heart failure

Conditions: Heart Failure

Summary: working hypothesis: a treatment with thiamine improves functional status and heart function of patients with congestive heart failure when on a diuretic treatment.

in the treatment of congestive heart failure, diuretic drugs have become a firm cornerstone of therapy. up to 50% of patients with congestive heart failure in industrialized nations will undergo long-term diuretic treatment. diuretic therapy is associated with a loss of water soluble vitamins, including vitamin b1 (thiamine). electrolyte dysbalance, a major side effect of diuretic therapy, has been extensively studied. in sharp contrast, only few data are available about the effects of vitamin loss and in particular of thiamine in this setting. available data suggest that a diuretic treatment is associated with an increased risk for thiamine deficiency. thiamine plays a crucial role for normal cardiac function, since severe thiamine deficiency leads to congestive heart failure (wet beriberi). consequently, patients undergoing diuretic treatment might have compromised heart function. supplementation of thiamine has been reported to improve cardiac function in patients with congestive heart failure on long-term treatment with diuretic drugs. however, no efforts have been made to confirm those preliminary observations by a placebo-controlled, double-blind study.

Eligibility criteria:
inclusion criteria: * patients with stable congestive heart failure on a prescription for diuretic drugs exclusion criteria: * acute heart failure * foreseeable need for further changes in medication * current medication containing vitamins * patients with a creatinine above 250 μmol/l
lived experience of overweight/obese patients who have benefited from a mindful eating program.

Conditions: Overweight or Obesity

Summary: the main objective is to understand the lived experience of overweight/obese patients who have followed the mindful eating program at montpellier university hospital. semi-structured face-to-face interviews will be conducted in the nutrition-diabetes service by using a questionnaire.


Eligibility criteria:
inclusion criteria: - people who have attended at least 6 out of 8 sessions of the mindful program exclusion criteria: * people who have attended less than 6 sessions of the program. * declining participation
the activity school in finnmark for overweight children

Conditions: Obesity; Overweight

Summary: the purpose of this study is to evaluate the effectiveness of a life style counseling programme designed for overweight and obese children and their parents in groups compared to traditional individual counseling in the pediatric outpatient clinic and the community. the two interventions are both hospital and community based.

randomized study design with two parallel groups.active intervention in two years, last follow-up after 3 years.

Eligibility criteria:
inclusion criteria: * overweight or obese. * bmi \> iotf (international obesity taskforce) cut-points 27,5. kg/ m2. exclusion criteria: * diseases not compatible with normal physical activity. * disorders not compatible with group treatment.

Keywords: childhood therapy life style motor activity obesity overweight body mass index treatment
the potential immunomodulatory effects of spirulina on thalassemic children

Conditions: Beta Thalassemia Major

Summary: the aim of this study is to evaluate the possible immunologic effects of spirulina in children with beta thalassemia.


Eligibility criteria:
inclusion criteria: * children with thalassemia major exclusion criteria: * children with other chronic hemolytic anemias
weight based enoxaparin in trauma patients

Conditions: Venous Thromboembolism

Summary: hospitalized trauma patients frequently suffer from blood clots in the legs or lungs. to minimize the risk of these blood clots developing, patients may be given a blood-thinner drug such as enoxaparin. until now, a set dose of enoxaparin has been given to a patient, regardless of his or her weight. however, a recent study suggests that for obese patients, the set dose may be inadequate. the purpose of this study is to evaluate whether or not a dose of enoxaparin that is based on the patient's weight will help to prevent the formation of blood clots. the information gathered through this study will help doctors to understand the best way to prevent blood clots in future trauma patients. the potential risks of participating in this study include the minor risks of blood draws and ultrasounds, as well as the more significant risks of bleeding as a side effect of the enoxaparin.


Eligibility criteria:
inclusion criteria: * 18 years of age or older * body weight \>60 kg * admitted to the trauma services at intermountain medical center * have received 1 standard dose of enoxaparin for vte prophylaxis during current hospital admission. exclusion criteria: * significant bleeding injury such as solid organ laceration or intracranial bleed at discretion of attending physician * renal insufficiency (gfr \<30) * platelet count \<100 thousand per cubic ml * hypersensitivity to heparin or prior documented heparin induced thrombocytopenia (hit) by patient report or in medical record * pregnant or breast feeding * hemorrhagic stroke in proceeding 3 months * abnormal baseline coagulation characterized by an inr \>1.4, obtained at the discretion of the treating clinician * required therapeutic anticoagulation for atrial fibrillation, prior vte, or mechanical heart valve * treatment with concomitant antiplatelet agent other than aspirin 326 mg or more daily * subjects with a life expectancy less than 1 month * subjects hospitalized more than 72 hours prior to randomization.

Keywords: trauma enoxaparin weight based prophylaxis