Kornimate/medical-research-clean huggingface dataset:
detection of aortic stenosis with smartphone auscultation using machine learning (heartbeat-pilot)

Conditions: Aortic Valve Stenosis

Summary: severe aortic stenosis, a common heart valve issue, is usually treated surgically or through intervention. diagnosis typically occurs after symptoms appear, but research suggests already treating asymptomatic cases may help patients live longer. current diagnostics using echocardiography are detailed but time-consuming, prompting the exploration of a smartphone application using built-in microphones and machine learning for quicker and more accessible screening.

severe aortic stenoses usually is treated either surgically or interventionally, making it the most frequently treated among heart valve diseases. typically, severe aortic stenosis is diagnosed only after the onset of the first symptoms. however, initial studies suggest that treating asymptomatic aortic stenoses could also extend the lifespan of affected individuals. therefore, a widely applicable and cost-effective diagnostic method would be desirable for screening. the current gold standard for diagnosing aortic stenosis is echocardiography. it allows for detailed measurement and evaluation, assisting in detection and diagnostic assessment. however, it is time-consuming and therefore not readily applicable to a larger population. alternatively, auscultation as an acoustic method is suitable, where typical noise changes due to turbulence in blood flow can be detected using a stethoscope. since stethoscopes are only conditionally accessible for self-use, both in terms of availability and usability, this study aims to investigate whether a mobile application based on artificial intelligence for common smartphones using built-in microphones can also be diagnostically used. for this purpose, microphone recordings at the typical five auscultation points of 50 patients with severe aortic stenosis and 50 patients without any relevant heart valve disease are recorded. a digital stethoscope (3m deutschland gmbh, germany) and echocardiography findings serve as references. based on the data, a classification model will be developed in a first step, which can detect severe aortic stenoses in smartphone recordings using machine learning.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * no relevant heart valve disease or severe aortic stenosis with no other relevant heart valve disease in echocardiography no older than 3 months exclusion criteria: * previous surgerical or interventional therapy of a heart valve

Keywords: machine learning digital health heart valve disease cardiology
tooth autotransplantation and bone dimension changes

Conditions: Bone Loss, Alveolar; Tooth Loss; Bone Atrophy, Alveolar

Summary: tooth autotransplantation is a treatment option to replace tooth with imposible prognosis. in several cases the receipt site has a reduced bone dimension. this situation may be imposible the treatment with dental implants without bone reconstruction. autotransplantation seem to improve the anatomic characteristic of the receipt site without any reconstruction approach. the aim of this study is to evaluate the bone dimension changes followed autotransplantation treatment.


Eligibility criteria:
inclusion criteria: * tooth with imposible prognosis * plaque index score less than 30% * no relevant systemic disease * smokers (less than 20 cigars/day) exclusion criteria: * pregnancy-lactation * relevant systemic disease
a closer look at the effect of dextrose on postoperative nausea and vomiting

Conditions: Postoperative Nausea and Vomiting

Summary: "the purpose of this investigator-initiated study is to see if giving dextrose fluid in the veins (iv) decreases the risk of postoperative nausea and vomiting (ponv) in female urologic, gynecologic and breast outpatient surgery patients and at what blood surgery level. the reason for this study is that iv dextrose has been shown to decrease the incidence of ponv and the use of medications to treat ponv, while leading to sooner discharge after surgery. this can decrease overall healthcare cost and improving patient satisfaction."


Eligibility criteria:
inclusion criteria: 1. asa i or ii 2. female urologic, gynecologic and breast surgery patients undergoing scheduled same day procedures at llumc heart and surgical hospital exclusion criteria: 1. age \ 65; 2. severe hypertension,diabetes mellitus, significant hepatic or renal disease 3. excessive blood loss 4. sustained (\>10 min)\>20% from baseline drop in bp after treatment 5. inability to follow protocol 6. refusal to sign consent
mission-cj for justice-involved homeless veterans

Conditions: Substance Use Disorder; Mental Health Disorder; Homelessness

Summary: the purpose of this study is to determine whether maintaining independence and sobriety through systems integration, outreach and networking - criminal justice version (mission-cj) is effective for reducing criminal recidivism and improving other health-related outcomes (substance use, mental health, housing, employment, community integration) among justice-involved, homeless veterans with a co-occurring substance use and mental health disorder.

vha mental health residential rehabilitation treatment programs (mh rrtps) serve veterans with an estimated 50% having criminal justice involvement annually. justice-involved veterans (jivs) receive assistance with their addiction and behavioral health needs, but mh rrtp programs do not directly address their antisocial behaviors and cognitions. furthermore, mh rrtp discharge is a vulnerable transition and no national transitional approach facilitates veteran's engagement in prosocial community behaviors that sustain mh rrtp gains, ultimately reducing revolving door service use. maintaining independence and sobriety through systems integration, outreach, and networking-criminal justice version (mission-cj) is a new case manager and peer delivered team-based treatment for jivs with a co-occurring substance use and mental health disorder (cod). while mission-cj derives in part from an evidence-based treatment for homeless individuals (mission), it includes a new conceptual framework and numerous new and differentiating features for a cj population including: (1) a treatment planning tool focused on criminogenic needs that monitors progress and tunes service delivery elements; (2) a prosocial treatment curriculum; and (3) tools/resources to address jivs' legal issues. with mission-cj, this study attempts to change the practice paradigm and transform care for jivs by moving beyond the current model of linking veterans to va care and tracking behavioral health outcomes, to a hybrid treatment/linkage approach that addresses criminogenic needs, supports engagement in va and non-va care, and targets recidivism as an outcome-the gold standard for cj research. using a hybrid type 1 design, this project will test the effectiveness of mission-cj in a three-site rct (bedford, palo alto, and little rock vas) with jivs with a cod, admitted to an mh rrtp, and previously arrested and charged and/or released from incarceration in the past 5-years.

Eligibility criteria:
inclusion criteria: * (a) are entering a mental health residential rehabilitation treatment program (mh rrtp) * (b) were arrested and charged and/or released from incarceration in the past 5 years * (c) have a co-occurring substance use and mental health disorder (cod) exclusion criteria: * the only exclusion criterion is being too cognitively impaired to understand the informed-consent process and other study procedures.

Keywords: veterans co-occurring disorder homeless persons crime substance-related disorders mental disorders
an ambispective registry study comparing clinical outcomes of surgical interventions for the treatment of nasal airway obstruction.

Conditions: Nasal Airway Obstruction

Summary: the purpose of this study is to assess and compare the clinical outcomes associated with common surgical interventions for the treatment of nasal airway obstruction (nao).

this is a multicenter, ambispective registry study. the study will include assessment of prospective, long term outcomes by remote administration of patient reported outcome questionnaires. participants identified in part 1 of the study with outcomes available for at least 12 months following their surgical procedure for nasal airway obstruction will be identified by the treating physician and invited to participate in the long-term follow-up study. participants agreeing to participate will be asked to complete a series of questions about their health experience following their surgery and will be asked to complete select health outcome questionnaires using a secure electronic survey platform.

Eligibility criteria:
inclusion criteria: * age 22 to 85 years old (inclusively). * sought treatment at the clinic for nasal airway obstruction. * had either a functional rhinoplasty or septoturbinoplasty within the time frame of january 01, 2013 to december 31, 2023 or a temperature-controlled radiofrequency (tcrf) procedure between the dates of november 19, 2015 to december 31, 2023. * has access to a mobile device, tablet, or computer with internet access and has access to an email address. * willing and able to provide consent. * willing and able to complete the survey, including patient-reported outcome measures. * willing and able to comply with the patient-specific requirements outlined in the study protocol. exclusion criteria: * had extreme nasal pathology or a history of extreme nasal injuries. * had cosmetic rhinoplasty with no functional component.
safety and effectiveness of low dose edoxaban in patients with nvaf

Conditions: Atrial Fibrillation

Summary: the efficacy and safety of edoxaban has not been adequately studied in asians versus non-asians, who are quite different physiologically from each other. compared with non-east asian patients, the east asia patients were twice as likely to have the reasons for requiring dose reduction of edoxaban, such as crcl 30-50 ml/min (30.0% and 18.2%, respectively), weight ≤60 kg (30.6% and 7.8%, respectively), or concomitant use of verapamil or quinidine (p-gp inhibitors, 6.6% and 3.3%, respectively). this study is aimed to evaluate the safety of the low dose edoxaban therapy in patients with high bleeding risk and non-valvular af in the real world population of korea.

the efficacy and safety of edoxaban has not been adequately studied in asians versus non-asians, who are quite different physiologically from each other. although 1,943 patients from east asia (1,010 were from japan, 469 from china, 234 from taiwan, and 230 from south korea) were included in engage af-timi 48, majority of the patient (19,162) were from non-east asia. compared with non-east asian patients, the east asia patients were twice as likely to have the reasons for requiring dose reduction of edoxaban, such as crcl 30-50 ml/min (30.0% and 18.2%, respectively), weight ≤60 kg (30.6% and 7.8%, respectively), or concomitant use of verapamil or quinidine (p-gp inhibitors, 6.6% and 3.3%, respectively). due to the relatively small number of patients in the east asian group included in the analysis compared with that of the patients in the non-east asian group, a limitation preventing it from providing sufficient power for such comparison is unavoidable. this study is aimed to evaluate the safety of the low dose edoxaban therapy in patients with high bleeding risk and non-valvular af in the real world population of korea.

Eligibility criteria:
inclusion criteria: * atrial fibrillation low dose edoxaban exclusion criteria: -

Keywords: safety effectiveness low dose
sn514-066b enzyme in deep partial thickness burns

Conditions: Burn Injury

Summary: this study will examine the tolerability of a gel formulation of the enzyme sn514 in patients with burns suitable for enzymatic debridement. in a rising dose fashion by sequential cohort, concentrations of 0.1%, 0.2%, 0.4% and 0.8% will be tested. groups of 3 will undergo daily debridement for up to 7 days. extent of debridement and adverse signs and symptoms will be recorded daily. dose escalation will stop if a dose level is found to be intolerable. dose escalation may accelerate if a tested dose is entirely ineffective. there is no placebo control as all burn wounds require debridement.

the design of the study is a sequential rising dose to the maximum tolerated dose, in which each subject will be exposed to only one concentration of the test article. dose limiting toxicities are defined as "severe" or ctcae v5 grade 3 or higher adverse events. this study in burn patients is designed to apply sn514-066b over 25 cm2 (0.14% tbsa for a 1.73 m2 adult) up to 500 cm2 (2.9%), at sequentially rising concentrations of 0.1%, 0.2%, 0.4% and 0.8% (\&lt; 1.0 mg/cm2). the highest exposure would be 0.8% (8 g per 100 cc of gel) over 2.9% of 1.73 m2 = 800 mg or 11.4 mg/kg applied topically (70 kg patient).

Eligibility criteria:
main inclusion criteria: 1. thermal burns caused by fire/flame, scalds or contact 2. total burns area available for treatment is 25 to 500 cm2 (a larger area may be burned, but the treatment area must be limited to the stated size, and the treatment area must be exclusive of face, hands, genitalia and sites deemed to be at high risk for developing compartment syndrome) 3. target burns for treatment is deep partial thickness (dpt) in depth main exclusion criteria: 1. subject has another life threatening traumatic injury 2. patient's proposed study wound site has any of the following conditions: * electrical or chemical etiology * pre-enrollment escharotomy * area is devoid of circulation * located on the face, perineum or genitalia * clinical evidence of wound infection 3. poorly controlled diabetes mellitus (hba1c \&gt;12%) 4. bmi greater than 40 kg/m2 5. cardio-pulmonary disease (mi within 6 months prior to injury, severe or unstable ischemic heart disease, severe or unstable heart failure, severe pulmonary hypertension, severe copd or pre-existing oxygen-dependent pulmonary diseases, severe broncho-pneumonia within 1 month prior to injury, steroid dependent asthma, or uncontrolled asthma) 6. pre-existing diseases which interfere with circulation (severe peripheral vascular disease, severe circulatory edema and/or lymphedema, regional lymph nodes dissection, significant varicose veins) 7. any conditions that would preclude safe treatment or adding further risk to the basic acute burn trauma (such as severe immuno-compromising diseases, life threatening trauma, severe pre-existing coagulation disorder, severe cardiovascular disorder, significant pulmonary disorder, significant liver disorder including post alcoholic abuse impaired function or neoplastic disease, blast injury)

Keywords: maximum tolerated dose debridement
pilot study of ezetimibe for chronic hepatitis c virus (hcv) infection

Conditions: Chronic Hepatitis C

Summary: infection by hepatitis c virus (hcv) affects more than 170 million people in the world and 80.000 in chile. it causes more deaths than hiv infection in the us and is a leading cause for liver transplantation in chile. even though treatments are evolving with new direct antiviral agents (daas) that are increasing response rates, there are several issues with these new approaches, including increased toxicity, need for using interferon and ribavirin, complex algorithms of treatment, high cost, limited effectivity in certain groups (liver transplant patients) and drug interactions. treatments targeted at host factors required for the viral cycle are becoming increasingly explored as an alternative or complement to daas. it has been recently described that niemann-pick c1-like 1 (npc1l1), the intestinal receptor of cholesterol, serves as an entry factor for hcv. npc1l1 is, therefore, a key transporter in the enterohepatic cycle of cholesterol. npc1l1 can be blocked with ezetimibe, which is an approved and generally safe drug used for the management of hypercholesterolemia. our hypothesis posits that blocking hcv entry to the hepatocyte or intestinal hcv reabsorption with ezetimibe may have an antiviral effect. in the study, we will administer ezetimibe 20 mg/d to 20 patients with stable chronic hepatitis c for 12 weeks and assess changes in hcv rna and core antigen in plasma, bile and feces.


Eligibility criteria:
inclusion criteria: * chronic hepatitis c defined as detectable hcv rna for more than 6 months. * age \> 18 years old. * compensated liver disease (bilirubin \ 3 g/dl, inr \< 2, no hepatic encephalopathy, no ascites or recent -1 month- history of variceal bleeding). * hcv rna level \> 10.000 iu/ml. * signed informed consent document. exclusion criteria: * history of cholecystectomy or known gallstones. * current hcv antiviral treatment. * medications for dyslipidemia in the preceding 2 months. * abdominal surgery that could alter biliary or intestinal anatomy. * evidence of sitosterolemia. * negative pregnancy test in urine (for females).

Keywords: hcv ezetimibe cholesterol host
laparoscopic versus combined laparoscopic and hysteroscopic repair of cs niche

Conditions: Cesarean Scar Niche

Summary: uterine niche is a frequent condition in patients with a history of cesarean section. many treatment methods have been described for repair of niche with varying effectivities. in conventional laparoscopic approach, not all bleeding points and fibrotic area are resected, while conventional hysteroscopic one result in more wide defect with high risk of recurrence and cannot be used in large niche with low rmt. in this new double approach (hysteroscopy and laparoscopy) technique, the benefit of both laparoscopy and hysteroscopy will be attained.

in all patient involved in the study, laparoscopic entry will be done, then adhesiolysis and creation of the bladder flap(dissection of the bladder from the uterine scar) then: group (i): laparoscopic excision of large cesarean scar niche: intentional perforation of the niche will be done using uterine sound and excision of the fibrotic edges then suturing the uterine incision using 2-0 absorbable suture. group (ii): combined hysteroscopic and laparoscopic repair without excision of large cesarean scar niche: the investigators will do the hysteroscopic resection of the niche under laparoscopic guide to avoid perforation of the niche. after completion of the hysteroscopic approach, laparoscopic plication of the niche without opening it will be done using multiple interrupted 2-0 absorbable suture after suturing, the hysteroscopy will be introduced again to assess the repair the patient will be sent home the day after. they will be followed up after 3 and 6 months. checkup of csd repair: after 6 month of surgery both groups will be examined using sonohysterography to assess the changes in niche diameters core outcome sets: * enlargement of the residual myometrium thickness and reduction of postmenstrual bleeding will be measured at the 3-month and 6-month. * subsequent fertility outcome

Eligibility criteria:
inclusion criteria: history of cesarean section postmenstrual and or intermenstrual spotting large cesarean scar niche, depth more than 50% of adjacent myometrial thickness (amt). failed medical treatment signed informed consent. exclusion criteria: a contraindication for a hysteroscopic niche resection women with a positive pregnancy test. a contraindication for general or local anaesthesia. coagulation disorders that lead to higher risks on bleeding or anticoagulant use. a (suspected) malignancy, endometrial polyps, atypical endometrial cells, cervical dysplasia, hydrosalpinx that may communicate with the uterus. adenomyosis or leiomyoma (the international federation of gynecology and obstetrics (figo) leiomyomia subclassification system type 0, 1, 2, 3) or large leiomyomas causing the uterine cavity length to be ≥ 9 cm as examined by transvaginal ultrasound or mri. endocrine disorders that interfere with the menstrual cycle. irregular menstrual cycle (\>35 days or intercycle variation of 2 weeks or more). patients who are not willing to conceive before and/or after the hysteroscopic surgery.
resolving bile reflux by lanreotide in patients with roux-en-y gastrojejunostomy

Conditions: Acid Reflux Esophagitis; Non-acid Reflux Esophagitis

Summary: somatostatine induces a dose-dependent reduction of postprandial plasma cholecystokinin (cck) secretion with a concomitant inhibition of postprandial gallbladder contraction, abolishing almost completely bile salts output from the gallbladder. somatostatine is also known to decrease acid production with significant increase of intragastric ph. in this way, somatostatine could influence acid as well as non-acid reflux by decreasing gallbladder emptying and decreasing acid secretion. purpose of the study is to evaluate the efficacy of lanreotide autogel 120 mg on symptoms and endoscopic lesions in patients with an endoscopic gastrointestinal reflux esophagitis that cannot be controlled with classic therapy.

patients presenting with persistent esophagitis on endoscopy while on proton pump inhibitors (ppi) treatment will receive a maximal therapy consisting of 2 x 40 mg of ppi before the meals (morning and evening) and a h2 blocker before bedtime (standard practice). they will be reevaluated endoscopically and clinically 2 months later (standard practice). if reflux persists, objectivized by impedancemetry (standard practice), they will be asked to participate in this study. lanreotide autogel 120 mg deep subcutaneously every 4 weeks will be added to the treatment. a total of 3 injections per patient have been foreseen in this proof of concept study. patients will be reevaluated clinically after 2, 4 and 8 weeks. at the end of the study a new upper gastrointestinal endoscopy and impedancemetry will be performed.

Eligibility criteria:
inclusion criteria: * persistent endoscopic reflux in spite of maximal medical therapy with ppi 2 x 40 mg (before breakfast and dinner) and 300 mg of h2 blocker ranitidine (at bedtime). the los angeles classification (la) will be used to evaluate endoscopic reflux. any distal esophageal ulcer with negative biopsy is also diagnostic for reflux. persistent reflux is defined as: no reflux complaints but continuing endoscopic lesions and positive impedancemetry. reflux complaints with continuing endoscopic lesions and positive impedancemetry. reflux complaints without endoscopic lesions but positive impedancemetry. exclusion criteria: * pregnancy or inadequate anticonception, breast feeding. * negative impedancemetry. * diabetes. * placement of a gastric ring for weight loss.

Keywords: bile reflux reflux esophagitis lanreotide autogel somatuline endoscopy impedancemetry