Kornimate/medical-research-clean huggingface dataset:
double blind crossover comparison of diuretics in the young

Conditions: Low-Renin Hypertension

Summary: the principle objective of the study is to determine whether low-renin (i.e. salt sensitive) hypertension at a young age is caused by the kidneys hanging onto too much salt as a result of an over active salt pump in the kidney. the kidneys have four different salt pumps, and each is blocked by a different type of diuretic (salt losing tablet)if one out of the four is overactive, we would expect patients to respond much better to one diuretic than to the alternatives - rather than responding equally well to all available types of diuretic.

studies suggest that patients with low renin hypertension respond better to diuretics than other hypertensive drug groups. the aim of the study is to rotate patients through the four main diuretic groups and see if it is possible to identify the most effective diuretic for this group, as measured by a \>=10mghg decrease in systolic blood pressure in one specific group a compared to the others. as most caucasians with low renin hypertension are older (\>55), presentation with this type of hypertension at a younger age suggests the presence of substantial genetic variation in order to cause the atypical presentation. it is hoped that by identifying the best diuretic for these patients we will also be able to identify: 1. whether the young low-renin hypertensives can be sub-classified according to their most effective diuretic; 2. whether this sub-classification helps us to identify the genes and mutations responsible, since these are to expected to be in the so-called sodium channels (i.e. salt pumps)which the kidneys use to prevent salt being excreted in the urine.

Eligibility criteria:
inclusion criteria: * aged 18-45 * male or female * hypertensive - 3 clinic sbp \>=140mmhg; or 3 clinic dbp \>=90mmhg; or abpm or home bp \>=130(sbp) or 85(dbp) * 24hr na+\<160mmol/l * either {plasma renin\<=10mu/l (measured untreated, or whilst receiving only ccb+/-diuretic} + {plasma renin \<=40mu/l (measured on an acei or arb, which approximately double s the plasma renin)} or plasma renin \<5mu/l (measured untreated, or receiving any antihypertensive drug other than a beta-blocker exclusion criteria: * documented history of gout * abnormal renal function (both elevated serum creatinine and reduced creatinine clearance * sbp \> 170mmhg or diastolic \>110mmhg despite treatment with permitted background treatment

Keywords: hypertension low renin
glomerular filtration rate (gfr) reporting on nephrology referral patterns by internists

Conditions: Chronic Kidney Disease

Summary: the addition of an estimate value of glomerular filtration rate (gfr) per modification of diet in renal disease \[mdrd\] (levey) equation is being included and reported on all routine chemistry panels in the experimental group. the control group is only having serum creatinine, the current standard of care, reported on routine chemistry panels.

all patients already referred to or being followed by nephrologists were excluded. inclusion criteria were all patients in the internal medicine clinic at nmcsd who were sent to the lab to obtain routine chemistry panels for follow up by their primary care providers. the primary outcome is increased referral to nephrology in accordance with nkf k/doqi guidelines if gfr values are reported on routine chemistry panels. key secondary outcomes are primary care provider knowledge of nkf k/doqi guidelines, specifically when patients with chronic kidney disease need to be referred to a nephrologist for further evaluation.

Eligibility criteria:
inclusion criteria: * all patients in the internal medicine clinic at naval medical center, san diego (nmcsd) who were sent to the lab to obtain follow up by their primary care providers. exclusion criteria: * all patients referred to or being followed by nephrologists.

Keywords: gfr serum creatinine
statins in chronic hepatitis c patients receiving sofosbuvir/daclatasvir combination

Conditions: Chronic Hepatitis c; Metabolic Syndrome

Summary: the purpose of the study is to determine if statin can affect the clinical outcome of chronic hepatitis c patients receiving sofosbuvir/daclatasvir/ribavirin combination

aim of the work to determine the benefits of statin use in chc patients treated with sofosbuvir/daclatasvir/ribavirin through : primary outcome: assessment of therapeutic svr12 seconadry outcome 1. assessment of chronic hepatitis c(chc) infection risk on development of metabolic syndrome through assessment of lipid profile , fasting glucose test , hgba1c and c-reactive protein(crp). 2- evaluation of chc related complications such as fibrosis and cirrhosis patients will be followed up for the whole study period and will be subjected to assessment of the following: 1. cbc , liver function test , lipid profile and ck every month till the end of therapy. 2. hga1c and crp at the end of therapy. 3. hcv-pcr test 3 months after the end of therapy. 4. fibrosis using (fib-4) 3 months after the end of therapy.

Eligibility criteria:
inclusion criteria: 1. male patients age 18 to 70 years old. 2. easy to treat group: treatment naïve patients with serum hcv rna positivity by pcr. 3. clinically stable condition outpatients. 4. platelet count ≥ 150,000/mm³. 5. inr ≤ 1.2. 6. serum albumin ≥ 3.5 g/dl. 7. total serum bilirubin ≤ 1.2 mg/dl. exclusion criteria: 1. inadequately controlled diabetes mellitus (hba1c \> 9%) . 2. total serum bilirubin \> 3mg/dl. 3. hcv-hiv co infection. 4. hbv-hcv co infection. 5. any cause for chronic liver disease other than hepatitis c 6. uncontrolled hypothyroidism. 7. hepatocellular carcinoma, except 4 weeks after intervention aiming at cure with no evidence of activity by dynamic imaging (ct or mri). 8. extra-hepatic malignancy except after two years of disease-free interval. 9. child's c cirrhotic patients. 10. creatinine kinase \> 350 u/l
a comparison of two albumin administration schedules for spontaneous bacterial peritonitis

Conditions: Spontaneous Bacterial Peritonitis

Summary: spontaneous bacterial peritonitis (sbp) is a common and frequently fatal complication of end-stage liver disease with a mortality of up to 10% primarily due to the development of kidney failure. current standard practice is to treat this infection with broad spectrum antibiotics and salt-poor albumin administration on day one and three of treatment. in this study the investigators test the hypothesis that the administration of a second dose of albumin at 48 hours only to patients with renal insufficiency is as effective at preventing kidney failure as administering the second dose to all patients at 72 hours. in addition, a kidney function determined approach to albumin dosing may lead to substantial cost and resource saving from decreased albumin use without compromising treatment efficacy.


Eligibility criteria:
inclusion criteria: * age 18 to 75 * evidence of end stage liver disease / cirrhosis * documented sbp (anc \> 250 or positive ascites culture * ability to provide informed consent * serum creatinine \> 1.0 mg/dl and/or total bilirubin \> 4.0 mg/dl exclusion criteria: * nonportal hypertensive ascites (i.e. malignancy)
a clinical trial to evaluate the efficacy and safety of pitavastatin/fenofibrate in complex-dyslipidemia

Conditions: Complex-dyslipidemia

Summary: the purpose of this study is to evaluate the efficacy and safety of pitavastatin versus pitavastatin/fenofibrate in complex-dyslipidemia patients.

the purpose of this study is to demonstrate the efficacy of the pitavastatin/fenofibrate in complex-dyslipidemia patients by the reduction of non-hdl-cholesterol levels compared with pitavastatin.

Eligibility criteria:
inclusion criteria: * high risk patient to coronary heart disease * at visit 1(screening) 1. if treated with pitavastatin 2mg monotherapy 4 weeks prior to this study : ldl-c\<100mg/dl and 150mg/dl≤tg\<500mg/dl, randomize without run-in period 2. if non treated with pitavastatin 2mg monotherapy 4 weeks prior to this study : ldl-c≥100mg/dl and 150mg/dl≤tg\<500mg/dl, treatment of pitavastatin 2mg for 4 weeks(run-in period) * ldl-c\<100mg/dl and 150mg/dl≤tg\<500mg/dl after 4 weeks of pitavastatin 2mg monotherapy exclusion criteria: * subject with acute artery disease * subject with congestive heart failure(nyha class iii\~iv) or uncontrolled arrhythmia * secondary or iatrogenic dyslipidemia caused by hypothyroidism, nephrotic syndrome etc. * ast or alt \> 2xuln, serum creatinine \> 2.5mg/dl, creatinine phosphokinase \> 2xuln * subject with gall bladder disease or pancreatitis * uncontrolled hypertension * endocrine or metabolic disease affected on serum lipid or liprotein * subject with medical history of myopathy or rhabdomyolysis caused by statin treatment, hereditary myopathy or family history * not eligible to participate for the study at the discretion of investigator
treatment of complex anal fistula with draining seton with or without rerouting of track

Conditions: Anal Fistula

Summary: this randomized trial aimed to compare conventional draining seton with or without rerouting of the fistula track in treatment of complex anal fistula

placement of seton is typically employed when the fistula track is involving more than 30% of the external anal sphincter. however, attempts to reroute the seton and the involved fistula track were made to preserve the external anal sphincter fibers and hasten healing of the anal wound. mann and clifton first introduced a transposition technique for the management of high anal and anorectal fistulas by re-routing the extrasphincteric portion of the track into an intersphincteric position with immediate repair of the external sphincter and reported successful outcomes of five patients in terms of quick healing and preserved anal continence. the present study aimed to evaluate the outcome of draining seton with or without rerouting of the fistula track in treatment complex high anal fistula regarding healing time, postoperative pain, and incidence of recurrence and fi postoperatively. we hypothesized that rerouting the seton to include the fistula track and the internal anal sphincter only, preserving the external anal sphincter muscles, would serve to hasten healing and decrease the incidence of recurrence and continence disturbances.

Eligibility criteria:
inclusion criteria: * adult patients of both genders aging below 60 years old with complex crypto-glandular anal fistula were included. complex anal fistula were defined as high trans-sphincteric anal fistulas involving more than 30% of the external anal sphincter fibers, suprasphincteric, extrasphincteric, and horse-shoe fistula exclusion criteria: * patients with simple anal fistula. * patients with acute anorectal sepsis. * patients with secondary anal fistula caused by inflammatory bowel diseases, sexually transmitted diseases, malignancy, or irradiation. * patients with associated anorectal conditions as hemorrhoids, anal fissure, rectal prolapse, or malignancy. * patients with history of previous surgical treatment of anal fistula. * patients with symptomatic preoperative fecal incontinence.
a study of ly353381 (arzoxifene) for patients who benefitted from this drug in other oncology trials and wished to continue treatment

Conditions: Breast Cancer; Endometrial Cancer; Ovarian Cancer

Summary: patients who were previously enrolled on the ly353381 arm of any ly353381 oncology trial could enroll in this "roll-over" study if they had exhibited clinical benefit from treatment and wished to continue on treatment. patients were monitored for safety.


Eligibility criteria:
inclusion criteria: * participation in a clinical trial of ly353381 that has met its main safety and efficacy objectives, and could otherwise close. * evidence of continuing benefit with ly353381 (eg. complete response, partial response or stable disease with no symptomatic or clinical evidence of disease progression). * adequate bone marrow reserve, liver and renal function, consistent with the previous ly353381 protocol, with no recent significant deterioration or metabolic condition that could affect patient safety or compliance with the protocol (eg, hypercalcemia). * written informed consent from patient. * childbearing potential either terminated by surgery, radiation, menopause, or attenuated by use of an intra-uterine contraceptive device or barrier method during and for 3 months after the trial. exclusion criteria: * no concurrent systemic therapy (immunotherapy, hormone therapy or chemotherapy) for cancer. palliative radiotherapy is allowed (eg, for pain) as long as there is no evidence of disease progression. investigational agents, other than ly353381, within the 4 weeks prior to this study enrollment and other serms are also not permitted. * no concurrent use of oral contraceptives, gnrh agonists, or coumarin (warfarin). * no serious concomitant systemic disorders incompatible with the study (at the discretion of investigator), including predisposition to thromboembolic disorder. * must not be pregnant or breast-feeding. * must not have a gap in treatment of more than 4 weeks between previous ly353381 study and enrollment in current study.
e-health intervention for cancer survivors 2.0

Conditions: Cancer

Summary: this study will develop and examine the effectiveness of an intervention that utilizes technology to improve cancer survivors' access to mental health care and increase their ability to manage the stressors involved in cancer survivorship. the intervention, referred to as project onward, uses an interactive website and an online social network. the purpose of this study is to pilot a novel intervention that can reduce costs, examine methods to improve adherence to internet based treatment and overcome numerous barriers to treatment for mental health concerns.

nearly 65% of those with cancer diagnoses will survive for at least 5 years, with approximately 10.5 million cancer survivors in the united states. the time of transition for cancer patients, from active treatment to survivorship, has been identified as a time of high risk for depression and anxiety. cancer survivors experience higher rates of anxiety and depression than those without a cancer history. research has identified fear of recurrence, perceived loss of support, and social pressure to resume a "normal" life, among other phenomena, as sources for this emotional distress. however, only about 20% of all patients referred for psychotherapy ever enter treatment and of those who initiate treatment, nearly half drop out before completion. this suggests that there are significant barriers to receiving care. these barriers may be even higher for cancer survivors struggling with issues related to re-entry, such as returning to work, resuming household responsibilities and managing residual symptoms such as fatigue or pain. the internet promises to provide inexpensive access to treatment at any time of the day or night. unfortunately, the potential for internet delivered services has not been realized. studies examining treatments that simply provide access to an internet site commonly result in very high dropout after the first site visit, and typically little or no improvement target symptoms. a variety of methods to improve responses to internet interventions have been examined. in general, e-mail support improves adherence and telephone support can improve adherence even more. another type of support that has only begun to be investigated is the use of social networks to help maintain adherence. this intervention will use an online social network, to increase adherence and promote the use of the website and the skills it teaches.

Eligibility criteria:
inclusion criteria: * any cancer diagnosis. * has completed treatment for cancer and is currently in full remission. * ecog performance status of \< 3. * has a telephone, e-mail account, computer, and broadband access to the internet. * has familiarity with using the internet that allows for adequate navigation of website. * is able to speak and read english. * is at least 19 years of age. * is able to give informed consent. exclusion criteria: * has visual impairment that would prevent use of the website and completion of assessment materials. * diagnosis of basal or squamous cell skin cancers.

Keywords: cancer cancer survivors internet depression anxiety
remote monitoring of uroflowmetry

Conditions: Lower Urinary Tract Symptoms

Summary: the aim of the study is to assess the possibility of using remote monitoring of urination.


Eligibility criteria:
inclusion criteria: 1. men over 18 years old. 2. the patient has performed uroflowmetry according to indications in the hospital no later than 7 days before the planned inclusion in the trial. 3. qmax = or \<15 ml / sec. 4. the patient has a smartphone (with android 4.0 and higher, ios 10.0 and higher) with internet access exclusion criteria: 1. a patient with emergency conditions requiring surgical treatment 2. intellectual and cognitive abilities of the patient that do not allow him to follow the doctor's instructions and make it difficult to use the smartphone.
randomized trial with an observational component of non-operative versus operative treatment for ao type a3 fractures

Conditions: Spinal Fractures

Summary: the purpose of this study is to compare surgery plus bracing versus bracing alone. both groups are considered standard of care treatments. the goal of this study is to determine which group is a better treatment.

patient must be between 18 and 65 years old and had an acute trauma with an ao type a3 burst fracture (a spinal injury where one of the bony parts of the spine \[vertebra\] breaks due to immediate and severe compression). the purpose of this study is to compare surgery plus bracing versus bracing alone. patients will be followed for 10 years. the investigators will compare patients' x-ray outcomes and clinical outcomes (i.e. how a patient is feeling and how a patient is able to do usual daily activities) as well as patients' immediate and delayed medical and surgical side effects between the 2 study arms. the goal of this study is to determine if treating patients with surgery plus bracing is better than just bracing alone.

Eligibility criteria:
inclusion criteria: 1. age 18-65 years 2. acute trauma patient with ao type a3.1-a3.3 fractures of t10-l2 3. neurologically intact 4. tlics score of 4 5. women of childbearing potential must have a negative serum pregnancy test exclusion criteria: 1. severe poly-trauma (injury severity score \>15 and/or intubation required for \> 24 hours) 2. sepsis and/or organ failure 3. prior instrumented arthrodesis of the thoracolumbar spine 4. severe co-morbidities (e.g., heart, respiratory, or renal disease) 5. recent history (\<3 years) of concomitant spinal tumor or infection 6. greater than single level fracture involvement (other than transverse process fractures) 7. ao type a3 fracture with associated load sharing score ≥7 8. ≥ 30 degrees regional kyphosis on standing 9. history of autoimmune (seronegative) spondyloarthropathy (i.e., ankylosing spondylitis) 10. history of osteoporosis 11. subjects who are pregnant or plan to become pregnant in the next 24 months. patients will be advised on the use of contraceptives during this time. methods include abstinence or two acceptable forms including condoms with spermicide, birth control pills, injections, or an iud. 12. co-morbidity requiring medication that may interfere with bone or soft tissue healing (i.e., oral or parenteral glucocorticoids, nsaids immunosuppressive agents, methotrexate) 13. severe morbid obesity (bmi \> 40) 14. history of metal sensitivity/foreign body sensitivity 15. history of prior laminectomy at the fracture site 16. associated scoliotic (\> 10°) or pre-existing thoracolumbar kyphotic deformity 17. history of substance abuse (recreational drugs, prescription drugs or alcohol) that could interfere with protocol assessments and/or with the subject's ability to complete the protocol required follow-up 18. prisoner

Keywords: groups: group 1 (2 treatment arms (randomized between 2 treatments)) treatment 1: surgery + bracing treatment 2: bracing alone group 2 the patient will decide which group is best for themselves.
subjective intraoperative use of epidural steroid administration following discectomy

Conditions: Lumbar Disc Herniation

Summary: the purpose of this study is to determine a grading system for inflammation in lumbar disc herniation and which groups, if any, benefit most from the administration of an intra-operative epidural steroid.

intraoperative epidural administration of steroids following discectomy for herniated lumbar disc has been the topic of multiple studies in the literature. the results have been mixed, with the majority of the studies finding some benefit, but outcomes have varied drastically amongst the many studies. the aim of this study is to develop a grading scale for intraoperative assessment of nerve root inflammation to determine if this subjective assessment is an adequate indicator for response to epidural steroids following discectomy. patients will be allocated randomly preoperatively to the intervention group versus control group. pictures of the spinal cord and associated nerve root will be captured intraoperatively. these pictures will be scrutinized postoperatively and an inflammation grade will be assigned. the investigators will then identify if nerve roots with a higher-grade of inflammation respond differently to epidural steroid administration when compared to lesser-grades of inflammation. this will be measured with the a variety of outcome measures.

Eligibility criteria:
inclusion criteria: * presenting to the university of missouri hospital system - including the university of missouri hospital and missouri orthopaedic institute - with a clinical assessment indicative of a lumbar disc herniation * failed conservative treatment - rest, anti-inflammatory medications, physical therapy * radiculopathy present - positive tension signs or sensory/motor neurologic deficits present * recent mri confirming single-level lumbar disc herniation corresponding to clinical evaluation exclusion criteria: * concomitant spinal stenosis, segmental instability, or spondylolisthesis * previous surgery at the affected level or recurrent herniation * underlying disease that may affect response to steroids - immunocompromise, use of chronic steroids or immunosuppression * pregnancy - qualitative human chorionic gonadotropin (hcg) testing will be performed prior to enrollment * diagnosis of or symptoms concerning for cauda equina syndrome
the presence of microbes in the sperm and their impact on sperm capacitation and ivf treatment

Conditions: Infertility

Summary: study goals: 1. finding the prevalence of bacteria of the sperm in an innovative and more accurate methode 2. understanding the effect of microbes on the process of capacitation 3. the impact of microbes in the sperm on ivf success rate 4. finding the incidence of vaginal bacteria and their relationship to bacteria of the sperm 5. the impact of vaginal flora on ivf success rate

prospective non interventional study in the department of life sciences, bar-ilan university and ivf unit at meir hospital. the control group consisting of 50 semen samples from men with no sperm problems and 50 vaginal samples from their partners. the study group consisting of 50 semen samples from men with male fertility problems and 50 vaginal samples from their partners. the semen taken from the remains after fertilization of the ivf laboratory. (liquid otherwise routinely thrown). vaginal samples taken from women undergoing ivf treatment under anesthesia after informed consent. enrollment also collect the following data: age, race, chronic illnesses, past surgeries and former fertility treatments. data will be collected through anamnesis of the patient or the medical file after consent.

Eligibility criteria:
inclusion criteria: * male and female undergoing fertility treatments exclusion criteria: * male and female not undergoing fertility treatments