Kornimate/medical-research-clean huggingface dataset:
a study of mitral annular disjunction in mitral valve prolapse patients and arrhythmia risk

Conditions: Mitral Valve Prolapse; Mitral Valve Insufficiency

Summary: this study investigates the characteristics and prevalence of mitral annular disjunction in patients with mitral valve prolapse with severe mitral regurgitation (mr) at assiut university heart hospital.

mitral annular disjunction is a structural defect of the mitral annulus fibrous commonly associated with mitral leaflet prolapse. however, there have been few cases of mitral annular disjunction in mitral valve prolapse (mvp). mitral annular disjunction (mad) is a structural defect characterized by a clear separation between the mitral valve annulus, the left atrium wall, and the myocardial continuity. this condition can be seen in a 360-degree circle around the mitral valve annulus. however, it is most typically seen in the inferolateral myocardium, right behind the posterior mitral valve leaflet. it is generally present in the p1 and p2 mitral valve scallops. mitral valve prolapse (mvp) occurs in 3% of the population and is the most common reason for mitral valve replacement\[1\]. according to population and cohort studies, the patient's age significantly influences mitral valve prolapse (mvp) outcomes, left ventricular ejection fraction, and the severity of mitral regurgitation. mitral regurgitation has little influence if it is not severe. while the link between mvp and sudden cardiac death was first discovered many years ago, it was once assumed to be extremely low risk. recent observational studies have found a link between mvp and malignant ventricular arrhythmias, as well as sudden cardiac death, in a particular population of young and middle-aged people. this raise worries regarding the existence of an arrhythmic mvp variation. recent research has led to a better knowledge of the aberrant physiological processes and circumstances that enhance the likelihood of developing irregular heart rhythms in people with mitral valve prolapse. the diagnosis of mitral valve regurgitation can be accurately determined by non-invasive imaging techniques such as transthoracic echocardiography, transesophageal echocardiography, and cardiac magnetic resonance imaging. this study tries to improve patient risk assessment

Eligibility criteria:
inclusion criteria: * all consecutive patients \> 18 years of age presenting to assiut university heart hospital with mvp and more than moderate mr. exclusion criteria: * previous mitral valve surgery. * mvp due to infective endocarditis. * moderate or more significant aortic stenosis, aortic regurgitation or mitral stenosis. * congenital heart disease and poor image quality precluding accurate assessment of the mitral valve.

Keywords: mitral annular disjunction
registry for chronic obstructive pulmonary disease with sleep apnea hypopnea syndrome in china

Conditions: COPD; Sleep Apnea Syndromes

Summary: copd and sleep apnea dyspnea syndrome represent two of the most common chronic lung diseases. it is reported that the prevalence of copd with sleep apnea dyspnea syndrome is also very high. copd and sleep apnea may have pathological or genetics interactions so that patients having both disorders tend to have worse outcomes than either condition alone. data reflecting the prevalence, disease course and outcome of overlap syndrome is very limited in china. therefore, the aim of the study is to describe the prevalence, treatment and outcome in chinese patients and exploring the underlying interaction mechanism.


Eligibility criteria:
inclusion criteria: * copd patients with informed consent exclusion criteria: * pregnant patients, patients with serious respiratory diseases other than copd, patients with limited life expectancy, patients that can't coordinate well
treatment of chronic subdural hematoma by corticosteroids

Conditions: Chronic Subdural Hematomas

Summary: chronic subdural hematomas are a frequent neurosurgical pathology in the elderly. gold standard is surgical evacuation of these hematomas. physiopathology of chronic subdural hematoma involves numerous inflammatory processes which could be inhibited by steroids.

the primary objective is to evaluate the efficacy of corticosteroids treatment in patients with chronic subdural hematomas without clinical or radiological signs of severity. secondary objectives are to assess the effect of methylprednisolone on: * quality of life evolution, * morbidity and mortality, * radiological evolution of the lesions.

Eligibility criteria:
inclusion criteria: * age 18 years old, * with chronic or subacute, uni or bilateral subdural hematoma, * confirmed by cerebral scan without contrast enhancement, * without clinical and radiological signs of severity, * written informed consent from patients or their next of kin according to the patients cognitive status. exclusion criteria: * diabetics patients, * contraindication for methylprednisolone, * previous surgery for chronic subdural hematoma during the past 6 months, * pre-existing severe dementia related to other etiology than the chronic subdural hematomas, * existing neurological pathology that can be associated with dementia, * patients treated with corticosteroids, * protected person (adults legally protected (under judicial protection, guardianship or supervision), person deprived of their liberty, pregnant woman, lactating woman and minor), * participating in other concomitant research.

Keywords: chronic subdural hematomas surgical treatment corticosteroids
efficacy, safety and tolerability of nangibotide in patients with septic shock

Conditions: Shock, Septic

Summary: this is a randomized, double-blind, placebo-controlled dose-selection study in which two doses of nangibotide are tested versus placebo.

all patients with a diagnosis of septic shock will be considered for study participation. all potential study patients will receive standard of care for the treatment of septic shock. after screening for eligibility, patients meeting all inclusion and no exclusion criterion will be randomized. patients will be randomized to one of three treatment arms. treatment with study drug must be initiated as early as possible, but no later than 24 hours after the onset of septic shock, defined by the start of vasopressor therapy. patients will be treated for at least 3 days with study drug. after the first 3 days of treatment, patients still requiring vasopressor will be treated until 24 hours after vasopressor withdrawal with a maximum treatment duration of 5 days. patients will be assessed at the end of study (eos) visit at day 28. after the last patient's day 28 visit, the study will be analyzed. additional follow up (fu) visits will be conducted after 90 days, 6 and 12 months. the objective of the study ist to compare the safety, tolerability and efficacy of two doses of nangibotide versus placebo, when given in addition to standard of care.

Eligibility criteria:
inclusion criteria: 1. provide written informed consent 2. age 18 to 85 years (inclusive) 3. documented or suspected infection: lung, abdominal or urinary tract infection (uti) in the elderly (≥65 years) 4. organ dysfunction defined as acute change in total sofa score ≥ 2 points 5. refractory hypotension requiring vasopressors to maintain map ≥65mm hg despite adequate volume resuscitation 6. hyperlactatemia (blood lactate \>2 mmol/l or 18 mg/dl). exclusion criteria: 1. previous episode of septic shock requiring vasopressor administration within current hospital stay 2. underlying concurrent immunodepression with anti-cd52 alemtuzumab (campath) or glucocorticoids \>75 mg prednisone daily or equivalent for more than 7 days 3. immunosuppressive therapy related to recent (\<6 months) transplantation 4. cancer chemotherapy (\<3 months) implying an immunodepression 5. known hiv infection with low cd4 cell count (\<200) for at least 6 months 6. known pregnancy (positive urine or serum pregnancy test) 7. shock of any other cause, e.g. hypotension related to gastrointestinal bleeding 8. ongoing documented or suspected endocarditis, history of prosthetic heart valves 9. prolonged qt syndrome 10. end-stage neurological disease 11. end-stage cirrhosis (child pugh class c) 12. acute physiology and chronic health evaluation (apache ii) score \<15 or ≥ 34 13. home oxygen therapy on a regular basis for \> 6 h/day 14. recent cardiopulmonary resuscitation (cpr) (within current hospital stay) 15. body mass index (bmi) ≥ 40 kg/m2or weight ≥ 130 kg 16. moribund patients 17. decision to limit full care taken before obtaining informed consent 18. participation in another interventional study in the 3 months prior to randomization

Keywords: septic shock
healthy families: transforming care for obese children at nyu lutheran family health centers

Conditions: Childhood Obesity

Summary: childhood obesity is a contributing factor to health complications such as diabetes, heart disease, high blood pressure, cancer and asthma. it is of particular concern among hispanic populations in the united states as that group has the fastest growing childhood obesity rate. nearly two in five hispanic children ages 2 to 19 are overweight or obese. this program aims to test whether it is beneficial to routinize a multi-disciplinary pediatric weight management program within the highest volume clinic (nyu-lfhc women, adolescents and children), and to add a home-visit component to reinforce teaching on food selection and preparation. the intervention will include 27-hour intervention session which will be distributed into 12-session series over a 3 month period. the program will target hispanic children between the ages of 9 and 11 with a body mass index (bmi) between the 95th and 99th percentiles. to assess the effectiveness of this program, the investigators propose to conduct a general prospective study using randomized pre-test and post-test control group design with minimal risk for participants.

the proposed intervention will engage pediatricians at nyu lutheran family health centers (nyu lfhc) and providers at the school-based clinics in referring hispanic children ages 9-11 years with a bmi between the 95th and 99th percentile to the study. in addition, a list will be generated from nyu lutheran's quality improvement department if recruitment through providers is low. providers will refer patients who meet the above criteria through eclincialworks (ecw). a research assistant will then randomize the referrals after acquiring informed consent forms to either the control group or the intervention group. the control group will receive standard of care by nutritionists at nyu lfhc. the intervention group will receive a 27-hour intervention session which will be split into a 12-session series. the sessions will be conducted weekly over a 3 month period. this study will include three cycles with three separate cohorts. the healthy families intervention group will include: 1. bilingual english and spanish group nutrition education, behavioral social support, and physical activity (e.g. kickboxing, zumba, yoga, aerobics). 2. monthly home visits by a nutritionist for family including specific recommendations on food purchasing and preparation. children randomized to standard of care will attend monthly sessions with a nutritionist.

Eligibility criteria:
inclusion criteria: * patient of nyu-lfhc women's, pediatric, and adolescent medicine (5610) * hispanic ethnicity * bmi percentile between the 95th and 99th * ages between 9 and 11 years old at the time the program begins exclusion criteria: * autism spectrum disorder (299.0) * pervasive developmental disorder-not otherwise specified (pdd nos 299.9) and * other pdd (299.8)

Keywords: behavioral health intervention randomized control trial family intervention nutrition weight management multidisciplinary program
comparison between two non-surgical periodontal treatment procedures with and without interdental hygiene devices in periodontitis patients: a longitudinal prospective controlled clinical trial

Conditions: Chronic Periodontitis

Summary: periodontitis is treated by regularly clearance of the disease-causing biofilm through domestic care and dental measures (petersilka et al., 2002, herrera et al., 2008). healthy gums have intact papillae occluding the interdental area. successful brushing cleans these areas; the prophylaxis of gingivitis for such patients does therefore not require special aids. in contrast, initial attachment loss as a result of inflammation or restorative therapy leads to additional cleaning needs, since the normal brush is not able to clean interdental areas as successful as vestibular and oral surfaces (dörfer and staehle, 2010). it can be said that interdental brushes are the most effective tools for cleaning interdental spaces (salzer et al., 2015). compared with a toothbrush, they are the only tool showing better results of plaque removal and reduction of gingivitis (slot et al., 2008). therefore their use should not be restricted to older people with already reduced interdental papillae. a big advantage is that interdental brushes are generally easy to use. if brush sizes are chosen correctly, insertion and multiple forward and backward movement is sufficient to obtain com- plete cleaning of the interproximal surfaces. additional cleaning by other means such as dental floss is not always necessary because interdental brushes clean approximal and subgingival surfaces sufficiently, providing the size was chosen correctly (dörfer and staehle, 2010). due to the above mentioned coherences and associations, this study includes the hypothesis that patients with periodontitis would benefit from the instruction and motivation of interdental brushes within the active periodontitis therapy in comparison to a periodontitis therapy without the instructed domestic interdental hygiene by a stronger reduction of clinical inflammatory characteristics (salzer et al., 2015). the corresponding zero-hypothesis says that no difference would be found between both groups.


Eligibility criteria:
inclusion criteria: * generalized chronic periodontitis (cp) * generalized aggressive periodontitis (agp) * availability for non-surgical periodontal therapy and reevaluation after 3±1 months. * moderate to advanced severity of periodontitis (≥30% of the sites with attachment loss ≥3mm) * age: 18 - 70 years * ≥16 scorable teeth, without root caries exclusion criteria: * localized chronic or aggressive periodontitis (\<30% diseased teeth of all teeth) * smoking * tumour(s) of the soft or hard tissues of the oral cavity. * systematic disease, which include specific conditions to treat (e.g. prophylaxis of endocarditic) * women who are aware of being pregnant or who are breastfeeding. * forms of acute necrotizing ulcerating periodontitis
maxillary patient specific implants in bimaxillary orthognathic surgery

Conditions: Retrognathia; Malocclusion, Angle Class II

Summary: orthognathic surgery is a type of jaw surgery where a surgeon cuts the bones of the upper and lower jaw and places them better. there are two ways they can put the bones in the correct place and keep them in place after the surgery. one way, called the "conventional method", is to use a 3d-printed guide called a splint to set the bones in the right place and then screw the bones together using metal plates that the surgeon bends into shape to fit during the surgery. another way is to use a patient-specific implants (psi) that has been 3d-printed in titanium beforehand that because of its unique shape both places and keeps all the bones in the correct place after they are screwed in. both ways of doing it are golden standards, meaning they are already approved. measuring the accuracy of the surgery is done by comparing the positions of the bones after the surgery with the intended positions of those bones, according to the surgical plan. the closer the achieved position of each bone is to the intended position, the more accurate the result. measuring the stability of the surgery is done by comparing the positions of the bones after the surgery with the positions of the bones two years later. the less the position is changed, the more stable the result. the goal of this clinical trial is to see how accurate and stable psis are in orthognathic surgery when the maxilla is split in 3 pieces, and to compare them with the conventional method in patients with overjet or overbite. the main questions it aims to answer are: * does using psis provide accurate movements of the maxilla pieces? * does using psis provide more accurate movements of the maxilla pieces than the conventional method? * does using psis provide stable movements of the maxilla pieces after 2 years? * does using psis provide more stable movements of the maxilla pieces than the conventional method? participants will get orthognathic surgery as part of their normal orthodontic treatment. investigators will compare the psi and conventional groups to see if the psis are more accurate than the conventional method.


Eligibility criteria:
inclusion criteria: * mandibular retrognathia * occlusion class ii * three-piece le fort i osteotomy, as part of bimaxillary orthognathic surgery with or without genioplasty exclusion criteria: * cleft lip * craniofacial syndromes * former trauma * obstructive sleep apnea

Keywords: orthognathic surgery computer-assisted surgery three-dimensional imaging cone-beam computed tomography virtual surgical planning maxillary osteotomy mandibular osteotomy genioplasty osteotomy, le fort patient-specific implants accuracy stability
performance and adherence in children using spacers

Conditions: Asthma; Asthma in Children

Summary: asthma is a common disease which causes swelling in the airways, making it difficult to breathe. asthma is common in children, affecting 1 in 11 children in the uk. asthma is treated with inhalers which reduce the swelling. if inhalers are taken correctly they can help keep symptoms under control, allowing asthma sufferers to go about their day with less chance of having an asthma attack. many patients have been found to not take their inhalers correctly and either under use (which leads to poor control of symptoms) or over use (which leads to potential side effects). although asthma in most patients can be controlled with inhalers, not using inhalers correctly is one of the most common causes of poor control. this is common in children and young people (cyp) with all severities of asthma, resulting in high burden on the families and healthcare systems. the biggest challenge facing doctors and nurses helping cyp with asthma is finding a way to ensure that they take the medication. whilst there are many studies looking into inhaler use, there are no large studies about how inhalers are used between clinic visits in cyp with asthma. the smart spacer is monitoring device which allows doctors to monitor when and how effectively inhalers are being used. this study wants to find out how well this device works, how well and how often cyp are using their inhalers, and if tailored education improves asthma control. to do this, participants in the study will be randomly selected to have "tailored education" or "standard care education". the investigators are inviting 100 children and young people (cyp) aged 6-18 years who have asthma to join this study.


Eligibility criteria:
inclusion criteria: * aged 6-18 years; * attending secondary care with a diagnosis of asthma; * willing and able to give fully informed consent, or, participants having an acceptable individual capable of giving consent on the participant's behalf (e.g. parent or guardian of a child under 16 years of age); * able to perform lung function and exhaled nitric oxide measurements; * take twice-daily preventer medication using a valved holding chamber (spacer device) i.e. inhaled corticosteroid with or without long-acting beta antagonist; * willing and able to comply with the study procedures. exclusion criteria: * significant co-existing respiratory disease (e.g. cystic fibrosis); * currently participating in another clinical trial of an investigational medicinal product or medical device; * non-english speaker where translation facilities are insufficient to guarantee informed consent.
postoperative oral nutritional supplementation after major gastrointestinal surgery

Conditions: Gastric Cancer; Colon Cancer; Pancreatic Cancer; Duodenal Cancer; Biliary Cancer; Peptic Ulcer; Inflammatory Bowel Diseases

Summary: patients who underwent major gastrointestinal surgery is potentially at risk of malnutrition due to reduced oral intake, increased nutritional need, reduced gastrointestinal absorption function, and/or metabolic changes after surgery. the postoperative malnutrition is associated with low quality of life and seems to be related long-term nutritional status. this study is a multicenter, open-labeled prospective randomized clinical trial to examine the effect of postoperative oral nutritional supplements (ons) after major gastrointestinal surgery by comparing the change of body weight and other nutritional parameters between the experiment group that is supplied with ons and the control group without ons.


Eligibility criteria:
inclusion criteria: * male or female who are 20 or more years old and not more than 80 years old * discharge from a hospital is planned within 2 weeks after major gastrointestinal surgery (except when ileostomy is performed) * oral intake is possible at the time of discharge * no preoperative chemotherapy or preoperative radiotherapy * voluntarily agreed with the informed consent of this clinical trial exclusion criteria: * intravenous or other specific nutritional treatment is needed * bmi \>25 and postoperative weight loss is not \> 5% of preoperative body weight at the time of discharge * allergy to milk, whey, bean, salmon, or the investigational product * residual of cancer in the abdominal cavity postoperatively if it is cancer case * presence of synchronous other cancers that needs treatment. * when investigator judged that the patient is not eligible to the trial
protective role of n-acetylcisteine from cisplatin-induced ototoxicity in patients with head and neck cancer

Conditions: Cisplatin Adverse Reaction; Hearing Loss Ototoxic

Summary: introduction. cisplatin-induced ototoxicity is a very frequent event and its consequences can cause a lot of deterioration in patients. early diagnosis is essential because it would allow the appropriate implementation of strategies to reduce its effect. among these n-acetylcysteine, an antioxidant agent that has shown otoprotective effect. study design. randomized, parallel design and placebo controlled clinical trial. methods. patients with head and neck cancer who require treatment with cisplatin were enrolled in 2 branches: a control group that receives a placebo and experimental group that receives the drug. high-frequency audiometries (6 - 16 khz) are performed before, during and after the treatment finalization.


Eligibility criteria:
inclusion criteria: * adults patients with head and neck squamous cell carcinoma requiring chemoradiotherapy including cisplatin. exclusion criteria: * conductive hearing loss * snhl with \>= 40db pta

Keywords: cisplatin ototoxicity n-acetylcisteine