Kornimate/medical-research-clean huggingface dataset:
metabolic study of women with polycystic ovary syndrome and sleep apnea

Conditions: Polycystic Ovary Syndrome; Obstructive Sleep Apnea

Summary: the purpose of this study is to look at the metabolic (use of energy) and hormonal features of sleep problems in women with polycystic ovary syndrome (pcos).

the prevalence of obesity and chronic sleep loss are at record levels among americans and evidence continues to emerge to support a causal link between the two conditions. metabolic abnormalities related to sleep disruption are particularly evident in individuals with obstructive sleep apnea (osa), a disorder traditionally associated with male gender. while more prevalent in men, osa is underrecognized in women in part because its clinical and polysomnographic features differ from those of men. women with polycystic ovary syndrome (pcos) are particularly susceptible to osa with at least a 5-fold higher risk for its development compared to obese women without pcos. this study will enroll obese women with pcos, with and without osa. those with osa will be randomized to receive cpap or to receive depot leuprolide to suppress ovarian steroid output over 12 weeks, reassessed at 6 weeks, and then randomized (double-blind, placebo controlled) to 6 weeks of either micronized estrogen + placebo or micronized progestin + placebo. the independent effects of androgen, estrogen, and progesterone on osa and metabolic function will be assessed. in addition, primary human adipocytes will be prepared from fat biopsies obtained from subjects. insulin sensitivity will be determined by phospho-specific immunoblotting in conjunction with glucose uptake and anti-lipolysis assays. in parallel, adipocytes from these subjects will be cultured for 1-5 days prior to metabolic assays to ascertain if removal of from circulating factors will improve insulin signaling, or if insulin resistance persists in vitro. finally, there will be an interface with the metabolomics laboratory at duke university (c. newgard, lab director), and metabolomics assessment will be done on blood and urine samples.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of pcos * obese (bmi of at least 30 kg/m2) exclusion criteria: * diagnosis of nonclassic 21-hydroxylase deficiency, cushing syndrome, hypothyroidism, or significant elevations in prolactin * taking steroid preparations (including oral contraceptives), medications known to alter insulin secretion and/or action, or medications known to influence sleep during the 2 months prior to starting the study * positive pregnancy test * diagnosis of diabetes mellitus * hypertension (systolic \> 140 mmhg and/or diastolic \> 90 mmhg) not well-controlled on stable medication with either ace inhibitors or diuretics * habitual alcohol use * excessive caffeine intake of more than 300 mg/day * known peanut allergies, or allergies to medications used in the study * hemoglobin \< 11g/dl and/or hematocrit \< 33% * systemic illnesses, including heart, renal, liver, or malignant disease

Keywords: pcos osa metabolism diabetes
efficacy of add-on therapy with vildagliptin in chinese patients with type 2 diabetes inadequately controlled with prior metformin monotherapy

Conditions: Type 2 Diabetes Mellitus

Summary: the purpose of this study is to assess the efficacy and safety of vildagliptin 50 mg bid compared to placebo as an add-on therapy to metformin in chinese patients with t2dm inadequately controlled by metformin alone.


Eligibility criteria:
inclusion criteria: * patients with t2dm who have received metformin for at least 8 weeks and have been on a stable dose of at least 1500 mg daily for a minimum of 4 weeks prior to visit 1 * agreement to maintain the same dose of metformin from randomization to the end of the study * age in the range of 18-78 years inclusive * body mass index (bmi) in the range of 20-40 kg/m2 inclusive at visit 1 * hba1c in the range of \> 7.0 to ≤10% at visit 1 * agreement to maintain prior diet and exercise habits during the full course of the study * ability to comply with all study requirements exclusion criteria: * fasting plasma glucose (fpg) \> 270 mg/dl (15 mmol/l) at visit 1 * pregnant or nursing (lactating) women other protocol-defined inclusion/exclusion criteria may apply

Keywords: diabetes mellitus hba1c reduction vildagliptin add-on to metformin chinese patients
safe colorectal surgery in the elderly

Conditions: Rectal Cancer

Summary: the objective was to evaluate the use and outcomes of robotic proctectomy compared to open and laparoscopic approaches for rectal cancer in the elderly. a retrospective cross-sectional cohort study utilizing the nationwide inpatient sample (nis; 2006-2013) was performed.

the objective was to evaluate the use and outcomes of robotic proctectomy compared to open and laparoscopic approaches for rectal cancer in the elderly. a retrospective cross-sectional cohort study utilizing the nationwide inpatient sample (nis; 2006-2013) was performed. all cases were restricted to age 70 years old or greater. the incidence of robotic proctectomy from 2006 - 2013 both as a whole as well as divided into approach was analyzed. each approach was compared for both primary and secondary outcomes.

Eligibility criteria:
inclusion criteria: * 70 years of age or older * underwent proctectomy exclusion criteria: * emergent admissions * abdominoperineal resections
patterns of arrhythmias and conduction block in covid-19 patients and its relation to myocardial injury detected by cardiac magnetic resonance

Conditions: Covid19

Summary: detection of the incidence and types of arrhythmia and conduction block in covid - 19 patients detection and description of cmr patterns of myocardial injury in covid-19 patients with arrhythmias.

covid-19 has been declared a global pandemic by the world health organization and is responsible for hundreds of thousands of deaths worldwide. early reports from china suggested an overall cardiac arrhythmia incidence of 17% in patients hospitalized for covid-19. a higher arrhythmia rate (44%) was observed in patients with covid-19 admitted to the intensive care unit (icu). however, details of the type and burden of arrhythmias in this population have not been elucidated. myocardial injury is common in patients with covid-19, accounting for 7%-23% of reported cases in wuhan, china. among covid-related myocardial injury, etiologies vary and can include myocarditis, myocardial infarction, sepsis-related myocardial injury, and/or stress induced cardiomyopathy. myocardial injury is associated with high risk of developing all types of arrhythmia including atrial fibrillation, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation, and variable degrees of heart block. sudden cardiac death was also reported. the pathophysiology of covid-19-related myocarditis is a combination of direct viral injury and cardiac damage due to the host's immune response. although the pathophysiology of arrhythmias is still speculative, clinicians should provide prompt monitoring and treatment. the long term impact of covid-19 myocarditis remains unknown meanwhile, cardiac magnetic resonance (cmr) imaging is an integral test in the diagnosis of myocardial injury. it can safely be used as a first-line diagnostic tool in the workup of myocardial injury associated with covid-19. investigators believe that proper diagnosis and management of covid 19 related arrhythmias and their etiology can lead to both in-hospital and long term reduction of morbidity and mortality of this dangerous presentation of the disease.

Eligibility criteria:
inclusion criteria: 1. covid 19 suspected patients presented by chest pain, dyspnea, chest discomfort \&/or palpitations 2. ecg changes (lbbb, pvcs, ventricular tachycardia, af, atrial flutter, st-t changes, and conduction defects). 3. increased inflammatory markers and / or tropnin-i. exclusion criteria: 1. covid 19 patients without ecg changes. 2. patients known to have the same pattern of arrhythmia or conduction system defects before covid-19 infection. 3. patients contraindicated for cmr.
ivermectin in treatment of covid-19

Conditions: COVID

Summary: confirmed cases with covid-19 will receive ivermectin as a therapeutic option as well as standard of care treatment and will be compared to those that will receive only standard of care ttt


Eligibility criteria:
inclusion criteria: covid-19 patients during period of the study more than 18 years old exclusion criteria: refuse to participate pregnancy or lactation hypersensitivity to ivermectin receive any drug with interaction with ivermectin
description of the evolution of functional dysphonia managed by hypnotherapy

Conditions: Functional Dystonia (Disorder)

Summary: hypnodys is a single-center study evaluating the evolution of perceived voice-related disability before and after 3 standardized hypnosis sessions in patients with functional dysphonia.

functional or psychogenic voice and speech disorders are characterized by various changes in voice (aphonia or dysphonia) or speech (stuttering, foreign accent syndrome, and childish prosody in adults) without organic damage associated. these disorders have a significant functional impact (physical and mental handicap) and a significant cost for society. their management, like that of functional neurological disorders in general, is still poorly codified. different therapeutic strategies are mentioned, especially in the event of speech therapy failure, in particular behavioural and cognitive psychotherapeutic approaches. the recent explanatory hypotheses of functional neurological disorders are that the processing of sensory and motor information can be modulated, or even inhibited, by cognitive and attentional mechanisms. different elements (volition, emotions, attention) can exclude certain psychic representations from consciousness. hypnosis, by exercising direct control over attentional resources makes it possible to obtain hypoactivation of the medial prefrontal cortex and hyperactivation of the executive and salience networks, making greater use of the buffer of working memory and activate the para-sympathetic system. thus, one can observe analgesia, amnesia, a loss of the notion of time, plurimodal hallucinations, a detachment from oneself, a distortion of reality and logic. hypnosis has been used since the 19th century in the treatment of functional paralysis. to date, there are only presentations and case series evaluating the value of hypnosis in functional disorders of voice and speech. however, from a clinical standpoint, the use of hypnosis seems to show a significant interest in functional speech disorders. functional neurological disorders are located at the crossroads of neurological and psychiatric disorders, psychiatric and psychological evaluation of these patients therefore seems necessary in order to measure their impact on the pathological and recovery processes through hypnotherapy.

Eligibility criteria:
inclusion criteria: * diagnosis of functional neurological disorder according to the dsm-5 * supported at the rothschild foundation as part of a hypnotherapy protocol * mastering the understanding of the french language * express consent to participate in the study exclusion criteria: * organic etiology of dysphonia * decompensation of a psychiatric pathology * discovery during study of an organic etiology not initially identified
genetic basis of mitral valve prolapse

Conditions: Mitral Valve Prolapse

Summary: the investigators have successfully identified two novel genetic loci for mvp on chromosomes 11 and 13 and are searching for altered genes in these regions. this requires recruiting large families who may have mvp linked to these or other chromosomes; and obtaining dna samples from 1,000-1,500 individually affected patients to study the relation between dna markers throughout the genome and mvp. it is our expectation that the results of this study will lead to the discovery of gene(s) responsible for mvp. this will lead to improved understanding of the disease and, in turn, improved ability to treat and prevent progression in genetically susceptible individuals.

this is a genome-wide association study.

Eligibility criteria:
inclusion criteria: * mitral valve prolapse exclusion criteria: * other mitral valve diseases

Keywords: mvp, mitral valve
the efficacy of adductor-canal-blockade on pain and morphine consumption after revision knee arthroplasty

Conditions: Postoperative Pain; Knee Arthroplasty

Summary: the purpose of this study is to determine whether adductor-canal-blockade is effective at reducing pain and morphine consumption after revision knee arthroplasty.


Eligibility criteria:
inclusion criteria: * revision knee arthroplasty in general anaesthesia * american society of anesthesiologists (asa) 1-3 * bmi 18-40 * written informed consent exclusion criteria: * can not cooperate to the exam * do not speak or understand danish * drug allergy * alcohol or drug abuse

Keywords: adductor-canal-blockade postoperative pain us-guided nerve block revision knee arthroplasty
family intervention for mental illness and substance abuse

Conditions: Schizophrenia; Bipolar Disorder; Substance-related Disorders

Summary: this study will evaluate a family intervention program for individuals with bipolar disorder, schizophrenia, or schizoaffective disorder and co-occurring substance use disorders.

substance use disorder (sud) in persons with severe mental illness may worsen the course of psychiatric illness. the loss of family support for individuals with mental illness is a major contributing factor to housing instability, homelessness, and other problems. despite progress toward integrating mental health and substance abuse services, interventions that improve the course of mental illness while helping the families of the mentally ill are not currently available. enhancing skills for coping with mental illness may be an effective strategy for treating sud, decreasing caregiver burden, and improving the long-term outcomes for people with mental illness. patients and their families are randomly assigned to either the family intervention for dual diagnosis (fidd) program or family psychoeducation. the fidd program lasts for up to 3 years and includes both single and multiple-family group formats. the family psychoeducation program consists of 6 weekly sessions. routine assessments are conducted on all patients, and relatives are evaluated on a wide range of outcomes, including substance abuse, hospitalizations, psychiatric symptoms, legal problems, aggression, housing and homelessness, family burden, social support, and quality of life. to determine the effectiveness of the fidd program, knowledge of mental illness and problem-solving skills are assessed in the families following treatment.

Eligibility criteria:
inclusion criteria: * have schizophrenia, schizoaffective disorder, or bipolar disorder * have a current substance use disorder (within the past 6 months) * are willing to have at least 4 hours of contact per week with family members or significant others * plan to remain in the community * have family members or significant others who consent to participate in the study and plan to remain in the community

Keywords: psychotic disorders schizoaffective disorder substance abuse
nt-probnp in acute dyspnea: effects on treatment, hospitalisation and costs

Conditions: Heart Failure; Dyspnea

Summary: diagnostic uncertainty in patients with complaints of shortness of breath presenting to the emergency department of a hospital may delay treatment and proper care. in patients with shortness of breath due to heart failure increased plasma levels of nt-pro-b-type natriuretic peptide (nt-probnp) can be demonstrated. the use of nt-probnp as a biomarker for heart failure in patients presenting to the emergency department with dyspnea might improve care and reduce length of hospital stay. to investigate the effect of nt-probnp testing on patient care and time to discharge the nt-probnp test will be randomized. in patients in the study group, the nt-probnp plasma level is determined at admission and the physician in charge will immediately receive the result of the test. in patients in the control group blood will be sampled but the physician will recieve no information on the nt-probnp plasma level. in our study we will investigate the effect of introduction of nt-probnp as biomarker for heart failure on treatment, time to discharge and costs.


Eligibility criteria:
inclusion criteria: * age 18 years or older * acute dyspnea as their most prominent complaint exclusion criteria: * acute dyspnea due to a trauma * acute dyspnea due to cardiogenic shock * renal failure requiring dialysis

Keywords: heart failure diagnostic natriuretic peptide nt-pro b-type natriuretic peptide length of stay costs
core stabilization training in juvenile spondyloarthropathy

Conditions: Spondylarthritis; Spondylarthropathies; Juvenile Idiopathic Arthritis

Summary: core stabilization exercises developed by mcgill have been shown to be one of the physiotherapy techniques aimed at reducing pain, increasing aerobic capacity, enhancing muscle strength, and thereby improving bone health in children with jia. however, there is no study that has investigated core stabilization training for different types of jia. in our study, we aim to compare the effectiveness of core stabilization training and a daily physical activity program in children with spondyloarthropathy, to help identify the most effective strategy for clinical practice. additionally, highlighting the specific effects of core stabilization training on the treatment of juvenile spondyloarthropathy (pain, functional status, fatigue, and quality of life) will make a significant contribution to the literature. taking into account the gaps in the literature, our study will investigate the effect of core stabilization training on pain, functional status, fatigue, and quality of life in patients with juvenile spondyloarthropathy.

core stabilization exercises are one of the physiotherapy techniques aimed at reducing pain, increasing aerobic capacity, enhancing muscle strength, and thereby improving bone health in children with jia (1). spondyloarthropathy typically begins as asymmetric oligoarthritis in children, and enthesitis and axial skeleton involvement may develop over the course of the disease (4). since juvenile spondyloarthropathies can lead to severe functional impairments and long-term sequelae, the primary goal in treatment should be to suppress inflammation as early as possible and to prevent sequelae (5). physiotherapy is recommended for children and adolescents with enthesitis or sacroiliitis, or those with functional limitations (6). yoga exercises focusing on the core region have shown significant effects on lower extremity functional status, pain levels, and quality of life in patients with enthesitis-related conditions (2). studies have supported that core stabilization exercises, combined with traditional physical therapy aimed at improving bone health status and functional capacity, serve as an effective combination therapy for children with jia involving multiple joint involvement (3). therefore, this study aims to fill the knowledge gap regarding core stabilization training in children with spondyloarthropathy.

Eligibility criteria:
inclusion criteria: * "according to the international league of associations for rheumatology criteria, individuals aged 10-18 diagnosed with spondyloarthritis within the jia subgroup will be included. * only cases with stable disease activity and without additional neurological or orthopedic conditions will be considered. * participants must also possess the cognitive ability to engage in active rehabilitation. exclusion criteria: * individuals with a cardiovascular disease that impedes exercise * those who have participated in a rehabilitation program within the last 6 months * cases with variable medical treatment will be excluded.
effectiveness of calisthenic exercises in post-covid syndrome

Conditions: Quality of Life

Summary: post-covid syndrome is known as the appearance of some symptoms for 12 weeks or more after covid-19 infection, affecting the patient's quality of life. the wide range of symptoms that occur after post-covid syndrome has led to the development of different interventions. in this study, we tried to measure changes in quality of life in people with post-covid syndrome as a result of using calisthenics with therapists and home exercise. quality of life scale scores were compared before and after an 8-weeks exercise intervention.

in this study, a quantitative approach with a pre-test-post-test design was applied to compare the effect of calisthenic exercises on quality of life in individuals with post-covid syndrome in the form of a therapist-guided and home exercise programme. participants signed an informed consent form before inclusion in the study and the details of the study were clearly explained. at baseline, age, gender, height, weight, symptoms and duration of symptoms were recorded. quality of life data were recorded with the eq-5d-3l questionnaire at baseline and 8 weeks after the exercise intervention.

Eligibility criteria:
inclusion criteria: * to be 18 years of age or older, previous having covid-19 infection, 12 weeks or more of post-covid symptoms. exclusion criteria: * the presence of acute viral or bacterial infection, having been previously diagnosed with a rheumatic, neurological, metabolic or oncological disease, having undergone any surgical procedure after musculoskeletal injury, use of intra-articular prosthesis

Keywords: post-covid condition long covid life quality exercise training
strategic use of new generation antidepressants for depression

Conditions: Unipolar Major Depressive Episode

Summary: the purpose of the study is to establish the optimum treatment strategy for first-line and second-line antidepressants in the acute phase treatment of major depression.


Eligibility criteria:
inclusion criteria: * non-psychotic unipolar major depressive episode (diagnostic and statistical manual, fourth edition \[dsm-iv\]) in the preceding month * age 25-75 * starting treatment with sertraline clinically indicated * tolerability to sertraline 25 mg/d ascertained * can understand and sign informed consent form * can be contacted by telephone for symptom severity and adverse events exclusion criteria: * have received antidepressants, mood stabilizers, antipsychotics, psychostimulants, electroconvulsive therapy (ect) or depression-specific psychotherapies in the preceding month * history of schizophrenia, schizoaffective disorder or bipolar disorder * current dementia, borderline personality disorder, eating disorder or substance dependence * physical disease interfering with sertraline or mirtazapine treatment * allergy to sertraline or mirtazapine * terminal physical illness * currently pregnant or breast-feeding * high risk of imminent suicide * requiring compulsory admission * expected to change doctors within 6 months * cohabiting relatives of research staff * cannot understand japanese