Kornimate/medical-research-clean huggingface dataset:
fecal microbiota transplantation for the treatment of metabolic syndrome

Conditions: Metabolic Syndrome

Summary: obesity is associated with changes in the composition and metabolic function of the gut microbiota. fecal microbiota transplantation (fmt), also known as "fecal bacteriotherapy" or "fecal infusion", refers to the process of injecting a liquid suspension of stool from a healthy donor into the gastrointestinal (gi) tract of a patient to cure a specific disease. however, since the recently established concept of human gut microbiome and its significant role in health and disease has caught on in the medical scientific world, this procedure has gained a great pathophysiological strength, meaning not only the simple infusion of stools, but the transplantation of a healthy gut microbiota in a patient with a disrupted one. in a recent dutch experience, fmt from lean donors was able to increase the insulin sensitivity in patients with metabolic syndrome. our primary aim is to evaluate if fmt from lean healthy donors, in association to lifestyle changes, is able to reduce insulin-resistance more than lifestyle changes alone in patients with metabolic syndrome. all the patients with metabolic syndrome will receive lifestyle counselling (1400 kilocalories diet and physical activity encouragement), than will be randomized to fmt from healthy lean donors by upper endoscopy (group a) or no treatment (group b)


Eligibility criteria:
inclusion criteria: * both males and females between 30 and 60 years old * bmi\>30 and \>35 kg/m2 * diagnosis of metabolic syndrome according to national cholesterol education program's adult treatment panel iii criteria * no ongoing therapy for diabetes, hyperlipidemia or arterial hypertension * signature of written informed consent exclusion criteria: * recent (3 months) use of probiotic, antibiotics or other drugs * increase in triglycerides levels, (≥ 300 mg/dl), ldl levels (≥ 190 mg/dl, or modification of body weight (±5%) during the last 3 months * relevant cardiovascular diseases or kidney diseases * relevant gastrointestinal diseases (such as inflammatory bowel disease or celiac disease) * former gastrointestinal surgery
study on number and outcome of pregnancy in acute promielocitic leukaemia (apl) patients treated with chemotherapy

Conditions: Acute Promyelocytic Leukemia; Pregnancy

Summary: the gimema foundation promotes an observational (retrospective) study on number and outcome of pregnancy in childbearing age female patients treated with chemotherapy for apl. these patients were enrolled in studies aida0493, aida2000 and were in cr.

acute promielocitic leukaemia (apl) among all the aml subtypes, apl has the distinction of being the most curable. the median age at diagnosis is 40 years, which is younger than with other aml subtypes. the fact that apl is more common in younger patients increases the likelihood that it may occur during fertile age. the introduction of atra and ato has substantially modified the outcome of apl: in two successive studies 94% of patients achieved cr and the 6-yr os rates (pethema and gimema) were about 80% 2,3,6. atra is highly effective in apl patients, but adverse effects such as retinoic acid syndrome, arrhythmias, headache, rash, dizziness have been reported. moreover, retinoids are known to be potent teratogens and increased rates of spontaneous abortion and major fetal abnormalities have been reported 10. most of the cases reported suggest that atra is relatively safe for both mother and fetus when used in the second and third trimesters. by contrast, when it was used in the first trimester, a negative foetal outcome was reported. no data have yet been reported on the outcomes of pregnancies in young patients with apl, occurring during ccr following atra-including chemotherapy regimens. apl therapy aida regimen: simultaneous atra plus idarubicin (aida) combination for induction treatment, followed by 3 courses of intensive chemotherapy as consolidation2. consolidation therapy in the aida-0493 trial consisted of 3 chemotherapy courses with ara-c and idarubicin3. consolidation treatment in the aida-2000 was given according to a risk-adapted strategy as follows: patients with low-/intermediate-risk received the same 3 consolidation courses as in the aida-0493 but with omission of cytarabine; patients in the high-risk group received the identical 3 cycles as in the aida-0493. study rationale this is an observational (retrospective) study on number and outcome of pregnancy in childbearing age female patients treated with chemotherapy for apl. these patients were enrolled in studies studies aida0493, aida2000 and were in cr.

Eligibility criteria:
inclusion criteria: * patients alive aged between 18 and 50 years * patients with unequivocal diagnosis of apl according to the fab classification or who 2008 diagnostic criteria. female in childbearing age treated for apl, enrolled in the studies aida0493, aida2000 in cr after 2 years of maintenance with the exclusion of those randomized to observation in the aida2000, aida0493 exclusion criteria: * patients aged \ 50 years; * patients receiving chemotherapy; * concomitant psychiatric disorder that would interfere or prevent the subject from participating in the study.

Keywords: pregnancy apl female patients
analysis of the evolution of mortality in an intensive care unit

Conditions: Intensive Care Unit; Mortality; Epidemiology; Respiration, Artificial; Sepsis Syndrome; Respiratory Failure; Neurologic Disorder

Summary: the intensive care units is of the main components of modern healthcare systems. formally, its aim is to offer the critically ill health care fit to their needs; ensuring that this health care is appropriate, sustainable, ethical and respectful of their autonomy. intensive medicine is a cross-sectional specialty that encompasses a broad spectrum of pathologies in their most severe condition, and specifically has as its foundation the practice of comprehensive care of the patient with organ dysfunction and susceptible to recovery. although critically ill patients are a heterogeneous population, they have in common the need for a high level of care, often requiring the use of high technology, specific procedures for the support of organ dysfunction and the collaboration of other medical and surgical specialties for their management and treatment. since their origins in the late 1950s, intensive care units have been adapting to the changes arising from the best scientific evidence. in the late 1990s and early 2000s, there were some successful clinical trials published that had tested alternative management strategies in the icu. mechanical ventilation is an intervention that defines the critical care specialty. between 1970 and the 1990s, the management focused on normalizing arterial blood gas with aggressive mechanical ventilation. over the ensuing decades, it became apparent that performing positive pressure ventilation worsened lung injury. the pivotal moment in the mechanical ventilation story would be the low versus high tidal volume trial. this trial shifted the focus away from normalizing gas exchange to reducing harm with mechanical ventilation. further, it paved way for further trials testing ventilation interventions (peep strategy, prone position ventilation) and nonventilation interventions (neuromuscular blockade, corticosteroids, inhaled nitric oxide, extracorporeal gas exchange) in critically ill patients. that evidence-based intensive care medicine has undoubtedly had an influence on the outcome of critically ill patients, in general, and, particularly, of patients requiring mechanical ventilation. temporal changes in mortality over the time have been scarcely reported for patients admitted to intensive care unit. objective of this study is to estimate the changes over the time in several outcomes in the patients admitted to an 18-beds medical-surgical intensive care unit from 1991 (year of start of activity) to 2026


Eligibility criteria:
inclusion criteria: • patients admitted to intensive care unit exclusion criteria: • none

Keywords: intensive care units outcome mortality
study of the causal link between rheumatoid arthritis and periodontitis using mendelian randomization

Conditions: Rheumatoid Arthritis; Periodontitis

Summary: this study aims to investigate the causal relationship between rheumatoid arthritis and periodontitis using mendelian randomization. data will be sourced from genome-wide association studies (gwas) to explore genetic associations and assess potential risk factors in an east asian population.

the purpose of this study is to explore the causal association between rheumatoid arthritis (ra) and periodontitis using mendelian randomization (mr). ra and periodontitis share similar inflammatory pathways and immune responses, but their causal relationship remains unclear. this study will utilize genome-wide association studies (gwas) data from an east asian population to identify single nucleotide polymorphisms (snps) associated with ra and assess their potential impact on the risk of developing periodontitis. statistical methods such as inverse-variance weighting, mr-egger regression, and weighted median analysis will be employed to analyze the data. the findings may provide insights into the shared genetic basis and causal relationships between these two conditions, offering potential targets for preventive strategies.

Eligibility criteria:
inclusion criteria: * participants included in the genome-wide association study (gwas) database. * subjects with available genotypic data relevant to rheumatoid arthritis and periodontitis. exclusion criteria: * individuals without complete genotypic data or those with missing critical phenotypic information.

Keywords: mendelian randomization genome-wide association study (gwas) inflammatory diseases genetic risk factors snp (single nucleotide polymorphism)
evaluation of feasibility of radial access for primary angioplasty and to assess it in high risk subgroups

Conditions: Primary Angioplasty

Summary: primary percutaneous coronary intervention is the preferred treatment for patients with st-segment acute coronary syndrome. the radial access is an established approach, associated with a reduction in vascular access related complications after primary percutaneous coronary interventions. the purpose of this study is to examine the baseline characteristics, risk factors, procedural parameters and complications in patients with stemi taken for primary angioplasty by radial access. data of all patients with acute stemi with primary pci through radial access is to be evaluated for baseline characteristics and procedural parameters and complications. patients in the prospective study are followed up till discharge and any in-hospital complication noted. this was a prospective, observational and descriptive study. three hundred fifteen consecutive patients with an st-segment elevation acute myocardial infarction (stemi) treated with primary angioplasty by radial access, admitted between march 2016 and feb 2017 were analyzed for their baseline characteristics, risk factors, and procedural parameters, complications and outcomes. high risk sub-groups analysis was also done. high risk groups includes patients with age \>75yrs, cardiogenic shock, severe lv systolic dysfunction, acute left ventricular failure, high degree av block, right ventricular infarction and low bmi. the study is conducted among patients with acute stemi, considered for primary pci through radial artery access at operator discretion. this study analyzed the baseline characteristics of patients which includes clinical history, clinical examination, ecg, 2d echo, coronary angiogram to evaluate cardiovascular risk factors.


Eligibility criteria:
inclusion criteria: * all patients presenting with stemi and being considered for primary pci through radial access between march 2016 and feb 2017. exclusion criteria: * patients with acs other than stemi * all primary pci in stemi through femoral access. * all radial elective pci.

Keywords: primary angioplasty radial access stemi
the effect of diaphragm muscle training on chronic low back pain

Conditions: Low Back Pain; Diaphragm

Summary: brief summary: low back pain is very common problem in all the developed countries and affects children to elderly. based on the etiology the low back pain is divided into two type: nonspecific and specific low back pain. if the pathological reason is known it is defined as specific and if the reason for the pain is unknown it is defined as nonspecific low back pain. the postulated reason for nonspecific low back pain is the segmental instability of the lumbar spine. diaphragm muscle has a role in maintaining the segmental stability. the aim of this study to reduce the severity of the low back pain with improving the stability of the lumbar spine by using diaphragm training.

the study is a randomized controlled trial. the participants are divided randomly into two groups. one of the groups take part in a complex training which contains stretching, strengthening, mobilizing exercises and proprioceptive training and this training is completed by diaphragm strengthening exercises. this group is defined as diaphragm training group. the members of the diaphragm training group use the powerbreathe medic plus device. opposed to the diaphragm training group the members of the control group take part only in the complex training without strengthening the diaphragm muscle. the pain intensity is assessed by visual analogue scale and the diameter of the stabilizer muscles' belly is measured by b-mode ultrasound examination, using zonare z.one ultrasound system (mountain view, ca, usa). the thickness of the transversus abdominis muscle, the lumbar multifidus muscle and the diaphragm muscle is assessed in two different positions: during lying and during sitting position with weightlifting. the muscles are measured in two different states: a relaxed and a contracted state. functional tests and a balance platform (neurocom) are used to measure the stability, and the function of the diaphragm is assessed by using a powerbreathe kh2 device.

Eligibility criteria:
inclusion criteria: * chronic low back pain * do not take part in other treatment * be able to learn the usage of diaphragm trainer exclusion criteria: * balance problems with neurological cause * malignant tumor * serious organ disease * respiratory disease * a previous surgical intervention which affected the trunk * the patient is unable to cooperate

Keywords: low back pain diaphragm
role of nitric oxide in cirrhosis: relationship with systemic hemodynamics, renal function, vasoactive systems and endotoxemia

Conditions: Cirrhosis; Liver Cirrhosis

Summary: this study is to determine whether a compound, nitric oxide, made within the body, is the factor responsible for the changes in blood pressure and renal (kidney) functions that may occur during the course of cirrhosis. patients with cirrhosis (liver scarring which causes poor liver function) will be eligible to participate. a group of healthy subjects will also be studied to compare the effects of the treatment to patients with cirrhosis and to confirm safety. a total number of 30 patients with cirrhosis and 10 healthy subjects will be enrolled in the study.

upon admission, the patients will be physically examined and started on a special diet that will continue throughout the study. during the first four days of the study, the weight, heart rate and blood pressure of the patients will be measured every morning and 24-hour urine will be collected. on day 5, intravenous lines will be inserted in the patient's arms. one line will be used to draw blood samples and the other line will be used to infuse medications. blood samples will be taken to measure liver and kidney function, nitric oxide, and other hormones that participate in the regulation of body fluids and blood pressure. inulin and paraaminohippurate infusions (substances used routinely in the study of kidney function) will be started and blood and urine samples will then be taken at periodic intervals. ninety minutes after the initiation of inulin and pah infusions, l-nmma (an investigational drug expected to increase the blood pressure and improve the kidney functions) will be infused. blood and urine samples will be collected every 30 minutes. these procedures will take 4 hours. a total amount of about 10 tablespoons of blood will be drawn during the study. the patients will be discharged from the gcrc the next morning and restarted on their regular medications.

Eligibility criteria:
inclusion criteria: * patients with compensated cirrhosis without previous history of ascites or edema * cirrhotic patient with ascites without renal failure * cirrhotic patients with ascites with functional renal failure * age and sex-matched healthy subjects
transcranial magnetic stimulation and anti-epileptic effect: optimization and evaluation with electrophysiology.

Conditions: Refractory Frontal Lobe Epilepsy

Summary: epileptic disease is characterised by enhanced brain excitability. low frequency repetitive transcranial magnetic stimulation (rtms) can be an effective treatment for refractory frontal epilepsy. thought, physiological mechanisms of its effectivity are still unknown. it is yet possible to evaluate cortical excitability and inhibition with tms-coupled electromyography before and after rtms sessions ; this could provide clues for basic mechanisms of rtms effects on the epileptic brain. we assume that rtms decrease brain excitability by improving brain inhibition. such an information could help for treating patients with both pharmacological and non-pharmacological methods.


Eligibility criteria:
inclusion criteria: * cryptogenic frontal lobe epilepsy * normal cerebral mri

Keywords: repetitive transcranial magnetic stimulation low frequency frontal lobe epilepsy brain excitability electromyography
a clinical trial to compare the safety, tolerability, and pk properties of da-5216 and da-5216-r and to evaluate the food effect on da-5216.

Conditions: Healthy

Summary: this is a randomized, open-label, single dose, 2-part, cross-over clinical trial to compare the safety, tolerability, and pharmacokinetic properties of da-5216 and da-5216-r and to evaluate the food effect on da-5216 in healthy adult subjects


Eligibility criteria:
inclusion criteria: * healthy male and female volunteer 19 years to 50 years * body weight in the range of 50.0kg and body mass index in the range of 18 to 27kg/m2 * subject who are negative in pregnancy test or pregnant or lactating women * the subjects personally signed and dated informed consent document after informed of all patient aspects of the study, fully understanding and determined spontaneously to participate * the subjects who are judged appropriate to participate this clinical trial according to the physical examination, routine laboratory examination and questionnaire exclusion criteria: * subject with serious active hepatobiliary, respiratory, digestive, hematologic, endocrine(diabetes mellitus, aldosteronism), immunologic, cardiovascular(hypertension, angina, heart failure, myocardial infarction, etc.), neurologic, urologic, otorhinolaryngologic, musculoskeletal, psychological disease or history of such disease * subject with gastrointestinal disease (crohn's disease, peptic ulcer, acute or chronic pancreatitis, etc.) or history of such disease/surgery (excluding simple appendic surgery, hernia surgery, hemorrhoid surgery). * subject who have galactose intolerance, lapp lactase deficiency or glucose galactose malabsorption * subject who have had one or more of the following findings * ast, alt \> 1.5 times the upper limit * cpk \> 2.5 times the upper limit * egfr \<60ml/min/1.73m2
protein supplementation in thiazide-induced hyponatremia

Conditions: Hyponatremia; Hypertension; Blood Pressure

Summary: high blood pressure is very common among elderly canadians. clinical trials show clear benefit from lowering blood pressure in hypertensive elderly patients. these trials also demonstrate safety for several classes of blood pressure lowering drugs including water pills. however, water pills (thiazide diuretics) used for treatment of hypertension, can cause low sodium (hyponatremia), a significant clinical problem mainly among elderly and very elderly. causes are age related decrease in kidneys' ability to get rid of water and low salt coupled with high water intake. a standard approach to treatment is lacking since higher salt intake may worsen hypertension, and lower water and higher protein intake is difficult to understand and actually implement. 'nepro' is a nutritional drink high in protein, and low in potassium and sodium. it is used frequently as a dietary supplement in patients with kidney disease specifically for low sodium and high protein content. the high protein content in nepro can help the kidney get rid of excess water, and the low sodium and potassium content will make this a safe option to use. hence investigators propose a proof-of-concept trial on an easy to understand and administer, and relatively affordable solution to this issue. it could be summarized in one sentence: "will a bottle of nepro a day keep thiazide-caused hyponatremia and the doctor away?"


Eligibility criteria:
inclusion criteria: * elderly (\>65 years old) * with diagnosed hypertension (htn) treated with thiazide (hydrochlorothiazide) or thiazide-like (chlorthalidone and indapamide) diuretic and * mild to moderate hyponatremia (plasma sodium concentration 125-133 mmol/l). exclusion criteria: * pregnancy * estimated glomerular filtration rate (egfr) \<45 ml/min/1.75 m2, * other causes of hyponatremia (liver cirrhosis, uncontrolled hypothyroidism, adrenal insufficiency) * unable to provide informed consent; * patients with generalized volume overload who may require immediate changes in diuretic therapy (at the discretion of treating htn specialist); * patients taking drugs which may interfere with urinary sodium excretion (such as carbamazepine, loop diuretics, potassium sparing diuretics, mineralocorticoid and glucocorticosteroids, selective serotonin receptor inhibitors, tricyclic antidepressants, amiodarone, and lithium); * patients with moderate to severe hyponatremia (plasma sodium concentration \< 125 mmol/l) who may require immediate discontinuation of the thiazide diuretic .

Keywords: dietary supplement