Kornimate/medical-research-clean huggingface dataset:
jugular ultrasound for spinal hypotension

Conditions: Hypotension; Anesthesia, Spinal; Aged

Summary: spinal induced hypotension is common complication in geriatric group of patient with percentage up to 73% among these group\]. the most common causes that enhance occurrence of post spinal anesthesia induced hypotension among elderly are poor physical condition , chronic systemic diseases , medications and long fasting time, intraoperative hypotension if severe or prolonged is associated with hazardous complication such as myocardial infarction , stroke, renal failure and perioperative mortality ,so accurate assessment of intravascular volume before induction of anesthesia is necessary to limit these hazards. various studies had reported that ultrasonographic measurements of inferior vena cava collapsibility index is a good predictor for reflexing the intravascular volume status\[5\]\[6\] , this is non invasive , on the other hand ivc is not easily feasible in obese and pregnant women. some studies compared the difference between ivc and ijv as predictor marker for fluid responsiveness and reported that right internal jugular vein distensibility appears to be a surrogate marker for inferior vena cava vein distensibility for evaluating fluid responsiveness. almost great percentage of anesthesiologist easily use ijv ultrasonography for catheterization and it is easily feasible in almost all patients, recent studies documented that noninvasive ultrasonographic measurements of internal jagular vein diameter has a role in assessment of intravascular volume status in spontaneously and mechanically breathing patients, passive leg raising has been shown to be useful in assessing intravascular volume depletion or fluid responsiveness , some studies compared ijv changing in diameter for supine and trendelenburg positions, there is a similar change in ijv diameter will occur with passive leg raising positions , trendelenburg position may be disadvantageous as it impair gas function and cardiac function especially in elderly and obese patients , on the other hand passive leg raising is simpler and more comfortable to the elderly. finally preoperative detection of decreased intravascular volume is crucial in elderly patients, so we hypothesized that preoperative ultrasonographic evaluation of the internal jagular vein measurements may be a reliable tool for estimating intravascular volume and prediction of post spinal hypotension in elderly.


Eligibility criteria:
inclusion criteria: * • age \> 65 years old. * both sexes. * american society of anesthesiologists (asa) physical status i, ii , iii. * elective surgeries under spinal anesthesia in the supine position. exclusion criteria: * • body mass index (bmi) more than 35 kg/m2. * uncontrolled hypertension. * ejection fraction less than 40% * emergency cases. * absolute or relative contraindications to spinal anesthesia. * patients with a baseline arterial systolic blood pressure (sbp) less than 90 mmhg or mean arterial blood pressure (mbp) less than 65 mmhg.

Keywords: spinal anesthesia elderly hypotension ultrasound passive leg raising ijv
a study to evaluate lenalidomide combined with dexamethasone in relapsed or refractory diffuse large b-cell lymphoma

Conditions: Diffuse Large B-cell Lymphoma

Summary: to evaluate the safety and efficacy of lenalidomide (revlimid ®) in combination with dexamethasone in subjects with relapsed or refractory diffuse large b-cell lymphoma.

non-hodgkin's lymphoma (nhl) can be divided into two general prognostic groups: the indolent lymphomas and the aggressive lymphomas. indolent lymphomas have a relatively good prognosis, with median survival time as long as 10 years, but they are not usually curable in advanced stages. aggressive nhl constitutes about half of all cases of nhl in north america and western europe. of the aggressive lymphomas, diffuse large b-cell lymphoma (dlbcl) is the most common type, accounting for up to 30 percent of newly diagnosed cases. the aggressive type of nhl has a shorter natural history; approximately 50-60% of these subjects can be cured with combination chemotherapy regimens. even with recent advances, many patients with advanced stage dlbcl are not cured with conventional therapy. this leaves a subset of subjects who will eventually relapse or who are refractory to treatment. due to the variation in the clinical behavior of the different types of aggressive nhl, it is important to test lenalidomide in dlbcl. other studies are addressing the activity of lenalidomide in the other types of aggressive lymphomas, as well as in indolent nhl. it is important to test lenalidomide in combination therapy. this study is focused on treating subjects with relapsed or refractory dlbcl using oral lenalidomide in combination with oral dexamethasone.

Eligibility criteria:
inclusion criteria: * biopsy-proven diffuse large b-cell non-hodgkin's lymphoma * relapsed or refractory to previous therapy for non-hodgkin's lymphoma * measurable disease on cross sectional imaging that is at least 2 cm in the longest diameter * ecog performance score of 0,1 or 2 * willing to follow the pregnancy precautions exclusion criteria: * any of the following laboratory abnormalities. * absolute neutrophil count (anc) \< 1,500 cells/mm3 (1.5 x 109/l). * platelet count \< 60,000/mm3 (60 x 109/l). * serum sgot/ast or sgpt/alt 5.0 x upper limit of normal (uln). * serum total bilirubin \> 2.0 mg/dl (34 µmol/l). * subjects who are candidates for and willing to undergo an autologous stem cell transplant. * history of active cns lymphoma within the previous 3 months * subjects not willing or unable to take dvt prophylaxis * history of other malignancies within the past year * positive hiv or active hepatitis b or c

Keywords: celgene revlimid lenalidomide diffuse large b-cell lymphoma non-hodgkins lymphoma cc-5013 response rate tumor control rate duration of response time to progression progression-free survival and safety
optimizing beta blocker dosage in women while using the wearable cardioverter defibrillator

Conditions: Cardiomyopathies; Heart Failure

Summary: the primary objective of this pilot study is to document the percentage achievement in effective hr control (average nighttime hr \< 70 bpm) during wcd use in a cohort of female patients with cardiomyopathy in an outpatient setting using continuous heart rate (hr) trends data from the wcd to optimize bb/ivabradine dosage, as compared to a prior historical control.

the primary objective of this pilot study is to document the percentage achievement in effective hr control (average nighttime hr \< 70 bpm) during wcd use in a cohort of female patients with cardiomyopathy in an outpatient setting using continuous heart rate (hr) trends data from the wcd to optimize bb/ivabradine dosage, as compared to a prior historical control. adult female patients (18 years or older) who are prescribed the wearable cardioverter defibrillator (wcd) for 3 months for ischemic or non-ischemic cardiomyopathy with a low ejection fraction. subjects will wear an fda-approved wcd with a 3 month follow-up period. heart rate (hr) will be continuously monitored by the wcd. every two weeks a report showing daily hr trends will be emailed to the healthcare provider. the healthcare provider will also receive a hr control alert if the hr exceeds a predetermined threshold for 3 days in a row. based on this information, clinicians should follow guideline-directed medical therapy (gdmt) to add or titrate medication accordingly. the goal of these changes will be to achieve the average nighttime hr to recommended guidelines (\<70 bpm) by the end of wcd use.

Eligibility criteria:
inclusion criteria for screening phase: * female patients with newly diagnosed (never hospitalized for hf in the last 30 days prior to enrollment) ischemic or non-ischemic cardiomyopathy and an ef ≤ 35% at the time of wcd prescription. * patients prescribed the wcd for an intended 90 ± 14 days of use. * patients have used the wcd for no more than 14 days from the day of consent. * patients 18 years of age or older at the time of consent. inclusion criteria for continuation phase: -after the first 2 weeks of wcd wear, only actively wearing patients averaging at least 105 hours of wcd wear per week (or 15 hours/day) are eligible to continue. exclusion criteria for screening phase: * patients with a known contraindication or intolerance to beta-blocker therapy. * patients with permanent atrial fibrillation. * patients who have a pacemaker. * patients with a current or prior implantable cardioverter defibrillator (icd). * patients who are self-reporting to be pregnant. * patients with known congenital or inherited heart disease. * patients participating in another interventional clinical trial. * patients not expected to live longer than 3 months. exclusion criteria for continuation phase: -patients ending wcd use within the first two weeks of use.
progesterone for maintenance tocolysis: a randomized placebo controlled trial

Conditions: Pregnancy Complications

Summary: preterm delivery is the most common cause of infant morbidity and mortality in the united states. some women have episodes of preterm labor during their pregnancy which can be temporarily stopped. these women, however, are at high risk for delivering before term. at this time, we do not have sufficient evidence to use any medication to help prevent these women from delivering early. recently, preliminary studies have shown that progesterone may help prevent some women at high risk for preterm delivery from delivering early. our study will investigate whether progesterone can help this specific group of women, women with arrested preterm labor, deliver healthy infants at term.

the purpose of this study is to test the efficacy of progesterone in prolonging human pregnancies complicated by arrested preterm labor. animal labor has not been shown to be equivalent to human labor and would not be an appropriate substitute for this study. in addition, this medication has been previously used in pregnant women without any evidence of significant harm to the mother or fetus. women will be approached for enrollment in the study during their hospitalization for preterm labor. if they choose to enroll, they will have weekly md visits at the obstetrical clinic, daily use of vaginal progesterone that will be self administered, and routine obstetric care at the time of recurrent labor and delivery. the daily progesterone is not a part of routine care for these patients. in addition, we will ask patients to fill out a written questionaire one week after starting the medication to describe any subjective symptoms that may be associated with this medication. finally, we will assess the peripheral levels of progesterone with a blood draw prior to starting the mediation, one week after starting the medication, and at the time of recurrent pre-term labor or delivery. the first two of these blood draws will be in addition to the standard treatment. the final blood draw will involve collecting an extra sample at a time when the participant would normally have blood drawn as a part of routine care.

Eligibility criteria:
inclusion criteria:1. pregnant women with arrested preterm labor between 24+0 to 33+6 weeks pregnant. 2. intact membranes 3. singleton pregnancy 4. greater than or equal to 18 years of age 5. cervical dilation less than or equal to 4cm exclusion criteria:1. any contraindication to on-going pregnancy 2. placental abruption 3. placenta previa 4. lethal fetal anomalies 5. premature rupture of membranes 6. multiple gestation 7. less than 18 years old 8. known allergy to any component of the study medication or placebo 9. severe maternal medical illness
patient assisted intervention for neuropathy: comparison of treatment in real life situations

Conditions: Cryptogenic Sensory Polyneuropathy

Summary: the purpose of this large comparative effectiveness study led by richard j. barohn, md, of the university of kansas medical center, is to learn about the safety and effectiveness of nortriptyline, duloxetine, pregabalin and mexiletine in treating cryptogenic sensory polyneuropathy (cspn).

the goal of this research project is to find the best drug for the treatment of pain in patients with cspn. while the pharmaceutical industry has focused attention on drugs for treating diabetic sensory neuropathy (dspn), and two drugs are now fda approved, there have not been any prospective trials in cspn. and, because there are no studies with cspn patients, insurance carriers often reject authorizing prescriptions for some drugs for patients with cspn. there are four drugs that will be tested in this study: nortriptyline, duloxetine, pregabalin and mexiletine. these drugs are not approved by the fda for the treatment of cspn and are considered "investigational" in this study. there are two periods in this study: screening/baseline and study drug. during the screening/baseline period the researchers will determine eligibility for potential subjects. during the second period, eligible patients who consented to participate will take the study drug. participants will be randomized to receive one of the four drugs in this study. participants will know which drug they are taking. participants will not be allowed to switch groups and receive a different drug during the study. this study uses an adaptive study design. this means the study can enroll less participants and provide better conclusions. the study design allows the researchers the ability to make changes to the approach of the study or to stop the study early if there are strong results.

Eligibility criteria:
inclusion criteria: * diagnosis of cryptogenic sensory polyneuropathy. * likert pain score of greater than or equal to 4. * must not currently be on nortriptyline, duloxetine, pregabalin or mexiletine or similar class of medication for at least 7 days from baseline study visit. exclusion criteria: * any medical condition or current medication that would prevent them from taking either nortriptyline, duloxetine, pregabalin or mexiletine. * unable to give consent. * unable or not willing to comply with the study. * other causes for polyneuropathy.

Keywords: cspn neuropathy pain pain management
effects of different sports supplements on metabolism and perceptual responses during distance running

Conditions: Anomalies Gastrointestinal

Summary: several previous studies have shown that repeatedly ingesting carbohydrate supplements during exercise training sessions, over a period of days and weeks, can gradually increase carbohydrate oxidation and reduce gut discomfort during exercise. however, repeatedly ingesting large amounts of carbohydrate during training sessions can be burdensome and can cause gut distress. thus, it would be advantageous if the same long-term benefits could be realized from consuming these carbohydrate supplements at rest instead of specifically during training sessions. therefore, the goal of this study is to examine whether repeatedly ingesting a carbohydrate-rich beverage at rest over a 5-day period alters metabolism and gut symptoms while ingesting carbohydrate during exercise.


Eligibility criteria:
inclusion criteria: * be currently running ≥15 miles per week * have completed at least one run \>60 minutes over the past month * have completed one or more marathons within the past year exclusion criteria: * overt cardiovascular disease or metabolic disorder * adverse symptoms (e.g., unusual shortness of breath, dizziness, chest pain) with exercise * allergies/intolerances to any of the ingredients in the beverages
safety & effectiveness of clobex spray, followed by calcitriol ointment in management of plaque psoriasis

Conditions: Psoriasis

Summary: the primary objectives of this study are to evaluate the safety \& efficacy of consecutive treatments of clobex® spray and silkis® ointment in the management of plaque psoriasis.

same as above.

Eligibility criteria:
inclusion criteria: * diagnosis of moderate to severe plaque psoriasis, defined as 3% - 20% treatable body surface area * overall disease severity of at least 3 (moderate) exclusion criteria: * surface area involvement too large (\>20% bsa) * psoriasis involving only the scalp, groin, axillae, and/or other intertriginous areas
study evaluating the benefit of two immunosuppressive strategies on renal function

Conditions: Chronic Kidney Disease

Summary: prospective, multicenter, randomized and open label study evaluating the benefit on renal function at 12 months post-transplantation, with an immunosuppression without calcineurin inhibitor at 3 months and combining mycophenolate sodium-everolimus versus an immunosuppression combining everolimus-tacrolimus, in de novo renal transplant patients.


Eligibility criteria:
inclusion criteria: * patients receiving a first kidney transplant from a cadaveric or living donor exclusion criteria: * double transplant * patient who has been treated with an immunosuppressive drug or study drug during the four weeks before administration of the first dose of everolimus
colorectal resection in emergency general surgery

Conditions: Colorectal Resection

Summary: primary anastomosis is associated with higher rates of perioperative morbidity/mortality and that fecal diversion improves overall mortality, decreases length of stay, and lowers rates of surgical complications requiring unplanned operative intervention.

this is a prospective observational study. all patients undergoing colon resection in the urgent/emergent setting meeting our inclusion/exclusion criteria will be enrolled in the study. data will be collected prospectively and the decision to perform proximal diversion or anastomosis is solely the responsibility of the managing acute care surgeon. no guidelines or protocols will be suggested so as to avoid any influence on practitioner decision-making. the plan is to complete the data collection and analysis by 03/01/2020

Eligibility criteria:
inclusion criteria: * patients undergoing urgent/emergent colon resection (less than 24 hours after decision to operate) by an acute care surgeon exclusion criteria: * elective operations performed by acute care surgeons within 24-hours of the decision to operate (e.g., scheduled resection of non-obstructed, non-perforated malignancy) * prisoners * pregnancy * wards of the state * patients less than 18-years of age * traumatic mechanisms of injury * death within 24-hours of index operation
eletriptan vs sumatriptan: a double-blind, placebo-controlled, multiple migraine attack study

Conditions: Migraine With or Without Aura

Summary: a previously published, placebo-controlled, head-to-head comparator study found eletriptan to have superior efficacy to oral sumatriptan 100 mg in treating a single acute migraine attack. the goal of the current study was to extend the findings of that study by examining the efficacy of eletriptan compared with both 50- and 100-mg doses of sumatriptan; and to evaluate the comparative efficacy of eletriptan and sumatriptan across additional important clinical outcomes. in particular, early response (at 1 hour), sustained response (without need for additional treatment) at 24 hours, and consistency of response across multiple attacks were examined.


Eligibility criteria:
inclusion criteria: * eligible patients were men and women with a minimum age limit of 18 years of age (in canada there was also an age limit of 65 years) who were expected to have at least one attack of migraine with or without aura, as defined by the international headache society (ihs) criteria,15 every 6 weeks. * patients had to be capable of taking study medication as outpatients and recording the effects. exclusion criteria: * pregnant or breast-feeding women and those not using adequate contraception were excluded from the trial. * patients with frequent nonmigrainous headache, atypical migraine that had not previously responded to therapy, migraine with prolonged aura, familial hemiplegic migraine, basilar migraine, or migrainous infarction were excluded from the trial.
assess the efficacy, safety and tolerability of gefitinib (iressa® 250mg) as maintenance therapy in locally advanced or metastatic (stage iiib/iv) non small cell lung cancer (nsclc)

Conditions: Non-small Cell Lung Cancer (NSCLC)

Summary: this is a double blind, multicentre, randomized, placebo-controlled study. the eligible patients will be randomized to receive gefitinib or placebo at 1:1 ratio. this study will recruit 296 male or female, histologically or cytologically diagnosed locally advanced or metastatic nsclc patients with a world health organization (who) performance status (ps) 0-2. patients must have completed 4 cycles of platinum based first line doublet chemotherapy without experiencing disease progression or unacceptable toxicity. the chemotherapy shall be given every 3 weeks, which includes cisplatin or carboplatin, combined with any one of the following: gemcitabine, paclitaxel, docetaxel, vinorelbine.


Eligibility criteria:
inclusion criteria: * histologically or cytologically confirmed locally advanced or metastatic (stage=iiib/iv) non-small cell lung cancer (nsclc) before the front line chemotherapy. note: sputum cytology alone is not acceptable * patients have completed 4 cycles of first line platinum contained doublet chemotherapy without progression or intolerable toxicity. * patients with pr or sd on study entry need to have one or more measurable lesions according to recist criteria. * the study treatment should be started at least 3 weeks (21 days) but no more than 6 weeks (42 days) since last dose of chemotherapy, and within 4 weeks (28 days) since last tumour assessment. exclusion criteria: * prior exposure to monoclonal antibodies or small molecule inhibitors against egfr receptors. (e.g. gefitinib, erlotinib, c225) * patients with previously diagnosed and treated cns metastases or spinal cord compression may be considered if they are clinically stable and have been discontinued from steroid therapy for at least 4 weeks prior to first dose of study medication. * any evidence of clinically active interstitial lung disease (patients with chronic, stable, radiographic changes who are asymptomatic need not be excluded) * known biomarker status of one or more of the following: tumour egfr gene copy number, tumour egfr gene mutation status, tumour egfr protein expression.

Keywords: non-small cell lung cancer (nsclc) gefitinib