Kornimate/medical-research-clean huggingface dataset:
smartcap stroke study: a field deployable blood test for stroke

Conditions: Stroke

Summary: the hypothesis is that a stroke causes release of purines from brain into blood and that this is a very early biomarker of brain ischaemia. the investigators propose a simple blood test of substances (the purines) that result from cellular metabolism and are produced in excess when brain cells are starved of oxygen and glucose (as occurs during a stroke).

in this study, the investigators propose to use newly developed biosensor technology (smartcap) to directly address whether purines are indicators of real strokes, and can distinguish strokes from other conditions with similar symptoms, more rapidly.

Eligibility criteria:
inclusion criteria: 1. stroke patients: admitted to the hyperacute stroke unit having a suspected stroke within 1 hour of admission. important to note that not all these patients will have suffered a stroke 2. control participants: relatives of patients admitted to the stroke treatment pathway, who are healthy and have no signs of cardiovascular illness 3. healthy volunteers exclusion criteria: 1. stroke patients: delay in admission exceeds the time window of 4 hours between stroke symptoms and admission 2. control participants: obvious signs or history of cerebrovascular disease 3. unhealthy volunteers

Keywords: smartcap
the use of b-type natriuretic peptide (bnp) to predict closure of a patent ductus arteriosus (pda) in premature infants

Conditions: Indomethacin Therapy; Patent Ductus Arteriosus

Summary: a patent ductus arteriosus (pda) is associated with increased morbidity in premature infants. standard indomethacin treatment is associated with intestinal and renal morbidity. b-type natriuretic peptide is elevated in significant pdas. this study will determine whether bnp guided therapy could reduce doses of indomethacin.


Eligibility criteria:
inclusion criteria: * infants with echocardiographically confirmed pda * infants determined by attending physician to require pda closure exclusion criteria: * infants with congenital hearts disease * infants with creatinine value \> 2.0

Keywords: indomethacin therapy patent ductus arteriosus
erector spina plan block in patients with lumbar disc herniation

Conditions: Low Back Pain

Summary: erector spina plan block (espb) is a technique used in surgical interventions, acute and chronic pain. the aim of this study was to investigate the effect of espb and core stabilization exercises on functionality in patients with lumbal disc herniation. espb will be applied to the patients in the study group. stabilization exercises will be applied together with espb treatment. only stabilization exercises will be applied to the patients in the control group. patients will be asked to complete a questionnaire inquiring sociodemographic data (age, height, weight, bmi, smoking and alcohol use), vas and modified oswestry questionnaire at initial presentation and after 8 weeks of exercise (8 weeks 3 days a week).

low back pain is defined as pain in the lower back and/or legs that negatively affects comfort. low back pain lasting less than 6 weeks is defined as acute, 6-12 weeks as subacute, and more than 12 weeks as chronic low back pain. the goals of the exercise program include reducing pain, strengthening weak muscles, stretching tense muscles, reducing mechanical stress on spinal structures, mobilizing hypomobile segments and stabilizing hypermobile segments. erector spina plan block (espb) is a technique used in surgical interventions, acute and chronic pain. the aim of this study was to investigate the effect of espb and core stabilization exercises on functionality in patients with lumbal disc herniation. espb will be applied to the patients in the study group. stabilization exercises will be applied together with espb treatment. the needle will be inserted between the erector spinae muscle and the transverse process structures.the local anesthetic will be monitored to spread along the erector spinae muscle. only stabilization exercises will be applied to the patients in the control group. patients will be asked to complete a questionnaire inquiring sociodemographic data (age, height, weight, bmi, smoking and alcohol use), vas and modified oswestry questionnaire at initial presentation and after 8 weeks of exercise (8 weeks 3 days a week).

Eligibility criteria:
inclusion criteria: * 18-50 years old * patients diagnosed with disc herniation by clinical, physical examination and mr imaging * low back pain for \>6 weeks exclusion criteria: * severe spinal stenosis * diagnosis of pregnancy, infection or malignancy * presence of systemic inflammatory rheumatic disease * having neurological, orthopedic or congenital problems that prevent physical activity * history of spinal surgery

Keywords: low back pain erector spina plane block exercise
pain relief after forefoot surgery

Conditions: Orthopedic Surgery

Summary: the aim to test whether continues local anaesthetic infusion via tibial catheter or wound catheter will improve pain relief following forefoot surgery in this sequential prospective randomised, controlled clinical trial,75 patients undergoing forefoot surgery will be randomized into three groups (tibial, wound, control). all groups will receive ankle block ± general anesthetic (standard technique). the tibial group will have a tibial catheter inserted through which local anaesthetic will be infused. the wound group will have a catheter inserted directly into the wound immediately after surgery. the control group will have a sham catheter (covered by a bandage across foot) attached to a pump which will not infuse. patient maximum pain scores (primary outcome measure), nausea/ vomiting, analgesia use, satisfaction and sleep disturbance will be recorded postoperatively. all groups will be then followed by telephone calls 48 hours. patients will be instructed to come to the clinic on the 4th postoperative day where the catheter will be removed.


Eligibility criteria:
inclusion criteria: * age 18 years or older (asa i \& ii) * able to give written consent * patients having elective forefoot surgery with a planned ankle block. * expected postoperative pain to be at least moderate in severity the day following surgery exclusion criteria: * refusal * inability to communicate * history of alcohol or opioid abuse (also chronic opioid user) * mental or medical conditions which may affect quantifying pain scores (vas)

Keywords: post-operative analgesia opioid catheter tibial nerve block
ehp-5 in preoperative assessment in women with endometriosis

Conditions: Endometriosis; Endometriosis Ovary; Endometriosis-related Pain; Quality of Life; Endometrioma; Endometriosis, Rectum

Summary: there is no validated tool in quality-of-life assessment of women with endometriosis in croatia. first aim is to validate endometriosis health profile-5 (ehp-5) before implementing this questionnaire in clinical practice. after validation, we will prospectively follow women with endometriosis through whole process - pre- and postoperatively.

there is no validated tool in quality-of-life assessment of women with endometriosis in croatia. first aim is to validate endometriosis health profile-5 (ehp-5) before implementing this questionnaire in clinical practice. after validation, we will prospectively follow women with endometriosis through whole process - pre- and postoperatively, including comparison with rasrm and enzian score which are already established in our clinic. we will try to identify correlation between ehp-5 score and surgical findings and to provide better insight in quality of life consideration of women with endometriosis particularly in croatia. since we are tertiary referral centre with almost 250 operative procedures which include ovarian, pelvic and/or extra pelvic endometriosis, we believe that this study will bring new tool not only for preoperative assessment but postoperative surveillance.

Eligibility criteria:
inclusion criteria: * aged between 18 and 50 years; symptoms of endometriosis (pelvic pain, dyspareunia, dysmenorrhea) for at least 6 months or previously verified primary sterility; pathohistological confirmation of diagnosis after surgical treatment or indicated diagnostic laparoscopy; fluent and literate in croatian language; ability to independently understand the questions in the questionnaires exclusion criteria: * pregnant women; cognitive impairment or intellectual disability; neurological disorders (e.g. epilepsy, parkinson disease, multiple sclerosis, cerebrovascular insult); lack of independent mobility and polytraumatic patients; diagnosed vulvodynia and active vulvovaginitis; ongoing urinary tract infection; any form of prior conservative and/or surgical treatment for endometriosis; lack of informed consent

Keywords: endometriosis quality of life
protein-bound uremic retention solutes in long nocturnal hemodialysis

Conditions: End Stage Renal Disease

Summary: although remarkable progress has been made, chronic kidney disease still poses a major burden on both individual patients, as well as on society as a whole. there is a strong inverse relationship between decreasing renal function, as estimated by glomerular filtration rate, and mortality rate, especially death due to cardiovascular disease. the exact cause(s) remain to be elucidated. uremic toxins might play an important role. in the course of decreasing renal function the concentration of numerous intracellular and extracellular compounds vary from the non-uremic state. but still increasing number of uremic retention solutes are being identified. renal replacement strategies aim to remove potentially harmful substances from the body. traditionally much attention has been paid to small water-soluble molecules such as urea nitrogen and creatinine. based on the results of the recent hemo and ademex studies, increases of small water-soluble solute removal above the level reached with modern dialysis techniques - hemodialysis, peritoneal dialysis (hd, pd) - seem not to be advantageous with regard to patient outcome. these findings may point to the importance of other distinct groups of uremic retention solutes. in view of the data described above, protein-bound solutes might be good candidates. several advantages of long duration hemodialysis have been observed, including a better control of blood pressure by decreasing extracellular fluid volume, lowering peripheral vascular resistance and improving endothelium-dependent and -independent vasodilation. a normalization of heart rate variability and improvement of left-ventricular function was noted as well. furthermore, anemia control has been shown to be easier and several nutritional parameters improved in patients treated with long duration hd. the therapy results in higher small water-soluble solute removal, phosphate removal and greater elimination of larger molecules (e.g. β2-microglobulin). it seems an appealing question whether a better control of the serum levels of protein-bound solutes can be achieved by long duration (nocturnal) hemodialysis. this might be another advantage of this therapeutic modality, or may even in part explain the better outcome of patients treated this way. the study compares intermittent hemodialysis with long nocturnal hemodialysis with respect to serum concentrations of several protein bound uremic toxins, as well as solute removal.


Eligibility criteria:
inclusion criteria: * age \> 18 years * maintenance hemodialysis (\> 3 months duration) * informed consent exclusion criteria: * no consent

Keywords: hemodialysis dialysis adequacy chronic kidney disease
deep rtms in central neuropathic pain syndromes

Conditions: Pain; Spinal Cord Injury; Post Stroke Pain

Summary: pain affects up to 30% of the general population. in particular, neuropathic pain (nep) is caused by lesion or desease affecting peripheral or central somatosensory pathways and affects 7% of the adult population. despite the availability of evidence based pharmacological and surgical treatment for nep, about 50% of patients remais symptomatic despite best medical treatment. some neuropathic pain syndromes are specially refractory. in particular, central nep is caused by disease or lesion to central structures involves in somatosensory integration of nociceptive information is non-responsive to drugs usually employed in other nep syndromes. classical neuromodulatory techniques such as conventional repetitive transcranial magnetic stimulation aiming at the motor of prefrontal cortices are ineffective to relieve pain in this population. recently new technology advances have made possible non-invasive stimulation of deeper cortical targets. some of them are activelly involved in the integration of the perception of pain, such as the anterior cingulate cortex or the posterior insula. the aim this study is to treat 90 patients with central pain (post stroke pain, spinal cord lesions after trauma or demyelinizating diseases) under best medical pharmacological treatment in three different conditions: aac (n= 30 with the h-coil), superior posterior insula (spi) n=30 cooled double cone coil double cool coil, and sham(n=30). each patients will undergo daily stimulation for a week, then weekly stimulations for 3 months (total of 17 sessions). the main study outcome is pain relief at the last stimulation week (visual-analogic scale). secondary end-points are changes in the mcgill pain questionnaire, neuropathic pain symptom inventory, dn4 questionnaire, sf -36, brief pain inventory and cognitive assessment including the trail making test a and b, strrop color interference test, and subscalles from the cerad. all patients will undergo quantitative sensory test and measurements of cortical excitability over m1 before and after to treatment.


Eligibility criteria:
inclusion criteria: * signed term of informed consent * central pain exclusion criteria: * trauma of skull, epilepsy don't treated, * use of medications decrease the seizure threshold * patients in use of drugs, how cocaine and alcohol * neurosurgical clips, pacemakers, increased intracranial pressure (risk of sequelae after seizure) * pregnant or lacting women

Keywords: deep repetitive transcranial magnetic stimulation chronic pain assessment neuropathic pain central pain treatment
prediction of acute pancreatitis outcome

Conditions: Acute; Pancreatitis

Summary: aim of study prediction of acute pancreatitis outcome by using cheap and available laboratory resources

acute pancreatitis (ap) is a sudden inflammation of the pancreas that can vary from mild, self-resolving episodes to severe, potentially fatal conditions(1). clinically, ap is classified into mild acute pancreatitis and severe acute pancreatitis (sap), and sap patients are described by multi-organ failure and high mortality rates(2). the mortality rate of acute pancreatitis varies, ranging from 3% in cases of mild edematous pancreatitis to as high as 20% in patients with pancreatic necrosis(3).the progression of ap can lead to systemic complications, making early prediction of clinical outcomes essential for effective management(4). in recent years, there has been growing interest in identifying reliable biomarkers that can predict the severity and outcomes of acute pancreatitis(5). systemic inflammation is a key factor in the pathophysiology of acute pancreatitis, often leading to systemic inflammatory response syndrome (sirs) and subsequent organ dysfunction(6). consequently, assessing systemic inflammation has become a crucial aspect of managing ap patients(7). the systemic inflammation response index (siri) is recognized in the literature as an inflammatory marker that combines routine blood parameters, such as neutrophils, monocytes, and lymphocytes(8). both siri and the systemic immune inflammation index (sii) are emerging as novel biomarkers for systemic inflammation(9). siri is calculated using neutrophil, monocyte, and lymphocyte counts, while sii is based on platelet, neutrophil, and lymphocyte counts(10)

Eligibility criteria:
inclusion criteria: patients age \>18 years old serum amylase \>3 times the upper limit of normal. abdominal pain consistent with acute pancreatitis. typical abdominal ultrasonography and tomography findings in the routine imaging of the patients were accepted as acute pancreatitis. patient complaint of abdominal pain - exclusion criteria: liver diseases patients renal diseases patients malignancy patients -

Keywords: acute pancreatitis outcome
intravenous immunoglobulin (ivig) for treatment of unexplained secondary recurrent miscarriage

Conditions: Miscarriage, Recurrent; Abortion, Habitual

Summary: recurrent miscarriage is a prevalent reproductive problem that affects many couples who are trying to establish a family. this clinical study will evaluate the effectiveness of intravenous immunoglobulin (ivig) in improving the live birth rate in couples who suffer from secondary recurrent miscarriage. this study will help in providing an answer to the question of whether ivig is helpful in secondary recurrent miscarriage.

the purpose of this multi-center trial is to evaluate the efficacy of ivig in improving the ongoing pregnancy (\>20 weeks of gestation) rate in couples with unexplained secondary recurrent miscarriage, and; to characterize and compare pharmacokinetic and pharmacodynamic parameters for ivig pre-conceptually and in the 1st and 2nd trimesters of pregnancy, so that an improved ivig dosing strategy can be determined.

Eligibility criteria:
inclusion criteria: * couple has a history of unexplained secondary recurrent miscarriage. * most recent pregnancy occurred within one year of discontinuing contraception. exclusion criteria: * maternal iga deficiency * maternal history of immunoglobulin hypersensitivity. * maternal contraindication to pregnancy. * evidence of active hepatitis or immunocompromised state in either partner. * concomitant use of medication(s) for treatment of recurrent miscarriage, such as but not limited to progesterone, clomiphene citrate, acetylsalicylic acid, heparin, glucocorticoids or hcg injections.

Keywords: recurrent miscarriage recurrent spontaneous abortion habitual abortion ivig randomized controlled trial
effect of vitamin d supplementation on inflammatory markers

Conditions: Vitamin D Deficiency; Type2 Diabetes

Summary: previous studies have shown that improving vitamin d status among the elderly may lead to an improvement in some inflammatory markers, especially with patients with type 2 diabetes. the aim of our trial is study the effect of vitamin d supplementation on inflammatory markers in patients having type 2 diabetes.

vitamin d was shown crucial for insulin secretion and glucose homeostasis. furthermore, one of the markers of type 2 diabetes is low-grade inflammation, which can be the result of an elevated circulation of cytokines. high amounts of circulating inflammatory cytokines such as tumor necrosis factor-alpha (tnf-α) and interleukin-6 (il-6) contribute significantly to insulin resistance in muscle and adipose tissues. the aim of this randomized, controlled, double blind study is to examine the effect of vitamin d supplementation on some inflammatory markers in older lebanese patients having type 2 diabetes.

Eligibility criteria:
inclusion criteria: * subjects deficient in vitamin d * subjects having type 2 diabetes * non-obese subjects exclusion criteria: * subjects having hyperparathyroidism * subjects suffering from hepatic disease / kidney disease

Keywords: vitamin d, type 2 diabetes, inflammation
strong hearts: a remote, app-enabled, exercise program for patients with congenital heart disease (strong hearts app)

Conditions: Congenital Heart Disease

Summary: the overall goal of this program is to create a remote, mobile application enabled exercise program for patients with congenital heart disease (chd). pilot trials will consist of a remote exercise program with app-embedded exercise modules designed to promote and encourage safe and healthy exercise habits across a range of chd anatomies. this app-enabled program will allow for real time data collection integrating wearable devices, as well as compliance and safety monitoring to enhance research capabilities. the app-enabled program will be versatile and may be applied in the future to patients with non-cardiac conditions.


Eligibility criteria:
inclusion criteria: * repaired or unrepaired congenital heart disease (chd) * between ages 10 and 50, inclusive, at time of consent * android or apple smartphone that meets the operating systems below with the ability to download applications from either google play or the apple store * android: 6.0 or higher * apple: iphone operating system (ios) 13 or higher exclusion criteria: * physical or mental disabilities preventing exercise participation * uncontrolled systemic hypertension (symptomatic or greater than stage 2 hypertension while on therapy) * poorly controlled arrhythmia * clinically unstable heart failure * known pregnancy at the time of enrollment

Keywords: child adult
cerament treatment of fracture defects

Conditions: AO 41-B2 and AO 41-B3 Tibia Fractures

Summary: the aim of the study is to compare fracture healing, quality of life, pain, and cost of care of the use of cerament™\|bone void filler as bone graft substitute to the use of autologous cancellous bone graft (iliac crest) in the treatment of patients with tibia fractures treated by internal fixation and void reconstruction.


Eligibility criteria:
inclusion criteria: * patients with traumatic, closed, depression fracture of the proximal tibia (limited to ao type b2 \& b3) * solitary trauma * candidate for bone grafting * patients between the age of 18 and 65 years * written informed consent obtained before any study-related activities * patients with communicative ability to understand the procedure and participate in the study and comply with the follow up program exclusion criteria: * patients with multiple injuries * polytrauma patients * compartment syndrome * previous iliac crest bone graft harvesting * local infection at the site of implantation * chronic pain disease * malignancy * rheumatoid arthritis * chronic cortisone intake * x-ray diagnostics not available, fracture cannot be classified * clinically significant or unstable medical or surgical condition that may preclude safe and complete study participation * a pre-existing calcium metabolism disorder (e.g. hypercalcemia) * known hyperthyroidism or autonomous thyroid adenoma * history of serious reaction to iodine based radio contrast agents * women who are pregnant or breastfeeding * irreversible coagulopathy or bleeding disorder * history of physical or psychological condition that contraindicates the use of an investigational device or render the patient at high risk from treatment complications * history of hypersensitivity to the investigational device or any of its ingredients * participation in other clinical trials during the present clinical trial or within the last 1 month

Keywords: tibia fracture bone graft iliac crest bone graft substitute cerament void filler quality of life pain costs of care