Kornimate/medical-research-clean huggingface dataset:
preoperative focused cardiac ultrasound in hip fracture surgery (precho)

Conditions: Echocardiography; Hip Fractures; Risk Assessment; Anesthesia; Hemodynamic Instability

Summary: the primary objective of this study is to investigate the impact of preoperative focused transthoracic ultrasound (focus) on intraoperative hypotension and postoperative complications in hip fracture surgery. our hypothesis is that a preoperative focus along with a hemodynamic optimization protocol will reduce the occurrence of intraoperative drops in blood pressure and post-operative complications.

hip fracture surgery is a common procedure, and despite progress in perioperative management, cardiac complications are common, and the post-operative mortality remains high. in this geriatric patient population, cardiac disease as well as varying degrees of dehydration is common, and preoperative knowledge of these conditions have a key role in enabling a proactive perioperative hemodynamic management. however, clinical assessment is surprisingly unreliable and has been shown to easily fail to identify significant cardiac disease and lack of venous return. transthoracic echocardiography (tte) is a well-established and non-invasive investigation that can identify cardiac disease and aberrations in volume status prior to surgery. in a preoperative practice, the use of focused cardiac ultrasound (focus) enables an individualized anesthesia management and has been demonstrated to influence anesthesiologist decision making. furthermore, measurements of inferior vena cava used as a surrogate for venous return have been shown to be a predictor of intraoperative hypotension. patients scheduled for daytime hip fracture surgery will be screened for eligibility. random allocation (1:1 allocation ratio) of patients to receive standard care (control group) or standard care + preoperative focused cardiac ultrasound with a preoperative hemodynamic optimization (intervention group). registration of pre- and intraoperative blood pressure, as well as post-operative complications and mortality will be conducted. primary outcome measure: intraoperative hemodynamic instability defined as map \< 60 mmhg.secondary outcome measures: time to surgery, length of hospital stay, renal failure, cardiac complications (myocardial ischemia, heart failure, post-operative atrial fibrillation, pulmonary edema, pulmonary embolism), 7-,30- and 90-day mortality.

Eligibility criteria:
inclusion criteria: * patients ≥ 65 years of age, with american socieity of anesthesiologists (asa) physical status classification 2-4, that are scheduled for acute hip fracture surgery (icd-codes s72.0, s72.00, s72.01, s72.1, s72.2) exclusion criteria: * metastatic cancer and/or suspect pathological fracture. * concurrent other fracture/surgery. * reoperation within 72 hours from primary operation. * severe dementia. * preoperative echocardiography for other reason than participation in the study.

Keywords: focus point-of-care echocardiography
effect of selected types of breathing exercises on different outcome measures in covid-19 patients

Conditions: COVID-19

Summary: coronavirus disease 2019 (covid-19) infection leads to significant respiratory that have negative impact on function and quality of life (qol). breathing exercises are effective and important in patients with covid-19.

coronavirus disease 2019 (covid-19) infection leads to significant respiratory symptoms that have negative impact on function and quality of life (qol). breathing exercises are effective and important in patients with covid-19. this study aimed to evaluate the effect of buteyko breathing versus bhastrika pranayama on different outcome measures in covid-19 patients. sixty patients of both genders with age range from 40-50 years old were recruited from el khankah centeral hospital with positive nasopharyngeal swab samples and presence of ground-glass opacification in their chest computed tomography scan (ct-scan). patients were assigned randomly into two groups a \& b and took their medications. group a received traditional physical therapy program (mobility exercises and postural drainage) with bhastrika pranayama breathing exercise. group b received traditional physical therapy program with buteyko breathing exercise. patients were assessed by modified borg dyspnea scale (mbs), blood samples (levels of crp and d-dimer), six-minute walk test (6mwt), pittsburgh sleep quality index (psqi), 36-item short-form health survey (sf-36) questionnaire.

Eligibility criteria:
inclusion criteria: * their age ranged from 40 to 50years old. * with confirmed covid-19 by positive nasopharyngeal swab samples and presence of ground-glass opacification in their chest computed tomography scan (ct-scan). * moderate hospitalized covid-19 patient. * full consciousness and oriented. * bmi 20-25 kg/m2. exclusion criteria: * presence of any type of musculoskeletal disorder prohibits the patient from participating in the study * history of chronic diseases as (diabetes, hypertension and heart diseases) * any type of obvious clinically mental or cognitive impairment. * history of previous other respiratory disease.
rescue fecal microbiota transplantation for national refractory intestinal infections

Conditions: Intestinal Infection; Clostridioides Difficile Infection; Antibiotic-associated Diarrhea

Summary: a national data registry of patients receiving the rescue fecal microbiota transplantation for the refractory intestinal infections from the china microbiota transplantation system was designed to assess the short-term and long-term safety and efficacy.

this registry will enroll national patients with refractory intestinal infections (including clostridioides difficile infection, other infections with known or unknown pathogens) receiving rescue fecal microbiota transplantation (fmt) from the the china microbiota transplantation system. the improved methodology of fmt based on the automatic washing process and the related delivering consideration was named as washed microbiota transplantation (wmt) by the consensus statement from the fmt-standardization study group in 2019.12. data of demographic characteristics, symptoms of intestinal infections, previous medicine treatment and clinical outcomes will be collected retrospectively abstracted from the electronic medical records or prospective follow-up. all the patients will be followed up for at least 12 weeks post-fmt. information on follow-up will be designed to assess the short-term and long-term adverse events.

Eligibility criteria:
inclusion criteria: national patients with refractory intestinal infections receiving rescue fmt from the china microbiota transplantation system from september 2015 to december, 2029 will be included. - exclusion criteria: patients will be excluded from the analysis if they are not followed up for at least 12 weeks post-fmt. -

Keywords: fecal microbiota transplantation intestinal infection clostridioides difficile infection antibiotic-associated diarrhea washed microbiota transplantation
maintenance rtms for treatment-resistant depression (trd): a one-year double blind controlled study

Conditions: Major Depressive Disorder

Summary: number of center : 1 * duration of study : 24 months * recruitement time : 23 months * aim :principal evaluate the interest of maintenance rtms in a one-year double blind randomized controlled study for trd patients. secondary evaluate the impact of rtms on cognitive functions.

the study involves 40 trd patients in a single site trial which consisted of two phases: an acute phase (phase i) in which all the participants receive active high-frequency stimulation during 4 blocks of five consecutive working days (monday to friday) in an open-label design and a maintenance phase (phase ii) in which responders (\> 49% hdrs-17 reduction from baseline) at the end of the phase i are randomized in two arms with sham or active high-frequency rtms maintenance treatment for the eleven following months. the rhythm of rtms sessions in this maintenance phase is gradually reduced as follows: 3 sessions per week for 2 weeks, 2 session per week for the 2 following weeks, 1 session per week the third (m3) and fourth month (m4) and then 1 session every fortnight the last eight months (m5 to m12).

Eligibility criteria:
inclusion criteria: * trd stage i thase-rush * hdrs + or = 18 * patients age 18 to 70 years. * negative pregnancy test and contraception for women. * informed consent exclusion criteria: * patient was treated with mood stabilizer in the previous week * other disorder on axis i of the dsm iv than depressive disorder. * patient with an addiction problem other than tobacco and caféine * antécedent of epilepsy ,other neurological pathology and intra cranial metal diapositive or pacemaker * previous history of head trauma the previous two years. * intracranial hypertension. * not affiliated to the social security patient * patient under constraint hospitalisation * under legal protection measure

Keywords: depression repetitive transcranial magnetic stimulation tolerability efficiency tms refractory
feasibility study of unfractionated heparin in acute chest syndrome

Conditions: Acute Chest Syndrome; Sickle Cell Disease

Summary: the purpose of this study is to determine the feasibility of performing a larger multicenter phase iii trial to assess the effects of unfractionated heparin (ufh) in acute chest syndrome (acs). prespecified feasibility criteria consists of the ability to enroll potential study participants, which includes the timely notification of hospitalized patients with acs, the capacity to consent eligible individuals, and the ability to appropriately randomize eligible patients within 24 hours of diagnosis. additional feasibility objectives involve ensuring appropriate eligibility criteria, proper administration of the study drug, and the ability to completely and accurately collect clinical data of interest. the final aim of our pilot study is to provide preliminary data, with respect to treatment effect and variance, to allow sample size calculation in a larger trial given the lack of data available to help guide this process. the investigators hypothesize that the use of ufh in acs will result in a decrease in the duration of hospitalization and improve other clinical outcomes, such as the duration of hypoxemia and duration of moderate to severe pain.


Eligibility criteria:
inclusion criteria: * diagnosis of acs defined as a new pulmonary infiltrate involving at least one segment of the lung on a chest x-ray or chest ct scan with 2 or more of the following: chest pain, tachypnea, dyspnea, cough, hypoxemia, or body temperature greater than or equal to 38.0 degrees celsius * hemoglobin electrophoresis confirming hbss, sc, or b0 (historical records sufficient) * age greater than or equal to 18 exclusion criteria: * any absolute contraindication to heparin * platelet count less than 50 per microliter (current admission) * historical diagnosis of moyamoya disease as documented in medical records * historical diagnosis of proliferative retinopathy as documented in medical records * current participation in a chronic exchange transfusion program * underlying hypercoagulable disorder other than sickle cell disease * currently receiving therappeutic anticoagulation * currently receiving antiplatelet agents * currently receiving estrogen containing oral contraceptives * chest ct scan documented pe performed as standard of care prior to study enrollment (current admission)

Keywords: sickle cell disease acute chest syndrome hemoglobinopathy hemolytic anemia heparin anticoagulant
to investigate the effect of 2019 novel coronavirus infection on the condition of patients with hyperthyroidism

Conditions: Graves Disease; COVID-19

Summary: the goal of this observational study is to learn about the correlation between covid-19 and hyperthyroidism in patients with hyperthyroidism complicated with covid-19. the main questions it aims to answer are： * the main research object is graves disease (gd) patients. * changes of hyperthyroidism in gd patients complicated with covid-19 * changes of anxiety and depression in gd patients before and after sars-cov-2 infection. * the effect of psychological intervention in gd patients after covid-19. participants will have regular follow-upfor one year to hyperthyroidism in our hospital, and the investigators will collect the thyroid function and related examination indexes of patients in the corresponding time period.

longitudinal analysis of gd status was performed: three follow-up time points were identified: before covid-19, three months and one year after recovering from covid-19 (the first follow-up visit, the second follow-up visit. main collection items: hyperthyroidism symptoms, signs, hyperthyroidism complications, psychological evaluation results, other complications，blood routine, liver and kidney function, thyroid function (ft3, ft4, tsh), thyroid-related antibodies, glucose and lipid metabolism (fbg, hba1c, tc, tg, hdl-c, ldl-c), thyroid ultrasound and hyperthyroidism medication.through this to understand the changes of hyperthyroidism in ht patients complicated with covid-19 and the changes of anxiety and depression in hyperthyroidism patients before and after sars-cov-2 infection.and the effect of psychological intervention in gd patients after covid-19.

Eligibility criteria:
inclusion criteria: 1. according to the diagnostic criteria of hyperthyroidism in the chinese guidelines for the diagnosis and treatment of thyroid diseases formulated by the chinese society of endocrinology of the chinese medical association, the patient had been diagnosed with hyperthyroidism. 2. in accordance with the diagnostic criteria of "the diagnosis and treatment protocol for novel coronavirus infection (trial version 10). exclusion criteria: 1. cases with incomplete data 2. patients with severe autoimmune diseases, hematological diseases and malignant tumors 3. immunodeficiency (e.g.aids, long-term use of corticosteroids or other immunosuppressive drugs leading to immunodeficiency) 4. follow-up was less than 30 days 5. the results of thyroid function were less than 3 times
pbc induced fatigue treated with thiamine

Conditions: Primary Biliary Cirrhosis

Summary: primary biliary cholangitis (pbc) is a chronic autoimmune liver disease characterised by destruction of the intrahepatic bile ducts leading to liver inflammation and fibrosis, and ultimately liver cirrhosis and end-stage liver disease. more than 50% of patients with pbc suffer from chronic fatigue, and approximately 20% suffer from severe fatigue with negative impact on their quality of life. although fatigue is a large problem in patients with pbc, no effective treatments are available. a danish intervention study have shown that high dose oral thiamine (vitamin b1) were effective in treating chronic fatigue in patients with inflammatory bowel disease. in this study, only few and minor adverse events to thiamine treatment were observed. although the precise mechanism of work remains unknown, the investigators see no reason that this cannot be transferred topatients with pbc. hence, the investigators aim to conduct a study investigating the use of oral thiamine in chronic fatigued patients with pbc. the study will be conducted as a double-blinded, placebo-controlled, randomised, crossover trial including 36 patients with pbc and with a higher fatigue level than in the general population for more than six months. the patients will be randomised into one of two 3x4 weeks setups; 1) thiamine for four weeks followed by four weeks washout and finally four weeks of placebo or 2) placebo for four weeks followed by four weeks washout and finally four weeks of thiamine. the primary endpoint is to investigate the fatigue-level before and after treatment with thiamine and placebo using every patient as their own control. fatigue-level will be measured using international validated questionnaires. the doses of thiamine are calculated based on the patient gender and weight. all patients will be included in the outpatient clinic at the department of hepatology and gastroenterology at aarhus university hospital.


Eligibility criteria:
inclusion criteria: * pbc for more than 3 months * pbc-40 fatigue score \>32 * fatigued for at least 6 months exclusion criteria: * comorbidity that can explain fatigue * non-compliant patients * pregnancy * expected surgical interventions during the study period * chronic kidney disease (egfr\<60)
efficacy of second forward-view examination of left colon for adenoma detection during colonoscopy

Conditions: Colon Adenoma

Summary: the incidence of colorectal cancer in china is increasing year by year. studies have shown that colorectal cancer is more common in the left colon，especially in the china. our previous study also showed a higher rate of missed adenoma in the left colon than the right colon during colonoscopy. additionally, prolonging withdrawal time could only improve the adr of right colon, but had limited effect on the adr of left colon in our previous research. our aim is to evaluate the effect of a second forward view examination of the left colon on the detection of adenoma detection during colonoscopy.


Eligibility criteria:
inclusion criteria: * patients whose age are between 40-75, or aged 76-85 depending on his condition * patients who have indications for screening * patients who have signed inform consent form. exclusion criteria: * patients who have undergone colonic resection * patients with alarming signs and symptoms of colorectal cancer: hematochezia, melena, anemia, weight loss, abdominal mass, positive digital rectal examination * patients with abnormal blood coagulation or taking antiplatelets or anticoagulants within 7 days before colonoscopy * patients with inflammatory bowel diseases * patients with a history of abdominal surgery, or highly suspected or confirmed colorectal cancers by radiographic and laboratory tests patients with hereditary colorectal cancer syndrome (including familial adenomatous polyposis). * patients with pregnancy, severe chronic cardiopulmonary and renal disease. * patients with failed cecal intubation * patients with poor bpq that necessitated a second bowel preparation * patients with therapeutic colonoscopy for existing lesions * patients refusing to participate or to provide informed consent

Keywords: adenoma detection rate colonoscopy
a long-term study on safety of jns001 in adults with attention-deficit hyperactivity disorder

Conditions: Attention-Deficit / Hyperactivity Disorder

Summary: the main purpose of this study is to evaluate long-term safety and tolerability of jns001 at 18 to 72 mg per day in adults with attention-deficit/hyperactivity disorder (adhd).

this is a multicenter, open-label (all people involved know the identity of the intervention), dose-titration (to adjust the dose of a drug until optimal result is reached), long-term safety study in adult patients with a diagnosis of adhd. the study consists of the long-term phase (4-week titration period and 44-week maintenance period) and the 1-week post-study phase. the 4 week-titration period is to find the individualized dose for each patient regardless of the treatments in the preceding study (jns001-jpn-a01). patients will be titrated from a starting dose of 18 mg/day for 7 days, and continue with a weekly (+/- 2 days) increment of 9 or 18 mg until an individualized dose is achieved. the titration period will be followed by a 44-week maintenance period which has combined 48-week (1-year) treatment duration with the titration period. during the maintenance period, the dose will be adjusted between 18 to 72 mg depending on the patients' symptoms. in the post-study phase, safety information will be collected after the last dose of the study treatment or premature discontinuation. the study drug will be administered with water once daily in the morning at doses of 18 mg, 27 mg, 36 mg, 45 mg, 54 mg, 63 mg, or 72 mg per day. the study treatment period is 48 weeks (titration period of 4 weeks and maintenance period of 44 weeks).

Eligibility criteria:
inclusion criteria: * patients (and their legally-acceptable representative if patients are 18 or 19 years old) must have signed an informed consent form (icf) indicating that they understand the purpose of and procedures required for the study and are willing to participate in the study * patients who completed the preceding study (jns001-jpn-a01), are considered to be appropriate to continue jns001 treatment into this extension study by investigator or subinvestigator * women of childbearing potential must have a negative urine pregnancy test at the final assessment in the preceding study. if sexually active, continue to use an effective method of birth control throughout the study * men must agree to use a double-barrier method of birth control and not donate sperm during the study and for 90 days after receiving the last dose of study drug. exclusion criteria: * patients who have reported aes which would prevent transfer to this study from the preceding study (jns001-jpn-a01) * patients who had been judged ineligible as patients for this study by investigator or subinvestigator

Keywords: methylphenidate hydrochloride concerta adults attention-deficit / hyperactivity disorder adhd long term safety
cteph identification an standard computerised tomography pulmonary angiography in pulmonary embolism patients

Conditions: CTEPH; Pulmonary Embolism; Early Diagnosis

Summary: in this study the investigators will evaluate whether more careful reading (than the current standard) of routine computerised tomography pulmonary angiography (ctpa) performed in the clinical work-up of suspected (pulmonary embolism (pe) will differentiate patients with acute pe from those with more chronic or acute on chronic pe, which could be indicative of the presence of chronic thromboembolic pulmonary hypertension (cteph)"

the investigators will study 50 consecutive patients diagnosed with cteph as well as 50 patients diagnosed with acute pe in whom cteph was ruled out 2 years after the pe diagnosis by sequential echocardiography. the cases and controls will be matched based on the right-to-left ventrilcle diameter ratio. three experienced thorax radiologists with specific expertise on acute pe and cteph will blindly assess the index ctpas of the study population. in addition to the binominal judgement whether cteph signs are already present (or not), the presence of the following items will be scored by all 3 readers independently: * webs or bands * residual thrombus attached to the vascular wall * complete occlusion /retraction * mosaic perfusion * pulmonary infarct * parenchymal bands * bronchial arteries * right atrial (ra) dilatation * right ventricle (rv) dilatation * flattening of the septum * right ventricle (rv) hypertrophy * dilated truncus pulmonalis * cardiac signs of pulmonary hypertension (ph) * further remarks (free text)

Eligibility criteria:
inclusion criteria: * patients after an acute pe diagnosed with cteph according to current guidelines, patients after an acute pe in whom cteph is excluded by follow-up echocardiography * availability of the ctpa scan of the initial pe episode exclusion criteria: * cteph diagnosis based on other test results than a rhc * patients who did not receive anticoagulation after pe diagnosis * patients under the age of 18 years old * patients in the control group with a follow-up duration of less than 2 years after the index pe episode * use of a ctpa scanner with less than 32-detector rows