Kornimate/medical-research-clean huggingface dataset:
atrial deganglionation as a therapy for cardiac surgery patients with atrial fibrillation

Conditions: Atrial Fibrillation

Summary: a prospective single-arm study of ganglionated plexi ablation in cardiothoracic surgery patients with a history of atrial fibrillation.

this study assesses the use of electroporation/pulsed field ablation (pfa) to selectively ablate ganglionated plexi in cardiothoracic surgery patients with atrial fibrillation. the pfa treatment will be performed in up to 12 patients with a history of paroxysmal atrial fibrillation. the primary end point will be recurrence of atrial fibrillation out to 1 year follow-ups.

Eligibility criteria:
inclusion criteria: * age is between 18 and 70 years. * scheduled for open-chest cardiothoracic surgery, for coronary artery bypass grafting and/or aortic valve repair/replacement * have a documented medical history of paroxysmal or early-stage persistent atrial fibrillation within the previous 12 months. * legally competent and willing to sign the informed consent. * life expectancy of at least 2 years. exclusion criteria: * previous cardiac surgery * prior pericardial interventions * prior endocardial or epicardial pulmonary vein isolation (pvi), or any other invasive af therapy * previous or existing pericarditis * use of amiodarone within the previous 12 months. * long-standing persistent atrial fibrillation * indication for mitral or tricuspid valve surgery * indication for concomitant left atrial appendage (laa) ligation or excision * history of previous radiation therapy on the thorax * history of previous thoracotomy. * prior electrical or mechanical isolation of the left atrial appendage (laa) * the presence of laa occlusion devices, coronary stents, prosthetic heart valves, pacemakers or implantable cardioverter defibrillators (icds) * myocardial infarction within the previous 2 months * new york heart association (nyha) class iv heart failure symptoms * left ventricular ejection fraction (lvef) \< 40%, measured by transthoracic echocardiography (tte) * left atrial diameter \> 5.0 cm, measured by transthoracic echocardiography (tte) * the presence of left atrial thrombus when examined by transesophageal echocardiography (tee) * the presence of atrial fibrillation (af) attributable to non-cardiovascular causes such as thyroid disease, electrolyte imbalance/dehydration or other reversible causes * active infection or sepsis as evidenced by increased white blood cell count, elevated c-reactive protein (crp) or temperature \> 38.5°c * known or documented carotid stenosis \> 80% * stroke or transient ischemic attack within the previous 6 months * known or documented epilepsy * pregnancy or child-bearing potential without adequate contraception * circumstances that prevent follow-ups * drug abuse * patients cannot be enrolled in another clinical study
fluid management in patients undergoing cardiac surgery

Conditions: Critical Illness

Summary: background: currently used crystalloid solutes have a variable composition and may therefore influence acid-base status, intra- and extracellular water content and plasma electrolyte compositions and have a major impact on organ function and outcome. despite continuing evaluation no superiority of one particular type of fluid has been reached so far. to the best of the investigators' knowledge no study in humans has ever assessed whether the type of crystalloid fluid given for fluid resuscitation in patients undergoing cardiac surgery has an impact on hemodynamic stability and cardiac function so far. nonetheless in the animal model it was shown that the choice of crystalloid fluid may greatly influence cardiac performance primary aim: in this study the investigators want to clarify whether a balanced type acetate-buffered fluid solution in patients undergoing cardiac surgery is associated with better hemodynamic stability and cardiac function than a lactate-buffered crystalloid solute.


Eligibility criteria:
inclusion criteria: * elective single heart valve replacement * elective double valve replacement * elective single or double valve replacement and coronary artery bypass grafting exclusion criteria: * patients unable to give informed consent * patients younger than 18 years of age or older than 80 years * pregnancy or breastfeeding * ejection fraction (ef) of less than 30% preoperatively * preexisting renal insufficiency with a glomerular filtration rate below 30ml/min * patients transferred form the intensive care unit to the operating theater * emergency operation * reoperation * patients planned for fast-track surgery * patients planned for minimal extracorporal circuits * preexisting anemia requiring immediate perioperative blood transfusion * chronic inflammatory diseases * any signs of infection or sepsis * limitation of full therapy (e.g. jehowa's witnesses)

Keywords: fluid management critical illness hemodynamics buffered infusates
evaluation of risk factors for gestational diabetes mellitus

Conditions: Diabetes, Gestational; Menstrual Cycle Abnormal

Summary: this study examines the relationship between the age at menarche and gestational diabetes mellitus (gdm). in this retrospective study, the sample included all pregnant women diagnosed with gdm in a pregnancy polyclinic in kocaeli, turkey between 2014 and 2019. the sample included 373 participants: 233 in the gdm group and 140 in the control group. the groups were compared in terms of age at menarche.


Eligibility criteria:
inclusion criteria: * pregnant women with gestational diabetes exclusion criteria: * patients with hypertension and pregestational diabetes mellitus * patients with rheumatologic, nephrological, and hematological diseases * presence of active infection, * corticosteroid use, acetylsalicylic acid, and anticoagulant use

Keywords: menarche gestational diabetes mellitus cycle, menstrual
assessing the utility of cognitive behavioral therapy for pain control in patients with chronic pancreatitis

Conditions: Chronic Pancreatitis

Summary: this study will assess cognitive behavioral therapy as an adjunct to conventional symptom control for patients with chronic pancreatitis.

all patients with chronic pancreatitis will be considered for participation in this study. patients selected for participation will be evaluated 4 weeks prior to the first one-on-one therapy session. a baseline pain score will be assessed using the visual analog pain scale. narcotic dosage and frequency as well as anti-emetic usage will be evaluated at this time. a pre-treatment quality of life score will be recorded using the sf-12® patient questionnaire. patients will also be queried about the presence of nausea and reflux. after the pre-intervention evaluations are complete, patients will be randomized into one of two arms: treatment with cognitive behavioral therapy and narcotics as needed or treatment with conventional narcotic analgesics alone. patients undergoing cbt intervention will participate in eight weekly therapy sessions. follow-up assessments will be conducted six months and nine months after the last therapy session is completed. the patients will be evaluated based on pain score, narcotic dosage and frequency, anti-emetic usage, quality of life assessment, and pain related hospitalizations.

Eligibility criteria:
inclusion criteria: 1. patient must be18 years of age 2. diagnosed with chronic pancreatitis 3. willing and able to comply with the protocol requirements 4. able to comprehend and have signed the informed consent form (icf) to participate in the study exclusion criteria: 1. participating in another clinical trial for the treatment of chronic pancreatitis at the time of screening
an observational retrospective study to evaluate treatment patterns of botulinum toxin type a

Conditions: Facial Rhytides

Summary: this is a retrospective chart review to evaluate treatment patterns of botulinum toxin type a for the treatment of facial lines.


Eligibility criteria:
inclusion criteria: * previously treated for glabellar lines (hyperfunctional facial lines) with botulinum toxin type a preparation * received 2 treatment cycles wtih botulinum toxin type a (botox®) prior to at least 1 treatment with botulinum toxin type a (xeomin®) exclusion criteria: * none
30gy versus 40gy involved-field radiotherapy for localized diffuse large b cell lymphoma achieving cr after chemotherapy

Conditions: Lymphoma, Large B-Cell, Diffuse

Summary: the purpose of this study is to determine whether 30gy involved-field radiotherapy (ifrt) is as effective as 40gy in the treatment of localized diffused large b cell lymphoma (dlbcl) when completing cr after chemotherapy.

the best proper doses of ifrt in combined modality treatments (cmt) for localized dlbcl is still undetermined. existing treatment guidelines recommend 40gy or above as the standard treatment dosage. however, there were large-scaled clinical trials implying smaller doses such as 30gy may be equivalent effective. lowering radiation doses can decrease treatment toxicities and radiotherapy-induced diseases, which has been conformed by hd13 study for hodgkin's lymphoma. it may even retain the truth when modern era radiation techniques are involved and especially in patients achieving cr after chemotherapy. a comprehensive, prospective dose-comparing study is needed.

Eligibility criteria:
inclusion criteria: * biopsy-proved diffuse large b cell lymphoma * nonbulky stage i, nonbulky stage ie, nonbulky stage ii, or nonbulky stage iie disease(bulky disease was defined as a mass 10 cm or more in maximal diameter) according to ann arbor staging * provide written informed consent * complete regression after chemotherapy * considerable to ct simulation and 3d crt or imrt * performance status 0-2 who criteria；life expectation\>6 months * negative for human immunodeficiency virus syndrome (hiv) * minimal staging included chest radiograph, computed tomography of the abdomen and pelvis, and single percutaneous bone marrow biopsy and blood studies exclusion criteria: * primary mediastinal large b cell lymphoma * dermatological lymphoma * testicular lymphoma * primary central nerve system lymphoma * prior rt * history of low-grade lymphoma congestive * history of heart failure (chf; new york heart association \[nyha\] classifications iii-iv), history of neoplasm (adequately treated basal cell carcinoma of the skin or in situ carcinoma of the uterine cervix were allowed), abnormal liver function tests (aminotransferases and alkaline phosphatase \> 2.5 times the upper limit of normal, bilirubin \> 50 ), renal insufficiency (serum creatinine \> 300 ), and patients with any serious medical or psychiatric illness that would prevent informed consent or completion of protocol-prescribed treatment and follow-up

Keywords: b cell cll/lymphoma, human
prehospital prediction of large anterior vessel occlusion

Conditions: Stroke, Acute

Summary: for the clinical benefit of intravenous thrombolysis "ivt" or intra-arterial thrombectomy "iat" time is the most crucial factor. reducing the time between stroke onset en treatment is therefore a major goal. since iat is only suitable for stroke due to large anterior vessel occlusion "lavo" which is only performed in specialized comprehensive stroke centers "csc", triage of lavo-patients in the prehospital phase (i.e. in the ambulance) in order to directly allocate them to such a specialized csc will save vital time (time=brain!). several lavo-prediction scales for clinical triage have been developed but most were tested in- hospital by experienced neurologists. consequently, there is a great need for validation of these scales in the prehospital setting by emergency medical services "ems" personnel. objective: to recalibrate, validate performance and assess feasibility of several existing lavo-prediction scales in the prehospital phase (i.e. assessment by ems personnel). study design: multiregional, multicenter observational cohort study to investigate performance and feasibility of lavo-prediction scales a. study population: all patients potentially eligible for ivtiat according to the protocol used by ems personnel except for when younger than 18 years.

the study will be conducted in two ems regions: hollands midden and haaglanden. in addition, all hospitals in these regions that treat over 30 patients per year with ivt will participate, including at least 1 csc with iat-availability per region. these hospitals are: leiden university medical center "lumc"; alrijne hospital (location leiderdorp); haaglanden medical center (hmc+); haga hospital; langeland hospital (llz) and reinier de graaf hospital (rdgg). the observational design is pragmatic and reflects standard practice for acute stroke care. inclusion: all patients with suspected stroke potentially eligible for ivt/iat as estimated by the on-site ems nurse. a web based application is used that merely structures observations that are currently noted on transport charts. ems personnel will have access to the web-based application via the ipad/tablet/smartphone/computer on which the ems transport chart is already filled out as part of standard care. or via their patient record as used in the ambulance. the application will consist of the following items: * ems transport number * time of symptom onset * probability of lavo estimated by ems nurse * 9-12 questions to structure clinical observations made by the ems nurse. the application will be straightforward and designed in close co-operation with ems personnel. with the items acquired all prediction scales can be reconstructed. data of the application will be retrieved retrospectively and coupled with retrospectively collected data from the participating hospitals by a trusted third party

Eligibility criteria:
inclusion criteria: * acute stroke code activated by ems personnel exclusion criteria: * age \<18 years

Keywords: large vessel occlusion endovascular trombectomy pre-hospital stroke triage
home-based cardiac rehabilitation with spot-jogging

Conditions: Heart Failure; Cardiac Rehabilitation

Summary: the first purpose of this study is to investigate the physiological changes of heart failure patients during cardiopulmonary exercise test with spot jogging and compare them with the standard stationary bike cardiopulmonary exercise test. the second one is to compare the effect between home-based cardiac rehabilitation using different step frequency and toe lift or not to adjust spot jogging intensity and outpatient center-based cardiac rehabilitation for heart failure patients.

this is a pilot, prospective, randomized controlled trial design. we will recruit 40 heart failure patients aged over 18 year-old who have completed stationary bike cardiopulmonary exercise test and was referred to phase ii cardiac rehabilitation. after providing informed consent, participants will be randomly assigned to either the home-based cardiac rehabilitation group or the outpatient center-based cardiac rehabilitation group. all participants will undergo spot jogging cardiopulmonary exercise test and six-minute walking test. the home-based spot jogging cardiac rehabilitation group will receive exercise intensity guidance in the outpatient cardiac rehabilitation room for 30 minutes of spot jogging and treadmill exercise during the first, fourth, and seventh weeks, and will perform spot jogging for 30 minutes twice a week at home. the outpatient center-based cardiac rehabilitation group will perform stationary bike or treadmill exercise for 30 minutes twice a week in the outpatient cardiac rehabilitation room. both groups will achieve their target heart rate or 13 in rating perceived exertion. after 18 exercise sessions, participants will undergo stationary bike exercise test and six-minute walking test again.

Eligibility criteria:
inclusion criteria: * heart failure patients aged over 18 year-old who have completed stationary bike cardiopulmonary exercise test and was referred to phase ii cardiac rehabilitation. exclusion criteria: * atrial fibrillation * other neurological or musculoskeletal issues that affect physical activity. * undergoing dialysis. * having a pacemaker. * unable to cooperate in completing cardiopulmonary exercise testing. * do not agree to participate in the trial.

Keywords: hf cr
tocilizumab (roactemra) and tranexamic acid (cyklokapron) used as adjuncts to chronic subdural hematoma surgery

Conditions: Chronic Subdural Hematoma

Summary: primary objectives of the study are to investigate whether adjuvant treatment in the form of tranexamic acid (cyklokapron) and tocilizumab (roacmera) to surgery in patients with chronic subdural hematomaina can: 1. effectively decrease the rate of lesion recurrence requiring re-operation, 2. effectively shorten the time of lesion resolution. secondary objectives of the study are:1) assess the postoperative functional outcome and quality of life of participants, 2) assess the postoperative mortality of participants, 3) assess the treatment safety data, 4) assess the cure rate of participants.

primary endpoints in the study are: 1) determine postoperative recurrence requiring reoperation using clinical examination and ct imaging, 2) determine the time period necessary to complete healing using clinical examination and ct imaging. secondary endpoints in the study are: 1) to determine the functional outcome and quality of life of the participants using questionnaires, 2) to determine the mortality of the participants related to chronic subdural hematoma, 3) to determine the treatments complications and adverse events of the participants, 4) to determine the curation using clinical examination and ct imaging.

Eligibility criteria:
inclusion criteria: * patients with informed consent, without presenting of any known contraindication for the use of tranexamic acid and tocilizumab. exclusion criteria: * patients or relatives who refused to consent, presenting of any known contraindication for the use of tranexamic acid and tocilizumab.
ngal and its association with the no-reflow phenomenon in st-elevation myocardial infarction

Conditions: No-Reflow Phenomenon; STEMI - ST Elevation Myocardial Infarction

Summary: the aim of this study is to investigate the association between ngal plasma levels in st-elevation myocardial infarction and the no-reflow phenomenon, adverse events during hospitalization and at 30-day follow-up.

neutrophil gelatinase-associated lipocalin (ngal) is a acute phase protein which is elevated in conditions like acute kidney injury and myocardial infarction. when a coronary artery is occluded, detrimental changes occur in myocardial vessels. after relief of the occlusion, blood flow to the heart may still be impeded, a phenomenon known as "no-reflow". data is lacking on factors associated with early detection of patients at risk for this phenomenon, and early stratification of this group seems vital since the no-reflow phenomenon is associated with worse outcomes. the investigators hypothesized that there might be an association between higher ngal levels and the occurrence of no-flow findings, and that ngal might serve as a marker of worse prognosis in this population. the investigators also hypothesized that ngal levels might serve as a marker of early acute kidney injury and that there might be specific patterns of ngal levels over time in different subsets of patients. the aim of the study is to determine the association between ngal levels at admission and during the first days after a st-elevation myocardial infarction, the occurrence of the no-reflow phenomenon, the extent of myocardial damage ascertained by cardiac imaging techniques (echocardiography and cardiac resonance imaging). data regarding patients' clinical, laboratory, electrocardiogram, coronary angiography and percutaneous coronary intervention, in-hospital and 30-day follow-up after discharge will be recorded.

Eligibility criteria:
inclusion criteria: * patients \> 18 years old presenting with st-elevation myocardial infarction and undergoing urgent coronary angiography with or without pci. * signed informed consent to participate in the study. exclusion criteria: * inability to sign written informed consent. * chronic renal failure (egfr \< 30 ml/min/1.73m2).

Keywords: ngal stemi no-reflow pci (percutaneous coronary intervention)
fear conditioning paradigm in obesity

Conditions: Obesity

Summary: fear processing in obesity and specifically the ability to i) learn and remember threatening stimuli, and ii) implicitly (i.e., unconsciously) and explicitly (consciously) discriminate them from neutral ones, will be investigated in affected individuals through the fear-conditioning paradigm.


Eligibility criteria:
inclusion criteria: * right-handed * diagnosis of obesity (the level of body mass index - bmi - higher or equal to 30). exclusion criteria: • concurrent neurological, neurodevelopmental (e.g., autism), motor, somatosensory and/or psychiatric disorders.

Keywords: fear conditioning fear processing anxiety
fit moms in partners, children, and other members

Conditions: Obesity

Summary: the purpose of this ancillary study is to determine whether a behavioral weight loss intervention for postpartum mothers (5r01dk087889-02, pi phelan; co-i tate) has a positive "ripple" effect on weight and health of partners and children/offspring.

lifestyle interventions targeting overweight/obese individuals can produce positive "ripple" effects on untreated overweight partners in the home. interestingly, ripple effects on partners' weight appear most pronounced when the interventions target women. women, and mothers in particular, remain the primary "nutritional gatekeepers" of the home. despite widespread recognition that motherhood is a powerful motivator for behavior changes, no study to date has examined the "ripple" effects of a postpartum internet-based lifestyle intervention that target mothers' weight. the purpose of this ancillary study is to determine whether a behavioral weight loss intervention for postpartum mothers (5r01dk087889-02, pi phelan; co-i tate) has a positive "ripple" effect on weight and health of partners and children/offspring. the proposed study is ancillary to an ongoing clinic-randomized trial examining the efficacy of an innovative multicomponent (online, face-to-face, mobile phone) postpartum behavioral weight loss intervention in 408 low-income women in the women, infants, and children program. the proposed study will determine whether partners of women randomized to the postpartum bwl intervention have greater weight losses and greater improvements in health outcomes than partners of women in standard wic. similar to the parent grant, assessments will occur at study entry, 6 months, and 12 months. this project is highly innovative, as it capitalizes on existing funded research and is the first study to examine ripple effects of multicomponent internet-based intervention in low-income individuals. the project also has high impact, as the postpartum period is a powerful motivator for behavior and environmental changes in the home; and, if positive ripple effects occur, the field of obesity treatment and prevention could move beyond focus on individual level to the often, unrecognized interpersonal effects of lifestyle interventions. public health relevance: this research project will examine whether a postpartum weight-loss intervention has a positive "ripple" effects on weight and health of untreated partners and offspring/children in the home.

Eligibility criteria:
inclusion criteria: * man or woman who self-identifies as sharing an intimate relationship and cohabitating in the home with the postpartum woman (enrolled in the parent grant) for the previous 3 months or recently been married and living in the home * ≥18 years * willing to provide informed consent exclusion criteria: * none