Kornimate/medical-research-clean huggingface dataset:
pre-operative exposure to sglt2 inhibitors and post-operative acute renal failure in cardiac surgery: a retrospective monocentric cohort study

Conditions: Acute Kidney Injury; Cardiac; Surgery

Summary: cardiac surgery with cardiopulmonary bypass exposes patients to the risk of post-operative acute kidney injury. in the specific setting of cardiac surgery, acute kidney injury is often of multifactorial origindue to particular haemodynamic mechanisms, renal hypoxia, or damage linked in the inflammatory reaction or haemolysis (1). in recent years, inhibitors of the sodium/glucose co-transporter type 2 (sglt2i) have demonstrated their relevance in reducing the morbidity and mortality associated with chronic or acute heart failure and chronic kidney disease. these drugs were initially developed to optimise glycaemic control in diabetic patients. they are currently recommended as part of the management of diabetic patients at high cardiovascular risk, patients with systolic and/or diastolic heart failure, and patients with chronic kidney disease. some pharmacodynamic properties of sglt2i suggest that they could have a beneficial effect in preventing the onset of acute kidney injury, but also that they could lead to potentially deleterious effects in renal haemodynamic in specific situations. the aim of the study was to estimate the impact of pre-operative exposure to sglt2i on the occurrence of post-operative acute kidney injury in high-risk renal patients undergoing cardiac surgery.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years * cardiac surgery with cardiopulmonary bypass * presenting a simplified renal risk score ≥ 2 points defined as follows: * pre-operative glomerular filtration rate (≤ 60; ≤ 30 ml/min/1.73m2): 1-2 points * diabetes requiring treatment: 1 point * lvef ≤ 40%: 1 point * previous cardiac surgery: 1 point * pre-operative intra-aortic counter pulsation: 1 point * non elective surgery: 1 point * surgery other than closure of an atrial septal defect or coronary bypass surgery: 1 point exclusion criteria: * haemodialysis prior to surgery * acute kidney injury prior to surgery as defined in the primary endpoint. if this criterion is not available, patients will only be included if glomerular filtration rate estimated by the ckd-epi formula is ≥75 ml/min/1.73m2. * death in the operating theatre * opposition of the patient to the use of his/her health data

Keywords: acute kidney injury cardiac surgery sodium/glucose cotransporter inhibitor 2
bile leakage test in emergency hydatid liver cyst surgery case report

Conditions: Surgery--Complications

Summary: in liver cyst hydatid surgery, presence of cysto-biliary communication (cbc) is important for the prevention of postoperative morbidity. if cysto-biliary connections are not obvious, diagnosis is not easy. intraoperative bile leakage test has been shown to reduce postoperative biliary complications by revealing occult cbcs. however, bile leakage testing in emergency conditions such as hydatid cyst perforation has not been experienced so far.

in liver cyst hydatid surgery, presence of cysto-biliary communication (cbc) is important for the prevention of postoperative morbidity. if cysto-biliary connections are not obvious, diagnosis is not easy. intraoperative bile leakage test has been shown to reduce postoperative biliary complications by revealing occult cbcs. however, bile leakage testing in emergency conditions such as hydatid cyst perforation has not been experienced so far. here, a bile leakage test performed in a 23-year-old male patient undergoing emergency surgery due to the perforation of the hydatid liver cyst was presented. following the treatment of perforated hydatid liver cyst and biliary peritonitis, a bile leakage test was performed. the common bile duct was cannulated with a 22 gauge catheter, normal saline and parenteral lipid solution were given to demonstrate the cbcs, and leakage areas were suture ligated. the patient was discharged postoperatively without any problem. the investigators recommend detection and treatment of the cbcs even in emergency hydatid liver cyst surgery for prevention of postoperative biliary complications.

Eligibility criteria:
inclusion criteria: * this study is a case report exclusion criteria: * this study is a case report

Keywords: hydatidosis complications intra-biliary rupture biliary duct echinococcus echinococcosis
the effect of subcutaneous injection of botulinum toxin a on chronic wound pain in lower extremities

Conditions: Chronic Pain; Lower Extremity Wound

Summary: the aim of the study is to investigate the effect of subcutaneous administration of botulinum toxin a on wound pain, wound healing and safety of treatment.


Eligibility criteria:
inclusion criteria: 1. age ≥ 18 years old. 2. lower extremity ulcer ≥ 4 weeks. 3. ulcer area ≥ 1,5 cm2 and ≤ 20 cm2 4. patients with neuropathic pain related to the ulcer (daily vas pain scores ≥ 30 mm at rest and dn4 score ≥ 4). 5. normal monofilament and vibration test in lower extremities. 6. patients who can fill out pain diary correctly. 7. written informed consent to participate in the study after having fully understood the contents of the protocol and restrictions. exclusion criteria: 1. infection at injection site. 2. hypersensitivity to botulinum toxin a. 3. peripheral neuropathy. 3. diabetic foot ulcer. 4. unstable critic peripheral ischemia judged by investigator 5. exposed capsule, tendon, muscle or bone in the ulcers. 6. tunnelling, undermining or sinus tracts. 7. disorders of the neuromuscular junction (e.g. myasthenia). 8. topical analgesic (e.g biatain ibu or lidocain) within 7 days before inclusion. 9. pregnant or lactating woman and woman with childbearing potential but does not use contraception. 10. judgment by the investigator that the patient is not suited for study participation.

Keywords: botulinum toxin a
impaired insulin-like growth factor-1 (igf-1) generation causes protein catabolism and poor growth in children with crohn disease

Conditions: Crohns Disease

Summary: the investigators will prospectively recruit 26 children with moderate - severe active crohn disease (pcdai \>30). results will be compared to 26 patients in sustained remission (pcdai \<10 and physician global assessment of remission over the previous 6 months) who are matched for age and gender. subjects will be studied at baseline and six months. the primary study end-points will be leucine rate of appearance (a measure of protein breakdown) and igf-1 levels. this study will test the hypothesis that children with greater disease severity will have worse longitudinal growth and protein catabolism. the investigators will also explore the secondary hypothesis that children with crohn disease have abnormal igf-1 generation which is linked to underlying inflammation and disease severity.


Eligibility criteria:
inclusion criteria: * diagnosed with crohn disease by endoscopy and histologic samples * chronological and/or bone age 6-15 years old * tanner 1 - 2 * willing to participate in our longitudinal evaluation exclusion criteria: * concomitant persistent chronic infectious disease * inflammatory bowel disease not diagnosed as crohn disease * immunological disorder (excluding crohn disease) * associated severe concomitant chronic illnesses (cf, liver failure) * pregnancy
cardiac ct in the treatment of acute chest pain 2 - myocardial ct perfusion

Conditions: Coronary Artery Disease

Summary: the aim of this study is to assess whether the clinical management of patients with recent acute-onset chest pain without acute coronary syndrome may be optimized by a combined coronary ct angiography (cta) + ct myocardial perfusion (ctp) guided, rapid diagnostic strategy as compared to cta alone. ct diagnostic evaluation and potential referral for invasive testing will be performed within 2 weeks after hospital discharge. the following main hypothesis will be tested: - combined assessment of coronary anatomy and myocardial perfusion using 320 mdct results in a safe and optimized, cost-effective invasive treatment strategy

material - consecutive patients referred with chest pain in whom acute coronary syndrome has been excluded, yet with a maintained clinical suspicion of coronary artery disease will be included in the study. only patients deemed clinically suited for subsequent invasive evaluation and treatment will be included. methods -if the patients accept participation in the trial a computerized 1:1 randomization for cta alone (control group) or cta and ctp combined (intervention group) within 2 weeks from discharge will be conducted. ct angiography and ct myocardial perfusion imaging will be performed using a 320-slice msct toshiba vision edition aquilion one scanner according to recommendations from the vendor and clinical routine developed at rigshospitalet. based on cta and/or ctp findings patients will be referred for invasive evaluation including fractional flow reserve assessment (ffr) and treatment within 30 days. invasive procedures will be performed according to international guidelines and the frequency of revascularization procedures recorded. clinical outcome data according to specified secondary endpoints will be recorded from hospital charts and medical registries.

Eligibility criteria:
inclusion criteria: * recent acute-onset chest pain where coronary artery disease is suspected * during initial acute hospitalization: 1. normal coronary biomarkers (troponins) 2. no or non-diagnostic ecg changes (lv hypertrophy, bundle branch blok, pacemaker rhythm) * age ≥50 years * ≥ 1 cardiovascular risk factor (family history of cad, hypertension, hypercholesterolemia, diabetes, smoking) corresponding to a duke clinical score ≥20% exclusion criteria: * known iodine contrast allergy * estimated gfr below 50 ml/min * adenosine intolerance - known allergic asthma * previous cabg * patient related circumstances which preclude informed consent from the patient * patients in whom psychiatric, physical or geographic conditions do not allow long-term clinical followup * expected survival of less that 2 years

Keywords: multidetector computed tomography myocardial perfusion imaging coronary stenosis coronary artery disease angina pectoris
effectiveness of whole-body vibration

Conditions: Spastic Cerebral Palsy; Physical Therapy Modalities; Vibration; Exposure; Lower Extremity Weakness, Spastic; Muscle Spasticity

Summary: cerebral palsy is the most common cause of severe physical disability in childhood and may present difficulties and limitations that will have an impact on their independence and integration in all social areas. within interventions aiming to manage cp whole-body vibration (wbv) has shown some benefits such as reducing spasticity or improving strength and functionality of the lower limbs. the aim of this study is to assess the effectiveness on motor function and spasticity of the lower limbs by adding an intervention with wbv to an evidence-based multimodal physiotherapy treatment in children with cp.

cerebral palsy is the most common cause of severe physical disability in childhood (1.5 - 3 cases per thousand live births) and may or may not be accompanied by intellectual, sensory, communication deficits and epileptic syndromes depending on the brain region affected. the most frequent form of presentation is spastic cerebral palsy, characterized by atypical motor development, abnormal movement or posture, hyperreflexia, and increased muscle tone. these difficulties and limitations will have an impact on their independence and integration in all social areas. the use of whole-body vibration (wbv) to reduce spasticity of the lower limb and thereby improve functionality has been used for more than a decade showing some benefits such as reducing spasticity or improving strength and functionality of the lower limbs. the purpose of this randomized controlled trial is to assess the effectiveness on motor function and spasticity of the lower limbs by adding an intervention with wbv to an evidence-based multimodal physiotherapy treatment in children with cp.

Eligibility criteria:
inclusion criteria: * patients diagnosed with spastic cerebral palsy. * aged between 8 and 14 years. * gmfcs i, ii or iii: with the ability to walk independently with or without technical aids; with the ability to stand for 3 minutes independently or gripped on the stand; with the ability to understand and follow simple instructions; with the ability to tolerate clinical tests and examinations. exclusion criteria: * participation in treatments with serial casting or botulinum toxin during the 3 months prior to the study. * recent orthopedic surgery (less than 12 months). * participation in other muscle strengthening programs during the 4 months prior to this clinical study. * children who have developed fixed contractures in lower limbs joints. * medical conditions where physical exercise is contraindicated.

Keywords: spastic cerebral palsy physical therapy whole-body vibration gross motor function lower limb spasticity
evaluation of diagnostic accuracy of mcg(magnetocardiography) scan in suspected coronary artery disease

Conditions: Coronary Artery Disease

Summary: this multicenter clinical trial is designed to evaluate the diagnostic accuracy of mcg scan in detecting significant cad compared to the reference standard cag.

this is multicenter, prospective, observational trial to evaluate the diagnostic accuracy of magnetocardiography(mcg) scan in detecting significant coronary artery disease(cad) compared to the reference standard coronary arteriography(cag). chest pain patients scheduled for cag will be offered to enroll in this clinical trial and provide informed consent to undergo with a rest/stress mcg scan prior to cag. this mcg scan with a new 96 channel superconducting quantum interference device(squid) system is radiation-free, contactless and takes less than ten minutes to complete. multiple studies have shown that the diagnostic accuracy of stress mcg scan is quite high in identifying patients with symptomatic cad. results will be interpreted and compared to the results of cardiac spect stress test, if available, and cag. participants will be followed up to 30 days via phone call or chart review. 30 day major adverse cardiac event(mace) will be recorded and correlated with initial mcg scan results.

Eligibility criteria:
inclusion criteria: * over 19 years of age at the time of enrollment * patient presenting for cag * consents to having an mcg scan study exclusion criteria: * patients unable to fit into mcg scan device * patients with implanted cardiac pacemakers/defibrillators * atrial fibrillation with rapid ventricular response * patients with other sustained or incessant arrhythmias * presence clinical suspicious of any acute coronary syndrome

Keywords: magnetocardiography scan coronary artery disease
intraosseous morphine in primary tka

Conditions: Knee Disease; Arthritis Knee; Pain, Acute

Summary: the research team wants to investigate if an intraosseous injection (directly into the bone marrow) of morphine during primary total knee replacement helps with post-operative pain following primary total knee replacement surgery. for this study patients will either be randomized into one of two groups: group 1: receives an intraosseous injection of morphine (mixed with standard antibiotics) during their primary total knee replacement or group 2: serves as the control group and only receives an intraosseous injection of antibioitics during their total knee replacement. the research team will have patients fill out a symptom journal for two weeks following their surgery to measure pain levels and pain medication consumed throughout the day as well as nausea and other symptoms. additionally, the research team will take blood samples both intraoperatively and post-operatively (10 hours post-op) to measure the level of inflammatory markers as well as morphine.


Eligibility criteria:
inclusion criteria: * patient gives informed consent to participate in the study * patient is undergoing a primary total knee arthroplasty. * age \> 18 and \<80 years old. exclusion criteria: * patient lacks the capacity to consent to the research project (study will not utilize lar signatures during the informed consent process) * weigh \< 100 pounds * bmi \> 35 * pregnancy or suspected pregnancy * past medical history of opioid addiction. * established hypersensitivity (ie allergy) to morphine. * acute or chronic liver disease for example cirrhosis. * use of any narcotics 5 days before surgery (opioids, hydrocodone, morphine, hydromorphone, fentanyl, etc). * undergoing bilateral total knee replacement, revision total knee arthroplasty, or any additional procedure outside of a primary total knee arthroplasty. * unable to get general and spinal anesthesia.

Keywords: intraosseous total knee arthroplasty morphine
impact of therapeutic education, being set up under the authorized program for diabetics patients in hospital

Conditions: Diabetes Complications

Summary: to assess the impact of therapeutic education on: * the occurrence of long term diabetes complications . * balance of his diabetes

evaluation of the benefits of therapeutic education by: * glycated hemoglobin assay * telephone monitoring * quiz * monitoring of adverse event related to diabete

Eligibility criteria:
inclusion criteria: patients * diabetic * hospitalized in léon berard * with telephone line * written consent given * belong to a social security system exclusion criteria: * no diabetics * patient having alredy completing a therapeutic education program * minor patient (\<18 years) * pregnant woman * without telephone line * no belong to a social security system * patient alredy inclued on clinical study. * patient tutelage or under curatorship
longitudinal assessment of atypical tripeptidyl peptidase 1 enzyme deficiency patients

Conditions: Neuronal Ceroid-Lipofuscinoses; Neuronal Ceroid Lipofuscinosis CLN2; Spinocerebellar Ataxia, Autosomal Recessive 7

Summary: the purpose of this study is to gather information on the possible symptoms that patients with atypical neuronal ceroid lipofuscinosis type 2 (also known as atpp1 or atypical tripeptidyl peptidase deficiency) have and how they change over time.

this study aims characterize the natural history of atypical tpp1 deficiency patients via longitudinal multidisciplinary assessments. multifaceted clinical, laboratory, imaging, and diagnostic assessments will be performed at regular intervals upon enrolled atpp1 deficiency patients, collated, and analyzed over a three-year longitudinal period.

Eligibility criteria:
inclusion criteria: * any patient with documented tpp1 enzymatic deficiency or tpp1 sequence variants * onset of first symptom after 4 years of age * parental provision of informed consent; child provision of assent (if necessary) exclusion criteria: * any patient with "classical" tpp1 deficiency (onset of first symptom prior to 4 years of age) * investigator assessment that patient is not suitable candidate to participate in the study

Keywords: neuronal ceroid lipofuscinosis atypical cln2 disease natural history
rct long covid-19 rehabilitation

Conditions: Rehabilitation; Post-Acute COVID-19 Syndrome; Post-Infectious Disorders

Summary: the coronavirus 2019 (covid-19) pandemic has resulted in at least four million infections in norway. the vast majority of cases are diagnosed and followed up in the community, but some with extensive symptoms and large degree of reduced function are referred to regional covid-clinics. in total this patient group is placing an enormous burden on the already over stretched health care services. as the pandemic subsides the emerging threat of long-term disability from covid remains to be quantified. brain fog and cognitive symptoms are common in long covid in 30% of mild infections resulting in sick leave and loss of daily function, with women overrepresented among long covid sufferers. the true prevalence and underlying mechanisms of long covid remains to be quantified. although vaccination prevents severe infection and death, we have little knowledge on how best to rehabilitate those who suffers from long covid. here we propose to develop knowledge on treatment interventions to counteract disability from long covid and lessening the burden on health care services. we will conduct a study of where we compare a short group intervention with systematic personalised neurocognitive rehabilitation to document symptom alleviation. our overarching goal is to develop effective programmes for this evolving disease to reduce the suffering for the patients, and thereby reducing costs for health services and society at large.


Eligibility criteria:
inclusion criteria: * symptoms attributable to long covid according to who definition \[14\] that affect their daily activities * positive covid test; a home-test, pcr test or serology. * neurocognitive symptoms * age between 18 and 65 years * participant is able and willing to provide informed consent exclusion criteria: * patients that do not want to comply to planned physical study visits * patients who are unable to complete surveys in norwegian * patients with known chronic neurocognitive disease before covid-19 or other diseases that can explain current symptoms

Keywords: rehabilitation long covid clinical trial telemedicine inflammation post-acute covid-19 syndrome covid-19 post-infectious disorders
prediction of intra-abdominal adhesion before cs

Conditions: Intra-Abdominal; Adhesion

Summary: recognition of intraabdominal adhesion before doing repeated cesarean section is helpful for the surgeon and patients.

the repeated cesarean section is associated with recorded maternal morbidity including placenta preavia and accreta , liability to injuries to the bladder, intestine or vascular injuries. the anticipation of the problem is important for decreasing its adverse effect . preoperative diagnosis of pelvic adhesion between the uterus and anterior abdominal wall, bladder, intestine or omentum could b of help to give time for a surgeon to prepare senior staff obstetrician or others and theatre requirements to overcome any problem happened.

Eligibility criteria:
inclusion criteria: * pregnant in their 9th-month singleton, planned for elective cs and had a history of previous cs exclusion criteria: * included multiple pregnancies, preterm labour, emergency cs, skin burn at the site of cs

Keywords: sliding test , ceaserean section
efficacy and safety, long-term study of npc-16 to treat dysmenorrhea

Conditions: Dysmenorrhea

Summary: the purpose of this long-term study is to determine whether npc-16 is effective in the treatment of dysmenorrhea.


Eligibility criteria:
inclusion criteria: * dysmenorrhea exclusion criteria: * severe hepatopathy * pregnant woman