Kornimate/medical-research-clean huggingface dataset:
anti-coagulation on left ventricular thrombus after st segment elevation myocardial infarction

Conditions: ST-segment Elevation Myocardial Infarction (STEMI); Left Ventricular Thrombus

Summary: contemporary data are lacking regarding the management of left ventricular thrombus (lvt) developed after st segment elevation myocardial infarction

left ventricular thrombus (lvt) is a commom complication after st segment elevation myocardial infarction (stemi), reperfusion therapy have reduced the incidence of lvt, however, about 6% of all stemi patients will develop lvt. the risk of lvt development in anterior stemi with reduced lvef are as high as 20%. although current guideline recommend anti-coagulation therapy, but the evidence still based on observational data, there has been inconsistency with the benefit of the coagulation therapy, give the significant increased bleeding risk by superimpose anti-coagulation therapy to the dual anti-platelet therapy. especially in the era of more potent anti-platelet p2y12 inhibitor widely used clinical. the mechanism of lvt is different from that of the atrial fibrillation in which the risk of systemic embolism is persistent, coagulation bring absolute clinical benefit for high risk patients. however, for lvt developed following stemi tend to be temporary, majority of thrombus resolve within 1-3 months after stemi event. more likely a reflection of coagulation system in response to the necrosis of infarct myocardium. the optimal management in lvt after stemi warrants further exploration. the desiring of randomized controlled clinical trial to compare dual anti platelet + anti-coagulation and dual anti-platelet without anti-coagulation in patient lvt are justified.

Eligibility criteria:
inclusion criteria: established st segment elevation myocardial infarction within 7 days left ventricular thrombus (lvt) is detected by either cardiac magnetic resonance (cmr) or tte. ongoing treatment with dual anti-platelet therapy according to esc/aha guidelines at the time of randomization exclusion criteria: clinically or hemodynamically unstable planed major surgeon such as cabg or valve replacement within next 12 months concomitant condition that requires anti- coagulation therapy, such as af, dvt. any contraindication of anticoagulant therapy history of intracranial hemorrhage; woman who is currently pregnant, or breastfeeding serious impaired renal and liver functions life expectancy less than 1 year can not provide consent

Keywords: stemi, lvt, anticoagulation
safety and efficacy study of betoptic s 0.25% and timolol gel-forming solution 0.25% and 0.5% in pediatric patients with glaucoma or ocular hypertension

Conditions: Glaucoma; Ocular Hypertension

Summary: the purpose of this study is to evaluate the safety and efficacy of betoptic s and timolol gel-forming solution in pediatric patients. patients will dose with study drug at 8 am and 8 pm daily for twelve weeks. patients will have vision tested, slit lamp exam, blood pressure and pulse checks at each visit. patients will have a dilated fundus exam and corneal measurements taken at first and last visit.


Eligibility criteria:
inclusion: * children 5 years old and younger * require treatment for glaucoma or ocular hypertension * whose vision is 20/80 or better * have a cup-to-disc ratio of 0.8 or less exclusion: * do not have abnormal fixation * iop greater than 36 mm hg * significant retinal disease * penetrating keratoplasty * severe ocular pathology * optic atrophy * eye surgery in the past 30 days * cardiovascular abnormalities * hypersensitivity to beta blockers

Keywords: glaucoma ocular hypertension
stepcare extended follow-up substudy

Conditions: Cardiac Arrest With Successful Resuscitation; Hypoxia, Brain; Cognitive Impairment; Caregiver Burden

Summary: to provide detailed information on long-term outcomes in relation to potential neuroprotection and improvements in recovery for different targets of sedation, temperature, and pressure management in post out of hospital cardiac arrest survivors at 6 and 12 months. in addition, the impact of caring for a post ohca survivor will be explored.

this extended follow-up substudy is incorporated into the multi-center, international, factorial randomized sedation, temperature and pressure after cardiac arrest and resuscitation -stepcare trial (clinical trials identifier:nct05564754) were out of hospital cardiac arrest participants will be randomized to different targets of sedation, temperature, and map management. only selected stepcare sites will participate in this extended follow-up substudy. at the extended follow up participating sites all out of hospital cardiac arrest participants randomized in the stepcare trial, who survive and provide consent, will be eligible to participate in this substudy, with no further inclusion or exclusion criteria.the extended follow-up substudy is estimated to enroll approximately 600 post ohca survivors. one nominated caregiver per post ohca survivor will be invited to be included in the study. participants will be followed up at 6 and 12 months. the primary outcome for this extended follow up substudy is cognitive function at 6 months for the out of hospital cardiac arrest survivors andcaregiver burden at 6 months for the caregivers.

Eligibility criteria:
all ohca participants randomized in the stepcare trial at the extended follow-up participating sites, who survive and provide consent, with no further inclusion or exclusion criteria. the inclusion and exclusion criteria for the stepcare trial are: * inclusion criteria: out-of-hospital cardiac arrest of non-traumatic origin, minimum of 20 minutes without chest compressions (defined as stable return of spontaneous circulation. rosc), unconsciousness (defined as not being able to obey verbal commands equal to a four-score motor response of \<4, or being intubated and sedated because of agitation after sustained rosc, eligible for intensive care without restrictions or limitation, inclusion within 4 hours (240 minutes) of rosc (or 220 minutes of stable rosc). * exclusion criteria: on ecmo prior to randomization, pregnancy, suspected or confirmed intracranial hemorrhage, previously randomized in the stepcare trial. for caregivers, the eligibility will be that they live with, or have weekly or more frequent contact (in person or over the telephone) with the post ohca survivor. only one nominated caregiver per post ohca survivor will be able to be included in the study. this would typically be the caregiver that would identify as the primary caregiver of the post ohca survivor if needed, but may also be another close family member.
pilot study of antithrombin as prophylaxis of acute respiratory distress syndrome in patients with covid-19

Conditions: Covid19; Severe Acute Respiratory Syndrome; Distress Respiratory Syndrome

Summary: pilot clinical trial, with a marketed drug -natural component of human plasma-, not approved for this indication, single-center, exploratory, open, randomized, controlled, to study the efficacy and safety of human antithrombin in patients with confirmed covid-19 disease and criteria high risk to develop sars.


Eligibility criteria:
inclusion criteria: * age \>= 18 and \< 85 years * covid-19 diagnosis confirmed. * radiological image compatible with covid-19 * present any of the following clinical-functional criteria considered risk: 1. respiratory distress: tachypnea \> 26 breaths / minute 2. pao2 / fio2 oxygenation index # 300 3. alteration of one or more of the following parameters: c.i. dd\> 1,000 µg / l c.ii. ferritin\> 800 ng / ml 4.c.iii. lymphocytes \ 100 mg / l 4.c.v. ldh\> 500 u / l c.vi. il-6\> 15 pg / ml * direct or delegated verbal informed consent exclusion criteria: * signs of active bleeding * immunosuppression by cancer or transplant * intolerance or allergy to at or its components * pregnancy

Keywords: antithrombin covid-19 distress respiratory syndrome
effects of ischemic preconditioning after aortic clamping

Conditions: Vascular Surgery; Ischemia-reperfusion; Ischemia Preconditioning

Summary: open surgery for aneurysmal aortic disease can lead to cardiac, renal, pulmonary or muscular complications, essentially due to the aortic clamping. ischemic preconditioning can be useful in order to decrease these complications. the investigators would like to use an ischemic preconditioning protocol during open surgery of aortic aneurysm in order to decrease these complications.


Eligibility criteria:
inclusion criteria: * patients with an aortic aneurysm requiring open surgery (with no possibility of endovascular surgery) * patients who received clear information, with signed consent * patients 18 to 85 years exclusion criteria: * patients under guardianship * no possibility to give the patients clear information (comprehension difficulties, emergency surgery) * pregnancy, lactation * hemodialysis
maturation of the autonomic nervous system in prematures

Conditions: Analysis, Event History

Summary: the purpose of this study is to try to evaluate the maturation of the autonomic nervous system in prematures.

to evaluate the maturation of the autonomic nervous system in prematures by using heart rate variability analyses.

Eligibility criteria:
inclusion criteria: * all prematures
ivabradine versus propranolol for induced hypotension in endoscopic sinus surgery

Conditions: Hypotension

Summary: the study is designed to compare the effect of addition of oral ivabradine, propranolol to general anesthesia aimed reduction in blood loss during functional endoscopic sinus surgery.


Eligibility criteria:
inclusion criteria: * age of 18 - 60 years. * patients of both genders. * asa grade i - ii . exclusion criteria: * patient refusal. * any contraindication to medication included in the study . * patients with allergy to medication included in the study.
chasing biomarkers in post-concussion syndrome

Conditions: Post Concussive Symptoms

Summary: the goal of this study was to investigate the biomarkers, neurofilament light chain, inflammatory markers, calcitonin-gene-related peptide, and metabolites from the kynurenine pathway in patients with severe post-concussive symptoms. the main question it aimed to answer was: * are the biomarker concentrations significantly changed in patients with severe post-concussive symptoms compared to healthy individuals? * do the biomarker concentrations change at follow-up? participants were recruited from a recently published randomized controlled trial (clinicaltrials.gov no. nct02337101 / pmid: 31891145 ). the biomarker concentrations were compared to a healthy control group recruited from the blood bank at aarhus university hospital in 2022.

in the previously published rct-study (pmid: 31891145), 86 participants with severe post-concussive symptoms provided blood samples at baseline (4 months after the concussion). severe post-concussive symptoms were defined as having a rivermead post concussion questionnaire \>20. around 7 months later, a follow-up blood sample was obtained from 54 participants. these blood samples were used to investigate blood biomarkers for the condition.

Eligibility criteria:
patients with severe post-concussive symptoms: inclusion criteria: 1. concussion caused by a head trauma based on the diagnostic criteria recommended by the world health organization (who) task force 2. age between 18 and 30 years 3. able to understand, speak and read danish. 4. a score of 20 or more on the rivermead post concussion symptoms questionnaire (rpq). exclusion criteria: 1. objective neurological findings indicating neurological disease or brain damage. 2. previous concussion leading to persistent post-concussional symptoms within the last two years. 3. severe misuse of alcohol, prescription drugs and / or illegal drugs. 4. severe psychiatric, neurological,or other medical disease that would impede participation in the intervention 5. inability to speak and read danish healthy control group (recruited from december 2021 - march 2022): - individuals from the blood bank at aarhus university hospital in denmark. inclusion criteria were: 1. age between 18-30 years 2. equal distribution between the genders (60 men and 60 women). this number was based on a power analysis using published data from neurofilament light chain.
natural history study of patients with x-linked retinal dystrophy associated with mutations in retinitis pigmentosa gtpase regulator (rpgr)

Conditions: Retinitis Pigmentosa

Summary: the rod-cone dystrophies (often referred to as retinitis pigmentosa (rp)) are a clinically and genetically heterogeneous group of disorders in which there is progressive loss of rod and later cone photoreceptor function leading to severe visual impairment. rp usually occurs as an isolated retinal disorder, but it may also be seen in association with systemic abnormalities.

x-linked retinitis pigmentosa (xlrp) is a severe form of rp with early onset of nyctalopia and progression to legal blindness by the 3rd to 4th decade. most affected males show symptomatic night blindness before the age of 10 years, are often myopic and show fundus abnormalities and erg changes in early childhood. examination of close female relatives is helpful in the absence of a family history, as the recognition of the xl carrier state will confirm the diagnosis.

Eligibility criteria:
inclusion criteria: * males \& females aged 5 years or older * have rpgr-associated retinal dystrophy * are able to give informed consent or assent, with the guidance of their parent/guardian where appropriate * are able to undertake age-appropriate clinical assessments as specified in the protocol * have genetic mutation within the rpgr gene confirmed by an accredited lab or research lab. exclusion criteria: * are unable or unwilling to undertake consent or clinical testing
sarcopenia, fall and osteoporosis in chronic kidney disease

Conditions: Sarcopenia; Chronic Kidney Diseases; Osteoporosis

Summary: this study is a cross-sectional study that wishes to investigate whether there is an increased incidence of sarcopenia in patients with chronic kidney disease compared to the danish background population. a possible association between sarcopenia and fall, as well as the incidence of osteoporosis in patients with chronic kidney disease will also be described.

sarcopenia is a condition diagnosed from different clinical findings such as low muscle mass, low muscle strength and possibly also poor physical performance. in the general population, the risk of fall and bone fracture increases, when sarcopenia is also present. sarcopenia is known to occur in patients with chronic kidney disease, but whether, and if so, how this differs from the incidence in patients without kidney disease has not previously been described. patients with chronic kidney disease have a 3 times higher risk of bone fracture compared to the danish background population, and they also have an increased risk of falls. the association between sarcopenia, risk of falls and osteoporosis in patients with kidney disease is until now sparsely described, and because of this, the investigators want to explore this further in this cross-sectional study.

Eligibility criteria:
inclusion criteria: * age ≥20 years * chronic kidney disease stage 4-5 not on dialysis (nond) (corresponding to an estimated glomerular filtration rate (egfr) ≤30 ml/min based on kidney disease improving global outcomes (kdigo) definition and not on dialysis) exclusion criteria: * kidney transplanted * immobilized/hospitalized for more than 1 week within the last 6 weeks * active treatment with growth hormone or sex hormone * known muscle disease * the lack of ability to speak or understand danish * the lack of ability to give an informed consent * the lack of ability to participate in a clinical study based on the assessment by the local investigator

Keywords: fall chronic kidney disease-mineral and bone disorder (ckd-mbd)
does adding posterior block to sfib increase the quality of analgesia in hip fractures?

Conditions: Acute Pain Management; Hip Surgery

Summary: the researchers aimed to compare the effects of adding a deep posterior gluteal compartment block to a suprainguinal fascia iliaca compartment block (sficb) versus sficb alone on pain, analgesic consumption, and positioning pain for neuraxial anesthesia.

adding deep posterior gluteal compartment block to suprainguinal fascia iliaca block applied before neuraxial anesthesia in hip fracture surgeries can reduce the pain sensation originating from the posterior region of the hip joint. thus, participants can experience less pain in the perioperative period, consume less analgesics and reduce complications related to these in the postoperative period. in addition, possible complications can be prevented with early mobilization of the participants. it was aimed to compare the effects of adding deep posterior gluteal compartment block to suprainguinal fascia iliaca block with only suprainguinal fascia iliaca block on these results.

Eligibility criteria:
inclusion criteria: * volunteering to participate in the study * patients between the ages of 18-90 * asa i, ii, iii * patients whose surgery duration does not exceed 2 hours * patients who will undergo surgery under spinal anesthesia exclusion criteria: * patients who do not want to participate in the study/do not give consent * patients with a condition that prevents regional anesthesia * patients with cognitive dysfunction who are unable to evaluate the nrs score and who cannot use pca (patient controlled analgesia device) * history of hypersensitivity or allergy to local anesthetics * patients with psychiatric disorders and those using psychiatric medications * presence of hematological disease * presence of oncological disease * patients with serious major organ failure * presence of multiple fractures * patients with alcohol or drug addiction * patients who have used analgesic drugs up to 12 hours before surgery * asa iv-v patients * morbidly obese patients

Keywords: acute pain management hip surgery deep posterior gluteal compartment block suprainguinal fascia iliaca plane block
combined cingulate and thalamic dbs for chronic refractory chronic pain

Conditions: Chronic Refractory Neuropathic Pain

Summary: deep brain stimulation (dbs) of the sensory thalamus has been proposed for 40 years to treat medically refractory neuropathic pain, but its efficacy remains partial and unpredictable. recently, bilateral dbs of the dorsal anterior cingulate cortex (acc), a brain region involved in the integration of the affective and cognitive aspects of pain, has been successively proposed to treat few patients suffering from refractory chronic pain, by decreasing the emotional impact of their chronic pain. acc-dbs could be an alternative or complementary approach to thalamic dbs in these patients, but the consequences of chronic dacc-dbs on cognition and affects have not been studied specifically. the primary objective is to evaluate the feasibility and safety of bilateral acc-dbs combined with unilateral thalamic dbs in patients suffering from chronic unilateral pain, refractory to medical treatment. secondary objective will evaluate the efficacy of this combined dbs compared to thalamic dbs only.

chronic pain represents a major personal and societal burden, especially for medically resistant patients. deep brain stimulation (dbs) of the sensory thalamus has been proposed for 40 years to treat medically refractory neuropathic pain, but its efficacy remains partial and unpredictable. recently, bilateral dbs of the dorsal anterior cingulate cortex (acc), a brain region involved in the integration of the affective, emotional and cognitive aspects of pain, has been successively proposed to treat few patients suffering from refractory chronic pain. in a pilot study, 16 patients treated by acc-dbs experienced a significant improvement of their quality of life despite a slight decrease of their pain intensity, by improving the affective and emotional impacts of their chronic pain. acc-dbs could be an alternative or complementary approach to thalamic dbs in these patients. however the consequences of chronic dacc-dbs on cognition and affects have not been studied specifically. the primary objective of this study is to evaluate the feasibility and safety of bilateral acc-dbs combined with unilateral thalamic dbs in patients suffering from chronic unilateral pain, refractory to medical treatment. secondary objective will evaluate the efficacy of this combined dbs compared to thalamic dbs only

Eligibility criteria:
inclusion criteria: * adult patients (age 18-70 years old) suffering from chronic (duration \>1 year) unilateral neuropathic pain * severe (vas score \>6/10) * with high emotional impact (had subscores \> 10) considered as resistant to medication specific to neuropathic pain at sufficient doses and durations (including at least antiepileptics and antidepressants) and not sufficiently improved by rtms and relevant surgical solutions. non inclusion criteria: * previous history of stroke, * cognitive impairment (mmse score \<24), * dsmiv axis i psychiatric disorder, * contra-indication to surgery, anesthesia or mri; * patient responder to rtms,
virtual cardiac wellness program following hypertensive disorders of pregnancy

Conditions: Hypertension in Pregnancy; Gestational Hypertension; Preeclampsia; Chronic Hypertension With Pre-Eclampsia; Eclampsia; Chronic Hypertension in Obstetric Context

Summary: hypertensive disorders of pregnancy (hdp) are now well-recognized risk factors for adverse outcomes in the postpartum period and for development of future cardiovascular disease (cvd). postpartum bmi has emerged as a strong predictor of both short- and long-term blood pressure (bp) control in observational studies suggesting that earlier postpartum lifestyle modifications may be instrumental in future cvd risk reduction in women with hdp. while such lifestyle modifications are recognized as critical for postpartum health, implementation and engagement of postpartum women remains a challenge as new mothers face greater barriers to in-person care given childcare responsibilities. the proposed study will investigate the acceptability of a virtual cardiac wellness program and its impact on weight, lifestyle modifications, cardiometabolic health, patient engagement, and outcomes following hdp as compared to the standard of care for postpartum women at massachusetts general hospital.


Eligibility criteria:
inclusion criteria: * women with a diagnosis of hdp inclusive of gestational hypertension, preeclampsia, eclampsia, and chronic hypertension with superimposed preeclampsia * pre-pregnancy bmi \>18.5 * age ≥ 18 years * access to a phone * delivery at mgh and receive longitudinal obstetrics care at mgh exclusion criteria: * moderate or severe cognitive impairment * current incarceration * pre-pregnancy bmi ≤ 18.5 * women without a documented pre-natal weight or weight recorded 1 year prior to pregnancy * baseline exercise of \> 150 minutes/ week at the time of study enrollment * not cleared for exercise by primary ob