Kornimate/medical-research-clean huggingface dataset:
factors associated with posttransplant cardiac outcomes

Conditions: Cardiovascular Diseases; Liver Transplantation

Summary: cardiovascular disease has become the leading cause of death early after liver transplantation (lt). the aging lt population is accompanied with the increasing prevalence of cardiovascular risk factors such as hypertension, diabetes, and hyperlipidemia. furthermore, cirrhosis has been known to cause alterations in the systemic haemodynamic system and cardiac muscle dysfunction, systolic and/or diastolic, known as cirrhotic cardiomyopathy (ccm). hence, transthoracic echocardiography is required in all lt candidates for preprocedural evaluation and risk stratification. however, traditional echocardiographic indices of cardiac function have low sensitivity. it is unclear whether comprehensive echocardiographic multiparameters, including speckle tracking echocardiograph (ste) and tissue doppler imaging (tdi) can help improve preoperative risk stratification. therefore, we sought to analyze the ability of clinical and comprehensive echocardiography variables to predict intraoperative and perioperative cardiac events and cardiac mortality in our lt patient experience up to early post-liver transplant.


Eligibility criteria:
inclusion criteria: * age \> 18 years, * end-stage cirrhosis patients who will receive liver transplantation, * patients voluntarily take part in the study and write informed consent. exclusion criteria: * decreased left ventricular systolic function (ejection fraction \<45%), * significant uncorrectable structural cardiac abnormalities (eg, symptomatic coronary heart disease, advanced cardiomyopathy, severe valvular disease, severe congenital heart disease, etc), * uncontrolled pulmonary hypertension defined as pulmonary arterial systolic pressure ≧ 35mm hg at rest despite maximal medical management, * circulatory or respiratory system with a score of 4 based on the preoperative organ dysfunction (clif-sofa) score, * second-time liver transplantation, * combined organ transplantation, * satisfactory quality echocardiography could not be obtained before operation.
comparison of body hydration state in hemodialysis patients

Conditions: Hemodialysis; Chronic Kidney Disease

Summary: estimation of hydration state in dialysis patients is a major challenge in clinical practice. although many methods have been studied, none have been established yet for clinical routine practice. the investigators have developed a method, using segmental and calf bioimpedance spectroscopy (cbis) techniques to measure body hydration. the device we used based on the fda-approved hydra 4200 (xitron technologies, san diego, ca). the hydra 4200 was initially developed to measure whole body and segmental body fluid volumes but hydra is approved only for measuring healthy subjects. the cbis monitors hydration state by continuously measuring change in resistance and resistivity in the calf during hemodialysis (hd) or it can be used for simple measurement before, during and after dialysis. preliminary results in clinical studies have shown that optimal hydration state of hd patients may be determined by the calf method. this study aims to compare the hydra 4200 to two other devices: the fda approved zoe (100 khz) fluid status monitor (noninvasive medical technologies, inc, las vegas) and a modified version zoe 5 khz. the modified zoe monitor (zoe (5 khz)) delivers frequency of 5 khz and 0.8 ma current instead of 100 khz and 2 ma. the subjects of this study include a group of hemodialysis patients and a group of healthy controls. the healthy controls are used to identify a normal range within the healthy population for each method. each hemodialysis patient will be studied twice in different hydration state. the study will not change the procedure of the patient's dialysis treatment. since all devices are based on noninvasive bioimpedance technique, this study has minimal risk.


Eligibility criteria:
inclusion criteria: * clinically stable exclusion criteria: * implants including pacemakers, implantable pumps, artificial joints * limb amputations * pregnancy * simultaneous participation in another clinical study except observational trials.
the effect of metformin and dpp4 inhibitors on cognition and cardiovascular protection in type 2 diabetic patients

Conditions: Type 2 Diabetes Mellitus

Summary: the impact of metformin and dipeptidyl peptidase- 4 inhibitors on cognitive function and cardiovascular protection in type 2 diabetic patients

this study aims to investigate the effect of daily oral dpp4 inhibitors and oral metformin on neurodegeneration in type 2 diabetic patients. this study aims to compare between the cardiovascular protective properties of dpp-4 inhibitors and metformin in type 2 diabetic patients.

Eligibility criteria:
inclusion criteria: * patient should be diagnosed with type 2 diabetes mellitus (t2dm) and guided with ha1c ≥7, age ≥40 years. * moderate hypertension. exclusion criteria: * • diabetic patients who have been currently receiving anti-diabetic agents other than metformin and/or insulin * patients with type 1 dm, active liver disease, recent history of cardiovascular disease (acute coronary syndrome, coronary artery intervention, new york heart association class iii/iv heart failure, stroke, transient ischemic neurologic event, or new/worsening symptoms of coronary heart disease or cerebrovascular disease), severe peripheral vascular disease, triglyceride levels ≥ 600 mg/dl, history of hiv infection, pancreatitis, malignancy or clinically important hematologic disorder, and an estimated glomerular filtration rate (egfr; calculated using the modification of diet in renal disease formula) less than 30 ml/min/1.73 m2. * moreover, patients with dementia, ad, those were in delirium status during evaluation period, patients with psychotic disease (schizoaffective disorder, etc.) * alcohol and substance addiction were not enrolled in the study. * also, patients who have any hypersensitivity to metformin or to dpp4 inhibitors were also excluded.
study of the p16 gene as a predictor of myelosuppression in breast cancer patients

Conditions: Breast Cancer

Summary: the primary purpose of this study is to measure the association between baseline expression of the senescence effector protein p16ink4a and myelosuppression due to chemotherapy in patients with breast cancer. patients with stage i-iv breast cancer will be included and myelosuppression will be assessed after the first cycle of chemotherapy via measurement of an absolute neutrophil count (anc) measured one time between days 7-11 post cycle one. study subjects will also be asked to complete a brief health behaviors questionnaire to gather information on other relevant variables.


Eligibility criteria:
inclusion criteria: * ≥ 18 years of age; * histologically confirmed stage i-iv breast cancer; * ecog performance status 0-3; * scheduled to start a new course of chemotherapy in the neo-adjuvant, adjuvant or metastatic setting for newly diagnosed or recurrent disease; * growth factors, e.g., filgrastim, pegfilgrastim, are allowed, but their dose and duration will be tracked. * absolute lymphocyte count (alc) \> 500 cells/μl as determined by routine cbc with differential; * signed, irb approved written informed consent. exclusion criteria: * presence of acute, active infection; * history of clonal bone marrow disorder (i.e., myelodysplastic or myeloproliferative disorder, acute or chronic leukemia); * other co-morbid illness which would impair ability to participate in the study; * concurrent experimental therapy (note: concurrent biologic therapy is permitted, provided it is not experimental). * prior or current receipt of histone deacetylase (hdac) inhibitors

Keywords: breast cancer breast cancer new diagnosis treatment chemotherapy blood blood draw lab draw gene gene therapy geriatric oncology muss unc north carolina cancer hospital initial treatment cbc
effect of education on resident physician knowledge of sepsis

Conditions: Sepsis; Systemic Inflammatory Response Syndrome

Summary: a questionnaire was provided, including clinical vignettes and free text answers, to assess and evaluate the ability of resident physicians to identify systemic inflammatory response syndrome (sirs), sepsis, and severe sepsis. questionnaire scores were compared between specialties. a whole-hospital educational campaign was provided with the aim to improve sepsis recognition, and the questionnaire survey was repeated after one year to assess the effect of the education on the recognition of sepsis.

sepsis is the number one cause of mortality in us hospitals. an aim of this study was to evaluate the ability of resident physicians with different training backgrounds to recognize sirs, sepsis, and severe sepsis. a survey assessment of the definition of sirs, sepsis, and severe sepsis was administered to internal medicine, emergency room, orthopedic, neurosurgery, and general surgery residents. then, an intensive educational campaign designed to improve recognition of the patient with sepsis was launched. for approximately 1 year, posters with this educational information were displayed in the hospital, one-on-one educational sessions were provided to residents, and didactic sessions focusing on sepsis were conducted. the survey was then redesigned and administered it to the same groups as described previously.

Eligibility criteria:
inclusion criteria: resident physician in an university of utah training program exclusion criteria: not willing to participate
efficacy and safety of wuling san on breast cancer-related lymphedema

Conditions: Breast Cancer; Lymphedema

Summary: the purpose of this study is to assess the efficacy and safety of wuling san, a traditional chinese medicine, in reducing arm volume excess in women with stage i-ii breast cancer related unilateral lymphedema.

the investigators will aim to enroll 200 female adult patients (aged between 20 and 40 years) of all ethnicities/races, who have been referred to the fourth affiliated hospital of guangxi medical university for breast cancer related unilateral lymphedema. the investigators will be using a standardized data collection form in this study, where standard of care will be practiced and the patients are not placed at additional risk from participating in this study. however, as the investigators are collecting data prospectively, all participants will sign consent.

Eligibility criteria:
inclusion criteria: * women completed all primary and adjuvant treatments (surgery, chemotherapy, radiotherapy) * age 20-40 with unilateral bcrl, stage i or ii, bmi of 18-25 * volume difference ≥300 ml between the normal and lymphedematous upper extremity based on perometry evaluation * no evidence of breast cancer recurrence * at least 6 months postoperative from axillary lymph node dissection exclusion criteria: * bilateral lymphedema or stage iii lymphedema * history of bilateral axillary lymph node dissection * recent history of cellulitis in the affected extremity (within last 3 months) * recurrent breast cancer or other malignancy * current (within last month) use of chemotherapy for breast or other malignancy * current (within last 3 months) use of radiation for breast or other malignancy * recent (within last month) or current intensive mld and/or short stretch bandage use * unstable lymphedema (i.e. worsening symptoms/measurements in the past 3 months) * pregnant or nursing (lactating) women * patients that take drugs like diosmin at the time of enrollment, or within 30 days. * use of other investigational drugs at the time of enrollment, or within 30 days or 5 half-lives of enrollment, whichever is longer. * unable to comply with the protocol, measurement and follow-up schedule.
feasibility of automated insulin delivery with an interoperable algorithm using an alternative insulin pump

Conditions: Type 1 Diabetes

Summary: this clinical study assesses the feasibility of implementing the incontrol automated insulin delivery algorithm with dexcom continuous glucose monitoring and a compatible insulin pump in adults with type 1 diabetes. it additionally provides pilot efficacy outcomes for interoperable automated insulin delivery.

self-management of type 1 diabetes is challenging, efforts to optimise time spent in the target range can result in hypo- and hyperglycaemia. structured education, glucose monitoring and advances in insulin delivery can increase time in range and reduce exposure to extremes of glucose and recent data confirm that automated insulin delivery can enable further increases in time spent in the target range of 3.9 to 10mmol/l (70 - 180mg/dl). the incontrol algorithm, developed by typezero technologies is embedded in the tandem x2 insulin pump and operates with the dexcom g6 continuous glucose sensor and transmitter in a ce-marked and commercially available system (known as control-iq). this system optimises time in range compared with sensor-augmented pump therapy, and the improvement was maintained when participants were further randomised to predictive low glucose suspend or automated insulin delivery. the united states food and drug administration has defined interoperable standards for automated insulin delivery systems, including the icgm designation for continuous glucose sensors, the interoperable automated glycaemic controller designation, and alternate controller enabled insulin pumps. however, while standards have been defined, to date, interoperability of automated insulin delivery components has not been demonstrated.

Eligibility criteria:
inclusion criteria: * aged 18 years of age or older * type 1 diabetes confirmed on the basis of clinical features * type 1 diabetes for greater than 1 year * on an intensified insulin regimen with multiple dose injection or insulin pump for \> 3 months * hba1c \>7.5% (58mmol/mol) (or %tir 3.9-10mmol/l \<52% for participants already using a continuous glucose sensor) exclusion criteria: * total daily insulin dose greater than 100 units * weight greater than 140kg * pregnant or planning pregnancy * have active malignancy or under investigation for malignancy * severe visual impairment * reduced manual dexterity * use of any automated insulin delivery system * unable to participate due to other factors, as assessed by the chief investigator

Keywords: automated insulin delivery
obstructive sleep apnea patients treated with mandibular advancement device

Conditions: Sleep Apnea, Obstructive

Summary: the purpose of this study is to evaluate efficacy of mandibular advancement device (mad). on treating obstructive sleep apneas, symptoms, apnea/hypopnea index (qhi) and the respiratory arousal index (ahi/rei) and peripheral capillary oxygen saturation (spo2) range, pulse in patients with mild to moderate obstructive sleep apnea/hypopnea syndrome, and evaluating potential dental side effects

the primary oral appliance (oa) used in obstructive sleep apnea (osa) treatment is the mandibular advancement device (mad). mads may be either an over-the-counter stock device or customized for individual patients. mads come in various designs and materials, but most comprise upper and lower splints mounted over the dentition as either a 1-piece monoblock or a 2-piece biblock connectors or blocks relate the upper and lower splints in a biblock to protrude the mandible in a forward position during sleep. although the efficacy of oral appliances has been proved, the relationship to the nature of airway enlargement in patients with osa has not yet been clearly demonstrated. the aim of this study is therefore to evaluate the efficacy mandibular repositioning appliance reduces sleep apneas symptoms with mild to moderate obstructive sleep apnea . secondary outcomes include the dental side effects of such appliance. at baseline and after 4 month's treatment, this study will be conducted to estimate frequency of osa on population sample from erbil study, in addition trying to evaluate the efficiency of mad on some patients who are diagnosed with osa.

Eligibility criteria:
inclusion criteria: 1. sample will be taken from kurdish population in erbil city. 2. obstructive sleep apnea, apnea-hypopnea index of \<30 with excessive daytime sleepiness exclusion criteria: 1. people with problems in nasal part of airway. 2. people with cleft lip and palate 3. patient who did tonsillectomy and / or other pharyngeal operations. 4. people who take any kind of sleep medication. 5. temporomandibular disorders. 6. people with periodontal disease. 7. less than 8 teeth/ arch.

Keywords: orthodontic
treatment of orthostatic hypotension

Conditions: Autonomic Nervous System Diseases; Orthostatic Hypotension; Dopamine Beta-Hydroxylase Deficiency; Orthostatic Intolerance

Summary: the purpose of this study is to try different medications in patients with low blood pressure and other problems with their involuntary (autonomic) nervous system. the pharmacological trials in this study will perhaps lead to more effective treatment. the protocol includes single dose trials, dose-selection trials, 5-day trials and chronic (approximately 2 months) trials, although only dose-selection trials were consistently performed and have results presented.

we see many patients at the autonomic dysfunction center who can be given a fairly definitive diagnosis, e.g., orthostatic intolerance, pure autonomic failure, multiple system atrophy, and baroreflex failure. however, some patients present with a unique constellation of symptoms of autonomic dysfunction so that they do not fit into a diagnostic category. we hypothesize that a genetic cause exists in some of these patients. we further propose that our comprehensive evaluation of these patients will provide us with information on the pathophysiology of their condition and assist us in optimizing their treatment.

Eligibility criteria:
inclusion criteria: * patients with severe orthostatic hypotension and other autonomic symptoms who do not meet criteria for one of our standard diagnoses * non-smokers * drug-free * able to give informed consent * free of pulmonary, renal, hematopoietic, hepatic and cardiac disease exclusion criteria: * medications affecting the autonomic nervous system * any chronic illness (cardiac, pulmonary, endocrine, gastrointestinal, rheumatologic) * anemia (hct \< 30) * women of childbearing age who are pregnant or nursing * smokers

Keywords: autonomic nervous system diseases blood pressure congenital orthostasis catecholamines
effect of two different solutions on wound healing in pressure injury

Conditions: Pressure Injuries; Wound Care; Wound Cleansing

Summary: pressure injuries are a condition that reduces patients' quality of life, increases hospitalization time and healthcare costs. when accompanied by infection and complications, mortality increases. the primary goal in pressure injuries is to prevent their occurrence, but once the injury has occurred, it is to provide effective and appropriate care. it is known that 0.9% sodium chloride (nacl) is used routinely in pressure ulcer care. in addition, if the effectiveness of 0.1% polyhexanide in pressure ulcer care is demonstrated, it may provide data for its use in wound care. for this purpose, the study was completed as a randomized controlled trial with 32 individuals in the 0.1% polyhexanide group and 31 individuals in the 0.9% nacl group, totaling 63 individuals.

the european pressure ulcer advisory panel (epuap) and the national pressure ulcer advisory panel (npuap) defined pressure injury (pi) as "local skin and/or subcutaneous tissue damage caused by pressure alone, or by a combination of pressure and shear, most often occurring over bony prominences". it has been stated that the prevalence of pressure ulcers varies between 0-72.5%, and that it is a condition that reduces the quality of life of patients, increases the length of hospital stay and health care costs. in particular, the accompanying infection and complications of pi cause increased mortality. the primary purpose of pis is to prevent their occurrence and after the injury occurs, it is necessary to provide care with effective and appropriate methods. the determined method should have the feature that can contribute to wound healing. there are many products and methods with appropriate features that can be used in pis. in addition to the wet-dry gauze dressing used in wound care from past to present, different care solutions are also used. 0.9% nacl solutions are frequently used in wound care. since 0.1% polyhexanide solution is also an effective antiseptic, we thought that its use in pi care would contribute to treatment management by determining its effect on wound healing.

Eligibility criteria:
inclusion criteria: * patients over the age of 18 who have developed pressure injuries * patients who have received informed consent from themselves or their guardians exclusion criteria: * patients with clotting problems * patients using corticosteroids * patients receiving additional medical treatment for wound care

Keywords: pressure injury %0.1 poliheksanit solution %0.9 sodium chloride
effects of perturbation based balance training in reactive balance control among chronic stroke patients

Conditions: Stroke

Summary: chronic stroke patients often have impaired balance on reactive balance control. task specific exercises are important part of the fall intervention in daily activities of life should be incorporated during the rehabilitative services objective: effects of perturbation based balance training in reactive balance control in chronic stroke patients.

rct (randomized control trail) study was conducted. stroke patients who have impaired balance and reactive control were determined on inclusion \& exclusion criteria. stroke patients with impaired balance control were arbitrarily allocated into two groups with one control and one interventional group ages ranged from 45 to 50 years. the sample size was 20 patients. group 1 (control group) received tradional balance training and group 2 (interventional group) received perturbation based training for balance control. the interval of treatment was 6 weeks. data is collected from azra naheed medical college (ch muhammad akram teaching \& research hospital) lahore and physiotherapy department of social security hospital manga mandi lahore. tinetti performance oriented mobility assessment (poma),time up and go (tug) and activity specific balance confidence (abc) was used to evaluate the pre and post values of balance control.

Eligibility criteria:
inclusion criteria: * individuals who was not obese and bmi was \<28 * individuals at chronic stroke level (\>6 months post stroke). * the patients who can walk with or without a gait aid (but without assistance of another exclusion criteria: * • different neurological diseases and problems that can impaired balance control (e.g. parkinson's disease); upper or the lower body parts amputation; cognitive, language, or social impairments which can affect the following of instructions. * patients who were attending any perturbation based training * patients who were visually impaired, having orthostatic hypotension or dizziness

Keywords: stroke perturbation based training fall berg balance scale performance oriented mobility assessment