Kornimate/medical-research-clean huggingface dataset:
st-t segment changes in emergency physicians while on duty

Conditions: ST-T Segment Changes

Summary: preclinical emergency management is frequently associated with a combination of physical and psychological stress. this stress is known to lead to a broad variety of changes in the physiology even extending in the cardiovascular system. both physical and psychological stress induces ecg changes. these changes include not only arrhythmias but also deviations in st-t segment representing the phase of repolarization. information about changes in st-t segment are missing until now. the investigators hypothesise that st-t deviations occur in emergency physicians during shift at an emergency response car. in order to show changes in st-t segment a prospective observational trial will be conducted. by using a 12 lead ecg holter the investigators will obtain ecgs during shifts of emergency physicians at an emergency response vehicle. during 12-hour shifts emergency physicians will be attached to the 12 lead holter ecg. ecgs will be analysed after blinding of names and reason of call (code) to the investigators. the primary outcome will be st-t segment changes greater than 0.1mv in two corresponding leads for more than 30 seconds per 100 calls. as secondary outcomes, other ecg changes such as st-t segment changes \<0.1mv, t wave inversion or hrv will be analysed. furthermore, surrogate parameter of stress will be measured using nasa-task load index and cognitive appraisal and correlated to st-t segment changes. correlations between different phases of calls, different indications of calls and ecg changes will be assessed. furthermore, correlation between alarm codes apriori defined as stressfull using a delphi process and st-t segment changes as well es surrogate parameters of stress will be assessed.


Eligibility criteria:
inclusion criteria: * healthy emergency physicians doing shifts at the medical university of vienna's emergency response car exclusion criteria: * known pregnancy * pre-existing cardiac diseases (valvular heart disease \> i°, any form of cardiomyopathy, history of coronary artery disease, history of myocarditis, any channelopathy, known high degree (\>1% of all beats within 24h) premature atrial or ventricular beats or atrial fibrillation or conduction disturbance. * any antiarrhythmic therapy * any implanted cardiac device * manifest hyperthyroidism * termination of exercise testing due to the commonly used criteria26 or not reaching 85% of maximal predicted load.

Keywords: st segment preclinical emergency medicine stress occupational health emergency medicine 24h ecg
scaling up science-based mental health interventions in latin america

Conditions: Depression; Problematic Alcohol Use

Summary: conduct systematic, multi-site mental health implementation research in both rural and urban primary care settings with a broad group of stakeholders in the us and latin america.

the investigators plan to launch and evaluate a new mental health service delivery model in latin america. specifically, in this new multi-component, mental health service delivery intervention, the investigators propose to: (1) harness mobile behavioral health technology for mental health (with a primary focus on depression and a secondary focus on problematic alcohol and other substance abuse), (2) launch new workforce training and service delivery models (including the integration of technology into service delivery), (3) launch and evolve an integrated data management system for systematic data tracking and outcomes assessment, and (4) launch and grow a learning collaborative of organizations integrating mental health into primary care. the investigators will launch this project at multiple primary care sites in various parts of colombia, with a plan to inform subsequent adoption in several other latin american countries, including chile and peru.

Eligibility criteria:
inclusion criteria: * provider and administrative staff inclusion criteria: * aged \> 18 years * have worked for the study site for at least 3 months. * participant inclusion criteria: * aged \> 18 years * patients at one of our collaborating primary care sites * screen positive for minor (score of 5-9), moderate (score of 10-14), moderately severe (score of 15-19) or severe (score of 20-27) depression on patient health questionnaire (phq-9)62 and/or screen positive for problematic alcohol use on alcohol use disorder identification test (audit) developed by the world health organization (a score of 8 or more on 10-item audit)63 and have a confirmed diagnosis of depression and/or alcohol use disorder based on clinical consultation at the primary care site * willing to provide informed consent to use mobile intervention and complete study assessments exclusion criteria: -participant exclusion criteria * diagnosis with co-occurring severe mental illness (e.g., schizophrenia, bipolar disorder, depression with psychotic features) * alcohol withdrawal symptoms that require higher level of care (e.g., emergency medical or inpatient treatment) * express suicidal intention. this assessment will be based on a combination of a patient's response on the phq-9 assessment followed by further assessment by a primary care clinician. the phq-9 measure will not be used solely to determine eligibility on this criterion. persons who express suicidal intention will immediately be provided immediate crisis management in accordance with the crisis management protocol at the collaborating primary care site. * intoxicated or otherwise impaired at the time of assessment (rendering the individual incapable of informed consent)

Keywords: latin america depression mhealth problematic alcohol use
desensitization of renal transplant candidates

Conditions: End Stage Renal Disease; Kidney Transplantation

Summary: trial of the use of myfortic to reduce anti-hla alloantibody in patients waiting for renal transplantation.

pre-formed hla antibodies prevent renal transplantation because of the risk of hyperacute rejection. we propose a prospective study evaluating the efficacy of enteric coated mycophenolate sodium (myfortic) in decreasing the titers of anti-hla alloantibodies in patients awaiting kidney transplantation. myfortic is an immunosuppressant that inhibits the proliferation of b and t cells by blocking the enzyme inosine monophosphate dehydrogenase. we will attempt to determine whether a 6-week course of myfortic adequately decreases the antibody reactivity to a level compatible with transplantation.

Eligibility criteria:
inclusion criteria: * patients on the deceased donor kidney transplant waiting list with panel reactive antibodies \>50% and living donor waiting list patients who have a history of a positive crossmatch (donor-specific antibodies) will be eligible for the study. exclusion criteria: * any subjects not meeting the inclusion criteria * subjects unable to attend weekly clinic visits for six weeks * inability to tolerate myfortic

Keywords: renal transplant pra
ex vivo lung perfusion : effect of cellular perfusate on mechanical properties and gas exchange function of donor lungs

Conditions: Organ Preservation

Summary: the lungs retrieved from the brain dead multi organ donor will be placed in a lab . they will be connected to a ventilator and preservative solution will be circulated through it . blood will be added to the fluid depending on the group to which the lungs are allocated and its effects on lung function will be seen

the lungs of a brain dead multi organ donor will be retrieved according to standard protocol. once a decision is made not to transplant the lungs either because of not satisfying ideal criteria or in the absence of a potential recipient they will be included in the study.they will be ventilated optimally and connected to a cardiopulmonary bypass machine for circulating preservative solution through it . red blood cells will be added to the solution either initially or later depending on the group to which it is allocated .monitoring of mechanical and gas exchange function and pathological examination of the lungs will be performed at various time points to observe the effect of red blood cells. the lungs will be properly discarded at the end of the procedure and will not be used for transplantation.

Eligibility criteria:
inclusion criteria: * brain death certified multi organ donor * absence of ideal lung donor criteria or absence of suitable lung recipient exclusion criteria: * presence of severe mechanical lung injury on visual inspection or radiography * presence of pneumonia * positive serology ( hepatitis b,c and hiv

Keywords: ex vivo lung perfusion
a study of the efficacy of rwj-333369 in the prevention of migraine

Conditions: Migraine Headaches

Summary: the purpose of this study is to evaluate whether rwj-333369 is a safe and effective treatment in reducing the number of migraine headaches when added to a person's usual medications for acute migraine headache relief.


Eligibility criteria:
inclusion criteria: * established history of migraines for at least 1 year; * have between 3 and 12 migraine attacks per month, and no more than 15 headache days in total per month; * migraines must have first started before age 50. exclusion criteria: * most frequent headache type is not migraine; * failed 3 or more studies of effective migraine-preventing medications; * overuse of pain medications to treat migraines; * not willing to stop use of migraine-preventing medications; * significant serious concomitant diseases.

Keywords: migraine headaches migraine headaches head pain
strength and strength-ratio of hip rotator muscles at soccer players

Conditions: Hip Injuries; Muscular Atrophy; Dysfunction

Summary: at this investigation we want to find out whether there is a difference in muscle strength of the internal and external rotation hip muscles between soccer players and non-soccer players caused by typical movement patterns seen in soccer sport.

nontraumatic hip injuries are a problem often seen in soccer players. a biomechanical formation mechanism is probably. little research has focused on the measurement of hip external and internal rotation strength at soccer players. the purpose of this study is to investigate the influence of soccer sports at the isometric force and force ratio of the hip rotator muscle system. two samples of athletes will be compared: soccer players (n15) and non-soccer players (n15) matched in sex, age and level of physical activity to investigate hip rotator force in 3 different angles of hip flexion (0°/45°/90°). the measurement will be made with a handheld dynamometer.

Eligibility criteria:
inclusion criteria: study group: amateur footballers (n15) in the age between 18 and 35 at least five years of active footballer's career football training twice weekly active participation in play no pain or limitations in the area of the hip or the lower extremity control group: athletes (n15), non-soccer players with now asymmetric leg activities in the age between 18 and 35 at least twice weekly sports activity for at least 30 minutes no pain or limitations in the area of the hip or the lower extremity exclusion criteria: professions with asymmetric leg activities pain or limitations in the area of the hip or the lower extremity surgery on the hip in the prehistory
antiseizure medication in seizure networks at early acute brain injury

Conditions: Brain Injuries, Acute; Brain Injuries, Traumatic; Brain Ischemia; Brain Hypoxia; Hypoxia-Ischemia, Brain; Heart Arrest; Stroke; Intracranial Hemorrhages; Coma; Persistent Vegetative State

Summary: the goal of this clinical trial is to explore the effect of fda-approved antiseizure drugs in the brain connectivity patterns of severe and moderate acute brain injury patients with suppression of consciousness. the main questions it aims to answer are: * does the antiseizure medication reduce the functional connectivity of seizure networks, as identified by resting state functional mri (rs-fmri), within this specific target population? * what is the prevalence of seizure networks in patients from the target population, both with eeg suggestive and not suggestive of epileptogenic activity? participants will have a rs-fmri and those with seizure networks will receive treatment with two antiseizure medications and a post-treatment rs-fmri. researchers will compare the pretreatment and post-treatment rs-fmris to see if there are changes in the participant's functional connectivity including seizure networks and typical resting state networks.


Eligibility criteria:
inclusion criteria: * currently icu hospitalized. * suppression of consciousness related to a neurological injury by medical chart review. * glasgow coma scale of less than 13 at enrollment by medical chart review. * diagnosis of acute brain injury by tbi, hypoxic-ischemic insult, cardiac arrest, or stroke by medical chart review. * 2 to 90 days from acute brain injury to enrollment time by medical chart review. * have a surface eeg performed after the current icu admission * clinically stable to undergo mri scan, this stability is defined by care team concept, which should be stated in the medical records. exclusion criteria: * previous medical history of epilepsy by medical chart review. * previous medical history of neurological sequels that lead to dependence on care for basic daily activities, by barthel index score less than 80. * known allergy/hypersensitivity or medical contraindications (like porphyria or cardiac arrhythmias) to the treatment protocol options, leaving no potential combination of drugs for the intervention without concerns for adverse events related to known preexistent conditions. * considered with brain death by the care team in the medical record, at any time. * speaking fluently or at their prior reported baseline mental status by medical chart review before the intervention starts. * contraindications for mri scan. * prisoner human subjects by medical chart review. * confirmed currently pregnant by medical history or by positive blood or urine pregnancy test done in the present hospital admission. * treating physician determines the patient is no candidate to receive 2 of the 5 protocol-specified asm.

Keywords: coma vegetative state suppression of consciousness antiseizure medication brain networks functional connectivity unresponsive wakefulness functional mri resting state brain injuries, acute
statin treatment for unruptured intracranial aneurysms study

Conditions: Intracranial Aneurysm; Inflammation Vascular

Summary: this study was designed to identify whether there is a measurable reduction in inflammation in walls of intracranial aneurysms with oral atorvastatin.

unruptured intracranial aneurysms (uias) are increasingly detected and often remain clinically asymptomatic for a long time before rupture. however, once the uias ruptured, the incidence of mortality rate varies from 30% to 60% within 6 months. thus, the risk of uias rupture should be weighed, and need an individual criterion for predicting rupture in clinical decision making. histopathological studies indicated that inflammation may play an important role in the formation, growth, and rupture of uias. wall enhancement of a saccular aneurysm on high resolution magnetic resonance (hrmri) is a proven sign of inflammatory change and might predict an unsteady state of an intracranial saccular aneurysm. statins inhibit 3-hydroxy-3-methylglutaryl coenzyme a reductase and are established first-line treatments for hypercholesterolemia. statins produce a range of pleiotropic effects in addition to inhibition of cholesterol synthesis, especially to reduce inflammation, which may be important in reducing the growth and rupture of uias. in the study, participants known to have uia that is not planned for treatment and has not yet ruptured, take atorvastatin daily for six months, and have an hrmri scan before and after to look for the role of atorvastatin in inflammation.

Eligibility criteria:
inclusion criteria: 1. be aged 18 or over, male or non-pregnant female; 2. patients have a saccular uia identified on imaging (ct, mri or dsa), and the aneurysm ≥3mm; 3. patients with wall enhancement of aneurysm by mri vwi before treatment; 4. patients who is able to understand the objective of the trial, agrees and signs the written informed consent form. exclusion criteria: 1. patient with mri contraindications: metallic implant, contrast allergy, claustrophobia, etc.; 2. planned treatment of the aneurysm within 6 months; 3. patient taking the drugs, which might have an anti-inflammatory effect, such as aspirin, statin, immunosuppressive drug, etc. 4. dyslipidemia or severely impaired liver or renal functions 5. retreatment of recurrent aneurysm; 6. pregnant or lactating women; 7. patients with malignant diseases, such as liver disease, kidney disease, congestive heart failure, malignant tumors, etc; 8. poor compliance patients.

Keywords: high resolution magnetic resonance atorvastatin ruptured risk
bringing parkinson care back home

Conditions: Parkinson Disease

Summary: summary rationale: for persons with parkinson's disease (pd), medical decisions are based almost exclusively on periodic in-clinic evaluations by a neurologist or a nurse. for a variety of reasons, such "snapshots" are unable to capture the actual impact of pd on the patient's functioning in their own home environment. outpatient evaluations cannot detect rare and typically domestic events, such as falls. in addition, episodic visits are not well suited to detect changes in important lifestyle issues, such as gradual declines in physical activity. objective: to objectively, continuously and accurately collect detailed information on (changes in) physical activity and fall patterns among patients with pd in daily life. study design: observational cohort study in 200 patients with pd, with a 12 month follow-up period. study population: patients with pd (n=200), with an increased fall risk (i.e. at least one fall within the last six months). intervention (if applicable): this study does not include an intervention. after a baseline assessment on demographics and pd symptoms, patients will use a remote monitoring system at home (a pendant falls detector) combined with an smartphone application aimed at falls self-reporting, and an application to report medication intake for 12 months. a similar set up (i.e.vital@home) has been previously tested on feasibility (dossiernummer: 2017-3382). additionally, patients will report sleep patterns through paper-based diaries. main study parameters/endpoints: the main study parameters are physical activity and number of falls. they are remotely registered by the pendant falls detector. nature and extent of the burden and risks associated with participation, benefit and group relatedness: in this study, no invasive measurements will be performed. the participation is free of risks. subjects could potentially benefit personally from participating in this study, as they can use the devices for free during the study and receive periodically feedback about physical activity and the occurrence of falls.


Eligibility criteria:
inclusion criteria: * subjects must confirm that they have been diagnosed with parkinson's disease by a neurologist (self-reported) * age 18 or older * at least 1 fall incident in the previous 6 months. a fall is defined as any unexpected event that caused the person to unintentionally land on any lower surface (object, floor, or ground), regardless of any sustained injury (self-reported) * able and willing to provide written informed consent in accordance with good clinical practice, and national and local regulation * fluent in dutch exclusion criteria: * the patients receives advanced therapy for their parkinson's disease (deep brain stimulation, duodopa pump, apomorphine pump); * the patients shows cognitive of psychiatric impairments that may hinder successful completion of the study protocol (as judged by the researcher running the recruitment).

Keywords: wearable sensors falls physical activity parkinson's disease
cardiamend and amiodarone for the prevention of poaf

Conditions: POAF; Atrial Fibrillation

Summary: the principal purpose of this investigator-initiated trial is to study the use of the cardiamend device soaked in the anti-arrhythmic drug amiodarone, and how it may decrease the development of atrial fibrillation in patients that have undergone a coronary artery bypass surgery, or isolated valve surgery.


Eligibility criteria:
inclusion criteria: * aged 21-85 years * able to provide written informed consent, understand and be willing to comply with study-related procedures. * scheduled to undergo open-chest cardiac surgery via complete median sternotomy for coronary artery bypass graft (cabg), or isolated valve repair/replacement. * inclusionary valve repair/replacement procedures with the primary reason for surgery inclusive of aortic valve repair/replacement or mitral valve repair/replacement. * left atrial appendage (laa) procedures are allowed if cabg and/or valve repair or replacement is the qualifying surgical procedure, but is not a qualifying surgical procedure on its own. * in sinus rhythm at the time of consultation and on a previous ekg, or no history of atrial fibrillation (note: continuous ecg monitoring for 48 hours is not required) exclusion criteria: * unable to give voluntary written informed consent, is unlikely to cooperate or is legally incompetent, including subjects who are institutionalized by court or official order, or in a dependency relationship with testing center or investigator. * any condition which could interfere with the subject's ability to comply with the study. * ongoing participation in an interventional clinical study or during the preceding 30 days. * female subjects who are pregnant, breastfeeding, were pregnant within the last three months or are planning a pregnancy during the course of the study. * active skin or deep infection at the site of implantation. * history of chronic wounds or wound-healing disorders. * known connective tissue diseases (e.g. ehlers-danlos syndrome, epidermolysis bullosa, marfan syndrome, osteogenesis imperfecta). * immune-suppressed subjects, immune-deficiency subjects (properly managed diabetes mellitus is not an exclusion criterion). * the subject has an implantable cardiac device (i.e., cardiac resynchronization therapy devices with and without defibrillator capabilities (crts and crt-ds), implantable cardioverter-defibrillators (icd) and pacemakers). * known history of atrial fibrillation (in any form including paroxysmal atrial fibrillation). * history of ablation for atrial fibrillation. * patients already receiving amiodarone as a treatment for atrial fibrillation or ventricular arrhythmias during the procedure. * disease of the left pleura, previous intervention in the left pleural space, or chest deformity. * subjects with end-stage chronic-renal disease / dialysis. * subjects with heart failure (bnp\>1000), low ejection fraction (\ 1.8). * sts risk \>5.5% for 30 day mortality. * patients electing to receive an ablative procedure for atrial fibrillation.