Kornimate/medical-research-clean huggingface dataset:
regenerative cellular therapies, physiology, pathology and developmental biology

Conditions: Graft Rejection; Transplantation; Diabetes Mellitus

Summary: this study aims to use tissue from deceased organ donors to investigate organ physiology, developmental biology, as well as the development of future regenerative cellular therapies. it will investigate function and immune response to stem cells as well as their generation from adult cells and generation of induced pluripotent stem cells (ipscs).

the purpose of this study is to use tissue from deceased organ donors to address questions that are of importance for the development of regenerative cellular therapies for better understanding of organ physiology and developmental biology. this study aims to maximise the clinically available data as well as patient benefit that can be generated from donated tissue. it also aims to reduce number of consent forms given to patients by consolidating and coordinating a number of related investigations. the study aims are: * to examine function and the immune response to stem cells and their differentiated progeny as well as development of immunomodulatory approaches to prevent their rejection. * generation of induced pluripotent stem cells (ipscs) and their subsequent differentiation into functional cells as potential therapies. * generation of differentiated cells from native adult stem cells as cellular therapies. * investigation of organ physiology.

Eligibility criteria:
inclusion criteria: * all deceased organ donors with informed consent from the donor family exclusion criteria: * donors aged \<16

Keywords: regenerative medicine stem cells immunomodulatory induced pluripotent stem cells gut physiology
treatments of acquired apraxia of speech

Conditions: Aphasia; Apraxia of Speech; Stroke

Summary: this study was designed to examine the effects of speech therapy on ability to produce speech sounds in persons with acquired apraxia of speech.

this study was designed to investigate the effects of sound production treatment (spt; a treatment for acquired apraxia of speech) on sound production accuracy in persons with chronic apraxia of speech (aos). organization of practice (blocked practice or randomized practice) will be manipulated in an effort to determine the most efficacious application of spt. a combination of group and single-subject experimental designs wasl be completed with 20 speakers with aos (2 groups of 10 participants).

Eligibility criteria:
inclusion criteria: * must have acquired apraxia of speech that occurred following a stroke or other brain injury. * must be at least 6 months post-onset of brain injury. * may have aphasia. exclusion criteria: * history of drug or alcohol abuse. * history of mental illness. * neurological condition other than that which resulted in apraxia of speech.

Keywords: speech speech therapy apraxia of speech
2024 tirzepatide-bariatric surgery

Conditions: Obesity and Obesity-related Medical Conditions; Bariatric Surgery

Summary: this clinical trial will test whether preoperative tirzepatide treatment improves outcomes after bariatric surgery. the outcome of this study could impact therapeutic guidelines for the multimodal treatment of obesity. the major objectives are: 1. to evaluate whether pre-operative tirzepatide treatment reduces tissue and circulating inflammatory markers at the time of surgery. 2. to establish the relationship of these changes with postoperative improvements in weight loss, metabolic and inflammatory profiles, comorbidity resolution (glycemic control, blood pressure, lipid profile), and 30-day surgical complications. researchers will compare data from patients taking tirzepatide to data from patients not taking tirzepatide before their planned bariatric surgery to see if tirzepatide reduces inflammation and improves health outcomes after bariatric surgery. participants will: take or not take tirzepatide, depending on what study group they are in, once a week for 3 months. visit the endocrine clinic once a month for 3 months to be prescribed the drug and for checkups regarding side effects due to the drug. keep a diary to document taking the drug and any side effects. continue with their planned bariatric surgery and post-surgery follow-ups according to their healthcare provider.


Eligibility criteria:
inclusion criteria: * adults who have been enrolled in the multidisciplinary metabolic and bariatric surgery program at the uk healthcare weight loss surgery clinic and are scheduled to receive laparoscopic or robotic sleeve gastrectomy * bmi greater than or equal to 45 kg/m2 with one or more obesity-related comorbidities * have demonstrated abstinence from any form of nicotine use, confirmed by serum nicotine and metabolite testing * have expressed preference and are deemed a suitable candidate for laparoscopic or robotic vertical sleeve gastrectomy * enrollment in the adore bariatric tissue bank (irb #69767) exclusion criteria: * any contraindication to the use of tirzepatide (per package insert) * personal or family history of medullary thyroid carcinoma * patients with multiple endocrine neoplasm syndrome type 2 * hypersensitivity to tirzepatide * history of pancreatitis * type 1 diabetes * patients with active, untreated or symptomatic cholelithiasis or jaundice * current use of a glp-1 or glp-1/gip receptor agonist, or use within past 90 days * a history of prior metabolic and bariatric surgery * diagnosed autoimmune disease * current use of immunosuppressive agents or use within the past 30 days * moderate or severe substance use disorder according to dsm-5 criteria * uncontrolled significant psychiatric disorder as assessed by specialized bariatric psychologist * female participant who is pregnant, breast-feeding, or intends to become pregnant with in 1 year following surgery * a prisoner
capnogram and fluid responsiveness

Conditions: Healthy; Blood Pressure

Summary: predicting fluid responsiveness in critically ill patients is of paramount importance. it can help define an adequate fluid balance. overzealous fluid administration is poorly tolerated and has been associated with poor outcomes but so has insufficient administration. currently available predictors of fluid responsiveness rely on invasive monitors and require patients to be on mechanical ventilation. it is thus important to develop non invasive novel methods to assess fluid responsiveness to provide an accurate management for a favorable outcome. we propose a readily available non-invasive method that relies on improvement of the ventilation perfusion mismatch as recorded by end tidal co2. ventilation of physiologic dead space is part of a spectrum of mismatch between ventilation and perfusion of the lungs. the extent of pulmonary dead space varies depending on factors affecting pulmonary perfusion (e.g. pulmonary capillary hydrostatic pressure) and alveolar pressure (e.g. positive pressure ventilation). compromised pulmonary capillary perfusion can lead to ventilation-perfusion mismatch in a patient with clear conductive airway and adequate alveolar oxygen pressure. alveolar dead space results in decreased co2 exchange that translates into lower levels of expired co2. stroke volume of the right ventricle is a major determinant of the pulmonary capillary perfusion. right ventricular cardiac output can be increased by passive lower limb elevation maneuver, which ultimately results in improvement of the ventilation to perfusion ratio. this effect leads to a higher participation of perfused (and ventilated) alveolar units in gas exchange and narrowing of the gradient between arterial and expired co2 concentration. performing a passive leg raising (plr) maneuver leads to stroke volume enhancement in both healthy patients and in those experiencing hemodynamic instability. responsiveness to plr can be assessed by different methods including echocardiography and pulse pressure variation. left ventricular cardiac output (lvco) can be easily measured by transthoracic echo and be used as a surrogate of right ventricular preload changes. lvco can thus be used to assess the fluid responsiveness of plr and the effects of on end tidal co2 that ensue. we propose this study to test the hypothesis that expired co2 is a reliable predictor of fluid responsiveness after performance of the plr maneuver, based on the assumption that increasing right ventricular output causes a reduction of the ventilation to perfusion ratio, leading to increased levels of expired co2. t


Eligibility criteria:
inclusion criteria: * age older than 18 years exclusion criteria: * cardiovascular and respiratory disease reported by the participant
fertility-sparing therapy for patients with stage ia endometrial cancer

Conditions: Endometrial Neoplasms; Endometrial Neoplasm Malignant; Endometrial Neoplasm Malignant Stage I; Carcinoma, Endometrioid; Fertility Preservation

Summary: the goal of this clinical trial is to explore the feasibility and outcome of fertility-sparing therapy in stage ia g1-g2 endometrial cancer with less than 1/2 myometrial invasion. researchers will render participants indication-extended fertility-sparing therapy. researchers will compare the myometrial invasion group with the no myometrial invasion group to see if it is possible to propose an extension indication of fertility-sparing therapy for endometrial cancer.

the study population is patients with stage ia endometrial adenocarcinoma with no myometrial invasion or less than 1/2 myometrial invasion. the sample size is 57 cases (myometrial invasion group : no myometrial invasion group = 1 : 2). follow up every 3-6 months until the end of the fifth year of treatment. the primary outcome measure is the complete remission rate after 9 months of treatment. secondary outcome measures include complete remission rate (6 months/12 months after initial treatment), complete remission time, recurrence rate (1 year/2 years after complete remission), recurrence time, pregnancy rate (1 year after complete remission), pregnancy outcome, blood molecular biomarkers, pathological markers, adverse reactions, etc.

Eligibility criteria:
inclusion criteria: * stage ia (figo 2009) ; * pathological diagnosis: endometrial adenocarcinoma g1-g2; * mri or ultrasound: tumor limited to endometrium or invading less than 1/2 of myometrium； * 18 years old ≤ age ≤ 45 years old; * with a strong desire for fertility preservation； * sign the informed consent. exclusion criteria: * complicated with any other malignancy； * contraindications to conservative treatment； * contraindications to progestin use; * contraindications to pregnancy, or judged by the researcher to be unfit for pregnancy or delivery.

Keywords: fertility-sparing fertility-preserving endometrial carcinoma endometrial cancer indication extension
incentive spirometer training and oropharyngeal motor training for pulmonary dysfunction in spastic diplegic children

Conditions: Pulmonary Dysfunction; Spastic Diaplegia

Summary: purpose of the study to determine the impact of incentive spirometer training and the oropharyngeal motor training or the combination of both for pulmonary dysfunction in spastic diplegic children

this is a prospective randomized controlled clinical trial, conducted at kafr el sheikh hospital. * forty-eight children of both genders. * the study will include children (age 3-7 years) post selective pulmonary dysfunction. * children meeting the inclusion criteria will be randomly assigned to one of three groups: * first experimental group: children in this group will receive incentive spirometer training. * second experimental group:children in this group will receive oropharyngeal motor training. . * third experimental group: patients in this group will receive combination of incentive spirometer training and oropharyngeal motor training * randomization will be achieved using computer-generated random numbers to ensure an equal distribution of patients between the two groups. conditions: cerebral palsy

Eligibility criteria:
inclusion criteria: * the children with spastic cp between the age from 3 to 7 years old. level i to iv on the gross motor function classification system (gmfcs) , who have the partial ability to maintain antigravity head and trunk postures. * cognitive and cooperative function allowing pulmonary function measurements. * no history of psychiatric or neurological disorders rather than cp. exclusion criteria: * any uncontrolled clinically significant medical conditions such as coexistent cardiac disease or respiratory disease * children with cognitive impairment who are unable to comply with the protocol required procedure * children who are taking medications that can affect respiratory function * children with presence or history of tracheostomy

Keywords: pulmonary dysfunction
clinical outcomes of primary versus secondary antiphospholipid syndrome

Conditions: Antiphospholipid Syndrome

Summary: observational retrospective cohort study to assess clinical outcomes in patients with primary versus secondary antiphospholipid syndrome

antiphospholipid antibody syndrome is an autoimmune disorder associated with positive antiphospholipid antibodies including the lupus anticoagulant, anticardiolipin antibodies igg or igm, and/or anti-ß2-glycoprotein igg or igm associated with thrombotic problems and pregnancy loss. antiphospholipid syndrome is one of the most frequent forms of acquired thrombophilia and is associated with an increased risk of both venous and arterial thrombotic events. thirty to 40% of systemic lupus erythematosus (sle) patients have associated antiphospholipid syndrome. antiphospholipid syndrome has estimated incidence in the general population of 2.1 (1.4-2.8) per 100 000, and the prevalence of 50 (42-58) per 100 000. aps is more common in female with a female to male ratio is 3.5:1 for primary and 7:1 for secondary. antiphospholipid syndrome is divided into two types primary syndrome without an underlying disease, and secondary antiphospholipid syndrome that is associated with another autoimmune syndrome, most commonly systemic lupus erythematosus (sle). patients with aps are more at risk of recurrent thrombosis (3). n a retrospective analysis of 160 patients with aps, venous thromboembolism (vte) was found to be the commonest manifestation (47.5%) followed by arterial thromboembolism (43.1%) then materno fetal problems which were found only in 9.7% of patients, and finally, catastrophic antiphospholipid syndrome (caps) represented in only 2.5 percent of the cases (4). the clinical manifestations of antiphospholipid syndrome include haematological (thrombocytopenia, venous thrombosis), obstetrical (recurrent pregnancy loss), neurological (stroke, transient ischaemic attack, seizures), cardiovascular, dermatological such as livedo reticularis, skin ulceration and necrosis, renal (glomerulonephritis and renal thrombotic microangiopathy), and orthopedic (avascular necrosis of bones). the manifestation spectrum ranged from asymptomatic antiphospholipid antibodies positivity, various non-criteria manifestations, obstetric morbidity, thrombosis, to life-threatening catastrophic antiphospholipid syndrome. the wide manifestation spectrum led to a heterogeneous entity and brought challenges to management of the syndrome. the aim of this study was to compare primary versus secondary effects of antiphospholipid syndrome on the development of thrombosis and its outcomes.

Eligibility criteria:
inclusion criteria: * all patients diagnosed as antiphospholipid syndrome in clinical hematology or rheumatology units in internal medicine department, assiut university hospital. exclusion criteria: * patients with other risk factor for thrombosis (malignancy, cocs, protein c or protein s deficiency etc

Keywords: thrombosis antiphospholipid syndrome
dexmedetomidine as adjuvant for bupivacaine in ultrasound guided infraorbital nerve block for cleft lip repair

Conditions: Cleft Lip

Summary: to assess the efﬁcacy of dexamethasone versus dexmedetomidine as adjuncts to bupivacaine for infra-orbital nerve block in infants undergoing cleft lip surgery.

regarding patient registry; a prior g power analysis was done. using the results obtained from previous studies and assuming an alpha error of 0.05 and beta error 0f 0.2 (power of the study 80 %), a sample size of 20 patients per group was calculated. a drop out 10% of cases is expected, so; 22 cases per group will be required. statistical analysis: data will be analyzed through spss (statistical package for social sciences). program version 22. distribution of data will be first tested by shapiro test. data will be presented as mean and standard deviation (sd), median and range or numbers and percentages. for normally distributed data, unpaired t test will be used to compare between mean values of both groups. for pain and sedation scores, mann whitney u test will be used. fisher's exact test will be used for comparison of categorical data. the p value ≤ 0.05 will be considered as the level of statistical significance.

Eligibility criteria:
inclusion criteria: * american society of anesthesiologist (asa) physical status i or ii exclusion criteria: * known allergy to any of drugs used * coagulopathy * any wound or infection related to puncture site * major illness * failure to gain consent of parents.
zithromax ev in community-acquired pneumonia (cap)

Conditions: Pneumonia

Summary: the intravenous (iv) regimen containing azithromycin (zithromax) plus ampicillin-sulbactam is consistent with current guidelines for the treatment of cap. in fact the international guidelines for the treatment of cap in hospitalised patients suggests the use of a combination between a b-lactam and a macrolide. this trial will allow investigators to evaluate the efficacy of azithromycin plus ampicillin-sulbactam in the treatment of hospitalized subjects with community acquired pneumonia. in addition, this trial will allow investigators to evaluate the safety and toleration of combination therapy.


Eligibility criteria:
inclusion criteria: * subjects must require hospitalization and intravenous therapy. * subjects must have a fine pneumonia score \> 70 (fine class \> ii). * subjects must have a medical history and clinical and radiological findings consistent with a community-acquired bronchopneumonia or lobar pneumonia. the following criteria must be met: * new infiltrate(s) on chest x-ray; and * at least two of the cap signs or symptoms. exclusion criteria: * treatment with any systemic antibiotic for 24 hours or longer within 72 hours of the baseline visit, or treatment for more than 7 days within 15 days. * specific systemic diseases or other medical conditions that would interfere with the evaluation of the therapeutic response or safety of the study drug, including: * known acquired immunodeficiency syndrome (aids) or suspected pneumocystis carinii pneumonia; * neutropenia; * cavitary lung disease by chest x-ray; * primary lung cancer or other malignancy metastatic to the lung; * aspiration pneumonia; * empyema; * known or suspected tuberculosis; * neoplastic disease; * cystic fibrosis; * a history of any form of epilepsy or seizure; * ddm; * bronchiectasis, bronchial obstruction or history of post-obstructive pneumonia (this does not exclude patients with chronic obstructive pulmonary disease); * significant gastrointestinal or other conditions which may affect study drug absorption; and * significant cardiovascular disorders. * immunosuppressive therapy, defined as chronic treatment with known immunosuppressant medications * impaired hepatic function, as shown by, but not limited to, ast, (sgot), or alt (sgpt) greater than three times the laboratory upper limit of normal, or total bilirubin greater than two times the upper limit of normal. * subjects already hospitalized or who resided in a long-term-care facility for greater than 14 days before the onset of symptoms.
study on copd corticosteroid-induced hyperglycemia on clinical outcome in patients with copd

Conditions: COPD

Summary: hyperglycemia is a common complication of corticosteroid (cortisone) therapy. it is estimated that more than a third of patients with chronic pulmonary disease (copd) exacerbation (16). despite its frequency, the impact of corticosteroid-induced diabetes on clinical outcome and mortality is not known. a computerized search of biomedical journal literature from medline, pubmed, and ovid from 1966 to 2006 provided very little information on the prevalence and outcome of corticosteroid-induced diabetes in patients with copd. therefore, the present study aims to evaluate the impact of corticosteroid-induced diabetes on clinical outcome in patients with copd exacerbation. we will perform a retrospective chart review of all patients admitted to the hospital with copd exacerbation from 1/01/05 to 06/30/06 at grady memorial hospital. medical records of all patients with copd exacerbation treated with corticosteroids will be analyzed. data on demographics, laboratory values, mortality rate, rate of hypoglycemic events, length of stay, as well as disposition at discharge will be analyzed.

hypotheses: we hypothesize that copd patients with corticosteroid-induced hyperglycemia experience higher morbidity (infections, ventilator associated pneumonia, length of stay, acute renal failure) and mortality compared to copd patients with normal glucose levels. specific aim: to determine the impact of corticosteroid-induced hyperglycemia on clinical outcome (length of stay, disposition, apache score, need for ventilatory support and icu admission, mortality) in patients with copd exacerbation.

Eligibility criteria:
inclusion criteria: patients admitted with copd exacerbation

Keywords: copd diabetes respiratory disorders
the impact of fascia thickness on chronic low back pain

Conditions: Low Back Pain; Disability Physical; Pain, Chronic

Summary: this study aimed to investigate the impact of lumbar perimuscular and subcutaneous zone thickness on pain, functionality, disability, and depression in individuals with chronic low back pain (clbp).

this study investigates the role of the thoracolumbar fascia (tlf) in chronic low back pain (clbp) persisting for more than one year. specifically, the researchers aim to examine the relationships between various factors in individuals with clbp, including the thickness of the perimuscular and subcutaneous regions in the lumbar and hamstring regions. the relationship with functional tests of the lower back and lower limbs will also be analysed. in addition, the intensity of the pain experienced by the participants, the extent to which the pain restricts their daily activities, and depression scores will be assessed. through this analysis, the researchers aim to gain a deeper understanding of tlf's involvement in clbp and its impact on the overall well-being of affected individuals.

Eligibility criteria:
inclusion criteria: * the absence of lbp in the last 12 months, * a body mass index (bmi) of 18.5 to 30, * an age between 30 and 50 years. exclusion criteria: * history of musculoskeletal diseases, * a history of back and lower limb surgery, * the use of anti-inflammatory drugs and steroids