Kornimate/medical-research-clean huggingface dataset:
reducing treatment risk in older adults with diabetes

Conditions: Type 2 Diabetes Treated With Insulin; Hypoglycemia; Primary Health Care; Polypharmacy

Summary: this study will evaluate the impact of academic detailing (evidence-based provider education) with or without patient pre-visit preparation (elicitation of values and preferences) on safe insulin de-prescribing among older patients with type 2 diabetes at risk for hypoglycemia. the hypothesis is that patients who are well-prepared for their primary care visit will engage in more informed discussions with their providers regarding re-evaluation of current treatment regimens. in clinically appropriate cases, these more effective discussions will result in safe de-prescribing and fewer future episodes of hypoglycemia.

in this comparative effectiveness clinical trial, primary care physicians (pcps) will receive 2 academic detailing sessions 6 months apart. eligible patients (age 75 years or greater, type 2 diabetes, prescribed insulin or sulfonylureas \[sus\], and last measured hba1c \<=8%) of these pcps will be randomized to receive either a pre-visit conversation aid/communication tool that elicits values and preferences regarding safe insulin/su deprescribing \[intervention\] or a general health education handout ("embracing life as you age") \[attention control\]. patient-reported outcomes (e.g., self-reported hypoglycemia episodes) and clinical outcomes (e.g., changes in glycemic regimen) will be compared between study arms. if successful, this study will provide evidence to support strategies for safer treatment in older adults with type 2 diabetes.

Eligibility criteria:
inclusion criteria: * age ≥ 75 years * type 2 diabetes with last measured hemoglobin a1c (hba1c) ≤ 8.0% * currently prescribed insulin and/or sulfonylureas (sus) * kaiser permanente northern california member exclusion criteria: * given the requirements of this funding mechanism, we will not be able to develop new patient materials in languages other than english, and patients unable to communicate in english will be excluded. * similarly, patients unable to provide informed consent and/or participate in informed decision making due to cognitive or communication-related deficits will be excluded. * excluded by their primary care provider

Keywords: clinical trial
dispensing study for a new study lens

Conditions: Myopia

Summary: this study investigated the performance criteria over one week of daily wear to determine if the comfilcon a asphere lens (test) performed equivalently to the comfilcon a sphere (control) in terms of measurement and subjective ratings of visual performance.

this study was a prospective, single site, daily wear, double masked, randomized bilateral cross over dispensing study of binocular wear of comfilcon a asphere lens (test) and comfilcon a sphere lens (control) over 1 week of daily wear.

Eligibility criteria:
inclusion criteria: a person is eligible for inclusion in the study if he/she: * oculo-visual examination in the last two years * between 18 and 35 years of age and has full legal capacity to volunteer * has read and understood the informed consent letter * is willing and able to follow instructions and maintain the appointment schedule * is correctable to a visual acuity of 20/25 or better (in each eye) with their habitual correction or 20/20 best corrected * currently wears, or has previously successfully worn, soft contact lenses between -1.00d (diopoter) and -4.00d * spherical contact lens rx between -1.00 and -4.00 and spectacle cylinder \<-0.75 * has not worn lenses for at least 12 hours before the initial visit * has a subjective response at baseline, which indicates suitability for this study * currently spends a minimum of 4 hours a day; 5 days a week on digital devices and can replicate this time during the study period * is willing and able to wear the study contact lenses a minimum of 10 hours per day; 5 days a week exclusion criteria: a person will be excluded from the study if he/she: * has never worn contact lenses before * any systemic disease affecting ocular health * is using any systemic or topical medications that will affect ocular health * has known sensitivity to the diagnostic pharmaceuticals or study products used in this study. * has any ocular pathology or anomaly that would affect the wearing of the lenses * has persistent, clinically significant corneal or conjunctival staining using sodium fluorescein dye * is aphakic * has anisometropia of \>1.00 * has undergone corneal refractive surgery * has strabismus * has any ocular amblyopia \>= 1line of hc (high contrast) visual acuity * is participating in any other type of eye related clinical or research study * has previously participated in study of the phenacite lenses
safety and tolerability of open-labeled iloperidone in adolescents

Conditions: Schizophrenia; Bipolar I Disorder

Summary: to evaluate the safety and tolerability of iloperidone in adolescent patients with schizophrenia or bipolar i disorder for up to 52 weeks of treatment.


Eligibility criteria:
inclusion criteria: * patient is willing and able to provide assent and willing to complete all aspects of the study * patient's parent or legal guardian willing and able to provide consent * male or female patients 12 through 17 years of age (inclusive) * clinical diagnosis of either schizophrenia or bipolar i disorder exclusion criteria: * use of other investigational drugs at the time of enrollment, or within 30 days or 5 half-lives of enrollment, whichever is longer * a positive test for drugs of abuse

Keywords: fanapt
feasibility and identification of breast cancer patients for potential avoidance of surgery

Conditions: Breast Cancer

Summary: the goal of this clinical research study is to compare the use of an ultrasound-guided biopsy with what is found during surgery in finding evidence of the disease.

if you agree to take part in this study, you will have an ultrasound-guided biopsy of the tumor site. to perform this biopsy, a needle is inserted into the affected area using an ultrasound to collect cells or tissue from a tumor mass. the doctor will use the ultrasound to guide the needle into the area. two (2) types of samples will be collected: a fine needle aspirate (fna) that collects cells and a core biopsy that collects a small piece of tissue. if the tumor is not seen well by the ultrasound, the study doctor may use a mammogram to perform the biopsy. you will then have the same planned surgery and post-operative care that you would normally have. you will sign a separate consent for your surgery. your medical records may be reviewed and information recorded from your routine follow-up visits in order to follow your general health and the outcome of your surgery. length of study participation: your active participation in this study will be finished when you have had your surgery and completed your post-operative care. this is an investigational study. it is investigational to compare the use of an ultrasound-guided biopsy with what is found during surgery in finding evidence of the disease. up to 40 participants will take part on this study. all will be enrolled at md anderson.

Eligibility criteria:
inclusion criteria: 1. \>/= 18 years old 2. histologic diagnosis of triple negative or her2 amplified breast cancer, clinical stage t1-4, n0-3, m0/1 receiving preoperative systemic therapy and planned surgery exclusion criteria: 1) n/a

Keywords: breast cancer triple negative breast cancer her2 amplified breast cancer ultrasound-guided biopsy fine needle aspirate fna core biopsy
frailty, physical capacity and lung function in postoperative pulmonary endarterectomy patients

Conditions: Chronic Thromboembolic Pulmonary Hypertension; Physical Disability; Fragility

Summary: the goal of this observational and prospective study is to investigate changes in physical performance, lung function, respiratory and peripheral muscle strength in patients during the postoperative period following pulmonary endarterectomy (pet).

this study aims to investigate the physical changes in patients undergoing pulmonary endarterectomy (pet). it will observe alterations in physical performance, lung function, and muscle strength during the postoperative period. this study, observational and prospective, will include individuals aged ≥18 scheduled, evaluating them preoperatively, post-intensive care unit discharge, before hospital discharge and after six months . assessments involve tests like the six-minute walk test, short physical performance battery, one-minute sit-to-stand test, manovacuometry, dynamometry, spirometry and clinical frailty scale to identify frailty and measure muscle and lung function. the study also aims to explore predictive variables for functional loss during hospitalization.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * both genders * elective pulmonary endarterectomy surgery * absence of cognitive or peripheral motor impairment that prevents the performance of functional tests in the preoperative period. exclusion criteria: * reoperation for any reason * presence of cognitive or peripheral motor impairment that prevents the performance of functional tests in the postoperative period.

Keywords: pulmonary endarterectomy surgery six-minute walk test short physical performance battery one-minute sit-to-stand test muscular strength spirometry
oropharyngeal colostrum for immune stimulation in very low birth weight infants

Conditions: Very Low Birth Weight Infants

Summary: colostrum, mothers' early breastmilk, contains multiple factors that provide immune protection to very low birth weight (vlbw) infants, a population at high risk for hospital-acquired infections. however, critical illness during the first few days of life often prevents the initiation of enteral feeds, placing these infants at even higher risk for morbidities including feeding intolerance and infection. oropharyngeal administration has been proposed as an alternative route of delivery for colostrum and the immune benefits it provides. research from animal and adult human models supports oropharyngeal administration as a potentially safe and effective mode of delivery for immune therapies. immune components of colostrum, such as secretory iga, may have both direct and indirect effects on the immune system. the purpose of this proposed randomized, placebo-controlled pilot study is to determine the effect of oropharyngeally administered colostrum (oac) on immune stimulation in vlbw infants, as measured by secretory iga (siga) levels. in addition to measuring siga response to oac the investigators will also collect clinical data to determine if oac has effects on tolerance of enteral feedings and rates of infection. the investigators hypothesize oac will have a moderate effect on salivary secretory iga concentration in vlbw infants. if proven efficacious, utilization of oac in vlbw infants could have far reaching consequences for these highly fragile babies including lower rates of infection, improved tolerance of enteral feedings, and shorter nicu stays.


Eligibility criteria:
inclusion criteria: * infants with a birth weight less than 1500 grams (or 3.3 lbs) born at penn state hershey medical center and admitted to the psuch nicu immediately after birth exclusion criteria: * infants with major congenital anomalies or chromosomal syndromes incompatible with life infants of mothers not willing to provide colostrum for their infant in the first week of life infants of mothers with known hiv, hepatitis b or hepatitis c as these infections may be transmitted through breast milk

Keywords: very low birth weight infants vlbw infants colostrum
nol-index guided remifentanil analgesia versus standard analgesia during moderate-to-high risk cardiovascular surgery

Conditions: Nociceptive Pain; Goal-directed Therapy; Hemodynamic Instability; Nol-Index; Remifentanil; Cardiac Surgery; Vascular Surgery; General Anesthesia

Summary: this study will investigate the potential of guiding remifentanil analgesia during cardiac and vascular surgery in moderate to high risk patients requiring general anesthesia.

justification: moderate-to-high risk cardiovascular surgery is associated with perioperative morbidity and mortality. these patients undergo general anesthesia and often require tight blood pressure control (e.g., using norepinephrine titration) to avoid the complications associated with hypotension and reduced cardiac output. standard analgesia opioid titration to control nociception (i.e., the patient's unconscious response to noxious stimuli) is based on the anesthesiologist's experience and variations in the patient's heart rate and blood pressure. this causes anesthesiologists to often give too much analgesic, which can lead to inhibition of the sympathetic autonomic nervous system, hypotension, and associated side effects. a recently developed nociception monitor, the pmd-200 (medasense, israel), is capable of measuring the patient's level of nociception-antinociception balance and can guide opioid administration. this monitor may allow anesthesiologists to administer only the required amount of opioid, which may lead to better hemodynamic stability and better postoperative outcome. objectives: the goal of this study is to determine if titrating analgesia using the nol-index, when compared to standard care, leads to decreased infused remifentanil, decreased norepinephrine, increased cardiac output, more stable blood pressure control, and decreased postoperative complications in moderate-to-high risk patients undergoing cardiac or vascular surgery.

Eligibility criteria:
inclusion criteria: * moderate-to-high risk cardiac or vascular surgery * asa 2-4 exclusion criteria: * chronic arrhythmia (e.g. atrial fibrillation) * aortic insufficiency * pacemaker * implanted defibrillator * valve surgery
effect of laser acupuncture on menstrual back pain

Conditions: Laser Acupuncture; Low Back Pain; Menstruation

Summary: effect of laser acupuncture on menstrual back pain

the aim of this study is to determine the effect of laser acupuncture on the points bl23, bl26, bl40 and sp6 in relieving menstrual back pain.

Eligibility criteria:
inclusion criteria: * all females will have low back pain during menstruation * age of the patients will range from 20-30 years. * their bmi will be range from 20-30 kg/ m 2 exclusion criteria: * - psychiatric disorders * pelvic floor dysfunction * lumber disc prolapse or any previous surgery on spine. * tumor in lumbar spine
cytosorb therapy in cardiac surgery

Conditions: Cardiopulmonary Surgery; Endocarditis; Peri-operative Cytokines Levels

Summary: cardiopulmonary surgery is associated with inflammatory responses that can lead to systemic inflammatory responses (sirs), organ dysfunction (mod) and death especially in patients with endocarditis. cytokine removal might therefore improve outcomes of patients undergoing cardiac surgery. cytosorb is a device designed to remove cytokine (il-6, il-10, tnfalpha) from the blood to reduce immune reactions. this trial investigates the use of cytosorb during cardiac surgery in patients with endocarditis at the university hospital basel.


Eligibility criteria:
inclusion criteria: * patients with endocarditis undergoing cardiac surgery with cardio-pulmonary bypass circuit exclusion criteria: * denial of consent for data use

Keywords: cytokine clearance cardiac surgery cytosorb cytokine removal
ramosetron, aprepitant and dexamethasone versus ondansetron, aprepitant and dexamethasone

Conditions: Cancer; Malignancy

Summary: the purpose of this study is to assess the efficacy and safety of ramosetron, aprepitant and dexamethasone therapy versus ondansetron, aprepitant and dexamethasone therapy for preventing of nausea and vomiting in highly emetogenic chemotherapy (road study): prospective multicenter, randomized, single blinded, phase iii study.

to assess the efficacy and safety of ramosetron, aprepitant and dexamethasone therapy versus ondansetron, aprepitant and dexamethasone therapy for preventing of nausea and vomiting in highly emetogenic chemotherapy (road study):

Eligibility criteria:
inclusion criteria: 1. patients diagnosed as malignancy who will be treated with highly emetogenic chemotherapeutic agents (nccn guideline v1.0 2011 anti-emesis), over 20 years and both sex 2. ecog performance status 0-2 3. available oral administration of study drugs 4. patients must sign an informed consent indicating that they are aware of the investigational nature of the study in keeping with the policy of the hospital exclusion criteria: 1. severe hypertension, severe heart disease, kidney disease (serum creatinine \> 3 mg/dl), liver disease (ast, alt \> 3 times of upper normal range, alp \> 2 times of upper normal range) 2. patients with gi obstruction, active gastric ulcer or other diseases that could provoke nausea and vomiting 3. patients who have nausea and vomiting within 1 week before chemotherapy 4. patients who should take steroid, antiemetics, pimozide, terfenadine, astemizole, cisapride, rifampin, carbamazepine, phenytoin, ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir or nelfinavir for the treatment of other diseases 5. patients with brain tumor, brain metastasis or seizure 6. patients receiving chemotherapy within 12 months before enrollment 7. patients who need radiation therapy during study period or receiving radiation therapy within 2 weeks before chemotherapy 8. patients who have known allergy or severe side effect on study drugs 9. pregnant or lactating women, or women who wish to become pregnant 10. others whom the investigator judges inappropriate as subjects for this study

Keywords: ramosetron ondansetron aprepitant chemotherapy induced nausea & vomiting
adjunction of daptomycin for the treatment of pneumococcal meningitis

Conditions: Pneumococcal Meningitis

Summary: pneumococcal meningitis is an infection of the membrane that covers the brain. it is a serious infection which is currently treated with a combination of corticosteroids (dexamethasone) and 3rd generation cephalosporins. nevertheless, complications associated with meningitis are relatively frequent and severe. recent animal studies have shown that another antibiotic, daptomycin, can reduce the mortality and long-term effects of pneumococcal meningitis. daptomycin is widely used worldwide in humans for other diseases, with few side effects. this study aims to evaluate the effect of daptomycin on the proliferation of the bacterial infection, and therefore on inflammation. daptomycin will be added to the currently recommended treatment with the same dosage used for other diseases. roughly 130 patients with suspected pneumococcal meningitis admitted to the emergency departments of hospitals throughout france will be asked to participate in this study. the participation period will last approximately 3 months.


Eligibility criteria:
inclusion criteria: * persons aged over 18 years * with suspected pneumococcal meningitis : * clinical presentation evocative of pneumococcal meningitis : acute onset of ,meningeal signs, history of cranial trauma or fistula, knowledge of alteration of humoral immunity,, asplenia, alcoholism with/or * clearly purulent csf with/ or, * presence of diplococcus on the gram stain of csf or positive pneumococcal antigen in the csf, or polymorphonuclear cells in csf \> 100 * written consent or inclusion in an emergency * affiliation to a social security system exclusion criteria: * contraindication to cephalosporin * immediate and severe hypersensitivity to β-lactam antimicrobial * contraindication to dexamethasone * contraindication to daptomycin * previous exposition to daptomycin (within one year) * women who are able to procreate without effective contraception and pregnant or breastfeeding women * patients under ward of court * refusal at any time after acceptation of the study from the patient or her/his legal representative.
post-stroke motor rehabilitation using functional near-infrared spectroscopy-based brain-computer-interface

Conditions: Hemiparesis

Summary: chronic stroke survivors suffering from weaknesses or movement difficulties in their hand/arm are provided a system to aid in at-home rehabilitation for 6 weeks. this rehabilitation system includes a headband that measures and provides feedback from the brain during rehabilitation, together with tablet-based software. throughout the 6 week rehabilitation period (as well as in a follow-up session 1 month afterwards) several assessments are taken to understand the effect of this rehabilitation on participant's movement abilities, as well as their brain activity.


Eligibility criteria:
inclusion criteria: * age 18 - 90 years * 6 months - 5 years since most recent stroke * upper-extremity fugl-meyer motor function (fma-ue) score ≤56 * able to follow simple commands * fluency in english * not currently receiving therapy for the upper extremity exclusion criteria: * visual impairment that would interfere with visualization of the therapy interface (score \>0 on the visual subscale of the nih stroke scale) * montreal cognitive assessment (moca) score ≥10 * history of significant physical disability prior to most recent stroke * open wounds on the scalp * unable or unwilling to remove hair braids or head coverings which interfere with the axem home device efficacy. * inability to follow training instructions for at-home bci system.
student pharmacist non-pharmacological intervention on type 2 diabetes management in older asian adult populations

Conditions: Type 2 Diabetes Mellitus (T2DM)

Summary: this study is being done to assess the impact of student pharmacist involvement on blood glucose control through non-pharmacological interventions in people of asian and asian descent over the age of 50 with type 2 diabetes. this study team is trying to advance the field of pharmacy and expand the roles of student pharmacists.

this study aims to assess the clinical impact of student pharmacist-led interventions on glycemic control in adult populations. this study will specifically target adults aged 50 years and older of asian or asian-descent with diagnosed type 2 diabetes, residing in san francisco. the goal of the study is to demonstrate the utility of pharmacy students in a community setting on chronic disease management through patient-specific education and interventions. the aims of this study are to compare glycemic control in patients with type 2 diabetes who receive continuous assessment and non-pharmacological counseling from student pharmacists versus those who do not. specifically, this study will evaluate: 1. the impact of student pharmacist assessments and personalized recommendations on diet, exercise, and adherence to treatment regimens, and their lasting effects on blood glucose control. 2. if participants perceived any value and effect of student pharmacist involvement in managing chronic diseases.

Eligibility criteria:
inclusion criteria: * adults ≥ 50 years old * asian or asian-descent * diagnosed with t2dm * a1c \>7.0% (uncontrolled) * take blood glucose measurements as prescribed by their physician, or consistently (defined as missing no more than 1 reading from their regular routine). exclusion criteria: * age \< 50 years old * not diagnosed with type 2 diabetes, or have diagnoses such as type 1 diabetes, gestational diabetes, or medication induced diabetes * patients that are on medications that affect glycemic control * corticosteroids * first-generation antipsychotics (e.g. chlorpromazine, perphenazine, phenothiazines) * immunosuppressants (e.g. tacrolimus, cyclosporine) * experiencing acute disease states * recent surgery/hospitalized within the last 3 months * active infections * non-adherence to blood glucose monitoring (defined as missing \> 1 reading from their regular routine or not taking readings as prescribed by their doctor) * patients with late stage t2dm requiring insulin therapy * diagnosed with cancer, end-stage renal disease, end-stage liver disease * received any organ transplant

Keywords: student pharmacist non-pharmacological diabetes management spy-dm glucose control asian older adult