Kornimate/medical-research-clean huggingface dataset:
patient-centered treatment of anxiety after low-risk chest pain in the emergency room

Conditions: Generalized Anxiety Disorder; Chest Pain; Panic

Summary: the goal of this research is to compare the benefits and risks of three anxiety treatments that are pragmatic, graduated in the level of resource intensity, and have demonstrated efficacy and feasibility for real world adoption.

the goal of this research is to compare the benefits and risks of three anxiety treatments that are pragmatic, graduated in the level of resource intensity, and have demonstrated efficacy and feasibility for real world adoption. low-risk (non-cardiac) chest pain patients with anxiety will be recruited to participate in the study using the sbirt (screening, brief intervention, and referral to treatment) model and enrolled participants will be randomly assigned to one of three treatment arms: 1) referral to primary care with enhanced care coordinated (low intensity); 2) online cbt with support from a certified peer recovery specialist (medium intensity); and 3) therapist-led cbt via tele-health (high intensity). we expect improved symptoms and functional capacity, reduced ed return visits, and heterogenous treatment effects.

Eligibility criteria:
inclusion criteria: * adult emergency department (ed) patients (≥18yoa) presenting to the ed * within 1 week of ed presentation if discharged at time of screening. * chief complaint of chest pain or similar chief complaint leading to a standard of care diagnostic protocol to rule out possible acute coronary syndrome. * heart score of 0-3 indicating major adverse cardiac events (mace) risk equivalent to ≤2% * "functionally" low risk status - (moderate heart score of 4-6) plus diagnostic protocol evaluation with at least two serial normal troponins spaced at least six hours apart with or without cardiovascular stress testing in the observation unit. * moderate to severe anxiety as defined by a gad-7 score ≥ 8 or a phq panic screener score ≥ 2 * expected to be discharged from the ed or only undergo observation \<24 hours. exclusion criteria: * \> 1 week from ed discharge * traumatic reason for chest pain * those admitted to the hospital (inpatient status) as part of their ed presentation (those placed in the observation unit for planned observation less than \<24 hours are eligible) * active psychosis or behavioral issues requiring psychiatric monitoring or consultation of psychiatry for psychosis, schizophrenia, or suicidal ideation * hemodynamic instability as assessed by the treating provider * issues likely to affect follow up, including prisoners and homelessness * inability to understand and speak english to participate in telehealth therapy sessions and peer support.
a phase i/ii trial of a tetravalent live attenuated den vaccine in flavivirus antibody naive children

Conditions: Dengue

Summary: one year follow-up on immunogenicity and safety of a booster dose of den vaccine administered approx. 1 year following the second dose

the purpose of this study is to find out more about the two doses of dengue vaccine, over a five year period, that the children received in the dengue-003 study and to study a third dose of dengue that will be given to the children * do children still have dengue antibodies intended to provide protection against dengue infection one year after the two doses of vaccine given in study dengue-003? * were there any major medical problems that appeared as dengue-like symptoms during the one year after vaccinations? * will a third dose of dengue help to further stimulate the part of the immune system intended to help protect against dengue infection? * is a third dose as safe as the first two doses? * are the local reactions to a third dose of the vaccine similar to what your child experienced after the first two doses?

Eligibility criteria:
inclusion criteria: * subjects who received two doses of den vaccine in the dengue-003 study * subjects whos parents signed an informed consent form were eligible for participation in the five year follow-up study exclusion criteria: * none

Keywords: dengue, vaccine, thailand
a study to evaluate tirzepatide (ly3298176) in pediatric and adolescent participants with type 2 diabetes mellitus inadequately controlled with metformin or basal insulin or both

Conditions: Type2 Diabetes; Diabetes Mellitus; Diabetes Mellitus, Type 2; T2D; T2DM (Type 2 Diabetes Mellitus); Glucose Metabolism Disorders; Endocrine System Diseases; Metabolic Disease

Summary: the purpose of this study is to learn more about the safety and efficacy of tirzepatide compared to placebo in children or teenagers with type 2 diabetes taking metformin, or basal insulin, or both. the overall study will last about 60 weeks with up to 14 clinic visits and 6 phone visits. clinic visits will include blood sample collection, physical exam and questionnaire.


Eligibility criteria:
inclusion criteria: * male or female, aged 10 to below 18 years at screening visit * have type 2 diabetes, treated with diet and exercise and metformin and/or basal insulin. metformin and/or basal insulin dose must be stable for at least 90 days prior to study screening. * have hba1c \>6.5% to ≤11% at screening * have body weight ≥50 kilogram (kg) 110 pounds and bmi of \>85th percentile of the general age and gender-matched population for that country or region. exclusion criteria: * have type 1 diabetes mellitus (t1dm), or positive gad65 or ia2 antibodies * after the t2dm diagnosis, have a history of diabetic ketoacidosis or hyperosmolar syndrome * have had ≥1 episode of severe hypoglycemia and/or ≥1 episode of hypoglycemic unawareness within the last 6 months. * have family or personal history of medullary thyroid carcinoma (mtc) or multiple endocrine neoplasia syndrome type 2 (men2). * had chronic or acute pancreatitis any time prior to study entry * female participants who are pregnant or breast feeding or intending to become pregnant. * using prescription or over the counter medications for weight loss within 90 days of the screening visit.

Keywords: glp-1 ra glucose-dependent insulinotropic polypeptide (gip) glucagon-like peptide-1 (glp-1) gip/glp-1 dual receptor agonist incretins
mri in renal tumors

Conditions: Renal Cell Carcinoma

Summary: diagnostic imaging for renal masses of unknown nature using conventional imaging modalities such as 3 phase contrast-enhanced computed tomography (ct) is not always conclusive. after (partial) nephrectomy, 10-20 % of the resected tumors show benign histology which could not be identified on diagnostic imaging. with improved imaging techniques available, leading to improvements in characterisation of renal tumors, the number of unnecessary resections may be reduced. the objective of this study is to assess the ability to discriminate oncocytoma from rcc based on the adc distribution parameters with addition of, tumor volume, and patient demographic characteristics.


Eligibility criteria:
inclusion criteria: * radiologic diagnosis of renal tumor based on previous ultrasonography, ct or mri examinations. * signed institutional review board (irb) approved informed consent form. * being at least 18 years of age. * histopathologically confirmed renal tumor diagnosis. exclusion criteria: * relative contra indications for mri (metal device/foreign bodies, claustrophobia); * active renal or perirenal infection; * minor and/or incapacitated adult.

Keywords: magnetic resonance imaging diffusion weighted mri diffusion tensor imaging
lab skills nursing education into effective clinical practice during covid-19: elsevier clinical skill platform

Conditions: Educational Problems

Summary: this study aimed to investigate the effectiveness of utilizing an elsevier clinical skill platform in clinical nursing education. 1.2. research hypotheses 1. nursing students who assign for the critical care clinical course modules using elsevier clinical skill platform obtain a higher score in the osce than who receive clinical lab session on campus. 2. nursing students who utilize an elsevier clinical skill are more satisfied in the clinical education journey.

a quasi-experimental, two groups, pre-posttest study was carried out in nursing college, king khalid university, kingdome of saudi arabia. 2.2 instruments 1. pre-posttest per skill was conducted for both group the elsevier clinical skill group (ecs group) and traditional clinical lab session group (cls group), to assess the students' knowledge level before and after receiving each scheduled lab module. 2. objective structured clinical evaluation (osce): the summative osce included practical stations with an associated written paper for each skill examined. for the practical station, students must pass the practical station (100%), as well as the relevant written station (70%) to achieve a pass in that scope of practice skill according to exam policy \& procedure. 3. students' perception of usability and learning of elsevier clinical skill: included 8 questions developed by rowe et al, 2017 categorized into two main themes: 1st theme is relevant to the usability of the platform (4 items) and 2nd theme reflected the learning enhancement while using the platform (4 items). each item was scored on a three-point likert scale as follows: strongly agree or agree (3), neither agree nor disagree (2) and strongly disagree or disagree (1). the overall perceptions of students with both online and traditional lab experiences included and score ranged between (1-3) as 1= much better than or better than, 2= about the same as 2, much worse than or not as good as 3 2.3 participants: a convenience sample of all students enrolled in the critical care nursing course (n=52) were divided into two groups and random selection was implemented by the registration office following the inclusion criteria for all students who were enrolled first time receive critical care nursing course. therefore, two students were withdrawn at the beginning of the course. the first group represented the control group the clinical lab session (25 students), whilst the second group represented the intervention group the elsevier clinical skill (25 students).

Eligibility criteria:
inclusion criteria: * must be passed all prerequisite nursing courses exclusion criteria: * unwilling to participate * request to use traditional lab session

Keywords: clinical lab session elsiever clinical skill traditional lab session students satisfaction
investigation of endothelium in saphenous vein grafts

Conditions: Endothelial Function of Saphenous Vein Grafts

Summary: this is a single center prospective study of 30 patients undergoing elective heart bypass surgery (cabg) with at least two vein grafts from the leg (svg). the purpose of this ex vivo study is to evaluate the function of vein grafts from small tissue samples treated with a pressure syringe and a non-pressure syringe. syringes are routinely used to flush out the veins in preparation of bypass grafting. it is unknown if different levels of pressure in the syringe affect the vein or damage the vein. small sections of tissue samples which are normally discarded will be obtained immediately after retrieval from the leg and before grafting to the heart. tissue samples will be taken to the laboratory for study. there are no clinical endpoints in this study, however, clinical information will be obtained from the society of thoracic surgeons database and will include demographics, risk factors, and perioperative outcomes.


Eligibility criteria:
inclusion criteria: * patients undergoing elective coronary artery bypass graft surgery requiring at least 2 saphenous vein grafts exclusion criteria: * patients undergoing any concomitant surgical procedures

Keywords: endoscopic vein harvest saphenous vein graft endothelial function
evaluation of the use of trental and vitamin e for prophylaxis of radiation necrosis

Conditions: Brain Metastasis

Summary: the purpose of this study is to determine whether the use of trental and vitamin e can help reduce the incidence of radiation necrosis (a lesion that usually occurs at the original tumor site) after radiosurgery. these two drugs are commonly used to treat radiation necrosis when it occurs but the hope is that these drugs can be used to prevent radiation necrosis from ever occurring.

the treatment phase of the study is 6 months. study procedures will be conducted such as: history, physical and neurological exam, pregnancy testing (for women of child bearing age) and a brain mri. follow-up appointments will be every 3 months for 1 year at which time, your participation in the study will be concluded.

Eligibility criteria:
inclusion criteria: * plan to undergo single or five fraction radiosurgery for a metastatic brain tumor * diagnosis of a metastatic brain tumor may be accomplished by histologic confirmation or by clinical confirmation by the treating physician based on mr imaging characteristics in the setting of a known history of cancer * age \> 18 years * partial or total resection of a metastatic tumor are eligible exclusion criteria: * known sensitivity to vitamin e or trental * recent intracranial bleed or retinal hemorrhage * treatment with a non-approved or investigational drug within 30 days before day 1 of study treatment * history of avastin treatment * anticipated need for treatment with avastin * history of bleeding disorder * history of liver disorder

Keywords: brain metastasis
incisional vacuum assisted closure (ivac) device and its effect on implanted bone morphogenic protein (bmp-2)

Conditions: Fractures, Closed

Summary: people who have been scheduled for surgery using bone morphogenic protein (called bmp-2) and an incisional vacuum assisted closure device (called ivac) will be asked to join this study. the purpose of this study is to see if using the ivac device removes bmp-2 from the wound. bmp-2 is a protein used by the body to increase bone healing, decrease the need for additional surgery, and reduce infection rates. the ivac is a device that involves a foam dressing secured with an adhesive drape to make an airtight seal over a surgical incision. tubing runs from the foam dressing to a device that uses gentle suction to drain fluid out (like a vacuum). the ivac stays on for 48-72 hours depending on amount of drainage. the ivac by itself helps reduce wound swelling and complications (such as infection).

it is hypothesized that the negative pressure associated with an ivac is not sufficient to remove bmp-2 from a surgical wound. bmp-2 is commonly used in open tibia fractures at the time of definitive wound closure, and these wounds are prone to increased swelling and wound complications. the recent observation that ivac decreases wound edema and increases oxygenation has led to their use in such cases. used in conjunction, it is entirely possible that the negative pressure exerted by the ivac can remove bmp-2 from surgical site and therefore decreases the effectiveness of bmp-2. we seek to determine if bmp-2 is present in effluent from the ivac. if in this study the hypothesis is found to be wrong, and bmp-2 is found within the ivac effluent, we are prepared to proceed with a follow-up study to quantify the bmp-2 removed by the ivac.

Eligibility criteria:
inclusion criteria: * subject is 18 years or older * subject has tibia fracture requiring treatment with bmp-2 * subject to have an incisional vacuum closure (ivac) device, placed on the skin directly over the bmp-2 implantation site * subject/guardian able to provide informed consent exclusion criteria: * subject is less than 18 years old * subject has a wound at fracture/surgical site that cannot be closed * subject/guardian unable to provide informed consent

Keywords: bmp-2 incisional vacuum assisted closure (ivac)
saphenous vein allografts for coronary bypass

Conditions: Coronary Artery Disease; Occlusion of Artery

Summary: the primary objective of this observational study is to evaluate the function (patency) of cryopreserved saphenous vein allografts used as coronary artery bypass grafts (cabg) for patients with occlusive coronary artery disease.

this study is designed as a combination retrospective/prospective single center study in which all patients will be eligible for enrollment based on having a previous implant of cryovein saphenous vein for cabg during the 2008-2010 time frame. a comprehensive chart review of former and previously implanted allograft patients will be performed for the retrospective portion of this study. an effort will be made to include all patients from this site. eligible patients will be consented into the study for a single, prospective, observational imaging evaluation of their bypass conduits.

Eligibility criteria:
inclusion criteria: * any patient implanted with a cryovein saphenous vein allograft for cabg during 2008 - 2010 time frame. * patients \> 18 years of age at implant. exclusion criteria: • patients \< 18 years of age.

Keywords: allograft coronary patency morbidity
prediction of dementia in parkinson's disease by measuring cerebral metabolism with pet scan

Conditions: Parkinson Disease

Summary: parkinson's disease (pd) is a common disease. dementia will affect 80% of these patients during their evolution. in addition, treatments of motor signs have a potential impact on these disorders and conversely. the purpose of this study is to show focal abnormalities in brain metabolism in the precuneus and posterior cingulate region are predictive of the onset of dementia within 2 years.

cognitive impairment and dementia have become major factors of disability induced by parkinson's disease. the prediction of dementia in any given patient may be useful for prognosis but also for discussion of setting up heavy therapeutic techniques, especially surgical. currently, known predictors are disease severity, age and existence of pre-cognitive disorders; other assumptions are discussed. among these, morphological imaging techniques (mri) and functional techniques (mri, pet) are proposed. use increasingly early of heavy, expensive and potentially ineffective surgical treatment in dementia makes it necessary to find independent, early and reliable markers of the onset of dementia in parkinson's disease.

Eligibility criteria:
inclusion criteria * male or female with parkinson's disease * 45 \< age ≥ 75 years * parkinson's disease with clinical diagnosis made for at least 5 years (60 months) * patient able to perform cognitive tests in french during 1 hour 30 minutes * patient having provided a signed consent to participate in this trial * be either affiliated to, or a beneficiary of, a social security category * existence of caregiver at least contactable by phone exclusion criteria * parkinson's disease diagnosed before 40 years old * clinical evidence for dementia or dementia criteria according to level 1 mds-task force (dubois et al. 2007) * atypical form of parkinsonism * other disease affecting the central nervous system * poorly controlled diabetes with glucose \> 2.0 g/l or hba1c\>7,5% based on results of less than 3 months * taking a cholinesterase inhibitor treatment, memantine or long-term benzodiazepines other than referred hypnotic, neuroleptic * history of surgery for parkinson's disease or planned surgery within 6 months. surgery is possible beyond * cons-indication to 3t mri * inability to lie down for 60 minutes * legal protection * patient living outside the ile-de france region secondary exclusion criteria * pregnant, breastfeeding or non-menopausal woman not taking contraception in the first 2 months of the study * existence of a significant brain injury on mri * neuropsychological assessment at baseline showing dementia * fasting glucose \> 1.6 g/l the day of fdg-pet

Keywords: dementia cerebral metabolism pet scan
cmr exercise stress testing in hfpef

Conditions: Diastolic Heart Failure

Summary: patients of the university hospital göttingen with echocardiographic signs for diastolic heart failure and indication for right heart catheterisation will undergo additional diagnostic testing with cmr including exercise stress for detailed evaluation of diastolic dysfunction and tissue characterisation correlating the results with well-established clinical standards.


Eligibility criteria:
inclusion criteria: * adult patients with dyspnoea under stress, echocardiographic criteria for diastolic dysfunction (e/e'\>8) and clinical indication for right heart catheterisation exclusion criteria: * arrhythmia (brady- or tachycardic) * bronchial asthma (allergic) * incompliant patient * pacemaker, icd, non mri-capable devices * inability to use the ergometer in the mri * haemodynamic relevant valvular heart disease * pulmonary disease (vital capacity or forced expiratory flow \<80% of healthy control) * angina pectoris * post cardiac infarction * anaemia (hb \<12 g/dl) * uncontrollable hypertension (\>150 mmhg systolic or \>100 mmhg diastolic) * age \<18 years * pregnancy * claustrophobia * renal insufficiency * allergic to gadolinium based contrast agents
management and clinical outcome of neonatal arrhythmias

Conditions: Neonatal Arrhythmias

Summary: assess the management and clinical outcome of neonatal arrhythmia

cardiac arrhythmia is a significant cardiovascular disorder in the neonatal period and can result in infant mortality if not diagnosed or treated promptly. the incidence of arrhythmia is about 0.1% to 4.8% during the neonatal period. in neonatal intensive care units (nicus), the incidence of cardiac arrhythmia could reach 10%. approximately 1% to 3% of fetal * cardiac arrhythmias were detected during pregnancy the clinical presentation of na is variable. some neonates do not become symptomatic, and could not be diagnosed during * neonatal period, whereas others may develop signs of congestive heart failure and cardiogenic shock even before birth the most common significant arrhythmia is supraventricular tachycardia (svt), but atrial flutter (afl), various forms of atrioventricular block (avb), and ventricular tachycardia (vt) may also occur. because of the immature physiology of * the fetal and neonatal myocardium, heart failure may occur at either abnormally low or high ventricular rates * the electrocardiogram (ecg) is the gold standard for identifying problems with heart rate and regularity. however investigations of arrhythmias were hampered by their transitory nature. monitoring rhythm patterns over extended duration makes holter monitors a very helpful complementary noninvasive tool in the diagnosis of cardiac arrhythmias. it allows the cumulative evaluation of heart rhythm and rhythm variability, which is important in diagnosing silent and episodic * arrhythmias in high-risk groups medical management of svt consists of a trial of vagal maneuvers, adenosine, and medications to maintain sinus rhythm such as beta blockers and class i or class iii antiarrhythmic medications. for neonates who have hemodynamically * significant svt, frequent svt requiring medical management, pre-excitation on ecg, or congenital cardiac defect chronic medical treatment is appropriate. af is common in newborns, usually in structurally normal hearts, and long term medical therapy besides initial conversion to sinus rhythm is usually not needed, given the low probability of recurrence * the prognosis depends on the early recognition and proper management of the condition in some serious neonatal cases precise diagnosis with risk stratification of patients with non-benign neonatal arrhythmia is needed to reduce morbidity and mortality.

Eligibility criteria:
inclusion criteria: * neonates up to 28 day with arrhythmia except premature atrial contraction. exclusion criteria: * more than 28 day * neonates with other diseases other than arrhythmia .