Kornimate/medical-research-clean huggingface dataset:
a prognostic model to predict relapse of depression in primary care

Conditions: Depression

Summary: the investigators aim to develop a prognostic model to predict the risk of relapse within 6-8 months of patients entering remission. the long-term objective is to facilitate more efficient targeting of evidence-based relapse prevention strategies to these patients.

most patients with depression are treated in primary care by general practitioners (gps). relapse of depression is common and leads to considerable morbidity and decreased quality of life for patients. estimates suggest that at least 50% of patients treated for depression will relapse after a single episode. the majority of these will relapse within 6 months and the risk of relapse increases for each successive episode of depression. gps see a largely undifferentiated case-mix of patients and, once patients with depression reach remission, there is limited guidance and no validated tools to help gps stratify patients according to risk of relapse.this study will potentially derive a statistical model to predict relapse of depression in remitted depressed patients in primary care. the investigators have created a longitudinal cohort of patients drawn from seven randomised controlled trials (rcts) of non-pharmacological primary care-based interventions for depression and one longitudinal cohort study. the investigators will use logistic regression to predict the outcome of relapse of depression within 6-8 months. the investigators plan to include the following well-evidenced relapse predictors in the model: residual depressive symptoms; number of previous episodes of depression; co-morbid anxiety; and severity of the index episode. they will also control for rct intervention received by participants. if sample size and availability of predictor information allows, the investigators will include the following predictors in an exploratory analysis: age; relationship status; multi-morbidity; employment status; gender; and ethnicity. generalisability will be assessed through internal-external cross-validation and net benefit will be explored.

Eligibility criteria:
inclusion criteria: * remitted depressive disorder exclusion criteria: * co-existing severe mental illness

Keywords: prediction prognostic model relapse
high-intensity interval training enhances mobilization/functionality of endothelial progenitor cells and depressed shedding of vascular endothelial cells undergoing hypoxia

Conditions: Hypoxia

Summary: exercise training improves endothelium-dependent vasodilation, whereas hypoxic stress causes vascular endothelial dysfunction. monocyte- derived endothelial progenitor cells (mon-epcs) contribute to vascular repair process by differentiating into endothelial cells. this study investigates how high-intensity interval (hit) and moderate intensity-continuous (mct) exercise training affect circulating mon-epc levels and epc functionality under hypoxic condition. sixty healthy sedentary males were randomized to engage either hit (3-minute intervals at 40% and 80%vo2max , n=20) or mct (sustained 60%vo2max , n=20) for 30 minutes/day, 5 days/week for 6 weeks, or to a control group that did not received exercise intervention (n=20). mon-epc characteristics and epc functionality under hypoxic exercise (he, 100w under 12%o 2 ) were determined before and after various interventions.


Eligibility criteria:
inclusion criteria: * sedentary life * age 20\~28 exclusion criteria: * smokers * users of medication/vitamins * any cardiopulmonary/hematological risk * regular exercise habits at least 1 year * exposed to high altitudes (\>3000 m) for at least 1 year

Keywords: endothelial progenitor cell hemodynamic exercise hiit
fast assay for pathogen identification and characterization

Conditions: Bacteremia; Sepsis; Septic Shock

Summary: sepsis is a life-threatening disease caused by a dysregulated host response to infection. this can lead to organ-dysfunction and septic shock, which is a subset of sepsis where underlying abnormalities increase mortality remarkably. blood cultures are the gold standard for identifying pathogens in the bloodstream (bacteremia). it is based on cultivation techniques which, theoretically, can detect a single pathogenic cell from a patient sample. however, blood cultures have serious limitations, such as long time to result (3-7 days). this leads to the fact that only a small fraction of the patients obtain a correct diagnosis and in further consequence get the optimal antimicrobial treatment. patients with sepsis should get antimicrobial treatment within the hour. thus, physicians start treatment empirically, with broad-spectrum antibiotics. this puts a selective pressure on pathogens and has led to an increased amount of antibiotic resistance. faster diagnostics are necessary to ensure an immediate and targeted treatment. in the eu-funded fapic project, two diagnostic systems that can be used with direct sample material from patients will be developed, avoiding the time-consuming cultivation of pathogens. in this study, the evaluation of the rapid diagnostics will be performed in patients with sepsis, suspected of bacteremia. to this aim, the performance of the diagnostic systems will be evaluated using blood samples that are collected in parallel with blood cultures. in addition, clinical data of the patients will be collected. in routine care, two blood culture sets (2x2 bottles) per patient are collected. one extra blood samples (edta, 9 ml) will be sampled with each blood culture set, totaling 2 samples per patient. in this study, patients presenting at the emergency department (ed), and the department of infectious diseases/nephrology will be included. the results will be used to estimate the performance, sensitivity, and specificity of the diagnostic systems compared to blood culture. furthermore, in order to determine the severity of sepsis and to describe the patient population, clinically relevant parameters and laboratory parameters (ferritin, hla-dr, serum lactate, sofa score) will be assessed to determine its association with severity of disease and patient mortality. evaluation will be done exclusively in the lab, and will not be used directly for the diagnosis or management of patients. standard care will still be provided.

this study is a follow-up study of the first prospective study performed in 2017 in the same hospital. the clinicaltrials.gov id number of the previous study was nct03025802.

Eligibility criteria:
inclusion criteria: * patients for whom blood cultures are drawn * age ≥ 18 exclusion criteria: * age \< 18 * patients who are not hospitalized and sent home after ed admission * patients from the haematology department * duplicate blood cultures from the same bacteraemia episode (blood cultures drawn \<7 days after first blood culture)

Keywords: blood cultures
avian influenza studies in lebanon

Conditions: Avian Influenza; Virus Diseases

Summary: the highly pathogenic avian influenza (hpai) h5n1 virus arrived in the middle east in 2005 and has since established itself in local domestic birds and is now considered endemic in several middle eastern countries.few studies indicate the presence of low pathogenicity avian influenza (lpai) viruses of the h9 type among lebanese poultry and wild birds. these studies also provide some evidence suggesting that humans exposed to these sick birds are showing elevated antibody titers against these lpai h9 viruses. this study will focus on the following objectives: * to determine the seroprevalence of ai in poultry-exposed and non-exposed human populations. * to identify risk factors associated with ai infections in occupationally-exposed poultry workers. * to conduct nation-wide cross-sectional surveillance for ai viruses among domestic birds in low biosecurity farms and backyard flocks.

this study will examine the sera of 200 poultry-exposed adults and 50 adult controls and administer questionnaires to identify risk factors for ai infections in human beings.study volunteers will be interviewed regarding their exposures, medical history, and behaviors using a close-ended questionnaire specifically tailored for this study. a blood sample will be collected from every participant to verify presence of antibodies against the viruses under study. all study materials are in english and arabic. along side the human aspect of the study, specimens will be collected from the birds that the individual handles. this study hypothesizes that they will find evidence of previous infection with these viruses among poultry workers. furthermore, the study team will collect animal specimens from the farms of the study volunteers and determine the types of avian influenza viruses that they harbour.

Eligibility criteria:
inclusion criteria: * be at least 18 years old. * be willing to participate by signing a consent form, completing the study questionnaire, and providing a blood sample. exclusion criteria: * less than 18 years old. * any known immunosuppressive condition or immune deficiency disease (including hiv infection), or ongoing receipt of any immunosuppressive therapy. (note that we have chosen to exclude such populations because of their increased risk of acquiring infections, they are relatively few, and are not representative of a national sample). * any individual with unknown poultry exposure status, or who was exposed to poultry more than 5 years ago.

Keywords: h5n1 subtype avian viruses highly pathogenic avian influenza (hpai)
climatotherapy versus topical combination of corticosteroids and salicylic acid in treatment of psoriasis

Conditions: Papulosquamous Skin Disease

Summary: psoriasis is a multisystem disease predominately manifested as chronic inflammation of the skin and characterized by scaly, erythematous patches, papules and plaques, which are often pruritic. as chronic disease, psoriasis waxes and wanes throughout patient life time. the disease course is modified with initiation and cessation of treatment, and spontaneous remission is rare. clinically lesions can be distributed in any part of the body, this leads to impaired consequences on the perception of body image, social relations and in general on quality of life.

the severity of psoriasis is defined by the extent of body surface involvement as well as the involvement of areas that substantially affect daily life such as hands, feet, face and genital region . approximately 80% of patients have mild to moderate disease and 20% have moderate to severe disease. although the precise etiology of psoriasis remains unknown, a combination of immunologic, genetic and environmental factors contribute to its development and exacerbation. psoriasis has multifactorial pathogenesis in which predisposing genetic factors (dysregulation of the immune system and alteration of keratinocytes) and environmental trigger factors (such as local trauma, streptococcal infections, emotional stress, drugs as b-blockers and lithium) interact with each other by triggering a specific immune response mediated by t-lymphocytes.treatment of psoriasis is still very complex. several treatments for plaque psoriasis are available as topical medications for mild to moderate cases of psoriasis (corticosteroids, vit d3 analogues, salicylic acid, dithranol etc.). phototherapy is useful in moderately-severe psoriasis unresponsive to topical therapy alone. systemic treatment is used for severe forms of psoriasis including immunosuppressive drugs such as methotrexate or cyclosporine, retinoids, etc., and in cases of contraindications or ineffectiveness of these drugs these severe forms of psoriasis can be treated with biological drugs such as adalimumab, etanercept, infliximab, etc.the climatotherapy presents a safe and efficient alternative to conventional therapeutic modality for psoriasis. climatotherapy treatment is based on healing capacities of natural resources.climatic treatment includes balneotherapy and sun exposure. balneotherapy represents a set of methods and practices (bathing, drinking, inhalation, etc.)

Eligibility criteria:
inclusion criteria: 1. clinical diagnosis of psoriasis(mild to moderate) . 2. age 9-60 years exclusion criteria: 1-patients under 9 years. 2-patient with severe psoriasis. 3-skin cancer. 4-renal insufficiency. 5-acute infections. 6-severe hypertension. 7-skin and systemic diseases worsened by sun exposure. 8-acute and non controlled concomitant diseases. 9-ischemic heart diseases or any disease rendering them unable to bathe.
hemodynamic management in women with shs

Conditions: Supine Hypotensive Syndrome

Summary: supine hypotensive syndrome often occurs following spinal anesthesia for cesarean delivery.in our study we base the regulation and drug administration both on the regular monitor and on a novel monitor which reflects upon the hemodynamic changes. our aim is to observe whether the outcome of shs patients with anesthesia management based on hemodynamic figures differs from those based on experience.


Eligibility criteria:
inclusion criteria: * american society of anesthesiologists (asa) physical status classification ii and had no significant cardiovascular, pulmonary, renal or endocrine disease, without contraindications to csea,and could be diagnosed as shs according to the criteria. exclusion criteria: * patients undergoing emergency cd, cd under general anesthesia or patients' refusal to participate, or multiple fetations.

Keywords: supine hypotensive syndrome cesarean delivery spinal anesthesia csea
effect of electronic cigarette use on cough reflex sensitivity

Conditions: Cough

Summary: although electronic cigarettes (e-cigs) are now widely used, very little information exists regarding the effect of electronic cigarette use (vaping) on the respiratory system. the aim of this study is to evaluate the acute effect of one e-cig vaping session (30 puffs 30 seconds apart) on cough reflex sensitivity in healthy adult nonsmokers.

30 adult nonsmokers will have their cough reflex sensitivity measured at baseline, 15 minutes after an e-cig vaping session, and 24 hours subsequently. one e-cig vaping session will consist of 30 puffs of an e-cg (blu) 30 seconds apart, which will deliver the approximate nicotine amount delivered by one tobacco cigarette. cough reflex sensitivity, defined as c5, the concentration of capsaicin inducing 5 or more coughs, is the standard end point of cough challenge studies.

Eligibility criteria:
inclusion criteria: * healthy adults (age18 years and above) * nonsmokers exclusion criteria: * previous smoker * asthma/other respiratory illness * acute viral upper respiratory tract infection (common cold) in previous 4 weeks

Keywords: cough cough reflex sensitivity electronic cigarette capsaicin
evaluation of changes in prescribing behavior of er/la opioid prescribers

Conditions: Opioid Related Disorders; Opiate Addiction; Narcotic Abuse; Drug Abuse

Summary: a study will be performed to evaluate changes in prescribing behavior of prescribers of er/la opioids

a study will be performed to evaluate changes in prescribing behavior of prescribers. 1. for products that are indicated for use in opioid-tolerant patients only (i.e., fentanyl transdermal patches, extended-release hydromorphone pills and extended-release morphine pills \>90mg), describe trends in the proportion of prescriptions for these products to opioid-non-tolerant patients in the year preceding the availability of rems-compliant ce courses and compare the proportion of prescriptions to opioid non-tolerant patients pre- versus post-rems ce course availability 2. for products whose labels indicate that higher dosage strengths should only be used in opioid-tolerant patients, describe trends in the proportion of prescriptions prescribed to opioid non-tolerant patients with a high starting dosage strength; compare the proportion of prescriptions for such products that are prescribed to opioid non-tolerant patients with a high starting dosage strength pre- versus post-rems ce course availability 3. describe trends in the proportion of prescriptions for er/la opioids prescribed to patients that have early refills of prescriptions and compare this proportion pre- versus post-rems ce course availability. 4. compare the concomitant use of benzodiazepines with er/la opioids before and after rems implementation.

Eligibility criteria:
inclusion criteria: * subjects filling a prescription for a product of interest during the specified time period will be included. exclusion criteria: * none
pico dressings for emergency laparotomy

Conditions: Surgical Site Infection

Summary: ssi (surgical site infection) rate is an important consideration after emergency laparotomy. ssis carry a high financial burden for health institutes with the cost of major ssis after emergency laparotomy to add an additional cost of £10000-£15000 per patient. nice has recommended the use of pico dressings for the reduction of ssi rate as a cost-neutral. the purpose of this study was to review the current ssi rate, assess the patient risk factors for development of ssis and evaluate if the use of pico dressings as per nice guidelines will reduce the ssi rate.


Eligibility criteria:
inclusion criteria: * all emergency midline laparotomy * laparoscopic converted open exclusion criteria: - reoperation with 28 days of index laparotomy
evaluation of different benznidazole regimens for the treatment of chronic chagas disease.

Conditions: Chagas Disease; Trypanosoma Cruzi Infection

Summary: a phase 2 clinical trial to evaluate the the efficacy of different benznidazole regimens (300mg/day for 60 days, 150mg/day for 60 days, and 400mg/day for 15 days) for the treatment of chronic chagas disease in adult patients. the efficacy is assessed through the proportion of patients with negative parasitaemia measured by polymerase chain reaction (pcr) during the first 12 months after starting treatment. the study will be performed in spain, brazil, argentina and colombia.


Eligibility criteria:
inclusion criteria: * over 18 years old. * diagnosis of chagas disease through two different serological tests. * positive t. cruzi pcr in peripheral blood. * signed informed consent. exclusion criteria: * previous treatment with benznidazole or nifurtimox. * alcohol consumption. * acute or chronic health problems that could interfere in the assessment of the efficacy or safety of the drug (acute infections, hiv infection, liver or renal impairment, etc). * nitroimidazole hipersensitivity. * concomitant or previous treatment with allopurinol or antifungal drugs. * pregnancy.

Keywords: benznidazole pcr
knowledge of predicting increased risk for an overuse injury in runners

Conditions: Overuse Injuries; Musculoskeletal Make-up in the Lower Extremities

Summary: the purpose of this study is to examine the skeleton of the legs and the running style in order to predict a possible overuse injury.

the running style and the training composition and the body composition are thought to have major effect on the development of overuse injuries. to define a prevention strategy, one must have the knowledge about risk factors and causation. the training composition is very relevant clinically but the underlying factors have not been studied yet. for the present there is no scientifical evidence of a possible relation between the body composition such as the mutual length and width of femur and tibia and the development of overuse injuries. thus, the aim of this study is to achieve evidence-based knowledge of these factors in order to advice runners about the precautions and to avoid that people get a sedentary lifestyle.

Eligibility criteria:
inclusion criteria: * men between 18 and 60 years * access to an e-mail * two years running experience as a minimum * exercises three times weekly as a minimum, on annual average or until any excessive load on the body occurs * experience with running machines * a written signed statement of consent exclusion criteria: * lack of a written signed statement of consent * unwillingness to keep a journal during the running exercises * unwillingness to register data during the follow-up period * injury in the lower extremities within 3 months before baseline * the runner uses insoles or he has been through a surgical procedure in the lower extremities * a mental disability for example dementia or challenging behaviour * the runner plays heavy sport, cf. american college of sports medicine * unability to read or understand danish * unability to cooperate

Keywords: overuse injury femur tibia running prevention
surgery for intravenous leiomyomatosis

Conditions: Leiomyomatosis

Summary: intravenous leiomyomatosis (ivl) with intracardiac extension is a rare benign smooth muscle tumor. reviewing literature, intracardiac extension of the ivl has been reported in at least 70 cases. most are individual case reports. surgical experience is not much. however, different opinion of surgical strategies remain controversial. the purpose of this report is to describe our experience of surgical management for the ivl with intracardiac extension.

all patients underwent surgical management. clinical data were obtained from medical reports. following-up was made through email and telephone.

Eligibility criteria:
inclusion criteria: * age more than 18 years. * tumor markers were all within normal limits. * patients underwent surgical management. * patients were followed-up for more than 12 months. exclusion criteria: -tumor markers were all within abnormal limits

Keywords: intravenous leiomyomatosis surgery smooth muscle tumor
cardiac effects of spiolto®/respimat® in patients with congestive heart failure and copd

Conditions: COPD

Summary: the aim of this study is to evaluate the pulmonary and cardiac effects of the laba / lama combination tiotropium / olodaterol therapy in patients suffering from both congestive heart failure and chronic obstructive pulmonary disease.


Eligibility criteria:
inclusion criteria: * adults who are contractually capable and mentally able to understand and follow the instructions of the study personnel * symptomatic with regard to dyspnea (nyha ii-iii, mmrc dyspnea score \> 1) * diagnosis of copd (fev1/fvc ratio \<70%, fev1 \< 80%) * patients with hyperinflation at rest defined as residual volume (rv) \> 135 % predicted * diagnosis of moderate symptomatic ischaemic congestive heart failure (lvef \> 35 -45%) * stability of chf during the preceding 3 months (no hospitalization due to chf, stable chf medication) * male or female aged \> 18 years * written informed consent prior to study participation * the subject is willing and able to follow the procedures outlined in the protocol exclusion criteria: * lack of informed consent * pregnant and lactating females * acute moderate-severe exacerbation of copd, acute respiratory failure (ph \ 30/min within 3 months prior to inclusion) * unstable heart failure or planned change in medication (hospitalization due to chf within 3 months prior to inclusion), any angina pectoris * not symptomatic * patient has been committed to an institution by legal or regulatory order * participation in a parallel interventional clinical trial * any copd maintenance therapy before start of randomization * history or diagnosis of asthma * lvef \<35 % or icd or pacemaker * myocardial infarction 6 months prior inclusion * history of life-threatening arrhythmias (e.g. nsvt or ventricular tachycardia, afib, av-block, pacemaker treatment etc.) * history of diagnosis of thyrotoxicosis * chronic kidney disease with an crea-clearance ≤30 ml/min * history of significant alcohol or drug abuse, as judged by the investigator * fibrotic lung disease (e.g. ipf, ild) * contraindications for mrt (e.g. pacemaker, defibrillator, ferromagnetic metal implants, tattoos, claustrophobia, etc. according to mri checklist used in the clinical routine)