Kornimate/medical-research-clean huggingface dataset:
effectiveness and implementation of brief cognitive behavioral therapy in cbocs

Conditions: Depression

Summary: the purpose of this study is to determine the effectiveness of a brief cognitive behavioral therapy (bcbt) intervention for veterans with depression delivered by mental health providers located at va community based outpatient clinics (cboc's) associated with the houston and oklahoma city vamcs.

depression is a serious health condition that places tremendous burden on patients and healthcare systems and is especially prevalent in veterans. in 2008, the vha released the uniform mental health services handbook (handbook 1160.01) in an effort to expand services for veterans with depression, including those in primary care and cboc settings. the va remains a national leader in mental health services, but the provision of psychotherapy within va is limited, especially for rural veterans and those cared for in cbocs. the va has invested significant resources to improve access to high-quality mental health care, including a rapid expansion into cbocs. currently, there is a need to work with clinicians and stakeholders to address practice barriers related to mental health practices in cbocs. a recent survey of 4,200 mental health providers in va found that, although robust expansion and improved quality of mental health care services has occurred, access to proven effective psychotherapies in cbocs remains a focused area for improvement. the study will examine whether existing va cboc mental health clinicians, with training and support, can effectively administer a structured brief cognitive behavioral therapy (bcbt) intervention for veterans with clinically elevated symptoms of depression.

Eligibility criteria:
inclusion criteria: * must have clinically significant symptoms of depression; * must be current recipients of services at cbocs associated with the houston and oklahoma city vamcs. exclusion criteria: * cognitive impairment; * presence of bipolar, psychotic or substance-abuse disorders. * veterans currently receiving psychotherapy will be excluded.

Keywords: depression brief cognitive behavioral therapy (bcbt) randomized controlled trial
effect of automatic recruitment maneuver on peroperative lung mechanics of obese laparoscopic abdominal surgery patients

Conditions: Recruitment; Obesity, Morbid; Laparoscopy

Summary: this study aims to demonstrate the effects of automatic recruitment maneuver on peroperative lung mechanics of obese patients undergoing laparoscopic abdominal surgery. 128 obese patients undergoing abdominal laparoscopic surgery are randomly going to be assigned to automatic recruitment maneuver group and no recruitment maneuver group (control group). both groups are going to be taken to the operating table. electrocardiography (ecg), noninvasive blood pressure (nibp), pulse oximeter and peripheral oxygen saturation (spo2) and post-intubation end-tidal carbon dioxide (etco2) and train of four (tof) monitoring will be performed. then, general anesthesia induction procedure will be started. following intubation, patients will be ventilated according to the ideal weight within the scope of intraoperative protective ventilation strategy and in pressure-controlled ventilation (pcv) mode. then, automatic recruitment maneuver will be applied to the recruitment group twice, after insufflation and desufflation. it will not be applied to the control group. during recruitment maneuver, peep (positive end-expiratory pressure), where dynamic compliance is measured highest, will be the ideal peep (positive end-expiratory pressure) for the patient, and peep (positive end-expiratory pressure) will be adjusted at this value after recruitment. if map (mean arterial pressure) is \<60 mmhg during the maneuver, the maneuver will be terminated and these patients will be excluded from the study. respiratory mechanics for both groups (peak pressure, plateau pressure, driver pressure, static compliance, dynamic compliance, etco2) and hemodynamic parameters (heart peak, mean arterial pressure, spo2) at 5 different times (t1: post intubation; t2 : after insufflation; t3: 5 minutes after insufflation / after the first recruitment maneuver; t4: after desufflation; t5: 5 minutes after desufflation / after the second recruitment maneuver) will be recorded. throughout the surgery, insufflation pressure will be kept as 10-13 cmh20. at the end of the surgery, the anesthesia maintenance of all patients will be terminated and the routine wake-up phase will be initiated. creatinine values and hourly urine outputs of all patients routinely monitored at the postoperative 24th hour will be recorded on the case follow-up form.


Eligibility criteria:
inclusion criteria: 1. patients between the ages of 18 and 65 2. body mass index (bmi)\> 30 patients undergoing laparoscopic abdominal surgery 3. asa (american society of anesthesiologists) 2-3 patients exclusion criteria: 1. smokers 2. patients with previous abdominal surgery 3. patients with obstructive / restrictive lung disease, 4. patients with coronary artery disease, heart failure 5. patients with chronic kidney failure
volume management under body composition monitoring in critically ill patients on crrt

Conditions: Renal Dialysis; Fluid Overload

Summary: although monitoring fluid balance for continuous renal replacement therapy-treated patients is an important issue, most physicians usually use conventional methods such as the difference between the amount of intake and output (i \& o), which is not objective way. meanwhile, bioimpedance electrical vector analysis presents the patients' fluid status with more objective data. thus, the investigators will investigate the clinical benefit for monitoring fluid balance when the investigators use inbody s10, one of representative bioimpedance electrical vector analysis, compared with conventional methods among the patients who need continuous renal replacement therapy.

although monitoring fluid balance for continuous renal replacement therapy-treated patients is an important issue, most physicians usually use conventional methods such as the difference between the amount of intake and output (i \& o), which is not objective way. meanwhile, bioimpedance electrical vector analysis presents the patients' fluid status with more objective data. thus, the investigators will investigate the clinical benefit for monitoring fluid balance by using inbody s10 (0, 1, 2-day, and 7-day from crrt initiation), one of representative bioimpedance electrical vector analysis, compared with conventional methods among the patients who need continuous renal replacement therapy.

Eligibility criteria:
inclusion criteria: * patients will be eligible for inclusion in the study if all the following criteria are met; 1. the treating clinician believes that the patient requires continuous renal replacement therapy for acute renal failure. 2. the treating clinicians anticipate treating the patient with continuous renal replacement therapy for at least 72 hours. 3. informed consent has been obtained. 4. the patient fulfills one of the following clinical criteria for initiating continuous renal replacement therapy: urine output \< 100 ml/6 hr that has been unresponsive to fluid resuscitation measures * k+\> 6.5 mmol/l * ph \< 7.2 * urea \> 25 mmol/l * clinically significant organ edema in the setting of acute kidney injury 5. patients who are over 5% of fluid overload or their total body water/height\^2 ≥13 l/m\^2 exclusion criteria: * patients will be excluded from the study if, in the opinion or knowledge of the responsible clinician any of the following criteria are present: 1. patient age is \< 18 years 2. death is imminent (\<24 hours) 3. there is a strong likelihood that the study treatment will not be continued in accordance with the study protocol. 4. the patient has been treated with continuous renal replacement therapy or other dialysis previously during the same hospital admission. 5. the patient has been on maintenance dialysis prior to the current hospitalization. 6. any other major illness that, in the investigator's judgement, will substantially increase the risk associated with the subject's participation in this study.

Keywords: fluid management conventional method inbody s10 crrt
nutritional counseling to change eating behavior, metabolism and anthropometry in adults with abdominal obesity

Conditions: Obesity, Abdominal

Summary: this study evaluates the impact of changes in eating behavior through nutritional counseling, after nine months of intervention, on body composition and metabolism in adult workers with abdominal obesity

this study is a nutritional intervention in voluntary workers with abdominal obesity (waist circumference ≥102cm and ≥88cm). the intervention is divided into two phases: the intensive one has a duration of 6 months and consisted in a 4 face-to-face sessions with 9 online or telephone contacts based on the use of nutritional counseling \[academy of nutrition and dietetics, 2013\] and the second phase: consisted in a 3 months' follow-up with 2 telephone contacts and a final visit face-to-face. the investigators used the cognitive behavior therapy process as a theoretical framework, and also used the intervention comprised sessions designed to promote motivation, social support, self-regulation to promote the eating behavior change process. the participants were measured weight loss, waist circumference, and the lipid profile change, pre-intervention, and after six and nice months post-intervention.

Eligibility criteria:
inclusion criteria: * with abdominal obesity: men with waist circumference (cc) ≥102 cm and women with cc ≥88 cm. * literacy. * sign the informed consent exclusion criteria: * participants with severe alterations of their renal function, hepatic, thyroid and circulatory system (self-reported or found in their laborarotorio analysis) * participants with any serious illness, hospitalization in the 6 months prior to the start of the study. * in nutritional treatment for weight loss in the last three months. * in psychological and / or psychiatric treatment. * depression or anxiety. * history of bariatric surgery. * pregnant or lactating women.

Keywords: obesity nutritional counseling weight loss eating behaviors abdominal obesity
influence of timing on motor learning

Conditions: Cerebrovascular Accident

Summary: the purpose of this research study is to compare different methods for training hand movement at home after stroke. this study involves research because it will test two experimental devices, the musicglove and the resonating arm exerciser (rae), compared to conventional hand and arm exercises. the musicglove is a glove that measures finger movements and allows its user to play a musical computer game using those movements. the rae is a lever that attaches to a manual wheelchair with elastic bands and can be pushed back and forth to exercise the arm.

the purpose of this research study is to compare different methods for training hand movement at home after stroke. this study involves research because it will test two experimental devices, the musicglove and the resonating arm exerciser (rae), compared to conventional hand and arm exercises. the musicglove is a glove that measures finger movements and allows its user to play a musical computer game using those movements. the rae is a lever that attaches to a manual wheelchair with elastic bands and can be pushed back and forth to exercise the arm.

Eligibility criteria:
inclusion criteria: * age 18 to 80 years of age * sustained a single stroke affecting the arm, at least three months prior to enrollment * minimal to moderate lost motor control of the arm after stroke * no active major psychiatric problems, or neurological/orthopedic problems affecting the stroke-affected upper extremity * no active major neurological disease other than the stroke * absence of pain in the stroke-affected upper extremity exclusion criteria: * severe tone at the affected upper extremity * severe aphasia * severe reduced level of consciousness * severe sensory/proprioception deficit at the affected upper extremity * currently pregnant * difficulty in understanding or complying with instructions * inability to perform the experimental task that will be studied * increased pain with movement of the stroke-affected upper extremity

Keywords: stroke
assessing the pharmacokinetics of nktr-118 in subjects with renal impairment compared to that in subjects with normal renal function

Conditions: Renal Impairment

Summary: this study will be assessing the pharmacokinetics of nktr-118 in subjects with renal impairment compared to that in subjects with normal renal function.


Eligibility criteria:
inclusion criteria: * provision of signed written and dated informed consent prior to any study specific procedures. * male or female volunteers aged 18 to 80 years (inclusive) having normal renal function, or suffering from moderate or severe renal impairment or esrd. male subjects who are sexually active must be willing to use a barrier method of contraception (condom). women must be of non-childbearing potential or, if of childbearing potential, must have a negative pregnancy test (at screening and at each admission) and be using a highly effective form of birth control for 3 months before enrollment and be willing to use a highly effective form of birth control during the study and until 3 months after their last dose of ip. * have a bmi between 18 and 40 kg/m2 (inclusive) and weigh at least 50 kg. * subjects must be able to understand and to comply with study procedures, restrictions and requirements. exclusion criteria: * history of any clinically significant medical history which, in the opinion of the investigator and sponsor, may either put the subject at risk because of participation in the study, or influence the results, or the subject's ability to participate in the study. * history or presence of gastrointestinal hepatic or other condition known to interfere with disposition of the study drug (except for renal function impairment). * subjects who have a functioning kidney transplant. * acute illness, surgical procedures or trauma from within 2 weeks before enrollment until first administration of study drug * known or suspected history of drug abuse as judged by the investigator.

Keywords: phase 1 pharmacokinetics nktr-118 renal impairment parallel study qtcf interval auc(0-t) cmax tmax
comparison of the clinical efficacy of ketoprofen, associated or not with omeprazole in lower third molar removal

Conditions: Pain; Other Surgical Procedures

Summary: the control of pain, swelling and trismus in patients undergoing oral and maxillofacial surgery is frequently performed through the administration of non-steroidal anti-inflammatory drugs (nsaids). the present study aims to evaluate in a double blind, randomized and crossover manner the clinical efficacy of ketoprofen (immediate release - 100 mg) and ketoprofen in association with omeprazole (modified release - 200 mg ketoprofen with 20 mg omeprazole) in 50 patients aged 18 years or older that require removal of both lower third molars symmetrically positioned. after collection, data will be analyzed by means of graphs and tables to allow the appropriate analyses. paired t-test will be used to compare the duration of surgeries. nonparametric wilcoxon test will be used for the analysis of "rescue medication" and postoperative pain parameters (visual analog scale). data of "mouth opening" and "swelling" will be statistically analyzed through analysis of variance (anova) followed by tukey's test for multiple comparisons. statistical significance will be set at 5%. results will be presented as mean ± standard deviation of the mean.

studies have shown that nsaids exert their therapeutic effect by the inhibition of cyclooxigenases (cox) 1 and 2, which determines the inhibition of prostaglandins production whose effects potentiate the action of many inflammatory mediators. the protocol for the administration of these formulations will involve the administration of a tablet of the immediate release product (100 mg) every 12 hours, and one capsule of the modified release product (200 mg ketoprofen with omeprazole) every 24 hours, during 4 days. the following parameters will be analyzed: 1. subjective postoperative pain evaluation, with the aid of a visual analogue scale, 2. mouth opening before the surgery, on the 2nd and 7th postoperative days (moment of suture removal), 3. beginning and duration of the surgery after anesthetic administration, 4. incidence, type and severity of adverse reactions, 5. total amount of rescue analgesic medication (paracetamol), 6. facial swelling measured on the 2nd and 7th postoperative days (in comparison with the measurements before the surgery).

Eligibility criteria:
inclusion criteria: * need of lower third molar surgeries in similar positions exclusion criteria: * presence of systemic diseases; * presence of local inflammation and/or infection; * any history of allergic reaction to local anesthetics, gastrointestinal bleeding or ulceration; * cardiovascular, kidney or hepatic diseases; * patients who are making use of antidepressants, diuretics or anticoagulants; * asthma and allergy to aspirin, naproxen or any other nonsteroidal antiinflammatory drug; * regular use of any nonsteroidal antiinflammatory drug, pregnancy or breast feeding.

Keywords: ketofrofen omeprazole lower third molar oral surgery
comparison of alogliptin versus alogliptin and pioglitazone on insulin resistance of metformin treated women with pcos

Conditions: Polycystic Ovary Syndrome; Insulin Resistance

Summary: the purpose of this study was to determine whether dual treatment with metformin and alogliptin is more effective than treatment with metformin, alogliptin and pioglitazone in the treatment of obese women with polycystic ovary syndrome (pcos) regarding insulin resistance and beta cell function.


Eligibility criteria:
inclusion criteria: * 18 years old to menopause * polycystic ovary syndrome (nichd criteria) * bmi of 30 kg/m² or higher exclusion criteria: * type 1 or type 2 diabetes mellitus * history of carcinoma * cushing's syndrome or congenital (non-classic) adrenal hyperplasia * personal or family history of men 2 * significant cardiovascular, kidney or hepatic disease
brief roc training effects on alcohol drinking

Conditions: Binge Drinking; Heavy Drinking; Young Adult; Heavy Drinker; Alcohol Drinking; Alcohol Drinking in College; Drinking Behavior; Drunkenness; Drinking Excessive; Drinking Problem; Drink Too Much; College Drinking

Summary: the goal of the proposed study is to examine whether a single session of training in regulation of craving (roc-t) affects alcohol drinking. the study will consist of (1) a basic screening (phone and/or online) and an in-person visit, to determine eligibility and conduct pre-intervention baseline assessments; (2) a training (roc-t) visit, (3) a post-intervention assessment visit, and (4) 1-2 phone/online follow-up assessments. the study will take up to 10 hours of the participants' time.

the investigators propose to test the efficacy of such training by randomizing 120 individuals who report alcohol drinking to the following conditions: (1) a brief training in cognitive regulation and (2) a control or no-training condition. training will be delivered in a computerized session (approximately 60 minutes). if randomized into the cognitive regulation training, subjects will be trained to use a cognitive strategy while viewing images of alcoholic drinks. the strategy would be to follow instructions to think about the adverse outcomes associated with continued alcohol drinking. if randomized into the control condition, participants will only view non-alcohol-related images with no use of strategy. after all the training sessions are completed, participants will complete several follow-ups. the investigators will evaluate the effects of training on alcohol drinking pre- and post-training.

Eligibility criteria:
inclusion criteria: 1. adults ages 18-25 2. capability of performing the experimental tasks (e.g., can read, able to use computers) 3. native or fluent speaker of english 4. provides informed consent 5. normal or corrected-to-normal vision 6. willing to commit to the full length of the protocol 7. heavy drinking or binge-drinking exclusion criteria. 1. present dsm disorders, apart from alcohol use disorders 2. reports of neurological or systemic disorders that can cause cognitive impairment 3. minor cognitive impairment evidenced by an inability to correctly understand study information 4. reports entirely no interest in reducing the amount of drinking (alcohol contemplation ladder score of 9 or 10).

Keywords: binge drinking heavy drinking young adult heavy drinker regulation of craving cognitive behavioral therapy neurocognitive training emotion regulation alcohol
nasopharyngeal carcinoma post imrt

Conditions: Nasopharyngeal Carcinoma

Summary: nasopharyngeal carcinoma (npc) is a type of head and neck cancer. the last three decades of research in head and neck radiation oncology have largely focused on improvements in survival, which have mostly come at the cost of long term toxicity for surviving patients. this is an observational study that is being done to learn about the long-term symptoms and side effects that survivors of nasopharyngeal cancer may have following radiation treatment. this study will include assessment of patient report outcomes, physician-graded adverse events, neurocognitive assessment and endocrine and hearing testing

this study is designed to provide comprehensive cross sectional information on the late toxicities following radical chemoradiotherapy in nasopharyngeal carcinoma in patients who are disease free with a minimum of four years follow-up and who were treated with contemporary radiotherapy techniques (imrt). this is an observational cross-sectional study which will aim to define the late effects in this population, investigating both well known toxicities identified from studies using earlier radiotherapy techniques (2d and 3d radiotherapy) as well as toxicities which have not been well defined in the current literature and which may be under-recognized and under treated (pituitary function and neurocognitive outcomes). this study will assess survivors at a single time point four years after completion of their treatment who are disease free. this comprehensive review will include demographic data, clinical assessment, biochemical assessment of hormonal (pituitary and thyroid) function, patient reported outcomes, and quality of life and neurocognitive questionnaires. this study will attempt to comprehensively review these toxicities in a contemporary patient group with modern radiotherapy techniques in an attempt to bridge the gap between current recommended follow up protocols and the actual challenges faced by long term survivors. some of these factors will be correlated with radiation doses received by the patient to inform on radiation dose thresholds for appropriate toxicities (hypothalamic-pituitary, thyroid, temporal lobe necrosis, neurocognitive performance). patients will be offered follow-up, if required with appropriate personnel if appropriate, including neuropsychology, endocrinology and otoloryngology.

Eligibility criteria:
inclusion criteria: all patients with a previous diagnosis of npc treated with curative intent who are alive and disease free with a minimum of four years of follow up following completion of treatment * received treatment with imrt * age 18 or above, no upper limit * ability to comply with the protocol exclusion criteria: * history of recurrent nasopharyngeal disease * a history of any physical, psychological or social condition which would impair with the ability of the patient to cooperate in this study * unable to provide consent

Keywords: nasopharyngeal carcinoma intensity-modulated radiotherapy post treatment