Kornimate/medical-research-clean huggingface dataset:
mindfulness intervention to study the neurobiology of depression

Conditions: Depression

Summary: the pediatric mood disorders program at the university of illinois at chicago is conducting a research study examining how mindfulness can help teenagers stay healthy and prevent depression relapse.

study involves: * brain scan using fmri technology * questions about mood and behavior * meeting with a clinician * possibility of 8 weekly treatment sessions using mindfulness * ongoing assessment of depression for next 2 years eligible participants will be compensated for their time.

Eligibility criteria:
inclusion criteria: * between the ages of 12 and 18 * history of major depressive disorder exclusion criteria: * braces * afraid of small spaces

Keywords: mindfulness relapse prevention recovery depression adolescents
the effect of opioids on p2y12 receptor inhibition in patients with st-elevation myocardial infarction who are pre-treated with crushed ticagrelor

Conditions: STEMI; STEMI - ST Elevation Myocardial Infarction

Summary: fast and accurate platelet inhibition is an important therapeutic goal in the acute treatment of patients with st-segment elevation myocardial infarction (stemi). platelet inhibitory effects induced by normal oral p2y12 receptor antagonists, for example ticagrelor, are delayed in stemi patients undergoing primary percutaneous coronary intervention (primary pci), which may be attributed to impaired absorption affecting drug pharmacokinetics (pk) and pharmacodynamics (pd). another therapeutic goal in the acute treatment of stemi is reduction of sympathetic stress and catecholamine release, thereby improving the balance between the demand for and supply of oxygen, by analgesia like fentanyl of morphine. to date, there are no studies that have specifically assessed the pharmacodynamics influences of fentanyl on platelet inhibition in stemi patients who are pre-treated with crushed ticagrelor tablets. therefore, in the on-time-3 study, the investigators seek to show the influence of fentanyl on platelet inhibition in stemi patients who are pre-treated with crushed ticagrelor in the ambulance.


Eligibility criteria:
inclusion criteria: i. age ≥18 years ii. referred by ambulance paramedics to isala (zwolle) or zuyderland hospital (heerlen) iii. diagnosed in the ambulance with stemi defined as: 1. ongoing chest pain \>30 minutes and \<12 hours duration and 2. st-segment elevation \>0.1 millivolt in at least 2 contiguous leads iv. ongoing chest pain with a pain score (nrs) ≥4 v. the patient has been informed of the nature of the study, agrees to its provisions and has provided verbal informed consent in the pre-hospital phase followed by written informed consent in hospital exclusion criteria: i. presenting with cardiogenic shock; defined as: 1. systolic blood pressure \<90 mmhg and 2. heart rate \>100/min and 3. peripheral oxygen saturation \<90% (without oxygen administration) ii. patients with a nasogastric tube in situ or requiring a nasogastric tube iii. patients who already received fentanyl or paracetamol \<2 hours prior to randomization iv. patients on current treatment with p2y12 inhibitors (ticagrelor, clopidogrel or prasugrel) v. allergy to morphine or paracetamol vi. patients with recent major bleeding complications or contraindication to dual antiplatelet therapy: 1. hypersensitivity to aspirin or ticagrelor 2. current use of (new) oral anticoagulation 3. history of bleeding diathesis or known coagulopathy 4. active bleeding 5. refusal of blood transfusions 6. history of intracerebral mass, aneurysm, arteriovenous malformation, or hemorrhagic stroke 7. known severe liver dysfunction vii. received any organ transplant or is on a waiting list for any organ transplant viii. patients undergoing dialysis ix. pregnant or lactating female x. patients currently participating in another investigational drug or device study
acetato de caspofungin (cancidas®) in the treatment of fungal infection

Conditions: Candidiasis; Aspergillosis

Summary: we wanted to determine the efficacy and the safety of caspofungin acetate (cancidas®) in the treatment of invader fungal infection (ifi) specifically, invasive candidiasis (ci) in adults patients without neutropenia and invasive aspergillosis (ai) in adults patients who are refractory to or intolerant of other therapies (i.e., amphotericin b, lipid formulations of amphotericin b, and/or itraconazole).

study post-marketing (observational). it is multicenter and prospective. no masking is used, without control group neither is randomized

Eligibility criteria:
inclusion criteria: * female and male with 18 years old at least. * diagnosis of ai or ci. it will be based in clinical history, signs and symptoms that the patient takes, discovery of studies of radiology and results of cultivation and/or studies of anatomopathology positives for candida spp. or aspergillus spp. * patients with ai, must be refractory to or intolerant of other therapies antifungal used in the hospital. * patients with ci, must be or not refractory to or intolerant of other therapies antifungal used in the hospital. exclusion criteria: * patients with diagnosis uncertain based in one or more of next criterions: cultivation positive for candida in an only localization (urine, spittle, end/current of catheter; osteomyelitis or endocarditis by candida without treatment appropriated surgical; infection by candida of prosthetic material without retired of the same; positive blood cultive for candida in appearance of vascular prosthesis; allergic lung aspergillosis; and aspergilloma or aspergillosis eye without treatment appropriated surgical). * allergic / hypersensitivity to caspofungin. * insufficiency several liver (rate of chile-pugh \>9). * prediction of survival \<5 days. * pregnant or breast feeding. * previous participation of patient in this study. * presence of other disease or any condition that it can mix up the interpretation of results or create risks. * previous participation of patient in other clinical study that it involve the administration of a drug in investigation in the 14 days previous to your inclusion in the study or during the administration of caspofungin. we can include patients took with antineoplastic drugs in research whenever at lefts a investigator coordinator authorizes it before

Keywords: invader fungal infection (ifi) invasive aspergillosis (ai) invasive candidiasis (ci) caspofungin acetate
barbed suture for hysterotomy closure during cesarean section

Conditions: Hysterotomy

Summary: this is a randomized controlled trial. the purpose of this study is to see if patients whose uterine incision (hysterotomy), at the time of scheduled cesarean section, is closed with barbed suture, have less blood loss compared to women whose incision is closed with the standard suture (vicryl). the primary outcome is quantification of blood loss (qbl). secondary outcomes include time for hysterotomy closure, need for additional hemostatic sutures, rate of endometritis, use of hemostatic agents, and differences in pain which will be assessed by a telephone screening in the days following delivery. study participation will last 1 year and will include the following research procedures : 1. randomization to barbed suture vs. standard suture 2. collection of data for primary and secondary outcomes 3. telephone survey 2 weeks following the procedure to assess pain, bowel/bladder habits, and evidence of wound infection. the barbed suture is approved by the fda for use in soft tissue approximation and this is not an off-label usage.

this is a prospective, randomized controlled trial (rct) evaluating whether using a barbed suture to close a c-section incision can reduce blood loss. patients undergoing c-section will be randomized with equal allocation to a barbed suture or a standard antimicrobial suture. the primary outcome is quantification of blood loss (qbl). differences between the groups will be assessed using a 0.05 level wilcoxon rank-sum test. secondary outcomes include time for hysterotomy closure, need for additional hemostatic sutures, rate of endometritis/ssi (superficial wound infection, deep wound infection, and endometritis) within 6 weeks postpartum, use of hemostatic agents, and differences in pain which will be assessed by a telephone screening in the days following delivery.

Eligibility criteria:
inclusion criteria: * all patients undergoing a scheduled primary cesarean section at mount sinai hospital * age 18-64. exclusion criteria: * multifetal gestations * placenta previas * pre-term patients * patients with prior uterine incisions or a coagulopathy (dic, von willebrands disease, etc) * patients undergoing an unplanned or emergency cesarean section

Keywords: barbed suture blood loss hysterotomy cesarean section
tele-exercise platform for plantar wound healing

Conditions: Diabetic Foot Ulcer; Wound Healing; Wound Care

Summary: the purpose of the study is design and use a telemedicine platform which integrates video-chat, pre-programmed interactive game-based foot, and ankle exercise modules, and real-time quantitative performance metrics displayed to the clinician to improve patient's perfusion to the lower extremity, improve diabetic wound healing and prevent muscle loss in the lower extremity.this is a cross sectional and comparative feasibility study. it is designed to explore acceptability, feasibility and proof of concept/ .

foot ulceration is the most common and costly late complication of diabetes, with morbidity and mortality being worse than many cancers. it is estimated that up to one-third of people with diabetes will develop a diabetic foot ulcer (dfu) in their lifetime. non-healing dfus are a leading cause of hospitalization, amputation, disability, and death among people with diabetes. in the united states, one-third of all diabetes-related costs are spent on diabetic foot care, with two-thirds of the costs incurred in inpatient settings, constituting a substantial economic burden to society. therefore, every means possible should be used to try to heal dfu and prevent amputation. in this regard, there is a significant body of evidence related to the clinical benefits of exercise for people with dfu, including improving blood flow and oxygen supply, muscle loss prevention, and joint mobility. despite this evidence, exercise is not part of the standard care for wound healing, mainly because there is no solution for promoting and managing home-based exercise programs for people with dfu. to address the gaps described above, the investigators propose an interactive foot and ankle tele-exercise platform called "tele-footx". this platform allows clinicians to remotely and virtually supervise exercise tasks and coach patients to perform evidence-based foot and ankle exercises inspired by the validated buerger-allen (ba), while also educating and monitoring the patients adherence to the exercise program.

Eligibility criteria:
inclusion criteria: * male or female adults (age 18 years and older) * having diabetic foot ulcer * ambulatory (in the home without the aid of another person) * willing and able to provide informed consent exclusion criteria: * foot wound present for more than a year * hba1c \> 12% * abi index limb is \<0.60 and/or they are being considered for revascularization within the course of the study * ulcer involving bone or tendon * ulcer not caused by diabetes * fully confined to a wheelchair * any condition limiting the ability to engage in tele-footx exercise routine such as major cognitive decline, and major visual or hearing problem * unable or unwilling to attend prescribed clinic visits

Keywords: diabetic foot ulcer ambulatory in the home without the aid of another person able to provide written informed consent
improving patient understanding of gep test results: phase 4

Conditions: Breast Cancer

Summary: the primary aim of the study is to determine if provision of a patient information film about oncotype dx improves patients' knowledge and understanding about gene expression profiling (gep) test and risk of recurrence results in early breast cancer (ebc) patients, identified by their clinical teams as potentially benefiting from having their tumor samples sent for gep analysis.

advances made in our understanding of the molecular biology of breast cancer have improved diagnostic testing and therapeutic options available to patients. importantly results from genomic testing provide more accurate tailoring of treatments potentially enhancing the benefit to harm ratio by only offering adjuvant chemotherapy to those patients at highest risk of recurrence, and sparing those at lower risk the unwanted side effects of cytotoxic treatment. conversations about risks and optimal treatments can be complex. to aid understanding about gep tests many clinical teams provide patients with information leaflets about gep testing. unfortunately these are often written by either academic or commercial sponsors and designed to meet certain ethical and regulatory guidelines rather than effectively educate the end-user. there is some evidence that user-friendly patient information films might enhance patient knowledge and understanding and are more accessible to certain individuals, especially those with low literacy. imparter project has developed eight-minute film explaining why oncotype dx gep tests is used in ebc, what it is, and how the results help determine whether or not chemotherapy is recommended as a useful treatment option. this study wish to examine the utility of the information film in the clinic setting with ebc patients identified by their clinical teams as potentially benefiting from having their tumor samples sent for gep analysis.

Eligibility criteria:
inclusion criteria: * first presentation of early stage breast cancer with all known disease surgically removed * estrogen receptor (er) positive and human epidermal growth factor receptor 2 (her-2) negative * no clear decision on whether chemotherapy should be given as adjunct based on current prognostic criteria * consented to gep testing * able to give full informed consent to imparter study * good comprehension of the italian language * access to internet connection and devices (e.g. smart phone, tablet, laptop or desktop computer) exclusion criteria: * other breast cancer diagnosis (e.g. ductal carcinoma in situ, metastatic) * unable to give fully informed consent * under 18 years of age * unable to understand and speak italian * no access to internet connection or devices

Keywords: early breast cancer gene expression profiling oncotype dx
blood flow restriction in post-surgery rehabilitation of latarjet procedure

Conditions: Shoulder Dislocation

Summary: the goal of this clinical trial is to evaluate the effects of blood flow restriction (bfr) training on post-surgery rehabilitation following the latarjet procedure in athletes aged 18-35. the main questions it aims to answer are: does bfr training improve scapular belt muscle strength post-surgery? does bfr training enhance shoulder function during rehabilitation? researchers will compare three groups: bfr group with 50% aop \[arterial occlusion pressure\] compression bfr placebo group with 10% aop compression control group participants will: perform the same four strengthening exercises twice a week complete 16 semi-autonomous strength training sessions over 8 weeks undergo isokinetic and isometric strength tests, shoulder mobility assessments, and complete self-assessment questionnaires.


Eligibility criteria:
inclusion criteria: * age: 18-35 years * indication for shoulder stabilization surgery using the latarjet procedure (documented anterior dislocations with proof of emergency reduction, with or without hypermobility and confirmation of traumatic capsulo-ligamentous injury by mri). * regular exercise (min. 1x / week) * signed the informed consent form for the study. exclusion criteria: * pregnant or breast-feeding women * active oncological disease under treatment. (patient with stable oncological disease eligible) * adverse events during the 6-week post-operative period such as:-fracture/displacement of the reconstructed bone-luxation of the operated shoulder-requirement for emergency hospitalization * history of deep vein thrombosis/pulmonary embolism * inability to follow study procedures, due to language problems, psychological disorders, dementia. * need for skin grafting following shoulder stabilization surgery * coronary heart disease * unstable hypertension * peripheral vascular disease * hypercoagulable states (blood coagulation disorders) * left ventricular dysfunction * hemophilia

Keywords: blood flow restriction latarjet surgery rehabilitation
cognitive behavioral therapy with our without exposure therapy for irritable bowel syndrome

Conditions: Irritable Bowel Syndrome

Summary: patients with a diagnosis of irritable bowel syndrome (ibs) are recruited by self-referral. they are randomized to two 10 weeks of internet-delivered cognitive behavioral programs. both programs include mindfulness training, education about how excessive avoidant and control behaviors maintain ibs symptoms, and changing of these behaviors to live a richer life. one of the programs also includes instructions on how to perform systematic exposure. the hypothesis of the study is while both groups will show improvement in terms of ibs symptom severity and quality of life, the addition of systematic exposure will lead to more improvement in symptoms.


Eligibility criteria:
inclusion criteria: * fluency in swedish * ibs-diagnosis established by physician * fulfillment of rome iii criteria for ibs exclusion criteria: * diarrhea predominance with no colonoscopy performed * blood in stool without benign medical explanation * rapid weight loss without benign medical explanation * ongoing alcohol or drug abuse * suicidal ideation
norepinephrine prophylaxis for postspinal anesthesia hypotension

Conditions: Adverse Effect

Summary: the purpose of this study is to investigate the suitable infusion dose of norepinephrine for prophylaxis against post-spinal anesthesia hypotension.

post-spinal anesthesia hypotension is a frequent complication during spinal anesthesia for cesarean section. the incidence of post-spinal anesthesia hypotension is as high as 62.1-89.7% if prophylactic measures are not taken. vasopressors has been highly recommended for routine prevention and/or treatment of post-spinal anesthesia hypotension. as a potential substitute drug for phenylephrine, norepinephrine has gradually been used in parturients undergoing cesarean section. there's some evidence that prophylactic infusion of norepinephrine could effectively reduce the incidence of post-spinal anesthesia hypotension in parturients undergoing cesarean section. but the ideal infusion dose of norepinephrine is still unknown. the purpose of this study is to investigate the suitable infusion dose of norepinephrine for prophylaxis against post-spinal anesthesia hypotension.

Eligibility criteria:
inclusion criteria: * 18-40 years * primipara or multipara * singleton pregnancy ≥37 weeks * american society of anesthesiologists physical status classification i to ii * scheduled for elective cesarean section under spinal anesthesia exclusion criteria: * body height \< 150 cm * body weight \> 100 kg or body mass index (bmi) ≥ 40 kg/m2 * eclampsia or chronic hypertension or baseline blood pressure ≥ 160mmhg * hemoglobin \< 7g/dl * fetal distress, or known fetal developmental anomaly

Keywords: norepinephrine hypotension cesarean section dose-finding
study on prevalence and impact of brain metastases on survival in lung cancer by line of treatment

Conditions: Non-small Cell Lung Cancer; Lung Cancer; Metastatic Cancer; Brain and Central Nervous System Cancer

Summary: this study will use real-world data to assess prevalence of brain metastases in metastatic non-small cell lung cancer (mnsclc) patients and its impact on associated clinical outcomes.

this retrospective cohort database study will generate real-world evidence describing prevalence of brain metastases at metastatic diagnosis and by line of therapy, patient characteristics, treatment patterns, and clinical outcomes in metastatic non-small cell lung cancer (mnsclc) patients

Eligibility criteria:
inclusion criteria: 1. diagnosis of mnsclc in study period (01/01/2015-06/30/2023) including newly diagnosed at metastatic stage or progression from advanced stage nsclc 2. age 18+ years at the time of diagnosis of mnsclc additional inclusion criteria for 1st line of therapy cohort: 3. treated with systemic anti-cancer therapy in 1l setting additional inclusion criteria for 2nd line of therapy and 3rd line of therapy cohorts: 4. treated with systemic anti-cancer therapy in 2l setting treated with systemic anti-cancer therapy in 3l setting exclusion criteria: 1. evidence of other primary malignancy in the 365-day baseline period immediately prior to the first mnsclc diagnosis in the study period 2. evidence of stereotactic radiosurgery (srs), stereotactic radiation therapy (srt), or whole brain radiotherapy (wbrt) in the baseline period

Keywords: real world evidence nsclc brain metastases
a study of microcirculatory function in type 2 myocardial infarction (t2mi)

Conditions: Myocardial Infarction; Coronary Microvascular Disease

Summary: the purpose of this research is to find out if patients with type 2 myocardial infarction (t2mi) without significant epicardial coronary artery disease (cad) have a greater chance of having coronary microvascular disease (cmd).


Eligibility criteria:
inclusion criteria: * ability to give informed consent * structurally normal heart (normal lv and rv function, no more than mild valvular heart disease) * for controls: atypical chest pain with indication for cmd testing * for t2mi: meet criteria for t2mi according to the 4th universal definition of mi (rise/fall of troponin with at least 1 value \>99th centile+ evidence of symptoms or signs of myocardial ischemia) exclusion criteria: * acute coronary event (evidence of plaque rupture, fissure or dissection on coronary angiogram) * known to have angiographically significant cad/pressure wire positive for epicardial cad * inability to receive heparin products * allergy/contraindication to acetylcholine/adenosine/nitroglycerine products * prior coronary artery bypass grafting * pregnancy (if sexually active woman of reproductive age, need negative pregnancy test prior to proceeding with coronary angiography - this is standard of care in cath lab) * asthma with prior icu admission due to bronchospasm/need for invasive ventilation