Kornimate/medical-research-clean huggingface dataset:
biofeedback for dyssynergic constipation

Conditions: Constipation

Summary: constipation affects 4% of adults in the united states (u.s.). an estimated half of constipated patients are unable to relax pelvic floor muscles during defecation, a type of constipation called pelvic floor dyssynergia (pfd). biofeedback has been recommended for the treatment of constipation because uncontrolled studies over the past 10 years suggest that these treatments are as effective as medical or surgical management and involve no risk. however, placebo-controlled trials are still lacking. the aims of this study are: * to compare biofeedback to alternative therapies for which patients have a similar expectation of benefit; * to identify which patients are most likely to benefit; and * to assess the impact of treatment on quality of life.

this study is a long-term prospective, single-blind study comparing biofeedback for pelvic floor dyssynergia to a skeletal muscle relaxant drug (diazepam 5 mg two hours before attempted defecation) and to placebo medication. prior to randomization, patients will first receive medical therapy (laxatives and education) for 4 weeks and only those remaining constipated will be randomized. physiological tests of anal canal pressure during straining to defecate and ability to pass a 50-ml air filled balloon will be tested before and after treatment. patients will keep a diary throughout baseline and treatment, and they will be reassessed at 3, 6, and 12 months follow-up. treatment will consist of 6 clinic visits at 2-week intervals. the investigators will develop a detailed treatment manual for this disorder which would permit other investigators to replicate their study.

Eligibility criteria:
inclusion criteria: * males or females ages 16 or above who have symptoms of constipation due to pelvic floor dyssynergia exclusion criteria: * pregnancy (because of the possibility of randomization into the diazepam group) * prior history of biofeedback treatment for pelvic floor disorders

Keywords: constipation biofeedback dyssynergia pelvic floor dyssynergia outlet dysfunction
effects of electrical stimulation for preventing loss of muscle mass in patients with sirs, sepsis and septic shock

Conditions: Sepsis; Septic Shock; SIRS

Summary: background: electrical stimulation has been used in critical patients as an adjunct strategy of early rehabilitation. in septic or septic shock patients there are reports of only two studies in the literature, with conflicting results. objective: to evaluate the effects of electrical stimulation in the prevention of muscle mass loss in patients admitted to the icu with systemic inflammatory response syndrome (sirs), sepsis or septic shock. methods: this is a randomized, controlled, double-blind clinical trial. thirty-six patients with a diagnosis of sirs, sepsis or septic shock (including patients with sepsis due to the new coronavirus - covid-19) will be randomly assigned to experimental group and sham group. they will be evaluated in relation to muscle mass, peripheral muscle strength and functional status. they will also be submitted to the collection of inflammatory, metabolic, damage and muscular trophism markers. expected results: electrical stimulation is expected to be able to prevent loss of muscle mass in patients admitted to the icu with sirs, sepsis or septic shock. in addition, it is expected to be able to preserve strength in this population without increasing the pro-inflammatory or metabolic response.

this is a randomized, controlled, double-blind clinical trial. thirty-six patients with a diagnosis of sirs, sepsis or septic shock (including patients with sepsis due to the new coronavirus - covid-19) will be randomly assigned to experimental group and sham group.they will be evaluated in relation to muscle mass, peripheral muscle strength and functional status. they will also be submitted to the collection of inflammatory, metabolic, damage and muscular trophism markers.

Eligibility criteria:
inclusion criteria: * patients admitted to the icu with a diagnosis of sirs, sepsis or septic shock, * aged ≥ 18 years, * body mass index (bmi) ≤ 35 kg / m2, * without diabetic polyneuropathy, * without cardiac pacemaker, * without diagnosis of neuromuscular diseases, * absence of skin lesions. exclusion criteria: * heart attack, * death.

Keywords: sepsis septic shock electrical stimulation
co2 laser and open surgery for t1n0 glottic scc with anterior commissure involved

Conditions: Squamous Cell Carcinoma of Glottis

Summary: open surgery and co2 laser surgery are both established treatment modalities for t1n0 glottic carcinoma. it is controversial for t1n0 glottic carcinoma with anterior commissure involved.


Eligibility criteria:
inclusion criteria: * t1n0 scc of glottic carcinoma with anterior commissure involve * no nodal metastasis and distant metastasis * all patients must have ct/mr and electronic laryngoscope test before surgery and after surgery * expected lifetime\>1 year * patients and families agreed to participate in the test and sign the informed consent * without cognitive impairment. exclusion criteria: * with severe cardiac insufficiency liver and kidney function is not complete systemic infection patients * patients with pregnancy and lactation * have surgery contraindications

Keywords: co2 laser surgery open surgery multicenter prospective randomized controlled clinical studies t1n0 squamous cell carcinoma of glottis with anterior commissure involved
comparison between myopia versus hypermetropia with progressive addition lenses in computer users

Conditions: Myopia; Hypermetropia

Summary: this study examines how myopia (nearsightedness) and hyperopia (farsightedness) affect the use of progressive addition lenses (pals) for computer users. pals offer a range of vision correction within one lens, ideal for presbyopia (age-related near focusing difficulty). we'll compare visual comfort, eye strain, and user preference for pals between myopic and hyperopic individuals while focusing on computer screens.

the research will also consider if general-purpose pals differ from computer-specific pals in these user groups, and how presbyopia progression might influence pal effectiveness for each condition. this information can help eye doctors recommend the most suitable pal design for computer users with myopia or hyperopia.

Eligibility criteria:
inclusion criteria: * the age of participant will be 40 to 55 years * participant diagnosed with myopia having -0.50 to -3.00ds and astigmatism up to -0.75dc * patient diagnosed with hypermetropia having +050 to +3.00 ds and astigmatism up to +0.75dc * presbyopia addition will range from +1.00 to +2.50 ds * participants who have worked more than 4 hours on the computer screen. * participants who will be already progressive users and first-time users. * patients with no ocular disease. exclusion criteria: * participants with pre presbyopia and above 55 years of age * participants with significant ocular disease. * participants with uncontrolled diabetes and hypertension * participants who will not be willing for pal,s * participants with more than 0.75 astigmatism * participants with known allergies and sensitivity.
study on pharmacokinetics of single injection of ciprofol in patients with moderate to severe hypoproteinemia

Conditions: Hypoproteinemia; Pharmacokinetics; Ciprofol

Summary: blood concentrations of ciprofol were measured at different time points after single injection in patients with hypoproteinemia

this study was a single-center, interventional clinical study. patients with different plasma albumin levels were selected before surgery and induced by a single injection of ciprofol at a depth of 0.3 mg/kg. 2ml of venous blood was collected before and 0.5, 1, 2, 3, 5, 8, 15, 30min, 1h, 2h and 4h after administration. the pharmacokinetics of ciprofol were studied by measuring the concentration of ciprofol in blood.

Eligibility criteria:
inclusion criteria: * patients with moderate to severe hypoproteinemia (albumin \< 30g/l, protein detection time uniformly within three days before surgery） * weight greater than 45kg, bmi20-24 * the asa rating is class i or class ii exclusion criteria: * severe liver dysfunction * severe renal dysfunction * patients with asa grade iii and above * known allergy to eggs, soy products, opioids and their relief drugs, propofol * emergency surgery
evaluate egfr mutation status and impact factors in north china

Conditions: Non-Small Cell Lung Cancer

Summary: approximately 3000 advanced nsclc patients, who fulfil the inclusion/exclusion criteria, will be recruited by 30 sites in north china.

approximately 3000 advanced nsclc patients will be recruited , and the medical information of recruited patients must be recorded in the hospital electronic system from jan 1st 2014 to dec 31st 2014 .the study will focus on the egfr testing rate in adenocarcinoma patients，so the collecting data for non-adenocarcinoma patients will be controlled in less than 10% for each site.

Eligibility criteria:
inclusion criteria: * histological or cytological confirmed nsclc; * patients were diagnosed with advanced nsclc from jan 1st 2014 to dec 31st 2014; * researchers should collect the records of consecutive nsclc patients in each site. exclusion criteria: * any patients without nsclc diagnosis; * any patients which were diagnosed with advanced nsclc before jan 1st 2014 or after dec 31st 2014.
a study of avastin (bevacizumab) in combination with low-dose-interferon in patients with metastatic clear cell renal cell carcinoma (rcc).

Conditions: Renal Cell Cancer

Summary: this single arm study will assess progression free survival, tumor response and safety of avastin in combination with interferon alfa-2a (ifn) as first line treatment in patients with metastatic clear cell renal cell carcinoma. patients will receive avastin (10mg/kg iv) every 2 weeks in combination with a low dose of interferon alfa-2a (3 miu sc three times per week (t.i.w.). the anticipated time on study treatment is until disease progression, and the target sample size is 100-500 individuals.


Eligibility criteria:
inclusion criteria: * adult patients, \>=18 years of age; * metastatic rcc with majority (\>50%) of conventional clear-cell type; * prior total nephrectomy for primary rcc; * at least one measurable or non-measurable lesions; * ecog performance score of 0 or 2. exclusion criteria: * prior systemic treatment for metastatic rcc; * current or previously treated but non-stable cns metastases or spinal cord compression; * major surgery (including open biopsy) or radiation therapy within 28 days prior to enrollment; * significant cardiovascular disease within 6 months prior to enrollment.
influence of muscular atrophy on biological and functional benefit of respiratory rehabilitation in patients with chronic respiratory failure

Conditions: Respiratory Insufficiency

Summary: the prevalence of chronic respiratory failure (crf) is increasing worldwide and will become the 3rd cause of death by 2020. at the stage of the disease requiring ventilatory assistance, this relates to 50,000 patients in france, life expectancy is very limited, and quality of life is poor. crf led to a reduction in muscle mass, which is found in 35 and 55% of patients, in some to a profound cachexia. a reduced fat free mass (ffm) is a factor associated with a poor tolerance to exercise and an halved survival. the exact causes and mechanisms leading to cachexia are not yet established. recently, a chronic inflammatory condition has been quoted as a putative cause. this chronic inflammation would involve the molecular mechanisms leading to poor regulation of the balance of synthesis / protein degradation in muscle. a decrease in plasma and muscle amino acids was found among patients with a low ffm.. in addition, a decrease of plasma levels of some anabolic hormones, gh and androgens or igf-1 has been found that could explain a lack of protein synthesis. it is now well established that respiratory rehabilitation, including a program of exercise reconditioning, increases tolerance to exercise and improve the quality of life. besides the classical type of endurance exercises stimulating the cardio-respiratory system, it is suggested to add resistance exercises. several studies have reported the benefit of this strategy but the link with intracellular molecular pathways has not been described; moreover, it is unknown whether the existence of an initial muscular atrophy influences the gain in muscle strength/mass.

we therefore propose to explore the effect of a rehabilitation program including endurance and resistance exercises on muscle biopsies. the present study should help to know the molecular pathways implicated in muscle atrophy in crf patients and to assess their evolution with rehabilitation. this could lead to individualized recommendation for exercise program according to the muscle mass of the patients.

Eligibility criteria:
inclusion criteria: * prescription of an exercise training program as part of a respiratory rehabilitation * existence of an obstructive ventilatory deficit * signature of written consent exclusion criteria: * exacerbation of copd * patient with a long-term oxygen therapy * active smoker * lower limb locomotor limitation preventing to achieve the full respiratory rehabilitation program * lower limbs arteritis * myocardial infarction or pulmonary embolism of less than 3 months * long term anticoagulant * type 1 diabetes

Keywords: respiratory insufficiency muscular atrophy respiratory rehabilitation
abdominal aortic aneurysm patients remain at risk for delirium on the surgical ward after intensive care unit dismissal

Conditions: Delirium; AAA; Intensive Care Unit Delirium; Surgery--Complications; Surgery; Aortic Aneurysm, Abdominal

Summary: the incidence of delirium following open abdominal aortic aneurysm (aaa) surgery is significant, with incidence rates ranging from 12 to 33%. the occurrence of delirium on the surgical ward after intensive care unit (icu) dismissal in aaa patients remains unclear. differences in outcomes between a delirium on the icu and a delirium on the surgical ward have not been previously investigated. delirium is a frequent complication in patients who underwent open aaa surgery. this study demonstrated that patients on the surgical ward remain at risk for developing a delirium after icu dismissal. physicians should therefore maintain a high level of awareness for delirium in aaa patients who return to the surgical ward after icu dismissal. this simultaneously emphasises the necessity of delirium preventive measures and early recognition on the surgical ward in order to improve clinical outcomes.

the incidence of delirium following open abdominal aortic aneurysm (aaa) surgery is significant, with incidence rates ranging from 12 to 33%. the occurrence of delirium on the surgical ward after intensive care unit (icu) dismissal in aaa patients remains unclear. differences in outcomes between a delirium on the icu and a delirium on the surgical ward have not been previously investigated. an observational cohort study was conducted that included all patients treated electively for an abdominal aortic aneurysm (aaa) by open repair and patients undergoing emergency treatment for a ruptured aaa between 2013 and 2018. the diagnosis of delirium was verified by a psychiatrist or geriatrician using the diagnostic and statistical manual of mental disorders (dsm-v) criteria. cox proportional hazards regression analysis was used to analyse 6- and 12-months survival rate.

Eligibility criteria:
inclusion criteria: * all patients treated electively for an abdominal aortic aneurysm (aaa) by open repair and patients undergoing emergency treatment for a ruptured aaa between 2013 and 2018. exclusion criteria: * patients that did not survive surgery * patients that did not go to the intensive care unit postoperatively.

Keywords: delirium intensive care unit surgical ward abdominal aortic aneurysm surgery
incidence and patterns of nausea/vomiting with combined chemotherapy and radiation

Conditions: Cancer of the Head and Neck; Cancer of the Lung; Cancer of the Esophagus; Gastro-esophageal Junction Cancer

Summary: questionnaire study to observe the incidence and pattern or nausea and vomiting in patients receiving combined chemotherapy and radiation. 83% of patients experience radiation therapy-induced vomiting; significant nausea and vomiting could develop with concurrent chemotherapy despite standard anti-nauseous medication prophylaxis.

questionnaires will be answered daily on a weekly basis during period of radiation and chemotherapy.

Eligibility criteria:
inclusion criteria: * concurrent radiation and chemotherapy treatment * aerodigestive malignancy exclusion criteria: * other causes of vomiting (i.e.gastrointestinal obstruction...)
24-hr intraocular pressure control with dorzolamide/timolol vs the brimonidine/timolol fixed combination

Conditions: Glaucoma

Summary: the proposed study will compare for the first time the quality of 24-hour iop control with brimonidine/timolol fixed combination (btfc) versus dorzolamide/timolol fixed combination (dtfc) after a run-in period of 2 months with timolol. this crossover comparison may determine the real efficacy of the two fixed combinations and the design of the proposed study may explain for the first time why the 24-hour iop reduction provided by btfc is less than might be anticipated.


Eligibility criteria:
inclusion criteria: * consecutive, newly diagnosed or previously untreated poag patients * patients with typical glaucomatous disc, or visual field damage * patient must have iop (at 10:00 ± 1 hour)greater than 25 mm hg exclusion criteria: * uncontrolled glaucoma * distance best corrected snellen visual acuity worse than 1/10 * contraindications to brimonidine or dorzolamide and β-blockers * history of lack of response (\<10% morning iop reduction) to any medication * patient can not understand the instructions and adhere to medications * patient is a female of childbearing potential or lactating mother * prior surgery, past use of steroids (within 2 months) * severe dry eyes and use of contact lenses * history of non-adherence * patients with closed angles

Keywords: 24-hour iop control primary open-angle glaucoma brimonidine/timolol dorzolamide/timolol
sustainment of mental health supports

Conditions: Behavior Disorders

Summary: schools are in great need of service delivery systems that can improve school climate and also attend to students' mental health. one effective approach is positive behavioral interventions and supports (pbis), a multitiered framework for defining and organizing practices and interventions (including mental health practices).


Eligibility criteria:
inclusion criteria: * schools: any school in the school district of philadelphia (sdp) already implementing positive behavioral interventions and supports (pbis). * tier 2 team members: any staff from participating schools involved in the pbis leadership team at that school. * tier 2 implementers: any masters-level staff assigned by their school's principal to deliver tier 2 interventions. * tier 2 coaches: any masters-level clinician employed by the sdp to support staff implementing tier 2 interventions * students: any student at participating schools in grades 4-8 who scores as eligible for pbis based on the social, academic, and emotional behavioral risk screener (saebrs), which is standard screening criteria in the sdp for tier 2 services and scores above \> 1 sd above the mean on the emotional symptoms or conduct problems scales of the strengths and difficulties questionnaire (sdq) plus impact supplement scores of 1 (a medium amount) or 2 (a great deal) completed by a parent or a teacher exclusion criteria: * schools: any schools not currently implementing pbis at tier 1. * tier 2 team members and implementers: any school personnel that are not involved in the leadership team or tier 2 team. * students: any student with a special education classification of "intellectual disability;" or with a history of psychotic or autistic spectrum disorders according to school records will be excluded because they would be unlikely to benefit from our tier 2 interventions
optimization of pk/pd target attainment for meropenem in critically ill patients with sepsis

Conditions: Critical Illness; Pharmacokinetics

Summary: wp1.1. pk/pd target attainment: plasma exposure, excretion via urine \& elf exposure; wp1.2. predictive dosing algorithm; wp1.3. ecmo subset

first, the investigators will document exposure to meropenem in plasma and epithelial lining fluid. moreover excretion in urine will be documented. second, the investigators will try to identify risk factors for not attaining pk/pd target. based on significant predictors for target non attainment a predictive dosing algorithm will be constructed. finally in a small subset of ecmo patients pk exposure will be explored.

Eligibility criteria:
inclusion criteria: * severe sepsis or septic shock * admitted to an icu ward * treated with meropenem exclusion criteria: * egfr(ckd-epi) \< 70ml/min/1.73m² * renal replacement therapy * pregnancy * dnr code 1-3

Keywords: pharmacokinetics meropenem critical illness capillary leak augmented renal clearance
use of air purifiers to improve respiratory health in children

Conditions: Asthma in Children

Summary: the goal of this pilot study is to investigate if installing an air purifier in the homes of children and young people with asthma improves their asthma outcomes. the main questions it aims to answer are: * does installing an air purifier in the homes of children and young people with asthma improve their asthma outcomes * is the use of an air purifier in the home acceptable to children and young people and their families? children and young people with asthma attending our clinic will be selected at random to be invited to take part. for those that take part, an air purifier (rensair ltd. - rensair compact) will be installed in their home for a one-year period. data will be collected on numbers of asthma attacks, rescue oral steroids, quality of life, symptoms, lung function at the beginning and at three-monthly intervals throughout the study period. the acceptability to children and young people and their families taking part in this study of using an air purifier in their home will also be assessed.

the goal of this pilot study is to investigate if installing an air purifier in the homes of children and young people with asthma improves their asthma outcomes. the main questions it aims to answer are: * does installing an air purifier in the homes of children and young people with asthma improve their asthma outcomes (including reduction in asthma exacerbations, improvement in symptom control, improvement in quality of life). * is the use of an air purifier in the home acceptable to children and young people and their families?

Eligibility criteria:
inclusion criteria: * aged 5 to 15 years old * attend the asthma clinic in our hospital * have a confirmed physician-diagnosis of asthma from the asthma clinic * live in mainland england (this is due to delivery of the air purification units and also associated maintenance of them) exclusion criteria: * nil specific other than not meeting inclusion criteria