Kornimate/medical-research-clean huggingface dataset:
implementing enhanced recovery after surgery (eras) pathways in major gynecologic oncology operations in greece

Conditions: Ovarian Cancer; Hysterectomy; Endometrial Cancer; Gynecologic Cancer

Summary: the enhanced recovery after surgery (eras) program includes preoperative counseling, fasting avoidance, non-opioid analgesia, fluid balance, normothermia and early mobilization. eras pathways were developed to reduce hospital length of stay, reduce costs and decrease perioperative opioid requirements, and be beneficial for patients. we propose the hypothesis that the eras pathway could reduce the length of stay (los) in hospital for patients undergoing major gynecologic oncology surgery (mgos). patients were randomly allocated in two groups: an eras pathway group including preoperative counseling, early feeding/mobilization, and opioid-sparing multimodal analgesia; and a classic model group of post operative recovery as control.

the gynecological cancer of the inner genital organs includes ovarian cancer, endometrial and cervical cancer and its therapeutic approach is surgical removal of the organ with cancer. the last decade has developed various postoperative recovery protocols aimed at safe and rapid recovery of the patient after a surgery and early discharge from the hospital. these protocols are known as eras (enhanced recovery after surgery) protocols or fast-track (ft) and combine various evidence-based perioperative care techniques. the eras protocols include specific approaches preoperative, intraoperative and postoperative, by the multidisciplinary team (surgeon, anesthetist and nurse), and aim at reducing the postoperative stress and pain, fasten the feeding and the mobilization of the patient after the surgery and rapid the hospital discharge. this trial is designed to evaluate the superiority of the eras pathway to conventional non-eras clinical practice in reducing the los. the results may provide new insight into the clinical applications of the eras pathway for mgos. this doctoral thesis aims to compare the effectiveness of the protocol eras against the classical model of recovery, in the postoperative recovery of patients with gynecological cancer undergoing mgos, in a public oncology hospital in greece. the importance of eras programs is expected to emerge in the length of hospital stay, in pain control, in perioperative stress, in the early feeding and mobilization of patients who have undergone mgos.

Eligibility criteria:
inclusion criteria: * greek language speakers * have complete mental clarity * age \>18 years exclusion criteria: * refusal to sign consent * patients receiving treatment for chronic pain * patients receiving antipsychotic therapy, psychopathy * they have acute or chronic kidney and / or liver disease * history or family history of malignant hyperthermia * known allergy to propofol, desflurane, or any other anesthetic agent * impairment of cognitive function or communication * history of postoperative delirium

Keywords: gynecologic cancer eras protocols eras pathways gynecologic/oncology surgery
evaluation of igra, symptoms and chest radiograph for subclinical tb detection in esrd and kt

Conditions: Tuberculosis (TB); End-Stage Kidney Disease

Summary: this is an observational study among approximately 160 end-stage renal disease patients on renal replacement therapy and post-living donor or deceased donor kidney transplant recipients. investigators aim to assess the proportion of positive igra associated with symptom development, sputum xpert mtb/rif assay, and chest radiograph to define latent tb infection and subclinical tb among eskd and renal transplant patients.

patients with chronic kidney disease and end-stage kidney disease (eskd) are at risk of developing tuberculosis and are often delayed in diagnosis. herein, investigators aim to assess the proportion of positive igra associated with symptom development, sputum xpert mtb/rif assay, and chest radiograph to define latent tb infection and subclinical tb among eskd and renal transplant patients.

Eligibility criteria:
inclusion criteria: 1. end-stage renal disease on renal replacement therapy (hemodialysis or peritoneal dialysis) or status-post-living donor or deceased donor kidney transplantation 2. aged more than or equal 18 years exclusion criteria: 1. positive ppd test or a previously documented positive ppd 2. active pulmonary or extrapulmonary tuberculosis

Keywords: subclinical tuberculosis interferon gamma release assays end-stage kidney disease detection of subclinical tuberculosis tuberculosis igras
a feasibility study to improve colorectal cancer screening among racially diverse zip codes in a persistent poverty county using navigation and machine learning predictive algorithms

Conditions: Colorectal Cancer

Summary: the overarching goals of the "pcsnap" research study is to support the abramson cancer center (acc) of the university of pennsylvania in carrying out its mission to increase colorectal cancer (crc) screening completion among high-risk individuals living in a persistent poverty county by designing, conducting, disseminating and evaluating an electronic health record-based automated identification program to target effective, culturally-sensitive crc screening navigation to individuals who have not completed an ordered colonoscopy or fecal immunochemical test (fit).


Eligibility criteria:
inclusion criteria: * patients residing in 18 zip codes in western and southwestern philadelphia who have primary care providers in 4 penn medicine internal medicine practices and 3 penn medicine family medicine practices * patients who have had a colonoscopy order placed in the past 6 months and have not scheduled, cancelled, or no-showed to their colonoscopy
evaluating quality of life of af patients following a bleed

Conditions: Atrial Fibrillation

Summary: equal-af is an observational feasibility study which will determine if there is a long-term effect of bleeding for patients diagnosed with af, who are taking anticoagulants. the investigators will use three validated questionnaires/proms (afeqt, eq5d-3l, and pact-q) to gather data from a patient perspective. patients will complete all questionnaires no more than 4 weeks following a bleed and a second time 3 months later. as this study tests feasibility, progression criteria will apply. the primary objective is to assess recruitment success to ensure that the patient population is accessible and willing to engage with the research team. additionally, the investigators will look to identify the need for a specific bleeding prom which will assess long-term quality of life impact for patients experiencing bleeds while anticoagulated.


Eligibility criteria:
inclusion criteria * adult patients (\>= 18 years old) * patients who can understand all study information and literature to provide fully informed consent * atrial fibrillation (af) as the primary diagnosis * having a major or minor bleed up to a maximum of 30 days prior to point of enrolment * receiving oral anticoagulation therapy for af exclusion criteria: * pregnant women * patients with active cancer * patients unable to consent for themselves * patient on concomitant antiplatelet therapy

Keywords: quality of life bleed events patient reported outcome measure anticoagulation
designing a bayesian model of the plasma clearance of calcium edetate de sodium for the calculation of gfr and validity compared to the renal clearance of inulin

Conditions: Kidney Disease

Summary: diagnosis of patients with renal insufficiency and recommendations for medical treatment of patients who suffer from chronic renal failure are based on the different stages of glomerular filtration rate (gfr). many formulas exist to assess gfr. however these formulas are unreliable in many clinical situations (old people, obese patients...). methods for measuring gfr using exogenous tracers exist: inulin and 51cr-edta are historical reference tracers. renal clearance of inulin is the gold standard. however, using these methods is restricted to specialized services because it is long and expensive. there is no medical data for the use of calcium edetate de sodium as a tracer to assess gfr. calcium edetate de sodium is a treatment for lead intoxication. the extension of use as a tracer comes from its exclusive elimination by glomerular filtration. plasma and renal clearance of calcium edetate de sodium and inulin will be measured for every included patient during a hospital day care (first visit v1). for transplanted patients, plasma clearance of calcium edetate de sodium will be repeated within one week (more or less 48hours) during annual medical check-up of renal transplantation (second visit v2).


Eligibility criteria:
inclusion criteria: * inclusion criteria for v1: * for transplanted patients : patients from 18 to 80 years, after estimation of their renal function by mdrds formulas (mdrd = modification of diet in renal disease) , regardless their nephropathy, regardless the age of the transplantation, with a normal state body hydratation, with a social insurance and who have given their prior consent. * for other patients : patients from 18 to 80 years, after estimation of their renal function by mdrds formulas, who need a reliable assess of their renal function, with a normal state body hydratation, with a social insurance and who have given their prior consent. * inclusion criteria for v2: transplanted patients who have participated to v1, with stable clinical conditions, with a stable gfr (less than 30% variation of creatinine clearance by mdrds formulas) and who have given their prior consent. exclusion criteria: * hypersensitivity to calcium edetate de sodium * inulin or excipients * lead or other heavy metal intoxication * volume expansion or dehydration * acute renal disease * bladder voiding affections * coagulation disorders * poor venous capital * people in guardianship * patients already involved in an other research * women in child bearing age without any method of contraception * pregnant or lactating women.

Keywords: gfr bayesian model plasma clearance calcium edetate de sodium inulin
observational epidemiologic study in women with premature ovarian failure (pof)

Conditions: Primary Ovarian Insufficiency

Summary: this is an observational epidemiologic multicentric study of follow-up a cohort for described the situation of patients with primary ovarian insufficiency in public population with respect to the age of apparition the primary ovarian insufficiency . ipoi (investigators in premature ovarian insufficiency): m. guinot, b. roca, j. tomás, p. escamilla, j. hernández, p. llaneza, n. mendoza ladrón de guevara, b. otero garcía, i. ñiguez, a. castro, l. baquedano, p. romero, s. sánchez.


Eligibility criteria:
inclusion criteria: * women between 18 years and 39 years. * primary ovarian insufficiency demonstrated with amenorrhea and levels of follicle stimulating hormone (fsh) over to 40 iu in two determinations measured with a difference of one moth. * not present linguistic barriers ,shaw attitude towards collaboration ,be able to attend the study center for all follow-up visits. * signed informed consent before inclusion in the study and after having been informed of the procedures performed in this study. exclusion criteria : * women with secondary hormonal alteration that do no meet the diagnostic criteria of the disease. * refusal to participate. * withdrawal of informed consent.
multicenter assessment of clinical utility pet / mr with the use of the radiotracer 68ga-psma-11 in therapy planning personalized in patients with prostate cancer

Conditions: Prostate Cancer

Summary: the aim of multicentre phase 3 trial is evidence diagnostic value of 68ga-psma-11 (in pet / ct and pet / mr techniques) in patients with high-risk and intermediate prostate cancer before radical treatment and in diagnosed patients biochemical recurrence after radical treatment


Eligibility criteria:
inclusion criteria: group 1. patients with diagnosis or high probability of medium and high prostate cancer according international society of urological pathology (isup) risk for whom radical treatment is planned * prostate adenocarcinoma confirmed by biopsy and histopathological examination * results indicating a moderate rgk (gleason score 7 or ct2b or psa 10-20 ng / ml) or high (gleason score\> 7 or ct2c or psa\> 20 ng / ml) risk according to isup * creatinine value allowing for safe pet / mr examination with a contrast agent: creatinine less than or equal to 1.5 times the upper limit of normal, creatinine clearance\> 60 ml / min * age ≥18 years * signing informed consent to participate in the study * pelvic / prostate mpmr examination performed, not earlier than 30 days before inclusion in the study group 2. patients with rgk after radical treatment, with biochemical recurrence according to eau criteria, who are scheduled for further treatment and the result of the imaging / molecular examination may affect change of therapeutic decision: * prostate adenocarcinoma confirmed by biopsy and histopathological examination * after radical treatment * in patients after radical prostatectomy: with at least two psa measurements ≥0.2 ng / ml not earlier than after 6-13 weeks after radical prostatectomy or psa≥0.1 with psadt (psa doubling time) \<3 months psa on at least two consecutive studies in consecutive last 6 months before qualification (last determination within 6 weeks before qualification) or * in patients after radical radiotherapy: biochemical recurrence defined as nadir psa + 2 ng / ml * age ≥18 years * signing informed consent exclusion criteria: * presence of metallic foreign bodies / implants / prostheses / stimulators etc. inside the body, the possession of which is a contraindication to the mr 3t examination * claustrophobia * patient size precluding pet / mr examination due to diameter gantry * known contraindications for the use of radiopharmaceuticals or substances auxiliary (e.g. renal failure and allergy to ingredients in the preparation) * treatment for malignant neoplasm not associated with the prostate gland * participating in another clinical trial * lack of informed consent to participate in the study * age \<18 years

Keywords: pet/ct pet/mr 68ga-psma-11 psa
evaluating the need for new rhinitis treatment

Conditions: Rhinitis

Summary: the proposed study will evaluate the unmet therapy need in seasonal rhinitis by aiming to answer the following research questions 1. what is the first prescription of the hay-fever season and how many of these patients are on some form of combination therapy? 2. to what extent does initial therapy not meet clinical need (as measured by need for additional medical intervention in terms of consultations and changes in therapy)? 3. does treatment for allergic rhinitis differ for asthma vs non-asthma and seasonal vs perennial patients?

allergic rhinitis is a chronic respiratory disease with a major impact on quality of life. in a study looking at the burden of allergic rhinitis amongst uk patients 75% reported some impact of their allergic rhinitis symptoms on health-related quality of life. allergic rhinitis currently affects 10-30% of the world population with prevalence and impact continuing to increase. this leads to substantial economic costs both of prescription medication and time taken off work by both patients and carers due to the disease. in view of this, there may be a substantial need for improved therapy or management to ensure that patients with allergic rhinitis can carry out a normal lifestyle. the proposed study will evaluate the unmet therapy need in seasonal rhinitis by examining the current medication requirements of patients who suffer from seasonal grass-pollen hay fever and determining whether current therapies are sufficient for managing rhinitis. this study aims to evaluate the unmet therapy need in seasonal rhinitis by - 1. examining and describing current medication requirements 2. quantifying the extent of co-prescribing of multiple agents 3. comparing the effectiveness of current prescription drugs for managing and controlling patient's seasonal rhinitis and using changes in treatment during the hay fever season to determine the effectiveness of current therapy options. for managing and controlling seasonal rhinitis in primary care patients who suffer from seasonal grass-pollen hay fever.

Eligibility criteria:
inclusion criteria the analysis will include patients who, at the index date, receive a therapy prescription for allergic rhinitis and have been diagnosed with a hay fever read code during their time at the practice. the following patients will be included within the study population: (i)patients receiving therapy: defined as those with a prescription for the increase or initiation of hay fever therapy during the hay fever season (ii)hay-fever code recorded ever exclusion criteria (i)patients taking maintenance oral steroids during the baseline period (ii)patients who only received ltra during the study period and had already been receiving ltra previously

Keywords: rhinitis antihistamine nasal steroid therapy
systemic steroids for peripheral nerve blocks

Conditions: Osteoarthritis, Hip

Summary: this study will investigate the ability of systemic dexamethasone to prolong the sensory block duration for lumbar plexus nerve blockade.

the purpose of this randomized, double-blinded, placebo-controlled trial is to examine the equivalency of two different doses of dexamethasone when given intravenously as an adjuvant medication for postoperative pain management. specifically, this study will investigate the prolongation of time to recovery of sensation following a lumbar plexus block in patients undergoing total hip arthroplasties. the investigators hypothesize that dexamethasone will prolong the sensory block time when compared to placebo and that similar results will be obtained in the 4 mg arm when compared to the 8 mg arm. the primary end point will be time to sensory recovery in the femoral nerve cutaneous distribution (part of the lumbar plexus) as determined by pin-prick sensation assessment. secondary endpoints will include, but are not be limited to: time to first opioid administration, total opioid consumption over 30 hours, and rest and incident verbal numerical pain scores at 6,12,18,24 and 30 hours post block placement.

Eligibility criteria:
inclusion criteria: primary elective total hip arthroplasty surgery * must be a candidate for placement of a lumbar plexus block under anatomic landmark technique using electrical stimulation * must give written informed consent for anesthesia * must also be reliable and able to give accurate verbal pain scores postoperatively exclusion criteria: * contraindications to regional anesthesia including, allergy to amide local anesthetics, presence of peripheral neurologic dysfunction, pre-existing coagulopathy or infection in the area of interest will be excluded. * insulin and non-insulin dependent diabetes mellitus * preoperative use of systemic corticosteroids within 30 days of surgery * chronic opioid use (defined as daily opioid dose of greater than 40 mg of oxycodone equivalents or any long-acting opioid) * pregnancy * failure to effectively place the lumbar plexus block. * known prior adverse reaction to dexamethasone (for example: psychosis) or an allergy to dexamethasone

Keywords: arthroplasty, hip, replacement anesthesia, local anesthesia conduction bupivacaine dexamethasone preanesthetic medications nerve block lumbar plexus block analgesia glucocorticoids local anesthetics
safety and efficacy of rx-10100 to treat major depressive disorder

Conditions: Major Depressive Disorder

Summary: the purpose of this study is to determine whether rx-10100 are effective in the treatment of major depressive disorder (mdd).


Eligibility criteria:
inclusion criteria: • moderate to severe mdd as determined by the dsm-iv-tr axis 1 disorders and by the montgomery asberg depression rating scale (madrs). exclusion criteria: * women who are pregnant, women who will be breastfeeding during the study, and women with childbearing potential who are not willing to practice a reliable method of birth control * depressive episode duration of less than 1 month * lifetime history of any psychotic disorders * anxiety disorders * significant suicidality * clinically significant medical conditions

Keywords: mdd depression major depression
efficacy of ctpt method in the treatment of post stroke shoulder subluxation

Conditions: Subluxation of Inferior Shoulder

Summary: california tri-pull taping (ctpt) method might be effective in reducing shoulder subluxation, pain, and improving active flexion range (aflxn) range of motion, and functional recovery after stroke.

all the experimental group participants will receive conventional neuro rehabilitation for 45 minutes along with california tri-pull taping on the subluxed extremity. lead researcher applied the ctpt method. the tape was applied as following manner. before the first intervention day, participants with hair on their shoulder or upper arm were asked to shave the area. two types of tape was used, a self-adhesive 1.5" cotton undercover tape and a 1" rigid strapping tape. participants placed their affected arm on a supporting surface to better approximate the humeral head back into the glenoid fossa. the three pieces of rigid tape were applied to the patient's shoulder on top of the already applied self-adhesive cotton tape. the first piece (medial) was applied from 1.5" below the deltoid tuberosity running straight up the middle of the arm to 2" above the top of the glenoid fossa between the clavicle and the spine of the scapula. the second piece (posterior) was located from 1.5" below the deltoid tuberosity to 1.5" above the middle of the spine of the scapula. the medial border of this second piece ran along the acromial process. last, the third piece (anterior) was located from 1.5" below the deltoid tuberosity to run around the front of the humeral head and over the coracoid process, up to 1.5" above the clavicle. the tape will removed and new tape applied every monday, wednesday, and friday and remained on the patient for 6 consecutive weeks. following the 6 weeks, each patients of both group was individually re-assessed and evaluated the effect of intervention and parameters were recorded. the recording and measurement obtained before and after intervention was subjected to statistical analysis and the result of that interpreted to obtain the significance of study.

Eligibility criteria:
inclusion criteria: 1. acute stroke. 2. a minimum of 5 mm (0.2 in) shoulder subluxation in the involved upper extremity. 3. mini mental status examination (mmse) score \>23. 4. age (35-70 yrs.) and of either sex. 5. brunnstroms stage 1 and 2. - exclusion criteria: 1. mini mental status examination (mmse) score \<23. 2. other musculoskeletal disorder of the affected upper extremity. 3. history of trauma to the affected upper extremity. 4. hyper or hypo sensitivity disorders. 5. any skin allergy. 6. brunnstorm's stage 3 and 4. 7. individual affected from neurological disorder other than stroke. 8. un-cooperative patients. 9. individuals with psychosomatic disorder

Keywords: stroke, subluxation