Kornimate/medical-research-clean huggingface dataset:
integrated management program advancing community treatment of atrial fibrillation

Conditions: Atrial Fibrillation

Summary: research question: among community-based patients with af, does providing an integrated clinical decision support system (cdss) to providers and patients improve process of care and clinical outcomes, and decrease the healthcare costs and resource utilization over 12 months, as compared to usual care? intervention: a web-based clinical decision support system, computerizing the canadian af clinical guidelines, to support primary care providers and patients in optimizing and standardizing af care.

atrial fibrillation (af) is the most common abnormality of cardiac rhythm. it is also a disease of aging, affecting 3% of adults aged \> 45 years and 12% of those aged \> 75. individually, af's rapid and irregular heart beat is most frequently perceived as undesirable palpitations, but more threatening impacts are heart failure, catastrophic stroke and premature death. af also markedly impairs quality of life. although patients with af are at increased risk of stroke, death and hospitalization, many patients are not benefiting from evidence-informed, best-care strategies. gaps have been documented in the knowledge, skills and competencies of primary care clinicians concerning the management of af in canada. for example, a large proportion of af patients at moderate to high risk for stroke do not receive guideline recommended thromboprophylaxis; and of those that do, many are not optimally controlled. one canadian study also found that in patient with known af and a prior stroke, who were then admitted with a second stroke, 15% were not on any anticoagulation and only 18% were on warfarin and within the therapeutic range. opportunities certainly exist to enhance the uptake of the canadian af clinical practice guideline recommendations and best-care approaches in the primary care setting. patients need to be the focus of care services and be actively engaged and empowered to manage their care, with the support of health care providers. we believe that health system efficiency, care quality and patient safety can be enhanced through the use of innovative, integrated, interactive, pro-active and personalized point-of- care solutions targeting both providers and patients. this is the premise for the impact-af study. primary care providers and their patients are anticipated to benefit from enhanced use of health information technology regarding the management of patients with af. a clinical guideline-based decision support system (cdss) will be developed and tested in primary care settings across nova scotia.

Eligibility criteria:
inclusion criteria: * age \>/= 18 years (no max age limit) * confirmed atrial fibrillation. * able to provide informed consent in english. exclusion criteria: * patients unable to provide informed consent. * patients who are not expected to be alive at the end of the 12 month follow up.

Keywords: clinical decision support system primary health care clinical practice guidelines
anti-lps antibody treatment for pediatric nafld

Conditions: Nonalcoholic Fatty Liver Disease (NAFLD)

Summary: the main objective of this pilot study is to evaluate whether 12 weeks of imm-124e in children with nonalcoholic fatty liver disease (nafld) in combination with standard of care treatment will decrease inflammation in the liver as measured by alanine transaminase (alt). specifically, investigators will measure percent change in alt from week 0 to week 12 in treatment compared to placebo.

this is a randomized, double blind, placebo controlled, three month treatment trial of children aged 6-19 years. participants will be recruited from the children's healthcare of atlanta pediatric liver clinical practice.the purpose of this study is to evaluate if a three month treatment with imm-124e (a bovine colostrum enriched with anti-lps antibodies) in combination with standard of care lifestyle advice is safe and leads to greater improvement in hepatic inflammation, insulin sensitivity, and blood lipids in children with nonalcoholic fatty liver disease (nafld) compared to placebo with standard of care treatment. investigators also seek to define the mechanism of action in response to three months of treatment with imm-124e.

Eligibility criteria:
inclusion criteria: * nonalcoholic fatty liver disease (nafld) diagnosis confirmed by liver biopsy or mri * alt ≥ 2 x uln at screening (girls ≥ 46, boys ≥ 54) * written informed parent consent and child assent * willingness to take imm-124e or placebo powder 3 x daily for 12 weeks * at least 2 months of attempted lifestyle changes after diagnosis exclusion criteria: * disease or condition deemed by physician to interfere with absorption, digestion, or mechanism of intervention of drug * diagnosis of diabetes and an hba1c of \> 9% * change in supplement or anti-oxidant therapy within past 90 days (must be on a stable dose and willing to continue it throughout the trial or not on any vitamin or supplement, includes same, vitamin e, betaine, milk thistle etc) * use of probiotics or antibiotics in the past 30 days * use of anti-nafld medications (metformin, thiazolidinediones, udca) in the 30 days prior to randomization * acute illness within past 2 weeks prior to enrollment (defined as fever \> 100.4ºf) * planned pregnancy, nursing an infant, confirmed or suspected to be pregnant between screening and time of study enrollment * evidence of other chronic liver disease other than nafld (hepatitis b and c, alpha-1 antitrypsin, wilson's disease) * intolerance to lactose or dairy-based products * unable to have blood drawn at study visits * unwillingness to provide and/or collect stool samples * current gastrointestinal (gi) bleeding or inflammatory bowel disease (irritable bowel disease (ibd), colitis) * current enrollment in another therapeutic clinical trial or receipt of an investigational study drug within 6 months prior to study enrollment * participants who are not able or willing to comply with the protocol or have any other condition that would impede compliance or hinder completion of the study, in the opinion of the investigator
evaluation of thiol disulfide balance in stage 1 endometrium cancer

Conditions: Endometrium Cancer; Oxidative Stress

Summary: the purpose of this study is to investigate thiol-disulfide balance in early stage endometrium cancer patients.

to date various oxidative stress paramaters were studied in patients with endometrial cancer, however dynamic thiol disulfide hemostasis has not been previously investigated. the thiol-disulfide balance in the circulation will be measured by the automated system created by erel \& neselioglu(1). references 1- erel o, neselioglu s. a novel and automated assay for thiol/disulphide homeostasis. clin biochem 2014;47:326-32. doi:10.1016/j.clinbiochem.2014.09.026.

Eligibility criteria:
inclusion criteria: • histopathologically confirmed diagnosis of stage i endometrium cancer exclusion criteria: * pulmonary disease * pulmonary hypertension * cardiac dysfunction * renal dysfunction * liver disease * chronic ishemia * systemic inflammation * concomitant malignancy * patients who use vitamin a,c or e (antioxidant vitamins) * patients who use smoke * patients who use drink alcohol * patients who use addictive for any drug

Keywords: early stage thiol disulfide hemostasis malignancy
effectiveness and safety evaluation of aqueduct 100-device

Conditions: Cervix Uteri Dilation

Summary: evaluation of efficacy and safety of using aqueduct -100 - cervical dilator device, focusing on diagnostic or operative hysteroscopies.

there are predominantly two major dilatation techniques that are employed in dilating the cervix. the first technique uses expansible dry solid material, such as laminaria (seaweed) is inserted into the cervix in its dried stiff form. in the cervix it comes into contact with body fluids that cause the laminaria to swell and enlarge the cervical cavity. the second more widespread procedure, involves the use of series of solid, rod like instruments of graduated diameter used in serial fashion by the physician (hegar dilators). the physician first inserts a rod like dilator and replaces it with the dilator of next higher diameter. this procedure continues until adequate dilatation occurs. the problem is that each of the above-mentioned methods has its shortcomings: the use of the laminaria method (rarely done) requires preliminary patient visit, for insertion of the laminaria rod and is extremely slow and typically involves often as much as 10-12 hours for a significant amount of dilatation to occur. the use of rod-like instruments (hegar) requires general or regional anesthesia, when local anesthetics are used, the patient nevertheless frequently experiences a great amount of discomfort from the procedure. the mechanical dilatation of the cervix demands a large amount of longitudinal force that may damage or even puncture the cervix and the uterus. aqueduct 100 is a catheter for use in dilating various body cavities and especially the human cervix. the device will enable continuous, fast and safe dilatation of the cervix to a pre-determined diameter as a pre-procedure to intrauterine surgeries.

Eligibility criteria:
inclusion criteria: * subjects, females, 18 years of age or older. * subjects undergoing diagnostic or operative hysteroscopies * subjects willing to sign informed consent form. exclusion criteria: * subjects younger than 18 years of age * subjects unwilling to sign the informed consent form * pregnancy

Keywords: cervix cervical dilation balloon catheter
turkish version of the chalder fatigue scale: an investigation of its psychometric properties in healthy young adults

Conditions: Fatigue; Healthy

Summary: the aim of this study was to adapt the chalder fatigue scale to turkish and to examine its psychometric properties in young adults. within the scope of the study, firstly the turkish version of the scale will be developed and then its reliability and validity will be examined in healthy young adults in turkey.

fatigue is a subjective experience that can affect all individuals. it is a protective symptom against physical or psychological stress for healthy individuals. however, it can negatively affect the performance of individuals in activities of daily living. in the clinic, fatigue is assessed by self-reported scales. different fatigue scales have some advantages and disadvantages compared to each other. moreover, it is stated that only one scale cannot fully measure the fatigue of individuals in different health status, therefore different scales have been developed.chalder fatigue scale (cfs) is an easy-to-understand, short, fast and useful fatigue scale that evaluates fatigue with two dimensions (physical and mental) and enable individuals to express perceived fatigue clearly. psychometric properties of cfs have been investigated in general population and different disease groups but not in only healthy young adults.

Eligibility criteria:
the inclusion criteria for participants are: to be aged between 20 and 40 years old, volunteer to participate the study, able to read and speak turkish. exclusion criteria are determined as individuals with known acute or chronic health conditions and illnesses and who had surgery in the past 6 months. further exclusion criteria are to take over-the-counter medication or food supplement, have abnormal body mass index (bmi) (lower 17 kg/m2 or higher 30 kg/m2), self reported depression as indicated by a score of \> 21 on the beck depression scale (bds), pain as indicated by a score of \> 0 on pain subscale of nottingham health profile (nhp). additionally, female participants were excluded if they use oral contraceptives, experience premenstrual syndrome or were pregnant within the last one year period.

Keywords: fatigue assessment reliability validity chalder fatigue scale turkish version healthy young adults
the potential protective role of venlafaxine versus memantine in paclitaxel induced peripheral neuropathy

Conditions: Oncology Pain; Chemotherapy-induced Peripheral Neuropathy

Summary: this is a double blinded two-arm randomized case-only interventional trial. a total of 60 patients who are to receive paclitaxel to be included and allocated in two groups. the protocol is to be reviewed by the research ethics committee of faculty of medicine cairo university. all procedure will be done in kasr el-einy center of radiation oncology and nuclear medicine. the first arm (venlafaxine group) will receive venlafaxine extended release (37.5 mg) tablets (zimmerman et al., 2016). the second arm (memantine group) will receive memantine 10 mg once daily (morel et al., 2016)


Eligibility criteria:
inclusion criteria: 1. all patients, 18 years of age or older, with a cancer treated with paclitaxel 2. patients must have a life expectancy of at least 24 weeks. 3. patients must sign an informed consent. 4. patients may have a grade 0 (chemotherapy naive) or 1 neuropathy (history of prior chemotherapy) prior to entry. 5. patient matching high risk on the cipn risk stratification scoring system exclusion criteria: 1. patients with symptomatic brain metastases. 2. pregnant women or nursing mothers. patients of child bearing potential must use adequate contraception. 3. patients may receive no other concurrent complementary medicines during this study. 4. patients with neuropathy induced diabetes. 5. patients with severe medical problems such as uncontrolled diabetes mellitus or cardiovascular disease or active infections.
blue laser imaging (bli) for detection of secondary head and neck cancer

Conditions: Head Neck Cancer; Esophageal Cancer; Gastrostomy

Summary: this study wants to focus on carcinoma detection rates with blue laser imaging (bli) for participants with head-neck cancer who need a percutaneous endoscopic gastrostomy (peg). bli is a new imaging technique that can easily be used within a standard gastroscopy.

head-neck cancers are a significant burden all around the world. patients suffering from one tumor are at high risk for a second cancer or another precancerous lesion. before or during cancer treatment a peg is needed to maintain a sufficient calories intake. peg is established by performing a standard gastroscopy. this randomised study wants to compare the detection rates of standard white light endoscopy compared to the additional use of blue laser imaging for second cancers or precancerous lesions in participants presenting for peg establishment.

Eligibility criteria:
inclusion criteria: * all participants with the need of peg due to head neck cancers or esophageal carcinoma exclusion criteria: * minors, pregnant women, contraindication for endoscopy, contraindications for establishment of a peg

Keywords: esophageal cancer blue laser imaging percutaneous endoscopic gastrostomy head neck cancer
hypertension in postpartum preeclampsia study

Conditions: Hypertension, Pregnancy-Induced

Summary: this study aims to evaluate whether nsaids (non-steroidal antiinflammatory drugs) administered during the postpartum period influence blood pressure in women with hypertensive disorders of pregnancy. the study design is a prospective double blinded randomized control trial with participants randomized to receive postpartum analgesic regimens with and without nsaids.

non-steroidal antiinflammatory drugs (nsaids) are effective agents for the management of pain in the postpartum period. the addition of nsaids to post-cesarean analgesic regimen has been shown to improve post-cesarean pain and reduce opioid requirements. however, concern has been raised over use of nsaids in hypertensive pregnant patients, as recent evidence suggests the potential for increased blood pressure in patients with chronic hypertensive disorders receiving these agents. notably, these studies were conducted on patients with longstanding chronic hypertension, which included males and non-pregnant females, and it is therefore unclear whether this recommendation is appropriate for patients with transient hypertensive disorders of pregnancy. this protocol describes a randomized trial to evaluate whether nsaids influence blood pressure parameters in patients with hypertensive disorders of pregnancy. patients with severe hypertensive disorders of pregnancy (severe hdp) will be studied separately from women with mild hypertensive disorders of pregnancy (mild hdp).

Eligibility criteria:
inclusion criteria: * delivery occurred at equal to or greater than 24 0/7 weeks gestational age * patient receiving care with the women's perinatal group (maternal fetal medicine practice) or obstetric clinic resident services * diagnosis of a hypertensive disorder of pregnancy (hdp), including the following: * gestational hypertension * preeclampsia without severe features * preeclampsia with severe features * hemolysis, elevated liver enzymes, low platelet (hellp) syndrome * eclampsia exclusion criteria: * diagnosis of chronic hypertension or documentation of elevated blood pressures before 20 weeks gestational age. * severe hypertension: patients with at least one severe blood pressure measurement (systolic \>160mmhg or diastolic \>105mmhg) prior to randomization * renal dysfunction (serum creatinine measurement \>1.3mg/dl during the current pregnancy) * low platelet count (recorded measurement \<50,000 during hospital admission) * significant liver dysfunction (ast or alt \>500) * known sensitivities to ibuprofen or acetaminophen * use of therapeutic doses of anticoagulation (low dose anticoagulation used for routine prophylaxis of venous thromboembolism is acceptable) * postpartum hemorrhage requiring transfusion

Keywords: postpartum
the effect of lower back massage on perceived labor pain

Conditions: Labor Pain

Summary: the aim of the study was to assesment the change in pain scores with lower back massage, a non-pharmacological method, on perceived labor pain in the early active phase of the first stage of labor.


Eligibility criteria:
inclusion criteria: * the study group consisted of pregnant women who were at 37-40 weeks of pregnancy, * had cervical dilatation of 4-6 cm, * had a single, live, and vertex fetus, * had an uncomplicated pregnancy, * had no contraction anomalies, * could communicate in turkish * planned for a vaginal delivery. exclusion criteria: * with cognitive dysfunction * using narcotic analgesics or sedative drugs * had any contraindications for applying a back massage
dose-finding study: popliteal sciatic nerve block in patients undergoing diabetic foot surgery

Conditions: Diabetic Foot; Diabetic Neuropathies

Summary: the purpose of this study was to determine the minimum effective dose of a local anesthetic for proper anesthesia for popliteal sciatic nerve block under ultrasound guidance in patients undergoing surgery for diabetic foot disease.

unlike general patients, patients with diabetic foot disease often have diabetic neuropathy and thus have increased sensitivity to local anesthetics. therefore, when performing sciatic nerve block, it is essential to properly adjust the dose to prevent neurotoxicity and delay in recovery due to local anesthetics. if the appropriate effective dose of local anesthetic for sciatic nerve block is found in patients with diabetic foot through this study, it is expected that it will be a useful basis for establishing a safe anesthetic method in the case of diabetic foot surgery.

Eligibility criteria:
inclusion criteria: * adult patients who can be operated under popliteal sciatic nerve block among patients undergoing surgery for diabetic foot disease exclusion criteria: 1. infection of the popliteal region 2. severe coagulation abnormality 3. allergic reaction or hypersensitivity to local anesthetics 4. neurological abnormalities other than diabetic neuropathy in the lower extremity of the operation site 5. when it is impossible to evaluate sensory blockage and motor blockage 6. when the patient refuses
impact of skin to skin contact on maternal satisfaction, pain scores, and narcotic usage after cesarean delivery

Conditions: Skin to Skin Contact in Cesarean Deliveries

Summary: early skin to skin contact has beneficial effects and is part of the healthy birth initiative. positive effects on breast feeding, cardiorespiratory status, blood glucose control, and temperature has been demonstrated. it is the standard of care for vaginal deliveries but surgery is a barrier in its initiation in the operating room. this study is evaluating initiating skin to skin contact as soon as feasible in the operating room. informed consent will be obtained from scheduled/non emergent cesarean sections who are of ega.37 weeks who are asa i-ii and receiving the standard spinal anesthetic. skin to skin contact will be initiated after delivery as soon as apgars and newborn assessment has been completed. goal is a minimum of 60 minutes of skin to skin contact between the mother and the newborn, with the only interruption being upon movement from the or table to the stretcher when leaving the or. subjects seen post delivery day 1 for assessments of pain and maternal satisfaction utilizing a sliding 100mm vas assessment tool.

initiation of skin to skin contact between the mother and the baby will be done in the operating room during surgery rather than waiting until the recovery room as is our standard of care. after assurance that both mom and newborn are stable, the newborn will be placed across the mother's chest and covered with a blanket to help maintain body temperature. the skin to skin contact is maintained throughout the remaining surgical time and then continued into the recovery room. the subjects are seen post delivery day 1 for evaluation of their pain and satisfaction with care using a 0-100mm sliding vas scale, with 0=not satisfied at all or no pain at all through 100 = total satisfaction and most severe pain ever.

Eligibility criteria:
inclusion criteria: * non emergent cesarean deliveries term gestation age asa i or ii spinal anesthetic exclusion criteria: * contraindication to spinal anesthetic or to medications utilized emergence cesarean delivery under age 18 less than 37 weeks gestational age
randomized controlled study evaluating genicular artery embolization against intra-articular corticosteroid knee injection for osteoarthritic knee pain

Conditions: Knee Osteoarthritis (Knee OA)

Summary: multi-center, prospective, randomized trial of gae using nexsphere-f against steroid injection


Eligibility criteria:
inclusion criteria: * patient has localized knee pain * must be an appropriate candidate for arterial vascular access procedure exclusion criteria: * known sensitivity or allergy to implant materials * unable or unwilling to comply with study requirements