Kornimate/medical-research-clean huggingface dataset:
palliative use of high-flow oxygen nasal cannula in end-of-life lung disease patients

Conditions: Lung Disease; Acute Respiratory Distress Syndrome

Summary: the prevalence of severe dyspnoea among terminally ill patients has been reported as 70% and 90% for lung cancer and chronic obstructive pulmonary disease (copd) patients, respectively. current management to dyspnoea includes opioids, psychotropic drugs, inhaled frusemide, heliox 28 and oxygen. conventional oxygen supplementation is often used in these patients, but it may be inadequate, especially if they require high flows (from 30l/min to 120l/min in acute respiratory failure). high-flow oxygen nasal cannula (hfonc) is a new technological device in high-flow oxygen system that consists of an air-oxygen blender (allowing from 21% to 100% fio2) which generates the gas flow rate up to 55 l/min and a heated humidification system. this technology may have an important role in reducing respiratory distress in do-not-intubate patients. some hfonc's beneficial effects are the washout of the nasopharyngeal dead space reducing rebreathing of co2 and improvement oxygenation through greater alveolar oxygen concentration; a better matching between patient's inspiratory demand and oxygen flow; generation of a certain level of positive pressure (peep) contributing to the pulmonary distending pressure and recruitment; improvement of lung and airway mucociliary clearance due to the heated and humidified oxygen; and patient's comfort because of the nasal interface allowing feeding and speech. the investigators hypothesize that patients supported with hfonc need less opioids to decrease dyspnoea.


Eligibility criteria:
inclusion criteria: * consecutive patients who had end-stage lung disease (lung cancer, pulmonary fibrosis, copd, ...) - (mccabe score \> 3 \[\<6 months life expectancy\] and a palliative prognostic index score ≥ 4) admitted to hospital because of acute respiratory failure and distress * had chosen to forego all life support and receiving only palliative care * severe hypoxemia (pao2/fio2\< 250) * at least one of the following: dyspnoea (borg scale ≥4), signs of respiratory distress, and respiratory rate greater than 30 beats per min exclusion criteria: * patients had to be competent (kelly score \<4) * refusal of treatment * weak cough reflex * agitation or non-cooperation * uncontrolled cardiac ischemia or arrhythmias * failure of more than two organs * use of opioids within the past 2 weeks * adverse reactions to opioids * history of substance misuse * known contraindication for morphine (acute renal failure and recent head injury)

Keywords: palliative care lung disease acute respiratory distress syndrome high-flow oxygen nasal cannula dyspnoea opioids
heavy lifting strength training in head and neck cancer survivors

Conditions: Cancer of Head and Neck

Summary: the lifting trial will examine the feasibility and safety of a heavy lifting strength training (hlst) program in head and neck cancer survivors (hncs) at least 1 years post surgical neck dissection. the trial will determine whether this training style is safe and feasible in hncs. physical and psychosocial changes will also be reported.

rationale despite improvements in treatments, hncs still endure numerous acute and chronic side effects. strength training has been shown to manage some of these side effects but most interventions have involved light-to-moderate resistance training programs. hlst may produce better outcomes but it is unknown if such a weight training program is feasible and safe for hncs. objective the primary aim of this proposed study is to examine the feasibility and safety of a hlst program in hncs at least 1 year post-surgical neck dissection. methods this single arm feasibility study will recruit 15-20 hncs to complete the hlst program 2 times per week. the primary feasibility outcomes will include the eligibility rate (with reasons for ineligibility), recruitment rate (with reasons for refusal), 1 repetition maximum testing rate (with reasons for not completing the test), program adherence (including attendance, dose modifications, and progression), and follow-up assessment rate (with reasons for drop out). the primary efficacy outcome will be strength gains from baseline. secondary efficacy outcomes will include physical functioning, quality of life, fear of cancer recurrence, pain, body composition, anxiety, fatigue, stress, shoulder mobility, self-esteem, sleep, and motivation to engage in a hlst program. significance weight training is an effective intervention in hncs but the optimal weight training prescription is unknown. if heavy weight training is deemed safe and feasible in hncs, it can be compared to light-to-moderate load weight training to determine if it is a better prescription for improving outcomes that are important to hncs.

Eligibility criteria:
inclusion criteria: * previously diagnosed with any subtype and stage of head and neck cancer * at least one year post surgical neck dissection for head and neck cancer and showing full shoulder range of motion or recovery of the spinal accessory nerve * adults ages 18 and older * no unmanaged medical conditions, alcohol, and drug abuse * approved for a heavy lifting strength training program by the treating surgeon and a certified exercise physiologist * ability to understand and communicate in english exclusion criteria: * having comorbidities or uncontrolled medical conditions that their referred clinicians indicate as inappropriate to participate in exercise

Keywords: surgery neck dissection strength training survivors exercise
combination of tate and pd-1 inhibitor in liver cancer

Conditions: Hepatocellular Carcinoma; Gastric Cancer

Summary: this is a multi-center, open-label phase iia study that investigates the preliminary efficacy of trans-arterial tirapazamine embolization (tate) treatment of liver cancer followed by a pd-1 checkpoint inhibitor (nivolumab). patients with two types of cancers will be enrolled, advanced hepatocellular carcinoma (hcc),and metastatic gastric cancer. all enrolled patients need to have liver lesions and have progressed on a prior immune checkpoint inhibitor.

the goal of the study is to investigate whether tumor necrosis induced by trans-arterial tirapazamine embolization (tate) treatment can boost anti-tumor immunity and enhance the therapeutic efficacy of immune checkpoint inhibitor. patients with advanced liver cancers (primary hcc or metastatic gastric cancer) who have progressed on a prior immune checkpoint inhibitor will be enrolled in the study. liver lesions will be treated with up to 4 tate treatments for optimal debulking, which also serve as a vaccination process toward tumor. lesion not treated with tate will be used for monitoring the response toward a pd-1 inhibitor (nivolumab) for abscopal effect. if a patient subsequently develops an "escape" to the pd-1 inhibitor, patient can have another 2 tate treatments of the escaped tumor lesion. dosing of the pd-1 inhibitor is per standard fda-approved dosing schedule and continues until progressive disease. the efficacy will be assessed by the response rate (rr) using recist.

Eligibility criteria:
1. patients with a confirmed diagnosis of (1) advanced hcc or (2) metastatic gastric cancer. 2. patients between ages 18 and 80 3. if hcc patients, they should have progressive disease (pd) on an immune therapy for advanced hcc. for patients with metastatic gastric cancer, they should have failed at least one line of systemic chemotherapy and an immune checkpoint inhibitor. 4. patients with liver tumor lesions with at least one with a diameter of 2 cm or bigger, which is amendable for (super-)selective tate as the target lesion. 5. ecog score 2 or less 6. child-pugh scores 5-7 for hcc patients 7. all prior chemotherapy at least 4 weeks prior to study treatment. immunotherapy not subject to this limitation. 8. no major gi bleeding in the prior 2 months. 8. hgb\>=8, platelet \>= 50,000, cr =\< 2, ast and alt \< 10 x uln, t-bilirubin \< 3, 9. patients with a history of major autoimmune disorders excluded.

Keywords: hepatocellular carcinoma immune checkpoint inhibitor gastric cancer progression
asthma clinical research network (acrn) trial - long-acting beta agonist response by genotype (large)

Conditions: Asthma

Summary: the purpose of this trial is to determine whether regularly scheduled use of an inhaled long-acting beta agonist (salmeterol) in the setting of concomitant use of inhaled corticosteroids (beclomethasone hydroflouroalkane (hfa) inhaler) will have a detrimental effect on asthma control in people who bear the b16-arg/arg genotype of the beta-2 adrenergic receptor gene, as compared to people with asthma of similar severity who bear the b16-gly/gly genotype.

background: the purpose of this study is to compare the effects of a long-acting beta agonist in patients with asthma receiving inhaled corticosteroids who express two distinct polymorphisms of the beta-2 adrenergic receptor. design narrative: participants were homozygous for arginine or glycine at the 16th amino-acid position of the β-2 adrenergic receptor (b16 arg/arg or b16 gly/gly). individuals were matched against their opposite genotype by forced expiratory volume in one second (fev1) and race. matched participants entered an 8-week run-in period. this is a 62-week crossover design where subjects receive the following therapies: * beclomethasone hfa (240 µg twice a day (bid)) + as-needed (prn) albuterol: 8-week run-in * beclomethasone hfa (240 µg bid) + salmeterol (50 µg bid) + prn ipratropium bromide + prn albuterol: 18-week treatment period * beclomethasone hfa (240 µg bid) + prn albuterol: 8-week run-out * beclomethasone hfa (240 µg bid) + placebo salmeterol + prn ipratropium bromide + prn albuterol: 18-week treatment period * beclomethasone hfa (240 µg bid) + prn albuterol: 10-week run-out the order of treatments received during the two treatment periods is randomized.

Eligibility criteria:
inclusion criteria: * male or female, ages 18 and older * clinical history consistent with asthma * for subjects regularly using inhaled corticosteroids, fev1 50% of predicted, methacholine pc20 fev1 16 mg/ml or 12% and 200 ml, improvement in fev1 after 2 puffs of inhaled albuterol * for subjects not regularly using inhaled corticosteroids, fev1 40% of predicted, methacholine pc20 fev1 8 mg/ml or 12% and 200 ml, improvement in fev1 after 2 puffs of inhaled albuterol * genotype eligibility (determined during screening) exclusion criteria: * smoker (total smoking history must be less than 10 pack years) * significant unstable medical condition other than asthma * history of life-threatening asthma requiring treatment with intubation and mechanical ventilation in the past 10 years * pregnant or lactating
model to predict coinfection in elderly patients with covid-19

Conditions: Covid19

Summary: the goal of this observational study is to learn about the clinical characteristics and construction of a predictive model in elderly covid-19 patients. the main question it aims to answer is the main clinical characteristics and risk factors of elderly covid-19 patients. participants will not be asked to do any other intervening measure.


Eligibility criteria:
inclusion criteria: * age greater than or equal to 65 years old; * covid-19 was diagnosed with sars-cov-2 reverse transcription-polymerase chain reaction positive or rapid antigen test positive or a clinical diagnosis made by the radiological responsible clinician based on signs, symptoms, or radiology consistent with covid-19; * hospitalization more than one day, including patients in emergency. exclusion criteria: * age less than 65 years old; * pregnancy; * hospitalization less than one day; * outpatients; * patients with missing or incomplete information.

Keywords: covid-19 elderly nomogram coinfections diagnosis
postoperative basal bolus or sliding scale insulin regimen in dm2 and its effect on surgical site infections.

Conditions: Diabetes Mellitus, Type 2; Surgical Site Infection

Summary: a multicentre, matched-pair, cluster randomised controlled superiority trial to investigate the effect of a proactive basal bolus insulin regimen compared to the reactive sliding scale insulin regimen, targeting a glucose level of 3.9-10.0 mmol/l, to reduce the number of surgical site infections within the first 30 days postoperatively in adult patients with diabetes mellitus type 2.

people with type 2 diabetes mellitus (pwt2d) are at increased risk of postoperative complications, especially surgical site infections (ssi). the aim of this study to reduce ssi in pwt2d by implementing a proactive basal-bolus insulin regimen, compared to the reactive sliding scale regimen. adult patients with type 2 diabetes will be included in this multi-centre study. participants will receive a blind cgm, i.e. glucose data are masked for the participants and study team, from admission to the ward until discharge from the hospital. in addition, all participants are asked to complete several questionnaires 30 days after surgery. both regimens are currently used in clinical practice. therefore, there is no additional trial-related burden depending on the intervention group allocation. participants will be monitored intensively and insulin dosage will be adjusted adequately to the measured glucose values by the treatment team. the sample size is based on the ssi incidence rates. wards are matched into pairs with comparable baseline incidence rates and in each pair, one ward will be randomly assigned to the intervention group; the other serves as the control. 18 wards from 8 participating centres are planned to be recruited, this translates to 9x2x56=1008 evaluable participants. keywords: diabetes mellitus, basal bolus, sliding scale, insulin regimen, surgical site infections

Eligibility criteria:
inclusion criteria: * patients aged 18 or older * diagnosed with type 2 diabetes mellitus * undergoing gastointestinal or vascular surgery * admitted to one of the participating surgical wards * expected duration of stay at least one overnight stay * willing and able to provide informed consent exclusion criteria: * diagnosed with type 1 diabetes mellitus * female of child-bearing potential who is pregnant or breastfeeding. * undergoing complete pancreatectomy * undergoing bariatric surgery * patients using a continuous insulin pump at home * patients undergoing a necrotectomy/wound debridement from a pre-existent wound.

Keywords: diabetes mellitus basal bolus regimen surgical site infections sliding scale insulin regimen
efficacy of internet and smartphone application-delivered tinnitus retraining therapy

Conditions: Tinnitus

Summary: the purpose of this study is to prove the efficacy of the internet and smartphone application-delivered tinnitus retraining therapy (trt).

to investigate the effect of trt with minimized counseling

Eligibility criteria:
inclusion criteria: * chronic subjective tinnitus exclusion criteria: * thi \< 18

Keywords: tinnitus smartphone web
effect of laser treatment for diabetic retinopathy on the optic disc topography

Conditions: Diabetic Retinopathy

Summary: this study analyzed diabetic patients without evidence of glaucoma who underwent panretinal photocoagulation to determine the effect on optic disc topographic parameters in non-glaucomatous patients with proliferative diabetic retinopathy (pdr).

glaucoma and proliferative diabetic retinopathy (pdr) are two very prevalent diseases that often coexist. previous literature suggest that panretinal photocoagulation may somehow lead to optic disk cupping. therefore, evaluation of the optic disc cupping and of possible glaucomatous damage in patients with diabetic retinopathy can be difficult, especially after prp treatment. the purpose of this study is to determine the long-term effect of prp on optic disc topographic parameters in non-glaucomatous patients with pdr using heidelberg retina tomograph (hrt) parameters and stereo photography. the investigators found that prp does not cause morphological optic disk changes in diabetic pdr patients after one year of follow-up.

Eligibility criteria:
inclusion criteria: * diagnosis of pdr (due to type 1 or 2 diabetes mellitus) * intraocular pressure \< 18 mmhg * nonglaucomatous optic disc characteristics at fundus examination * vertical cup-to-disc (c/d) ratio \<0.7 * absence of media opacities exclusion criteria: * previous diagnosis of glaucoma * family history of glaucoma * neuroophthalmic disease * uveitis * retinal artery or vein occlusion * optic disc neovascularization * diabetic macular edema (dme) * corneal opacity * previous laser photocoagulation treatment

Keywords: optic disc topography panretinal photocoagulation confocal scanning laser ophthalmoscopy stereoscopic disc photographs diabetic retinopathy optic nerve head parameters
usefulness of cephalometry in the second and third trimester of pregnancy in the diagnosis of fetal microretrognathia

Conditions: Pierre Robin Sequence

Summary: congenital retrognathia, with or without pierre robin sequence (prs), is a rare anomaly which can be associated with chromosomal abnormalities. respiratory and feeding consequences can be present at birth. after birth, the diagnosis of retrognathia is based on the clinical examination. cephalometry can be used to complete the diagnosis. several authors have proposed the use of objective quantitative ultrasound parameters for the antenatal screening of prs. in our study, the investigators evaluated fetal cephalometry. the aim first, the investigators studied the inter- and intra-observer reproducibility of cephalometry. second, the investigators established reference values for antenatal cephalometry in normal fetuses. third, the investigators compared the diagnostic performance of cephalometry and the other angles described in the literature for the diagnosis of retrognathia.


Eligibility criteria:
inclusion criteria: * pregnant patient (aged \>18years old) * with one or more fetuses suffering from a microretrognathia * diagnosed prenatally * integrated into a pierre robin sequence exclusion criteria: * uncvertain diagnosis * absence of 3d rendering volume

Keywords: with one or more fetuses suffering from a microretrognathia cephalometry prenatal diagnosis facial angles fetal echography microretrognathia diagnosed prenatally
comparison of the effect of combined glenohumeral joint and subdeltoid bursa injection with platelet-rich plasma (prp), corticosteroid, and normal saline in addition to physical therapy for treatment of frozen shoulder

Conditions: Frozen Shoulder; Adhesive Capsulitis; Shoulder; Platelet-rich Plasma; Corticosteroid; Injection

Summary: frozen shoulder, adhesive capsulitis, shoulder, platelet-rich plasma, corticosteroid, injection.

this is a prospective assessor-blinded randomized controlled trial. we plan to enroll 90 participants with frozen shoulder from the outpatient clinic of the department of physical medicine and rehabilitation in our hospital. the study protocol and consent form have been approved by our ethics committee. after detailed explanation about the content of this study, participant is asked to sign an informed consent. the patients will be randomly divided into three groups: 1). prp injection (prp group); 2). corticosteroid injection (cs group); 3). normal saline injection (ns group). randomization will be assigned according to a random number from a computer program by a statistician. the patients and the evaluator are unknown which group the patients are allocated, but the physician who performs joint injection knows which group the patients are assigned.

Eligibility criteria:
inclusion criteria: 1. age between 20 to 80 years old; 2. shoulder pain for ≥ 1 month; 3. \> 30% loss of passive range of motion (rom) of the affected shoulder in external rotation and/or abduction, comparing with the sound side; 4. visual analog scale for pain on maximal passive external rotation or abduction \> 4; 5. an empty or soft end feel on passive external rotation, or abduction and/or presence of night pain or rest pain; 6. showing willing to attend regular physical therapy programs for 8 weeks. exclusion criteria: 1. severe systemic disorders including cancer, stroke, or cardiopulmonary diseases; 2. uncontrolled dm; 3. rotator cuff tear or calcification of the affected shoulder; 4. fracture, dislocation, or arthritis of the shoulder due to rheumatic disorders; 5. a hard end feel on passive external rotation or abduction of the affected shoulder; 6. a history of drug allergy to local anesthetics or corticosteroids; 7. receiving corticosteroid or hyaluronic acid joint or bursa injection of the affected shoulder during the preceding three months.

Keywords: frozen shoulder adhesive capsulitis shoulder platelet-rich plasma corticosteroid injection
characterization of the use of antipsychotics in posttraumatic stress disorder during the past decade

Conditions: PTSD; Posttraumatic Stress Disorder

Summary: the main purpose is to show the percentage of patients taking antipsychotics with ptsd by looking at approximately ten year's worth of data from 1994 through 2004. we will also determine the type and dose of antipsychotics the patients received, and to determine how many of those patients had psychotic versus nonpsychotic symptoms. we will be obtaining this data from the visn 7 corporate data warehouse. we hypothesize that there has been an overall increase in antipsychotic use in patient's with ptsd over the last 10 years.

this study is a retrospective chart review of patients, at the tuscaloosa va medical center, who were, treated with antipsychotics as monotherapy or adjunctive therapy. the data will be retrieved from a computerized list of patients treated at the tvamc for ptsd from 1994-2004 charts will be reviewed by looking at approximately ten year's worth of data. charts will then be examined to determine what type of antipsychotics patients were prescribed, the dose and duration of the antipsychotics, and the presence or absence of documented psychotic symptoms.

Eligibility criteria:
inclusion criteria: 1. have a diagnosis of ptsd (309.81) 2. male or female patients at least 19 years of age exclusion criteria: • none

Keywords: antipsychotics ptsd posttraumatic stress disorder