Kornimate/medical-research-clean huggingface dataset:
impact of gdt in robot-assisted laparoscopic urological surgery for low to moderate risk patients

Conditions: Vascular Hypotension; Hypovolemia; Hypervolemia

Summary: robot assisted urological procedures are often long surgical cases that can potentially result in complicated postoperative hospital course. the amount of intravenous (iv) fluids administered to patients during these operations fluctuates based on the length of the case, surgical blood loss, hemodynamic monitors, and the discretion of the anesthesiologist. the goal of intraoperative fluid therapy is to maintain optimal tissue perfusion without causing fluid overload. we plan to use a goal directed fluid therapy protocol to optimize fluid status and analyze post-operative outcomes.


Eligibility criteria:
inclusion criteria: * patients undergoing robot-assisted laparoscopic urological procedures in which the patient would have an arterial catheter placed as part of their routine inoperative anesthetic management exclusion criteria: * age less than 18; * current pregnancy; * history of congestive heart failure, arrhythmias, coagulopathy, cerebral vascular disease , copd, significant liver or renal impairment, required flotrac per treating anesthesiologist; * patient refusal to consent

Keywords: goal directed fluid therapy
evaluation of intern dentists in emergency management of traumatic dental injuries in primary anterior teeth

Conditions: Traumatic Injury

Summary: this study aim to evaluate knowledge, attitude, and practice of intern dentistry in emergency management of traumatic dental injures in primary anterior teeth in children aged from 3-5 years old. questionnaire survey will be designed to evaluate knowledge - attitude - and practice of intern dentists who met the eligibility criteria

questionnaire survey will be designed to evaluate knowledge - attitude - and practice of intern dentists toward different forms of traumatic dental injuries in primary anterior teeth in children aged from 3 to 5 years old.

Eligibility criteria:
inclusion criteria: * intern dentists attending their internship in faculty of dentistry- cairo university, other private university (modern science and arts university- msa). * the intern dentists who agree to participate. * intern dentists who did not attend pediatric dentistry round, endodontic round, emergency round and surgery round at cairo university. * intern dentists irrespective of age and sex.

Keywords: dental trauma emergency management traumatic injures.
efficacy and safety of reduced pelvic floor mesh implants

Conditions: Post Operative Pain; Complication of Surgical Procedure

Summary: pelvic organ prolapse is an herniation process, needing a mesh reconstruction for long lasting therapeutic effect. yet, mesh implants were reported to be related to severe adverse effects. this study looks at the potential benefit of mesh size reduction regarding avoiding operative complications.

pelvic organ prolapse is a common disorder that results in significant patient morbidity. approximately 1 in 9 women undergo surgery for the correction of pelvic organ prolapse (pop) and associated bladder and bowel dysfunction. despite its common occurrence, the cause of pop remains largely unknown. prolapse is thought to be caused by direct injury to the levator ani (la) muscle, denervation of the pelvic floor musculature, or fascial damage incurred during childbirth trauma. it is evident that pelvic organ prolapse (pop) occurs when the supporting pelvic floor becomes weakened or stretched, usually caused by childbirth, leading to descent of the pelvic organs to the vagina and beyond. this contributes to the impairment of pelvic organ function and a deterioration of patient quality of life. pop is estimated to severely affect approximately 11% of the female population. symptomatic pop patients might benefit from conservative management, such as the use of physiotherapy or vaginal pessaries. however, advanced pop necessitates surgical reconstruction. this might be achieved by the abdominal approach by an open operation or by laparoscopy, or by the vaginal approach. synthetic permanent or absorbable meshes or biological grafts, or any synthesis of these might be used for reinforcement of the weakened pelvic floor structures that led to pop. the need for reinforcement of the weakened fascia for achieving a long lasting cure of herniation processes is un-questionable. given that the underlying pathology leading to pop is actually just a hernia of the pelvic floor, one must admit that the very same surgical principles used for any hernia repair are applicable for pop. most of the adverse effects are related to excessive implanted mesh mass. thus, our goal with this study is to look at the issue of reducing the mesh size, surface area and the total mesh mass, assuming that the less quantity of left over implant the less mesh related complication will occur. the narrative for that is the notion that the natural pelvic floor connective tissue architecture is ligamentary and not "sheath like", while available pre-cut meshes are much too wide spread. this study concept is that reducing the mesh surface will lead to reduction with the mesh related complication. given that the mesh implant size will be reduced, so will also be the wide of the extent of preliminary dissection, necessary for proper mesh placement. thus, the dissection related adverse effects are expected to reduce as well.

Eligibility criteria:
inclusion criteria: -patients with advanced pelvic organ prolapse exclusion criteria: - patients with active infections or after pelvic irradiation

Keywords: pelvic floor reconstruction mesh implants
thol'impilo: bringing people into care

Conditions: HIV

Summary: the main objective of this study is to compare the effectiveness of combinations of three patient-oriented strategies, compared to the standard of care, to increase the proportion of patients who enter-into-care for hiv within 90 days of testing hiv positive.

background: mortality remains high among individuals with hiv in south africa largely due to low cd4 at initiation of combination antiretroviral therapy (cart) or failure to initiate cart altogether. the problem of advanced hiv at the time of entry-into-care persists despite increases in cd4 count initiation thresholds and higher cd4 counts among individuals testing hiv positive at hiv counselling and testing services (hct). a reason for the discord between cd4 at hct and cd4 at cart initiation is a failure to effectively link people who test positive into hiv care; less than half of individuals testing hiv positive enter hiv care within 3-6 month of hiv diagnosis. however, not only do these delays increase hiv associated mortality, delays from testing positive to entry-into-care for hiv also reduces the ability of test-and-treat strategies to reduce hiv transmission through hiv treatment. study design: thol'impilo is an open (non-masked) individually-randomized implementation science evaluation of the effectiveness and cost-effectiveness of combinations of three strategies to increase timely entry-into-care for hiv compared to the standard of care. participants are randomly assigned to one of four arms to increase timely entry into care: (1) standard of care, (2) point-of-care cd4 and transport assistance, (3) point-of-care cd4 and care facilitator and (4) point-of-care cd4 alone. sample size: the study aims to enrol 2500 participants (i.e. 650 participants per arm). setting: the study is built onto the current community-based hiv counselling and testing (hct) services. the hct units serve peri-urban townships and informal settlements, rural farm workers, and both urban and rural communities.

Eligibility criteria:
inclusion criteria: * aged 18 years and older, diagnosed hiv positive at enrolling mobile hct units, no prior self-reported registration at a health care facility for hiv care, provide consent for participation exclusion criteria: * self-reported prior or current registration as an hiv patient at a healthcare facility

Keywords: hiv care treatment retention implementation science
isoflavones and magnolia extract in the quality of life in menopausal women

Conditions: Menopause

Summary: in menopause, the vasomotor symptomatology, accompanied or less by affective and behavioural symptoms, globally worsens the quality of daily life. the improvement of the quality could be reached with adequate food supplements, named phytoestrogens, in particular soy isoflavones (si), which are natural substances with estrogen-like and estrogen-antagonistic activity, which are active in the control of menopausal vasomotor symptoms. besides, combined with magnolia extract it could improve the psychological symptomatology also improving the quality of life.

multicenter, observational, prospective, longitudinal study of clinical practice conducted in 10 gynecological centers. the study will be conducted in patients with typical mild to moderate vasomotor symptoms and psycho symptoms such as mood disorders, or sleep, anxiety / depression, which do not require specific drug treatment. quality of life will be analyzed by the scale of cervantes.

Eligibility criteria:
inclusion criteria: * women with at least 12 months of amenorrhea * presence of 1 or more vasomotor symptoms as hot flushing, nocturnal sweating or palpitations * one or more psychological symptoms as insomnia, irritability, anxiety, depressed mood. also with concomitant symptoms of sexual area as reduction of libido and vaginal dryness. * women must give the informed consent exclusion criteria: * clinical history of medical or surgical pathologies that could affect the results of the study, including serious cardiovascular, metabolic, kidney or liver diseases * patients with the habit of eating soy foods or dietary supplements with soy extract * patients diagnosed with breast or uterine mass (neoplasia hormone sensitive) * patients that were treated with estrogens (hrt or phytoestrogens)in the 2 months before the beginning of the study. * patients with treatment with antibiotics, antidepressant and/or anxiolytic products

Keywords: menopause quality of life soy isoflavones magnolia extract
novel approach to radiotherapy in locally advanced lung cancer concomitant navelbine®

Conditions: NSCLC

Summary: to investigate the effect of escalation of radiation dose to tumor and lymph nodes based on an inhomogeneous dose distribution controlled by fdg-pet positive areas compared to a standard homogeneous dose spread

to investigate the effect of escalation of radiation dose to tumor and lymph nodes based on an inhomogeneous dose distribution controlled by fdg-pet-positive areas compared to a standard homogeneous dose spread.

Eligibility criteria:
inclusion criteria: * patients with histologically or cytologically proven locally advanced nsclc stage iib to iiib * performance status 0-1 * able to comply with treatment and follow study and follow-up procedures * women must have negative pregnancy test * signed, informed consent * plan for radiotherapy with conventional 66 gy/ 33 f, which meets all dosing limits two normal tissue must be available exclusion criteria: * any unstable systemic disorder (including infection , unstable angina, congestive heart failure , severe liver , kidney or metabolic disease) * need for nasal oxygen * former thoracic radiotherapy, unless there is no significant overlap with previous fields * any other active malignant disease * unable to take oral medications or needing intravenous nutrition * ulcer * nursing women
bivalirudin with prolonged infusion during pci versus heparin after fibrinolytic therapy

Conditions: ST-segment Elevation Myocardial Infarction (STEMI)

Summary: this multicenter, randomized controlled trial in china aims to enroll 2,400 patients with st-segment elevation myocardial infarction undergoing percutaneous coronary intervention (pci) within 24 hours post-fibrinolysis. participants will be randomly assigned in a 1:1 ratio to receive either bivalirudin or heparin, with follow-up at 30 days and 1 year. the primary endpoint is a composite of all-cause mortality and bleeding academic research consortium (barc) type 3 or 5 bleeding at 30 days.

bivalirudin is a direct thrombin inhibitor that exhibits a reversible and transient anticoagulant effect. randomized trials have shown conflicting results for bivalirudin in reducing the risk of bleeding for st-segment elevation myocardial infarction (stemi) patients undergoing primary pci (ppci) compared to heparin. recently, the bright-4 study, which assigned 6016 stemi patients to bivalirudin with a prolonged high dose infusion or heparin during ppci, showed bivalirudin decreased the risk of a composite endpoint of all-cause mortality and bleeding. however, few studies have focused on the safety and efficacy of bivalirudin in pci post-fibrinolysis. we therefore aim to conduct the bivalirudin with prolonged infusion during pci versus heparin following fibrinolytic therapy (bright-fit) trial to examine whether bivalirudin with a high-dose infusion in pci after fibrinolysis in superior to heparin in reducing mortality and major bleeding.

Eligibility criteria:
inclusion criteria: * any age * stemi patients received fibrinolysis therapy within 12h of symptom onset and are planned to undergo pci within 24h of symptom onset. * dual antiplatelet drugs must be administrated according to guidelines before pci (loading doses and maintenance doses of aspirin and clopidogrel or ticagrelor) * patients requiring staged revascularization of non-culprit vessels within 30 days may be enrolled. in such cases the same antithrombotic agents and pci procedures must be used in the staged procedure consistent with the index procedure pci, in particular the assigned antithrombin agent heparin vs. bivalirudin); * the subject or legal representative has been informed of the nature of the study, understood the provisions of the protocol, was able to ensure adherence, and signed informed consent. exclusion criteria: * not suitable for pci; * mechanical complications (such as ventricular septal rupture, papillary muscle rupture with acute mitral regurgitation, etc.); * cardiogenic shock(killip iv) * known allergy or contraindications to heparin, bivalirudin, aspirin, or both clopidogrel and ticagrelor * patients who underwent pci in past 30 days * patients in whom the investigators consider inappropriate to participate in this study (eg, have participated in another drug/instrument study or undergoing another drug/instrument study, pregnancy).

Keywords: stemi, pci, fibrinolysis, bivalirudin, heparin, bleeding, mortality
effects of aerobe interval training and moderate continuous training in chronic obstructive pulmonary disease patients

Conditions: COPD; Chronic Obstructive Pulmonary Disease

Summary: reduced exercise tolerance is one of the hallmarks of copd. the principal causes for exercise intolerance are ventilatory limitation leading to deconditioning and inactivity. so far it is poorly understood which form of exercise is the most effective in training this condition. the investigators want to study the physiological response to two different training programs (high intensity aerobe interval training and moderate continuous aerobe training)with special focus on cardiac and skeletal muscle adaptions

reduced exercise tolerance is one of the hallmarks of copd and the principal causes for exercise intolerance are ventilatory limitation leading to deconditioning and inactivity. however the weak correlation between exercise capacity and fev1 implies that other factors than reduced pulmonary function contributes to this impairment . several studies have found changes in skeletal muscle, with fibre shift, increased oxidative stress, increased inflammatory cytokines and impaired mitochondrial function, suggesting a lower limb dysfunction numerous exercise studies in copd patients have shown physiological and physiological benefits of training and endurance training is now regarded as an important part in pulmonary rehabilitation. it is still uncertain what type of endurance training that is most favourable for copd patients. in patients with heart failure and metabolic syndrome aerobe interval exercise have be shown to be superior in improving aerobic capacity and cardiac function we therefore want conduct a study comparing training effects in patients with moderate to severe copd, that participated in an identical training program that in hf and metabolic syndrome patients gave significant improvement in aerobic capacity, cardiac function and skeletal muscle function. patients will therefore be assigned to either 4x4 minutes high intensity interval treadmill exercise or continuous moderate intensity treadmill exercise 3 times pr week for 12 weeks. aerobic capacity and work economy, pulmonary,cardiac and skeletal muscle function before and after the exercise training will be measured.

Eligibility criteria:
inclusion criteria: * copd with fev1 25-60 % of exp , fev1%fvc\<70 %. age 45-80 years exclusion criteria: * heart failure * symptomatic coronary artery disease * cancer * alcohol and drug abuse * severe mental illness * lower respiratory infection last 4 weeks * participation in exercise- or lung rehabilitation program last 3 months. * oral steroid use

Keywords: exercise training copd
effects of livoletide (azp-531) on food-related behaviors in patients with prader-willi syndrome

Conditions: Prader-Willi Syndrome; Hyperphagia

Summary: this phase 2b/3 double-blind, placebo-controlled study will evaluate the safety, tolerability, and effects of livoletide on food-related behaviors in patients with prader-willi syndrome (pws).

the protocol includes 2 consecutive parts: 1. the first part is a phase 2b dose-response study consisting of a 3-month double-blind, placebo-controlled core period followed by a 9-month extension period. 2. the second part is a phase 3 study consisting of a 6-month double-blind, placebo-controlled core period followed by a 6-month extension period. phase 3 may be initiated following review of safety and efficacy results at the completion of the phase 2b core period. a total of approximately 50 patients per group (8 to 65 years of age) will be randomized (approximately 150 patients in total). in addition to this cohort of 150 patients, a separate cohort of patients 4 to 7 years of age will also be randomized. note: the 8-65 year old cohort has been fully enrolled. enrollment into the 4-7 year age cohort remains ongoing.

Eligibility criteria:
inclusion criteria: * confirmed genetic diagnosis of pws * evidence of increased appetite or hyperphagia * patient must have a single primary caregiver who should be available for certain durations of the study * bmi ≤ 65 kg/m2 * growth hormone treatment permitted if doses have been stable for at least 1 month prior to screening exclusion criteria: * history of chronic liver disease * type 1 diabetes mellitus * hba1c \> 10% * body weight \<20 kg

Keywords: prader-willi syndrome pws
connect2bwell: an evidence-based screening, brief intervention, and referral to treatment (sbirt) program

Conditions: Substance Use Disorders

Summary: this study will evaluate the effectiveness of the digital + telehealth connect2bwell program among 336 safety net patients. adults patients with an upcoming medical medical visit, and/or who screen positive for substance use disorder (sud) during routine sbirt screening during their visit, will receive an email invitation from the research team to complete an online risk assessment to assess study eligibility. the assessment will include the alcohol, smoking and substance involvement screening test (assist). patients scoring in the moderate- or high-risk range for one or more drugs--including alcohol, excluding tobacco--and who meet all other study inclusion criteria, will alternately be assigned to the connect2bwell condition or a comparison condition. assist scores will be sent to the patient's electronic health record (ehr). patients assigned to the treatment condition will receive three brief online intervention sessions followed by dashboard-guided telehealth sessions with a study nurse, text messages, and access to a patient portal. patients assigned to the comparison condition will receive an sbirt session delivered via telehealth by a member of their clinic care team. outcomes, assessed at baseline, 3, 6 and 9 months, include days of use of most problematic drug during the past 30 days, the assist risk score of the most problematic drug, depression, well-being, satisfaction with care, and treatment uptake, if indicated. all patient-facing materials are available in english and spanish.


Eligibility criteria:
inclusion criteria: * moderate/high risk use of at least 1 substance (identified using the assist) * can receive text messages * can access internet via smart phone, tablet, or computer exclusion criteria: * pregnant * admitted to inpatient psychiatric hospital or substance use treatment program, past 30 days * has serious medical condition that could impede study participating, next 9 months * receiving treatment with goal of quitting or reducing use of substances
sodium butyrate for improving cognitive function in schizophrenia

Conditions: Schizophrenic Disorder; Cognitive Impairment

Summary: the purpose of this grant is to evaluate the efficacy of sodium butyrate as a novel treatment for cognitive deficits in schizophrenia (sz). the aims will be to evaluate its effects on improving symptoms and functioning in sz, and the relationship of the drug's clinical effects to epigenetic and inflammation related biochemical changes.

the persistent cognitive deficits which can be appreciated across the course of sz, from prodromal to chronic sz, may be the most important underlying dysfunction in preventing functional, occupational, and social recovery in sz compared to other symptom domains. sodium butyrate is a short chain fatty acid and binds to the zinc site of histone deacetylases (hdac). the inhibition of hdac results in histone hyperacetylation. this study aims to evaluate its effects on improving symptoms and functioning in sz, and the relationship of the drug's clinical effects to epigenetic and inflammation related biochemical changes. the proposed study will be a double blind study of the effects of sodium butyrate on cognitive function and symptoms in chronic sz patients showing continued cognitive deficits.the primary specific aims of the proposal will be to test the the matrics (mccb) battery,delayed recall performance, and performance on real world functional tasks as assessed by the uscd performance- based skills assessment battery (upsa). in addition, we will also investigate whether sodium butyrate may improve other aspects of cognition. we will also explore whether improvement in cognition is related to change in hdac activity in peripheral blood cells and changes in inflammatory makers in the blood, and assess whether there is any improvement in psychopathology as measured by panss scale.

Eligibility criteria:
inclusion criteria: 1. subjects who have cognitive deficits as indicated by a score of \< 85 on rbans, 2. meet criteria for dsm-5 diagnosis of chronic sz, schizoaffective disorder (sa), 3. subjects who are stably treated with antipsychotic medications and are not in acute exacerbation of illness symptoms. exclusion criteria: 1. history of mental retardation or pervasive developmental disorder, 2. subjects with a current serious neurological/cns disorder (such as seizure disorder, stroke or multiple sclerosis) or brain trauma, 3. current treatment with valproic acid, butyrate drugs, sulforaphane, or other drugs or chemicals known to have high hdac inhibitory activity, 4. pregnancy, 5. severe unstable medical condition, 6. current suicidal or homicidal thoughts, 7. current alcohol or substance abuse (other than nicotine or occasional marijuana) in the last month.

Keywords: hdac inhibitors inflammation