Kornimate/medical-research-clean huggingface dataset:
characteristics of covid-19 patients in kazakhstan in early 2020

Conditions: Covid19; Pneumonia, Viral

Summary: the aim of this study is to assess the epidemiological and clinical features of patients diagnosed with covid-19 in kazakhstan at the onset of the pandemic.

there is a paucity of data available on the epidemiological and clinical characteristics of coronavirus disease 2019 (covid-19) in kazakhstan. while a global effort in search for effective treatments and vaccines against covid-19 is in effect, it is important that high quality and up-to-date information be available from a broad variety of populations on the dynamics of infection. this is especially important in regions where, due to resource shortage, epidemiologic surveillance may have gaps. to address the current gaps, medical records will be obtained for patients with confirmed covid-19 during the first months of the pandemic (february-april 2020). the epidemiologic and clinical features including the demographics, clinical manifestation, laboratory parameters, radiologic assessments and clinical outcomes will be analyzed. the results of this study will facilitate the clinical management of covid-19 patients in kazakhstan and ultimately inform the ongoing efforts to curb the spread of the severe acute respiratory syndrome coronavirus 2 (sars-cov-2) in the region.

Eligibility criteria:
inclusion criteria: * laboratory confirmation of sars-cov-2 infection by polymerase chain reaction.
radiotherapy in preoperative setting with cyberknife for breast cancer

Conditions: Early Breast Cancer

Summary: the aim of this study is to prospectively evaluate, in patients affected by early breast cancer, safety and feasibility of single fraction radiotherapy with cyberknife r in preoperative setting, and to identify factors predictive for outcome based on biologic and clinical parameters.

monocentric, open-label, single-arm phase ii study evaluating safety and efficacy of neoadjuvant radiotherapy in early breast cancer patients. patients eligible are women aged 50 or more years old, affected by histologically proven invasive breast cancer, with positive hormonal receptors, grading 1 or 2, her-2 negative, without lymphovascular invasion, and tumour size up to 2 cm (measured on mammography, ultrasound or magnetic resonance), negative clinical nodal status, eligible for bcs.

Eligibility criteria:
inclusion criteria: 1. signed informed consent 2. women ≥ 50 years old 3. histological diagnosis of invasive breast cancer 4. er positive (≥ 10% of tumoral cells present er) and/or pr positive (≥ 10% of tumoral cells present pr) 5. grading 1 or 2 6. her2 negative (ihc 0-1+; in patients with ihc 2+, absence of amplification at fish 7. no lymphovascular invasion evidence at biopsy 8. early breast cancer (t1 n0 m0) clinically and radiologically defined (ultrasound study/ magnetic resonance) 9. patients eligible for bcs. exclusion criteria: extension of breast disease within 5 mm from the skin surface 2. tumor size \&gt; 2 cm 3. patients affected by collagenopathies 4. patients with brca1/2 mutations 5. previous irradiation to homolateral breast 6. previous irradiation to homolateral thoracic wall 7. dcis and/or paget's disease 8. psychiatric disorders preventing informed consent signature. -
measurement of antioxidant activity and oxidative stress in patients undergoing ophthalmic surgery.

Conditions: Cataract; Myopia

Summary: this trial hypothesized that novel laser refractive surgery techniques (lasik, klex) or laser-assisted cataract surgery (flacas) could suppress postoperative inflammation and improve recovery in patients by reducing oxidative stress generated by the surgical procedure. it is also intended to verify whether the new laser technology is necessary for clinical use in groups with low antioxidant activity through the detection of antioxidant activity in the eyes of patients.

simultaneously measure total reactive oxygen species (ros), antioxidant capacity (tac) and ascorbic acid (aa) in aqueous humor (cataract surgery only) or tears. all patients underwent the same examination at our institution, including uncorrected visual acuity (ucva), intraocular pressure (iop), as well as central corneal thickness (cct) with pneumatic tonometer, apparent refraction with autorefractor, and corneal curvature with keratometer. the axial length (axl), anterior chamber depth (acd) and lens thickness (lt) were measured by optical biometer.

Eligibility criteria:
inclusion criteria: * at least 20 years old * corneal refractive surgery or cataract surgery patients exclusion criteria: * patients with eye infections * presence of severe retinal disease * presence of severe eye injury or severe ptosis

Keywords: antioxidants
recovery by endovascular salvage for cerebral ultra-acute embolism (rescue)-japan registry 2

Conditions: Ischemic Stroke

Summary: the aim of this study is to clarify treatment status and clinical results of acute cerebral ischemia after approval of clot retriever in japan, and also to obtain a basis for comparative studies.


Eligibility criteria:
inclusion criteria: * patients admitted from oct. 1st 2014 to sep. 30st 2016. * patients who were 20 years and older admitted within 24 hours after onset. * the patients with large vessel occlusion (ica, mca, va, ba, pca). * patients who did not fulfill the criteria of rescue-japan rct. exclusion criteria: ･patients who are considered inappropriate to participate in the study are excluded.
ultrasound-guided blocks for ambulatory knee arthroscopy

Conditions: Postoperative Pain; Postoperative Nausea and Vomiting; Postoperative Function Level

Summary: in this study, we wish to investigate the effect of ultrasound (us) -guided block of the saphenous nerve (sn) and the posterior branch of the obturator nerve (onp) on postoperative pain and the use of opioids (morphine-like pain medicine) in the first 24 hours following ambulatory knee arthroscopy. we wish to investigate the analgesic effect of these two blocks compared to placebo (injection of local anesthetic with known pain blocking properties compared with injection of a saline solution), when used as a supplement to conventional oral analgesics. we hypothesize that patients receiving the active treatment may experience less pain during the first 24 hours after their operation than patients receiving the placebo treatment, and possibly require less opioid analgesics, experience less opioid related side effects and have a higher function level in this period than patients receiving the placebo treatment.


Eligibility criteria:
inclusion criteria: * planned ambulatory knee arthroscopy, except cruciate ligament surgery * american society of anesthesiologists (asa) class 1-3 exclusion criteria: * cannot cooperate * do not speak or understand danish * daily use of opioid analgesics * allergy towards any of the drugs used in the investigation * medicine abuse (at the investigators discretion) * alcohol abuse, as defined by the national board of health * general anesthesia contraindicated, or the patient wants spinal anesthesia * visualization of necessary structures by ultrasound not possible, or block not possible for other technical reasons

Keywords: nerve block ultrasound postoperative pain saphenous nerve obturator nerve
safety and efficacy of ilaprazole 5, 20 and 40 mg qd and lansoprazole 30 mg qd on healing of erosive esophagitis

Conditions: Esophagitis

Summary: the purpose of this study is to assess the efficacy and safety of 8 weeks of daily treatment with ilaprazole (5, 20 and 40 mg), once daily (qd), compared to lansoprazole 30 mg in healing subjects with endoscopically proven erosive esophagitis.

this 8 week study will be conducted by approximately 160 investigators in the united states. during this study, esophagitis healing will be evaluated by endoscopy, heartburn and other symptom relief will be evaluated by questionnaire and study drug levels will be measured.

Eligibility criteria:
inclusion criteria: * subject must have endoscopically confirmed erosive esophagitis as defined by the los angeles (la) classification grading system (a-d). exclusion criteria: * evidence of uncontrolled, clinically significant systemic disease; acquired immunodeficiency syndrome (aids); a condition likely to require surgery; cancer within 5 years of screening; or abnormal laboratory values. * co-existing diseases affecting the esophagus; history of esophageal radiation therapy, cryotherapy, or physiochemical trauma. * history of esophageal surgery or dilatation of an esophageal stricture other than schatzki's ring; gastric or duodenal surgery except simple oversew of an ulcer. * active gastric or duodenal ulcers or acute upper gastrointestinal hemorrhage within 30 days prior to screening. * current or history of zollinger-ellison syndrome or other hypersecretory conditions. * allergy to any proton pump inhibitor drug (omeprazole, lansoprazole, pantoprazole, rabeprazole, esomeprazole), any component of ilaprazole, or antacid. * unable to tolerate lactose. * use of the following medications prior to randomization or anticipated use during the study: proton pump inhibitors, antacids, biphosphonates, histamine (h2) receptor antagonist (examples: zantac, tagamet), sucralfate, misoprostol, corticosteroids, prokinetics, non-steroidal anti-inflammatory drugs (nsaids), strong anticholinergics, anticoagulant/anti-platelet aggregate therapy, anticoagulants, digoxin, theophylline, phenytoin. * history of alcoholism or drug addiction.

Keywords: heartburn erosive esophagitis healing population pharmacokinetics quality of life (qol)
lung aeration after flexible bronchoscopy in intubated critically ill patients

Conditions: Acute Respiratory Failure

Summary: in patients suffering from acute respiratory failure, ineffective cough and the consequent retention of secretions are common clinical problems, which often lead to the need for tracheostomy for the sole purpose of aspiration of secretions from the airways. mechanically ventilated critically ill patients often have impaired mucus transport which is associated with secretion retention and subsequent development of pneumonia. the accumulation of tracheobronchial secretions in ventilated patients in icu is due not only to an increased production, but also to a decreased clearance. in the event that secretions occlude a bronchus, an atelectasis of the lung parenchyma is created downstream. therefore, it is often necessary to perform a flexible bronchoscopy (fob) to proceed with the removal of the secretion plug. after its removal, the lung is supposed to be reventilated and recruited. in intubated icu patients, the application of a recruiting maneuver (rm) is commonly used to reopen the collapsed lung in patients with acute respiratory distress syndrome or in case of atelectasis in other clinical conditions. however, no studies have so far investigated the role of the application of a rm after a fob performed to remove a secretion plug in intubated icu patients. this observational and physiological study aims to assess if the application of a rm would modify the lung aeration soon after an fob to remove secretion plug (first outcome). moreover, the study aims to assess if eit could be an additional bedside imaging tool to monitor modifications of lung ventilation and aeration during and after a flexible bronchoscopy, as compared with both chest-x-ray and lung ultrasound.


Eligibility criteria:
inclusion criteria: * invasive mechanical ventilation * need for flexible bronchoscopy to remove secretion plug from the airway exclusion criteria: * hemodynamic instability, (i.e. systolic arterial pressure \<90 mmhg or mean systolic pressure \<65 mmhg despite fluid repletion); * need for vasoactive agents, i.e. vasopressin or epinephrine at any dosage, or norepinephrine \>0.3 mcg/kg/min or dobutamine\>5 mcg/kg/min; * life-threatening arrhythmias or electrocardiographic signs of ischemia; * contraindications to placement of electrical impedance tomography belt, lung ultrasound or application of a recruiting maneuver (i.e., pneumothorax, pulmonary emphysema, chest burns or thoracic surgery within 1 week); * inclusion in other research protocols.

Keywords: secretions bronchoscopy lung ultrasound electrical impedance tomography
study of intraoperative colonic irrigation versus stent placement in obstructive left-sided colonic cancer

Conditions: Colon Neoplasm; Colorectal Surgery; Intestinal Obstruction

Summary: introduction: there are several alternatives for one-stage emergency treatment of obstructive left-sided colonic cancer (olcc): subtotal colectomy, intraoperative colon lavage (iocl) with primary anastomosis, and the placement of a stent as a temporary measure prior to scheduled surgery. at present, it is not clear whether emergency perioperative lavage or the placement of a stent is the better technique. the hypothesis is that iocl and primary anastomosis is equal safe or even safer than placement of a stent as a temporary measure prior to scheduled surgery, less length of stay and less cost. objective: to establish which of these two techniques is more efficient in olcc from the point of view of morbimortality, economic cost, and long-term survival. material and methods: prospective, controlled, randomized study of patients diagnosed with olcc. patients were divided into two groups: group 1: stent and deferred surgery; group 2: emergency iocl. a simple randomization system was used. the estimated sample size required per group was 21 patients. demographic variables, risk prediction models, postoperative morbimortality, staging, complications due to the placement of stent, surgical time, clinical follow-up, health costs and follow-up of survival were recorded.


Eligibility criteria:
inclusion criteria: * patients over the age of 18 diagnosed with complete intestinal obstruction due to tumor in the left colon using abdominal ct scan exclusion criteria: * unresectable lesion (intraoperative), severe ischemia or cecal perforation, fecal or advanced purulent peritonitis, hemodynamic instability during surgery, immunodepressed state (corticoids, chemotherapy, hiv, major surgery in the last two months) and septic shock.

Keywords: obstructive left-sided colonic cancer colorectal stent intraoperative colon lavage lavage stent
carpometacarpal fracture-dislocations

Conditions: Carpometacarpal; Dislocation

Summary: fracture-dislocation of the carpometacarpal (cmc) joints of the ring and little finger are the most affected cmc joints and the dislocation may be accompanied by other hand injuries. fracture-dislocation of the cmc joints of the ring and little finger are extremely mobile because of their saddle shape anatomy and loose ligamentous attachments. missed and incorrect diagnosis is very frequent in metacarpal base injuries of the hand and results in impaired function and weak grip. in these lesions immediate reduction is imperative. treatment options for these injuries include non-operative management, closed reduction with kirschner wire fixation (k-wire) and open reduction with internal fixation (orif). in chronic cmc fracture-dislocations orif is mandatory. although operative treatment is recommended in the literature in fracture-dislocation of the cmc joints of the ring and little finger, other authors, in specific cases, performed conservative treatment through immediate reduction and splint immobilization and this treatment can be sufficient.

physical examination in carpometacarpal injuries reveals ulnar-sided pain, swelling, diffuse edema, a palpable lump and tenderness of the hand. radiological examination include hand-wrist radiographs in the posteroanterior (pa), true lateral and 45º oblique views. a true lateral view of the hand may demonstrate the dislocation, although overlapping of the joints can mask the dislocation. on pa radiographs, fisher et al. propose using the so-called m-line parallelism of the cmc joints. a break in this m-line suggests a dislocation. another method is to draw metacarpal cascade lines on a pa radiographs. it is important to recognise the associate lesions, for example hamate fractures, because this fracture can change the prognosis, surgical planning and treatment. the investigators hypothesized that there is an interobserver variability to evaluate the carpometacarpal fracture-dislocation and associated lesions in x-rays are underestimated. the investigators propose a protocol with a ct scan to asses this lesions. the researchers hypothesised that surgical reconstruction would result in better clinical result and lower complications rate than non-surgical treatment.

Eligibility criteria:
inclusion criteria: * closed carpometacarpal fracture dislocation of the hand * adults from 18 to 80 years old exclusion criteria: * history of fractures or tendon lesions in the same hand * children * open fracture dislocations
emails promoting covid-19 vaccination among healthcare workers

Conditions: Vaccination Refusal; Communication

Summary: in this evaluation, two versions of emails will be sent to geisinger employees who have not been vaccinated against covid-19. a delayed-contact control group will be emailed after a delay of at least two days. the researchers hypothesize that either of the emails - which use content informed by behavioral nudge theory - will lead to more covid-19 vaccinations than the delayed-contact control group.

the researchers aim to evaluate the effectiveness of email reminders in promoting covid-19 vaccinations among geisinger employees. the project will compare two emails, which will vary in the subject line and email content. both emails will test different approaches that draw from principles in behavioral science: social proof, reframing, and scarcity. employees receiving these emails will be compared with employees in a delayed-contact group, who will not receive emails. employees in the control group will later receive one of the emails.the responses to the emails will help determine the communications later sent to the control group. all emails will ask recipients if they want to receive a covid-19 vaccination. if they click on a hyperlink indicating yes, they will be forwarded to an online registration and scheduling homepage. if they click on a hyperlink indicating no, they will be forwarded to an online questionnaire surveying people about their main reason for declining the vaccine at this time. the questionnaire will automatically present information intended to assuage the specific concern that people endorse, followed by a hyperlink to the scheduling site. the data will be analyzed with logistic regression models with the control group as the reference group, to compare the two email conditions versus the control group. this set of analyses will only be conducted for scheduling a vaccination appointment as opposed to email engagement outcomes (e.g., number of emails opened), which will not be applicable for the control group. a second set of logistic regression models predicting scheduling a vaccination appointment and email engagement will also be run, comparing the two email conditions against each other. the data will be examined two days later (to help decide which email to send to the delayed-control group) and four days later (when the policy for employee vaccination will change, making the content of the email irrelevant). update: the researchers looked at 3 days of data - as the emails to the delayed contact group were only sent at that time - and 4 days of data when the policy for employee vaccinations changed.

Eligibility criteria:
inclusion criteria: * employees at geisinger health system who have not gotten a covid-19 vaccination exclusion criteria: * none

Keywords: immunization persuasive communication electronic mail economics, behavioral psychology
early administration of steroids in the ambulance setting

Conditions: Asthma in Children

Summary: asthma is the most common chronic disease of childhood and is a leading cause of emergency medical treatment. for children experiencing an asthma exacerbation, emergency department (ed) guidelines recommend early systemic corticosteroid (cs) administration, since studies have shown associated, time-sensitive, decreases in hospital admissions and ed length-of-stay (los). for patients who are treated by 911 emergency medical services (ems) first, there exists an opportunity for even earlier administration of cs, prior to ed arrival. yet, preliminary data demonstrate that currently less than 10% of ems pediatric asthma patients receive cs prior to ed arrival. given the known time-sensitivity of cs' effects on patient outcomes, the investigators hypothesize that even earlier ems administration of cs will decrease hospital admissions, ed los, and intensive care unit admissions for pediatric patients with an acute asthma exacerbation. using a pragmatic observation design in multiple ems agencies, we will enroll patients to analyze clinical outcomes and comparative costs of ems cs administration, and how both are influenced by ems transport time. that novel combination of analyses will help build evidence-based guidelines adaptable for diverse ems agencies nationwide.


Eligibility criteria:
inclusion criteria: * primary problem: asthma exacerbation * stable to take an oral medication * transported by ems to an ed exclusion criteria: * unconscious, hemodynamically unstable, or critically ill -\> ems will proceed with usual critical care (includes iv methylprednisolone as per protocol) * daily or every other day corticosteroid therapy * allergy to prednisolone or another corticosteroid * chronic lung disease besides asthma, airway anatomic abnormalities, tracheostomy, immunocompromised, traumatic injury, pregnancy, law enforcement custody, non-english speaking
endobronchial ultrasound-transbronchial needle aspiration (ebus-tbna) sample division

Conditions: Lung Cancer

Summary: ebus-tbna specimen are used for lung cancer diagnosing and staging, as well for molecular analysis. the purpose of this study is to evaluate if samples from on lymph node site can be divided for diagnosis and molecular analysis.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of lung cancer * enlarged mediastinal or hilar lymph nodes (\>10 mm) exclusion criteria: -