Kornimate/medical-research-clean huggingface dataset:
increasing the coverage of severe acute malnutrition (sam) treatment in ethiopia

Conditions: Acute Malnutrition, Severe; Malnutrition, Child; Wasting

Summary: the r-switch intervention aims to address the low coverage of treatment for severe wasting (sam) by leveraging existing community groups to deliver an integrated package focused on prevention, screening, referral, and treatment of sam. it includes behavior change communication on child nutrition and health, active screening, improved passive screening at health posts, and follow-up of referred cases and those enrolled in outpatient treatment programs (otp). the primary objectives of the r-switch studies are to assess the intervention's impact on otp coverage, identify implementation barriers and facilitators, and evaluate its cost-efficiency and cost-effectiveness.

despite the high mortality risk of severe wasting (also referred to as severe acute malnutrition or sam), only a small proportion of children with severe wasting are currently identified and admitted to available outpatient treatment programs (otp). in 2020, an estimated 4.9 million children with severe wasting received treatment, approximately a third of the total burden. outside of humanitarian settings, this proportion is even lower (estimated to be around 15%). these figures highlight the urgent need to increase treatment coverage to meet the sustainable development goals (sdg), which aim to reduce the prevalence of child wasting to less than 5% by 2025 and less than 3% by 2030. the continuum of care for sam, from case identification, referral to treatment, and post-treatment follow-up, is hampered by several barriers including caregiver lack of awareness on the risks and treatment services of sam, stigma related to sam, poor accessibility to treatment, frequent stockouts of treatment inputs, and the overall workload faced by first-line health workers. the r-switch intervention will leverage existing community groups to deliver an integrated package aimed at preventing sam through behavior change communication (bcc) on child nutrition and health, increasing wasting screening coverage through active screening, family-led muac and improved passive screening health posts, increasing treatment coverage through follow-up of earlier referred cases, cases enrolled in otp, and children who completed otp and recovered. the primary objectives of the r-switch studies are: * to assess the impact of the r-switch intervention on sam otp coverage * to identify implementation barriers and facilitators * to assess the cost-efficiency and cost-effectiveness of the intervention package and services

Eligibility criteria:
inclusion criteria: * child 6-59 months of age * suffering from sam (defined as muac \< 115mm or presence of bilateral pitting edema or weight-for-length z-score \<-3) or currently enrolled in sam otp exclusion criteria: - anthropometric malformation or being handicapped which hampers anthropometric measurements.

Keywords: outpatient therapeutic feeding program treatment screening wasting severe acute malnutrition
randomized controlled trial of a multiple intervention program to decrease heart failure rehospitalization

Conditions: Heart Decompensation

Summary: the prevalence of heart failure (hf) is constantly increasing in france due to the aging of the population, better management of etiological factors and improved treatments (drug / interventional). on the other hand, re-hospitalizations for heart failure continue to increase, exceeding reception capacities and constitute a real challenge for current public health systems. the prado system provides administrative support (through a health insurance advisor) in the management of patient appointments with their doctors as well as home visits by a nurse trained in heart failure. other interventional medical and educational interventions performed during an out-of-hospital consultation guided by a computer platform would help to optimize the care and continuity of care.

the aim of this study is to demonstrate the value of a multiple intervention program in reducing early readmissions for heat failure in patients hospitalized for cardiac decompensation. this work will create an interventional assistance program to structure the exit consultation in order to optimize treatment, educate patients, ensure the continuity of hospital-city care and improve compliance (reminders) to reduce re-hospitalizations. this program will be carried out by using a computer platform allowing the systematization of output documents and the sending of messages (e-mail / sms) for making appointments (medical consultations, biologicals sampling) and perfect therapeutic education.

Eligibility criteria:
inclusion criteria: * heart decompensation requiring hospitalization and the use of intravenous diuretic therapy * left ventricular ejection fraction ≤ 40%. exclusion criteria: * hospitalization for cardiac decompensation leading to an invasive procedure (valve, coronary, etc.). * acute reversible cause of heart failure. * incurable disease (other than heart failure) or estimated life expectancy of less than one year. * patient transferred directly to another department or cardiac rehabilitation center. * significant cognitive impairment. * patient without cell phone or email. * linguistic or psychic refusal or inability to sign the informed consent. * current participation in a clinical tria

Keywords: heart failure multiple intervention program
efficacy of therapeutic exercise vs. treatment of myofascial trigger points.

Conditions: Shoulder Tendinopathy

Summary: background: shoulder pain commonly affects the general population, with rotator cuff tendinopathy being the most common cause. the most common cause, with rotator cuff tendinopathy diminishing function and quality of life, leading to a major socio-economic impact. quality of life, leading to a major socio-economic impact. as a result, there are two treatment approaches with potential effectiveness: therapeutic exercise (te) and myofascial trigger point treatment (tmt). trigger point treatment (ttp). objective: the main objective of this randomised clinical trial is to determine the efficacy of et versus treatment of mtps in shoulder tendinopathies. methods: for this study, 20 participants were randomly divided into two groups: a et group, with which a 10-exercise programme was initiated (n = 10), and a pgm group which was given an intervention protocol (n = 10). intervention protocol (n = 10). both received a total of 10 sessions. pain intensity pain intensity, pressure pain threshold (ppt) and range of motion (rom) were assessed before starting and after 10 sessions. and after 10 sessions.


Eligibility criteria:
inclusion criteria: * signed informed consent form. * patients diagnosed by an orthopaedic surgeon with shoulder tendinopathy. tendinopathy. * symptoms of shoulder pain lasting more than 3 months. * pain on jobe, patte and infraspinatus assessment manoeuvres (highlighting abduction and abduction and external rotation). exclusion criteria: * previous shoulder surgery. * radiating (non-referred) pain from cervical radiculopathy. * shoulder pain associated with other diagnoses (examples: retractile capsulitis, subacromial syndrome, tendon rupture, posterosuperior conflict, etc.). subacromial syndrome, tendon rupture, posterosuperior conflict, etc). * patients with multiple pathologies. * patients with neurological disorders.

Keywords: shoulder tendinopathy supraspinatus infraspinatus physiotherapy techniques therapeutic exercise trigger points
consolidation whole abdominal intensity-modulated radiation therapy (imrt) in advanced ovarian cancer

Conditions: Ovarian Cancer; Tubal Carcinoma; Primary Peritoneal Carcinoma

Summary: the primary objective of this phase-ii study is to assess the toxicity of consolidation intensity-modulated whole-abdominal radiotherapy using tomotherapy in patients with advanced optimally debulked stage international federation of gynecology and obstetrics (figo) iii ovarian cancer with a complete remission after adjuvant chemotherapy. 36 patients will be treated to a total dose of 30 gy in 1.5 gy fractions. the planning target-volume includes the entire peritoneal cavity and the pelvic and para-aortal node regions. intensity-modulated whole-abdominal radiotherapy allows an effective sparing of liver, kidneys and bone-marrow (vertebral bodies and pelvic bones).


Eligibility criteria:
inclusion criteria: * histologically confirmed ovarian cancer or tube cancer or primary peritoneal carcinoma stage figo iii * primary optimal debulking surgery * postoperative gross residual tumor ≤ 1cm ( r0, r1 oder r2 \< 1cm situation) * adjuvant chemotherapy with platin and taxane * complete remission after chemotherapy * karnofsky performance score \> 60 * patients \>18 years of age * written informed consent exclusion criteria: * stage figo i or ii * stage iii with postoperative gross residual tumor \> 1cm * stage figo iv * recurrence situation * delayed wound healing post laparotomy * leucopenia \<2000/ml before radiotherapy * thrombocytopenia \<75000/ml before radiotherapy * clinically active renal, hepatic, cardiac, metabolic, respiratory, coagulation or hematopoietic disease * status post pelvic or abdominal radiotherapy * status post other cancer disease in the past 5 years (cervical cancer in situ, basal cell carcinoma, squamous cell carcinoma of the skin are excluded) * participation in another clinical trial

Keywords: ovarian cancer whole-abdominal radiotherapy consolidation treatment helical tomotherapy
an efficacy and safety study of periarticular parecoxib sodium for pain management in total knee arthroplasty

Conditions: Unilateral Primary Osteoarthritis of Knee

Summary: primary research objective: the primary objective of this study is to determine efficacy of periarticular parecoxib sodium in a multimodal cocktail versus intravenous parecoxib injections for pain management in total knee arthroplasty secondary research objective: * to determine if perioperative use of parecoxib sodium was associated with improved clinical outcomes * to evaluate the safety, in terms of adverse events; serious adverse events and tolerability of parecoxib sodium in periarticular injections in a multimodal cocktail

this is a multi-center, open label, parallel randomized trial designed to evaluate the efficacy and safety of periarticular parecoxib sodium compared to intravenous parecoxib sodium. 125 patients with primary knee osteoarthritis from 4 participating sites who meet inclusion/exclusion criteria will be enrolled into the trial. after initial screening, patients will attend clinic for baseline examination. subjects will then randomly allocated to periarticular parecoxib sodium or intravenous sodium in ratio of 1:1. patients are observed at post-operative 6, 12, 24 hours, subsequently daily for 4 days and finally at 2 week follow-up

Eligibility criteria:
inclusion criteria: * patients with primary knee osteoarthritis on treatment and planned for unilateral total knee arthroplasty and on spinal/general anesthesia * subjects age more than 50 and less than 85 years * patients with body weight at least 50 kg and not more than 50%above ideal body weight * written informed consent obtained from patient or guardian exclusion criteria: * female patients who are attempting to conceive/pregnant * known allergy or hypersensitivity to cocktail regime or to cox-2 inhibitors * history of bleeding disorders or coagulation defect * patients with abnormal liver profile * patients with history of stroke or major neurological defect * patients with neuropathic pain/sensory disorder * patients with peptic ulceration or anticoagulant use within 1 month * history of previous major knee surgery/trauma * patients with renal insufficiency * history of revision total knee arthroplasty * patients with knee deformity \> 20 degrees * patients planned for bilateral knee arthroplasty during the same setting * patients with significant bone loss requiring augmentation * patients with history of using nsaids 24 hours before the surgery
study to evaluate the safety and efficacy of dr-3001 versus placebo in women with overactive bladder

Conditions: Urinary Incontinence

Summary: this is a placebo-controlled, double-blind study to evaluate the safety and efficacy of two doses of dr-3001 in women with overactive bladder who have symptoms of predominant or pure urge incontinence, urinary urgency and elevated urinary frequency

this is a multi-center, randomized, placebo-controlled study to compare two doses of dr-3001 to placebo for a 12-week treatment period. the overall duration of patient participation will be for approximately 19 weeks. patients will be required to keep a daily diary record of study medication use and incontinence episodes

Eligibility criteria:
inclusion criteria: * diagnosis of overactive bladder and incontinence for at least 6 months * using birth control or menopausal * willing to discontinue current medication for overactive bladder exclusion criteria: * pregnant or given birth in the last 6 months * three or more urinary tract infections a year * uncontrolled glaucoma, hypertension, diabetes or myasthenia gravis * history of bladder cancer, ulcerative colitis or severe constipation * any contraindication to vaginal delivery systems

Keywords: overactive bladder urge incontinence urinary incontinence
lung ultrasound in procalcitonin- guided antibiotic discontinuation in ventilator associated pneumonia

Conditions: Ventilator Associated Pneumonia

Summary: ventilator associated pneumonia (vap) is associated with longer icu length of stay, prolonged mechanical ventilation, and increased use of antimicrobials, health-care cost and mortality . acute respiratory infections (aris) comprise a large and heterogeneous group of infections, including bacterial infections, viral infections, and infections of other etiologies. early initiation of adequate antibiotic therapy is the cornerstone in the treatment. however, overuse of antibiotics and prolonged duration of antibiotic therapy in patients with bacterial aris in the hospital and intensive care setting is associated with increased resistance for common bacteria, high costs, and adverse drug reactions.


Eligibility criteria:
inclusion criteria: * 18 years old or greater * ventilator associated pneumonia (vap) with positive sputum culture. exclusion criteria: * pregnancy, * use of immunosuppressive agents except for steroids, * neutropenia (white blood cell count ≤1000/ml) * patients whose primary diagnosis was community acquired pneumonia and other source of infection.
computed tomography (ct) perfusion imaging of lung cancer

Conditions: Carcinoma, Non Small Cell Lung

Summary: this is an experimental study of the feasibility and efficacy of ct perfusion (ctp) imaging (ct blood flow measurements) in subjects with non-small cell lung cancer.

drug/device information 1) contrast 30 cc bolus of a low osmolar, iodinated ct contrast agent, which is fda approved and used in the clinical ct imaging procedure. 2) scanner the 64 row-multidetector row ct unit (lightspeed vct, ge healthcare, milwaukee, wi) is fda approved for clinical ct imaging research design and methods 1) primary endpoint 1. diagnostic yield of tumor perfusion measurements using a contrast assisted computed tomography technique. 2) secondary endpoints 1. reproducibility of tumor blood flow estimates derived by ct. 2. assessment of the association between tumor vascularity responses after two cycles of chemotherapy and subsequent best tumor response according to standard anatomic response evaluation criteria (recist). 3. predictive value of tumor blood flow for patient survival, compared to the predictive power of tumor size determinations.

Eligibility criteria:
inclusion criteria: * patient with any stage non-small cell lung cancer (nsclc) who will undergo imaging with ct of the chest with intravenous contrast as standard of care. other imaging tests will be performed as clinically indicated. * patient should be receiving, or planning to receive, or have received systemic therapy (chemotherapy and/or novel agents) treatment with or without radiotherapy. patients should not be receiving adjuvant or postoperative treatment but neoadjuvant treatment is allowed. * histologically or cytologically proven nsclc. * at least one measurable primary or other intrathoracic/supraclavicular lesion ≥ 1 cm, according to response evaluation criteria in solid tumors (recist); this lesion should be either proven to be malignant by biopsy or be considered malignant based on its evolution on previous imaging studies. a scan within 3-6 months prior to registration can be used as the baseline scan. * age 18 years or older and ability to provide informed consent. * subjects must use medically appropriate contraception if sexually active; women of childbearing potential must not be pregnant or breastfeeding * subjects must have normal renal function to participate. standard laboratory testing to evaluate renal function will be performed prior to administering iv contrast and will be available as standard of care. renal impairment is defined as a glomerular filtration rate of less than 60 ml/min/1.73 m2 bsa, derived from the patients' serum creatinine concentration. exclusion criteria: * subjects of reproductive potential, who are sexually active but unwilling and/or unable to use medically appropriate contraception, or women who are pregnant or breastfeeding; * established allergy to iodine containing contrast media

Keywords: non small cell lung cancer nsclc ctp perfusion imaging
renal sympathetic denervation as a new treatment for therapy resistant hypertension

Conditions: Hypertension; Chronic Kidney Disease

Summary: the aim of this study is to assess whether renal denervation (rd) added to usual care compared to usual care alone reduces blood pressure (bp) as determined with ambulatory bp monitoring (abpm) after 6 months in subjects with an average day-time systolic bp of at least 135 mmhg as determined with use of abpm, despite use of three or more bp lowering agents or with documented intolerance or contraindication for to 2 or more of the 4 major classes of antihypertensive drugs (acei/arb, calcium channel blockers, betablockers and diuretics) obstructing use of 3 antihypertensives further aims are to assess the effect of renal denervation on the use of bp lowering agents, to explore the effect of renal denervation in strata of estimated glomerular filtration rate (egfr) (egfr 20-60 ml/min per 1.73m2 and egfr\>60 ml/min per 1.73m2) and according to baseline office bp. randomization will be stratified by hospital and egfr and will be at a 2:1 ratio.


Eligibility criteria:
inclusion criteria: 1. individual has a mean day-time sbp ≥ 135 mmhg, as determined with the use of abpm, while using 3 or more antihypertensive agents for at least 3 months prior to inclusion or with documented intolerance to 2 or more of the 4 major classes antihypertensive drugs ( ace/arb, calcium channel blocker, beta blocker, diuretic) and no possibility to take 3 anti-hypertensive drugs. 2. individual is ≥18 years of age. exclusion criteria: 1. individual is unable or unwilling to sign informed consent. 2. individual has a treatable secondary cause of hypertension. 3. individual has an egfr below 20 ml/min/1.73m2 using the modification of diet in renal disease (mdrd) calculation. 4. individual has renal artery anatomy that is ineligible for treatment 5. individual has any serious medical condition, which in the opinion of the investigator, may adversely affect the safety and/or effectiveness of the participant or the study. 6. individual is pregnant, nursing or planning to be pregnant. 7. individual has a known, unresolved history of drug use or alcohol dependency, lacks the ability to comprehend or follow instructions, or would be unlikely or unable to comply with study follow-up requirements. 8. individual is currently enrolled in another investigational drug or device trial.

Keywords: hypertension renal denervation sympathetic denervation
safety and efficacy of ledipasvir/sofosbuvir fixed-dose combination (fdc) with and without ribavirin for the treatment of hcv

Conditions: Chronic Hepatitis C Virus

Summary: the purpose of this study is to evaluate the safety, tolerability, and antiviral efficacy of ledipasvir (ldv)/sofosbuvir (sof) fixed-dose combination (fdc) tablets with or without ribavirin (rbv) administered for 12 and 24 weeks in treatment-naive subjects with chronic genotype 1 hcv infection.


Eligibility criteria:
inclusion criteria: * age ≥ 18, with chronic genotype 1 hcv infection * hcv treatment-naive * hcv rna \> 10,000 iu/ml at screening * cirrhosis determination; a liver biopsy may be required * screening laboratory values within defined thresholds * use of two effective contraception methods if female of childbearing potential or sexually active male exclusion criteria: * pregnant or nursing female or male with pregnant female partner * co-infection with hiv or hepatitis b virus (hbv) * current or prior history of clinical hepatic decompensation * hepatocellular carcinoma (hcc) or other malignancy (with exception of certain resolved skin cancers) * chronic use of systemic immunosuppressive agents * history of clinically significant illness or any other medical disorder that may interfere with subject treatment, assessment or compliance with the protocol

Keywords: hcv genotype 1 (gt-1) hcv sustained virologic response direct acting antiviral combination therapy gs-7977 gs-5885 ribavirin open label sofosbuvir additional relevant mesh terms: hepatitis hepatitis, chronic hepatitis c hepatitis c, chronic liver diseases digestive system diseases hepatitis, viral, human virus diseases enterovirus infections picornaviridae infections rna virus infections flaviviridae infections antiviral agents anti-infective agents therapeutic uses pharmacologic actions antimetabolites molecular mechanisms of pharmacological action