Kornimate/medical-research-clean huggingface dataset:
intravenous allopurinol in heart failure

Conditions: Congestive Heart Failure

Summary: this study tests the hypothesis that allopurinol, a xanthine oxidase inhibitor, improves heart metabolism in patients with heart failure.

xanthine oxidase have been reported to improve mechano-energetic coupling in failing hearts. the investigators developed a means to directly measure creatine kinase flux, the major energy reserve of the heart, in the human heart exploiting new magnetic resonance technologies. the investigators propose to study 10 healthy subjects and up to 25 with heart failure (dilated cardiomyopathy) before and after a single 300mg iv infusion of allopurinol.

Eligibility criteria:
inclusion criteria: * age \> 18 years * the patient is willing and able to provide informed consent * clinical diagnosis of chronic heart failure * ejection fraction (ef) \< 40% by echocardiography, nuclear multigated acquisition (muga) or cath ventriculography * no significant coronary disease at cardiac catheterization * new york heart association (nyha) class i-iv symptoms * clinical stabilization for two weeks if following recent congestive heart failure (chf) decompensation. exclusion criteria: * metallic implant prohibiting magnetic resonance (mr) evaluation * inability to lie flat for mr study * administration of additional investigational drugs * calculated creatinine clearance \< 50 ml/min * allergy to allopurinol * current gout flare * currently taking oral allopurinol

Keywords: metabolism congestive heart failure allopurinol adenosine triphosphate (atp)
post-licensure safety surveillance study of menactra vaccine when administered as a 2-dose schedule to children

Conditions: Meningitis; Meningococcal Infection

Summary: this is a passive-surveillance study that will accrue subjects for surveillance. for each accrued subject, surveillance for outcomes will continue for six months following the first dose. if a second dose is given within that time, then surveillance will be continued for six months following the second dose. observational objective: * to describe and characterize adverse events occurring after vaccination with menactra vaccine.

the study will be carried out in collaboration with the kaiser permanente medical care program (kpmcp) under the direction of the kaiser permanente vaccine study center (kpvsc). kpmcp is a closed-panel healthcare organization that maintains comprehensive encounter databases that capture all medical care received by enrollees. vaccination will be according to routine clinical practice. vaccination databases will be reviewed to identify eligible persons receiving menactra vaccine within the kpmcp system.

Eligibility criteria:
inclusion criteria: * age 9 to 23 months at the time of receipt of the first dose of menactra vaccine during the study period.

Keywords: meningitis meningococcal infection menactra®
treatment of breast fibroadenoma with fastscan hifu

Conditions: Breast Fibroadenoma

Summary: this study evaluates the efficacy of the hifu for the treatment of breast fibroadenoma with the fastscan version using assessment of patient experience and adverse event reporting.

echopulse is specially designed, manufactured and ce marked for treating breast fibroadenoma. hifu is a completely alternative to surgery which utilizes high-energy ultrasound to deliver a large amount of sound energy to a focal point to rapidly induce tissue heating to 85-90°c.this initiates tissue coagulation followed by tissue necrosis ablating the targeted area. in a previous european feasibility study performed at 4 sites (france and bulgaria), 51 fibroadenomas in 42 patients were treated. the hifu treatment was well tolerated and showed efficacy (mean volume reduction of 72.5% +/-16.7 at 12 months follow-up.

Eligibility criteria:
inclusion criteria: * female patients 18 years or older with one diagnosed breast fibroadenoma. * diagnosis of fibroadenoma must be based on : * clinical examination, * ultrasound image alone for patients under 35 years old. for women older than 35 years, a mammogram will be performed in addition to ultrasound. the bi-rads (breast imaging, reporting and data system) score of this mammogram must be less than 3. * histologic confirmation after core needle biopsy by two independent readers (biopsy must be performed at least two weeks before therapy unless a microbiopsy has been already done less than 3 months before inclusion visit and histopathology slices are available). * the requirements for the distance from the skin and the following regions of the fibroadenoma are: * ≤ 23 mm from the posterior border of the fibroadenoma * ≥ 5 mm from the anterior border of the fibroadenoma * ≥ 11mm from the focal point of the hifu treatment. these criteria shall be evaluated immediately prior to treatment once breast is immobilized and potentially compressed * the rib cage should not be in the prefocal ultrasound path or behind the target fibroadenoma (minimum distance behind the focal point= 10 mm). this criterion shall only be reached in treatment conditions, once breast is immobilized and potentially compressed. * patient's fibroadenoma is 1 cm or greater at its largest dimension * fibroadenoma is palpable * patient has signed a written informed consent. exclusion criteria: * patient who is pregnant or lactating. * patient with a bi-rads score \> 2 at the mammogram, or presence of microcalcifications within the lesion. * patient with history of breast cancer or history * patient with history of laser or radiation therapy to the target breast * patient with breast implants in the target breast * patient with a breast cyst * patient's fibroadenoma not clearly visible on the ultrasound images (in b mode) at the inclusion visit * patient participating in other trials using drugs or devices.
chronic low back pain: a multidisciplinary approach

Conditions: Chronic Pain

Summary: introduction: non-specific chronic low back pain (clbp) is one of the most frequent causes for patient disability and a general recurrent cause for medical consultation with high costs to public health. from rehabilitative medicine, physiotherapy is commonly offered. although this treatment is aimed to reduce disability, pain severity and pain-related anxiety-depressive symptoms, many patients report partial improvement and recurrent intensive and disabling pain episodes. therefore, a new approach in the treatment and rehabilitation of this pathology that takes into account psychosocial aspects that might be modulating pain is necessary. material and methods: this project aims to assess the efficacy of two complementary interventions to standard physical therapy, such as relaxation techniques and cognitive-behavioral intervention, to improve health-related quality of life (hrqol) among patients with clbp. it is hypothesized that groups receiving these complementary interventions will significantly improve their adherence to physiotherapy and the control of their pain and, ultimately, these aspects will facilitate a decreasing of pain intensity and better hrqol. for these purposes, a pre-post longitudinal design will be carried out, with follow-up assessments at 6 and 12 months in a sample of 66 participants. this sample will be divided into: control group (physiotherapy), intervention group 1 (physiotherapy and relaxation techniques-sophrology) and intervention group 2 (physiotherapy and cognitive-behavioral intervention). expected impact: study results are not available yet. however, if working hypotheses are confirmed, a multidisciplinary model of care for clbp will be empirically justified. this approach is expected to benefit hrqol among these patients implying a significant short-mid term reduction of public health costs.


Eligibility criteria:
inclusion criteria: * non-specific chronic (\> 6 months of evolution) low back pain diagnosis * ability to read and speak in spanish exclusion criteria: * addictive behaviors (dast-10 \> 3, alcoholism, drug addiction or other drug abuse) * psychiatric contraindications (bdi \> 15 or other severe psychiatric disorder not stabilized) * neurological impairment * no mental competence (mec \< 23) * fibromyalgia and/or chronic fatigue

Keywords: non-specific chronic low back pain, health-related quality of life, physioterapy, sophrology, cognitive-behavioral therapy, motivational interviewing
cesarean section scar evaluation by saline contrast sonohysterography during hysteroscopy

Conditions: Cesarean Section Scar

Summary: to apply an existing diagnostic imaging test (saline infusion sonohysterography by hysteroscopic) to characterize the "filling defect" of a previous cervical cesarean delivery scar in the nonpregnant uterus


Eligibility criteria:
inclusion criteria: cesarean section diverticula patients in our hospital from 2016 to dec 2018.the diagnosis was confirmed on the basis of medical history (at least one c-section), clinical symptoms (post¬menstrual spotting, no significant change of cycle before and after c-section),transvaginal ultrasonography (tvu), and mag¬netic resonance imaging (mri) findings exclusion criteria: 1) irregular menstrual cycle before cesar¬ean section; 2) previous placement of an intrauterine contracep¬tive device; and 3) presence of another organic uterine pathology responsible for abnormal uterine bleeding examined by hysteroscopy, such as endome-trial hyperplasia, endometrial polyps, malignancy, or submucosal myomas
opioid tapering after spine surgery

Conditions: Opioid Withdrawal; Postoperative Pain

Summary: the effect of a tapering plan combined with telephone counselling to assist patients in opioid tapering after surgery remains unexplored. a prospective, randomized controlled trial investigating the effect of a tapering plan in combination with telephone counselling in patients scheduled for spine surgery on a degenerative basis is therefore conducted.

background with aim: preoperative opioid-use is one of the strongest predictors for not tapering off opioids after discharge from surgery. in qualitative studies on chronic opioid use, patients call for further help and assistance in tapering opioids. the aim of this study is to investigate the effect of receiving a tapering plan at discharge and telephone counselling one week after discharge on short and long-term opioid-use in preoperative opioid-users who undergo scheduled spine surgery. methods: one-hundred and ten adult patients scheduled for spine surgery will be included in an investigator-initiated, prospective, randomized, controlled trial with two arms: an intervention arm (receiving tapering plan at discharge and telephone counselling on opioid tapering 5-7 days after discharge) or a control arm (receiving no tapering plan or telephone counselling). the study is approved by the danish data protection agency (1-16-02-211-19) and the central denmark region committees on health research ethics (1-10-72-138-19). hypothesis: our primary hypothesis is that a tapering plan and telephone counselling reduces the percentage of patients who exceed their preoperative opioid consumption from 25% to 5% one month after discharge.

Eligibility criteria:
inclusion criteria: * daily opioid consumption at least 14 days before surgery * planned degenerative cervical, thoracic or lumbar spine surgery exclusion criteria: * severe physical co-morbidity or inability to participate (dementia, language problems or mental illness)

Keywords: opioid tapering withdrawal symptoms spine surgery patient satisfaction
photodynamic therapy (pdt) oncology registry

Conditions: Lung Cancer; Esophageal

Summary: the data elements for the pdt registry project include virtually all the elements in the standard hospital-based cancer registry record, although in some cases at a finer level of detail. all data points should be found in the participant's medical record. the principal difference between the pdt registry data set and that collected by the registries is the inclusion of more information specific to pdt.

participating centers will need to describe its own mechanism for patient identification and eligibility screening. a data manager, identified by the principal investigator at each participating center, will screen all patients for eligibility. appointment, diagnosis and treatment data will be reviewed using information such as clinic records, appointment lists, pathology department records, or schedule and/or tumor registries. patients meeting inclusion criteria will be enrolled in the 3-year registry which will comprise retrospective and prospective parts. patients will be accrued retrospectively for the first 12-month period of the registry. the retrospective part will include patients who received pdt with photofrin® from 2007 up to 2012. patients who are eligible but die prior to enrollment will also be included to minimize bias resulting from non-inclusion of advanced stage patients. the prospective recruitment parts will be three years. the estimated length of follow-up for each patient will be 3 years. follow-up will be conducted by research study staff at each institution via medical record review, under the direction of the principal investigator at that site. no patients will be contacted at any point to obtain study data or for follow-up.

Eligibility criteria:
inclusion criteria: * 18 years of age or older, male or female, diagnosed with cancer and is undergoing or has undergone photodynamic therapy (pdt). * patients must have undergone pdt with photofrin® at a participating institution. * patients scheduled to undergo pdt with photofrin® * cancer patients receiving some or all primary care (e.g.,cancer-directed surgery, systemic therapy, radiation therapy, palliative care)in the participating institution. * cancer patients with a history of any type of cancer who have been no evidence of disease(for five years but without a history of distant metastases or evidence of relapse if they meet the previous criteria). exclusion criteria: * cancer patients who present to the participating institution with a diagnosis of a simultaneous second primary. * cancer patients receiving all primary cancer care (e.g., cancer-directed surgery, chemotherapy, targeted therapy, radiation therapy, palliative care) outside of participating institution. * patients treated with photosensitizers other than photofrin®

Keywords: pdt photodynamic therapy
treatment of heavy and/or prolonged menstrual bleeding without organic cause

Conditions: Improve Quality of Life; Heavy Menstrual Bleeding

Summary: abnormal uterine bleeding encompasses abnormalities in the regularity, duration of flow, frequency, and/or blood flow volume relative to normal menstruation. of these menstrual abnormalities, heavy menstrual bleeding (hmb), defined objectively as a blood loss of 80 ml or more per menstrual cycle , which is unrelated to pregnancy or known pelvic or systemic disease.


Eligibility criteria:
inclusion criteria: regular menstrual cycles with bmi (19-29 kg/m2). heavy and/or prolonged menstrual bleeding involving at least last three consecutive menstrual cycles. exclusion criteria: 1. postmenopausal bleeding (over one year since the last menstrual period). 2. irregular menses or intermenstrual bleeding. 3. organic causes of heavy menstrual bleeding suspected or confirmed by experienced abdominal and transvaginal ultrasound after thorough general and gynecological examination. 4. iatrogenic (treatment-related) causes of heavy menstrual bleeding (e.g. non-progestogen-releasing intrauterine contraceptive device, oral contraceptives, other hormonal drug use or anticoagulant agent). 5. iron deficiency anemia. 6. history of chronic diseases known to interfere with menstrual bleeding or prevent the use of any of the listed drugs e.g previous or current thromboembolic disease.
chinese and western medicine treatment of fever associated with bleeding symptoms

Conditions: Viral Haemorrhagic Fever; Dengue Fever

Summary: to meet eligibility criteria, this study and informed consent of the syndrome of fever associated with bleeding of infectious diseases, severe patients to carry out multicenter, practical randomized controlled clinical research, to compare the curative effect of western medicine, combining chinese and western medicine treatment, and security, and pathogenesis of tcm and syndrome, severe immune related factor and syndrome type of traditional chinese medicine, chinese medicine prescriptions mechanism research.

randomized method: using large sample, central randomized, parallel comparison of chinese and western medicine and western medicine group.

Eligibility criteria:
inclusion criteria: * viral diseases, such as dengue fever, kidney of hemorrhagic fever, such as xinjiang hemorrhagic fever; or clinical has fever associated with bleeding as the main performance, and confirmed as the new emergent infectious diseases exclusion criteria: * diagnosed with flu, hand, foot and mouth disease, viral hepatitis (except the carrier), liver cirrhosis after hepatitis, aids, rabies, encephalitis, polio, measles, german measles, chickenpox, herpes, infectious mononucleosis, infectious atypical pneumonia
comparison of troponin assay with new poct method in the decision-making pathway of patient with chest pain suspected of acute myocardial ischemia in emergency room (poct)

Conditions: Chest Pain; Myocardial Ischemia

Summary: this is a prospective observational study aiming to evaluate the diagnostic accuracy of the high-sensitivity troponin assay performed with the atellica vtli poct system (by comparison with the results obtained with the atellica diagnostic system currently in use) and to evaluate the impact of the poct system on the reduction of decision-making time (particularly of "rule-out"), by evaluating the number of cases in which the conclusion of the decision pathway at 3 h (algorithm currently in use) could have been concluded at 1 h.

patients accessing the emergency room for chest pain suspected of acute myocardial ischemia, who are asked for troponin determination for the decision pathway, will be asked to participate at the study. a blood draw will be performed (for determination of troponin value, with classical method in use and with poct method) at time: * zero (acess at the emergency room) * 1 h * 3 h

Eligibility criteria:
inclusion criteria: * emergency department access for acute non-traumatic chest pain suspected of myocardial ischemia * sign of informed consent exclusion criteria: * diagnostic electrocardiographic picture for acute coronary syndrome-stemi (acs-stemi) * absence of symptomatology in the 12 hours prior to admission to the emergency room * post-traumatic chest pain

Keywords: chest pain myocardial ischemia poct troponin
exercise rehabilitation for hip-related pain and dysfunction in student circus arts performers

Conditions: Hip Dysplasia; Femoro Acetabular Impingement

Summary: hip injuries are reported to account for 71% and 29% of all injuries reported in female and male performers, respectively, at the national institute of circus arts. there are no reports on hip pathology in circus performers, nor are there any reported exercise interventions for hip pain in circus performers. this study aims to: to assess the effect of an exercise rehabilitation program on patient-reported outcome measures, hip strength and range of movement, and functional assessments in circus arts students with clinically and radiologically diagnosed hip pain-related disorders. participants will undertake a 12-week strength exercise protocol that has been specifically designed to focus on hip rehabilitation appropriate for circus performance. expected outcome: improvements in patient reported outcome measure (prom) scores and an increase in function, strength and hip range of movement in people with hip pain


Eligibility criteria:
inclusion criteria: * 3-month history hip/groin pain +/- symptoms including clicking, giving way, locking, or catching, one or more of a positive * positive fadir pain provocation test * positive heer test (hip extension and external rotation) * positive prone instability test * imaging to support a pathological hip (e.g., cam morphology, hip dysplasia) exclusion criteria: * oa degree \>1 on classification of tönnis * centre edge-angle \<10 degrees * legg-calvé-perthes or epiphysiolysis * history of hip joint surgery or significant hip trauma (fracture +/- dislocation) * neurologic motor deficit (lower limb power, strength or reflex deficit) * hip pain from a lumbar origin (positive passive straight leg raise, combined lumbar extension and rotation) * connective tissue disorder (e.g., ehlers-danlos or marfan syndrome) * pregnancy or breastfeeding.
pericapsular nerve group (peng) block on pain during participant positioning for spinal anesthesia in hip fracture surgery

Conditions: Femur Fracture; Hip Surgery

Summary: hip fracture surgery is a common orthopedic procedure, especially in elderly patients. these fractures are quite common in adults over the age of 65, and the one-year mortality rate ranges from 12% to 37%. recent studies have suggested that general anesthesia and spinal anesthesia are not superior to each other in patients undergoing hip fracture surgery. untreated/poorly managed perioperative pain is directly linked to delirium, poor prognosis, and secondary chronic pain in hip fracture patients. therefore, considering the associated mortality, morbidity, and early recovery, control of perioperative pain should be one of the highest priorities of the anesthesiologist, regardless of the anesthesia method used.

ultrasonography (usg)-guided regional anesthesia techniques are often used as part of multimodal analgesia in the management of perioperative pain in patients with hip fractures. one of the most recently described blocks used in hip fracture surgery, the usg-guided pericapsular nerve group (peng) block, aims to directly block the articular branch of the femoral nerve, the articular branch of the obturator nerve, and the accessory obturator nerve, which selectively innervates the anterior aspect of the hip capsule. case reports and a limited number of clinical studies have reported that peng block is effective in managing acute fracture-related pain, neuraxial anesthesia positioning pain, and postoperative pain in hip fracture patients. in this study, investigators aimed to investigate the effect of usg-guided peng block on positional pain before spinal anesthesia in patients undergoing surgery for hip fractures and to compare this effect with intravenous ketamine. in addition, investigators aimed to investigate the effect of peng block on pain scores, perioperative opioid consumption, time to first analgesic requirement in the postoperative period, and quality of recovery in the first 24 hours after surgery.

Eligibility criteria:
inclusion criteria: hip fracture aged between 35 and 90 years old exclusion criteria: contraindications for spinal anesthesia and peng block impaired cognition or dementia multiple fractures any previous analgesic administration during the last 12 hours

Keywords: peng block regional anesthesia geriatric population