Kornimate/medical-research-clean huggingface dataset:
study of virtual reality therapy and cognitive behavior therapy in panic disorder with agoraphobia

Conditions: Panic Disorder; Agoraphobia

Summary: the study aims at comparing virtual reality therapy (vrt) with a usual cognitive behavior therapy (cbt) program for agoraphobia. a waiting list represents the control condition. the investigators' purpose is to test a pure vrt compared with a pure cbt, as previous works suggest that the combination of the two methods are clinically effective. patients receive a two-page information leaflet about the trial and sign an informed consent. after the first evaluation, they are randomized, in three centers (lyon, paris, luxemburg), either to vrt (12 sessions) or cbt (12 sessions), or a waiting-list control condition for three months. after three months the waiting list is randomized to vrt or cbt. the follow-up is one year from entry into the active part of the trial.


Eligibility criteria:
inclusion criteria: * the study includes 90 patients, aged from 18 to 60, with dsm-4 panic disorder with agoraphobia. * patients should not be clinically depressed and present a hamilton scale of depression score of less than 18. exclusion criteria: * patients with active medication (antidepressants, neuroleptics, mood stabilizers, benzodiazepines, kava kava, or hypericum) or street drugs. minor herbal medicine is tolerated.

Keywords: agoraphobia panic disorder virtual reality therapy cognitive behavior therapy cognition spatial cognition panic disorder with agoraphobia
survey assessing the level of knowledge of postoperative delirium in poland.

Conditions: Postoperative Delirium

Summary: postoperative delirium (pod) is one of the most common complications occurring after surgery with an incidence ranging from 4 to 53%. it may lead to increased postoperative morbidity and mortality, with loss of independence and cognitive dysfunction in certain groups of patients. aiming to reduce the incidence of pod and improve the outcome of patients diagnosed with pod, it is necessary to raise awareness regarding pod. the most important issue are: identification of risk factors, improved monitoring, necessary prevention and adequate treatment. the polish society of anaesthesiology and intensive therapy (ptaiit) has made an attempt to improve the situation in poland by testing the implementation of official pod guidelines published by the european society of anesthesiology in year 2017. while the guidelines provide recommendations for daily practice it is necessary to identify the degree of their implementation in each country. therefore survey has been prepared regarding postoperative delirium in poland. this survey has been submitted to the bioethical committee of the pomeranian medical university in szczecin (poland) and received a waiver due to the non-interventional, observational character of the study (decision no. kb-0012/06/01/2020/z).


Eligibility criteria:
inclusion criteria: * specialists and residents working in the field of anesthesiology and intensive therapy, anesthesiology nurses who respond to an invitation to an on-line survey of the polish society of anesthesiology and intensive therapy (ptaiit) exclusion criteria: * none

Keywords: postoperative delirium pod anesthetics neurocognitive disorders central nervous system confusion neurologic manifestations
individual patient data meta-analysis on prehospital risk assessment in patients suspected of non-st-segment elevation acute coronary syndrome

Conditions: Acute Coronary Syndrome; Non ST Segment Elevation Acute Coronary Syndrome

Summary: patients with a non-st-segment elevation acute coronary syndrome (nste-acs) are currently transported and admitted to the nearest emergency department (ed) for risk stratification, diagnostic workup, and treatment. recently, several prospective studies have been performed on the diagnostic performance of point-of-care (poc)-troponin and combined risk scores (crs) for pre-hospital risk assessment and triage of nste-acs patients. also the first intervention trials on triage decisions based on poc troponin and crs have been performed. initial results are indicating that prehospital triage based on these diagnostic tools is feasible and safe, although sample sizes were relatively small and underpowered to detect differences in major adverse cardiac events (mace). the objective of this individual patient data meta-analysis is to determine the diagnostic performance of poc troponin and combined risk scores for prehospital risk assessment and triage in suspected nste-acs patients.


Eligibility criteria:
inclusion criteria: 1. patients suspected for nste-acs; 2. prospective study 3. original data 4. presenting prehospital (ems) 5. prehospital risk assessment using at least poc-troponin, performed and analyzed by ems. 6. outcome data available on in-hospital acs or mace within 30 days. exclusion criteria: 1. enrolling only a specific subpopulation from the general acs population 2. studies with less than 100 patients 3. studies enrolling only patients with stemi. 4. studies published before 1995 / the pre-troponin era 5. studies performed by general practitioners.

Keywords: ems poc-troponin combined risk scores prehospital
preventive approach using venlafaxine

Conditions: Peripheral Neuropathy Due to Chemotherapy

Summary: peripheral and motor neuropathy represent a main obstacle for a better quality of life for cancer patients, venlafaxine is introduced in a new dosing regimen for treating of oxaliplatin and taxanes induced peripheral neuropathy in cancer patients.

neurologic complications of anticancer therapy may result from direct toxic effects on the nervous system or via indirectly induced metabolic derangements or cerebrovascular disorders. a wide range of neurologic complications can associate antineoplastic drug treatment. among the widely used anticancer drugs are the platinum-based compounds cisplatin and oxaliplatin which are the most commonly associated with various forms of neurotoxicity. moreover, taxanes (paclitaxel) are also associated with neurotoxicity. in a double-blind trial in which 48 patients who treated with oxaliplatin-induced acute neurotoxicity were randomly assigned to venlafaxine (37.5 mg extended release twice daily from day 2 to 11) or placebo, however the 2014 systematic review of neuroprotectants from asco concluded that the venlafaxine data were not strong enough to recommend its use in clinical practice, until additional supporting data become available. patients will be randomly assigned to treatment arms: 1. arm a: to receive venlafaxine hydrochloride 75 mg (effexor x.r) 75mg once daily from day 1 to day 7 to avoid need of dose tapering . 2. arm b: to receive gabapentin 100-400 mg once daily from day 1 to day 7.

Eligibility criteria:
inclusion criteria: * patients \>24 years of age, men or women to lower risk of suicidal tendency. * patients with histologically proven cancer * patients receiving oxaliplatin or taxanes-based regimen * who performance status of 0-2 * serum ast or alt no higher than two times the upper limit of normal * serum creatinine level less than 2 mg/dl * platelet count of at least 100,000/mm3 * absolute neutrophil count of at least to 1.0 g/l * female patients, those with a negative urine pregnancy test. exclusion criteria: * patients with brain or leptomeningeal metastasis. * patients with previous platinum-based chemotherapy * patients with history of alcoholic intoxication, diabetes, preexisting neuropathy or unstable psychological conditions. * patients with history of calcium/magnesium concomitant infusions, use of antiepileptics, antidepressants or lithium.

Keywords: peripheral neuropathy taxanes oxaliplatin chemotherapy venlafaxine
estrogen and microvascular function

Conditions: Estrogen; Cardiovascular Diseases; Microvasculature; Oral Contraceptive Use

Summary: the goal of this study is to learn how long-term use of estrogen affects blood vessels in healthy adults. participants will: * give one blood draw of 5 ml * have one dexa scan taken to measure adipose and muscle mass * have a camera placed under the tongue to take pictures of blood vessels * have 2 laser doppler microdialysis catheters placed on the forearm to monitor blood vessels before and after local drug infusion researchers will compare blood vessel function of those who take estrogen to those who do not.


Eligibility criteria:
inclusion criteria: estrogen/progestin group * adults aged 18-40 years * females with estrogen/progestin treatment for a minimum of 1 year. * blood pressure \<140/ \< 90 mmhg * no more than 1 cardiovascular risk factor control groups * adults aged 18-40 years * female with no estrogen/progestin treatment for minimum of 5 years. * female undergoing progestin only treatment for a minimum of 1 year. * blood pressure \<140/ \< 90 mmhg * no more than 1 cardiovascular risk factor exclusion criteria: * medications that could alter cardiovascular control * rash, skin disease, or pigmentation disorders on both forearms * anemia * kidney disease * known skin allergies * smoking or tobacco use within last 6 months * coronary artery disease -1 cardiovascular risk factor hypertension diabetes hypercholesterolemia hyperlipidemia * bleeding disorders * use of anti-coagulants * allergies to study drugs * use of topical/non-topical steroids in last 6 months * internal mouth sores * forearms covered with tattoos * pregnancy

Keywords: female oral contraceptive
screening for liver fibrosis by using non-invasive methods in patients with diabetes. a prospective study

Conditions: Diabetes

Summary: the aim of this study is to evaluate liver fibrosis using fibroscan and biochemical markers in patients with diabetes.

patients with diabetes are at risk for nonalcoholic fatty liver disease (nafld) leading to advanced fibrosis, cirrhosis, and liver cancer. however, liver fibrosis screening in this large population needs non-invasive methods. recently, fibroscan was shown to be a good method for the diagnosis of advanced fibrosis in nafld patients. we examined the efficacy of a screening strategy with a noninvasive fibrosis biomarker (fibrotest) and transient elastography (fibroscan) in patients with diabetes.

Eligibility criteria:
inclusion criteria: * male or female subjects * more than 18 years of age * patients with diabetes * written informed consent exclusion criteria: * patients refusing to participate to the study and to provide written informed consent

Keywords: liver fibrosis diabetes fibroscan fibrotest noninvasive fibrosis biomarkers
evaluation of a proactive identification and digital mental health intervention approach to address unmet psychosocial needs of individuals living with cancer

Conditions: Depression; Depressive Symptoms; Cancer

Summary: the purpose of this research study is to evaluate a mobile application (app) for depression treatment called "moodivate" among cancer survivors. moodivate was developed by the investigators to assist with the treatment of depressed mood. participants will be randomly assigned to either download the mobile app, "moodivate", or not. approximately 2/3 of participants enrolled will receive the mobile app and the remaining 1/3 will not. all participants will complete electronic questionnaire measures throughout the study period. questionnaires will assess symptoms of depression, as well as the participant's experiences using moodivate and participating in this trial. participation in this study will take about 4 weeks, beginning today. participation in this study may help in the treatment of future cancer survivors. the greatest risks of this study include frustration, worsening of emotional distress, data breach, and/or loss of confidentiality. alternative treatments include the participant contacting their primary care provider or their oncology care team to discuss other available treatments for depressed mood.


Eligibility criteria:
inclusion criteria: 1. elevated depressive symptoms, defined as a score of ≥ 10 on the phq-936 2. illic (as determined during manual chart review) 3. age 18+ 4. currently own an ios- or android-compatible smartphone 5. report willingness to utilize a mobile app for the treatment of depressed mood (response of "yes" on yes/no item) 6. have a valid e-mail address that is checked regularly or have regular access to text messages (to access follow-up assessments) 7. english fluency exclusion criteria: 1. severe cognitive impairment that precludes completion of informed consent 2. current suicidal ideation on the phq-9 at screening or final study eligibility, defined as a response ≥1 (several days) on item nine
phase 1b safety study of xevinapant, weekly cisplatin, and rt in participants with unresected la scchn (hyperlynx)

Conditions: Head and Neck Cancer

Summary: the purpose of this study is to evaluate the tolerability and safety of xevinapant when added to weekly cisplatin-based concurrent chemoradiotherapy (crt) in the treatment of participants with unresectable locally advanced squamous cell carcinoma of the head and neck, suitable for definitive chemoradiotherapy.


Eligibility criteria:
inclusion criteria: * participants having an eastern cooperative oncology group performance score (ecog ps) of 0 - 1 * histologically confirmed diagnosis in previously untreated locally advanced squamous cell carcinoma of head and neck (la scchn) patient (stage iii, iva, or ivb according to the american joint committee on cancer \[ajcc\]/ tumor nodes and metastases (tnm) staging system, 8th edition) suitable for definitive chemoradiotherapy (crt), with one of the following primary sites: oropharynx (opc) human papillomavirus (hpv)-negative, hypopharynx, and larynx * participant should be able to swallow liquids or has an adequately functioning feeding tube, gastrostomy, or jejunostomy in place. for participants requiring liquid nutrition at baseline or during the study including the follow-up period, access to liquid nutrition supply should be ensured * participant with evaluable tumor burden (measurable and/or non-measurable tumor lesions) assessed by ct scan and/or mri, based on recist v 1.1. * adequate hematological, hepatic, and renal function as defined in the protocol * other protocol defined inclusion criteria could apply exclusion criteria: * primary tumor of nasopharyngeal, paranasal sinuses, nasal, or oral cavity, salivary, thyroid, or parathyroid gland pathologies, skin, or unknown primary site * metastatic disease (stage ivc as per ajcc/tnm, 8th edition) * existing need of a hearing aid or greater than or equal to (\>=) 25 decibel shift over 2 contiguous frequencies on a pretreatment hearing test as clinically indicated * known history of infection with human immunodeficiency virus (hiv). if unknown history of hiv, an hiv screening test is to be performed and participants with positive serology for hiv-1/2 must be excluded * known gastrointestinal disorder with clinically established malabsorption syndrome and major gastrointestinal surgery in the last 12 months that may limit oral absorption * other protocol defined exclusion criteria could apply

Keywords: unresected combination with crt stage iii stage iva stage ivb oropharynx hypopharynx larynx
thiamine as a metabolic resuscitator in septic shock

Conditions: Septic Shock

Summary: the major goal of this project is to determine whether the use of thiamine in patients with septic shock will result in attenuation of lactic acidosis and a more rapid reversal of shock.


Eligibility criteria:
inclusion criteria: * greater than 18 years old * suspected or confirmed source of infection * hypotension (systolic pressure \<90 mmhg) after a minimum 2 liter fluid bolus followed by vasopressor-dependence. * lactic acidosis \> 3 mmol/dl exclusion criteria: * competing cause of lactic acidosis including: seizures within 3 hours of enrollment, use of linazolid metformin or anti-retrovirals at the time of enrollment, carbon monoxide or cyanide poisoning, highly suspected or known ischemic bowel, and known mitochondrial disorders * liver dysfunction specifically defined as ast or alt elevation greater than 240 * current thiamine supplements or usage * competing indication for thiamine administration * cardiac arrest * dnr/dni or comfort care status (dnr status in an intubated patient receiving full care is eligible)

Keywords: septic shock sepsis
a mind-body intervention for chemotherapy-induced peripheral neuropathy

Conditions: Chemotherapy-induced Peripheral Neuropathy; Cancer

Summary: this pilot study will include up to 25 patients with cancer experiencing chemotherapy-induced peripheral neuropathy. patients enrolled in the study will participate in a 10-week qigong for chemotherapy-induced neuropathy program. patients will be evaluated before and after their program participation. within 2 weeks before the program start date, patients will be administered an objective neuropathy assessment by a physician or nurse, and will complete questionnaires assessing chemotherapy-induced peripheral neuropathy, perceived cognitive functioning, quality of life, and cancer-related symptoms. patients will repeat these assessments at the end of the last qigong class and will be asked to provide feedback on the qigong program as a whole. self-report questionnaires will also be repeated one week after the last class. total duration of subject participation will be 11-13 weeks. total duration of the study is expected to be approximately 9 months.


Eligibility criteria:
inclusion criteria: * diagnosed with cancer, stage 1-4. * completed taxane- or platinum-based chemotherapy at least three months (90 days) ago but within 24 months of signing consent. current use of anti-estrogen therapy, herceptin, or parp inhibitors is okay. * experiencing at least grade 1 peripheral sensory neuropathy, peripheral motor neuropathy, or dysesthesias based on the national cancer institute common terminology criteria for adverse events version 4 (nci ctcae v4.0). * age ≥ 18 years. * concomitant use of analgesics is permitted if the dose has been stable for at least 2 weeks prior to study enrollment (no new analgesics have been added, discontinued, or changed in the 2 weeks prior to study enrollment). * reasonable functional stability as assessed by the evaluating physician. * must be able to understand and communicate proficiently in english. * written informed consent obtained from subject and ability for subject to comply with the requirements of the study. exclusion criteria: * syphilis, alcoholic neuropathy, diabetic neuropathy, neurological disorders, brain injury, or stroke, as assessed by the treating physician. * medical history of neuropathy from any type of nerve compression (e.g., carpal tunnel or tarsal tunnel syndrome, radiculopathy, spinal stenosis, brachial plexopathy, leptomeningeal carcinomatosis), as assessed by the treating physician. * neuropathy related to abnormal tsh or b12 levels as assessed by treating physician * current severe depression, suicidal ideation, bipolar disease, alcohol abuse, or major eating disorder, as assessed by the treating physician. * severe personality disorder or psychiatric disorder that would interfere with participation in a qigong program, as assessed by the evaluating physician. * currently participating in another qigong or tai chi program.

Keywords: qi gong
role of intravenous versus home oral antibiotics in perforated appendicitis

Conditions: Perforated Appendicitis

Summary: to compare the effect of a single-agent home intravenous (iv) versus oral antibiotic therapy on complication rates and resource utilization following appendectomy for perforated appendicitis

appendicitis is the most common cause of abdominal pain requiring emergent surgical intervention in children and approximately one third of patients present with perforation. perforated appendicitis has been demonstrated to have a significant impact on patients and families due to the prolonged hospitalization, high complication rates, and tremendous economic burden from treatment. the most significant complication following operative treatment of perforated appendicitis is intra-abdominal abscess, which develops in approximately 20% of children following appendectomy in recent literature. due to this frequent and morbid complication, continued research has been driven at determining the most efficacious and cost-effective postoperative antibiotic treatment regimen to reduce post-operative abscess. as postoperative abscess rates following appendectomy for perforated appendicitis remain high, the primary aim of this study was to evaluate a new postoperative antibiotic treatment regimen based on single daily dosing ertapenem while inpatient with randomization into ten day completion course of home antibiotics with iv ertapenem versus oral amoxicillin/clavulanate. the hypothesis is that the ertapenem based regimen will offer reduced rates of postoperative abscess, with no major difference between completion courses of home iv versus oral antibiotics.

Eligibility criteria:
inclusion criteria: * patients 4-17 years of age with perforated acute appendicitis diagnosed at time of appendectomy. exclusion criteria: * patients with a known severe allergy to penicillin (anaphylaxis), prior severe side effects from ertapenem or amoxicillin-clavulanate, pregnancy, or previous drainage procedure for abscess and/or fluid collection related to appendicitis.

Keywords: appendectomy
natural history study of homocystinuria caused by cystathionine beta-synthase deficiency (acappella)

Conditions: Homocystinuria Due to CBS Deficiency

Summary: the purpose of the study is to characterize the clinical course of homocystinuria in pediatric and adult patients aged 1 to 65 years under current clinical management practices


Eligibility criteria:
inclusion criteria: * patients who are clinically diagnosed with homocystinuria * male/female patients aged 1 to 65 years * patients who consented and/or assented * patients who are willing and able to comply with all study-related procedures. exclusion criteria: * medically significant postnatal complications or congenital anomalies that are not associated with homocystinuria * received any experimental therapy for homocystinuria during the 6 months prior to enrollment or expected to receive any such therapy during duration of the study