Kornimate/medical-research-clean huggingface dataset:
comparison of standard versus high dose urokinase for dysfunctional tunneled dialysis catheters in haemodialysis patients: a randomized controlled trial

Conditions: Hemodialysis; Thrombolytic Therapy; Dialysis Access Dysfunction; Randomised Controlled Trial; End Stage Renal Disease (ESRD)

Summary: tunneled dialysis catheters (tdcs) remain a frequent form of vascular access for patients undergoing long-term haemodialysis (hd). in our local setting, thrombolytic therapy with urokinase is used as first line therapy to restore catheter patency in patients who develop tdc dysfunction before considering a tdc exchange which is more invasive, requires hospital admission, and involves a higher cost. there are no published local data on the efficacy of urokinase, though this is widely used in local practice as first line in the management of tdc dysfunction. previous studies have also varied in terms of study methodology, dose and administration of urokinase in the form of systemic infusion or catheter lock therapy, with varying success rates of 78-97% (2,4-8). overall, majority of these studies utilized higher doses of urokinase - some studies reported higher patency rates with high dose systemic infusion (4,5) or higher success rates when a higher dose was compared to a lower dose of urokinase lock (6-8). bleeding events were very rare even in studies that use much higher doses or systemic infusion of urokinase (2,4-8). our own preliminary data show lower lower success rates of around 52.5% compared to published reports, the question remains on how we can improve our patency rate and cost-effectiveness in treating tdc dysfunction without an increase in risk of adverse events. therefore, we aim to answer the question as to whether an increase in dose of urokinase will achieve the above outcomes and result in a reduced need for tdc exchange.


Eligibility criteria:
inclusion criteria: all hd patients aged 21 or above with tdc dysfunction and able to provide informed consent and do not meet any exclusion criteria are eligible for enrolment in the study. catheters eligible for the study include: (i) incident catheters that have never received urokinase; including newly inserted catheters for previously enrolled patients are allowed. (ii) prevalent catheters that have not received urokinase for the last 6 months exclusion criteria: * patients with tdc non-function, defined as no inflow and outflow from both arterial and venous ports upon catheter testing. * patients with contraindications to urokinase including active internal bleeding; recent cerebrovascular accident (\< 2 months); recent intracranial or intraspinal surgery (\< 2 months); intracranial neoplasm, aneurysm or arteriovenous malformation; recent trauma, including cardiopulmonary resuscitation; recent gastrointestinal bleeding (\<2 months); known bleeding diathesis; severe uncontrolled hypertension; known hypersensitivity to urokinase or any ingredient present in its formulation. * pregnancy. * tunneled dialysis catheter-related blood stream infection

Keywords: urokinase
a study of clinical outcomes in chronic lymphocytic leukemia (cll) patients treated with venetoclax in greece

Conditions: Chronic Lymphocytic Leukemia

Summary: this study is being done to evaluate the clinical outcomes of chronic lymphocytic leukemia (cll) participants treated with venetoclax as routine standard of care in greece. the decision to treat with venetoclax is made by the participant's physician prior to being offered enrollment in this study. the objectives of this study include determining overall response rate, assessing safety information, analyzing patient profiles and disease characteristics and participant quality of life.


Eligibility criteria:
inclusion criteria: * confirmed diagnosis of chronic lymphocytic leukemia (cll) according to the international workshop on chronic lymphocytic leukemia (iwcll) criteria * eligible to receive venetoclax as per local label * physician has decided to initiate cll treatment with venetoclax and the decision to treat is made by the physician in accordance with the local label prior to any decision to approach the participant about the study * participant has been fully informed verbally and in writing about the study and does not object to their data being processed or subjected to data quality control exclusion criteria: * prescribed or treated with venetoclax outside of marketing authorization * currently participating in, or previously participated within 30 days prior to venetoclax start, in any other interventional clinical trial

Keywords: chronic lymphocytic leukemia venetoclax relapsed/refractory
a prospective clinical study to explore response to prone positioning in ards patients

Conditions: Covid19; ARDS

Summary: the proposed study will be conducted to investigate the mechanism of patients' responses to prone positioning with coronavirus disease 2019 (covid-19) acute respiratory distress syndrome (ards) and non-covid-19 ards utilizing lung ultrasound.

this is a prospective observational study of adult patients with coronavirus disease 2019 (covid-19) acute respiratory distress syndrome (ards) and non-covid-19 ards who are intubated, in the prone position and receiving mechanical ventilation in the intensive care units at rush university medical center. in this study design, we will prospectively enroll subjects, who fulfill eligibility criteria, to investigate the mechanism of their responses to the first three prone positioning sessions, utilizing lung ultrasound (lus). inclusion criteria include: adult subjects 18 years and older with a diagnosis of ards, endotracheally intubated and receiving assisted mechanical ventilation, meet criteria for prone positioning (ratio of arterial oxygen tension to the fraction of inspired oxygen (pao2/fio2) of ≤ 150 mm hg with ventilator parameters of positive end-expiratory pressure (peep) ≥ 10 cm h2o and fio2 of .60, and order for prone positioning. patients will be excluded from the study if they meet the following criteria: pregnant, tracheostomy, receiving extracorporeal membrane oxygenation (ecmo), palliative care, received prone positioning more than once during intubation in an outside hospital, or receive invasive ventilation in an outside hospital for more than 72 hours. enrolled subjects will undergo lus 1 hour before and 1 hour after prone positioning by a trained clinician and will be assessed using a lus score based on lus pattern. lus will then be performed again 1 hour before supination (16 hours) and assessed by a lus score. this process will be repeated on the first 3 prone sessions. patients will be enrolled in the study for 4 weeks in order to observe patient outcomes.

Eligibility criteria:
inclusion criteria: 1. adult subjects 18 years and older, diagnosis of ards 2. endotracheally intubated and receiving assisted mechanical ventilation 3. meet criteria for prone positioning: pao2/fio2 (p/f ratio) of ≤ 150 mm hg with ventilator parameters of peep ≥ 10 cm h2o and fio2 of .60 4. receive an order for prone positioning. exclusion criteria: 1. pregnant 2. tracheostomy 3. receiving ecmo 4. palliative care 5. receive prone positioning more than once during intubation in an outside hospital 6. receive invasive ventilation in an outside hospital for more than 72 hours

Keywords: prone positioning lung ultrasound
evaluating the impact of chronic rhinosinusitis on the health-related quality of life among adults with cystic fibrosis

Conditions: Cystic Fibrosis

Summary: individuals with cystic fibrosis (cf) have a defective protein, which is known as the cystic-fibrosis transmembrane regulator (cftr). the cftr transports salt and hydrates mucous. cftr defects may result in the accumulation of thick mucous in the sinus cavities. as a result, the tiny hair-like structures that sweep mucous out of the sinuses cannot function properly, which can lead to recurrent infection and swelling of the sinus walls. when symptoms are persistent for more than 12 weeks, this is known as chronic rhinosinusitis (crs). the symptoms that are associated with crs are nasal discharge, congestion, facial pain or pressure and reduced sense of smell. crs in non-cf patients affects a large number of individuals in canada and has been found to be associated with poor quality of life. in the cf population the life expectancy is increasing but chronic disease like crs is becoming increasingly prevalent. investigators currently do not know the impact that crs has on the health-related quality of life in adults with cf and how many suffer from symptoms. the investigators aim to determine the impact of crs among adults with cf, in order to gain a better understanding of chronic disease among these individuals. the investigators strongly feel this research will improve the referral processes between respirologists and otolaryngologists, thereby improving treatment and quality of life for patients.


Eligibility criteria:
inclusion criteria: * 19 years of age or older * definitive diagnosis of cystic fibrosis from positive genetic or sweat chloride test * currently enrolled at the st. paul's cystic fibrosis clinic exclusion criteria: * individuals unable to understand the purpose, methods and conduct of this study. * patients unwilling to provide informed consent.
efficacy evaluation of the (serodase 5 mg tablet) in the treatment of inflammation after third molar surgery

Conditions: Trismus; Swelling; Inflammation

Summary: the purpose of this study is to examine the efficacy of dose regimen of serratiopeptidase (serodase 5 mg) as a prospective, randomized, parallel, double blind placebo- controlled study.

a prospective, randomized, parallel, double blind placebo- controlled study to examine the efficacy of dose regimen of serratiopeptidase (serodase 5 mg) on 112 males and females volunteers in the treatment of inflammation after third molar surgery, comparing drug treatment vs placebo over a period of 20 weeks to assess the dose effectiveness of the dose regimen of serodase 5 mg; the primary outcomes are trismus and swelling while inflammation is a secondary outcome.the expected duration of participants participation will be around 5 days divided into 4 visits, the time point of the measurment are (0,2,4 and 5 days). the results are expected to assess the improvement of the maximal interincisal distance, reduction of swelling and improvment in the sensation of post-operative pain.

Eligibility criteria:
inclusion criteria: * participants presented with impacted lower wisdom tooth needs buccaneers flap with buccal and distal bone removal. * male or female 18-50 * participant is willing and able to give informed consent for paricipation in the study. * able and willing and able with all study requirments. exclusion criteria: * other oral surgical procedures during the same session except the removal of supernumerary third molars. * female subject who is pregnant or lactating * subjects has participated in any clinical research study within the previous 8 weeks. * subjects on anti coagulant drugs . * unwilling participants to continue the study and those with abnormality of wound healing process.
combined effects of buteyko breathing technique and chest wall mobilization on pulmonary functions and quality of life

Conditions: Chronic Smokers

Summary: the study aims to evaluate the effects of buteyko breathing techniques with and without chest wall mobilization on pulmonary functions, and quality of life in chronic smokers. the study design will be a randomized clinical trial. the study will be completed in 10 months after the approval of the synopsis from the ethical committee of rcrs \& ahs. a non-probability convenient sampling technique will be used to recruit the individuals. group 1-buteyko breathing technique + chest wall mobilization and group 2-buteyko breathing technique + without chest wall mobilization

this randomized clinical trial will evaluate the combined effect of the buteyko breathing technique and chest wall mobilization on pulmonary functions and quality of life in chronic smokers. a sample size of 40 is calculated through a non-probability convenient sampling technique. participants will be recruited into group 1 and group 2 by lottery method (without replacement). group 1 will be engaged in the buteyko breathing technique + chest wall mobilization and group 2 will undergo buteyko breathing technique + without chest wall mobilization. pre and post-outcome measures of pulmonary functions will be measured through a digital spirometer and quality of life will be assessed by the st george quality of life questionnaire. spirometry assesses the amount and speed of air that can be inhaled and exhaled. key measurements include forced vital capacity (fvc): the maximum volume of air forcefully exhaled after a full inhalation. forced expiratory volume in 1 second (fev1): the volume of air exhaled in the first second of the fvc test, indicates how quickly the lungs can be emptied. st saint georg quality of life questionnaire for assessing the qol. the sgrq is a standardized self-administered airway disease-specific questionnaire divided into 2 subscales, a total of 12 questions. for each subscale and the overall questionnaire, scores range from zero (no impairment) to 100 (maximum impairment).

Eligibility criteria:
inclusion criteria: * both male and female participants were included * the age of participants was 40 -55 years. * individuals who fulfilled the criteria of smoking which is calculated by multiplying the number of packs smoked per day by the number of years smoked were included. * individuals who are current smokers or history of long-term smoking were included. * predicted values fev1 \< 75% and fev1/fvc \<70% exclusion criteria: * participants with neurological disorders were excluded * participants with musculoskeletal disorders were excluded as it affects the physical activity of the 6-minute walk test. * participants having any pulmonary complications or lung disease were excluded. * participants previously involved in any other exercise or physical activity were excluded.

Keywords: buteyko breathing technique, chest wall mobilization
comparison of the physical activity in cancer patients assessed by questionnaire and motion tracker

Conditions: Lymphoma; Pancreas Cancer; Colorectal Cancer

Summary: physical activity is an important aspect of cancer therapy but correct measurement of physical activity is difficult. in this study, the physical activity of patients undergoing cancer therapy is assessed by questionnaire and by motion tracker. the results are then compared to answer whether there are differences between the two measurements. findings of this study will help to improve the assessment of physical activity in cancer patients.

although physical activity has been identified as a relevant determinant of cancer therapy outcome, its valid assessment remains challenging. in principle, direct and indirect assessment instruments can be employed for assessment of physical activity. while direct instruments, e.g. accelerometers, are considered to provide a more objective measurement, indirect tools such as questionnaires are less expensive and more applicable for use in larger study populations. the validity of both forms of measurements in cancer patients is however not well studied. therefore, this study aims to elucidate the relative validity of an accelerometer in comparison to a standardized physical questionnaire at different time points of cancer therapy. findings of this study will allow conclusions regarding the ideal modalities for assessment of physical activity in cancer patients.

Eligibility criteria:
inclusion criteria: * verified diagnosis of lymphoma, colorectal or pancreatic cancer * requirement of surgical, chemo or radio therapy * provision of informed consent exclusion criteria: * pregnancy * inability to provide consent * use of a rollator

Keywords: physical activity accelerometer international physical activity questionnaire cancer therapy geneactiv quality of life fatigue
efficacy and safety of dupilumab in patients with bullous pemphigoid

Conditions: Bullous Pemphigoid

Summary: this study was designed to be a retrospective, multicentre, observational study to evaluate the efficacy and safety of dupilumab in the treatment of bullous pemphigoid and to find predictors of efficacy.


Eligibility criteria:
inclusion criteria: * adult bullous pemphigoid patients treated with dupilumab between january 1, 2021, and july 31, 2022, at six leading dermatology departments in the chinese collaborative network for autoimmune bullous diseases. * the diagnosis of bp requires clinical manifestations and immunological or pathological evidences. * dupilumab treatment should continue for at least 4 weeks and possibly longer. exclusion criteria: * drug-induced bp, γ-1 pemphigoid * patients with less than 4 weeks of follow-up * patients were given any other biologicals within 6 months before the first dupilumab administration
a trial comparing ferumoxytol to iron sucrose for the treatment of iron deficiency anemia in adult subjects with chronic kidney disease

Conditions: Iron Deficiency; Anemia; Kidney Disease

Summary: the purpose of the study is to evaluate the safety and efficacy of intravenous (iv) ferumoxytol compared to iv iron sucrose for the treatment of iron deficiency anemia (ida) in participants with chronic kidney disease (ckd).


Eligibility criteria:
inclusion criteria: key inclusion criteria include: 1. males and females ≥18 years of age 2. an estimated glomerular filtration rate \<60 ml/minute or a diagnosis of ckd (such as nephropathy, nephritis) 3. hemoglobin \<11.0 g/deciliter (dl) 4. transferrin saturation \<30% 5. hemodialysis participants on maintenance dialysis for at least 3 months prior to screening and currently receiving dialysis 3 times per week 6. female participants of childbearing potential who are sexually active must be on an effective method of birth control for at least 1 month prior to screening and agree to remain on birth control until completion of the study exclusion criteria: key exclusion criteria include: 1. history of allergy to iv iron 2. allergy to 2 or more classes of drugs 3. female participants who are pregnant or intend to become pregnant, breastfeeding, within 3 months postpartum, or have a positive serum or urine pregnancy test 4. hemoglobin ≤7.0 g/dl 5. received another investigational agent within 4 weeks prior to screening, or planned receipt of an unspecified investigational agent during the study period 6. known causes of anemia other than iron deficiency (such as hemolysis and vitamin b12 or folate deficiency)

Keywords: iron deficiency anemia chronic kidney disease feraheme ferumoxytol iron sucrose ida ckd venofer
inpatient single dose interventions for alcohol use disorder

Conditions: Alcohol Use Disorder, Severe

Summary: every year, alcohol use disorder (aud) generates millions of emergency department (ed) visits and hospital admissions, costing the u.s. health sector over $90 billion. these hospital admissions are critical opportunities to start patients on addiction pharmacotherapy, but factors like medication non-adherence and post-discharge relapse contribute to frequent re-admissions. two single-dose interventions are well suited to facilitate treatment retention and prevent re-admissions due to their prolonged, adherence-independent effects: extended-release (xr) naltrexone injection and intravenous (iv) ketamine infusion. these have not been thoroughly investigated in the hospital setting among high-utilizer, safety-net populations. therefore, the investigators aim to: 1. test the feasibility of randomizing hospitalized patients (n=45-60, age 18-65) with multiple aud-related admissions to treatment with either extended-release (xr) naltrexone, intravenous (iv) ketamine, or no single-dose medication, all with enhanced linkage to care. feasibility outcomes such as recruitment rate, patient acceptability, post-discharge follow-up rate, and adverse events will help to identify key lessons for a future comparative effectiveness study. 2. estimate the 30-day re-admission rate for patients randomized to treatment with xr naltrexone, with iv ketamine, or no single-dose medication, all with enhanced linkage to care. the investigators hypothesize that the re-admission rate will be lower for each of the two single-dose medication groups than for the "linkage-alone" group.


Eligibility criteria:
inclusion criteria: * age 18-65 * 1+ alcohol-related\* admission(s) or emergency department visit(s) in past 12 mo. * has insurance (public or private) * seen by inpatient addiction consult service exclusion criteria: * known or suspected active covid-19 infection * hepatic: ast/alt \>5x upper-limit of normal, decompensated liver failure * renal: glomerular filtration rate \<30ml/min * cardiovascular: history of acute coronary syndrome, cerebrovascular event, hypertensive crisis, known cardiomyopathy * known elevated intracranial pressure * thrombocytopenia (\<50/microliter) * active moderate/severe withdrawal (based on hospital withdrawal protocol) * active delirium (alcohol-related or otherwise) * already enrolled in study * xr naltrexone or iv ketamine in last 30 days * known intolerance to naltrexone or ketamine * other active severe substance use disorder (tobacco, cannabis excluded) * pregnant or breast-feeding, or planning. * opioids: chronic, recent (\<24h), or anticipated * unstable psychiatric illness (active psychosis, active suicidality) * moving from region within 30-days of discharge * discharge to acute/residential treatment * involuntary hold
an observational study of iga nephropathy: pathological variants and clinical data

Conditions: IgA Nephropathy

Summary: the pathological variants of iga nephropathy identified by the oxford classification may be related to the clinical data at presentation and follow-up, including proteinuria and renal function. this study is aimed to identify the potential relationship between pathological variants and clinical data in iga nephropathy.


Eligibility criteria:
inclusion criteria: * biopsy-proven iga nephropathy; exclusion criteria:

Keywords: iga nephropathy
determines of quality of life in patients

Conditions: Chronic Neck Pain

Summary: pain, muscle spasm, loss of muscle strength and impaired posture adversely affect the daily life activities and quality of life of neck pain patients.however, the quality of life; it is a multifaceted concept that includes not only the age, sex, marital status, educational status and duration of pain, but also the number of children, bmi, depression, sleep quality, pain-related inadequacy and fatigue. therefore, considering all these; quality of life; the aim of our study was to determine the factors affecting the quality of life in nonspesific neck patients with the effect that the determinants affecting physical, physical role difficulty, pain, general health, vitality, social function, emotional role difficulty and mental health may be different.

the study will include 93 people with a diagnosis neck disease who apply to the physical therapy outpatient clinic. after recorded sociodemographic and clinical characteristics of the individuals, some evaluations will be done only once. the evaluations to be used in the study are as follows: pain assesment will be evaluated with mcgill pain questionnaire, sleep disorders will be evaluated with pitsburgh sleep quality index (psqi), fatigue level will be assessed by the fatigue questionnaire, beck depression inventory (bdi) will be used to determine depression levels. the quality of life of the subjects wiil be evaluate by using the short form-36 questionnaire.

Eligibility criteria:
inclusion criteria: 1) people 18 years and older exclusion criteria: 1. hospitalized people 2. newly operated people 3. people with psychological diagnosis

Keywords: chronic neckpain