Kornimate/medical-research-clean huggingface dataset:
the prognostic role and diagnostic efficacy of exercise right heart catheterization with a simultaneous echocardiography in patients with dyspnea on exertion

Conditions: Heart Failure With Preserved Ejection Fraction; Chronic Pulmonary Thromboembolism (Disorder)

Summary: to evaluate the role of exercise hemodynamic testing in the diagnostic workup for patients with dyspnea on exertion referred to the catheterization lab.

heart failure with preserved ejection fraction (hfpef) is a major public health problem that has no proven effective treatment. however, in practice, it's difficult to recognize early stage of hfpef by resting hemodynamic study and echocardiography because the patients mainly complaint of dyspnea only during exercise but not resting condition. accordingly, exercise stress test will be helpful to provide more information on pathophysiology, diagnosis, and severity in various cardiovascular diseases such as hfpef, valvular heart disease, and chronic thromboembolic pulmonary hypertension. thus, the broad objective of this proposal is to characterize the dynamic changes in cardiopulmonary mechanics during stress in patients with exertional dyspnea, establishing a comprehensive multimodality diagnostic approach to the evaluation of exercise intolerance. specifically, this study will compare established and novel parameters derived from echocardiography and cpx with simultaneous, gold standard invasive measures of cardiovascular hemodynamics at rest and with exercise stress to define the role of noninvasive testing in the diagnostic workup for patients with dyspnea on exertion referred to the catheterization lab.

Eligibility criteria:
inclusion criteria: * subject must be at least 19 years of age. * patients with dyspnea on exertion * written informed consent of participating subjects after being fully briefed (for prospective analysis) exclusion criteria: * patients with incomplete hemodynamic data at rest or exercise * advanced tumor disease or other diseases with a short life expectancy * uncontrolled systemic arterial hypertension ( \> 160/100 mmhg at rest) * fev1\<50% predicted * tlc\<60% predicted

Keywords: exercise hemodynamic test heart failure with preserved ejection fraction cardiac catheterization
pain coping skills for colorectal cancer survivors

Conditions: Colorectal Cancer

Summary: colorectal cancer survivors experience long-term negative physical and psychosocial consequences of their disease. there is a critical need to develop novel behavioral interventions for improving colorectal cancer survivor outcomes. the investigators have developed a pain management intervention for colorectal cancer survivors that focuses on addressing both pain and psychological distress. colorectal cancer survivors who endorse pain and comorbid psychological distress as a concern during a clinic-based survivorship care consult will be recruited. participants will be randomized into either: telephone-based coping skills training (cst) for pain and comorbid psychological distress or standard care. the cst condition will receive 5 sessions of a cognitive behavior theory-based protocol that teaches coping skills (e.g., relaxation, activity pacing/planning, cognitive restructuring) relevant to managing pain and psychological distress. the standard care control condition will receive resources and referrals related to managing survivorship health.


Eligibility criteria:
inclusion criteria: * \>21 years old * personal history of colorectal cancer * finished active cancer treatment within the past 12 months * reported pain as a concern as well as psychological distress on a national comprehensive cancer network screener * able to speak and read english * able and willing to give informed consent exclusion criteria: * currently undergoing active cancer treatment * have a major mental illness (e.g., schizophrenia) * have a mental illness that is not being treated/controlled (e.g., bipolar disorder)

Keywords: colorectal cancer survivor cancer pain psychological distress coping skills training symptom management cancer survivorship
the impact of nursing delirium preventive interventions in the intensive care unit

Conditions: Delirium

Summary: delirium is a common disorder in intensive care unit (icu) patients and is associated with serious short- and long-term consequences. this study focuses on a program of standardized nursing and physical therapy interventions to prevent delirium in the icu, and determines the effect of the program on the number of delirium-coma-free days in 28 days and several secondary outcomes in a multicenter randomized controlled trial.

delirium is a common disorder in intensive care unit (icu) patients and is associated with serious short- and long-term consequences, including re-intubations, icu readmissions, prolonged icu and hospital stay, persistent cognitive problems, and higher mortality rates. considering the high incidence of delirium and its consequences, prevention of delirium is imperative. this study focuses on a program of standardized nursing and physical therapy interventions to prevent delirium in the icu, called underpin-icu (nursing delirium preventive interventions in the icu). objective: to determine the effect of the underpin-icu program on the number of delirium-coma-free days in 28 days and several secondary outcomes, such as delirium incidence, the number of days of survival in 28 and 90 days and delirium-related outcomes. design and setting: a multicenter stepped wedge cluster randomized controlled trial. methods: eight to ten dutch icus will implement the underpin-icu program in a randomized order. every two months the underpin-icu program will be implemented in an additional icu following a two months period of staff training. underpin-icu consists of standardized protocols focusing on several modifiable risk factors for delirium, including cognitive impairment, sleep deprivation, immobility and visual and hearing impairment. participants: icu patients aged ≥ 18 years (surgical, medical, or trauma) and at high risk for delirium, e-pre-deliric ≥35%, will be included, unless delirium was detected prior icu admission, expected length of icu stay is less then one day or when delirium assessment is not possible.

Eligibility criteria:
inclusion criteria: * aged ≥ 18 years * surgical, medical or trauma patients * admitted to one of the participating icus * at high risk for delirium (\>35% determined with the e-pre-deliric prediction tool) exclusion criteria: * delirious before icu admission * an icu stay \< one day * reliable assessment for delirium is not possible due to: sustained coma; serious auditory or visual disorders; inability to understand dutch; severely mentally disabled; serious receptive aphasia.

Keywords: prevention critical care delirium nurse rct
acute impact of cardiac resynchronization on vascular function (rva-crt)

Conditions: Heart Failure

Summary: evaluation of the effect of short term activation/deactivation of biventricular pacing (bivp) of the crt (during routine crt interrogation) on vascular function as assessed via retinal vessel analysis (rva), in patients treated with crt.

heart failure is a condition in which the heart becomes unable to maintain the body's need of blood supply. congestive heart failure can be considered a syndrome but the final common path of many cardiovascular diseases. recently, the investigators of this study confirmed an increased impairment in retinal microvascular function in patients with ischemic heart failure compared to patients with stable coronary disease. if medication fails to improve ejection fraction, cardiac resynchronization therapy (crt) is the guideline-recommended treatment for patients with advanced heart failure and bundle branch block. the question remains if crt changes purely hemodynamics by synchronizing the heart or has potential impact on the microvasculature to cause reverse remodeling of the failing heart. measuring retinal vascular function might increase knowledge on the effects of cardiac resynchronization therapy.

Eligibility criteria:
inclusion criteria: * informed consent as documented by signature * patients ≥ 18 years of age, male or female, diagnosed with advanced heart failure * implanted as well as activated crt device for at least 3 months prior to visit 1 exclusion criteria: * current acute decompensated hf * documented pacing dependency * documented av-block ii (mobitz typ 2) or iii in patient's history * history of hypersensitivity or allergy to tropicamide * acute coronary syndrome, stroke, transient ischemic attack, cardiac, carotid or other major cardiovascular (cv) surgery, percutaneous coronary intervention (pci) or carotid angioplasty within 3 months prior to visit 1. * history of heart transplant, on a transplant list or with ventricular assistance device (vad). * presence of any other disease with a life expectancy of \< 6 months * presence of significant endocrine diseases, including primary hyperparathyroidism, cushing's disease, adrenal insufficiency, pituitary tumors, primary hyperaldosteronism, manifest hyperthyroidism or genetic endocrine disorders * presence of active acute infectious diseases. * inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc * women who are pregnant or breast feeding * known narrow-angle glaucoma * known epilepsy (flicker-light could trigger a seizure)
14y prospective study on posterior zirconia-based 3-unit fdps

Conditions: Prosthesis Survival

Summary: the main objective of the present prospective study is to evaluate the effectiveness of posterior zirconia fdps after 14 years of function.

thirty-seven patients needing to replace either premolars or molars were involved and 48 3-unit zirconia-based fdps were fabricated. patients included in the present clinical study met specific inclusion criteria and clinical procedures were standardized. frameworks with a 9 mm2 cross section of the connectors and 0.6 mm minimum thickness of the retainers were made by means of computer aided design/computer assisted manufacturing. a resin cement was used to lute the restorations. the patients were recalled after 6 and 12 months and then yearly up to a total follow-up of 14 years. the united states public health service criteria were used in order to examine technical and esthetic outcomes. success and survival rates

Eligibility criteria:
inclusion criteria: * good general health; * asa i or asa ii according to the american society of anesthesiologists; * good periodontal health; * angle class i occlusal relationship; * minimum of 20 teeth; * good oral hygiene; * no evident signs of occlusal parafunctions and/or temporo-mandibular disorders. moreover, the abutment teeth had to fulfill the following inclusion criteria: * periodontal health (absence of tooth mobility, absence of furcation involvement); * proper positioning in the dental arch (tooth axes adequate for a fdp); * sufficient occlusal-cervical height of the clinical crown (≥4 mm) for the retention of a fdp; * vital or endodontically treated to a clinically sound state; * opposing natural teeth or fixed prostheses. exclusion criteria:- subjects preferring implant-supported prostheses; * high caries activity; * occlusal-gingival height of the abutment teeth \<4 mm; * reduced interocclusal distance or supraerupted opposing teeth; * unfavorable crown-to-root ratio; * severe wear facets, clenching, bruxism; * presence of removable partial dentures; * pregnancy or lactation.

Keywords: zirconia all ceramic prosthesis prosthodontics fixed dental prosthesis prosthetic dentistry prospective clinical study
comparison of peng associated with lfcn block versus ficb for multimodal analgesic management in tha

Conditions: Regional Anesthesia Morbidity; Arthropathy of Hip; Hip Arthropathy; Post Operative Pain; Anesthesia Complication

Summary: optimal pain control with limited muscle weakness is paramount for a swift initiation of physical therapy and ambulation. fascia iliaca compartment block (fic) has been recommended since it offers the best pain control with low risk of motor block. pericapsular nerve group block (peng) with lateral femoral cutaneous block (lfcn) has been proposed as an effective alternative to fib that offers similar pain control with a considerably lower risk of motor block. the aim of this study is to compare the afore mentioned blocks and determine which one yielded the least degree of quadriceps femoris muscle weakness and the better pain control (the lowest nrs score with least need for opioids).

this single-center, double blinded rct investigation will be conducted at asst nord milano - bassini hospital. the study was approved by the ethics committee "comitato etico territoriale lombardia 3". each patient undergoing elective total hip replacement surgery with anterior approach will be subjected (unless contraindicated) to subarachnoid neuraxial anesthesia and immediately afterwards to a peripheral analgesic block: the fic block or the association of peng and fcln block. the choice of block type will be randomized. at the end of the procedure, a clinician unaware of the anesthetic technique used will assess the degree of residual motor block. simultaneously, he will assess pain control in terms of nrs (numerical rating scale) and the need for opioid use.

Eligibility criteria:
inclusion criteria: * elective total hip replacement surgery for non-traumatic hip disease, * tha (total hip arthroplasty) with lateral approach * age \>18 years, * signed consent form for spinal anesthesia and peripheral nerve block provided by the patient or legal guardian if appointed exclusion criteria: * non elective tha * lack of consent to the procedure * contraindications to performing neuraxial anesthesia (i.e. signs suggestive of puncture site infection, inr \> 1.5, aptt \> 1.5, plt \< 40.000) * documented or suspected allergy to local anesthetics

Keywords: eras postoperative muscle weakness regional block post operative analgesia
covid-19 and disease progression to the severe form: a study on the use of monoclonal antibodies against sars-cov-2

Conditions: COVID-19

Summary: this is a national multicentre observational study with retrospective and prospective data collection to assess the time to hospitalisation of patients with a confirmed diagnosis of sars-cov-2 infection receiving treatment with anti-sars-cov-2 monoclonal antibodies. the subjects enrolled will be patients with early infection of sars-cov-2, paucisymptomatic, with risk factors for evolution to the severe form (according to aifa criteria). also, hospitalised subjects will be enrolled to receive sars-cov-2 monoclonal antibodies because of negative serology (according to aifa criteria). it is estimated to enrol about 1000 subjects. patients will be evaluated at enrollment and 28 days following administration to collect data on symptoms, possible hospitalization and final clinical outcome (alive with symptoms, alive without symptoms, alive with symptoms and hospitalized or deceased). data will be collected using a dedicated electronic case report form (ecrf).


Eligibility criteria:
inclusion criteria: * \>/= 18 years * confirmed diagnosis of sars-cov-2 infection * having received or receiving any anti-sars-cov-2 monoclonal antibody (or combination of monoclonal antibodies) prescribed through the aifa registry * signature of informed consent (for subjects enrolled in the prospective part) exclusion criteria: * absence of criteria for prescribing monoclonal antibodies as determined by aifa * patients already hospitalised for non-covid reason at the time of monoclonal antibody administration

Keywords: sars-cov-2 infection monoclonal antibodies casirivimab imdevimab bamlanivimab etesevimab sotrovimab
foam: functional outcome after ventral mesh rectopexy

Conditions: Rectal Prolapse

Summary: rectal prolapse is a protrusion of rectal wall through the anus. a surgical technique called ventral mesh rectopexy has become a standard procedure for this condition in many centers. the goal of this trial is to investigate functional outcome, recurrence rates and complications after ventral mesh rectopexy. the main question it aims to answer is: - do bowel function, quality of life and sexual function improve after ventral mesh rectopexy? participants will: * be asked to fill in questionaires before surgery, 3-6 months after surgery and 12 months after surgery. * be examined by a surgeon 3-6 months, 12 months and 3 years after surgery.

several different procedures have been described for surgical treatment of rectal prolapse and a consensus has not yet been reached. over the past 20 years, the use of ventral mesh rectopexy to treat external rectal prolapse has gained increasing worldwide acceptance. ventral mesh rectopexy has become a standard procedure in many centers based on low recurrence rates, limited complications and good functional results but the use and type of mesh have been debated. concerns have also been expressed regarding the choice of surgical technique, which differs between centers, and the lack of high-level evidence. there are few prospective trials and the use of lvmr in a swedish setting has not yet been evaluated. foam (functional outcome after ventral mesh rectopexy) therefore aims to investigate bowel function, quality of life, sexual function, recurrence rates and complications after ventral mesh rectopexy. a prospective cohort study on patients undergoing ventral mesh rectopexy for external rectal prolapse in sweden will be conducted. approximately 70 patients will be included at a maximum of 10 hospitals in sweden.

Eligibility criteria:
inclusion criteria: * full-thickness rectal prolapse * the surgeon agrees that ventral mesh rectopexy is needed for the condition * capable of participating in follow-up visits and answering questionnaires * informed consent exclusion criteria: * patient below 18 years of age * ongoing pregnancy * inability to understand the swedish language * dementia or other cognitive disorder that unables informed consent

Keywords: ventral mesh rectopexy laparoscopic ventral mesh rectopexy quality of life bowel function recurrence sexual function
effects on anxiety in physiotherapy students after simulation as an active method for learning the clinical enterview

Conditions: Clinical Interview

Summary: the aim of the main study is to find out the effects on anxiety in physiotherapy students after role playing in the learning of the clinical history.

thirty-one first-year physiotherapy students will carry out the role-playing methodology to learn how to take a clinical history in physiotherapy. before and after the realization, they will be measured by means of a validated questionnaire in spanish, the language in which they study, the variable of anxiety.

Eligibility criteria:
inclusion criteria: * men and women who are studying the first year of physiotherapy at the complutense university of madrid and wish to participate in the study. exclusion criteria: * students who do not wish to participate in the study.

Keywords: medical education nursing education physiotherapy empathy anxiety
self-sampling and human papillomavirus (hpv)-testing for unscreened women in cervical cancer prevention

Conditions: Cervical Cancer; Human Papillomavirus Infection

Summary: scientific context: high-risk types of human papillomavirus (hpv) are the causative agents for cervical cancer. cervical cancer screening strategies rely on periodic papanicolaou (pap) testing. it's well-known that this test has significantly contributed to the reduction of mortality and morbidity due to cervical cancer. in france, it now seems that the screening strategy could be optimized. the two main ways are to reach the 7 million underscreened women (organized screening, self-sampling for hpv dna testing) and to improve the screening test (hpv dna testing, computer-assisted cytology). self-collected vaginal samples (scvs) for hpv dna testing could be a relevant screening option: this technique appears reliable and it could allow to reach women who are never or seldom screened. the performance of the scvs to detect cervical hpv infection has been assessed by the first part of the whole study: apache-1. the goal of this study is to compare the attitudes of women not attending organized cervical cancer screening face to different strategies: further invitation to make a cervical smear or kit for self-collected vaginal sample sent at home. description of the project : nine months after a primary invitation to make a cervical smear, a random sample of 6000 women not attending organized cervical cancer screening will be randomly assigned to one of the following arms: * intervention arm 1: women will receive a further invitation to make a cervical smear * intervention arm 2: women will be directly sent the kit for self-collected vaginal sample at home. the women who will send the self-sample to the laboratory for analyse will receive their results at home as well as their general practitioner if the hpv dna test is positive (infection by a high-risk hpv). for them who will have a hpv dna test positive, it will be necessary to complete the screening action with a cervical smear. that's why those women will receive an invitation to make a cervical smear if they won't do it during the 9 months following the first mail. * control arm: those women will receive complete information about the study, the main results and the screening recommendations at the end of the study.


Eligibility criteria:
inclusion criteria : * women from 30 to 65 years * living in indre-et-loire (french territorial division 37) exclusion criteria : * women who attend organized cervical cancer screening or who answer to the invitation * cervical smear made in the three last years * hpv linked cervical condition undergoing treatment * hysterectomy (including cervix)

Keywords: cervical cancer screening human papillomavirus (hpv) self-collected vaginal sample cervical smear
local anesthesia for facial fractures

Conditions: Pain Management

Summary: the study is a double-blind randomized, placebo controlled trial examining the impact of perioperative bupivacaine nerve block on pacu recovery metrics. patients with operative facial fractures are randomized to receive either bupivacaine or saline injections prior to the anesthesia emergence.

effective pain management is critical to successful postoperative care and is known to decrease patient morbidity, incurred patient and hospital costs, and length of hospital stay. pain and nausea after surgery for traumatic facial fractures can limit patients' early morbidity, oral intake, and ability to communicate. the study is a double-blind randomized, placebo controlled trial examining the impact of perioperative bupivacaine nerve block on pacu recovery metrics. patients with operative mandibular or midface fractures are randomized to receive either bupivacaine or saline injections prior to the anesthesia emergence. the primary outcome measure is the amount of opioid that patients receive in pacu in morphine milligram equivalent (mmes). the purpose of the study is to define whether a perioperative bupivacaine nerve block results in a decrease in the amounts of opioids and antiemetics that patients receive in pacu after cmf trauma surgery.

Eligibility criteria:
inclusion criteria: 1. adults age 18 and over 2. isolated facial fracture to the mandible and/or midface undergoing surgical repair 3. no allergy to local anesthetic 4. ability to read, write, and understand english exclusion criteria: 1. patients under the age of 18 2. isolated nasal bone fracture 3. polytrauma (i.e. injury pattern resulting in hospital admission for multiple bony fractures outside of the face) 4. allergy to local anesthetic

Keywords: otolaryngology surgery facial plastic trauma