Kornimate/medical-research-clean huggingface dataset:
the influences of dialysate bicarbonate concentrations on hemodialysis patients

Conditions: End Stage Renal Disease on Dialysis

Summary: background: patients with decreased kidney function are in the positive acid balance due to insufficient renal acid excretion. to correct the varying degrees of metabolic acidosis in these hd patients, a high concentration of hco3 in the dialysate is routinely used. during every 3-to-4 hours of hd treatment, a massive surge of hco3 would enter the circulation and typically overcorrects predialysis acidosis to alkalosis and alkalemia. the sharp acid-base shift can cause some adverse consequences. the investigators believe that the rapid correction (or overcorrection) from the pre-dialysis metabolic acidosis to post-dialysis metabolic alkalosis during the 3-to-4 hours hd treatment would relate to adverse effects on hd patients. thus the investigators conduct this study to prove the hypothesis that "prevention of post-dialysis alkalosis by using lower dialysate hco3 concentration might cause less adverse outcomes in esrd patients on hd." study design: prospective cross-over case-control study. study population: a total of 60 patients who receive regular hemodialysis (three times per week) for more than 6 months in the regional teaching hospital.


Eligibility criteria:
inclusion criteria: * adult uremic patients who received hemodialysis thrice weekly exclusion criteria: * hospitalized patients * patients newly initiated on hd (\<6 months) * patients with hd access problems * patients recently discharged from the hospital (within one month). * patients on chemotherapy for cancer. * patients with a kidney transplant. * patients on steroids or other immunosuppressive therapy. * patients with recent surgery (within one month) * patients with an active bacterial infection. * patients with decompensated cirrhosis.

Keywords: metabolic acidosis sodium bicarbonate hemodialysis dialysate
assessing optimal xrb initiation points in jail

Conditions: Opioid Use Disorder

Summary: this application describes a 3-year, randomized controlled trial. eligible, consenting adults (n=200) with existing sublingual buprenorphine (slb) prescriptions who enter middlesex county house of corrections (mchoc) as pre-trial detainees will be randomized at admission on a 1:1 basis to be inducted onto extended-release buprenorphine (xrb) at the time of admission (experimental condition) or remain in slb (e-tau; all participants will also receive naloxone). the two approaches will be compared with regard to (1) the percentage of participants released from jail with at least 7 days of buprenorphine in their system, (2) percentage of participants continuing moud treatment in the community, and (3) infractions related to buprenorphine diversion.


Eligibility criteria:
inclusion criteria: * incarcerated men able to provide written informed consent in english.\* * unsentenced. * entering the facility with a prescription for slb and receiving slb for at least the previous 3 days. * minimum anticipated jail stay is 4 days. * willing to accept being randomized to the experimental condition (i.e., transitioning to xrb while incarcerated). exclusion criteria: * sentenced. * allergy, hypersensitivity or medical contraindication to either medication. * chronic pain requiring opioid pain management or other contraindicated medications.
breast mri in evaluation of pathologic response in patients with breast cancer with neoadjuvent chemotherapy

Conditions: Role of MRI in Evaluation of Breast Cancer

Summary: evaluation of pathological response in breast mass by use of breast mri in patients receiving neoadjuvent chemotherapy via comparison with pathological results

evaluation of pathological response in locally advanced breast masses by use of breast mri in patients receiving neoadjuvent chemotherapy via comparison with pathological results

Eligibility criteria:
inclusion criteria: * all women referred to the radiology department for breast mri examination either for screening, evaluation of suspicious lesions onsono-mammography \\ * patients with locally advanced breast cancer * patients with early stage breast cancer and chemo-responsive tumour markers (i.e. triple negative, her2+), who will benefit from downsizing for breast conserving surgery (bcs) * absolute or relative contraindications to surgery (advanced age/multiple medical comorbidities) in the setting of estrogen receptor positive tumours (for consideration of neoadjuvant endocrine therapy)3 * patients must be elder than 18 years old. * patients with accepted renal function exclusion criteria: * patients with metastatic breast cancer. * patient with breast mass more than 5 cm . * patients with fungating breast mass . * patients with stage iv \[tumor spread to chest wall and to skin \]. * pregnant women especially in 1th trimester. * patient with presence of any paramagnetic substance as pacemakers. * severely ill patients . * patients with claustrophobia. * arrhythmic patients
effective onabotulinumtoxina dose response study for upper facial wrinkles

Conditions: Rhytides

Summary: this research is being done to determine if lower doses of botox than what is currently recommended can give similar results to patients, at lower cost and lower risk to them. subjects will receive botox in the same areas of the upper face with standard doses on one side of the face. on the other side, double the botox concentration will be administered, free of charge to the participant, in order to see if the difference in concentration creates a difference in wrinkle reduction and participant satisfaction over time.


Eligibility criteria:
inclusion criteria: * provision of signed and dated informed consent form * stated willingness to comply with all study procedures and availability for the duration of the study * male or female, aged 18-65 * in good general health as evidenced by medical history and exhibiting upper facial wrinkles on physical examination * agreement to adhere to lifestyle considerations (see section 5.3) as appropriate throughout study duration exclusion criteria: * current use of aminoglycosides, curare like agents, and muscle relaxants * pregnancy or lactation * known allergic reactions to components of the botox formulation and any of its ingredients * treatment with another botox product for the face within 4 months * infections/preexisting weakness at the proposed injection sites on physical examination * history of neuromuscular disorder, pre existing severe cardiovascular disease, compromised respiratory function, severe dysphagia * pediatric population, patients older than 65 since the effect of botox in terms of duration and magnitude is highly variable in these age groups.

Keywords: botox facial wrinkles onabotulinumtoxina cosmetic dosage
effects of ondansetron on gastrointestinal sensorimotor dysfunctions in diabetes mellitus and dyspepsia

Conditions: Indigestion; Diabetes Mellitus

Summary: researchers are trying to understand why people with indigestion and diabetes mellitus have gastrointestinal symptoms and in particular to understand whether symptoms are related to increased sensitivity to nutrients in the small intestine. as part of this investigation, a medication called ondansetron will also be studied to determine its effects on gastrointestinal function and associated symptoms.

the primary objectives of this study are to evaluate the effects of ondansetron, on symptoms (i) during a gastric emptying study, (ii) during enteral lipid infusion and (iii) in daily life.

Eligibility criteria:
inclusion criteria: * healthy male or non-pregnant, non-breastfeeding female volunteers; * 18-75 years old; * able to provide written informed consent before participating in the study * able to communicate adequately with the investigator and to comply with the requirements for the entire study; including the willingness and ability to consume the components of the test meals * symptoms of dyspepsia (i.e., early satiety, postprandial discomfort, nausea, vomiting, regurgitation) * patients in the dm group will also require type 1 or 2 dm of ≥ 3 years duration; in patients with type 2 dm, the dyspepsia symptoms should have begun or worsened after dm was diagnosed exclusion criteria: * major abdominal surgery (i.e., appendectomy, cholecystectomy, tubal ligation, hysterectomy, herniorrhaphy, and limited colonic resection are permissible) * clinical evidence (including physical exam and ekg) of significant cardiovascular, respiratory, renal, hepatic, gastrointestinal, hematological, neurological, psychiatric or other disease that may interfere with the objectives of the study and/or pose safety concerns * current use of opiates, alpha adrenergic agonists, metoclopramide, monoamine oxidase inhibitors, more than one serotonergic medication, and high doses of anticholinergic agents (eg, amitriptyline greater than 50 mg daily). if medically safe, these drugs may be discontinued for four half lives prior to study assessments. * treatment with glp-1 agonists and amlyin which cause vagal blockade and may affect central processing of pain * bleeding or clotting disorders or medications that increase risk of bleeding from mucosal biopsies * positive tissue transglutaminase antibodies (ttg), * pregnant or breast-feeding females * known intolerance or allergy to eggs * poor peripheral venous access, if central venous access is not available * any other condition or prior therapy that, in the opinion of the investigator, would make the patient unsuitable for the study * history of long qt syndrome or prolonged qt interval (i.e., corrected qt interval \> 480 ms) * current symptoms of a functional gastrointestinal disorder assessed by questionnaire * severe vomiting that would preclude tube placement or participation in the study * structural cause for symptoms by endoscopy within the past 12 months * patients with gastric pacemakers
a phase 2 study of cal101 in patients with idiopathic pulmonary fibrosis

Conditions: Idiopathic Pulmonary Fibrosis

Summary: the goal of this clinical trial is to learn if the investigational drug cal101 can help prevent further decline in lung function in adults with idiopathic pulmonary fibrosis. researchers will compare cal101 with placebo to compare change from baseline in forced vital capacity (fvc). participants will be randomly assigned to a study group that will receive an iv infusion of either the study medication or placebo about once a month for 6 months.

this is a randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of cal101 in participants with ipf, taking and not taking background therapy (i.e. nintedanib or pirfenidone). the study will consist of a 28-days screening period, intravenous (iv) infusions of cal101 once every 4 weeks over 24 weeks, and a 16 week follow-up period.

Eligibility criteria:
inclusion criteria: * ≥ 40 years of age * diagnosis of ipf supported by centrally read chest high-resolution computed tomography * definite or probable usual interstitial pneumonia (uip) pattern on chest high-resolution computed tomography (hrct) performed within 12 months of screening, confirmed by central review (if an evaluable hrct \< 12 months is not available, the baseline hrct will be used to determine eligibility). * fvc ≥ 45% of predicted. * diffusing capacity of the lung for carbon monoxide (dlco) ≥ 25% predicted. * forced expiratory volume in 1 second (fev1)/fvc ≥ 0.7 * either stable dose with antifibrotics (either nintedanib or pirfenidone) for at least 8 weeks prior to screening or not treated with antifibrotics for at least 8 weeks prior to screening. exclusion criteria: * in the opinion of the investigator, other clinically significant lung disease (e.g. asthma, emphysema, chronic obstructive pulmonary disease, cavitary or pleural diseases) at screening. * interstitial lung disease (ild) other than ipf (including, but not limited to, connective tissue diseases, vasculitis). * acute ipf exacerbation within 16 weeks prior to screening and/or during the screening period (investigator-determined). * lower respiratory tract infection requiring antibiotics within 4 weeks prior to screening and/or during the screening period. * evidence of impaired kidney function, unstable cardiovascular disease, moderate or severe hepatic impairment or any significant disease or condition other than ipf which may interfere with trial procedures or interpretation of trial results, or cause concern regarding the patient's ability to participate in the trial or any medical condition which could lead to a life expectancy \< 12months
simdiscovery: the benefits of utilizing a simulation preparation program for spinal fusion surgery

Conditions: Scoliosis Idiopathic Adolescent

Summary: this is a pilot study aiming to examine preliminary effectiveness of a preparation program which includes simulation (simdiscovery) in reducing anxiety and increasing feelings of preparedness among parents and their children who will undergo spinal fusion surgery. simdiscovery is an experiential learning preparation program which aims to educate children and families about different medical procedures through simulation play.


Eligibility criteria:
inclusion criteria: * children and adolescents with adolescent idiopathic scoliosis and their parent(s) * spinal fusion surgery scheduled * developmental age range (10+; no upper age range) * males and females of all races and ethnicities * english-speaking families (although english need not be their primary language) * both patient and caregiver (when patient is under 18 years of age) are able to attend simdiscovery program exclusion criteria: * - other significant chronic medical conditions (e.g., spina bifida, muscular dystrophy) * anterior surgical access * icu stay expected post-op * cognitive functioning level below 10yo

Keywords: anxiety preparedness spinal fusion
minimal residual disease dynamic monitoring in first-line serplulimab plus chemotherapy in treatment of extensive small cell lung cancer: an observational study

Conditions: Lung Cancer

Summary: small cell lung cancer (sclc) is one of the most aggressive lung cancer subtypes, accounting for approximately 15-20% of total lung cancer cases. although sclc is relatively sensitive to chemotherapy, it is highly susceptible to recurrence. the advent of immunotherapy has revolutionized the clinical practice of oncology, and the newly released results of the astrum-005 study have led to the incorporation of serplulimab into the first-line treatment of extensive-stage sclc. although immunotherapy in combination with chemotherapy is currently the most promising regimen, due to the limited understanding of genetic alterations and the marked genetic heterogeneity of sclc, treatment responsiveness varies greatly. thus, there is an urgent need to find molecular biomarkers that can effectively predict prognosis and further suggest the effectiveness of this new treatment mode. minimal residual disease (mrd) refers to the presence of tumor cells disseminated from the primary lesion to distant organs in patients who lack any clinical or radiological signs of metastasis or residual tumor cells left behind after local therapy that eventually lead to local recurrence. these years, the development of real-time, high-sensitivity liquid biopsy assays have enabled the identification of mrd in individual patients with cancer. multiple studies have demonstrated that detection of mrd dynamics following definitive therapy for solid cancers is strongly prognostic and has extremely high positive predictive value for risk of recurrence and treatment efficacy. the aim of this study was to explore the predictive value of mrd dynamics on disease prognosis before and after the first-line treatment of serplulimab in combination with chemotherapy for extensive-stage sclc.


Eligibility criteria:
key inclusion criteria: * eastern cooperative oncology group (ecog) performance status of 0 or 2. * have previously untreated and confirmed by histological and imaging examinations as extensive small cell lung cancer * adequate organ function and expected survival time ≥ 12 weeks; * evidence of post-menopausal status or negative urinary or serum pregnancy test for female pre-menopausal patients. key exclusion criteria: * presence of mixed carcinoma component on histology. * patients with other active malignancies within 5 years prior to enrollment. * known active autoimmune diseases. * currently participate in an interventional clinical study treatment or have been treated with another drug or investigational device within 4 weeks prior to the first dose. * use of immunosuppressive agents within 14 days prior to the first dose of study treatment. * presence of other uncontrolled serious medical conditions.

Keywords: small cell lung carcinoma
early vascular adjustments during hypertensive pregnancy

Conditions: Hypertension, Pregnancy-Induced; Pre-Eclampsia

Summary: paradoxical fetal and maternal results of studies have led to inconsistent use of antihypertensive drugs or no treatment at all in mild to moderate gestational hypertension in the netherlands. however, none of the studies have taken the individual maternal circulatory state or the contemplated blood pressure response into account. hypertension may be accompanied by high (hyperdynamic vasodilated profile), normal (normodynamic profile) of low (hypodynamic vasoconstrictive profile) cardiac output, and preeclampsia is not restricted to one circulatory profile. therefore antihypertensive drugs should be viewed upon as correctors of the hemodynamic state rather than solely reducers of blood pressure. without taking the maternal hemodynamic profile and condition into account, generic antihypertensive treatment can be expected to result in disappointing, inadequate and paradoxical results. the investigators hypothesize that in mild to moderate hypertension, personalized hemodynamically guided antihypertensive therapy (with target systolic and diastolic blood pressure \<130/80mmhg), prevents the progression to severe hypertension and/or preeclampsia compared to no treatment, without the alleged side-effects.


Eligibility criteria:
inclusion criteria: * patients ages 18years or older * before 37 weeks of gestational age; * diagnosed with mild to moderate gestational hypertension exclusion criteria: * women with severe hypertension: systolic blood pressure ≥ 160mmhg and/or diastolic blood pressure ≥ 110mmhg. * women with chronic hypertension who are already on antihypertensive drugs. if no antihypertensive drugs are used yet, women with pre-existent hypertension are eligible to participate. * women diagnosed with preeclampsia or eclampsia in the current pregnancy. * women who are not able to comprehend the study outline. * women who have already participated in this study cannot be included a second time. * women who have a (relative) contra-indication for one of the possible prescribed medications (for example women who have tested positive for antinuclear antibodies, which is a contraindication for methyldopa). * women who intend to terminate the pregnancy * women who have a fetus with a major anomaly or chromosomal abnormality
stress reduction in middle eastern refugees

Conditions: Post Traumatic Stress Disorder

Summary: this interventional, randomized controlled study tests the effects of a a brief psychological intervention (narrative exposure therapy) against a wait list control group among refugees who have experienced trauma and have some symptoms of ptsd.


Eligibility criteria:
inclusion criteria: * refugees from the middle east, and possible from africa, who have experienced conflict-related trauma, have symptoms of ptsd, and speak either arabic or english exclusion criteria: * currently received exposure therapy for ptsd * planning to leave area in next 4 months

Keywords: refugees trauma narrative exposure middle east therapy
anterior shoulder dislocation at emergency department

Conditions: Shoulder Dislocation; Analgesia; Pain, Shoulder

Summary: in this study, investigator will analyze the demographic characteristics of patients presenting to emergency department with anterior shoulder dislocation. investigators will document the mechanism of injury, orthopedic classification of shoulder dislocation, associated treatments, pre-procedural pain scoring, post-procedural pain scoring, as well as the duration of emergency department stay related to the preferred treatment, orthopedic consultation, and patient outcomes (discharge, admission to ward or intensive care unit, mortality). aim of the study to investigate whether the current treatments used provide any superiority in emergency department outcomes for patients

intravenous analgesia (paracetamol, nsaids, opioids) is preferred for patients during the treatment and reduction stages of anterior shoulder dislocation. additionally, patients may receive regional anesthesia and analgesia (lidocaine, bupivacaine). the route and dosage of analgesic administration are chosen by the attending physician managing the patient. in this study, investigators plan to observationally evaluate the analgesic management of patients without intervening in the method and dosage chosen by the primary treating physician. patients receiving analgesia will be chosen according to preffered treatment at emergency department. the study population will consist of patients presenting to the emergency department with shoulder dislocation who receive analgesia and fall into the following 4 treatment groups. these 4 group will consist in: 1. ketamine group 2. interscalene nerve block group 3. suprascapular nerve block group 4. intraarticular lidocaine injection group. the study will compare these 4 treatment methods in terms of analgesia management, reduction time, comfort, and length of hospital stay for patients presenting to the emergency department with shoulder dislocation and receiving analgesia. the researcher will not interfere with the treatment decision made by the responsible physician or the treatment process

Eligibility criteria:
inclusion criteria: patients aged 18 years and older exclusion criteria: patients who are not conscious at the time of admission and do not consent to participate in the study. patients who do not have follow-up in our healthcare system or cannot be followed up. patients with allergies to opioids or local anesthetics. patients presenting to the emergency department with suspicion of multiple fractures and dislocations involving ≥2 different types of injuries will also be excluded from the study. forensic cases

Keywords: shoulder dislocation interscalene nerve block suprascapular nerve block intraarticular lidocaine injection emergency department