Kornimate/medical-research-clean huggingface dataset:
behavioral insights to encourage judicious prescribing of opioids

Conditions: Substance-Related Disorders

Summary: in collaboration with the san diego medical examiner's office and the state of california's controlled substance utilization review and evaluation system (cures), the investigators propose to review opioid poisonings over the past 12 months and will send letters to prescribers in california when at least one of the provider's prescription(s) was filled by a patient who died of an opioid poisoning in san diego county. the letters will be non-judgmental and factual, explaining that a patient of the provider who was being treated with prescription narcotics died of an opioid poisoning. the letter will also encourage judicious prescribing including use of the cures system before prescribing. the investigators will evaluate physician prescribing practices over 24 months 12 months pre- and 12 months post-letter using data from the cures database. the investigators' hypothesis is that letters will make the risk of opioids more cognitively available and that physicians will respond by prescribing opioids more carefully. this will result in fewer deaths due to misuse and more frequent use of the cures system.


Eligibility criteria:
the investigators will not be enrolling subjects. this is an evaluation of a public health intervention involving sending prescriber's factual and nonjudgmental letters, signed by the county medical examiner, that would state that a patient the provider had treated with controlled substances died of an opioid poisoning. inclusion criteria: * prescribers in california for whom at least one of their prescription(s) was filled by a patient who died of an opioid poisoning in san diego county exclusion criteria: * prescriber is licensed outside the state of california and does not hold a california license, but the prescription was filled in california * the prescriber does not have a cures report on record * the prescriber has issued only one opioid prescription in the last 12 months since the time of the deceased death (and the prescription was to the deceased) * prescribers with unknown drug enforcement agency number

Keywords: safe prescribing opioids
accuracy of maxillary repositioning with bi or tripartite disjonction by virtual planning in orthognathic surgery using patient-specific titanium plates

Conditions: Occlusal Trauma

Summary: the aim of this study was to assess the accuracy of computer-aided orthognathic surgery and patient specific titanium plates for maxillar osteotomy with bi or tripartite disjonction in 22 patients who underwent bimaxillar osteotomy for occlusal trouble.


Eligibility criteria:
inclusion criteria: - bimaxillar osteotomy with maxillar segmentation and full imageries . exclusion criteria: none
role of hypothermia in endovascular stroke thrombectomy

Conditions: Stroke, Acute Ischemic

Summary: reducing or suspending the increase of the infarcted core, i.e., "freezing" the ischemic penumbra, may help improve the efficacy of mechanical thrombectomy. hypothermia effectively reduces the metabolic level of brain tissue, may prolong the time window for recanalization therapy, and its multi-target therapeutic effect make it one of the most promising neuro-protection approach. in recent years, hypothermia has been increasingly used to treat acute ischemic stroke. however, its role in acute ischemic stroke is unclear. the objective of this trial is to investigate whether hypothermia combined with endovascular thrombectomy could add additional benefit without increasing the risk of adverse events such as pneumonia, intracerebral hemorrhage, and mortality.


Eligibility criteria:
inclusion criteria: 1. aged ≥ 18 years or more; 2. acute ischemic stroke within 24 hours from onset to randomization; 3. nihss ≥6 points before randomization; 4. internal carotid artery, or the middle cerebral artery m1 or m2 occlusion confirmed by cta/mra/dsa; 5. baseline aspects score ≥ 3 and ≤8, or cerebral infarction core volume \< 100ml; 6. the patient decides to undergo endovascular therapy; 7. the patient or patient's representative signs a written informed consent form. exclusion criteria: 1. ct or mr evidence of hemorrhage; 2. currently pregnant or lactating (women patients); 3. allergy to radiographic contrast agents, or nitinol devices; 4. arterial tortuosity and/or other arterial disease that would prevent the device from reaching the target vessel; 5. multiple vessel occlusion (e.g., bilateral anterior circulation, or occlusion of both anterior and posterior circulation); 6. preexisting neurological or psychiatric disease that would confound the neurological functional evaluations; 7. previous bleeding disorders, severe heart, liver or kidney disease, or sepsis; 8. brain tumors with mass effect (except meningiomas) that are radiographically pleasant; 9. intracranial aneurysm, arteriovenous malformation; 10. any terminal illness with life expectancy less than 6 months; 11. participating in other clinical trials.

Keywords: endovascular thrombectomy hypothermia large vessel occlusion randomized controlled trial
impact of music therapy on pain in patients treated for advanced cancer

Conditions: Advanced Cancer

Summary: the aim of this study is to assess the impact of music therapy on the pain of patients cared at the montpellier cancer institute (icm) for advanced cancer in a palliative situation and requiring full hospitalization or on an outpatient basis.

music therapy is a care practice that falls within the field of support, help and accompaniment therapies. sound, musical and music are the means used to support, maintain or improve a person's physical and mental health. the patients involved in the study are patients cared at the icm for advanced cancer in a palliative situation and requiring full hospitalization or on an outpatient basis. the aim is to assess the impact of music therapy on the pain of these patients. the patient is proposed to participate in a music therapy session. before this session, the music therapist will assess the pain and the presence of symptoms with the patient. following this exchange, she will define the device best suited to his expectations and his needs and will propose his a relaxation session induced by music. after the session the music therapist will assess with the patient the pain and the presence of symptoms. the patient's feelings and satisfaction about this music therapy session as well as his possible wish to participate in another session will also be evaluated.

Eligibility criteria:
inclusion criteria: * male/female over 18 years old * patient cared for at the icm for advanced cancer followed by the mobile palliative and/or pain care team * patient with pain score \>= 3 (cancer related) * patient who accepts a music therapy session * patient having expressed his oral non-opposition * patient able to communicate * patient affiliated to the french social security system. exclusion criteria: * patient with uncorrected hearing loss to normal * patient under guardianship, curatorship or safeguard of justice

Keywords: music therapy
benefits of using a transparent visor to replace the face mask in speech therapy rehabilitation of oral-linguo-facial praxies in the context of covid-19: a series of cases

Conditions: Oral-Linguo-Facial Praxies; Covid19

Summary: the primary objective of the study is to compare the effectiveness of the use of a transparent covering visor with that of the face mask, with or without the use of video sequences, for speech therapy rehabilitation of oral-linguo-facial praxies in the context of the covid 19 epidemic.

statistic analysis: single case experimental design (sced) method.

Eligibility criteria:
inclusion criteria: * aged \>= 18 years; * hospitalization for more than 2 weeks prior to enrollment in the adult post intensive care rehabilitation care unit (picru) of raymond poincaré hospital in garches; * with oral-linguo-facial praxis disorders whatever the cause; * has been informed and not in opposition to participation of the study. exclusion criteria: * patient with fever or any suspect symptom of a sars-cov2 infection; * planned discharge of hospital in 2 weeks; * patient with cognitive, phasic or vigilance disorders preventing to understand the study; * under guardianship or curator; * patient under french ame scheme.

Keywords: oral-linguo-facial praxies covid19 speech therapy rehabilitation
psychological symptoms and burden in caregivers of patients with disorders of consciousness

Conditions: Psychological Distress; Anxiety Depression; Burden, Caregiver; Disorders of Consciousness

Summary: caregivers of patients with disorders of consciousness are highly prone to developing mental health issues. the aim of this study is to investigate the psychological symptoms and care burden of caregivers of patients with disorders of consciousness (doc), and to examine which characteristics of patients were burden predictors to caregivers.

this is a multi-center cross-sectional study in china, from august 2021 to october 2022. patients were assessed by coma recovery scale-revised (crs-r), and caregivers' anxiety, depression, and burden were assessed by state-trait anxiety inventory form y (stai), beck depression inventory-ii (bdi- ii), and zarit caregiver burden scale (zbi). the comparison with patients' age and caregivers' age-matched subjects who were randomly selected and without doc; intra-group comparison of caregivers for doc was conducted. descriptive statistics were used to illustrate the socio-demographics. one-sample t-test, independent sample t-test, one-way anova, mann-whitney u test, and kruskal-wallis test were executed to detect the difference between groups due to the distribution of each variable.

Eligibility criteria:
inclusion criteria: - (1) family caregivers without neurological, mental health, or learning disability history. (2) family caregiver with consciousness and capability of independently completing questionnaires. exclusion criteria: 1. caregivers unwilling to participate 2. not the dominant caregivers
randomized controlled clinical outcomes of the vanguard xp bicruciate knee system

Conditions: Osteoarthritis; Rheumatoid Arthritis; Traumatic Arthritis; Lower Limb Deformity; Post-traumatic Deformity; Complications, Arthroplasty

Summary: randomized controlled study to determine if preservation of ligaments provides increased functional ability post-operatively in comparison to traditional tka which sacrifices soft tissue.

randomized controlled study to compare clinical and patient reported outcomes of the vanguard xp bicruciate total knee system to the vanguard cr knee system through 10 years of follow-up.

Eligibility criteria:
inclusion criteria: * cemented application of components * bilateral subjects randomized by knee * patients with pre-existing contralateral knee surgery * painful and disabled knee joint resulting from osteoarthritis, rheumatoid arthritis, or traumatic arthritis where one or more compartments are involved * correction of varus, valgus, or posttraumatic deformity * sufficient soft tissue surrounding the knee, including the anterior cruciate ligament exclusion criteria: * cementless application of components * bmi greater than or equal to 40 * use of anterior stabilized bearings * patients with severe pre-operative varus or valgus deformity greater than or equal to 15 degrees * correction or revision of previous joint replacement procedure on index knee * infection * sepsis * osteomyelitis relative exclusion criteria: * uncooperative patient or patient with neurological disorders who is incapable of following directions * osteoporosis * metabolic disorders which may impair bone formation * osteomalacia * distant foci of infections which may spread to the implant site * rapid joint destruction, marked bone loss, or bone resorption apparent on roentgenogram * vascular insufficiency, muscular atrophy, neuromuscular disease * incomplete or deficient soft tissue surrounding the knee, including the anterior cruciate ligament
effect of walking to the operating room on preoperative anxiety

Conditions: Vein, Varicose

Summary: the operating room environment can be a source of anxiety for the patient, including in the context of outpatient surgery for which anxiolytic medication is rarely used. this anxiety-induced effect can be reinforced by the patient's lack of active participation. some studies have already shown the feasibility of patient walking to the operating room (or) and advantages this approach(kojima and ina 2002; lack 2016; nagraj et al. 2006). moreover, recovery room complications and pain have also been shown to be greater after varicose vein surgery in patients with significant preoperative anxiety (scavee et al. 2016). therefore, the investigators decided to test the effects of walking to or for patients admitted for outpatient surgery for varicose vein surgery.


Eligibility criteria:
inclusion criteria: * outpatient minimal invasive laser therapy for venous insufficiency exclusion criteria: * inpatient surgery * invasive surgery * need for premedication * use of walking aid * non-french speaking patient * patient refusal
gazyva infusion reaction investigation

Conditions: Chronic Lymphocytic Leukemia

Summary: the study evaluate safety and effectiveness of chlorambucil and obinutuzumab in routine clinical practice in patients with chronic lymphatic leukemia and with certain comorbidities (any cardiac pathology, diabetes mellitus (dm), kidney pathology or cytopenia), whom obinutuzumab \& chlorambucil have been applied according to indications before enrollment in the study.

mrd (minimal residual disease) evaluation was chosen as a primary measure outcome as it is considered as prognostic marker for long-term progression freee survival (pfs) and as a potential therapeutic goal in chronic lymphocytic leukemia/ cll . minimal residual disease (mrd-negative) is assessed in the clinic by 8-color flow cytometry giving the sensitivity level of mrd detection 10-5; mrd is measured in real clinical practice at this clinical center according to national recommendations in diagnostics and treatment of lymphoproliferative disorders. to achieve study objectives medical patients' charts will be analyzed retrospectively. in the frame of this program 104 patients' charts treated in defined clinical site, are planned to be analyzed. this number of patients corresponds to the patient flow with this pathology at a defined clinical site for 1 years. data collection is considered to be retrospective as data will be transferred to e-crf from patient medical charts. during this study no further specific extra procedures for data gathering is expected. but since patients included in the study will be at the center of ongoing therapy, the study was called a prospective.

Eligibility criteria:
inclusion criteria: 1. cd20+/ (cluster of differentiation antigen 20 positive) b-cll pts on the 1st line treatment therapy, whom have been already applied obinutuzumab and chlorambucil 2. age ≥ 18 years. 3. eastern cooperative oncology group scale (ecog) 0-2. 4. total chronic illness resources survey scale (cirs) score \>6 or creatinine clearance \<70 ml/min or both for patients ≥ 18 years old or all cll pts ≥ 75 years old 5. any cardiac pathology/ diabetes mellitus/ kidney pathology/ cytopenia (hb \<100 g/l, platelets \< 100 x 109/l) 6. life expectancy more than 6 months according to the physician's opinion. 7. signed informed consent that allow personal data and data that refer to patient confidentiality processing exclusion criteria: the refusal of the patient to participate in the observational study and the withdrawal of informed consent that allow processing of personal data and data that refer to patient confidentiality.

Keywords: chlorambucil obinutuzumab
adherence rate to dmards in egyptian patients with ra

Conditions: Rheumatoid Arthritis

Summary: the study aims at determining adherence rate to dmards and predicting factors affecting treatment adherence among sample of egyptian patients with ra.

rheumatoid arthritis (ra) is an autoimmune disease that causes inflammation of the joints. it is chronic disease and often progressive in course and has a strong impact on people's everyday lives. disease modifying anti-rheumatic drugs (dmards), such as methotrexate, leflunomide, hydroxychloroquine, and sulfasalazine are the cornerstone of therapy in ra and are invariably used as initial therapy. these drugs have shown to retard disease progression including joint destruction. it is believed that adherence to treatment is crucial for successful therapy, however, non-adherence is a substantial problem in patients with chronic rheumatic conditions, including ra. previous studies have reported that dmards non adherence results in more disease activity, loss of function, and a lower quality of life. the depression is a common co-morbidity in ra, its presence can alter the course of ra negatively via cognitive-behavioral or inflammatory pathways: patients with concurrent depression suffer from more pain, show a heightened disease activity. as non-adherence to medication regimen is considered a serious public health issue that can have great impact on clinical and economic consequences. therefore, it is crucial for health care providers to assess the patient condition, predict the possible causes of non-adherence, and put a policy for increasing medication adherence and achieving the best health outcome. also, improving medication adherence enhances patients' safety and health condition.

Eligibility criteria:
inclusion criteria: 1. age more than or equal 18 years old. 2. on current diagnosis of ra determined by a rheumatologist according to 2010 acr/eular classification criteria for ra. 3. on current treatment with one or more of dmards from at least 6 months duration. 4. patients with cognitive level enabling them to interact in the study. - exclusion criteria: 1. age less than 18 years old. 2. patients receiving one or more of dmards of period less than 6 months. 3. patients with psychiatric diagnosis other than effective disorder. 4. patients with associated disability due to neurological disorder or trauma. 5. patients with major internal organ failure e.g. heart failure, end stage renal disease or hepatic failure. 6. patients with severe cognitive impairment interfering with the proper communication and interaction within the study process.
prevention of bleeding in patient with cirrhosis undergoing dental extraction

Conditions: Liver Cirrhosis; Coagulopathy

Summary: the purpose of this study is to investigate how effective and cost saving 1-deamino-8-d-arginine vasopressin (desmopressin, ddavp) is as opposed to the transfusion of blood products in preventing bleeding after teeth extraction in persons with severe liver disease being evaluated for liver transplant.

liver cirrhosis is associated with dysregulation of the coagulation system resulting in an increased bleeding tendency in cirrhotic patients. the treatment approach to offset these abnormalities may involve transfusion with fresh frozen plasma (ffp) and platelets. fluid overload may become a concern as the large amount of ffp (10-20mls/kg or \>1,500ml) required to achieve the hemostatic effect could be contraindicated in some patients. furthermore, repeated platelet transfusion induces alloimmunization and refractoriness to new transfusion, which is an important issue in patients on the waiting list for liver transplantation in which hla-matched and cross-matched platelets may be required. non-transfusional drugs that help to stop bleeding have been used in patients with congenital bleeding disorders. 1-deamino-8-d-arginine vasopressin (ddavp, desmopressin), a synthetic analogue of the antidiuretic hormone, l-arginine, has been used as a non-transfusional form of replacement therapy in a variety of congenital and acquired bleeding disorders. through unknown mechanisms, ddavp shortens the prolonged bleeding times of cirrhotic patients despite the high plasma concentrations of factor viii and von willebrand factor sound in chronic liver disease, indicating that it might be useful as a prophylactic treatment in cirrhotic patients undergoing minimally invasive procedures, i.e. dental extraction.

Eligibility criteria:
inclusion criteria: * adult patients with biopsy-proven liver cirrhosis or clinical/radiological evidence of cirrhosis, requiring dental extraction * platelet count of 30,000-50,000/microl and/or inr 2.0-3.0 exclusion criteria: * the presence of other bleeding disorders besides cirrhosis such as renal dysfunction (creatinine \> 2.0) or hiv * receipt of blood transfusion within 2 weeks prior to study * recent acute decompensation of liver cirrhosis * malignancy excluding hepatocellular carcinoma in the absence of portal vein thrombosis * treatment with anti-platelet medications (aspirin, non-steroidal anti-inflammatory drugs or clopidogrel) within ten days prior to the extraction * documented allergy to ddavp.

Keywords: liver cirrhosis coagulopathy desmopressin blood transfusion
tl1a expression in psoriatic skin

Conditions: Psoriasis

Summary: tl1a is a newly discovered signal molecule that may be crucially involved in the maintenance of chronic inflammatory disorders. tl1a has also been demonstrated in psoriatic skin but the importance of tl1a in psoriasis is still unknown. understanding inflammatory signal molecules in psoriasis is important because the development of new drugs directed against relevant signal molecules (e.g. tnf-α and il12/23) has proved to be a very efficacious treatment principle. however, despite the dramatic progress in therapeutic options during the last decade, there is still a fraction of patients that are insufficiently treated with the currently available therapies. tl1a has been claimed to be the next important target for development of biologics in the field of chronic inflammation.

psoriasis is a common autoimmune disease; affecting approximately 2 % of the western population. among these 15% are estimated to have severe disease that requires systemic therapy with e.g. methotrexate, cyclosporine or acitretin that are all drugs associated with high frequencies of side-effects. in contrast to this the recent development of the biologic drugs has provided very efficacious and in general well-tolerated new therapeutics. but even with these newer drugs treatment-failures exist and for this group new treatments are needed tnf-like ligand 1a (tl1a) is a novel member of the tnf family of cytokines. increasing evidence suggests that in addition to tnf-alfa and ifn-gamma psoriasis is also an il-23 and il-17 dependent disease so th1 and th17 t cells are suggested to be important in driving the disease. therefore tl1a, which through binding to dr3 influences th1 and th17 t cell differentiation, could be an important cytokine in the early inflammatory process in psoriasis. recently expression of tl1a in psoriatic skin lesions has been demonstrated but the importance of this remains to be investigated. tl1a exists in both a membrane bound- and a soluble form and is secreted from antigen presenting cells (apcs) such as monocytes, dendritic cells and macrophages in response to stimulation with immune complexes, bacteria or cytokines (tnf-alfa and il-1beta). membrane bound tl1a has also been described in t cells. recently, a new isoform of soluble tl1a (tl1a(v84-l251)) was discovered with functional differences to tl1a(l72-l251. it's unknown whether this isoform is present in psoriatic skin. research on tl1a has focused on autoimmune diseases where immune complexes are formed, e.g. rheumatoid arthritis. however, studies have suggested that early pathogenesis in psoriasis could dependent on formation of large complexes between bacterial dna and the anti-microbial peptide ll-37 which induce cytokine secretion from apc. cytokines that could lead to tl1a excretion. whether tl1a can be secreted in this way is unknown.

Eligibility criteria:
inclusion criteria: * plaque type psoriasis * at least 6 month history of psoriasis exclusion criteria: * systemic anti-psoriatic medication * topical anti-psoriatic medication (wash-out period 2 weeks)