Kornimate/medical-research-clean huggingface dataset:
a pilot study of an rct to improve infection management in advanced dementia

Conditions: Dementia

Summary: to conduct a pilot study of cluster randomized clinical trial of an practice intervention to improve the quality of care for suspected lower respiratory and and urinary tract infections among 60 nursing home residents with advanced dementia living in 4 facilities (2 matched intervention/control pairs) for 12 months. we hypothesize that 1. in the intervention compared to the control facilities there will be a trend towards a greater proportion of infections for which antimicrobials were initiated appropriately, and 2. in the intervention compared to the control facilities there will be a trend towards higher proxy satisfaction with decision-making, fewer hospital transfers, and lower antimicrobial exposure.


Eligibility criteria:
inclusion criteria: resident eligibility criteria include: 1) age \> 65, 2) dementia, 3) global deterioration scale score of 7,59 and 4) a proxy is available who can speak in english. features of global deterioration stage 7 include: profound memory deficits (cannot recognize family), total functional dependence, speech \< 5 words, incontinence, and inability to ambulate. eligibility criteria for providers in the intervention nursing homes include: medical doctor,a. nurse, nurse practitioner, physician assistant identified by a senior administrator as an individual who cares for residents with advanced dementia, and is 2. able to communicate in english because on-line course and algorithms are in english., and 3. over 21 years of age. - exclusion criteria: residents with cognitive impairment due to causes other than dementia (e.g., head trauma) and in short-term, sub-acute snfs will be excluded. -
biology in patients with reflux esophagitis

Conditions: GERD

Summary: gerd is a common condition in the western world. in most cases, the diagnostic is established by good response to empiric proton pump inhibitor (ppi) therapy. when the patient symptoms are refractory to therapy, multiple invasive tests are available. the results of those tests (egd, manometry, ph monitoring and impedance) are clues that the physician use together to establish the diagnostic. no test however can be use alone because of their poor specificity and sensitivity. recently, microscopy has been used to detect dilated intercellular space in between distal esophageal cells tissue; unfortunately this marker again failed to diagnose gerd. in search of more sensitive and specific markers of gerd, we propose to assess if acid exposure affects: 1) gene and proteins expression in the esophageal/post-cricoid area tissue; and 2) local impedance of the mucosa. the secondary aim of this proposal is to determine if correlation exists between the two approaches.


Eligibility criteria:
inclusion criteria (gerd cases): * male or female * ages 18 years or older * undergoing egd as standard of care at vanderbilt's digestive diseases center * esophageal erosion detected at egd * abnormal ph monitoring inclusion criteria (controls): * male or female * ages 18 years or older * undergoing egd as standard of care at vanderbilt's digestive diseases center * no complaints or history o heartburn or acid regurgitation * no erosion at egd * normal ph monitoring exclusion criteria: * less than 18 years of age * unable to provide informed consent * use of acid suppressive therapy within last 14 days * known history of barrett's esophagus, gastric surgery, alcoholism, significant motility condition * contraindications to biopsy such as taking anticoagulants other than aspirin (coumadin, plavix) or allergies to local anesthetic

Keywords: esophageal erosion abnormal ph monitoring
resect and discard strategy in clinical practice

Conditions: Endoscopic Assessment; Colonic Polyps; Endoscopic Surveillance; NBI

Summary: nowadays, post-polypectomy surveillance intervals are determined by combining endoscopic and pathologic data. real-time imaging technologies, have shown promising results in discriminating adenomatous from non-adenomatous polyps. the "resect and discard strategy" for small polyps (based on real-time assessment of the histology and on the endoscopic resection without pathological examination) has been shown to be cost-effective in simulation models. no data exist about the impact of this strategy in clinical practice. the aim of present study was to assess whether the systematic use, in the everyday clinical practice, of the "resect and discard strategy" allows to correctly manage patients with small colonic polyps.


Eligibility criteria:
inclusion criteria: * consecutive adult outpatients undergoing colonoscopy for routine clinical indications exclusion criteria: * surveillance interval was not necessarily directed by endoscopic findings (history of colorectal cancer, inflammatory bowel disease, hereditary polyposis syndromes, hereditary non-polyposis colorectal cancer) * colonoscopy was performed without nbi technology * at least one lesion \> 10 mm or \< 10 mm but with morphologic features suspect for malignancy (depressed or ulcerated lesions) was detected * bowel preparation was inadequate * caecal intubation was not accomplished * polyps could not be resected for concomitant anticoagulation treatment, 7) polyps were resected but not retrieved for pathology.
low-dose hydrocortisone in acutely burned patients

Conditions: Burns

Summary: major burns trigger the release of circulating mediators, as cytokines and endotoxin that induces a systemic inflammatory response syndrome. the cardiovascular effects are similar to those seen in septic shock. after the initial hypovolemic phase, patients with extensive burns often present a shock with increased cardiac output and reduced systemic vascular resistances. as described in septic shock, we test the hypothesis that low-dose hydrocortisone could decrease the duration of the shock period.


Eligibility criteria:
inclusion criteria: * males and females, * between 18 and 75 year old * who present a burned surface more than 30% of the body surface * who need catecholamine infusion * between j0 and j3 after the injury. exclusion criteria: * pregnancy, * trauma, * sepsis, * cardiac insufficiency, * aids, * etomidate administration

Keywords: burn adrenal insufficiency hydrocortisone short corticotropin test
effect of aquatic exercise and traditional physical therapy on gout in hypertensive menopausal women with hyperuricemia

Conditions: Gout

Summary: aquatic exercise and traditional physical therapy are effective methods of treatment for gout and hypertension in menopausal women.

menopause is defined as a point in time 12 months after a woman's last period. during the menopausal transition, changes in estrogen and progesterone levels affect not only vasomotor symptoms, sexual dysfunction, osteoporosis, and cardiovascular disease (cvd), but also uric acid level1. an association between menopausal status and hyperuricemia has been previously examined. a study using the third national health and nutrition examination survey showed a positive and independent association of menopause with hyperuricemia and gout. it's believed that estrogen has a protective effect that is removed at menopause, thus accounting for the rise in gout in women who are postmenopausal2. hyperuricemia is a common biochemical abnormality resulting from excessive uric acid production or impaired clearance of uric acid. although its pathophysiology is not fully understood, genetic, comorbid disease-related, and environmental (drug, diet, and toxic exposure-induced) factors are involved in hyperuricemia3. gout is a multifactorial disease caused by hyperuricemia and monosodium urate crystals deposition. pain typically comes on rapidly, reaching maximal intensity in less than 12 hours. the joint at the base of the big toe is affected in about half of cases4.

Eligibility criteria:
inclusion criteria: * 100 patients with gout * age between 45 -65 years * cooperative patient. * a physician referred all patients with the diagnosis of gout exclusion criteria: * history of kidney disease such as chronic kidney disease, cancer patients. smokers patients with chronic heart disease.
artificial saliva containing cumin and ginger extract in hemodialysis patients with xerostomia

Conditions: Xerostomia

Summary: hemodialysis patients with xerostomia are divided into 2 groups which are group a (start with artificial saliva containing cumin and ginger extract for 2 weeks, free periods 2 weeks, then placebo for 2 weeks) and group b (start with placebo for 2 weeks, free periods 2 weeks, then artificial saliva containing cumin and ginger extract for 2 weeks). amount of saliva (g/min), xerostomia's questionnaire, increase of saliva score, world health organization oral mucositis grading scale, acid and base of saliva, quality of life's questionnaire will measure before, after using the sample for 7 and 14 days.


Eligibility criteria:
inclusion criteria: * age more than 18 years * hemodialysis patients with xerostomia (saliva flow rate less than 0.2 g/min) * hemodialysed history more than 3 months * be willing to participate in the study exclusion criteria: * patients with sialolith or sjogren's syndrome * uncontrolled other diseases * using artificial saliva for more than 2 weeks * taking pilocarpine and cevimeline * allergic to ginger, cumin, xylitol, and glycerin * have mucositis * pregnancy or lactation
evaluate the impact of drawtex in venous leg ulcers

Conditions: Moderatley to Highly Exuding Venous Leg Ulcers

Summary: this is a clinical study to comparatively evaluate the impact of drawtex wound dressing against wound bioburden in moderately to highly exuding venous leg ulcers.

each subject is expected to participate in this study for a period of four weeks or until reepithelialization, whichever occurs first. subjects may participate for an additional period of four weeks or until reepithelialization, whichever occurs first: this it to be decided by the investigator and will be determined by the accessibility of the patient (physical location) and the suitability of the wound to further treatment. the maximum time period for the study is 8 weeks. the minimum time frame is at least 4 week, or until reepithelialization occurs.

Eligibility criteria:
inclusion criteria: * subject \> 18 years. * subject is attending weekly office visits at sw wound care center as an out-patient. * subject has a moderately to highly exudative venous leg ulcer that would be indicated for treatment with drawtex * subject or is informed about the trial, understands its nature of the study and provides written informed consent prior to study enrollment. * subject is willing and able to comply with all specified care and visit requirements exclusion criteria: * subject has a lesion that does not meet the inclusion criteria. * subject refuses to participate in the study. * subject already participates in the this study with one wound (only one wound per subject is allowed) * subject has known sensitivity to the trial product or any of its compounds. * subject is expected to be non-compliant. * subject's lesion is a primary skin cancer. * subject's lesion is the manifestation of a metastasis. * subject is pregnant.

Keywords: dressing for venous leg ulcers
comparison of antegrade and retrograde fixation with intramedullary screws in metacarpal fractures

Conditions: Metacarpal Fracture

Summary: purpose: intramedullary fixation has proven to be an efficacious intervention for metacarpal fractures. advantages involve stable fixation facilitating early surgical rehabilitation and higher fracture union rates, without increased morbidity. we aimed to compare the results of fixation of metacarpal fractures with headless cannulated screws towards antegrade or retrograde on pain, function and quality of life in patients with metacarpal fractures. methods: patients admitted to pamukkale university orthopedics and traumatology department, due to metacarpal fracture were prospectively included in the study and randomly grouped. a total of 22 patients and 26 metacarpal fractures were assessed. group i patients were operated with antegrade(proximal entry) , and group ii with retrograde (distal entry) , using intramedullary headless cannulated screws. appropriate screw selection was made by measuring the metacarpal isthmus diameter of the patient's x-ray results (ap and oblique direction). we used headless cannulated screws with diameters between 3.5mm and 5mm in the fractures.

this was a prospective randomised comparative single-blinded study comparing the effects of intramedullary fixation direction and entry site in patients with metacarpal fractures. the participants were first evaluated at post-operative 6th week and the last evaluation was performed at post-operative 12th week the evaluations included radiographic union, grip strength measurement (with jamar hydraulic hand dynamometer), range of motion measurement (compared to the opposite hand), and michigan hand outcome questionnaire (mhq) questionnaire. all assessments were performed by the same investigator. the researcher who performed the evaluations did not know which group the participants were in. in the antegrade headless cannulated screw fixation technique, a small incision was made on the extensor aspect of the fractured metacarpal at the level of the carpometacarpal (cmc) joint and the extensor tendon was excised. after fracture reduction, k-wire was inserted intramedullarly. after appropriate drilling, 1 headless cannulated screw was applied distally.(figure 1) in the fixation technique with retrograde headless cannulated screw, a small incision was made on the extensor side of the fractured metacarpal at the level of the mcp joint, and the extensor tendon split was passed. after fracture reduction, k-wire was inserted intramedullarly. after appropriate drilling, headless cannulated screw was applied proximally.

Eligibility criteria:
inclusion criteria: * operated for metacarpal fracture, * speak and understand turkish, * understand the verbal and written information given. * regular follow-up visits exclusion criteria: * open epiphysis * pathological fractures * fractures requiring bone grafting

Keywords: metacarpal fracture, intramedullary fixation
randomized controlled trial of tranexamic acid in total knee arthroplasty: intravenous vs. topical

Conditions: Osteoarthritis

Summary: the purpose of this study is to determine whether topical or intravenous administration of tranexamic acid during unilateral total knee replacement is more effective at reducing bleeding in the first 24 hours following surgery. tranexamic acid is a synthetic drug that has been shown to reduce blood drain output and the need for blood transfusions in both its topical and intravenous forms and is commonly used in orthopedic surgery. we hypothesize that iv and topical administration of tranexamic acid will be equally good at reducing the loss of blood and the need for transfusion immediately following total knee replacement.

this randomized controlled trial compares the blood loss of patients undergoing unilateral total knee replacements who randomly receive either the topical or the intravenous form of tranexmamic acid during surgery. patients in the intravenous arm of the study will receive 1 gram of tranexamic acid in 10 milliliters of solution prior to inflation of the tourniquet and 1 gram of tranexamic acid in 10 milliliters of solution during closure. for patients in the topical arm of the study, prior to the release of the tourniquet they will receive 3 grams of tranexamic acid in 75ccs of solution directly on the site of the incision. the primary result measurement will be blood drain output from the knee at 24 hours after surgery.

Eligibility criteria:
inclusion criteria: * primary total knee replacmeent * osteoarthritis * unilateral exclusion criteria: * revision surgery * donated preoperative autologous blood * on chronic anticoagulation medication such as coumadin, xarelto, plavix, or aspirin (other than 81mg) * preoperative hepatic or renal dysfunction * diagnosis of inflammatory disease * diagnosis of inflammatory arthritis * pregnant * breastfeeding * preoperative hemoglobin \<10g/dl * international normalized ratio\>1.4 * abnormal partial thromboplastin time * preoperative platelet count of \<150,000mm\^3 * creatinine \> 1.4

Keywords: total knee arthroplasty total knee replacement tranexamic acid osteoarthritis degenerative joint disease
study to assess the safety and efficacy of subcutaneously injected risankizumab in adult participants with genital or scalp psoriasis

Conditions: Genital Psoriasis; Scalp Psoriasis

Summary: psoriasis (pso) is a chronic disease characterized by marked inflammation of the skin that results in thick, red, scaly plaques. this study will assess how safe and effective risankizumab is in adult participants with moderate to severe genital psoriasis or moderate to severe scalp psoriasis. adverse events and change in disease signs and symptoms will be monitored. risankizumab (skyrizi) is a drug being studied for the treatment of moderate to severe genital psoriasis or moderate to severe scalp psoriasis. approximately 200 participants with moderate to severe genital psoriasis or moderate to severe scalp psoriasis will be enrolled across approximately 45 sites globally. the study will be broken up into 2 sub-studies by disease location, participants with moderate to severe genital psoriasis (study g) and moderate to severe scalp psoriasis (study s). in both sub-studies participants will receive subcutaneous (sc) injections of risankizumab during the 52 week treatment period, or sc injections of placebo risankizumab during the 16 week treatment period followed by sc injections of risankizumab during the 36 week treatment period, with an 8-week follow-up period after the 52 week treatment period. there may be higher treatment burden for participants in this trial compared to their standard of care. participants will attend regular visits during the study at a hospital or clinic. the effect of the treatment will be checked by medical assessments, blood tests, checking for side effects and completing questionnaires.


Eligibility criteria:
inclusion criteria: * must have clinical diagnosis of chronic plaque psoriasis with or without psoriatic arthritis for at least 6 months before the baseline visit. * must have a current diagnosis of moderate to severe genital psoriasis (study-g) defined as static physician global assessment of genitalia (spga-g) ≥ 3 or moderate to severe scalp psoriasis (study-s) defined as psoriasis scalp severity index (pssi) \>= 12, scalp investigator global assessment (iga) \>= 3, and \>= 30% of the scalp affected. * must have body surface area (bsa) ≥ 1% with at least 60% of subjects having bsa ≥ 10%; spga ≥ 3; inadequate control of psoriasis and/or intolerance to topical treatment, phototherapy and/or systemic therapy; and be candidates for systemic therapy or phototherapy as assessed by the investigator. exclusion criteria: * had previous exposure to il-23 inhibitors including but not limited to guselkumab, tildrakizumab, ustekinumab, mirikizumab, or risankizumab. * history of an allergic reaction or significant sensitivity to constituents of the study drug (and its excipients) and/or other products in the same class. * non-plaque forms of psoriasis or other active skin disease.

Keywords: genital psoriasis scalp psoriasis plaque psoriasis psoriasis abbv066 skyrizi risankizumab
fractionated versus target-controlled propofol administration in bronchoscopy

Conditions: Lung Cancer; Sarcoidosis; Interstitial Pneumonia

Summary: after randomization, the subjects undergo flexible bronchoscopy either with fractionated propofol administration or with propofol-tci. measurement of blood pressure, heart rate, oxygen saturation, and oxygen requirement are measured continuously during the procedure and thereafter. cumulative propofol dose, and induction, procedure, and recovery time are noted continuously during and after the procedure.

in daily clinical praxis, propofol sedation is given manually in repeated doses (fractionated) by a specially-trained nurse in attendance of the bronchoscopist. but, fractionated propofol administration (fpa) may lead to oversedation and enhanced side effects (oxygen desaturation and arterial hypotension), as a stable plasma concentration of propofol is not maintainable. in contrast to fpa, continuous infusions of propofol are commonly used to induce and maintain long-term sedation in intensive care units and general anesthesia. recently, continuous propofol infusion for sedation in bronchoscopy has been shown comparable to fpa in terms of safety and efficacy. generally, infusion devices can be manually controlled (mci) or target-controlled (tci). in the latter, the physician sets a target blood concentration and the computerized infusion device makes the necessary changes to the infusion rate. the objective of this study is to compare propofol tci with fpa in flexible bronchoscopy concerning patient safety and sedation quality.

Eligibility criteria:
inclusion criteria: * subjects undergoing a planned, ambulatory flexible bronchoscopy (for transbronchial lung biopsy or endobronchial ultrasound guided procedures) in moderate sedation, aged between 18 and 85 years exclusion criteria: * history of solid organ or bone marrow transplantation with the use of an immunosuppressive therapy * hiv infection on anti-retroviral therapy * alcohol consumption more than two standard drinks per day * use of illicit drugs (heroin, opiates) * any contraindication to use propofol for sedation (e.g. allergy) * body mass index \> 35 kg/m2 * mental disorder preventing appropriate judgment concerning study participation * missing written patient's informed consent
test safety and efficacy of zotarolimus- and everolimus-eluting stents (zes/ees) assessed by optical coherence tomography

Conditions: Coronary Heart Disease

Summary: the objective of the study is to assess the superiority of the everolimus-eluting stent (endeavor resolute®) compared with the everolimus-eluting stent (xience v®) regarding uncovered stent strut segments.

the mid-term efficacy of drug-eluting stents has been well-established, but there is an ongoing debate on the potential of an increased incidence of late stent thrombosis, particularly after discontinuation of thienopyridine therapy, as well as of delayed onset of restenosis or catch-up phenomenon with permanent polymer-based des. the extent of strut coverage with reduction of exposed thrombogenic material has been shown to be associated with the inflammatory reaction grade and with the incidence of stent thrombosis. the optical coherence tomography (oct) is an intravascular imaging modality based on light. the principle is similar to intravascular ultrasound, but due to the much shorter wave length of light, it offers a much better resolution up to 10µm, enabling the exact determination of strut coverage, neointimal thickness, vessel size, presence of dissections, and even the presence of inflammation.

Eligibility criteria:
inclusion criteria: * patients older than age 18 with ischemic symptoms or evidence of myocardial ischemia in the presence of ≥ 50% stenosis located in native coronary vessels. * written, informed consent by the patient or her/his legally-authorized representative for participation in the study. * in women with childbearing potential a negative pregnancy test is mandatory. exclusion criteria: * lesion length \>16mm requiring a stent length \>18mm * target lesion located in the left main trunk. * in-stent restenosis. * acute myocardial infarction * malignancies or other comorbid conditions (for example severe liver, renal and pancreatic disease) with life expectancy less than 12 months or that may result in protocol non-compliance. * known allergy to the study medications: everolimus, zotarolimus, stainless steel or cobalt chrome. * inability to take dual antiplatelet therapy for at least 6 months. * pregnancy (present, suspected or planned) or positive pregnancy test. * previous enrollment in this trial. * patient's inability to fully cooperate with the study protocol.