Kornimate/medical-research-clean huggingface dataset:
telemedicine - evaluation of the impact of a telemedicine device (dtm) on the prevention of emergency department visits and hospitalizations of nursing home residents aged polypathological

Conditions: Polypathology

Summary: for several decades, there is an aging population, particularly in industrialized countries. this lengthening of the duration of life is accompanied by an increase in the number of chronically ill patients. on an estimate of 15 million patients in france today, the figure reported for 2020 would be 20 million patients. chronic diseases are responsible for functional decompensation and admission responsible autonomy breaks in nursing homes (accommodation establishment of people dependent elderly). an estimated 700,000 the number of people currently living in retirement homes in france. these residents are mostly dependent and multiple pathologies requiring regular general and specialist medical monitoring . medical concern demographic outlook and the need for access to quality care across the country leads to the development of telemedicine. the need for telemedicine is not the same throughout the territory. it is less, or different, in highly urbanized areas where the density of health professionals is high, then it can be a new response to the needs of rural, isolated or landlocked. telemedicine promotes the development of the concept of graduated care sector, especially in the management of patients with chronic diseases. telemedicine in rural nursing homes and can be a tool for assessing, monitoring and coordination to avoid decompensation of chronic conditions and rehospitalization. this organization can afford to break the isolation of general practitioners and ehpad coordinators physicians in rural areas and provide access to several specialties.


Eligibility criteria:
inclusion criteria: * resident in one of 9 nursing homes participating in the project * resident polypathologique has at least two comorbidities * having made no request to change place of residence at the time of the inclusion visit * having given free consent, informed writing and signed by himself and / or his legal representative exclusion criteria: * unaffiliated resident or non-receiving of social security * severe pathology (ies) involving life-threatening in the short term * resident whose return home, transfer to another nursing home or to a long term care unit is programmed

Keywords: telemedecine
evaluating a virtual stepped care portal in youth awaiting tertiary chronic pain care: an implementation-effectiveness hybrid type iii study

Conditions: Chronic Pain

Summary: pain is one of the most common symptoms of extreme stress in youth. without treatment, short-term pain can last for months to years (called 'chronic pain'; cp), a problem already affecting 1 in 5 canadian youth. the covid-19 pandemic is one of the greatest threats to youth mental health seen in generations. cp in childhood can trigger a wave of mental health issues that last well into adulthood. in 2019, we learned that "access to pain care" is poor and a priority for youth with cp and their families. unfortunately, covid-19 has only made access more difficult. in 2020, we created an online "stepped care" program called the power over pain portal for youth with cp. stepped care is a promising way to improve access to cp care by tailoring care based on the symptoms each youth is experiencing. like a ladder, youth start with one type of care and then "step up" or "step down" to more or less intense care depending on what they need. over the past year, funded by cihr, we worked with hundreds of youth and healthcare professionals across canada to understand how the pandemic has affected pain and mental health. we also summarized all online pain self-management programs including peer support for youth to find the best resources to include in the portal and will translate the portal content into french. together with a diverse group of youth with cp, we have now co-designed the online portal. the next step (focus of this grant) is to test the portal with youth to ensure it can be implemented and is helpful. we will recruit 93 youth with cp waiting for specialist care at 11 cp clinics across canada to use the portal for 4 months. we will see how they use the portal and if it helps to improve their pain and mental health. this study is important because it will allow us to understand how the portal works in the real world before wide public release (english and french) to support all youth in canada with cp with accessible, evidence-based pain care.


Eligibility criteria:
inclusion criteria: * experience chronic pain * speak and read english or french * have access to internet / smartphone (or are willing to be loaned a study phone with a data plan) * are on the waitlist of a tertiary care cp clinic in canada * intend to use the pop portal for at least 4 months * have the capacity to consent exclusion criteria: * have moderate to severe cognitive impairments that may impact their ability to understand and use the pop portal or complete self-reported clinical outcome measures * have untreated major psychiatric illness (e.g., anorexia, psychosis) and/or active suicidality as assessed by the pop portal screening. youth who have co-occurring clinically significant anxiety or depression that is currently being treated will be eligible if they meet other inclusion criteria.
hmo research network cert: acute myocardial infarction

Conditions: Acute Myocardial Infarction (AMI)

Summary: the primary goal of this study is to evaluate the effectiveness of direct-to-patient mailings designed to increase patient's adherence to prescribed beta-blockers following an acute myocardial infarction (ami). prior to developing patient materials, focus groups were conducted with patient who had previously suffered an acute myocardial infarction (ami) to identify the issues and information that patients felt were important to include in our materials as well as the best way to present the information. additionally, patient materials were "pre-tested" with ami patients to ensure that the materials were clear and easy to read and that the key messages were understood.

specific aims: 1. assess the persistence of beta blocker use for post-acute myocardial infarction (ami) patients following a direct to patient intervention designed to increase rates of evidence-based long-term use of medications (beta blockers, lipid lowering agents, aspirin and ace inhibitors) that increase survival following ami. 2. describe patient and system characteristics associated with differences in impact of the intervention research design and methods: we will conduct a randomized controlled trial within the 4 participating hmos (kaiser permanente northwest, harvard pilgrim health care, health partners, and kaiser permanente georgia). inpatient data will be used to identify patients with a primary discharge diagnosis of ami 4-6 months before the extraction date. practices will be block-randomized to the intervention group or to usual care. to increase repetition of the message, there will be two personalized mailings, occurring at 4-6 months post ami, and at 9 months. the first message will include elements in the table below, and the repeat message will be shorter, but include similar information. the message will come from the patient's own health plan with the choice of specific individual (e.g. quality assurance department, medical director, or chief of cardiology) being informed by our qualitative work. this intervention will be done in collaboration with the cardiovascular care committees and quality assurance departments of participating health maintenance organizations (hmos).

Eligibility criteria:
inclusion criteria: * clinical diagnosis of acute myocardial infarction (ami) from 12/1/03 to 5/31/04 * beta-blocker dispensing following ami * beta-blocker dispensing prior to intervention date exclusion criteria: none

Keywords: acute myocardial infarction (ami) heart attack adherence beta-blocker behavior change
pilot study of patients chronic hepatitis c in co-infected hiv patients relapsers after previous therapies

Conditions: Chronic Hepatitis C; HIV Infections

Summary: to determine the efficacy and safety of peginterferón alfa-2a (40 kd) plus ribavirin in patients who have relapsed or not responded to a previous suboptimal therapy based in interferon.

an important number of co-infected patients were treated suboptimally in the past with others ineffective therapies interferon-based. all co-infected patients should be an opportunity of retreatment with actually therapies.

Eligibility criteria:
inclusion criteria: * male and female patients between 18 and 65 years of age * anti-hcv positive * detectable plasma hcv-rna * relapsers after treatment with interferon o peginterferon +/- ribavirin * hiv positive * cd4 \>/= 200 cell * patients on clinically stable liver disease with: * hgb \>/= 12 g/dl in women or 13 g/dl in men * leucocytes \>/= 3000 mm3 * neutrophil count (anc) \>/= 1500 cells/mm3 * platelet count \>/= 100.000 cells/mm3 * normal prothrombin, bilirubin, albumin, creatinine and uric acid * hbsag negative * with antecedents of diabetes or hypertension is necessary an previous ocular exploration exclusion criteria: * women with ongoing pregnancy or breast feeding * positive test at screening for anti-hav igm ab, hbsag, anti-hbc igm ab, hbeag * hemochromatosis * deficit of alfa-1 antitrypsin * wilson disease * alcoholic liver disease * autoimmune hepatitis * hepatitis by toxin exposures * hepatitis by obesity * hemoglobinopathy (e.g. thalassemia) * history or other evidence of bleeding from esophageal varices or other conditions consistent with decompensated liver disease * hepatocarcinoma observed in the liver ecography. * history of severe psychiatric disease, especially depression. severe psychiatric disease is defined as treatment with an antidepressant medication or a major tranquilizer at therapeutic doses for major depression or psychosis, respectively, for at least 3 months at any previous time or any history of the following: a suicidal attempt, hospitalization for psychiatric disease, or a period of disability due to a psychiatric disease * history of a severe seizure disorder or current anticonvulsant use * history of significant cardiac disease that could be worsened by acute anemia (e.g. nyha functional class iii or iv, myocardial infarction within 6 months, ventricular tachyarrhythmias requiring ongoing treatment, unstable angina) * diabetes mellitus * history of immunologically mediated disease (e.g., inflammatory bowel disease, idiopathic thrombocytopenic purpura, lupus erythematosus, autoimmune hemolytic anemia, scleroderma, severe psoriasis, rheumatoid arthritis) * history or other evidence of chronic pulmonary disease associated with functional limitation * drug use within 6 months of 1st dose and excessive alcohol consumption. * concomitant treatment with ddi * male partners of women who are pregnant

Keywords: co-infected hcv/hiv relapsers
early effect of fasting on metabolic, inflammatory, and behavioral responses in females with and without obesity

Conditions: Healthy; Obese

Summary: the aim of this study is to investigate the effect of overnight fasting versus a diurnal fasting (during daily life activities) in females with and without obesity on inflammation, neurotrophins, energy metabolism, mood, food cravings, and appetite sensations. this study will be an acute fasting intervention.


Eligibility criteria:
inclusion criteria: * body mass index between 18.5 and 24.9 kg/m² or equal or greater 35 kg/m²; * able to sign the informed consent. exclusion criteria: * chronic health conditions (e.g., cancer, renal, heart or liver disorders, and autoimmune diseases), or history of thyroid alterations or use of related medications; * use of corticosteroids, immunosuppressors, anti-inflammatories, hypoglycemics, medications for weight loss, or any medication known to interfere with metabolic and inflammatory processes (e.g., corticosteroids, nonsteroidal anti-inflammatory drugs); * previous surgery for weight loss; * inability to eat any of the components of the standardized breakfast * pregnancy or breastfeeding; * smokingç * alcohol use (\>2 doses/day).

Keywords: acute fasting inflammatory response energy expenditure
significance of disseminated intravascular coagulation score in mortality for children with shock

Conditions: Shock, Septic

Summary: evaluates whether the dic score, as defined according to the international society of thrombosis and hemostasis guidelines is associated with mortality in children with shock and dic

disseminated intravascular coagulation (dic) is an acquired syndrome characterized by excessive systemic activation of coagulation, resulting in both hemorrhage and thrombosis. dic can progress rapidly into lifethreatening multiorgan failure. under normal hemostatic conditions, clot formation and resolution are tightly regulated. in dic, dysregulated activation of the coagulation system results in a consumptive coagulopathy and microvascular thrombosis. dic is always a secondary process caused by a variety of underlying disorders (eg, sepsis, trauma, or malignancy), which can cause endothelial tissue damage and procoagulant exposure . this activates the coagulation cascade, which promotes fibrin production and deposition and consumption of clotting factors. the subsequent consumption of coagulation factors and platelets, inhibition of natural anticoagulants and fibrinolysis, and fibrin deposition result in the clinical picture of dic: a bleeding diathesis accompanied by microvascular thrombosis that often leads to end-organ damage . the international society of thrombosis and hemostasis and the japanese association for acute medicine scoring systems are useful for detection of the dic in critically ill pediatric patients . the overall incidence of dic to be 1.2%, using a scoring system comprised of etiologic factors, clinical features, platelet count, prothrombin time, fibrinogen, and fibrin degradation products (fdps) . the dic score, easily computed in real-time at the bedside with routine laboratory values, is associated with mortality for children with sepsis andshock. diagnosis of dic through test of the d-dimer. accordingly, testing for ddimer or fdps may be helpful for evulating relationship between dic score and mortality rate among children with shock .

Eligibility criteria:
inclusion criteria: * all children with shock and dic will developed during the period from 1-1-2025 to 31-12-2025 exclusion criteria: * any shock not complicated with dic

Keywords: dic score
trial of s-1 plus cisplatin (sp) versus gemcitabine plus cisplatin (gp) in advanced biliary tract adenocarcinoma

Conditions: Metastatic Biliary Cancer

Summary: to select a better agent between s-1 or gemcitabine in combination with cisplatin for the conventional chemotherapy platform for future development in advanced biliary tract adenocarcinoma (bta), the investigators conduct a randomized phase ii trial of s-1 and cisplatin (sp) versus gemcitabine and cisplatin (gp) as first line therapy in advanced bta.


Eligibility criteria:
inclusion criteria: 1. pathologically proven biliary adenocarinoma 2. age \> 18 3. evaluable disease 4. ecog performance status of 2 or better 5. no prior exposure to chemotherapy, but adjuvant chemotherapy (or chemoradiotherapy) completed 6 moths or more before study enrollment is allowed 6. adequate bone marrow function a. wbcs \> 4,000/µl, absolute neutrophil count \[anc\]\>1,500/µl b. hemoglobin \>9.0 g/dl c. platelets \> 100,000/µl 7. adequate kidney function (creatinine\<1.5 mg/dl) 8. adequate liver function (bilirubin\ 2.5 mg/dl) 9. no serious medical or psychological condition that would preclude study treatment 10. willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures exclusion criteria: 1. other tumor type than adenocarcinoma 2. evidence of gi bleeding or gi obstruction 3. presence or history of cns metastasis 4. pregnancy or breastfeeding 5. other serious illness or medical conditions 6. axial skeletal radiotherapy within 6 months 7. neuropathy grade 2 or worse

Keywords: biliary cancer systemic chemotherapy s-1 gemcitabine cisplatin
comparative study of inguinodynia after inguinal hernia repair

Conditions: Inguinal Hernia; Inguinal Hernia Repair; Open Inguinal Hernia

Summary: to evaluate the postoperative pain and the relapse after the repair of the inguinal hernia by lichtenstein technique with four different mesh types with different types of fixation in patients undergoing major ambulatory surgery.

since the widespread use of meshes in the repair of inguinal hernia, recurrence rates have acceptable values, so, today, the focus is on trying to decrease chronic pain after hernioplasty. chronic postoperative inguinal pain (cpip) is an important clinical problem, which can significantly influence the quality of life of the patient. different studies have published cpip rates from 9.7% to 51.6%. the reasons for cpip are unclear; lesion and entrapment of the nerves, the type of mesh used, and the fixation material of this has been related to the causes of inguinodynia. cpip can be divided into neuropathic pain and non-neuropathic pain. according to the international association for the study of pain (iasp), neuropathic pain is caused by the primary lesion or nerve dysfunction, causing burn-like pain that radiates through the area innervated by the injured nerve, intensifying the nerve with light touch. the causes of this type of pain are the entrapment of the nerve by the mesh or sutures or by the formation of neuromas associated with the partial or complete transection of the nerve. the nerves that run through the inguinal region and are therefore susceptible to injury when the anterior approach is the ilioinguinal nerve, the genitofemoral genital branch, and the iliohypogastric nerve. neuropathic pain may occur immediately after surgery, but may also occur months or years after surgery. non-neuropathic or nociceptive pain is caused by the activation of mediators of inflammation due to the continuous inflammatory reaction that occurs around the mesh. according to amid, nociceptive pain is caused by the mechanical pressure of the mesh over adjacent tissue, including the vas deferens and nerves. this type of pain is acute and stabbing and is aggravated by intense exercise. in conclusion, the use of foreign materials in hernia surgery may induce intense inflammation that can result in chronic pain. the hypothesis of our work is that: "the use of glue-attached meshes (self-adhesive) compared to those fixed with suture present lower rates of post-hernioplasty pain".

Eligibility criteria:
inclusion criteria: * age: over 18 years * patients undergoing inguinal hernia surgery on a scheduled basis in surgery without hospitalization. * sign informed consent. * asa i-ii. * inguinal hernia. * unilateral or bilateral hernia. * lichtenstein hernia repair technique exclusion criteria: * patients with asa iii-iv. * psychiatric disorders. * pregnant or breastfeeding. * non-acceptance of informed consent. * no acceptance or inability to follow a follow-up protocol. * any hernia repair technique other than lichtenstein. * recurrent inguinal hernia

Keywords: inguinal hernia chronic postoperative inguinal pain glue mesh suture mesh
the effect of long-acting mesalamine on post-infective irritable bowel syndrome- a pilot study

Conditions: Irritable Bowel Syndrome

Summary: the purpose of this study is to evaluate the effects of long acting mesalamine (lialda) in patients with post-infective irritable bowel syndrome (pi-ibs). the investigators will evaluate gastrointestinal symptoms, ibs specific quality of life (ibs-qol), and plasma cytokines before and after treatment with lialda.

this study will test long acting mesalamine in the management of pi-ibs. it has the potential to improve qol and perhaps gastrointestinal symptoms, in patients with pi-ibs. the results of this study, if positive, will provide preliminary data for a large scale clinical trial. this study will also provide information about plasma cytokines in patients with pi-ibs and whether improvement in symptoms correlates with improvement in plasma cytokines.

Eligibility criteria:
inclusion criteria: inclusion criteria 1. men and women age 18-75 years 2. rome iii criteria for ibs 3. symptom onset after apparent acute gastroenteritis 4. symptoms of 6 months or greater duration 5. normal gross appearance of the colonic mucosa other than erythema 6. negative markers for celiac disease and inflammatory bowel disease 7. normal thyroid function and serum calcium 8. stable medication regimens for other medical conditions. exclusion criteria: 1. age \ 75 years 2. previous diagnosis of or history compatible with ibs 3. constipation-predominant ibs. 4. clinically significant chronic cardiac, pulmonary, hepatic, renal dysfunction or hiv 5. history of/or presence of malignancy 6. current evidence of any gastrointestinal disorder such as celiac disease, inflammatory bowel disease, chronic pancreatitis, scleroderma, hiv, small bowel or colonic resection, paraplegia or quadriplegia. . 7. current evidence of drug or alcohol abuse as judged by the investigator 8. allergy to mesalamine or aspirin 9. investigator perception of patient's inability to comply with the study protocol 10. unstable psychiatric disease 11. recent change in gastrointestinal medications

Keywords: irritable bowel syndrome diarrhea mesalamine gastroenteritis abdominal pain hypersensitivity
rv001v, a rhoc anticancer vaccine, against metastasis from solid tumours

Conditions: Prostate Cancer

Summary: the study will evaluate safety and immunological response to rhoc peptide vaccine in patients with prostate cancer


Eligibility criteria:
inclusion criteria: * patients prostatectomised (pt) due to histologically verified adenocarcinoma of the prostate gland who currently are not being treated, or expected within the next 8 months to be treated, with any anti-cancer treatment. * ecog performance status 0 or 1. exclusion criteria: * patient has been treated with androgen deprivation therapy (adt), or expected to receive such treatment within the next 8 months from enrolment. * severe medical conditions, such as but not limited to severe asthma/chronic obstructive pulmonary disease (copd), new york heart association (nyha) grading 3 or above, poorly regulated insulin dependent diabetes, any significant organ damage as judged by the investigator.

Keywords: prostatectomised cancer patients