Kornimate/medical-research-clean huggingface dataset:
telemedicine use in preoperative counseling for endometrial cancer survivors

Conditions: Telemedicine; Counseling

Summary: to determine whether telemedicine is an acceptable addition to pre-operative counseling, compared to face-to-face communication alone for patients with endometrial cancer.

newly diagnosed endometrial cancer survivors, who are presenting for their initial consultation with a plan for minimally invasive surgery, will be randomized 1:1 to standard counseling or standard counseling plus asynchronous telemedicine video. the asynchronous video will be available outside of the office and can be viewed multiple times. the primary endpoint is patient anxiety, measured via the state-trait anxiety inventory (stai) questionnaire, assessed before surgery. the secondary outcomes of anxiety following surgery as well as patient satisfaction with counseling type (measured via the patient satisfaction questionnaire (psq-18)) before and after surgery will be compared between groups. both groups will complete questionnaires following their initial consultation (but before surgery) and at their post-operative visit. for the telemedicine group, the duration and frequency of video views will be collected. participants completing both surveys will receive a survivorship gift bag.

Eligibility criteria:
inclusion criteria: 1. patients with clinical stage i histologically confirmed endometrial carcinoma, which is clinically confined to the uterus and comprises approximately two-thirds of all endometrial carcinoma cases 2. patients undergoing planned minimally invasive surgical procedures, such as a minimally invasive technique such as conventional laparoscopy or robotic-assisted laparoscopy, as part of treatment at the division of gynecologic oncology at carilion clinic, roanoke, va 3. internet/cellular access at home 4. ability to read and comprehend materials on questionnaires exclusion criteria: 1 patients that do not meet the inclusion criteria

Keywords: telemedicine preoperative counseling
ace and hla genotypes predict severity and disease progression in danish sarcoid patients

Conditions: Sarcoidosis

Summary: sarcoidosis is a multisystem granulomatous disease of unknown cause histologically characterized by noncaseating granulomas. genetic factors affect disease course, which is highly variable and difficult to predict. this study aims to evaluate the predictive value of ace and hla genotypes on disease severity and progression in danish patients with sarcoidosis.


Eligibility criteria:
inclusion criteria: * diagnosis of sarcoidosis * signed informed consent exclusion criteria: * inability or unwillingness to adhere to the study * inability to give informed consent
optimized caloric-proteic nutrition in critically ill patients

Conditions: Critically Ill

Summary: in this prospective randomized controlled trial the investigators intend to compare the use of a nutritional therapy based on caloric intake determined by indirect calorimetry and a high protein intake (2.0 to 2.2 g/kg/day) with a nutritional regimen based on 25 kcal/kg/day and protein intake usually recommended to critically ill patients (1.4 to 1.5 grams/kg/day).

objectives to evaluate the effect of nutritional therapy with caloric intake determined by indirect calorimetry and high protein intake (2.0 to 2.2 g/kg/day) compared to nutritional therapy with 25 kcal/kg/day and 1.4 to 1, 5 g/kg/day of protein on short-term outcomes and physical component (pcs) of quality of life after 3 and 6 months of randomization in severe icu patients. the primary objective will be the evaluation of the physical component summary (pcs) of sf-36 (short form 36), a questionnaire used to evaluate quality of life, validated for the brazilian population. patients will be assessed at least 3 and 6 months after randomization. secondary objectives: measurement of handgrip strength measured on the 7th and 14th day of the study and on discharge from the icu, icu mortality, hospital mortality, mechanical ventilation time and length of stay in the icu. methods the study will include patients over 18 years of age, not pregnant, submitted to mechanical ventilation, whose expectation of stay in the icu is greater than 3 days. the sample size was calculated based on the following parameters: patient population under mechanical ventilation, 528, 15% relative risk reduction in the evaluation parameter of the sf-36 tool, level of significance (α) of 5%, test power of 80%, thus the number of individuals to be sampled will be 294, i.e., two groups of 147 patients. a computer-generated list for randomization and sequentially numbered opaque sealed envelopes is used. the level of significance to reject the null hypothesis will be 5%, that is, a value of p \<0.05 will be considered as statistically significant. informed consent was obtained from the patient or a next of kin.

Eligibility criteria:
inclusion criteria: * critically ill patients mechanically ventilated expected length in the icu \> 3 days exclusion criteria: * pregnancy requirement for inspired oxygen (fio2) \> 0.60 high output bronchopleural fistula

Keywords: critical illness indirect calorimetry dietary proteins
therapeutic effects of "ibuprofen, diphenhydramine and aluminium mgs" on recurrent aphthous stomatitis

Conditions: Aphthous Stomatitis

Summary: the intention of the study is to study the effects of ibuprofen, diphenhydramine and aluminium mgs in decreasing the signs of recurrent aphthous stomatitis (ras)

recurrent aphthous stomatitis (ras) is the most painful oral lesion with a considerable prevalence . the most common aphthous ulcer treatments include applying topical agents such as antibiotics, non steroidal anti inflammatory drugs (nsaids) to immunosuppressants. the mixture of diphenhydramine and aluminum mgs suspension has been prescribed as an analgesic mouthwash for a long time in order to decrease a great number of oral ulcers symptoms such as aphthous ulcers. ibuprofen is a potent nsaid with fair anti-inflammatory potential prescribed in dental pains. this double-blind randomized clinical trial was conducted to assess the effect of ibuprofen, diphenhydramine and aluminium mgs mixture on symptoms of aphthous ulcers.40 patients will be participating in this study,20 will receive the mixture of diphenhydramine and aluminium mgs while the other group will receive ibuprofen, diphenhydramine and aluminium mgs mixture. all patients will be instructed to apply the drug on the site of the ulcer 30-60 minutes before meals, 3 times daily. the ulcers will be assessed when the drug is applied for 3 days and the level of pain and irritation will be estimated by vas (visual analogue scale, a scaled ruler which the zero point displays the zone of lack of pain and the 10th point was considered as the zone of maximum pain).

Eligibility criteria:
inclusion criteria: * possessing at least one painful aphthous ulcer in the last 3 days * older than 10 years of age exclusion criteria: * systemic disease or specific syndrome (such as behcet's) * pregnancy * breastfeeding * allergy to nsaids * history of asthma, peptic ulcers, hepatic and renal failures and hemorrhagic disorders * consumption of anti-inflammatory medications in the last 24 hours

Keywords: aphthous stomatitis ibuprofen treatment efficacy
risk factors of post-ercp sepsis

Conditions: Sepsis; Intraoperative Hypotension; Bacteremia Sepsis

Summary: for the treatment of numerous biliary and pancreatic problems, the procedure known as endoscopic retrograde cholangiopancreatography (ercp) is regarded as a crucial therapeutic intervention. however, ercp is known to be connected to a variety of issues, including post-ercp sepsis. this study's goal is to investigate the relationship between unexplained hypotension during or just after surgery and the emergence of sepsis after ercp.

at the gastrointestinal surgery centre, mansura university, egypt, a cohort study will be conducted on a sample of 50 adult (18+) patients who undergoing ercp. hypotension that occurred during surgery or shortly after will be classified as exposure when it cannot be linked to a particular cause. in this study, post-ercp sepsis will be the major outcome measure, while other ercp-related sequelae will be the supplementary outcome measures. discussion: the findings of this study will significantly advance our understanding of the potential link between intraoperative hypotension and the development of post-ercp sepsis. this study's goal is to increase knowledge of the challenges presented by ercp, which will aid in the creation of patient treatment methods that are more effective.

Eligibility criteria:
inclusion criteria: * undergoing ercp for obstructive jaundice * adult (older than 18 years old) * written informed consent exclusion criteria: * already on sepsis before the ercp * pregnancy
the safety and efficacy of ric on adult moyamoya disease

Conditions: Moyamoya Disease

Summary: there are a series of symptoms such as ischemic stroke、transient ischemic attack 、hemorrhagic stroke、headache 、seizure and so on in moyamoya disease( mmd) patients .nowadays, revascularization is the only effective way for ischemic mmd and there is no effective conservative treatment for mmd. this study was to explore the safety and efficacy of remote ischemic conditioning(ric ) on adult mmd patients.

there are a series of symptoms such as ischemic stroke、transient ischemic attack 、hemorrhagic stroke、headache 、seizure and so on in moyamoya disease. nowadays, revascularization is the only effective way for ischemic mmd while controversial for hemorrhagic mmd patients. surgical complications including hyperperfusion syndrome, cerebral infarction or bleeding often occurred postoperatively. there is no effective conservative treatment for mmd up to now. remote ischemic conditioning is remote ischemic conditioning (ric) is a noninvasive and easy-to-use neuroprotective strategy, and it has potential effects on preventing ischemia reperfusion injury and ischemic infarction.this study was to explore the safety and efficacy of remote ischemic conditioning on adult mmd patients.

Eligibility criteria:
inclusion criteria: * age: 18-60 years * all of the patients underwent digital subtraction angiography (dsa) and met the current diagnostic criteria recommended by the research committee on mmd of the ministry of health and welfare of japan in 2012. * mrs≤3 * informed consent obtained from patient or acceptable patient's surrogate. exclusion criteria: * patients with acute ischemic or hemorrhagic stroke within 3 months. * severe hepatic or renal dysfunction. * severe hemostatic disorder or severe coagulation dysfunction. * severe cardiac diseases. * patients with severe existing neurological or psychiatric disease * patients with moyamoya syndrome caused by autoimmune disease, down syndrome , neurofibromatosis, leptospiral infection, or previous skull-base radiation therapy. * patients have been done or plan to accept revascularization surgery.

Keywords: moyamoya disease remote ischemic conditioning cerebral blood flow
effect of dialectical behavior in patients with bipolar disorder

Conditions: Dialectical Behavior Therapy

Summary: this study aims to: • determine the effect of implementing dialectical behavior therapy on emotion regulation difficulties, distress tolerance, and social functioning among patients with bipolar disorder. research hypothesis patients with bipolar disorder who are exposed to dialectical behavior therapy will exhibit lower emotion regulation difficulties, distress tolerance, and higher social functioning than those who are not exposed to such training.

the researchers decided to work on a convenient sample of 30 adult patients with bipolar disorder. dialectical behavior therapy will be applied through psychoeducation, discussion, rehearsal, and homework assignments. four modules were administered in mindfulness, emotion regulation, emotion regulation, and emotion regulation.

Eligibility criteria:
inclusion criteria:1. diagnosed with bipolar disorder for at least one month according to dsm v with no co-morbidity. 2. their age does not exceed 60 years old. 3. able to read and write. 4. able \& willing to participate in the study. 5. living in alexandria governorate, egypt. exclusion criteria: demonstrate severe psychopathological symptom ( i.e: patient in acute stage) -
neurectomy vs nerve sparing in open inguinal hernia repair

Conditions: Inguinal Hernia

Summary: it is a randomized controlled trial in which we are treating inguinal hernia patients with mesh hernioplasty and either neurectomy of iliohypogastric nerve and ilioinguinal neurectomy or preservation comparing post operative acute or chronic pain


Eligibility criteria:
inclusion criteria: * patients male, and age between 20 to 70 years reducible inguinal hernia exclusion criteria: * irreducible, obstructed or strangulated hernia uncontrolled diabetes
rivaroxaban for treatment of patients with suspected or confirmed heparin-induced thrombocytopenia

Conditions: Heparin-induced Thrombocytopenia

Summary: heparin is an anticoagulant (blood thinner) that is commonly used to treat patients with heart attacks and patients with blood clots in their legs or lungs (venous thrombosis). some patients develop an allergic reaction to heparin, a condition called heparin-induced thrombocytopenia (hit). hit makes blood clot, which is the opposite of what heparin was designed to do. these blood clots can lead to heart attacks, strokes, limb amputations, and death. the objective of this 200 patient study is to determine if a new blood thinner called rivaroxaban (xarelto) can be used to treat hit. rivaroxaban can be taken by mouth, does not require blood testing, and had a low risk of bleeding when it was used to treat blood clots in other clinical trials. if this study shows that rivaroxaban can be used to treat hit, there will be two very important benefits. for patients with hit, the benefit will be having a safe, and easy-to-use drug to protect them from developing further life or limb-threatening blood clots. for the canadian health care system, the benefit will be having a drug that is much less expensive than the drugs currently used to treat hit.

consecutive adult patients with an intermediate or high clinical probability for hit (according to the clinical prediction rule called the "4t's score) will receive rivaroxaban 15 mg bid while awaiting confirmation or exclusion of hit by the local laboratory assay. patients who are confirmed to have hit by the local laboratory assay will continue to receive rivaroxaban 15 mg bid until their platelet count ≥ 150 or until end of study (day 30). at the time of platelet count recovery (typically 4-7 days), they will be transitioned to a maintenance dose of rivaroxaban (20 mg od) for a maximum of 30 days.

Eligibility criteria:
inclusion criteria: * adult patients with 4t's score greater than or equal to 4. exclusion criteria: * require ongoing anticoagulant therapy for a mechanical heart valve. * severe renal insufficiency (crcl\<30 ml/min) * hepatic disease (including child-pugh b and c) associated with coagulopathy and a clinically relevant bleeding risk * inability to take oral medications. * ongoing requirement for systemic treatment with azole-antimycotics (except fluconazole) or hiv-protease inhibitors or strong cyp3a4 inducers * clinically significant active bleeding or lesions at increased risk for bleeding within the last 6 months * platelet count less than 80 and an ongoing need for antiplatelet therapy may be excluded at the discretion of the investigator * pregnant or a woman of child-bearing potential not using an adequate birth control method * hypersensitivity to rivaroxaban or to any ingredient in the formulation.

Keywords: rivaroxaban treatment venous thromboembolism arterial thromboembolism thrombocytopenia
home monitoring after primary total knee arthroplasty

Conditions: Osteoarthritis, Knee

Summary: home monitoring technologies have recently emerged in many different areas of healthcare. these technologies are being used to provide rehabilitation to patients, and to prevent, identify, and manage complications. the investigators are proposing a method to monitor and communicate with patients during the first 12 weeks after total knee arthroplasty (tka) using an electronic home-based patient monitoring system with unique connectivity capabilities and prescriptive controls. the investigators will prospectively, electronically capture range of motion and gait parameters at specified intervals using bluetooth sensors worn by the patient. the unique in-home patient monitoring platform will be utilized by 10 tka patients once they return home following surgery. the investigators hypothesize that the use of an internet based home patient monitoring technology platform will reliably provide information related to the patients' pain and function and enhance patient feedback and communication after tka. the hypothesis will be tested with the following aim: 1) to test the reliability of all technology utilized within the patient's home including but not limited to the sensors, the communication controller, the patient interface (android tablet) and the internet by prospectively comparing between data collected through the home monitoring technology and traditional clinical measurements taken during physical therapy and surgical follow-up visits.

over one million primary total hip and total knee arthroplasty (tka) surgeries are being performed annually in the u.s. and this number is expected to increase over the next seven years, along with a simultaneously projected shortage of trained orthopaedic surgeons to care for these patients. this proposal addresses the optimization of the surgeons' clinical time through utilization of innovative home based technologies to monitor and communicate with patients during the first 12 weeks after total knee arthroplasty. this will be accomplished by establishing home monitoring connectivity with novel technology and measure validated patient-reported outcomes, knee rom and gait parameters in a postoperative tka patient's native living environment. it will allow the investigators to prospectively, electronically capture clinically relevant tka outcomes at the patient's home and provide insight into postoperative rehabilitation progress, predictors of suboptimal clinical outcomes, and guide future randomized controlled trial development to improve outcomes.

Eligibility criteria:
inclusion criteria: * unilateral primary tka * surgery is performed at cleveland clinic main campus or at lutheran hospital * patient must reside within 75 miles (driving distance) from cleveland clinic main campus * patient expected to utilize cleveland clinic home care services after surgery exclusion criteria: * revision or simultaneous bilateral tka * english is not the patient's preferred language for healthcare discussions * currently participating in any other research study
the analgesic effect of transversus abdominis plane (tap) block following radical prostatectomy

Conditions: Postoperative Pain

Summary: this study is conducted to evaluate different analgesic treatments effect following operation where the prostate gland is surgically removed. the different treatments the investigators wish to investigate is: 1. transversus abdominis plane (tap) block. the tap block is a rather new method, where a local anaesthetic is deposited between the two inner abdominal muscles. between these muscles, the nerves that innervates the anterior part of the abdominal wall is situated. 2. wound infiltration in this method you deposit a local anaesthetic in the edges of the wound. 3. placebo no active local treatment is given. all patients who wish to participate will be allocated to one of three different treatment groups. group 1: will receive tap block with a local anaesthetic and wound infiltration with saline. group 2: will receive wound infiltration with a local anaesthetic and tap block with saline. group 3: will receive tap block with saline and wound infiltration with saline. beside this local treatment all patients will be given systemic paracetamol (tablet) and ibuprofen (tablet). in addition all patients will be given a pump containing morphine. the pump is connected to a button which the patient can activate when they experience pain. this enables the patient to control how much morphine he needs, following the operation. the hypothesis is that the tap block is superior in reducing pain and thereby reducing morphine consumption compared to wound infiltration and placebo.


Eligibility criteria:
inclusion criteria: * bmi \> 18 and \< 35 * patients who have given their informed consent and have fully understood the nature and limitations of the study * patient who is planned for radical prostatectomy exclusion criteria: * not able to cooperate to complete the study * is not able to speak and understand danish * allergy towards the drugs which is used in the study * daily use of strong opioids * infection at the injection area

Keywords: postoperative analgesic treatment tap block prostatectomy double blinded randomized clinical trial
studying biopsy samples in women undergoing first-line chemotherapy for metastatic breast cancer

Conditions: Breast Cancer

Summary: rationale: studying biopsy samples in the laboratory from patients with cancer may help doctors learn more about changes that occur in dna and identify biomarkers related to cancer. purpose: this clinical trial is studying biopsy samples in women who are receiving first-line chemotherapy for metastatic breast cancer.

objectives: primary * evaluate the effect of first-line chemotherapy on expression of hormone receptors and biomarkers in women with metastatic breast cancer. secondary * assess changes in her1 and her2 expression during treatment. outline: this is a multicenter study. patients receive 6-9 courses of front-line chemotherapy according to the investigator. patients with estrogen receptor- and/or progesterone receptor-positive disease receive hormone therapy. patients undergo biopsy prior to and after completion of chemotherapy for examination of hormone receptors and her1 and her2 expression. after completion of study treatment, patients are followed every 6 months for 5 years.

Eligibility criteria:
disease characteristics: * histologically confirmed adenocarcinoma of the breast * metastatic disease * no inflammatory breast cancer * measurable disease according to recist criteria * hormone receptor status: * estrogen receptor- and/or progesterone receptor-negative by ihc patient characteristics: * menopausal status not specified * who performance status 0-2 * life expectancy \> 3 months * anc \> 1.5 x 10\^9/l * platelet count \> 100 x 10\^9/l * liver transaminases ≤ 3 times upper limit of normal (uln) * alkaline phosphatase ≤ 3 times uln * bilirubin ≤ 1.5 times uln * creatinine ≤ 2 times uln * not pregnant or nursing * fertile patients must use effective contraception * no allergy to xylocaine * no heart failure, or kidney, bone marrow, respiratory, or liver insufficiency prior concurrent therapy: * no prior first-line treatment for metastatic disease

Keywords: stage iv breast cancer estrogen receptor-negative breast cancer progesterone receptor-negative breast cancer