Kornimate/medical-research-clean huggingface dataset:
patient outcomes from second film-readers and test threshold relaxation in breast screening

Conditions: Breast Cancer; Ductal Carcinoma in Situ

Summary: analysis of women's medical records to understand the impact of previous changes to breast cancer screening (increase from one to two clinicians examining each woman's mammograms, and what proportion of women they recall for further tests)

retrospective observational study examining the records and outcomes of women who attended breast cancer screening between 1988 and 2016. linkage of records from the breast screening service, the cancer registry, and mortality. analysis of whether changing the threshold for whether to recall women for further tests or the number of clinicians examining the mammograms for signs of cancer affects outcomes.

Eligibility criteria:
inclusion criteria: * women who attended the english national health service (nhs) breast cancer screening service at least once between 1988 and 2016, aged between 47 and 73 * all eligible episodes of screening for each woman (we expect women to be screened around 7 times each) exclusion criteria: * women who did not attend routine english nhs breast screening service within the specified date and age range, even if they attended symptomatic breast cancer services, high risk (family history) breast screening services, or if they were referred for mammograms by their general practitioner
hypothermia risk with continuous renal replacement therapy

Conditions: Acute Kidney Injury; Hypothermia

Summary: the present study aims at testing if the thermax blood warmer is more accurate and reliable in reaching and maintaining chosen target temperature during continuous renal replacement therapy as compared to the prismaflo iis blood warmer used for the prismaflex system.

blood warming devices during continuous renal replacement therapy (crrt) have not been adequately tested. the novel thermax blood warmer for the newly introduced prismax system heats blood and replacement solutions via a dry heat plate system. in contrast, the prismaflo iis blood warmer for prismaflex system uses an electric heating sleeve on a standard crrt filter set. data on adverse events (ae) during continuous renal replacement therapy (crrt) has been studied and one of the most common ae was hypothermia, reported in 44% of all cases. the present study aims at testing if the thermax blood warmer is more accurate and reliable in reaching and maintaining chosen target temperature during crrt as compared to the blood warmer used for the prismaflex system.

Eligibility criteria:
inclusion criteria: * adult (18-100 years) critically ill patients treated with crrt. exclusion criteria: * patients under 18 years of age. non-rrt patients.

Keywords: continuous renal replacement therapy
observing the perioperative effects of prehabilitation in colorectal cancer patients

Conditions: Colon Cancer

Summary: quality improvement project to evaluate how prehabilitation can be incorporated into our colorectal cancer pathway and assess its clinical benefits.

the aim was to evaluate how prehabilitation (ph) can be incorporated into our colorectal cancer pathway and assess its clinical benefits. patients underwent ph (exercise, nutrition and psychological support) before resection of colorectal carcinoma in a dgh over fourteen months. patients were matched by operation, age, sex and asa to non-prehabilitation (nph) patients using a prospectively maintained database. length of stay (los) and complication rate and 90-day readmission rates were compared using wilcoxon and mcnemar's methods. prehabilitation significantly improved peak vo2 and at. this corresponds to a reduction in predicted 30-day mortality. despite a higher charlson index los was unchanged suggesting prehabilitation may permit safe resection in comorbid patients.

Eligibility criteria:
inclusion criteria: * adults over the age of 18 who had prehabilitation for colorectal cancer exclusion criteria: * children * patients who had prehabilitation but not for colorectal cancer

Keywords: prehabilitation
cognitive behavioral therapy for hyperacusis

Conditions: Hyperacusis

Summary: the main purpose of this study is to investigate whether cognitive behaviour therapy (cbt) can be useful for people suffering from hyperacusis. also, the investigators are interested in investigating this group of patients on psychiatric and somatic comorbidity, personality traits, and startle response to sounds. the investigators will also study the audiological measures commonly used in sweden to measure hyperacusis, and investigate their validity. the investigators hypothesize that cbt might be helpful for patients suffering from hyperacusis.

hyperacusis, defined as unusual intolerance to ordinary environmental sounds, is a common problem for which there are no controlled trials on psychological treatment. given the avoidance strategies present in hyperacusis, and similarities with problems such as tinnitus and chronic pain, cognitive behaviour therapy (cbt) is hypothesized to be helpful for patients with hyperacusis. in this randomized controlled study of 60 patients with hyperacusis, cbt was compared with a waiting list control group using the loudness discomfort level test (ldl), the hyperacusis questionnaire, the hospital anxiety and depression scales, the quality of life inventory and an adapted version of the tampa scale of kinesiophobia. there were significant between-group effects in favour of the cbt group on all measures except for the hads anxiety scale. between-group effect sizes were moderate to high, with cohen's d = 0.67 and 0.69 per ear, respectively, for the primary measure ldl, and ranging from d = 0.32 to 1.36 for the secondary measures. the differences between groups ceased to exist when the waiting list group was treated later with cbt, and the treatment results were largely maintained after 12 months. in conclusion, cbt is a promising treatment for hyperacusis, although more research is necessary.

Eligibility criteria:
inclusion criteria: * patient understands and can speak swedish well * hyperacusis is the primary audiological problem * loudness discomfort thresholds below 90 db * hearing levels better than 40db on the best ear * resident of uppsala, stockholm or vastmanland * possibility to travel to uppsala or vasteras for examination and treatment exclusion criteria: * scoring "moderate" or "high" on suicidality, according to m.i.n.i * moderate to severe depression * psychotic disorders

Keywords: hyperacusis personality comorbidity treatment cognitive behavioral therapy
effects of cpap therapy on ptsd symptoms

Conditions: PTSD; Sleep; Obstructive Sleep Apnea; Quality of Life

Summary: the purpose of this study is to evaluate the effects of treating obstructive sleep apnea (osa) with continuous positive airway pressure (cpap) therapy on symptoms of post traumatic stress disorder (ptsd). the study hypotheses are that cpap use will improve ptsd symptoms overall and that cpap use will improve sleep quality and duration, nocturnal symptoms related to ptsd, mood, daytime sleepiness, sleep-related quality of life, and general health perception.

post traumatic stress disorder (ptsd) is associated with increased healthcare utilization, decreased functional status, and overall poor health. sleep disturbances in ptsd are common, including nightmares, dream enactment, and poor sleep quality. obstructive sleep apnea (osa) is also highly prevalent in the veteran population and may exacerbate ptsd symptoms by triggering arousals from sleep that promote recollection of dreams, enactment of dreams, and disrupt sleep continuity. improvements in sleep quality and ptsd symptoms have been reported when osa is treated with continuous positive airway pressure (cpap) therapy. however, formal assessment using validated questionnaires and documentation of cpap compliance to correlate with these tools has not yet been performed. this study will recruit veterans with ptsd who have been newly diagnosed with osa and who are willing to try cpap therapy. baseline assessments of ptsd symptoms, daytime sleepiness, sleep-related quality of life, sleep quality, general health perception, and mood will be performed before initiation of treatment and after 3 and 6 months of therapy. this study will have the following specific aims: aim 1: to evaluate the effect of cpap use on ptsd symptoms. hypothesis: after 6 months of treatment, cpap use will improve ptsd symptoms as assessed by the ptsd checklist (pcl-s). aim 2: to evaluate the effect of cpap use on 1)sleep quality and duration, 2)nocturnal symptoms of nightmares, movement disorders, dream enactment, and insomnia, 3)mood, 4)daytime sleepiness, 5)sleep-related quality of life, and 6) general health perception. hypothesis: after 6 months of treatment, cpap use will improve sleep quality, sleep duration, mood, daytime sleepiness, sleep-related quality of life, general health perception, and nocturnal symptoms of nightmares, movement disorders, dream enactment, and insomnia.

Eligibility criteria:
inclusion criteria:the intent is to recruit a study population that is as representative as possible of the veteran ptsd population. thus, entry criteria are as inclusive as possible: * age \>18 year * confirmed diagnosis of ptsd (pcl checklist minimum score of 45) * confirmed diagnosis of sleep apnea (apnea hypopnea index \>5/h) * newly starting cpap (not previously treated) exclusion criteria: * fatal co-morbidity with life expectancy of less than 6 months, * residing in a geographically remote area that would make follow up at 3 and 6 months difficult.

Keywords: ptsd cpap osa
evaluation of upper gi ulceration induced by pl2200 versus aspirin in at-risk subjects

Conditions: Gastroduodenal Ulceration

Summary: this trial is a phase 2, randomized, controlled study to compare the degree of mucosal injury after the oral administration of an investigational product, pl2200, and a marketed 325 mg immediate-release aspirin product.

each group will be treated with either an immediate-release aspirin tablet or pl2200 capsule at 325 mg per day for 6 weeks, and evaluated via an endoscope for any gastrointestinal injury that may have been caused by study medication.

Eligibility criteria:
inclusion criteria: * healthy volunteers, ≥50 and ≤75 years of age. * no endoscopically observed baseline gastrointestinal lesions. exclusion criteria: * baseline gastrointestinal lesions or abnormal screening/baseline laboratory parameters deemed clinically significant by the investigator. * significant history of substance abuse or uncontrolled acute or chronic medical illness. * active h. pylori infection. * current use of low-dose aspirin for cardioprevention, or other ulcerogenic medications, gastroprotective, or anti-platelet agents. * hypersensitivity to aspirin or other nsaids.

Keywords: healthy volunteer comparison of incidence of treatment groups.
efficacy and safety of oral probiotics on ocular symptoms and gut microbiome of children with vernal keratoconjunctivitis

Conditions: Probiotic; Ocular Surface Disease; Ocular Diseases; Ocular Dryness; Gut Microbiome Dysbiosis; Gut -microbiota

Summary: the primary goal of this study is to determine the effects of oral probiotics on the severity of ocular symptoms and the alterations of the gut microbiome of children (4-18 years old) with vernal keratoconjunctivitis. the current study will also assess the safety of oral probiotics among children with vernal keratoconjunctivitis. the main questions it aims to answer: 1- does treatment with oral probiotics improve the severity of ocular symptoms in children with vernal keratoconjunctivitis? 2- does treatment with oral probiotics alter the gut microbiome of children with vernal keratoconjunctivitis? researchers will compare the ocular symptoms and gut microbiome between two groups receiving oral probiotics and placebo among children with vernal keratoconjunctivitis. participants the participants will receive the oral probiotics and placebo ever day for one month. record their regimen and keep a diary of their symptoms.


Eligibility criteria:
inclusion criteria:1- patients whose diagnosis of vernal keratoconjunctivitis is confirmed based on clinical criteria. 2-patients with an age range of 4 to 18 years. 3-patients who have not received drug treatment for vernal keratoconjunctivitis disease recently. - exclusion criteria:1-having other eye diseases (except refractive error) 2-change in the diagnosis of the disease during the study 3-antibiotics, anti-inflammatory drugs, immunosuppressive drugs 4-history of known gastrointestinal diseases (such as ibd, celiac,...) 5- history of digestive problems in the last two weeks 6- lack of consent to participate in the study 7- having an eye infection in the last one month 8- people who were athletes or involved in intense physical activity 9- smoking, alcohol and drugs. 10- using drugs that affect appetite, bowel movements, and nutrient absorption 11- using prebiotics, probiotics or synbiotics in the last 3 months 12- people who have been on a diet to lose or gain weight in the last 3 months 13- people who have undergone gastrointestinal surgery. 14- changing the patient's diagnosis in the course of treatment 15- failure to follow up the patient at the specified times for the visit and assessment of the patient's bed 16- taking fat-reducing drugs 17-oral hypoglycemic drugs, insulin, antihypertensive drugs-18- diuretics, laxatives, antacids 19-food supplements in the last 3 months. -

Keywords: probiotic vernal keratoconjunctivitis clinical trial gut microbiome
neurofeedback based on near-infrared spectroscopy as a therapy for food addiction in obese subjects.

Conditions: Obesity; Craving

Summary: the hypothesis is that the increase in dlpfc brain activity via near-infrared spectroscopy-based neurofeedback (fnirs-based nf) training based on near-infrared spectroscopy would allow an improvement of the eating behavior, thus promoting a long-term weight loss in obese subjects. patients will be trained during a month with 8 nf sessions and results based on clinical data and different questionnaires results will be compared between inclusion and 3 months later

obesity is a disease of increasing prevalence due in part to the greater availability of fatty, sugary and/or salty foods which, when consumed chronically and in excess, can lead to food addiction. according to the neurocognitive model of addiction, the development and maintenance of addiction is associated with deficits in cognitive control, as well as a decrease prefrontal cortex (dlpfc). self-control in food choice situations also depends on prefrontal network with the dlpfc as a hub, strongly connected with striatal and cingulate structures. neurofeedback (nf) is a technique that relies on the patient's positive or negative self-regulation of brain activity. it has been shown to be effective in several pathologies, in particular attention deficit/hyperactivity disorder in young people and more recently in depression and emotion regulation. in this study, nf will be based on near-infrared spectroscopy (fnirs), because its use is easy mobile and inexpensive. the hypothesis is that the increase in dlpfc brain activity via fnir-based nf training based on fnirs would allow an improvement of the eating behavior, thus promoting a long-term weight loss in obese subjects.

Eligibility criteria:
inclusion criteria: * eligible for obesity surgery according to the 2009 french high authority on health (has) criteria (bmi ≥40 or bmi ≥35 with comorbidities) * right-handed * presenting a food addiction determined by the yfas 2.0 questionnaire ; * affiliated to a social security system; * having given free and informed consent in writing. exclusion criteria: * psychotic psychiatric disorders (schizophrenic disorders and bipolar disorders); * psychotropic drugs, except antidepressants stabilized for at least 3 weeks and benzodiazepines * addiction to alcohol or other psychoactive substances (except tobacco); * history of bariatric surgery; * current treatment in the nutrition unit; * insufficient command of french; * pregnant or breast-feeding woman; * persons of legal age under legal protection (safeguard of justice, curatorship, guardianship), persons deprived of liberty. * contraindications to fmri * inability to perform the fnirs procedure due to blockage or attenuation of the light at the capillary level
clinical pilates (cp) exercises and kinesiophobia in cabg

Conditions: Post-cardiac Surgery

Summary: to determine effect of clinical pilates (cp) exercises on kinesiophobia and post-operative cardiopulmonary parameters in cabg patients. kinesiophobia may lead to patients\&#39; psychological fear of rehabilitation exercise, thereby refusing rehabilitation exercise, affecting the rehabilitation process of patients, resulting in disuse syndrome, depression, disability and other adverse consequences. thus, this study is to be conducted to find out the effects pilates exercises with cardiac rehabilitation for management of kinesiophobia in post cabg patients.

clinical pilates are also evident to be safe and effective in post-surgical patients with different surgical interventions. a study was conducted in 2021 to evaluate the effects of the pilates method on pulmonary function and range of motion after coronary artery bypass grafting and concluded that the pilates method is a safe, viable, and playful option for the patient profile after cabg but they did not evaluate kinesiophobia of patients

Eligibility criteria:
inclusion criteria: * hemodynamically stable patient who underwent elective cabg. * patients diagnosed with kinesiophobia via tampa scale for kinesiophobia heart (tsk-sv heart) exclusion criteria: * neuromuscular conditions which lead to kinesiophobia * diseases that seriously affected the functional capacity or mobility such as liver cirrhosis, chronic renal failure and disabled patients. * prolong intubation * vital instability * patients needing maximum assistance * decline consent

Keywords: cabg clinical pilates kinesiophobia post-operative cardiopulmonary parameters
using biomarkers to optimize antibiotic strategies in sepsis

Conditions: Sepsis

Summary: the proposed work will provide critical insights into the potential impact of a biomarker-based algorithm on reducing unnecessary antibiotic use in different adult and pediatric/neonatal icu's. this proposal will also assess the costs (or savings) of a biomarker-based intervention. overall, the results of this work will be critical in informing future strategies to eliminate unnecessary antibiotic use and curb the continued rise in antimicrobial resistance.

the goal of this project is reduce unnecessary use of antibiotics in the icu. the purpose of phase i of the study is to identify the biomarker, or combination of biomarkers, that provides optimal test characteristics in identifying adults and children/neonates with presumed sepsis who have a very low likelihood of bacterial infection. results of phase i will result in development of a biomarker-based algorithm to inform need for antibiotic use in icu patients. in phase ii, the impact of this biomarker-based algorithm on reducing antibiotic use in the icu will be determined. costs or savings associated with the algorithm will also be assessed.

Eligibility criteria:
inclusion criteria: 1. sirs criteria sirs is considered to be present when patients have more than one of the following clinical findings: * body temperature \>38°c or \<36°c * heart rate \>90 min-1 * respiratory rate of \>20 min-1 or a paco2 of \<32 mm hg * and a white blood cell count of \>12,000 cells µl-1 or \<4,000 µl-1 2. new empiric antibiotic therapy is initiated, indicating the suspicion of infection. accepted criteria for sirs will be used for the medical intensive care unit and surgical intensive care unit populations, with appropriate age-specific vital signs definitions to help make the definitions relevant for the pediatric intensive care unit population. exclusion criteria: 1. a code status of "do not resuscitate" 2. absence of initiation or expansion of antibiotic therapy despite meeting criteria for sepsis 3. presence of an immunocompromising condition. an immunocompromising condition will be defined as one of the following: * human immunodeficiency virus (hiv) infection with a t-helper cell (cd4) count \<200 cell/mm3; 2) immunosuppressive therapy after organ transplantation * neutropenia (\<500 neutrophils/mm3) * active chemotherapy within the 3 months preceding eligibility or * diagnosis of cystic fibrosis. these criteria all represent conditions in which antibiotic use is much less likely to be decreased regardless of the results of a biomarker and are consistent with exclusion criteria used in past studies of the impact of biomarkers.

Keywords: sepsis systemic inflammatory response syndrome (sirs) antibiotic use intensive care unit
classification and prediction of difficult awake tracheal intubation with flexible bronchoscopes

Conditions: Anesthesia; Airway Management; Intubation, Intratracheal; Bronchoscopy; Endoscopes

Summary: airway management problems are key drivers for anesthesia-related adverse events. awake tracheal intubation using flexible bronchoscopes with preserved spontaneous breathing (ati:fb) is a recommended technique to manage difficult tracheal intubation in anesthesia, intensive care and emergency medicine. however, a prospective developed classification for this type of airway management is lacking. due to the absence of a specifically tailored, validated classification for awake intubation with flexible bronchoscopes, many airway operators and institutions use classification tools that were originally developed for direct laryngoscopy, such as the percentage of glottic opening (pogo) score or cormack-lehane classification, although their diagnostic performance for the classification of ati:fb is unknown. this prospective model development and validation study aims to develop two multivariable prediction models: a diagnostic prediction model to classify difficult ati:fb after ati:fb has been performed and a second prognostic prediction model to predict the risk for difficult ati:fb before ati:fb is performed. an additional aim is to develop a machine learning algorithm to evaluate ati:fb.


Eligibility criteria:
inclusion criteria: * patients with an anticipated difficult airways scheduled for ati:fb * consent by the patient * minimum 18 years of age exclusion criteria: * patients not scheduled for ati:fb * pregnant or breastfeeding patients * consent not given by the patient

Keywords: airway management classification flexible endoscopy guided intubation fibroptic guided intubation respiratory system laryngeal diseases health records