Kornimate/medical-research-clean huggingface dataset:
cardiovascular disease study

Conditions: Spinal Cord Injury

Summary: coronary heart disease (chd) is a leading cause of death in the spinal cord injured (sci) population, occurring at younger ages than in the able-bodied population. conventional risk factors for chd include high concentrations of low-density lipoprotein (ldl), low concentrations of high-density lipoprotein (hdl), diabetes mellitus (dm), smoking history, and family history. other factors that may influence progression of chd include c-reactive protein (an inflammatory marker), and fibrinogen (a pro-coagulant marker). individuals with sci with longer duration and greater completeness of injury are more likely to have significantly worse carbohydrate tolerance compared to other neurological deficit subgroups. muscle atrophy after sci is associated with increased insulin resistance. prolonged inactivity has been shown to be associated with hyperinsulinemia and impaired glucose tolerance. body composition changes after sci to indicate significantly more total body fat mass and percent fat and less lean mass compared to able-bodied individuals. carotid intima-media thickness is correlated with atherosclerosis progression and abdominal adiposity. individuals with abdominal adiposity are at a higher risk for chd, dm, hypertension, insulin resistance, and dyslipidemia. abdominal adiposity and insulin resistance are contributors to postprandial lipemia, which may be a more sensitive indicator of chd risk and progression. the purpose of this study is to determine the prevalence of conventional risk factors by assessing the 10-year risk for chd, and identify emerging risk factors for chd in the spinal cord injured population. subjects will have the option to participate in a high fat meal test to determine postprandial lipemic responses. knowledge of this information may be able to detect and prevent future cardiovascular events related to chd.


Eligibility criteria:
inclusion criteria: * male 45-75 years old with at least 5 years of sci * female 45-50 years old with at least 10 years of sci * female 50-75 years old with at least 5 years of sci exclusion criteria: * acute medical illness * pregnant females * chronic debilitating disease (i.e., heart disease, pulmonary disease, etc.) * atrial fibrillation * history of percutaneous coronary angiography with stent placement

Keywords: coronary heart disease spinal cord injury risk factor postprandial lipemia
goal elicitation, treatment prioritization, & electronically-practiced discussion for psychiatry

Conditions: Mental Illness; Shared Decision Making

Summary: get prepd-psychiatry is a mixed-methods, developmental study to adapt a shared decision making (sdm) intervention to be specific for psychiatry decisions (aim 1, previously completed), evaluate its feasibility and acceptability (aim 2), and examine potential mechanisms of change and preliminary outcomes (aim 3) of this innovative intervention to increase sdm and self-management for adults with serious mental illness (smi). in line with national institute of mental health (nimh) priorities, we are examining whether get prepd-psychiatry engages the target mechanisms that putatively underlie the intervention (i.e., patient activation and communication self-efficacy; aim 3). aim 1 used approximately 200 deidentified transcripts from our prior study of sdm in psychiatry to cull language used in decision-making. these conversations were then used to program the virtual provider to represent common interactions and decisions in psychiatric visits. iterative testing of the use of the virtual provider has been completed and feedback was obtained from our psychiatry consultants to refine the program. for aim 2, we will recruit up to 40 patients to participate in get prepd-psychiatry (4 weekly goal setting/coaching sessions, coupled with virtual provider training and practice). we will assess participant satisfaction and utility ratings, as well as track their use (frequency and time-on-task) of the virtual provider program. for aim 3, we will follow enrolled patient participants, interviewing them at baseline and approximately 3 months later. we hypothesize that participants will have significantly 1) improved mechanisms of change, demonstrated by increases in self-reported activation and communication self-efficacy, 2) improved sdm, and 3) improved self-management and recovery attitudes. the narrative evaluation of intervention interview (neii), completed at approximately 3 months, will be used as a qualitative interview guide to understand the acceptability and impact of the intervention.


Eligibility criteria:
inclusion criteria: * at least 18 years of age * current patient at the participating mental health center * english speaking * willingness to participate in weekly coaching sessions, engage in practice with the virtual provider program exclusion criteria: * under 18 years of age * no reasonable access to use of internet on a computer * inability or unwillingness to use a computer (necessary for virtual provider program practice) * never or rarely uses a computer or similar device (based on self-report) * very or somewhat uncomfortable using a computer or similar device (based on self-report)

Keywords: serious mental illness shared decision making-psychiatric medications mental health
minimally invasive locking plate fixation vs reamed intramedullary nail fixation on patients with open tibia fracture

Conditions: Open tíbia Fracture

Summary: the best treatment for the open tibia fractures remains controversial. it is unknown whether minimally invasive locking plate or reamed intramedullary nail fixation will result in lower complication rates and better function.

the best fixation method for open tibial fractures remains controversial. the current standard treatment options recommended the use of intramedullary nail for treating such fractures. recent studies also showed favorable results for the use of plates in managing open tibial fractures. however, it is unknown whether locking plate or intramedullary nail fixation will result in lower complication rates and better function. this study is a prospective, randomized trial to compare the safety and efficiency of minimally invasive plate osteosynthesis and reamed intramedullary nails in treating type i-ii open tibial shaft fractures. the investigators hypothesize that neither intervention resulted in a superior disability rating at 12 months. outcomes evaluated will include the rate of infection, the number of re-hospitalization for the complication, the time to bone healing, patient-reported outcome and quality of life and other complications.

Eligibility criteria:
inclusion criteria: * ages 18 - 60 years inclusive * open diaphyseal fracture * gustilo-anderson type i, ii, iiia exclusion criteria: * closed, periarticular or pathological fracture * gustilo-anderson type iiib,iiic * patients with concomitant fractures in the ipsilateral limb * the patient is unable to medically tolerate general anesthesia * the patient is unable to provide informed consent or comply with completing questionnaires * tibia already infected as diagnosed by a surgeon * the patient has been diagnosed with a severe psychiatric condition
dexmedetomidine versus dexmedetomidine and ketamine (ketodex) in ear and nose surgeries

Conditions: Ear and Nose Surgeries With Hypotensive Anaesthesia e.g FESS , MLS , TURBINECTOMY

Summary: the study aims to compare the efficacy, safety and overall effectiveness of dexmedetomidine and dexmedtomidine and ketamine (ketodex) in achieving controlled hypotension during ear and nose surgeries. - assessment the analgesic and sedative role of both drugs.

comparison regarding the efficacy, safety and overall effectiveness of dexmedetomidine and dexmedtomidine and ketamine (ketodex) in achieving controlled hypotension during ear and nose surgeries. * comparison between both drugs in recovery and hemodynamics stability * assessment the analgesic and sedative role of both drugs

Eligibility criteria:
inclusion criteria * age range: patients aged 18-60 years who are scheduled for elective ear and nose surgeries requiring controlled hypotensive anesthesia. * asa classification: patients classified as american society of anesthesiologists (asa) physical status i or ii. * surgical procedures: individuals undergoing specific ear and nose surgeries where controlled hypotensive anesthesia is typically indicated. * stable cardiovascular health: patients with stable cardiovascular function, without significant history of uncontrolled hypertension , hypotension or ischaemic heart diseases. exclusion criteria * severe cardiovascular conditions: patients with severe cardiovascular diseases such as congestive heart failure, uncontrolled hypertension , arrhythmias or ischaemic heart diseases . * any cardiac patients. * respiratory conditions: individuals with significant respiratory conditions like chronic obstructive pulmonary disease (copd) or severe asthma. * drug allergies: patients with known hypersensitivity or allergic reactions to dexmedetomidine, ketamine or any other components of the study drugs. * pregnancy or lactation: pregnant or breastfeeding women, due to potential risks to the fetus or infant. * chronic medication use: patients on chronic medications that could interfere with blood pressure regulation or interact with the study drugs (e.g., beta-blockers, mao inhibitors). * patients with chronic liver or renal diseases. * psychiatric or neurological disorders: individuals with severe psychiatric or neurological disorders that could impact the study outcomes or the patient's ability to consent. * substance abuse: patients with a history of substance abuse, particularly involving sedatives or opioids, which could affect anesthesia requirements or recovery. * coagulation disorders: individuals with coagulation disorders or on anticoagulant therapy, due to the increased risk of bleeding.
impact of arterial cannulation site on vasopressor requirement in cardiac surgery

Conditions: Cardiac Disease

Summary: choice of arterial cannulation site during cardiac surgery is controversial. some physicians in our institution prefer radial artery site, others prefer aortic site (via femoral artery or brachial artery). the investigators aim to compare these two strategies for vasopressor requirement. the study hypothesis is that radial artery cannulation is associated with a larger dose of vasopressor due aortic to radial arterial pressure gradient phenomenon.


Eligibility criteria:
inclusion criteria: * adult patient * scheduled for cardiac surgery with cardiopulmonary bypass exclusion criteria: * more than one arterial cannula at the beginning of the surgery

Keywords: cardiac surgery aortic to radial arterial pressure gradient vasopressor
interprofessional training to improve diabetes care: the respect trial

Conditions: Diabetes Mellitus

Summary: the investigators' study focuses on improving the care of diabetes, a complex chronic illness, by providing important insights into interprofessional training and its potential role in fostering the necessary interdisciplinary management needed for chronic conditions and in addressing the gap between best practice and actual care provided.

the complexity of diabetes management challenges the acute care-oriented healthcare system. some experts suggest part of the problem is that the healthcare system fosters a separate silos decision making model. while there is increasing recognition that quality diabetes care is best provided in an interdisciplinary manner, interprofessional training models are limited, as is understanding of the links between interprofessional training, actual practice, and patient outcomes. advancing our understanding of interprofessional training models is critical because most of the complications associated with diabetes (e.g., amputations, renal failure, strokes) can be prevented or delayed with proper management. the investigators' objective is to better understand the processes and mechanisms by which interprofessional training impacts on chronic care management (practice patterns) and the ways it translates into improved patient outcomes.

Eligibility criteria:
inclusion criteria: clinicians * all clinicians in all of ohio's cbocs (except for the georgetown cboc) will be eligible for the study (all pcps have patients with dm in their panel of patients). patients * all diabetic patients who are seen in ohio's cbocs (except for the georgetown cboc) will be eligible for the study. exclusion criteria: clinicians * any clinician who does not have diabetic patients on their panel, who aren't apart of ohio's cboc's, or see patients at the georgetown cboc will not be eligible to participate. patients * patients who don't have a diagnosis of diabetes, who aren't seen at one of ohio's cboc's, or is seen for their medical care at the georgetown cboc will not be eligible to participate.

Keywords: diabetes telemedicine shared medical appointments
tailoring patient education to perceived risk for falls in hospitalized oncology patients

Conditions: Malignant Neoplasm

Summary: this randomized pilot clinical trial studies tailored patient educational intervention or standard education in assessing perceived risk for falls in hospitalized oncology patients. a tailored patient educational intervention may be more beneficial than standard education in preventing patients from falling by increasing the patient's knowledge of the risk factors for falling routinely and then providing education in deficit areas. making patients more aware of the risk factors for falling may lead to greater engagement in preventative activities.

primary objectives: i. to evaluate the effect of a tailored, nurse-delivered intervention, as compared to the control group, on perceived risk for falls in hospitalized hematology-oncology patients. ii. to evaluate the effect of a tailored, nurse-delivered intervention, as compared to the control group, on confidence to minimize falls in hospitalized hematology-oncology patients. iii. to evaluate the relationship between patients' perceived risk for falling and their willingness to call for assistance with ambulation. secondary objectives: i. to evaluate the relationship between patients' perceived risk for falls and nursing risk assessments when using the standard hospital assessment tool and the investigator-designed perceived risk survey. ii. to evaluate the relationship between a patients' perceived risk for falls and sustaining a fall. iii. to evaluate patient satisfaction with the intervention. outline: all participants complete the perceived risk survey comprising the participants' perceived risk for falls, their confidence to prevent a fall, and their willingness to ask for assistance at baseline and at 24 and 72 hours (or at discharge if stay is less than 72 hours) post-intervention. patients are then randomized to 1 of 2 arms. arm i: participants receive tailored education comprising one of four two-minute videos determined by which educational group the participant is placed in: high risk/high perception, high risk/low perception, low risk/high perception, or low risk/low perception. participants also receive printed education sheets based on the participants' answers given on the perceived risk survey and are tailored to the participants' perception of falls risk. arm ii: participants receive a generic educational instruction sheet on falls prevention and receive standard care by nurses comprising a falls risk assessment and verbal education.

Eligibility criteria:
inclusion criteria: * diagnosis of cancer * admitted to the third floor of seidman cancer center (scc) * cognitively intact (alert, oriented to self, place, and time, and able to participate in the intervention) * ability to speak, read, and comprehend english exclusion criteria: * nonmalignant diagnosis * actively dying * patients with a physician order for bed rest
iscar for supplemental care in stage iv lung cancer

Conditions: Lung Cancer

Summary: the purpose of this study it to determine whether supplemental treatment with iscar improves immune function and quality of life among stage iv non-small cell lung carcinoma patients receiving conventional chemotherapy. iscar is an herbal medicine made from the total plant extract of mistletoe. this preparation is already in use in europe and its use in the us is likely to increase as cancer patients continue to seek alternative therapies.

see brief summary

Eligibility criteria:
inclusion criteria: * stage iv nsclc patients who receive standard chemotherapy exclusion criteria: * known allergy to viscum album l. * concomitant use of other mistletoe products * concomitant use of mushroom glucan and proteoglycan extracts * concomitant use of thymus extract products * inability to self-report quality of life utilizing assessment tools * ongoing steroid or acth therapy * co-morbid immunocompromised state * pregnancy * participation in other clinical trials

Keywords: lung cancer herbal medicine non-small cell cancer iscar mistletoe
corticosteroids for acute migraine in the emergency department

Conditions: Migraine

Summary: this is an emergency department based randomized trial in which we compare two different treatment for migraine headache. the goal is to decrease the number of headache days during the week after ed discharge.


Eligibility criteria:
inclusion criteria: * migraine without aura criteria (international classification of headache disorders 3b ) * headache rated as moderate or severe in intensity exclusion criteria: * concern for secondary cause of headache * contra-indications to investigational medications
brain-train home based pain treatment

Conditions: Neuropathic Pain

Summary: a study examining the effectiveness of neurofeedback therapy for the treatment of central neuropathic pain (cnp), in patients with a spinal cord injury, using a small user-friendly device which can be operated by patients at home.

spinal cord injury (sci) affects a person's ability to move and feel sensation from the body. sci is also an indirect cause of a persistent pain, called central neuropathic pain (cnp). this pain typically develops several months after the injury. in 30% to 40% of sci patients, severe cnp affects their everyday living including sleep and mood. medical treatment of cnp is moderately effective and costly, both to the patient and to the health care system. in a previous study, some characteristic 'signatures' of brain waves that are related to cnp were defined. based on this, a novel treatment for cnp based on neurofeedback was developed and clinically tested on five sci patients. electroencephalograph (eeg) was used to record patients' brain waves and shown to patients on a computer screen in a simple graphical form (e.g. bars). patients were trained to change their brain activity at will and, as a consequence, their pain was reduced. costly laboratory devices were used and once the study was over, an adequate alternative could not be offered to patients. in this study, a cheap, portable, wireless and user friendly, conformité européenne (ce) marked eeg device will be used to train 10 patients to self-administer the therapy in the comfort of their homes. participants will be given initial training to use the equipment then will be asked to use the system at home for 3 months - initially, 3-5 times a week then, if/when pain subsides, at least once a week or as required. the primary purpose of the study is to determine whether a portable system for neuromodulation is a useful tool for administering therapy for pain (intensity of pain will be measured by the visual numerical scale (vns)). the secondary purpose of the study is a quantitative analysis of changes in the brain activity due to therapy, as measured by eeg; patients' perspective of the home based neuro-therapy (assessed by questionnaires and one-to-one, semi-structured interviews).

Eligibility criteria:
inclusion criteria: * normal or corrected to normal vision * no history of brain disease or injury * incomplete/complete injury at level c5 to t12 * central neuropathic pain (below the level of injury) * intensity of pain 4 or above (vns) * stable medication regime (expected not to change during the period of the study), responding to some extent to cnp medication treatment * patient or caregiver minimum computer literacy (owning a computer, laptop, tablet, ipad etc) exclusion criteria: * chronic or acute muscular or visceral pain larger than 4 vns * epilepsy * diagnosed mental health problems * active intervention of pain team (changing existing treatments)

Keywords: spinal cord injury
clinical efficacy of insulin pumps in type 1 diabetes mellitus patients in spain

Conditions: Type 1 Diabetes

Summary: observational cross-sectional multicenter study about clinical efficacy of insulin pumps in type 1 diabetes mellitus patients.

observational cross-sectional multicenter study about clinical efficacy of continuous subcutaneous insulin infusion in type 1 diabetes mellitus patients. all clinical variables are gathered from the spanish insulin pump national registry. data analysis is conducted using spss (chicago, il) statistic software. results are presented as mean +/- sd values. a paired student's t-test or a wilcoxon signed-rank test were used for the analysis of differences. comparisons between proportions were analyzed using a chi-squared test. a p value \< 0.05 was considered statistically significant. the protocol was approved by the reference castilla-la mancha public health institute ethic committee. all participants provided written informed consent.

Eligibility criteria:
inclusion criteria: * type 1 diabetes patients treated with insulin pump. * medical treatment received in spain. exclusion criteria: - any other kinds of diabetes.

Keywords: type 1 diabetes treatment insulin pump continuous subcutaneous insulin infusion
postural correction exercises effect on forward head posture

Conditions: Musculoskeletal Disorder of the Neck

Summary: to determine the effect of postural correction exercise in universities students regarding cervical sagittal posture, head flexion angle in forward head posture.

informed consent will be taken from the participants, then we move further toward their demographics which will lead to initial readings after completion of authenticated questionnaire, then application of performing technique/exercise protocol by therapist and note the measurements again then interpret and analyze the data through data analyzing software which will lead to conclude the process.

Eligibility criteria:
inclusion criteria: * university students of age between 18 to 30 years. * smart devices addictions for one or more than one year and 2 h per day. * cva of less than 54°. * smartphone addicted scale - short version sas-sv exclusion criteria: * history of neurological symptoms and surgery to the neck and/or upper limbs. * smart devices usage less than one year. * unable to perform the exercises
study to evaluate the safety and efficacy of lenacapavir (gs-6207) in combination with other antiretroviral agents in people living with hiv

Conditions: HIV-1-infection

Summary: the primary objective of this study is to evaluate the efficacy of lenacapavir (formerly gs-6207) containing regimens in people living with human immunodeficiency virus (hiv) (plwh).


Eligibility criteria:
key inclusion criteria: * antiretroviral (arv) naive with no use of any arv within one month of screening. use of pre-exposure prophylaxis (prep) (any duration), post-exposure prophylaxis (pep) (any duration), or hiv-1 treatment (\ 1 month prior to screening is permitted * hiv-1 ribonucleic acid (rna) ≥ 200 copies/ml at screening * cluster determinant 4+ (cd4+) cell count ≥ 200 cells/microliter at screening key exclusion criteria: * current hepatitis b virus (hbv) or hepatitis c virus (hcv) infection note: other protocol defined inclusion/exclusion criteria may apply.