Kornimate/medical-research-clean huggingface dataset:
comparing arthroscopic tennis elbow release with arthroscopic debridement

Conditions: Tennis Elbow

Summary: we propose a randomized, double-blind controlled trial comparing arthroscopic release with arthroscopic debridement for the management of chronic tennis elbow in an effort to definitively determine whether arthroscopic tennis elbow release is an effective treatment of tennis elbow, and to further provide better recommendations for the use of this procedure, in an effort to improve patient care.

lateral epicondylitis (tennis elbow) is a common occurrence in the general population with an incidence of 4-7/1000/year. more recent literature describes a 1-3% rate over the course of a lifetime, most typically affecting individuals between the ages of 35 and 50. tennis elbow is a common occurrence in the general population that causes lateral elbow pain and diminished grip strength, which may be debilitating. most affected individuals achieve symptom resolution within 6 months to 1 year with measures such as physiotherapy, anti-inflammatories and corticosteroid injections, but a small subset will go on to develop chronic symptoms. chronic tennis elbow can be treated surgically, by arthroscopic tennis elbow release (ater), which has gained popularity in recent years as it presents a less invasive option, allows for direct visualization of the elbow joint for other pathology and has a faster return-to-work time compared to other surgical procedures. despite its promise there have been no high quality studies evaluating the efficacy of arthroscopic tennis elbow release, bringing the actual efficacy of this procedure into question. a randomized controlled trial on arthroscopic tennis elbow release would provide much needed evidence in order to define its role in the management of tennis elbow and to help refine treatment protocols.

Eligibility criteria:
inclusion criteria: * symptoms consistent with lateral epicondylitis persisting for \>6 months, and have failed conservative management * adult, skeletally mature (\>18yrs) * provision of informed consent exclusion criteria: * alternative diagnosis that better explain their symptoms * previous elbow trauma or surgery * case involving workplace insurance claims (e.g. wsib) * unwilling, or unlikely in the opinion of the investigator to be followed for the duration of the study (e.g., patient refusal, unfixed address, plans to move...etc.) * cognitive difficulties that prevent ability to provide informed consent and reliable completion of questionnaires * bilateral lateral epicondylitis
anticoagulation in critically ill patients with covid-19 (the impact trial)

Conditions: COVID-19

Summary: the purpose of this study is to determine if therapeutic dose anticoagulation (experimental group) improves 30-day mortality in participants with covid-19 compared to those patients receiving the intermediate dose prophylaxis (control group). following screening, subjects will be randomized 1:1 to intermediate dose prophylaxis or therapeutic dose anticoagulation treatment arms.treatment will continue for 28 days, followed by a 6 month follow-up period.


Eligibility criteria:
inclusion criteria: * age \>18 years old * covid-19 positive on (rt-pcr) nasopharyngeal swab, or suspected covid-19 infection with detectable sars-cov-2 igg or igm. * intensive care unit (icu) patient or non-icu patient on invasive mechanical ventilation, bipap, 100% non-rebreather mask, or high flow oxygen or supplemental oxygen of at least 4 liters per minute nasal cannula. * d dimer level greater than 700 ng/ml (3 times the upper limit of normal). exclusion criteria: * objectively documented deep vein thrombosis or pulmonary embolism * patients in whom there is very high suspicion for pulmonary embolism and are on full-dose anticoagulation as per the treating physician * platelets \<30,000 not due to disseminated intravascular coagulation (dic), based on the international society of thrombosis and haemostasis (isth) criteria and american society of hematology (ash) frequently asked questions * active bleeding that poses a contraindication to therapeutic anticoagulation in the opinion of the investigator. * history of bleeding diathesis (e.g., hemophilia, severe von willebrand disease, severe thrombocytopathy) * history of intracranial hemorrhage in the last 90 days * history of ischemic stroke in the past 2 weeks * major neurosurgical procedure in the past 30 days * cardiothoracic surgery in the past 30 days * intra-abdominal surgery in the past 30 days * intracranial malignancy * patients who require therapeutic anticoagulation for other reasons like atrial fibrillation, deep venous thrombosis, pulmonary embolism, or antiphospholipid syndrome.

Keywords: covid-19 anticoagulation
comparison between pre-operative prescription delivered during anesthesia consultation or post-operative prescription

Conditions: Postoperative Pain; Ambulatory Surgery; Anesthesia; Postoperative Complication

Summary: this study evaluates the comparison of the incidence of postoperative home pain after ambulatory surgery with general anesthesia between a group with pre-surgical prescription delivered during anesthesia preoperative clinic and a group with postoperative prescription.

the ambulatory surgery increased over the last twenty years in france. the management of home pain after ambulatory surgery is a major challenge because it is the principal complication after day surgery with several consequences: nausea and vomiting, chronic pain, functional impairment with handicap, sleeping troubles, extra-hospital consultation. management of home pain remains currently could be performed in ambulatory surgery. the french society of anesthesiology recommends to deliver pre-surgical prescription during the preoperative anesthesia clinic but this guideline is not bases on evidence in the literature. also, we have previously shown in a retrospective non-randomized work a decrease of postoperative home pain in patient with general anesthesia. the main objective of this controlled and comparative study is to compare the incidence of postoperative home pain after ambulatory surgery with general anesthesia between a group with pre-surgical prescription delivered during anesthesia consultation and a group with postoperative prescription.

Eligibility criteria:
inclusion criteria: * any major ambulatory surgery patient with general anesthesia. exclusion criteria: * pregnancy. * minor patient. * asa score \> 3. * lack of general anesthesia. * general anesthesia combined with locoregional anesthesia. * contraindication to ambulatory surgery. * chronic pain. * chronic analgesic consumption. * no indication of non steroidal anti-inflammatory drug, paracetamol with codeine and morphine. * active or old drug addiction. * cognitive disorders or dementia. * serious psychiatric disorders. * patient under curatorship or tutorship. * no social protection * misunderstanding of the french language * patient participating in another trial

Keywords: postoperative pain ambulatory surgery general anesthesia anesthesia consultation post-op prescription
point-of-care testing (poct) detection and management of metabolic syndrome in patients with mental illness

Conditions: Hyperlipidemia; Diabetes; Hypertension

Summary: the study was a 12-month, multi-centered, quasi-experimental design to assess point-of-care (poct) screening/monitoring of subjects on antipsychotic agents for metabolic syndrome. subjects were also randomized to either an extended treatment group (etg) defined by receiving comprehensive medication management (cmm) pharmacist interventions or a usual treatment group (utg) receiving no cmm interventions. all subjects were recruited from three community mental health clinic settings in minnesota.

it is well recognized that patients on antipsychotic agents with mental illness continue to be affected by a severe health disparity due to lack of adequate metabolic monitoring.1-7 a major healthcare concern is the life-expectancy decrease of \~25 years for patients with illnesses such as schizophrenia as compared with the general population. equally concerning is that patients with severe persistent mental illness (spmi) continue to have inadequate integration of care between psychiatry and medicine. because of the difficulty getting patients to primary care or hospital based laboratories, the use of capillary blood, point-of-care tests (poct) to monitor glucose and lipids in addition to vital signs and other anthropometric measurements in community mental health centers might prove beneficial. it is highly likely that this advanced level of screening in the mental health setting may lead to identifying new metabolic abnormalities or improved treatment with careful monitoring of previously diagnosed metabolic syndrome, diabetes, and/or hypertension in antipsychotic treated patients. it is hypothesized that if metabolic abnormalities are identified; then providing pharmacist cmm consultative services would reduce medication related problems by improving medication adherence, coordination of care between psychiatry and primary care, and outcomes in metabolic indices.

Eligibility criteria:
inclusion criteria: * english speaking * age 18-64 * competent to understand and make medical choices independently exclusion criteria: * currently or previously seen by a cmm pharmacist

Keywords: metabolic syndrome antipsychotics schizophrenia bipolar disorder diabetes dyslipidemia hyperlipidemia hypertension obesity medication therapy management (mtm) pharmacist comprehensive medication management (cmm) health disparity monitoring point of care testing chronic persistent mental illness
impact of nurse-led programme with carotid ultrasound on addressing cardiovascular risk in patients with arthritis

Conditions: Arthritis, Rheumatoid; Arthritis, Psoriatic

Summary: elevated cvd risk is a significant public health problem that contributes greatly to the increased morbidity and shortened lifespan of individuals with ra and psa. over the past decades, there has been great progress into the understanding of the severity of cvd risk in these patients but these risk factors are not well managed. the development of the high-risk strategy is therefore necessary, with more intensive therapy reserved for patients identified as high-risk, e.g. because they have high-risk frs. however, these risk scores under-estimated cv risk in patients with ra and psa. an intermediate approach is to use quantification of preclinical vascular disease to further identify high-risk patients. results from this study will provide clinical implications in terms of detecting and managing cardiovascular morbidity in patients with ra and psa.

objectives this study investigates the impact of a nurse-led programme on cardiovascular (cv) risk screening with and without carotid ultrasound for carotid plaque on cv risk factor control in asymptomatic rheumatoid arthritis (ra) and psoriatic arthritis (psa) patients. hypothesis the investigators hypothesize that cv risk stratification and management in ra and psa may be improved by incorporation of carotid ultrasound to assess for carotid plaque.

Eligibility criteria:
inclusion criteria: * patients with ra fulfilled the 2010 acr/eular classification criteria or psa fulfilled the classification of psoriatic arthritis (caspar) criteria * aged between 18 and 75 will be recruited. exclusion criteria: * had a history of overt cvd (ie, symptomatic coronary artery disease \[cad\] or ischemic stroke or transient ischemic attack or peripheral vascular disease) * had significant co-morbidities including severe renal impairment or severe deranged liver function * female of childbearing potential who are unwilling to use adequate contraception, pregnant or breastfeeding women * patients who are already taking lipid lowering therapy.

Keywords: carotid atherosclerosis arterial stiffness cardiovascular risk
diagnostic performance of small rna blood test in patients undergoing follow-up imaging after positive low dose ct screening for cancer of the lung

Conditions: Lung Cancer

Summary: 2,000 individuals, aged 50-80 who have received a lung-rads category 3 or 4 result on a ldct screening study and who are scheduled for follow-up diagnostic imaging study, biopsy, clinical consultation or surgical appointment at one of the participating hospitals.

the study is a prospective, longitudinal, observational study to evaluate the performance of a novel diagnostic test for early-stage lung cancer. study duration: expected patient enrollment to be completed within 12 months after study initiation. patients will be followed for a minimum of 12 months from the date of enrollment. the study duration is approximately 2 years. participant duration: the day of blood collection. participants will follow their regular standard of care schedule as recommended by existing guidelines; no extra visits are planned. follow up data will be obtained from the electronic medical record within at least 12 months of follow-up period.

Eligibility criteria:
inclusion criteria: * adult male and female patients, aged 50 to 80 years * received a lung rads category 3 or 4 finding on a ldct screening exam (first or subsequent) and are referred to undergo further diagnostic procedures for the detection of lung cancer * has undergone ld-ct screening exam within last 90 days and allows for blood sampling within this period * subject may not have undergone any invasive diagnostic procedure in relation to the suspicious nodule * able and willing to provide informed consent exclusion criteria: * prior history of diagnosed lung cancer * history of gastrointestinal, hematological, breast, thyroid, and genitourinary cancer within the past 10 years * active infectious diseases, such blood borne viral diseases (e.g. aids, hepatitis) * immunosuppressive medication * deemed not able to participate in the study by the investigator
povidone-iodine versus chlorhexidine in surgical wound care

Conditions: Wound

Summary: this comparison examines the effectiveness of povidone-iodine and chlorhexidine in managing iatrogenic wounds in surgical patients. both antiseptics are commonly used to prevent postoperative infections, but they differ in mechanism, efficacy, and safety profiles. povidone-iodine releases iodine, which acts broadly against bacteria, viruses, and fungi, while chlorhexidine disrupts cell membranes, providing rapid bactericidal action. studies suggest that chlorhexidine may offer longer-lasting antibacterial effects, but povidone-iodine has a wider antimicrobial range. optimal choice depends on patient needs, wound type, and potential for adverse reactions, emphasizing the need for tailored antiseptic strategies in wound care.


Eligibility criteria:
inclusion criteria: * elderly patients undergoing surgical procedures resulting in iatrogenic wounds (surgical wounds of various specialties, such as abdominal, orthopedic, cardiovascular, etc.). * availability for follow-up during the postoperative period, ensuring attendance at medical check-ups for the evaluation of healing and prevention of infections. * ability to provide informed consent, understanding the objectives, risks and benefits of the study. * absence of previous infections at the surgical site, ensuring that the wounds are recent and derived from the current surgical procedure. exclusion criteria: * known allergies or hypersensitivity to povidone iodine or chlorhexidine, to avoid risks of serious adverse reactions. * immunocompromised patients, such as those with advanced hiv, on immunosuppressant treatment, or with decompensated chronic diseases (poorly controlled diabetes, kidney failure, etc.), due to increased susceptibility to infections and altered healing. * patients with active infections or infected wounds prior to surgery, to avoid biasing the results by pre-existing infections. * pregnancy or breastfeeding, due to safety considerations and the possible alteration of healing and immunity processes during these stages. * use of other antiseptics or topical treatments at the wound site that may interfere with the efficacy of povidone iodine or chlorhexidine. * patients with known wound healing disorders (such as autoimmune diseases or hematological disorders), which may affect the results in terms of healing time and quality.
a study of bevacizumab (avastin) in participants with newly diagnosed locally advanced rectal cancer

Conditions: Rectal Cancer

Summary: this study will assess the efficacy and safety of two different neoadjuvant treatment approaches including bevacizumab in newly diagnosed participants with high risk locally advanced rectal cancer. participants will be randomized into one of two treatment arms (arm a or arm b).


Eligibility criteria:
inclusion criteria: * histologically confirmed locally advanced rectal cancer; * measurable disease; * eastern cooperative oncology group (ecog) performance status 0-1. exclusion criteria: * prior treatment with bevacizumab; * prior radiotherapy to pelvic region, or previous cytotoxic chemotherapy; * previous history of malignancy (other than basal and squamous cell cancer of the skin, or in situ cancer of the cervix); * history or evidence of central nervous system (cns) disease; * clinically significant cardiovascular disease; * chronic treatment with high dose aspirin (more than \[\>\] 325 milligrams per day \[mg/day\]) or non-steroidal anti-inflammatory drugs.
inflammation and the host response to injury (in healthy volunteers)

Conditions: Immune System

Summary: the body's immune response to injury or infection is very complex.endotoxin is a man-made substance, which causes the body to "mimic" sickness (fever,chills, and achiness)for a few hours. this study is designed to determine whether certain proteins, genetics, or heart rate variability change affects the body's response to endotoxin.

the body's immune response to injury or infection is very complex.immune cell activity, the release of specific mediators(such as proteins, genetics(deoxyribonucleic acid or dna), the body's "instructions" for making proteins (ribonucleic acid or rna) and heart rate variability (hrv,the intervals between heartbeats) may affect the body's clinical response to stress such as infection.endotoxin is a man-made substance, which causes the body to "mimic" sickness (fever,chills, and achiness)for a few hours. this study is designed to determine whether any of the above (proteins,genetics,or hrv, etc.) correlate with or affect the body's response to endotoxin.this will enable the investigator to better understand the mechanisms involved in the immune response as well as potential therapeutic strategies to improve outcomes in patients.

Eligibility criteria:
inclusion criteria: * good general health as demonstrated by medical history,physical exam, and laboratory tests within 6 weeks of study. * written informed consent prior to the performance of any study related procedure. exclusion criteria: * history of cancer, rheumatoid arthritis, or immunological, renal, hepatic, endocrine, neurologic, heart disease or hypertension * recent history of alcohol or drug abuse * mental capacity limited to the extent that the subject cannot provide written informed consent or information regarding treatment-emergent adverse events and/or tolerance of study medication and/or study procedures * exposure to any experimental agent or procedure within 30 days of study * pregnancy or breast feeding * prior exposure to endotoxin in an experimental setting -

Keywords: healthy immune system
prospective registration study of robtic laparoscopy versus laparoscopy assisted colon cancer surgery

Conditions: Da Vinci Robot; Colon Cancer; Surgery

Summary: the purpose of this study is to compare the clinical data of patients with colon cancer who received robotic or laparoscopic surgery, and to compare the short-term and long-term effects of robotic surgery in the treatment of colon cancer. to verify the safety and effectiveness of the corresponding surgical methods, and provide better guidance for the following clinical practice.


Eligibility criteria:
inclusion criteria: 1. age: 18-80 years old, male or female; 2. colon cancer (ascending colon, transverse colon, descending colon, sigmoid colon) is diagnosed by histology or cytology; 3. the clinical stage is t1-4an0-2m0; 4 no multiple distant metastases; 5. ecog score 0-2; 6. heart, lung, liver, and kidney functions can tolerate surgery; 7. patients and their families can understand and are willing to participate in this clinical study, and sign an informed consent. exclusion criteria: 1. past history of malignant colorectal tumors or recent diagnosis combined with other malignant tumors; 2. patients with intestinal obstruction, intestinal perforation, intestinal bleeding, etc. who need emergency surgery; 3. neighboring organs need to be combined with organ resection; 4. new adjuvant therapy before surgery; 5. asa grade ≥ grade iv and/or ecog physical status score\> 2 points; 6. those who have severe liver and kidney function, cardiopulmonary function, blood coagulation dysfunction, or combined with serious underlying diseases that cannot tolerate surgery; 7. have a history of severe mental illness; 8. pregnant or lactating women; 9. patients with other clinical and laboratory conditions considered by the investigator should not participate in the trial.
improve management of heart failure with procalcitonin

Conditions: Heart Failure; Infection

Summary: patients presenting to the emergency department with shortness of breath and (suspected) heart failure will be screened and randomized to either a standard of care or a procalcitonin-guided arm. procalcitonin-guided arm: a procalcitonin level (cutoff 0.2 ng/ml) will be used to support decision on antibiotic therapy initiation. standard of care arm: the decision on antibiotic therapy will be based on the physicians intent to treat. the patients will be followed up 30 and 90 days after randomization to evaluate the survival status, re-hospitalizations and further antibiotic therapies.


Eligibility criteria:
inclusion criteria: 1. patients who present to the emergency department (ed) with leading symptom dyspnea 2. suspected or known heart failure 3. midregional pro atrial natriuretic peptide (mr-proanp)\>300 pmol/l, brain natriuretic peptid (bnp) \>350 ng/ml or n-terminal of the prohormone brain natriuretic peptide (nt-probnp)\>1800 ng/l 4. patient has given written informed consent within study timelines to allow antibiotic therapy within 8 hours 5. adult patients (i.e. \>18 years of age) 6. hospitalization for at least 1 overnight stay planned exclusion criteria: 1. patient participates in any other interventional clinical trial 2. trauma related shortness of breath 3. patient diagnosed with lung or thyroid cancer 4. known terminal disease with life expectancy of less than 6 months, e.g. advanced metastasized cancer disease 5. organ transplant requiring immunosuppression 6. abdominal, vascular or thorax surgery within the last 30 days 7. end stage/advanced heart failure - defined by planned heart transplantation, or cardiogenic shock 8. female patients who have given birth within 3 months before study enrolment 9. current use of antibiotics or requirement of immediate antibiotic therapy before randomization and measurement of procalcitonin 10. end stage renal failure requiring dialysis 11. patient is not willing, or it is not possible or advisable for the patient, to follow the study schedule, including antibiotic therapy and 90 days follow up 12. patient has already participated in the clinical trial previously 13. pregnant or lactating women 14. patients who are institutionalized by official or judicial order 15. dependants of the sponsor, the contract research organization (cro), the study site or the investigator

Keywords: procalcitonin biomarker antibiotic therapy emergency department cardiology in vitro diagnostics