Kornimate/medical-research-clean huggingface dataset:
comparison between two strategies of discharge planning for the reduction of short term hospital readmissions

Conditions: Patient Discharge

Summary: the purpose of this study is to improve discharge planning effectiveness by comparing two strategies \[on-demand discharge planning (ddp) vs. routine discharge planning (rdp)\], in terms of reduction of hospital readmissions for inpatients classified at intermediate risk of complex discharge using the simplified blaylock risk assessment screening score (brass).

the purpose of this study is to improve discharge planning effectiveness by comparing two strategies \[on-demand discharge planning (ddp) vs. routine discharge planning (rdp)\], in terms of reduction of hospital readmissions for inpatients classified at intermediate risk of complex discharge using the simplified blaylock risk assessment screening score (brass). five internal medicine unit and four units of neurology will be randomized to the two different strategies of discharge planning (rdp or ddp), based on two different alternating sequences of four periods (each period comprising three months). the randomization will be stratified by type of unit. patients at risk of complex discharge, according to the simplified brass score, are assigned to the hospital unit of continuity of care (nocc) team, using the hospital telematics system. afterwards, the nocc team proposes an appropriate discharge planning, considering clinical and social needs.

Eligibility criteria:
inclusion criteria: * adults patients (age ≥ 18 years); * residents in piedmont, italy; * patients admitted to general internal medicine or neurology units of molinette hospital (turin) * patients with a score in the simplified brass between 4 and 6 at admission no specific exclusion criteria were applied.
the preservation of muscle function in critically ill patients (presmus)

Conditions: Critically Ill

Summary: this study evaluates the effect of whey protein enriched enteral nutrition in addition to exercise training on the preservation of muscle function in critically ill patients. one half of patients receive whey protein enriched enteral nutrition with a protein intake of 1.5 g/kg/day and the other half of patients receive standard enteral nutrition with a protein intake of 1 g/kg/day.

muscle wasting has an enormous impact on long-term physical performance and quality of life of intensive care survivors. limitation of muscle wasting might therefore improve physical performance and quality of life. data on high protein nutritional intake in addition to a standardized exercise training program to prevent skeletal muscle wasting during critical illness are lacking. objective: to determine whether early high protein intake, using an enteral whey protein supplement, in addition to a standardized exercise training program and standard enteral nutrition preserves: a) in vitro skeletal muscle function in critically ill patients during the first week of intensive care unit (icu) admission and b) short- and long-term in vivo muscle function and mass, clinical outcomes and quality of life in critically ill patients. secondly, to determine whether high protein intake, in addition to standardized exercise and standard enteral nutrition, increases muscle protein synthesis and attenuates activation of the ubiquitin-proteasome pathway in critically ill patients.

Eligibility criteria:
inclusion criteria: * admitted to the intensive care * mechanically ventilated * expected duration of ventilation of 72 hours * expected to tolerate and require enteral nutrition for more than 72 hours * sequential organ failure assessment (sofa)-score\>6 on admission day * written informed consent of patient or legal representative exclusion criteria: * contra-indication to enteral nutrition * short bowel syndrome * child c liver cirrhosis or acute liver failure * dialysis dependency * requiring other specific enteral nutrition for medical reason * body mass index (bmi) \> 35 kg/m2 * extensive treatment limitations * disseminated malignancy * haematological malignancy * primary neuromuscular pathology * chronic use of corticosteroids for \> 7 days before icu admission * contra-indication for muscle biopsy (need for uninterrupted systemic anticoagulation, prothrombin time \>1.4 , thrombocytes \<100).

Keywords: critical care nutrition whey protein mechanical ventilation muscle function
a dialectical behavioral therapy digital health solution for outpatients seeking support for substance use

Conditions: Alcohol Use Disorder; Substance Use Disorders

Summary: the purpose of this study is to compare the feasibility, acceptability, and efficacy of a dialectical behavior therapy skills training webapp known as "pocket skills" in outpatients and community members seeking treatment for substance use, across those who receive immediate versus delayed access to the intervention (e.g., a waitlist control condition).

seventy adult outpatients and community members seeking treatment for substance use from the centre for addiction and mental health addictions program will be randomized to receive immediate or delayed (1 month) access to a web-based dbt skills training intervention called pocket skills in addition to standard care. participants will complete interviews and questionnaires at baseline. following baseline, participants complete questionnaires at months 1, 2, and 3 months. measures will assess alcohol and drug consumption, substance use disorder symptoms, and other clinical features.

Eligibility criteria:
inclusion criteria: 1. 18-65 years of age 2. fluency in english 3. understanding and willingness to comply with study requirements 4. referred to addictions program at camh or seeking treatment from the community and currently waiting for psychosocial services 5. smartphone, tablet, or computer with access to the internet 6. reports at least "contemplation" levels of wanting to reduce substance use 7. use of target substance in past month 8. alcohol or substance use disorder in the past year exclusion criteria: 1. any known practical factor that would preclude participation (e.g., extended absences) 2. untreated or unstable severe psychiatric or medical disorder that precludes participation in the study (e.g., acute suicidality, untreated psychosis) 3. participation in another treatment/intervention study

Keywords: dialectical behavior therapy, digital health
the effect of music therapy on upper extremity functions and quality of life in individuals with cerebral palsy

Conditions: Cerebral Palsy; Hemiplegic Cerebral Palsy; Music Therapy

Summary: the main purpose of this study is to investigate the effect of music therapy on the upper extremity functions and quality of life of individuals with cerebral palsy (cp). the secondary aim is to investigate the effect of music therapy on the sensory functions of the upper extremity in individuals with cp. adolescent individuals with hemiparetic cp will participate in this study, and the participants will experience music therapy, which is a scientific intervention approach. if music therapy has a positive effect on upper extremity functions, they will be more active in daily life and their quality of life will increase. in the light of these data to be presented, a contribution will be made to the evidence level of music therapy in the literature and to the content of sp upper extremity rehabilitation.


Eligibility criteria:
inclusion criteria: * between the ages of 6-21 * with upper extremity dysfunction * macs score between 2-4, * according to mas, spasticity severity ranges from (1+) to (3), * individuals diagnosed with hemiparetic cerebral palsy who are at a cognitive level that can follow simple instructions during applications and evaluations will be included. exclusion criteria: * having another neurological disorder * having undergone upper extremity orthopedic surgery or botulinum toxin a (btx-a) application in the last 6 months, * individuals currently receiving another rehabilitation program in addition to classical physiotherapy for upper extremity rehabilitation will be excluded from the study.

Keywords: cerebral palsy music therapy upper extremity quality of life
efficiency study of triple-site cardiac resynchronization in patients with heart failure

Conditions: Congestive Heart Failure; Heart Disease

Summary: the purpose of this study is to assess the efficiency of permanent biventricular pacing using three ventricular leads in terms of reduction in adverse cardiac events rates, improvement in cardiac capacity and patients' functional status in subjects with congestive heart failure and a physiologic (sinus) rhythm.


Eligibility criteria:
inclusion criteria: * age 18 or more, * congestive heart failure (hf) in nyha class iii-iv within last 90 days despite optimal medical treatment, * left ventricular ejection fraction (ef) \<=35% measured with echocardiography, * sinus rhythm \>90% of the time in 24-h holter monitoring 1-3 days prior to randomization, * inter- or intraventricular mechanical dyssynchrony ≥40ms measured with pulse doppler and tissue doppler echocardiography, * optimal pharmacotherapy during the last 90 days, * signed informed, written consent. exclusion criteria: * pregnancy or breastfeeding, * unstable hf requiring hospitalization with intravenous inotropic drugs within last 90 days, * myocardial infarction, percutaneous/surgical revascularization or any cardiosurgical procedure within 90 days prior to randomization, * stroke within last 90 days, * history of chronic or persistent atrial fibrillation, flutter, tachycardia, * acute myocarditis, * implanted previously pacemaker, icd or crt-device, * participation in a concurrent trial that could confuse the results of this study, * mechanical right heart valve, * prior heart transplant, * valvular disease that is indication for valve surgery, * coronary heart disease if percutaneous or surgical revascularization is indicated and possible, * any state, apart from hf, that limits the estimated survival time to \<1 year, * unwillingness or inability to understand the nature of the study, to participate or to give written informed consent.

Keywords: heart failure dyssynchrony cardiac resynchronization triple-site pacing
a post-market study evaluating the prodigy mri and proclaim elite mr conditional scs systems

Conditions: Chronic Pain

Summary: a post market study evaluating the safety of the prodigy mri and proclaim elite mr conditional spinal cord stimulator (scs) systems.

the study will be performed as an international, multicenter, prospective and single-arm design. the study will be conducted as a post market clinical follow up (pmcf) study and the results will be submitted to the notified body: bsi group (bsi).

Eligibility criteria:
inclusion criteria: * patient has been implanted with a prodigy mri or proclaim elite mr conditional scs system * patient will receive an mri scan in compliance with the instructions for use (ifu) for the implanted mr conditional scs system * patient is ≥ 18 years of age * patient must be willing and able to comply with study requirements * patient must indicate his/her understanding of the study and willingness to participate by signing an appropriate informed consent form exclusion criteria: * patient has another implanted device (active or passive) that prohibits safe scanning * patient has previously experienced an mri scan-related adverse event * patient is currently enrolled in another abbott study that collects mri safety data * patient is incapacitated, is unable to read or write, or is pregnant or breastfeeding
bedside lung ultrasonography by nurses in acute dyspnea.

Conditions: Dyspnea; Cardiac

Summary: this study assesses the potential of lung ultrasonography to diagnose heart failure.

dyspnea is one of the most distressing situations for the patient . emergency cases do not always present in conditions that are ideal for immediate diagnosis, which sometimes compromises outcome. physical examination, laboratory findings and radiography are imperfect, resulting in a need for sophisticated test results that delay management. lung ultrasonography is becoming a standard tool in critical cases in the ed. the investigators aim to perform ultrasonography on consecutive patients admitted to the icu with dyspnea, comparing lung ultrasonography results on initial presentation with the final diagnosis by the nurses. three items were assessed: artifacts (horizontal a lines or vertical b lines indicating interstitial syndrome), lung sliding, and alveolar consolidation and/or pleural effusion, these items were grouped to assess ultrasound profiles. the study aimed to evaluate the accuracy and reproducibility of b-lines testing assessed by emergency nurses after 12-h training in the diagnosis of hf in patients admitted to the emergency department with acute dyspnea.

Eligibility criteria:
inclusion criteria: * non traumatic dyspnea with the final diagnosis of heart failure exclusion criteria: * age less than 18 years * impossibility to give consent to participate in the study * post-traumatic dyspnea * pregnant women * need for endotracheal intubation or inotropic drugs * patients who were deemed too unstable for sonography by the treating team

Keywords: lung ultrasound heart failure diagnosis accuracy nurses
randomized clinical trial comparing conventional laparoscopic surgery and robot-assisted laparoscopic surgery for the treatment of parastomal hernia of the oncology patient

Conditions: Parastomal Hernia; Oncology

Summary: prospective randomized prospective interventional study with 40 consecutive patients for whom surgical treatment for ph was indicated and who are in postoperative follow-up with the oncology surgery group of the department of digestive tract surgery and coloproctology, faculty of medicine, university of são paulo . the free and informed consent form will be applied to the patient by the researchers in two copies of equal content and after any doubts related to the research are resolved, the patient will sign the copies together with the researcher. at any time, the patient may opt out of the study. the contacts of the researchers and the institution will be fully available to the research subject to resolve doubts and for any eventuality that may occur.


Eligibility criteria:
inclusion criteria: * patients with ph in permanent ostomy, aged between 18 and 75 years, undergoing surgery for cancer treatment at icesp, with stable cancer disease (recurrence or metastasis without evolution) or in follow-up after treatment with curative intent, who have computed tomography with a diagnosis of hp, and who agree to participate in the study. exclusion criteria: * patient with progressive cancer disease. presence of disease that prevents the performance of videolaparoscopic surgical procedure such as severe heart failure, severe lung disease, etc. clinical criteria according to the research team that may indicate the application of another specific technique that is not covered in this study.
transcatheter mitral valve replacement system (tmvr) pilot study and the early feasibility study of the tmvr transseptal system

Conditions: Mitral Valve Insufficiency

Summary: pilot: the study is pilot trial to evaluate the safety and performance of the twelve tmvr system in very high risk mitral regurgitation patients. efs: the study is an efs trial to evaluate the safety and performance of the medtronic intrepid™ transcatheter mitral valve replacement system with transfemoral transseptal access in patients with severe, symptomatic mitral regurgitation

pilot: the study is a prospective, multi-center, non-randomized trial to evaluate the safety and performance of the twelve tmvr system in very high-risk patients with severe, symptomatic mitral regurgitation, who are deemed ineligible for standard surgery. efs: the study is a multi-center, prospective, non-randomized, trial to evaluate the safety and performance of the medtronic intrepid™ transcatheter mitral valve replacement system with transfemoral transseptal access in patients with moderate-severe or severe, symptomatic mitral regurgitation

Eligibility criteria:
key inclusion criteria: * severe mitral regurgitation (mr grade 3-4+) * symptomatic mitral regurgitation (nyha class ii-iv) * trans-apical access deemed feasible by the treating physician (pilot only) * subjects anatomically suitable for the intrepid tmvr delivery system including transfemoral and transseptal access (efs only) * native mitral valve geometry and size compatible with the twelve tmvr/intrepid key exclusion criteria: * left ventricular ejection fraction (lvef) \< 20 (pilot) or \<25% (efs) * evidence of intracardiac mass, thrombus, or vegetation * prior valve surgery or need for other valve surgery * prior stroke within 4 weeks (pilot) or 90 days (efs) * prior myocardial infarction within 6 months (pilot) or 90 days (efs) * need for coronary revascularization * history of, or active, endocarditis * renal insufficiency (creatinine \> 2.5 mg/dl)
impact of the introduction of a gastro-intestinal panel by polymerase chain reaction (pcr).

Conditions: Gastroenteritis

Summary: evaluation of the impact of the introduction of multiplex pcr panels on the clinical management of patients with gastroenteritis at the university hospital of lausanne, switzerland.

gastrointestinal multiplex pcr panels have been introduced in clinical practice several years ago, but the impact on the management of patients is yet unknown. the investigators are interested to evaluate if the multiplex pcr panels introduced at the university hospital of lausanne in july 2017 modified the usual medical care and in particular the prescription of anti-infectious treatments. the high sensitivity of the multiplex pcr panels should allow a more precise diagnosis of the etiology of the gastrointestinal symptoms of the patients than the traditional methods of stool culture and microscopy. the investigators expect therefore to observe a modification of the proportion of patients receiving anti-infectious treatment, but it is uncertain if it will lead to an increase or a decrease in the use of antibiotics. on one hand antibiotics could be prescribed more often due to a greater and faster detection of enteropathogens. on the other hand antibiotics could be prescribed less often due to more precise diagnosis, showing that viruses and certain bacteria do not require antibiotic treatment.

Eligibility criteria:
inclusion criteria: ambulatory patients who consulted the university hospital of lausanne between july 2016 and may 2017, and were investigated by traditional methods (stool microscopy and culture). ambulatory patients who consulted the university hospital of lausanne between july 2017 and may 2018 and had stool investigations by a gastro-intestinal panel. exclusion criteria: patients for whom there ia record in the file that they do not accept that their data are used for research purposes.

Keywords: gastroenteritis, panel by pcr, antibiotic use
treatment of anal high-grade squamous intraepithelial lesions (hsil) through use of a chinese herbal topical cream

Conditions: Anus Neoplasms

Summary: the purpose of this study is to find out if a chinese herbal cream is effective in treating hsil (high-grade squamous intraepithelial lesions, also known as hgain, or high-grade anal intraepithelial neoplasia).

the purpose of this study is to test a new noninvasive topical cream, aijp (arnebia indigo jade pearl), for treatment of precancerous anal lesions in order to prevent their progression to anal cancer. aijp is a topical chinese herbal cream that has been specifically designed to treat people with the cancer precursor lesions caused by human papillomavirus (hpv). in general, hpv infection is a key factor in development of cervical, anal and vulvar cancers. people with hiv are especially vulnerable to develop anal cancer associated with hpv. it is known that prior to development of anal cancer a person develops a precancerous condition known as a high-grade squamous intraepithelial lesion (hsil). treatment of the hsil can prevent progression to anal cancer. current therapies for hsil and anal cancer are highly invasive. a new effective noninvasive topical therapy for precancerous hsil could have a high impact on prevention of anal cancer.

Eligibility criteria:
inclusion criteria: * anal hsil confirmed by biopsy no more than 30 days prior to entry * anal hsil deemed not amenable to therapy or participant declines routine ablative therapy * hiv positive * stable hiv treatment regimen for at least 8 weeks prior to entry * at least 18 years of age * women of childbearing potential must use contraception * platelet count above 70,000/mm3 within 30 days prior to entry * anc greater or equal to 1000/mm3 within 30 days prior to entry * creatinine less then or equal to 1.5 times uln within 30 days prior to entry * ast and alt less than or equal to 3 times uln within 30 days prior to entry exclusion criteria: * prior history of invasive anal, cervical, vaginal, or vulvar cancer * pregnancy or lactation and breast-feeding * must not participate in a conception process including sperm donation * medical or psychiatric illness that precludes ability to give informed consent or is likely to interfere with ability to comply with protocol * known allergy to any topical cream components * patients with lesions clinically suspicious per hra examiner for early progression (less than one year) to anal cancer

Keywords: hsil hgain ain neoplasia dysplasia tcm traditional chinese medicine
a study of avastin (bevacizumab) + xeloda (capecitabine)as maintenance therapy in patients with her2-negative metastatic breast cancer

Conditions: Breast Cancer

Summary: this randomized study will compare maintenance therapy with avastin (bevacizumab) + xeloda (capecitabine) versus avastin alone, in patients with her2-negative metastatic breast cancer who have not progressed during first-line therapy with docetaxel + avastin. eligible patients will receive up to 6 x 3 week cycles of treatment with avastin (15 mg/mg iv on day 1 of each cycle) + docetaxel (75-100 mg/m2 iv on day 1 of each cycle). those patients who do not progress will be randomized to 3 week cycles of either a) avastin (15 mg/kg iv on day 1 of each cycle) + xeloda (1000 mg/m2 po bid on days 1-14 of each cycle) or b) avastin alone. study treatment will continue until disease progression, unacceptable toxicity, patient request for withdrawal or end of study, and the target sample size is 100-500 individuals.


Eligibility criteria:
inclusion criteria: * adult patients, \>=18 years of age; * her2-negative metastatic breast cancer * candidates for taxane-based chemotherapy; * ecog performance status of 0 or 1. exclusion criteria: * previous chemotherapy for metastatic breast cancer; * prior adjuvant/neo-adjuvant chemotherapy within 6 months prior to study; * prior radiotherapy for treatment of metastatic disease; * chronic daily treatment with aspirin (325 mg/day) or clopidogrel(\>75mg/day).