Kornimate/medical-research-clean huggingface dataset:
a study of the implementation of an electronic consultation ("econsult") platform

Conditions: Cardiovascular Diseases

Summary: the purpose of this study is to evaluate the implementation of an electronic consultation model for specialty services (econsults) to improve quality of care and reduce health system costs. an econsult is a non-face-to-face consultation between a primary care provider and a specialist that takes place via secure messaging.

the study is a randomized, controlled trial where the intervention is the evidence-based econsult model in which consults are submitted by electronic, secure messaging to a specialist for review and "virtual" consultation. primary care providers will be randomized to the control or intervention group. in the intervention group, all new, non urgent, adult cardiology referrals will be submitted to the econsult cardiology team for an econsult. consults for children (age \<18) and consults for patients who already have an established relationship with another cardiologist will not be eligible for an econsult. urgent consults, such as those for patients with active chest pain or other acute conditions, will not be submitted for econsult and should instead be handled by the on-site care team as per the standard protocol. for econsults, the consult will be submitted using the econsult pathway within the electronic health record. econsults will be created in the same way that standard referrals are created, with attachment of a treatment summary, ekg, relevant results, and specification of the consultative question. the econsult will be received by the intervention cardiology team and reviewed within 2 business days. one cardiologist per day will be assigned to review and respond to econsults. the result will be received by the primary care provider who will be responsible for acting appropriately on the cardiologist's recommendations. recommendations will be case specific and may include one of three broad areas of suggestion: 1) suggestions for ongoing management by the primary care provider, 2) suggestions for additional testing in advance of a cardiology face to face appointment or to better determine a next course of action, and 3) immediate cardiology referral. for each of these options, the primary care provider will be responsible for following up and implementing the recommendations made by the cardiologist. when referral is recommended the primary care provider will refer the patient to the cardiologist of their choice based on their location and the patient's preference. while not required, they may refer the patient to the econsult cardiology team at university of connecticut for face to face care if desirable, but may also refer to other cardiologists. the intervention will last one year. providers randomized to the control group will provide standard care which involves a traditional referral for an in-person cardiology visit.

Eligibility criteria:
inclusion criteria: * primary care provider at community health center, inc who work at least 30 hours per week and see adult patients exclusion criteria: -

Keywords: health services accessibility
effect of incentive spirometry on post-operative pulmonary complications after bariatric surgery

Conditions: Bariatric Surgery Candidate

Summary: today, obesity is the major concern and obese patients are at higher risk of developing pulmonary complications. incentive spirometry is widely used worldwide to reduce rates of pulmonary complications. in this study, effect of incentive spirometry (is) on post operative bariatric patients (male and female) will be studied on patients about sample size of 140 including male and female gender, bmi above 30 kg/m2 having post operative bariatric surgeries with chances of generating pulmonary complications.

research will be conducted in shalamar hospital lahore and data will be collected through predesigned proforma. in previous studies some studies show positive and but some studies don't recommend incentive spirometry as a post operative rehabilitation therapy.but this therapy device is still used in present days in post operative patients to prevent pulmonary complications. in this study we conclude the positive or negative effect of incentive spirometry.

Eligibility criteria:
inclusion criteria: * patient having weight above 25 bmi * age between 18 years to 60 years * having post operative pulmonary complication. * bariatric patients (sleeve gastrectomy,mini gastric bypass,sleeve gastrectomy to gastric bypass ,sleeve re do surgery).. exclusion criteria: * patients weight below 25bmi. * other abdominal surgeries. * patients having absence of teeth. * patients age below 18 years .
thromboelastography normal reference values in china hunan province

Conditions: Coagulopathy; Blood Transfusion Complication

Summary: the purpose of this study was to establish the normal reference range of thrombelastogram parameters in hunan by a multicenter study, and to analyze the specificity of thrombelastogram detection and the influence of gender, age and blood type on thrombelastogram. the study will provide basic data and statistical basis for the establishment of normal reference range of thrombelastogram in hunan.

thrombelastograghy (teg) is an important test to assess the blood coagulation function to monitor the whole process of perioperative coagulation. teg can evaluate the coagulation cascade, from platelet aggregation, clot strengthening and fibrin cross-linking to eventually clot lysis in small volume of whole blood. the reference range is one important element to influence the teg results. at present, a number of studies have shown that reference range of teg exists significant differences between different racial and geographic. at the same time, reagent manufacturers also suggested that each teg laboratory should establish its own reference range. so it is important to establish our own reference range of teg to guide the clinical blood transfusion and treatment.

Eligibility criteria:
inclusion criteria: (1) 18\< age \<65, and han chinese residents living in hunan more than 3 years. (2) health examination population who physical examination, assistant examination and serological examination were normal; not suffer from other diseases last 3 months; not take any medication last 7 days. exclusion criteria: 1. informed refusal. 2. pregnancy, woman with menstrual period; volunteers who suffer from hematological system diseases such as hemorrhagic or thrombotic disease and take medicines that affect the function of blood coagulation (clopidogrel and aspirin, warfarin, rivaroxaban, dipyridamole, oral contraceptives, estrogen, antibiotics and traditional chinese medicine related with blood coagulation, etc.) 3. volunteers who have a history of liver disease, immune system disease, allergy and other disease within the last 3 months were excluded.

Keywords: thrombelastograghy reference ranges racial geographic blood transfusion
stepped care for treating obsessive-compulsive disorder

Conditions: Obsessive-compulsive Disorder

Summary: this study will determine the effectiveness and cost-effectiveness of a stepped-care treatment program for people with obsessive-compulsive disorder.

obsessive-compulsive disorder (ocd) is a chronic and debilitating anxiety disorder. people with ocd often experience recurrent unwanted thoughts, called obsessions, and repetitive behaviors, called compulsions. these thoughts and behaviors interfere with everyday life to a great extent. currently, the most frequently used psychosocial treatment for ocd is cognitive-behavioral therapy (cbt) that incorporates exposure with ritual prevention (ex/rp). however, although effective, this treatment approach is largely inaccessible, time-consuming, labor-intensive, and expensive. a stepped-care approach to treating ocd may be more cost-effective and therefore more accessible for many individuals. stepped-care cbt begins with the least expensive, least intrusive, most accessible option, and works up to the most expensive option if the less intrusive treatments do not work. this study will determine the benefits and cost-effectiveness of a stepped care treatment program for ocd. participants in this open label study will be randomly assigned to receive cbt for 6 to 14 weeks either through the stepped-care approach or immediately upon study entry. participants will report to the study site for treatments and assessments on a regular basis, ranging from every 2 weeks to twice a week, depending on the stage of the study and the assigned treatment group. stepped-care cbt will begin with self-administered ex/rp combined with counseling to address medication issues, life stress, and motivational enhancement. if ineffective, this treatment will be followed by therapist-administered ex/rp. ocd symptoms will be assessed at week 6. participants who have responded to treatment after 6 weeks will not receive further treatment. all others will continue for an additional 8 weeks. these participants' ocd symptoms will be assessed again at week 14. participants assigned to the stepped-care approach whose ocd symptoms improved initially, but relapsed without further treatment by the week 14 evaluation will receive full-scale cbt. outcomes will be assessed again at 1- and 3-month follow-up visits.

Eligibility criteria:
inclusion criteria: * primary diagnosis of ocd of moderate or greater severity * presence of ocd symptoms for at least 1 year exclusion criteria: * history of psychotic or developmental disorder * uncontrolled bipolar disorder * serious suicide risk * prior history of adequate cbt, including exposure and response prevention

Keywords: anxiety behavior therapy cognitive-behavioral therapy stepped care cost-effectiveness
effect of myofascial release of subscapularis along with shoulder mobilization in adhesive capsulitis

Conditions: Adhesive Capsulitis of Shoulder

Summary: this randomized control trial aims to compare the effect of myofascial release of subscapularis along with shoulder mobilization vs mobilization alone among patients with adhesive capsulitis. the study will be conducted at physiotherapy outpatient department (opd) of sindh institute of physical medicine and rehabilitation, and dow university ojha campus, karachi. according to study criteria, 70 patients with sub-acute adhesive capsulitis will be selected through a non-randomized purposive sampling technique by a consultant physician. after taking informed consent, participants will be randomly divided into 2 groups through the sealed envelope method. both the groups will receive conventional treatment while group 1 will be given an additional treatment of myofascial release of subscapularis through ischemic compression technique. total 6 treatment sessions will be provided and assessment will be done at baseline and end of the 6th session.

the sample size of 31 per group was determined using planning and specification software (pass) version 15 software based on two independent sample t-test using 95%confidence interval and 80% power of the test. this sample was raised to 35 per group with 4 patients as drop out per group. mean and standard deviation will be calculated for the quantitative variables while frequency and percentages will be calculated for qualitative variables. inter-group comparison at baseline will be calculated using an independent sample t-test. the mean difference between both the techniques in terms of numeric pain rating scale (nprs), range of motion (rom), shoulder pain and disability index (spadi), and pain pressure threshold(ppt) will be determined using repeated measure 2-way anova.

Eligibility criteria:
inclusion criteria: * patients aged between 40-65 years * diagnosed with sub-acute adhesive capsulitis * pain range of 3 to 8 on nprs * spadi score of \>40 * presence of myofascial trigger point in subscapularis muscle exclusion criteria: * history of fracture * rheumatoid arthritis * shoulder osteoarthritis * any malignancy * shoulder dislocation * subacute adhesive capsulitis with impingement syndrome

Keywords: adhesive capsulitis muscle stretching exercise myofascial trigger point range of motion pain
nutritional intervention with the dietary supplement, immunocal® in mci patients: promotion of brain health

Conditions: Mild Cognitive Impairment (MCI)

Summary: alzheimer disease (ad) is a dementing illness characterized by progressive neuronal degeneration, gliosis, and the accumulation of intracellular inclusions and extracellular deposits of amyloid in discrete regions of the basal forebrain, hippocampus, and the association cortices. mild cognitive impairment (mci) refers to individuals with cognitive impairment (often memory loss) that fails to meet clinical criteria for ad or another dementing illness.


Eligibility criteria:
this study is recruiting mild cognitive impaired (mci) patients from the memory clinic of the jewish general hospital only. inclusion criteria: subjects meeting diagnostic criteria for mci: * age 55-85 * male or female * non-smoker to ensure that the subject can physically fit in the scanner: 1. body weight ≤ 120 kg and 2. with a linear dimension max 55cm (shoulders or belly) expected to remain in the greater montreal area for the duration of study. exclusion criteria: * presence of an active, systemic illness (e.g., cancer, rheumatoid arthritis, etc.) or other chronic neurological (e.g. parkinson's disease, multiple sclerosis) or psychiatric (e.g. major depression, schizophrenia) disease. * subjects taking other experimental medications or psychotropic agents. * subjects with mri contraindications such as pacemaker, aneurysm clips, artificial heart valves, metal fragments, foreign objects or claustrophobia. * ambulatory subjects: as wheelchair-bound subjects present additional difficulties for transportation and mri scanning. musculoskeletal abnormalities that preclude the ability of the subject to lie on his/her back for 1hr during mri scanning. * subjects who have a protein restricted diet as per their medical history. * pregnancy * subjects using n-acetylcysteine, α-lipoic acid supplements, other whey protein supplements or vitamin c, within 2 months of enrolment and during the entire 6 months study period. * allergies to milk proteins/ milk protein intolerance

Keywords: mci, ad, mri, gsh, immunocal, brain health, neuropsychological evaluation
epidemiological study of hepatitis e virus in maintenance hemodialysis patients

Conditions: Hepatitis E Virus Infection

Summary: primary purpose: 1. evaluate the prevalence and incidence of hev infection in mhd patients. 2. compare differences of the prevalence and incidence between the mhd patients and the control. . secondary purpose: analyze risk factors of hev infection.

this is an epidemiological study manufactured by xiamen university. the primary purpose of this study is to evaluate the prevalence and incidence of hev infection in mhd patients and to compare differences between the mhd patients and the control. the secondary purpose of this study is to analyze risk factors of the infection of hev. there are two phases in this study. the first phase is a cross-sectional study. approximately 200 mhd patients will be enrolled in mhd patient group, followed by control group's enrollment according to the age and gender of the mhd patient group. blood samples and questionnaire were got at this time. secondly, 100 enrolled volunteers in each group who is negative for hev-igm、hev-igg、hev rna will be introduced into the cohort study. the mhd patient group will been taken blood samples at an interval of 3 month until the 12th month after the first phase, however, the control group only need one blood sample at 12th month.

Eligibility criteria:
inclusion criteria: * maintenance hemodialysis patients and healthy people as control * can understand the study progress, willing to sign the informed consent and participate the study exclusion criteria: * has received hev vaccines
vacuumtherapy after venous hybrid procedures

Conditions: Wound Infection

Summary: all patients with deep venous obstruction below the sapheno-femoral junction elective for hybrid procedure with creation of an arterio venous-fistula (avf) in the mumc or patients with primary percutaneous procedure (and thus venous obstruction above the sapheno-femoral junction) who present with occluded stents which need an additional avf after thrombolysis will receive a prevena npwt. incidence of wound infections and wound scoring will be performed afterwards.


Eligibility criteria:
inclusion criteria: * all patients with deep venous obstruction below the sapheno-femoral junction primary elective for hybrid procedure with creation of an av-fistula in the mumc * be able to communicate in dutch * life expectancy \>1 year exclusion criteria: * patients with allergies for the components of the used negative pressure incision management system (prevena)
observational study of safety of flu cell culture derived adjuvanted swine origin a (h1n1) pandemic subunit vaccine

Conditions: Novel Influenza A (H1N1); A New Flu Virus of Swine Origin

Summary: this is an observational study of safety and occurrence of influenza-like illness following administration of flu cell culture derived adjuvanted swine origin a (h1n1) pandemic subunit vaccine in subjects 6 months of age and older.


Eligibility criteria:
inclusion criteria: * age ≥ 6 months * subjects will be vaccinated with flu cell culture derived adjuvanted swine origin a (h1n1) pandemic subunit vaccine, independently of this study. * subjects or parent/guardian willing to provide informed consent prior to vaccination administration and complete all of the study, including follow-up contact exclusion criteria: • received any prior h1n1 vaccination

Keywords: swine flu h1n1 vaccine adjuvanted flu cell culture derived
efficacy of early administration of tocilizumab in covid-19 patients

Conditions: COVID-19 Pneumonia

Summary: the clinical study aims at assessing whether early administration of tocilizumab compared to late administration of tocilizumab can reduce the number of patients with covid-19 pneumonia who require mechanical ventilation. the clinical study includes patients with recent-onset covid-19 pneumonia who require hospital care, but not invasive or semi-invasive mechanical ventilation procedures.


Eligibility criteria:
inclusion criteria: * age \> 18 years * informed consent for participation in the study * real time polymerase chain reaction (pcr) diagnosis of sars-cov2 infection * hospitalization due to clinical / instrumental diagnosis (high resolution chest ct scan or chest x-ray or pulmonary ultrasound) * presence of acute respiratory distress syndrome with arterial partial pressure of oxygen / fraction of inspired oxygen (pao2 / fio2) between 200 and 300 mm/hg * presence of exaggerated inflammatory response defined by the presence of at least 1 of the following criteria: * at least one body temperature measurement \>38° c in the past two days; * serum crp greater than or equal to 10 mg/dl; * crp increase of at least twice the basal value exclusion criteria: * patients with respiratory distress syndrome with arterial partial pressure of oxygen / fraction of inspired oxygen (pao2 / fio2) \<200 mm/hg or * patients in non-invasive ventilation or * patients in invasive ventilation or presence of shock or presence of concomitant organ failure that requires admission to the intensive care unit * severe heart and kidney failure * pregnant or breastfeeding patient * patient who, in the opinion of the clinician or by the patient's express will, will not go to intensive care regardless of the evolution of the lung picture. * known hypersensitivity to tcz or its excipients * patient being treated with immuno-depressors or anti-rejection drugs * known active infections or other clinical conditions that contraindicate tcz and cannot be treated or resolved according to the physician's judgment * glutamate-pyruvate transaminase (gpt) or glutamine oxaloacetic transaminase (got) \> 5 times the upper limit of the norm * neutrophils \<500 /mmc * platelets \<50.000 /mmc * diverticulitis or intestinal perforation * suspicion of latent tuberculosis
vienna pilot study for automated annular suturing technology

Conditions: Aortic Valve Disease; Mitral Valve Disease

Summary: the objective of this study is to compare surgical outcomes between patients who underwent valve replacement with and without the help of the automated annular suturing technology. in addition, data of the early and intermediate postoperative period will be collected within routine clinical follow-up in order to assess morbidity and mortality as well as echocardiographic parameters.

this study is a clinical, single-center pilot-study to evaluate safety and performance. 30 patients (n=20 aortic valve replacement/ n=10 mitral valve replacement) with aortic and mitral valve pathology, highly likely for prosthetic valve replacement, who are planned for surgery at the vienna general hospital (akh) will be included in this study with respect to the inclusion and exclusion criteria. the patients will undergo aortic or prosthetic mitral valve replacement using a specified automated annular suturing system for placement of the annular pledgeted sutures.

Eligibility criteria:
inclusion criteria: * patients with low to moderate operative risk (defined by sts mortality risk below 8%) * patients above the age of 18 years * patients willing and able to sign the informed consent exclusion criteria: * patients with active endocarditis * patients with previous cardiac surgery other than pacemaker implantation * emergency procedures * patient who did not sign the informed consent form and/ or refuse to participate * patients unable to read or understand the informed consent

Keywords: surgical aortic valve replacement surgical mitral valve replacement
safety & efficacy of symbicort® turbuhaler® (1, 2, and 4 x 160/4.5 µg twice daily) in japanese patients with asthma

Conditions: Asthma

Summary: this study is to confirm the safety of symbicort® turbuhaler® 160/4.5 µg 1, 2 or 4 inhalation b.i.d. over a 52 week treatment period in asthmatic patients who are being treated with igcs and long acting β2-agonist (laba) and/or other anti-asthmatic drugs.


Eligibility criteria:
inclusion criteria: * diagnosis of asthma with a documented history of at least 6 months duration prior to visit 1 * prescribed daily use of an igcs for ≥12 weeks prior to visit 1 * prescribed daily use of at least one of the following: theophylline, long acting β2-agonist (laba), other anti-asthmatic drugs (leucotrine antagonists, inhaled anti-cholinergics, th2 cytokine inhibitor) for at least 4 weeks prior to visit 1 at a constant dose exclusion criteria: * any significant disease or disorder that may jeopardize the safety of the patient * respiratory infection, judged by the investigator(s) as an infection affecting the asthma, within 4 weeks prior to visit 1 * treatment with oral, parenteral or rectal gcs within 4 weeks prior to visit 1

Keywords: asthma