Kornimate/medical-research-clean huggingface dataset:
evaluation of the medical psychiatry alliance senior's outpatient collaborative care project

Conditions: Anxiety; Depression

Summary: this study evaluates the effectiveness of a collaborative care model designed to treat frail seniors with both a mental (anxiety and/or depression) and a physical health condition impacting function with a comparison group that receives a psychiatric mood consult and a letter of recommendation but who are mainly cared for by their pcp.

literature suggests seniors with co-existing mental and physical health concerns encounter challenges with accessing care including limited availability of geriatric specialists, inadequate navigational support, disjointed communication, and limited provider knowledge/ capacity to manage these complex patients. in conjunction with primary care, a new program was created to assist in addressing these concerns. a novel collaborative care model was developed integrating geriatric medicine and geriatric psychiatry anchored in primary care, where primary care remains the most responsible provider. care managers (cms) work with seniors in the community, for up to 16 weeks, who have at least one chronic health condition affecting function and depressed mood and/or anxiety. the care model focusses on 4 main components: integrated therapeutic care management, systematic case reviews (scrs), integrated care planning, and education/capacity building. cms provide comprehensive assessments, system navigation, monitoring using symptom rating scales, and a problem solving psychotherapy for seniors using reward exposure to form action plans (engage). cms present cases weekly at scrs, where the team includes a geriatrician, geriatric psychiatrist, primary care, and allied health. recommendations are made then sent to the pcp for implementation. in the current evaluation study we will compare levels of depression, anxiety and functioning of seniors receiving the collaborative care model with those receiving a one time mood consultation.

Eligibility criteria:
inclusion criteria: * depressive mood phq-9 \>9 or anxiety gad-7 \>9 * one or more chronic medical condition(s) impacting function * had a one time mood consultation at camh or has been a patient in the medical psychiatry alliance senior outpatient program * able to speak english exclusion criteria: * moderate to severe cognitive decline * positive psychotic symptoms * active suicidal ideation or attempt within the last year * psychiatric admission within the last year
uncovering potential breast cancer biomarkers amp; possible drug targets using advanced quantitative mass spectrometry

Conditions: Breast Cancer

Summary: the purpose of this study is to evaluate the use of advanced quantitative mass spectometry (super silac) as a discovery platform to uncover novel protein biomarkers in tumor and to compare the protein profile between different subtypes of breast cancer (er positive, her2 positive, triple negative). a maximum of 100 breast tumor specimens will be obtained from the nuhs tissue repository, comprising approximately equal proportion of er positive, her2 positive, and triple negative tumors. samples will be analyzed using advanced mass spectrometry (super silac) as a discovery platform to identify novel protein biomarkers that may be important in cancer. dna and rna will also be extracted from tumor samples for correlative analysis with the proteomics data. genomics and proteomics data will be correlated with clinical data including treatment response and survival data. importance of proposed research to science or medicine:identification of tumor biomarkers may allow better prognostication, follow-up, and selection of treatment for cancer patients in the future. potential benefits and risks: no direct benefit to the patient. risk to the subjects is minimal as there is no direct patient contact, and analysis is done on previously donated tumor samples. patients have previously provided consent to donate their samples for research into the nuhs tissue repository. novel tumor biomarkers that determine tumor biology, including prognosis and treatment sensitivity, may be detectable using the novel advanced quantitative mass spectromy method (super silac). different subtypes of breast cancers will have different proteomic profiles analyzed using super silac.


Eligibility criteria:
inclusion criteria: * patients with breast cancer
minimally invasive techniques in ventral hernioplasty

Conditions: Ventral Hernia

Summary: 1. review the surgical outcome of different techniques using extraperitoneal ventral hernia repair regarding postoperative pain. wound infection ,hospital stay , recurrence ,mesh migration and mesh induced visceral complications. 2. reviewing advantages and drawbacks of each surgical technique regarding feasibility ,cost effectiveness and technical difficulties

the laparoscopic ventral hernia repair was first introduced by leblanc and booth in the early 1990s . since its introduction, it has continued to evolve and has become an important option in the hernia surgeon's armamentarium. however, only 27.4% of ventral hernia repairs are performed laparoscopically, likely because of the relatively advanced nature of this procedure and because all hernias may not be suitable for a laparoscopic approach. using current techniques, numerous studies have documented the safety and efficacy of this approach. some data suggest that the laparoscopic approach results in a shorter hospital stay and lower recurrence rates compared with open approaches. however, pain may still be significant after laparoscopic repairs and there are not significant advantages from this standpoint. nonetheless, it is well accepted that the primary advantage of the laparoscopic approach is that wound infections are less frequent compared with open approaches .leblanc and booth in 1993 first reported application of intra-peritoneal onlay mesh (ipom) for ventral and incisional hernia, however the technique requires expensive fixation devices which may cause acute and chronic pain .the laparoscopic groin hernia repair using synthetic mesh in tep or tapp are acceptable surgical techniques today these techniques are rarely associated with mesh induced complications, the reason being extraperitoneal placement of synthetic mesh. it is apparent that despite great progress in mesh technology, nearly all types of meshes have been found to produce a varying level of adhesion or tissue reaction, regardless of the material and coating used. preoperatively unpredictable, a mesh-induced visceral complication may occur in some patients to produce severe reaction or major mesh-related adverse events.the incitation to develop certain novel minimally invasive techniques that enables researchers to bring the mesh out of abdominal cavity has been an exciting trend in laparoscopic hernia repair.

Eligibility criteria:
inclusion criteria: * • able to give informed consent for inclusion in the study * age of the patient : above 18 years * any type of ventral hernia including umbilical,paraumbilical,epigastric,spigelian and incisional hernias exclusion criteria: * • patients with inguinal hernia. * strangulated or obstructed hernia. * previous mesh hernia repair. * loss of abdominal domain. * infected or contaminated field. * defect size more than 10cm.
pressure therapy in the treatment of upper arm of cerebral palsy children

Conditions: Cerebral Palsy

Summary: the purpose of this study is to assess the efficacy of a 6 months upper arm proprioceptive pressure therapy on assisting hand assessment ("aha") performance in cerebral palsy (cp). to perform this study, 80 cp patients aged of 5 to 10 years old will be included in a multicentric, double blind, prospective parallel-group randomized study. treatment will be a pressure therapy using a lycra® compressive sleeve initially used in burn therapy. primary outcome is to increase of 60% of aha performance. the secondary outcome are to increase quality of upper extremity skill test (quest), quality of life and improve somatosensory evoked potentials (sep).

the purpose of this study is to assess the efficacy of a 6 months upper arm proprioceptive pressure therapy on assisting hand assessment ("aha") performance in cerebral palsy (cp). to perform this study, 80 cp patients aged of 5 to 10 years old will be included in a multicentric, double blind, prospective parallel-group randomized study. treatment will be a pressure therapy using a lycra® compressive sleeve initially used in burn therapy. primary outcome is to increase of 60% of aha performance. the secondary outcome are to increase quality of upper extremity skill test (quest), quality of life and improve somatosensory evoked potentials (sep)

Eligibility criteria:
inclusion criteria: * children with upper limb with pre/peri birth etiologic cp. * children aged 5 to 10 years exclusion criteria: * children with language dysfunction * lycra® allergia * botulic toxin injection on upper limb 4 month before inclusion

Keywords: upper limb proprioceptive pressure therapy children assisting hand assessment performance
improving stroke prevention in atrial fibrillation through pharmacist prescribing

Conditions: Atrial Fibrillation; Stroke

Summary: the purpose of this study is to compare the effectiveness of prescribing oral anticoagulation therapy by pharmacist intervention compared to enhanced usual care in participants with unrecognized af and/or known af but not taking blood thinners.

background: af is the most common arrhythmia and the leading cause of stroke. despite robust evidence oral anticoagulation (oac) therapy is effective and safe for stroke prevention in patients with af; there is a lack of real-world application. alternative strategies to deliver stroke prevention therapy need to be explored. although pharmacists' prescribing of antihypertensive and lipid lowering drug therapy has been shown to increase adherence to guideline-based targets and warfarin management improve control of international normalized ratios in anticoagulation clinics, the role of pharmacist initiation of oac therapy compared to usual care in af patients for stroke prevention in a community setting is unclear. in this study, the investigators will screen participants presenting to community pharmacies to identify participants with unrecognized af and/or known af but not taking blood thinners or not on optimal oac therapy and randomize care to either the pharmacist or enhanced usual care (family physician notification by pharmacist).

Eligibility criteria:
inclusion criteria: * age ≥ 65 years with one additional stroke risk factor (hypertension, diabetes, heart failure history of or left ventricular ejection fraction \<0.40), previous stroke or transient ischemic attack). * atrial fibrillation and not on oral anticoagulation (oac) therapy but eligible * atrial fibrillation on sub-optimal oac exclusion criteria: * uncontrolled hypertension (defined as average sbp ≥ 160 mmhg \[2 readings taken at time of screening\]). * end stage renal disease (crcl \< 15 ml/min) * valvular heart disease including those with prosthetic valve, mitral stenosis (moderate to severe) or valve repair. * excess alcohol intake (males: ≥ 28 units/week, females: ≥ 21 units/week. one unit of alcohol = 8 oz beer, 1 oz hard liquor or 4 oz wine). * intracranial bleed at any point. * history of "major bleeding" at any point (defined as overt bleeding at a critical site including intracranial, intraspinal, intraocular, pericardial, or retroperitoneal; or bleed requiring hospitalization). * foreshortened life-expectancy or severe comorbidities precluding study follow-up period * unable to read/understand english * severe cognitive impairment (defined as score ≥ 5 on the short portable mental status questionnaire)

Keywords: atrial fibrillation stroke oral anticoagulation therapy pharmacist case management
snapshot study on patients with heart failure

Conditions: Heart Failure

Summary: the goal of this observational study is to provide a better understanding of medical practice for heart failure management based on real-world data, collected both across europe and the rest of the world, using robust methodology and representativeness within each country. standard management of patients will be the diagnostic and therapeutic interventions routinely performed in each center for patients presenting with signs and symptoms of chronic/acute heart failure.


Eligibility criteria:
inclusion criteria: adult patients with chronic or acute heart failure (hf), regardless of ejection fraction, either: • outpatient with chronic hf (including first-time diagnosis), according to the clinical judgment. or • patients admitted to hospital or presenting to emergency department or acute out-patient care for acute hf for whom an iv (diuretics, inotropes, vasodilators) or mechanical therapy for hf (mechanical circulatory support) is administered. exclusion criteria: * age \<18 years * patients unwilling to consent (or patient's legally authorized representative unwilling to consent, if the patient is unable to consent).
a study of mirabegron (ym178) in men with lower urinary tract symptoms (luts) and bladder outlet obstruction (boo)

Conditions: Lower Urinary Tract Symptoms; Bladder Outlet Obstruction

Summary: this study examined the safety, tolerability, and efficacy of mirabegron (ym178) compared to placebo.


Eligibility criteria:
inclusion criteria: * men 45 years of age or older * documented bladder outlet obstruction exclusion criteria: * history of urinary retention * symptomatic and recurrent urinary tract infection (uti)

Keywords: beta-3 receptor agonist ym178 men lower urinary tract symptoms bladder outlet obstruction
evaluation of the zetiq histological and cytological staining technique for the detection cervical cancer

Conditions: Cervical Cancer

Summary: zetiq has introduced a histochemical stain that claims to tinctorially identify cancer and neoplastic cells. because of the potential importance of such a capability, the investigators undertook to investigate zetiq's celldetect® staining technology as applied to cultured cell lines as well as an initial sample of clinical cases. this goal was pursued by investigating four types of comparisons: 1) cancer cell lines before and after differentiation; 2) cervical squamous-cell carcinoma (scc) biopsies to non-neoplastic squamous epithelium; 3) sccs to neoplastic, nonmalignant squamous epithelium; and 4) neoplastic squamous cells to non-neoplastic squamous cells in cytological preparations. the clinical material was also stained with hematoxylin and eosin (biopsies) or pap (cytologies) for diagnostic purposes. the investigators found that all celldetect®-stained cells exhibited one of the two tinctorial outcomes. cell lines with malignant phenotype uniformly had red/purple cytoplasm, whereas the differentiated phenotype changed the color to blue/green.


Eligibility criteria:
inclusion criteria: 1. female subject between 18 and 75 years of age. 2. ability to provide informed consent exclusion criteria: 1. subject with known pregnancy at time of screening. 2. previous history of hysterectomy 3. participation in another clinical trial within last 30 days.

Keywords: zetiq celldetect ® stain distinct red/purple color to the cytoplasm of neoplastic distinguishes green/blue stained non-neoplastic cells and tissues
the effectiveness of the modified bundle in the prevention of vap.

Conditions: VAP - Ventilator Associated Pneumonia

Summary: ventilator-associated pneumonia (vap) is an important cause of prolonged intensive care unit and hospital length of stay, healthcare costs and mortality in mechanically ventilated patients. there are an international guidelines for vap diagnosis, treatment and prevention (infectious diseases society of america(idsa)/american thoracic society (ats) 2016 and european respiratory society (ers) / european society of intensive care medicine (esicm) / european society of clinical microbiology and infectiuos diseases (escmid) / asociacion latinoamericana del torax (alat) 2017) routinely used in most icus. the investigator planed on comparing two strategies for prevention of vap in mechanically ventilated patients: the routine vap bundle ( historical group - vap1) and the modified vap bundle ( study group - vap2) by using 3 modifications ( shiley evac endotracheal tube with taperguard cuff, automatic continuous subglottic secretion drainage (ssd) and continuous tube cuff pressure monitoring). the aim of the study is an assessment of the effectiveness of the modified prevention of vap in reduction of: early and late vap cases, mechanical ventilation days (mv), length of stay (los) in the icu, 28 day mortality and multi drug resistent pathogens (mdr) cases in adult icu patients.


Eligibility criteria:
inclusion criteria: vap2 - study group * mechanically ventilated patients with an artificial airways (endotracheal tube, tracheostomy tube) * age over 18 years * modified bundle in the prevention of vap vap1 - historical group * mechanically ventilated patients with an artificial airways (endotracheal tube, tracheostomy tube) * patients hospitalised in the icu for last 12 months before modified bundle in the prevention of vap has been started (from 01.05.2017 to 30.04.2018) * age over 18 years * routine bundle in the prevention of vap exclusion criteria: * lack of an informed consent in awake patients in the icu * age under 18 years * patients with no mechanical ventilation in the icu * patients with probability of mechanical ventilation days and los in the icu less than 48 hours * patients intubated and mechanically ventilated without the bundle in the prevention of vap for a period of time longer than 12 hours before the admission to the icu

Keywords: vap evac endotracheal tube with taperguard cuff mdr - multi drug resistant pathogens ssd - subglottic secretion drainage,
scandinavian intensive care unit (icu) glutamine study

Conditions: ICU Patients

Summary: this is a prospective double-blinded placebo-controlled block randomized study in intensive care patients comparing intravenous glutamine supplementation to placebo. the hypothesis is an improvement of clinical outcome. the primary endpoint is a reduction in the sequential organ failure assessment (sofa) score on day 7 of treatment.

this is a prospective double-blinded placebo-controlled block randomised study in intensive care patients comparing intravenous glutamine supplementation (0.285 g/kg body weight/24 h) to placebo. inclusion criteria are patients treated for more than 3 days. primary endpoint is a reduction in sofa-score on day 7 of treatments. secondary endpoints are: icu-mortality, 6-months mortality, length of icu stay, organ failure free days as well as reduction in sofa-score on day 10 of treatment. nutrition will be standardised so that not less than 80% of the target which is basal energy expenditure according to harris \& benedict is given daily. enteral nutrition is preferred, but a combination of enteral and parenteral nutrition is recommended to achieve the nutritional target. for statistical comparison non-parametric rank order statistics will be used. to detect a 0.75-point difference in the reduction of sofa-score on day 7 of treatment, a total of 1,000 patients will be needed.

Eligibility criteria:
inclusion criteria: * admission to the icu * decision to give the patient full nutrition * apache ii score \> 10 at admission * age 18-85 years exclusion criteria: * readmission to the icu after a previous icu-stay in which the patient has been included into the study * subjects with any condition which in the opinion of the attending physician makes the subject unsuitable for inclusion * no informed consent

Keywords: glutamine icu patients critically ill nutrition
combination chemotherapy in treating patients with aids-related hodgkin's disease

Conditions: Lymphoma

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. combining more than one drug may kill more tumor cells. purpose: phase ii trial to study the effectiveness of combination chemotherapy with lomustine, etoposide, cyclophosphamide, and procarbazine in treating patients with stage iib, stage iii, or stage iv aids-related hodgkin's disease.

objectives: * determine the objective response rate, response duration, and survival of patients receiving lomustine/etoposide/cyclophosphamide/procarbazine (cecp) for stage iib-iv aids-related hodgkin's disease. * assess the feasibility and toxic effects of cecp in this patient population. outline: patients receive oral lomustine on day 1, oral etoposide on days 1-3, and oral cyclophosphamide and procarbazine on days 22-31. filgrastim (granulocyte colony-stimulating factor) is given subcutaneously on days 5-21 and 33-42. the course is repeated every 6 weeks. patients with a complete or partial response after 1 course of treatment receive two additional courses, but lomustine is omitted in the second course. patients with partial response or stable disease receive radiation therapy and/or continued chemotherapy. patients failing to respond after 1 course are removed from the study. patients will be followed every 3 months until death. projected accrual: a minimum of 16 evaluable patients will be accrued.

Eligibility criteria:
disease characteristics: * histologically proven stage iib-iv aids-related hodgkin's disease * patients with hodgkin's disease as the only hiv-related condition must have a positive elisa for hiv confirmed by western blot * measurable or evaluable disease * no cytologic or radiologic evidence of cns involvement patient characteristics: age: * any age performance status: * ecog 0-3 life expectancy: * at least 6 weeks hematopoietic: * wbc at least 1,500/mm3 * platelet count at least 50,000/mm3 hepatic: * bilirubin no greater than 3.0 mg/dl renal: * creatinine no greater than 3.0 mg/dl other: * active infection is allowed (provided prognosis is estimated to be at least 6 weeks) prior concurrent therapy: biologic therapy: * not specified chemotherapy: * no prior chemotherapy for hodgkin's disease * at least 4 weeks since chemotherapy for kaposi's sarcoma endocrine therapy: * not specified radiotherapy: * prior radiotherapy for localized stage i or ii disease that has progressed beyond initial radiation ports is allowed surgery: * not specified other: * concurrent azt therapy is allowed

Keywords: aids-related lymphoma hiv-associated hodgkin lymphoma
dna fragmentation - effect on pregnancy rate

Conditions: Infertility, Male

Summary: the purpose of this study is to determine whether punalpin, an antioxidant, has a positive impact on dna fragmentation in spermatozoa in male fertility patients with increased amount of dna fragmentation in their spermatozoa. secondary purpose is to investigate whether there is any positive effect on the subsequent pregnancy rates from the fertility treatment.


Eligibility criteria:
inclusion criteria: * male fertility patients with increased amount of dna fragmentation in their spermatozoa exclusion criteria: -