Kornimate/medical-research-clean huggingface dataset:
assessment of primary oxygenation and airflow measurement for endoscopic laryngeal surgery

Conditions: Laryngotracheal Stenosis

Summary: this research is being done to determine the resistance across stenosis in the airway.

there is significant utility in objectively measuring airflow as subjects, undergoing endoscopic laryngeal surgery, commonly have difficulties with airflow secondary to their stenosis. easier and quicker quantification will tailor diagnosis and treatment. in order to obtain an objective measure of airflow in these participants, we will place a 20-gauge angiocatheter needle into the airway. the catheter will be in situ for a short duration during several spontaneous and non-spontaneous breaths. this will be achieved via the existing tracheostomy stoma or percutaneously via the cricothyroid membrane. this technique is commonly used to access the muscles of the larynx, however, the primary purpose will be to measure airflow in this setting.

Eligibility criteria:
inclusion criteria: * patients 18 years or older that require outpatient endoscopic laryngeal airway surgery, in the operating room, at a tertiary academic center. exclusion criteria: * pregnancy (status will be determined by a urine test as part of standard clinical care in the preoperative setting) * patients that are not cleared for surgery by the preoperative evaluation * patients with severe laryngotracheal stenosis * patients who are morbidly obese (bmi \> 40) * patients with lung disease (asthma, copd)
pharmacogenomics of new antiretrovirals

Conditions: HIV

Summary: some genetic polymorphisms are known to interfere with arv metabolism and are therefore likely to explain some of the inter-individual variations (efficacy,toxicity,resistance) observed during art. the most common form of human dna variations consists of a change of a base in the nucleotide sequence of an individual at a given position, the single nucleotide polymorphism (snp). therefore,the purpose of this research will be the identification and characterization of the clinical impact of several snps in gene coding for transport proteins (e.g.abcb1,abcc1) and biotransformation enzymes (e.g.cyp3a4,cyp2b6) known to be involved in the pharmacokinetic pathway of selected arv drugs for which the therapeutic response is difficult to predict. aside,the influence of these snps on the response to treatment (cd4+cell,viral load) and on the toxicity will be evaluated. plasma concentrations of arv drugs correlate with therapeutic efficacy but also with the risk of toxicity and of virological failure, which is the basis of the therapeutic drug monitoring. however,given the intracellular location of hiv, analyzing intracellular drug concentrations is fundamental and the investigators will also focus of this new topic.

some genetic polymorphisms are known to interfere with arv metabolism and are therefore likely to explain some of the inter-individual variations (efficacy,toxicity,resistance) observed during art. the most common form of human dna variations consists of a change of a base in the nucleotide sequence of an individual at a given position, the single nucleotide polymorphism (snp). therefore,the purpose of this research will be the identification and characterization of the clinical impact of several snps in gene coding for transport proteins (e.g.abcb1,abcc1) and biotransformation enzymes (e.g.cyp3a4,cyp2b6) known to be involved in the pharmacokinetic pathway of selected arv drugs for which the therapeutic response is difficult to predict. considering that cyp3a5 may represent up to 50% of the total hepatic cyp3a content in cyp3a5\*1 allele carriers, the cyp3a5 genetic polymorphism may be therefore the most important genetic contributor not only to interindividual but also to interracial differences in cyp3a-dependent drug clearance. aside,the influence of these snps on the response to treatment (cd4+cell,viral load) and on the toxicity will be evaluated. plasma concentrations of arv drugs correlate with therapeutic efficacy but also with the risk of toxicity and of virological failure, which is the basis of the therapeutic drug monitoring. however,given the intracellular location of hiv, analyzing intracellular drug concentrations is fundamental and the investigators will also focus of this new topic.

Eligibility criteria:
inclusion criteria: * hiv-1 positive treated with drug of interest exclusion criteria: * \<18 years old
comparing cognitive therapy and exposure therapy in individuals with hypochondriasis

Conditions: Hypochondriasis; Somatoform Disorders

Summary: this study will compare the efficacy of cognitive therapy and exposure therapy for treating hypochondriasis.

hypochondriasis is defined as a preoccupation with the fear of having a serious disease based on the person's misinterpretation of bodily symptoms (apa). for a long time hypochondriasis was seen as difficult to treat. meanwhile effective psychological treatment for hypochondriasis exists. psychotherapies using cognitive therapy (ct), cognitive behavioral therapy (cbt), exposure therapy (et) or behavioral stress management approaches are effective in reducing symptoms of hypochondriasis. however, few studies compare different types of psychotherapy. in addition, in these studies numbers of participants were small, no differences between different treatments were found, and one third of the participants showed no satisfactory change. this study will compare the efficacy of ct and et in a larger sample of 84 participants. participants in this randomized controlled trial (rct) will first undergo baseline assessment. then they will be randomly assigned to either ct, et or a waiting list (wl), all conditions are for the duration of 12 weeks. ct includes psychoeducation, attention training, cognitive restructuring, behavioral experiments, imagery rescripting and relapse prevention. et includes change of safety behavior, exposition (in sensu and in vivo), and relapse prevention. both treatment trials contain the identical number of sessions. treatment response will be assessed at week 12 and additionally one and three years after treatment. participants of the wl will be assigned to ct or et after the waiting period.

Eligibility criteria:
inclusion criteria: * meets dsm-iv criteria for hypochondriasis * german fluency and literacy * informed consent exclusion criteria: * major medical illness expected to worsen significantly * currently in psychotherapy * suicidal tendency * clinical diagnosis of alcohol or drug addiction, schizophrenia, schizoaffective disorder or bipolar disorder according to dsm-iv

Keywords: hypochondriasis health anxiety randomized controlled trial cognitive therapy exposure therapy
the role of skin microbiota in hepatic or renal pruritus

Conditions: Renal Failure; Hepatic Failure; Pruritus

Summary: * various neurotransmitters may share in the pathogenesis of hepatic and renal itching. * skin microbiota may share in the pathogenesis of pruritus.

uremic pruritus (up) is a frequent phenomenon and it is regarded as one of the most bothersome symptoms in patients with chronic renal disease. the prevalence of up is still high and reported in around 40% to 50%. up has an important impact on patients' quality of life and sleep, depression, and increased mortality. the pathogenesis of up remains blurry, although many different factors have been indicated in the etiology of this symptom, including increased systemic inflammation, abnormal serum parathyroid hormone, calcium, and phosphorus levels, an imbalance in opiate receptors, a neuropathic process, or even skin dryness. this is why until now there is no specific treatment for patients with up and many of the available therapeutic modalities are not satisfactory pruritus in liver diseases can often be a debilitating symptom causing significant impairment in quality of life. not all patients with liver disease develop pruritus and its prevalence varies depending on the underlying cause of liver disease. it is more common in conditions characterized by bile duct inflammatory destruction than in those characterized by hepatocellular injury. cutaneous microbiota delivers a diverse and far-reaching influence on our physiology by calling upon the host nervous system. bacteria make metabolites, toxins, and structural components that are recognized by peripheral and central neurons via matching receptors. microbiota also indirectly affects neural function by causing endocrine (i.e., keratinocytes) and immune cells to transmit signals (i.e., cytokines, proteases). itch is a prototypic sensory neural function, and the microbiota propels the itch-scratch cycle.

Eligibility criteria:
inclusion criteria: * patients of both sexes. patients with hepatic illness (autoimmune liver diseases, chronic viral hepatitis, and drug-induced liver injury) or patients with renal failure willing to sign an informed consent.
family lifestyle overweight prevention program-physical activity only

Conditions: Obesity

Summary: this randomized control trial evaluates the physical activity component of the family lifestyle overweight prevention program compared to physical education class as usual among hispanic middle school students.

family lifestyle overweight prevention program (flow) is an intensive, multi-component obesity intervention designed to take place during physical education class. this intervention has established efficacy at improving standardized bmi among low income, hispanic middle school students with overweight classification or obesity. however, the efficacy of individual components of the intervention have not been investigated. the purpose of this study was to compare only the physical activity component of flow to a physical education class as usual. the primary outcome of the study is time spent in moderate-vigorous physical activity. secondarily the study evaluated the impact of the intervention on standardized bmi.

Eligibility criteria:
inclusion criteria: * age 10-17 years old * enrolled in a middle school pe class at yes prep brays oaks exclusion criteria: * pregnant * cognitive impairment significantly below average age or grade level
the effect of lumbar stabilization exercise and gait training on lower back muscles- electromyographic(emg) analysis

Conditions: Low Back Pain

Summary: the purpose of this study is to determine the effective exercise protocol in chronic low back pain patients.

* design: prospective study * setting: hospital rehabilitation department * intervention: participants are randomly assigned 4 different exercise group: flexibility exercise, bracing exercise + stabilization exercise group, bracing exercise+ walking exercise group and bracing+ walking + stabilization exercise group * main outcome measures: numeric rating scale(nrs), oswestry disability index peak torque of lumbar extensor by surface electromyography time duration of capability of maintenance the posture

Eligibility criteria:
* inclusion criteria: * age\>20 * who suffered low back pain more than 3 months. * exclusion criteria: * pregnancy * under 20-year-old * who have significant neurologic deficit * who experienced spine operation * who cannot walking

Keywords: low back pain exercise electromyography
aki management using electronic alerts

Conditions: Acute Kidney Injury

Summary: acute kidney injury (aki) is a common clinical event with severe consequences. in the united states alone, greater than one million hospitalized patients per year are diagnosed with aki. it has been independently associated with prolonged hospital stays, 25-80% risk of in-hospital death, and future progression to chronic kidney disease. while there has been an increase in awareness about the prevalence and significance of aki, studies have uncovered systematic failure in the management of aki, largely relating to the failure of clinicians to recognize and manage the condition appropriately. this is where we can use electronic health records (ehrs) and electronic alerts (e-alerts) to our advantage. in this study, the investigators plan to use e-alerts integrated into a clinical decision support (cds) system to improve the care of and outcomes of patients with aki. the aims are to study the prevalence of aki and its progression among hospitalized patients using an 'aki sniffer' (an ehr based automated system) and to prospectively study if introducing a complex intervention (an e-alert combined with a clinical decision support system) will reduce progression of aki in children. the investigators have developed an aki care bundle which provides simple guidelines for management of aki along with specific discharge instructions to improve follow up care. the primary outcome is aki progression. secondary outcomes include morbidity, mortality, length of hospital stay, need for renal replacement therapy, and recovery of renal function by time of hospital discharge. the investigators will also look at documentation of aki and if these participants get appropriate follow up.


Eligibility criteria:
inclusion criteria: all patients between 6 months-18 years admitted to the surgical and medical floors of seattle children's hospital exclusion criteria: 1. history of chronic kidney disease stage 4 or worse (i.e., patients on chronic renal replacement therapy or glomerular filtration rate \< 30 ml/min/1.73 m2) 2. history of renal transplantation within the last 3 months 3. history of nephrectomy within last 3 months 4. patients admitted to observation units
lung ultrasound in covid-19 patients

Conditions: Covid19; Ultrasound; ARDS

Summary: to assess the prognostic performance of an early global lus score with respect to the mortality in icu and duration of ventilation.

this is an international multicenter cohort study on data collected between march and april 2020. the first available lung ultrasound examination that used a 12-regions approach was used to calculate the global lus score. patients are included if they fulfilled the following criteria: 1) admitted to one of the participating icu; 2) for invasive ventilation; 3) for respiratory failure due to confirmed covid-19; and 4) having had a lus examination performed within the first week of start of invasive ventilation. the primary and secondary outcomes were liberation from invasive ventilation and mortality. demographic, clinical and outcome variables will be presented as percentages for categorical variables and as medians with interquartile ranges (iqr) for continuous variables. receiver operating characteristics (roc) analysis will be used to derive the prognostic discriminatory performance of global lus score in determining succesful extubation and mortality at day 28. the youden index will be used to derive the optimal cut-off. the association of global lus with unfavourable outcomes are analyzed with cox proportional hazard analysis (for successful extubation and alive at day 28), logistic regression models (mortality at day 28). hazard ratio or odds ratio with 95% confidence intervals were calculated for each outcome.

Eligibility criteria:
inclusion criteria: * admitted to an icu participating in this study between february 1, 2020 and april 30, 2020 * confirmed with reverse transcriptase polymerase chain reaction (rt-pcr) covid-19 infection * having had received invasive ventilation * having had examined at least once with lung ultrasound under invasive ventilation exclusion criteria: * age \<18 years * first examination with lus in patients already under extracorporeal membrane oxygenation (ecmo) support.

Keywords: new coronavirus disease coronavirus disease 2019 lung imaging lung ultrasound lung ultrasound score prognostication duration of ventilation mortality
behavioral interventions for chronic pain and opioid-related problems

Conditions: Chronic Pain

Summary: the purpose of this study is to examine the effects of mindfulness-oriented recovery enhancement versus a social support group (supportive counseling) intervention for chronic pain patients receiving long-term opioid pharmacotherapy for pain.


Eligibility criteria:
inclusion criteria: * age 18-60+ * current chronic pain condition * current use of prescription opioid agonist or mixed agonist-antagonist analgesics for \>90 days exclusion criteria: * prior experience with mindfulness-based stress reduction, mindfulness-based cognitive therapy, or mindfulness-based relapse prevention * active suicidality, schizophrenia, psychotic disorder, and/or severe substance dependence (other than opioid dependence) * opioid misuse as determined by current opioid misuse measure
antimullerian hormone versus antral follicle count for determination of gonadotrophin dosing in ivf

Conditions: Infertility

Summary: this is a prospective randomized trial to compare the use of afc and serum amh as the basis for gonadotrophin dosing in in-vitro fertilization treatment. the hypothesis is that the use of serum amh as the criterion for determination of gonadotrophin dosing in ivf treatment results in more optimal ovarian response than afc.

patients undergoing the first-time ivf treatment cycle using either conventional insemination technique or intracytoplasmic sperm injection at queen mary hospital will be invited to participate in this study. participating subjects will be randomized into either (i) afc or (ii) amh group, where the gonadotrophin dosing will be determined based on the baseline afc and serum amh respectively as assessed one month before the ivf treatment. randomisation will be performed according to a computer-generated list which will be read by an independent research nurse. that research nurse will assign the initial gonadotrophin dose according to the study protocol. in the afc group, starting dose of gonadotrophin will be determined based on serum amh concentration as follows: afc \ 5 and \ 15: 150 iu daily in the amh group, starting dose of gonadotrophin will be determined based on serum amh concentration as follows: amh \ 1.0 and \ 3.3 ng/ml: 150 iu daily the clinician and patient will both be blinded to the randomization throughout the course of treatment. the proportion of subjects having appropriate ovarian response, defined as the number of oocytes retrieved being 6 to 14 inclusive, will be compared between the two arms.

Eligibility criteria:
inclusion criteria: * subjects undergoing the first ivf cycle during the study period. exclusion criteria: * body mass index \>=30 kg/m2 * subjects in repeated ivf cycles * subjects undergoing ivf treatment using donor oocytes * subjects undergoing pre-implantation genetic diagnosis

Keywords: ovarian response anti-mullerian hormone antral follicle count
vagal nerve stimulation in coma patients

Conditions: Chronic Consciousness Disorders; Vegetative State; Minimally Conscious State; Akinetic Mutism

Summary: minimally conscious (mcs) or vegetative state (vs) are disorders of consciousness which often occur following traumatic brain injury or ischemia. these alterations result most of the time in patients' loss of autonomy and require long years of special care. no efficient therapy to improve patients' consciousness has been found so far. investigators propose to use vagal nerve stimulation (vns) to restore cortical activity and patients' embodied self. the investigators' main hypothesis is that vns will reestablish the thalamo-cortical connectivity leading to an improvement of the consciousness state. to test this hypothesis, investigators will use behavioral measures as well as fmri, pet scan and eeg to assess brain activity. patients will be evaluated before and during eight months following implantation of the stimulation device.


Eligibility criteria:
inclusion criteria: * aged between 18 and 60 years old * patients with history of cranial trauma, cerebrovascular accident, or other event leading to cerebral anoxia, suffering of chronic alteration of consciousness (vegetative state, minimally conscious state, akinetic mutism). the diagnostic will be based on clinical scales * patients already having a neurophysiologic checkup (eeg) * patients breathing without invasive help, and who are in a stable medical state * patients with a history of disease of at least 6 months * patients without clinical evolution for several months * patients with social security * patients for whom a family member have signed a written consent exclusion criteria: * patients with tracheotomy * pregnant women * intubated patients * patients with damaged vagus nerves * patients with pre existing neurological conditions other than the one responsible for the consciousness disorder * patients with medical complications * patients suffering of septic infection * patients with a significant dysphagia * patients with dyspnea or shortness of breath * patients with obstructive sleep apnea * patients with any conditions non authorized by the stimulating device manufacturer (cyberonics)

Keywords: vagus nerve stimulation vegetative state minimally conscious state akinetic mutism consciousness connectivity
combining observational and physiologic sedation assessment tools

Conditions: Brain Injury

Summary: when a physiologic tool to measure the patient's hypnotic state is added to current practice tools is there a decrease in the amount of drug the patient receives.

the purposes of this study were to examine the effect of combining a physiologic measure of consciousness (bis) with observational assessment of sedation (ramsay) on infused sedation drug volumes, undersedation events, and the recovery time to arouse from sedation, in a group of neurocritically ill patients. during a 12-hour data collection period, patients received sedation assessment and management with either the current standard of care (sedation assessment with the ramsay scale), or the standard of care plus the addition of physiologic data from bis monitoring. planned research questions explored how bis monitoring impacts short-term sedation-related outcomes. research questions * is there less sedation drug use for patients when nurses monitor sedation with bis augmentation of ramsay than when nurses monitor patients with ramsay alone? * is sedation assessment augmented by bis use associated with a decreased time to wake-up (recovery time) when nurses are instructed to interrupt sedation and obtain a neurologic examination, compared to use of ramsay alone? * are there differences in the number of events associated with undersedation (e.g., self-extubation) for patients assigned to bis augmentation compared to patients assigned to ramsay alone?

Eligibility criteria:
inclusion criteria: * adult * admitted with a neurological or neurosurgical diagnosis * intubated and on mechanical ventilatory support * receiving continuous sedation with propofol * glasgow coma score \<12 exclusion criteria: * bifrontal brain injury * status epilepticus * barbiturate coma therapy * continuous benzodiazepine administration

Keywords: nursing critical care sedation assessment bispectral index