Kornimate/medical-research-clean huggingface dataset:
a study to evaluate the efficacy of xlear vs. placebo for acute covid-19 infection

Conditions: Covid19

Summary: this study aims to find out the efficacy of xlear nasal spray as an adjunct medication against covid-19. this encompasses reduction in the number of days to negativization via nasal swab pcr from the average 14 days and early improvement of symptoms.

patients will be informed about the study including potential risk and benefits. once written informed consent are obtained, patients will undergo a brief screening period to determine eligibility for the study. once eligibility is confirmed, eligible patients will be placed in a randomized placebo control manner. patient will be assigned to xlear (2 puffs per nostrils, every 3-4 hours a day) or placebo. patient will be followed for 1 week. inflammatory markers will be obtained on day 4 and repeat covid-19 reverse transcriptase pcr (rt pcr) on day 7. follow up will be done on day 14 for all patients.

Eligibility criteria:
inclusion criteria: 1. adults of ages 18 to 90 years of both sexes 2. with positive sars-cov-2 carriage confirmed by nasopharyngeal pcr 3. signed informed consent 4. mild symptoms: minimum respiratory symptoms or asymptomatic plus positive test 5. moderate symptoms: respiratory symptoms such as cough, mild shortness of breath with mild oxygen desaturation(room air spo2 \ 88% or \ 92% with 2 liters of oxygen) exclusion criteria: 1. patient with very low viral load (threshold cycle \[ct\] \> 25 per pcr). 2. known hypersensitivity to one of the constituents, particularly to xylitol or grapefruit seed extract (gse) 3. under 18 years of age 4. women of childbearing age who are pregnant, breastfeeding mothers, and intend to become pregnant during the study period; unwilling/unable to take a pregnancy test. 5. unable to provide informed consent or decline to consent or unwillingness to adhere to the standard of care protocol. 6. patients with severe symptoms -hypoxia (spo2 \<88% not corrected by 2 liter non-concentrated oxygen) plus severe shortness of breath 7. history of immunodeficiency or are currently receiving immunosuppressive therapy 8. have had a planned surgical procedure within the past 12 weeks. 9. already part of this trial, recruited at a different hospital. 10. patient unable to perform oro-nasopharyngeal decolonization 11. patients with acute exacerbation of severe comorbidities like heart disorders chronic obstructive pulmonary disease (copd), heart failure new york heart association (nyha) class 3 and 4 and/or diseases with severe oxygenation problems 12. patients on remdesivir and/or other clinical trials.
a single-arm trial of the flow diverter (tonbridge) for endovascular treatment of intracranial aneurysms

Conditions: Intracranial Aneurysm

Summary: the purpose of this study is to assess the effectiveness and safety of the flow diverter (tonbridge) by collecting data from subjects who receive endovascular treatment of intracranial aneurysms.

this is a prospective, multi-center, single-arm clinical trial carried out in 7 research centers over china. in this study, enrolled patients are treated with the flow diverter (tonbridge) for intracranial aneurysms. the objective of this study is to evaluate the effectiveness and safety of the flow diverter (tonbridge) for treatment of intracranial aneurysms.

Eligibility criteria:
inclusion criteria: * age 18 to 80 years, any gender; * a single unruptured intracranial aneurysm locates in the intracranial segment of internal carotid artery (ica) or vertebral artery (va), which diagnosed by dsa; * the maximal diameter of the target aneurysm \< 10 mm diagnosed by dsa; * the target aneurysm with a neck ≥ 4 mm or a dome to neck ratio \< 2 diagnosed by dsa; * the target aneurysm with a parent vessel diameter of 2.0-6.5 mm; * subject or guardian is able to understand the purpose of study, shows sufficient compliance with the study protocol and provides a signed informed consent form. exclusion criteria: * diagnosed as with cerebrovascular malformations; * intracranial hemorrhage within 30 days pre-procedure; * modified rankin scale (mrs) score ≥ 3 in pre-procedure; * platelet (plt) \ 1.5; * heart, lung, liver and renal failure or other severe diseases (such as intracranial tumor, systemic infection, disseminated intravascular coagulation, myocardial infarction within 12 months before enrollment, history of severe psychosis, severe stenosis or occlusion of cerebral feeding artery); * subject who is not appropriate for flow diverter delivery and deployment judged by investigators (severe stenosis of parent artery, severe tortuosity of parent artery, stent failing to reach the lesion, stent in the target lesion of parent artery, etc.); * major surgery within 30 days before enrollment, or intending to receive surgery within 180 days after enrollment; * allergic history of anesthetics and contrast agents, or contraindication for dual antiplatelet or/and anticoagulant therapy; * allergic history of metals such as nickel-titanium alloy; * life expectancy \< 12 months; * pregnant or breastfeeding women; * subject has participated in other drug or medical device clinical trials within 1 month before signing informed consent; * other conditions judged by the investigators as unsuitable for enrollment.
effects of pap on afib recurrence risk after catheter ablation in osa patients

Conditions: Obstructive Sleep Apnea; Atrial Fibrillation

Summary: with this pilot study, we are hoping to test the feasibility of a larger study in the future and to learn whether positive airway pressure therapy reduces the recurrence risk of atrial fibrillation after successful catheter ablation procedure among patients with atrial fibrillation and obstructive sleep apnea. the results from this study will help us refine the design for a future larger study, and will ultimately improve care of patients with obstructive sleep apnea and atrial fibrillation.

obstructive sleep apnea, a sleep-related breathing disorder in which breathing stops for short periods during sleep, is a common condition in patients with atrial fibrillation. studies have shown that up to 75% of atrial fibrillation patients undergoing catheter ablation procedure have obstructive sleep apnea. obstructive sleep apnea increases the risk of atrial fibrillation recurrence after successful catheter ablation by 40%. however, whether treatment of obstructive sleep apnea with positive airway pressure (pap, the current most effective treatment for obstructive sleep apnea that uses a machine to help breathe more easily) reduces the risk of atrial fibrillation recurrence is not fully understood. the purpose of this study, therefore, is to examine whether positive airway pressure therapy reduces atrial fibrillation recurrence after catheter ablation in patients with obstructive sleep apnea and atrial fibrillation.

Eligibility criteria:
inclusion criteria: 1. men and women 18 years or older 2. first-time catheter ablation for atrial fibrillation 3. moderate-to-severe obstructive sleep apnea diagnosed with a sleep study (apnea-hypopnea index ≥ 15) exclusion criteria: 1. current or prior use of positive airway pressure for obstructive sleep apnea 2. any household member with current/past positive airway pressure use 3. did not meet minimal adherence to positive airway pressure treatment (≥ 4 hours/night and ≥ 70% of time in 2 weeks) 4. history of motor vehicle or occupational accident related to excessive sleepiness 5. severe nocturnal desaturation documented on sleep study as \>10% of total sleep time with oxygen saturation of \< 75% 6. any condition determined by physicians that constrains the use of positive airway pressure such as anatomically fixed nasal obstruction, neurological impairment, and significant claustrophobia. 7. congestive heart failure (new york heart association iv) 8. severe valvular disease 9. planned coronary revascularization procedure in the next 6 months 10. severe pulmonary disease 11. participation in another treatment intervention trial that might influence results of this trial 12. ablation procedure scheduled in the next 8 weeks
a comparison of vie-scope and macintosh blade laryngoscopes in morbidly obese.

Conditions: Obesity, Morbid; Intubation Complication

Summary: macintosh laryngoscope is still considered a standard for tracheal intubation, however, visualization of the glottis may be inadequate mainly in morbidly obese patients. the vie scope is a novel type of laryngoscope consisting of a straight, shielded, illuminated tube that offers intubation via a bougie using the paraglossal technique. in this prospective, non-randomized study, we tested the research hypothesis that the use of vie scope may improve visualization of the larynx in comparison with the macintosh blade.

prior to tracheal intubation, all patients were placed in the head-elevated laryngoscopy position (help). all study subjects were anesthetized with the concordance to european society for peri-operative care of obese patient (www.espcop.eu) protocols: proper positioning, pre-oxygenation with cpap, induction of anesthesia with propofol 2.0 mg kg-1 of corrected body weight; for muscle relaxation rocuronium 0.6 mg kg-1 of ideal body weight (ibw); ketamine 50 mg ; lidocaine 100 mg, and fentanyl 0.1 mg. after achieving 100% neuromuscular block confirmed by tof-watch monitoring, laryngoscopy was performed by the anesthesiologist familiar with the use of both vie scope and macintosh blade laryngoscope, and also experienced in bariatric anesthesia. all anesthesiologists participating in the study underwent training with vie scope on the manikin model. the evaluation of glottis visualization in direct laryngoscopy using cormack-lehane scale (cl) in all patients was performed in sequence using two laryngoscopes: first macintosh blade laryngoscope (mcl) and then vie scope laryngoscope (vs). tracheal intubation was performed with the vs. the study subjects all received oxygen using nasal cpap in order to maintain sufficient oxygenation

Eligibility criteria:
inclusion criteria: * morbid obesity bmi\>40 kg/m2 * scheduled for elective bariatric procedure * no anatomy abnormalities of upper airway exclusion criteria: * lack of conscent * predicted difficult intubation

Keywords: morbid obesity endotracheal intubation
effects of apixaban on brain protection in patients with sinus rhythm and heart failure: apixbrain-hf trial

Conditions: Heart Failure; Sinus Rhythm; Cerebrovascular Disease

Summary: objectives: the primary aim of apixbrain-hf trial is to explore the effects of apixaban on brain protection in patients with sinus rhythm and heart failure primary / secondary endpoint 1. new occurrence of brain pathology 1) cortical cerebral microinfarcts 2) silent lacunar infarction 3)progression of white matter hyperintensities 2. secondary endpoint 1) the change of cognitive function evaluated by mmse-2 2) individual variable of primary endpoint 3. safety endpoint evaluation 1) cerebral microbleeds on imaging

this study is a double-blind, parallel-group, and randomization study. the investigators will enroll the patients with heart failure who demonstrated lv systolic dysfunction (lvef ≤ 40%) and sinus rhythm with a cha2ds2-vasc score ≥ 3. all patients would be randomly assigned to either the apixaban group or placebo group. patients assigned to the apixaban group will receive 5mg bid or 2.5mg bid (patients with at least 2 of the following characteristics: aged≥80-year, bodyweight ≤60kg, serum creatinine 1.5 ml/dl) and patients in the placebo group will receive a placebo of apixaban. both drugs will be maintained for 6 months. during the study period, all patients will be carefully monitored for thromboembolic events, including stroke. at the beginning of the study and 6 months after randomization, 3t brain mri and mmse-2 test will be performed to identify changes in brain structure and cognitive function.

Eligibility criteria:
inclusion criteria: * patients aged over 19 years old * patients with sinus rhythm * newly diagnosed of heart failure or aggravated heart failure symptom 1. dyspnea (≥ nyha ii) 2. plasma bnp ≥ 200 pg/ml or nt-probnp ≥ 800 pg/ml * lv systolic dysfunction on echocardiography within 3 month of enrollment 1) lvef ≤ 40% * those with cha2ds2-vasc ≥ 3 * modified rankin score ≤ 4 exclusion criteria: * patients already subscribed warfarin or antiplatelet therapy or have clear indication for warfarin or antiplatelet therapy * at high risk for bleeding * patients with atrial fibrillation * estimated glomerular filtration rate (ckd-epi formula) \< 15 ml/min/1.73 m2) * recent stroke or brain hemorrhage (within 3 months) * patients who was diagnosed of myocardial infarction or who has plan to pci/cabg at enrollment * end stage heart failure with life expectancy ≤ 6 months * patients with bed ridden status (modified rankin score ≥ 5) * patients with liver dysfunction (ast, alt \> 2 times of upper normal limits or total bilirubin \> 1.5 of upper normal limits) * at of pregnancy or breastfeeding * patients who disagree with the use of medically acceptable contraception during the clinical trial period * patients with contraindication of apixaban

Keywords: heart failure sinus rhythm noac brain
effect of sirolimus on molecular alterations in cerebral aneurysms

Conditions: Cerebral Aneurysm

Summary: the objective of this study is to explore the effects of sirolimus on the underlying molecular alterations of cerebral aneurysms.


Eligibility criteria:
inclusion criteria: 1. undergoing one of the following procedures at jackson memorial hospital: * clipping of an unruptured cerebral artery aneurysm * endovascular treatment of unruptured cerebral aneurysms (including those receiving coiling) 2. ≥ 18 years of age 3. willing and able to give informed consent exclusion criteria: 1) subjects meeting any of the following criteria will be excluded: * dissecting, traumatic, or mycotic brain aneurysm. * women who are pregnant, or have a positive urine or blood (β-hcg) pregnancy test. * women who are breastfeeding. * any clinically significant psychiatric or psychological disease, which would preclude the patient from completing the protocol. * patients with known human immunodeficiency virus (hiv) infection or other known immunodeficiency. * patient with renal or liver failure * interstitial pneumonitis * history of lymphoma * history of skin cancer * hypersensitivity to sirolimus * severe or unstable concomitant condition disease or chronic condition, which in the opinion of the investigator could affect assessment of the safety or efficacy of study intervention.
transversus abdominis plane block versus paravertebral block for post operative pain relief in open renal surgeries

Conditions: Postoperative Pain

Summary: pain relief after renal surgeries is essential as it may lead to reduction in the incidence of many post operative complications . there are a lot of regional anesthetic techniques to provide analgesia postoperatively as paravertebral block (pvb) and transversus abdominis plane (tap) block. tap block has been used to provide postoperative analgesia in a lot of abdominal surgeries including upper abdominal surgeries.it is safer technique than pvb, but the effectiveness of tap block is unknown in comparison with pvb in post operative analgesia after renal surgeries .

pain relief after renal surgeries is essential as it may lead to reduction in the incidence of post operative respiratory complications . a lot of patients presented to these operations may have comorbidities as impaired renal function and respiratory problems , conditions like these may contraindicate aministration of systemic analgesia as opioids . there are a lot of techniques to provide analgesia postoperatively as paravertebral block (pvb) and transversus abdominis plane (tap) block . paravertebral block is effective technique for post operative analgesia for upper abdominal surgeries , but it may be associated with some complications as : pneumothorax , spread of local anesthetic to the epidural space and paravertebral blood vessels , and this may lead to systemic toxicity of local anesthetic . tap block has been used to provide postoperative analgesia in a lot of abdominal surgeries including upper abdominal surgeries , but it is safer technique than pvb , but the effectiveness of tap block is unknown in comparison with pvb in post operative analgesia after renal surgeries .

Eligibility criteria:
inclusion criteria: * aged 18 - 60 years * asa i-ii class exclusion criteria: * patient refusal * any contraindication of regional anesthesia block (coagulopathy,infection at the needle insertion site) * patients with allergy to amide local anesthetics or medication included in the study.
narrow band versus conventional endoscopic imaging for screening colonoscopy

Conditions: Adenoma

Summary: narrow band imaging (nbi) with high-definition (hdtv) visualization has been implemented into gi endoscopy with the purpose to better highlight endoluminal pathological structures by improving their contrast. previous studies from referral centers could not show significant differences in terms of colonoscopic adenoma detection rate, but either very high adenoma rates or some numerical differences suggested that some benefit may exist which may become evident with average adenoma rates and/or large case numbers. in a prospective randomized trial performed exclusively in a multicenter private practice setting involving 6 examiners with substantial life-time experience (\>10.000 colonoscopies) 1200 patients will undergo hdtv screening colonoscopy with either nbi or conventional imaging technique on instrument withdrawal. primary outcome measure is the adenoma detection rate (adr; i.e. number of adenomas per patient).

in 5 private practices with 6 examiners, consecutive asymptomatic persons willing to undergo screening colonoscopy will be asked to participate in this randomized study. after introduction of the colonoscope into the cecum, patients will be randomized into withdrawal with either the nbi mode or conventional imaging by using wide-angle colonoscopes with hdtv imaging (olympus corp., hamburg, germany) in both groups. randomization lists will be used for group allocation in each individual practice. in the nbi group, switching back to conventional imaging, and the number of occasions for switching back and the reasons for it are documented in this group. patients bowel preparation consists mostly of polyethylene glycol lavage with 4-5 liters until clear rectal fluid is evacuated. all examiners shall take special care to wash and clean the entire large bowel during instrument introduction and withdrawal, in order to provide optimal imaging conditions. the following parameters are documented: * age and sex of the patient * type and dosage of sedation * examination time, both for instrument introduction and withdrawal * polyp characteristics: size (measured by open forceps or snare), shape (pedunculated/elevated, sessile/flat, and location * polyp histology after removal using snare polypectomy or forceps removal (for polyps \< 3 mm), or biopsy if there are contraindications * other lesions found such as cancers, diverticula, inflammatory lesions etc. the main outcome parameter is the adenoma detection rate (number of polyps/number of patients examined) in the two groups. secondary outcome measures include analysis of the total number of polyps, flat/sessile adenomas, small adenomas (\< 1 cm), hyperplastic polyps with size determination and right-sided versus left-sided polyp location in both groups.

Eligibility criteria:
inclusion criteria: * asymptomatic persons \> 55 years willing to undergo screening colonoscopy exclusion criteria: * missing consent * symptomatic persons * poor general conditions, significant comorbidity

Keywords: colonoscopy narrow band imaging adenoma diagnosis colonoscopic adenoma detection
efficacy of different doses of tai chi chuan on cognitive function in persons with mild cognitive impairment

Conditions: Mild Cognitive Impairment

Summary: to determine the relationship between the effects of different frequencies and duration of tai chi chuan in dose parameters to improve cognitive function in elderly persons with mild cognitive impairment.

mild cognitive impairment (mci) is regarded as a prodrome to dementia and affects 16% to 20% of people aged older than 65 years. tai chi chuan is an increasingly popular multi-modal physical and mental exercise. studies have shown that tai chi chuan can effectively improve the cognitive function of elderly persons with mci. however, the relationship between the effects of different frequencies and duration of tai chi chuan to improve the cognitive function of elderly persons with mci is not yet clear. the purpose of this study is to determine the optimal frequency and duration of tai chi chuan. the investigators will conduct a single-blind, randomized controlled trial in 350 persons who meet the presence of mci without dementia. persons will be randomly assigned to either the tai chi chuan intervention group once or twice a week for 12 or 24 weeks, or the health education control group once every four weeks for 24 weeks. all groups will be followed for 52 weeks.

Eligibility criteria:
inclusion criteria: 1. presence of mild cognitive impairment, not demented; 2. age ≥ 60 years old; 3. informed consent and voluntary participation. exclusion criteria: 1. geriatric depression scale score ≥ 9 points; 2. cognitive impairment caused by other reasons, taking drugs, poisoning, etc; 3. suffer from severe musculoskeletal system diseases and other contraindications to exercise and are not suitable for tai chi chuan training, such as those who suffer from stroke, parkinson's disease, and have a history of lower limb arthritis, hip and knee joint replacement, etc; 4. patients with severe heart, liver, kidney failure, malignant tumors, and other major diseases; 5. individuals with visual/auditory impairments, writing/reading impairments, illiteracy, etc. that affect training and evaluation; 6. individuals with uncontrolled hypertension (systolic blood pressure greater than 160mmhg or diastolic blood pressure greater than 100mmhg after medication); 7. participating in other experiments that influence this study; 8. engaged in regular exercise in the last three months (at least 3 times a week, at least 20 minutes of regular exercise each time).

Keywords: tai chi chuan cognitive function
screening brief intervention referral to treatment (sbirt) in new mexico

Conditions: Drug Abuse; HIV Risk Behavior

Summary: the purpose of this study is to compare the effectiveness in reducing drug use and its associated problems of a brief intervention for drug use delivered by a behavioral health counselor as compared to a brief intervention delivered by a computerized intervention.

drug use is a significant cause of morbidity and mortality in the united states. efforts to develop and rigorously evaluate methods to provide screening, brief intervention and referral to treatment (sbirt) for drug users are needed. computerized screening and brief interventions in particular have the potential to circumvent some of the potential problems of integrating sbirt delivered by a counselor into busy primary care settings. these interventions may reduce drug use among individuals who are using drugs but are not yet drug dependent.

Eligibility criteria:
inclusion criteria: * 18 years or older * moderate risk category on the assist scores exclusion criteria: * planning to move out of new mexico in the next year * receipt of formal drug abuse treatment or a brief intervention for drug use in the past month.

Keywords: sbirt drug abuse