Kornimate/medical-research-clean huggingface dataset:
high risk outpatient intern-led care (heroic) clinic initiative

Conditions: Comorbidities and Coexisting Conditions; Risk Reduction; Emergencies

Summary: background: a small subset of the patient population is responsible for a significant proportion of healthcare expenditures. these patients are cared for in academic medical centers by internal medicine residents however there has been no research to date about the education or the management of patients with complex multimorbidity in the outpatient setting. objective: to evaluate the impact of the high risk outpatient intern-led care (heroic) clinic on internal medicine interns' perceived ability to manage complex outpatients as well as pre and post intervention total patient healthcare cost. methods: the investigators created the heroic outpatient clinic environment to comprise longer visit time slots, "bedside" presentations, and team-based care (one intern primary care provider, one secondary intern, and one longitudinal attending). all non-preliminary interns based at one primary care site participated in the intervention while interns at a second site continued to practice in the usual outpatient clinic environment. the interns in the heroic clinic arm assumed the roles of primary care providers for 34 complex patients in total. the primary outcome was the perceived confidence in the management of complex outpatients as assessed by a survey. secondary outcomes included perceptions about the ability to provide high-quality outpatient and evidence-based outpatient care, as well as statewide pre-post patient healthcare cost data.


Eligibility criteria:
inclusion criteria: * ≥ 6 medical comorbidities * ≥ 2 admissions past 6 months or ≥ 4 past 1 year * new or returning patient in resident primary care clinic exclusion criteria: * primary mental health disease driving hospitalizations

Keywords: high utilizer high needs multimorbidity intensive outpatient care resident education
assessment of early detection based on liquid biopsy in intracranial tumors

Conditions: Intracranial Tumors

Summary: ascend-brain is a prospective, observational study aimed at early-detection of intracranial tumors by combined assays of cfdna methylation and other biomarkers. the study will enroll approximately 358 participants including intracranial malignant tumors, patients with benign disorders of central nervous system and healthy participants.


Eligibility criteria:
inclusion criteria for cancer participants: * age 40-75 years * ability to provide a written informed consent * pathologically confirmed diagnosis or highly suspicious cases of intracranial malignant tumors * no prior or ongoing anti-cancer treatment (local or systematic) prior to study blood draw inclusion criteria for benign disease participants: * age 40-75 years * ability to provide a written informed consent * pathologically confirmed diagnosis or highly suspicious cases with benign disorders of central nervous system * no prior or ongoing radical treatment of the benign disorders of central nervous system prior to study blood draw inclusion criteria for healthy participants * age 40-75 years * ability to provide a written informed consent * no cancer-related symptoms or other uncomfortable symptoms prior to study blood draw exclusion criteria for all participants: * insufficient qualified blood samples * recipient of organ transplant or prior non-autologous (allogeneic) bone marrow or stem cell transplant * recipient of blood transfusion within 7 days prior to blood draw * recipient of anti-tumor drugs to treat non-cancer diseases within 30 days prior to blood draw, such as rheumatic drugs (methotrexate, cyclophosphamide, or azathioprine), or endocrine drugs (tamoxifen) additional exclusion criteria for cancer participants: -other current malignant diseases or multiple primary tumors additional exclusion criteria for benign disease participants: -current or history of malignancies additional exclusion criteria for healthy participants: * recipient of anti-infectious therapy within 14 days prior to study blood draw * prior or ongoing treatment of cancer within 3 years prior to study blood draw * current autoimmune disease or clinically significant or uncontrolled comorbidities

Keywords: intracranial tumors, early detection, liquid biopsy, cell-free dna methylation
study of interventional pulmonologic treatment of benign central airway fibrotic stricture

Conditions: Obstructive Airway Disease

Summary: the purpose of this study is to evaluate the efficacy and safety of four interventional pulmonology techniques for the treatment of fibrotic central airway stricture. the four techniques are： * balloon dilation * balloon dilation plus cryotherapy * balloon dilation plus spiculiform electrosurgery * balloon dilation plus mitomycin c injection


Eligibility criteria:
inclusion criteria: * tracheal incision,intubation or bronchial tuberculosis caused central airway fibrotic stenosis * the degree of stenosis is above 50% * estimated survival duration is longer than 3 months * recieved no treatment one month before * can understand the statement informed consent * agree to enroll in the study exclusion criteria: * older than 70 years or younger than 18 years * not fibrotic stenosis * not central airway stenosis * existence of lumina collapse or twisting * severe arrhythmia, myocardial ischemia or hypertensive crisis * coagulation disorders * existence of severe organ disfunction * allergic to anesthesia drugs * refuse to participate the study
a comparison of tissue adhesive material and suture as wound-closure techniques following carpal tunnel decompression

Conditions: Carpal Tunnel Syndrome

Summary: participants will be randomly assigned to suture-based wound closure (n=50) or tissue adhesive-based wound closure (n=50) with two-component skin adhesive glubran tiss 2®. the outcomes will be assessed during the follow-up period at intervals of 2, 6, and 12 weeks postoperatively. a scar assessment will be using the posas (patient and observer scar assessment scale) and cosmetic vas (visual analog scale). the vnrs (verbal number rating scale) will used to assess pain.


Eligibility criteria:
inclusion criteria: (all of the above) * age \>18 years * carpal tunnel syndrome * weakness of thumb abduction * with atrophy of the thenar * median nerve conduction impairment estimated by electromyography exclusion criteria: (one or more) * threatening haemorrhagic complications (patients with peroral anticoagulation and/or antithrombotic therapy) * previous wrist trauma or surgery on the wrist region * another aetiology of neuropathy * previous allergic reactions (with lidocaine, cyanoacrylate, formaldehyde, tapes, or adhesives) * personal or family history of keloids or hypertrophic scars * severe general illness with cachexia
measuring cardiovascular stress in patients on hemodialysis study ii

Conditions: Hypotension of Hemodialysis; Hypotension; Estimated Dry Weight; Myocardial Injury; Arrhythmia

Summary: the overall goal is to evaluate the predictive accuracy of a measure of autoregulatory adequacy derived from cvinsight and compare it with other measures in recognizing hypotensive events during hemodialysis..

specific aims are as follows: 1. assess the accuracy of a new rule set for cvinsight® in predicting intradialytic hypotensive episodes. 2. assess the comparative predictive accuracy of cvinsight® to other measures with regard to intradialytic hypotensive events. 3. assess estimated dry weight goals by monitoring post-dialytic vascular refill using cvinsight® and other measures. 4. assess hemodialysis(hd)-induced myocardial injury by monitoring the occurrence and frequency of arrhythmias and the levels of cardiac troponin t.

Eligibility criteria:
inclusion criteria: eligibility shall consist of the following: * age ≥ 20 years old * speaks and understands english, spanish or chinese * provides informed consent * patients with 20% intradialytic hypotensive events over the last two months. exclusion criteria for both groups: * unstable hemodialysis patients per judgment of the clinician prior to the start of the treatment * patients unable to have blood pressure cuff measured on the upper arm * inability to wear monitor on forehead * patients treated with sodium or ultrafiltration profiling and the patient's nephrologist is unwilling to alter this for the study treatments * patients unwilling to shave the anterior chest * patients with active infection of the upper chest wall tissue. * patients with a deep brain stimulator, as it may disrupt the quality of the ecg data. * patients who are unwilling to take short showers versus bathing during the 7 day period . * patients who require intradialytic testing (ie transonic) during the monitored treatment.
the ventor clinical study

Conditions: Cardiac Arrest (CA)

Summary: to evaluate the initial safety and effectiveness of the ventor airway system in providing short-term ventilation support in non-breathing subjects during cardiopulmonary resuscitation (cpr) and respiratory arrests.


Eligibility criteria:
inclusion criteria: 1. adults aged 18-75 years, inclusive 2. ihca (non-traumatic) 3. at least 4 feet in height exclusion criteria: 1. intubated with an endotracheal tube (et) 2. valid do-not-attempt-resuscitation (dnar) or study opt-out bracelet (including previous enrollment bracelet) 3. lar or family member objects to enrollment 4. obvious signs of irreversible death (rigor mortis, dependent lividity, decapitation, transection, decomposition) 5. responsive with an intact gag reflex 6. blunt, penetrating, or burn-related injury, drowning, or electrocution 7. known upper airway foreign body or mass 8. lower airway obstruction 9. dental gap of \< 2 cm 10. ingested caustic substances 11. medicine admitting note's medical history is incomplete or has only been completed by an emergency physician. 12. known esophageal disease or facial/perforating neck trauma defined as study candidates with the following medical history: 1. diseases: (esophageal varices, esophageal cancer, esophageal strictures) 2. any patient on the following medications will be excluded: (oxaliplatin, leucovorin, fluorouracil) 3. any patient with the following examination findings will be excluded: (caput medusae, history or evidence of vomiting blood) 13. known vulnerable subject other inclusion #3, such as known (e.g.: prisoner, pregnancy, terminal illness, dementia) 14. history of medical, surgical or other conditions that, in the opinion of the investigator, would limit study participation
comparison of changes in tumor burden in 68ga-psma-11 pet/ct and 177lu-psma spect/ct in metastatic castration-resistant prostate cancer

Conditions: Prostate Cancer Metastatic

Summary: to demonstrate the prognostic value of using post-therapy 177lu-psma spect/ct versus 68ga-psma-11 pet/ct in mcprc patients progressing despite chemotherapy and treated with 177lu-psma.

since few years, therapy by 177lu-psma in nancy hospital began. a lot's of datas were collected. prostate cancer is the number one killer in france and this is very important to find a diagnostic tool. the hypothesis of this study is to demonstrate the prognostic value of using post-therapy 177lu-psma spect/ct versus 68ga-psma-11 pet/ct in mcprc patients progressing despite chemotherapy and treated with 177lu-psma.

Eligibility criteria:
inclusion criteria: * patient who received a dose of 177lu-psma * patient who had imaging by 68ga-psma * patient treated in nancy hospital for its cancer prostate exclusion criteria: * no social security * no acceptation to participating in retrospective study

Keywords: prostate cancer theragnostic
effect of n-acetylcysteine versus calcium hydroxide used as an intracanal medicament on the intensity of postoperative pain, bacterial load reduction and levels of mmp -9 in periapical fluids in patients with necrotic pulp

Conditions: Intracanal Medication; N-acetylcystine; Calcium Hydroxide; Mediators

Summary: to compare the effect of n-acetylcysteine versus calcium hydroxide as intra canal medication on: * intensity of postoperative pain. * bacterial load reduction. * levels of mmp -9 in periapical fluids.


Eligibility criteria:
inclusion criteria: * patients who are free from any physical or mental handicapping condition. * males \& females with * mandibular single rooted permanent premolar teeth. * absence of spontaneous pain. * slight widening in the periodontal membrane space or with periapical radiolucency not exceeding 2\*2 mm radiographically. * patients' acceptance to participate in the trial. * patients who can understand pain scale and can sign the informed consent (appendix i) exclusion criteria: 1. medically compromised patients. 2. pregnant women 3. patients undergoing previous endodontic treatment or analgesics and/or antibiotics have been administrated by the patient during the past 24 hours preoperatively. 4. patients reporting bruxism or clenching. 5. teeth that show association with acute periapical abscess and swelling. 6. greater than grade i mobility or pocket depth greater than 5mm. 7. non-restorable teeth or teeth that could not be adequately isolated with a rubber dam 8. teeth with vital pulp. 9. immature teeth. 10. radiographic evidence of external or internal root resorption vertical root fracture, perforation, calcification.
effects of fish oil on post ablation arrhythmias

Conditions: Atrial Fibrillation

Summary: to determine if peri-operative treatment with omega-3 fatty acids is associated with a decrease in the incidence of early recurrences of atrial arrhythmias (within 30 days) and an improvement in probability of long-term maintenance of sinus rhythm after radiofrequency catheter ablation for atrial fibrillation.

af is the most prevalent arrhythmia, affecting \>2 million americans. antiarrhythmic drug therapy often is ineffective to eliminate recurrent episodes of af. in recent years radiofrequency catheter ablation has emerged as a highly effective treatment strategy in patients with paroxysmal and chronic af.6, 7 however, af may recur within days to weeks after a successful ablation procedure in up to 50% of the patients, probably because of an inflammatory response to thermal injury caused by radiofrequency energy application. these early recurrences of af after ablation do not necessarily predict long-term clinical outcome and 30-50% of patients who develop early recurrences ultimately remain in sinus rhythm without the need for additional ablation.8 however, early recurrences of af may be associated with significant morbidity due to troubling symptoms of rapid ventricular rates, multiple hospital visits and cardioversions, need for antiarrhythmic drug therapy and prolongation in duration of anticoagulant therapy. it is also possible that if early recurrences of af after ablation can be avoided, the probability of remaining in sinus rhythm during long-term follow-up may be higher, as maintenance of sinus rhythm early-on may facilitate reverse left atrial remodeling. a similar phenomenon may occur in post-operative af, that develops in \~30% of patients who undergo cardiac surgery. post-operative af is often transient and usually resolves within 3 months after the surgery. perioperative treatment with omega-3 fatty acids has been reported to decrease the incidence of postoperative af after coronary artery by-pass surgery.4 because the pathogenetic factors that play a role in postoperative af and early recurrences of af after radiofrequency catheter ablation may be similar, it is plausible that treatment with omega-3 fatty acids before and after ablation will be associated with a reduction in the incidence of early recurrences of af.

Eligibility criteria:
inclusion criteria: * age \> 18 years and \< 70 years old * left atrial size \<55 mm exclusion criteria: * inability or unwillingness to provide informed consent * current therapy with omega-3 fatty acids * current therapy with a statin * active liver disease * significant comorbidity such as end-stage renal disease or cirrhosis * valvular prosthesis

Keywords: radiofrequency ablation atrial fibrillation
prospective double arm randomized trial: wbrt alone and wbrt plus silibinin

Conditions: Brain Metastases, Adult

Summary: the occurrence of brain metastases (bms) is increasing given the availability of a more accurate radiological imaging such as mri for detecting also small brain lesions and the most effective systemic therapy able to control extracranial disease. although, the new target therapy and immunotherapy has proven to be effective on brain metastasis too, a subgroup of patients shows prove themselves unresponsive to medical treatment. a further subgroup of patients exhibit diffuse brain disease for the presence of multiple brain lesion (\>10 bms) or leptomeningeal carcinomatosis. among these patients the most treatment employed is represented by whole brain rt. since the 1950s, whole-brain radiation therapy (wbrt) has been the most widely used treatment for patients with multiple brain metastases, given its effectiveness in palliation, widespread availability, and ease to delivery. however, the median overall survival recorded is restricted to 3 months, on the average. a better understanding of the molecular and cellular mechanisms underlying brain metastasis might be expected to lead to improvements in the overall survival rate for these patients. recent studies have revealed complex interactions between metastatic cancer cells and their microenvironment in the brain. priego et al. describe that brain metastatic cells induce and maintain the co-option of a pro-metastatic program driven by signal transducer and activator of transcription 3 (stat3) in a subpopulation of reactive astrocytes surrounding metastatic lesions. in patients, active stat3 in reactive astrocytes correlates with reduced survival from diagnosis of intracranial metastases. blocking stat3 signaling in reactive astrocytes reduces experimental brain metastasis from different primary tumor sources, even at advanced stages of colonization. silibinin (or silybin) is a natural polyphenolic flavonoid isolated from seed extracts of the herb milk thistle (silybum marianum). silibinin has been shown to impair stat3 activation. preclinical studies show that silibinin has an anticancer effects in vitro and in vivo. based on this background, the investigators designed a double arm randomized trial evaluating the benefit of silibinin (in the form of marketed supplement) associated to wbrt respect to wbrt alone.


Eligibility criteria:
inclusion criteria: * age \>18 years * histological or cytological confirmation of solid tumor malignancy * clinical indication for whole brain radiotherapy * karnofsky performance status (kps) ≥60 * written informed consent exclusion criteria: * prior wbrt * kps \< 60 * diagnosis of lymphoproliferative disease * pregnant women

Keywords: brain metastases wbrt silibinin
estromineral serena plus and symptomatic menopause

Conditions: Menopause

Summary: oestrogen hormone deficiency in menopause leads to symptoms of which hot flushes, night sweats, insomnia and mood changes are the most frequent and, ultimately, worsen the quality of life. the gradual decline of oestrogen from peri-menopause results in altered function of many neurotransmitters, such as dopamine, melatonin and neuropeptides including beta-endorphins, which modulate the function of the hypothalamus and are involved in body thermoregulation. in post-menopause, dopaminergic activity is significantly reduced and stimulus of the d2 receptors is effective in relieving hot flushes and in reducing the accompanying psychological symptoms. the use of hormone replacement therapy, which is generally prescribed in the case of moderate or severe symptoms, is limited due to real contraindications or simply the woman's refusal to take the therapy, despite the presence of symptoms requiring its use. a food supplement, named estromineral (e), based on natural ingredients such as isoflavones, the absorption of which is increased by the presence of lactobacillus sporogenes, and vitamin d3 and calcium, strengthening bone mineralization, has been found to be effective at reducing vasomotor symptoms. to potentiate the effect of e on the most frequent symptoms in menopause, it was considered rational to add the extracts of magnolia, active on psycho-affective symptoms, and chaste tree, acting on both hot flushes and psychological symptoms and a new food supplement was developed: estromineral serena plus (esp). estromineral serena plus is an association of isoflavones with added lactobacillus, chaste tree and magnolia, active on menopausal vasomotor symptoms and on psycho-affective symptoms.


Eligibility criteria:
inclusion criteria: * female menopausal age * more than 5 hot flushes/day * mood or sleep changes exclusion criteria: * hormone replacement therapy

Keywords: menopause kupperman hot flushes isoflavones magnolia chaste tree
a study of gender-specific impact factors on elderly disability and cognitive impairment

Conditions: Aging

Summary: elderly disability and cognitive impairment rates were different between elderly man and woman. sex-specific risk factors and observed gender differences across the lifespan were associated with different degrees of cognitive and activity of daily living function decline between men and women. however, some of these viewpoint remains controversial. the aim of this study is to explore the gender differences and influencing factors of disability and cognitive impairment among the elderly.

with the rapid increase in the aging population in china, age-related cognitive impairment and disability has become a pressing public health concern. a number of large-scale studies in china and abroad have shown that the average life expectancy of women elderly is higher than men, but the rates of disability and cognitive impairment are higher. however, it is lack of exploration of the factors associated with the gender-specific of disability and cognitive impairment. the aim of this study is to explore the gender differences and influencing factors of disability and cognitive impairment among the elderly. a retrospective cohort based on shandong provincial qianfoshan hospital healthcare big data platform is conducted to collect data. and the data from the china longitudinal healthy longevity survey (clhls) was used to further validate the results.

Eligibility criteria:
inclusion criteria: 1.the elderly aged 65 and above. exclusion criteria: 1. lack of diagnostic information. 2. missing key influencing factors such as gender and age. 3. hearing or linguistic impairment. 4. comatose patients.

Keywords: elderly disability cognitive impairment gender-specific