Kornimate/medical-research-clean huggingface dataset:
comparison of ecmo use and conventional treatment in adults with septic shock

Conditions: Septic Shock

Summary: although few cases reported successful treatment of septic shock using extracorporeal membrane oxygenation (ecmo) in adults, no studies compared ecmo to conventional treatment (without ecmo) as treatment for adults with septic shock. since it is difficult to conduct a randomized study to allocate patients in such critical condition, we aimed to conduct a retrospective observational study using propensity score matched analysis to compare the survival of adults with septic shock treated by ecmo or conventional treatment.


Eligibility criteria:
inclusion criteria: * age \>20 * admitted at icu * septic shock exclusion criteria: * nil

Keywords: adults ecmo
promotion of physical activity in adolescents with intellectual and developmental disabilities

Conditions: Adolescent Behavior; Intellectual Disability; Down Syndrome; Physical Activity

Summary: the objective of this study is to compare the effect of two strategies to increase mvpa in adolescents with intellectual and developmental disabilities (idd): a single level intervention delivered to the adolescent only, and a multi-level intervention delivered to both the adolescent and a parent .

we will study adolescents with mild to moderate idd. each participant will have 1 designated parent who supports the participant during the physical activity (pa) intervention and in the adolescent and parent arm does the physical activity with the participant. approximately 29 participants/yr. over 4 yrs. will be randomized in a 1:1 allocation to a remote group-based program of mvpa delivered to the adolescent (ao) or a multi-level intervention delivered to both the adolescent and a parent (a+p). both interventions will be 12 mos. (6 mos. active intervention, 6 mos. maintenance intervention) with a 6 mos. no-contact follow-up targeted to increase mvpa to the recommended 60 min/d. both intervention will include real-time mvpa sessions delivered to groups of 5-7 adolescents in their homes using video conferencing software (zoomtm) with homework assignments designed to increase mvpa on the non-group session days. parents of adolescents in the a+p group will be asked to participate in the group video mvpa sessions and homework activity, and to attend sessions (0-6 mos. 2 session/mo.; 7-12 mos. 1 session/mo.) with their adolescent and the health coach designed to educate/support parents regarding the role of mvpa in health and function and strategies for increasing mvpa and decreasing sedentary time in both their adolescent and themselves. all participants will monitor their daily pa using a fitbit wireless activity tracker.

Eligibility criteria:
inclusion criteria: * mild to moderate idd (iq of 74-40). * sufficient functional ability to understand directions, communicate preferences, wants, and needs through spoken language. * living at home with a parent or guardian who is willing to participate in the intervention, with no plans to change this living situation and/or to leave the study area in the next 18 mos. * wireless internet access in the home. exclusion criteria: * unable to participate in moderate to vigorous physical activity (mvpa). * pregnancy during the previous 6 mos., currently lactating, or planned pregnancy in the following 18 mos. * unwilling to be randomized.
a trial of nov-205 in hepatitis c patients who failed standard therapy

Conditions: Hepatitis C

Summary: the purpose of this research study is to find out the effect of the investigational drug nov-205 on the level of hepatitis c virus in the blood and whether nov-205 is well-tolerated at different doses when taken by subjects with hepatitis c.


Eligibility criteria:
inclusion criteria: * a serum hcv rna level of \>100,000 iu/ml using a quantitative, branched-chain-dna (bdna)-based assay (lower limit of quantitation = \~650 iu/ml) or other equally sensitive quantitative methods. * infection with genotype 1 hcv * documented failure to respond to treatment (defined as a patient who did not achieve an early viral response (evr) (≥2 log reduction in serum hcv rna or undetectable hcv rna after 12 weeks of treatment) or is serum hcv rna positive after 24 weeks of treatment with pegylated interferon plus ribavirin for hepatitis c * adequate laboratory parameters * women of childbearing potential willing to use two acceptable methods of birth control during trial participation or are sterile or post-menopausal (defined as not having a menstrual cycle for greater than two years) * sexually active male subjects are practicing acceptable methods of contraception during trial participation * have the ability to understand the requirements of the trial, have provided written informed consent, and agree to abide by the trial restrictions and to return for the required assessments * the subject must be able to self administer daily subcutaneous injections or their caregiver must be able to administer daily subcutaneous injections exclusion criteria: * clinical, laboratory, or histological evidence of liver cirrhosis * evidence of hepatic decompensation (presence of or a history of ascites, hepatic encephalopathy, variceal bleeding, or hepatocellular carcinoma) * co-infection with human immunodeficiency virus (hiv) or active hepatitis b virus (hbv) (as determined by presence of hepatitis b surface antigen (hbsag) * have received pegylated interferon and/or ribavirin within the 60 days prior to enrollment * any known preexisting medical condition that could interfere with the subject's participation in and completion of the protocol * pregnant female or nursing mother

Keywords: hepatitis c chronic hcv viral hcv genotype 1 failed treatment with pegylated interferon plus ribavirin
virtual group fitness and nutrition intervention for individuals with psychosis

Conditions: Schizophrenia Spectrum Disorder (SSD)

Summary: individuals with schizophrenia spectrum disorder (ssd) often face unique barriers that limit the development of long-lasting lifestyle changes. in this study, the investigators will investigate the feasibility and impact of a novel lifestyle intervention in individuals with schizophrenia or schizoaffective disorder. the intervention will be composed of group fitness instruction and educational nutrition didactics that will be accessible to participants at-home through remote streaming. the fitness component will consist of weekly group fitness sessions delivered by a certified personal trainer over a virtual interface. the educational nutritional component of this intervention will involve interactive didactic sessions designed to improve knowledge of nutrition and positively change dietary behavior in this population.


Eligibility criteria:
inclusion criteria: * receiving outpatient psychiatric care for early-episode psychosis, schizophrenia, or schizoaffective disorder at boston medical center or the mass general hospital * proficient in english * cleared by their primary care provider to perform 30 minutes of aerobic and strength exercise exclusion criteria: * documented history of one of the absolute contraindications to exercise defined in the "exercise standards for testing and training" by the american heart association in our electronic medical record which includes the following: 1. acute myocardial infarction 2. ongoing unstable angina 3. uncontrolled cardiac arrhythmia with hemodynamic compromise 4. endocarditis 5. symptomatic severe aortic stenosis 6. decompensated heart failure 7. acute pulmonary embolism, pulmonary infarction, or deep vein thrombosis 8. acute myocarditis or pericarditis 9. acute aortic dissection * inability to ambulate independently

Keywords: lifestyle changes fitness instruction nutrition education virtual interventions
study of rtms analgesic effect in chronic neuropathic pain,

Conditions: Chronic Neuropathic Pain

Summary: the purpose of this study is to compare the analgesic effectiveness of three modes of repetitive transcranial magnetic stimulation (rtms) in chronic neuropathic pain: * classical rtms stimulation * deeper rtms stimulation * sham rtms stimulation

conduct of study: * entry into the study: after informed consent, patients will be randomised. the physician responsible for conducting neurostimulation sessions will make the randomization via an interactive web response system (iwrs). only this physician will have the knowledge of the group allocated to the patient. * baseline : patients, will record on a diary form, a daily visual numeric scale(vns) of pain intensity for 1 week. * treatment sessions: after the baseline, sessions of neurostimulation will begin for seven weeks. * after the end of neurostimulation sessions, patients will be followed for 2 weeks. * throughout their participation in the study, patients will plot on a diary form their daily vns.

Eligibility criteria:
inclusion criteria: * patient's written consent * affiliated with social security system * male or female, suffering for more than a year from unilateral refractory neuropathic pain: hemi-body, upper limb, lower limb and facial chronic pain. * patient whose analgesic treatment, is stable for at least 1 month. * patient not responding to conventional treatments * prescreening evn \>3 exclusion criteria: * history of drug addiction, epilepsy, cranial trauma * history of psychiatric disorder * patients previously treated with rtms * patient with intracranial ferromagnetic material or implanted stimulator * new treatment for less than one month * pregnant or breastfeeding woman * patient who does not understand the study protocol * persons who are protected under the act.

Keywords: rtms chronic neuropathic pain repetitive transcranial magnetic stimulation
a study of raltegravir in a diverse cohort of hiv-infected patients (0518-055)

Conditions: Human Immunodeficiency Virus

Summary: a study to test the safety and effect of twice daily raltegravir in a diverse cohort of patients currently infected with human immunodeficiency virus (hiv), where at least 50% are african american and at least 25% are female, either having received antiretroviral drugs before or not.


Eligibility criteria:
inclusion criteria: * patient is hiv positive * patient agrees to use (or have their partner use) birth control as defined by the study doctor exclusion criteria: * if female, pregnant or breastfeeding * patient has used an investigational agent in the last 30 days * patient has acute hepatitis * patient has received mk0518 (raltegravir) before * patient has used another experimental hiv-integrase inhibitor
food for thought: food insecurity screening in the emergency department

Conditions: Hunger; Child Nutrition Disorders

Summary: this study compares food insecurity disclosure rates in face-to-face interviews versus electronic formats, and explores caregiver preferences regarding screening modality and location, in a large, urban pediatric emergency department. half of the participants were screened for food insecurity verbally, face-to-face by a research assistant, and half of the participants were screened electronically by a tablet.

children are disproportionately affected by the rise in poverty rates in the united states, and economic hardships can compromise their development, negatively affect their overall health, and adversely affect their abilities to succeed in school and in life. food insecurity (fi)-the limited or uncertain availability of nutritionally adequate or safe foods- while strongly associated with poverty, is an independent predictor of poor health outcomes for children. the emergency department (ed) of academic medical centers often serves as a point of care entry for impoverished and high-risk families. although there is a growing interest in the healthcare system's ability to address social determinants of health (sdh), little is known about food insecurity in the pediatric ed. additionally, there are limited data on how to implement fi screening into practice in a way that maximizes elicitation of social need, while assuring patient and family comfort.

Eligibility criteria:
inclusion criteria: * english speaking * adult caregiver accompanying pediatric patient in the children's hospital of philadelphia (chop) emergency department exclusion criteria: * patient (child) in critical condition * patient (child) \>18 years of age * previously enrolled in study

Keywords: social determinants of health food insecurity screening pediatrics
comparison of denture base adaptation and per-iimplant tissue health between cad and cam implant overdenture

Conditions: Periimplantitis

Summary: background: complete overdenture manufacturing has been greatly developed using computer-aided designing and computer-aided manufacturing (cad-cam) technology. material and method: 15 completely edentulous patients, divided into two groups, received two implants in the mandibular canine area with ball attachment. the first group received a cad/cam-milled mandibular overdenture and a maxillary acrylic conventional complete denture, while the second group received a 3d-printed mandibular overdenture and a maxillary acrylic complete denture. peri-implant soft tissue and denture adaptation were evaluated using clinical parameters

background: in recent years, complete overdenture manufacturing has been greatly developed using computer-aided designing and computer-aided manufacturing (cad-cam) technology. this clinical study compared the soft tissue health between cad/cam-milled and 3d-printed implants that retained complete overdentures. material and method: 15 completely edentulous patients, divided into two groups, received two implants in the mandibular canine area with ball attachment. the first group received a cad/cam-milled mandibular overdenture and a maxillary acrylic conventional complete denture, while the second group received a 3d-printed mandibular overdenture and a maxillary acrylic complete denture. peri-implant soft tissue was evaluated using clinical parameters including the gingival index, plaque index, bleeding index, and probing depth at the time of mandibular complete overdenture insertion (t0), six months (t6), and twelve months (t12) of denture use.

Eligibility criteria:
inclusion criteria: poor denture adaptation co-operative patients exclusion criteria: metabolic diseases uncontrolled diabetes osteoporosis and hyperparathyroidism.
impact of perioperative hyperoxia on cancer recurrence and mortality after elective colorectal cancer surgery

Conditions: Recurrence; Survival Rate; Mortality; Colorectal Surgery; Hyperoxia

Summary: the goal of this observational study is to evaluate whether perioperative hyperoxia (fio₂ \> 0.8), compared to conventional oxygen therapy (fio₂ \< 0.4), is associated with increased cancer recurrence and mortality in patients undergoing curative elective colorectal cancer surgery.

in 2016, the world health organization (who) recommended the use of perioperative hyperoxia (fio₂ \> 0.8) to reduce the risk of postoperative surgical site infections (ssis). however, the who also highlighted potential adverse effects associated with hyperoxia, including increased cancer recurrence and mortality. this study aims to evaluate whether perioperative hyperoxia (fio₂ \> 0.8), compared to conventional oxygen therapy (fio₂ \< 0.4), is associated with increased cancer recurrence and mortality in patients undergoing curative elective colorectal cancer surgery. this study is a follow-up of a previously published cohort originally designed to assess whether fio₂ \> 0.8 was associated with a higher incidence of perioperative cardiovascular complications. in this follow-up, oncological recurrence and mortality events were recorded at least three years after the index surgery. the primary outcome was recurrence-free survival over the follow-up period, analyzed using kaplan-meier curves and a cox proportional hazards model. the secondary outcome was the 3-year mortality rate, analyzed using the chi-square test.

Eligibility criteria:
inclusion criteria: * patients over 18 years old; * scheduled for major elective colorectal surgery under general anaesthesia with tracheal intubation. exclusion criteria: * non-oncologic surgery or non-curative oncological surgery * pregnant or breastfeeding women * chronic obstructive pulmonary disease (forced expiratory volume in one second \<50% or in need of domiciliary oxygen thera-py) * acute coronary event or stroke during the previous six weeks (before the surgery) * chronic renal failure requiring renal replacement therapy; * predicted length of stay of less than one day; * any patient that has received general anaesthesia during the previous month.

Keywords: hyperoxia recurrence-free survival colorectal surgery
mk-0954a in japanese patients with essential hypertension not adequately controlled with losartan (mk-0954a-352)

Conditions: Hypertension

Summary: this study is being conducted to evaluate the efficacy of mk-0954a in essential hypertension participants who are not adequately controlled with losartan.


Eligibility criteria:
inclusion criteria: * participant has a diagnosis of essential hypertension. * participant is not treated with antihypertensive medication and meets protocol-specified blood pressure criteria. * participant is treated with single antihypertensive medication, and meets protocol-specified blood pressure criteria. * participant is being treated with up to dual oral antihypertensive medications, and will be able to discontinue the prior antihypertensive medication. * participant has no clinically meaningful findings to be disqualified from the study at the discretion of the investigator. exclusion criteria: * regarding hypertension, participant is currently taking \> 2 antihypertensive medications. * participant has a history of significant multiple and/or severe allergies to ingredients of nu-lotan or preminent and thiazide drug or related drug (i.e., sulfonamide-containing "chlortalidone" medicines) * participant is, at the time of signing informed consent, a user of recreational or illicit drugs or a recent history within the last year of drug or alcohol abuse or dependence. * participant is pregnant or breastfeeding or expecting to conceive or has a positive pregnancy test at the screening visit. * participant is currently participating or has participated in a study with an investigational compound (except losartan at any doses) or device within 30 days of signing informed consent.

Keywords: essential hypertension uncontrolled hypertension antihypertensive agents blood pressure
spinal morphine for postoperative analgesia in urology

Conditions: Pain, Postoperative

Summary: the study was performed in urology patients elicited for open prostatectomy or open nephrectomy. comparison of analgesic effect between group (m) with spinal morphine before general anaesthesia and group without this intervention was measured.

patients elicited for open prostatectomy or open nephrectomy were randomly divided in 2 groups. group m were administered preservative-free morphine 250 mcg in 2.5 ml ns intrathecal using 25 g needle in l1/2 - l5/s1 interspaces. control group (c) were given no intervention. placebo intrathecal injection in c was not used because of ethical reason. standard general anaesthesia was used in both groups. after surgery all patients were transferred to urology icu and were given standard analgesic regimen according to level of pain measured by numeric rating scale (nrs) 0 - 10: nrs \> 3 metamizol 1 g iv every 6 h., max. 4 g/24 h., nrs \> 3 paracetamol 1g iv every 6 h., max. 4 g/24 h., nrs \> 3 lasting 30 min. after administration of previous ones diclofenac 75 mg im á 12 h., max. 150 mg/24 h., nrs \> 4 morphine 10 mg sc á 6 h. personnel of icu was blinded to the analgesic method used. noticed parameters: pain intensity (nrs), time to nrs ≥ 4, time to the first morphine request, side effects (respiratory rate \<8, spo2\<90 %, nausea, vomiting, naloxone administration for spo2\<88 %, itching). standard statistical analysis was used, p value \< 0.05 was considered significant.

Eligibility criteria:
inclusion criteria * elicited open prostatectomy or open nephrectomy exclusion criteria * drug or alcohol dependence * psychiatric drug use * asa classification iv or v * general contraindication to neuroaxial injection

Keywords: morphine spinal prostatectomy nephrectomy
rituximab in hairy cell leukemia: a multicenter retrospective study

Conditions: Hairy-cell Leukemia

Summary: hairy-cell leukemia is a rare and indolent lymphoid disorder, representing 2% of all cases of lymphoid leukemias. treatment of hairy-cell leukemia relies mainly on the purine analogs, cladribine and pentostatin, which have shown similar efficacy and constitute the gold standard of care either as front-line therapy or for relapsed patients. however, despite the remarkable response rates obtained with purine analogs therapy, some patients will eventually relapse and the efficacy of these agents seems to decrease at each line of treatment. the addition of new molecules to purine analogs may improve the response rates and prevent relapse. rituximab is a chimeric igg1 kappa-type monoclonal antibody directed against the cd20 molecule. it was first used in relapsed patients with hairy-cell leukemia more than 10 years ago and several series of patients treated with rituximab as monotherapy were published in the following decade, reporting response rates ranging from 25% to 80%.

aims of the study were : * to assess the overall efficacy of rituximab in a cohort of unselected patients with hairy-cell leukemia * to identify factors associated to treatment response, to duration of treatment response and to patient survival in a cohort of unselected patients with hairy-cell leukemia

Eligibility criteria:
inclusion criteria: * patients with hairy-cell leukemia diagnosed between july 2002 and september 2012 * patients had received at least 3 subsequent injections of rituximab * aged \> 18 years
neural functioning of feeding centers in obese youth

Conditions: Obesity; Insulin Resistance

Summary: to explore whether obese adolescents with insulin resistance and relative low leptin levels exhibit functional alterations of the neuronal circuits involved in the regulation of energy metabolism and food seeking behaviors. we here propose to test the hypothesis that the reward circuitry is dysregulated in obese adolescents and is related to the degree of insulin resistance and hyperinsulinemia.

functional magnetic resonance imaging (fmri) provides a non-invasive method to assess the functional pathways affected by nutrient ingestion and therefore can help answer important questions regarding potential differences in the response of brain regions involved in feeding.

Eligibility criteria:
inclusion criteria: * obese adolescents * good general health, * taking no medication on a chronic basis * age 12 to 17 yrs, * in puberty (girls and boys: tanner stage ii - iv) obese insulin resistant adolescents * (bmi\> 95th) * (wbisi\<1.2 plus a low adiponectin \<6 ug/dl and * high triglyceride levels \>130mg/dl) obese insulin sensitive adolescents * (bmi\>95th) * (wbisi \>3) plus high adiponectin \>8 ug/ml and * triglyceride levels \> 80 mg/dl girls who begin menstruating must have a negative pregnancy test during the study eligibility criteria for healthy non-obese children and adolescents: * brother or sister with obesity * age 12 to 17 years * normal fasting glucose and lipids in the child, and * normal ogtt * no use of any medication known to affect glucose, lipid metabolism and inflammation * no endocrinopathies * no use of any antipsychotic medication * bmi \>25th to \<75th ( center for disease control (cdc) bmi charts) * minimum weight of 90lbs (cdc growth charts) exclusion criteria * baseline creatinine \>1.0 mg * pregnancy * presence of endocrinopathies (e.g. cushing syndrome) * cardiac or pulmonary or other significant chronic illness * adolescents with psychiatric disorder or with substance abuse determined via self-report. * use of anorexic agents no metal implants

Keywords: obesity insulin resistance functional magnetic resonance imaging glucose fructose hypothalamus neuronal circuits feeding behavior