Kornimate/medical-research-clean huggingface dataset:
leveraging technology to address unhealthy drug use in primary care settings

Conditions: Addiction

Summary: this study will develop a clinical decision support tool that assists primary care providers in carrying out substance use interventions, and then compare (in phase 2) two clinical scenarios, screening only (so) vs. susit, (on dose of substance use brief intervention received) and changes in drug use at 3 and 6 months, among primary care patients. investigators will develop the clinical decision support (cds) component and then test the full susit approach, using mixed methods to assess its acceptability and adoption, and gathering preliminary data on its efficacy for reducing unhealthy drug use. cds development is concurrent with the so phase to avoid losing valuable time, but will be conducted at a secondary study site to avoid contaminating the so condition.

this study has 3 specific aims: aim 1 is to develop clinical decision support that assists primary care providers in carrying out a brief intervention. aim 2 is to assess the impact of the susit on dose of substance use brief intervention received by patients. aim 3 is to gather preliminary evidence on the efficacy of the susit approach for reducing moderate-risk drug use.

Eligibility criteria:
inclusion criteria: * substance use screening results (collected using the tablet-based screening tool) indicating current moderate risk drug use, based on a substance specific involvement score (ssis) indicating current (past 3 months) use of at least one drug with a moderate risk level (ssis 4-26), in the absence of any high-risk drug or alcohol use (ssis 27+); * presenting for visit with a participating pcp exclusion criteria: * prior participation in the study (i.e. participation in the so study phase would preclude participation in the susit phase); * attending a formal addiction treatment program (not including informal treatment such as alcoholics anonymous, narcotics anonymous), in the past 3 months; * pregnant (based on self-report).

Keywords: drug use
internal mammary sentinel lymph node biopsy in early breast cancer patients with clinically axillary node -positive

Conditions: Breast Cancer

Summary: in addition to the axillary lymph nodes, the internal mammary lymph nodes (imlns) drainage is another important lymphatic channel of the breast. the status of imlns also provides important prognostic information for breast cancer patients. the technical evolvements of sentinel lymph node biopsy (slnb) and lymphoscintigraphy provided a less invasive method for assessing imlns than surgical dissection. recently, many study concerning imslnb was performed in the patients with clinically negative axillary nodes. however, previous published studies concerning patients with breast cancer who all underwent a radical mastectomy have shown that imln metastases are mostly found concomitantly with axillary metastases. for this reason, im-slnb is even more important for clinically axillary node-negative patients. to our knowledge, this is the first attempt of the im-slnb in early breast cancer patients with clinically positive axillary nodes.

objectives: * determine the impact of routinely performed internal mammary sentinel lymph node biopsy on the systemic and locoregional treatments plan. * evaluate the metastasis rate of internal mammary sentinel lymph nodes in patients with clinically axillary node-positive. * draw the learning curve of internal mammary sentinel lymph node biopsy. outline: 3\~18 hours before surgery, under ultrasonographic guidance, 0.5\~1.0 mci 99mtc-labeled sulfur colloid in sterile saline (total volume 0.2\~2.0 ml) is injected intraparenchymally into 2 quadrants of breast. subsequently, lymphoscintigraphy is performed 0.5\~1.0 hour before surgery. internal mammary sentinel lymph node biopsy is performed during the surgery and the internal mammary sentinel lymph nodes were sent to histologic examination.

Eligibility criteria:
inclusion criteria: * primary breast cancer * clinically axilla-positive exclusion criteria: * enlarged internal mammary nodes by imaging

Keywords: breast cancer clinically axillary node -positive sentinel lymph node biopsy internal mammary
a placebo-controlled study of a combination of metyrapone and oxazepam in cocaine addiction

Conditions: Cocaine Dependence; Cocaine Addiction

Summary: subjects will be randomly assigned to receive either one of the two potential dose combinations of the study medications or placebo over 6 weeks. the study will include twice weekly visits to the research clinic for laboratory studies, safety assessments and urine drug screens. subjects will also be questioned regarding drug craving and mood symptoms.


Eligibility criteria:
inclusion criteria: * male or female, 18 - 50 years of age * requests treatment for cocaine addiction * meets the dsm-iv criteria for cocaine dependency * able to provide written informed consent and comply with the study * females of childbearing potential must have a negative pregnancy test and must be using adequate birth control during the study * test positive for cocaine on a urinary drug screen * healthy and medically stable in the opinion of the principal investigator exclusion criteria: * liver enzymes greater than two times normal * any history of hepatitis * history of disorders requiring chronic treatment with steroids * significantly abnormal ecg * any prominent dsm-iv axis i disorders other than cocaine dependence * any subject who presents as a danger to self or others in the opinion of the principal investigator * concomitant use of methamphetamine as determined by self-reporting and verified by measurement of methamphetamine in urinary drug screen * alcohol consumption greater than 4 drinks per day (1 drink = 12 oz beer; 5 oz wine; 1.5 oz shot of liquor) * any clinically significant laboratory test abnormalities * use of any concomitant medication during the study that would interfere with study medications * serum cortisol less than 3 µg/dl at any time before or during study * treatment with an investigational product within 30 days prior to study enrollment * currently seeking other forms of professional addiction treatment * known allergic reaction to oxazepam or metyrapone * lactose intolerance

Keywords: cocaine dependence addiction cortisol gaba
an extension study for subjects who are deriving benefit with idelalisib (gs-1101; cal-101) following completion of a prior idelalisib study

Conditions: Chronic Lymphocytic Leukemia; Lymphoma, Non-Hodgkin

Summary: this is a long-term safety extension study of idelalisib (gs-1101; cal-101) in patients with hematologic malignancies who complete other idelalisib studies. it provides the opportunity for patients to continue treatment as long as the patient is deriving clinical benefit. patients will be followed according to the standard of care as appropriate for their type of cancer. the dose of idelalisib will generally be the same as the dose that was administered at the end of the prior study, but may be titrated up to improve clinical response or down for toxicity. patients will be withdrawn from the study if they develop progressive disease, unacceptable toxicity related to idelalisib, or if they no longer derive clinical benefit in the opinion of the investigator.


Eligibility criteria:
key inclusion criteria: * patients with hematologic malignancies completing a prior idelalisib study with a clinical benefit are eligible * women of childbearing potential must have a negative pregnancy test to be eligible * male patients, and female patients of childbearing potential, must agree to use method(s) of contraception specified in the protocol key exclusion criteria: * patients who are unwilling or unable to comply with the protocol are not eligible note: other protocol defined inclusion/exclusion criteria may apply.

Keywords: idelalisib chronic lymphocytic leukemia (cll) non-hodgkin lymphoma (nhl) phosphatidylinositol 3-kinase (pi3k)
radiation therapy compared with chemotherapy in treating patients with stage i testicular cancer

Conditions: Testicular Germ Cell Tumor

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. radiation therapy uses high-energy x-rays to damage tumor cells. it is not yet known whether chemotherapy is more effective than radiation therapy for testicular cancer. purpose: randomized phase iii trial to compare the effectiveness of carboplatin with that of radiation therapy in treating patients who have stage i testicular cancer.

objectives: i. compare relapse rates in patients with stage i testicular seminoma treated with adjuvant radiotherapy vs carboplatin. ii. compare quality of life of patients before and after treatment with these regimens. iii. compare the acute and intermediate (1-2 year) side effects of these regimens in these patients. iv. determine the incidence of late side effects (such as bowel dysfunction) of treatment and second malignancies in these patients. outline: this is a randomized study. patients are randomized to 1 of 2 treatment arms. arm i: patients receive a single dose of carboplatin iv. arm ii: patients undergo radiotherapy once daily, 5 days a week. patients are followed every 3 months for 1 year, every 4 months for 1 year, every 6 months for 1 year, and then annually thereafter. projected accrual: approximately 800 patients will be accrued for this study within 4 years.

Eligibility criteria:
disease characteristics: histologically confirmed stage i seminomatous germ cell tumor of the testis categorized as either "classical" or "anaplastic" patient characteristics: age: 16 and over performance status: not specified hematopoietic: not specified hepatic: not specified renal: creatinine less than 1.4 mg/dl other: no concurrent or previously treated malignancy except successfully treated nonmelanoma skin cancer no medical condition or other factor that would preclude study prior concurrent therapy: biologic therapy: not specified chemotherapy: not specified endocrine therapy: not specified radiotherapy: not specified surgery: no more than 8 weeks since prior orchidectomy prior inguino-pelvic or scrotal surgery allowed must be treated with "dog-leg" field if randomized to radiotherapy if prior vasectomy, choice of fields is at the discretion of the clinician

Keywords: stage i malignant testicular germ cell tumor testicular seminoma
advanced ultrasound in pleural infection

Conditions: Pleural Infection

Summary: pleural infection is a potentially serious infection of the fluid normally found around the lung and current evidence suggests its incidence is increasing in both adult and paediatric populations. identification of bacterial pathogens causing pleural infection is of paramount importance in the clinical care of patients are currently, only 40% of patients have a laboratory confirmed microbiological diagnosis for their pleural infection. an unclear diagnosis can be due to various reasons such as a small sample volume therefore the aim of the audio study is to ascertain the capacity of pleural biopsies in improving the microbiological yield of pleural infection. currently, there are no well validated methods for identifying patients presenting with pleural infection on the basis of initial ultrasound imaging. the audio study will define the role of baseline thoracic ultrasound in predicting the radiographic, clinical and surgical outcomes of patients with pleural infection. the audio study aims to recruit 50 patients from 2 centres with specific pleural expertise and these patients will be followed up over a 12 month period. investigators hope that through the information gathered from ultrasound imaging and pleural biopsies, it will aid physicians' clinical and therapeutic decision making when treating patients with pleural infection.


Eligibility criteria:
inclusion criteria: * a clinical presentation compatible with pleural infection * a pleural fluid collection that may or (rarely according to clinical judgement) may not require drainage that meets at least one or more of the following criteria: * purulent * gram stain positive for bacteria * bacterial culture positive * acidic with a ph \<7.2 * low pleural fluid glucose \<3mmol/l (\<55mg/dl) * ct evidence of pleural infection (consolidation of underlying lung with enhancing pleural collection on contrast-enhanced ct) exclusion criteria: * age \<18 years * no pleural fluid available for analysis * previous pneumonectomy on the side of pleural infection * expected survival \<3 months due to co-morbid disease * inability to give informed consent.
comparison of two oxygen setting during non-invasive mechanical ventilation of chronic obstructive pulmonary disease

Conditions: Chronic Obstructive Pulmonary Disease With Acute Exacerbation, Unspecified

Summary: hypoxaemic patients with exacerbations of chronic obstructive pulmonary disease (copd) are at some risk of carbon dioxide (co2) retention during oxygen therapy. main mechanism of co2 retention is believed to be reversal of preexisting regional hypoxic pulmonary vasoconstriction, resulting in a greater dead space. risk of co2 retention during mechanical ventilation remains controversial. thus recent study suggested limited risk of co2 retention with controlled oxygen supplementation during mechanical ventilation. conversely, controlled oxygen supplementation might decrease dyspnea and respiratory workload, increase comfort and improve both urinary output and renal function.


Eligibility criteria:
inclusion criteria: * age \> 18 years * acute hypercapnic copd exacerbation * respiratory acidosis * intensive care unit admission * non-invasive mechanical ventilation for less than 24 hours * patients or proxy consent * patients affiliated with the general social security health system exclusion criteria: * pregnancy * sickle cells disease * acute coronary syndrome * restrictive respiratory disease * stage 4 or 5 chronic kidney disease * copd exacerbation following a first episode of conventional mechanical ventilation * contraindications to non-invasive ventilation

Keywords: noninvasive ventilation pulmonary disease chronic obstructive renal doppler oxygen hypercapnia
lower extremity outcome measures in sci

Conditions: Spinal Cord Injuries

Summary: lower extremity (le) function of patients with a spinal cord injury (sci) will be assessed in an observational project with a cross-sectional and a longitudinal study design. the main goal is to identify kinematic and kinetic parameters to precisely characterize le function and in parallel the impairment and limitation in sci patients throughout rehabilitation in acute patients and in chronic patients to define le function and le recovery.


Eligibility criteria:
inclusion criteria - patients: * age 18-80 * written informed consent * general consent * spinal cord injury (sci) * asia a-d injury with lowest extent of lesion between c1 and th12 * mini-mental stat examintation score \> 26 exclusion criteria - patients: * inability to undertake any component of the trial protocol * clinically significant conditions such as severe cardiovascular, pulmonary or malignant disease * pure cauda equina i.e. peripheral nerve injury inclusion criteria - healthy controls: * age 18-80 * written informed consent * general consent exclusion criteria - healthy controls: * reliance on walking aids / prostheses for mobilisation * orthopaedic diagnosis with potential impact on gait * previous operations on the lower limbs or spine with potential impact on gait * inabilitay to undertake any component of the trial protocol * clinically significant conditions such as severe cardiovascular, pulmonary or malignant disease
rapid non-invasive brain stimulation for hoarding disorder

Conditions: Hoarding Disorder; Hoarding; Clutter

Summary: this study explores whether rapid non-invasive brain stimulation can help reduce hoarding disorder symptoms.

hoarding disorder (hd) is characterized by difficulty letting go of possessions, leading to clutter that congests living spaces and impairs daily functioning. the majority of hd patients treated with cognitive behavioral therapy for hd usually experience considerable residual symptoms. new treatments are greatly needed. this study explores whether rapid non-invasive brain stimulation can help reduce hoarding disorder symptoms.

Eligibility criteria:
inclusion criteria: 1. age 18-70 years 2. primary diagnosis of hoarding disorder 3. sufficient severity of hoarding symptoms 4. willing and able to understand and complete consent and study procedures exclusion criteria: 1. psychiatric or medical conditions or medications that make participation unsafe 2. pregnant or nursing females 3. previous exposure to tms or ect 4. history of any implanted device or psychosurgery

Keywords: tms hoarding disorder hoarding clutter itbs
lifestyle interventions for pain relief (inspire)

Conditions: Osteoarthritis, Knee

Summary: this pilot study will be a placebo controlled randomised intervention study in which participants with knee pain will be grouped into the diet intervention, exercise intervention, diet and exercise intervention or placebo arm. the study involves intake of dietary supplements and performing routine exercises which are commonly used and are not pharmacological agents. the end-points of the study are non-clinical outcomes. n= 120. 2x2 intervention with 30 individuals per block: placebo, diet only, exercise only, diet + exercise


Eligibility criteria:
inclusion criteria: * participant is willing and able to give informed consent for participation in the study * participant eligibility includes those aged \>18 years who have a body mass index (bmi) between 18.5 and 39.9 kg/m2 exclusion criteria: the participant may not enter the study if any of the following apply: * have psychosocial or gastrointestinal (e.g. malabsorptive conditions such as ibs/ibd, coeliac) * are taking the following medications: immunosuppressants, anticoagulants, amiodarone and/or perhexiline * are currently following or anticipated to commence a specialised commercially available weight loss diet and/or program * pregnant or breast feeding * history or current psychiatric illness * history or current neurological condition (e.g. epilepsy) * those undergoing revision, having severe hip oa, inflammatory arthropathies * diagnosed non-oa cause of knee pain (e.g. rheumatoid arthritis) * neuropathy or diabetes mellitus * having taken part in a research study in the last 3 months involving invasive procedures or an inconvenience allowance (this must remain for all uon fmhs urec approved studies)
efficacy study of the music glove patients with spinal cord injuries

Conditions: Spinal Cord Injuries

Summary: investigators are trying to determine the therapeutic effect of the music glove and conventional hand exercise program to patients with spinal cord injuries. all participants will be randomized into two groups: ab and ba. they will all exercise at least 3 times a week for 3 weeks with minimum of 3 hours of exercise time per week. participants will receive the other intervention at their 3 week post-therapy follow-up visits. clinical evaluations will be performed at baseline 1 and 2 (3 to 10 days apart), post-therapy after the first intervention, 3-week post-therapy follow up, post-therapy after the second intervention, and 3-week post-second intervention follow up visits.


Eligibility criteria:
inclusion criteria: * history of spinal cord injury affecting the arm and hand functions, at least 6 months prior to enrollment * upper extremity weakness as measured on a standard clinical scale * no active major psychiatric problems, or neurological/orthopedic problems affecting the training upper extremity * no active major neurological disease other than the spinal cord injury * absence of pain in the affected upper extremity exclusion criteria: * severe tone at the affected upper extremity as measured on a standard clinical scale * severe sensory/proprioception deficit at the affected upper extremity as measured on a standard clinical scale * difficulty in understanding or complying with instructions given by the experimenter * inability to perform the experimental task that will be studied * increased pain with movement of the training upper extremity
effect of epap device on emphysema and lung bullae

Conditions: Emphysema; Bullous Disease Lung

Summary: the purpose of this study is to evaluate the safety and the effects and of the application of expiratory positive airway pressure (epap) device on dynamic hyperinflation and dyspnea in patients with emphysema and pulmonary bullae.

the trial will last for six months. patients will be collected clinical and anthropometric data by using questionnaires initially. patients will have the pulmonary function test and ct scan and conduct 6mwt every two months. and borg scale data will be collected every two months. the application of epap (15cmh2o) via face mask will be randomized with the help of opaque envelopes.

Eligibility criteria:
inclusion criteria: * the patient was ≤75 years old * ct examination revealed emphysema (absolute ct value ≥900) or bullae * ct do not show other imaging changes of lung diseases, such as mass, exudation and interstitial changes * no history of lung cancer, pneumonectomy, any history of cystic fibrosis, allergic alveolitis, or pulmonary fibrosis * patients volunteer to participate and sign informed consent exclusion criteria: * patients with asthma, bronchiectasis, interstitial lung disease and other basic lung diseases * patients with heart failure * patients with a history of malignancy * patients are reluctant to participate

Keywords: emphysema bullous expiratory positive airway pressure
continuous sciatic block nerve in the management of vascular pain in critical ischemia of lower limbs patients

Conditions: Critical Limb Ischemia

Summary: critical limb ischemia (cli) is associated with severe pain that is a therapeutic challenge whit therapeutic limits for the use of conventional analgesics medications. ultrasound-guided continuous sciatic block (ccbn) is strategy effective and safe to consider in this patients. this prospective descriptive exploratory cohort study evaluates ccbn as a effective therapeutic tools for patients whit (cli)

critical limb ischemia is the final stage of peripheral vascular disease identified by resting pain greater than 2 weeks with ulcers or gangrene in 1 or both extremities. pain relief is a therapeutic challenge due to its severity, which significantly affects the quality of life, and the comorbidities that occur frequently in these patients, which limits the use of analgesics medications. regional techniques can play an important role as they are safe and effective in analgesic management . within these we find the ultrasound guided continuous sciatic block as a strategy to consider in the periods of exacerbation of pain, as a bridge to a palliative or resolutive management. prospective descriptive exploratory cohort study. patients with a diagnosis of critical ischemia of the lower limb with severe pain and side effects of opioids will be included. a continuous ultrasound-guided sciatic nerve block with longitudinal approach will be performed, with no anti-aggregation or anticoagulation suspension, continuing with an infusion of bupivacaine 0.1% the primary outcome will be numerical pain rating scale (nprs) and secondary outcome pinprick test, catheter duration, opioid consumption reduction and side effects to it.

Eligibility criteria:
inclusion criteria: * patients with a diagnosis of critical ischemia of the lower limb with severe pain and side effects of opioids exclusion criteria: * under 18 years old