Kornimate/medical-research-clean huggingface dataset:
intima media thickness regression in dyslipidemic teenagers

Conditions: Obesity; Dyslipidemia

Summary: randomized controlled trial of statin intervention in dyslipidemic obese teenagers. primary outcome is intima media thickness before and after intervention.

obese teenagers with abnormal lipid profiles were randomized to either low dose statin or placebo and had their carotid intima media thickness compared before and after intervention.

Eligibility criteria:
inclusion criteria: * obesity * abnormal triglyceride levels (\>1.7mmol/l). * abnormal hdl-c levels (1.0mmol/l) exclusion criteria: * abnormal thyroid unfction (not treated) * diabetes

Keywords: obesity dyslipidemia cholesterol intima media thickness
uterine preservation in the management of placenta accreta spectrum disorders

Conditions: Placenta Accreta Spectrum

Summary: this study for the conservative management of placenta accreta spectrum disorders (pas), which are a major cause of maternal morbidity and mortality. the most common management strategy for pas in the united states is a preterm cesarean-hysterectomy. however, accumulating data show that conservative management is safer and is preferred by some patients. in selected participants (n=15) who desire uterine preservation, the investigators provide the option of conservative management, which will be defined as leaving the placenta in the uterus after delivery of the infant. this is a single-arm single-site pilot study where all participants will be carefully monitored during a standard postpartum inpatient stay and with outpatient follow-up until the uterus is empty.


Eligibility criteria:
inclusion criteria: 1. provision of signed and dated informed consent form. 2. stated willingness to comply with all study procedures and availability for the duration of the study. 3. a person with a uterus, age 18 or older 4. currently 16-36 weeks pregnant with an intrauterine gestation 5. history of cesarean delivery and placenta previa or anterior low-lying placenta and suspected of having pas on prenatal imaging (ultrasound/mri) 6. patients for whom the usual management would be cesarean-hysterectomy. 7. patient desires uterine preservation 8. agreement to adhere to lifestyle considerations (see section 5.3) throughout study duration. exclusion criteria: • have a low antenatal suspicion for pas based on imaging.
researching the effectiveness of acceptance-based coping during hospitalization

Conditions: Psychosis; Schizophrenia

Summary: to test the effectiveness of acceptance and commitment therapy (act) versus enhanced treatment as usual (etau) delivered by hospital staff for inpatients with psychotic-spectrum disorders.

patients with psychotic disorders frequently require treatment at inpatient hospital settings during periods of acute illness for crisis management and stabilization. although these patients often receive efficacious pharmacotherapy, there is a recognized lack of empirically-supported psychosocial interventions provided to patients in typical hospital settings. the provision of high quality psychosocial treatment during hospitalization is challenging due to short lengths of stay and a general lack of trained therapist employed on hospital units who can provide these evidence-based therapies. this unmet need for hospital psychosocial treatment represents a crucial missed opportunity to teach patients coping strategies that can speed time to recovery and impact post-discharge risk factors. acceptance and commitment therapy (act) is a newer cognitive-behavioral approach that combines innovative mindfulness-based strategies for helping patients to cope more successfully with psychotic and other symptoms and implement values-consistent behavioral goals. however, adaptations to the original act approach are urgently needed to foster widespread implementation in community settings. the aim of the current study is to adapt the only promising acute-care psychosocial treatment for psychosis to be implementable in an inpatient setting and pilot test its effectiveness.

Eligibility criteria:
inclusion criteria: 1. current psychiatric hospitalization 2. diagnosis of schizophrenia, schizoaffective disorder, schizophreniform, brief psychotic disorder, delusional disorder, specified/unspecified other psychotic disorder, or a diagnosis of a mood disorder (major depressive disorder or bipolar disorder) with psychotic features, as determined by chart review and confirmed by the structured clinical interview for diagnostic and statistical manual (dsm)-5 3. 18 years or older 4. ability to speak and read english. exclusion criteria: 1. psychosis severe enough to prevent participation in regular hospital groups 2. psychotic disorder related to a general medical condition or substance-induced psychotic disorder 3. significant cognitive impairment (mini-mental state exam score \< 15).

Keywords: acceptance and commitment therapy mindfulness inpatients psychiatric hospitalization
caries detection with two different caries detecting devices

Conditions: Caries,Dental

Summary: the primary aim of this study will be to compare the effectiveness of the novel lumicare™ rinse and with qlf in determining caries progression. the secondary aim is to compare the progression of carious lesions between patients who reported use of e-cigarettes/vapes and those who did not.


Eligibility criteria:
inclusion criteria: * patients of tusdm comprehensive care clinic * adult patients over the age of 21 * extreme/high caries risk classification per tusdm caries management by risk assessment (cambra) form * presence of 2 or more initial active primary carious lesions on a free coronal surface of any tooth by visual assessment, qlf, and lumicare™ * presence of at least 1 cavitated lesion * updated (no more than 6 months old) bite wing radiographs available. * patients who responded either yes/no to use of e-cigarettes/vapes * 1 active caries, 1 inactive caries and 1 sound tooth surface. exclusion criteria: * low or moderate caries risk classification per tusdm cambra form * no clinically detectable carious lesions on free coronal surfaces * no cavitated caries lesions * carious teeth with caries lesions concomitant with extrinsic stains, fluorosis, or developmental defects. * patients who responded yes to the use of conventional cigarettes or smokeless tobacco
multisite rtms for mood, cognitive impairment and other symptoms of depression

Conditions: Unipolar Depression; Bipolar Disorder

Summary: depressed mood is the main symptom of depression, but other symptoms like cognitive impairment, anhedonia or sleep disorders may also contribute to patients suffering and are difficult to treat. rtms is a relatively novel treatment option, whose therapeutic potential is still investigated and optimized. the aim of this study is to assess the effect of rtms applied over two stimulation sites on cognitive impairment, anhedonia and sleep disorders in depression.

depression is one of the most common and disabling disorders, affecting approximately three hundred million people worldwide. depressive mood is the main symptom, but other symptoms like cognitive impairment, anhedonia or sleep disorders contribute significantly to patients suffering, decrease quality of life and may even lead to suicide attempt. while modern pharmacotherapy can significantly improve symptoms in many patients, still one third of patients remains drug-resistant. repetitive transcranial magnetic stimulation (rtms) is a non-invasive method of inducing brain plasticity. stimulation over the left and right dorsolateral prefrontal cortex (dlpfc) and possibly over several other areas can improve mood. only few studies investigated the effect of rtms on negative psychiatric symptoms, such as anhedonia, sleeplessness or cognitive impairment. in these trials, either the dlpfc or the dorsomedial prefrontal cortex (dmpfc) were stimulated and sometimes other areas such as the insular cortex. the aim of this study is to investigate if a stimulation over both sites (multi-site stimulation) has better therapeutic potential for depressed mood, cognitive impairment, anhedonia and sleep disorders than stimulation over dlpfc alone and placebo.

Eligibility criteria:
inclusion criteria: * severe or moderate depressive episode (according to international classification of diseases (icd)-10) without psychotic symptoms at the time of inclusion * hamilton depression rating scale between between 20 and 35 points at inclusion * the score in the athens insomnia scale eight or more * the score of three or more points in items 4 and 21 of the beck depressions inventory 2 * complaining about problems with memory and concentration timely related with the onset of depression exclusion criteria: * contraindications to transcranial magnetic stimulation, including ferromagnetic elements in head, pregnancy and epilepsy * psychotic symptoms at the time of inclusion * suicidal ideations and/or attempts within three months prior to inclusion

Keywords: depression repetitive transcranial magnetic stimulation dorsolateral prefrontal cortex dorsomedial prefrontal cortex cognitive impairment anhedonia sleep disorders
the (cost-)effectiveness of physician assistants working at the primary out of hours emergency service

Conditions: Primary Healthcare; Out-of-hours Medical Care

Summary: the aim of this study is to explore the effect of substituting general practitioners (gps) by physician assistants (pas) in out-of-hours primary care. effects are measured in terms of the implication for the care model, quality of care delivered by pas in comparison to gps; the complaints treated by pas in comparison to gps; safety, efficiency and patient satisfaction. lastly, this study will provide insight in the changes in costs of healthcare.

out-of-hours care in the netherlands is under pressure. workload for general practitioners (gps) during out-of-hours care is high and there are concerns about maintaining the quality of care. since 80% of the complaints shown in out-of-hours care are low complex and not urgent, not all patients necessarily have to be seen by a physician. shifting care from gps to physician assistants (pas) is considered to be a possible method to reduce workload while maintaining high quality and safety of care. previous research, on pas in primary care during office hours, has shown pas were found to be acceptable, effective and efficient in complementing the work of gps. we hypothesize that in a team of pas and gps working out-of-hours primary care, the pas will deliver care to less urgent and complex complaints, deliver quality of care comparable to gps and their implementation will lead to a reduction in cost of healthcare. we compare care provided by a team of pas and gps with a team of only gps. within the team of pas and gps we make a comparison between the two healthcare professionals.

Eligibility criteria:
inclusion criteria: * patients (with urgency u2, u3, u4, or u5) requesting an appointment at the primary out of hours emergency service during the weekend between 9.00 and 17.00 hours. exclusion criteria: * none

Keywords: physician assistants out-of-hours medical care primary healthcare emergency medical services
pre-habilitation to improve outcomes in patients undergoing liver resection for cancer

Conditions: Colorectal Neoplasm; Biliary Tract Neoplasm; Liver Neoplasm

Summary: 1. to determine whether a combined nutritional support program and exercise-based prehabilitation is superior to nutritional support alone in increasing functional recovery and reducing post-operative morbidity after surgery for hpb malignancy. 2. to understand which measures of immediate surgical recovery are sensitive to prehabilitation interventions and predict change in later outcome measures.

patients scheduled for elective liver resection be will be approached andrandomized to one of two groups using a computer generated block randomisation scheme. the first group (pre-hab) will receive both nutritional supplementation and a prehabilitation program as outlined below. the second group (nutrition) will receive only nutritional supplementation. both groups will be given a post-operative exercise program. once randomized, the subjects will be called by the research co-ordinator and an appointment will be made for the initial assessment. after the study is explained and consent obtained, subjects will be tested on 6mwt, followed by a 30 minute rest period during which various questionnaires assessing physical activity, quality of life, fatigue and nutritional status will be completed with the aid of the coordinator. the prehabilitation program will last a minimum of four weeks and a maximum of 8 weeks. surgery will be performed by one of the hpb surgeons at the mcgill university health center. surgical approach, including laparoscopic or open surgery will be at the discretion of the surgeon. perioperative care will follow an enhanced recovery after surgery (eras)-based clinical care pathway27, 28, a fast-track care plan including patient education, afferent neural blockade, multimodal analgesia, early oral intake and mobilization, early removal of catheters and drains, and a planned 6-8 day hospital admission. this pathway has already been implemented at the royal victoria hospital as part of standard patient care.

Eligibility criteria:
inclusion criteria: * subjects eligible to enter the prehabilitation program will include those aged 18 and above and referred electively for resection of malignancies. exclusion criteria: * excluded will be persons with american society of anesthesiologists (asa) health status class 4-5 or co-morbid medical, physical and mental conditions (e.g. dementia, disabling orthopedic and neuromuscular disease, psychosis), cardiac abnormalities, severe end-organ disease such as cardiac failure, copd, and hepatic failure (alt and ast \>50% over the normal range), and sepsis), morbid obesity (bmi \>40), anemia (hematocrit \< 30 %) and other conditions interfering with the ability to perform exercise at home or to complete the testing procedures. * patients will be excluded if they have poor english or french comprehension.

Keywords: liver resection hepatectomy pre-habilitation
effect of fistula training in hemodialysis patients

Conditions: Hemodialysis

Summary: it was planned to examine the effect of fistula-related education given to patients receiving hemodialysis treatment on their self-care behaviors. nurse-led education about fistula for hemodialysis patients affects fistula self-care behaviors. nurse-led training regarding fistula to hemodialysis patients does not affect fistula self-care behaviors.

hemodialysis patients in the experimental group will be given face-to-face training in 2 sessions. patients will also receive an educational brochure on fistula self-care. simultaneously, patients will receive routine treatment and care. no intervention will be performed on patients in the control group. these patients will receive normal treatment and care. a pre-test will be applied to both groups at the first meeting and their self-care behaviors related to fistula will be examined. three months later, fistula-related self-care behaviors will be evaluated again with the relevant scale.

Eligibility criteria:
inclusion criteria: * 18 years and over,with chronic kidney disease * having a fistula as a vascular access route * receiving hemodialysis treatment for at least 6 months exclusion criteria: * those with acute renal failure, * having a graft and catheter as a vascular access route, * not volunteering to participate in the research * those with communication problems (hearing, language, understanding, etc.)

Keywords: hemodialysis fistula self care education
efficacy of 8-week supervision in home based pulmonary rehabilitation

Conditions: Chronic Obstructive Pulmonary Disease

Summary: in korea, it is not easy to practice standard pulmonary rehabilitation (pr). in this study, we'll educate pr to patients and make reservation for re-visiting outpatients clinics with pr diary. we want to confirm whether patients, who perform home based pr during more than 30 minutes in 3 days per week, present improved dyspnea score or quality of life compared with non-compliance group.


Eligibility criteria:
inclusion criteria: * forced expiratory volume-one second / forced vital capacity \< 0.7 in post-bronchodilator pulmonary function test * adults 40 years or older * no history of acute exacerbation within 4 weeks * no history of education for pulmonary rehabilitation within 6 months * no change of medication for chronic obstructive pulmonary disease within 4 weeks * dyspnea more than modified medical research council grade 0 exclusion criteria: * adults under 40 years old * no consent * history of acute exacerbation within 4 weeks * history of education for pulmonary rehabilitation within 6 months * change of medication for chronic obstructive pulmonary disease within 4 weeks * dyspnea only modified medical research council grade 0 * comorbidity, including cardiovascular disease, orthopedic disease, neurologic disease, optic disease, uncontrolled hypertension * enrolled other clinical trial * on long term oxygen therapy
ketamine versus haloperidol for severe agitation outside the hospital

Conditions: Agitation

Summary: this research study is being done to find out if one of two drugs, ketamine or haloperidol, is better for treating agitation. agitation is a state of extreme emotional disturbance where patients can become physically aggressive or violent, endangering themselves and those who are caring for them. often chemical substances or severe mental illness is involved in this level of agitation. specifically, the investigators are interested in studying agitation that is treated in the prehospital setting by paramedics. this study's hypothesis is that ketamine is superior to haloperidol for treatment of agitation in the prehospital environment.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of severe agitation in the prehospital environment exclusion criteria: * prisoners * persons known to be younger than 18 years old * persons suspected to be younger than 18 years old * obviously gravid women * persons with profound agitation * persons who are unable to be transported to the treating facility

Keywords: agitation ketamine haloperidol emergency medical services feeling of restlessness increased motor activity
preoperative embolization of hypervascular head and neck tumors to improve surgical outcomes

Conditions: Malignant Neoplasm in the Head and Neck; Metastatic Malignant Neoplasm in the Head and Neck

Summary: this phase i trial tests whether embolization done prior to surgery (preoperative) will improve surgical outcomes in head and neck tumors with large amounts of blood vessels (hypervascular). embolization is a minimally invasive surgical technique performed under angiographic (imaging of blood vessels) guidance. embolization therapy injects tiny particles into the arteries feeding tumors to cut off their blood supply which may help improve outcomes by preventing blood loss during surgery, reducing surgical times, and shrinking tumors or reducing recurrence.

outline: patients receive iodixanol via injection and undergo diagnostic cerebral angiogram over 30 minutes. if the tumor blood supply is suitable, patients undergo tumor vessel embolization with polyvinyl alcohol (pva) suspended in ethiodized oil (eov) and delivered via a catheter. patients also undergo head and neck computed tomography (ct) scans immediately after completion of tumor vessel embolization, and again between 2-3 months later. after completion of study, patients are followed for up to 6 months.

Eligibility criteria:
inclusion criteria: * primary or metastatic extra-axial tumor involving one or more anatomic structures in the head and neck * vascular supply from one or more branches of the external carotid artery * planned surgical resection * all stages * extra-axial head and neck tumor greater than 1 cm in any dimension * confirmed by contrast-enhanced magnetic resonance imaging (mri) or computed tomography (ct) of the head and/or neck * subjects who have undergone prior therapies are eligible * adults aged 18-80; no data outside this age range * minimum of 3-month life expectancy * estimated glomerular filtration rate (egfr) greater than 30 ml/min/1.73 m\^2 * subjects must be non-pregnant at the time of angiographic intervention * resectable tumor as determined by the tumor board * medically stable at the time of the planned intervention, despite potential comorbidities * in english or spanish. all study materials have been professionally translated into spanish exclusion criteria: * recent hemorrhage or trauma * pregnancy * nursing mothers * contrast medium allergy * hypersensitivity or known allergy to ethiodized oil, poppy seeds, or poppy seed oil * uncontrolled or concurrent illness including ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements * pregnancy is a contraindication to angiography outside of the emergency setting * active thyroid disease may be affected by iodinated products * subject is participating in another clinical trial at the enrollment of the study or duration of the study that can affect the treatment and outcome of the study
clinical study of khk7791 in hyperphosphatemia patients on hemodialysis

Conditions: Hyperphosphatemia

Summary: to evaluate the efficacy of khk7791 by comparing changes in serum phosphorus levels from baseline values between hemodialysis patients with hyperphosphatemia receiving repeated administration of khk7791 for 8 weeks and those receiving placebo.


Eligibility criteria:
inclusion criteria: 1. has voluntarily provided written informed consent to participate in the study. 2. aged ≥ 20 years (expressed in completed years) at the time of providing informed consent. 3. stable chronic renal failure patients who have undergone hemodialysis 3 times per week for at least 12 weeks until screening examination. 4. dialysis conditions (dialysate, dialyzer, frequency of dialysis per week, dialysis duration, blood flow rate, and dialysate and substitution fluid flow rates), excluding dry weight, should have been unchanged during the last 2 weeks before screening examination. 5. the prescribed drug and dosage regimen should have been unchanged during the last 4 weeks before screening examination. 6. serum phosphorus levels should be in the range of ≥ 3.5 and ≤ 6.0 mg/dl at screening examination. 7. if on any vitamin d, calcimimetics regimen, bisphosphonate, calcitonin preparations, selective estrogen receptor modulators or teriparatide preparations then the prescribed drug and dosage regimen should have been unchanged for the last 4 weeks before screening examination. 8. kt/v urea ≥ 1.2 at the most recent test in routine medical practice before screening examination. exclusion criteria: 1. peritoneal dialysis was performed within 12 weeks before screening examination. 2. ipth \>600 pg/ml (should be based on the most recent value from the patients' medical records, etc. before pre-enrollment) 3. having concurrent or a history of inflammatory bowel disease (ibd) or diarrhea-predominant irritable bowel syndrome 4. history of gastrectomy or enterectomy or having undergone gastrointestinal tract surgery within 3 months before screening examination. 5. subjects who used anti rankl preparations within 6 weeks before screening examination. 6. subjects who used anti-sclerostin antibody preparations within 12 weeks before screening examination. 7. having concurrent severe heart disease or hepatic impairment. 8. developed cerebrovascular disease or cardiovascular disease requiring hospitalization within 6 months before screening examination. 9. uncontrollable hypertension or diabetes. 10. scheduled for living donor kidney transplant, change in the mode of dialysis, home hemodialysis, or change in the dialysis center during the study period. 11. any diagnosis of and treatment of malignancy within 5 years before screening examination.

Keywords: tenapanor hyperphosphatemia hemodialysis