Kornimate/medical-research-clean huggingface dataset:
the dementia symptom management at home program

Conditions: Dementia

Summary: persons with dementia and their caregivers are often cared for in the community through home healthcare (hhc). while these patients and their caregivers need significant help and often have difficulty maintaining their quality of life, home healthcare clinicians are often unprepared to care for this population. this study will therefore examine the ability of an integrated, multi-pronged evidence-based practice intervention for home healthcare registered nurses, occupational therapists and physical therapists, the dsm-h, to improve the quality of care and quality of life for persons with dementia and their family caregiver. the investigators will enroll persons with dementia and their family caregiver upon admission to the hhc agency and examine their quality of life over 60 days following admission, comparing those who receive the intervention to those who serve as controls.

the dementia symptom management at home (dsm-h) program is an integrated bundled implementation science intervention to improve interprofessional care in home healthcare (hhc). it consists of training, assessment instruments, patient-caregiver centered care plans and workflow changes. the investigators will perform a cluster randomized controlled clinical trial at a single, urban, non-profit hhc agency, randomizing care teams to either be trained in performing the intervention or serve as controls. the aims of this program are to examine the efficacy of this program to: aim 1: measure the effects of dsm-h on pain, neuropsychiatric symptoms, and caregiver rated qol in the person with dementia receiving hhc. aim 2: assess the effects of dsm-h on qol, burden and depression for the informal caregiver of persons with dementia receiving hhc. aim 3: assess the effects of dsm-h on the number of emergency room visits and hospital admissions.

Eligibility criteria:
inclusion criteria: * patient-caregiver dyad admitted to the hhc agency * patients must be 65 or older and speak english and/or spanish. * patient must have an informal caregiver who is at least 18 years old and spends at least 8 hours per week with the patient. * patients must score greater than 4 on the cognitive subscale of the healthy aging brain care monitor signifying at least mild impairment exclusion criteria: * patients with concomitant axis i disorders other than dementia, depression, adjustment disorders, sleep disorders. * patients being seen only in the behavioral health unit without another skilled need.

Keywords: dementia neuropsychiatric symptoms implementation science depression pain
resipi for reducing perioperative major adverse cardiac events

Conditions: Inotropy; Fluid Management; Cardiac Event; Perioperative Cardiac Risk; Vascular Resistance; Hemodynamic Monitoring; Hemodynamic Management; Fluid Responsiveness

Summary: this study aims to evaluate the effect of a novel hemodynamic management and monitoring strategy for reducing cardiac bio marker elevations and major adverse cardiac events.

modest elevations in cardiac biomarkers in the immediate postoperative period are associated with significantly increased risk of morbidity and mortality. the resipi model of hemodynamic monitoring and management in the perioperative period takes into account the dynamic interplay of vascular resistance, inotropy, and fluid management. this study aims to evaluate the effect of a novel hemodynamic management and monitoring strategy for reducing cardiac bio marker elevations and major adverse cardiac events.

Eligibility criteria:
inclusion criteria: * revised cardiac risk index greater than or equal to 1, history of diastolic dysfunction, or age greater than 55 years. * surgery type: major abdominal oncologic surgery * planned surgery length greater than or equal to 90 minutes with planned in-patient stay of at least 2 days exclusion criteria: * patients who are unstable by current american heart association/american college of cardiology clinical practice guidelines * patients with chronic kidney disease stage iv or v * urgent/emergent surgical interventions (e.g. level 1 or 2 by vumc vor definitions) * no signs of ischemia, congestive heart failure, or volume overload: creatinine clearance greater than 30
cloud-based mapping for personalized ablation

Conditions: Atrial Fibrillation; Arrhythmias, Cardiac

Summary: atrial fibrillation is a serious public health issue that affects over 5 million americans in whom it may cause skipped beats, dizziness, stroke and even death. this study seeks to improve our understanding of the causes of atrial fibrillation and to design new and more effective therapy for this heart rhythm disorder.

this project will focus on the development of a novel paradigm for electrophysiologic data analysis and interpretation using cloud-based computing resources and mobile technology. currently, electrophysiologic data gathered during a procedure is analyzed by the operator using multiple separate desk-based computer systems in the electrophysiology laboratory. the investigators propose that advances in cloud-based computing resources and network connectivity should apply a mobile paradigm to apply to invasive electrophysiologic procedures. this project will provide proof-of-concept that open-access software the investigators have developed and made available online could be used, via a mobile phone interface, to identify sites in the heart where therapy is effective. at no time will patient therapy be guided by this system. the investigators will pursue therapy using only clinical means. in parallel, a double-blinded team will analyze data in real time using our online software visualized on a smartphone. only when the case is concluded will the data be unblinded, to determine if the mobile system was accurate in real time. thus, development and testing of the cloud-based computing system is designed only to establish feasibility of the paradigm, followed by improvement of computational modeling algorithms. the data that is collected will add to the investigators' existing unique catalogue of multimodal (structural, clinical, and electrophysiologic) data. the importance of this novel paradigm is to move from analyzing large volumes of data in isolation to creating a mobile platform, and to allow scalability to increase access, such as to underdeveloped medical centers.

Eligibility criteria:
inclusion criteria: * men and women of any ethnicity * aged 21-80 years * undergoing ablation of atrial fibrillation at stanford university * failed or be intolerant of ≥ 1 anti-arrhythmic drug or not willing to accept antiarrhythmic drug therapy. exclusion criteria: * active coronary ischemia or decompensated heart failure * atrial or ventricular clot on trans-esophageal echocardiography * pregnancy (to minimize fluoroscopic exposure) * inability or unwillingness to provide informed consent * rheumatic valve disease (because it results in a unique af phenotype) * thrombotic disease or venous filters * significantly reduced kidney function

Keywords: arrhythmia cardiac electrophysiology ablation
post-dilatation to improve outcomes in acute stemi patients undergoing primary with oct assessment

Conditions: Acute Myocardial Infarction

Summary: to evaluate the effective and safety of post-dilatation in patients with acute st segment elevated myocardial infarction undergoing primary percutaneous intervention after thrombus aspiration assessed by optical coherence tomography to examine stent incomplete apposition and strut coverage in patients treated with drug-eluting stents .


Eligibility criteria:
clinical inclusion criteria: * age ≥18 years * stemi \>20 mins and \<12 hours in duration * st-segment elevation of ≥1 mm in ≥2 contiguous leads; or presumably new left bundle branch block; or true posterior mi with st depression of ≥1 mm in ≥2 contiguous anterior leads * written, informed consent angiographic inclusion criteria * the presence of least 1 acute infarct artery target vessel\* in which: 1. all significant lesions are eligible for stenting with study stents, and 2. all such lesions have a visually estimated reference diameter ≥2.5 mm and ≤4.0 mm 3. all culprit lesion timi flow ≤ 0 or 1 grade prior to guide wire crossing * expected ability to deliver the stent(s) to all culprit lesions (absence of excessive proximal tortuosity or severe calcification) * expected ability to fully expand the stent(s) at all culprit lesions (absence of marked calcification) clinical exclusion criteria: * contraindication to any of the study medications * patients with cardiogenic shock * history of bleeding diathesis or known coagulopathy , or will refuse blood transfusions * history of intracerebral mass, aneurysm, avm, or hemorrhagic stroke; stroke or tia within 6 months or any permanent neurologic deficit; gi or gu bleed within 2 months, or major surgery within 6 weeks; recent or known platelet count \<100,000 cells/mm3 or hgb \<10 g/dl * planned elective surgical procedure that would necessitate interruption of thienopyridines during the first 6 months post enrollment angiographic exclusion criteria * bifurcation lesion definitely requiring implantation of stents in both the main vessel + side branch * infarct related artery is an unprotected left main * \>38 mm of study stent length anticipated * infarction due to stent thrombosis, or infarct lesion at the site of a previously implanted stent * high likelihood of cabg within 30 days anticipated * the culprit lesion will be judged unsuitable for oct procedure, because of conditions such as left main trunk disease or shock vital

Keywords: acute st segment elevated myocardial infarction primary percutaneous intervention stent incomplete apposition
survivin as predictive biomarker for ra

Conditions: Rheumatoid Arthritis; Arthralgia; Joint Pain

Summary: purpose: to examine the possibility of using the onco-protein survivin as a predictive biomarker for identifying individuals at risk of developing rheumatoid arthritis within a cohort of patients seeking treatment for joint pain/stiffness. secondly, to study survivin as a prognostic marker for joint destruction, refractory and highly active disease in patients with established ra.

the study will analyse survivin levels in a non-selected material within a cohort of patients seeking help at their primary health care for joint pain, stiffness, swelling etc. patients presenting with such symptoms (not explained by injury or other factors) are suspected to have an arthritic condition such as ra, and are routinely tested for presence of autoantibodies rf and acpa. in this observational study we add measurement for survivin to the blood analyses of these patients. information about patients expressing high levels of survivin will be reported to the referring doctor at the primary health care, and for patients not previously having been examined by a rheumatologist this will be offered. the study will be performed at sahlgrenska university hospital gothenburg and umeå university hospital.

Eligibility criteria:
inclusion criteria: * patients seeking treatment at the primary health care for problems with their joints (pain, stiffness). exclusion criteria: * patients diagnosed with ra

Keywords: predictive factor prognostic factor
parecoxib vs paracetamol in the treatment of acute renal colic

Conditions: Acute Renal Colic; Ureteric Stone

Summary: this study will be conducted to compare the efficacy and safety of parecoxib versus paracetamol for treatment of acute renal colic due to ureteric stones.

eligible patients will be randomized to one of the two treatment groups. group 1 patients will receive iv 1 g of paracetamol while group 2 patients will receive 40 mg of parecoxib iv. the visual analogue scale (vas) will be calculated on presentation and at 30 minutes after analgesia administration. patients who do not respond to an initial dose of the analgesia will receive rescue analgesia in the form of morphine, 01.mg/kg, iv.

Eligibility criteria:
inclusion criteria: * clinical signs and symptoms consistent with acute renal colic exclusion criteria: * hypersensitivity to either paracetamol or parecoxib. * history of peptic ulcer. * pregnant or breastfeeding females. * patients with hepatic impairment (child-pugh score \>10). * patients with chronic kidney disease (ckd) stage 4 or 5 (egfr \<30mls/min). * history of coronary ischemia, peripheral vascular or cerebrovascular disease.

Keywords: acute renal colic ureteric stone selective cox2 inhibitor parecoxib paracetamol
clinical trial with combination of dienogest/ethytnilestradiol and drosperidona/ethyniestradiol

Conditions: Metrorrhagia

Summary: this trial will study the percentage of women with at least one occurrence of intracyclic bleeding (bleeding and/or spotting) during the cycles 2 and 3 of treatment with test or reference drug.


Eligibility criteria:
inclusion criteria: * sign, initial and date the informed consent form; * female patients, with child bearing potential, aged 18 to 35 years; * have indication to receive progesterone and estrogen-based low oral hormone treatment for at least 7 cycles (approximately 7 months) for birth control; * be able to comply with the study protocol; * show normal result in cervical-vaginal cytology conducted up to 3 months before study enrollment or be willing to repeat the screening visit test, which result must also be normal; * be willing to use one of the study drugs exclusion criteria: * is pregnant or breastfeeding, suspecting to be or planning to get pregnant; * patients currently using oral contraceptives with drospirenone 3 mg/ ethynilestradiol 30 mcg or dianogest 2 mg/ ethynilestradiol 30 mcg. * have history of gynecologic surgery such as hysterectomy, total oophorectomy or tubal ligation; * smoke over 10 cigarettes a day; * have any severe comorbidities (at the investigator's criteria), including bowel inflammatory disease * have hypertension, showing at least one of the following conditions: systolic pressure \>140 mm hg or diastolic pressure \>90 mm hg in sitting position; * current use of pharmacological treatment for hypertension; * show history or currently have venous or arterial thromboembolism; * history of breast or genital cancer; * have obesity (bmi \>30 kg/m2); * have liver disease or changed lab values; * currently have dysplasia or malignancy in cervical-vaginal cytology; * concomitantly use cyp3a4 metabolizing drugs or drugs causing drug interaction with other study drugs; * history of abortion one (1) month before study enrollment; * history of childbirth or breastfeeding 3 months before study enrollment; * have hypersensitivity to any of the study drug components; * patients with long-term disability, who have undergone a major surgery or any surgery in legs or major traumatism in the last 6 months; * have current diagnosis of sexually transmitted disease; * have used injectable hormones 3 months before study enrollment; * have used hormone implant 6 months before study enrollment; * have participated in another clinical trial in the last 12 months.
post-sleeve gastrectomy gastroesophageal reflux disease prediction

Conditions: Gastroesophageal Reflux; Sleeve Gastrectomy; Bariatric Surgery Complication

Summary: researchers are trying to identify predictors for gastroesophageal reflux disease after sleeve gastrectomy.

subjects will undergo an upper endoscopy with endoflip before sleeve gastrectomy to measure parameters from endoscopy and endoflip device to develop a prediction model for post-operative gastroesophageal reflux disease. subjects will undergo a repeat upper endoscopy with endoflip at 6 months if an upper endoscopy is clinically indicated after surgery and complete questionnaires during follow-ups up to 5 years.

Eligibility criteria:
inclusion criteria: * adult patients \> 18 years * bmi 30 or greater kg/m2 * participants can give a consent to the procedure * participants have no contraindications to lsg (gastric ulceration) exclusion criteria: * participants who have la grade c or d esophagitis, barrett mucosa or peptic stricture. * patients who have evidence of a major motility abnormality defined by the chicago classification version 3.0 (achalasia, absent contractility, esophagogastric junction outflow obstruction, distal esophageal spasm, or hypertensive peristalsis) * patients with hiatal hernia \> 3 cm * patients with previous esophageal or stomach surgery

Keywords: gastroesophageal reflux sleeve gastrectomy
the effect of desflurane on postopertative cognitive dysfunction

Conditions: Postoperative Cognitive Dysfunction; Postoperative Delirium

Summary: the purpose of this study is to determine the effect of desflurane on postoperative cognitive dysfunction

postoperative cognitive dysfunction is a common complication during postoperative period，especially in elderly patients. it is characterized by cognitive decline, inattention and abnormal mental status following surgery. the presence of postoperative cognitive dysfunction is independently associated with poor recovery, increased hospital length of stay and increased mortality. desflurane is a widely used volatile anesthetic, associated with shorter emergence times than other volatile anesthetics. this study aims to access the effect of desflurane in preventing postoperative cognitive dysfunction.

Eligibility criteria:
inclusion criteria: * 1. written consent given * 2. scheduled to undergo elective non-cardiac surgeries under general anesthesia * 3. asa physical score i-iii exclusion criteria: * 1. patients with a history of neurological disease, such as alzheimer disease. * 2. patients with a history of psychiatric disease * 3. patients with a medication history of antipsychotic drugs. * 4. unable to complete neuropsychological testing including patients with severe visual or hearing impairment. * 5. patients with preoperative delirium. * 6. patients who have severe adverse events, such as cardiac arrest. * 7. patients who preoperative mmse score are below 20; * 8. patients who undergo second operation in a short period.
quality of life in a representative swedish population

Conditions: Quality of Life

Summary: cohort descriptive study of quality of life and body functions in a reference population of swedish inhabitants from age 30 to age 89. the population was selected to be representative for the general swedish population and 500 in each 10 year group, 250 men and 250 women. the population is contacted and asked for informed consent, whereafter a questionnaire of about 200 questions, used in a number of studies in clinical studies and trials, are sent out. the results will be used as reference values to our patient cohorts

individuals contacted by letter with information about the study and it's aim. the next step is a telephone contact from the study secretariate where the person can ask for more detailed information and put questions to the reserach nurse. the call leads up to a question to the person, if the questionnaire can be sent. if yes, the questionnaire is posted includeing the consent form and an pre-paid return envelope. after two weeks a thank you/reminder letter is sent out, and if no reply one more phone call is made two weeks further on.

Eligibility criteria:
inclusion criteria: * list generated by the equivalent to inland revenue ("skatteverket", sweden) exclusion criteria: * unable to read and understand swedish * no informed consent

Keywords: health related quality of life
cart-egfr-il13ra2 in egfr amplified recurrent gbm

Conditions: Glioblastoma

Summary: this is an open-label phase 1 study to assess the safety and feasibility of autologous t cells co-expressing two cars targeting the cryptic egfr epitope 806 and il13ra2 (referred to as "cart-egfr-il13ra2 cells") in patients with egfr-amplified glioblastoma, idh-wildtype that has recurred following prior radiotherapy. this study will take place in two parts: an initial dose escalation phase followed by a dose exploration phase. in the dose expansion phase, the maximum tolerated dose (mtd) of cart-egfr-il13ra2 cells will be determined using a standard 3+3 design. once the mtd has been determined, the dose exploration phase will allow for further identification of a recommended dose for expansion (rde) as well as the safety and feasibility of alternative dosing schedules.


Eligibility criteria:
inclusion criteria: 1. signed, written informed consent 2. male or female age ≥ 18 years 3. patients with glioblastoma, idh-wildtype (as defined by who 2021 classification of cns tumors) that has recurred following prior radiotherapy. for patients with tumors harboring methylation of the mgmt promoter, at least 12 weeks must have elapsed since completion of first-line radiotherapy. 4. tumor tissue positive for wild-type egfr amplification by neogenomics laboratories. archival tumor from patient's initial surgery at time of original diagnosis or recently collected tumor from time of recurrence are acceptable. 5. surgical tumor resection for disease control/management or tumor biopsy to confirm tumor recurrence is clinically indicated in the opinion of the physician-investigator. 6. adequate organ function defined as: 1. serum creatinine ≤ 1.5 x uln or estimated creatinine clearance ≥ 30 ml/min and not on dialysis. 2. alt/ast ≤ 3 x upper limit of normal range and total bilirubin ≤ 2.0 mg/dl, except for patients in whom hyperbilirubinemia is attributed to gilbert's syndrome (≤ 3.0 mg/dl). 3. left ventricular ejection fraction (lvef) ≥ 45% confirmed by echo/muga 4. must have a minimum level of pulmonary reserve defined as ≤ grade 1 dyspnea and pulse oxygen \> 92% on room air 7. karnofsky performance status ≥ 60%. 8. subjects of reproductive potential must agree to use acceptable birth control methods. exclusion criteria: 1. active hepatitis b or hepatitis c infection. 2. any other active, uncontrolled infection. 3. class iii/iv cardiovascular disability according to the new york heart association classification. 4. tumors primarily localized to the brain stem or spinal cord. 5. severe, active co-morbidity in the opinion of the physician-investigator that would preclude participation in this study. 6. receipt of bevacizumab within 3 months prior to physician-investigator confirmation of eligibility. 7. active autoimmune disease requiring systemic immunosuppressive treatment equivalent to ≥ 10 mg daily of prednisone. patients with autoimmune neurological diseases (such as ms or parkinson's) will be excluded. 8. patients who are pregnant or nursing (lactating). 9. history of allergy or hypersensitivity to study product excipients (human serum albumin, dmso, and dextran 40).