Kornimate/medical-research-clean huggingface dataset:
st. paul's advanced resection center cohort for colorectal neoplasia (sparc-c)

Conditions: Colon Adenoma; Colon Polyp; Colon Lesion

Summary: the sparc-c study is a prospective, single-centre observational study of patients referred for the management of large (≥ 20mm) non-pedunculated colorectal polyps (lnpcps). patients are managed consistent with current standards of care. prospectively collected data includes: patient clinicodemographic details, lesion details, procedural details, and clinical outcomes.

endoscopic resection techniques, including endoscopic mucosal resection (emr), endoscopic submucosal dissection (esd), and cold snare resection (csr), have become the primary treatment strategy for the vast majority of large non-pedunculated colorectal polyps (lnpcps). this is because of the efficacy, safety, and cost-effectiveness of endoscopic techniques compared to surgery. site-specific technical modifications and the development of auxiliary techniques/strategies have mitigated the risk of technical failure, clinically significant post-resection bleeding (cspeb), significant deep mural injury (s-dmi)/perforation, and recurrence. however, questions still remain about the application and selection of these techniques. this is a single-centre cohort study of consecutive patients referred for the management of lnpcps to one of two interventional endoscopists with a tertiary referral practice in minimally invasive endoscopic resection techniques. it is based at st. paul's hospital and its affiliated sites, with the aim of enrolling 3500 participants over 10 years. this cohort serves as a platform to continue refining the management of lnpcps. we will evaluate lnpcp management outcomes, including technical success, clinical success, clinically significant intra-procedural bleeding (csipb), s-dmi, cspeb, delayed perforation, recurrence, and referral to surgery. findings will also help to further refine mitigating strategies for intra-procedural and post-procedural adverse outcomes (cspib, s-dmi, cspeb, delayed perforation, recurrence, and referral to surgery). finally, we aim to optimize the application of minimally invasive endoscopic resection techniques for the management of lnpcps, including the development of artificial intelligence clinical decision support solutions (ai-cdss).

Eligibility criteria:
inclusion criteria: * patients ≥ 18 years of age referred for the management of an lnpcp * able to provide informed consent. exclusion criteria: * unable to provide informed consent * pregnant or lactating women.

Keywords: colorectal neoplasia advanced endoscopy endoscopic resection
intravitreal injection of bevacizumab and gas for diabetic premacular hemorrhage with active fibrovascular proliferation

Conditions: Diabetic Retinopathy With Premacular Hemorrhage

Summary: diabetic premacular hemorrhage occurs when blood from preretinal neovascular tissue is entrapped between the retina and the posterior hyaloid in the macular area. it may occur spontaneously or secondary to traction from a localized posterior vitreous detachment. this complication may greatly disturb the central vision and may be an important stimulant of fibrovascular proliferation. bevacizumab (avastin, genentech, inc.) is a humanized monoclonal antibody against vascular endothelial growth factor (vegf), which has been used to treat a variety of neovascular ocular diseases. in proliferative diabetic retinopathy, intravitreal bevacizumab has been shown to induce prompt regression of neovascularization and may enhance resolution of vitreous hemorrhage. in this study, we propose that simultaneous intravitreal injection of gas and bevacizumab may be a useful treatment option in diabetic premacular hemorrhage with active fibrovascular tissue. in this procedure, gas is used to displace the blood while bevacizumab may render the neovascularization less active to decrease the likelihood of recurrent hemorrhage.

in this study, consecutive cases of acute diabetic premacular hemorrhage and active fibrovascular proliferation will receive intravitreal injection of bevacizumab (1.25 mg in 0.05 ml) and c3f8 (0.2-0.3 ml) during the same setting. before intravitreal injection, all patients should either have complete panretinal photocoagulation (prp) treatment or prp to the peripheral retina. after treatment, patients will maintain a prone position for three days and be followed at regular interval. after vitreous clear-up, further supplementary prp extending beyond equator will be done. snellen best-corrected visual acuity measurements, intraocular pressure, slit-lamp examination and non-contact lens biomicroscopic examination will be performed before treatment and at each follow-up visit. data including the extent of premacular hemorrhage, and the interval between the treatment and clearing of premacular hemorrhage will also be recorded.

Eligibility criteria:
inclusion criteria: * acute diabetic premacular hemorrhage and minor active fibrovascular proliferation exclusion criteria: * anticoagulant therapy * blood diseases associated with abnormal coagulation * proliferative retinopathy severe enough to warrant vitrectomy

Keywords: bevacizumab diabetic premacular hemorrhage intravitreal gas
intra-hospital transport of critically ill patients in intensive care unit

Conditions: Critical Illness; Transportation Accidents; Intensive Care Unit

Summary: intra-hospital transport is a frequent procedure in the icu, involving patients with the highest severity scores. although some studies estimate the rate of adverse events to be around 33% during intra-hospital transport, including 4% of serious adverse events, the epidemiological data available is small, heterogeneous, and probably subject to methodological bias. the aim of this study observational prospective observatoinal study is to determine: * the different practices existing between icus ("practice survey") * the occurrence of adverse events during intra-hospital transport provided by intensive care units (epidemiological study)

this is a multicenter prospective observational study on evaluation of practices between icus and to describe the occurence of adverse events during intra-hospital transport provided by icus (epidemiological study)

Eligibility criteria:
inclusion criteria: * patients aged over 18 years old * hospitalized in icu * requiring an intra-hospital transport (e.g imagery, operating room, etc) by the icu team * with a departure from icu and arrival to icu exclusion criteria: * person under guardianship * protected majors * already included in the study * transport for an icu discharge in a medical or surgical ward * transport with another team than the icu team * not affiliated to french social security

Keywords: intra-hospital transport critical ill patients intensive care unit
economic evaluation in teledermatology

Conditions: Skin Diseases

Summary: introduction: previous studies confirm that teledermatology allows the generation of a quick response from the specialist's consultation, reduction of unnecessary travels, early diagnosis and priority in the attention to the most urgent cases. despite these advantages and that teledermatology has experienced exponential growth since its introduction approximately 16 years ago in spain, in andalusia, its use is still very limited. the objective of this project will be to carry out an analysis of the quality of life related to health, costs, cost-utility and informal care of teledermatology services in primary care compared to conventional monitoring carried out at the hospital de poniente. methodology: a randomized, controlled, unmasked, inter-level clinical trial (primary care-hospital de poniente) and multicentre (all health centers attached to the poniente health district of almería) will be carried out with a 6-month follow-up. patients will be assigned to the teledermatology group (experimental) or the conventional monitoring group in the hospital (control). the patients included in the experimental group will be monitored asynchronously. baseline characteristics, number of visits to the hospital, health-related quality of life, costs, informal care and satisfaction from the perspective of the andalusian public health system and patients and their caregivers will be analyzed. the generic euroqol-5d questionnaire (eq-5d) will be administered to assess health-related quality of life and the skindex-29 quality of life dermatological questionnaire. a cost-utility analysis will be performed to assess whether tele-dermatology is cost-effective in terms of additional cost for additional quality-adjusted life years (qalys).


Eligibility criteria:
inclusion criteria: * 1. be over 18 years old. * 2. having any skin disease. * 3. accept to participate in the study. exclusion criteria: * 1. non-dermatological disease. * 2. be participating in another study. * 3. refuse to participate in the study.
mechanical heat recovery ventilation on house dust mite sensitive asthma

Conditions: Asthma

Summary: asthma has become increasingly common in the uk, demanding our consideration of the cause. many patients with asthma are allergic to house dust mites, which thrive in modern housing. improving ventilation in the home has been shown to reduce dust mite levels, by reducing humidity levels. it is hoped that, by removing the dust mites from homes, asthma may improve. in this study, 140 volunteers will have their carpets steam-cleaned and new allergy bedding provided, before a team of architects installs a ventilation system in the loft. half of the units will be switched on at the beginning of the study. the other half will be switched on in 12 months time, but only the architects know which units are active. the medical team will compare the asthma, and measures of inflammation in the airways, over that year. it is due for completion in april 2007.

the prevalence of asthma is rising sharply in the uk. the house dust mite is the most common trigger associated with asthma, thriving in the humid microclimate favoured by modern housing. could this be redressed by investment in improved ventilation in local housing? in a pilot study in north lanarkshire council housing stock, we demonstrated that dust mite avoidance, in combination with installation of domestic mechanical heat recovery ventilation (mhrv), could inhibit the re-colonisation of house dust mites by reduction of indoor air humidity. in this second phase, a double blind randomized placebo- controlled trial will test the resultant effect on asthma. it will be complete in november 2006. 140 patients with asthma and house dust mite allergy are being recruited and all will have new bedding, mattress covers and carpets cleaned. all will have mhrv units installed in their home, but only half will be activated, before 12 months of environmental and clinical monitoring. the primary endpoint is morning peak flow rate. secondary endpoints include symptom scores, spirometry, rates of exacerbations, quality-of-life, and economic evaluations. demonstration that well ventilated, energy efficient dwellings improve the respiratory health of patients with allergic asthma could be of considerable importance in helping the nhs cope with the commonest chronic disease in scotland.

Eligibility criteria:
inclusion criteria: * house dust mite sensitive * fev1 greater than 50% * symptomatic asthma or 12% reversibility on spirometry or 15%pefr lability exclusion criteria: * multi-storey flat

Keywords: asthma house dust mite allergy housing avoidance humidity
stress response and hemodynamic changes associated with intrathecal anesthesia versus caudal epidural anesthesia in infants undergoing laparoscopic inguinal herniorrhaphy

Conditions: Stress Response; Hemodynamic Changes; Intrathecal Anesthesia; Caudal Epidural Anesthesia; Infants; Laparoscopic Inguinal Herniorrhaphy

Summary: the aim of this work was to assess stress response and hemodynamic changes associated with intrathecal anesthesia versus caudal epidural anesthesia in infants undergoing laparoscopic inguinal herniorrhaphy.

inguinal hernia repair is the most frequent surgical procedure in early childhood. various regional anesthetic techniques have been employed to provide optimum intraoperative and postoperative pain control after this procedure. introduced decades ago, the use of intrathecal (spinal) anesthesia and caudal block in procedures for different types of laparoscopic abdominal surgery is safe and efficient. caudal block is now frequently used in intraoperative and postoperative analgesia for pediatric surgery. in infants and children, central neuraxial block is an important modality for acute postoperative analgesia in addition to combined anesthesia, the goals of postoperative analgesia in children are pain eradication, expedient recovery to daily activities, and prevention of progression of acute postsurgical pain to chronic pain or hyperalgesia

Eligibility criteria:
inclusion criteria: * age from full term one month to one year. * both sexes. * patients with clinical criteria of laparoscopic inguinal herniorrhaphy. exclusion criteria: * refusal of patients' parents. * diseases of the central nervous system. * patients with metabolic and coagulation defects. * pre-term infant. * infection at the site of injection. * congenital anomaly in vertebral column. * patient treated with corticosteroids. * patients with respiratory dysfunction.
pfx closure system in subjects with cryptogenic stroke,transient ischemic attack,migraine or decompression illness(pfo)

Conditions: Patent Foramen Ovale

Summary: the primary objective of this study is to demonstrate the safety and performance of the pfx closure system when utilized for patients with pfos suffering from cryptogenic stroke, transient ischemic attack, migraine or decompression illness.

patent foramen ovale has been implicated in the etiology of paradoxical embolism, cryptogenic stroke, transient ischemic attack, and right to left gas embolism in severe decompression illness. an association between patent foramen ovale and severe migraine headaches has also been reported. several implantable devices are being used for percutaneous closure of patent foramen ovale; this study uses a non-implantable system to safely effect closure with the application of radiofrequency energy.

Eligibility criteria:
inclusion criteria: * age between 18 and 65 years old * documented pfo * subjects with one or more of the following:cryptogenic stroke, transient ischemic attack, embolism, migraine headaches, decompression illness exclusion criteria: • inappropriate anatomy (vascular or cardiac) or inappropriate medical condition for pfo closure and study medications.

Keywords: pfo migraine stroke tia (transient ischemic attack) decompression illness
minimum effective duration of intrauterine balloon tamponade for the management of postpartum hemorrhage

Conditions: Postpartum Hemorrhage, Immediate

Summary: intrauterine balloon tamponade (iubt) is recommended worldwide as the second-line therapy to treat postpartum hemorrhage. while much literature demonstrates the effectiveness of this therapy, little is known about how long the iubt should be used once placed. though it is common to use iubt for 12-24 hours, the balloon may be equally effective when used for shorter durations of time, which could have beneficial effects for patients and hospitals. the proposed study is a pragmatic randomized controlled trial of non-inferiority comparing two durations of time for intrauterine balloon tamponade placement, 6 and 18 hours, in controlling postpartum hemorrhage. the specific aims of the proposed study are to determine: 1) whether quantitative blood loss significantly differs when the balloon is removed in 6 hours compared to 18 hours, 2) whether hemorrhage-related morbidity differs when the iubt is kept in place for 6 or 18 hours, and 3) whether shorter duration of iubt placement has beneficial effects including shortened postpartum hospital stays, improved maternal-infant bonding, and reduced postpartum pain prior to maternal discharge from hospital. we hypothesize that, once hemorrhage control has been achieved with iubt placement, there is no clinically significant difference in postpartum blood loss when the balloon is removed 6 hours after placement compared to 18 hours after placement.


Eligibility criteria:
inclusion criteria: * women at denver health and hospital authority (dhha) who have an iubt placed for postpartum hemorrhage due to uterine atony will be approached for enrollment in the study. exclusion criteria: * women will be excluded from the study if they: are less than 18 years of age; had a cesarean delivery; are unable to consent for themselves; have a preexisting or acquired clotting factor disorder such as von willebrand or hemophilia, disseminated intravascular coagulation, or therapeutic anticoagulation at time of delivery; would refuse blood product transfusion; have a fetal demise or birth of a previable fetus; or are incarcerated at the time of delivery. women who do not speak english or spanish will be offered enrollment if a phone interpreter is available to review the consent, but will be excluded from the survey portion of the study.
emotion and symptom-focused engagement for caregivers (ease-cg) pilot study

Conditions: Leukemia, Acute

Summary: the purpose of this study is to test the feasibility and acceptability of an adapted psychosocial intervention, called emotion and symptom-focused engagement for caregivers (ease-cg), to reduce traumatic stress symptoms and other psychological distress and increase well-being in primary caregivers of patients newly diagnosed with acute leukemia.

emotion and symptom-focused engagement for caregivers (ease-cg) is a brief psychotherapeutic intervention designed for primary caregivers of patients newly diagnosed with acute leukemia (al). the ease-cg intervention was adapted from a previous psychotherapeutic intervention for adult patients newly diagnosed with al, called emotion and symptom-focused engagement (ease). in a previous pilot trial, ease was associated with reductions in traumatic stress and physical symptom burden in adult patients with al. ease-cg is a sub-study of a multi-center, longitudinal, mixed-methods study on the experience of traumatic stress in primary caregivers of patients newly diagnosed with al within three months of admission to the hospital (main study). the purpose of this sub-study is to conduct a non-randomized, mixed-methods pilot study to test the feasibility and acceptability of ease-cg. a subset of caregivers of pediatric patients from the main study will be approached to participate in ease-cg. quantitative measures will be administered at baseline, 1, 3 (primary endpoint), 6, 9, and 12 months (main study endpoint). participants may be invited to brief, semi-structured interviews. the study will take place at the hospital for sick children; the largest leukemia treatment center in canada for pediatric patients.

Eligibility criteria:
inclusion criteria: * self-identified primary caregiver (i.e., person assuming the majority of care activities) or co-primary caregiver (i.e., assuming at least 40% of care activities alongside another co-primary caregiver) of an adult or pediatric patient who is newly diagnosed with acute leukemia within 3 months of admission to the princess margaret cancer centre or the hospital for sick children * age ≥18 years * fluency in english exclusion criteria: none

Keywords: caregivers psychosocial intervention traumatic stress hematological malignancies supportive care acute leukemia
kidney transplants in hepatitis c negative recipients with hepatitis c viremic donors

Conditions: End Stage Renal Disease; Hepatitis C

Summary: in this study, individuals without hepatitis c infection who are on the kidney transplant waitlist will receive a kidney from a deceased donor with hepatitis c infection and will be treated for hepatitis c at the same time. treatment will include glecaprevir 300 mg / pibrentasvir 120 mg (g-p) administered on-call to the operating room for the renal transplant procedure and continued for 2 weeks post-renal transplant.

in this study, individuals without hepatitis c infection who are on the kidney transplant waitlist will receive a kidney from a deceased donor with hepatitis c infection and will be treated for hepatitis c at the same time. treatment will include glecaprevir 300 mg / pibrentasvir 120 mg (g-p) administered on-call to the operating room for the renal transplant procedure and continued for 2 weeks post-renal transplant. the participant will continue to be tested for hepatitis c for 12 weeks post-treatment. the primary hypothesis is that prophylactic treatment with glecaprevir/pibrentasvir before and after transplant will prevent the establishment of hcv infection in the recipients of kidneys from hcv-infected deceased donors. based on the success of preliminary studies, the objective of the study is to evaluate the safety and efficacy of 2 weeks of g-p as prophylaxis for hcv d+/r- kidney transplant.

Eligibility criteria:
recipient inclusion criteria: * participants ≥ 18 years old * on the deceased donor kidney waitlist at johns hopkins hospital * awaiting a first or second kidney transplant * no available living kidney donors * on hemodialysis or peritoneal dialysis or stage 5 chronic kidney disease (ckd) defined as a glomerular filtration rate \<15 ml/min for ≥ past 90 days * hcv-uninfected (by both antibody and rna pcr) and without any behavioral risk factors for contracting hcv other than being on hemodialysis * calculated panel reactive anti-human leukocyte antigens (anti-hla) antibody (flow cpra) below 80% recipient exclusion criteria: * plan to receive a multi-organ transplant * plan to receive a dual kidney transplant (including en bloc) * history of prior solid organ transplant other than first kidney transplant * participating in another study that involves an intervention or investigational product * plan to receive a blood type incompatible kidney * history of human immunodeficiency (hiv), hepatitis c (hcv), or active hepatitis b (hbv) infection, defined as being on active antiviral treatment for hbv, detectable hepatitis b surface ag or detectable hepatitis b dna * unable to safely substitute or discontinue a medication that is contraindicated with the study medication * psychiatric or physical illness that in the opinion of the investigator would make it unsafe to proceed with transplantation or interfere with the ability of the subject to participate in the study
discovering the effect of venous insufficiency on nocturia

Conditions: Nocturia; Venous Insufficiency of Leg; Fluid Overload

Summary: with this prospective controlled trial, we hope to obtain more information about the coexistence between venous insufficiency and nocturia. in our opinion, venous insufficiency (ceap 2-3a) leads to an increase in fluid accumulation in the lower limbs due to moving around all day. when laying down during nighttime, this fluid is reabsorbed into the systimic fluid pool, leading to an increase in diuresis and thus an increase in nocturnal voiding. aim of this study is observe difference in nocturnal frequency and urine production before and after surgical treatment of venous insufficiency.


Eligibility criteria:
inclusion criteria: * ceap 2 till 4a exclusion criteria: * bmi higher than 30 * previous surgery due to venous insufficiency at the lower limbs * cronic edema (cronic heart failure, liver cirrosis, nefrotic syndrome) * pregnant patient * patients on the following medication: calcium-antagonists, lithium, nsaid's or corticosteroids, glitazones, insuline, diuretics, sartans, ace-inhibitors, desmopressine,