Kornimate/medical-research-clean huggingface dataset:
attentional control training for treating alcohol use disorder

Conditions: Alcohol Use Disorder (AUD); Attentional Bias

Summary: background: there is consistent evidence that community and clinical samples of individuals with an alcohol use disorder (aud) have attentional biases toward alcohol cues. the alcohol attentional control training program (aactp) has shown promise for retraining these biases and decreasing alcohol consumption in community samples of excessive drinkers. however, there is a lack of evidence regarding the effectiveness of actp in clinical aud samples. the main aim of the present study is to investigate whether primary pharmacological and psychological, evidence-based alcohol treatment can be enhanced by the addition of a gamified aactp smartphone application for patients with an aud. design and methods: the study will be implemented as a randomized controlled trial. a total of 268 consecutively enrolled patients with aud will be recruited from alcohol outpatient clinics in denmark. patients will be randomized to one of three groups upon initiation of primary alcohol treatment: group a: a gamified aactp smartphone application + treatment as usual (tau); or group b: a gamified aactp sham-control application + tau. treatment outcomes will be assessed at baseline, post-treatment, and at 3- and 6-month follow-ups. repeated measures manova will be used to compare the trajectories of the groups over time on alcohol attentional bias, alcohol craving, and drinking reductions. it is hypothesized that group a will achieve better treatment outcomes than either group b. perspectives: because attentional bias for alcohol cues is proportional to the amount of alcohol consumed, and these biases are not addressed within current evidence-based treatment programs, this study is expected to provide new evidence regarding the effectiveness of the gamified aactp in a clinical population. furthermore, due to promising results found using aactp in community samples of excessive drinkers, there is a high probability that the aactp treatment in this study will also be effective, thereby allowing aactp to be readily implemented in clinical settings. finally, it is expected that this study will increase the effectiveness of evidence-based aud treatment and introduce a new, low-cost gamified treatment targeting patients with an aud. overall, this study is likely to have an impact at the scientific, clinical, and societal levels.


Eligibility criteria:
to be eligible to participate, patients must fulfill the following criteria. inclusion criteria: they must (1) sign written informed consent, (2) be between 18 and 65 years old (because the intervention is web-based), (3) be fluent in danish, (4) have completed detoxification (if deemed appropriate), (5) have been admitted to primary treatment within the past eight weeks. exclusion criteria: be color-blind, have a severe psychiatric or neurological illness (e.g., a psychotic disorder, intellectual disability, dementia) or terminal physical illness.

Keywords: cognitive bias attentional bias alcohol use disorder
oral hygiene with chlorhexidine and incidence of ventilator-associated pneumonia in children submitted to heart surgery

Conditions: Ventilator Associated Pneumonia; Nosocomial Pneumonia; Heart Surgery

Summary: hospital infections play an important role in the increase of patients' morbimortality and hospitalization costs, especially in the case of individuals admitted to intensive care units (icu) during postoperative heart surgery. analysis of the epidemiological profile of the hospital infections in the pediatric-icu (p-icu) of hospital das clínicas da faculdade de medicina de ribeirão preto, university of são paulo (hcfmrp-usp) demonstrated a 31.1% incidence of pneumonia (pnm) and a rate of ventilator-associated pneumonia (vap) of 23.81 per 1000 ventilators-day between march 2004 and february 2005 in the group submitted to cardiac surgery. knowledge of the pathophysiology and risk factors associated with this infection allows for measures aiming at reducing its incidence. the objective of the present study is to evaluate the effect of oral hygiene with a 0.12% chlorhexidine solution on the incidence of pnm and pav in children submitted to cardiac surgery.


Eligibility criteria:
inclusion criteria: * age 0 to 18 years submitted to heart surgery * parent approval exclusion criteria: * previous oral intubation * previous or present pneumonia * parent refusal * death during surgery

Keywords: chlorexidine ventilator-associated pneumonia nosocomial pneumonia heart surgery oral hygiene
ed90 of bupivacaine after lidocaine test dose with dpe and epl

Conditions: Labor Pain

Summary: the primary objective of our study is to use a biased coin up-down allocation methodology to estimate the dose of bupivacaine required after the lidocaine test dose to achieve initial effective comfort in 90% of patients (post test-dose ed90) via the epidural (dpe or epl) technique in women undergoing labor induction or augmentation; the investigators hypothesize that the investigators will be able to determine the post test-dose ed90 of bupivacaine for each technique with adequate precision to inform the optimal doses to study in a subsequent randomized trial comparing the analgesic effects of dpe vs. epl. the investigators also hypothesize that the post test-dose ed90 of bupivacaine is lower with a dpe technique than with a conventional epidural technique.

the investigators will be conducting a randomized controlled trial with patients randomized into either an epl or a dpe group. for the first subject in the dpe and epl techniques, the initial dose of bupivacaine 25 mg will be used, with an endpoint being the achievement of an nrs \< 3 at 30 min. subsequent patients are administered bupivacaine doses determined by the response of the previous subject, as per the biased coin method. the subsequent up and down interval doses are bupivacaine 2.5 mg (1 ml) increments. hence, if the first subject does not respond successfully, the dose for the second subject will be bupivacaine 27.5 mg. if the second subject does not respond successfully, the dose for the third subject will be bupivacaine 30 mg. by contrast, if a subject responds successfully, the bupivacaine dose will be decreased to 22.5 mg with a probability of 10% and maintained with a probability of 90% (ratio 1:9).

Eligibility criteria:
inclusion criteria: 1. parturient with no major co-morbidities 2. singleton, vertex gestation at term (37-42 weeks) 3. less than or equal to 5 cm dilation 4. desire to receive epidural labor analgesia 5. numerical rating scale greater than or equal to 5 (nrs 0-10, where 0 = no pain, and 10 = worst pain imaginable), at time of epidural labor analgesia request. exclusion criteria: 1. current or historical evidence of clinically significant disease or condition, including diseases of pregnancy (i.e., preeclampsia, gestational diabetes) 2. any contraindication to the administration of an epidural technique (e.g., thrombocytopenia, antiplatelet meds). 3. history of hypersensitivity or idiosyncratic reaction to an amide local anesthetic agent 4. evidence of anticipated fetal complications (i.e., fetal anomalies, iugr (intrauterine growth restriction), oligohydramnios, polyhydramnios)
comparing topical tetracaine drops to topical focal phenol for local anesthesia during intratympanic steroid injection

Conditions: Intratympanic Steroid Injection; Idiopathic Sudden Sensorineural Hearing Loss; Meniere Disease

Summary: intratympanic steroid injections are an accepted treatment for meniere's disease and idiopathic sudden sensorineural hearing loss. this treatment is typically performed using local topical anesthesia. there is very limited research on the differences of medications and application procedures effect on patients' pain during the procedure.topical tetracaine solution and topical phenol have been shown to be effective as local anesthesia for the tympanic membrane when used for myringotomy. currently there is no consensus on medication and technique however focally applied phenol is the more widely used technique. we believe this study can provide valuable information given the disadvantages of topical phenol including burning upon application as well as possible increase in persistent tympanic membrane perforation. the objectives are to determine the effectiveness of tetracaine drops for local anesthesia for intratympanic steroid injections compared to focal topical phenol application and to identify if tetracaine drops provides adequate anesthesia for intratympanic steroid injection with less pain on application than focal phenol.


Eligibility criteria:
inclusion criteria: * adult subjects (18 years of age or greater) * diagnosed with idiopathic sudden sensorineural hearing loss or meniere's disease * care plan includes treatment via intratympanic steroid injection exclusion criteria: * having a current tympanic membrane perforation * adults unable to sign written consent * individuals less than 18 years of age * pregnant women * prisoners
the influence of adjuvant medical treatment of peritoneal endometriosis on the outcome of ivf. a prospective randomized analysis.

Conditions: Infertility; Endometriosis

Summary: in this study of endometriosis patients we compare a common treatment of surgical therapy and medical treatment for 3 months (zoladex) with patients receiving only surgical therapy. in both cases they immediately start in vitro fertilization (ivf) treatment.


Eligibility criteria:
inclusion criteria: * laparoscopical vaporization of endometriosis * 1,2, 3e ivf cycle * endometriosis stage i and ii * younger than 38 years exclusion criteria: * endometriosis cysts * uterine pathology * endocrinological diseases and problems

Keywords: endometriosis pregnancy in vitro fertilization (ivf)/intra cytoplastic sperm injection (icsi) peritoneal implants embryo quality
scale up of project workout on wheels internet intervention (wowii)

Conditions: Spinal Cord Injuries

Summary: this study is designed is to test the feasibility, fidelity, and effectiveness of scaling up an evidence- and theory-based virtually delivered physical activity intervention (wowii) for individuals living with chronic sci for delivery through other rehabilitation settings. the study outcomes address (1) feasibility based on participant enrollment, retention, and program engagement; (2) fidelity of intervention delivery; and (3) program effectiveness based on subjective and objective exercise data, and participant exercise perceptions regarding self-efficacy and barriers.


Eligibility criteria:
inclusion criteria: * more than 12 months post sci * requires use of wheelchair due to sci * receive signed approval from medical provider to initiate moderate-intensity exercise program * have internet access via computer, tablet, or smartphone * provide informed consent exclusion criteria: * already engaged in engaged in sufficient physical activity to meet cdcp guidelines * cognitive of language impairments that would affect ability to participate * presence of medical issue for which exercise is contraindicated * pregnancy
ketogenic diet adjunctive to hd-mtx chemotherapy for primary central nervous system lymphoma

Conditions: Primary Central Nervous System Lymphoma

Summary: ketogenic diet has shown auxiliary effect on treatment of malignant tumors require high glucose consumption. this study is designed to evaluate the safety and efficacy of ketogenic diet adjunctive to high dose methotrexate(hd-mtx) chemotherapy for primary central nervous system lymphoma (pcnsl).

in a pilot study of primary central nervous system(cns) lymphoma patients, ketogenic diet was given in adjunction with standard hd-mtx chemotherapy as interventional group; standard hd-mtx is given with routine diet as control group. the primary endpoint is the safety of ketogenic diet in pcnsl patients receiving chemotherapy, secondary endpoints include rate of complete remission, remission time, rate of tumor relapse and overall survival.

Eligibility criteria:
inclusion criteria: 1. age 18-70 2. histopathologically confirmed pcnsl 3. no systemic involvement 4. ability and willingness to sign informed consent 5. normal liver and kidney function 6. karnofsky performance score of 60 or more exclusion criteria: 1. any systemic involvement of the tumor 2. systemic illness or medical condition may pose additional risk, including cardiac, metabolic or endocrine disorders; incompensated renal or liver disfunction; history of renal calculi, hyperuricemia, hyper calcemia, mitochondrial disease, known disorder of fatty acid metabolism, porphyria, carnitine deficiency and pancreatitis 3. uncontrolled hyperlipidemia or hyperglycemia 4. human immunodeficiency virus positive, or hepatitis c positive 5. pregnancy of breastfeeding 6. inability or unwillingness to give written informed consent.

Keywords: ketogenic diet primary central nervous system lymphoma chemotherapy
determinants of gestational weight gain in obese pregnant women

Conditions: Energy Intake; Energy Expenditure

Summary: the purpose of this study is to measure energy intake and energy expenditure during and after pregnancy. the investigators hypothesize that obese pregnant women with weight gain above the institute of medicine (iom) guidelines, 'high gainers', will have increased energy intake but no evidence for changes in energy expenditure after adjustment for the weight gained when compared to women with appropriate gestational weight gain, 'normal gainers'. additionally, the investigators will measure the babies born to the pregnant women enrolled in momee at one time point before 10 days of life.


Eligibility criteria:
inclusion criteria: * are pregnant * have a body mass index (bmi) greater than or equal to 30kg/m2 * are 18-40 years old * medically cleared for participation by primary care obstetrician * medically cleared for participant by medical investigator * willingness to allow the study access to information in the participant's medical record * willingness to be notified of incidental findings from study procedures exclusion criteria: clinical * hypertension (i.e. systolic blood pressure (sbp) \>160 mmhg \& diastolic blood pressure (dbp) \>110 mmhg)\* * diagnosis of diabetes prior to pregnancy * hb a1c ≥6.5 %\* * implanted metal objects that render mri unsafe * hiv or aids (self-reported) * severe anemia (hemoglobin \<8g/dl and/or hematocrit \<24%)\*\* psychological * history or current psychotic disorder or diagnosis of a current major depressive episode or bipolar disorder * past history of anorexia or bulimia by medical history or patient report (binge eating disorder is not an exclusion) or current eating disorder * actively suicidal defined as a value ≥2 on the beck depression index (bdi-ii) question 9\* medications * current use of one or more of the following medications: metformin, systemic steroids, antipsychotic agents (e.g., abilify, haldol, risperdal, seroquel, zyprexa), anti-seizure medications or mood stabilizers that would be expected to have a significant impact on body weight (e.g., depakote, lamictal, lithium, neurontin, tegretol, topamax, keppra), medications for attention-deficit/hyperactivity disorder (adhd) including amphetamines and methylphenidate * continued use of weight loss medication including over the counter (otc) and dietary supplements for weight loss (e.g., adipex, suprenza, tenuate, xenical, alli, conjugated linoleic acid, hoodia, green tea extract, guar gum, hydroxycut, sensa, corti-slim, chromium, chitosan, bitter orange) other exclusion criteria * recent history of or currently smoking, drinking alcohol or abusing drugs (prescription or recreational) * plans to move out of the study area within the next 2 years or plans to be out of the study area for more than 4 weeks in the next 12 months * planned termination of pregnancy * unwillingness to avoid pregnancy for 12 months following delivery * claustrophobia * prior or planned (within 1 year of expected delivery) bariatric surgery * participant's unwillingness or inability to commit to a 1 year follow-up

Keywords: pregnancy postpartum
the effects of using different anesthetics on the prognosis of primary lung tumors and its mechanism of action

Conditions: Lung Cancer; Progression, Disease; Anesthesia

Summary: this is a two-arm, parallel-group randomized clinical trial. routine perioperative care would be performed in volunteers with primary early lung cancer. the study will enroll approximately 300 volunteers to compare the progression-free or overall survival in patients undergoing video-assisted thoracoscopic surgery (vats) for primary lung tumors between propofol and sevoflurane for the maintenance of anesthesia.

before the scheduled procedure, the patients are randomly assigned into peopofol group or groups (1:1) according to the randomization generated by the computer. both groups were induced with propofol 1\~2.5 mg/kg propofol. the propofol group was maintained at an effect-site concentration of 2.0-4.0 mcg/ml by a target-controlled infusion system. the sevoflurane group was maintained via sevoflurane vaporizer between 1% and 3% (target minimum alveolar concentration of 0.7-1.3 mac). during the operation, the dose of anesthetic drugs (propofol/fentanyl /remifentanil and sevoflurane/cisatracurium/rocuronium) are adjusted to maintain the mean arterial pressure and heartbeat fluctuations within 20% of the baseline value and entropy (or bis) value at 40-60in both groups. the following patient data were recorded, the type of anesthesia, sex, age at the time of surgery, preoperative karnofsky performance status score and functional capacity, the postoperative complications within 30 days (according clavien-dindo classification), american society of anesthesiologists physical status scores, tumor size, intraoperative blood loss/transfusion, duration of surgery, duration of anesthesia, total opioid (remifentanil/fentanyl/ propofol) use, postoperative radiation therapy, postoperative chemotherapy, postoperative concurrent chemoradiotherapy, the presence of disease progression, and 6-month, 1-year, and 3-year overall survival and karnofsky performance status score were recorded.

Eligibility criteria:
inclusion criteria: * eighteen to eighty-year-old * asa class i-iii patients * received elective thoracic surgery for primary lung tumors under general anesthesia exclusion criteria: * mental disorder * poor liver function * pregnant or lactating women * morbidly obese * allergy to any of the drugs used in this study * recurrent tumor or repeat surgery * biopsy cases * incomplete outcome-data * palliative treatment after surgery * simultaneous treatment of other malignancies * emergency surgery * presence of other malignant tumors * combined propofol and inhalation anesthesia or other anesthetics, such as ketamine or dexmedetomidine * diagnosed as benign lung tumor, or other metastatic lung tumor

Keywords: propofol sevoflurane lung cancer vats
zinc dosing trial - does dose reduction reduce side effects but retain efficacy in diarrhoea management

Conditions: Diarrhea

Summary: diarrhoea continues to be a major cause of child deaths. current treatment of acute watery diarrhoea includes oral rehydration solution (ors), zinc and continued feeding. the use of zinc is based on a number of studies that showed that zinc reduces the duration and severity of diarrhoea. the recommended dose of zinc in 6-59 month old children is 20mg/day for 10-14 days. this dose is associated with an increased risk of vomiting. no dosing studies are available to determine the optimal dose of zinc, which while maintaining the benefits also has a low risk of vomiting. the investigators will conduct a double-blind randomized controlled trial of three doses of zinc (20mg/day, 10mg/day and 5mg/day) in two settings - one in sub-saharan africa and the other in south asia. the study population will be 4500 children with diarrhoea of less than 72 hours duration who are aged 6-59 months. they will be recruited from outpatient health facilities. all enrolled children will receive ors and continued feeding as recommended by the world health organization. those allocated to the standard zinc dose will receive an oral dispersible tablet with 20mg zinc daily for 14 days. those allocated to lower dose zinc will receive identical tablets with either 10mg or 5mg zinc daily for 14 days. enrolled children will be followed by until recovery from diarrhoea or 15 days after enrolment, whichever is later. in addition, study children will be assessed again at thirty (30), forty-five (45), and sixty (60) days to estimate impact on post illness outcomes. primary outcomes will be mean duration of diarrhoea, proportion of episodes that last longer than 5 days, mean number of stools and proportion of children with vomiting.


Eligibility criteria:
inclusion criteria: * 6 to 59 completed months of age * acute diarrhoea of less than 3 days at the time of screening or dysentery, defined as visible blood in the stool, of less than 3 days at the time of screening * likely to stay within the study area for the next 2 months * written informed consent from caretaker exclusion criteria: * presence of severe acute malnutrition (whz\<-3 or oedema) * presence of severe dehydration that cannot be corrected in 4 to 6 hours * signs of severe pneumonia (who definition of pneumonia with danger signs), sepsis, rapid diagnostic test (rdt) -confirmed malaria or other severe illness * previously or currently enrolled in the study * currently enrolled in another study * other child currently enrolled in the study in the same household * not intending to remain in study area for the duration of the study * parents refuse participation in the study
search for new genetic causes of hypercalcemia by massively parallel sequencing of a genes panel

Conditions: Hypercalcemia

Summary: hypercalcemia, whether chronic or acute, exposes the patient to potentially serious complications (arrhythmias, nephrolithiasis, nephrocalcinosis, ...). prevention relies primarily on effective etiological necessary for taking matched load. under the french reference center for rare disorders of calcium and phosphorus, the investigators looked for mutations in the coding sequence of the cyp24a1 gene (encoding the enzyme responsible for the breakdown of vitamin d), among patients with hypercalcemia without hyperparathyroidism with hypersensitivity to vitamin d. however, only 25% of these patients have a genetic anomaly suggesting the involvement of other genes (molin et al. 2015). recently our team, combined with kaufmann et al. (2014 jcem) validated the interest of the determination of metabolites of vitamin d by liquid chromatography-tandem mass spectrometry (lc-ms / ms), as biological pre-screening stage for patients with hypercalcemia. the objective of this project is to complement the molecular and biochemical studies of patients without mutation of the coding sequence of cyp24a1, in a gene candidate approach using massively parallel sequencing (mps) which allows to study a panel of gene potentially involved in disorder of metabolism of calcium and phosphorus. highlighted variations will be tested in silico, and if possible in vitro. the investigators will also use lc-ms / ms to evaluate in vivo the effects of these variations on the metabolism of vitamin d, to develop a genotype / phenotype correlation. the work carried out within the genetics department caen university hospital in collaboration with physicians of the rare disease reference center of the metabolism of calcium and phosphorus should identify new genetic mechanisms underlying hypercalcemia. at the time of development of personalized medicine, it will adapt the therapy in patients at risk for metabolic complications and / or kidney following administration of vitamin d and finally to offer genetic counseling.


Eligibility criteria:
inclusion criteria * chronic hypercalcemia or at least one episode of acute hypercalcemia not linked to hyperparathyroidism * consent to the realization of a genetic analysis for medical purposes non-inclusion criteria * another genetic disorder identified with hypercalcemia (eg williams-beuren syndrome) * primary hyperparathyroidism (high pth) * neoplasia * granulomatosis