Kornimate/medical-research-clean huggingface dataset:
the effects of hyperventilation prior to co2 insufflation during laparoscopic cholecystectomy

Conditions: Laparoscopic Cholecystectomy

Summary: the investigators postulated that the use of hyperventilation after induction of anesthesia before co2 insufflation for laparoscopic surgery in trendelenburg position would maintain normocapnia and reduce the hemodynamic percussion response of co2 insufflation.

the use of laparoscopic techniques has become common in clinical practice. absorption of carbon dioxide (co2) from the peritoneal cavity is the potential mechanism for hypercapnia and a rise in the end-tidal carbon dioxide (etco2). mild hypercarbia causes sympathetic stimulation which results in a fivefold increase in arginine vasopressin (avp), tachycardia, increased systemic vascular resistance, systemic arterial pressure, central venous pressure and cardiac output.1 severe hypercarbia exerts a negative inotropic effect on the heart and reduces left ventricular function.2 hemodynamic alterations occur only when the paco2 is increased by 30 per cent above the normal levels. clearance of co2 is a function of the adequacy of alveolar ventilation with respect to pulmonary perfusion. controlled hyperventilation has proved to be superior over spontaneous respiration or controlled normo-ventilation for maintaining normal pco2 during laparoscopy. during pelvic laparoscopy there was a rapid rise of about 30% in the co2 load eliminated by the lungs. this quickly reached a plateau and could be compensated by hyperventilation of the lungs with a 30% increase in minute ventilation. papadimitriou and co' workers concluded that under sevoflurane anesthesia mac, prophylactic hyperventilation to ensure mild hypocapnia, (around 33 mmhg) limits the cerebral blood flow velocities enhancing effect of co2 insufflation, compared with permissive hypercapnia (up to 45 mmhg), during gynecological laparoscopies. however, others advocated that hyperventilation and the head-up position before co2 insufflation are not sufficient to prevent the co2-mediated cerebral hemodynamic effects of low-pressure pneumoperitoneum (5-8 mmhg) in children, underwent laparoscopic fundoplication.

Eligibility criteria:
inclusion criteria: * asa i \& ii * aged 18-45 years * undergoing elective laparoscopic cholecystectomy exclusion criteria: * history of cardiovascular disease * respiratory diseases * neurological disease * renal disease * liver disease * hormonal disease * pregnancy * obesity (defined as a body mass index\> 29) * smokers

Keywords: anaesthesia laparoscopic cholecystectomy co2 insufflation hemodynamic hyperventilation
combined prostate-specific antigen, multi-parametric mri and targeted prostate biopsy for prostate cancer screening

Conditions: Prostate Cancer

Summary: the study aims to investigate the incidence of prostate cancer among males in nanjing and whether a combination of psa, multi-parametric mri and targeted biopsy is a feasible approach for screening prostate cancer in china.

the investigators are going to collect serum samples and clinical information from men aged ≥50 years taking physical examination in community health service centers in nanjing. the investigators will propose mpmri for those with serum psa ≥4 ng/ml. transperineal systematic biopsy (tpsb) combined with mri /ultrasound fusion targeted biopsy (tb) will be offered for those scored ≥3 on the prostate imaging-reporting and data system version 2 (pi-rads v2). tpsb alone will be offered for those scored \<3 and serum psa ≥10 ng/ml. subjects with serum psa between 4 ng/ml and 10 ng/ml and pi-rads score \<3 points will be referred to follow-up examinations every 6 months.

Eligibility criteria:
inclusion criteria: * age ≥ 50 * (eastern cooperative oncology group)ecog grade: 0-1 * normal organic function indexes: * (absolute neutrophil count)anc ≧1.5×109/l * (platelet count)plt ≧100×109/l * hb ≧90 g/l * (total bilirubin)tbil ≦1.5×uln * (aspartate aminotransferase)alt≦2.5×uln * (alanine aminotransferase)ast ≦2.5×uln * (blood urea nitrogen)bun (orurea) and cr ≦1.5×uln exclusion criteria: * former serum psa detection * having took proscar in the past 3 months * suffered from any other malignant tumor in the past 5 years * history of acute urinary retention, acute or chronic bacterial or abacterial prostatitis within 6 weeks or other recent infection of the urinary system * having took proscar in the past 3 months * suffered from any other malignant tumor in the past 5 years * history of acute urinary retention, acute or chronic bacterial or abacterial prostatitis within 6 weeks or other recent infection of the urinary system
interval inspiratory training and aerobic exercise for muscle recovery in myasthenia gravis post-hospitalization

Conditions: Myasthenia Gravis

Summary: the goal of this clinical trial is to determine whether inspiratory muscle training aids in the recovery of respiratory muscle strength and helps prevent further muscle weakness in patients with myasthenia gravis. the primary research questions are: does inspiratory muscle training enhance respiratory muscle strength recovery? does the intervention lead to improved lung volumes? participants underwent daily inspiratory muscle training and aerobic exercise for six consecutive weeks.

patients with myasthenia gravis who experience acute exacerbations requiring hospitalization often suffer a significant decline in muscle strength, followed by partial recovery after the acute phase. this randomized controlled trial aims to evaluate the potential of early inspiratory muscle training and aerobic exercise in promoting muscle strength recovery and preventing further weakness. the study will assess differences in lung function, respiratory muscle strength, and dyspnea levels following the intervention after patients are discharged from the hospital post-acute exacerbation.

Eligibility criteria:
inclusion criteria: * hospitalized due to a myasthenia gravis crisis * cleared for discharge from the hospital * capable of completing six weeks of home-based respiratory muscle and exercise training exclusion criteria: * myasthenia gravis foundation of america (mgfa) classification i or v * presence of concurrent heart, kidney, liver, or metabolic diseases, or malignant tumors * ability to follow exercise instructions * new york heart association (nyha) class iii/iv * pulmonary disease (fev1/fvc ratio \&lt; 0.7 and fev1 \&lt; 50% predicted)

Keywords: myasthenia gravis inspiratory muscle training respiratory muscle strength spirometery
a phase iii study to evaluate efficacy and safety of first-line treatment with hlx10 + chemotherapy in patients with advanced cervical cancer

Conditions: Cervical Cancer

Summary: the purpose of this study is to assess the efficacy and safety of hlx10(recombinant anti-pd-1 humanized monoclonal antibody injection) plus chemotherapy compared to the efficacy and safety of placebo plus chemotherapy in the treatment of adult women with persistent, recurrent, or metastatic cervical cancer. chemotherapy regimens include: paclitaxel plus cisplatin and paclitaxel plus carboplatin. the primary study hypotheses are that the combination of hlx10 plus chemotherapy is superior to placebo plus chemotherapy with respect to: 1) progression-free survival (pfs) per response evaluation criteria in solid tumors (recist 1.1) as assessed by the irrc or, 2) overall survival (os).


Eligibility criteria:
inclusion criteria: 1. has persistent, recurrent, or metastatic squamous cell carcinoma, adenosquamous carcinoma, or adenocarcinoma of the cervix which has not been treated with systemic chemotherapy and is not amenable to curative treatment (such as with surgery and/or radiation) 2. cps≥1 3. has measurable disease per recist 1.1 as assessed by irrc 4. has an eastern cooperative oncology group (ecog) performance status of 0 to 1 within 14 days prior to randomization 5. has adequate organ function exclusion criteria: 1. has known active central nervous system (cns) metastases and/or carcinomatous meningitis. 2. has a known additional malignancy that is progressing or has required active treatment within the past 2 years. 3. has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis 4. has an active infection requiring systemic therapy 5. has a known history of human immunodeficiency virus (hiv) infection 6. has received prior therapy with an anti-pd-1, anti-pd-l1 or with an agent directed to another stimulatory or co-inhibitory t-cell receptor (e.g. ctla-4）
psychological distress in emerging adulthood: a longitudinal study

Conditions: Psychological Distress

Summary: emerging adulthood (18-29 years) is a critical stage in lifespan development. during this stage, people experience instability: shifts from their families of origin, breakups of relationships and job changes are frequent before most young adults stabilize their lives and make more lasting decisions. this study seeks to understand the psychological distress of emerging adults in quito, ecuador and define how it varies over a year.

emerging adulthood is often a period of some instability with relationship changes and often a series of job changes before life trajectories clarify and more lasting decisions are possible. these changes often produce distress and they might explain why most of the symptoms that impact the individual's mental health throughout their lives appear at this stage, although full-blown disorders are often only diagnosed subsequently. there are several studies that describe the prevalence of mental disorders in this age group, however, there are few studies that refer to how psychological distress changes during this phase of emotional, social, and financial instability. the few existent studies refer mostly to college student populations, with relative neglect of the non-student populations. the objective of this study is to analyze the intraindividual changes in psychological distress of emerging adults over one year. these changes will be compared between those participants who are college students and those who are not. sociodemographic data will be recorded in the first assessment and the last assessment, while psychological distress and health-related quality of life will be monitored bimonthly for seven assessment points in total. everyday relevant events will be also recorded bimonthly for seven assessment points, and this information will be used as a time-varying covariate. an electronic survey will be used for data collection through formr system (https://formr.org/). the results of this research will show if the distress changes significantly in the studied population for one year and it will be possible to identify some of the events and variables that are related to these changes. this knowledge might help to create interventions that are tailored to the needs of this population.

Eligibility criteria:
inclusion criteria: * competence to read and understand spanish * living in ecuador * being a student (for the student cohort) * not attending to a formal student program (for the non-student cohort) exclusion criteria: * none

Keywords: young adult life change events students mental health observational study longitudinal studies surveys and questionnaires self report
communityrx-dementia

Conditions: Health Related Social Needs (HRSN)

Summary: caregivers of home-dwelling people with alzheimer's disease and related dementias (adrd) are one of the most rapidly growing populations in the united states. among adrd caregivers with unmet health-related social needs, this study aims to evaluate the effects of the crx-d intervention versus usual care on caregiver self-efficacy.

the crx-d intervention is a caregiver-centered adaptation of communityrx (crx), an information-based intervention that systematically matches people to nearby community resources for health-related social needs. we are conducting a single-blind randomized controlled trial and enrolling caregivers through uchicago-affiliated clinic sites. caregivers will be screened and asked about unmet health-related social needs at the outpatient visit. eligible, self-identified caregivers will complete an in-person baseline survey on-site (face to face), followed by phone surveys at 7, 30, 90 days, and 12 months. caregivers randomized to the intervention will receive tailored information on community resources for their identified health-related social needs. they will also be given access to an online community-resource tool and shown how to use it, so they can search for additional resources in their community beyond the point-of-care and outside of the clinic. all caregivers (regardless of research arm) will also receive a series of text messages related to the study such as reminders to schedule the phone survey with a member of the research team. the anticipated sample (n=414) includes pretest participants (n=20), rct participants enrolled in the 12-month rct (n=344) and additional men caregivers enrolled in a 3-month rct (n=50).

Eligibility criteria:
inclusion criteria: * resides in the target geographic region of the study (living in 1 of the 35 target zip codes) * self-identifies as a caregiver of a home-dwelling person with alzheimer's disease or related dementia using an adaptation of the brfss caregiver module * has access to a cell phone and provides the research interviewer with the cell phone number * agrees to receive text messages from the study * has a personal email address. * self-report their gender identity to be male or trans male/trans man (only for additional 50 caregivers enrolled in the 3-month rct) exclusion criteria: * past enrollment in the communityrx-c study * recollection of previous receipt of a healtherx

Keywords: caregivers dementia information-sharing alzheimer's disease caregiving community resources
nutrition knowledge for spanish-speaking parents

Conditions: Obesity; Dental Caries

Summary: providing child nutrition information is a major goal of every pediatric well-child visit. unfortunately, due to a wide array of issues, doing this effectively during clinic visits is challenging and insufficient. it is because of this that some have looked for innovative ways to enhance the delivery of this information. one such way is the use of touch screen computer programs containing nutritional information. several studies have documented the value of patients receiving health information in such a manner. nonetheless, the use of this medium has not been well studied in spanish-speaking care providers of young children. the investigators recently conducted a study that evaluated user's perception of the usability of such technology, finding that most users thought that the touchscreen was easy to use, despite their low computer confidence levels. the investigators also evaluated the impact of using nutrition modules on user's nutrition knowledge, finding that immediately after use; participant's nutrition knowledge was improved. i now propose to evaluate this technology further through a 4 armed randomized controlled trial. the goal here is to evaluate the longer term impact of the educational modules on nutrition knowledge and the impact, if any, of additional web access to the modules, on longer term knowledge. a secondary goal is to better understand nutritional habits in this population and perceptions of weight.


Eligibility criteria:
inclusion criteria: * self identify as latino/a * spanish-speaking * over 18 years old * primary caregiver to a child 2 years old and under exclusion criteria: * child 2 years old and under has significant medical issue requiring special nutrition needs, e.g. g-tube or feeding tube dependent, severe food allergies. * person has used the nutrition modules before in prior studies
implementation trial to evaluate a population health combination intervention to meet hiv testing, linkage, and viral suppression goals in alabama

Conditions: HIV; HIV Linkage to Care; HIV Testing; HIV Treatment

Summary: the purpose of this study is to adapt and evaluate a combination intervention that includes: (1) a data-driven approach to directed community-based hiv testing to areas with high need, (2) project connect to expedite linkage to care at time of diagnosis, (3) and a rapid art (antiretroviral therapy)start program, all in mobile county health department (mchd) jurisdictions in alabama.

aim 1. adapt and integrate coast-al using a pre-implementation formative assessment guided by the cfir. in-depth interviews and clinic observations with community clinic providers, clinic administrators, and mchd and alabama department of public health (adph) officials will inform targeted community-based testing, linkage through project connect, and rapid start into existing work flows (inner setting, process), identify opportunities to use publicly available data to inform testing outreach (outer setting), and explore provider attitudes towards rapid start (individuals). aim 2. assess the clinical and implementation effectiveness of coast-al in six al counties served by mchd. using re-aim, the investigators will evaluate the effects of coast-al on clinical and implementation outcomes on progress towards ehe goals. the primary clinical effectiveness outcome is days to viral suppression (vs) for new hiv diagnoses. the primary implementation outcome is the proportion of zip code tabulation areas with at least 15% of adult population tested for hiv (reach). aim 3. utilize a community-academic partnership to identify implementation strategies to support maintenance and future dissemination of coast-al. using interviews, concept mapping, and nominal group techniques to inform implementation mapping, the investigators will work collaboratively with local and state health department stakeholders to identify and prioritize implementation strategies to sustain and implement coast-al in other health departments across al and rural ehe(ending the epidemic)-focus states.

Eligibility criteria:
inclusion criteria: * aim 1 \& 3: * fit into one of the following categories: 1) mchd leadership, 2) adph leadership, 3) clinic administrators, 4) outreach testing specialists, 5) linkage coordinators and community health workers, 6) physicians, 7) nurses, 8) counselors all working at hiv care facilities in the six mchd jurisdiction counties. * over the age of 18 years old. aim 2: (idis) * over the age of 13 years old * tested for hiv in mchd jurisdiction from time of coastal implementation to 36 months post-implementation start date. exclusion criteria: * exclusion criteria include unwillingness or inability to provide informed consent.
safety and preliminary efficacy of the malaria vaccine candidates falciparum merozoite protein-1 (fmp1) and smithklinebeecham (skbb) candidate malaria vaccine rts,s

Conditions: Malaria, Falciparum

Summary: the purpose of this study is to see if two new malaria vaccines called fmp1 and rtss, combined with an adjuvant (called sbas2) which helps stimulate the body's immune system, are safe, demonstrate an immune response through blood tests, and lastly, to see if the vaccines can prevent malaria infection. the rts,s vaccine contains a malaria protein in combination with a portion of the commercially available hepatitis b vaccine. the fmp1 vaccine also contains a malaria protein. the adjuvant called sbas2, is a special oil in water emulsion. vaccinations are done at study days 0, 28 and 84, followed by a malaria challenge approximately 14 days after the 3rd vaccination.


Eligibility criteria:
inclusion criteria: * healthy adult, 18-45 * available for duration of study (9 months) * written informed consent prior to any study procedures exclusion criteria: * prior receipt of an investigational malaria vaccine or one containing mpl or qs-21 * use of any investigational or non-registered drug/vaccine or planned administration of vaccine not foreseen by study protocol; each issue within 30 days preceding the first dose of study vaccine * administration of chronic immunosuppressants * chronic use of antibiotics * history of malaria ever, or use of malaria chemoprophylaxis within 60 days prior to vaccination * known exposure to malaria within the past 12 months or planned travel to malarious area during the study period * confirmed or suspected immunosuppressive or immunodeficient condition * family history of congenital or hereditary immunodeficiency * history of allergic disease or reactions likely to be exacerbated by any component of the vaccine * chronic or active neurologic disease including seizures * history of splenectomy * seropositive for hepatitis b or hepatitis c or human immunodeficiency virus (hiv), or other abnormal labs such as significant anemia, elevated creatinine * hepatomegaly, or right upper quadrant abdominal pain * pregnant or lactating female * chronic or active drug or alcohol use * history of severe reactions to mosquito bites * any history of anaphylaxis to vaccinations

Keywords: p. falciparum vaccine healthy volunteers
evaluation of the implementation of the pharmacogenetics and personalized medicine program "medea" in the extremadura health service.

Conditions: Adverse Drug Event

Summary: an open longitudinal observational study, non-randomized, which will include the adult population, attended by the ses, in which preference will be given to those patients under treatment with drugs that can produce relevant adverse effects. it is a naturalistic study in which no pharmacological or other type of intervention will be carried out, only the information recommended in the drug data sheet (pharmacogenetic biomarkers, relevant interactions and clinical contraindications) will be provided.


Eligibility criteria:
inclusion criteria: patients with a recent diagnosis and who are to be or are being treated according to usual clinical practice, who meet the criteria to participate in the study, read the corresponding information sheet, sign informed consent and agree to participate, provided they meet the following inclusion criteria: general criteria for all patients: * age ≥ 18 years. in case of minors, they may be included, under the following assumptions: * if the minor is under 12 years of age, participation will require the consent and signature of the informed consent document by both parents (or their guardian). * if the minor is between 12 and 16 years of age, a proxy informed consent form will be provided and signed by both parents (if both parents are present at the time of the interview) or only one of them (in which case one of the following two conditions must be stated: that the other parent is not present at the time of the interview but does not object to the participation of the minor in the study or that the signatory is the sole legal guardian of the minor). * be registered or potentially/have been attended in the extremadura health service. * not have language or communication barrier or present disability being totally dependent on another person. exclusion criteria: * failure to meet any of the inclusion criteria described above. * refusal by the patient to be part of the cohort initially, or to continue to be part of the cohort during follow-up. * manifest difficulty for follow-up.
rollover study of weekly paclitaxel (bms-181339) in patients with advanced breast cancer

Conditions: Breast Cancer

Summary: the purpose of this study is to evaluate the safety and efficacy of continued administration of paclitaxel given weekly in subjects considered to need to continue treatment after completion of the preceding "phase ii clinical study of weekly paclitaxel (bms-181339) with advanced breast cancer (protocol no. ca139-371)"


Eligibility criteria:
inclusion criteria: * subjects who were confirmed to have a response after receiving at least two courses of weekly paclitaxel therapy and considered to need to continue the therapy by the investigator/subinvestigator among the patients with advanced or recurrent breast cancer who had met the selection criteria and participated in the preceding phase ii clinical study