Kornimate/medical-research-clean huggingface dataset:
buprenorphine and methadone for opioid dependent chronic pain patients

Conditions: Opiate Addiction

Summary: the purpose of this study is to determine if buprenorphine or methadone is better for the treatment of chronic pain among patients who have become addicted to prescription narcotics.

the purpose of this randomized clinical trial is to compare methadone with buprenorphine for the treatment of chronic pain among patients who have developed a physical dependence on prescription opiate analgesics that is associated with psychosocial dysfunction (i.e., addiction).

Eligibility criteria:
inclusion criteria: * chronic back pain * opioid addiction * not successful with abstinence * at least 18 years old * able to understand spoken english * live in western new york state (erie or niagara county) * have health insurance or ability to pay for health care * no methadone or buprenorphine treatment within past year * not member of a vulnerable population (e.g., pregnancy, prisoner) exclusion criteria: * homelessness * unable to give consent (e.g., dementia, psychosis) * serious heart or lung disease * taking a medication that could interact with methadone or buprenorphine * pregnancy

Keywords: opiate addiction narcotic addiction drug addiction pain
renal resistive index as a predictor of acute renal impairment in high-risk patients

Conditions: Acute Kidney Injury; Critical Illness

Summary: to study the ability of rri, measured by bedside doppler ultrasound, in detecting acute kidney injury in high-risk patients admitted to surgical intensive care unit, aswan university hospital, compared with renal biomarkers and conventional assessment using urine output and serum creatinine levels.

acute kidney injury (aki) is a common clinical problem encountered in critically ill patients, frequently in the setting of multiple organ failure, and is an independent risk factor for increase hospital stay and mortality risk. early-stage acute kidney injury was first assessed based on the risk, injury, failure, loss and end-stage (rifle) criteria in 2004, and then by the acute kidney injury network (akin) criteria in 2007. the kidney disease: improving global outcomes (kdigo) classification, based on both the akin and rifle criteria, was introduced in 2012, offering an assessment based on baseline creatinine and urine output. the best strategy in clinical practice is to identify aki as early as possible, reverse its cause, and even improve the sequelae. in the past decades, several serum creatinine (scr)-based classification systems have been proposed to define aki. the limitations of scr is that the determinants of scr (rate of production, apparent volume of distribution, and rate of elimination) are variable. therefore, there is an unmet need for other objective measures to help detect aki in a timely manner. the role of several biomarkers in the early prediction or risk assessment of aki has been proposed, including kidney tubular damage markers (e.g., neutrophil gelatinase-associated lipocalin (ngal), kidney injury molecule-1 (kim- 1), liver-type fatty acid-binding protein (l-fabp) and cystatin c). cystatin c is a protein from the family of cysteine proteinase inhibitors and is of interest as an early marker of decreased renal function. it is a protein that is synthesized at a constant rate by all cells containing nuclei, secreted into biological fluids: plasma, pleural, ascitic, cerebrospinal fluid, freely filtered through the glomerular membrane (due to its low molecular weight), fully metabolized in the kidneys, not secreted by the proximal renal tubules. renal resistive index (rri) is a noninvasive instrument to evaluate kidney hemodynamics, and it is obtained by analysis of intrarenal arterial waves using doppler ultrasound.

Eligibility criteria:
inclusion criteria: * patients with severe pre-eclampsia and eclampsia. * polytraumatized patients. * patients admitted to icu with sepsis. * both genders. * patients above 18 years. exclusion criteria: * patients known to have ckd. * patients with congenital renal anomalies. * patients with renal transplantation.

Keywords: renal resisitive index surgical icu cystatin c
sparebrain - mechanisms and prevention of secondary brain injury in subarachnoid haemorrhage

Conditions: Aneurysmal Subarachnoid Hemorrhage

Summary: subarachnoidal hemorrhage (sah) is a cause of long-term disability and death. annually about 1000 people in finland suffer from sah, their average age being under 50 years. sah has a mortality rate of 12 % acutely and 40 % of patients die within a month from admission to hospital. in addition, 30 % of the surviving patients remain with neurological deficits. most survivors of the primary insult suffer from secondary injury during the first 2-3 weeks from the insult. despite the advances in neurosurgical and -radiological techniques and intensive care, the mortality and morbidity rates in sah have not changed in recent years. there is still only limited understanding of the mechanisms of secondary insults causing brain injury after sah. in this study the investigators are aiming to clarify the timescale and mechanisms contributing to the secondary insults. the investigators also explore usability of novel biomarkers to guide treatment of the patients suffering from sah.

subarachnoidal hemorrhage (sah) is a cause of long-term disability and death. annually about 1000 people in finland suffer from sah, their average age being under 50 years. sah has a mortality rate of 12 % acutely and 40 % of patients die within a month from admission to hospital. in addition, 30 % of the surviving patients remain with neurological deficits. most survivors of the primary insult suffer from secondary injury during the first 2-3 weeks from the insult. despite the advances in neurosurgical and -radiological techniques and intensive care, the mortality and morbidity rates in sah have not changed in recent years. there is still only limited understanding of the mechanisms of secondary insults causing brain injury after sah. in this study the investigators are aiming to clarify the timescale and mechanisms contributing to the secondary insults. the investigators also explore usability of novel biomarkers to guide treatment of the patients suffering from sah.

Eligibility criteria:
inclusion criteria: * aneurysmal subarachnoid haemorrhage exclusion criteria: * age under 18 years * pregnant * moribund patient

Keywords: subrachnoid hemorrhage secondary brain injury
multi breath nitrogen washout (mbnw) as a measure of small airway function in patients with respiratory disease

Conditions: Cystic Fibrosis; Asthma; Bronchiolitis Obliterans; Lung Transplantation

Summary: the researchers are investigating a novel technique, the multi breath nitrogen washout technique, to measure airway changes in various respiratory diseases.

it is well documented that there are significant ventilatory changes in respiratory diseases such as cystic fibrosis, asthma and the onset of bronchiolitis obliterans syndrome (bos) following chronic rejection of lung transplantation. at present, we use measures such as spirometry and lung biopsies to determine the changes of airway function and disease severity. our aim is to develop a novel technique called the multi breath nitrogen washout (mbnw) which we believe is able to measure the inhomogeneity of ventilation in both the larger airways (conductive region, generation 1 - 16) as well as the smaller airways (acinar region 17 - 23). our belief is that these measurements are much more subtle than current techniques and will be more sensitive in measuring large and small airway changes in disease. the mbnw can also give us an insight as to which particular zones of the lung are affected in differing respiratory disease. for example, it is believed that bos begins at the distal portion of the lung (acinar region) and proceeds towards the proximal zone (conductive). however, at present no current techniques can differentiate between damage to the acinar zone and the conductive zone or indeed accurately measure small airway (acinar zone) function. we believe the the mbnw has the capacity to do so.

Eligibility criteria:
inclusion criteria: * doctor diagnosed cystic fibrosis, asthma * lung transplant recipient exclusion criteria: * smoke history of less than 10 pack years

Keywords: mbnw ventilation small airways lung transplant recipients (bronchiolitis obliterans syndrome)
induction of puberty with 17-beta estradiol in girls with turner syndrome

Conditions: Genetic Disorder; Turner Syndrome

Summary: this trial is conducted in europe. the aim of the trial is to induce normal pubertal development in girls with turner syndrome in accordance with that of their peers and their individual state psychosocial maturation.


Eligibility criteria:
inclusion criteria: * turner syndrome * treatment with growth hormone * bone age minimum 12 years and maximum 14 years * clear signs of ovarian insufficiency * well documented growth rate during the last 12 months exclusion criteria: * signs of spontaneous puberty * known or suspected hypersensitivity to trial product * acute or chronic liver disease * previous treatment with estrogen * undiagnosed abnormal genital bleeding * known thyroid diseases not adeadequately treated * porphyria
efficacy of prevention for postoperative nausea and vomiting after intrathecal morphine in cesarean section

Conditions: Pregnancy; PONV

Summary: post-operative nausea and vomiting are the major complications after spinal anesthesia with intrathecal morphine, therefore antiemetic drugs should be administered for best satisfaction of anesthesia to prevent these complication. furthermore, administration of a combination of antiemetic drugs with different mechanisms of action appears reasonable and synergistic effect of drugs. in conclusion, we study efficacy of antiemetic effect of single antiemetic drug compare with combination antiemetic drugs.

in this study : a randomized, double-blind, placebo-controlled, clinical trial comparing single doses of metoclopramide 10 mg and ondansetron 8 mg alone and a combination of dexamethasone 5 mg and metoclopramide 10 mg or a combination of dexamethasone 5 mg and ondansetron 8 mg for prevention of ponv after spinal morphine for cesarean section. inclusion criteria 1. patient undergoes elective cesarean section age more than 18 years 2. patient accepted in spinal anesthesia technique 3. asa classification i-ii 4. patient understand question and evaluation process exclusion criteria 1. hyperemesis gravidarum 2. patient with ongoing antiemetic drugs treatment 3. patient with history of drug allergy in metoclopramide,ondansetron and dexamethasone outcome measurement by oral interview and nurse notification in 24 hr. post-operatively. detail of outcome measurement 1. nausea and vomiting score 2. pain score 3. sedation score 4. itch symptom 5. patient satisfaction

Eligibility criteria:
inclusion criteria: * pregnancy patients undergo elective cesarean section age more than 18 years * patient accept spinal anesthesia technique * asa classification i-ii * patient understand question and evaluation process exclusion criteria: * hyperemesis gravidarum * patient ongoing treatment with antiemetic drugs * allergy to metoclopramide,ondansetron and dexamethasone

Keywords: intrathecal morphine cesarean section nausea and vomiting prevention
pulsed dye laser (pdl) vs. microsecond 1064-nm nd:yag laser for treatment of diffuse facial redness

Conditions: Rosacea

Summary: the primary objective of this study is to compare the efficacy of pdl and the 1064-nm nd:yag laser in the treatment of facial redness.


Eligibility criteria:
inclusion criteria: * healthy patients 18-55 years of age with erythematotelangiectatic rosacea (as verified by the the pi). * subjects who are willing to provide informed consent for participation in the study. exclusion criteria: * pregnant or lactating individuals * subjects who are unable to understand the protocol or to give informed consent. * subjects who have a known history of photosensitive conditions (e.g. systemic lupus, polymorphous light eruption) * subjects who have facial telangiectasia of diameter greater than 2 mm. * subject who have significant (as determined by the pi) acute inflammatory papules, pustules, and vesicle involving the central face.
renal denervation in patients with chronic heart failure & renal impairment clinical trial

Conditions: Heart Failure

Summary: this is a feasibility study enrolling up to 40 patients in australia and europe. the primary aim of the study is to demonstrate the renal denervation with the symplicity catheter is safe and determine the evidence of a response to renal denervation in patients with heart failure.


Eligibility criteria:
inclusion criteria: * heart failure patients nyha class ii or iii * renal impairment left ventricular ejection function \<40% * gfr 30 to 75 ml/min/1.73m2 * optimal stable medical therapy exclusion criteria: * renal artery anatomy must be eligible for treatment as determined by angiography, and * history of prior renal artery intervention * single functioning kidney. * myocardial infarction, unstable angina pectoris or cerebrovascular accident within 3 months * systolic bp \< 90 mmhg

Keywords: renal impairment
acceptance and commitment therapy (act) - based treatment development for cancer patients treated for pain

Conditions: Cancer

Summary: the purpose of this research study is to develop a psychological treatment for patients with cancer, focused on the psychological symptoms they experience during opioid therapy.

this research study is a treatment development study, which is the first time investigators are developing this psychological intervention in patients with cancer, on opioid therapy. this study is being conducted to develop a psychological intervention designed specifically for individuals with cancer. the purpose of this study is to determine how practical this intervention is, to determine patient satisfaction, and test the study procedures.

Eligibility criteria:
inclusion criteria: * must be at least 18 years of age * speak and comprehend english sufficiently to be able to complete the study procedures and participate in psychotherapy in english * have been diagnosed with cancer * have an estimated survival time ≥6 months (as approximated by palliative care clinic staff) * score ≥4 on the opioid risk tool (webster \& webster, 2005) with psychosocial distress as one of the positive items. exclusion criteria: * untreated bipolar disorder * untreated psychotic disorders * untreated borderline personality disorder * have an estimated survival time ≤6 months (as approximated by clinic staff).

Keywords: cancer
ejaculation preserving photoselective vaporization versus plasma kinetic vaporization versus transurethral resection of the prostate: a rct

Conditions: Ejaculation Abnormal; BPH With Urinary Obstruction; Prostatic Hyperplasia; Prostate Disease; Prostate Obstruction

Summary: to evaluate and compare the outcome and coast of ejaculation sparing management of bph using 3 different techniques: pvp, pkvp and turp. ejaculation sparing turp group is considered the standard control group. evaluation will be carried out through a prospective randomized powered trial


Eligibility criteria:
inclusion criteria: * 1. age \>50 years 2. prostate volume (measured by trus): 30-80 gm 3. international prostate symptom score (ipss )\>15 and quality of life score (qol)\< 3. 4. maximum flow rate of uroflometry \<10 ml/second 5. patients with active sexual life (or interested) and having the ability to ejaculate and desire to preserve ejaculation. 6. failure or intolerance to medical treatment, recurrent urinary infection, urine retention, significant hematuria or deterioration of the upper urinary tract function secondary to boo. exclusion criteria: 1. bleeding disorders and patients on anticoagulant treatment 2. histologically proved cancer prostate 3. neurogenic voiding dysfunction 4. lower urinary tract malignancy 5. preoperative ejaculation or sexual dysfunction 6. presence of stricture urethra 7. unfit for spinal anathesia -
18f fes-pet/mri for tailoring treatment of luminal a and lobular breast cancer

Conditions: Breast Cancer Female; Lobular Breast Carcinoma; PET/MRI; Axillary Lymphadenopathy; Luminal a Breast Cancer

Summary: study hypothesis is that combining the advantages of hybrid pet/mri and the high sensitivity/specificity of 16-alpha-18f-fluoro-17-beta-estradiol(fes), a radiolabeled form of estrogen binding to functionally active er, the investigators could obtain a reliable, non-invasive, operator-independent, one-stage imaging method for staging luma and er-positive lobular tumours.

this is a single-centre prospective cohort study where patients with luma and er-positive lob will be enrolled in 4 cohorts undergoing: primary surgery; induction endocrine therapy; neoadjuvant chemotherapy; systemic therapy for metastatic disease. for the purpose of the study an additional fes pet/mri exam will be performed at baseline for local and systemic staging and a second exam after systemic therapy. correlations between fes pet/mri parameters and pathology, gene expression and fdg pet parameters, when available, will be investigated. aim 1: evaluating the performance of fes pet/mri in axillary staging compared with axillary surgery. aim 2: evaluating potential correlations between changes in fes uptake and changes in proliferation index after 3 weeks of endocrine therapy before surgery. aim 3: evaluating the performance of fes pet/mri in staging of patients undergoing systemic therapy in comparison with standard imaging. additionally, biological determinants of tumor heterogeneity will be investigated.

Eligibility criteria:
inclusion criteria: * female patients, age\>= 18 yrs, diagnosed with primary or advanced breast cancer * luma or er-positive lobular subtypes cohort a * candidates to surgery as first treatment regardless of cn * er-positive her2 negative bc with ki67\>10% cohort b * er positive bc treated with induction et cohort c * candidates to neoadjuvant chemotherapy cohort d * metastatic luma or er-positive lob bc, at first diagnosis or in progression exclusion criteria: * er-negative tumors * pregnancy; * contraindication to pet; * contraindication to mri; * claustrophobia; * allergy to the mr contrast agent; * severe renal insufficiency
a study to assess the pharmacokinetics, safety, and efficacy of two doses of bimekizumab in adolescent study participants with moderate to severe plaque psoriasis

Conditions: Moderate to Severe Plaque Psoriasis

Summary: the purpose of the study is to assess th pharmacokinetics (pk) of bimekizumab administered subcutaneously (sc) in adolescents with moderate to severe plaque psoriasis (pso).


Eligibility criteria:
inclusion criteria: * participant must be ≥12 to less than 18 years of age at the time of signing the informed consent/assent according to local regulation * participant has had a diagnosis of moderate to severe plaque psoriasis (pso) for at least 3 months prior to the screening visit and: 1. body surface area (bsa) affected by pso ≥10% 2. investigator's global assessment (iga) score ≥3 (on a scale from 0 to 4) 3. psoriasis area and severity index (pasi) score ≥12 or 4. pasi score ≥10 plus at least 1 of the following: i. clinically relevant facial involvement ii. clinically relevant genital involvement iii. clinically relevant hand and foot involvement * participant must be candidate for systemic pso therapy and/or photo/chemotherapy * body weight ≥30 kg and body mass index for age percentile of ≥5 at baseline * male or female a female participant will be eligible to participate if she is not pregnant, not breastfeeding, and a woman of childbearing potential (wocbp) agrees to follow the contraceptive guidance * capable of giving/having parent(s) or legal representative provide signed informed consent/assent (where appropriate) exclusion criteria: * participant has a presence of guttate, inverse, pustular, or erythrodermic pso or other dermatological condition that may impact the clinical assessment of pso * participant has a history of inflammatory bowel disease (ibd) or symptoms suggestive of ibd * history of active tuberculosis unless successfully treated, latent tb unless prophylactically treated * participant has an active infection or history of infections (such as serious infection, chronic infections, opportunistic infections, unusually severe infections) * participant has laboratory abnormalities at screening * participant has experienced primary failure to one or more interleukin-17 (il-17) biologic response modifier or primary failure to more than 1 biologic response modifier other than an il-17 biologic response modifier * presence of active suicidal ideation, or positive suicide behavior * participant has been diagnosed with severe depression in the past 6 months

Keywords: bimekizumab bkz adolescent study participants psoriasis pso
educational intervention in increasing knowledge about prostate cancer in high-risk neighborhoods

Conditions: Prostate

Summary: this clinical trial studies how well an educational intervention works in increasing knowledge about prostate cancer in high-risk neighborhoods. learning about prostate cancer and the pros and cons of screening for prostate cancer may increase knowledge about prostate cancer while decreasing anxiety and concerns about prostate cancer screening.

primary objectives: i. to identify neighborhoods with disproportionately high rates of advanced prostate cancer and describe patient- and neighborhood-level risk factors associated with the high-risk neighborhoods. ii. to develop, using a mixed methods approach, a targeted educational intervention about prostate cancer for men who live in high risk neighborhoods. iii. to test the impact of the targeted intervention on levels of knowledge, anxiety, and informed decision making about prostate cancer (pca) screening. iv. to observe the rates of pca screening in the intervention and control groups.

Eligibility criteria:
inclusion criteria: * focus groups consisting of men who live, work, or worship in the 4 predetermined neighborhoods * currently reside in one of the four selected high risk neighborhoods exclusion criteria: • men who do not reside in one of the four neighborhoods, who self-report that they have previously been diagnosed with prostate cancer, or who have had prostate cancer screening (prostatic specific antigen \[psa\] or digital rectal examination \[dre\]) within the past 12 months