Kornimate/medical-research-clean huggingface dataset:
outcome and predictors of mortality of patients on prolonged mechanical ventilation

Conditions: Outcome

Summary: prolonged mechanical ventilation (pmv) and weaning failure are factors associated with prolonged hospital length of stay and increased morbidity and mortality. in addition to the individual challenges that stress patients and their families, the resource-intensive care these patients receive places a significant burden on the public health system. these burdens often persist over the long term, especially in the case of weaning failure with subsequent home mechanical ventilation (hmv). this study will provide invaluable and in-depth knowledge of major sources of admission to icu and will clarify the cause for the outcomes seen after prolonged mechanical ventilation in icu admission, at dessie comprehensive hospital, the result of our study will also serve as a source or baseline information for future valuable researches to be undergone around the subject of interest.

the number of patients requiring prolonged mechanical ventilation after acute illness is increasing. their long-term outcome is poor and has not improved significantly over the past 20 years. the symptom burden for patients is considerable, and family members often suffer from significant physical and emotional strain. long-term survivors report lasting physical limitations, but their emotional health is generally good. care for many patients requiring prolonged mechanical ventilation is shifting t post-intensive care unit settings. while this trend has resulted in cost savings for hospitals and payers, it has not had a major impact on patient outcomes. patients requiring prolonged mechanical ventilation consume a disproportionate amount of healthcare resources and clinician time. measurement and knowledge of their outcomes will guide efforts to improve their care. this study will be conducted in dessie comprehensive specialized hospital from august 2023 to january 2024. a retrospective cohort study will be conducted. data will be checked, coded, entered, and analyzed using spss version 22 software. descriptive statistics will be used to summarize data, tables, and figures for display results. bivariate and multivariate analyses will be used to see the effect of the independent variable on the outcome variable. variables that are significant on bivariate analysis at a p-value less than 0.2 will be taken to multivariate analysis. in multivariate analysis, a p-value of less than 0.05 will be used as a cut-off point for the presence of association. the strength of the association will be measured by 95% confidence interval and odd ratio.

Eligibility criteria:
inclusion criteria: * all charts of critically ill patients on prolonged mechanical ventilation in of dessie comprehensive specialized hospital during the study period. exclusion criteria: * charts with incomplete information and missing values as well as those that are not available will be excluded from the study.
bariatric electrical impedance tomography

Conditions: Anesthesia

Summary: this study investigates under controlled conditions the variation of poorly ventilated lung units (silent spaces) in obese patients scheduled for laparoscopic bariatric surgery in the perioperative phase.

eligible patients with written informed consent, scheduled for laparoscopic bariatric surgery. as for standard of care no premedication will be given for bariatric patients. patients will be monitored according the local standard. thoracic electrical impedance tomography measurements (each measurement will last 1 min) will be performed at the following time points: before induction of the anaesthesia; before the surgical procedure when the induction is terminated and recruitment manoeuvers have been performed; after the termination of the surgical procedure; before transport to the post anaesthesia care unit (pacu); before the discharge from the pacu after 2 hours of monitoring. an additional thoracic electrical impedance tomography measurement (duration 1 min) will be performed before discharge at home. for this, resulting potential differences are measured, and impedance distribution sampled at 30 hz will be calculated by an automated linearized newton-raphson reconstruction algorithm. relative change in poorly ventilated lung regions (silent spaces) and end-expiratory lung impedance (eeli) and measures of ventilation inhomogeneity such as the global inhomogeneity index will be calculated.

Eligibility criteria:
inclusion criteria: * bmi \>40 * asa physical status 1 to 4 * over 18 years of age providing written informed consent exclusion criteria: * bmi \<40 * known severe pulmonary hypertension, * need of home oxygen therapy * known heart failure * suspected, or known recent pulmonal infections

Keywords: bariatric obese laparoscopic electrical impedance tomography
adenotonsillectomy and obstructive sleep apnea study

Conditions: Adenotonsillectomy

Summary: adenotonsillectomies are one of the most common childhood surgeries and are first-line treatment to correct childhood obstructive sleep apnea syndrome (osas). this is a study comparing patients with and without osa looking at the length of stay following adenotonsillectomy and the factors affecting length of stay.


Eligibility criteria:
inclusion criteria: 1. history of snoring/gasping/ or pause in breathing reported by caregivers. 2. age 3-6 years old 3. undergoing adenotonsillectomy only no concurrent surgery 4. scheduled as outpatient and plan for discharge home exclusion criteria: 1. preoperatively requiring additional respiratory support 2. scheduled for concurrent surgery that could increase total general anesthetic time 3. recurrent adenotonsillitis as sole indication for surgery
spinal cord stimulation combined with exercise in persistent spinal pain syndrome

Conditions: Failed Back Surgery Syndrome

Summary: introduction. at the neurophysiological level, it is possible to observe an increase in the central processing of pain in patients diagnosed with persistent spinal pain syndrome (psps-t1/2), potentially stemming from dysfunctions in the endogenous facilitation and inhibition of pain. administration of high doses of spinal cord stimulation to individuals with psps-t1/2 may induce supraspinal descending activation. similarly, exercise is recognized as a fundamental aspect of spinal pain management. studies have demonstrated its impact on neurophysiological factors, including the release of spinal and supraspinal beta-endorphins, which activate μ-opioid receptors. therefore, the purpose of this study will be to examine the effect of scs in combination with lumbo-pelvic stability core training on perceived low back pain, quality of life and disability in failed back surgery syndrome (fbss) patients. methods/materials. a double-blind randomized clinical trial (rct) has been designed. all participants will be randomized from a pre-set sequence. the intervention design has been elaborated from the consort guidelines. this study protocol has been approved by the ethics committee in research of salamanca health area (protocol number pi 2023 101435 in (24/01/2024) in accordance with the ethical guidelines of the helsinki declaration. sample size was calculated using g power® sample size software (university of düsseldorf). the calculation was based on a moderate effect size of 0.4 (partial η2 = 0.40, α = .05, power = 0.90), resulting in a total of 28 patients. assuming a 30% dropout rate, 36 participants will be recruited in total. two sessions per week will be scheduled for 8 weeks with a total of 16 sessions. each work session will have a duration of 60 minutes. the exercise will be adapted according to the phases based on the results already published, limiting in each phase the degrees of flexion and extension of the spine in order to avoid the risk of electrode migration. primary outcomes will be functionality, satisfaction, strength, psychosocial variables, quality of life and pain perception.


Eligibility criteria:
inclusion criteria: * have a diagnostic of psps-t1/2 with leg pain and back pain, * patients older than 18 years * 6 months with pain * visual analogue scale score \>7 * spanish native language exclusion criteria: * previous surgeries in abdominal area * pregnant or lactating * severe fractures or pathologies * spine structural deformity * neurologic or psychiatric issues.

Keywords: spinal cord stimulation exercise
efficacy of the triangle operation on clinical outcomes in patients with pancreatic cancer

Conditions: Hepato-Biliary Precancerous Condition

Summary: we aimed to analyze postoperative short-and long-terms clinical outcomes after the triangle procedure in patients with pancreatic head, periampullary and duodenal cancer.

after laparotomy and exploration of the abdominal cavity to rule out peritoneal or hepatic metastases, the initial steps of the operation were to determine if there was true arterial tumor infiltration, along the celiac artery, hepatic artery or superior mesenteric artery. to clarify this, an "arteryfirst" maneuver was performed. the strategy depended on the results of preoperative imaging defining the site of the most likely tumor infiltration. the sma was approached from a left-sided infracolic approach if tumors of the body or tail of the pancreas were suspected to infiltrate the artery from this direction or from a posterior approach in respective situations. once the arterial level of suspected attachment/encasement was reached, a frozen section was performed to confirm or exclude viable tumor tissue at this site. in case of remaining viable tumor, most patients will not qualify for further surgical therapy at this point. in contrast, if frozen section confirms fibrous tissue without viable tumor, this offers the possibility to perform a radical but artery-sparing procedure, all other surgical steps are carried out as usual during partial pancreatoduodenectomy (pd), distal (dp) or total pancreatectomy. anatomic triangle bordered by the sma, ca and pv confirming the complete removal of all soft tissue usually contained within these borders.

Eligibility criteria:
inclusion criteria: * no age restriction or gender exclusion, all diagnosed fit patients with pancreatic head, periampullary and duodenal cancer will be included. exclusion criteria: * unfit or inoperable patients will be excluded.
effect of sarcopenia on clinical outcome of total knee arthroplasty

Conditions: Knee Osteoarthritis

Summary: as human life expectancy increases, the prevalence of degenerative osteoarthritis of the knee joints is steadily rising, leading to a significant surge in the frequency of total knee arthroplasty (tka). however, research on sarcopenia in the population that comprises the primary recipients of these orthopedic joint surgeries has been notably lacking. since the release of the 2019 consensus update on sarcopenia by the asian walking group for sarcopenia (awgs) in 2020, research on sarcopenia has gained momentum in various domains. yet, as previously mentioned, the field of orthopedics still lags behind in investigating sarcopenia. therefore, it is believed that establishing the relationship between sarcopenia and surgical outcomes in the elderly, who are the primary targets of orthopedic joint replacement surgery, could offer insights to further enhance the results of joint replacement surgeries.


Eligibility criteria:
inclusion criteria: * a woman aged 60 or older who is undergoing tka due to degenerative osteoarthritis of the knee joint at the our institution. exclusion criteria: 1. male 2. under 60 years of age 3. patients with a history of rheumatoid arthritis, traumatic joint disease, and post-infection joint disease 4. patients who cannot undergo tests for muscle weakness diagnosis a. patients unable to walk b. patients unable to stand alone due to conditions like cerebral palsy or brain disorders c. patients unable to use muscle strength 5. patients considered inappropriate for recruitment in this study based on the judgment of the research team.
sleep hygiene and relaxation intervention to improve sleep and fatigue for children receiving maintenance chemotherapy

Conditions: Sleep; Fatigue; Acute Lymphoblastic Leukemia

Summary: this pilot randomized controlled trial examined the feasibility, acceptability and effectiveness of an intervention to improve sleep quality and decrease fatigue levels in children with a diagnosis of all, during maintenance treatment. families were randomized to usual care or the intervention. the intervention included a sleep hygiene and relaxation education session with a nurse practitioner, literature for home, two story books, and a follow-up phone call. self-reported measures were used in addition to actigraphy to measure children's quality and quantity of sleep.

sleep is an essential restorative function that promotes both physical and cognitive health. previous studies have demonstrated that children on acute lymphoblastic leukemia (all) maintenance therapy have problematic sleep patterns and experience fatigue. this pilot randomized controlled trial examined the feasibility, acceptability and effectiveness of an intervention to improve sleep quality and decrease fatigue levels in children aged 4-10, with a diagnosis of all, during maintenance treatment. families were randomized to usual care or the intervention. the intervention included a sleep hygiene and relaxation education session with a nurse practitioner, literature for home, two story books, and a follow-up phone call. self-reported measures were used in addition to actigraphy to measure children's quality and quantity of sleep. sleep tips were evaluated by intervention group families.

Eligibility criteria:
inclusion criteria: * child aged 4-10 with a diagnosis of precursor acute b lymphoblastic leukemia (b all) in maintenance phase of therapy beyond 3rd course (protocol aall0331) * child and parent able to understand and read english * child is within one year of age-appropriate grade in school exclusion criteria: * child who is receiving palliative care * child with diagnosis of depression * child who has been prescribed medications for insomnia * child who has a physician-diagnosed sleep disorder (e.g. narcolepsy, restless legs syndrome) * child who has received radiation therapy * child has potential sleep disordered breathing (measured by children's sleep habits questionnaire)

Keywords: sleep acute lymphoblastic leukemia fatigue sleep hygiene relaxation rct
tea and forearm blood flow

Conditions: Vascular Function

Summary: the study will explore the benefit of tea for microcirculation. subjects will consume tea ar a placebo matched for taste and appearance in a blinded cross over design.

epidemiological studies indicate that regular consumption of black tea reduces the risk of cardiovascular diseases. tea consumption can result in improvements in endothelial function of conduit arteries as measured by flow mediated dilation. less is known however about its effects in other vascular beds. the study will test the hypothesis that tea affects endothelial function in the muscle microcirculation. this will be done by assessment of forearm blood flow using venous occlusion plethysmography after consumption of black tea against or placebo in a randomised, full cross-over study in 20 healthy middle-aged to elderly subjects

Eligibility criteria:
inclusion criteria: * males and post menopausal (\> 1 years) females * aged ≥ 45 and ≤ 75 years * body mass index (bmi) of ≥ 18.0 and ≤ 35.0 kg/m2 * judged to be in good health on the basis of medical history, physical examination and routine laboratory tests (total cholesterol, hdl cholesterol, ldl cholesterol, triglycerides, glucose, highly sensitive c-reactive protein). * normal blood coagulation as assessed by routine lab tests exclusion criteria: * strenuous exercise \> 2 hours per week. strenuous exercise is defined as exercise which induces sweating and causes sufficient breathlessness to limit conversation * current smoker or has stopped smoking less than 6 months before start of study * self reported alcohol intake of \> 21 units/week) * established cardiovascular disease or clinically significant arrhythmia * diabetes mellitus * blood pressure \> 160/100 mmhg * taking medication that might affect endothelial function (as judged by the pi)
a study to evaluate the safety and efficacy of caelyx in combination with carboplatin in patients with ovarian cancer recurrent within six to twelve months after initial carboplatin and paclitaxel chemotherapy (p03625)

Conditions: Ovarian Neoplasms

Summary: doxorubicin has been used to treat ovarian cancer as part of different combination therapies, but high cumulative doses should be avoided because of the risk of cardiotoxicity. pegylated liposomal doxorubicin (caelyx) has been developed to reduce the risk of cardiotoxicity. the purpose of this study is to evaluate the safety and efficacy of caelyx in combination with carboplatin in women with recurrent ovarian cancer.


Eligibility criteria:
inclusion criteria: * age \>=18 years old * subject must have histological diagnosis of epithelial ovarian cancer * subject must have received a taxane and platinum regimen and have maintained a treatment-free status for at least six months and not more than twelve months following completion of first line therapy. * subject must have measurable ovarian cancer by appropriate radiological imaging. * ecog performance score of 0 or 1. * subject's life expectancy must be \> 6 months. * subject must have normal organ function, except if abnormal due to tumor involvement: * adequate bone marrow function (platelets \>=100 x 10\^9/l, hemoglobin \>=100 g/l, neutrophils \>=1.5 x 10\^9/l) * adequate renal function (serum creatinine\<=1.5 x the upper limit of normal (uln) * adequate liver function (bilirubin and ast or alt\<=2 times uln, unless related to primary disease. * muga scan must indicate left ventricular ejection fraction above 90%. * women of childbearing potential must be using adequate contraception (prescribed under medical supervision) and have a negative pregnancy test at the time of enrollment. * subject must be able to sign written informed consent. exclusion criteria: * subject who is pregnant or is breast feeding. * subject who has history of cardiac disease, with new york heart association class ii or greater. * subject with a history of severe hypersensitivity reactions to products containing cremophor® el. * subject with clinically significant hepatic disease. * subject who has uncontrolled bacterial, viral, or fungal infection. * subject who exhibits confusion or disorientation. * subject with any condition that would prevent adequate follow-up. * subject with a history of prior malignancy treated with systemic chemotherapy or radiotherapy. * subject who has received two or more prior chemotherapy regimens for ovarian cancer.
naltrexone in borderline personality disorder

Conditions: Borderline Personality Disorder

Summary: the purpose of this study is to investigate whether naltrexone reduces the intensity and duration of flashbacks and dissociative states in patients with borderline personality disorder.


Eligibility criteria:
inclusion criteria: * in- and outpatients:borderline personality disorder according to the diagnostic and statistical manual for mental disorders, 4.edition (dsm iv) * des-(dissociative experience scale)-score: \> or equal 18 according to amendment4 (former value according to amendment 2 was \> or equal 25). * urinary test of opiates negative * no psychopharmacological treatment for two weeks prior to study (fluoxetine four weeks) * no lithium for two months exclusion criteria: * lifetime diagnosis of psychotic disorder * current major depressive disorder (mdd) * lifetime diagnosis opioid dependence or current opioid abuse (10 to 7 days prior to study) * comedication with opioid analgetics * known naltrexone intolerance * liver disease * pregnancy and lactation period * other severe medical or neurological diseases * simultaneous participation in another study

Keywords: dissociation flashbacks self-injurious behavior
new csf biomarkers for alzheimer's disease

Conditions: Alzheimer Disease; Dementia; Neurodegenerative Diseases

Summary: today, the alzheimer's disease (ad) diagnosis is founded not only on clinical criteria but also on complementary examinations to confirm a physiopathological process of ad. in complex cases, lumbar punction could be necessary in order to measure aβ peptides and total and phosphorylated tau but new biomarkers could be useful. the main objective of this project is to conserve these cerebrospinal fluids, collected in usual practice in order to validate new biomarkers for diagnosis, prognosis or therapeutic following of alzheimer's disease and other dementia.


Eligibility criteria:
inclusion criteria: * lumbar punction collected in usual practice in the context of dementia diagnosis exclusion criteria: * absence of consent
randomized trial of telemedicine for diabetes care

Conditions: Diabetes Mellitus

Summary: the ideatel study is a multicenter randomized controlled trial to evaluate the efficacy, acceptability, and cost-effectiveness of telemedicine case management to provide diabetes care to elderly medicare beneficiaries residing in medically underserved areas of new york state.

the project is designed as a randomized controlled trial with approximately 750 subjects receiving a telemedicine intervention and approximately 750 receiving usual care. eligibility requires having diabetes, being a medicare beneficiary, and living in a medically underserved area. the project is conducted in new york city, in northern manhattan (urban component), and in rural upstate new york through a consortion of participating institutions based at the state university of new york (suny) upstate medical university at syracuse (rural component). subjects are randomized to receive telemedicine case management or usual care for diabetes. the intervention utilizes a home telemedicine unit (htu). the htu is a specially designed, web-enabled device with a data port connected to a home glucometer and home blood pressure cuff whereby measurements obtained with these devices can be directly uploaded to a computer database. a diabetes nurse case manager interacts regularly with intervention participants through videoconference via the htu.

Eligibility criteria:
inclusion criteria: * age 55 years or greater * being a current medicare beneficiary (verified by the centers for medicare and medicaid services) * having diabetes mellitus as defined by a physician's diagnosis and being on treatment with diet, an oral hypoglycemic agent, or insulin * residence in a federally designated medically underserved area (either of two federal designations, medically underserved area \[mua\] or health manpower shortage area \[hpsa\]) in new york sate * fluency in either english or spanish exclusion criteria: * moderate or severe cognitive, visual, or physical impairment * the presence of severe co-morbid disease.

Keywords: telemedicine diabetes mellitus