Kornimate/medical-research-clean huggingface dataset:
postoperative nausea and vomiting in laparoscopic abdominal surgery

Conditions: Postoperative Nausea; Vomiting

Summary: the goal of this clinical trial is to compare frequency with postoperative nausea and vomiting in asa( american society of anesthesiologists) i, ii patients undergoing laparoscopic surgery. the main question\[s\] it aims to answer are: * primary outcome is the incidence of nausea and vomiting between 0-6 and 6-24 hours postoperatively and the need for additional antiemetics * secondary outcome is detection of additional analgesic needs and complications between 0-6 and 6-24 hours postoperatively. participants will receive aprepitant or granisetron for prevention of postoperative nausea and vomiting.

the aim of this study is to investigate the effectiveness of drugs used for postoperative nausea and vomiting in laparoscopic surgeries. in the research; during the operation, the patient's vitals will be recorded intraoperative forms. vitals are; heart rate, blood pressure, oxygen saturation, end tidal carbon dioxide levels; according to the pain level after awakening from the patient follow-up forms in the service. the doses and times of analgesics will be screened, the frequencies of postoperative nausea, retching, vomiting, and additional antiemetic doses will be screened, respiratory depression, complications of anesthesia, arrhythmia, laryngospasm, hypo-hypertension, headache, dizziness, allergic reactions anxiety symptoms will be screened too. we will try to emphasize which antiemetic is more effective than the other and which one has few side effects

Eligibility criteria:
inclusion criteria: * asa i, ii patients patients undergoing laparoscopic surgery exclusion criteria: * asa iii and above patients who refused to participate in the study

Keywords: postoperative nausea and vomiting laparoscopic surgery
computerized cognitive behavioral treatment for insomnia: improving rural veteran access to evidence-based treatment to reduce suicide risk (r-vets sleep)

Conditions: Insomnia; Mental Health Functioning; Physical Health Functioning

Summary: insomnia is a major problem among veteran populations. insomnia impacts physical and mental health functioning and is associated with reduced quality of life. cognitive behavioral therapy for insomnia (cbt-i) is one of the most promising treatments for insomnia; however, access to cbt-i is severely limited by a lack of trained clinicians within the veterans health administration (vha). there is a critical need to offer innovative approaches to meet the demand and need for insomnia treatment. leveraging technology to meet treatment demands is consistent with service delivery models based upon stepped care principles. this randomized controlled trial will determine whether a computerized, self-guided, web-based version of cbt-i is efficacious in reducing insomnia symptoms and improving functioning compared to a computerized program control.


Eligibility criteria:
inclusion criteria: 1. age between 18 and 89 2. eligible to receive care through va echcs 3. reliable access to the internet 4. english speaking 5. able to provide informed consent 6. current insomnia diagnosis as defined by diagnostic and statistical manual of mental disorders 5 (dsm 5) criteria exclusion criteria: 1. currently enrolled in/participating in other intervention research studies 2. other untreated sleep disorders (e.g., sleep apnea, periodic limb movement) 3. currently receiving formal psychological treatment for insomnia (not including sleep medications) 4. past 3 month change in schedule and/or dosage of medications that are designed to improve/impact sleep 5. history of bipolar disorder (with manic episodes), schizophrenia, schizoaffective disorder, or a psychotic disorder 6. untreated seizures or seizure disorder 7. physical illness that is active, unstable, degenerative, and/or progressive 8. currently pregnant or plan to become pregnant in the next 6 months 9. irregular work schedule, shift work, and/or life changes (e.g., new baby) interfering with regular sleep patterns 10. significant cognitive impairment, as determined by chart review and/or during screening, that would interfere with ability to engage in shuti 11. current non-alcohol substance use disorder, excluding cannabis use disorder, as determined by chart review and/or self-report screen of drug use (\> 1 time) in past 3 months 12. current alcohol use diagnosis, as determined by scid 5 module, in the past 3 months

Keywords: cbt-i insomnia
the impact of the pace program implementation on health services utilization by obese arab women

Conditions: Obesity

Summary: scientific background: obesity is a known risk factor for cardiovascular disease, metabolic syndrome, and diabetes. in israel, the prevalence of obesity and diabetes among arab females is 2 and 2.8 times higher than jewish females, respectively. the economic impact of obesity and overweight in terms of illness, disease and lost productivity is estimated to amount to 2-9% of the national health budget in countries with high gdp. diabetics have medical expenditure that is 2.4 times higher than non diabetics per capita. lifestyle modification is an effective tool in reducing morbidity and health care expenditure but despite that most family practitioners usually treat the complications of obesity rather than preventing it. pace is a comprehensive health promotion guide in counseling patients to an active healthy lifestyle. pace is designed to assist the primary health care providers to promote physical activity and dietary changes during routine office visits. objectives: to asses the impact of pace program on increasing the amount of physical activity, improving clinical and metabolic indices, increasing the documentation of lifestyle indices in the medical records and reducing health care expenditure and utilization. working hypothesis: implementing a modified pace protocol can achieve this objectives in arab women. methodology: the investigators will conduct a structured, multidisciplinary and continuous primary care based intervention, assisted by trained health promoters and applying a locally adjusted pace protocol.


Eligibility criteria:
inclusion criteria: * arab women * age range 35-64 * insured by clalit health services (chs) * residence in the target communities * bmi \> 30 kg/m2 * signed informed consent exclusion criteria: * failure in any of the inclusion criteria

Keywords: physical activity (pa) obesity life style modification physical activity diet bmi reduction clinical and metabolic measure health expenditure improvement of patient readiness for lifestyle change
addition of vismodegib to neoadjuvant chemotherapy in triple negative breast cancer patients

Conditions: Breast Cancer

Summary: to evaluate safety and efficacy of vismodegib with standard neoadjuvant chemotherapy in breast cancer patients based on the ctcae v4 2010 1. to study changes in biomarkers involved in the hedgehog (hh) pathway in the first biopsy as compared to the later one 2. to detect predictive factors among patients who reached pathological complete response (pcr) as compared to those with no pcr 3. to evaluate the role of the addition of vismodegib in the pcr rate 4. to evaluate clinical responses by breast mri and rates of breast conservative surgery after neoadjuvant chemotherapy 5. to evaluate qol with eortc qlq-c30 scale


Eligibility criteria:
inclusion criteria: 1. female sex 2. ability to give informed agreement and to carry out the whole study protocol during the study period 3. the patient should be able to carry out the needs of the clinical trial and have measurable disease 4. the patient should be 18-75 year-old 5. triple negative breast cancer (er\<1%, progesteron receptor (pr)\<1%, non-overexpressing her2). 1. patients with oligometastatic disease (1-2 resectable metastases) could be included 6. no previous systemic therapies 7. patients who are going to benefit from neoadjuvant chemotherapy 8. eastern cooperative oncology group (ecog)\<2 or karnofsky≥70% 9. blood tests and biochemistry suitable: (absolute neutrophil count\> 1500/ul; haemoglobin\>9 gr/dl; platelets\>100000/ul (microliters); total bilirubin≤ 1.5 the upper normal limit; got and gpt (transaminases)≤twice the upper normal limit; fasting glucose≤150 gr/dl; hba1c≤8%, serum creatinine≤2 mg/dl. exclusion criteria: 1. severe diseases or infectious diseases or liver, kidney or bone marrow failure that advise not to participate in the study according to investigator criteria 2. pregnancy or breast feeding period or fertility women who are not agree with contraception methods 3. other primary tumors except for breast in situ carcinoma (cis), cervical neoplasia(cin) or localized skin tumors 4. inflammatory breast cancer or bilateral breast cancer 5. bone fractures, peptic ulcus or healing disorders 6. any local or systemic therapy for breast cancer 7. to be maintained on immunosuppressants (prednisone \> 10 mgr daily or others), aspirin\> 325 mgr per day or clopidogrel \> 75 mgr daily 8. cardiomyopathy by new york heart association (nyha) class ii-iv; heart stroke in the previous 6 months; uncontrolled blood pressure (systolic \> 150 mm hg and /or diastolic \> 100 mm hg), coagulopathy or hemorrhagic diseases 9. previous lung diseases 10. personal history of abdominal perforation, abdominal abscess, or abdominal fistula. 11. inability to swallow pills 12. intolerance to galactose, malabsorption to galactose or/and glucose, or primary hypolactasia

Keywords: breast cancer triple negative neoadjuvant
steppin' up: positive youth development program

Conditions: Mentoring

Summary: as an antidote to juvenile aggression and violence, which has increased in recent years, group mentoring offers a viable alternative to intensive one-on-one mentoring. however, no group-mentoring programs have been evaluated. the purpose of this study is to assess the efficacy of a school-based, group-mentoring intervention designed to prevent aggressive and deviant behavior among early adolescents. study participants will be incoming 6th grade students from two inner-city baltimore middle schools and their parents. approximately 1,400 students and their parents are expected to participate. all 6th grade students in these schools are eligible for the study. weekly student group-mentoring sessions are the principal component of this study. these groups will be held during the school day and will be designed to increase social skills and encourage academic engagement, restraint, and problem-solving. a master's level professional will direct and conduct these intervention activities, which will employ the use of field trips, cooperative games, discussion of real-life situations, and role playing. students will also complete a 1-hour written survey each fall and spring from grades 6-8 about the program and about attitudes and behaviors related to school involvement and staying healthy and safe. study staff will contact participants' teachers and review their past and current school records, including attendance, grades, and disciplinary information. parents may be asked to participate in group meetings and will complete in-person or telephone interviews (about 20 minutes each) about similar information over a 3-year period (6th grade to 8th grade).

group mentoring offers a potentially viable alternative to intensive one-on-one mentoring. however, no group mentoring programs have been evaluated. the purpose of this study is to assess the efficacy of a school-based, group-mentoring intervention designed to prevent aggressive and deviant behavior among early adolescents. two successive cohorts of incoming 6th grade students from two inner-city baltimore middle schools and their parents will be randomized to comparison group or intervention group consisting of weekly group-mentoring sessions for youth and persuasive communication and small-group media-development projects for parents.

Eligibility criteria:
* inclusion criteria: the population of interest for the randomized trial is 6th-grade students and their parents in two participating baltimore middle schools. participating schools are urban, inner-city schools located in neighborhoods with low ses and high rates of unemployment and crime.

Keywords: aggression violence adolescents randomized trial behavioral intervention
neoadjuvant radiotherapy before surgery for rectal cancer, surgical and oncological outcome analysis, retrospective case control study in a single institute.

Conditions: General Surgery; Radiology

Summary: pre-operative radiotherapy for clinical stage 3 rectal cancer outcome analysis, retrospective case-control study.

for clinical t3 rectal cancer, neo-adjuvant radiotherapy was proved to reduce local recurrent rate in the clinical trials. in this study, we analysis surgical and oncological outcomes of neo-adjuvant radiotherapy for stage 3 rectal cancer in the real world in a single institute and do further subgroups analysis as references for treatment plans.

Eligibility criteria:
inclusion criteria: * rectal cancer, clinical stage t3 or higher, with no distant metastasis. * age \> =20 years, asa class i-iii. * underwent surgery. * complete medical records. exclusion criteria: * non-rectal cancer. * clinical stage t1-t2. * stage iv with distant metastasis. * age \< 20 years, asa class iv-v. * incomplete medical records. * hiv-positive patients (human immunodeficiency virus). * patients who completed treatment after october 1, 2024.

Keywords: neo-adjuvant rectal cancer radiotherapy concurrent chemo-radiation therapy
routine use of antiretroviral therapy to prevent mother-to-child hiv transmission in the kafue district of zambia

Conditions: HIV Infections

Summary: the investigators will enroll a cohort of hiv-infected pregnant women accessing pmtct services, to better understand the incremental benefits (e.g. reduction in hiv transmission, improvements in hiv-free survival) and risks (e.g. drug toxicities) of the routine haart strategy, in comparison to hiv-infected pregnant women accessing the zambian standard of care services. the investigators will test the hypothesis that routine use of haart produces significant reductions in hiv transmission rates, with only minimal side effects.


Eligibility criteria:
inclusion criteria: * hiv infected * pregnant women * ability to provide informed consent. * meets eligibility criteria for haart initiation exclusion criteria: * unwillingness to provide informed consent * below the age of legal consent

Keywords: pmtct haart pregnancy hiv infection hiv transmission hiv seronegativity
a pilot and feasibility study of fecal microbiota transplantation for ulcerative colitis

Conditions: Ulcerative Colitis

Summary: the investigators are conducting an open-label study of fecal microbiota transplantation (fmt) for adult patients with mildly-moderately active ulcerative colitis. in this pilot study the investigators will evaluate the feasibility, safety, and tolerability of a single application of fmt delivered colonoscopically. the investigators will also characterize the impact of fmt on the microbiota of the recipient and determine if it correlates with the microbiota from the fmt donor.


Eligibility criteria:
inclusion criteria: * men or women, aged 18-65 years old * prior endoscopic confirmation of uc: mildly to moderately active uc with simple clinical colitis activity index (sccai) activity index \>4-9 * failing standard therapy with: stable doses of 5-asa \>2 weeks; thiopurines \>3 months; or is steroid dependent at a dose \<20mg/d; (inability to taper off steroid for longer than 1 week) * stable medications dose for at least 2 weeks prior to screening and upon entry into trial * ability to understand and willingness to sign informed consent document exclusion criteria: * diagnosis of crohn's disease, indeterminate colitis, or proctitis alone * severe or fulminate colitis * women who are pregnant or nursing * patients who are unable to give informed consent * patients who are unable or unwilling to undergo colonoscopy * patients who have previously undergone fmt * patients who have a confirmed malignancy or cancer * patients who are immunocompromised * treatment within last 12 weeks with cyclosporine, tacrolimus, infliximab, adalimumab, certolizumab, natalizumab, thalidomide * antibiotic use within 2-months of start date * participation in a clinical trial in the preceding 30 days or simultaneously during this trial * probiotic use within 30 days of start date * rectal therapy within 14 days of start date * decompensated cirrhosis * congenital or acquired immunodeficiencies * other comorbidities including: diabetes mellitus, cancer, systemic lupus, must be able to tolerate conscious sedation with colonoscopy * chronic kidney disease as defined by a gfr \<60ml/min/1.73m2 (40) * history of rheumatic heart disease, endocarditis, or valvular disease due to risk of bacteremia. * steroid \>20mg/day * positive screening and confirmatory tests for hiv 1 \& 2, hepatitis a, b, \& c, and syphilis

Keywords: ulcerative colitis fecal microbiota transplantation
neonatal multiexposure to medical devices plasticizers: endocrine disruption mixture effects and neurodevelopmental disorders

Conditions: Neurodevelopmental Disorder (Diagnosis)

Summary: the goal of this observational study is to evaluate the neurodevelopment of children from the armed neo cohort through the asq3 score. dose the multiexposure to medical devices plasticizers during the neonatal intensive care unit stay increases the risk of developing neurodevelopmental disorders ? patients (their parents) will complète several questionnaires (asq3, environnemental survey, epices score) during a planned teleconsultation with the research team


Eligibility criteria:
inclusion criteria: * live patient who participated in the armed neo study, included at the clermont-ferrand or lille hospitals * patient whose holders of parental authority have expressed their non-opposition to their participation in the study exclusion criteria: * patient whose guardians have expressed opposition to their participation in the study * patient with no french speaking parent * patient

Keywords: neurodevelopmental disorder multiexposure medical devices plasticizers cocktail effects
phage therapy for the treatment of a chronic enterococcus faecium periprosthetic joint infection

Conditions: Periprosthetic Joint Infection

Summary: this purpose of this clinical trial is to evaluate the safety, tolerability and efficacy of a bacteriophage therapy in a patient with a methicillin-susceptible enterococcus faecium (e. faecium) prosthetic joint infection (pji) of the hip. we have exhausted all surgical and medical management of pji for our patient. the phage will be administered to the study patient during a 14 days period via intravenous and intra-articular. the patient will be monitored in clinic for up to 1 year.

this is a single-patient study, to assess a treatment option for a case of a recurrent methicillin-susceptible e. faecium infection in a prosthetic hip joint. the patient has repeatedly failed standard of care medical and surgical management. given the severity and chronicity of e. faecium infection and burden of infected hardware, the only option to achieve surgical source control would involve an aggressive, high risk surgical approach: a high amputation of the left leg to remove infected hardware and peri-implant bone and tissues. in the absence of any viable adjunctive antimicrobial therapy, this patient is at high risk of mortality and morbidity. it is therefore paramount that we explore alternative treatment modalities for the management of this infection, such as bacteriophage (phage) therapy. the primary objective of this study is to investigate the preliminary efficacy, safety, and tolerability of systemic (intravenous) and intra-articular administration of a lytic phage (in our patient with chronic e. faecium pji. secondary objectives will be documenting clinical changes pre- and post-therapy, as well as identifying adjunctive changes in biomarkers (c-reactive protein \[crp\], erythrocyte sedimentation rate \[esr\], and interleukin-6 \[il-6\]) correlated with pji as well as phage titres. in this study, lytic phage prepared in injection-grade saline will be administered to the patient both intravenously and intraarticularly, twice a day for a duration of 14 days. in addition to phage therapy, the patient will receive standard of care antibiotic therapy. the patient will remain in clinical follow-up for up to one year.

Eligibility criteria:
inclusion criteria: this n-of-1 phage therapy is designed for one patient who meet the following conditions * willingness to provide signed and dated informed consent form to participate in the clinical study * chronic prosthetic joint infection * history of multiple surgical and medication managements with no success exclusion criteria: * below 18 years of age
efficacy study of a facemask device to treat hypotension

Conditions: Hypotension

Summary: the purpose of this study is to determine if the impedance threshold device (itd) attached to a facemask can increase blood pressure in patients who present to the emergency department with hypotension secondary to hypovolemia. the cause of hypovolemia could be blood loss, sepsis, or dehydration.

the study is designed to test the hypothesis that use of the itd will result in a rapid rise in blood pressure secondary to an increase in cardiac output. either an active or sham itd will be applied to hypotensive patients when initially presented to the emergency department with a systolic blood pressure of \<95mmhg. the main endpoint of this study will be the rise in blood pressure over the first 10 minutes of use. based upon pre-clinical studies as well as clinical studies performed to date, we hypothesize that use of the active itd will result in a more rapid and higher blood pressure than the sham itd. multiple additional clinical parameters will also be compared between the two groups of patients.

Eligibility criteria:
inclusion criteria: * conscious patient * systolic blood pressure \< 95 mmhg * hypotension caused by blood loss, sepsis, or dehydration exclusion criteria: * hypotension secondary to heart failure * complaints of chest pain * history of heart failure * complaints of shortness of breath

Keywords: hypotension hypovolemia dehydration sepsis blood loss
wheelchair positioning and pain in neuromuscular patients

Conditions: Adult Patients With Neuromuscular Disorders Using Wheelchair

Summary: a retrospective study with the patients having a positioning consultation at hospital, between 2009 and 2014. in every neuromuscular disorder, the investigators describe the population seen in consultation, the aim of consultation, the postural problem observed in wheelchair, pain when sitting in wheelchair, and pressure ulcer.

postural problem is described with mcpaa (measure of postural control in sitting position, created by b. gagnon, physiotherapist in quebec) : we look at pelvic obliquity, pelvic rotation, pelvic anteversion or retroversion, trunk slope and rotation, kyphotic or scoliotic posture, neck posture and legs posture. we evaluate if these deformities are soft, moderate or severe, and if they are relievable

Eligibility criteria:
inclusion criteria: * adult patient with neuromuscular disorder * using wheelchair * patient having a positioning consultation in garches hospital exclusion criteria: * refusal to participate to the protocol * pregnancy

Keywords: neuromuscular wheelchair pain bedsore trouble postural