Kornimate/medical-research-clean huggingface dataset:
adaptation and validation of recent life changes questionnaire for measuring stress among adults in karachi, pakistan

Conditions: Life Change Events

Summary: stressors impair optimum function of an individual physiologically and psychologically. overcoming stress is possible when one knows which aspects of life are the most troublesome to manage for individuals. there are certain tools available in pakistan that can measures stress in selected populations but there are no validated tools that may quantify stress which results from events occurring in different aspects of life. recent life changes questionnaire (rlcq) is a tool that measures stress of individuals through life changing events. it has five categories; work, home and family, health, personal and social and financial. the objective of the study is to adapt rlcq and validate it so that it may measure stress among people living in karachi, pakistan.

in order to make rlcq a tool to measure stress within pakistani context, we would want to adapt rlcq and then validate it. the study design is a validation study where the construct of recent life changing events will be validated by comparing it with a gold standard to assess the extent of accuracy of measurement by exploring the agreement between them. the mode of data collection is cross-sectional by administering the adapted rlcq and the gold standard simultaneously. since stress is a subjective phenomenon and serves as a root cause for many neurodegenerative diseases and mental disorders, a tool for screening mental illnesses is selected against which we could compare the adapted rlcq for validation. the mini international neuropsychiatric interviews (mini) is a structured diagnostic interview developed and validated by sheehan in 1997, florida. it is based on the dsm iv criteria and icd-10. the design of this study incorporates content and criterion validity as we have a pre-existing 'gold standard' which is widely accepted and is in current practice of mental health screening in pakistan. the study will be conducted in six phases. phase i includes conducting qualitative interviews to explore the phenomenon. in phase ii, adaptation of rlcq will be done and review of the adapted tool will be done with the help of subject experts. phase iii will verify the face validity of the tool by translations and back translations. in phase iv, pre-testing of the tool will be done whereas in phase v, we will administer the tool in the community along with conducting mini interviews. phase vi tests the reliability of the tool.

Eligibility criteria:
inclusion criteria: * adults aged 18 years or above * those who would stay in the study site for at least one month * those who provide a written informed consent exclusion criteria: * those who do not understand urdu * those who have cognitive or hearing difficulties * people with known psychiatric conditions and are under treatment.

Keywords: stressful events psychological stress life experiences
atrial fibrillation prevention in post coronary artery bypass graft surgery with cryoablation for ganglionic plexi

Conditions: Complication of Coronary Artery Bypass Graft; Atrial Fibrillation

Summary: atrial fibrillation after coronary artery bypass graft is a common complication. the investigators have thought that the mechanism of temporarily postoperative atrial fibrillation is closely related to the autonomic nervous system imbalance. in a last several years, cryoablation was substituted for atrial incision in many reports to simplify the maze procedure. however, there has been no comparative study to delineate the feasibility of the use of cryoablation.

modified maze procedures that use energy sources for the ablation of atrial fibrillation concomitant with cardiac surgery have been shown to improve outcomes in patients with atrial fibrillation. cryoablation of atrial fibrillation recently has been shown to lead to outcomes that were at least equivalent to those reported for other energy modalities over both short- and medium-term follow-up times.

Eligibility criteria:
inclusion criteria: * coronary artery graft bypass patient * sinus rhythm exclusion criteria: * patients using antiarrhythmic * severe hypotension after surgery ( systolic blood pressure \<90mmhg) * history of atrial fibrillation

Keywords: atrial fibrillation coronary artery bypass graft cryoablation ganglionic plexi
use of fentanyl patch in partial doses than the original

Conditions: Chronic Pain

Summary: fentanyl is considered a potent synthetic opioid widely used in anesthesiology, for short and long-term pain management, and for sedation. the fentanyl patch is constructed like a matrix, a system based on a polyacrylate net with fentanyl that attaches directly onto the skin. the doses available today are from 12µg/h, 25, 50, 75, to 100 µg/h. despite the variable doses available, often in certain patients as the elderly or children, there is a need for slower titration than the 12 µg/h currently available. in this study, the investigators aim to evaluate pain control and to examine the blood fentanyl concentration of patients on a fix dose of fentanyl patch up to 100 µg/h every two or three days, and compare it with pain control and concentration levels obtained from a similar dose patch, but after cutting the patch into two. the study will take place at the pain clinic of clalit health services-south district (chs-sd), and the negev home palliative care unit. in chs-sd there are approximately 300 patients treated regularly with opioids and about 120 patients in the home palliative care unit. a sample of 95 patients will be recruited. once consent form is signed, blood samples will be collected twice: 1. at the time of the visit; 2. after 144 hours (about 6 days) from the first sample, and at least 36 hours after replacing the cut patch. pain management will be evaluated at both visits using the brief pain inventory (hebrew version) - bpi questionnaire, and rescue doses used before and after the cutting of the patch. the blood samples will be transferred to the laboratory for testing of fentanyl concentration levels.


Eligibility criteria:
inclusion criteria: * patients suffering from chronic pain on a fixed dose of fentanyl patch for over two weeks, with a maximum dose of 100 µg/h every two or three days, and have given their informed consent will be included in the study. exclusion criteria: * patients with cognitive problems * non-hebrew speaking * patients that their medical condition prevents them from participation in the study.
bilateral prophylactic mastectomy; should we preserve the pectoral fascia?

Conditions: BRCA1/2 Mutation; Bilateral Prophylactic Mastectomy; Seroma; Pectoral Fascia

Summary: many surgical guidelines promote the removal of the pectoral fascia in mastectomies for invasive breast cancer, but there is no evidence to support this statement in (bilateral) prophylactic mastectomies. reported wound-related local complications following mastectomy include seroma, flap necrosis, infection, hematoma, and nerve injury. seroma causes discomfort and may delay the reconstructive procedures. whether the removal or preservation of the pectoral fascia influences seroma formation following mastectomy remains unclear to our knowledge.

the primary objective of this pilot study is to investigate the impact of removal versus preservation of the pectoral fascia on drain policy and needle aspirations in women who undergo a bilateral prophylactic mastectomy. the secondary objective is to investigate the impact of removal versus preservation of the pectoral fascia on postoperative (surgical) complications. the study design includes a double-blinded, prospective, randomized controlled pilot study with a within-subject design. all patients will undergo a bilateral prophylactic mastectomy and randomization will occur within the patient. preservation of the pf will be performed in one breast (intervention), while removal of the pf will be performed in the contralateral breast of the same patient (control). consequently, the operation involves a total bilateral prophylactic mastectomy, with unilateral preservation of the pf the follow-up time of each patient will be 6 weeks. the patients' files will be viewed after the removal of the drain for additional recorded variables.

Eligibility criteria:
inclusion criteria: * female patient * scheduled for a bilateral prophylactic mastectomy in the erasmus mc academic breast cancer centre in rotterdam * ability to give written consent * adequate understanding of dutch language exclusion criteria: * history of diagnosis of invasive breast cancer or ductal carcinoma in situ (dcis) * other malignancies
engaging caregivers in dementia care

Conditions: Dementia

Summary: this pilot study seeks to examine the extent to which, relative to usual care, a dementia care management program for veterans and their caregivers (cgs)improves patient (e.g., behavioral symptoms, delayed nursing home placement) and caregiver (e.g., cg mastery, burden, affect) outcomes.

dementia care guidelines and pharmacological and non-pharmacological treatments have been shown to reduce symptom burden and rates of institutionalization for individuals with dementia. however, there remain a variety of factors that complicate dementia care management in primary care settings. patient-centered, integrated care management programs that involve caregiver (cg) education and psychosocial support may help facilitate access to and use of services and improve outcomes. the aims of this pilot were to examine 1) whether, relative to usual care (uc), a dementia care management program is associated with improved cg (e.g., mastery, burden, affect) and patient (e.g., behavioral symptoms) outcomes, 2) if, relative to uc, participants enrolled in the program have greater perceived access to and use of medical, social, and community/va services, and 3) whether the dementia care management program is feasible and acceptable to participants.

Eligibility criteria:
inclusion criteria: * patient and caregiver 18 years of age or older * patient is community dwelling * patient has a confirmed dementia diagnosis and/or significant cognitive impairment (per provider or cg report) that is verified upon the ra's cognitive screening assessment (per veteran (bomc, score of 16 or above) or informant (ad8, score of 2 or above) and/or chart review * cg lives with and/or provides care for the patient for an average of at least 4 hours per day. * veteran provides assent to contact his/her representative to pursue study participation * veteran representative as caregiver is willing and able to provide informed consent exclusion criteria: * cognitive, hearing, visual, or other physical impairments leading to difficulty with assent/ informed consent process and/or assessment (veteran or caregiver)
dexmedetomidine or hyalase : which of them can augment lumbar epidural steroid injection in failed back surgery patients. a randomized clinical trial

Conditions: Pain, Chronic

Summary: hyalase and dexmedtemodine are well known adjuvants given epidurally to alleviate chronic back pain. use in failed back surgery is an up to date field to hasten analgesia and py off recurrence .


Eligibility criteria:
inclusion criteria: * age group. 25-75ys old * both sex. * persistent (at least 6 month) pain and or disability following laminectomy with or without sensory-motor neurological deficits or any form of urinary or bowel incontinence * patients suffering from persistent (\> 6 months) back pain following laminectomy for spinal canal stenosis and/or discectomy for herniated nucleus pulposus documented by magnetic resonance imaging (mri) were included for screening and enrollment. exclusion criteria: * diabetic patients. * refusal to participate * mri with disc sequestration, concurrent sacro-ilitis, facet arthropathy . * coagulopathic patients * surgical induced discitis.
daily home spirometry for early detection of pulmonary complications in patients with covid19

Conditions: COVID 19

Summary: the aim of this preliminary study is to describe the potential decline in forced expiratory volume in 1 second (fev1) or forced vital capacity (fvc) as measured by home spirometry in high-risk subjects infected with covid-19. we hypothesize that the magnitude of such a decline in fev1 and/or fvc may be associated with clinical deterioration and hospitalization. the study will ultimately inform a larger subsequent rct that will evaluate the efficacy of home spirometry in the early detection (pre respiratory symptoms) of respiratory complications and therefore prompt early medical attention which is a key for improving outcome.


Eligibility criteria:
inclusion criteria: 1. without dyspnea and with no evidence of pneumonia, ards, organ failure or requiring admission to icu. 2. all patients ≥55 years age or ≥1 risk factor for disease complications (prior pulmonary, kidney or cardiovascular disease, diabetes mellitus, hypertension, bone merrow suppression, solid organ transplant, hiv with cd4\ 30). all participants will sign a written informed consent. exclusion criteria: 1. patients unable to perform spirometry 2. contraindications for spirometry (hemoptysis, active tuberculosis, syncope associated with forced exhalation or increased risk for spirometry) 3. adhere to the follow-up protocol.
evaluation of muscle strength by transcutaneous electrical stimulation

Conditions: Muscle Weakness

Summary: acquired neuromyopathy of resuscitation (nmar) is a common condition. its diagnosis is difficult and often late because it is based on a clinical assessment of muscle strength (mrc score) requiring the patient to be awake and cooperative. transcutaneous electrical stimulation consists of applying electrical stimulation along the path of a motor nerve in order to generate contraction of the previously relaxed muscle. the mechanical response thus generated is recorded and allows the muscular strength developed to be assessed. non-invasive and easily performed in the patient's bed, transcutaneous electrical stimulation could be an interesting alternative for early assessment of muscle strength in the still sedated resuscitation patient. however, this technique could be perceived as uncomfortable or painful in the awake patient so that magnetic stimulation, which is generally much better tolerated, should be preferred. however, magnetic stimulators have a limited maximum magnetic field which may prevent supramaximal stimulation especially in patients developing generalized edema (i.e., in the initial resuscitation phase).

we propose to conduct a reproducibility study of quadriceps force measurement in patients undergoing resuscitation by transcutaneous electrical and/or magnetic neurostimulation in the initial (i.e., \ 96 h) phases of resuscitation and then in the recovery phase. for each investigative technique (i.e., electrical vs. magnetic), we will perform 2 types of stimulation: single stimulation and high frequency doublet stimulation (100 hz), repeated 3 times each.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * admitted in intensive care unit b of st-etienne hospital * predictable duration of mechanical ventilation of more than 72 hours * patient whose family has given informed and written consent to the patient's participation in the study exclusion criteria: * pregnant woman, * patients with peripheral nerve damage prior to or at the time of measurement * curarized patients (non-efficacy of neurostimulation) * fracture of limb or pelvis * presence of a catheter in the stimulation zone (femoral artery or vein) * patients suffering from psychiatric pathologies. * brain pathology leading the patient to intensive care. * patients with neuromuscular pathology. * patients carrying equipment subject to possible electrical and/or magnetic interference, * patient with spinal fracture(s) at risk of spinal cord injury

Keywords: intensive care unit acquired muscle weakness transcutaneous electrical stimulation magnetic stimulation
dark adaptation as an early indicator of response to statin therapy for intermediate amd

Conditions: Age-related Macular Degeneration

Summary: interventional trial for off label use of high dose atorvastatin 80 mg in intermediate amd patients and correlate recovery response measured by dark adaptation recovery time with drusen volume reduction measured by sd-oct

dark adaptation recovery time is a sensitive marker of amd progression in intermediate amd, largely owing to drusen volume providing a transport barrier that slows the transfer of nutrients between the choroid and photoreceptors2. consequently, dark adaptation may provide an early indication of response vs. nonresponse, aiding case-by-case decisions on continuation of treatment when patients experience adverse side effects (e.g., elevated cpk or liver enzymes) or when atorvastatin provides insufficient lipid control in patients also at high-risk for cardiovascular disease (and switching to an alternative statin might be desirable).

Eligibility criteria:
inclusion criteria: * all subjects with intermediate amd diagnosis in one or both eyes will be considered, regardless the severity stage and subtype of disease in the other eye. high-risk iamd (numerous large, confluent drusen covering ≥ 0.5 disk area, with or without pigmentary changes but having no evidence of ga or cnv) in the study eye subjects can have either: (i) bilateral high-risk iamd, or (ii) high-risk iamd in one eye with ga and/or cnv in the fellow eye. exclusion criteria: * patient previously taking high dose atorvastatin 80 mg * patients previously taking other statins than high dose atorvastatin, in whom primary care provider (pcp) feels cannot be safely moved to high dose atorvastatin or those in which high dose atorvastatin is deemed contraindicated by pcp * patients with known adverse reaction to statins * patients with severe renal disease or multiple comorbidities * age \>85 years * pregnancy * patients with concomitant use of cyclosporine * active uveitis; * ocular infection; * any retinopathy other than amd; * media opacities; * refractive error equal or superior to 6 diopters (spherical equivalent); * any previous retina surgery; * other ocular surgery or intra-ocular procedure in the study eye (injection other than anti angiogenic injection, laser) within the 90 days prior to enrollment
shifting and distribution of foot pressure among obese subjects

Conditions: Obesity

Summary: background: the foot is considered a sensitive structure of musculoskeletal system that bears significant loads of the body weight during walking. so, the evaluation of the body weights on planter pressure distribution during walking among adult obese subjects is very critical for foot dysfunctions.the aims:to evaluate the planter pressure distribution in normal ,over weight and obese adult during dynamic situation. subjects and methods: a one-hundred fifty normal adult (male and female) subjects will be recruited in this study. they will be divided into group-i: includes 50 normal subjects group-ii: includes 50 of over weight subjects.group-iii 50 obese adult subjects the all three groups will be detected according to the individual bmi. the details of the study will be explained to each participant and a consent form was signed by each subject.each participant should be free from any musculoskeletal or locomotors disorders conclusion: results of this study can help physical therapists to understand the foot pressure distribution map for normal , over weight and obese and non-obese subjects to detect any foot abnormalities and detect any causes of foot dysfunctions.

a one hundred fifty volunteers (male and female), age from 20 to 40 years old subjects will be recruited in this study. demographic data of all participating subjects like age, weight, height, feet size, and body mass index (bmi) will be assessed. all participants will be assigned to three groups per measurement of individual bmi: group-i: includes 50 normal subjects (18.5 -24.9 bmi); group-ii: includes50 overweight subjects (25.0 -29.9 bmi); group-iii: includes 50 obese subjects (30.0 and above bmi) (nuttall, 2015). the procedure and purpose of the study will be explained in details for all participants. a consent form will be signed by each participant. human research already approved by institutional review board of imam abdulrahman bin faisal university(university of dammam previously ).irb.2017- 03-065.

Eligibility criteria:
inclusion criteria: subjects who are normal or over weight or obese . subjects who are free from any musculoskeletal abnormalities . exclusion criteria: subjects has any foot deformity, flat foot, acute lower extremity trauma, lower extremity surgery like prosthesis operations of the hip, knee, ankle or foot, subjects has problems of cooperation including; eye, ear oar cognitive disorders, diabetes or related peripheral neuropathy, vascular insufficiency, walking aids . subjects has age greater than 40 or less than 25 years.

Keywords: foot pressure, obese, and normal subjects
perioperative specimen imaging using high-resolution 18f-fdg-pet-ct during thoracic surgery: a pilot study

Conditions: Lung Neoplasms; PET-CT Specimen Imager

Summary: in this pilot study the investigators propose the intraoperative use of a high-resolution pet-ct imaging system which can assess resection margins and lymph node status in the operating room. this will allow for a faster and stepwise assessment (estimated to be under 10 minutes per specimen), enabling the surgeon to decide on subsequent surgical steps after each previous assessment.


Eligibility criteria:
inclusion criteria: * patient is 18 years of age or older. * patient with suspected or confirmed lung malignancies * patient is indicated to undergo thoracic surgery. * patient is estimated to be compliant for study participation by the investigator. * patient has freely given his/her informed consent to participate in this study. exclusion criteria: * patient has general or local contra-indications for thoracic surgery. * patient has active infection. * blood glucose level over 200 mg/dl on the day of surgery. * pregnancy or lactation. * patient participated in other clinical studies with radiation exposure of more than 1 msv in the past year