Kornimate/medical-research-clean huggingface dataset:
symptom control satisfaction with proton pump inhibitor regimen

Conditions: Heartburn

Summary: the overall aim of this study is to assess if patients with persistent gastroesophageal reflux disease (gerd) symptoms receiving sub-optimal omeprazole dosing experience improvement in gerd symptoms when prescribed an optimal dosing regimen. the optimal dosing regimen is defined as taking omeprazole 30 minutes prior to the first meal of the day.

gerd remains a common gastrointestinal complaint, resulting in 6% of outpatient visits. the economic burden is significant with direct costs exceeding $12 billion/year and indirect cost as high as $75 billion/year. the primary aim of this study was determine whether a brief educational intervention optimizing proton pump inhibitor (ppi) dosing would reduce gerd symptoms using the gastroesophageal reflux disease symptom assessment scale (gsas) questionnaire. further, secondary analysis would utilize the results of the trial and combine them with costs related to uncontrolled gerd to estimated the potential economic impact.

Eligibility criteria:
inclusion criteria: * ≥ 18 years old * taking omeprazole 20 mg * episodic heartburn at least 3 times per week * provides consent and be willing to complete study questionnaires * read, speak and write english exclusion criteria: * weight loss (alarm symptom) * normal esophagogastroduodenoscopy (egd) in last one year * pregnant or women planning on becoming pregnant at any time during the study * history of barrett's esophagus * prior esophageal strictures * intolerance/allergy to study medications * patients on plavix or a history of upper gastrointestinal surgery * investigators or their immediate family (spouse, children, sibling)
an intervention to improve end of life decision making among homeless persons

Conditions: End of Life Decision Making; Advance Care Planning

Summary: this project is a prospective, randomized controlled trial to improve the end of life experience for homeless persons by facilitating the expression of their wishes and enhancement of their dignity when facing serious illness, death, or the prospect of dying. our main hypothesis is that homeless persons will engage in this intervention and increase rates of advance directive completion.

this project is a prospective, randomized controlled trial to improve the end of life experience for homeless persons by facilitating the expression of their wishes and enhancement of their dignity when facing serious illness, death, or the prospect of dying. our main hypothesis is that homeless persons will engage in this intervention and increase rates of advance directive completion. participants were recruited from listening house, a drop-in center for homeless individuals located in st. paul, minnesota and represent a convenience sample. participants were required to speak english, not be overtly intoxicated, and have been homeless during the previous six months. the study was reviewed and approved by the institutional review board of the university of minnesota. all participants who entered the study gave written and oral consent for randomization and data measurement and screening. after recruitment and consent, participants were randomized into two intervention arms, minimal intervention (mi) and guided intervention (gi). all participants received educational materials about advance directives and advance care planning, pre-intervention surveys, and an advance care planning document, designated help, specifically designed for marginalized populations to preserve autonomy and elicit preferences of eol care. all participants completed a baseline written pre-test and survey. for this, they received compensation of $5. those randomized to the minimal intervention were provided the opportunity to complete a help document if they so desired. participants randomized to the gi group were provided with the written instructions and tools and asked to return to meet with investigators for one-on-one counseling and assistance in completion of the help document on one of several days later during the week of enrollment. three months after enrollment, post-intervention evaluations were sought from both mi and gi subjects. there was no financial incentive offered for completion of the help form. measurement the primary outcome of interest was the completion of a legally valid advance directive, the help document, which was measured by inspection of help documents as well as self-report. secondary outcomes include knowledge, attitude, and behavior variables measured through a questionnaire administered at baseline and at follow-up. demographic information, including education and living situations, was also collected at baseline.

Eligibility criteria:
inclusion criteria: * homeless in last six months * speak english * age 18-65 exclusion criteria: * intoxicated * minor
biphasic material with prf in lateral sinus floor augmentation

Conditions: Maxillary Sinus Disease

Summary: a lack of bone in the posterior maxilla, mainly resulting from the combination of alveolar bone resorption after tooth loss, pneumatization of the maxillary sinus, and periodontal disease, leads to increased difficulty during dental implant treatment. the classic technique for maxillary sinus floor augmentation entails the preparation of the trap door to elevate the schneiderian membrane in the lateral sinus wall. it can be done either in a single stage with simultaneous implant placement or in two stages with delayed implant placement, depending on the available residual alveolar ridge height that necessary for implant primary stability. the new compartment created between the floor of maxillary sinus and the elevated membrane was filled with either autogenous, allografts, xenograft or combination of them to maintain space for new bone formation. the disadvantages of such methods are high costs for grafting material, time consuming and high morbidity, because harvesting of bone grafts is needed.

recently, a systematic review demonstrated the effectiveness of synthetic bone materials, including biphasic calcium phosphate (bcp), as substitutes for autogenous bone. bcp consists of hydroxyapatite (ha) and β-tricalcium phosphate (β-tcp). in contrast with stable ha, β-tcp is highly resorptive and is replaced by newly formed bone; therefore, the resorption rate of bcp could be influenced by the ratio of ha and β-tcp. platelet-rich fibrin (prf) was recently introduced as additional or replacement materials in bone augmentation procedures. the use of biologic mediators with osteoinductive properties has been considered to reduce the time interval and accelerate the formation of new bone. the strengths of prf in reducing tissue inflammation, promoting the vascularization of bone tissue, accelerating new bone formation, and improving scaffold mechanics have been reported.

Eligibility criteria:
inclusion criteria: * residual bone crest height \< 5 mm and width≥6 mm in the planned implant site. * healed bone crest (at least 6 months elapsed from tooth loss/extraction); exclusion criteria: * absolute medical contraindications to implant surgery such as uncontrolled diabetes mellitus, blood platelet disorders, serious osseous disorders, and cardiac arrhythmia; history of bone grafting in the posterior maxilla, immunocompromised patients, taking corticosteroids, taking aspirin before the procedure, positive history of chemotherapy and radiotherapy, and maxillary sinus pathologies

Keywords: sinus floor augmentation biphasic calcium phosphate prf
the effect of roux-en-y gastric bypass on mitochondrial function in type 2 diabetes

Conditions: Type 2 Diabetes; Obesity

Summary: roux-en-y gastric bypass (rygb) surgery induces resolution of type 2 diabetes, often within days after surgery and before significant weight loss. the aim of this study is to investigate whether changes in mitochondrial function contributes to the early improvement of type 2 diabetes after rygb.

mitochondrial dysfunction has been linked to development of insulin resistance in the muscle and hence to the pathogenesis of type 2 diabetes. mitochondrial function can be studied non-invasively by 31 phosphor magnetic resonance spectroscopy (31pmrs). in this study we will investigate changes in mitochondrial function using the combination of 31 pmrs and near infra-red spectroscopy (nirs) after gastric bypass.

Eligibility criteria:
inclusion criteria: * patients eligible for gastric bypass surgery or cholecystectomy * verified type 2 diabetes or normal glucose tolerance by ogtt exclusion criteria: * patients unable to fit the dimensions of the mri-scanner

Keywords: type 2 diabetes gastric bypass surgery obesity mitochondrial function
does ultrasound of the spine improve labor epidurals/spinal anesthesia in obstetric patients?

Conditions: Pregnancy; Labor Pain

Summary: the investigators are interested in determining the utility of ultrasound of the spine for labor epidurals or spinal anesthesia for women in labor or having a cesarean delivery. the investigators hypothesized that in women with poor spinal landmarks that the use of ultrasound of the spine will improve the process of placing labor epidurals or spinal anesthetics

ultrasound has been in use for peripheral regional anesthesia for several years and is becoming more common. it is currently routinely used here at the university of missouri. ultrasound for neuraxial anesthesia, however, is less common and is only being done in a few centers.. there have been several case reports of its use in obstetric anesthesia for patients with prior spinal surgery or spinal deformity. there have been even few prospective randomized studies. while its use may have significant advantages, it is not yet clear what those advantages are and in whom it may be most beneficial. the investigators seek to answer the following questions regarding the use of preprocedure ultrasound for neuraxial analgesia/anesthesia in obstetric patients: * are there benefits to the use of pre procedure ultrasound for neuraxial analgesia/anesthesia? * if so, what are the benefits? * if measurable, to what extent does the patient benefit? * do all patients benefit or only a specific subgroup? * is there a "cost" to the use of pre procedure ultrasound, i.e. extra time needed to perform the ultrasound exam vs a "savings" with the use of pre procedure ultrasound, i.e., less time to perform the epidural analgesic or spinal anesthetic as a direct result of the use of ultrasound? * in particular the investigators hypothesize that in patients whose spinal landmarks are not palpable or are barely palpable, ultrasound will be found to be beneficial as determined by metrics described below (see item #6). in patients whose landmarks are prominent or easily palpable pre procedure ultrasound will not be of significant benefit.

Eligibility criteria:
inclusion criteria: * women in labor * women scheduled for cesarean delivery exclusion criteria: * under age 18 * emergency cesarean deliveries * unable to cooperate with ultrasound examination or regional anesthesia * advanced labor * contraindications to regional anesthesia * unable to understand the consent process

Keywords: pregnancy labor epidural analgesia epidural anesthesia spinal anesthesia ultrasound neuraxial analgesia neuraxial anesthesia cesarean delivery
a study of rebif® in subjects with relapsing multiple sclerosis

Conditions: Multiple Sclerosis, Relapsing-Remitting

Summary: this is an open-label, multi-center, 12-week, randomized, controlled, parallel group, phase 4 study to assess whether the morning administration of interferon beta 1a (rebif®) leads to a lower severity of flu-like symptoms (fls) as compared to the evening administration, in subjects with relapsing multiple sclerosis (rms).


Eligibility criteria:
inclusion criteria: * males and females between 18 and 60 years of age * female subjects must be neither pregnant nor breast-feeding and must lack child-bearing potential. furthermore, female subjects must not have been pregnant from at least three months prior to enter in the study * subjects have rms according to the revised mcdonald criteria (2010) * subjects with an expanded disability status scale (edss) score of less than 6.0 * subjects naive to treatment and eligible for treatment with rebif® 44 three times a week, or patients having received glatiramer acetate with a wash-out from at least one month, or patients having received treatment with natalizumab or fingolimod with a wash-out from at least three months * subjects able to self-inject treatment using rebismart® * subjects willing and able to comply with the protocol for the duration of the study * subjects have given written informed consent to take part in the study exclusion criteria: * subjects have any disease other than ms that could better explain his/her signs and symptoms * subjects who have received any immunosuppressive agents within 3 months prior to baseline * subjects who have received any corticosteroids within 30 days prior to baseline * subjects have a ms relapse within 30 days prior to baseline * subjects have inadequate liver function and bone marrow reserve as defined in the protocol * subjects have moderate to severe renal impairment * subjects have any visual or physical impairment that precludes the subjects from self-injecting the treatment using rebismart® * subjects have hypersensitivity to natural or recombinant interferon, or to any of its excipients * subjects have any contra-indications to treatment with interferon (ifn) beta 1a according to summary of product characteristics (smpc) * subjects have any contra-indications to treatment with ibuprofen/paracetamol according to smpc * obese subjects, defined by body mass index greater than 30 kilogram per square meter (kg/m\^2) * subjects have participated in any other investigational trial within 30 days from baseline * subjects have any other significant disease that in the investigator's opinion would exclude the subject from the trial

Keywords: multiple sclerosis, relapsing-remitting interferon beta 1a rebif®
efficacy and effectiveness of combined therapy for uncomplicated malaria treatment in peru

Conditions: Malaria Falciparum

Summary: this is a study of the efficacy and effectiveness of combination therapy for malaria due to p. falciparum in the loreto department, iquitos, peru. the investigators will enroll subjects ≥ 1 year-old who have a diagnosis of uncomplicated malaria due to p. falciparum. patients will receive a treatment regimen consisting of mefloquine (25 mg/kg per day for two days) and artesunate (12 mg/kg per day for three days). patients will be divided into two groups: one will receive drugs under direct supervision and the other will be instructed on how to take the drugs by themselves. clinical and parasitologic response will be monitored for a follow-up period of 28 days. the findings of this study will be used to guide the ministry of health in evaluating its national policy for p. falciparum malaria treatment.


Eligibility criteria:
inclusion criteria: * age \> 1 year * axillary temperature ≥ 37.5ºc and/or history of fever in the previous 48 hours without any other evident cause * unmixed infection with p. falciparum of between 250 and 100,000 asexual parasites/mm3 as determined by microscopic exam of the thick or thin smear * an informed consent obtained from the patient or his/her guardian (in case of patients ≤ 18 years old) and assent for children (8-18 years old) * willingness to come to the health facility for the following 28 days exclusion criteria: * signs or symptoms of severe malaria * other severe chronic diseases (e.g., cardiologic, renal, or hepatic diseases; hiv/aids; severe malnutrition) * history of allergy to any of the proposed treatment or its alternatives, i.e. mefloquine, artesunate, quinine, tetracycline, or clindamycin * pregnancy (based on urine test), since this group of patients receives other drugs for malaria treatment in accordance with peruvian national guidelines.

Keywords: malaria combination therapy mefloquine artesunate peru malaria, uncomplicated
comparison of a comfort scale and a numerical pain scale on opioid consumption after surgery

Conditions: Pain Management; Analgesia

Summary: the objective is to show that the use of therapeutic communication tools, in this case a comfort scale, a low cost and simple to implement method, can reduce pain and therefore the consumption of opioids in the postoperative care unit. our hypothesis is that the use of a comfort scale will lead to significant postoperative opioid sparing, and consequently to a decrease in the opioid-related side effects the aim of this study is to compare postoperative opioid consumption between patients whose pain is assessed by a numerical verbal scale and those assessed with a comfort scale.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years; * patient eligible for any surgery requiring postoperative opioid administration; * patient with a social security plan; * french-speaking patient * free, informed and oral consent by the patient. exclusion criteria: * woman claiming to be pregnant or breast feeding; * emergency surgery; * patients using preoperative opioids ; * opioid addiction; * patients unable to understand the assessment scales; * adults under legal protection (safeguard of justice, curatorship, guardianship), persons deprived of liberty.

Keywords: comfort scale pain scale numerical verbal scale postoperative pain
sbrt combined with fruquintinib plus pd-1/ctla-4 antibody for third-line treatment in mcrc

Conditions: Metastatic Colorectal Cancer

Summary: the study is a phase ii clinical study. the purpose of the study is to evaluate the efficacy and safety of sbrt combined with fruquintinib plus pd-1/ctla-4 antibody for third-line treatment in mcrc.


Eligibility criteria:
inclusion criteria: 1. patients must have biopsy proven unresectable mcrc. 2. patients must have received first-line and second-line chemotherapy, and approved a progressive disease. 3. age ≥ 18 years 4. patients must have measurable disease at baseline. 5. patients can have up to only 5 discrete active extracranial lesions (≤3 in the liver and ≤3 in the lung) identified by position-emission tomography (pet) scan and also seen on correlative plain film, ct scan, or mri within 8 weeks prior to the initiation of radiotherapy. 6. patients who previously received radiotherapy to the primary site will be ineligible if there is ct evidence of disease progression within the past 3 months. 7. patients must have a karnofsky performance scores (kps) \>60 8. aspartate aminotransferase, alanine aminotransferase \& alkaline phosphates must be ≤ 2.5 times the upper limit of normal (uln). total bilirubin must be within the limit of normal. 9. patients should have adequate bone marrow function as defined by peripheral granulocyte count of ≥1500/mm3. 10. patients should have adequate renal function (serum creatinine ≤1.5 times the uln). 11. females of childbearing potential should have a negative pregnancy test. 12. patients who would be receiving radiation for lung lesions who are known or suspected by the treating radiation oncologist to have compromised lung function must have a documented forced expiratory volume in 1 second (fev1) ≥ 1 litre. 13. patients must provide verbal and written informed consent to participate in the study. 14. total bilirubin: within normal institutional limits exclusion criteria: 1. patients with either untreated brain metastases or brain metastases treated within the past three months are ineligible 2. patients with serious, uncontrolled, concurrent infection(s). 3. significant weight loss (\>10%) in the prior 3 months. 4. treatment for other carcinomas within the last five years, except cured non-melanoma skin and treated in-situ cancers. 5. patients with more than 5 discrete metastatic lesions. 6. participation in any investigational drug study within 4 weeks preceding the start of study treatment. 7. unwillingness to participate or inability to comply with the protocol for the duration of the study. 8. patients who are pregnant. patients with reproductive capability will need to use adequate contraception during the time of participation in the study
study of pneumococcal carriage in rsv bronchiolitis in infants aged 6 to 18 months

Conditions: Bronchiolitis

Summary: the relationship between rsv (human respiratory syncytial virus) infections and invasive infections or pneumonia caused by streptococcus pneumoniae has been observed epidemiologically for several years. few fundamental data exist to support the epidemiological relationship. this study will investigate the proportion of pneumococcal carriage in rsv-infected infants and noninfected infants (proportion, serotype profile).

the relationship between rsv (human respiratory syncytial virus) infections and streptococcus pneumoniae pneumonia has been suggested for many years based on a similar seasonal pattern and cohort studies, but it could not be confirmed due to the circulation of several viruses concurrently. the post-covid-19 period was marked by a temporal association between rsv infections and invasive pneumococcal disease (and pneumonia) in children under five, highlighting the potential role of rsv in the dynamics of pneumococcal disease in infants. furthermore, the carriage rate of s. pneumoniae in infants under 2 years of age in healthy populations is described as around 25%. in the case of rsv infection, this rate rises to 50%. some data from animal models have shown that rsv infection increases s. pneumoniae transmission within a group of individuals, partly explaining this difference. however, data remain limited, particularly in human samples, and further research is needed to better understand the role of the rsv-pneumococcal relationship in the occurrence of severe rsv infections (pneumonia) and invasive pneumococcal infections. this study will examine pneumococcal carriage in bronchiolitis in infants aged 6-18 months, through nasopharyngeal swabs from infants with bronchiolitis and healthy infants. pneumococcal carriage rates and serotype profiles will be investigated.

Eligibility criteria:
inclusion criteria: * infants aged 6 months to 18 months inclusive * with bronchiolitis during rsv epidemic season (bronchiolitis group) or without evidence of rsv viral infection (healthy group) * no chronic illness * no history of bronchiolitis * signed consent from parents or legal guardians * patient affiliated to a social security scheme exclusion criteria: * chronic respiratory illness * medical history of bronchiolitis or newborn asthma * treatment with immunosuppressants * patient on ame

Keywords: bronchiolitis pneumonia