Kornimate/medical-research-clean huggingface dataset:
ventilation strategies during spontaneous breathing trial

Conditions: Acute Respiratory Insufficiency

Summary: patients who are intubated and mechanically ventilated for acute respiratory failure in the intensive care unit (icu) are at some point eligible for weaning. the common way to wean them from mechanical ventilation is to screen criteria for feasibility and, if present, to test feasibility by performing spontaneous breathing trial. this latter can be done either by setting a low pressure support level (expected to compensate the airflow resistance due to endotracheal tube) or by allowing the patient to breathe spontaneously through the tube without any support from the ventilator. combination of low pressure assistance strategy (7 cm h2o) and positive expiratory pressure (pep) of 4 cm h2o is the strategy used in our unit. such a low pressure support level should actually result in a real assistance and, hence this is not the real spontaneous breathing capacity that is tested. some icu ventilators offer the option of compensating for the airflow resistance due to endotracheal tube, automatic tube compensation (atc). therefore, investigators aimed at comparing in patients ready to wean the usual procedure in our icu and the atc mode. in the atc arm, the patients are breathing spontaneously through the endotracheal tube and are connected to the ventilator set at inspiratory pressure support of 0 cm h2o, pep 4 cm h2o and atc on. two parallel arms depending on the order of allocation of each mode: pressure support 7 cm h2o + pep 4 cm h2o then atc or the opposite. the primary endpoint is the power of the work of breathing. the hypothesis is that the power of the work of breathing is greater in atc than in the usual procedure, and hence this latter is a real ventilator support.


Eligibility criteria:
inclusion criteria: * age 18 years or more * intubated and mechanically ventilated for at least 24 consecutive hours * staying in the medical icu at the croix rousse hospital, lyon, france * pressure support ventilation 10-15 cm h2o, total respiratory rate 25-35 breaths/min, expired tidal volume 6-8 ml/kg predicted body weight * meeting criteria for spontaneous breathing trial (able to answer simple questions, no ongoing intravenous sedation, norepinephrine ≤ 1 mg/h, dobutamine ≤ 20 mg/h, fraction of inspired oxygen (fio2 ≤ 50%), pep ≤ 5 cm h2o, respiratory rate ≤ 35 breaths/min, saturation in oxygen (spo2) ≥88%) * under dräger evita xl ou v500 icu ventilator * agreement to participate from the patient or next of kin exclusion criteria: * chronic respiratory failure under long term home oxygen therapy and/or non invasive ventilation before icu admission * tracheotomy * nasogastric tube contra-indicated * thoracic tube in place * no agreement to participate * under justice protection * deprived of freedom * pregnant or breastfeeding * not affiliated to social insurance * involved into another study that may interfere with present study

Keywords: weaning mechanical ventilation work of breathing automatic tube compensation pressure support ventilation
the use of humor with young adults in psychiatric care

Conditions: Treatment Adherence and Compliance; Psychiatric Disorder

Summary: clinical study in psychiatry in young adult patients between 18 and 25 years old. the aim of the study is to evaluate the therapeutic impact of the clinical use of humor through 6 group sessions (group of 5 to 10 patients), at the rate of one hour session per week for 6 weeks. the investigators will form 2 groups of 5 to 10 patients matched in terms of gender, education level and score on a scale measuring their sense of humor. the participants will be asked to complete a series of tests measuring their ability to use humor, psychiatric symptoms and well-being. group 1 (test group) will participate in the humor-based sessions, while group 2 (control group) will receive regular treatment for 6 weeks (waiting list: patients in group 2 will attend humor-based sessions once group 1 has completed their 6 weeks). at the end of the 6-week sessions, both groups will receive the same series of pre-session tests to see whether or not there has been improvement in their overall functioning, psychiatric symptomatology and appreciation/use of humor. at the end of the 2x 6-week sessions, group 2 will again receive this series of pre-session tests to see whether or not their overall functioning, psychiatric symptomatology and appreciation/use of humour has improved. objective(s)/aim: to evaluate the resilience of young adult psychiatric patients and their ability to cope with stress through the use of humor in a set of 6 modules on the use of humor. to evaluate the symptoms. outcome/endpoints : using scales, measure this evolution.

project design and procedures : the investigators will form 2 groups of 5 to 10 patients matched on their score on the sense of humor scale, their gender and their level of education. the participants will be asked to complete a series of tests measuring their ability to use humor, clinical variables and general functioning. group 1 - experimental - will participate in a "humor group" with a one-hour group session per week for 6 weeks. group 2 - the control group - will follow a usual treatment regimen for 6 weeks. at the end of the "humor group" of group 1, the 2 groups of patients will undergo a second series of tests identical to those of the pregroup. the paired patients should be randomly assigned. the control group will do the "humor group" after 6 weeks.

Eligibility criteria:
inclusion criteria: * young adult patients of a psychiatric's unit (young people from 18 to 25 years old with beginner psychic disorders) who are french-speaking and able to give their informed consent. exclusion criteria: * those who do not meet the above criteria.

Keywords: young people young adults humor psychotherapy group psychotherapy resilience
chiropractic maintenance care of persistent or recurrent low back pain

Conditions: Recurrent Low Back Pain; Persistent Low Back Pain; Chronic Low Back Pain

Summary: as low back pain is often a recurrent and sometime persistent problem, research into prevention is important. chiropractors have traditionally treated patients with maintenance care, which means that patients are seen on a regular basis to prevent recurrences or to stop a persistent problem getting worse. however, it is not known if this has the expected effect. this study will test the effectiveness of the maintenance care approach. patients with recurrent or persistent low back pain will be treated in accordance with two different models. the first model is the maintenance care model, meaning that chiropractors will see the patient on a regular basis, regardless symptoms. the other model means that patients should be treated patients only when they themselves experience symptoms bad enough to seek care. after one year, it will be possible to see if there has been any difference between the groups in terms of pain, disability, quality of life and total number of treatments over the study period and to investigate if there is any difference in the cost-effectiveness between the two treatment models.thus, the study hypothesis is that there is no difference between the two models regarding the number of days with pain. this study will be a multi-centre trial, and as part of the study, it will be necessary to formalize a network of research clinics all over sweden in which participating chiropractors accept to perform complex data collection. this network will then have the expertise and potential to perform future clinical studies together with networks in other countries, allowing large clinical trials across countries.


Eligibility criteria:
inclusion criteria: * non-specific low back pain \> 30 days previous year * non-specific low back pain with previous episodes * age 18-65 * access to a mobile phone * knowledge of how to text message * proficiency in the swedish language * must rate themselves as "definitely improved" by the 4th visit exclusion criteria: * pregnancy * contraindication to spinal manipulative therapy * liability issues
impact of facemasks on running during covid-19 pandemic

Conditions: Shortness of Breath

Summary: randomized crossover clinical trial in which a group of runners are ask to complete a 15 minutes standardized physical test on a treadmill. the same group of participants are randomized to the order in which they use a facemask (surgical mask, polyester reusable cloth mask) or no mask, while running. each test, according to the type of mask or no mask, are held on different dates. heart rate, oxygen saturation and shortness of breath are measured every 3 minutes during the test.

between 15-20 recreational runners are included in a crossover trial to run under three different conditions the same 15-minutes treadmill running test. they will run wtih surgical mask, polyester reusable cloth mask or without mask. the order in which they use or not the mask is randomized. each test is done on a different day. heart rate, oxygen saturation and shortness of breath are measured every 3 minutes during the test. the primary outcomes are the differences in heart rate, oxygen saturation and shortness of breath at the end of the test, between groups.

Eligibility criteria:
inclusion criteria: * recreational runners. * age between 16-65 years. * workers or students from the health area. exclusion criteria: * none.

Keywords: oxymetry shortness of breath running masks covid-19
orelabrutinib in the treatment of hp-positive gastric malt lymphoma

Conditions: MALT Lymphoma of Stomach; Helicobacter Pylori Infection

Summary: describe the efficacy and safety of orelabrutinib in the treatment of hp-positive gastric malt lymphoma

this multicenter, open-label, randomized controlled trial is trying to evaluate the efficacy and safety of orelabrutinib in the first-line treatment of hp-positive gastric malt lymphoma

Eligibility criteria:
inclusion criteria: * age ≥ 18 years old * histologically confirmed gastric mucosa-associated lymphoid tissue (malt) lymphoma; * current infection with helicobacter pylori (hp): diagnosis can be made if any of the following criteria are met: a) positive result in at least one of the following: rut (rapid urease test), histological staining, or bacterial culture of gastric mucosal tissue; b) positive result in 13c or 14c-ubt (urea breath test); c) positive result in hpsa detection. a positive result in serum hp antibody test indicates past infection, and patients who have never been treated can be considered as having current infection. * ecog (eastern cooperative oncology group) performance status 0-2. * lugano staging i-ii1. * signed informed consent form. * evaluable lesions present. exclusion criteria: * negative for helicobacter pylori (hp); * history of other tumors, except for cured cervical cancer or basal cell carcinoma of the skin; * patients with active hiv and syphilis infections; * pregnant or lactating women; * patients with severe active infections; * patients with multiple factors affecting oral medication (such as dysphagia, nausea, vomiting, chronic diarrhea, and intestinal obstruction); * other comorbidities or conditions that may prevent patients from completing the clinical trial.
participant reported outcomes and treatment experiences in kidney cancer

Conditions: Kidney Cancer

Summary: the purpose of this observational study is to collect contemporary real-world treatment patterns, clinical outcomes, humanistic burden (including patient-reported disease-specific health-related quality of life (hrqol), and treatment- related adverse events (aes) or adverse reactions (ars) among advanced renal cell carcinoma (arcc) patients initiating first-line systemic therapy.


Eligibility criteria:
for more information regarding bristol-myers squibb clinical trial participation, please visit www.bmsstudyconnect.com inclusion criteria: cohort 1 * primary diagnosis of arcc (advanced renal cell carcinoma) or metastatic rcc * medical history must be available from date of arcc diagnosis * initiated 1lot between april 2018 - march 2020 cohort 2: * primary diagnosis of arcc (not amenable to curative surgery or radiation therapy/ ajcc stage iii unresectable) or metastatic rcc (ajcc stage iv). * medical history must be available from date of arcc diagnosis. * initiate 1lot. exclusion criteria: * currently enrolled in a clinical trial for treatment of arcc * any prior malignancy active within the previous 3 year, except for locally curable cancers that have been cured * any prior systemic therapy for arcc, with the exception of neoadjuvant or adjuvant therapy (cohort 2 only) other protocol-defined inclusion/exclusion criteria apply
effectiveness of embrace scar therapy device after cutaneous wound closure

Conditions: Linear Cutaneous Wound

Summary: the purpose of this study is to determine whether the use of the embrace device after repair of linear cutaneous surgery wounds improves scar cosmesis.

the purpose of this study is to determine whether the use of the embrace device after repair of linear cutaneous surgery wounds improves scar cosmesis. we will use a split wound model, half of the wound is treated with the embrace device and the other half is not treated. three-months post-surgery, the scar will be measured via the physician observer scar assessment scale, a validated scar instrument. the scar width and adverse events will also be recorded. following the surgical repair of cutaneous wounds, scar formation is inevitable and results in varying degrees of aesthetic and/or functional impairment. numerous treatment modalities have been employed to treat scars. carbon dioxide and pulse dye lasers, as well as dermabrasion can reduce erythema and irregular topology of the scar surface1,2. silicone-based products have also been used to treat post-surgical scars, including gels, sheets, and tape3-5. intralesional steroids are often injected into to induce flattening of a scar6. more recent research has highlighted the impact of mechanical forces and tension on scar formation. in one report, incisions in both pigs and humans were treated with a tension-shielding device and showed a reduction in scarring7. more recently two clinical trials have been published in the plastic surgery literature showing that the use of the embrace device, a silicone-based dressing designed to minimize wound tension, is effective in improving the aesthetic outcome following scar revision surgery8,9. while these initial studies of the embrace device have promising findings, there are significant drawbacks to both studies including small study population, inclusion of patients seeking scar revision (a select group likely predisposed to poor scar cosmesis and not representative of first-time surgical patients), investigator conflict of interest, and the use of a digital software-based scar assessment tool using patients photos that were not standardized with respect to lighting or distance. therefore, larger studies in first-time surgical patients with standardized photos for scar assessment are required to validate this potentially promising device for improved scar cosmesis.

Eligibility criteria:
inclusion criteria: * 18 years of age or older * able to give informed consent themselves * patient scheduled for cutaneous surgical procedure along a flat surface suitable to application of the embrace with predicted primary closure. * able to apply dressings themselves. * willing to return for follow up visits. exclusion criteria: * mentally handicapped * unable to understand written and oral english * incarceration * under 18 years of age * pregnant women * wounds with predicted closure length less than 3 cm * patients with known adverse reactions to adhesives * patients with history of collagen vascular disease

Keywords: scar cosmesis embrace device split wound wound closure cutaneous wound
the united kingdom national registry for myotonic dystrophy

Conditions: Myotonic Dystrophy

Summary: myotonic dystrophy (dystrophia myotonica - dm) exists in two forms, usually referred to as dm1 (type 1) and dm2 (type 2). both conditions are genetic disorders but each affects a different gene. dm1 is the most common adult-onset muscular dystrophy, and is thought to affect at least 1 in 8,000 people worldwide. the aim is to facilitate a questionnaire based research study in order to better characterise and understand the disease in the uk. by maintaining a national registry this will help identify potential participants eligible for clinical trials in the future.

the uk dm patient registry (https://www.dm-registry.org/uk/) aims to recruit any individual, from anywhere within the united kingdom, with a diagnosis of myotonic dystrophy. participants may be referred to the registry by health care professionals, or genetic testing/laboratory centres who are aware of the registry. alternatively, a participant may have discovered the registry via promotional activities or by their own online searches. after completing the consent process, participants are able to enter information on to the registry platform (note all forms are also available offline as well). this is an ongoing database and all participants will invited to update their information on an annual basis. the registry is sponsored by muscular dystrophy uk, cure-dm and the myotonic dystrophy support group. the database is divided into two main sections: 1. mandatory items (demographic information, clinical diagnosis, genetic test result, current best motor function and wheelchair use) and 2. highly encouraged items (severity of muscle symptoms, cardiac status, respiratory function, digestion, cataracts, and fatigue, ethnic origin and data on involvement with other registries) the database is designed to be self reporting, however where specialised clinical or genetic information is required, the neuromuscular specialist in charge of the participants care can be invited to provide some additional information. the participant is able to select a health care provider from a pre-populated list at registration stage, if they wish to (optional feature). this information is included in the patient information and consent.

Eligibility criteria:
inclusion criteria: * all patients with a confirmed myotonic dystrophy diagnosis (or pending diagnosis) are eligible for inclusion. diagnosis will be confirmed via genetic testing results exclusion criteria: * there are no exclusion criteria for the registry

Keywords: myotonic dystrophy myotonic dystrophy type 1 myotonic dystrophy type 2 dm dm1 dm2
cev with/without periocular carboplatin chemotherapy for extraocular retinoblastoma

Conditions: Retinoblastoma

Summary: this study will evaluate a uniform chemotherapy protocol for nonmetastatic extraocular retinoblastoma

this study will be a phase 4 open label interventional case series. patients with retinoblastoma will be receive chemotherapy with or without periocular injections of carboplatin at a dose of 20mg/2 ml. patients will receive chemotherapy on a monthly basis for a total duration of therapy of 6 months. patients will be followed for 18 months .

Eligibility criteria:
inclusion criteria: * irss stage ii or stage iiia rb patients. * for patients with irss stage ii disease, if scleral surface invasion alone was observed, only systemic chemotherapy was administered, whereas other irss stage ii and iiia patients received systemic chemotherapy plus additional local chemotherapy. * no tumor-related treatment was given prior to this chemotherapy regimen. exclusion criteria: * metastasis, including lymph node metastasis. * the diagnosis of irss stage i or above in the non-target eye.

Keywords: retinoblastoma carboplatin
role of eus in high risk of choledocholithiasis

Conditions: Choledocholithiasis

Summary: the aim of this study is to demonstrate that patients with high risk of choledocholithiasis who undergo ercp only for patients with choledocholith in the eus examination\[eus-ercp group\] have less negative outcomes (including false-negative results and procedure-related complications) than patients who undergo ercp in all patients with high risk of choledocholithiasis\[ercp group\]. the primary outcome is the incidence of negative outcomes (including false-negative results and procedure-related complications) in both groups. the secondary outcomes included days of hospitalization and the rate of diagnostic erc.

several studies have shown that eus testing prior to ercp may reduce ercp complications in patients with intermediate-risk choledocholithiasis. in other words, this results obtained by not performing ercp in patients without choledocholith in the eus examination. however, to the best of our knowledge, no prospective study has been conducted on the role of eus in patients with high risk of choledocholithiasis. therefore, we investigate the role of eus screening in patients with high risk of choledocholithiasis. we compare the negative outcomes (including false negative and procedure-related complications of eus and ercp) of the 'eus-ercp group' in which ercp is performed when necessary after the eus examination and the 'ercp group' in which ercp is performed in all patients.

Eligibility criteria:
inclusion criteria: * abdominal ct or us showed a common bile duct diameter \> 6mm (\>8mm in patients with previous cholecystectomy) and elevated total bilirubin from 1.8mg/dl to less than 4.0mg/dl exclusion criteria: * severe mental illness * severe co-morbidity (esrd, advanced copd, severe heart failure, poorly controlled blood sugar) * pregnancy * pancreatic cancer or suspected malignant tumor of the biliary tract * acute pancreatitis * patient who has confirmed biliary stones in abdominal ultrasonography or ct * severe cholangitis according to tg 18 guideline * total bilirubin \> 4mg/dl * patients who have difficulty with eus or ercp due to previous gastric surgery (billroth ii or tg with r-en-y)