Kornimate/medical-research-clean huggingface dataset:
brazilian intervention to increase evidence usage in practice - acute coronary syndromes

Conditions: Acute Coronary Syndrome

Summary: phase 1: an observational study (registry) will be conducted which will objectively document the acs clinical practice in brazilian public hospitals, and identify the important barriers for the evidence usage incorporation in the clinical practice. phase 2: a cluster randomized clinical trial in which public hospital will be randomized to receive or not a multifaceted strategy in order to increase evidence based therapy in clinical practice.

study population: patients with thoracic pain who the emergency department physician suspects of acs and plans start a treatment for this issue; it will be excluded patients transferred of others institutions with 12 hours of symptoms. program: there are multifaceted interventions including 1. distribution of educational materials 2. case manager: use of a trained person who works in the hospital and will be responsible to assure that all interventions were used 3. reminders: specific information that is designed or intended to prompt a health professional to recall information (patient bracelets, labels, posters, pocket cards, checklists). 4. practical training endpoints: phase 1 primary outcome; patient who've received interventions based on evidence proportion informed by the indicators; phase 2 primary outcome: increase of prescription of evidence based treatment in clinical practice secondary outcome total mortality and major cardiovascular events

Eligibility criteria:
patient eligibility criteria inclusion criteria: * patients with thoracic pain who the emergency department physician suspects of acs and plans start a treatment for this issue exclusion criteria: * patients transferred from others institutions within 12 hours of the symptoms cluster eligibility criteria * national public hospitals with emergency department. a cluster can be one hospital with emergency department, or 2 or more hospitals (for example: 1 emergency hospital and 1 general hospital which receive the patients to perform pci).

Keywords: acute coronary syndrome randomized cluster trial quality improvement
hydrogel coil versus bare platinum coil in recanalization imaging data study

Conditions: Intracranial Aneurysm; Subarachnoid Hemorrhage

Summary: hybrid study is prospective randomized open label controlled multi center trial, to compare hydrocoil and bare platinum coil for recanalization after endovascular treatment of intracranial aneurysms.

at least one hydrocoil have to use in hydrocoil arm, and only bare platinum coil have to use in control arm. primary endpoint is recanalization within 1 year after embolization, and secondary endpoint are: 1. aneurysmal rupture within 1 year after embolization 2. any event within 30 days after embolization 3. recanalization within 6 months after embolization 4. aneurysmal retreatment within 1 year after embolization 5. aneurysmal rupture and any death within 1 year after embolization 6. any stroke within 1 year after embolization 7. any stroke, death hemorrhagic event, aneurysmal recanalization or retreatment within 1 year after embolization 8. change in aneurysmal occlusion 9. any comlicaion within 1 year after embolization 10. %length of hydrocoil, maximum diameter of aneurysm, volume embolization ratio.

Eligibility criteria:
inclusion criteria: * saccular intracranial aneurysm * endovascular treatment scheduled within 60days after consent * 20-79 years old * unruptured, chronic sah or acurte sah grade 1-iii * 7-20mm in size * 1 year follow up possibel * independent (mrs 0-2) * document consent exclusion criteria: * previous endovascular treated * additional aneurysm scheduled of endovascular treatment * pregnant * ineligible for study

Keywords: intracranial aneurysm endovascular therapy detachable coil recanalization
retrospective review of esophageal cancer at mskcc

Conditions: Esophageal Cancer; Esophagus Cancer

Summary: residual tumor at the proximal or distal margin after esophagectomy is a known prognostic factor for poor survival outcomes in patients with esophageal cancer; however, the significance of the circumferential resection margin (crm) remains controversial. in this study, the investigators sought to evaluate the prognostic significance of the crm in patients with esophageal cancer undergoing resection.


Eligibility criteria:
inclusion criteria: * histologically confirmed esophageal adenocarcinoma (eac) or esophageal squamous cell carcinoma (escc) undergoing esophagectomy * pathologic staged t3 tumors (pt3) exclusion criteria: * pathologic staged t0-2 (pt0-2) or t4 tumors (pt4) * patients with histologic types other than eac or escc, dysplasia or carcinoma in situ without tumor invasion, * patients undergoing salvage esophagectomy * evidence of distant metastatic disease * patients with a positive proximal or distal margin

Keywords: esophageal cancer esophagus cancer memorial sloan kettering cancer center 16-1631
central sleep apnea treated by co2 supplied by a novel device

Conditions: Central Sleep Apnea

Summary: in general, central sleep apnea is not as common as obstructive sleep apnea but it is common in patients with heart failure. it has been repeatedly shown that central sleep apnea worsens the prognosis of heart failure. the current concept in the development of csa is hypocapnia which causes temporary cessation of respiratory neural output. different methods for supplement of co2 have been used to eliminate csa. however, variation of co2 concentration during overnight treatment and tight-fitting mask made the treatment uncomfortable. it is important to develop a device with a comfortable mask to supply constant low dose co2 without breathing difficulty. we recently developed a device for treatment of csa.

objective: to determine whether the device could improve sleep quality while eliminating csa during the overnight study. methods: patients with central sleep apnea diagnosed by diaphragm emg will be recruited in this study. co2 concentration for treatment would be manually titrated during overnight psg. patients were then treated with an effective lowest concentration of co2 derived from titration under psg on the third night. the sleep apnea hypopnea index (ahi), central sleep apnea index (chi), arousal index (ari), oxygen desaturation index (odi), sleep structure, blood pressure, heart rate, diaphragm emg, treatment side effects and treatment preference were to be observed.

Eligibility criteria:
inclusion criteria: 1. willing to participate after informed consent 2. males and females, any race and aged≥18yeras 3. objectively confirmed central sleep apnea/cheyne stokes respiration with an apnoea-hypopnoea- index (ahi)≥5/h by overnight polysomnography exclusion criteria: 1. obstructive sleep apnea 2. severe copd，fev1/fvc\<70% and fev1\<60% 3. chronic co2 retention with unknown reason 4. severe nasal congestion 5. poor understanding

Keywords: csa
pediatric ultrasound-guided dorsal penile nerve block plus sedation in spontaneous breathing

Conditions: Child, Only

Summary: one of the most frequent surgical procedures in the pediatric population is circumcision, following which postoperative pain could be stressful. usually, the most common approach is combining regional anesthesia techniques such as landmark dorsal penile nerve block (dpnb) with general anesthesia (ga). the hypothesis of this study investigates ultrasound-guided dpnb plus sedation in spontaneous breathing.


Eligibility criteria:
inclusion criteria: * candidates to circumcision * age between 6 months and 17 years * american society of anesthesiologists (asa) physical status \< 3 * written consent of the parents exclusion criteria: * allergies to local anesthetics * younger than 6 months and older than 17 years * asa physical status =/\> 3 * no written consent of the parents

Keywords: dorsal nerve penis block sedation spontaneous breathing circumcision pediatric surgery ultrasound guided
prevalence of obstructive sleep apnea and accuracy of type 3 home sleep apnea test for obstructive sleep apnea diagnosis in difficult-to-treat asthma

Conditions: Difficult-to-treat Asthma, Underwent Type 1 In-laboratory Polysomnography and Type 3 HSAT Within 1 Month Apart

Summary: cross sectional cohort study enroll patients diagnosed with difficult-to-treat asthma, aged over 18 years, and experiencing persistent symptoms as assessed by the asthma control test (act) underwent type 1 in-laboratory polysomnography and type 3 hsat within 1 month apart


Eligibility criteria:
inclusion criteria: * difficult-to-treat asthma . * patients aged 18 years or older exclusion criteria: * patients or volunteers unable to undergo type 1 and type 3 sleep studies, * patients with symptoms compatible with other sleep disorders, * patients with a history of or current stroke or transient ischemic attack and other chronic respiratory diseases. * patients diagnosed with obstructive sleep apnea

Keywords: asthma osa hsat home sleep test
an observational study evaluating symlin® (pramlintide acetate) injection use in insulin using patients with type 2 and type 1 diabetes

Conditions: Type 1 Diabetes Mellitus; Type 2 Diabetes Mellitus

Summary: this is an open label, observational study designed to collect data that characterize the use of symlin following the introduction of the medication into the marketplace. health care providers and subjects selected for study participation are intended to be representative of those providers prescribing, and subjects receiving, symlin therapy.


Eligibility criteria:
inclusion criteria: * the following inclusion criteria are consistent with information in the symlin package insert and apply to insulin using patients with type 2 or type 1 diabetes who: * have failed to achieve the desired or optimal level of glycemic control despite utilizing appropriate, individualized insulin regimens * have a1c \<=9.0% within 3 months of study enrollment * are receiving ongoing diabetes care under the guidance of a health care provider (hcp) trained in the use of symlin exclusion criteria: * the following exclusion criteria are consistent with the symlin package insert and specifically exclude patients who: * are poorly compliant with their current insulin regimen, as defined by their hcp * are poorly compliant with prescribed blood glucose self monitoring, as defined by their hcp * have experienced recurrent patient-ascertained severe hypoglycemia requiring assistance during the past 6 months * have hypoglycemia unawareness * have a confirmed diagnosis of gastroparesis * require the use of drugs that stimulate gastrointestinal motility * are female and pregnant or lactating and for whom the hcp determines the potential benefit does not justify the potential risk to the fetus or infant * have been treated with symlin within 3 months prior to study start

Keywords: diabetes pramlintide symlin amylin phase 4
registry for temsirolimus, sunitinib, and axitinib treated patients with metastatic renal cell carcinoma (mrcc), mantle cell lymphoma (mcl), and gastro-intestinal stroma tumor (gist) [star-tor]

Conditions: Carcinoma, Renal Cell, Advanced; Lymphoma, Mantle-Cell; Gastrointestinal Stroma Tumors

Summary: the purpose of this registry is to obtain a general view as regards efficacy, tolerability and safety issues of the torisel®, sutent®, and/or inlyta® therapies in patients with advanced renal cell carcinoma, recurrent / refractory mantle cell lymphoma (mcl) and gastro-intestinal stroma tumors (gist) under the conditions of routine use

treatment of the metastatic renal cell carcinoma (mrcc) has experienced fundamental changes within a very short period of time. in the past few years, introduction of various new substances for the treatment of mrcc has therefore resulted in new scientific research questions. temsirolimus and sunitinib are current standard therapies in the first-line treatment of mrcc. inlyta® is a new substance that was developed for the treatment of mrcc after failure of sunitinib or cytokines. since august 2009, torisel® is available as another treatment option for patients with mantle cell lymphoma (mcl). in addition, sutent® is used for patients with non-resectable / metastatic gastro-intestinal stroma tumors (gist) after failure or intolerability of imatinib. the routine use of drugs in the usual clinical setting faces additional challenges that generally cannot be completely reflected by clinical trials. therefore, the purpose of this registry is to obtain a general view as regards efficacy, tolerability and safety issues of the torisel®, sutent®, and/or inlyta® therapies in patients with advanced renal cell carcinoma, recurrent / refractory mantle cell lymphoma (mcl) and gastro-intestinal stroma tumors (gist) under the conditions of routine use. therefore, the following information is of particular interest in the course of the investigation: * efficacy (best response, overall survival, progression-free survival) * tolerability of the therapy (assessed by the physician) * safety profile (overall incidence of adverse events as well as side-effect rate) of subjects with mrcc, rmcl, and gist under treatment with torisel®, sutent®, and/or inlyta® * profile, comorbidities, and characteristics of subjects treated with torisel® sutent®, and/or inlyta® * the sequence of using the systemic therapies for rcc, mcl, and gist * patient survey on the quality of life of mrcc patients

Eligibility criteria:
inclusion criteria: * patients with proven tumor of rcc, mcl or gist by histology. * informed consent signed by patient. exclusion criteria: * pregnancy
online cognitive behavioral therapy (cbt) for stress disorders in health workers involved in the care of patients during the covid-19 epidemic

Conditions: Stress - Prevention of Sleep Disorders, PTSD and Depression

Summary: some preliminary epidemiological research conduct in china in health workers involved in the care of covid-19 patients has shown high rates of depression (\>50%), generalized anxiety disorder (\>44%), insomnia (\>36%) and stress symptoms (\>73%), which negatively impact their well-being as well as their ability to work effectively . these rates were observed during the epidemic peak, but they can also have a long-term mental health effect, both individually, but also in a systemic manner , similar to what has been reported relative to the sars-cov-1 . cognitive behavioral therapy (cbt) is recognized as an effective treatment for stress-reduction, as well as for the prevention of multiple mental health problems in at-risk individuals . moreover, cbt has been found to be effective in brief online formats , which could make it feasible during the current covid-19 epidemic. to our knowledge, there are no online cbt programmes targeting stress problems in health workers involved in the care of patients during the current epidemic context. the aim of our study is to evaluate the efficacy of the online cbt programme we have developped to specifically address immediate perceived stress in health workers, as well as the prevention of mental health problems at 3- and 6-months follow-up


Eligibility criteria:
inclusion criteria: * health worker * male or female * aged 18-70 * able to understand the french language exclusion criteria: * pss \< 16 * suicidal ideation assessed as \< 3 on the item 9 of the phq-9 * legally able to provide informed consent
description of lung transplant patients with microbiologically documented stenotrophomonas maltophilia pneumonia and impact of treatment on outcome

Conditions: Transplantation Infection

Summary: stenotrophomonas maltophilia is a multi-resistant gram-negative bacillus and is an opportunistic pathogen. stenotrophomonas maltophilia infections are associated with a significant morbidity and mortality, particularly in immunocompromised patients. the mortality of infections (bacteremia, pneumonia) related to stenotrophomonas maltophilia is variable and is estimated between 21 and 69%. stenotrophomonas maltophilia pneumopathies have been mainly described in patients hospitalized in intensive care and benefiting from mechanical ventilation. the existence of immunosuppression seems to be a risk factor for the transition from stenotrophomonas maltophilia pulmonary colonization to stenotrophomonas maltophilia pulmonary infection. the reference treatment for stenotrophomonas maltophilia-associated pneumonia is the combination of trimethoprim and sulfamthoxazole, a molecule that lung transplant patients routinely receive as a preventive treatment for pneumocysitis jirovecii infection. there is no consensus on the value of routine dual-antibiotic therapy, and it varies from one center to another and from one country to another. the main objective is to compare the clinical-microbiological evolution of lung transplant patients treated for stenotrophomonas maltophilia pneumopathy according to the prescription of a mono- or bi-antibiotherapy. the secondary objective is to evaluate the resistance rate of stenotrophomonas maltophilia strains isolated from respiratory samples according to the anti-pneumocystis prophylactic molecule received by the patient.


Eligibility criteria:
inclusion criteria: * patient whose age ≥ 18 years * patient who has received a lung (mono or bi-pulmonary) or heart-lung transplant * patient with documented pneumopathy (clinico-radiological definition) (positive respiratory specimen for stenotrophomonas maltophilia) * french speaking patient exclusion criteria: * patient under guardianship or curatorship * patient deprived of liberty * patient under court protection * patient objecting to the use of his data for this research
feasibility of short breast mri (sbmri) for screening patients at high risk for breast cancer

Conditions: Breast Cancer

Summary: the goal of this clinical research study is to test if a short breast mri scan (about 10 minutes) can be used for breast cancer screening in high risk people and to learn if it is as effective as a routine breast mri scan (30-60 minutes).

if you agree to take part in this study, you will have the short breast mri scan (the scan for research purposes) with contrast on a different day than your scheduled routine mri screening scan with contrast. you will have your routine scan the first day and the research scan at least 1 day after. the research scan will take about 10 minutes to complete. after your short breast mri scan is completed, you will complete a questionnaire about your comfort level and experience of the research scan. it should take about 10 minutes to complete the questionnaire. this is an investigational study. the short breast mri is considered investigational. up to 200 participants will be enrolled in this study. all will be enrolled at md anderson.

Eligibility criteria:
inclusion criteria: 1. 18 years and older female patients 2. bmri indication: high risk screening per acs guidelines 3. no contraindications to undergo mri 4. creatinine \ 40 5. no requirement for sedation. exclusion criteria: 1. \<18 years 2. male 3. is pregnant (confirmed by the patient as imaging clinic standard of care) or nursing mother 4. contraindication to gd contrast agents 5. previous documented history of moderate to severe hypersensitivity to gd contrast agents 6. contraindications to mri

Keywords: breast cancer short breast mri scan sbmri routine mri high risk for breast cancer screening
niclosamide in moderate covid-19

Conditions: COVID

Summary: this is a phase 2, multicentre, randomized, double blind, 2 arm placebo-controlled study in adults with moderate covid-19 with gastrointestinal signs and symptoms.


Eligibility criteria:
inclusion criteria: * patients hospitalized for treatment of covid-19 with or without pneumonia, who are expected to remain in hospital at least seven days after the randomization and who accept continuing to be assessed for the study procedures (home or outpatient unit) up to 6 weeks in case of discharge. * patients who prior to developing covid-19 usually have normal bowel habits defined as at least 3 stools per week and no more than 3 stools per day. * sars-cov-2 infection confirmed by rt-pcr in rectal swab (or stool test) ≤2 days before randomization by local or central lab. * diarrhea defined as at least 3 watery stools in the last 24 hours prior to enrolment exclusion criteria: * at the time of randomization patients requiring icu admission or patients with severe respiratory insufficiency requiring mechanical ventilation or with rapid worsening of respiratory function leading to expectation for mechanical ventilation or icu admission. * evidence of rapid clinical deterioration or existence of any life-threatening co-morbidity or any other medical condition which, in the opinion of the investigator, makes the patient unsuitable for inclusion.
the radiation metabolic signature of patient undergoing radiotherapy. a pilot study

Conditions: Breast Cancer

Summary: rationale: local radiotherapy applied in the treatment of tumors changes the metabolic profile in the exposed area and/or systemically and specific radiation biomarkers can be identified in the respective matrices. purpose: this is a pilot study to verify in humans the results obtained from two animal models exposed to ionizing gamma-radiation. the classification of patients results from the treatment volume of radiotherapy for cancer disease. two patient groups with breast cancer undergoing high-dose radiotherapy are selected and compared to control group of age matched healthy women.

background humans are exposed to ionizing radiation from several sources. gamma-radiation exposure induces thereby both short- and long-term adverse effects. the radiation injuries to be expected in humans in the acute stage (days to some weeks after radiation exposure) correlate with the radiation dose that the individual has received. with very high doses gastrointestinal syndrome leads to death within a few days. the survival of the individual in the acute stage is therefore dramatically dependent on the rapid application of suitable therapies. it is decisive here to identify in the shortest possible time those persons who have been exposed to a critical radiation dose and to estimate the dose received in order to apply an adequate therapy. there are no satisfying test methods available today, which would enable the mass screening for radiation injury. furthermore to identify changes in the local or systemic human metabolic fingerprint, which are useful for the prediction of the individual sensitivity of patients to radiotherapy and / or lead to a better understanding of the molecular mechanisms involved in radiotherapy. objective primary: the primary endpoint is to affirm the results from the animal model in radiation metabolomics in human radiotherapy treatment. secondary: the secondary endpoints are to find new potential biomarkers for radiation biodosimetry in humans and to identify changes in the different sequences in measuring from local (sebum) and systemic (blood, saliva and urine) material. methods gas chromatographic separation and mass spectrometric detection of the metabolites present in a given matrix (urine, saliva, plasma, sebum).

Eligibility criteria:
radiotherapy: cancer treatment with total doses of more than 30 gy, single fraction dose of at least 1.8 gy/die. big treatment/target volume. age over 50 years, according to postmenopausal status. no simultaneous chemotherapy in breast cancer patients. for the control group: healthy volunteers (women), age over 50 years, according to postmenopausal status; no previous chemo - and cancer therapy.