Kornimate/medical-research-clean huggingface dataset:
the influence of combining the pulmonary recruitment maneuver with active gas aspiration on post-laparoscopic shoulder pain in patients having a gynecologic laparoscopy, randomized double blinded clinical trial

Conditions: Post Laparoscopic Shoulder Pain

Summary: laparoscopy is among the most used minimally invasive procedures that can reduce postoperative pain, lessen the duration of hospital stay and facilitate recovery. laparoscopy has been widely used in various abdominal surgeries, such as gastrectomy, cholecystectomy, appendectomy, hernia and gynecological surgery . however, the post-laparoscopic shoulder pain (plsp) often occurs following laparoscopic surgeries, and its reported incidence varies from 35-80% this study aims to assess the effect of combining pulmonary recruitment maneuvers (prm) with active gas aspiration on post-laparoscopic shoulder pain in patients undergoing gynecological laparoscopic procedures.

the plsp can even remain for up to three days and often upsets the patients . moreover, it can increase the costs of healthcare owing to an increased usage of analgesics, delayed discharge, and even re-admission . therefore, necessary measures should be taken to diminish the intensity of plsp. although the exact mechanism of plsp remains unclear, some studies have suggested that it is caused by the trapping of carbon dioxide (co2) between the liver and the right diaphragm and subsequent conversion into carbonic acid, which irritates the diaphragm and subsequently generates referred shoulder pain (c4 dermatomal) . therefore, several studies have attempted to decrease the incidence or severity of plsp by promoting the removal of remaining co2 from the abdominal cavity. these efforts include drainage tube insertion, intraperitoneal saline instillation (ipsi), and the usage of intraperitoneal local anesthetic agents . more-over, the pulmonary recruitment maneuver (prm) can also facilitate the removal of co2 from the abdominal cavity by increasing positive airway pressure and intrathoracic pressure. prm is more commonly used in clinical practice because it does not require drugs, specialized apparatus, or additional medical costs, unlike the other methods . several trials have described the advantages of prm in patients undergoing laparoscopic operations compared to passive abdominal compression.

Eligibility criteria:
inclusion criteria: * • age 18- 65 years. * american society of anesthesiologists physical status classification (asa) i - ii * scheduled for an elective gyncologic laparoscopic procedures exclusion criteria: * • urgent or emergency case. * asa classification more than iii. * age less than 16 years. * reduced left and right ventricular function (ejection fraction \<40%). * previous respiratory disease such as chronic obstructive pulmonary disease, restrictive lung disease, or had a history of thoracic or shoulder surgery * patient conversion to a laparotomy. * the operation time is more than 3 h

Keywords: pulmonary recruitment maneuver active gas aspiration
therapist-guided internet-delivered cognitive behavioural therapy

Conditions: Anxiety; Depression

Summary: depression and anxiety are prevalent and disabling conditions that often go untreated. internet-delivered cognitive behaviour therapy (icbt) is a relatively new approach to treatment that is a convenient way for patients to access care. icbt is typically highly standardized and involves patients reviewing weekly lessons over the internet. patients also receive brief weekly support from a therapist via secure emails or phone calls. past research shows that \~75% of patients complete icbt and report large symptom improvements. although these results are very promising, research also suggests that icbt could potentially be improved by being more personalized in terms of amount of therapist contact, especially for clients with more severe symptoms. the current trial will involve therapists who work in a clinic that specializes in icbt. over one year, 440 patients with depression and/or anxiety will be randomized to either receive standardized (5 lessons completed in 8 weeks; once week therapist contact) or personalized icbt (5 lessons completed in 8 weeks; personalized therapist contact depending on needs of patient). psychosocial outcomes of patients in the two treatment arms will be compared post-treatment and at 3-month, 6-month, and 1-year follow-up from enrollment. data on intervention usage, satisfaction measures, and costs will also be assessed.


Eligibility criteria:
inclusion criteria: * 18 years of age or older * residing in saskatchewan, canada * endorsing symptoms of anxiety or depression * able to access a computer and internet service * willing to provide a physician as emergency contact exclusion criteria: * high suicide risk * suicide attempt or hospitalization in the last year * primary problems with psychosis, alcohol or drug problems, mania * currently receiving active psychological treatment for anxiety or depression * not present in province during treatment; concerns about online therapy

Keywords: anxiety depression internet-delivered cognitive behaviour therapy randomized controlled trial patient-centered knowledge implementation mental health system therapist-assistance
chromocolonoscopy for the detection of flat adenomas in routine colorectal cancer screening.

Conditions: Colon Cancer; Polyp; Adenoma

Summary: the proposed research aims to determine the prevalence, size, shape and histology of flat colorectal neoplasms in a cohort of asymptomatic, average-risk individuals presenting for screening colonoscopy. patients will be randomized to either conventional colonoscopy or chromocolonoscopy, where the entire colon will be sprayed with indigocarmine dye and examined in the usual manner. the primary outcome will be the total number of adenomas detected, with special attention to the subgroup of flat and depressed lesions. to promote the generalizability of the results, neoplasms will be described according to standard western and japanese classification schemes.


Eligibility criteria:
inclusion criteria: * patients undergoing screening colonoscopy exclusion criteria: * age \< 50 * prior colon resection * inflammatory bowel disease * prior colonoscopy or sigmoidoscopy * more than one first-degree relative with colon cancer

Keywords: colonoscopy chromoscopy prevention
efficacy and safety of combination ambrisentan and tadalafil in patients with portopulmonary hypertension

Conditions: Portopulmonary Hypertension; Pulmonary Hypertension; Cirrhosis, Liver

Summary: the purpose of this study is to evaluate the efficacy and safety of the combination of ambrisentan and tadalafil in reducing mpap to below 35mmhg in patients with moderate to severe portopulmonary hypertension (poph) as a means to candidacy for liver transplantation.

the outcome of liver transplantation (lt) in the presence of moderate to severe poph is significantly poor with a 50% reported mortality rate in lt recipients having a mean pulmonary artery pressure (mpap) \>35 mmhg and 100% when the mpap is greater than 50 mmhg; therefore, making moderate to severe poph a contraindication to liver transplants. those recipients with significant pulmonary artery pressure (pap) may be denied the opportunity for transplant unless the mpap is brought below 35 mmhg with medical treatment. this study will test the efficacy \& safety of the combination of using ambrisentan and tadalfil in reducing the pulmonary arterial pressure to below 35 mmhg in patients with moderate to severe poph as a means to candidacy for liver transplantation.

Eligibility criteria:
inclusion criteria: * child-pugh class class a \& b cirrhosis * mpap ≥35mmhg * pulmonary capillary wedge pressure (pwcp) \<15mmhg on right heart catheterization's (rhcs) * mpap \> 50mmhg will be considered eligible unless they are world health organization (who) functional class iv exclusion criteria: * end stage renal disease on hemodialysis (esrd on hd) * renal dysfunction and gfr \< 30 * ast, alt \> 5 times the upper limit of normal * total bilirubin ≥ 6.0 * inr \> 2 * initially, child-pugh class c patients will be excluded; however, after the first 5 patients are included, if there is no signal of worsening liver function, the protocol may be amended to include patients with class c cirrhosis.
carvedilol versus placebo for treatment in post traumatic stress disorder (ptsd)

Conditions: Post-Traumatic Stress Disorder

Summary: the investigators hypothesize that carvedilol, at less then therapeutic doses for cardiac effect, will reduce symptoms of post traumatic stress disorder.

this initial proof of concept trial design is intended to explore multiple variables. fist, it is intended to determine if carvedilol has any statistically significant effect over placebo on the various overall symptoms, symptom clusters, or individual symptoms of post traumatic stress disorder. next, the flexible dosing trial design is aimed to detect the therapeutic dose, or dosing range for carvedilol when used in the treatment of ptsd

Eligibility criteria:
inclusion criteria: * diagnosis of post traumatic stress disorder according to dsm-iv * must be able to speak, read and understand the english language and be able to provide written informed consent exclusion criteria: * current, unstable and significant medical condition/illness * bronchial asthma or related bronchospastic condition * av block * sick sinus syndrome * bradycardia * peripheral hear disease * unstable thyroid disorder * history of seizure disorder * females who are pregnant, lactating or planning to become pregnant * bipolar * schizophrenia * dementia * intolerance or hypersensitivity to alpha or beta blockers

Keywords: ptsd anxiety trauma assault victim witness post traumatic stress disorder combat veteran flashbacks nightmares sleep disturbance hyperarousal numbness avoidance
prospective, post market surveillance q3-registry (polaris)

Conditions: Peripheral Artery Disease

Summary: this is a prospective, non-randomized post market surveillance registry designed to document the clinical performance in routine clinical practice of the polaris peripheral vascular self expanding stent system


Eligibility criteria:
inclusion criteria: * age \>18 years * single target de novo superficial femoral artery lesion (angiographic evidence of \>50% stenosis or occlusion) by visual estimate * rutherford category ii-iv * at least one patent outflow artery to the ankle. * patient signed the informed consent exclusion criteria: * patient with acute or subacute thrombus * patients with hyperkoagulopathy * patients with stenosis or occlusion where lesion crossing with guide wire is not possible * pregnancy or positive pregnancy test * previous enrolment in this trial or other industrial trials * patient´s inability to fully cooperate with the registry protocol patient with cancer treatment (life expectancy less than 2 years) patients with renal failure

Keywords: superficial femoral artery self expanding stent system
a study evaluating slow response/non-rapid response in patients with chronic hepatitis c, genotype 1, 2, 3 & 4 treated with pegasys (peginterferon alfa-2a) and copegus (ribavirin)

Conditions: Hepatitis C, Chronic

Summary: this multi-center study will evaluate the viral response in patients with chronic hepatitis c, genotype 1, 2, 3 \& 4 on standard anti-viral treatment with pegasys (peginterferon alfa-2a) and copegus (ribavirin). patients will receive weekly subcutaneous pegasys plus daily oral copegus for 24 weeks (genotype 2 \& 3) or 48 weeks (genotype 1 \& 4). patients identified as slow responders/non-rapid virological responders will be eligible for an additional 24 weeks of treatment.


Eligibility criteria:
inclusion criteria: * adult patients, \>/= 18 years of age * serologic evidence of chronic hepatitis c, genotype 1, 2, 3 or 4 by anti-hcv antibody test * documented pre-treatment hcv rna quantitative result * compensated liver disease (child-pugh grade a) * patient receiving standard combination treatment of pegasys (peginterferon alfa-2a and copegus (ribavirin) exclusion criteria: * decompensated liver disease (child-pugh class b or c cirrhosis) * co-infection with active hepatitis a and/or hepatitis b * history or evidence of a medical condition associated with liver disease other than hcv * signs and symptoms of hepatocellular carcinoma * history of poorly controlled thyroid disease, elevated tsh or any clinical manifestations of thyroid disease * therapy with antineoplastic treatment \</= 6 months prior to study day * diabetes mellitus in subjects receiving an insulin therapy * evidence of severe retinopathy * pregnant or breast-feeding women, and male partners of women who are pregnant
effects of connective tissue massage in women with overactive bladder

Conditions: Overactive Bladder

Summary: the aim of this study was to compare the effects of pelvic floor muscle trainig with connective tissue massage and only pelvic floor muscle training in women with overactive bladder


Eligibility criteria:
inclusion criteria: * 18 to 65 years of age, * having overactive bladder * being volunteer exclusion criteria: * being in the period of pregnancy or breastfeeding, * having an accompanying neurological disease, presence of a mental issue that would prevent cooperation in examinations and/or implementations, history of acute infectionor presence of a malignce
interactive digital game for improving visual perceptual defects in children with developmental disability

Conditions: Developmental Disability

Summary: visual perceptual defects in children can negatively affect their activities of daily living.the aims of this study were to develop and evaluate an interactive digital game system for correcting visual perceptual defects and to evaluate the effectiveness of the proposed system.


Eligibility criteria:
inclusion criteria: * record of developmental disability diagnosis * ability to understand instructions * tvps-3 score lower than 25% of the norm reference and diagnosis of visual perceptual defect * test of nonverbal intelligence-3rd edition score higher than 70 exclusion criteria: * did not follow or understand the instructions for participating in the study * had severe defects in vision, hearing, etc.
voluntary drug poisoning by psychoactive molecules: identify cognitive markers

Conditions: Suicide; Drug Poisoning

Summary: to identify in patients admitted for voluntary drug poisoning (imv) by psychoactive substances, t1 predictors of t2 recall of psychiatric interview and care project.

the methodology will compare the episodic memory results of patients admitted for imv who have exclusively ingested amnesic substances to a subject control group that has made imv with non-amnesic substances such as paracetamol. the purpose of this comparison is to ensure that memory problems are not related to the context of the suicidal crisis. the second step will be able to relate the memory score of the predictor variables. to achieve this, it will perform a multivariate linear regression in each group in order to confirm the results of the pilot study and to be able to regress in the control group which was not possible in the pilot study because of the lack of effective. finally, this study will try to establish, using receiver operating characteristic (roc) curves, thresholds for cognitive scores and begin to develop a tool for clinical practice.

Eligibility criteria:
inclusion criteria: group amnesic substances : * age from 18 to 65 years * admitted to emergencies for imv by benzodiazepines * supported at toulouse university hospital (hospitalization, outpatient) group control : * age from 18 to 65 years * admitted to emergencies for imv by non-depressive substances of the central nervous system * supported at toulouse university hospital (hospitalization, outpatient) exclusion criteria: * cognitive disorder due to an organic disorder neuro degenerative disease, korsakoff syndrome) or mental retardation diagnosed * patient under guardianship * not speaking and / or not reading french * neurodegenerative disease diagnosed
sarcoma treatment guide in improving self-monitoring in patients with sarcoma receiving chemotherapy

Conditions: Sarcoma

Summary: this randomized pilot clinical trial studies how well the sarcoma treatment guide works in improving self-monitoring in patients with sarcoma who are receiving chemotherapy. the sarcoma treatment guide may help patients with sarcoma to be better informed, become more engaged with care, encourage communication, and to better manage side effects associated with chemotherapy treatments in order to improve quality of life.

primary objectives: i. to evaluate whether symptom management and communication are improved in patients who are chemotherapy naive who receive a sarcoma treatment guide as compared to those that have not. secondary objectives: i. to explore whether patients who have previously undergone chemotherapy benefit from a sarcoma treatment guide (stg) in regard to symptom management and have improved communication between patient and providers. ii. to assess patient satisfaction with using the stg at the end of the trial. outline: patients are randomized to 1 of 2 arms. arm a: patients receive the stg before completing 4 courses of standard of care chemotherapy. arm b: patients complete 2 courses of standard of care chemotherapy and then receive the stg before completing 2 additional courses of standard of care chemotherapy.

Eligibility criteria:
inclusion criteria: * be able to read, write, and understand english * sarcoma clinic patient * about to begin either oral or cytotoxic chemotherapy exclusion criteria: * received previous chemotherapy
study on the relationship between maternal exposure to environmental factors and fetal congenital heart disease

Conditions: Congenital Heart Disease

Summary: the objective of this study is to research the relationship between maternal exposure to environmental factors and fetal congenital heart disease in a community-based case-control study.

this is a community-based case-control study in shanghai,a municipality in china. cases will be identified from maternity centers. matched controls will be accrued from the same region as the case came from. pregnant cases and their controls are women (18-45 years). cases are gravidas with fetal congenital heart disease diagnosed by echocardiography in 16th-29nd of gestational weeks. controls are pregnant women without fetal congenital heart disease diagnosis. only gravidas who are willing to have complete pregnancy checks and finally delivery or abortion in the hospital are interviewed are eligible for the study. about 2 controls matched by year of birth and region will be allocated to each case. a standardized questionnaire will be used for all cases and controls. field investigations are also conducted for them by quantitative measurement of some chemical, physical and nutritional factors related indicators may affect fetal cardiovascular development. study participants will be asked for their informed consent.

Eligibility criteria:
inclusion criteria: 1. gravida with singleton pregnancy taking fetal echocardiography in 16th-29nd of gestational weeks. 2. complete pregnancy check in the hospital, and finally delivery or abortion in the hospital. 3. on the basis of informed consent，willing to cooperate with our group. exclusion criteria: 1. pregnant women with serious pregnancy complications . 2. pregnant women suffering from mental illness, can't take care of themselves. 3) fetus diagnosed with chromosomal abnormalities in pregnant women . 4）repeated explanation does not cooperate in pregnant women.

Keywords: case control study environmental factors fetal congenital heart disease
a study comparing short-course antifungal therapy (scat) 7 day vs standard 14 day antifungal therapy for uncomplicated candidemia

Conditions: Candidemia

Summary: the goal of this clinical trial is to assess whether a seven-day course of standard of care (echinocandin) antifungal therapy is non-inferior to a 14-day course of echinocandin antifungal therapy in patients with uncomplicated candidemia in terms of clinical, mycologic, adverse events and all cause mortality.


Eligibility criteria:
inclusion criteria: 1. patients ≥ 18 years of age 2. uncomplicated candidemia (positive blood culture only). no evidence of invasive candidiasis at day 1 or until day 7. 3. received \< 5 days of prior antifungal therapy 4. informed consent for randomization 5. patients that did not consent to randomization have consented to be used as a natural history (controls) and will allow collection of available data from the medical record. exclusion criteria: 1. inadequate source control (e.g., unable to remove endovascular devices, urinary catheters). 2. invasive candidiasis of any type (e.g., deep seated candidiasis from sources other than blood) 3. abnormal lfts \> 10-fold 4. greater than 5 days of prior antifungal therapy 5. endovascular devices that cannot be removed. 6. immunocompromised patients (aids/hiv; solid organ transplant, bone marrow transplant patients, oncology patients receiving chemotherapy, neutropenic patients (anc of \< 1,500 cells/l 7. neutropenic at time of consent (what does this mean) 8. break-through candidemia (people with prior candidemia who relapsed) after treatment with antifungal therapy) 9. unable to provide informed consent from either the patient or legally authorized authority (lar) 10. expected mortality within 96 hours

Keywords: candidemia uncomplicated candidemia antifungal therapy echinocandin caspofungin micafungin rezafungin anidulafungin
methylphenidate in myotonic dystrophy type 1

Conditions: Dystrophia Myotonica 1

Summary: the purpose of this study is to determine whether methylphenidate is effective in the treatment of excessive daytime sleepiness due to myotonic dystrophy type 1 (dm1).

myotonic dystrophy type 1 (dm1) is a multisystemic disorder characterized by muscle weakness, myotonia, and the involvement of several systems. hypersomnolence is one of the most frequently reported symptoms in patients with dm1 and often lead to handicap such as cessation of employment and withdrawal from social activities.the current investigation represents a prospective, double-blind, randomized, crossover, placebo-controlled study designed to evaluate the efficacy of methylphenidate for the treatment of excessive daytime sleepiness (eds) in adults with dm1.

Eligibility criteria:
inclusion criteria: * adults * epworth score ≥ 10 * diagnosis of myotonic dystrophy type 1 exclusion criteria: * hypersensibility to methylphenidate * pregnancy * patients who receive drugs that interfere with methylphenidate * cognitive impairment * sleep apnea

Keywords: randomized double-blind crossover methylphenidate excessive daytime sleepiness
rapid genetic diagnosis employing next generation sequencing for critical illness in infants and children

Conditions: Congenital Metabolic Disorder; Acute Disease

Summary: under the joint efforts of genetic and intensive expert, to establish the high-throughput whole exon sequencing(wes) and analysis all the possible pathogenic genes. to provide patient with the appropriate treatment for genetic disease. besides, it can identify the genetic factor of idiosyncrasy or susceptibility to explain the medical difficulties and give patients personalized advice.


Eligibility criteria:
inclusion criteria: * pediatric patients admitted to intensive care unit * infants with abnormal newborn screening result that is medical emergency exclusion criteria: * participants or parents who cannot comply with study