Kornimate/medical-research-clean huggingface dataset:
frailty screening in the swedish emergency department setting

Conditions: Frailty; Frailty Syndrome; Emergency Department; Geriatric Assessment; CFS

Summary: this prospective observational study will investigate the correlation of frailty in relation to serious outcomes. serious outcomes are defined as: mortality within 30 days, admission to hospital, length of stay in the emergency department(ed), in hospital length of stay and revisits to the ed. the exposure, frailty, will be assessed according to clinical frailty scale. ed patients \>65 years of age in a swedish regional health care system (region östergötland, sweden) comprising three eds in linköping, norrköping and motala. the outcomes will be compared according to the degree of frailty and censored over 7, 30 and 90 days respectively.

frailty is a common clinical syndrome in older adults that carries an increased risk for poor health outcomes including falls, incident disability, hospitalization, and mortality. the clinical frailty scale (cfs) is a measure of frailty based on clinical judgement in a 9 level scale, categorized as "vulnerable" (1-4), "mildly frail" (5), moderatly frail (6) and severely and very severely frail (7-8).". a validation study of the cfs in community-dwelling older people showed that it performed better than measures of cognition, function or comorbidity in assessing risk for death. in a prospective observational study including consecutive ed patients aged 65 years or older the hosmer-lemeshow test indicated a good agreement between predicted probability and observed frequency of 30-day mortality and icu admission. the aim of this study will be to investigate if the fraily, assessed according to cfs, is associated with increased 30-day mortality. in a swedish emergency care context. secondary outcomes included 7-and 90-day mortality, ed length of stay, hospital admission, hospital length of stay, subsequent falls and medication changes. additionally, we collect data on morbidity and comorbidities to assess the association with the level of frailty. since this is a multicenter study, possible geographic differences will be studied as well. based on the results of this study, possible interventions could be identified to improve the care of the frail geriatric patients presenting at the ed.

Eligibility criteria:
inclusion criteria: * ≥65 years, able to answer any questions, alternatively have a proxy exclusion criteria: - patients: \<65 years
assessment of the efficacy and safety of (hcq) as a prophylaxis for covid19 for health professionals

Conditions: COVID19; Sars-CoV2; Hydroxychloroquine; Prophylaxis; Healthcare Worker

Summary: assessment of the efficacy and safety of hydroxychloroquine (hcq) administered as a prophylaxis for health professionals exposed to covid19 and working in medical intensive care units, in tunisia. multicentric, randomized comparative study

interventional, multicentric, randomized controlled study in two parallel groups of 530 healthcare professionals working in the intensive care unit exposed to risk of covid19 infection taking hydroxychloroquine (hcq) (200 mg/day) vs placebo

Eligibility criteria:
inclusion criteria: * diagnosis of covid-19 (-) * works in a medical intensive care unit exposed to covid-19 infection * 18 years old \< age \< 65 years old * having given written consent for their participation in the study. exclusion criteria: * diagnosis of covid-19+ * retinopathies, * hydroxychloroquine or other prophylactic treatments for vidoc19 within one month prior to inclusion and throughout the study. * hypersensitivity to chloroquine or hydroxychloroquine or 4-aminoquinolines or any of the other components of this drug, * contraindication to prophylactic use of chloroquine, e.g. liver failure, known epilepsy, creatinine clearance \< 30 ml/min. * inability to be monitored during the trial period * pregnancy and breastfeeding * psoriasis

Keywords: hcq prophylaxie healthcare worker hydroxychloroquine covid19
gastric ultrasound for estimation of the aspiration risk study

Conditions: Respiratory Aspiration of Gastric Contents

Summary: the purpose of this research study is to look at the effectiveness of current anesthesia guidelines regarding food and drink prior to surgery in patients who are likely to have food and drink remain in their stomach longer than might ordinarily be expected.

examine the utility of ultrasound examination of the stomach in estimating aspiration risk in patient populations whose aspiration risk is currently poorly understood. evaluate the applicability of current pre-surgical fasting guidelines in the same patient populations whose aspiration risk is poorly understood. evaluate the residual gastric contents in patients presenting for upper gi endoscopy procedures who have adhered to pre-operative fasting guidelines. evaluate the residual gastric contents in patients presenting for upper gi endoscopy procedures who have not adhered to pre-operative fasting guidelines. only patients expected to have an oral-gastric tube placed during upper gi endoscopy procedure will be included. both groups will be evaluated to learn if their residual gastric contents conform to currently-accepted standards for low aspiration risk.

Eligibility criteria:
inclusion criteria: * presenting for upper gi endoscopy procedures or surgical repair of a trauma- related injury * expected to have an oral-gastric tube placed as part of scheduled procedure * willing to undergo an ultrasound exam * patients ≥ 18 years of age exclusion criteria: * unwilling to undergo an ultrasound exam * oral-gastric tube placement is not indicated * oral-gastric tube placement is contraindicated * pregnant patients and patients from defined vulnerable populations (ex. pediatric patients, mentally handicapped patients, prisoners, etc.) * surgical trauma patients who are not expected to have an og tube placed during surgery * patients with history of gastric bypass surgery * patients that are gastrostomy tube dependent

Keywords: aspiration risk gi endoscopy fasting guidelines delayed gastric emptying
trial of autism parent navigator program

Conditions: Autism Spectrum Disorder

Summary: to address the dual needs of parents for support in navigating autistic spectrum disorder (asd) services and maintaining positive family functioning, the investigators propose to test autism parent navigators (apn), an innovative in-home, peer support model for parents with a young child recently diagnosed with asd.


Eligibility criteria:
inclusion criteria: * parents of children who have been newly diagnosed with autism spectrum disorder (asd). * the child will be age 2-6 years and been diagnosed with asd in the past four months. * the child is the first child in the family to be diagnosed with asd. * parents are not already involved in a parent mentoring relationship. * parents are currently involved in a couple relationship, including same-sex partners, dating couples, adoptive parents and step-parent families. exclusion criteria: none
guidance of patients with asthma during preparation and during expedition to the aconcagua mountain

Conditions: Asthma

Summary: a selection of asthma patients were followed during preparation to climb the aconcagua mountain. the primary goal of this follow up was to optimize patients' asthma status. also during expedition, these patients were daily consulted by a physician. all data obtained during preparation and expedition will now be retrospectively analyzed.

preparation phase: eighteen asthma patients were selected based on physical and medical characteristics. during the year of preparation, several time points of evaluation were planned: evaluation at baseline, maximal exercise test in hypoxia (fio2: 11%), 24hour stay at cold air environment. at baseline, medical history was evaluated and clinical examination, ecg, lung function, fraction of exhaled no measurement and histamine provocation were performed. during a second visit, patients stayed for approximately one hour in a chamber to simulate high altitude (fio2:11%) and performed a maximal exercise test after 30 minutes of rest. oxygen saturation, ecg and oxygen consumption were continuously monitored. lung function and fraction of exhaled no were assessed before and after the test. also, peripheral blood was drawn before and after the test. this test allowed us to identify whether patients may develop acute mountain sickness later on during expedition. during a third visit, patients stayed for 24 hours in a indoor ski centre to practice climbing techniques, building up a tent and working with the specialized materials. temperature at the ski piste varies between -5°c and -10°c. lung function, fraction of exhaled no and induced sputum was assessed before and after the stay at the ski centre. during the expedition, clinical status, heart rate and oxygen saturation were measured daily. also, lung function and fraction of exhaled no were regularly measured. a screening for acute mountain sickness was performed daily. asthmatics patients were supported by two pulmonologist. before and after expedition, spirometry, histamine provocation and induced sputum were performed.

Eligibility criteria:
inclusion criteria: * asthma patient * positive histamine provocation exclusion criteria: * exacerbation during the year prior to inclusion
a study to investigate the efficacy and safety of ono-4578 in combination with nivolumab and chemotherapy in chemotherapy-naïve participants with her2-negative unresectable advanced or recurrent gastric cancer (including esophagogastric junction cancer)

Conditions: Gastric Cancer

Summary: this study is to compare and evaluate the efficacy and safety of the treatment with ono-4578 in combination with nivolumab and chemotherapy with those of the treatment with placebo in combination with nivolumab and chemotherapy in chemotherapy-naïve participants with her2- negative unresectable advanced or recurrent gastric cancer (including esophagogastric junction cancer).


Eligibility criteria:
inclusion criteria: * patients with gastric or esophagogastric junction cancer histologically diagnosed as adenocarcinoma * patients have not been treated with systemic chemotherapy as first-line therapy * patients who can provide tumor tissue samples exclusion criteria: * patients unable to take oral medicines * patients with her2-positive * patients with contraindications to nivolumab, oxaliplatin, s-1, or capecitabine * patients who have a history of severe drug-related adverse reactions caused by non- steroidal anti-inflammatory drugs (nsaids) or who have complications caused by nsaids requiring treatment * patients with concurrent autoimmune disease or a history of chronic or recurrent autoimmune disease, such as rheumatoid arthritis * patients with headache and/or nausea associated with brain metastasis
an accessible and inclusive artificial intelligence assisted chronic disease self-management telehealth platform

Conditions: Disability Physical; Chronic Condition; Chronic Conditions, Multiple

Summary: the purpose of this study to pilot test an accessible and inclusive artificial intelligence (ai)-assisted, individualized, family-focused lifestyle modification intervention (ai4chron) for health-related quality of life for adults with impaired mobility and chronic medical conditions.

the ai4chron study will use a four-arm randomized control trial design. eligible and consented participants will be assigned to one of four groups: 1) scheduled coaching calls with gamified rewards, 2) scheduled coaching calls with rewards independent of gamification, 3) no scheduled coaching calls with gamified rewards, and 4) no scheduled coaching calls with rewards independent of gamification. the active intervention period will be six months.

Eligibility criteria:
inclusion criteria: * 18 years or older * diagnosis of heart disease, chronic lung disease, or type 2 diabetes * living with a permanent physical disability (i.e., spina bifida, multiple sclerosis, stroke,) * have the ability to converse in and read english * availability of a smartphone or computer exclusion criteria: * current enrollment in any structured intervention * severe cognitive impairment * severe untreated depression in the past 6 months * major cardiac event in the past 12 months * uncontrolled blood pressure * resting tachycardia * renal failure * severe peripheral neuropathy * active treatment for cancer in the past 12 months * having both visual and hearing impairments (either of them is fine)
study of vaginal dilator use after pelvic radiotherapy

Conditions: Cervical Cancer; Endometrial Cancer; Rectal Cancer; Anal Cancer

Summary: patient will have radiation to treat the cancer. this treatment can make the vagina both narrower and shorter. that can cause two problems. it can make it harder for the doctor to do a pelvic exam during a follow-up visits. and, it can make sexual intercourse uncomfortable. we tell women to use a vaginal dilator after radiation to the pelvis. this is standard education. we do not routinely ask women how they do with it. we are doing this study to see if using the dilator as we instruct will help the vagina stretch. the patient will have an examine of the vagina before the start of radiation. we will see what size dilator can fit. the goal of this study is to have the patient be able to use that size dilator within six months after radiation.


Eligibility criteria:
inclusion criteria: * female with cervical, endometrial, rectal or anal cancer * scheduled to begin one of the following treatments at mskcc: * definitive external beam radiation therapy * preoperative external beam radiation therapy of followed by surgery * postoperative external beam radiation therapy * definitive external beam radiation therapy with intracavitary brachytherapy (tandem and ring or syed)± surgery * postoperative intravaginal brachytherapy (once every two weeks times three) * ≥ or = to 21 years of age exclusion criteria: * women with cervical, endometrial, rectal or anal cancer who are/have: * unable to speak and write english so that it would prohibit them from full participation in the study. patient education, instruction and questionnaire are validated in english. * mental or physical handicaps that would prohibit them from full participation in the study. * prior radiation to the pelvis. * evidence of metastatic disease.

Keywords: external beam pelvic radiation brachytherapy
celiac disease and diabetes longitudinal follow-up and evaluation study

Conditions: Celiac Disease; Celiac; Diabetes Mellitus, Type 1

Summary: to the investigators' knowledge, no single long-term prospective observational study has assessed dietary factors, diabetes clinical variables (metabolic control and associated complications), and self -perceived health and wellness in t1d patients (both pediatric and adult) with cd identified by screening (positive/weakly positive serology). the aim of the current study is to observe the short- and long-term outcomes for type 1 diabetic patients with new serology positive asymptomatic cd.


Eligibility criteria:
inclusion criteria: 1. males and females between the ages of 8 and 50 years with positive/weakly positive serologic cd screening or who have completed the cd-diet trial. 2. diagnosis of t1d by american diabetes association (ada) criteria with duration of t1d equal to or greater than 1 year from time of signing screening informed consent for cd-diet trial. 3. ability of the subject or a legally authorized representative to speak and read english or french. 4. participation in the screening portion of the cd-diet study. exclusion criteria: 1. a condition which, in the opinion of the investigator, may interfere with the subject's ability to participate in the study.

Keywords: pediatric dietary treatment celiac disease t1d
early evaluation of exosome multiomics and clinical prognosis in patients with sudden death

Conditions: Sudden Cardiac Death; Exosome Multiomics; Clinical Prognosis

Summary: acute coronary syndrome (acs) is one of the main causes of death. worldwide, tens of millions of patients are hospitalized for coronary heart disease and acs every year. acs may show acute myocardial infarction, unstable angina pectoris, and even induce early arrhythmia, leading to sudden death. sudden cardiac death (scd) has a strong correlation with acs. data from clinical and autopsy studies and death certificates show that 62-85% of patients with out of hospital scd have a history of acs, 10% have other cardiac structural abnormalities, and 5% have no cardiac structural abnormalities. an scd surveillance study from ireland concluded that most cases occurred in families, and the successful recovery of scd was mainly related to ventricular fibrillation with arrhythmia. at present, there are few reports on the clinical and prognosis of acs in china, and there is no guideline or consensus on the prevention and treatment of acs patients. known domestic research results show that the proportion of male, overweight / obese, smokers in young acs patients is higher than that in the elderly group, while the proportion of patients with hypertension, diabetes and cerebrovascular diseases is less than that of the elderly group. the levels of tc, tg, ldl-c and ua and the proportion of low hdl-c in young acs patients were higher than those in elderly patients; the diagnosis of stemi was the highest in the young acs group, while the diagnosis of unstable angina pectoris was the most common in the elderly acs group. the clinical manifestations of acs vary greatly. 3% \~ 5% of patients who exclude acs only through myocardial markers, clinical blood transfusion and ecg still have myocardial infarction (mi). for the emergency department, early prediction of the risk of scd in acs patients and timely and accurate screening of high-risk patients are very important.


Eligibility criteria:
inclusion criteria: * the death event happens suddenly. * age ≥ 18 years * the patient had obvious clinical symptoms 24 hours before treatment * life expectancy exceeds 3 days * proxy of patients signs the informed consent form * comply with acs diagnostic indicators recommended by acc / aha guidelines in 2016 exclusion criteria: * death caused by accident, such as trauma, poisoning, etc. * death from accidental or intentional overdose * death from asphyxia * death is caused by chronic disease or terminal illness * the patient died naturally * has participated in other clinical studies * immediate family members give up continuing treatment
prospective randomized controlled study of intravitreal injection of bevacizumab for proliferative diabetic retinopathy

Conditions: Proliferative Diabetic Retinopathy; Diabetic Traction Retinal Detachment; Vitreous Hemorrhage

Summary: we hypothesized that to reduce the adverse effects of intravitreal bevacizumab on ocular tissue and whole body, intravitreal injection of a low concentration of bevacizumab and conducting vitrectomy shortly after the injection is useful. in the present prospective, double-masked, randomized, controlled study, we aimed to verify the usefulness of intravitreal injection of 0.16 mg/0.05 ml bevacizumab one day before conducting vitrectomy for pdr.

early postoperative hemorrhage in proliferative diabetic retinopathy (pdr) patients is a major complication. intravitreal injection of anti-vascular endothelial growth factor (vegf) has reported to reduce vitreous hemorrhage. recently, numerous reports have shown the efficacy of reducing neovascularization activity before vitrectomy by preoperative intravitreal injection of anti-vegf agents. when intravitreal bevacizumab (ivb) injection is used as an adjunct therapy, a shortterm effect is needed. because it is reported some adverse events caused by bevacizumab injection. hattori et al reported intravitreal injection of 0.16 mg/0.05 ml bevacizumab in pdr patients marked blockage of intravitreal vegf concentrations in the pilot study. the purpose of this study is to evaluate low dose of intravitreal bevacizumab as a preoperative adjunct therapy reduce the postoperative vitreous hemorrhage. this study involves pdr patients who underwent vitrectomy between may 2012 and august 2013 at surugadai hospital of nihon university. the risks to participants are accompanied by the intravitreal injection of bevacizumab (especially the possibility of endophthalmitis and thromboembolic events). between june 2012 and august 2013, one investigator (am) randomized pdr patients with an indication for primary 25-gauge vitrectomy into a sham group and an ivb group. one day after injection, three surgeons except am conducted the surgeries. vitreous samples were collected at the start of surgery, and intraoperative and postoperative complications were evaluated.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of proliferative diabetic retinopathy (pdr) * indicated for vitrectomy exclusion criteria: * history of intraocular surgery, intravitreal injection of drugs or sub-tenon injection of steroids or retinal photocoagulation within 6 months
efficacy and safety ofsangrow decoction for patients with diabetes

Conditions: Diabetes Mellitus

Summary: medlineplus related topics: blood sugar primary outcome measures: * fast glucose and hba1c change between the baseline and end of study \[ time frame: from baseline to 30 and 100 days\] * \[ designated as safety issue: no \] * successful rate of blood glucose control (the proportion of patients with hba1c \<7%) \[ time frame: from baseline to 30 days and 100 days\] \[ designated as safety issue: no \] secondary outcome measures: • to evaluate the change of quality of life in the 1 months by the health questionnaire sf-36 \[ time frame: from baseline to month 1 \] \[ designated as safety issue: no \]

this study is aimed to evaluate the safety and efficacy of sangrow decotion, diet and exercise for the treatment of type 2 diabetes. previous study has shown that this therapeutic regimen is safe and effective.

Eligibility criteria:
inclusion criteria: * type ii diabetes mellitus patients who have received medical treatment for more than 3 months * patients willing to sign written informed consent form exclusion criteria: * patients unable or unwilling to comply with the requirements of the protocol * females who are pregnant or nursing or females of childbearing potential who are unwilling to maintain contraceptive therapy for the duration of the study * life expectancy \< 6 months due to concomitant illnesses.

Keywords: diabetes mellitus chinese medicine exercise diet