Kornimate/medical-research-clean huggingface dataset:
case volume and adenoma rate during screening colonoscopy

Conditions: Colorectal Cancer

Summary: screening colonoscopy has been established as the most effective means of colorectal cancer prevention. this is based on the fact that colonoscopy detects and removes colonic polyps (adenomas) which are known to progress to cancer if left untreated. the present study examines the question whether case volume (i.e., the number of colonoscopies performed per year) correlates with colonoscopy quality, i.e., adenoma detection rate.

21 private practice gastroenterologist endoscopists from berlin performed a prospective quality assessment study including at least 10.000 screening colonoscopies. after informed consent, patients data are included (age, sex, family history, colonoscopy performance parameters and findings, therapy performed, histology of biopsies and/or polypectomies, complications (immediate and late) and patient acceptance. the latter was retrieved by patient questionnaires returned after a minimum of 2 weeks. data were centrally collected in an anonymized way primary outcome parameter: * correlation of adenoma detection rate with case volume and other confounding factors (e.g., withdrawal time) secondary outcome parameters: * complications and method of assessment (immediate recording versus later questionnaire enquiry) * quality of bowel preparation in relation to outcome patient acceptance in relation to procedural factors (e.g., sedation) * quality of pathology reports and histologic outcome of polypectomy later follow-up (after 5-10 years) of the preventive effect of colonoscopy is planned and has been part of the protocol and patient consent form.

Eligibility criteria:
inclusion criteria: * all persons willing and able to undergo screening colonoscopy over the age of 55 years exclusion criteria: * any condition not compatible with the definition of screening colonoscopy

Keywords: colorectal cancer prevention colonoscopy screening quality assessment colorectal cancer prevention
effect of real-time continuous glucose monitoring on glucose control and outcomes of critically ill patients

Conditions: Hyperglycemia

Summary: the purpose of the study is to evaluate the effect of real-time continuous glucose monitoring system on glucose control and outcomes of critically ill patients.

real-time continuous glucose monitoring system has shown great accuracy and feasibility in critically ill patients. however, its impact on glucose control and outcomes has nearly unknown. thus, investigators designed this study to evaluate the effect of real-time continuous glucose monitoring system on glucose control and outcomes of critically ill patients.

Eligibility criteria:
inclusion criteria: * more than 18 years old male or female; * expected icu stays longer than 72 hours; * glucose level more than 8 mmol/l when enrolls in the icu; * patients or their legal surrogates have signed the informed consent. exclusion criteria: * pregnant or lactating women; * icu stays less than 72 hours; * usage of real-time continuous glucose monitoring system is considered as a contraindication.

Keywords: continuous glucose monitoring； critically ill;
prasugrel versus high dose clopidogrel in clopidogrel resistant patients undergoing chronic hemodialysis

Conditions: Hemodialysis; Chronic Renal Failure

Summary: clopidogrel administration is essential in patients undergoing percutaneous coronary intervention, in patients with previous stroke, in patients under chronic hemodialysis via fistulae and in patients with chronic atrial fibrillation if coumarin administration is not a viable option. patients with chronic renal failure present lower clopidogrel response compared to those with normal renal function. additionally, hemodialysis via the dialysis filter causes a decrease in glycoprotein platelet receptors, potentially associated with thienopyridine hyporesponsiveness. clopidogrel resistant patients as assessed by verifynow p2y12(accumetrics)will be randomized in 1:1 fashion to prasugrel 10mg/day or clopidogrel 150mg/day. on day 15±2 days a crossover directly to the alternate treatment group will be carried out, without an interventing washout period. all patients will undergo platelet reactivity assessment, documentation of major adverse cardiac events and documentation of any serious adverse events(stroke, bleeding)at day 15 and day 30.


Eligibility criteria:
inclusion criteria: 1. age ≥18 years old 2. history of chronic renal failure under hemodialysis for at least 6 months 3. under clopidogrel 75mg/day treatment for at least 7 days before randomization 4. informed consent obtained in writing exclusion criteria: 1. treatment with other investigational agents (including placebo) or devices within 30 days prior to randomization or planned use of investigational agents or devices prior to the day 30 visit. 2. pregnancy 3. breastfeeding 4. inability to give informed consent or high likelihood of being unavailable for the day 30 follow up. 5. malignancy 6. acute coronary syndrome or hemodynamic instability within 30 days prior to randomization 7. requirement for oral anticoagulant prior to the day 30 visit 8. requirement for discontinuation of thienopyridine treatment prior to the day 30 visit 9. treatment with iib/iiia inhibitors within 30 days prior to randomization or planned administration prior to the day 30 visit 10. known hypersensitivity to prasugrel or clopidogrel. 11. history of gastrointestinal bleeding, genitourinary bleeding or other site abnormal bleeding within the previous 6 months. 12. other bleeding diathesis, or considered by investigator to be at high risk for bleeding on thienopyridine therapy. 13. any previous history of ischemic stroke, intracranial hemorrhage or disease (neoplasm, arteriovenous malformation, aneurysm). 14. thrombocytopenia (\<100.000 / μl) at randomization 15. known liver failure (bilirubin \> 2mg/dl)

Keywords: clopidogrel resistance prasugrel hemodialysis
evaluation of digit tip and split skin donor site transcriptome

Conditions: Digit Tip Wound; Split Skin Donor Site

Summary: regrowth of amputated fingertips presents a unique regenerative healing process in mammals, with subcutaneous volume regrowth, restoration of the dactylogram, and suppression of scar formation. in addition, wound healing from split-thickness donor sites shows almost scar-free healing. transcriptome analysis is necessary to better understand the specific healing mechanisms of these two wound entities. since no data are available to date, this study aims to fill the gap.

regrowth of amputated fingertips presents a unique regenerative healing process in mammals, with subcutaneous volume regrowth, restoration of the dactylogram, and suppression of scar formation. in addition, wound healing from split-thickness donor sites shows almost scar-free healing. transcriptome analysis is necessary to better understand the specific healing mechanisms of these two wound entities. since no data are available to date, this study aims to fill the gap.

Eligibility criteria:
inclusion criteria: 1. digit tip wound: wound exudate from healthy patients: consent-capable patients ≥18 years of age with clean digit tip wound 2. split skin donor site wound: wound exudate from healthy patients: consent-capable patients ≥18 years of age with clean split skin donor site wound exclusion criteria: * inflammation * borderline * infectious disease

Keywords: digit tip split skin donor site transcriptome
combination chemotherapy in patients with zollinger-ellison syndrome and tumors of the pancreas

Conditions: Islet Cell Adenoma; Neoplasm Metastasis; Zollinger Ellison Syndrome

Summary: patients with zollinger-ellison syndrome suffer from ulcers of the upper gastrointestinal tract, higher than normal levels of gastric acid, and tumors of the pancreas known as non-beta islet cell tumors. prior to the use of drugs to cure the ulcers, patients typically died due to severe ulcers. because of such effective drugs to treat the ulcers it is more common to see patients dying due to the pancreatic tumors. the study will observe patients suffering from zollinger-ellison syndrome and non-beta islet cell tumors and determine the effectiveness of combined chemotherapy with streptozotocin, 5-fluorouracil, and doxorubicin.

heretofore morbidity and risk of death in zollinger-ellison syndrome were caused by severe ulcer disease. the advent of specific drugs to cure ulcer disease now extends life until metastases from the non-beta-islet cell tumor cause death. the present study proposes to continue to test the effect of combined chemotherapy with streptozotocin, 5-fluorouracil and doxorubicin in biopsy-proven cases of metastatic non-beta-islet cell tumor in patients with zollinger-ellison syndrome. we published our initial experience with this protocol in 1988. an objective response was observed in 40% of patients.

Eligibility criteria:
inclusion criteria subjects selected for this study will be patients with zollinger-ellison syndrome who are being evaluated under the protocol entitled "diagnostic evaluation of patients with suspected abnormalities of gastric secretion" (80-dk-0123). histologically proven gastrinoma; evidence of metastatic disease or locally invasive tumor by angiography, ultrasound, computerized axial tomography, mri scan or bone scan; progression of the tumor during the preceding 6 months. exclusion criteria the following pre-existing conditions will exclude patients from the study: congestive heart failure; proteinuria greater than 1 gram/day; serum creatinine greater than 1.5 mg%; platelet count less than 100,000/mm3; white blood count less than 2500/mm3; pregnancy.

Keywords: gastrinoma acid secretion toxicity
efficacy of betalactam antibiotics in prolonged infusion compared to intermittent in pediatric patients with sepsis

Conditions: Sepsis

Summary: this study evaluates the efficacy and safety of the administration of betalactam antibiotics in prolonged infusion compared to intermittent infusion in children with sepsis. half of participants will receive piperacillin/tazobactam, imipenem or meropenem in continuous or extended infusion, while the other half will receive piperacillin/tazobactam, imipenem or meropenem in intermittent infusion.

sepsis is the leading cause of morbidity and mortality in hospitalised patients globally. betalactams are time-dependent antibiotics, and so, the duration of time for which the free drug plasma concentration remains above the minimum inhibitory concentration (ft \> mic) is the pharmacokinetic/pharmacodynamic index associated with bacterial killing and clinical improvement. numerous studies have demonstrated that continuous infusion (infusion in 24 hours) and extended infusion (through prolonging the infusion time to greater than 3 hours) allows the maintenance of concentrations above the mic for a longer period of time within the dosing interval (30 minute or 1 hour), and so, capitalises on the pharmacodynamic properties of betalactams and maximises bacterial killing, therefore potentially improving clinical outcomes. in adult patients, the several studies suggest that prolonged infusion may offer clinical benefits and significant reduction in mortality without increasing the risk of toxicity, however, there is limited information about these dosing strategies in pediatric patients.

Eligibility criteria:
inclusion criteria: * patients diagnosed with sepsis, who have been evaluated by an infectious physician and are candidates to receive piperacillin/tazobactam, imipenem or meropenem as empiric treatment. exclusion criteria: * patients with a history of allergy to one or more of the proposed antibiotics. * patients with chronic kidney disease or acute renal failure. * patients with acute liver failure of any cause. * patients in palliative or supportive care only.
beta-blocker continuation versus interruption in heart failure worsening

Conditions: Heart Failure, Congestive

Summary: the objective of the b-convinced study is to demonstrate the non-inferiority of beta-blocker continuation compared to its interruption in patients with congestive heart failure who are treated by a beta-blocker and present with an episode of heart failure worsening with pulmonary oedema requiring hospital admission. 162 patients will be randomized in cardiology centers in france. clinical status (primary endpoint) will be evaluated with a standardized questionnaire 3 days after hospital admission.

therapeutic strategy of beta-blocker treatment during an episode of heart failure worsening remains unclear. the objective of the b-convinced study is to demonstrate that continuation of beta-blocker treatment in case of hospitalisation for heart failure worsening is as safe as the interruption of such treatment. hypothesis: the proportion of patients clinically improving within 3 days is not inferior when beta-blocker treatment is maintained compared to beta-blocker interruption in case of hospitalisation for heart failure worsening with pulmonary oedema. design: open, randomized non-inferiority trial on two parallel groups of patients. randomization performed centrally with a vocal server. tested hypothesis: 90% of success in the interruption group, power of 80%, non-inferiority limit of 15% (relative reduction). 162 patients are required with such a hypothesis. primary endpoint: clinical improvement within 3 days of hospital admission evaluated by the investigator by a standardized questionnaire. secondary endpoints: clinical improvement at day 8 or at hospital discharge, morbidity-mortality at 4 months. 34 participating centres in france.

Eligibility criteria:
inclusion criteria: * patients with heart failure treated with beta-blocker; hospitalisation for heart failure worsening with pulmonary oedema. * left ventricular ejection fraction less than 40% exclusion criteria: * indication of intravenous positive inotropic treatment * indication to withdraw beta-blocker treatment

Keywords: heart failure, congestive beta-adrenergic blockers
effects of breathing retraining in patients with chronic obstructive pulmonary disease (copd)

Conditions: Chronic Obstructive Pulmonary Disease

Summary: conventional pulmonary rehabilitation programs improve exercise tolerance, peripheral muscle strength, and health related quality of live but not pulmonary function in patients with chronic obstructive pulmonary disease (copd). the role of breathing retraining techniques in the rehabilitation of patients with copd remains unclear. the hypothesis to be tested in this study is that pulmonary function, cardio-pulmonary exercise capacity, health related quality of life and cardiac autonomic modulation of patients with copd who undergo pulmonary rehabilitation plus breathing retraining will be better than that of patients undergoing a conventional pulmonary rehabilitation.

to address this uncertainty, we performed a randomized controlled trial to assess the effects of a 4-week rehabilitation program including breathing retraining on pulmonary function (pft), cardio-pulmonary exercise capacity (cpet), health related quality of life (hrql) and cardiac autonomic modulation (cam). a randomized controlled trial comparing the effects of a conventional 4-week pulmonary rehabilitation program with those of a 4-week pulmonary rehabilitation program plus breathing retraining on pulmonary function (fev1), cardiopulmonary exercise capacity (6-minute walking distance, 6mwd), health related quality of life (chronic respiratory questionnaire, crq) and cardiac autonomic function (rmssd) was performed.

Eligibility criteria:
inclusion criteria: * clinically stable patients with copd (gold-classification i-iv) exclusion criteria: * patients with clinical signs of copd exacerbation * cardiac arrhythmia * coronary artery disease * primary pulmonary vascular disease * oxygen desaturation to less than 80% during exercise on room air

Keywords: clinically stable copd (gold-classification i-iv) copd breathing retraining pulmonary rehabilitation cardiac autonomic function quality of life exercise capacity pulmonary function
a study to assess the effect of elx/tez/iva on glucose tolerance in participants with cystic fibrosis (cf)

Conditions: Cystic Fibrosis

Summary: this study was evaluate the effect of elexacaftor (elx)/tezacaftor (tez)/ivacaftor (iva) on glucose tolerance in cf participants, 12 years of age and older who are heterozygous for the f508del mutation and a minimal function mutation (f/mf genotypes), with abnormal glucose metabolism.


Eligibility criteria:
key inclusion criteria: * heterozygous for f508del and an mf mutation (f/mf genotypes) * forced expiratory volume in 1 second (fev1) value ≥ 30% of predicted mean for age, sex, and height * abnormal glucose tolerance determined by an ogtt as either: * impaired glucose tolerance (igt) defined as 2 hour post ogtt blood glucose level ≥140 to \<200 mg/dl (≥7.77 to \<11.10 mmol/l) and fasting blood glucose level \<126 mg/dl (\<7.00 mmol/l) * cf-related diabetes (cfrd) defined as either fasting hyperglycemia (blood glucose level ≥126 mg/dl \[≥7.00 mmol/l\] after an 8-hour fast) or 2-hour post ogtt blood glucose level ≥200 mg/dl (≥11.10 mmol/l) key exclusion criteria: * clinically significant liver cirrhosis with or without portal hypertension * solid organ or hematological transplantation * lung infection with organisms associated with a more rapid decline in pulmonary status * type 1 or type 2 diabetes * duration of cfrd ≥5 years other protocol defined inclusion/exclusion criteria may apply.
experience of adolescents with anorexia nervosa towards antidepressants

Conditions: Adolescents Cared for Anorexia Nervosa at Maison de Solenn

Summary: the purpose of this study is to explore the experience of adolescents suffering from anorexia nervosa confronted with the prescription of antidepressants

in our adolescent psychiatric unit, antidepressant's prescription is common during the care pathway for adolescents with anorexia nervosa. the literature highlights a paradox between scientific data and clinical practice, based on expert consensus. there are a very few qualitative studies in this subject and none of them concern adolescents. the purpose of this qualitative study is to explore the experience and opinion of adolescents suffering from anorexia nervosa confronted with the prescription of antidepressants

Eligibility criteria:
inclusion criteria: * adolescents aged 12 to 25 * suffering from anorexia nervosa \[according to dsm-5 criteria\] * has been prescribed for a type of ssris antidepressant (still ongoing or interrupted at the time of the interview) * non-opposition to the study exclusion criteria: * atypical eating disorder that do not meet dsm-5 criteria for restrictive anorexia nervosa * body mass index \< 15 * prescribed for another antidepressant than ssris

Keywords: anorexia nervosa adolescents antidepressive agents
progressive muscle relaxation exercises on pain, kinesiophobia and functional status

Conditions: Fibromyalgia

Summary: relaxation techniques are a non-pharmacological therapy option applied to alleviate the symptoms of many different chronic diseases. it has been reported in the literature that pmr is effective on pain, fatigue and stress symptoms in fibromyalgia patients. no study has been found examining the effect of pmr on kinesiophobia and functional status in fm. this study was planned to examine the effect of progressive muscle relaxation exercises on pain, kinesiophobia and functional status in fibromyalgia patients.

fibromyalgia (fm), which is a chronic pain disorder, is a difficult disease to treat, and it is stated that a multidisciplinary approach is required in its treatment rather than a single treatment method. approaches that consider optimal symptom management and functional status in treatment, include non-pharmacological methods in addition to pharmacological treatment, and include psychosocial and behavioral methods are recommended. non-pharmacological methods that have proven their effectiveness in fm treatment include aerobic exercise, patient education, cognitive therapies, balneotherapy, and physical therapy agents. one of the methods that can be applied in patients with fm is progressive muscle relaxation (pmr) exercises. pmr is an easy, low-cost, and side-effect-free relaxation technique. pmr helps individuals feel calmer and more relaxed through sequential muscle tension and relaxation. it has been reported in the literature that pmr is effective on pain, fatigue and stress symptoms in fibromyalgia patients. no study has been found examining the effect of pmr on kinesiophobia and functional status in fm. therefore, this study was planned to examine the effect of progressive muscle relaxation exercises on pain, kinesiophobia and functional status in fibromyalgia patients.

Eligibility criteria:
inclusion criteria: * being older than 18 years of age * having been diagnosed with fibromiyalgia for at least 6 months ago. * having no mental disability exclusion criteria: * individuals receiving another complementary and integrative treatment * individuals who have done progressive muscle relaxation exercise before.
results following the vitrification of human oocytes using 2 methodologies

Conditions: Infertility

Summary: the investigators are going to compare embryo developmental rates of human eggs following freezing in two different freezing methods. the investigators are going to compare the pregnancy rates following transfer to patients as well. null hypothesis: the type of vitrification methodology used will not have an impact on the following: * survival rates * embryonic developmental rates * pregnancy and implantation rates.

randomization of oocytes: oocytes will be denuded approximately 1-2 hours post retrieval and graded for maturity. only the metaphase ii oocyte will be vitrified. half of the oocytes within each donor will be randomized to the following treatments. 1. frozen using an open system using a metal grid to hold the oocyte. three to five oocytes will be frozen on the metal grid using a minute amount (\< 2-3 µls) of cryoprotectant. a top is put over the metal grid to protect the oocytes. this system has proven to be successful in limited cases in peru. this is an open system of vitrification where the oocytes are directly plunged into liquid nitrogen. this will serve as the control. 2. frozen in closed straws using a methodology developed by jim stachecki. three to five oocytes will be frozen in ¼ cc straws. this is very similar to the method used to successfully vitrify blastocysts. this will be the experimental treatment. null hypothesis: the type of vitrification methodology used will not have an impact on the following: * survival rates * embryonic developmental rates * pregnancy and implantation rates. measured outcomes the effect of vitrification technique will be measured using the appropriate statistical analysis on the following parameters. 1. survival rates following thawing. 2. effect of vitrification technique on how oocytes react to icsi. the parameters have been previously defined at ncrs. 3. normal fertilization rates, abnormal fertilization rates and rates of degeneration following icsi. 4. embryonic development rates. embryos will be cultured until day 5/6 and rate as well as quality of blastocyst will be noted. 5. pregnancy and implantation rates following replacement in endometrial prepared recipients.

Eligibility criteria:
inclusion criteria: * must be healthy and pass testing as per clinic standards exclusion criteria: * are over the age or cannot carry a pregnancy safely

Keywords: infertile patients