Kornimate/medical-research-clean huggingface dataset:
psychological impact of pregnancy of unknown location

Conditions: Pregnancy of Unknown Location; Ectopic Pregnancy; Anxiety

Summary: to assess the psychological impact of pregnancy of unknown location (pul) classification pending a final diagnosis.

pul is a syndrome of early pregnancy composed of a positive urine pregnancy test without the visualisation of a pregnancy on trans-vaginal ultrasound (tvus). the current method for risk stratifying a pul is via serum bhcg levels at the time of identification of pul and after 48 hours, in order to ascertain the viability of the pregnancy. patients and their partners need to wait for this result before a management plan can be adopted, taking at least 2-3 hours. there is a clear need for the patient care pathway to evolve in order to aid and improve the management of women classified with a pul. by using point-of-care bhcg testing, the investigators hope to shorten the time to management. the investigators therefore propose that shortening the time interval would reduce psychological morbidity. this is a prospective cohort observational study.

Eligibility criteria:
inclusion criteria: * pregnant women attending the early pregnancy unit in the first trimester (up to 14 weeks gestation) with a pregnancy of unknown who are over 18 years old and are able to give consent. exclusion criteria: * presence diagnosed with cancer * the presence of an acute medical condition * patients/partners aged less than 18 years * patients or partners who cannot give fully informed study consent (language or learning impairment) * presence of a viable intrauterine pregnancy, ectopic pregnancy and miscarriage.

Keywords: pregnancy of unknown location pul ectopic pregnancy anxiety
quality of life of the piloted individuals and a cost-efficiency analysis

Conditions: Terminal Illness

Summary: the increasing life expectancy and global aging population necessitate changes in long-term gerontological services based on person-centred care approaches. this study aims to improve person-centred care in geriatric centers through meaningful activities and the role of occupational therapists and direct care professionals in developing these activities. a descriptive cross-sectional quasi-experimental design was proposed, with 10 participants.

background: increasing life expectancy means that the ageing of populations globally is on the rise. it is therefore important to promote changes in long-term gerontological services based on person-centred care approaches, in which meaningful occupation serves as a basis and is supported by appropriate professional support, such as the occupational therapist and the direct care professional. objective: the study aims to analyze the needs, quality of life, and coping strategies of terminally ill patients over five months, as well as burnout and dehumanization among caregivers and healthcare staff. methods: this study examines factors influencing the quality of life (qol) of terminally ill patients and the burnout and dehumanization of caregivers and health professionals using a mixed methodology. the study proposes a 3-time longitudinal design, with evaluations at baseline, 2.5 months, and 5 months, to measure the impact of an intervention on terminally ill patients and their families, focusing on health status, quality of life, and emotional well-being.

Eligibility criteria:
inclusion criteria: * that the direct care worker has a degree as a nursing assistant, dependency care technician, geroculturist or certificate of professionalism. * the worker must speak and understand spanish. * the residence must offer service during the day, in the morning or afternoon shift. * workers must have been with the department for more than 4 months. exclusion criteria: * workers who work night shift only. * workers on rotating shifts in all departments of the residence. * workers absent at the time of the study due to temporary leave, vacations or other causes.

Keywords: person-centred care meaningful activities direct care professional occupational therapist
influence of pharmacogenetic factors, paroxetine and clarithromycin on pharmacokinetics of clomiphene

Conditions: Anovulation; Disorder Due Cytochrome P450 CYP2D6 Variant; Cytochrome P450 CYP3A Enzyme Deficiency

Summary: aim of the study is the clinical validation of the metabolism and the pharmakokinetic of clomifen in correlation to cyp2d6 and inhibition of cyp3a4.


Eligibility criteria:
inclusion criteria: * healthy * female caucasians * age 18 - 45 years old * bmi 18.5 - 26 kg/m2 exclusion criteria: * persons with known sensitivity of clomifen and/or paroxetine and/or clarithromycin * pregnancy/lactation period * meno-/postmenopausal * smokers

Keywords: pharmacokinetic clomiphene cyp2d6 polymorphisms inhibition of cyp2d6 and cyp3a4
nitroglycerine versus dexmedetomidine infusion in intraoperative management of uncontrolled hypertension

Conditions: Hypertension

Summary: this study aim to compare the efficacy of intraoperative dexmedetomidine infusion versus nitroglycerin infusion in cancer patients with accidental uncontrolled intraoperative elevation of blood pressure.

nitroglycerine is a direct vessel wall vasodilator with more venodilator effect than arterial dilator effect. it is used as an anti-anginal and antihypertensive drug. on the other hand, dexmedetomidine is a highly selective alpha 2 adrenergic agonist with sympatholytic effect. this study aim to compare the efficacy of intraoperative dexmedetomidine infusion versus nitroglycerin infusion in cancer patients with accidental uncontrolled intraoperative elevation of blood pressure.

Eligibility criteria:
inclusion criteria: * cancer patients with controlled hypertension and undergoing surgical procedures under general anesthesia * ≥ age 18 years. exclusion criteria: * patient refusal * patients on beta blockers * kidney or liver function impairment * bradycardia, any degree of heart block and severe cardiorespiratory disease
protocol establishment for the prevention of lamotrigine-induced skin rash in epilepsy patients

Conditions: Lamotrigine Allergy

Summary: the investigators intend to find a way to lower drug rash occurrence by applying drug tolerance induction protocol at the beginning of lamotrigine administration. genotyping of participants with rash and those without rash after taking lamotrigine and genetic testing to find common gene mutations in these participants.


Eligibility criteria:
inclusion criteria: * adults aged 18-85 years old * epilepsy patients * patients who started lamotrigine first time exclusion criteria: * those who do not agree with prior consent * women taking oral contraceptives. * history of drug rash * taking enzyme-inducing antiepileptic drugs (eiaed) or valproate (vpa)
using exhaled air to determine changes in nutritional status of patients on intravenous nutrition

Conditions: Obesity; Malnourished; Fasting

Summary: carbon-12 and carbon-13 are naturally-occurring isotopes that are found in exhaled breath. investigators have proved that the 13co2/12co2 breath delta value (bdv) changes in subjects who were in negative energy balance then fed a positive energy balance meal. measuring one liter of exhaled breath daily may be a more convenient way to measure negative or positive energy balance in patients receiving intravenous nutrition.

this is a prospective, pilot study to determine if there is change in the 12c/13c bdv between days 0-7 in patients who receive parenteral nutrition. investigators will recruit subjects from inpatient units at the university of wisconsin hospital and clinics whose primary team consult the nutrition support team to institute parenteral nutrition for clinical reasons. subjects with clinical indications for parenteral nutrition are moderately to severely malnourished due to little to no nutrition by other means (oral nutrition or nutrition per tube) for a period of time (0-10 days based on state of nourishment prior to admission). investigators will record baseline nutritional status from the medical record notes (dietitian, nutrition support team, etc.), as well as medication, demographic information and medical history. investigators will take a baseline exhaled co2 measurement and then a daily measurement at approximately the same time daily (+/- an hour). the daily exhaled 12c/13c breath delta value will be matched with the subjects' daily caloric intake from parenteral nutrition (and oral nutrition and nutrition per tube, if applicable). the breath delta value, the caloric intake, plus the subjects' degree of malnourishment will be parameters with which to build further research. investigators hypothesize that the breath delta value will increase from baseline and then stabilize after the patient reaches goal energy needs as defined by the nutrition support team.

Eligibility criteria:
inclusion criteria: * 18 years of age or older * anticipated start of parenteral nutrition * expected duration of stay at least 5 days from enrollment * subject speaks english * subjects with inability to take adequate oral nutrition who are developing or have developed malnutrition who require parenteral nutrition exclusion criteria: * subjects unable to coordinate well enough to give a 1 liter breath sample * subjects receiving parenteral nutrition prior to admission * subjects who are pregnant * subjects who are prisoners * subjects who are pharmacologically sedated or with altered consciousness * subjects who are mechanically ventilated * subjects admitted for bone marrow or stem cell transplants * known participation in another interventional research study within 30 days prior to enrollment (note: to be eligible, any interventional treatment must have ended at least 30 days ago) * subjects with disease states or clinical conditions that do not make them study candidates, per the primary investigator's discretion
patient satisfaction study of combined facial treatment with botox® cosmetic, juvéderm® and latisse® (harmony study)

Conditions: Facial Rhytides; Crow's Feet Lines; Glabellar Lines; Nasolabial Fold

Summary: a study to evaluate patient satisfaction, aesthetic and psychological impact of combined treatment with botox® cosmetic (onabotulinumtoxina), juvéderm® ultra xc, juvéderm® ultra plus xc, juvéderm® voluma® xc, and latisse® (bimatoprost ophthalmic solution).


Eligibility criteria:
inclusion criteria: * qualified to receive treatment with botox® cosmetic, a facial filler (juvéderm® ultra xc and/or juvéderm® ultra plus xc and/or juvéderm® voluma® xc) and latisse® treatment * naïve to botulinum toxin therapy of any serotype for any indication * naïve to prescription eyelash growth products of any type * naïve to dermal filler treatment in the face and neck exclusion criteria: * undergone facial plastic surgery, tissue grafting, tissue augmentation or facial dermal filler injections * had laser, photomodulation, intense pulsed light, radio frequency, dermabrasion or chemical peel in the face or neck * have received skin resurfacing (laser, photomodulation, intense pulsed light, radio frequency, dermabrasion, chemical peel, or non-ablative procedures) in the face or neck within 3 months * systemic retinoid therapy within 1 year prior to study enrollment * presence of inflammation at the proposed injection site(s) * profound atrophy/excessive weakness of muscles in target areas of injection * known immunization or hypersensitivity to any botulinum toxin serotype * undergone oral surgery or dental procedures within 30 days * no visible eyelashes * use of permanent eyeliner, eyelash implants, semi-permanent eyelash tint, dye or extension * use of prescription eyelash growth products * unwilling or unable to remove contact lenses prior to study medication application in the evening and keep lenses out for 30 minutes * diagnosis of myasthenia gravis, eaton-lambert syndrome, amyotrophic lateral sclerosis, or any other disease that might interfere with neuromuscular function.
combined effects of active cycle breathing technique and buteyko technique in post sternotomy patients

Conditions: Sternotomy

Summary: this randomized clinical trial seeks to compare the efficacy of the active cycle of breathing technique (acbt) and buteyko breathing techniques in sternotomy patients undergoing coronary artery bypass graft (cabg) surgery, aged 30 to 60. data will be collected from surgical intensive care unit (icu) in selected hospitals. participants will be assigned to intervention to receiving acbt and buteyko breathing techniques standard protocol including chest percussion , tissue blowing exercises, incentive spirometer , cough technique, breathing control, deep breathing, and deep breathing techniques.

this randomized clinical trial seeks to compare the efficacy of the active cycle of breathing technique (acbt) and buteyko breathing techniques in sternotomy patients undergoing coronary artery bypass graft (cabg) surgery, aged 30 to 60. data will be collected from surgical intensive care unit (icu) in selected hospitals. participants will be assigned to intervention to receiving acbt and buteyko breathing techniques standard protocol including chest percussion , tissue blowing exercises, incentive spirometer , cough technique, breathing control, deep breathing, and deep breathing techniques. the three-day trial, starting upon icu/ccu admission, will measure primary and secondary outcomes before and after each session for both groups. statistical analysis using spss version 25 will be employed post data collection.

Eligibility criteria:
inclusion criteria: * age 40-60 years * patient underwent cardiac surgery for first time * having speaking, hearing, cognitive ability * both genders ( male and female) * on mechanical ventilation for less than 24h after surgery exclusion criteria: * • hemodynamic ally unstable patients * patients with reopening of sternum * infection patients * renal failure * arrhythmia * patient on mechanical ventilator * cancer * tuberculosis

Keywords: buteyko
the effects of nutritional supplementation and drug abuse on hiv

Conditions: HIV Infections; Substance-Related Disorders

Summary: the purpose of this trial is to determine whether supplementation with multivitamins and selenium will delay disease progression in hiv infected individuals in botswana. the study will also assess how drug abuse modifies the effect of nutritional supplementation on hiv disease progression.

botswana has the highest rates of hiv infection in the world. in addition, drug abuse has become an emerging problem in botswana. past research suggests that multivitamin and selenium supplementation slows the progression of hiv disease. the purpose of this trial is to evaluate the effectiveness of supplementation with multivitamins and selenium in hiv infected individuals in botswana. this trial will last 2 years. participants will be randomly assigned to 4 groups: a combination of multivitamins with selenium, multivitamins alone, selenium alone, or placebo.

Eligibility criteria:
inclusion criteria: * hiv infected * cd4 count greater than 350 cells/mm3 * identified from the infectious disease care clinic * body mass index greater than 18 for women and greater than 18.5 for men exclusion criteria: * current aids-defining condition * currently participating in another clinical trial * pregnant or intends to become pregnant during the study

Keywords: treatment naive multivitamins selenium supplementation hiv disease progression
virtual reality rehabilitation in patients with total knee replacement

Conditions: Knee Arthropathy; Total Knee Replacement

Summary: impaired proprioceptive accuracy could be a risk factor for progression of gait limitations in knee osteoarthritis patients, even after the total knee replacement (tkr). recent studies on virtual reality (vr) in rehabilitation show its efficacy in restoring proprioceptive capacity, postural control and gait. however, literature lacks such studies in tkr patients. this preliminary study aims to evaluate the efficacy of a vr system for the enhancement of motor skills in tkr patients compared to a traditional approach of rehabilitation.

in this randomized controlled trial (rct), the randomization of the sample will be performed by a local software and in a single blind design. forty patients will be enrolled and after giving the informed consent, assigned to two groups : * the experimental group (vrg), which will be undergone to treatment with virtual reality for the recovery of load distribution and proper gait pattern; * the control group (cg), which will be undergone to a traditional rehabilitation addressed to recovery of correct gait pattern for the same time period as vrg. both treatments consist in 15 sessions, at least 5 per week , each lasting 45 minutes. both vrg or cg will last for 21 days from the start of treatment. all patients, in adjunction to virtual reality rehabilitation (eg) or traditional rehabilitation (cg), will execute a global rehabilitation project, consisting in physiotherapy, physical therapies for pain and inflammation control, and occupational therapy, personalized by a multidisciplinary rehabilitation team for a minimum of 150-180 minutes per day, and according to their clinical conditions for them. the purposes of this study in detail are: 1. observing differences in the distribution of the bi-podalic load in the group that performs a re-education with virtual reality compared to those who perform the traditional treatment. 2. observing differences in the recovery time of a correct pattern of gait in the group that performs a re-education with virtual reality compared to those who perform a traditional treatment. 3. observing changes in neurophysiological patterns in the two groups.

Eligibility criteria:
inclusion criteria: * recruitment and initial assessment within 10 days of surgery; * monolateral knee arthroplasty in election; * collaborating patients who are able to perform the proposed exercise; * good cardiovascular compensation; * cognitively intact; * able to provide informed consent; exclusion criteria: * no severe cognitive / behavioral deficit; * refusal or inability to provide informed consent; * presence of sever cardiorespiratory co-morbidities; * peripheral and /or central neurological deficits; * visual deficits; * presence of serious osteo-arthro-muscular diseases at controlateral lower limb against the prosthetic side; * complication at surgical wound

Keywords: virtual reality total knee replacement proprioception balance gait
ultrasound and left ventricular systolic function

Conditions: Dysfunction, Left Ventricular

Summary: the aim of this study is to evaluate, in an intensive care unit, the reproducibility between two non-cardiologists operators and a cardiologist expert in echocardiogram, of the simpson method and of the calculation of gls for the evaluation of the systolic function of the left ventricle in critically ill patients intubated and ventilated.


Eligibility criteria:
inclusion criteria: * icu patients intubated and ventilated exclusion criteria: * arrhythmia or variability of heart rate * technical impossibility to perform the ultrasound exam * known pregnancy or lactation * non-affiliation to a social security scheme (beneficiary or assignee) * patient under legal protection * patient refusal to participate
vaccine therapy in treating patients with melanoma

Conditions: Melanoma (Skin)

Summary: phase i trial to study the effectiveness of vaccine therapy in treating patients with melanoma that cannot be treated with surgery. vaccines may make the body build an immune response that may kill tumor cells. combining more than one vaccine may kill more tumor cells.

objectives: i. determine the toxic effects associated with alvac-hb7.1 alone or combined with alvac-hil-12 in patients with surgically incurable melanoma. ii. characterize the inflammatory and lymphokine response to this regimen in these patients. iii. examine the extent of nodule regression, humoral immune response, and cytolytic t cell activity with this regimen in these patients. outline: this is a dose escalation study of alvac-hb7.1 patients receive alvac-hb7.1 alone or combined with alvac-hil-12 intratumorally on days 1, 4, 8, and 11. treatment continues in the absence of disease progression or unacceptable toxicity. cohorts of 3-6 patients are treated at each dose level of alvac-hb7.1. the maximum tolerated dose is defined as the dose of alvac-hb7.1 at which no more than 1 of 5 patients experiences dose limiting toxicity. patients are followed at 1, 2, 4, 8, 11, 15, 22, and 43 days after the first vaccination.

Eligibility criteria:
disease characteristics: * histologically confirmed melanoma that is surgically incurable * at least one dermal, subcutaneous or lymph node metastasis that is evaluable for local response and accessible for injection * if only one accessible lesion is available, it must be at least 2 cm * if two or more accessible lesions exist, then none of them are required to be at least 2 cm patient characteristics: * age: over 18 * performance status: ecog 0-2 * life expectancy: greater than 3 months * leukocyte count at least 3,000/mm3 * platelet count at least 120,000/mm3 * sgot and alkaline phosphatase less than 5 times normal * bilirubin less than 1.5 mg/dl (unless secondary to hepatic metastasis) * bun less than 40 mg/dl * creatinine less than 2.5 mg/dl * no evidence of congestive heart failure, unstable angina, or serious cardiac arrhythmias * not positive for hepatitis b virus * not positive for hiv * no history of allergy to vaccinia virus * no evidence of other primary tumors except for basal cell carcinoma, squamous cell skin carcinoma, or carcinoma in situ of the cervix * not pregnant or nursing * fertile patients must use effective contraception * no underlying immunodeficiency disorder prior concurrent therapy: * at least 30 days since prior biologic therapy (e.g., interferon or il-2) * at least 30 days since prior chemotherapy * no concurrent steroids * at least 30 days since prior radiotherapy * prior radiotherapy to no greater than 50% of nodal groups * no prior splenectomy * no concurrent drugs which affect immune function (e.g., glucocorticoids or cimetidine)

Keywords: stage iv melanoma recurrent melanoma
effect of advanced care at home vs. traditional brick-and-mortar hospital care in acutely ill adults: a pragmatic clinical trial

Conditions: Acute Illness

Summary: the purpose of this study is to compare two care delivery models that are currently being implemented in routine practice settings. the findings from this study will inform future clinical decision making, such as which patients might be more suited for which care delivery model.


Eligibility criteria:
inclusion criteria: * adult patients, 18 years of age and older * present to one of the participating hospitals * have a chief complaint of one of the target diagnoses * are within a certain geographical area (based on zip codes) * have a health insurance plan that covers ach services * have the capacity to consent or could assent with the consent of a health care proxy who is physically present exclusion criteria: * not suitable for ach or inpatient hospital care as determined by the patient's clinical team * do not have the capacity to consent or assent with the assistance of a health care proxy