Kornimate/medical-research-clean huggingface dataset:
effects of nurse-led case management based on prevention and control of acute myocardial infarction

Conditions: Acute Myocardial Infarction

Summary: acute myocardial infarction (ami) is a major disease that endangers people's health china. at present, clinical emphasis is given to "treatment" rather than "prevention", and a large number of ami patients are hospitalized repeatedly without systematic and standardized health management after acute stage, falling into a vicious circle of "treatment without recovery". nurse-led case management based on multidisciplinary collaboration is a new mode of disease management. in 1994, the united states took the lead in applying case management to the acute and chronic care system, providing comprehensive care services and promoting comprehensive recovery through multidisciplinary collaboration led by case managers. at present, the case management model of cardiovascular disease in europe and the united states has been mature, but it is still in the exploratory stage in china. through the establishment and application of nurse-led ami case management program based on multidisciplinary collaboration, this study wants to establish a novel, standardized, and easy to popularize ami whole-course prevention and control mode, providing theoretical and research basis for ami disease management.

there are few domestic studies on cardiovascular disease case management in china, and the studies mainly aimed at the application of case management in out-of-hospital follow-up management. at present, there has been no reports on nurse-led the multidisciplinary whole course case management of ami patients from admission to discharge, diagnosis and treatment, rehabilitation and secondary prevention. this study would apply case management to the whole course management of ami patients from admission to 6 months after discharge. pharmacists, nutritionists, rehabilitation specialists and psychiatrists coordinated by nurse would take the initiative to conduct individualized assessment and health guidance, and case managers would participate in the whole process of inpatient diagnosis and treatment. coordinating multidisciplinary medical resources to jointly implement diagnosis and treatment and rehabilitation for patients can save medical costs and improve the quality of care.

Eligibility criteria:
inclusion criteria: * in line with the diagnosis of chinese 2019 guidelines for ami. age greater than or equal to 18 years old and less than or equal to 75 years old patients have clear consciousness and agree to participate in this study. exclusion criteria: * verbal communication disorders. patients have a clear history of allergic constitution, and have allergies or intolerance to the drugs recommended by the guidelines (including antiplatelet drugs, ß receptor blockers, statins, various antihypertensive and hypoglycemic drugs, etc.). patients have severe heart, brain, liver, kidney, motor dysfunction.

Keywords: acute myocardial infarction case management
mag con: efficacy of oral mag. in acute concussion in adolescents

Conditions: Concussion, Mild; Traumatic Brain Injury, Mild

Summary: this randomized trial will compare the clinical efficacy of adding oral magnesium oxide to acetaminophen and ondansetron in the treatment of adolescents presenting within 48 hours of a mild traumatic brain injury using the post-concussion symptom severity score index.

this randomized trial will compare the clinical efficacy of oral magnesium oxide, acetaminophen and ondansetron, to that of po acetaminophen and ondansetron in the treatment of adolescents presenting within 48 hours of a mild traumatic brain injury. our primary endpoint will be to evaluate if magnesium has an impact on patient's post-concussion symptom severity score index. this will be evaluated both at the initial presentation in-person and then at 24, 48, and 72 hours via phone

Eligibility criteria:
inclusion criteria: * age 12 to 18 years; * presenting chief complaint of headache, head injury, or concussion within the first 48 hours of injury; * gcs \> 13 on arrival exclusion criteria: * age \ 18 years; * inability to provide informed consent; * vomiting \> 2 episodes following injury; * physical or mental disability hindering adequate response to assessment of symptoms; * hemodynamic instability/medical condition requiring further acute life-saving medical intervention; * known brain mass, intracranial hemorrhage, skull fracture; * known contraindications/allergy to magnesium, ondansetron, or acetaminophen * pregnant patients
breathing device in postural orthostatic tachycardia syndrome (pots)

Conditions: Postural Tachycardia Syndrome; Postural Orthostatic Tachycardia Syndrome

Summary: the investigators will test whether breathing through an inspiratory resistance device will improve the ability to be upright and decrease heart rate increases on standing in patients with postural tachycardia syndrome.

chronic orthostatic intolerance, sometimes known as the postural tachycardia syndrome (pots), is the most common disorder among patients seen at several centers specializing in diseases of the autonomic nervous system. it affects an estimated 500,000 people in the united states alone. pots (excessive increase in heart rate \[\>30 min-1\] on standing associated with orthostatic symptoms \[including palpitation, chest pain syndrome, dyspnea on standing, mental clouding and difficulties with concentration\], in the absence of orthostatic hypotension) can produce substantial disability among otherwise healthy people. patients with pots typically feel tired and run down. many also report a myriad of symptoms that are hard to categorize, often involving fatigue. one study, from the mayo clinic, found that patients with pots had a diminished quality of life when measured using a standard health status instrument (sf-36). in this pilot study, we will test the hypothesis that breathing through an inspiratory resistance device will improve orthostatic tolerance and reduce orthostatic tachycardia in patients with postural tachycardia syndrome.

Eligibility criteria:
inclusion criteria: * diagnosed with postural tachycardia syndrome by the vanderbilt autonomic dysfunction center * increase in heart rate ≥ 30 beats/min with position change from supine to standing (10 minutes) * chronic symptoms consistent with pots that are worse when upright and get better with recumbence * able and willing to provide informed consent exclusion criteria: * overt cause for postural tachycardia (such as acute dehydration) * inability to give, or withdrawal of, informed consent * pregnant * other factors which in the investigator's opinion would prevent the subject from completing the protocol

Keywords: heart rate tachycardia orthostatic intolerance
asymptomatic primary hyperparathyroidism: a prospective, randomized trial

Conditions: Primary Hyperparathyroidism

Summary: the present study is a randomized, controlled trial that investigates the effects of parathyroidectomy or medical observation in mild asymptomatic phpt on morbidity and quality of life (qol).

the patients are included and randomized by block randomization to medical observation or parathyroidectomy by an experienced parathyroid surgeon. the patients will be followed up for 10 years.

Eligibility criteria:
inclusion criteria: * untreated, asymptomatic phpt * 2.60\>s-ca\<2.85 mmol/liter * age between 50 and 80 yr * no medications interfering with ca-metabolism * informed consent exclusion criteria: * hyperparathyroid bone disease * previous operation in the neck * impaired kidney function * kidney stones * complicating medical conditions * psychiatric disorders * multiple endocrine neoplasia, * familial hypocalcuric hypercalcemia * familial hpt

Keywords: qol osteodensitometry arterial pressure pth
modified abc: a home-based parenting program for opioid-dependent mothers and their infants

Conditions: Opioid-Related Disorders; Parent-Child Relations; Infant Development; Parenting

Summary: this study will assess the efficacy of the modified attachment and biobehavioral catch-up intervention, adapted for use with peripartum mothers receiving medication-assisted treatment for opioid use disorder. the investigators expect that mothers who receive the modified attachment and biobehavioral catch-up intervention will show more nurturing and sensitive parenting and more adaptive physiological regulation than parents who receive a control intervention. the investigators expect that infants whose mothers receive the modified attachment and biobehavioral catch-up will show better outcomes in attachment, behavior, and physiological regulation compared to infants of parents who receive the control intervention.

peripartum mothers will be randomly assigned to receive the modified abc intervention or the control intervention (modified def). hypotheses relate to parent and child outcomes associated with the intervention. hypothesis 1: compared to mothers who receive the control intervention, mothers who receive the abc intervention will show more nurturing and sensitive parenting, enhanced neural activity during parenting-relevant tasks, and more normative patterns of dna methylation, autonomic nervous system activity, and cortisol production. hypothesis 2: compared to infants of mothers who receive the control intervention, infants of mothers who receive the abc intervention will show more organized and secure attachment patterns, better behavioral regulation during stressors, more advanced social-emotional development, and more normative patterns of dna methylation, autonomic nervous system activity, and cortisol production. hypothesis 3: enhanced maternal sensitivity will mediate effects of the abc intervention on improved infant outcomes.

Eligibility criteria:
inclusion criteria: * in third trimester of pregnancy or up to one month postpartum * receiving medication-assisted treatment for opioid use disorder exclusion criteria: * none
a trial to explore the tolerability, safety and efficacy of paliperidone extended release in patients with schizophrenia

Conditions: Schizophrenia

Summary: the purpose of this study is to explore the tolerability, safety and efficacy of flexibly dosed paliperidone extended release (er) among patients with schizophrenia.

this is a single arm (the same intervention is given to all patients), multicenter study that aimed to explore the tolerability, safety and efficacy of flexibly dosed paliperidone extended release (er) among filipino patients with schizophrenia who have not taken any antipsychotics in the past, and among newly diagnosed schizophrenia patients who have not taken any antipsychotics for at least one month prior to screening. antipsychotics are drugs that are helpful in the treatment of psychosis and have a capacity to ameliorate thought disorders. flexible dosing allows the investigators to adjust the dosage of each patient based on the individual needs.

Eligibility criteria:
inclusion criteria: * patients diagnosed with schizophrenia * patient with positive and negative syndrome scale (panss) score of 80 to 120 at screening * patients who have not taken any antipsychotics in the past, and those were newly diagnosed with schizophrenia who have not taken any antipsychotics for at least one month prior to screening * patient healthy on the basis of a physical examination, laboratory examination, and vital signs * women must have a negative pregnancy test, and agree to practice an effective method of birth control before entry and throughout the study exclusion criteria: * serious unstable medical condition, including known clinically relevant laboratory abnormalities * judged to be at high risk for adverse events, violence or self-harm * inability to swallow the study medication whole with the aid of water (patients may not chew, divide, dissolve, or crush the study medication) * biochemistry results that are out of the laboratory's normal reference range and are deemed to be clinically significant by the investigator * patients with a current use or known history (over the past 6 months) of substance dependence * positive urine drug examination

Keywords: schizophrenia paliperidone er treatment naive patients newly diagnosed patients
the effectiveness of locomotor therapy using robot-driven gait orthosis system in multiple sclerosis patients

Conditions: Multiple Sclerosis

Summary: objective: to evaluate the efficacy of robot-assisted gait training (ragt) in ms patients with severe walking disabilities (expanded disability status scale \[edss\] 5.5-7) as compared to regular physiotherapy. methods: prospective, randomized, controlled clinical trial comparing ragt with conventional walking training (cwt) in a group of stable ms patients (n=40) during an outpatient rehabilitation program. inclusion criteria are chronic or secondary progressive ms patients with edss between 5.5-7, stable treatment 3 months before study entry, without generalized diseases. all patients will sign an informed consent. following randomization, 20 patients will be treated with ragt, 12 sessions over three weeks. the control group will be treated by cwt, 12 sessions in three weeks. the primary outcome measures will be the functional ambulatory capacity (fac) scale and the 6-minutes walking distance. the secondary outcome measures will be the time up \& go (tug) test, 10 meter walking test, berg balance test, edss score, fim score and rand questioner for quality of life. all tests will be performed by an external blinded assessor at baseline, after three weeks, and at follow-up after 3 months and six months. importance: we anticipated that robot-assisted gait training will be found as feasible and may be an effective therapeutic option in ms patients with severe walking disabilities.


Eligibility criteria:
inclusion criteria: 1. chronic or secondary progressive ms patients with edss between 5.5-7, 2. stable treatment 3 months before study entry. exclusion criteria: 1. other generalized diseases. 2. pregnancy.
biodesign® otologic repair graft

Conditions: Tympanic Membrane Perforation; Eardrum Perforation

Summary: the post-market follow-up clinical trial of the cook® biodesign® otologic repair graft will follow patients up to 3 months post-implantation to determine the percent of patients with complete closure of the tympanic membrane.


Eligibility criteria:
inclusion criteria: * patient requires tympanic membrane closure. exclusion criteria: * life expectancy \< 12 months * known sensitivity to porcine material

Keywords: tympanoplasty myringoplasty
comparison of laparoscopic surgery versus open surgery in the treatment of adhesive small bowel obstruction

Conditions: Adhesive Small Bowel Obstruction

Summary: small bowel obstruction is a common reason for surgical admission. most common reason for small bowel obstruction is adhesions, which account up to 70-80 % of small bowel obstructions. large proportion of adhesive small bowel obstructions may be treated nonoperatively, but up to 50-60% may need surgical intervention. current golden standard for surgical intervention is open adhesiolysis. recently, retrospective studies have provided encouraging results of laparoscopic adhesiolysis for small bowel obstructions. however, no prospective randomized trials have been carried out and retrospective series carries a high risk for patient selection and bias. although in general laparoscopy has been associated with shortened hospital stay, less pain and reduced mortality, laparoscopic adhesiolysis for small bowel obstruction has been reported to cause iatrogenic small bowel lesions up to 7% of patients. aim of the study is to compare open adhesiolysis to laparoscopic adhesiolysis. the investigators hypothesis is that laparoscopic adhesiolysis is safe, will shorten the hospital stay, and reduce mortality compared to open approach.


Eligibility criteria:
inclusion criteria: * all patients with clinical and computed tomography-diagnosed adhesive small bowel obstruction and * obstruction is not relieved by conservative methods (nasogastric tube, npo) including gastrografin is not passed to colon within 8 hours (48-hour conservative treatment without gastrografin® is allowed if gastrografin® is contraindicated (e.g. allergy) or not available) exclusion criteria: * strong suspicion of strangulation or clinical peritonitis thus indicating an urgent operative intervention * earlier confirmed or strongly suspected peritoneal carcinosis * earlier confirmed wide diffuse adhesions of abdominal cavity * earlier open surgery for endometriosis * earlier generalized diffuse peritonitis (not including local peritonitis such as appendicitis) * active abdominal malignancy or remission less than 10 years * earlier abdominal region radiotherapy * earlier obesity surgery * 3 or more earlier open abdominal operations (not including caesarean section(s)) * suspicion of other cause for obstruction than adhesions in ct-scan * earlier abdominal surgical operation within 30 days * earlier surgical operation for aorta or iliac vessels performed through laparotomy * crohn's disease * anesthesiological contraindication for laparoscopy * missing informed consent * age less than 18 years or over 95 years * pregnancy * patient living in institutional care (such as health centre ward), not including retirement homes * over 1 week of hospital stay directly prior surgical consultation
tai chi for improving functions of frail older adults

Conditions: Frailty

Summary: the goals of this study are to examine the physical function, cognitive function, and quality of life among frail elderly residing in the community

this randomized clinical trial recruited 100 frail older adults, assigned to either the tai chi group or the wait-list control group. tai chi intervention will be provided to the tai chi group for 12 weeks with 12-week follow-up and pretest and posttest measures will be conducted. the primary outcome is the function variables (physical function of balance, flexibility, mobility; cognitive function of moca-k) the secondary outcome is quality of life measured by sf12.

Eligibility criteria:
inclusion criteria: * being frail (3 out of the following 5 criteria): feeling fatigued, difficulty climbing 10 stairs without help, difficulty walking 300m without help, more than 5 chronic illness, weight loss 5 % or more past 1-5 years * living in the community * able to participate in tai chi program twice a week exclusion criteria: * participated in any formal exercise program past 6 months * not have transportation to come to the class

Keywords: tai chi frail older adults
the effect of different methods of airway management on the stomatognathic system: an observational prospective study.

Conditions: Airway Management; Endotracheal Intubation; Supraglottic Airway Device; Regional Anesthesia

Summary: the manipulations required during airway management and the different methods of establishing an airway (endotracheal intubation, supraglottic airway device etc) during anesthesia, as well as certain drugs used during anesthesia and sedation, may have an impact to the stomatognathic system. these effects can vary from a subtle temporomandibular joint disc displacement with reduction to the onset of temporomandibular disorders to previously healthy subjects.this observational prospective study aims at investigating the effect of different methods of airway management during anesthesia on the stomatognathic system (including temporomandibular joint, mastication muscles, occlusion etc).

after being informed about the study, all patients giving written informed consent will undergo elective abdominal surgery or elective gynecological surgery (both open or laparoscopic surgeries), under general or regional anesthesia. participants will be assigned to groups, depending on the method of airway management during anesthesia (endotracheal intubation, supraglottic airway device, sontaneous breathing). clinical examination of the stomatognathic system will be performed preoperatively and postoperatively (24 hours after surgery) and data concerning signs and symptoms associated with the development of temporomandibular disorders will be recorded. a follow-up questionnaire will be administered by telephone 30 days after surgery in order to record data concerning the stomatognathic system and mandibular function. parameters related to the physiology of the stomatognathic system, parameters related to the airway management technique, patient position, parameters related to postoperative recovery, as well as postoperative analgesic consumption will be studied.

Eligibility criteria:
inclusion criteria: * men and women * 18-70 years old * asa i-iii * elective abdominal surgery or elective gynecological surgery * general or regional anesthesia exclusion criteria: * edentulous patients * ear disease * history of head and/or neck cancer * head and neck surgery, surgery that is known to affect temporomandibular joints * nose and/or skull base fractures * history of dystonia/musculoskeletal disease that require treatment with muscle relaxant drugs * cognitive impairment * asa \> 3 * patients which underwent over 3 attempts of airway establishment during airway management * change of anesthesia plan during surgery * patient refusal to participate * inability to comprehend greek or english * patient participation in another research project during the previous 30 days

Keywords: intubation laryngeal masks temporomandibular joint disorders orofacial pain
rf-assisted splenic preservation vs conventional treatment of blunt splenic injury.

Conditions: Radiofrequency Can be Used to Treat Splenic Trauma Because of Its Excellent Coagulation Hemostasis

Summary: radiofrequency (rf) can be used to treat splenic trauma because of its excellent coagulation hemostasis. this study aimed to compare the efficacy of rf-assisted spleen-preserving surgery with that of conventional splenorrhaphy/splenectomy in the treatment of blunt splenic injury. a total of 122 patients with splenic trauma admitted to two tertiary referral centers from june 2011 to june 2014 were included in this prospective cohort study. the 67 patients at one center were treated by radiofrequency-assisted spleen-preserving therapy (rf group), and the 55 patients admitted at the other center underwent conventional treatment (ct group). demographics and clinical characteristics of the two groups were comparable. compared to traditional splenorrhaphy and splenectomy, rf-assisted splenic hemostasis and salvage was safe, effective and easy to use in the treatment of splenic injuries. in particular for high-grade splenic injuries, these techniques preserved sufficient splenic tissue without any increase in patients with surgical risk.


Eligibility criteria:
inclusion criteria： 1. age below 70 2. blunt abdominal injury combined with indication of post-traumatic splenectomy according to the guidelines provided by the society for surgery of the alimentary tract in 2005 3. patients transferred directly to the trauma center after injury who had not been treated by any specific spleen-directed therapy in the transferring hospital 4. aast grade ii splenic injury with hemodynamic instability or progressive bleeding requiring active intervention 5. aast grade ⅲ-ⅳsplenic injury, or splenic laceration involving less than 50% of the splenic parenchyma exclusion criteria: 1. penetrating abdominal injury 2. concomitant organ injury with an abbreviated injury scale (ais) greater than 4 that threatened the life of the patient 3. excessive vascular injury to the splenic pedicle or substantial devitalized splenic tissues when it was expected in when less than 25% of the spleen could be preserved 4. patients who had failed nom 5. patients with pathologic splenic rupture