Kornimate/medical-research-clean huggingface dataset:
evaluating the cost effectiveness of istdp: a quasi experimental study

Conditions: Anxiety; Somatoform Disorders; Personality Disorders; Depression; Psychotic Disorders

Summary: objective: to evaluate whether or not cases treated with intensive short-term dynamic psychotherapy (istdp) facilitate healthcare cost reduction, whether any observed reduction is greater than that of a control group and whether any such gains would be maintained in follow up. design: a quasi-experimental design was employed in which pre and post healthcare cost and usage data were extracted for all istdp treated cases from 1999 to 2008 and compared to parallel measures of a control group of cases referred but never treated.

importance: psychiatric and psychological disorders result in excess health care service use and costs. brief psychotherapy methods may be effective across a broad range of mental disorders and could therefore result in healthcare cost reduction. objective: to evaluate whether or not cases treated with intensive short-term dynamic psychotherapy (istdp) facilitate healthcare cost reduction, whether any observed reduction is greater than that of a control group and whether any such gains would be maintained in follow up. design: a quasi-experimental design was employed in which pre and post healthcare cost and usage data were extracted for all istdp treated cases from 1999 to 2008 and compared to parallel measures of a control group of cases referred but never treated. setting: treatments were provided at an urban university based psychotherapy service. participants: all cases from the province of nova scotia treated within the research time frame were included. 890 patients were included with a very broad range of psychiatric disorders including anxiety, mood, somatoform, personality and psychotic disorders. 192 referred but never see cases served as non randomized controls. intervention(s): istdp is an emotionally focused form of brief psychotherapy which has supportive, cognitive, experiential and primarily psychodynamic elements. in this setting the average length of treatment was 7.3 sessions and cost an estimated $500 dollars per treatment course.

Eligibility criteria:
inclusion criteria: * all patients referred for istdp treatment exclusion criteria: * patients not referred for istdp treatment

Keywords: somatoform disorder psychotherapy depression anxiety personality disorder
study on fertility parameters in women with germline variants in brca1 and brca2

Conditions: BRCA1 and/or BRCA2 Variant Carriers; Fertility; Reproductive Age; Menopause; Pregnancy Outcomes

Summary: pathogenic variants (pvs) in the brca1 and brca2 genes are associated with an increased risk of developing breast and ovarian cancers. according to current guidelines from the national comprehensive cancer network, the risk of developing breast cancer exceeds 60% for both genes, while the risk for ovarian cancer ranges from 39% to 58% for the brca1 and from 13% to 29% for the brca2. the detection of a pathogenic variant in the brca1 or brca2 genes necessitates both the establishment of appropriate primary and secondary surveillance measures for carriers and the discussion of the familial implications of such findings. the molecular basis initially suggesting a possible association between germline variants in brca1 and brca2 genes and diminished ovarian reserve lies in the cellular impact of impaired or defective repair of dna double-strand breaks (dsbs) on oocytes. notably, brca1 and brca2 genes play a key role in the atm-related mechanism for dsb repair through the homologous recombination (hr) pathway. although preclinical evidence supports a potential correlation between defective dsb repair and normal follicle maturation processes, clinical studies on large cohorts of patients with pathogenic brca1 and brca2 variants yield inconsistent results. this discrepancy is likely attributable to the inherent challenges in recruiting a sufficiently homogeneous and statistically significant sample size. the aim of the study is to evaluate reproductive capacity in women carrying pathogenic variants in the brca1/2 genes by assessing the number of pregnancies during the period from january 1, 2018, to december 31, 2023. secondary objectives include evaluating menopausal characteristics and pregnancy outcomes.


Eligibility criteria:
brca1 and brca2 carriers inclusion criteria: * age \> 18 years * presence of a pathogenic variant in the brca genes * signed informed consent exclusion criteria * presence of a pathogenic variant in another gene (not brca) * significant psychiatric or clinical impairment affecting the ability to consent to the study control cohort inclusion criteria: - relatives up to the third degree of the first cohort who tested negative on predictive testing for the familial pathogenic variant in the brca genes, matched for age where possible. exclusion criteria: * absence of a pathogenic variant in another gene (non-brca) found in a family member * significant psychiatric or clinical impairment affecting the ability to consent to the study
co2 clearance during noninvasive ventilation (niv)

Conditions: Acute Hypercapnic Respiratory Failure

Summary: in this randomized cross over study the investigators will evaluate the effects on gas exchange and patients' tolerance of a new co2 non rebreathing devices incorporated in the mask vs the traditional mask copd patients undergoing niv for an episode of acute hypercapnia respiratory failure, will be randomized after at least 12 hour of ventilation to 1 h.trial with the usual full face mask or the same mask with the addition of a new co2 clearance device

in this randomized cross over study the investigators will evaluate the effects on gas exchange and patients' tolerance of a new co2 non rebreathing devices incorporated in the mask vs the traditional mask copd patients undergoing niv for an episode of acute hypercapnia respiratory failure, will be randomized after at least 12 hour of ventilation to 1 h.trial with the usual full face mask (fm) or the same mask with the addition of a new co2 clearance device (fm+d) in the interval between niv sessions, arterial blood gases will be monitored and if paco2 will return to a baseline value with a tolerance of 10%, the patients will undergo another 1 h trial using the other mask. the subjects will be studied in the sitting position and asked to relax throughout the period of the study. the patients will be ventilated using pressure support ventilation (psv) the order of use of the two interfaces will be determined for each patient by a previously generated randomized sequence. fio2 will be adjusted to obtain oxygen saturation around 92% at baseline and never modified throughout the study. end-expiratory pressure will always fixed at 2 cm h2o, and trigger sensitivity will set at -0.5 cm h2o. inspiratory assistance during either psv will be titrated to achieve a tidal volume between 6-8 ml/kg while avoiding occurrence of discomfort or visually assessed "wasted efforts". the ventilatory settings will determined at the beginning of the first trial, and maintained unmodified throughout all the 3 runs. patient tolerance to nimv, defined as the level of comfort using the different mask, will be assessed by means of a scale used and validated in previous studies that is defined as follows: 1, bad; 2, poor; 3, sufficient; 4, good; 5, very good. the patients were asked by the respiratory therapist to answer the following question: "how do the patient feel your breathing is using this mask?" the patient will give the score to the therapist at the end of each run, just before abg measurements.

Eligibility criteria:
inclusion criteria: * copd diagnosis * sign inform consent * able to tolerate the application of niv exclusion criteria: * inability to tolerate the mask * contraindication to niv * cancer, neurological diseases, and need of another life support besides the ventilator
iris color and day-night changes in the sympathovagal ratio

Conditions: Iris Diseases

Summary: iris melanocytes are innervated by parasympathetic and sympathetic nerve endings. light affects autonomic nervous system activity via the retino-hypothalamic pathway. the hypothesis that the day-to-night variations in the sympatovagal ratio (lf/hf) may differ among individuals with different brown iris patterns was tested.

a total of 621 healthy adults, aged between 16 and 50, with brown eyes and not diagnosed with a disease that might affect the autonomous nerve system were included in the study. a digital camera was used to acquire iris photos. subjects were grouped into iris color groups (2-0 bg, 1-0 bg, 1-1 db, 1-1 lb, 2-0 b, and 1-0 b). iris photos were analyzed with picture color analyzer rbg software. the central/peripheral (r/rgb) ratio was used for objective distinction between the groups. using 24-h holter ecg monitoring, the change in the sympathovagal ratio from day (between 07:00 and 23:00 hrs) to night (between 23:00 and 07:00 hrs) was determined with the formula \[(day - night) lf/hf)/day lf/hf\].

Eligibility criteria:
inclusion criteria: a total of 650 healthy individuals between the ages of 16 and 50 . exclusion criteria: diseases that could affect the autonomic nervous system; obesity obstructive sleep apnea syndrome hypertension diabetes mellitus atrial fibrillation coronary disease heart failure goiter, etc.

Keywords: lf/hf ratio, iris color, melanin
actinic cheilitis pre-treated with dna repair enzyme cream

Conditions: Actinic Cheilitis

Summary: it is well known that ultraviolet (uv) light causes sunburn and dna damage that can lead to skin cancer. despite preventative measures of sunscreens and other topicals the incidence of skin cancers continues to increase every year. chronic exposure can lead to development of both basal and squamous cell carcinoma that also is correlated to the risk of melanoma. when epidermal keratinocytes are exposed to uv radiation, they form cyclobutane pyrimidine dimmers (cpds), 6-pyrimidine-4-pyrimidones (6-4-pps), and oxygen radicals that alter the structure of nucleotides. when these lesions are not repaired, dna replication is altered that leads to mutations in p53 and ptch tumor suppressor gene and ultimately tumor development. it has been discovered that intracellular delivery of bacterial dna incision repair enzyme t4 endonuclease v dna repair enzymes can repair sun induced damaged dna in patients with xeroderma pigmentosum4,. yarosh et al also showed that t4 endonuclease v dna repair enzymes are specific to reducing the amount of cyclobutane pyrimidine dimers and were found to lower the rate of new actinic keratoses compared to placebo lotion by 68% with no adverse effects observed. additionally yarosh et al also showed that t4n5 liposomes can repair keratinocyte dna in skin cancer patients. this study will examine if pretreating actinic cheilitis with dna repair enzyme cream before standard treatments can decrease the need for additional and possibly more aggressive therapies, decrease the surface area of affected areas, and possibly improve skin thickening and texture.


Eligibility criteria:
inclusion criteria: * 18 years or older with clinically confirmed actinic cheilitis * fitzpatrick type i, ii, iii, or iv skin. * at least 20% of upper and/or lower lip affected by actinic cheilitis exclusion criteria: * pregnant or nursing * allergies to any component of the study topical medication * prior treatment of actinic cheilitis within the past month, including cryotherapy, pdt, 5-fu, picato, retinoid, diclofenac * prior ablative laser therapy to the lips, including fractional erbium and co2 lasers. * prior use of lip fillers * presence of any skin disease that might interfere with the study treatments, including, but not limited to, rosacea, atopic dermatitis, lip lickers dermatitis, perioral dermatitis, perleche, active herpes infection. * presence of hypertrophic and hyperkeratotic lesions or cutaneous horns within the treatment area * any diagnosis of active, untreated skin cancer of the lip
allogenic stem cells derived from lipoaspirates for the treatment of recto-vaginal fistulas associated to crohn's disease (aloreva)

Conditions: Rectovaginal Fistula; Crohn Disease

Summary: the purpose of this study is to determine safety and efficacy of allogenic eascs (expanded adult stem cells) for the treatment of recto-vaginal fistula in patients with crohn´s disease.


Eligibility criteria:
inclusion criteria: * signed informed consent. * patients with crohn´s disease diagnosed at least 12 months earlier in accordance with accepted clinical, endoscopic, anatomopathological and/or radiologic criteria. * fulfilling one of the following criteria: * at least, one previous surgery for fistulous disease. * physical status which discourage liposuction. * rectovaginal fistula. * women of a childbearing age. good general state of health according to the findings of the clinical history and the physical examination. exclusion criteria: * presence of severe proctitis (prominent friability, spontaneous bleeding, multiple erosions, deep ulcers) or dominant active luminal disease requiring immediate therapy, assessed by rectosigmoidoscopy * patients with cdai≥201 * patients with an abscess unless a complete toilet of the area with drainage of the collections and the absence of abscess and other collections is confirmed prior to treatment start * patients who have received infliximab or any other anti tnf agent in the 8 weeks before the cell treatment administration * patients who have received tacrolimus or cyclosporine in the 4 weeks before the cell treatment administration * patients with a history of abuse of alcohol or other addictive substances in the 6 months prior to inclusion * patients with malignant tumor, except for basal cell or cutaneous squamous cell carcinoma, or patients with a prior history of malignant tumors, unless the neoplastic disease has been in remission for the previous 5 years * patients with cardiopulmonary disease which, in opinion of the investigator, in unstable or sufficiently serious to exclude the patient from the study. * patients with any type of medical or psychiatric disease which, in the opinion of the investigator, could be grounds for exclusion from study * patients with congenital or acquired immunodeficiencies. hiv, hbv, hcv or treponema infection, whether active or latent. * patients allergic to local anesthetics or gadolinium (mri contrast) mri is unfeasible (e.g. due to the presence of pacemakers, hip replacements or severe claustrophobia) * patients who have suffering major surgery or severe trauma in the prior 6 months * pregnant or breastfeeding women * patients currently receiving, or having received within 1 month prior to enrolment into this clinical trial, any investigational drug.

Keywords: rectovaginal fistula crohn disease allogenic adipose-derived stem cells
nedaplatin (jiebaishu®) combined with docetaxel for advanced lung squamous cell carcinoma

Conditions: Squamous Cell Carcinoma

Summary: the treatment of squamous cell carcinoma of lung has not improved suffuciently. nedaplatin is a second-generation platinum compound that is more active against squamous cell carcinoma of the lung with a response rate of 60%, issued by the finished phase ii trial in japan.


Eligibility criteria:
inclusion criteria: 1. primary lung squamous carcinoma confirmed by cytology and histology, excluding sputum examination. 2. iiib-no radiotherapy indication /iv phased by aslc 2009 tnm criteria. 3. at least one measurable tumor based on recist ( longest diameter: ≥20 mm by ct scan or 10 mm by spiral ct ) 4. male or female, age≥18 or ≤75 years old 5. ecog ps: 0 or 1 6. estimated time of survival: ≥12 weeks 7. suitable hematologic function: anc≥2×109/l, plc≥100×109/l and hb≥9 g/dl 8. suitable liver function: total bilirubin≤normal uln, ast and alt≤2.5×normal uln, alp≤5×normal uln. 9. suitable renal function: cr≤normal uln,or ccr≥60 ml/min 10. no history of chemotherapy 11. at the enrollment, the past operation has been over 4 weeks and the subject recovered. 12. for the female subject with the intact uterus, if amenorrhea is less than 24 months, pregnancy test must be negative within 28 days of enrollment. if pregnancy test has been past 7 days at the time of initial chemotherapy, urine pregnancy test must be done. 13. the authorized icf must be signed exclusion criteria: 1. having the other cancer in the recent five years, cured skin basal cell carcinoma and cervical carcinoma excluded. 2. having the evidence of cns metastasis, no matter if treated; if being suspicious of cns metastasis, cns mri or enhanced ct scan must be done within 28 days of enrollment. 3. ast and /or alt\>2.5×normal uln, and alp\>5×normal uln. 4. radiotherapy in the past (excluding palliative radiotherapy for pain relief and the measurable tumor outside the radio field) 5. chemotherapy in the past (excluding bisphosphonates ) 6. having the other uncontrolled diseases. 7. the female in pregnancy or feeding. 8. the subjects with the productivity capacity, but refusal to use the effective contraception measure. 9. participating in other clinical trial and at the time of treatment period. 10. allergy to the tested drugs 11. having the other uncontrolled diseases 12. bmt had been done.

Keywords: nedaplatin lung squamous cell carcinoma
a case control study of women with multiple sexual partners

Conditions: Sexually Transmitted Diseases

Summary: both population based surveys and more focused research studies indicate that increased numbers of sexual partners and partner concurrency contribute to increased risk for acquisition of sexually transmitted infection (sti), including hiv infection. however, unlike for men, both national and sub-population-based studies consistently find that the great majority of women with or without stis report only 1-2 sex partners in the preceding year and that a minority of women acknowledge \> 3 sex partners over the same period, suggesting that this relatively small proportion of women with higher numbers of sex partners play a disproportionate role in sustaining community sti rates. despite these observations, surprisingly little is known about women with increased numbers of sexual partners, the factors which contribute to increased partner number, and the potential for those factors to be intervened upon to reduce risk for sti. the implications of these facts for sti/hiv prevention efforts are profound. for instance, interventions that include the implication that target audiences have multiple sex partners might be dismissed as irrelevant by those with single partners. conversely, interventions targeting women with multiple sex partners may be based on assumptions derived from data which, while representative of the general target audience, may not reflect relevant circumstances for the subset of women with higher numbers of partners. this study will begin to generate data that will provide critical information on this topic and help inform future development of sti/hiv interventions tailored to womens' individual circumstances and contexts. the investigators hypothesize that women with 4 or more sexual partners during the past year will report higher rates of depression and substance abuse (alcohol and drugs), higher rates of intimate partner violence, less social support, more non-vaginal sex, more same-sex contacts, and higher rates of stis than women reporting only one sexual partner during the past year.

the objectives of this protocol are: (1) to delineate factors that are important modifiable predictors of sexually transmitted infection (sti) risk in the context of increased numbers of sexual partners, comparing those participants with one sexual partner to those with 4 or more sexual partners during the past year. (2) to define the prevalence of infection with chlamydia, gonorrhea, trichomoniasis, syphilis, genital herpes, and hiv in women reporting one sexual partner in the past year compared to women reporting 4 or more sexual partners during the past year.

Eligibility criteria:
inclusion criteria: * female, * age 16 years or older, * report of either one sexual partner during the past year or 4 or more sexual partners in the past year, * able to provide written informed consent exclusion criteria: * drug and/or alcohol intoxication at the time of enrollment, * exhibition of any type of disruptive or unsafe behavior that would not be conducive to participating in this study
prunes for gastrointestinal function after gynecologic surgery

Conditions: Constipation

Summary: this is a prospective, randomized control trial that randomizes patients post-operatively into standard care versus standard care plus prunes. patients in the control arm will take 100 mg docusate twice per day for 3 days (standard care). participants in the treatment arm will consume 4 oz prunes daily and take 100 mg docusate twice per day for 3 days. the primary objective is to determine the time to first bowel movement after surgery.

a major postoperative complaint among benign gynecological surgery patients is constipation. improved management of constipation among these patients has the potential to both alleviate pain and for significant savings for health care systems. this is a prospective, randomized control trial that randomizes patients post-operatively into standard care versus standard care plus prunes. the primary objective is to determine the time to first bowel movement after surgery. secondary objectives are pain associated with first bowel movement, stool consistency using bristol stool form scale, compliance and patient satisfaction. the study population includes women over the age of 18 undergoing benign gynecologic surgery with overnight stay. patients in the control arm will take 100 mg docusate twice per day for 3 days (standard care). participants in the treatment arm will consume 4 oz prunes daily and take 100 mg docusate twice per day for 3 days. follow-up phone calls will be made 3 and 5 days postoperatively to inquire about primary and secondary outcomes. participants will be randomized to the treatment or control group at a 1:1 ratio and using randomization blocks of 6. participant characteristics will be presented as means and standard deviations for continuous variables and counts and percentages for categorical variables. the primary and secondary outcomes will be assessed using two-sample t-tests.

Eligibility criteria:
inclusion criteria: 1. female patients seen in the gynecology or urogynecology clinics at lac+usc medical center who are planned for surgery requiring at least 24 hour stay 2. age 18 or greater 3. able to give informed consent 4. no contraindications to docusate or prune consumption exclusion criteria: 1. unable to give informed consent 2. unwilling to follow protocol 3. active malignancy 4. emergency surgery 5. diabetes mellitus 6. inflammatory bowel disease, gastroparesis, or other bowel disorder 7. history of bowel resection or presence of colostomy 8. dependence on regular laxative use prior to surgery 9. baseline frequency of bowel movements less than weekly 10. intraoperative enterotomy or any bowel surgery performed at the time of surgery 11. patient unable to initiate oral intake on post op day 1 for any reason 12. allergy to docusate or prunes