Kornimate/medical-research-clean huggingface dataset:
determinants and effects in the use of noharm pain management

Conditions: Surgical Procedure, Unspecified

Summary: the objective of this study is to enrich the ongoing non-pharmacological pain management after surgery (noharm) pragmatic trial (nct04570371) with a mixed methods analysis of patient and care team factors that affect the routine adoption, implementation, and meaningful and sustainable use of the noharm intervention.

aim 1: explore differences in patient engagement with the noharm intervention, use of non-pharm modalities, and clinical outcomes by key patient demographics, including surgical procedure type, gender, and opioid abuse risk. this aim will provide information about patient characteristics that may better predict who will use and/or benefit from the noharm intervention and who will not. aim 2: qualitatively explore determinants of patient-level factors contributing to their ability to effectively engage with the noharm intervention in a diverse subgroups that adopt and use the intervention as intended and those that do not, respectively. this aim will provide information that helps us explain why some patients tend to use and/or benefit from noharm and others do not. aim 3: characterize, using mixed methods, the relative fidelity and sustainability of implementation of noharm among ambulatory and inpatient surgical practices and test for associations with patient engagement and clinical outcomes. this aim will provide information about the characteristics of care teams that tend to adopt and maintain use of the noharm intervention and those that do not. it will also provide information about whether care teams play an important role in prompting patients to engage with and benefit from the noharm intervention.

Eligibility criteria:
inclusion criteria: * participants eligible for this study will be patients on the noharm trial registry (e.g., patients that were automatically assigned to receive the noharm intervention as part of their surgical care) and/or their charts and members of their care teams, including nurses, doctors, physical therapists, nurse practitioners and physician assistants, and medical assistants. exclusion criteria: * individuals not on the noharm trial registry.
aspirin withdrawal and clinical outcome in patients with moderate to high cardiovascular risk but without cardiovascular disease

Conditions: Healthy Participants With Moderate and High Cardiovascular Risk

Summary: while the efficacy of aspirin for the secondary prevention of cardiovascular disease is evident, the effect of aspirin for primary prevention is unclear. the use of aspirin reduces cardiovascular mortality and myocardial infarction but increases side effects such as bleeding. therefore, the use of aspirin for primary prevention in people without cardiovascular disease should be determined by individual risk and clinical benefit. the european guidelines have been changed to not recommend aspirin use in people without cardiovascular disease, but there are still people taking aspirin for primary prevention. the purpose of this study is to investigate the effect of aspirin withdrawal on cardiovascular events in patients without cardiovascular disease. this is a single center, prospective, randomized clinical study evaluating the safety and efficacy of withdrawal of aspirin among patients with moderate or high cardiovascular risk.

patients taking aspirin will be randomly assigned to a group that maintains taking aspirin and a group that discontinues to take aspirin by 1:1 manner. the follow-up duration is five years and clinical outcomes will be investigated.

Eligibility criteria:
inclusion criteria: * adults aged 19-80 years old * subjects who are taking for more than 12 months * subjects with moderate or high cardiovascular risk based on cardiovascular risk classification of 2015 korea society of lipidology and atherosclerosis guideline or 2004 american heart association guideline: 1) moderate risk: people with ≥2 major risk factors, 2) high risk: people with carotid atherosclerosis, abdominal aortic aneurysm, or diabetes, who is taking statin * subjects who voluntarily participate in the study and sign informed consent form exclusion criteria: * subjects with a history of major cardiovascular disease confirmed by medical history and medical history; myocardial infarction, angina pectoris, coronary angioplasty, coronary artery bypass surgery, peripheral vascular disease, ischemic stroke, transient ischemic attack * subjects has any contraindication to use of aspirin or hypersensitivity to aspirin * subjects with atrial fibrillation * subjects who are taking anti-platelet agents other than aspirin or anticoagulants * subjects who have been diagnosed with cancer within the last 5 years * pregnant women or those who have pregnancy plan after enrolling in this study
to evaluate the safety of dbs in patients with primary parkinson's disease

Conditions: Parkinson Disease Dementia

Summary: to evaluate the safety of implantable rechargeable computer deep nerve stimulation system produced by jiangsu changyida medical technology co., ltd. for patients with primary parkinson's disease

to evaluate the safety of implantable rechargeable computer deep nerve stimulation system produced by jiangsu changyida medical technology co., ltd. for patients with primary parkinson's disease

Eligibility criteria:
inclusion criteria:1. aged 18-70 years old, patients with primary parkinson's disease;2. the duration of parkinson's disease is 5 years or more;3. the stage of hoehn-yahr in the "off" (without medication) state is 2 or more stages;4. updrs motion score ≥30 in "off" state;5. good response to dopamine drugs, acute levodopa experiment updrs exercise score improvement rate of more than 30% (experimental drug medoba 250mg);6. the daily drug shutdown period is at least 6 hours, or there are sports complications such as serious transactions, and repeated adjustments of drugs still cannot be effectively improved;7. mmse score ≥24 points on the simple intelligent mental state examination scale;8. have the ability of independent external charging operation;9. patients or their family members can fully understand the treatment and sign informed consent;10. the patient had good compliance and was able to meet the requirements of postoperative follow-up. exclusion criteria:1. have received surgical treatment for parkinson's disease other than deep brain stimulation, such as stereotactic destruction, cell transplantation, gamma knife, etc.;2. the "off" state has serious language disorders, dysphagia, balance disorders and other midline symptoms;3. there are contraindications for neurosurgery, such as cerebral infarction, hydrocephalus, cerebral atrophy, ventricle enlargement, cerebrovascular sequelae, heart disease, severe thrombocytopenia and other cardiovascular and cerebrovascular diseases;4. have other concomitant diseases, have or need to implant a pacemaker, defibrillator, cochlear implant, other neurostimulator, or need to undergo frequent magnetic examinations;5. patients who are abnormally sensitive to temperature or allergic to heat;6. there are concomitant diseases that seriously affect health, such as tumors, serious abnormalities of liver and kidney function (indicators exceeding three times the normal value).7. patients with anxiety and depression.
cbt versus selective serotonin reuptake inhibitor for treatment of depression in temporal lobe epilepsy patients

Conditions: Depression; Epilepsy, Temporal Lobe

Summary: the aim of the study is to compare the effect of group-cognitive-behavioral therapy (cbt)versus treatment as usual with the selective serotonin reuptake inhibitor sertraline, in patients with diagnosis of temporal lobe epilepsy (tle) and depressive disorder.

patients with temporal lobe epilepsy and depression will be enrolled into one of two treatment modality. the first group will receive 12 group cognitive behavioral sessions. cbt is a psychotherapy focused on the recognition and change of distorted thoughts and maladaptive behaviors. the second group will receive treatment with the selective serotonin reuptake inhibitor sertraline or citalopram for 12 weeks. this antidepressant is wide used to treat depression in patients with tle.

Eligibility criteria:
inclusion criteria: * with major depressive disorder according to criteria from the fourth edition of the diagnostic and statistical manual of mental disorders (dsm-iv) * diagnosed with tle according to the criteria of the international league against epilepsy * literates had sign an informed consent * patients on antidepressant treatments will be allowed to participate only if they had been at stable doses for more than 8 weeks and still show signs of significant depression exclusion criteria: * patients with high risk of suicide who required hospitalization * patients who abused or are dependent on drugs * those with a history of head trauma six months prior to the interview * patients who have any condition that would prevent them from understanding the study or the psychotherapeutic process, such as mental retardation, psychosis, delirium, dementia, etc * patients who have previously received cbt * patients who have started, an antidepressant drug the last 8 weeks

Keywords: cognitive behavioral therapy selective serotonin reuptake inhibitor depression epilepsy
dietary intervention in type-2 diabetes and pre-diabetes

Conditions: Diabetes Mellitus, Type 2; Pre-diabetes; Metabolic Syndrome

Summary: the primary purpose of this research is to demonstrate the therapeutic effects of implementing a well-formulated low carbohydrate lifestyle program over 2 years in patients with type 2 diabetes, pre-diabetes, and metabolic syndrome.

the primary purpose of this research is to demonstrate the therapeutic effects of implementing a well-formulated low carbohydrate lifestyle program over 2 years. positive therapeutic effects would be represented by improved glycemic control in patients with type 2 diabetes without use of additional glycemic control medications and failure to progress to type 2 diabetes in individuals with pre-diabetes and metabolic syndrome. secondary purposes of this research are to determine if therapeutic effects of the intervention differ between patients who self-select onsite vs. web-based education delivery, explore relationships between change in ldl cholesterol and carotid intima media thickness, and to evaluate the sustainability of health outcomes achieved and the economic impact of therapeutic effects over 5 years.

Eligibility criteria:
inclusion criteria: body weight/diabetes: * diagnosis of type-2 diabetes with bmi \> 25 (without end-organ failure) * fasting glucose \>126 mg/dl or hba1c \>6.5 body weight/ pre-diabetes: • diagnosis of metabolic syndrome with bmi \>30 and hba1c \> 5.6 (note: this does not apply to usual care control subjects) ethnicity: all ethnic groups exclusion criteria: * bmi \<30 without diagnosis of type-2 diabetes, metabolic syndrome * type 1 diabetes * history of keto-acidosis * history of mi, stroke, angina, coronary insufficiency within the last 6 months * diabetic retinopathy requiring treatment * creatinine \> 2.0 * urinary albumin \> 1 g/d * impaired hepatic function (bilirubin \>2, albumin \< 3.5) * cholelithiasis or biliary dysfunction * cancer requiring treatment in the past 5 years, with the exception of non-melanoma skin cancer * chronic infectious disease requiring ongoing treatment * other chronic diseases or condition likely to limit lifespan to \<6 years * non-english speaking * unable or unwilling to participate in group sessions (e.g., plans to relocate within the next year) or conform to a carbohydrate restricted diet lifestyle (e.g., food intolerances, religious or personal restrictions) * weight loss of \>10% in past 6 months * currently pregnant or nursing, or planning to become pregnant during the study * major psychiatric disorder (e.g., schizophrenia, bipolar disorder) currently uncontrolled * excessive alcohol intake (acute or chronic) defined as average consumption of 3 or more alcohol-containing beverages daily or consumption of more than 14 alcoholic beverages per week
a trial of neurofeedback as an adjunctive treatment for youth in outpatient mental health settings

Conditions: Trauma

Summary: the purpose of this study is to test the feasibility and effectiveness of a neurofeedback intervention conducted as an adjunctive behavioral health treatment to reduce trauma and affective symptoms in trauma-exposed youth.


Eligibility criteria:
inclusion criteria: (children) * caregiver-reported exposure to two or more ace types on the ace-q-child measure. * ages of 6-12 years old * receiving or eligible to receive trauma-focused cognitive behavior therapy or another type of trauma-focused therapy, as determined by their primary therapist, designated as the tau condition * speaks and reads english (caregivers) * own an iphone, ipad, smartphone, or tablet that is equipped with bluetooth and uses an apple or android operating system that is compatible with the muse calm app and accompanying muse wearable neurofeedback device * speaks and read english exclusion criteria: child-caregiver dyads will be excluded if * the child falls outside of the required age range, * has a documented history of epilepsy * is currently considered to be at high risk for suicide attempt * is currently experiencing psychosis
total knee arthroplasty with and without tourniquet: comparative study

Conditions: Total Knee Arthroplasty

Summary: tourniquet use during total knee arthroplasty (tka) improves visibility and reduces intraoperative blood loss. however, tourniquet use may also have a negative impact on early recovery of muscle strength and lower extremity function after tka.seventy patients are involved in this study and were divided into two groups; group a (35) patients were treated with tka with pneumatic thigh tourniquet. group b (35) patients were treated with tka without tourniquet. all patients were suffering from severe knee osteoarthritis and they failed to respond to conservative treatment so they are candidates for primary tka. the two groups are matched related to age and gender. selection of patients into two groups done randomly with regard of odd number for group a and even number for group b

this study started on march 2016 and ends on october 2018. seventy patients are involved in this study and were divided into two groups; group a (35) patients were treated with tka with pneumatic thigh tourniquet. group b (35) patients were treated with tka without tourniquet. all patients were suffering from severe knee osteoarthritis and they failed to respond to conservative treatment so they are candidates for primary tka. the two groups are matched related to age and gender. selection of patients into two groups done randomly with regard of odd number for group a and even number for group b. all patients were followed for a period of two weeks until removal of skin sutures for the following parameters: amount of blood transfusion done at and after surgery. amount of blood drained postoperatively through suction drain. occurrence of postoperative wound hematoma. vas (visual analogue score) for thigh pain at 1st day and (2) weeks postoperatively. clinical dvt.

Eligibility criteria:
inclusion criteria: * patients were suffering from severe knee osteoarthritis and they failed to respond to conservative treatment exclusion criteria: * hb less than 12. * d.m.,blood dyscrasia. * any evidence of infection by screening test esr and crp. , * bmi more than 30.

Keywords: thigh pain total knee arthroplasty tourniquet
levonorgestrel intrauterine system and adenomyosis

Conditions: Adenomyosis

Summary: adenomyosis is defined when the endometrial tissue (gland and stroma) is present within the myometrium . the depth of endometrial penetration which uses in diagnosis of adenomyosis not yet agreed; opinions range from one high power field to 25% of the myometrial thickness. it is a common condition in women aged 40-50 years and is considered an important cause of dysmenorrhea and menorrhagia in around 65 % of cases. until past few years; hysterectomy was the suggested definitive treatment, however; this may not be acceptable to women not willing to loss their fertility. many treatment lines were studied and proved their beneficial effect on adenomyosis such as gnrh agonists, danazol, combined oral contraceptive pills, dienogest and finally endometrial ablation. however, these line of treatment are not commonly used because high incidence of side effects and relatively high cost of some of them. the levonorgestrel-releasing intrauterine system (lng-ius) was emerged as an effective line for treatment of adenomyosis associated pain and bleeding. it can successfully, within 6 to 12 months, down-regulate the estrogen receptors in adenomyotic tissues which lead to decidualization and atrophy of the adenomyosis . in fact, some adenomyotic women respond well to lng-iuds and show high acceptability and satisfaction, on the other hand; a group of women may not respond to lng-iuds and opt to remove it and start a new medical or surgical option for treatment. however, factors related to lng-ius effectiveness in patients with adenomyosis were not well available. only one report states that a large uterine volume could be a factor associated with lng-ius treatment discontinuation in adenomyotic patient. for this reason; the prediction of the responsiveness to lng-ius is interesting issue which should be addressed. the present study examines the hypothesis that patient's data reported at baseline visit before using lng-iusfor controlling pain/bleeding with adenomyosis can help the prediction of the responsiveness for this important line of treatment at 6 months follow up visit. up to our knowledge; no clinical trial had been registered or conducted to predict the responsiveness for lng-ius in controlling the pain/ bleeding with adenomyosis.


Eligibility criteria:
inclusion criteria: * adenomyosis * request for contraception * resident in the nearby vicinity to make the follow-up easy and feasible exclusion criteria: * history of ectopic pregnancy * puerperal sepsis * pelvic inflammatory disease * evidence of coagulopathy * abnormalities of the uterine cavity
clinical characteristics analysis and prediction model establishment of fatal esophageal and gastric variceal bleeding

Conditions: Acute Variceal Bleeding

Summary: the purpose of this study is to analyze the clinical characteristics of patients with fatal acute variceal bleeding (avb) and establish a mortality risk prediction model to identify patients at high risk of death after admission, so as to guide clinical practice, further optimize the allocation of emergency resources, and further reduce the mortality of avb patients.

how to predict adverse outcomes of acute variceal bleeding and identify high-risk patients remains unclear. most studies related to risk factors for adverse outcomes in avb patients took 5 days and 6 weeks as time nodes, and the main outcome indicators were the rebleeding rate and mortality rate at 5 days and 6 weeks. however, some patients admitted to hospital may suffer death within a short period of time ,the investigators will define avb patients at high risk of death in several hours after admission as fatal acute variceal bleeding.to identify such patients and give more positive treatment can further reduce the mortality of avb. such risk stratification can be used to further guide the rational allocation of emergency resources, improve the efficacy of medical resources. this study intends to retrospectively collect the clinical data of avb patients in renmin hospital of wuhan university, analyze the risk factors for death after admission, establish a mortality risk prediction model, and compare and validate the new model and the scoring model to be verified.

Eligibility criteria:
inclusion criteria: 1. history of cirrhosis/previous history of endoscopic varicose veins/undiagnosed liver disease but signs related to liver disease, hematemesis or melena; the diagnosis of cirrhosis is based on liver biopsy or the usual clinical and radiological criteria; 2. avb was confirmed by endoscopy without special medical history; exclusion criteria: 1. patients who cannot obtain complete data (vital signs, medical history, laboratory tests and other data are seriously missing); 2. patients with upper gastrointestinal bleeding have no evidence of avb.

Keywords: acute variceal bleeding mortality risk prediction model
the effect on small airways of addition of theophylline as inducer of histone deacilase activity for patients with moderate to severe chronic obstructive pulmonary disease (copd), treated with inhaled steroids and long acting beta agonists

Conditions: COPD

Summary: chronic obstructive pulmonary disease (copd) is a chronic progressive respiratory disorder causing disability with an increasing burden to the patient, his family and to the health services. treatment of copd patients depends on the stage of the disease. copd responds poorly to corticosteroids, in spite of inflammation is a major component in its pathogenesis. a major barrier to therapy of copd is resistance to the anti-inflammatory effects of corticosteroids. the molecular mechanisms for this corticosteroid resistance are now being elucidated, particularly as the molecular basis for the anti-inflammatory effects of corticosteroids is better understood (12). an important mechanism of corticosteroid resistance in copd, which is also linked to amplification of the inflammatory process, is a reduction in the critical nuclear enzyme histone deacetylase (hdac)2 . since the major changes are at the level of small airways. we will examine the effect of addition of theophylline product to stable copd patients treated with combined inhaler of inhaled corticosteroids.


Eligibility criteria:
inclusion criteria: * stable stage ii and iii (gold) copd, diagnosed 2 years ago and up exclusion criteria: * heart failure malignancy immune suppressed

Keywords: forced expiratory volume in one second inspiratory capacity endurance time residual volume