Kornimate/medical-research-clean huggingface dataset:
evaluate early invasive strategy for patients with stemi presenting 24-48 hours from symptom onset

Conditions: ST-segment Elevation Myocardial Infarction (STEMI)

Summary: the primary objective of the trial is to evaluate the efficacy of early invasive strategy for stemi patients within 24-48h of symptom onset.

at present, timely primary percutaneous coronary intervention (pci) is the preferred strategy for st-segment elevation myocardial infarction (stemi) patients within 24h of symptom onset. in stable stemi patients presenting 12 to 48 hours from symptom onset, brave-2 trial (n = 365) showed improved myocardial salvage and 4-year survival in patients treated with primary pci compared with conservative treatment alone. however, data is scarce about the reperfusion strategy focusing on stemi patients within 24-48h of symptom onset. further investigations are warranted to explore the best timing of invasive strategy for stemi patients within 24-48h of symptom onset. given that no randomized clinical trial is designed especially for stemi patients within 24-48h of symptom onset, and limited data is available to evaluate the efficacy of early invasive strategy for the special subgroup of stemi patients, investigators plan to perform a controlled, randomized trial to evaluate the efficacy of early invasive strategy for stemi patients within 24-48h of symptom onset.

Eligibility criteria:
inclusion criteria: 1. age: 18 or over and less than 75 years old; 2. ecg: a) ≥2 mm st-segment elevation in 2 contiguous precordial leads or ≥1 mm st-segment elevation in 2 contiguous extremity leads; or b) new or presumable new left bundle branch block in the presence of typical symptoms; 3. patents with stemi with symptom onset between 24 and 48 hours before randomization; 4. signed informed consent form prior to trial participation. exclusion criteria: 1. patents with stemi with symptom onset \ 48h or uncertain time onset. 2. prior administration of thrombolytic therapy or attempted pci before randomization; 3. presence of indications for primary pci, such as persistent chest pain, cardiogenic shock, life-threatening arrhythmias or cardiac arrest, severe acute heart failure, and mechanical complications; 4. coagulopathy, active peptic ulcer, history of cerebral or subarachnoid hemorrhage, stroke within 6 months, other contraindications for antiplatelet or anticoagulant therapy; 5. known intolerance to antiplatelet (e.g. aspirin, clopidogrel, ticagrelor) and anticoagulant therapy (e.g. heparin, bivalirudin); 6. presence of contraindications for cmr; 7. congenital heart disease or severe valvular disease; 8. egfr \<30 ml/min/1.73 m2; 9. history of malignant tumors; 10. combined with other diseases and life expectancy ≤12 months; 11. pregnancy; 12. inclusion in another clinical trial; 13. inability to provide informed consent or not available for follow-up judged by investigator.

Keywords: st-segment elevation myocardial infarction (stemi) early invasive strategy
perceptions,social representations and experience of lyme borreliosis and ticks in adolescents likely to be infected and their parents

Conditions: Lyme Disease

Summary: the study is offered to adolescents aged 12 to 17 and their families suspected of or suffering from lyme barilliosis. during inclusion, three interviews will be carried out for each family. this choice of the number of interviews per family seems the most appropriate to have a plurality of answers to the questions asked. thus, these will have a duration of 30 min to 1 hour and will be carried out by an anthropologist. the first interview will be with the teenager. the second interview will then concern the parent(s). finally, the last appointment will be with the teenager and his parents.

the study is offered to adolescents aged 12 to 17 and their families suspected of or suffering from lyme barilliosis. during inclusion, three interviews will be carried out for each family. this choice of the number of interviews per family seems the most appropriate to have a plurality of answers to the questions asked. thus, these will have a duration of 30 min to 1 hour and will be carried out by an anthropologist. the first interview will be with the teenager. the second interview will then concern the parent(s). finally, the last appointment will be with the teenager and his parents. after a few introductory questions concerning the socio-demographic characteristics of adolescents, their medical history and their exposure to ticks, the anthropologist will ask the semi-open questions. as for the parent(s), the anthropologist will ask them questions directly related to lyme borreliosis and the tick. finally, questions will be proposed simultaneously during a joint interview with the teenager and his parents.

Eligibility criteria:
inclusion criteria: * be at least 12 years old and maximum 17 years old. * be accompanied by a holder of parental authority * live in metropolitan france. * suspect or have lyme borreliosis * non-objection for participation in the protocol exclusion criteria: * refusal of participation of a holder of parental authority and of the adolescent * non-mastery of oral french by the teenager or his parents * protected persons (patients under guardianship or curatorship, pregnant or nursing women, persons deprived of liberty, person unable to express their non-objection)
histological characterization and differentiation of rash from other epidermal growth factor receptor (egfr) inhibitors

Conditions: Skin Rash

Summary: the purpose of this study is to characterize the microscopic findings of skin rash associated with the use of chemotherapeutic anticancer agents known as epidermal growth factor inhibitors (egfris).

epidermal growth factor (egf) and its receptor, the egfr, are known to be key drivers in cellular proliferation and survival. malignant tumors result from uncontrolled cell proliferation. the use of drugs which target the egf receptor has offered patients with non-small cell lung cancer, pancreatic cancer, head and neck cancer, and colorectal cancer additional targeted anti-cancer therapy in addition to their chemotherapeutic regimens. as a result of increased use of these egfr inhibitors, adverse events have emerged involving the skin, hair, nails and eyes. while the egfr inhibitors block the signal transduction that interfere with cellular proliferation and survival of cancerous cells, they also affect the normal egf function in the skin (papulopustular rash), hair, and nails. in this study, we seek to histologically characterize the papulopustular rash in patients who have been treated with lapatinib and compare our findings with those associated with three other egfris, cetuximab, erlotinib and panitumumab.

Eligibility criteria:
inclusion criteria: * patients treated with lapatinib who developed skin toxicities and were biopsied. * patients treated with erlotinib, cetuximab, or panitumumab who have been biopsied for skin rash. exclusion criteria: * patients who do not fit above criteria.

Keywords: skin rash, lapatinib, cetuximab, erlotinib, panitumumab
effectiveness of using a meditation app in reducing anxiety and improving well-being during the covid-19 pandemic

Conditions: Anxiety; Well-being

Summary: this interventional study will investigate the effect of daily use of a mindfulness app on measures of participant anxiety, well-being, and future outlook during the covid-19 pandemic, by comparing pre-intervention survey responses to post-intervention survey responses.

question 1: can 30 days of daily use of a mindfulness app during the covid-19 pandemic reduce anxiety and improve general well-being and future outlook? outcomes measured: pre- and post-intervention surveys to assess well-being and anxiety (primary outcomes), future outlook, hopefulness, and sleep habits (secondary outcomes). many of these survey questions come from well-validated surveys (who-5 well-being survey, gad7 anxiety survey). post intervention surveys will be administered at the end of the 30d intervention, as well as 2 months after the completion of the 30d intervention. question 2: can 30 days of daily use of a mindfulness app during the covid-19 pandemic improve nutritional habits? outcomes measured: pre- and post-intervention surveys to assess general nutrition habits, including frequency of consuming whole foods (fruits, vegetables, whole grains) and frequency of consuming prepared meals (secondary outcomes). post intervention surveys will be administered at the end of the 30d intervention, as well as 2 months after the completion of the 30d intervention. question 3: will study participants be more likely to continue to use the mindfulness app after completion of the study? outcomes measured: post-intervention survey administered at the end of the 30d intervention will be used to assess likelihood to continue using app and frequency of anticipated continued use. the post-intervention survey administered 2 months after the completion of the 30d intervention will ask if participants continued to use the app, and the frequency of use (secondary outcomes).

Eligibility criteria:
inclusion criteria: * participants must be 18 or older. inclusion criteria are access to a smartphone and ability to download the mindfulness app, fluency in english, and the ability to complete surveys independently. exclusion criteria: * exclusion criteria include current regular use of a mindfulness or meditation app, regular practice of mindfulness or meditation, regular therapy sessions, inability to complete surveys independently, or any mental health restrictions that would prevent them from participating.
additive beneficial effects of atorvastatin combined with amlodipine in treatment of hypertension

Conditions: Hypertension

Summary: the investigators hypothesized combination therapy would be superior to monotherapy.


Eligibility criteria:
inclusion criteria: * hypertension exclusion criteria: * chronic renal disease * severe hypertension

Keywords: endothelial function insulin sensitivity
does dhea ivf outcomes in poor responders?

Conditions: Infertility, Female; Poor Response to Ovulation Induction

Summary: this study is a rct to examine whether dhea is capable of improving results for poor responders to ovarian stimulation during ivf treatment

poor responders to ovarian stimulation for ivf may be either predicted or evidenced from previous treatment. the eshre criteria for poor responders will be used to select candidates for this trial. a power calculation determined that 200 subjects should be recruited to each arm to receive either dhea or placebo.

Eligibility criteria:
inclusion criteria: * age ≥ 40 years * markers for poor ovarian reserve (amh \<7 pmol/l(\<1.1 ng/ml) and/or afc\< 7) * previous poor response to ovarian stimulation ( ≤3 oocytes with a conventional stimulation protocol) exclusion criteria: * women \> 42 years * women with premature ovarian failure / premature menopause (fsh\>40 u/l). women already taking dhea. * patients with a known allergy to the trial drug or any of the active ingredients in the placebo.
assessment of two levels of arterial pressure on survival in patients with septic shock

Conditions: Septic Shock; Arterial Pressure; Hemodynamics; Mortality; Clinical Trial

Summary: the ideal mean arterial pressure in patients with septic shock is unknown. the expert's recommandations have stated a target between 65 and 70 mm hg. however the scientific basis are weak. indead there are only few prospective studies which addressed this question without clear answer. therefore we designed a rct in order to assess the effect on mortality of two levels of mean arterial pressure in patients with septic shock.(800 patients, 30 centres)


Eligibility criteria:
inclusion criteria: * patients with septic shock according criteria of bone * minimal dose of norepinephrine * written informed consent obtained from the patient or surrogate exclusion criteria: * age \< 18 years * pregnancy * participation in other trials with the same endpoints * moribund * absence of registration in french health care system * patient protected by law
salvage brachytherapy and hyperthermia for recurrent h&n-tumours

Conditions: Locally Recurrent Head and Neck Cancer

Summary: the aim of the present trial is to assess the prospective results of protocol-based interstitial pulsed-dose-rate (pdr) brachytherapy with interstitial hyperthermia (iht) in a group of selected patients where salvage surgery with clear resection margins was not possible.


Eligibility criteria:
inclusion criteria: * histologically confirmed recurrent carcinoma of the head and neck region * stage rct1-3 * tumor anatomy and location suitable for brachytherapy techniques. * cn0/pn0 or rpn+ \& r0 with \<3 pos. lnd \& without invasion of capsula. * m0 * ecog 0-2 * previous radiation therapy up to at least 50 gy * previous radiation therapy completed more than 6 months ago * written study-specific informed consent exclusion criteria: * ct4 * rpn+ with \>2 pos. lnd or invasion of capsula * pregnant or lactating women * collagen vascular disease * the presence of congenital diseases with increased radiation sensitivity, for example ataxia telangiectatica or similar * psychiatric disorders

Keywords: head and neck cancer locally recurrent head and neck cancer brachytherapy hyperthermia
usage and plan of care changes due to drug screenings

Conditions: Pain Management

Summary: the purpose of this minimal risk, observational survey is to document the accuracy, benefits, and how qualitative and quantitative results affect patients' plan of care.

pain is the most common reason patients consult primary care providers. according to recent surveys, one in six americans live with chronic or recurrent pain and pay an estimated $120 billion a year in medical costs in the united states. oral opioids are the common treatment options for various chronic pains including joint pain, musculoskeletal pain, neuropathic pain and migraines. this narcotic-based management of pain is often associated with undesirable side effects with addictive and potential abuse. to ensure proper usage of prescribed medications, physicians use drug screens to monitor therapeutic levels and test for presence of illegal drugs or medications that may cause a drug-drug interaction. upon receiving quantitative or qualitative results from these drug screens, the physician may change the treatment plan for patients to improve efficacy of prescribed medications.

Eligibility criteria:
inclusion criteria: * must be a medical practioner * medical doctor (md) * doctor of osteopathic (do) * physician assistant (pa) * advanced practice registered nurse (aprn) * nurse practioner (np) * must have a current standard operating procedure that includes obtaining/reviewing medical history. exclusion criteria: * government-funded insurance data cannot be included in the study.
esp in breast surgery due to cancer

Conditions: Breast Cancer; Pain, Acute; Anesthesia, Local

Summary: patients scheduled for breast surgery due to cancer. each patient will be treated with intravenous (i.v.) oxycodone - patient-controlled analgesia (pca). patients will be allocated to one of three groups: erector spinae plane (esp) block, sham block, controlled group.

only patients who are qualified for an elective procedure of mitral breast surgery may participate in the study. each patient will be anesthetized generally. the same drugs will be used in each stage of anesthesia. the induction: propofol, fentanyl, rocuronium. the airway will be secured with a laryngeal mask airway (lma). when there is a risk of aspiration, the patient will be intubated. then, rocuronium or suxamethonium will be used. the anesthesia maintenance: sevoflurane, fentanyl. the emergence: oxygen, sugammadex or neostigmine a required. after the induction of general anesthesia, an opaque envelope with the selected group will be opened. in the controlled group, the procedure will be continued in the patient's supine position. women from the esp and sham groups will be placed in the lateral position. the operated side will be above. then, the ultrasound-guided esp block with saline or ropivacaine will be performed. at the end of the surgery, an anesthesiologist will administer oxycodone intravenously (0.1 mg/kg). after emergence from anesthesia, the patient will be transferred to the postoperative care unit. vital signs will be monitored. the patient-controlled analgesia pump with oxycodone will be used.

Eligibility criteria:
inclusion criteria: * elective surgery of breast due to cancer * obtained consent exclusion criteria: * the lack of consent * the surgery of two breasts * reoperation of the same breast * previous participation in the study * coagulopathy * allergy to morphine and local anesthetics * depression, antidepressant drugs treatment * epilepsy * usage of painkiller before surgery * addiction to alcohol or recreational drugs

Keywords: erector spinae plane block visual analog scale quality of recovery patient-controlled analgesia
implications of covid-19 on the lifestyle changes

Conditions: COVID-19

Summary: northern italy has been profoundly touched by the covid-19 pandemic. to limit the outbreaks of contagion, the italian government imposed 2.months of complete lock-down, which imposed the social isolation for the whole population and, for those positive to the covid-19, the complete confinement at home. despite the recommendations for conserving healthy lifestyle of the italian government, during the lock-down the likelihood to fall into unhealthy behaviours might have increased. this study aims to describe the impact of covid-19 on the lifestyles of a population of italian adults living in an area of high spread of sars-cov-2.

the aims of this study were to detect the changes in lifestyles occurred during the imposed lock-down phase and the support services used the most by participants. this study consists in the administration of an on-line survey addressed to adult individuals living in the province of reggio emilia (italy). the survey was posted on-line on the website of the azienda usl- irccs di reggio emilia and it was spread to the community through apps and social networks. the on-line survey is free to access, self-administered and it consists of 50 questions. the questions investigates the changes occurred in employment status, physical exercise, diet, tobacco and alcohol consumption, sleep quality and leisure activities during the pandemic lock-down phase as well as the available local support services used and perceived as useful.

Eligibility criteria:
inclusion criteria: * adult individuals living in the province of reggio emilia (italy) exclusion criteria: -

Keywords: italy lifestyle pandemics quarantine
comparative study of carvedilol monotherapy versus combination therapy with endoscopic variceal ligation (evl) for primary prophylaxis of variceal bleeding in patients with hepatocellular carcinoma with high-risk esophageal varices

Conditions: Hepatocellular Carcinoma

Summary: esophageal varices are common in patients with hepatocellular carcinoma (hcc), with an incidence rate of 63% at the time of hcc diagnosis. following an acute variceal bleed, the 6-week mortality rate for hcc patients is as high as 26%. mortality rates escalate notably in hcc patients experiencing acute variceal bleeding, especially with increasing cancer severity indicated by blcl status. research suggests that the cumulative incidence rate of variceal bleeding at one year in patients receiving primary prophylaxis is almost half that of patients not receiving any prophylaxis. beta blockers are the standard therapy for primary prophylaxis in patients with portal hypertension to prevent variceal bleeding. endoscopic band ligation has also shown promising results in recent studies. however, the combined impact of beta blockers and esophageal band ligation on lowering the incidence of variceal bleeding remains unstudied. the aim of this study is to compare the efficacy of carvedilol monotherapy versus combination therapy with carvedilol and endoscopic band ligation in patients with hcc for primary prophylaxis of high-risk esophageal varices.

study population: all patients aged ≥ 18 years and ≤ 80 years admitted in institute of liver and biliary sciences, new delhi with hcc of any cause and high risk esophageal varices and are giving written consent for participation in the study. study design - single center, open label, randomized controlled trial study period - 6 months intervention - the patients will be randomized into group -a (nsbb arm) and group-b (evl + nsbb arm). both the group will receive the remaining treatment as per protocol group a: non-selective beta blocker (carvedilol 3.125 mg bd for 3 days followed by 6.25 mg bd , maximum dose would be 12.5 mg bd , same shall be switch to maximum tolerable dose if sbp\< 90 , h,r\<55) group b: non-selective beta blocker (carvedilol 3.125 mg bd for 3 days followed by 6.25 mg bd , maximum dose would be 12.5 mg bd , same shall be switch to maximum tolerable dose if sbp\< 90 , h,r\<55) + evl every 3 weeks till eradication of varices followed by every 3 months. monitoring and assessment: monitoring and evaluation would be done once a month for first 3 months then at 6th month.

Eligibility criteria:
inclusion criteria: 1. age 18-80 years 2. cirrhosis with hcc 3. high risk oesophageal varices (\*large or small with rcs) 4. valid consent exclusion criteria: 1. any contra-indication to beta-blockers 2. any evl or sclerotherapy within last 3 months 3. any past history of tips or surgery for portal hypertension 4. hcc with bclc-d 5. patients with past history of variceal bleed. 6. patient with liver transplant expected in next 2 weeks would be excluded
cardiac rehabilitation: optimisation of the functional capacity of patients hospitalized with cardiac disease

Conditions: Myocardial Ischemia; Heart Diseases

Summary: the world health organization \[who\] (2021) states that cardiovascular diseases \[cvd\] are the leading cause of death in the world, and in 2019 around 17.9 million deaths were caused by cvd and the national picture is no different. in portugal, demographic ageing continues to be established by the increase in average life expectancy, which in turn leads to an increase in the percentage of the population with cvds. of particular note is ischemic heart disease \[ihd\], which is the second leading cause of death in portugal in order to prevent and combat the progression of cvd and its complications, cardiac rehabilitation \[cr\] programs have emerged as a secondary prevention method supported by relevant scientific evidence. in this sense, the portuguese society of cardiology recognizes the role of the rehabilitation nurse specialist as a crucial element of cr teams. objective: to evaluate the effectiveness of the phase i cardiac rehabilitation program in patients hospitalized with ischemic heart disease, in terms of functional capacity.


Eligibility criteria:
inclusion criteria: * patients with myocardial ischemia * patients who agree to take part in the rehabilitation exercise program * patients with the cognitive capacity to understand the instructions given, the exercises to be carried out and the teaching provided * patients with clinical and hemodynamic stability * patients participating in the rehabilitation exercise program for at least 2 sessions. exclusion criteria: * patients who do not meet the safety criteria for exercising after a cardiac event * patients with osteoarticular pathology that compromises their ability to exercise.

Keywords: cardiac rehabilitation phase i myocardial ischemia rehabilitation nursing