Kornimate/medical-research-clean huggingface dataset:
train the trainer curriculum to scale up ai supported echo for rhd screening in a public health system

Conditions: Rheumatic Heart Disease

Summary: the first primary objective of this study is to determine the diagnostic performance (sensitivity and specificity) of primary moh nurses who have completed certification in focused echocardiography acquisition and interpretation by expert trainers to accurately identify patients who are screen positive and screen negative for rheumatic heart disease. the second primary objective is to determine the diagnostic performance (sensitivity and specificity) of secondary moh nurses who have completed certification in focused echocardiography acquisition and interpretation by moh nurse trainers to accurately identify patients who are screen positive and screen negative for rheumatic heart disease.

objective 1: 4 ultrasound naïve nurses (primary) employed at the hciii/ivs participating in add-rhd part 1 (somrec ref 2021-61) in lira, will be trained and certified by experts in echocardiography for rhd on focused rhd echocardiographic screening examination and interpretation using a novel ai guided software. focused rhd screening echocardiograms by the 4 nurses will be integrated into routine clinical practice at their assigned hciii/ivs for 1 month. screen positive patients will be referred to lrrh for confirmatory echocardiogram using a standard echocardiographic machine under the national rhd registry (somrec ref 2014-137). all echocardiograms will be uploaded to a secure cloud-based server and over-read by a cardiologist with in one - two (1 - 2) weeks to ensure patient safety and to determine trainee performance. diagnostic accuracy, sensitivity, specificity, positive and negative predictive values will be calculated. 4 moh trainees will use pre-recorded powerpoint presentations to conduct hands-on training for phase 2 (secondary) nurses. objective 2: similar to phase 1 with just a few exceptions. 12 moh nurses will be trained and certified by moh nurse trainers from phase 1 to acquire and interpret rhd focused screening echocardiograms using a novel ai guided software. screening will be integrated into routine care for 2 months and diagnostic performance assessed.

Eligibility criteria:
inclusion criteria: * attend same hciii/iv sites that the moh nurses work at * agree to participate via the study's informed consent exclusion criteria: * very sick participants requiring transfer to higher level facility or inpatient care
assessment of facial measurements, the length of mouth corner-mandible angle and incisors-mandible angle, for determining the proper sizes of oropharyngeal airway

Conditions: General Anesthesia

Summary: the purpose of this study is to assess the facial measurements for determining the proper sizes of oropharyngeal airway. investigators hypothesized that the length between incisors and mandible angle is more appropriate to estimate the size of oropharyngeal airway compared with the length between mouth corner and mandible angle.


Eligibility criteria:
inclusion criteria: * adult patients undergoing surgery that requires general anesthesia exclusion criteria: * anticipated difficult intubation * patients without teeth or with loose teeth * cervical spine disease * upper airway disease * body mass index over 35 kg/m2 * pregnancy

Keywords: airway management ventilation
a phase ii study of igev +/- bortezomib before hign dose consolidation in relapsed/refractory hodgkin's lymphoma

Conditions: Hodgkin Disease

Summary: the purpose of this study is to evaluate if the addition of bortezomib (velcade) to igev combination (ifosfamide, gemcitabine and vinorelbine) in patients with relapsed/refractory hodgkin's lymphoma increases the rate of complete remission (pet negativity) at transplantation.


Eligibility criteria:
inclusion criteria: * diagnosis of hodgkin's lymphoma failing or relapsing after first-line chemotherapy (mopp/avbd , mopp/ebv/cad and analogs are considered one line) * age \>18 and \<65 years * signed informed consent * if female, patient is either postmenopausal or surgically sterilized or willing to use an acceptable method of birth control * if male, patient agrees to use an acceptable barrier method for contraception * ecog performance status \<2 * platelet count \>100.000/mmc * hemoglobin \>7.5 g/dl * absolute neutrophil count (anc) \>1.500/mmc * serum calcium \<3.5 mmol/l (\<14 mg/dl) * ast/alt: \<2.5 x the uln * total bilirubin: \<1.5 x the uln exclusion criteria: * previous treatment with velcade * nitrosoureas within 6 weeks or any other chemotherapy within 3 weeks before enrollment * immunotherapy or antibody therapy within 4 weeks before enrollment * experimental drug or medical device within 4 weeks before start of treatment * major surgery within 4 weeks before enrollment * history of allergic reaction attributable to compounds containing boron or mannitol or any of the drugs in the igev regimen * peripheral neuropathy of nci ctcae grade 2 or higher * myocardial infarction within 6 months of enrollment or nyha class iii or iv heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities * history of clinically relevant liver or renal insufficiency; significant cardiac, vascular, pulmonary, gastrointestinal, endocrine, neurologic, rheumatologic, hematologic, psychiatric, or metabolic disturbances including diabetes mellitus * need for therapy with concomitant cyp 3a4 inhibitors or inducers * hiv-positive, if known * hepatitis b surface antigen-positive or active hepatitis c infection, if known * active systemic infection requiring treatment * if female, pregnancy or breast-feeding.

Keywords: hodgkin disease salvage therapy bortezomib transplantation
effect of local infiltration anesthesia with ropivacaine on postoperative pain after hip hemiarthroplasty

Conditions: Femoral Neck Fractures

Summary: at st.olavs hospital each year about 400 patients are treated for femoral neck fractures, 250 of them receiving hemiarthroplasty. implementation of fast-track clinical pathways reduces morbidity and enhances recovery of patients undergoing hemiarthroplasty. one of the key prerequisites for early rehabilitation is optimized pain relief. local infiltration anesthesia with ropivacaine is part of a multimodal pain regimen for patients receiving hemiarthroplasty at st.olavs hospital, although the pain reducing effect of local ropivacaine after hemiarthroplasty has not been investigated in clinical trials. in this study it will be investigated whether a single shot with ropivacaine reduces acute postoperative pain and opioid requirement after hemiarthroplasty. the findings of this study will have a direct impact on patient treatment.


Eligibility criteria:
inclusion criteria: * scheduled for hemiarthroplasty at st. olavs hospital * competent and willing to give consent * able to be mobilized in the pacu and in the trauma ward unit. exclusion criteria: * contraindications for spinal anesthesia, dexamethasone, dolcontin or acetaminophene * receiving general anesthesia * patients operated on with an approach different to standard direct lateral surgery * receiving osteosyntheses * receiving femoral block less than 4 hours before surgery

Keywords: hemiarthroplasty anesthesia, local pain, postoperative
long term effects of heat and moisture exchangers (hmes)

Conditions: Laryngectomy; Status

Summary: assessment of long term effect of provox life hme use on pulmonary symptoms in laryngectomized patients.


Eligibility criteria:
inclusion criteria: * total laryngectomy, irrespective of pharynx reconstruction method * 18 years or older * longer than 3 months after total laryngectomy * longer than 6 weeks after postoperative radiotherapy exclusion criteria: * current use of hmes (within last 3 months) * medical problems prohibiting the use of hme * active recurrent or metastatic disease (medical deterioration) * recent pulmonary infections/unstable pulmonary condition * insufficient physical, cognitive, or mental ability required to attach, remove or operate the devices themselves * low tidal volumes * unable to understand the participant information and/or unable to give informed consent

Keywords: laryngectomy heat and moisture exchanger hme pulmonary rehabilitation
gene expression profiles in cml non-responders

Conditions: Gene Expression Profiles in CML Non-responders

Summary: chronic myeloid leukaemia (cml) is a haematological malignancy primarily driven by the fusion oncogene bcr-abl1, resulting in a constitutively expressed tyrosine kinase. cml is treated very effectively by the tyrosine kinase inhibitors (tkis) resulting in almost undetectable levels of disease. however, some patients show resistance to first line treatment, requiring second and third generation tkis. such resistance is due to the presence of tyrosine kinase domain (tkd) mutations, however tkds do not appear to be present in all patients who do not respond to treatment. the aim of this project is to utilise gene expression arrays to identify transcriptomic profiles associated with resistance to tkis in the absence of a demonstrable tkd mutation. the presence of such profiles may allow for a more targeted approach to treatment, if non-responders can be identified earlier in the disease management pathway. being able to predict those that will not respond to first line treatment will allow for better stratification of patients.

the aim of this project is to use gene expression microarrays to detect expression profiles which may be associated with tki resistance in order to better stratify cml patients and allow a more targeted approach to therapy. the project may also help elucidate the mechanism of resistance in those without a discernible tkd mutation. ultimately it is hoped that this would lead to larger studies which could improve the clinical pathway for cml patients without tkd mutations. some previous studies have studied the gene expression profile of cml patients demonstrating resistance to tkis, using affymetrix arrays. however, none of these appear to have specifically investigated non-responders with and without a tkd mutation.

Eligibility criteria:
inclusion criteria: * cml patients with poor response to tkis as identified through routine clinical testing at sdgs, either with or without a tyrosine kinase domain mutation as tested for by mutational analysis. exclusion criteria: * any samples that do not meet the above inclusion criteria, but particularly not cml patients with an optimal response to tkis.
evaluation of accuracy of guardian sensor 3 in diabetes patients on peritoneal dialysis

Conditions: Diabetes Mellitus (Diagnosis); End Stage Renal Disease; Dialysis

Summary: assessment of performance (precision and accuracy) of guardian sensor™ 3 as compared with a gold standard reference laboratory method (ysi glucose) in diabetes patients on peritoneal dialysis.


Eligibility criteria:
inclusion criteria: 1. type 1 or 2 diabetes mellitus diagnosed for at least 3 months 2. on continuous ambulatory peritoneal dialysis (capd) for at least 3 months 3. male or female age ≥ 18 years old and ≤ 75 year old. 4. women who are not pregnant, lactating or planning a pregnancy during their participation in the clinical study. 5. willingness, ability and commitment to comply with the testing, procedure and follow-up outlined in this protocol including (but not limited to) frequency of clinic visits and use of pre-specified glucose monitoring devices. 6. willingness to abstain from swimming during their participation in the measurement phase. 7. in the opinion of the investigator, absence of any physical limitations, addictive diseases, or underlying medical conditions (including mental health) that may preclude the patient from being a good study candidate. 8. written informed consent to participate in the study provided by the patient. exclusion criteria: 1. poorly controlled diabetes mellitus with hba1c\>11% 2. peritonitis within 1 month 3. on icodextrin pd solutions 4. planned for switching to hemodialysis or living donor transplant in future 3 months 5. currently pregnant, as demonstrated by a positive pregnancy test at screening 6. any active acute or chronic disease or condition that, in the opinion of the investigator, might interfere with the performance of this study. 7. any active acute or chronic infectious disease that, in the opinion of the investigator, would pose an excessive risk to study staff. 8. current use or recent exposure to any medication that in the opinion of the investigator could have an influence on the patient's ability to participate in this study or on the performance of the test device. 9. extensive skin changes/diseases that preclude wearing the required number of devices on normal skin at the proposed application sites (e.g., extensive psoriasis, recent burns or severe sunburn, extensive eczema, extensive scarring, extensive tattoos, dermatitis herpetiformis). 10. have a known allergy to medical-grade adhesives, or known hypersensitivity to any of the products used in the study. 11. blood donation of more than 500 ml within the last three months 12. currently participating in another investigational study protocol where the testing or results may interfere with study compliance, diagnostic results, or data collection. 13 has a mri scan, ct scan, or diathermy scheduled during the proposed study participation. 14. an identified protected vulnerable patient (including but not limited to those in detention, or a prisoner). 15. women of reproductive potential who are unwilling to adopt contraceptive measures during the study period 16. patients with history of pacemaker and prosthesis implantation.
short term comparison of two different techniques of uterine cesarean incision closure

Conditions: Cesarean Section Complications

Summary: cesarean section (c/s) is an operation most commonly performed in obstetrics and gynecology clinics. complications related with incomplete healing of kerr uterine incision after c/s (adhesions, separation (dehiscence), endometritis, endometriosis, anomalous placentation in subsequent pregnancies, incomplete or complete uterine rupture in subsequent pregnancies, ...) are very important issues. classically kerr incision is repaired with continuous locked suturing. purse string suturing of kerr incision may reduce the size of the incision and in turn may reduce short and long term complications. for this reason, the investigators aimed to compare two closure techniques.

in the clinic, patients undergoing cesarean section that meet the criteria for inclusion into the study and agreed to participate in the study will be randomized into two groups (computer-assisted randomization method will be used.) in the first group of patients classical closure method of kerr incision (double layered continuously locked suturing) will be used. in the second group of patients double layered purse string closure technique will be used. the two groups will be compared after 6 weeks in terms of healing, operation time, blood loss, incision size and incisional scar defect( if present). a physician who does not know the method of closure will evaluate incision size by transabdominal and/or transvaginal ultrasound. the length of the incision and myometrial thickness in kerr incisional line will be measured and recorded in longitudinal and transverse axis separately. if any incisional scar defect is determined it will be measured and recorded also.

Eligibility criteria:
inclusion criteria: * singleton pregnancy * term (\> 37 weeks) pregnancy * cervical dilatation \< 4 cm * kerr incision * age \> 18 years old exclusion criteria: * being in active phase of labor * emergency situations (fetal distress, cord prolapse, placental abruption,severe pre-eclampsia, eclampsia, placenta previa, vasa previa ) * having a history of uterine surgery (myomectomy, hysterotomy)other than c/s * extension of kerr incision * multiple pregnancy * maternal diabetes mellitus * maternal connective tissue disease * uterine malformation * uterine fibroids on kerr incision line * chorioamnionitis

Keywords: cesarean section kerr incision purse string suturing in c/s continuous locked suturing in c/s
high flow nasal oxygenation and gastric insufflation in anesthetized patients

Conditions: Gastric Distention

Summary: transnasal humidified rapid-insufflation ventilatory exchange(thrive), or also termed high flow nasal oxygenation (hfno) is a method of supplying heated, humidified high concentrations of oxygen via nasal cavity. the purpose of this study is to investigate the effect of hfno on gastric insufflation in paralyzed anesthetized patients undergoing laryngologic surgery.

hfno can be used during intraoperative period. hfno reduces the risk of desaturation and prolongs the safe apnea time, compared with conventional oxygenation. in laryngeal microsurgery, hfno therapy make possible to perform tubeless anesthesia, providing perfect exposure of structure of the vocal cords. hfno have a risk for low level of positive pressure can make gastric distension, but gastric reflux or aspiration were not occurred during rapid sequence induction for emergency operation. the purpose of this study is to investigate the effect of hfno on gastric insufflation in paralyzed anesthetized patients undergoing laryngologic surgery.

Eligibility criteria:
inclusion criteria: * american society of anesthesiology physical status classification i and ii * patients scheduled for laryngeal microsurgery under general anesthesia exclusion criteria: * gastroesophageal reflux * gastric pathology * pregnancy * major cardiovascular, pulmonary, or cerebrovascular disease * severe obesity (body mass index\>35 kg/m2)
intrathecal pethidine plus dexamethasone for distal lower orthopedic surgeries

Conditions: Postoperative Pain

Summary: bupivacaine is commonly used as a sole agent for spinal anesthesia unlike pethidine. pethidine (meperidine) is a unique opioid. in addition to its analgesic activity, it also has significant local anesthetic activity. this property enables it to be used as the sole agent for spinal anesthesia

pethidine compared favorably with bupivacaine as the sole anesthetic agent, providing excellent conditions for lower abdominal and pelvic surgery. some studies showed that intrathecal pethidine has short motor recovery and prolonged postoperative analgesia in comparison to intrathecal bupivacaine. the side effects of pethidine in spinal anesthesia are pruritus nausea, vomiting and respiratory depression. a dose of 1mg/kg intrathecal pethidine provides surgical anesthesia .however, its effects are not widely available in recent studies. dexamethasone is used as an adjuvant to local anesthetic during spinal anesthesia and other techniques of regional anesthesia, it reduces pain and prolongs the duration of post-operative analgesia. it was shown that intrathecal dexamethasone reduces the complications of spinal anesthesia such as arterial hypotension, nausea, vomiting and shivering. the investigators suppose that addition of intrathecal dexamethasone to pethidine may be a better alternative to intrathecal bupivacaine during spinal anesthesia for lower extremity orthopedic surgery with better outcome and less side effects

Eligibility criteria:
inclusion criteria: * patient acceptance. * patients scheduled for lower extremity orthopedic surgery * both sex * patient's age \>18 years. * patients with american society of anaesthesia (asa)physical status i, ii. exclusion criteria: * patient's age ≤18 years. * uncooperative patients and patients with psychological problems. * patients with contraindications to spinal anesthesia. * patients with contraindications to bupivacaine or dexamethasone or pethidine. * patients with asa physical status iii and iv. * morbid obesity (bmi \>35).
radiological examination of the mentally handicapped patients

Conditions: Profound Mental Retardation

Summary: aim of this study is to evaluate the necessity of the radiological examinations of mentally handicapped or uncooperative patients.

dental radiography has become an indispensable part of routine dental examination with the help of the technological development of radiological devices. however, medical procedures like dental treatment and medical imaging (magnetic resonance imaging-mri, computed tomography-ct, orthopantomography- opg, etc.) that require cooperation are usually hard to apply to mentally handicapped (mhp) or uncooperative patients (ucp). treatments that will be done without radiological examination can be missing or incorrect.

Eligibility criteria:
inclusion criteria: 1. mentally handicapped patients that radiological examination cannot performed 2. suitable for iv sedation exclusion criteria: 1. healthy patients 2. patients in which the radiological examination performed

Keywords: cone-beam computed tomography mentally handicapped
post-operative radiation with cetuximab for locally advanced cutaneous squamous cell carcinoma of the head and neck

Conditions: Head and Neck Cancer

Summary: the standard treatment of surgery followed by radiation therapy can stop tumors from growing in the head and neck region in most patients. however, the cancer can recur or can spread to other parts of the body. cetuximab is a drug that may delay or prevent tumor growth by blocking certain cellular chemical pathways that lead to tumor development. it was approved by the united states food and drug administration (fda) in 2006 for the treatment of head and neck cancer. the purpose of this study is to determine how easily cetuximab can be added to treatment with radiation therapy in patients with cutaneous cancer of the head and neck. this study will also look at how well cetuximab added to radiation therapy works over time and how well this treatment is tolerated.

this is a phase ii trial to characterize the feasibility of treating patients with locally advanced cutaneous squamous cell carcinomas of the head and neck with post-operative radiotherapy and cetuximab. cetuximab has previously been given safely in conjunction with head and neck radiotherapy for mucosal squamous cell carcinoma in multiple phase iii trials, and so phase i data is not necessary here.

Eligibility criteria:
inclusion criteria: * pathologically (histologically) proven diagnosis of cutaneous squamous cell carcinoma of the head and neck * clinical stage \>/= t3 or \>/= n1, m0 including no distant metastases * gross total resection of the primary tumor with curative intent must be completed within 7 weeks of registration * performance status of 0-1 within 2 weeks prior to registration * age \>/= 18 * adequate labs within 2 weeks prior to registration exclusion criteria: * prior invasive malignancy unless disease free for a minimum of 3 years; noninvasive cancers (for example, carcinoma in situ of the breast, oral cavity, or cervix are all permissible) are permitted even if diagnosed and treated \< 3 years ago. patients with a history of t1-2, n0, m0 resected differentiated thyroid carcinoma are considered eligible. * prior systemic chemotherapy or anti-epidermal growth factor therapy for the study cancer or for a different prior cancer * prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields

Keywords: head and neck cancer