Kornimate/medical-research-clean huggingface dataset:
new therapy for advanced stage leukemia after stem cell transplantation

Conditions: Leukemia

Summary: hematopoietic stem cell transplantation (hsct) is one of the best, and sometimes the only, option for the treatment of leukemia, particularly for patients with advanced-stage leukemia. however, relapse rate was still very high for advanced-stage leukemia. it was found in our previous study that infusion of granulocyte colony-stimulating factor (g-csf)-primed peripheral blood progenitor cells (gpbpc) instead of non-primed lymphocytes exhibited a comparative or stronger graft-versus-leukemia (gvl) effect and comparative or less incidence of gvhd, rarely being complicated with pancytopenia. when gpbpc infusion was combined with the use of short-term immunosuppressant for gvhd prophylaxis, the incidence of fatal gvhd complicated with gpbpci was further reduced. our primary data showed the gpbpci combined with the use of short-term immunosuppressant was feasible in patients with advanced leukemia to prevent relapse after hla-mismatched hsct. the study hypothesis: prevention of relapse using granulocyte colony-stimulating factor-primed peripheral blood progenitor cells following hematopoietic stem cell transplantation in patients with advanced-stage acute leukemia can * reduce relapse rate * improve survival

a g-csf-primed pbpci was planned within day 60 post-transplantation before hematologic relapse was diagnosed in patients for which no gvhd occurred or free of gvhd after 2 weeks off immunosuppression for patients receiving gpbpci after day 90 post hsct. before administration of gpbpci, serious infection had to be cleared and no serious organ failure could be present. the gpbpci regimen was comprised of g-csf-primed pbscs instead of harvested non-primed donor lymphocytes and short-term immunosuppressive agents for prevention of gvhd after gpbpci. chimerism status was examined before and after prophylactic treatment with gpbpci.

Eligibility criteria:
inclusion criteria: * high-risk leukemia after hsct exclusion criteria: * active gvhd * early relapse
enhancing systems of care to improve hypertension guideline implementation

Conditions: Hypertension

Summary: this study is a prospective cluster randomized trial testing a systems-level strategy to implement current american heart association hypertension guidelines in african american communities at risk for cardiovascular related health disparities. the trial will take place within an integrated health system serving detroit and will assess blood pressure control over one year's time.

the trial will randomize 12 clinics within the henry ford health system to two arms. the first arm will be comparison clinics that continue to use existing team-based strategies for hypertension management. the second arm will be intervention clinics. these clinics will have enhancements to existing team-based hypertension management. the first enhancement is clinical decision support based in the electronic health record. the second enhancement is improved protocols to implement telehealth prescribing that is nurse-led. the trial will enroll participants through an urban emergency department. participants will be assigned to one of these 12 clinics and continue study activities for 1 year. clinicians at the clinics will manage blood pressure. study specific visits will occur at 3, 6, 9, and 12 months. primary outcome assessment is 12 months.

Eligibility criteria:
inclusion criteria: * adult (\>18 years) african americans * lacks established primary care for bp management * history of htn * sbp ≥ 140 mmhg exclusion criteria: * pregnancy * need for hospitalization from ed * serious comorbid conditions * alcohol or drug dependence * suspected resistant htn * anticipated poor-adherence to study designated primary care clinic

Keywords: hypertension team-based guidelines implementation
power mobility training for persons with stroke

Conditions: Stroke; Mobility

Summary: to test the hypothesis that persons with stroke can safely and effectively learn to use power mobility devices. the primary objective of this project is to test the hypothesis that, with formal wheelchair skills training, people who have had a stroke and have been prescribed a power wheelchair will have a larger improvement in performance and safety scores on the wheelchair skills test than people who have not received wheelchair skills training.


Eligibility criteria:
inclusion criteria: * be an inpatient at the nova scotia rehabilitation centre with a primary diagnosis of stroke within the previous 6 months; * be competent to provide informed consent; * have permission of the attending physician to participate; * require no more than minimal assistance for verbal/non-verbal communication and auditory comprehension as evaluated by a therapist or by chart review of the baseline cihi evaluation;27 * be able to attend during a 20-minute therapy session as evaluated by the occupational or physical therapist; * use a manual wheelchair for at least 1 hour per day; * be able to be safely seated in the power wheelchair that we will be using for the study; * have no significant visual impairment (such that a subject would be unable to see barriers) as evaluated by his/her therapist based on his/her performance during functional tasks; * not currently be using a power wheelchair * have no physical or mental health condition (as determined by the health-care team) that would make participation dangerous. exclusion criteria: * none

Keywords: stroke power wheelchair skills training safety
treatment of alveolar osteitis: traditional or regenerative?

Conditions: Alveolar Osteitis; Dry Socket; Pain; Healing; Tooth Extraction

Summary: alveolar osteitis, commonly referred to as dry socket, is a common painful postoperative complication following tooth extraction. it is defined as pain in and around an extraction socket which increases at any time between one and three days following extraction, accompanied by partial or total loss of the blood clot from the socket, with or without halitosis (blum, 2002). the incidence of the complication varies from 1-5% for routine extractions up to approximately 30% for third molar extractions. there are a variety of factors that contribute to the incidence of dry socket including tissue trauma, smoking in the early postoperative period and the oral contraceptive pill. although it is a self- limiting condition, symptoms can be very debilitating for patients and therefore following diagnosis, immediate treatment should be provided to expedite resolution and to their improve quality of life during the healing period. treatment options for dry socket vary from rinsing of the socket, regular analgesia and sometimes placement of an obtundent, sedative dressing such as alveogyl or a zinc oxide eugenol alternative. this study will aim to compare two treatments for patients who present with alveolar osteitis (dry socket) to dublin dental university hospital after tooth extraction. following randomisation, one of two treatment modalities will be used, either a experimental treatment (bio-prf) or a positive control (alveogyl). the results of this study will enable us to learn more about the efficacy of these treatment options for dry socket and how they affect patients.


Eligibility criteria:
inclusion criteria: * male and females adults at least 18 years old * a diagnosis of alveolar osteitis following tooth extraction based on patients having both pain and exposed bone * good command of the english language * willingness to keep a diary of symptoms and travel for the review appointment on day 7 following intervention exclusion criteria: * pregnant or breastfeeding women * current or previous bisphosphonate used or history of radiotherapy to the jaws * allergy or intolerance to study materials * lack of capacity to consent to participate in the study
randomized comparison of morning versus bedtime administration of statins: a cardiovascular circadian chronotherapy (c3) trial

Conditions: Cardiovascular Diseases (CVD); Drug Effect; Atherosclerosis Cardiovascular Disease

Summary: statins inhibit hydroxy-methylglutaryl coenzyme a (hmg-coa) reductase which catalyzes the rate-limiting step in cholesterol synthesis. this in turn leads to reductions in concentrations of low-density lipoprotein (ldl) cholesterol and c-reactive protein which reduces the risk of incident atherosclerotic events among individuals both with and without a history of atherosclerotic cardiovascular several pilot studies have suggested potential benefits of taking statin in the evening rather than in the morning. the primary objective of this study is to examine whether statin administration at bedtime versus in the morning provides a superior reduction in the incidence of major adverse cardiovascular events among patients with or without established atherosclerotic cardiovascular disease, who are already taking statin.

the study is a pragmatic, registry-based, open-label, randomized controlled trial combining the utilization of the danish nationwide health registries and the official danish electronic letter system (digital post/eboks) into an innovative, decentralized trial requiring no study visits from participants. the nationwide health registries will be used for identification of potential participants and data collection, including baseline information and follow-up data, while the electronic letter system will be used for sending recruitment letters and communicating with participants. study participants will provide electronic informed consent from home before inclusion and randomization. the trial will include patients currently in statin treatment regardless of the presence or absence of established cardiovascular disease. participants will be randomized 1:1 to either statin administration at bedtime or in the morning. the trial is event-driven.

Eligibility criteria:
inclusion criteria: * age \>=18 years * current treatment with atorvastatin 10-80 mg, rosuvastatin 5-40 mg, simvastatin 10-80 mg or pravastatin 20-40 mg (as recorded in the danish national prescription registry and confirmed by the participant via questionnaire) * signed informed consent exclusion criteria: * none

Keywords: statin circadian rhythm randomized controlled trial pragmatic outcomes cardiovascular disease prevention
effects of an exercise program on cognition and brain in overweight/obese preadolescent children

Conditions: Cognitive Function 1, Social; Mental Health Wellness 1; Obesity; Overweight

Summary: the activebrains project aims to examine whether a 5-months physical exercise program has benefits on cognition and brain, as well as on selected physical and mental health outcomes in preadolescent overweight/obese children.

new advances in neuroelectric and neuroimaging technologies in the last years provide a golden opportunity to further explore and understand how cognition and brain function can be stimulated by environmental factors, such as exercise, and particularly to study whether physical activity influences brain development in early ages. the present study, namely the activebrains project, aims to examine the effects of a 5-months physical exercise program on cognition and brain, as well as on selected physical and mental health outcomes in preadolescents overweight/obese children. a total of 100 overweight/obese preadolescent children aged 9 to 10 years will be randomized into an exercise group (n=50) and a control group (n=50). for practical and feasibility reasons, the study will be conducted in 2 waves, a 1st wave with a sample of 30 and a 2nd wave with a sample of 75. in this regard, 15 children will be intervened within one academic year (5-month intervention) and 35 children will be intervened within the following academic year. the control group will receive the usual physical education sessions (2 per week). in order to study the extent to which the effect of the intervention remains or disappears once the formal intervention is finished, we will do a 3rd evaluation in a subsample (50 participants from the 1st wave) 9 months after the intervention has finished. waitlist control group strategy will be used, through which the control group will also receive an after-school exercise program but later, after all the assessments of the effectiveness of the program have been completed. based on existing literature, we believe that a 5-months physical exercise program is potentially beneficial for the cognition and brain, and for the physical and mental health of the overweight/obese children participating.

Eligibility criteria:
inclusion criteria: * preadolescent children of tanner stage of i, ii or iii. * children of 8 to 11 years-old, * overweight or obese defined based on the sex-and-age specific body mass index standards of cole (2002). * girls must not have menstruation. exclusion criteria: * children with attention-deficit hyperactivity disorder or any other psychiatric disorder. * left-handed children. * children with medical problem that prevent to practice physical activity.

Keywords: exercise-based randomized controlled trial brain structure brain function cognitive function physical fitness body mass index cardiovascular disease risk factors mental health stress neurology obesity brain risk factors bone bones body composition
comparison of iodine + isopropyl alcohol versus iodine + antimicrobial sealant for skin preparation

Conditions: Surgical Site Infection

Summary: the purpose if this study is to determine whether a microbial sealant (iodine + cyanoacrylate) \[integuseal®, kimberly-clark\] reduces surgical site infections when compared to iodine and isopropyl alcohol (povacrylex in isopropyl alcohol) \[duraprep®\] in oncologic surgery.

patient's skin flora is a major source of pathogens, and microbial contamination of the surgical site is a likely precursor of ssi. a variety of skin products may be used, including iodophors, alcohol-containing products, and clorhexidine gluconate. despite these perioperative tactics, bacteria continue to survive at the skin level and migrate to contaminate the wound. a microbial sealant (integuseal®, kimberly-clark) that uses cyanoacrylate to seal endogenous skin flora has demonstrated to reduce wound contamination. the efficacy of the microbial sealant in preventing ssi has been tested in cardiovascular surgery and open inguinal hernia repair, with a reduction on ssi rate when compared to standard skin preparations. this cyanoacrylate has not been tested in oncologic surgeries.

Eligibility criteria:
inclusion criteria: * patients \>= 18 years undergoing elective clean or clean-contaminated breast, gynecologic or digestive tract surgery * accepts to participate and signs the informed consent form * have a telephone number to be contacted after surgery exclusion criteria: * previous allergy to one of the study products * two or more procedures in different anatomical sites at the same time / surgery (v.g. hysterectomy and mastectomy) * pregnancy * breast feeding * contaminated or infected surgeries

Keywords: surgical site infection skin preparation cost analysis
exploring the effects of genetic variants and inflammation on vitamins supplementation treatment outcomes in epilepsy

Conditions: Epilepsy

Summary: the management of patients with epilepsy is focused on controlling seizures, avoiding treatment side effects, and restoring quality of life. however, about 30% of people are antiepileptic drugs (aeds) resistance epilepsy after the adequate trials of two aeds treatment. genetic factors may contribute to the high interindividual variability in response or adverse effects (such as weight gain and altered lipid profiles) to aeds. what's more, previous observational studies indicated that vitamin deficiency, such as vitamin b6, is common in patients with epilepsy due to epilepsy itself, aeds use, or both. therefore, investigators aim to (1) evaluate the impact of genetic variants on aed and multi-vitamins supplementation in epilepsy, and (2) establish the pharmacogenomics knowledge base of aed and multi-vitamins supplementation on clinical effectiveness in patients with epilepsy.

in the current study, investigators will evaluate the association among the genetic polymorphisms, epilepsy, and multi-vitamins supplementation from taiwan biobank and will further investigate potential genes related to vitamins signal pathways (especially vitamin b6, b9, d, e, and q) involved in epilepsy. these results will not only generate the field of aeds pharmacogenomics for further study, but also provide new potential treatment targets that may involve in epilepsy therapeutics. the clinical outcomes indicate disease severity, body weight, metabolic indices (i.e., the fasting levels of lipid), hrqol, anxiety and depression scores. all outcome indicators will be repeated measured at baseline and after 1, 3 and 6 months multi-vitamins supplementation. all of the participants will be assessed the genotypes.

Eligibility criteria:
inclusion criteria: * diagnostic criteria of epilepsy * receive anti-epileptic drugs (aeds) exclusion criteria: * have an organic mental disorder, mental retardation, dementia, or other diagnosed neurological illness * have a surgical condition or a major physical illness * pregnant or breast-feeding

Keywords: pharmacogenomics antiepileptic drugs multi-vitamins supplementation epilepsy
incorporating eprognosis for the encouragement of smarter screening for breast and colorectal cancer in older adults

Conditions: Breast Carcinoma; Colorectal Carcinoma

Summary: this clinical trial assesses the feasibility and acceptability of a smarter screening intervention for breast and colorectal cancer in older adults. this study aims to learn more about how to support patients and physicians in making cancer screening decisions for older adults.

primary objectives: i. complete development of and refine "smarter screening", a multi-component, patient-centered intervention centered around eprognosis: cancer screening to facilitate shared decision-making screening discussions for breast and colorectal cancer in older adults. ii. assess feasibility and acceptability of the "smarter screening" intervention and assess its impact versus usual care on shared decision-making about whether or not to continue breast and colorectal cancer (crc) screening among multi-ethnic and socioeconomically diverse primary care patients. exploratory objectives: i. impact on breast and crc screening versus usual care. ii. risk perception, worry, and a patient-reported measure of decision quality. outline: participants are randomized to 1 of 2 arms. arm i: participants receive passport to health booklet and complete eprognosis before scheduled primary care visit. arm ii: participants receive usual care before scheduled primary care visit. after completion of study, participants are followed up at 1 week post primary care visit.

Eligibility criteria:
inclusion criteria: * age 70 years and above * ability to understand study procedures and to comply with them for the entire length of the study * ability of individual to understand a written informed consent document, and the willingness to sign it * have no prior history of cancer * scheduled for an upcoming appointment in university of california, san francisco (ucsf) general internal medicine or women's health primary care clinics * english-speaking exclusion criteria: * contraindication to any study-related procedure or assessment * non-english speaking * are under the current medical care of either the study primary investigator (pi) or co-investigator (co-i)
comparison of dexmedetomidine and midazolam for prevention of emergence delirium in children

Conditions: Tonsillitis

Summary: emergence delirium is a common complication in children after anesthesia. the incidence of emergence delirium is reported upto 50%. prevention of emergence delirium in children is important not only for the patient safety but also for the satisfaction of the parents. midazolam is the most commonly used medications for prevention of emergence delirium. however, it might lead to delayed awakening from anesthesia and respiratory depression. in this study, the investigators will evaluate whether dexmedetomidine can be effectively and safely administered for prevention of emergence delirium in children compared to midazolam.

in this study, seventy patients scheduled for elective tonsillectomy aged from 24 months to 12 years old anesthesiologists physical status (asa) class 1 and 2 will be enrolled. the sample size was calculated based on the former study with a type 1 error estimate of 0.05 at 80% power. the proportion in dexmedetomidine group (group d) was assumed to be 0.4 and the proportion in midazolam group (group m) was 0.1. considering the drop-out rate of 10%, seventy patients in total were needed.the patients will randomly be allocated into the group d or the group m. the group d will receive dexmedetomidine0.3mcg/kg mixed with 0.9% normal saline, 10ml in total. the group m will receive 0.03mg/kg of midazolam mixed with 0.9% normal saline, 10ml in total. randomization and drug administration will be done by a single anesthesiologist. assessment of the patient will be done by another anesthesiologist blinded by the group. five minutes before the end of the surgery, the study drug will be slowly infused for 5 minutes. in the postanesthesia circuit unit (pacu), presence of emergence delirium will be assessed. the emergence delirium will be assessed by the four-point agitation scale. (1 = calm, 2 = not calm but gould be easily calmed, 3 = not easily calmed, moderately agitated or restless, and 4 = combative, exited or disoriented.) patients with score 3 and 4 will be diagnosed as emergence delirium and treated with intravenous fentanyl 1mcg/kg. severity of emergence delirium will be assessed with the pediatric anesthesia emergence delirium scale after 10 mins on arrival of pacu. pain wil be scored by 5-point scale (0 = no pain, 5 = severe pain ever). time from discontinuation of anesthetic gas to extubate will be recorded. the data will be compared between the groups by the independent t-test or mann-whitney test for the continuous variables. chi-square test or fisher's exact test will be used for the categorial variables.

Eligibility criteria:
inclusion criteria: * patients undergoing elective tonsillectomy under general anesthesia * american society of anesthesiologist physical status 1,2 * aged from 24 months to 12 years old * obtaining written informed consent exclusion criteria: * known history of allergy to dexmedetomidine or midazolam * renal impairment * hepatic impairment * long qt syndrome * developmental disorder * congenital disorder * neurologic disorder * psychogenic disorder