Kornimate/medical-research-clean huggingface dataset:
a multi-site study of strategies for implementing schizophrenia guidelines

Conditions: Schizophrenia

Summary: schizophrenia, a chronic psychiatric disorder, is the second most frequent va discharge diagnosis. medication management practices for schizophrenia often are not guideline-concordant and place patients at risk for adverse outcomes. this project tests a new strategy to standard implementation for vha schizophrenia guidelines.

background: schizophrenia, a chronic psychiatric disorder, is the second most frequent va discharge diagnosis. medication management practices for schizophrenia often are not guideline-concordant and place patients at risk for adverse outcomes. this project tests a new strategy to standard implementation for vha schizophrenia guidelines. objectives: research objectives are: (1) to compare the effectiveness of a conceptually-based, enhanced intervention to that of a basic educational strategy with regard to improving guideline adherence and patient compliance; (2) to compare the effectiveness of the two strategies with regard to improving symptom and side effect outcomes; (3) to determine the effect of the enhanced intervention on service utilization for acute exacerbations of schizophrenia; (4) to determine the extent to which guideline-concordant medication management improves patient outcomes; and (5) to examine providers' knowledge of and attitudes toward guidelines. methods: thirteen va sites were considered for the study, and vista data were extracted to assess baseline guideline performance. seven sites were selected and received basic education about schizophrenia guidelines. three of these sites were randomly selected to receive the enhanced intervention, employing a nurse coordinator to promote providers' guideline adherence and patients' treatment adherence. subjects with an acute exacerbation of schizophrenia were enrolled and were interviewed at baseline and six months using the positive and negative syndrome scale, the schizophrenia outcomes module, and the barnes akathisia scale. data on guideline adherence were collected from medical records and vista files. when data collection is completed, analyses will be conducted to determine the effectiveness of the enhanced intervention with regard to improving guideline adherence and patient outcomes. status: the project is ongoing. to date, 401 subjects have been enrolled in the intervention study. the rate of completed follow-up assessments to date is 86 percent.

Eligibility criteria:
inclusion criteria: 1. subjects must have a diagnosis of schizophrenia. 2. subjects must have been admitted to an inpatient psychiatry unit or seen in an ambulatory care clinic or the emergency room at a study site for symptoms of acute exacerbation. 3. must be able to provide informed consent themselves or informed consent by a guardian. exclusion criteria:
safety and efficacy of uk-432,097 in chronic obstructive pulmonary disease.

Conditions: Pulmonary Disease, Chronic Obstructive

Summary: safety and efficacy (measured by spirometry) of uk-432,097 administration will be tested in patients with chronic obstructive pulmonary disease.


Eligibility criteria:
inclusion criteria: * patients with a diagnosis, for at least 6 months, of moderate to severe copd (gold) and who meet the criteria for stage ii-iii disease * patients must have a smoking history of at least 10 pack-years * patients must have stable disease for at least 1 month prior to screening. exclusion criteria: * more than 2 exacerbations of copd in the preceding year * history of a lower respiratory tract infection or significant disease instability during the month proceding screening or during the time between screen and randomization. * history or presence of respiratory failure, cor pulmonale or right ventricular failure

Keywords: dry powder for inhalation chronic obstructive pulmonary disease lung function testing
impact of coaching patients on pain control with and without financial incentivization

Conditions: Opioid Use

Summary: opioids are commonly prescribed pain medications, but they can lead to addiction. the study team is trying to determine if providing someone with an incentive (money in the form of a visa gift card) to use less pain medications will result in study participants actually using fewer pain tablets than allowed by their health care provider. the study team also wants to know if providing the incentive (the visa gift card alone) works the same as the incentive (the visa gift card) plus providing additional information about addiction and alternative pain management.

study participants will receive the standard of care for pain management at discharge. if study participants were not hospitalized at discharge, the study team will begin that standard of pain management at the participant's first outpatient clinic visit. study participants will be randomized to 1 of 3 groups. all groups will receive a gift card if participants return the completed medication diary to the study team. * group 1 will complete a medication diary. also, group 1 will be encouraged to return any unused tablets to the study clinic. * group 2 will be asked to complete a medication diary. group 2 will also have a 50/50 chance of receiving money for each unused opioid tablet returned to the study clinic. * group 3 will be the same as group 2 except in addition, they will be given a coaching session about the use of pain medication and a simple way that may help participants use less opioid pain medication.

Eligibility criteria:
inclusion criteria: * patients suffering from a burn injury of one or both hands/upper extremities * patients staying less than 2 midnights after date of injury or presenting for first visit to the clinic 4 or less days after injury * patients able to self-administer their oxycodone. * aged 18-89 years old exclusion criteria: * no burns on either hand or upper extremity * patients suffering chemical or electrical burns * patients with other traumatic injuries for which they might require opioids/pain treatment * patients taking opioids prior to injury * patients who are discharged with prescriptions other than oxycodone with a dosage of 5 milligrams by mouth every six hours as needed

Keywords: opioid buyback opioid misuse prevention
neoadjuvant nivolumab combination treatment in resectable non-small cell lung cancer patients

Conditions: NSCLC Stage II; NSCLC, Stage IIIA; NSCLC, Stage I

Summary: the primary objective of this study is to determine the feasibility of four weeks of preoperative immunotherapy with nivolumab, and nivolumab plus relatlimab in patients with early stage or locally advanced non-small cell lung cancer eligible for curative resection.


Eligibility criteria:
inclusion criteria: * patients with histologically confirmed non-small cell lung cancer (nsclc) eligible for anatomic resection (clinical stages i b, ii and selected stage iii a) * eastern cooperative oncology group (ecog) ≤ 1 * sufficient pulmonary function to undergo curative lung cancer surgery * adequate hematological, hepatic and renal function parameters: * sufficient cardiac left ventricular defined as left ventricular ejection fraction (lvef) ≥ 50% documented either by echocardiography or multigated acquisition scan (muga) * patient able and willing to provide written informed consent and to comply with the study protocol and with the planned surgical procedures exclusion criteria: * active or history of autoimmune disease or immune deficiency * subjects with a condition requiring systemic treatment with either corticosteroids (\> 10 mg daily prednisone equivalents) or other immunosuppressive medications within 14 days of study drug administration * subjects who have undergone organ transplant or allogeneic stem cell transplantation * uncontrolled or significant cardiovascular disease * patients with active neurological disease * active malignancy or a prior malignancy within the past 3 years * receipt of live attenuated vaccine within 30 days prior to the first dose of study medication * peripheral polyneuropathy nci ctcae grade ≥ 2 * history of gastric perforation or fistulae in past 6 months * serious or non-healing wound, ulcer, or bone fracture within 28 days prior to enrollment. * the patient has undergone major surgery within 28 days prior to enrollment except staging mediastinoscopy, diagnostic video assisted thoracoscopic surgery (vats) or implantation of a venous port-system. * any other concurrent preoperative antineoplastic treatment including irradiation * pregnant/breastfeeding women * subjects with history of severe toxicity or life-threatening toxicity (grade 3 or 4) related to prior immune therapy * prior treatment with lymphocyte-activation gene 3 (lag-3) targeting agent * previous treatment with nivolumab or relatlimab
an aerobic exercising program on respiratory muscle strength in patients with adolescent idiopathic scoliosis

Conditions: Adolescent Idiopathic Scoliosis

Summary: adolescent idiopathic scoliosis (ais) can change the respiratory dynamics and performance of the inspiratory and expiratory muscles, affecting ventilatory capacity. this was a randomized, controlled, open study to test the impact of a physiotherapeutic program of aerobic exercises on respiratory muscle strength, in patients with adolescent idiopathic scoliosis. patients with ais were randomly assigned to the aerobic exercise-training program group or the no treatment group. there was a significant increase in pimax and pemax in the group which received physiotherapy.

study design: this was a randomized, controlled, open study to test the impact of a physiotherapeutic program of aerobic exercises on respiratory muscle strength, in patients with adolescent idiopathic scoliosis (ais). objective. to analyze, by means of maximum respiratory pressure measurements, the conditioning of the respiratory muscles after four months of aerobic exercise training. summary of background data. ais can change the respiratory dynamics and performance of the inspiratory and expiratory muscles, affecting ventilatory capacity. methods: patients with ais, aged between 10 and 20 years, were randomly assigned to the aerobic exercise-training program group or the no treatment group. they were evaluated for respiratory muscle strength before and after the treatment period, by means of a manometer, and radiographs of the chest and spine. the physical therapy exercise protocol consisted of three weekly sessions, including stretching, aerobic exercises (first mild and then accelerated) and relaxation techniques, for a period of four months.

Eligibility criteria:
inclusion criteria: * aged between 10 and 20 years * diagnosed as having adolescent idiopathic scoliosis with a spinal angle of scoliotic deformity of at least 45º, and candidates for surgical correction * sedentary exclusion criteria: * spinal angle deformities of less than 45º * previous operation for spinal correction * comorbidities (lung, heart or neurological diseases) that could interfere with the understanding of the procedures of this study (both diagnostic and interventional) * regular physical activity

Keywords: scoliosis muscle strength respiratory function tests exercise therapy
cahnge in management of suspected early onset neonetal sepsis after assimilation of early onset sepsis calculator

Conditions: Neonatal Early-onset Sepsis

Summary: early neonatal sepsis requires rapid and efficient intervention to prevent morbidity and mortality. management of such a case includes invasive blood examinations, elongation of maternal and neonatal length of stay, and empiric antibiotic therapy. these actions has major side effects. on 2017, kaiser-permanente started using a calculator that weighs the chances for early onset neonatal sepsis, and states the best investigation and follow-up regimn for the specific newborn infant. eversince, policy of managing neonatal suspected early onset sepsis has chaged globally, including in israel. current knowledge regarding the local outcome since the use of the calculatir is scarce. the goal of the study is to evaluate the change in management of suspected neonatal early onset sepsis, including its economic value, between periods before and after assimilation of the calculator in hillel yaffe nedica l center.

early neonatal sepsis requires rapid and efficient intervention to prevent morbidity and mortality. management of such a case includes invasive blood examinations, elongation of maternal and neonatal length of stay, and empiric antibiotic therapy. these actions has major side effects. on 2017, kaiser-permanente started using a calculator that weighs the chances for early onset neonatal sepsis, and states the best investigation and follow-up regimn for the specific newborn infant. eversince, policy of managing neonatal suspected early onset sepsis has chaged globally, including in israel. current knowledge regarding the local outcome since the use of the calculatir is scarce. the goal of the study is to evaluate the change in management of suspected neonatal early onset sepsis, including its economic value, between periods before and after assimilation of the calculator in hillel yaffe nedical center.

Eligibility criteria:
inclusion criteria: * newborn unfants born in hillel yaffe medical center * 35 weeks of gestation or more * blood culture was taken exclusion criteria: * sepsis workup for other reason * 34 weeks of gestation or less

Keywords: neonatal early onset sepsis kaiser permanente calculator
a comparative analysis of portable bladder scanner to determine age/ volume specific accuracy in 0-6 years of children

Conditions: Neurogenic Bladder; Detrusor Underactivity; Detrusor Overactivity

Summary: as a part of the urodynamic studies, urinary catheterization is inserted to measure residual urine, however, it has shown to be an invasive procedure, cause urinary tract infection, and traumatic experience. bladder scan has been introduced as an alternative and non-invasive method to measure urine residual in the bladder.

functional urinary disorders are common as more than 15% of children are diagnosed. during the normal course of urinary tract development, bladder and urinary sphincter develop by 2 to 4 years old, and by five years old, the tract is completely developed. the underdevelopment of the urinary tract may lead to complications of the bladder and kidneys along with social impairment. therefore, the diagnosis is critical as an early diagnosis can prevent long term complications. to diagnose, newborns undergo basic urinalysis, urine culture examination, blood creatinine analysis, and kidney and bladder ultrasound. if any abnormalities are present at the under the age of five, it is recommended that they are followed up on a regular basis. also, urodynamic studies should be performed every year along with others for early identification and intervention. studies have shown that uds (urodynamic studies) significantly reduce the deterioration of the bladder and kidney and the need for operation such as bladder dilation. as a part of the urodynamic studies, urinary catheterization is inserted to measure residual urine, however, it has shown to be an invasive procedure, which can cause urinary tract infection. the bladder scanner is an ultrasonic imaging device that has been developed for non-invasive measurement of residual volume in the bladder. the images and measurements are obtained by applying a probe onto the abdomen. it constructs 12 cross-sectional images at 15 degree interval using the reflection signals from urine in the bladder and extracts the position of the bladder wall. the objective of the study is to assess the validity of existing pediatric algorithms for diagnosing neurogenic bladder and evaluate the accuracy of measuring the post-void residual volume between the ages of 0 to 6 years old. it hypothesizes that when the portable bladder scanner (bladder scanner, biocon-900) is used in pediatric population between the ages of 0 to 3 years old will show greater difference in infused and scanned volume than 4 to 6 years old.

Eligibility criteria:
inclusion criteria: * under the age of 6 years old. * urodynamic study is scheduled to due to suspected changes in the bladder function or shape. * those who understand and sign the informed consent form. exclusion criteria: * subjects with surgical history of the bladder. * constant leaking of the urine due to bladder neck contracture. * any congenital abnormalities that induce changes in the shape of the bladder. * unsuitable to participate in the study at the discretion of the principal investigator.
methylene blue chromoendoscopy in barrett's esophagus

Conditions: Barrett Esophagus

Summary: this study is being done to: determine if a temporary dye applied to the esophagus identifies areas of dysplasia (pre-cancer). determine if certain dye patterns indicate specific grades of dysplasia. determine if overall endoscopy costs can be reduced with this dye technique. determine if the dye could allow fewer biopsies to be obtained in the future.

although methylene blue has been used effectively to identify areas of sim in several studies, its superiority in identifying dysplasia in the setting of barrett's esophagus has been inconclusive. in all studies to date dysplastic yield was equivalent or better than protocol techniques while requiring fewer biopsies. variations in study design, staining technique and inexperience in staining interpretation are some of the reasons. our goal is to build on the techniques that have been shown to be effective, standardize them for the purposes of our study, and to objectively evaluate if mb directed biopsies are useful in screening barrett's patients for dysplasia. at the time of egd when length of barrett's is determined, patients will be stratified into either intermediate (2-4cm) or long segment (\>4cm) barrett's. short segment barrett's esophagus patients will not be considered, as mb techniques have not proved beneficial in dysplasia detection as previously described 7.

Eligibility criteria:
inclusion criteria: * history of barrett's with or without dysplasia * able to give consent exclusion criteria: * pregnancy or women of child-bearing potential * active esophagitis * esophageal varices * esophageal cancer (history of or current) * hypersensitivity to methylene blue * severe renal impairment (creatinine\>2.0) * known glucose-6-phosphate dehydrogenase (g-6-pd) deficiency * symptomatic coronary artery disease * coagulopathy (inr\>/=1.5) * thrombocytopenia \</= 20k/ul * previous esophageal ablative therapy (emr,pdt, apc)

Keywords: barrett esophagus methylene blue chromoendoscopy
efficacy and safety of intravenous vitamin k1 in management of acute variceal bleeding

Conditions: Variceal Bleeding

Summary: the administration of vitamin k1 (vit-k1) injection is frequently utilized in clinical practice for managing upper gastrointestinal bleeding (ugib) associated with liver cirrhosis, despite insufficient evidence supporting its effectiveness. this research aimed to assess the safety and efficacy of intravenous vit-k1 in the management of acute variceal bleeding in cirrhotic patients. this randomized, open-label clinical trial involved 66 cirrhotic cases with ugib of suspected variceal origin. the cases were randomly assigned to two groups: one group (n = 33) had a 10 mg intravenous infusion of vit-k1 daily for three days, while the other group (n = 33) received nothing, along with standard pharmacologic and endoscopic treatments. endoscopic evaluation confirmed ruptured varices as the cause of bleeding in 59 cases. the primary endpoint was a composite measure that involved (bleeding control, rebleeding prevention, or death). adding vitamin k1 to standard-of-care therapy in managing acute variceal bleeding complicating liver cirrhosis showed no advantage over standard-of-care therapy in terms of bleeding control, prevention of rebleeding, or reducing mortality during hospital stay.


Eligibility criteria:
inclusion criteria: * active acute upper gastrointestinal bleeding suspected of being of variceal origin (e.g., melena and/or hematemesis within 24 hours before inclusion) and required admission to the icu. * endoscopic confirmation of variceal bleeding, carried out within twelve to twenty-four hours of icu admission, was defined by either direct visualization of blood from a gastric or esophageal varix or the presence of red color signs on varices along with blood in the stomach or esophagus, with no other identifiable bleeding source. * cirrhosis has been confirmed through histology or by clear clinical, endoscopic, or sonographic signs of portal hypertension and cirrhosis. exclusion criteria: * known hypersensitivity to vit-k1. * known hypercoagulopathy. * recent history (within 6 months) including deep vein thrombosis or pulmonary embolism. * history of persistent or unstable angina pectoris, portal vein thrombosis, intermittent claudication, myocardial infarction, ischemic stroke, transient ischemic attack. * prior parenteral or oral vit-k1 administration within the previous two weeks.

Keywords: vitamin k1 liver cirrhosis esophageal and gastric varices upper gastrointestinal bleeding
non-luer butterfly needle with one-way valve for the epidural blood patch: does it alter blood clotting?

Conditions: Post-Dural Puncture Headache; Low Pressure Headache

Summary: the department of health recommends using equipment which prevents wrong route drug administration. however, the epidural blood patch requires equipment that connects to the intravenous and epidural route. to comply with these recommendations a non-luer butterfly needle with one-way valve has been produced. the one-way valve and length of tubing has the potential to activate the clotting cascade. this could reduce the time clinicians have to utilise the blood in the syringe. also any alteration in clotting could affect the therapeutic value of the epidural blood patch. the primary objective of this research was to determine if phlebotomy using this new 21g needle altered blood clotting, determined by thromboelastograph analysis, compared to a standard 21g hypodermic needle.

ethical approval was gained from the health research authority (north west - greater manchester south research ethics committee, rec reference number: 16/nw/0570). after informed consent, we enrolled participants

Eligibility criteria:
inclusion criteria: * participant is willing and able to give informed consent for participation in the study. * male or female. * aged 18 years or above. * within first 2 days postnatal for postnatal group * healthy participants must be in good health. * able (in the investigators opinion) and willing to comply with all study requirements. * willing to allow his or her general practitioner and consultant, if appropriate, to be notified of participation in the study. exclusion criteria: * any medical condition * in postnatal group, women with haemorrhage greater than 1l * in postnatal group, less than 12 hours post prophylactic dalteparin * any clotting abnormality * on any medication including herbal medication (vitamins taken during pregnancy are acceptable) * age less than 18 years at recruitment * adults who are not capable of giving valid consent * adults with learning disabilities/ difficulties * adults in emergency situations * unable to speak or read english * prisoners * adults unable to consent for themselves * any person considered to have a particularly dependent relationship with investigators * any others deemed to belong to a vulnerable group. * any other significant disease or disorder which, in the opinion of the investigator, may either put the participants at risk because of participation in the study, or may influence the result of the study, or the participant's ability to participate in the study. * participants who have participated in another research study involving an investigational product in the past 12 weeks