Kornimate/medical-research-clean huggingface dataset:
damage control surgery over the world in acute diverticulitis (dacosad)

Conditions: Diverticular Perforation; Open Abdomen

Summary: to analyze the possible benefit of damage control surgery by performing bowel resection, open abdomen, and delayed anastomosis in the treatment of hinchey iii or iv diverticulitis.

hartmann procedure (hp) is still widely performed in the treatment of purulent or fecal generalized peritonitis as a consequence of a complicated acute large bowel diverticulitis (the so labeled iii and iv grade of the hinchey's classification). more than half of those patients do not undergo to stoma reversal because of its association with significant morbidity and mortality. to date, the use of resection with primary anastomosis (pa) should be preferred, as it is reported in the literature that it is more favorable than hp in terms of morbidity, mortality, and length of postoperative stay. however, pa is often reserved for younger patients with few co-morbidities and a lesser degree of peritoneal contamination while hp is performed in the elderly. initially described for the treatment of major abdominal injuries, indications for damage control surgery (dcs) have subsequently been extended to septic shock, abdominal compartment syndrome and impossibility to perform a primary closure. in the last decade, dcs has emerged as a valid alternative to hp and resection-anastomosis (ra) in patients presenting a severe sepsis caused by purulent or fecal peritonitis in acute diverticulitis. although dcs is cited as an option in case of impaired hemodynamic status in face of perforated acute diverticulitis, there is still no consensus about such use of dcs. previous study demonstrated that dcs reduce the hartmann rate in patients otherwise scheduled for such procedure. the aim of this study was to describe the potential rationale and outcome of the damage control surgery in patients with purulent and fecal peritonitis.

Eligibility criteria:
inclusion criteria: * patients \>18 year-old underwent surgery for hinchey iii and iv and submitted to resection, clip and drop, and open abdomen exclusion criteria: * subjects \<18 year-old

Keywords: diverticulitis surgery open abdomen septic shock
immunogenicity of hpv vaccine in transplant recipients.

Conditions: Chronic Kidney Diseases; Kidney Transplant

Summary: to measure levels of hpv antibodies in post-solid-organ transplant recipients who have gotten the hpv9 vaccine.

this is a prospective open-label nonrandomized single-center cohort study aimed to analyze the immunogenicity of nanovalent human papillomavirus vaccination (gardasil 9) in post-solid-organ transplant patients. the study duration is anticipated to be 36 months. the expected duration of subject participation is 24 months. immunocompromised populations are at greater risk of hpv infection. quadrivalent hpv vaccination has been performed and lower titers of antibodies have been compared to published date in non-immunocompromised population (controls). the hpv9 vaccination titers have not been measured in the immunocompromised population to date. we plan to enroll 30 adult solid-organ transplant recipients ages 18-45 years \>6 months from transplant receiving treatment at clinics at f\&mcw main campus. patients will be scheduled to receive 3-dose 9vhpv vaccination (vaccination at enrollment \[time 0\], 2 months \[+ 6 weeks\], and 6 months \[+ 6 weeks\] per standard guidelines). serial serum samples will be obtained for geometric mean titers (gmt) prior to vaccination, at 7 months (+ 6 weeks), 12 months (+ 6 weeks), and 24 months (+ 6 weeks) after completion of the vaccination series. if a patient is subsequently scheduled to undergo a transplant, we will obtain the gmt prior to the transplant. subjects will be asked to consent to optional banking of whole-blood for future research and translational studies. blood will be stored in the obstetrics \& gynecology specimen and data bank (pro 11631) at medical college of wisconsin. if subjects chose to participate in the optional banking of their blood, approximately 5 mls of additional blood will be drawn prior to vaccination and at the time of the 7, 12, and 24- month gmt blood draws. anti-hpv antibody responses will be measured using a proprietary merck competitive luminex immunoassay (clia) which will be performed by merck and expressed as geometric mean titers (gmt).

Eligibility criteria:
inclusion criteria: 1. patient between the age of 18 and 45 years 2. patient is at least 6 months post-solid-organ transplant and has not received gardasil 9. 3. patient who can participate in their health care and sign informed consent. 4. patient may have had bivalent or quadrivalent hpv vaccination previously. 5. living or deceased donor transplant patient is eligible. exclusion criteria: 6. contraindication: hypersensitivity, including severe allergic reactions to yeast (a vaccine component), or after a previous dose of gardasil 9 or gardasil. 7. patient had completed vaccination series with a nonavalent hpv vaccine (e.g., gardasil 9) in the past 8. patient with a diagnosis of hiv. 9. patient that endorses being currently pregnant.
the oakland men's health disparities study

Conditions: Behavior; Cardiovascular Risk Factor; Influenza

Summary: reducing racial disparities in health outcomes is a major policy concern in the united states. although there has been recent progress to close the gap, black men continue to experience earlier morbidity and mortality from preventable and manageable medical conditions, and live on average 4.2 years less than their white male peers. an oft-prescribed solution to close this stubborn gap is to increase the diversity of the healthcare workforce. another common policy tool to increase take-up of preventative healthcare services is financial incentives. in this randomized evaluation, we will estimate the effects of financial incentives and a racially concordant physician on the uptake of preventive health services in oakland, california.


Eligibility criteria:
inclusion criteria: * african american male adults exclusion criteria: -
varenicline effects in schizophrenic smokers

Conditions: Schizophrenia; Tobacco Use Disorder; Nicotine Dependance

Summary: this is an open label pre-post study of the effects of clinical treatment with varenicline on 1) decreasing smoking in schizophrenic patients, 2) improving selected cognitive measures in schizophrenic patients, and 3) psychopathology in schizophrenic patients. patients are assessed on subjective and objective measures of smoking, selected cognitive measures, and special chemical measures, during baseline testing and during 8 weeks of treatment with varenicline (1-2 mg/day).


Eligibility criteria:
inclusion criteria: * clinical diagnosis of schizophrenia or schizoaffective psychosis * recent history of cigarette smoking * ages 18-65

Keywords: schizophrenia varenicline cognition cigarette smoking
trial on mechanical bowel preparation in laparoscopic colorectal surgery

Conditions: Rectal Cancer; Colon Cancer

Summary: this is a randomized trial on mechanical bowel preparation in laparoscopic colorectal surgery. in this trial patients with left sided colon and rectal tumors were randomized to receive mechanical bowel preparation or no preparation to assess postoperative complications and outcome

in this prospective randomized trial,patients were randomized to receive mechanical bowel preparation or no preparation to assess postoperative complications and outcome following elective laparoscopic surgery for left sided colon and rectal tumors. randomization is done from the out -patient department at the time of admission, using random numbers from a computer generated list from a sealed envelope method. patients who did not have mechanical bowel preparation had a normal meal on the day before the operation. those who did were given a fluid diet, and mechanical bowel preparation with polyethylene glycol one day prior to surgery. both groups will have the scheduled laparoscopic colonic resections. use of diverting stoma is left to the discretion of the operating surgeon. cases that needed a diverting stoma, will be analyzed separately.

Eligibility criteria:
inclusion criteria: * left sided colonic and rectal tumors * eligible for elective laparoscopic surgery exclusion criteria: * patients with intestinal obstruction or perforation. * patients with t4b tumors. * metastatic tumors * patients with multiple previous abdominal surgeries

Keywords: mechanical bowel preparation colon cancer
determining clinical trial experiences of lung cancer patients

Conditions: Lung Cancer

Summary: participation in medical trials usually favors a particular demographic group. but there is limited research available to explain what trial attributes affect the completion of these specific demographic groups. this trial will admit a wide range of data on the clinical trial experience of lung cancer patients to determine which factors prevail in limiting a patient's ability to join or finish a trial. it will also try to analyze data from the perspective of different demographic groups to check for recurring trends which might yield insights for the sake of future lung cancer patients.


Eligibility criteria:
inclusion criteria: * patient has been diagnosed with lung cancer * patient has self-identified as planning to enroll in an observational clinical trial * patient is a minimum of 18 years or older exclusion criteria: * pregnant or nursing patients * inability to perform regular electronic reporting * patient does not understand, sign, and return consent form

Keywords: lung cancer
exit: prospective study of the response to exercise

Conditions: Liver Fat; Type 2 Diabetes

Summary: background : regular exercise is a cornerstone in the prevention and the management of comorbidities. unfortunately, the metabolic benefit of exercise training is not universal and varies among individuals. a main factor likely to explain the exercise training variability is the lack of empirical evidence on the determinants of exercise training. a series of muscle-derived cytokines have recently been discovered that (1) are released during exercise and (2) exert positive effects on peripheral tissues. irisin is one of these novel "myokines" and might contributes to the metabolic adaptations to exercise training. methods: the investigators will perform a pilot cohort study in which obese adolescents will perform resistance exercise training for 6 weeks. the main exposure variable will be the acute release of irisin during resistance exercise. the main outcome measures will be the change in hepatic triglyceride content and glucose area under the curve during a 75g, 2-hour oral glucose tolerance test. study hypothesis: the primary overall hypothesis is that the change in plasma irisin with a single bout of exercise will be associated with the metabolic adaptations to 6 weeks of resistance training, specifically, the reductions in hepatic triglyceride content and post-prandial glucose excursions, in obese adolescents.


Eligibility criteria:
inclusion criteria: 1. adolescents (12-18 years) 2. body mass index considered obese according to the international obesity task force exclusion criteria: 1. adolescents with medication-induced or type 1 diabetes 2. are currently being treated with corticosteroids or atypical antipsychotics, as these agents significantly influence carbohydrate metabolism 3. have an orthopaedic injury or chronic illness that would prevent them from performing the intervention 4. have experienced \>10% weight loss or enrolled in weight loss program within six months of enrolment 5. a history of alcoholism or drug abuse 6. require use of medication(s) known to affect insulin sensitivity or secretion within the last 30 days 7. medication(s) known to cause weight gain 8. anabolic steroids 9. weight loss medication(s) 10. pregnant or planning to be pregnant

Keywords: irisin obesity exercise myokine impaired glucose tolerance
comparison of effectiveness of pentobarbital and thiopental in patients with refractory intracranial hypertension

Conditions: Traumatic Brain Injury

Summary: objective: to assess the effectiveness of pentobarbital and thiopental to control raised intracranial pressure (icp), refractory to first level measures, in patients with severe traumatic brain injury. material and methods: prospective, randomized open study to compare the effectiveness between two treatments: pentobarbital and thiopental. the patients will be selected from those admitted to the intensive care unit with a severe traumatic brain injury (postresuscitation glasgow coma scale equal or less than 8 points) and raised icp (icp\>20 mmhg) refractory to first level measures according to the brain trauma foundation guidelines. the adverse effects of both treatments were also collected.


Eligibility criteria:
inclusion criteria: * patients with a severe closed head injury and a post-resuscitation glasgow coma scale (gcs) score below or equal to 8 * age between 15 and 76 years (inclusive) * high icp (\> 20 mm hg) refractory to first-tier therapeutic measures according to btf guidelines (1) * hemodynamic stability defined as a systolic blood pressure of at least 100 mm hg or above at the moment of entering the trial * written informed consent obtained from next-of-kin or the patient's legally authorized representative exclusion criteria: * previously known ischemic heart failure (ejection fraction \< 35%) * pregnancy * bilateral dilated and unreactive pupils and a gcs of 3 * intolerance to barbiturates

Keywords: traumatic brain injury, barbiturate coma
pilot for the breast cancer endocrine therapy adherence (beta) trial

Conditions: Breast Cancer

Summary: pilot study to assess feasibility and patient acceptance of a text message cell phone application for patients with stage i-iii, hormone receptor positive breast cancer who start adjuvant endocrine therapy.

approximately 75% of breast cancers express the estrogen and/or progesterone receptor (hormone receptors). the standard of care for women with hormone receptor positive breast cancer is five to ten years of adjuvant endocrine therapy with drugs such as tamoxifen or aromatase inhibitors (ais). in women with stage i-iii breast cancer, treatment with adjuvant endocrine therapy has been shown to reduce recurrences by 30-50% and improve survival. unfortunately, it is estimated from large population databases that up to 35-40% of patients may discontinue adjuvant endocrine therapy before completing the recommended 5 years for various reasons, and non-adherence may reduce survival. the current protocol is a pilot study in women with hormone receptor positive breast cancer who are beginning adjuvant endocrine therapy, the purpose of which is to assess the feasibility of a two-way text messaging application, with goals for a larger randomized control study to assess if the application will increase adherence and therefore improve disease free survival. this application includes daily text message medication reminders and periodic assessment of side effects and barriers to medication adherence and simultaneously offers assistance for treatment related issues. the investigators will collect information on qol and financial burden during the 3 month period and will correlate these metrics with adherence. this larger randomized control study would be the first such interventional study to increase adherence with adjuvant endocrine therapy in breast cancer in the us. our larger randomized control trial would provide the first longitudinal prospectively collected information on qol, financial burden and adherence over the entire 5-year treatment period in the routine clinical practice setting.

Eligibility criteria:
inclusion criteria: * patients with histologically confirmed stage i-iii, estrogen and/or progesterone receptor positive, as defined by asco-cap guidelines, invasive breast cancer for whom adjuvant hormonal therapy is indicated following standard nccn practice guidelines * patients may enter the study before or within one month of starting endocrine treatment * patients with synchronous bilateral breast cancers are eligible if both tumors are hormone receptor positive * patient must be able to provide informed consent and agree to: * complete questionnaires according to the pre-specified study design * own a personal cell phone, agree to receive text messages on a monthly basis (including any costs), and share their personal cell phone number to receive text message reminder * sign consent to allow research staff to contact their pharmacies to determine prescription refill dates exclusion criteria: * patients with ductal carcinoma in situ

Keywords: hormone receptor positive
exercise training adherence after cardiac rehabilitation in coronary heart disease patients

Conditions: Coronary Disease

Summary: it is known that organized cardiac rehabilitation is effective in improving exercise capacity in coronary heart disease patients. less is known about the long-term results after cardiac rehabilitation. earlier studies have shown that many patients quit exercising when no longer attending formal rehabilitation. the investigators wish to investigate the effect of a maintenance program after ending a rehabilitation program, and to compare this to usual care. the investigators hypothesis is that the maintenance program will result in higher exercise capacity and more physical activity compared to usual care.


Eligibility criteria:
inclusion criteria: * coronary heart disease patients exclusion criteria: * unstable angina pectoris * hemodynamic significant valve disease (\> new york heart association class ii) * pregnancy * left ventricular ejection fraction \<30% * kidney failure (creatinin \> 140) * uncontrolled hypertension

Keywords: exercise heart coronary disease rehabilitation
evalution of the effects of prp and lllt on postoperative complications and wound healing after impacted third molar

Conditions: Impacted Third Molar Tooth

Summary: the aim of the study was to compare the possible effects of platelet-rich plasma (prp) and low-level laser (biolase) on postoperative complications after extraction of impacted mandibular wisdom teeth. 60 impacted wisdom teeth of 30 healthy individuals who applied to the department of oral and maxillofacial surgery, faculty of dentistry, xxx university, with the indication of extraction of impacted mandibular wisdom teeth were included in the study. 60 impacted wisdom teeth of the individuals were randomly divided into two groups (a and b). in a randomized controlled trial, platelet-rich plasma (prp) was applied to the first group (a) (one side of the same patients) and low-level laser therapy (lllt) was applied to the second group (b) (the other side of the same patient) immediately after surgery. vas (visual analog scale) for pain assessment, facial measurements for edema assessment and maximum mouth opening for trismus assessment were compared with preoperative values.

the aim of the study was to compare the possible effects of platelet rich plasma (prp) and low level laser (biolase) on postoperative complications after extraction of impacted lower wisdom teeth. sixty impacted wisdom teeth of 30 healthy individuals who applied to xxx university, faculty of dentistry, department of oral, dental and maxillofacial surgery with an indication for extraction of impacted lower wisdom teeth were included in the study. the 60 impacted wisdom teeth of the individuals were randomly divided into two groups (a and b). in a randomised, controlled study, the first group (a) (one side of the same patients) received platelet-rich plasma (prp) and the second group (b) (the other side of the same patient): diode laser low-level laser therapy (lllt) were applied immediately to the patient after surgery. vas (visual analogue scale) was used for pain assessment and assessments were made at 3rd, 6th, 12th and 24th hours and at 2nd, 3rd, 4th, 5th, 6th and 7th days. for edema assessment, preoperative facial measurements were repeated on the 2nd and 7th postoperative days and recorded. for trismus evaluation, the maximum mouth opening measurement made preoperatively was repeated and recorded on postoperative days 2 and 7.

Eligibility criteria:
inclusion criteria; * individuals aged 18 and over, * patients with partially impacted wisdom teeth, * individuals with systemic status asa0 and asa1 according to asa classification, * individuals who have not used any medication in the last two weeks, * individuals who do not have a lower second molar missing. exclusion criteria; * individuals with mouth opening less than 25 mm for various reasons, * pregnant and breastfeeding individuals, * individuals who do not come to postoperative check-ups, * individuals who use different medications other than the recommended medication.

Keywords: platalet rich plasma low level laser impacted third molar
anesthesia and circulating tumor cells in breast cancer

Conditions: Female Breast Carcinoma

Summary: serious concern about the role of anesthesia in tumor recurrence has considerably risen over years, but the lack of surrogate markers for tumor spreading made trials addressing this issue difficult to realize. in breast cancer patients ctc positivity has been recently recognized as an independent prognostic factor. in this respect, we postulated that in a first step changes in the number of ctc after general anesthesia would help to determine the effect of anesthesia on this tumor marker.

patients with primary breast cancer will be randomized to either propofol or sevoflurane anesthesia for curative surgery. ctc will be determined in the pre- as well as postoperative phase and the kinetic of ctc in the two groups will be compared.

Eligibility criteria:
inclusion criteria: \> female * age 18 to 85 * asa i-iii * primary breast cancer (tnm stage = t1-3, n0-2, m0) * primary surgery * written informed consent exclusion criteria: * metastatic breast cancer * other than primary surgery (recurrence, reconstruction) * pre-operative chemotherapy or radiotherapy * auto-immune disease, hiv, other active cancer, age\>85, asa iv or v * concomitant regional anesthesia * chronic opioids medication * any systemic immunosuppressive therapy * known hypersensitivity or suspected allergy to propofol, soya or egg proteins * known hypersensitivity to volatile anesthetics (malignant hyperthermia) * pregnancy * breast feeding * non german-speaking patients * enrollment in any other clinical trial during the course of this trial, 30 days prior to its beginning or 30 days after its completion
effects of yoga on sodium-induced pressor responses in african american adults

Conditions: Blood Pressure

Summary: this investigation aims to determine the effects of a 4-week yoga intervention on sodium-induced pressor and endothelial function responses as well as markers of renal sodium handling in african american adults.


Eligibility criteria:
inclusion criteria: * african american * adults ages 18-60 years exclusion criteria: * pregnancy or within 60 days postpartum * having taken blood pressure (including diuretics beta-blockers, ace inhibitors, angiotensin receptor blockers, and calcium channel blockers) or statin medications within the past 3 months (statins have been demonstrated to reduce oxidative stress which could impact flow-mediated dilation); * infection (viral or other) within the past 4 weeks; * having adrenal or endocrine tumors (these could impact bp); * renal disease defined as a glomerular filtration rate (gfr) of less than 60 (creatinine will be tested at initial screening and gfr will be calculated); * prior myocardial infarction; vii) known coronary heart disease; * personal history of stroke; * heart failure; * cardiac arrhythmias; * chronic obstructive pulmonary disease; * recent chest pain or dyspnea; * orthopedic limitations that preclude the execution of yoga postures; * current insulin dependence; * currently taking steroid medications; * currently undergoing chemotherapy or radiation; * having practiced yoga or yogic breathing techniques at least once weekly consistently within the past 3 months; * heat intolerance or electrolyte imbalances (hypo- or hyper-natremia or hypo- or hyper-kalemia).

Keywords: blood pressure salt sensitivity