Kornimate/medical-research-clean huggingface dataset:
intravenous saline pre-hydration in patients undergoing outpatient colonoscopy

Conditions: Colonic Diseases

Summary: colonoscopy and sedation are frequently accompanied by hypotension, which reduces the amount of sedation able to be employed. blood pressure is restored by the infusion of intravenous normal saline. prophylactic infusion of normal saline may enhance the colonoscopy completion rate, and patient comfort during colonoscopy and during the recovery from colonoscopy. the investigators propose randomising consenting adult patients attending outpatient colonoscopy to one of two treatment arms: (i) a control arm (ii) a treatment arm, with pre-hydration with an infusion of 1.0 litre of normal saline immediately prior to colonoscopy. outcome measures include colonoscopy completion rates, hypotension during or after colonoscopy, and patient ratings of comfort and satisfaction.

outpatient colonoscopy is a generally well-tolerated elective procedure. colonoscopy completion rate is governed in part by patient comfort, which is enhanced by adequate sedation. in addition, comfort following colonoscopy determines timely recovery from the procedure and return to usual activities. colonoscopy and sedation are frequently accompanied by hypotension (systolic blood pressure less than 100 mm hg), which reduces the amount of sedation able to be employed. where apparent, blood pressure is restored by infusion of intravenous normal saline. we have observed that hypotension is relatively common and may be present at or shortly after the commencement of the procedure, suggesting that many patients undergoing colonoscopy have reduced blood volume. therefore, prophylactic infusion of normal saline may enhance colonoscopy completion rate, and patient comfort during colonoscopy and during recovery from colonoscopy. we propose randomising consenting adult patients attending outpatient colonoscopy to one of two treatment arms: (i) a control arm, with standard sedation and monitoring during colonoscopy, and infusion of normal saline if systolic bp ≤ 95 mmhg for more than 3 minutes (two observation periods) until completion of the procedure; (ii) a treatment arm, with pre-hydration with an infusion of 1.0 litre of normal saline immediately prior to colonoscopy. outcome measures include colonoscopy completion rates, hypotension during or after colonoscopy, and patient ratings of comfort and satisfaction.

Eligibility criteria:
inclusion criteria: * aged 18 or older * able to provide informed consent * booked for outpatient colonoscopy, where appointment has been generated by gastroenterology unit bookings staff. exclusion criteria: * booked for anaesthetist-supervised colonoscopy because of previous sedation difficulties or significant co-morbidity (american society of anesthesiology class iii or iv) * subjects requiring dialysis * subjects receiving parenteral nutrition * subjects with current congestive cardiac failure * subjects with conditions preventing placement and accurate use of the automatic blood pressure cuff on the left arm, such as morbid obesity or lymphoedema

Keywords: colonoscopy rehydration sedation
vaccine- and infection-derived correlates of protection for cholera.

Conditions: Cholera

Summary: background: vibrio cholerae causes millions of cholera cases and thousands of deaths annually. vaccines are in short supply. there is no agreement on how to introduce new vaccines or evaluate their effectiveness, and the lack of 'correlates of protection' (cops) against cholera is a major obstacle to vaccine development. cops are markers of effective immune response to vaccination. while other infectious diseases have well established cops, none are widely accepted for cholera. relevance: lack of accepted cops impedes development of cholera vaccines, limiting progress toward improved vaccines, slowing the licensure of new vaccines, and contributing to the current vaccine shortage; an immediate obstacle to achieving reductions in cholera-related illness and deaths. the identification of new cops will speed the development of improved cholera vaccines and provide a pathway to their licensure and use. hypothesis: the investigators hypothesize that some individuals who receive inactivated oral cholera vaccine (ocv) will develop antibody responses which predict protection against v. cholerae infection and that specific immune responses distinguish individuals who are protected against cholera by prior natural infection from those who are protected from ocvs. objectives: the investigators will administer an ocv or typhoid vaccine (tcv) control and monitor antibody responses to identify better cops for cholera following both vaccination and natural infection. methods: the investigators will randomize 1219 participants; 554 participants will receive an inactivated bivalent ocv, 665 participants will receive a tcv control. the investigators will collect 12 blood samples over two-years following vaccination to measure antibodies against v. cholerae and to monitor for re-infection. outcome measures/variables: the endpoint of interest is v. cholerae infection after vaccination. the investigators define infection as positive culture or pcr for v. cholerae or seroconversion events observed over the 2-year follow up period.


Eligibility criteria:
inclusion criteria 1. ages 2 - 80 years. 2. informed consent from study participants and guardian in case of children (2-17 years) and assent from children aged 11-17 years. 3. intention to participate in the study for a 2-year period. 4. no major co-morbid conditions, per the supervising clinician investigator, including underlying immunodeficiency, diabetes, liver diseases, renal disease, cardiac disease, and/or active malignancy. exclusion criteria 1. suffering from diarrhoea or abdominal pain or vomiting in the past 24 hours or diarrhoea lasting for more than 2 weeks in the past 6 months. 2. history of taking another oral cholera vaccine. 3. history of taking any other live or killed enteric vaccine in the last 8 weeks.
using novel behavioral approaches to improve long-term weight loss outcomes

Conditions: Obesity

Summary: this project is a randomized controlled trial to compare the efficacy of two interventions- one based on acceptance and commitment therapy (act) and one based on self-regulation (sr)- and a control group (called weight loss only (wlo)) on 24-month weight loss outcomes. all participants will first participate in an initial 4-month standard behavioral weight loss program. participants will be randomized into 1 of 3 groups and receive a 3-part workshop; the act workshop will teach act skills including acceptance and mindfulness techniques designed to promote behavior change and health behavior persistence consistent with one's core values. the sr program will focus on self-regulation, regular weighing, and modeling behavior on successful maintainers. the wlo group will receive a control workshop focused on cooking demonstrations and general nutrition topics.the primary outcome is weight loss at 24 months. the secondary outcome is change in psychological flexibility, a critical component of act interventions and a potential innovative mediating mechanism. primary hypothesis: at 24 months, the act group will show significantly greater weight loss as compared to the sr and wlo groups.


Eligibility criteria:
inclusion criteria: * bmi 27.5-40 * age 30-65 exclusion criteria: * currently participating in a weight loss program * pregnant or planning to become pregnant * medical condition that would preclude physical activity * terminal illness * plans to relocate * history of substance abuse or psychological problems that are judged by the investigators to be likely to interfere with study participation
ipratropium bromide in peri-operative copd

Conditions: Pulmonary Disease, Chronic Obstructive

Summary: this is a randomized, double-blind, placebo-controlled, parallel-group, multi-centre trial.the trial aims to evaluate efficacy of nebulized ipratropium bromide in chinese peri-operative patients with copd under general anaesthesia.


Eligibility criteria:
inclusion criteria: * all patients must sign an informed consent. * male or female patients aged \>= 40 years and \<= 80 years * all patients must be diagnosed with copd and must meet the following spirometric criterion: post-bronchodilator forced expiratory volume in 1 second (fev1) \< 70% of forced vital capacity (fvc) at screening visit (visit 1). * all patients have relatively stable copd (i.e. have no copd exacerbation within 4 weeks prior to screening visit). * all patients are about to receive selective surgical procedures of lobectomy or right bilobectomy or segmentectomy under general anaesthesia, whilst the estimated time of surgical procedures lasts for not less than 2 hours, and the estimated time of general anaesthesia lasts for not less than 3 hours and not longer than 5 hours. * patients must be able to perform all study related procedures including technically acceptable pulmonary function tests (pfts). exclusion criteria: * patients who need maintenance treatment of bronchodilators (including anticholinergics, ß-agonists, xanthines). * patients with a recent history (i.e. six months or less) of myocardial infarction * patients with any unstable or life-threatening cardiac arrhythmia requiring intervention or change in drug therapy during the last year * patients with symptomatic chronic heart failure (i.e. new york heart association functional class iii-iv) * known narrow angle glaucoma * patients with prostatic hyperplasia or bladder neck obstruction with significant symptoms * patients with a history of asthma, allergic rhinitis or who have a blood eosinophil count \>= 600 / mm3 (0.6×10\^9/l). a repeat eosinophil count will not be conducted in these patients
low energy ketogenic diet in obese subjects - the impact on whole organism

Conditions: Obesity

Summary: the study evaluates the timeline of changes of body composition, physical and psychological performance, and biochemical markers of metabolism and inflammation responses to low energy ketogenic diet for loosing weight in obese individuals. the participants will be monitored and guided by the interdisciplinary obesity team for 12 weeks.

ketogenic diets have been shown to be an effective tool to fight obesity with reported good adherence due to their ability to suppress the drive to eat. they are also gaining popularity in public, despite some concerns regarding the quality and timeline of changes of body composition and the effects on health parameters of whole organism. for effective weight loss, energy deficit is required. very low energy (600 - 800 kcal) ketogenic diets have been extensively studied. the proposed study combines low energy (800 - 1500 kcal) and ketogenic diet intervention. the aim of the study is a comprehensive determination of quality of body mass loss, metabolic states changes, physical and psychological performance changes, and inflammatory and hormones profile changes during and post a 12-week low energy ketogenic diet intervention.

Eligibility criteria:
inclusion criteria: * bmi \> 30 kg/m2 * asymptomatic for any disease except obesity exclusion criteria: * presence of cardiovascular, endocrine, acute or chronic inflammatory diseases; * taking medications for lipid metabolism, or psychiatric disorders; * adherence to a prescribed diet; * unstable weight in the past 3 months; * bmi \< 30 kg/m2; * unwilling or unable to eat the foods prescribed in the study; * vigorous physical activity; * pregnancy or lactation.

Keywords: ketogenic diet body composition metabolism body dissatisfaction cognition
on versus off pump myocardial revascularization study

Conditions: Coronary Artery Disease

Summary: compare completeness and modality of revascularization, operative and postoperative results and 1 year clinical outcomes in unselected high risk patients referred for primary coronary artery bypass surgery. patients will be randomized to undergo off-pump coronary artery bypass graft (opcab) or coronary artery bypass graft with cardiopulmonary bypass (cpb/cab).

the initial application of off-pump coronary artery bypass in the early nineties was mainly directed to highly selected and relatively low risk surgical patients. since then there has been a growing body of evidence suggesting many potential advantages of the opcab technique over the conventional cardiopulmonary bypass (cpb) technique in different groups of high-risk patients. on-off study is a multicentre, prospective, randomized, parallel, trial.patients indicated for elective or urgent isolated coronary artery bypass graft with additive european system for cardiac operative risk evaluation ≥ 6 were enrolled. patients in cardiogenic shock were excluded. patients were randomly assigned either to coronary artery bypass surgery with cardiopulmonary bypass (on arm) or to off-pump coronary artery bypass graft (off arm). the composite primary end point included operative mortality, myocardial infarction, stroke, renal failure, re-operation for bleeding and adult respiratory distress syndrome, within 30 days after surgery. the total planned sample size was 693 patients; the actual number of enrolled patients was 411,according to the results of the interim analysis scheduled at 400 enrollments (alfa-spending=0.029, pocock method).

Eligibility criteria:
inclusion criteria: * pts candidate to a myocardial revascularization for any patter of coronary artery disease, ventricular dysfunction or any other co-morbidity * euroscore ≥ 6 * pts who signed the informed consent * age ≥ 18 years exclusion criteria: * patients in cardiogenic shock requiring emergency surgery or preoperative intra-aortic balloon pump * patients requiring additional surgical procedures * porcelain aorta * lack of informed consent

Keywords: off-pump bypass coronary artery surgery
reducing suicidal ideation through treatment of nightmares-post traumatic stress disorder (ptsd)

Conditions: Post Traumatic Stress Disorder; Suicidal Ideation; Nightmares

Summary: patients with ptsd, and frequent nightmares, and mild-moderate suicidal ideation, who are already taking a selective serotonin reuptake inhibitor (ssri) or serotonin norepinephrine reuptake inhibitor (snri) will be randomized to either prazosin or placebo. the investigators hypothesize that patients receiving prazosin will have a greater reduction in suicidal ideation.


Eligibility criteria:
inclusion criteria: * ptsd * frequent nightmares * suicidality exclusion criteria: * schizophrenia * bipolar * substance abuse
forensic dental age estimation : validation of computed tomography for third molar demirjian's staging

Conditions: Mandible Fracture

Summary: age can be estimated in different ways by using skeletal age and dental age. currently, bone age is determine thanks to the wrist x-rayed, and the dental age using variation in mineralization (demirjian's score) on the dental panoramic (mincer 1993). more recently, reviews indicate the computed tomography (ct) scan of the medial clavicular epiphysics can contribute to improve the accuracy of individual's age estimation (houpert, 2016). furthermore, with the recent advances, the very low dose ct scan acquisitions can be perform with sufficient quality for the teeth analysis. the goal of this study is to validate the use of dental ct for demirjdian's staging method.


Eligibility criteria:
inclusion criteria: * patient aged between 0 and 25 years old * complete dental panoramic * ct scan including mandible and maxilla * maximum of 2 months between ct scan and dental panoramic * medical imaging available on the pacs exclusion criteria: * medical imaging missing on the pacs * patient refuses to participate

Keywords: dental age estimation ct scan dental panoramic validation ct scan radiography
a french multicenter observational retrospective study of rare primary liver cancers

Conditions: Hepatocholangiocarcinoma; Fibrolamellar Carcinoma; Hepatic Epithelioid Hemangioendothelioma; Hepatoblastoma; Hepatic Neuroendocrine Carcinoma; Hepatic Carcinosarcomas; Hepatic Cystadenoma; Hepatic Leiomyosarcomas; Hepatic Angiosarcomas; Cholangiocarcinoma

Summary: the aim of this french multicenter retrospective study is to describ rare primary hepatic cancers clinical, histological and radiological features, to obtain a biological tumor and blood collection, and to evaluate the efficacy of treatments received in clinical practice in order to determine optimal therapeutic sequences. this retrospective cohort will be the backbone of future translational studies aimed at identifying new molecular, histological, circulating and radiological tumor biomarkers, potentially useful at every stage of diagnosis and prognostic or theranostic evaluation.

the aim is to describ rare primary hepatic cancers clinical, histological and radiological features, to obtain a biological tumor and blood collection, and to evaluate the efficacy of treatments received in clinical practice in order to determine optimal therapeutic sequences.

Eligibility criteria:
inclusion criteria: * 18 years of age or older, * with histologically proven hepato-cholangiocarcinoma, fibrolamellar hepatocellular carcinoma, epithelioid hemangioendothelioma or hepatic angiosarcoma * diagnosed after january 01, 2018 living or deceased at the time of registration in the cohort * for living patients who have not objected to the research: (note of non-objection to be attached° agreeing to participate in ancillary studies must sign the biological consent form for participation in biological studies. exclusion criteria: * without social security * no access to tumor block

Keywords: rare primary liver cancers liver hepatic cohort risk factors
coreg mr versus toprol-xl on the lipid profile of normolipidemic or mildly dyslipidemic patients with hypertension

Conditions: Hypertension

Summary: this study was designed to determine whether treatment with coreg mr is more effective at maintaining a better lipid profile than treatment with toprol-xl for hypertension.


Eligibility criteria:
inclusion criteria: * documented history of hypertension * triglycerides of 120-400 mg/ml * ldlc levels not requiring lipid lowering medication. exclusion criteria: * has known contraindication to alpha- or beta-blocker therapy. * has taken any non-ocular beta-blockers within three months before screening. * has type i or ii diabetes. * taking lipid lowering medications.

Keywords: hypertension
unsedated colonoscopy for colorectal cancer screening and surveillance

Conditions: Colon Polyp

Summary: in a prospective, randomized, controlled study, two methods (water method vs. air method) of performing colonoscopy will be compared in patients undergoing unsedated colonoscopy for crc screening. the investigators hypothesize that: 1. study method increases overall cecal intubation with comparable assessment of current experience and patient willingness to repeat future colonoscopy compared with conventional colonoscopy 2. study method improves bowel preparation and increases polyp pickup rate

colorectal cancer (crc) screening for the high and the low risk healthy asymptomatic veterans affairs (va) patients is being promoted. compliance with this directive will result in an increased number of va patients undergoing colonoscopy. the demand for colonoscopy far exceeds the capacity available to perform the procedure in the va system. the conventional practice for colonoscopy at va facilities across the country is to perform colonoscopy under conscious sedation with air insufflation. efficiency is governed by the fact that sedated patients require time and space for recovery and these are major limiting factors in the current setting for the use of colonoscopy for crc screening. in a prospective, randomized, controlled trial (rct), two methods of performing colonoscopy will be compared in patients undergoing unsedated colonoscopy for crc screening. we compared the water infusion in lieu of air insufflation (water method) with the conventional air insufflation method. we hypothesize that the water method (study method) increases overall cecal intubation with comparable assessment of current experience and patient willingness to repeat future colonoscopy compared with conventional colonoscopy. in addition, the water method improves bowel preparation and increases polyp pickup rate.

Eligibility criteria:
inclusion criteria: * adult (\>50 years old) * male and female patients * scheduled and consented for screening or surveillance colonoscopy without medications * accept randomization to the study or the conventional method * agree to complete study questionnaires * the adults will be normal healthy patients or patients with mild systemic disease, asa 1 or asa 2. exclusion criteria: * patients who decline to participate * unable to give informed consent or complete the questionnaires due to language or other difficulties

Keywords: water method air method unsedated colonoscopy adenoma detection
the health and social consequences of depression among the elderly

Conditions: Depression; Functional Impairment

Summary: mental illnesses often go undiagnosed or untreated in low-income settings. mental health care may be especially important for the elderly - events in the lives of the elderly, like illnesses or deaths of peers, may put these individuals at high risk of mental illness. the study will constitute a randomized controlled trial aimed at reducing depression among elderly women over a 12-week period. through two interventions, the investigators will aim to improve women elder's outlook on life and relationships through cognitive behavioral therapy (cbt) and facilitated group activities. there will be a total of four treatment arms: one for cbt during home visits, one for facilitated group activities, one for both, and a control group receiving neither the cbt nor facilitated group activities. all activities will be delivered by lay government community volunteers. randomization for group activities will be at the village level, and randomization for cbt will be at the individual-level within each village. investigators will track outcomes of the elderly at two points in time: immediately after the 12-week intervention and 6 months after the intervention.


Eligibility criteria:
inclusion criteria: * at least 55 years of age * women exclusion criteria: * those with hearing, speech or mental impairment

Keywords: elderly india cbt group activities depression
gilles de la tourette syndrome (ts) and seasonality

Conditions: Tourette Syndrome

Summary: this retrospective and prospective observational study intends to evaluate the correlation between seasons and the variation of the syndromic structure of the tourette.


Eligibility criteria:
inclusion criteria: * patients attending the tourette center since january 2012. * males and females. * age between 6 and 50 (completed). * diagnosis of tourette syndrome ascertained * presence of a value equal to or greater than 15/40 of the y-bocs. exclusion criteria: * presence of allergic pathology. * presence of significant psychiatric symptoms, with the exception of those belonging to the tourette syndrome itself (eg adhd, ocd)