Kornimate/medical-research-clean huggingface dataset:
a health economic evaluation of using n-terminal pro brain natriuretic peptide (nt-pro bnp) in acute heart failure

Conditions: Heart Failure

Summary: cardiac biomarkers have dramatically impacted the way hf patients are evaluated and managed. in fact, the role of biomarkers has developed to better differentiate hf against other diseases and, to timely initiate and influence more accurate diagnosis (rule out) and treatments, to predict the onset of future hf, to risk-stratify affected patients, and to serve as a tool to guide intensity of therapy. nt-probnp has become validated biomarkers with highest guideline recommendation (class i) and independent predictors for re-hospitalization and mortality in hf patients. however, many indonesian cardiologists do not use of those biomarkers, mostly due to limited available cardiac biomarkers for the cost effective heart failure management. we evaluate 2 alternative treatments which one that more cost-effective between biomarker's guided therapy and without biomarker.

with growing demands on limited health care budgets, optimal resource allocation in hf patients is essential. although nt pro bnp is proposed to be effective for the evaluation and management patients with heart failure, no data exist about cost-effectiveness analysis that are based on practice patterns endorsed by universal coverage systems in indonesia (jaminan kesehatan nasional). because nt-probnp therapy guidance in hf is believed to create additional costs, it is not yet broadly applicable. its why we need to elaborate this issue.

Eligibility criteria:
inclusion criteria: * patients aged 18-75 years * the primary diagnosis at the emergency department (ed) is acute decompensated heart failure (adhf) * using the national health insurance * willing to be followed for 3 months * willing to sign informed consent. exclusion criteria: * severe life-threatening comorbidities with a life expectancy of \<2 years * acute heart failure other than adhf such as acute pulmonary edema, acute heart failure in the setting of acute coronary syndrome, cardiogenic shock, right heart failure, and hypertensive heart failure * adhf accompanied by sepsis, liver disease, lung disease with severe radiological findings, mechanical complications of acute myocardial infarction, aortic dissection, congenital heart disease, idiopathic pulmonary hypertension, lung emboli, severe respiratory failure, and severe burns * patients admitted to icvcu (intensive cardiovascular care unit) * patients did not take medication regularly and controls routinely.

Keywords: acute heart failure cost nt-pro bnp
tools and practices to decrease cvd and complications in the diabetic population of mexico

Conditions: Diabetes; Cardiovascular Disease

Summary: this project will look to improve standards of care for diabetic patients by evaluating a program that supports participants in making healthy lifestyle changes. the program consists of 13 educational sessions that contain information about the prevention and care of diabetes and cardiovascular disease, physical activity, nutrition, community health and emotional well being.

researchers propose to address extremely high rates of cardiovascular disease morbidity and mortality in sonora, mexico through use of an evidence-based community health worker intervention for adult patients with diabetes who receive care at health centers operated by the secretaría de salud, an office of the mexican government. researchers will conduct a cluster-randomized trial with a total of 400 patients at 20 health centers to understand whether the 13-week educational intervention, meta salud diabetes, can effectively reduce clinical, behavioral, and psychosocial risk for cardiovascular disease among adults with diabetes. researchers will also conduct an implementation study that will consist of systematic engagement of local, state and national decision makers to identify barriers, facilitators, and strategies to adopt and integrate community health worker-led cardiovascular disease prevention interventions throughout the 209 health centers in sonora.

Eligibility criteria:
inclusion criteria: * adults ≥18 years old * have been diagnosed with controlled or uncontrolled diabetes exclusion criteria: * \< than 18 years of age * not diagnosed with diabetes
correlation of two methods for cough peak flow measurement in intubated patients

Conditions: Respiratory Insufficiency; Ventilator Weaning

Summary: cough peak flow (cpf) seems to be an efficient tool to assess cough capacity for the intensive care unit (icu) ventilated patient. cpf can be used in the ventilator weaning process, as reflecting the upper airways protection capacity. cpf requires disconnection of the patient from the icu ventilator, supplemental material (handheld spirometer, antibacterial filter) and an excellent synchronization between the specialized caregiver and the patient. we aimed that cpf with the ventilator built-in flow-meter is correlated with cpf using a handheld flowmeter connected to the endotracheal tube.


Eligibility criteria:
inclusion criteria: * age \> 18 years * mechanically ventilated patient \> 24 hours * weaning ventilator phase (peep \< 9 cmh2o and support \< 15 cm h2o) * richmond agitation sedation scale between -1 and +1 * patient's agreement to participate exclusion criteria: * pregnant women * bronchospasm * fio2 \> 70% * thoracic surgery \< 7 days * abdominal surgery \< 7 days * thoracic injury with rib fracture \< 21 days * pneumothorax \< 24 hours
team based psychosocial care to promote, maintain and restore wellness of breast cancer patients

Conditions: Breast Cancer

Summary: researchers are trying to see if proactive identification and team based individualized care of cancer patients having emotional difficulties can improve quality of life relative to treatment as usual. also, to see if proactive approaches to maintain wellness can prevent grief among breast cancer patients, experiencing no emotional difficulties relative to treatment as usual.

consented subjects will be randomized into two separate groups. groups will be distressed and non-distressed subjects. each group will be randomized into either intervention education training or standard of care. both groups will be asked to fill out questionnaires during the duration of the study. subjects will be remain in the study for up to one year.

Eligibility criteria:
inclusion criteria: * diagnosis of breast cancer within last three years * able to communicate in english or with the help of an interpreter. * access to a device with internet connection exclusion criteria: * breast cancer patients who are considered for hospice or expected survival of less than six months. * presence of active suicidal ideations. * presence of active psychosis. * presence of dementia

Keywords: psychosocial care wellness
determinants of vasospasm and delayed ischemic deficits in aneurysmal subarachnoid hemorrhage

Conditions: Ischemia

Summary: the risk of delayed cerebral ischemia (dci) after subarachnoid hemorrhage (sah) is associated with large cerebral artery vasospasm, but vasospasm is not a strong predictor for dci. assessment of cerebral autoregulation with transcranial doppler (tcd) may improve the prediction of dci. the aim of this prospective study was to assess the value of tcd-derived variables to be used alone or in combination for prediction of dci


Eligibility criteria:
inclusion criteria: group 1 : • patients who presented a ruptured aneurysm by aneurysmal subarachnoid hemorrhage (sah) older than 72 hours. diagnosis of sah was confirmed by computed tomography, magnetic resonance imaging (mri) or lumbar puncture as recommended * symptomatic aneurysm treated with endovascular, * absence of achieving a lumbar puncture, * patients affiliated to a social security scheme, * patients who have given their free and informed consent and signed the consent or consent of the family. group 2 : healthy volunteers with cerebrospinal fluid sample exclusion criteria: * patients with no readable acoustic temporal bone window * patients with previous disease that might impair cerebral autoregulation (e.g., carotid stenosis, history of stroke or head injury).

Keywords: cerebral ischemia
clinical study of breast conserving surgery combined with intraoperative radiotherapy for early breast cancer

Conditions: Breast Cancer; HER2-negative Breast Cancer

Summary: a single-center, open, prospective study，for analyzing the local recurrence rate, the incidence of incision complications and the aesthetic effect of intraoperative radiotherapy in early breast cancer patients after breast-conserving surgery.

this is a single-center, open, prospective study. a total of 620 breast cancer patients meeting the exclusion criteria were included and assigned to the iort group and the wbi group according to the patients' wishes. the iort group received intraoperative radiotherapy with a regimen of 50-kf-x 20gy/1f, and the wbi group received whole milk external irradiation with a regimen of 50gy/25f. if the postoperative paraffin pathology of patients in the iort group indicated positive axillary lymph nodes, the radiologist should determine whether to irradiate the whole milk and lymph nodes in the drainage area. if the postoperative pathology of patients in the wbi group indicated the need for chemotherapy, radiotherapy was initiated within 6 weeks after the end of chemotherapy, allowing both endocrine therapy and radiotherapy to be performed simultaneously. the clinical standard treatment regimen (chemotherapy, endocrine therapy, etc.) was developed based on postoperative pathological and immunohistochemical reports.

Eligibility criteria:
inclusion criteria: 1. age ≥55 years old； 2. cytology or histology confirmed invasive breast cancer or intraductal carcinoma in situ (dcis) with a clinical stage of tis-1n0m0； 3. patients who are willing to preserve milk and intend to undergo breast-conserving surgery； 4. if invasive breast cancer is confirmed, the surgical margin negative ≥2mm should be met. if dcis is confirmed, the surgical margin should be negative ≥3mm； 5. er≥ 30% and pr≥ 1%, her2 negative； 6. voluntary participation in this study, signed informed consent, good compliance, cooperate with follow-up. exclusion criteria: 1. simultaneous diagnosis of bilateral or multifocal breast cancer； 2. previous ipsilateral breast cancer and/or prior chest wall radiation therapy； 3. there are active connective tissue diseases such as scleroderma and systemic lupus erythematosus in the chest； 4. the investigators did not consider the patient suitable for participation in any other conditions of the study.

Keywords: breast preservation surgery breast cancer invasion radiotherapy
2px (topical strontium chloride hexahydrate) in patients with post-amputation stump pain.

Conditions: Amputation Stumps; Pain

Summary: the objective of this study is to investigate the analgesic effect of topical strontium chloride in stump pain, and to prospectively determine other efficacy and safety measures of topical strontium chloride in stump pain.


Eligibility criteria:
inclusion criteria: * lower limb amputation at least 6 months prior to inclusion * presenting with moderate-to-severe pain intensity (above 50 on 100 mm vas) at screening, to be confirmed prior to randomisation as: mean (over the 14 days run-in period) stump api rating above 50 on a 100 mm vas * outpatients, aged 18 years and above * written informed consent exclusion criteria: * subjects who have received treatment with any potent opioid in the 4 weeks prior to study entry (i.e. an opioid assumed to cause abstinence symptoms upon abrupt cessation) * subjects taking any analgesic medication (except for rescue medication as defined in this protocol) * subjects with expressed dissatisfaction with their prosthesis comfort * pregnant or breast-feeding women * any malignant disease * subjects who have received an investigational drug or used an investigational device in the 30 days prior to study entry. * subjects unable to comply with the study assessments * subjects with documented or suspected alcohol or drug abuse

Keywords: lower limb amputation at least 6 months prior to inclusion presenting with moderate-to-severe pain intensity outpatients, aged 18 years and above
menstrual phase endometrial scratch in iui cycles

Conditions: Fertility Disorders; Fertility Issues

Summary: patients undergoing treatment with intrauterine insemination (iui) will be randomized to receive an endometrial scratch or sham procedure during the menstrual phase of the treatment cycle.

infertility is a common issue faced by many couples throughout the united states. there are multiple fertility treatment options, including in vitro fertilization (ivf) and intrauterine insemination (iui). additionally, methods such as endometrial scratch (a modified endometrial biopsy) have been postulated to increase success rate. this prospective, randomized control trial will assess whether performing an endometrial scratch improves cycle outcomes and decreases time to pregnancy following iui. each patient will be randomly assigned to receive either an endometrial scratch or undergo a "sham" procedure (speculum insertion but no scratch) during the menstrual phase of the iui cycle.

Eligibility criteria:
inclusion criteria: * all patients undergoing intrauterine insemination procedures between the ages of 18 and 37 who have undergone a complete fertility work up (tubal, uterine, hormonal and sperm assessments) and do not have a current tubal or uterine factor infertility or severe male factor (expected to have \< 10 million total motile sperm on iui sample) unless using donor sperm. exclusion criteria: * age \ 37, expectation (prior to randomization) of \< 10 million total motile sperm on iui sample, tubal factor, uterine factor, incomplete fertility work up.

Keywords: infertility insemination
risk factors and the effect of plasma exchange on prognosis of pregnancy-related thrombotic microangiopathies

Conditions: Pregnancy-related Thrombotic Microangiopathies

Summary: early identification of the risk factors of pregnancy-related thrombotic microangiopathies can help us reduce the complications of such patients and increase the survival rate of patients. in addition, it is still controversial whether patients with pregnancy-related thrombotic microvessels should receive plasma therapy.

"objective: to evaluate the risk factors of pregnancy-related thrombotic microangiopathies and the effect of plasma exchange on the prognosis (recovery status of renal function, recovery status of platelets, survival or death within 28 days). design: a retrospective analysis of pregnant patients admitted to the icu from 2015 to 2019. according to the outcome indicator of the occurrence of pregnancy-related thrombotic microangiopathies, they were divided into thrombotic microangiopathies group and non-thrombotic microangiopathies group. patients in the pregnancy-related thrombotic microangiopathy group were divided into plasma exchange combined non-plasma exchange group according to whether they received plasma exchange. collect the clinical data of the patients, and analyze the data using spss 1 7.0 statistical software package. the measurement data were compared by paired t test and one-way analysis of variance; the count data were compared by χ2 test. compare the differences of the indicators between the two groups and analyze the risk factors of pregnancy-related thrombotic microangiopathies. then compare whether there is a difference in the prognosis between the plasma exchange group and the non-plasma exchange group."

Eligibility criteria:
inclusion criteria: * pregnant patients admitted to the department of critical care medicine, the third hospital of peking university from 2015 to 2019 exclusion criteria: * no

Keywords: pregnancy thrombotic microangiopathies
validation of uhear™ as a screening tool to detect hearing impairment in older cancer patients within a comprehensive geriatric assessment - bis

Conditions: Older Cancer Patients

Summary: the aim of this study is to validate uhear™, an ios-based tool, as a screening tool to detect significant hearing impairment as part of a comprehensive geriatric assessment in patients aged 70 years and older. the pass or fail screening cut-off is defined as having two or more consecutive hearing grades starting from the moderate-severe threshold zone ranging from 0.5 - 2.0 khz.


Eligibility criteria:
inclusion criteria: * patients should have reached the age of 70 or more at enrolment * histologically confirmed diagnosis of solid cancer or hematologic malignancy. all stages of cancer are eligible * patients should be fluent in dutch or french * patients must receive their primary oncology care in the participating hospital * patients should be cognitively capable of performing the audiology assessment * patients should be scheduled to receive a cga * patients should have signed informed consent exclusion criteria: * patients who do not match the above inclusion criteria * patients presenting with clinically diagnosed meniere's disease, retrocochlear hearing loss, autoimmune inner ear disease, fluctuating hearing loss or a history of sudden sensory neural hearing loss * patients who already have a hearing aid or a previously diagnosed hearing loss
a long-term study of jns007er in patients with schizophrenia

Conditions: Schizophrenia

Summary: the purpose of this study is to assess the safety of jns007er 3-12 mg once daily in patients with schizophrenia over a long term period.

this is a 48-week, multicenter, open-label (all people know the identity of the intervention), non-controlled, arbitrary-dose study. the patients included in this study are those who participated in the preceding double-blind (neither physician nor patient knows the treatment that the patient receives) comparative trial (study jns007er-jpn-s31) of jns007er and completed the study, or those who remained in the study up to the evaluation at 2 weeks and discontinued the study after that for insufficient treatment efficacy. the study will assess the safety of jns007er in the clinical recommended dose range in a long term treatment. the dosage will be started at 6 mg/day, and it can be increased or decreased 3 mg at a time depending on the patient's symptom within the range of 3 mg/day to 12 mg/day. for dose adjustments, the investigator will evaluate the psychiatric symptoms before defining the dose change. detailed description: extended description of the protocol, including more technical information (as compared to the brief summary) if desired. do not include the entire protocol; do not duplicate information recorded in other data elements, such as eligibility criteria or outcome measures.

Eligibility criteria:
inclusion criteria: * patients diagnosed with schizophrenia * patients who have given their own consent in writing to participate in the study * patients untreated with antipsychotics within 28 days before the screening test * patients who have completed study jns007er-jpn-s31, or those who continued the study at least up to the evaluation at 2 weeks and subsequently discontinued the study due to insufficient efficacy * patients participating in study jns007er-jpn-s31 and whose ratio of treatment to the evaluation at 2 weeks is ≥75% exclusion criteria: * patients diagnosed with a mental disease other than schizophrenia * a total panss score \> 120 at baseline * substance-related disorders * parkinson's disease complications * current or a past history of convulsive disease such as epilepsy * current or a past history of cerebrovascular accident * diabetes mellitus * significant hepatic or renal impairment * significant cardiovascular disorders * abnormal results of hematological examination, blood chemistry test and urinalysis at screening * pregnant women, breast-feeding mothers, and patients who wish pregnancy during the study period or those whose pregnancy test at screening was positive * contraindications to risperidone products * patients who discontinued study jns007er-jpn-s31 due to an adverse event not related to the underlying disease * patients judged inadequate by the investigator to participate in the study

Keywords: schizophrenia jns007er paliperidone extended-release
magnetic stimulation therapy for treating vascular depression

Conditions: Depressive Disorder; Depression

Summary: this 12-week study will evaluate the effectiveness of repetitive transcranial magnetic stimulation (rtms) of the brain, followed by citalopram (celexa®), for treatment of depression associated with small vascular lesions in the brain (vascular depression).

vascular depression is a condition that typically affects the elderly and is associated with small vascular lesions. it is more resistant to treatment and has a poorer outcome than nonvascular depression. by altering excitability in the cortical area of the brain, rtms may be an effective treatment neuropsychiatric conditions, particularly depression. participants in this study will be randomly assigned to 15 treatments of either rtms or sham rtms for 3 weeks. following treatment, participants will receive citalopram for 9 weeks. response rates to treatment; relapse rates; the size, number, and location of the vascular lesions; and the amount of regional brain atrophy will be measured. improvements in activities of daily living, quality of life, and cognitive function will also be also measured.

Eligibility criteria:
inclusion criteria: * dsm-iv diagnosis of unipolar major or minor depressive disorder * hamilton depression rating scale score of at least 18 * depression that is associated with cerebrovascular disease * failed at least 1 treatment for vascular depression

Keywords: aged