Kornimate/medical-research-clean huggingface dataset:
gastric varices treatment: coil + cyanoacrylate versus cyanoacrylate

Conditions: Gastric Varices

Summary: the purpose of the spring is to maintain the cyanoacrylate polymer of the gastric varix, forming a conglomerate spring-cyanoacrylate, and thus preventing their migration to the adhesive embolism. the introduction of the spring is held by a echo-guided puncture. the window can be puncture through the distal esophagus or directly in the gastric varix via retroflexion to the fundus. another advantage of this technique is its use in the presence of bleeding, when large amounts of blood in the stomach hinders the injection of the cyanoacrylate, by pricking the distal esophagus that difficulty decreases. the first study of this technique was performed by binmoeller et al (21) and had good results with 100% hemostasis and low rebleeding rate (16%), but more studies are needed to prove the safety and efficacy of this technique.

objective compare the results of the treatment of gastric varices, coil associated with cianoarilato versus cyanoacrylate in patients with systemic shunts in relation to efficacy and embolic complications. patients, materials and methods drawing this is a prospective clinical trial, double-blind, comparative, randomized, single center, performed on quaternary level hospital involving patients with portal hypertension with gastric varices type 2 gov or igv 1. 28 cirrhotic patients will be randomized to the treatment of gastric varices type gov2 igv1 or more cyanoacrylate cyanoacrylate or only patients with splenorenal shunt or gastrorenal spring. after signing the consent form, patients will undergo ct angiography to evaluate the presence of shunt and classification of the same. patients without shunt will be excluded from the protocol. dopller colored portal system will also be conducted in all patients prior to treatment for analysis of portal flow. after confirming the presence of shunt patients will be examined by echo-endoscopy for completion of treatment the following data will be collected: demographic data (age and gender), etiology of cirrhosis, degree of liver function, primary or secondary prophylaxis diameter of gastric varix, varices of the esophagus with or without signs of red color, size and type of shunt detected by ct, amount of springs inserted, number of ampoules of cyanoacrylate injected complications (bleeding, damage to the endoscope by cyanoacrylate)

Eligibility criteria:
inclusion criteria: * patients with portal hypertension and pseudo-tumor gastric varices type igv1 or gov2 and presence of gastrorenal or splenorenal shunt. exclusion criteria: * refusal of the patient or their legal guardian.

Keywords: gastric varices,coil,cyanoacrylate,treating gastric varices.
efficacy and safety of nitazoxanide 600 mg bid versus placebo for the treatment of hospitalized patients with covid-19

Conditions: covid19

Summary: this is a pivotal phase iii study to evaluate the efficacy of nitazoxanide 600 mg bid compared to placebo to treat hospitalized patients with non-critical covid-19.

this is pivotal phase iii study to evaluate the efficacy of nitazoxanide 600 mg bid compared to placebo to treat hospitalized patients with non-critical covid-19. the aim is to demonstrate a decrease in hospital related complications among patients who are hospitalized with moderate covid-19 by treating them with nitazoxanide bid 600 mg for 7 days on top of standard care compared to placebo on top of standar care.. therefore, patients hospitalized with confirmed diagnosis of covid-19 will be randomized to receive either nitazoxanide 600 mg bid or placebo.

Eligibility criteria:
inclusion criteria: 1. informed consent from patient or legal representative. 2. male or female, aged ≥ 18 years; 3. laboratory confirmation of 2019-ncov infection by reverse-transcription polymerase 4. chain reaction (rt-pcr) from any diagnostic sampling source; 5. hospitalized for up to 48h with signs of respiratory failure with or without non-invasive ventilation and i. oxygen saturation \<98%; 7. negative result for pregnancy test (if applicable). exclusion criteria: 1. participating in another rct in the past 12 months; 2. known allergy to nitazoxanide 3. severely reduced lv function; 4. severely reduced renal function; 5. pregnancy or breast feeding; 6. diagnosis of any other active infection (viral, bacterial, fungal or caused by another pathogen, except the one studied in the trial); 7. history of hiv 1 and/or 2 (anti-hiv-1,2) and/or htlv i and ii positive; 8. ongoing antineoplastic treatment with chemotherapy or radiation therapy; 9. diagnose of severe autoimmune diseases in immunosuppression; 10. transplanted patients; 11. any other clinical condition which, in the opinion of the principal investigator, would not allow safe completion of the protocol and safe administration of the investigational products
ketamine sedation as neuroprotective agent following out-of-hospital cardiac arrest

Conditions: Out-of-hospital Cardiac Arrest (OHCA)

Summary: ohca is a critical medical emergency with significant mortality and morbidity primarily due to hypoxic-ischemic brain injury (hibi). despite advances in resuscitation techniques, the neurological outcomes for survivors remain poor. current post-resuscitation practices lack specific neuroprotective strategies. ketamine, an n-methyl-d-aspartate (nmda) receptor antagonist, has shown potential neuroprotective properties in preclinical and clinical studies due to its ability to inhibit excitotoxicity and reduce neuronal apoptosis. this trial hypothesizes that ketamine, when used for sedation in ohca patients, may offer superior neuroprotective benefits compared to the commonly used sedative propofol. by comparing the effects of ketamine and propofol on neuronal damage markers and long-term neurological outcomes, this study aims to identify a potentially effective intervention to improve the prognosis of ohca patients.


Eligibility criteria:
inclusion criteria: * adults (age ≥18 years) and * resuscitated ohca of presumed cardiac cause with a shockable first recorded heart rhythm and * mean arterial pressure (map) \>40 mmhg and * a decision to perform prehospital intubation. exclusion criteria: * advanced life support termination-of-resuscitation (tor) criteria met * systolic blood pressure \>190 mmhg * known allergy to ketamine or propofol * chronic diseases making 180-day survival unlikely * body temperature \<30° c.
tetracycline (doxycycline) and post myocardial infarction remodeling

Conditions: Myocardial Infarction; Left Ventricular Remodeling

Summary: the aim of the study is to assess the efficacy of an antibiotic treatment with tetracycline (doxycycline) in the early stage of large reperfused acute myocardial infarction (ami), in preventing left ventricular (lv) remodeling.

a myocardial interstitial matrix, that provides structural support and integrity to the myocardium, is a key element to determine post infarction left ventricular remodeling (lvr). the metalloproteinases (mmps), an enzymatic system secreted in the extracellular medium by macrophages, has been shown to be able to degrade the most important extracellular matrix components. various animal experimental models have demonstrated that mmp specific inhibition in the first phase of myocardial infarction is able to contrast lvr. doxycycline, a member of the tetracyclines, has been shown to block various inflammation mediators and to attenuate mmp-2 and mmp-9 expression and activity at a sub-antimicrobial dosage. some experimental studies on rat models have suggested an anti-remodeling effect of doxycycline in myocardial infarction. in the present study we want to evaluate if a treatment with doxycycline (100 mg b.i.d.) in the first seven days after a reperfused large (ejection fraction less than 40%) acute myocardial infarction, is effective in preventing six-month lvr.

Eligibility criteria:
inclusion criteria: * acute myocardial infarction * left ventricular ejection fraction less than 40% exclusion criteria: * no written consensus * allergy to tetracycline * mechanical complication of ami * previous myocardial infarction * valvular and/or myocardiopathy known or suspected * renal failure (creatinine above 2 mg/dl) * connective tissue disease * pregnancy

Keywords: myocardial infarction ventricular remodeling matrix metalloproteinases doxycycline
pharmacokinetics of maraviroc and boosted atazanavir dual regimen in stable hiv-infected patients

Conditions: HIV Infection

Summary: the purpose of this study is to describe pharmacokinetics of maraviroc (mvc) 300 mg and atazanavir/ritonavir (atv/r) 200/100 mg qd in hiv-infected stable patients.

the rational of this study is to save therapeutic options, toxicity and costs. the available literature shows that antiretroviral regimens that do not include a nucleoside backbone of tenofovir resulted in less bone and kidney toxicity. atazanavir dosing 200/100 mg qd represents a simplification strategy correlated with virologic efficacy and a reduction of parameters toxicity associated. maraviroc is suggested as a possible drug associated to pi/r in dual therapies. even in this case, the available evidence supports the choice of the dosage of 300 mg/day.

Eligibility criteria:
inclusion criteria: * age\>18 years; * confirmed hiv-antibodies positivity; * signed informed consent; * hiv-rna \<20 cp/ml for the last 24 months; * no virological failures to pi regimens; * no major pi resistance associated mutations; * genotypic tropism for ccr5 co-receptor. exclusion criteria: * active opportunistic infections or neoplasms; * need for drugs with known drug-drug interactions with included drugs; * liver cirrhosis; * any evidence of tropism for cxcr4 or dual infection; * pregnancy; * self-reported adherence\<90%; * hbsag positivity; * detectable hcv rna.

Keywords: maraviroc atazanavir ritonavir
the digital version of holistic healthy life education(e2hle)

Conditions: Hypertension

Summary: the digital version of holistic healthy life education" (e2hle) is a holistic, person-centric, multi-component and lifestyle modification intervention that we developed, alongside the who integrated care for older people (icope) model and a home-based self-monitoring bio-signals system "hera leto". this randomized controlled trial aims to evaluate the effectiveness of e2hle intervention for achieving weight loss and enhancing self-care and intrinsic capacity (i.e. psychological and mental wellbeing, vitality and nutritional health) as well as improving cardio-metabolic profiles (e.g. blood pressure and lipid profile) compared to usual care.


Eligibility criteria:
inclusion criteria: * aged 50 years old or above, * able to use internet and tablet; * education level of primary or above; * understand chinese and speak cantonese; * have central obesity (waist circumference: male \>90 cm, female \>80 cm) and two of the following: (a) hypertension (systolic blood pressure ≥130 or diastolic blood pressure ≥85 mmhg, or treatment of previously diagnosed hypertension), (b) hyperglycemia (fasting plasma glucose ≥100 mg/dl (5.6 mmol/l) or (c) previously diagnosed type 2 diabetes), (d) hyperlipidemia (triglyceride concentrations ≥150 mg/dl (1.7 mmol/l), or treatment for this lipid abnormality); hdl cholesterol;40 mg/dl (1.03 mmol/l) in males and 50 mg/dl (1.29 mmol/l) in females, or treatment for this lipid abnormality), (e) bmi over 23; and chronic pain or bad mood caused by the psychosomatic disorder for no less than six months * have at least 2 of the following distressing symptoms due to psychosomatic or pain and stress symptoms, including physical and mental agitation, feeling tired, often crying, feeling angry/depressed, feeling isolated from family and friends, feeling great stress, insomnia, health is worse than before. exclusion criteria: * non-chinese nationality or can't speak cantonese; * participating in any cancer treatment; * will leave hong kong within a short period or the next three months; * participating in another experiment; living in or planning to live in a facility-care home; * cognitive difficulties (spmsq score equal to or lower than 4); * taking medications such as estrogenic, synthetic glucocorticoids, anti-steroids, and antiepileptic drugs which may affect cortisol levels.

Keywords: healthy lifestyle
a multi-center study to evaluate bone loss, survival rate and stability of spi implant

Conditions: Implant Clinical Survival; Dental Implant Bone Loss

Summary: the current prospective clinical study's aim is to determine abt's spi implant survival rate, crestal interproximal bone resorption during 24 months post implant insertion and to assimilate the drilling sequence during the clinical use of spi implants.


Eligibility criteria:
inclusion criteria: 1. men and women over the age of 18 years who need implantation of 1-4 implants. 2. patients who are able to understand the requirements of the study, and are willing and able to comply with its instructions and schedules. 3. patients who had provided written informed consent to participate in the study prior to any study procedure. 4. patients in general good health in the opinion of the principal investigator as determined by medical history and oral examination. exclusion criteria: 1. immediate loaded implants. 2. patient requiring bone augmentation 3. treatment with anticoagulant drugs (inr under 1.8) or bisphosphonates. 4. treatment with anticonvulsants drugs. 5. untreated periodontal disease and inability of the patient to maintain reasonable oral hygiene according to study requirements. 6. patients with history of alcohol, narcotics or drug abuse. 7. patients under steroid therapy. 8. patients receiving radiotherapy, chemotherapy or any other immunosuppressive treatment or who have been administered radiotherapy in the last 5 years. patients through at anytime received radiotherapy to the head and neck region will be excluded anyway. 9. metabolic bone disorders and/or bone augmentation. 10. uncontrolled bleeding disorders such as: hemophilia, thrombocytopenia, granulocytopenia. 11. degenerative diseases. 12. osteoradionecrosis. 13. renal failure. 14. organ transplant recipients. 15. hiv positive. 16. malignant diseases. 17. diseases that compromise the immune system. 18. unbalanced diabetes mellitus. (hba1c above 6.5) 19. psychotic diseases. 20. hypersensitivity to one of the components of the implant in general and titanium in particular. 21. women who are pregnant or lactating. 22. lack of patient cooperation. 23. uncontrolled endocrine diseases. 24. any systemic condition that is unbalanced and therefore precludes surgical procedures. 25. parafunctional habits.- e.g bruxism. 26. temporomandibular joint disease. 27. various pathologies of the oral mucosa for example: benign mucous pemphigoid, desquamative ginigivitis, erosive lichen planus ,malignancy of oral cavity, bolus erosive diseases of the oral mucosa. 28. flapless procedures. -
treatment to quit smoking

Conditions: Smoking

Summary: this protocol evaluates the efficacy of combining pharmacologic treatments for smoking cessation, entailing the use of the nicotine skin patch with the nicotinic antagonist mecamylamine, with a specific behavioral therapy designed to inhibit the smoking urge.

previous studies have found that nicotine/mecamylamine treatment more than doubles the long-term abstinence rates relative to nicotine replacement alone. recent evidence supports the hypothesis that nicotine/mecamylamine treatment prior to smoking cessation partially blocks the rewarding effects of cigarette smoking and hence promotes extinction of the smoking habit, facilitating subsequent abstinence. the behavioral approach employed is also an extinction strategy and involves having smokers switch to de-nicotinized tobacco cigarettes for two weeks prior to quitting smoking. it is hypothesized that the use of de-nicotinized cigarettes might provide more complete extinction than provided by the partial pharmacologic blockade using nicotine/mecamylamine alone. the pharmacologic treatment was expected to increase compliance with the de-nicotinized cigarette smoking regimen, because subjects' usual brands of cigarettes will be less appealing than in the absence of nicotine/mecamylamine treatment. together the brand-switching and nicotine/mecamylamine therapies were expected to reduce cravings and other withdrawal symptoms as well as increase long-term abstinence from smoking.

Eligibility criteria:
* smokers, * ages 18-65, wanted to quit smoking. * must be in good health * exclude cardiac disease, hypotensive or hypertensive, skin allergy, glaucoma, prostatic hypertrophy, pregnant women, drug or alcohol abuse, kidney disease.

Keywords: nicotine addiction cigarette smoking
family-based prevention program for childhood anxiety

Conditions: Anxiety Disorders

Summary: this study will evaluate the effectiveness of a short-term family-based program for preventing anxiety disorders in at-risk children.

anxiety disorders are serious conditions that can negatively impact a person's overall functioning. this study will enroll mothers with anxiety disorders and their children to determine whether a brief family-based intervention will reduce childhood anxiety better than standard care. participants will be randomly assigned to either the family-based prevention program or to evaluation only for 8 weeks. participants in the prevention program will have weekly sessions with a therapist and will learn skills to help reduce anxiety. self- and parent-reports, diagnostic interviews, a computerized memory task, and a videotaped parent-child interaction task will be used to assess participants. assessments will be conducted at study start and one week after intervention completion (week 9). follow-up visits will be conducted at 6 and 12 months after intervention completion.

Eligibility criteria:
inclusion criteria: * mothers with a current, primary anxiety disorder * 7-12 year old children without an anxiety disorder exclusion criteria: * mothers that do not have a current, primary anxiety disorder * 7-12 year old children with an anxiety disorder * 7-12 year old children that are currently receiving treatment for anxiety that could interfere with the study

Keywords: anxiety
lymph node mapping in patients with newly diagnosed endometrial cancer undergoing surgery

Conditions: Stage I Endometrial Carcinoma; Stage II Endometrial Carcinoma; Stage III Endometrial Carcinoma; Stage IV Endometrial Carcinoma

Summary: this clinical trial studies lymph node mapping in patients with newly diagnosed endometrial cancer undergoing surgery. lymph node mapping may help in planning surgery to remove endometrial cancer and affected lymph nodes.

primary objectives: i. to determine the detection rate, sensitivity, and negative predictive value of sentinel lymph node (sln) biopsy in endometrial cancer patients. secondary objectives: i. to compare different surgical modalities (open procedures, minimally invasive procedures, and single-site technology) and different injectants (isosulfan blue and indocyanine green) for sln biopsy. ii. to determine total operating room time (from the time the patient enters the room to the time the patient leaves the room) as well as console time (robotic)/operating time for minimally invasive procedures. outline: patients undergo sln mapping using isosulfan blue and/or indocyanine green solution injected directly into the cervix. following sln identification and biopsy, patients undergo hysterectomy, bilateral salpingo-oophorectomy, and/or complete pelvic lymphadenectomy. patients expressing sln positive for metastasis undergo para-aortic lymphadenectomy. after completion of study treatment, patients are followed up at 2-4 weeks.

Eligibility criteria:
inclusion criteria: * women must have newly diagnosed histologically or cytologically confirmed endometrial cancer * women should have received no prior therapy for their disease * women who are planning to undergo hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy for the management of their endometrial cancer * women must have the ability to understand and the willingness to sign a written informed consent document exclusion criteria: * women who are receiving any other investigational agents * women with a history of allergic reactions attributed to compounds of similar chemical or biologic composition to isosulfan blue or indocyanine green or other agents used in this study * women with hypersensitivity to phenylmethane compounds, or a history of allergic reaction to iodides * patients with uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements * women with a history of prior loop electrosurgical excision procedure (leep) or cone procedures performed on their cervix * women with a history of lymphedema, lymphoma, or lymphatic hyperplasia (castleman disease) * women with a history of a prior malignancy * women may also be excluded at the discretion of their surgeon if he or she feels that the patient is not an appropriate candidate
efficacy of two interventions increasing sensory stimulus in elderly patients with oropharyngeal dysphagia

Conditions: Dysphagia

Summary: this study will evaluate with videofluoroscopy (radiologic method to study the deglutitive physiology) the effect on the deglutition of two therapeutic treatments with the duration of 2 weeks, based on the increase of the sensorial stimuli in older patients with oropharyngeal dysphagia: 1. stimulation of transient receptor potential vanilloid 1 (trpv1) oropharynx chanels using a natural agonist administrated in the alimentary bolus. 2. stimulation of the sensorial neurons of the pharynx and larynx using transcutaneous electrical stimuli. moreover, with an electroencephalographic study we will assess the effect of both treatments in the cortical neuroplasticity.

this study will evaluate with videofluoroscopy (radiologic method to study the deglutitive physiology) the effect on the deglutition of two therapeutic treatments with the duration of 2 weeks, based on the increase of the sensorial stimuli in older patients with oropharyngeal dysphagia: 1. stimulation of transient receptor potential vanilloid 1 (trpv1) oropharynx chanels using a natural agonist administrated in the alimentary bolus. 2. stimulation of the sensorial neurons of the pharynx and larynx using transcutaneous electrical stimuli. the study will last 5 weeks per patient. at the beginning of the study, patients will receive a videofluoroscopic evaluation and an electroencephalography (evoked potentials) to asses dysphagia and cortical activity of deglutition. after that the first day of the third week they will begin the treatment (group a or b) during 2 weeks. finally in the fifth week an evaluation of dysphagia will be performed the same way as in week 1 to asses the effects of the treatments.

Eligibility criteria:
inclusion criteria: * elderly patients (≥70 years) with oropharyngeal dysphagia (od) * patients have to fill in and sign the written informed consent. * patients without any of the exclusion criteria. exclusion criteria: * patients not able to comply with the protocol. * patients currently participating or having participated in another clinical trial in the last 4 weeks. * patients with active neoplasia. * patients with an active infectious process. * patients with severe dementia or inability to communicate. * patients with pacemakers. * patients with implanted electrodes. * patients with epilepsy or convulsive disorders. * patients with gastroesophageal reflux disease.

Keywords: oropharyngeal dysphagia elderly transcutaneous electrical stimulation trpv1 agonist