Kornimate/medical-research-clean huggingface dataset:
a randomized controlled study of cognitive behavioral therapy for adults with attention deficit disorder

Conditions: Attention Deficit Disorder

Summary: the purpose of this study is to determine whether cognitive behavioral therapy (cbt) is effective in the treatment of attention deficit and emotional, executive function and social function dysregulation due to attention deficit disorder (adhd).

participations will be randomly assigned to 3 groups which are cbt with booster sessions group, cbt only group and waiting group.with the comparison of first tow groups we will explore the effect of booster sessions, and the last two groups the effect of cbt programme.

Eligibility criteria:
inclusion criteria: * outpatients from peking university sixth hospital * diagnosis of adult adhd based on diagnostic and statistical manual of mental disorders, fourth edition (dsm-iv) * stable on medications for adult adhd for at least 2 months exclusion criteria: * severe major depression, clinically significant panic disorder, bipolar disorder, organic mental disorders, psychotic disorders, or pervasive developmental disorders * intelligence quotient (iq) less than 90 * suicide risk * unstable physical condition * prior participation in cognitive behavioral therapy for adhd or other psychological therapy

Keywords: attention deficit disorder (adhd) cognitive behavioral therapy (cbt) adult
a guided self-determination intervention versus attention control for people with type 2 diabetes in outpatient clinics

Conditions: Type 2 Diabetes

Summary: background in management of type 2 diabetes, autonomy supporting interventions may be a prerequisite to achieve 'real life' patient engagement and more long-term improvement. preliminary evidence has previously shown that the autonomy supporting intervention, guided self-determination method might have effect on hba1c and diabetes distress in people with type 1 diabetes. however, previous trials were all rated as high risk of bias and did not assess potential harm of the the intervention. thus, in the current trial, the objective is to investigate the benefits and harms of guided self-determination interventions versus an attention control group intervention in adults with type 2 diabetes. methods/design the trial planned is a randomised, pragmatic, investigator-initiated, dual-centre, parallel group, clinical superiority trial of guided self-determination intervention versus an attention control group for people diagnosed with type 2 diabetes in outpatient clinics. the participants (n=224) will be recruited from the department of endocrinology at a university hospital of copenhagen, the capital region of denmark and from steno diabetes center odense, university hospital in the southern region of denmark. the experimental stepped-care intervention will consist of 3-5 analogue or digitally provided guided self-determination sessions lasting up to one hour with a guided self-determination facilitator. the attention control group will receive similar number of sessions lasting up to one hour with a communication trained healthcare professional provided face-to-face, digitally, or over telephone.this trial protocol is guided by the spirit and consort guidelines. participants will be included if they have type 2 diabetes, \> 18 years old, and, are not pregnant. participants will be assessed before randomisation, at 5- and 12-months follow-up. the primary follow-up timepoint will be 12-months follow-up. the primary outcome will be diabetes distress. secondary outcomes will be quality of life, depressive symptoms, and adverse events not considered serious. exploratory outcome will be glycated haemoglobin, motivation, and serious adverse events. data will be collected using redcap. the analyses will be performed using the statistical programme stata version 16.


Eligibility criteria:
inclusion criteria: * \>18 years of age. * diagnosed with type 2 diabetes ≥ 3 months according to the international classification system of diseases (icd-11.2-11.9) \[43\]. * signed informed consent exclusion criteria: * pregnancy * prior participation in gsd course(s) for the past two years * lack of signed of informed consent
oral refeeding intolerance after nasogastric tube feeding (orion)

Conditions: Acute Pancreatitis

Summary: acute pancreatitis (ap) is one of the most common diseases in routine clinical practice of surgeons and gastroenterologists throughout the world. the high rate of pain relapse after oral refeeding contributes to high consumption of healthcare resources and prolonged hospital stay in ap patients. the data from the pilot mimosa trial suggest that early administration of nasogastric tube feeding may prevent pain relapse after oral refeeding in ap. the potential beneficial effects of enteral tube feeding include induction of postprandial gastrointestinal motility and improving the tolerance of oral refeeding. this may reduce the risk of pain relapse, thereby shortening length of hospital stay and reducing cost of treatment. the primary endpoint of the orion trial will be the incidence of oral food intolerance. all eligible ap patients will be randomly allocated to either the early nasogastric tube (ent) group or conventional nutritional management group (cnm) at 24h of hospital admission.


Eligibility criteria:
inclusion criteria: * diagnosis of ap * age 18 years or older * written informed consent * ongoing need for opiates exclusion criteria: * 96 hours after onset of symptoms * chronic pancreatitis * post-ercp pancreatitis * intraoperative diagnosis * pregnancy * malignancy * received nutrition before randomisation

Keywords: enteral nutrition acute pancreatitis oral food intolerance
validation of the euroscore ii in open and trans-catheter mitral valve repair.

Conditions: Mitral Valve Regurgitation

Summary: the euroscore ii is widely used to predict 30-day mortality in patients undergoing open and trans-catheter cardiac surgery * however, it has not been validated in patients undergoing surgical or trans- catheter mitral valve repair. * the aim of this study is to evaluate the predictive value of the euroscore ii in estimating 30-day mortality in a large cohort of patients undergoing surgical and trans-catheter repair by means of mitraclip implantation. methods * institutional database retrospective review for surgical mitral repair and mitraclip implantation. * time frame: january 2012-december 2019 * 2793 patients identified; euroscore ii 1.3% \[0.6%-2%\] * survival after hospital discharge was assessed by outpatients visit, usually done 2 months after the index procedure. statistical analysis * receiver operating characteristic (roc) curves were used to determine the cut-offs of euroscore ii. roc area under the curve (auc) values varies between 0 and 1, where 0.5 denotes a bad diagnostic test and 1 denotes an excellent diagnostic test. * the maximum youden's index (j=sensitivity + specificity - 1) was employed to define the optimal cut-point. * roc curves were repeated for surgical and mitraclip patients separately, and for primary and secondary etiology as well.


Eligibility criteria:
inclusion criteria: * patients undewent mitral valve repair with an open surgical approach, also in association with concomitant procedures (for example, but not limited to, aortic valve replacement, tricuspid repair, etc.) * patients undergoing transcatheter mitral valve repair with mitraclip implantation * patients operated on at the u.o. of cardiac surgery at the san raffaele hospital from january 2012 to december 2019 exclusion criteria: * patients underwent mitral valve replacement with prosthesis * cardiac surgery patients not eligible for mitral valve surgery * patients undergoing mitral implantation, both open and transcatheter, of devices in experimental clinical study (e.g., but not limited to, adjustable rings and neocords, etc.)
effect of shock waves on tooth movement and miniscrew stability

Conditions: Mesial Movement of Teeth; Miniscrew Stability

Summary: the low-energy extracorporal shockwave is a scientifically approved method to activate respectively increase bone-turnover processes especially in orthopedic medicine. the aim of this clinical study is to apply this effect in orthodontic dentistry and evaluate the orthodontic tooth movement respectively miniscrew stability clinically. this randomized clinical study is carried out in orthodontic patients undergoing space closure therapy at the university clinic of dentistry. during this period the tooth movement rate as well as the miniscrew stability are evaluated consecutively chairside.


Eligibility criteria:
inclusion criteria: * healthy patients which don´t fulfill the exclusion criteria exclusion criteria: * disease (syndroms,infections,...) which influence the bone turnover and the oral health * medication, which influences the bone turnover and the oral health * pregnancy

Keywords: velocity location periodontal status
radiographic evaluation of adaptation of universal adhesives

Conditions: Class II Dental Caries

Summary: class 2 restorations are analyzed to see whether or not the use of modified universal adhesive will result in similar adaptation to conventional universal adhesive.

the newly modified adhesive with its careful formulation offers: radiopacity like dentin to reduce the risk of x-ray misdiagnosis and overtreatment. ability to bond and seal caries-affected dentin to support minimally invasive preparation guidelines and maximize preservation of natural tooth structure. adhesion to all dental substrates and all direct and indirect materials, including glass ceramics. full dual- and self-cure compatibility without the need for an additional dual-cure activator bottle. a bisphenol a (bpa) derivative-free formulation to alleviate concerns about bpa in dental materials. a fully aligned system with relyx™ universal resin cement, offering excellent bond strength for virtually all dual-cure resin cement indications. as with any new material or technique, clinical evaluations are needed to demonstrate the value of universal bonding agents adequately. therefore, the aim of the current study was to evaluate adaptation of class 2 restorations either using radio-opaque universal adhesive or universal adhesive using digital radiography.

Eligibility criteria:
inclusion criteria: * small to moderate carious proximal lesions. (international caries detection and assessment system (icdas) scores 3,4) * good oral hygiene (mild to moderate plaque accumulation) * vital teeth with no signs of irreversible pulpitis. * presence of favorable occlusion and normal contact with adjacent teeth. exclusion criteria: * patients with systemic diseases, severe medical complications or allergic history concerning methacrylates. * lack of patient compliance, pregnancy, rampant caries, heavy smoking or xerostomia. * evidence of parafunctional habits and tempromandibular joint disorders. * deep carious defects (close to pulp, less than 1 mm distance). * teeth with signs and symptoms of irreversible pulpitis or pulp necrosis. * endodontically treated teeth. * tooth hypersensitivity. * possible prosthodontic restoration of teeth. * heavy occlusion and occlusal contacts or history of bruxism. * severe periodontal affection.
mulligan mobilization versus instrument assissted soft tissue mobilization in chronic iateral epicondylitis

Conditions: Lateral Epicondylitis

Summary: this study will be conducted to compare between mulligan mobilization and instrument assisted soft tissue mobilization on pain intensity, range of motion, hand grip strength, and hand function in the treatment of chronic lateral epicondylitis

lateral epicondylitis is one of the elbow conditions that affects about 1-3% of the population at large. it produces a heavy burden of workdays lost and residual impairments. although many treatment modalities are used, few of them rest on scientific evidence and none has been proven more effective than the others. this lack of evidence on treatments for lateral epicondylitis may stem from several sources, including the possible self-limiting nature of the condition, the lack of pathophysiological data, the methodological shortcomings of available studies, and the existence of numerous factors influencing the outcome. the physiotherapeutic treatment has been shown to be effective. in general, it must include manual therapy to relieve the pain and improve the joint's range of motion (rom), taking into account that it must be performed under the pain threshold. mulligan mobilization with movement (mwm) is a modern technique developed by mulligan for treating lateral epicondylitis (le). instrument-assisted soft tissue mobilization is a form of augmented soft tissue mobilization (iastm) in which stainless steel instruments are utilized to apply controlled microtrauma to the affected soft tissues. sixty patients will be allocated randomly to three groups; the first one will receive mulligan mobilization with movement, the second one will receive instrument-assisted soft tissue mobilization and the third one will receive traditional therapy three times a week for four weeks

Eligibility criteria:
inclusion criteria: all patients will be diagnosed with chronic lateral epicondylitis from both genders. patients with chronic lateral epicondylitis were diagnosed by orthopedists. positive clinical manifestation in all patients. patients' age will be ranged from 18 to 80 years, pain onset is more than 3 months. all participants must be medically stable and not be treated with analgesics or any medication which may cause misleading results. all patients have a body mass index between 18.5 and 29.9 kg/m2. exclusion criteria: patients who received an intra-articular injection for a duration of less than 3 months. patients receiving oral or injected corticosteroids for the last 3 months at least. history of elbow surgery/fracture. acute synovitis/arthritis including infectious. presence of malignancy. pregnancy. patients with, topical lesions, contact dermatitis, and a history of cutaneous hypersensitivity

Keywords: instrumented assisted soft tissue mobilization mulligan mobilization lateral epiconylitis
radio frequency ablation in unresectable malignant biliary obstruction

Conditions: Bile Duct Neoplasms; Gall Bladder Carcinoma

Summary: endoscopic retrograde cholangio pancreatography procedure will performed as per local standard procedure.after common bile duct cannulation,cholangiography will be performed (to confirm the stricture) followed by biliary sphincterotomy. all biliary strictures(bismuth type i/ii/iii/iv) will be enrolled for the study. patient opting for uncovered self expandable metallic stent / plastic stent will undergo biliary stent placement and considered under control arm patient opting for radio frequency ablation + uncovered sems/plastic stent will undergo radio frequency ablation and biliary stent placement and considered under study arm the rfa probe will be inserted into the bile duct alongwith the guidewire. keeping the electrode overlapping the stricture, rfa will be performed using a power of 10w for 120 seconds. the electrode will be kept at the ablation site for an additional 1 minute to allow the rfa probe to cool before removal to prevent thermal injury of normal tissue and/or endoscope accessory channel. if the stricture is more than 3 cm, step-by-step rfa will be performed from the superior to inferior aspect. after rfa application, an uncovered sems/plastic stent will be placed.

placement of self expandable metallic stent is the standard of care in the palliative management of patients with malignant biliary strictures . relieves biliary obstruction and jaundice. self expandable metallic stent provide efficient drainage and have superior patency rates compared with the plastic stents endoscopic radio frequency ablation combined with stent placement can significantly prolong survival and the stent patency period without increasing the incidence of adverse events in patients with extra hepatic cholangiocarcinoma patient. compared to plastic/ metal stent placement alone the addition of radio frequency ablation to stent placement would have better outcomes.

Eligibility criteria:
inclusion criteria: 1. age 18-75 years 2. malignant biliary obstruction confirmed using computed tomography (ct) or abdominal magnetic resonance imaging(mri), with pathological confirmation whenever possible; 3. clinical jaundice, a serum bilirubin level greater than 5 mg/dl, and/or cholangitis; 4. ecog performance status score≤2 5. un resectability or refusal to be surgically treated. 6. eligible patients were those with biliary obstruction due to cancer of the gallbladder, or bile ducts; who were considered unsuitable for surgery because of distant metastases, vascular invasion, or severe disability due to age or associated diseases. 7. non-resectability was established through the consensus opinion of a multidisciplinary tumor board. 8. written informed consent signed by the patient. exclusion criteria:
tight glycemic control by artificial pancreas

Conditions: Pancreatic Disease; Cardiovascular Diseases

Summary: hyperglycaemia has been repeatedly associated with risk of mortality and morbidity in the intensive care unit (icu). the evidence currently available is in favour of a 'normal ≤ 6.1 mmol/l' level for blood glucose control in icus according to two large randomized control trials of van den berghe g and is not supportive of j. miles's viewpoint in this debate. in this study, the investigators would like to evaluate that the target of blood glucose level, whether is a normal level (80-110 mg/dl) or another level (140-160 mg/dl), should be set for the reduction of perioperative mortality and complications.

our previous prospective randomized clinical trial suggested that the postoperative morbidities were reduced by tight glycemic control of a normal level for blood glucose using artificial pancreas. however, the most feared one is hypoglycaemia, which, when severe and prolonged, may cause convulsions, coma and brain damage, as well as cardiac arrhythmias. recently, ven den berghe g report that the development of accurate, continuous blood glucose monitoring devices, and preferably closed-loop systems for computer-assisted blood glucose control in the icu, will help to avoid hypoglycaemia. in our study, no hypoglycemia showed in more than 100 patients who performed perioperative tight glycemic control by artificial pancreas.

Eligibility criteria:
inclusion criteria: * patients who were suffering from liver, pancreas or cardio-vascular diseases, were informed of the purpose and details of the study, and written consent was obtained from them prior to enrolment. exclusion criteria: * patient exclusion criteria included a body weight loss greater than 10% during the six months prior to surgery * the presence of distant metastases, or seriously impaired function of vital organs due to respiratory, renal or heart disease.

Keywords: surgery artificial pancreas tight glycemic control liver
inspiratory muscle training during right-heart catheterization

Conditions: Right-heart Hemodynamics; Respiratory Muscle Training; Inspiratory Resistance

Summary: the purpose of this study is to assess hemodynamic effects of inspiratory muscle training during routinely performed right-heart catheterization.

during the last years, respiratory muscle training (rmt) in patients with impaired respiratory muscle function, e.g. in chronic obstructive pulmonary disease (copd), is increasingly applied. rmt can be done by applying increased respiratory effort for several minutes via an apparatus providing an inspiratory stenosis. threshold imt® (philips respironics) for example is such a training device, which is in the market for several years now and which has been used to conduct studies applying rmt. for example, it has been shown that training with the threshold imt® in patients with copd increases inspiratory muscle strength, endurance and functional capacity and ameliorates dyspnea and quality of life. furthermore, patients suffering from cardiac illness can also be affected by respiratory muscle impairment, which can add to their cardiogenic dyspnea. rmt can help improve dyspnea and physical exercise capacity in those patients as well. to date, no studies have been performed addressing acute hemodynamic effects of inspiratory muscle training. however, this is of special interest: copd as well as heart failure patients show an increased prevalence of pulmonary hypertension. in case of suspected pulmonary hypertension, patients usually are subjected to right-heart catheterization (rhc) to arrive at a definitive diagnosis and assess severity and etiology of potentially present pulmonary hypertension. rhc is also a sensitive method to exclude an intracardial shunt in copd patients. in this study, patients who are routinely subjected to rhc for the above mentioned reasons will be instructed to do rmt using the threshold imt® during rhc. two days in advance they will begin a guided training to get familiar with the threshold imt®. the device's inspiratory resistance can be set between 9 and 41 cm h2o. a single training session consists of 7 cycles with 2 min inspiratory training each, followed by a 1 min break (total duration 21 min). rmt will be conducted with 20-30% of individual inspiratory muscle strength, which will be measured beforehand. during the rhc procedure the patients will again conduct rmt as instructed while the suspected hemodynamic effects will be documented.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * indication for right-heart catheterization * informed consent provided exclusion criteria: * age \< 18 years * inability or contraindication to undergo right-heart catheterization * inability or contraindication to undergo respiratory muscle training as required per protocol * pregnancy, lactation * any medical, psychological or other condition restricting the patient's ability to provide informed consent * participation in another clinical trial

Keywords: right-heart catheterization respiratory muscle training inspiratory resistance hemodynamics
analysis of clinical and laboratory variables with prediction capability for indication of invasive mechanical ventilation in patients with covid-19

Conditions: COVID-19

Summary: this observational and retrospective study will follow the recommendations of the strengthening the reporting of observational studies in epidemiology (strobe). the aim is to verify and analyze the clinical and laboratory variables with prediction capability for indication of invasive ventilatory support in patients with covid-19. the present study will be carried out in specific care units for patients with suspected or confirmed covid-19. individuals with suspected or clinical diagnosis of covid-19, with a minimum hospital stay of 24 hours and submitted to oxygen therapy or non-invasive ventilation will be selected. clinical and laboratory variables will be collected from the moment of admission and every 12 hours until the third day of hospitalization. the primary outcome will be rate of endotracheal intubation, while secondary outocomes will be lenght of stay in intensive care unit, and hospital, as well as mortality rate.

clinical and laboratory data will be collected from medical records from the period of the covid-19 pandemic (february 2020 to june 2021)

Eligibility criteria:
inclusion criteria: * the inclusion criteria will be individuals with confirmed diagnosis of covid-19 by rt-pcr (reverse- transcriptase polymerase chain reaction), with minimum length of stay of 24 hours in the icu and, patients who sign the free and clarified consent. exclusion criteria: * the exclusion criteria for participation in the study will be as follows: (1) patients under the age of 18; (2) patients with a negative laboratory test for covid-19; (3) patients in need of emergency intubation; (4) patients who underwent previous endotracheal intubation at the same hospitalization.

Keywords: mechanical ventilation covid-19