Kornimate/medical-research-clean huggingface dataset:
continuum of care for frail elderly people

Conditions: Frail Elderly People

Summary: the present study "continuum of care for frail elderly people" form part of the research programme "support for frail elderly persons - from prevention to palliation" (www.vardalinstitutet.net) which comprises research into three interventions. the program comprises interventions addressing frail elderly people in different phases of the disablement process, from elderly people who are beginning to develop frailty to very frail elderly people receiving palliative care. the intervention "continuum of care for frail elderly people" addresses elderly people who are frail and that have a great risk of high health care consumption. the hypothesis is that an intervention program for frail elderly people can reduce the number of visits to the emergency department, increase the life satisfaction and maintain the functional ability. the intervention, including an early geriatric assessment at the emergency department, early family support, a case manager in the community with a multi-professional team and active follow-up by the case manager, contributes to early recognition of the elderly people's need of information, care and rehabilitation and of informal caregivers' need of information. it enhances the transfer of information and integrates the care between different caregivers and different care levels, thereby better recognize frail elderly people's needs. specifically, this study is expected to show that the intervention has a positive effect on the frail elderly person's functional ability, life satisfaction, satisfaction with health and social care, and health care consumption.


Eligibility criteria:
inclusion criteria: * 80 years and older or 65 to 79 years and having at least one chronic disease and being dependent in at least one activity of daily living exclusion criteria: * acute severely sick who immediately needs the assessment of a physician (within ten minutes) * those with diagnosis of dementia (or severe cognitive impairment) * patients in palliative care

Keywords: very frail case manager integrated care multiprofessional intervention
bupivacaine digital blocks: how long is the pain relief and temperature elevation?

Conditions: Pain

Summary: no one knows how long bupivacaine finger blocks last. many use bupivacaine with and without epinephrine, but no one knows how the epinephrine affects the duration of the block. we also don't know how long the pain part of the block lasts, which is what counts. the goal of the study is to determine the duration of action of bupivacaine digital nerve blocks (with and without epinephrine) on finger temperature and the sensory modalities of pain, touch, and pressure. 2 ml of bupivacaine 0.5% with and without epinephrine will be injected at the base of each ring finger on the palm surface. at the end of 1 hr, 6 hrs, 12 hrs, 14 hrs and each additional hour, patients will use an insulin lancet to measure pain, the semmes weinstein monofilament test to measure light touch and pressure and a body surface thermometer to measure finger temperature. the time for the finger to return to normal sensation and temperature will be measured.

lidocaine finger blocks have been shown to provide analgesia for nearly 5 hours without epinephrine and approximately 10 hours with epinephrine - essentially doubling its duration.1,2 the analgesic effect of epinephrine on the duration of bupivacaine finger blocks remains unknown. bupivacaine finger injection provides a much longer duration of action than lidocaine. previous studies have shown the duration of action to be as long as 24.9 hours.1 in the senior author's experience, however, patients who get bupivacaine blocks start asking for pain medication as early as 7 hours after the block. is it possible that the pain blocking effect of bupivacaine has a different duration than the touch and pressure effects? the answer to this question also remains unknown. the third unknown question about bupivacaine digital blocks is their effect on fingertip temperature. it has been shown that lidocaine wrist blocks increase temperature in finger tips, and this has been postulated to be potentially helpful in frostbite to provide pain relief and hyperemia.3 previous studies have shown bupivacaine to exhibit vasodilatory properties at clinical concentrations of injection.4-7 does bupivacaine provide increased warmth to the finger tip? how long does it last? the goals of this study are three fold: 1.) to determine what effect epinephrine has on the duration of bupivacaine finger block anesthesia. 2.) to assess the duration of action of bupivacaine with and without epinephrine on the digital sensory modalities of pain, touch and pressure, and 3.) to assess the finger tip temperature changes that result from bupivacaine digital blocks with and without epinephrine.

Eligibility criteria:
inclusion criteria: * healthy adult volunteer exclusion criteria: * under the age of majority * unable to give consent * pregnancy * diabetes * allergy to local anesthetic * prior finger surgery * preexisting digital vascular ischemia

Keywords: bupivacaine digital nerve block epinephrine duration of action pain touch pressure temperature
rattrap: infliximab versus rituximab in systemic necrotizing vasculitides

Conditions: Wegener's Granulomatosis; Churg-Strauss Syndrome; Microscopic Polyangiitis

Summary: the purpose of this study is to compare a 2 immunosuppressant regimen for the treatment of relapsing or refractory necrotizing antineutrophil cytoplasmic antibody (anca) associated vasculitides.

the aim of this study is to compare the efficacy of rituximab versus infliximab in relapsing or refractory forms of anca+ vasculitides (microscopic polyangiitis, wegener's granulomatosis and churg-strauss syndrome).

Eligibility criteria:
inclusion criteria: * systemic anca positive (+) vasculitides * relapsing or refractory vasculitides, resistant to corticosteroids and reference immunosuppressant therapies * age \>18 years old * written informed consent exclusion criteria: * newly diagnosed patient * patient that had never received an immunosuppressant before to treat his/her vasculitis * malignancy * pregnancy

Keywords: systemic anca+ vascularizes relapse corticosteroids immunosuppressant infliximab/rituximab patients with relapsing or refractory forms of anca associated vasculitides microscopic polyangiitis
acute kidney injury in covid-19

Conditions: Acute Kidney Injury

Summary: this is a prospective observational parallel group cohort study that will aim to recruit 220 participants who were admitted to the hospital with covid-19 between 1st march 2020 and 30th june 2020 (group a - 110 participants who had covid-19 with aki; group b - 110 participants who had covid-19 without aki). data from groups a and b will be compared with aki and non-aki groups from an existing study database (arid study, n=1125) who were recruited before the outbreak of the covid-19 pandemic (recruitment 2013-2016) and who have all completed at least three years of follow up. participants who have recovered from covid-19 will be matched for analysis to participants from the arid study for aki status, baseline estimated glomerular filtration rate (egfr) stage, age (± 5 years) and presence of diabetes. potential participants will receive a letter of invitation along with a comprehensive participant information sheet (pis).

after the participants have read and understand the pis, and had sufficient time (at least 24 hours) to consider their participation in this study, the investigators will ask them to sign a consent form, which shows their willingness to take part. the investigators will then collect information from their medical records about their hospital admission with covid-19, including their age, ethnicity, medical conditions, length of hospital stay, tablets or any other treatments they received, as well as details of their stay in the intensive care unit. for the two groups - covid aki and covid non-aki, telephone follow-up with a study questionnaire will be performed at recruitment, 6-9 months and 12-15 months after hospital discharge. the study questionnaire will include the following: 1. details of any medical event and date of medical event since last study follow-up. 2. details of any hospital re-admission. 3. details of current medication. in addition, at the same time points, participants will be asked to attend their general practitioner surgery or other clinic to have simple clinical measurements (height, weight and blood pressure), blood and urine tests.

Eligibility criteria:
inclusion criteria: 1. adult patients greater or equal to 18 years of age. 2. swab results positive for sars-cov-2. 3. patients admitted to the hospital for ≥24hrs. exclusion criteria: 1. paediatric patients as defined by age of \<18 years of age. 2. patients \>90 years of age. 3. swab results negative for sars-cov-2. 4. patients on haemodialysis or peritoneal dialysis, pre-existing ckd stage 5 (egfr \<15ml/min/1.73m2), solid organ transplant. 5. inability/refusal to give informed consent to participate. 6. death during the same hospital admission that aki occurred.
prevalence of rheumatic heart disease among pregnant women in kenya

Conditions: Cardiac Disease; Pregnancy Related

Summary: there is currently no routine screening for cardiac disease for pregnant women in areas of high prevalence. this study will aim to determine the point prevalence of cardiac disease in women presenting for antenatal care at moi teaching and referral hospital. more specifically, it will aim to use focused echocardiography as a screening tool to determine the prevalence of cardiac disease among pregnant women attending mtrh antenatal clinic.

rheumatic heart disease (rhd) in pregnancy can be associated with severe maternal and neonatal morbidity and mortality. early identification of these women and referral to specialized, multi-disciplinary care is essential. overall, studies on rhd prevalence are lacking in sub-saharan countries and a significant gap in the literature exists for the prospective assessment of disease in the context of pregnancy. at moi teaching and referral hospital, there are an estimated 3-4 cases per month of women presenting with acute exacerbations of either known or newly diagnosed cardiac disease. these women are often the most challenging clinically and emotionally for the reproductive health team to manage, and contribute to a significant number of the 2-3 maternal deaths per month at mtrh. there is currently no routine screening for cardiac disease in the mtrh antenatal clinics. this study will aim to determine the point prevalence of cardiac disease in women presenting for antenatal care at moi teaching and referral hospital. more specifically, it will aim to: 1. use focused echocardiography as a screening tool to evaluate cardiac structure and function; 2. use focused echocardiography as a screening tool to determine the prevalence of cardiac disease among pregnant women attending mtrh antenatal clinic.; 3. determine the proportion of pregnant women with cardiac disease who endorse clinical symptoms as a potential means to develop a screening tool; 4. promote a case-finding culture for cardiac disease in pregnancy

Eligibility criteria:
inclusion criteria: * pregnant women at any gestational age * capable to give informed consent exclusion criteria: * medically unstable: any condition or complication resulting from or independent of pregnancy that necessitates urgent care or that precludes full and informed consent process
outcomes of anti-hiv therapy during early hiv infection

Conditions: HIV Infections

Summary: the purpose of this study is to find out if it is effective to give aggressive anti-hiv therapy to patients who have been infected recently with hiv. many doctors recommend that patients who have recently been infected with hiv begin anti-hiv treatment as soon as possible. however, early hiv infection is not yet completely understood, so it is not known if this is the best approach. this study will look at the effects of beginning anti-hiv treatment during early hiv infection.

although many researchers have recommended initiation of aggressive antiretroviral therapy as soon as possible after hiv infection occurs, the tolerability and efficacy of this approach has not been systemically evaluated. many features of primary hiv pathogenesis are incompletely understood. a more complete understanding of immune dynamics and viral pathogenesis during primary hiv infection is critical to determine optimal treatment intervention strategies. this study will evaluate the outcomes of potent antiretroviral therapy initiated at different stages of primary hiv infection. thirty-six of the study patients are coenrolled to actg 371 or another treatment protocol. all study drug treatment and toxicity management is performed according to guidelines in these treatment protocols. an untreated cohort of 12 patients is also followed on this study. patients are stratified at enrollment according to their stage of acute or early hiv infection. patients are evaluated for virologic, immunologic, and clinical parameters for 96 weeks. in addition, novel studies of source partner identification are proposed. an effort is made to determine the most likely source partner(s) for each study patient on the basis of patient recall of possible exposures. a separate study protocol will evaluate the source partner.

Eligibility criteria:
inclusion criteria patients may be eligible for this study if they: * are at least 13 years old. * have acute or early hiv infection. the stage of hiv infection will depend on the results from certain lab tests. exclusion criteria patients will not be eligible for this study if they: * are pregnant or breast-feeding.

Keywords: immunity, cellular sexual partners treatment outcome anti-hiv agents viral load acute infection
an evaluation of the efficacy and safety of al-46383a ophthalmic solution for the treatment of adenoviral conjunctivitis

Conditions: Adenoviral Conjunctivitis

Summary: the purpose of this study is to evaluate the safety and efficacy of al-46383a ophthalmic solution for the treatment of adenoviral conjunctivitis.


Eligibility criteria:
inclusion criteria: * at least one eye must have either a positive adenovirus test (using the adeno detector™ for adenoviral conjunctivitis, rapid pathogen screening, inc.) or a positive clinical diagnosis assessed by the adenoviral clinical diagnostic checklist. * onset and development of ocular symptoms and/or signs of conjunctivitis ≤ 7 days prior to enrollment (day 1) in either eye. * able to understand and sign an informed consent form that has been approved by an institutional review board/ independent ethics committee (irb/iec). * must agree to comply with the visit schedule and other requirements of the study. * females who are not pregnant and are not lactating. all females of childbearing potential (those who are not pre-menarcheal, not postmenopausal or surgically sterile) may participate only if they have a negative urine pregnancy test prior to randomization, and if they agree to use adequate birth control methods to prevent pregnancy throughout the study. * other protocol-defined inclusion criteria may apply. exclusion criteria: * sub-epithelial infiltrates at the day 1 visit in either eye. * corneal opacity or any corneal abnormality at the day 1 visit in either eye. * contact lens wear during the course of the study. participants requiring correction must have spectacles with appropriate correction. * only one sighted eye or vision in either eye not correctable to 0.6 or better logmar (using etdrs chart) at the day 1 visit. * abnormal findings in the posterior pole of the retina or any media opacity found in a dilated fundus examination at the day 1 (screening/ baseline) visit. * suspected fungal, herpes, chlamydia or acanthamoeba infection, based on clinical observation. * history of active uveitis or iritis in either eye. * history of corneal transplant in either eye. * presence of nasolacrimal duct obstruction at day 1. * use of specified prohibited medications. * other protocol-defined exclusion criteria may apply.

Keywords: pink eye eye infection conjunctivitis
effectiveness of a treatment with the robot - assisted gait training system walkbot in patients with cerebral palsy

Conditions: Cerebral Palsy

Summary: the improvement of walking capacity is a key objective of the rehabilitation of children with pc. there are different approaches from physiotherapy to address this need, including walking on the ground and on treadmill with partial weight support. currently, there are robotic technologies adapted to the functional rehabilitation of patients. assisted gait training with robotic devices such as the walkbot allows a longer duration of training, at more variable speeds, and with a constant gait pattern adapted to the patient. this training, based on the intensity and repetition of the movement, has beneficial effects on the recovery and improvement of the patient's postural and locomotor functions. there are some studies that evaluate walking interventions on treadmill with partial weight support, on the ground and in assisted walking robot in patients with pc. currently, there are no studies conducted that report the effectiveness of interventions performed with robotic walking training device walkbot k on pc. however, studies in adults with walkbot s, affected with neurological injury, have reported good results. assisted gait training with robotic devices such as the walkbot, based on the intensity and repetition of the movement, has beneficial effects on the recovery and improvement of the patient's postural and locomotor functions. however, due to the little evidence that exists, it is necessary to know the effectiveness of the walkbot assisted walking robot in these patients by means of a clinical trial that allows to firmly establish the scope of its benefits.


Eligibility criteria:
inclusion criteria: * cerebral palsy diagnosis (diplegia or tetraplegia) * ability to communicate even if not verbal (yes/not; gestures; pictograms; sounds) * levels ii, iii and iv in gmfcs * unsupported seating capacity * go on standing with or without help * not receiving therapy with a walking robot and not having received it in at least one year exclusion criteria: * serious psychiatric problems * serious heart problems * active tumors * severe joint degenerative problems * degenerative diseases of the nervous system * mitochondrial diseases * recent surgeries * unbound fractures * severe osteoporosis * uncontrolled seizures * open wounds in the lower half of the body * extreme fear of being placed in robotic devices * anthropomorphic measures are below the minimum required to use the device
taxotere + cisplatin in nasopharyngeal carcinoma

Conditions: Nasopharyngeal Neoplasms

Summary: primary objective: to assess and compare the toxicities of patients with advanced npc treated with concurrent cisplatin-radiotherapy with or without neoadjuvant taxotere (docetaxel) and cisplatin. secondary objective: to assess tumor control and survival


Eligibility criteria:
inclusion criteria: * international union against cancer stages iii and iv newly diagnosed npc exclusion criteria: * inadequate bone marrow reserve * inadequate renal function * other primary malignancy * evidence of distant metastases the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
tiii over ti in subjects with myocardial infarction

Conditions: NSTEMI - Non-ST Segment Elevation MI

Summary: study was performed to identify ecg criteria for unmasking of subjects with nstemi at elevated risk.

in the present study the investigators assessed the value of t wave changes in subjects with nstemi (tiii\>ti).

Eligibility criteria:
inclusion criteria: * nstemi and pci exclusion criteria: * nstemi without percutaneous intervention

Keywords: nstemi, ecg
a study with central nervous system metastatic egfr mutation positive non-small cell lung cancer

Conditions: NSCLC

Summary: this is a descriptive observational study, in which data are collected in an epidemiological fashion and prospective. this study does not intend to intervene the current medical practice of the recruited patients.

this is a descriptive observational study, in which data are collected in an egfr mutant nsclc. our research plan aims to use multi-omics approaches to predict the likelihood of patients developing brain metastases, assess the prognosis of brain metastasis treatment, and identify potential biomarkers.

Eligibility criteria:
inclusion criteria: * patients must be ≥18 years. * provision of fully informed consent prior to any study specific procedures. * patient with egfr 19del or l858r mutation diagnosed histologically or cytologically. the mutations above may exist alone or together. * patients must have untreated advanced non-small cell lung cancer (nsclc). * according to the recist 1.1 standard, the patient must have at least one measurable lesion. exclusion criteria: * none
morphology effects of extended wear hearing instrument

Conditions: Hearing Loss

Summary: the lyric hearing device is a commercially available device produced by sonova, and designed to be used for extended periods of time. we further want to investigate the morphology of the tissue around the device at different periods of time after the device has been fitted and used for a while. an initial imaging of the tissue will be taken for baseline measurements. questionnaires will also be used to assess patients satisfaction with the device and cognitive abilities.

if the person seems to be a good candidate for the study, the audiologist could discuss with the patient the time involved in the study and arrange an appointment with the patient if interested. a series of appointments are designed to follow up the patient's development with the device at determined times during the process. on the first appointment the patient will be consented prior to any tests or health services given. the first and last appointments are the longest ones with a duration of about 1 and a half hours for questionnaires, medical history, and device fitting. additionally, all appointments include measurement of ear canal relative humidity which should take a total of 30 minutes and imaging of the area to determine thickness and blood flow in the tissue surrounding the device. follow-up appointments with the audiologist will take 45 minutes for all basic procedures. the lyric device is used commercially and audiologist can provide it to patients already, but the purpose of this study is to use a pioneer technique with a device that looks inside the ear canal in the same way as a regular used speculum to look at details of the tissue around the device to see if any changes occur due to extended wear of the lyric hearing aid device. the complete study per person will be completed in about six months. an audiologist will perform all the audiology testing plus the ear canal humidity measurements and his/her time will be covered by the sponsor (a total of 9 hours per patient). the lyric devices will be provided on loan by the sponsor as well as the equipment and software needed to make the ear canal humidity measurements. the imaging measurements will be conducted by the audiologist trained in using the handheld device.

Eligibility criteria:
inclusion criteria: * adult patients in the usc otolaryngology clinic who are determined to be candidates for a lyric extended wear hearing aid device by their treating audiologist (in general people with mild to moderate hearing loss may be eligible). exclusion criteria: * patients in the usc clinic who are determined by the audiologist not to be good candidates for the hearing aid extended wear device (in general, people with severe hearing loss are not eligible).

Keywords: hearing loss, hearing aid