Kornimate/medical-research-clean huggingface dataset:
using practice facilitation in primary care settings to reduce risk factors for cardiovascular disease

Conditions: Cardiovascular Disease; High Blood Pressure

Summary: the primary purpose of this study is to evaluate the effectiveness of practice facilitation as a quality improvement strategy for implementing the million hearts' abcs treatment guidelines for reducing cardiovascular disease (cvd) among high-risk patients who receive care in primary care practices in new york city. the abcs refer to the following: aspirin in high-risk individuals (a), blood pressure control and management (b), cholesterol management (c), and smoking cessation (s). the long-term goal is to create a robust infrastructure to disseminate and implement evidence based practice guidelines (ebpg) findings in primary care practices and improve practices' capacity to receive and implement other ebpg findings in the future.


Eligibility criteria:
inclusion criteria: provider and staff eligibility inclusion criteria. * eligibility includes working full or part time at the study site. stakeholder eligibility inclusion criteria. * steering committee members or other key stakeholder from the following groups: health plan chief medical officer, state health officials in the chronic disease program, and leadership from relevant national associations (american heart association), members of advisory board of chcanys (these are physician leaders). patient eligibility inclusion criteria: * at least one of the abcs risk factors for cvd (i.e., hypertension, hyperlipidemia, eligible for aspirin and/or is a current smoker) * must have received care at the clinic for at least 12 months * patients eligible for aspirin are those with a documented icd-9 code for ischemic vascular disease in the last 12 months. similarly, patients with a diagnosis of hypertension and/or hyperlipidemia will have a documented icd-9 code for the targeted risk factor * smokers will be identified by a documented icd-9 code, prescription for a cessation medication in the last 12 months or documentation in the chart (e.g. meaningful use measure) during the last 12 months (see outcome measures)

Keywords: cholesterol smoking aspirin chronic care model
cardiotoxic effects of chemotherapy in patients with sarcomas: a two and three-dimensional echocardiographic speckle tracking imaging study

Conditions: Sarcoma

Summary: this study is being done to identify markers that will allow researchers to identify in advance patients with sarcomas who are at highest risk for developing heart failure related to chemotherapy.

primary objectives: i. to detect acute and subacute changes in myocardial function by two-dimensional (2d)-speckle tracking echocardiography (ste) derived strain and strain rate in sarcoma patients undergoing chemotherapeutic treatment. ia. to compare 2d-ste and three-dimensional (3d)-ste derived strain and strain-rate; ib. to compare 2d-ste and 2d- and 3d-left ventricle ejection fraction (lvef); ic. if feasible, to compare 2d-ste and cardiac biomarkers \[serum cardiac troponin t and n-terminal fragment of brain natriuretic peptide (nt-probnp)\]. ii. to predict chemotherapy-induced cardiotoxicity by using 2d-ste and/or other significant parameters for early detection of cardiac dysfunction. outline: this is an observational study. patients receive anthracycline once a day or split between 2-3 days per standard of care (soc). patients undergo 2d-ste throughout the study and have their medical records reviewed on study.

Eligibility criteria:
inclusion criteria: * patients followed at mayo clinic and treated for sarcoma with doxorubicin as first-line treatment exclusion criteria: * first-line treatment not including doxorubicin * treatment performed outside of mayo clinic with different protocols * age \< 18 years
intrathecal atropine versus intravenous ondasetron in post operative nausea due to intrathecal morphine

Conditions: Perineal Surgery

Summary: to compare between intrathecal atropine versus preoperative administration of iv ondansetron in decreasing incidence of post operative nausea and vomiting related to intrathecal opioids in post operative period in perineal surgery as regard : efficacy and side effects .


Eligibility criteria:
inclusion criteria: * age between ( 18 - 45 ) years. * body mass index between ( 18.5 - 35 ) * patients undergoing perineal surgery as anal fissure , piles and rectocele * patients receiving bupivacaine ( 20 mg / 4 ml ) as spinal anesthesia * patinets with physical status 1 or 2 according to asa classification exclusion criteria: * patient refusal . * any contraindication of neuraxial block as : coagulopathy , skin infection at injection site or bacteremia , hypovolemia and shock , history of allergy to l.a , sever aortic stenosis or mitral stenosis ......... etc * patients with physical status other than 1 and 2 according to asa classification * those with history of nausea and vomiting , also those who received anti emetic drugs in last 2 hours of operation . * allergy to any of the drug included in this study .
longitudinal long-term study (10 years) of the sample of first episode of non-affective psychosis: pafip

Conditions: Schizophrenia

Summary: schizophrenia is a chronic brain disease that is still understood as a condition that limits the development of a normal life for the patient who suffers it and their families. the idea that only one third of patients have a good outcome is still in force, despite the lack of clinical and epidemiological longitudinal studies that have addressed this issue rigorously. most studies that have established the poor prognosis of the disease have followed a cross-sectional design and are based on samples of patients undergoing treatment in healthcare devices and therefore represents an important bias. based on clinical, cognitive, functional outcome and biomarkers studies (brain imaging) to medium term (3 years) we can establish that the particular idea of poor prognosis should be reconsidered. the development of longitudinal studies of first-episode patients in representative samples of a population and long-term it is of high value to shed light on the clinical course of the disease. the belief that there are factors determining the disease progression beyond the initial three years brings us to publish this study. given this background, our project's main objective is to know the evolution at 10 years of patients followed in the first episode psychosis clinical program (pafip). our hypothesis is that a higher percentage of expected patients have a favorable outcome of the disease. factors such as enhancing treatment completion, abstinence from drug use, return to work, the reduction of expressed emotion in families during the early years of the disease (at least 3 years of intensive intervention pafip) will have a positive impact on the evolution of patients on long-term (10 years). our hypothesis defends the existence of certain factors as independent risk factors for poor clinical and functional outcome of patients who should be known for establishing intervention strategies that attempt to mitigate their impact on the quality of life of patients and their families.


Eligibility criteria:
inclusion criteria: * patients followed in the first episode psychosis clinical program (pafip) from february 2001 to december 2007. * diagnostic and statistical manual of mental disorders, fourth edition (dsm-iv) criteria of brief psychotic disorder, schizophreniform disorder, schizophrenia or schizoaffective disorder. exclusion criteria: * meeting dsm-iv criteria for drug dependence. * meeting dsm-iv criteria for mental retardation. * having a history of neurological disease or head injury.

Keywords: psychosis schizophrenia
prognostic value of cardiovascular risk of sst2 and troponin i-hs in patients with acute chest pain

Conditions: Acute Chest Pain; Acute Coronary Syndrome

Summary: the role of the sst2 biomarker has been widely explored in heart failure, so much so that it was included in the aha guidelines in 2013 and 2017. recently, several studies are proposing a role of sst2 in the prognostic stratification of patients with acute coronary syndrome and ischemic heart disease, in association with other biomarkers even proposing a possible therapeutic differentiation. the combined use of sst2 with high-sensitivity troponins could be a promising strategy to identify those patients who, despite having early rule-out after evaluation at the emergency department, have a higher risk of onset of cardiovascular events in the medium-long term.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years; * chest pain of presumable cardiac origin and uncertain etiological diagnosis * ecg not diagnostic for ischemia * troponin values within normal ranges exclusion criteria: * stemi myocardial infarction * sepsis and viral infections * patients with ecg abnormalities that make it uninterpretable for ischemic purposes * patients with previous coronary events * history of heart failure * known diagnosis of cardiovascular disease, acute or chronic, including pericarditis, myocarditis * conditions involving sst2 elevations unrelated to cardiac causes, particularly acute/chronic inflammatory or fibrotic conditions (inflammatory bowel disease, malignancy, moderate to severe pulmonary fibrosis, chronic liver disease; autoimmune disorders)

Keywords: troponin sst2
epigenetic modifications of diabetes mellitus type i

Conditions: Type I Diabetes

Summary: this research is being done to find out if significant changes in blood glucose cause bad outcomes in patients with diabetes.


Eligibility criteria:
inclusion criteria: * 18-65 years old * diagnosis of type i diabetes * willing to wear continuous blood glucose monitor as specified in protocol exclusion criteria: * pregnant or planning to become pregnant during the study healthy control group inclusion: * 18-65 years old * willing to wear continuous blood glucose monitor as specified in protocol exclusion: * pregnant or planning to become pregnant during the study * diagnosis of type i or ii diabetes
cognitive impairment following elective spine surgery

Conditions: Cognitive Impairment; Postoperative Delirium; Spine Fusion

Summary: older people are a rapidly growing proportion of the world's population and their number is expected to increase twofold by 2050. when these people become patients that require surgery, they are at particular high risk for postoperative delirium (pod), which is associated with longer hospital stays, higher costs, risk for delayed complications and cognitive dysfunction (pocd). having suffered an episode of delirium is furthermore a predictor of long-term care dependency. despite these risks, an increasing number of elderly undergo major elective surgery. this is reflected by the frequency of elective spinal surgery, in general, and instrumented fusions, in particular, which has markedly increased over the past few decades. it is yet insufficiently understood, which, particularly modifiable, factors contribute to the development of pod and pocd following these major but plannable surgeries. a better understanding of risk factors would facilitate informed patient decisions and surgical strategies could be tailored to individual risk profiles.


Eligibility criteria:
inclusion criteria: * age ≥ 60 years * scheduled for elective spine surgery without opening the dura * patient can give informed consent him-/herself * german native speaker exclusion criteria: * dementia or neurodegenerative disease * psychiatric disease * prescription of cns-active medication (e.g. antidepressants, antipsychotics, sedatives, alpha-1-antagonists) * impossible to participate in follow-up * participation in an interventional trial * electronic or displacable metallic implants * active neoplasm

Keywords: delirium postoperative cognitive dysfunction spine surgery elderly neuroinflammation magnetic resonance imaging resting state fmri cerebral vasculature quality of life
a translational study investigating pd-l1 expression after radiotherapy for non-small cell lung cancer

Conditions: Non-Small Cell Lung Cancer

Summary: participants with non-small cell lung cancer (nsclc), performance status (ps) 0-2, not suitable for concurrent chemo-radiotherapy (ctrt), will be treated with standard radiotherapy (radical or palliative). archival tumour biopsies will be analysed for baseline programmed death ligand 1 (pd-l1) expression. some participants will have a biopsy before radiotherapy if the archive biopsy is not suitable. participants will be required to undergo an additional mandatory biopsy of the irradiated site during the second week of radiotherapy.

the purpose of this prospective, multicentre, non-randomised translational study is to provide proof of feasibility of achieving paired biopsies for pd-l1 assessment in patients with nsclc treated with palliative or radical radiotherapy. this is a non-ctimp study. all participants will have a minimum of 1 mandatory biopsy (during radiotherapy \[irradiated site\]) and the potential to have a pre-treatment biopsy if archival biopsy does not meet the suitability criteria. participants will have up to a maximum of 2 additional optional biopsies (during radiotherapy \[within the rt field e.g supraclavicular fossa node\], \[outside rt field e.g. skin met\]). blood samples will also be taken on study at specified time points for immune monitoring (exploratory endpoints). the study will be carried out in two stages as follows: stage 1: following the enrolment of the first 15 evaluable participants, an interim analysis will take place by the trial steering committee (tsc). the tsc will make a recommendation on whether recruitment should continue to the trial management group (tmg). stage 2: a further 15 evaluable participants will be recruited onto the study to achieve a total of 30 evaluable participants.

Eligibility criteria:
inclusion criteria: * histologically confirmed nsclc * diagnostic/pre-treatment biopsy suitable for pd-l1 analysis\* * tumour judged inoperable by a lung mdt * tumour that is accessible to core biopsy * age 18 and over, no upper age limit * performance status (ps) - ecog 0-2 * participant considered suitable for radiotherapy (palliative or radical) or sequential chemo-radiotherapy * before participant registration, written informed consent must be given according to gcp and national regulations * pre-treatment biopsy must be from gross tumour volume within planned radiation field, and must also: * have been formalin fixed for \>12h and ≤24h * have tumour tissue and morphology confirmed by h\&e staining * contain sufficient tumour cells (\>100) to determine pd-l1 status exclusion criteria: * participant suitable for standard concurrent ctrt * participant deemed unsuitable for repeat biopsies in the opinion of the treating oncologist * participant known to have an egfr mutation or an alk rearrangement * intercurrent or history of hepatitis b, c or human immunodeficiency virus infection, if known * participants who have received more than 1 line of chemotherapy prior to radiotherapy
phase iii study with idebenone in patients with duchenne muscular dystrophy (sideros-e)

Conditions: Duchenne Muscular Dystrophy

Summary: the purpose of the study is to assess the long-term safety and efficacy of idebenone in patients with duchenne muscular dystrophy (dmd) who completed the sideros study.

the study is an open-label, single-group, multi-center extension study in patients with dmd receiving glucocorticoid steroids who participated in the sideros study and who meet all the inclusion criteria and none of the exclusion criteria for this extension study. the study consists of 4 study visits scheduled every 6 months (visit 1/baseline, visit 2/week 26, visit 3/ week 52 and visit 4/ week 78), and a follow-up visit 4 weeks after treatment discontinuation. visit 8/week 78 in sideros study is also sideros-e visit 1/baseline.

Eligibility criteria:
inclusion criteria: 1. completion of the sideros study at visit 8/ week 78 2. signed and dated informed consent form for sideros-e exclusion criteria: 1. patients who discontinued sideros study prematurely (i.e. did not attend all visits from v1 to v8) 2. safety, tolerability or other issues arising during the course of the sideros study which in the opinion of the investigator may put the patient at significant risk or may interfere significantly with the patient's participation in the sideros-e study 3. use of any investigational drug other than the study medication

Keywords: respiratory function in dmd
program of digital accompaniment to optimize homework performances and increase familial quality of life in 9 to 16 years children with adhd

Conditions: ADHD

Summary: attention deficit disorder with or without hyperactivity (adhd) is a frequent pathology in children that has important consequences on schooling both in terms of academic level (due to the attentional disorder) and behavior (disruption of the class). adhd also has an impact on family functioning, which can generate stress and family altercations. the homework period can be a particularly tense time and a source of conflict with the child, which has negative consequences on the family atmosphere, learning efficiency and of course academic success. the investigators wish to evaluate an innovative digital device (a smartphone application) to accompany the child during homework periods.


Eligibility criteria:
inclusion criteria: * patients aged 9-16 years old with adhd assessed by conners 3 scales * parents and children giving informed consent * patients in follow-up list of participant centers * patients with unchanging care for the last 3 months (medication and therapy) exclusion criteria: * patients with severe psychiatric disease such as schizophrenia, bipolar disorder, or autism spectrum disorders and suicidal behavior (all assessed by child behavior checklist scale) * patients with no smartphone or not easy access to smartphone (ie patients of social facilities, internship...) * patients with mild to severe mental retardation or that may obviously not be able to use the app * patients included in special program other the care as usual (defined in the adhd french network) in follow-up list. * patients with methylphenidate treatment or change of titration for less than 3 months.
integrated treatment of marijuana abuse for hiv+ youth

Conditions: HIV Infections

Summary: this is an exploratory study that will adapt and test a combined cognitive behavioral treatment and contingency management intervention for alcohol and/or marijuana abuse for use in hiv-infected adolescents.


Eligibility criteria:
inclusion criteria: * adolescents between the ages of 16-24 years (inclusive) at the time of informed consent/assent as determined by medical record review or verbal verification from referring professional * hiv-infected and aware of their status as documented by medical record review or verbal verification from referring professional * receives services at one of the three participating atn clinic site or their community partners * a score of 2 or greater on the crafft indicating possible alcohol or marijuana use problem or abuse * alcohol and/or marijuana use or abuse disorder as indicated by the sspq-x * appropriate for an outpatient or intensive outpatient level of care in accordance with the american academy of child and adolescent psychiatry practice parameters as decided by site mental health provider in consultation with drs. brown and esposito-smythers * english-speaking * ability and willingness to provide informed consent/assent for study participation * satisfactorily understands the nature of the study and the informed consent process as documented by the consent form comprehension assessment questionnaire exclusion criteria: * presence of serious psychiatric symptoms (e.g., active hallucinations, thought disorder) * visibly distraught (e.g., suicidal, homicidal, exhibiting violent behavior) * intoxicated or under the influence of alcohol or other substances at the time of study entry

Keywords: substance abuse adolescent community reinforcement approach adolescent risk behavior assessment child and adolescent services assessment cognitive behavioral therapy cognitive therapy rating scale individual behavior therapy individual cognitive problem solving motivational enhancement therapy hiv-positive youth with substance abuse complementary therapies
smartphone confocal microscopy for diagnosing kaposi's sarcoma

Conditions: Kaposi Sarcoma

Summary: the investigators propose to evaluate a novel diagnostic approach for kaposi's sarcoma (ks) that may be eventually deployed with portable, point-of-care techniques. this approach features confocal microscopy. the investigators will compare this new approach with the gold standard of histology from a traditional skin punch biopsy (which is standard of care) to determine the sensitivity and specificity of portable confocal microscopy in diagnosing ks.

the investigators will perform a cross-sectional study of 500 patients in routine clinical care settings who are suspected to have ks on clinical grounds and for whom skin punch biopsy and histopathological examination is indicated as part of standard of care. patients will be evaluated with both the gold standard for diagnosis of ks (skin punch biopsy followed by histopathology) and portable confocal microscopy.

Eligibility criteria:
inclusion criteria: i. ≥ 18 years old ii. clinically suspected ks iii. presence of suspected ks lesions in areas which are considered safe to biopsy by the ugandan providers, which means all areas of the skin except for the mouth and eye. exclusion criteria: i. presence of suspected ks lesions exclusively on the mouth or eye unless clinical specialists trained in biopsy of the mouth or eye are available locally to biopsy the mouth or eye. oral and eye sites would typically only be biopsied when clinical diagnosis has proved to be problematic and definitive diagnosis is needed to inform a treatment plan.

Keywords: smartphone confocal microscopy kaposi sarcoma point of care diagnosis
effect of monitoring of pulse index continuous cardiac output (picco) on shock patients in intensive care unit

Conditions: Shock

Summary: picco has become a widely used haemodynamic monitoring device in the management of shock patients in icu patients nowadays. but the effects on outcome of use of picco, such as hospital mortality, vasoactive agents-free days, intensive care unit, and mechanical ventilation-free days and change of lactate and bnp in shock patients has not been determined. patients will be randomly assigned to a picco group or the control group, hospital mortality, vasoactive agents-free days, intensive care unit, and mechanical ventilation-free days and change of lactate and bnp will be observed. the conclusion will supply evidence for the clinical effectiveness of picco in shock patients.


Eligibility criteria:
inclusion criteria: * critically ill patients with shock: mean arterial pressure (map) \< 65 mmhg (\< 8,7 kpa) or systolic arterial pressure (sap) \< 90 mmhg (\< 12 kpa) or the need for vasopressor (norepinephrine \<0.05µg/kg/min) to support the map ≥ 65 mmhg (≥ 8,7 kpa) or the sap ≥ 90 mmhg ≥ 12 kpa), when one of these criteria has lasted for 4 hours or longer exclusion criteria: * age \< 18 years * age \> 85 years * pregnancy (positive pregnancy test in women of child bearing age)

Keywords: picco