Kornimate/medical-research-clean huggingface dataset:
developing screening clinical breast examination implementation strategies in south africa

Conditions: Breast Cancer

Summary: the goal of this observational study is to engage with multilevel stakeholders to collaboratively and to systematically develop a suite of strategies for implementing breast cancer screening using clinical breast examination (cbe) in the primary health centers within the catchment area of chris hani baragwanath academic hospital (bara hospital), johannesburg, south africa. the main questions it aims to answer are: what barriers and facilitators exist to conducting screening cbe in soweto's primary care setting and what implementation strategies would support cbe in primary care clinics? participants will: * allow observation of study clinic workflows * participate in focus group discussions regarding screening cbe implementation


Eligibility criteria:
in order to be eligible for inclusion in the focus group discussions held with screening cbe "adopters" and "implementers," an individual must meet all of the following criteria: 1. be an employee or volunteer working at a participating phc or be an employee or volunteer working at south africa's national department of health or be an employee or volunteer working with a non-governmental organization that performs breast cancer related activities within the catchment area of a participating phc 2. be willing to commit to keeping the content of focus group discussions confidential in order to be eligible for inclusion in the focus group discussions held with screening cbe "recipients," an individual must meet all of the following criteria: 1. be female 2. be between the ages of 40 and 65 years 3. be living within the catchment area of a participating phc 4. be willing to commit to keeping the content of focus group discussions confidential
multivariate analysis and risk factors were used to predict the short-term postoperative pain of degenerative lumbar spine

Conditions: Lumbar Disc Herniation; Lumbar Degenerative Disease; Sarcopenia

Summary: the objective of this retrospective clinical study wasto study the risk factors for short-term low back and leg pain after plif in patients with lumbar degenerative disease, and to establish a risk prediction model for short-term low back and leg pain after plif based on relevant risk factors.


Eligibility criteria:
inclusion criteria: 1. confirmed diagnosis of lumbar degenerative disease (spinal stenosis, disc herniation with lumbar instability, and lumbar spondylolisthesis), with no significant symptomatic relief after conservative treatment for more than 3 months, and in need of surgical intervention; 2. lumbar spinal fusion surgical treatment with plif; 3. grouping based on the presence or absence of a lumbar or limb pain with vas ≥3 at the 3th month postoperative follow-up; 4. observational indicators including individual factors, surgical factors, spine-pelvis sagittal balance parameters, and paravertebral muscle parameters. exclusion criteria: (1) those with a history of lumbar spine trauma, inflammation, tumor, or surgery; (2) those with congenital or acquired severe lumbar vertebral deformity; (3) those with severe neurological dysfunction; (4) those with incomplete baseline and follow-up data.

Keywords: lumbar degenerative disease plif sarcopenia sagittal bit balance machine learning
b cell response to a primary and a booster course of the novartis meningococcal acwy conjugate vaccine in healthy infants

Conditions: Meningococcal Disease

Summary: this study is aimed to assess whether the frequency of meningococcal serogroup a, c, w-135 and y specific memory b cells, measured 1 month after a primary vaccination series of novartis menacwy vaccine, predicts the specific serum bactericidal activity using human complement (hsba) of (respectively) serogroup a, c, w-135 and y at 12 months of age


Eligibility criteria:
inclusion criteria: subjects who were eligible to be enrolled in the study: * healthy infants aged 2 months (56 - 83 days old, inclusive); * available for the visits scheduled in the study; * mother available for blood draw at visit 1; * good health as determined by the clinical judgement of the investigator; * whose parents gave written informed consent for the infant to be enrolled in the study. the infant's parents must have been willing for the infant to receive the full primary immunization course. exclusion criteria: subjects who were not eligible for the study were those: * whose parents had not given or were unwilling or unable to give written informed consent to their child's participation in the study * with known hypersensitivity to any vaccines contained within the routine immunization schedule * with unacceptable concurrent illnesses or conditions - e.g.: 1. a severe acute or chronic illness; with any present or suspected serious disease such as metabolic, cardiac or autoimmune disease or insulin dependent diabetes or with any other serious disease (e.g., with signs of cardiac or renal failure or severe malnutrition), including progressive neurological disease; 2. a genetic anomaly, e.g. down's syndrome; 3. any immunodeficiency, including use of systemic corticosteroids; 4. born at less than 36 weeks gestation; 5. weighing less than 2.5 kg at birth; 6. previous clinical or bacteriological diagnosis of meningitis, or with a history of household contact or intimate exposure to an individual with culture proven neisseria meningitidis disease; 7. known bleeding diathesis, or any condition associated with a prolonged bleeding time; * who have received any prohibited prior or concomitant medications - e.g.: 1. any immunizations within the 30 days prior to enrollment, with the exception of bcg or hepatitis b; 2. immunoglobulin; 3. any blood products; * participating in any other clinical trial either currently or in the previous month; * unable to adhere to the protocol, including plans to move from the area; * other: had any condition which, in the opinion of the investigator, might interfere with the evaluation of the study objectives.

Keywords: meningococcal disease prevention vaccination
impact of unenhanced computed tomography (ct) in elderly patients admitted to the emergency department with acute abdominal pain

Conditions: Abdominal Pain

Summary: the purpose of this study is to determine whether non-contrast abdominal computed tomography (ct) impacts management (diagnosis, need for surgery and treatment) in elderly patients admitted to the emergency department with abdominal pain.

a systematic unenhanced abdominal ct is performed in elderly patients admitted to the emergency patients with acute abdominal symptoms. accuracy of unenhanced ct is assessed by comparing diagnosis and therapeutic management recorded before and after unenhanced ct versus gold standard diagnosis and management. gold standard diagnosis and management are established at 3 month follow up, based on patient's medical records and a systematic telephone interview.

Eligibility criteria:
inclusion criteria: * elderly patients admitted to the emergency department (aged 75 year old and older) * acute abdominal pain * informed consent exclusion criteria: * traumatic pain * symptom duration of more than a week * unability for the patient to give informed consent
an analgesia protocol for acute renal colic in the emergency department

Conditions: Kidney Stone

Summary: an analgesia protocol for acute renal colic will lead to faster significant reductions in pain than prior practice.

a retrospective study was performed that assessed the time to significant analgesia and medications used to achieve analgesia in the dhmc ed. based upon this a prospective pain management protocol was designed and we will track the difference in time to significant pain relief between the two groups.

Eligibility criteria:
inclusion criteria: * kidney stone on stone protocol ct scan * acute pain from a kidney stone exclusion criteria: * age \ 65 * pregnant women * contraindications to nsaid's or opiates

Keywords: renal colic, pain, protocol, emergency department
alterations in the vaginal microenvironment using a non-pharmacological intervention

Conditions: Adherence, Medication

Summary: breast cancer patients commonly take medications to reduce the risk of recurrence, including aromatase inhibitors (ais). ais can cause significant side effects that reduce patient adherence. early discontinuation of ai therapy results in an increased risk of cancer recurrence and increased risk of breast cancer-related death. common side effects include vaginal dryness and vulvovaginal atrophy leading to worsening sexual function. to increase ai adherence, the investigators will study a non-pharmaceutical vaginal renewal program (vrp) aimed at stimulating nitric oxide production to consequently increase vaginal lubrication, and improve the symptoms of vulvovaginal atrophy.


Eligibility criteria:
inclusion criteria: * have completed active primary treatment * defined as surgery chemotherapy and/or radiation for the treatment of breast cancer * does not include immunotherapy or other targeted therapies such as trastuzumab, cdk 4/6 or mtor inhibitors * have been receiving ais for at least 6 months prior to enrollment * plan to continue ais for an additional 3 months * amenorrhea for at least 12 months at enrollment * participants must be able to read and write in english * participants must have \< 2% superficial vaginal cells on cytologic evaluation exclusion criteria: * pre-existing hypertonic pelvic floor dysfunction identified in the medical record * unresolved or recurrent vaginismus identified in the medical record * aversion to touching one's own body, including genitals, or using vibration therapy on the genitals * currently receiving estrogen therapy, including topical and/or systemic estrogens * have received estrogen therapy within 6 months of study enrollment, including topical and/or systemic estrogens * any surgical procedure to the vagina or vulva, excluding office biopsies, within the previous 12 months * receipt of pelvic or vaginal or vulvar radiation therapy within the 12 months prior to enrollment or if the subject is anticipated to receive radiation targeted to any of these 3 locations within 6 months following enrollment * any use of the vrp off study within the last 6 months
spinal manipulative therapy treatment effect modifiers in individuals with low back pain

Conditions: Low Back Pain

Summary: this study considers whether treatment effects in response to spinal manipulative therapy for individuals experiencing low back pain are dependent upon the context in which the intervention is provided. half of the participants will receive spinal manipulative therapy with encouragement to interact with the provider and information to enhance expectations for the effectiveness of the intervention. the other half will receive spinal manipulative therapy with minimal interaction with the provider.


Eligibility criteria:
inclusion criteria: * currently experiencing low back pain defined as pain located below the 12th rib and above the inferior gluteal fold with or without corresponding leg pain; * low back pain symptom intensity rated as 4/10 or higher during the last 24 hour; * appropriate for conservative treatment for low back pain. exclusion criteria: * non-english speaking; * systemic medical conditions know to affect sensation (e.g. diabetes); * history of lumbar surgery or fracture within the past 6 months; * received spinal manipulative therapy for treatment of low back pain within past 6 months; * current or history of chronic pain condition other than low back pain
pharmacogenomic evaluation of antihypertensive responses in induced pluripotent stem (ips) cells study

Conditions: Hypertension

Summary: patients enrolled in this study will have completed one of the parent studies "pharmacogenomic evaluation of antihypertensive responses" (pear-1 or pear-2) evaluating how well their blood pressure was controlled by medication. patients in the current study will provide a single tube of blood which will be used to create adult stem cells that can be converted into other cell types, like heart or vasculature. patients will not be asked to return for any follow up visits.

if the patient decide to participate in this study, they will have 1 visit for the study that will include a blood draw. upon arrival to the clinic, the study will be explained to the patient in detail. the patient will be asked at that time to sign this consent form. the patient will have the opportunity to ask questions and the research staff will answer those questions. if the patient decides to participate in this study and sign a consent form, then a blood sample will be collected from a vein in the arm. a total of 2 teaspoons full of blood will be drawn for the study. during this visit, in addition to collecting a blood sample, patients will be asked about their medical history and medications they are currently taking, and will have their vital signs assessed, including blood pressure, pulse, and temperature. blood will be drawn by a trained nurse or a phlebotomist at a family medicine clinic in gainesville, florida. the blood sample will be further processed in laboratories at the university of florida, for the establishment of ips cells. ips cells will retain the patient's genetic makeup which makes them useful for research. several experiments will be conducted on these cells that will provide data that can be used to learn more about how genetic markers can lead to differences in blood pressure response to medicines. these cells will be used for up to 8 years.

Eligibility criteria:
inclusion criteria: * participation in the parent trial pear (201-2005) or pear2 (271-2010) * assigned to a diuretic arm exclusion criteria: * no participation in the parent trial pear (201-2005) or pear2 (271-2010) * assigned to a beta blocker arm

Keywords: hypertension
study to determine if pre- and post- operative tap catheters with ropivacaine versus placebo affects anesthetic, narcotic dosing, and pain scores

Conditions: Pain, Postoperative; Delirium; Anesthesia, Local

Summary: a randomized controlled trial to determine if pre- and post- operative regional pain control (transversus abdominis plane block) with ropivacaine versus placebo leads to lower anesthetic and narcotic dosing, and alters pain scores. this study plans to learn more about regional anesthesia and pain control during abdominal surgery. the study will gather data about the effectiveness of continuous catheter infusion of local anesthetic after an abdominal operation. outcomes include pain scores, iv pain medicine requirements, and delirium.


Eligibility criteria:
inclusion criteria: * age \>=50 years. * subjects will be undergoing an elective intra-abdominal or abdominal wall operation, including pelvic operations. surgery specialties included are general surgery, surgical oncology, urology, gynecology, plastic surgery. exclusion criteria: * subjects with a history of dementia or aphasia, as visual analog scale and confusion assessment will be unreliable. * patients with an epidural or spinal catheter block. * patients who do not speak english so that a language barrier is not confused with vas scoring or confusion. * patients who are abusing alcohol defined by a high audit score (\>8) will be excluded. * history of bipolar disorder or a psychotic disorder (such as a psychotic major depression, schizophrenia, schizoaffective disorder, or psychosis in alzheimer's disease or other dementia). * patients with a documented allergy to ropivacaine or other sodium channel blockers.
efficacy study of delayed primary closure to reduce rate of wound infection in complicated appendicitis

Conditions: Surgical Site Infection

Summary: research hypothesis: does delayed primary wound closure after appendectomy in adults with complicated appendicitis reduce postoperative superficial surgical site infection compare to primary wound closure. study design: this study is a multicenter randomized controlled trial of delay versus primary wound closure in complicated appendicitis. setting: thammasat hospital, ramathibodi hospital, chonburi hospital, chonpratarn hospital, vachira hospital, and pathumthani hospital participants: adult patients age 18 years or older and non-pregnant in women who have been diagnosed as gangrenous or ruptured appendicitis. outcome: superficial surgical site infection period of study: august 2012 - august 2014


Eligibility criteria:
inclusion criteria 1. adult patients age 18 years or older 2. have been diagnosed as gangrenous or ruptured appendicitis base on clinical criteria with the following conditions a.gangrenous appendicitis i.erythematous or swelling of appendix and ii.appearance of necrotic wall (dark, grayish color) b.ruptured appendicitis i. erythematous or swelling of appendix and ii.appearance of hole in an appendix or iii.rupture of appendix during a procedure c.appearance of frank pus 3. non-immunocompromised hosts which include 1. aids 2. history of end-stage renal disease (esrd) 3. history of autoimmune disease (sle) 4. taking immunosuppressive agents (e.g, steroids, cyclophosphamide, tacrolimus, mycophenolate mofetil) 5. cirrhosis with ascites 6. morbid obesity (bmi \> 40 kg/m2) 4. non-pregnant women 5. willing to participate and provide written informed consent

Keywords: complicated appendicitis wound closure infection
skin irritation test of ten products

Conditions: Dermatitic Reaction of Face

Summary: evaluation of cutaneous tolerance of ten products by primary irritant patch test

the purpose of this clinical study was the evaluation of skin irritation potential of ten products after a single application under occlusive patch on human skin.

Eligibility criteria:
inclusion criteria: * 20 to 70 years old, healthy male and female (sex ratio 1:1) * no acute or chronic diseases including skin diseases. * no current medications. exclusion criteria: * pregnancy or breast feeding. * abnormal blood test result/results (evaluation criteria: wbc, ast, alt, and creatinine) * back skin with moles, acne, tattoo, scars, red spots, burns, etc. * current dermatology medication which might affect skin condition evaluation. * current irritated reaction on test site. * participating in other clinical trial(s) within 7 days.

Keywords: skin skin health allergen
medico-economic evaluation of strategies for the lead extraction of implantable defibrillator and pacemakers

Conditions: Prosthesis-Related Infections; Equipment Failure; Heart Failure; Arrhythmias; Thrombosis

Summary: the growing use and the expanding indications for cardiovascular implantable electronic devices (cieds) have been associated to an increase of device removal. the indications of cieds removal are infectious (55%) or noninfectious (45%) such as upgrading of devices, nonfunctional devices and thrombosis. removal can be performed according to transvenous or surgical procedures. transvenous lead removal (tlr) must be done by experimented cardiologists and respecting current consensus. tlr can be done with conventional techniques involving inserting locking stylets and telescoping sheaths around the pacing leads to separate them from the surrounding scar tissue. these conventional procedures have a success rate of ≈65%. tlr thanks to laser sheath has been validated and improved the success rate until \>95%. however, the tlr from chronically implanted cieds still carries a significant risk of procedural failure, morbidity, and mortality, related to tearing of the great vessels and cardiac structures, even when performed by experienced operators. even if the transvenous extraction using laser sheath seems to be more effective, this strategy would be more expensive. considering the availability of several strategies for tlr and the cost heterogeneity of procedures, a cost assessment in real life of these therapeutic strategies is essential for an optimal choice of therapeutic strategies.

the study will compare the strategies of percutaneous extraction to surgical extraction. * mechanical percutaneous extraction is the conventional technique using locking stylets and telescoping sheaths around the pacing leads to separate them from the surrounding scar tissue. * laser-assisted lead extraction is most often used in complex procedures and dissolves rather than tear the scar tissue. * sternotomy is the surgical procedure used when leads cannot be removed by percutaneous extraction. it is rarely employed.

Eligibility criteria:
inclusion criteria: * - patients who have undergone an extraction of implantable pacemaker or defibrillator leads whatever the indication for the period march 2013-2017 exclusion criteria: * - none

Keywords: cardiology device removal pacemaker defibrillators catheterization laser therapy cost-benefit analysis
evaluation of the effect of crowns applied with hall technique on occlusion

Conditions: Child, Only; Quality of Life

Summary: this study aims to evaluate and compare the change on occlusion after placing stainless steel crowns (scc) using hall technique and conventional technique in children between the ages of 5-8. in addition, the investigators planned to analyze the change in oral health-related quality of life between scc applied with the hall technique and scc applied with the conventional method, before and after clinical application.

first, the participants who met the inclusion criteria were included in 2 study groups according to age, gender, dental experience, tooth number, applied stainless steel crown technique, decayed, missing due to caries, and filled teeth in the permanent teeth/decayed, missing due to caries, and filled teeth in the deciduous teeth (dmft/dmft index) values and international caries detection and assessment system (icdas ii) and radiographic evaluation criteria. in the experimental group, stainless steel crowns were placed on the teeth of 39 participants using the hall technique. in the control group, stainless steel crowns were placed on the teeth of 39 participants using conventional technique.

Eligibility criteria:
inclusion criteria: * subjects with american society of anesthesiologists score i (asa i), * subjects with frankl's behavior rate iii (positive) and iv (definitely positive), * clinically, black class ii enamel-dentin caries in the upper jaw primary second molar is; icdas ii scale score 4, score 5 and the accepted values in the evaluation of radiographic dental caries are d1-ra3, d2-rb4, d3-rc5, * antagonist of the tooth planned to be processed, * lamina dura and periodontal space can be observed normally * there is permanent tooth germ underneath or the position is normal. exclusion criteria: * allergic to the local anesthetics or sulfites, * had teeth with pain or sepsis, * were uncooperative during clinical examination, * tmj disorder, * had parafunctional habit

Keywords: hall technique paediatric dentistry stainless steel