Kornimate/medical-research-clean huggingface dataset:
effect of finerenone in iga nephropathy

Conditions: IgA Nephropathy

Summary: the aim of this trial is to conduct a randomized, multicenter, placebo-controlled, double-blind clinical trial to determine the safety and efficacy of finerenone in reducing proteinuria and protecting renal function in patients with iga nephropathy. the primary endpoint event was the change in urinary albumin/creatinine ratio between the two groups at 12 months of treatment.

this is a randomized, multicenter, placebo-controlled, double-blind clinical trial aimed at clarifying the safety and efficacy of finerenone in reducing proteinuria and protecting renal function in patients with iga nephropathy. study population will include participants with renal biopsy confirmed iga nephropathy (egfr ≥ 30 ml/min/1.73 m2) and uacr ≥500mg/g ≤3500mg/g. participants receiving maximum tolerated dose of ras inhibitor treatment for more than 3 months are eligible for the study. the study will be conducted at 4 sites. 120 participants will be randomised to one of 2 arms in a 1:1 ratio: * finerenone 10mg/20 mg * placebo 10mg/20 mg for each participant, the total duration of participation will be approximately 12 months.

Eligibility criteria:
inclusion criteria: * kidney biopsy confirmed iga nephropathy within 2 years, with secondary iga nephropathy excluded; * age ≥ 18 years; * maximum tolerated dose of ras inhibitors for more than 3 months, with urine albumin/creatinine ratio ≥ 500 mg/g and ≤ 3500 mg/g; v1 laboratory test showing urine albumin/creatinine ratio ≥ 500 mg/g and ≤ 3500 mg/g. after maximum tolerated dose of ras inhibitors or arb, v2 urine albumin/creatinine ratio ≥ 500 mg/g and ≤ 3500 mg/g; * egfr calculated by epi ≥ 30 ml/min/1.73 m²; * serum potassium level ≤ 4.8 mmol/l; * sbp ≤ 150 mmhg, dbp ≤ 110 mmhg; * lvef \> 40%; * willing and able to provide informed consent. exclusion criteria: * there are clear indications for the use of immunosuppressive therapy, such as: nephrotic syndrome (urine protein greater than 3.5 g/d, blood albumin less than 30 g/l), pathological minimal change disease combined with iga nephropathy; the proportion of crescents in kidney biopsy is ≥ 50%. * any existing life-threatening condition with a life expectancy of less than 2 years; * active infection, hbv infection, or active lesions (nodules, cavities, or tuberculomas); * aki causing renal dysfunction; * use of steroids/immunosuppressive drugs within the past 3 months; * history of malignant tumors, regardless of treatment status or evidence of local recurrence or metastasis; * any surgical or medical condition that may significantly alter the absorption, distribution, metabolism, or excretion of the investigational drug; * history of drug or alcohol abuse within the past 12 months; * history of drug allergies or contraindications; * previous noncompliance or unwillingness to follow the study protocol; * any condition that may affect safety or efficacy; * history of kidney transplantation or currently receiving immunosuppressive treatment; * pregnant or breastfeeding women; * obese patients with a bmi \> 35.
"follow-up of midlines placed outside the intensive care unit: what side effects? an observational study"

Conditions: Thrombosis

Summary: midline catheter is a peripherally-inserted catheter, with the distal tip being placed into the axillary vein. for some indications, it's an alternative to the peripheral insert central catheters in case of limited venous access and infusions less than one month. the midline catheter is poorly described in scientific literature; therefore, the aim of the study is to determinate the incidence of adverse events (infections and thrombosis) and risk factors for patients with this device.

the midline is a deep peripheral venous catheter whose insertion is between the lower and upper third of the arm and whose distal end does not extend beyond the axillary vein. it requires the identification of the vein by ultrasound which reserves its installation for professionals trained and authorized to use the ultrasound scanner. midline is currently indicated for intravenous treatments \> 7 days and in patients with precarious venous capital. according to the manufacturer's instructions, it can be kept in place for up to 30 days, while the recommendations of the centers disease of control specify that this period could be extended to 49 days. its use is expanding rapidly in france, thus meeting the needs of patients who do not require a central line and whose use of a standard peripheral venous catheter is not possible (low venous capital or treatment duration \> 7 days). its installation, essentially carried out by qualified anaesthetists, does not increase medical planning and is therefore an attractive alternative to the installation of a central catheter whose complications (thrombosis and infections) are known. the only data on the complication rate, estimated at 1-2%, are from low-potency observational studies. in the absence of high-level evidence, most of the good practice recommendations published in 2019 are based on expert consensus. this leads us to conduct a large-scale observational study to assess the complication rate and identify the associated factors. this study will provide professionals with reliable scientific data for the next review of good practice recommendations.

Eligibility criteria:
inclusion criteria: * adult patient * no opposition to the study * patient requiring a midline exclusion criteria: * patient in intensive care unit or acute care unit. * patient with a contra indication to midline insertion: arterio-venous fistula, history of axillary lymph node clearance or radiotherapy in the infusion arm, presence of infectious skin lesions near the infusion area, presence of a prosthesis on the infusion arm or hemiplegic arm. * patient under legal protection measure * patient already enrolled * minor patient; * pregnant woman.

Keywords: midline catheter adverse event catheter-related bloodstream infections thrombosis
virtual behavioral health integration

Conditions: Depression; Substance Use Disorder; Anxiety

Summary: the primary objective is to evaluate the effectiveness of the virtual behavioral health integration (vbhi) program compared to usual care, on reducing the total cost of care reimbursed from medicare and value-based contracts within 90 days of a patient's primary care visit.

to enhance the care of patients seen in the primary care setting, atrium health has designed a virtual behavioral health integration program. a behavioral health care team comprised of licensed clinicians (behavioral health professionals), health coaches, a consulting psychiatric pharmacist and psychiatric providers follow patients for up to 3 months or more depending on patient need after their primary care office visit. this virtual behavioral health integration (vbhi) program is currently available in 36 atrium health primary care practices providing support to over 200 providers and medical residents. the behavioral health service line is expanding the program to additional primary care practices. atrium health and the carolinas physician alliance is interested in evaluating the effectiveness of the program on reducing the total cost of care.

Eligibility criteria:
inclusion criteria: * 18 years of age or older * primary care office visit * have a patient health questionnaire-9 (phq-9) and overall score \>=10 or question 9 \>0 * medicare or value-based contract associated with a patient in the past year at the time of the primary care visit. exclusion criteria: * a patient will contribute to the analysis once using their initial enrollment to either arm of the study. * no insurance claim for the index primary care visit in the data warehouse upon evaluation.
wear measurements of e-poly in an uncemented tha with either 32 or 36 mm caput of ceramics.

Conditions: Primary Arthrosis; Osteoarthritis

Summary: the aim of the study is to compare polyethylene wear in an uncemented total hip prosthesis with 3rd. generation highly cross-linked polyethylene with a 32 mm ceramic femoral head compared to a 36 mm ceramic head. using x-ray, rsa and dexa. the polyethylene to be used is e-poly (biomet). the h0 hypothesis is that there is no difference with regard to polyethylene wear and bone loss between the two groups.

uncemented tha, 32 mm or 36 mm caput of ceramics, e-poly inserts. measure wear with rsa, x-ray and bone mineral density with dexa.

Eligibility criteria:
inclusion criteria: * 50-65 years old * primary or secondary osteoarthritis exclusion criteria: * significant anatomical divergence are excluded * rheumatoid arthritis * fracture sequelae * dysplasia * immune suppression or grave systemic illness

Keywords: vitamine e e-poly hip degenerative joint disease
effect of regional versus general anesthesia on thirty-day outcomes following carotid endarterectomy: a matched-pairs cohort study.

Conditions: Regional Anesthesia Morbidity; Carotid Artery Diseases; Perioperative/Postoperative Complications

Summary: the goal of this observational study is to assess the effect of regional versus general anesthesia on carotid endarterectomy thirty-day outcomes. the main questions it aims to answer are: * is regional anesthesia associated with lower incidence of major morbidity and mortality? * is regional anesthesia associated with lower incidences of secondary adverse events? participants will be sampled from the 2015-2019 american college of surgeons national surgical quality improvement program


Eligibility criteria:
inclusion criteria: * elective, non-emergent cases * regional anesthesia * general anesthesia exclusion criteria: * concurrency in procedures * acute kidney injury (preoperative) * end-stage renal disease (preoperative) * metastatic disease (preoperative) * wound infection (preoperative) * sepsis (preoperative) * asa 5
using social media to decrease healthcare utilization for pediatric asthma

Conditions: Asthma in Children

Summary: the purpose of this study is to evaluate if social media enhanced education (sme) will reduce total number of treatment days defined as summation of days of subsequent hospital admission, emergency room visits, and clinic visits, reduce missed school days, reduce total costs from a health system perspective, have increased effect with increased social media engagement, have increased effect in participants with both caregiver and patient (combined) with social media accounts, compared to participants where only the patient or only the caregiver uses social media (single),have increased patient satisfaction in the asthma education received and to obtain the experience and data needed to refine sme to be able to expand this platform for other chronic medical conditions with high healthcare utilization including pediatric diabetes, epilepsy, and sickle cell disease in children with asthma.


Eligibility criteria:
inclusion criteria: * hospitalized to children's memorial hermann admitted for asthma exacerbation * patient and/or primary caregiver must have internet access on cellular phones or at home and use a social media account (facebook, twitter, instagram, and/or snapchat) exclusion criteria: * other chronic conditions besides asthma that may necessitate frequent health care utilization. i.e. children with complex chronic conditions, sickle cell, seizures, diabetes.

Keywords: social media pediatric asthma healthcare utilization
mirogabalin for total hip arthroplasty

Conditions: Hip Osteoarthritis

Summary: the purpose of this study is to confirm the analgesic effect of mirogabalin in patients undergoing unilateral hip arthroplasty.


Eligibility criteria:
inclusion criteria: 1. patients 19 years of age or older who are expected to undergo unilateral hip arthroplasty 2. american society of anesthesiologists class 1-3 exclusion criteria: 1. major prior ipsilateral open hip surgery 2. allergies to drugs used in research 3. difficult to manage diabetes mellitus (including insulin dependence) 4. chronic use of gabapentin or pregabalin (regular use for more than 3 months) 5. patients taking cimetidine, probenecid, or lorazepam 6. patients with moderate or severe hepatic impairment (ast/alt 2.5 times or more of the upper limit of normal) 7. estimated glomerular filtration rate \< 60 ml/min/1.73m2 8. dependence on opioids 9. in the case of subjects who cannot read the consent form (e.g. illiterate, foreigners, etc.)
pleural bleomycin vs mechanical abrasion in malignant pleural effusion

Conditions: Malignant Pleural Effusion

Summary: comparision between pleurodesis by pleural abrasion using medical thoracoscopy and bleomycin instillation via indwelling pleural catheter. evaluating the effectiveness of pleural abrasion using medical thoracoscopy in patients with malignant pleural effusion and evaluating the role of rose in diagnosis and management of malignant pleural effusion

malignant pleural effusion cause significant morbidity so drainage effusion can provide great palliation and improve quality of life of these patients. there are several diagnostic tools for diagnosing malignant pleural effusion as pleural fluid cytology, closed pleural biopsy or thoracosopic pleural biopsy. medical thoracoscopy has significant role in diagnosis and management of malignant pleural effusion. also, pleurodesis may be performed through it by mechanical methods as pleural abrasion or chemical methods by talc poudrage, bleomycin or cisplatin instillation . and surgically through pleurectomy. recently, using of rose (rapis on-site examination) technique during medical thoracoscopy showed high accuracy for distinguishing between benign and malignant lesions, and this help in decision making. in our study, we will use mechanical pleurodesis by pleural abrasion using medical thoracoscpy and chemical pleurodesis by instillation of bleomycin via indwelling pleural catheter.

Eligibility criteria:
inclusion criteria: * patients who are 18 years old or more. * patients with rapidly accumulating moderate \& massive malignant pleural. effusion that need frequent aspiration to relieve dyspnea and affect quality of life of the patient. exclusion criteria: * patients not fit for thoracoscoy. * patients with life expectency less than 1 month . * trapped lung (endobronchial lesion). * excessive pleural adhesios. * mild effusion not need frequent aspiration and not affect * quality of life . * patients with chest infection : pneumonia , empyema . * patients with performance status that doesn't expected to increase by 1
stress in couples undergoing assisted reproduction technology with donor sperm and its impact on pregnancy outcomes

Conditions: Infertility, Male

Summary: donor sperm provides a viable option for patients with significant male factor infertility. however, since the source of sperm is not from the male partner, the psychological burden of these couples is more pronounced and complex than other patients.the purpose of this study is to investigate the stress faced by participants undergoing assisted reproduction with donor sperm and to further investigate its impact on pregnancy outcomes.

the number of infertility patients has increased significantly in recent years, and infertility caused by the male partner accounts for about 30%-50% of infertility factors. donor sperm provides a viable option for patients with significant male factor infertility. however, since the source of sperm is not from the male partner, the psychological burden of these couples is more pronounced and complex than other patients. many factors such as social, marital, and family problems may contribute to their depressed emotional state. and the impact of these negative emotions on pregnancy outcomes cannot be ignored. in this study, investigators intend to investigate the stress faced by participants undergoing assisted reproduction with donor sperm to provide a reliable basis for future psychological interventions and health education for this group of patients and improve the quality of life of infertility patients.

Eligibility criteria:
inclusion criteria: * female partners' \>18\< 40 years * male partners' \>18\< 40 years * patients undergoing assisted reproductive technology with donor sperm or husband's semen due to male factor exclusion criteria: * female partners with polycystic ovary * female partners with insufficiency or premature ovarian failure * female partners with endometriosis * female partners with abnormal profile of thyroid hormones * chromosomal abnormalities of either spouse * mental disorder of either spouse
a study about safety and efficacy of pirfenidone to treat grade 2 or grade3 radiation-induced lung injury.

Conditions: Radiation-induced Lung Injury

Summary: using pirfenidone to treat grade 2 or grade3 radiation-induced lung injury, and observe the efficacy and safety of the drug.

the study is a randomized, controlled, multi-site clinical trial.

Eligibility criteria:
inclusion criteria: 1. 18-75 years old (including 18 and 75 years); 2. clinically diagnosed grade 2 or 3 radiation-induced lung injury; 3. the course of radiation-induced lung injury is less than 2 months; 4. ecog 0-2; 5. the expected survival time is more than 6 months; 6. the functional level of major organs meets the following standards: anc≥3.0×109/l，plt≥100×109/l，hb≥90g/l, tbil、bun and cr≤1.5×uln， alt、ast≤2.0×uln 7. capable of eating solid food upon enrollment; 8. subjects will voluntarily participate in this study and sign the informed consent. exclusion criteria: 1. have a history of chronic bronchial acute attack or severe pulmonary heart disease; 2. pneumonectomy; 3. tumor progression; 4. severe pulmonary infection; 5. creatinine clearance rate \< 30ml/min, severe renal disease or need dialysis; 6. concomitant with other serious diseases: for example, myocardial infarction within 6 months, uncontrolled diabetes, etc., were considered not suitable for the participants in the study; 7. patients with active peptic ulcer; 8. pregnant women and patients with mental illness; 9. participating in clinical trials of other drugs within 3 months; 10. the investigator determined that subject was not suitable.

Keywords: pirfenidone
functional urodynamic changes in chronic kidney disease patients and does insertion of urinary catheter delay the need for kidney dialysis

Conditions: Renal Insufficiency, Chronic

Summary: the aim of the investigators work is to describe the urodynamic results in the ckd (chronic kidney disease) grade 4 patients and to verify observations that urinary catheter may improve kidney function in those patients. 100 patients with ckd grade 4 will do urodynamic examination. all patients will be randomized into two groups / the intervention group that will be inserted urinary catheter for 2 weeks and the follow up group. kidney function will be monitored by creatinin values and the investigators will measure the time to dialysis in the two groups.


Eligibility criteria:
inclusion criteria: * age \> 18 * chronic kidney disease grade 4-5 (egfr (estimated glomerular filtration rate) \<30) * eligible to sign a consent form exclusion criteria: * non controlled diabetes melitus (hba1c\>10%) * not controlled htn (hypertension) * cardiovascular event requiring cardiac stenting * renal hydronephrosis or post void rest \> 200cc according to us (ultrasound) * acute renal failure * not eligible for urodynamics for any reason * constant urinary catheter for any reason
safety and efficacy of olopatadine hydrochloride/ketorolac tromethamine ophthalmic solution compared with olopatadine hydrochloride ophthalmic solution in patients with seasonal allergic conjunctivitis

Conditions: Rhinitis, Allergic, Seasonal; Conjunctivitis, Allergic

Summary: this study will investigate the safety and efficacy of olopatadine hydrochloride / ketorolac tromethamine fixed dose combination ophthalmic solution compared with olopatadine hydrochloride ophthalmic solution in patients with seasonal allergic conjunctivitis.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of seasonal allergic conjunctivitis exclusion criteria: * ocular infection or history of ocular herpes infection * history of retinal detachment or diabetic retinopathy * prior or current use of systemic or topical steroids, nsaids, anticholinergics, immunosuppressants, or antihistamines * ocular surgery within 8 weeks
cardiovascular autonomic function and endogenous pain modulation

Conditions: Fibromyalgia; Exercise; Pain; Autonomic Dysfunction; Physical Activity

Summary: the study has three aims: 1. to investigate the influence of cardiovascular autonomic function on pain sensitivity at rest in patients with fibromyalgia and age- and sex-matched controls 2. to investigate the influence of cardiovascular autonomic function at baseline and during exercise on the pain response following submaximal isometric exercise 3. to study the relation between the pain response following physical and cognitive tasks (exercise and mental math, respectively).

fibromyalgia (fm) affects 2 -8% of the population with a higher prevalence in women than men. people with fm report widespread pain that impacts their quality of life. patients may also experience other symptoms besides pain such as depression, anxiety, fatigue, sleep difficulties and others. exercise is one of the interventions that have been shown to reduce pain in chronic pain populations. the phenomenon by which exercise reduces pain sensitivity is known as exercise-induced hypoalgesia (eih). although exercise is strongly recommended by american pain society guideline for the treatment of fm, some patients with fm report an increase in pain and worsening symptoms following acute exercise. the worsening of symptoms may impact adherence to exercise training. why some people with fm report pain exacerbation while others report pain relief following exercise is not known. this study aims at assessing the influence of the cardiovascular autonomic nervous system on pain sensitivity at rest and following exercise in patients with fibromyalgia and pain-free individuals.

Eligibility criteria:
inclusion criteria: * fibromyalgia * healthy controls without fibromyalgia * stable medical management plan for four weeks prior to participation in the study. * physical activity readiness questionnaire * english proficiency exclusion criteria: * elbow arthritis * carpal tunnel syndrome * cardiovascular disease * cervical surgery * cerebrovascular accident / stroke * multiple sclerosis * parkinson's disease * any central neurodegenerative disease * traumatic brain injury * peripheral neuropathy of the upper extremity * myocardial infarction * chronic obstructive pulmonary disease * any unstable medical or psychiatric condition * diabetes mellitus * active cancer * lymphedema of the upper extremity * claustrophobia * raynaud's phenomenon * osteoporosis * major depressive disorder * bipolar disorder * rheumatoid arthritis * lupus * polymyalgia rheumatica * pregnancy