Kornimate/medical-research-clean huggingface dataset:
ultrasound-guided catheterization of the axillary vein

Conditions: Critical Illness

Summary: the central venous catheterization (central line placement) is the common procedure performed in the intensive care unit. this procedure is performed by percutaneous puncture of so called 'the central vein' and than advancement of the catheter over the guidewire (seldinger technique). the tip of the catheter is left in the superior vena cava in the vicinity of the right atrium of the heart. central veins are large veins in the human body passing the blood into the heart. typical, clinical indications for the central line placement in the intensive care unit are hemodynamic monitoring, volume monitoring, administration of medications, long-term total parenteral nutrition, access for renal replacement therapy, difficult peripheral catheterization. there are two methods of the central venous catheterization in terms of visualization. first and older is the blind technique. the operator is locating the anatomical landmarks and then performing the entire procedure blindly by percutaneous puncture. this is called the landmark technique. second and new is the ultrasound-guided technique. the operator is locating the vein using ultrasonography and then performing the entire procedure under ultrasonographic visualization. the real time ultrasound-guided central venous catheterization became the standard of care in recent years mainly because of safety issues (is regarded as safer than landmark technique) the catheterization of the axillary vein is not popular procedure in daily clinical practice. but it can be reasonable and safe alternative to others, typically performed central venous catheterizations like the internal jugular vein and the subclavian vein catheterizations. the main intention of this study is to assess usefulness and safety of the real time ultrasound guided axillary vein catheterization in mechanically ventilated patients admitted to the intensive care unit.


Eligibility criteria:
inclusion criteria: * mechanically ventilated intensive care patients with clinical indications for central venous line placement exclusion criteria: * trauma and hematoma at the catheterization site * history of multiple central venous catheterizations (three or more) * chest wall deformities * major blood coagulation disorders * history of thoracic surgery * anatomical abnormalities at the catheterization site * infection at the catheterization site * age less than 18 years * lack of patients or closest relatives consent

Keywords: ultrasonography catheterization central line mechanical ventilation intensive care axillary vein
health economics of the use of ferrous iron salts in primary care in the uk.

Conditions: Anemia

Summary: iron deficiency anaemia (ida) affects approximately 4.7 million of people in the uk, with children and pre-menopausal women being at higher risk (1). each year more than 6.8 million prescriptions for oral iron are filled in england alone (nhs information centre data). however, gastrointestinal symptoms limit adherence in 10-30% of otherwise healthy patients (2-4) and in up to 50% of patients with gastrointestinal disorders (5). simple ferrous iron salts constitute the vast majority of currently prescribed oral iron because these are cheap and well absorbed. however, they are also poorly tolerated and thus, we believe, are expensive to the nhs. funded by the medical research council, we have developed an alternative oral iron supplement, that we name ihat (iron hydroxide adipate tartrate), as an efficacious therapy for ida with minimal side-effects. in the study proposed here we aim to assess the total health cost associated with current oral iron supplements and, hence, define the clinical unmet need for alternative treatments. we will use clinical practice research datalink (cprd) gold data to (i) estimate the pattern of prescribing to oral iron in primary care in the general population and (ii) develop a health economics model in pre-menopausal women. these data will provide evidence for the total health system costs associated with current oral iron treatment. furthermore, this study will provide data from which the cost-effectiveness and total health system costs of alternative effective and treatments with minimal side-effects could be estimated.

our research objective is to gather evidence for the unmet clinical need for safe, low-side-effect oral iron in the uk. to achieve this objective we aim to determine: 1. pattern of prescribing to oral iron in primary care in gp practices in england: estimate prescription rates, efficacy and intolerance of treatment with all forms of currently prescribed oral iron. 2. health economics of the use of ferrous iron salts in primary care: estimate patterns of individual response to treatment; determine the costs of ferrous iron (sulphate, fumarate and gluconate) therapy in pre-menopausal women in primary care, and develop a cost-effectiveness model for alternative treatments with minimal side-effects.

Eligibility criteria:
inclusion criteria: * patients prescribed oral iron in primary care practices included in the uk cprd database exclusion criteria: * n/a

Keywords: iron deficiency
evaluating the number of passes required for diagnostic cell block during eus-fna of solid pancreatic mass lesions

Conditions: Pancreatic Cancer

Summary: this study will test the amount of tissue, called "cell block", obtained from your pancreas. patients who are asked to participate in this study have a growth (mass) in the pancreas that needs a biopsy so a diagnosis can be made. although we usually perform 2 to 4 passes (number of times the doctor biopsies the mass), at this time we do not know the ideal number of passes needed to obtain adequate amount of tissue for making a diagnosis. the purpose of this study is to compare the amount of tissue obtained with 2 passes versus 4 passes.

primary aim: to compare the number of passes required for obtaining adequate cell block material during eus-guided fna of solid pancreatic mass lesions. primary research hypothesis: more specimen is required to obtain definitive diagnosis on cell block. this translates to less need for repeat procedures (due to nondiagnostic index procedure due to inadequate fna passes), prompt treatment to patients and better use of health care resources. therefore, we will be comparing 2 versus 4 fna passes to determine which number of fna pases will yield an adequate diagnostic cell block. secondary aims: to compare the rate of complications when performing 2 versus 4 eus-fna passes of solid pancreatic mass lesions. secondary research hypothesis: eus-guided fna is a safe procedure with a complication rate of \< 1%. by performing more (four) na passes one is likely to yield a better quality cell block while at the same time without compromising patient safety.

Eligibility criteria:
inclusion criteria: 1) all patients referred to florida hospital endoscopy unit for assessment of pancreatic mass lesions that require fna. exclusion criteria: 1. age \<19 years 2. unable to safely undergo eus for any reason 3. coagulopathy (inr \>1.6, prothrombin time \>18secs, thrombocytopenia \<80,000 cells/ml) 4. unable to consent 5. non-english speaking patients. 6. participation in any other clinical trial (excluding registries and databases)

Keywords: cell block, number of passes
cancer and aging resilience evaluation in older adults with hematologic malignancies: the care-heme registry

Conditions: Multiple Myeloma; Amyloidosis; Plasma Cell Leukemia

Summary: the primary purpose of this protocol is to create a registry of older (≥50 years old) patients with hematologic malignancies. our main objectives include: to understand the prevalence of frailty and geriatric impairments among patients aged ≥50y and above diagnosed with a hematologic malignancy at uab and to gather information that would lend support for future research in this vulnerable population.

all participants will be invited to participate in a patient reported geriatric assessment questionnaire as well as an objective physical function testing. this includes the short physical performance battery (sppb) that evaluates lower extremity performance and muscle strength assessment via hand grip dynamometer. participants will also complete a 12 item modified version of pro-ctcae. this will be administered by trained research staff at the time of study enrollment. repeat care instruments (follow-up ga questionnaire and physical function test) will be administered after the baseline visit to measure changes in patient reported outcomes at 3 months, 6 months, and one year. a one-time blood or saliva sample will be requested and obtained at baseline or a follow-up visit.

Eligibility criteria:
inclusion criteria: * patients are ≥50 years of age. * patients have a biopsy proven diagnosis of hematologic malignancy (multiple myeloma, al amyloidosis, waldenstrom's macrogloblunemia, hodgkin lymphoma, non-hodgkin lymphoma, myelodysplastic syndromes, myeloproliferative neoplasm, acute/chronic myeloid leukemia, acute/chronic lymphoid leukemia). * patients have appointments at uab including if they are an inpatient or other clinic locations. exclusion criteria: * individuals who are \<50 years old. * patients who do not read and/or speak english will not be eligible for this study as many of the questionnaires are not validated in other languages. no exclusions will be made based on gender, ethnicity or race.
a phase ib/iii clinical study to evaluate the efficacy and safety of ibi318 in combination with paclitaxel versus placebo in combination with paclitaxel in patients with small cell lung cancer who have failed first-line or above chemotherapies

Conditions: Small Cell Lung Carcinoma

Summary: this study is a phase ib/iii clinical study to evaluate the efficacy and safety of recombinant fully human anti-programmed cell death receptor 1 (pd-1) and anti-programmed cell death ligand 1 (pd-l1) bispecific antibody injection (ibi318) in combination with paclitaxel versus placebo in combination with paclitaxel in subjects with small cell lung cancer who have failed first-line or above chemotherapies.


Eligibility criteria:
inclusion criteria: 1. signed the informed consent form; 2. male or female ≥ 18 and≤75 years of age; 3. life expectancy ≥ 12 weeks; 4. pathologically confirmed limited or extensive stage small cell lung cancer according to veterans lung administration lung study group (valg) staging; 5. at least had progressive disease during or after platinum-based first-line chemotherapy or chemoradiotherapy, and with clear evidence of radiographic progression. exclusion criteria: 1. previous exposure to immune-mediated therapy; previous use of taxane chemotherapy; 2. received the last anti-tumor therapy (chemotherapy, radiotherapy) within 4 weeks prior to the first dose of study drug; 3. received any investigational agent within 4 weeks prior to the first dose of study drug; 4. received systemic treatment with chinese herbal medicine indicated for cancer or drugs used for immunoregulation (including thymosin, interferon, interleukin, except for local use for pleural effusion) within 2 weeks before the first dose; 5. are participating in another interventional clinical study, or observational (non-interventional) clinical study or in the follow-up phase of an interventional study; 6. pregnant or breastfeeding woman.
impact of moderate intensity physical activities on pk-guided ehl fviii concentrates prophylaxis severe ha patients

Conditions: Hemophilia

Summary: to compare clinical outcomes before and after using combination between moderate to vigorous-intensity physical activities and pharmacokinetic-guided extended half-life fviii concentrates prophylaxis in moderate to severe hemophilia a patients

this is a prospective cohort study of severe hemophilia a patients receiving low-dose ehl fviii concentrates with pk-guided ehl fviii concentrates prophylaxis alone for 6 months. additional exercise workshops from sport scientists were introduced individually to this group of patients along with using the same prophylaxis method for another period of 6 months. the annualized bleeding rates (abr), the annualized joint bleeding rates (ajbr), the haemophilia-specific quality-of-life (haemo-qol-a) scores, the hemophilia joint health scores (hjhs) and skeletal muscle mass were compared between these two periods

Eligibility criteria:
inclusion criteria: * severe hemophilia a patients exclusion criteria: -
cd11b and cd56 as prognostic markers in acute myeloid leukemia

Conditions: Adult Acute Myeloid Leukemia

Summary: 1. detect the expression of marker cd56 and cd11b in newly diagnosed cases of adult aml. 2. study correlation between cd56 and cd11b expression with haematological parameters in cases of adult aml.

1. cd11b expression level is a prognostic biomarker for aml patient. cd11b positivity could predict a poor prognosis for aml patients. 2. cd56 antigen expression, an inexpensive, easy to detect and reproduce index, is closely related to the prognosis of aml patients

Eligibility criteria:
inclusion criteria: anew diagnosis cases of adult aml exclusion criteria: 1. pediatric aml . 2. follow up cases of adult aml
tenecteplase for acute ischemic stroke within 4.5 to 6 hours of onset (exit-bt2)

Conditions: Stroke, Ischemic

Summary: to date, the benefit of intravenous thrombolysis is confined within 4.5 hours of onset for acute ischemic stroke (ais) patients without advanced neuroimaging selection. unpublished pilot exit-bt (extending the time window of thrombolysis by butylphthalide up to 6 hours after onset) suggest the safety, feasibility and potential benefit of intravenous tenecteplase (tnk) in ais within 4.5 to 6 hours of onset. the current study aims to investigate the efficacy and safety of tnk for ais within 4.5 to 6 hours of onset.


Eligibility criteria:
inclusion criteria: * age ≥ 18 year * acute ischemic stroke confirmed by non-contrast computed tomography and use of cta for assessment of lvo as determined by local investigators; * the time from last known well to treatment: 4.5 - 6 hours; * nihss ≥ 4 at randomization; * first stroke onset or past stroke without obvious neurological deficit (mrs≤1); * uncertainty over the benefits and risks of thrombolysis by researcher; * signed informed consent. exclusion criteria: * pre-stroke disability (mrs≥2); * planned intravenous thrombolysis based on wake-up or extend study criterion; * any contraindication to intravenous thrombolysis: obvious head injury or stroke within 3 months; subarachnoid or intracranial hemorrhage; history of intracranial hemorrhage; intracranial tumor, arteriovenous malformation or aneurysm; intracranial or spinal cord surgery within 3 months; myocardial infarction within 3 months; major surgery within 1 month; gastrointestinal or urinary tract hemorrhage within the previous 30 days; arterial puncture at a noncompressible site within the previous seven days; active internal hemorrhage; coagulation abnormalities: platelet count of \ 1.6 or aptt abnormal; systolic pressure ≥185 mmhg or diastolic pressure ≥110 mmhg; blood glucose \< 50 mg/dl (2.7mmol/l); neurological deficit after epileptic seizures; * pregnancy; * allergy to test drugs; * comorbidity with other serious diseases; * participating in other clinical trials within 3 months; * patients not suitable for the study considered by researcher.

Keywords: thrombolysis
chronic postoperative pain after laparoscopic groin hernia repair

Conditions: Postoperative Pain; Chronic Pain

Summary: the study attempts to quantify the relative risks for chronic postoperative inguinal pain (cpip) depending on different combinations of mesh and mesh fixation. for this purpose the investigators will analyze data from the swedish hernia registry (shr).

this is an open cohort study design where the investigators will analyze existing data that have been prospectively collected in the swedish hernia registry (shr), which covers \> 95% of all groin hernia repairs in sweden. the very large cohort of approximately 25,000 primary tep (totally extraperitoneal) and tapp (transabdominal preperitoneal) repairs enable assessment of the relative risks for cpip depending on different combinations of mesh and mesh fixation. each participant was entered at the date of surgery when demographic and intraoperative data were registered. the possible presence of cpip after 1 year postoperative was evaluated with a prom questionnaire.

Eligibility criteria:
inclusion criteria: all laparoscopic tep and tapp repairs that have been registered in the shr from september 1, 2012, until december 31, 2018. exclusion criteria: * open repairs. * hernioplasties that were converted from laparoscopic to open surgery. * previous hernioplasty in the same groin * surgery merely for hernia (eg obturator) other than lateral, medial or femoral. * age \< 15 years. * patients not having a 10-digit state-assigned patient identification number.
long-term study of asenapine in participants with residual subtype, receiving multiple or/and high dose drugs, or treatment refractory schizophrenia (p06238)

Conditions: Schizophrenia

Summary: this is a multi-site, open-label fixed-flexible dose long-term study of asenapine in participants with schizophrenia. participants in this study consist of schizophrenia with residual subtype or receiving high dose/multiple antipsychotic drugs, treatment refractory, or elderly participants with schizophrenia. the treatment period is up to 52 weeks.


Eligibility criteria:
inclusion criteria: * minimum age of 20 years * participants who meet at least one of the following: * current diagnosis of schizophrenia of residual subtype * received treatment with 3 or more antipsychotic drugs * treatment-refractory participants with schizophrenia * 65 years old and over with positive schizophrenia symptoms with score of 3 (mild) or more in 1 or more items in the positive subscale of the positive and negative syndrome scale (panss) at the baseline * participants who have a clinical global impressions-severity (cgi-s) score of at least 4 (moderately ill) at the baseline exclusion criteria: * uncontrolled, unstable clinically significant medical condition * clinically significant abnormal laboratory, vital sign, physical examination, or electrocardiogram (ecg) findings at screening * positive pregnancy test at screening, or the intention to become pregnant during the course of the study * seizure disorder beyond childhood (12 years old or younger) * history of neuroleptic malignant syndrome * allergy or sensitivity to drugs such as psychotropics and antipsychotics * known history of or currently treated for narrow angle glaucoma * parkinson's disease * diagnosis of schizoaffective disorder; schizophreniform disorder * concurrent psychiatric disorder other than schizophrenia coded on axis i; a primary diagnosis other than schizophrenia * diagnosis of borderline personality disorder * diagnosis of mental retardation or organic brain disorder * current (past 6 months) substance abuse or dependence according to diagnostic and statistical manual of mental disorders, fourth edition (dsm-iv) criteria (excluding nicotine) * positive drug/alcohol tests at the screening visit * imminent risk of self-harm or harm to others, in the investigator's opinion * substance induced psychotic disorder or a behavioral disturbance thought to be due to substance abuse * currently under involuntary inpatient confinement * use of a non-approved drug in japan within 12 weeks prior to informed consent * previously treated in an asenapine study
in vitro fertilization impact on metabolic parameters

Conditions: GDM; Insulin Resistance; Glucose Intolerance; PCOS; Obesity

Summary: a quantitative prospective cohort study will be conducted, where blood samples will be collected at different timings during the ivf protocol, to assess the impact of fertility medications on metabolic parameters of patients undergoing ivf treatment.

numerous factors predispose women to develop pregnancy-related complications, these include gestational diabetes (gdm), pre-pregnancy obesity, advanced maternal age (\> 35 years) and gestational age, abnormal weight gain during pregnancy, family history of diabetes, pcos and low parity. evidenced-based studies reported that women with pcos have a significantly higher risk of developing gdm compared with women without pcos, independently of the obesity factor; this risk is higher when both factors coexist. given the known effect of reproductive hormones on weight-gain, controversies still exist on whether art predispose women to more adverse obstetric outcomes compared to normal pregnancy. art describes different procedures to help women become pregnant, with in vitro fertilization (ivf) being the most commonly performed. it has been demonstrated that ivf is associated with glucose intolerance in mice and it will be interesting to determine whether this physiologic phenomenon is also altered by ivf medication (such as estrogen and progesterone) in humans. while some studies reported that singleton pregnancies conceived by art (ivf or ovulation induction) were strongly associated with gdm compared to spontaneous conceptions, other studies did not find significant differences in the risk of gdm. increased gdm risk presented with ivf can be associated with prenatal obesity or secondary to maternal pcos condition. the former studies did not specify the body mass index (bmi) and the medical history of participants undergoing ivf, such as the presence of pcos. due to limited available data, we still cannot distinguish whether these adverse pregnancy outcomes are due to the pre-existing conditions such as pcos, or are secondary to the ivf therapy itself.

Eligibility criteria:
any patient presenting to us for fresh ivf with the following: inclusion criteria: * presenting with or without pcos * presenting with structural or mechanical infertility, such as fallopian tube obstruction, endometriosis, fibroids * presenting with male factor * presenting with or without insulin resistance * combination of more than one of the listed above criteria exclusion criteria: * pre-diabetes or diabetes patients (confirmed by impaired or abnormal ogtt) * age above 39 years of age * taking glucose-lowering meds, such as metformin or janumet. * taking corticosteroids

Keywords: ivf, glucose homeostasis, metabolic parameters
buprenorphine detox with two types of treatment. bbd i - 10

Conditions: Opioid-Related Disorders

Summary: the purpose of this study is to compare overall treatment outcome between behavioral versus standard treatment types.


Eligibility criteria:
please contact site for information.
additive renoprotective effects of oral calcitriol in iga nephropathy patients taking renin-angiotensin system blockers

Conditions: IgA Nephropathy

Summary: this study will help to show the efficacy of vitamin d and address the optimal strategy to minimize renal injury in igan patients.


Eligibility criteria:
inclusion criteria: * biopsy-proven ig an patients aged 20-70 years * patients with residual proteinuria \> 500 mg/g creatinine despite renin-angiotensin system blockade and adequate blood pressure control for more than 3 months * patients who give informed consent, and 4) estimated gfr \>= 30 ml/min/1.73 m2. exclusion criteria: * patients \ 70 years * hypersensitivity to vitamin d analogs * patients who need urgent dialysis * hypercalcemia within 3 months (uncorrected serum calcium level \> 10.2 mg/dl) * clinical features of rapidly progressive glomerulonephritis * life expectancy less than 24 months * uncontrolled hypertension * decompensated liver or lung disease * symptomatic heart failure (nyha class ii-iv or lvef \< 40%) * estimated gfr \< 30 ml/min/1.73 m2.