Kornimate/medical-research-clean huggingface dataset:
erector spinae plane block versus serratus plane block for breast surgery

Conditions: Postoperative Pain; Breast Cancer

Summary: serratus plane block (spb) was first described in 2013 by blanco and designed to primarily block the thoracic intercostal nerves. and this block provides sufficient analgesia lateral anterior and posterior part of thoracic wall.erector spinae plane block (espb) is a newly described and effective interfascial plane block for thoracic and abdominal surgery. it was first described by forero et al. in 2016, effectiveness being reported in four cases. the aim of this study is to compare serratus plane block and erector spinae plane block on postoperative pain in patients undergoing modified radical mastectomy and axillary lymph node dissection


Eligibility criteria:
inclusion criteria: * american society of anesthesiologist's physiologic state i-iii patients * undergoing breast cancer surgery * 18-65 years exclusion criteria: * chronic pain * bleeding disorders * renal or hepatic insufficiency * patients on chronic non-steroidal anti-inflammatory medications * emergency cases * coagulopathy
european transfusion practice and outcome study

Conditions: Surgery; Erythrocyte Transfusion; Habits; Anemia; Blood Coagulation Disorders

Summary: the aim of the etpos study is to describe differences in transfusion habits throughout europe and to correlate these habits to perioperative outcome parameters. special focus is put on the number of prbcs (packed red blood cells) transfused and the ratio of prbcs to other blood products or coagulation factors in the operating room. furthermore the motivation of physicians to transfuse prbc and blood products in the operating room will be investigated.

in european patients undergoing elective non-cardiac surgery receiving at least one prbc(packed red blood cells) during their surgery it is proposed to: 1. evaluate evidence of differences in the standard of peri-operative transfusion care in different healthcare systems within europe, and the use of blood conserving techniques. 1. evaluate the ratio of transfusion of prbc to blood products in the operating room 2. evaluate which factors determine transfusion of prbc (is it patient's haemodynamics / haemoglobin threshold/ pressure from the surgeon / acute brisk bleeding / else) and blood products (ratio to prbc / poc (point of care) monitoring/ per protocol/ else) in the operating room 2. evaluate whether there are factors in transfusion therapy that are associated with outcome (in-hospital mortality and unplanned admission to icu(intensive care unit).)

Eligibility criteria:
inclusion criteria: - patients undergoing elective non-cardiac surgery commencing during the three-month period and who received at least one erythrocyte concentrate during their intra-operative stay. exclusion criteria: * age \< 18 years * cardiothoracic surgery * emergency trauma patients

Keywords: transfusion packed red blood cells (prbc) transfusion practice transfusion habits outcome elective surgery etpos esa european society of anaesthesiology
efficacy of a habit reversal treatment on tic-symptoms

Conditions: Tic-Disorder

Summary: the main purpose of this study is to evaluate the efficacy of a habit reversal based treatment programme in children and adolescents aged 8 to 18 years with tic disorders.

the main purpose of this study is to evaluate the efficacy of a habit reversal based treatment programme for children and adolescents with tic disorders. this habit reversal treatment programme was developed at the department of child and adolescent psychiatry and psychotherapy at the university of cologne and has already been evaluated in a pilot-study (woitecki \& döpfner, 2011, 2012).

Eligibility criteria:
inclusion criteria: * 8-18 years * diagnosis of chronic motor or vocal tic (f95.1) or tourette-syndrome (f95.2) * ygtss total score f95.2\>13, f95.1\>9 * tics are the main problems * iq\>80 * if medication, then has been stable for at least one months in medicated patients * no change in medication treatment is planned * ability to participate in weekly outpatient treatment * acceptance of randomization exclusion criteria: * diagnosis of autism spectrum disorder or psychosis * parallel continuous psychotherapy of tics or comorbid

Keywords: tic-disorder, tourette-disorder, habit reversal training
omega-3 fatty acids that affect the immune system in kidney transplant patients

Conditions: Kidney Diseases

Summary: the purpose of this study is to evaluate the effectiveness of nutritional supplements in increasing the amount of omega-3 fatty acids (and arginine) in the red blood cell membranes and plasma of kidney transplant patients, and, secondarily, to compare patient compliance. the long-term goal of this study is to develop low risk therapies that will allow improved and lasting survival of donor tissue with minimal suppression of the immune system.

short-term survival rates of donor tissue after kidney transplantation have improved significantly in recent years because of improved immunosuppression. rates of long-term tissue loss have changed less because of a high incidence of chronic rejection, infectious complications, and cardiovascular disease. data suggest that both early and late complications might be reduced in transplant recipients by dietary intervention to raise levels of omega-3 fatty acids and arginine. prior to transplantation, participants are randomized to one of three groups. group 1 participants serve as controls and receive no dietary supplements. participants in group 2 receive daily nutritional supplements of arginine and canola oil according to body weight. group 3 participants receive daily nutritional supplements of arginine and a fish oil emulsion according to body weight. all participants receive a standard, low-fat dietary consultation. the status of participants is evaluated peri-transplant and at 1, 3, 6, and 9 months.

Eligibility criteria:
inclusion criteria: * end-stage renal disease. * candidate to receive a living-related donor, living unrelated donor, or first cadaver kidney with at least 1 hla mismatch. * negative crossmatch with the intended donor. * adults must have moderate to severe hypertension and/or take at least 1 medication for hypertension daily. * willingness to comply with the dietary supplements, including canola oil, a flavored drink mix, or an orange flavored pudding. exclusion criteria: * pregnancy or breast-feeding. * women of childbearing age who are not willing or able to practice acceptable methods of contraception. * hiv-positive. * positive test for hbv e-ag/dna and hcv. * received an organ transplant or plan to receive a multiple organ transplant. * phenylketonuria. * participation in other investigational studies within 30 days of the renal transplant. * allergy or anaphylactic reactions to eggs or l-arginine. * abo blood incompatibility. * children who have previously received more than 5 blood transfusions. * history of stroke.

Keywords: kidney transplantation fatty acids, omega-3 erythrocyte membrane graft survival
pragma (prostate radio ablation guided by magnetic resonance imaging acquisition) in metastatic prostate cancer

Conditions: Metastatic Prostate Cancer

Summary: patients with metastatic prostate cancer can undergo mri-guided prostate stereotactic body radiation therapy (sbrt) without significant adverse events, similar to what has been reported for patients with localized prostate cancer. we hypothesize that prostate sbrt will be well-tolerated in metastatic prostate cancer patients, with quality of life outcomes similar to what has been reported in non-metastatic prostate cancer patients.

the mridian viewray offers delivery of prostate sbrt with real-time mr guidance, which provides superior soft-tissue differentiation with excellent visualization of the prostate. this viewray platform offers the ideal setting for this study, that aims at precisely delivering prostate sbrt with a simultaneous integrated boost (when indicated) to visible nodules. in this study, we hope to demonstrate the safety and feasibility of using 36.25 gy in 5 fractions, plus a simultaneous integrated boost (when indicated), in patients with metastatic prostate cancer.

Eligibility criteria:
inclusion criteria: * biopsy-proven diagnosis of prostate adenocarcinoma * age ≥ 18 * must have biopsy-proven metastatic prostate cancer exclusion criteria: * history of prior pelvic radiation (external beam or brachytherapy) * inability to undergo mri * aua score \>20 * for patients on systemic therapy, enrollment must be within six months of start of therapy unless exception is made by protocol pis.
the social determinants of health screening and referral project

Conditions: Preterm Birth

Summary: up to a quarter of the families with preterm infants have unmet social needs, such as housing or job insecurity, which represent adverse social determinants of health (sdoh). preterm infants are especially vulnerable to the social conditions they grow up in, with sustained impacts on function across multiple organ systems. the goal of this study is to translate an established model of sdoh screening and referral from the outpatient setting to the nicu, thereby maximizing the potential to offset the effects of adverse sdoh on vulnerable mother-preterm infant dyads.

the goal of this study is to implement sdoh screening and referral models in 7 safety net nicus, examining their potential to offset the effects of adverse sdoh for a highly vulnerable population at the earliest stages of life. the investigators propose a hybrid effectiveness-implementation stepped wedge cluster randomized trial using the proctor conceptual model of implementation research. the investigators will follow a cohort of 882 mother-infant dyads longitudinally for 12 months after nicu discharge to examine family, maternal, and infant outcomes. each site will participate in three phases: usual, experimental, and sustainment. the study aims are to: aim 1: examine the implementation of sdoh screening and referral models into the nicu (acceptability, feasibility, penetration, equity, and sustainability). aim 2: examine the effectiveness and equity of sdoh screening and referral models in the nicu setting on parental receipt of community resources for unmet social needs 3 months post-nicu discharge. aim 3: explore the effectiveness of sdoh screening and referral models in the nicu to improve (a) maternal mental health (depression) and (b) health and developmental outcomes of preterm infants (quality of life, growth, development, and respiratory disease) during the 12 months post-nicu discharge.

Eligibility criteria:
inclusion criteria: * infant gestational age \<34 weeks' gestation; singleton or multiple. * infant hospitalized for at least 14 days of life (to allow for sdoh screening/referral and contact with resources if applicable). * mother and infant are alive. * mother speaks and reads english or spanish. * infant will be discharged home from the nicu (to allow for follow-up). * mother will care for her infant(s) at home in the us for at least 12 months after discharge from the nicu. exclusion criteria: * mothers or infants who die before anticipated infant discharge. * infant discharged after 52 weeks postmenstrual age.

Keywords: neonatal intensive care unit (nicu) social determinants of health (sdoh) we care sdoh screening and referral mother-infant dyads maternal depression safety net hospitals
use of compromised lung volume in monitoring usage of steroid therapy on severe covid-19

Conditions: COVID-19 Pneumonia; Quantitative Computed Tomography

Summary: since december 2019, the outbreak of coronavirus disease 2019 (covid-19) has become a public health emergency of international concern. although corticosteroid therapy represents a milestone in the management of covid-19, many questions remain unanswered. the optimal type of corticosteroids, timing of initiation, dose, mode of administration, duration, and dose tapering are still unclear. an approach to resolve these issues is to develop accurate tools to assess or monitor the progression of covid-19 during the corticosteroid therapy process. quantitative computed tomography (qct) analysis may serve as a tool for assessing the severity of covid-19 and for monitoring its progress. however, the effect of steroids on quantitative chest ct parameters during the treatment process remains unknown. in this retrospectively study, we aimed to assess the association between steroid administration and qct variables in a longitudinal cohort with covid-19

since december 2019, the outbreak of coronavirus disease 2019 (covid-19) has become a public health emergency of international concern. although corticosteroid therapy represents a milestone in the management of covid-19, many questions remain unanswered. the optimal type of corticosteroids, timing of initiation, dose, mode of administration, duration, and dose tapering are still unclear. an approach to resolve these issues is to develop accurate tools to assess or monitor the progression of covid-19 during the corticosteroid therapy process. quantitative computed tomography (qct) analysis may serve as a tool for assessing the severity of covid-19 and for monitoring its progress. however, the effect of steroids on quantitative chest ct parameters during the treatment process remains unknown. in this retrospectively study, we aimed to assess the association between steroid administration and qct variables in a longitudinal cohort with covid-19.

Eligibility criteria:
inclusion criteria: * (1) age 18-90 years * (2) patients with severe or critical covid-19. exclusion criteria: * (1) hematological or solid malignancies * (2) patients with less than two ct scans during hospital stay * (3) systemic corticosteroid or immunosuppressive therapy in the previous 6 weeks.

Keywords: steroid covid-19 quantitative computed tomography compromised lung volume
postoperative knee strength following total knee replacement: a double-blinded randomized comparison study

Conditions: Total Knee Replacement; Primary Knee Arthroplasty

Summary: major surgery involving the knee is often associated with severe postoperative pain. postoperative pain control remains a significant contributor to delayed recovery and length of hospital stay. approaches to minimize postoperative pain after surgery are a matter of major concern due to the need for early mobilization, a crucial factor in good postoperative rehabilitation. femoral nerve blocks by either continuous infusion or single injection of anesthetics provide an effective method for analgesia while minimizing the need for systemic opioid therapy, reducing the opioid induced side effects, and facilitating early ambulation. administration of fentanyl has shown to be a highly effective method to control pain after total knee replacement (tkr). the investigators hypothesize that fentanyl infusions will result in greater post-operative strength in the operative knee.

all subjects scheduled to receive a unilateral, primary total knee replacement were evaluated for eligibility in the preoperative anesthesia center. adults, older than 18 years of age, asa i-iii were included in the study. subjects who were either pregnant, on anticoagulant therapy, allergic to opioids, local anesthetics, chronic pain patients, history of traumatic lower extremity injury, or had a body mass index of greater than 35 kg/m2 were excluded from the study.

Eligibility criteria:
inclusion criteria: * patients undergoing unilateral primary total knee replacement * asa class i-iii * 18 years and older exclusion criteria: * patient refusal * pregnancy * coagulopathy * adverse/allergic reaction to any opioids or local anesthetics * history of long-term opioid use (greater than 60 days) * infection * traumatic lower extremity injury

Keywords: regional anesthesia post-operative pain management femoral nerve block total knee replacement
telehealth intervention for youth with t1dm

Conditions: Type 1 Diabetes Mellitus

Summary: hospitalization of youth with established diabetes is both costly and frequently preventable. poor glycemic control is a risk factor for hospitalization and is also associated with adolescent age and lower socioeconomic status. this is a randomized, controlled trial for high-risk adolescent youth with t1dm and suboptimal glycemic control with an intervention arm and usual care control arm matched for frequency of contacts. there will be 110 subjects with t1dm and hba1c\>8%, aged 13 to 17 years, recruited from the diabetes program at boston children's hospital and followed for 6 months. the intervention will be implemented by a diabetes nurse educator and social worker, who will each have monthly contact with the adolescent and a parent/guardian through a telehealth (videoconference) visit. care will be guided by a diabetes action plan. telehealth interventions have been utilized successfully in both adults and youth with diabetes. they facilitate frequent contact with the care team allowing barriers to adherence to be addressed, education to be reinforced, care plans to be updated, and diabetes-specific family support to be provided.


Eligibility criteria:
inclusion criteria: * age 13 to 17 years * type 1 diabetes for ≥1 year * hba1c\>8% * able to speak and read english (child) * able to speak and read english (parent) * parent agrees to participate * parent and child each have email addresses exclusion criteria: * plan to transition diabetes care to a center other than boston children's hospital * no visit to boston children's hospital diabetes program in year prior to recruitment * current participation in another diabetes-related study with an intervention * living with or related to another study participant * significant psychopathology or medical illness that would limit the subject's ability to provide assent and/or participate in the study procedures as determined by the pi. * no internet access

Keywords: diabetes mellitus adolescents
study of vidaza versus conventional care regimens for the treatment of acute myeloid leukemia (aml)

Conditions: Acute Myeloid Leukemia

Summary: the purpose of this study is to compare the effect of azacitidine (vidaza) to conventional care regimens on overall survival in elderly aml patients.


Eligibility criteria:
inclusion criteria: * diagnosis of one of the following * newly diagnosed de novo acute myeloid leukemia (aml) * aml secondary to myelodysplastic syndromes (mds) * aml secondary to exposure to leukemogenic therapy or agents with primary malignancy in remission for at least 2 years * bone marrow blasts \>30% * age ≥ 65 years * easter cooperative oncology group (ecog) 0-2 exclusion criteria: * previous cytotoxic or biologic treatment for aml (except hydroxyurea) * previous treatment with azacitidine, decitabine or cytarabine * prior use of targeted therapy agents (e.g., flt3 inhibitors, other kinase inhibitors) * aml french american british subtype (fab m3) * aml associated with inv(16), t(8;21), t(16;16), t(15:17), or t(9;22) karyotypes * prior bone marrow or stem cell transplantation * candidate for allogeneic bone marrow or stem cell transplant * diagnosis of malignant disease within the previous 12 months (excluding base cell carcinoma, "in-situ" carcinoma of the cervix or breast or other local malignancy excised or irradiated with a high probability of cure) * malignant hepatic tumors * uncontrolled systemic infection * active viral infection with human immunodeficiency virus (hiv) or hepatitis type b or c * use of any experimental drug or therapy within 28 days prior to day 1

Keywords: acute myeloid leukemia cytarabine vidaza azacitidine intensive chemotherapy low dose cytarabine celgene
pulmonary rehabilitation: effects on cognitive functioning, mood, anxiety, and quality of life in patients with copd

Conditions: Chronic Obstructive Pulmonary Disease COPD

Summary: the purpose of this project is to investigate whether a 12-week, fulltime pulmonary rehabilitation program can enhance cognitive functioning, mood, anxiety, and quality of life in patients with chronic obstructive pulmonary disease (copd).


Eligibility criteria:
inclusion criteria: * copd * referral to the extensive pulmonary rehabilitation program exclusion criteria: * unfinished primary school * referral to the compact pulmonary rehabilitation program

Keywords: copd cognitive dysfunction pulmonary rehabilitation quality of life cognitive rehabilitation
sitagliptin reduces left ventricular mass in normotensive type 2 diabetic patients with coronary artery disease

Conditions: Newly Diagnosed Type 2 Diabetes; Coronary Artery Disease

Summary: cardiovascular complications account for the highest mortality in type 2 diabetic patients, mainly due to coronary artery disease (cad).left ventricular hypertrophy (lvh) is widespread in type 2 diabetic patients with cad, even in the absence of hypertension .it is a strong predictor of cardiovascular events and all-cause mortality . sitagliptin, an inhibitor of dipeptidyl peptidase-4 (dpp-4), may regress left ventricular mass (lvm) in newly diagnosed type 2 diabetic patients with cad .


Eligibility criteria:
inclusion criteria:patients had to have the levels of hemoglobin a1c (hba1c) \> 7.0 %. they also had to have either angiographically documented coronary artery disease or a previous history of myocardial infarction. in addition, they were also required to have an office bp \ 115 g/m2 for men and \> 95 g/m2 for women) . - exclusion criteria:patients were excluded if they were currently prescribed glucagon-like peptide (glp) -1 analogues or dpp-4 inhibitors or glucosidase inhibitor or anti-hypertensive drugs (including b-blockers), diabetes medications, estrogen supplements, thyroxine, diuretics, hypolipidemic drugs. they were also excluded if they had renal and liver dysfunction, heart failure, or malignancy, or were unable to give informed consent. patients with contraindications to cardiac magnetic resonance (cmr) (pacemakers, claustrophobia) were also excluded, as were pregnant or lactating women. -

Keywords: type 2 diabetes left ventricular mass inhibitor of dipeptidyl peptidase-4
protocolized reduction of non-resuscitation fluids versus usual care in septic shock patients

Conditions: Septic Shock

Summary: the objective of this trial is to assess the beneficial and harmful effects of a restrictive strategy for administration of non-resuscitation fluids in adult patients with septic shock.


Eligibility criteria:
inclusion criteria: * adult (≥ 18 years of age) * septic shock according to the sepsis 3 criteria at any time within 12 hours after icu admission (suspected or confirmed infection, plasma lactate above 2 mmol/l, and infusion of vasopressor/inotrope to maintain mean arterial pressure of 65mmhg or above after receiving adequate fluid resuscitation \[\> 1l within 12 h of screening\]) and need for vasopressors at the time of screening. exclusion criteria: * confirmed or suspected pregnancy * previous inclusion in the trial * screened more than 12 hours after icu admission

Keywords: septic shock