Kornimate/medical-research-clean huggingface dataset:
therapeutic intervention code in a cognitive geriatric unit

Conditions: Cognitive Impairment

Summary: the diagnostic and therapeutic progresses, associated with modifications in lifestyle and socio-cultural level of populations, have led to a remarkable increase in life expectancy. at the same time, the increasing medicalization of the individual has eroded the traditional boundaries between health and illness, normal and pathological state. this leads to the patient losing his sense of ownership of his own death. if most patients died at home before the second world war, 75% of the population dies in hospital or institution at the present date. most hospitals and care institutions have developed codes, in multidisciplinary internal consultation, to address the interruption or lack of implementation of treatments that make no sense from a medical point of vue. this avoids therapeutic relentlessness.the code in place within the chu brugmann is: * code a: no therapeutic restriction * code b: not to be resuscitated * code c: not to be intensively treated (no escalation in therapeutic treatments) * code d: best palliative care (progressive de-escalation in therapeutic treatments). these codes are established in consultation with the patient or his legal representative and are re-evaluated in a multidisciplinary way every week. planning a care path and therefore establishing a therapeutic code is particularly important for people with cognitive impairment and dementia because the progressive loss of cognitive abilities complicates the process of decision making. a large part of the admissions are made via the emergency department. for these patients, no therapeutic plan has been established beforehand. however, the perception of the functional and cognitive status of the patient directly influences the intensity of care provided. cognitive disorders are a risk factor for the exclusion of access to palliative care for the elderly patient. the objectives of this study are: * to establish a record of the therapeutic limitation codes in an acute cognitive geriatric unit * to correlate the therapeutic limitation code with the comorbidities of the patients


Eligibility criteria:
inclusion criteria: elderly patients with cognitive impairment admitted in the geriatric unit 83 within the chu brugmann between 01-01-2016 and 31-12-2016. exclusion criteria: none

Keywords: therapeutic code geriatry
long-term outcomes of laa contrast flow in ct scans after endocardial laa closure: the cf-ct registry

Conditions: Atrial Fibrillation; Ischemic Stroke, Acute

Summary: this study is intended to assess the incidence and correlation to the development of peri-device leaks (pdls), device related thrombosis (drts) and cerebral vascular accident (cva)/transient ischemic attacks (tias) in association with left atrial appendage contrast flow (laa-cf). it will be a multi-center, retrospective study. approximately 100 subject charts will be reviewed.

although the clinical significance of long-term left atrial appendage contrast flow (laa-cf) in computerized tomography (ct) scan is unknown, study by lim et al reported that 45 days are not enough for complete left atrial appendage (laa) seal-off after left atrial appendage occlusion (laao) in humans and anatomic closure may not necessarily ensure treatment success. long-term monitoring is warranted in high-risk patients with laao after switching from anticoagulation to antiplatelet therapy. they reported possible explanations for residual laa-cf after laao to be related to peri-device gaps, incomplete endothelialization on the device surface, an off-axis device, fabric leak through the non-endothelialized portion of the device. to this date no studies or registries exist on long term follow up and association of left atrial appendage contrast flow (laa-cf). in this study with two fda approved devices (watchman/watchman flx and amplatzer amulet), it is hypothesized that the laa contrast-flow (cf) rate is related to lack of endothelization of the implanted devices and potentially associated with peri-device leaks (pdls), device related thrombosis (drt).

Eligibility criteria:
inclusion criteria: * subjects must be at least 18 years of age. * subjects underwent laa closure with watchman/watchman flx or amplatzer amulet at our institution from january 2019 till june 2022 exclusion criteria: * no definite exclusion criteria are defined for the study as all patients with watchman-flx or amplatzer amulet will be included in the study.
14-3-3η protein, disease activity and bone mineral density, in female patients with rheumatoid arthritis

Conditions: Rheumatoid Arthritis; Osteoporosis

Summary: is to investigate the relation between 14-3-3η protein, disease activity, and bone mineral density in female patients with rheumatoid arthritis.

methods: all patients in the study will subject to: * clinical assessment, wt, height ,bmi, parity, medications, * das 28. * serum 14-3-3η protein. * dexa scan. grouping: * group i: ra patients with low bmd. * group ii: ra patients with normal bmd. * group iii: normal control.

Eligibility criteria:
inclusion criteria: * rheumatoid arthritis according to acr 2010 criteria with at least one year duration. * premenopausal females. * on conventional dmard with maximum 5 mg steroids. exclusion criteria: * biological treatment. * previous antiresorptive treatment, or bone anabolics. * high dose corticosteroid. * chronic renal or kidney disease. * medications affecting bone metabolism. * thyroid or adrenal dysfunction,

Keywords: 14-3-3η protein
camprobe: developing a safer and simple device for local anaesthetic transperineal prostate biopsies

Conditions: Prostate Cancer

Summary: the camprobe study investigates the rate of infective complications using the cambridge prostate biopsy device method of local anaesthetic transperineal prostate biopsies.

the current method for diagnosing prostate cancer requires a biopsy needle to pass through the bowel wall to reach the prostate. bacteria in the bowel inevitably enter the urinary system and blood stream. a significant number of men develop infections despite preventative antibiotics (1 in 10 develop fevers/shivers and 1-2 in 100 get a life-threatening infection). it is crucial we find a safer biopsy method for suspected prostate cancer as over 1 million rectal biopsies occur each year. a safer alternative device was developed, performed under local anaesthetic using the transperineal route: camprobe (cambridge prostate biopsy device). camprobe biopsies are taken through the perineum (the area under the testicles), so there is no infection risk, and it's just as good at diagnosing prostate cancer. this investigation progresses from a prototype to a disposable, single use device that any uk hospital can use. the study will assess camprobe's ability to reduce infections from prostate biopsies and its usability as an alternative to the current standard biopsies. men recommended to undergo a prostate biopsy will be eligible for this multi-centre study. for each patient, the study will take approximately 30 days, consisting of: recruitment, 1 day for the procedure (replaces the standard biopsy pathway) and questionnaires on day 1, 7 and 30. this timeframe will not introduce delays in the patients' normal standard care pathway. patients will have a transperineal biopsy with camprobe instead of the current transrectal method. biopsy samples will be treated the same as standard procedure. patients' acceptability of the procedure and complications will be measured using patient self-reported questionnaires.

Eligibility criteria:
inclusion criteria: to be included in the clinical investigation the participant must: * have given written informed consent to participate * be aged 18 years and over * be suitable for a prostate biopsy and clinically due to have a biopsy for diagnostic or surveillance purposes * be willing and able to comply with scheduled visits and completion of study questionnaires exclusion criteria: the presence of any of the following will preclude participant inclusion: * contraindication to a prostate biopsy * previous perineal or anal surgery * unable to lie down with legs in a stirrup for at least 45 minutes, as assessed by a clinician
corifollitropin alfa versus daily rfsh in the controlled ovarian stimulation of poor responders

Conditions: Infertility

Summary: a randomised, crossover, multicentre, national, clinical trial comparing the efficacy of corifollitropin alfa versus daily recombinant fsh and hmg in the controlled ovarian stimulation of women with a poor ovarian response undergoing ivf treatments. the main objective of this study is comparing the number of oocytes obtained after the follicle puncture when using each of these two stimulation protocols. only poor responders according to the bologna criteria will be recruited for this trial. all participants will undergo two stimulation cycles to obtain and accumulate oocytes by vitrification. one of the cycles will be done with the corifollitropin alfa protocol and the other with daily rfsh and hmg, the order of application of these protocols will be randomised (crossover clinical trial) in each patient.


Eligibility criteria:
inclusion criteria: * advanced maternal age (≥40 years) * a previous poor ovarian response (≤3 oocytes with a conventional stimulation protocol) * an abnormal ovarian reserve test (i.e. antral follicle count \<5-7 follicles or anti-mullerian hormone level \<0.5-1.1 ng/ml)

Keywords: poor ovarian response controlled ovarian stimulation randomised clinical trial corifollitropin alfa recombinant follicle-stimulating hormone (rfsh) human menopausal gonadotropin (hmg)
magnesium sulfate for analgesia in pediatric transplant

Conditions: Postoperative Pain

Summary: to use magnesium sulfate as adjuvant analgesia by implementing a treatment protocol in order to determine whether can benefit pediatric pain in post-operative transplanted patients and decrease overall opioid consumption.

the post-operative icu course for children receiving liver transplants and tpiat (total pancreatectomy with islet cell autotransplantation) includes a number of different challenges, one of which includes pain. pain is treated with both medications and approaches without medications (such as music and other distraction techniques). opioids are one such effective pain medication which is universally used, however like all medications has risks of certain side effects (such as nausea, constipation, itching, and others). modern research has searched for other medications and methods to treat pain in both children and adults. in this study, the investigators aim to apply one of these methods that has been shown to be effective in certain operative populations through a medicine called magnesium-sulfate, which may be a safe way to decrease the use of other pain medications (specifically opioids). magnesium is already a physiologic electrolyte the body uses, which are consumed from certain foods. used as an iv medication to reach higher levels of magnesium can work to decrease pain via its action on specific nerve receptors. magnesium-sulfate will be given at the beginning of transplant surgery for consented liver and tpiat transplant patients, and continue an infusion for 48 hours into their icu course. the investigators will monitor side effects and treat pain the same way otherwise the care team would without magnesium to determine whether there is any beneficial effect that can be applied to children in the future.

Eligibility criteria:
inclusion criteria: experimental group: - be scheduled for and receive a liver transplant or total pancreatectomy and islet cell autotransplantation control group: - received a liver transplant or total pancreatectomy and islet cell autotransplantation. exclusion criteria: experimental group: * pregnant or unwilling to abstain from sex if not practicing birth control during participation in the study. * presence of a condition or abnormality that in the opinion of the investigator would compromise the safety of the patient or the quality of the data. * known allergic reactions to components of the mgso4 * history of heart block or myasthenia graves in past medical history. * presence of cardiac pacemaker * any patient with preoperative creatinine level \> 1.5x upper limit of normal. control group: * any patient who had filed as research-exempt (opt-out of research previously). * any patient with preoperative creatinine level \> 1.5x upper limit of normal.
accuracy of extra-oral bite-wing radiography in detecting calculus and crestal bone loss

Conditions: Periodontitis; Calculus, Dental; Bone Loss, Alveolar

Summary: to compare the diagnostic accuracy of extra-oral x-rays with intra-oral x-rays, in contrast to clinically observed measurements, for the detection of calculus and bone loss of either the suprabony or infrabony types in patients undergoing periodontal surgery.


Eligibility criteria:
inclusion criteria: * patients must be active patients of record at cu school of dental medicine * patients will have an active treatment plan for periodontal open flap surgery * patients will be classified as either asa i or asa ii * patients must have periodontal probing depths \>/= 5mm and radiographic sings of marginal bone loss (supra or infra bony) exclusion criteria: * less than 18 years of age * asa iii or above * emergency patients * pregnant patients * patients who are not patients of record at the cu school of dental medicine * patients with a recent panoramic radiograph that contraindicates the need for new imaging in the form of extra-oral bitewings
sharing and talking about my preferences

Conditions: Chronic Disease

Summary: the purpose of this study is to figure out the best way to help veterans do advance care planning. this study will examine the effects of two theory based behavior interventions by randomizing veteran into 4 groups to see which veterans will complete the 4 step process of advance care planning.

purpose: the purpose of this study is to examine the effects of two theory-based behavior interventions on engagement of veterans in advance care planning (acp) by means of the following specific aim: primary aim: to conduct a randomized controlled trial examining the effects of: a) usual care; b) computer-tailored intervention (cti); c) motivational enhancement therapy (met); d) cti + met on the proportion of middle-age and older veterans receiving primary care at the va who complete the process of acp, defined as completing a total of 4 key acp behaviors, including selecting a health care proxy, communicating with the proxy about goals of care, communicating with the clinician about goals of care, and documenting proxy selection and goals. primary hypothesis: the proportion of veterans completing acp will be higher among those in each of the intervention groups compared to veterans receiving usual care. all of 4 groups will receive their assessments and, if, their interventions, by telephone and/or mail. the veterans will from the va connecticut healthcare system. participants will be identified through a data query of the regional data warehouse who have had a primary care visit in the past 12 months. we will then be able to oversample female and minority veterans.

Eligibility criteria:
inclusion criteria: * veteran ---must have seen primary care provider in the past 12 months * primary language is english exclusion criteria: * severe hearing or vision loss * moderate-to-severe cognitive impairment * active psychiatric illness * no regular phone or permanent address
functional endoscopic evaluation of swallowing

Conditions: Cerebral Palsy; Dysphagia

Summary: the investigators objective is to describe functional endoscopic evaluation of swallowing findings in children with cerebral palsy.

cerebral palsy (cp) is a predominantly motor disorder and dysphagia is a frequent complaint. functional endoscopic evaluation of swallowing (fess) involves anatomic and functional observation of the larynx and pharynx, evaluation of swallowing and maneuvers to improve it, also testing the laryngeal sensitivity. we evaluated nine patients with cp of both sexes, which age varied from 1 to 10 years old, attended at dysphagia multidisciplinary clinic, at nami (integrated medical assistance nucleons).

Eligibility criteria:
inclusion criteria: * medical diagnosis of cerebral palsy. exclusion criteria: * medical diagnoses not associated with cerebral palsy that affect swallowing.

Keywords: cerebral palsy dysphagia deglutition endoscopy
mapping of sentinel lymph node drainage using spect (suspect) (suspect)

Conditions: Head and Neck Cancer

Summary: this study aims to explore the feasibility, safety and outcome of a non-invasive sentinel node mapping (snm) to individually tailor the elective nodal irradiation (eni) to the ipsilateral neck only and to exclude the contralateral negative neck from the irradiation fields when there is no draining sentinel node. subsequently the dose to the salivary glands, mucosal area and the swallowing and chewing muscles and structures involved in voicing and articulation will significantly be reduced


Eligibility criteria:
inclusion criteria: * newly diagnosed patients with histopathologic proven primary hnscc (t1 -3 n0 -1) located in the oral cavity, oropharynx, larynx (except t1 glottic ), and hypopharynx, not crossing the midline and planned for treatment with (chemo)radiotherapy in curative setting * no chemotherapy or surgery prior to inclusion * no distant metastatic spread at the time of inclusion * age ≥ 18 years * who performance status 0 or 1 * signed written informed consent exclusion criteria: * patients with previously radiation treatment in the head and neck region, for any reason * patients with previous neck dissection * patients with recurrent or second primary tumor in the head and neck region * patients with head and neck malignancies arising from skin, lip, nose, sinuses, nasopharynx, salivary glands, thyroid gland or esophagus * previous history of cancer in the last five years (excluding basal cell carcinoma of the skin and in situ scc of the cervix) * pregnancy or no active contraception for pre-menopausal women * known hypersensitivity to iodine or nanocolloid injection * having any condition (physical, mental, sociological) that interferes with the informed consent procedure and follow up schedules

Keywords: radiotherapy, sentinel node mapping, spect
oxymorphone extended release in patients with cancer or neuropathic pain

Conditions: Chronic Pain; Neuropathic Pain; Cancer

Summary: the purpose of this study is to determine if oxymorphone extended release is effective and safe in treating chronic pain in patients with cancer or neuropathic pain.

the purpose of this study is to evaluate the analgesic effectiveness and tolerability of oxymorphone er in the treatment of cancer or neuropathic pain. opioid-naïve subjects are gradually titrated from oxymorphone er 5 mg, every 12 hours (q12h). all other subjects are titrated to a stable dose (defined as pain scores ≥ 4 on bpi question 5 on 3 of 5 consecutive days while receiving the same total daily dose of study medication including rescue) with tolerable side effects. subjects could potentially receive therapy for up to 12 months after the first dose of study medication.

Eligibility criteria:
inclusion criteria: * ≥ 18 years of age or older, with moderate to severe chronic malignant and/or neuropathic pain of at least 3 months duration and either: 1. have an initial pain intensity score of greater than 4 on a 10-point scale using bpi question 5, if sub-optimally responding to their current analgesic regimen, or 2. have intolerable side effects to one or more components of their current opioid-containing analgesic regimen. * currently receive a stable (at least 2 weeks duration) analgesic regimen * if female, must be practicing abstinence or using a medically acceptable form of contraception (e.g., intrauterine device, hormonal birth control, or double barrier method). * understand written and spoken english * have been informed of the nature of the study and provided written informed consent additional inclusion criteria for cancer patients only: * have a life expectancy of at least 12 months additional inclusion criteria for neuropathic patients only: * have a diagnosis of: * post-herpetic neuralgia (phn) * diabetic neuropathy (dn) * complex regional pain syndrome (crps) * hiv neuropathy * idiopathic sensory neuropathy * traumatic peripheral neuropathy * central neuropathic pain condition (spinal cord injury, post-stroke pain), or * other peripheral neuropathy (upon mutual agreement of the sponsor and investigator). exclusion criteria: * have a positive pregnancy test (females only) * have a history of or active asthma or emphysema * have clinically significant hepatic impairment * have a history of alcohol or substance abuse within the last 3 years * have a history of opioid abuse within 6 months prior to study entry * have a known allergy or significant reaction to opioids, including codeine * have a known oxymorphone sensitivity or allergy * have received an investigational drug or product or participated in an investigational drug study within a period of 30 days prior to receiving study medication

Keywords: cancer pain neuropathic pain extended release long-acting opioid oxymorphone
3d ultrasound measurement of junctional zone thickness and its relation to implantation success

Conditions: Infertility

Summary: 100 patients aged 21-40 years old, diagnosed as primary or secondary infertility . these patients are then assigned to receive fertility treatment (ovulation induction, icsi, intrauterine insemination and ivf). they undergo a 3d vaginal ultrasound before treatment to measure the junctional zone thickness and followed up after treatment to determine the rate of implantation.


Eligibility criteria:
inclusion criteria: * infertile women exclusion criteria: * congenital uterine anomalies medical disease contraindicating pregnancy

Keywords: junctional zone implantation three d ultraosund assisted reproductive technology pregnancy
intensive combined chelation therapy for iron-induced cardiac disease in patients with thalassemia major

Conditions: Iron Overload; Cardiomyopathy

Summary: myocardial iron overload is the leading cause of death in patients with beta-thalassemia major (tm). therapy with deferoxamine (dfo) combined with deferiprone (dfp) reduces myocardial iron and improves cardiac function. however, the prognosis for tm patients with established cardiac disease switched from dfo monotherapy to combined dfp/dfo chelation is unknown. twenty-eight tm patients with cardiac disease were enrolled in a prospective study lasting 42±6 months. fifteen (9 high-ferritin and 6 low-ferritin) were placed on dfp/dfo (dfp, 75 mg/kg t.i.d.; dfo, 40-50 mg/kg over 8-12 h at night 5-7 d/wk), while 13 (5 high- and 8 low-ferritin) received dfo alone. no cardiac events were observed among high-ferritin patients on combination therapy, whereas 4 cardiac events (p=0.0049), including three deaths, occurred in high-ferritin patients on dfo monotherapy. these findings demonstrate that in tm patients with well-established cardiac disease combined iron-chelation therapy with dfp/dfo is superior to dfo monotherapy.


Eligibility criteria:
inclusion criteria: cardiomyopathy secondary to iron overload exclusion criteria: heart failure