Kornimate/medical-research-clean huggingface dataset:
plantar pressure analysis and foot biomechanics in lipedema and chronic venous disease

Conditions: Chronic Venous Insufficiency; Lipedema

Summary: chronic venous disease (cvd) are common vascular pathology characterized by a wide spectrum of clinical manifestations occurring with symptoms and/or signs that vary in type and severity. the pathophysiological mechanisms of cvd start from the development of venous hypertension, leading to endothelial dysfunction and venous wall dilatation. lipedema is subcutaneous adipose tissue disorder characterized by enlargement of both lower extremities. previous studies showed that foot deformities such as pes planus or cavus are at a high prevalence in cvd patients, and the authors indicated that foot disorders are an important risk factor that negatively affects venous disease. to the best of our knowledge, there is only one study investigating plantar arch abnormalities in lipedema patients based on clinical observation. therefore, the study aimed to investigate plantar foot distribution and foot deformity in patients with cvd and lipedema.


Eligibility criteria:
inclusion criteria: * diagnosed with cvd or cvd combined with lipedema, * the clinic (c) score of clinical, etiological, anatomical, pathophysiological (ceap) classification was c1, c2 or c3 (c1: telangiectasia-reticular vein; c2: varicose vein; c3: edema) exclusion criteria: * c4, c5 or c6 (presence of skin changes or ulcer) in c score of ceap classification * undergone lower extremity orthopedic surgery within the last year, * have peripheral artery disease * patients who could not mobilize independently

Keywords: foot deformity venous insufficiency pressure lipedema
prophylactic tranexamic acid versus adrenaline during flexible bronchoscopy

Conditions: Bleeding; Hemoptysis

Summary: endobronchial bleeding is a common complication of bronchoscopy. major bleeding, although rare, can be life threatening and often requires advanced therapeutic interventional pulmonary procedures which are not widely available. minor bleeding can negatively impact outcomes such as diagnostic yield, sample size and bronchoscopy duration. both adrenaline and tranexamic acid are successfully used topically for hemostasis during diagnostic bronchoscopy. the aim of this study is to evaluate the efficacy of prophylactically applied adrenaline and tranexamic acid in bleeding prevention during diagnostic bronchoscopy.


Eligibility criteria:
inclusion criteria: * all patients undergoing diagnostic bronchoscopy with sampling (including transbronchial biopsy, endobronchial forceps biopsy, brushing, transbronchial needle aspiration) * signed informed consent exclusion criteria: * any existing contraindication for diagnostic bronchoscopy * coagulopathy (pv inr \> 1.3) * thrombocytopenia (\<50x10\*9 or anemia (hgb \<80 g/l) * doac, lmwh or antiplatelet drug therapy * thrombophilia, history of pulmonary embolism or deep vein thrombosis * contraindication for endobronchial application of adrenaline * uncontrolled coronary artery disease, cerebrovascular disease or arrhythmia * uncontrolled pulmonary hypertension * cardiovascular decompensation * severe hypoxia (pao2 \ =60%)

Keywords: bronchoscopy tranexamic acid adrenaline prophylaxis
mechanisms of the relaxation response in elderly hypertensives

Conditions: Hypertension

Summary: systolic hypertension is a disorder which is characterized by significant elevations in systolic blood pressure in association with normal diastolic blood pressure. typically, this develops in individuals \>50 years of age and is associated with an increased risk of stroke and myocardial infarction. while there are many effective therapies for essential/diastolic hypertension, the treatment of systolic hypertension is complicated by side effects from traditional therapies. this limits therapeutic options and has resulted in a number of at-risk individuals being left untreated. we are conducting a randomized, controlled trial (n=90) to compare the effects of two different stress management training on blood pressure. the primary outcome is change in systolic blood pressure and pulse pressure. secondary outcomes are changes in nitric oxide, stress hormones and psychological well-being. additional analyses will be conducted to assess for other confounding effects on bp and pp.


Eligibility criteria:
inclusion criteria: * male or female; stage i sh (140-159 mm hg sbp and \ 55 years of age; taking at least 1 anti-hypertensive medication at a stable dose for 1 month preceding the screening visit; understanding of english; normal hearing; and able to provide informed consent. exclusion criteria: * presence of current neurological, psychiatric, medical or musculoskeletal disorder; current asthma; severe seasonal allergies resulting in screening no values \> 60 ppb; current smoking; experience with yoga, meditation, guided imagery or other techniques that evoke the rr; hematocrit below 32; glucose lower than 50 or higher than 200; a creatinine greater than 1.3, mini-mental status exam score less than 26 or clinical depression based on a score of greater than 15 on the ces-d and health counselor's clinical evaluation. subjects can not take the following medications: beta-agonist bronchodilators, systemic corticosteroids, anti-convulsants, immunosuppressive or cytotoxic therapy (currently or within the last 12 months), anabolic steroids, anti-depressants (not including ssris), anti-psychotics, chronic sypathomimetic medications, and dicyclomine.

Keywords: nitric oxide
complete decongestive therapy in breast cancer-related lymphedema

Conditions: Lymphedema of Upper Limb

Summary: the purpose of this study is to investigate which number of lymphedema therapy treatments/week best reduces upper extremity swelling, increased arm function, and reduces the most lymphedema symptoms.

complete decongestive therapy (cdt) is the "gold standard" in lymphedema care and has been found to be efficacious in numerous studies. these studies have varying treatment protocols of intensive phase i cdt with dosing ranging from 2x/wk for a mean of 7.5 wks to 6x/wk until a plateau in arm volumes were achieved. this variability in research does not lend itself to recommendations of evidence-based protocol use of cdt in an outpatient setting. although cdt is backed by efficacy studies, the daily dosing given to patients is based on anecdotal rather than evidence-based practice. because the traditional protocol was developed from "longstanding experience," research is necessary to determine the best dosing of the intensive phase of cdt. the purpose of this study is to investigate what level of dosing in the intensive cdt phase promotes best volume reduction and increased upper extremity function in the breast cancer-related lymphedema patient population. this particular study will answer: what dosing produces best volumetric reduction and upper extremity function in the intensive phase of complete decongestive therapy for outpatients with breast cancer-related lymphedema 2x/wk for 4wks or 4x/wk for 4 wks?

Eligibility criteria:
inclusion criteria: 1. have active unilateral breast cancer-related lymphedema 2. medically stable 3. have not participated in lymphedema therapy the past 3 months 4. an affected limb volume measurement of \>10% excess volume 5. ages 18-95 years old * patients undergoing any medical treatment for their breast cancer diagnosis will be included in this study. * patients with any stage breast cancer will be included in this study. * patients with a prior diagnosis of breast cancer, other cancer will be included in this study. there is no minimum time requirement that has prolapsed between their diagnosis and this study. all subjects must have given signed, informed consent prior to registration on study. exclusion criteria: 1. prophylactic treatment indicated 2. a presence of upper extremity wounds present 3. active signs of infection or deep vein thrombosis (dvt) 4. bilateral lymphedema present 5. evidence of contraindications to cdt: uncontrolled hypertension, heart disease including congestive heart failure, and renal insufficiency 6. severe lymphedema present as defined by \> 30% increase in limb volume

Keywords: breast cancer lymphedema
neuromuscular electrical stimulation: a novel treatment for improving metabolism

Conditions: Insulin Resistance

Summary: once written consent is obtained, the participant will be provided with an accelerometer to be worn for 7 days to assess current physical activity levels. subjects will be provided with a standardized diet (55/15/30% cho/pro/fat) prior to collection of pre-intervention data of insulin sensitivity. individuals will then participate in an 8-week electrical stimulation intervention (30min/day, 3x/week) and randomized into placebo/control, nmes, resistance training combined with nmes (rt +nmes), or resistance training (rt) group (n=20 per group), followed by collection of post-intervention data. the control group will receive electrical stimulation up to sensory level, the nmes group will receive stimulation up to tolerable intensity to induce visible muscle contraction, the rt+ nmes will receive stimulation up to tolerable intensity during resistance training, and the rt group will only receive exercise training. control and nmes group will self administer stimulation at home. pre-and post-intervention data includes measurements for body composition, resting metabolic rate, vo2max, insulin sensitivity, and comprehensive blood work.


Eligibility criteria:
inclusion criteria: * overweight/obese (bmi ≥25) * sedentary lifestyle: physical activity level\&lt;1.4 * less than 150min/week of structured exercise exclusion criteria: * use of anti-hypertensive, lipid-lowering or insulin sensitizing medications * excessive alcohol, drug abuse, smoking * pregnant women * unwilling to adhere to the study intervention

Keywords: neuromuscular electrical stimulation glucose continuous monitor blood glucose obesity resting metabolic rate
community-based interventions for infant health in nepal

Conditions: Child Mortality

Summary: an evaluation of the cost-effectiveness of community-based participatory interventions for pregnant women in nepal to reduce fetal \& infant mortality and to improve fetal growth \& cognitive development in infancy


Eligibility criteria:
inclusion criteria: * mothers, community health volunteers exclusion criteria: * none

Keywords: child mortality, nepal, community, care practices
gender-specific preoperative anxiety level and postoperative opioid requirement after ent surgery.

Conditions: Anxiety; Acute Post Operative Pain

Summary: the study will be designed to investigate the impact of the preoperative anxiety level on postoperative opioid requirement during the pacu stay, in order to improve postoperative pain treatment in the long term after ent surgery. the present study can contribute to improve postoperative pain management in patients in the field of ent surgery, as new influencing parameters and risk factors may be discovered.

background due to the frequency of surgeries, acute postsurgical pain (apsp) is a common clinical problem. in this study, the investigators will investigate pre-surgical psychological factors associated with the experience of apsp in ent surgery. the study will be designed to investigate the impact of gender-specific preoperative anxiety states, using the stoa, apais, pcs and vas-a scoring systems, on postoperative opioid consumption after elective ent surgery. these findings may have important implications for developing more personalized strategies in acute postoperative pain therapy in selected patients. aim study aim is to investigate the impact of the preoperative anxiety level, using the validated stoa questionnaire, on postoperative opioid requirement during the pacu stay, in order to improve postoperative pain treatment in the long term after ent surgery. the present study can contribute to improve postoperative pain management in patients in the field of ent surgery, as new influencing parameters and risk factors may be discovered. the investigators hypothesize that a higher preoperative anxiety state, is a predictive factor of opioid requirement in the early postoperative period after ent surgery. methods surgery-related psychological factors like anxiety state will be assessed gender-specific, in patients scheduled for elective ent surgery by validated questionnaires (stoa, apais, pcs and vas-a), filled out by the patient the day before surgery and on the day of surgery, to investigate the correlation with the postoperative opioid consumption.

Eligibility criteria:
inclusion criteria: * american society of anesthesiology (asa) physical status i-iv * able to read and understand the information sheet and to sign the consent form * being scheduled for elective ent surgery under general anesthesia * written informed consent * age≥18 years exclusion criteria: * difficulty to understand study procedure, pain scoring system or questionnaires * surgical procedure warranting elective postoperative ventilation

Keywords: catastrophizing opioid consumption
manuka honey for wound care

Conditions: Wound Healing

Summary: since antiquity, honey has been recognized for its healing properties. literature about the use of medicinal honey for wound care dates back centuries with recent data suggesting its use in patients suffering from burns or pressure ulcers. research has shown manuka honey (leptospermum scoparium) to have significant immune benefits and the ability to influence all phases of wound healing: inflammation, proliferation and remodeling. in addition, numerous clinical studies have identified positive benefits for wound healing. however, there is a lack of prospective, randomized controlled data on the use of honey as a medicinal agent in local wound care and scar healing. in order to better understand manuka honey's ability to aid in healing, the investigators are conducting a randomized, controlled, single-blinded study of patients undergoing reconstructive surgery. this project uses split thickness skin graft and free tissue transfer donor sites as standard wound models to compare the effects of manuka honey versus standard wound care therapies. through the use of standard wound model and objective measurement tools, the investigators hope to better elucidate any benefits of this novel wound care 'technology.'

free tissue transfer (ftt) and split-thickness skin grafting (stsg) are important aspects of head and neck reconstruction. the radial forearm skin flap and fibula osteocutaneous flap are commonly used in head and neck reconstruction. after harvest, closure of these donor sites often requires split thickness skin grafting. the grafting is usually done from the thigh. the grafted free flap donor site along with the stsg donor site is often the source of significant post-operative pain and complications including delayed wound healing, graft loss and infection. there is no consensus in the literature on the best care for these donor sites with surgeons employing a wide variety of surgical dressings for local wound care. there is literature dating back centuries on the use of medicinal honey for wound care, with recent data suggesting its use in patients suffering from burns or pressure ulcers. however, there is a lack of prospective, randomized controlled data on the use of honey as a medicinal agent in local wound care.

Eligibility criteria:
inclusion criteria: * all patients over the age of 18 undergoing reconstructive surgery with ftt and/or stsg exclusion criteria: * all patients under the age of 18 * any patients with documented honey allergy * patients with documented collagen vascular diseases * patients with documented coagulopathy * patients with history of prior skin grafting

Keywords: wound healing honey skin grafts free tissue transfer
a study to investigate safety, tolerability, and pharmacokinetics of azd7503 in participants with suspected nash.

Conditions: Steatohepatitis

Summary: the purpose of this study is to measure the safety, tolerability, and pk (measurement of drug activity in the body over time) of azd7503 injected subcutaneously, and compared to placebo, in participants with suspected nash, a type of liver disease.

this is a phase i, randomised, single-blind (in which the study centre staff including the principal investigator, remain blinded during the clinical conduct of a given cohort) placebo controlled, multiple ascending dose (mad) study in male and female participants conducted at multiple centres. each participant is expected to be in the study for approximately 24 weeks, including a screening period of up to 4 weeks, a 12-week study intervention period, and a follow-up visit at week 18 (10 weeks following the final dose). participants will be randomly assigned in a 3:1 ratio to receive azd7503 or placebo. study intervention will be administered via subcutaneous injection.

Eligibility criteria:
key inclusion criteria 1. biopsy-confirmed nash diagnosis with crn score of fibrosis stage of f1 to f3 within the previous 12 months prior to screening or history of fatty liver disease by imaging plus clinical suspicion of nash based on history of type 2 dm for at least 5 years or overweight/obesity with bmi 25 to 40 kg/m\^2 with 2 additional metabolic syndrome components. 2. males and females of non-child bearing potential. 3. willing to provide written informed consent and comply with study requirements. key exclusion criteria 1. evidence of any clinical important condition which in the investigator opinion makes it undesirable for the participant to participate in the study 2. any clinically significant illness, medical/surgical procedure, or trauma within 4 weeks of the first administration of study intervention 3. history of liver transplant or presence or history of hepatic disease other than nash or histological or imaging evidence of cirrhosis. 4. human immunodeficiency virus (hiv) infection, seropositive for hepatitis b (hbv)virus, seropositive for hepatitis c virus (hcv) 5. history of excessive alcohol consumption 6. uncontrolled high blood pressure 7. any clinically important abnormalities in ecg 8. suspected history of illicit drug abuse 9. clinically important abnormalities in urine and blood laboratory results 10. changes in concomitant medication within 1 month of screening 11. received another investigational drug within 90 days of administration of study intervention in this study 12. has received any chemical entity or investigational drug targeting hsd17b13 (eg, aro-hsd or aln-hsd).

Keywords: cirrhosis
artesunate plus sulfadoxine-pyrimethamine versus chloroquine for vivax malaria

Conditions: Malaria, Vivax

Summary: the purpose of this study was to determine whether the proposed first line treatment for falciparum malaria in this region (sulfadoxine-pyrimethamine + artesunate) would be no worse a treatment for vivax malaria that the standard vivax treatment of chloroquine. in areas where vivax and falciparum malaria co-exist misdiagnosis of vivax malaria as falciparum is not unlikely; it is important to know whether adequate treatment will be received in these cases.

in areas co-endemic for falciparum and vivax malaria incorrect differential diagnosis is always a risk. where the recommended treatment for the two diseases is the same this presents no problem for effective treatment or clinical cure of either species. chloroquine remains an effective treatment of choice for vivax malaria in most settings, but with the spread of chloroquine-resistant falciparum malaria across asia, many countries now use artemisinin-based combination therapy for this species of malaria. differential diagnostic practices, have not improved in parallel. in afghanistan the adoption of sulfadoxine-pyrimethamine plus artesunate (sp+as) as first-line falciparum treatment raises the prospect of a significant proportion of vivax malaria being misdiagnosed and treated with the combination. sp is considered to have limited efficacy against vivax malaria and the efficacy of sp+as against vivax has not been established in areas that have made the switch. a randomized, non-inferiority trial comparing sp+as (1 day sp, 3 days as) to chloroquine monotherapy was undertaken on 190 vivax patients in eastern afghanistan. a margin of equivalence of 14%, with 90% power and 95% ci (two-sided α = 0.05) was used. standard who procedures for in vivo evaluation of antimalarial drugs were followed. 180 individuals completed the trial to day 42. the primary outcome was proportion of patients free from failure at day 28. using a per protocol analysis both regimens resulted in ≥96% treatment success at 28 days, but significantly more cases failed in the cq arm (46%) than in the sp+as arm (24%) by day 42. based on predetermined statistical criteria sp+as was shown to be non-inferior to the standard chloroquine treatment. in areas where vivax infections might be misdiagnosed as falciparum infections and treated with sp+as, patient management would be as good or better than with the standard cq treatment.

Eligibility criteria:
inclusion criteria: * microscopy confirmed p. vivax mono-infection * age \>2 years * weight \>5kg * \>1 asexual parasite per 10 fields exclusion criteria: * pregnant * evidence of concomitant infection or serious disease * recent use of antimalarial drugs * severe malaria * known allergy to study drugs

Keywords: malaria, vivax afghanistan sulfadoxine-pyrimethamine drug resistance
projection of visual material on postoperative delirium in patients undergoing cardiac surgery

Conditions: Delirium; Postoperative Delirium; Cardiac Surgery

Summary: the aim is to evaluate the impact of visual projection of images of relatives or loved ones in patients undergoing cardiac surgery in the immediate postoperative period, and its influence on the incidence and development of postoperative delirium. a randomized, double-blind clinical trial was designed in the immediate postoperative period of adult patients undergoing cardiac surgery. consort guidelines were followed. a control group and an intervention group were established. in the intervention group, the patients underwent a visual projection, while the usual unit treatment was carried out with the control group. sociodemographic, anthropometric, anesthetic, and surgical variables were also recorded. the postoperative delirium assessment scale used was the "confusion assessment method for the intensive care unit scale" (cam-icu). the projection of visual material could reduce the incidence of postoperative delirium in patients undergoing cardiac surgery, although it cannot be established that it is effective as a treatment once the pathology is already established. the results obtained suggest that the visual projection of images is an effective and economical tool to address an increasingly incidental problem due to the aging of the population.


Eligibility criteria:
inclusion criteria: * patients undergoing heart surgery (aortic valve replacement, mitral valve replacement and/or coronary bypass) in the immediate postoperative period during their stay in the cardiac resuscitation unit. * over 18 years of age exclusion criteria: * not being sedated for at least 24 hours. * leven of consciousness. * spanish speaker.

Keywords: cardiac surgery delirium intensive care visual material mental health