Kornimate/medical-research-clean huggingface dataset:
recurrent throat infections and tonsillectomy

Conditions: Tonsillitis; Pharyngitis

Summary: the purpose of this study is to find out if tonsillectomy reduces the short-term risk of having an objectively confirmed (sequential changes in serum crp and procalcitonin levels) delayed pharyngitis episode among patients suffering from recurrent pharyngitis episodes. other aims are to find out the effect of tonsillectomy to reduce the number of pharyngitis episodes or symptoms. still, the possible disadvantages of tonsillectomy and changes in the quality of life after tonsillectomy among these patients are examined.

we will have a prospective randomized study. we allocated 87 consecutive patients referred for tonsillectomy randomly in two groups: tonsilectomy group or waiting list(control group). patients in tonsillectomy group were operated as soon as possible and data on postoperative morbidity was collected. in the control group, patients were placed on our normal waiting list and they were operated on in normal time (about 5-6 months). the data on preoperative morbidity was collected. all the pharyngitis episodes were treated by a study investigator and laboratory tests (crp, procalcitonin) were taken at that time and after three days. in addition, the patients record their symptoms on a diary.

Eligibility criteria:
inclusion criteria: * patients selected among the cases referred to tonsillectomy for recurrent pharyngitis episodes to a tertiary care university ent clinic (oulu, finland). * at least three pharyngitis episodes difficult enough for the patients to seek for medical attention during the past 12 months exclusion criteria: * patients with other serious diseases (day surgery not feasible) * patients having long time antibiotic treatment for other disease * patients diagnosed to have peritonsillar abscess * pregnancy * age of 12 or under * patients living outside oulu or its 8 neighbouring cities (day surgery not feasible) * patients suffering only from halitosis or bacterial plugs of palatine tonsils

Keywords: adults children tonsillectomy
age related effects consuming phaeodactylum tricornutum

Conditions: Aging; Well Aging

Summary: investigation of the microalgae phaeodactylum as food with regard to the uptake of omega-3 fatty acids and effects on various blood parameters in relation to age. bioavailability and excretion of nutrients and their effects on fatty acid status and inflammatory markers.

due to a multifaceted redesign of all areas of life, older people face many nutritional challenges, such as cognitive change, sarcopenia and micronutrient deficiency. in addition to age-associated diseases, cognitive decline is usually a precursor to neurodegenerative processes, such as alzheimer's disease. the full molecular mechanisms are still unknown, but classic aging mechanisms, such as oxidative stress and subclinical inflammation, play a role. due to the changed life situation, there is a reduced need for energy, while the need for nutrients remains, which greatly increases the risk of malnutrition in old age. this results in an increasing prevalence of sarcopenia. the decrease in muscle mass and strength leads to functional limitations in the elderly and also promotes oxidative stress. this increases the need for antioxidant nutrients such as carotenoids and vitamins. studies show that age-related chronic subclinical inflammation, such as occurs in the context of an omega-6 fatty acid (-fs) emphasized diet, plays a central role in the pathogenesis of age-associated diseases due to this, the microalgae pt could be a goud supplier of nutrients like omega-3 fs, especially eicosapentaenoic acid (epa), which is otherwise found mainly in fatty fish, and fucoxanthin, an antioxidant. the investigator study the change of omega-3, -6 and -9 fs in blood plasma, in erythrocytes, as well as the change of fucoxanthin and beta-carotene. the investigator measure blood parameters for safety and control the influence on the intestinal barrier.

Eligibility criteria:
inclusion criteria: age ≥60 ≤90 years, weight ≥50 kg, generally healthy * signed informed consent form * willingness to follow the prescribed diet for the duration of the study * no participation in any other clinical trial (current or within the last 30 days) exclusion criteria: * taking intestinal therapeutics, antibiotics, immunosuppressants or similar. (if necessary, decision on a case-by-case basis) * pregnancy/breastfeeding * relevant violations of the dietary protocol * occurrence of relevant diseases (if necessary, individual case decision) * withdrawal of consent * placement in a clinic or similar facility due to official or court order

Keywords: microalgae omega-3 fatty acids micronutrients carotinoids inflammation
comparison of crystalloid and colloid i.v fluid therapy in prevention of paracentesis induced circulatory dysfunction (picd) and renal dysfunction in patients with decompensated liver cirrhosis in egypt: a randomized piolet study

Conditions: Ascites

Summary: 2.2 aim(s) of the research (50 words max): to compare between crystalloid and colloid i.v fluid therapy in the prevention of paracentesis induced circulatory dysfunction (picd) and renal dysfunction in patients with decompensated liver cirrhosis in egypt. to evaluate systemic vascular resistance in cirrhotic patients with tense ascites before and after therapeutic paracentesis.

background (research question, available data from the literature, current strategy for dealing with the problem, rationale of the research that paves the way to the aim(s) of the work). (200-250 words max.) in the advanced stages of cirrhosis, there is pronounced arterial vasodilatation that further worsens by therapeutic paracentesis which plays a major role in causing circulatory dysfunction (el-motey et al. 2013). paracentesis-induced circulatory dysfunction (picd) in cirrhotics with tense ascites develops in the majority of patients not receiving plasma volume expansion (hamdy et al.,2014). paracentesis induced circulatory dysfunction (picd) will induce pronounced arterial vasodilatation in cirrhotic patients with tense ascites which can be prevented by the infusion of albumin, (arora et al.,2020). albumin infusion is highly effective in preventing this disorder. however, albumin substitution is costly and holds the theoretical risk of infectious complications and allergic reactions (arora et al.,2020). various vasoconstrictors have also been used to prevent picd such as terlipressin and noradrenaline. however, terlipressin is expensive and not available in some countries, and the use of noradrenaline requires intravenous (iv) infusion and intense monitoring (singh et al .,2006), but there are few studies about the usage of crystalloids (arora et al.,2020).

Eligibility criteria:
inclusion criteria: * patients less than 70 years of age and more than 18 years, diagnosed as having liver cirrhosis with tense refractory ascites (\> 5 liters). these diagnoses are determined by clinical, biochemical, morphological, and sonographic criteria. exclusion criteria: * patients with blood pressure \ 110 b/m patients with heart disease, pulmonary disease, alcohol consumption, pregnancy, hepatorenal syndrome patients with hepatic encephalopathy, hepatorenal syndrome, or recent git haemorrage in last week patients with spontaneous bacterial peritonitis or sepsis. prothrombin time less than 30%, platelet count less than 30,000/mm3, serum creatinine level greater than 240 mmol/l patients receiving any drugs that could interfere with cardiovascular, hepatic, or renal function, however, the use of diuretics and/or beta-blockers were permitted, but they were temporarily discontinued for 2 days before the investigations to eliminate the pharmacological influence on systemic vascular resistance work or volume status
efficacy of sacral nerve stimulation before definitive implantation

Conditions: Fecal Incontinence

Summary: sacral nerve stimulation (sns) is an emerging treatment for patients with severe fecal incontinence. the test stimulation is minimally invasive, associated to low morbidity and relatively cheap. on the contrary, implantation of the definite stimulator is related to higher morbidity and considerable costs. a careful patent selection for definite implantation is therefore crucial. however, indication for implantation is actually based only on the subjective criteria reported in the patients´ diary only. patients and care providers are likely to overestimate the real effect of sns leading to an unjustified overuse of this expensive device. it is therefore necessary to evaluate real efficacy of sns during the testing phase in a unbiased setting in order to avoid unnecessary morbidity and costs.

sacral nerve stimulation (sns) is an emerging treatment for patients with severe faecal incontinence when conservative measures fail and surgical repair is not indicated. in a minimally-invasive approach and under local anaesthesia, an electrode is placed around sacral nerve root s2-4 and electrical stimulation is applied to the sacral spinal nerves. effectiveness of sns is definitively not only explained by placebo effect but the pathophysiologic mechanisms remain unclear. suggested pathways include modulation of afferent nerve fibres and direct stimulation of the pelvic floor and anal sphincter muscle. after placement of the electrode, the patient is stimulated by an external stimulator for 1-3 weeks. during this period, the patient documents the number of faecal incontinence episodes or urgencies in a symptom diary. by convention, indication for permanent stimulation is based on a 50% reduction in the number of episodes. after a successful testing period, the permanent stimulator is implanted, generally in the upper gluteal region. previous studies report success rates up to 80%. the only randomized trial with a proper sample size evaluated the efficacy of sns after definite implantation. in this study, 63% of the patients felt improved during the placebo period and might not really benefit from the device. the real success rate of sns is therefore likely to be considerably lower. efficacy of sns during the testing phase has never been assessed in a blinded randomized study.

Eligibility criteria:
inclusion criteria: * all patients admitted to sns test for treatment of faecal incontinence after unsuccessful conservative (or surgical) treatment. exclusion criteria: * absence of informed consent. * patients not speaking french or german.

Keywords: fecal incontinence sacral nerve stimulation
vulnerable patients in primary care: nurse case management and self-management support

Conditions: Chronic Diseases

Summary: the purpose of this study is to implement a pragmatic intervention in four (4) family medicine groups(fmgs) in the region of saguenay-lac-saint-jean (quebec, canada)for patients with chronic diseases.

chronic diseases represent a major health burden worldwide. some people with chronic diseases require a higher level of care due to personal characteristics that increase their vulnerability. for these patients, nurse effective case management in primary care are associated with positive outcomes. moreover, self-management programs, such as the standford program developed by the school of medicine at the university of standford in california (usa), are also recognized for their benefits on patients with chronic diseases. the aim of our project is to implement, within four (4) fmgs of the region of saguenay-lac-saint-jean , a practical intervention involving case management by a nurse to promote interdisciplinary person-centered monitoring and self-management support for highly vulnerable individuals with chronic diseases (diabetes, cardiovascular diseases, respiratory diseases, musculoskeletal diseases and/or chronic pain). the objectives of our study : 1) to analyze the implementation of the intervention in the participating fmgs in order to determine how the various contexts have influenced the implementation and the observed effects; 2) to evaluate the proximal and intermediate effects of the intervention on patients; 3) to conduct an economic analysis of the effectiveness and cost-benefit of the intervention. the analysis of the implementation will be conducted using realistic evaluation approaches and participatory practice within four categories of key players (fmg stakeholders, fmg/health center managers, patients and their families, health center partners or communities). the data will be obtained through individual or group interviews, literature reviews and documentation from the intervention undertaken. the evaluation of the effects in patients will be based on a pragmatic randomized experimental design before and after (six months) with delayed intervention in the control group. economic analysis will include a cost-effectiveness analysis and a cost-benefit analysis.

Eligibility criteria:
inclusion criteria: * patient of the participating fmgs * aged between 25 and 80 years * affected by chronic disease (diabetes, cardiovascular diseases, respiratory diseases, musculoskeletal diseases and/or chronic pain) * identified as a frequent user of health services (by a health care provider or/and a software) exclusion criteria: * patient unable to provide consent * with cognitive impairment * with uncontrolled psychiatric illness * patient with a prognostic of less than one years

Keywords: primary care self-management self-support nurse case management
stratus versus cirrus oct in amd

Conditions: Age-Related Macular Degeneration; Choroidal Neovascularization

Summary: the cirrus oct provides due to the spectral domain technology a 2-fold resolution than stratus oct generated in a comparable amount of time. due to this higher resolution the retinal surface and the retinal pigment epithelium can be identified more clearly, a significantly reduced number of algorithm failures is expected


Eligibility criteria:
inclusion criteria: * age\>55 years * age-related macular degeneration exclusion criteria: * not consented patients

Keywords: age-related macular degeneration choroidal neovascularization stratus oct cirrus oct
relationship between central corneal thickness and intraocular pressure measures instruments.

Conditions: Glaucoma; Glaucoma, Open Angle; Ocular Hypertension; Keratoconus

Summary: the purpose of this study is to evaluate the relationship between intraocular pressure and central corneal thickness using various instruments in ocular hypertension, normal-tension glaucoma, primary open angle glaucoma, keratoconus and normal eyes.

the purpose of this study is to evaluate the relationship between intraocular pressure and ultrasound pachymetry measured central corneal thickness using goldman tonometry and pascal instruments. patient groups examined include: ocular hypertensives normal-tension glaucoma primary open angle glaucoma keratoconus control normal eyes

Eligibility criteria:
inclusion criteria: adults over the age of 18 years clinical diagnosis of glaucoma, open angle; ocular hypertension; glaucoma (low-tension); keratoconus and other healthy volunteers. exclusion criteria: children under the age of 18 years adults with learning disabilities adults who are unconscious or severely ill adults who have known terminal illness adults in emergency situations adults with dementia prisoners young offenders those who could be considered to have a dependant relationship with the investigator (i.e. those in care homes or medical students) other vulnerable groups

Keywords: corneal thickness intraocular pressure instrumentation glaucoma keratoconus
effect of improving caregiving on early mental health

Conditions: Child Development Disorders

Summary: this study evaluates the effect on children and caregivers of providing training in warm, sensitive, responsive caregiving to caregivers in three orphanages in st. petersburg, russia. the study also assesses the effectiveness of having more consistent care from fewer caregivers in a family-like environment.

this project will provide experimental evidence that warm, sensitive, responsive caregiving and structural changes that promote more consistent and fewer caregivers will lead to better physical, mental, social, and emotional development of young children. structural changes are designed to facilitate a more family-like environment and include smaller group sizes, more consistent caregiving from fewer caregivers, integration by age and disability status, and establishing two daily 60-minute family hours in which children and caregivers interact together. the project also attempts to demonstrate that training caregivers can be beneficial to both caregivers and children. all caregivers and children in three orphanages for children under 4 years old in st. petersburg, russia will participate in this study. one orphanage will implement both training and structural changes. a second orphanage will receive training only. the third orphanage will serve as a control, receiving neither training nor structural changes. caregivers are assessed annually for attitudes to and problems with their jobs; anxiety and depression; coping styles; traditional versus progressive attitudes toward caregiving; sensitivity to children's emotions; values; and perceptions of their own relationships. children are assessed at 3, 6, 9, 12, 18, 24, 36, and 48 months for physical growth, chronic and acute disorders, functional abilities, and mental, motor, social, and emotional development.

Eligibility criteria:
inclusion criteria * all caregivers and children in three baby homes in st. petersburg, russia, who remain in the baby homes for at least 4 months.

Keywords: orphanage caregiving training child development
high-dose dexamethasone plus hetrombopag vs high-dose dexamethasone alone as frontline treatment for newly diagnosed adult primary immune thrombocytopenia: a prospective, multicenter, randomized trial

Conditions: ITP - Immune Thrombocytopenia

Summary: the project was undertaking by qilu hospital of shandong university in china. in order to report the efficacy and safety of hetrombopag plus high-dose dexamethasone for the treatment of adults with newly-diagnosed primary immune thrombocytopenia (itp).

the investigators anticipate to undertaking a parallel group, randomised controlled trial of 100 itp patients. one part of the participants are randomly selected to receive hetrombopag with starting dose 5mg po qd for 8 weeks（increase daily dose to a maximum of 7.5 mg/day if platelet count\<50000 per μl following at least 2 weeks of treatment) combining with dexamethasone (given at a dose of 40 mg qd for 4 consecutive days). the others are selected to receive high-dose of dexamethasone alone. patients who do not respond to dexamethasone may receive another cycle of high-dose dexamethasone therapy within 2 weeks. platelet count, bleeding and other symptoms were evaluated before and after treatment. adverse events are also recorded throughout the study. the purpose of this study is to report the efficacy and safety of hetrombopag combining with high-dose dexamethasone therapy for the treatment of newly diagnosed itp.

Eligibility criteria:
inclusion criteria: * older than 18 years * meet the diagnostic criteria for newly diagnosed immune thrombocytopenia (diagnosed within 3 month); * platelet count \<30\*10\^9/l, or \< 50\*10\^9/l with bleeding manifestations, both; * willing and able to sign written informed consent exclusion criteria: * secondary thrombocytopenia or graded mf≥2 myelofbrosis based on the european consensus scale * previous history of treatment for itp, except platelet transfusion, itp-directed prednisone therapy no more than 2 weeks or tpo therapy no more than 1 week and stopped ≥1 week before randomization * no response to tpo-ra or rhtpo * hiv, hepatitis c or b virus infection * pregnancy or lactation; * arterial or venous thromboembolism within the 6 months before screening * total bilirubinalanine, aminotransferase or aspartate transaminase\>3×upper limit of normal (uln), serum creatinine\>1.5×uln * congestive heart failure (new york heart association \[nyha\] class iii/iv); * neoplastic disease within the past 5 years; * liver cirrhosis * people who could not adhere to the protocol or were planning to have a surgical procedure in 6 months.

Keywords: hetrombopag, dexamethasone
pilot study: paravertebral analgesia vs epidural analgesia after thoracotomy

Conditions: Hypotension

Summary: paravertebral analgesia is non-inferior to epidural analgesia for pain control and superior to epidural analgesia in terms of the main complication of hypotension.

there is some evidence that paravertebral analgesia is similar to epidural analgesia in efficacy but superior in maintenance of blood pressure. this is a double blind, randomized control trial comparing paravertebral catheters to epidural catheters for the management of post thoracotomy analgesia. both groups will undergo placement of a pre-induction epidural catheter as well as a surgically placed paravertebral catheter. patients will also receive pca morphine. the primary outcome will be daily morphine use measured in milligrams. the co-primary outcome will be time spent with a systolic blood pressure below 90mmhg. outcomes will be measured during the first five postoperative days.

Eligibility criteria:
inclusion criteria: * open thoracotomy * age \> 18 yo * able to use a patient controlled analgesia device exclusion criteria: * previous thoracotomy * previous spine surgery * chronic pain condition * ongoing narcotic use * prior narcotic abuse * active chest infection * chest trauma * anticoagulation * other contraindication to epidural catheter placement * allergy to local anesthetic or narcotic

Keywords: paravertebral catheter epidural catheter analgesia hypotension analgesia,epidural analgesia,paravertebral
a randomized, double-blind, placebo-controlled, parallel-group study of the relationship between intraoperative intravenous acetaminophen and postoperative opioid avoidance for ambulatory surgical procedures

Conditions: Postoperative Pain; Intraoperative and Postoperative Opioid Requirements

Summary: this is a research study to determine if giving acetaminophen intravenously in hte operating room will decrease the number of patients who require additional pain medicine, such as morphine, after surgery in the recovery room.

primary specific aim: to determine if adding an intraoperative dose of intravenous acetaminphen to usual and customary analgesics during ambulatory surgery impacts the proportion of patients remaining opioid-free in the post-anesthesia recovery room. hypothesis: adding an intraoperative dose of intravenous acetaminophen to usual and customary analgesics during ambulatory surgery increases the proportion of patients remaining opioid-free in the post-anesthesia recovery room. secondary specific aim: to determine if adding an intraoperative dose of intravenous acetaminophen to usual and customary analgesics during amublatory surgery impacts the required doses of additional perioperative analgesics. hypothesis: adding an intraoperative dose of intravenous acetaminophen to usual and customary analgesics during ambulatory surgery decreases the required doses of additional analgesics in both the operating room and post-anesthesia recovery room.

Eligibility criteria:
inclusion criteria: * undergoing ambulatory surgery under general anesthesia * expected postoperative pain to be mild-moderate * age 18 years or older * have an asa physical status or 1, 2, or 3 exclusion criteria: * anticipated peripheral or neuraxial nerve block * any physical, mental or medical conditions which may confound quantifying postoperative pain resulting from surgery * current chronic opioid or tramadol use * history of alcohol or opioid abuse * known allergy to the study medications * pregnancy * any health condition requiring greater than 100 micrograms of fentanyl during anesthesia induction * treated with any acetaminophen-containing medication in the previous 8 hours * treated with mao inhibitors within 10 days prior to surgery * inability to communicate with the investigators and hospital staff * known or impaired liver function