Kornimate/medical-research-clean huggingface dataset:
noninvasive monitoring in lower body negative and positive pressure tests

Conditions: Hemorrhage

Summary: the goal of these studies is to assess the use of phonocardiograhy to monitor blood volume. we will evaluate phonocardiographic parameters in normal subjects in increasing levels of lower body negative pressure (lbnp) and lower body positive pressure (lbpp).


Eligibility criteria:
inclusion criteria: * at least 18 years old * good health * free of systemic diseases * no contraindications to lbnp/lbpp exposure * normal resting systolic blood pressure (sbp, 100-140 mm hg) and diastolic blood pressure (dbp, 60-90 mm hg) exclusion criteria: * pregnancy * prior history of cardiovascular disease

Keywords: phonocardiogram
splenic injury embolization - the question about nom (sine qua nom)

Conditions: Wounds and Injuries

Summary: the primary objective is to compare the failure rate due to splenic bleeding between the patients undergoing pre-emptive splenic arterial embolization (sae) as part of non-operative management (nom) and the patients not undergoing sae. we hypothesize that the use of pre-emptive sae will decrease the delayed bleeding rate and increase the success rate of nom.

this randomised controlled study will follow the clinical course of hemodynamically normal trauma patients with organ injury scale (ois) grade 4 or 5 blunt splenic injuries, undergoing sae or observation only until day 7 post injury. only hemodynamically normal patients will be considered for enrolment into the study, and written informed consent from the patient is required. control the control arm in this randomized controlled trial will include only nom patients diagnosed with splenic injuries ois grade 4 or 5 and suitable for observation alone, and will comprise clinical observation according to local routines and protocols. the patients will be observed with special focus on delayed bleeding and failure of nom. a contrast enhanced us or ct scan with arterial phase will be performed on day 3-5 to exclude psa. on day 7, the decision to perform sae, splenectomy or continue nom is left to the discretion of each participating institution, and registered in the case report form (crf). intervention the intervention arm will perform sae as a central embolization of the splenic artery. additional peripheral embolization is left to the discretion of the interventional radiologist. each institution decides whether patients in the sae group are to undergo immunization or not. the study does not interfere with local diagnostic work-up and treatment protocols. we hypothesize that the use of pre-emptive sae will decrease the delayed bleeding rate and increase the success rate of nom leading to fewer splenectomies in this group of patients without concomitant increased complication rates. additionally, we want to explore the effects of pre-emptive sae vs observation alone on all cause failure rate, operative procedures, repeat angiography rate, complications, critical care stay, and mortality.

Eligibility criteria:
inclusion criteria: * blunt splenic injury ois grade 4 or 5 * adult trauma patients (according to local definitions) * present hemodynamically normal as judged by the responsible trauma consultant surgeon and eligible for nom * randomised within 48 hours of injury * written informed consent is obtained exclusion criteria: * hemodynamically compromised (not suitable for nom) * needing transfusions * ct shows evidence of significant contrast extravasation * other indications for laparotomy * prisoners * pregnant * \>80 years old * penetrating injury * contraindication to iv contrast

Keywords: non-operative management splenic injury blunt splenic artery embolization trauma
to evaluate the efficacy and tolerability of the use of vitatonus dexa compared to dexamethasone in patients with neuralgia of various origins

Conditions: Neuralgia

Summary: to evaluate the efficacy and tolerability of vitatonus dexa compared with dexamethasone in the signs and symptoms of neuralgia of various origins. clinical study, randomized prospective and random in nature, with a patients diagnosed with neuralgia of diverse origin. patients will be include in sufficient quantity to achieve the minimum of 104 evaluable patients.


Eligibility criteria:
inclusion criteria: 1. patients who consent to participate in the study by signing the icf; 2. patients of any ethnic group of both sexs aged over 18 years; 3. patients with clinical diagnosis of neuralgia of various origins. 4. patients who present scores on the visual analogue scale (vas) greater than or equal to 4 for pain. exclusion criteria: 1. patients with known hypersensitivity to lidocaine and thiamine or any component of the formula; 2. pregnant women and nursing mothers; 3. hypertensive or cardiac patients; 4. patients with history of ulcers in the stomach or duodenum, diabetes mellitus or severe infections; 5. patients who use levodopa, salicylates, colchicine, aminoglycosides, chloramphenicol, anticonvusivantes or potassium supplement. 6. patient with a history of alcohol or use illicit drugs;

Keywords: neuralgy dexamethasone complex vitamins injection symptoms of neuralgy of various origins
ai chatbot for migraine management in hong kong women

Conditions: Migraine

Summary: the goal of this randomized crossover trial is to examine whether the ai-empowered chatbot will effectively collect comprehensive migraine feature data and demonstrate higher compliance, accuracy, utilization, acceptability, feasibility, and validity in migraine feature tracking compared to traditional paper-based migraine diaries among hong kong women with migraine. participants will use different tools (ai-empowered voice-interactive chatbot or paper migraine diary) for migraine tracking. participants will be randomly allocated to one of two intervention sequences: (1) ai-empowered voice-interactive chatbot followed by paper migraine diary, or (2) paper migraine diary followed by ai-empowered voice-interactive chatbot. the study will consist of two intervention periods, each lasting one month, with a 1:1 allocation ratio.


Eligibility criteria:
inclusion criteria: * women aged 18 years or older * meet diagnostic criteria for migraine according to ichd-3 * experiencing at least 2 headache days per month * living in hong kong * fluent in cantonese * owning a smartphone with internet access * willing to provide informed consent exclusion criteria: * individuals with severe cognitive impairments or communication difficulties * those unable to use a smartphone or the chatbot due to physical or mental limitations * using another alternative electronic migraine diary during recruitment or in the past 12 weeks

Keywords: migraine rct migraine diary artificial intelligence chatbot
comparison of vascular remodeling between different antianginal medication evaluated by noninvasive ecg-gated fundus photographic evaluation

Conditions: Stable Angina

Summary: treatments for stable angina includes drug therapy such as calcium-channel blocker, beta blocker, and acei/arb. to obtain good prognosis in patients with coronary artery disease,preventing or correcting the progression of atherosclerosis and dyslipidemia is more important than relieving angina symptom. dysfunction of microvessel is one of the most important factor in patients with coronary artery disease. recently, we developed the new non-invasive method of evaluating the microvessel in fundus. with this methods, we will compare the effect of each drug (beta blocker, ccb, arb).


Eligibility criteria:
inclusion criteria: * stable angina patients whose coronary lesions is confirmed by angiography or receives pci * unstable angina/nstemi patients who completed pci for main lesions * either systolic \> 130mmhg or diastolic \> 80mmhg, or patients with anti-hypertensive drugs exclusion criteria: * stemi patients within one month * variant angina * liver function abnormality or renal failure * history of hypersensitivity to testing drugs * severe heart failure(nyha class\>3) or uncorrectable hematologic disease * woman possible to be pregnant * uncontrolled diabetes * expected life span \< one year
sulphonylurea receptor mutation and responsiveness to gliclazide - a pilot proof of concept, randomised cross-over study

Conditions: Diabetes

Summary: gliclazide has greater glucose lowering efficacy than glibenclamide among type 2 diabetes mellitus patients with minor haplotype (k23/a1369) at the kcnj11/abcc gene locations.

sulphonylurea (su) is a glucose-lowering agent used widely to treat type 2 diabetes mellitus (t2dm). su promotes insulin secretion from the pancreatic islet beta cell via binding and inhibition of the atp-sensitive potassium (katp) channel. the katp channel is made up of two subcomponents, an inner kir6.2 k+ channel (coded by the kcnj11 gene) and an outer su receptor 1 (sur1) (coded by the abcc8 gene). although all sus are mechanistically similar in terms of increasing insulin secretion, they bind to distinct regions of kir 6.2 and sur1 to exert their function. different types of su (e.g. tolbutamide, glibenclamide, glipizide, glimepiride and gliclazide) can therefore be grouped by their binding sites (a/b/a+b site) on the katp channel \[3\]. interestingly, the kcnj11 e23k (rs5219) variant was shown to confer susceptibility to t2dm and the abcc8 s1369a (rs757110) variant was found to be in complete linkage disequilibrium with it i.e. inherited together as a genetic block (haplotype). a recent in vitro molecular study suggested that the minor haplotype (k23/a1369) of katp channel is sensitive to inhibition by gliclazide (binds to a-site) but not glibenclamide (binds to a+b site), and that the increased responsiveness to gliclazide was largely due to the a1369 allele. understanding how the response to these two sus may vary with the presence of the minor haplotype (k23/a1369) would therefore be beneficial for customization of patient treatment to achieve better clinical outcomes.

Eligibility criteria:
inclusion criteria: * type 2 diabetes * age 21-65 * hba1c \>8.0% on two consecutive visits exclusion criteria: * currently taking insulin at a regime more complex than basal insulin * not willing to perform self-blood glucose monitoring (sbgm) * renal impairment i.e. egfr\<50mls/min * pregnancy or unwilling to practice adequate contraception * taking other medications that may affect blood glucose e.g. systemic glucocorticoids.

Keywords: sulphonylureas gliclazide glibenclamide
study of the safety & efficacy of intravenous acetaminophen in pediatric inpatients

Conditions: Pain; Fever

Summary: intravenous acetaminophen (ivapap) is safe in repeated dose, multi-day clinical use when administered at a daily dose of 40 to 75 mg/kg body weight

to assess the safety of intravenous acetaminophen (iv apap) when used over one or more days for the treatment of acute pain or fever in pediatric (neonates, infants, children and adolescents) inpatients who are unable to take anything by mouth (npo), require or would benefit from iv treatment, or are willing and able to stay on ivapap therapy for 1 to 7 days.

Eligibility criteria:
inclusion criteria: * the subject's parent or guardian must provide written informed consent, with subject assent where appropriate, prior to the subject's participation in the study. * be less than 17 years of age and older than 37 weeks post conception * anticipated by the investigator to require multi-day (minimum of one day) use of intravenous (iv) treatment either because of a having a status of nothing by mouth (npo) or a medical condition that makes oral intake difficult or be willing to undergo at least 5 days of treatment with iv acetaminophen for the treatment of pain or fever * have the ability to read and understand the study procedures and have the ability to communicate meaningfully with the study investigator and staff (if the subject is of preverbal age or cannot read or communicate meaningfully, then the subject's parent or guardian must meet this criterion) * if a female of child bearing potential, have a negative pregnancy test exclusion criteria: * has significant medical disease(s), laboratory abnormalities or condition(s) that in the investigator's judgment could compromise the subject's welfare, ability to communicate with the study staff, complete study activities, or would otherwise contraindicate study participation * has known hypersensitivity or contraindication to receiving iv acetaminophen or the inactive ingredients (excipients) of iv acetaminophen * has impaired liver function, e.g. alanine aminotransferase (alt) greater than or equal to 3 times the upper limit of normal (uln), bilirubin greater than or equal to 3 times uln, known active hepatic disease (e.g., hepatitis), evidence of clinically significant chronic liver disease or other condition affecting the liver (e.g., alcoholism as defined by the diagnostic and statistical manual of mental disorders, fourth edition (dsm-iv), cirrhosis, or chronic hepatitis) that may suggest the potential for an increased susceptibility to hepatic toxicity with iv acetaminophen exposure * has participated in an interventional clinical study (investigational or marketed product) within 30 days of study entry
a 3-year cross-sectional assessment of the tianjin child and adolescent large-scale eye study

Conditions: Myopia

Summary: this is a school-based, cross-sectional study to assess the incidence and prevalence, risk factors of myopia among schoolchildren in both eye-use environment, eye-use habits, lifestyle, and family and subjective factors before and during covid-19. large population and representative study subjects. environmental exposure and daily within and out-of-school activities will be evaluated in a random subgroup.

myopia is the most common refractive error and a major reason for reducing uncorrected visual acuity among schoolchildren. it was reported that during covid-19, home confinement resulted in a significant increase in myopia due to the changed lifestyle of schoolchildren dramatically. however, it is unclear which kind of risk factors should be the first to bear the brunt before and during covid-19. and which factors should be emphasized and confronted as the optimum strategy for myopia prevention and control? this cohort study aims to determine the risk factors, prevalence, and incidence of myopia, and se changes among schoolchildren before and during covid-19, hence identifying the factors that impact the onset and progression of myopia. this is a 3-year cross-sectional study. this study plans to enroll 126,810 participants (aged 6-18 years) from tianjin, china. all grade students from 10 regions of tianjin city, china will be analyzed. over a 3-year follow-up period, students will receive detailed eye examinations annually and complete questionnaires about eye-use environment, eye-use habits, lifestyle, and family and subjective factors. in a 5% random sample size of this cohort study, outdoor activity, light intensity, eye use habits, and eye use environment data will be obtained using objective measuring devices. myopia was defined as spherical equivalent refractive (ser) of ≤ -0.5d.

Eligibility criteria:
inclusion criteria: * all 6-18 years students exclusion criteria: * no eye diseases such as cataracts, glaucoma, keratoconus, etc. * no psychiatric disorders * astigmatism ≤ -6.00d
caudal epidural catheterization in pediatric renal transplant: effect on hemodynamics and pain after surgery

Conditions: Renal Failure

Summary: pain control in pediatric renal transplant is a major concern. the main goal during anesthesia of renal transplant in pediatrics is to maintain hemodynamics in a range close to that of the adult donor. epidural analgesia is thought to be very effective in pain control. this study emphasises the ease of application of epidural catheter via the caudal route to the lower thoracic level; avoiding possible complications that may arise from lumbar or thoracic routes, and its effects on hemodynamics when using analgesic doses of local anesthetics and narcotics.


Eligibility criteria:
inclusion criteria: * 3-12 years * end stage renal disease * no known allergy to bupivacaine * both sexes exclusion criteria: * known allergy to bupivacaine * inflammation at caudal area * spinal cord deformity

Keywords: caudal epidural pediatric renal transplant hemodynamics
ketamine infusion for pediatric patients with obstructive sleep apnea syndrome (osas) after tonsillectomy

Conditions: Obstructive Sleep Apnea Syndrome

Summary: the study will evaluate the post-operative morphine-sparing effect, pain reduction, and side effects of a continuous ketamine infusion after tonsillectomy in pediatric patients.

eligible pediatric patients that are undergoing tonsillectomy for sleep-disordered breathing or obstructive sleep apnea and are to be admitted into a monitored setting will be recruited for this study. they will be randomized into two groups:1) control group receiving continuous infusion of saline (placebo) and 2) study group receiving continuous infusion of low-dose ketamine at 0.1 mg/kg/hr. both patients will receive scheduled oral acetaminophen and rescue intravenous morphine as required. the infusions will be stopped at 0600 the next morning. morphine requirements, pain scores at selected times, central nervous system side effects, and adverse cardiorespiratory events will be recorded.

Eligibility criteria:
inclusion criteria: * patients requiring tonsillectomy for diagnosis of sleep disordered breathing/obstructive sleep apnea that will be admitted for overnight cardiorespiratory monitoring, based on positive polysomnography test, positive nocturnal home oximetry, or strong signs/symptoms of osas exclusion criteria: * patients with significant developmental delay, abnormal airway anatomy, significant co-morbidities such as cardiac disorders, respiratory disorders, neurological disorders, anad renal disorders. * previous reaction to study medications. * postoperative bleeding within the first 24 hours * refusal to be involved in the study..

Keywords: pediatric obstructive sleep apnea tonsillectomy analgesia
ciprofloxacin intralesional injection for the treatment of cutaneous leishmaniasis compared to sodium stibogluconate

Conditions: Cutaneous Leishmaniasis

Summary: the aim of the trial to evaluate the effectiveness of intralesional ciprofloxacin 0.2% solution as a local injection in treating cutaneous leishmaniasis and compare its effect with intralesional sodium stibogluconate (ssg) 10% intravenous solution in cutaneous leishmaniasis as a local injection. in a randomized parallel groups clinical trial, patients were divided into two groups based on therapeutic regimen: 1) intralesional sodium stibogluconate weekly injection and 2) intralesional ciprofloxacin injection. each lesion was considered a case in the final analysis. each lesion will be followed up for 90 days (censor endpoint) or until the lesions are cured.


Eligibility criteria:
inclusion criteria: * patients with single or multiple (less than seven lesions) lesions of cutaneous leishmaniasis exclusion criteria: * patients who received anti-leishmaniasis treatment locally or systemically for the last month before this study * patients on prolonged corticosteroid therapy.
effects of frailty, sarcopenia and muscle wasting on outcomes of patients in the surgical intensive care unit

Conditions: Critical Illness; Sarcopenia; Muscle Wasting

Summary: the primary aim of the study is to evaluate consequences of frailty in critically ill patients. we hypothesize that a higher frailty index (based on published questionnaires) predicts a longer surgical intensive care unit and hospital length of stay, less ventilator-free days and a higher likelihood of an adverse discharge disposition. our secondary aim is to identify muscle-size derived variables that can be used to predict frailty. we hypothesize that a low skeletal muscle mass measured by ultrasound can be used to quantify frailty, and to also predict the outcome of sicu patients, expressed as longer stay in the surgical intensive care unit and longer stay in the hospital, less ventilator-free days and a higher likelihood of an adverse discharge disposition. our third aim is to examine potential triggers of muscle wasting in critically ill patients. muscle wasting will be assessed by repetitive ultrasound measurements of muscle mass. we hypothesize that a significant decrease in skeletal muscle mass predicts longer stay at the surgical intensive care unit and longer hospital length of stay, less ventilator-free days and adverse discharge disposition.

frailty is defined as status of decreased physiological reserve which leads to a higher vulnerability to stressors. it is associated with a higher risk of morbidity and mortality. within the geriatric population, frailty is common and a known predictor of adverse outcomes. the usefulness of a frailty assessment as an outcome measure in critically ill patients of all ages needs to be evaluated. this study evaluates whether frailty has an effect on outcome of critically ill patients. muscle weakness predicts outcome of icu patients but is hard to determine in the icu since the measurement is volition dependent. muscle mass correlates with muscle weakness and can be assessed objectively. this study evaluates the consequences of reduced muscle mass or sarcopenia on the outcome of critically ill patients. in addition, muscle wasting in the icu may predict persistent functional disability. this study aims to examine muscle wasting of critically ill patients on the surgical icu.

Eligibility criteria:
inclusion criteria: * patients admitted to the sicu (within 72 hours of admission) * age over 18 years * stay on the sicu for at least 24 hours exclusion criteria: * ongoing discussions about goals of care * motor component of glasgow coma scale \<5 * unstable fractures * preexisting paralysis * pregnancy * absence of both lower limbs

Keywords: critically illness intensive care unit outcome frailty
effect of trimetazidine on the improvement of coronary microvascular dysfunction in patients with inoca(ischemia and no obstructive coronary artery disease)

Conditions: Patients With INOCA(Ischemia and no Obstructive Coronary Artery Disease) Who Have Coronary Microvascular Dysfunction

Summary: this is a prospective study which aims to explore the effect of trimetazidine on the improvement of coronary microvascular dysfunction in patients with inoca (ischemia and no obstructive coronary artery disease). enrolled patients will be assessed saq(seattle angina score), canadian angina grade(canadian cardiovascular society, ccs), six-minute walk test, cfr(coronary flow reserve) .cfr inspection with d-spect and pressure guide wire.patients will receive six months trimetazidine(35mg tid) after enrollment. and their saq (seattle angina score), canadian angina grade(canadian cardiovascular society, ccs), six-minute walk test, cfr will be followed up.


Eligibility criteria:
inclusion criteria: * age≥18 years * typical angina symptoms * coronary angiography or coronary computed tomography examination showed no significant epicardial coronary artery stenosis (\<20%) * never used trimetazidine * the cfr measured by the pressure guide wire is less than 2.0 * agree to participant the study and sign informed written consent * available for six months follow up exclusion criteria: * severe liver and kidney disease * contraindications of trimetazidine * use of cyp3a inhibitors, such as diltiazem, verapamil, and other drugs that may affect cfr measurements * qt interval extension * atrial fibrillation or left bundle branch block * left ventricular systolic dysfunction (ef \<55%) * coronary artery fistula * myocardial bridge * non-cardiogenic chest pain and other heart diseases * severe heart valve disease * diabetes * recent acs( acute coronary syndrome) * pregnancy * failed to complete inspection