Kornimate/medical-research-clean huggingface dataset:
pain control after trauma

Conditions: Trauma

Summary: using virtual reality as a form of pain control for trauma patients.

the purpose of the study is to investigate the effectiveness of virtual reality (a form of distraction) in order to reduce patients' pain from trauma.

Eligibility criteria:
inclusion criteria: * age greater than or equal to 12 years * compliant and able to complete questionnaires * hospitalization for internal injuries requiring a laparotomy or for orthopedic injuries (closed long bone or calcaneus fractures). * a minimum of 3 days hospitalization * no history of psychiatric (dsm-iv-r axis i) disorder * not demonstrating delirium, psychosis or any form of organic brain disorder * able to communicate verbally * able to take oral medications * baseline pain level of \>=5/10 * english-speaking exclusion criteria: * age less than 12 years * not capable of indicating pain intensity * not capable of filling out study measures * hospitalization of less than 3 days * evidence of traumatic brain injury * history of psychiatric (dsm-iv-r axis i) disorder as evidenced in the admitting rn and md admission notes. * demonstrating delirium, psychosis or any form of organic brain disorder and associated memory problems. * unable to communicate orally. * unable to take oral medications * history of sig. cardiac, endocrine, neurologic, metabolic, respiratory, gastrointestinal or genitourinary impairment * receiving prophylaxis for alcohol or drug withdrawal * developmental disability * mini-mental status score of greater than 20 in patients older than 80 years or suspected of cognitive deficits * non-english speaking * extreme susceptibility to motion sickness * seizure history
targeting inflammation with losartan to improve response to modulator therapy in cystic fibrosis.

Conditions: Cystic Fibrosis

Summary: the goal of this clinical trial is to test use of losartan in those with cystic fibrosis (cf) on modulator therapy. the main question it aims to answer is if treatment with losartan improves response of the cf transmembrane conductance regulator (cftr) channel to modulator therapy. participants will be asked take losartan or placebo for twelve weeks and will have changes in sweat chloride levels measured as a marker of cftr function.

this is a randomized, placebo-controlled, parallel group clinical trial in those those with cf on elexacaftor/tezacaftor/ivacaftor to determine if treatment with losartan improves response to modulator therapy using sweat chloride as an marker of cftr function.

Eligibility criteria:
inclusion criteria: * established diagnosis of cystic fibrosis * age 12 years and older * stable use of elexacaftor/tezacaftor/ivacaftor for 90 days prior to enrollment * sweat chloride concentration 50 mmol/l or greater while on elexacaftor/tezacaftor/ivacaftor exclusion criteria: * prior lung transplant * bmi \<18 * cf pulmonary exacerbation requiring hospitalization or intravenous antibiotics in the preceding 30 days * systemic corticosteroid or regular non-steroidal anti-inflammatory use in the preceding 30 days * chronic use of angiotensin receptor blockers or angiotensin converting enzyme inhibitors * concomitant use of medications known to interact with losartan, including aliskiren * chronic renal insufficiency (creatinine clearance \<45 ml/min) * pregnancy or lactation * inability or unwillingness to comply with approved contraceptive method during the study period (females of childbearing age) * in the opinion of the investigator any severe or acute or chronic condition or laboratory abnormality that may increase the risk associated with trial participation or make the participant inappropriate for enrollment * participation in another interventional trial that, in the opinion of the investigator, has the potential to affect the primary outcome

Keywords: losartan
effects of immunonutrition in patients undergoing pancreaticoduodenectomy

Conditions: Pancreaticoduodenectomy

Summary: the purpose of this study is to determine whether immunonutrition is effective on surgical site infection and th1/th2/th17 differentiation in patients undergoing pancreaticoduodenectomy

perioperative immunonutrition is reported to improve the incidence of postoperative infectious complication in patients with gastrointestinal surgery. it has also been recognized that th1/th2 balance shifts toward th2 by surgical stress. on the other hand, the change of th17 status after surgery has not been established. furthermore, the change of th1/th2 balance and th17 status with immunonutrition on pancreaticoduodenectomy have not been reported yet. objective of this study is to investigate the effects of perioperative immunonutrition on incidence of postoperative infectious complication, th1/th2 balance and th17 status after pancreaticoduodenectomy.

Eligibility criteria:
inclusion criteria: * patients underwent pancreaticoduodenectomy exclusion criteria: * age younger than 18 years or older than 75 years * preoperative chemotherapy or radiation * ongoing infection * diabetes mellitus * gastrointestinal obstruction * respiratory dysfunction * cardiac dysfunction * hepatic dysfunction * renal failure * history of recent immunosuppressive or immunological diseases * preoperative evidence of widespread metastatic disease

Keywords: immunonutrition pancreaticoduodenectomy th1 th2 th17
clinical comparison of femoral nerve versus adductor canal block following anterior ligament reconstruction

Conditions: Anterior Cruciate Ligament Injury

Summary: this study will examine the potential differences between femoral nerve blockade (fnb) and adductor canal blockade (acb) for pain control and quadriceps muscle activation for patients following anterior cruciate ligament (acl) reconstruction.

adequate pain control following anterior cruciate ligament reconstruction (acl) often requires a regional nerve block. the femoral nerve block (fnb) has been traditionally employed. more recently, ultrasound application to regional nerve blocks allows for the use of alternatives such as the adductor canal block following acl reconstruction. in 2009, manickam et al. were the first to describe the ultrasound guided adductor canal technique for the purposes of knee joint analgesia. unlike other traditional techniques that seek to cause a sensory as well as a motor blockade, the adductor canal block attempts to spare the motor block of the neighboring distributions in an attempt to offer selective analgesia and strength preservation. chisholm et al demonstrated the adductor canal block provides similar and adequate postoperative analgesia when compared to the fnb, following arthroscopic acl reconstruction with patellar tendon autograft. their study focused on analgesia and did not evaluate quadriceps function or impact on rehabilitation. sharma et al drew the first association between femoral nerve blocks and increased fall risk due to muscle weakness in total knee arthroplasty population. a randomized, blinded study to compare quadriceps strength following adductor canal versus fnb was performed by kwofie et al. they showed that compared with fnb, adductor canal block results in significant quadriceps motor sparing and significantly preserved balance. these studies focused on acute muscle weakness after regional anesthesia and its relation to safety. quadriceps function is very important in rehabilitation of acl reconstruction. luo et al demonstrated long term deficits related to fnb. they demonstrated that patients treated with fnb after acl reconstruction had significant isokinetic deficits in knee extension and flexion strength at 6 months when compared with patients who did not receive a nerve block. patients without a block were 4 times more likely to meet criteria for clearance to return to sports at 6 months. in addition, krych et al found significantly inferior quadriceps strength and function at 6 months in fnb group. based on the available literature, we aim to compare femoral nerve versus adductor canal block in regards to pain control and muscle strength in acl reconstruction patients until return to sport.

Eligibility criteria:
inclusion criteria: * males \& females ages 16-30 yrs * undergoing acl reconstruction by co-investigator (walter lowe) * receiving peri-operative fnb or acb exclusion criteria: * not enrolled within the cofaks study * receiving intrathecal nerve blockade or no blockade

Keywords: femoral nerve block adductor canal block
effect of low-dose esketamine combined with target-controlled infusion of propofol for painless gastrointestinal endoscopy

Conditions: Pain; Anesthesia

Summary: purpose: 1. to determine the efficacy of low-dose esketamine in painless gastrointestinal endoscopy. 2. to determine the safety of low-dose esketamine in painless gastrointestinal endoscopy. 3. to provide a theoretical basis and new ideas for the application of esketamine as a new drug in perioperative period.

keeping spontaneous breathing anesthesia can provide patients with comfortable diagnosis and treatment experience during gastrointestinal endoscopy, which is a vital prerequisite for the large-scale development of this operation as well as the early screening and treatment of gastrointestinal malignancies. clinically, fentanyl combined with propofol is the most commonly used anesthesia regimen for the painless gastroscopy, however its high incidence of respiratory and circulatory depression will threaten the safety of patients. instead, esketamine has a good action in anesthesia and analgesics, a slighter respiratory depression, as well as with a remarkable improvement in adverse effects than ketamine. what has already been proved is that low- dose of esketamine can remarkably reduce the dosage of propofol during endoscopic retrograde cholangiopancreatography; in our pilot study, we found that not only the incidence of respiratory depression was significantly lower than that of fentanyl during endoscopic polypectomy, but also the dosage of propofol was reduced at the same time,suggesting that esketamine may have a potential superiority in the painless gastrointestinal endoscopy.our project plans to collect the patients who have received painless gastroscopy and polypectomy in the hospital, and use a target-controlled infusion (tci) of propofol in combination with esketamine, by observing the total dose of propofol , the time of recovery and the length of hospital stay, the satisfaction of patients and endoscopists, drug side effects,adverse events of respiratory and circulatory system and other indicators ,to evaluate the efficacy and safety of this anesthetic scheme.

Eligibility criteria:
inclusion criteria: 1. subject's american society of anesthesiologists physical status is i-iii. 2. subject has no symptoms of allergy to anesthetics. 3. subject has no contraindications for gastrointestinal endoscopy. 4. subject has given written informed consent to participate. exclusion criteria: 1. subject's bmi \ 30 2. subject has poorly controlled or untreated hypertension. 3. subject has severe ischemic heart disease. 4. subject is an untreated or undertreated patient with hyperthyroidism. 5. subject has used drugs that affect their central nervous system. 6. .subject has mental illness. 7. .subject has epilepsy. 8. .subject has a history of chronic pain. 9. .subject is pregnant or breast-feeding.

Keywords: esketamine; gastrointestinal endoscopy; analgesia; sedation; respiratory depression
fapi-pet/ct in psoriatic arthritis

Conditions: Psoriatic Arthritis

Summary: 68ga-fapi has been developed as a tumor-targeting agent as fibroblast activation protein is overexpressed in cancer-associated fibroblasts and some inflammation, such as igg4-related disease. therefore, this prospective study is going to investigate whether 68ga-fapi pet/ct may be superior for disease activity assessment and follow-up of psoriatic arthritis than 18f-naf pet/ct.

psoriatic arthritis (psa) is a chronic inflammatory disease that develops in up to 30% of patients with psoriasis and characterized by diverse clinical features including peripheral and axial arthritis, enthesitis, dactylitis and nail dystrophy, leading to impaired function and reduced quality of life. positron emission tomography (pet) allows for highly sensitive depiction of targets at the molecular level and can be used to specifically visualize immune cells of interest through the use of specific tracers. in this study, we used two tracers: 68ga-fibroblast activation protein inhibitor (fapi) and 18f-sodium fluoride (18f-naf) to evaluate both joint inflammation and bone metabolism in patients with psa. and the study is going to investigate whether 68ga-fapi pet/ct may be superior for disease activity assessment and follow-up of psoriatic arthritis than 18f-naf pet/ct.

Eligibility criteria:
inclusion criteria: * fulfilled the 2006 classification criteria for psoriatic arthritis (caspar) * 18f-naf pet/ct within two weeks * signed written consent. exclusion criteria: * pregnancy * breast feeding * known allergy against fapi * any medical condition that in the opinion of the investigator may significantly interfere with study compliance.
arginine and nitric oxide (no) early prognostic markers for non-union development

Conditions: Fracture Healing; Atrophic Non Union Development; Hypertrophic Non Union Development

Summary: objective: primary objective is to study the arginine-no metabolism during fracture healing and dysfunctional fracture healing. secondary objective: to investigate if differences or decreased arginine and no concentrations in bone healing form a prognostic marker for non-union development hypothesis: early detection of disturbances in the arginine and nitric oxide metabolism during fracture healing are a good prognostic marker for non-union development. study design: prospective observational study. study population: all acute fracture patients (age \>18 years), with a fracture of the tibia or femur attending the department of general surgery, to investigate the arginine -no metabolism during normal fracture healing and possible dysfunctional healing. in total 100 patients will be included during this study. main study parameters/endpoints: primary endpoints are arginine and nitric oxide levels in the plasma during normal and dysfunctional fracture healing the bone in patients with and without non-union secondary endpoints are levels of nitric oxide citrulline, ornithine and other amino acids in bone and in plasma other parameters: baseline demography details will be obtained, including possible confounders, such as bodyweight, smoking, alcohol abuse, which may interfere with the outcome of this study. nature and extent of the burden and risks associated with participation, benefit and group relatedness: the extent of the burden and risk associated with participation is expected to be low during this study. in total, 7 blood samples will be taken during this study (45ml, in total). during the primary (and possible secondary) surgical procedure, bone debris will be taken. bone debris is usually discarded but will be used for analysis in this study. there is no extra surgical procedure necessary to obtain the bone debris.


Eligibility criteria:
inclusion criteria: * written informed consent * age \> 18 years * patient with a fracture of the femur or tibia for which a surgical procedure providing bone debris is performed as therapy exclusion criteria: * patients with another bone fracture in their recent medical history * infectious complications, such as infected pseudo-arthrosis * use of chronic corticosteroids or nitrovasodilating medication * patients with severe metabolic disturbances (liver, and renal insufficiency, diabetes). * patients with metastases, haematological malignancies or chemotherapy

Keywords: non union fracture healing arginine no
healthy meals: a restaurant-based study to promote healthy and allergy adapted diet

Conditions: Intervention; Food Allergy; Food Preferences; Food Intolerance; Diet Habit; Diet Modification

Summary: this study evaluates the effect of a multicomponent intervention applied to restaurant staff about training and nutritional quality of menu improvement, in order to promote a healthy diet and a better management of allergies and intolerances addressed to each family member satisfying the customers with specific needs (allergies and intolerances of food).

the aim is to test the effect of a multicomponent intervention applied to restaurant staff about training and nutritional quality of menu improvement, in order to promote a healthy diet and a better management of allergies and intolerances addressed to each family member satisfying the customers with specific needs (allergies and intolerances of food). the study is a 12-month restaurant-based intervention study, randomized, controlled and parallel.

Eligibility criteria:
the inclusion and exclusion criteria were about restaurants, as a unit of randomization. this study is randomized. inclusion criteria: * to have signed informed consent by the restaurant owner, * to have minimum 5 tables of service, * to offer local or mediterranean food and recipes on the menu, * to have the recipes with ingredient and cooking steps details, and * to share the food products information used in the restaurant with the research team. exclusion criteria: * to be an ethnic restaurant, fast-food restaurant or a restaurant with a single product like only pizza, sushi, etc * lack of one of the inclusion criteria

Keywords: mediterranean diet food allergen restaurant-based intervention
international, multicenter, open-label and randomized withdrawal study of oral lixivaptan in heart failure patients with chronic hyponatremia

Conditions: Hypervolemic Hyponatremia

Summary: to demonstrate that after 12 weeks of open-label lixivaptan treatment, serum sodium is maintained in hyponatremic patients continuing to receive lixivaptan compared to placebo during the 4 week double blind treatment period.


Eligibility criteria:
inclusion criteria: 1. men and women with age greater than or equal to 18 years. 2. prior successful participation in a randomized, blinded, placebo-controlled phase 3 lixivaptan study of hyponatremia in heart failure (protocol ck-lx3401) with evidence of continued need for therapy as follows: * patient completed full course of treatment (e.g., either placebo or lixivaptan). treatment assignments for protocol ck-lx3401 will not be unblinded prior to participation in the extension study. * baseline serum sodium concentration \< 135 meq/l following a 30 day post treatment follow-up period in a lixivaptan hyponatremia parent trial. repeat measures of serum sodium are allowed; the last serum sodium result within 24 hours prior to randomization will serve as the qualifying measurement. 3. the patient has clinical evidence of volume overload with at least one of the following: * dyspnea * pulmonary congestion (rales) * peripheral edema * increased jugular venous pressure and/or hepatic congestion with ascites * chest x-ray consistent with chf; or * plasma bnp ≥150 pg/ml or nt pro-bnp ≥ 450 pg/ml exclusion criteria: 1. women who are pregnant (positive pregnancy test), breastfeeding or who will not adhere to the reproductive precautions as outlined in this protocol and in the informed consent form. 2. inability to provide informed consent. 3. acute severe hyponatremia with overt symptoms of hyponatremia requiring immediate medical intervention (e.g., coma, seizures). 4. acute or transient hyponatremia (e.g., associated with head trauma or postoperative state). 5. hyponatremia in hypovolemic states. hypovolemia is defined as the presence of clinical evidence of fluid volume depletion. 6. euvolemic hyponatremia (e.g., siadh, etc.). euvolemic hyponatremia is defined as low serum sodium in the presence of normal total body sodium due to mild to moderate increases in total body water without edema.

Keywords: hypervolemic hyponatremia serum sodium fluid overload heartfailure acute heart failure vasopressin antagonist
flexwave trial: efficacy of extracorporeal shock wave therapy in post-stroke upper limb spasticity

Conditions: Stroke; Spasticity, Muscle

Summary: extracorporeal shock wave therapy (eswt) has emerged as an effective therapeutic intervention for addressing post-stroke limb spasticity. this research aims to explore the therapeutic implications of focused eswt for wrist and finger flexor muscles in patients suffering from post-stroke upper limb spasticity.

this study aimed to evaluate the effects of focused extracorporeal shock wave therapy (eswt) on upper limb flexor spasticity in stroke patients. participants were randomized into two groups: an experimental group receiving targeted eswt on specific forearm flexor muscles, and a control group receiving placebo treatments mimicking the shockwave therapy, with treatments administered twice weekly over two weeks for a total of four sessions. the efficacy of the treatment was measured using a comprehensive set of assessment tools, including range of motion, hand grip strength, pain levels, spasticity scales, functional assessments, as well as measures of daily living activities, ultrasound strain elastography, and electromyography. the outcomes were evaluated at multiple points in time: before treatment, and 1, 4, 12, and 24 weeks after the therapy concluded, to assess both immediate and sustained effects of the treatment on upper limb function and spasticity in stroke survivors.

Eligibility criteria:
inclusion criteria: * individuals aged 18 years or older with unilateral cerebral stroke. * wrist and finger flexor muscle tone with a score greater than 1 on the modified ashworth scale. * stable medical condition and vital signs. * conscious and able to comply with instructions. exclusion criteria: * history of more than one stroke, traumatic brain injury, or cerebral neoplasm. * coexisting central nervous system disorders (e.g., spinal cord injury, parkinson's disease) or other musculoskeletal diseases affecting muscle tone assessment. * contraindications for shockwave intervention, such as malignancies, coagulopathies, local infections, or use of cardiac pacemakers. * undergone shockwave therapy or botulinum toxin injections for post-stroke spasticity in the past three months. * cognitive, consciousness, or language impairments preventing participation in the intervention or functional assessments.

Keywords: stroke spasticity shock wave wrist finger