Kornimate/medical-research-clean huggingface dataset:
exhaled nitric oxide in respiratory syncytial virus (rsv) bronchiolitis: a pilot study

Conditions: RSV Infection; Bronchiolitis

Summary: the fraction of exhaled nitric oxide (feno) in expired air is a reliable measure of airway inflammation. some research experiments have demonstrated stimulation of nitric oxide production in respiratory epithelial cells infected with rsv. the principal aims are to determine if the fraction of exhaled nitric oxide (feno) is elevated in hospitalized pediatric patients with viral lower respiratory illness and to determine if there is a difference in feno level between rsv and non-rsv infection. no may play a role in the association between rsv, airway reactivity, and airway inflammation. this is a prospective, pilot study that will noninvasively measure feno in children 0-4 years of age admitted to winthrop university hospital, as well as controls (children in the same age range without respiratory conditions and who are well enough to perform the test). hospitalized children will be tested for rsv (enzyme immunoassay (eia) \& dfa) and via direct fluorescent antigen technique (dfa) for influenza a \& b, parainfluenza, human metapneumovirus and adenovirus. method of feno measurement will utilize the offline options for preschool children \& infants appropriate for age as described in the 2005 joint statement of the american thoracic society \& the european respiratory society when discussing tidal breathing techniques with uncontrolled flow rate offline exhaled air can be collected via a mouthpiece or a face mask connected to a non-re-breathing valve that allows inspiration of no-free air from an no-inert reservoir to avoid contamination by ambient no. exhaled breath samples are collected into an no-inert bag fitted with the expiratory port once a stable breathing pattern is present. the results of all 3 groups will be compared: control, rsv positive and rsv negative samples.


Eligibility criteria:
inclusion criteria: * admitted subjects with diagnosis of bronchiolitis, viral pneumonia or other significant respiratory viral infection exclusion criteria: * asthma/rad * recurrent wheezing * "recurrent bronchiolitis" * allergic rhinitis * atopy * chronic lung disease * hypertension * heart failure * pulmonary hypertension * primary ciliary dyskinesia * bronchiectasis * alveolitis * lung transplant rejection * pulmonary sarcoidosis * chronic cough (i.e. greater four weeks) * systemic sclerosis * hypersensitivity * cystic fibrosis * hiv * sickle cell anemia * cardiac pulmonary bypass * liver cirrhosis * alpha-1 anti-trypsin disease * interstitial lung
study of a new laparoscopic technique for parastomal hernia repair with mesh

Conditions: Hernia; Abdominal Hernia

Summary: the purpose of the study is to evaluate a new laparoscopic technique for parastomal hernia repair using an intraperitoneally placed proceed mesh, looking at postoperative complications, recurrence rate and postoperative pain and quality of life.

parastomal hernia affects up to 50% of all patients following formation of a stoma, most often in patients with a colostomy. about 20% of the patients need surgical correction of their parastomal hernia. symptoms associated with parastomal hernias goes from mild physical (pain) and cosmetic discomfort to life threatening conditions with obstruction, strangulation and perforation. parastomal hernias have big socioeconomic consequences and remain a considerable clinical problem. the surgical treatment of parastomal hernias is controversial. the best way to treat it is to restore the continuity of the intestine, but in permanent stomas, this is not an option. many surgical techniques have been described when intervention is required, but the results are unacceptable. the traditional open techniques are local simple suturing of the fascia defect, stoma relocation, or repair with a prosthetic material either intraperitoneally or extraperitoneally (subfascial or onlay). overall, the results of all methods are poor with high recurrence rates and high morbidity and mortality. mesh repair has the lowest recurrence rate (0-39%) and stoma relocation and simple suture has reported recurrence rates on 0-76% and 46-100%, respectively. laparoscopic repair of parastomal hernias with a prosthetic mesh inserted intraperitoneally is a new method described in a few small series. the results so far are encouraging, but the follow-up period is short. looking at the disappointing results from the traditional open techniques in the treatment of parastomal hernias together with the enormous success in laparoscopic ventral hernia repair and laparoscopy overall, we believe that laparoscopic parastomal hernia repair with mesh will be an effective treatment option in the future. therefore, we find it interesting to investigate the technique in a prospective study

Eligibility criteria:
inclusion criteria: * age 18 - 80 years * indication for laparoscopic parastomal hernia repair in general anaesthesia. * danish speaking * asa group i-iii * no remaining malignancy after former primary radical operation for colorectal cancer exclusion criteria: * former operation (open/lap) for parastomal hernia with insertion of mesh, or other mesh operation in the area of herniation * incarcerated hernia (acute operation) * history of abuse or permanent morphine use * expected bad compliance * current systemic steroid use or other immuno-suppressive treatment * hiv-positive, pregnant or breast feeding * medical conditions contraindicating general anaesthesia * simultaneous operation for other ventral, inguinal or umbilical hernia * epidural or spinal anaesthesia * conversion to open procedure

Keywords: laparoscopic parastomal hernia repair intraperitoneally mesh quality of life postoperative pain recurrence
ucla tai chi in a community setting study

Conditions: Physical Activity; Fatigue

Summary: although a number of studies have examined the effects of tai chi in older adult populations, few have methodically assessed its effects on vitality, fatigue and physical activity. some studies have shown that fatigue relates to negative mood and poor health-related quality of life in older persons. tai chi is an ancient chinese form of calisthenics that utilizes the body's internal energy (chi), mind, and breathing; which may be a useful exercise for older adults in increasing their activity level. a twenty-four of yang style of tai chi is a simple form of tai chi that is particularly well-suited for older adults. this proposed study to investigate the effects of a tai chi intervention on decreasing fatigue level, and increasing level of activity in healthy older adults. the investigators research group has focused on the tai chi as a strategy to reduce stress and improve sleep, and their preliminary evidence suggest it strongly affects energy level and vitality. the investigators are focused on taking this intervention into the community testing its efficacy. the investigators preliminary data shows that tai chi is of benefit to older adults; however, this study will test whether their research findings are generalizable to community settings. tai chi-naïve participants from culver city senior center will receive a 10-week tai chi. the investigators will compare this group to a wait-list control group. all subjects will receive a packet of questionnaires of pre- and post-intervention vitality, fatigue and health-related quality of life. subjects will also be given an activity monitor to wear for 2 days before they start the tai chi class and for 2 days after they complete the class, to determine if there is a change in general physical activity level.


Eligibility criteria:
inclusion criteria: * healthy * older adult \> 60 years of age exclusion criteria: * older adults who have severe osteoarthritis or chronic pain disorders * non ambulatory * any condition that would adversely impact their participation in tai chi

Keywords: exercise physical activity tai chi
post operative cognitive dysfunction and delirium after spinal surgery

Conditions: Emergence Delirium; Post-Operative Cognitive Dysfunction

Summary: aim of this trial is to define if post-operative cognitive dysfunction and delirium, detected analyzing changes between pre-operative and post-operative neurocognitive test, relate to concentration of effector's site concentration of propofol and remifentanil tci and to the common intraoperative neuromonitoring values.

post-operative cognitive dysfunction and emergence delirium has not been yet investigated after general anaesthesia with targeted-controlled-infusion (tci), daily used in the investigator's hospital to anesthetize patients undergoing spinal surgery. aim of this trial is to define if neurocognitive tests (pfeiffer test, montreal cognitive assessment, trail making test a and b, digit span test, confusion assessment method) before and after surgery relate to concentrations at effector's site (ec) of propofol and remifentanil tci, the values of bispectral index, blood pressure values and usage of drugs to increase arterial blood pressure.

Eligibility criteria:
inclusion criteria: * general anaesthesia delivered with propofol and remifentanil with targeted controlled infusion * surgical duration \> 60 minutes exclusion criteria: * neurological pathologies

Keywords: infusion pumps intraoperative brain monitoring
social-economics profile of the asthmatic patients attended at nucleus of integrated medical care

Conditions: Asthmatic Patients

Summary: this study had a descriptive, retrospective, transversal character with quantitative approach, which aimed to delineate the social-economics profile of the asthmatic patients that used the health service available at the care nucleon medical integrate (nami)

the need of studies to develop programs of pharmaceutical attention for asthmatics was given because of the increase of incidence and prevalence of the disease in the population. this study had a descriptive, retrospective, transversal character with quantitative approach, which aimed to delineate the social-economics profile of the asthmatic patients that used the health service available at the care nucleon medical integrate (nami). the studied population was composed of 40 asthmatic patients who attended between april and may, during 2006. data collection was performed through a semi-structured stereotypic questionnaire, with closed and opened questions. the age range of the interviewee between 0 to 5 years old represents the biggest percentage of patients, obtaining 60% of the answered questionnaires. according to social-economics conditions, 55% were illiterate or were learning to read, 75% were using some drug prescribed at nami, 72.5% deny completely the disease, 52.5% recognized the factors that triggered the asthmatic crisis and 55% said having often crisis. seventy per cent (70%) of the interviewee showed some difficulty related to the use of the drugs; 47.5% have different problems related to the access to the medications. through the analysis of the social-economics profile delineated of the asthmatics patients attended at nami, it could be revealed that the biggest part of the patients are people with little instruction, due to the social exclusion in which they are found; being the majority of them children of the female gender.

Eligibility criteria:
inclusion criteria: * patients enrolled in regular nucleus of integrated medical care; * patients presented within the age group above to 80 years; * patients accepted voluntarily join the search; * they used any medicine that received at the pharmacy of nucleus of integrated medical care. exclusion criteria: * patients who don´t residing in the neighborhood of community; * patients who don´t accepted part of the study by answering the questionnaire; * have not made use of medicines in the last 60 days or have not received in the pharmacy of of integrated medical care.

Keywords: asthma epidemiology
genome-wide association study

Conditions: Esophageal Squamous Cell Carcinoma

Summary: to explore biomarkers predictive of clinical response to taxane/5-fu/platinum based chemotherapy in esophageal squamous cell carcinoma. to identify negative predictive markers to 5-fu/platinum/taxane. to elucidate signal transduction pathway attributable to 5-fu/platinum/taxane resistance. to analyze correlation between the quantity of circulating tumor cells and circulating endothelial cell precursors and treatment response to taxane/5-fu/platinum based chemotherapy.


Eligibility criteria:
inclusion criteria: * histological confirmed esophageal squamous cell carcinoma * patients treated with taxane or 5-fu or platinum based chemotherapy. * provision of a signed written informed consent. exclusion criteria: * patients not signed written informed consent. * patient unacceptable for study in the judgement of the investigator.
penicillin allergy in shfayim clinic

Conditions: Penicillin Allergy

Summary: revising penicillin allergy in the medical records, by taking full medical history and giving a challange test, in order to imrove the medical records and treatment possibilities.

issuing a list of patients with a title of penicillin allergy in their medical record. inviting these patients to an appointmnet with their family physician, in which a specific history will be take to evaluate the quality of the allergy. patients with suscpition of a life threatening allergic reaction will be reffered to an allergy clinic for the challange test. the rest of the pateints will be given the test in the primary clinic: 1ml (50 grams) of amoxicillin, and an hour later a full dose of 500 mg amoxicillin. after determining no allergic reaction develops the title will be erased from the medical record.

Eligibility criteria:
inclusion criteria: penicillin allergy in the medical record exclusion criteria: pregnancy lack of informed consent

Keywords: penicillin allergy chalenge test primary clinic
autonomous robotics for transcatheter cardiac procedures

Conditions: Mitral Valve Disease; Heart Valve Diseases; Structural Heart Abnormality

Summary: cardiovascular diseases represent the most common cause of death worldwide. percutaneous approaches with intravascular catheters are pivotal, since they allow to treat patients with high perioperative risks. however, catheter-based treatments require steep learning curves and are characterized by poor ergonomics and exposure to damaging radiation. artery will offer a radiation-free approach based on shared-autonomy robotic catheters, with increased user engagement and easy interaction. intraprocedural three-dimensional echocardiography as well as computed tomography images obtained during usual clinical practice will provide artificial intelligence algorithms that will turn catheter navigation to a simple task. optical and electromagnetic sensing techniques will ensure a superior view upon the cardiovascular anatomy and will guide the autonomous catheter upon the interventionist supervision, who will be able to take over control at any instant.


Eligibility criteria:
inclusion criteria: * adult patients * patients admitted to hospital undergoing percutaneous cardiac procedure * patients able to give informed consent exclusion criteria: * age \<18 years * refuse to give informed consent
avation electric stimulation system for spinal cord injury neurogenic bladder

Conditions: Neurogenic Bladder

Summary: the purpose of this study is to assess and optimize the avation electric stimulation system output and electromyography (emg) processing to stimulate the tibial nerve in people with chronic spinal cord injury (sci) who have foot muscle atrophy and edema, both of which may affect proper device operations, to evaluate the safety, feasibility, and effectiveness of avation electric stimulation system for bladder neuromodulation in people with sci and identify barriers to implementation of the existing avation electric stimulation system to help with developing it towards a new indication for routine care of sci nb.


Eligibility criteria:
inclusion criteria: * injury level above t10. * diagnosis of neurogenic bladder (performing intermittent catheterization). * english or spanish speaker. * toe flexion upon tibial nerve stimulation with transcutaneous electric stimulation. * no adverse events during the vivally 5-minute trial exclusion criteria: * intradetrusor botulinum toxin within six months. * presence of urinary tract infection (uti) symptoms. * pregnancy or breastfeeding. * known allergy to electrode or device materials. * known intolerance to leg electric stimulation * patient with no smartphone access. * pain/discomfort or adverse reaction with the trial of toe flexion.

Keywords: spinal cord injury tibial nerve stimulation
paravertebral block for mastectomy with immediate reconstruction

Conditions: Postoperative Pain

Summary: following a mastectomy, patients may develop chronic pain, called post-mastectomy pain syndrome (pmps). this syndrome manifests itself as complex neuropathic pain that seems linked to nerve damage suffered either during surgery, during healing or by nervous system dysfunction. however, the exact pathophysiology remains unknown. typically, the pain is located on the ipsilateral side of the surgery and projects to the anterior thorax to the lateral thorax and may affect the proximal part of the arm. this pain persists for more than three months following the procedure and has the characteristics of neuropathic pain: burning sensation, tingling, electric shock, hyperalgesia, etc. the prevalence of pmds varies between 2% and 78%; this disparity comes from the fact that there are no clear criteria in the literature for making the diagnosis. one of the risk factors for developing pmds is the presence of acute pain immediately postoperatively. the main objective of this study is to compare two analgesic modalities, namely bpv (study modality) and usual analgesia (control modality), in patients undergoing total mastectomy with immediate reconstruction under general anesthesia with the aim of to evaluate their functional pain score at 24, 48 and 72 hours following the surgical procedure.


Eligibility criteria:
inclusion criteria: * 18-70 years of age * woman scheduled for unilateral mastectomy with immediate reconstruction exclusion criteria: * patients who will have an axillary dissection during surgery. * woman with severe hepatic insufficiency (child pugh classification b and above24). * woman with kidney failure stage 4 and above25. * body mass index (bmi) \> 40 kg/m2. * woman with an allergy to local anesthetics. * woman with a bleeding disorder in whom bpv is contraindicated. * woman in whom stopping antiplatelet or anticoagulant therapy does not allow compliance with the standards of practice of neuraxial anesthesia issued by the american society of regional anesthesia. * woman with a single lung. * pregnant woman.
clinical experimentation with tenofovir disoproxyl fumarate and emtricitabine for covid-19

Conditions: Covid19

Summary: clinical, control, double-blind, randomized trial with tenofovir disoproxyl fumarate and emtricitabine for covid-19

several therapeutic agents have been evaluated for the treatment of covid-19, and only one using an antiviral drug called remdesivir administered intravenously has shown efficacy to reduce the duration of the disease in 26.7% in critically ill patients. this proposal has as its primary objective (a) determine the effect of tdf and tdf + ftc on the duration of covid-19 evaluated in the 14th. day of follow-up at the outpatient clinic in the hospital, duration of the disease observing clinical signs and symptoms, as well as evaluating the rt-pcr viral load tests on the 1st, 7th, 14th. and 28th. days of the study protocol. in addition, the proposal assesses several secondary objectives: (b) assess the action of tdf and tdf + ftc on the immune response using the rapid elisa test (igm / igg) to be performed on the 7th. and 28th. days of monitoring the experimental protocol; (c) determine the effect of clinical interventions with the drugs tdf and tdf + ftc in the short and medium term on the viral load of sars-cov-2; and (d) assess the effect of tdf and tdf + ftc on inflammation biomarkers cytokines and chemokines (il-6, mcp-3, d-dimer, il1-ra, il-10, gcsf, tnf-α, mcp-1 , il-2r, mip-1 alpha, ip-10, il-8, nt-probnp, troponin i, crp and procalcitonin) in the blood of patients collected in the 1st, 14th. and 28th. study days. the study will be a prospective, double-blind, placebo control and randomized clinical trial of a total of 219 patients with mild to moderate disease, aged 18 years or over, with clinical signs and symptoms of covid-19 and certified after the rt-pcr test for the detection of sars-cov-2 viral load. the study will be carried out at the outpatient clinic of hospital são josé, fortaleza, ce. the random groups will be: (1) group - placebo control (vitamin c - 500mg / day, for 10 days); (2) group - tenofovir disoproxyl fumarate (tdf; 300 mg / day, for 10 days); and (3) group - tdf + emtricitabine (ftc; 200 mg / day, for 10 days). the study aims to evaluate the efficacy of tenofovir alone or combined with emtricitabine in the duration of mild to moderate covid-19 cases. the study will also assess the effect of drugs on viral load and immune-inflammatory response. in this sense, the study has the perspective of minimizing the evolution of the disease to severe cases, thus relieving the collapse of the health system and minimizing the social, economic and health disorders of the pandemic by sars-cov-2.

Eligibility criteria:
inclusion criteria: * patient is \> 18 years old * patient diagnosed with covid-19 exclusion criteria: * patient is already receiving some of the study drugs * there is a hospitalization plan in the next 24h * some study treatment is contraindicated * patient has hiv infection * patient has vhb infection * patient lives in another city or state * female patient, pregnant

Keywords: tenofovir emtricitabine covid-19 clinical trial
probiotics at the treatment of antibiotic associated diarrhea

Conditions: Antibiotic-Associated Diarrhea

Summary: the purpose of this study is to know the efficacy of the treatment with probiotics, lactobacillus casei and bifidobacterium breve, on clinical evidences and occurence of relapses on antibiotic-associated diarrhea.

the antibiotic-associated diarrhea (aad)is defined as that developed after the started antibiotic therapy ou until six to eight weeks after the end of the treatment. the occurence of aad is about 5% to 25% of the patients using antibiotics and cause watery diarrhea, fever and vomit, mainly on pseudomembranous colitis. several studies had demonstrated the use of probiotics as therapeutic or preventive form of aad with or without the presence of c. difficile. about the tolerance of the probiotics,there weren´t observed deleterious effects on health with the consumption of 106 - 107 ufc of lactobacillus spp and bifidobacterium spp during a period of one year. the realization of this study can demonstrate the efficacy of lactobacillus casei e bifidobacterium breve at the treatment of aad.

Eligibility criteria:
inclusion criteria: * hospitalized patients with diarrhea using antibiotic during, at least, 24 hours or had used antibiotic 07 days prior to study entry. exclusion criteria: * patients with chronic diarrhea, viral diarrhea, critical patients, during or after radio or chemiotherapy treatment, * hiv infections, * ulcerative colitis, * crohn´s disease, * hydroelectrolytic disturbance, * small intestine syndrome, * colostomized, jejunostomized * lactose intolerance, * rapid enteral diet infusion (\>120mh/h), * hyperosmolar enteral diet.

Keywords: antibiotic associated diarrhea probiotics treatment