Kornimate/medical-research-clean huggingface dataset:
the effect of femoral nerve block on opioid requirements after surgery for a femur fracture in children

Conditions: Pain, Postoperative

Summary: this study evaluates the effect of a femoral nerve block on opioid requirements following femoral fracture fixation with flexible nails in the paediatric population. this is a double blind, prospective randomized clinical trial.


Eligibility criteria:
inclusion criteria: * femoral shaft fracture requiring intra-medullary nailing * surgery performed within 24 hours of injury * ability of child or family to use patient-controlled analgesia (pca) * no allergy or sensitivity to bupivacaine * informed consent and assent exclusion criteria: * open femur fractures * closed fractures needing open reduction * fractures associated with neurovascular complications * fractures associated with compartment syndrome * repeat femoral surgeries * patients who received a femoral nerve block more than 1 hour prior to surgery * complex associated injuries or pre-existing condition that will delay time to ambulation * children who are allergic and/or sensitive to bupivacaine

Keywords: femur fracture morphine sparing preemptive analgesia post-operative pain and post- operative opioid use
impact of gluten contamination in celiac patients clinically responsive and unresponsive to the gluten-free diet

Conditions: Celiac Disease

Summary: the primary aim of the study is to detect the presence of gluten immunogenic peptides (gip) in urine samples from celiac patients on a gluten-free diet clinically responsive and non-responsive to dietary treatment and from suspected celiac patients already on a gluten-free diet.

once a year, celiac patients perform a clinical (gastroenterological visit) and blood chemistry (blood tests) check. at the center for the prevention and diagnosis of celiac disease, about 1400 check-ups of celiac patients are carried out per year. during this annual control visit, consecutive patients afferent to the center and suffering from celiac disease who have been treated for more than 6 months, clinically "responsive" and "non-responsive" to the gluten free diet (gfd), will be invited to participate in the proposed study. those who participate will be given the symptom questionnaires (vas), the food questionnaire in order to evaluate the relevance of the symptoms reported and the type of diet followed by the patient and the adherence test to the gluten-free diet (cdat). urine samples will be collected to test the presence of gip (gluten immunogenic peptides) and for patients whose samples test positive, will be asked for a stool sample to detect gip. subjects with suspected celiac disease but already on a gluten-free diet will undergo a challenge, or the reintroduction of gluten in incremental steps of three weeks (routinely performed as per the instructions of the italian health care system).

Eligibility criteria:
inclusion criteria: * age: 18 to 65 years old * gender: males and females * patients: suffering from celiac disease and suspected, but already on a gluten-free diet exclusion criteria: * celiac patients less than 6 months after diagnosis * celiac patients reporting intentional gluten ingestion

Keywords: non celiac gluten sensitivity gluten reintroduction gip
farewell depression - facial exercise program to treat depression

Conditions: Depression

Summary: this study investigates if a physiotherapeutic exercise program designed to relax facial muscles associated with the expression of negative emotions and to activate and strengthen facial muscles associated with the expression of positive emotions can reduce the symptoms of depression and improve wellbeing and quality of life in the affected patients.

activity of the facial musculature expresses emotions, but also generates proprioceptive signals to the emotional brain that maintain and reinforce the expressed emotions. this has been described by charles darwin and william james in the facial feedback hypothesis. studies have shown that interruption of facial feedback by the injection of botulinum toxin into the corrugator and procerus muscles, which express negative emotions like sadness, anger, and fear, can reduce the symptoms of depression. in the present study we investigate, if similar effects can be achieved by a relaxing massage of these and other muscles that are associated with the expression of negative emotions and if strengthening exercises of muscles that express positive emotions, the zygomaticus and orbicularis oculi muscles, can contribute to the rehabilitation of positive emotionality in depression. after instruction by a physiotherapist, participants will practice the exercises daily for 15 minutes.

Eligibility criteria:
inclusion criteria: * mild to moderate unipolar depression * stable treatment for at least 6 weeks exclusion criteria: * organic mental disorders * mental disorders due to psychoactive substance use * schizophrenia and other psychotic disorders * previous cosmetic procedures (botulinum toxin, fillers, lifting) * facial palsy * facial skin disorders
gip/glp-1 co-activity in subjects with obesity: lowering of food intake

Conditions: Obesity; Adiposity; Type 2 Diabetes

Summary: we aim to delineate the effects of separate and combined infusion of gip and glp-1 on food intake, appetite, bone health and fat metabolism in overweight/obese subjects.

the gut-derived incretin glucagon-like peptide-1 (glp-1) is a potent regulator of gastric emptying, appetite and food intake in humans whereas its sister incretin hormone, glucose-dependent insulinotropic polypeptide (gip), does not seem to have independent effects on these variables in humans. interestingly, recent data from rodents have shown that concomitant activation of the gip and the glp-1 receptor may potentiate the satiety-promoting and body weight-reducing effects of glp-1. also, evidence suggests that gip may be an important mediator of bone remodelling and lipid deposition. the effect of simultaneous activation of the gip and glp-1 receptors on appetite, food intake, fat metabolism and bone health has not been thoroughly examined in humans. the aim of this study is to delineate the effects of gip/glp-1 receptor co-activation on food intake, mechanisms regulating food intake, fat and bone metabolism in obese subjects. material and methods: the investigators plan to include 18 obese/overweight men without diabetes. the primary endpoint of the study is food intake during continuous intravenous infusions of saline (placebo), gip, glp-1 and gip+glp-1, respectively. secondary endpoints includes resting energy expenditure (measured by indirect calorimetry), appetite, satiety and hunger assessments (measured by visual analogue scales), plasma insulin, c-peptide and glucagon secretion, plasma triglycerides, cholesterols, and free fatty acid responses and changes in plasma bone turnover markers.

Eligibility criteria:
inclusion criteria: * caucasian men * age between 25 and 70 years * body mass index (bmi) between 25 and 40 kg/m2 exclusion criteria: * diabetes or prediabetes (defined as glycated haemoglobin (hba1c) ≥ 43 mmol/mol) * anaemia (defined as haemoglobin \< 8.3 mmol/l) * any gastrointestinal disease that may interfere with the endpoint variables * anorexia, bulimia or binge eating disorder * allergy or intolerance to ingredients included in the standardised meals * tobacco smoking * any regular drug treatment that cannot be discontinued for minimum 18 hours * any physical or psychological condition that the investigator feels would interfere with trial participation

Keywords: incretin hormones gip glp-1
menorrhagia study in women with treatment-resistant menorrhagia

Conditions: Menorrhagia

Summary: the aim of this study is to explore effects of the investigational product for the treatment of treatment-resistant menorrhagia without organic cause.

the study has previously been posted by schering ag, germany. schering ag, germany has been renamed to bayer schering pharma ag, germany.bayer schering pharma ag, germany is the sponsor of the trial.

Eligibility criteria:
inclusion criteria: * patients with treatment-resistant menorrhagia scheduled for hysterectomy. exclusion criteria: * organic causes of menorrhagia * current hormone treatment

Keywords: treatment-resistant menorrhagia
impact of frailty on postoperative complications in oncosurgery

Conditions: Frailty; Postoperative Complications

Summary: advanced ageing is accompanied by loss of reserve in multiple organ systems leading to increased risk of complications after surgery.frailty is a functional syndrome involving reduced physiological reserve and 25-56% of all elderly surgical patients are reported to be frail .

patients above 65 years age undergoing major oncosurgery under general anaesthesia with or without epidural will included , written informed consent will be obtained from all patients. age, heigth , weigth , polypharmacy , smoking status , history of diabetes ,hypertension will be noted. basic investigation hb% , serum albumin , serum creatinine will be done. asa physical status and surgical risk will be noted .patients will be evaluated for frieds 5 point frailty assessment scale (i) unintended weigth loss of \> 5kg in last one year.(ii) self reported exhaustion, (iii) muscle weakness (grip strength) (iv)slow walking speed,(v) low physical activity and assigned to either no frail group (0 criteria) , pre-frail (1-2 positive criteria ), frail (3-5 positive criteria group).the assessment will be done in the preoperative anaesthesia clinic and include paper based questionnaire, hand dynamometer to measure muscle strength and walking test . all patients will receive standard general anaesthesia along with epidural for abdomino-pelvic surgeries.intraoperative monitoring 5 lead ecg, nibp/ibp , spo2, etco2, cvp(optional),bis will be done.after induction of anaesthesia ultrasonography will be performed with curvilinear probe --- at the midpoint of femur anteriorly to measure rectus femoris muscle thickness of right thigh , three consecutive readings will be measured and average of value noted for all patients. at the end of surgery patient's neuromuscular block will be reversed and trachea extubated , if any patient requires ventilator support note will be made accordingly. postoperative patients vitals and input/output charting will be done .postoperative analgesia either epidural analgesia or intravenous opioids according to institutional protocol will be given .length of icu stay and any major cardiac , respiratory , renal complications , re-exploration will be noted.

Eligibility criteria:
inclusion criteria: patients undergoing major onco-surgey exclusion criteria: * patient refusal to participate * age \<65 years. * emergency surgery * pre-existing dementia * language barrier
mri changes of acute kidney injury in covid-19

Conditions: Acute Kidney Injury

Summary: this is a prospective observational cohort study that will aim to recruit 60 participants who have had covid-19, were admitted to hospital, required intensive care, and/or developed aki during their hospital stay. potential participants will be approached either by telephone by a member of the research team or via clinics (nephrology, post-icu follow up clinics).

after the participants have read and understand the participant information sheet, and had sufficient time (at least 24 hours) to consider their participation in this study, the investigators will ask them to sign a consent form, which shows their willingness to take part. the investigators will then collect information from their medical records about their hospital admission with covid-19, including their age, ethnicity, medical conditions, length of hospital stay, tablets or any other treatments they received, as well as details of their stay in the icu. the investigators will also arrange their first study visit which should be 3-6 months after they had been discharged from the hospital. during this first study day, the investigators will: * measure weight and height and take blood pressure. * take blood and urine samples. * ask participants to complete three questionnaires about their health, symptoms of fatigue and quality of life (sf-36, eq-5d-5l and fatigue questionnaires). * measure the accumulation of toxins in the skin using a safe, quick (less than five minutes) and painless technique called skin autofluorescence. this involves placing the forearm on a piece of equipment that shines a light on the skin and measures the amount of light that is reflected back. * conduct an mri scan of the kidneys, muscles, abdomen and heart. the mri scan will take 60-70 minutes in total. the investigators will ask participants not to eat or drink anything two hours before the mri scan. after this visit, the investigators will ask participants to come back for two more study visits, which will be arranged at 12 and 24 months after their hospital discharge. these visits will consist of the same procedures and measurements done in the first study visit.

Eligibility criteria:
inclusion criteria: 1. adult patients aged 18 years or older. 2. swab result positive for sars-cov-2. 3. patients admitted to the hospital for ≥24 hrs. 4. patients who received icu care or who sustained aki stage 2/3 (as per kdigo serum creatinine criteria). exclusion criteria: 1. patients \> 90 years of age. 2. patients on haemodialysis or peritoneal dialysis or pre-existing ckd stage 5 (egfr \<15ml/min/1.73m2). 3. solid organ transplant. 4. inability/refusal to give informed consent to participate. 5. contraindications to mri scan - claustrophobia, metal body implants, extensive tatoos, inability to lie supine for 1 hour.
effectiveness of yoga@work to reduce head and muscle pain in office workers

Conditions: Headache; Cervical Pain; Musculoskeletal Pain

Summary: the primary objective of this study is to evaluate the effectiveness of a workplace yoga intervention in reducing the frequency of pain involving the head and neck area.


Eligibility criteria:
inclusion criteria: * office workers * willing to participate an give consent exclusion criteria: * secondary headache * neck injury * trauma * critically ill * cognitive impairment * pregnancy
characterizing upper airway collapse to guide patient selection for oral appliance therapy for obstructive sleep apnea

Conditions: Sleep Apnea, Obstructive

Summary: obstructive sleep apnea (osa) is characterized by collapse of one or more pharyngeal structures during sleep (velum, tongue base, lateral walls, epiglottis). structure-specific therapies for osa have emerged as alternatives to positive airway pressure (pap). oral appliance (oa) therapy is increasingly being indicated for osa treatment, although a complete response occurs in approximately 50% of patients. in general, oa devices are designed to maintain the mandible and/or tongue in a protruded posture during sleep, preventing upper airway obstruction. limited studies in awake or sedated patients have demonstrated the effects of mandibular advancement on aspects of pharyngeal structure and function. the objective of the proposed research is to fully characterize upper airway collapse in osa patients during natural sleep and use this information to understand why some patients appear to exhibit a large improvement in pharyngeal collapsibility whereas others do not.

osa patients will undergo a baseline sleep endoscopy study to identify the site of pharyngeal collapse. subsequently, they will undergo two clinical polysomnographies (psgs) to measure the effect of an oral appliance (a site specific therapy) on upper airway collapsibility and sleep apnea severity. during the first hour of each clinical psg, the passive pharyngeal collapsibility will be determined using the standard 5-breath continuous positive airway pressure (cpap) drop method. during the remainder of the night, patients will be monitored to determine sleep apnea severity (apnea-hypopnea index). these measurements will allow the investigators to determine which pharyngeal collapsing site responds best (both in terms of collapsibility and ahi) to mandibular advancement with an oral appliance. patients who have their own oral appliance will be recruited. in addition, patients without an oral appliance will be provided with a temporary oral appliance for the study.

Eligibility criteria:
inclusion criteria: * patients with obstructive sleep apnea exclusion criteria: * any unstable cardiac condition (other than well controlled hypertension) or pulmonary problems. * any medication known to influence breathing, sleep/arousal or muscle physiology * concurrent sleep disorders (insomnia, narcolepsy, central sleep apnea or parasomnia) * claustrophobia * inability to sleep supine * periodontal disease and/or insufficient number of teeth * allergy to lidocaine or oxymetazoline hydrochloride * for women: pregnancy
gensarc 2008 : medical economic evaluation of the molecular detection by fish (fluorescent in situ hybridization) and by pcr (polymerase chain reaction) of sarcomas specific translocations and amplifications .

Conditions: Sarcoma

Summary: the clinical and histological diagnosis of sarcomas is often very difficult. the identification of chromosomal and molecular anomalies, such as amplifications, deletions or fusion genes is a powerful help for establishing a correct diagnosis of sarcomas and their benign counterparts. however, the cost of the cytogenetic and molecular techniques for the detection of these alterations is often a limitation to their use. the aim of our study is to evaluate the direct cost of the molecular techniques in comparison to the cost that would be generated by an appropriate therapy and care management of the patient in case of an erroneous diagnosis.


Eligibility criteria:
inclusion criteria: * patients with biopsy or excision of sarcoma (suspected or diagnosed) * sampling reviewed by pathologists * frozen sampling * clinical data available exclusion criteria: * opposition of patient

Keywords: economic evaluation diagnostics sarcoma
effects of multipoint pacing crt-d on neurohormonal activation.

Conditions: Heart Failure

Summary: this study will examine the additional clinical benefit conferred by multipoint pacing (mpp) compared to standard crt over a period of 3 months. patients will be randomized to mpp on vs. off and followed for a total of 6 months. this includes two crossover periods for each pacing modality (mpp on vs. off).

cardiac resynchronization therapy (crt) is limited by a high proportion of non-responders. pacing activation from multiple separated left ventricular (lv) sites might improve the depolarization pattern, thereby promoting more physiological activation. to explore the effect of mpp on cardiac neuro-hormonal activity, the investigators will enroll approximately 30 patients who already underwent crt-d implantation with a quadripolar lv lead connected to a device capable of mpp. this pilot study will have a randomized, double-blind, cross-over design. patients will be randomized to receive either standard biventricular pacing (mpp-off) or mpp (mpp-on) within 4-6 months following the implantation procedure. each subject will crossover to the other study group after three months. the baseline evaluation should be acquired prior to the device being programmed to the randomized setting. repeat evaluations will be performed at the end of each 3 month crossover period. participation in this study will last approximately 6 months. patients, as well as investigators other than the ep physicians, will be blinded to the pacing mode.

Eligibility criteria:
inclusion criteria: * patients implanted with a st. jude medical crt-d system with mpp capability * patients must be willing and able to sign an appropriate informed consent form and comply with study requirements * nt pro-bnp levels equal to or greater than 500 pg/ml. exclusion criteria: * history of stroke, pci, myocardial infarction or unstable angina pectoris within the last 3 months. * atrial fibrillation with noncontrolled heart rate * need for intravenous inotropic support for chf * classification of status 1 for cardiac transplantation or consideration for transplantation over the next 12 months * undergone a cardiac transplantation * currently participating in any other clinical investigation * life expectancy \< 12 months due to a disorder other than chf * inability to comply with the follow-up procedures * patients who are or may potentially be pregnant

Keywords: cardiac resynchronization therapy non responders multipoint pacing (mpp)
the influence of sedation for endoscopy on cognitive function

Conditions: Esophagogastroduodenoscopy; Deep Sedation; Cognition Disorders

Summary: it is commonly recommended that patients should refrain from driving for 24 hours after sedation for endoscopy，however，this recommendation has been queried recently．to investigate the effect of sedation on early postoperative cognitive function in patients undergoing endoscopy.

one hundred adult patients undergoing sedative esophagogastroduodenoscopy ( egd) were randomly recruited，and another 100 adult patients undergoing conventional（without sedation） egd were served as controls． all patients had an education level more than 9 years． cognitive function was assessed by montreal cognitive assessment（moca）1 week before egd exam, 10 mins before propofol sedation or the beginning of endoscopic procedure, 30mins after egd exam, and 2 week after exam.

Eligibility criteria:
inclusion criteria: 1. the scores of mmse are more than 26. 2. the aha grade i and ii. exclusion criteria: 1. the aha grade iii, iv or v. 2. binge drinking. 3. take sedatives, sleeping agents and some drug which may affect the study in a month. 4. psychiatric disorders. 5. the dysfunction of heart, lung, liver and kidney.

Keywords: esophagogastroduodenoscopy deep sedation cognition disorders patient discharge automobile driving
a study for patients with head and neck cancer

Conditions: Head and Neck Neoplasms

Summary: this study will compare the effects of pemetrexed plus cisplatin versus cisplatin alone in head and neck cancer patients.


Eligibility criteria:
inclusion criteria: * you must have head and neck cancer that has returned and cannot be treated with surgery or other types of treatment. or you must have head and neck cancer that was just found and has spread to other parts of your body. * you must have a performance status of 0,1 or 2. this means that you must at least be able to get around, be able to take care of yourself and must be up and about most of the day. * your test results must show that your liver, kidneys and blood cells are working normally. * you must understand and sign the form that gives your agreement to willingly be part of the study. * you must be at least 18 years of age. exclusion criteria: * you cannot have previously been given other treatment for cancer that has spread to other parts of your body. * you cannot have a serious sickness that might keep you from finishing the study (for example a bad infection). * you cannot have any extra fluid in your chest or bowel area unless your doctor tells you it can be drained before you join the study. * you cannot have any cancer called nasopharyngeal cancer, paranasal sinus cancer, lip cancer, or salivary gland cancer. * if you are taking high dose aspirin or other medicines called non-steroidal anti-inflammatory drugs and cannot stop taking them for at least 5 days, you cannot be in the study. your doctor or a member of the study team can explain which drugs are non-steroidal anti-inflammatory drugs.