Kornimate/medical-research-clean huggingface dataset:
range of motion following intraoperative coban dressing application in hand burns

Conditions: Burns; Hand Injuries

Summary: participants of this study will include burns requiring skin graft to hand(s). after informed consent, an occupational therapy evaluation will be performed. participants will consent to surgery, in which skin graft will be applied by physician during surgery, occupational therapy will apply coban dressing. participant will seen daily by occupational therapist during hospitalization for active range of motion to hand(s). occupational therapist will measure range of motion of hand(s) and physician will assess graft success at one and four days after surgery and at three out patient clinic visits. hand strength will also be measured at three out patient visits. does the initiation of range of motion on post operative day kone with coban dressing improve hand function without compromising graft success?

the participant will be evaluated by occupational therapist prior to surgery. the coban dressing will be applied to the participant's hand(s)during surgery for a skin graft. this portion will occur whether the participant agrees to participate or not. the participant will begin range of motion exercises the day after surgery (post operative day one) with and occupational therapist. the occupational therapist will see the participant daily for supervised range of motion while in the hospital. the coban dressing will be removed on post operative day one if a sheet graft is placed to assess bleeding under graft. the coban dressing will be reapplied and removed again on post operative day four. when a meshed graft is placed, coban dressing will be removed on post operative day four only. all skin grafts (meshed and sheet grafts) and range of motion will be assessed on post operative day four. coban dressing will be reapplied. the participant will continue range of motion exercise program at home. an appointment will be scheduled for 3 consecutive weeks in out patient burn clinic. during clinic visits, skin graft, range of motion, and grip strength will be measured. the participant will seen in out patient burn clinic whether they choose to participate in the study or not as a standard of burn care.

Eligibility criteria:
inclusion criteria: * less than 15% burn, burn requires skin graft to dorsum of hand, burn involves at least 2 metacarpophalangeal joints * 18 and older exclusion criteria: * latex allergy * documented diagnoses of mental illness that interferes with patients ability to participate

Keywords: hand burn skin graft coban dressing range of motion
the effect of oral administration of hesperidin and diosmin in reducing paclitaxel-induced peripheral neuropathy in breast cancer patients

Conditions: Breast Cancer

Summary: the aim of this study is evaluation of the potential neuroprotective effect of oral hesperidin and diosmin in reducing paclitaxel- induced peripheral neuropathy in the treatment of breast cancer patients.


Eligibility criteria:
inclusion criteria: 1. female patients over 18 years of age with pathologically confirmed breast cancer. 2. breast cancer patients candidate for chemotherapy and will receive paclitaxel. 3. patients having an eastern cooperative oncology group (ecog) score more than 2 exclusion criteria: 1. patients with signs and symptoms of clinical neuropathy at baseline. 2. patients with diabetes mellitus, alcoholic disease, heart failure, pregnant or lactating women. 3. patients receiving vitamin/ supplementation drugs that interfere with the study intervention. 4. patients who have previously received chemotherapy. 5. hepatic impaired patients. 6. patient with history of allergy to hesperidin. 7. patients with history of allergy to diosmin. 8. renal impaired patients. 9. patient inadherent to paclitaxel. 10. patients inadherent to the administered hesperidin and diosmin during the study period.

Keywords: paclitaxel-induced peripheral neuropathy
the role of ultrasound in cholecystitis

Conditions: Cholecystitis, Acute

Summary: the aim of this study is: 1. to describe the natural course of acute cholecystitis, by performing repeated ultrasound examinations from day of admission to hospital until day of surgery or discharge. 2. to investigate if there is anything in the ultrasound picture that can predict a difficult operation. patients will be prospectively enrolled. the ultrasound picture (ultrasound variables: gallbladder volume, gallbladder wall thickness, and presence of oedema in the gallbladder wall), will be compared to clinical variables (tenderness in right upper quadrant, wbc, crp and temperature) and to the time (hours) from onset of symptoms. statistical analyses will be made to see if statistically significant, and clinically relevant, associations between variables exist. furthermore, for participants receiving acute surgery, an upper gi surgeon will evaluate the operation as easy, intermediate or difficult. in extension, investigators will look at associations between difficult surgery and all the variables previously mentioned (both ultrasound variables, clinical variables and time).

patients admitted to stockholm south general hospital's surgery department, with a confirmed diagnosis of acute cholecystitis (according to the tokyo guidelines 2013) will be considered eligible for the study and asked to participate. informed consent will be obtained from all participants. participants will be examined with ultrasound of the gallbladder daily, while receiving regular care for acute cholecystitis, which means either waiting for acute surgery or being treated conservatively for as long as inpatient care is needed. the ultrasound examinations will be performed by a radiologist or a specialised certified ultrasound trained nurse as well as by an ultrasound trained surgeon. measures of gallbladder volume (measured in cm3), gallbladder wall thickness (measured in mm:s) and presence of oedema in the gallbladder wall (noted as a binomial variable 'yes/no') are recorded in a case report form (no.1) together with body temperature, labs and information about onset of symptoms. the operating surgeon (a specialist in surgery) will evaluate the operation and grade it from easy to difficult and fill in a case report form (no.2). data will be collected from the forms and analysed using a regression model (generalised estimated equation or a mixed model).

Eligibility criteria:
inclusion criteria: * acute cholecystitis according to the tokyo guidelines 2013 criteria exclusion criteria: * difficulties to communicate
lmb-7 immunotoxin in treating patients with leptomeningeal metastases

Conditions: Brain and Central Nervous System Tumors

Summary: rationale: lmb-7 immunotoxin can locate tumor cells and kill them without harming normal cells. purpose: phase i trial to study the effectiveness of lmb-7 immunotoxin in treating patients who have leptomeningeal metastases metastases.

objectives: i. determine the toxicity of intrathecal lmb-7 immunotoxin in patients with leptomeningeal metastases. ii. identify objective therapeutic responses in this group of patients. outline: this is a dose escalation study. patients receive lmb-7 intrathecally on days 1, 3, and 5. treatment may be repeated every 4 weeks if the patient does not demonstrate hama neutralizing antibodies to pe-38 in csf, has stable or responding disease, and has not experienced greater than grade ii toxicity. three to six patients are entered at each dose level. dose escalation continues until the maximum tolerated dose (mtd) is determined. the mtd is defined as the dose preceding that at which 2 of 6 patients experience grade 3 or worse toxicity or a neuroradiology toxicity score of 10 or greater. projected accrual: approximately 15 to 24 patients will be accrued over one year.

Eligibility criteria:
disease characteristics: histologically proven primary intracranial or extraneural neoplasm with leptomeningeal metastases at least 30% of malignant cells in the cerebrospinal fluid, primary tumor, or metastatic tumor must react with the b3 mouse monoclonal antibody patient characteristics: age: 18 and over performance status: karnofsky 50-100% life expectancy: not specified hematopoietic: anc greater than 1000/mm3 platelet count greater than 100,000/mm3 hepatic: bilirubin less than 1.5 mg/dl renal: creatinine less than 1.2 mg/dl pulmonary: dlco at least 60 other: no neutralizing antibodies to pseudomonas exotoxin not pregnant or nursing not allergic to penicillin prior concurrent therapy: biologic therapy: not specified chemotherapy: no chemotherapy within past 4 weeks (6 weeks for nitrosoureas) unless there is evidence of disease progression in cns no concurrent chemotherapy endocrine therapy: patients receiving corticosteroids must be on stable dose for 10 days prior to entry radiotherapy: no radiotherapy to disease site within past 3 months unless there is evidence of disease progression in cns no concurrent radiotherapy surgery: not specified

Keywords: leptomeningeal metastases
remifentanil for sedation of patients with traumatic brain injury (tbi)

Conditions: Traumatic Brain Injury

Summary: this is a descriptive retrospective study designed to measure the efficacy of remifentanil sedation and the ability to perform frequent neurological examinations of patients with traumatic brain injuries.


Eligibility criteria:
inclusion criteria: * patients previously admitted to the hospital presenting with traumatic brain injury (tbi) * patients who have undergone sedation after presenting with tbi exclusion criteria: * none
assessment of the diagnostic capacity of the mini-broncho alveolar lavage performed through a suction catheter

Conditions: Bacterial Pneumonia

Summary: the aim of this study is to develop a safe and effective technique to take sample for lower respiratory tract cultures easy to perform in conditions of acute respiratory failure and spontaneous ventilation for patients admitted in intensive care unit for acute infectious pneumonia and non intubated. the investigators perform sample collection with a mini bronchoalveolar lavage catheter introduced by nasotracheal way through a suction catheter. the purpose of the study is to assess the microbiological diagnostic capacity of this new technique.

at the moment we lack an effective and safe technique to obtain lower respiratory tract cultures for patient with mild serious infectious pneumonia admitted in intensive care unit and non intubated. invasive procedure may worsen respiratory distress and non invasive procedure such expectorated sputum culture is not enough effective. the purpose of the study is to assess the microbiological diagnosis capacity of a new technique for taking samples from the lower respiratory tract: mini bronchoalveolar lavage performed by naso tracheal way through a suction catheter.each consecutive patient admitted in intensive care unit for a community acquired or nosocomial pneumonia and not requiring intubation and mechanical ventilation will be included. written informed consent by patient himself will be required. for each patient, after the introduction of a suction catheter, an endotracheal aspiration will be performed. then, the mini bronchoalveolar lavage will be performed through the suction catheter with a specific catheter.the whole time of the procedure is about ten minutes.expectorated sputum will also be ordered for each patient.this study is a pilot and prospective study.

Eligibility criteria:
inclusion criteria: * age over 18 * radiological diagnosis of pneumonia (community acquired or nosocomial) * no microbiological diagnosis known * indication for culture of lower respiratory tract * admission in intensive care unit required exclusion criteria: * age lower than 18 * bronchospasm * coagulopathy ( platelets count below 100 000/mm3, prothrombin time less than 50%, activated partial thromboplastin time ratio higher than 2) * intubation with mechanical ventilation * known microbiological diagnosis * incapacity for consenting himself to the study

Keywords: community acquired pneumonia nosocomial pneumonia mini bronchoalveolar lavage endotracheal aspirates expectorated sputum
the effect of neuromuscular stimulation on post-transplant leg edema

Conditions: Kidney Transplant; Kidney Pancreas Transplant; Edema

Summary: this will be a randomized, controlled trial involving kidney and kidney pancreas transplant patients. there will be 2 groups and patients that will be randomized to one of the two groups. clinical outcomes will be compared for those in each group and clinical differences between patients who receive routine medical therapy with ipc/teds versus the geko device will also be evaluated.

this will be a randomized, controlled trial involving kidney and kidney pancreas transplant patients. there will be 2 groups and patients will be randomized to one of the two; one will receive standard of care ipc or ted stockings to help with circulation, the other group will use the geko device which is a newer device with health canada approval. clinical outcomes will be compared for those in each group and clinical differences between patients who receive routine medical therapy with ipc/teds versus the geko device will also be evaluated.

Eligibility criteria:
inclusion criteria: * male or female * at least 18 years old * undergoing kidney or kidney pancreas transplant surgery as the recipient * able and willing to provide written informed consent * absence of known peripheral vascular disease * body mass index of between 18 and 34 * leg circumference at site of geko™ device placement is 24" or less exclusion criteria: * history of deep vein thrombosis * temporary or permanent cardiac pacing * patient is pregnant * any patient which may be excluded by way of warnings in the manufacturer's instructions for use * any patient who requires an ecg electrode applied on the leg for continuous monitoring throughout therapy * previous leg(s) amputation * presence of any of the following in the site of intended device placement: cancerous lesion, swollen or infected or inflamed areas or skin eruptions i.e. phlebitis, thrombophlebitis, varicose veins * history or signs of haematological disorders (especially in relation to clotting or coagulation disorders) including presence or history of thrombus formation * bmi index \>36 * patients with any neurological disorder or disease that would interfere with proper assessment and or conduct of the trial * history of implantable brain or other stimulator * patients who can not tolerate the stimulation from the geko device

Keywords: ipc/teds geko device
henry ford heart score randomized trial: rapid discharge of patients evaluated for possible myocardial infarction

Conditions: Chest Pain; Heart Attack; Coronary Artery Disease

Summary: this was a prospective randomized, controlled trial designed to quantify the reduction in cost and length of stay of early discharge of emergency department patients evaluated for acute myocardial infarction, who are deemed to be low risk based on a modified heart score (a score that incorporates troponin biomarker, ecg, patient characteristics, and physician clinical judgment).

this was a prospective randomized, controlled trial conducted from february 2014 to may 2015 designed to quantify the reduction in cost and length of stay of early discharge of emergency department patients evaluated for acute myocardial infarction, in those deemed to be low risk based on a modified heart score. our study enrolled only those deemed low risk, as these are the patients we believe best served by utilization of the heart score decision aid. a total of 105 patients evaluated for ami in the ed with a modified heart score ≤ 3 (which includes cardiac troponin i \< 0.04 ng/ml at 0 and 3 hours) were randomized to immediate discharge (n = 53) vs management in an observation unit with stress testing (n = 52). the primary endpoints were 30-day total cost and length of stay. secondary endpoints were all-cause death, nonfatal ami, rehospitalization for evaluation of possible ami, and coronary revascularization at 30 days. that such an early discharge strategy would decrease cost and length of stay is intuitively expected; our goal was to quantify such a reduction.

Eligibility criteria:
inclusion criteria: * patients 21 years or older * patients who presented to the emergency department with symptoms suspicious for ami. * patients for whom the ed physician's intention to send the patient to the observation unit for stress testing exclusion criteria: * cardiac troponin i \> 0.04 ng/ml at 0 or 3 hours * clinical presentation warranting admission * inability or unwillingness to consent * trauma as etiology of presenting symptoms.
comparison of two counseling induction strategies

Conditions: Methadone; Drug Use Disorders

Summary: new admissions (n = 120) to the addiction treatment services (ats) will be stabilized on methadone and randomly assigned to one of two induction conditions: 1) routine stepped care, or 2) low threshold stepped care. all participants will continue with routine stepped care in month 4. treatment retention is the primary outcome measure, while drug use (measured via weekly urinalysis testing) is the major secondary outcome.

this randomized clinical trial will evaluate two induction strategies for helping out-of-treatment opioid abusers transition to methadone maintenance treatment. all study participants (n = 120) will be new admissions to the addiction treatment services at hopkins bayview (ats), stabilized on 80 mg of methadone, and randomly assigned to one of two study conditions. the experimental induction condition will receive low threshold stepped care (ltsc) for the first 3-month of treatment that reduces the counseling demands of maintenance treatment (i.e., one counseling session / month). this condition will be compared to routine stepped care (rsc) for the first 3-months, which provides escalating intensity of counseling schedules contingent on drug use or poor adherence. rsc is routine treatment at ats. all participants will receive routine stepped care following the 3-month induction phase, and will have the opportunity to remain in treatment at ats following study participation. participation is for 4-months. retention is the primary outcome. participants will also submit urine samples weekly on a random schedule each month. we hypothesize that ltsc participants will exhibit better retention than rsc participants, and that both conditions will exhibit reductions in drug use compared to baseline.

Eligibility criteria:
inclusion criteria: * new admissions to methadone maintenance exclusion criteria: * pregnant * acute medical or psychiatric condition

Keywords: treatment retention methadone maintenance treatment induction retention in methadone maintenance treatment
preoperative iv versus oral acetaminophen

Conditions: Pain, Postoperative

Summary: the current study proposes to examine whether there is a significant difference in patient outcomes related to the administration route of preoperative acetaminophen. specifically, the study will compare outcomes of surgical patients who receive iv acetaminophen with surgical patients who receive oral acetaminophen.

this study will use a randomized, double-blind, controlled design with two arms: arm 1: scheduled iv acetaminophen and po placebo provided preoperatively arm 2: scheduled po acetaminophen and iv placebo provided preoperatively 120 patients will be randomized 1:1 into arm 1 or arm 2. all other care, except route of preoperative acetaminophen, will follow standard care procedures. the following outcome measures will be collected: postoperative pain, postoperative opioid medication administration, postoperative nausea and vomiting, occurrence of respiratory depression postoperatively, occurrence of administration of reversal agent postoperatively, length of stay in recovery room, patient satisfaction with pain control.

Eligibility criteria:
inclusion criteria: * 18 years old or older * admitted to bethesda butler main perioperative services for an outpatient surgical procedure performed under general anesthesia exclusion criteria: * allergy to acetaminophen * lactose intolerance or lactose allergy (placebo capsules contain lactose) * hepatic disease * having taken a product containing acetaminophen within 6 hours of scheduled surgery time * pregnant * weight less than 50kg * opioid addiction - admits to current opioid addiction and/or substance abuse disorder, and/or currently in treatment for opioid addiction or substance abuse * emergent or on-call procedures * inpatient surgery
the effect of late na current blocker mexiletine on giant t-wave electrical alternans(stop-twa)

Conditions: Giant T-wave Electrical Alternans

Summary: the electrocardiogram is one of the most basic tests for cardiovascular disease. t wave alternans (twa), which reflects abnormal ventricular repolarization, can easily trigger ventricular tachycardia (vt) and ventricular fibrillation (vf), which are important warning clues for sudden cardiac death (scd). the late sodium current (inal) is an important component of the frequency-dependent regulation of cardiac repolarization, and various causes of delayed repolarization can increase inal. our study on long qt syndrome (lqts) found that inal abnormalities can lead to abnormal myocardial repolarization, producing a giant twa that triggers vt and vf. vt and vf, and inal inhibition by the inal blocker mexilate can terminate this process. this suggests that pharmacological blockade of inal may be a potential target for the prevention of scd by ameliorating the different causes of giant twa and its triggering ventricular arrhythmic events. in this study, we propose to randomize patients with vt/vf triggered by giant twa to conventional treatment and conventional treatment adds mexiletine treatment to compare the effects of the two treatment regimens on giant twa and its triggered nonsustained vt, sustained vt, and vf; at the same time, we will compare the effects of mexiletine on giant twa and its triggered ventricular arrhythmias of various etiologies by intra-group control before and after treatment. the safety and efficacy of the treatment of twa and its triggered ventricular arrhythmias are compared.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of macroscopic twa exclusion criteria: * the patients who do not agree to participate in the study, * patients with acute coronary syndrome or with progressive myocardial ischemia according to clinical manifestations, electrocardiogram or myocardial biochemical markers; * those who have used other class i antiarrhythmic drugs or who are contraindicated by mexiletine.