Kornimate/medical-research-clean huggingface dataset:
effect of propofol administration time on the incidence and severity of intrathecal morphine-induced pruritus in parturient undergoing elective cesarean delivaries

Conditions: Cesarean Section

Summary: our hypothesis suggests that administration time of intravenous propofol may affect pruritus incidence and severity that occur after intrathecal morphine in parturient undergoing elective cesarean section (cs). the aim of the study is to investigate effect of prophylactic administration of intravenous sub-hypnotic dose of propofol before intrathecal morphine compared with the administration after intrathecal morphine on intrathecal morphine-induced pruritus incidence and severity in parturient undergoing elective cesarean delivaries.

neuraxial anaesthesia is a frequent anaesthetic approach for cesarean delivery and other lower abdominal and lower limb anaesthetic procedures. neuraxial morphine addition to local anaesthetic provides an effective and prolonged postoperative analgesia, but has been associated with a frequent incidence of pruritus and postoperative nausea and vomiting (ponv). neuraxial opioids are thought to act on central nervous system pathways to cause pruritus. although precise mechanisms are incompletely understood, numerous interventions have been investigated to prevent opioid-induced pruritus in the peripartum period as: opioid receptor agonist-antagonists, serotonin receptor antagonists. there is dense concentration of opioid receptors and 5-ht3 receptors in the dorsal part of the spinal cord and nucleus of the spinal tract of the trigeminal nerve in the medulla. activation of these receptors by neuraxial opioid administration or by circulating estrogen in parturient results in pruritus which is usually localized to face, neck, or upper thorax. propofol exerts its antipruritic action through inhibition of the posterior horn transmission in spinal cord. series of clinical trials have reported that a sub-hypnotic dose of propofol is equally effective in reducing the incidence of pruritus following intrathecal morphine. however these studies have limited information about dose and timing of administration of propofol.

Eligibility criteria:
inclusion criteria: * parturient of american society of anaesthesiologists (asa) class i or ii physical status. * age: 20-40 years. * at term gestation (≥ 37 weeks) with a singleton uncomplicated pregnancy. * elective cesarean delivery under intrathecal anaesthesia exclusion criteria: * parturient refusal. * significant organ dysfunctions (e.g., cardiac, respiratory, renal, or liver disorders). * morbid obesity (bmi \>35). * parturient with known hypersensitivity to propofol, morphine or amide local anaesthetics. * parturient with pruritogenic systemic disease. * a coexisting skin disorder or preexisting pregnancy induced pruritus. * parturient with any contraindication for intrathecal anaesthesia, e.g. coagulopathy. * emergency cesarean section. * failed or unsatisfactory intrathecal block.

Keywords: propofol administration time intrathecal morphine-induced pruritus
mobile mindfulness meditation intervention to improve the well-being of cancer survivors

Conditions: Cancer, Other Than Non-melanoma Skin Cancer

Summary: evaluate the impact and satisfaction of mobile mindfulness meditation on anxiety, pain, fatigue, trauma, and sleep in cancer survivors.

through previous research, mindfulness meditation has been linked to decreases in anxiety, increased pain tolerance, better mood, and improved quality of life, in both healthy and medical populations. although mindfulness meditation is well promoted both clinically and in the media, finding ways to promote engagement in and fidelity to the intervention, in a format that is accessible for cancer survivors is crucial, as the availability of resources and appreciation of the benefits does not necessarily lead to behavior change. with many more people surviving cancer than in previous decades, there is an opportunity to act on the residual effects of cancer diagnosis and treatment, and with the prevalence of technology ever increasing, online and mobile interventions have become more frequently delivered and have a particular utility for this population. physical and geographic limitations could prevent cancer survivors from accessing psychosocial interventions. whether the repeated beneficial findings of face-to-face training in mindfulness meditation will be found in a mobile environment is an open and timely question. this intervention will include two arms: the impact of the use of the mobile app for anxiety and for cancer related neuropathy.

Eligibility criteria:
inclusion criteria anxiety arm: 1. previous diagnosis of cancer, other than non-melanoma skin cancer 2. over 21 years of age 3. routine access to the internet 4. comfortable reading and writing in english 5. have completed primary treatment for cancer 6. indicate the presence of cancer related anxiety as indicated by the promis measure 7. not currently practicing meditation regularly (more than one hour per week), and 8. diagnosed with any stage of cancer 9. own a smartphone or tablet cancer related neuropathy arm 1. diagnosis of cancer 2. use of a taxane or platinum agent 3. experiencing cipn, per self-report 4. over 21 years of age 5. routine access to a smart device 6. comfortable reading and writing in english, and 7. not currently practicing meditation regularly (more than one hour per week). exclusion criteria: none

Keywords: previous diagnosis of cancer, completed primary treatment of cancer
anorectal function in perianal crohn's disease

Conditions: Crohn Disease

Summary: perianal crohn's disease is a disabling disease associated with increased morbidity and impaired quality of life. it is associated with pain, discharge, fecal incontinence and sexual and psychological impairment. in refractory cases, a stoma may be necessary. a higher prevalence is seen with increasing crohn's disease duration and appears to vary according to the disease location. the presence of symptoms associated with anorectal dysfunction, such as fecal incontinence, can sometimes poorly correlate with the presence of anal sphincter abnormalities. moreover, even in patients without symptoms, the presence of anal sphincter abnormalities may have important implications for the future selection of type of delivery, and might even pose a contra-indication for certain types of anorectal surgeries. studies evaluating possible chronic complications of perianal crohn's disease on anorectal function are lacking. there is a need for a better understanding of the chronic complications of this disease, and the role of high-resolution anorectal manometry in diagnosing these abnormalities during follow-up of these patients. this study will evaluate the chronic repercussions of perianal crohn's disease in patients with a previous anal fistula and/or abscess that has healed and/or is inactive.


Eligibility criteria:
inclusion criteria: 1. ≥ 18 and ≤ 75 year-old patients 2. cd in clinical remission, defined by a harvey-bradshaw index \<5 3. perianal cd history, defined by the presence of a perianal fistula and/or abscess that were treated/heal/inactive 4. perianal disease activity index (pdai) of ≤4 5. asymptomatic or symptomatic patients (anorectal symptoms) will be included, as long they fulfill the other inclusion criteria, like for anorectal symptomatic patients having a pdai≤4 6. endoanal ultrasound without an image compatible with new/non-treated abscess or perianal fistula 7. both previous simple or complex perianal fistula (according to the american college of gastroenterology) will be considered. exclusion criteria: 1. women with previous vaginal delivery 2. ileostomy 3. previous anorectal surgery as hemorrhoidectomy or lateral sphincterotomy 4. active rectal disease. no rectal involvement will be defined by no previous rectal involvement ever described or if previous involvement, endoscopy within 18 months showing no current involvement 5. previous or current anal fissure 6. anal stricture 7. current or previous rectovaginal fistula (previous/last pelvic mri). a previous seton placement, abscess drainage, fistulotomy and lay open fistula are not an exclusion criteria. patients with a current seton can only be included if the seton was place more than 24 weeks ago, and the endoanal ultrasound does not show any new/non-treated perianal fistula/abscess.
integrated patient avatars for guiding systemic therapy treatments in metastatic breast cancer patients

Conditions: Breast Cancer; Breast Neoplasms; Metastatic Breast Cancer; Cancer, Breast

Summary: the investigators propose to use clinically validated patient avatar technology ("pdxovo") that can test multiple drugs against patients' cancers to identify the most promising systemic therapy for each individual.

the primary goal of this feasibility study is to determine the percentage of patients for whom pdxs are successfully generated within 7-10 days. this will give the investigators an indication of the success rate for providing patients with actionable information if this pdx technology were to be implemented in the clinic. since the pdxs will also receive the same drug as the patient, there is an opportunity to assess the agreement between the clinical response and the pdx response. as a secondary goal, the response of pdxs will be compared to the patient's response to systemic therapy, as measured using the objective response rate at 12 weeks +/- 4 weeks (orr, measured using recist 1.1 criteria).

Eligibility criteria:
inclusion criteria: 1. age 18+. 2. metastatic breast cancer irrespective of subtype. 3. measurable disease as per recist 1.1 criteria. 4. metastatic disease involving the lymph nodes and/or visceral organs is required. 5. willingness to undergo a biopsy prior to the start of planned systemic therapy. exclusion criteria: 1. lack of feasibility to obtain a core biopsy of a metastatic site other than the bone (e.g. a metastatic lesion cannot be safely sampled due to proximity to vasculature). 2. inability to provide informed consent.

Keywords: metastatic breast cancer systemic therapy needle core biopsy pdxovo feasibility study tumor take rate
optimal dose of surfactant for preterm infants with respiratory distress syndrome

Conditions: Respiratory Distress Syndrome, Newborn; Patent Ductus Arteriosus; Bronchopulmonary Dysplasia; Preterm

Summary: in preterm infants with neonatal respiratory distress syndrome (rds), exogenous pulmonary surfactant(ps) replacement therapy is one of the most important therapeutic breakthrough to reduce neonatal incidences of bronchopulmonary dysplasia(bpd) and/or death. but not all preterm infants with rds can be beneficial. otherwise, the international neonatal acute rds (nards) collaborative group provides the first consensus definition for nards in 2017. and whether or not ps being beneficial in preterm infants with nards remains unknown.

to date, the optimal dose of ps is inconsistent, although the recommended dose of ps is given in the 2019 update guideline. ps is not recommended to adult and pediatric ards. systematic review indicates that ps does not reduce the incidences of bpd and death in infants with meconium aspiration syndrome(mas, a subtype of nards). a reasonable speculation is that preterm infants with nards do not benefit from ps. and the speculation can explain why not all preterm infants with rds can be beneficial from ps. in the era of pre-nards, the preterm infants fulfilling the definition of nards may have been considered as rds in the first three days after birth. meantime, the dose of ps given to infants with nards remains unknown. the aim of the present study is to assess the optimal dose of ps. the control group: ps is given according to the european rds management guideline in 2019 edition. the study group: ps is stopped when the pressure is equal between before patent ductus arteriosus(bpda) and after pda(apda). the primary outcomes are the closure rate of pda within 7 days, the incidence of bpd and/or death.

Eligibility criteria:
inclusion criteria: * gestation age less than or equal to 32 weeks * ps is needed exclusion criteria: * main congenital abnormalities * parents' refusal or quit
turkish version of the individual knowledge statement questionnaire of chronic obstructive pulmonary disease (copd)

Conditions: Chronic Obstructive Pulmonary Disease; Knowledge, Attitudes, Practice

Summary: the individual knowledge statement questionnaire of chronic obstructive pulmonary disease (copd) patient and resident proxies questionnaire, which can be used in patients with chronic obstructive pulmonary disease (copd) and their relatives, will be adapted into turkish and its psychometric properties will be examined, and the knowledge level of patients and their relatives about the disease and general health will be investigated.

the socio-demographic characteristics of the patients and their relatives will be obtained by asking to them by mutual interview method. a disease-specific test, the copd assessment test (cat), will be used to assess patients' own health, and the st george respiratory questionnaire (sgrq) will be used to assess patients' quality of life. comorbidities reported by the patient and their relatives will be filled in the charlson comorbidity index. the dyspnea that patients encounter in their daily lives will be questioned with the modified medical research council (mmrc) dyspnea scale. the "individual knowledge statements of patients and resident proxies" will be used for the individual information of the patient and their relatives about the disease and general health. there is no control group in the study. sgrq, cat and numerical rating scale will be used for the validity of the turkish version of individual knowledge statements of patients and resident proxies. for the test-retest, the evaluation will be done again after 15 days.

Eligibility criteria:
inclusion criteria: * being 18 years or older * being diagnosed with copd by a specialist physician (for patients) * being clinically stable (for patients, no history of hospital admission/hospitalization due to exacerbation in the last 4 weeks) * having information about the diagnosis (for patients) * to read, write and understand turkish * volunteering to participate in the study * being a proxy of the patient (living with the patient regardless of whether they are providing care or not) exclusion criteria: * having musculoskeletal, neurological, cardiac, and/or cognitive problems other than copd, which may create a caregiver burden for the patient's relative

Keywords: copd patient knowledge proxies
external oblique intercostal plane block versus subcostal transversus abdominis plane block in supra-umbilical surgical incisions

Conditions: Pain, Postoperative

Summary: various newer techniques have been proposed to enhance analgesia in upper abdominal region. the subcostal transverse abdominis plane (sctap) block is the deposition of local anesthetic in the transverse abdominis plane inferior and parallel to the costal margin. there is a growing consensus that the sctap block provides better analgesia for upper abdominal incisions than the traditional transverse abdominis plane block. the external oblique intercostal plane (eoip) block is a novel technique reported by hamilton et al. performed eopb by administering la superior or deep of the external oblique muscle from the sixth intercostal space leading to the blockage of thoracoabdominal nerves at t6-t10. it has several attractive aspects such as easy sono-anatomy ribs one strip of muscle so easy to demonstrate even in obese patients, there is a bony backstop, easy expandable fascial plane that can accommodate a catheter and it is shallow block with no big vessels nearby.


Eligibility criteria:
inclusion criteria: 1. american society of anesthesiologists (asa) physical status grade i -ii, 2. scheduled to undergo elective supra-umbilical surgeries under ga (epigastric herniotomy- gastrectomy- open cholecystectomy- nephrectomy). exclusion criteria: 1. allergy to local anesthetics, 2. infection at the site of injection, 3. coagulopathy, 4. chronic pain syndromes, 5. prolonged opioid medication, 6. patients who received any analgesic 24 h before surgery. 7. chronic liver disease, chronic renal disease, and cognitive impairment.
role of chest ultrasound in diagnosing and follow-up of pneumonia

Conditions: Pneumonia

Summary: the study of a large number of patients (at least 200 patients) from several european centres aims to investigate the value of chest ultrasound in diagnosing and checking the course of pneumonia as compared to a chest x-ray film in two planes and - in case of a controversial x-ray finding- as compared to low-dose ct. an x-ray finding is regarded controversial, if infiltrates cannot be reliably excluded or not reliably represented and if a definite diagnosis is, thus, not possible. a low-dose ct is indicated even in case of a positive chest ultrasound and negative x-ray finding. sonographic recording and characterization of pneumonic infiltrates is performed both at the time of diagnosing and in the further course under therapy.

the primary target criterion is • assessing the sensitivity of chest ultrasound in diagnosing pneumonia. secondary target criteria comprise * assessing specificity, negative and positive predictive value of chest ultrasound at the time of diagnosing, * characterizing pneumonic infiltrates at the time of diagnosing and further course, * describing the association between clinical, x-ray and sonographic findings in the course of pneumonia. the tertiary target criterion includes • characterizing the range of pathogens detected by microbiological examination.

Eligibility criteria:
inclusion criteria: patients with clinically suspected cap who received no antibiotic treatment yet * patients in whom a chest x-ray in 2 planes was already performed, can be included in the study, if chest ultrasound is performed within 24 hours after x-ray and if the x-ray finding is neither available to nor known to the examiner doing the ultrasound examination. * age \> 18 years * patient's declaration of consent is available. exclusion criteria: * patients with hap * age \<18 years * patients in whom the time difference between chest ultrasound and chest x-ray in 2 planes is more than 24 hours * patients whose x-ray findings are with the examiner doing the ultrasound or are known to him * pregnancy and lactation * missing declaration of consent by the patient.

Keywords: chest ultrasound pneumonia x-ray ct sensitivity and specificity of chest ultrasound in diagnosing pneumonia
prospective l-arginine study

Conditions: Heart Transplant

Summary: hypothesis the investigators primary hypothesis is that peripheral endothelial function and exercise tolerance will be abnormal in the population of young heart transplant patients at baseline, and that each will show a trend towards improvement following a 12 week course of oral l-arginine, with regression towards the baseline following the 12 week washout period.


Eligibility criteria:
inclusion criteria: * university of michigan pediatric heart transplant clinic patient. * greater than or equal to 8 years of age. * heart transplant between 1 and 8 years prior to enrollment in the study exclusion criteria: * relative hypotension for age * refusal to participate * inability to cooperate with endo-pat testing * pregnant or nursing women. * insulin dependent diabetes

Keywords: patients
radiofrequence microtenotomy for treatment of achilles tendinose

Conditions: Achilles Pain

Summary: prospective randomized controlled study using radio-frequency microtenotomy or physical therapy (eccentric training) for treatment of achilles tendinose

achilless tendinosis is a major clinical problem. there is a need for new studies to map the effectiveness of treatment. this study will compare treatment effectiveness between traditional physical therapy with surgical treatment using (rfm). the tendinosis grade will be evaluated using mri and /or ultrasound before and after intervention. the outcome measurment include vas and function using ( faos foot \& ankle survey) at 6,12 weeks and 6, 12 months after intervention.

Eligibility criteria:
inclusion criteria: * patients with pain in achilles tendon for at least 6 weeks. * mr / ultrasound confirms diagnosis tendinose. * pain in sport and daily activities exclusion criteria: other co-morbidity that constitutes contraindication for surgery, serious illness, bad compliance

Keywords: achilles, tendinose, tendinopathy, pain
early onset and familial gastric cancer registry

Conditions: Gastric Cancer

Summary: the purpose of this study is to establish a gastric cancer registry. a registry is a database of information. with the registry, we can learn more about the genetic causes of gastric cancer in order to develop better methods of early diagnosis, prevention, and treatment of gastric cancers. as part of this study, you will be asked to join a registry of families who are affected with various forms of gastric cancer. these registries are important because they may help physicians better manage gastric cancer now and in the future. participating in the early onset and familial gastric cancer registry can also be educational for families, since it will provide important information to patients, families, and physicians. all of this will help to further our understanding of genetic causes of gastric cancer and eventually, help determine better ways to diagnose, treat, and survey patients with gastric cancer and people who may have a higher risk for gastric cancer.


Eligibility criteria:
inclusion criteria: patient/relative cohort: must meet one or more criteria below: 1. a person with a diagnosis of gastric or gastroesophageal junction (gej) adenocarcinoma confirmed at the treating institution. 2. a person without gastric or gej adenocarcinoma who has or had a first degree relative eligible for a high risk genetic sub-group (eogc/fgc). 1. early onset gastric cancer - diagnosis of gastric cancer before the age of 50 without a family history of the disease. 2. familial gastric cancer - having a family history of gastric cancer as defined as one first degree relative or 2 second degree relatives. 3. a person without gastric or gej adenocarcinoma who has a personal family history of a genetic mutation associated with the development of gastric or gej adenocarcinoma (i.e. family history of cdh1 mutation). ii. must be willing to provide a blood sample for germline dna. these individuals will sign the "patient/relative consent". following enrollment, we will assign individuals to the appropriate high genetic risk or low genetic risk groups based on the age of diagnosis and their family history. subject exclusion criteria patients are ineligible for the study if they: * have any condition, which in the opinion of the primary msk clinician or investigators precludes their ability to provide informed consent. * relatives of patients that are not eligible for the high genetic risk cohorts who are less than 18 years of age are excluded. * relatives of patients eligible for the high genetic risk cohorts who do not have a proband available to join the study are excluded. (unless there is a known cdh1 mutation in the family).

Keywords: gastric cancer stomach cancer 05-118