Kornimate/medical-research-clean huggingface dataset:
comparison of crp levels, neutrophil count, and clinical outcomes of low dose ketamine between at anesthesia induction and at the end of surgery in patients undergo elective laparotomy

Conditions: General Anesthesia; Laparotomy; Inflammation

Summary: the effects of anesthesia and surgery can lead to stress responses that result in hormonal and metabolic changes in the body. the immune system and the nervous system communicate both ways, and it was found that nociception and proinflammatory cytokines play a joint regulatory role, i.e., increased production of proinflammatory cytokines can worsen the pain. major surgery can trigger the release of cytokines such as il-1, il-6, and tnf-α.

the effects of anesthesia and surgery can lead to stress responses that result in hormonal and metabolic changes in the body. the immune system and the nervous system communicate both ways, and it was found that nociception and proinflammatory cytokines play a joint regulatory role, i.e., increased production of proinflammatory cytokines can worsen the pain. major surgery can trigger the release of cytokines such as il-1, il-6, and tnf-α. the acute analgesic effect of ketamine is generally believed to be mediated through the blockade of the phencyclidine binding site of the n-methyl-d-aspartate (nmda) receptor of nociceptive neurons. ketamine can reduce the inflammatory response marked by a decrease in crp levels to surgical trauma and can prevent secondary damage to tissues/organs that were not initially affected by surgery by reducing inflammation. this also reduces postoperative pain and analgesics.

Eligibility criteria:
inclusion criteria: 1. patients undergoing elective laparotomy with general anesthesia at sanglah hospital from july to september 2020. 2. patients aged 18-65 years. 3. patient physical status american american society of anesthesiologist (asa) 1 and 2. exclusion criteria: 1. contraindication to ketamine. 2. allergy to morphine 3. presence of cardiorespiratory chronic diseases. 4. presence of autoimmune diseases. 5. history of the central nervous system or psychiatric disorders. 6. bmi \<18.5 kg/m2 or ≥30 kg/m2. 7. a history of chronic pain killer medications (such as opioid or non-steroidal anti- inflammatory drugs) drop out criteria 1. patients with class 3 bleeding during the surgery 2. patients with more than 5-hours duration of surgery 3. patients need mechanical ventilation after the surgery

Keywords: stress response infammation general anesthesia
ai mobile application versus hcp for bodyweight squats

Conditions: Squat Form

Summary: to assess if an artificial intelligence (ai) mobile application can identify and improve bodyweight squat form in adult participants when compared to a physical therapist (pt).

artificial intelligence (ai) is changing the way people can address their health needs. one such way related to physical exercise is ai-enabled exercise mobile application (digital coach), which uses motion tracking technology to monitor and provide real-time audio feedback on a person's exercise form. however, this ai technology has yet to be independently tested against an in-person evaluator (human coach) for its ability to improve exercise form. this study is a blinded randomized controlled trial comparing the ability of the digital coach (n=15) and a physical therapist (pt) human coach (n=15) to improve bodyweight squat form in 30 able-bodied volunteers age 20 - 35. each volunteer performs 10 unassisted control squats, then 10 squats with assistive vocal feedback from either coach after each repetition, and finally 10 more unassisted test squats, all squats video-recorded. three independent video evaluators count the number of correct squat repetitions completed by volunteers before and after intervention by the different coaches. this project is important to validate the digital coach compared to a pt human coach in a small population using a bodyweight squat for its wide applicability to daily movement patterns.

Eligibility criteria:
inclusion criteria: * columbia university affiliate * aged 20 to 35 years * able to perform moderate bodyweight exercise for 10 minutes exclusion criteria: * unable to provide consent

Keywords: exercise squat physical therapist artificial intelligence (ai)
cold therapy for pain control following caesarean section

Conditions: Post Operative Pain

Summary: cold therapy has been used for a variety of procedures and has been studied in several but not recently studied for reducing postop pain following caesarean sections. the hypothesis is that cold therapy will reduce postop pain and increase patients mobility and improve care of her newborn.

cesarean section (c/s) is one of the most commonly performed surgeries in many parts of the world. in the united states the c/s rate in 1965 was 4.5% and increased to 30.5% in 2010. while the number of c/s has increased, pain management has primarily been via epidural, spinal, local and general anesthesia and narcotic medication for the immediate postpartum period (pp). this has lead to an increase in associated cost and problems with pain management. limited studies have been performed to evaluate cold compresses on pain relief in the immediate pp and there potential to reduce cost. cold therapy (ct) is most often utilized in orthopedics, sports medicine, and in general surgery. ct has been used to improve range of motion (rom) and reduce pain medication utilization. we surmise ct may be useful in decreasing narcotic utilization after c/s, as well as improve mobility and allow for improved care of the newborn. this is significant as erlanger baroness hospital (ebh) is becoming baby friendly (bf). this is a national initiative for children's healthcare quality (nichq) which desires having babies rooming in with their mothers and increasing breastfeeding rates. the goal of this study is to evaluate a newer sterile delivery system for decreasing pp pain via ct. this will be done as a randomized controlled trial (rct).

Eligibility criteria:
inclusion criteria: * greater than 36 weeks gestation * primary c/s with epidural for labor problems or breech presentation * repeat c/s with spinal exclusion criteria: * less than 36.0 week gestations * vertical skin incisions * classical or vertical hysterotomy incisions * failed vaginal births after c/s (vbac) * past history of drug or alcohol abuse * positive drug screens unless medical prescribed drugs * general anesthesia * caesarean hysterectomy * primary c/s with spinal anesthesia
prognostic value of surem traf3ip2 level in patients with acute myocardial infarction

Conditions: Myocardial Infarction, Acute

Summary: to evaluate the prognostic value of surem traf3ip2 levels in patients with acute myocardial infarction

previous study had concluded that traf3ip2 plays a causal role in atherosclerotic plaque development and vulnerability in mice. however, no human data was available. in the present study, patients diagnosed with acute myocardial infarction who receive coronary angiography will be enrolled. their surem traf3ip2 levels will be tested using elasa. the association of surem traf3ip2 levels with the major adverse cardiac events will be evaluated.

Eligibility criteria:
inclusion criteria: 1. patients with acute myocardial infarction 2. patients received coronary angiography 3. invasive management within 72 h of hospital admission exclusion criteria: 1. nyha iii-iv 2. malignant tumor 3. acute infection 4. thyroid dysfunction 5. life expectancy of b1 y 6. unsuitable for pci

Keywords: traf3ip2, myocardial infarction, coronary angiography, maces
18f-fspg pet/ct for cancer patients on therapy

Conditions: B-Cell Neoplasm; Estrogen Receptor Negative; HER2/Neu Negative; Metastatic Renal Cell Cancer; Progesterone Receptor Negative; Stage III Mesothelioma; Stage III Renal Cell Cancer; Stage IIIA Breast Cancer; Stage IIIA Non-Small Cell Lung Cancer; Stage IIIB Non-Small Cell Lung Cancer; Stage IIIC Breast Cancer; Stage IV Breast Cancer; Stage IV Mesothelioma; Stage IV Non-Small Cell Lung Cancer; Stage IV Renal Cell Cancer; Triple-Negative Breast Carcinoma

Summary: the goal of this phase 2 study trial is to evaluate the utility of the radiolabel 18f-fspg used before and after treatment to diagnose, predict, and evaluate response to therapy in patients with a wide variety of metastatic cancers.

outline: patients are evaluated with a pet/ct scan using the radiolabel 18f-fspg \[18f-(s)-4-(3-fluoropropyl)-l-glutamic acid\] or 18f-fdg (\[18f\]-fluorodeoxyglucose), before and after therapeutic treatment. primary objective: uptake of the radiolabel 18f-fspg in patients with biopsy-proven cancer will be evaluated and compared to the uptake of 18f-fdg, before and after therapy (non-specified) in the same group of patients. secondary objectives: * compare the agreement of the clinical assessment for cancer status between 18f-fspg and 18f-fdg. * safety and tolerability of 18f-fspg and 18f-fdg.

Eligibility criteria:
inclusion criteria: * written informed consent * able to complete a pet/ct scan without the use of sedation * females: * of childbearing potential must: * not be nursing * have a negative serum pregnancy test documented within 48 hours prior to administration of 18f fspg pet/ct * not of childbearing potential must be: * physiologically postmenopausal (cessation of menses for more than 1 year) * surgically sterile (has had a documented bilateral oophorectomy and/or documented hysterectomy) * histologically confirmed cancer that is advanced; metastatic; or otherwise not suitable for surgical resection with curative intent * scheduled to begin therapy * the time interval between 18f fspg pet/ct and standard of care imaging (ie, 18f fdg pet/ct, diagnostic ct, or mri) should be within 4 weeks (exceptions will be allowed for 6 weeks, if there are no other options) * ideally, there should be no chemotherapy, radiotherapy, or immune/biologic therapy or biopsy between other imaging (pet/cts, mri, or diagnostic cts) and 18f fspg pet/ct scheduled or performed (exceptions by investigator discretion) * no clinically relevant deviations in renal function (serum creatinine \> grade 2 common terminology criteria for adverse events \[ctcae\] version 4.0); maximal interval between confirmation of renal function and injection of 18f fspg is 1 week exclusion criteria: * scheduled for surgery and/or another invasive procedure (except biopsy) within the time period of 1 month prior to 18f fspg administration * known sensitivity to 18f fspg or components of the preparation * investigator precludes participation for scientific reasons, for reasons of compliance, or for reasons of the patient's safety
bismuth for pcab-based h. pylori eradication

Conditions: H. Pylori Infection

Summary: tegoprazan is a new potassium-competitive acid blocker (pcab) that has been clinically available since 2018 in south korea. p-cab is highly active drugs targeting h+, k+ -atpase in the gastric acid secretion of parietal cells. the mechanism of action is different from that of ppis. conventional ppis require 3-5 days to achieve maximal and steady-state gastric acid inhibition, whereas p-cab increases the intragastric ph to nearly 7 within four hours. in japan, h. pylori eradication success rates has increased by therapies using p-cab than those using proton pump inhibitors, owing to the stronger acid suppression capability of p-cab. bismuth has long been used to treat peptic ulcer disease, dyspepsia, parasite infections, and infectious diarrhea. the antibacterial effects of bismuth include inhibition of protein and cell wall synthesis in h. pylori. the main role of bismuth is to increase the eradication rate by 30%-40% in resistant h. pylori strains.

the investigators aim to evaluate the success rate and adverse drug events of bismuth added to pcab-based triple therapy as a first-line regimen for h. pylori infection.

Eligibility criteria:
inclusion criteria: * gastroscopy can be performed * h. pylori test and pathological analysis can be performed exclusion criteria: * age \ 80 years * anemia (serum hemoglobin level \< 10 g/dl) * severe systemic disease * advanced chronic liver disease * use of certain medications, including proton pump inhibitors, h2- receptor antagonists, or antibiotics * history of h. pylori eradication * drug allergy to antibiotics * history of gastric surgery * recent history of upper gastrointestinal bleeding
pre-hospital ultrasound guided peripheral venous catheter insertion

Conditions: Prehospital

Summary: this study evaluates two different techniques for ultrasound guided peripheral venous catheter insertion in pre-hospital emergency care in comparison with conventional approach without any ultrasound guidance.

peripheral venous catheter placement is one of the most common interventions in emergency medicine. when performed by conventional approach, the failure of the first attempt occurs up to 22 % and cannulation time exceed 2 minutes in up to 15 %. ultrasound guidance of peripheral venous catheter (pvc) insertion may improve both. however, this approach has not been verified in the setting of pre-hospital emergency care so far.

Eligibility criteria:
inclusion criteria: * awake patient indicated for peripheral venous catheter placement while treated by emergency medical service exclusion criteria: 1. coma 2. age \<18 years 3. patient disagreement with the insertion of peripheral venous catheter 4. disagreement of the patient with inclusion in a clinical trial 5. contraindication of ultrasound examination of the venous system 6. contraindication of the introduction of peripheral venous cannula on both upper limbs 7. investigator's opinion that ultrasonic control cannulation would cause undue delay and a other procedure is required

Keywords: ultrasound peripheral venous catheter
inhaled colistin to prevent pediatric ventilator-associated pneumonia

Conditions: Ventilator Associated Pneumonia

Summary: the goal of this clinical trial is to learn if nebulized colistimethate sodium can prevent pneumonia in ventilated children. the main question it aims to answer is: • does nebulized colistimethate sodium lower the number of times participants develop ventilation associated pneumonia? researchers will compare nebulized colistimethate sodium to a placebo (a look-alike substance that contains no drug) to see if nebulized colistin works to prevent ventilation associated pneumonia in children. participants will: * take nebulized colistimethate sodium or a placebo twice a day for a maximum of 7 days. * will be followed to check for pneumonia occurrence while they are on mechanical ventilation.

the aim of the study is to evaluate the benefit of a 3 to 7 day course of inhaled colistimethate sodium among children undergoing invasive mechanical ventilation for more than 2 days on the occurrence of ventilator-associated pneumonia. a double-blind, multicenter randomized controlled trial will be conducted. patients on mechanical ventilation for more than 2 days will be randomized to receive inhaled colistin twice daily for 3 days or inhaled placebo (0.9% sodium chloride). primary outcome will be the occurrence of ventilator-associated pneumonia from randomization to day 28.

Eligibility criteria:
inclusion criteria: * children older than 1 month and younger than 14 years * patients on invasive mechanical ventilation for more than 48 hours * informed parental consent exclusion criteria: * suspected or confirmed vap on the day of inclusion * indication for systemic colistin therapy before or at enrolment in the study * plan for extubation within the next 24h * known allergy to colistin * no parental consent * tracheostomy * appearance of allergic clinical manifestations in the days of colistin nebulization * appearance of undesirable clinical or biological manifestations presumed attributable to nebulization with colistin

Keywords: colistin mechanical ventilation pneumonia nebulization prevention pediatrics
preventing levodopa induced dyskinesia in parkinson's disease with hmg-coa reductase inhibitors

Conditions: Parkinson Disease; Dyskinesia, Drug-Induced

Summary: in this study, the investigators will examine the association of statin use and dyskinesia in a convenience sample parkinson's disease patients in the veterans administration health care system.

long term treatment with levodopa, the gold standard treatment of parkinson's disease (pd), can lead to the development of abnormal involuntary movements called levodopa induced dyskinesia (lid). the severity of lid can range from mild to severely debilitating. a majority of pd patients will develop lid in their treatment life-time. in a recent study of the mptp monkey model of pd, statin use was found to reduce lid (45%) without a worsening of parkinsonism symptoms1. another study showed rats treated with lovastatin prior to and with initiation of levodopa after substantia nigra lesioning showed dramatically less lid evolution compared to animals without lovastatin exposure2. in this study, the investigators will examine the association of statin use and dyskinesia in a convenience sample parkinson's disease patients in the veterans administration health care system. this study is a retrospective three cohort design and will compare statin exposure before beginning ld, versus statin exposure after ld is begun, versus no statin exposure in pd subjects controlling for disease characteristics (severity), gender, and total ld exposure the primary endpoint is the severity of lid between the groups after years of opportunity to develop lid. levodopa-induced dyskinesia is a major cause of reduced quality of life for veterans with pd and, in some cases, leads to costly surgical interventions. this project examines the impact of statin use on the presence of lid, and could lead to a future intervention trial. the reduction, delayed onset, or elimination of lid could improve the quality of life of many veterans nationwide.

Eligibility criteria:
inclusion criteria: * parkinson's disease * age diagnosed with parkinson's disease greater than or equal to 50 years * treatment with levodopa greater than or equal to 5 years exclusion criteria: * deep brain stimulation * unable to stand for 1 minute intervals, or sensory deficits in the feet * significant cognitive impairment as measured by the montreal cognitive assessment score of \< 18 * subjects with unstable medical or psychiatric conditions (including hallucinations). * history of unstable medical conditions (i.e. active cardiac disease, recent unwellness, surgery etc.) * current use of drugs that may affect parkinsonism or dyskinesia: * dopamine receptor blocking medications * depakote * lithium * amiodarone * tetrabenazine * metoclopramide * dronabinol * and illicit drugs such as marijuana (thc) * cocaine * methamphetamine * statins other than simvastatin or lovastatin, atorvastatin ie. fluvastatin (rationale is that while all other statins are thought to not cross the blood brain barrier well, the central nervous system penetrating nature of others is not perfectly clear and could confound results)
mathematical modeling to determine basic muscle properties in the failing heart

Conditions: Diastolic Heart Failure

Summary: according to the most recent information released by the american heart association, heart failure affects 5.8 million americans and over 23 million people worldwide. in particular, diastolic heart failure (dhf) has emerged in approximately half of those suffering from heart disease and has become a major public health problem for many reasons, including the complexity of the disease, lack of effective drugs/therapies, requirement of invasive tests to diagnose and monitor dhf, and the absence of a suitable scientific model to study the disease. scientists and physicians alike still do not fully understand what happens to the muscles in the heart (myocardium) patients who present with diastolic dysfunction or dhf. therefore, the medical field is in need of an accurate model that can evaluate how diastolic dysfunction leads to heart failure and what happens at a cellular level as this disease emerges and progresses.

our group has developed a mathematical model of the heart that gathers data from a procedure called an echocardiograph (echo) to analyze how muscles in the heart are functioning. this model incorporates how the heart muscle functions on a cellular level along with the overall functionality of the heart. we hypothesize that this model will measure the specific properties of the heart muscle that affect their ability to contract and relax. this study will determine whether these properties will be different in patients with dhf compared to healthy controls. we also propose that these abnormalities in the heart muscle will correlate with the patient's degree of heart failure and their prognosis when doctors evaluate using standard clinical tests. this study will be conducted at the university of nebraska medical center (unmc). 40 subjects will be enrolled, 20 healthy controls with no history of heart disease and 20 subjects who have been diagnosed with diastolic heart failure. healthy controls will be required to undergo 1 echocardiograph procedure at unmc. subjects diagnosed with dhf will be required to undergo 6 echocardiograph procedure over the course of 2 years.

Eligibility criteria:
inclusion criteria: * subjects must be 19 years of age or older * control subjects must have no prior history or current signs of heart disease. * subjects with heart failure must meet one or more of the following criteria: * documented diastolic heart failure, grade ii or greater (via nyha functional class) * grade ii or greater diastolic dysfunction by echocardiographic evaluation exclusion criteria: * subjects under the age of 19 or unable to give consent will be excluded from this study. * greater than mild valvular disease * prior valve repair/replacement

Keywords: diastolic dysfunction, diastolic heart failure, diastolic echocardiography