Kornimate/medical-research-clean huggingface dataset:
the comparison of the success rate of the endotracheal intubation between the stylet and the frova with acute angled videolaryngoscope

Conditions: Anesthesia, General

Summary: the purpose of this study is to compare the effect of frova and stylet on the success rate of tracheal intubation when using a video laryngoscope.


Eligibility criteria:
inclusion criteria: * 1. adult patients aged over 19 years who are undergoing endotracheal intubation for elective surgery. * 2. patients who have one of the predictors of difficult intubation such as mallampati classification 3 or 4, limited the movement of the neck, body mass index less than 35 kg/m2, a distance from the tip of the chin to the thyroid cartilage of less than 6.5 cm, a interincisor distance less than 3.5 cm, inability to protrude of lower incisors over the upper incisors, or a diagnosis of obstructive sleep apnea. exclusion criteria: * 1. patients receiving emergency surgery * 2. pregnant women * 3. patients scheduled for oral surgery such as tonsillectomy, vocal cord surgery * 4. patients who have a history of ankylosing spondylitis or have a large tumor of 4 cm or more on the tongue and need an awake intubation * 5. patients who are at risk of vomiting due to not fasting time
exubera vs lispro in a lantus-based regimen for improved glycemic control in type 2 diabetes

Conditions: Diabetes Mellitus

Summary: the current trial will examine the efficacy and safety of exubera administered as a mealtime insulin compared to lispro, when added to an existing regimen of basal insulin glargine + or = oral agents (oas). dose titrations will be provided which should allow a large proportion of subjects to reach target glycosylated hemoglobin (a1c) levels.


Eligibility criteria:
inclusion criteria: * adults with type 2 diabetes using lantus® (insulin glargine) as their basal insulin, not at glycemic goal. exclusion criteria: * lung disease * current smoking or discontinued smoking within past 6 months

Keywords: type two diabetes, insulin, hba1c
effects of warmed, humidified co2 insufflation on body core temperature and cytokine response

Conditions: Hypothermia

Summary: the aim of this study is to assess if the conditioning of the insufflation carbon dioxide (co2) allows for an additional benefit in terms of prevention of the heat loss, when compared with the usual prevention with a forced warm air blanket alone, in the setting of robot-assisted radical prostatectomy (rarp).

among the possible consequences of cool and dry gas insufflation during laparoscopic procedures are hypothermia and cytokine response, which might cause significant perioperative morbidity. more in detail, body core temperature decrease during laparoscopic surgery has been calculated in humans as 0.3 °c for every 50 l of cold and dry insufflation gas. the reported temperature drop is caused by redistribution of heat and heat loss, both non-specific (due to anaesthesia and environmental patient exposure) and specific (due to peritoneal dry and cool insufflations). the resulting hypothermia can be severe, particularly after prolonged surgery. as for cytokine response, an increase of several pro-inflammatory cytokines has been described following the irritating effect of peritoneal co2 insufflation. that said, various devices of conditioning of the insufflating gas have been investigated to reduce the specific heat losses resulting from peritoneal insufflations, as well as to evaluate the inflammatory response. previous studies conducted on animal models and clinical settings have suggested that warmed and humidified insufflation allows for an improved maintenance of body core temperature, a reduction in the degree of inflammatory response and an improved quality of postoperative course, compared with standard insufflating gas. these findings, however, are still not conclusive as they have not been confirmed by adequate randomized, controlled trials. furthermore, no device providing warming and humidification has demonstrated a conclusive advantage over standard cold dry gas in terms of prevention of hypothermia during laparoscopy in man. on the basis of the current available studies favouring warmed and humidified insufflation, the investigators hypothesize that a new device providing warmed and humidified insufflation (humigard® fisher and paykel healthcare®) might achieve significant benefits over standard insufflation in terms of body core temperature maintenance. the investigators also expect to document a decrease of pro-inflammatory cytokines, as a response to a diminished peritoneal irritation.

Eligibility criteria:
inclusion criteria: * all patients undergoing rarp, with or without pelvic lymph node dissection, with a co2 insufflation scheduled to last more than 60 minutes exclusion criteria: * patients over 80 years old, patients american society of anesthesiologist (asa) status 4 or higher, patients not willing to sign the informed consent, conversions to open surgery

Keywords: co2 insufflation robot assisted radical prostatectomy laparoscopy hypothermia cytokine response
safety of cardioversion of acute atrial fibrillation

Conditions: Atrial Fibrillation

Summary: the purpose of this study is to investigate the complications of cardioversion of acute (\<48 hours duration) atrial fibrillation (af). primary outcome measures: - incidence and predictors of thromboembolic complications, especially stroke, and death \<31 days after cardioversion of acute af secondary outcome measures: * number of therapy non-responder and early recurrence of af * bleeding complications during the 31 days follow-up * hemodynamic complications of cardioversion estimated enrollment: 3000 cases study start date: jun 2011 estimated study completion date: december 2011

it has been a common practice to perform cardioversion of acute (\<48 hour) af without any anticoagulation. the new european guidelines recommend that anticoagulation should be started already before cardioversion in all patients with chads2vasc score indicating need for long-term oral anticoagulation. the evidence behind these guidelines is, however, scarce. in this retrospective study we collect data on the safety of acute af cardioversion from emergency rooms of two university hospitals and one secondary referral center from the years 2003-2010. inclusion criteria: all patients admitted to emergency room because of acute af in whom electrical or pharmacological cardioversion was attempted \<48 from the beginning of the symptoms.

Eligibility criteria:
inclusion criteria: * patients admitted to emergency room because of acute af in whom electrical or pharmacological cardioversion was attempted \<48 from the beginning of the symptoms exclusion criteria: * duration of the af is unknown or \>48 hours

Keywords: atrial fibrillation cardioversion stroke thromboembolism
epidural intervention of spinal nerves with tumor necrosis factor-alpha inhibitor

Conditions: Spinal Stenosis

Summary: this study is to assess the clinical efficacy of epidural injections with tumor necrosis factor-alpha(tnf-α) inhibitor in patients with chronic radicular pain caused by lumbar spinal stenosis.

this study is to assess the clinical efficacy of epidural injections with tumor necrosis factor-alpha(tnf-α) inhibitor in patients with chronic radicular pain caused by lumbar spinal stenosis.ninety patients were diagnosed with lumbar spinal stenosis and were randomly assigned to 3 groups, for each group 30 cases. patients in group a received epidural injection of spinal nerve with 2.0 ml of lidocaine and 10 mg of tumor necrosis factor-alpha inhibitor (etanercept) onto the affected spinal nerve, group b patients received epidural injection with lidocaine 2ml mixed with 2ml of steroid(diprospan), and group c patients received epidural injections with 4.0 ml of lidocaine only. all the 3 groups were evaluated by vas and odi, and received 6 months' follow-up.

Eligibility criteria:
inclusion criteria: * diagnosis of spinal stenosis with radicular pain at least 5 scores of vas(ranging from 0 to 10). * failed to improve symptom significantly through conservative treatment, including physiotherapy, chiropractic therapy, exercise, medication and bed rest. exclusion criteria: * lumbar surgery history, * spinal stenosis without radicular pain, * uncontrollable or unstable use of opioids, * uncontrolled mental illness, * pregnant or lactating women, * patients with a history of adverse reactions or possible adverse reactions to local anesthetics, etanercept or steroids.
sex differences in the risk of cardiovascular diseases associated with diabetes

Conditions: Diabetes Mellitus

Summary: to evaluate the risk of cardiovascular events associated with medication use for controlling blood glucose, blood pressure and cholesterol levels in men and women with diabetes treated in primary care

the management and treatment of adult diabetes is far from optimal. the most recent report from the national diabetes audit showed that only one in three people with diabetes are achieving recommended standards for controlling blood glucose, blood pressure and cholesterol levels; and only three in five received basic care processes to reduce their risk of diabetes-related complications such as blindness, amputation and kidney disease. women did 15% worse than men, which may explain some of the reported higher excess risk of coronary heart disease and stroke, consequent to diabetes in women than men. more efficient and equitable care in people with diabetes could lead to substantial cost savings, and would improve the lives of women and men currently living with diabetes. the objective of this research isto evaluate the risk of cardiovascular events associated with medication use for controlling blood glucose, blood pressure and cholesterol levels in men and women with diabetes treated in primary care.

Eligibility criteria:
inclusion criteria: * patients with diabetes at or before study entry, and participants who develop new-onset diabetes during follow-up. * age ≥ 18 years * data collected in the period 1997-2010 * minimum time since registration of 1 year * minimum of 1 year of up to standard data (cprd quality standard) exclusion criteria: • none

Keywords: diabetes mellitus stroke myocardial infarction stable angina pectoris heart failure quality of care
prospective observational trial to evaluate quality of life after neoadjuvant or definitive chemoradiation in patients with esophageal cancer

Conditions: Quality of Life; Chemoradiation; Esophageal Cancer

Summary: prospective observational study to evaluate the quality of life based on standardized eortc questionaires as well as toxicities, functional and oncological outcomes in patients treated with neoadjuvant or definitive chemoradiation for esophageal cancer.

prospective observational study to evaluate the quality of life based in patients treated with neoadjuvant or definitive chemoradiation for esophageal cancer. qol will be evaluated by standardized eortc questionaires. acute and late toxicity will be assessed according to ctcae 4.03. outcome measures will include local control, distant control, freedom from treatment failure and overall survival. correlations are planned between patient- and physician-assessed functional outcome.

Eligibility criteria:
inclusion criteria: * histologically proven esophageal cancer (scc or adenocarcinoma) without distant metastases (except supraclavicular nodes) * indication for neoadjuvant or definitive chemoradiation using either cisplatin/5-fu or carboplatin/paclitaxel with curative intent * age \>= 18 years * written informed consent * ability to answer the standardized questionaires according to the treating physician exclusion criteria: * age \< 18 years * treatment with palliative intent * distant metastases (except supraclavicular nodes) * second malignancy * prior systemic treatment for esophageal cancer * treatment in an interventional study

Keywords: quality of life neoadjuvant definitive chemoradiation esophageal cancer
the use of continuous wound infusion analgesia in total knee arthroplasty

Conditions: Total Knee Arthroplasty

Summary: the main purpose of this study is to determine if there is improvement in pain and other patient outcomes when using a continuous wound analgesia system after total knee replacement, compared to usual methods of pain control. another purpose is to determine if the system makes it easier for nurses to care for these patients.

continuous local wound infusion analgesia is a relatively new way of managing post-operative pain, whereby a local anesthetic is continuously infused into the surgical area. some studies and users have reported decreased pain, decreased opioid use, decreased post-operative nausea and vomiting, decreased length of stay, and improved patient and caregiver satisfaction with the use of continuous local wound infusion analgesia, when compared to placebo, or usual care, in arthroplasty and other surgical interventions. hypotheses: primary: the on-q painbuster (continuous wound infusion analgesia) in tka will result in improved patient pain control, compared to usual care. secondary: * pain scores post-operatively will be better than usual care. * fewer narcotics will be ingested post-operatively than with usual care. * post-op nausea and vomiting will be less than usual care. * length of stay will be shorter compared to usual care. * patient satisfaction will be greater than satisfaction with usual care. * post-operative infection rates will be no different between groups. * fall rates will be no different between groups. * subjects will participate in physical therapy the day of surgery. * nursing intensity requirements will be less with the wound infusion due to fewer requests for pain medication.

Eligibility criteria:
inclusion criteria: * scheduled for tka at the royal alexandra hospital * patient of dr. arnett * deemed fit for continuous wound infusion (no allergies to bupivacaine or related medications) by anesthesia * cognitively aware, and provides informed consent * elective (not trauma-related) surgery * able to read, speak and understand english * adult \< 70 years of age * intra-operative spinal anaesthesia * reside within metropolitan edmonton, in a bungalow * have a caregiver at home * asa risk classification of 1 or 2 * do not regularly use opioid medication pre-operatively * have preoperative knee range of motion \> 90 degrees * body mass index \< 40 * no known hepatic or liver insufficiency exclusion criteria: * deemed unfit for continuous wound infusion due to allergies * other exclusion criteria to be determined

Keywords: arthritis of the knee knee replacement osteoarthritis, knee arthroplasty, knee
evaluation of a toolkit to improve cardiovascular disease screening and treatment for people with diabetes

Conditions: Diabetes Mellitus; Cardiovascular Disease

Summary: diabetes is a common and serious chronic disease. however, there is a large gap between the level of care that people should receive (based on research and guidelines) and the level of care they actually receive. with the release of their 2008 clinical practice guidelines, the canadian diabetes association has a strategy to improve heart disease screening and treatment for people with diabetes. this study will evaluate whether the strategy works. the focus of the strategy was to give all family physicians in canada a toolkit in june 2009 to help them delivery better care for their diabetic patients. in ontario, only half of doctors received this toolkit. we will compare the quality of care received by diabetic patients whose doctors received this toolkit versus those who doctors did not.

a cardiovascular disease toolkit was developed by the canadian diabetes association and mailed to family physician with the spring/summer 2009 edition of the newsletter, canadian diabetes. the toolkit was packaged in a brightly-coloured box with canadian diabetes association branding, and contained: 1) an introductory letter from the chair of the practice guidelines' dissemination and implementation committee; 2) an eight page summary of selected sections of the practice guidelines targeted towards primary care physicians; 3) a four page synopsis of the key guideline elements pertaining to cardiovascular disease risk; 4) a small double-sided laminated card with a simplified algorithm for cardiovascular risk assessment, vascular protection strategies and screening for cardiovascular disease; and 5) a pad of tear-off sheets for patients with a cardiovascular risk self-assessment tool and a list of recommended risk reduction strategies.

Eligibility criteria:
inclusion criteria: * alive on 1 july 2009 with prevalent diabetes exclusion criteria: * age \<= 39 * residing in long-term care secondary analysis: * analysis will be repeated using all people alive on 1 july 2009 without prevalent diabetes using the same exclusion criteria, to determine the spill-over effect of the intervention on physicians' other patients.

Keywords: pragmatic randomized controlled trial cardiovascular risk reduction knowledge translation clinical practice guidelines administrative databases
effect of non-invasive lung fluid monitoring for heart failure management in primary care

Conditions: Heart Failure

Summary: remote dielectric sensing (reds) technology offers a non-invasive method for assessing lung congestion. this randomized controlled trial aims to evaluate the effectiveness and processes of the reds-guided heart failure management program in primary care settings for patients with heart failure.

remote dielectric sensing (reds) technology offers a non-invasive method for assessing lung congestion. our newly developed reds-guided heart failure management program, led by nurses, incorporates algorithms for a follow-up schedule, diuretic adjustments, and symptom monitoring. the specific aims of the study are: 1. to examine whether the program decreases the number of urgent healthcare visits for heart failure, unplanned heart failure hospitalisations, and all-cause death in patients with heart failure. 2. to evaluate the intervention processes and explore barriers to and facilitators for the implementation of the program. this is a multicentre 1:1 randomised controlled clinical trial with a 6-month follow-up. study participants will be patients with diagnosed with heart failure. the primary outcome will be the total number of urgent healthcare visits for heart failure, unplanned heart failure hospitalisation, and all-cause death at 3 months. secondary outcomes will include health-related quality of life, self-care behaviour, and healthcare cost. throughout the randomised controlled trial, a process evaluation will be conducted to assess the fidelity, dose, and reach of the intervention program. additionally, we will explore both barriers and facilitators for program implementation among study patients and healthcare professionals.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years, there is no upper age limit * diagnosed with heart failure regardless of left ventricular ejection fraction * having new york heart association (nyha) class iii/iv irrespective of prior hospitalisation for heart failure, or nyha ii with a history of at least one hospitalisation for heart failure within the previous 12 months * elevated n-terminal pro-b-type natriuretic peptide (nt-probnp) within 12 months: (a) ≥450 pg/ml for patients under 50 years; (b) ≥900 pg/ml for patients aged 50-75 years; (c) ≥1800 pg/ml for patients over 75 years. exclusion criteria: * nyha i * life expectancy \<6 months * physical characteristics that prevented use of the reds (body mass index \ 39, and height less than 155 cm or higher than 195 cm) * implantation of a left ventricular assist device or cardiac transplantation.

Keywords: heart failure primary care nursing monitoring self-care community
effect of sch 497079 on metabolic parameters and influence of race/ethnic origin on therapeutic response (study p05338)(completed)

Conditions: Type 2 Diabetes Mellitus

Summary: the purpose of this study is to evaluate the effect of sch 497079 on metabolic parameters and to determine the influence of race/ethnic origin on therapeutic response.

this study includes two parts, each part includes three consecutive 28-day treatment periods. part 1 (to be conducted in the united states): each participant will receive the following treatments for 28 days in each of three treatment periods in an order determined by a random code: sch 497079, or matching placebo, or metformin. part 2 (to be conducted in india): this part of the study will be conducted after completion of part 1 and an analysis indicates a clinically significant decrease in blood glucose in participants with type 2 diabetes mellitus (t2dm) compared to placebo. the same procedures conducted in part 1 will be conducted in part 2.

Eligibility criteria:
inclusion criteria: * \>=18 years of age to 65 years of age, of either sex, and having a body mass index (bmi) between 27 and 35, inclusive (usa participants) * clinical laboratory tests (complete blood count, blood chemistry, and urinalysis) within normal limits (excluding glucose and other changes usually associated with diabetes eg, dyslipidemia) * type 2 diabetes mellitus exclusion criteria: * female participants who are premenopausal or are not surgically sterilized. participants who are pregnant, intend to become pregnant (within 3 months of ending the study), or are breast-feeding. * participants who have received insulin therapy within 6 months, prior to day 1/period 1 or who require thiazide diuretics, beta-blockers and cyclic hormone therapy.