Kornimate/medical-research-clean huggingface dataset:
a novel closed-loop integrated system for the maintenance of haemodynamic stability

Conditions: Hypotension

Summary: hypotension occurs commonly during spinal anaesthesia for caesarean section with maternal and fetal adverse effects. the investigators developed a double-vasopressor automated system incorporating continuous non-invasive haemodynamic monitoring using nexfintm with a two-step algorithm.

hypotension occurs commonly during spinal anaesthesia for caesarean section with maternal and fetal adverse effects. we developed a double-vasopressor automated system incorporating continuous non-invasive haemodynamic monitoring using nexfin cardiac output monitor with a two-step algorithm. the system delivered phenylephrine 25 mcg or ephedrine 2 mg (if heart rate\<60 beats.min-1) every 30 seconds when systolic blood pressure was between 90-100% of baseline. the system delivered phenylephrine 50 mcg or ephedrine 4 mg (if heart rate\<60 beats.min-1) every 30 seconds when systolic blood pressure was \<90% of baseline. a randomised controlled trial will be done to compare with manual bolus technique. with the manual bolus technique, phenylephrine 50mcg or ephedrine 4mg (if heart rate\<60 beats.min-1) every 60 seconds when systolic blood pressure was between 90-100% of baseline. the system delivered phenylephrine 100mcg or ephedrine 8mg (if heart rate\<60 beats.min-1) every 60 seconds when systolic blood pressure was \<90% of baseline.

Eligibility criteria:
inclusion criteria: * age 21-45 years old, * weight 40-90 kg, * height 145-170 cm exclusion criteria: * contraindications to spinal anaesthesia, * allergy to drugs used in the study, and * those with uncontrolled medical conditions such as hypertension, diabetes mellitus, and cardiovascular disease

Keywords: hypotension
emergency ultrasound of the gallbladder

Conditions: Gallbladder Diseases

Summary: the purpose of this study is to determine whether fasting for 8 hours prior to ultrasonography for cholelithiasis (gallbladder pain) is needed.

ultrasonography of the gallbladder is currently the diagnostic modality of choice in determining cholelithiasis and cholecystitis. historically this test has been performed in the radiology suites where the patient was expected to fast for times of six to ten hours. patients presenting to emergency departments (ed) have also been required to wait to have their study performed in order to have better visualization of the gallbladder. however, few studies have examined whether a fasting time matters in determining gallbladder pathology. furthermore, with the emphasis on through-times in the ed, most eds cannot afford holding their patients in the ed to wait for a test. finally, with the advent of emergency bedside ultrasonography and the greater level of comfort emergency physicians (ep) have in diagnosing gallbladder pathology, it is possible to now determine an answer within minutes. we will test to see if eps trained in the use of emergency bedside ultrasound can effectively and efficiently determine gallbladder pathology and if fasting has an impact on their ability to perform a quality ultrasound.

Eligibility criteria:
inclusion criteria: * male or female between the ages of 18 and 75 * ability to consent for study exclusion criteria: * inability to give informed consent * known pregnancy * prior cholecystectomy * inability to consume a fast food breakfast * known history of cholelithiasis

Keywords: gallbladder ultrasound emergency medicine
treatment of geotropic horizontal canal benign paroxysmal positional vertigo

Conditions: Benign Paroxysmal Positional Vertigo

Summary: the purpose of this study was to compare the immediate efficacies of each treatment maneuvers in treatment of geotorpic horizontal canal benign paroxysmal positional vertigo (hc-bppv).

a randomized prospective study of patients with hc-bppv. patients with geotropic type of hc-bppv were randomized to one of each three treatment groups at their first clinic visit. these groups included the barbecue maneuver, gufoni's maneuver, and sham group in geotropic hc-bppv. responsiveness of treatment maneuver was determined by positioning maneuver immediately after each treatment method based on resolves of vertigo and positional nystagmus.

Eligibility criteria:
inclusion criteria: * a history of brief episodes of positional vertigo, direction-changing horizontal nystagmus beating toward the uppermost (apogeotropic nystagmus) ear in both the lateral head turning positions, * no spontaneous nystagmus during upright sitting position * absence of identifiable central nervous system disorders that could explain the positional vertigo and nystagmus exclusion criteria: * central positional nystagmus with identifiable cns lesions that could explain the positional nystagmus

Keywords: bppv(benign paroxysmal positional vertigo) hc-bppv(bppv involving the horizontal semicircular canal) nystagmus treatment outcome horizontal canal benign paroxysmal positional vertigo
effect of sleep quality on hematopoietic cell transplant patient outcomes

Conditions: Sleep; Multiple Myeloma

Summary: this randomized, controlled study will compare mindfulness awareness practices for insomnia (map-i) to sleep health education (she) in subjects receiving autologous hematopoietic cell transplant for multiple myeloma.

this randomized controlled study will evaluate the feasibility of implementing a mindfulness intervention targeting inpatient autologous hematopoietic cell transplantation (hct) recipients (first hct) with multiple myeloma (mm) and the preliminary efficacy of mindfulness awareness practices for insomnia (map-i) vs. sleep health education (she) to improve insomnia outcomes, cellular and transcriptomic markers of inflammation, and insomnia associated behavioral symptoms (depression, fatigue). patients enrolled in this study will be randomized to either receive map-i or she starting 2-4 weeks prior to hct. patients will receive two sessions prior to inpatient admission for hct, and four sessions in the two weeks of hospitalization following hct, for a total of six intervention (or control) sessions. primary objective: determine the feasibility of implementing map-i among hct recipients under first autologous hct for mm.

Eligibility criteria:
inclusion criteria: * ≥18 years of age * ≤ 1 year since initiation of systemic anti-myeloma therapy * no prior progression or relapse of myeloma prior to hct * patient should be eligible to receive melphalan 200 mg/m2 as conditioning regimen * stem cell graft with \> 2.0 x10\^6 cluster of differentiation 34 cells (cd34+)/kg available for transplant * karnofsky performance score (kps) ≥70 * agreeable to random assignment and data collection, including survey completion and blood draws * available to attend the outpatient intervention portion. * voluntary written consent must be given before performance of any study related procedure not part of standard medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care exclusion criteria: * prior autologous hct * outpatient hct * presence of coexistent amyloidosis * presence of known obstructive sleep apnea (osa)

Keywords: sleep insomnia mindfulness awareness practices for insomnia sleep health education multiple myeloma autologous hematopoietic cell transplantation depression inflammation sleep hygiene fatigue
mrd guided de-intensification of bendamustine/rituximab for indolent non-hodgkin lymphoma

Conditions: Lymphoma; Indolent Non-hodgkin Lymphoma

Summary: this is a phase ii pilot, single arm, open label study designed to assess the efficacy, safety, and feasibility of mrd adapted duration of br for untreated or r/r inhl.

this is a phase ii pilot, single arm, open label study designed to assess the efficacy, safety, and feasibility of mrd adapted duration of br for untreated or r/r inhl. all patients with untreated or r/r (not previously treated with bendamustine) inhl (follicular lymphoma (grade 1-3a2), marginal zone lymphoma, lymphoplasmacytic lymphoma) are candidates for this trial. patients requiring treatment per treating physician's discretion are eligible for the trial. patients who recently started on and received two cycles of bendamustine at 90 mg/m2 dose with ritxumab 375 mg/m2 are also eligible for this trial. for these patients, c2d1 br should be no more than 14 days prior to the time of study enrollment (i.e. enrollment no later than c2d14). patients who have received two cycles of 90mg/m2 bendamustine dose with rituximab 375 mg/m2 can enter the study and initiate cycle 3 once pre-screening and screening procedures have been completed.

Eligibility criteria:
inclusion criteria: patients must have pathologically confirmed: * indolent non-hodgkin lymphoma, consistent with one of the below diagnoses: * follicular lymphoma (grade 1-3a) * marginal zone lymphoma * lymphoplasmacytic lymphoma patient may be treatment naïve or relapsed/refractory without having received prior bendamustine or patients recently started on bendamustine 90 mg/m2 with rituximab 375 mg/m2 are eligible if c2d1 br is no more than 14 days prior to enrollment and they otherwise meet eligibility criteria * age \> 18 years * ecog performance status 0-2 patients must have normal organ and marrow function as defined below: * absolute neutrophil count \>1000mm3 and hemoglobin \>8 g/dl (unless due to bone marrow involvement by lymphoma) * total bilirubin \> 1.5x upper limit of normal (patients with gilbert's syndrome can have total bilirubin up to 3x upper normal limit) * aspartate aminotransferase/ alanine aminotransferase (serum glutamic-oxaloacetic transaminase/ serum glutamic-pyruvic transaminase) \< 5 times institutional normal limits * creatinine clearance \> 30 ml/min exclusion criteria: * radiation or systemic treatment for lymphoma within the past 28 days prior to cycle 1 day 1 of br. * patients with pathologically confirmed transformed lymphoma, including diffuse large b cell lymphoma or other high grade lymphomas * patients on active treatment for second malignancy with the exception of endocrine therapy for non-metastatic breast cancer, hormone therapy for prostate cancer, or local treatment for non-melanoma skin cancer. * pregnant or breast-feeding. refer to section 5.4 for further detail. * failure to identify a dominant clonal sequence with clonoseq from pre-treatment specimen or inadequate tissue for testing
aerosolized surfactant in neonatal rds

Conditions: Respiratory Distress Syndrome, Newborn

Summary: respiratory distress syndrome (rds), caused by surfactant deficiency, is the leading cause of mortality and morbidity in preterm infants. intratracheal instillation, the only approved means of surfactant delivery, requires endotracheal intubation and mechanical ventilation with their attendant risks. interventions that decrease need for intubation and mechanical ventilation like noninvasive ventilation (niv) including nasal continuous positive airway pressure, high flow nasal cannula or nasal intermittent mandatory ventilation are increasingly being used for initial respiratory support in preterm neonates with rds to improve outcomes. aerosolized surfactant delivered during niv is an innovative and promising concept for the treatment of rds - retaining the advantages of early surfactant with alveolar recruitment while obviating the risks of intubation and mechanical ventilation. the investigators overall hypothesis is that treatment of rds with aerosolized surfactant in preterm infants undergoing niv is safe and feasible and will result in short-term improvement in oxygenation and ventilation. the objective of this proposal is to perform a single-center unblinded phase ii randomized clinical trial of aerosolized surfactant for the treatment of rds in preterm neonates undergoing niv. funding source - fda-oopd.


Eligibility criteria:
inclusion criteria: 1. infants admitted to the nicu at hutzel women's hospital (hwh)/children's hospital of michigan (chm) 2. gestational age of 240/7-366/7 weeks 3. postnatal age ≤ 24 hours 4. clinical diagnosis of rds based on (i) presence of at least two of the four classic symptoms (need of supplemental oxygen, tachypnea, intercostal retractions or grunting), and (ii) exclusion of other causes of respiratory failure and (iii) clinician intent to administer surfactant if infant requires intubation 5. respiratory support with niv (cpap or nippv or hfnc) with fio2 ≥25% or peep ≥ 4 cmh20 or hfnc rate ≥ 2 lpm for ≤8 hours 6. written informed consent from parent/guardian exclusion criteria: 1. previous receipt of surfactant 2. infants with respiratory distress who are unstable and require immediate intubation 3. active air leak syndrome (e.g. pneumothorax, pneumomediastinum) 4. lethal congenital malformations; death anticipated within first 3 days of life; decision to withhold support 5. serious abdominal, cardiac, airway or respiratory malformations including tracheal esophageal fistula, intestinal atresia, omphalocele, gastroschisis, pulmonary hypoplasia, or diaphragmatic hernia 6. neuromuscular disorder resulting in respiratory compromise
presbyopia compensation: looking for electrophysiological predictors

Conditions: Presbyopia

Summary: the main purpose of this study was to identify electrophysiological predictive markers of post-correction visual comfort for presbyopic patients.

for each participant, presbyopia was compensated with contact lenses by monovision during three weeks and multifocality (three weeks again). a break of two weeks without any presbyopia compensation came in between the two phases of the test that were randomized. all subjects were tested three times: before any compensation, after three weeks with monovsion and after three weeks with multifocality. each testing session was strictly the same including visual examinations and veps (visual evoked potentials).

Eligibility criteria:
inclusion criteria: * normal acuity exclusion criteria: * stereoacuity disorder * neurological disorders

Keywords: multifocality monovision
topical application of prf before radiation therapy

Conditions: PRF

Summary: the primary goal of this study is to observe whether prp promotes the wound healing before a radiation therapy or not, compared to the natural healing of a tooth extraction socket. secondary aim is to monitore the effect on the pain perception.

head and neck cancer patients are required for a dental checkup before the beginning of the radiation therapy. during this checkup the patients gets a radiological and clinical examination in order to determine any tooth or alveolar bone bound inflammatory processes. teeth associated to those conditions, or those which are likely to result in any of this, have to be extracted in order to prevent radiation associated complications such as osteomyelitis or further osteoradionecrosis of the jaw. in order to prevent this illness it is essential to not start before the healing of the post-extraction socket has reached a sufficient state, which is usually around 3 weeks post-extracitonem. to facilitate the healing, recent studies have shown an positive effect by applying prf and a lower pain perception after surgical tooth removal. so far it is not documented for the prevention of a osteoradionecrosis of the jaw. the patients who receive two or more tooth extractions before radiation therapy can participate in the study. the preliminary diagnosis has to be a head and neck tumor which is planned to be treated with ionizing radiation equally on both sides of the jaw(s). both teeth have to have a similar size (e.g. molar and molar). patient and doctors a blinded, the site of prf application is chosen by random. after surgical removal of the teeth one extraction socket is filled with prf while the other is left for its natural formation of a blood clot. during the first 7 days the patient protocols the pain perception and the amount of painkillers used for both sides of the jaw. after 7d, 14d, 21d, 30d, the wound healing is recorded until it reached is end in complete epithelization. 3 months after the surgery a intermediate clinical examination is performed for early signs of any complication due to the radiation therapy. 6 months after the surgery a opg-radiograph will be taken to determine the bone healing comparing the test site and the control site.

Eligibility criteria:
inclusion criteria: * head and neck cancer with planed radiation therapy * bilateral tooth extraction * similar tooth size * atraumatic tooth extractions without flap surgery * patients age above 18y of age exclusion criteria: * prior radiation therapy in the head and neck area * prior and current therapy with bisphosphonates or equivalent modern biologics * patients during pregnancy or breastfeeding

Keywords: prf wound healing dentistry oral surgery radiation therapy cancer
effects of dexmedetomidine on the postoperative experience in children

Conditions: Failed Moderate Sedation During Procedure

Summary: background: the study aim was to compare the efficacy of dexmedetomidine versus midazolam for sedation during the early postoperative period in children who underwent scoliosis surgery. methods: we performed a prospective, randomized trial in an intensive care unit (icu) in a tertiary care center. in this study, 42 patients (american society of anesthesiology physical status i and ii) who underwent scoliosis surgery were divided into 2 groups according to sedation protocols: group dex (n = 22) and group mdz (n = 20). children (12-18 years) requiring mechanical ventilation underwent a continuous infusion of either dexmedetomidine (group dex; starting dose, 0.4 μg•kg-1•h-1) or midazolam (group mdz; starting dose, 0.1 mg•kg-1•h-1) with intermittent fentanyl, as needed. the efficacy of sedation was assessed using the richmond agitation sedation scale (rass). quality of pain relief was measured using the numeric visual analog scale (nvas). during the arousal assessment, delirium was determined in patients in the rass range of -2 to +1 using the confusion assessment method for the icu (cam-icu). fentanyl consumption, incidence of delirium, nvas scores, and hemodynamics were recorded postoperatively at 2, 4, 6, and 24 h in the icu.


Eligibility criteria:
inclusion criteria: admittance to the icu and a requirement of mechanical ventilation with an endotracheal tube. exclusion criteria: patients who had a history of allergies to midazolam and/or dexmedetomidine; delirium, developmental delay, or mental retardation, as reported by parents; an american society of anesthesiologists classification greater than iii; any known previous reactions to anesthesia; or a history of asthma or an anticipated difficult airway and concomitant disease (neuromuscular scoliosis or neurodegenerative disease) were excluded from the study.

Keywords: scoliosis, sedation, children, fentanyl consumption, pain
evaluation of performance of an aspergillus pcr in tissue and pleural effusion samples of immunocompromised patients

Conditions: Aspergillosis; Immunosuppression

Summary: although being a frequent and lethal complication in patients (pts) with hematologic malignancies, diagnosing invasive aspergillosis (ia) still remains a difficult issue as culture-based methods show low sensitivity especially under the current clinical practice of antifungal prophylaxis or rapid antifungal therapy. in certain clinical settings, performing biopsies for identification of the underlying infectious organism becomes important. however, as culture-based methods only yield results in a minority of patients, using non-culture-based methods like aspergillus specific polymerase chain reaction (pcr) for detection of ia directly in clinical specimens is becoming increasingly important and might help to characterize the causative pathogen. therefore the performance of an established aspergillus-specific nested pcr in biopsies, re-section material or pleural effusions is evaluated.


Eligibility criteria:
inclusion criteria: * immunocompromised individuals with suspicion of harbouring an invasive fungal infection * definition by 2008 eortc/msg criteria (de pauw cid 2008) exclusion criteria: * none
the role of skin care regimen in skin health

Conditions: Itching; Xerosis

Summary: this research is being done to evaluate the role of a regular skin care regimen comprising of a mild soap and moisturizer in improving dry skin and overall skin health. in this study, the investigators hope to learn the importance of regular skin care regimen in improving dry skin and overall skin health.

dry skin is a common phenomenon and can dramatically decrease a person's quality of life as well as contribute to a wide variety of skin diseases. skin care products hydrate the skin and breaks the dry skin cycle. while there is extensive evidence of benefits of using mild cleansers and moisturizers, much of the previous studies are limited to the effects of single cleanser or moisturizer. in this study, the investigators are going to enroll up to 100 people over the age of 18 with dry, itchy skin and they will be split into 2 groups. participants will be randomly assigned to skin care regimen group (approximately 75% of total enrolled) and control group (approximately 25% of total enrolled). all evaluation include clinical assessments, subject questionnaires and photography will be conducted similarly in both groups. analysis will include paired and unpaired t-tests with two-tailed p-values. values obtained at baseline, in middle of the study and after completing the study will be compared. the difference of measure values will be compared between application group and control group. the moisturizing lotion and wash are generally very well tolerated.rarely, they can induce a burning sensation, dryness, skin irritation, erythema, stinging, sensitization, and dermatitis. risk events, problems, and deviations will be reported by the pi directly to the institutional review boards. the investigators hope to learn the importance of regular skin care regimen in improving dry skin and overall skin health.

Eligibility criteria:
inclusion criteria: * participants must be over the age of 18 years old with dry, itchy skin; * participant must be willing to comply with the requirements of the protocol; * participant must have the ability to understand and communicate with the investigator; * participant must provide informed consent. exclusion criteria: * subjects who are unable to provide informed consent; * subjects who are unable to refrain from swimming or hot tub use throughout the study duration * subject with significant medical history or current skin diseases that the investigator feels is not safe for study participation; * subjects who have been treated with systemic retinoids or steroids within the past month prior to entry to the study; * subjects who have been treated with topical steroids, retinoids or other topical drugs within 2 weeks prior to entry to the study; * recently treated or current skin diseases that would affect clinical evaluation; * subjects who self-report that they are pregnant or nursing; * patients with history of investigational drug use in the 30 days prior to entry into the study.

Keywords: skin regimen moisturizer dry skin dry itchy skin skin care