Kornimate/medical-research-clean huggingface dataset:
individualized positive end-expiratory pressure (peep) on oxygenation, hemodynamics, and early postoperative atelectasis in laparoscopic bariatric surgery

Conditions: Positive End-expiratory Pressure; Hemodynamic Variable; Postoperative Atelectasis; Laparoscopic Bariatric Surgery

Summary: the aim of this study is to evaluate the effectiveness of intraoperative individualized positive end-expiratory pressure (peepind) titration, compared to fixed positive end-expiratory pressure of 5 cmh2o, on oxygenation, hemodynamic variables, and early postoperative complications in obese patients undergoing laparoscopic bariatric surgery.

obesity is a major health problem, and the incidence is increasing worldwide. so far, the only treatment for morbid obesity with good long-term results is bariatric surgery. obese patients have unique respiratory physiology and ventilatory mechanics characteristics. their lung function is impaired due to the reduction of oxygen reserve, functional residual capacity, and lung compliance. in addition, they frequently present with respiratory comorbidities, which increases the risk of developing postoperative pulmonary complications (ppcs) such as atelectasis especially after procedures under general anesthesia. atelectasis has been hypothesized as a main cause of postoperative hypoxemia. to reduce the incidence of atelectasis, positive end-expiratory pressure (peep) and recruitment maneuvers are used as a protective lung strategy to improve gas exchange and lung mechanics through reopening collapsed alveoli and maintaining the aeration of lungs. application of peep may also eliminate auto-peep without increasing plateau pressure.

Eligibility criteria:
inclusion criteria: * age from 21 to 60 years. * both sexes. * american society of anesthesiologists (asa) physical status class i-iii * patients who are scheduled for elective laparoscopic bariatric surgery under general anesthesia. exclusion criteria: * patients who are unwilling to participate in the study * actively smokers. * patients who had a history of chronic obstructive pulmonary disease or bronchial asthma. * patients who are receiving renal replacement therapy prior to surgery. * patients who had a history of heart failure. * pregnant. * patients who have allergies to any drug used in the study.
catalytic antibodies and lupus in martinique

Conditions: Systemic Lupus Erythematosus

Summary: * the martinique island (french west-indies) is an area of high prevalence and incidence for systemic lupus erythematosus (sle), respectively 64,2/ 100000 and 4,7/ 100000. in many cases, this disease concerns afro caribbean women, whose auto-antibodies are excessively high; also, organic damages are frequent. the disease can be fatal. * studies have shown that some cytotoxic auto-antibodies may have a responsibility in the hydrolysing of dna. this study will focus on the dna activity and also on the overwhelm hydrolase activity dealing with the lupus disease in order to measure the link between the disease activity and the catalytic activity. patients concerned by this study will be martinique people.

this study will be conducted as an case-control survey. * the first group with patients: 60 sle patients, 30 patients with a quiescent lupus and 30 patients with an active lupus. patients that will be included are followed by the university hospital of fort-de-france. * the second group is the control group: subjects will be recruited by the french organisation responsible for donation of blood. test will be done at the umrs 872 laboratory of the inserm - laboratory of immunopathology and therapeutic immunointervention - in paris ; two catalytic activities will be tested: the dnase activity and the hydrolase activity. means to analyse the two activities: digestion of plasmid and affinity-linked oligonucleotide nuclease assay for dnase activity and hydrolysis of a peptide pfr-mca for hydrolase activity.

Eligibility criteria:
inclusion criteria: for patients: * presence of systemic lupus erythematosus according to the criteria of the modified 1997 ara 1982 lupus systemic evolution: rates of anti dna\> 100 u/l in elisa and sledai\> 7. quiescent systemic lupus: sledai \<7 * be aged 18 years and over * patient who has his main home in martinique * patient who gave his agreement to participate in this clinical study for control subjects: * voluntary donor who gave freely his agreement to participate in this study * be aged 18 years and over * patient who has his main home in martinique * voluntary who gave his agreement to participate in this clinical study exclusion criteria: for patients: * presence of mixed connective tissue disease, hashimoto * patients with other diseases: cancer, current infection * patient pregnant or breast-feeding * patient who refuse to participate in the study * patient not affiliated with a social security scheme (beneficiary or beneficiary) * specially protected persons (or under guardianship) * patient who has not his main home in martinique for control subjects: * voluntary donor who refused to participate in this study * voluntary who has not main home in martinique

Keywords: systemic lupus erythematosus in martinique hydrolase and dnase activities
hematotoxicity in maintenance therapy of children with acute lymphoblastic leukemia

Conditions: Mercaptopurine Adverse Reaction; Leukemia, Lymphoblastic

Summary: subjects who are recruited in this study are lla patient, who are treated for routine control to cipto mangunkusumo hospital, who meet the inclusion criteria and do not meet the exclusion criteria.

on the day of the control patient, (usually the patient is asked for routine control at week 3 on mercaptopurin) routine blood tests are performed. patients and parents were given an explanation of this study. if patients and parents are willing to take part in the study, they are asked to sign informed consent. patients who meet the inclusion criteria and do not meet the exclusion criteria, are recorded for demographic data and 5 ml of blood taking. the blood is directly divided into three, 2 ml for hematologic examination and albumin level, 1 ml for genotyping, and 2 ml for examination of drug levels. routine hematologic examination and albumin levels were performed in the cipto mangunkusumo hospital laboratory. for genotypic examination, blood samples were stored at -80c, until they were used for analysis. for examination of the drug levels the blood sample is centrifuged and the erythrocyte preparation is then stored at -80c, until it is used for analysis.

Eligibility criteria:
inclusion criteria: * acute lymphoblastic leukemia (all) patients, 1 until 18 years old, male or female, who come to cipto mangunkusumo hospital, jakarta, indonesia * received 6mp chemotherapy at least 1 month maintenance phase * received maintenance phase treatment regimen * willing to participate in research, signed informed consent and obtained parental consent to participate in research exclusion criteria: * patients are experiencing severe infections * patients receiving colony stimulating factor (csf), allopurinol, mesalazine, olsalazine, and sulfasalazine

Keywords: mercaptopurine, acute lymphoblastic leukemia, hematotoxicity
the impact of telehealthcare intervention on glycemic control in children and adolescents with type 1 diabetes

Conditions: Type 1 Diabetes Mellitus

Summary: this study evaluates the effect of telemedicine intervention program upon glycemic control in type 1 diabetes mellitus children and their parents in israel. half of the participants will receive the telemedicine intervention for a period of six months while the other half will receive the regular treatment then vice versa. each group will receive in the intervention period 6 telemedicine meeting with a dietician and six telemedicine meetings with a nurse. the investigators hypothesized that the participants that are recieving the telemedicine intervention will have a better glycemic control after 6 months.

the prevalence of type 1 diabetes has been steadily increasing for the past few decades and is a relatively common chronic disease of childhood (1). managing type 1 diabetes in young children presents unique challenges to the patient, parents, and to the pediatric health care provider. the diabetes regimen includes intensive blood glucose monitoring, multiple daily injections of insulin ,and frequent insulin dose adjustments according to the amount of carbohydrate eaten, blood sugar, and physical activity. the diabetes control and complications trail (dcct) showed a significant link between blood glucose control and a slower onset and progression of diabetes complications, with improved glycemic control decreasing the risk of micro- and macro- vascular complication (2,3,4). glycosylated hemoglobin a1c (hba1c) measures the in the past decade a significant progress took place in therapy and treatment of diabetes. however poor glycemic control is recorded in a significant proportion of adolescents. telehealthcare is the use of telecommunications to deliver healthcare services and involves the remote interaction between a primary care provider and specialist. telemedicine represents a useful and cost-effective solution to the strict follow-up required in diabetes management ,

Eligibility criteria:
inclusion criteria: diagnosed with typ1 1 diabetes for at least 6 months insulin dependent participants provided consent to participate in the study consent to use the accu-chek connect diabetes management app - exclusion criteria: new onset of diabetes type 1 not specified as type 1 diabetes -

Keywords: glycosylated hemoglobin a1c (hba1c), telemedicine
inhaled granulocyte-macrophage colony stimulating factor (gm-csf) in hereditary pulmonary alveolar proteinosis (pap)

Conditions: Hereditary Pulmonary Alveolar Proteinosis

Summary: the purpose of this study is to evaluate the therapeutic efficacy of inhaled recombinant human gm-csf in individuals with hereditary pulmonary alveolar proteinosis (pap) due to partial dysfunction of the gm-csf receptor.


Eligibility criteria:
inclusion criteria: * a diagnosis of pap caused by bi-allelic mutations in csf2ra or csf2rb associated with impaired gm-csf-r-alpha or gm-csf-r-beta function, respectively, resulting in reduced but non-zero gm-csf signaling * able and willing to give written informed consent / assent as necessary * clinically stable exclusion criteria: * confirmed diagnosis of a disorder of surfactant production caused by bi-allelic mutations in abca3, sftpb, or sftpc * confirmed diagnosis of autoimmune pap caused by a high level of gm-csf autoantibody * confirmed diagnosis of secondary pap caused by an underlying clinical disorder known to be associated with the development of pap, e.g., inhalation of silica or titanium; myelodysplasia and others * treatment with any investigational agent in the 3 months prior to enrollment * history of severe allergic or anaphylactic reactions to gm-csf or other yeast-derived products * history of asthma or other reactive airways disease * known active, viral, fungal, mycobacterial, or other infection * a serious medical condition which, in the opinion of the investigator or data and safety monitoring committee, would make the patient unsuitable for the study

Keywords: pap
the utility of ischemia modified albumin (ima) in sepsis

Conditions: Sepsis; Severe Sepsis; Systemic Inflammatory Response Syndrome; Sepsis Syndrome

Summary: the purpose of this study is to determine if levels of ischemia modified albumin (ima) in blood are elevated in patients with suspected infection and are predictive of severity of illness in patients with sepsis. in order to compare subjects with infection to those without infection who are representative of the ed population at each site, a group of non-infected control patients will be enrolled. each hospital will enroll subjects with age (by decade) and sex matched controls to reflect the population of subjects suspected of infection.

sepsis is an unconquered challenge in medicine, affecting people of all ages and demographics. severe sepsis affects approximately 751,000 patients in the united states per annum, with healthcare costs approaching $16.7 billion dollars a year. mortality from severe sepsis and septic shock approaches 30 - 70 % with 215,000 deaths annually. thus, sepsis is a disease with healthcare dollars and mortality rates approaching those of heart disease and cancer. identifying patients with sepsis, and in particular hypoperfusion, is a challenge to the clinician. a variety of clinical and laboratory findings are helpful, but there is no single test to identify sepsis or assess its severity. ischemia and reactive oxygen species play a significant role in the pathogenesis of sepsis. moreover, there is evidence to suggest that septic shock results in dysfunction of autoregulatory mechanisms and misdistribution of blood flow, precipitating both regional and global ischemia. a method that can help rapidly assess hypoperfusion would be clinically useful. ischemia modified albumin (ima) is a potential marker for ischemia in acute coronary syndrome patients; thus, it is hypothesized that ima may be also useful as a prognostic biomarker for clinical identification of infection and the severity of illness in patients with sepsis.

Eligibility criteria:
inclusion criteria for sepsis subjects: * 18 years of age or older * able to provide informed consent * clinical suspicion of infection exclusion criteria for sepsis subjects: * active chest pain of suspected cardiac origin * st elevation myocardial infarction or dynamic st changes on ekg * pregnant women * cocaine use * liver disease * unable to speak or understand the english language inclusion criteria for control subjects: * 18 years of age or older * emergency department presentation as a result of a non-infectious etiology as determined by the treating clinicians * able to provide informed consent exclusion criteria for control subjects: * suspected infection * temperature \>100.4°f * pregnant women * possible cardiac, intestinal or cerebral ischemia * liver disease * any source of inflammation as part of their presentation * cancer, any type

Keywords: sepsis ischemia modified albumin systemic inflammatory response syndrome
intranasal sufentanil pain-management at entrance of emergency department : influence on pain-relief delay

Conditions: Single Traumatic Limb Injury With Severe Pain (Score > 5/10 on Numerical Pain Scale)

Summary: non-invasive and simple, intranasal (in) route of administration seems promising for pain management in the emergency department (ed), especially when used precociously by triage nurse to rapidly deliver the first opioid dose to severely painful patients. this randomized double-blind placebo-controlled study will focus on severe traumatic pain experienced by adults admitted in our ed. we hypothesized that, in addition to traditional morphine titration, a single dose of in sufentanil given at triage would significantly increase the proportion of patients relieved 30 minutes after their ed admission. time to discharge, proportion of side effects and satisfaction rates will also be recorded.

time to pain-relief can vary widely in the emergency department (ed), depending on various factors such as ed overcrowding or inadequate training in pain management. as intravenous (iv) opioid administration is world-wide recommended for severe pain treatment, delays from triage to room admission and to first iv injection directly influence this time to pain-relief. moreover, it is proven that an incorrect adherence to morphine titration protocol can participate in ed oligoanalgesia. although ed experience in intranasal (in) opioid administration is still lacking, this simple and non-invasive way of treating pain seems safe and promising. opioid pharmacokinetic by in route indeed is interesting for ed practitioners : while assuring a timely analgesia, the lower cmax and delayed tmax by in route can theoretically limit the risk of respiratory depression, in comparison with iv route. we propose a randomized double-blind placebo-controlled study on a convenience sample of adult patients admitted in our ed (annual census of 80000 attendances) for an isolated limb injury, and experiencing a severe pain (score \> 5/10 on numerical pain scale). for primary outcome, we will compare the proportion of patients relieved (score \< 4/10) 30 minutes after admission, depending on the administration (or not) of a single intranasal dose of sufentanil (0,4 mcg/kg) given by the triage nurse. other secondary outcomes will include : evolution of pain scores in the first hour of admission and during entire ed stay, proportions of opioid-induced side-effects, proportions of patients receiving morphine and doses of morphine administrated, times for discharge, patient and staff satisfaction scores.

Eligibility criteria:
inclusion criteria: * single traumatic limb injury. * severe pain (score \> 5/10 on numerical pain scale) * age ≥ 18 years and \< 75 years exclusion criteria: * abdominal, thoracic, vertebral or cranial injury associated * hemodynamic instability (systolic blood pressure \ 110 / min) * oxygen saturation \< 96% on room air * chronic respiratory, renal or cardiac failure * impaired mental status (glasgow coma scale \< 15)
screening covid-19 by point-of-care lung ultrasound: a validation study

Conditions: COVID-19 Pneumonia; Lung Ultrasound

Summary: covid-19 is a rapidly spreading and very contagious disease caused by a novel coronavirus that can lead to respiratory insufficiency. in many patients, the chest radiograph at first presentation be normal, and early low-dose ct-scan is advocated to diagnose viral pneumonia. lung ultrasound (lus) has similar diagnostic properties as ct for diagnosing pneumonia. however, it has the advantage that it can be performed at point-of-care, minimizing the need to transfer the patient, reducing the number of health care personnel and equipment that come in contact with the patient and thus potentially decrease the risk of spreading the infection. this study has the objective to examine the accuracy of lung ultrasound in patients with proven covid-19 pneumonia.


Eligibility criteria:
inclusion criteria: 1. high probability ct thorax or chest x-ray for viral pneumonia within five days of the day of inclusion 2. positive covid-19 nasopharyngeal swab within 10 days of inclusion 3. 18 years or older 4. oxygen saturation of \< 93% in ambient air 5. signed written informed consent exclusion criteria: * contra-indication for lung ultrasound * other causes of hypoxia or of pulmonary infiltrates on ct thorax or chest x-ray

Keywords: accuracy inter-observer variability
the effect of sutures versus mesh in umbilical hernia repair

Conditions: Ventral Hernia Midline

Summary: background mesh repair reduces the risk of reoperation for recurrence in patients with small umbilical and epigastric hernias compared with sutured repair. however, reoperation for recurrence underestimates total recurrence (reoperation or clinical) and mesh reinforcement may induce chronic pain. this study investigated the cumulated risk of recurrence after open mesh and sutured repair in small (≤2 cm) umbilical and epigastric hernias. possible risk factors were evaluated for chronic pain and recurrence. methods a cohort study with questionnaire-follow-up was conducted. patients with primary, elective, open mesh or sutured repair for a small umbilical or epigastric hernia (≤2 cm) were included. follow-up was performed by a validated questionnaire regarding suspicion of recurrence and chronic pain (moderate or severe). suspected recurrence qualified for clinical examination. recurrence was defined as reoperation for recurrence or clinical recurrence. risk factors for recurrence and chronic pain were investigated by multivariate analyses. results 1 313 patients completed the questionnaire and/or clinical follow-up (83 % response rate) and follow-up time was median 40 months (range 0-66 months). the total cumulated recurrence rate 55 months after primary repair was 10 % for mesh repair and 21 % for sutured repair (p=0.001). the incidence of chronic pain was 6 % after mesh repair and 5 % after sutured repair (p = 0.711). recurrence was the only independent risk factor for chronic pain (p\<0.001). conclusion mesh repair halved the long-term risk of recurrence after repair for small umbilical and epigastric hernias without increased risk of chronic pain.


Eligibility criteria:
inclusion criteria: * elective open mesh or sutured repair of small umbilical or epigastric hernia repairs exclusion criteria: * acute operation * operation outside region of zealand * laparoscopic repair
risk factors for falls and neurocognitive disorders clsa

Conditions: Neurocognitive Disorders; Geriatrics

Summary: the study evaluates the association between the neurocognitive decline and falls.

falls in older adults are a major canadian public health concern because: 1) they have a high prevalence and incidence (e.g., up to 30% each year in canada, regardless the cognitive status of fallers), 2) they negatively impact an individual's health condition (e.g., hip fracture) and quality of life (e.g., social withdraw), and 3) they impose a high financial burden on the canadian health care system (e.g., $2 billion per year). major neurocognitive disorders are strongly associated with falls and their adverse outcomes. there is a greater risk for falls and fall-related injuries in cognitively impaired individuals, more than doubled compared to cognitively healthy individuals (chi). the nature of the interactions between neurocognitive disorders and the other risk factors for falls and fall-related injuries are still a matter of debate. for instance, the presence of specific patterns (i.e., types and combinations) of risk factors for falls and fall-related injuries associated with neurocognitive disorders at their onset (i.e., mild cognitive impairment \[mci\] and mild dementia) compared to chi is questioned. recently, the investigators howed that the identification of risk factors for falls is influenced by the method of data analysis used. the investigators demonstrated that emerging modeling techniques such as artificial neural networks (anns) improve the performance criteria of fall prediction compared to classical linear models. other methods such as factor mixture models (fmms) may also be helpful in identification of patterns of risk factors for falls and fall-related injuries associated with neurocognitive disorders. using baseline data from the canadian longitudinal study on aging (clsa), the investigator will examine the patterns (i.e., types and combinations) of risk factors for falls and fall-related injuries associated with neurocognitive disorders at their onset by 1) examining the epidemiology of falls and fall-related injuries, and 2) modeling and comparing the associations of risk for falls and fall-related injuries between cognitively healthy and impaired (i.e., mci and mild dementia) older adults participating in the clsa.

Eligibility criteria:
inclusion criteria: * age ≥ 65 and * participants of the comprehensive clsa (i.e., individuals who participated in a 90-minute in-home face-to-face interview, and a visit to one of 11 data collection sites across canada where they took part in a range of physical assessments). exclusion criteria: * a fall resulting from acute medical events and/or external force, * moderate to severe dementia (estimated from performance on cognitive tests and scores of the activity of daily living (adl) and instrumental activity daily living (iadl) scales. abnormal scores will be defined as 2 standard deviations (sds) or more below the normal score of all cognitive tests associated with scores of adl (/6) \<3 and a score of iadl (/8) \<4)
large scale icu data sharing for 1000 critically ill patients with severe acute respiratory distress syndrome coronavirus (sars.cov19) in three distinct isolation centers

Conditions: Median Nerve Entrapement

Summary: cohort study of patients with severe respiratory distress syndrome coronavirus2 in three different isolation hospitals recording data about outcome.


Eligibility criteria:
inclusion criteria: * all covid positive candidates exclusion criteria: * patient refusal

Keywords: neuropathy