Kornimate/medical-research-clean huggingface dataset:
the role of fat emboli in the trauma inflammatory response

Conditions: Femoral Fracture

Summary: this is an observational study designed to investigate the role of fat emboli in patients who are undergoing a tibial or femoral fracture procedure in the operating room. the purpose of this study is to obtain samples of bone marrow and blood during tibial or femoral fracture procedures to understand the inflammatory response.

bone marrow is routinely removed during a tibial or femoral fracture procedure; researchers will take samples for this study from bone marrow that has already been removed as part of this procedure. no additional marrow samples will be taken as part of this research study. also, researchers will collect blood (about 4 teaspoons) for testing inflammatory response and coagulation. researchers may need to insert an additional line to collect your blood.

Eligibility criteria:
inclusion criteria: * patients undergoing a tibial or femoral fracture procedure in the operating room. exclusion criteria: * n/a

Keywords: femur fat emboli bone marrow proteomic proteomics metabolomics metabolomic inflammatory cytokine chemokine anaphlylatoxin thromboelastography medical center of the rockies fat embolism syndrome injury fracture metabolite mcr teg fes
pharmacist-led cognitive behavioral intervention for diabetic patients: a randomized interventional trial to evaluate the impact on medication adherence and quality of life

Conditions: Diabete Mellitus

Summary: this interventional study will to assess the impact of pharmacist-led educational intervention along with cognitive behavioral intervention in diabetic patients. participants of this study will be provided regular counselling or cognitive behavioral intervention and educational material as part of their routine pharmacy visit. researchers will compare the two groups to see which of the two groups improve in term of medication adherence and quality of life.

the purpose of the study is to investigate whether incorporating pharmacist-led educational interventions along with cognitive behavioral therapy (cbt) can result in better outcomes for diabetic patients. effective diabetes management requires proper education and adherence to medication. missed doses or irregular medication use can lead to poor glycemic control and increased complications. the study will examine if educational interventions along with cognitive behavioral therapy (cbt) can have a favorable effect on various aspects of diabetes management coping techniques, medication beliefs, reduction in hypo and hyperglycemic frequency, hba1c and medication related problems (mrps) medication adherence and overall quality of life of diabetic patients.

Eligibility criteria:
inclusion criteria: all confirmed type ii diabetic patients who visit endocrinology opd clinic during study duration. patients having hba1c \>8%. follow up as well as new patients were included subjects willing to participate in the study with or without other severe co-morbidities were included in the study. exclusion criteria: gdm diabetic patients patients with central obesity type i dm patients patients with inadequate medical history patient having hba1c \<8% patient who are not interested in the study are excluded.

Keywords: educational intervention cognitive behavioral therapy pharmacist medication adherence quality of life
erector spinae plane (esp) block for postoperative pain management in lumbar spine surgery

Conditions: Erector Spinae Block

Summary: lumbar vertebra surgery is one of the most common surgical procedures. after lumbar veretebra surgery, patients complain of excessive pain. postoperative pain usually occurs in the early postoperative period and delays patient mobilization and thus lengthens hospital stay. the aim of this study was to investigate the effect of this field block on postoperative pain and respiratory function in patients undergoing esp with lomber vertebra surgery and with ultrasound guidance for postoperative analgesia.

lumbar vertebra surgery is one of the most common surgical procedures. after lumbar veretebra surgery, patients complain of excessive pain. postoperative pain usually occurs in the early postoperative period and delays patient mobilization and thus lengthens hospital stay. the aim of this study was to investigate the effect of this field block on postoperative pain and respiratory function in patients undergoing esp with lomber vertebra surgery and with ultrasound guidance for postoperative analgesia. asa i-iii, 68 patients between 18-75 years of age were planned to be included in the study. 34 participants were expected to be included in the control and implementation group. in our study, the esp block was planned to be applied to the patients in the block group. peroperative analgesia plan will be applied to all patients in the same way. in this protocol, intravenous paracetamol 1 gr and tramadol 1 mg / kg were determined. then, every eight hours, paracetamol and contromal infusion. at the end of the operation, the patients will be determined by the numeric rating scale (nrs) system at the 30th hour, 1st, 6th, 12th and 24th hours after the first hour of the operation. tramadol pca and paracetamol are administered every eight hours. age, sex, weight, body mass index, application of esp block, time of surgery, duration of surgery, evaluation of pain in postoperative recovery room and 24-hour follow-up will be recorded when the patient is mobilized and discharged. it is thought that the esp block will decrease postoperative pain by providing effective pain control after surgery in patients undergoing lumbar vertebra surgery. in addition, it is thought to accelerate mobilization in the postoperative period and shorten the time of discharge.

Eligibility criteria:
inclusion criteria: * 68 patients * asa i-iii, * aged 18-75 years * underwent lumbar spine surgery under elective conditions exclusion criteria: * presence of contraindications to la agents used in this study * use of chronic opioids, * psychiatric disorders. * surgical procedures that lasted \ 300 minutes * the presence of infection at the injection area.
sglt2 inhibitors as first line therapy to prevent renal decline in type 2 diabetes

Conditions: Type 2 Diabetes

Summary: the aim of the trial is to evaluate the effects of the sglt2 inhibitor, dapagliflozin, compared to metformin on annual decline in egfr when used as first line therapy in people with type 2 diabetes.

this study is a randomised, double blinded clinical trial and will be undertaken in primary care and community sites across australia and tertiary care centres in sri lanka. following a 4-week active run-in period, eligible participants will be randomised to either dapagliflozin 10mg daily, or metformin xr 2000mg daily in a 1:1 ratio.

Eligibility criteria:
inclusion criteria: * diagnosis of t2d; * aged ≥18 years; * body mass index \> 18.5 kg/m2; * drug naïve, or managed with metformin monotherapy and willing to be randomised to either dapagliflozin or metformin; * egfr ≥45 ml/min/1,73m2; and * signed informed consent. exclusion criteria: * have an immediate need for rapid intensification of glucose lowering therapy due to marked hyperglycaemia; or * there is a definite indication for, or contraindication to, either metformin or sglt2 inhibitor; or * they have clearly documented coronary artery disease (defined as a previous acute coronary syndrome, coronary stent or bypass surgery) or clearly documented heart failure (defined on the basis of a hospital admission, specialist diagnosis or an echocardiogram or other imaging modality); or * pregnant or breast-feeding.

Keywords: diabetes renal decline metformin sodium glucose co-transporter 2 inhibitor
the effects of self directed exercise on people with fibromyalgia

Conditions: Fibromyalgia

Summary: the purpose of this study is to determine the effects of self directed exercise on pain and function reported in patients with fibromyalgia both in the short term and long term. previous studies have shown that patients with fibromyalgia respond better to a single session of self directed exercise compared to prescriptive exercise. to the investigator's knowledge, no studies have examined the impact on pain and function after multiple sessions of self directed exercise in this patient population. this study hoes to be a case series exploring the effects of self directed exercise on participants with fibromyalgia. participants will be encouraged to exercise 8-12 times in a 4 week time frame at a self selected pace and intensity on a stationary bicycle. outcome measures such as the fibromyalgia impact questionnaire, sf-36 and numeric pain rating scale will be used prior to study participation as well as 4 and 8 weeks following the start of participation.


Eligibility criteria:
inclusion criteria: * over the age of 18 * a medical diagnosis of fibromyalgia * sedentary level of activity prior to entry. sedentary level of activity is defined as: no participation in regular physical activity more strenuous than slow paced walking for a maximum of 2 times per week for the 4 months prior to study entry. * signed release from their physician stating that they are able to participate in the study. exclusion criteria: * presence of an acute or chronic medical condition such as cancer * infection, cardiovascular or respiratory disease (that would limit their exercise participation), metabolic or musculoskeletal or neurologic condition (systemic lupus or rheumatoid arthritis, or other pain disorders) * already participating or plan on participating in a regular aerobic exercise program 6 months prior to the study * ongoing or planned physical therapy treatment * drug dependency
transabdominal ultrasound with br55 for characterization of pancreatic lesions

Conditions: Pancreatic Ductal Adenocarcinoma

Summary: this is an exploratory, single center, open label, parallel-dose, and prospective study of br55 contrast-enhanced ultrasonography (ceus) for characterization of solid pancreatic lesions in subjects with suspected pancreatic ductal adenocarcinoma (pdac) using transabdominal us.

approximately twenty-four (24) subjects with suspected pdac and scheduled to undergo surgical resection within 30 days (but not before 24 hours) after the transabdominal br55 ceus examination will be enrolled into 3 dose groups, 0.03, 0.05, and 0.08 ml/kg, with a maximum of 8 patients in each dose group.

Eligibility criteria:
inclusion criteria: enroll a subject in this study if the subject meets the following inclusion criteria: * is at least 18 years of age; * has at least one solid pancreatic lesion; * is scheduled to undergo surgical resection for suspected pdac not earlier than 24 hours and not later than 30 days following br55 administration; * provides written informed consent and is willing to comply with protocol requirements. exclusion criteria: exclude a subject from this study if the subject does not fulfill the inclusion criteria, or if any of the following conditions are observed: * is a pregnant or lactating female. exclude the possibility of pregnancy: * by testing on site at the institution (serum βhcg) within 24 hours prior to the start of investigational product (ip) administration, * by surgical history (e.g., tubal ligation or hysterectomy), * by post-menopausal status with a minimum 1 year without menses; * has undergone prior systemic therapy for pancreatic cancer; * has history of any concurrent malignancy; * has history of any clinically unstable cardiac condition including class iii/iv congestive heart failure; * has had any severe cardiac rhythm disorders within 7 days prior to enrolment; * has severe pulmonary hypertension (pulmonary artery pressure \> 90mmhg) or uncontrolled systemic hypertension and/or respiratory distress syndrome; * has open and/or non-healing wounds in the chest, abdomen and pelvis; * has other systemic vascular abnormalities associated with neovascularization, such as macular degeneration, that in the opinion of the investigator could significantly affect the ability to evaluate the effects of br55; * is participating in a clinical trial or has participated in another trial with an investigational compound within the past 30 days prior to enrolment; * has previously been enrolled in and completed this study; * has any known allergy to one or more of the ingredients of the ip or to any other contrast media; * is determined by the investigator that the subject is clinically unsuitable for the study; * has had major surgery, including laparoscopic surgery within 3 months prior to enrolment; * has history of pancreatic surgery (e.g., cyst removal); * has acute pancreatic abnormalities (acute pancreatitis or trauma).
operative management of scapular fractures

Conditions: Scapular Fracture

Summary: assessment of functional outcome of operative management of scapular fractures through arabic version dash score

scapular fractures are rare, accounting less than1% all fractures. 3-5%all fractures of shoulder girdle, however very serious because 80-90% due to high energy trauma such as motor car accidents or fall from height. it can be associated with life-threatening injuries such as thoraco-scapular dissociation and vascular injury as subclavian and axillary vessels and brachial plexus injuries.so morbidity and mortality reports are relatively high.it can be diagnosed by x ray and computed tomography scan (ct scan) that play important role to discover scapular fractures and associated injuries ,and to guide clinical decision such as approaches and other surgical interventions.most of scapular fractures are managed conservatively by immbolization in sling .literature stated that conservative management of scapular body fractures and scapular neck fractures displaced less than 10 mm have satisfactory outcome and operative management suitable for displaced glenoid fossa fractures and scapular neck fractures more than 10 mm and associated with better functional outcome.others stated that conservative management with highly displaced scapular body and neck fractures are associated with satisfactory long -term functional outcome with minor loss of motion and strength. so standard treatment of scapular fracture is still controversial and there is no clear guidelines about management of scapular fractures. in investigators hypothesis, operative management of scapular fractures is better choice due to better functional outcome, early rehabilitation ,high union rate and less complications. investigators will try to answer this question ''what is the effect of operative management of scapular fractures on functional outcome?''

Eligibility criteria:
inclusion criteria: * 1.all patient presented with scapular fractures more than 18 years old involving body, neck and glenoid 2.intraarticular glenoid fractures with step-off \>4 mm 3.\>20% of the joint is involved and fragment large enough to be hold by lag screw. exclusion criteria: 1- low demanded patients:age \>65 yrs . 2.scapular fractures of acromion and coracoid process and osteoporotic fractures . 3.scapular fractures associated with brain injuries cervical spine injuries and brachial plexus injuries.
comparative evaluation of gingival health and bacterial adhesion in bioflx vs. zirconia crowns on primary molars

Conditions: Carious Primary Molars

Summary: the goal of this clinical trial is to evaluate the evaluation of gingival health and bacterial adhesion of bioflx crowns compared to zirconia crowns on primary molars of bioflx crowns compared to zirconia crowns in the restoration of primary molars. the main question\[s\] it aims to answer is there are the differences in bacterial adhesion and gingival health between bioflx and zirconia crowns the study will also assess the clinical performance of both types of crowns in terms of bacterial adhesion , child and parents satisfaction,as well as preparation time.

dental caries is an oral disease most ubiquitous among children, characterized by a series of demineralization and remineralization cycles. if left untreated, it can progress to cavitated lesions. usually, the familiar method of managing multi-surface carious lesions in primary teeth with stainless steel crowns .streptococcus mutans is considered to be the main colonizer and primary etiological factor in caries progression as it stimulates the production of glucans from the food substrates. research has indicated that s. mutans can be isolated from plaque samples. consequently the long-term success of a restored tooth is significantly affected by the adhesion of s. mutans to the preformed crowns.bacterial adhesion on zirconia are sparse. an in vitro study reported the initial bacterial adhesion on the surface of zirconia to be less compared with resins. when a primary tooth is restored with a full-coverage restoration, it establishes a fresh environment conducive to microbial adhesion. bioflx crowns the first flexible, durable, and esthetic preformedcrown for primary molars .bfcs are monochromatic, metal-free, tooth-colored crowns used in the medical device industry having high strength, flexibility, and durability. these crowns are autoclavable and are similar to ssc in tooth preparation. additionally, they offer a cost benefit compared to zircon crowns,

Eligibility criteria:
inclusion criteria: 1. patients aged 4-8 years. 2. decayed in primary molars require full-coverage crowns. 3. no history of systemic diseases affecting oral health. 4. cooperative children. exclusion criteria: -patients with severe medical conditions, badly decayed in primary molars and trauma.
establishing a tumor registry of patients with mesonephric-like adenocarcinoma (mla)

Conditions: Mesonephric-like Adenocarcinoma

Summary: to develop a database of medical information about patients with mla in an effort to increase our understanding of the characteristics of mla, which is the rarest form of endometrial carcinoma.

primary objectives 1. to collect, both prospectively and retrospectively, data on participants characteristics, disease characterization, pathology and molecular data, treatment, and outcomes for participants with gynecologic mesonephric-like adenocarcinoma (mla). secondary objectives 1. to organize clinical information to support multifaceted queries of participant characteristics, treatment, and disease outcome data and to facilitate correlation of these characteristics with participant outcome. 2. to have a single data repository kept on a secure platform that will integrate clinical information and research findings and serve as an archive for future research.

Eligibility criteria:
inclusion criteria: 1. adult patients with a diagnosis of gynecologic mesonephric-like adenocarcinoma (mla). 2. patients can also be diagnosed with mesonephric adenocarcinoma (ma) or patients with mesonephric and mesonephric-like carcinosarcomas. 3. patients who are receiving or have received treatment at any facility, including but not limited to md anderson cancer center are eligible. 4. patients may be residents of any country and be of any ethnic background. 5. patients who request to participate in the registry, regardless of the method by which they learned of it, are eligible to participate. 6. patients who do not speak english can be eligible if accompanied by an institutional interpreter. exclusion criteria: 1. patients with other subtypes of eacs.
sepsis at södersjukhuset-adherence to treatment guidelines

Conditions: Sepsis

Summary: a retrospective single-center study with patients with suspected sepsis admitted to the emergency department at södersjukhuset during a period of two years. the aim is to describe the association between adherence to treatment guidelines, gender, incidence and mortality for patients with sepsis.

in this single-center study, patients with suspected sepsis admitted to the emergency department at södersjukhuset during a period of two years will be included. about 11,000 patients will be included. patient data including described sepsis symptoms will be drawn from the electronic medical record, takecare and clinisoft. logistic regression analysis will adjust for age, gender, comorbidity according to charlson score, vital signs, with preliminary focus of infection (pneumonia, urinary tract infection, abdominal, other, unknown). the surviving sepsis guidelines for the time period are: 3-hour bundle including lactate measurement, obtaining blood culture, fluid treatment if hypotensive and administration of broad-spectrum antibiotics. the 6-hour bundles with administration of vasopressors if needed, remeasure lactate if elevated, with persistent hypotension re-asses volume status and tissue perfusion. time zero is defined as the admission time to the emergency department. the aim is to describe the association between adherence to treatment guidelines, gender, incidence and mortality for patients with sepsis.

Eligibility criteria:
inclusion criteria: • patients admitted to the emergency department at södersjukhuset with suspicion of sepsis defined as blood cultures taken and intravenous antibiotics of type beta-lactam or aminoglycoside prescribed within 48 hours of admission. exclusion criteria: • patients transferred from other hospitals or treatment clinics.

Keywords: treatment
trial of micafungin (fk463) in combination with liposomal amphotericin b (ambisome) for aspergillosis

Conditions: Aspergillosis

Summary: the purpose of this study is to evaluate the safety and effectiveness of micafungin in combination with ambisome as first-line therapy in the treatment of invasive aspergillosis.


Eligibility criteria:
inclusion criteria * have proven or probable systemic infection with aspergillus species and have received no more than 96 hours of prior therapeutic doses of systemic antifungal therapy exclusion criteria * has abnormal liver test parameters, e.g., ast or alt \> 10 times upper limit of normal * has allergic bronchopulmonary aspergillosis, aspergillomas, or with sinus aspergillosis or external otitis who do not have evidence of tissue invasion * has life expectancy of less than five days

Keywords: aspergillus aspergillosis anti-fungal ambisome micafungin