Kornimate/medical-research-clean huggingface dataset:
randomized control trial, cryoablation as an adjunct to surgical stabilization of rib fractures

Conditions: Pain, Postoperative; Rib Fracture Multiple

Summary: to determine if patients with intraoperative cryoablation have better analgesia results compared to the control group of surgical stabilization of rib fractures (ssrf) without cryoablation

locoregional pain control with cryoneurolysis of intercostal nerves has been employed as an adjunct for longer term pain control. initially introduced in thoracic surgery, intercostal nerve cryoablation has demonstrated adequate pain control and substantial decrease in opioid consumption and hospital length of stay.

Eligibility criteria:
inclusion criteria: * the patient is admitted to the trauma service. * the patient has multiple displaced rib fractures (≥2 ribs), offered fixation, and consents to ssrf * the patient is not being treated for chronic pain * the patient is \>18 years of age. * surgery anticipated \<120 hours from injury exclusion criteria: * age \< 18 years or ≥ 80 years * flail chest: either radiographic or clinical. radiographic flail chest is defined on ct chest as ≥ 2 ribs each fractured in ≥ 2 places. clinical flail is defined as visualization of a segment of chest wall with paradoxical motion on physical exam. * moderate or severe traumatic brain injury (intra-cranial hemorrhage visualized on ct head with gcs at the time of consideration for enrollment \< 12) * prior or expected emergency exploratory laparotomy during this admission * prior or expected emergency thoracotomy during this admission * prior or expected emergency craniotomy during this admission * spinal cord injury * pelvic fracture that has required, or is expected to require, operative intervention during this admission * the patient was unable to accomplish activities of daily living independently prior to injury (e.g., dressing, bathing, preparing meals) * the patient is incarcerated * the patient is known to be pregnant * unable to perform video assisted thoracoscopy (vats) at time of ssrf due to lung isolation or previous pathology

Keywords: locoregional pain thoracotomy
biomechanical parameters of gait in patients with symptomatic lumbar spinal stenosis and healthy elderly.

Conditions: Lumbar Spinal Stenosis; Healthy Elderly

Summary: the aim of this study is to compare biomechanical walking parameters between patients with symptomatic lumbar spinal stenosis and healthy elderly.


Eligibility criteria:
inclusion criteria: patients with lumbar spinal stenosis * having a diagnosis of lumbar spinal stenosis (at least 1 level) * having neurologic claudication due to the lumbar spinal stenosis healthy elderly * being over 50 years old of age * no back or leg pain during walking exclusion criteria: * symptomatic hip or knee ostearthritis * not able to give their free consent * being in a wheelchair (not able to walk 30 meters)

Keywords: lumbar spinal stenosis healthy elderly walking capacity biomechanical parameters
influence of vaginal lactoferrin on amniotic fluid cytokines to avoid pregnancy complications

Conditions: Pregnancy

Summary: objective: to evaluate the influence of vaginal lactoferrin administration on amniotic fluid concentration of 47 cytokines, chemokines and growth factors.

60 women undergoing genetic amniocentesis will be enrolled at the obstetric unit, university of ferrara. the selected patients will be randomly assigned to receive 300 mg of vaginal lactoferrin to obtain 3 groups: a, 20 untreated patients; b and c (20 patients each one) respectively treated 4 and 12 h before amniocentesis. cytokines, chemokines and growth factors concentrations will be quantified by a magnetic bead luminex multiplex immunoassays panel technology. amniotic fluid samples will be obtained by transabdominal amniocentesis and the sample not required for clinical purposes will be centrifuged to remove particulate material and the supernatants will be aliquoted and stored at -80°c until assay.

Eligibility criteria:
inclusion criteria: * singleton physiological pregnancy; * maternal age as the only indication to foetal karyotyping exclusion criteria: * assumption of drugs interfering with the immune system; * previous miscarriages; * pregnancy at risk for maternal or foetal disease; * lactose intolerance.

Keywords: amniocentesis
effect of the different methods of kinesiology taping on the muscle contraction performance of fatigued biceps brachii

Conditions: Muscle Fatigue

Summary: recently, kinesiology tape is a common intervention in clinic and sport. according to the theory mentioned by the founder (dr. kenzo kase), the elasticity of kinesiology tape has different effects from different taping skill. for muscle and fascia, taping could promote or inhibit contraction of muscle. for skeletal system, the intervention could correct posture and improve movement pattern through limiting joint mobility. for swelling, it may increase circulation of lymph during acute stage. however, whether these theories are feasible are still controversial in most studies. the differences between results may be related to the high heterogeneity of taping method and outcome measures. on the other hand, there are lack of studies with high quality. the differences of taping method and skill should be considered for investigating the effect of kinesiology tape. and the performance of muscle contraction should be assessed by accurate instruments.

double-blind and crossover study design will be used in this study. the taping method is divided into 4 types: tradition (from origin to insertion), cross, new (from insertion to origin) and control (non-taping). the order of types will be assigned to subjects randomly. the 4 types of taping will be applied in 2 days that one week apart. ultimate physical rehabilitation system (pris rs, bte, usa) will be used to access the differences of muscle strength and muscular endurance between different taping skills. the aims are to investigate the effect of the different method of kinesiology tape on performance of fatigued biceps brachii.

Eligibility criteria:
inclusion criteria: * healthy adults aged 20 years or older exclusion criteria: * those who were unable to follow verbal instructions, had open wounds, or were allergic to kinesiology tape were excluded.

Keywords: kinesiology tape fatigue muscle contraction performance
breathing device for orthostatic hypotension (oh)

Conditions: Orthostatic Hypotension

Summary: the investigators will test whether breathing through an inspiratory resistance device will improve the ability to be upright and decrease blood pressure drops on standing in patients with orthostatic hypotension.

orthostatic hypotension is commonly described, especially in an elderly population. using data from a national hospital inpatient database, shibao et al. have reported that the annual hospitalization rate for orthostatic hypotension was 233 per 100000 among patients older than 75 years. orthostatic hypotension is associated with an increased risk of falls, increased risk of coronary heart disease and mortality. orthostatic hypotension is defined as a fall in systolic blood pressure of at least 20 mmhg within 3 minutes upon standing 3. patients with orthostatic hypotension commonly experience lightheadedness or syncope. in normal individuals, changes in posture do not results in significant changes in blood pressure due to physiological compensation for the gravity-mediated pooling of blood in the lower limbs with upright posture. unfortunately, in patients with impairments of the autonomic nervous system, one or more of these adaptive mechanisms fail, and an orthostatic fall in blood pressure results. in this pilot study, we will test the hypothesis that breathing through an inspiratory resistance device will improve orthostatic tolerance and reduce orthostatic hypotension in patients with neurogenic orthostatic hypotension.

Eligibility criteria:
inclusion criteria: * diagnosed with neurogenic orthostatic hypotension by the vanderbilt autonomic dysfunction center * decrease in systolic blood pressure ≥ 20 mmhg with position change from supine to standing (10 minutes) * evidence of reproducibility suggestive of non-reversible nervous system origin for the orthostatic hypotension * age between 18-80 years * male and female subjects are eligible * able and willing to provide informed consent exclusion criteria: * overt cause for orthostatic hypotension (such as acute dehydration) * inability to give, or withdrawal of, informed consent * pregnant * other factors which in the investigator's opinion would prevent the subject from completing the protocol

Keywords: orthostatic hypotension breathing blood pressure standing
tolerability and efficacy of ibuprofen 800 mg in a walking model of osteoarthritis pain (0000-057)

Conditions: Osteoarthritis, Knee

Summary: the purpose of the study is to see if generic ibuprofen has an effect on osteoarthritis knee pain during a series of timed walks on a treadmill.


Eligibility criteria:
inclusion criteria: * the primary source of pain is the study knee of one lower extremity * patient is willing to limit alcohol and caffeine intake * aside from osteoarthritis, patient is in generally good health * patient is capable of completing protocol specified walks * patient is able to understand and complete questionnaires in english * patient has previously benefited from the use of either nsaids, cox-2 inhibitors, or acetaminophen exclusion criteria: * patient has another condition which could interfere with evaluating pain in the knee being tested * patient is not able to take a non-steroidal anti-inflammatory drug (nsaid) such as ibuprofen * patient has a history or current evidence of stroke, transient ischemic attack, liver disease or cancer * patient has a history or current evidence of dizziness, unsteadiness, or falling * patient has congestive heart failure, unstable angina or uncontrolled high blood pressure * patient has a history of stomach, digestive track, or small intestine surgery * patient is unable to complete the study questionnaires in english
effect of ticagrelor vs. dipyridamole on adenosine uptake

Conditions: Coronary Artery Disease

Summary: the investigators are trying to determine if a single dose of ticagrelor will increase delivery of intraarterially-infused adenosine into the forearm interstitium, consistent with adenosine reuptake blockade.

the investigators will compare adenosine interstitial levels using a parallel design study with three groups of subjects. forearm interstitial adenosine levels will be measured at baseline and after intrabrachial infusion of adenosine at two doses. subjects will then randomly receive ticagrelor 180 mg, dipyridamole 200 mg, or placebo. two hours later the investigators will repeat the dialysate collections at baseline and after adenosine infusions.

Eligibility criteria:
inclusion criteria: 1. subjects will be healthy volunteers, without significant pulmonary, cardiovascular gastrointestinal, hematological or renal diseases 2. not taking any regular medications 3. able to provide signed consent prior to study participation. exclusion criteria: 1. history of asthma 2. pregnancy 3. exposure to an investigational drug in the last 2 months. 4. known hypersensitivity to study medications

Keywords: adenosine ticagrelor microdialysis
evaluation of egfr tki resistance mechanism using plasma dna analysis

Conditions: EGFR Mutation Positive Non-small Cell Lung Cancer

Summary: to detect resistance gene from serially collected plasma dna in non-small cell lung cancer harbouring egfr activating mutation who are being treated with egfr tkis by using castpcr method.


Eligibility criteria:
inclusion criteria: * 1. histologically confirmed nsclc 2. aged of or older than 20 years 3. ecog performance status 0-2 4. adequate hematological, renal, hepatic function 5. patients with tumors harboring egfr mutation (del 19 or l858r mutation) 6. patient who are about to be treated with egfr tki (gefitinib, erlotinib or other egfr tki) 7. at least more than one measurable disease 8. informed consent exclusion criteria: * 1. active infection 2. active bleeding
delta variation to guide hemodynamic optimization

Conditions: Hemodynamic MAP Stability

Summary: intraoperative hemodynamic optimization will be based on the percentage of variation of the parameters


Eligibility criteria:
inclusion criteria: all patients \> 18 years old scheduled for major abdominal exclusion criteria: body mass index \> 35 kg/m2 pregnancy refusal to sign written informed consent urgent and/or emergency surgery
metabolomic study in exhaled breath condensate of thoracic surgical patients

Conditions: Acute Pulmonary Insufficiency Following Thoracic Surgery; Ventilator-associated Lung Injury

Summary: acute lung injury (ali) following thoracic surgery remains a major source of morbidity and mortality after lung resection. one-lung ventilation (olv) is usually required in thoracic surgery. olv is also an important predictor of postoperative ali. recent laboratory findings suggested that tissue hypoxemia and ischemia / reperfusion injury of the collapsed lungs during olv is the major cause of lung injury. exhaled breath condensate (ebc), which is the exhalate from breath typically collected by cooling device, contains most molecules found in the airway. metabolomics refers to systematic and scientific study of chemical processes involving metabolites. this study will collect ebc for metabolomic analysis and aim to elucidate the biochemical reactions during one-lung ventilation and pathological mechanisms of acute lung injury following thoracic surgery.

acute lung injury (ali) following thoracic surgery remains a major source of morbidity and mortality after lung resection. despite the advancement in both the surgical techniques and the perioperative management, the incidence of postoperative ali remains remarkable. risk factors for postoperative lung injury are evident, including preoperative pulmonary function, type of surgical procedure, intraoperative fluid management, one-lung ventilation, and ventilator settings. one-lung ventilation (olv) is usually required in thoracic surgery. olv is also an important predictor of postoperative ali. recent laboratory findings suggested that tissue hypoxemia and ischemia / reperfusion injury of the collapsed lungs during olv is the major cause of lung injury. exhaled breath condensate (ebc), which is the exhalate from breath typically collected by cooling device, contains most molecules found in the airway. ebc analysis has potential applications in lung disease, such as severity of airway inflammation in asthmatic patients. collecting ebc is simple and non-invasive, in contrast to bronchoscopy for lung biopsy or bronchoalveolar lavage. metabolomics refers to systematic and scientific study of chemical processes involving metabolites. this study will collect ebc from thoracic surgical patients before, during, and after olv. the investigators will perform metabolomic analysis and aim to elucidate the biochemical reactions during one-lung ventilation and pathological mechanisms of acute lung injury following thoracic surgery.

Eligibility criteria:
inclusion criteria: * thoracic surgical patients requiring lung isolation * pulmonary resection: lobectomy, segmentectomy * esophageal surgery and no pulmonary resection * mediastinal surgery and no pulmonary resection exclusion criteria: * metabolic disorder * metabolic syndrome * diabetes * pregnancy
microvascular partial toe transfer

Conditions: Amputation, Traumatic; Hand Injuries

Summary: microvascular partial toe transfer for reconstruction of traumatic amputation of the digits

microsurgical toe transfer has become a gold standard option for amputated digit reconstruction. it can be used to correct almost any thumb defect. however, for optimal functional and esthetic results, proper initial care, preoperative planning, proper selection of suitable techniques, adjunct or secondary procedures and proper, postoperative rehabilitation are important. the transfer of a toe to replace an amputated thumb represents one of the first applications of microsurgical techniques, yet to this day remains an epitome of reconstructive surgery, restoring critical function and form to the hand-injured patient. while techniques have greatly evolved to permit the treatment of multiple finger amputations, dystrophic nails and pulps, and traumatized or arthritic joint, the amputated thumb retains its status among the most indubitable indications for toe transfer. microsurgical techniques have been refined to such a degree that almost any ablative deformity of the thumb could be corrected with some form of toe transfer. the question, therefore, is not if a defect could be reconstructed, but whether the patient is willing to undergo reconstruction. the concepts of "adequate function" and "optimal function" are therefore of central importance when discussing treatment options with a patient. obviously, these parameters will be different for each patient depending upon his/her vocation, avocations, and desires. for many people, adequate function might be expected with an amputation that retains some length of the proximal phalanx (assuming sufficient soft tissue coverage is present or can be provided). however, for patients who require full length of their thumb, or who desire optimal rather than adequate function, toe transfer should be considered. at present, the decision to use a particular toe transfer technique is mostly based on the surgeon's preference and training. the current data are inadequate to make any comments with regards to donor site morbidity. till such data are available, an evidence-based recommendation for the superiority of a specific type of toe-to-thumb transfer cannot be made. we hypothesis that partial toe transfer provides the best aesthetic and functional reconstruction and the least donor site morbidity amongst all other types of transfers.

Eligibility criteria:
inclusion criteria: * patient from 18-50 years old * one or more finger amputations * minimum follow-up period of 6 months exclusion criteria: * patients whose loss was due to congenital anomaly. * patients who did not have a minimum follow-up period of six months .
hematologic response of epoetin alfa (procrit) versus darbepoetin alfa (aranesp) in chemotherapy induced anemia

Conditions: Anemia; Chemotherapy

Summary: the purpose of this study is to compare hemoglobin (hgb) response rates between epoetin alfa (procrit; 40,000 units (u) sc weekly) and darbepoetin alfa (aranesp; 200 mcg every other week) in anemic cancer patients receiving chemotherapy.

chemotherapy related anemia occurs in a majority of cancer patients and can cause impaired treatment outcomes, increased treatment-related complications and altered quality of life. epoetin alfa administered on a weekly dosing schedule of 40,000 units subcutaneously (\[sc\], under the skin) with dose adjustments based on hematologic response produces significant improvement in hemoglobin levels, decreased transfusion frequency and improved quality of life. it is unknown if the recently developed agent, darbepoetin alfa, administered on an every other week fixed dose will produce similar improvements in hematologic and quality of life outcomes. thus, further randomization studies are warranted utilizing once weekly dosing (qw) of epoetin alfa compared to once every other week (q2w) darbepoetin alfa. patients will receive study medications for up to 16 weeks.safety \& efficacy evaluations will be performed at specified intervals throughout the study.the study hypothesis is that the week 5 hemoglobin response rate in the epoetin alfa group is better than that in the darbepoetin alfa group. the starting dose for study drug is either epoetin alfa (procrit) 40,000 units sc qw or darbepoetin alfa (aranesp) 200 mcg sc q2w. doses may be adjusted depending on the patient's hemoglobin levels up a maximum of 60,000 iu sc qw epoetin alfa or 300 mcg sc q2w darbepoetin alfa.

Eligibility criteria:
inclusion criteria: * histologically confirmed diagnosis of a solid tumor malignancy * baseline hemoglobin value of \<11 g/dl * scheduled to receive cyclic chemotherapy for a minimum of 12 weeks * \< 2 prior chemotherapy regimens in a metastatic setting * adequate hematologic \& renal function and platelet count \>100,000/mm3 * estimated life expectancy of \> 6 months * eastern cooperative oncology group (ecog) performance status 0 - 2 exclusion criteria: * history of stem cell or bone marrow transplant * anemia due to factors other than cancer/chemotherapy * prior treatment with epoetin alfa or darbepoetin alfa or any investigational forms of erythropoietin within the previous 3 months * significant, uncontrolled disease/dysfunction of the pulmonary, cardiovascular, endocrine, neurologic, gastrointestinal, or genitourinary systems not attributable to underlying malignancy or chemotherapy * uncontrolled hypertension or recent history (within 6 months) of uncontrolled cardiac arrhythmias, pulmonary embolism, thrombosis * new onset of seizures * history of second active malignancy * major infection requiring hospitalization and antibiotics within 14 days of randomization * transfusion of white blood cells or packed red blood cells within 28 days of randomization.

Keywords: anemia chemotherapy hemoglobin level recombinant human erythropoietin epoetin alfa darbepoetin alfa
effects of sleep restriction and stimulus control in chronic insomnia patients

Conditions: Chronic Insomnia

Summary: the study aims to validate the effect of sleep restriction and stimulus control on improving chronic insomnia patients\&#39; sleep habits and maladaptive sleep behaviors.

the purpose of sleep restriction is to reduce the patient\&#39;s time in bed, bringing it closer to their actual sleep time, thereby improving sleep efficiency and quality. stimulus control, on the other hand, aims to associate the bed with a rapid sense of falling asleep, reducing the negative association between the bed and insomnia.

Eligibility criteria:
inclusion criteria: 1. meet the diagnostic criteria for insomnia disorder as per dsm-5. 2. pittsburgh sleep quality index (psqi) total score \> 5. 3. age ≥ 18 years, at least a junior high school education level. 4. assessment of sleep-wake behavior by sleep diary. 5. assessment of "maladaptive sleep behavior" by self-designed 8-item questionnaire. 6. voluntary participation in the study and signing an informed consent form. exclusion criteria: 1. presence of severe physical or severe mental illness, and suicide risk. 2. clinical diagnosis or suspicion of sleep-breathing disorders, restless leg syndrome, and sleep-wake rhythm disorders, as well as individuals working in rotating shifts or with shift work. 3. pregnant or lactating women. 4. currently undergoing any form of psychological therapy.

Keywords: chronic insomnia sleep restriction stimulus control sleep hygiene education